Department of Clinical & Health Psychology, University of Florida, Gainesville, Florida, USA.
Obes Rev. 2012 Jun;13(6):509-17. doi: 10.1111/j.1467-789X.2011.00972.x. Epub 2011 Dec 29.
Behavioural weight management interventions consistently produce 8-10% reductions in body weight, yet most participants regain weight after treatment ends. One strategy for extending the effects of behavioural interventions has been the provision of extended care. The current study is a systematic review and meta-analysis of the literature on the effect of extended care on maintenance of weight loss. Through database searches (using PubMED, PsychInfo and Cochrane Reviews) and manual searches through reference lists of related publications, 463 studies were identified. Of these, 11 were included in the meta-analysis and an additional two were retained for qualitative analysis. The average effect of extended care on weight loss maintenance was g=0.385 (95% confidence interval: 0.281, 0.489; P<0.0001). This effect would lead to the maintenance of an additional 3.2 kg weight loss over 17.6 months post-intervention in participants provided extended care compared with control. There was no significant heterogeneity between studies, Q=5.63, P=0.845, and there was minimal evidence for publication bias. These findings suggest that extended care is a viable and efficacious solution to addressing long-term maintenance of lost weight. Given the chronic disease nature of obesity, extended care may be necessary for long-term health benefits.
行为体重管理干预措施通常可使体重减少 8-10%，但大多数参与者在治疗结束后体重会反弹。延长行为干预效果的一种策略是提供扩展护理。本研究是对关于扩展护理对体重减轻维持效果的文献进行的系统评价和荟萃分析。通过数据库搜索（使用 PubMED、PsychInfo 和 Cochrane Reviews）和对相关出版物参考文献的手动搜索，确定了 463 项研究。其中，11 项研究纳入荟萃分析，另外两项研究进行定性分析。扩展护理对体重减轻维持的平均效果为 g=0.385（95%置信区间：0.281，0.489；P<0.0001）。与对照组相比，接受扩展护理的参与者在干预后 17.6 个月内可额外维持 3.2 公斤的体重减轻。研究之间没有显著的异质性，Q=5.63，P=0.845，且没有明显的出版偏见证据。这些发现表明，扩展护理是解决长期体重维持问题的一种可行且有效的方法。鉴于肥胖是一种慢性疾病，长期护理可能是长期健康获益所必需的。
