Maintenance of Weight Loss in Adolescents: Current Status and Future Directions

There is a dearth of research on the long-term efficacy and safety of treatments for adolescent obesity. This narrative review examined several approaches to treatment, focusing on long-term effectiveness data in adolescents, as well as relevant findings from studies of adults. The available research suggests that lifestyle modification has promise in obese adolescents, although it is not clear that any particular dietary or physical activity approach is more effective than another. Meal replacements are quite effective in adults and deserve further research in adolescents. Extending the length of treatment to teach weight loss maintenance skills is likely to improve long-term outcomes in adolescents, and delivering treatment via the Internet or telephone is a novel way of doing so. Treatment that combines lifestyle modification with the medication orlistat generally appears to be safe but only marginally superior to lifestyle modification alone. More research is needed on the management of adolescent obesity, which has been overlooked when compared with research on the treatment of obesity in children and adults

Computerized neurocognitive training for improving dietary health and facilitating weight loss

Nearly 70% of Americans are overweight, in large part because of overconsumption of high-calorie foods such as sweets. Reducing sweets is difficult because powerful drives toward reward overwhelm inhibitory control (i.e., the ability to withhold a prepotent response) capacities. Computerized inhibitory control trainings (ICTs) have shown positive outcomes, but impact on real-world health behavior has been variable, potentially because of limitations inherent in existing paradigms, e.g., low in frequency, intrinsic enjoyment, personalization, and ability to adapt to increasing ability. The present study aimed to assess the feasibility, acceptability, and efficacy of a gamified and non-gamified, daily, personalized, and adaptive ICT designed to facilitate weight loss by targeting consumption of sweets. Participants (N = 106) were randomized to one of four conditions in a 2 (gamified vs. non-gamified) by 2 (ICT vs. sham) factorial design. Participants were prescribed a no-added-sugar diet and completed 42 daily, at-home trainings, followed by two weekly booster trainings. Results indicated that the ICTs were feasible and acceptable. Surprisingly, compliance to the 44 trainings was excellent (88.8%) and equivalent across both gamified and non-gamified conditions. As hypothesized, the impact of ICT on weight loss was moderated by implicit preference for sweet foods [F(1,95) = 6.17, p = .02] such that only those with higher-than-average implicit preference benefited (8-week weight losses for ICT were 3.1% vs. 2.2% for sham). A marginally significant effect was observed for gamification to reduce the impact of ICT. Implications of findings for continued development of ICTs to impact health behavior are discussed

A Proof-of-Concept Pilot Test of a Behavioral Intervention to Improve Adherence to Dietary Recommendations for Cancer Prevention

OBJECTIVES: Prevention programs that can help adults improve the quality of their diets to reduce cancer risk are needed. This Phase IIa study prospectively tested a mHealth intervention designed to improve adherence to dietary quality guidelines for cancer prevention. METHODS: All participants (N = 62) received nutrition education and a self-regulation skills curriculum, with a primary target of changing grocery shopping behavior. Using a randomized, factorial design, the study varied whether each of the following 4 components were added to the 20-week intervention: (1) location-triggered app messaging, delivered when individuals arrived at grocery stores, (2) reflections on benefits of change, delivered with extra coaching time and tailored app messages, (3) coach monitoring, in which food purchases were digitally monitored by a coach, and (4) involvement of a household member in the intervention. RESULTS: Benchmarks were successfully met for recruitment, retention, and treatment acceptability. Across conditions, there were significant reductions in highly processed food intake ( CONCLUSION: This study showed feasibility, acceptability, and preliminary signals of efficacy of a remotely delivered intervention to facilitate adherence to dietary guidelines for cancer prevention and that coach monitoring and household support may be especially effective strategies. A fully powered clinical trial is warranted to test an optimized version of the intervention that includes nutrition education, self-regulation skills training, coach monitoring, and household member involvement. TRIAL REGISTRATION: ClinicalTrials.gov NCT04947150

The Effects of Physical Activity on Cancer Patients Undergoing Treatment with Immune Checkpoint Inhibitors: A Scoping Review

Background: Cancer therapies are associated with multiple adverse effects, including (but not limited to) cancer-related fatigue (CRF). Fatigue is one of the most common side effects of immune checkpoint inhibitors (ICIs), occurring in up to 25% of patients. Physical activity has been shown to help reduce CRF through modulating the immune system, and may synergistically aid in the anti-tumor effects of ICIs. This review describes the nature and scope of evidence for the effects associated with concurrent physical activity while undergoing ICI therapy. Method: Scoping review methodology was utilized to identify studies, extract data, and collate and summarize results. Results: In literature published from January 2010 through to August 2021, only one human study and three pre-clinical studies met inclusion criteria. Conclusion: Existing evidence supports that physical activity is associated with decreased treatment-related toxicities such as CRF. However, further investigation is warranted. The dearth of clinical studies illustrates the need for more research to address this question, to guide patients and their providers in the application of appropriate physical activity interventions in those patients undergoing ICI

The Effects of Physical Activity on Cancer Patients Undergoing Treatment with Immune Checkpoint Inhibitors: A Scoping Review.

BACKGROUND: Cancer therapies are associated with multiple adverse effects, including (but not limited to) cancer-related fatigue (CRF). Fatigue is one of the most common side effects of immune checkpoint inhibitors (ICIs), occurring in up to 25% of patients. Physical activity has been shown to help reduce CRF through modulating the immune system, and may synergistically aid in the anti-tumor effects of ICIs. This review describes the nature and scope of evidence for the effects associated with concurrent physical activity while undergoing ICI therapy. METHOD: Scoping review methodology was utilized to identify studies, extract data, and collate and summarize results. RESULTS: In literature published from January 2010 through to August 2021, only one human study and three pre-clinical studies met inclusion criteria. CONCLUSION: Existing evidence supports that physical activity is associated with decreased treatment-related toxicities such as CRF. However, further investigation is warranted. The dearth of clinical studies illustrates the need for more research to address this question, to guide patients and their providers in the application of appropriate physical activity interventions in those patients undergoing ICI

Randomized trial of weight gain prevention interventions for young women: Effectiveness and influence on bulimic pathology

Potential interventions for weight gain prevention include encouraging weight self-monitoring and teaching strategies that facilitate healthy eating. In young women, such interventions may also positively influence risk for disordered eating. In this pilot study, 70 normal weight young women were randomly assigned to 1) an assessment-only control group; 2) a weight monitoring (WM) intervention; or 3) a weight monitoring plus healthy eating condition (WM+HE). After 8 weeks, participants’ weight significantly increased, on average, but weight change did not differ across groups. Positive changes in some weight control behaviors were observed in WM+HE participants who participated in most intervention activities. Iatrogenic effects on eating behavior were not observed in either intervention, although the statistical power to detect such changes was limited.Ph.D., Clinical Psychology -- Drexel University, 200

Consistent Self-Monitoring of Weight: A Key Component of Successful Weight Loss Maintenance

Objective: The objectives were to investigate the characteristics associated with frequent self-weighing and the relationship between self-weighing and weight loss maintenance. Research Methods and Procedures: Participants (n = 3003) were members of the National Weight Control Registry (NWCR) who had lost ≥30 lbs, kept it off for ≥1 year, and had been administered the self-weighing frequency assessment used for this study at baseline (i.e., entry to the NWCR). Of these, 82% also completed the one-year follow-up assessment. Results: At baseline, 36.2% of participants reported weighing themselves at least once per day, and more frequent weighing was associated with lower BMI and higher scores on disinhibition and cognitive restraint, although both scores remained within normal ranges. Weight gain at 1-year follow-up was significantly greater for participants whose self-weighing frequency decreased between baseline and one year (4.0 ± 6.3 kg) compared with those whose frequency increased (1.1 ± 6.5 kg) or remained the same (1.8 ± 5.3 kg). Participants who decreased their frequency of self-weighing were more likely to report increases in their percentage of caloric intake from fat and in disinhibition, and decreases in cognitive restraint. However, change in self-weighing frequency was independently associated with weight change. Discussion: Consistent self-weighing may help individuals maintain their successful weight loss by allowing them to catch weight gains before they escalate and make behavior changes to prevent additional weight gain. While change in self-weighing frequency is a marker for changes in other parameters of weight control, decreasing self-weighing frequency is also independently associated with greater weight gain

Understanding the Effects of Physical Activity on the Cancer Patient Currently Undergoing Treatment with Immune Checkpoint Inhibitors: A Scoping Review Protocol

Scoping review protoco

Pilot Trial of an Acceptance-Based Behavioral Intervention to Promote Physical Activity Among Adolescents

Prior interventions have shown limited efficacy in increasing the number of adolescents engaging in adequate physical activity (PA). Preliminary evidence suggests acceptance-based behavioral treatments (ABTs) may increase PA; however, this approach has not been tested in adolescents. This was a nonrandomized experimental pilot study that examined feasibility, acceptability, and treatment outcomes of a school-based, acceptance-based behavioral intervention for PA. Adolescents (n = 20) with low activity received a PA tracking device and were allocated to device use only or device use plus 10-weeks of ABT. PA, cardiovascular fitness, and physiological outcomes were measured pre- and postintervention. The intervention was found to be feasible and acceptable. PA, cardiovascular fitness, and physiological outcomes improved over time in the intervention group, but not in the comparison condition. This study demonstrated feasibility, acceptability, and preliminary treatment efficacy based on effect sizes for an acceptance-based behavioral intervention to increase PA in adolescents