Wadden T A, Bartlett S J, Foster G D, Greenstein R A, Wingate B J, Stunkard A J, Letizia K A
Dept. of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia 19104, USA.
Obes Res. 1995 Nov;3(6):549-57. doi: 10.1002/j.1550-8528.1995.tb00189.x.
This study examined the combination of sertraline, a selective serotonin reuptake inhibitor, and relapse prevention training in the maintenance of weight loss following treatment by a very-low-calorie diet. A total of 53 women who had lost a mean (+/- SD) of 22.9 +/- 7.1 kg from a pretreatment weight of 103.1 +/- 17.8 kg were randomly assigned to a 54-week weight maintenance program that was combined with either: 1) 200 mg/d of sertraline; or 2) placebo. During the first 6 weeks, sertraline subjects lost significantly more weight and reported significantly greater reductions in hunger and preoccupation with food than did subjects on placebo. After this time, however, women in both conditions regained weight steadily. The 13 sertraline subjects who completed the 54-week study regained 17.7 +/- 10.6 kg of their original 26.3 +/- 7.6 kg loss, equal to a regain of 70.9 +/- 41.7%. The 17 placebo completers regained 11.8 +/- 9.0 kg of their 23.4 +/- 7.8 kg loss, equal to a 46.5 +/- 34.6% regain. End-of-treatment differences between groups in weight change were not statistically significant. Nor were there significant differences between the two conditions at any time in changes in fat-free mass, resting metabolic rate or dysphoria, all of which tended to increase with weight regain. The results are discussed in relation to findings from other long-term studies that combined diet and medication.
本研究探讨了选择性5-羟色胺再摄取抑制剂舍曲林与预防复发训练相结合，对极低热量饮食治疗后体重减轻维持情况的影响。共有53名女性参与研究，她们的体重从治疗前的103.1±17.8kg平均（±标准差）减轻了22.9±7.1kg，这些女性被随机分配到一个为期54周的体重维持计划中，该计划结合了以下两种方式之一：1）每日200mg舍曲林；或2）安慰剂。在最初的6周内，服用舍曲林的受试者体重减轻得更多，并且与服用安慰剂的受试者相比，她们报告饥饿感和对食物的关注显著减少。然而，在此之后，两种情况下的女性体重都稳步回升。完成54周研究的13名服用舍曲林的受试者，在最初减轻的26.3±7.6kg体重中，又重新增加了17.7±10.6kg，相当于回升了70.9±41.7%。17名服用安慰剂的完成者在最初减轻的23.4±7.8kg体重中，又重新增加了11.8±9.0kg，相当于回升了46.5±34.6%。两组在治疗结束时体重变化的差异无统计学意义。在无脂肪体重、静息代谢率或烦躁不安的变化方面，两种情况在任何时候也都没有显著差异，所有这些指标都随着体重的回升而趋于增加。结合其他饮食与药物相结合的长期研究结果对本研究结果进行了讨论。
