Service of Therapeutic Education for Chronic Diseases, WHO Collaborating Centre, Department of Community Medicine, University Hospitals of Geneva, Geneva, Switzerland.
Patient Educ Couns. 2010 Jun;79(3):333-7. doi: 10.1016/j.pec.2009.11.001. Epub 2009 Dec 3.
The aim of the present study was to evaluate the body weight evolution in obese patients admitted for a 2-week residential program and followed-up on ambulatory basis, as well as to evaluate factors having impact on weight evolution after 5 years.
Thirty-nine obese patients participated in a 2-week structured interdisciplinary weight loss program, involving individual and group therapies, and including physical activity, nutritional education and standard cognitive-behavioral techniques. Patients were then followed-up regularly by their general practitioners for 5 years.
After 5 years, 33 subjects completed the study. Seventy percent of the patients lost weight or maintained their weight loss. Total score for dietary structure, eating behavior disorders, dietary surveillance and weight management strategies, as evaluated by a validated questionnaire, was significantly lower in the weight loss group (22.4+/-4.3) as compared to maintenance group (24.4+/-6.1, p<0.05) and regain group (29.7+/-4.0, p<0.01). Patients who lost weight presented a more important follow-up on long-term weight management (p<0.05), a better dietary results (p<0.01) as well as more physical activity (p<0.05) that the regain group.
The present study demonstrated that an initial multidimensional and multidisciplinary in-hospital program with a consecutive long-term ambulatory follow-up may lead to a significant weight loss (55%) and/or weight maintenance (15%).
A multidisciplinary and well-designed initial treatment and long-term follow-up program is mandatory for obesity management.
本研究旨在评估接受为期 2 周住院减肥计划治疗并接受门诊随访的肥胖患者的体重变化情况，并评估对 5 年后体重变化有影响的因素。
39 名肥胖患者参加了为期 2 周的结构化跨学科减肥计划，包括个体和小组治疗，以及身体活动、营养教育和标准认知行为技术。然后，患者由他们的全科医生定期随访 5 年。
5 年后，33 名患者完成了研究。70%的患者体重减轻或保持了减肥效果。通过验证的问卷评估，减肥组的饮食结构、进食行为障碍、饮食监测和体重管理策略的总评分（22.4+/-4.3）明显低于维持组（24.4+/-6.1，p<0.05）和反弹组（29.7+/-4.0，p<0.01）。减肥组的患者在长期体重管理方面的随访更为重要（p<0.05），饮食效果更好（p<0.01），体力活动更多（p<0.05）。
本研究表明，初始的多维和多学科住院治疗计划以及随后的长期门诊随访可能会导致显著的体重减轻（55%）和/或体重维持（15%）。
多学科和精心设计的初始治疗和长期随访计划是肥胖管理所必需的。
