Department of Health and Nursing Sciences, University of Agder, Jon Lilletuns vei 9, Grimstad, 4879, Norway.
Health Qual Life Outcomes. 2013 Oct 3;11:165. doi: 10.1186/1477-7525-11-165.
Studies of lifestyle intervention programs in morbid obesity report large variations in weight loss outcomes. This is reported not only between but also within standardized programs. Such reports point to participants' characteristics as possible predictors of this outcome. The aim of this prospective cohort study was to identify predictors of weight loss after a 1-year partly residential intensive lifestyle intervention program (ILI).
Morbidly obese patients (n=199), all Caucasian, 71% women, mean (SD) age 45.2 (11.1) years, body mass index (BMI) 42.0 (6.2) kg/m(2), and excess body weight (>BMI=25 kg/m(2)) 49.4 (19.6) kg, were referred from public hospitals to a rehabilitation center and enrolled consecutively. The 1-year ILI comprised of four (n=104) or five (n=95) stays at the rehabilitation center. In both cases there was one main stay for 4 weeks and the remaining stays lasted 1 week each. In the home periods the patients were followed up by telephone and by their general practitioners (GP). The patients were also encouraged to use a predefined paper based diary. Health related quality of life (HRQL), diagnostic, anthropometric, socio-demographic, psychosocial and intervention characteristics were measured at baseline, 12 weeks and 1 year. Multiple linear regression analyses were performed to extract possible predictors of weight loss at 1-year. Direct and indirect effects of these predictors were tested through structural equation modeling.
The mean (SD) 1-year weight loss was 10 (11) kg, corresponding to an 8 (8) % reduction of body weight from baseline. Mean excess weight loss (EWL) was 20 (22) % ranging from 104% to -77%. The adherence to a diary (r=.16), type 2 diabetes (r=-.14) and frequency of GP-visits (r=.23) were significantly associated with EWL at 12 weeks. Predictors of 1-year EWL were 12 week EWL (r=.66), occupational status (r=.11), age (r=.19), and mental HRQL (r=-.16), all p<.05. The path model explained 50% of the variation (r(2)=.50) of 1-year EWL.
Larger 12 week weight loss, being employed, lower mental HRQL and being older predicts larger weight loss after 1 year in morbidly obese patients following ILI. Not having type 2 diabetes, using a diary combined with regular GP follow-up influence the 12-week weight loss.
Clinicaltrials.gov: NCT00477399.
病态肥胖患者生活方式干预项目的研究报告显示，体重减轻的结果存在很大差异。这种差异不仅存在于不同的研究之间，也存在于标准化的项目之内。这些报告指出，参与者的特征可能是这种结果的预测因素。本前瞻性队列研究的目的是确定经过 1 年部分住院强化生活方式干预项目（ILI）后体重减轻的预测因素。
肥胖患者（n=199），均为白种人，71%为女性，平均（SD）年龄 45.2（11.1）岁，体重指数（BMI）42.0（6.2）kg/m2，超重（BMI>25kg/m2）49.4（19.6）kg，全部来自公立医院，被转诊到康复中心并连续登记。为期 1 年的 ILI 包括在康复中心进行四次（n=104）或五次（n=95）住院。在这两种情况下，都有一次为期 4 周的主要住院，其余的住院每次持续 1 周。在家庭期间，通过电话和患者的全科医生（GP）对患者进行随访。还鼓励患者使用预定义的纸质日记。在基线、12 周和 1 年时测量健康相关生活质量（HRQL）、诊断、人体测量、社会人口统计学、心理社会和干预特征。通过多元线性回归分析提取 1 年体重减轻的可能预测因素。通过结构方程模型测试这些预测因素的直接和间接影响。
1 年平均（SD）体重减轻 10（11）kg，相当于体重从基线减少 8（8）%。平均超重减轻率（EWL）为 20（22）%，范围为 104%至-77%。对日记的遵守（r=.16）、2 型糖尿病（r=-.14）和 GP 就诊频率（r=.23）与 12 周时的 EWL 显著相关。1 年 EWL 的预测因素为 12 周 EWL（r=.66）、职业状态（r=.11）、年龄（r=.19）和心理 HRQL（r=-.16），均 P<.05。路径模型解释了 1 年 EWL 变化的 50%（r(2)=.50）。
12 周时体重减轻更大、就业、较低的心理 HRQL 和年龄较大的患者，在接受 ILI 治疗后，1 年后体重减轻更大。没有 2 型糖尿病、使用日记并结合定期 GP 随访会影响 12 周的体重减轻。
Clinicaltrials.gov：NCT00477399。
