- 學位論文
心理減重團體應用於傳統減重方案之療效
The effects of combined weight management and psychological intervention
摘要
目的：過去研究發現，合併多元心理治療技巧的統合型生活型態介入（comprehensive lifestyle intervention）相較傳統生活型態介入（lifestyle intervention），除了能提供效果更佳、時間更長久的減重成效之外，也更能穩定改善致胖飲食行為。本研究目的為探討合併認知行為治療（cognitive-behavioral therapy）與正念飲食技巧（mindful eating）的統合型生活型態介入，相較單獨提供飲食和運動介入的傳統生活型態介入，在體態和致胖飲食行為的療效差異。 方法：本研究採非隨機對照試驗（non-randomized controlled trail），與醫院體重管理中心合作招募減重班學員，進行每週2次、為期2個月，共16次的減重課程，並分成課程包含8次營養課和有氧課、8次肌力課的傳統減重組（traditional weight management group, TWM；n = 13；年齡 = 36.00歲；69.23%為女性），以及課程包含8次營養課和有氧課、4次肌力課、4次心理課的傳統合併心理組（combined weight management and psychological intervention group, PSY；n = 22；年齡 = 36.41歲；72.72%為女性）。兩組在前測皆測量體態資料（包含：體重、BMI、體脂率、體脂量、腰圍、臀圍、腰臀比），並填寫中文版情緒飲食者量表（Emotional Eater Questionnaire, EEQ）和中文版嘴饞量表（Grazing Questionnaire, GQ），並在2個月課程結束後再次測量體態資料與填寫後測心理量表。 結果：體態部分，在體重、BMI、體脂率、體脂量、腰圍、臀圍和腰臀比有顯著「時間」主效果；在腰圍和腰臀比有顯著「組別*時間」交互作用效果（腰圍：F(1, 29) = 5.79, p = .023, ηp2 = .166；腰臀比：F(1, 29) = 4.32, p = .047, ηp2 = .130），單純主效果事後檢定發現，傳統合併心理組之後測腰圍與後測腰臀比皆顯著低於前測，而傳統減重組僅後測腰圍顯著低於前測，此外傳統合併心理組之腰圍改變量和腰臀比改變量皆顯著較傳統減重組佳（腰圍：PSY = -7.78cm, TWM = -3.36 cm, p = .023；腰臀比：PSY = -0.04, TWM = -0.01, p = .047）。心理量表部分，在中文版EEQ總分和中文版GQ總分有顯著「時間」主效果；在中文版EEQ總分有顯著「組別*時間」交互作用效果（F(1, 33) = 12.54, p = .001, ηp2 = .275），單純主效果事後檢定發現，傳統合併心理組之後測中文版EEQ總分顯著低於前測，且後測時傳統合併心理組之中文版EEQ總分顯著低於傳統減重組，此外傳統合併心理組之中文版EEQ總分改變量顯著較傳統減重組佳（EEQ: PSY = -5.05, TWM = +0.31 cm, p = .001）。 結論：本研究支持接受合併認知行為治療與正念飲食技巧之心理減重團體的減重班學員，相較僅接受飲食和運動課程的傳統減重班學員，在腰圍、腰臀比和情緒型飲食有較佳的療效。
並列摘要
Background: Comprehensive lifestyle intervention combined skills of psychological intervention not only provided better and longer-lasting effects of weight loss, but also better improved eating behavior which caused obesity. The purpose of the present study was to validate the effects on weight loss and eating behavior, between comprehensive lifestyle intervention combined skills of cognitive-behavioral therapy (CBT) and mindful eating and traditional lifestyle intervention that provided diet and exercise intervention only. Methods: This study was a non-randomized controlled trail. Participants were recruited from weight management center of local hospital, and received a twice weekly weight loss program for two months. Participants were divided into traditional weight management group (TWM; n = 13, mean age = 36.00 years, 69.23% females) and psychological intervention combined group (PSY; n = 22, mean age = 36.41 years, 72.72% females), while the former contained nutrition classes, aerobic classes and strength classes, and the latter contained additional psychological classes. Before and after the program, weight, BMI, body fat, body fat ratio, waist circumference, hip circumference and waist-hip ratio were measured, and the Taiwanese version of Emotional Eater Questionnaire (EEQ) and Taiwanese version of Grazing Questionnaire (GQ) were filled in. Results: For the body weight, there were significant time effects on weight, BMI, body fat ratio, body fat, waist circumference, hip circumference and waist-hip ratio; besides, there were significant interaction effects of Group*Time on waist circumference and waist-hip ratio (WC: F(1, 29) = 5.79, p = .023, ηp2 = .166; WHR: F(1, 29) = 4.32, p = .047, ηp2 = .130), and simple main effects were found which showed lower WC of TWM at post-test than pre-test, and lower WC and WHR of PSY at post-test than pre-test. Otherwise, change of WC and WHR of PSY were both better than that of TWM (WC: PSY = -7.78cm, TWM = -3.36 cm, p = .023; WHR: PSY = -0.04, TWM = -0.01, p = .047). For the psychological questionnaire, there were significant time effects on EEQ and GQ; besides, there was significant interaction effect of Group*Time on EEQ (F(1, 33) = 12.54, p = .001, ηp2 = .275), and simple main effects were found which showed lower EEQ of PSY at post-test than pre-test, and lower EEQ of PSY at post-test than that of TWM. Otherwise, change of EEQ of PSY was better than that of TWM (EEQ: PSY = -5.05, TWM = +0.31 cm, p = .001). Conclusion: This study indicated that participants who took the weight loss program combined psychological classes that provided CBT and mindful eating skills would have better effects on WC, WHR and EEQ scores than those who took traditional weight loss program that provided diet and exercise classes only.