免费预备餐和有奖减肥计划对肥胖和超重女性减肥和减肥维持的影响：一项随机对照试验。

Effect of a free prepared meal and incentivized weight loss program on weight loss and weight loss maintenance in obese and overweight women: a randomized controlled trial.

机构信息

School of Medicine, University of California, San Diego, and Moores UCSD Cancer Center, La Jolla, California 92093, USA.

出版信息

JAMA. 2010 Oct 27;304(16):1803-10. doi: 10.1001/jama.2010.1503. Epub 2010 Oct 9.

DOI:10.1001/jama.2010.1503

PMID:20935338

Abstract

CONTEXT

The prevalence of overweight and obesity in the United States remains high. Commercial weight loss programs may contribute to efforts to reduce the prevalence of overweight and obesity, although few studies have examined their efficacy in controlled trials.

OBJECTIVE

To test whether a free prepared meal and incentivized structured weight loss program promotes greater weight loss and weight loss maintenance at 2 years compared with usual care.

DESIGN, SETTING, AND PARTICIPANTS: A randomized controlled trial of weight loss and weight loss maintenance in 442 overweight or obese women (body mass index, 25-40) aged 18 to 69 years (mean age, 44 years) conducted at US institutions over 2 years with follow-up between November 2007 and April 2010.

INTERVENTION

The program, which involves in-person center-based or telephone-based one-to-one weight loss counseling, was available over a 2-year period. Behavioral goals were an energy-reduced, nutritionally adequate diet, facilitated by the inclusion of prepackaged food items in a planned menu during the initial weight loss phase, and increased physical activity. Participants assigned to usual care received 2 individualized weight loss counseling sessions with a dietetics professional and monthly contacts.

MAIN OUTCOME MEASURES

Weight loss and weight loss maintenance.

RESULTS

Weight data were available at 24 months for 407 women (92.1% of the study sample). In an intent-to-treat analysis with baseline value substitution, mean weight loss was 7.4 kg (95% confidence interval [CI], 6.1-8.7 kg) or 7.9% (95% CI, 6.5%-9.3%) of initial weight at 24 months for the center-based group, 6.2 kg (95% CI, 4.9-7.6 kg) or 6.8% (95% CI, 5.2%-8.4%) for the telephone-based group, and 2.0 kg (95% CI, 0.6-3.3 kg) or 2.1% (95% CI, 0.7%-3.5%) for the usual care control group after 24 months (P < .001 for intervention effect).

CONCLUSION

Compared with usual care, this structured weight loss program resulted in greater weight loss over 2 years.

TRIAL REGISTRATION

clinicaltrials.gov Identifier: NCT00640900.

摘要

背景

美国超重和肥胖的患病率仍然很高。商业减肥计划可能有助于降低超重和肥胖的患病率，尽管很少有研究在对照试验中检验其效果。

目的

测试免费准备餐和激励结构化减肥计划是否比常规护理更能促进 2 年内体重减轻和体重维持。

设计、地点和参与者：一项在美国机构进行的为期 2 年的减肥和体重维持的随机对照试验，共有 442 名年龄在 18 至 69 岁（平均年龄 44 岁）的超重或肥胖女性（体重指数 25-40）参与，随访时间为 2007 年 11 月至 2010 年 4 月。

干预措施

该计划包括面对面的中心或电话一对一减肥咨询，为期 2 年。行为目标是通过在初始减肥阶段纳入预制食品，实现能量减少和营养充足的饮食，并增加身体活动。分配到常规护理的参与者接受了 2 次与营养师专业人员的个体化减肥咨询，并每月进行联系。

主要结果测量

体重减轻和体重维持。

结果

在 24 个月时，407 名女性（研究样本的 92.1%）提供了体重数据。在基于意向治疗的分析中，采用基线值替代法，中心组的平均体重减轻量为 7.4kg（95%置信区间[CI]，6.1-8.7kg）或初始体重的 7.9%（95%CI，6.5%-9.3%），电话组为 6.2kg（95%CI，4.9-7.6kg）或 6.8%（95%CI，5.2%-8.4%），常规护理对照组为 2.0kg（95%CI，0.6-3.3kg）或 2.1%（95%CI，0.7%-3.5%），在 24 个月后（干预效果 P <.001）。