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首页> 外文期刊>Preventive Medicine: An International Journal Devoted to Practice and Theory >Behavioral lifestyle interventions for moderate and severe obesity: A systematic review
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Behavioral lifestyle interventions for moderate and severe obesity: A systematic review

机译：适度和严重肥胖的行为生活方式干预：系统审查

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Moderate and severe obesity (BMI >= 35 kg/m(2)) affect 15% of US adults, with a projected increase over the next two decades. This study reviews evidence of behavioral lifestyle interventions for weight loss in this population. We searched PubMed, PsychInfo, CINAHL (R), and Scopus through February 2016 for experimental and quasi-experimental studies that tested a dietary and/or physical activity intervention with a behavioral modification component versus a comparator; and had >= six-month follow-up and a weight-related primary outcome. Twelve studies representing 1862 participants (mean BMI 37.5-48.3, mean age 30-54 years) were included. Nine studies compared different behavioral interventions and three tested behavioral intervention(s) versus pharmacological or surgical treatments. Among the 25 behavioral interventions in the 12 studies, 18 reported percent of participants achieving clinically significant weight loss up to 12 months (32-97% achieving 5% or 3-70% achieving 10%). Three studies measured other cardiometabolic risk factors, but showed no significant risk reduction. Seven interventions with greater effectiveness (i.e., at least 31% achieving >= 10% or 62% achieving >= 5% weight loss up to one year) included multiple components (diet, physical activity, and behavioral strategies), long duration (e.g., one year), and/or intensive contacts (e.g., inpatient stays for clinic-based interventions, weekly contacts for community-based ones). Evidence for the effectiveness of behavioral interventions versus pharmacological or surgical treatment was limited. Comprehensive and intensive behavioral interventions can result in clinically significant, albeit modest, weight loss in this obese subpopulation but may not result significant improvements in other cardiometabolic risk factors. More research on scalable and sustainable interventions is needed. (C) 2017 Elsevier Inc. All rights reserved.
机译：适度和严重的肥胖（BMI> = 35公斤/米（2））影响美国成年人的15％，未来二十年的预计增加。这项研究审查了这种人群体重减轻的行为生活方式干预的证据。我们在2016年2月搜索了PubMed，Psychinfo，Cinahl（R）和Scopus进行了实验和准实验研究，该研究用行为修饰组件与比较器进行了测试膳食和/或身体活动干预;并且有> =六个月的随访和与权重的主要结果相关。包括1862名参与者的十二项研究（意思是BMI 37.5-48.3，平均年龄为30-54岁）。九项研究比较了不同的行为干预和三种测试的行为干预与药理或手术治疗。在12项研究中的25项行为干预中，18例报告的参与者百分比可达12个月（32-97％达到5％或3-70％，实现10％）。三项研究衡量了其他心脏差异危险因素，但没有显着降低风险。七次干预效果更高（即至少31％的达到= 10％或62％，达到一年的1年）包括多个组分（饮食，身体活动和行为策略），持续时间长（例如，一年）和/或密集的联系人（例如，住院患者停留基于诊所的干预措施，每周对社区的界面的联系方式）。有限的行为干预有效性与药理或手术治疗有限的证据是有限的。综合性和强化行为干预措施可能导致临床显着，虽然适度，肥胖，体重减轻，但可能不会导致其他心脏差异危险因素的显着改善。需要更多关于可扩展和可持续干预措施的研究。 （c）2017年Elsevier Inc.保留所有权利。

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