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前瞻性体重评估:一项由营养师和心理学家在国民保健服务体系专业体重管理服务中开展的团体干预措施。

Evaluation of Weigh Forward: A group intervention delivered by dietitians and psychologists within a National Health Service specialist weight management service.

作者信息

Moffat Helen, Campbell Fiona, Donald Claire, Insch Pauline, Little Sophie, Logan Susan, McCallum Mary

机构信息

Adult Weight Management Services, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, UK.

出版信息

Clin Obes. 2019 Apr;9(2):e12291. doi: 10.1111/cob.12291. Epub 2018 Dec 27.

Abstract

There is limited evidence of the effectiveness of non-surgical interventions for severe obesity. Our aim was to evaluate a group intervention delivered by a National Health Service (NHS) specialist weight management service to contribute to the evidence base and inform the development of future services. Participants in this prospective cohort study were patients attending NHS Grampian Specialist Weight Management Services. The intervention was an interactive 12-session group programme based on evidence-based psychological model, with combined dietetic and psychological knowledge and support provided. The primary outcome was mean weight change at the end of the intervention and for 12-mo follow-up (including programme completers, baseline observation carried forward [BOCF], last observation carried forward). Secondary outcome measures included mood, anxiety, binge eating and quality of life. A total of 166 patients accepted a place on the group programme, mean body mass index was 48.9 kg/m . Mean weight loss at 6 mo was 5.6 kg and 35.2% of those who completed the group (n = 88) lost ≥5%. Using BOCF, 18.7% lost ≥5% at 6 mo. Those who remained in the programme maintained their weight loss 12 and 18 mo after the start of the intervention. Significant improvements were also found in psychological variables, including reduced depression, anxiety, binge eating and improved emotion regulation. This real-world evaluation of an NHS intervention for patients with severe obesity suggests that individuals who engage achieve a moderate weight loss, which most maintain a year later, although further research is needed to strengthen this conclusion.

摘要

关于非手术干预对重度肥胖有效性的证据有限。我们的目的是评估由英国国家医疗服务体系(NHS)专科体重管理服务提供的小组干预措施,以充实证据基础并为未来服务的发展提供信息。这项前瞻性队列研究的参与者是就诊于NHS格兰扁专科体重管理服务的患者。干预措施是一个基于循证心理模型的12节互动式小组项目,提供了饮食和心理方面的综合知识及支持。主要结局是干预结束时以及12个月随访期(包括项目完成者、结转基线观察值[BOCF]、末次观察值结转)时的平均体重变化。次要结局指标包括情绪、焦虑、暴饮暴食和生活质量。共有166名患者接受了该小组项目,平均体重指数为48.9kg/m²。6个月时的平均体重减轻了5.6kg,完成小组项目的患者中(n = 88)有35.2%体重减轻≥5%。采用BOCF方法,6个月时有18.7%的患者体重减轻≥5%。继续参与项目的患者在干预开始后12个月和18个月保持了体重减轻。心理变量也有显著改善,包括抑郁、焦虑、暴饮暴食减轻以及情绪调节能力提高。这项对NHS针对重度肥胖患者干预措施的实际评估表明,参与项目的个体实现了适度的体重减轻,大多数人在一年后仍能保持,不过还需要进一步研究来强化这一结论。

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