心理治療有效減輕心因性肥胖患者之體重

Body Weight Reduction in an Obese Patient with Emotional Disturbances

陳冠宇(Kuan-Yu Chen)

《北市醫學雜誌》 2卷3期 (2005/03) Pp. 305-310

https://doi.org/10.6200/TCMJ.2005.2.3.11

摘要

背景：部分肥胖者有狂食的狀況，而狂食則與情緒問題相關，但精神科治療在肥胖問題的角色尚未明。本報告敘述一位因為情緒問題，導致過量飲食的嚴重肥胖者，透過心理治療，改善情緒狀態，進而成功減重的個案。案例報告：個案為國中畢業的家庭主婦，身高153cm。她於民國32歲開始出現恐慌發作症狀，並且養成深夜進食大量食物的習慣，體重曾上升至9lKg(BMI＝38.9)。案母體格肥胖，有長期高血壓問題，39歲時腦中風發作。個案家人均體重過重，但其肥胖程度均不如個案。經過將近三年的精神官能症患者的團體治療後，個案於39歲那年起接受了將近一年，共33次的個別心理治療，情緒控制與自信心有明顯的改善，夜間狂食症狀緩解，體重也在治療結束後的一年內逐漸減輕至最輕70Kg的狀況(BMI=29.9)。結論：對於合併狂食症狀，且有意願的肥胖者，心理治療似乎可以成為有效的療法之一，值得進行相關研究以確認心理治療淤體重控制上的角色。

關鍵字

心理治療 ； 肥胖症 ； 狂食症 ； 薩提爾模式

並列摘要

A 39-year-old married woman underwent year-long 33-session individual psychotherapy to improve her panic and anxiety state, which had lasted for 7 years and was linked to concomitant overeating behavior and severe obesity. She was 153 cm high and weighed 91Kg (BMI=38.9) at the first session of therapy. Before individual psychotherapy, she had received several kinds of group psychotherapy over about 3 years, including interpersonal group and educational group therapy for bulimic patients. Her self-esteem and emotional management ability improved during the therapy and she stopped her nighttime overeating habit after termination of the therapy. Her body weight reduced gradually to about 70Kg (BMI=29.9) over the year after therapy. Further research to clarify the role of psychiatric treatment for obesity victims with overeating behavior and mood disturbance is warranted.

並列關鍵字

psychotherapy ； obesity ； binge-eating disorder ； Satir model