Hays Nicholas P, Roberts Susan B
D.W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, USA.
Obesity (Silver Spring). 2008 Jan;16(1):52-8. doi: 10.1038/oby.2007.12.
The causes of adult weight gain leading to obesity are uncertain. We examined the association of adult weight gain and obesity with subscales of eating behavior characteristics in older women.
Current height and weight, eating behavior subscales (disinhibition subscales-habitual, situational, and emotional; restraint subscales-flexible and rigid; hunger subscales-internal and external) as assessed using the Eating Inventory (EI), and self-reported body weight at six prior age intervals were reported by 535 women aged 55-65 years. Multiple regression analysis was used to examine the relationships between EI subscale scores and weight change from the age interval of 30-39 to 55-60 years and current BMI.
The strongest correlate of weight gain over 20 years was susceptibility to overeating in response to everyday cues within the environment (habitual disinhibition; partial correlation coefficient (r) = 0.25, P < 0.001); susceptibility to overeating in response to emotional states such as depression (emotional disinhibition) was a quantitatively weaker but significant correlate (partial r = 0.17, P < 0.001), and susceptibility to overeating in response to specific situations such as social occasions (situational disinhibition) was not associated with weight gain. Flexible control of dietary restraint attenuated the influence of habitual disinhibition in particular on weight gain and BMI, and was less effective in attenuating associations of emotional or situational disinhibition.
Lifestyle modification programs for prevention and treatment of adult-onset obesity currently focus on reducing situational and emotional overeating; the results of this study suggest that a stronger emphasis on strategies that target habitual overeating may be warranted.
导致成年人体重增加进而肥胖的原因尚不确定。我们研究了成年女性体重增加及肥胖与饮食行为特征分量表之间的关联。
535名年龄在55 - 65岁的女性报告了她们当前的身高和体重、使用饮食量表(EI)评估的饮食行为分量表(去抑制分量表——习惯性、情境性和情绪性;克制分量表——灵活性和刚性;饥饿分量表——内在和外在),以及之前六个年龄阶段自我报告的体重。采用多元回归分析来研究EI分量表得分与30 - 39岁至55 - 60岁年龄段的体重变化及当前体重指数(BMI)之间的关系。
20年体重增加的最强相关因素是对环境中日常线索做出反应的暴饮暴食易感性(习惯性去抑制;偏相关系数(r) = 0.25,P < 0.001);对抑郁等情绪状态做出反应的暴饮暴食易感性(情绪性去抑制)在数量上较弱但具有显著相关性(偏r = 0.17,P < 0.001),而对社交场合等特定情境做出反应的暴饮暴食易感性(情境性去抑制)与体重增加无关。灵活控制饮食克制尤其减弱了习惯性去抑制对体重增加和BMI的影响,在减弱情绪性或情境性去抑制的关联方面效果较差。
目前用于预防和治疗成年期肥胖的生活方式改变项目侧重于减少情境性和情绪性暴饮暴食;本研究结果表明,可能有必要更加强调针对习惯性暴饮暴食的策略。