某醫學中心體重管理門診肥胖患者之飲食異常行為及相關影響因子

Disordered Eating Behavior and Associated Risk Factors amongst Obese Outpatients at a Weight Management Clinic in a Medical Center

吳筱瑩(Hsiao-Ying Wu) ； 黃珮嘉(Pei-Chia Huang) ； 郭柏秀(Po-Hsiu Kuo) ； 張秦松(Chin-Sung Chang) ； 李國鼎(Kuo-Ting Lee) ； 陳秋盈(Chiu-Ying Chen) ； 郭素娥(Su-E Kuo) ； 曾美智(Meg Mei-Chih Tseng) ； 游一龍(Lung Yu) ； 吳至行(Chih-Hsing Wu)

《台灣家庭醫學雜誌》 24卷1期 (2014/03) Pp. 21-34

https://doi.org/10.3966/168232812014032401003

摘要

背景及目的：肥胖與飲食障礙有關，然很少研究肥胖者之飲食障礙傾向。本研究旨在探討體重管理門診肥胖患者之飲食障礙盛行率與相關因子。方法：本研究共收集18-55歲之132名體重管理門診肥胖患者（身體質量指數≥25.0 kg/m^2）與103名非肥胖志願者。使用中文版飲食態度量表-26題（EAT-26）評估飲食障礙傾向，以≥11分為飲食障礙高危險（high-riskeating disorder，簡稱HRED）切點及≥20分為疑似飲食障礙（probableeating disorder，簡稱PED）切點，並分析人口學特徵、身體質量指數、腰圍、生活型態等可能的交互影響因子。結果：肥胖患者中，HRED與PED的盛行率分別為35.6%及10.6%，非肥胖者中則為23.3%及6.8%，肥胖患者在HRED的盛行率、EAT-26總分與節食次量表分數均顯著高於非肥胖者（p值均＜0.05），兩組在PED比例、暴食與食物偏見及口腔控制次量表則未達顯著差異。以邏輯斯迴歸分析發現較年長、未婚、身體質量指數較低、腰圍較大為肥胖患者HRED之顯著影響因子。結論：本研究發現體重管理門診肥胖患者有較高的飲食障礙風險，且似乎呈現不同於非肥胖者的人口學特徵與生活型態。臨床上宜落實飲食障礙篩檢，以早期發現並適時提供心理諮詢介入。

並列摘要

Background and Purpose: It has been suggested that obesity is associated with eating disorders; however, only a few studies have focused on disordered eating behaviors amongst obese adults. The aim of the current study was to determine the prevalence and putative factors of eating disorders amongst obese outpatients in a weight management outpatient clinic. Methods: One hundred thirty-two obese patients (60 men and 72 women; age range, 18-55 years; body mass index, ≥ 25.0 kg/m^2) from a weight management outpatient clinic in a medical center and 103 non-obese volunteers (38 men and 65 women; body mass index, 18.5 -24.9 kg/m^2) were enrolled. Disordered eating behavior was assessed using the Eating Attitudes Test (EAT-26) with cut-offs for high-risk eating disorder (HRED) and probable eating disorder (PED) at ≥ 11 and ≥ 20, respectively. The interactive factors for eating disorders, such as demographic characteristics, body mass index, waist circumference, and life style, were analyzed further. Results: The prevalence of HRED and PED was 35.6% and 10.6% in obese patients, and 23.3% and 6.8% in non-obese patients, respectively. There was a higher prevalence of HRED, and higher total EAT-26 and dieting subscale scores in obese patients than non-obese adults (p＜0.05). The prevalence of PED, bulimia, and food pre-occupation, and the oral control subscale score were not significantly different between the obese and non-obese groups. Logistic regression analysis revealed that older age, non-married status, lower body mass index, and higher waist circumference were significant risk factors for HRED in obese outpatients. Conclusions: Obese subjects in a weight management outpatient clinic had a higher risk of disordered eating behaviors than non-obese adults, and exhibited significantly different characteristics and life style. We suggest that screening for eating disorders and referral to psychological counseling is appropriate.

並列關鍵字

obesity ； disordered eating ； weight management outpatient ； EAT-26

參考文獻

WHO.Global status report on noncommunicable diseases 2010.

Pan, WH,Wu, HJ,Yeh, CJ(2011).Diet and health trends in Taiwan: comparison of two nutrition and health surveys from 1993-1996 and 2005-2008.Asia Pac J Clin Nutr.20,238-50.

Yeh, CJ,Chang, HY,Pan, WH(2011).Time trend of obesity, the metabolic syndrome and related dietary pattern in Taiwan: from NAHSIT 1993-1996 to NAHSIT 2005-2008.Asia Pac J Clin Nutr.20,292-300.

Boffetta, P,McLerran, D,Chen, Y(2011).Body mass index and diabetes in Asia: a cross-sectional pooled analysis of 900,000 individuals in the Asia cohort consortium.Plos One.6,e19930.

Wu, JS,Lu, FH,Yang, YC(2008).Epidemiological evidence of altered cardiac autonomic function in overweight but not underweight subjects.Int J Obes (Lond).32,788-94.