Foster G D, Wadden T A, Phelan S, Sarwer D B, Sanderson R S
Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA.
Arch Intern Med. 2001 Sep 24;161(17):2133-9. doi: 10.1001/archinte.161.17.2133.
Despite considerable professional consensus that modest weight losses of 5% to 10% are successful for reducing the comorbid conditions associated with obesity, obese patients often desire weight losses 2 to 3 times greater than this. Examining ways to reduce the disparities between treatment expectations and subsequent outcomes, this study evaluated the role of physical characteristics, treatment setting, and mood in patients' evaluations of treatment outcomes.
This study was conducted in a university outpatient weight loss clinic with a sample of 397 obese individuals seeking weight loss by a variety of modalities. Before treatment, participants' heights and weights were measured, and the Beck Depression Inventory and the Goals and Relative Weight Questionnaire were administered.
Outcome evaluations ranged from 64.4 +/- 11.1 kg (mean +/- SD) for dream weight to 90.1 +/- 19.1 kg for disappointed weight. Initial body weight was the strongest predictor of disappointed, acceptable, and happy weights (beta =.90,.76, and.57, respectively). Sex (beta = -.37) and height (beta =.37) were the strongest determinants of dream weight. Heavier participants chose higher absolute weights, but the weight loss required to reach each of the outcomes was greater for heavier than for lighter patients.
These data signal a therapeutic dilemma in which the amount of weight loss produced by the best behavioral and/or pharmacologic treatments is viewed as even less than disappointing. Patients with the highest pretreatment weights are likely to have the most unrealistic expectations for success.
尽管专业人士普遍认为，适度减重5%至10%对于减轻与肥胖相关的合并症是成功的，但肥胖患者通常期望的体重减轻幅度是这一数值的2至3倍。为了研究如何缩小治疗期望与后续结果之间的差距，本研究评估了身体特征、治疗环境和情绪在患者对治疗结果评估中的作用。
本研究在一家大学门诊减肥诊所进行，样本为397名寻求通过多种方式减肥的肥胖个体。治疗前，测量参与者的身高和体重，并进行贝克抑郁量表以及目标与相对体重问卷的测试。
结果评估范围从梦想体重的64.4±11.1千克（均值±标准差）到失望体重的90.1±19.1千克。初始体重是失望、可接受和满意体重的最强预测因素（β分别为0.90、0.76和0.57）。性别（β = -0.37）和身高（β = 0.37）是梦想体重的最强决定因素。体重较重的参与者选择的绝对体重更高，但与体重较轻的患者相比，体重较重的患者达到每种结果所需的体重减轻幅度更大。
这些数据表明存在一种治疗困境，即最佳行为和/或药物治疗所产生的体重减轻量甚至被视为令人失望。治疗前体重最高的患者可能对成功抱有最不切实际的期望。
