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在体重维持期间促进身体活动:一项随机对照试验。

Promotion of physical activity during weight loss maintenance: A randomized controlled trial.

机构信息

Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University.

Center for WorkLife Wellbeing, ChristianaCare.

出版信息

Health Psychol. 2021 Mar;40(3):178-187. doi: 10.1037/hea0001043.

Abstract

OBJECTIVE

Behavioral weight loss (BWL) programs are not sufficiently effective at promoting high levels of moderate-to-vigorous physical activity (MVPA), despite the clear health benefits of exercise and the possibility that high levels of MVPA may improve long-term weight loss. This three-arm randomized controlled trial tested the hypotheses that 1) BWL interventions with an intensive focus on exercise would result in higher amounts of MVPA and greater long-term weight loss, compared to standard BWL, and 2) among interventions with an intensive focus on exercise, outcomes would be superior when skills for exercise promotion were taught from an acceptance-based theoretical framework (which fosters willingness to accept discomfort in the service of valued behaviors), versus a traditional behavioral approach.

METHOD

Three hundred and twenty adults with overweight/obesity received group-based BWL for induction of weight loss (Months 1-6) and were randomized to receive one of three interventions for weight loss maintenance (Months 7-18): continued standard behavioral treatment (BT), behavioral treatment with an emphasis on exercise (BT + PA), or acceptance-based treatment with an emphasis on exercise (ABT + PA).

RESULTS

MVPA and percent weight loss did not significantly differ by condition at 12 or 18 months. Participants engaging in relatively higher levels of MVPA had greater long-term weight losses compared to participants engaging in lower levels of MVPA.

CONCLUSIONS

Further clinical innovations are needed so that participants in BWL programs can more readily adopt and maintain the recommended amounts of MVPA. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

摘要

目的

尽管运动对健康有明显的益处,而且高水平的中高强度体力活动(MVPA)可能会改善长期的减肥效果,但行为减肥(BWL)计划在促进高水平的 MVPA 方面效果并不理想。本三项随机对照试验检验了以下两个假设:1)与标准 BWL 相比,重点强调锻炼的 BWL 干预措施会导致更高水平的 MVPA 和更大程度的长期减肥效果;2)在强调锻炼的干预措施中,当从基于接受的理论框架(促进对行为的意愿)教授促进锻炼的技能时,与传统行为方法相比,结果会更优。

方法

320 名超重/肥胖成年人接受了基于小组的 BWL 来诱导减肥(第 1 至 6 个月),并随机分为三组接受减肥维持干预(第 7 至 18 个月):继续接受标准行为治疗(BT)、强调锻炼的行为治疗(BT + PA)或强调锻炼的基于接受的治疗(ABT + PA)。

结果

在 12 个月和 18 个月时,MVPA 和体重减轻百分比在不同条件下没有显著差异。与 MVPA 水平较低的参与者相比,进行相对较高水平 MVPA 的参与者具有更大的长期体重减轻效果。

结论

需要进一步的临床创新,以便 BWL 计划的参与者能够更容易地采用和维持推荐的 MVPA 量。

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The Physical Activity Guidelines for Americans.美国人体育活动指南。
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Precision medicine: diagnosis and management of obesity.精准医学:肥胖症的诊断与管理
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