Yamada Tomohide, Hara Kazuo, Svensson Akiko Kishi, Shojima Nobuhiro, Hosoe Jun, Iwasaki Minaka, Yamauchi Toshimasa, Kadowaki Takashi
Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, University of Tokyo, Japan.
Obesity (Silver Spring). 2015 Jan;23(1):183-91. doi: 10.1002/oby.20874. Epub 2014 Oct 16.
The influence of the amount and rate of weight loss on subsequently regaining weight and dropout from treatment in severely obese patients targeting 5% weight loss was investigated.
A total of 120 consecutive hospital patients with severe obesity (BMI: 42 ± 9 kg/m(2) ) participated in an inpatient program targeting 5% weight loss that involved goal setting, charting weight four times daily, and diet and exercise. They were followed after discharge to assess subsequent regaining of weight and dropout.
Mean weight loss was 4.9 ± 2.4% after a mean of 19 days in the hospital, and 43% of the patients achieved the target weight loss (>5%). Over the median 2-year follow-up period, greater than 5% in-hospital weight loss was associated with a significantly lower risk of regaining weight after adjustment for various factors (>5% to ≤7% loss: hazard ratio 0.30 [0.11-0.85] for regaining all of the lost weight and 0.32 [0.13-0.78] for regaining half of the lost weight). No significant relation between the amount or rate of weight loss and dropout from subsequent outpatient treatment was seen.
Successfully achieving the target weight loss in a comprehensive program predicts subsequent maintenance of lower weight without increasing the risk of dropout. Successful in-hospital weight loss might increase the motivation of obese patients.
研究在以减轻5%体重为目标的重度肥胖患者中，体重减轻的量和速度对随后体重反弹及治疗中断的影响。
共有120例连续入院的重度肥胖患者（BMI：42±9kg/m²）参加了一个以减轻5%体重为目标的住院项目，该项目包括设定目标、每天四次记录体重以及饮食和运动。出院后对他们进行随访，以评估随后的体重反弹和治疗中断情况。
住院平均19天后，平均体重减轻了4.9±2.4%，43%的患者实现了目标体重减轻（>5%）。在中位2年的随访期内，校正各种因素后，住院期间体重减轻超过5%与体重反弹风险显著降低相关（体重减轻>5%至≤7%：恢复全部减轻体重的风险比为0.30[0.11-0.85]，恢复一半减轻体重的风险比为0.32[0.13-0.78]）。未发现体重减轻的量或速度与随后门诊治疗中断之间存在显著关系。
在一个综合项目中成功实现目标体重减轻可预测随后较低体重的维持，且不会增加治疗中断的风险。住院期间成功减轻体重可能会增强肥胖患者的动机。
