Omaha VA Medical Center, Omaha, NE, USA.
Diabetes Obes Metab. 2012 May;14(5):419-23. doi: 10.1111/j.1463-1326.2011.01544.x. Epub 2011 Dec 28.
Obesity, which is at epidemic proportions in the USA, is associated with a higher risk of several co-morbid diseases including, cardiovascular disease, cancer and sleep apnea. Weight loss and weight maintenance programmmes are difficult to sustain for long term. Mental health problems such as apathy may be a major factor in patients unsuccessful in adhering to weight loss programmes. We propose that treating apathy will result in better weight loss in obese patients.
This was a randomized prospective pilot study. Obese patients (n = 101) were randomized in a 1:2:2 ratio to either (i) standard nutrition counselling; or (ii) the Department of Veterans Affairs weight loss programme called 'motivate obese veterans everywhere ' (MOVE); or (iii) methylphenidate treatment plus the MOVE programme together. The intervention was for 6 months (26 weeks).
For the within groups analysis, the absolute changes in weight (kg) are as follows, for MOVE (mean: -1.84; 95% confidence interval (CI): -4.56 to 0.87; p = 0.25), Methylphenidate (mean: -4.61; 95% CI: -7.90 to -1.33; p = 0.04), standard nutrition counselling (mean: -0.60; 95% CI: -2.59 to 1.39; p = 0.21), which indicates that although all three groups lost weight, only the methylphenidate group achieved statistical significance. The between group differences of the relative change in weight were not statistically different. The apathy evaluation score and the patient activation measure improved in all groups.
Together these data suggest that treating apathy might be an important factor in the success of weight management programmes.
肥胖在美国已呈流行趋势，与多种合并疾病的风险增加相关，包括心血管疾病、癌症和睡眠呼吸暂停。减肥和体重维持计划很难长期维持。冷漠等心理健康问题可能是患者无法坚持减肥计划的一个主要因素。我们提出，治疗冷漠将导致肥胖患者更好的减肥效果。
这是一项随机前瞻性试点研究。肥胖患者（n = 101）按 1:2:2 的比例随机分为三组：（i）标准营养咨询；（ii）退伍军人事务部的减肥计划，称为“激励肥胖退伍军人无处不在”（MOVE）；或（iii）哌醋甲酯治疗加 MOVE 计划。干预持续 6 个月（26 周）。
对于组内分析，体重（kg）的绝对变化如下，MOVE 组（均值：-1.84；95%置信区间（CI）：-4.56 至 0.87；p = 0.25），哌醋甲酯组（均值：-4.61；95% CI：-7.90 至-1.33；p = 0.04），标准营养咨询组（均值：-0.60；95% CI：-2.59 至 1.39；p = 0.21），这表明尽管所有三组都减轻了体重，但只有哌醋甲酯组达到了统计学意义。体重相对变化的组间差异无统计学意义。所有组的冷漠评估评分和患者激活测量都有所改善。
这些数据表明，治疗冷漠可能是体重管理计划成功的一个重要因素。
