以生活型態調整探討減重及健康相關生活品質之改善

Lifestyle Modification, Weight Reduction, and Health Improvement

張敬仁(Ching-Jen Chang) ； 張文道(Wen-Dau Chang) ； 張文瀚(Bruno Man-Hon Cheung) ； 蔡森蔚(Sen-Wei Tsai) ； 周崇頌(Chorng-Sonq Chou) ； 陳妍蒨(Yen-Chien Chen) ； 趙蘭芬(Lan-Fen Chao)

《台灣公共衛生雜誌》 22卷4期 (2003/08) Pp. 308-317

https://doi.org/10.6288/TJPH2003-22-04-07

摘要

目標：生活模式的調整可以改善許多肥胖相關的共病，如糖尿病、高血脂症等，已在許多研究中證實；但在健康相關的生活品質、及暴食習慣上的改變，在國內尚沒有太多的研究觸及。方法：我們針對本院健康減重門診的病患進行生活模式改變(Therapeutic Lifestyle Change, TLC)的減重治療，並於治療開始及三個月後，作血液檢查及自填結構式問卷調查。結果：自九十年九月至九十二年一月間，總共收案40位門診患者，有效完成三個月追蹤者有32人（男13人，女19人），平均年齡39.0歲(SD:11.6)。減重前平均體重84.5公斤(SD:15.8)，減重後平均體重79.1公斤(SD:15.7)，平均減重5.4公斤(SD:3.0)，減輕體重佔原始體重百分比之平均值為6.5%(SD:3.6%)。BITE中文版暴食問卷總分呈現有意義的下降。SF-36健康相關生活品質量表在「身體疼痛」、「整體健康」、「活力」、「社會功能」四個向度及「體能綜合評估」呈現統計學意義上的進步。結論：三個月生活模式改變的減重治療，雖然只減少原始體重的5-10%，但已足以改善肥胖病人的輕度高血糖症及高膽固醇血症、控制暴食傾向並明顯改善以SF-36所測得的體能方面健康相關生活品質。

關鍵字

生活模式調整 ； 健康相關生活品質 ； 代謝症候群 ； 肥胖 ； 減肥

並列摘要

Objectives: It has been proved in a number of studies that lifestyle modification can improve many obesity-related comorbid conditions such as diabetes mellitus and hyperlipidemia. Yet, so far little investigation has been done in this country regarding the change in Health-Related Quality of Life (HRQL), and binge eating habit. Methods: Participants in our Healthful Weight Reduction OPD program received blood biochemical examinations and were asked to complete several self-administered structured questionnaires before and after three months of therapeutic lifestyle change (TLC) weight reduction therapy. Results: From September 2001 to January 2003, a total of 40 patients were included in the present study. We completed a three-month follow-up on 32 patients (13 males and 19 females), their mean age being 39.0 y/o (SD:11.6). Their mean body weight was 84.5 kg (SD:15.8) before and 79.1 kg (SD:15.7) after the treatment. With a weight loss of 5.4 kg (SD:3.0), they lost 6.5% (SD:3.6%) of their original weight. The scores of the BITE (Chinese Version of Bulimic Investigatory Test Edinburgh) lowered significantly. Bodily pain, general health, vitality and social functioning dimensions and physical component summary in the Medical Outcomes Study Short-Form 36 Health Survey (SF-36, as the assessment of HRQL) showed significant improvement. Conclusions: Although the weight loss was only 5-10%, the three-month TLC weight reduction program succeeded in improving mild hyperglycemia and hypercholesterolemia, controlling binge-eating tendency, and improving physical aspects of HRQL as measured by SF-36 in obese patients.

並列關鍵字

lifestyle modification ； health-related quality of life ； metabolic syndrome ； obesity ； weight loss

參考文獻

Chehade, J. M., Mooradian, A. D.(2000).A Rational Approach to Drug Therapy of Type 2 Diabetes Mellitus.Drugs.60

Fine, J. T., Colditz, G. A., Coakley, E. H.(1999).A Prospective Study of Weight Change and Health-Related Quality of Life in Women.JAMA.282

Flegal, K. M., Carroll, M. D., Kuczmarski, R. J., Johnson, C. L.(1998).Overweight and Obesity in the United States: Prevalence and Trends, 1960-1994.Int J Obes.22

Fontaine, K. R., Barofsky, I., Andersen, R. E.(1999).Impact of Weight Loss on Health-Related Quality of Life.Qual Life Res.8

Fontaine, K. R., Barofsky, I., Cheskin, L. J.(1997).Predictors of Quality of Life for Obese Persons.J Nerv Ment Dis.185