Gowey Marissa A, Neumeier William H, Henry Samantha, Wadley Virginia G, Phillips Janice, Hayden Kathleen M, Espeland Mark A, Coday Mace, Lewis Cora E, Dutton Gareth R
University of Alabama at Birmingham Birmingham Alabama USA.
U.S. Army Research Institute of Environmental Medicine Natick Massachusetts USA.
Obes Sci Pract. 2020 Oct 16;7(1):25-34. doi: 10.1002/osp4.458. eCollection 2021 Feb.
Executive function (EF) is associated with obesity development and self-management. Individuals who demonstrate or self-report poorer EF performance tend to have poorer short-term outcomes in obesity treatment. There may be distinct behavioral self-management strategies and EF domains related to initial weight loss as compared to weight loss maintenance.
To characterize EF in individuals who achieved clinically significant weight loss via behavioral intervention and examine potential differences in EF between those who maintained versus regained lost weight.
Participants who previously achieved ≥5% weight loss via lifestyle intervention were included ( = 44). "Maintainers" ( = 16) maintained this minimum level of weight loss for ≥1 year. "Regainers" ( = 28) regained some or all initially lost weight. Performance-based EF, intelligence quotient, health literacy, depression, anxiety, binge eating, demographics, and medical/weight history were assessed using a cross-sectional design. Descriptive statistics and age-, gender-, education-adjusted reference ranges were used to characterize EF. Analyses of covariance were conducted to examine EF differences between maintainers and regainers.
The sample consisted primarily of females with obesity over age 50. Approximately half self-identified as African-American. Decision-making performance was better in maintainers than regainers ( = 0.003, η = 0.19). There were no differences between maintainers and regainers in inhibitory control, verbal fluency, planning/organization, cognitive flexibility, or working memory (s > 0.05, ηs = 0.003-0.07). At least 75% of the sample demonstrated average-above average EF test performance, indicated by scaled scores ≥13 or t-scores > 60.
Most individuals with obesity who achieved clinically significant weight loss via behavioral intervention had average to above average EF. Individuals who maintained (vs. regained) their lost weight performed better on tests of decision-making.
执行功能（EF）与肥胖的发展及自我管理相关。表现出或自我报告执行功能较差的个体在肥胖治疗中的短期效果往往较差。与体重维持相比，在初始体重减轻方面可能存在不同的行为自我管理策略和执行功能领域。
描述通过行为干预实现临床显著体重减轻的个体的执行功能，并检查体重维持者与体重反弹者之间执行功能的潜在差异。
纳入先前通过生活方式干预实现体重减轻≥5%的参与者（n = 44）。“维持者”（n = 16）将这一最低体重减轻水平维持≥1年。“反弹者”（n = 28）重新增加了部分或全部最初减轻的体重。采用横断面设计评估基于表现的执行功能、智商、健康素养、抑郁、焦虑、暴饮暴食、人口统计学以及医疗/体重史。使用描述性统计和年龄、性别、教育程度调整后的参考范围来描述执行功能。进行协方差分析以检查维持者和反弹者之间的执行功能差异。
样本主要由50岁以上患有肥胖症的女性组成。约一半人自我认定为非裔美国人。维持者的决策表现优于反弹者（p = 0.003，η = 0.19）。在抑制控制、言语流畅性、计划/组织、认知灵活性或工作记忆方面，维持者和反弹者之间没有差异（p > 0.05，ηp = 0.003 - 0.07）。至少75%的样本在执行功能测试中的表现达到平均水平以上，量表分数≥13或T分数> 60表明了这一点。
大多数通过行为干预实现临床显著体重减轻的肥胖个体的执行功能处于平均水平或以上。体重维持（与反弹）的个体在决策测试中的表现更好。
