首頁資訊減肥后體重反彈更快與初始體重減輕幅度更大有關(guān)—小柯機(jī)器人—科學(xué)網(wǎng)

減肥后體重反彈更快與初始體重減輕幅度更大有關(guān)—小柯機(jī)器人—科學(xué)網(wǎng)

來源：泰然健康網(wǎng) 時(shí)間：2025年05月23日 14:18

減肥后體重反彈更快與初始體重減輕幅度更大有關(guān)

作者：小柯機(jī)器人發(fā)布時(shí)間：2021/8/22 10:35:57

英國牛津大學(xué)Jamie Hartmann-Boyce團(tuán)隊(duì)研究了行為減肥計(jì)劃的特征與計(jì)劃結(jié)束后體重變化之間的相關(guān)性。相關(guān)論文發(fā)表在2021年8月17日出版的《英國醫(yī)學(xué)雜志》上。

為了確定行為減重方案的特點(diǎn)是否會影響方案結(jié)束后體重的變化率，研究組在試驗(yàn)登記處和11個(gè)電子數(shù)據(jù)庫等檢索截至2019年12月關(guān)于超重或肥胖成人行為減肥方案的隨機(jī)試驗(yàn)，均報(bào)告≥12個(gè)月的結(jié)果，包括方案結(jié)束時(shí)和方案結(jié)束后的結(jié)果，對這些隨機(jī)試驗(yàn)進(jìn)行系統(tǒng)回顧和薈萃分析。

這些研究由兩名獨(dú)立評審員進(jìn)行篩選，差異通過討論解決。檢索確定的研究中有5%符合納入標(biāo)準(zhǔn)。一名評審員提取數(shù)據(jù)，另一名評審員檢查數(shù)據(jù)。使用Cochrane偏差風(fēng)險(xiǎn)工具（第1版）評估偏差風(fēng)險(xiǎn)。計(jì)算體重變化率，并檢測體重變化率與預(yù)先指定變量之間的相關(guān)性。

數(shù)據(jù)分析包括249項(xiàng)試驗(yàn)（59081例參與者）?，平均隨訪時(shí)間為兩年（最長30年）。56%的研究（140項(xiàng)）存在不明確的偏倚風(fēng)險(xiǎn)，21%（52項(xiàng)）偏倚風(fēng)險(xiǎn)低，23%（57項(xiàng)）偏倚風(fēng)險(xiǎn)高。干預(yù)組的體重恢復(fù)速度快于未干預(yù)對照組，但兩組之間的差異至少維持了五年。

在項(xiàng)目結(jié)束時(shí)，每減輕一公斤體重，體重就會以每年0.13-0.19公斤的速度更快反彈。減肥的經(jīng)濟(jì)激勵(lì)與更快地以1-1.5千克/年的速度恢復(fù)體重有關(guān)。與無膳食替代的計(jì)劃相比，部分膳食替代的干預(yù)措施與更快的體重反彈有關(guān)，但在計(jì)劃期間對體重減輕進(jìn)行校正后則不相關(guān)。在研究之外參加該項(xiàng)目與體重恢復(fù)較慢有關(guān)。在多變量分析中，相互作用強(qiáng)度逐漸降低的方案也與體重恢復(fù)較慢有關(guān)，盡管點(diǎn)估計(jì)表明這種關(guān)聯(lián)性很小。其他特征不能解釋體重恢復(fù)的異質(zhì)性。

研究結(jié)果表明，減肥后體重反彈更快與初始體重減輕幅度更大有關(guān)，但至少在項(xiàng)目結(jié)束后的5年內(nèi)，初始體重減輕幅度更大仍與體重減輕有關(guān)，但之后的數(shù)據(jù)有限。

附：英文原文

Title: Association between characteristics of behavioural weight loss programmes and weight change after programme end: systematic review and meta-analysis

Author: Jamie Hartmann-Boyce, Annika Theodoulou, Jason L Oke, Ailsa R Butler, Peter Scarborough, Anastasios Bastounis, Anna Dunnigan, Rimu Byadya, F D Richard Hobbs, Falko F Sniehotta, Susan A Jebb, Paul Aveyard

Issue&Volume: 2021/08/17

Abstract:

Objective To determine if the characteristics of behavioural weight loss programmes influence the rate of change in weight after the end of the programme.

Design Systematic review and meta-analysis.

Data sources Trial registries, 11 electronic databases, and forward citation searching (from database inception; latest search December 2019). Randomised trials of behavioural weight loss programmes in adults with overweight or obesity, reporting outcomes at ≥12 months, including at the end of the programme and after the end of the programme.

Review methods Studies were screened by two independent reviewers with discrepancies resolved by discussion. 5% of the studies identified in the searches met the inclusion criteria. One reviewer extracted the data and a second reviewer checked the data. Risk of bias was assessed with Cochrane’s risk of bias tool (version 1). The rate of change in weight was calculated (kg/month; converted to kg/year for interpretability) after the end of the programme in the intervention versus control groups by a mixed model with a random intercept. Associations between the rate of change in weight and prespecified variables were tested.

Results Data were analysed from 249 trials (n=59081) with a mean length of follow-up of two years (longest 30 years). 56% of studies (n=140) had an unclear risk of bias, 21% (n=52) a low risk, and 23% (n=57) a high risk of bias. Regain in weight was faster in the intervention versus the no intervention control groups (0.12-0.32 kg/year) but the difference between groups was maintained for at least five years. Each kilogram of weight lost at the end of the programme was associated with faster regain in weight at a rate of 0.13-0.19 kg/year. Financial incentives for weight loss were associated with faster regain in weight at a rate of 1-1.5 kg/year. Compared with programmes with no meal replacements, interventions involving partial meal replacements were associated with faster regain in weight but not after adjustment for weight loss during the programme. Access to the programme outside of the study was associated with slower regain in weight. Programmes where the intensity of the interaction reduced gradually were also associated with slower regain in weight in the multivariable analysis, although the point estimate suggested that the association was small. Other characteristics did not explain the heterogeneity in regain in weight.

Conclusion Faster regain in weight after weight loss was associated with greater initial weight loss, but greater initial weight loss was still associated with reduced weight for at least five years after the end of the programme, after which data were limited. Continued availability of the programme to participants outside of the study predicted a slower regain in weight, and provision of financial incentives predicted faster regain in weight; no other clear associations were found.

DOI: 10.1136/bmj.n1840

Source: https://www.bmj.com/content/374/bmj.n1840

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