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一项针对肥胖和暴食障碍的随机对照试验:低能量密度饮食咨询和认知行为疗法。

A randomized controlled trial for obesity and binge eating disorder: low-energy-density dietary counseling and cognitive-behavioral therapy.

机构信息

Yale School of Medicine, Department of Psychiatry, 301 Cedar Street, P.O. Box 208098, New Haven, CT 06520-8098, USA.

出版信息

Behav Res Ther. 2011 Dec;49(12):821-9. doi: 10.1016/j.brat.2011.09.006. Epub 2011 Sep 28.

Abstract

The present study examined a dietary approach - lowering energy density - for producing weight loss in obese patients with binge eating disorder (BED) who also received cognitive-behavioral therapy (CBT) to address binge eating. Fifty consecutive participants were randomly assigned to either a six-month individual treatment of CBT plus a low-energy-density diet (CBT+ED) or CBT plus General Nutrition counseling not related to weight loss (CBT+GN). Assessments occurred at six- and twelve-months. Eighty-six percent of participants completed treatment, and of these, 30% achieved at least a 5% weight loss with rates of binge remission ranging from 55% to 75%. The two treatments did not differ significantly in weight loss or binge remission outcomes. Significant improvements were found for key dietary and metabolic outcomes, with CBT+ED producing significantly better dietary outcomes on energy density, and fruit and vegetable consumption, than CBT+GN. Reductions in energy density and weight loss were significantly associated providing evidence for the specificity of the treatment effect. These favorable outcomes, and that CBT+ED was significantly better at reducing energy density and increasing fruit and vegetable consumption compared to CBT+GN, suggest that low-energy-density dietary counseling has promise as an effective method for enhancing CBT for obese individuals with BED.

摘要

本研究考察了一种饮食方法——降低能量密度——在接受认知行为疗法(CBT)治疗暴食症(BED)的肥胖患者中产生减肥效果,该方法同时也用于解决暴食问题。五十名连续参与者被随机分配到为期六个月的个体 CBT 加低能量密度饮食(CBT+ED)治疗组或 CBT 加与体重减轻无关的一般营养咨询(CBT+GN)组。在六个月和十二个月时进行评估。86%的参与者完成了治疗,其中 30%至少减轻了 5%的体重,暴食缓解率从 55%到 75%不等。两种治疗方法在体重减轻或暴食缓解结果方面没有显著差异。关键饮食和代谢结果均有显著改善,CBT+ED 在能量密度、水果和蔬菜摄入量方面的饮食结果明显优于 CBT+GN。能量密度降低和体重减轻与治疗效果的特异性有关。这些有利的结果,以及 CBT+ED 在降低能量密度和增加水果和蔬菜摄入量方面明显优于 CBT+GN,表明低能量密度饮食咨询作为一种增强对肥胖伴 BED 个体的 CBT 的有效方法具有潜力。

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