Annesi J J, Mareno N
Wellness Department, YMCA of Metro Atlanta, Atlanta, GA, USA.
Department of Health Promotion and Physical Education, Kennesaw State University, Kennesaw, GA, USA.
Clin Obes. 2017 Feb;7(1):22-33. doi: 10.1111/cob.12173. Epub 2017 Jan 12.
Although health-enhancing weight reductions are associated with behavioural treatments initially, a trajectory towards full regain typically begins within 6-9 months. Women with obesity (body mass index = 30-40 kg m ) who lost at least 3% of their baseline weight within two trials of a new cognitive-behavioural treatment incorporating physical activity prior to changes in eating behaviours, and either regained ≥50% of that weight over 2 years (Regain group, n=32) or continued to lose weight (ContinuedLoss group, n = 34), were assessed from months 6 to 24 on changes in weight-loss behaviours and psychosocial predictors of those behaviours derived from established behavioural theories. For the Regain group, significant decreases in physical activity and fruit/vegetable intake during months 12-24, from both months 6 to 24 and 12 to 24 in eating- and physical activity-related self-regulation and from months 6 to 24 in eating-related self-efficacy (i.e. feelings of ability), were found. No significant behavioural or psychosocial changes were found over those times in the ContinuedLoss group. Changes in self-regulation and self-efficacy completely mediated the relationship between changes in fruit/vegetable intake and group (Regain vs. ContinuedLoss) (McFadden's R = 0.19 and 0.20, respectively), with self-regulation independently contributing to the explained variance. Changes over both months 6-24 and 12-24 in self-regulation significantly mediated the relationship between changes in physical activity and group membership (McFadden's R = 0.24 and 0.27, respectively). Findings suggested that approximately 6 months after treatment initiation would be a suitable time to intervene with some bolstering methods, while approximately 12 months post-initiation would be most applicable for others.
虽然最初健康减重与行为治疗相关，但体重完全反弹的轨迹通常在6 - 9个月内开始。肥胖女性（体重指数 = 30 - 40 kg/m²）在一项新的认知行为治疗的两次试验中，在饮食行为改变之前先进行体育活动，体重减轻了至少3%的基线体重，其中在2年内体重反弹≥50%的女性（反弹组，n = 32）或继续减重的女性（持续减重组，n = 34），在第6至24个月期间，对体重减轻行为的变化以及源自既定行为理论的这些行为的心理社会预测因素进行了评估。对于反弹组，发现在第12 - 24个月期间，体育活动和水果/蔬菜摄入量显著下降，在第6至24个月以及第12至24个月期间，与饮食和体育活动相关的自我调节能力下降，在第6至24个月期间饮食相关的自我效能感（即能力感）下降。在持续减重组中，在这些时间段内未发现显著的行为或心理社会变化。自我调节和自我效能感的变化完全介导了水果/蔬菜摄入量变化与组间（反弹组与持续减重组）的关系（麦克法登R²分别为0.19和0.20），自我调节独立地对解释方差有贡献。在第6 - 24个月和第12 - 24个月期间自我调节的变化显著介导了体育活动变化与组别的关系（麦克法登R²分别为0.24和0.27）。研究结果表明，治疗开始后约6个月可能是采用一些强化方法进行干预的合适时机，而开始后约12个月可能最适用于其他方法。
