Smith D E, Wing R R
Department of Psychiatry, University of Pittsburg School of Medicine.
Health Psychol. 1991;10(6):378-83. doi: 10.1037//0278-6133.10.6.378.
Compared weight losses during first and second bouts of a very low calorie diet (VLCD) and examined whether decreased compliance might in part explain the decrease in weight loss during the second bout. Forty-five Type II diabetic patients participated in a year-long behavioral weight-reduction program that incorporated a VLCD (400 to 500 kcal/day) during Weeks 1 to 12 and 28 to 40. Weight losses decreased dramatically from the first to the second VLCD (15.54 vs. 1.42 kg, p less than .0001). There was also markedly diminished adherence as assessed by weeks ketonuric, attendance, and completeness of self-monitoring records. The percentage of weeks subjects were in ketosis dropped from 61% during VLCD 1 to 13% during VLCD 2 (p less than .0001). Similarly, subjects attended significantly fewer treatment meetings during VLCD 2 and self-monitored less during VLCD 2 than during VLCD 1. Weeks ketonuric and initial weight accounted for 63% of the variance in weight loss during VLCD 1 (p less than .0001); weeks ketonuric and attendance predicted weight loss during VLCD 2 (p less than .0001), accounting for 54% of the variance. These results suggest the importance of behavioral factors in explaining poorer performance on a repeated diet.
比较了极低热量饮食（VLCD）第一阶段和第二阶段的体重减轻情况，并研究了依从性下降是否可能部分解释了第二阶段体重减轻的减少。45名II型糖尿病患者参加了一项为期一年的行为减肥计划，该计划在第1至12周和第28至40周纳入了VLCD（400至500千卡/天）。从第一次VLCD到第二次VLCD，体重减轻显著下降（15.54对1.42千克，p小于0.0001）。通过尿酮周数、出勤率和自我监测记录的完整性评估，依从性也明显降低。受试者处于酮症状态的周数百分比从VLCD 1期间的61%降至VLCD 2期间的13%（p小于0.0001）。同样，与VLCD 1期间相比，受试者在VLCD 2期间参加的治疗会议显著减少，自我监测也减少。尿酮周数和初始体重占VLCD 1期间体重减轻方差的63%（p小于0.0001）；尿酮周数和出勤率可预测VLCD 2期间的体重减轻（p小于0.0001），占方差的54%。这些结果表明行为因素在解释重复节食效果较差方面的重要性。
