一项多专业非手术肥胖治疗项目的评估：哪些参数表明生活方式改变和体重减轻？
Evaluation of a multiprofessional, nonsurgical obesity treatment program: which parameters indicated life style changes and weight loss?
作者信息
Müller Roland, Laimer Markus, Hagenbuch Niels, Laederach Kurt, Stanga Zeno
机构信息
Department of Diabetes, Endocrinology, Clinical Nutrition and Metabolism, University of Bern and University Hospital of Bern, 3010 Bern, Switzerland.
Private statistician, Spiez, Switzerland.
出版信息
J Eat Disord. 2017 May 15;5:14. doi: 10.1186/s40337-017-0144-4. eCollection 2017.
BACKGROUND
According to the current evidence, behavior modifications are an effective part of a non-surgical multiprofessional obesity treatment program (MOTP). The purpose of the present study was to report changes in weight as well in psychological variables during a one year MOTP. We aimed to identify the associations of emotional state and patients' emotion regulation skills with weight change.
METHODS
Prospective interventional study. Data of participants attending the one year obesity treatment in either a group or individual structured MOTP were analyzed. Weight, BMI (Body Mass Index) and measures on psychosomatic variables, emotion regulation skills, affective state, shame and guilt were collected at baseline, after three months and after one year. Mixed-effects models were used for the statistical analysis of BMI.
RESULTS
We included 238 patients at baseline (t1), 234 after three months (t2) and 179 after one year (t3). A drop in BMI measurements of at least 5% was observed in 20.6% of participants at t2 and 41.4% of participants at t3. After three months, participants showed significant improvements in the following psychosomatic variables: somatisation ( < 0.001), interpersonal sensitivity ( < 0.001), emotion regulation skills ( < 0.01), and attention to emotions ( < 0.05). Most of the improvements could be maintained after one year. BMI reduction was associated with a positive change in emotions, improvements in emotion regulation skills, and a reduction of depressive symptoms, disgust and shame.
CONCLUSIONS
The results indicate that the assessment and treatment of psychological aspects like depression, emotion regulation skills, body awareness, and acceptance should be a vital part of an interdisciplinary MOPT.
TRIAL REGISTRATION
Ethical approval for the present study was obtained from the Bern Kantonal Ethics Committee (KEK-Bern-Study Nr 258/14), Bern, Switzerland.
背景
根据目前的证据，行为改变是非手术多专业肥胖治疗方案（MOTP）的有效组成部分。本研究的目的是报告在为期一年的MOTP期间体重以及心理变量的变化。我们旨在确定情绪状态和患者情绪调节技能与体重变化之间的关联。
方法
前瞻性干预研究。分析了参加为期一年的团体或个体结构化MOTP肥胖治疗的参与者的数据。在基线、三个月后和一年后收集体重、体重指数（BMI）以及心身变量、情绪调节技能、情感状态、羞耻感和内疚感的测量数据。使用混合效应模型对BMI进行统计分析。
结果
我们纳入了238名基线时（t1）的患者，三个月后（t2）为234名，一年后（t3）为179名。在t2时，20.6%的参与者和t3时41.4%的参与者的BMI测量值下降了至少5%。三个月后，参与者在心身变量方面有显著改善：躯体化（<0.001）、人际敏感性（<0.001）、情绪调节技能（<0.01）和对情绪的关注（<0.05）。大多数改善在一年后得以维持。BMI降低与情绪的积极变化、情绪调节技能的改善以及抑郁症状、厌恶和羞耻感的减轻有关。
结论
结果表明，对抑郁、情绪调节技能、身体意识和接纳等心理方面的评估和治疗应成为跨学科MOPT的重要组成部分。
试验注册
本研究已获得瑞士伯尔尼州伦理委员会（KEK - Bern - 研究编号258/14）的伦理批准。
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