Calugi Simona, Marchesini Giulio, El Ghoch Marwan, Gavasso Ilaria, Dalle Grave Riccardo
J Acad Nutr Diet. 2017 Jan;117(1):32-38. doi: 10.1016/j.jand.2016.09.001. Epub 2016 Oct 22.
Conflicting evidence exists as to whether cognitive mechanisms contribute to weight loss and maintenance.
To assess the influence of weight-loss expectations on weight loss, and of weight-loss satisfaction on weight maintenance, in individuals with severe obesity.
A randomized controlled trial comparing two types of energy-restricted diets (high protein vs high carbohydrate) combined with weight-loss cognitive behavioral therapy, conducted over 51 weeks and divided into two phases: weight-loss phase (3 weeks of inpatient treatment and 24 weeks of outpatient treatment) and weight maintenance phase (24 weeks of outpatient treatment).
PARTICIPANTS/SETTING: Eighty-eight participants with severe obesity (mean age=46.7 years and mean body mass index=45.6), referred to an eating and weight disorders clinical service, were studied.
Body weight was assessed at baseline, and after 3, 27 (end of weight-loss phase), and 51 weeks (end of weight maintenance phase). Weight loss expectations were assessed at the time of enrollment, and weight-loss satisfaction was assessed after 27 weeks.
The relationship between weight-loss expectations and weight loss was assessed using a linear mixed model. The association between weight-loss satisfaction and final outcomes was tested by linear regression.
The two groups had similar weight-loss expectations and satisfaction, and their results were therefore pooled. In general, the total amount of expected weight loss (in kilograms), but not the percentage of expected weight loss, predicted weight loss, and both satisfaction with weight loss and the amount of weight lost (in kilograms) were independent predictors of weight maintenance.
Higher expected weight loss improves weight loss, and both the total amount of weight lost and satisfaction with weight loss are associated with weight-loss maintenance at 1-year follow-up.
关于认知机制是否有助于体重减轻和维持，存在相互矛盾的证据。
评估重度肥胖个体中减肥期望对体重减轻的影响，以及减肥满意度对体重维持的影响。
一项随机对照试验，比较两种能量限制饮食（高蛋白与高碳水化合物）与减肥认知行为疗法相结合，为期51周，分为两个阶段：减肥阶段（3周住院治疗和24周门诊治疗）和体重维持阶段（24周门诊治疗）。
参与者/地点：对88名重度肥胖参与者（平均年龄=46.7岁，平均体重指数=45.6）进行了研究，这些参与者被转介到一家饮食和体重障碍临床服务机构。
在基线时、3周后、27周（减肥阶段结束）和51周（体重维持阶段结束）评估体重。在入组时评估减肥期望，在27周后评估减肥满意度。
使用线性混合模型评估减肥期望与体重减轻之间的关系。通过线性回归测试减肥满意度与最终结果之间的关联。
两组的减肥期望和满意度相似，因此将结果合并。总体而言，预期体重减轻的总量（以千克为单位）而非预期体重减轻的百分比可预测体重减轻，减肥满意度和体重减轻量（以千克为单位）均是体重维持的独立预测因素。
更高的预期体重减轻可改善体重减轻情况，并且体重减轻总量和减肥满意度均与1年随访时的体重维持相关。
