Whitham C, Mellor D D, Goodwin S, Reid M, Atkin S L
HONEI Project, University of Hull, Hull, UK.
J Hum Nutr Diet. 2014 Aug;27(4):384-90. doi: 10.1111/jhn.12178. Epub 2013 Nov 18.
The results of weight maintenance after initial weight loss are reported infrequently, although, when they have been reported, the outcomes are generally poor and weight regain is common.
After an initial 12-week randomised intervention comparing all meal provision against a self-directed energy restriction, participants re-consented to participate in a follow-on study. Participants were given the option to choose to continue with the same dietary intervention (either all meal provision (provided free of charge) or self-directed diet) or change to the other diet for a further 12 weeks. Participants were followed up at 4-weekly intervals during both intervention periods (a total of 24 weeks), with a final follow up at 12 months.
Eighty-five out of 86 individuals who completed the original 12-week randomised phase chose to continue on to the follow-up study. No significant differences in further weight loss between groups (P = 0.138) [mean (SEM): -3.4% (1.1%) for all meal provision only; -3.4% (0.6%) self-directed then all meal provision; -1.1% (1.2%) all meal provision then self-directed] were seen after a further 12 weeks. Meal provision for a total of 24 weeks resulted in 67% of individuals losing at least 10% body weight. The groups switching from self-directed dieting to meal provision (or vice versa) were the only groups to have a lower mean weight at 12 months than at the start of the follow-on study.
Structured support for 24 weeks followed by 28 weeks of self-care can result in weight maintenance, with initial weight loss maintained at 12 months from enrolling on a 12-week weight loss intervention, with a 12-week follow-on period.
尽管初始体重减轻后的体重维持结果鲜有报道,但一旦报道,结果通常不佳,体重反弹很常见。
在进行了为期12周的随机干预(比较全餐供应与自主能量限制)后,参与者重新同意参加一项后续研究。参与者可以选择继续采用相同的饮食干预措施(全餐供应(免费提供)或自主饮食),或者更换为另一种饮食方式,再持续12周。在两个干预阶段(共24周),每隔4周对参与者进行随访,并在12个月时进行最终随访。
完成最初12周随机阶段的86名个体中有85人选择继续参加后续研究。在接下来的12周后,各小组之间在进一步减重方面没有显著差异(P = 0.138)[平均值(标准误):仅全餐供应组为-3.4%(1.1%);自主饮食后改为全餐供应组为-3.4%(0.6%);全餐供应后改为自主饮食组为-1.1%(1.2%)]。总共24周的全餐供应使67%的个体体重减轻了至少10%。从自主饮食改为全餐供应(或反之)的小组是仅有的在12个月时平均体重低于后续研究开始时的小组。
24周的结构化支持,随后28周的自我护理,可以实现体重维持,在参加为期12周的体重减轻干预并进行12周后续随访后的12个月时,初始体重减轻得以保持。