Vermeiren Eline, Naets Tiffany, Van Eyck Annelies, Vervoort Leentje, Ysebaert Marijke, Baeck Nele, De Guchtenaere Ann, Van Helvoirt Maria, Tanghe Ann, Bruyndonckx Luc, De Winter Benedicte Y, Verhulst Stijn L, Van Hoorenbeeck Kim, Braet Caroline
Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium.
Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium.
Front Pediatr. 2021 Dec 23;9:794256. doi: 10.3389/fped.2021.794256. eCollection 2021.
Currently available treatment programs for children with obesity only have modest long-term results, which is (at least partially) due to the poorer self-control observed within this population. The present trial aimed to determine whether an online self-control training, training inhibition, and redirecting attentional bias, can improve the short- and long-term treatment outcome of (in- or outpatient) child obesity treatment programs. In this double-blind multi-center randomized controlled trial (RCT), participants aged 8-18 years with obesity were allocated in a 1:1 ratio to receive an online self-control or sham training added to their in- or outpatient multidisciplinary obesity treatment (MOT) program. The primary endpoint was BMI SDS. Data were analyzed by linear mixed models and the main interactions of interest were randomization by time and randomization by number of sessions, as the latter was cumulatively expressed and therefore represents the effect of increasing dose over time. One hundred forty-four inpatient (mean age 14.3 ± 2.2 years, BMI 2.7 ± 0.4 SDS, 42% male) and 115 outpatient children (mean age 11.9 ± 2.1 years, BMI 2.4 ± 0.4 SDS, 45% male) were included. Children's BMI lowered significantly during treatment in both the in- and outpatient treatment centers, < 0.001. In a mixed model with BMI as dependent variable, randomization by time was non-significant, but the number of self-control trainings (randomization number of sessions) interacted significantly with setting and with age ( = 0.002 and = 0.047), indicating a potential effect in younger inpatient residents. Indeed, a subgroup analysis on 22 inpatient children of 8-12 years found a benefit of the number of self-control trainings on BMI ( = 0.026). The present trial found no benefit of the self-control training in the entire study population, however a subgroup of young, inpatient participants potentially benefited.
目前针对肥胖儿童的治疗方案长期效果有限，（至少部分原因）是该人群自我控制能力较差。本试验旨在确定在线自我控制训练、抑制训练和注意力偏差重新定向训练是否能改善（住院或门诊）儿童肥胖治疗方案的短期和长期治疗效果。在这项双盲多中心随机对照试验（RCT）中，8至18岁的肥胖参与者按1:1的比例分配，在其住院或门诊多学科肥胖治疗（MOT）方案基础上，接受在线自我控制训练或假训练。主要终点是BMI SDS。数据采用线性混合模型进行分析，主要的感兴趣交互作用是按时间随机分组和按训练次数随机分组，因为后者是累积表达的，因此代表了随着时间推移剂量增加的效果。纳入了144名住院儿童（平均年龄14.3±2.2岁，BMI 2.7±0.4 SDS，42%为男性）和115名门诊儿童（平均年龄11.9±2.1岁，BMI 2.4±0.4 SDS，45%为男性）。在住院和门诊治疗中心，治疗期间儿童的BMI均显著降低（<0.001）。在以BMI为因变量的混合模型中，按时间随机分组无显著意义，但自我控制训练次数（按训练次数随机分组）与治疗环境和年龄有显著交互作用（=0.002和=0.047），表明对年轻住院患者可能有效果。事实上，对22名8至12岁住院儿童的亚组分析发现，自我控制训练次数对BMI有有益影响（=0.026）。本试验在整个研究人群中未发现自我控制训练的益处，然而，一组年轻的住院参与者可能从中受益。
