Sasdelli Anna Simona, Petroni Maria Letizia, Delli Paoli Anna, Collini Giulia, Calugi Simona, Dalle Grave Riccardo, Marchesini Giulio
Unit of Metabolic Diseases and Clinical Dietetics, "Alma Mater Studiorum" University, S. Orsola-Malpighi Hospital, Via Massarenti, 9, 40138, Bologna, Italy.
Obesity Unit, "Solatrix" Private Hospital, Via Bellini 11, 38068, Rovereto, Italy.
Eat Weight Disord. 2018 Apr;23(2):205-214. doi: 10.1007/s40519-017-0475-9. Epub 2018 Jan 24.
We aimed to determine cognitive drivers, expected to play a role in target reach and/or attrition in obesity programs.
We recorded the expected benefits of weight loss, weight targets, primary motivation for weight loss, perceived treatment needs, readiness and self-confidence to be successful and a battery of psychopathology questionnaires in 793 subjects with obesity (68% women; mean age 48.7; 46% obesity class III) enrolled into a group-based cognitive-behavioral treatment program. Their relevance on attrition and successful weight loss outcome were tested by logistic regression analysis.
The expected benefits of weight loss scored very high in all physical, psychological and social areas, with differences between genders. Attrition rate was 24, 41 and 65% at 6-, 12-, and 24-month follow-up. Average weight loss was 5.8 ± 7.1 kg (- 4.8%) at 6 months, with 17% of cases (32% of continuers) maintaining weight loss > 10% at 24 months. After adjustment for confounders, attrition was reduced by concern for present health, motivation/consciousness of the importance of physical activity and need for support; treatment discontinuation was favored by concern for body image, by expectations for drug treatment or bariatric surgery, and by high-challenging weight loss targets. Male gender, higher BMI and concern for present health predicted weight loss > 10%, whereas concern for body appearance was associated with lower probability of attaining the desired weight loss targets.
A more precise definition of needs and expectations might help tailor treatment to individual patients, but attrition rates and target reach remain difficult to predict.
Level V, descriptive studies.
我们旨在确定认知驱动因素，这些因素预计在肥胖症项目的目标达成和/或损耗方面发挥作用。
我们记录了793名肥胖受试者（68%为女性；平均年龄48.7岁；46%为III级肥胖）的体重减轻预期益处、体重目标、减肥的主要动机、感知到的治疗需求、成功的准备情况和自信心，以及一系列心理病理学问卷。通过逻辑回归分析测试了它们与损耗和成功减肥结果的相关性。
体重减轻的预期益处在所有身体、心理和社会领域得分都很高，且存在性别差异。在6个月、12个月和24个月的随访中，损耗率分别为24%、41%和65%。6个月时平均体重减轻5.8±7.1千克（-4.8%），24个月时17%的病例（32%的持续参与者）体重减轻超过10%。在对混杂因素进行调整后，对当前健康的关注、对体育活动重要性的动机/意识和对支持的需求降低了损耗；对身体形象的关注、对药物治疗或减肥手术的期望以及具有高挑战性的减肥目标则有利于治疗中断。男性、较高的BMI和对当前健康的关注预示着体重减轻超过10%，而对身体外观的关注与达到理想体重减轻目标的可能性较低相关。
对需求和期望进行更精确的定义可能有助于为个体患者量身定制治疗方案，但损耗率和目标达成情况仍然难以预测。
V级，描述性研究。
