Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida.
Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania.
J Consult Clin Psychol. 2023 Jul;91(7):398-410. doi: 10.1037/ccp0000819. Epub 2023 May 8.
To test the long-term effects of a group-based, psychological intervention designed to reduce internalized weight stigma (IWS, i.e., self-stigma), delivered in combination with behavioral weight loss (BWL) treatment, compared to BWL alone.
Adults with obesity who had experienced and IWS ( = 105, = 49 years, 90.5% women, 70.5% White, 24.8% Black, = 38 kg/m²) were randomized to receive BWL with the Weight Bias Internalization and Stigma (BIAS) Program or BWL alone. Participants received weekly group treatment for 20 weeks, followed by 52 weeks of monthly and every-other-month sessions. Percent weight change at Week 72 was the primary outcome, with secondary outcomes of weight change at other time points; physical activity (measured by accelerometry, interview, and self-report); cardiometabolic risk factors; and psychological and behavioral outcomes. Intention-to-treat analyses used linear mixed models to test for between-group differences. Treatment acceptability was assessed.
Participants in the BWL + BIAS versus BWL group lost 2 percentage points more of baseline weight at Week 72, which was not a significant difference (mean weight change = -7.2% vs. -5.2%, 95% CI [-4.6 to 0.6], = 0.14, = 0.18). The BWL + BIAS (vs. BWL) group produced significantly greater improvements in weight self-stigma, eating self-efficacy, and some aspects of quality of life at specific time points. Most outcomes improved significantly over time but did not differ between groups. The trial had high retention and treatment acceptability, with higher ratings in the BWL + BIAS versus BWL group.
No significant differences in weight loss were observed between the BWL + BIAS versus BWL group. Possible benefits of addressing weight stigma in weight management warrant further investigation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
测试基于小组的心理干预的长期效果，该干预旨在减少内化的体重歧视（IWS，即自我污名化），与单独进行行为体重减轻（BWL）治疗相结合，与单独进行 BWL 治疗相比。
经历过 IWS（肥胖成年人，n=105，年龄=49 岁，90.5%为女性，70.5%为白人，24.8%为黑人，BMI=38kg/m²）的参与者被随机分为接受 BWL 和体重偏见内化和耻辱感（BIAS）计划或单独接受 BWL 的两组。参与者每周接受一次小组治疗 20 周，然后每月和每两个月进行 52 周的治疗。第 72 周的体重变化百分比是主要结果，次要结果包括其他时间点的体重变化；身体活动（通过加速度计、访谈和自我报告测量）；心血管代谢风险因素；以及心理和行为结果。意向治疗分析使用线性混合模型来检验组间差异。评估了治疗的可接受性。
与 BWL 组相比，BWL+BIAS 组在第 72 周时基线体重下降了 2 个百分点，但差异无统计学意义（平均体重变化=-7.2%对-5.2%，95%CI[-4.6 到 0.6]，=0.14，=0.18）。BWL+BIAS（与 BWL）组在特定时间点体重自我污名化、饮食自我效能和生活质量的某些方面有显著改善。大多数结果随着时间的推移而显著改善，但两组之间没有差异。该试验的保留率和治疗接受率均较高，BWL+BIAS 组的评分更高。
在 BWL+BIAS 组与 BWL 组之间，体重减轻没有观察到显著差异。在体重管理中解决体重歧视的潜在好处值得进一步研究。（APA，2023 年，所有权利保留）。
