Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA.
Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA.
Ann Behav Med. 2023 Feb 4;57(2):146-154. doi: 10.1093/abm/kaac028.
Physical activity (PA) may promote long-term weight loss, but facilitating high levels of PA in behavioral weight loss programs is challenging.
This study reports the 36-month follow-up of a behavioral weight loss trial that tested the efficacy of increasing the emphasis on PA during treatment and using traditional or acceptance-based therapy (ABT) for this purpose. We also examined the extent to which long-term weight loss differed by PA pattern and tested if individual differences in eating behavior moderated this relationship.
Participants (N = 320) were randomized to (1) standard behavioral weight loss treatment (BT), (2) BT with a focus on PA, or (3) ABT with a focus on PA. Weight loss and PA were measured at 24- and 36-month follow-up.
There were no differences between conditions in weight loss or PA at 24 or 36 months. Participants consistently engaging in high PA experienced the greatest weight losses. The positive impact of PA on weight loss was more pronounced among those with low emotional eating and those who believed that exercise did not affect their appetite.
Findings emphasize the difficulty of improving long-term PA among adults with overweight/obesity beyond what standard behavioral weight loss treatment achieves. This study highlights the need to develop new PA treatment strategies, and suggests that ABT for weight loss may be more effective when applied to eating behavior versus PA. Results also demonstrate the importance of addressing problematic eating behavior and cognitions to fully realize the benefits of PA for weight loss.
ClinicalTrials.gov identifier: NCT02363010.
身体活动（PA）可能促进长期体重减轻，但在行为体重管理计划中促进高水平的 PA 是具有挑战性的。
本研究报告了一项行为体重管理试验的 36 个月随访结果，该试验测试了在治疗过程中强调 PA 以及为此目的使用传统或基于接受的治疗（ABT）的功效。我们还检查了长期体重减轻与 PA 模式的差异程度，并测试了个体饮食行为差异是否会调节这种关系。
参与者（N=320）被随机分配到（1）标准行为体重管理治疗（BT）、（2）BT 加 PA 重点，或（3）ABT 加 PA 重点。在 24 个月和 36 个月的随访中测量体重减轻和 PA。
在 24 个月和 36 个月时，各组之间的体重减轻或 PA 均无差异。持续进行高 PA 的参与者体重减轻最多。PA 对体重减轻的积极影响在情绪性进食较低和认为运动不会影响食欲的参与者中更为明显。
研究结果强调了在超重/肥胖成年人中，除了标准行为体重管理治疗所达到的效果之外，提高长期 PA 的难度。本研究强调了需要开发新的 PA 治疗策略，并表明，ABT 用于减肥可能更有效，当应用于饮食行为而非 PA 时。研究结果还表明，解决有问题的饮食行为和认知对于充分实现 PA 对体重减轻的益处至关重要。
ClinicalTrials.gov 标识符：NCT02363010。
