Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
Ann Behav Med. 2021 Jun 28;55(7):698-704. doi: 10.1093/abm/kaaa076.
Concurrent general psychopathology (GP) and eating disorder psychopathology (EDP) are commonly reported among youth with overweight/obesity and may impact weight change.
We identified patterns of GP and EDP in children with overweight/obesity and examined the impact on weight change following family-based behavioral obesity treatment (FBT) and maintenance interventions.
Children (N = 172) participated in 4 month FBT and subsequent 8 month weight maintenance interventions. GP and EDP were assessed prior to FBT (baseline). Child percentage overweight was assessed at baseline, post-FBT (4 months), and post-maintenance (12 months). Latent profile analysis identified patterns of baseline GP and EDP. Linear mixed-effects models examined if profiles predicted 4- and 12-month change in percentage overweight and if there were two-way and three-way interactions among these variables, adjusting for relevant covariates.
Results indicated a three-profile structure: lower GP and EDP (LOWER); subclinically elevated GP and EDP without loss of control (LOC; HIGHER); and subclinically elevated GP and EDP with LOC (HIGHER + LOC). Across profiles, children on average achieved clinically meaningful weight loss (i.e., ≥9 unit change in percentage overweight) from baseline to 4 month FBT and sustained these improvements at 12 month maintenance. There was no evidence that latent profiles were related to percentage overweight change from baseline to FBT (p > .05) or baseline to maintenance (p > .05). There was no evidence for two-way or three-way interactions (p > .05).
Concurrent GP and EDP do not portend differential short- or long-term weight change following FBT and maintenance. Future research is warranted on the durability of weight change among youth with GP and EDP.
NCT00759746.
超重/肥胖青少年常同时存在一般精神病理学（GP）和饮食障碍精神病理学（EDP），这可能会影响体重变化。
我们在超重/肥胖儿童中确定了 GP 和 EDP 的模式，并研究了家庭为基础的行为肥胖治疗（FBT）和维持干预后对体重变化的影响。
共有 172 名儿童参与了为期 4 个月的 FBT 和随后 8 个月的体重维持干预。在 FBT 之前（基线）评估了 GP 和 EDP。在基线、FBT 后（4 个月）和维持后（12 个月）评估儿童超重百分比。潜在剖面分析确定了基线 GP 和 EDP 的模式。线性混合效应模型检查了这些模式是否预测了 4 个月和 12 个月时超重百分比的变化，以及这些变量之间是否存在双向和三向相互作用，并对相关协变量进行了调整。
结果表明存在三种模式结构：较低的 GP 和 EDP（较低）；轻度升高的 GP 和 EDP 但没有失控（LOC；较高）；轻度升高的 GP 和 EDP 伴有失控（HIGHER + LOC）。在所有模式中，儿童平均从基线到 4 个月的 FBT 时实现了临床显著的体重减轻（即超重百分比变化≥9 个单位），并在 12 个月的维持阶段保持了这些改善。没有证据表明潜在模式与从基线到 FBT（p>.05）或基线到维持（p>.05）的体重百分比变化有关。没有证据表明存在双向或三向相互作用（p>.05）。
FBT 和维持治疗后，同时存在 GP 和 EDP 并不预示着短期或长期体重变化的差异。需要对 GP 和 EDP 青少年的体重变化的持久性进行进一步研究。
NCT00759746。
