Jeffery R W, Wing R R, Thorson C, Burton L R
Division of Epidemiology, University of Minnesota School of Public Health, Minneapolis 55454-1015, USA.
J Consult Clin Psychol. 1998 Oct;66(5):777-83. doi: 10.1037//0022-006x.66.5.777.
Exercise is the best predictor of long-term weight loss. This study evaluated two strategies for improving exercise adherence and long-term weight loss in obese outpatients. Obese men and women (N = 193) were randomized to 1 of 5 treatment groups for 18 months: standard behavior therapy (SBT); SBT with supervised walks (SW) 3 times per week; SBT + SW with personal trainers (PT), who walked with participants, made phone reminders, and did make-up SW; SBT + SW with monetary incentives (I) for completing SW; and SBT + SW + PT + I. Both PT and I enhanced attendance at SWs, the combination producing the best adherence. Increased walk attendance did not result in higher overall energy expenditure, however, and long-term weight loss was also not improved. Post hoc analyses suggest that the level of exercise needed for successful long-term weight loss is much higher than that usually recommended in behavioral treatment programs.
运动是长期体重减轻的最佳预测指标。本研究评估了两种改善肥胖门诊患者运动依从性和长期体重减轻的策略。肥胖男性和女性（N = 193）被随机分配到5个治疗组中的1组，为期18个月：标准行为疗法（SBT）；每周3次有监督步行（SW）的SBT；有私人教练（PT）的SBT + SW，私人教练与参与者一起步行、进行电话提醒并安排补步行；完成SW有金钱奖励（I）的SBT + SW；以及SBT + SW + PT + I。私人教练和奖励都提高了步行的出勤率，两者结合产生了最佳的依从性。然而，步行出勤率的提高并没有导致总体能量消耗增加，长期体重减轻也没有得到改善。事后分析表明，成功实现长期体重减轻所需的运动量远高于行为治疗项目通常建议的水平。
