Short- and Long-Term Theory-Based Predictors of Physical Activity in Women Who Participated in a Weight-Management Program

ERIC Educational Resources Information Center

Wasserkampf, A.; Silva, M. N.; Santos, I. C.; Carraça, E. V.; Meis, J. J. M.; Kremers, S. P. J.; Teixeira, P. J.

2014-01-01

This study analyzed psychosocial predictors of the Theory of Planned Behavior (TPB) and Self-Determination Theory (SDT) and evaluated their associations with short- and long-term moderate plus vigorous physical activity (MVPA) and lifestyle physical activity (PA) outcomes in women who underwent a weight-management program. 221 participants (age…

Use of a mobile phone diary for observing weight management and related behaviours.

PubMed

Mattila, Elina; Lappalainen, Raimo; Pärkkä, Juha; Salminen, Jukka; Korhonen, Ilkka

2010-01-01

We studied self-observations related to weight management recorded with a Wellness Diary application on a mobile phone. The data were recorded by 27 participants in a 12-week study, which included a short weight management lecture followed by independent usage of the Wellness Diary. We studied the validity of self-observed weight, and behavioural changes and weight patterns related to weight management success. Self-observed weight data tended to underestimate pre- and poststudy measurements, but there were high correlations between the measures (r >or= 0.80). The amount of physical activity correlated significantly with weight loss (r = 0.44) as did different measures representing healthy changes in dietary behaviours (r >or= 0.45). Weight changes and the weekly rhythms of weight indicated a strong tendency to compensate for high-risk periods among successful weight-losers compared to unsuccessful ones. These preliminary results suggest that the mobile phone diary is a valid tool for observing weight management and related behaviours.

Fight Cravings with Exercise

MedlinePlus

... Challenges When Quitting Nicotine Withdrawal Cravings & Triggers Handling Stress Manage Your Mood Weight Gain & Appetite Stay Smokefree for Good Stick with It Weight Management Eat Healthy Get Active Help Others Quit For ...

Perceptions of factors associated with weight management in obese adults with schizophrenia.

PubMed

Lundgren, Jennifer D; Rempfer, Melisa V; Lent, Michelle R; Foster, Gary D

2014-12-01

Individuals with serious mental illnesses are at increased risk of obesity, although the behavioral factors contributing to excess weight are not well understood. We report on the eating behavior, physical activity, and body image of obese adults with and without schizophrenia spectrum disorders. Twenty-two obese adults diagnosed with schizophrenia or schizoaffective disorder were compared to demographically matched obese adults without psychiatric diagnoses on their responses to a comprehensive assessment of several psychosocial and behavioral domains relevant to obesity and weight management. The schizophrenia group, compared to controls, reported more difficulty with several eating behaviors that were self-identified as contributing to increased weight. They also reported more enjoyment of physical activity and greater satisfaction with body weight and shape compared to controls. Clinically relevant group differences were identified that should be considered when designing ecologically valid weight management assessments and interventions for individuals diagnosed with serious mental illnesses. Health care providers are encouraged to assess an individual's weight management strengths and barriers through available assessment tools and home visits, as well as offer specific environmental and behavioral changes to manage hunger and modify eating patterns. (c) 2014 APA, all rights reserved.

Overweight perception: associations with weight control goals, attempts and practices among Chinese female college students

PubMed Central

Tanenbaum, Hilary C.; Felicitas, Jamie Q.; Li, Yawen; Tobias, Malaika; Chou, Chih-Ping; Palmer, Paula H.; Spruijt-Metz, Donna; Reynolds, Kim D.; Johnson, C. Anderson; Xie, Bin

2015-01-01

Background Concurrent with the dramatic cultural and economic shifts occurring as Mainland China becomes increasingly “Westernized,” the weight perceptions, ideal body weight, and weight management goals and practices of Chinese females have also undergone significant changes. Objective To investigate relationships between overweight status, weight perception patterns, and weight management goals and practices in Chinese female college students. Design/Participants/Setting A cross-sectional analysis was conducted with data from 902 female subjects aged 18 to 25 years participating in the China Seven Cities Study, a health promotion and smoking prevention study conducted in Mainland China in 2003. Main Outcome Measures/ Statistical Analyses Logistic regression models were used to explore associations between overweight status, weight perception, specific weight management goals and practices, and current levels of vigorous-intensity physical activity and food consumption. Results Based on World Health Organization standards for Asian adults, 16.7% of college females were overweight or obese, although 50.8% considered themselves to be “too heavy.” Among participants perceiving themselves as overweight (n=458), 69.2% (n=371) were inaccurate, and did not meet criteria for overweight or obese. The percentage of participants attempting weight loss was 48.2%, and 33.1% wanted to maintain their current weight. Attempts to lose or maintain weight were related to actual and perceived weight status, but not to increased vigorous-intensity physical activity or fruit and vegetable intake, nor to decreased consumption of sweets, soda, Western fast foods and fried foods. Only 21.5% of participants desiring weight loss or maintenance reported using a combination of vigorous-intensity physical activity and a reduced fat and calorie diet, while 20.2% tried extreme methods such as fasting, using diet pills, vomiting, or smoking. Conclusions Our findings underscore the need to promote healthy weight management practices among Chinese female college students, with an emphasis on diet and physical activity strategies that encourage balance rather than extremes. PMID:26260670

Overweight Perception: Associations with Weight Control Goals, Attempts, and Practices among Chinese Female College Students.

PubMed

Tanenbaum, Hilary C; Felicitas, Jamie Q; Li, Yawen; Tobias, Malaika; Chou, Chih-Ping; Palmer, Paula H; Spruijt-Metz, Donna; Reynolds, Kim D; Anderson Johnson, C; Xie, Bin

2016-03-01

Concurrent with the dramatic cultural and economic shifts occurring as mainland China becomes increasingly "Westernized," the weight perceptions, ideal body weight, and weight management goals and practices of Chinese females have also undergone significant changes. To investigate relationships between overweight status, weight perception patterns, and weight management goals and practices in Chinese female college students. A cross-sectional analysis was conducted with data from 902 female subjects aged 18 to 25 years participating in the China Seven Cities Study, a health promotion and smoking prevention study conducted in mainland China in 2003. Logistic regression models were used to explore associations between overweight status, weight perception, specific weight management goals and practices, and current levels of vigorous-intensity physical activity and food consumption. Based on World Health Organization standards for Asian adults, 16.7% of college females were overweight or obese, although 50.8% considered themselves to be "too heavy." Among participants perceiving themselves as overweight (n=458), 69.2% (n=371) were inaccurate and did not meet criteria for overweight or obese. The percentage of participants attempting weight loss was 48.2%, and 33.1% wanted to maintain their current weight. Attempts to lose or maintain weight were related to actual and perceived weight status, but not to increased vigorous-intensity physical activity or fruit and vegetable intake, nor to decreased consumption of sweets, soda, Western fast foods, and fried foods. Only 21.5% of participants desiring weight loss or maintenance reported using a combination of vigorous-intensity physical activity and a reduced-fat and -calorie diet, whereas 20.2% tried extreme methods such as fasting, using diet pills, vomiting, or smoking. Our findings underscore the need to promote healthy weight management practices among Chinese female college students, with an emphasis on diet and physical activity strategies that encourage balance rather than extremes. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Adherence to a multi-component weight management program for Mexican American adolescents

USDA-ARS?s Scientific Manuscript database

This study examined weight loss among Mexican American students in a weight management program. A total of 358 participants completed a 12-week intervention that incorporated four program components: nutrition education (NE), physical activity (PA), sedentary behavior (SB), and a snacking interventi...

Understanding weight management perceptions in first-year college students using the health belief model.

PubMed

Das, Bhibha M; Evans, Ellen M

2014-01-01

To examine weight management barriers, using the Health Belief Model, in first-year college students. First-year college students (n = 45), with data collected in April, May, and November 2013. Nominal group technique sessions (n = 8) were conducted. First-year students recognize benefits to weight management beyond physical attractiveness to quality-of-life domains, including social (eg, bonding opportunities and energy to socially engage) and mental health (eg, stress management). Men believe that weight management is important for career/financial reasons, whereas women voiced that it will allow them to live a full, independent life with a high level of multitasking. Men believed that their barriers were external (eg, campus resources/programs), whereas females perceived their barriers to be internal (eg, poor time management). College students are challenged by weight management and want the institution to provide resources, including curriculum, to help them manage their physical activity and nutrition behaviors.

Incorporating a Weight Management Skills Workshop in Pharmacy Curricula in Australia

PubMed Central

Krass, Ines; Armour, Carol; Gill, Timothy; Chaar, Betty B.

2016-01-01

Objective. To develop, implement, and evaluate a competency-based weight management skills workshop for undergraduate pharmacy students in an Australian university. Design. A 3-hour workshop titled “Weight Management in Pharmacy” was implemented with a cohort of fourth-year undergraduate pharmacy students (n=180). Learning activities used included case-based learning, hands-on experience, role-play, and group discussion. Assessment. A 22-item attitudinal survey instrument and the validated Obesity Risk Knowledge (ORK-10) scale were administered at baseline and postworkshop to evaluate the impact of this educational workshop. There was significant improvement in the students’ ORK scores and students’ perceived level of self-confidence in performing weight management skills. Conclusion. An educational workshop designed to enhance professional competencies in weight management ensured graduates were “service-ready” and had the appropriate knowledge, skills, and attributes to deliver patient-centered pharmacy-based weight management services. PMID:27293236

Incorporating a Weight Management Skills Workshop in Pharmacy Curricula in Australia.

PubMed

Um, Irene S; Krass, Ines; Armour, Carol; Gill, Timothy; Chaar, Betty B

2016-05-25

Objective. To develop, implement, and evaluate a competency-based weight management skills workshop for undergraduate pharmacy students in an Australian university. Design. A 3-hour workshop titled "Weight Management in Pharmacy" was implemented with a cohort of fourth-year undergraduate pharmacy students (n=180). Learning activities used included case-based learning, hands-on experience, role-play, and group discussion. Assessment. A 22-item attitudinal survey instrument and the validated Obesity Risk Knowledge (ORK-10) scale were administered at baseline and postworkshop to evaluate the impact of this educational workshop. There was significant improvement in the students' ORK scores and students' perceived level of self-confidence in performing weight management skills. Conclusion. An educational workshop designed to enhance professional competencies in weight management ensured graduates were "service-ready" and had the appropriate knowledge, skills, and attributes to deliver patient-centered pharmacy-based weight management services.

Weight management interventions in adults with intellectual disabilities and obesity: a systematic review of the evidence.

PubMed

Spanos, Dimitrios; Melville, Craig Andrew; Hankey, Catherine Ruth

2013-09-23

To evaluate the clinical effectiveness of weight management interventions in adults with intellectual disabilities (ID) and obesity using recommendations from current clinical guidelines for the first line management of obesity in adults. Full papers on lifestyle modification interventions published between 1982 to 2011 were sought by searching the Medline, Embase, PsycINFO and CINAHL databases. Studies were evaluated based on (1) intervention components, (2) methodology, (3) attrition rate (4) reported weight loss and (5) duration of follow up. Twenty two studies met the inclusion criteria. The interventions were classified according to inclusion of the following components: behaviour change alone, behaviour change plus physical activity, dietary advice or physical activity alone, dietary plus physical activity advice and multi-component (all three components). The majority of the studies had the same methodological limitations: no sample size justification, small heterogeneous samples, no information on randomisation methodologies. Eight studies were classified as multi-component interventions, of which one study used a 600 kilocalorie (2510 kilojoule) daily energy deficit diet. Study durations were mostly below the duration recommended in clinical guidelines and varied widely. No study included an exercise program promoting 225-300 minutes or more of moderate intensity physical activity per week but the majority of the studies used the same behaviour change techniques. Three studies reported clinically significant weight loss (≥ 5%) at six months post intervention. Current data indicate weight management interventions in those with ID differ from recommended practice and further studies to examine the effectiveness of multi-component weight management interventions for adults with ID and obesity are justified.

Differences in body dissatisfaction, weight-management practices and food choices of high-school students in the Bangkok metropolitan region by gender and school type.

PubMed

Chongwatpol, Pitipa; Gates, Gail E

2016-05-01

The present study aimed to compare body dissatisfaction, food choices, physical activity and weight-management practices by gender and school type. A questionnaire was used to obtain height, weight, body image perception using Stunkard's figure rating scale, food choices, physical activity and weight-management practices. Nine single- and mixed-gender schools located in Bangkok Metropolitan Region, Thailand. Students in 10th-12th grade, aged 15-18 years (n 2082). Only 18% of females and 21% of males did not indicate body dissatisfaction. About 66% of females selected a thinner ideal figure than their current figure. Among males, 44% wanted a thinner figure, but 35% wanted a bigger figure. However, univariate analysis found differences by school type but not gender in the degree of body dissatisfaction; students in single-gender schools had more body dissatisfaction. Females reported using more weight-management practices but less physical activity, while males reported healthier food choices. Participants in single-gender schools had healthier food choices compared with those in mixed-gender schools. Adolescents who were at increased risk of a greater degree of body dissatisfaction were females, attended single-gender schools, had lower household income, higher BMI and less physical activity. Most participants reported being dissatisfied with their current body shape, but the type and level of dissatisfaction and use of weight-management practices differed by gender and type of school. These findings suggest that programmes to combat body dissatisfaction should address different risk factors in males and females attending single- and mixed-gender schools.

Weight management interventions in adults with intellectual disabilities and obesity: a systematic review of the evidence

PubMed Central

2013-01-01

To evaluate the clinical effectiveness of weight management interventions in adults with intellectual disabilities (ID) and obesity using recommendations from current clinical guidelines for the first line management of obesity in adults. Full papers on lifestyle modification interventions published between 1982 to 2011 were sought by searching the Medline, Embase, PsycINFO and CINAHL databases. Studies were evaluated based on 1) intervention components, 2) methodology, 3) attrition rate 4) reported weight loss and 5) duration of follow up. Twenty two studies met the inclusion criteria. The interventions were classified according to inclusion of the following components: behaviour change alone, behaviour change plus physical activity, dietary advice or physical activity alone, dietary plus physical activity advice and multi-component (all three components). The majority of the studies had the same methodological limitations: no sample size justification, small heterogeneous samples, no information on randomisation methodologies. Eight studies were classified as multi-component interventions, of which one study used a 600 kilocalorie (2510 kilojoule) daily energy deficit diet. Study durations were mostly below the duration recommended in clinical guidelines and varied widely. No study included an exercise program promoting 225–300 minutes or more of moderate intensity physical activity per week but the majority of the studies used the same behaviour change techniques. Three studies reported clinically significant weight loss (≥ 5%) at six months post intervention. Current data indicate weight management interventions in those with ID differ from recommended practice and further studies to examine the effectiveness of multi-component weight management interventions for adults with ID and obesity are justified. PMID:24060348

Avoiding Weight Gain in Cardiometabolic Disease: A Systematic Review

PubMed Central

Maruthur, Nisa M.; Fawole, Oluwakemi A.; Wilson, Renee F.; Lau, Brandyn D.; Anderson, Cheryl A. M.; Bleich, Sara N.; Segal, Jodi

2014-01-01

Patients with cardiometabolic disease are at higher risk for obesity-related adverse effects. Even without weight loss, weight maintenance may be beneficial. We performed a systematic review to identify the effect of nonweight loss-focused lifestyle interventions in adults with cardiometabolic disease. We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials to identify comparative studies of lifestyle interventions (self-management, diet, exercise, or their combination) without a weight loss focus in adults with or at risk for diabetes and cardiovascular disease. Weight, BMI, and waist circumference at ≥12 months were the primary outcomes. Of 24,870 citations, we included 12 trials (self-management, n = 2; diet, n = 2; exercise, n = 2; combination, n = 6) studying 4,206 participants. Self-management plus physical activity ± diet versus minimal/no intervention avoided meaningful weight (−0.65 to −1.3 kg) and BMI (−0.4 to −0.7 kg/m2) increases. Self-management and/or physical activity prevented meaningful waist circumference increases versus control (−2 to −4 cm). In patients with cardiometabolic disease, self-management plus exercise may prevent weight and BMI increases and self-management and/or exercise may prevent waist circumference increases versus minimal/no intervention. Future studies should confirm these findings and evaluate additional risk factors and clinical outcomes. PMID:25610639

Factors Associated With Weight Change in Online Weight Management Communities: A Case Study in the LoseIt Reddit Community

PubMed Central

Ribeiro, Antonio; Couto Silva, Ana Paula; Meira Jr, Wagner

2017-01-01

Background Recent research has shown that of the 72% of American Internet users who have looked for health information online, 22% have searched for help to lose or control weight. This demand for information has given rise to many online weight management communities, where users support one another throughout their weight loss process. Whether and how user engagement in online communities relates to weight change is not totally understood. Objective We investigated the activity behavior and analyze the semantic content of the messages of active users in LoseIt (r/loseit), a weight management community of the online social network Reddit. We then explored whether these features are associated with weight loss in this online social network. Methods A data collection tool was used to collect English posts, comments, and other public metadata of active users (ie, users with at least one post or comment) on LoseIt from August 2010 to November 2014. Analyses of frequency and intensity of user interaction in the community were performed together with a semantic analysis of the messages, done by a latent Dirichlet allocation method. The association between weight loss and online user activity patterns, the semantics of the messages, and real-world variables was found by a linear regression model using 30-day weight change as the dependent variable. Results We collected posts and comments of 107,886 unique users. Among these, 101,003 (93.62%) wrote at least one comment and 38,981 (36.13%) wrote at least one post. Median percentage of days online was 3.81 (IQR 9.51). The 10 most-discussed semantic topics on posts were related to healthy food, clothing, calorie counting, workouts, looks, habits, support, and unhealthy food. In the subset of 754 users who had gender, age, and 30-day weight change data available, women were predominant and 92.9% (701/754) lost weight. Female gender, body mass index (BMI) at baseline, high levels of online activity, the number of upvotes received per post, and topics discussed within the community were independently associated with weight change. Conclusions Our findings suggest that among active users of a weight management community, self-declaration of higher BMI levels (which may represent greater dissatisfaction with excess weight), high online activity, and engagement in discussions that might provide social support are associated with greater weight loss. These findings have the potential to aid health professionals to assist patients in online interventions by focusing efforts on increasing engagement and/or starting discussions on topics of higher impact on weight change. PMID:28093378

Healthy Weight

MedlinePlus

... certain health conditions External Resources Weight loss, weight management, nutrition, meal planning tools… Super Tracker SuperTracker: My Plan Food Diary [PDF – 34KB] Physical Activity Diary [PDF – 52KB] ...

Opportunities for Intervention Strategies for Weight Management: Global Actions on Fluid Intake Patterns

PubMed Central

Lafontan, Max; Visscher, Tommy L.S.; Farpour-Lambert, Nathalie; Yumuk, Volkan

2015-01-01

Water is an essential nutrient for all physiological functions and particularly important for thermoregulation. About 60% of our body weight is made of water. Under standard conditions (18-20 °C and moderate activity), water balance is regulated within 0.2 % of body weight over a 24-hour period. Water requirement varies between individuals and according to environmental conditions. Concerning considerations related to obesity, the health impact of fluid intake is commonly overlooked. Fluid intake advices are missing in most of food pyramids offered to the public, and water requirements and hydration challenges remain often neglected. The purpose of this paper is to emphasize and discuss the role of water consumption in the context of other important public health measures for weight management. Attention will be focused on fluid intake patterns and hydration-related questions in the context of global interventions and/or physical activity programs settled in weight management protocols. PMID:25765164

Chili pepper as a body weight-loss food.

PubMed

Varghese, Sharon; Kubatka, Peter; Rodrigo, Luis; Gazdikova, Katarina; Caprnda, Martin; Fedotova, Julia; Zulli, Anthony; Kruzliak, Peter; Büsselberg, Dietrich

2017-06-01

Chili has culinary as well as medical importance. Studies in humans, using a wide range of doses of chili intake (varying from a single meal to a continuous uptake for up to 12 weeks), concluded that it facilitates weight loss. In regard to this, the main targets of chili are fat metabolism, energy expenditure, and thermogenesis. To induce weight loss, the active substance of chili, capsaicin, activates Transient Receptor Potential Cation Channel sub-family V member 1 (TRPV1) channels) receptors causing an increase in intracellular calcium levels and triggering the sympathetic nervous system. Apart from TRPV1, chili directly reduces energy expenditure by activating Brown Adipose Tissue. Weight loss by chili is also the result of an improved control of insulin, which supports weight management and has positive effects for treatment for diseases like obesity, diabetes and cardiovascular disorders. This review summarizes the major pathways by which chili contributes to ameliorating parameters that help weight management and how the consumption of chili can help in accelerating weight loss through dietary modifications.

Using synchronous distance-education technology to deliver a weight management intervention.

PubMed

Dunn, Carolyn; Whetstone, Lauren MacKenzie; Kolasa, Kathryn M; Jayaratne, K S U; Thomas, Cathy; Aggarwal, Surabhi; Nordby, Kelly; Riley, Kenisha E M

2014-01-01

To compare the effectiveness of online delivery of a weight management program using synchronous (real-time), distance-education technology to in-person delivery. Synchronous, distance-education technology was used to conduct weekly sessions for participants with a live instructor. Program effectiveness was indicated by changes in weight, body mass index (BMI), waist circumference, and confidence in ability to eat healthy and be physically active. Online class participants (n = 398) had significantly greater reductions in BMI, weight, and waist circumference than in-person class participants (n = 1,313). Physical activity confidence increased more for in-person than online class participants. There was no difference for healthy eating confidence. This project demonstrates the feasibility of using synchronous distance-education technology to deliver a weight management program. Synchronous online delivery could be employed with no loss to improvements in BMI, weight, and waist circumference. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Young Adults’ Attitudes and Perceptions of Obesity and Weight Management: Implications for Treatment Development

PubMed Central

Lanoye, Autumn; Gorin, Amy A.; LaRose, Jessica Gokee

2017-01-01

Young adults are underrepresented in standard behavioral weight loss trials, and evidence suggests that they differ from older adults on many weight related constructs. The aim of this review is to explore young adults’ attitudes toward obesity and weight management, with particular attention to those factors that may play a role in development of future treatment efforts. Both intrapersonal and interpersonal considerations unique to young adulthood are assessed; in addition, we examine young adults’ perceptions of specific weight-related behaviors such as dieting, physical activity, and self-weighing. Conclusions are consistent with other findings suggesting that weight management interventions should be adapted and designed specifically for this age group. PMID:26923688

Equivalent weight loss for weight management programs delivered by phone and clinic

PubMed Central

Donnelly, Joseph E.; Goetz, Jeannine; Gibson, Cheryl; Sullivan, Debra K.; Lee, Robert; Smith, Bryan K.; Lambourne, Kate; Mayo, Matthew S.; Hunt, Suzanne; Lee, Jae Hoon; Honas, Jeffrey J.; Washburn, Richard A.

2013-01-01

Objective Face-to-face weight management is costly and presents barriers for individuals seeking treatment; thus, alternate delivery systems are needed. The objective of this study was to compare weight management delivered by face-to-face (FTF) clinic or group conference calls (phone). Design and Methods Randomized equivalency trial in 295 overweight/obese men/women (BMI = 35.1±4.9, Age = 43.8±10.2, Minority = 39.8%). Weight loss (0–6 months) was achieved by reducing energy intake between 1,200– 1,500 kcal/day and progressing physical activity to 300 minutes/week. Weight maintenance (7–18 months) provided adequate energy to maintain weight and continued 300 minutes/week of physical activity. Behavioral weight management strategies were delivered weekly for 6 months and gradually reduced during months 7–18. A cost analysis provided a comparison of expenses between groups. Results Weight change from baseline to 6 months was −13.4 ± 6.7% and −12.3 ± 7.0% for FTF clinic and phone, respectively. Weight change from 6 months to 18 months was 6.4 ± 7.0% and 6.4 ± 5.2%, for FTF clinic and phone, respectively. The cost to FTF participants was $789.58 more person. Conclusions Phone delivery provided equivalent weight loss and maintenance and reduced program cost. Ubiquitous access to phones provides a vast reach for this approach. PMID:23408579

Weight expectations, motivations for weight change and perceived factors influencing weight management in young Australian women: a cross-sectional study.

PubMed

Holley, Talisha J; Collins, Clare E; Morgan, Philip J; Callister, Robin; Hutchesson, Melinda J

2016-02-01

To examine young Australian women's weight expectations, motivations for weight change and perceived factors influencing weight management, and to determine if these factors differ by age, BMI, marital status, education or income. Cross-sectional study. An online survey captured respondents' weight, height, ideal weight, main reasons for wanting to change their weight and challenges to managing their weight. Online survey in Australia. Six hundred and twenty women aged 18-30 years currently living in Australia who completed the survey between 31 July and 30 September 2012. Approximately half of participants (53·1 %) were a healthy weight, 25·2 % overweight and 19·0 % obese. Women unhappy at their current weight (78·1 %) reported a median ideal weight -12·3 % less than their current weight. The key motivators for weight change were to improve health (24·4 %, ranked 1), feel better in oneself (22·3 %) and improve self-confidence (21·5 %). Lack of motivation, time constraints because of job commitments and cost were the most commonly reported factors influencing weight management. Age, BMI, marital status, education and income were found to influence weight expectations, motivations for weight change and/or factors perceived to influence weight management. The findings suggest potential implications for weight management interventions and public health messaging targeting young women, to improve long-term health outcomes. Strategies that promote the health benefits of physical activity and healthy eating, feeling better about oneself and improved self-confidence, and address the main factors influencing weight management including lack of motivation, time constraints and cost, may be used to engage this target group.

Exergaming for health: a community-based pediatric weight management program using active video gaming.

PubMed

Christison, Amy; Khan, Huma Ali

2012-04-01

To evaluate the efficacy and feasibility of a multifaceted, community-based weight intervention program for children using exergaming technology (activity-promoting video gaming). This is a prospective observational pilot study. Forty-eight children, between the ages of 8 and 16 years, who are overweight or obese, enrolled in Exergaming for Health, a multidisciplinary weight management program, which used active video gaming. Primary outcome measures were change in body mass index (BMI) z scores. Most children (n = 40, 83%) completed the program and participated in outcome evaluations. The average BMI change was -0.48 kg/m(2) (SD = 0.93), P < .002 (BMI z-score change was -0.072, SD = 0.14, P < .0001). The average Global Self-Worth score improved, screen time and soda intake reduced, and exercise hours per week increased. The Exergaming for Health program may be an effective weight management intervention that is feasible with high participation rates. A larger randomized controlled trial is needed to confirm these results.

The relationship between doctors' and nurses' own weight status and their weight management practices: a systematic review.

PubMed

Zhu, D Q; Norman, I J; While, A E

2011-06-01

It has been established that health professionals' smoking and physical activity influence their related health-promoting behaviours, but it is unclear whether health professionals' weight status also influences their related professional practices. A systematic review was conducted to understand the relationship between personal weight status and weight management practices. Nine eligible studies were identified from a search of the Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL and Chinese databases. All included studies were cross-sectional surveys employing self-reported questionnaires. Weight management practice variables studied were classified under six practice indicators, developed from weight management guidelines. Syntheses of the findings from the selected studies suggest that: normal weight doctors and nurses were more likely than those who were overweight to use strategies to prevent obesity in-patients, and, also, provide overweight or obese patients with general advice to achieve weight loss. Doctors' and nurses' own weight status was not found to be significantly related to their referral and assessment of overweight or obese patients, and associations with their relevant knowledge/skills and specific treatment behaviours were inconsistent. Additionally, in female, primary care providers, relevant knowledge and training, self-efficacy and a clear professional identity emerged as positive predictors of weight management practices. This review's findings will need to be confirmed by prospective theoretically driven studies, which employ objective measures of weight status and weight management practices and involve multivariate analyses to identify the relative contribution of weight status to weight management. © 2011 The Authors. obesity reviews © 2011 International Association for the Study of Obesity.

Integrating a family-focused approach into child obesity prevention: Rationale and design for the My Parenting SOS study randomized control trial

PubMed Central

2011-01-01

Background More than 20% of US children ages 2-5 yrs are classified as overweight or obese. Parents greatly influence the behaviors their children adopt, including those which impact weight (e.g., diet and physical activity). Unfortunately, parents often fail to recognize the risk for excess weight gain in young children, and may not be motivated to modify behavior. Research is needed to explore intervention strategies that engage families with young children and motivate parents to adopt behaviors that will foster healthy weight development. Methods This study tests the efficacy of the 35-week My Parenting SOS intervention. The intervention consists of 12 sessions: initial sessions focus on general parenting skills (stress management, effective parenting styles, child behavior management, coparenting, and time management) and later sessions apply these skills to promote healthier eating and physical activity habits. The primary outcome is change in child percent body fat. Secondary measures assess parent and child dietary intake (three 24-hr recalls) and physical activity (accelerometry), general parenting style and practices, nutrition- and activity-related parenting practices, and parent motivation to adopt healthier practices. Discussion Testing of these new approaches contributes to our understanding of how general and weight-specific parenting practices influence child weight, and whether or not they can be changed to promote healthy weight trajectories. Trial Registration ClinicalTrials.gov: NCT00998348 PMID:21639940

Integrating a family-focused approach into child obesity prevention: rationale and design for the My Parenting SOS study randomized control trial.

PubMed

Ward, Dianne S; Vaughn, Amber E; Bangdiwala, Kant I; Campbell, Marci; Jones, Deborah J; Panter, Abigail T; Stevens, June

2011-06-05

More than 20% of US children ages 2-5 yrs are classified as overweight or obese. Parents greatly influence the behaviors their children adopt, including those which impact weight (e.g., diet and physical activity). Unfortunately, parents often fail to recognize the risk for excess weight gain in young children, and may not be motivated to modify behavior. Research is needed to explore intervention strategies that engage families with young children and motivate parents to adopt behaviors that will foster healthy weight development. This study tests the efficacy of the 35-week My Parenting SOS intervention. The intervention consists of 12 sessions: initial sessions focus on general parenting skills (stress management, effective parenting styles, child behavior management, coparenting, and time management) and later sessions apply these skills to promote healthier eating and physical activity habits. The primary outcome is change in child percent body fat. Secondary measures assess parent and child dietary intake (three 24-hr recalls) and physical activity (accelerometry), general parenting style and practices, nutrition- and activity-related parenting practices, and parent motivation to adopt healthier practices. Testing of these new approaches contributes to our understanding of how general and weight-specific parenting practices influence child weight, and whether or not they can be changed to promote healthy weight trajectories. ClinicalTrials.gov: NCT00998348.

Developing and testing evidence-based weight management in Australian pharmacies: A Healthier Life Program.

PubMed

Um, Irene S; Krass, Ines; Armour, Carol; Gill, Timothy; Chaar, Betty B

2015-10-01

Pharmacies represent a valuable opportunity to deliver weight management services, rather than just the routine supply of weight-loss products. In order to provide optimal services and translation of evidence-based weight management in community pharmacy, a best practice model program was designed and pilot tested to facilitate implementation of such services in pharmacies in Australia. To develop and pilot a pharmacist-delivered, evidence-based, non-product-centred weight management service for community pharmacy in Australia. Setting Sydney, New South Wales, Australia. A pharmacy-based weight management service called the A Healthier Life Program (AHLP), for overweight and obese individuals, was developed based on current Australian weight management guidelines and recommendations made by key stakeholders. The pharmacist undertook training to acquire specific competencies to deliver the program. The AHLP involved six individual face-to-face sessions with the pharmacist over 3 months. The intervention targeted three areas: diet, physical activity and behavioural change. Weight, BMI, waist circumference, blood pressure, dietary intake, and physical activity levels at 3 months were compared with values at baseline. Qualitative feedback on participants' satisfaction and willingness to pay were also analysed. Eight pharmacies provided the AHLP between February and December 2013. Thirty-four participants were enrolled in the AHLP; mean age 50.7 years (SD 15.7) and mean BMI 34.3 kg/m(2) (SD 5.3). Of the 22 (65%) participants who completed the program, six had achieved the target weight loss of ≥5%. The mean change in weight was -3.5 kg (95% CI -4.8, -2.2) and waist circumference -2.0 cm (95% CI -2.8, -1.3) for program completers at 3 months. Furthermore, participants reported overall positive experiences of the program, and identified accessibility of the pharmacy and high comfort level with the pharmacist, as the major advantages. The AHLP was well received and participants achieved targeted weight loss. This study demonstrated that an evidence-based patient-centred weight management program can be implemented in Australian pharmacies.

Physical activity, eating behaviour and body image perception among young adolescents in Kuantan, Pahang, Malaysia.

PubMed

Farah Wahida, Z; Mohd Nasir, M T; Hazizi, A S

2011-12-01

A cross-sectional study was conducted to determine physical activity, eating behaviour, body weight management knowledge, perception of body image and their association with body weight status of adolescents. Respondents were 360 adolescents, aged between 13 to 14 years, from six randomly selected secondary schools in Kuantan, Pahang. Physical activity, eating behaviour, body weight management knowledge and perception of body image were measured by the Physical Activity Questionnaire for Older Children (PAQ-C), Eating Attitude Test-26 (EAT-26), Weight Management Knowledge Inventory (WMKI) and Contour Drawing Rating Scale (CDRS), respectively. Almost half of the respondents were categorised as having a normal BMI, while 30.3% were severely thin and thin and 20.3% were overweight and obese. Mean physical activity score was 2.06 +/- 0.45 with more males (35.0%) being physically active than females (17.3%). Mean eating behaviour score was 15.41 +/- 10.37, with 27.8% of the respondents being at-risk for eating disorders. Mean weight management knowledge score was 5.35 +/- 1.80, with more females (77.7%) having higher mean scores than males (42.3%). Further, mean discrepancy score for body image perception was 1.24 +/- 0.99, with 78.1% of the respondents being dissatisfied with their current body size. Positive associations were found between eating behaviour (r = 0.28, p < 0.05) and body image (r = 0.35, p < 0.05) with BMI. Respondents with high eating behaviour scores and body image discrepancy scores were more likely to have greater BMI. This study shows the need for healthy eating and body image intervention programmes to prevent overweight and obesity problems among adolescents.

Changing the endpoints for determining effective obesity management.

PubMed

Ross, Robert; Blair, Steve; de Lannoy, Louise; Després, Jean-Pierre; Lavie, Carl J

2015-01-01

Health authorities worldwide recommend weight loss as a primary endpoint for effective obesity management. Despite a growing public awareness of the importance of weight loss and the spending of billions of dollars by Americans in attempts to lose weight, obesity prevalence continues to rise. In this report we argue that effective obesity management in today's environment will require a shift in focus from weight loss as the primary endpoint, to improvements in the causal behaviors; diet and exercise/physical activity (PA). We reason that increases in PA combined with a balanced diet are associated with improvement in many of the intermediate risk factors including cardiorespiratory fitness (CRF) associated with obesity despite minimal or no weight loss. Consistent with this notion, we suggest that a focus on healthy behaviors for the prevention of additional weight gain may be an effective way of managing obesity in the short term. Copyright © 2014 Elsevier Inc. All rights reserved.

An opportunity to combat obesity lies in the at-risk college population.

PubMed

Swanson, Wendi Mortimer

2016-04-01

Approximately 70% of United States [or U.S.] adults are either overweight or obese. Obesity increases the risk of chronic disease and strains healthcare access, quality, and cost. Weight gain occurs in college students threatening optimal weight maintenance. Physical activity is fundamental to preventing disease. College students incur multiple challenges in weight management. The purpose of the article is to describe the opportunity for Advanced Practice Registered Nurses (APRNs) to intentionally become wellness promoters. The literature was reviewed and interventions developed. Guided by Bandura's Social Cognitive Theory, focus was concentrated on environmental influences through a proposed Staying Active Campaign (SAC). College students are a vulnerable population at risk for unhealthful practices. Young adulthood is a critical period of weight gain that carries risk for later adulthood. College students desire and require assistance for successful weight management. Interventions can be directed by APRNs to achieve healthful weight management and create a campus-wide culture that reinforces healthful practices. Obesity in the college population is a twofold circumstance. Action by APRNs is needed to address obesity and advocate for the prevention of future obesity. The SAC decreases the confounding college environment and supports the students' ability to be physically active while establishing personal lifelong behaviors to emulate and share with others. ©2016 American Association of Nurse Practitioners.

National Athletic Trainers' Association position statement: safe weight loss and maintenance practices in sport and exercise.

PubMed

Turocy, Paula Sammarone; DePalma, Bernard F; Horswill, Craig A; Laquale, Kathleen M; Martin, Thomas J; Perry, Arlette C; Somova, Marla J; Utter, Alan C

2011-01-01

To present athletic trainers with recommendations for safe weight loss and weight maintenance practices for athletes and active clients and to provide athletes, clients, coaches, and parents with safe guidelines that will allow athletes and clients to achieve and maintain weight and body composition goals. Unsafe weight management practices can compromise athletic performance and negatively affect health. Athletes and clients often attempt to lose weight by not eating, limiting caloric or specific nutrients from the diet, engaging in pathogenic weight control behaviors, and restricting fluids. These people often respond to pressures of the sport or activity, coaches, peers, or parents by adopting negative body images and unsafe practices to maintain an ideal body composition for the activity. We provide athletic trainers with recommendations for safe weight loss and weight maintenance in sport and exercise. Although safe weight gain is also a concern for athletic trainers and their athletes and clients, that topic is outside the scope of this position statement. Athletic trainers are often the source of nutrition information for athletes and clients; therefore, they must have knowledge of proper nutrition, weight management practices, and methods to change body composition. Body composition assessments should be done in the most scientifically appropriate manner possible. Reasonable and individualized weight and body composition goals should be identified by appropriately trained health care personnel (eg, athletic trainers, registered dietitians, physicians). In keeping with the American Dietetics Association (ADA) preferred nomenclature, this document uses the terms registered dietitian or dietician when referring to a food and nutrition expert who has met the academic and professional requirements specified by the ADA's Commission on Accreditation for Dietetics Education. In some cases, a registered nutritionist may have equivalent credentials and be the commonly used term. All weight management and exercise protocols used to achieve these goals should be safe and based on the most current evidence. Athletes, clients, parents, and coaches should be educated on how to determine safe weight and body composition so that athletes and clients more safely achieve competitive weights that will meet sport and activity requirements while also allowing them to meet their energy and nutritional needs for optimal health and performance.

Weight management by phone conference call: A comparison with a traditional face-to-face clinic. Rationale and design for a randomized equivalence trial

PubMed Central

Lambourne, Kate; Washburn, Richard A.; Gibson, Cheryl; Sullivan, Debra K.; Goetz, Jeannine; Lee, Robert; Smith, Bryan K.; Mayo, Matthew S.; Donnelly, Joseph E.

2012-01-01

State-of-the-art treatment for weight management consists of a behavioral intervention to facilitate decreased energy intake and increased physical activity. These interventions are typically delivered face-to-face (FTF) by a health educator to a small group of participants. There are numerous barriers to participation in FTF clinics including availability, scheduling, the expense and time required to travel to the clinic site, and possible need for dependent care. Weight management clinics delivered by conference call have the potential to diminish or eliminate these barriers. The conference call approach may also reduce burden on providers, who could conduct clinic groups from almost any location without the expenses associated with maintaining FTF clinic space. A randomized trial will be conducted in 395 overweight/obese adults (BMI 25–39.9 kg/m2) to determine if weight loss (6 months) and weight maintenance (12 months) are equivalent between weight management interventions utilizing behavioral strategies and pre-packaged meals delivered by either a conference call or the traditional FTF approach. The primary outcome, body weight, will be assessed at baseline, 6, 12 and 18 months. Secondary outcomes including waist circumference, energy and macronutrient intake, and physical activity and will be assessed on the same schedule. In addition, a cost analysis and extensive process evaluation will be completed. PMID:22664647

Weight management by phone conference call: a comparison with a traditional face-to-face clinic. Rationale and design for a randomized equivalence trial.

PubMed

Lambourne, Kate; Washburn, Richard A; Gibson, Cheryl; Sullivan, Debra K; Goetz, Jeannine; Lee, Robert; Smith, Bryan K; Mayo, Matthew S; Donnelly, Joseph E

2012-09-01

State-of-the-art treatment for weight management consists of a behavioral intervention to facilitate decreased energy intake and increased physical activity. These interventions are typically delivered face-to-face (FTF) by a health educator to a small group of participants. There are numerous barriers to participation in FTF clinics including availability, scheduling, the expense and time required to travel to the clinic site, and possible need for dependent care. Weight management clinics delivered by conference call have the potential to diminish or eliminate these barriers. The conference call approach may also reduce burden on providers, who could conduct clinic groups from almost any location without the expenses associated with maintaining FTF clinic space. A randomized trial will be conducted in 395 overweight/obese adults (BMI 25-39.9 kg/m(2)) to determine if weight loss (6 months) and weight maintenance (12 months) are equivalent between weight management interventions utilizing behavioral strategies and pre-packaged meals delivered by either a conference call or the traditional FTF approach. The primary outcome, body weight, will be assessed at baseline, 6, 12 and 18 months. Secondary outcomes including waist circumference, energy and macronutrient intake, and physical activity and will be assessed on the same schedule. In addition, a cost analysis and extensive process evaluation will be completed. Copyright © 2012 Elsevier Inc. All rights reserved.

Clinical evaluation of Moro (Citrus sinensis (L.) Osbeck) orange juice supplementation for the weight management.

PubMed

Cardile, Venera; Graziano, Adriana Carol Eleonora; Venditti, Alessandro

2015-01-01

In the last years, several studies have recently evaluated the beneficial effects of red orange juice (Citrus sinensis (L.) Osbeck) and its active components in weight management and obesity. Moro orange is a cultivar of red orange, particularly rich in active compounds such as anthocyanins, hydroxycinnamic acids, flavone glycosides and ascorbic acid, which displays anti-obesity effects in in vitro and in vivo studies. In this clinical study, the effect of a Moro juice extract (Morosil(®), 400 mg/die) supplementation was evaluated in overweight healthy human volunteers for 12 weeks. Results showed that Moro juice extract intake was able to induce a significant reduction in body mass index (BMI) after 4 weeks of treatment (p < 0.05). Moreover, in subjects treated with Moro extract, body weight, BMI, waist and hip circumference were significantly different from the placebo group (p < 0.05). In conclusion, it could be suggested that the active compounds contained in Moro juice have a synergistic effect on fat accumulation in humans and Moro juice extract can be used in weight management and in the prevention of human obesity.

Evaluation of a multidisciplinary Tier 3 weight management service for adults with morbid obesity, or obesity and comorbidities, based in primary care

PubMed Central

Jennings, A; Hughes, C A; Kumaravel, B; Bachmann, M O; Steel, N; Capehorn, M; Cheema, K

2014-01-01

A multidisciplinary Tier 3 weight management service in primary care recruited patients with a body mass index ≥40 kg·m−2, or 30 kg·m−2 with obesity-related co-morbidity to a 1-year programme. A cohort of 230 participants was recruited and evaluated using the National Obesity Observatory Standard Evaluation Framework. The primary outcome was weight loss of at least 5% of baseline weight at 12 months. Diet was assessed using the two-item food frequency questionnaire, activity using the General Practice Physical Activity questionnaire and quality of life using the EuroQol-5D-5L questionnaire. A focus group explored the participants' experiences. Baseline mean weight was 124.4 kg and mean body mass index was 44.1 kg·m−2. A total of 102 participants achieved 5% weight loss at 12 months. The mean weight loss was 10.2 kg among the 117 participants who completed the 12-month programme. Baseline observation carried forward analysis gave a mean weight loss of 5.9 kg at 12 months. Fruit and vegetable intake, activity level and quality of life all improved. The dropout rate was 14.3% at 6 months and 45.1% at 1 year. Focus group participants described high levels of satisfaction. It was possible to deliver a Tier 3 weight management service for obese patients with complex co-morbidity in a primary care setting with a full multidisciplinary team, which obtained good health outcomes compared with existing services. PMID:25825858

Weight maintenance, behaviors and barriers among previous participants of a university-based weight control program.

PubMed

Befort, C A; Stewart, E E; Smith, B K; Gibson, C A; Sullivan, D K; Donnelly, J E

2008-03-01

To examine weight loss maintenance among previous participants of a university-based behavioral weight management program and to compare behavioral strategies and perceived barriers between successful and unsuccessful maintainers. Previous program participants (n=179) completed mailed surveys assessing current weight, weight control behaviors and perceived barriers to weight loss maintenance. At 14.1+/-10.8 months following completion of treatment, survey respondents were on average 12.6+/-12.6 kg, or 11.3+/-10.7%, below baseline weight; 76.5% of respondents had successfully maintained weight, defined as maintaining a weight loss of at least 5% below baseline. Compared to unsuccessful maintainers, successful maintainers reported practicing four dietary and three physical activity weight control strategies more often and experiencing five barriers to healthy eating and exercise less often. After accounting for time since treatment and maximum weight loss while in treatment, the strongest correlates of successful weight loss maintenance were frequent exercise and perceived difficulty of weight management. Clinically meaningful weight loss maintenance was achieved by the majority of participants. Findings support the literature indicating that physical activity is one of the strongest predictors of successful weight loss maintenance. Findings also suggest that strategies to reduce the level of perceived effort required for long-term weight control may improve maintenance outcomes.

Weight Measurements and Standards for Soldiers, Phase 2

DTIC Science & Technology

2011-10-01

Eating, Activity, and Lifestyle Training Headquarters (H.E.A.L.T.H.) (1). This program was designed to address weight management needs and non-compliance...and safe lifestyle change to sustain healthy weight and performance on a year-round basis. The H.E.A.L.T.H. website was specifically designed to aid...accessed and utilized via Smartphone devices, e.g. Droid, iphone, Blackberry. The launch of the program on Smartphones has enabled field managers

Eating for 1, Healthy and Active for 2; feasibility of delivering novel, compact training for midwives to build knowledge and confidence in giving nutrition, physical activity and weight management advice during pregnancy

PubMed Central

2014-01-01

Background Women in Wales are more likely to be obese in pregnancy than in any other United Kingdom (UK) country. Midwives are ideally placed to explore nutrition, physical activity and weight management concerns however qualitative studies indicate they lack confidence in raising the sensitive issue of weight. Acknowledging this and the reality of finite time and resources, this study aimed to deliver compact training on nutrition, physical activity and weight management during pregnancy to increase the knowledge and confidence of midwives in this subject. Methods A compact training package for midwives was developed comprising of evidence based nutrition, physical activity and weight management guidance for pregnancy. Training was promoted via midwifery leads and delivered within the Health Board. Questionnaires based on statements from national public health guidance were used to assess changes in self-reported knowledge and confidence pre and post training. Descriptive statistics were applied and 95% confidence intervals were calculated. Results 43 midwives registered for training, 32 (74%) attended and completed the questionnaires. Although, pre training knowledge and confidence varied between participants, statistically significant improvements in self-reported knowledge and confidence were observed post training. 97% indicated knowledge of pregnancy specific food and nutrition messages as ‘better’ (95% CI 85 to 100), as opposed to 3% stating ‘stayed the same’ – 60% stated ‘much better’. 83% indicated confidence to explain the risks of raised BMI in pregnancy was either ‘much’ or ‘somewhat better’ (95% CI 66 to 93), as opposed to 17% stating ‘stayed the same’. 89% indicated confidence to discuss eating habits and physical activity was ‘much’ or ‘somewhat better’ (95% CI 73 to 97) as opposed to 11% stating ‘stayed the same’. Emergent themes highlighted that training was positively received and relevant to midwifery practice. Conclusions This study provides early indications that a compact nutrition, physical activity and weight management training package improves midwives self-reported knowledge and confidence. Cascading training across the midwifery service in the Health Board and conducting further studies to elicit longer term impact on midwifery practice and patient outcomes are recommended. PMID:24996422

Apollo Soyuz Test Project Weights and Mass Properties Operational Management System

NASA Technical Reports Server (NTRS)

Collins, M. A., Jr.; Hischke, E. R.

1975-01-01

The Apollo Soyuz Test Project (ASTP) Weights and Mass Properties Operational Management System was established to assure a timely and authoritative method of acquiring, controlling, generating, and disseminating an official set of vehicle weights and mass properties data. This paper provides an overview of the system and its interaction with the various aspects of vehicle and component design, mission planning, hardware and software simulations and verification, and real-time mission support activities. The effect of vehicle configuration, design maturity, and consumables updates is discussed in the context of weight control.

Control systems engineering for optimizing a prenatal weight gain intervention to regulate infant birth weight.

PubMed

Savage, Jennifer S; Downs, Danielle Symons; Dong, Yuwen; Rivera, Daniel E

2014-07-01

We used dynamical systems modeling to describe how a prenatal behavioral intervention that adapts to the needs of each pregnant woman may help manage gestational weight gain and alter the obesogenic intrauterine environment to regulate infant birth weight. This approach relies on integrating mechanistic energy balance, theory of planned behavior, and self-regulation models to describe how internal processes can be impacted by intervention dosages, and reinforce positive outcomes (e.g., healthy eating and physical activity) to moderate gestational weight gain and affect birth weight. A simulated hypothetical case study from MATLAB with Simulink showed how, in response to our adaptive intervention, self-regulation helps adjust perceived behavioral control. This, in turn, changes the woman's intention and behavior with respect to healthy eating and physical activity during pregnancy, affecting gestational weight gain and infant birth weight. This article demonstrates the potential for real-world applications of an adaptive intervention to manage gestational weight gain and moderate infant birth weight. This model could be expanded to examine the long-term sustainable impacts of an intervention that varies according to the participant's needs on maternal postpartum weight retention and child postnatal eating behavior.

Hispanic Male’s Perspectives of Health Behaviors Related to Weight Management

PubMed Central

Garcia, David O.; Valdez, Luis A.; Hooker, Steven P.

2015-01-01

Hispanic males have the highest prevalence of overweight and obesity among men in the United States; yet are significantly underrepresented in weight loss research. The purpose of the current study was to examine Hispanic male’s perspectives of health behaviors related to weight management to refine the methodologies to deliver a gender-sensitive and culturally sensitive weight loss intervention. From October 2014 to April 2015, semistructured interviews were conducted with 14 overweight Hispanic men of ages 18 to 64 years. The interviews lasted approximately 60 minutes. Participants also completed a brief questionnaire and body weight/height were measured. Grounded in a deductive process, a preliminary codebook was developed based on the topics included in the interview guides. A thematic analysis facilitated the identification of inductive themes and the finalization of the codebook used for transcript analysis. Four overarching themes were identified: (a) general health beliefs of how diet and physical activity behaviors affect health outcomes, (b) barriers to healthy eating and physical activity, (c) motivators for change, and (d) viable recruitment and intervention approaches. Future research should examine feasible and appropriate recruitment and intervention strategies identified by Hispanic males to improve weight management in this vulnerable group. PMID:26634854

Behavioral and Psychological Phenotyping of Physical Activity and Sedentary Behavior: Implications for Weight Management.

PubMed

Bryan, Angela D; Jakicic, John M; Hunter, Christine M; Evans, Mary E; Yanovski, Susan Z; Epstein, Leonard H

2017-10-01

Risk for obesity is determined by a complex mix of genetics and lifetime exposures at multiple levels, from the metabolic milieu to psychosocial and environmental influences. These phenotypic differences underlie the variability in risk for obesity and response to weight management interventions, including differences in physical activity and sedentary behavior. As part of a broader effort focused on behavioral and psychological phenotyping in obesity research, the National Institutes of Health convened a multidisciplinary workshop to explore the state of the science in behavioral and psychological phenotyping in humans to explain individual differences in physical activity, both as a risk factor for obesity development and in response to activity-enhancing interventions. Understanding the behavioral and psychological phenotypes that contribute to differences in physical activity and sedentary behavior could allow for improved treatment matching and inform new targets for tailored, innovative, and effective weight management interventions. This summary provides the rationale for identifying psychological and behavioral phenotypes relevant to physical activity and identifies opportunities for future research to better understand, define, measure, and validate putative phenotypic factors and characterize emerging phenotypes that are empirically associated with initiation of physical activity, response to intervention, and sustained changes in physical activity. © 2017 The Obesity Society.

Prevalence and impact of obesity in people with haemophilia: Review of literature and expert discussion around implementing weight management guidelines.

PubMed

Kahan, S; Cuker, A; Kushner, R F; Maahs, J; Recht, M; Wadden, T; Willis, T; Majumdar, S; Ungar, D; Cooper, D

2017-11-01

Obesity affects more than 35% of Americans, increasing the risk of more than 200 comorbid conditions, impaired quality of life and premature mortality. This review aimed to summarize literature published over the past 15 years regarding the prevalence and impact of obesity in people with haemophilia (PWH) and to discuss implementing general guidelines for weight management in the context of the haemophilia comprehensive care team. Although few studies have assessed the effects of obesity on haemophilia-specific outcomes, existing evidence indicates an important impact of weight status on lower extremity joint range of motion and functional disability, with potentially important effects on overall quality of life. Data regarding bleeding tendency in PWH with coexisting obesity are largely inconclusive; however, some individuals may experience reduced joint bleeds following moderate weight loss. Additionally, conventional weight-based dosing of factor replacement therapy leads to increased treatment costs for PWH with obesity or overweight, suggesting pharmacoeconomic benefits of weight loss. Evidence-based recommendations for weight loss include behavioural strategies to reduce caloric intake and increase physical activity, pharmacotherapy and surgical therapy in appropriate patients. Unique considerations in PWH include bleed-related risks with physical activity; thus, healthcare professionals should advise patients on types and intensities of, and approaches to, physical activity, how to adjust treatment to accommodate exercise and how to manage potential activity-related bleeding. Increasing awareness of these issues may improve identification of PWH with coexisting obesity and referral to appropriate specialists, with potentially wide-ranging benefits in overall health and well-being. © 2017 The Authors. Haemophilia Published by John Wiley & Sons Ltd.

Evaluation of a multidisciplinary Tier 3 weight management service for adults with morbid obesity, or obesity and comorbidities, based in primary care.

PubMed

Jennings, A; Hughes, C A; Kumaravel, B; Bachmann, M O; Steel, N; Capehorn, M; Cheema, K

2014-10-01

A multidisciplinary Tier 3 weight management service in primary care recruited patients with a body mass index ≥40 kg·m(-2) , or 30 kg·m(-2) with obesity-related co-morbidity to a 1-year programme. A cohort of 230 participants was recruited and evaluated using the National Obesity Observatory Standard Evaluation Framework. The primary outcome was weight loss of at least 5% of baseline weight at 12 months. Diet was assessed using the two-item food frequency questionnaire, activity using the General Practice Physical Activity questionnaire and quality of life using the EuroQol-5D-5L questionnaire. A focus group explored the participants' experiences. Baseline mean weight was 124.4 kg and mean body mass index was 44.1 kg·m(-2) . A total of 102 participants achieved 5% weight loss at 12 months. The mean weight loss was 10.2 kg among the 117 participants who completed the 12-month programme. Baseline observation carried forward analysis gave a mean weight loss of 5.9 kg at 12 months. Fruit and vegetable intake, activity level and quality of life all improved. The dropout rate was 14.3% at 6 months and 45.1% at 1 year. Focus group participants described high levels of satisfaction. It was possible to deliver a Tier 3 weight management service for obese patients with complex co-morbidity in a primary care setting with a full multidisciplinary team, which obtained good health outcomes compared with existing services. © 2014 The Authors. Clinical Obesity published by John Wiley & Sons Ltd on behalf of World Obesity.

Weight management in community pharmacy: what do the experts think?

PubMed

Um, Irene S; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B

2013-06-01

The increasing prevalence of obesity and overweight adults creates a significant public health burden and there is great potential for pharmacists to be involved in the provision of weight management services, other than the mundane supply of commercial products. In order to provide optimal services that can be integrated into the healthcare system, a best practice model for weight management services in community pharmacy should be in place. We sought experts' and key stakeholders' opinions on this matter. (1) To identify components of a best practice model of a weight management service feasible in Australian community pharmacy. (2) To identify the role of pharmacists and the training requirements to up-skill pharmacists to competently provide weight management services. (3) To elicit any practical suggestions that would contribute to successful implementation of weight management services in pharmacy. Australian primary care sector. Semi-structured interviews were conducted with a purposive sample of 12 participants including Australian experts in obesity and representatives of main Australian professional organisations in pharmacy. Interviews were digitally recorded, transcribed verbatim and thematically analysed using the framework approach. Recommended components of pharmacy-based weight management services and training requirements. Participants perceived two potential roles for pharmacists involved in weight management: health promotion and individualised service. Multi-component interventions targeting all three areas: diet, physical activity and behaviour change were emphasised. Physical assessment (e.g. weight, waist circumference measurements), goal setting, referral to allied healthcare professionals and on-going support for weight maintenance were also proposed. Participants suggested pharmacists should undergo formal training and identified various training topics to improve pharmacists' knowledge, attributes and skills to acquire competencies necessary for delivery of this service. Some physical and financial barriers in providing these services were also identified including infrastructure, pharmacists' time and cost-effectiveness. Pharmacists are well-positioned to promote healthy weight and/or implement weight management interventions. Furthering pharmacists' role would involve training and up-skilling; and addressing key practice change facilitators such as pharmacy layout and remuneration. This study provides some insight into the design and implementation of a best practice model for pharmacy-based weight management services in Australia.

National Athletic Trainers' Association Position Statement: Safe Weight Loss and Maintenance Practices in Sport and Exercise

PubMed Central

Turocy, Paula Sammarone; DePalma, Bernard F.; Horswill, Craig A.; Laquale, Kathleen M.; Martin, Thomas J.; Perry, Arlette C.; Somova, Marla J.; Utter, Alan C.

2011-01-01

Objective: To present athletic trainers with recommendations for safe weight loss and weight maintenance practices for athletes and active clients and to provide athletes, clients, coaches, and parents with safe guidelines that will allow athletes and clients to achieve and maintain weight and body composition goals. Background: Unsafe weight management practices can compromise athletic performance and negatively affect health. Athletes and clients often attempt to lose weight by not eating, limiting caloric or specific nutrients from the diet, engaging in pathogenic weight control behaviors, and restricting fluids. These people often respond to pressures of the sport or activity, coaches, peers, or parents by adopting negative body images and unsafe practices to maintain an ideal body composition for the activity. We provide athletic trainers with recommendations for safe weight loss and weight maintenance in sport and exercise. Although safe weight gain is also a concern for athletic trainers and their athletes and clients, that topic is outside the scope of this position statement. Recommendations: Athletic trainers are often the source of nutrition information for athletes and clients; therefore, they must have knowledge of proper nutrition, weight management practices, and methods to change body composition. Body composition assessments should be done in the most scientifically appropriate manner possible. Reasonable and individualized weight and body composition goals should be identified by appropriately trained health care personnel (eg, athletic trainers, registered dietitians, physicians). In keeping with the American Dietetics Association (ADA) preferred nomenclature, this document uses the terms registered dietitian or dietician when referring to a food and nutrition expert who has met the academic and professional requirements specified by the ADA's Commission on Accreditation for Dietetics Education. In some cases, a registered nutritionist may have equivalent credentials and be the commonly used term. All weight management and exercise protocols used to achieve these goals should be safe and based on the most current evidence. Athletes, clients, parents, and coaches should be educated on how to determine safe weight and body composition so that athletes and clients more safely achieve competitive weights that will meet sport and activity requirements while also allowing them to meet their energy and nutritional needs for optimal health and performance. PMID:21669104

Mail and phone interventions for weight loss in a managed-care setting: Weigh-To-Be one-year outcomes.

PubMed

Jeffery, R W; Sherwood, N E; Brelje, K; Pronk, N P; Boyle, R; Boucher, J L; Hase, K

2003-12-01

To describe methods, recruitment success, and 1-y results of a study evaluating the effectiveness of phone- and mail-based weight-loss interventions in a managed care setting. Randomized clinical trial with three groups, that is, usual care, mail intervention, and phone intervention. In total, 1801 overweight members of a managed-care organization (MCO). Height, weight, medical status, and weight-loss history were measured at baseline. Participation in intervention activities was monitored for 12 months in the two active treatment groups. Self-reported weight was obtained at 6 and 12 months. More individuals assigned to mail treatment started it (88%) than did those assigned to phone treatment (69%). However, program completion rates were higher in the phone (36%) than mail (7%) intervention. The mean weight losses were 1.93, 2.38, and 1.47 kg at 6 months in the mail, phone, and usual care groups, respectively. The differences between the phone and usual care groups were statistically significant. The mean weight losses at 12 months did not differ by treatment group (2.28 kg mail, 2.29 kg phone, and 1.92 kg usual care). Greater weight loss was seen in men, older participants, and those with no prior experience in a weight-loss program. Heavier participants and those who reported current treatment for depression lost less weight. Although mail- and phone-based weight-loss programs can be delivered to large numbers of people in an MCO setting, additional work is needed to enhance their clinical efficacy as well as to assess their costs.

Individual, social and environmental factors and their association with weight in rural-dwelling women.

PubMed

Harrison, Cheryce L; Teede, Helena J; Kozica, Samantha; Zoungas, Sophia; Lombard, Catherine B

2016-11-20

Obesity is a major public health concern and women living in rural settings present a high-risk group. With contributing factors poorly explored, we evaluated their association with weight in rural Australian women. Women aged 18-50 years of any body mass index (BMI) were recruited between October 2012 and April 2013 as part of a larger, randomised controlled trial within 42 rural towns. Measured weight and height as well as self-reported measures of individual health, physical activity, dietary intake, self-management, social support and environmental perception were collected. Statistical analysis included linear regression for continuous variables as well as chi-squared and logistic regression for categorical variables with all results adjusted for clustering. 649 women with a mean baseline age and BMI of 39.6±6.7 years and 28.8±6.9 kg/m 2 respectively, were studied. Overall, 65% were overweight or obese and 60% overall reported recent weight gain. There was a high intention to self-manage weight, with 68% attempting to lose weight recently, compared to 20% of women reporting health professional engagement for weight management. Obese women reported increased weight gain, energy intake, sitting time and prevalence of pre-existing health conditions. There was an inverse relationship between increased weight and scores for self-management, social support and health environment perception. Many women in rural communities reported recent weight gain and were attempting to self-manage their weight with little external support. Implications for Public Health: Initiatives to prevent weight gain require a multifaceted approach, with self-management strategies and social support in tandem with building a positive local environmental perception. © 2016 Public Health Association of Australia.

Using new technologies to promote weight management: a randomised controlled trial study protocol.

PubMed

Jane, Monica; Foster, Jonathan; Hagger, Martin; Pal, Sebely

2015-05-27

Over the last three decades, overweight and obesity and the associated health consequences have become global public health priorities. Methods that have been tried to address this problem have not had the desired impact, suggesting that other approaches need to be considered. One of the lessons learned throughout these attempts is that permanent weight loss requires sustained dietary and lifestyle changes, yet adherence to weight management programs has often been noted as one of the biggest challenges. This trial aims to address this issue by examining whether social media, as a potential health promotion tool, will improve adherence to a weight management program. To test the effectiveness of this measure, the designated program will be delivered via the popular social networking site Facebook, and compared to a standard delivery method that provides exactly the same content but which is communicated through a pamphlet. The trial will be conducted over a period of twelve weeks, with a twelve week follow-up. Although weight loss is expected, this study will specifically investigate the effectiveness of social media as a program delivery method. The program utilised will be one that has already been proven to achieve weight loss, namely The CSIRO Total Wellbeing Diet. This project will be conducted as a 3-arm randomised controlled trial. One hundred and twenty participants will be recruited from the Perth community, and will be randomly assigned to one of the following three groups: the Facebook group, the pamphlet group, or a control group. The Facebook Group will receive the weight management program delivered via a closed group in Facebook, the Pamphlet Group will be given the same weight management program presented in a booklet, and the Control Group will follow the Australian Dietary Guidelines and the National Physical Activity Guidelines for Adults as usual care. Change in weight, body composition and waist circumference will be initial indicators of adherence to the program. Secondary outcome measures will be blood glucose, insulin, blood pressure, arterial stiffness, physical activity, eating behaviour, mental well-being (stress, anxiety, and depression), social support, self-control, self-efficacy, Facebook activity, and program evaluation. It is expected that this trial will support the use of social media - a source of social support and information sharing - as a delivery method for weight management programs, enhancing the reduction in weight expected from dietary and physical activity changes. Facebook is a popular, easy to access and cost-effective online platform that can be used to assist the formation of social groups, and could be translated into health promotion practice relatively easily. It is anticipated in the context of the predicted findings that social media will provide an invaluable resource for health professionals and patients alike. Australian New Zealand Clinical Trials Register (ANZCTR): ACTRN12614000536662. Date registered: 21 May 2014.

Weight-Loss and Nutrition Myths

MedlinePlus

... For Reporters Meetings & Workshops Follow Us Home Health Information Weight Management Some Myths about Nutrition & Physical Activity Related Topics ... at NIDDK Technology Advancement & Transfer Meetings & Workshops Health Information ... Disease Urologic Diseases Endocrine Diseases Diet & Nutrition ...

Exercise, an Active Lifestyle, and Obesity. Making the Exercise Prescription Work.

ERIC Educational Resources Information Center

Andersen, Ross E.

1999-01-01

An active lifestyle is important in helping overweight people both lose and manage their weight. Exercise has many health benefits beyond weight control. The traditional exercise prescription of regular bouts of continuous vigorous exercise may need modification to increase rates of adoption and compliance, with people needing encouragement to…

Equivalent weight loss for weight management programs delivered by phone and clinic.

PubMed

Donnelly, Joseph E; Goetz, Jeannine; Gibson, Cheryl; Sullivan, Debra K; Lee, Robert; Smith, Bryan K; Lambourne, Kate; Mayo, Matthew S; Hunt, Suzanne; Lee, Jae Hoon; Honas, Jeffrey J; Washburn, Richard A

2013-10-01

Face-to-face (FTF) weight management is costly and presents barriers for individuals seeking treatment; thus, alternate delivery systems are needed. The objective of this study was to compare weight management delivered by FTF clinic or group conference calls (phone). Randomized equivalency trial in 295 overweight/obese men/women (BMI = 35.1±4.9, Age = 43.8±10.2, Minority = 39.8%). Weight loss (0-6 months) was achieved by reducing energy intake between 1,200 and 1,500 kcal/day and progressing physical activity (PA) to 300 min/week. Weight maintenance (7-18 months) provided adequate energy to maintain weight and continued 300 min/week of PA. Behavioral weight management strategies were delivered weekly for 6 months and gradually reduced during 7-18 months. A cost analysis provided a comparison of expenses between groups. Weight change from baseline to 6 months was -13.4 ± 6.7% and -12.3 ± 7.0% for FTF clinic and phone, respectively. Weight change from 6-18 months was 6.4 ± 7.0% and 6.4 ± 5.2%, for FTF clinic and phone, respectively. The cost to FTF participants was $789.58 more per person. Phone delivery provided equivalent weight loss and maintenance and reduced program cost. Ubiquitous access to phones provides a vast reach for this approach. Copyright © 2013 The Obesity Society.

Prepare, a randomized trial to promote and evaluate weight loss among overweight and obese women planning pregnancy: Study design and rationale

PubMed Central

Vesco, Kimberly K.; Funk, Kristine L.; Karanja, Njeri; Smith, Ning; Stevens, Victor J.

2017-01-01

Background Women who are overweight or have obesity at pregnancy onset, and those who gain excessive weight during pregnancy, are at increased risk of pregnancy-related complications and large for gestational age infants. Objective This report describes methodology for the Prepare study, a randomized, controlled clinical trial testing a preconception and pregnancy weight management program for women who are overweight or have obesity (BMI ≥ 27 kg/m2). Outcomes This trial examines multiple pregnancy and neonatal outcomes, with the primary outcome being gestational weight gain (GWG). Secondary outcomes include change in weight before conception, offspring birth weight adjusted for gestational age, offspring weight for length, and pregnancy diet quality and physical activity level. Methods Nonpregnant women who anticipate becoming pregnant in the next 2 years are randomly assigned to an intervention program or a usual care control condition. Intervention participants receive weight management counseling by telephone before and during pregnancy, with weekly contacts during the first 6 months and monthly contacts for the next 18 months. Intervention participants also have unlimited access to a study website that provides self-management tools. All participants who become pregnant are contacted at 20 weeks' gestation to assess physical activity levels and dietary habits. All other outcome data are obtained from medical records. Intervention satisfaction is assessed via questionnaire. Summary This clinical trial tests the efficacy of an intervention program designed to help overweight and obese women achieve healthy lifestyle changes that will result in a healthy weight prior to pregnancy and appropriate weight gain during pregnancy. PMID:27394386

Parents as the start of the solution: a social marketing approach to understanding triggers and barriers to entering a childhood weight management service.

PubMed

Gillespie, J; Midmore, C; Hoeflich, J; Ness, C; Ballard, P; Stewart, L

2015-01-01

Childhood obesity is a sensitive subject and barriers exist with respect to accessing weight management programmes. Social marketing insight gathering provides an opportunity to understand behaviours and address these challenges. This project gained insight into the views of parents/carers on triggers and barriers to entering a childhood weight management service. Participants were identified from the public using marketing recruitment. Four focus groups were conducted with parents of school aged children (n = 27) by an experienced interviewer. Twenty two mothers, three fathers and two grandmothers participated, with half describing their child as overweight. Groups discussed health behaviours; attitudes to health messages and weight issues; and motivations, benefits and barriers with respect to accessing weight management services. Discussions were taped and transcribed. Themes were identified using framework analysis of content matrix data analysis. Participants were aware of healthy lifestyle messages, although the ability to implement these was variable. Triggers to seeking help included bullying, health concerns and inability to participate in school activities. Barriers included feeling a lack of control, desire to avoid conflict and no proven case that weight was a problem. Parents wished to be given information regarding their child's weight by a trusted person. The Internet and word of mouth were identified as methods of recruitment into a weight management service, with a focus on fitness, fun and friendliness and being free-of-charge. Insight gathering can be used to establish parental/carer opinion regarding engaging in childhood weight management services. A fun, friendly programme that is free of charge appealed to parents. Local community involvement around normalising child weight issues may boost referrals into child healthy weight interventions. © 2014 The British Dietetic Association Ltd.

Weight management during pregnancy: a systematic review of qualitative evidence.

PubMed

Johnson, Maxine; Campbell, Fiona; Messina, Josie; Preston, Louise; Buckley Woods, Helen; Goyder, Elizabeth

2013-12-01

increasing overweight and obesity rates in pregnant women present health risks to mother and unborn infant. to identify barriers and facilitators to implementing and carrying out maternal weight management interventions. searches were carried out in medical, midwifery and nursing databases, augmented by hand searching of midwifery journals. articles were included that were published in the UK after 1990, with a focus on women's and health professional's views about weight management during pregnancy. from 6423 citations, 126 full text papers were retrieved. Of these, 18 (reporting 17 studies) fulfilled the inclusion criteria. Included papers were assessed for quality. Reported findings were analysed and synthesised using thematic analysis. a major theme was access to relevant and appropriate information; advice was reported as vague or inadequate. Overweight or obese women reported feelings of stigmatisation during routine examinations. Health professionals reported a reluctance to discuss weight with larger women. Perceived risk to the fetus as well as changes in women's physiological responses to pregnancy, were reported barriers to optimal physical activity and dietary intake. Perceptions of control were related to women's feelings about their body image. evidence suggests that the complexity of interactions with advice sources, bodily changes, feelings of control, as well as perceived risks may explain the relative ineffectiveness of weight management interventions during pregnancy. Focusing on healthy diet and physical activity levels may be more useful and less stigmatising than focusing on weight. Copyright © 2012 Elsevier Ltd. All rights reserved.

Exercise therapy in polycystic ovary syndrome.

PubMed

Hoeger, Kathleen M

2008-01-01

Women with polycystic ovary syndrome (PCOS) demonstrate a high prevalence of obesity across all populations studied. The role of decreased energy expenditure through reduced physical activity in contributing to obesity in PCOS is not well studied. The independent benefits of exercise in improving metabolic disease, cardiovascular health, and diabetes have been shown in the general population. Moderate activity incorporated into daily activities appears to be as effective in the reduction in diabetes risk and cardiovascular disease as that achieved with vigorous activity and may be more sustainable over the long-term. The role of physical activity in the management of the reproductive dysfunction of PCOS is less established, although lifestyle change incorporating increased physical activity with reduced caloric intake has shown benefit in small published trials. Studies of weight loss demonstrate an essential role for increased physical activity in maintenance of weight loss over the long-term although minimal effect in the achievement of weight loss with exercise alone. Further studies of the role for exercise in the management of reproductive dysfunction in PCOS as well as clarification of the type, frequency, and duration of exercise to achieve the best outcomes are needed.

A mixed method evaluation of adult tier 2 lifestyle weight management service provision across a county in Northern England.

PubMed

Ells, L; Watson, P; Carlebach, S; O'Malley, C; Jones, D; Machaira, T; Whittaker, V; Clements, H; Walker, P; Needham, K; Summerbell, C; Coulton, V; Araujo-Soares, V

2018-06-01

Adult obesity in the UK remains a public health priority. Current guidance recommends local areas provide multicomponent interventions to treat adults with overweight and obesity; however, there is currently a dearth of published evidence on the evaluation of these programmes. This study reports on a mixed method evaluation of seven tier 2 weight management programmes funded by a local authority in the North of England through their public health grant (a lifestyle multicomponent weight management programme for the treatment of adults with overweight and obesity, but not severe obesity, or obesity with severe co-morbidities). Data collected from over 2000 participants demonstrated that the proportion of participants achieving 5% initial body weight loss was comparable to that reported in recent UK weight management trials. Two services exceeded national criteria of 30% of participants achieving 5% initial body weight loss at 12 weeks, although long term data was limited. Greater weight loss was also observed in participants aged 35-44 and those without co-morbidities. This study provides important learning points for improvements in real world weight management services, these include: standardised data collection and management tools; staff training and communication requirements; the importance of programmes that are joined up to wider support services; and the importance of providing ongoing peer and provider support, continuous monitoring and feedback, and physical activities tailored to user needs. © 2018 World Obesity Federation.

Pain, physical functioning, and overeating in obese rheumatoid arthritis patients: do thoughts about pain and eating matter?

PubMed

Somers, Tamara J; Wren, Anava A; Blumenthal, James A; Caldwell, David; Huffman, Kim M; Keefe, Francis J

2014-08-01

Obese rheumatoid arthritis (RA) patients have higher levels of pain, disability, and disease activity than do nonobese patients with RA. Patients' health-related thoughts about arthritis and weight may be important to consider in obese patients with RA who face the dual challenge of managing RA and weight. The objective of this study was to examine the relationships of pain catastrophizing, self-efficacy (ie, confidence) for arthritis management and self-efficacy for weight management to important outcomes in obese patients with RA. We expected that after controlling for demographic and medical variables, higher levels of pain catastrophizing and lower levels of confidence would account for significant and unique variance in pain, physical functioning, and overeating. Participants had a diagnosis of RA and a body mass index of 28 kg/m or greater and completed self-report questionnaires assessing pain, physical functioning, overeating, pain catastrophizing, self-efficacy for arthritis management, self-efficacy for weight management, and a 6-minute walk test. Pain catastrophizing, self-efficacy for arthritis, and self-efficacy for weight management were significantly and uniquely related to RA-related outcomes. Pain catastrophizing was a significant independent predictor of pain severity (β = 0.38); self-efficacy for arthritis was a significant independent predictor of self-report physical functioning (β = -0.37) and the 6-minute walk performance (β = 0.44), and self-efficacy for weight management was a significant independent predictor of overeating (β = -0.58). Pain catastrophizing, self-efficacy for arthritis, and self-efficacy for weight management each contributed uniquely to relate to key outcomes in obese patients with RA. Clinicians should consider assessment of thought processes when assessing and intervening with patients who face dual health challenges; unique intervention approaches may be needed for addressing the challenges of arthritis and weight.

Impacts of efficacy and exemplification in an online message about weight loss on weight management self-efficacy, satisfaction, and personal importance.

PubMed

Sarge, Melanie A; Knobloch-Westerwick, Silvia

2013-01-01

Health information search is among the most popular Internet activities, requiring health campaigns to attract attention in a context of unprecedented competition with alternative content. The present study reconstructs a similar context that allows selective avoidance and exposure in order to examine which health message characteristics foster particular message impacts. Drawing on social cognitive theory, a 3-session study examined short-term and delayed impacts of efficacy and exemplification as characteristics of a weight loss online message, offered for selective reading among other content, on weight management self-efficacy, satisfaction, and personal importance. Short-term impacts and impacts 2 weeks after exposure reflect that the high-efficacy exemplar version increased self-efficacy and satisfaction, while the high-efficacy base-rate version lowered them. However, the exemplar and base-rate versions of the low-efficacy message increased importance of body weight management.

Management of weight loss in obesity-associated male infertility: a spotlight on bariatric surgery.

PubMed

Abiad, Firass; Awwad, Johnny; Abbas, Hussein A; Zebian, Dina; Ghazeeri, Ghina

2017-12-01

In recent years, there has been a paralleled increase between male obesity and infertility rates. Obesity is associated with impaired hypothalamic-pituitary-gonadal axis, aberrant semen parameters, and subfertility or infertility. Weight loss is strongly recommended for the management of obesity-associated infertility. Lifestyle modifications that include caloric restriction and increased physical activity have a short-lived impact. Bariatric surgery is a better and more durable weight loss alternative. Comprehensive information about the benefits of weight loss on obesity-associated male infertility following bariatric surgery is still emerging. In this review, we discuss the hormonal, physical and environmental mechanism contributing to obesity-associated infertility. We then assess weight loss approaches, which include lifestyle modification, medical and surgical approaches, that can improve fertility in obese men. This review focuses also on bariatric surgery for the management of obese men seeking fertility treatment. Anecdotal evidence suggesting that bariatric surgery can impair fertility is also discussed.

Strategies for Sustained Weight Management: Perspectives From African American Patients With Type 2 Diabetes.

PubMed

Fitzpatrick, Stephanie L; Hill-Briggs, Felicia

2017-06-01

Purpose The purpose of this study was to identify effective strategies for sustained weight management used by African American patients with obesity and type 2 diabetes. Methods In this study, nominal group technique was used to identify effective strategies for weight management used by 12 African Americans with overweight/obesity and type 2 diabetes who successfully lost or maintained their weight after completing DECIDE (Decision-making Education for Choices In Diabetes Everyday), a 9-module, literacy-adapted diabetes and cardiovascular disease (CVD) education and problem-solving training program. Results Participants generated a list of 101 strategies that covered 4 domains: nutrition, physical activity, cognitive-behavioral strategies, and other. Self-monitoring and relying on social support were the top 2 strategies for weight maintenance. Conclusion Future obesity studies should consider including friends/family as well as electronic tools to facilitate self-monitoring and regular practice of behavioral strategies for long-term success.

Mobile Apps for Weight Management: A Scoping Review.

PubMed

Rivera, Jordan; McPherson, Amy; Hamilton, Jill; Birken, Catherine; Coons, Michael; Iyer, Sindoora; Agarwal, Arnav; Lalloo, Chitra; Stinson, Jennifer

2016-07-26

Obesity remains a major public health concern. Mobile apps for weight loss/management are found to be effective for improving health outcomes in adults and adolescents, and are pursued as a cost-effective and scalable intervention for combating overweight and obesity. In recent years, the commercial market for 'weight loss apps' has expanded at rapid pace, yet little is known regarding the evidence-based quality of these tools for weight control. To characterize the inclusion of evidence-based strategies, health care expert involvement, and scientific evaluation of commercial mobile apps for weight loss/management. An electronic search was conducted between July 2014 and July 2015 of the official app stores for four major mobile operating systems. Three raters independently identified apps with a stated goal of weight loss/management, as well as weight loss/management apps targeted to pediatric users. All discrepancies regarding selection were resolved through discussion with a fourth rater. Metadata from all included apps were abstracted into a standard assessment criteria form and the evidence-based strategies, health care expert involvement, and scientific evaluation of included apps was assessed. Evidence-based strategies included: self-monitoring, goal-setting, physical activity support, healthy eating support, weight and/or health assessment, personalized feedback, motivational strategies, and social support. A total of 393 apps were included in this review. Self-monitoring was most common (139/393, 35.3%), followed by physical activity support (108/393, 27.5%), weight assessment (100/393, 25.4%), healthy eating support (91/393, 23.2%), goal-setting (84/393, 21.4%), motivational strategies (28/393, 7.1%), social support (21/393, 5.3%), and personalized feedback (7/393, 1.8%). Of apps, 0.8% (3/393) underwent scientific evaluation and 0.3% (1/393) reported health care expert involvement. No apps were comprehensive in the assessment criteria, with the majority of apps meeting less than two criteria. Commercial mobile apps for weight loss/management lack important evidence-based features, do not involve health care experts in their development process, and have not undergone rigorous scientific testing. This calls into question the validity of apps' claims regarding their effectiveness and safety, at a time when the availability and growth in adoption of these tools is rapidly increasing. Collaborative efforts between developers, researchers, clinicians, and patients are needed to develop and test high-quality, evidence-based mobile apps for weight loss/management before they are widely disseminated in commercial markets.

Unique barriers and needs in weight management for obese women with fibromyalgia.

PubMed

Craft, Jennifer M; Ridgeway, Jennifer L; Vickers, Kristin S; Hathaway, Julie C; Vincent, Ann; Oh, Terry H

2015-01-01

The aim of this study was to identify barriers, needs, and preferences of weight management intervention for women with fibromyalgia (FM). Obesity appears in higher rates in women with fibromyalgia compared to the population at large, and no study to date has taken a qualitative approach to better understand how these women view weight management in relation to their disease and vice versa. We designed a qualitative interview study with women patients with FM and obesity. Women (N = 15) were recruited by their participation in a fibromyalgia treatment program (FTP) within the year prior. The women approached for the study met the following inclusion criteria: confirmed diagnosis of FM, age between 30 and 60 years (M = 51 ± 6.27), and body mass index (BMI) ≥ 30 (M = 37.88 ± 4.87). Patients completed questionnaire data prior to their participation in focus groups (N = 3), including weight loss history, physical activity data, the Revised Fibromyalgia Impact Questionnaire (FIQR), and the Patient Health Questionnaire 9-item (PHQ-9). Three focus group interviews were conducted to collect qualitative data. Consistent themes were revealed within and between groups. Patients expressed the complex relationships between FM symptoms, daily responsibilities, and weight management. Weight was viewed as an emotionally laden topic requiring compassionate delivery of programming from an empathetic leader who is knowledgeable about fibromyalgia. Patients view themselves as complex and different, requiring a specifically tailored weight management program for women with FM. Women with FM identify unique barriers to weight management, including the complex interrelationships between symptoms of FM and health behaviors, such as diet and exercise. They prefer a weight management program for women with FM that consists of an in-person, group-based approach with a leader but are open to a tailored conventional weight management program. Feasibility may be one of the biggest barriers to such a program both from an institutional and individual perspective. Copyright © 2015 Elsevier Inc. All rights reserved.

Physical Activity and Cancer Survivorship

PubMed Central

Garcia, David O.; Thomson, Cynthia A.

2015-01-01

There has been an increase in the cancer survivor population in the United States over the past several decades primarily due to improvements in early detection of first malignancies and effective treatment modalities. A wealth of evidence has demonstrated that regular physical activity is associated with a lower risk of death, all-cause mortality, cancer recurrence, and several chronic diseases, including type 2 diabetes and cardiovascular disease, common comorbid conditions in people who have survived cancer. Physical activity also is a central component of weight management. Methods This review summarizes the current physical activity recommendations and the evidence linking physical activity to improvements in weight management, physiological effects, and psychological health outcomes for cancer survivors. Results The available literature suggests physical activity is safe and is positively associated with weight management, cardiorespiratory fitness, muscular strength and endurance, quality of life, fatigue, and other psychosocial factors in cancer survivors. Yet relationships related to specific cancer diagnoses, treatments, and underlying cardiometabolic mechanisms associated with survival have not been thoroughly examined in randomized controlled trials. Furthermore, factors that influence adherence to physical activity behaviors must be identified to develop effective exercise programs. The use of objective measures of physical activity and the standardization of reporting outcome measures within intervention trials are needed to complement this effort. Conclusions Healthcare providers should consider individual differences among cancer survivors and tailor physical activity programs to meet the individual needs of the patient to assist in the adoption and maintenance of a physically active lifestyle. PMID:25335787

African American and White women׳s perceptions of weight gain, physical activity, and nutrition during pregnancy.

PubMed

Whitaker, Kara M; Wilcox, Sara; Liu, Jihong; Blair, Steven N; Pate, Russell R

2016-03-01

To describe African American and White women's perceptions of weight gain, physical activity, and nutrition during pregnancy and to explore differences in perceptions by race. Qualitative interview study. Two Ob/Gyn clinics in South Carolina, USA. Thirty pregnant women (15 African American, 15 White) between 20 and 30 weeks gestation, equally represented across pre-pregnancy BMI categories (10 normal weight, 10 overweight, and 10 obese). White women more frequently described intentions to meet weight gain, physical activity, and dietary guidelines in pregnancy than African American women. African American women were more concerned with inadequate weight gain while White women more commonly expressed concerns about excessive weight gain. More White women discussed the importance of physical activity for weight management. Regardless of race, few women described risks of excessive weight gain or benefits of physical activity as it relates to the baby's health. The primary cited barrier of healthy eating was the high cost of fresh produce. Several knowledge gaps as well as race differences were identified in women's perceptions and intentions toward weight gain, physical activity, and nutrition during pregnancy. Future interventions should seek to educate women about common misperceptions. It may be necessary to culturally tailor gestational weight gain interventions to optimise health outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

A randomized pilot study of a community-based weight loss intervention for African-American women: Rationale and study design of Doing Me! Sisters Standing Together for a Healthy Mind and Body.

PubMed

Springfield, Sparkle; Buscemi, Joanna; Fitzgibbon, Marian L; Stolley, Melinda R; Zenk, Shannon N; Schiffer, Linda; Sampson, Jameika; Jones, Quiana; Murdock, Tanine; Davis, Iona; Holland, Loys; Watkins, April; Odoms-Young, Angela

2015-07-01

Despite the high prevalence of obesity among African-American women and modest success in behavioral weight loss interventions, the development and testing of weight management interventions using a community-based participatory research (CBPR) approach have been limited. Doing Me!: Sisters Standing Together for Healthy Mind and Body (Doing Me!) is an intervention adapted from an evidence-based behavioral obesity intervention using a CBPR approach. The purpose of Doing Me! is to test the feasibility and acceptability of this adapted intervention and determine its efficacy in achieving improvements in anthropometrics, diet, and physical activity. Sixty African-American women, from a low-income, urban community, aged 30-65 years will be randomized to one of two arms: 16-week Doing Me! (n = 30) or waitlist control (n = 30). Doing Me! employs CBPR methodology to involve community stakeholders and members during the planning, development, implementation, and evaluation phases of the intervention. There will be thirty-two 90-minute sessions incorporating 45 min of instruction on diet, physical activity, and/or weight management plus 45 min of physical activity. Data will be collected at baseline and post-intervention (16 weeks). Doing Me! is one of the first CBPR studies to examine the feasibility/acceptability of an adapted evidence-based behavioral weight loss intervention designed for obese African-American women. CBPR may be an effective strategy for implementing a weight management intervention among this high-risk population. Copyright © 2015 Elsevier Inc. All rights reserved.

Lifestyle behaviours and weight among hospital-based nurses.

PubMed

Zapka, Jane M; Lemon, Stephenie C; Magner, Robert P; Hale, Janet

2009-11-01

The purpose of this study was to (i) describe the weight, weight-related perceptions and lifestyle behaviours of hospital-based nurses, and (ii) explore the relationship of demographic, health, weight and job characteristics with lifestyle behaviours. The obesity epidemic is widely documented. Worksite initiatives have been advocated. Nurses represent an important part of the hospital workforce and serve as role models when caring for patients. A sample of 194 nurses from six hospitals participated in anthropometric measurements and self-administered surveys. The majority of nurses were overweight and obese, and some were not actively involved in weight management behaviours. Self-reported health, diet and physical activity behaviours were low, although variable by gender, age and shift. Reports of co-worker norms supported low levels of healthy behaviours. Findings reinforce the need to address the hospital environment and culture as well as individual behaviours for obesity control. Nurse managers have an opportunity to consider interventions that promote a climate favourable to improved health habits by facilitating and supporting healthy lifestyle choices (nutrition and physical activity) and environmental changes. Such efforts have the potential to increase productivity and morale and decrease work-related disabilities and improve quality of life.

Effects of weight management program on postural stability and neuromuscular function among obese children: study protocol for a randomized controlled trial.

PubMed

Sun, Fenghua; Wang, Li-Juan; Wang, Lin

2015-04-10

Childhood obesity is one of the most critical public health problems in the world. It is associated with low neuromuscular function and postural deformities. Whether weight loss can improve postural stability and neuromuscular control, benefit daily activities, or prevent injury is unknown. Therefore, this study attempts to investigate the effect of a 6 month weight management program on postural stability and neuromuscular control among obese children. We will conduct a prospective, single-blind, randomized controlled trial with 120 prepubescent obese children. Participants will be randomly assigned to a weight management group or a control group. The weight management group will participate in a dietary and exercise program. The control group will receive health education. After the intervention, participants will be followed for 6 months with no active intervention. The primary and secondary outcomes will be assessed at the baseline, and after 6 months and 12 months. Primary outcome measures will include body weight, body height, body mass index, waist circumference, hip circumference, and body fat percentage. Secondary outcome measures will include three-dimensional functional biomechanics in different tasks, proprioception tests of the knee and ankle, neuromuscular response of the leg muscles, and muscle strength tests of the knee and ankle. Furthermore, adverse events will be recorded and analyzed. An intention-to-treat analysis will be performed if any participants withdraw from the trial. The important features of this trial include the randomization procedures and large sample size. This study attempts to estimate the effect of weight loss intervention on outcomes, including daily life function, postural stability, and neuromuscular control in prepubescent obese children. Therefore, our results can be useful for obese children, medical staff, and healthcare decision makers. Chinese Clinical Trial Registry ChiCTR-IOB-15005874.

Long-term weight loss maintenance for obesity: a multidisciplinary approach

PubMed Central

Montesi, Luca; El Ghoch, Marwan; Brodosi, Lucia; Calugi, Simona; Marchesini, Giulio; Dalle Grave, Riccardo

2016-01-01

The long-term weight management of obesity remains a very difficult task, associated with a high risk of failure and weight regain. However, many people report that they have successfully managed weight loss maintenance in the long term. Several factors have been associated with better weight loss maintenance in long-term observational and randomized studies. A few pertain to the behavioral area (eg, high levels of physical activity, eating a low-calorie, low-fat diet; frequent self-monitoring of weight), a few to the cognitive component (eg, reduced disinhibition, satisfaction with results achieved, confidence in being able to lose weight without professional help), and a few to personality traits (eg, low novelty seeking) and patient–therapist interaction. Trials based on the most recent protocols of lifestyle modification, with a prolonged extended treatment after the weight loss phase, have also shown promising long-term weight loss results. These data should stimulate the adoption of a lifestyle modification-based approach for the management of obesity, featuring a nonphysician lifestyle counselor (also called “lifestyle trainer” or “healthy lifestyle practitioner”) as a pivotal component of the multidisciplinary team. The obesity physicians maintain a primary role in engaging patients, in team coordination and supervision, in managing the complications associated with obesity and, in selected cases, in the decision for drug treatment or bariatric surgery, as possible more intensive, add-on interventions to lifestyle treatment. PMID:27013897

Barriers to Engagement in a Workplace Weight Management Program: A Qualitative Study.

PubMed

Clancy, Shayna M; Stroo, Marissa; Schoenfisch, Ashley; Dabrera, Thushani; Østbye, Truls

2018-03-01

To investigate (1) why some participants in a workplace weight management program were more engaged in the program, (2) specific barriers and facilitators for engagement and weight loss, and (3) suggest how workplaces may better engage employees in these programs to improve their effectiveness. Qualitative study (8 focus groups). A large academic university and medical system. Twenty-six (5%) of the 550 employees who participated in a weight management program as part of the Steps to Health study. A trained moderator guided the audio-recorded focus groups. Transcripts were analyzed using the directed content analysis approach. Participants faced numerous barriers to engagement in workplace weight management programs, both within and outside the workplace. Participants viewed the coaches positively and reported that the coaches had a strong influence on their engagement in the program. Participants suggested increased frequency and variety of contact by coaches, on-site group exercise classes, and tailored educational materials. Workplace weight management programs may be improved by being more flexible around participants' schedules and changing needs, by increasing access to affordable, convenient exercise facilities, and by implementing institutional changes that encourage healthy eating and physical activity during the workday. Employers should measure program engagement and solicit participant feedback to ensure that the programs are appropriate and delivered in an optimal manner.

Physical activity counseling intervention to promote weight loss in overweight rural women.

PubMed

Peterson, Jane Anthony; Cheng, An-Lin

2013-07-01

To identify key behavioral factors that contribute to physical activity and weight management in overweight, rural women and determine the degree to which social support, stage of behavior change, and self-efficacy for physical activity and depressive symptoms are linked to physical activity, body weight, and body mass index (BMI). Twenty-five overweight or obese rural women completed self-report scales and height and weight measurements; BMI was calculated. Self-report scales included the International Physical Activity Questionnaire (physical activity level), Social Support for Exercise and Social Support Questionnaire (social support), Stage of Exercise Adoption (stage of behavior change), Self-efficacy for Exercise (self-efficacy), and the Patient Health Questionnaire (depressive symptoms). Higher levels of physical activity were associated with greater self-efficacy and the self-esteem domain of social support. Rural women reported more depressive symptoms over the year. Women did not significantly increase physical activity and gained weight during the 1-year study. Rural women have limited resources available to increase physical activity to facilitate weight loss. Routine screening and treatment for depression in rural women may need to be initiated concurrently with interventions to promote health behavior changes. ©2012 The Author(s) ©2012 American Association of Nurse Practitioners.

Strategies, barriers, and motivation for weight loss among veterans living with schizophrenia.

PubMed

Klingaman, Elizabeth A; Viverito, Kristen M; Medoff, Deborah R; Hoffmann, Rebecca M; Goldberg, Richard W

2014-12-01

Weight loss programs for veterans living with schizophrenia have demonstrated mixed efficacy, highlighting unique obstacles faced by this population. Data from a large national sample provide an opportunity to characterize the unique factors related to weight loss for veterans with schizophrenia. The present study compared veterans living with schizophrenia (n = 5,388) to veterans with no mental health diagnoses (n = 81,422) on responses to the MOVE!23, a multidimensional assessment of factors related to weight management. Responses to the MOVE!23 between August, 2005 and May, 2013 by veterans with a body mass index in the overweight or obese range were used to describe clinical characteristics, current strategies, perceived barriers, stages of readiness, and importance of and confidence to change behaviors related to their weight management. Both groups reported similar stages of readiness and high ratings of importance and confidence regarding weight loss behaviors. Compared with veterans with no mental health diagnoses, over 5 times as many veterans living with schizophrenia reported smoking to control weight, and a greater number endorsed 18 of the 21 barriers to modifying eating and physical activity. RESULTS highlight the necessity of addressing healthy lifestyles from a holistic perspective for all veterans. Adding regular physical activity as part of daily treatment may address the accessibility, safety concerns, and lack of social support reported as physical activity barriers. Increased access to healthier food choices and addressing smoking in conjunction with weight loss are also warranted. (c) 2014 APA, all rights reserved.

Study protocol: evaluation of 'JenMe', a commercially-delivered weight management program for adolescents: a randomised controlled trial.

PubMed

Dordevic, Aimee L; Bonham, Maxine P; Ware, Robert S; Brennan, Leah; Truby, Helen

2015-06-19

Early lifestyle intervention with overweight and obese adolescents could help to avoid serious health events in early adulthood, ultimately alleviating some of the strain on the public health system due to obesity-related morbidity. Commercial weight loss programs have wide reach into the community setting, and have demonstrated success in long term weight management in adults, beyond that of current public health care. Commercial weight-management programs have not been evaluated as a method of delivery for overweight and obese adolescents. This study aims to evaluate the efficacy of a new adolescent weight management program in a commercial environment. One hundred and forty adolescents, 13 to 17 years old, will be randomised to either a weight management program intervention or a wait-listed group for 12 weeks. The commercial program will consist of a combined dietary and lifestyle approach targeting improved health behaviours for weight-loss or weight-stability. Participants will be overweight or obese (above the 85(th) percentile for BMI) and without existing co-morbidities. Outcome measures will be assessed at baseline and after 12 weeks. Primary outcome measures will be changes in BMI Z-score and waist-height ratio. Secondary outcome measures will include changes in behaviour, physical activity and psychosocial wellbeing. Intervention participants will be followed up at 6 months following completion of the initial program. Ethics approval has been granted from the Monash University Human Research Ethics Committee (CF11/3687-2011001940). This independent evaluation of a weight management program for adolescents, delivered in a commercial setting, will provide initial evidence for the effectiveness of such programs; which may offer adolescents an avenue of weight-management with ongoing support prior to the development of obesity related co-morbidities. The protocol for this study is registered with the International Clinical Trials Registry ISRCTN13602313.

Community pharmacy-delivered interventions for public health priorities: a systematic review of interventions for alcohol reduction, smoking cessation and weight management, including meta-analysis for smoking cessation

PubMed Central

Brown, Tamara J; Todd, Adam; O'Malley, Claire; Moore, Helen J; Husband, Andrew K; Bambra, Clare; Kasim, Adetayo; Sniehotta, Falko F; Steed, Liz; Smith, Sarah; Nield, Lucie; Summerbell, Carolyn D

2016-01-01

Objectives To systematically review the effectiveness of community pharmacy-delivered interventions for alcohol reduction, smoking cessation and weight management. Design Systematic review and meta-analyses. 10 electronic databases were searched from inception to May 2014. Eligibility criteria for selecting studies Study design: randomised and non-randomised controlled trials; controlled before/after studies, interrupted times series. Intervention: any relevant intervention set in a community pharmacy, delivered by the pharmacy team. No restrictions on duration, country, age, or language. Results 19 studies were included: 2 alcohol reduction, 12 smoking cessation and 5 weight management. Study quality rating: 6 ‘strong’, 4 ‘moderate’ and 9 ‘weak’. 8 studies were conducted in the UK, 4 in the USA, 2 in Australia, 1 each in 5 other countries. Evidence from 2 alcohol-reduction interventions was limited. Behavioural support and/or nicotine replacement therapy are effective and cost-effective for smoking cessation: pooled OR was 2.56 (95% CI 1.45 to 4.53) for active intervention vs usual care. Pharmacy-based interventions produced similar weight loss compared with active interventions in other primary care settings; however, weight loss was not sustained longer term in a range of primary care and commercial settings compared with control. Pharmacy-based weight management interventions have similar provider costs to those delivered in other primary care settings, which are greater than those delivered by commercial organisations. Very few studies explored if and how sociodemographic or socioeconomic variables moderated intervention effects. Insufficient information was available to examine relationships between effectiveness and behaviour change strategies, implementation factors, or organisation and delivery of interventions. Conclusions Community pharmacy-delivered interventions are effective for smoking cessation, and demonstrate that the pharmacy is a feasible option for weight management interventions. Given the potential reach, effectiveness and associated costs of these interventions, commissioners should consider using community pharmacies to help deliver public health services. PMID:26928025

Implementation of pregnancy weight management and obesity guidelines: a meta-synthesis of healthcare professionals' barriers and facilitators using the Theoretical Domains Framework.

PubMed

Heslehurst, N; Newham, J; Maniatopoulos, G; Fleetwood, C; Robalino, S; Rankin, J

2014-06-01

Obesity in pregnancy is rising and is associated with severe health consequences for both the mother and the child. There is an increasing international focus on guidelines to manage the clinical risks of maternal obesity, and for pregnancy weight management. However, passive dissemination of guidelines is not effective and more active strategies are required for effective guideline implementation into practice. Implementation of guidelines is a form of healthcare professional behaviour change, and therefore implementation strategies should be based on appropriate behaviour change theory. This systematic review aimed to identify the determinants of healthcare professionals' behaviours in relation to maternal obesity and weight management. Twenty-five studies were included. Data synthesis of the existing international qualitative and quantitative evidence base used the Theoretical Domains Framework to identify the barriers and facilitators to healthcare professionals' maternal obesity and weight management practice. The domains most frequently identified included 'knowledge', 'beliefs about consequences' and 'environmental context and resources'. Healthcare professionals' weight management practice had the most barriers compared with any other area of maternal obesity practice. The results of this review will be used to inform the development of an intervention to support healthcare professional behaviour change. © 2014 The Authors. obesity reviews © 2014 International Association for the Study of Obesity.

Body weight management effect of burdock (Arctium lappa L.) root is associated with the activation of AMP-activated protein kinase in human HepG2 cells.

PubMed

Kuo, Daih-Huang; Hung, Ming-Chi; Hung, Chao-Ming; Liu, Li-Min; Chen, Fu-An; Shieh, Po-Chuen; Ho, Chi-Tang; Way, Tzong-Der

2012-10-01

Burdock (Arcticum lappa L.) root is used in folk medicine and also as a vegetable in Asian countries. In the present study, burdock root treatment significantly reduced body weight in rats. To evaluate the bioactive compounds, we successively extracted the burdock root with ethanol (AL-1), and fractionated it with n-hexane (AL-2), ethyl acetate (AL-3), n-butanol (AL-4), and water (AL-5). Among these fractions, AL-2 contained components with the most effective hypolipidemic potential in human hepatoma HepG2 cells. AL-2 decreased the expression of fatty acid synthase (FASN) and inhibited the activity of acetyl-coenzyme A carboxylase (ACC) by stimulating AMP-activated protein kinase (AMPK) through the LKB1 pathway. Three active compounds were identified from the AL-2, namely α-linolenic acid, methyl α-linolenate, and methyl oleate. These results suggest that burdock root is expected to be useful for body weight management. Copyright © 2012 Elsevier Ltd. All rights reserved.

Beating Obesity: Factors Associated with Interest in Workplace Weight Management Assistance in the Mining Industry.

PubMed

Street, Tamara D; Thomas, Drew L

2017-03-01

Rates of overweight and obese Australians are high and continue to rise, putting a large proportion of the population at risk of chronic illness. Examining characteristics associated with preference for a work-based weight-loss program will enable employers to better target programs to increase enrolment and benefit employees' health and fitness for work. A cross-sectional survey was undertaken at two Australian mining sites. The survey collected information on employee demographics, health characteristics, work characteristics, stages of behavior change, and preference for workplace assistance with reaching a healthy weight. A total of 897 employees participated; 73.7% were male, and 68% had a body mass index in the overweight or obese range. Employees at risk of developing obesity-related chronic illnesses (based on high body mass index) were more likely to report preference for weight management assistance than lower risk employees. This indicates that, even in the absence of workplace promotion for weight management, some at risk employees want workplace assistance. Employees who were not aware of a need to change their current nutrition or physical activity behaviors were less likely to seek assistance. This indicates that practitioners need to communicate the negative effects of excess weight and promote the benefits of a healthy lifestyle to increase the likelihood of weight management. Weight management programs should provide information, motivation. and trouble-shooting assistance to meet the needs of at-risk mining employees, including those who are attempting to change and maintain behaviors to achieve a healthy weight and be suitably fit for work.

From instinct to intellect: the challenge of maintaining healthy weight in the modern world.

PubMed

Peters, J C; Wyatt, H R; Donahoo, W T; Hill, J O

2002-05-01

The global obesity epidemic is being driven in large part by a mismatch between our environment and our metabolism. Human physiology developed to function within an environment where high levels of physical activity were needed in daily life and food was inconsistently available. For most of mankind's history, physical activity has 'pulled' appetite so that the primary challenge to the physiological system for body weight control was to obtain sufficient energy intake to prevent negative energy balance and body energy loss. The current environment is characterized by a situation whereby minimal physical activity is required for daily life and food is abundant, inexpensive, high in energy density and widely available. Within this environment, food intake 'pushes' the system, and the challenge to the control system becomes to increase physical activity sufficiently to prevent positive energy balance. There does not appear to be a strong drive to increase physical activity in response to excess energy intake and there appears to be only a weak adaptive increase in resting energy expenditure in response to excess energy intake. In the modern world, the prevailing environment constitutes a constant background pressure that promotes weight gain. We propose that the modern environment has taken body weight control from an instinctual (unconscious) process to one that requires substantial cognitive effort. In the current environment, people who are not devoting substantial conscious effort to managing body weight are probably gaining weight. It is unlikely that we would be able to build the political will to undo our modern lifestyle, to change the environment back to one in which body weight control again becomes instinctual. In order to combat the growing epidemic we should focus our efforts on providing the knowledge, cognitive skills and incentives for controlling body weight and at the same time begin creating a supportive environment to allow better management of body weight.

Perceived Barriers to Healthy Eating and Physical Activity Among Participants in a Workplace Obesity Intervention.

PubMed

Stankevitz, Kayla; Dement, John; Schoenfisch, Ashley; Joyner, Julie; Clancy, Shayna M; Stroo, Marissa; Østbye, Truls

2017-08-01

To characterize barriers to healthy eating (BHE) and physical activity (BPA) among participants in a workplace weight management intervention. Steps to health participants completed a questionnaire to ascertain barriers to physical activity and healthy eating faced. Exploratory factor analysis was used to determine the factor structure for BPA and BHE. The relationships of these factors with accelerometer data and dietary behaviors were assessed using linear regression. Barriers to physical activity included time constraints and lack of interest and motivation, and to healthy eating, lack of self-control and convenience, and lack of access to healthy foods. Higher BHE correlated with higher sugary beverage intake but not fruit and vegetable and fat intake. To improve their effectiveness, workplace weight management programs should consider addressing and reducing barriers to healthy eating and physical activity.

Combined strategies in the management of obesity.

PubMed

Dixon, John B; Dixon, Maureen E

2006-01-01

Obesity is a chronic relapsing disease requiring a similar long term approach to management as that of other chronic conditions. Management needs to be multifaceted aiming to achieve sustainable behavioural changes to physical activity and diet to alter the patient and family microenvironment to one favouring better weight control. A range of therapies including specific diets, calorie counting, meal replacements, very low calorie diets, pharmacotherapy, intragastric balloons and surgery can provide very useful additional benefit. Use of these should be guided by the extent of weight loss required to reduce BMI to an acceptable level with regard to the patient's ethnicity, risk and comorbid conditions. Patients need to set goals that are optimistic, but realistic, and understand the benefits of sustained modest weight loss and the likelihood of weight regain requiring repeat episodes of weight loss. Practitioners need to be informed about the efficacy of current therapies and their combinations to enhance choice of suitable methods for achieving the optimal weight loss required by the patient. They will also need to anticipate trigger points for renewed periods of weight loss in the event of weight regain, as relapse is likely but not a reason for abandoning the battle.

Telehealth weight management intervention for adults with physical disabilities: a randomized controlled trial.

PubMed

Rimmer, James H; Wang, Edward; Pellegrini, Christine A; Lullo, Carolyn; Gerber, Ben S

2013-12-01

Weight reduction programs are not generally designed or adapted for people with physical disabilities. This study examined the effect of a 9-months remote, telephone-based weight management program for people with physical disabilities using a Web-based system (Personalized Online Weight and Exercise Response System [POWERS]). A total of 102 participants (mean ± SD age, 46.5 ± 12.7 yrs; body mass index, 32.0 ± 5.8 kg/m(2)) with a physical disability (spinal cord injury, multiple sclerosis, spina bifida, cerebral palsy, stroke, or lupus) were randomized to one of three conditions: physical activity only (POWERS), physical activity plus nutrition (POWERS(plus)), and control. The POWERS group received a physical activity tool kit and regular coaching telephone calls. The POWERS(plus) group received an intervention identical to that of the POWERS group plus nutritional information. The control group received the physical activity tool kit and self-guided health promotion resources at the completion of the trial but no coaching. Postintervention differences in body weight were found between the groups. There was a significant group × time interaction (P < 0.01) in postintervention body weight, with both the POWERS and POWERS(plus) groups demonstrating greater reduction in body weight compared with the control group (POWERS: -2.1 ± 5.5 kg, -2.4 ± -5.9%; POWERS(plus): -0.5 ± 5.0 kg, -0.6 ± 4.3%; control: +2.6 ± 5.3 kg, 3.1 ± 7.4%). A low-cost telephone intervention supported with a Web-based remote coaching tool (POWERS) can be an effective strategy for assisting overweight adults with physical disabilities in maintaining or reducing their body weight.

Exploring the relationship between parental concern and the management of childhood obesity.

PubMed

Moore, Lucas C; Harris, Carole V; Bradlyn, Andrew S

2012-05-01

Parental concern about child weight has been identified as a factor in parental monitoring and regulation of child diet. However, little is known about factors that influence parental concern or about how concern may influence parent management of child physical activity. The objectives of the current study were to identify the factors associated with parental concern about child weight and determine if parental concern is associated with specific actions to improve diet and increase physical activity. A stratified random sample of 1,500 parents of children in kindergarten, 2nd, 4th, 5th, 7th, and 9th grade were interviewed. Interviews addressed: (a) child and parent physical activity, (b) child and family nutrition, (c) child and parent BMI weight category, (d) interactions with health care providers, (e) parent obesity knowledge, (f) school assessment of BMI, and (g) parent perception of and concern about child weight. Child gender, weight status, and parent perception of child weight were significant predictors of parental concern. Parents were significantly more likely to report concern if their child was female, they believed their child to be overweight/obese, or their child was overweight/obese as indicated by BMI percentile. Concerned parents were significantly more likely to limit child screen time, take steps to improve child diet, and increase child physical activity than were parents who reported no concern. Treatment and prevention efforts should emphasize parental concern and awareness about child weight by providing accurate feedback on child weight status and education regarding the health risks associated with childhood overweight and obesity. Schools can play an important role in this process through the incorporation of BMI screenings.

Obesity weight management and bariatric surgery case management programs: a review of literature.

PubMed

Echols, Jennie

2010-01-01

The proportion of Americans with clinically severe obesity has vast implications for the nation's healthcare system since this population have twice as many chronic medical conditions as people with normal weight. Through the use of review of literature, this article (a) describes the types of weight loss programs; (b) reviews the results from studies on effectiveness of bariatric surgery; and (c) identifies recommendations for obesity and bariatric surgery case management programs. Disease management companies appear to be concentrating on general weight loss strategies associated with wellness and other condition-specific disease management products, whereas larger national healthcare companies with at-risk and insurance products offer specific bariatric surgery management products. Case management programs within healthcare systems, health management organizations, and insurance companies are frequently faced with the management of individuals with morbid obesity and, increasingly, those who are requesting or have undergone bariatric surgery. Research shows that morbid obesity is a disease that remains generally unresponsive to diet and drug therapy but appears to respond well to bariatric surgery. Research findings suggest that surgical treatment is more effective than pharmacological treatment of weight loss and the control of some comorbidities associated with obesity. The number of Americans having weight loss surgery increased by 804% between 1998 and 2004, which appears to be a driver for the recent development of obesity disease management and bariatric surgery case management programs. Although the immaturity and lack of studies citing outcomes of obesity disease and case management programs limit the identification of best practices based on outcomes, emerging practices can be identified and recommendations for case management can be formulated. In addition to primary prevention and treatment programs for obesity, this article describes program activities in detail for the following key areas: (1) identification and engagement; (2) coaching, education, and support; (3) collaboration among treating providers; (4) preparation, management, and follow-up when bariatric surgery is indicated; (5) aggressive follow-up until personal goals are achieved; and (6) outcome measurement.

Primary-Care Weight-Management Strategies: Parental Priorities and Preferences

PubMed Central

Turer, Christy Boling; Upperman, Carla; Merchant, Zahra; Montaño, Sergio; Flores, Glenn

2015-01-01

Objective Examine parental perspectives/rankings of the most important weight-management clinical practices; and, determine whether preferences/rankings differ when parents disagree that their child is overweight. Methods Mixed-methods analysis of a 32-question survey of parents of 2-18 year-old overweight children assessing parental agreement that their child is overweight, the single most important thing providers can do to improve weight status, ranking AAP-recommended clinical practices, and preferred follow-up interval. Four independent reviewers analyzed open-response data to identify qualitative themes/subthemes. Multivariable analyses examined parental rankings, preferred follow-up interval, and differences by agreement with their child’s overweight assessment. Results Thirty-six percent of 219 children were overweight, 42% were obese, and 22% severely obese; 16% of parents disagreed with their child’s overweight assessment. Qualitative analysis of the most important practice to help overweight children yielded 10 themes; unique to parents disagreeing with their children’s overweight assessments was, “change weight-status assessments.” After adjustment, the three highest-ranked clinical practices included, “check for weight-related problems,” “review growth chart,” and “recommend general dietary changes” (all P<.01);” parents disagreeing with their children’s overweight assessments ranked “review growth chart” as less important, and “reducing screen time” and “general activity changes” as more important. The mean preferred weight-management follow-up interval (10-12 weeks) did not differ by agreement with children’s overweight assessments. Conclusions Parents prefer weight-management strategies that prioritize evaluating weight-related problems, growth-chart review, and regular follow-up. Parents who disagree that their child is overweight want changes in how overweight is assessed. Using parent-preferred weight-management strategies may prove useful in improving child weight status. PMID:26514648

Primary-Care Weight-Management Strategies: Parental Priorities and Preferences.

PubMed

Turer, Christy Boling; Upperman, Carla; Merchant, Zahra; Montaño, Sergio; Flores, Glenn

2016-04-01

To examine parental perspectives/rankings of the most important weight-management clinical practices and to determine whether preferences/rankings differ when parents disagree that their child is overweight. We performed mixed-methods analysis of a 32-question survey of parents of 2- to 18-year-old overweight children assessing parental agreement that their child is overweight, the single most important thing providers can do to improve weight status, ranking American Academy of Pediatrics-recommended clinical practices, and preferred follow-up interval. Four independent reviewers analyzed open-response data to identify qualitative themes/subthemes. Multivariable analyses examined parental rankings, preferred follow-up interval, and differences by agreement with their child's overweight assessment. Thirty-six percent of 219 children were overweight, 42% obese, and 22% severely obese; 16% of parents disagreed with their child's overweight assessment. Qualitative analysis of the most important practice to help overweight children yielded 10 themes; unique to parents disagreeing with their children's overweight assessments was "change weight-status assessments." After adjustment, the 3 highest-ranked clinical practices included, "check for weight-related problems," "review growth chart," and "recommend general dietary changes" (all P < .01); parents disagreeing with their children's overweight assessments ranked "review growth chart" as less important and ranked "reducing screen time" and "general activity changes" as more important. The mean preferred weight-management follow-up interval (10-12 weeks) did not differ by agreement with children's overweight assessments. Parents prefer weight-management strategies that prioritize evaluating weight-related problems, growth-chart review, and regular follow-up. Parents who disagree that their child is overweight want changes in how overweight is assessed. Using parent-preferred weight-management strategies may prove useful in improving child weight status. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

A new evidence-based model for weight management in primary care: the Counterweight Programme.

PubMed

Laws, Rachel

2004-06-01

Obesity has become a global epidemic, and a major preventable cause of morbidity and mortality. Management strategies and treatment protocols are however poorly developed and evaluated. The aim of the Counterweight Programme is to develop an evidence-based model for the management of obesity in primary care. The Counterweight Programme is based on the theoretical model of Evidence-Based Quality Assessment aimed at improving the management of obese adults (18-75 years) in primary care. The model consists of four phases: (1) practice audit and needs assessment, (2) practice support and training, (3) practice nurse-led patient intervention, and (4) evaluation. Patient intervention consisted of screening and treatment pathways incorporating evidence-based approaches, including patient-centred goal setting, prescribed eating plans, a group programme, physical activity and behavioural approaches, anti-obesity medication and weight maintenance strategies. Weight Management Advisers who are specialist obesity dietitians facilitated programme implementation. Eighty practices were recruited of which 18 practices were randomized to act as controls and receive deferred intervention 2 years after the initial audit. By February 2004, 58 of the 62 (93.5%) intervention practices had been trained to run the intervention programme, 47 (75.8%) practices were active in implementing the model and 1256 patients had been recruited (74% female, 26% male, mean age 50.6 years, SD 14). At baseline, 75% of patients had at one or more co-morbidity, and the mean body mass index (BMI) was 36.9 kg/m(2) (SD 5.4). Of the 1256 patients recruited, 91% received one of the core lifestyle interventions in the first 12 months. For all patients followed up at 12 months, 34% achieved a clinical meaningful weight loss of 5% or more. A total of 51% of patients were classed as compliant in that they attended the required level of appointments in 3, 6, and 12 months. For fully compliant patients, weight loss improved with 43% achieving a weight loss of 5% or more at 12 months. The Counterweight Programme is an evidence-based weight management model which is feasible to implement in primary care.

Obesity and weight management at menopause.

PubMed

Proietto, Joseph

2017-06-01

Many women report gaining weight as they transition through menopause. For most, the weight gain is modest and can be reduced with a conscious effort to limit energy intake and increase energy expenditure. However, many women who are already overweight and obese will gain more weight as they approach menopause. The aims of this paper are to explain the reasons for menopausal weight gain and to detail a method for achieving and sustaining a substantial weight loss. Weight gain during menopause is predominantly due to a reduction in spontaneous activity. For women who are lean, advice about controlling energy intake and increasing physical activity may be all that is required to prevent weight gain. For women who are overweight and obese rapid weight loss is best achieved with the help of a very low energy diet. This must be followed by lifelong behaviour modification with or without the help of hunger-suppressing pharmacotherapy.

Effectiveness of Workplace Weight Management Interventions: a Systematic Review.

PubMed

Weerasekara, Yasoma Kumari; Roberts, Susan B; Kahn, Mira A; LaVertu, Amy E; Hoffman, Ben; Das, Sai Krupa

2016-06-01

A systematic review was conducted of randomized trials of workplace weight management interventions, including trials with dietary, physical activity, environmental, behavioral, and incentive-based components. Main outcomes were defined as change in weight-related measures. Keywords related to weight management and workplace interventions were used to search relevant databases, and 23 eligible studies were reviewed in detail using a data extraction form and quality assessment checklist. The trials were conducted mainly in the USA and Europe, with four additional countries represented. Interventions were mostly multicomponent and were implemented in both sexes and in a range of employment categories. Intervention effectiveness appeared unrelated to region of the world and was highest in 6-12-month trials. The results ranged widely from clinically significant 8.8-kg weight loss in one trial to less effective than the control treatment in others. Some workplace interventions achieve clinically significant benefits, and further studies are needed to replicate those results in wider sociocultural and geographical contexts.

Medical and psychosocial barriers to weight management in older veterans with and without serious mental illness.

PubMed

Muralidharan, Anjana; Klingaman, Elizabeth A; Prior, Steven J; Molinari, Victor; Goldberg, Richard W

2016-11-01

Older adults with serious mental illness (SMI) are an understudied population with complex care needs and high rates of obesity/overweight. Little is known about the experiences of older adults with SMI with weight management. The present study is an observational study of veterans ages 55 and over with a body mass index in the overweight or obese range, comparing Veterans with schizophrenia or bipolar disorder (n = 9044) to their same-age peers with no mental health disorders (n = 71156), on their responses to a questionnaire assessment of medical and psychosocial factors related to weight management. Responses to the questionnaire between August, 2005 and May, 2013 were used to examine the following: demographics, clinical characteristics, medical barriers to weight management, current weight loss plan, reliability of social support, reasons for being overweight, and weight loss barriers. Physical health concerns were highly prevalent in both groups. Veterans in the SMI group endorsed more medical issues and were significantly more likely to endorse experiences that indicated that their medical conditions were poorly controlled (e.g., shortness of breath). Veterans in the SMI group were more likely to endorse many barriers to healthy eating and physical activity, across medical, psychological, social, and environmental domains. Even within a sample at medically high-risk for complications related to obesity and metabolic syndrome, older veterans with SMI and overweight/obesity experience more challenges with weight management than their same-age peers with overweight/obesity and no mental health disorders. Weight management interventions for this population should take a multifaceted approach. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Handbook for predicting residue weights of Pacific Northwest conifers.

Treesearch

J.A. Kendall Snell; James K. Brown

1980-01-01

Procedures are given forest estimating weights of potential residue from Douglas- fir and western hemlock created by forest management activities west of the summit of the Cascade Range. Preliminary estimates are given for six other species. The weight tables are in pounds per tree and pounds per square foot of basal area for a 6- or 8- inch unmerchantable tip. The...

Steps to Health employee weight management randomized control trial: short-term follow-up results.

PubMed

Østbye, Truls; Stroo, Marissa; Brouwer, Rebecca J N; Peterson, Bercedis L; Eisenstein, Eric L; Fuemmeler, Bernard F; Joyner, Julie; Gulley, Libby; Dement, John M

2015-02-01

To present the short-term follow-up findings of the Steps to Health study, a randomized trial to evaluate the effectiveness of two employee weight management programs offered within Duke University and the Health System. A total of 550 obese (body mass index, ≥30 kg/m2) employees were randomized 1:1 between January 2011 and June 2012 to the education-based Weight Management (WM) or the WM+ arm, which focused on behavior modification. Employees were contacted to complete a follow-up visit approximately 14 months after baseline. There were no clinically, or statistically, meaningful differences between arms, but there were modest reductions in body mass index, and positive, meaningful changes in diet and physical activity for both arms. The modest positive effects observed in this study may suggest that to achieve weight loss through the workplace more intensive interventions may be required.

Dynamic Density: An Air Traffic Management Metric

NASA Technical Reports Server (NTRS)

Laudeman, I. V.; Shelden, S. G.; Branstrom, R.; Brasil, C. L.

1998-01-01

The definition of a metric of air traffic controller workload based on air traffic characteristics is essential to the development of both air traffic management automation and air traffic procedures. Dynamic density is a proposed concept for a metric that includes both traffic density (a count of aircraft in a volume of airspace) and traffic complexity (a measure of the complexity of the air traffic in a volume of airspace). It was hypothesized that a metric that includes terms that capture air traffic complexity will be a better measure of air traffic controller workload than current measures based only on traffic density. A weighted linear dynamic density function was developed and validated operationally. The proposed dynamic density function includes a traffic density term and eight traffic complexity terms. A unit-weighted dynamic density function was able to account for an average of 22% of the variance in observed controller activity not accounted for by traffic density alone. A comparative analysis of unit weights, subjective weights, and regression weights for the terms in the dynamic density equation was conducted. The best predictor of controller activity was the dynamic density equation with regression-weighted complexity terms.

How Can I Keep Track of Physical Activity and Eating?

MedlinePlus

... Weight Management How Can I Keep Track of Physical Activity and Healthy Eating? Taking care of your heart ... life. Planning a healthy diet and a regular physical activity program is the key to success. Prepare yourself ...

Active at Any Size

MedlinePlus

... For Reporters Meetings & Workshops Follow Us Home Health Information Weight Management Staying Active at Any Size Related Topics Section ... at NIDDK Technology Advancement & Transfer Meetings & Workshops Health Information ... Disease Urologic Diseases Endocrine Diseases Diet & Nutrition ...

Weight-loss strategies of South African female university students and comparison of weight management-related characteristics between dieters and non-dieters.

PubMed

Senekal, Marjanne; Lasker, Gabrielle L; van Velden, Lindsay; Laubscher, Ria; Temple, Norman J

2016-09-01

Female university students are at risk for weight gain and use of inappropriate weight-loss strategies. By gaining a greater understanding of the weight-loss strategies used by and weight management related characteristics of these students, effective weight management interventions for this vulnerable group can be developed. Two hundred and fifty female students from South Africa universities, aged 18-25 years, participated in this cross-sectional study; 162 attempted weight loss during the year preceding the study (dieters) and 88 were non-dieters. Weight and height were measured and BMI (kg/m(2)) computed. A self-administered questionnaire was used to record all other variables. Weight loss strategies were described for dieters and compared between BMI groups within the dieters group. Weight management related characteristics were compared between dieters and non-dieters. Statistical tests included Pearson Chi-square test, independent samples t-test or Mann-Whitney U test (depending on distribution of the data). Predictors for a higher BMI and being overweight/obese (BMI ≥25 kg/m(2)) were identified using regression models. Healthy weight-loss strategies included increased exercise and fruit/vegetable intake and decreased intake of sugar and fat containing items; unhealthy methods included eating little food and skipping meals; and extreme weight loss strategies included laxatives and vomiting. The most commonly used weight-loss product was Herbex. Dieters were characterized by a higher BMI, overestimation of their weight (especially normal weight students), dissatisfaction with weight and select body parts, higher intake of breakfast and healthy foods, lower intake of unhealthy foods, higher levels of vigorous physical activity, higher use of select informal weight-loss information sources and experiencing more pressure to lose weight from mothers, siblings and friends. Predictors of higher BMI and/or increased risk for BMI ≥25 included weight-loss attempt during the past year, race, dissatisfaction with waist, perception of currently being "chubby," and higher frequencies of intake of a snack and fatty foods. Attempting weight-loss is common among female students and predicts BMI. Healthy (mainly), unhealthy and extreme weight loss methods are used. Dieters are characterized by a less realistic body image, lower body satisfaction, higher pressure to lose weight, use of informal weight-management information and a healthier life-style.

Effects of a weight management program delivered by social media on weight and metabolic syndrome risk factors in overweight and obese adults: A randomised controlled trial.

PubMed

Jane, Monica; Hagger, Martin; Foster, Jonathan; Ho, Suleen; Kane, Robert; Pal, Sebely

2017-01-01

The aim of this project was to evaluate the effectiveness of using social media to augment the delivery of, and provide support for, a weight management program delivered to overweight and obese individuals during a twenty four week intervention. Participants randomly divided into either one of two intervention groups or a control group. The two intervention groups were instructed to follow identical weight-management program. One group received the program within a Facebook group, along with a support network with the group, and the other intervention group received the same program in a booklet. The control group was given standard care. Participants' weight and other metabolic syndrome risk factors were measured at baseline and at weeks 6, 12, 18 and 24. The Facebook Group reported a 4.8% reduction in initial weight, significant compared to the CG only (p = 0.01), as well as numerically greater improvements in body mass index, waist circumference, fat mass, lean mass, and energy intake compared to the Pamphlet Group and the Control Group. These results demonstrate the potential of social media to assist overweight and obese individuals with respect to dietary and physical activity modifications for weight management, and justify further research into the inclusion of social media in clinical weight management programs. It is anticipated that social media will provide an invaluable resource for health professionals, as a low maintenance vehicle for communicating with patients, as well as a source of social support and information sharing for individuals undergoing lifestyle modifications.

Participant Retention in the Veterans Health Administration’s MOVE! Weight Management Program, 2010

PubMed Central

Sohn, Min-Woong; Spring, Bonnie; Hadi, Sattar; Weaver, Frances M.

2012-01-01

Introduction Participant retention is a frequent concern in structured weight-management programs. Although research has explored participant characteristics influencing retention, little attention has been given to the influence of program characteristics. The objective of this study was to examine how program characteristics relate to participant retention in the Veterans Health Administration’s weight-management program, MOVE! Methods We conducted semistructured interviews with coordinators of 12 MOVE! programs located throughout the United States, 5 with high participant retention rates and 7 with low rates. We transcribed and descriptively coded interviews and compared responses from high- and low-retention programs. Results Characteristics related to retention were provider knowledge of and referral to the program, reputation of the program within the medical facility, the MOVE! meeting schedule, inclusion of physical activity in group meetings, and involvement of the MOVE! physician champion. MOVE! introductory sessions, frequency of group meetings, and meeting topics were not related to retention. Coordinators described efforts to improve retention, including participant contracts and team competitions. Coordinators at 5 high-retention facilities and 1 low-retention facility discussed efforts to improve retention. Conclusion Coordinators identified important program characteristics that could guide improvements to retention in group-based weight-management programs. Training for providers is needed to assist with referral decisions, and program planners should consider incorporating physical activity in group meetings. PMID:22814235

Individualized weight management: what can be learned from nutrigenomics and nutrigenetics?

PubMed

Rudkowska, Iwona; Pérusse, Louis

2012-01-01

The rise in the prevalence of obesity observed over the past decades is taken by many as an indication of the predominance of environmental factors (the so-called obesogenic environment) over genetic factors in explaining why obesity has reached epidemic proportions. While a changing environment favoring increased food intake and decreased physical activity levels has clearly contributed to shifting the distribution of body mass index (BMI) at the population level, not everyone is becoming overweight or obese. This suggests that there are genetic factors interacting with environmental factors to predispose some individuals to obesity. This gene-environment interaction is not only important in determining an individual's susceptibility to obesity but can also influence the outcome of weight-loss programs and weight-management strategies in overweight and obese subjects. This chapter reviews the role of gene-nutrient interactions in the context of weight management. The first section reviews the application of transcriptomics in human nutrition intervention studies on the molecular impact of caloric restriction and macronutrient composition. The second section reviews the effects of various obesity candidate gene polymorphisms on the response of body weight or weight-related phenotypes to weight-loss programs which include nutritional interventions. Copyright © 2012 Elsevier Inc. All rights reserved.

Why Should I Be Physically Active?

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... ANSWERS by heart Lifestyle + Risk Reduction Fitness + Weight Management Why Should I Be Physically Active? How often should I exercise? • Work up to a total of least 150 minutes of moderate- intensity physical ...

Tips for Starting Physical Activity

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Tips to Help You Get Active

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... Take Charge of Your Health View More Weight Management Information National Center on Health, Physical Activity and Disability ( ... at NIDDK Technology Advancement & Transfer Meetings & Workshops Health Information ... Disease Urologic Diseases Endocrine Diseases Diet & Nutrition ...

[Weight misperception and physical fitness perception in relation to the physical activity level, dietary behaviour and psychosocial well-being].

PubMed

Ruiz-Prieto, Inmaculada; Carbonero-Carreño, Rocío; Jáuregui-Lobera, Ignacio

2014-09-28

Most of the studies on weight misperception have been carried out in the US where it has been estimated that 20-40% of overweight or obese people underestimate their weight status. The perception of the physical fitness is a little studied variable but suggested as relevant in the adoption of healthy behaviours. The aims were to analyze weight misperception and physical fitness perception in adolescents, evaluating the relationship between weight misperception and physical fitness perception and body weight management behaviours (diet and exercise) as well as to analyze the relationship between weight misperception and psychosocial well-being. A total of 655 students participated voluntarily in the study during which they completed a series of questionnaires. Weight and height of all participants were collected. Many young people misperceived their weight and its physical fitness. The majority of participants who were overweight or obese did not go on diet to manage their body weight. Those who overestimated their weight had the worst psycho-emotional state. The work is novel in Spain, it follows the methodology carried out in international studies on the same topic and the results are similar to those obtained in other populations. Weight misperception and physical fitness perception influence the adoption of healthy body weight management behaviors and is related to psychosocial well- being of young people. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Self-Efficacy in Weight Management.

ERIC Educational Resources Information Center

Clark, Matthew M.; And Others

1991-01-01

Developed and validated Weight Efficacy Life-Style Questionnaire (WEL), which consists of five situational factors: Negative Emotions, Availability, Social Pressure, Physical Discomfort, and Positive Activities. Found hierarchical model to provide best fit to data. Results from two studies (total n=382) showed WEL to be sensitive to changes in…

The steps to health employee weight management randomized control trial: rationale, design and baseline characteristics.

PubMed

Østbye, Truls; Stroo, Marissa; Brouwer, Rebecca J N; Peterson, Bercedis L; Eisenstein, Eric L; Fuemmeler, Bernard F; Joyner, Julie; Gulley, Libby; Dement, John M

2013-07-01

The workplace can be an important setting for addressing obesity. An increasing number of employers offer weight management programs. Present the design, rationale and baseline characteristics of the Steps to Health study (STH), a randomized trial to evaluate the effectiveness of two preexisting employee weight management programs offered at Duke University and Medical Center. 550 obese (BMI ≥30) employee volunteers were randomized 1:1 to two programs. Baseline data, collected between January 2011 and July 2012, included height/weight, accelerometry, workplace injuries, health care utilization, and questionnaires querying socio-cognitive factors, perceptions of health climate, physical activity, and dietary intake. In secondary analyses participants in the two programs will also be compared to a non-randomized observational control group of obese employees. At baseline, the mean age was 45 years, 83% were female, 41% white, and 53% black. Mean BMI was 37.2. Participants consumed a mean of 2.37 servings of fruits and vegetables per day (in the past week), participated in 11.5 min of moderate-to-vigorous physical activity, and spent 620 min being sedentary. STH addresses the need for evaluation of worksite interventions to promote healthy weight. In addition to having direct positive effects on workers' health, worksite programs have the potential to increase productivity and reduce health care costs. Copyright © 2013 Elsevier Inc. All rights reserved.

Diet or exercise interventions vs combined behavioral weight management programs: a systematic review and meta-analysis of direct comparisons.

PubMed

Johns, David J; Hartmann-Boyce, Jamie; Jebb, Susan A; Aveyard, Paul

2014-10-01

Weight loss can reduce the health risks associated with being overweight or obese. However, the most effective method of weight loss remains unclear. Some programs emphasize physical activity, others diet, but existing evidence is mixed as to whether these are more effective individually or in combination. We aimed to examine the clinical effectiveness of combined behavioral weight management programs (BWMPs) targeting weight loss in comparison to single component programs, using within study comparisons. We included randomized controlled trials of combined BWMPs compared with diet-only or physical activity-only programs with at least 12 months of follow-up, conducted in overweight and obese adults (body mass index ≥25). Systematic searches of nine databases were run and two reviewers extracted data independently. Random effects meta-analyses were conducted for mean difference in weight change at 3 to 6 months and 12 to 18 months using a baseline observation carried forward approach for combined BWMPs vs diet-only BWMPs and combined BWMPs vs physical activity-only BWMPs. In total, eight studies were included, representing 1,022 participants, the majority of whom were women. Six studies met the inclusion criteria for combined BWMP vs diet-only. Pooled results showed no significant difference in weight loss from baseline or at 3 to 6 months between the BWMPs and diet-only arms (-0.62 kg; 95% CI -1.67 to 0.44). However, at 12 months, a significantly greater weight-loss was detected in the combined BWMPs (-1.72 kg; 95% CI -2.80 to -0.64). Five studies met the inclusion criteria for combined BWMP vs physical activity-only. Pooled results showed significantly greater weight loss in the combined BWMPs at 3 to 6 months (-5.33 kg; 95% CI -7.61 to -3.04) and 12 to 18 months (-6.29 kg; 95% CI -7.33 to -5.25). Weight loss is similar in the short-term for diet-only and combined BWMPs but in the longer-term weight loss is increased when diet and physical activity are combined. Programs based on physical activity alone are less effective than combined BWMPs in both the short and long term. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Using PRECEDE to develop a weight management program for disadvantaged young adults.

PubMed

Walsh, Jennifer R; White, Adrienne A; Kattelmann, Kendra K

2014-01-01

To conduct a needs assessment using the PRECEDE model for the development of a weight management program for low-income young adults. Four phases were implemented using qualitative (focus groups and interviews) and quantitative (survey) methodologies, with steering committee guidance. Northeastern residential vocational center. Convenience sample of low-income young adults, 18-24 years old (total n = 203), who were attending a job training vocational center. General themes of life satisfaction determinants and issues related to weight, self-reported weight and related behavior, existing environmental supports, and desired changes of behavioral and environmental influences of weight. Content analysis of qualitative data; descriptive analysis and Student t test. Self-image and discrimination were themes for weight issues. More than half of participants were overweight or obese (57%) and had low levels of physical activity (58%). Self-reported fruit and vegetable intake was inadequate (<2.5 cups/d). Identified environmental factors most needing improvement were accessibility for walking and biking and availability of healthful food. Participants reported exercising, getting adequate sleep, eating healthful snacks, and effectively managing stress as behavior they were willing to change. The PRECEDE model was useful to identify concerns, priorities, and modifiable factors among a young adult community that can increase the relevancy of a weight management program. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Distance learning strategies for weight management utilizing social media: A comparison of phone conference call versus social media platform. Rationale and design for a randomized study.

PubMed

Willis, Erik A; Szabo-Reed, Amanda N; Ptomey, Lauren T; Steger, Felicia L; Honas, Jeffery J; Al-Hihi, Eyad M; Lee, Robert; Vansaghi, Lisa; Washburn, Richard A; Donnelly, Joseph E

2016-03-01

Management of obesity in the context of the primary care physician visit is of limited efficacy in part because of limited ability to engage participants in sustained behavior change between physician visits. Therefore, healthcare systems must find methods to address obesity that reach beyond the walls of clinics and hospitals and address the issues of lifestyle modification in a cost-conscious way. The dramatic increase in technology and online social networks may present healthcare providers with innovative ways to deliver weight management programs that could have an impact on health care at the population level. A randomized study will be conducted on 70 obese adults (BMI 30.0-45.0 kg/m(2)) to determine if weight loss (6 months) is equivalent between weight management interventions utilizing behavioral strategies by either a conference call or social media approach. The primary outcome, body weight, will be assessed at baseline and 6 months. Secondary outcomes including waist circumference, energy and macronutrient intake, and physical activity will be assessed on the same schedule. In addition, a cost analysis and process evaluation will be completed. Copyright © 2016 Elsevier Inc. All rights reserved.

Antipsychotic induced weight gain in schizophrenia:mechanisms and management.

PubMed

Rege, Sanil

2008-05-01

The aim of the present paper was to describe the mechanisms and management of antipsychotic-induced weight gain in schizophrenia patients. A comprehensive literature review of all available articles on the mechanisms and management of antipsychotic-induced weight gain was done by searching databases PsychINFO and PubMed. A summary of the available guidelines for monitoring of antipsychotic-induced weight gain and metabolic syndrome is also provided. There has been a substantial increase in the number of studies investigating the mechanisms and management of antipsychotic-induced weight gain after 2002. These include advances in the understanding of pharmacogenomics of weight gain and several randomized controlled trials (RCTs) evaluating pharmacological and psychological treatments to promote weight loss. The most effective strategy for prevention of weight gain is the choice of antipsychotic medication with low weight gain potential. In individuals with established weight gain and metabolic issues, switching to an antipsychotic agent with lower weight gain potential and/or lifestyle modifications with physical activity are most effective in promoting weight loss. Pharmacological agents such as orlistat and sibutramine are effective in general obesity but have not been sufficiently evaluated in antipsychotic-induced weight gain. The case to prescribe routine pharmacological treatment to promote weight loss is weak. Long-term, pragmatic studies are required to inform clinical practice. Weight gain in schizophrenia is associated with significant physical and psychological morbidity. Achieving an optimal trade-off between effectiveness and side-effects of antipsychotic agents, although difficult, is achievable. This should be based on three main principles: (i) a shared decision-making model between the patient, clinician and carer(s) when choosing an antipsychotic; (ii) a commitment to baseline and follow-up monitoring with explicit identification of the responsible individual or team; and (iii) the adoption of clear structured protocols for clinicians to follow in case of clinically significant weight gain and metabolic issues, which should incorporate greater collaboration between various health professionals from psychiatric and medical specialist services.

Keeping Active and Healthy Eating for Men

MedlinePlus

... For Reporters Meetings & Workshops Follow Us Home Health Information Weight Management Keeping Active and Healthy Eating for Men Related ... at NIDDK Technology Advancement & Transfer Meetings & Workshops Health Information ... Disease Urologic Diseases Endocrine Diseases Diet & Nutrition ...

The effect of physical activity homework on physical activity among college students.

PubMed

Claxton, David; Wells, Gayle M

2009-03-01

This study examined the effect of using physical activity homework on physical activity levels of college students. Students in randomly assigned sections of a university health course were assigned 30 minutes of physical activity homework 3 days a week or no homework for 12 weeks. Participants completed self-reports of physical activity before the homework intervention and again at the conclusion of the 12 weeks of physical activity homework. Participants in all course sections reported significant increases in the number of days per week of moderate and vigorous physical activity. Participants in homework sections additionally showed significant increases in the days they engaged in muscular strength/endurance training and activities to manage weight. Participants in sections without homework showed a significant increase in the number of days engaged in flexibility training. Comparison of gain scores showed statistically significant increases by the homework group in the days they participated in activities designed to manage weight. Physical activity homework was deemed to be an effective method of increasing college students' levels of physical activity.

Dissonance and Healthy Weight Eating Disorder Prevention Programs: A Randomized Efficacy Trial

ERIC Educational Resources Information Center

Stice, Eric; Shaw, Heather; Burton, Emily; Wade, Emily

2006-01-01

In this trial, adolescent girls with body dissatisfaction (N = 481, M age = 17 years) were randomized to an eating disorder prevention program involving dissonance-inducing activities that reduce thin-ideal internalization, a prevention program promoting healthy weight management, an expressive writing control condition, or an assessment-only…

Nutraceuticals for body-weight management: The role of green tea catechins.

PubMed

Janssens, Pilou L H R; Hursel, Rick; Westerterp-Plantenga, Margriet S

2016-08-01

Green tea catechins mixed with caffeine have been proposed as adjuvants for maintaining or enhancing energy expenditure and for increasing fat oxidation, in the context of prevention and treatment of obesity. These catechins-caffeine mixtures seem to counteract the decrease in metabolic rate that occurs during weight loss. Their effects are of particular importance during weight maintenance after weight loss. Other metabolic targets may be fat absorption and the gut microbiota composition, but these effects still need further investigation in combination with weight loss. Limitations for the effects of green tea catechins are moderating factors such as genetic predisposition related to COMT-activity, habitual caffeine intake, and ingestion combined with dietary protein. In conclusion, a mixture of green tea catechins and caffeine has a beneficial effect on body-weight management, especially by sustained energy expenditure, fat oxidation, and preservation of fat free body-mass, after energy restriction induced body-weight loss, when taking the limitations into account. Copyright © 2016 Elsevier Inc. All rights reserved.

Weight-Related Goal Setting in a Telephone-Based Preventive Health-Coaching Program: Demonstration of Effectiveness.

PubMed

O'Hara, Blythe J; Gale, Joanne; McGill, Bronwyn; Bauman, Adrian; Hebden, Lana; Allman-Farinelli, Margaret; Maxwell, Michelle; Phongsavan, Philayrath

2017-11-01

This study investigated whether participants in a 6-month telephone-based coaching program, who set physical activity, nutrition, and weight loss goals had better outcomes in these domains. Quasi-experimental design. The Australian Get Healthy Information and Coaching Service (GHS), a free population-wide telephone health-coaching service that includes goal setting as a key component of its coaching program. Consenting GHS coaching participants who had completed coaching between February 2009 and December 2012 (n = 4108). At baseline, participants select a goal for the coaching program, and sociodemographic variables are collected. Self-reported weight, height, waist circumference, physical activity, and nutrition-related behaviors are assessed at baseline and 6 months. Descriptive analysis was performed on key sociodemographic variables, and the relationship between goal type and change in health outcomes was assessed using a series of linear mixed models that modeled change from baseline to 6 months. Participants who set goals in relation to weight management and physical activity achieved better results in these areas than those who set alternate goals, losing more than those who set alternate goals (1.5 kg and 0.9 cm in waist circumference) and increasing walking per week (40 minutes), respectively. There was no difference in food-related outcomes for those that set nutrition-related goals. Goal setting for weight management and increasing physical activity in the overweight and obese population, undertaken in a telephone-based coaching program, can be effective.

Following Suit: Using Conversation Cards for Priority Setting in Pediatric Weight Management.

PubMed

Kebbe, Maryam; Byrne, Jillian L S; Damanhoury, Samah; Ball, Geoff D C

To describe families' selections of Conversation Cards (CCs), a priority-setting tool in pediatric weight management, and examine CC-related differences based on families' anthropometric and sociodemographic characteristics. A retrospective medical record review was conducted of 2- to 17-year-olds with obesity and their families who enrolled in a pediatric weight management clinic between January, 2012 and September, 2016. Medical records of 146 children were included. On average, families selected 10 ± 6 CCs (range, 3-32 CCs); only 50% of families (n = 73) indicated perceived readiness to make healthy changes. Adolescents (vs children) revealed less healthy eating behaviors (P = .001) and physical activity habits (P = .002). Goal setting was perceived to be a motivator across several sociodemographic characteristics (all P < .05). The CCs were useful in describing families' priorities. The diversity of issues identified by families highlighted the importance of multidisciplinary expertise in pediatric weight management. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Community pharmacy-delivered interventions for public health priorities: a systematic review of interventions for alcohol reduction, smoking cessation and weight management, including meta-analysis for smoking cessation.

PubMed

Brown, Tamara J; Todd, Adam; O'Malley, Claire; Moore, Helen J; Husband, Andrew K; Bambra, Clare; Kasim, Adetayo; Sniehotta, Falko F; Steed, Liz; Smith, Sarah; Nield, Lucie; Summerbell, Carolyn D

2016-02-29

To systematically review the effectiveness of community pharmacy-delivered interventions for alcohol reduction, smoking cessation and weight management. Systematic review and meta-analyses. 10 electronic databases were searched from inception to May 2014. randomised and non-randomised controlled trials; controlled before/after studies, interrupted times series. any relevant intervention set in a community pharmacy, delivered by the pharmacy team. No restrictions on duration, country, age, or language. 19 studies were included: 2 alcohol reduction, 12 smoking cessation and 5 weight management. Study quality rating: 6 'strong', 4 'moderate' and 9 'weak'. 8 studies were conducted in the UK, 4 in the USA, 2 in Australia, 1 each in 5 other countries. Evidence from 2 alcohol-reduction interventions was limited. Behavioural support and/or nicotine replacement therapy are effective and cost-effective for smoking cessation: pooled OR was 2.56 (95% CI 1.45 to 4.53) for active intervention vs usual care. Pharmacy-based interventions produced similar weight loss compared with active interventions in other primary care settings; however, weight loss was not sustained longer term in a range of primary care and commercial settings compared with control. Pharmacy-based weight management interventions have similar provider costs to those delivered in other primary care settings, which are greater than those delivered by commercial organisations. Very few studies explored if and how sociodemographic or socioeconomic variables moderated intervention effects. Insufficient information was available to examine relationships between effectiveness and behaviour change strategies, implementation factors, or organisation and delivery of interventions. Community pharmacy-delivered interventions are effective for smoking cessation, and demonstrate that the pharmacy is a feasible option for weight management interventions. Given the potential reach, effectiveness and associated costs of these interventions, commissioners should consider using community pharmacies to help deliver public health services. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Fit and Strong! Plus: Design of a Comparative Effectiveness Evaluation of a Weight Management Program for Older Adults with Osteoarthritis

PubMed Central

Smith-Ray, Renae L.; Fitzgibbon, Marian L.; Tussing-Humphreys, Lisa; Schiffer, Linda; Shah, Amy; Huber, Gail M.; Braunschweig, Carol; Campbell, Richard T.; Hughes, Susan L.

2014-01-01

Osteoarthritis (OA) is the most common chronic condition and principal cause of disability among older adults. The current obesity epidemic has contributed to this high prevalence rate. Fortunately both OA symptoms and obesity can be ameliorated through lifestyle modifications. Physical activity (PA) combined with weight management improves physical function among obese persons with knee OA but evidence-based interventions that combine PA and weight management are limited for this population. This paper describes a comparative effectiveness trial testing an evidence-based PA program for adults with lower extremity (LE) OA, Fit and Strong!, against an enhanced version that also addresses weight management based on the evidence-based Obesity Reduction Black Intervention Trial (ORBIT). Adult participants (n=400) with LE OA, age 60+, overweight/obese, and not meeting PA requirements of >=150 minutes per week, are randomized to one of the two programs. Both 8-week interventions meet 3 times per week and include 60 minutes of strength, flexibility, and aerobic exercise instruction followed by 30 minutes of education/group discussion. The Fit and Strong! education sessions focus on using PA to manage OA; whereas Fit and Strong! Plus addresses PA and weight loss management strategies. Maintenance of behavior change is reinforced in both groups during months 3 - 24 through telephone calls and mailed newsletters. Outcomes are assessed at baseline, and 2, 6, 12, 18, and 24 months. Primary outcomes are dietary change at 2 months followed by weight loss at 6 months that is maintained at 24 months. Secondary outcomes assess PA, physical performance, and anxiety/depression. PMID:24316240

Living Well with Diabetes: a randomized controlled trial of a telephone-delivered intervention for maintenance of weight loss, physical activity and glycaemic control in adults with type 2 diabetes.

PubMed

Eakin, Elizabeth G; Reeves, Marina M; Marshall, Alison L; Dunstan, David W; Graves, Nicholas; Healy, Genevieve N; Bleier, Jonathan; Barnett, Adrian G; O'Moore-Sullivan, Trisha; Russell, Anthony; Wilkie, Ken

2010-08-03

By 2025, it is estimated that approximately 1.8 million Australian adults (approximately 8.4% of the adult population) will have diabetes, with the majority having type 2 diabetes. Weight management via improved physical activity and diet is the cornerstone of type 2 diabetes management. However, the majority of weight loss trials in diabetes have evaluated short-term, intensive clinic-based interventions that, while producing short-term outcomes, have failed to address issues of maintenance and broad population reach. Telephone-delivered interventions have the potential to address these gaps. Using a two-arm randomised controlled design, this study will evaluate an 18-month, telephone-delivered, behavioural weight loss intervention focussing on physical activity, diet and behavioural therapy, versus usual care, with follow-up at 24 months. Three-hundred adult participants, aged 20-75 years, with type 2 diabetes, will be recruited from 10 general practices via electronic medical records search. The Social-Cognitive Theory driven intervention involves a six-month intensive phase (4 weekly calls and 11 fortnightly calls) and a 12-month maintenance phase (one call per month). Primary outcomes, assessed at 6, 18 and 24 months, are: weight loss, physical activity, and glycaemic control (HbA1c), with weight loss and physical activity also measured at 12 months. Incremental cost-effectiveness will also be examined. Study recruitment began in February 2009, with final data collection expected by February 2013. This is the first study to evaluate the telephone as the primary method of delivering a behavioural weight loss intervention in type 2 diabetes. The evaluation of maintenance outcomes (6 months following the end of intervention), the use of accelerometers to objectively measure physical activity, and the inclusion of a cost-effectiveness analysis will advance the science of broad reach approaches to weight control and health behaviour change, and will build the evidence base needed to advocate for the translation of this work into population health practice. ACTRN12608000203358.

Dynamic Energy Balance: An Integrated Framework for Discussing Diet and Physical Activity in Obesity Prevention—Is it More than Eating Less and Exercising More?

PubMed Central

Manore, Melinda M.; Larson-Meyer, D. Enette; Lindsay, Anne R.; Hongu, Nobuko; Houtkooper, Linda

2017-01-01

Understanding the dynamic nature of energy balance, and the interrelated and synergistic roles of diet and physical activity (PA) on body weight, will enable nutrition educators to be more effective in implementing obesity prevention education. Although most educators recognize that diet and PA are important for weight management, they may not fully understand their impact on energy flux and how diet alters energy expenditure and energy expenditure alters diet. Many nutrition educators have little training in exercise science; thus, they may not have the knowledge essential to understanding the benefits of PA for health or weight management beyond burning calories. This paper highlights the importance of advancing nutrition educators’ understanding about PA, and its synergistic role with diet, and the value of incorporating a dynamic energy balance approach into obesity-prevention programs. Five key points are highlighted: (1) the concept of dynamic vs. static energy balance; (2) the role of PA in weight management; (3) the role of PA in appetite regulation; (4) the concept of energy flux; and (5) the integration of dynamic energy balance into obesity prevention programs. The rationale for the importance of understanding the physiological relationship between PA and diet for effective obesity prevention programming is also reviewed. PMID:28825615

Dynamic Energy Balance: An Integrated Framework for Discussing Diet and Physical Activity in Obesity Prevention-Is it More than Eating Less and Exercising More?

PubMed

Manore, Melinda M; Larson-Meyer, D Enette; Lindsay, Anne R; Hongu, Nobuko; Houtkooper, Linda

2017-08-19

Understanding the dynamic nature of energy balance, and the interrelated and synergistic roles of diet and physical activity (PA) on body weight, will enable nutrition educators to be more effective in implementing obesity prevention education. Although most educators recognize that diet and PA are important for weight management, they may not fully understand their impact on energy flux and how diet alters energy expenditure and energy expenditure alters diet. Many nutrition educators have little training in exercise science; thus, they may not have the knowledge essential to understanding the benefits of PA for health or weight management beyond burning calories. This paper highlights the importance of advancing nutrition educators' understanding about PA, and its synergistic role with diet, and the value of incorporating a dynamic energy balance approach into obesity-prevention programs. Five key points are highlighted: (1) the concept of dynamic vs. static energy balance; (2) the role of PA in weight management; (3) the role of PA in appetite regulation; (4) the concept of energy flux; and (5) the integration of dynamic energy balance into obesity prevention programs. The rationale for the importance of understanding the physiological relationship between PA and diet for effective obesity prevention programming is also reviewed.

Using self-determination theory to promote physical activity and weight control: a randomized controlled trial in women.

PubMed

Silva, Marlene N; Vieira, Paulo N; Coutinho, Sílvia R; Minderico, Cláudia S; Matos, Margarida G; Sardinha, Luís B; Teixeira, Pedro J

2010-04-01

Behavior change interventions are effective to the extent that they affect appropriately-measured outcomes, especially in experimental controlled trials. The primary goal of this study was to analyze the impact of a 1-year weight management intervention based on self-determination theory (SDT) on theory-based psychosocial mediators, physical activity/exercise, and body weight and composition. Participants were 239 women (37.6 +/- 7.1 years; 31.5 +/- 4.1 kg/m(2)) who received either an intervention focused on promoting autonomous forms of exercise regulation and intrinsic motivation, or a general health education program (controls). At 12 months, the intervention group showed increased weight loss (-7.29%,) and higher levels of physical activity/exercise (+138 +/- 26 min/day of moderate plus vigorous exercise; +2,049 +/- 571 steps/day), compared to controls (P < 0.001). Main intervention targets such as more autonomous self-regulation (for treatment and for exercise) and a more autonomous perceived treatment climate revealed large effect sizes (between 0.80 and .96), favoring intervention (P < 0.001). Results suggest that interventions grounded in SDT can be successfully implemented in the context of weight management, enhancing the internalization of more autonomous forms of behavioral regulation, and facilitating exercise adherence, while producing clinically-significant weight reduction, when compared to a control condition. Findings are fully consistent with previous studies conducted within this theoretical framework in other areas of health behavior change.

Evaluation of indigenous grains from the Peruvian Andean region for antidiabetes and antihypertension potential using in vitro methods.

PubMed

Ranilla, Lena Galvez; Apostolidis, Emmanouil; Genovese, Maria Ines; Lajolo, Franco Maria; Shetty, Kalidas

2009-08-01

The health-relevant functionality of 10 thermally processed Peruvian Andean grains (five cereals, three pseudocereals, and two legumes) was evaluated for potential type 2 diabetes-relevant antihyperglycemia and antihypertension activity using in vitro enzyme assays. Inhibition of enzymes relevant for managing early stages of type 2 diabetes such as hyperglycemia-relevant alpha-glucosidase and alpha-amylase and hypertension-relevant angiotensin I-converting enzyme (ACE) were assayed along with the total phenolic content, phenolic profiles, and antioxidant activity based on the 1,1-diphenyl-2-picrylhydrazyl radical assay. Purple corn (Zea mays L.) (cereal) exhibited high free radical scavenging-linked antioxidant activity (77%) and had the highest total phenolic content (8 +/- 1 mg of gallic acid equivalents/g of sample weight) and alpha-glucosidase inhibitory activity (51% at 5 mg of sample weight). The major phenolic compound in this cereal was protocatechuic acid (287 +/- 15 microg/g of sample weight). Pseudocereals such as Quinoa (Chenopodium quinoa Willd) and Kañiwa (Chenopodium pallidicaule Aellen) were rich in quercetin derivatives (1,131 +/- 56 and 943 +/- 35 microg [expressed as quercetin aglycone]/g of sample weight, respectively) and had the highest antioxidant activity (86% and 75%, respectively). Andean legumes (Lupinus mutabilis cultivars SLP-1 and H-6) inhibited significantly the hypertension-relevant ACE (52% at 5 mg of sample weight). No alpha-amylase inhibitory activity was found in any of the evaluated Andean grains. This in vitro study indicates the potential of combination of Andean whole grain cereals, pseudocereals, and legumes to develop effective dietary strategies for managing type 2 diabetes and associated hypertension and provides the rationale for animal and clinical studies.

The importance of body weight and weight management for military personnel.

PubMed

Naghii, Mohammad Reza

2006-06-01

Weight or fat reduction and maintenance among military personnel and attainment of desired body composition and physical appearance are considered important. A high level of body fat has been shown to have an adverse effect on performance in a number of military activities. The effect of rapid weight loss on performance appears to depend on the method of weight loss, the magnitude of weight loss, and the type of exercise or activity performance test used. Personnel who undertake imprudent weight-loss strategies, that is, personnel who try to change their usual body size by chronically restricting their food and fluid intake, may suffer a number of problems. Overweight personnel and their military coaches are just as susceptible to false ideas about weight loss and dieting as the rest of the community. Inappropriate weight loss causes a loss of lean tissue and can reduce, rather than enhance, performance. The understanding and promotion of safe, effective, appropriate weight-loss and weight-maintenance strategies represent important functions of the military system and officials. The greatest likelihood of success requires an integrated program, both during and after the weight-loss phase, in which assessment, increased energy expenditure through exercise and other daily activities, energy intake reduction, nutrition education, lifestyle changes, environmental changes, and psychological support are all components.

The assessment of weight status in children and young people attending a spina bifida outpatient clinic: a retrospective medical record review

PubMed Central

Swift, Judy Anne; Yung, Emily; Lyons, Julia; Church, Paige

2013-01-01

Purpose Children with disabilities are two to three times more likely to become overweight or obese than typically developing children. Children with spina bifida (SB) are at particular risk, yet obesity prevalence and weight management with this population are under-researched. This retrospective chart review explored how weight is assessed and discussed in a children’s SB outpatient clinic. Method Height/weight data were extracted from records of children aged 2–18 with a diagnosis of SB attending an outpatient clinic at least once between June 2009–2011. Body mass index was calculated and classified using Centers for Disease Control and Prevention cut-offs. Notes around weight, diet and physical/sedentary activities were transcribed verbatim and analysed using descriptive thematic analysis. Results Of 180 eligible patients identified, only 63 records had sufficient data to calculate BMI; 15 patients were overweight (23.81%) and 11 obese (17.46%). Weight and physical activity discussions were typically related to function (e.g. mobility, pain). Diet discussions focused on bowel and bladder function and dietary challenges. Conclusions Anthropometrics were infrequently recorded, leaving an incomplete picture of weight status in children with SB and suggesting that weight is not prioritised. Bowel/bladder function was highlighted over other benefits of a healthy body weight, indicating that health promotion opportunities are being missed. Implications for Rehabilitation It is important to assess, categorise and record anthropometric data for children and youth with spina bifida as they may be at particular risk of excess weight. Information around weight categorisation should be discussed openly and non-judgmentally with children and their families. Health promotion opportunities may be missed by focusing solely on symptom management or function. Healthcare professionals should emphasise the broad benefits of healthy eating and physical activity, offering strategies to enable the child to incorporate healthy lifestyle behaviours appropriate to their level of ability. PMID:23510013

The assessment of weight status in children and young people attending a spina bifida outpatient clinic: a retrospective medical record review.

PubMed

McPherson, Amy C; Swift, Judy Anne; Yung, Emily; Lyons, Julia; Church, Paige

2013-01-01

Children with disabilities are two to three times more likely to become overweight or obese than typically developing children. Children with spina bifida (SB) are at particular risk, yet obesity prevalence and weight management with this population are under-researched. This retrospective chart review explored how weight is assessed and discussed in a children's SB outpatient clinic. Height/weight data were extracted from records of children aged 2-18 with a diagnosis of SB attending an outpatient clinic at least once between June 2009-2011. Body mass index was calculated and classified using Centers for Disease Control and Prevention cut-offs. Notes around weight, diet and physical/sedentary activities were transcribed verbatim and analysed using descriptive thematic analysis. Of 180 eligible patients identified, only 63 records had sufficient data to calculate BMI; 15 patients were overweight (23.81%) and 11 obese (17.46%). Weight and physical activity discussions were typically related to function (e.g. mobility, pain). Diet discussions focused on bowel and bladder function and dietary challenges. Anthropometrics were infrequently recorded, leaving an incomplete picture of weight status in children with SB and suggesting that weight is not prioritised. Bowel/bladder function was highlighted over other benefits of a healthy body weight, indicating that health promotion opportunities are being missed. Implications for Rehabilitation It is important to assess, categorise and record anthropometric data for children and youth with spina bifida as they may be at particular risk of excess weight. Information around weight categorisation should be discussed openly and non-judgmentally with children and their families. Health promotion opportunities may be missed by focusing solely on symptom management or function. Healthcare professionals should emphasise the broad benefits of healthy eating and physical activity, offering strategies to enable the child to incorporate healthy lifestyle behaviours appropriate to their level of ability.

Physical activity in obesity and metabolic syndrome

PubMed Central

Strasser, Barbara

2013-01-01

Biological aging is typically associated with a progressive increase in body fat mass and a loss of lean body mass. Owing to the metabolic consequences of reduced muscle mass, it is understood that normal aging and/or decreased physical activity may lead to a higher prevalence of metabolic disorders. Lifestyle modification, specifically changes in diet, physical activity, and exercise, is considered the cornerstone of obesity management. However, for most overweight people it is difficult to lose weight permanently through diet or exercise. Thus, prevention of weight gain is thought to be more effective than weight loss in reducing obesity rates. A key question is whether physical activity can extenuate age-related weight gain and promote metabolic health in adults. Current guidelines suggest that adults should accumulate about 60 minutes of moderate-intensity physical activity daily to prevent unhealthy weight gain. Because evidence suggests that resistance training may promote a negative energy balance and may change body fat distribution, it is possible that an increase in muscle mass after resistance training may be a key mediator leading to better metabolic control. PMID:23167451

Healthy weight regulation and eating disorder prevention in high school students: a universal and targeted Web-based intervention.

PubMed

Jones, Megan; Taylor Lynch, Katherine; Kass, Andrea E; Burrows, Amanda; Williams, Joanne; Wilfley, Denise E; Taylor, C Barr

2014-02-27

Given the rising rates of obesity in children and adolescents, developing evidence-based weight loss or weight maintenance interventions that can be widely disseminated, well implemented, and are highly scalable is a public health necessity. Such interventions should ensure that adolescents establish healthy weight regulation practices while also reducing eating disorder risk. This study describes an online program, StayingFit, which has two tracks for universal and targeted delivery and was designed to enhance healthy living skills, encourage healthy weight regulation, and improve weight/shape concerns among high school adolescents. Ninth grade students in two high schools in the San Francisco Bay area and in St Louis were invited to participate. Students who were overweight (body mass index [BMI] >85th percentile) were offered the weight management track of StayingFit; students who were normal weight were offered the healthy habits track. The 12-session program included a monitored discussion group and interactive self-monitoring logs. Measures completed pre- and post-intervention included self-report height and weight, used to calculate BMI percentile for age and sex and standardized BMI (zBMI), Youth Risk Behavior Survey (YRBS) nutrition data, the Weight Concerns Scale, and the Center for Epidemiological Studies Depression Scale. A total of 336 students provided informed consent and were included in the analyses. The racial breakdown of the sample was as follows: 46.7% (157/336) multiracial/other, 31.0% (104/336) Caucasian, 16.7% (56/336) African American, and 5.7% (19/336) did not specify; 43.5% (146/336) of students identified as Hispanic/Latino. BMI percentile and zBMI significantly decreased among students in the weight management track. BMI percentile and zBMI did not significantly change among students in the healthy habits track, demonstrating that these students maintained their weight. Weight/shape concerns significantly decreased among participants in both tracks who had elevated weight/shape concerns at baseline. Fruit and vegetable consumption increased for both tracks. Physical activity increased among participants in the weight management track, while soda consumption and television time decreased. Results suggest that an Internet-based, universally delivered, targeted intervention may support healthy weight regulation, improve weight/shape concerns among participants with eating disorders risk, and increase physical activity in high school students. Tailored content and interactive features to encourage behavior change may lead to sustainable improvements in adolescent health.

Individually Tailored, Adaptive Intervention to Manage Gestational Weight Gain: Protocol for a Randomized Controlled Trial in Women With Overweight and Obesity.

PubMed

Symons Downs, Danielle; Savage, Jennifer S; Rivera, Daniel E; Smyth, Joshua M; Rolls, Barbara J; Hohman, Emily E; McNitt, Katherine M; Kunselman, Allen R; Stetter, Christy; Pauley, Abigail M; Leonard, Krista S; Guo, Penghong

2018-06-08

High gestational weight gain is a major public health concern as it independently predicts adverse maternal and infant outcomes. Past interventions have had only limited success in effectively managing pregnancy weight gain, especially among women with overweight and obesity. Well-designed interventions are needed that take an individualized approach and target unique barriers to promote healthy weight gain. The primary aim of the study is to describe the study protocol for Healthy Mom Zone, an individually tailored, adaptive intervention for managing weight in pregnant women with overweight and obesity. The Healthy Mom Zone Intervention, based on theories of planned behavior and self-regulation and a model of energy balance, includes components (eg, education, self-monitoring, physical activity/healthy eating behaviors) that are adapted over the intervention (ie, increase in intensity) to better regulate weight gain. Decision rules inform when to adapt the intervention. In this randomized controlled trial, women are randomized to the intervention or standard care control group. The intervention is delivered from approximately 8-36 weeks gestation and includes step-ups in dosages (ie, Step-up 1 = education + physical activity + healthy eating active learning [cooking/recipes]; Step-up 2 = Step-up 1 + portion size, physical activity; Step-up 3 = Step-up 1 + 2 + grocery store feedback, physical activity); 5 maximum adaptations. Study measures are obtained at pre- and postintervention as well as daily (eg, weight), weekly (eg, energy intake/expenditure), and monthly (eg, psychological) over the study period. Analyses will include linear mixed-effects models, generalized estimating equations, and dynamical modeling to understand between-group and within-individual effects of the intervention on weight gain. Recruitment of 31 pregnant women with overweight and obesity has occurred from January 2016 through July 2017. Baseline data have been collected for all participants. To date, 24 participants have completed the intervention and postintervention follow-up assessments, 3 are currently in progress, 1 dropped out, and 3 women had early miscarriages and are no longer active in the study. Of the 24 participants, 13 women have completed the intervention to date, of which 1 (8%, 1/13) received only the baseline intervention, 3 (23%, 3/13) received baseline + step-up 1, 6 (46%, 6/13) received baseline + step-up 1 + step-up 2, and 3 (23%, 3/13) received baseline + step-up 1 + step-up 2 +step-up 3. Data analysis is still ongoing through spring 2018. This is one of the first intervention studies to use an individually tailored, adaptive design to manage weight gain in pregnancy. Results from this study will be useful in designing a larger randomized trial to examine efficacy of this intervention and developing strategies for clinical application. RR1-10.2196/9220. ©Danielle Symons Downs, Jennifer S Savage, Daniel E Rivera, Joshua M Smyth, Barbara J Rolls, Emily E Hohman, Katherine M McNitt, Allen R Kunselman, Christy Stetter, Abigail M Pauley, Krista S Leonard, Penghong Guo. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 08.06.2018.

Cohort Study of the Success of Controlled Weight Loss Programs for Obese Dogs.

PubMed

German, A J; Titcomb, J M; Holden, S L; Queau, Y; Morris, P J; Biourge, V

2015-01-01

Most weight loss studies in obese dogs assess rate and percentage of weight loss in the first 2-3 months, rather than the likelihood of successfully reaching target weight. To determine outcome of controlled weight loss programs for obese dogs, and to determine the factors associated with successful completion. 143 obese dogs undergoing a controlled weight loss program. This was a cohort study of obese dogs attending a referral weight management clinic. Dogs were studied during their period of weight loss, and cases classified according to outcome as "completed" (reached target weight), "euthanized" (was euthanized before reaching target weight), or "stopped prematurely" (program stopped early for other reasons). Factors associated with successful completion were assessed using simple and multiple logistic regression. 87/143 dogs (61%) completed their weight loss program, 11 [8%] died or were euthanized, and the remaining 45 [32%] stopped prematurely. Reasons for dogs stopping prematurely included inability to contact owner, refusal to comply with weight management advice, or development of another illness. Successful weight loss was positively associated with a faster rate (P < .001), a longer duration (P < .001), and feeding a dried weight management diet (P = .010), but negatively associated with starting body fat (P < .001), and use of dirlotapide (P = .0046). Just over half of all obese dogs on a controlled weight loss program reach their target weight. Future studies should better clarify reasons for success in individual cases, and also the role of factors such as activity and behavioral modification. Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Best practice for obesity and weight management: finding success through linking effective gastric bypass surgery policy and health management.

PubMed

Foust, Robin F; Burke, Rosemary; Gordon, Neil

2006-06-01

Obesity is a health issue of epidemic proportions in the United States, creating a health and financial burden for Medicare, Medicaid, and commercial populations alike. While obesity has been linked to an increased risk for any number of health conditions, including heart disease, diabetes, and certain cancers, even a moderate weight loss can mitigate some of the negative medical consequences of unhealthy weight. Obese individuals are often unsuccessful at meeting their weight loss goals for a variety of reasons. Many are increasingly looking to gastric bypass surgery as an easy-fix weight loss solution without fully addressing underlying issues for the original weight gain and failures with previous attempts to lose weight. Because of this, over the past five years an increase in gastric bypass surgeries has resulted in cases with poor outcomes and a subsequent reaction by health plans and employers across the country to eliminate coverage. Others have determined that, while exclusion is not the answer, neither is coverage as standard policies allow. Instead, these groups are opting to implement best practice programs that merge individualized counseling, nutritional education/ planning, and physical activity goals with specific policy changes. Evidence has shown that they are achieving success in managing obesity and its impact on healthcare costs and outcomes.

Weight management in the performance athlete.

PubMed

Manore, Melinda M

2013-01-01

Management of weight is an ever-increasing challenge in societies where good tasting food is convenient, relatively inexpensive, and abundant. Developing a weight management plan is essential for everyone, including athletes that expend high amounts of energy in their sport. This brief review addresses the concept of dynamic energy balance and dietary approaches that can be successfully used with active individuals to facilitate weight loss, while retaining lean tissue and minimizing risks for disordered eating. Emphasis is placed on teaching athletes the benefits of consuming a low-energy-dense diet (e.g. high-fiber, high-water, low-fat foods), which allows for the consumption of a greater volume of food that is satiating but reduces energy intake. Other dietary behaviors important for weight loss or weight maintenance after weight loss are also emphasized, such as eating breakfast, spreading food and protein intake throughout the day, eating after exercise, elimination of sweetened beverages, and avoiding fad diets. As the general population becomes heavier, more young athletes will come to their sport needing to alter bodyweight or composition to perform at their peak. Health professionals need to be prepared with effective and evidence-based dietary approaches to help the athletes achieve their bodyweight goals. Copyright © 2013 Nestec Ltd., Vevey/S. Karger AG, Basel.

Preventing the obesity epidemic by second generation tailored health communication: an interdisciplinary review.

PubMed

Enwald, Heidi Päivyt Karoliina; Huotari, Maija-Leena Aulikki

2010-06-28

The prevention of obesity and health concerns related to obesity are major challenges worldwide. The use of eHealth communication and the tailoring of information delivered via the Internet at the individual level may increase the effectiveness of interventions. Mastering behaviors related to nutrition, physical activity, and weight management are the main issues in preventing obesity, and the need for interdisciplinary knowledge within this area is obvious. The objectives were to review the literature on tailored health communication and to present an interdisciplinary analysis of studies on "second" generation tailored interventions aimed at behavior change in nutrition, physical activity, or weight management. A literature search was conducted of the main electronic information sources on health communication. Selection criteria were defined, and 23 intervention studies were selected. The content analysis focused on the following: study designs, objectives of behavior change, target groups, sample sizes, study lengths, attrition rates, theories applied, intervention designs, computer-based channels used, statistically significant outcomes from the perspective of tailoring, and possible biases of the studies. However, this was not a structured meta-analysis and cannot be replicated as such. Of the 23 studies, 21 were randomized controlled trials, and all focused on behavior change: 10 studies focused on behavior change in nutrition, 7 on physical activity, 2 on nutrition and physical activity, and 4 on weight management. The target groups and the number of participants varied: 8 studies included more than 500 participants, and 6 studies included less than 100. Most studies were short; the duration of 20 studies was 6 months or less. The Transtheoretical Model was applied in 14 of the 23 studies, and feedback as a tailoring mechanism was used in addition to an Internet site (or program) in 15 studies and in addition to email in 11 studies. Self-reporting was used in 15 studies, and 14 studies did not have a no-information control group. Tailoring was more effective in nutrition interventions than in physical activity and weight management interventions. The outcomes were mixed or negative in 4 studies of physical activity interventions and in 3 studies of weight management. The use of a no-information control group seemed to have been linked to statistically significant between-group effects in measuring physical activity. This bias effect related to intervention design may explain the differences in the outcomes of the physical activity studies. Tailoring was shown to have been an effective method in nutrition interventions, but the results for physical activity were mixed, which is in line with previous studies. Nevertheless, the effect of possible biases, such as relying solely on self-reports and on intervention design without a no-information control group, should not be underestimated. Thus, the issue of bias merits more attention in planning interventions and in future meta-analyses.

The Dietary guideline 2005 and physical activities role in weight management of University Arkansas at Pine Bluff

USDA-ARS?s Scientific Manuscript database

To evaluate the effectiveness of the weight loss initiative, researchers at the University of Arkansas at Pine Bluff conducted an obesity prevention intervention based on the Dietary Guidelines for Americans approach. A 12 month study was conducted that focused on interventions to improve physical ...

Use of Low Molecular Weight Heparin and Aminocaproic Acid in Chronic DIC Associated with Prostate Cancer- A Case Report

PubMed Central

Shirai, Keisuke; Chaudhary, Uzair B.

2007-01-01

Disseminated Intravascular Coagulopathy (DIC) is the most common coagulopathy in patients with prostate cancer. Though rare, it could be fatal without treatment. Literature suggests that there is significant activation of fibrinolytic pathway. Pathophysiology of DIC in patients with prostate cancer is not completely understood. We present here a case of chronic DIC in a patient with metastatic androgen independent prostate cancer. His DIC was managed successfully with a combination of aminocaproic acid and low weight molecular heparin. The use of low molecular weight heparin may make management of chronic DIC in prostate cancer more feasible in an out patient setting. PMID:17619757

Intensive Lifestyle Intervention for Obesity: Principles, Practices, and Results.

PubMed

Webb, Victoria L; Wadden, Thomas A

2017-05-01

Using the Guidelines for the Management of Overweight and Obesity in Adults as a framework, this article reviews intensive lifestyle interventions for weight loss. The Guidelines recommend a minimum of 6 months of high-intensity, comprehensive lifestyle intervention, consisting of a reduced-calorie diet, increased physical activity, and behavior therapy. Persons with obesity typically lose approximately 8 kg (approximately 8% of initial weight) with this approach, accompanied by improvements in health and quality of life. To prevent weight regain, the Guidelines recommend a 1-year weight loss maintenance program that includes at least monthly counseling with a trained interventionist. Lifestyle interventions usually are delivered in-person; however, treatment increasingly is being disseminated through community- and commercial-based programs, as well as delivered by telephone, Internet, and smartphone platforms. These latter modalities expand treatment reach but usually produce smaller weight losses than in-person interventions. The review concludes with an examination of challenges in weight management. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Spirituality, Religiosity, and Weight Management Among African American Adolescent Males: The Jackson Heart KIDS Pilot Study.

PubMed

Bruce, Marino A; Beech, Bettina M; Griffith, Derek M; Thorpe, Roland J

2016-01-01

Spirituality and religion have been identified as important determinants of health for adults; however, the impact of faith-oriented factors on health behaviors and outcomes among African American adolescent males has not been well studied. The purpose of this study is to examine the relationship between religiosity and spirituality and obesity-related behaviors among 12-19 year old African American males (N = 105) in the Jackson Heart KIDS Pilot Study. Key variables of interest are church attendance, prayer, daily spirituality, weight status, attempts to lose weight, nutrition, physical activity, and stress. Daily spirituality is associated with whether an individual attempts to lose weight. The results from logistic regression models suggest that daily spirituality increases the odds that African American male adolescents attempt to lose weight (OR = 1.22, CI: 1.07-1.41) and have a history of diet-focused weight management (OR = 1.13, CI: 1.02-1.26). Future studies are needed to further explore the association between religion, spirituality, and obesity-related behaviors.

Association between the Family Nutrition and Physical Activity Screening Tool and obesity severity in youth referred to weight management.

PubMed

Tucker, Jared M; Howard, Kathleen; Guseman, Emily H; Yee, Kimbo E; Saturley, Heather; Eisenmann, Joey C

The Family Nutrition and Physical Activity Screening Tool (FNPA) evaluates family behavioural and environmental factors associated with pediatric obesity, but it is unknown if FNPA scores differ among youth across obesity severities. Our aim was to determine the association between the FNPA and obesity severity in youth referred to weight management. Upon initiating treatment, height, weight, and the FNPA were collected according to standard procedures. Cut-points for overweight/obesity, severe obesity (SO) class 2, and SO class 3 were calculated. FNPA scores were compared across weight status groups using analysis of covariance, and odds of SO across FNPA quartiles were evaluated with multiple logistic regression. Participants included 564 5-18year old who initiated treatment and completed the FNPA. After adjustment, FNPA scores differed by weight status with higher/healthier scores in youth with overweight/obesity (56.6±8.5) when compared to those with SO class 2 (55.0±7.1; p=0.015) or SO class 3 (53.6±9.0; p<0.001). Compared to those in the highest FNPA quartile, youth in the 2nd quartile had 1.8 (95% CI: 1.1, 2.9) times higher odds of SO, and those in the lowest FNPA quartile had 2.1 (95% CI: 1.3, 3.4) times higher odds of SO. Youth with SO had unhealthier subscale scores among 6 of 10 constructs, including nutritional, physical activity, sedentary, and sleep behaviours. Results suggest a consistent inverse relationship between the FNPA and adiposity among youth presenting for weight management. The FNPA is a useful metric for programs and clinicians targeting family behaviours and the home environment to combat obesity. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

[Prevention of shoulder dystocia risk factors before delivery].

PubMed

Fuchs, F

2015-12-01

To determine whether it is possible to prevent the occurrence of risk factors for shoulder dystocia before or during pregnancy. The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. Studied measures were exercise before or during pregnancy, dietary management, and gestational diabetes management in obese and non-obese patients. No study has proven that the correction of these risk factors (except gestational diabetes) would reduce the risk of shoulder dystocia. In the general population, physical exercise is recommended either before or during pregnancy to reduce the risk of gestational diabetes (physical activity before pregnancy) (grade B), fetal macrosomia (grade C) or maternal weight gain during pregnancy (grade C). No dietary regimen is recommended to reduce these issues (grade B). In overweight or obese (body mass index [BMI]>25), physical activity coupled with dietary management is recommended (grade A) because it reduces fetal macrosomia (EL1). In addition, it allows a modest reduction in maternal weight gain during pregnancy (EL2), but did have an effect on the occurrence of gestational diabetes (EL1). In case of gestational diabetes, diabetes care is recommended (diabetic diet, glucose monitoring, insulin if needed) (grade A) as it reduces the risk of macrosomia and shoulder dystocia (EL1). The recommended weight gain during pregnancy is 11.5 kg to 16 kg for normal BMI patients (grade B). Obese patients should be aware of the importance of controlling their weight gain during pregnancy (professional consensus). It is recommended that patients regain their pre-conception weight, and ideally a BMI between 18 and 25 kg/m(2), 6 months postpartum (grade B) to reduce the risk of gestational diabetes and macrosomia in a subsequent pregnancy (EL2). Physical activity is recommended before and during pregnancy to reduce the occurrence of risk factors for shoulder dystocia. In obese patients, physical activity should be coupled with dietary measures to reduce fetal macrosomia and weight gain during pregnancy. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

42 CFR 410.15 - Annual wellness visits providing Personalized Prevention Plan Services: Conditions for and...

Code of Federal Regulations, 2012 CFR

2012-10-01

... risk factors and improving self management, or community-based lifestyle interventions to reduce health risks and promote self-management and wellness, including weight loss, physical activity, smoking... satisfaction, stress, anger, loneliness/social isolation, pain, and fatigue. (D) Behavioral risks, including...

50 CFR 660.502 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... terms used in this subpart have the following meanings: Actively managed species (AMS) means those CPS... management according to the provisions of the FMP. Advisory Subpanel (AP) means the Coastal Pelagic Species..., by weight, of a coastal pelagic species population. The term biomass means total biomass (age 1 and...

50 CFR 660.502 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... terms used in this subpart have the following meanings: Actively managed species (AMS) means those CPS... management according to the provisions of the FMP. Advisory Subpanel (AP) means the Coastal Pelagic Species..., by weight, of a coastal pelagic species population. The term biomass means total biomass (age 1 and...

Fit and Strong! Plus: design of a comparative effectiveness evaluation of a weight management program for older adults with osteoarthritis.

PubMed

Smith-Ray, Renae L; Fitzgibbon, Marian L; Tussing-Humphreys, Lisa; Schiffer, Linda; Shah, Amy; Huber, Gail M; Braunschweig, Carol; Campbell, Richard T; Hughes, Susan L

2014-03-01

Osteoarthritis (OA) is the most common chronic condition and principal cause of disability among older adults. The current obesity epidemic has contributed to this high prevalence rate. Fortunately both OA symptoms and obesity can be ameliorated through lifestyle modifications. Physical activity (PA) combined with weight management improves physical function among obese persons with knee OA but evidence-based interventions that combine PA and weight management are limited for this population. This paper describes a comparative effectiveness trial testing an evidence-based PA program for adults with lower extremity (LE) OA, Fit and Strong!, against an enhanced version that also addresses weight management based on the evidence-based Obesity Reduction Black Intervention Trial (ORBIT). Adult participants (n=400) with LE OA, age 60+, overweight/obese, and not meeting PA requirements of ≥ 150 min per week, are randomized to one of the two programs. Both 8-week interventions meet 3 times per week and include 60 min of strength, flexibility, and aerobic exercise instruction followed by 30 min of education/group discussion. The Fit and Strong! education sessions focus on using PA to manage OA; whereas Fit and Strong! Plus addresses PA and weight loss management strategies. Maintenance of behavior change is reinforced in both groups during months 3-24 through telephone calls and mailed newsletters. Outcomes are assessed at baseline, and 2, 6, 12, 18, and 24 months. Primary outcomes are dietary change at 2 months followed by weight loss at 6 months that is maintained at 24 months. Secondary outcomes assess PA, physical performance, and anxiety/depression. Copyright © 2014 Elsevier Inc. All rights reserved.

Management of Hypothalamic Obesity during Transition from Childhood to Adulthood.

PubMed

Bretault, Marion; Carette, Claire; Barsamian, Charles; Czernichow, Sébastien

2018-01-01

Hypothalamic obesity (HO) is a rare and serious disease of various origins: tumor, traumatism, radiotherapy, vascular, genetic, or even psychotropic drug use. HO usually begins in childhood with eating disorders and progresses with an aggregate of severe comorbidities. Transition from pediatric to adult health care is a critical period to assure weight stability and a good management of comorbidities. In case of loss to follow-up, there is an increased risk of major weight gain and long-term complications with severe obesity. To minimize this risk, pediatric and adult specialists must work together to prepare, supervise, and monitor transition. Transition ideally involves the patient, parents, and care providers with a good communication between pediatric and adult teams from expert centers. Maintaining a diet and physical activity management plan, acquisition of autonomy for hormone replacement therapy and management of psychosocial consequences of obesity are fundamental issues in patients with HO. Patient associations and specialized diet center weight loss programs can help as well as group approaches. © 2018 S. Karger AG, Basel.

An exploration of the experiences and perceptions of people who have maintained weight loss.

PubMed

Hindle, L; Carpenter, C

2011-08-01

  In clinical weight-loss trials, the majority of those who lose weight will regain almost all of it within 5 years, yet there is limited evidence about effective strategies to support weight maintenance. The present study aimed to increase understanding of the experiences of those who have been successful at weight maintenance.   This qualitative study used a phenomenological approach. Semi-structured interviews were undertaken with a purposive sample of 10 participants who had maintained a minimum of 10% weight loss for at least 1 year. Interviews were transcribed and then analysed using a foundational thematic approach based on the Colaizzi method.   Participants believed that a more relaxed approach to weight management with realistic, long-term goals was more appropriate for long-term control. They had a strong reason to lose weight often with a medical trigger and had elicited support to help them. Most described the presence of saboteurs. Participants took personal responsibility for their weight management and were in tune with their nutrition and activity needs. Self-monitoring was a strategy commonly used to support this. They described the lack of positive reinforcement in the maintenance phase as a major difficulty.   This small-scale study provides evidence to suggest the importance of a medical prompt to lose weight; planning for how to manage saboteurs and identifying methods of minimising the impact of a reduction in positive reinforcement. It reinforces the importance of many of the strategies known to support the weight-loss phase. © 2011 The Authors. Journal of Human Nutrition and Dietetics © 2011 The British Dietetic Association Ltd.

Smart self management: assistive technology to support people with chronic disease.

PubMed

Zheng, Huiru; Nugent, Chris; McCullagh, Paul; Huang, Yan; Zhang, Shumei; Burns, William; Davies, Richard; Black, Norman; Wright, Peter; Mawson, Sue; Eccleston, Christopher; Hawley, Mark; Mountain, Gail

2010-01-01

We have developed a personalised self management system to support self management of chronic conditions with support from health-care professionals. Accelerometers are used to measure gross levels of activity, for example walking around the house, and used to infer higher level activity states, such as standing, sitting and lying. A smart phone containing an accelerometer and a global positioning system (GPS) module can be used to monitor outdoor activity, providing both activity and location based information. Heart rate, blood pressure and weight are recorded and input to the system by the user. A decision support system (DSS) detects abnormal activity and distinguishes life style patterns. The DSS is used to assess the self management process, and automates feedback to the user, consistent with the achievement of their life goals. We have found that telecare and assistive technology is feasible to support self management for chronic conditions within the home and local community environments.

Military service and other socioecological factors influencing weight and health behavior change in overweight and obese Veterans: a qualitative study to inform intervention development within primary care at the United States Veterans Health Administration.

PubMed

Jay, Melanie; Mateo, Katrina F; Squires, Allison P; Kalet, Adina L; Sherman, Scott E

2015-01-01

Obesity affects 37 % of patients at Veterans Health Administration (VHA) medical centers. The VHA offers an intensive weight management program (MOVE!) but less than 10 % of eligible patients ever attend. However, VHA patients see their primary care provider about 3.6 times per year, supporting the development of primary care-based weight management interventions. To address gaps in the literature regarding Veterans' experiences with weight management and determine whether and how to develop a primary care-based weight management intervention to both improve obesity counseling and increase attendance to MOVE!, we conducted a qualitative study to assess: 1) Veterans' personal experiences with healthy weight-related behavior change (including barriers and facilitators to behavior change and experiences with primary care providers, staff, and the MOVE! program), and 2) potential new approaches to improve weight management within primary care at the VHA including goal setting and technology. Overweight/obese VHA patients (aged 18-75, BMI greater than 30 or greater than 25 with at least 1 co-morbidity) were recruited for focus group sessions stratified by gender, MOVE! referral, and attendance. Each session was facilitated by a trained moderator, audio-recorded, and professionally transcribed. Using an iterative coding approach, two coders separately reviewed and coded transcripts, and met frequently to negotiate codes and synthesize emerging themes. Of 161 eligible patients, 54 attended one of 6 focus groups (2 female, 4 male, 9-11 participants per session): 63 % were male, 46 % identified as African-American, 32 % White/Caucasian, 74 % were college-educated or higher, and 61 % reported having attended MOVE!. We identified two major themes: Impact of Military Service and Promotion and Sustainability of Healthy Behaviors. After service in a highly structured military environment, Veterans had difficulty maintaining weight on their own. They perceived physical activity as having more impact than diet, but chronic pain was a barrier. We identified individual/interpersonal-, community/environment-, and healthcare system-related factors affecting healthy behaviors. We also received input about Veteran's preferences and experiences with technology and setting health goals. Unique factors influence weight management in Veterans. Findings will inform development of a technology-assisted weight management intervention with tailored counseling and goal-setting within primary care at the VHA.

Change of behaviour when selecting food products in a supermarket environment after reminding consumers about weight management.

PubMed

Saarela, Anna-Maria

2014-05-01

The aim was to explore how the behaviour of consumers changed while they selected food in a supermarket environment after they were reminded about weight management. This investigation was carried out from the perspective of selection criteria, reading of package labels, nutritional quality of the products selected and time taken to select a product. The subjects, who were actively watching their weight, participated in two consecutive tasks in a supermarket. They were given a shopping list of eleven food categories and asked to think aloud while selecting from each category a product they usually buy and a product they would use for weight management. The data (n 792 selections) were collected through interviews and a verbal analysis protocol combined with wireless audio-visual observation. Thirty-six consumers were recruited from a sample of 367 supermarket customers. Kuopio, Finland. The subjects' behaviour changed radically after they were reminded about weight management. In the first selection, taste and familiarity were the main food selection criteria while in the latter selection the energy/fat content predominated. Consequently, the nutritional quality of products improved greatly because subjects read package labels twice as much in the latter selection. The time taken to select a product increased significantly, on average, from 23 (sd 10) to 60 (sd 51) s/product (P = 0·000). Only by reminding consumers about weight management was there a significant impact on their food selection behaviour. Marketing communication should be developed which quickly and easily promotes consumers' awareness of healthy food in supermarkets.

Effectiveness of extended contact interventions for weight management delivered via text messaging: a systematic review and meta-analysis.

PubMed

Job, J R; Fjeldsoe, B S; Eakin, E G; Reeves, M M

2018-04-01

Extended contact interventions provide support for continued weight management (weight loss/prevention of weight regain) following a weight loss intervention. Text messages offer a medium for delivery in a potentially cost-effective, broad-reach manner. This study aims to examine (i) the effectiveness of extended contact, text message interventions for adults in supporting weight management, and (ii) which intervention characteristics are common to those that are effective. A systematic database search (to 19 September 2016) was conducted. Meta-analyses were performed to quantify the average weight changes (kg) during the extended contact intervention, net of control (if a control group was present) and within-group. Seven studies were eligible for inclusion. The pooled effect of the extended contact intervention compared with control (n = 3 studies) was -0.82 kg (95% confidence interval -1.43, -0.21), while the pooled within-group weight loss (n = 6 studies) during the extended contact interventions was -2.16 kg (95% confidence interval -3.40, -0.91). Interventions considered 'effective' (n = 4) were more likely to be >12 weeks duration, compared with interventions considered 'ineffective' (n = 3). Evidence from the small number of studies reviewed suggests that extended contact, text message-delivered interventions are effective. Further research is required to elucidate effective intervention components and the longer-term impact on weight, diet and physical activity behaviour. © 2017 World Obesity Federation.

Innovations in the Use of Interactive Technology to Support Weight Management

PubMed Central

Spruijt-Metz, D.; Wen, C.K.F.; O’Reilly, G.; Li, M.; Lee, S; Emken, B.A.; Mitra, U.; Annavaram, M.; Ragusa, G.; Narayanan, S.

2015-01-01

New and emerging mobile technologies are providing unprecedented possibilities for understanding and intervening on obesity-related behaviors in real time. However, the mobile health (mHealth) field has yet to catch up with the fast-paced development of technology. Current mHealth efforts in weight management still tend to focus mainly on short message systems (SMS) interventions, rather than taking advantage of real-time sensing to develop Just-In-Time, Adaptive Interventions (JITAIs). This paper will give an overview of the current technology landscape for sensing and intervening on three behaviors that are central to weight management; diet, physical activity, and sleep. Then five studies that really dig into the possibilities that these new technologies afford will be showcased. We conclude with a discussion of hurdles that mHealth obesity research has yet to overcome, and a future-facing discussion. PMID:26364308

Correlations among Stress, Physical Activity and Nutrition: School Employee Health Behavior

ERIC Educational Resources Information Center

Gillan, Wynn; Naquin, Millie; Zannis, Marie; Bowers, Ashley; Brewer, Julie; Russell, Sarah

2013-01-01

Employee health promotion programs increase work productivity and effectively reduce employer costs related to health care and absenteeism, and enhance worker productivity. Components of an effective worksite health program include stress management, exercise and nutrition and/or weight management classes or counseling. Few studies have documented…

An adaptive CBPR approach to create weight management materials for a school-based health center intervention.

PubMed

Sussman, Andrew L; Montoya, Carolyn; Werder, Olaf; Davis, Sally; Wallerstein, Nina; Kong, Alberta S

2013-01-01

From our previous clinical work with overweight/obese youth, we identified the need for research to create an effective weight management intervention to address the growing prevalence of adolescent metabolic syndrome. Formative assessment through an adaptive community-based participatory research (CBPR) approach was conducted toward the development of a nutritional and physical activity (DVD) and clinician toolkit for a school-based health center (SBHC) weight management intervention. We first conducted parent and adolescent interviews on views and experiences about obesity while convening a community advisory council (CAC) recruited from two participating urban New Mexico high schools. Thematic findings from the interviews were analyzed with the CAC to develop culturally and developmentally appropriate intervention materials. Themes from the parent and adolescent interviews included general barriers/challenges, factors influencing motivation, and change facilitators. The CAC and university-based research team reached consensus on the final content of nutrition and physical activity topics to produce a DVD and clinician toolkit through six monthly sessions. These materials used in the SBHC intervention resulted in a greater reduction of body mass index when compared to adolescents receiving standard care. Formative assessment using an adaptive CBPR approach resulted in the creation of culturally and age appropriate weight reduction materials that were acceptable to study participants. This trial is registered with ClinicalTrials.gov NCT00841334.

Effect of mindfulness meditation on short-term weight loss and eating behaviors in overweight and obese adults: A randomized controlled trial.

PubMed

Spadaro, Kathleen C; Davis, Kelliann K; Sereika, Susan M; Gibbs, Bethany B; Jakicic, John M; Cohen, Susan M

2017-12-05

Background There is a significant health crisis with rates of obesity continuing to increase despite research and clinical standard behavioral weight loss programs (SBWP). Mindfulness meditation (MM), with demonstrated benefits on physical, psychological health, and self-regulation behaviors was explored with SBWP. Methods Forty-six adults (BMI=32.5±3.7 kg/m2; age=45.2±8.2 years, 87 % female, 21.7 % African American) were randomly assigned to a 6-month SBWP only (n=24) or SBWP+MM (n=22) at a university-based physical activity and weight management research center in a northeastern US city. Participants were instructed to decrease intake (1200-1500 kcal/day), increase physical activity (300 min/wk), and attend weekly SBWP or SBWP+MM sessions. SBWP+MM had the same SBWP lessons with addition of focused MM training. Outcome measures collected at 0, 3, and 6 months included: weight, Block Food Frequency Questionnaire, Eating Behavior Inventory, Eating Inventory and Paffenbarger Physical Activity Questionnaire. Data were analyzed using linear mixed modeling for efficacy analysis of weight (primary) and eating, exercise and mindfulness (secondary outcomes). Results Retention rate was 76.1 % (n=35). A significant group by time interaction (p=0.03) was found for weight, with weight loss favoring SBWP+MM (-6.9 kg+2.9) over SBWP (-4.1 kg+2.8). Eating behaviors (p=0.02) and dietary restraint (p=0.02) improved significantly in SBWP+MM, compared to SBWP. MM enhanced weight loss by 2.8 kg potentially through greater improvements in eating behaviors and dietary restraint. Conclusions These findings support further study into the use of MM strategies with overweight and obese adults. The use of this low-cost, portable strategy with standard behavioral interventions could improve weight management outcomes.

Weight management in Canada: an environmental scan of health services for adults with obesity

PubMed Central

2014-01-01

Background Obesity in Canada is a growing concern, but little is known about the available services for managing obesity in adults. Our objectives were to (a) survey and describe programs dedicated to weight management and (b) evaluate program adherence to established recommendations for care. Methods We conducted an online environmental scan in 2011 to identify adult weight management services throughout Canada. We examined the degree to which programs adhered to the 2006 Canadian Clinical Practice Guidelines on the Management and Prevention of Obesity in Adults and Children (CCPGO) and the analysis criteria developed by the Association pour la Santé Publique du Québec (ASPQ). Results A total of 83 non-surgical (34 community-based, 42 primary care-based, 7 hospital-based) and 33 surgical programs were identified. All programs encouraged patient self-management. However, few non-surgical programs adhered to the CCPGO recommendations for assessment and intervention, and there was a general lack of screening for eating disorders, depression and other psychiatric diseases across all programs. Concordance with the ASPQ criteria was best among primary care-based programs, but less common in other settings with deficits most frequently revealed in multidisciplinary health assessment/management and physical activity counselling. Conclusions With more than 60% of Canadians overweight or obese, our findings highlight that availability of weight management services is far outstripped by need. Our observation that evidence-based recommendations are applied inconsistently across the country validates the need for knowledge translation of effective health services for managing obesity in adults. PMID:24521300

Football Fans in Training: the development and optimization of an intervention delivered through professional sports clubs to help men lose weight, become more active and adopt healthier eating habits

PubMed Central

2013-01-01

Background The prevalence of obesity in men is rising, but they are less likely than women to engage in existing weight management programmes. The potential of professional sports club settings to engage men in health promotion activities is being increasingly recognised. This paper describes the development and optimization of the Football Fans in Training (FFIT) programme, which aims to help overweight men (many of them football supporters) lose weight through becoming more active and adopting healthier eating habits. Methods The MRC Framework for the design and evaluation of complex interventions was used to guide programme development in two phases. In Phase 1, a multidisciplinary working group developed the pilot programme (p-FFIT) and used a scoping review to summarize previous research and identify the target population. Phase 2 involved a process evaluation of p-FFIT in 11 Scottish Premier League (SPL) clubs. Participant and coach feedback, focus group discussions and interviews explored the utility/acceptability of programme components and suggestions for changes. Programme session observations identified examples of good practice and problems/issues with delivery. Together, these findings informed redevelopment of the optimized programme (FFIT), whose components were mapped onto specific behaviour change techniques using an evidence-based taxonomy. Results p-FFIT comprised 12, weekly, gender-sensitised, group-based weight management classroom and ‘pitch-side’ physical activity sessions. These in-stadia sessions were complemented by an incremental, pedometer-based walking programme. p-FFIT was targeted at men aged 35-65 years with body mass index ≥ 27 kg/m2. Phase 2 demonstrated that participants in p-FFIT were enthusiastic about both the classroom and physical activity components, and valued the camaraderie and peer-support offered by the programme. Coaches appreciated the simplicity of the key healthy eating and physical activity messages. Suggestions for improvements that were incorporated into the optimized FFIT programme included: more varied in-stadia physical activity with football-related components; post-programme weight management support (emails and a reunion session); and additional training for coaches in SMART goal setting and the pedometer-based walking programme. Conclusions The Football Fans in Training programme is highly acceptable to participants and SPL coaches, and is appropriate for evaluation in a randomised controlled trial. PMID:23496915

Older adults' intrinsic and extrinsic motivation toward physical activity.

PubMed

Dacey, Marie; Baltzell, Amy; Zaichkowsky, Len

2008-01-01

To examine how motives discriminate 3 physical activity levels of inactive, active, and sustained maintainers. Six hundred forty-five adults (M age = 63.8) completed stage-of-change and Exercise Motivations Inventory (EMI-2) scales. Exploratory factor analysis established psychometric properties of the EMI-2 suitable for older adults. Six factors emerged in the EMI-2: health and fitness, social/emotional benefits, weight management, stress management, enjoyment, and appearance. Enjoyment contributed most to differentiating activity levels. Moderators of age and gender were delineated. Intrinsic motivation and self-determined extrinsic motivation distinguish older adults' activity levels.

Exploring motivation for leisure-based physical activity: a case study of college students

Treesearch

Alvin Hung Chih Yu

2007-01-01

The benefits of physical activity have been well documented in recent years. Physical activity may decrease the risk of cardiovascular disease, assist in weight management, improve personal mood, and promote physiological health. In light of this increased activity, it is important to understand the reasons for it. This exploratory study attempted to identify college...

Associations between self-reported post-diagnosis physical activity changes, body weight changes, and psychosocial well-being in breast cancer survivors.

PubMed

Phillips, Siobhan M; McAuley, Edward

2015-01-01

Decreased physical activity and weight gain post-breast cancer diagnosis are associated with negative psychosocial, health, and disease outcomes, but little is known about how these factors interact. The purpose of the present study was to conduct a preliminary examination of the association between post-diagnosis physical activity changes, weight changes, and psychosocial well-being in breast cancer survivors. We examined the association between retrospectively collected, self-reported post-diagnosis changes in physical activity and body weight and post-diagnosis fatigue, anxiety, depression, stress, self-esteem, and health-related quality of life (HRQOL) in breast cancer survivors (N = 1,348) using univariate analyses of covariance with Bonferroni's adjustment. After adjusting for covariates, maintaining and/or increasing physical activity post-diagnosis was significantly (p < 0.05 for all), independently associated with lower fatigue, anxiety, depression and stress and higher physical self-worth, physical, social, emotional, functional and breast cancer specific well-being and overall HRQOL (effect sizes = 0.23 to 0.60). Maintaining and/or losing weight was significantly (p < 0.05), independently associated with lower fatigue and higher physical self-worth, physical and breast cancer-specific well-being, and overall HRQOL (effect sizes = .28 to 0.87). There were no significant interaction effects between physical activity and body weight changes. This study provides preliminary data to suggest that maintaining or increasing physical activity and controlling weight post-diagnosis may be independently, positively associated with psychosocial well-being and HRQOL in breast cancer survivors. In addition, weight management effects may be larger and more outcome-specific while physical activity effects may be more general. Future research is warranted to replicate and confirm these findings.

Credit card debt, stress and key health risk behaviors among college students.

PubMed

Nelson, Melissa C; Lust, Katherine; Story, Mary; Ehlinger, Ed

2008-01-01

To examine cross-sectional associations between credit card debt, stress, and health risk behaviors among college students, focusing particularly on weight-related behaviors. Random-sample, mailed survey. Undergraduate and graduate students (n = 3206) attending a large public university. Self-reported health indicators (e.g., weight, height, physical activity, diet, weight control, stress, credit card debt). More than 23% of students reported credit card debt > or = $1000. Using Poisson regression to predict relative risks (RR) of health behaviors, debt of at least $1000 was associated with nearly every risk indicator tested, including overweight/obesity, insufficient physical activity, excess television viewing, infrequent breakfast consumption, fast food consumption, unhealthy weight control, body dissatisfaction, binge drinking, substance use, and violence. For example, adjusted RR [ARR] ranged from 1.09 (95% Confidence interval [CI]: 1.02-1.17) for insufficient vigorous activity to 2.17 (CI: 0.68-2.82) for using drugs other than marijuana in the past 30 days. Poor stress management was also a robust indicator of health risk. University student lifestyles may be characterized by a variety of coexisting risk factors. These findings indicate that both debt and stress were associated with wide-ranging adverse health indicators. Intervention strategies targeting at-risk student populations need to be tailored to work within the context of the many challenges of college life, which may serve as barriers to healthy lifestyles. Increased health promotion efforts targeting stress, financial management, and weight-related health behaviors may be needed to enhance wellness among young adults.

The experience of weight management in normal weight adults.

PubMed

Hernandez, Cheri Ann; Hernandez, David A; Wellington, Christine M; Kidd, Art

2016-11-01

No prior research has been done with normal weight persons specific to their experience of weight management. The purpose of this research was to discover the experience of weight management in normal weight individuals. Glaserian grounded theory was used. Qualitative data (focus group) and quantitative data (food diary, study questionnaire, and anthropometric measures) were collected. Weight management was an ongoing process of trying to focus on living (family, work, and social), while maintaining their normal weight targets through five consciously and unconsciously used strategies. Despite maintaining normal weights, the nutritional composition of foods eaten was grossly inadequate. These five strategies can be used to develop new weight management strategies that could be integrated into existing weight management programs, or could be developed into novel weight management interventions. Surprisingly, normal weight individuals require dietary assessment and nutrition education to prevent future negative health consequences. Copyright © 2016 Elsevier Inc. All rights reserved.

Smartphone Interventions for Weight Treatment and Behavioral Change in Pediatric Obesity: A Systematic Review.

PubMed

Chaplais, Elodie; Naughton, Geraldine; Thivel, David; Courteix, Daniel; Greene, David

2015-10-01

Traditional approaches for treating or managing children and adolescents with overweight or obesity have limited effectiveness. Current advances in smartphone technology may improve the attractiveness and accessibility of weight management support for children and adolescents with overweight or obesity. This systematic review aimed to provide a comparative evaluation of the effectiveness of using smartphones in the multidisciplinary treatment of child and adolescent overweight or obesity, with a specific interest in behavior change. The databases of Medline complete, OVID, CINAHL, EMBASE, and PubMed were searched for randomized controlled trial (RCT) studies addressing behavioral change using smartphone technology, plus nutrition and/or physical activity, to treat or manage child and adolescent obesity. Only two RCTs have described the effectiveness of smartphone devices in pediatric overweight or obesity treatment. Within the limitation of the two studies, electronic contact (e-contact) appeared unsuccessful in achieving weight loss. However, smartphone usage was linked to improved engagement and reduced dropout rates during important sustainability phases of these long-term interventions. Smartphone technologies allow users to accomplish tasks anywhere and anytime and, as such, provide researchers with additional and generationally appropriate capacities to deliver health promotion. E-contact should be used for its significant capacity to prolong engagement and decrease withdrawal during sustainability phases that follow intensive intervention for weight management in young populations. Despite increasing popularity in published protocols of weight management trials, the effectiveness of the impact of smartphone technology in pediatric programs remains equivocal.

Current nutritional treatments of obesity.

PubMed

Greenwald, Ashli

2006-01-01

Obesity in our country is a growing concern. There are several different options for weight loss; however, individuals must be self-motivated and amendable to change in order to achieve success with their weight loss goals. Several strategies used by professionals in the US today to treat overweight and obesity, include diet therapy, exercise, behavior modification, pharmacotherapy, and surgery. The focus of the American Dietetic Association (ADA) Weight Management Position Statement is no longer just on weight loss but now on weight management. Reaching one's ideal body weight is recommended but not often realistic. Frequently, the goal of treatment shifts to maintenance of ones current weight or attempts at moderate weight loss. Lifestyle modification or behavioral modification interventions rely on analyzing behavior to identify events that are associated with appropriate vs. inappropriate eating, exercise, or thinking habits. Certain primary strategies that have been found to be useful for helping people change their behaviors so that they can lose weight and maintain their weight loss, include self-monitoring, stimulus control, cognitive restructuring, stress management, social support, physical activity, and relapse prevention. Weight loss programs should strive to combine a nutritionally balanced dietary regimen with exercise and lifestyle modifications at the lowest possible cost. There are several different methods used for dietary modifications; low calorie diets, very low calorie diets, fasting, formula diets and meal replacement programs, and popular diets. Bariatric surgery is gaining popularity as it has been an effective way to treat obesity. Following gastric bypass surgery, the patients must be prepared to modify their eating behaviors and dietary selections to assist with weight loss and prevent potential complications. Patients should be educated on the dietary guidelines extensively prior to surgery and again post-operatively.

Committed to kids: an integrated, 4-level team approach to weight management in adolescents.

PubMed

Sothern, Melinda S; Schumacher, Heidi; von Almen, T Kristian; Carlisle, Lauren Keely; Udall, John N

2002-03-01

The integrated, 4-level approach of Committed to Kids is successful because of several factors: The sessions are designed to entertain the adolescents and promote initial success; The program features parent-training methods in short, interactive, educational sessions; In severely obese adolescents, the diet intervention results in noticeable weight loss that motivates the patient to continue; also, the improved exercise tolerance resulting from the weight loss promotes increased physical activity; and The program team provides consistent feedback-patients and their families receive results and updates every 3 months. Most importantly, the program is conducted in groups of families. The adolescent group dynamics and peer modeling are primary components of the successful management of obesity in youth.

Why do parents enrol in a childhood obesity management program?: a qualitative study with parents of overweight and obese children.

PubMed

Davidson, Kamila; Vidgen, Helen

2017-02-02

Despite the high prevalence of childhood overweight and obesity enrolment to weight management programs remains difficult, time consuming, costly and has limited effectiveness. The aim of this paper was to explore parents' perspectives on factors that influence their decision to enrol in a program to address their child's weight. Semi-structured qualitative telephone interviews were undertaken with 21 parents of primary school aged children above the healthy weight range who had enrolled in a healthy lifestyle program. Questions were developed and analysed using the Theory of Planned Behaviour. They addressed parental reasons for enrolment, expectations of the program and apprehensions regarding enrolling. Prior to deciding to enrol, parents tended to be aware of the child's weight status, had attempted to address it themselves and had sought help from a number of people including health professionals. Parental decision to enrol was influenced by their evaluation of their previous attempts and their child's emotional state. Awareness of their child's weight status is an important first step in parents taking action at this health issue however it is unlikely to be sufficient on its own. Parental decision to join a childhood obesity management program can be complex and is likely to be made after numerous and unsuccessful attempts to address the child's weight. Strategies to encourage parents to enrol in programs should include activities beyond awareness of weight status. Health professionals should use contact time with parents to raise awareness of the child's weight status and to provide encouragement to address overweight and obesity. Parents must be supported in their attempts to address their child's overweight and obesity whether they choose to manage it themselves or within a program.

Predictors of weight stigma experienced by middle-older aged, general-practice patients with obesity in disadvantaged areas of Australia: a cross-sectional study.

PubMed

Spooner, Catherine; Jayasinghe, Upali W; Faruqi, Nighat; Stocks, Nigel; Harris, Mark F

2018-05-21

Rates of obesity have increased globally and weight stigma is commonly experienced by people with obesity. Feeling stigmatised because of one's weight can be a barrier to healthy eating, physical activity and to seeking help for weight management. The aim of this study was to identify predictors of perceived weight among middle-older aged patients with obesity attending general practices in socioeconomically disadvantaged urban areas of Australia. As part of a randomised clinical trial in Australia, telephone interviews were conducted with 120 patients from 17 general practices in socioeconomically disadvantaged of Sydney and Adelaide. Patients were aged 40-70 years with a BMI ≥ 30 kg/m 2 . The interviews included questions relating to socio-demographic variables (e.g. gender, language spoken at home), experiences of weight-related discrimination, and the Health Literacy Questionnaire (HLQ). Multi-level logistic regression data analysis was undertaken to examine predictors of recent experiences of weight-related discrimination ("weight stigma"). The multi-level model showed that weight stigma was positively associated with obesity category 2 (BMI = 35 to < 40; OR 4.47 (95% CI 1.03 to 19.40)) and obesity category 3 (BMI = ≥ 40; OR 27.06 (95% CI 4.85 to 150.95)), not being employed (OR 7.70 (95% CI 2.17 to 27.25)), non-English speaking backgrounds (OR 5.74 (95% CI 1.35 to 24.45)) and negatively associated with the HLQ domain: ability to actively engage with healthcare providers (OR 0.12 (95% CI 0.05 to 0.28)). There was no association between weight stigma and gender, age, education or the other HLQ domains examined. Weight stigma disproportionately affected the patients with obesity most in need of support to manage their weight: those with more severe obesity, from non-English speaking backgrounds and who were not in employment. Additionally, those who had experienced weight stigma were less able to actively engage with healthcare providers further compounding their disadvantage. This suggests the need for a more proactive approach to identify weight stigma by healthcare providers. Addressing weight stigma at the individual, system and population levels is recommended. The trial was registered with the Australian Clinical Trials Registry ACTRN126400102162 .

Do weight management programmes delivered at professional football clubs attract and engage high risk men? A mixed-methods study.

PubMed

Hunt, Kate; Gray, Cindy M; Maclean, Alice; Smillie, Susan; Bunn, Christopher; Wyke, Sally

2014-01-21

The prevalence of obesity in men in the UK is amongst the highest in Europe but men are less likely than women to use existing weight loss programmes. Developing weight management programmes which are appealing and acceptable to men is a public health priority. Football Fans in Training (FFIT), a men-only weight management programme delivered to groups of men at top professional football clubs, encourages men to lose weight by working with, not against, cultural ideals of masculinity. To inform further development of interventions in football club settings, the current study explored who is attracted to FFIT and why overweight/obese men choose to take part. A mixed-methods study analysing baseline data on 747 men aged 35-65 years with BMI ≥ 28 kg/m2 who were participants in a randomised controlled trial of FFIT, and data from 13 focus group discussions with 63 men who had attended the programme. Objectively-measured mean body mass index was 35.3 kg/m2 (sd 4.9). Overall over 90% of participants were at very high or extremely high risk of future ill-health. Around three-quarters of participants in all age groups were at 'very high' risk of type 2 diabetes, hypertension and cardiovascular disease (72%, 73% and 80% of men aged 35-44, 45-54 and 55-64 years respectively). A further 21%, 16% and 13% were at 'extremely high' risk. Qualitative data revealed that the powerful 'draw' of the football club attracted men otherwise reluctant to attend existing weight management programmes. The location and style of delivery of early FFIT sessions fostered team spirit; men appreciated being with others 'like them' and the opportunity to undertake weight management in circumstances that enhanced physical and symbolic proximity to something they valued highly, the football club. The delivery of a weight management intervention via professional football clubs attracted men at high risk of ill-health. The setting enabled men to join a weight management programme in circumstances that felt 'right' rather than threatening to themselves as men. FFIT is an example of how to facilitate health promotion activities in a way that is consistent with, rather than challenging to, common ideals of masculinity.

Do weight management programmes delivered at professional football clubs attract and engage high risk men? A mixed-methods study

PubMed Central

2014-01-01

Background The prevalence of obesity in men in the UK is amongst the highest in Europe but men are less likely than women to use existing weight loss programmes. Developing weight management programmes which are appealing and acceptable to men is a public health priority. Football Fans in Training (FFIT), a men-only weight management programme delivered to groups of men at top professional football clubs, encourages men to lose weight by working with, not against, cultural ideals of masculinity. To inform further development of interventions in football club settings, the current study explored who is attracted to FFIT and why overweight/obese men choose to take part. Methods A mixed-methods study analysing baseline data on 747 men aged 35–65 years with BMI ≥ 28 kg/m2 who were participants in a randomised controlled trial of FFIT, and data from 13 focus group discussions with 63 men who had attended the programme. Results Objectively-measured mean body mass index was 35.3 kg/m2 (sd 4.9). Overall over 90% of participants were at very high or extremely high risk of future ill-health. Around three-quarters of participants in all age groups were at ‘very high’ risk of type 2 diabetes, hypertension and cardiovascular disease (72%, 73% and 80% of men aged 35–44, 45–54 and 55–64 years respectively). A further 21%, 16% and 13% were at ‘extremely high’ risk. Qualitative data revealed that the powerful ‘draw’ of the football club attracted men otherwise reluctant to attend existing weight management programmes. The location and style of delivery of early FFIT sessions fostered team spirit; men appreciated being with others ‘like them’ and the opportunity to undertake weight management in circumstances that enhanced physical and symbolic proximity to something they valued highly, the football club. Conclusions The delivery of a weight management intervention via professional football clubs attracted men at high risk of ill-health. The setting enabled men to join a weight management programme in circumstances that felt ‘right’ rather than threatening to themselves as men. FFIT is an example of how to facilitate health promotion activities in a way that is consistent with, rather than challenging to, common ideals of masculinity. PMID:24443845

Short-Term Efficacy of an Innovative Mobile Phone Technology-Based Intervention for Weight Management for Overweight and Obese Adolescents: Pilot Study

PubMed Central

Guedes, Claudia M; Cooper, Bruce A; Lung, Audrey E

2017-01-01

Background In the United States, approximately one-third of adolescents are now overweight or obese, and one in six is obese. This financial cost and the larger nonfinancial costs of obesity make obesity prevention and management for adolescents imperative for the health of the nation. However, primary care visits are typically brief, and primary care providers may lack adequate resources to help overweight or obese adolescents to manage weight issues. To augment the efficacy of primary care visits for adolescent weight management, mobile phone technology can be used as an adjunct treatment that provides additional opportunities for encouraging improvement in lifestyle, attainment, and maintenance of healthy weight. Objective The purposes of this study were to (1) measure effects of an innovative mobile phone technology-based intervention for overweight and obese adolescents and to (2) examine the intervention’s feasibility for use in primary care clinics. Methods The mobile phone-based intervention had three components: use of the Fitbit Flex, participation in an online educational program, and receipt of biweekly text messages during the maintenance phase. A randomized controlled study design was utilized. Data regarding anthropometrics (body mass index [BMI] and waist-to-hip ratio), blood pressure, levels of physical and sedentary activity, diet, and self-efficacy regarding physical activity and diet were collected at baseline and at 3 and 6 months after the baseline assessment. Results A total of 40 adolescents participated in the study. At the 6-month follow-up visit, compared to participants in the control group, the mobile phone-based intervention participants had significant improvement in BMI (z=–4.37, P=.001), diastolic blood pressure (z=–3.23, P=.001), physical activity days per week (z=2.58, P=.01), TV and computer time (z=–3.34, P=.001), servings of fruits and vegetables per day (z=2.74, P=.006), servings of soda and sweetened drinks (z=–3.19, P=.001), physical activity self-efficacy (z=2.75, P=.006), and dietary self-efficacy (z=5.05, P=.001). Medium to large effect sizes were found in these outcome variables. Conclusions The use of mobile technologies may offer a practical, reliable adjunct to weight management for overweight and obese adolescents in busy primary care clinics serving adolescents. Trial Registration Clinicaltrials.gov NCT 01693250; https://clinicaltrials.gov/ct2/show/NCT01693250? term=Adolescent+ obesity+AND+mhealth&rank=5 (Archived by WebCite at ) PMID:28768612

Guidelines for dietary management of menopausal women with simple obesity.

PubMed

Brończyk-Puzoń, Anna; Piecha, Dariusz; Nowak, Justyna; Koszowska, Aneta; Kulik-Kupka, Karolina; Dittfeld, Anna; Zubelewicz-Szkodzińska, Barbara

2015-03-01

The problem of obesity affects all age groups. It is also observed among menopausal women. Menopause is the time in a woman's life when, as a consequence of hormonal changes occurring in the body, the risk of overweight and obesity increases significantly and, therefore, so does the risk of metabolic and cardiovascular diseases. Excess body weight in menopausal women may also be of social and psychological importance since the occurring symptoms may considerably decrease quality of life and sexual activity of these women. Reduction of body weight in obese menopausal women should play a vital role in treatment of this group of patients. Therefore, adequate management seems to be essential, and it should involve dietary, pharmacological and/or surgical treatment, depending on the patient's needs. Following a rational weight loss plan provided by a dietician under medical supervision may contribute to improvement of the health condition and quality of life. It is recommended to observe the guidelines on dietary management described in this article by adjusting a diet plan individually. The following work constitutes a review of articles from 2004-2014 which are available in the PubMed medical knowledge base and the Polish Medical Bibliography (Polska Bibliografia Lekarska). For this purpose, the following controlled vocabulary has been used: menopausal woman, menopausal diet, menopausal weight gain, menopausal weight loss, dietary management in menopause.

Liraglutide 3.0 mg for weight management: weight-loss dependent and independent effects.

PubMed

Bays, Harold; Pi-Sunyer, Xavier; Hemmingsson, Joanna Uddén; Claudius, Birgitte; Jensen, Christine B; Van Gaal, Luc

2017-02-01

As an adjunct to a reduced-calorie diet and increased physical activity, treatment with liraglutide 3.0 mg for weight management provides a statistically significant and clinically meaningful weight loss of 5.7%-8.0% compared to 1.6%-2.6% with placebo. The objective of this post hoc analysis was to quantify the relative contribution of weight loss to the treatment effects of liraglutide 3.0 mg on key efficacy endpoints. The analysis utilized data from 4725 participants across three randomized, placebo-controlled, double-blind trials that evaluated the efficacy and safety of liraglutide 3.0 mg versus placebo, as an adjunct to a reduced-calorie diet and increased physical activity (ClinicalTrials.gov identifiers: NCT01272219, NCT01272232 and NCT01557166). The duration of two of the trials was 56 weeks; one trial was of 32 weeks' duration. A mediation analysis was performed, which ranked the relative contribution of weight loss to the treatment effects of liraglutide 3.0 mg on key cardiometabolic efficacy endpoints, Apnea-Hypopnea Index (AHI) and health-related quality of life (QoL). A limitation of this type of analysis is that it cannot conclusively prove a causal relationship. In individuals without type 2 diabetes mellitus (T2DM), endpoints predominantly driven by liraglutide-induced weight loss included waist circumference, diastolic blood pressure, triglycerides, high density lipoprotein cholesterol, AHI, and Impact of Weight on Quality of Life-Lite total and physical function scores. Endpoints predominantly independent of weight loss included the glycemic endpoints hemoglobin A1c and fasting plasma glucose in individuals with and without T2DM. Regardless of the degree of dependence on weight loss according to the mediation analysis, greater weight loss was associated with greater improvement in all endpoints. Treatment with liraglutide 3.0 mg contributes to improved cardiometabolic parameters, AHI and health-related QoL through both weight-loss dependent and weight-loss independent mechanisms.

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2012-06-27

... 0910-New) I. Background A recent study of obesity indicates that 35.5 percent of men and 35.8 percent... were spent in 2008 to treat obesity-related diseases (Ref. 2). Studies have shown that weight loss can significantly reduce the burden of obesity-related comorbidities (Refs. 3 and 4), and that weight lost as a...

Evidence-based lifestyle interventions in the workplace--an overview.

PubMed

Schröer, S; Haupt, J; Pieper, C

2014-01-01

Lifestyle-related health issues affect the economic position of organizations and contribute to reduced productivity, increased absenteeism and health care costs. To summarize the effectiveness of different workplace health interventions for promoting healthy lifestyle, preventing diseases and reducing health care costs. We searched MEDLINE via Pubmed, EMBASE, Cochrane Library, NelH, HighWire Press and Google Scholar in March 2012. Systematic reviews and meta-analyses of workplace interventions aimed at promoting physical activity, healthy weight and good nutrition were included. Three authors assessed the quality of the reviews and extracted data on methods, interventions, outcomes, results and effect sizes. We identified 15 publications covering a total of 379 original studies. Three systematic reviews found beneficial effects of workplace nutrition interventions on employees' dietary behaviour. Three reviews found multi-component physical activity interventions to be effective in increasing employees' physical activity and fitness. The other activity promotion interventions were less effective regarding physical activity and weight-related outcomes. In terms of weight management, our findings favour multi-component interventions that focus on both physical activity and nutrition over single dietary programmes. Workplace health promotion interventions may improve physical activity, dietary behaviour and healthy weight. There is no evidence of increased efficacy associated with specific intervention types. Workplace health promotion should focus on either physical activity or weight or nutrition behaviour to maximize effectiveness. Best evidence is available for multi-component interventions.

Relationships Between Body Size Satisfaction and Weight Control Practices Among US Adults

PubMed Central

Millstein, Rachel A.; Carlson, Susan A.; Fulton, Janet E.; Galuska, Deborah A.; Zhang, Jian; Blanck, Heidi M.; Ainsworth, Barbara E.

2008-01-01

Context Few studies of US adults have specifically examined body size satisfaction Objectives Describe correlates of body size satisfaction and examine whether satisfaction was associated with trying to lose weight or specific weight control practices among US adults using a national sample of women and men. Design, Setting & Participants The National Physical Activity and Weight Loss Survey (NPAWLS) was a population-based, cross-sectional telephone survey of US adults (n = 9740). Main Outcome Measures Participants reported their weight, height, body size satisfaction, and weight loss practices. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for each dependent variable. Results Among women and men, higher body mass index (BMI) was significantly associated with body size dissatisfaction. Dissatisfaction, compared with being very satisfied, was positively associated with trying to lose weight among women and men. This association was modified by BMI for women (OR normal weight = 19.69, overweight = 8.79, obese = 4.05; P < .01 for interaction) but not men (OR normal weight = 8.72, overweight = 10.50, obese = 7.86; P = 0.93 for interaction). Compared with women who were very satisfied, dissatisfied women used diet more (OR = 2.03), but not physical activity/exercise (OR = 0.55) or both strategies (OR = 0.63), to try to lose weight. Men who were somewhat satisfied, compared with those who were very satisfied, were more likely to use physical activity/exercise (OR = 1.64) and both diet and physical activity/exercise (OR = 1.54) to try to lose weight. Conclusion These findings highlight the sex differences in body size satisfaction, actions taken to try to lose weight, and the importance of considering body size satisfaction when designing weight-management programs. PMID:18596944

A behavioral weight-loss intervention for persons with serious mental illness in psychiatric rehabilitation centers.

PubMed

Daumit, G L; Dalcin, A T; Jerome, G J; Young, D R; Charleston, J; Crum, R M; Anthony, C; Hayes, J H; McCarron, P B; Khaykin, E; Appel, L J

2011-08-01

Overweight and obesity are epidemic in populations with serious mental illnesses. We developed and pilot-tested a behavioral weight-loss intervention appropriately tailored for persons with serious mental disorders. We conducted a single-arm pilot study in two psychiatric rehabilitation day programs in Maryland, and enrolled 63 overweight or obese adults. The 6-month intervention provided group and individual weight management and group physical activity classes. The primary outcome was weight change from baseline to 6 months. A total of 64% of those potentially eligible enrolled at the centers. The mean age was 43.7 years; 56% were women; 49% were white; and over half had schizophrenia or a schizoaffective disorder. One-third had hypertension and one-fifth had diabetes. In total, 52 (82%) completed the study; others were discharged from psychiatric centers before completion of the study. Average attendance across all weight management sessions was 70% (87% on days participants attended the center) and 59% for physical activity classes (74% on days participants attended the center). From a baseline mean of 210.9 lbs (s.d. 43.9), average weight loss for 52 participants was 4.5 lb (s.d. 12.8) (P<0.014). On average, participants lost 1.9% of body weight. Mean waist circumference change was 3.1 cm (s.d. 5.6). Participants on average increased the distance on the 6-minute walk test by 8%. This pilot study documents the feasibility and preliminary efficacy of a behavioral weight-loss intervention in adults with serious mental illness who were attendees at psychiatric rehabilitation centers. The results may have implications for developing weight-loss interventions in other institutional settings such as schools or nursing homes.

Weight management for overweight and obese men delivered through professional football clubs: a pilot randomized trial

PubMed Central

2013-01-01

Background The prevalence of male obesity is increasing, but men are less likely than women to attend existing weight management programmes. We have taken a novel approach to reducing perceived barriers to weight loss for men by using professional football (soccer) clubs to encourage participation in a weight management group programme, gender-sensitised in content and style of delivery. Football Fans in Training (FFIT) provides 12 weeks of weight loss, physical activity and healthy eating advice at top professional football clubs in Scotland. This pilot randomized trial explored the feasibility of using these clubs as a setting for a randomized controlled trial of 12 month weight loss following men’s participation in FFIT. Methods A two-arm pilot trial at two Scottish Premier League football clubs (one large, one smaller), with 103 men (aged 35–65, body mass index (BMI) ≥27 kg/m2) individually randomized to the intervention (n=51, received the pilot programme (p-FFIT) immediately) and waitlist comparison (n=52, received p-FFIT after four months) groups. Feasibility of recruitment, randomization, data collection and retention were assessed. Objective physical measurements (weight, waist circumference, blood pressure, body composition) and questionnaires (self-reported physical activity, diet, alcohol consumption, psychological outcomes) were obtained from both groups by fieldworkers trained to standard protocols at baseline and 12 weeks, and from the intervention group at 6 and 12 months. Qualitative methods elicited men’s experiences of participation in the pilot trial. Results Following a short recruitment period, the recruitment target was achieved at the large, but not smaller, club. Participants’ mean age was 47.1±8.4 years; mean BMI 34.5±5.0 kg/m2. Retention through the trial was good (>80% at 12 weeks and 6 months; >75% at 12 months), and 76% attended at least 80% of available programme delivery sessions. At 12 weeks, the intervention group lost significantly more weight than the comparison group (4.6% c.f. -0.6%, p<.001) and many maintained this to 12 months (intervention group baseline-12 month weight loss: 3.5%, p<.001). There were also improvements in self-reported physical activity and diet, many sustained long term. Conclusions The results demonstrated the feasibility of trial procedures and the potential of FFIT to engage men in sustained weight loss and positive lifestyle change. They supported the conduct of a fully-powered randomized controlled trial. PMID:24171842

Activation of the hip adductor muscles varies during a simulated weight-bearing task.

PubMed

Hides, Julie A; Beall, Paula; Franettovich Smith, Melinda M; Stanton, Warren; Miokovic, Tanja; Richardson, Carolyn

2016-01-01

To investigate the pattern of muscle activation of the individual hip adductor muscles using a standardised simulated unilateral weight-bearing task. A repeated measures design. Laboratory. 20 healthy individuals (11 females, 9 males) participated in the study. Age ranged from 20 to 25 years. Surface electromyography recordings from adductor magnus and adductor longus muscles were taken at levels representing 10-50% of body weight during a simulated weight-bearing task. Electromyography (EMG) data were normalised to maximal voluntary isometric contraction. The adductor magnus was recruited at significantly higher levels than the adductor longus muscle during a simulated weight-bearing task performed across 10-50% of body weight (p < 0.01). Adductor magnus and adductor longus muscles are recruited to different extents during a simulated weight-bearing task. This information should be considered when selecting exercises for management and prevention of groin strains. Closed chain exercises with weight-bearing through the lower limb are more likely to recruit the adductor magnus muscle over the adductor longus muscle. Copyright © 2015 Elsevier Ltd. All rights reserved.

Antenatal weight management: Diet, physical activity, and gestational weight gain in early pregnancy.

PubMed

Swift, Judy A; Langley-Evans, Simon C; Pearce, Jo; Jethwa, Preeti H; Taylor, Moira A; Avery, Amanda; Ellis, Sarah; McMullen, Sarah; Elliott-Sale, Kirsty J

2017-06-01

to investigate women's physical activity levels, diet and gestational weight gain, and their experiences and motivations of behavior change. analysis of cross-sectional data collected during a longitudinal, cohort study examining physiological, psychological, sociodemographic, and self-reported behavioural measures relating to bodyweight. women recruited from routine antenatal clinics at the Nottingham University Hospitals NHS Trust. 193 women ≤27 weeks gestation and aged 18 years or over. MEASUREMENTS & FINDINGS: measurements included weight and height, the Dietary Instrument for Nutrition Education (Brief Version), the International Physical Activity Questionnaire (Short Form), and open questions of perceptions of behaviour change. 50.3% (n=97) were overweight/obese, and women gained 0.26kg/wk (IQR 0.34kg/wk) since conception. The majority consumed low levels of fat (n=121; 63.4%), high levels of unsaturated fat (n=103; 53.9%), and used a dietary supplement (n=166; 86.5%). However, 41% (n=76) were inactive, 74.8% (n=143) did not consume high levels of fibre, and 90.0% (n=171) consumed less than 5 portions of fruit and vegetables a day. Body mass index category was not associated with diet, physical activity levels, or gestational weight gain. Themes generated from open-questions relating to behaviour change were: (1) Risk management, (2) Coping with symptoms, (3) Self-control, (4) Deviation from norm, (5) Nature knows best. early pregnancy is a period of significant and heterogeneous behaviour change, influenced by perceptions of risk and women's lived experience. Behaviour was influenced not only by perceptions of immediate risk to the fetus, but also by the women's lived experience of being pregnant. There are exciting opportunities to constructively reframe health promotion advice relating to physical activity and diet in light of women's priorities. The need for individualized advice is highlighted, and women across all body mass index categories would benefit from improved diet and physical activity levels. Copyright © 2017 Elsevier Ltd. All rights reserved.

Modelling the Interplay between Lifestyle Factors and Genetic Predisposition on Markers of Type 2 Diabetes Mellitus Risk.

PubMed

Walker, Celia G; Solis-Trapala, Ivonne; Holzapfel, Christina; Ambrosini, Gina L; Fuller, Nicholas R; Loos, Ruth J F; Hauner, Hans; Caterson, Ian D; Jebb, Susan A

2015-01-01

The risk of developing type 2 diabetes mellitus (T2DM) is determined by a complex interplay involving lifestyle factors and genetic predisposition. Despite this, many studies do not consider the relative contributions of this complex array of factors to identify relationships which are important in progression or prevention of complex diseases. We aimed to describe the integrated effect of a number of lifestyle changes (weight, diet and physical activity) in the context of genetic susceptibility, on changes in glycaemic traits in overweight or obese participants following 12-months of a weight management programme. A sample of 353 participants from a behavioural weight management intervention were included in this study. A graphical Markov model was used to describe the impact of the intervention, by dividing the effects into various pathways comprising changes in proportion of dietary saturated fat, physical activity and weight loss, and a genetic predisposition score (T2DM-GPS), on changes in insulin sensitivity (HOMA-IR), insulin secretion (HOMA-B) and short and long term glycaemia (glucose and HbA1c). We demonstrated the use of graphical Markov modelling to identify the importance and interrelationships of a number of possible variables changed as a result of a lifestyle intervention, whilst considering fixed factors such as genetic predisposition, on changes in traits. Paths which led to weight loss and change in dietary saturated fat were important factors in the change of all glycaemic traits, whereas the T2DM-GPS only made a significant direct contribution to changes in HOMA-IR and plasma glucose after considering the effects of lifestyle factors. This analysis shows that modifiable factors relating to body weight, diet, and physical activity are more likely to impact on glycaemic traits than genetic predisposition during a behavioural intervention.

Intentional weight loss in older adults: useful or wasting disease generating strategy?

PubMed

Darmon, Patrice

2013-05-01

Strategies for weight management in older adults remain controversial as overweight may protect them against mortality whereas weight loss may have harmful effects by promoting sarcopenia and bone loss. It has been suggested that weight management for obese older adults should focus more on maintaining weight and improving physical function than promoting weight loss. This review aims to specify whether intentional weight loss in older adults is a useful or a wasting disease generating strategy. Recent randomized controlled studies have shown that a supervised, moderate caloric restriction coupled with regular exercise (both aerobic and resistance) in obese older adults do not increase mortality risk and may conversely reduce insulin resistance, metabolic complications, and disabilities without exacerbating lean mass and bone mineral density loss. In obese older adults, moderate weight loss may have beneficial effects on comorbidities, functional performances, and quality of life provided that regular physical activity can be associated. An individual approach considering life expectancy, chronic comorbidities, functional status, personal motivation, and social support should be preferred. More research is needed to define the circumstances in which cautious dietary restrictions are reasonably justified in older adults. In any case, in the oldest (≥80 years) as in frail individuals, it seems reasonable to abstain from recommending weight loss.

Weight maintenance: challenges, tools and strategies for primary care physicians[Link

PubMed Central

Soleymani, T.; Daniel, S.

2015-01-01

Summary Obesity is recognized as a chronic disease and one of the major healthcare challenges facing us today. Weight loss can be achieved via lifestyle, pharmacological and surgical interventions, but weight maintenance remains a lifetime challenge for individuals with obesity. Guidelines for the management of obesity have highlighted the role of primary care providers (PCPs). This review examines the long‐term outcomes of clinical trials to identify effective weight maintenance strategies that can be utilized by PCPs. Because of the broad nature of the topic, a structured PubMed search was conducted to identify relevant research articles, peer‐reviewed reviews, guidelines and articles published by regulatory bodies. Trials have demonstrated the benefit of sustained weight loss in managing obesity and its comorbidities. Maintaining 5–10% weight loss for ≥1 year is known to ameliorate many comorbidities. Weight maintenance with lifestyle modification – although challenging – is possible but requires long‐term support to reinforce diet, physical activity and behavioural changes. The addition of pharmacotherapy to lifestyle interventions promotes greater and more sustained weight loss. Clinical evidence and recently approved pharmacotherapy has given PCPs improved strategies to support their patients with maintenance of weight loss. Further studies are needed to assess the translation of these strategies into clinical practice. PMID:26490059

Using Qualitative Methods to Understand Physical Activity and Weight Management Among Bangladeshis in New York City, 2013.

PubMed

Riley, Lindsey; Mili, Saima; Trinh-Shevrin, Chau; Islam, Nadia

2016-07-07

South Asians experience high rates of cardiovascular disease and type 2 diabetes, coupled with low rates of reported physical activity. We report findings from a qualitative sub-study that was conducted in 2013 among Bangladeshi immigrants in New York City to understand factors that affect physical activity practices and weight management in this community. Qualitative study participants were recruited from community-based settings. Sex-specific focus groups were conducted by trained community health workers. Proceedings were audio-recorded for translation and transcription and coded using a constant comparative approach. Data were coded using Atlas.ti software. Six focus groups were completed with a final sample of 67 participants (63% male, 37% female). Mean participant age was 42 years; mean years of residence in the United States was 12. Key themes that emerged were beliefs about modesty and sex-separated facilities that may prevent women from engaging in physical activity. Distinctions were made between men and women about what constitutes exercise versus physical activity; religious prayer was considered to be health-promoting because of the movement involved. Other important themes that emerged were cultural dietary practices and evolving conceptions of healthy weight. Tailored interventions that take into account the cultural context of this growing community are needed. Findings may also provide insight into barriers to health promotion experienced by other US Muslim communities, which are growing rapidly.

Changes in autonomic nervous system activity, body weight, and percentage fat mass in the first year postpartum and factors regulating the return to pre-pregnancy weight.

PubMed

Izumi, Mie; Manabe, Emiko; Uematsu, Sayo; Watanabe, Ayako; Moritani, Toshio

2016-10-27

Many women become obese during pregnancy and the postpartum period. Weight gain and obesity in the general population are often attributed to abnormalities of autonomic nervous system (ANS) activity. The aim of this study was to clarify change in ANS activity, body weight, percentage fat mass (%FM), and body mass index (BMI) and the factors regulating the return to the pre-pregnancy weight in the first year postpartum. This study was conducted from 2012 to 2016 at the University Hospital of the Kyoto Prefectural University of Medicine and a nearby obstetrics and gynecology clinic in Japan. Body weight and %FM were measured in 51 women using a dual-frequency body composition measuring device. Heart rate variability and R-R spectral transformation were used as indicators of ANS activity. All parameters were calculated at three postpartum time points. Repeated measure analysis of variance was used for comparisons between measurement times. A multivariable Cox proportional hazards model was conducted to determine factors associated with the return to pre-pregnancy weight. Mean body weight, %FM, and BMI decreased significantly over time after delivery (P < 0.001, P < 0.001, P < 0.001). However, ANS activity did not differ among subjects in the three time points. 25.5 % of subjects had still not returned to their pre-pregnancy body weight by 150-270 days postpartum, and 19.6 % had not by 270-360 days postpartum. Normal-weight obesity (NWO; BMI of 18.5-25 kg/m 2 and %FM of ≥30 %) was observed in several subjects at each measurement. The results of analysis using a multivariable Cox proportional hazards model suggest that ANS activity had no significant correlation with the return to pre-pregnancy weight. The management of body weight and %FM after delivery is considered important. These findings suggest that ANS activity is not associated with the return to pre-pregnancy weight, albeit that sample size was small.

Changes in Body Weight Among People With Type 2 Diabetes Mellitus in the United States, NHANES 2005-2012.

PubMed

Wang, Yiting; Bolge, Susan C; Lopez, Janice M S; Zhu, Vivienne J; Stang, Paul E

2016-06-01

To understand weight loss strategies, weight changes, goals, and behaviors in people with type 2 diabetes mellitus (T2DM) and whether these differ by ethnicity. T2DM was identified by self-reported diagnosis using the NHANES 2005-2012 data, which also included measured and self-reported current body weight and height, self-reported weight the prior year, and self-reported aspired weight. Nineteen weight loss strategies were evaluated for association with ≥5% weight loss or weight gain versus <5% weight change. Among people with T2DM, 88.0% were overweight/obese (body mass index [BMI] ≥25 kg/m(2)) in the prior year and 86.1% the current year. About 60% of the overweight/obese took weight loss actions, mostly using diet-related methods with average weight lost <5%. Two most "effective" methods reported (smoking, taking laxatives/vomiting) are also potentially most harmful. Similar BMI distributions but different goals and behaviors about weight and weight loss were observed across ethnicity. Only physical activity meeting the recommended level and changing eating habits were consistently associated with favorable and statistically significant weight change. Weight management in T2DM is an ongoing challenge, regardless of ethnicity/race. Among overweight/obese T2DM subjects, recommended level of physical activity and changing eating habits were associated with statistically significant favorable weight change. © 2016 The Author(s).

"You've got to walk before you run": positive evaluations of a walking program as part of a gender-sensitized, weight-management program delivered to men through professional football clubs.

PubMed

Hunt, Kate; McCann, Claire; Gray, Cindy M; Mutrie, Nanette; Wyke, Sally

2013-01-01

To explore men's views of a pedometer-based walking program, part of a weight-management intervention delivered through Scottish Premier League football clubs, and the congruence or challenge this poses to masculine identities. Semistructured telephone interviews with a sample of participants in a gender-sensitized, group weight-management program. Interviewing continued until data saturation was reached (n = 29). All men were positive about the context, style of delivery, and content of the broader intervention. These things encouraged men to increase their physical activity (and adopt other behavioral changes) that they may not otherwise have found appealing. The success and acceptability of the walking program resided in three interrelated factors: (a) the utility of pedometers as a technology for motivation, self-monitoring and surveillance, and target setting; (b) the speed with which fitness was regained and weight reduced (enabling men to begin to do more desired forms of physical activity, and so regain visceral, experiential, and pragmatic masculine capital); and (c) bolstering their masculine identities through the receipt of the program in a valued, masculinised context. These data suggest that men will enthusiastically embrace a graduated walking program when the presentation is gender sensitive in context, content, and delivery. Pedometers were viewed as a valuable, reliable technological aid which motivated men and empowered them in self-monitoring of progress toward self-defined goals. Many men experienced the walking program as a means of regaining fitness, thereby enabling them to also regain valued masculine identities and activities, and a step toward regaining a more acceptable masculine body. PsycINFO Database Record (c) 2013 APA, all rights reserved.

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Knowledge, attitudes and management skills of medical practitioners regarding weight management.

PubMed

Mkhatshwa, Vangile B; Ogunbanjo, Gboyega A; Mabuza, Langalibalele H

2016-11-29

Overweight and obesity have become a global problem. Health professionals are poorly prepared in weight management, which has an effect on their attitudes and management skills with regard to overweight and obese patients.Aim and setting: To assess the knowledge, attitudes and management skills of medical practitioners regarding weight management at Odi District Hospital, Gauteng Province, South Africa. We conducted a cross-sectional study on 48 medical practitioners at Odi Hospital between 01 October and 31 October 2013. A self-administered questionnaire was used to assess their knowledge, attitudes and management skills in weight management. The SPSS® statistical software (Version 22) was used for data analysis. A p < 0.05 was considered significant. Fifty medical practitioners were recruited, 48 consented to participate and 28 (58.3%) were male. Their categories were community service doctors (3), medical officers (21), registrars (22) and others (2). Thirty-seven (77.1%) never received training in weight management (p < 0.001). Thirty-two (66.7%) regarded weight management as not confined to a dietician (p < 0.001) and 27 (56.2%) regarded weight management as usually unsuccessful (p = 0.004). Forty-seven (97.9%) provided lifestyle modifications and 43 (89.6%) involved the patient's family in weight management (p < 0.001). More non-registrars [14 (77.8%)] than registrars [8 (38.1%)] measured the body mass index (BMI) routinely (p = 0.013). Few medical practitioners received training in weight management. They regarded weight management as usually unsuccessful and lacked confidence in the same owing to lack of training. They provided lifestyle modifications and involved the patient's family in weight management. Non-registrars measured the BMI routinely. There is a need for training in weight management at undergraduate and post-graduate levels.

Polycystic ovary syndrome and weight management.

PubMed

Moran, Lisa J; Lombard, Catherine B; Lim, Siew; Noakes, Manny; Teede, Helena J

2010-03-01

Polycystic ovary syndrome (PCOS) is a common condition in women of reproductive age, and has reproductive, metabolic and psychological implications. Weight gain and obesity worsen the features of PCOS, while weight loss improves the features of PCOS. While there are potential barriers to successful weight management in young women who do not suffer from PCOS, women with PCOS may experience additional barriers. Weight management strategies in younger women with or without PCOS should encompass both the prevention of excess weight gain and achieving and maintaining a reduced weight through multidisciplinary lifestyle management, comprising dietary, exercise and behavioral therapy, as well as attention to psychosocial stress and practical and physiological barriers to weight management. Further research is warranted in the examination of specific barriers to weight management in women with PCOS, as well as in the determination of optimal components of lifestyle weight management interventions in young women in order to facilitate long-term compliance.

Macronutrient Content of the Diet: What Do We Know About Energy Balance and Weight Maintenance?

PubMed

Fleming, Jennifer A; Kris-Etherton, Penny M

2016-06-01

The 2013 AHA/ACC Clinical Guideline for the Management of Overweight and Obesity recommends a reduced energy diet for weight loss regardless of the macronutrient content. However, diet composition may affect the maintenance of weight loss. In general, a healthful dietary pattern with reduced portion sizes, low energy dense foods, and physical activity are successful for many. Certain populations, such as those with insulin resistance, may find reductions in carbohydrate and higher levels of unsaturated fats to be more effective and promote greater adherence. Of importance is that metabolic adaptations following weight loss also may impact weight loss maintenance and should be considered in the transition from weight loss to weight stabilization. Thus, weight loss and weight maintenance strategies are both important in an intervention for sustaining long-term behavior change.

Goal setting frequency and the use of behavioral strategies related to diet and physical activity.

PubMed

Nothwehr, Faryle; Yang, Jingzhen

2007-08-01

Goal setting is an effective way to focus attention on behavior change. Theoretically, frequency of goal setting may indicate the level of commitment to diet and physical activity behavior change. Yet, little is known about the association between goal setting frequency and use of specific diet or physical activity-related strategies. This study examines whether changes in goal setting frequency predict changes in use of behavioral strategies over time, controlling for baseline strategy use, demographics and whether a person was trying to lose weight. Data are from a baseline and 1-year follow-up survey of adults in rural Iowa (n = 385). Overall, goal setting frequency was positively associated with use of the strategies measured, at baseline and overtime. Frequent goal setting that is focused specifically on diet or physical activity was more predictive of using dietary or physical activity strategies, respectively, than goal setting focused on weight loss overall. The study provides empirical support for what has been assumed theoretically, that is, frequent goal setting for weight management is an indicator of use of specific behavioral strategies. Significant challenges remain in regard to maintenance of this activity and attainment of weight loss goals.

Effects of photoperiod on food intake, activity and metabolic rate in adult neutered male cats.

PubMed

Kappen, K L; Garner, L M; Kerr, K R; Swanson, K S

2014-10-01

With the continued rise in feline obesity, novel weight management strategies are needed. To date, strategies aimed at altering physical activity, an important factor in weight maintenance, have been lacking. Photoperiod is known to cause physiological changes in seasonal mammals, including changes in body weight (BW) and reproductive status. Thus, our objective was to determine the effect of increased photoperiod (longer days) on voluntary physical activity levels, resting metabolic rate (RMR), food intake required to maintain BW, and fasting serum leptin and ghrelin concentrations in adult cats. Eleven healthy, adult, neutered, male domestic shorthair cats were used in a randomized crossover design study. During two 12-week periods, cats were exposed to either a short-day (SD) photoperiod of 8 h light: 16 h dark or a long-day (LD) photoperiod of 16 h light: 8 h dark. Cats were fed a commercial diet to maintain baseline BW. In addition to daily food intake and twice-weekly BW, RMR (via indirect calorimetry), body composition [via dual-energy X-ray absorptiometry (DEXA)] and physical activity (via Actical activity monitors) were measured at week 0 and 12 of each period. Fasting serum leptin and ghrelin concentrations were measured at week 0, 6 and 12 of each period. Average hourly physical activity was greater (p = 0.008) in LD vs. SD cats (3770 vs. 3129 activity counts/h), which was primarily due to increased (p < 0.001) dark period activity (1188 vs. 710 activity counts/h). This corresponded to higher (p < 0.0001) daily metabolizable energy intake (mean over 12-week period: 196 vs. 187 kcal/day), and increased (p = 0.048) RMR in LD cats (9.02 vs. 8.37 kcal/h). Body composition, serum leptin and serum ghrelin were not altered by photoperiod. More research is needed to determine potential mechanisms by which these physiological changes occurred and how they may apply to weight management strategies.

Low-maintenance energy requirements of obese dogs after weight loss.

PubMed

German, Alexander J; Holden, Shelley L; Mather, Nicola J; Morris, Penelope J; Biourge, Vincent

2011-10-01

Weight rebound after successful weight loss is a well-known phenomenon in humans and dogs, possibly due to the fact that energy restriction improves metabolic efficiency, reducing post-weight-loss maintenance energy requirements (MER). The aim of the present study was to estimate post-weight-loss MER in obese pet dogs that had successfully lost weight and did not subsequently rebound. A total of twenty-four obese dogs, successfully completing a weight management programme at the Royal Canin Weight Management Clinic, University of Liverpool (Wirral, UK), were included. In all dogs, a period of >14 d of stable weight ( < 1 % change) was identified post-weight loss, when food intake was constant and activity levels were stable (assessed via owners' diary records). Post-weight-loss MER was indirectly estimated by determining dietary energy consumption during this stable weight period. Multivariable linear regression was used to identify factors that were associated with post-weight-loss MER. The mean length of stable weight after weight loss was 54 (SD 34.1) d. During this time, MER was 285 (SD 54.8) kJ/kg(0.75) per d. The rate of prior weight loss and food intake during the weight-loss phase was positively associated with post-weight-loss MER, while the amount of lean tissue lost was negatively associated with post-weight-loss MER. MER are low after weight loss in obese pet dogs (typically only 10 % more than required during weight-loss MER), which has implications for what should constitute the optimal diet during this period. Preserving lean tissue during weight loss may maximise post-weight-loss MER and help prevent rebound.

Smartloss: A Personalized Mobile Health Intervention for Weight Management and Health Promotion

PubMed Central

Gilmore, L. Anne; Apolzan, John W; Myers, Candice A; Thomas, Diana M

2016-01-01

Background Synonymous with increased use of mobile phones has been the development of mobile health (mHealth) technology for improving health, including weight management. Behavior change theory (eg, the theory of planned behavior) can be effectively encapsulated into mobile phone-based health improvement programs, which is fostered by the ability of mobile phones and related devices to collect and transmit objective data in near real time and for health care or research professionals and clients to communicate easily. Objective To describe SmartLoss, a semiautomated mHealth platform for weight loss. Methods We developed and validated a dynamic energy balance model that determines the amount of weight an individual will lose over time if they are adherent to an energy intake prescription. This model was incorporated into computer code that enables adherence to a prescribed caloric prescription determined from the change in body weight of the individual. Data from the individual are then used to guide personalized recommendations regarding weight loss and behavior change via a semiautomated mHealth platform called SmartLoss, which consists of 2 elements: (1) a clinician dashboard and (2) a mobile phone app. SmartLoss includes and interfaces with a network-connected bathroom scale and a Bluetooth-connected accelerometer, which enables automated collection of client information (eg, body weight change and physical activity patterns), as well as the systematic delivery of preplanned health materials and automated feedback that is based on client data and is designed to foster prolonged adherence with body weight, diet, and exercise goals. The clinician dashboard allows for efficient remote monitoring of all clients simultaneously, which may further increase adherence, personalization of treatment, treatment fidelity, and efficacy. Results Evidence of the efficacy of the SmartLoss approach has been reported previously. The present report provides a thorough description of the SmartLoss Virtual Weight Management Suite, a professionally programmed platform that facilitates treatment fidelity and the ability to customize interventions and disseminate them widely. Conclusions SmartLoss functions as a virtual weight management clinic that relies upon empirical weight loss research and behavioral theory to promote behavior change and weight loss. PMID:26983937

Smartloss: A Personalized Mobile Health Intervention for Weight Management and Health Promotion.

PubMed

Martin, Corby K; Gilmore, L Anne; Apolzan, John W; Myers, Candice A; Thomas, Diana M; Redman, Leanne M

2016-03-16

Synonymous with increased use of mobile phones has been the development of mobile health (mHealth) technology for improving health, including weight management. Behavior change theory (eg, the theory of planned behavior) can be effectively encapsulated into mobile phone-based health improvement programs, which is fostered by the ability of mobile phones and related devices to collect and transmit objective data in near real time and for health care or research professionals and clients to communicate easily. To describe SmartLoss, a semiautomated mHealth platform for weight loss. We developed and validated a dynamic energy balance model that determines the amount of weight an individual will lose over time if they are adherent to an energy intake prescription. This model was incorporated into computer code that enables adherence to a prescribed caloric prescription determined from the change in body weight of the individual. Data from the individual are then used to guide personalized recommendations regarding weight loss and behavior change via a semiautomated mHealth platform called SmartLoss, which consists of 2 elements: (1) a clinician dashboard and (2) a mobile phone app. SmartLoss includes and interfaces with a network-connected bathroom scale and a Bluetooth-connected accelerometer, which enables automated collection of client information (eg, body weight change and physical activity patterns), as well as the systematic delivery of preplanned health materials and automated feedback that is based on client data and is designed to foster prolonged adherence with body weight, diet, and exercise goals. The clinician dashboard allows for efficient remote monitoring of all clients simultaneously, which may further increase adherence, personalization of treatment, treatment fidelity, and efficacy. Evidence of the efficacy of the SmartLoss approach has been reported previously. The present report provides a thorough description of the SmartLoss Virtual Weight Management Suite, a professionally programmed platform that facilitates treatment fidelity and the ability to customize interventions and disseminate them widely. SmartLoss functions as a virtual weight management clinic that relies upon empirical weight loss research and behavioral theory to promote behavior change and weight loss.

Social/Electronic Media Use of Children and Adolescents Who Attend the Pediatric Weight Management Programs of the COMPASS Network.

PubMed

Siegel, Robert; Fals, Angela; Mirza, Nazrat; Datto, George; Stratbucker, William; Ievers-Landis, Carolyn E; Christison, Amy; Wang, Yu; Woolford, Susan J

2015-10-01

Obesity is a major healthcare problem in youth and their social/electronic media (SEM) use has been described as a risk factor. Though much is known about the newer technologies youth use to communicate, little is known about what is used by those in weight management programs. The aim of this study was to determine what types of SEM, including sedentary and active video games, youth in weight management programs use and which they prefer for communicating with healthcare providers. This was a multisite study using a 24-question online SurveyMonkey® questionnaire. Youth, 12-17 years old, attending pediatric weight management programs at seven participating centers in the Childhood Obesity Multi Program Analysis and Study System network were eligible. There were 292 responders with a mean age of 14.2 years. Fifty-four percent were female, 36% Caucasian, 35% African American, and 33% were Hispanic. Ninety-four percent had access to a computer, 71% had Internet access, and 63% had smartphones. Whereas 87% had at least one gaming system at home, 50% reported they never played sedentary video games (71% of females vs. 25% males; p < 0.0001) and 63% never played exercise video games during the week. The preferred method of communication with a healthcare provider was face to face (60%), with few indicating a preference for communication by texting (13%), phone (12%), or social media (6%). Face-to-face communication with healthcare providers is the preferred method for youth in pediatric weight management programs. They self-reported video game use less than previously described.

Study protocol: differential effects of diet and physical activity based interventions in pregnancy on maternal and fetal outcomes--individual patient data (IPD) meta-analysis and health economic evaluation.

PubMed

Ruifrok, Anneloes E; Rogozinska, Ewelina; van Poppel, Mireille N M; Rayanagoudar, Girish; Kerry, Sally; de Groot, Christianne J M; Yeo, SeonAe; Molyneaux, Emma; McAuliffe, Fionnuala M; Poston, Lucilla; Roberts, Tracy; Riley, Richard D; Coomarasamy, Arri; Khan, Khalid; Mol, Ben Willem; Thangaratinam, Shakila

2014-11-04

Pregnant women who gain excess weight are at risk of complications during pregnancy and in the long term. Interventions based on diet and physical activity minimise gestational weight gain with varied effect on clinical outcomes. The effect of interventions on varied groups of women based on body mass index, age, ethnicity, socioeconomic status, parity, and underlying medical conditions is not clear. Our individual patient data (IPD) meta-analysis of randomised trials will assess the differential effect of diet- and physical activity-based interventions on maternal weight gain and pregnancy outcomes in clinically relevant subgroups of women. Randomised trials on diet and physical activity in pregnancy will be identified by searching the following databases: MEDLINE, EMBASE, BIOSIS, LILACS, Pascal, Science Citation Index, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, and Health Technology Assessment Database. Primary researchers of the identified trials are invited to join the International Weight Management in Pregnancy Collaborative Network and share their individual patient data. We will reanalyse each study separately and confirm the findings with the original authors. Then, for each intervention type and outcome, we will perform as appropriate either a one-step or a two-step IPD meta-analysis to obtain summary estimates of effects and 95% confidence intervals, for all women combined and for each subgroup of interest. The primary outcomes are gestational weight gain and composite adverse maternal and fetal outcomes. The difference in effects between subgroups will be estimated and between-study heterogeneity suitably quantified and explored. The potential for publication bias and availability bias in the IPD obtained will be investigated. We will conduct a model-based economic evaluation to assess the cost effectiveness of the interventions to manage weight gain in pregnancy and undertake a value of information analysis to inform future research. PROSPERO 2013: CRD42013003804.

76 FR 41501 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-14

... of infant feeding practices in the development and progression of food allergy and childhood... development; the child's family medical history; the mother's height and weight, physical activity, depression... Request; Followup Study for Infant Feeding Practices Study II AGENCY: Food and Drug Administration, HHS...

Using focus groups to identify factors affecting healthy weight maintenance in college men.

PubMed

Walsh, Jennifer R; White, Adrienne A; Greaney, Mary L

2009-06-01

Healthful eating and physical activity are important for healthy weight maintenance. The hypothesis for this study was that college-aged men would perceive factors affecting eating and physical activity as both contributing to and inhibiting healthy weight maintenance. The overall objective was to explore how men view weight maintenance in the context of these aspects. Subjects (n = 47, mean age = 20.3 +/- 1.7 years) completed an online survey, including the 51-item Three-Factor Eating Questionnaire, and participated in 1 of 6 focus groups. Three face-to-face and 3 online synchronous groups were conducted using a 15-question discussion guide to identify weight maintenance issues around eating, physical activity, and body perceptions. Weight satisfaction decreased with increase in both dietary restraint and disinhibition. Number of attempts to lose weight was positively associated with BMI (r [44] = .465, P = .01) and dietary restraint (r [44] = .515, P = .01). Findings from both focus group formats were similar. Motivators (sports performance/fitness, self-esteem, attractiveness, long-term health) were similar for eating healthfully and being physically active; however, more motivators to be physically active than to eat healthfully emerged. Enablers for eating healthfully included liking the taste, availability of healthful foods, using food rules to guide intake, having a habit of healthful eating, and internal drive/will. Barriers to healthful eating included fat in dairy foods, fruit and vegetable taste, and quick spoilage. Barriers to being physically active included lack of time/time management, obligations, being lazy, and girlfriends. Results may be used to inform future obesity prevention interventions.

Current attitudes and practices of obesity counselling by health care providers.

PubMed

Petrin, Christine; Kahan, Scott; Turner, Monique; Gallagher, Christine; Dietz, William H

Relatively few patients receive obesity counselling consistent with the USPSTF guidelines, and many health care professionals (HCPs) are biased in their attitudes towards obesity management. A national sample of family physicians, internists, OB/GYN physicians, and nurse practitioners (NPs) completed a web-based survey of beliefs, practice, and knowledge regarding obesity management. A majority of HCPs believe that it is both the patient's and the provider's responsibility to ensure that the patient is counselled about obesity. Obesity (77%), obesity-related diseases (79%), or obesity-related risk factors (71%) prompt HCPs to offer obesity counselling; 59% of HCPs wait for the patient to broach the subject of their weight. Increased blood pressure (89%) and heart disease risks (90%) are the most common themes in counselling. Across all HCPs except NPs "exercise" is discussed more frequently than "physical activity" (85% vs 81%), "diet" more frequently than "eating habits" (77% vs 75%), and "obesity" more frequently than "unhealthy weight" (60% vs 45%). NPs are more likely to discuss physical activity, eating habits, and unhealthy weight instead. To improve counselling for obesity, HCPs reported needing more time (70%), training in obesity management (53%), improved reimbursement (53%), and better tools to help patients recognise obesity risks (50%). Obesity-related diseases, risk factors, or obesity alone predict obesity counselling amongst HCPs. Better training in weight management and tools to help patients recognise risks appear to be key elements in helping patients compare the risks of what they may consider invasive therapy against the risks of continued obesity. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Development of a Weight Loss Mobile App Linked With an Accelerometer for Use in the Clinic: Usability, Acceptability, and Early Testing of its Impact on the Patient-Doctor Relationship.

PubMed

Choo, Seryung; Kim, Ju Young; Jung, Se Young; Kim, Sarah; Kim, Jeong Eun; Han, Jong Soo; Kim, Sohye; Kim, Jeong Hyun; Kim, Jeehye; Kim, Yongseok; Kim, Dongouk; Steinhubl, Steve

2016-03-31

Although complications of obesity are well acknowledged and managed by clinicians, management of obesity itself is often difficult, which leads to its underdiagnosis and undertreatment in hospital settings. However, tools that could improve the management of obesity, including self-monitoring, engagement with a social network, and open channels of communication between the patient and doctor, are limited in a clinic-based setting. The objective of our study was to evaluate the usability and acceptability of a newly developed mobile app linked with an accelerometer and its early effects on patient-doctor relationships. From September 2013 to February 2014, we developed a mobile app linked with an accelerometer as a supportive tool for a clinic-based weight loss program. The app used information from electronic health records and delivered tailored educational material. Personal goal setting, as well as monitoring of weight changes and physical activity combined with feedback, are key features of the app. We also incorporated an interactive message board for patients and doctors. During the period of March 2014 to May 2014, we tested our mobile app for 1 month in participants in a hospital clinic setting. We assessed the app's usability and acceptability, as well as the patient-doctor relationship, via questionnaires and analysis of app usage data. We recruited 30 individuals (18 male and 12 female) for the study. The median number of log-ins per day was 1.21, with the most frequently requested item being setting goals, followed by track physical activities and view personal health status. Scales of the depth of the patient-doctor relationship decreased from 27.6 (SD 4.8) to 25.1 (SD 4.5) by a Wilcoxon signed rank test (P=.02). A mobile phone app linked with an accelerometer for a clinic-based weight loss program is useful and acceptable for weight management but exhibited less favorable early effects on patient-doctor relationships.

The effect of inulin and fructo-oligosaccharide supplementation on the textural, rheological and sensory properties of bread and their role in weight management: a review.

PubMed

Morris, Cécile; Morris, Gordon A

2012-07-15

There is evidence that fructo-oligosaccharides (FOS) and inulin can impart a range of health benefits if consumed on a regular basis. The health benefits include increased mineral absorption and improved immune response and while there is mounting evidence that prebiotics play a role in colorectal cancer prevention, their role of satiety and weight management is still being investigated. In this review we look at the evidence published so far on FOS or inulin supplementation and weight management. We also establish whether prebiotic enriched breads are feasible in terms of dough machinability, bread characteristics and consumers acceptance. Addition of inulin to bread generally resulted in smaller loaves with a harder crumb and darker colour. The limited sensory studies on those products reflect those findings and acceptability decreased with inulin content. However, a fortification of 5% seems achievable. Despite evidence that yeast invertase and dry heat degrade inulin, the extent to which this is the case and whether the prebiotics maintain their activity is not known. There is still a great deal of work to be done to establish whether a bread prepared with enough inulin to retain a significant activity can be manufactured without compromising consumer acceptance. Copyright © 2012 Elsevier Ltd. All rights reserved.

Who are mobile app users from healthy lifestyle websites? Analysis of patterns of app use and user characteristics.

PubMed

Elavsky, Steriani; Smahel, David; Machackova, Hana

2017-12-01

The use of online communities and websites for health information has proliferated along with the use of mobile apps for managing health behaviors such as diet and exercise. The scarce evidence available to date suggests that users of these websites and apps differ in significant ways from non-users but most data come from US- and UK-based populations. In this study, we recruited users of nutrition, weight management, and fitness-oriented websites in the Czech Republic to better understand who uses mobile apps and who does not, including user sociodemographic and psychological profiles. Respondents aged 13-39 provided information on app use through an online survey (n = 669; M age = 24.06, SD = 5.23; 84% female). Among users interested in health topics, respondents using apps for managing nutrition, weight, and fitness (n = 403, 60%) were more often female, reported more frequent smartphone use, and more expert phone skills. In logistic regression models, controlling for sociodemographics, web, and phone activity, mHealth app use was predicted by levels of excessive exercise (OR 1.346, 95% CI 1.061-1.707, p < .01). Among app users, we found differences in types of apps used by gender, age, and weight status. Controlling for sociodemographics and web and phone use, drive for thinness predicted the frequency of use of apps for healthy eating (β = 0.14, p < .05), keeping a diet (β = 0.27, p < .001), and losing weight (β = 0.33, p < .001), whereas excessive exercise predicted the use of apps for keeping a diet (β = 0.18, p < .01), losing weight (β = 0.12, p < .05), and managing sport/exercise (β = 0.28, p < .001). Sensation seeking was negatively associated with the frequency of use of apps for maintaining weight (β = - 0.13, p < .05). These data unveil the user characteristics of mHealth app users from nutrition, weight management, and fitness websites, helping inform subsequent design of mHealth apps and mobile intervention strategies.

Comparison of a low carbohydrate and low fat diet for weight maintenance in overweight or obese adults enrolled in a clinical weight management program

PubMed Central

LeCheminant, James D; Gibson, Cheryl A; Sullivan, Debra K; Hall, Sandra; Washburn, Rik; Vernon, Mary C; Curry, Chelsea; Stewart, Elizabeth; Westman, Eric C; Donnelly, Joseph E

2007-01-01

Background Recent evidence suggests that a low carbohydrate (LC) diet may be equally or more effective for short-term weight loss than a traditional low fat (LF) diet; however, less is known about how they compare for weight maintenance. The purpose of this study was to compare body weight (BW) for participants in a clinical weight management program, consuming a LC or LF weight maintenance diet for 6 months following weight loss. Methods Fifty-five (29 low carbohydrate diet; 26 low fat diet) overweight/obese middle-aged adults completed a 9 month weight management program that included instruction for behavior, physical activity (PA), and nutrition. For 3 months all participants consumed an identical liquid diet (2177 kJ/day) followed by 1 month of re-feeding with solid foods either low in carbohydrate or low in fat. For the remaining 5 months, participants were prescribed a meal plan low in dietary carbohydrate (~20%) or fat (~30%). BW and carbohydrate or fat grams were collected at each group meeting. Energy and macronutrient intake were assessed at baseline, 3, 6, and 9 months. Results The LC group increased BW from 89.2 ± 14.4 kg at 3 months to 89.3 ± 16.1 kg at 9 months (P = 0.84). The LF group decreased BW from 86.3 ± 12.0 kg at 3 months to 86.0 ± 14.0 kg at 9 months (P = 0.96). BW was not different between groups during weight maintenance (P = 0.87). Fifty-five percent (16/29) and 50% (13/26) of participants for the LC and LF groups, respectively, continued to decrease their body weight during weight maintenance. Conclusion Following a 3 month liquid diet, the LC and LF diet groups were equally effective for BW maintenance over 6 months; however, there was significant variation in weight change within each group. PMID:17976244

Normobaric hypoxic conditioning to maximize weight loss and ameliorate cardio-metabolic health in obese populations: a systematic review.

PubMed

Hobbins, L; Hunter, S; Gaoua, N; Girard, O

2017-09-01

Normobaric hypoxic conditioning (HC) is defined as exposure to systemic and/or local hypoxia at rest (passive) or combined with exercise training (active). HC has been previously used by healthy and athletic populations to enhance their physical capacity and improve performance in the lead up to competition. Recently, HC has also been applied acutely (single exposure) and chronically (repeated exposure over several weeks) to overweight and obese populations with the intention of managing and potentially increasing cardio-metabolic health and weight loss. At present, it is unclear what the cardio-metabolic health and weight loss responses of obese populations are in response to passive and active HC. Exploration of potential benefits of exposure to both passive and active HC may provide pivotal findings for improving health and well being in these individuals. A systematic literature search for articles published between 2000 and 2017 was carried out. Studies investigating the effects of normobaric HC as a novel therapeutic approach to elicit improvements in the cardio-metabolic health and weight loss of obese populations were included. Studies investigated passive ( n = 7; 5 animals, 2 humans), active ( n = 4; all humans) and a combination of passive and active ( n = 4; 3 animals, 1 human) HC to an inspired oxygen fraction ([Formula: see text]) between 4.8 and 15.0%, ranging between a single session and daily sessions per week, lasting from 5 days up to 8 mo. Passive HC led to reduced insulin concentrations (-37 to -22%) in obese animals and increased energy expenditure (+12 to +16%) in obese humans, whereas active HC lead to reductions in body weight (-4 to -2%) in obese animals and humans, and blood pressure (-8 to -3%) in obese humans compared with a matched workload in normoxic conditions. Inconclusive findings, however, exist in determining the impact of acute and chronic HC on markers such as triglycerides, cholesterol levels, and fitness capacity. Importantly, most of the studies that included animal models involved exposure to severe levels of hypoxia ([Formula: see text] = 5.0%; simulated altitude >10,000 m) that are not suitable for human populations. Overall, normobaric HC demonstrated observable positive findings in relation to insulin and energy expenditure (passive), and body weight and blood pressure (active), which may improve the cardio-metabolic health and body weight management of obese populations. However, further evidence on responses of circulating biomarkers to both passive and active HC in humans is warranted. Copyright © 2017 the American Physiological Society.

Optimal weighted averaging of event related activity from acquisitions with artifacts.

PubMed

Vollero, Luca; Petrichella, Sara; Innello, Giulio

2016-08-01

In several biomedical applications that require the signal processing of biological data, the starting procedure for noise reduction is the ensemble averaging of multiple repeated acquisitions (trials). This method is based on the assumption that each trial is composed of two additive components: (i) a time-locked activity related to some sensitive/stimulation phenomenon (ERA, Event Related Activity in the following) and (ii) a sum of several other non time-locked background activities. The averaging aims at estimating the ERA activity under very low Signal to Noise and Interference Ratio (SNIR). Although averaging is a well established tool, its performance can be improved in the presence of high-power disturbances (artifacts) by a trials classification and removal stage. In this paper we propose, model and evaluate a new approach that avoids trials removal, managing trials classified as artifact-free and artifact-prone with two different weights. Based on the model, a weights tuning is possible and through modeling and simulations we show that, when optimally configured, the proposed solution outperforms classical approaches.

Predictors of weight loss in low-income mothers of young children.

PubMed

Clarke, Kristine K; Freeland-Graves, Jeanne; Klohe-Lehman, Deborah M; Bohman, Thomas M

2007-07-01

To identify predictors of weight loss in a tri-ethnic population of low-income mothers. An 8-week dietary and physical activity program was tested. Demographic data were collected at baseline; anthropometric, dietary, physical activity, and psychosocial data were measured at baseline and week 8. A convenience sample of 114 Hispanic, African-American, and white, low-income mothers with a body mass index > or = 25 (calculated as kg/m2) participated in the intervention. Weight-loss classes that incorporated nutrition, physical activity, and behavior modification were administered for 8 weeks. Anthropometry (body weight, weight loss). Analysis of variance, chi2 tests, and Spearman and Pearson correlations were used to test for associations between baseline and change data and total weight loss. Hierarchical regression was employed to assess the marginal importance of factors beyond socioeconomic influences. Correlates of weight loss included less satisfaction with appearance (r=0.24), greater percentage of energy from protein (r=-0.22), enhanced nutrition knowledge (r=-0.23), and higher scores for benefits of weight loss (r =-0.20) at baseline; and the change in healthful eating attitudes (r=-0.28) and social support (r=-0.21) at 8 weeks. The predictive models of baseline and change variables represented 11.4% and 13.8% of the variance, respectively. Weight-management programs serving low-income mothers should provide techniques to enhance social support, attitudes toward healthful eating, benefits of weight loss, and nutrition knowledge.

Body Weight Relationships in Early Marriage: Weight Relevance, Weight Comparisons, and Weight Talk

PubMed Central

Bove, Caron F.; Sobal, Jeffery

2011-01-01

This investigation uncovered processes underlying the dynamics of body weight and body image among individuals involved in nascent heterosexual marital relationships in Upstate New York. In-depth, semi-structured qualitative interviews conducted with 34 informants, 20 women and 14 men, just prior to marriage and again one year later were used to explore continuity and change in cognitive, affective, and behavioral factors relating to body weight and body image at the time of marriage, an important transition in the life course. Three major conceptual themes operated in the process of developing and enacting informants’ body weight relationships with their partner: weight relevance, weight comparisons, and weight talk. Weight relevance encompassed the changing significance of weight during early marriage and included attracting and capturing a mate, relaxing about weight, living healthily, and concentrating on weight. Weight comparisons between partners involved weight relativism, weight competition, weight envy, and weight role models. Weight talk employed pragmatic talk, active and passive reassurance, and complaining and critiquing criticism. Concepts emerging from this investigation may be useful in designing future studies of and approaches to managing body weight in adulthood. PMID:21864601

Postpartum weight self-management: a concept analysis.

PubMed

Ohlendorf, Jennifer M

2013-01-01

The aim of this concept analysis is to create a clear definition and framework to guide weight self-management research and promotion of healthy weight self-management during the postpartum period. A woman's ability to manage her weight through the postpartum transition has lifelong implications for her weight status. This concept analysis was guided by Walker and Avant (2005). A broad search of sources was performed, yielding 56 articles in which postpartum weight self-management was the main focus. From consideration of the attributes of postpartum weight self-management, a descriptive, situation-specific theory emerged: Postpartum weight self-management is a process by which the transition to motherhood is viewed by the woman as an opportunity to intentionally engage in healthy weight self-management behaviors by minimizing the salient inhibitors and maximizing the salient facilitators to action. This analysis provides a clarification of the process concept of postpartum weight self-management and its consequences, giving direction for measurement, clinical application, and further research. Future nursing interventions and research should be aimed at helping women to view the postpartum period as a normative transition in which they have the opportunity to take charge of their own health and the health of their family.

Weight Management

MedlinePlus

... Expectations & Goals Healthier Lifestyle Healthier Lifestyle Physical Fitness Food & Nutrition Sleep, Stress & Relaxation Emotions & Relationships HealthyYouTXT Tools Home » Weight Management Weight Management Fear of weight gain keeps a ...

Efficacy of a Pilot Internet-Based Weight Management Program (H.E.A.L.T.H.) and Longitudinal Physical Fitness Data in Army Reserve Soldiers

PubMed Central

Newton, Robert L; Han, Hongmei; Stewart, Tiffany M; Ryan, Donna H; Williamson, Donald A

2011-01-01

Background The primary aims of this article are to describe the utilization of an Internet-based weight management Web site [Healthy Eating, Activity, and Lifestyle Training Headquarters (H.E.A.L.T.H.)] over a 12–27 month period and to describe concurrent weight and fitness changes in Army Reserve soldiers. Methods The H.E.A.L.T.H. Web site was marketed to Army Reserve soldiers via a Web site promotion program for 27 months (phase I) and its continued usage was observed over a subsequent 12-month period (phase II). Web site usage was obtained from the H.E.A.L.T.H. Web site. Weight and fitness data were extracted from the Regional Level Application Software (RLAS). Results A total of 1499 Army Reserve soldiers registered on the H.E.A.L.T.H. Web site. There were 118 soldiers who returned to the H.E.A.L.T.H. Web site more than once. Registration rate reduced significantly following the removal of the Web site promotion program. During phase I, 778 Army Reserve soldiers had longitudinal weight and fitness data in RLAS. Men exceeding the screening table weight gained less weight compared with men below it (p < .007). Percentage change in body weight was inversely associated with change in fitness scores. Conclusions The Web site promotion program resulted in 52% of available Army Reserve soldiers registering onto the H.E.A.L.T.H. Web site, and 7.9% used the Web site more than once. The H.E.A.L.T.H. Web site may be a viable population-based weight and fitness management tool for soldier use. PMID:22027327

Physical Activity, Dietary Habits and Overall Health in Overweight and Obese Children and Youth with Intellectual Disability or Autism

ERIC Educational Resources Information Center

Hinckson, Erica A.; Dickinson, Annette; Water, Tineke; Sands, Madeleine; Penman, Lara

2013-01-01

In children and youth with disability, the risk of obesity is higher and is associated with lower levels of physical activity, inappropriate eating behaviors, and chronic health conditions. We determined the effectiveness of a program in managing weight, through changes in physical activity and nutrition behaviors in overweight and obese New…

Motivation and obstacles for weight management among young women - a qualitative study with a public health focus - the Tromsø study: Fit Futures.

PubMed

Sand, Anne-Sofie; Emaus, Nina; Lian, Olaug S

2017-05-08

Due to a worldwide increase in overweight and obesity, weight-management through lifestyle changes has become an important public health issue. Adolescents and young adults comprise a vulnerable group. The transition into adulthood represents a stage in life when establishing good lifestyle habits for the future is important. The aim of this study was to explore motivation and obstacles for weight reduction, weight maintenance and healthy lifestyle choices in young women. We conducted semi-structured in depth interviews with 12 young women, both overweight and normal weight, recruited from a school-based population survey. By the use of thematic analysis we searched the interview text for relevant meaning units that emerged as topics that illuminated our research questions. A strong motivation for obtaining or keeping normal weight was clearly present among the participants. Independent of weight-group, the participants described increased levels of physical activity, better eating habits and regularity in daily life as desirable changes. Parents were described as important influencers regarding lifestyle habits. Several participants expressed a need for more information about healthy nutrition and eating. Their motivation for physical activity depended on a positive social setting and elements of joy. The participants described the transition into adulthood including moving out of their parents' home and other structural changes in everyday life, as challenging. It affected their food choices and eating habits and other lifestyle issues. High costs of healthy food and sports activities were frequently mentioned among the obstacles they encountered. The results revealed an obvious motivation for lifestyle changes in individuals and environmental challenges for young women in the relevant stage of their life-course. There seems to be a need for health strategies that strengthens individuals' capacity to overcome the environmental challenges in the transition to adulthood. This should include reliable and accessible health education/information regarding healthy nutrition, eating habits, food choices and preparation of meals. Structural initiatives such as easier access to affordable healthy food and less expensive opportunities for physical activity and sports should be considered.

Adopting a healthy lifestyle when pregnant and obese - an interview study three years after childbirth.

PubMed

Dencker, Anna; Premberg, Åsa; Olander, Ellinor K; McCourt, Christine; Haby, Karin; Dencker, Sofie; Glantz, Anna; Berg, Marie

2016-07-30

Obesity during pregnancy is increasing and is related to life-threatening and ill-health conditions in both mother and child. Initiating and maintaining a healthy lifestyle when pregnant with body mass index (BMI) ≥ 30 kg/m(2) can improve health and decrease risks during pregnancy and of long-term illness for the mother and the child. To minimise gestational weight gain women with BMI ≥ 30 kg/m(2) in early pregnancy were invited to a lifestyle intervention including advice and support on diet and physical activity in Gothenburg, Sweden. The aim of this study was to explore the experiences of women with BMI ≥ 30 kg/m(2) regarding minimising their gestational weight gain, and to assess how health professionals' care approaches are reflected in the women's narratives. Semi-structured interviews were conducted with 17 women who had participated in a lifestyle intervention for women with BMI ≥ 30 kg/m(2) during pregnancy 3 years earlier. The interviews were digitally recorded and transcribed in full. Thematic analysis was used. The meaning of changing lifestyle for minimising weight gain and of the professional's care approaches is described in four themes: the child as the main motivation for making healthy changes; a need to be seen and supported on own terms to establish healthy routines; being able to manage healthy activities and own weight; and need for additional support to maintain a healthy lifestyle. To support women with BMI ≥ 30 kg/m(2) to make healthy lifestyle changes and limit weight gain during pregnancy antenatal health care providers should 1) address women's weight in a non-judgmental way using BMI, and provide accurate and appropriate information about the benefits of limited gestational weight gain; 2) support the woman on her own terms in a collaborative relationship with the midwife; 3) work in partnership to give the woman the tools to self-manage healthy activities and 4) give continued personal support and monitoring to maintain healthy eating and regular physical activity habits after childbirth involving also the partner and family.

Low weight and overweightness in older adults: risk and clinical management.

PubMed

Jahangir, Eiman; De Schutter, Alban; Lavie, Carl J

2014-01-01

The prevalence of individuals who are overweight or obese is growing exponentially in the United States and worldwide. This growth is concerning, as both overweightness and obesity lead to impaired physical function, decreased quality of life, and increased risk of chronic diseases. Additionally, overweightness and obesity are related to increased mortality among young and middle-aged adults. This weight-related risk of mortality is more ambiguous among older adults. In fact, obesity may be protective in this population, a relationship described as the "obesity paradox". In this review we discuss the effects of overweightness and obesity among the elderly on cardiovascular disease and all-cause mortality, along with the risks of low weight. We conclude by discussing the goal of weight management among older adults, focusing particularly on benefits of preserving lean body mass and muscular strength while stabilizing body fat. Ideally, overweight or mildly obese elderly individuals should devise a plan with their physicians to maintain their weight, while increasing lean body mass through a plan of healthy diet, behavioral therapy, and physical activity. Copyright © 2014 Elsevier Inc. All rights reserved.

The Proposal of Key Performance Indicators in Facility Management and Determination the Weights of Significance

NASA Astrophysics Data System (ADS)

Rimbalová, Jarmila; Vilčeková, Silvia

2013-11-01

The practice of facilities management is rapidly evolving with the increasing interest in the discourse of sustainable development. The industry and its market are forecasted to develop to include non-core functions, activities traditionally not associated with this profession, but which are increasingly being addressed by facilities managers. The scale of growth in the built environment and the consequential growth of the facility management sector is anticipated to be enormous. Key Performance Indicators (KPI) are measure that provides essential information about performance of facility services delivery. In selecting KPI, it is critical to limit them to those factors that are essential to the organization reaching its goals. It is also important to keep the number of KPI small just to keep everyone's attention focused on achieving the same KPIs. This paper deals with the determination of weights of KPI of FM in terms of the design and use of sustainable buildings.

Conceptual Model of Weight Management in Overweight and Obese African-American Females.

PubMed

Sutton, Suzanne M; Magwood, Gayenell S; Nemeth, Lynne S; Jenkins, Carolyn M

2017-04-01

Weight management of overweight and obese (OWO) African-American females (AAFs) is a poorly defined concept, leading to ineffective treatment of overweight and obesity, prevention of health sequelae, and risk reduction. A conceptual model of the phenomenon of weight management in OWO AAFs was developed through dimensional analysis of the literature. Constructs were identified and sorted into the dimensions of perspective, context, conditions, process, and consequences and integrated into an explanatory matrix. Through dimensional analysis, weight management in OWO AAFs was characterized as a multidimensional concept, defined from the perspective of weight loss in community-dwelling AAFs. Behaviors associated with weight management are strongly influenced by intrinsic factors and extrinsic conditions, which influence engagement in the processes and consequences of weight management. The resulting conceptual model of weight management in OWO AAFs provides a framework for research interventions applicable in a variety of settings. © 2016 Wiley Periodicals, Inc.

Short-Term Efficacy of an Innovative Mobile Phone Technology-Based Intervention for Weight Management for Overweight and Obese Adolescents: Pilot Study.

PubMed

Chen, Jyu-Lin; Guedes, Claudia M; Cooper, Bruce A; Lung, Audrey E

2017-08-02

In the United States, approximately one-third of adolescents are now overweight or obese, and one in six is obese. This financial cost and the larger nonfinancial costs of obesity make obesity prevention and management for adolescents imperative for the health of the nation. However, primary care visits are typically brief, and primary care providers may lack adequate resources to help overweight or obese adolescents to manage weight issues. To augment the efficacy of primary care visits for adolescent weight management, mobile phone technology can be used as an adjunct treatment that provides additional opportunities for encouraging improvement in lifestyle, attainment, and maintenance of healthy weight. The purposes of this study were to (1) measure effects of an innovative mobile phone technology-based intervention for overweight and obese adolescents and to (2) examine the intervention's feasibility for use in primary care clinics. The mobile phone-based intervention had three components: use of the Fitbit Flex, participation in an online educational program, and receipt of biweekly text messages during the maintenance phase. A randomized controlled study design was utilized. Data regarding anthropometrics (body mass index [BMI] and waist-to-hip ratio), blood pressure, levels of physical and sedentary activity, diet, and self-efficacy regarding physical activity and diet were collected at baseline and at 3 and 6 months after the baseline assessment. A total of 40 adolescents participated in the study. At the 6-month follow-up visit, compared to participants in the control group, the mobile phone-based intervention participants had significant improvement in BMI (z=-4.37, P=.001), diastolic blood pressure (z=-3.23, P=.001), physical activity days per week (z=2.58, P=.01), TV and computer time (z=-3.34, P=.001), servings of fruits and vegetables per day (z=2.74, P=.006), servings of soda and sweetened drinks (z=-3.19, P=.001), physical activity self-efficacy (z=2.75, P=.006), and dietary self-efficacy (z=5.05, P=.001). Medium to large effect sizes were found in these outcome variables. The use of mobile technologies may offer a practical, reliable adjunct to weight management for overweight and obese adolescents in busy primary care clinics serving adolescents. Clinicaltrials.gov NCT 01693250; https://clinicaltrials.gov/ct2/show/NCT01693250? term=Adolescent+ obesity+AND+mhealth&rank=5 (Archived by WebCite at ). ©Jyu-Lin Chen, Claudia M Guedes, Bruce A Cooper, Audrey E Lung. Originally published in the Interactive Journal of Medical Research (http://www.i-jmr.org/), 02.08.2017.

[Wellness-activities to prevent metabolic syndrome among patients with schizophrenia].

PubMed

Brönner, Monika; Betz, Christine; Christ, Sarah; Froböse, Teresa; Pitschel-Walz, Gabi; Bäuml, Josef

2010-01-01

Weight gain and metabolic disturbances are growing side effects of a modern antipsychotic therapy. Different programs were developed to reduce them. This article gives an overview of existing and evaluated programs. A literature research was made through PubMed. Relevant reviews and intervention studies were identified. Studies with the main outcome variable of weight reductions are numerous, even randomised controlled trials. Short-term weight loss under antipsychotic treatment is possible, but there is still a lack of long-term studies. Life style interventions, which include e. g. physical exercise, are not that common. Also, interventions such as wellness-activities, which contribute by means of adequate motivation strategies to an enhancement of the general well-being, are still missing. Present results turned out to be positive. Further programs which exceed weight management are required. There is necessity for more studies with consistent outcome variables and methods, especially long-term programs. Georg Thieme Verlag KG Stuttgart, New York.

My student body: effects of an internet-based prevention program to decrease obesity among college students.

PubMed

Lachausse, Robert G

2012-01-01

To determine the impact of My Student Body (MSB)-Nutrition, an Internet-based obesity prevention program for college students. Three hundred and twenty ethnically diverse undergraduate students were randomly assigned to 1 of 3 conditions: MSB-Nutrition program, an on-campus weight management course, and a comparison group. Students completed baseline and follow-up surveys regarding their nutrition and physical activity behaviors, self-efficacy, stress, attitudes, and body weight. Compared with the on-campus course and a comparison group, the MSB-Nutrition program increased fruit and vegetable consumption, reduced stress, and increased fruit and vegetable self-efficacy but had no significant effect on students' exercise self-efficacy, exercise behavior, or weight loss. The MSB-Nutrition program was effective in changing students' nutrition behaviors but had no effect on physical activity behaviors or weight loss. Suggestions for improving Internet-based interventions aimed at decreasing obesity rates among college students are offered.

Using Qualitative Methods to Understand Physical Activity and Weight Management Among Bangladeshis in New York City, 2013

PubMed Central

Riley, Lindsey; Mili, Saima; Trinh-Shevrin, Chau

2016-01-01

Introduction South Asians experience high rates of cardiovascular disease and type 2 diabetes, coupled with low rates of reported physical activity. We report findings from a qualitative sub-study that was conducted in 2013 among Bangladeshi immigrants in New York City to understand factors that affect physical activity practices and weight management in this community. Methods Qualitative study participants were recruited from community-based settings. Sex-specific focus groups were conducted by trained community health workers. Proceedings were audio-recorded for translation and transcription and coded using a constant comparative approach. Data were coded using Atlas.ti software. Results Six focus groups were completed with a final sample of 67 participants (63% male, 37% female). Mean participant age was 42 years; mean years of residence in the United States was 12. Key themes that emerged were beliefs about modesty and sex-separated facilities that may prevent women from engaging in physical activity. Distinctions were made between men and women about what constitutes exercise versus physical activity; religious prayer was considered to be health-promoting because of the movement involved. Other important themes that emerged were cultural dietary practices and evolving conceptions of healthy weight. Conclusion Tailored interventions that take into account the cultural context of this growing community are needed. Findings may also provide insight into barriers to health promotion experienced by other US Muslim communities, which are growing rapidly. PMID:27390073

Effects of management in gestational diabetes mellitus with normal prepregnancy body mass index on pregnancy outcomes and placental ultrastructures: a prospective cohort study.

PubMed

Han, Yun; Zheng, Yan-Li; Wu, Ai-Min; Liu, Hong-Bin; Su, Jian-Bin; Lu, Xiao-Yan; Han, Yu-Wen; Ji, Jin-Long; Ji, Ju-Hua; Shi, Yue

2016-12-01

A great quantity of gestational diabetes mellitus with normal prepregnancy body mass index have emerged with the new criteria of gestational diabetes mellitus in China based on the International Diabetes in Pregnancy Consensus group criteria, and understanding placental changes and how they affect outcomes are necessary in order to develop effective management approach. The aim of this study was to prospectively explore the effect of active management starting from the late second trimester in gestational diabetes mellitus women with normal prepregnancy body mass index on pregnancy outcomes and placental ultrastructures, and to provide scientific evidences for optimizing the management of gestational diabetes mellitus in China. Gestational diabetes mellitus women with normal prepregnancy body mass index in the same period of this prospective cohort study were divided into intervention group (n = 51) and control group (n = 55). The intervention group was managed rigorously, while the control group received conventional prenatal cares. The glucose profile, gestational weight gain and pregnancy outcomes were followed up and placental ultrastructures were observed and recorded by transmission electron microscopy. The blood glucose level and gestational weight gain in intervention group were significantly better controlled than those in control group (P < 0.01). The incidences of fetal distress, cesarean section and large for gestational age were significantly lower in intervention group than in control group (P < 0.05). There was a significant reduction in the incidence of abnormal placental ultrastructure in the intervention group (P < 0.01). After adjustment for confounding factors, the undesirable glycemic control and conventional management were related to abnormal placental ultrastructure (P < 0.05). Meanwhile, the undesirable glycemic control, abnormal placental ultrastructure and conventional management made sense in the incidence of fetal distress (P < 0.05), and the target glycemic control, recommend weight gain and active management were associated with reductions in the prevalence of cesarean delivery and large for gestational age (P < 0.05). The active management of gestational diabetes mellitus women with normal prepregnancy body mass index can improve pregnancy outcomes and placental ultrastructures, and the abnormal placental ultrastructure might be closely associated with the undesirable glycemic control and adverse pregnancy outcomes.

[Experiences of a nation-wide integrated program for healthy body weight among students].

PubMed

Liou, Yiing Mei; Chen, Mei-Yen; Chiang, Li-Chi; Chien, Li-Yin; Chang, Po-Lun; Hung, Yung-Tai

2007-10-01

Taiwan has good support systems for obesity prevention and management. The percentage of elementary school students with normal body weight, however, has undergone a sustained decrease to 55%. Many factors are associated with this trend, such as lack of physical activity, dissatisfaction with body image, unbalanced dietary pattern, and unsupportive environment. Even though the rate of overweight and obesity is under control, the rate of underweight among girls has undergone a sustained increase, to 28%. Nurses therefore organized the "Aid students to fit" project, which emphasizes the bipolar issue of overweight and underweight. This national project is sponsored by the Ministry of Education and is expected to establish a beneficial environment, in which students can easily adopt healthy lifestyles and increase self-esteem. The program incorporates the AID triangle concept (Active, Image, Diet) and five strategies for achieving the goals. These strategies are: 1. Develop a persuasive statement to fit in with the philosophies of parents, students and teachers. 2. Set up measurable behavior indices and slogans. (Active life: 210 minutes per week. Image: confident and elegant. Diet: balanced and wise choice of low fat and high fiber foods.) 3. Establish a nation-wide interactive surveillance system for body weight control. 4. Develop an internet system that emphasizes tailored case management for overweight students. 5. Develop a supportive teaching plan, material, and aids to promote a healthy school environment. Five modeling schools, moreover, can be used to demonstrate the program. Educators can also download a free teaching plan, material, and aids at the website for healthy weight management (www.ym.edu.tw/active/aid). The authors brought together scholars from eight universities to accomplish the program. In support of the program, the Taiwan Ministry of Education addressed the new recommendation for physical activity which is to engage in moderate intensity physical activity every day for 30 minutes. We also shared this unique Asian experience at the round table discussion addressing the practical and policy issues of implementing public health strategies to reduce physical inactivity and prevent obesity in children. This was hosted by the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) Collaborating Center for Physical Activity in order to establish declarations and recommendations for the prevention of obesity in children.

Effect of psychological distress on weight concern and weight control behaviors.

PubMed

Roohafza, Hamidreza; Kabir, Ali; Sadeghi, Masoumeh; Shokouh, Pedram; Aalaei-Andabili, Seyed Hossein; Mehrabi, Yadollah; Sarrafzadegan, Nizal

2014-09-01

Obesity is associated with chronic disorders like coronary artery diseases, metabolic syndrome, cancers, and psychiatric disorders. Stress may contribute to weight gain by disrupting weight concern, and lead to uncontrolled eating behavior. This study aimed to investigate the effects of stress on weight concern and control behaviors in normal weight and obese adults. A total of 9544 subjects were selected by multi-stage random sampling from three provinces in central Iran. Information related to weight concern and control behavior was registered in normal weight and obese participants. Psychological distress was measured by a 12-item General Health Questionnaire (GHQ-12) and subjects were divided into high and low stress groups. Logistic regression was used for analysis. The mean age of participants was 38.7 ± 15.5 years and 50% (4772) of them were males. The adjusted odds ratio (OR) for age, sex and education of high stress to low stress level for weight concern, weight control behavior and acceptable physical activity behavior was more than 1; but the OR was less than 1 for waist circumference, obesity and healthy diet behavior. Among obese participants, higher levels of stress were associated with lower weight concern with OR, 95%CI: 0.821, (0.682 - 0.988), lower acceptable physical activity with OR = 0.833, 95%CI: (0.624 - 0.912), but higher rates of healthy diet behavior with OR = 1.360, 95% CI: (1.040 - 1.780). Individuals with high stress level have lower weight concern and lower physical activity; therefore, they are prone to weight gain and obesity. It could be concluded that stress management should be considered as a crucial component of obesity prevention and control programs.

When weight management lasts. Lower perceived rule complexity increases adherence.

PubMed

Mata, Jutta; Todd, Peter M; Lippke, Sonia

2010-02-01

Maintaining behavior change is one of the major challenges in weight management and long-term weight loss. We investigated the impact of the cognitive complexity of eating rules on adherence to weight management programs. We studied whether popular weight management programs can fail if participants find the rules too complicated from a cognitive perspective, meaning that individuals are not able to recall or process all required information for deciding what to eat. The impact on program adherence of participants' perceptions of eating rule complexity and other behavioral factors known to influence adherence (including previous weight management, self-efficacy, and planning) was assessed via a longitudinal online questionnaire given to 390 participants on two different popular weight management regimens. As we show, the regimens, Weight Watchers and a popular German recipe diet (Brigitte), strongly differ in objective rule complexity and thus their cognitive demands on the dieter. Perceived rule complexity was the strongest factor associated with increased risk of quitting the cognitively demanding weight management program (Weight Watchers); it was not related to adherence length for the low cognitive demand program (Brigitte). Higher self-efficacy generally helped in maintaining a program. The results emphasize the importance of considering rule complexity to promote long-term weight management. 2009 Elsevier Ltd. All rights reserved.

Reliability and concurrent and construct validity of the Strategies for Weight Management measure for adults.

PubMed

Kolodziejczyk, Julia K; Norman, Gregory J; Rock, Cheryl L; Arredondo, Elva M; Roesch, Scott C; Madanat, Hala; Patrick, Kevin

2016-01-01

This study evaluates the reliability and validity of the strategies for weight management (SWM) measure, a questionnaire that assesses weight management strategies for adults. The SWM includes 20 items that are categorized within the following subscales: (1) energy intake, (2) energy expenditure, (3) self-monitoring, and (4) self-regulation. Baseline and 6-month data were collected from 404 overweight/obese adults (mean age=22±3.8 years, 68% ethnic minority) enrolled in a randomized controlled trial aiming to reduce weight by improving diet and physical activity behaviours. Reliability and validity were assessed for each subscale separately. Cronbach alpha was conducted to assess reliability. Concurrent, construct I (sensitivity to the study treatment condition), and construct II (relationship to the outcomes) validity were assessed using linear regressions with the following outcome measures: weight, self-reported diet, and weekly energy expenditure. All subscales showed strong internal consistency. The strength of the validity evidence depended on subscale and validity type. The strongest validity evidence was concurrent validity of the energy intake and energy expenditure subscales; construct I validity of the energy intake and self-monitoring subscales; and construct II validity of the energy intake, energy expenditure, and self-regulation subscales. Results indicate that the SWM can be used to assess weight management strategies among an ethnically diverse sample of adults as each subscale showed evidence of reliability and select types of validity. As validity is an accumulation of evidence over multiple studies, this study provides initial reliability and validity evidence in one population segment. Copyright © 2015 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Middle-aged women's decisions about body weight management: needs assessment and testing of a knowledge translation tool.

PubMed

Stacey, Dawn; Jull, Janet; Beach, Sarah; Dumas, Alex; Strychar, Irene; Adamo, Kristi; Brochu, Martin; Prud'homme, Denis

2015-04-01

This study aims to assess middle-aged women's needs when making body weight management decisions and to evaluate a knowledge translation tool for addressing their needs. A mixed-methods study used an interview-guided theory-based survey of professional women aged 40 to 65 years. The tool summarized evidence to address their needs and enabled women to monitor actions taken. Acceptability and usability were reported descriptively. Sixty female participants had a mean body mass index of 28.0 kg/m(2) (range, 17.0-44.9 kg/m(2)), and half were premenopausal. Common options for losing (82%) or maintaining (18%) weight included increasing physical activity (60%), eating healthier (57%), and getting support (40%). Decision-making involved getting information on options (52%), soliciting others' decisions/advice (20%), and being self-motivated (20%). Preferred information sources included written information (97%), counseling (90%), and social networking websites (43%). Five professionals (dietitian, personal trainer, occupational therapist, and two physicians) had similar responses. Of 53 women sent the tool, 27 provided acceptability feedback. They rated it as good to excellent for information on menopause (96%), body weight changes (85%), and managing body weight (85%). Most would tell others about it (81%). After 4 weeks of use, 25 women reported that the wording made sense (96%) and that the tool had clear instructions (92%) and was easy to use across time (88%). The amount of information was rated as just right (64%), but the tool had limited space for responding (72%). When making decisions about body weight management, women's needs were "getting information" and "getting support." The knowledge translation tool was acceptable and usable, but further evaluation is required.

Middle-aged women’s decisions about body weight management: needs assessment and testing of a knowledge translation tool

PubMed Central

Stacey, Dawn; Jull, Janet; Beach, Sarah; Dumas, Alex; Strychar, Irene; Adamo, Kristi; Brochu, Martin; Prud’homme, Denis

2015-01-01

Abstract Objective This study aims to assess middle-aged women’s needs when making body weight management decisions and to evaluate a knowledge translation tool for addressing their needs. Methods A mixed-methods study used an interview-guided theory-based survey of professional women aged 40 to 65 years. The tool summarized evidence to address their needs and enabled women to monitor actions taken. Acceptability and usability were reported descriptively. Results Sixty female participants had a mean body mass index of 28.0 kg/m2 (range, 17.0-44.9 kg/m2), and half were premenopausal. Common options for losing (82%) or maintaining (18%) weight included increasing physical activity (60%), eating healthier (57%), and getting support (40%). Decision-making involved getting information on options (52%), soliciting others’ decisions/advice (20%), and being self-motivated (20%). Preferred information sources included written information (97%), counseling (90%), and social networking websites (43%). Five professionals (dietitian, personal trainer, occupational therapist, and two physicians) had similar responses. Of 53 women sent the tool, 27 provided acceptability feedback. They rated it as good to excellent for information on menopause (96%), body weight changes (85%), and managing body weight (85%). Most would tell others about it (81%). After 4 weeks of use, 25 women reported that the wording made sense (96%) and that the tool had clear instructions (92%) and was easy to use across time (88%). The amount of information was rated as just right (64%), but the tool had limited space for responding (72%). Conclusions When making decisions about body weight management, women’s needs were “getting information” and “getting support.” The knowledge translation tool was acceptable and usable, but further evaluation is required. PMID:25816120

The Penn State Heart Assistant: A pilot study of a web-based intervention to improve self-care of heart failure patients.

PubMed

Lloyd, Tom; Buck, Harleah; Foy, Andrew; Black, Sara; Pinter, Antony; Pogash, Rosanne; Eismann, Bobby; Balaban, Eric; Chan, John; Kunselman, Allen; Smyth, Joshua; Boehmer, John

2017-05-01

The Penn State Heart Assistant, a web-based, tablet computer-accessed, secure application was developed to conduct a proof of concept test, targeting patient self-care activities of heart failure patients including daily medication adherence, weight monitoring, and aerobic activity. Patients (n = 12) used the tablet computer-accessed program for 30 days-recording their information and viewing a short educational video. Linear random coefficient models assessed the relationship between weight and time and exercise and time. Good medication adherence (66% reporting taking 75% of prescribed medications) was reported. Group compliance over 30 days for weight and exercise was 84 percent. No persistent weight gain over 30 days, and some indication of weight loss (slope of weight vs time was negative (-0.17; p value = 0.002)), as well as increased exercise (slope of exercise vs time was positive (0.08; p value = 0.04)) was observed. This study suggests that mobile technology is feasible, acceptable, and has potential for cost-effective opportunities to manage heart failure patients safely at home.

Designing for psychological change: individuals' reward and cost valuations in weight management.

PubMed

Hsu, Anne; Blandford, Ann

2014-06-26

Knowledge of the psychological constructs that underlie behavior offers valuable design opportunities for persuasive systems. We use the decision theory, which describes how behavior is underpinned by reward-cost valuations, as a framework for investigating such psychological constructs to deliver design objectives for weight management technologies. We applied a decision theory-based analysis in the domain of weight management to understand the rewards and costs that surround individuals' weight management behaviors, with the aim of uncovering design opportunities for weight management technologies. We conducted qualitative interviews with 15 participants who were or had been trying to lose weight. Thematic analysis was used to extract themes that covered the rewards and costs surrounding weight management behaviors. We supplemented our qualitative study with a quantitative survey of 100 respondents investigating the extent to which they agreed with statements reflecting themes from the qualitative study. The primary obstacles to weight management were the rewards associated with unhealthy choices, such as the pleasures of unhealthy foods and unrestricted consumption in social situations, and the significant efforts required to change habits, plan, and exercise. Psychological constructs that supported positive weight management included feeling good after making healthy choices, being good to oneself, experiencing healthy yet still delicious foods, and receiving social support and encouraging messages (although opinions about encouraging messages was mixed). A rewards-costs driven enquiry revealed a wide range of psychological constructs that contribute to discouraging and supporting weight management. The constructs extracted from our qualitative study were verified by our quantitative survey, in which the majority of respondents also reported similar thoughts and feelings. This understanding of the rewards and costs surrounding weight management offers a range of new opportunities for the design of weight management technologies that enhance the encouraging factors and alleviate the discouraging ones.

Mobile applications for obesity and weight management: current market characteristics.

PubMed

Nikolaou, C K; Lean, M E J

2017-01-01

Mobile-Health (mHealth) is the fastest-developing eHealth sector, with over 100 000 health applications (apps) currently available. Overweight/obesity is a problem of wide public concern that is potentially treatable/preventable through mHealth. This study describes the current weight-management app-market. Five app stores (Apple, Google, Amazon, Windows and Blackberry) in UK, US, Russia, Japan and Germany, Italy, France, China, Australia and Canada were searched for keywords: 'weight', 'calorie', 'weight-loss', 'slimming', 'diet', 'dietitian' and 'overweight' in January/February 2016 using App-Annie software. The 10 most downloaded apps in the lifetime of an app were recorded. Developers' lists and the app descriptions were searched to identify any professional input with keywords 'professional', 'dietitian' and 'nutritionist'. A total of 28 905 relevant apps were identified as follows: Apple iTunes=8559 (4634, 54% paid), Google Play=1762 (597, 33.9% paid), Amazon App=13569 (4821, 35.5% paid), Windows=2419 (819, 17% paid) and Blackberry=2596 (940, 36% paid). The 28 905 identified apps focused mainly on physical activity (34%), diet (31%), and recording/monitoring of exercise, calorie intake and body weight (23%). Only 17 apps (0.05%) were developed with identifiable professional input. Apps on weight management are widely available and very popular but currently lack professional content expertise. Encouraging app development based on evidence-based online approaches would assure content quality, allowing healthcare professionals to recommend their use.

Tools for Successful Weight Management in Primary Care

PubMed Central

Turer, Christy Boling

2015-01-01

Obesity is one of the most pervasive and costly public-health problems. Clinicians need effective tools to address weight management in primary care, including evaluation and communication methods, guideline-based weight-management interventions, and safe and effective weight-loss medications and surgery. The objective of this Grand-Rounds presentation is to provide practicing clinicians with the latest information regarding effective ways to care for and communicate with patients about weight loss; evidence-based guidelines for selecting weight-management therapies; and safety, efficacy, and adverse effects of weight-loss medications and surgery. PMID:26218666

General practitioners' views and experiences of counselling for physical activity through the New Zealand Green Prescription program.

PubMed

Patel, Asmita; Schofield, Grant M; Kolt, Gregory S; Keogh, Justin W L

2011-11-02

Regular physical activity is beneficial in both the prevention and management of chronic health conditions. A large proportion of adult New Zealanders, however, are insufficiently active. To help increase population levels of physical activity in New Zealand the Green Prescription, a primary care physical activity scripting program, was developed. The primary aim of this study was to identify why general practitioners (GPs) counsel for physical activity and administer Green Prescriptions. A secondary aim was to examine GPs' views and experiences of Green Prescription counselling for the management of depression. Individual face-to-face interviews were conducted with 15 GPs. All interviews were audio-taped and transcribed. Data were analysed using an inductive thematic approach. Several themes and sub-themes emerged from the data. Notably, GPs counselled for physical activity and prescribed Green Prescriptions for both primary preventive (e.g., weight control) and secondary management (e.g., diabetes management) purposes. GPs reported the benefits of the Green Prescription centred around two main themes: (i) a non-medication approach to a healthier lifestyle and (ii) the support benefits of physical activity. Time constraints within the consultation was the only main theme that emerged regarding the barriers GPs perceived to Green Prescription use. Physical activity in general, and physical activity prescribed through the Green Prescription, were also viewed by GPs as beneficial for the management of depression. The results of this study suggest that New Zealand GPs view the Green Prescription program as beneficial for their patients with pre-existing conditions and/or weight problems. While this is encouraging, the Green Prescription may also be used to promote physical activity in currently healthy but low-active and sedentary individuals. Such individuals are currently disease free, but are at risk for future health-related problems because of their inactive lifestyle. It is recommended that time constraints of the consultation in regard to administering Green Prescriptions could be dealt with by delegating the more time consuming tasks to the patient support counsellors that support the Green Prescription program, and having practice nurses assist in the administration of Green Prescriptions. Green Prescription counselling in conjunction with antidepressant medication may be beneficial for the management of depression and warrants further research.

General practitioners' views and experiences of counselling for physical activity through the New Zealand Green Prescription program

PubMed Central

2011-01-01

Background Regular physical activity is beneficial in both the prevention and management of chronic health conditions. A large proportion of adult New Zealanders, however, are insufficiently active. To help increase population levels of physical activity in New Zealand the Green Prescription, a primary care physical activity scripting program, was developed. The primary aim of this study was to identify why general practitioners (GPs) counsel for physical activity and administer Green Prescriptions. A secondary aim was to examine GPs' views and experiences of Green Prescription counselling for the management of depression. Methods Individual face-to-face interviews were conducted with 15 GPs. All interviews were audio-taped and transcribed. Data were analysed using an inductive thematic approach. Results Several themes and sub-themes emerged from the data. Notably, GPs counselled for physical activity and prescribed Green Prescriptions for both primary preventive (e.g., weight control) and secondary management (e.g., diabetes management) purposes. GPs reported the benefits of the Green Prescription centred around two main themes: (i) a non-medication approach to a healthier lifestyle and (ii) the support benefits of physical activity. Time constraints within the consultation was the only main theme that emerged regarding the barriers GPs perceived to Green Prescription use. Physical activity in general, and physical activity prescribed through the Green Prescription, were also viewed by GPs as beneficial for the management of depression. Conclusions The results of this study suggest that New Zealand GPs view the Green Prescription program as beneficial for their patients with pre-existing conditions and/or weight problems. While this is encouraging, the Green Prescription may also be used to promote physical activity in currently healthy but low-active and sedentary individuals. Such individuals are currently disease free, but are at risk for future health-related problems because of their inactive lifestyle. It is recommended that time constraints of the consultation in regard to administering Green Prescriptions could be dealt with by delegating the more time consuming tasks to the patient support counsellors that support the Green Prescription program, and having practice nurses assist in the administration of Green Prescriptions. Green Prescription counselling in conjunction with antidepressant medication may be beneficial for the management of depression and warrants further research. PMID:22044577

Evaluation of a type 2 diabetes prevention program using a commercial weight management provider for non-diabetic hyperglycemic patients referred by primary care in the UK

PubMed Central

Piper, Carolyn; Marossy, Agnes; Griffiths, Zoe; Adegboye, Amanda

2017-01-01

Objectives To determine if a diabetes prevention program (DPP) delivered by a commercial weight management provider using a UK primary care referral pathway could reduce the progression to type 2 diabetes (T2D) in those diagnosed with non-diabetic hyperglycemia (NDH—being at high risk of developing T2D). Research design This is a quasi-experimental translational research study. Methods 14 primary care practices identified, recruited and referred patients with NDH (fasting plasma glucose ≥5.5 to ≤6.9 mmol/L and/or glycated hemoglobin (HbA1c) ≥42 to 47 mmol/mol (6.0%–6.4%)) and a body mass index (BMI) ≥30 kg/m2 to a DPP. Eligible patients were asked to contact Weight Watchers to book onto their DPP, an intensive lifestyle intervention which included a 90 min activation session followed by the offer of 48 weekly Weight Watchers community group meetings. Patients’ blood tests were repeated by primary care, weight change plus self-reported data was recorded by Weight Watchers. Results 166 patients were referred to the program and 149 were eligible. 79% of eligible patients attended an activation session (117 eligible patients) and 77% started the weekly sessions. The study sample was primarily female (75%), white (90%), with 5% living in the most deprived quintile in the UK. Using intention-to-treat analysis, the DPP resulted in a mean reduction in HbA1c of 2.84 mmol/mol at 12 months (from 43.42±1.28 to 40.58±3.41, p<0.01). 38% of patients returned to normoglycemia and 3% developed T2D at 12 months. There was a mean weight reduction in BMI of 3.2 kg/m2 at 12 months (35.5 kg/m2±5.4 to 32.3 kg/m2±5.2, p<0.01). Conclusion A UK primary care referral route partnered with this commercial weight management provider can deliver an effective DPP. The lifestyle changes and weight loss achieved in the intervention translated into considerable reductions in diabetes risk, with an immediate and significant public health impact. PMID:29225891

Evaluation of a type 2 diabetes prevention program using a commercial weight management provider for non-diabetic hyperglycemic patients referred by primary care in the UK.

PubMed

Piper, Carolyn; Marossy, Agnes; Griffiths, Zoe; Adegboye, Amanda

2017-01-01

To determine if a diabetes prevention program (DPP) delivered by a commercial weight management provider using a UK primary care referral pathway could reduce the progression to type 2 diabetes (T2D) in those diagnosed with non-diabetic hyperglycemia (NDH-being at high risk of developing T2D). This is a quasi-experimental translational research study. 14 primary care practices identified, recruited and referred patients with NDH (fasting plasma glucose ≥5.5 to ≤6.9 mmol/L and/or glycated hemoglobin (HbA1c) ≥42 to 47 mmol/mol (6.0%-6.4%)) and a body mass index (BMI) ≥30 kg/m 2 to a DPP. Eligible patients were asked to contact Weight Watchers to book onto their DPP, an intensive lifestyle intervention which included a 90 min activation session followed by the offer of 48 weekly Weight Watchers community group meetings. Patients' blood tests were repeated by primary care, weight change plus self-reported data was recorded by Weight Watchers. 166 patients were referred to the program and 149 were eligible. 79% of eligible patients attended an activation session (117 eligible patients) and 77% started the weekly sessions. The study sample was primarily female (75%), white (90%), with 5% living in the most deprived quintile in the UK. Using intention-to-treat analysis, the DPP resulted in a mean reduction in HbA1c of 2.84 mmol/mol at 12 months (from 43.42±1.28 to 40.58±3.41, p<0.01). 38% of patients returned to normoglycemia and 3% developed T2D at 12 months. There was a mean weight reduction in BMI of 3.2 kg/m 2 at 12 months (35.5 kg/m 2 ±5.4 to 32.3 kg/m 2 ±5.2, p<0.01). A UK primary care referral route partnered with this commercial weight management provider can deliver an effective DPP. The lifestyle changes and weight loss achieved in the intervention translated into considerable reductions in diabetes risk, with an immediate and significant public health impact.

A qualitative evidence synthesis on the management of male obesity

PubMed Central

Archibald, Daryll; Douglas, Flora; Hoddinott, Pat; van Teijlingen, Edwin; Stewart, Fiona; Robertson, Clare; Boyers, Dwayne; Avenell, Alison

2015-01-01

Objectives To investigate what weight management interventions work for men, with which men, and under what circumstances. Design Realist synthesis of qualitative studies. Data sources Sensitive searches of 11 electronic databases from 1990 to 2012 supplemented by grey literature searches. Study selection Studies published between 1990 and 2012 reporting qualitative research with obese men, or obese men in contrast to obese women and lifestyle or drug weight management were included. The studies included men aged 16 years or over, with no upper age limit, with a mean or median body mass index of 30 kg/m2 in all settings. Results 22 studies were identified, including 5 qualitative studies linked to randomised controlled trials of weight maintenance interventions and 8 qualitative studies linked to non-randomised intervention studies, and 9 relevant UK-based qualitative studies not linked to any intervention. Health concerns and the perception that certain programmes had ‘worked’ for other men were the key factors that motivated men to engage with weight management programmes. Barriers to engagement and adherence with programmes included: men not problematising their weight until labelled ‘obese’; a lack of support for new food choices by friends and family, and reluctance to undertake extreme dieting. Retaining some autonomy over what is eaten; flexibility about treats and alcohol, and a focus on physical activity were attractive features of programmes. Group interventions, humour and social support facilitated attendance and adherence. Men were motivated to attend programmes in settings that were convenient, non-threatening and congruent with their masculine identities, but men were seldom involved in programme design. Conclusions Men's perspectives and preferences within the wider context of family, work and pleasure should be sought when designing weight management services. Qualitative research is needed with men to inform all aspects of intervention design, including the setting, optimal recruitment processes and strategies to minimise attrition. PMID:26459486

A qualitative evidence synthesis on the management of male obesity.

PubMed

Archibald, Daryll; Douglas, Flora; Hoddinott, Pat; van Teijlingen, Edwin; Stewart, Fiona; Robertson, Clare; Boyers, Dwayne; Avenell, Alison

2015-10-12

To investigate what weight management interventions work for men, with which men, and under what circumstances. Realist synthesis of qualitative studies. Sensitive searches of 11 electronic databases from 1990 to 2012 supplemented by grey literature searches. Studies published between 1990 and 2012 reporting qualitative research with obese men, or obese men in contrast to obese women and lifestyle or drug weight management were included. The studies included men aged 16 years or over, with no upper age limit, with a mean or median body mass index of 30 kg/m(2) in all settings. 22 studies were identified, including 5 qualitative studies linked to randomised controlled trials of weight maintenance interventions and 8 qualitative studies linked to non-randomised intervention studies, and 9 relevant UK-based qualitative studies not linked to any intervention. Health concerns and the perception that certain programmes had 'worked' for other men were the key factors that motivated men to engage with weight management programmes. Barriers to engagement and adherence with programmes included: men not problematising their weight until labelled 'obese'; a lack of support for new food choices by friends and family, and reluctance to undertake extreme dieting. Retaining some autonomy over what is eaten; flexibility about treats and alcohol, and a focus on physical activity were attractive features of programmes. Group interventions, humour and social support facilitated attendance and adherence. Men were motivated to attend programmes in settings that were convenient, non-threatening and congruent with their masculine identities, but men were seldom involved in programme design. Men's perspectives and preferences within the wider context of family, work and pleasure should be sought when designing weight management services. Qualitative research is needed with men to inform all aspects of intervention design, including the setting, optimal recruitment processes and strategies to minimise attrition. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

2011 Health Related Behaviors Survey of Active Duty Military Personnel

DTIC Science & Technology

2013-02-01

oatmeal, etc. e. DAIRY: milk , yogurt, cheese, etc. f. LEAN PROTEIN : baked or broiled lean (low fat ) meat, eggs, natural peanut butter, nuts, beans or...2010).19 One measure of weight management is the Body Mass Index (BMI), an indirect measure of body fat , to detect possible weight problems. BMI...BMI does not distinguish between muscle mass and body fat in a person’s body; as such, there may be

A comparison of a behavioral weight loss program to a stress management program: A pilot randomized controlled trial.

PubMed

Webber, Kelly H; Casey, Erin M; Mayes, Lindsey; Katsumata, Yuriko; Mellin, Laurel

2016-01-01

This study compared a behavioral weight loss program (BWL) with a stress management-based program, Emotional Brain Training (EBT), on weight loss, blood pressure, depression, perceived stress, diet, and physical activity. Subjects with a body mass index (BMI) of >28 and <45 kg/m(2) were recruited in Lexington, Kentucky in January 2014 and randomized to BWL or EBT for a 20-week intervention. Of those recruited, 49 participants were randomized to EBT or BWL. Randomization and allocation to group were performed using SPSS software. Weight, blood pressure, depression, perceived stress, dietary intake, and physical activity were measured at baseline, 10 week, and 20 week. Linear models for change over time were fit to calculate 95% confidence intervals of intervention effects. BWL produced greater changes in BMI than EBT at both 10 (P = 0.02) and 20 wk (P = 0.03). At 10 wk, both EBT and BWL improved BMI, systolic blood pressure, depression and perceived stress (P < 0.05). BWL also improved diastolic blood pressure (P = 0.005). At 20 wk, EBT maintained improvements in BMI, systolic blood pressure, depression, and perceived stress while BWL maintained improvements only in BMI and depression (P < 0.05). BWL produced greater weight loss than EBT; however, EBT produced sustained improvements in stress, depression, and systolic blood pressure. A combination of the two approaches should be explored. Copyright © 2016 Elsevier Inc. All rights reserved.

A smartphone-supported weight loss program: design of the ENGAGED randomized controlled trial.

PubMed

Pellegrini, Christine A; Duncan, Jennifer M; Moller, Arlen C; Buscemi, Joanna; Sularz, Alyson; DeMott, Andrew; Pictor, Alex; Pagoto, Sherry; Siddique, Juned; Spring, Bonnie

2012-11-30

Obesity remains a major public health challenge, demanding cost-effective and scalable weight management programs. Delivering key treatment components via mobile technology offers a potential way to reduce expensive in-person contact, thereby lowering the cost and burden of intensive weight loss programs. The ENGAGED study is a theory-guided, randomized controlled trial designed to examine the feasibility and efficacy of an abbreviated smartphone-supported weight loss program. Ninety-six obese adults (BMI 30-39.9 kg/m2) will be randomized to one of three treatment conditions: (1) standard behavioral weight loss (STND), (2) technology-supported behavioral weight loss (TECH); or (3) self-guided behavioral weight loss (SELF). All groups will aim to achieve a 7% weight loss goal by reducing calorie and fat intake and progressively increasing moderate intensity physical activity to 175 minutes/week. STND and TECH will attend 8 group sessions and receive regular coaching calls during the first 6 months of the intervention; SELF will receive the Group Lifestyle Balance Program DVD's and will not receive coaching calls. During months 1-6, TECH will use a specially designed smartphone application to monitor dietary intake, body weight, and objectively measured physical activity (obtained from a Blue-tooth enabled accelerometer). STND and SELF will self-monitor on paper diaries. Linear mixed modeling will be used to examine group differences on weight loss at months 3, 6, and 12. Self-monitoring adherence and diet and activity goal attainment will be tested as mediators. ENGAGED is an innovative weight loss intervention that integrates theory with emerging mobile technologies. We hypothesize that TECH, as compared to STND and SELF, will result in greater weight loss by virtue of improved behavioral adherence and goal achievement. NCT01051713.

Rates and Determinants of Uptake and Use of an Internet Physical Activity and Weight Management Program in Office and Manufacturing Work Sites in England: Cohort Study

PubMed Central

Hurling, Robert; Bataveljic, Ogi; Fairley, Bruce W; Hurst, Tina L; Murray, Peter; Rennie, Kirsten L; Tomkins, Chris E; Finn, Anne; Cobain, Mark R; Pearson, Dympna A; Foreyt, John P

2008-01-01

Background Internet-based physical activity (PA) and weight management programs have the potential to improve employees’ health in large occupational health settings. To be successful, the program must engage a wide range of employees, especially those at risk of weight gain or ill health. Objective The aim of the study was to assess the use and nonuse (user attrition) of a Web-based and monitoring device–based PA and weight management program in a range of employees and to determine if engagement with the program was related to the employees’ baseline characteristics or measured outcomes. Methods Longitudinal observational study of a cohort of employees having access to the MiLife Web-based automated behavior change system. Employees were recruited from manufacturing and office sites in the North West and the South of England. Baseline health data were collected, and participants were given devices to monitor their weight and PA via data upload to the website. Website use, PA, and weight data were collected throughout the 12-week program. Results Overall, 12% of employees at the four sites (265/2302) agreed to participate in the program, with 130 men (49%) and 135 women (51%), and of these, 233 went on to start the program. During the program, the dropout rate was 5% (11/233). Of the remaining 222 Web program users, 173 (78%) were using the program at the end of the 12 weeks, with 69% (153/222) continuing after this period. Engagement with the program varied by site but was not significantly different between the office and factory sites. During the first 2 weeks, participants used the website, on average, 6 times per week, suggesting an initial learning period after which the frequency of website log-in was typically 2 visits per week and 7 minutes per visit. Employees who uploaded weight data had a significant reduction in weight (−2.6 kg, SD 3.2, P< .001). The reduction in weight was largest for employees using the program’s weight loss mode (−3.4 kg, SD 3.5). Mean PA level recorded throughout the program was 173 minutes (SE 12.8) of moderate/high intensity PA per week. Website interaction time was higher and attrition rates were lower (OR 1.38, P= .03) in those individuals with the greatest weight loss. Conclusions This Web-based PA and weight management program showed high levels of engagement across a wide range of employees, including overweight or obese workers, shift workers, and those who do not work with computers. Weight loss was observed at both office and manufacturing sites. The use of monitoring devices to capture and send data to the automated Web-based coaching program may have influenced the high levels of engagement observed in this study. When combined with objective monitoring devices for PA and weight, both use of the website and outcomes can be tracked, allowing the online coaching program to become more personalized to the individual. PMID:19117828

Obesity among those with mental disorders: a National Institute of Mental Health meeting report.

PubMed

Allison, David B; Newcomer, John W; Dunn, Andrea L; Blumenthal, James A; Fabricatore, Anthony N; Daumit, Gail L; Cope, Mark B; Riley, William T; Vreeland, Betty; Hibbeln, Joseph R; Alpert, Jonathan E

2009-04-01

The National Institute of Mental Health convened a meeting in October 2005 to review the literature on obesity, nutrition, and physical activity among those with mental disorders. The findings of this meeting and subsequent update of the literature review are summarized here. Levels of obesity are higher in those with schizophrenia and depression, as is mortality from obesity-related conditions such as coronary heart disease. Medication side effects, particularly the metabolic side effects of antipsychotic medications, contribute to the high levels of obesity in those with schizophrenia, but increased obesity and visceral adiposity have been found in some but not all samples of drug-naïve patients as well. Many of the weight-management strategies used in the general population may be applicable to those with mental disorders, but little is known about the effects of these strategies on this patient population or how these strategies may need to be adapted for the unique needs of those with mental disorders. The minimal research on weight-management programs for those with mental disorders indicates that meaningful changes in dietary intake and physical activity are possible. Physical activity is an important component of any weight-management program, particularly for those with depression, for which a substantial body of research indicates both mental and physical health benefits. Obesity among those with mental disorders has not received adequate research attention, and empirically-based interventions to address the increasing prevalence of obesity and risk of cardiovascular and metabolic diseases in this population are lacking.

I am pregnant and want to do better but i can't: focus groups with low-income overweight and obese pregnant women.

PubMed

Chang, Mei-Wei; Nitzke, Susan; Buist, Diana; Cain, Deborah; Horning, Stefanie; Eghtedary, Kobra

2015-05-01

This study was conducted to identify factors that influenced stress, healthy eating and physical activity among low-income overweight or obese pregnant women. We conducted seven focus groups with 96 low-income overweight and obese pregnant women. Common themes were identified from audio tapes and transcripts. Women said that poor communication affected their relationships with spouses or significant others. They were frustrated or upset with significant others for three key reasons: failure to understand or listen to the pregnant women's pregnancy concerns, refusal to be helpful when asked and being overly concerned with the woman's safety. Most women said that they were emotional and took naps throughout the day after becoming pregnant. Many withdrew from their social interactions. They also faced numerous challenges that made healthy eating more difficult, e.g., craving for unhealthy foods and eating foods for comfort. To eat healthier, some reminded themselves to avoid overeating or stop eating in the car. Women were not physically active because of tiredness, lack of motivation, inadequate social support, or bad weather. Some stayed physically active to prevent excessive pregnancy weight gain and have an easier labor. Women equivocally said weighing themselves to manage weight would add to their stress and make them feel more depressed. When designing interventions to help low-income overweight and obese pregnant women avoid excessive pregnancy weight gain, it is important to include information and practical advice on stress management, emphasizing effective communication skills with significant others and helping them plan effective ways to manage negative feelings.

Determining how best to support overweight adults to adhere to lifestyle change: protocol for the SWIFT study.

PubMed

Taylor, Rachael W; Roy, Melyssa; Jospe, Michelle R; Osborne, Hamish R; Meredith-Jones, Kim J; Williams, Sheila M; Brown, Rachel C

2015-09-04

Physical activity plays a critical role in health, including for effective weight maintenance, but adherence to guidelines is often poor. Similarly, although debate continues over whether a "best" diet exists for weight control, meta-analyses suggest little difference in outcomes between diets differing markedly in macronutrient composition, particularly over the longer-term. Thus a more important question is how best to encourage adherence to appropriate lifestyle change. While brief support is effective, it has on-going cost implications. While self-monitoring (weight, diet, physical activity) is a cornerstone of effective weight management, little formal evaluation of the role that self-monitoring technology can play in enhancing adherence to change has occurred to date. People who eat in response to hunger have improved weight control, yet how best to train individuals to recognise when true physical hunger occurs and to limit consumption to those times, requires further study. SWIFT (Support strategies for Whole-food diets, Intermittent Fasting, and Training) is a two-year randomised controlled trial in 250 overweight (body mass index of 27 or greater) adults that will examine different ways of supporting people to make appropriate changes to diet and exercise habits for long-term weight control. Participants will be randomised to one of five intervention groups: control, brief support (monthly weigh-ins and meeting), app (use of MyFitnessPal with limited support), daily self-weighing (with brief monthly feedback), or hunger training (four-week programme which trains individuals to only eat when physically hungry) for 24 months. Outcome assessments include weight, waist circumference, body composition (dual-energy x-ray absorptiometry), inflammatory markers, blood lipids, adiponectin and ghrelin, blood pressure, diet (3-day diet records), physical activity (accelerometry) and aerobic fitness, and eating behaviour. SWIFT is powered to detect clinically important differences of 4 kg in body weight and 5 cm in waist circumference. Our pragmatic trial also allows participants to choose one of several dietary (Mediterranean, modified Paleo, intermittent fasting) and exercise (current recommendations, high-intensity interval training) approaches before being randomised to a support strategy. SWIFT will compare four different ways of supporting overweight adults to lose weight while following a diet and exercise plan of their choice, an aspect we believe will enhance adherence and thus success with weight management. Australian and New Zealand Clinical Trials Registry ACTRN12615000010594. Registered 8th January 2015.

Diet and diabetes.

PubMed

Deed, Gary; Barlow, John; Kawol, Dev; Kilov, Gary; Sharma, Anita; Hwa, Liew Yu

2015-05-01

Guidelines for the prevention and management of type 2 diabetes mellitus (T2DM) reinforce lifestyle management, yet advice to guide general practitioners on principles around dietary choices is needed. This article provides current evidence regarding the differing diets in diabetes prevention and management once T2DM arises, including the role in management of complications such as hypoglycaemia. Diets should incorporate weight maintenance or loss, while complementing changes in physical activity to optimise the metabolic effects of dietary advice. Using a structured, team-care approach supports pragmatic and sustainable individualised plans, while incorporating current evidence-based dietary approaches.

Increasing the use of preventative health services to promote healthy eating, physical activity and weight management: the acceptability and potential effectiveness of a proactive telemarketing approach

PubMed Central

2012-01-01

Background Telephone based interventions are effective in promoting health behaviours. The use of telephone based support services to promote healthy eating, activity or weight loss, however, are currently under-utilised. The aim of this study was to assess the acceptability and potential effectiveness of a telemarketing approach in increasing community use of proactive services to encourage healthy eating, physical activity and weight loss. Methods The study employed a cross sectional design. Eligible consenting participants completed a 15 minute telephone survey conducted by trained telephone interviewers using computer assisted telephone interviewing technology. Results Overall, 87% of participants considered it acceptable for a health service to contact people by telephone to offer assistance to help them lose weight, eat healthily or be more physically active. Among participants with inadequate fruit and vegetable intake, physical activity or who were overweight, 64%, 54% and 61% respectively reported that they would use one or more of the proactive support services offered. Females and those from non -English speaking households who did not eat sufficient serves were significantly more likely to report that they would use support services. Conclusions The findings suggest that proactive telemarketing of health services to facilitate healthy eating, physical activity or weight loss is considered highly acceptable and may be effective in encouraging service use by more than half of all adults with these behavioural risks. PMID:23134686

Managing your weight gain during pregnancy

MedlinePlus

... basis for a healthy pregnancy. For most pregnant women, the right amount of calories is: 1,800 calories per ... are already overweight when they get pregnant. Other women gain ... on eating the right foods and staying active. If you do not ...

Integrated Advanced Microwave Sounding Unit-A (AMSU-A): Monthly Report for August

NASA Technical Reports Server (NTRS)

Nieto, A.

2000-01-01

Included in this report are Combined Program Delivery Schedules and Reports; a report from the Product Team Leaders on the status of all major program elements; Contract Data Requirements List (CDRL) 503, the Weight and Power Budgets; CDRL 204, reporting on the activities of Performance Assurance; CDRL 203, the Configuration Management Status Report; and the Documentation/Data Management Status Report.

Managing Weight: What Do People with an Intellectual Disability Want from Mobile Technology?

PubMed

Smyth, Phil; McDowell, Claire; Leslie, Julian C; Leader, Geraldine; Donnelly, Mark; Simpson, Elizabeth; Skelly, Laura

2017-01-01

Obesity is a significant health challenge. People with Intellectual Disability (ID) are particularly vulnerable to developing obesity. Mobile technology has been developed to support the management of weight and obesity in the form of apps, although not with people with an ID in mind. As a result existing off-the-shelf weight management apps currently available may not be functional in supporting weight reduction within this population. This paper presents the results of consultations with people with ID regarding weight management, comfort with mobile technology and desired characteristics in apps designed for people with ID that target weight management.

The effect of weight management interventions that include a diet component on weight-related outcomes in pregnant and postpartum women: a systematic review protocol.

PubMed

Spencer, Lisa; Rollo, Megan; Hauck, Yvonne; MacDonald-Wicks, Lesley; Wood, Lisa; Hutchesson, Melinda; Giglia, Roslyn; Smith, Roger; Collins, Clare

2015-01-01

What are the effects of weight management interventions that include a diet component on weight-related outcomes in pregnant and postpartum women?The primary objective of this systematic review is to evaluate the effectiveness of weight management interventions which include a diet component and are aimed at limiting gestational weight gain and postpartum weight retention in women.The second objective of this systematic review is to investigate included intervention components with respect to effect on weight-related outcomes. This may include, but is not limited to: length of intervention, use of face-to-face counselling, group or individual consultations, use of other interventions components including exercise, use of goals and use of support tools like food diaries, coaching, including email or text message support. Around half of all women of reproductive age are either overweight or obese, with women aged 25-34 years having a greater risk of substantial weight gain compared with men of all ages. Excessive gestational weight gain (GWG) and postpartum weight retention (PPWR) may play a significant role in long term obesity. Having one child doubles the five- and 10-year obesity incidence for women, with many women who gain excessive weight during pregnancy remaining obese permanently. Excessive GWG and/or PPWR can also significantly contribute to short- and long-term adverse health outcomes for mother, baby and future pregnancies.Maternal obesity increases the risk of pregnancy related complications such as pre-eclampsia, gestational diabetes mellitus, stillbirth and the rate of caesarean section. Childhood obesity is a further long term complication of maternal obesity for offspring, which may persist in to adulthood. Excess GWG is also a risk factor for PPWR both in the short and long-term. Nehring et al. conducted a meta-analysis with over 65,000 women showing that, compared to women who gained weight within recommendations during pregnancy, women with GWG above Institute of Medicine weight gain recommendations, retained an additional 3.1 kg and 4.7kg after three and greater than or equal to 15 years postpartum, respectively. The health risk associated with PPWR is highlighted in a study of 151,025 Swedish women followed between 1992 and 2001.The study identified the risk of adverse pregnancy outcomes for those who gained three or more units of Body Mass Index (kg/m2) between consecutive pregnancies (an average of two years) was much higher compared with women whose BMI changed from -1.0 and 0.9 units. Long-term chronic disease risk may also be affected by PPWR as weight retention at the end of the first year post-partum has been found to be a predictor of maternal overweight 15 years later.With around 14-20% of women retaining 5kg or more 12 months postpartum, the risk of developing conditions like diabetes, metabolic syndrome and cardiovascular disease may be increased. It becomes evident that interventions which aim to support attainment of healthy weight both in the antenatal and postpartum periods are key health priorities for women during this life stage.Lifestyle factors of overweight, having poor diet quality, and not undertaking enough moderate-to-vigorous physical activity are amongst the top five predictors of mortality in women. Additionally it is noted that, for many women, pregnancy and the postpartum period are associated with a reduction in physical activity. It is known that a combination of poor dietary choices, an increase in sedentary time and reduction in physical activity are all contributors to the development of overweight and obesity. With this in mind, current research has focused on lifestyle interventions to limit GWG and PPWR. Thangaratinam et al. reviewed 44 randomized controlled trials (7278 women) where interventions including diet, physical activity or both were evaluated for their influence on maternal weight during pregnancy. Results indicate that all were significantly effective in reducing GWG compared with the control group. More specifically, dietary interventions were the most effective in reducing weight gain, with a mean weight loss of -3.84kg compared with -0.72kg and -1.06kg for physical activity and the mixed (diet plus physical activity) approach, respectively. This finding is supported by Hill and colleagues' recent systematic review of theory based interventions to limit GWG. Included studies in this review reported an underpinning theory base and were classified as adopting a dietary, physical activity or mixed approach. Hill et al. concluded that studies which included a diet intervention were significantly more effective at limiting GWG.In 2011 Tanentsapf et al. reviewed the effect of dietary interventions alone for reducing GWG in normal weight, overweight and obese pregnant women. This review analysed 13 randomized controlled trials and quasi-randomized controlled trials with a dietary intervention to prevent excessive GWG in women. The review concluded that dietary interventions during pregnancy were effective in reducing GWG with an effect of -1.92kg (n=1434) compared with the control group.Tanentsapf et al. identified that trials differed in the conduct of the interventions with various diet and non-diet related components utilised. Dietary approaches were highly variable with some trials focusing only on calorie restriction and others included additional target macronutrient distribution for intake. Some trials further provided feedback based on maternal weight gain guidelines. Interventions also varied in delivery method with a variety of modes used, including face-to-face, individual or group consultations and/or written correspondence. The frequency of communication, despite the type or mix, also changed from trial to trial with additional methods via telephone, posted materials, feedback or food diaries utilised. The inclusion of physical activity in addition to diet intervention was also common. Whilst the recent review by Tanentsapf et al. identified that dietary interventions are effective in reducing GWG, the review did not investigate the impact that different intervention components, delivery methods or dietary counselling approaches had on gestational weight management. It remains unclear as to which intervention components optimize GWG in women.The impact of lifestyle interventions has also been investigated in the postpartum period. The recent systematic review from van der Pligt et al. reported seven of 11 studies reviewed were successful in limiting PPWR. As with studies aimed at limiting GWG, interventions included in van der Pligt et al.'s review differed greatly in their conduct. Six of these seven studies included both dietary and physical activity components for the intervention, with the final successful study including a diet only intervention. Five of the successful studies recruited overweight or obese women only. Intervention time varied considerably in successful studies with some running for as little at ten days, and others up to six months.Bertz et al. demonstrated that their 12-week behavior modification intervention which targeted diet alone or diet and exercise, including two individual sessions with a dietitian and physical therapist, provision of scales for weight self-monitoring and bi-weekly text messages was successful in achieving significant weight loss following the intervention, and sustained at one year. The diet intervention and the diet and exercise intervention yielded significant weight loss compared to the control. Following 12 weeks a reduction of -8.3 +/- 4.2kg for diet intervention and -6.9 +/- 3.0kg for diet and exercise was observed. Additionally after one year, the diet intervention showed -10.2 +/- 5.7kg reduction and -7.3 +/- 6.3kg for the diet and exercise intervention (p<0.001). Colleran et al. also found significant weight change results by implementing a 16-week intervention which consisted of weekly individual sessions with a dietitian regarding calorie restriction, two additional home visits regarding exercise, weekly food diary completion and email support. The intervention group had greater weight loss compared to the control group (-5.8kg +/- 3.5kg vs -1.6kg +/- 5.4kg). It can be seen that various methods have been utilized in investigating the impact of diet and physical activity interventions on PPWR. The review by van der Pligt et al. highlights the impact successful lifestyle interventions can have on postpartum weight change. However, this review did not investigate the different intervention strategies utilized. It remains unclear as to the optimal setting, delivery method, diet strategy, contact frequency or intervention length to limit PPWR.Previous systematic reviews for both GWG and PPWR have focused on the effectiveness of lifestyle interventions as a whole for weight management in pregnant and postpartum women. And despite Tanentsapf et al.'s focus on dietary interventions for GWG, much is still unknown about the effectiveness of differing diet interventions over the antenatal and postpartum period. Specifically, the impact of differing diet intervention strategies on maternal weight gain is not known. Firstly, this systematic review will focus on whether weight management interventions which include a dietary component are effective in pregnant and postpartum women. In addition to this, this review will investigate the different intervention strategies utilized and their effectiveness in maternal weight management. A search of systematic review protocol databases has shown that there is no current review underway for this topic.

Brief report: Weight dissatisfaction, weight status, and weight loss in Mexican-American children

USDA-ARS?s Scientific Manuscript database

The study objectives were to assess the association between weight dissatisfaction, weight status, and weight loss in Mexican-American children participating in a weight management program. Participants included 265 Mexican American children recruited for a school-based weight management program. Al...

[Management of children and adolescents with severe obesity].

PubMed

Valerio, G; Licenziati, M R; Tanas, R; Morino, G; Ambruzzi, A M; Balsamo, A; Brambilla, P; Bruzzi, P; Calcaterra, V; Crinò, A; De Falco, R; Franzese, A; Giordano, U; Grugni, G; Iaccarino Idelson, P; Iughetti, L; Maffeis, C; Manco, M; Miraglia Del Giudice, E; Mozzillo, E; Zito, E; Bernasconi, S

2012-08-01

Obesity is a complex public health issue. Recent data indicate the increasing prevalence and severity of obesity in children. Severe obesity is a real chronic condition for the difficulties of long-term clinical treatment, the high drop-out rate, the large burden of health and psychological problems and the high probability of persistence in adulthood. A staged approach for weight management is recommended. The establishment of permanent healthy lifestyle habits aimed at healthy eating, increasing physical activity and reducing sedentary behavior is the first outcome, because of the long-term health benefits of these behaviors. Improvement in medical conditions is also an important sign of long-term health benefits. Rapid weight loss is not pursued, for the implications on growth ad pubertal development and the risk of inducing eating disorders. Children and adolescents with severe obesity should be referred to a pediatric weight management center that has access to a multidisciplinary team with expertise in childhood obesity. This article provides pediatricians a comprehensive and evidence based update on treatment recommendations of severe obesity in children and adolescents.

Major initiatives related to childhood obesity and physical inactivity in Canada: the year in review.

PubMed

Tremblay, Mark S

2012-01-01

This manuscript briefly reviews 15 significant initiatives related to childhood obesity and physical inactivity in Canada between September 2010 and September 2011. These include the: announcement of a Federal-Provincial-Territorial framework for action to promote healthy weights; implementation of the nutrition labeling initiative; launch of the CBC "Live Right Now" campaign; announcement of the Public Health Agency of Canada's innovation strategy funding related to obesity; publication of the Canadian Health Measures Survey physical activity findings; release of new Canadian physical activity and sedentary behaviour guidelines; launch of ParticipACTION's "Think Again" campaign; workshop on building trust to address the epidemic of obesity; start of the Canadian Pediatric Weight Management Registry; initiation of "Our Health Our Future: A National Dialogue on Healthy Weights"; release of the Active Healthy Kids Canada Report Card on Physical Activity for Children and Youth; National Obesity Summit; Nature Play Day and Sports Day in Canada; development of the Canadian Assessment of Physical Literacy; and the creation of Active Canada 20/20--A National Physical Activity Plan. The diversity and intensity of activity addressing the childhood obesity and physical inactivity "epidemic" in Canada is encouraging and must be maintained and enhanced.

Designing for Psychological Change: Individuals’ Reward and Cost Valuations in Weight Management

PubMed Central

Blandford, Ann

2014-01-01

Background Knowledge of the psychological constructs that underlie behavior offers valuable design opportunities for persuasive systems. We use the decision theory, which describes how behavior is underpinned by reward-cost valuations, as a framework for investigating such psychological constructs to deliver design objectives for weight management technologies. Objective We applied a decision theory–based analysis in the domain of weight management to understand the rewards and costs that surround individuals’ weight management behaviors, with the aim of uncovering design opportunities for weight management technologies. Methods We conducted qualitative interviews with 15 participants who were or had been trying to lose weight. Thematic analysis was used to extract themes that covered the rewards and costs surrounding weight management behaviors. We supplemented our qualitative study with a quantitative survey of 100 respondents investigating the extent to which they agreed with statements reflecting themes from the qualitative study. Results The primary obstacles to weight management were the rewards associated with unhealthy choices, such as the pleasures of unhealthy foods and unrestricted consumption in social situations, and the significant efforts required to change habits, plan, and exercise. Psychological constructs that supported positive weight management included feeling good after making healthy choices, being good to oneself, experiencing healthy yet still delicious foods, and receiving social support and encouraging messages (although opinions about encouraging messages was mixed). Conclusions A rewards-costs driven enquiry revealed a wide range of psychological constructs that contribute to discouraging and supporting weight management. The constructs extracted from our qualitative study were verified by our quantitative survey, in which the majority of respondents also reported similar thoughts and feelings. This understanding of the rewards and costs surrounding weight management offers a range of new opportunities for the design of weight management technologies that enhance the encouraging factors and alleviate the discouraging ones. PMID:24972304

Efficacy of physical activity interventions in post-natal populations: systematic review, meta-analysis and content coding of behaviour change techniques.

PubMed

Gilinsky, Alyssa Sara; Dale, Hannah; Robinson, Clare; Hughes, Adrienne R; McInnes, Rhona; Lavallee, David

2015-01-01

This systematic review and meta-analysis reports the efficacy of post-natal physical activity change interventions with content coding of behaviour change techniques (BCTs). Electronic databases (MEDLINE, CINAHL and PsychINFO) were searched for interventions published from January 1980 to July 2013. Inclusion criteria were: (i) interventions including ≥1 BCT designed to change physical activity behaviour, (ii) studies reporting ≥1 physical activity outcome, (iii) interventions commencing later than four weeks after childbirth and (iv) studies including participants who had given birth within the last year. Controlled trials were included in the meta-analysis. Interventions were coded using the 40-item Coventry, Aberdeen & London - Refined (CALO-RE) taxonomy of BCTs and study quality assessment was conducted using Cochrane criteria. Twenty studies were included in the review (meta-analysis: n = 14). Seven were interventions conducted with healthy inactive post-natal women. Nine were post-natal weight management studies. Two studies included women with post-natal depression. Two studies focused on improving general well-being. Studies in healthy populations but not for weight management successfully changed physical activity. Interventions increased frequency but not volume of physical activity or walking behaviour. Efficacious interventions always included the BCTs 'goal setting (behaviour)' and 'prompt self-monitoring of behaviour'.

A Nutrition Journal and Diabetes Shopping Experience to Improve Pharmacy Students' Empathy and Cultural Competence

PubMed Central

Hardy, Yolanda

2009-01-01

Objectives To implement and assess the effectiveness of an exercise designed to develop pharmacy students' empathy toward patients regarding diabetes and obesity and encourage cultural and “economic” competence. Design Students in the Nutrition Journal and Diabetes Shopping Experience attended a nutrition and weight management lecture, monitored their own nutritional intake by maintaining an online nutrition and exercise journal, and grocery shopped based on an assigned patient scenario. Scenarios varied in terms of income, ethnicity, insurance coverage, family size, grocery store, and medication lists. Students completed written reflections and group discussions and completed pre- and post-assignment survey instruments. Assessment The activities improved student confidence levels regarding nutrition and weight-related patient counseling, and knowledge about general nutrition and weight management. The majority of students agreed that the activities improved their ability to empathize with overweight patients regarding the challenges of nutrition and lifestyle changes and enhanced their awareness of the impact that cultural and financial situations have on nutrition and lifestyle. Conclusion The Nutrition Journal and Diabetes Shopping Experience positively impacted the way pharmacy students view the challenges surrounding nutrition and healthy eating in patients with culturally and socioeconomically diverse backgrounds. PMID:19513175

Development of a Weight Loss Mobile App Linked With an Accelerometer for Use in the Clinic: Usability, Acceptability, and Early Testing of its Impact on the Patient-Doctor Relationship

PubMed Central

Choo, Seryung; Jung, Se Young; Kim, Sarah; Kim, Jeong Eun; Han, Jong Soo; Kim, Sohye; Kim, Jeong Hyun; Kim, Jeehye; Kim, Yongseok; Kim, Dongouk; Steinhubl, Steve

2016-01-01

Background Although complications of obesity are well acknowledged and managed by clinicians, management of obesity itself is often difficult, which leads to its underdiagnosis and undertreatment in hospital settings. However, tools that could improve the management of obesity, including self-monitoring, engagement with a social network, and open channels of communication between the patient and doctor, are limited in a clinic-based setting. Objective The objective of our study was to evaluate the usability and acceptability of a newly developed mobile app linked with an accelerometer and its early effects on patient-doctor relationships. Methods From September 2013 to February 2014, we developed a mobile app linked with an accelerometer as a supportive tool for a clinic-based weight loss program. The app used information from electronic health records and delivered tailored educational material. Personal goal setting, as well as monitoring of weight changes and physical activity combined with feedback, are key features of the app. We also incorporated an interactive message board for patients and doctors. During the period of March 2014 to May 2014, we tested our mobile app for 1 month in participants in a hospital clinic setting. We assessed the app’s usability and acceptability, as well as the patient-doctor relationship, via questionnaires and analysis of app usage data. Results We recruited 30 individuals (18 male and 12 female) for the study. The median number of log-ins per day was 1.21, with the most frequently requested item being setting goals, followed by track physical activities and view personal health status. Scales of the depth of the patient-doctor relationship decreased from 27.6 (SD 4.8) to 25.1 (SD 4.5) by a Wilcoxon signed rank test (P=.02). Conclusions A mobile phone app linked with an accelerometer for a clinic-based weight loss program is useful and acceptable for weight management but exhibited less favorable early effects on patient-doctor relationships. PMID:27032541

A nutrition and physical activity intervention promotes weight loss and enhances diet attitudes in low-income mothers of young children.

PubMed

Jordan, Kristine C; Freeland-Graves, Jeanne H; Klohe-Lehman, Deborah M; Cai, Guowen; Voruganti, V Saroja; Proffitt, J Michael; Nuss, Henry J; Milani, Tracey J; Bohman, Thomas M

2008-01-01

The purpose of this study was to evaluate a nutrition and physical activity program for reducing body weight and improving nutrition attitudes in mothers of young children. A convenience sample of 114 intervention mothers and 33 comparison mothers was recruited from public health clinics and community centers. Eligibility criteria included Hispanic, African American, or white ethnicity; body mass index of at least 25 kg/m(2); low income (< 200% of the federal poverty index); and youngest child aged 1 to 4 years. For intervention participants, height, weight, percentage of body fat, waist circumference, demographics, nutrition attitudes, and dietary intake were measured at weeks 0 and 8; height, weight, percentage of body fat, and waist circumference were reassessed at 6 months. Overweight mothers in the comparison group provided anthropometric and demographic data at weeks 0 and 8. Changes in anthropometrics, attitudes, and dietary intake were evaluated in intervention mothers. Anthropometric data of intervention vs comparison group mothers were examined. Differences in anthropometrics and attitude scores between weight loss responders (> or = 2.27 kg) and nonresponders (< 2.27 kg) were assessed at week 8. Intervention participants lost weight (x = -2.7 kg; P < .001), whereas comparison mothers gained a slight amount of weight (x = 0.1 kg) by week 8. Weight loss responders had healthier eating attitudes (5.6 vs 5.2; P < .01) and fewer perceived barriers (2.4 vs 2.9; P < .05) than nonresponders postintervention. In conclusion, this dietary and physical activity curriculum is a valuable resource for weight management programs serving low-income women.

Effective Use of Weigh-in-Motion Data : The Netherlands Case Study

DOT National Transportation Integrated Search

2007-10-01

Transportation and law enforcement agencies in the Netherlands have developed a robust weigh-in-motion (WIM) data management system that supports a broad array of vehicle weight regulation and enforcement activities, as well as long-term planning and...

Comparison of a reduced carbohydrate and reduced fat diet for LDL, HDL, and VLDL subclasses during 9-months of weight maintenance subsequent to weight loss.

PubMed

LeCheminant, James D; Smith, Bryan K; Westman, Eric C; Vernon, Mary C; Donnelly, Joseph E

2010-06-01

This study compared LDL, HDL, and VLDL subclasses in overweight or obese adults consuming either a reduced carbohydrate (RC) or reduced fat (RF) weight maintenance diet for 9 months following significant weight loss. Thirty-five (21 RC; 14 RF) overweight or obese middle-aged adults completed a 1-year weight management clinic. Participants met weekly for the first six months and bi-weekly thereafter. Meetings included instruction for diet, physical activity, and behavior change related to weight management. Additionally, participants followed a liquid very low-energy diet of approximately 2092 kJ per day for the first three months of the study. Subsequently, participants followed a dietary plan for nine months that targeted a reduced percentage of carbohydrate (approximately 20%) or fat (approximately 30%) intake and an energy intake level calculated to maintain weight loss. Lipid subclasses using NMR spectroscopy were analyzed prior to weight loss and at multiple intervals during weight maintenance. Body weight change was not significantly different within or between groups during weight maintenance (p>0.05). The RC group showed significant increases in mean LDL size, large LDL, total HDL, large and small HDL, mean VLDL size, and large VLDL during weight maintenance while the RF group showed increases in total HDL, large and small HDL, total VLDL, and large, medium, and small VLDL (p<0.05). Group*time interactions were significant for large and medium VLDL (p>0.05). Some individual lipid subclasses improved in both dietary groups. Large and medium VLDL subclasses increased to a greater extent across weight maintenance in the RF group.

Educating patients about the benefits of physical activity and exercise for their hip and knee osteoarthritis. Systematic literature review.

PubMed

Gay, C; Chabaud, A; Guilley, E; Coudeyre, E

2016-06-01

Highlight the role of patient education about physical activity and exercise in the treatment of hip and knee osteoarthritis (OA). Systematic literature review from the Cochrane Library, PubMed and Wiley Online Library databases. A total of 125 items were identified, including 11 recommendations from learned societies interested in OA and 45 randomized controlled trials addressing treatment education and activity/exercise for the treatment of hip and knee osteoarthritis. In the end, 13 randomized controlled trials and 8 recommendations were reviewed (1b level of evidence). Based on the analysis, it was clear that education, exercise and weight loss are the pillars of non-pharmacological treatments. These treatments have proven to be effective but require changes in patient behaviour that are difficult to obtain. Exercise and weight loss improve function and reduce pain. Education potentiates compliance to exercise and weight loss programs, thereby improving their long-term benefits. Cost efficiency studies have found a reduction in medical visits and healthcare costs after 12 months because of self-management programs. Among non-surgical treatment options for hip and knee osteoarthritis, the most recent guidelines focus on non-pharmacological treatment. Self-management for general physical activity and exercise has a critical role. Programs must be personalized and adjusted to the patient's phenotype. This development should help every healthcare professional adapt the care they propose to each patient. Registration number for the systematic review: CRD42015032346. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Exploring the need for interventions to manage weight and stress during interconception.

PubMed

Huberty, Jennifer; Leiferman, Jenn A; Kruper, Abbey R; Jacobson, Lisette T; Waring, Molly E; Matthews, Jeni L; Wischenka, Danielle M; Braxter, Betty; Kornfield, Sara L

2017-02-01

Interventions to manage weight and stress during the interconception period (i.e., time immediately following childbirth to subsequent pregnancy) are needed to promote optimal maternal and infant health outcomes. To address this gap, we summarize the current state of knowledge, critically evaluate the research focused on weight and stress management during the interconception period, and provide future recommendations for research in this area. Evidence supports the importance of weight and stress management during the reproductive years and the impact of weight on maternal and child health outcomes. However, evidence-based treatment models that address postpartum weight loss and manage maternal stress during the interconception period are lacking. This problem is further compounded by inconsistent definitions and measurements of stress. Recommendations for future research include interventions that address weight and stress tailored for women in the interconception period, interventions that address healthcare providers' understanding of the significance of weight and stress management during interconception, and long-term follow-up studies that focus on the public health implications of weight and stress management during interconception. Addressing obesity and stress during the interconception period via a reproductive lens will be a starting point for women and their families to live long and healthy lives.

Obesity: Risk factors, complications, and strategies for sustainable long-term weight management.

PubMed

Fruh, Sharon M

2017-10-01

The aims of this article are to review the effects of obesity on health and well-being and the evidence indicating they can be ameliorated by weight loss, and consider weight-management strategies that may help patients achieve and maintain weight loss. Narrative review based on literature searches of PubMed up to May 2016 with no date limits imposed. Search included terms such as "obesity," "overweight," "weight loss," "comorbidity," "diabetes," cardiovascular," "cancer," "depression," "management," and "intervention." Over one third of U.S. adults have obesity. Obesity is associated with a range of comorbidities, including diabetes, cardiovascular disease, obstructive sleep apnea, and cancer; however, modest weight loss in the 5%-10% range, and above, can significantly improve health-related outcomes. Many individuals struggle to maintain weight loss, although strategies such as realistic goal-setting and increased consultation frequency can greatly improve the success of weight-management programs. Nurse practitioners have key roles in establishing weight-loss targets, providing motivation and support, and implementing weight-loss programs. With their in-depth understanding of the research in the field of obesity and weight management, nurse practitioners are well placed to effect meaningful changes in weight-management strategies deployed in clinical practice. ©2017 American Association of Nurse Practitioners.

Associations between psychological stress, eating, physical activity, sedentary behaviours and body weight among women: a longitudinal study

PubMed Central

2013-01-01

Background There is an increased risk of obesity amongst socioeconomically disadvantaged populations and emerging evidence suggests that psychological stress may be a key factor in this relationship. This paper reports the results of cross-sectional and longitudinal analyses of relationships between perceived stress, weight and weight-related behaviours in a cohort of socioeconomically disadvantaged women. Methods This study used baseline and follow-up self-report survey data from the Resilience for Eating and Activity Despite Inequality study, comprising a cohort of 1382 women aged 18 to 46 years from 80 of the most socioeconomically disadvantaged neighbourhoods in Victoria, Australia. Women reported their height (baseline only), weight, sociodemographic characteristics, perceived stress, leisure-time physical activity, sedentary and dietary behaviours at baseline and three-year follow-up. Linear and multinomial logistic regression were used to examine cross-sectional and longitudinal associations between stress (predictor) and weight, and weight-related behaviours. Results Higher perceived stress in women was associated with a higher BMI, and to increased odds of being obese in cross-sectional and longitudinal analyses. Cross-sectional and longitudinal associations were found between stress and both less leisure-time physical activity, and more frequent fast food consumption. Longitudinal associations were also found between stress and increased television viewing time. Conclusion The present study contributes to the literature related to the effects of stress on weight and weight-related behaviours. The findings suggest that higher stress levels could contribute to obesity risk in women. Further research is needed to fully understand the mechanisms underlying these associations. However, interventions that incorporate stress management techniques might help to prevent rising obesity rates among socioeconomically disadvantaged women. PMID:24020677

A biomedical and feminist perspective on women's experiences with weight management.

PubMed

Allan, J D

1994-10-01

Weight concerns and dieting have become so normative for U.S. women that weight is the lens through which experience is viewed. The obsession with weight and dieting among women is considered by feminists to be one result of the oppression by women resulting from questionable weight standards and weight control programs that foster a view of overweight as a sign of addiction and lack of control. Feminist critique is used to deconstruct both the literature related to weight standards and health and the research on weight loss/weight management. Feminist and ethnographic methods are used to describe successful and unsuccessful experiences with weight management of 20 Euro-American women who had participated in a 1985 weight study and agreed to be reinterviewed. Success at weight management was examined from a biomedical perspective using Body Mass Index (BMI) norms and from a feminist perspective using participants' subjective definitions of success. Based upon BMI, only 8 members of the study group were defined as successful, whereas based upon the women's perspectives, 11 members were successful. Participants' definitions of successful weight management were divergent from biomedical definitions and could be categorized into three perspectives: biomedical, reframed normal weight, and holistic. Women who ascribed to the biomedical definition of success embodied the cultural ideal of thinness by adhering to an underweight weight norm. Participants using the reframed normal weight definition of success rejected biomedical weight norms and created their own weight norms. The holistic perspective on success involved the use of a broader, health-focused definition of successful weight management and offers some directions for revising current health promotion care relative to weight.

WEIGHT LOSS IN A YOUNG PATIENT WITH TYPE 2 DIABETES: CHALLENGES OF DIABETES MANAGEMENT USING ONLINE PROGRAM OF GOOD NUTRITION (CASE REPORT).

PubMed

Krylov, V

2018-04-01

A 31-year-old male with a history of obesity, type 2 diabetes mellitus (T2DM) and hypercholesterolemia came to our clinic for medical weight-loss management. According to his initial anthropometric measurements (weight - 193 kg, height - 181 cm, and body mass index (BMI) - 58 kg/m2) patient had morbid obesity. In order to educate our patient about good nutrition, physical activity and the need of sun exposure we used an online system based on the video lessons, full of humor, pictures, and cartoons. Even one month of watching the short educational movies was sufficient for the patient to form the habits of healthy eating, including restriction of fat and digestible carbohydrates and increase in daily consumption of low-fat dairy products, slow carbohydrates, protein and fiber. Endocrinologist was regularly available for any questions and inquiries that the patient might have had. In addition to the dietary recommendations subcutaneous liraglutide 2.4 mg daily was initiated. After 8 months of treatment the patient has lost 58 kg and reached the body weight of 135 kg; moreover, he had motivation to continue losing weight.

A Pilot Feasibility Study of Whole-systems Ayurvedic Medicine and Yoga Therapy for Weight Loss.

PubMed

Rioux, Jennifer; Thomson, Cynthia; Howerter, Amy

2014-01-01

To develop and test the feasibility of a whole-systems lifestyle intervention for obesity treatment based on the practices of Ayurvedic medicine/ Yoga therapy. A pre-post weight loss intervention pilot study using conventional and Ayurvedic diagnosis inclusion criteria, tailored treatment within a standardized treatment algorithm, and standardized data collection instruments for collecting Ayurvedic outcomes. A convenience sample of overweight/obese adult community members from Tucson, Arizona interested in a "holistic weight loss program" and meeting predetermined inclusion/exclusion criteria. A comprehensive diet, activity, and lifestyle modification program based on principles of Ayurvedic medicine/yoga therapy with significant self-monitoring of lifestyle behaviors. The 3-month program was designed to change eating and activity patterns and to improve self-efficacy, quality of life, well-being, vitality, and self-awareness around food choices, stress management, and barriers to weight loss. Changes in body weight, body mass index; body fat percentage, fat/lean mass, waist/hip circumference and ratio, and blood pressure. Diet and exercise self-efficacy scales; perceived stress scale; visual analog scales (VAS) of energy, appetite, stress, quality of life, well-being, and program satisfaction at all time points. Twenty-two adults attended an in-person Ayurvedic screening; 17 initiated the intervention, and 12 completed the 3-month intervention. Twelve completed follow-up at 6 months and 11 completed follow-up at 9 months. Mean weight loss at 3 months was 3.54 kg (SD 4.76); 6 months: 4.63 kg, (SD 6.23) and 9 months: 5.9 kg (SD 8.52). Self-report of program satisfaction was more than 90% at all time points. An Ayurveda-/yoga-based lifestyle modification program is an acceptable and feasible approach to weight management. Data collection, including self-monitoring and conventional and Ayurvedic outcomes, did not unduly burden participants, with attrition similar to that of other weight loss studies.

Toward a Middle-Range Theory of Weight Management.

PubMed

Pickett, Stephanie; Peters, Rosalind M; Jarosz, Patricia A

2014-07-01

The authors of this paper present the middle-range theory of weight management that focuses on cultural, environmental, and psychosocial factors that influence behaviors needed for weight control. The theory of weight management was developed deductively from Orem's theory of self-care, a constituent theory within the broader self-care deficit nursing theory and from research literature. Linkages between the conceptual and middle-range theory concepts are illustrated using a substruction model. The development of the theory of weight management serves to build nursing science by integrating extant nursing theory and empirical knowledge. This theory may help predict weight management in populations at risk for obesity-related disorders. © The Author(s) 2014.

The effects of Young Adults Eating and Active for Health (YEAH): a theory-based Web-delivered intervention.

PubMed

Kattelmann, Kendra K; Bredbenner, Carol Byrd; White, Adrienne A; Greene, Geoffrey W; Hoerr, Sharon L; Kidd, Tandalayo; Colby, Sarah; Horacek, Tanya M; Phillips, Beatrice W; Koenings, Mallory M; Brown, Onikia N; Olfert, Melissa D; Shelnutt, Karla P; Morrell, Jesse Stabile

2014-01-01

To assess the effectiveness of a tailored theory-based, Web-delivered intervention (Young Adults Eating and Active for Health) developed using community-based participatory research process. A 15-month (10-week intensive intervention with a 12-month follow-up) randomized, controlled trial delivered via Internet and e-mail. Thirteen college campuses. A total of 1,639 college students. Twenty-one mini-educational lessons and e-mail messages (called nudges) developed with the non-diet approach and focusing on eating behavior, physical activity, stress management, and healthy weight management. Nudges were short, frequent, entertaining, and stage-tailored to each behavior, and reinforced lesson content. All participants were assessed at baseline, postintervention (3 months from baseline), and follow-up (15 months from baseline) for primary outcomes of weight, body mass index (BMI), fruit and vegetable intake (FVI), physical activity (PA), and perceived stress; and secondary outcomes of waist circumference, percent dietary fat, energy from sugar-sweetened beverages, servings of whole grains, self-instruction and regulation for mealtime behavior, hours of sleep, and stage of readiness for change for consuming 5 cups of FVI, completing 150 minutes of PA/wk, and managing stress on most days of the week. Demographics were collected at baseline. Chi-square analysis and mixed-models repeated measures analysis were performed to determine differences between experimental and control outcomes. There were no differences between experimental and control participants in BMI, weight, and waist circumference. There were small improvements in FVI (P = .001), vigorous PA in females (P = .05), fat intake (P = .002), self-instruction (P = .001), and regulation (P = .004) for mealtime behavior, and hours of sleep (P = .05) at postintervention, but improvements were not maintained at follow-up. At postintervention, a greater proportion of experimental participants were in the action/maintenance stages for FVI (P = .019) and PA (P = .002) than control. Young Adults Eating and Active for Health is one of the first studies to use the community-based participatory research process of PRECEDE-PROCEED to develop a non-diet approach intervention. Although there were no differences between experimental and control participants in weight change or BMI, the intervention supported positive change in behaviors that may mediate excessive weight gain, such as increasing FVI and more healthful self-regulation mealtime behaviors immediately postintervention. Additional strategies to maintain the behavior changes need to be explored. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

The Influence of U.S. Chain Restaurant Food Consumption and Obesity in China and South Korea: An Ecological Perspective of Food Consumption, Self-Efficacy in Weight Management, Willingness to Communicate About Weight/Diet, and Depression.

PubMed

Wright, Kevin B; Mazzone, Raphael; Oh, Hyun; Du, Joshua; Smithson, Anne-Bennett; Ryan, Diane; MacNeil, David; Tong, Xing; Stiller, Carol

2016-11-01

This study examined the impact of U.S. chain restaurant food consumption in China and South Korea from an ecological perspective. Specifically, it explored the relationships among several environmental and individual variables that have been found to affect obesity/weight management in previous research, including the prevalence/popularity of U.S. chain restaurants in these countries, frequency of U.S. chain restaurant food consumption, self-efficacy in weight management, willingness to communicate about weight/diet, self-perceptions of weight/obesity stigma, body mass index (BMI), and depression. The results indicated that willingness to communicate about weight/diet predicted increased self-efficacy in weight management. Higher BMI scores were found to predict increased weight/obesity stigma, and increased frequency of U.S. restaurant food consumption, weight/obesity stigma, and reduced self-efficacy in weight management were found to predict increased levels of depression. The theoretical and practical implications of the findings are discussed, along with limitations and directions for future research.

Body Mass Index Self-Perception and Weight Management Behaviors during Late Adolescence

ERIC Educational Resources Information Center

Yang, Kyeongra; Turk, Melanie T.; Allison, Virginia L.; James, Khara A.; Chasens, Eileen

2014-01-01

Background: This study examined the relationship between actual body weight and self-perceived weight, and how perception of one's weight affects weight management behaviors among US adolescents. Methods: Adolescents ages 16-19 years with objectively-measured weight and height and self-reported perception of weight, weight-loss efforts, and…

Weight management in obese pets: the tailoring concept and how it can improve results.

PubMed

German, Alexander J

2016-10-20

Obesity is now recognised as the most important medical disease in pets worldwide. All current strategies for weight management involve dietary energy restriction with a purpose-formulated diet. Whilst current weight management regimes can be successful, outcomes are often disappointing with the rate of weight loss progressively slowing down as time goes on. Success is most challenging for the most obese dogs and cats that are more likely to discontinue the programme before reaching target weight. To improve outcomes, clinicians must focus carefully on better tailoring programmes, paying particular to setting an appropriate target weight so as to maximise the benefits for the individual. In this opinionated review, the author will discuss findings from recent clinical research studies examining weight management in obese dogs and cats. A strategy for tailoring weight management targets will then be discussed, illustrated with case examples.

Women's attitudes towards a pre-conception healthy lifestyle programme.

PubMed

Funk, K L; LeBlanc, E S; Vesco, K K; Stevens, V J

2015-04-01

Nearly half of US women begin pregnancy overweight or obese and more than half of overweight or obese pregnant women experience excessive gestational weight gain. Recent lifestyle intervention programmes have helped women avoid excessive weight gain during pregnancy, but helping women lose weight before pregnancy may be a more effective way to improve pregnancy outcomes. This study assessed women's attitudes towards pre-conception diet and weight management interventions. An anonymous survey was conducted in patients waiting in a health maintenance organization's obstetrics and primary care waiting rooms. It focused on attitudes towards participating in a pre-conception, lifestyle change programme. Eighty percent of the 126 women surveyed were pregnant or considering pregnancy within 5 years. Of the 126 respondents, 60 (48%) were overweight or obese. Of these, 96% rated healthy diet and healthy weight before pregnancy as very important or important and 77% favoured a healthy lifestyle programme (diet, weight management and physical activity) before becoming pregnant. Likewise, overweight or obese women reported being likely or highly likely to participate in specific intervention programme aspects such as keeping phone appointments (77%), using a programme website (70%) and keeping food and exercise records (63%). Survey results show that women in this population believe that adopting a healthy lifestyle and losing weight are important before pregnancy and that they are enthusiastic about programmes that will help them achieve those goals in preparation for pregnancy. © 2015 World Obesity.

Weight Management

MedlinePlus

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Nuts for diabetes prevention and management

USDA-ARS?s Scientific Manuscript database

Type 2 diabetes mellitus is an important preventable disease and a growing public health problem. Epidemiologic and clinical studies suggest that healthy eating, physical activity, and body weight control are the main driving forces to reduce diabetes risk. Owing to their low available carbohydrate ...

Short and long-term lifestyle coaching approaches used to address diverse participant barriers to weight loss and physical activity adherence.

PubMed

Venditti, Elizabeth M; Wylie-Rosett, Judith; Delahanty, Linda M; Mele, Lisa; Hoskin, Mary A; Edelstein, Sharon L

2014-02-12

Individual barriers to weight loss and physical activity goals in the Diabetes Prevention Program, a randomized trial with 3.2 years average treatment duration, have not been previously reported. Evaluating barriers and the lifestyle coaching approaches used to improve adherence in a large, diverse participant cohort can inform dissemination efforts. Lifestyle coaches documented barriers and approaches after each session (mean session attendance = 50.3 ± 21.8). Subjects were 1076 intensive lifestyle participants (mean age = 50.6 years; mean BMI = 33.9 kg/m²; 68% female, 48% non-Caucasian). Barriers and approaches used to improve adherence were ranked by the percentage of the cohort for whom they applied. Barrier groupings were also analyzed in relation to baseline demographic characteristics. Top weight loss barriers reported were problems with self-monitoring (58%); social cues (58%); holidays (54%); low activity (48%); and internal cues (thought/mood) (44%). Top activity barriers were holidays (51%); time management (50%); internal cues (30%); illness (29%), and motivation (26%). The percentage of the cohort having any type of barrier increased over the long-term intervention period. A majority of the weight loss barriers were significantly associated with younger age, greater obesity, and non-Caucasian race/ethnicity (p-values vary). Physical activity barriers, particularly thought and mood cues, social cues and time management, physical injury or illness and access/weather, were most significantly associated with being female and obese (p < 0.001 for all). Lifestyle coaches used problem-solving with most participants (≥75% short-term; > 90% long term) and regularly reviewed self-monitoring skills. More costly approaches were used infrequently during the first 16 sessions (≤10%) but increased over 3.2 years. Behavioral problem solving approaches have short and long term dissemination potential for many kinds of participant barriers. Given minimal resources, increased attention to training lifestyle coaches in the consistent use of these approaches appears warranted.

Health investment decisions in response to diabetes information in older Americans.

PubMed

Slade, Alexander N

2012-05-01

Diabetes is a very common and serious chronic disease, and one of the fastest growing disease burdens in the United States. Further, health behaviors, such as exercise, smoking, drinking, as well as weight status, are instrumental to diabetes management and the reduction of its medical consequences. Nine waves of the Health and Retirement Study are used to model the role of a recent diabetes diagnosis and medication on present and subsequent weight status, exercise, drinking and smoking activity. Several non-linear dynamic population average probit models are estimated. Results suggest that compared to non-diagnosed individuals at risk for high blood sugar, diagnosed diabetics respond initially in terms of increasing exercise, losing weight, and curbing smoking and drinking behavior, but the effect diminishes after diagnosis. Evidence of recidivism is also found in these outcomes, especially weight status and physical activity, suggesting that some behavioral responses to diabetes may be short-lived. Copyright © 2012 Elsevier B.V. All rights reserved.

Comprehensive obesity evaluation and treatment of three adolescents: a case series.

PubMed

Taylor, Sharonda J Alston; Peterson, Mitchell A; Garland, Beth H; Hastings, Elisabeth S

2016-02-01

Adolescent obesity is a chronic disease that is impacted from each patient's biopsychosocial milieu. Successfully treating pediatric obesity requires long-term, innovative, systematic involvement to facilitate patient and family engagement and change. Extensive chart review was done for three obese adolescents who underwent comprehensive weight management in an adolescent clinic seen within the past 5 years. The charts were reviewed starting from the time of initial contact through the last visit in the clinic. The patients are no longer receiving care within the clinic. The patients presented with BMI>99th percentile, family history of obesity, severe psychosocial stressors, and multiple obesity-related comorbidities. Their treatment involved comprehensive multidisciplinary intervention in an adolescent weight management clinic within a tertiary care center. In addition to rigorous support through frequent office visits, these patients all eventually required temporary, alternative living arrangements to successfully implement recommendations. One patient resided with another family member; two went to inpatient weight management program care for 2-3 months. All subjects successfully lost weight when away from their primary residence, and they demonstrated improvement or resolution of comorbidities. This case series of three adolescents who underwent comprehensive obesity evaluation and treatment demonstrates multidisciplinary care across interconnected treatment programs and active engagement of family. Those who maintained successful weight loss reduced sedentary time, demonstrated family support (e.g., key members attending follow-up visits), and altered their living environment and were committed to their own health goals.

Metabolic advantages of higher protein diets and benefits of dairy foods on weight management, glycemic regulation, and bone.

PubMed

Pasiakos, Stefan M

2015-03-01

The Inst. of Medicine and World Health Organization have determined that 0.8 to 0.83 g protein·kg(-1) ·d(-1) is the quantity of protein required to establish nitrogen balance in nearly all healthy individuals. However, consuming higher protein diets may be metabolically advantageous, particularly for overweight and obese adults attempting weight loss, and for physically active individuals such as athletes and military personnel. Studies have demonstrated that higher protein diets may spare lean body mass during weight loss, promote weight management, enhance glycemic regulation, and increase intestinal calcium absorption, which may result in long-term improvements in bone health. The extent to which higher protein diets are beneficial is largely attributed to the digestive and absorptive properties, and also to the essential amino acid (EAA) content of the protein. Proteins that are rapidly digested and absorbed likely contribute to the metabolic advantages conferred by consuming higher protein diets. The EAA profiles, as well as the digestive and absorptive properties of dairy proteins, such as whey protein and casein, are particularly advantageous because they facilitate a rapid, robust, and sustained delivery of EAAs to the periphery. This article reviews the scientific literature assessing metabolic advantages associated with higher protein diets on weight management, glycemic regulation, and bone, with emphasis given to studies evaluating the potential benefits associated with dairy. © 2015 Institute of Food Technologists®

[Perioperative management of new oral anticoagulants].

PubMed

Samama, Charles-Marc; Pernod, Gilles; Albaladejo, Pierre; Sie, Pierre

2014-06-01

New oral anticoagulants do represent a major step forward as compared to low molecular weight heparins and vitamin K antagonists. Several issues deserve attention regarding their perioperative management. Three (and very soon four or five) active molecules are available on the market, adding to the major intra- and inter-individual variability, to the high number of drug-drug interactions, and to the interferences of renal function and many other parameters. New tests are available including the diluted thrombin time for dabigatran and a specific anti-Xa test for rivaroxaban and apixaban. No antidote is approved yet. Scheduled surgery: the safest suggestion is to mimic the perioperative management of vitamin K antagonist, with a 5-day interruption and low molecular weight heparin bridging whenever necessary. Emergency procedures: several suggestions issued from the Groupe d'Intérêt en Hémostase Péri-opératoire are proposed. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

[Controlled weight bearing after osteosynthesis].

PubMed

Perren, T; Matter, P

1993-01-01

Patient compliance with postoperative partial weight bearing can be a difficult management problem. The problem may be intentional or unintentional. There is no objective way to assess the amount of weight placed on the lower extremity by the patient. It is our clinical suspicion that patients place more weight than is desirable on the effected limb. There are few reports in the literature on this topic. One study has confirmed our suspicion of poor patient compliance with postoperative weight bearing. Our goal is to develop a system to accurately assess weight bearing and to improve this aspect of postoperative fracture care. Through an active feedback device we hope to improve patient education and understanding. We plan to study the clinical applications of using a pressure sensitive shoe insert device. Our ultimate goal is to improve upon the present device and to study the clinical application of there use.

Motivational "spill-over" during weight control: increased self-determination and exercise intrinsic motivation predict eating self-regulation.

PubMed

Mata, Jutta; Silva, Marlene N; Vieira, Paulo N; Carraça, Eliana V; Andrade, Ana M; Coutinho, Sílvia R; Sardinha, Luis B; Teixeira, Pedro J

2009-11-01

Successful weight management relies on at least two health behaviors, eating and exercise. However, little is known about their interaction on a motivational and behavioral level. Based on the Hierarchical Model of Motivation the authors examined whether exercise-specific motivation can transfer to eating regulation during a lifestyle weight control program. The authors further investigated whether general, treatment-related, and exercise motivation underlie the relation between increased exercise and improved eating regulation. Overweight/obese women participated in a 1-year randomized controlled trial (N = 239). The intervention focused on promoting physical activity and internal motivation for exercise and weight loss, following Self-Determination Theory. The control group received general health education. General and exercise specific self-determination, eating self-regulation variables, and physical activity behavior. General self-determination and more autonomous exercise motivation predicted eating self-regulation over 12 months. Additionally, general and exercise self-determination fully mediated the relation between physical activity and eating self-regulation. Increased general self-determination and exercise motivation seem to facilitate improvements in eating self-regulation during weight control in women. These motivational mechanisms also underlie the relationship between improvements in exercise behavior and eating regulation. PsycINFO Database Record (c) 2009 APA, all rights reserved.

Work site stress management: national survey results.

PubMed

Fielding, J E

1989-12-01

The National Survey of Work Site Health Promotion Activities established baseline data on the frequency of nine types of health promotion activity at private work sites with more than 50 employees in the United States. Stress management activities were provided at 26.6% of work sites. Types of activities at those work sites with some stress management activity included group counseling (58.5%), individual counseling (39.3%), follow-up counseling (25.9%), special events (11.5%), providing information about stress (80.7%), providing a place to relax (64.8%), and making organizational changes to reduce employee stress (81.2%). Frequency of activities varied by industry type and by region of the country. Incidence of most types of activities did not increase as work site size increased, although the likelihood of having any of these activities did increase with work site size. Stress management activities were more likely to be present at work sites with a medical staff or health educator. An increase in output, productivity, or quality was the most frequently cited benefit (46.5%). Negative effects were reported at 2.6% of the work sites. Other health promotion activities found at the work sites surveyed included smoking cessation (61.8%), treatment and control of high blood pressure (36.7%), and weight control (34.7%). Employee Assistance Programs were responsible for stress management at 62% of the work sites with an Employee Assistance Program.

Assessment of Processes of Change for Weight Management in a UK Sample

PubMed Central

Andrés, Ana; Saldaña, Carmina; Beeken, Rebecca J.

2015-01-01

Objective The present study aimed to validate the English version of the Processes of Change questionnaire in weight management (P-Weight). Methods Participants were 1,087 UK adults, including people enrolled in a behavioural weight management programme, university students and an opportunistic sample. The mean age of the sample was 34.80 (SD = 13.56) years, and 83% were women. BMI ranged from 18.51 to 55.36 (mean = 25.92, SD = 6.26) kg/m2. Participants completed both the stages and processes questionnaires in weight management (S-Weight and P-Weight), and subscales from the EDI-2 and EAT-40. A refined version of the P-Weight consisting of 32 items was obtained based on the item analysis. Results The internal structure of the scale fitted a four-factor model, and statistically significant correlations with external measures supported the convergent validity of the scale. Conclusion The adequate psychometric properties of the P-Weight English version suggest that it could be a useful tool to tailor weight management interventions. PMID:25765163

Low-molecular-weight heparins: pharmacologic profile and product differentiation.

PubMed

Fareed, J; Jeske, W; Hoppensteadt, D; Clarizio, R; Walenga, J M

1998-09-10

The interchangeability of low-molecular-weight heparins (LMWHs) has been the subject of discussion since these products were first introduced for the prophylaxis of deep vein thrombosis. Experimental evidence now exists to show that LMWHs differ from each other in a number of characteristics. Products have been differentiated on the basis of molecular weight and biologic properties, but only limited information derived from the clinical setting is available. Potency has been described on the basis of anti-Factor Xa activity, but at equivalent anti-Xa activities, the anti-Factor IIa activity of different products shows marked variations. At the relatively small doses used for the management of postsurgical deep vein thrombosis, the effect of these interproduct differences may be relatively minor, but as LMWHs are developed for therapeutic use at much higher doses, such differences may become clinically important. Variations in safety and efficacy reported in clinical trials of LMWHs may reflect the known differences in their molecular composition and pharmacologic properties.

Depression and Smoking

MedlinePlus

... Quit Stress & Mood Stress & Mood Smoking & Mood Stress Depression Anger Weight Management Weight Management Smoking and Weight Healthy Weight Loss Being Comfortable in Your Own Skin Your Weight Loss Expectations & Goals Healthier Lifestyle ... » Depression Basics » Depression and Smoking Depression and Smoking Why ...

Physiological adaptations to weight loss and factors favouring weight regain

PubMed Central

Greenway, F L

2015-01-01

Obesity is a major global health problem and predisposes individuals to several comorbidities that can affect life expectancy. Interventions based on lifestyle modification (for example, improved diet and exercise) are integral components in the management of obesity. However, although weight loss can be achieved through dietary restriction and/or increased physical activity, over the long term many individuals regain weight. The aim of this article is to review the research into the processes and mechanisms that underpin weight regain after weight loss and comment on future strategies to address them. Maintenance of body weight is regulated by the interaction of a number of processes, encompassing homoeostatic, environmental and behavioural factors. In homoeostatic regulation, the hypothalamus has a central role in integrating signals regarding food intake, energy balance and body weight, while an ‘obesogenic' environment and behavioural patterns exert effects on the amount and type of food intake and physical activity. The roles of other environmental factors are also now being considered, including sleep debt and iatrogenic effects of medications, many of which warrant further investigation. Unfortunately, physiological adaptations to weight loss favour weight regain. These changes include perturbations in the levels of circulating appetite-related hormones and energy homoeostasis, in addition to alterations in nutrient metabolism and subjective appetite. To maintain weight loss, individuals must adhere to behaviours that counteract physiological adaptations and other factors favouring weight regain. It is difficult to overcome physiology with behaviour. Weight loss medications and surgery change the physiology of body weight regulation and are the best chance for long-term success. An increased understanding of the physiology of weight loss and regain will underpin the development of future strategies to support overweight and obese individuals in their efforts to achieve and maintain weight loss. PMID:25896063

Healthy Eating and Exercise: Strategies for Weight Management in the Rural Midwest

ERIC Educational Resources Information Center

Nothwehr, Faryle; Peterson, N. Andrew

2005-01-01

Obesity prevalence has increased dramatically in the United States. Rural areas have been especially affected, yet few weight management studies have been conducted in these populations. This study was designed to assess weight management attitudes and strategies used when rural adults in particular attempt to lose weight, employing measures that…

A Cross Sectional Comparison of Predisposing, Reinforcing and Enabling Factors for Lifestyle Health Behaviours and Weight Gain in Healthy and Overweight Pregnant Women.

PubMed

de Jersey, Susan J; Mallan, Kimberley; Callaway, Leonie; Daniels, Lynne A; Nicholson, Jan M

2017-03-01

Objectives Little is known about the antecedents to dietary and physical activity behaviours that can support healthy gestational weight gain (GWG) across different weight status groups in pregnancy. The aim of this study was to use constructs common to dominant health behaviour theories to determine if predisposing, reinforcing and enabling factors for healthy eating, physical activity and weight gain differed between healthy and overweight pregnant women. Methods Pregnant women (n = 664) aged 29 ± 5 (mean ± SD) years were recruited at 16 ± 2 weeks gestation. Measures were self-reported pre-pregnancy weight, psychosocial constructs for healthy eating, physical activity and GWG and demographic data. Height was measured at 16 weeks. Psychosocial constructs were compared between women with pre-pregnancy weight status of healthy (BMI < 25 kg/m 2 ) and overweight (BMI ≥ 25 kg/m 2 ). Results Health behaviour intentions, positive outcome expectations and social support for healthy eating and physical activity were not different between healthy (66 %) and overweight (34 %) women. Overweight women had lower self-efficacy for healthy eating, physical activity and GWG (p < 0.001), higher negative outcome expectations for GWG (p = 0.004), and higher barriers to healthy eating (p = 0.002), and physical activity (p = 0.006). Conclusions for practice Both healthy and overweight women appear motivated to follow a healthy diet, exercise and avoid excess gestational weight during pregnancy. However many psychosocial factors associated with achieving these goals were different between healthy and overweight women. Health behaviour interventions tailored to overweight pregnant women should consider improving self-efficacy, providing support to overcome perceived barriers, validate positive changes made, and assist in managing negative expectations.

Exploring weight loss services in primary care and staff views on using a web-based programme.

PubMed

Ware, Lisa J; Williams, Sarah; Bradbury, Katherine; Brant, Catherine; Little, Paul; Hobbs, F D Richard; Yardley, Lucy

2012-01-01

Demand is increasing for primary care to deliver effective weight management services to patients, but research suggests that staff feel inadequately resourced for such a role. Supporting service delivery with a free and effective web-based weight management programme could maximise primary care resource and provide cost-effective support for patients. However, integration of e-health into primary care may face challenges. To explore primary care staff experiences of delivering weight management services and their perceptions of a web-based weight management programme to aid service delivery. Focus groups were conducted with primary care physicians, nurses and healthcare assistants (n = 36) involved in delivering weight loss services. Data were analysed using inductive thematic analysis. Participants thought that primary care should be involved in delivering weight management, especially when weight was aggravating health problems. However, they felt under-resourced to deliver these services and unsure as to the effectiveness of their input, as routine services were not evaluated. Beliefs that current services were ineffective resulted in staff reluctance to allocate more resources. Participants were hopeful that supplementing practice with a web-based weight management programme would enhance patient services and promote service evaluation. Although primary care staff felt they should deliver weight loss services, low levels of faith in the efficacy of current treatments resulted in provision of under-resourced and 'ad hoc' services. Integration of a web-based weight loss programme that promotes service evaluation and provides a cost-effective option for supporting patients may encourage practices to invest more in weight management services.

Comparing women pharmacy consumers’ experiences with weight loss treatment in Victoria and Nottingham: a cross-sectional study

PubMed Central

2014-01-01

Background There has been a recent increase in weight management services available in pharmacies across Australia and England. The aim of this study was to determine the following between women in Victoria and Nottingham: similarities and differences of what weight management options are preferred by women pharmacy consumers; how they feel about pharmacists providing advice in this area; and what they desire in a weight management program. Method Women pharmacy consumers were randomly approached by a researcher in community pharmacies in Victoria and Nottingham and asked to complete a questionnaire regarding their own weight management experiences. The questionnaire was self-completed or researcher-administered and was comprised of four main sections that focused on the participant’s general health, previous weight loss experiences, their ideal weight management program and their demographics. Data was entered in SPSS 19 and logistic regression was used to identify any differences in weight loss experiences between women. Results The participant rates were high: 86% (n = 395/460) in Victoria and 98% in Nottingham (n = 215/220). Overall, women in Victoria and Nottingham were similar with comparable demographics. Approximately 50% (250/507) of women were in the overweight or obese body mass index category, with over 70% (n = 436/610) of women having attempted to lose weight in the past. The majority of women (n = 334/436) felt comfortable receiving advice from pharmacists. In the logistic regression analysis women in Nottingham were found to be significantly less likely to have utilised a pharmacy weight management program in the last five years (OR: 0.23 CI: 0.08, 0.63) and were significantly less likely to want an ideal weight management program located in a pharmacy (OR: 0.49 CI: 0.30, 0.82) compared to women in Victoria. No significant associations between location and feeling comfortable with a pharmacist advising on weight loss or wanting a pharmacist in an ideal weight management program were seen. Conclusion Results from this study have provided information on possible ideal pharmacy weight management programs in both Victoria and Nottingham. Although differences were seen between the two populations, similarities between ideal weight management programs and comfort level with pharmacist interaction were noted. PMID:24972611

Comparison of range of commercial or primary care led weight reduction programmes with minimal intervention control for weight loss in obesity: lighten Up randomised controlled trial.

PubMed

Jolly, Kate; Lewis, Amanda; Beach, Jane; Denley, John; Adab, Peymane; Deeks, Jonathan J; Daley, Amanda; Aveyard, Paul

2011-11-03

To assess the effectiveness of a range of weight management programmes in terms of weight loss. Eight arm randomised controlled trial. Primary care trust in Birmingham, England. 740 obese or overweight men and women with a comorbid disorder identified from general practice records. Weight loss programmes of 12 weeks' duration: Weight Watchers; Slimming World; Rosemary Conley; group based, dietetics led programme; general practice one to one counselling; pharmacy led one to one counselling; choice of any of the six programmes. The comparator group was provided with 12 vouchers enabling free entrance to a local leisure (fitness) centre. The primary outcome was weight loss at programme end (12 weeks). Secondary outcomes were weight loss at one year, self reported physical activity, and percentage weight loss at programme end and one year. Follow-up data were available for 658 (88.9%) participants at programme end and 522 (70.5%) at one year. All programmes achieved significant weight loss from baseline to programme end (range 1.37 kg (general practice) to 4.43 kg (Weight Watchers)), and all except general practice and pharmacy provision resulted in significant weight loss at one year. At one year, only the Weight Watchers group had significantly greater weight loss than did the comparator group (2.5 (95% confidence interval 0.8 to 4.2) kg greater loss,). The commercial programmes achieved significantly greater weight loss than did the primary care programmes at programme end (mean difference 2.3 (1.3 to 3.4) kg). The primary care programmes were the most costly to provide. Participants allocated to the choice arm did not have better outcomes than those randomly allocated to a programme. Commercially provided weight management services are more effective and cheaper than primary care based services led by specially trained staff, which are ineffective. Trial registration Current Controlled Trials ISRCTN25072883.

School restrictions on outdoor activities and weight status in adolescent children after Japan’s 2011 Fukushima Nuclear Power Plant disaster: a mid-term to long-term retrospective analysis

PubMed Central

Nomura, Shuhei; Blangiardo, Marta; Hodgson, Susan

2016-01-01

Objective Radiation fears following Japan's 2011 Fukushima nuclear disaster affected levels of physical activity in local children. We assessed the postdisaster versus predisaster weight status in school children and evaluated to what extent school restrictions on outdoor activities that were intended to reduce radiation exposure risk affected child weight. Participants We considered children aged 13–15 years from 4 of the 5 secondary schools in Soma City (n=1030, 99.1% of all children in the city), located in 35–50 km from the Fukushima nuclear plant, postdisaster (2012 and 2015) and predisaster (2010). Methods Weight status, in terms of body mass index (BMI), percentage of overweight (POW) and incidence of obesity and underweight (defined as a POW ≥20% and ≤−20%, respectively) were examined and compared predisaster and postdisaster using regression models. We also constructed models to assess the impact of school restrictions on outdoor activity on weight status. Results After adjustment for covariates, a slight decrease in mean BMI and POW was detected in females in 2012 (−0.37, 95% CI −0.68 to −0.06; and −1.97, 95% CI −3.57 to −0.36, respectively). For male children, obesity incidence increased in 2012 (OR for obesity: 1.45, 95% CI 1.02 to 2.08). Compared with predisaster weight status, no significant weight change was identified in 2015 in either males or females. School restrictions on outdoor activities were not significantly associated with weight status. Conclusions 4 years following the disaster, weight status has recovered to the predisaster levels for males and females; however, a slight decrease in weight in females and a slight increase in risk of obesity were observed in males 1 year following the disaster. Our findings could be used to guide actions taken during the early phase of a radiological disaster to manage the postdisaster health risks in adolescent children. PMID:27683520

Adiposity, hypertension and weight management behaviours in Ghanaian type 2 diabetes mellitus patients aged 20-70 years.

PubMed

Mogre, Victor; Apala, Peter; Nsoh, Jonas A; Wanaba, Peter

2016-01-01

This study assessed the prevalence of general and abdominal obesity and hypertension as well the weight management behaviours of type 2 diabetes mellitus patients. It included 378 diabetes patients seeking care from two hospitals in Ghana. Standard methods and tools were used to assess participants' weight, height, waist circumference (WC), blood pressure (BP) and fasting plasma glucose (FPG). Weight management behaviours were measured using a questionnaire. The prevalence of general obesity, abdominal obesity and hypertension was 20.1%, 46.6% and 67.7% respectively. Abdominal obesity was more likely in participants who: skipped breakfast, engaged in exercise to lose weight and were generally overweight/obese. General overweight and obesity was more likely in participants who: reported receipt of weight management counselling, engaged in exercise to lose weight, had a weight management plan/goal, and were abdominally obese. Hypertension was less likely in participants who had: no formal education, diabetes for ≥5 years and modified their dietary habits to lose weight but more likely in those who skipped breakfast. Abdominal obesity, general overweight/obesity, and hypertension were frequent in this sample and were influenced by weight management behaviours. Copyright © 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.

50 CFR 660.502 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., industrial uses or long-term storage, including, but not limited to, cooking, canning, smoking, salting... terms used in this subpart have the following meanings: Actively managed species (AMS) means those CPS..., by weight, of a coastal pelagic species population. The term biomass means total biomass (age 1 and...

1995 Truck Size and Weight Performance-Based Workshop report : activity 5 : document North American and European experiences

DOT National Transportation Integrated Search

2012-08-01

This report presents the test plan for conducting the Technical Capability Analysis for the United States Department of Transportation (U.S. DOT) evaluation of the San Diego Integrated Corridor Management (ICM) Initiative Demonstration. The ICM proje...

Weight management program for treatment-emergent weight gain in olanzapine-treated patients with schizophrenia or schizoaffective disorder: A 12-week randomized controlled clinical trial.

PubMed

Kwon, Jun Soo; Choi, Jung-Seok; Bahk, Won-Myoung; Yoon Kim, Chang; Hyung Kim, Chan; Chul Shin, Young; Park, Byung-Joo; Geun Oh, Chang

2006-04-01

The main objective was to assess the efficacy of a weight management program designed for outpatients taking olanzapine for schizophrenia or schizoaffective disorder and to compare these patients with a randomized control group. The effects of the weight management program were also assessed with regard to safety and quality of life. Forty-eight patients were enrolled in a 12-week, randomized, multicenter weight management study. Thirty-three patients were randomly allocated to an intervention group in which they received olanzapine within a weight management program. Fifteen patients were allocated to a control group in which they were given olanzapine treatment as usual outpatients. Weight, body mass index (BMI), and measurements of safety and quality of life were evaluated. The study was conducted from January 7, 2003, to September 16, 2003. Thirty-six patients (75%) completed this study. We found significant differences in weight (-3.94 +/- 3.63 kg vs. -1.48 +/- 1.88 kg, p = .006) and BMI (-1.50 +/- 1.34 vs. -0.59 +/- 0.73, p = .007) change from baseline to endpoint between the intervention and control groups, respectively. Significant differences in weight reduction were initially observed at week 8 (p = .040). No significant differences were found with regard to the safety outcomes. When the ratio of low-density lipoproteins to high-density lipoproteins was calculated, change from baseline was greater in the intervention group than the control group (-0.19 vs. -0.04), but the difference was not statistically significant (p = .556). After the completion of the weight management program, there was a trend toward statistical difference in the physical health score changes between the weight management and control groups (1.12 in the intervention group vs. -0.93 in the control group, p = .067). The weight management program was effective in terms of weight reduction in patients with schizophrenia or schizoaffective disorder taking olanzapine and was also found to be safe in terms of psychiatric symptoms, vital signs, and laboratory data. In addition, such a weight management program might improve quality of life in patients with schizophrenia or schizoaffective disorder with respect to their physical well-being.

Weight Goals, Perceptions, and Practices among Hispanic and Anglo College Females

ERIC Educational Resources Information Center

Shamaley-Kornatz, Angelee; Smith, Brenda; Tomaka, Joe

2007-01-01

This study explored the weight management practices, rates overweight and obesity, perceptions of body weight, and weight management goals in a large sample (N = 467) of Hispanic (n = 421) and Anglo (n = 46) female college students on the U.S.-Mexico border. Women self-reported their height and weight, weight perceptions, and weight management…

Treatment of NAFLD with diet, physical activity and exercise.

PubMed

Romero-Gómez, Manuel; Zelber-Sagi, Shira; Trenell, Michael

2017-10-01

Lifestyle intervention can be effective when treating non-alcoholic fatty liver diseases (NAFLD) patients. Weight loss decreases cardiovascular and diabetes risk and can also regress liver disease. Weight reductions of ⩾10% can induce a near universal non-alcoholic steatohepatitis resolution and fibrosis improvement by at least one stage. However, modest weight loss (>5%) can also produce important benefits on the components of the NAFLD activity score (NAS). Additionally, we need to explore the role of total calories and type of weight loss diet, micro- and macronutrients, evidence-based benefits of physical activity and exercise and finally support these modifications through established behavioural change models and techniques for long-term maintenance of lifestyle modifications. Following a Mediterranean diet can reduce liver fat even without weight loss and is the most recommended dietary pattern for NAFLD. The Mediterranean diet is characterised by reduced carbohydrate intake, especially sugars and refined carbohydrates (40% of the calories vs. 50-60% in a typical low fat diet), and increased monounsaturated and omega-3 fatty acid intake (40% of the calories as fat vs. up-to 30% in a typical low fat diet). Both TV sitting (a reliable marker of overall sedentary behaviour) and physical activity are associated with cardio-metabolic health, NAFLD and overall mortality. A 'triple hit behavioural phenotype' of: i) sedentary behaviour, ii) low physical activity, and iii) poor diet have been defined. Clinical evidence strongly supports the role of lifestyle modification as a primary therapy for the management of NAFLD and NASH. This should be accompanied by the implementation of strategies to avoid relapse and weight regain. Copyright © 2017 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Information needs of cancer patients and survivors regarding diet, exercise and weight management: a qualitative study.

PubMed

James-Martin, G; Koczwara, B; Smith, E L; Miller, M D

2014-05-01

While advanced cancer is often associated with weight loss, curative cancer treatment is often associated with weight gain. Weight gain during treatment may be associated with greater risk of cancer recurrence and development of lifestyle diseases. Currently, limited resources are available to cancer patients focussed on weight control. This study assessed the information needs of patients undergoing curative chemotherapy regarding diet, exercise and weight management for the purpose of developing weight management resources. Focus groups were held with oncology practitioners, patients and survivors to determine current information provision and needs. Focus groups highlighted a perception that information provision regarding diet, exercise and weight management is insufficient and no routine assessment of weight occurs during chemotherapy. Barriers to information provision described included lack of resources and time, and practitioners' uncertainty regarding appropriate messages to provide. Patients wanted more information regarding diet, exercise and weight during treatment time. The findings of this study suggest an increase in provision of diet, exercise and weight management information is needed. This information should be evidence-based and delivered at an appropriate time by the preferred health care professional. It would also be beneficial to implement protocols regarding assessment of weight during treatment. © 2013 John Wiley & Sons Ltd.

Impact of parental weight status on a school-based weight management programme designed for Mexican-American children.

PubMed

Moreno, J P; Johnston, C A; Hernandez, D C; LeNoble, J; Papaioannou, M A; Foreyt, J P

2016-10-01

While overweight and obese children are more likely to have overweight or obese parents, less is known about the effect of parental weight status on children's success in weight management programmes. This study was a secondary data analysis of a randomized controlled trial and investigated the impact of having zero, one or two obese parents on children's success in a school-based weight management programme. Sixty-one Mexican-American children participated in a 24-week school-based weight management intervention which took place in 2005-2006. Children's heights and weights were measured at baseline, 3, 6 and 12 months. Parental weight status was assessed at baseline. Repeated measures anova and ancova were conducted to compare changes in children's weight within and between groups, respectively. Within-group comparisons revealed that the intervention led to significant decreases in standardized body mass index (zBMI) for children with zero (F = 23.16, P < .001) or one obese (F = 4.99, P < .05) parent. Between-group comparisons indicated that children with zero and one obese parents demonstrated greater decreases in zBMI compared to children with two obese parents at every time point. The school-based weight management programme appears to be most efficacious for children with one or no obese parents compared to children with two obese parents. These results demonstrate the need to consider parental weight status when engaging in childhood weight management efforts. © 2015 World Obesity.

Stop the Pediatric Obesity Epidemic: Is the EMR a Solution to Alert Providers?

ERIC Educational Resources Information Center

Williams, Kim

2016-01-01

Introduction: Weight management is an unrelenting issue affecting people of all ages. Addressing weight management is among the priority health concerns in the United States. Evidence suggests that some health providers are not recognizing or managing patients' weight management issues. The electronic medical record and automation may help…

Influence of Highly Accessible Urban Food Environment on Weight Management: A Qualitative Study in Seoul

PubMed Central

Kwon, Soonman

2018-01-01

We explored the characteristics of the food environment and its influence on weight management in Seoul, Korea. Photo elicitation interviews were conducted with 73 participants who took three photographs per topic related to their food environment and discussed these photographs in groups. Through thematic analysis, we identified four themes concerning participants’ perceptions of the food environment and weight management: (1) “convenience comes first,” (2) “tempting food environment,” (3) “alcohol and anju,” and (4) “burden of individual effort to manage weight.” A systematic change toward an environment supportive of healthy eating and weight management is recommended. PMID:29662012

Systematic reviews of and integrated report on the quantitative, qualitative and economic evidence base for the management of obesity in men.

PubMed

Robertson, Clare; Archibald, Daryll; Avenell, Alison; Douglas, Flora; Hoddinott, Pat; van Teijlingen, Edwin; Boyers, Dwayne; Stewart, Fiona; Boachie, Charles; Fioratou, Evie; Wilkins, David; Street, Tim; Carroll, Paula; Fowler, Colin

2014-05-01

Obesity increases the risk of many serious illnesses such as coronary heart disease, type 2 diabetes and osteoarthritis. More men than women are overweight or obese in the UK but men are less likely to perceive their weight as a problem and less likely to engage with weight-loss services. The aim of this study was to systematically review evidence-based management strategies for treating obesity in men and investigate how to engage men in obesity services by integrating the quantitative, qualitative and health economic evidence base. Electronic databases including MEDLINE, EMBASE, PsycINFO, the Cochrane Central Register of Controlled Trials, the Database of Abstracts of Reviews of Effects and the NHS Economic Evaluation Database were searched from inception to January 2012, with a limited update search in July 2012. Subject-specific websites, reference lists and professional health-care and commercial organisations were also consulted. Six systematic reviews were conducted to consider the clinical effectiveness, cost-effectiveness and qualitative evidence on interventions for treating obesity in men, and men in contrast to women, and the effectiveness of interventions to engage men in their weight reduction. Randomised controlled trials (RCTs) with follow-up data of at least 1 year, or any study design and length of follow-up for UK studies, were included. Qualitative and mixed-method studies linked to RCTs and non-randomised intervention studies, and UK-based, men-only qualitative studies not linked to interventions were included. One reviewer extracted data from the included studies and a second reviewer checked data for omissions or inaccuracies. Two reviewers carried out quality assessment. We undertook meta-analysis of quantitative data and a realist approach to integrating the qualitative and quantitative evidence synthesis. From a total of 12,764 titles reviewed, 33 RCTs with 12 linked reports, 24 non-randomised reports, five economic evaluations with two linked reports, and 22 qualitative studies were included. Men were more likely than women to benefit if physical activity was part of a weight-loss programme. Reducing diets tended to produce more favourable weight loss than physical activity alone (mean weight change after 1 year from a reducing diet compared with an exercise programme -3.2 kg, 95% CI -4.8 kg to -1.6 kg). The type of reducing diet did not affect long-term weight loss. A reducing diet plus physical activity and behaviour change gave the most effective results. Low-fat reducing diets, some with meal replacements, combined with physical activity and behaviour change training gave the most effective long-term weight change in men [-5.2 kg (standard error 0.2 kg) after 4 years]. Such trials may prevent type 2 diabetes in men and improve erectile dysfunction. Although fewer men joined weight-loss programmes, once recruited they were less likely to drop out than women (difference 11%, 95% CI 8% to 14%). The perception of having a health problem (e.g. being defined as obese by a health professional), the impact of weight loss on health problems and desire to improve personal appearance without looking too thin were motivators for weight loss amongst men. The key components differ from those found for women, with men preferring more factual information on how to lose weight and more emphasis on physical activity programmes. Interventions delivered in social settings were preferred to those delivered in health-care settings. Group-based programmes showed benefits by facilitating support for men with similar health problems, and some individual tailoring of advice assisted weight loss in some studies. Generally, men preferred interventions that were individualised, fact-based and flexible, which used business-like language and which included simple to understand information. Preferences for men-only versus mixed-sex weight-loss group programmes were divided. In terms of context, programmes which were cited in a sporting context where participants have a strong sense of affiliation showed low drop out rates and high satisfaction. Although some men preferred weight-loss programmes delivered in an NHS context, the evidence comparing NHS and commercial programmes for men was unclear. The effect of family and friends on participants in weight-loss programmes was inconsistent in the evidence reviewed - benefits were shown in some cases, but the social role of food in maintaining relationships may also act as a barrier to weight loss. Evidence on the economics of managing obesity in men was limited and heterogeneous. The main limitations were the limited quantity and quality of the evidence base and narrow outcome reporting, particularly for men from disadvantaged and minority groups. Few of the studies were undertaken in the UK. Weight reduction for men is best achieved and maintained with the combination of a reducing diet, physical activity advice or a physical activity programme, and behaviour change techniques. Tailoring interventions and settings for men may enhance effectiveness, though further research is needed to better understand the influence of context and content. Future studies should include cost-effectiveness analyses in the UK setting. This project was funded by the NIHR Health Technology Assessment programme.

“At 150 kg, you can't run” men's weight loss stories in a popular health magazine provide appropriate examples of good health practice

PubMed Central

Couch, Danielle; Han, Gil-Soo; Robinson, Priscilla; Komesaroff, Paul

2014-01-01

We explore weight loss stories from 47 men collected from the Australian edition of Men's Health magazine between January 2009 and December 2012. Our analysis uses a mixed methods approach that combines thematic analysis and descriptive statistics to examine weight loss strategies against clinical practice guidelines for the management of overweight and obesity. All the stories reported the use of physical activity for weight loss and most stories detailed dietary changes for weight loss. Our findings indicate that most of the men reportedly used some form of behavioural strategies to assist them in their behaviour change efforts. The weight loss methods used were consistent with clinical practice guidelines, with the exception of some dietary practices. As narratives may assist with behaviour change, stories like those examined in this study could prove to be very useful in promoting weight loss to men. PMID:25750780

Obesity evaluation and treatment: Expert Committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services.

PubMed

Barlow, S E; Dietz, W H

1998-09-01

The development of recommendations for physicians, nurse practitioners, and nutritionists to guide the evaluation and treatment of overweight children and adolescents. The Maternal and Child Health Bureau, Health Resources and Services Administration, the Department of Health and Human Services convened a committee of pediatric obesity experts to develop the recommendations. The Committee recommended that children with a body mass index (BMI) greater than or equal to the 85th percentile with complications of obesity or with a BMI greater than or equal to the 95th percentile, with or without complications, undergo evaluation and possible treatment. Clinicians should be aware of signs of the rare exogenous causes of obesity, including genetic syndromes, endocrinologic diseases, and psychologic disorders. They should screen for complications of obesity, including hypertension, dyslipidemias, orthopedic disorders, sleep disorders, gall bladder disease, and insulin resistance. Conditions that indicate consultation with a pediatric obesity specialist include pseudotumor cerebri, obesity-related sleep disorders, orthopedic problems, massive obesity, and obesity in children younger than 2 years of age. Recommendations for treatment evaluation included an assessment of patient and family readiness to engage in a weight-management program and a focused assessment of diet and physical activity habits. The primary goal of obesity therapy should be healthy eating and activity. The use of weight maintenance versus weight loss to achieve weight goals depends on each patient's age, baseline BMI percentile, and presence of medical complications. The Committee recommended treatment that begins early, involves the family, and institutes permanent changes in a stepwise manner. Parenting skills are the foundation for successful intervention that puts in place gradual, targeted increases in activity and targeted reductions in high-fat, high-calorie foods. Ongoing support for families after the initial weight-management program will help families maintain their new behaviors. These recommendations provide practical guidance to pediatric clinicians who evaluate and treat overweight children.

The impact of social deprivation on the response to a randomised controlled trial of a weight management intervention (BeWEL) for people at increased risk of colorectal cancer.

PubMed

Fisher, A; Craigie, A M; Macleod, M; Steele, R J C; Anderson, A S

2018-06-01

Although 45% of colorectal cancer (CRC) cases may be avoidable through appropriate lifestyle and weight management, health promotion interventions run the risk of widening health inequalities. The BeWEL randomised controlled trial assessed the impact of a diet and activity programme in overweight adults who were diagnosed with a colorectal adenoma, demonstrating a significantly greater weight loss at 12 months in intervention participants than in controls. The present study aimed to compare BeWEL intervention outcomes by participant deprivation status. The intervention group of the BeWEL trial (n = 163) was classified by the Scottish Index of Multiple Deprivation (SIMD) quintiles into 'more deprived' (SIMD 1-2, n = 58) and 'less deprived' (SIMD 3-5, n = 105). Socio-economic and lifestyle variables were compared at baseline to identify potential challenges to intervention adherence in the more deprived. Between group differences at 12 months in primary outcome (change in body weight) and secondary outcomes (cardiovascular risk factors, diet, physical activity, knowledge of CRC risk and psychosocial variables) were assessed by deprivation status. At baseline, education (P = 0.001), income (P < 0.001), spending on physical activity (P = 0.003) and success at previous weight loss attempts (P = 0.007) were significantly lower in the most deprived. At 12 months, no between group differences by deprivation status were detected for changes in primary and main secondary outcomes. Despite potential barriers faced by the more deprived participants, primary and most secondary outcomes were comparable between groups, indicating that this intervention is unlikely to worsen health inequalities and is equally effective across socio-economic groups. © 2017 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.

Fifteen years of the Family Eating and Activity Habits Questionnaire (FEAHQ): an update and review.

PubMed

Golan, M

2014-04-01

The Family Eating and Activity Habits Questionnaire (FEAHQ) is a 32-item self-report instrument designed to assess the eating and activity habits of family members as well as obesogenic factors in the overall home environment (stimulus and behaviour patterns) related to weight. Originally, this questionnaire, which was developed in Israel, was designed for use in family-based weight-management interventions that emphasized changes in the environment, and in parents' knowledge, behaviours and modelling. It was developed for use with children aged 6-11 years and designed for co-completion by parents or caretakers and their children. Over the years, it has been administered in research and clinical settings in Israel, England, Australia and other countries. Its 15-year anniversary calls for an update in the literature regarding adjustments made to improve its use in different settings and with different ethnic populations and the psychometric properties of the revised version. The goal of this paper is threefold: (i) to describe the history and development of the FEAHQ; (ii) to present new data supporting the psychometric properties of the subscales of the Revised FEAHQ (FEAHQ-R) for ages 6-12 years and (iii) to review the clinical and research literature reporting on FEAHQ subscales. The psychometric properties of the revised questionnaire were evaluated in a randomized control trial and in a naturalistic, community-based study to promote healthy lifestyle among families with children 6-12 years of age from different ethnic populations. The tool demonstrated good test-retest reliability when completed by caretakers and very good internal consistency. The questionnaire scores discriminated between obese and normal-weight children and predicted the weight classification of 66% of the participants. The FEAHQ-R is a useful clinical tool for identifying target behaviors for treatment and monitoring treatment progress that centers on overweight prevention and weight management. © 2013 The Author. Pediatric Obesity © 2013 International Association for the Study of Obesity.

From weight management goals to action planning: identification of a logical sequence from goals to actions and underlying determinants.

PubMed

van Genugten, L; van Empelen, P; Oenema, A

2012-08-01

Weight gain prevention (WGP) among adults who are overweight is an important target in the prevention of obesity. However, little is known about the process from WGP as a goal to successful weight-management. The present study aimed to: (i) gain more insight into this process; (ii) identify cognitive predictors of intention for WGP; and (iii) examine WGP as a potential predictor for the intention to change weight-related behaviours [dietary intake (DI) and physical activity (PA)] and specific action planning. In this cross-sectional study, overweight adults [n = 510; body mass index 25-30 kg m(-2); mean (SD) age 48 (9.5) years; 30.8% male] completed an online questionnaire, assessing goal intention for WGP, behavioural intention for DI and PA, planning for change in DI and PA and socio-cognitive correlates. Ordinal regression analyses were used to analyse the data. In 89% of the sample, (parts of) the proposed sequence from goal intention (for WGP), behavioural intention (for DI/PA) and planning (for DI/PA) was observed. Attitude, social norm and perceived control towards WGP, and perceived weight status and risk perception, were associated with intention for WGP. Behaviour-specific perceived control and preferences were more strongly associated with intention to change DI or PA and planning for change than intention for WGP was. Intention for WGP is important in the process toward weight-management because, for most people, intention for WGP precedes behavioural intention, which precedes planning. Intention for WGP is associated with behavioural intention but behaviour-specific factors are the strongest correlates of behavioural intention and planning. © 2012 The Authors. Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

Effects of the Healthy Start randomized intervention trial on physical activity among normal weight preschool children predisposed to overweight and obesity.

PubMed

Händel, Mina Nicole; Larsen, Sofus Christian; Rohde, Jeanett Friis; Stougaard, Maria; Olsen, Nanna Julie; Heitmann, Berit Lilienthal

2017-01-01

There is limited evidence to support the effectiveness of primary interventions aiming to prevent excess weight gain among young children. Evaluating behavioral changes, such as physical activity (PA), may add to future development of efficient interventions. The objective was to evaluate the effect on PA outcomes of the 15 month Healthy Start intervention that focused on changing diet, PA, sleep and stress management among normal weight but obesity-prone preschool children. Children were defined as obesity-prone if they had a birth weight > 4,000 g, mothers with a pre-pregnancy body mass index of > 28 kg/m2, or mothers with ≤ 10 years of schooling. From a baseline study population of 635 normal weight 2-6 year old preschool children from the greater Copenhagen area, parents of 307 children had given information on PA at both the baseline and follow-up examinations. PA was obtained from a 7 days recording in the Children's Physical Activity Questionnaire. Time used for sport activities were combined with outdoor playing time to achieve a proxy of total PA level of moderate to vigorous intensity. Linear regression analyses revealed that at follow-up the intervention group spent more time on sports and outdoor activities combined per week than the control group (ITT analyses: intervention: 400 min/week; 95% confidence interval (CI): 341, 459 versus control: 321 min/week; 95% CI: 277, 366; p = 0.02), although no significant intervention effects were seen for each of the subcategories, e.g. sports participation, outdoor activities, screen time, or commuting frequency. Our results suggest that the overall time spent on sports and outdoor activities combined was increased at follow-up among normal weight obesity-prone children, as a result of the Healthy Start intervention. ClinicalTrials.gov NCT01583335.

Effects of the Healthy Start randomized intervention trial on physical activity among normal weight preschool children predisposed to overweight and obesity

PubMed Central

Larsen, Sofus Christian; Rohde, Jeanett Friis; Stougaard, Maria; Olsen, Nanna Julie; Heitmann, Berit Lilienthal

2017-01-01

Background There is limited evidence to support the effectiveness of primary interventions aiming to prevent excess weight gain among young children. Evaluating behavioral changes, such as physical activity (PA), may add to future development of efficient interventions. The objective was to evaluate the effect on PA outcomes of the 15 month Healthy Start intervention that focused on changing diet, PA, sleep and stress management among normal weight but obesity-prone preschool children. Children were defined as obesity-prone if they had a birth weight > 4,000 g, mothers with a pre-pregnancy body mass index of > 28 kg/m2, or mothers with ≤ 10 years of schooling. Method From a baseline study population of 635 normal weight 2–6 year old preschool children from the greater Copenhagen area, parents of 307 children had given information on PA at both the baseline and follow-up examinations. PA was obtained from a 7 days recording in the Children’s Physical Activity Questionnaire. Time used for sport activities were combined with outdoor playing time to achieve a proxy of total PA level of moderate to vigorous intensity. Results Linear regression analyses revealed that at follow-up the intervention group spent more time on sports and outdoor activities combined per week than the control group (ITT analyses: intervention: 400 min/week; 95% confidence interval (CI): 341, 459 versus control: 321 min/week; 95% CI: 277, 366; p = 0.02), although no significant intervention effects were seen for each of the subcategories, e.g. sports participation, outdoor activities, screen time, or commuting frequency. Conclusion Our results suggest that the overall time spent on sports and outdoor activities combined was increased at follow-up among normal weight obesity-prone children, as a result of the Healthy Start intervention. Trial registration ClinicalTrials.gov NCT01583335 PMID:28991907

Women's Reported Health Behaviours before and during Pregnancy: A Retrospective Study

ERIC Educational Resources Information Center

Smedley, Jenna; Jancey, Jonine M.; Dhaliwal, Satvinder; Zhao, Yun; Monteiro, Sarojini M. D. R.; Howat, Peter

2014-01-01

Objective: This study aimed to determine women's reported health behaviours (physical activity, diet, weight management) before and during pregnancy, and to identify sources of health information. Design: Retrospective study incorporating quantitative (a self-completed survey) and qualitative (one-on-one interviews) methods. Methodology:…

African american women, hair care, and health barriers.

PubMed

Gathers, Raechele Cochran; Mahan, Meredith Grace

2014-09-01

The objective of this study was to elucidate the prevalence of hair loss among African American women; explore the psychosocial impact of hair grooming difficulties; and examine both perceptions related to physician encounters in this group and the relationship between hair grooming, physical activity, and weight maintenance. An anonymous retrospective and qualitative survey, the Hair Care Assessment Survey, is an 18-question novel survey instrument designed at the Henry Ford Hospital Department of Dermatology Multicultural Dermatology Center. The Hair Care Assessment Survey was distributed at church-related functions at predominantly African American metropolitan Detroit churches. Two hundred African American women from metropolitan Detroit, Michigan, aged 21 to 83. The Hair Care Assessment Survey collected data relating to hair loss and hair care, psychosocial experiences relating to hair loss, and hair care as it relates to exercise and body weight management. Data was collected on doctor-patient hair-related medical visits and experiences with commercially available ethnic hair care products. More than 50 percent reported excessive hair loss. Twenty-eight percent had visited a physician to discuss hair issues, but only 32 percent felt their physician understood African American hair. Forty-five percent reported avoiding exercise because of hair concerns, and 22 percent felt that their hair impeded maintaining healthy body weight. Hair loss affects a compelling number of African American women, and a significant number express dissatisfaction in hair-related physician encounters. Additionally, hair styling problems present a serious impediment to physical activity and weight management among this already high-risk population.

The role of social support in weight loss maintenance: results from the MedWeight study.

PubMed

Karfopoulou, Eleni; Anastasiou, Costas A; Avgeraki, Evangelia; Kosmidis, Mary H; Yannakoulia, Mary

2016-06-01

The role of social support in weight management is not fully understood, as more support has been linked to both favorable and unfavorable outcomes. We examined social support in relation to weight loss maintenance, comparing between maintainers and regainers of weight loss. The MedWeight study is a Greek registry of people who have intentionally lost ≥10 % of their weight and are either maintaining this loss for over a year (maintainers), or have regained weight (regainers). Demographics and lifestyle habits questionnaires are completed online. Dietary assessment is carried out by two telephone 24 h recalls. Perceived social support was assessed by validated scales examining support from family and friends regarding healthy eating and exercise. 289 maintainers and 122 regainers participated. Regainers received more support compared to maintainers. However, maintainers reported receiving compliments and active participation, whereas regainers receiving verbal instructions and encouragements. Maintainers who received diet support displayed improved dietary intakes, such as lower energy intake; regainers' diet was unaffected by support. Positive, rather than instructive, support appears beneficial in weight loss maintenance.

Getting to More Effective Weight Management in Antipsychotic-Treated Youth: A Survey of Barriers and Preferences.

PubMed

Nicol, Ginger; Worsham, Elizabeth; Haire-Joshu, Debra; Duncan, Alexis; Schweiger, Julia; Yingling, Michael; Lenze, Eric

2016-02-01

Mentally ill youth are at risk for developing obesity, especially when they require antipsychotic treatment; moreover, they may face unique challenges in adhering to behavioral weight loss interventions. The aims of this project were to characterize the challenges families of youth with psychiatric disorders face when engaging in weight loss treatment and to gather information on attitudes and preferences for weight management interventions in this population. We devised a telephone survey to evaluate caregiver-perceived barriers/challenges to and preferences for behavioral weight loss treatment in overweight or obese mentally ill youth ages 6-18 treated with an antipsychotic agent in an outpatient setting. A total of 26 parents or primary caregivers completed the survey. The most commonly cited barriers to participation in physical activity (PA) and maintaining a healthy diet were child's dislike of PA and child's preference for energy-dense foods, respectively, which were impacted by psychiatric symptoms. Preferences for weight loss treatment included individualized, prescribed meal plans and shopping lists, and exercise support/demonstration, with a preference for Internet or cell phone applications to help with monitoring food intake and exercise. These results suggest that targets for obesity treatment in this population include individualized, specific support that takes into account the child's motivation, which is effected by psychiatric symptoms. Tools for providing support may include the use of telehealth visits and mobile device applications for self-monitoring.

Systematic Review and Meta-Analysis: The Impact of Multicomponent Weight Management Interventions on Self-Esteem in Overweight and Obese Adolescents.

PubMed

Murray, Margaret; Dordevic, Aimee L; Bonham, Maxine P

2017-05-01

Building self-esteem in overweight adolescents is key to long-term weight management; yet, self-esteem is rarely a key outcome of adolescent weight management interventions. This systematic review investigates the impact of multicomponent weight management interventions on self-esteem in overweight and obese adolescents. Six databases were searched in December 2014. Eligible studies met the following criteria: (1) randomized controlled trial, (2) overweight or obese participants, (3) adolescents (10-19 years), (4) multicomponent weight management intervention, (5) reported self-esteem and weight changes. Thirteen studies with 1,157 overweight or obese adolescents, aged 10-19 years, were included. Meta-analyses showed no significant change in self-esteem (0.27 [-0.04, 0.59]), but body mass index z -score reduced following intervention (-0.17 [-0.22, -0.11]). The lack of change in self-esteem suggests weight loss alone is insufficient to improve self-esteem. Multicomponent weight management interventions require a specific focus on self-esteem to improve this outcome in overweight and obese adolescents. © The Author 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Technology-based counseling in the management of weight and lifestyles of obese or overweight children and adolescents: A descriptive systematic literature review.

PubMed

Kaakinen, Pirjo; Kyngäs, Helvi; Kääriäinen, Maria

2018-03-01

The number of overweight and obese children and adolescents has increased worldwide. Obese children and adolescents need counseling interventions, including technology-based methods, to help them manage their weight by changing their lifestyles. To describe technology-based counseling interventions in supporting obese or overweight children and adolescents to change their weight/lifestyle. Descriptive systematic literature review. A literature search was conducted using Cinahl, Medline, PsycINFO, and Medic databases in September 2010 and updated in January 2015. Predefined inclusion criteria were used for the search. After a quality assessment, 28 studies were included in the data extraction. No statistically significant difference in BMI was detected between the intervention and control groups. However, in some studies, it was found that BMI decreases and there were statistically significant differences in fruit and vegetable consumption. In two studies, differences in physical activity were detected between the intervention and control groups, but in eight studies, the difference was not significant. Goal setting and feedback on progress support physical activity and changes in diet. This study identifies available technology interventions for obese or overweight children and adolescents. It seems that using technology-based counseling intervention may encourage obese and overweight children and adolescents to pursue a healthier lifestyle.

The association between physical activity and eating self-regulation in overweight and obese women.

PubMed

Carraça, Eliana V; Silva, Marlene N; Coutinho, Sílvia R; Vieira, Paulo N; Minderico, Cláudia S; Sardinha, Luís B; Teixeira, Pedro J

2013-01-01

Successful weight management relies heavily on eating and exercise behaviors. However, little is known about the association between both on a psychosocial level. This study examined the relationship between exercise and eating regulation by exploring the mediating effects of negative body image investment and depressive mood, and their stability through time. Analyses were conducted at two different moments (12 and 36 months), involving a sample of 221 overweight/obese women (age: 37.6 ± 7 years; BMI: 31.6 ± 4.1 kg/m(2)) that participated in a behavioral weight control intervention. Bivariate correlations and mediation analyses using Preacher & Hayes resampling procedures were conducted. At 12 months, negative body image investment was the only significant mediator of the exercise-eating relationship. This variable explained larger portions of the indirect effects of structured rather than lifestyle exercise on eating. At 36 months, negative investment and to a lesser extent depressive mood partially explained the exercise-eating association. Our findings suggest that, besides physiological effects of exercise, psychological mechanisms related to body image and mood also explain the role of physical activity as a 'gateway behavior' for improved eating regulation in overweight women. These effects appear to be stable and may help understand the key role of exercise in long-term weight management.

Antiobesity Effect of Caraway Extract on Overweight and Obese Women: A Randomized, Triple-Blind, Placebo-Controlled Clinical Trial

PubMed Central

Radzi, Che Wan Jasimah Bt wan Mohamed; Hajifaraji, Majid; Haerian, Batoul Sadat; Mosaddegh, Mohammad Hossein; Cordell, Geoffrey A.

2013-01-01

Caraway (Carum carvi L.), a potent medicinal plant, is traditionally used for treating obesity. This study investigates the weight-lowering effects of caraway extract (CE) on physically active, overweight and obese women through a randomized, triple-blind, placebo-controlled clinical trial. Seventy overweight and obese, healthy, aerobic-trained, adult females were randomly assigned to two groups (n = 35 per group). Participants received either 30 mL/day of CE or placebo without changing their diet or physical activity. Subjects were examined at baseline and after 90 days for changes in body composition, anthropometric indices, and clinical and paraclinical variables. The treatment group, compared with placebo, showed a significant reduction of weight, body mass index, body fat percentage, and waist-to-hip ratio. No changes were observed in lipid profile, urine-specific gravity, and blood pressure of subjects. The results suggest that a dietary CE with no restriction in food intake, when combined with exercise, is of value in the management of obesity in women wishing to lower their weight, BMI, body fat percentage, and body size, with no clinical side effects. In conclusion, results of this study suggest a possible phytotherapeutic approach for caraway extract in the management of obesity. This trial is registered with NCT01833377. PMID:24319489

Madres para la Salud: design of a theory-based intervention for postpartum Latinas.

PubMed

Keller, Colleen; Records, Kathie; Ainsworth, Barbara; Belyea, Michael; Permana, Paska; Coonrod, Dean; Vega-López, Sonia; Nagle-Williams, Allison

2011-05-01

Weight gain in young women suggests that childbearing may be an important contributor to the development of obesity in women. Depressive symptoms can interfere with resumption of normal activity levels following childbirth or with the initiation of or adherence to physical activity programs essential for losing pregnancy weight. Depression symptoms may function directly to promote weight gain through a physiologic mechanism. Obesity and its related insulin resistance may contribute to depressed mood physiologically. Although physical activity has well-established beneficial effects on weight management and depression, women tend to under participate in physical activity during childbearing years. Further, the mechanisms underpinning the interplay of overweight, obesity, physical activity, depression, and inflammatory processes are not clearly explained. This report describes the theoretical rationale, design considerations, and cultural relevance for "Madres para la Salud" [Mothers for Health]. Madres para la Salud is a 12 month prospective, randomized controlled trial exploring the effectiveness of a culturally specific intervention using "bouts" of physical activity to effect changes in body fat, systemic and fat tissue inflammation, and postpartum depression symptoms in sedentary postpartum Latinas. The significance and innovation of Madres para la Salud includes use of a theory-driven approach to intervention, specification and cultural relevance of a social support intervention, use of a Promotora model to incorporate cultural approaches, use of objective measures of physical activity in post partum Latinas women, and the examination of biomarkers indicative of cardiovascular risk related to physical activity behaviors in postpartum Latinas. Copyright © 2011 Elsevier Inc. All rights reserved.

Madres para la Salud: Design of a Theory-based Intervention for Postpartum Latinas

PubMed Central

Keller, Colleen; Records, Kathie; Ainsworth, Barbara; Belyea, Michael; Permana, Paska; Coonrod, Dean; Vega-López, Sonia; Nagle-Williams, Allison

2011-01-01

Background Weight gain in young women suggests that childbearing may be an important contributor to the development of obesity in women. Depressive symptoms can interfere with resumption of normal activity levels following childbirth or with the initiation of or adherence to physical activity programs essential for losing pregnancy weight. Depression symptoms may function directly to promote weight gain through a physiologic mechanism. Obesity and its related insulin resistance may contribute to depressed mood physiologically. Although physical activity has well-established beneficial effects on weight management and depression, women tend to under participate in physical activity during childbearing years. Further, the mechanisms underpinning the interplay of overweight, obesity, physical activity, depression, and inflammatory processes are not clearly explained. Objectives This report describes the theoretical rationale, design considerations, and cultural relevance for “Madres para la Salud” [Mothers for Health]. Design and Methods Madres para la Salud is a 12 month prospective, randomized controlled trial exploring the effectiveness of a culturally specific intervention using “bouts” of physical activity to effect changes in body fat, systemic and fat tissue inflammation, and postpartum depression symptoms in sedentary postpartum Latinas. Summary The significance and innovation of Madres para la Salud includes use of a theory-driven approach to intervention, specification and cultural relevance of a social support intervention, use of a Promotora model to incorporate cultural approaches, use of objective measures of physical activity in post partum Latinas women, and the examination of biomarkers indicative of cardiovascular risk related to physical activity behaviors in postpartum Latinas. PMID:21238614

Advice to Stay Active or Structured Exercise in the Management of Sciatica: A Systematic Review and Meta-analysis.

PubMed

Fernandez, Matt; Hartvigsen, Jan; Ferreira, Manuela L; Refshauge, Kathryn M; Machado, Aryane F; Lemes, Ítalo R; Maher, Chris G; Ferreira, Paulo H

2015-09-15

A systematic review and meta-analysis. To evaluate the evidence on comparative effectiveness of advice to stay active versus supervised structured exercise in the management of sciatica. Conservative management of sciatica usually includes interventions to promote physical activity in the form of advice to stay active or exercise, but there has been no systematic review directly comparing the effectiveness of these 2 approaches. Data Sources included MEDLINE, CINAHL, EMBASE, and PEDro databases. Studies were randomized controlled trials comparing advice with exercise. Two independent reviewers extracted data and assessed methodological quality using the PEDro scale. Pain and disability data were extracted for all time points and converted to a common 0 to 100 scale. Data were pooled with a random effects model for short, intermediate, and long-term follow-ups. The GRADE approach was used to summarize the strength of evidence. Five trials were included in the meta-analysis, which showed a significant, although small effect favoring exercise over advice for reducing leg pain intensity in the short term (weighted mean difference: 11.43 [95% confidence interval, 0.71-22.16]) but no difference for disability (weighted mean difference: 1.45 [95% confidence interval, -2.86 to 5.76]). Furthermore, there was no difference at intermediate and long-term follow-ups between advice and exercise for patient-relevant outcomes. There is low-quality evidence (GRADE) that exercise provides small, superior effects compared with advice to stay active on leg pain in the short term for patients experiencing sciatica. However, there is moderate-quality evidence showing no difference between advice to stay active and exercise on leg pain and disability status in people with sciatica in the long term. 1.

Therapy and Weight Management (For Teens)

MedlinePlus

... site Sitio para adolescentes Body Mind Sexual Health Food & Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) Staying Safe Videos for Educators Search English Español Therapy and Weight Management KidsHealth / For Teens / Therapy and Weight Management What's ...

The Effectiveness of a Weight Maintenance Intervention for Adults with Intellectual Disabilities and Obesity: A Single Stranded Study

ERIC Educational Resources Information Center

Spanos, Dimitrios; Hankey, Catherine R.; Melville, Craig A.

2016-01-01

Background: The evidence base for weight management programmes incorporating a weight loss and a weight maintenance phase for adults with intellectual disabilities (ID) is limited. This study describes the weight maintenance phase of a multicomponent weight management programme for adults with intellectual disability and obesity (TAKE 5).…

Health promotion through primary care: enhancing self-management with activity prescription and mHealth.

PubMed

Knight, Emily; Stuckey, Melanie I; Petrella, Robert J

2014-09-01

It is well established in the literature that regular participation in physical activity is effective for chronic disease management and prevention. Remote monitoring technologies (ie, mHealth) hold promise for engaging patients in self-management of many chronic diseases. The purpose of this study was to test the effectiveness of an mHealth study with tailored physical activity prescription targeting changes in various intensities of physical activity (eg, exercise, sedentary behavior, or both) for improving physiological and behavioral markers of lifestyle-related disease risk. Forty-five older adults (aged 55-75 years; mean age 63 ± 5 years) were randomly assigned to receive a personal activity program targeting changes to either daily exercise, sedentary behavior, or both. All participants received an mHealth technology kit including smartphone, blood pressure monitor, glucometer, and pedometer. Participants engaged in physical activity programming at home during the 12-week intervention period and submitted physical activity (steps/day), blood pressure (mm Hg), body weight (kg), and blood glucose (mmol/L) measures remotely using study-provided devices. There were no differences between groups at baseline (P > 0.05). The intervention had a significant effect (F(10 488) = 2.947, P = 0.001, ηP² = 0.057), with similar changes across all groups for physical activity, body weight, and blood pressure (P > 0.05). Changes in blood glucose were significantly different between groups, with groups prescribed high-intensity activity (ie, exercise) demonstrating greater reductions in blood glucose than the group prescribed changes to sedentary behavior alone (P < 0.05). Findings demonstrate the utility of pairing mHealth technologies with activity prescription for prevention of lifestyle-related chronic diseases among an at-risk group of older men and women. RESULTS support the novel approach of prescribing changes to sedentary behaviors (alone, and in conjunction with exercise) to reduce risk of developing lifestyle-related chronic conditions.

Management of diabetes by primary health care nurses in Auckland, New Zealand.

PubMed

Daly, Barbara; Arroll, Bruce; Kenealy, Timothy; Sheridan, Nicolette; Scragg, Robert

2015-03-01

The increasing prevalence of diabetes has led to expanded roles for primary health care nurses in diabetes management. To describe and compare anthropometric and glycaemic characteristics of patients with diabetes and their management by practice nurses, district nurses and specialist nurses. Primary health care nurses in Auckland randomly sampled in a cross-sectional survey, completed a postal self-administered questionnaire (n=284) and telephone interview (n=287) between 2006 and 2008. Biographical and diabetes management details were collected for 265 (86%) of the total 308 patients with diabetes seen by participants on a randomly selected day. Nurses were able to access key clinical information for only a proportion of their patients: weight for 68%; BMI for 16%; HbA1c for 76% and serum glucose levels for 34% (for either measure 82%); although most (96%) records were available about whether patients self-monitored blood glucose levels. Most nursing management activities focused on giving advice on dietary intake (70%) and physical activity (66%), weighing patients (58%), and testing or discussing blood glucose levels (42% and 43%, respectively). These proportions varied by nurse group (p<0.05), generally being highest for specialist nurses and lowest for district nurses. Most practice and specialist nurses could access patients' weight and HbA1c levels and focused their clinical management on health education to decrease these if indicated. Communication and organisational systems and contracts that allow district nurses to work across both primary and secondary health services are necessary to improve community-based nursing services for patients with diabetes.

Behavioural interventions for weight management in pregnancy: a systematic review of quantitative and qualitative data.

PubMed

Campbell, Fiona; Johnson, Maxine; Messina, Josie; Guillaume, Louise; Goyder, Elizabeth

2011-06-22

There is a rising prevalence of excessive weight gain in pregnancy and an increasing number of pregnant women who are overweight or obese at the start of the pregnancy. Excessive weight gain during pregnancy is associated with adverse maternal and neonatal consequences and increases the risk of long-term obesity. Pregnancy therefore may be a key time to prevent excessive weight gain and improve the health of women and their unborn child. This systematic review sought to assess the effectiveness of behavioural interventions to prevent excessive weight gain in pregnancy and explore the factors that influence intervention effectiveness. We undertook a systematic review of quantitative and qualitative evidence. This included a meta-analysis of controlled trials of diet and physical activity interventions to prevent excessive weight gain during pregnancy and a thematic synthesis of qualitative studies that investigated the views of women on weight management during pregnancy. A thorough search of eleven electronic bibliographic databases, reference lists of included studies, relevant review articles and experts in the field were contacted to identify potentially relevant studies.Two independent reviewers extracted data. RevMan software was used to perform the meta-analyses. Qualitative data was subject to thematic analysis. Both quantitative and qualitative data were aligned using a matrix framework. Five controlled trials and eight qualitative studies were included. The overall pooled effect size found no significant difference in gestational weight gain amongst participants in the intervention group compared with the control group (mean difference -0.28 95% CI -0.64 to 0.09). The study designs, participants and interventions all varied markedly and there was significant heterogeneity within this comparison in the meta-analysis (I2 67%). Subgroup and sensitivity analysis did not identify contextual elements that influenced the effectiveness of the intervention.In a thematic analysis of the qualitative studies, three major themes emerged relating to women's views of weight management in pregnancy: pregnancy as a time of transition and change, conflicting and contradictory messages and a perceived lack of control. When the results of both quantitative and qualitative data were aligned it was clear that some of the barriers that women described in achieving healthy weight gain in pregnancy were not addressed by the interventions evaluated. This may have contributed to the limited effectiveness of the interventions. Despite intense and often tailored interventions there was no statistically significant effect on weight gain during pregnancy. Inadequate and often contradictory information regarding healthy weight management was reported by women in qualitative studies and this was addressed in the interventions but this in itself was insufficient to lead to reduced weight gain. Multiple types of interventions, including community based strategies are needed to address this complex health problem.

Evaluating a multispecies adaptive management framework: Must uncertainty impede effective decision-making?

USGS Publications Warehouse

Smith, David R.; McGowan, Conor P.; Daily, Jonathan P.; Nichols, James D.; Sweka, John A.; Lyons, James E.

2013-01-01

Application of adaptive management to complex natural resource systems requires careful evaluation to ensure that the process leads to improved decision-making. As part of that evaluation, adaptive policies can be compared with alternative nonadaptive management scenarios. Also, the value of reducing structural (ecological) uncertainty to achieving management objectives can be quantified.A multispecies adaptive management framework was recently adopted by the Atlantic States Marine Fisheries Commission for sustainable harvest of Delaware Bay horseshoe crabs Limulus polyphemus, while maintaining adequate stopover habitat for migrating red knots Calidris canutus rufa, the focal shorebird species. The predictive model set encompassed the structural uncertainty in the relationships between horseshoe crab spawning, red knot weight gain and red knot vital rates. Stochastic dynamic programming was used to generate a state-dependent strategy for harvest decisions given that uncertainty. In this paper, we employed a management strategy evaluation approach to evaluate the performance of this adaptive management framework. Active adaptive management was used by including model weights as state variables in the optimization and reducing structural uncertainty by model weight updating.We found that the value of information for reducing structural uncertainty is expected to be low, because the uncertainty does not appear to impede effective management. Harvest policy responded to abundance levels of both species regardless of uncertainty in the specific relationship that generated those abundances. Thus, the expected horseshoe crab harvest and red knot abundance were similar when the population generating model was uncertain or known, and harvest policy was robust to structural uncertainty as specified.Synthesis and applications. The combination of management strategy evaluation with state-dependent strategies from stochastic dynamic programming was an informative approach to evaluate adaptive management performance and value of learning. Although natural resource decisions are characterized by uncertainty, not all uncertainty will cause decisions to be altered substantially, as we found in this case. It is important to incorporate uncertainty into the decision framing and evaluate the effect of reducing that uncertainty on achieving the desired outcomes

Nutrition Facts Use in Relation to Eating Behaviors and Healthy and Unhealthy Weight Control Behaviors.

PubMed

Christoph, Mary J; Loth, Katie A; Eisenberg, Marla E; Haynos, Ann F; Larson, Nicole; Neumark-Sztainer, Dianne

2018-03-01

Investigate the relationship between use of Nutrition Facts labels on packaged foods and weight-related behaviors. Cross-sectional survey in 2015-2016. Young adult respondents (n = 1,817; 57% women; average age 31.0 ± 1.6 years) to the Project Eating and Activity in Teens and Young Adults-IV survey, the fourth wave of a longitudinal cohort study. Use of Nutrition Facts labels on packaged foods; healthy, unhealthy, and extreme weight control behaviors; intuitive eating; binge eating. Linear and logistic regression models were adjusted for age, ethnicity/race, education, income, and weight status. In women, greater Nutrition Facts use was associated with a 23% and 10% greater likelihood of engaging in healthy and unhealthy weight control behaviors, respectively, and a 17% greater chance of engaging in binge eating. In men, greater label use was associated with a 27% and 17% greater likelihood of engaging in healthy and unhealthy weight control behaviors, respectively, and a lower level of intuitive eating. Professionals advising patients and clients on weight management may consider possible gender differences in response to weight loss and management guidance. Since label use was related to engagement in some unhealthy behaviors in addition to healthy behaviors, it is important to consider how individuals may use labels, particularly those at risk for, or engaging in, disordered eating behaviors. Future research investigating potential relationships between Nutrition Facts use, intuitive eating, and binge eating is needed. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Combating Obesity at Community Health Centers (COACH): A Quality Improvement Collaborative for Weight Management Programs

PubMed Central

Wilkes, Abigail E.; John, Priya M.; Vable, Anusha M.; Campbell, Amanda; Heuer, Loretta; Schaefer, Cynthia; Vinci, Lisa; Drum, Melinda L.; Chin, Marshall H.; Quinn, Michael T.; Burnet, Deborah L.

2013-01-01

Community health centers (CHCs) seek effective strategies to address obesity. MidWest Clinicians’ Network partnered with [an academic medical center] to test feasibility of a weight management quality improvement (QI) collaborative. MidWest Clinicians’ Network members expressed interest in an obesity QI program. This pilot study aimed to determine whether the QI model can be feasibly implemented with limited resources at CHCs to improve weight management programs. Five health centers with weight management programs enrolled with CHC staff as primary study participants; this study did not attempt to measure patient outcomes. Participants attended learning sessions and monthly conference calls to build QI skills and share best practices. Tailored coaching addressed local needs. Topics rated most valuable were patient recruitment/retention strategies, QI techniques, evidence-based weight management, motivational interviewing. Challenges included garnering provider support, high staff turnover, and difficulty tracking patient-level data. This paper reports practical lessons about implementing a weight management QI collaborative in CHCs. PMID:23727964

Introduction of the transtheoretical model and organisational development theory in weight management: A narrative review.

PubMed

Wu, Ya-Ke; Chu, Nain-Feng

2015-01-01

Overweight and obesity are serious public health and medical problems among children and adults worldwide. Behavioural change has been demonstrably contributory to weight management programs. Behavioural change-based weight loss programs require a theoretical framework. We will review the transtheoretical model and the organisational development theory in weight management. The transtheoretical model is a behaviour theory of individual level frequently used for weight management programs. The organisational development theory is a more complicated behaviour theory that applies to behavioural change on the system level. Both of these two theories have their respective strengths and weaknesses. In this manuscript, we try to introduce the transtheoretical model and the organisational development theory in the context of weight loss programs among population that are overweight or obese. Ultimately, we wish to present a new framework/strategy of weight management by integrating these two theories together. Copyright © 2015 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Managing the pain of knee osteoarthritis.

PubMed

Hrnack, Scott A; Barber, F Alan

2014-09-01

Pain from knee osteoarthritis creates a significant burden for symptomatic patients, who are often forced to change their lifestyle because of their symptoms. Activity modification, therapy, weight loss, nonsteroidal anti-inflammatory drugs, shoe orthotics, bracing, and injections are the nonoperative options available. New technologies are also emerging in the treatment of knee osteoarthritis. Ultimately, these therapeutic modalities should reduce pain and increase the overall functioning of patients. These nonoperative modalities give the clinician several effective options before surgical management is considered.

A comparison of meal replacements and medication in weight maintenance after weight loss.

PubMed

LeCheminant, James D; Jacobsen, Dennis J; Hall, Matthew A; Donnelly, Joseph E

2005-10-01

To compare the use of meal replacements or medication during weight maintenance subsequent to weight loss using a very low-energy diet (VLED) in overweight or obese adults. Participants followed a liquid VLED of 2177 kJ for 12 weeks followed by 4 weeks of re-orientation to solid foods. Participants were randomized at week 16 to receive either meal replacements or Orlistat both combined with a structured meal plan containing an energy value calculated to maintain weight loss. Sixty-four women (age = 49.9 +/- 10 y, weight = 101.6 +/- 17.1 kg, height = 164.9 +/- 6.0 cm, BMI = 36.7 +/- 5.4 kg/m(2)) and 28 men (age = 53.7 +/- 9.6 y, weight = 121.8 +/- 16.0 kg, height = 178.7 +/- 5.6 cm, BMI = 37.8 +/- 4.9 kg/m(2)) completed a 1 year weight management program. Behavioral weight management clinics included topics on lifestyle, physical activity (PA), and nutrition. Participants met for 90 min weekly for 26 weeks, and then biweekly for the remaining 26 weeks. Minutes of PA, fruits and vegetables (FV), and pedometer steps were recorded on a daily basis and reported at each group meeting. Body weight was obtained at each group meeting. During VLED, the MR group decreased body weight by 22.8 +/- 6.1 kg and the Orlistat group decreased body weight by 22.3 +/- 6.1 kg. During weight maintenance, there was no significant group by time interaction for body weight, PA, FV consumption, or pedometer steps. At week 16, the meal replacement group had a body weight of 85.4 +/- 14.3 kg that increased to 88.1 +/- 16.5 kg at 52 weeks (p < 0.05). At week 16, the Orlistat group had a body weight of 85.7 +/- 17.9 kg that increased to 88.5 +/- 20.3 kg at 52 weeks (p < 0.05). Subsequent to weight loss from a VLED, meal replacements and Orlistat treatments were both effective in maintaining weight significantly below baseline levels over a 52 week period of time. Meal replacements may be a viable alternative strategy to medications for weight maintenance.

A self-management intervention for African Americans with comorbid diabetes and hypertension: a pilot randomized controlled trial.

PubMed

Lynch, Elizabeth B; Liebman, Rebecca; Ventrelle, Jennifer; Avery, Elizabeth F; Richardson, DeJuran

2014-05-29

The objective of this pilot 6-month randomized controlled trial was to determine the effectiveness of an intensive, community-based, group intervention that focused on diet, physical activity, and peer support for reducing weight among urban-dwelling African Americans with comorbid type 2 diabetes and hypertension. Sixty-one participants were randomized into an intervention or control group. The 6-month intervention consisted of 18 group sessions led by a dietitian in a community setting and weekly telephone calls from a peer supporter. The intervention featured culturally tailored nutrition education, behavioral skills training, and social support focused on changes to diet and physical activity. The control group consisted of two 3-hour group sessions of diabetes self-management education taught by a community health worker. Outcome measures were assessed at baseline and 6 months. The primary outcome was achievement of a 5% weight reduction at 6 months. A secondary outcome was achievement of a 0.5 percentage-point reduction in hemoglobin A1c (HbA1c). Groups did not differ in achievement of the weight-loss goal. Intervention participants lost a mean of 2.8 kg (P = .01); control participants did not lose a significant amount of weight. A greater proportion of intervention (50.0%) than control (21.4%) participants reduced HbA1c by 0.5 percentage points or more at 6 months (P = .03). The intervention was more effective than usual care (short-term diabetes education) at improving glycemic control, but not weight, in low-income African Americans with comorbid diabetes and hypertension. A community-based 6-month group class with culturally tailored education, behavioral skills training, and peer support can lead to a clinically significant reduction in HbA1c.

Coal gasification systems engineering and analysis. Appendix H: Work breakdown structure

NASA Technical Reports Server (NTRS)

1980-01-01

A work breakdown structure (WBS) is presented which encompasses the multiple facets (hardware, software, services, and other tasks) of the coal gasification program. The WBS is shown to provide the basis for the following: management and control; cost estimating; budgeting and reporting; scheduling activities; organizational structuring; specification tree generation; weight allocation and control; procurement and contracting activities; and serves as a tool for program evaluation.

PCR Amplification and Cloning of Tyrosine Decarboxylase Involved in Synephrine Biosynthesis in Citrus

USDA-ARS?s Scientific Manuscript database

The phenolic amine synephrine is a vascoconstrictor and bronchiectatic agent and may have promise as an aid to weight management and obesity reduction. Synephrine is structurally similar to the active ingredients of several commercial cold remedies. Some Citrus have been shown to possess high conc...

A School Nurse-Delivered Intervention for Overweight and Obese Adolescents

ERIC Educational Resources Information Center

Pbert, Lori; Druker, Susan; Gapinski, Mary A.; Gellar, Lauren; Magner, Robert; Reed, George; Schneider, Kristin; Osganian, Stavroula

2013-01-01

Background: Models are needed for implementing weight management interventions for adolescents through readily accessible venues. This study evaluated the feasibility and ef?cacy of a school nurse-delivered intervention in improving diet and activity and reducing body mass index (BMI) among overweight and obese adolescents. Methods: Six high…

Drunkorexia: Understanding the Co-Occurrence of Alcohol Consumption and Eating/Exercise Weight Management Behaviors

ERIC Educational Resources Information Center

Barry, Adam E.; Piazza-Gardner, Anna K.

2012-01-01

Objective: Examine the co-occurrence of alcohol consumption, physical activity, and disordered eating behaviors via a drunkorexia perspective. Participants: Nationally representative sample (n = 22,488) of college students completing the Fall 2008 National College Health Assessment. Methods: Hierarchical logistic regression was employed to…

Assessment tools in obesity- psychological measures, diet, activity, and body composition

USDA-ARS?s Scientific Manuscript database

The global increase in the prevalence of obesity has led to an increased need for measurement tools for research, management and treatment of the obese person. The physical size limitations imposed by obesity, variations in body composition from that of normal weight, and a complex psychopathology a...

Comparing the effectiveness of a multi-component weight loss intervention in adults with and without intellectual disabilities.

PubMed

Spanos, D; Hankey, C; Boyle, S; Melville, C

2014-02-01

The prevalence of obesity in adults with intellectual disabilities (ID) is rising, although the evidence base for its treatment in this population group is minimal. Weight management interventions that are accessible to adults with ID will reduce the inequalities that they frequently experience in health services. This short report compared the effectiveness of weight management in those with and without ID who completed nine sessions of a multi-component weight management programme. TAKE 5 is a 16-week multi-component weight management intervention for adults with ID and obesity [body mass index (BMI) ≥30 kg m(-2) ]. This intervention is an adaption of the weight management programme provided by the Glasgow & Clyde Weight Management Service (GCWMS) for adults without ID and obesity (National Health Service based). Fifty-two participants of the TAKE 5 programme were individually matched by baseline characteristics (sex, age and BMI) with two participants without ID of the GCWMS programme. Comparisons in terms of weight and BMI change and rate of weight loss were made for those who attended all nine sessions. There were no significant differences between the groups in the amount of weight loss (median: -3.6 versus -3.8 kg, respectively, P = 0.4), change in BMI (median: -1.5 versus -1.4 kg m(-2) , P = 0.9), success of achieving 5% weight loss (41.3% versus 36.8%, P = 0.9) and rate of weight loss across the 16-week intervention. A multi-component weight loss intervention can be equally effective for adults with and without ID and obesity. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

The Effectiveness of eHealth Technologies on Weight Management in Pregnant and Postpartum Women: Systematic Review and Meta-Analysis.

PubMed

Sherifali, Diana; Nerenberg, Kara A; Wilson, Shanna; Semeniuk, Kevin; Ali, Muhammad Usman; Redman, Leanne M; Adamo, Kristi B

2017-10-13

The emergence and utilization of electronic health (eHealth) technologies has increased in a variety of health interventions. Exploiting the real-time advantages offered by mobile technologies during and after pregnancy has the potential to empower women and encourage behaviors that may improve maternal and child health. The objective of this study was to assess the effectiveness of eHealth technologies for weight management during pregnancy and the postpartum period and to review the efficacy of eHealth technologies on health behaviors, specifically nutrition and physical activity. A systematic search was conducted of the following databases: MEDLINE, EMBASE, Cochrane database of systematic reviews (CDSR), Cochrane central register of controlled trials (CENTRAL), CINAHL (Cumulative Index to Nursing and Allied Health Literature), and PsycINFO. The search included studies published from 1990 to July 5, 2016. All relevant primary studies that involved randomized controlled trials (RCTs), non-RCTs, before-and-after studies, historically controlled studies, and pilot studies were included. The study population was adult women of childbearing age either during pregnancy or the postpartum period. eHealth weight management intervention studies targeting physical activity, nutrition, or both, over a minimum 3-month period were included. Titles and abstracts, as well as full-text screening were conducted. Study quality was assessed using Cochrane's risk of bias tool. Data extraction was completed by a single reviewer, which was then verified by a second independent reviewer. Results were meta-analyzed to calculate pooled estimates of the effect, wherever possible. Overall, 1787 and 176 citations were reviewed at the abstract and full-text screening stages, respectively. A total of 10 studies met the inclusion criteria ranging from high to low risk of bias. Pooled estimates from studies of the effect for postpartum women resulted in a significant reduction in weight (-2.55 kg, 95% CI -3.81 to -1.28) after 3 to 12 months and six studies found a nonsignificant reduction in weight gain for pregnant women (-1.62 kg, 95% CI -3.57 to 0.33) at approximately 40 weeks. This review found evidence for benefits of eHealth technologies on weight management in postpartum women only. Further research is still needed regarding the use of these technologies during and after pregnancy. ©Diana Sherifali, Kara A Nerenberg, Shanna Wilson, Kevin Semeniuk, Muhammad Usman Ali, Leanne M Redman, Kristi B Adamo. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 13.10.2017.

Effect of Workplace Weight Management on Health Care Expenditures and Quality of Life.

PubMed

Michaud, Tzeyu L; Nyman, John A; Jutkowitz, Eric; Su, Dejun; Dowd, Bryan; Abraham, Jean M

2016-11-01

We examined the effectiveness of the weight management program used by the University of Minnesota in reducing health care expenditures and improving quality of life of its employees, and also in reducing their absenteeism during a 3-year intervention. A differences-in-differences regression approach was used to estimate the effect of weight management participation. We further applied ordinary least squares regression models with fixed effects to estimate the effect in an alternative analysis. Participation in the weight management program significantly reduced health care expenditures by $69 per month for employees, spouses, and dependents, and by $73 for employees only. Quality-of-life weights were 0.0045 points higher for participating employees than for nonparticipating ones. No significant effect was found for absenteeism. The workplace weight management used by the University of Minnesota reduced health care expenditures and improved quality of life.

Weight Management, Weight Perceptions, and Health-Compromising Behaviours Among Adolescent Girls in the COMPASS Study.

PubMed

Raffoul, Amanda; Leatherdale, Scott T; Kirkpatrick, Sharon I

2018-06-16

Evidence suggests associations between weight management intentions, weight perceptions, and health-compromising behaviours among adolescent girls. Drawing on cross-sectional data for 21,456 girls, we employed multinomial logistic regression to examine whether smoking, binge drinking, and breakfast-skipping were associated with weight management intentions and weight perceptions. According to self-reported heights and weights, 61.4% of girls were in the healthy weight category. However, most reported trying to manage their weight, with 58% trying to lose, 4.5% trying to gain, and 18% trying to maintain their weight. Smokers were more likely than non-smokers to report intentions to lose, gain, or maintain weight versus to do nothing. However, smokers were less likely than non-smokers to perceive themselves as underweight or overweight versus about the right weight. Binge drinkers were more likely than other girls to report an intention to gain and less likely to be trying to maintain their weight versus doing nothing, and breakfast-skippers were more likely to report trying to lose or gain weight but less likely to report trying to maintain weight versus doing nothing. Binge drinkers and breakfast-skippers were more likely than non-binge drinkers and non-breakfast-skippers, respectively, to perceive themselves as underweight, overweight or very overweight versus about the right weight. In sum, the majority of girls reported trying to manage their weight, and those engaging in other health-compromising behaviours were more likely to do so, though the exact nature of the associations differed by behaviour. Recognition of shared underlying risk factors for this clustering of behaviours may inform comprehensive health promotion efforts.

Dietary Management of Obesity: Cornerstones of Healthy Eating Patterns.

PubMed

Smethers, Alissa D; Rolls, Barbara J

2018-01-01

Several dietary patterns, both macronutrient and food based, can lead to weight loss. A key strategy for weight management that can be applied across dietary patterns is to reduce energy density. Clinical trials show that reducing energy density is effective for weight loss and weight loss maintenance. A variety of practical strategies and tools can help facilitate successful weight management by reducing energy density, providing portion control, and improving diet quality. The flexibility of energy density gives patients options to tailor and personalize their dietary pattern to reduce energy intake for sustainable weight loss. Copyright © 2017 Elsevier Inc. All rights reserved.

Increasing physical activity for veterans in the Mental Health Intensive Case Management Program: A community-based intervention.

PubMed

Harrold, S Akeya; Libet, Julian; Pope, Charlene; Lauerer, Joy A; Johnson, Emily; Edlund, Barbara J

2018-04-01

Individuals with severe mental illness (SMI), experience increased mortality-20 years greater disparity for men and 15 years greater disparity for women-compared to the general population (Thornicroft G. Physical health disparities and mental illness: The scandal of premature mortality. Br J Psychiatr. 2011;199:441-442). Numerous factors contribute to premature mortality in persons with SMI, including suicide and accidental death (Richardson RC, Faulkner G, McDevitt J, Skrinar GS, Hutchinson D, Piette JD. Integrating physical activity into mental health services for persons with serious mental illness. Psychiatr Serv. 2005;56(3):324-331; Thornicroft G. Physical health disparities and mental illness: The scandal of premature mortality. Br J Psychiatr. 2011;199:441-442), but research has shown that adverse health behaviors-including smoking, low rate of physical activity, poor diet, and high alcohol consumption-also significantly contribute to premature deaths (Jones J. Life expectancy in mental illness. Psychiatry Services. 2010. Retrieved from http://psychcentral.com/news/2010/07/13/life-expectancy-in-mental-illness). This quality improvement (QI) project sought to improve health and wellness for veterans in the Mental Health Intensive Case Management Program (MHICM), which is a community-based intensive program for veterans with SMI at risk for decompensation and frequent hospitalizations. At the time of this QI project, the program had 69 veterans who were assessed and treated weekly in their homes. The project introduced a pedometer steps intervention adapted from the VA MOVE! Program-a physical activity and weight management program-with the addition of personalized assistance from trained mental health professionals in the veteran's home environment. Because a large percentage of the veterans in the MHICM program had high blood pressure and increased weight, these outcomes were the focus of this project. Through mental health case management involvement and the comfort of their familiar living environment, veterans were assisted to meet their physical and mental health goals with a program that could easily be integrated into their daily lives. Healthy People 2020 developed goals to improve levels of physical activity and has ranked physical activity as a leading health indicator (US DHHS. Office of Disease Prevention and Health Promotion. Physical activity topic overview. In Healthy People 2020. 2016. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/physical-activity). Individuals with SMI are significantly less active than the general population (Shor and Shalev, 2014). It is sometimes difficult for the average individual to obtain the recommended 10,000 steps and even more difficult for those with SMI. Lifestyle modifications, in particular diet and exercise, are recommended for improvement of chronic disease outcomes (US Preventive Services Counseling Task Force, 2016). The health benefits of physical activity for people with SMI are mixed (Pearsall R, Smith D, Pelosi A, Geddes J. Exercise therapy in adults with serious mental illness: A systematic review and meta-analysis. BMC Psychiatr. 2014;14:117). Some studies found significant physical health benefits, while others did not. However, according to a review by Soundy et al., physical exercise is shown to not only have physical benefits but also psychosocial benefits. One of the barriers that hinder participation in physical activities is accessibility (Shor and Shalev, 2014). Integrating a more personalized supported, and in-home pedometer program into mental healthcare should ensure better access to interventions that could possibly reverse the causes of premature death. The program was offered to 69 veterans in the MHICM. Forty-nine agreed to start the program and 20 declined. Twenty-five clients actually started the program with 17 veterans completing it. Preimplementation data included collecting blood pressure and weight measures for all veterans in the MHICM program. Additionally, a focus group was held with case managers to obtain a group perspective on motivating veterans to participate in this program. Further, a teaching session was held to review pedometers use, the client video, the client booklet, methods for getting veterans started, and the progression of the walking intervention. The pedometer physical activity intervention continued for 2 months. At the end of the 2 months, aggregate de-identified data on number of steps, blood pressure, and weight were collected. At the end of the program, the data were reviewed, synthesized, and analyzed, being careful to account for potentially intervening conditions and other chronic illnesses. The postimplementation data revealed that the mean weight decreased by 9 lbs. The percentage of controlled blood pressure increased from 60 to 84, while the percentage of uncontrolled blood pressure decreased from 40 to 16. Implementation of a multiple component personalized exercise intervention program for veterans with SMI contributed to reduction in weight and blood pressure. © 2017 Wiley Periodicals, Inc.

Athletic Population with Spondylolysis: Review of Outcomes following Surgical Repair or Conservative Management

PubMed Central

Panteliadis, Pavlos; Nagra, Navraj S.; Edwards, Kimberley L.; Behrbalk, Eyal; Boszczyk, Bronek

2016-01-01

Study Design  Narrative review. Objective  The study aims to critically review the outcomes associated with the surgical repair or conservative management of spondylolysis in athletes. Methods  The English literature listed in MEDLINE/PubMed was reviewed to identify related articles using the term “spondylolysis AND athlete.” The criteria for studies to be included were management of spondylolysis in athletes, English text, and no year, follow-up, or study design restrictions. The references of the retrieved articles were also evaluated. The primary outcome was time to return to sport. This search yielded 180 citations, and 25 publications were included in the review. Results  Treatment methods were dichotomized as operative and nonoperative. In the nonoperative group, 390 athletes were included. A combination of bracing with physical therapy and restriction of activities was used. Conservative measures allowed athletes to return to sport in 3.7 months (weighted mean). One hundred seventy-four patients were treated surgically. The most common technique was Buck's, using a compression screw (91/174). All authors reported satisfactory outcomes. Time to return to play was 7.9 months (weighted mean). There were insufficient studies with suitably homogenous subgroups to conduct a meta-analysis. Conclusion  There is no gold standard approach for the management of spondylolysis in the athletic population. The existing literature suggests initial therapy should be a course of conservative management with thoracolumbosacral orthosis brace, physiotherapy, and activity modification. If conservative management fails, surgical intervention should be considered. Two-sided clinical studies are needed to determine an optimal pathway for the management of athletes with spondylolysis. PMID:27556003

Blogging for weight loss: personal accountability, writing selves, and the weight-loss blogosphere.

PubMed

Leggatt-Cook, Chez; Chamberlain, Kerry

2012-09-01

Body weight is a key concern in contemporary society, with large proportions of the population attempting to control their weight. However, losing weight and maintaining weight loss is notoriously difficult, and new strategies for weight loss attract significant interest. Writing about experiences of weight loss in online journals, or blogging, has recently expanded rapidly. Weight-loss bloggers typically write about daily successes and failures, report calorie consumption and exercise output, and post photographs of their changing bodies. Many bloggers openly court the surveillance of blog readers as a motivation for accountability to their weight-loss goals. Drawing from a sample of weight-loss blogs authored by women, we explore three issues arising from this practice of disclosing a conventionally private activity within an online public domain. First, we examine motivations for blogging, focusing on accountability. Secondly, we consider the online construction of self, exploring how weight-loss bloggers negotiate discourses around fatness, and rework selves as their bodies transform. Finally, we consider the communities of interest that form around weight-loss blogs. This 'blogosphere' provides mutual support for weight loss. However, participating in online social spaces is complicated and bloggers must carefully manage issues of privacy and disclosure. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

Parents' Readiness to Change Affects BMI Reduction Outcomes in Adolescents with Polycystic Ovary Syndrome

PubMed Central

Jakubowski, Karen P.; Black, Jessica J.; El Nokali, Nermeen E.; Belendiuk, Katherine A.; Hannon, Tamara S.; Arslanian, Silva A.; Rofey, Dana L.

2012-01-01

Evidence supports the importance of parental involvement for youth's ability to manage weight. This study utilized the stages of change (SOC) model to assess readiness to change weight control behaviors as well as the predictive value of SOC in determining BMI outcomes in forty adolescent-parent dyads (mean adolescent age = 15 ± 1.84 (13–20), BMI = 37 ± 8.60; 70% white) participating in a weight management intervention for adolescent females with polycystic ovary syndrome (PCOS). Adolescents and parents completed a questionnaire assessing their SOC for the following four weight control domains: increasing dietary portion control, increasing fruit and vegetable consumption, decreasing dietary fat, and increasing usual physical activity. Linear regression analyses indicated that adolescent change in total SOC from baseline to treatment completion was not predictive of adolescent change in BMI from baseline to treatment completion. However, parent change in total SOC from baseline to treatment completion was predictive of adolescent change in BMI, (t(24) = 2.15, p = 0.043). Findings support future research which carefully assesses adolescent and parent SOC and potentially develops interventions targeting adolescent and parental readiness to adopt healthy lifestyle goals. PMID:22970350

Developing and Pilot Testing the Readiness and Motivation Interview for Families in Pediatric Weight Management.

PubMed

Geller, Josie; Avis, Jillian; Srikameswaran, Suja; Zelichowska, Joanna; Dartnell, Katie; Scheuerman, Bailey; Perez, Arnaldo; Rasquinha, Allison; Brown, Krista E; Chanoine, Jean-Pierre; Ball, Geoff

2015-12-01

Clinical acumen is often used to assess families' motivation prior to initiating pediatric obesity management due to a lack of available tools. The purpose of this pilot study was to (i) develop and (ii) pilot test the "Readiness and Motivation Interview for Families" (RMI-Family) in pediatric weight management. We conducted 5 focus groups with parents (n = 15), youth with obesity (n = 11), and health care providers (n = 8) to explore perceptions of barriers to making healthy behaviour changes, which led to the creation of the RMI-Family as a semi-structured interview. Five domains (treat foods, overeating, emotional eating, total physical activity, and screen time) emerged from the focus groups to inform the development of the RMI-Family, which was then pilot tested with a sample of youth with obesity and their parents (n = 11 dyads). Interviewers administered the RMI-Family to youth (age 12.8 ± 1.7 years; body mass index [BMI] z-score: 2.71 ± 0.43) and parents (age 47.1 ± 3.7 years; BMI: 33.5 ± 10.1 kg/m(2)). The RMI-Family was feasible to administer, easily understood by families, and may be a useful tool for assessing families' motivation. Research is underway to determine the psychometric properties and utility of the RMI-Family in predicting clinical outcomes in pediatric weight management.

Feasibility of a virtual learning collaborative to implement an obesity QI project in 29 pediatric practices.

PubMed

John, Tamara; Morton, Michaela; Weissman, Mark; O'Brien, Ellen; Hamburger, Ellen; Hancock, Yolandra; Moon, Rachel Y

2014-04-01

Quality improvement (QI) activities are required to maintain board certification in pediatrics. However, because of lack of training and resources, pediatricians may feel overwhelmed by the need to implement QI activities. Pediatricians also face challenges when caring for overweight and obese children. To create a virtual (online) QI learning collaborative through which pediatric practices could easily develop and implement a continuous QI process. Prospective cohort. Pediatric practices that were part of the Children's National Health Network were invited to participate, with the option to receive continuing medical education and maintenance of certification credits. s) Practices conducted baseline and monthly chart audits, participated in educational webinars and selected monthly practice changes, using Plan-Do-Study-Act cycles. Practices reported activities monthly and periodic feedback was provided to practices about their performance. s) Improvement in (i) body mass index (BMI) percentile documentation, (ii) appropriate nutritional and activity counseling and (iii) follow-up management for high-risk patients. Twenty-nine practices (120 providers) participated, and 24 practices completed all program activities. Monthly chart audits demonstrated continuous improvement in documentation of BMI, abnormal weight diagnosis, nutrition and activity screening and counseling, weight-related health messages and follow-up management of overweight and obese patients. Impact of QI activities on visit duration and practice efficiency was minimal. A virtual learning collaborative was successful in providing a framework for pediatricians to implement a continuous QI process and achieve practice improvements. This format can be utilized to address multiple health issues.

Stress fracture of ulna due to excessive push-ups.

PubMed

Meena, Sanjay; Rastogi, Devarshi; Solanki, Bipin; Chowdhury, Buddhadev

2014-01-01

Stress fractures are most common in the weight-bearing bones of the lower extremities and spine, but are rarely found in non-weight-bearing bones of the body. Stress fracture of the ulna is extremely rare. We report a case of complete stress fracture of ulna caused due to excessive push ups in a young athlete. Conservative management was successful in healing of fracture and returning this patient back to his previous activity level. Physician should have high index of suspicion, whenever they encounter a young athlete complaining of forearm pain.

Employment and weight status: The extreme case of body concern in South Korea.

PubMed

Han, Seung-Yong; Brewis, Alexandra A; SturtzSreetharan, Cindi

2018-05-01

For an industrialized nation, obesity rates in South Korea are extremely low. Yet, reflecting an extremely fat-averse, thin-positive society, efforts to lose weight are now reportedly very common. Since the 1980s, South Korea has experienced an increasingly flexible and insecure labor market which was exacerbated by the 1997 economic recession. In this social and economic setting, body shape and weight status, as human capital, may have gained significant bargaining power in the labor market. Consequently, we propose that Koreans, particularly those who are employed in "stable" jobs (i.e., non-manual and regular jobs), would increasingly engage in intense weight management and reduction activities even when not technically overweight or obese as a means to job security and upward mobility. Using nationally-representative data from the Korean Nutrition and Health Examination Survey (KNHANES), we identify the changing role of weight concerns versus actual body weight in predicting South Korean efforts to lose weight between 2001 (KNHANES-phase 1) and 2007-2009 (phase 4). The patterns were examined by occupation type (manual and non-manual jobs) and status (regular and non-regular jobs). Oaxaca decomposition analysis supported that people's perception of being "fat," rather than actual weight status, was crucial to explaining accelerated weight management efforts in South Korea over the decade (coef. = 0.062 and p-value < .0001 for male with regular work; coef. = 0.031 and p-value = .002 for female with regular work). Occupation status, rather than employment in itself, mattered. Job stability predicted increased effort; the pattern of change through time suggests efforts to invest high levels of effort in appearance positively impacts both employment opportunity and stability. Copyright © 2018 Elsevier B.V. All rights reserved.

Potential role of meal frequency as a strategy for weight loss and health in overweight or obese adults.

PubMed

Kulovitz, Michelle G; Kravitz, Len R; Mermier, Christine; Gibson, Ann L; Conn, Carole A; Kolkmeyer, Deborah; Kerksick, Chad M

2014-04-01

Improved dietary strategies for weight loss are necessary to decrease metabolic disease risk in overweight or obese adults. Varying meal frequency (MF; i.e., increasing or decreasing eating occasions beyond the traditional pattern of three meals daily) has been thought to have an influence on body weight regulation, hunger control, and blood markers of health. It is common practice for weight management clinicians to recommend increasing MF as a strategy for weight management and to improve metabolic parameters. However, limited research exists investigating the effect of MF during controlled hypocaloric dietary interventions. Furthermore, MF literature often speculates with regard to efficacy of MF treatments based on research using normal weight, overweight/obese, or some combination, where much diversity exists within these various populations. In this review, we suggest that normal-weight and overweight/obese populations, as well as free-living versus investigator-controlled research trials, should be studied independently. Therefore, the objective of the present review is to survey the literature to assess whether the alteration of MF influences body weight regulation, hunger control, and/or blood markers of health in overweight/obese participants undergoing a controlled hypocaloric diet to induce weight loss. Findings of this review indicate that there is uncertainty in the literature when interpreting the optimal MF for obesity treatment, where reduced MF may even show more favorable lipid profiles in obese individuals compared with increased MF. Furthermore, the simple relationship of comparing MF with body fatness or body mass index should also consider whether eating frequency is associated with other healthy factors (e.g., increased physical activity). Copyright © 2014 Elsevier Inc. All rights reserved.

Can weight management programs in worksites reduce the obesity epidemic?

USDA-ARS?s Scientific Manuscript database

Worksites can potentially be important locations for weight management programs that contribute to curbing the national obesity epidemic. In published studies, weight loss programs targeting overweight and obese employees have been relatively more effective for weight loss than programs for preventi...

Mediation of the relationship of behavioural treatment type and changes in psychological predictors of healthy eating by body satisfaction changes in women with obesity.

PubMed

Annesi, James J

Psychological correlates of both short- and long-term weight loss are poorly understood. Changes in satisfaction with one's body might serve to motivate healthier eating by mediating treatments' effect on psychological factors previously suggested to be associated with weight loss. Women with obesity (age 48.6±7.1 years; BMI 35.4±3.3kg/m 2 ) were randomly assigned to social cognitive theory-based weight-management treatments that were either group sessions emphasizing physical activity-derived self-regulation (experimental; n=53) or review of a written manual and phone support (comparison; n=54). Changes in weight, physical activity, body satisfaction, negative mood, and self-efficacy and self-regulation for controlled eating were assessed over 3, 6, 12, and 24 months. The experimental treatment was associated with significantly more favourable changes across variables. Over 6, 12, and 24 months, body satisfaction change mediated relationships between treatment type and changes in each of the psychological predictors of healthier eating (mood, self-efficacy, self-regulation). Reciprocal, mutually reinforcing, relationships between changes in body satisfaction and those psychological predictors were also found. Increased physical activity was associated with improved body satisfaction, even after controlling for weight changes. Findings increased understandings of the role of body satisfaction in improving psychological predictors of healthier eating over both the short- and longer-term. Results also suggested that body satisfaction could be improved through increased physical activity, irrespective of change in weight. Although results were limited to women with class 1 and 2 obesity, findings on interactions of psychological factors associated with eating changes have implications for the architecture of improved behavioural treatments. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Role of exclusive breastfeeding in energy balance and weight loss during the first six months postpartum.

PubMed

Antonakou, A; Papoutsis, D; Panou, I; Chiou, A; Matalas, A L

2013-01-01

To investigate the energy intake (EI), energy expenditure (EE), and body weight changes of solely breastfeeding women during the first six months postpartum. This is a prospective observational study of lactating women (n = 64). Three-day dietary records were filled in to assess EI. EE was calculated with a short physical activity questionnaire. Energy cost of milk production was not included in EE estimation. Daily EI and EE for the six-month period was 2,000 Kcal and 1,870 Kcal, respectively. Women had a positive energy balance throughout the study period. Nevertheless, they had a significant weight loss of 0.7 kg/month by the first trimester of lactation, but a non-significant weight loss of 0.5 kg/month by the second trimester. Overall, women lost 86% of the weight gained during pregnancy. Exclusively breastfeeding women manage to lose weight during the first six months postpartum as part of the natural process of energy cost of lactation.

Sleep, circadian rhythm and body weight: parallel developments.

PubMed

Westerterp-Plantenga, Margriet S

2016-11-01

Circadian alignment is crucial for body-weight management, and for metabolic health. In this context, circadian alignment consists of alignment of sleep, meal patterns and physical activity. During puberty a significant reduction in sleep duration occurs, and pubertal status is inversely associated with sleep duration. A consistent inverse association between habitual sleep duration and body-weight development occurs, independent of possible confounders. Research on misalignment reveals that circadian misalignment affects sleep-architecture and subsequently disturbs glucose-insulin metabolism, substrate oxidation, leptin- and ghrelin concentrations, appetite, food reward, hypothalamic-pituitary-adrenal-axis activity and gut-peptide concentrations enhancing positive energy balance and metabolic disturbance. Not only aligning meals and sleep in a circadian way is crucial, also regular physical activity during the day strongly promotes the stability and amplitude of circadian rhythm, and thus may serve as an instrument to restore poor circadian rhythms. Endogenicity may play a role in interaction of these environmental variables with a genetic predisposition. In conclusion, notwithstanding the separate favourable effects of sufficient daily physical activity, regular meal patterns, sufficient sleep duration and quality sleep on energy balance, the overall effect of the amplitude and stability of the circadian rhythm, perhaps including genetic predisposition, may integrate the separate effects in an additive way.

How College Students Search the Internet for Weight Control and Weight Management Information: An Observational Study

ERIC Educational Resources Information Center

Senkowski, Valerie; Branscum, Paul

2015-01-01

Background: Few studies have attempted to examine how young adults search for health information on the Internet, especially information related to weight control and weight management. Purpose: The purpose of this study was to determine search strategies that college students used for finding information related to weight control and weight…

The application of the Yerkes-Dodson law in a childhood weight management program: Examining weight dissatisfaction

USDA-ARS?s Scientific Manuscript database

Our objective was to determine the effect of dissatisfaction with one's weight on outcomes in a weight management program. Participants included 149 children between the ages of 11 and 14 years who were enrolled in an intensive weight loss intervention. All participants had a body mass index (BMI) ...

Neonatal gastric perforation.

PubMed

Kuremu, R T; Hadley, G P; Wiersma, R

2004-01-01

Gastric perforation in neonates is a catastrophe associated with high morbidity. Most are due to underlying primary pathology. To review the management of gastric perforation in neonates in Kwa Zulu-Natal, South Africa. Retrospective study of consecutive complete data sets of neonates presenting with gastric perforation. Department of Paediatric Surgery, Nelson R. Mandela School of Medicine, University of Natal, Durban, South Africa. Eight neonates treated for gastric perforation between January 1998 and April 2003. Morbidity and mortality. There was an equal number of males and females. Median birth weight was 2.0 kg with a range of 1.4 to 3.2 kg. Five of the eight neonates were premature. Primary pathologies were associated with perforation in seven of the eight neonates. Prematurity, low birth weight and pneumonia were contributing factors to the poor outcome. Sepsis was a complication in seven of the eight neonates leading to their death (88% mortality). Active perinatal management, early treatment of primary pathologies, and protection of the stomach against distension in neonates at risk are essential in the management of neonatal gastric perforation.

Trial for Reducing Weight Retention in New Mums: a randomised controlled trial evaluating a low intensity, postpartum weight management programme.

PubMed

Wilkinson, S A; van der Pligt, P; Gibbons, K S; McIntyre, H D

2015-01-01

Failure to return to pregnancy weight by 6 months postpartum is associated with long-term obesity, as well as adverse health outcomes. This research evaluated a postpartum weight management programme for women with a body mass index (BMI) > 25 kg m(-2) that combined behaviour change principles and a low-intensity delivery format with postpartum nutrition information. Women were randomised at 24-28 weeks to control (supported care; SC) or intervention (enhanced care; EC) groups, stratified by BMI cohort. At 36 weeks of gestation, SC women received a 'nutrition for breastfeeding' resource and EC women received a nutrition assessment and goal-setting session about post-natal nutrition, plus a 6-month correspondence intervention requiring return of self-monitoring sheets. Weight change, anthropometry, diet, physical activity, breastfeeding, fasting glucose and insulin measures were assessed at 6 weeks and 6 months postpartum. Seventy-seven percent (40 EC and 41 SC) of the 105 women approached were recruited; 36 EC and 35 SC women received a programme and 66.7% and 48.6% completed the study, respectively. No significant differences were observed between any outcomes. Median [interquartile range (IQR)] weight change was EC: -1.1 (9.5) kg versus SC: -1.1 (7.5) kg (6 weeks to 6 months) and EC: +1.0 (8.7) kg versus SC: +2.3 (9) kg (prepregnancy to 6 months). Intervention women breastfed for half a month longer than control women (180 versus 164 days; P = 0.10). An average of 2.3 out of six activity sheets per participant was returned. Despite low intervention engagement, the high retention rate suggests this remains an area of interest to women. Future strategies must facilitate women's engagement, be individually tailored, and include features that support behaviour change to decrease women's risk of chronic health issues. © 2013 The British Dietetic Association Ltd.

Kaiser Permanente Georgia's Experience with Operation Zero: A Group Medical Appointment to Address Pediatric Overweight

PubMed Central

Hinchman, Josephine; Beno, Luke; Mims, Adrienne

2006-01-01

Context: The rate of overweight (OW) in children in the United States has more than tripled since 1980. The health consequences of pediatric OW include type 2 diabetes and significant illness later in life. Treating pediatric OW is a necessity; however, health care clinicians have minimal access to successful and comprehensive treatment modalities for addressing it. Objective: Kaiser Permanente of Georgia (KPGA) offers a group medical appointment clinic, Operation Zero (O.Z.), as a referral program for preadolescent and adolescent patients who are in the 85th or higher percentile for body mass index (BMI) for their age. The eight-session clinic uses a family-oriented approach and provides a supportive group environment with interactive learning, games, physical activity, and creative problem solving. The goal of the program is to improve lifestyle behaviors for nutrition and physical activity. Clinically, meeting these goals can manifest as reductions in body fat (BF), waist size, and BMI-for-age percentile. Two implementation models help improve dissemination of the program within KPGA. Design: Baseline and eight-week postclinical outcomes for O.Z. participants were analyzed to determine program effectiveness. A retrospective analysis with a control group looked at long-term clinical outcomes to determine weight maintenance. Main outcome measures were weight, BMI-for-age percentile, waist size, and percentage of body fat (%BF). Results: At eight weeks after program completion compared with baseline, there were significant reductions in %BF and waist size for the total sample and specifically for adolescents, preteens, and participants who attended six or more sessions. Among O.Z. participants, there were insignificant increases in weight at six months after program participation and BMI-for-age percentile at one year after participation. At six months, the mean change in weight and BMI in the O.Z. group was statistically less than the mean change in the control group. Conclusions: A structured, family-oriented weight management program is effective in changing measures consistent with improved weight management. PMID:21519478

Financial planning as a policy tool in the petroleum industry (the case study: ojsc ”SURGUTNEFTEGAS”)

NASA Astrophysics Data System (ADS)

Romanyuk, Vera; Karyakina, Anna; Vershkova, Elena; Grinkevish, Larisa; Pozdeeva, Galina

2016-09-01

The article deals with the financial planning of oil and gas company activities including capital structure optimization. One of the main tasks of up-to-date financial management is to optimize the capital structure of an organization and minimize the weighted average cost of capital. The applied method in capital structure optimization affects the research quality results, as well as management decisions. The study was conducted on the basis of OJSC "Surgutneftegas" financial statements.

Habitual physical activity and plasma metabolomic patterns distinguish individuals with low vs. high weight loss during controlled energy restriction.

PubMed

Piccolo, Brian D; Keim, Nancy L; Fiehn, Oliver; Adams, Sean H; Van Loan, Marta D; Newman, John W

2015-04-01

Total weight loss induced by energy restriction is highly variable even under tightly controlled conditions. Identifying weight-loss discriminants would provide a valuable weight management tool and insights into body weight regulation. This study characterized responsiveness to energy restriction in adults from variables including the plasma metabolome, endocrine and inflammatory markers, clinical indices, body composition, diet, and physical activity. Data were derived from a controlled feeding trial investigating the effect of 3-4 dairy product servings in an energy-restricted diet (2092 kJ/d reduction) over 12 wk. Partial least squares regression was used to identify weight-loss discriminants in 67 overweight and obese adults. Linear mixed models were developed to identify discriminant variable differences in high- vs. low-weight-loss responders. Both pre- and postintervention variables (n = 127) were identified as weight-loss discriminants (root mean squared error of prediction = 1.85 kg; Q(2) = 0.43). Compared with low-responders (LR), high-responders (HR) had greater decreases in body weight (LR: 2.7 ± 1.6 kg; HR: 9.4 ± 1.8 kg, P < 0.01), BMI (in kg/m(2); LR: 1.0 ± 0.6; HR: 3.3 ± 0.5, P < 0.01), and total fat (LR: 2.2 ± 1.1 kg; HR: 8.0 ± 2.1 kg, P < 0.01). Significant group effects unaffected by the intervention were determined for the respiratory exchange ratio (LR: 0.86 ± 0.05; HR: 0.82 ± 0.03, P < 0.01), moderate physical activity (LR: 127 ± 52 min; HR: 167 ± 68 min, P = 0.02), sedentary activity (LR: 1090 ± 99 min; HR: 1017 ± 110 min, P = 0.02), and plasma stearate [LR: 102,000 ± 21,000 quantifier ion peak height (QIPH); HR: 116,000 ± 24,000 QIPH, P = 0.01]. Overweight and obese individuals highly responsive to energy restriction had accelerated reductions in adiposity, likely supported in part by higher lipid mobilization and combustion. A novel observation was that person-to-person differences in habitual physical activity and magnitude of weight loss were accompanied by unique blood metabolite signatures. This trial was registered at clinicaltrials.gov as NCT00858312. © 2015 American Society for Nutrition.

Exploring Weight Management Recommendations across Australian Community Pharmacies Using Case Vignettes

ERIC Educational Resources Information Center

Fakih, Souhiela; Marriott, Jennifer L.; Hussainy, Safeera Y.

2014-01-01

With the increase in the overweight and obese population, it is critical that pharmacy staff are able to provide weight management advice to women at different stages of their life. This study utilized case vignettes to identify pharmacists' and pharmacy assistants' current weight management recommendations to women of different ages, life stages…

Level of interest in a weight management program among adult U.S. military dependents

USDA-ARS?s Scientific Manuscript database

There is little information on the extent to which different challenged populations with high rates of overweight and obesity have interest in participating in weight management programs. The purpose of this study was to identify potential rates of enrollment in a weight management program among adu...

Enhancing the role of nutrition professionals in weight management: A cross sectional survey

PubMed Central

Bleich, Sara N.; Bandara, Sachini; Bennett, Wendy; Cooper, Lisa A.; Gudzune, Kimberly A.

2014-01-01

Objective 1) To determine the non-physician health profession perceived as best qualified to provide weight management; 2) To examine nutrition professionals’ current practice characteristics and perceived challenges and solutions for obesity care; and 3) To examine the association between nutrition professionals’ quality of training and self-efficacy in weight management. Design and methods We analyzed a 2014 national cross-sectional online survey of 500 U.S. non-physician health professionals (100 from each: nutrition, nursing, behavioral/mental health, exercise, pharmacy). Results Nutrition professionals most commonly self-identified as the most qualified group to help patients lose weight (92%), sentiments supported by other health professionals (57%). The most often cited challenge was lack of patient adherence (87%). Among nutrition professionals, 77% reported receiving high quality training in weight loss counseling. Nutrition professionals who reported high quality training were significantly more likely to report confidence (95% vs. 48%) and success (74% vs. 50%) in helping obese patients lose weight (p<0.05) than those reporting lower quality training. Conclusion Across all non-physician health professionals, nutrition professionals were identified as best suited to provide routine weight management counseling to obese patients. Yet, nutrition professionals’ receipt of high quality weight management training appears critical to their success in helping patients lose weight. PMID:25445319

The Biggest Loser Thinks Long-Term: Recency as a Predictor of Success in Weight Management.

PubMed

Koritzky, Gilly; Rice, Chantelle; Dieterle, Camille; Bechara, Antoine

2015-01-01

Only a minority of participants in behavioral weight management lose weight significantly. The ability to predict who is likely to benefit from weight management can improve the efficiency of obesity treatment. Identifying predictors of weight loss can also reveal potential ways to improve existing treatments. We propose a neuro-psychological model that is focused on recency: the reliance on recent information at the expense of time-distant information. Forty-four weight-management patients completed a decision-making task and their recency level was estimated by a mathematical model. Impulsivity and risk-taking were also measured for comparison. Weight loss was measured in the end of the 16-week intervention. Consistent with our hypothesis, successful dieters (n = 12) had lower recency scores than unsuccessful ones (n = 32; p = 0.006). Successful and unsuccessful dieters were similar in their demographics, intelligence, risk taking, impulsivity, and delay of gratification. We conclude that dieters who process time-distant information in their decision making are more likely to lose weight than those who are high in recency. We argue that having low recency facilitates future-oriented thinking, and thereby contributes to behavior change treatment adherence. Our findings underline the importance of choosing the right treatment for every individual, and outline a way to improve weight-management processes for more patients.

A qualitative investigation of attitudes towards aerobic and resistance exercise amongst overweight and obese individuals.

PubMed

Guess, Nicola

2012-04-25

Most people are not meeting the minimal requirements for physical activity participation, particularly people who are overweight or obese. Numerous initiatives have been developed which aim to increase levels of physical activity in this group, yet little is known about their feelings towards different types of exercise. In particular, resistance exercise may offer unique benefits to people seeking to lose weight, yet no study to date has examined views of resistance exercise amongst the overweight and obese. This qualitative study examined the views and attitudes towards aerobic and resistance exercise amongst overweight and obese individuals engaged in a weight management clinic. 30 overweight and obese patients comprised of 25 females and 5 males, with a mean age of 40.7 years (SD = 15.2) and mean BMI of 33.8 kg/m2 (SD = 7.9) were recruited from a dietetic clinic to take part in baseline focus groups and interviews to assess their views on physical activity. After selecting and participating in a 12 week aerobic- or resistance-exercise program, the participants took part in follow-up interviews. Thematic analysis was then performed on the transcribed focus group and interview data. For the overweight and obese women in this study, weight loss was the primary motivation for physical activity participation. Subsequently, these women perceived a failure to lose weight as strongly affecting their motivation to continue or re-engage in physical activity. Only 3 participants selected the resistance exercise option. The view of resistance exercise as a masculine activity was a dominant theme amongst all participants. A lack of knowledge of how to perform certain exercises emerged as a barrier, but was seen by the participants as surmountable given appropriate instruction. The females in this study cited weight loss as a primary motivation for physical activity participation. This view must be reconciled with the existing knowledge base of physical activity requirements for successful weight loss and maintenance. Participants in this study had little awareness or experience of resistance exercise, and many were fearful of the potential risks.

A primary care based healthy-eating and active living education session for weight reduction in the pre-diabetic population.

PubMed

Weir, Daniala L; Johnson, Steven T; Mundt, Clark; Bray, Dianne; Taylor, Lorian; Eurich, Dean T; Johnson, Jeffrey A

2014-12-01

Many studies have demonstrated the effectiveness of primary prevention strategies in type 2 diabetes, however, questions remain around the feasibility of high resource, intensive interventions within a healthcare setting. We report the results of a dietitian-led pre-diabetes education session targeting healthy eating and active living as strategies for weight reduction. Participants were asked to complete a baseline questionnaire prior to completing the pre-diabetes education session and were sent follow-up questionnaires at 3 and 6 months. Differences between participants at baseline, 3 and 6 months were determined using χ(2), t-tests and ANOVA. Of the 211 participants asked to fill out baseline questionnaires, 45 participants completed questionnaires at baseline, 3 months and 6 months. Although we observed general trends towards improvements in diet, physical activity and weight related behaviours among the 45 completers, no significant changes were observed among participants between questionnaire periods. A "one-off", theory-guided group education session may be insufficient to support lifestyle modifications in the context of weight management in a pre-diabetic population. Further evaluation of the efficacy and feasibility of the PCN as a setting for lifestyle intervention is required. Copyright © 2014 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Short and long-term lifestyle coaching approaches used to address diverse participant barriers to weight loss and physical activity adherence

PubMed Central

2014-01-01

Background Individual barriers to weight loss and physical activity goals in the Diabetes Prevention Program, a randomized trial with 3.2 years average treatment duration, have not been previously reported. Evaluating barriers and the lifestyle coaching approaches used to improve adherence in a large, diverse participant cohort can inform dissemination efforts. Methods Lifestyle coaches documented barriers and approaches after each session (mean session attendance = 50.3 ± 21.8). Subjects were 1076 intensive lifestyle participants (mean age = 50.6 years; mean BMI = 33.9 kg/m2; 68% female, 48% non-Caucasian). Barriers and approaches used to improve adherence were ranked by the percentage of the cohort for whom they applied. Barrier groupings were also analyzed in relation to baseline demographic characteristics. Results Top weight loss barriers reported were problems with self-monitoring (58%); social cues (58%); holidays (54%); low activity (48%); and internal cues (thought/mood) (44%). Top activity barriers were holidays (51%); time management (50%); internal cues (30%); illness (29%), and motivation (26%). The percentage of the cohort having any type of barrier increased over the long-term intervention period. A majority of the weight loss barriers were significantly associated with younger age, greater obesity, and non-Caucasian race/ethnicity (p-values vary). Physical activity barriers, particularly thought and mood cues, social cues and time management, physical injury or illness and access/weather, were most significantly associated with being female and obese (p < 0.001 for all). Lifestyle coaches used problem-solving with most participants (≥75% short-term; > 90% long term) and regularly reviewed self-monitoring skills. More costly approaches were used infrequently during the first 16 sessions (≤10%) but increased over 3.2 years. Conclusion Behavioral problem solving approaches have short and long term dissemination potential for many kinds of participant barriers. Given minimal resources, increased attention to training lifestyle coaches in the consistent use of these approaches appears warranted. PMID:24521153

Energy Metabolism Profile in Individuals with Prader-Willi Syndrome and Implications for Clinical Management: A Systematic Review.

PubMed

Alsaif, Maha; Elliot, Sarah A; MacKenzie, Michelle L; Prado, Carla M; Field, Catherine J; Haqq, Andrea M

2017-11-01

Prader-Willi syndrome (PWS) is a rare genetic disorder associated with excessive weight gain. Hyperphagia associated with PWS may result in higher energy intake, but alterations in energy expenditure may also contribute to energy imbalance. The purpose of this critical literature review is to determine the presence of alterations in energy expenditure in individuals with PWS. Ten studies that measured total energy expenditure (TEE), resting energy expenditure (REE), sleep energy expenditure (SEE), activity energy expenditure (AEE), and diet induced thermogenesis (DIT) were included in this review. The studies provided evidence that absolute TEE, REE, SEE, and AEE are lower in individuals with PWS than in age-, sex-, and body mass index-matched individuals without the syndrome. Alterations in lean body mass and lower physical activity amounts appear to be responsible for the lower energy expenditure in PWS rather than metabolic differences. Regardless of the underlying mechanism for lower TEE, the estimation of energy requirements with the use of equations derived for the general population would result in weight gain in individuals with PWS. The determination of energy requirements for weight management in individuals with PWS requires a more comprehensive understanding of energy metabolism. Future studies should aim to comprehensively profile all specific components of energy expenditure in individuals with PWS with the use of appropriately matched controls and gold standard methods to measure energy metabolism and body composition. One component of energy expenditure that is yet to be explored in detail in PWS is DIT. A reduced DIT (despite differences in fat free mass), secondary to hormonal dysregulation, may be present in PWS individuals, leading to a reduced overall energy expenditure. Further research exploring DIT in PWS needs to be conducted. Dietary energy recommendations for weight management in PWS have not yet been clearly established. © 2017 American Society for Nutrition.

Healthy eating and lifestyle in pregnancy (HELP): a protocol for a cluster randomised trial to evaluate the effectiveness of a weight management intervention in pregnancy

PubMed Central

2014-01-01

Background Approximately 1 in 5 pregnant women in the United Kingdom are obese. In addition to being associated generally with poor health, obesity is known to be a contributing factor to pregnancy and birth complications and the retention of gestational weight can lead to long term obesity. This paper describes the protocol for a cluster randomised trial to evaluate whether a weight management intervention for obese pregnant women is effective in reducing women’s Body Mass Index at 12 months following birth. Methods/design The study is a cluster randomised controlled trial involving 20 maternity units across England and Wales. The units will be randomised, 10 to the intervention group and 10 to the control group. 570 pregnant women aged 18 years or over, with a Body Mass Index of +/=30 (kg/m2) and between 12 and 20 weeks gestation will be recruited. Women allocated to the control group will receive usual care and two leaflets giving advice on diet and physical activity. In addition to their usual care and the leaflets, women allocated to the intervention group will be offered to attend a weekly 1.5 hour weight management group, which combines expertise from Slimming World with clinical advice and supervision from National Health Service midwives, until 6 weeks postpartum. Participants will be followed up at 36 weeks gestation and at 6 weeks, 6 months and 12 months postpartum. Body Mass Index at 12 months postpartum is the primary outcome. Secondary outcomes include pregnancy weight gain, quality of life, mental health, waist-hip ratio, child weight centile, admission to neonatal unit, diet, physical activity levels, pregnancy and birth complications, social support, self-regulation and self-efficacy. A cost effectiveness analysis and process evaluation will also be conducted. Discussion This study will evaluate the effectiveness of a theory-based intervention developed for obese pregnant women. If successful the intervention will equip women with the necessary knowledge and skills to enable them to make healthier choices for themselves and their unborn child. Trial registration Current Controlled Trials: ISRCTN25260464 Date of registration: 16th April 2010. PMID:24886352

Determinants of weight outcomes in type 2 diabetes prevention intervention in primary health care setting (the DE-PLAN project).

PubMed

Gilis-Januszewska, Aleksandra; Piwońska-Solska, Beata; Lindström, Jaana; Wójtowicz, Ewa; Tuomilehto, Jaakko; Schwarz, Peter E H; Kissimova-Skarbek, Katarzyna; Szybiński, Zbigniew; Windak, Adam; Hubalewska-Dydejczyk, Alicja

2018-01-02

Real life implementation studies performed in different settings have proved that lifestyle interventions in the prevention of type 2 diabetes (DM2) can be effective, although the weight reduction results are typically modest compared to randomized control trials. Our objective was to identify the factors that predict successful weight loss in a less intensive, lower budget, real life setting lifestyle diabetes prevention intervention. Study participants (n = 175) with increased DM2 risk (Finnish Diabetes Risk Score (FINDRISC) > 14) but no diabetes at baseline received ten group lifestyle counselling sessions, physical activity and motivation sessions during a ten-month intervention. Stepwise regression analysis was used to determine demographic, clinical, and lifestyle predictors of successful weight reduction defined as a reduction of ≥5% of the initial body weight. At 12 months following the initiation of the intervention, 23.4% of study participants lost ≥5% weight (mean loss of 7.9 kg, SD = 5.8). Increased physical activity (44% vs 25%, p = 0.03), decreased total fat consumption (88% vs 65%, p = 0.006) and adherence to four-five lifestyle goals (71% vs 46%, p = 0.007) were more often reported among those who managed to lose ≥5% weight versus those who did not. In a multivariate analysis, meeting the ≥5% weight loss goal was most effective in individuals with a higher baseline BMI (OR 1.1, 95%CI 1.0-1.2), baseline and medium versus higher education (OR 5.4, 95% CI 1.2-24.7) and a history of increased glucose (OR 2.6, 95%CI 1.1-1.3). A reduction of total fat in the diet was an independent lifestyle predictor, increasing the probability of successful weight loss by 3.8 times (OR 3.8, 95% CI 1.2-11.4). Baseline higher BMI, lower education and a history of increased glucose predicted the successful weight loss among individuals with a high risk for the DM2 following lifestyle intervention in a real life primary health care setting. People who manage to lose weight more often adhere to lifestyle changes, while the reduction of total fat in diet independently predicts successful weight loss. Further studies exploring the predictors of success in implementation studies in DM2 prevention should help health care providers redesign interventions to improve their effectiveness and outcomes. ISRCTN, ID ISRCTN96692060 , registered 03.08.2016 retrospectively.

Lorcaserin for weight management

PubMed Central

Taylor, James R; Dietrich, Eric; Powell, Jason

2013-01-01

Type 2 diabetes and obesity commonly occur together. Obesity contributes to insulin resistance, a main cause of type 2 diabetes. Modest weight loss reduces glucose, lipids, blood pressure, need for medications, and cardiovascular risk. A number of approaches can be used to achieve weight loss, including lifestyle modification, surgery, and medication. Lorcaserin, a novel antiobesity agent, affects central serotonin subtype 2A receptors, resulting in decreased food intake and increased satiety. It has been studied in obese patients with type 2 diabetes and results in an approximately 5.5 kg weight loss, on average, when used for one year. Headache, back pain, nasopharyngitis, and nausea were the most common adverse effects noted with lorcaserin. Hypoglycemia was more common in the lorcaserin groups in the clinical trials, but none of the episodes were categorized as severe. Based on the results of these studies, lorcaserin was approved at a dose of 10 mg twice daily in patients with a body mass index ≥30 kg/m2 or ≥27 kg/m2 with at least one weight-related comorbidity, such as hypertension, type 2 diabetes mellitus, or dyslipidemia, in addition to a reduced calorie diet and increased physical activity. Lorcaserin is effective for weight loss in obese patients with and without type 2 diabetes, although its specific role in the management of obesity is unclear at this time. This paper reviews the clinical trials of lorcaserin, its use from the patient perspective, and its potential role in the treatment of obesity. PMID:23788837

Lorcaserin for weight management.

PubMed

Taylor, James R; Dietrich, Eric; Powell, Jason

2013-01-01

Type 2 diabetes and obesity commonly occur together. Obesity contributes to insulin resistance, a main cause of type 2 diabetes. Modest weight loss reduces glucose, lipids, blood pressure, need for medications, and cardiovascular risk. A number of approaches can be used to achieve weight loss, including lifestyle modification, surgery, and medication. Lorcaserin, a novel antiobesity agent, affects central serotonin subtype 2A receptors, resulting in decreased food intake and increased satiety. It has been studied in obese patients with type 2 diabetes and results in an approximately 5.5 kg weight loss, on average, when used for one year. Headache, back pain, nasopharyngitis, and nausea were the most common adverse effects noted with lorcaserin. Hypoglycemia was more common in the lorcaserin groups in the clinical trials, but none of the episodes were categorized as severe. Based on the results of these studies, lorcaserin was approved at a dose of 10 mg twice daily in patients with a body mass index ≥30 kg/m(2) or ≥27 kg/m(2) with at least one weight-related comorbidity, such as hypertension, type 2 diabetes mellitus, or dyslipidemia, in addition to a reduced calorie diet and increased physical activity. Lorcaserin is effective for weight loss in obese patients with and without type 2 diabetes, although its specific role in the management of obesity is unclear at this time. This paper reviews the clinical trials of lorcaserin, its use from the patient perspective, and its potential role in the treatment of obesity.

Lifestyle and Behavioral Management of Polycystic Ovary Syndrome.

PubMed

Brennan, Leah; Teede, Helena; Skouteris, Helen; Linardon, Jake; Hill, Briony; Moran, Lisa

2017-08-01

Polycystic ovary syndrome (PCOS) is a common condition with serious physiological and psychological health consequences. It affects women across their reproductive lifespan and is associated with pregnancy complications, including gestational diabetes, preeclampsia, and large gestational-age babies. PCOS is associated with excess weight gain, which, in turn, exacerbates the health burden of PCOS. Therefore, weight management, including a modest weight loss, maintenance of weight loss, prevention of weight gain, and prevention of excess gestational weight gain, is a first-line treatment for women with PCOS during and independent of pregnancy. Despite evidence-based guidelines, international position statements, and Cochrane reviews promoting lifestyle interventions for PCOS, the optimal complexity, intensity, and behavioral components of lifestyle interventions for women with PCOS are not well understood. The focus of this narrative review is the evidence supporting the use of behavioral strategies in weight management interventions for reproductive-aged women to apply to PCOS. Behavioral theories, behavior change strategies, and psychological correlates of weight management have been thoroughly explored in weight loss interventions in the general population, reproductive-aged women, and peri-natal women. This article uses this parallel body of research to inform suggestions regarding lifestyle interventions in women with PCOS. Outcomes of weight management programs in women with PCOS are likely to be improved with the inclusion of behavioral and psychological strategies, including goal setting, self-monitoring, cognitive restructuring, problem solving, and relapse prevention. Strategies targeting improved motivation, social support, and psychological well-being are also important. These can be applied to the clinical management of women with PCOS at different reproductive life stages.

Acceptability of a Weight Management Intervention for Pregnant and Postpartum Women with BMI ≥30 kg/m2: A Qualitative Evaluation of an Individualized, Home-Based Service.

PubMed

Atkinson, Lou; Olander, Ellinor K; French, David P

2016-01-01

There have been recent calls for more evidence regarding effective antenatal and postnatal interventions to address the serious health risks of maternal obesity and associated childhood obesity. The Maternal and Early Years Healthy Weight Service (MAEYS) is an innovative service, delivered by specialist healthy weight advisors, for obese women (BMI ≥30 kg/m2) during pregnancy and up to 2 years after delivery. The service focuses on healthy gestational weight gain, postpartum weight loss and establishing healthy infant feeding and active play. MAEYS was adopted by six local health organizations in the U.K. as a 1 year pilot program. The aim of the present research was to assess the acceptability of this intervention among MAEYS participants. Semi-structured interviews with 20 women, with data analyzed thematically. High levels of acceptability were reported. The convenience and comfort of home visits, personalized advice on diet and physical activity, supportive approach of the healthy weight advisor and regular weight monitoring were all cited as advantages of the service. Service users suggested that more frequent contact with advisors and practical support such as recipes would improve the service. MAEYS is a novel, community-based intervention delivered in the home which has demonstrated acceptability to its recipients. It therefore shows promise as an early intervention to reduce the risks of maternal obesity and subsequently reduce childhood obesity. An evaluation of the efficacy of MAEYS in preventing excess gestational weight gain and losing weight postpartum is now needed.

Salivary cortisol levels are associated with outcomes of weight reduction therapy in obese Japanese patients.

PubMed

Himeno, Akihiro; Satoh-Asahara, Noriko; Usui, Takeshi; Wada, Hiromichi; Tochiya, Mayu; Kono, Shigeo; Yamada-Goto, Nobuko; Katsuura, Goro; Hasegawa, Koji; Nakao, Kazuwa; Shimatsu, Akira

2012-02-01

Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis can increase the risk of cardiovascular disease (CVD). However, the detailed relationships of HPA axis activity with weight reduction and CVD risk factors in obese patients have not been examined. This study was designed to elucidate the associations of salivary cortisol levels with weight reduction and CVD risk factors in obese patients. As a marker of HPA axis activity, we measured the morning salivary cortisol levels of 83 obese Japanese outpatients. We also examined metabolic parameters, inflammatory markers, and indicators of arterial stiffness, that is, the pulse wave velocity and cardio-ankle vascular index. All 83 obese patients underwent 3-month weight reduction therapy with lifestyle modification. At the baseline, multivariate regression analysis revealed that only logarithmic transformation of C-reactive protein (β = 0.258, P < .05) and cardio-ankle vascular index (β = 0.233, P < .05) were independent determinants of the salivary cortisol levels. However, other metabolic parameters were not significantly associated with the salivary cortisol levels. In addition, lower salivary cortisol levels and higher body weight at the baseline were the only independent determinants of successful weight loss through the weight reduction therapy (P < .01). The present study demonstrates that the baseline morning salivary cortisol levels are significantly associated with the levels of an inflammatory marker, arterial stiffness, and successful weight reduction in obese patients. Therefore, salivary cortisol could be a useful marker for assessing and managing body weight and CVD risk factors in obese patients. Copyright © 2012 Elsevier Inc. All rights reserved.

The physical activity energy cost of the latest active video games in young adults.

PubMed

Howe, Cheryl A; Barr, Marcus W; Winner, Brett C; Kimble, Jenelyn R; White, Jason B

2015-02-01

Although promoted for weight loss, especially in young adults, it has yet to be determined if the physical activity energy expenditure (PAEE) and intensity of the newest active video games (AVGs) qualifies as moderate-to-vigorous physical activity (MVPA; > 3.0 METs). This study compared the PAEE and intensity of AVGs to traditional seated video games (SVGs). Fifty-three young adults (18-35 y; 27 females) volunteered to play 6 video games (4 AVGs, 2 SVGs). Anthropometrics and resting metabolism were measured before testing. While playing the games (6-10 min) in random order against a playmate, the participants wore a portable metabolic analyzer for measuring PAEE (kcal/min) and intensity (METs). A repeated-measures ANOVA compared the PAEE and intensity across games with sex, BMI, and PA status as main effects. The intensity of AVGs (6.1 ± 0.2 METs) was significantly greater than SVGs (1.8 ± 0.1 METs). AVGs elicited greater PAEE than SVGs in all participants (5.3 ± 0.2 vs 0.8 ± 0.0 kcal/min); PAEE during the AVGs was greater in males and overweight participants compared with females and healthy weight participants (p's < .05). The newest AVGs do qualify as MVPA and can contribute to the recommended dose of MVPA for weight management in young adults.

A New Measurement and Ranking System for the UK National Student Survey

ERIC Educational Resources Information Center

Canning, John

2015-01-01

Despite numerous criticisms of the UK National Student Survey (NSS) institutional managers still strongly support its use in informing student choice, quality and assurance and quality enhancement activities. This article outlines a granular and nuanced benchmarking system for the NSS which provides both a "raw" score (weighted student…

Using an adverse outcome pathway network to describe the weight of evidence linking nicotinic acetylcholine receptor activation to honey bee colony failure

EPA Science Inventory

Significant and unsustainable losses of managed honey bee (Apis mellifera) colonies have been documented over recent years, which have led to scientific investigation to determine the contributing factors. Evidence suggests that both chemical and non-chemical stressors play a rol...

Workplace health: engaging business leaders to combat obesity.

PubMed

Lankford, Tina; Lang, Jason; Bowden, Brian; Baun, William

2013-01-01

This article explores how employers can be part of the solution to obesity by offering workplace wellness programs and facilitating opportunities for physical activity, access to healthier foods and beverages, and incentives for disease management and prevention to help prevent weight gain among their employees. © 2013 American Society of Law, Medicine & Ethics, Inc.

Lifestyle Therapy for the Management of Atrial Fibrillation.

PubMed

Abdul-Aziz, Ahmad A; Altawil, Mahmoud; Lyon, Amanda; MacEachern, Mark; Richardson, Caroline R; Rubenfire, Melvyn; Pelosi, Frank; Jackson, Elizabeth A

2018-05-01

Atrial fibrillation (AF) is a common arrhythmia associated with increased risk of morbidity and mortality. There is evidence that lifestyle interventions may serve as complementary treatments to reduce AF burden. The objective of this review was to summarize the efficacy of lifestyle interventions for the management of AF. Studies which included patients with systolic heart failure (ejection fraction ≤40%), and those limited to an examination of vigorous physical activity were excluded from our search. Studies were identified through a search of the following databases: MEDLINE, EMBASE, CINAHIL, and PubMed, run from inception through August 2016. All studies were graded for quality using the Oxford Centre for Evidence-based Medicine recommendations. Meta-analyses of the studies were not performed due to the heterogeneity of the studies. From a total of 1,811 publications, 10 articles were identified and included. Selected publications included 1 study on yoga, 2 studies on acupuncture, 3 studies that examined weight loss programs, and 4 studies that evaluated the impact of moderate physical activity. Yoga was associated with less symptomatic AF episodes and improved quality of life. Acupuncture was associated with reduced AF occurrence in patients with persistent and paroxysmal AF. Weight loss was associated with a significant reduction AF burden and symptoms. Moderate exercise resulted in greater arrhythmia free survival and a mean reduction in AF burden. In conclusion, evidence exists to suggest that yoga, weight loss, and moderate exercise are associated with reductions in AF burden and symptoms. Evidence is greatest for weight loss and moderate exercise. Copyright © 2018 Elsevier Inc. All rights reserved.

African American Women, Hair Care, and Health Barriers

PubMed Central

Mahan, Meredith Grace

2014-01-01

Objectives: The objective of this study was to elucidate the prevalence of hair loss among African American women; explore the psychosocial impact of hair grooming difficulties; and examine both perceptions related to physician encounters in this group and the relationship between hair grooming, physical activity, and weight maintenance. Design: An anonymous retrospective and qualitative survey, the Hair Care Assessment Survey, is an 18-question novel survey instrument designed at the Henry Ford Hospital Department of Dermatology Multicultural Dermatology Center. Setting: The Hair Care Assessment Survey was distributed at church-related functions at predominantly African American metropolitan Detroit churches. Participants: Two hundred African American women from metropolitan Detroit, Michigan, aged 21 to 83. Measurements: The Hair Care Assessment Survey collected data relating to hair loss and hair care, psychosocial experiences relating to hair loss, and hair care as it relates to exercise and body weight management. Data was collected on doctor-patient hair-related medical visits and experiences with commercially available ethnic hair care products. Results: More than 50 percent reported excessive hair loss. Twenty-eight percent had visited a physician to discuss hair issues, but only 32 percent felt their physician understood African American hair. Forty-five percent reported avoiding exercise because of hair concerns, and 22 percent felt that their hair impeded maintaining healthy body weight. Conclusion: Hair loss affects a compelling number of African American women, and a significant number express dissatisfaction in hair-related physician encounters. Additionally, hair styling problems present a serious impediment to physical activity and weight management among this already high-risk population. PMID:25276273

Feasibility and acceptability of a physician-delivered weight management programme.

PubMed

Sturgiss, Elizabeth A; Elmitt, Nicholas; Haesler, Emily; van Weel, Chris; Douglas, Kirsty

2017-02-01

Primary health care requires new approaches to assist patients with overweight and obesity. This is a particular concern for patients with limited access to specialist or allied health services due to financial cost or location. The Change Program is a toolkit that provides a structured approach for GPs working with patients on weight management. To assess the acceptability and feasibility of a GP-delivered weight management programme. A feasibility trial in five Australian general practices with 12 GPs and 23 patients. Mixed methods were used to assess the objective through participant interviews, online surveys and the NOrmalization MeAsure Development (NoMAD) tool based on Normalization Process Theory. Content analysis of interviews is presented alongside Likert scales, free text and the NoMAD tool. The Change Program was acceptable to most GPs and patients. It was best suited to patient-GP dyads where the patient felt a strong preference for GP involvement. Patients' main concerns were the time and possible cost associated with the programme if run outside a research setting. For sustainable implementation, it would have been preferable to recruit a whole practice rather than single GPs to enable activation of systems to support the programme. A GP-delivered weight management programme is feasible and acceptable for patients with obesity in Australian primary health care. The addition of this structured toolkit to support GPs is particularly important for patients with a strong preference for GP involvement or who are unable to access other resources due to cost or location. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Effectiveness of hypnosis as an adjunct to behavioral weight management.

PubMed

Bolocofsky, D N; Spinler, D; Coulthard-Morris, L

1985-01-01

This study examined the effect of adding hypnosis to a behavioral weight-management program on short- and long-term weight change. One hundred nine subjects, who ranged in age from 17 to 67, completed a behavioral treatment either with or without the addition of hypnosis. At the end of the 9-week program, both interventions resulted in significant weight reduction. However, at the 8-month and 2-year follow-ups, the hypnosis clients showed significant additional weight loss, while those in the behavioral treatment exhibited little further change. More of the subjects who used hypnosis also achieved and maintained their personal weight goals. The utility of employing hypnosis as an adjunct to a behavioral weight-management program is discussed.

Parent predictors of child weight change in family based behavioral obesity treatment.

PubMed

Boutelle, Kerri N; Cafri, Guy; Crow, Scott J

2012-07-01

Family based behavioral treatment for overweight and obese children includes parenting skills targeting the modification of child eating and activity change. The purpose of this study was to examine parenting skills and parent weight change as predictors of child weight change in a sample of 80 parent/child dyads who were enrolled in a family based behavioral weight loss program for childhood obesity. Eighty overweight and obese children and their parents who enrolled in treatment in two sites were included in the study. Variables included those related to parent modeling (parent BMI), home food environment, parenting (parent and child report), and demographics. Results suggested that parent BMI change was a significant predictor of child weight, in that a reduction of 1 BMI unit in the parent was associated with a 0.255 reduction in child BMI. None of the other variables were significant in the final model. This study is consistent with other research showing that parent weight change is a key contributor to child weight change in behavioral treatment for childhood obesity. Researchers and clinicians should focus on encouraging parents to lose weight to assist their overweight and obese child in weight management.

Consumer perspectives about weight management services in a community pharmacy setting in NSW, Australia

PubMed Central

Um, Irene S.; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B.

2012-01-01

Abstract Background  Obesity is a public health challenge faced worldwide. Community pharmacists may be well placed to manage Australia’s obesity problem owing to their training, accessibility and trustworthiness. However, determining consumers’ needs is vital to the development of any new services or the evaluation of existing services. Objective  To explore Australian consumers’ perspectives regarding weight management services in the community pharmacy setting, including their past experiences and willingness to pay for a specific pharmacy‐based service. Design  An online cross‐sectional consumer survey was distributed through a marketing research company. The survey instrument comprised open‐ended and closed questions exploring consumers’ experiences of and preferences for weight management services in pharmacy. It also included an attitudinal measure, the Consumer Attitude to Pharmacy Weight Management Services (CAPWMS) scale. Setting and participants  A total of 403 consumers from New South Wales, Australia, completed the survey. Results  The majority of respondents had previously not sought a pharmacist’s advice regarding weight management. Those who had previously consulted a pharmacist were more willing to pay for and support pharmacy‐based services in the future. Most consumers considered pharmacists’ motivations to provide advice related to gaining profit from selling a product and expressed concerns about the perceived conflicts of interest. Participants also perceived pharmacists as lacking expertise and time. Conclusion  Although Australian consumers were willing to seek pharmacists’ advice about weight management, they perceived several barriers to the provision of weight management services in community pharmacy. If barriers are addressed, community pharmacies could be a viable and accessible setting to manage obesity. PMID:22646843

Consumer perspectives about weight management services in a community pharmacy setting in NSW, Australia.

PubMed

Um, Irene S; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B

2014-08-01

Obesity is a public health challenge faced worldwide. Community pharmacists may be well placed to manage Australia's obesity problem owing to their training, accessibility and trustworthiness. However, determining consumers' needs is vital to the development of any new services or the evaluation of existing services. To explore Australian consumers' perspectives regarding weight management services in the community pharmacy setting, including their past experiences and willingness to pay for a specific pharmacy-based service. An online cross-sectional consumer survey was distributed through a marketing research company. The survey instrument comprised open-ended and closed questions exploring consumers' experiences of and preferences for weight management services in pharmacy. It also included an attitudinal measure, the Consumer Attitude to Pharmacy Weight Management Services (CAPWMS) scale. A total of 403 consumers from New South Wales, Australia, completed the survey. The majority of respondents had previously not sought a pharmacist's advice regarding weight management. Those who had previously consulted a pharmacist were more willing to pay for and support pharmacy-based services in the future. Most consumers considered pharmacists' motivations to provide advice related to gaining profit from selling a product and expressed concerns about the perceived conflicts of interest. Participants also perceived pharmacists as lacking expertise and time. Although Australian consumers were willing to seek pharmacists' advice about weight management, they perceived several barriers to the provision of weight management services in community pharmacy. If barriers are addressed, community pharmacies could be a viable and accessible setting to manage obesity. © 2012 John Wiley & Sons Ltd.

Cultivation practices and manufacturing processes to produce Hoodia gordonii extract for weight management products.

PubMed

Knight, Tamsin L; Swindells, Chris M; Craddock, Andrew M; Maharaj, Vinesh J; Buchwald-Werner, Sybille; Ismaili, Smail Alaoui; McWilliam, Simon C

2012-01-01

Hoodia gordonii (Masson) Sweet ex Decne., is a succulent shrub, indigenous to the arid regions of southern Africa. Indigenous people have historically utilised certain species of Hoodia, including H. gordonii, as a source of food and water. Studies by the Council for Scientific and Industrial Research (CSIR, South Africa) identified that extracts of H. gordonii had appetite suppressant activity associated with specific steroid glycosides. A programme to develop weight management products based around this discovery was implemented in 1998. An agronomy programme was established which demonstrated that it was possible to cultivate this novel crop on a commercial scale (in excess of 70 ha). In parallel, a food grade manufacturing process was developed consisting of four main steps: harvesting of H. gordonii plant stems, comminution, drying under controlled conditions and extraction using food grade solvents. Appropriate Quality Control (QC) procedures were developed. The extraction process is capable of delivering a consistent composition despite natural variations in the composition of the dried H. gordonii. Specifications were developed for the resulting extract. The intended use of the standardised H. gordonii extract was as a functional food ingredient for weight management products. Other development studies on characterisation, toxicology and pharmacology are reported separately. Copyright © 2011. Published by Elsevier Ltd.

Linking Science and Management in an Interactive Geospatial, Mutli-Criterion, Structured Decision Support Framework: Use Case Studies of the "Future Forests Geo-visualization and Decision Support Tool

NASA Astrophysics Data System (ADS)

Pontius, J.; Duncan, J.

2017-12-01

Land managers are often faced with balancing management activities to accomplish a diversity of management objectives, in systems faced with many stress agents. Advances in ecosystem modeling provide a rich source of information to inform management. Coupled with advances in decision support techniques and computing capabilities, interactive tools are now accessible for a broad audience of stakeholders. Here we present one such tool designed to capture information on how climate change may impact forested ecosystems, and how that impact varies spatially across the landscape. This tool integrates empirical models of current and future forest structure and function in a structured decision framework that allows users to customize weights for multiple management objectives and visualize suitability outcomes across the landscape. Combined with climate projections, the resulting products allow stakeholders to compare the relative success of various management objectives on a pixel by pixel basis and identify locations where management outcomes are most likely to be met. Here we demonstrate this approach with the integration of several of the preliminary models developed to map species distributions, sugar maple health, forest fragmentation risk and hemlock vulnerability to hemlock woolly adelgid under current and future climate scenarios. We compare three use case studies with objective weightings designed to: 1) Identify key parcels for sugarbush conservation and management, 2) Target state lands that may serve as hemlock refugia from hemlock woolly adelgid induced mortality, and 3) Examine how climate change may alter the success of managing for both sugarbush and hemlock across privately owned lands. This tool highlights the value of flexible models that can be easily run with customized weightings in a dynamic, integrated assessment that allows users to hone in on their potentially complex management objectives, and to visualize and prioritize locations across the landscape. It also demonstrates the importance of including climate considerations for long-term management. This merging of scientific knowledge with the diversity of stakeholder needs is an important step towards using science to inform management and policy decisions.

Yoga's potential for promoting healthy eating and physical activity behaviors among young adults: a mixed-methods study.

PubMed

Watts, Allison W; Rydell, Sarah A; Eisenberg, Marla E; Laska, Melissa N; Neumark-Sztainer, Dianne

2018-05-02

A regular yoga practice may have benefits for young adult health, however, there is limited evidence available to guide yoga interventions targeting weight-related health. The present study explored the relationship between participation in yoga, healthy eating behaviors and physical activity among young adults. The present mixed-methods study used data collected as part of wave 4 of Project EAT (Eating and Activity in Teens and Young Adults), a population-based cohort study in Minneapolis-St. Paul, Minnesota. Young adults (n = 1820) completed the Project EAT survey and a food frequency questionnaire, and a subset who reported practicing yoga additionally participated in semi-structured interviews (n = 46). Analyses of survey data were used to examine cross-sectional associations between the frequency of yoga practice, dietary behaviors (servings of fruits and vegetables (FV), sugar-sweetened beverages (SSBs) and snack foods and frequency of fast food consumption), and moderate-to-vigorous physical activity (MVPA). Thematic analysis of interview discussions further explored yoga's perceived influence on eating and activity behaviors among interview participants. Regular yoga practice was associated with more servings of FV, fewer servings of SSBs and snack foods, less frequent fast food consumption, and more hours of MVPA. Interviews revealed that yoga supported healthy eating through motivation to eat healthfully, greater mindfulness, management of emotional eating, more healthy food cravings, and the influence of the yoga community. Yoga supported physical activity through activity as part of yoga practice, motivation to do other forms of activity, increased capacity to be active, and by complementing an active lifestyle. Young adult yoga practitioners reported healthier eating behaviors and higher levels of physical activity than non-practitioners. Yoga should be investigated as an intervention for young adult health promotion and healthy weight management.

Delta Healthy Sprouts: a randomized comparative effectiveness trial to promote maternal weight control and reduce childhood obesity in the Mississippi Delta.

PubMed

Thomson, Jessica L; Tussing-Humphreys, Lisa M; Goodman, Melissa H

2014-05-01

Excessive and inadequate gestational weight gain can complicate a woman's pregnancy and put her and her child at risk for poor delivery and birth outcomes. Further, feeding and activity habits established early in life can significantly impact the development of childhood obesity. The on-going Delta Healthy Sprouts Project is a randomized, controlled, comparative trial testing the efficacy of two Maternal, Infant, and Early Childhood Home Visiting programs on weight status and health behaviors of 150 mothers and their infants residing in the rural Mississippi Delta region of the United States. Women are enrolled in their second trimester of pregnancy and randomized to one of two treatment arms. The control arm curriculum is based on Parents as Teachers, an evidence based approach to increase parental knowledge of child development and improve parenting practices. The experimental arm, labeled Parents as Teachers Enhanced, builds upon the control curriculum by including culturally tailored nutrition and physical activity components specifically designed for the gestational and postnatal periods. We hypothesize that, as compared to the control arm, the experimental arm will be more effective in preventing inappropriate gestational weight gain, reducing postnatal weight retention, and decreasing infant obesity rates. We also will evaluate mother and child dietary and physical activity outcomes, breastfeeding initiation and continuation, and child feeding practices. The Delta Healthy Sprouts Project tests a novel, combined approach to maternal weight management and childhood obesity prevention in pregnant women and their children at high risk for obesity and chronic disease. Published by Elsevier Inc.

Effects of the weight management program based self-efficacy for body composition, blood lipid profile, weight self-efficacy lifestyles, depression in middle-aged obese women.

PubMed

Park, Nam Hee; An, Hye Gyung

2006-12-01

This study was done to determine the effects of weight management program using self-efficacy in middle-aged obese women. The study also attempted to measure the effects of the program on the weight efficacy lifestyle, body composition, and depression. The research design of this study was a nonequivalent control group pretest-posttest design. The experimental group consisted of 21 middle-aged obese women and another 21 middle-aged obese women in the control group. The women in the experimental group participated in the weight management program for 12 weeks using self-efficacy. The weight management program using self-efficacy included education on effects of exercise for weight control, aerobic exercise program, muscle training and counseling through the telephone. After 12 weeks of participation in the program, BMI (p<.0001), body fat % (p<.0001), abdominal fat (p<.0001), in the experimental group were significantly decreased compared to the control group. Weight self-efficacy lifestyle (p<.0001) and depression (p=.006) in the experimental group were significantly improved after the program compared to the control group. According to these findings, weight management program self-efficacy for middle-aged obese women could increase weight efficacy lifestyle, and decrease depression, BMI, body fat, and abdominal fat. The result also suggested that the increasing weight efficacy and lifestyle help the obese women to perform and continue exercise. This program could be used in the community such as public health center for weight care and mental health promotion of middle-aged obese women.

Relationship between environmental management with quality of kampong space room (Case study: RW 3 of Sukun Sub District, Malang City)

NASA Astrophysics Data System (ADS)

Wardhani, D. K.; Azmi, D. S.; Purnamasari, W. D.

2017-06-01

RW 3 Sukun Malang was one of kampong that won the competition kampong environment and had managed to maintain the preservation of the kampong. Society of RW 3 Sukun undertake various activities to manage the environment by optimizing the use of kampong space. Despite RW 3 Sukun had conducted environmental management activities, there are several locations in the kampong space that less well maintained. The purpose of this research was to determine the relation of environmental management with the quality of kampong space in RW 3 Sukun. This research used qualitative and quantitative research approaches. Quantitative research conducted by using descriptive statistical analysis in assessing the quality of kampong space with weighting, scoring, and overlay maps. Quantitative research was also conducted on the relation analysis of environmental management with the quality of kampong space by using typology analysis and pearson correlation analysis. Qualitative research conducted on the analysis of environmental management and the relation analysis of environmental management with the quality of kampong space. Result of this research indicates that environmental management in RW 3 Sukun have relation with the quality of kampong space.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Abercrombie, Robert K; Buckner Jr, Dooley; Newton, David D

The Oak Ridge National Laboratory (ORNL) Weigh-In-Motion (WIM) system provides a portable and/or semi-portable means of accurately weighing vehicles and its cargo as each vehicle crosses the scales (while in motion), and determining (1) axle weights and (2) axle spacing for vehicles (for determination of Bridge Formula compliance), (3) total vehicle/cargo weight and (4) longitudinal center of gravity (for safety considerations). The WIM system can also weigh the above statically. Because of the automated nature of the WIM system, it eliminates the introduction of human errors caused by manual computations and data entry, adverse weather conditions, and stress. Individual vehiclesmore » can be weighed continuously at low speeds (approximately 3-10 mph) and at intervals of less than one minute. The ORNL WIM system operates and is integrated into the Bethel Jacobs Company Transportation Management and Information System (TMIS, a Radio-Frequency Identification [RFID] enabled information system). The integrated process is as follows: Truck Identification Number and Tare Weight are programmed into a RFID Tag. Handheld RFID devices interact with the RFID Tag, and Electronic Shipping Document is written to the RFID Tag. The RFID tag read by an RFID tower identifies the vehicle and its associated cargo, the specific manifest of radioactive debris for the uniquely identified vehicle. The weight of the cargo (in this case waste debris) is calculated from total vehicle weight information supplied from WIM to TMIS and is further processed into the Information System and kept for historical and archival purposes. The assembled data is the further process in downstream information systems where waste coordination activities at the Y-12 Environmental Management Waste Management Facility (EMWMF) are written to RFID Tag. All cycle time information is monitored by Transportation Operations and Security personnel.« less

The Association between Physical Activity and Eating Self-Regulation in Overweight and Obese Women

PubMed Central

Carraça, Eliana V.; Silva, Marlene N.; Coutinho, Sílvia R.; Vieira, Paulo N.; Minderico, Cláudia S.; Sardinha, Luís B.; Teixeira, Pedro J.

2013-01-01

Objective Successful weight management relies heavily on eating and exercise behaviors. However, little is known about the association between both on a psychosocial level. This study examined the relationship between exercise and eating regulation by exploring the mediating effects of negative body image investment and depressive mood, and their stability through time. Methods Analyses were conducted at two different moments (12 and 36 months), involving a sample of 221 overweight/obese women (age: 37.6 ± 7 years; BMI: 31.6 ± 4.1 kg/m2) that participated in a behavioral weight control intervention. Bivariate correlations and mediation analyses using Preacher & Hayes resampling procedures were conducted. Results At 12 months, negative body image investment was the only significant mediator of the exercise-eating relationship. This variable explained larger portions of the indirect effects of structured rather than lifestyle exercise on eating. At 36 months, negative investment and to a lesser extent depressive mood partially explained the exercise-eating association. Conclusions Our findings suggest that, besides physiological effects of exercise, psychological mechanisms related to body image and mood also explain the role of physical activity as a ‘gateway behavior’ for improved eating regulation in overweight women. These effects appear to be stable and may help understand the key role of exercise in long-term weight management. PMID:24217426

Facilitators and Barriers to the Achievement of Healthy Lifestyle Goals: Qualitative Findings From Australian Parents Enrolled in the PEACH Child Weight Management Program.

PubMed

Perry, Rebecca Anne; Daniels, Lynne Anne; Bell, Lucinda; Magarey, Anthea Margaret

2017-01-01

To describe the qualitative research methods used in the Parenting Eating and Activity for Child Health (PEACH) randomized controlled trial and to examine parent-reported facilitators and barriers to the achievement of program goals. Qualitative study using semistructured interviews. Parents enrolled in the Australian PEACH randomized controlled trial, a family-focused child weight management program conducted blinded for review. A total of 95 parents of overweight children aged 5-10 years participated in face-to-face semistructured interviews. Factors external to the PEACH intervention that facilitated or inhibited their success. Interviews were recorded, transcribed, and analyzed using thematic analysis techniques. Three facilitator themes were identified: (1) internal locus of parental control, (2) external locus of parental control, and (3) child factors. Six barrier themes were identified: (1) internal locus of parental control, (2) external locus of parental control, and (3) child factors; (4) maintenance and managing special occasions; (5) time management challenges; and (6) inconsistencies or lack of support. The social and environmental barriers and time pressures identified by parents are a common feature of Western family life such that many parents are raising families in stressful situations. Insights provided by this qualitative research provide an important understanding of these experiences. Consideration of such issues in the design and implementation of future child weight management interventions may help to increase the acceptability and effectiveness of such programs. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

The role of social media in online weight management: systematic review.

PubMed

Chang, Tammy; Chopra, Vineet; Zhang, Catherine; Woolford, Susan J

2013-11-28

Social media applications are promising adjuncts to online weight management interventions through facilitating education, engagement, and peer support. However, the precise impact of social media on weight management is unclear. The objective of this study was to systematically describe the use and impact of social media in online weight management interventions. PubMed, PsycINFO, EMBASE, Web of Science, and Scopus were searched for English-language studies published through March 25, 2013. Additional studies were identified by searching bibliographies of electronically retrieved articles. Randomized controlled trials of online weight management interventions that included a social media component for individuals of all ages were selected. Studies were evaluated using 2 systematic scales to assess risk of bias and study quality. Of 517 citations identified, 20 studies met eligibility criteria. All study participants were adults. Because the included studies varied greatly in study design and reported outcomes, meta-analysis of interventions was not attempted. Although message boards and chat rooms were the most common social media component included, their effect on weight outcomes was not reported in most studies. Only one study measured the isolated effect of social media. It found greater engagement of participants, but no difference in weight-related outcomes. In all, 65% of studies were of high quality; 15% of studies were at low risk of bias. Despite the widespread use of social media, few studies have quantified the effect of social media in online weight management interventions; thus, its impact is still unknown. Although social media may play a role in retaining and engaging participants, studies that are designed to measure its effect are needed to understand whether and how social media may meaningfully improve weight management.

The Role of Social Media in Online Weight Management: Systematic Review

PubMed Central

Chopra, Vineet; Zhang, Catherine; Woolford, Susan J

2013-01-01

Background Social media applications are promising adjuncts to online weight management interventions through facilitating education, engagement, and peer support. However, the precise impact of social media on weight management is unclear. Objective The objective of this study was to systematically describe the use and impact of social media in online weight management interventions. Methods PubMed, PsycINFO, EMBASE, Web of Science, and Scopus were searched for English-language studies published through March 25, 2013. Additional studies were identified by searching bibliographies of electronically retrieved articles. Randomized controlled trials of online weight management interventions that included a social media component for individuals of all ages were selected. Studies were evaluated using 2 systematic scales to assess risk of bias and study quality. Results Of 517 citations identified, 20 studies met eligibility criteria. All study participants were adults. Because the included studies varied greatly in study design and reported outcomes, meta-analysis of interventions was not attempted. Although message boards and chat rooms were the most common social media component included, their effect on weight outcomes was not reported in most studies. Only one study measured the isolated effect of social media. It found greater engagement of participants, but no difference in weight-related outcomes. In all, 65% of studies were of high quality; 15% of studies were at low risk of bias. Conclusions Despite the widespread use of social media, few studies have quantified the effect of social media in online weight management interventions; thus, its impact is still unknown. Although social media may play a role in retaining and engaging participants, studies that are designed to measure its effect are needed to understand whether and how social media may meaningfully improve weight management. PMID:24287455

Overweight and Obesity, Weight Perception, and Weight Management Practices Among Supplemental Nutrition Assistance Program-Education (SNAP-Ed) Participants in Georgia: A Needs Assessment.

PubMed

Bailey, Claudette; Lee, Jung Sun

2017-05-01

Examine associations among weight status, weight perception, and weight management practices of Supplemental Nutrition Assistance Program-Education (SNAP-Ed) participants in Georgia. Self-reported weight, height, and weight-related practices were assessed and analyzed in 270 SNAP-Ed participants. Almost three quarters of the sample self-reported overweight or obesity. Among overweight and obese subjects, 39% and 69%, respectively, accurately perceived themselves as overweight. More than half of the sample desired weight loss and 44% had attempted weight loss in the past year. Overweight/obese subjects who accurately perceived their weight were more likely to desire and to have attempted weight loss than those who under-perceived their weight. Approximately 58% of all subjects who had attempted to lose weight reported use of both methods suggested for weight loss: exercise and dietary changes. The high prevalence of self-reported overweight/obesity combined with a desire to lose weight among the study sample demonstrated the necessity to develop SNAP-Ed curricula emphasizing weight management. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Why Weight? An Analytic Review of Obesity Management, Diabetes Prevention, and Cardiovascular Risk Reduction.

PubMed

Igel, L I; Saunders, K H; Fins, J J

2018-05-21

In this review, we examine one of the ironies of American health care-that we pay more for disease management than disease prevention. Instead of preventing type 2 diabetes (T2DM) by treating its precursor, obesity, we fail to provide sufficient insurance coverage for weight management only to fund the more costly burden of overt T2DM. There is a vital need for expanded insurance coverage to help foster a weight-centric approach to T2DM management. This includes broader coverage of anti-diabetic medications with evidence of cardiovascular risk reduction and mortality benefit, anti-obesity pharmacotherapy, bariatric surgery, weight loss devices, endoscopic bariatric therapies, and lifestyle interventions for the treatment of obesity. The fundamental question to ask is why weight? Why wait to go after obesity until its end-stage sequelae cause intractable conditions? Instead of managing the complications of T2DM, consider preventing them by tackling obesity.

Exploring the ameliorative potential of probiotic Dahi containing Lactobacillus acidophilus and Bifidobacterium bifidum on dextran sodium sulphate induced colitis in mice.

PubMed

Jadhav, Sagar R; Shandilya, Umesh Kr; Kansal, Vinod K

2013-02-01

Conventional medical therapies for ulcerative colitis (UC) are still limited due to the adverse side effects like dose-dependent diarrhoea and insufficient potency to keep in remission for long-term periods. So, new alternatives that provide more effective and safe therapies for ulcerative colitis are constantly being sought. In the present study, probiotic LaBb Dahi was selected for investigation of its therapeutic effect on DSS-induced colitis model in mice. LaBb Dahi was prepared by co-culturing Dahi culture of Lactococci along with selected strain of Lactobacillus acidophilus LaVK2 and Bifidobacterium bifidum BbVK3 in buffalo milk. Four groups of mice (12 each) were fed for 17 d with buffalo milk (normal control), buffalo milk plus DSS (Colitis control), Dahi plus DSS, and LaBb Dahi plus DSS, respectively, with basal diet. The disease activity scores, weight loss, organ weight, colon length, myeloperoxidase (MPO) and β-glucoronidase activity was assessed, and the histopathological picture of the colon of mice was studied. All colitis control mice evidenced significant increase in MPO, β-glucoronidase activity and showed high disease activity scores along with histological damage to colonic tissue. Feeding with LaBb Dahi offered significant reduction in MPO activity, β-glucoronidase activity and improved disease activity scores. We found significant decline in length of colon, organ weight and body weight in colitis induced controls which were improved significantly by feeding LaBb Dahi. The present study suggests that LaBb Dahi can be used as a potential nutraceutical intervention to combat UC related changes and may offer effective adjunctive treatment for management of UC.

Effectiveness of Hypnosis as an Adjunct to Behavioral Weight Management.

ERIC Educational Resources Information Center

Bolocofsky, David N.; And Others

1985-01-01

Subjects (N=109) completed a behavioral weight-management program either with or without the addition of hypnosis. Both interventions resulted in significant weight reduction. At the eight-month and two-year follow-ups, the hypnosis clients showed significant additional weight loss and were more likely to have achieved and maintained their…

The Biggest Loser Thinks Long-Term: Recency as a Predictor of Success in Weight Management

PubMed Central

Koritzky, Gilly; Rice, Chantelle; Dieterle, Camille; Bechara, Antoine

2015-01-01

Only a minority of participants in behavioral weight management lose weight significantly. The ability to predict who is likely to benefit from weight management can improve the efficiency of obesity treatment. Identifying predictors of weight loss can also reveal potential ways to improve existing treatments. We propose a neuro-psychological model that is focused on recency: the reliance on recent information at the expense of time-distant information. Forty-four weight-management patients completed a decision-making task and their recency level was estimated by a mathematical model. Impulsivity and risk-taking were also measured for comparison. Weight loss was measured in the end of the 16-week intervention. Consistent with our hypothesis, successful dieters (n = 12) had lower recency scores than unsuccessful ones (n = 32; p = 0.006). Successful and unsuccessful dieters were similar in their demographics, intelligence, risk taking, impulsivity, and delay of gratification. We conclude that dieters who process time-distant information in their decision making are more likely to lose weight than those who are high in recency. We argue that having low recency facilitates future-oriented thinking, and thereby contributes to behavior change treatment adherence. Our findings underline the importance of choosing the right treatment for every individual, and outline a way to improve weight-management processes for more patients. PMID:26696930

Guideline-concordant weight-loss programs in an urban area are uncommon and difficult to identify through the Internet

PubMed Central

Bloom, Benjamin; Mehta, Ambereen K.; Clark, Jeanne M.; Gudzune, Kimberly A.

2015-01-01

Objective To determine the reliability of Internet-based information on community-based weight-loss programs and grade their degree of concordance with 2013 American Heart Association, American College of Cardiology, and The Obesity Society weight management guidelines. Methods We conducted an online search for weight-loss programs in the Maryland-Washington, DC-Virginia corridor. We performed content analysis to abstract program components from their websites, and then randomly selected 80 programs for a telephone survey to verify this information. We determined reliability of Internet information in comparison with telephone interview responses. Results Of the 191 programs, we graded 1% as high, 8% as moderate, and 91% as low with respect to guideline concordance based on website content. Fifty-two programs participated in the telephone survey (65% response rate). Program intensity, diet, physical activity, and use of behavioral strategies were underreported on websites as compared to description of these activities during phone interview. Within our subsample, we graded 6% of programs as high based on website information, whereas we graded 19% as high after telephone interview. Conclusions Most weight-loss programs in an urban, mid-Atlantic region do not currently offer guideline-concordant practices and fail to disclose key information online, which may make clinician referrals challenging. PMID:26861769

The cost-effectiveness of weight management programmes in a postnatal population.

PubMed

Rawdin, A C; Duenas, A; Chilcott, J B

2014-09-01

The aim of the study was to estimate the cost-effectiveness of a weight management programme including elements of physical exercise and dietary restriction which are designed to help women lose excess weight gained during pregnancy in the vulnerable postnatal period and inhibit the development of behaviours which could lead to future excess weight gain and obesity. A mathematical model based on a regression equation predicting change in weight over a fifteen year postnatal period was developed. The model included programme effectiveness and resource data based on a randomized controlled trial of a weight management programme implemented in a postnatal population in the United States. Utility and mortality data based on body mass index categories were also included. The model adopted a National Health Service (NHS) and personal social services (PSS) perspective, a lifetime time horizon and estimated the cost effectiveness of a weight management programme against a no change comparator in terms of an incremental cost-effectiveness ratio (ICER). The baseline results show that the difference in weight between women who received the weight management programme and women who received the control intervention was 3.02 kg at six months and 3.53 kg at fifteen years following childbirth. This results in an ICER of £7355 per quality adjusted life year (QALY) for women who were married at childbirth. The estimated ICER would suggest that such a weight management programme is cost-effective at a NICE threshold of £20,000 per QALY. However significant structural and evidence based uncertainty is present in the analysis. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Efficacy of Continuing Education in Improving Pharmacists' Competencies for Providing Weight Management Service: Three-Arm Randomized Controlled Trial

ERIC Educational Resources Information Center

Sarayani, Amir; Rashidian, Arash; Gholami, Kheirollah; Torkamandi, Hassan; Javadi, Mohammadreza

2012-01-01

Introduction: Weight management is a new public health role for community pharmacists in many countries. Lack of expertise is one of the key barriers to counseling obese patients. We evaluated the comparative efficacy of three alternative continuing education (CE) meetings on weight management. Methods: We designed a randomized controlled trial…

The importance of food, nutrition and physical activity in cancer prevention: an interview with Dr Kate Allen.

PubMed

Allen, Kate

2018-05-02

Kate Allen speaks to Roshaine Wijayatunga, Managing Commissioning Editor. Dr Kate Allen works as an Executive Director in Science and Public Affairs at World Cancer Research Fund International ( http://wcrf.org ), an NGO and leading authority in the field of cancer prevention through diet, weight and physical activity. Kate is responsible for the organization's scientific, policy and conference programs in the areas of food, nutrition, physical activity and weight management. An important aspect of her role is helping to create collaborative relationships and activities across the WCRF national charities (in Europe, America and Asia) in these areas, as well as maintaining and creating external partnerships. Previously, Kate worked at the Institute of Cancer Research, where she set up an award-winning Interactive Education Unit to develop learning materials for scientists, healthcare professionals, students, patients and the general public. Before that she worked at Medi Cine International, a medical education agency, where she developed educational materials across all media, mainly for specialist physician audiences. Kate has a PhD in neuroscience, carried out at the Institute of Neurology and the National Hospital for Neurology and Neurosurgery at Queen Square, London and the Royal College of Surgeons of England. The Third Expert Report that Kate mentions in the interview, featuring the updated World Cancer Research Fund Cancer Prevention Recommendations is launched 24 May 2018. For more information see http://wcrf.org .

The effect of a mindful restaurant eating intervention on weight management in women.

PubMed

Timmerman, Gayle M; Brown, Adama

2012-01-01

To evaluate the effect of a Mindful Restaurant Eating intervention on weight management. Randomized control trial. Greater metropolitan area of Austin, Texas. Women (n = 35) 40-59 years old who eat out at least 3 times per week. The intervention, using 6 weekly 2-hour, small group sessions, focused on reducing calorie and fat intake when eating out through education, behavior change strategies, and mindful eating meditations. Weight, waist circumference, self-reported daily calorie and fat intake, self-reported calories and fat consumed when eating out, emotional eating, diet related self-efficacy, and barriers to weight management when eating out. General linear models examined change from baseline to final endpoint to determine differences in outcomes between the intervention and control group. Participants in the intervention group lost significantly more weight (P =.03), had lower average daily caloric (P = .002) and fat intake (P = .001), had increased diet-related self-efficacy (P = .02), and had fewer barriers to weight management when eating out (P = .001). Mindful Restaurant Eating intervention was effective in promoting weight management in perimenopausal women. Copyright © 2012 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

The Effect of a Mindful Restaurant Eating Intervention on Weight Management in Women

PubMed Central

Timmerman, Gayle M.; Brown, Adama

2011-01-01

Objective To evaluate the effect of a Mindful Restaurant Eating intervention on weight management. Design Random control trial. Setting Greater metropolitan area of Austin, Texas. Participants Women (n = 35) 40-59 years old who eat out at least 3 times per week. Intervention The intervention, using 6 weekly 2 hour small group sessions, focused on reducing calorie and fat intake when eating out through education, behavior change strategies, and mindful eating meditations. Main Outcome Measures Weight, waist circumference, self-reported daily calorie and fat intake, self-reported calories and fat consumed when eating out, emotional eating, diet related self-efficacy, and barriers to weight management when eating out. Analysis General linear models examined change from baseline to final endpoint to determine differences in outcomes between the intervention and control group. Results Participants in the intervention group lost significantly more weight (P =.03), had lower average daily caloric (P =.002) and fat intake (P =.001), had increased diet related self-efficacy (P =.02), and had fewer barriers to weight management when eating out (P =.001). Conclusions and Implications Mindful Restaurant Eating intervention was effective in promoting weight management in perimenopausal women. PMID:22243980

New therapeutic perspectives in non-alcoholic steatohepatitis.

PubMed

Ampuero, Javier; Sánchez-Torrijos, Yolanda; Aguilera, Virginia; Bellido, Francisco; Romero-Gómez, Manuel

2018-02-01

Management of non-alcoholic steatohepatitis is focused on restitution of metabolic derangement, weight loss and drugs able to improve steatosis, ballooning and fibrosis. Life-style interventions based on Mediterranean diet and increasing physical activity are the first line therapy. In patients with unsuccessful life-style intervention several drugs are under development: agonist PPAR, agonist GLP-1R and agonist FXR together with drugs focussing on inflammation, ballooning, apoptosis and fibrosis. Bariatric surgery or advanced endoscopy are reserved for morbid obese without response to life-style intervention and weighting loss drugs. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Dietary management of a patient with diabetes mellitus: a case report.

PubMed

Sidik, Sherina Mohd; Ahmad, Rozali

2003-09-01

The Ministry of Health has launched healthy lifestyle and diabetes campaigns. However, adopting healthy lifestyle practices is not easy as revealed in this case. Patients and their families need to be supervised personally and counseled regularly. Healthy lifestyle habits such as maintaining a balanced diet, ideal body weight and physical activities need to be cultivated and practised. Dietary counseling sessions need to be implemented, preferably by dietitians as this has been shown to be effective in motivating diabetic patients to achieve a better food choice, as well as better glycaemic, lipid and weight control, as shown in this case.

Piloting a manualised weight management programme (Shape Up-LD) for overweight and obese persons with mild-moderate learning disabilities: study protocol for a pilot randomised controlled trial.

PubMed

Beeken, Rebecca J; Spanos, Dimitrios; Fovargue, Sally; Hunter, Rachael; Omar, Rumana; Hassiotis, Angela; King, Michael; Wardle, Jane; Croker, Helen

2013-03-12

National obesity rates have dramatically risen over the last decade. Being obese significantly reduces life expectancy, increases the risk of a range of diseases, and compromises quality of life. Costs to both the National Health Service and society are high. An increased prevalence of obesity in people with learning disabilities has been demonstrated. The consequences of obesity are particularly relevant to people with learning disabilities who are already confronted by health and social inequalities. In order to provide healthcare for all, and ensure equality of treatment for people with learning disabilities, services must be developed specifically with this population in mind. The aim of this project is to pilot the evaluation of a manualised weight management programme for overweight and obese persons with mild-moderate learning disabilities (Shape Up-LD). An individually randomised, controlled pilot trial in 60 overweight and obese (body mass index ≥ 25) adults (age ≥ 18) with mild-moderate learning disabilities and their carers will be carried out, comparing "Shape Up-LD" with usual care. The manualised Shape Up-LD intervention will involve 12 weekly sessions, which include healthy eating messages, advice on physical activity and use of behaviour change techniques to help people manage their weight. Assessments of participants will be conducted at baseline, 12 weeks and 6 months. Service users and their carers and service providers will also give their perspectives on the experience of Shape Up-LD in qualitative interviews at 12 weeks. Feasibility outcomes will include recruitment rates, loss to follow-up, compliance rates, completion rates, collection of information for a cost-effectiveness analysis and an estimation of the treatment effect on weight. The findings from this study will inform our preparation for a definitive randomised controlled trial to test the efficacy of the programme with respect to weight loss and maintenance in this population. Weight loss through Shape Up-LD could lead to improvements in health and quality of life. Costs to the National Health Service might be reduced through decreased overall service use because of improved health. The programme would also ensure a more equitable service for overweight service users with learning disabilities and fill the current gap in weight management services for this population. International Standard Randomised Controlled Trial No ISRCTN39605930.

Missing an opportunity: the embedded nature of weight management in primary care

PubMed Central

Osunlana, A. M.; Ogunleye, A. A.; Sharma, A. M.; Campbell‐Scherer, D.

2015-01-01

Summary The 5As Team study was designed to create, implement and evaluate a flexible intervention to improve the quality and quantity of weight management visits in primary care. The objective of this portion of the study was to explore how primary care providers incorporate weight management in their practice. 5AsT is a randomized controlled trial (RCT) on the implementation of a 6‐month 5 As Team (5AsT) intervention designed to operationalize the 5As of obesity management in primary care. Data for the qualitative portion of the study presented here included semi‐structured interviews with 29 multidisciplinary team providers and field notes of intervention sessions. Thematic analysis was undertaken. A key pattern that emerged from the data was that healthcare providers usually do not address obesity as a primary focus for a visit. Rather, obesity is embedded in a wide range of primary care encounters for other conditions. Implications were it can take extra time to discuss weight, it can be inappropriate to bring up weight as a topic, and treating risk factors and root causes of obesity have indirect benefits to patient weight management. Our findings have implications for obesity treatment approaches and tools that assume a discreet weight management visit. The embedded nature of obesity management in primary care can be harnessed to leverage multiple opportunities for asking and assessing root causes of obesity, and working longitudinally towards individual health goals. PMID:26303812

Self-efficacy and dietary fat reduction behaviors in obese African-American and white mothers.

PubMed

Chang, Mei-Wei; Brown, Roger L; Baumann, Linda J; Nitzke, Susan A

2008-05-01

This study examined the influence of weight management and education on five types of fat reduction behaviors mediated through three task-specific domains of self-efficacy among young, low-income obese African-American and white mothers. It also investigated interaction of race with the relationships between weight management, education, self-efficacy, and fat reduction behaviors. A sample of obese African-American and white mothers was recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Wisconsin. Participants reported their weight management status, education, self-efficacy for eating low-fat food, and fat reduction behaviors. For both racial groups, weight management status predicted low-fat food substitution and meat modification behaviors; education predicted meat modification behavior. Three task-specific domains of self-efficacy (negative mood, positive mood, and food availability) predicted different types of fat reduction behaviors and differed by race. Weight management influenced behaviors of low-fat food substitution, meat modification, and fried-food avoidance, mediated partially through self-efficacies of negative mood (African Americans), positive mood (African Americans, whites), and food availability (African Americans). Race affected the relationships between weight management, education, three task-specific domains of self-efficacy, and five types of fat reduction behaviors. Self-efficacies operated differentially for African Americans and whites. Thus, strategies to address specific fat reduction behaviors have the potential to be more effective when tailored to specific individual characteristics such as racial background, history of weight management strategies and task-specific domains of self-efficacy.

The effectiveness of weight management interventions in breastfeeding women--a systematic review and critical evaluation.

PubMed

Neville, Charlotte E; McKinley, Michelle C; Holmes, Valerie A; Spence, Dale; Woodside, Jayne V

2014-09-01

The postpartum period is a vulnerable time for excess weight retention, particularly for the increasing number of women who are overweight at the start of their pregnancy and subsequently find it difficult to lose additional weight gained during pregnancy. Although postpartum weight management interventions play an important role in breaking this potentially vicious cycle of weight gain, the effectiveness of such interventions in breastfeeding women remains unclear. Our aim was to systematically review the literature about the effectiveness of weight management interventions in breastfeeding women. Seven electronic databases were searched for eligible papers. Intervention studies included were carried out exclusively in breastfeeding mothers, ≤2 years postpartum and with a body mass index greater than 18.5 kg/m(2) , with an outcome measure of change in weight and/or body composition. Six studies met the selection criteria, and were stratified according to the type of intervention and outcome measures. Despite considerable heterogeneity among studies, the dietary-based intervention studies appeared to be the most efficacious in promoting weight loss; however, few studies were tailored toward the needs of breastfeeding women. Weight management interventions which include an energy-restricted diet may play a key role in successful postpartum weight loss for breastfeeding mothers. © 2014 Wiley Periodicals, Inc.

Do weight management interventions delivered by online social networks effectively improve body weight, body composition, and chronic disease risk factors? A systematic review.

PubMed

Willis, Erik A; Szabo-Reed, Amanda N; Ptomey, Lauren T; Steger, Felicia L; Honas, Jeffery J; Washburn, Richard A; Donnelly, Joseph E

2017-02-01

Introduction Currently, no systematic review/meta-analysis has examined studies that used online social networks (OSN) as a primary intervention platform. Therefore, the purpose of this review was to evaluate the effectiveness of weight management interventions delivered through OSN. Methods PubMed, EMBASE, PsycINFO, Web of Science, and Scopus were searched (January 1990-November 2015) for studies with data on the effect of OSNs on weight loss. Only primary source articles that utilized OSN as the main platform for delivery of weight management/healthy lifestyle interventions, were published in English language peer-reviewed journals, and reported outcome data on weight were eligible for inclusion in this systematic review. Five articles were included in this review. Results One-hundred percent of the studies ( n = 5) reported a reduction in baseline weight. Three of the five studies (60%) reported significant decreases in body weight when OSN was paired with health educator support. Only one study reported a clinical significant weight loss of ≥5%. Conclusion Using OSN for weight management is in its early stages of development and, while these few studies show promise, more research is needed to acquire information about optimizing these interventions to increase their efficacy.

Testosterone and weight loss: the evidence

PubMed Central

Traish, Abdulmaged M.

2014-01-01

Purpose of review The purpose of this article is to examine the contemporary data linking testosterone therapy in overweight and obese men with testosterone deficiency to increased lean body mass, decreased fat mass, improvement in overall body composition and sustained weight loss. This is of paramount importance because testosterone therapy in obese men with testosterone deficiency represents a novel and a timely therapeutic strategy for managing obesity in men with testosterone deficiency. Recent findings Long-term testosterone therapy in men with testosterone deficiency produces significant and sustained weight loss, marked reduction in waist circumference and BMI and improvement in body composition. Further, testosterone therapy ameliorates components of the metabolic syndrome. The aforementioned improvements are attributed to improved mitochondrial function, increased energy utilization, increased motivation and vigor resulting in improved cardio-metabolic function and enhanced physical activity. Summary The implication of testosterone therapy in management of obesity in men with testosterone deficiency is of paramount clinical significance, as it produces sustained weight loss without recidivism. On the contrary, alternative therapeutic approaches other than bariatric surgery failed to produce significant and sustained outcome and exhibit a high rate of recidivism. These findings represent strong foundations for testosterone therapy in obese men with testosterone deficiency and should spur clinical research for better understanding of usefulness of testosterone therapy in treatment of underlying pathophysiological conditions of obesity. PMID:25105998

An Overview of Factors Associated with Adherence to Lifestyle Modification Programs for Weight Management in Adults

PubMed Central

Chan, Ruth S. M.; Sea, Mandy M. M.

2017-01-01

This review aims to provide an overview of the factors associated with adherence reported in existing literature on lifestyle modification programs for weight management among the adult population. An electronic search was performed using PubMed, Medline, PsycINFO and PsycARTICLE to identify studies that examined the factors of adherence to lifestyle modification programs with explicit definition of adherence indicators. We identified 19 studies published between 2004 and 2016. The most commonly used indicator of adherence was attrition, followed by attendance, self-monitoring and dietary adherence. A broad array of factors has been studied but only few studies exploring each factor. Limited evidence suggested older age, higher education, healthier eating and physical activity behaviours, higher stage of change at baseline and higher initial weight loss may predict better adherence. On the other hand, having depression, stress, strong body shape concern, more previous weight loss attempts and being unemployed may predict poor adherence. Inconsistent findings were obtained for self-efficacy, motivation and male gender. This review highlights the need for more rigorous studies to enhance our knowledge on factors related to adherence. Identification of the factors of adherence could provide important implication for program improvement, ultimately improving the effectiveness and the cost-effectiveness of lifestyle modification program. PMID:28813030

Bidirectional association between weight status and motor skills in adolescents : A 4-year longitudinal study.

PubMed

Greier, Klaus; Drenowatz, Clemens

2018-05-01

Despite considerable efforts the prevalence of overweight and obesity in youth remains high. Poor motor skills have been associated with increased body weight but there is still limited information on the longitudinal association of these health parameters. This study examined the prospective association between motor skills and body weight in 10- to 14-year-old youth. Body weight, height and motor skills, assessed via the German motor test 16-18 (Deutscher Motorik Test, DMT6-18), were measured in 213 middle school students (57% male) every year over a 4‑year period. Club sports participation and migration status were assessed via a questionnaire. Besides an inverse cross-sectional association between body weight and motor skills, excess body weight was associated with impaired development of motor skills (p < 0.05). Furthermore, weight loss was associated with enhanced motor development and allowed previously overweight students to catch up with their normal weight peers. High motor skills at baseline also reduced the odds of becoming overweight/obese during the observation period. These results were independent of club sports participation. There is a bidirectional, synergistic association between body weight and motor skills. Facilitating the development of motor skills in children and adolescents may therefore be a viable intervention strategy targeting weight management and physical activity in youth.

Lifestyle medicine consulting walking meetings for sustained weight loss

PubMed Central

Frates, Elizabeth Pegg; Crane, Margaret E

2016-01-01

With rates of obesity and diabetes rising worldwide, effective ways of managing weight are becoming more important. We present the case study of a middle-aged Caucasian-American woman (body mass index (BMI) 27.8, overweight category) who wanted to lose weight. The patient participated in a behaviour modification programme with a physician trained in lifestyle medicine as well as health and wellness coaching. After the 14-week programme, which included 9, 1 h long walking sessions with the clinician, the patient lost 11 Ibs (BMI 24.7, normal category). The programme included a combination of increasing physical activity, eating appropriate quantities of healthy foods, goal setting and a positive attitude. The patient has kept her BMI at or below 24.1 for over 2 years. This case demonstrates a novel approach to weight loss management—walking therapeutic sessions—and also outlines critical components of lifestyle medicine counselling that facilitate the process of sustainable weight loss and lasting change. PMID:26833954

One-year postpartum outcomes following a weight management intervention in pregnant women with obesity

PubMed Central

Vesco, Kimberly K.; Leo, Michael C.; Karanja, Njeri; Gillman, Matthew W.; McEvoy, Cindy T.; King, Janet C.; Eckhardt, Cara L.; Smith, K. Sabina; Perrin, Nancy; Stevens, Victor J.

2016-01-01

Objective This analysis focuses on 1-year maternal and infant follow-up of a randomized trial that tested a weight management intervention conducted during pregnancy. Methods We randomly assigned 114 women with obesity (mean BMI 36.7 kg/m2) at a mean of 15 weeks’ gestation to a weight management intervention or usual care control condition. The intervention ended at delivery and resulted in less gestational weight gain and a lower proportion of large-for-gestational age newborns among intervention compared to control participants. The primary outcome at 12 months postpartum was maternal weight. Secondary outcomes included infant weight-for-age and weight-for-length z-scores. Results At 1 year, mothers in the intervention group weighed 96.3±18.6 kg, and in the control group, 99.7±19.2 kg. There was no significant difference between groups in change in weight from randomization to 1-year postpartum (b=-0.47, 95% CI [-4.03, 3.08]. There was a significant main effect of group for infant weight-for-age z-score (b=-0.40, 95% CI [-0.75,-0.05]) but not infant weight-for-length z-scores (b=-0.20, 95% CI [-0.59,0.20]. Conclusions A gestational weight management intervention did not influence maternal weight or infant weight-for-length at 1-year postpartum. Future studies may be warranted to determine if extending prenatal interventions into the postpartum period would be beneficial for maternal and infant outcomes. PMID:27670399

Impact of parental weight status on a school-based weight management programme designed for Mexican-American children

USDA-ARS?s Scientific Manuscript database

While overweight and obese children are more likely to have overweight or obese parents, less is known about the effect of parental weight status on children's success in weight management programmes. This study was a secondary data analysis of a randomized controlled trial and investigated the impa...

It's Time to Include Nutrition Education in the Secondary Physical Education Curriculum

ERIC Educational Resources Information Center

Bertelsen, Susan L.; Thompson, Ben

2014-01-01

Although the primary focus of physical educators is to increase students' physical activity levels and their knowledge about the importance of movement, they also have the opportunity to affect students' overall wellness by teaching nutrition and how healthy eating contributes to overall health and weight management. Nutrition concepts…

A Resource Management Tool for Implementing Strategic Direction in an Academic Department

ERIC Educational Resources Information Center

Ringwood, John V.; Devitt, Frank; Doherty, Sean; Farrell, Ronan; Lawlor, Bob; McLoone, Sean C.; McLoone, Seamus F.; Rogers, Alan; Villing, Rudi; Ward, Tomas

2005-01-01

This paper reports on a load balancing system for an academic department, which can be used as an implementation mechanism for strategic planning. In essence, it consists of weighting each activity within the department and performing workload allocation based on this transparent scheme. The experience to date has been very positive, in terms of…

Health Benefits of Fiber Fermentation.

PubMed

Dahl, Wendy J; Agro, Nicole C; Eliasson, Åsa M; Mialki, Kaley L; Olivera, Joseph D; Rusch, Carley T; Young, Carly N

2017-02-01

Although fiber is well recognized for its effect on laxation, increasing evidence supports the role of fiber in the prevention and treatment of chronic disease. The aim of this review is to provide an overview of the health benefits of fiber and its fermentation, and describe how the products of fermentation may influence disease risk and treatment. Higher fiber intakes are associated with decreased risk of cardiovascular disease, type 2 diabetes, and some forms of cancer. Fiber may also have a role in lowering blood pressure and in preventing obesity by limiting weight gain. Fiber is effective in managing blood glucose in type 2 diabetes, useful for weight loss, and may provide therapeutic adjunctive roles in kidney and liver disease. In addition, higher fiber diets are not contraindicated in inflammatory bowel disease or irritable bowel syndrome and may provide some benefit. Common to the associations with disease reduction is fermentation of fiber and its potential to modulate microbiota and its activities and inflammation, specifically the production of anti-inflammatory short chain fatty acids, primarily from saccharolytic fermentation, versus the deleterious products of proteolytic activity. Because fiber intake is inversely associated with all-cause mortality, mechanisms by which fiber may reduce chronic disease risk and provide therapeutic benefit to those with chronic disease need further elucidation and large, randomized controlled trials are needed to confirm causality.Teaching Points• Strong evidence supports the association between higher fiber diets and reduced risk of cardiovascular disease, type 2 diabetes, and some forms of cancer.• Higher fiber intakes are associated with lower body weight and body mass index, and some types of fiber may facilitate weight loss.• Fiber is recommended as an adjunctive medical nutritional therapy for type 2 diabetes, chronic kidney disease, and certain liver diseases.• Fermentation and the resulting shifts in microbiota composition and its activity may be a common means by which fiber impacts disease risk and management.

Exercise and Type 2 Diabetes

PubMed Central

Colberg, Sheri R.; Sigal, Ronald J.; Fernhall, Bo; Regensteiner, Judith G.; Blissmer, Bryan J.; Rubin, Richard R.; Chasan-Taber, Lisa; Albright, Ann L.; Braun, Barry

2010-01-01

Although physical activity (PA) is a key element in the prevention and management of type 2 diabetes, many with this chronic disease do not become or remain regularly active. High-quality studies establishing the importance of exercise and fitness in diabetes were lacking until recently, but it is now well established that participation in regular PA improves blood glucose control and can prevent or delay type 2 diabetes, along with positively affecting lipids, blood pressure, cardiovascular events, mortality, and quality of life. Structured interventions combining PA and modest weight loss have been shown to lower type 2 diabetes risk by up to 58% in high-risk populations. Most benefits of PA on diabetes management are realized through acute and chronic improvements in insulin action, accomplished with both aerobic and resistance training. The benefits of physical training are discussed, along with recommendations for varying activities, PA-associated blood glucose management, diabetes prevention, gestational diabetes mellitus, and safe and effective practices for PA with diabetes-related complications. PMID:21115758

Effects of sports participation on psychiatric symptoms and brain activations during sports observation in schizophrenia.

PubMed

Takahashi, H; Sassa, T; Shibuya, T; Kato, M; Koeda, M; Murai, T; Matsuura, M; Asai, K; Suhara, T; Okubo, Y

2012-03-20

Weight gain has been identified as being responsible for increased morbidity and mortality rates of schizophrenia patients. For the management of weight gain, exercise is one of the most acknowledged interventions. At the same time, exercise and sports have been recognized for their positive impact on psychiatric symptoms of schizophrenia. However, the neurobiological basis for this remains poorly understood. We aimed to examine the effect of sports participation on weight gain, psychiatric symptoms and brain activation during sports observation in schizophrenia patients. Thirteen schizophrenia patients who participated in a 3-month program, including sports participation and 10 control schizophrenia patients were studied. In both groups, body mass index (BMI), Positive and Negative Syndrome Scale (PANSS), and brain activation during observation of sports-related actions measured by functional magnetic resonance imaging were accessed before and after a 3-month interval. BMI and general psychopathology scale of PANSS were significantly reduced in the program group but not in the control group after a 3-month interval. Compared with baseline, activation of the body-selective extrastriate body area (EBA) in the posterior temporal-occipital cortex during observation of sports-related actions was increased in the program group. In this group, increase in EBA activation was associated with improvement in the general psychopathology scale of PANSS. Sports participation had a positive effect not only on weight gain but also on psychiatric symptoms in schizophrenia. EBA might mediate these beneficial effects of sports participation. Our findings merit further investigation of neurobiological mechanisms underlying the therapeutic effect of sports for schizophrenia.

Medicaid beneficiaries in california reported less positive experiences when assigned to a managed care plan.

PubMed

McDonnell, Diana D; Graham, Carrie L

2015-03-01

In 2011 California began transitioning approximately 340,000 seniors and people with disabilities from Medicaid fee-for-service (FFS) to Medicaid managed care plans. When beneficiaries did not actively choose a managed care plan, the state assigned them to one using an algorithm based on their previous FFS primary and specialty care use. When no clear link could be established, beneficiaries were assigned by default to a managed care plan based on weighted randomization. In this article we report the results of a telephone survey of 1,521 seniors and people with disabilities enrolled in Medi-Cal (California Medicaid) and who were recently transitioned to a managed care plan. We found that 48 percent chose their own plan, 11 percent were assigned to a plan by algorithm, and 41 percent were assigned to a plan by default. People in the latter two categories reported being similarly less positive about their experiences compared to beneficiaries who actively chose a plan. Many states in addition to California are implementing mandatory transitions of Medicaid-only beneficiaries to managed care plans. Our results highlight the importance of encouraging beneficiaries to actively choose their health plan; when beneficiaries do not choose, states should employ robust intelligent assignment algorithms. Project HOPE—The People-to-People Health Foundation, Inc.

Weight outcomes audit in 1.3 million adults during their first 3 months' attendance in a commercial weight management programme.

PubMed

Stubbs, R James; Morris, Liam; Pallister, Carolyn; Horgan, Graham; Lavin, Jacquie H

2015-09-10

Over sixty percent of adults in the UK are now overweight/obese. Weight management on a national scale requires behavioural and lifestyle solutions that are accessible to large numbers of people. Evidence suggests commercial weight management programmes help people manage their weight but there is little research examining those that pay to attend such programmes rather than being referred by primary care. The objective of this analysis was to evaluate the effectiveness of a UK commercial weight management programme in self-referred, fee-paying participants. Electronic weekly weight records were collated for self-referred, fee-paying participants of Slimming World groups joining between January 2010 and April 2012. This analysis reports weight outcomes in 1,356,105 adult, non-pregnant participants during their first 3 months' attendance. Data were analysed by regression, ANOVA and for binomial outcomes, chi-squared tests using the R statistical program. Mean (SD) age was 42.3 (13.6) years, height 1.65 m (0.08) and start weight was 88.4 kg (18.8). Mean start BMI was 32.6 kg/m(2) (6.3 kg/m(2)) and 5 % of participants were men. Mean weight change of all participants was -3.9 kg (3.6), percent weight change -4.4 (3.8), and BMI change was -1.4 kg/m(2) (1.3). Mean attendance was 7.8 (4.3) sessions in their first 3 months. For participants attending at least 75 % of possible weekly sessions (n = 478,772), mean BMI change was -2.5 kg/m(2) (1.3), weight change -6.8 kg (3.7) and percent weight change -7.5 % (3.5). Weight loss was greater in men than women absolutely (-6.5 (5.3) kg vs -3.8 (3.4) kg) and as a percentage (5.7 % (4.4) vs 4.3 % (3.7)), respectively. All comparisons were significant (p < 0.001). Level of attendance and percent weight loss in the first week of attendance together accounted for 55 % of the variability in weight lost during the study period. A large-scale commercial lifestyle-based weight management programme had a significant impact on weight loss outcomes over 3 months. Higher levels of attendance led to levels of weight loss known to be associated with significant clinical benefits, which on this scale may have an impact on public health.

Fit Families Program Improves Self-Perception in Children.

PubMed

Archuleta, Martha; VanLeeuwen, Dawn; Turner, Carol

2016-06-01

To determine the impact of the Fit Families youth weight management program on self-perception of participants. Fit Families was delivered through Cooperative Extension and provided education to overweight and obese children and their families on healthful eating and physical activity along with building self-esteem and social competence. At the beginning and end of the 7-week program, a convenience sample of 46 youth completed the Self-Perception Profile for Children questionnaire to evaluate changes in self-perception. Youth had improved self-perception in the areas of athletic competence (P = .04) and physical appearance (P = .007) after participating in Fit Families. Fit Families provides a holistic approach to weight management that promotes positive self-perception, which may decrease the burden of depression, anxiety, and low self-esteem obese youth face. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Medical and surgical treatment of obesity.

PubMed

Kissane, Nicole A; Pratt, Janey S A

2011-03-01

The prevalence of obesity has reached epidemic proportions. Conceptualization of obesity as a chronic disease facilitates greater understanding its treatment. The NIH Consensus Conference on Gastrointestinal Surgery for Severe Obesity provides a framework by which to manage the severely obese--specifically providing medical versus surgical recommendations which are based on scientific and outcomes data. Medical treatments of obesity include primary prevention, dietary intervention, increased physical activity, behavior modification, and pharmacotherapy. Surgical treatment for obesity is based on the extensive neural-hormonal effects of weight loss surgery on metabolism, and as such is better termed Metabolic Surgery. Surgery is not limited to the procedure itself, it also necessitates thorough preoperative evaluation, risk assessment, and counseling. The most common metabolic surgical procedures include Roux-en-Y gastric bypass, adjustable gastric band, sleeve gastrectomy, and biliopancreatic diversion. Surgical outcomes for metabolic surgery are well studied and demonstrate superior long-term weight loss compared to medical management in cases of severe obesity.

Women's work. Maintaining a healthy body weight.

PubMed

Welch, Nicky; Hunter, Wendy; Butera, Karina; Willis, Karen; Cleland, Verity; Crawford, David; Ball, Kylie

2009-08-01

This study describes women's perceptions of the supports and barriers to maintaining a healthy weight among currently healthy weight women from urban and rural socio-economically disadvantaged areas. Using focus groups and interviews, we asked women about their experiences of maintaining a healthy weight. Overwhelmingly, women described their healthy weight practices in terms of concepts related to work and management. The theme of 'managing health' comprised issues of managing multiple responsibilities, time, and emotions associated with healthy practices. Rural women faced particular difficulties in accessing supports at a practical level (for example, lack of childcare) and due to the gendered roles they enacted in caring for others. Family background (in particular, mothers' attitudes to food and weight) also appeared to influence perceptions about healthy weight maintenance. In the context of global increases in the prevalence of obesity, the value of initiatives aimed at supporting healthy weight women to maintain their weight should not be under-estimated. Such initiatives need to work within the social and personal constraints that women face in maintaining good health.

Obesity prevention for children with physical disabilities: a scoping review of physical activity and nutrition interventions.

PubMed

McPherson, Amy C; Keith, Rebekah; Swift, Judy A

2014-01-01

Children with disabilities are at higher risk of obesity, engage in less physical activity and report poorer quality dietary habits than their non-disabled peers. This study reviewed current evidence on interventions designed to facilitate weight management and/or weight-related behaviors (i.e. physical activity and/or healthy eating habits) in children with physical disabilities. A scoping review was performed using established methodology. Data from studies meeting specific inclusion criteria were extracted and analyzed using summary statistics, and common characteristics thematically identified. Thirty-four articles were included in the synthesis. No long-term obesity prevention interventions were identified. The majority of research focused upon children with cerebral palsy, and had case study, quasi- or non-experimental designs. All interventions reporting positive outcomes (n = 18) addressed physical activity, with common themes including using motivational strategies for the child and child self-direction. Incremental increases in workload and engaging in strength training for longer than 15 minutes were also effective. Interventions targeting body weight/composition did not report success in the long term. A robust evidence base is lacking for long-lasting obesity interventions for children with physical disabilities. Current research provides some insights into the specific components that should be considered when planning such interventions in the future.

Diet modification for treatment and prevention of obesity.

PubMed

Ness-Abramof, Rosane; Apovian, Caroline M

2006-02-01

The obesity epidemic is best explained by global lifestyle alterations favoring weight gain in a susceptible population. The consumption of calorically dense foods, increased portion sizes, and a decrease in workplace and leisure physical activity most likely accounts for the increase in overweight and obesity worldwide. The cornerstone of overweight and obesity therapy is dietary intervention, but unfortunately most patients eventually regain the weight lost through diet alone. The search for a macronutrient composition that may enhance and help maintain weight loss has brought an abundance of fad diets into the lay literature. According to the available data, weight loss and maintenance of weight loss are dictated by total caloric intake, and not by macronutrient composition. There is epidemiologic data linking sugar-sweetened beverages to adult and childhood obesity, and an inverse relationship between dairy intake and overweight and obesity has also been observed. More research is needed to elucidate mechanisms explaining these relationships. Further research should focus on permanent lifestyle changes that may reverse this growing epidemic. This review will focus on current practices for the dietary management of obesity and to promote weight maintenance.

Tier 3 multidisciplinary medical weight management improves outcome of Roux-en-Y gastric bypass surgery.

PubMed

Patel, P; Hartland, A; Hollis, A; Ali, R; Elshaw, A; Jain, S; Khan, A; Mirza, S

2015-04-01

In 2013 the Department of Health specified eligibility for bariatric surgery funded by the National Health Service. This included a mandatory specification that patients first complete a Tier 3 medical weight management programme. The clinical effectiveness of this recommendation has not been evaluated previously. Our bariatric centre has provided a Tier 3 programme six months prior to bariatric surgery since 2009. The aim of our retrospective study was to compare weight loss in two cohorts: Roux-en-Y gastric bypass only (RYGB only cohort) versus Tier 3 weight management followed by RYGB (Tier 3 cohort). A total of 110 patients were selected for the study: 66 in the RYGB only cohort and 44 in the Tier 3 cohort. Patients in both cohorts were matched for age, sex, preoperative body mass index and pre-existing co-morbidities. The principal variable was therefore whether they undertook the weight management programme prior to RYGB. Patients from both cohorts were followed up at 6 and 12 months to assess weight loss. The mean weight loss at 6 months for the Tier 3 cohort was 31% (range: 18-69%, standard deviation [SD]: 0.10 percentage points) compared with 23% (range: 4-93%, SD: 0.12 percentage points) for the RYGB only cohort (p=0.0002). The mean weight loss at 12 months for the Tier 3 cohort was 34% (range: 17-51%, SD: 0.09 percentage points) compared with 27% (range: 14-48%, SD: 0.87 percentage points) in the RYGB only cohort (p=0.0037). Our study revealed that in our matched cohorts, patients receiving Tier 3 specialist medical weight management input prior to RYGB lost significantly more weight at 6 and 12 months than RYGB only patients. This confirms the clinical efficacy of such a weight management programme prior to gastric bypass surgery and supports its inclusion in eligibility criteria for bariatric surgery.

Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part II: patient activation mediates the effects of health behavior change counseling on rehabilitation engagement.

PubMed

Skolasky, Richard L; Maggard, Anica M; Li, David; Riley, Lee H; Wegener, Stephen T

2015-07-01

To determine the effect of health behavior change counseling (HBCC) on patient activation and the influence of patient activation on rehabilitation engagement, and to identify common barriers to engagement among individuals undergoing surgery for degenerative lumbar spinal stenosis. Prospective clinical trial. Academic medical center. Consecutive lumbar spine surgery patients (N=122) defined in our companion article (Part I) were assigned to a control group (did not receive HBCC, n=59) or HBCC group (received HBCC, n=63). Brief motivational interviewing-based HBCC versus control (significance, P<.05). We assessed patient activation before and after intervention. Rehabilitation engagement was assessed using the physical therapist-reported Hopkins Rehabilitation Engagement Rating Scale and by a ratio of self-reported physical therapy and home exercise completion. Common barriers to rehabilitation engagement were identified through thematic analysis. Patient activation predicted engagement (standardized regression weight, .682; P<.001). Postintervention patient activation was predicted by baseline patient activation (standardized regression weight, .808; P<.001) and receipt of HBCC (standardized regression weight, .444; P<.001). The effect of HBCC on rehabilitation engagement was mediated by patient activation (standardized regression weight, .079; P=.395). One-third of the HBCC group did not show improvement compared with the control group. Thematic analysis identified 3 common barriers to engagement: (1) low self-efficacy because of lack of knowledge and support (62%); (2) anxiety related to fear of movement (57%); and (3) concern about pain management (48%). The influence of HBCC on rehabilitation engagement was mediated by patient activation. Despite improvements in patient activation, one-third of patients reported low rehabilitation engagement. Addressing these barriers should lead to greater improvements in rehabilitation engagement. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Self-Management Patient Education and Weight Loss

ERIC Educational Resources Information Center

Stombaugh, Angela M.

2010-01-01

Self-management of a disease is defined as "having or being able to obtain, the skills and resources necessary to best accommodate to the chronic disease and its consequences" (Holman & Lorig, 1992, p. 309). Self-management has been used in the management of several chronic conditions and this model may be useful in the management of weight loss.…

Contingency management adapted for African-American adolescents with obesity enhances youth weight loss with caregiver participation: a multiple baseline pilot study.

PubMed

Hartlieb, Kathryn Brogan; Naar, Sylvie; Ledgerwood, David M; Templin, Thomas N; Ellis, Deborah A; Donohue, Bradley; Cunningham, Phillippe B

2015-12-07

Contingency management (CM) interventions, which use operant conditioning principles to encourage completion of target behavioral goals, may be useful for improving adherence to behavioral skills training (BST). Research-to-date has yet to explore CM for weight loss in minority adolescents. To examine the effects of CM in improving adolescent weight loss when added to BST. The study utilized an innovative experimental design that builds upon multiple baseline approaches as recommended by the National Institutes of Health. Six obese African-American youth and their primary caregivers living in Detroit, Michigan, USA. Adolescents received between 4 and 12 weeks of BST during a baseline period and subsequently received CM targeting weight loss. Youth weight. Linear mixed effects modeling was used in the analysis. CM did not directly affect adolescent weight loss above that of BST (p=0.053). However, when caregivers were involved in CM session treatment, contingency management had a positive effect on adolescent weight loss. The estimated weight loss due to CM when caregivers also attended was 0.66 kg/week (p<0.001, [95% CI; -1.96, -0.97]) relative to the baseline trajectory. This study demonstrates application of a novel experimental approach to intervention development and demonstrated the importance of parent involvement when delivering contingency management for minority youth weight loss. Lessons learned from contingency management program implementation are also discussed in order to inform practice.

Barriers and facilitators to providing primary care-based weight management services in a patient centered medical home for Veterans: a qualitative study.

PubMed

Jay, Melanie; Chintapalli, Sumana; Squires, Allison; Mateo, Katrina F; Sherman, Scott E; Kalet, Adina L

2015-11-14

Obesity is highly prevalent among Veterans. In the United States, the Veterans Health Administration (VHA) offers a comprehensive weight management program called MOVE!. Yet, fewer than 10 % of eligible patients ever attend one MOVE! visit. The VHA has a patient-centered medical home (PCMH) model of primary care (PC) called Patient-Aligned Care Teams (PACT) at all Veterans Affairs (VA) Medical Centers. PACT teamlets conduct obesity screening, weight management counseling, and refer to MOVE!. As part of a needs assessment to improve delivery of weight management services, the purpose of this study was to assess PACT teamlet and MOVE! staff: 1) current attitudes and perceptions regarding obesity care; 2) obesity-related counseling practices 3) experiences with the MOVE! program; and 4) targets for interventions to improve implementation of obesity care in the PC setting. We recruited 25 PACT teamlet members from a single VA study site-11 PC physicians, 5 registered nurses, 5 licensed practical nurses, 1 clerical assistant, and 3 MOVE! staff (2 dietitians, 1 psychologist)-for individual interviews using a combination of convenience and snowball sampling. Audio recorded interviews were professionally transcribed and iteratively coded by two independent reviewers. The analytic process was guided by discourse analysis in order to discover how the participants perceived and provided weight management care and what specific attitudes affected their practices, all as bounded within the organization. Emerging themes included: 1) role perceptions, 2) anticipated outcomes of weight management counseling and programs, and 3) communication and information dissemination. Perceived role among PCPs was influenced by training, whereas personal experience with their own weight management impacted role perception among LPNs/RNs. Attitudes about whether or not they could impact patients' weight outcomes via counseling or referral to MOVE! varied. System-level communication about VHA priorities through electronic health records and time allocation influenced teams to prioritize referral to MOVE! over weight management counseling. We found a diversity of attitudes, and practices within PACT, and identified factors that can enhance the MOVE! program and inform interventions to improve weight management within primary care. Although findings are site-specific, many are supported in the literature and applicable to other VA and non-VA sites with PCMH models of care.

Antenatal Weight Management: Women's Experiences, Behaviours, and Expectations of Weighing in Early Pregnancy.

PubMed

Swift, J A; Pearce, J; Jethwa, P H; Taylor, M A; Avery, A; Ellis, S; Langley-Evans, S C; McMullen, S

2016-01-01

The current emphasis on obstetric risk management helps to frame gestational weight gain as problematic and encourages intervention by healthcare professionals. However pregnant women have reported confusion, distrust, and negative effects associated with antenatal weight management interactions. The MAGIC study (MAnaging weiGht In pregnanCy) sought to examine women's self-reported experiences of usual-care antenatal weight management in early pregnancy and consider these alongside weight monitoring behaviours and future expectations. 193 women (18 yrs+) were recruited from routine antenatal clinics at the Nottingham University Hospital NHS Trust. Self-reported gestation was 10-27 weeks, with 41.5% ( n = 80) between 12 and 14 and 43.0% ( n = 83) between 20 and 22 weeks. At recruitment 50.3% of participants ( n = 97) could be classified as overweight or obese. 69.4% of highest weight women (≥30 kg/m 2 ) did not report receiving advice about weight, although they were significantly more likely compared to women with BMI < 30 kg/m 2 . The majority of women (regardless of BMI) did not express any barriers to being weighed and 40.8% reported weighing themselves at home. Women across the BMI categories expressed a desire for more engagement from healthcare professionals on the issue of bodyweight. Women are clearly not being served appropriately in the current situation which simultaneously problematizes and fails to offer constructive dialogue.

Acceptability and non-compliance in a family-led weight-management programme for obese Pacific children.

PubMed

Teevale, Tasileta; Taufa, Seini; Percival, Teuila

2015-10-01

To explore factors influencing participation and attrition in a family-led weight-management programme for obese Pacific children. Qualitative study used bilingual in-depth interviews at exit and end of an 8-week weight-management programme. New Zealand. Forty-two parents/primary caregivers of obese children who were randomised in the intervention weight-management programme. Programmatic factors that enhanced retention included: simultaneous delivery to both children and parents as participants; delivery of the programme in small group settings at local community venues; enabling trustworthy and accountable relationships; providing resources for travel to venues and regular telephone/text messaging follow-up calls reinforcing programme goals; and day and time scheduling. Suggested programme improvements included having ethnic-specific Island-language delivery and practical sessions like cooking classes and shopping expeditions at local food stores. The research found that unpredictable external life crises like extended family deaths, a change in job shift, family illnesses (both acute and those requiring chronic management) and long-term family visitations affected participation and momentum. A loss of momentum through managing life crises was often difficult to overcome for participants, leading them to drop out of the weight-management programme. Most drop-out participants preferred to defer their programme participation with hopes of re-committing to future programmes at another time. In order for weight-management programmes to be effective, participants must be able to complete them. Identifying factors that predict participation and attrition may serve as a basis for programme improvement.

Why don't families initiate treatment? A qualitative multicentre study investigating parents' reasons for declining paediatric weight management.

PubMed

Perez, Arnaldo; Holt, Nicholas; Gokiert, Rebecca; Chanoine, Jean-Pierre; Legault, Laurent; Morrison, Katherine; Sharma, Arya; Ball, Geoff

2015-05-01

Many families referred to specialized health services for managing paediatric obesity do not initiate treatment; however, reasons for noninitiation are poorly understood. To understand parents' reasons for declining tertiary-level health services for paediatric weight management. Interviews were conducted with 18 parents of children (10 to 17 years of age; body mass index ≥85th percentile) who were referred for weight management, but did not initiate treatment at one of three Canadian multidisciplinary weight management clinics. A semi-structured interview guide was used to elicit parents' responses about reasons for noninitiation. Interviews were audio-recorded and transcribed verbatim. Data were managed using NVivo 9 (QSR International, Australia) and analyzed thematically. Most parents (mean age 44.1 years; range 34 to 55 years) were female (n=16 [89%]), obese (n=12 [66%]) and had a university degree (n=13 [71%]). Parents' reasons for not initiating health services were grouped into five themes: no perceived need for paediatric weight management (eg, perceived children did not have a weight or health problem); no perceived need for further actions (eg, perceived children already had a healthy lifestyle); no intention to initiate recommended care (eg, perceived clinical program was not efficacious); participation barriers (eg, children's lack of motivation); and situational factors (eg, weather). Physicians should not only discuss the need for and value of specialized care for managing paediatric obesity, but also explore parents' intention to initiate treatment and address reasons for noninitiation that are within their control.

Health promotion lifestyle interventions for weight management in psychosis: a systematic review and meta-analysis of randomised controlled trials.

PubMed

Bonfioli, Elena; Berti, Loretta; Goss, Claudia; Muraro, Francesca; Burti, Lorenzo

2012-07-12

Psychiatric patients have more physical health problems and much shorter life expectancies compared to the general population, due primarily to premature cardiovascular disease. A multi-causal model which includes a higher prevalence of risk factors has provided a valid explanation. It takes into consideration not only risks such as gender, age, and family history that are inherently non-modifiable, but also those such as obesity, smoking, diabetes, hypertension, and dyslipidemia that are modifiable through behavioural changes and improved care. Thus, it is crucial to focus on factors that increase cardiovascular risk. Obesity in particular has been associated with both the lifestyle habits and the side effects of antipsychotic medications. The present systematic review and meta-analysis aims at collecting and updating available evidence on the efficacy of non-pharmacological health promotion programmes for psychotic patients in randomised clinical trials. We systematically reviewed the randomised controlled trials from 1990 onward, in which psychoeducational and/or cognitive-behavioural interventions aimed at weight loss or prevention of weight gain in patients with psychosis had been compared to treatment as usual. We carried out a meta-analysis and pooled the results of the studies with Body Mass Index as primary outcome. The results of the meta-analysis show an effect toward the experimental group. At the end of the intervention phase there is a -0.98 kg/m(2) reduction in the mean Body Mass Index of psychotic subjects. Notably, prevention studies with individual psychoeducational programmes that include diet and/or physical activity seem to have the highest impact. When compared with treatment as usual in psychotic patients, preventive and individual lifestyle interventions that include diet and physical activity generally prove to be effective in reducing weight. Physical screening and monitoring programmes are well accepted by patients and can be implemented in a variety of settings. A weight loss of 0.98 points in the Body Mass Index corresponds to a loss of 3.12% of the initial weight. This percentage is below the 5% to 10% weight loss deemed sufficient to improve weight-related complications such as hypertension, type II diabetes, and dyslipidemia. However, it is reported that outcomes associated with metabolic risk factors may have greater health implications than weight changes alone. Therefore, in addition to weight reduction, the assessment of metabolic parameters to monitor other independent risk factors should also be integrated into physical health promotion and management in people with mental disorders.

Weight Management and Fruit and Vegetable Intake among US High School Students

ERIC Educational Resources Information Center

Lowry, Richard; Lee, Sarah M.; McKenna, Mary L.; Galuska, Deborah A.; Kann, Laura K.

2008-01-01

Background: Consumption of fruits and vegetables is often recommended to promote healthy weight. The purpose of this study was to examine associations between fruit and vegetable intake and common weight management behaviors among US high school students who were trying to lose or stay the same weight. Methods: Data from the 1999, 2001, and 2003…

Unhealthy and healthy weight control behaviours among bus operators.

PubMed

Escoto, K H; French, S A

2012-03-01

Urban bus operators are an occupational group with high rates of overweight and obesity. Understanding methods bus operators use for weight control may be important; there may be increased risk for these workers to engage in less healthy weight management behaviours due to stressful working conditions. To examine the prevalence of unhealthy and healthy weight control behaviours used by bus operators and examine associations between use of unhealthy weight control behaviours and work-related and sociodemographic variables. Bus operators from four different transit garages were invited to complete a self-administered survey; height and weight were measured by research staff. Unhealthy and healthy weight control behaviours, work hours, work schedule and social support were measured with self-report items on the employee survey. Logistic regression analysis was conducted to estimate associations. Nearly 60% of bus operators endorsed at least one unhealthy method; over 50% reported skipping meals, 30% fasted and 10% reported taking diet pills in the past year. Bus operator gender, race, body mass index status and hours worked per week showed significant associations with using at least one unhealthy weight control behaviour. Worksite interventions should emphasize the benefit of healthy eating and physical activity but should also address the use of less healthy methods for weight control for individuals employed in transportation occupations.

Weight gain in women diagnosed with breast cancer.

PubMed

Demark-Wahnefried, W; Rimer, B K; Winer, E P

1997-05-01

This review of the literature indicates that weight gain is a common observation among women after the diagnosis of breast cancer. Gains in weight range from 0 to 50 lb and are influenced by menopausal status; nodal status; and the type, duration, and intensity of treatment. Weight gain appears to be greater among premenopausal women; among those who are node positive; and among those receiving higher dose, longer duration, and multiagent regimens. Psychosocial research suggests that weight gain has a profoundly negative impact on quality of life in patients with breast cancer. Recent findings also suggest that weight gain during therapy may increase the risk of recurrence and decrease survival. Although weight gain in patients with breast cancer is clinically well appreciated, little research has been conducted to investigate the underlying mechanisms of energy imbalance. Changes in rates of metabolism, physical activity, and dietary intake are all plausible mechanisms and call for more research. Further study will provide valuable insight into the problem of weight gain and encourage effective interventions to improve the quality and quantity of life for the woman with breast cancer. Until more is known, however, dietetics practitioners will have to monitor and work individually with patients with breast cancer and use empirical approaches to achieve the important goal of weight management.

Obesity Prevention and Weight Maintenance After Loss.

PubMed

German, Alexander James

2016-09-01

Obesity is one of the most prevalent medical diseases in pets. Outcomes are often disappointing; many animals either fail to reach target weight or regain weight. This article discusses managing obesity, focusing on prevention. It gives guidance on establishing monitoring programs that use regular body weight and condition assessments to identify animals at risk of inappropriate weight gain, enabling early intervention. Weight management in obese animals is a lifelong process. Regular weight and body condition monitoring are key to identifying animals that rebound early, while continuing to feed a therapeutic weight loss diet can help prevent it from happening. Copyright © 2016 Elsevier Inc. All rights reserved.

The need of a weight management control program in judo: a proposal based on the successful case of wrestling.

PubMed

Artioli, Guilherme G; Franchini, Emerson; Nicastro, Humberto; Sterkowicz, Stanislaw; Solis, Marina Y; Lancha, Antonio H

2010-05-04

Judo competitions are divided into weight classes. However, most athletes reduce their body weight in a few days before competition in order to obtain a competitive advantage over lighter opponents. To achieve fast weight reduction, athletes use a number of aggressive nutritional strategies so many of them place themselves at a high health-injury risk. In collegiate wrestling, a similar problem has been observed and three wrestlers died in 1997 due to rapid weight loss regimes. After these deaths, the National Collegiate Athletic Association had implemented a successful weight management program which was proven to improve weight management behavior. No similar program has ever been discussed by judo federations even though judo competitors present a comparable inappropriate pattern of weight control. In view of this, the basis for a weight control program is provided in this manuscript, as follows: competition should begin within 1 hour after weigh-in, at the latest; each athlete is allowed to be weighed-in only once; rapid weight loss as well as artificial rehydration (i.e., saline infusion) methods are prohibited during the entire competition day; athletes should pass the hydration test to get their weigh-in validated; an individual minimum competitive weight (male athletes competing at no less than 7% and females at no less than 12% of body fat) should be determined at the beginning of each season; athletes are not allowed to compete in any weight class that requires weight reductions greater than 1.5% of body weight per week. In parallel, educational programs should aim at increasing the athletes', coaches' and parents' awareness about the risks of aggressive nutritional strategies as well as healthier ways to properly manage body weight.

Temperament and body weight from ages 4 to 15 years.

PubMed

Sutin, A R; Kerr, J A; Terracciano, A

2017-07-01

In adulthood, conscientiousness and neuroticism are correlates of body weight and weight gain. The present research examines whether the childhood antecedents of these traits, persistence and negative reactivity, respectively, are associated with weight gain across childhood. We likewise examine sociability as a predictor of childhood weight gain and whether these three traits are associated with weight concerns and weight-management strategies in adolescence. Participants (N=4153) were drawn from the Longitudinal Study of Australian Children, an ongoing, population-based study of child and family health and well-being. At the baseline assessment, caregivers reported on their child's temperament. At every assessment from ages 4-5 to 14-15 years, study children were weighed and measured by trained staff; there were up to six biennial assessments of body mass index and waist circumference. At ages 14-15 years, study children (n=2975) also self-reported on their weight concerns and weight-management strategies. Study children rated lower in persistence or higher in negative reactivity in early childhood gained more weight between the ages of 4 and 15 years. Sociability was associated with weight gain among girls but not among boys. Lower persistence and higher negative reactivity at ages 4-5 years were also associated with greater weight concerns, restrained eating and use of unhealthy weight-management strategies at ages 14-15 years. Childhood traits related to conscientiousness and neuroticism are associated with objective weight gain across childhood and with concerns and strategies to manage weight in adolescence. These results are consistent with a lifespan perspective that indicates that trait psychological functioning contributes to health-related markers from childhood through old age.

Applying RE-AIM to the evaluation of FUEL Your Life : a worksite translation of DPP.

PubMed

Brace, Andrea M; Padilla, Heather M; DeJoy, David M; Wilson, Mark G; Vandenberg, Robert J; Davis, Marsha

2015-01-01

Weight management programs are becoming increasingly common in workplace settings; however, few target middle-aged men. The purpose of this article is to describe the process evaluation of a worksite translation of the Diabetes Prevention Program in a predominantly middle-aged male population. The translated program, FUEL Your Life, was largely self-directed, with support from peer health coaches and occupational health nurses. The RE-AIM (Reach Effectiveness Adoption Implementation Maintenance) framework was used to examine the factors that influenced program implementation using data from an environmental assessment, participant surveys, peer health coach surveys, and occupational health nurse interviews. An overwhelming majority of the employees who enrolled in the study were overweight or obese (92%). Overall, the program was effective for weight maintenance; those with higher levels of participation and engagement had better weight loss outcomes. The peer health coach and family elements of the intervention were underused. The program was successful in reaching the intended population; however, the program had limited success in engaging this population. Not surprisingly, weight loss was a function of participant engagement and participation. Increasing participant engagement and participation is important to the success of weight management interventions translated to the worksite setting. Garnering buy-in and support from management can serve to increase the perceived importance of weight management in worksites. With management support, weight management protocols could be integrated as a component of the mandatory safety and health assessments already in place, fostering promotion of healthy weight in the workforce. © 2014 Society for Public Health Education.

US Registered Dietitian Nutritionists' Knowledge and Attitudes of Intuitive Eating and Use of Various Weight Management Practices.

PubMed

Schaefer, Julie T; Zullo, Melissa D

2017-09-01

Researchers have been advocating for a new weight-inclusive paradigm that focuses on health rather than weight. One important component of this model is intuitive eating. Although registered dietitian nutritionists (RDNs) are the nation's food and nutrition experts, RDNs' knowledge of and attitudes toward intuitive eating and use of traditional or restrictive strategies are unknown. The purpose of this study was to characterize RDNs' knowledge of and attitudes toward an intuitive eating lifestyle and describe use of traditional weight management and nonrestrictive lifestyle practices with clients. This was a cross-sectional study. A validated survey was distributed using online survey software to 88,834 RDNs. There were 18,622 respondents who completed the survey (25%). The majority of RDNs were knowledgeable about intuitive eating, answering 71% of items correctly. The majority of RDNs had a positive view on each attitude item. RDNs who work in weight management reported using nonrestrictive/intuitive eating practices more than traditional/restrictive practices. RDNs who were women (P<0.001), had advanced education (P<0.001), worked in a private practice setting (P<0.001), completed at least one certificate of training in weight management (P<0.001), had more experience in weight management counseling (P<0.001), and had greater intuitive eating knowledge (P<0.001) were more likely to report greater use of nonrestrictive/intuitive eating practices. This study provides evidence that RDNs are using an intuitive eating approach more often than traditional weight management practices. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Weight management practices and their relationship to knowledge, perception and health status of Saudi females attending diet clinics in Riyadh city.

PubMed

Albassam, Reem Suliman; Abdel Gawwad, Ensaf S; Khanam, Latifa

2007-01-01

The objective of the study was to identify weight management (WM) practices among women attending diet clinics in Riyadh city, assess their impact on knowledge, perceptions, nutritional and health status and define some predictors for weight reduction among these women. The pretest-posttest research design was used. All female clients attending 8 diet clinics for the first visit within 8 months period and fulfilling the study inclusion criteria (212 out of 263) were included. The results show that out of 170 females who had previously tried to lose weight, only 32.4% reported success in reducing weight, meanwhile 61.7% reported weight regain. The mean total score of dietary practices, physical activity score, self efficacy and satisfaction of self-body image were improved significantly at posttest. Analysis of 24 h. dietary recall revealed that total energy and nutrients intake were significantly reduced at posttest. Dieting related problems increased significantly at posttest. Nutritional knowledge was at moderately fair level at both pretest and posttest; however it showed a significant improvement in the posttest. Perceived severity, perceived barriers and negative modeling effect were significantly decreased at the posttest. Over expectation for weight reduction was clearly evident as posttest body mass index (BMI) revealed a wide discrepancy between the expected and final weights. However, as compared to initial and final BMI, there was an increase in women who attained normal weight and a decrease in the percentage of obese and morbid obese women. All anthropometric indices, blood pressure, biochemical investigation showed significant improvement at posttest. Among the five WM modalities studied, moderate hypo-calorie plan diet modality was the longest (chi = 5.6 month) with the least weight loss (7.8%) and the minimum side effects. Both groups under very low calorie diet and protein diet had the highest weight reduction (13.2% &12.3%), at the same time both diets exhibited the highest number of side effects. The study recommends use of the primary approach for achieving weight loss through therapeutic life style change with banning those modalities accompanied with serious health complications.

"Don't eat that, you'll get fat!" Exploring how parents and children conceptualise and frame messages about the causes and consequences of obesity.

PubMed

Thomas, Samantha L; Olds, Timothy; Pettigrew, Simone; Randle, Melanie; Lewis, Sophie

2014-10-01

Family interactions about weight and health take place against the backdrop of the wider social discourse relating to the obesity epidemic. Parents (and children) negotiate complex and often contradictory messages in constructing a set of beliefs and practices around obesity and weight management. Despite this, very little research attention has been given to the nature of family-unit discourse on the subject of body weight and it's potential influence on the weight-related behaviours of family members. This includes the broad influence that dominant socio-cultural discourses have on family conceptualisations of weight and health. Using in-depth qualitative interviews with 150 family 'groups' comprised of at least one parent and one child in Victoria and South Australia, we explored how parents and children conceptualise and discuss issues of weight- and health-related lifestyle behaviours. Data were analysed using Attride-Stirling's (2001) thematic network approach. Three thematic clusters emerged from the analysis. First, both parents and children perceived that weight was the primary indicator of health. However, parents focused on the negative physical implications of overweight while children focused on the negative social implications. Second, weight and lifestyle choices were highly moralised. Parents saw it as their responsibility to communicate to children the 'dangers' of fatness. Children reported that parents typically used negatively-framed messages and scare tactics rather than positively-framed messages to encourage healthy behaviours. Third was the perception among parents and children that if you were thin, then eating habits and exercise were less important, and that activity could provide an antidote to food choices. Results suggest that both parents and children are internalising messages relating to obesity and weight management that focus on personal responsibility and blame attribution. These views reflect the broader societal discourse, and their consolidation at the family level is likely to increase their potency and make them resistant to change. Copyright © 2014. Published by Elsevier Ltd.

Review of Childhood Obesity: From Epidemiology, Etiology, and Comorbidities to Clinical Assessment and Treatment.

PubMed

Kumar, Seema; Kelly, Aaron S

2017-02-01

Childhood obesity has emerged as an important public health problem in the United States and other countries in the world. Currently 1 in 3 children in the United States is afflicted with overweight or obesity. The increasing prevalence of childhood obesity is associated with emergence of comorbidities previously considered to be "adult" diseases including type 2 diabetes mellitus, hypertension, nonalcoholic fatty liver disease, obstructive sleep apnea, and dyslipidemia. The most common cause of obesity in children is a positive energy balance due to caloric intake in excess of caloric expenditure combined with a genetic predisposition for weight gain. Most obese children do not have an underlying endocrine or single genetic cause for their weight gain. Evaluation of children with obesity is aimed at determining the cause of weight gain and assessing for comorbidities resulting from excess weight. Family-based lifestyle interventions, including dietary modifications and increased physical activity, are the cornerstone of weight management in children. A staged approach to pediatric weight management is recommended with consideration of the age of the child, severity of obesity, and presence of obesity-related comorbidities in determining the initial stage of treatment. Lifestyle interventions have shown only modest effect on weight loss, particularly in children with severe obesity. There is limited information on the efficacy and safety of medications for weight loss in children. Bariatric surgery has been found to be effective in decreasing excess weight and improving comorbidities in adolescents with severe obesity. However, there are limited data on the long-term efficacy and safety of bariatric surgery in adolescents. For this comprehensive review, the literature was scanned from 1994 to 2016 using PubMed using the following search terms: childhood obesity, pediatric obesity, childhood overweight, bariatric surgery, and adolescents. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Magnetic resonance imaging in active surveillance—a modern approach

PubMed Central

Moore, Caroline M.

2018-01-01

In recent years, active surveillance has been increasingly adopted as a conservative management approach to low and sometimes intermediate risk prostate cancer, to avoid or delay treatment until there is evidence of higher risk disease. A number of studies have investigated the role of multiparametric magnetic resonance imaging (mpMRI) in this setting. MpMRI refers to the use of multiple MRI sequences (T2-weighted anatomical and functional imaging which can include diffusion-weighted imaging, dynamic contrast enhanced imaging, spectroscopy). Each of the parameters investigates different aspects of the prostate gland (anatomy, cellularity, vascularity, etc.). In addition to a qualitative assessment, the radiologist can also extrapolate quantitative imaging biomarkers from these sequences, for example the apparent diffusion coefficient from diffusion-weighted imaging. There are many different types of articles (e.g., reviews, commentaries, consensus meetings, etc.) that address the use of mpMRI in men on active surveillance for prostate cancer. In this paper, we compare original articles that investigate the role of the different mpMRI sequences in men on active surveillance for prostate cancer, in order to discuss the relative utility of the different sequences, and combinations of sequences. We searched MEDLINE/PubMed for manuscripts published from inception to 1st December 2017. The search terms used were (prostate cancer or prostate adenocarcinoma or prostatic carcinoma or prostate carcinoma or prostatic adenocarcinoma) and (MRI or NMR or magnetic resonance imaging or mpMRI or multiparametric MRI) and active surveillance. Overall, 425 publications were found. All abstracts were reviewed to identify papers with original data. Twenty-five papers were analysed and summarised. Some papers based their analysis only on one mpMRI sequence, while others assessed two or more. The evidence from this review suggests that qualitative assessments and quantitative data from different mpMRI sequences hold promise in the management of men on active surveillance for prostate cancer. Both qualitative and quantitative approaches should be considered when assessing mpMRI of the prostate. There is a need for robust studies assessing the relative utility of different combinations of sequences in a systematic manner to determine the most efficient use of mpMRI in men on active surveillance. PMID:29594026

A randomized comparison of a commercially available portion-controlled weight-loss intervention with a diabetes self-management education program

PubMed Central

Foster, G D; Wadden, T A; LaGrotte, C A; Vander Veur, S S; Hesson, L A; Homko, C J; Maschak-Carey, B J; Barbor, N R; Bailer, B; Diewald, L; Komaroff, E; Herring, S J; Vetter, M L

2013-01-01

Objective: This study examined the efficacy of a commercially available, portion-controlled diet (PCD) on body weight and HbA1c over 6 months in obese patients with type 2 diabetes. Research Design and Methods: One-hundred participants with a mean±s.d. age of 55.6±10.6 year, body weight of 102.9±18.4 kg and HbA1c of 7.7±1.3% were randomly assigned to a 9-session group lifestyle intervention that included a PCD or to a 9-session group program of diabetes self-management education (DSME). Participants in the two groups were prescribed the same goals for energy intake (1250–1550 kcal per day) and physical activity (200 min per week). Results: While both groups produced significant improvements in weight and HbA1c after 6 months of treatment, PCD participants lost 7.3 kg [95% confidence interval (CI): −5.8 to −8.8 kg], compared with 2.2 kg (95% CI: −0.7 to −3.7 kg) in the DSME group (P<0.0001). Significantly more PCD than DSME participants lost ⩾5% of initial weight (54.0% vs 14.0%, P<0.0001) and ⩾10% (26.0% vs 6.0%, P<0.0001). HbA1c declined by 0.7% (95% CI: −0.4 to −1.0%) in the PCD group, compared with 0.4% (95% CI: −0.1 to −0.7%) in DSME (P<0.026). Across both groups, larger weight losses were associated with greater reductions in HbA1c (r=0.52, P<0.0001). Conclusions: These findings demonstrate that a commercially available portion-controlled meal plan can induce clinically meaningful improvements in weight and glycemic control in obese individuals with type 2 diabetes. These data have implications for the management of obesity in primary care, as now provided by the Centers for Medicare and Medicaid Services. PMID:23507967

Effectiveness of a psychosocial weight management program for individuals with schizophrenia.

PubMed

Niv, Noosha; Cohen, Amy N; Hamilton, Alison; Reist, Christopher; Young, Alexander S

2014-07-01

The objective of this study was to examine the effectiveness of a weight loss program for individuals with schizophrenia in usual care. The study included 146 adults with schizophrenia from two mental health clinics of the Department of Veterans Affairs. The 109 individuals who were overweight or obese were offered a 16-week, psychosocial, weight management program. Weight and Body Mass Index (BMI) were assessed at baseline, 1 year later, and at each treatment session. Only 51% of those who were overweight or obese chose to enroll in the weight management program. Participants attended an average of 6.7 treatment sessions, lost an average of 2.4 pounds, and had an average BMI decrease of 0.3. There was no significant change in weight or BMI compared to the control group. Intervention strategies that both improve utilization and yield greater weight loss need to be developed.

Implementation and Effectiveness of a Psychosocial Weight Management Program for Individuals with Schizophrenia

PubMed Central

Niv, Noosha; Cohen, Amy N.; Hamilton, Alison; Reist, Christopher; Young, Alexander S.

2013-01-01

The objective of this study was to examine the effectiveness of a weight loss program for individuals with schizophrenia in usual care. The study included 146 adults with schizophrenia from two mental health clinics of the Department of Veterans Affairs. The 109 individuals who were overweight or obese were offered a 16-week, psychosocial, weight management program. Weight and BMI were assessed at baseline, 1 year later and at each treatment session. Only 51% of those who were overweight or obese chose to enroll in the weight management program. Participants attended an average of 6.7 treatment sessions, lost an average of 2.4 pounds and had an average BMI decrease of 0.3. There was no significant change in weight or BMI compared to the control group. Intervention strategies that both improve utilization and yield greater weight loss need to be developed. PMID:22430566

Development and Phytochemical Characterization of High Polyphenol Red Lettuce with Anti-Diabetic Properties

PubMed Central

Cheng, Diana M.; Pogrebnyak, Natalia; Kuhn, Peter; Krueger, Christian G.; Johnson, William D.; Raskin, Ilya

2014-01-01

Polyphenol-rich Rutgers Scarlet Lettuce (RSL) (Lactuca sativa L.) was developed through somaclonal variation and selection in tissue culture. RSL may contain among the highest reported contents of polyphenols and antioxidants in the category of common fruits and vegetables (95.6 mg/g dry weight and 8.7 mg/g fresh weight gallic acid equivalents and 2721 µmol/g dry weight and 223 µmol/g fresh weight Trolox equivalents). Three main compounds accumulate at particularly high levels in RSL: chlorogenic acid, up to 27.6 mg/g dry weight, cyanidin malonyl-glucoside, up to 20.5 mg/g dry weight, and quercetin malonyl-glucoside, up to 35.7 mg/g dry weight. Major polyphenolic constituents of RSL have been associated with health promotion as well as anti-diabetic and/or anti-inflammatory activities. Daily oral administration of RSL (100 or 300 mg/kg) for up to eight days acutely reduced hyperglycemia and improved insulin sensitivity in high fat diet-induced obese hyperglycemic mice compared to vehicle (water) control. Data presented here support possible use of RSL as a functional food for the dietary management of diabetes. PMID:24637790

77 FR 32013 - Truck Size and Weight; Technical Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-31

...-2012-0037] RIN 2125-AF45 Truck Size and Weight; Technical Correction AGENCY: Federal Highway...: This rule makes a technical correction to the regulations that govern Longer Combination Vehicles (LCV... INFORMATION CONTACT: John Nicholas, Truck Size and Weight Program Manager, Office of Freight Management and...

Risk preferences, probability weighting, and strategy tradeoffs in wildfire management

Treesearch

Michael S. Hand; Matthew J. Wibbenmeyer; Dave Calkin; Matthew P. Thompson

2015-01-01

Wildfires present a complex applied risk management environment, but relatively little attention has been paid to behavioral and cognitive responses to risk among public agency wildfire managers. This study investigates responses to risk, including probability weighting and risk aversion, in a wildfire management context using a survey-based experiment administered to...

Can mindfulness influence weight management related eating behaviors? If so, how?

PubMed

Tapper, Katy

2017-04-01

Mindfulness is increasingly being used for weight management. However, the strength of the evidence for such an approach is unclear; although mindfulness-based weight management programs have had some success, it is difficult to conclude that the mindfulness components were responsible. Research in this area is further complicated by the fact that the term 'mindfulness' is used to refer to a range of different practices. Additionally, we have little understanding of the mechanisms by which mindfulness might exert its effects. This review addresses these issues by examining research that has looked at the independent effects of mindfulness and mindfulness-related strategies on weight loss and weight management related eating behaviors. As well as looking at evidence for effects, the review also considers whether effects may vary with different types of strategy, and the kinds of mechanisms that may be responsible for any change. It is concluded that there is some evidence to support the effects of (a) present moment awareness, when applied to the sensory properties of food, and (b) decentering. However, research in these areas has yet to be examined in a controlled manner in relation to weight management. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Technology-based interventions for weight management: current randomized controlled trial evidence and future directions

PubMed Central

Buscemi, Joanna; Hawkins, Misty A. W.; Wang, Monica L.; Breland, Jessica Y.; Ross, Kathryn M.; Kommu, Anupama

2018-01-01

Obesity is a prevalent health care issue associated with disability, premature morality, and high costs. Behavioral weight management interventions lead to clinically significant weight losses in overweight and obese individuals; however, many individuals are not able to participate in these face-to-face treatments due to limited access, cost, and/or time constraints. Technological advances such as widespread access to the Internet, increased use of smartphones, and newer behavioral self-monitoring tools have resulted in the development of a variety of eHealth weight management programs. In the present paper, a summary of the most current literature is provided along with potential solutions to methodological challenges (e.g., high attrition, minimal participant racial/ethnic diversity, heterogeneity of technology delivery modes). Dissemination and policy implications will be highlighted as future directions for the field of eHealth weight management. PMID:27783259

Weight Management Belief is the Leading Influential Factor of Weight Monitoring Compliance in Congestive Heart Failure Patients.

PubMed

Lu, Min-Xia; Zhang, Yan-Yun; Jiang, Jun-Fang; Ju, Yang; Wu, Qing; Zhao, Xin; Wang, Xiao-Hua

2016-11-01

Daily weight monitoring is frequently recommended as a part of heart failure self-management to prevent exacerbations. This study is to identify factors that influence weight monitoring compliance of congestive heart failure patients at baseline and after a 1-year weight management (WM) program. This was a secondary analysis of an investigative study and a randomized controlled study. A general information questionnaire assessed patient demographics and clinical variables such as medicine use and diagnoses, and the weight management scale evaluated their WM abilities. Good and poor compliance based on abnormal weight gain from the European Society of Cardiology (> 2 kg in 3 days) were compared, and hierarchical multiple logistic regression analysis was used to identify factors influencing weight monitoring compliance. A total of 316 patients were enrolled at baseline, and 66 patients were enrolled after the 1-year WM program. Of them, 12.66% and 60.61% had good weight monitoring compliance at baseline and after 1 year of WM, respectively. A high WM-related belief score indicated good weight monitoring compliance at both time points [odds ratio (OR), 1.043, 95% confidence interval (CI), 1.023-1.063, p < 0.001; and OR, 2.054, 95% CI, 1.209-3.487, p < 0.001, respectively). Patients with a high WM-related practice score had good weight monitoring compliance at baseline (OR, 1.046, 95% CI, 1.027-1.065, p < 0.001), and patients who had not monitored abnormal weight had poor weight monitoring compliance after the 1-year WM program (OR, 0.244, 95% CI, 0.006-0.991, p = 0.049). Data from this study suggested that belief related to WM plays an important role in weight monitoring compliance.

Mobile and Web 2.0 interventions for weight management: an overview of review evidence and its methodological quality

PubMed Central

Smith, Jane R.; Samaha, Laya; Abraham, Charles

2016-01-01

Abstract Background : The use of Internet and related technologies for promoting weight management (WM), physical activity (PA), or dietary-related behaviours has been examined in many articles and systematic reviews. This overview aims to summarize and assess the quality of the review evidence specifically focusing on mobile and Web 2.0 technologies, which are the most utilized, currently available technologies. Methods: Following a registered protocol (CRD42014010323), we searched 16 databases for articles published in English until 31 December 2014 discussing the use of either mobile or Web 2.0 technologies to promote WM or related behaviors, i.e. diet and physical activity (PA). Two reviewers independently selected reviews and assessed their methodological quality using the AMSTAR checklist. Citation matrices were used to determine the overlap among reviews. Results: Forty-four eligible reviews were identified, 39 of which evaluated the effects of interventions using mobile or Web 2.0 technologies. Methodological quality was generally low with only 7 reviews (16%) meeting the highest standards. Suggestive evidence exists for positive effects of mobile technologies on weight-related outcomes and, to a lesser extent, PA. Evidence is inconclusive regarding Web 2.0 technologies. Conclusions : Reviews on mobile and Web 2.0 interventions for WM and related behaviors suggest that these technologies can, under certain circumstances, be effective, but conclusions are limited by poor review quality based on a heterogeneous evidence base. PMID:27335330

Design and implementation of a randomized controlled social and mobile weight loss trial for young adults (project SMART).

PubMed

Patrick, K; Marshall, S J; Davila, E P; Kolodziejczyk, J K; Fowler, J H; Calfas, K J; Huang, J S; Rock, C L; Griswold, W G; Gupta, A; Merchant, G; Norman, G J; Raab, F; Donohue, M C; Fogg, B J; Robinson, T N

2014-01-01

To describe the theoretical rationale, intervention design, and clinical trial of a two-year weight control intervention for young adults deployed via social and mobile media. A total of 404 overweight or obese college students from three Southern California universities (M(age) = 22( ± 4) years; M(BMI) = 29( ± 2.8); 70% female) were randomized to participate in the intervention or to receive an informational web-based weight loss program. The intervention is based on behavioral theory and integrates intervention elements across multiple touch points, including Facebook, text messaging, smartphone applications, blogs, and e-mail. Participants are encouraged to seek social support among their friends, self-monitor their weight weekly, post their health behaviors on Facebook, and e-mail their weight loss questions/concerns to a health coach. The intervention is adaptive because new theory-driven and iteratively tailored intervention elements are developed and released over the course of the two-year intervention in response to patterns of use and user feedback. Measures of body mass index, waist circumference, diet, physical activity, sedentary behavior, weight management practices, smoking, alcohol, sleep, body image, self-esteem, and depression occur at 6, 12, 18, and 24 months. Currently, all participants have been recruited, and all are in the final year of the trial. Theory-driven, evidence-based strategies for physical activity, sedentary behavior, and dietary intake can be embedded in an intervention using social and mobile technologies to promote healthy weight-related behaviors in young adults. Copyright © 2013 Elsevier Inc. All rights reserved.

Finding the Beta for a Portfolio Isn't Obvious: An Educational Example

ERIC Educational Resources Information Center

Chong, James; Jennings, William P.; Phillips, G. Michael

2018-01-01

When a portfolio is not actively managed to maintain a fixed investment percentage in each asset but rather maintains a fixed number of shares for each asset, the portfolio weights will change over time because the market returns of the different assets will not be the same. Consequently, portfolio betas computed as a linear combination of asset…

The Use of Standing Frames for Contracture Management for Nonmobile Children with Cerebral Palsy

ERIC Educational Resources Information Center

Gibson, Susan K.; Sprod, Judy A.; Maher, Carol A.

2009-01-01

The objective of this study was to determine whether static weight-bearing in a standing frame affected hamstring length and ease of activities of daily living (ADLs) in nonambulant children with cerebral palsy (CP). A convenient sample of nonambulant children with CP was recruited for this one-group quasi-experimental study. Participants stood in…

Eating as a cultural expression of caring among Afro-Caribbean and African American Women: Understanding the cultural dimensions of obesity

PubMed Central

Bramble, Joy; Cornelius, Llewellyn J.; Simpson, Gaynell M.

2013-01-01

Background Obesity is a growing problem in the United States that is disproportionately increasing among persons of African Americans, yet little is know about the cultural factors that relate to dietary patterns, obesity and exercise among African Americans and other groups of African descent. The purpose of this paper is to examine the cultural context under which physical activity, healthy eating and weight management is viewed among African American and Caribbean American women. Methods Four focus groups were conducted of Afro-Caribbean and African American women (age 40 and older) between May and July of 2007 to explore cultural factors related to physical activity, healthy eating and weight management. Results Cultural variation was observed among Afro-Caribbean and African American woman in terms of indigenous traditions of food and preparation. These traditions influenced how they approached eating, views of obesity and exercise. At the same time community and economic factors influence the availability of healthy eating and exercise alternatives. Conclusions In the development of interventions to improve obesity among persons of African descent it may be important not to assume that one size fits all in terms of community based interventions PMID:19711493

Cardiovascular risk reduction and weight management at a hospital-based postpartum preeclampsia clinic.

PubMed

Janmohamed, Rahim; Montgomery-Fajic, Erin; Sia, Winnie; Germaine, Debbie; Wilkie, Jodi; Khurana, Rshmi; Nerenberg, Kara A

2015-04-01

Women who develop preeclampsia during pregnancy are at high risk of developing future chronic diseases, including premature cardiovascular disease. We have established an interdisciplinary clinic that aims to prevent cardiovascular disease through educational counselling focused on lifestyle modifications in the early postpartum period. The objective of this study was to evaluate changes in weight and cardiovascular risk factors in participating women after six months of attendance at the clinic. We conducted a retrospective chart review of women who had a pregnancy complicated by preeclampsia, and who subsequently attended the Postpartum Preeclampsia Clinic. Study subjects had baseline assessments of lifestyle, physical, and laboratory parameters. Individualized goals for cardiovascular risk reduction and lifestyle were established, centering on physical activity and dietary modifications. The primary outcome was change in weight. Over the study period, 21 women were seen for a minimum of six months of follow-up. At an average (± SD) of 4.4 ± 1.4 months postpartum, subjects showed a non-significant improvement in weight (mean weight loss of 0.4 ± 4.5 kg) and BMI (mean decrease in BMI 0.1 ± 1.7 kg/m2). Physical activity improved significantly, from 14% of subjects participating in physical activity before pregnancy to 76% at a mean of 4.4 months postpartum. This study has demonstrated the early benefits of a longitudinal interdisciplinary intervention with counselling about lifestyle modifications for prevention of cardiovascular disease in women with recent preeclampsia. A study with a larger sample size and longer duration of follow-up is planned to confirm these findings.

Process Evaluation Results from an Environmentally Focused Worksite Weight Management Study

ERIC Educational Resources Information Center

DeJoy, David M.; Wilson, Mark G.; Padilla, Heather M.; Goetzel, Ron Z.; Parker, Kristin B.; Della, Lindsay J.; Roemer, Enid C.

2012-01-01

There is currently much interest in exploring environmental approaches to combat weight gain and obesity. This study presents process evaluation results from a workplace-based study that tested two levels of environmentally focused weight management interventions in a manufacturing setting. The moderate treatment featured a set of relatively…

Antioxidant activities of bambara groundnut (Vigna subterranea) protein hydrolysates and their membrane ultrafiltration fractions.

PubMed

Arise, Abimbola K; Alashi, Adeola M; Nwachukwu, Ifeanyi D; Ijabadeniyi, Oluwatosin A; Aluko, Rotimi E; Amonsou, Eric O

2016-05-18

In this study, the bambara protein isolate (BPI) was digested with three proteases (alcalase, trypsin and pepsin), to produce bambara protein hydrolysates (BPHs). These hydrolysates were passed through ultrafiltration membranes to obtain peptide fractions of different sizes (<1, 1-3, 3-5 and 5-10 kDa). The hydrolysates and their peptide fractions were investigated for antioxidant activities. The membrane fractions showed that peptides with sizes <3 kDa had significantly (p < 0.05) reduced surface hydrophobicity when compared with peptides >3 kDa. This is in agreement with the result obtained for the ferric reducing power, metal chelating and hydroxyl radical scavenging activities where higher molecular weight peptides exhibited better activity (p < 0.05) when compared to low molecular weight peptide fractions. However, for all the hydrolysates, the low molecular weight peptides were more effective diphenyl-1-picrylhydrazyl (DPPH) radical scavengers but not superoxide radicals when compared to the bigger peptides. In comparison with glutathione (GSH), BPHs and their membrane fractions had better (p < 0.05) reducing power and ability to chelate metal ions except for the pepsin hydrolysate and its membrane fractions that did not show any metal chelating activity. However, the 5-10 kDa pepsin hydrolysate peptide fractions had greater (88%) hydroxyl scavenging activity than GSH, alcalase and trypsin hydrolysates (82%). These findings show the potential use of BPHs and their peptide fraction as antioxidants in reducing food spoilage or management of oxidative stress-related metabolic disorders.

Nicotine Withdrawal; Measure Your Symptoms (Quiz)

MedlinePlus

... Challenges When Quitting Nicotine Withdrawal Cravings & Triggers Handling Stress Manage Your Mood Weight Gain & Appetite Stay Smokefree for Good Stick with It Weight Management Eat Healthy Get ...

Randomised controlled trial and economic analysis of an internet-based weight management programme: POWeR+ (Positive Online Weight Reduction).

PubMed

Little, Paul; Stuart, Beth; Hobbs, Fd Richard; Kelly, Jo; Smith, Emily R; Bradbury, Katherine J; Hughes, Stephanie; Smith, Peter Wf; Moore, Michael V; Lean, Mike Ej; Margetts, Barrie M; Byrne, Christopher D; Griffin, Simon; Davoudianfar, Mina; Hooper, Julie; Yao, Guiqing; Zhu, Shihua; Raftery, James; Yardley, Lucy

2017-01-01

Behavioural counselling with intensive follow-up for obesity is effective, but in resource-constrained primary care settings briefer approaches are needed. To estimate the clinical effectiveness and cost-effectiveness of an internet-based behavioural intervention with regular face-to-face or remote support in primary care, compared with brief advice. Individually randomised three-arm parallel trial with health economic evaluation and nested qualitative interviews. Primary care general practices in the UK. Patients with a body mass index of ≥ 30 kg/m 2 (or ≥ 28 kg/m 2 with risk factors) identified from general practice records, recruited by postal invitation. Positive Online Weight Reduction (POWeR+) is a 24-session, web-based weight management intervention completed over 6 months. Following online registration, the website randomly allocated participants using computer-generated random numbers to (1) the control intervention ( n  = 279), which had previously been demonstrated to be clinically effective (brief web-based information that minimised pressure to cut down foods, instead encouraging swaps to healthier choices and increasing fruit and vegetables, plus 6-monthly nurse weighing); (2) POWeR+F ( n  = 269), POWeR+ supplemented by face-to-face nurse support (up to seven contacts); or (3) POWeR+R ( n  = 270), POWeR+ supplemented by remote nurse support (up to five e-mails or brief telephone calls). The primary outcome was a modelled estimate of average weight reduction over 12 months, assessed blind to group where possible, using multiple imputation for missing data. The secondary outcome was the number of participants maintaining a 5% weight reduction at 12 months. A total of 818 eligible individuals were randomised using computer-generated random numbers. Weight change, averaged over 12 months, was documented in 666 out of 818 participants (81%; control, n  = 227; POWeR+F, n  = 221; POWeR+R, n  = 218). The control group maintained nearly 3 kg of weight loss per person (mean weight per person: baseline, 104.4 kg; 6 months, 101.9 kg; 12 months, 101.7 kg). Compared with the control group, the estimated additional weight reduction with POWeR+F was 1.5 kg [95% confidence interval (CI) 0.6 to 2.4 kg; p  = 0.001] and with POWeR+R was 1.3 kg (95% CI 0.34 to 2.2 kg; p  = 0.007). By 12 months the mean weight loss was not statistically significantly different between groups, but 20.8% of control participants, 29.2% of POWeR+F participants (risk ratio 1.56, 95% CI 0.96 to 2.51; p  = 0.070) and 32.4% of POWeR+R participants (risk ratio 1.82, 95% CI 1.31 to 2.74; p  = 0.004) maintained a clinically significant 5% weight reduction. The POWeR+R group had fewer individuals who reported doing another activity to help lose weight [control, 47.1% (64/136); POWeR+F, 37.2% (51/137); POWeR+R, 26.7% (40/150)]. The incremental cost to the health service per kilogram weight lost, compared with the control group, was £18 (95% CI -£129 to £195) for POWeR+F and -£25 (95% CI -£268 to £157) for POWeR+R. The probability of being cost-effective at a threshold of £100 per kilogram was 88% and 98% for POWeR+F and POWeR+R, respectively. POWeR+R was dominant compared with the control group. No harms were reported and participants using POWeR+ felt more enabled in managing their weight. The qualitative studies documented that POWeR+ was viewed positively by patients and that health-care professionals generally enjoyed supporting patients using POWeR+. Maintenance of weight loss after 1 year is unknown. Identifying strategies for longer-term engagement, impact in community settings and increasing physical activity. Clinically valuable weight loss (> 5%) is maintained in 20% of individuals using novel written materials with brief follow-up. A web-based behavioural programme and brief support results in greater mean weight loss and 10% more participants maintain valuable weight loss; it achieves greater enablement and fewer participants undertaking other weight-loss activities; and it is likely to be cost-effective. Current Controlled Trials ISRCTN21244703. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol. 21, No. 4. See the NIHR Journals Library website for further project information.

Morinda citrifolia L. leaf extract prevent weight gain in Sprague-Dawley rats fed a high fat diet.

PubMed

Jambocus, Najla Gooda Sahib; Ismail, Amin; Khatib, Alfi; Mahomoodally, Fawzi; Saari, Nazamid; Mumtaz, Muhammad Waseem; Hamid, Azizah Abdul

2017-01-01

Background : Morinda citrifolia L. is widely used as a folk medicinal food plant to manage a panoply of diseases, though no concrete reports on its potential anti-obesity activity. This study aimed to evaluate the potential of M. citrifolia leaf extracts (MLE60) in the prevention of weight gain in vivo and establish its phytochemical profile. Design : Male Sprague-Dawley rats were divided into groups based on a normal diet (ND) or high fat diet (HFD), with or without MLE60 supplementation (150 and 350 mg/kg body weight) and assessed for any reduction in weight gain. Plasma leptin, insulin, adiponectin, and ghrelin of all groups were determined. 1 H NMR and LCMS methods were employed for phytochemical profiling of MLE60. Results : The supplementation of MLE60 did not affect food intake indicating that appetite suppression might not be the main anti-obesity mechanism involved. In the treated groups, MLE60 prevented weight gain, most likely through an inhibition of pancreatic and lipoprotein activity with a positive influence on the lipid profiles and a reduction in LDL levels . MLE60 also attenuated visceral fat deposition in treated subjects with improvement in the plasma levels of obesity-linked factors . 1 Spectral analysis showed the presence of several bioactive compounds with rutin being more predominant. Conclusion : MLE60 shows promise as an anti-obesity agents and warrants further research.

Weight loss strategies for adolescents: a 14-year-old struggling to lose weight.

PubMed

Ludwig, David S

2012-02-01

With prevalence approaching 20% in the United States, adolescent obesity has become a common problem for patients, parents, and clinicians. Obese adolescents may experience physical and psychosocial complications, as illustrated by the case of Ms K, a 14-year-old girl with a body mass index of 40. Unfortunately, the effectiveness of pediatric obesity treatment is modest in younger children and declines in older children and adolescents, and few interventions involving adolescents have produced significant long-term weight loss. Nevertheless, novel strategies to alter energy balance have shown preliminary evidence of benefit in clinical trials, including a diet focused on food quality rather than fat restriction and a lifestyle approach to encourage enjoyable physical activity throughout the day rather than intermittent exercise. Parents can have an important influence on weight-related behaviors in adolescents despite typically complicated emotional dynamics at this age, especially through the use of noncoercive methods. A key parenting practice applicable to children of all ages is to create a protective environment in the home, substituting nutritious foods for unhealthful ones and facilitating physical activities instead of sedentary pursuits. Other behaviors that may promote successful long-term weight management include good sleep hygiene, stress reduction, and mindfulness. Ultimately, the obesity epidemic can be attributed to changes in the social environment that hinder healthful lifestyle habits, and prevention will require a comprehensive public health strategy.

Outcomes of weight management in obese pet dogs: what can we do better?

PubMed

German, Alexander J

2016-08-01

Obesity is arguably the biggest health and welfare issue affecting pet dogs. Although successful weight loss has health benefits, current strategies are far from ideal. Many obese dogs that start a weight programme fail to lose weight, or subsequently regain the weight they have lost. Given that current weight loss strategies are not perfect, clinicians need to focus carefully on tailoring the programme, perhaps setting a pragmatic target for weight loss, so as to ensure the benefits are maximised. This review will summarise key findings from recent clinical research into pet obesity, and present a framework for improving success, by better tailoring weight management regimens and end points to the individual.

A data management system for weight control and design-to-cost

NASA Technical Reports Server (NTRS)

Bryant, J. C.

1978-01-01

The definition of the mass properties data of aircraft changed on a daily basis as do design details of the aircraft. This dynamic nature of the definition has generally encouraged those responsible for the data to update the data on a weekly or monthly basis. The by-product of these infrequent updates was the requirement of manual records to maintain daily activity. The development of WAVES changed the approach to management of mass properties data. WAVES has given the ability to update the data on a daily basis thereby eliminating the need for manual records. WAVES has demonstrated that a software product can support a data management system for engineering data.

Design of a cluster-randomized trial of electronic health record-based tools to address overweight and obesity in primary care.

PubMed

Baer, Heather J; Wee, Christina C; DeVito, Katerina; Orav, E John; Frolkis, Joseph P; Williams, Deborah H; Wright, Adam; Bates, David W

2015-08-01

Primary care providers often fail to identify patients who are overweight or obese or discuss weight management with them. Electronic health record-based tools may help providers with the assessment and management of overweight and obesity. We describe the design of a trial to examine the effectiveness of electronic health record-based tools for the assessment and management of overweight and obesity among adult primary care patients, as well as the challenges we encountered. We developed several new features within the electronic health record used by primary care practices affiliated with Brigham and Women's Hospital in Boston, MA. These features included (1) reminders to measure height and weight, (2) an alert asking providers to add overweight or obesity to the problem list, (3) reminders with tailored management recommendations, and (4) a Weight Management screen. We then conducted a pragmatic, cluster-randomized controlled trial in 12 primary care practices. We randomized 23 clinical teams ("clinics") within the practices to the intervention group (n = 11) or the control group (n = 12). The new features were activated only for clinics in the intervention group. The intervention was implemented in two phases: the height and weight reminders went live on 15 December 2011 (Phase 1), and all of the other features went live on 11 June 2012 (Phase 2). Study enrollment went from December 2011 through December 2012, and follow-up ended in December 2013. The primary outcomes were 6-month and 12-month weight change among adult patients with body mass index ≥25 who had a visit at one of the primary care clinics during Phase 2. Secondary outcome measures included the proportion of patients with a recorded body mass index in the electronic health record, the proportion of patients with body mass index ≥25 who had a diagnosis of overweight or obesity on the electronic health record problem list, and the proportion of patients with body mass index ≥25 who had a follow-up appointment about their weight or were prescribed weight loss medication. We encountered challenges in our development of an intervention within the existing structure of an electronic health record. For example, although we decided to randomize clinics within primary care practices, this decision may have introduced contamination and led to some imbalance of patient characteristics between the intervention and control practices. Using the electronic health record as the primary data source reduced the cost of the study, but not all desired data were recorded for every participant. Despite the challenges, this study should provide valuable information about the effectiveness of electronic health record-based tools for addressing overweight and obesity in primary care. © The Author(s) 2015.

Understanding barriers and facilitators to healthy eating and physical activity from patients either before and after knee arthroplasty.

PubMed

Pellegrini, Christine A; Ledford, Gwendolyn; Chang, Rowland W; Cameron, Kenzie A

2017-05-05

We sought to identify patient-reported barriers and facilitators to healthy eating and physical activity among patients before or after knee arthroplasty. Twenty patients with knee osteoarthritis aged 40-79 years who had knee arthroplasty surgery scheduled or completed within 3 months were interviewed. Interview topics included perceived barriers and facilitators to healthy eating and activity before or after surgery. Interviews were coded and analyzed using constant comparative analysis. Interviews were completed with 11 pre-operative (67.1 ± 7.6 years, 45.5% female, BMI 31.2 ± 6.3) and nine post-operative patients (61.7 ± 11.7 years, 44.4% female, BMI 30.2 ± 4.7 kg/m 2 ). The most commonly identified personal barriers to healthy eating identified were desire for high-fat/high-calorie foods, managing overconsumption and mood. Factors related to planning, portion control and motivation to improve health were identified as healthy eating facilitators. Identified personal barriers for activity included pain, physical limitations and lack of motivation, whereas facilitators included having motivation to improve knee symptoms/outcomes, personal commitment to activity and monitoring activity levels. Identifying specific eating and activity barriers and facilitators, such as mood and motivation to improve outcomes, provides critical insight from the patient perspective, which will aid in developing weight management programs during rehabilitation for knee arthroplasty patients. Implications for rehabilitation This study provides insight into the identified barriers and facilitators to healthy eating and physical activity in knee arthroplasty patients, both before and after surgery. Intrapersonal barriers that may hinder engagement in physical activity and rehabilitation include pain, physical limitations and lack of motivation; factors that may help to improve activity and the rehabilitation process include being motivated to improve knee outcomes, having a personal commitment to activity and tracking activity levels. Barriers that may interfere with healthy eating behaviors and knee arthroplasty rehabilitation include the desire for high-fat/high-calorie foods, overeating and mood; whereas planning and portion control may help to facilitate healthy eating. Understanding barriers and facilitators to healthy eating and physical activity can help guide rehabilitation professionals with their discussions on weight management with patients who had or are contemplating knee arthroplasty.