Department of Psychosomatic Medicine and Psychotherapy, LWL-Klinik Dortmund, Ruhr-University Bochum, 44287 Dortmund, Germany.
Gen Hosp Psychiatry. 2010 Mar-Apr;32(2):132-40. doi: 10.1016/j.genhosppsych.2009.09.001. Epub 2009 Oct 13.
This study aimed to assess the impact of mental disorders on weight loss maintenance among initially successful weight losers who participated in a very-low-calorie diet program.
A total of 251 obese individuals were assessed in a prospective longitudinal study over a period of 4 years. Mental disorders and eating patterns were assessed by structured interviews at baseline and by standardized questionnaires at baseline (T(1)), after 1 year (T(2)) and on 3-year follow-up (T(3)). Analyses were performed with an intention-to-treat method.
Based on the intention-to-treat sample, 166 successful weight losers at T(2) (weight loss > or = 10%) were identified. Of those, 47 (28.3%) maintained a weight loss of > or = 5% of their pretreatment weight, whereas 119 (71.7%) maintained a loss of less than 5% of their pretreatment weight at T(3). History of substance abuse/dependence disorder and grazing prior to treatment increased the likelihood of successful weight loss maintenance. High levels of cognitive control, low levels of disinhibition on 3-year follow-up and initial body mass index also were associated with successful weight loss maintenance.
Strategies that helped individuals overcome earlier mental disorders might help to establish better self-regulation and maintain high cognitive control of eating and subsequently increase the possibility of maintaining weight loss in the long run.
本研究旨在评估精神障碍对参加极低卡路里饮食计划的初始减重成功者维持体重的影响。
对 251 名肥胖个体进行了为期 4 年的前瞻性纵向研究。在基线（T1）、1 年后（T2）和 3 年随访（T3）时通过结构化访谈和标准化问卷评估精神障碍和进食模式。采用意向治疗法进行分析。
根据意向治疗样本，在 T2 时确定了 166 名成功减重超过 10%的减重者。其中，47 名（28.3%）维持了其治疗前体重超过 5%的减重，而 119 名（71.7%）维持了其治疗前体重不到 5%的减重。治疗前存在物质滥用/依赖障碍和放牧史可增加成功维持减重的可能性。高认知控制水平、低抑制水平在 3 年随访时和初始体重指数也与成功维持体重减轻有关。
帮助个体克服早期精神障碍的策略可能有助于建立更好的自我调节，保持对饮食的高认知控制，并最终增加长期维持体重减轻的可能性。
