減重個案長期體重控制之相關因素分析

Factors Associated with Long-term Weight Control in Weight Reduction Subjects

10.7023/TJFM.200709.0168

潘湘如(Hsiang-Ju Pan)；杜明勳(Ming-Hsun Tu)；葛魯蘋(Luo-Ping Ger)；洪麗如(Li-Ju Hung)

long-term weight maintenance ； weight loss expectations ； attrition ； BMItest ； interferon

台灣家庭醫學雜誌

17卷3期（2007 / 09 / 01）

168 - 177

繁體中文

Many overweight and obese individuals are able to lose significant amounts of weight, but the majority regain the weight over a period of time. There is also a significant patient dropout rate in weight control programs, thus not only resulting in wasted medical resources, but also increasing the frustration between the therapist and the patient. This study was aimed at determining the critical factors that lead to differences in long-term weight maintenance. According to The National Weight Control Registry, we defined long-term weight maintenance as the loss of at least 10% of the initial body weight and maintenance of the loss for at least one year. In this study, we enrolled 612 individuals who had a BMI≧25kg/m^2. Each participant was screened with a medical history and physical examination, and administered a questionnaire pertaining to sleep habits, weight loss expectations, dietary habits, whether or not they ate breakfast, and the weekly exercise time. The participants underwent weight reduction by changing their lifestyle, including controlling their diet and encouraging exercise. By the third month of treatment, 298 (48.7%) participants had dropped out. We analyzed the difference between the continuous treatment and attrition groups. Females had a greater tendency to drop from the program than males (51.1% vs. 42.5%), and those with a BMI＜30kg/m^2 (OR=2.09) and a weekly exercise time＜150 minutes (OR=1.67) had higher dropout rates. At the end of treatment, only 52 (8.5%) participants maintained weight loss successfully. We analyzed the difference between the successful long-term weight maintenance and the non-successful groups using logistic regression, which showed that an age below 30 years (OR=3.83) and a weekly exercise time ＞ 150 min (OR=4.56) were related to successful long-term weight maintenance.

Many overweight and obese individuals are able to lose significant amounts of weight, but the majority regain the weight over a period of time. There is also a significant patient dropout rate in weight control programs, thus not only resulting in wasted medical resources, but also increasing the frustration between the therapist and the patient. This study was aimed at determining the critical factors that lead to differences in long-term weight maintenance. According to The National Weight Control Registry, we defined long-term weight maintenance as the loss of at least 10% of the initial body weight and maintenance of the loss for at least one year. In this study, we enrolled 612 individuals who had a BMI≧25kg/m^2. Each participant was screened with a medical history and physical examination, and administered a questionnaire pertaining to sleep habits, weight loss expectations, dietary habits, whether or not they ate breakfast, and the weekly exercise time. The participants underwent weight reduction by changing their lifestyle, including controlling their diet and encouraging exercise. By the third month of treatment, 298 (48.7%) participants had dropped out. We analyzed the difference between the continuous treatment and attrition groups. Females had a greater tendency to drop from the program than males (51.1% vs. 42.5%), and those with a BMI＜30kg/m^2 (OR=2.09) and a weekly exercise time＜150 minutes (OR=1.67) had higher dropout rates. At the end of treatment, only 52 (8.5%) participants maintained weight loss successfully. We analyzed the difference between the successful long-term weight maintenance and the non-successful groups using logistic regression, which showed that an age below 30 years (OR=3.83) and a weekly exercise time ＞ 150 min (OR=4.56) were related to successful long-term weight maintenance.

1. (1998)。國民營養現況：1993-1996國民營養健康狀況變遷調查結果。行政院衛生署。
2. American College of Sports Medicine(2001).Position stand on the appropriate intervention strategies for weight loss and prevention of weight regain for adults.Med Sci Sports Exerc,33,2145-2156.
3. Diabetes Prevention Program Research Group(2002).Reduction in the incidence of type 2 diabestes with lifestyle intervention or Metformin.N Engl J Med,346,393-403.
4. Foster GD,Wadden TA,Vogt RA(1997).What is a reasonable weight loss? Patients` expectations and evaluations of obesity treatment outcomes.J Consult Clin Psychol,65,79-85.
5. Gangwiscb JE,Malaspina D,Boden-Albala B(2005).Inadequate sleep as a risk factor for obesity: analyses of the NHANES I.Sleep,28,1289-1296.
6. Jackie L,Bcucher, Julie,D: Scheumann(1999).The Effectiveness of Telephone Based Counseling for Weight Management.Diabetes Spectrum,12,121-123.
7. Klem ML,Wing RR,McGuire MT(1997).A descriptive study of individuals successful at long-term maintenance of substantial weight loss.Am J Clin Nutr,66,239-246.
8. Kopelman PG(2000).Obesity as a medical problem.Nature,404,635-643.
9. Linde JA,Jeffery RW,Finch EA(2004).Are unrealistic weight loss goals associated with outcomes for overweight women?.Obes Res,12,569-576.
10. Linde JA,Jeffery RW,Levy RL(2005).Weight loss goals and treatment outcomes among overweight men and women enrolled in a weight loss trial.Int J Obes,29,1002-1005.
11. MT McGuire,Wing RR,Klem ML(1999).Behavioral strategies of individuals who have maintained long-term weight losses.Obes Res,7,334-341.
12. National Centers for Health Statistics(1999).Centers for Disease Control. Prevalence of over-weight and obesity among adults: United States.
13. Pate RR,Pratt M,Blair SN(1995).Physical activity and public health: a recommendation from the Centers for Disease and Prevention and the American College of Sports Medicine.JAMA,273,402-407.
14. Riccardo DG,Simona C,Entice M(2005).Weight Loss Expectations in Obese Patients and Treatment Attrition: An Observational Multicenter Study.Obes Res,13,1961-1969.
15. Rirchic JD,Miller CK,Smiciklas-Wright H(2005).Tanita foot-to-foot bioelectsical impedance analysis system validated in older adults.J Am Diet Assoc,105,1617-1619.
16. Stunkard AJ,Mclaren-Hume M(1959).The results of treatment for obesity.Arch Intern Med,103,79-85.
17. Teixeira PJ,Going SB,Houtkooper LB(2004).Pretreatment predictors of attrition and successful weight management in women.Int J Obes,28,1124-1133.
18. Wing RR,Hill JO(2001).Successful weight loss maintenance.Annu Rev Nutri,21,323-341.
19. Wing RR,Phelan S(2005).Long-term weight loss maintenance.Am J Clin Nutr,82,222-225.
20. World Health Organization(2000).The Asia-Pacific perspective: Redefining obesity and its treatment.Geneva:WHO.
21. Wyatt HR,Bray GA (eds.)(2004).Office Management of Obesity.United States: Saunders.
22. Wyatt HR,Grunwald GK,Musca CL(2002).Long-term weight loss and breakfast in subjects in the National Weight Control Registry.Obes Res,10,78-82.