童年期虐待与行为性减肥结果的关联：考察 binge eating 严重程度的中介效应。
Association of childhood abuse with behavioral weight-loss outcomes: Examining the mediating effect of binge eating severity.
机构信息
Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth Campus, Duluth, Minnesota, USA.
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
出版信息
Obesity (Silver Spring). 2022 Jan;30(1):96-105. doi: 10.1002/oby.23320.
OBJECTIVE
The study aims were to (1) document the relationship between a history of childhood abuse and weight change during behavioral obesity treatment and (2) estimate the indirect effect of childhood abuse on weight change through binge eating severity.
METHODS
Participants (n = 431) were enrolled in a behavioral weight-loss intervention. Childhood physical and emotional abuse history and current binge eating severity were self-reported. Percent weight loss at 6 months was calculated using measured weight. Adjusted mediation models examined whether there was an indirect effect of childhood physical and emotional abuse on 6-month percent weight loss that operated through binge eating severity.
RESULTS
After covariate adjustment, childhood physical abuse, but not emotional abuse, predicted a lower percent weight loss (B = -1.78%; 95% CI: -3.10% to -0.47%). Although childhood physical and emotional abuse were positively related to baseline binge eating severity, binge eating severity did not mediate the associations between either childhood abuse type and percent weight loss.
CONCLUSIONS
Individuals with a childhood physical abuse history had a lower percent weight loss than those without such histories during behavioral obesity treatment. This effect was not explained by binge eating severity. Individuals with a history of childhood abuse may benefit from trauma-informed obesity care.
目的
本研究旨在：(1)记录儿童期虐待史与行为肥胖治疗期间体重变化之间的关系；(2)通过暴食严重程度来估计儿童期虐待对体重变化的间接影响。
方法
共纳入 431 名参与者，参加一项行为减肥干预。儿童期身体和情感虐待史以及当前暴食严重程度均采用自我报告的方式进行评估。采用测量体重计算 6 个月时的体重减轻百分比。调整后的中介模型检验了儿童期身体和情感虐待对 6 个月体重减轻百分比的间接影响是否通过暴食严重程度起作用。
结果
经过协变量调整，儿童期身体虐待而非情感虐待预测体重减轻百分比较低（B = -1.78%；95%CI：-3.10%至-0.47%）。虽然儿童期身体和情感虐待与基线暴食严重程度呈正相关，但暴食严重程度不能中介任何一种儿童期虐待类型与体重减轻百分比之间的关联。
结论
在行为肥胖治疗期间，有儿童期身体虐待史的个体体重减轻百分比低于无此类病史的个体。这种影响不能用暴食严重程度来解释。有儿童期虐待史的个体可能会受益于基于创伤的肥胖护理。
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