Wellspring, CRC Health Group, Cupertino, CA, USA.
Obes Rev. 2011 Jan;12(1):37-49. doi: 10.1111/j.1467-789X.2009.00710.x.
Obese children have attended weight loss camps and residential programmes for more than 40 years. This paper provides the first systematic review of the effects of those programmes. Twenty-two studies met inclusion criteria (targeted and assessed change in weight status, minimal stay of 10 days and nights). Similar components across programmes included controlled diet, activities, nutrition education, and therapy and/or education regarding behaviour change. Participants lost substantial amounts of weight in all 22 studies, as measured by reductions in per cent-overweight during intervention. Eleven programmes included long-term follow-up evaluations. Compared with results highlighted in a recent meta-analysis of out-patient treatments, these immersion programmes produced an average of 191% greater reductions in per cent-overweight at post-treatment and 130% greater reduction at follow-up. Furthermore, mean attrition rates were much lower when compared with standard out-patient treatment. Inclusion of a cognitive-behavioural therapy (CBT) component seemed especially promising; follow-up evaluations showed decreased per cent-overweight at follow-up by an average of 30% for CBT immersion programmes vs. 9% for programmes without CBT. Explanations for the potentially greater impact of immersion relative to out-patient treatments are presented, including possibly differential effects on self-efficacy for both children and their parents.
肥胖儿童参加减肥夏令营和住宿项目已有 40 多年的历史。本文首次对这些项目的效果进行了系统评价。符合纳入标准的研究有 22 项（以体重状况的改变为目标并进行评估，入住时间至少为 10 天 10 夜）。各个项目都包含类似的内容，如控制饮食、活动、营养教育，以及针对行为改变的治疗和/或教育。所有 22 项研究均表明参与者体重显著减轻，干预期间超重百分比有所降低。其中 11 个项目包括长期随访评估。与最近门诊治疗荟萃分析中的结果相比，这些沉浸式项目在治疗后平均降低超重百分比增加 191%，随访时降低超重百分比增加 130%。此外，与标准门诊治疗相比，平均辍学率要低得多。纳入认知行为疗法（CBT）似乎特别有希望；随访评估显示，接受 CBT 沉浸式项目的参与者超重百分比平均下降 30%，而未接受 CBT 的项目参与者超重百分比仅下降 9%。本文介绍了沉浸式治疗相对于门诊治疗可能具有更大影响的原因，包括对儿童及其父母的自我效能感可能产生不同的影响。
