Carels Robert A, Selensky Jennifer C, Rossi James, Solar Chelsey, Hlavka Reid
East Carolina University, United States.
East Carolina University, United States.
Eat Behav. 2017 Aug;26:76-82. doi: 10.1016/j.eatbeh.2017.01.009. Epub 2017 Feb 1.
The aims of the current study were twofold: 1) examine the effectiveness of an innovative three-step, stepped-care behavioral weight loss treatment, and 2) examine factors that contribute to poor weight loss outcomes and the need for more intensive treatment.
The total sample for the study consisted of 53 individuals (87% female) with M=35.6, SD=6.4. A three-step, stepped-care treatment approach was implemented over six months. Step 1 included the Diabetes Prevention Program manual adapted for self-administration augmented with monitoring technology shown to facilitate weight loss and participant accountability and engagement. Participants who were unsuccessful at achieving established weight loss goals received stepped-up treatments in 2-month increments beginning at month 2. The stepped progression included the addition of meal replacement at Step 2 and individual counseling concurrent with meal replacement at Step 3.
Un-stepped and once stepped participants lost a clinically significant amount of weight (i.e., >5%), while twice stepped participants lost an insignificant amount of weight. Twice stepped participants were significantly lower in health literacy and self-monitoring frequency.
In this investigation, approximately 60% of the participants were able to lose a clinically significant amount of weight utilizing a minimally intensive intervention with little additional support. Regular self-monitoring and high health literacy proved to be significant correlates of success.
本研究的目的有两个：1）检验一种创新的三步式、逐步护理行为减肥治疗的有效性，2）检验导致减肥效果不佳的因素以及对更强化治疗的需求。
该研究的总样本包括53名个体（87%为女性），平均年龄M = 35.6，标准差SD = 6.4。一种三步式、逐步护理的治疗方法在六个月内实施。第一步包括改编为可自我管理的糖尿病预防计划手册，并辅以经证明有助于减肥以及增强参与者责任感和参与度的监测技术。在实现既定减肥目标方面未成功的参与者从第2个月开始每两个月接受一次强化治疗。逐步升级包括在第二步增加代餐，在第三步增加与代餐同时进行的个人咨询。
未升级和仅升级一次的参与者减掉了临床上显著的体重（即>5%），而升级两次的参与者减掉的体重微不足道。升级两次的参与者在健康素养和自我监测频率方面明显较低。
在本调查中，约60%的参与者通过极少额外支持的最低强度干预能够减掉临床上显著的体重。定期自我监测和高健康素养被证明是成功的重要相关因素。
