Hoerr S L, Nelson R A, Essex-Sorlie D
Department of Food Science and Human Nutrition, Michigan State University, East Lansing 48824-1224.
J Adolesc Health Care. 1988 Jan;9(1):28-37. doi: 10.1016/0197-0070(88)90015-0.
An intervention program was conducted for 12 postmenarche, 12-15-year-old obese girls. Weight Winners, a multicomponent and multidisciplinary after-school intervention program, was developed in which behavior modification, aerobic exercise, and modeling appropriate behaviors for weight control were emphasized. Evaluation made before and immediately after the intervention and at a nine-month follow-up suggested that the after-school treatment program was successful in: 1) reducing the rate of gain and decreasing body weight by 11% while maintaining lean tissue and resting energy expenditure (REE), and 2) improving eating and exercise behaviors. Significant changes in eating behaviors (p less than 0.05) were: more low-calorie, nutritionally dense foods were consumed; the frequency and amount eaten decreased; and the speed of eating slowed. Implementing a fee contingent on attendance and on record keeping appeared to reduce attrition. Subjects cited the Weight Winners program, aerobic exercise, changes in eating behaviors, group and family support, and encouragement and praise from the group leaders as important contributions to their success in weight control. Barriers to change were reported by participants as boredom, hunger, lack of family and peer support, and having food in sight. An increase in lean tissue was associated with both improved self-esteem (p less than 0.05) and improved self-control (p less than 0.05). Subjects who had been obese the longest were the most responsive to hunger cues (p less than 0.05).
针对12名月经初潮后、年龄在12至15岁的肥胖女孩开展了一项干预计划。“体重赢家”是一个多方面、多学科的课后干预计划，该计划强调行为矫正、有氧运动以及为体重控制树立恰当行为榜样。在干预前、干预刚结束时以及九个月随访时进行的评估表明，课后治疗计划在以下方面取得了成功：1）降低体重增加率，使体重减轻11%，同时保持瘦体重和静息能量消耗（REE），以及2）改善饮食和运动行为。饮食行为的显著变化（p<0.05）包括：摄入更多低热量、营养丰富的食物；进食频率和量减少；进食速度减慢。实行基于出勤和记录情况的收费似乎降低了人员流失率。受试者提到“体重赢家”计划、有氧运动、饮食行为的改变、团体和家庭支持以及团体领导者的鼓励和赞扬是他们在体重控制方面取得成功的重要因素。参与者报告的改变障碍包括无聊、饥饿、缺乏家庭和同伴支持以及眼前有食物。瘦体重增加与自尊的改善（p<0.05）和自我控制的改善（p<0.05）均相关。肥胖时间最长的受试者对饥饿线索反应最强烈（p<0.05）。
