本研究探討以不同的減重介入計畫對肥胖的中國人之體重及生活品質(health-related quality of life, HRQOL)的影響。以減重門診的446位減重者中，完成為期6個月的減重計畫者為受試者，共有119位，平均身體質量指數(body mass index, BMI)在33.5 ± 0.4 Kg/m2，所有受試者均接受低熱量飲食建議，依其接受的減重介入計畫區分為四組：僅接受低熱量飲食建議的LCDS組、併用諾美婷(sibutramine)的SG組、併用羅氏鮮(orlistat)的OG組，以及併用極低熱量飲食(very low calorie diet)的VLCD組。在進入減重計畫前及第6個月時，以體脂計(TBF-410GS, Tanita Co., Tokyo, Japan)及生活品質問卷(36-item Short-Form questionnaire, SF-36)量測介入前後身體組成及生活品質的變化。結果顯示，四組受試者體重均降低，其中以VLCD組下降14.1 ± 1.2 Kg(15.1%)最多(p < 0.001)，其餘各組依次為OG組10.6 ± 0.9 Kg(11.5%)、SG組9.6 ± 1.3 Kg(10.2%)及LCDS組8.7 ± 1.2 Kg(11.1%)。在VLCD組、OG組及LCDS組，SF-36的8個面向分數增加(p < 0.001)，而SG組分數雖然增加，但無統計上的意義。女性在自覺一般健康(general health)及心理部份總和(mental component summary, MCS)介入前後分數增加較男性多(p < 0.05)。依體重降低程度分為超過15%、介於10~15%、介於5~10%及少於5%，比較各組在介入前後SF-36各分量分數變化，結果發現，體重降低超過15%者，分數有進步的SF-36分量數最多，而體重降低少於5%者，在各分量分數上的改變並無統計上意義，進一歩比較四組間的差異，則以體重降低在10%以下的2組，只有身體功能(physical functioning)分數進步量明顯低於其他2組，其餘各分量分數變化在四組間並不明顯。我們推論，對肥胖的中國人，不管是僅給低熱量飲食建議、或低熱量飲食建議併用諾美婷、羅氏鮮或極低熱量飲食的減重介入計畫皆可有效減輕體重，而要影響生活品質則體重減輕需達10%以上。

Objective: To examine the effects of different programmed interventions on weight reduction and health-related quality of life (HRQOL) in obese Chinese.
Research Methods and Procedures: A total of 119 subjects (BMI: 33.5 ± 0.4 Kg/m2) who had completed a 6-month programmed weight loss intervention (with either low calorie diet suggestion (LCDS) alone, add-on medication by sibutramine (SG) or orlistat (OG), or very low calorie diet (VLCD) were enrolled. The changes of body composition (TBF-410GS, Tanita Co., Tokyo, Japan) and HRQOL (36-item Short-Form (SF-36) questionnaire) were obtained before and after the intervention.
Results: The most significant weight reduction (p<0.001) was found in VLCD group (14.1 ± 1.2 Kg, 15.1%), followed by OG (10.6 ± 0.9 Kg, 11.5%), SG (9.6 ± 1.3 Kg, 10.2%) and LCDS alone (8.7 ± 1.2 Kg, 11.1%). The SF-36 scores (p<0.001) were also significantly improved in different dimensions by VLCD, orlistat and LCDS, but only favorable trend without statistical significance in SG. The females had higher change of self-perceived general health score (mean difference: 6.1 ± 2.8, p<0.05) and MCS score (mean difference: 3.5 ± 1.7, p<0.05) than males. Subjects with over 15 % of weight loss had the greatest improvements of SF-36 scores at the 6-month follow-up, but no significant changes in those weight loss < 5%. The mean changes of the SF-36 score were compared in the four groups. The improvement of physical functional was significance in groups of the weight loss 10% or more.
Discussion: Different interventions include LCDS alone, OG, SG and VLCD, had comparable effect of weight loss and improvement of HRQOL in obese Chinese. A substantial weight loss (>10%) is necessary to render the improved HRQOL in obese Chinese.

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