Annesi James J, Johnson Ping H
YMCA of Metro Atlanta, 100 Edgewood Avenue NE, Suite 1100, Atlanta, GA, 30303, USA,
Eat Weight Disord. 2015 Jun;20(2):223-32. doi: 10.1007/s40519-014-0159-7. Epub 2014 Oct 21.
To improve success rates of behavioral weight-loss treatments, a better understanding of psychosocial factors that discriminate between weight-loss success and failure is required. The inclusion of cognitive-behavioral methods and manageable amounts of exercise might induce greater improvements than traditional methods of education in healthy eating practices.
Women with morbid obesity [body mass index (BMI) ≥40 kg/m(2)] were recruited for a treatment of supported exercise paired with either a cognitive-behavioral or an educational approach to eating change over 6 months. They were classified as either successful with (i.e., at least 5 % loss; n = 40) or failed at (no loss, or weight gain; n = 43) weight loss. Discriminate function analysis incorporated theory-based models of 1 (self-efficacy), 5 (self-efficacy, self-regulation, mood, physical self-concept, body satisfaction), and 3 (self-efficacy, self-regulation, mood) psychosocial predictors at both month 6, and change from baseline-month 6.
All three models significantly discriminated weight-loss success/failure (66, 88, and 87 % for success; and 81, 87, and 88 % for failure, respectively). Self-regulation had the strongest correlations within the multi-predictor models (0.90-0.96), and all variables entered were above the standard of 0.30 set for relevance. Participants in the cognitive-behavioral nutrition group demonstrated significantly greater improvements in all psychosocial variables and success with weight loss. Completing at least two sessions of exercise per week predicted success/failure with weight loss better than overall volume of exercise.
New and relevant findings regarding treatment-induced psychosocial changes might be useful in the architecture of more successful behavioral weight-loss interventions.
为提高行为减肥治疗的成功率，需要更好地理解区分减肥成功与失败的心理社会因素。与传统的健康饮食教育方法相比，纳入认知行为方法和适量运动可能会带来更大的改善。
招募患有病态肥胖症（体重指数[BMI]≥40kg/m²）的女性，进行为期6个月的支持性运动治疗，并结合认知行为或饮食改变教育方法。她们被分类为减肥成功（即至少减重5%；n = 40）或失败（未减重或体重增加；n = 43）。判别函数分析纳入了基于理论的1个（自我效能感）、5个（自我效能感、自我调节、情绪、身体自我概念、身体满意度）和3个（自我效能感、自我调节、情绪）心理社会预测因素，分别在第6个月以及从基线到第6个月的变化情况。
所有三个模型都显著区分了减肥的成功/失败（成功的分别为66%、88%和87%；失败的分别为81%、87%和88%）。在多预测因素模型中，自我调节的相关性最强（0.90 - 0.96），所有纳入的变量均高于设定的0.30相关性标准。认知行为营养组的参与者在所有心理社会变量方面都有显著更大的改善，并且减肥成功。每周至少完成两次运动对减肥成功/失败的预测比运动总量更好。
关于治疗引起的心理社会变化的新的相关发现可能有助于构建更成功的行为减肥干预措施。
