Hamer Oliver, Kuroski Jennifer A, Bray Emma P, Harris Cath, Blundell Amy, Schneider Emma, Watkins Caroline
University of Central Lancashire, Preston, UK
Blackburn with Darwen Borough Council, Blackburn, UK.
BMJ Open. 2024 Dec 2;14(12):e082973. doi: 10.1136/bmjopen-2023-082973.
Overweight and obesity are growing public health problems worldwide. Both diet and physical activity have been the primary interventions for weight reduction over the past decade. With increasing rates of overweight and obesity, it is evident that a primary focus on diet and exercise has not resulted in sustained obesity reduction within the global population. There is now a case to explore other weight management strategies such as psychological therapies. However, there is a dearth of literature that has mapped the types of psychological interventions and the characteristics of these interventions as a means of achieving weight reduction.
The key objectives focused on mapping the types and characteristics of psychological interventions versus usual care for weight reduction and sustained weight reduction in adults with overweight or obesity. The study followed the scoping review methodology by Arksey and O'Malley and was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.
Intervention studies were included if participants were 18 years and over, classified as overweight or obese (body mass index ≥25 kg/m) and had received a psychological therapy intervention. Studies were excluded if they included a comparison with other active lifestyle interventions (unless classified as usual care), were not available in English, were not full-text articles or were non-peer-reviewed articles.
Six electronic databases were searched from inception to April 2023 to identify relevant articles.
The study employed a systematic charting method and narrative synthesis to organise and synthesise the data.
A total of 31 studies met the eligibility criteria and were included in the review. 13 unique psychological interventions for weight reduction in adults with overweight or obesity were identified, with cognitive-behavioural therapy and motivational interviewing being the most common. Eight types of usual care were identified, which largely included education and training on nutrition and physical activity. Gaps in the current research were also identified.
The findings highlighted several gaps within the existing literature, largely due to a lack of evidence relating to adults with low socioeconomic status, non-white participants, individuals under 40 years of age and the integration of digital health technologies.
超重和肥胖是全球日益严重的公共卫生问题。在过去十年中,饮食和体育活动一直是减肥的主要干预措施。随着超重和肥胖率的不断上升,显然仅将重点放在饮食和运动上并未使全球人口的肥胖率持续下降。现在有必要探索其他体重管理策略,如心理治疗。然而,缺乏将心理干预类型及其作为减肥手段的干预特征进行梳理的文献。
主要目标是梳理针对超重或肥胖成年人减肥及维持体重减轻的心理干预类型和特征,并与常规护理进行对比。该研究遵循了阿克西和奥马利的范围综述方法,并按照系统评价和Meta分析扩展版的范围综述首选报告项目指南进行报告。
如果参与者年龄在18岁及以上,被归类为超重或肥胖(体重指数≥25kg/m²)且接受了心理治疗干预,则纳入干预研究。如果研究包括与其他积极生活方式干预措施的比较(除非归类为常规护理)、非英文版本、不是全文文章或非同行评审文章,则将其排除。
检索了六个电子数据库,从建库至2023年4月以识别相关文章。
该研究采用系统图表绘制方法和叙述性综合来组织和综合数据。
共有31项研究符合纳入标准并被纳入综述。确定了13种针对超重或肥胖成年人减肥的独特心理干预措施,其中认知行为疗法和动机性访谈最为常见。确定了八种常规护理类型,主要包括营养和体育活动方面的教育和培训。还确定了当前研究中的差距。
研究结果突出了现有文献中的几个差距,主要原因是缺乏与社会经济地位低的成年人、非白人参与者、40岁以下个体以及数字健康技术整合相关的证据。