University of Connecticut School of Medicine, Farmington, CT, USA.
Am J Med. 2011 Nov;124(11):1082-5. doi: 10.1016/j.amjmed.2011.04.016. Epub 2011 Aug 17.
Reinforcement-based treatments, based on behavioral economics models, can improve outcomes of medical conditions with behavioral components. This study evaluated the efficacy of a low-cost reinforcement intervention to produce initial weight loss.
Overweight individuals (n=56) were randomized to one of two 12-week treatments: Lifestyle, Exercise, Attitudes, Relationships, Nutrition manual with supportive counseling or that same treatment with opportunities to win $1 to $100 prizes for losing weight and completing weight-loss activities.
Patients receiving reinforcement lost significantly more weight (6.0% ± 4.9% baseline bodyweight) than patients in the non-reinforcement condition (3.5% ± 4.1%; P=.04). Moreover, 64.3% of patients receiving reinforcement achieved weight loss of ≥ 5% baseline bodyweight versus 25.0% of those in the non-reinforcement condition (P=.003). Proportional weight loss was significantly related to reductions in total cholesterol and 24-hour ambulatory heart rate.
This reinforcement-based intervention substantially enhances short-term weight loss, and reductions in weight are associated with important changes in clinical biomarkers. Larger-scale evaluation of reinforcement-based treatments for weight loss is warranted.
基于行为经济学模型的强化治疗可以改善具有行为成分的医疗状况的结果。本研究评估了一种低成本强化干预措施在初始减肥方面的效果。
将超重个体（n=56）随机分为两种 12 周治疗之一：生活方式、运动、态度、关系、营养手册加支持性咨询，或相同的治疗方法，但有机会因减肥和完成减肥活动赢得 1 至 100 美元的奖品。
接受强化治疗的患者体重减轻显著更多（基线体重的 6.0%±4.9%），而非强化治疗组为 3.5%±4.1%（P=.04）。此外，接受强化治疗的患者中有 64.3%达到了基线体重的 5%以上的减肥效果，而非强化治疗组为 25.0%（P=.003）。体重的比例减轻与总胆固醇和 24 小时动态心率的降低显著相关。
这种基于强化的干预措施大大增强了短期减肥效果，体重的减少与重要的临床生物标志物的变化有关。需要对基于强化的减肥治疗进行更大规模的评估。
