식이행동설문지로 조사한 섭식척도 관련 요인과 비만 치료에 따른 섭식척도의 변화
Factors Related to Eating Behavior Assessed Using the Dutch Eating Behavior Questionnaire and Change of Eating Behavior after Receiving Weight Reduction Treatment
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초록
연구배경: 본 연구는 비만클리닉 환자와 건강검진 수진자에서 식이행동과 관련된 요인을 파악하고, 비만 환자에서 체중감량 치료 전후 식이행동변화 및 변화와 관련된 요인에 대해평가하였다. 방법: 비만클리닉 초진 여성환자(비만클리닉환자군) 76명과건강검진 여성 수진자(검진수진자군) 83명을 대상으로 국문Dutch Eating Behavior Questionnaire로 섭식척도(절제된 섭식,정서적 섭식, 외부적 섭식)를 평가하였고, 비만 환자 59명에서2-3개월 치료를 하면서 식이행동을 재조사 하였다. 인구학적특성, 신체활동, 건강관련습관, 감량 경험을 자가 설문지로 조사하였다. 체질량지수(BMI)는 측정된 체중과 신장으로 계산하였고, 체중변화량은 초기조사와 추구조사를 시행할 때 측정한 체중 간의 차이로 계산하였다. 결과: 비만클리닉환자군은 검진수진자군에 비해 절제된 섭식척도에서만 유의하게 점수가 높았다. 다이어트 경험이 있거나 정서적 섭식척도 점수가 클수록, BMI가 클수록 제한된섭식척도 점수가 증가하였다(R2=16%). 절제된 섭식척도 점수나 외부적 섭식척도 점수가 높을수록, 나이가 어릴수록 정서적 섭식척도 점수가 증가하였고(R2=27%), 정서적 섭식척도 점수가 클수록, 고졸 이상 학력에서(이하 학력보다), 규칙적으로 운동할수록, 과식을 자주할수록 외부적 섭식척도 점수가 증가하였다(R2=30%). 비만클리닉환자군에서 절제된 섭식척도 점수는 치료 후 유의하게 증가하였으나 정서적, 외부적 섭식척도 점수는 치료 전후에 차이가 없었다. 선형회귀분석에서 치료 후 절제된 섭식척도 점수의 증가와 관련된 특성은 빈번한 불규칙한 식사습관 뿐이었다(Beta=1.13, SE=0.51,P=0.033, R2=13.5%). 결론: 전체 대상자에서는 절제된 섭식의 증가가 체질량지수증가와 관련이 있지만 비만환자에 국한하였을 때 치료 후 절제된 섭식의 증가는 체중의 변화량이나 초기 체질량지수가아닌 불규칙한 식사습관과 관련이 있었다.
Abstract
Background: This study aimed to examine the factors related to eating behavior subscales and change of eating behavior subscales among obese patients received weight reduction management. Methods: Eating behavior subscales (restrained eating, emotional eating, and external eating) were assessed using the Korean version of Dutch Eating Behavior Questionnaire in 76 obese female patients at obesity clinic and 83 female visitors at health promotion center. Fifty nine patients received weight reduction management and completed followup survey after 2-3 months. Demographics, physical activity, health behaviors, diet experience, BMI, and weight change were assessed. Results: The score of restrained eating was significantly higher in obese patients compared to controls, while scores of other subscales were not different between the two groups. Diet experience, score of emotional eating, and BMI explained 15% of variance of restrained eating score after adjustment for covariates. Likewise, increase of restrained and external eating scores and younger age explained 27% of variance of emotional eating score. External eating score was associated with increase in emotional eating score, higher education, regular exercise, and frequent overeating (R2 = 30%). Among obese patients, the follow-up score of restrained eating was significantly higher compared to that score at baseline, while the scores of emotional and external eating were not significantly changed. After adjustment for covariates, only irregular eating habit was associated with the change of restrained eating score. Conclusion: Restrained eating score was associated with BMI regardless of subjects group, while, among obese patients,the change of restrained eating score was associated with frequent irregular eating habit.
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