合併飲食、運動與心理介入對體重與飲食行為之成效

The effects of combined diet, exercise, and psychological intervention on body weight and eating behaviors

目標：傳統減重以飲食和運動介入為主，本研究探討傳統減重合併心理介入對體重與飲食行為之成效。方法：採立意取樣招募體重管理中心體重過重與肥胖（身體質量指數大於等於24以上)的參與者，分為八週傳統減重組（以營養、有氧和肌力課程為主）與八週傳統合併心理組（包括傳統減重合併認知行為治療與正念飲食），分別於介入前、後測量參與者的體態、情緒飲食者量表（Emotional Eater Questionnaire,EEQ）和嘴饞量表（Grazing Questionnaire,GQ）。結果：二因子變異數分析發現「組別×時間」在腰圍和腰臀比有交互作用，事後檢定發現傳統合併心理組之後測腰圍與腰臀比低於前測，而傳統減重組僅後測腰圍低於前測。傳統合併心理組在腰圍和腰臀比的改變量高於傳統減重組。二因子變異數分析發現「組別×時間」在EEQ總分有交互作用，EEQ總分和GQ總分有顯著時間主效果，事後檢定發現傳統合併心理組在後測EEQ總分低於前測，後測時傳統合併心理組之EEQ總分低於傳統減重組，傳統合併心理組之EEQ總分改變量高於傳統減重組。結論：傳統減重合併心理課程在降低參與者腰圍、腰臀比、情緒型飲食與饞食型飲食之效果比傳統減重更佳。（台灣衛誌2020|39(3)：311—325）
Objectives: Traditional weight control programs include diet and exercise. The present study explored the effects on body weight and eating behaviors of traditional weight management (TWM) combined with psychological intervention versus TWM only. Methods: Purposive sampling was used in this study. Participants with body mass index ≥ 24 kg/m2 were recruited from a weight management center and assigned to an eight-week traditional weight management program (TWM| diet, aerobic, and muscle strength exercise) or eight weeks of TWM with psychological intervention (PSY| cognitive behavior therapy and mindfulness eating). The indices of body weight, Emotional-Eater-Questionnaire (EEQ) score, and Grazing Questionnaire (GQ) score were measured at pre-test and post-test. Results: Two-way analysis of variance (ANOVA) revealed significant Group × Time interaction effects on waist circumference (WC) and waisthip ratio (WHR). Post-hoc comparison found lower WC and WHR at post-test than pre-test in the PSY group, and lower WC at post-test than pre-test in the TWM group. There was a larger change in WC and WHR in the PSY group than the TWM group. Two-way ANOVA showed a significant Group × Time interaction effect on EEQ and Time main effects on EEQ and GQ. Posthoc comparison showed lower EEQ of PSY at post-test than pre-test, and lower EEQ in PSY than TWM at post-test. Otherwise, the change scores of EEQ in the PSY group were better than the TWM group. Conclusions: This study indicated that TWM combined with psychological intervention had better effects on WC, WHR, EEQ, and GQ than TWM alone. (Taiwan J Public Health. 2020|39(3):311-325)