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健康维护组织中患者的减肥目标。

Weight loss goals of patients in a health maintenance organization.

机构信息

Florida State University College of Medicine, Department of Medical Humanities and Social Sciences, 1115 W. Call St., Tallahassee, FL 32306, USA.

出版信息

Eat Behav. 2010 Apr;11(2):74-8. doi: 10.1016/j.eatbeh.2009.09.007. Epub 2009 Sep 27.

Abstract

Individuals seeking weight loss treatment endorse unrealistic expectations regarding their goals for weight loss, although these conclusions are primarily based on research conducted in obesity specialty clinics and/or controlled clinical trials. This study examined the weight loss goals and predictors of these goals among patients participating in obesity treatment in an applied, clinical setting (i.e., managed care organization). Managed care patients enrolled in a behavioral weight loss program (N=143; mean age=46.8 years; mean BMI=36.9 kg/m(2); 89.5% female; 64.5% Caucasian) completed a self-report survey during an initial weight loss session. The survey included items assessing patients' weight loss expectations, including goals for dream, happy, acceptable, and disappointed weights. Participants completed questions regarding contacts with their primary care physician and physician provision of weight loss counseling and/or referrals. They also provided values for current height and weight. BMI's and weight loss associated with dream, happy, acceptable, and disappointed weight goals were 24.8 kg/m(2) (30.9% loss), 27.1 kg/m(2) (25.2% loss), 29.3 kg/m(2) (19.7% loss), and 33.0 kg/m(2) (10.4% loss), respectively. There were significant gender differences in weight loss goals, with women endorsing more unrealistic goals than men for dream and happy weights, ps<0.001. Significant predictors of all four weight loss goals included baseline BMI, gender, ethnicity, and frequency of visits with one's primary care physician, ps<0.01. Consistent with previous research, patients participating in a weight loss program implemented in a managed care setting endorsed unrealistic expectations for weight loss. However, more frequent contact with one's primary care physician was associated with more realistic goals. Future, longitudinal research is needed to document the discrepancy between these goals and actual weight loss achieved in such settings as well as to determine whether excessive goals are associated with diminished treatment outcomes.

摘要

寻求减肥治疗的个体对减肥目标持不切实际的期望,尽管这些结论主要基于肥胖专科诊所和/或对照临床试验的研究。本研究在应用临床环境(即管理式医疗组织)中,检查了肥胖治疗患者的减肥目标及其预测因素。管理式医疗患者参加了一项行为减肥计划(N=143;平均年龄=46.8 岁;平均 BMI=36.9kg/m²;89.5%女性;64.5%白种人),在初始减肥疗程中完成了一份自我报告调查。该调查包括评估患者减肥期望的项目,包括梦想、快乐、可接受和失望体重的目标。参与者回答了关于与他们的初级保健医生的接触以及医生提供减肥咨询和/或转诊的问题。他们还提供了当前身高和体重的值。与梦想、快乐、可接受和失望体重目标相关的 BMI 和体重减轻分别为 24.8kg/m²(30.9%的减轻)、27.1kg/m²(25.2%的减轻)、29.3kg/m²(19.7%的减轻)和 33.0kg/m²(10.4%的减轻)。在减肥目标方面存在显著的性别差异,女性对梦想和快乐体重的目标比男性更不切实际,p<0.001。所有四个减肥目标的显著预测因素包括基线 BMI、性别、种族以及与初级保健医生的就诊频率,p<0.01。与先前的研究一致,参加管理式医疗环境中实施的减肥计划的患者对减肥抱有不切实际的期望。然而,与初级保健医生的接触频率越高,目标就越现实。未来需要进行前瞻性、纵向研究,以记录这些目标与此类环境中实际减肥效果之间的差异,并确定过度目标是否与治疗效果降低有关。

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