本研究探討營養教育配合不同程度商業減重代餐的應用在減重計畫上，對減重成效及生活品質之評估。實驗A組使用所提供之減重代餐一包取代一天的部份飲食，實驗B組每日使用兩包代餐取代部份飲食。兩組控制熱量的攝取是依照個別體重與活動量計算出總熱量後再減五百大卡，並完成自填式問卷包括生活品質問卷、及背景資料問卷等，實驗進行為期12週。實驗A組共16名，平均減輕體重和減輕BMI分別為8.23±3.70公斤和3.09±1.38，減輕體重和BMI分別為9.44±3.67%和9.75±3.87%。B組共14名，平均減輕體重和減輕BMI分別為9.43±2.74公斤和3.68±1.03，減輕體重和BMI分別為11.65±3.03%和11.60±3.04%。實驗A組減重後追蹤三個月之體重仍持續下降，體重從78.18±9.57降至73.96±6.92。實驗B組亦有顯著下降，體重從71.79±11.02公斤降至68.27±9.38公斤。A、B兩組追蹤六個月體重及BMI則與減重後三個月所測得的數值大致相同, 並無顯著下降。減重前後兩組腰臀圍、腰臀比、血糖、尿酸、血膽固醇、三酸甘油脂及低密度脂蛋白有顯著下降（p＜0.05）。但兩組間改變的差異並無達顯著的不同。SF-36兩組健康相關生活品質量表在減重12 週後，其SF-36健康相關生活品質量表中，生理功能（PF）、因生理功能問題而角色受限（RP）、身體疼痛（BP）、一般健康（GH）、活力（VT）、社會功能（SF）、因情緒問題而角色受限（RE）、心理健康（MH）八個構面及「體能綜合評估」（PCS）、「心理綜合評估」（MCS）兩個面向呈現統計學意義上的進步，尤其在一般健康（GH）最顯著。惟兩組之間在所測向度中也並未達顯著的不同。結論：代餐減重配合營養師的諮詢，可異於傳統的取代全餐的代餐介入方式，將代餐取代部分餐食，不僅有良好的減重成效並可全面提昇健康相關之生活品質，代餐介入的程度不同對減重成果及生活品質並無顯著的影響。

The purpose of this study was to evaluate the effectiveness of weight loss and life quality by the method of nutrition education along with providing different degree of liquid meal replacements. Group A and group B received meal replacements once and twice daily, respectively, for 12 weeks of study. The total calories controls in both groups are based on the calculated energy needs minus 500 Kcal/day. Body weight, waist and hip, biochemical examination and several structured questionnaires were used for data collection at before and after study. Group A (n＝16； male＝3，female＝13) and group B (n＝14；male＝6，female＝8) were aged 38.3±15.2 and 32.6±9.5 years, with body weights of 86.41±10.87 and 81.22±11.79 kg, and BMI of 31.54±3.65 and 31.81±3.24 kg/m2, respectively, before treatment. There were significant weight loss in both groups, 9.44±3.67% and 11.65±3.03%, however, no significant difference was found in between groups. Waist and hip measurements, blood sugar, cholesterol, triglyceride, and LDL concentrations had significantly decreased in both groups (p＜0.05), however, no significant difference was found in between groups. Physical functioning(PF), role-physical(RP), bodily pain(BP), general health(GH), vitality(VT), social functioning(SF), role-emotional (RE), and physical component summary (PCS) in the Medical Outcomes Study Short-Form 36 Health Survey (SF-36, as the assessment of HRQL) were also showed significant improvement, but again there was no significance in between groups. We concluded that the use of nutrition education along with liquid meal replacements provide significant weight loss and improvement in quality of living. However, the degrees of intervention did not contribute significant difference in the treatment outcomes.

目錄
中文摘要..................................................................................................... I
英文摘要................................................................................................... II
目錄..........................................................................................................III
圖表目錄.................................................................................................. VI
第一章 緒論...............................................................................................1
第一節 研究動機................................................................................................................. 1
第二節 研究目的................................................................................................................. 4
第三節 研究問題................................................................................................................. 5
第四節 名詞界定................................................................................................................. 6
第二章 文獻回顧......................................................................................8
第一節 肥胖流行病學......................................................................................................... 8
第二節 肥胖的定義及判斷標準....................................................................................... 11
第三節 肥胖的成因........................................................................................................... 13
第四節 肥胖對身體的影響............................................................................................... 18
第五節 減重的方法........................................................................................................... 22
第六節 飲食與肥胖之關係............................................................................................... 28
第七節 代餐減重之應用................................................................................................... 30
第八節 生活品質定義與相關研究................................................................................... 33
第三章 研究方法....................................................................................45
第一節 研究執行流程圖與實驗設計............................................................................... 45
第二節 研究對象............................................................................................................... 47
第三節 飲食介入............................................................................................................... 49
第四節 研究工具............................................................................................................... 51
IV
第五節 統計方法............................................................................................................... 59
第四章 研究結果....................................................................................60
第一節 基本資料............................................................................................................... 60
第二節 熱量及三大營養素控制的成效........................................................................... 61
第三節 減重成效............................................................................................................... 63
第四節 生活品質在代餐介入前後之比較....................................................................... 65
第五章 討論.............................................................................................78
第一節 代餐飲食調整對減重的影響............................................................................... 78
第二節 減重對體位測量值影響之探討........................................................................... 80
第三節 受試者血液生化值之探討................................................................................... 82
第四節 代餐減重對自覺健康狀態的影響....................................................................... 85
第六章 結論與建議................................................................................88
參考文獻...................................................................................................89
英文部分............................................................................................................................. 89
中文部分........................................................................................................................... 101
附錄一 義大醫院醫學倫理委員會同意臨床試驗計畫證明書........105
附錄二 受試者同意書........................................................................106
附錄三 飲食原則與食物代換............................................................107
附錄四 食物熱量介紹........................................................................108
附錄五 每日飲食記錄........................................................................109
附錄六 運動熱量消耗表....................................................................110
附錄七 配方食品說明書....................................................................111
V
附錄八 問卷...........................................................................................112
附錄九 SF-36 授權同意書.................................................................117
VI
圖表目錄
表一、受試者之基本資料概況..............................................................68
表二、受試者之生理基本資料..............................................................69
表三、減重前後總熱量及三大營養素的變化......................................70
表四、代餐減重介入十二週的體重及BMI 變化.................................71
表五、代餐減重介入十二週的體位測量值的變化..............................72
表六、代餐減重介入十二週的體位測量值的變化..............................72
表七、代餐減重介入十二週的血液生化值的變化..............................73
表八、代餐減重介入十二週的血液生化值的變化..............................73
表九、比較兩組之減重前後體位及生化測量值的變化......................74
表十、SF-36 健康量表代餐減重介入前後的變化..............................75
表十一、SF-36 健康量表代餐減重介入前後的變化..........................75
表十二、代餐減重介入十二週之SF-36 健康量表的變化.................76
圖一、減重前後及追蹤三個月、六個月之體重變化情形…………77
圖二、減重前後及追蹤三個月、六個月之BMI 變化情形…………77

Allison DB, Fontaine KR, Manson JE, Stevens J, VanItallie TB: Annual deaths attributable to obesity in the United States. JAMA 284: 1530-1538, 1999.
Anderson JW, Brinkman-Kaplan V, Hamilton CC, Logan JE, Collins RW, Gustafson NJ: Food-containing hypocaloric diets are as effective as liquid-supplement diets for obese individuals with NIDDM. Diabetes Care 17: 602-604, 1994.
Anderson RE, Wadder TA, Bartlett SJ, Vogt RA, Weinstock RS: Relation of weight loss to changes in serum lipids and lipoproteins in obese women. Am J Clin Nutr 62: 350-357, 1995.
Ashley JM, St Jeor ST, Schrage JP, Perumean-Chaney SE, Gilbertson MC, McCall NL, Bovee V: Weight control in the physician’s office. Arch Intern Med 161: 1599-1604, 2001.
Ayyad C, Andersen T: Long-term efficacy of dietary treatment of obesity: a systematic review of studies published between 1931 and 1999. Obes Rev 1: 113-119, 2000.
Banerji MA, Buckley MC, Chaiken RL, Gordon D, Lebovitz HE, Kral JG: Liver fat, serum triglycerides and visceral adipose tissue in insulin-sensitive and insulin-resistant black men with NIDDM. Int J Obes Relat Metab Disord 19: 839-840, 1995.
Bender R, Jöckel KH, Trautner C, Spraul M, Berger M: Effect of age on excess mortality in obesity. JAMA 281: 1498-1504, 1999.
Bergner M, Bobbitt RA, Carter WB, Gilson BS: The Sickness Impact Profile: development and final revision of a health status measure. Med Care 19: 787-805, 1981.
Blundell JE, King NA: Physical activity and regulation of food intake: current evidence. Med Sci Sports Exerc 31: S573-S583, 1999.
Blundell JE, Lawton CL, Cotton JR, Macdiarmid JI: Control of human appetite: implications for the intake of dietary fat. Annu Rev Nutr 16: 285-319, 1996.
Booth DA, Campbell AT, Chase A: Temporal bounds of post-ingestive glucose induced satiety in man. Nature 228: 1104-1105, 1970.
Booth-Kewley S, Friedman HS: Psychological predictors of heart disease: a quantitative review. Psychol Bull 101: 343-362, 1987.
Bravo G, Gauthier P, Roy P, Payette H, Gaulin P: A weight-bearing, waterbased exercise program for osteopenic women: its impact on bone, functional fitness, and well-being. Arch Phys Med Rehabil 78: 1375-1380, 1997.
Bray GA: Complications of obesity. Ann Intern Med 103: 1052-1062, 1985.
Bray GA: Overweight is risking fate. Definition, classification, prevalence, and risks. Ann N Y Acad Sci 499: 14-28, 1987.
Bray GA: Pathophysiology of obesity. Am J Clin Nutr 55: 488S-494S, 1992.
Brooks RG: Health status measurement: A perspective on change. London: MacMillan Press, 1995.
Brown WJ, Mishra G, Kenardy J, Dobson A: Relationships between body mass index and well-being in young Australian women. Int J Obes 24: 1360-1368, 2000.
Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW: Body-mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med 341: 1097-1105, 1999.
Chou P, Soong LN, Lin HY: Community-based epidemiological study on hyperuricemia in Pu-Li, Taiwan. J Formos Med Assoc 92: 597-602, 1993.
Cid-Ruzafa J, Damian-Moreno J: Disability evaluation: Barthel''s index. Rev Esp Salud Publica 71: 127-137, 1997.
Coakley EH, Kawachi I, Manson JE, Speizer FE, Willet WC, Colditz GA: Lower levels of physical functioning are associated with higher body weight among middle-aged and older women. Int J Obes 22: 958-965, 1998.
Coulston AM, Johnson RK: Sugar and sugars: myths and realities. J Am Diet Assoc 102: 351-353, 2002.
Crawford JD, Osler DC: Body composition at menarche: The Frisch-Revelle hypothesis revisited. Pediatrics 56: 449-458, 1975.
Dattilo AM, Kris-Etherton PM: Effect of American Heart Association diet, with or without weght loss, on lipide in obese middle-aged and older men.Am J Clin Nutr 62: 715-721, 1992.
Dattilo AM, Kris-Etherton PM: Effects of weight reduction on blood lipids and lipoproteins: a meta-analysis. Am J Clin Nutr 56: 320-328, 1992.
Davies KM, Heaney RP, Recker RR, Lappe JM, Barger-Lux MJ, Rafferty K, Hinders S: Calcium intake and body weight. J Clin Endocrinol Metab 85: 4635-4638, 2000.
Davis BR, Blaufox D, Oberman A, Wassertheil-Smoller S, Zimbaldi N, Cutler JA, Kirchner K, Langford HG: Reduction in long-term antihypertensive medication requirements: effects of weight reduction by dietary intervention in overweight persons with mild hypertension. Arch Intern Med 153: 1773-1782, 1993.
Dendel JL, Katzel Ll, Goldberg: Effect of and American Heart Association diet, with or without weight loss, on lipid in obese middle-aged and older men. Am J Clin Nutr 62: 715-721, 1995.
Deslypere JP: Obesity and cancer. Metabolism 44: 24-27, 1995.
DiMeglio DP, Mattes RD: Liquid versus solid carbohydrate: effects on food intake and body weight. Int J Obes 24: 794-800, 2000.
Ditschuneit HH, Flechtner-Mors M, Johnson TD, Adler G: Metabolic and weight-loss effects of a long-term dietary intervention in obese patients. Am J Clin Nutr 69: 198-204, 1999.
Doll HA, Petersen SEK, Stewart-Brown SL: Obesity and physical and emotional well-being: association between body mass index, chronic illness, and the physical and mental components of the SF-36 questionnaire. Obes Res 8: 160-170, 2000.
Dowse GK, Zimmet PZ, Gareeboo H, George K, Alberti MM, Tuomilehto J, Finch CF, Chitson P, Tulsidas H: Abdominal obesity and physical inactivity as risk factors for NIDDM and impaired glucose tolerance in Indian, Creole, and Chinese Mauritians. Diabetes Care 14: 271-282, 1991.
Drewnowski A, Kurth C, Holden-Wiltse J, Saari J: Food preferences in human obesity: carbohydrates versus fats. Appetite 18: 207-221, 1992.
Durnin JV, Womersley J: Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years. Br J Nutr 32: 77-97, 1974.
Egger G: Are meal replacements effective as a clinical tool for weight loss? Med J Aust 184: 52-53, 2006.
Ehrmann DA, Barnes RB, Rosenfield RL, Cavaghan MK, Imperial J: Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes Care 22: 141-146, 1999.
F. Xavier PS, Diane MB, Claude B: Examination of randomized controlled trial evidence clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults-the evidence report. NIH Publication, p29-55, 1998.
Fabitz RR, Carmelli D, Hewitt JK: Evidence of independent genetic influences on obesity in middle age. Int J Obes Relat Metab Disord 16: 657-666, 1992.
Ferrans CE: Development of a conceptual model of quality of life. Sch Inq Nurs Pract 10: 293-304, 1996.
Ferrara A, Hedderson MM, Quesenberry CP, Selby JV: Prevalence of gestational diabetes mellitus detected by the national diabetes data group or the Carpenter and Coustan plasma glucose thresholds. Diabetes Care 25: 1625-1630, 2001.
Finkelstein MM, Obesity, cigarette smoking and the cost of physicians’ services in Ontario. Can J Public Health 92: 437-440, 2001.
Flechtner-Mors M, Ditschuneit HH, Johnson TD, Suchard MA, Adler G: Metabolic and weight loss effects of long-term dietary intervention in obese patients: four-year results. Obes Res 8: 399-402, 2000.
Flegal KM, Carrol MD, Kuczmarski RJ, Johnson CL: Overweight and obesity in the United States: prevalence and trends, 1960-1994. Int J Obes 22: 39-47, 1998.
Foltin RW, Fischman MW, Moran TH, Rolls BJ, Kelly TH: Caloric compensation for lunches varying in fat and carbohydrate content by humans in a residential laboratory. Am J Clin Nutr 52: 969-980, 1990.
Fontaine KR, Barofsky I, Andersen RE: Impact of weight loss on health-related quality of life. Qual Life Res 8: 275-277, 1999.
Fontaine KR, Barofsky I: Obesity and health-related quality of life. Obes Rev 2: 173-182, 2001.
Gambineri A, Pelusi C, Genghini S, Morselli LAM, Cacciari M, Pagotto U, Baracat EC: Nonobese women with polycystic ovary syndrome respond better than obese women to treatment with metformin. Fertil Steril 81: 355-360, 2004.
Gans KM, Assmann SF, Sallar A, Laster TM: Knowledge of cardiovascular disease prevention: an analysis from two New England communities. Prev Med 29: 229-237, 1999.
Garfinkel L: Overweight and cancer. Ann Intern Med 103: 1034-1036, 1985.
Garratt AM, Ruta DA, Abdalla MI, Buckingham JK, Russell IT: The SF36 health survey questionnaire: an outcome measure suitable for routine use within the NHS? BMJ 306: 1440-1444, 1993.
German JB, Xu R, Walzem R, Kinsella JE, Knuckles B, Nakamura M, Yokoyama WH. Effect of dietary fats and barley fiber on total cholesterol and lipoprotein cholesterol distribution in plasma of hamster. Nutr Res 16: 1239-1249, 1996.
Gibson T, Grahame R: Gout and hyperlipidaemia. Ann Rheum Dis 33: 298-303, 1974.
Gorstein J, Grosse RN: The indirect costs of obesity to society. Pharmacoeconomics, 5: 58-61, 1994.
Grassi G, Cattaneo BM, Seravalle G, Colombo M, Cavagnini F, Mancia G: Obesity and the sympathetic nervous system. Blood Press Suppl: 43-46, 1996.
Haffiner S, Stern M, Hazuda H, Pugh J, Paterson J: Do upper-body and centralized adiposity measure different aspects of regional body-fat distribution? Relationship to non-insulin dependent diabetes mellitus, lipids, and lipoproteins. Diabetes 36: 43-51, 1987.
Hall JE: Mechanisms of abnormal renal sodium handling in obesity hypertension. Am J Hypertens 10: 49-55, 1997.
Han TS, Tijhuis MAR, Lean MEJ, Seidell JC: Quality of life in relation to overweight and body fat distribution. Am J Public Health 88: 1814-1820, 1998.
Harriet P, Dustan MD: Obesity and hypertension. Ann intern Med 103: 1047-1049, 1985.
Henry SK, Lilith MT, Carmen R, Eugenia EC, Michael JT, Clark WH: Stable behaviors associated with adults 10-year change in body mass index and likelihood of gain at the waist. Am J Public Health 87: 747-754, 1997.
Heymsfield SB, Greenberg S, Fujioka K, Dixon RM, Kushner R, Hunt T, MD; Lubina JA, Patane J, Self B, Hunt P, McCamish M: JAMA 282: 1568-1575, 1999.
Howard AN: The historicaldevelopmentefficacy and safety of very-low-calorie diets. Int J Obesity 5: 195-208, 1981.
Hubert HB, Feinleib M, McNamara PM, Castelli WP: Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation 67: 968-977, 1983.
Jacobs BL: Serotonin, motor activity and depression related disorders. Am J Sci 82: 456-463, 1994.
Joint National Committee: The sixth report of the Joint National Committee on prevention, detection, elevation, and treatment of high blood pressure. Arch Intern Med 157: 2413-2446, 1997.
Kannel WB, Gordon T, Castelli WP: Obesity, lipids, and glucose intolerance. The Framingham study. Am J Clin Nutr 32: 1238-1245, 1979.
Kaplan RM, Atkins CJ, Timms R: Validity of a quality of well-being scale as an outcome measure in chronic obstructive pulmonary disease. J Chronic Dis 37: 85-95, 1984.
Katz DA, McHorney CA, Atkinson RL: Impact of obesity on health-related quality of life in patients with chronic illness. J Gen Intern Med 15: 789-796, 2000.
Katz S, Downs TD, Cash HR, Grotz RC: Progress in development of the index of ADL. Gerontologist 10: 20-30, 1970.
Keith RA, Granger CV, Hamilton BB, Sherwin FS: The functional independence measure: a new tool for rehabilitation. Adv Clin Rehabil 1: 6-18, 1987.
Kennedy ET, Bowman SA, Spence JT, Freedman M, King J: Popular diets: correlation to health, nutrition, and obesity. J Am Diet Assoc 101: 411-420, 2001.
Kissebah AH, Krakower GR: Regional adiposity and morbidity. Physiol Rev 74: 761-811, 1994.
Kokkinos PF, Papademetriou V: Exercise and hypertension. Coron Artery Dis 11: 99-102, 2000.
Kolotkin RL, Meter K, Williams GR: Quality of life and obesity. Obes Rev 2: 219-229, 2001.
Kopelman: Obesity as a medical problem. Nature 404: 635-643, 2000.
Korkeila M, Kaprio J, Rissanen A, Koskenvuo M, Sørensen TIA: Predictors of major weight gain in adult Finns: stress, life satisfaction and personality traits. Int J Obes 22: 949-957, 1999.
Kuczmarski RJ, Flegal KM, Campbell SM, Johnson CL: Increasing prevalence of overweight among US adults. The National Health and Nutrition Examination Surveys, 1960 to 1991. JAMA 272: 205-211, 1994.
Kuller LH, Simkin-Silverman LR, Wing RR, Meilahn EN, Ives DG: Women’s healthy lifestyle project: A randomized clinical trial: results at 54 months. Circulation 103: 32-37, 2001.
Larsson U, Karlsson J, Sullivan M: Impact of overweight and obesity on health-related quality of life-a Swidish population study. Int J Obes 26: 417-424, 2002.
Lean MEJ, Han TS, Seidell JC: Impairment of health and quality of life using new US federal guidelines for the identification of obesity. Arch Intern Med 159: 837-843, 1999.
Lee CD, Blair SN, Jackson AS: Cardiorespiratory fitness, body composition, and all-cause and cardiovascular disease mortality in men. Am J Clin Nutr 69: 373-380, 1999.
Leon AS, Sanchez OA: Response of blood lipids to exercise training alone or combined with dietary interventions. Med Sic Sports Exerc 33: S502-515, 2001.
LePen C, Levy E, Loos F, Banzet MN, Basdevant A: “Specific” scale compared with “generic” scale: a double measurement of the quality of life in a French community sample of obese subjects. J Epidemiol Commun Health 52: 445-450, 1998.
Libel RL, Rosenbaum M, Hirsch J: Change in energy expenditure resulting from altered body weight. N Engl J Med 332: 621-628, 1995.
Lukkarinen H, Hentinen M: Assessment of quality of life with the Nottingham Health Profile among patients with coronary heart disease. J Adv Nurs 26: 73-84, 1997.
MacMahon SW, Norton RN: Alcohol and hypertension: Implications for prevention and treatment. Ann Intern Med 105: 124-126, 1986.
Mahoney FI, Barthel DW: Functional evaluation: The Barthel index. Md State Med J 14: 61-65, 1965.
Mattes RD, Pierce CB, Friedman MI: Daily caloric intake of normal-weight adults: responses in dietary energy density of a luncheon meal. Am J Clin Nutr 48: 214-219, 1988.
Mattes RD, Rothacker D: Beverage viscosity is inversely related to postprandial hunger in humans. Pbysiol Bebav 74: 551-557, 2001.
Mellinkoff SM, Frankland M, Boyle D, Greipel M: Relation-ship between serum amino acid concentration and fluctuations in appetite. American Physiological Society, 1956. Republished in Obes Res 5: 381-384, 1997.
Mensink RP, Katan MB: Effect of dietary fatty acids or serum lipids and liporoteis. A meta-analysis of 27 trials. Arterioscler Thromb 12: 911-919, 1992.
Miura J, Arai K, Tsukahara S, Ohno M, Ikeda Y: The long term effectiveness of combined therapy by behavior modification and very low calorie diet: 2 years follow-up. Int J Obes 13: 73-77, 1989.
Mokdad AH, Serdula MK, Dietz WH, Bowman BA, Marks JS, Koplan JP: The spread of the obesity epidemic in the United States, 1991-1998. JAMA 282: 1519-1522, 1999.
Must A, Spandano J, Coakley EH, Field AE, Colditz G, Dietz WH: The disease burden associated with overweight and obesity. JAMA 282: 1523-1529, 1999.
National Institute of Health: Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Washington DC, 1998.
Pascale RW, Wing RR, Bulter BA, Mullen M, Bononi P: Effects of a behavioral weight loss program stressing calorie restriction versus calorie plus fat restriction in obese individuals with NIDDM or a family history of diabetes. Diabetes Care 18: 1241-1247, 1995.
Patrick DL, Erickson P: Health status and health policy: quality of life in health care evaluation and resource allocation. New York: Oxford University Press, 1993.
Pavlou KN, Krey S, Steffee WP: Exercise as an adjunct to weight loss and maintenance in moderately obese subjects. Am J Clin Nutr 49: 1115-1123, 1989.
Pi-Sunyer FX: Health implications of obesity. Am J Clin Nutr 53: 1595s-1603s, 1991.
Pi-Sunyer FX: Medical hazards of obesity. Ann Intern Med 119: 655-660, 1993.
Pi-Sunyer FX: The obesity epidemic: Pathophysiology and consequences of obesity. Obes Res 10: 97S-104S, 2002.
Pliner PL: Effect of liquid and solid preloads on eating behavior of obese and normal persons. Physiol Behav 11: 285-290, 1973.
Poppitt SD, Prentice AM: Energy density and its role in the control of food intake: evidence from metabolic and community studies. Physiol Behav 26: 153-174, 1996.
Price RA,Gottesman II: Body fat in identical twins reared apart: Roles for genes and environment. Behav Genet 12: 1-7, 1991.
Racette SB, Deusinger SS, Deusinger RH: Obesity: overview of prevalence, etiology, and treatment. Phys Ther 83: 276-288, 2003.
Rathmann M, Funkhouser D, Dyer P, Roseman M: Relations of hyperuricemia with the various components of the insulin resistance syndrome in young black and white adults: The CARDIA Study. Ann Epidemiol 8: 250-261, 1998.
Rippe JM, Price JM, Hess SA, Kline G, DeMers KA, Damitz S, Kreidieh I, Freedson P: Improved psychological well-being, quality of life, and health practices in moderately overweight women participating in a 12-week structured weight loss program. Obes Res 6: 208-218, 1998.
Rolls BJ, Bell EA: Dietary approaches to the treatment of obesity. Med Clin North Am 84: 401-418, 1994.
Salonen JT, Lakka TA, Lakka HM, Valkonen VP, Everson SA, Kaplan GA: Hyperinsulinemia is associated with the incidence of hypertension and dyslipidemia in middle-aged men. Diabetes 47: 270-275, 1998.
Saris WH: Very-low-calorie diets and sustained weight loss. Obes Res 9: 295S-301S, 2001.
Scholock RL, Keith KD, Hoffman K: Quality of life questionnaire: standardization manual. Hastings, NE: Mid-Nebraska Mental Retardation Services, 1990.
Seidelly JC, Flegal KM: Assessing obesity: classification and epidemiology. Brit Med Bull 53: 238-252, 1997.
Shaffer EA, Small DM: Biliary lipid secretion in cholesterol gallstone disease. The effect of cholecystectomy and obesity. J Clin Invest 59: 828-840, 1977.
Sherwood NE, Jeffery RW, Wing RR: Binge status as a predictor of weight loss treatment outcome. Int J Obes Relat Metab Disord 23: 485-493, 1999.
Silvestri JM, Weese-Mayer DE, Bass MT, Kenny AS, Hauptman SA, Pearsall SM: Polysomnography in obese children with a history of sleep-associated breathing disorders. Pediatr Pulmonol 16: 124-129, 1993.
Simpson JM, Bernnan PJ, McGilchrist CA, Blocket RB: The inheritance of serum cholesterol levels for age, sex, and body weight using inverse-polynomial. Int J Epidemiol 11: 76-81, 1982.
Skov AR, Toubro S, Ronn B, Holm L, Astrup A: Randomized trial on protein verse carbohydrates in ad libitum fat reduced for treatment of obesity. Int J Obes 23: 528-536, 1999.
Srinivasan AR, Bao W, Wattigney WA, Berenson GS: Adolescent overweight is associated with adult overweight and related multiple cardiovascular risk factor: The Bogalusa heart study. Metabolism 45: 235-240, 1996.
Taubes G: As obesity rates rise, experts struggle to explain why? Science 280: 1367, 1998.
Taubes G: Weight increase Wordwide? Science 280: 1368, 1998.
Tominaga K, Kurata JH: Prevalence of fatty liver in Japanese children and relationship to obesity. Dig Dis Sci 40: 2002-2009, 1995.
Uysal KT, Wiesbrock SM, Hotamisligil GS: Functional analysis of tumor necrosis factor (TNF) receptors in TNF-alpha-mediated insulin resistance in genetic obesity. Endocrinology 139: 4832-4838, 1998.
Van IT: Health implications of overweight and obesity in the United States. Ann Intern Med 103: 983-988, 1985.
Vogler GP, Sorensen TA, Stunkard AJ: Influences of genes and shared family environment on adult body mass index assessed by a comprehensive path model in an adoption study. Int J Obes 19: 40-45, 1995.
Wadden TA, Atrunkard AJ: Social and psychological consequences of obesity. Ann Intern Med 103: 1062-1067, 1985.
Wadden TA, Stemberg JA, Letizia KA, Stunkard AJ, Foster GD: Treatment of obesity by very low calorie diet, behavior therapy and their combination: a five year perspective. Int J Obes Relat Metab Disord 13: 39-46, 1989.
Wadden TA, Stunkard AJ: Controlled trial of vary low calorie diet, behavior therapy, and their combination in the treatment of obesity. J Consult Clin N Psychol 54: 482-488, 1986.
Wadden TA, Womble LG, Stunkard AJ, Anderson DA: Psychosocial consequences of obesity and weight loss. In Wadden TA, Stunkard AJ (eds) “Handbook of ObesityTreatment”. New York: Guilford Press, pp 154-166, 2002.
Wadden TA: Treatment of obesity by moderate and severe caloric restriction. Results of clinical research trials. Ann Intern Med 119: 688-693, 1993.
Walker M, Berrish TS, James AR, Alberti KG: Effect of hyperinsulinaemia on the function of the pituitary-adrenal axis in healthy man. Clin Endocrinol (Oxf) 40: 493-497, 1999.
Ware JE Jr, Kosinski M, Keller SD: SF-36 physical and mental health summary scales: A user’s manual. Boston: The Health Institute, New England Medical Center, 1994.
Ware JE, Snow KK, Kosinski M, Gande KB: SF-36 Health Survey and Interpretation Guide Boston: The Health Survey and Institute, New England Medical Center Hospitals, 1993.
Ware JE: Conceptualizing disease impact and treatment outcomes. Cancer 53: 2316-2323, 1984.
Weinsier RL, Nelson KM, Hensrud DD, Darnell BE, Hunter GR, Schutz Y: Metabolic predictors of obesity. Contribution of resting energy expenditure, thermic effect of food, and fuel utilization to four-year weight gain of post-obese and never-obese women. J Clin Invest 95: 980-985, 1995.
Weisburger JH: Dietary fat and risk of chronic disease: mechanistic insights from experimental studies. J Am Diet Assoc 97: 16-32, 1997.
Wickelgren I: Obesity: How big a problem? Science 280: 1364-1367, 1998.
Wicklgren I: Do “apple” fare worse than “pears”? Science 280: 1365, 1998.
Willett WC, Dietz WH, Colditz GA: Guideline for healthy weight. N Engl J Med 341: 427-434, 1999.
Willett WC: Weight, weight change, and coronary heart disease in women: risk within the normal weight range. J Am Med Assoc 273: 461-465, 1995.
Williamson DF: National Institutes of Health Technology Assessment Conference: descriptive epidemiology of body weight and weight change in U.S. adults. Ann Itern Med 119: 646-649, 1993.
Wilson IB, Cleary PD: Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. JAMA 273: 59-65, 1995.
Woods SC, Seeley RJ, Porte Jr. D: Signals that regulate food intake and energy homeostasis. Science 280: 1378-1383, 1998.
World Health Organization: Obesity: Preventing and managing the global epidemic. WHO: Geneva, 1998.
World Health Organization: Physical Status: The use and interpretation of anthropometry—report of a WHO expert committee. Geneva, Switzerland: World Health Organization: 854, 1995. Technical report series.
World Health Organization: The Asia-Pacific perspective: redefining obesity and its treatment. WHO: Geneva, 2000.
World Health Organization: The World Health Organization Quality of Life Assessment (WHOQOL): development and general psychometric properties. Soc Sci Med 46: 1569-1585, 1998.
Yancy WS, Olsen MK, Westerman, Bosworth HB, Edelman D: Relationship between obesity and health-related quality of life in men. Obes Res 10: 1057-1064, 2002.
Zhan L: Quality of life: conceptual and measurement issues. J Adv Nurs 17: 795-800, 1992.
尤嫣嫣（1999）肥胖問題探討，學校衛生35：85－99。
方素瑜、王鳳英、牟宗宜、何素珍、林宜芬、徐明麗、陳筱敏、黃秀珠、劉素君合譯（1999）實用營養學，台北：華騰。
方進隆、吳仁宇、高美丁、陳偉德、劉貴雲、謝明哲（2001）體重控制指導手冊，教育部體育司。
行政院衛生署（2000）國民飲食指標，台北：衛生署保健處。
吳至行、梁忠君、張銘峰（2001）何謂減肥成功，基層醫學16：61－66。
李采娟（1998）測試醫療結果之新工具－中文版健康量表SF36效度評估之研究，國家科學委員會研究計畫報告。
林佳姿（2002）比較減重過程中導入節食的時間不同對減重成效、體組成及能量代謝率的影響，中山醫學大學營養科學研究所碩士論文。
林薇、劉貴雲（2000）減脂之旅－指導手冊，台北：行政院衛生署。
姚開屏（2000）簡介與評論常用的一般性健康相關生活品質量表兼談對未來研究的建議，測驗年刊47：111－138。
姚開屏（2002）健康相關生活品質概念與測量原理之簡介，台灣醫界6：183－192。
洪甄憶（2000）運動與體重控制，成大體育34：1－3。
洪寶玉（2000）淺談目前減肥方法與治療藥物，中化藥訊46：20－25。
高美丁、曾明淑、葉文婷、張瑛紹、潘文涵（1998）：台灣地區居民體位及肥胖狀況。國民營養健康狀況變遷調查1993-1996，行政院衛生署143－171。
國家衛生研究院（2001）飲食方法對體重控制，台北：國家衛生研究院。
國家衛生研究院（2001）飲食方法對體重控制成效之影響，台北：國家衛生研究院。
張天均（2000）運動、荷爾蒙與健康，當代醫學27：8－10。
張天均（2002）脂肪與健康，當代醫學29：7－10。
張育菁（2005）台灣地區肥胖與過重對醫療利用之影響，國立陽明大學醫務管理研究所碩士論文。
張雅君（2004）比較燕麥高纖代餐和傳統飲食對減重成效之不同，台北醫學院保健營養學系碩士論文。
張敬仁、張文道、張文瀚、蔡森蔚、周崇頌、陳姸蒨、趙蘭芬（2003）以生活型態調整探討減重及健康相關生活品質之改善，台灣衛誌22：308－316。
陸玓玲（1998）臺灣地區生活品質研究概況，中華公共衛生雜誌17：442－457。
傅正思（1996）運動與高血壓，中華體育9：74－80。
黃永任（1993）運動與高血壓，中華體育6：73－78。
黃柏欣（2002）不同體重控制課程對肥胖婦女減重成效及相關因素之探討，輔仁大學食品科學系碩士論文。
楊淑娟、魏明敏、王瑞蓮、卞秀娟、蔡秀玲（1999）實用公共衛生營養學，台中：華格那。
裴馰（2001）減肥的迷思。中華民國內分泌記糖尿病學會會訊14：25－28。
趙蓓敏、黃青真（2001）15-deoxy-△12,14-PGJ2對3T1-L1前脂肪細胞分化之影響，中國醫藥科學雜誌2：117－124。
劉伯恩（2004）麵條式代餐在減重上之應用，臺北醫學大學保健營養學系碩士論文。
劉建恆（2000）肥胖問題研究現況與發展趨勢，花蓮師院學報10：385－400。
劉倖吟（2001）青春期體重過重女生體重控制介入措施之成效探討，國立台北護理學院護理研究所碩士論文。
潘奎靜（2006）肥胖患者施行減重手術前後生活品質之探討，美和技術學院健康照護研究所碩士論文。
盧瑞芬（1996）SF-36 台灣版簡介，SF-36 台灣版網站，摘自http://sf-36.cgu.edu.tw/process.htm。
盧瑞芬、曾旭民、蔡益堅（2003）國人生活品質評量台灣版的發展及心理計量特質分析，台灣公共衛生雜誌22：501－511。
賴美淑（2000）運動、體適能與健康的流行病學與生理機轉，台北：國家衛生研究院。
賴美淑（2000）運動與心血管功能，台北：國家衛生研究院。
簡怡雯（2001）飲食方法對體重控制成效之影響。國家衛生研究院論壇8：3。
簡怡雯、黃美智、廖芳瑄、陳金發、謝明哲（2002）以商業減重代餐輔助減重計劃之成效評估，中華民國營養學會雜誌 27：239－246。
顏兆熊、沈德昌（2002）肥胖的治療，台灣醫界45：29－33。
羅俊欽（1998）運動對高血高血壓的影響，中華體育12：61－68。

網路資料
行政院衛生署（2002/04/15）。國人肥胖定義及處理原則出爐。民94年3月1日，取自：http://www.doh.gov.tw/cht/content.aspx?dept=R&class_no=25&now_fod_list_no=3942&array_fod_list_no=&level_no=2&doc_no=32&show=
孫崇文（2002）肥胖與疾病，http://www.a-sir.com.tw/news.asp