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在儿童肥胖慢性护理治疗项目中,紊乱的饮食行为不会影响治疗反应。

Disturbed eating behaviours do not impact treatment response in a paediatric obesity chronic care treatment programme.

作者信息

Fogh Mette, Lund Morten A V, Mollerup Pernille M, Johansen Mia Ø, Melskens Rikke H, Trier Caecilie, Kloppenborg Julie T, Hansen Torben, Holm Jens-Christian

机构信息

The Children's Obesity Clinic, Department of Paediatrics, Copenhagen University Hospital Holbaek, Holbaek, Denmark.

Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.

出版信息

J Paediatr Child Health. 2020 Apr;56(4):542-549. doi: 10.1111/jpc.14678. Epub 2019 Nov 6.

Abstract

AIM

This study investigates the prevalence of disturbed eating behaviours in children and adolescents initiating obesity treatment, and how the prevalence varies with age, sex and body mass index (BMI) standard deviation score (SDS). Secondly, it examines whether the presence of disturbed eating behaviours at enrolment is associated with the degree of weight loss after 12 months of treatment.

METHODS

A total of 3621 patients aged 3-18 years enrolled in a multidisciplinary obesity treatment programme were studied. Follow-up data after a median of 12.4 months were available for 2055 patients. Upon entry, patients were assessed for the following disturbed eating behaviours: meal skipping, emotional eating, overeating and rapid eating. Height and weight were measured at baseline and follow-up.

RESULTS

At enrolment, median age was 11.4 years, median BMI SDS was 2.87, and 82.2% of patients exhibited one or more disturbed eating behaviours. The prevalence of meal skipping, emotional eating and rapid eating increased with age (P < 0.01). Patients who reported overeating or rapid eating exhibited a 0.06-0.11 higher BMI SDS at enrolment than patients without these disturbed eating behaviours (P < 0.02). After 1 year of treatment, BMI SDS was reduced in 75.7% of patients, and the median reduction was 0.24 (95% confidence interval: 0.22-0.27). Overeating was associated with a higher degree of weight loss, while meal skipping, emotional eating and rapid eating did not associate with the degree of weight loss at follow-up.

CONCLUSIONS

Disturbed eating behaviours were highly prevalent in children and adolescents with overweight or obesity, and varied with age and sex. After 1 year of treatment, the degree of obesity improved, regardless of the presence of disturbed eating behaviours at treatment initiation.

摘要

目的

本研究调查开始接受肥胖治疗的儿童和青少年中饮食行为紊乱的患病率,以及该患病率如何随年龄、性别和体重指数(BMI)标准差评分(SDS)而变化。其次,研究入组时饮食行为紊乱的存在是否与治疗12个月后的体重减轻程度相关。

方法

对3621名年龄在3至18岁、参加多学科肥胖治疗项目的患者进行了研究。2055名患者有中位数为12.4个月的随访数据。入组时,对患者进行以下饮食行为紊乱评估:不规律进食、情绪化进食、暴饮暴食和进食过快。在基线和随访时测量身高和体重。

结果

入组时,中位年龄为11.4岁,中位BMI SDS为2.87,82.2%的患者表现出一种或多种饮食行为紊乱。不规律进食、情绪化进食和进食过快的患病率随年龄增加(P<0.01)。报告有暴饮暴食或进食过快的患者在入组时的BMI SDS比没有这些饮食行为紊乱的患者高0.06-0.11(P<0.02)。治疗1年后,75.7%的患者BMI SDS降低,中位降低值为0.24(95%置信区间:0.22-0.27)。暴饮暴食与更高程度的体重减轻相关,而不规律进食、情绪化进食和进食过快与随访时的体重减轻程度无关。

结论

饮食行为紊乱在超重或肥胖的儿童和青少年中非常普遍,且随年龄和性别而变化。治疗1年后,肥胖程度有所改善,无论治疗开始时是否存在饮食行为紊乱。

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