Health Behavior, Fay W. Boozman College of Public Health, University of Arkansas for the Medical Sciences, Little Rock, Arkansas, USA.
Obesity (Silver Spring). 2011 Sep;19(9):1791-5. doi: 10.1038/oby.2011.22. Epub 2011 Feb 17.
Clinical experience suggests some individuals begin obesity treatment weighing more than they did at pretreatment assessment. Weight fluctuations between baseline screening and the first treatment session were examined among individuals enrolling in a group behavioral obesity treatment outcome study. Participants (N = 480, 94% female; 28% African American; M BMI = 35.7) were classified into those who started treatment having gained weight (≥ +1.15% above screening weight), lost weight (≤ -1.15% below screening weight) or remained weight stable. The majority of participants were weight-stable (61%) during the waiting period, but 23% lost weight (-2.36 ± 1.26 kg) and 16% gained weight (+2.11 ± 1.04 kg) between baseline screening and initiating treatment. Those who lost during the pretreatment period went on to have the greatest losses at 6-months (-8.9 ± 4.9 kg), with significantly greater weight losses than either the weight-stable (-6.1 ± 5.8 kg) or the weight-gain (-5.7 ± 5.8 kg) groups. Further, those who lost weight during the waiting period went on to attend a significantly higher proportion of treatment sessions and submitted more self-monitoring diaries than those who gained weight and those who stayed weight stable while waiting. Thus, pretreatment weight change was associated with treatment outcomes and may be relevant for research screening. Further, pretreatment weight change may be a clinical marker for likely success in behavioral weight control and as such warrants additional investigation to inform potential methods for enhancing outcomes for individuals in obesity treatment.
临床经验表明，一些人开始接受肥胖治疗时的体重比治疗前评估时的体重更高。在一项群体行为肥胖治疗结果研究中，对参加者进行了基线筛查和第一次治疗期间的体重波动研究。参与者（N=480，94%为女性；28%为非裔美国人；平均 BMI=35.7）分为以下三组：治疗开始时体重增加（≥筛查体重的+1.15%）、体重减轻（≤筛查体重的-1.15%）或体重稳定。在等待期间，大多数参与者体重稳定（61%），但有 23%的人减轻体重（-2.36±1.26kg），16%的人增加体重（+2.11±1.04kg）。在治疗前期间体重减轻的参与者在 6 个月时体重下降最大（-8.9±4.9kg），与体重稳定组（-6.1±5.8kg）或体重增加组（-5.7±5.8kg）相比，体重下降显著更大。此外，在等待期间体重减轻的参与者继续参加治疗的比例显著更高，并且提交的自我监测日记也比体重增加和体重稳定的参与者更多。因此，治疗前的体重变化与治疗结果相关，可能与研究筛选有关。此外，治疗前的体重变化可能是行为体重控制中可能成功的临床标志，因此值得进一步研究，以确定增强肥胖治疗中个体治疗结果的潜在方法。
