WEIGHT MAINTENANCE FOLLOWING THE COMPLETION OF A WEIGHT LOSS TRIAL: EXPLORING RACIAL DIFFERENCES

Overweight and obesity are widespread, global health problems due in part to the relapse and weight gain that often follows weight loss treatment. Moreover, racial minorities are disproportionately affected by this chronic disorder. Empirical evidence is needed to better address the problem of poor weight maintenance after loss. This ancillary, prospective study examined weight maintenance 18 months after a behavioral weight loss trial and explored possible differences between black and white participants in percent weight change and successful weight maintenance. The relationships of psychosocial variables - experiences following a low-fat diet, barriers to healthy eating, self-efficacy for resisting eating and for exercising, social support, and stress - with weight maintenance were investigated as well as whether race moderated these relationships. Additionally, the study examined the behavioral strategies used for weight maintenance and explored dietary intake and physical activity as potential mediators of the relationship between psychosocial variables and weight maintenance. Hierarchical linear and logistic regression models were used to examine the effect of race, as well as the effect of psychosocial variables, on percent weight change and successful weight maintenance (defined as ≤ 5% weight regain), after controlling for age, gender, education, income, and marital status. Descriptive statistics and group comparative statistics (t-tests or Mann Whitney U tests) were used to examine behavioral strategies utilized for weight maintenance. Path analysis investigated possible mediation effects of lifestyle variables on percent weight change. Fifty-seven percent of the 107 participants (58% of the 81 white participants and 54% of the 26 black participants) were successful weight maintainers. No difference was found in weight maintenance between racial groups; black and white individuals gained a similar amount of weight (M = 5.0%, SD = 6.6% and M = 4.4%, SD = 5.6%, respectively). An increase in barriers to healthy eating and the impact of a stressful life event on eating affected the percent weight gained and unsuccessful weight maintenance, ps < .04. Most behavioral strategies for weight maintenance were used less than half the time. Dietary intake and physical activity did not mediate the relationship between the examined psychosocial variables and weight maintenance.A difference in weight maintenance between black and white individuals was not supported by this study. Future research should further explore the weight control barriers that individuals experience and the impact of stress on weight maintenance

Efficacy of a Manualized and Workbook-Driven Individual Treatment for Social Anxiety Disorder

Social anxiety disorder is a prevalent and impairing disorder for which viable cognitive-behavioral therapies exist. However, these treatments have not been easily packaged for dissemination and may be underutilized as a result. The current study reports on the findings of a randomized controlled trial of a manualized and workbook-driven individual cognitive-behavioral treatment for social anxiety disorder (Hope, Heimberg, Juster, & Turk, 2000; Hope, Heimberg, & Turk, 2006). This treatment package was derived from an empirically supported group treatment for social anxiety disorder and intended for broad dissemination, but it has not previously been subjected to empirical examination on its own. As a first step in that examination, 38 clients seeking treatment for social anxiety disorder at either the Adult Anxiety Clinic of Temple University or the Anxiety Disorders Clinic of the University of Nebraska–Lincoln were randomly assigned to receive either immediate treatment with this cognitive-behavioral treatment package or treatment delayed for 20 weeks. Evaluation at the posttreatment/postdelay period revealed substantially greater improvements among immediate treatment clients on interviewer-rated and self-report measures of social anxiety and impairment. Three-month follow-up assessment revealed maintenance of gains. Clinical implications and directions for future research are discussed

Speech Communication

Contains table of contents for Part V, table of contents for Section 1, reports on six research projects and a list of publications.C.J. Lebel FellowshipDennis Klatt Memorial FundNational Institutes of Health Grant R01-DC00075National Institutes of Health Grant R01-DC01291National Institutes of Health Grant R01-DC01925National Institutes of Health Grant R01-DC02125National Institutes of Health Grant R01-DC02978National Institutes of Health Grant R01-DC03007National Institutes of Health Grant R29-DC02525National Institutes of Health Grant F32-DC00194National Institutes of Health Grant F32-DC00205National Institutes of Health Grant T32-DC00038National Science Foundation Grant IRI 89-05249National Science Foundation Grant IRI 93-14967National Science Foundation Grant INT 94-2114

Adherence to mobile-app-based dietary self-monitoring-Impact on weight loss in adults

Objectives: Greater dietary self-monitoring adherence is associated with weight loss, however, the dietary self-monitoring adherence criteria that predict weight loss are unknown. The criteria used to define adherence to dietary self-monitoring in obesity treatment tend to vary, particularly in studies that include dietary self-monitoring via mobile applications (apps). The objectives of this study were to (a) determine weight change outcomes related to app-based dietary self-monitoring and (b) determine the associations between the frequency, consistency, and completeness of dietary self-monitoring and weight change. Methods: In this single-arm uncontrolled prospective study, employees at a large, urban health system who had overweight or obesity self-monitored dietary intake for 8 weeks using the Calorie Counter by FatSecret app. A paired sample t-test examined the association of app-based dietary self-monitoring and weight change; linear regression examined the associations of frequent, consistent, and complete dietary self-monitoring and weight change. Results: A significant mean difference [t (89) = 6.59, p \u3c 0.001] was found between baseline and 8-week weight (M = −1.5 ± 2.1 kg) in the sample (N = 90). Linear regression revealed a significant association [F (1, 88) = 7.18, p = 0.009] between total weeks of consistent dietary self-monitoring (M = 4.4 ± 2.8) and percent weight loss (M = −1.54% ± 2.26%), and a significant association [F (1, 88) = 6.42, p = 0.013] between dietary self-monitoring frequency (M = 50.1% ± 33.3%) and percent weight loss. The total weeks of complete dietary self-monitoring (M = 3.42 ± 2.87) was not associated [F (1, 88) = 3.57, p = 0.062] with percent weight loss. Conclusions: Consistent and frequent app-based dietary self-monitoring were associated with short-term weight loss. Emphasizing these aspects of self-monitoring may be an avenue for decreasing the burden of self-monitoring

Identification of Protease Specificity by Combining Proteome-Derived Peptide Libraries and Quantitative Proteomics

We present protease specificity profiling based on quantitative proteomics in combination with proteome-derived peptide libraries. Peptide libraries are generated by endoproteolytic digestion of proteomes without chemical modification of primary amines before exposure to a protease under investigation. After incubation with a test protease, treated and control libraries are differentially isotope-labeled using cost-effective reductive dimethylation. Upon analysis by liquid chromatography–tandem mass spectrometry, cleavage products of the test protease appear as semi-specific peptides that are enriched for the corresponding isotope label. We validate our workflow with two proteases with well-characterized specificity profiles: trypsin and caspase-3. We provide the first specificity profile of a protease encoded by a human endogenous retrovirus and for chlamydial protease-like activity factor (CPAF). For CPAF, we also highlight the structural basis of negative subsite cooperativity between subsites S1 and S2′. For A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) -4, -5, and -15, we show a canonical preference profile, including glutamate in P1 and glycine in P3′. In total, we report nearly 4000 cleavage sites for seven proteases. Our protocol is fast, avoids enrichment or synthesis steps, and enables probing for lysine selectivity as well as subsite cooperativity. Due to its simplicity, we anticipate usability by most proteomic laboratories

Experiences of self-monitoring: Successes and struggles during treatment for weight loss

We interviewed 15 individuals who completed a behavioral weight loss treatment study with the aim of exploring participants' reflections on their feelings, attitudes, and behaviors while using a paper diary to self-monitor their diet. Constant comparative and matrix analysis procedures were used to analyze interview data; the qualitative results were then interfaced with descriptive numerical data on individuals' adherence to self-monitoring and weight loss. Three categories of self-monitoring experience were identified: (a) well-disciplined - those who had high adherence to self-monitoring, high weight loss, and a "can do" positive approach, (b) missing the connection - those who had moderate adherence, moderate- to low weight loss, and an "it's an assignment" approach, without integrating self-monitoring into everyday life, and (c) diminished support - those who had poor adherence, poor weight control, and were adversely affected by coexisting negative factors. Given the variations in how individuals integrated the process of self-monitoring, we need to consider individualizing self-monitoring strategies to improve adherence. © 2009 The Author(s)