SELF EFFICACY, METABOLISM AND WEIGHT LOSS IN OLDER WOMEN

近27%的美国女性患有肥胖症。其患病率的增加 随着年龄和更年期的增加，患糖尿病的风险增加， 高脂血症、高血压、心血管疾病等 每年给国家造成超过400亿美元损失的疾病。肥胖是 既是一种行为疾病，也是一种代谢性疾病，因此体重减轻(WL) 干预必须对心理、行为和生理都产生影响 流程。这项肥胖症研究是基于这样一个前提： 绝经后妇女的功效信念与脂肪组织代谢 链接到西线及其维护。假设是：L)多- 针对不同自我效能感需求的多方面干预将 有效地改变认知、情绪和行为以减少进食 摄取，增加每日总能量消耗，促进WL和 在血脂、血糖、脂肪组织代谢方面的适应较平时有所照顾； 2)心理行为和代谢适应WL和ITS 自我效能感指导的WL和复发预防治疗将是 保持减肥状态所必需的。90例肥胖(BMI 27-40 Kg/m2)，健康，不吸烟，50-60岁绝经后妇女不穿 药物(特别是雌激素)已知会影响肥胖、新陈代谢或 将对其行为进行研究。确定自我效能感的影响 有针对性的干预，将根据种族和自我效能感对女性进行分层 类型(信仰者和不信仰者)，并随机接受有针对性的治疗 (心理行为、饮食和低强度运动)或常规护理。至 确定WL及其维持是否需要心理行为 和新陈代谢适应，女性接受自我效能感指导的WL和 复发预防治疗(每次为期六个月)或常规护理 同样的持续时间。研究设计许可：L)横断面分析 心理行为状态、能量平衡和代谢功能；2) 自我行为和代谢影响的纵向测定 针对WL的疗效和预防复发的治疗；以及3) 确定所需的心理行为和代谢适应 WL及其维护。这项临床研究的重点是健康 宣传、疾病预防和个性化护理使护士 特别适合在跨学科团队中进行协作， 提供关注个人信念和内在因素的WL干预 肥胖绝经后妇女的需求。

Obesity occurs in nearly 27% of American women. Its increase in prevalence with age and menopause is associated with an increased risk of diabetes, hyperlipidemia, hypertension, cardiovascular disease (CVD) and other illnesses that cost the nation more than $40 billion annually. Obesity is both a behavioral and a metabolic disease, hence weight loss (WL) interventions must impact on both psychobehavioral and biological processes. This obesity research is based on the premise that the self efficacy beliefs and adipose tissue metabolism of postmenopausal women are linked to WL and its maintenance. The hypotheses are that: l) multi- faceted interventions that target distinct self efficacy needs will more effectively modify cognitions, emotions, and behavior to diminish food intake, increase total daily energy expenditure, and promote WL and adaptations in lipid, glucose, adipose tissue metabolism than usual care; and 2) psychobehavioral as well as metabolic adaptations to WL and its self efficacy directed WL and relapse prevention treatments will be necessary to maintain the weight-reduced state. Ninety obese (BMI 27-40 kg/m2), healthy, non-smoking, 50-60 year old postmenopausal women not on medications (esp. estrogen) known to affect obesity, metabolism or behavior will be studied. To determine the effects of self efficacy targeted interventions, women will be stratified by race and self efficacy type (Assureds and Disbelievers) and randomized to targeted treatments (psychobehavior, diet and low intensity exercise) or usual care. To determine whether WL and its maintenance requires both psychobehavioral and metabolic adaptations, women receive self efficacy directed WL and relapse prevention treatments (each lasting six months) or usual care of the same duration. The study design permits: l) cross-sectional analysis of psychobehavioral status, energy balance and metabolic function; 2) longitudinal determination of the behavioral and metabolic effects of self efficacy targeted WL and relapse prevention treatments; and 3) identification of psychobehavioral and metabolic adaptations required for WL and its maintenance. The emphasis of this clinical research on health promotion, disease prevention and individualized patient care makes nurses particularly well-suited to collaborate on interdisciplinary teams that deliver WL interventions focused on the personal beliefs and intrinsic needs of obese postmenopausal women.