體重管理門診初診患者的飲食異常行為之盛行率及相關危險因子

Prevalence and Associated Risk Factors for Eating Behavior Disorders in First Visits of Outpatients to a Weight Management Clinic

目標：在體重過重患者中飲食疾患可能偏高，若未能正確介入將影響治療成效，然而國內在此方面的研究仍然稀少。本研究將評估體重管理門診中飲食異常行為盛行率，並探討可能的危險因子。方法：自2004年1月至2012年6月，選取年齡≥18歲（平均為36.0±11.5歲）且身體質量指數≥24 kg/m2（平均為34.7±7.2）之男性293位及女性523位至體重管理特別門診的初診病患。以病歷回溯分析人口基本資料、以及體重相關變項。使用SCOFF問卷篩檢飲食疾患的高危險群，並以總分≥2分為具有飲食異常行為。結果：816位初診個案SCOFF的平均分數為1.0±1.0，飲食異常行為共253位，盛行率為31.1%。女性的減重目標每月平均速率比男性快(p=0.037)，且在減重經驗(p<0.001)與使用減重藥物經驗(p<0.001)的比例皆高於男性，而SCOFF總分在性別無統計上的顯著差異。依肥胖程度分組，重度肥胖患者SCOFF的總分最高(p=0.034)。以複邏輯斯回歸分析結果顯示，年齡（勝算比=0.964, 95%信賴區間=0.950-0.979, p<0.001）、飲食過量者（勝算比=1.965, 95%信賴區間=1.361-2.837, p<0.001）及有情緒壓力者（勝算比=1.612, 95%信賴區間=1.141-2.277, p=0.007）為飲食異常行為獨立相關危險因子。結論：體重管理門診初診個案中以SCOFF問卷篩檢符合飲食異常行為比例達31.1%，其中以年紀較輕、自認肥胖成因為飲食過量或情緒壓力者的風險較高。

Objectives: Overweight subjects may have a higher prevalence of eating disorders but poorer therapeutic responses if treated inappropriately. However, few studies have been reported in Taiwan. This study evaluated the prevalence of eating behavior disorders and associated risk factors in a weight management clinic. Methods: From January 2004 to June 2012, a total of 293 males and 523 females aged≥18 y/o (mean=36.0±11.5) and with body mass index ≥ 24 kg/m2 (mean=34.7±7.2) making their first visit to a weight management clinic were enrolled in the study. Chart records, demographic data, self-reported SCOFF questionnaire results, and weight-related variables were analyzed. Eating behavior disorders were defined as having a SCOFF score≥2. Results: Among the 816 subjects, average SCOFF score was 1.0±1.0; 253 subjects (31.1%) were diagnosed with eating behavior disorders. Compared with males, females showed higher monthly rate of desired weight loss goals (p=0.037), higher weight loss (p≤0.001), and higher weight loss drug usage (p≤0.001). However, there was no significant difference in SCOFF scores between genders. Mean SCOFF score was highest in the most severely obese group (p=0.034). Using a logistic regression model, age (OR=0.964, 95% CI=0.950-0.979, p<0.001), overeating (OR=1.965, 95% CI=1.361-2.837, p<0.001), and emotional distress (OR=1.612, 95% CI=1.141-2.277, p=0.007) were independent risk factors for eating behavior disorders. Conclusions: The prevalence of eating behavior disorders screened by SCOFF questionnaires was 31.1% in a weight management clinic. Patients who were younger, with self-rated obesity from overeating, or emotionally distressed, had a higher risk of eating behavior disorders.