Effectiveness of a Group Support Lifestyle Modification (GSLiM) Programme among Obese Adults in Workplace: A Randomised Controlled Trial

BackgroundThere was an increasing trend in the prevalence of obesity and its comorbidities over the past decades in Malaysia. Effective intervention for obesity remains limited. This study aimed to compare the effectiveness of a group based lifestyle modification programme amongst obese individuals with an existing dietary counseling programme.MethodsWe recruited one hundred and ninety four overweight and obese (BMI>27.5 kg/m2) employees from a local university. They were randomly allocated to either Group Support Lifestyle Modification (GSLiM) (intervention)(n = 97) or dietary counseling (comparison)(n = 97). The GSLIM activities included self monitoring, cognitive-behaviour sessions, exercise as well as dietary change advocacy, which were conducted through seminars and group sessions over 24 weeks. The comparison group was given dietary counselling once in 12 weeks. Both groups were followed up for additional 12 weeks to check for intervention effect sustenance. Anthropometric and biochemical parameters were measured at baseline, 12, 24 and 36 weeks; while dietary intake, physical activities, psychological measures and quality of life measured at baseline, 24 and 36 weeks. Data analysis was conducted using ANOVA repeated measures with intention to treat principle.ResultsThe participants were predominantly women with mean (standard deviation) age of 40.5 (9.3) years. A total of 19.6% of the participants in GSLiM achieved 6% weight loss compared to 4.1% in the comparison group (Risk Ratio 4.75; 95% CI: 1.68, 13.45). At 24 weeks, the retention rate was 83.5% for GSLiM and 82.5% for comparison group. GSLiM participants also achieved significant improvement in total weight self-efficacy score, negative emotions and physical discomfort subscales, MDPSS friend subscale and all domains in quality of life. Participants in the comparison group experienced reduction in negative self-thoughts.ConclusionThe GSLiM programme proved to be more effective in achieving targeted weight loss, improving weight self-efficacy, friend social support, and quality of life compared to dietary counseling.Trial RegistrationIranian Registry of Clinical Trials IRCT201104056127N1研究背景 过去数十年来，马来西亚肥胖症及其合并症的患病率呈持续上升趋势，而针对肥胖的有效干预手段仍较为匮乏。本研究旨在对比基于团体的生活方式改良方案与现有膳食咨询方案在肥胖人群中的干预效果。 研究方法 本研究从某本地高校招募了194名超重及肥胖[体重指数（Body Mass Index, BMI）>27.5 kg/m²]员工，采用随机分组原则将其分为团体支持生活方式改良（Group Support Lifestyle Modification, GSLiM）干预组（n=97）与膳食咨询对照组（n=97）。GSLiM干预内容涵盖自我监测、认知行为辅导、运动指导及膳食改变倡导，通过为期24周的专题讲座与团体活动开展实施。对照组每12周接受1次膳食咨询。两组均追加12周随访，以评估干预效果的持续维持情况。 分别于基线、12周、24周及36周测量两组的人体测量学指标与生化指标；于基线、24周及36周评估膳食摄入、体力活动、心理状态及生活质量。数据分析采用意向性治疗原则结合重复测量方差分析（Analysis of Variance, ANOVA）完成。 研究结果 本研究参与者以女性为主，平均年龄为40.5岁（标准差9.3）。GSLiM组共有19.6%的参与者实现6%及以上的体重降幅，对照组仅为4.1%（风险比（Risk Ratio, RR）=4.75；95%置信区间（Confidence Interval, CI）：1.68~13.45）。干预24周时，GSLiM组的随访保留率为83.5%，对照组为82.5%。 GSLiM组参与者在总体体重自我效能感评分、负面情绪与躯体不适子量表、多维感知社会支持量表（Multidimensional Perceived Social Support Scale, MDPSS）朋友支持子量表及生活质量各维度上均获得显著改善；对照组参与者的负面自我思维水平有所降低。 研究结论 相较于膳食咨询方案，GSLiM方案在实现目标体重降幅、提升体重自我效能感、朋友社会支持水平及生活质量方面均展现出更优的干预效果。 试验注册 伊朗临床试验注册中心（Iranian Registry of Clinical Trials）IRCT201104056127N1