肥胖青少年之校園體重管理計畫之成效評估

A Campus Weight Management Program for Adolescent Obesity

隨著生活形態的改變，台灣青少年肥胖的盛行率逐年增加。肥胖會增加胰島素阻抗性、糖尿病、高血壓、心血管疾病及非酒精性脂肪肝的危險性，然而鮮少有在校園中對於肥胖青少年的體重管理計畫及成效的評估。本研究針對30名身體質量指數大於30 kg/平方公尺，平均年齡為16.4歲的青少年，透過校園體重管理的試辦計畫，包括飲食課程、運動介入及行為改變的8次介入。介入前肥胖的青少年膽固醇與三酸甘油酯異常的比例高達46.7%，血糖異常為13.3%，肝功能異常則為43.3%，憂鬱情緒部分，異常比例占46.2%。介入後平均體重下降2公斤，膽固醇下降19.3 mg/dL，及肝功能異常減少20%，具有統計上顯著的差異。血脂肪及肝功能的改善可能會隨著體重下降的程度較高而改善的更為明顯，此外短期體重減輕的效果可能有助於一年後體重的控制。本研究顯示短期校園體重管理的介入方式有助於體重控制及代謝異常的改善，然而青少年肥胖的防治需要多面向的介入，長期的效果仍需要進一步的研究評估。

In recent years, the prevalence of adolescence obesity has continued to rise rapidly with changing life style. Obesity increases the risk of insulin resistance, diabetes, hypertension, cardiovascular diseases, and nonalcoholic fatty liver. To date, few weight management programs have been implemented on campus. This research is designed to study the college student demographic group. This program involved 30 participants, whose mean age was 16.4 and whose BMI was over 30. Over the course of 10 weeks, participants were given combined dietary, behavioral, and physical-activity interventions. At the beginning of the program, the group showed high prevalence of hypercholesterolemia (46.7%), hypertriglyceridemia (46.7%), glucose intolerance (13.3%), abnormal liver function test (43.3%) and symptoms of depression (46.2%). After 8 weeks, there were significant changes in body weight (-2 kg), serum total cholesterol level (-19.3 mg/dL), and abnormal liver function tests (-20%). The degree of weight loss was probably associated with the improvement of hyperlipidemia and liver function, and those with significant weight loss (＞ 2.5%) tended to have better weight control one year after participating in the program. This research demonstrates that the combined dietary, behavioral, and physical-activity intervention helped to control weight and to improve metabolic abnormalities. It also emphasizes that intervention in adolescent obesity requires a holistic approach. Additional evaluations of long-term effectiveness are recommended.