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一项为期12个月的随机对照试验,比较生活方式组、个体咨询和书面信息对体重管理及健康结果的影响。

A randomised control trial comparing lifestyle groups, individual counselling and written information in the management of weight and health outcomes over 12 months.

作者信息

Ash S, Reeves M, Bauer J, Dover T, Vivanti A, Leong C, O'Moore Sullivan T, Capra S

机构信息

Princess Alexandra Hospital and Health Service District, Woolloongabba, Brisbane, Australia.

出版信息

Int J Obes (Lond). 2006 Oct;30(10):1557-64. doi: 10.1038/sj.ijo.0803263. Epub 2006 Mar 14.

Abstract

OBJECTIVE

To investigate the effect of an 8-week group-based cognitive behaviour therapy lifestyle intervention with monthly follow-up to 6 months and further follow up at 12 months on change in weight and other weight-related variables, change in physical activity and change in health and well being compared to individualised dietetic treatment or giving an information booklet only (BO).

DESIGN

A randomised controlled trial of two intervention groups, a group-based cognitive behaviour therapy lifestyle intervention, Fat Booters Incorporated--(FBI) and individualised dietetic treatment (IDT) and control group receiving an information booklet only (BO). The intervention groups involved weekly contact for 8 weeks with monthly follow-up to 6 months and further follow-up at 12 months, conducted in real practice setting.

SUBJECTS

A total of 176 adults with body mass index (BMI)>27 kg/m2, mean (+/-s.d.) age 48+/-13 years, mean BMI 34+/-5.5 kg/m2.

MAIN OUTCOME MEASURES

Weight, percent body fat, waist circumference, physical activity, health status, self-efficacy and satisfaction with life were measured at baseline, 3, 6 and 12 months.

RESULTS

A statistically significant difference between groups was observed for weight change over time (P=0.05). The change in weight (mean+/-s.e.) for the FBI group was significantly greater than the BO group at 3 and 12 months (-2.8+/-0.7 compared to -1.0+/-0.6 kg, P<0.05 and -2.9+/-0.9 compared to +0.5+/-0.9 kg, P<0.005, respectively). Change in weight in the IDT group did not differ from the FBI group at any time point. For all groups, waist circumference was significantly less than baseline at all time points (P<0.001). Significant differences in self-efficacy were observed over time (P=0.02), with both intervention groups having greater self-efficacy than the BO group. Significant drop-outs occurred over time for all three groups.

CONCLUSIONS

A cognitive behaviour-based lifestyle intervention was more effective than providing an information booklet alone and as effective as intensive individualised dietetic intervention in weight loss and improvements in self-efficacy.

摘要

目的

研究为期8周的基于团体认知行为疗法的生活方式干预(每月随访至6个月,并在12个月时进一步随访)对体重及其他与体重相关变量的变化、身体活动的变化以及健康和幸福感的影响,并与个体化饮食治疗或仅提供信息手册(BO)进行比较。

设计

一项随机对照试验,分为两个干预组,即基于团体认知行为疗法的生活方式干预组(Fat Booters Incorporated--(FBI))和个体化饮食治疗组(IDT),以及仅接受信息手册的对照组(BO)。干预组在实际环境中进行为期8周的每周一次接触,每月随访至6个月,并在12个月时进一步随访。

受试者

共有176名体重指数(BMI)>27 kg/m²的成年人,平均(±标准差)年龄48±13岁,平均BMI为34±5.5 kg/m²。

主要观察指标

在基线、3个月、6个月和12个月时测量体重、体脂百分比、腰围、身体活动、健康状况、自我效能感和生活满意度。

结果

观察到不同组间体重随时间的变化存在统计学显著差异(P=0.05)。FBI组在3个月和12个月时的体重变化(均值±标准误)显著大于BO组(分别为-2.8±0.7 kg与-1.0±0.6 kg,P<0.05;-2.9±0.9 kg与+0.5±0.9 kg,P<0.005)。IDT组在任何时间点的体重变化与FBI组均无差异。对于所有组,在所有时间点腰围均显著小于基线值(P<0.001)。随时间观察到自我效能感存在显著差异(P=0.02),两个干预组的自我效能感均高于BO组。所有三组随时间均出现显著的退出情况。

结论

基于认知行为的生活方式干预在减肥和提高自我效能感方面比单纯提供信息手册更有效,且与强化个体化饮食干预效果相当。

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