「認知行為治療」對營養衛教之輔助療效探討--以過重者之體重控制短期療效為主--

本研究欲探討「認知行為治療」（Cognitive-Behavior Therapy , CBT）對營養衛教於輔助體重控制之短期療效，研究對象取自高雄地區自認體重過重之一般民眾，個案身體質量指數(Body Mass Index ,BMI)必須大於24(kg/m2)，並排除有嚴重精神疾病、飲食疾患、懷孕、且不得同時有服用減重藥物或接受其他減重療程者。本研究共有27位受試者，將受試者隨機分派至對照組（13人）及實驗組（14人）兩組，對照組進行四週之營養衛教，實驗組則進行8週之營養衛教及認知行為治療。測量工具則包括貝克憂鬱量表、身體意象量表、飲食節制量表及恐懼肥胖量表，進行體重控制介入前後，對照組及實驗組則分別接受前後測評估。經由統計結果顯示，憂鬱情緒、身體意象、及身體質量指數在單獨營養衛教介入後已有改善，若再加上認知行為輔助治療亦有同樣的療效，且在體重控制上有加成的作用，但未達統計意義。認知行為輔助治療唯一有加成作用且具統計意義為飲食節制的改善，表示如果在營養衛教中再加入認知行為輔助治療的介入，可以改善個案之情緒及進食情境對其飲食行為的影響，且在進食時較可以控制其進食的數量。

關鍵字

認知行為治療；營養衛教；體重過重；體重控制

並列摘要

The purpose of this study is to investigate the short-term weight-control effect of the adjuvant of cognitive-behavior therapy to dietary treatment for overweight persons from Kaohsiung Subjects with body mass index (BMI) more than 24 (kg/m2) were randomly assigned to either experimental group (n=14) or control group (n=13). The experimental group subjects received 8 sessions of cognitive-behavior weight-control program with combination of 4 sessions of dietary treatment and the control group received 4 sessions of dietary treatment only. Four assessment batteries were given at pre and post-treatment point which included Beck Depressive Index (BDI), Body Image Scale(BIS), Diet Restricting Scale(DRS),and Fear of Obesity Scale(FOS). Analyses indicated that BDI, BIS, and BMI improve after dietary treatment only. Adjuvant cognitive-behavior therapy to dietary treatment in the experimental group could improve somewhat degree more than dietary treatment, but these changes did not reach statistical significance. Only diet restricting behaviors show significant improvement after adjuvant of cognitive-behavior weight-control program. It means cognitive-behavior therapy can change subjects’ eating behavior and enhance eating self-efficacy and foster strategies to manage negative affect.