逐步治疗干预方法对成人减肥的影响:一项随机临床试验
John M Jakicic1, Deborah F Tate, Wei Lang
1Department of Health and Physical Activity, Physical Activity and Weight Management Research Center, University of Pittsburgh, Pittsburgh, PA 15261, USA. jjakicic@pitt.edu
JAMA
|June 28, 2012
概括
标准的行为减肥干预 (SBWI) 在18个月的时间里,导致体重减轻比逐步护理 (STEP) 更大. 然而,STEP方法更具成本效益,提供了临床上有意义的结果,减少了实施费用.
科学领域:
- 肥胖研究的研究.
- 行为医学是一种行为医学.
- 公共卫生干预措施 公共卫生干预措施
背景情况:
- 由于肥胖流行病,有效和资源高效的减肥治疗非常重要.
- 阶段性治疗方法提供基于里程碑完成的可定制干预措施,与传统方法相比,可能提高疗效和降低成本.
研究的目的:
- 为了比较逐步护理减肥干预 (STEP) 与标准行为减肥干预 (SBWI) 在实现更大的减肥方面的有效性.
- 评估两种干预方法的成本效益.
主要方法:
- 一项随机临床试验 (Step-Up Study) 涉及363名超重和肥胖的成年人 (BMI 25-40,年龄18-55) 在美国两所大学进行.
- 在18个月的干预期内,参与者被随机分配到SBWI (n=165) 或STEP (n=198) 中.
- 两组都接受了低卡路里饮食,增加体力活动和小组咨询;根据体重减轻的进展,STEP小组的干预每3个月适应一次.
主要成果:
- 在18个月内,SBWI和STEP组都实现了显著的体重减轻 (P < .001).
- 与STEP相比,SBWI的平均体重减轻率 (-8.1%) 较大 (-6.9%),尽管这种差异在统计学上并不显著 (P = .09).
- STEP干预显著更具成本效益,每个参与者的成本为785美元,而SBWI的成本为1357美元 (P < .001). 这两种干预措施都在心血管健康和健身方面取得了相似的改善.
结论:
- 标准行为减肥干预 (SBWI) 在超重和肥胖的成年人中,在18个月的时间里,与阶段性护理 (STEP) 方法相比,显示出更大的平均体重减轻.
- 尽管体重减少较少,但STEP干预措施提供了临床上有意义的体重减轻,并且比SBWI更具成本效益.
- 研究结果表明,逐步护理模式可以成为一个可行的,资源高效的体重管理策略,平衡效率与经济考虑.
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