Waring Molly E, Schneider Kristin L, Appelhans Bradley M, Busch Andrew M, Whited Matthew C, Rodrigues Stephanie, Lemon Stephenie C, Pagoto Sherry L
Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States.
Department of Psychology, Rosalind Franklin University, North Chicago, IL, United States.
J Psychosom Res. 2014 May;76(5):394-9. doi: 10.1016/j.jpsychores.2014.03.004. Epub 2014 Mar 25.
Some adults with comorbid depression and obesity respond well to lifestyle interventions while others have poor outcomes. The objective of this study was to evaluate whether early-treatment weight loss progress predicts clinically significant 6-month weight loss among women with obesity and depression.
We conducted a secondary analysis of data from 75 women with obesity and depression who received a standard lifestyle intervention. Relative risks (RRs) and 95% confidence intervals (CIs) for achieving ≥5% weight loss by 6 months were calculated based on whether they achieved ≥1 lb/week weight loss in weeks 2-8. Among those on target at week 3, we examined potential subsequent time points at which weight loss progress might identify additional individuals at risk for treatment failure.
At week 2, women who averaged ≥1 lb/week loss were twice as likely to achieve 5% weight loss by 6 months than those who did not (RR=2.40; 95% CI: 2.32-4.29); weight loss at weeks 3-8 was similarly predictive (RRs=2.02-3.20). Examining weight loss progress at week 3 and subsequently at a time point during weeks 4-8, 52-67% of participants were not on target with their weight loss, and those on target were 2-3 times as likely to achieve 5% weight loss by 6 months (RRs=1.82-2.92).
Weight loss progress as early as week 2 of treatment predicts weight loss outcomes for women with comorbid obesity and depression, which supports the feasibility of developing stepped care interventions that adjust treatment intensity based on early progress in this population.
一些患有抑郁症和肥胖症的成年人对生活方式干预反应良好，而另一些人则效果不佳。本研究的目的是评估早期治疗的体重减轻进展是否能预测肥胖和抑郁症女性在6个月内实现具有临床意义的体重减轻。
我们对75名接受标准生活方式干预的肥胖和抑郁症女性的数据进行了二次分析。根据她们在第2 - 8周是否实现每周≥1磅的体重减轻，计算出6个月内体重减轻≥5%的相对风险（RRs）和95%置信区间（CIs）。在第3周达标的人群中，我们检查了后续可能的时间点，在这些时间点上体重减轻进展可能会识别出更多有治疗失败风险的个体。
在第2周，平均每周体重减轻≥1磅的女性在6个月内实现5%体重减轻的可能性是未达标的女性的两倍（RR = 2.40；95% CI：2.32 - 4.29）；第3 - 8周的体重减轻情况同样具有预测性（RRs = 2.02 - 3.20）。在第3周以及随后第4 - 8周的某个时间点检查体重减轻进展情况，52 - 67%的参与者体重减轻未达标，而达标的参与者在6个月内实现5%体重减轻的可能性是未达标的2 - 3倍（RRs = 1.82 - 2.92）。
早在治疗第2周的体重减轻进展就能预测肥胖合并抑郁症女性的体重减轻结果，这支持了开发分级护理干预措施的可行性，该措施可根据这一人群的早期进展调整治疗强度。
