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儿童超重维持治疗方法的有效性:一项随机对照试验
Denise E Wilfley1, Richard I Stein, Brian E Saelens
1Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA. wilfleyd@psychiatry.wustl.edu
JAMA
|October 11, 2007
概括
体重维护干预措施,如行为技能维护 (BSM) 和社会便利维护 (SFM),改善了儿童的短期体重减轻. 长期效应显示,SFM持续带来好处,特别是在社会问题较少的儿童中.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 行为医学是一种行为医学.
- 公共卫生 公共卫生
背景情况:
- 儿童超重缺乏关于减肥后维护干预措施的研究.
- 标准的基于家庭的行为减肥治疗需要增强,以获得持续的结果.
研究的目的:
- 评估两个不同的体重维持策略与儿童超重治疗后的对照组进行对比.
- 评估这些维护方法的短期和长期有效性.
- 调查儿童的社会功能是否会缓和治疗结果.
主要方法:
- 一个平行组随机对照试验,涉及204名超重儿童 (7-12岁) 和他们的父母.
- 参与者接受了最初5个月的减肥治疗,然后随机分配到4个月的行为技能维护 (BSM),社会便利维护 (SFM) 或对照组.
- 结果以BMI z分数和治疗后立即超重百分比以及1年和2年的随访量来衡量.
主要成果:
- 与对照组相比,BSM和SFM在治疗后立即显著改善了相对体重维持 (效果大小为0.72-0.96).
- 虽然积极治疗的效果随着时间的推移而减弱,但单独使用SFM和与BSM相结合,在2年的随访中显示出显著的长期益处 (效果大小为0.45和0.38).
- 在SFM组中,基线社会问题较少的儿童经历了最好的相对体重变化结果.
结论:
- 维护干预措施提高了儿童减肥计划的短期有效性.
- 随着时间的推移,治疗效果的减弱凸显了未来更强大的维护策略的需要.
- 儿童的社会功能可以缓解长期的体重管理结果,这表明个性化的方法可能是有益的.
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