本研究探討問題導向（problem based learning; PBL）課程介入過重或肥胖學童體重控制之成效。以健康知識與體育為基礎設計課程並介入12週，以台北市逸仙國小和蘭雅國小高年級過重或肥胖學童各26人（BMI>21.0）為研究對象。逸仙國小學童為實驗組以PBL體重控制健康與體育課程介入，蘭雅國小學童為對照組以傳統體重控制健康與體育課程介入。
在課程介入前進行前測，課程介入後進行後測以了解課程立即成效。於課程結束4個月後再進行追蹤學童課程吸收成效及復胖情形。收集兩組學生基本資料、體位和體適能資料、生化檢驗值、體重控制主因量表、體重控制問題解決能力問卷、互評量表、自評量表及學習單等資料，資料整理後以SPSS for Windows 10.0進行統計分析。研究結果如下：
1. 實驗組與對照組參加課程後在運動和飲食生活習慣、情緒管理、知識獲取等整體體重控制成因有顯著改善或進步。實驗組學童在體重控制問題解決能力上具顯著的增加且得分高於對照組，對照組學童體重控制問題解決能力則無增加之情形。
2. 實驗組與對照組學童皆能有效降低三頭肌皮層厚度、體脂肪百分比與飯前血糖、血清三酸甘油酯、血清總膽固醇及尿酸生化檢驗值。
3. 課程介入後，實驗組學童體適能檢測其心肺功能、瞬發力與肌耐力皆有顯著進步；對照組學童的心肺功能與柔軟度則有顯著進步。
4. 實驗組與對照組皆能有效降低學童體位，但對照組BMI值下降較實驗組明顯。課程介入4個月後實驗組BMI值下降至正常值有5人，復胖率為38.5％；對照組BMI值下降至正常值只有1人，復胖率為65.4％。
整體而言對照組體重控制立即性成效較實驗組體重控制佳，但實驗組長期體重控制成效優於對照組，實驗組多數國小高年級學童接受PBL體重控制課程後，了解並能解決自身肥胖的成因，較能維持健康的體位。體重控制是需要長期經營，短期的體重控制只能暫時性的降低BMI值無法維持或達到健康的體位，因此良好的體重控制需要持之以恆，從日常生活著手，配合飲食與運動，發覺自身體重控制問題並解決問題以達到維持健康體位的目的。
The purpose of this study is to investigate the effect of problem-based learning （PBL）on weight control for obese or overweight schoolchildren. The obese or overweight schoolchildren from Yi-Xian and Lanya elementary school were 26 subjects, respectively, who were given the 12wk-intervention lecture based on healthy and physical knowledge. Schoolchildren from Yi-Xian elementary school as an experimental group had the lecture designed by problem-based learning. Schoolchildren from Lanya elementary school as a control group took the conventional lecture about weight control.
The pre-test, posttest and follow-up test were held before, after and 4 months after lectures. The data of students' background, body mass index（BMI）, health fitness, biochemical examination as well as questionnaires of major causes for obesity, ability of problem solving for obesity, self-evaluation and peer- evaluation were all collected. The data then was analyzed by SPSS for Windows 10.0.
After lecture intervened the results showed that the ability of problem-solving obesity weight control was significantly improved in the experimental group. However, there was no any improvement of this test in the control group. Both of percentage of body fat and thickness of triceps skin fold were lowered and health fitness was progressive after intervention in 2 groups. Furthermore, BMI of obese or overweight schoolchildren were significantly decreased after intervention. The decreased level of BMI in control group（p＜0.001）was more significant compared to that in experimental group（p＜0.05）. However, weight re-gaining 4 months after intervention in experimental group was 42.3％ versus 65.4％ in control group.
It is necessary to keep weight control during lifetime. In this study, most of schoolchildren in the experimental group could realize and solve the major problems about obesity by themselves after taking PBL lectures to maintain a healthier body weight.
