目的：肥胖易與生理、心理疾病共病，減重可以改善這些與肥胖相關的疾病。肥胖患者常併有飲食異常行為，但常受到輕忽而可能影響減重的成效。台灣探討體重管理門診肥胖個案的飲食異常行為研究仍然稀少。本研究擬以SCOFF問卷於體重管理門診篩檢飲食異常行為的盛行率及相關危險因子，同時探討飲食異常行為是否會影響肥胖者參與減重介入計畫及相關成效並建立可能影響體重管理門診初診個案參與減重介入計畫、流失率以及減重成功的預測因子。
方法：自2004年1月至2012年6月，選取年齡≧18歲（平均為35.99±11.49歲）且身體質量指數≧24公斤/公尺2（平均為34.67±7.21公斤/公尺2）之男性292位及女性522位至體重管理特別門診的初診病患。以病歷回溯分析人口基本資料、體重相關變項以及使用SCOFF問卷篩檢飲食疾患的高危險群，探討飲食異常行為的危險因子和參與六個月減重計畫、流失率以及減重成功的預測因子。
結果：SCOFF問卷之Cronbach’s α為0.32，折半信度為0.41，因素分析的結果累積解釋量為48.41%。814位初診個案SCOFF問卷的平均分數為1.03±0.96，飲食異常行為共253位，盛行率為31.1%；年紀較輕者(勝算比=0.965, 95%信賴區間=0.951-0.979, p＜0.001)、飲食過量者(勝算比=1.977, 95%信賴區間=1.368-2.857, p＜0.001)及有情緒壓力者(勝算比=1.626, 95%信賴區間=1.150-2.299, p=0.006)為飲食異常行為獨立正相關危險因子。本研究共556位參與六個月的減重介入計畫，18歲之後最輕的體重愈重者(勝算比=1.057, 95%信賴區間=1.022-1.093, p=0.001)、愈多減重經驗者(勝算比=1.649, 95%信賴區間=1.150-2.365, p=0.007)以及每月減輕目標體重速率較少者(勝算比=0.942, 95%信賴區間=0.897-0.990, p=0.018)愈容易進入減重介入計畫。參加六個月減重介入計劃者的流失率為51.3%；飲食異常行為(勝算比=0.792, 95%信賴區間=0.644-0.974, p=0.027)與體重過重者(勝算比=0.457, 95%信賴區間=0.224~0.932, p=0.031)為完成減重計畫獨立負相關危險因子，手術(勝算比=18.144, 95%信賴區間=6.742-48.832, p＜.001)及藥物(勝算比=2.706, 95%信賴區間=1.840-3.978, p＜.001)介入方式為完成減重計畫的正相關預測因子。六個月達成減重成功比率為25.9%；飲食異常行為在減重成功與未成功之間無顯著差異，每月減輕目標體重速率較高者(勝算比=1.154, 95%信賴區間=1.034-1.287, p=0.011)、自覺需要減重者(勝算比=2.542, 95%信賴區間=1.473-4.388, p=0.001)以及手術介入者(勝算比=4.418, 95%信賴區間=1.619-10.631, p=0.003)可以預測減重成功。
結論：體重管理門診初診個案中以SCOFF問卷篩檢符合飲食異常行為比例達31.1%，其中以年紀較輕、自認肥胖成因為飲食過量或情緒壓力者的風險較高。具有飲食異常行為者可能較易於減重介入期間流失，但不會影響是否參與減重介入計畫或減重成功。體重較重、減重經驗較多、減重期望、飲食異常行為、以及不同的介入方式可能與體重管理門診初診個案參與減重計畫率、流失率、以及減重成功率相關。然而，SCOFF問卷運用於體重管理門診肥胖患者的信效度不高，未來需要更多研究探討其適用性。

The disordered eating behavior is not uncommon in obese pateients, but easily neglected even detrimented to the effect of weight reduction. This study was designed to use the SCOFF questionnaire to screen the prevalence of disordered eating behavior and its associated risk factors in weight management clinic. The role of SCOFF as a predictor of enrollment, drop-out and success of programmed weight loss in the weight management clinic will also be discussed. A total of 292 males and 522 females first visit to weight management clinic subjects with aged≧18 y/o (mean=35.99±11.49) and body mass index ≧ 24 kg/m2 (mean=34.67±7.21) were enrolled. According to the chart record, the data were analyzed. The prevalence of disordered eating behavior screened by the SCOFF questionnaires is 31.1% in a weight management clinic. Those who were younger, self-rated cause of obesity as overeating or emotional distress were the risk factors for disordered eating behavior. Those who were heavier, having more weight loss experiences and disordered eating behavior, having higher weight loss expectations, as well as having different interventions might be associated with rates of enrollment, drop-out and successful weight loss.

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