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基于家庭的行为治疗在肥胖青少年中的应用:从青春期到成年期的演变。

Family based behavioral treatment in adolescents suffering from obesity: evolution through adulthood.

机构信息

Health and Movement Consultation, Division of Pediatric Specialties, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.

Adolescent Health Unit, Division of General Pediatrics, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.

出版信息

BMC Pediatr. 2024 Jan 10;24(1):33. doi: 10.1186/s12887-023-04497-x.

Abstract

BACKGROUND

Family Based Behavioral Treatments (FBBT) are reported to have a favorable impact on the short and mid-term evolution on the body mass index (BMI) of adolescents suffering from obesity. This study investigated the long-term BMI z-score evolution, as well as variables associated with favorable or unfavorable evolution in adolescents who beneficiated from FBBT group therapy treatment for obesity.

METHODS

This was a prospective study including adolescents who participated in FBBT group therapy for obesity sessions (n = 131). All adolescents were invited for a study's clinical interview 4 years after the therapy, during which their weight and height were measured, and they answered a questionnaire on some life habits. Anthropometric measurements at the time of therapy as well as socio-demographic data were retrospectively extracted from the electronic medical record.

RESULTS

Seventy-six subjects (57% of the sample) accepted to participate in the study. At the study's clinical interview (mean 5.5 years after FBBT), 52.6% of the adolescents showed a favorable evolution of their weight status defined as a decrease (>-0.2) or stabilization (between - 0.2 and + 0.2) of their BMI z-score. 32% were engaged in a daily physical activity and 40.6% monitored their weight at least once a week or more. Only these 2 variables were associated with a favorable evolution (p = 0.009 and p = 0.001, respectively). Less than half of the sample (45.9%) have maintained a medical weight-management follow up, of which 67% had a BMI equal or more than 30.

CONCLUSIONS

Long-term evolution of the BMI z-score was favorable for most of the adolescents, emphasizing the potential benefits of FBBT treatment on the long term for adolescents suffering from obesity. This study highlighted the difficulty for long-term weight management follow up in this population at risk of numerous medical comorbidities, confirming the need to improve adherence to weight management treatment at this age of transition of care. Prospective observational study registered.

摘要

背景

家庭为基础的行为治疗(FBBT)被报道对肥胖青少年的体重指数(BMI)的短期和中期演变有积极影响。本研究调查了接受肥胖 FBBT 团体治疗的青少年的 BMI z 分数的长期演变,以及与 FBBT 团体治疗获益的青少年的有利或不利演变相关的变量。

方法

这是一项前瞻性研究,纳入了参加肥胖 FBBT 团体治疗的青少年(n=131)。所有青少年在治疗后 4 年都被邀请参加研究的临床访谈,在此期间测量他们的体重和身高,并回答有关生活习惯的问卷。治疗时的人体测量数据以及社会人口统计学数据从电子病历中回顾性提取。

结果

76 名受试者(样本的 57%)接受了研究。在研究的临床访谈(FBBT 后平均 5.5 年)时,52.6%的青少年体重状况有了有利的演变,定义为 BMI z 分数下降(>-0.2)或稳定(在-0.2 和+0.2 之间)。32%的青少年每天进行体育活动,40.6%的青少年每周至少监测一次体重或更频繁。只有这两个变量与有利的演变相关(p=0.009 和 p=0.001)。样本中不到一半(45.9%)的人保持了医学体重管理的随访,其中 67%的人 BMI 等于或大于 30。

结论

大多数青少年的 BMI z 分数长期演变良好,强调了 FBBT 治疗对肥胖青少年长期治疗的潜在益处。本研究强调了在这个有多种合并症风险的人群中,长期体重管理随访的困难,证实了需要在这个照顾过渡的年龄提高对体重管理治疗的依从性。前瞻性观察研究注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ee0/10777574/7ba0201ca124/12887_2023_4497_Fig1_HTML.jpg

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