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适应儿童肥胖的家庭为基础的治疗:一项随机对照试验。

Adapting family-based treatment for paediatric obesity: A randomized controlled pilot trial.

机构信息

Fairleigh Dickinson University, Teaneck, NJ.

University of California, San Francisco, San Francisco, CA.

出版信息

Eur Eat Disord Rev. 2019 Sep;27(5):521-530. doi: 10.1002/erv.2699. Epub 2019 Jul 25.

DOI:10.1002/erv.2699
PMID:31344751
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7106938/
Abstract

OBJECTIVE

This pilot study aimed to refine and test an adaption of family-based treatment (FBT) for eating disorders that addressed the distinct clinical needs of adolescents with overweight or obesity in the absence of eating disorder pathology. Our hypothesis was that FBT for paediatric obesity (FBT-PO) would be feasible to implement and superior to a nutrition education counselling (NEC) condition delivered to both parents and patients, thereby controlling for key information dissemination across groups while manipulating active therapeutic content and strategy.

METHOD

Seventy-seven adolescents were randomized to FBT-PO or NEC across two sites.

RESULTS

Results supported our core prediction, in that weight status among adolescent study participants receiving FBT-PO remained stable while increasing among participants randomized to NEC. Attrition was high in both conditions.

CONCLUSIONS

FBT-PO, while not seeming to yield a marked decrease in body mass index z-score, may arrest an otherwise-occurring weight-gain trajectory for these adolescents. This efficacy finding is consistent with the overall PO literature supporting parental involvement in the treatment of PO. Future research efforts should address retention in FBT-PO.

摘要

目的

本试点研究旨在改进并测试一种针对超重或肥胖青少年的基于家庭的治疗(FBT)适应方法,该方法针对青少年的独特临床需求,而无需治疗饮食失调症。我们的假设是,针对儿科肥胖症的 FBT(FBT-PO)在实施方面是可行的,并且优于向父母和患者提供的营养教育咨询(NEC)条件,从而控制了跨组关键信息的传播,同时操纵了积极的治疗内容和策略。

方法

在两个地点,将 77 名青少年随机分配到 FBT-PO 或 NEC 组。

结果

结果支持了我们的核心预测,即接受 FBT-PO 的青少年研究参与者的体重状况保持稳定,而随机分配到 NEC 的参与者的体重则增加。两种情况下的辍学率都很高。

结论

虽然 FBT-PO 似乎没有明显降低体重指数 z 分数,但可能会阻止这些青少年出现体重增加的轨迹。这一疗效发现与支持父母参与治疗肥胖症的总体 PO 文献一致。未来的研究应致力于解决 FBT-PO 的保留问题。

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Family-Based Treatment for Pediatric Obesity: Case Study of an Adaptation for a Non-Psychiatric Adolescent Population.基于家庭的儿童肥胖治疗:针对非精神科青少年人群的适应性案例研究。
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Obesogenic environments: current evidence of the built and food environments.致胖环境:建筑环境与食物环境的当前证据
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Parenting styles and body mass index: a systematic review of prospective studies among children.
青少年肥胖干预中的家长参与方法与饮食病理学变化
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Relationship between the home environment and fruit and vegetable consumption in children aged 6-12 years: a systematic review.6至12岁儿童的家庭环境与水果和蔬菜消费之间的关系:一项系统综述
Public Health Nutr. 2017 Feb;20(3):464-480. doi: 10.1017/S1368980016002883. Epub 2016 Nov 21.
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Trends in Obesity Prevalence Among Children and Adolescents in the United States, 1988-1994 Through 2013-2014.1988 - 1994年至2013 - 2014年美国儿童和青少年肥胖患病率趋势
JAMA. 2016 Jun 7;315(21):2292-9. doi: 10.1001/jama.2016.6361.
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Associations between parent-child relationship quality and obesogenic risk in adolescence: a systematic review of recent literature.亲子关系质量与青少年致胖风险之间的关联:近期文献的系统综述
Obes Rev. 2016 Jul;17(7):612-22. doi: 10.1111/obr.12413. Epub 2016 Apr 29.
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Body-Mass Index in 2.3 Million Adolescents and Cardiovascular Death in Adulthood.230 万青少年的体重指数与成年人心血管死亡。
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