Behavioral approaches to weight control: A review of current research

Weight management is a salient issue for women. Studies of behavioral, pharmacological and surgical interventions indicate that women comprise the majority of patients presenting for weight-loss treatment. In this review we discuss the health impact of obesity for women, review behavioral treatments for adult overweight and obesity, and address topics of particular relevance for women, including concerns that weight-loss treatment may precipitate the development of eating pathology, as well as time periods of high risk for weight gain such as pregnancy and menopause

What Do Physicians Recommend To Their Overweight and Obese Patients?

Background: It is recognized that physicians play an important role in responding to the nation\u27s obesity epidemic. Little is known, however, about what physicians say to their obese patients to help them lose weight. Objective: This cross-sectional survey examined weight loss recommendations of family physicians and internists. Surveys were mailed to 188 physicians and 54% (n = 101) responded. The survey assessed physicians’ weight loss recommendations, the basis for recommendations, and their expected weight loss outcomes for a hypothetical patient. Physicians rated the extent to which they recommended various weight control strategies to their obese patients. They also rated the extent to which clinical experience, personal experience, and the medical literature were important in formulating their recommendations. Results: The most common strategies recommended were increasing physical activity, reducing consumption of fast foods, reducing portion sizes, and reducing soda consumption. Physicians were less likely to recommended regular self-weighing, recording food intake, and decreasing television viewing. Meal replacements and weight loss medications were rarely advised. Physicians reported that they based their weight loss recommendations more on clinical experience than on the medical literature or personal experience; these latter 2 were rated as equally important. Physicians reported that, from their perspective, the equivalent of a 21.5% weight loss would be an acceptable outcome for a hypothetical obese patient; a 10.6% weight loss disappointing. Conclusions: Physicians, like patients, need to be educated about the benefits of modest weight loss and the weight loss strategies empirically proven to be most effective, including self-monitoring. Further research is needed to understand the barriers to recommending and implementing these effective strategies

Internal Disinhibition Predicts Weight Regain Following Weight Loss and Weight Loss Maintenance

Objective: The disinhibition scale of the Eating Inventory predicts weight loss outcome; however, it may include multiple factors. The purpose of this study was to examine the factor structure of the disinhibition scale and determine how its factors independently relate to long-term weight loss outcomes. Research Methods and Procedures: Exploratory factor analysis of the disinhibition scale was conducted on 286 participants in a behavioral weight loss trial (TRIM), and confirmatory factor analysis was conducted on 3345 members of the National Weight Control Registry (NWCR), a registry of successful weight loss maintainers. Multivariate regressions were used to examine the relationships between the disinhibition scale factors and weight over time in both samples. Results: Using baseline data from TRIM, two factors were extracted from the disinhibition scale: 1) an internal factor that described eating in response to internal cues, such as feelings and thoughts; and 2) an external factor that described eating in response to external cues, such as social events. This factor structure was confirmed using confirmatory factor analysis in the NWCR. In TRIM, internal disinhibition significantly predicted weight loss at 6 months (p = 0.03) and marginally significantly predicted weight loss at 18 months (p = 0.06), with higher levels of internal disinhibition at baseline predicting less weight loss; external disinhibition did not predict weight loss at any time-point. In NWCR, internal disinhibition significantly predicted one-year weight change (p = 0.001), while external disinhibition did not. Discussion: These results suggest that it is the disinhibition of eating in response to internal cues that is associated with poorer long-term weight loss outcomes

The role of adherence in mediating the relationship between depression and health outcomes

This article is part of our research for the doctoral thesis, which studies the labor experiences of young workers of a multinational supermarket company in the city of Rosario. In this particular text we will focus on the discussion about the short-term nature of work in the sector and how it is linked to the agency of the subjects. One of the general conclusions that we emphasize in our research was that the experiences in relation to the temporary place that has the work in the supermarket constituted the meaning of the work for these subjects. It was a central problem that linked the status of worker with the most general life experiences. In this article, we will focus in particular on analyzing these temporary experiences, placing the look on their explanation and how they relate to the agency of the subjects.Este artículo es parte de nuestra investigación realizada para la tesis doctoral que tiene como problemática el estudio de las experiencias laborales de jóvenes trabajadores en una empresa multinacional de supermercados en la ciudad de Rosario. En este texto en particular nos centraremos en la discusión sobre la temporalidad del trabajo en el sector y cómo se vincula con la agencia de los sujetos. Una de las conclusiones generales que destacamos en nuestra investigación fue que las experiencias en relación con el lugar temporal que tiene el trabajo en el supermercado eran constitutivas de una serie de dimensiones que conforman el significado del trabajo para estos sujetos. Se trató de un núcleo central que vinculaba la condición de trabajador con las experiencias de vida más generales. En este trabajo nos centraremos particularmente en analizar estas experiencias temporales, ubicando la mirada en la explicación de las mismas y en cómo se relacionan con la agencia de los sujetos

Home grocery delivery improves the household food environments of behavioral weight loss participants: Results of an 8-week pilot study

<p>Abstract</p> <p>Background</p> <p>Household food availability is consistently linked to dietary intake; yet behavioral weight control treatment includes only minimal instruction on how to change the home environment to support dietary goals. This pilot study examined whether it is feasible to change the household food environments of behavioral weight loss participants through the use of a commercially available grocery home delivery service.</p> <p>Methods</p> <p>Overweight participants (N = 28; BMI = 31.7 ± 3.6 kg/m²; 89.3% women, 47.9 ± 9.5 years) were randomly assigned to 8-weeks of standard behavioral weight loss (SBT) or to SBT plus home food delivery (SBT+Home). SBT+Home participants were instructed to do their household grocery shopping via an online service affiliated with a regional supermarket chain and were reimbursed for delivery charges.</p> <p>Results</p> <p>Compared to SBT, SBT+Home produced significantly greater reductions in the total number of foods in the home (p = .01) and number of foods that were high in fat (p = .002). While the groups did not differ in 8-week weight losses, within SBT+Home there was a trend for the number of home deliveries to be associated with weight loss (p = .08). Participants reported that the home delivery service was easy to use and that it helped decrease impulse purchases and lead to healthier choices; however, few planned to continue using the service after the study.</p> <p>Conclusion</p> <p>Encouraging weight loss participants to use a commercially available online grocery ordering and home delivery service reduces the overall number of food items in the home and decreases access to high-fat food choices. More research is needed to determine whether this is a viable strategy to strengthen stimulus control and improve weight loss outcomes.</p

The Relationship between Physical Activity Variety and Objectively Measured Moderate-to-Vigorous Physical Activity Levels in Weight Loss Maintainers and Normal-Weight Individuals

Given the importance of physical activity (PA) for weight control, identifying strategies to achieve higher PA levels is imperative. We hypothesized that performing a greater variety of self-reported moderate-to-vigorous activities (MVPAs) would relate to higher objectively measured MVPA minutes in two groups who were successfully maintaining their body weight: weight loss maintainers (WLM/n = 226) and normal-weight individuals (NW/n = 169). The Paffenbarger Questionnaire and RT3 accelerometer were used to determine variety/number of different MVPAs performed and MVPA minutes, respectively. The variety/number of different activities performed by WLM and NW was similar (1.8 ± 1.2 versus 1.7 ± 1.2, P = 0.52). Regression analyses showed that greater variety (P < 0.01) and WLM status (P < 0.05) were each positively related to greater MVPA minutes/day and meeting the ≥250 MVPA minutes/week guideline for long-term weight maintenance. The association between greater variety and higher MVPA was similar in NW and WLM. Future studies should test whether variety can facilitate engagement in higher MVPA levels for more effective weight control

What Distinguishes Weight-Loss Maintainers from the Treatment-Seeking Obese? Analysis of Environmental, Behavioral, and Psychosocial Variables in Diverse Populations

Background Understanding the factors that influence successful weight control is critical for developing interventions. Purpose The purpose of the study was to provide a comprehensive understanding of the role of psychosocial, environmental, and behavioral variables in distinguishing weight-loss maintainers (WLM) from treatment-seeking obese (TSO). Methods WLM (n=167) had lost ≥10% of their maximum body weight, had kept the weight off for ≥5 years, and were now of normal weight. TSO-1 and TSO-2 had a history of dieting and body mass index ≥25. TSO-1 was predominantly Caucasian; TSO-2 was predominantly African-American. Bayesian model averaging was used to identify the variables that distinguished WLM from TSO-1 and TSO-2. Results The variables that most consistently discriminated WLM from TSO were more physical activity (ORs = 3.95 and 2.85), more dietary restraint (ORs = 1.63 and 1.41), and less dietary disinhibition (ORs = 0.69 and 0.83). Environmental variables, including the availability of physical activity equipment, TVs, and high-fat foods in the home, also distinguished WLM from TSO. Conclusions Obesity treatment should focus on increasing conscious control over eating, engaging in physical activity, and reducing disinhibition. Changes in the home environment may help facilitate these behavioral changes

Recruitment of young adults for weight gain prevention: randomized comparison of direct mail strategies

Abstract Background Recruiting young adults (ages 18–35 years) into weight gain prevention intervention studies is challenging and men are particularly difficult to reach. This paper describes two studies designed to improve recruitment for a randomized trial of weight gain prevention interventions. Study 1 used a quasi-experimental design to test the effect of two types of direct mailings on their overall reach. Study 2 used a randomized design to test the effect of using targeted messages to increase recruitment of men into the trial. Methods For Study 1, 60,000 male and female young-adult households were randomly assigned to receive either a recruitment brochure or postcard. Visits to recruitment websites during each mailing period were used to assess response to each mailing. Study 2 focused on postcard recruitment only. These households received either a targeted or generic recruitment postcard, where targeted postcards included the word “Men” in the headline text. Response rates to each type of card were categorized based on participant report of mailing received. Results The reach of the postcards and brochures were similar (421 and 386 website visits, respectively; P = 0.22). Individuals who received the brochure were more likely to initiate the online screener than those who received a postcard (P = 0.01). In Study 2, of those who completed the telephone screening, 60.9 % of men (n = 23) had received the targeted postcard as compared to the generic postcard (39.1 %, P = 0.30). The reverse was true for women (n = 62, 38.7 vs. 61.3 %, P = 0.08). Conclusions These studies suggest there was little difference in the reach of postcards versus brochures. However, recipients of brochures were more likely to continue to the next stage of study participation. As expected, men’s response to the weight gain prevention messages was lower than women’s response; but using targeted messages appears to have modestly increased the proportion of male respondents. These studies add to the limited experimental literature on recruitment messaging and provide further indication for using targeted messages to reach underrepresented populations while providing initial evidence on the effect of mailing type on message reach. Trial registration The Study of Novel Approaches to Weight Gain Prevention was registered with ClinicalTrials.gov (identifier: NCT01183689) on 13 August 2010

Preventing Weight Gain in Young Adults. A Randomized Controlled Pilot Study

Weight gain in young adults is an important public health problem and few interventions have been successful