Wyshak Grace
Department of Psychiatry, Harvard Medical School; and the Department of Population and Department of International Health and Biostatistics, Harvard School of Public Health, Boston, Mass, USA.
Prim Care Companion J Clin Psychiatry. 2007;9(1):48-54. doi: 10.4088/pcc.v09n0108.
Overweight, weight cycling, and obesity are major health risks with psychological effects that should not be overlooked by mental health professionals.
This article examines behavioral and other factors associated with weight, weight changes, and obesity in 3940 college-educated women, using data from responses to self-administered mailed questionnaires received from fall 1996 to winter 1997.
The mean age of the women was 53.6 years, SD = 12.2. Body mass indexes, prevalence of obesity, and behavioral practices were more favorable than those of women in the general U.S. population. The mean body mass index of the sample was 23.3; median, 22.5; 6.5% were obese, 5% currently smoked, and 68% exercised regularly. Over the past 10 years, 31% maintained the same weight, 11% lost weight, 48% gained weight, and 10% gained and lost weight. Women who both gained and lost weight were more likely to report physician-diagnosed depression, alcoholism, and/or drug dependencies compared to women in the other 3 categories; the multivariable odds ratios are 1.48 (95% CI = 1.07, 2.05) versus those who maintained their weight, 1.38 (95% CI = 1.06, 1.80) versus those who gained weight, and 1.53 (95% CI = 1.06, 2.21) versus those who lost weight. Those who both lost and gained weight were also more likely to report having to forgo mental health care for financial reasons; the respective multivariable odds ratios versus those who maintained their weight, gained weight, and lost weight are 2.01 (95% CI = 1.28, 3.16), 2.21 (95% CI = 1.52, 3.22), and 2.19 (95% CI = 1.23, 3.89).
These findings affirm the view that mental health care deserves attention in the treatment of patients with problems with weight changes and weight control.
超重、体重循环波动和肥胖是主要的健康风险,其带来的心理影响不容忽视,心理健康专业人员对此应予以重视。
本文利用1996年秋季至1997年冬季收到的自我填写邮寄问卷的回复数据,研究了3940名受过大学教育的女性中与体重、体重变化和肥胖相关的行为及其他因素。
这些女性的平均年龄为53.6岁,标准差为12.2。她们的体重指数、肥胖患病率和行为习惯均优于美国普通女性群体。样本的平均体重指数为23.3;中位数为22.5;6.5%的女性肥胖,5%的女性目前吸烟,68%的女性定期锻炼。在过去10年中,31%的女性体重保持不变,11%的女性体重减轻,48%的女性体重增加,10%的女性体重有增减变化。与其他三类女性相比,体重有增减变化的女性更有可能报告有医生诊断的抑郁症、酗酒和/或药物依赖;多变量比值比分别为1.48(95%置信区间=1.07,2.05),与体重保持不变的女性相比;1.38(95%置信区间=1.06,1.80),与体重增加的女性相比;1.53(95%置信区间=1.06,2.21),与体重减轻的女性相比。体重有增减变化的女性也更有可能报告因经济原因而放弃心理健康护理;与体重保持不变、体重增加和体重减轻的女性相比,各自的多变量比值比分别为2.01(95%置信区间=1.28,3.16)、2.21(95%置信区间=1.52,3.22)和2.19(95%置信区间=1.23,3.89)。
这些研究结果证实了这样一种观点,即在治疗体重变化和体重控制有问题的患者时,心理健康护理值得关注。