Westenhoefer J
Department of Nutrition and Home Economics, Fachhochschule Hamburg-University of Applied Sciences, Lohbruegger Kirchstrasse 65, 21033 Hamburg, Germany.
Int J Obes Relat Metab Disord. 2001 May;25 Suppl 1:S85-8. doi: 10.1038/sj.ijo.0801706.
Long-term results of dietary and behavioral treatment of obesity fail to match the obese patients' expectations, as well as the professionals' requirements. The therapeutic challenge remains to induce behavioral changes during treatment which are maintained over a long period of time, thus enabling long-term weight maintenance. The paper develops a framework to improve lasting behavioral changes.
Four elements may enhance long-term success. First, patients' unrealistic expectations about the weight loss have to be modified and patients have to be supported in accepting moderate and modest weight losses as success. Second, behavioral change can only be achieved if treatment involves a long-lasting training process, which for most patients needs to continue more than a year. Third, behavioral and attitudinal change should be governed by the principle of flexible control of eating behavior, and rigid control should be discouraged. Forth, long-term success appears to be more likely, the more behavioral dimensions are involved in the process of behavioral change.
肥胖症饮食及行为治疗的长期效果未能达到肥胖患者的期望，也不符合专业人士的要求。治疗面临的挑战仍然是在治疗期间引发能够长期维持的行为改变，从而实现长期体重维持。本文提出了一个改善持久行为改变的框架。
有四个要素可提高长期成功率。首先，必须改变患者对体重减轻的不切实际期望，并支持患者将适度的体重减轻视为成功。其次，只有治疗包含长期训练过程，行为改变才能实现，而对大多数患者来说，这个过程需要持续一年以上。第三，行为和态度的改变应以灵活控制饮食行为的原则为指导，不鼓励严格控制。第四，行为改变过程涉及的行为维度越多，长期成功的可能性似乎就越大。
