• 한방비만학회지
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• 제20권2호
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• pp.178-192
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• 2020

Objectives: The present study aimed to compare the impacts of cognitive behavioral therapy (CBT) and behavioral treatment (BT) on weight loss and psychological outcomes among patients with three different subtypes of obesity: simple obesity, obesity with binge eating disorder, and obesity with depression. Methods: Embase, PubMed, the Cochrane Central Register of Controlled Trials, Research Information Sharing Service, and Korean Studies Information Service System were systematically searched for randomized controlled trials conducted on or before May 2020, that used CBT to treat obesity. Methodological quality was assessed using Cochrane's risk of bias tool 2 and publication bias was evaluated through the funnel plot using the trim and fill method, Egger's test, and Begg and Mazumdar rank correlation test. A meta-analysis was conducted using a random-effects model and the standardized mean difference with 95% confidence interval (CI) was used to determine effect size. Results: Twenty-one randomized controlled trials with a total of 22 intervention arms and 2,590 patients were included. Our study results revealed that the effects of CBT, compared with BT, on weight loss distinctly differed across all patient subgroups. In the simple obesity group, CBT was more effective than BT (Hedges' g=0.138, CI=0.012~0.264); however, in the obesity with binge eating disorder group, BT was more effective than CBT (Hedges' g=-0.228, CI=-0.418~-0.038); in the obesity with depression group, the effect of CBT was not statistically different from that of BT (Hedges' g=0.276, CI=-0.307~0.859). Further studies with larger sample sizes are required to confirm the outcomes observed in this study. Conclusions: Our results indicated that the effects of CBT on obesity treatment vary based on patient subtype. Therefore, our findings suggest that CBT or BT should be selectively recommended as a treatment strategy for different obesity subtypes.

• 한국심리학회지 : 문화 및 사회문제
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• 제25권4호
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• pp.325-351
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• 2019

본 연구는 외상 사건을 경험한 국내 성인의 외상 후 스트레스(Post Traumatic Stress Disorder) 증상과 외상 후 성장(Post Traumatic Growth) 양상을 토대로 잠재계층(latent class)을 도출하고, 각 집단 구분에 영향을 미치는 특성을 탐색하며, 집단에 따른 자기파괴적 행동의 차이를 탐색함으로써, 외상 사건을 경험한 개인에 대해 보다 심층적으로 이해하고자 한다. 이를 위해 본 연구에서는 DSM-5 진단기준에 해당하는 외상 사건을 경험한 국내성인 860명을 대상으로 잠재프로파일분석(Latent Profile Analysis)과 R-3STEP 방식을 이용하였다. 집단 예측 변인으로 개인의 인구사회학적 변인(성별, 연령, 최종 학력, 종교유무, 종교활동 정도, 월 평균 소득)과 사회적 고립, 외상 경험 빈도가 포함되었으며, 종속변인으로 자기파괴적 행동(폭식 정도, 비자살적 자해 유무, 음주의 양, 음주 형태, 음주로 인한 정신 사회적 문제)을 포함하였다. 연구결과 집단은 '저PTSD/중 PTG집단', '저 PTSD/고 PTG집단', '고 PTSD/고 PTG집단'으로 분류되었다. 또한 성별, 최종학력, 사회적 고립, 외상 노출 빈도가 집단 예측 변인으로 영향을 미치는 것으로 나타났으며, 폭식 정도, 비자살적 자해 유무, 음주 형태, 음주로 인한 정신사회적인 문제에서 집단 간 차이가 있는 것으로 나타났다. 마지막으로 본 연구의 결과를 바탕으로 논의와 시사점을 제시하였다.

• 한방비만학회지
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• 제5권1호
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• pp.75-85
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• 2005

Objectives : This study examined the association between body mass index(BMI) and psychological factors; self-esteem, depression, restraint eating, disinhibition, and hunger. The difference of TFEQ(restraint eating, disinhibition and hunger) was analyzed in variety of current diet situations. Methods : The research was based on a sample of people who visited our website and submit the result of self test(self-esteem n=3183; TFEQ n=5167; BDI n=2457). Results : Self-esteem and BDI was slightly correlated with BMI. There is negative correlation between restraint eating and BMI and positive correlations were observed between hunger and BMI, and disinhibition and BMI. We studied diet situation and eating habits. We divided the sample into 4 groups in accordance with self-submitted result: non-diet group(n=2806), diet-failed group within 3 months group(n=371), maintaining group after successful-diet(n=233), on-going diet group(n=1757) As to restraint eating, non-diet group showed the lowest score in restraint eating and maintaining group after successful-diet showed the highest. The score in disinhibition and hunger was significantly lower in maintaining group after successful-diet group than one in diet-failed group. Conclusion : These results suggest that it would be essential to treat these psychological factors such as depression and self-esteem in weight loss program. Considering the result in diet-situation and TFEQ, we insist that restraint-eating and disinhibition should be controlled. If these psychological factors were not treated in place, even the successful diet might turn out to be a worse situation like binge-eating

• Nutritional Sciences
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• 제4권1호
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• pp.39-46
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• 2001

The effects of a four-week weight control program including nutrition, exercise, behavior modification and meditation were studied in 15 obese children who resided in the Chuncheon area. There were no differences in anthropometric value, health perception, self-esteem and nutrition knowledge before and after the nutrition education program. Food behavior significantly improved after the program, especially in the area of binge eating (p〈0.05). Consumption of ramyon and fried chicken significantly decreased (p〈0.05). These results showed that short-term nutrition education programs did not do enough to change the anthroppometric value of study subject. These results suggest that it is necessary to include parents in nutrition education programs for greater effectiveness. And there is a need to develop an apply systematic nutrition education programs to reduce the weight of obese children.

• 대한응급의학회지
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• 제29권5호
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• pp.551-556
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• 2018

Cases of repeated acute gastric dilatations after binge eating in one patient are rarely reported. We report here a case of repeated acute gastric dilatations in a 22-year-old woman with bulimia nervosa. Her repeated acute gastric dilatations seem to have been related to superior mesenteric artery syndrome. On her last visit due to acute gastric dilatation, she underwent emergency gastric decompression surgery because of abdominal compartment syndrome; however, she eventually died because of ischemia reperfusion injury. Emergency physicians should be aware of the need to manage acute gastric dilatation in patients with eating disorder and should pay attention to the signs and distinctive clinical features of abdominal compartment syndrome.

• 정신신체의학
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• 제28권2호
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• pp.185-193
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• 2020

연구목적 본 연구의 목적은 한국판 섭식장애 진단척도 DSM-5 (Korean version Eating Disorder Diagnostic Scale, K-EDDS)를 웹 기반 진단 시스템으로 개발하고 타당도를 검증하는 데 있다. 방 법 본 연구는 섭식장애 환자(38명)와 대학생(81명)을 포함하여 총 119명이 참여하였다. 모든 참가자는 지필 섭식장애 스크리닝 검사인 Sick, Control, One, Fat, Food (SCOFF) 후 별도의 사이트에서 웹 기반 K-EDDS, 섭식장애검사(Eating Disorder Examination-Questionnaire, EDE-Q), 임상손상평가(Clinical Impairment Assessment Questionnaire, CIA)를 작성했다. SCOFF 점수가 2점 이상인 사람을 대상으로 EDE (Eating Disorder Examination Interview) 면담을 진행하였다. 검사 후 2주 이내에 웹 기반 K-EDDS, EDE-Q, CIA를 재실시하였다. 결 과 탐색적 요인분석 결과, 신체불만족, 폭식행동, 폭식빈도, 보상행동의 4가지 요인이 추출되어 총 분산의 82.4%를 설명하였다. 웹 기반 K-EDDS의 4개 하위요인은 EDE-Q의 4개 하위요인과 각각 유의미한 상관관계가 있었으며, 우수한 내적 일치도를 보였다(Cronbach's alpha=0.93). 웹 기반 K-EDDS와 EDE의 진단 일치도는 96.83%, 웹 기반 K-EDDS의 검사-재검사 진단 일치도는 92.86%로 우수하였다. 웹 기반 K-EDDS와 CIA에서 환자군과 정상군 간 차이가 유의하게 나타나, 본 척도의 판별 타당도를 검증하였다. 결 론 본 연구를 통해 웹 기반 K-EDDS는 임상 및 연구 현장에서 DSM-5를 기반으로 한 섭식장애 진단에 유용하게 사용할 수 있는 타당한 도구임을 확인하였다.

• 한국식생활문화학회지
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• 제26권4호
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• pp.354-363
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• 2011

This study aimed to find the differences in weight control status and eating behavior of satisfied and dissatisfied female high school students regarding their own body shape. The participants consisted of 238 students at two female high schools in Nonsan-si, Chungnam-do in May of 2008. Self-assessment evaluated present body shape and ideal body shape they would like to have by providing silhouette drawings. The subjects were divided into two groups, 'satisfied' and 'dissatisfied', according to the differences between present body shape and ideal body shape. In the distribution of subjects according to body mass index, 100% of overweight, 97.0% of normal weight and 48.7% of underweight belonged to the dissatisfied group. There were significant differences in weight control and eating behavior between dissatisfied and satisfied groups in terms of frequency and reasons of conducting weight control behavior, body weight return after weight reduction, skipping breakfast and consuming fast food. The satisfied group was two times more likely to not conduct weight control behaviors compared to the dissatisfied group. The main reason for trying to control weight differed according to the group; the reason was feeling fat in the dissatisfied group and desiring to be healthy in the satisfied group. The percentage of subjects that returned to their original weights after weight reduction was 5 times higher in the dissatisfied group. The percentages of subjects that regularly skip breakfast and consume fast food were both higher in the dissatisfied group than in the satisfied group. The dissatisfied group responded 'eating alone' more frequently among nine binge eating behaviors compared to the satisfied group. Both groups, however, did not show any difference in overeating of meals, eating speed, intake frequency of regular meals, food preference, preferred cooking method, carbonated beverage intake and snack eating behavior. In summary, the dissatisfied group tried more unnecessary body weight reduction and had poor eating behavior. Accordingly, to correct the biased perception of body shape by the majority of female high school students, the values of our society should change toward the pursuit of beauty of health.

• 한방비만학회지
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• 제19권2호
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• pp.119-136
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• 2019

Objectives: People often fail to maintain their weight even though they have succeeded in weight loss. The purpose of this study was to review previously published study results with regards to the predictive factors associated with weight loss maintenance after successful weight loss. Methods: The authors searched for the articles related to weight loss maintenance after successful weight loss, published up until June 2019 on PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, Research Information Sharing Service (RISS), and Koreanstudies Information Service System (KISS). A total of 76 articles were finally selected. From the study results, changeable and unchangeable predictors were extracted, and these predictors were examined according to detailed categories. Results: The changeable predictors of weight loss maintenance included behavioral factors, psychological factors and treatment process-related factors, whereas the unchangeable predictors included genetic and physiological factors, demographic factors, history of treatment on obesity-related factors. The main factors of weight loss maintenance were changeable predictors such as healthy eating habits, dietary intake control, binge eating control, regular exercise and physical activity, depression and stress control, social supports, self-regulation, self-weighing and initial weight loss and unchangeable predictors such as low initial weight and maximum lifetime weight. Conclusions: The results of our review results suggest that changeable and unchangeable predictors of weight loss maintenance should be carefully examined during treatments of obesity.

• 치위생과학회지
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• 제12권5호
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• pp.525-534
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• 2012

본 연구는 서울 및 서울 근교지역에서 치위생 업무를 수행하는 치과위생사 273명을 대상으로 직무스트레스 점수, 식행동 점수, 근무환경, 식습관, 스트레스 관련 요인을 조사하여 치과위생사의 건강증진을 위한 기초 자료로 쓰고자 하며, 그 결과를 요약하면 다음과 같다. 1. 조사대상자의 연령은 25세 이하 46.5%, 26~30세 38.1%로 나타났으며, 교육수준은 전문대 졸업이 71.4%로 가장 많았다. 근무형태는 치과위생사 7명 이상 치과의원이 33.0%, 치과병원 28.2%로 나타났고, 치과위생사 총 경력은 1~3년 38.1%, 3~5년 18.7%, 월 급여는 151~200만원이 46.9%로 가장 많게 나타났다. 2. 식습관과 관련된 요인에서 아침식사를 거르는 주된 원인으로 60.4%가 '시간이 없어서'로 응답하였고, 식습관 중 개선하기 원하는 것은 33.0%가 과식을 꼽았으며, 과식 혹은 폭식을 하는 경우는 51.6%가 스트레스 때문이라고 응답하였다. 3. 본인 스트레스 자각 정도는 15.8%가 스트레스를 '매우 많이', 43.2%가 '많이 느낀다'고 응답하였고, 스트레스 원인으로 39.6%가 업무량을, 동료관계가 28.2%로 나타났다. 스트레스 해결방법은 39.9%가친구들과 수다로 가장 많이 해결하고 있으며, 스트레스 시 선호하는 맛은 매운맛 54.2%로 가장 높았고, 스트레스 후 식사 섭취량의 증가는 12.1%가 평소보다 매우 많이, 49.8%가 평소보다 많이 먹는 것으로 조사되었다. 4. 직무스트레스가 높은 상위 그룹에서 본인 스트레스 자각 정도가 높게 나타났다(p<0.001). 5. 직무스트레스 점수가 높은 군에서 신경예민(p<0.01), 허리 통증(p<0.001), 눈의 피로(p<0.01), 두통(p<0.01), 소화불량(p<0.01)을 경험하고 있어, 직무스트레스가 건강에 영향을 끼치고 있음이 드러났다. 6. 직무스트레스와 식행동의 관계에서는 직무스트레스가 높을수록 식행동이 불량한 것(p<0.01)으로 조사 되었고, 사후분석(LSD)을 실시한 결과 Middle rank>Middle rank>High rank 순으로 직무스트레스가 식습관 정도에 대해 차이(p<0.05)가 있는 것을 알 수 있다. 7. 치과위생사 3명 이하 치과의원에서 직무스트레스 점수가 높았고(p<0.05), 식행동 점수도 낮게 나타났으며, 주 4일 야간진료를 하는 그룹에서 직무스트레스가 높고, 식행동 점수도 낮게 나타났다(p<0.05). 근무 중 휴식 시간이 없는 경우 직무스트레스 점수가 높게 나타났고(p<0.001), 식행동 점수도 낮게 드러났으며(p<0.01), 스트레스 자각을 매우 많이 느끼는 경우 직무스트레스 점수가 가장 높게 나타났으며(p<0.001), 식행동 점수도 가장 불량하게 조사되었다(p<0.05). 직무스트레스가 식행동 및 식습관뿐만 아니라 건강상태에도 불량하게 영향을 끼치는 것으로 확인 되었기에 각 사업장에서는 치과위생사의 건강증진을 위해 다양한 방안을 모색할 필요가 있다.

• Journal of Korean Biological Nursing Science
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• 제15권1호
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• pp.8-14
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• 2013

Purpose: The purpose of this study was to investigate factors related to obesity of mid-age women and to examine the relationship between obesity and chronic diseases including diabetes, hypertension, and heart disease. Methods: Using data from Korean American adults living in California, we analyzed the health behavior (diet, exercise, smoking, and binge drinking) and psychological stress of obese women with body mass index ${\geq}25$ by using chi-square test. Logistic regression was used to investigate independent effects of obesity on chronic diseases, after controlling for risk factors. Results: The prevalence of obesity appeared about 16.9%. The Obese group was less likely than the non-obese group to eat vegetables and more likely feel psychological stress. There were no significant differences in smoking, alcohol intake, and physical exercise between the two groups. Obesity was strongly related to chronic diseases (OR=4.642, 95% CI=1.328-16.222). Conclusion: This study suggests that obesity of mid-age women could be reduced by encouraging health behavior such as eating vegetables daily, performing physical exercise regularly, and taking care of emotional stress. Diet and physical activity interventions and emotional supports should be developed for weight loss and prevention of weight gain in mid-age women.