There is substantial evidence documenting the effects of behavioural interventions on weight loss (WL). However, behavioural approaches to initial WL are followed by some degree of longer-term weight regain, and large trials focusing on evidence-based approaches to weight loss maintenance (WLM) have generally only demonstrated small beneficial effects. The current state-of-the-art in behavioural interventions for WL and WLM raises questions of (i) how we define the relationship between WL and WLM, (ii) how energy balance (EB) systems respond to WL and influence behaviours that primarily drive weight regain, (iii) how intervention content, mode of delivery and intensity should be targeted to keep weight off, (iv) which mechanisms of action in complex interventions may prevent weight regain and (v) how to design studies and interventions to maximise effective longer-term weight management. In considering these issues a writing team within the NoHoW Consortium was convened to elaborate a position statement, and behaviour change and obesity experts were invited to discuss these positions and to refine them. At present the evidence suggests that developing the skills to self-manage EB behaviours leads to more effective WLM. However, the effects of behaviour change interventions for WL and WLM are still relatively modest and our understanding of the factors that disrupt and undermine self-management of eating and physical activity is limited. These factors include physiological resistance to weight loss, gradual compensatory changes in eating and physical activity and reactive processes related to stress, emotions, rewards and desires that meet psychological needs. Better matching of evidence-based intervention content to quantitatively tracked EB behaviours and the specific needs of individuals may improve outcomes. Improving objective longitudinal tracking of energy intake and energy expenditure over time would provide a quantitative framework in which to understand the dynamics of behaviour change, mechanisms of action of behaviour change interventions and user engagement with intervention components to potentially improve weight management intervention design and evaluation.
Obes Facts

中文翻译：

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H2020“NoHoW 项目”：关于长期体重管理行为方法的立场声明

有大量证据证明行为干预对减肥 (WL) 的影响。然而，初始 WL 的行为方法之后会出现某种程度的长期体重恢复，并且专注于基于证据的减肥维持 (WLM) 方法的大型试验通常只显示出很小的有益效果。当前 WL 和 WLM 行为干预的最新技术提出了以下问题：(i) 我们如何定义 WL 和 WLM 之间的关系，(ii) 能量平衡 (EB) 系统如何响应 WL 并影响主要的行为推动体重反弹，(iii) 应如何针对干预内容、交付方式和强度来保持体重减轻，(iv) 复杂干预措施中哪些作用机制可以防止体重反弹以及 (v) 如何设计研究和干预措施以最大限度地实现长期有效的体重管理。在考虑这些问题时，NoHoW 联盟内的一个写作团队被召集起来制定立场声明，并邀请行为改变和肥胖专家讨论这些立场并加以完善。目前的证据表明，发展自我管理 EB 行为的技能会导致更有效的 WLM。然而，行为改变干预对 WL 和 WLM 的影响仍然相对较小，我们对破坏和破坏饮食和身体活动自我管理的因素的理解是有限的。这些因素包括对减肥的生理抵抗，饮食和身体活动的逐渐补偿性变化以及与满足心理需求的压力、情绪、奖励和欲望有关的反应过程。将循证干预内容与定量跟踪的 EB 行为和个人的特定需求更好地匹配可能会改善结果。随着时间的推移，改进对能量摄入和能量消耗的客观纵向跟踪将提供一个定量框架，在该框架中了解行为改变的动态、行为改变干预的作用机制以及用户参与干预组件，以潜在地改进体重管理干预设计和评估。将循证干预内容与定量跟踪的 EB 行为和个人的特定需求更好地匹配可能会改善结果。随着时间的推移，改进对能量摄入和能量消耗的客观纵向跟踪将提供一个定量框架，在该框架中了解行为改变的动态、行为改变干预的作用机制以及用户参与干预组件，以潜在地改进体重管理干预设计和评估。将循证干预内容与定量跟踪的 EB 行为和个人的特定需求更好地匹配可能会改善结果。随着时间的推移，改进对能量摄入和能量消耗的客观纵向跟踪将提供一个定量框架，在该框架中了解行为改变的动态、行为改变干预的作用机制以及用户参与干预组件，以潜在地改进体重管理干预设计和评估。
肥胖事实