Weight-loss practices and asthma: findings from the behavioral risk factor surveillance system

OBJECTIVE: To describe weight-control practices and receipt of weight-loss advice among obese people with asthma. RESEARCH METHODS AND PROCEDURES: We analyzed data from the 2000 Behavioral Risk Factor Surveillance System. RESULTS: Among 13953 participants with current asthma, 27.3% had a body mass index of >or=30 kg/m2. Overall, 48.1% of participants with asthma reported trying to lose weight (64.1% among overweight or obese participants and 72.9% among obese participants). Among participants with asthma who were trying to lose or maintain weight, 74.7% reported trying to reduce their energy and/or fat intake, and 57.8% reported using physical activity. Approximately 29.7% were using the recommended combination of energy and/or fat intake reduction and physical activity of >or=150 min/wk. During the 12 months before the interview, 16.2% of overweight and 44.9% of obese participants with asthma reported receiving advice to lose weight. Among obese participants receiving weight-loss advice, 82.9% reported trying to lose weight compared to 63.8% of participants who did not receive such advice. DISCUSSION: Health professionals can play an important role in educating their patients with asthma about the importance of weight control and assisting their overweight and obese patients in setting appropriate weight goals and helping them achieve those goals.     

Diet and physical activity behaviors among Americans trying to lose weight: 2000 Behavioral Risk Factor Surveillance System

OBJECTIVE: To examine the prevalence and correlates of trying to lose weight among U.S. adults, describe weight loss strategies, and assess attainment of recommendations for weight control (eating fewer calories and physical activity). RESEARCH METHODS AND PROCEDURES: This study used the Behavioral Risk Factor Surveillance System, a state-based telephone survey of adults > or =18 years of age (N = 184,450) conducted in the 50 states, the District of Columbia, and Puerto Rico in 2000. RESULTS: The prevalence of trying to lose weight was 46% (women) and 33% (men). Women reported trying to lose weight at a lower BMI than did men; 60% of overweight women were trying to lose weight, but men did not reach this level until they were obese. Adults who had a routine physician checkup in the previous year and reported medical advice to lose weight vs. checkup and no medical advice to lose weight had a higher prevalence of trying to lose weight (81% women and 77% men vs. 41% women and 28% men, respectively). The odds of trying to lose weight increased as years of education increased. Among respondents who were trying to lose weight, approximately 19% of women and 22% of men reported using fewer calories and > or =150 min/wk leisure-time physical activity. DISCUSSION: A higher percentage of women than men were trying to lose weight; both sexes used similar weight loss strategies. Education and medical advice to lose weight were strongly associated with trying to lose weight. Most persons trying to lose weight were not using minimum recommended weight loss strategies.     

Perceived health risk of excess body weight among overweight and obese men and women: differences by sex

OBJECTIVES: To describe perceptions of health risk from excess body weight among adults, and assess if lack of perceived risk was associated with trying to lose weight. METHODS: Sex-specific logistic regression models were used to determine odds of disagreement that one's weight is a health risk and odds of trying to lose weight among overweight (BMI=25.0-29.9 kg/m(2), n=1296) and obese (BMI> or =30 kg/m(2), n=1335) adult participants in the 2004 Styles' surveys. RESULTS: Men were more likely than women to disagree their body weight was a health risk (among the overweight, 62% vs. 43%; the obese 20% vs. 14% obese). Disagreement with risk was associated with good health status and race/ethnicity among both sexes and lower education and income among women. Odds of currently trying to lose weight were significantly lower among obese men who disagreed, and overweight men and women who were neutral or disagreed that their body weight was a health risk. CONCLUSIONS: Many overweight and obese adults do not perceive their weight to be a health risk; this perception was associated with lower prevalence of trying to lose weight, particularly among men. Discussion by clinicians about the health risks of excess weight may alter perceived risk and help promote weight loss efforts.     

Physical activity, food choice, and weight management goals and practices among US college students

INTRODUCTION: Physical activity and a healthy diet have been recommended to help reverse the increasing prevalence of overweight among adolescents and adults in the United States. METHODS: Data is from the 1995 National College Health Risk Behavior Survey. A representative sample of US undergraduate college students (n = 4609) were analyzed to examine associations of physical activity and food choice with weight management goals and practices. RESULTS: Based on self-reported height and weight, 35% of students were overweight or obese (body mass index > or = 25.0). Nearly half (46%) of all students reported they were trying to lose weight. Female students were less likely than male students to be overweight, but more likely to be trying to lose weight. Among female and male students, using logistic regression to control for demographics, trying to lose weight was associated with participation in vigorous physical activity and strengthening exercises, and consumption of < or = 2 servings/ day of high-fat foods. Female and male students who reported using exercise to lose weight or to keep from gaining weight were more likely than those who did not to participate in vigorous, strengthening, and moderate physical activity, and were more likely to eat > or = 5 servings/day of fruits and vegetables and < or = 2 servings/day of high-fat foods. Among students who were trying to lose weight, only 54% of females and 41% of males used both exercise and diet for weight control. CONCLUSION: Colleges should implement programs to increase student awareness of healthy weight management methods and the importance of physical activity combined with a healthy diet.     

Obesity in Inner‐city African Americans

Objective. Obesity, a risk factor for chronic diseases, has a high prevalence in African Americans and low‐income individuals. However, little is known about perceptions of overweight, attempts to lose weight, and strategies used to lose weight among African Americans in inner cities.

Design. A 1990 cross‐sectional telephone survey (n = 1445) of north St Louis and central Kansas City, USA.

Results. Obesity was common (44%) in this sample of inner‐city African Americans. The obese perceived themselves as overweight (70%) and were trying to lose weight (66%). The majority of the obese (68%) were both dieting and exercising to lose weight. Smoking prevalence was not higher among the obese or those trying to lose weight. Many of the obese had received medical advice recently on low‐fat diets (51%) and had been advised to lose weight (40%). Factors independently associated with perception, attempts to lose weight and medical advice differed, but included degree of obesity.

Conclusions. These results corroborate US national data that obesity is a public health problem in this population and that obese inner‐city African Americans perceive themselves as overweight and are trying to lose weight, especially as degree of obesity increases. It also appears that smoking is not being used as a weight loss strategy and that the obese, as a group, are receiving some medical advice on low‐fat diets. This information is critical for designing culturally sensitive weight‐control programmes.     

Predictors of weight control advice in primary care practices: patient health and psychosocial characteristics

BACKGROUND: Past research has surveyed primary care physicians (PCP) about their attitudes and practices towards obese patients, yet less is known about the patients receiving advice. METHODS: The Primary Care Weight Control Project (PCWC) enrolled 18 PCPs in a randomized clinical trial and asked 255 of their patients who were either overweight or obese at baseline about past weight control advice. RESULTS: At baseline, 66.4% of patients reported that their physician previously told them they were overweight. Body mass index (BMI) was a strong predictor of being identified as obese. While 65.1% received information on the health benefits of weight loss, only 36.6% of patients were ever given specific weight control advice, and 28.2% were advised to increase their physical activity. A history of type 2 diabetes, high cholesterol, or hypertension was associated with physician-delivered weight control advice. Stages of change and number of prior visits with the PCP were also associated with physician advice. CONCLUSIONS: Patients were more likely to receive education about weight loss than specific behavioral advice on how to lose weight. Physicians were more likely to provide weight control advice to their patients who had obesity-related comorbidities than to patients who were overweight or obese and without risk factors.     

Obesity prevalence among veterans at Veterans Affairs medical facilities

BACKGROUND: Obesity is a significant public health problem in the United States. Comprehensive obesity prevalence data among veterans have not been previously reported. METHODS: This is a cross-sectional analysis of 1,803,323 veterans receiving outpatient care at 136 Veterans Affairs (VA) medical facilities in 2000. Measured weight, height, and demographic data were used to obtain age-adjusted prevalences of body mass index (BMI) categories, which were stratified by gender and examined by age and race/ethnicity. RESULTS: Of 93,290 women American veterans receiving care at VA medical facilities during 2000, 68.4% were at least overweight (body mass index [BMI]> or =25 kg/m(2)), with 37.4% classified as obese (BMI> or =30 kg/m(2)), and 6.0% as class-III obese (BMI> or =40 kg/m(2)). Of 1,710,032 men, 73.0% were at least overweight, 32.9% were obese, and 3.3% were class-III obese. Among women, obesity prevalence increased into the sixth and seventh decade of life before prevalence began to decline. Among men, prevalence was lowest for those aged <30 and >70. By race/ethnicity, Native American women (40.7%) and men (35.1%) had the highest prevalence of obesity, while Asian-American women (12.8%) and men (20.6%) had the lowest. CONCLUSIONS: There is a substantial burden of obesity among veterans using VA medical facilities. A comprehensive approach for weight management by the Veterans Health Administration is needed.     

Peer Reviewed: Lifestyle Behaviors and Physician Advice for Change Among Overweight and Obese Adults With Prediabetes and Diabetes in the United States, 2006

Introduction

The objective of this study was to examine the lifestyle behaviors of overweight and obese people with prediabetes or diabetes and to determine whether an association exists between reported behaviors and physician advice for behavior change.

Methods

This investigation included overweight and obese people (body mass index ≥25.0 kg/m²) with prediabetes and diabetes aged 40 years or older identified from the 2006 National Health Interview Survey. Respondents reported attempts to control or lose weight, reduce the amount of fat or calories in their diet, and increase physical activity. Respondents also reported receipt of a physician recommendation for behavioral change in 1 or more of these areas. Data analysis included use of logistic regression stratified by sex and prediabetes/diabetes status to model odds of behavior by physician advice.

Results

Most people reported trying to control or lose weight (prediabetes, 82%; diabetes, 75%). Fewer identified efforts to reduce the amount of fat or calories in their diet (prediabetes, 62%; diabetes, 71%) or increase physical activity (prediabetes, 53%; diabetes, 57%). Approximately one-third reported not receiving physician advice for each of these behavior changes. In logistic regression, physician advice for reducing the amount of fat or calories in the diet and increasing physical activity was generally associated with the reported corresponding behavior.

Conclusion

Many respondents reported trying to control or lose weight, but fewer reported actually reducing fat or calories in their diet or increasing physical activity. Physician advice may influence attempts at behavior change among overweight and obese patients with prediabetes and diabetes.     

Arthritis, body mass index, and professional advice to lose weight: implications for clinical medicine and public health

BACKGROUND: Arthritis is the leading cause of disability in the United States. Obesity is a risk factor for arthritis, but the relationship between arthritis and weight has not been well characterized at the population level in the United States. Previous research shows that physicians often fail to advise their obese patients to lose weight. OBJECTIVES: To describe the relationship between body weight and arthritis in the United States, and to assess predictors of efforts to lose weight among obese adults with arthritis, including the impact of professional advice to lose weight. METHODS: Data from the 2000 Behavioral Risk Factor Surveillance System (a population-based survey of U.S. adults) from the 35 states that collected information on weight and height, arthritis, and efforts to lose weight. Arthritis was based on self-report of doctor diagnosis or chronic joint symptoms. Main outcome measures were arthritis and efforts to lose weight among adults with arthritis. RESULTS: Overall, 31.7% of respondents had self-reported arthritis. There was a strong relationship between body weight and arthritis. Specifically, the prevalence of arthritis was 25.9% among normal weight (18.5 to 24.9 body mass index [BMI]) adults; 32.1% among overweight (25 to 29.9 BMI) adults; and 43.5% among obese (>30 BMI) adults. This association persisted after adjusting for other factors (adjusted odds ratio [AOR] for having arthritis among obese individuals compared with healthy weight individuals, 3.6; 95% confidence interval [CI]=3.2-3.8). Among obese adults with arthritis who had a routine checkup within the past 12 months, only 43% were advised to lose weight by a health professional. However, recipients of such advice were more likely to try to lose weight than nonrecipients, and professional advice was the strongest independent predictor of weight loss efforts (AOR=2.8; 95% CI=2.5-3.1). CONCLUSIONS: Body mass index (BMI) is an important independent risk factor for self-reported arthritis. Although physicians often fail to advise obese adults with arthritis to lose weight, adults who report receiving such advice were more likely to report weight-loss efforts. Improved awareness of the relationship between arthritis and weight might help motivate patients to lose weight, and physician advice to lose weight could contribute to the prevention and treatment of arthritis.     

Ecologic correlates of obesity in rural obese adults

OBJECTIVE: We examined relationships of individual and environmental factors with obesity and trying to lose weight in rural residents. METHODS: The joint contributions of individual and environmental factors on obesity status (obese vs. morbidly obese) and trying to lose weight (yes vs. no) were evaluated using generalized estimating equations. Patients at 29 clinics in rural areas (N = 414, M age 55.0 years (SD = 15.4), 66.3% female) completed anthropometric assessments of weight and height along with survey assessments of individual sociodemographics and trying to lose weight. Rural environments were assessed on aggregated physician access, and sociodemographic context. RESULTS: Most participants (70%, M BMI = 38.3) were obese and 30% morbidly obese. A majority (73%, n = 302) of the sample was trying to lose weight. Compared to obese, morbidly obese participants were more likely to be younger, disproportionately female, not have private insurance, have more comorbid conditions, and rate themselves in worse health in comparison to their obese peers. Compared to not trying to lose weight, trying to lose weight participants were more likely to be younger, disproportionately female, have fewer comorbid conditions, and have attempted to lose weight more times through exercise. Few relationships were seen between environmental variables and obesity or trying to lose weight. CONCLUSIONS: There was no consistent pattern of relationships between environment factors and obesity or trying to lose weight was seen. Unique aspects of rural living may not be captured by traditionally available neighborhood measures.     

Geographic variation in the prevalence of obesity, diabetes, and obesity-related behaviors

OBJECTIVE: To examine the variation in the prevalences of obesity and type 2 diabetes in weight loss counseling by health providers and in other potential obesity-related determinants in 100 metropolitan statistical areas in the United States. RESEARCH METHODS AND PROCEDURES: We performed a cross-sectional study using data from the 2000 Behavioral Risk Factor Surveillance System, the largest telephone survey of health behaviors in the United States, of age-adjusted prevalence of obesity, type 2 diabetes, intake of >or=five servings of fruits and vegetables per day, participation in 150 minutes of leisure-time physical activity per week, receipt of weight management advice, and reports of trying to lose or maintain weight among men and women more than 18 years old. RESULTS: The age-adjusted prevalence of obesity ranged from 13.1% to 30.0% and that of type 2 diabetes from 3.3% to 9.2%. Among participants who had visited a physician for a routine checkup in the previous 12 months, 13.1% to 27.1% of all participants recalled receiving advice from a health professional about their weight, and 11.7% to 34.6% of overweight or obese participants recalled receiving advice to maintain or lose weight. DISCUSSION: Significant differences in the prevalence of obesity and self-reported type 2 diabetes and in medical practice patterns regarding weight management advice exist among metropolitan statistical areas. These results suggest important opportunities to investigate reasons for these variations that could potentially be used to mitigate the current epidemic of obesity and to identify areas where obesity and diabetes prevention efforts may need to be targeted.     

Correlates of body mass index, weight goals, and weight-management practices among adolescents

The study examined associations among physical activity, cigarette smoking, body mass index, perceptions of body weight, weight-management goals, and weight-management behaviors of public high school adolescents. The CDC Youth Risk Behavior Survey provided a cross-sectional sample (n = 3,089) of public high school students in South Carolina. Logistic regression models were constructed separately for four race-gender groups. Adjusted odds ratios and 95% confidence intervals were calculated to determine the magnitude of associations. Based on self-reported height and weight, 13% of students were overweight, while 15% were at risk for becoming overweight. However, 42% of students were trying to lose weight, and 22% were trying to maintain current weight. Female students were less likely than male students to be overweight, but more likely to be attempting to lose weight. Extreme weight control practices were reported by 27% of the sample. Among Black females trying to lose weight, positive associations were observed for strengthening exercises (OR = 1.55), but that relationship was associated inversely in Black males (OR = .600). Among White females, attempted weight loss was associated with strengthening exercises (OR = 1.72) and cigarette smoking (OR = 1.54). For White males, attempted weight loss was associated positively with vigorous exercise (OR = 1.41) and inversely related to moderate exercise (OR = .617). Effective weight-management practices for adolescents should focus on appropriate eating behaviors, physical activity, and low-fat/calorie diets. Multicomponent weight management interventions should be conducted within a coordinated school health framework.     

Weight management goals and practices among U.S. high school students: associations with physical activity, diet, and smoking.

PURPOSE: To examine associations of physical activity, fruit and vegetable consumption, and cigarette smoking with weight management goals and practices of U.S. high school students.METHODS: Data were from the 1999 national Youth Risk Behavior Survey, a representative sample of U.S. high school students (n = 15,349). Adjusted odds ratios (OR) were calculated to describe associations, controlling for demographic characteristics.RESULTS: Based on self-reported height and weight, 25% of students were either overweight (11%) or at risk for becoming overweight (14%). However, 43% of students were trying to lose weight and 19% of students were trying to maintain their current weight. Female students were less likely than male students to be overweight, but more likely to be trying to lose weight. Trying to lose weight was associated with vigorous physical activity (OR = 1.5), strengthening exercises (OR = 2.2), and cigarette smoking (OR = 1.4) among female students; and vigorous physical activity (OR = 1.6), strengthening exercises (OR = 1.8), and eating > or =5 servings/day of fruits and vegetables (OR = 1.5) among male students. Among students trying to lose weight or stay the same weight, only 62% of females and 41% of males combined exercise with a reduced fat and calorie diet, while 32% of females and 17% of males used unhealthy weight control methods (fasting, diet pills, vomiting, or laxatives).CONCLUSIONS: Efforts to promote healthy weight management among adolescents are needed and should place greater emphasis on combining physical activity with a reduced fat and calorie diet, increasing fruit and vegetable consumption, and discouraging smoking and other unhealthy weight control practices.     

A national study of the prevalence of overweight and obesity in 6-12 y-old Swiss children: body mass index, body-weight perceptions and goals

OBJECTIVES: To estimate the prevalence of overweight and obesity in Swiss children and to obtain information on weight perceptions and weight control practices in this population. DESIGN: Cross-sectional, three-stage, probability-proportionate-to-size cluster sampling. SETTING: Middle schools throughout Switzerland. SUBJECTS: A representative national sample of 595 6-12 y-old schoolchildren. INTERVENTION: Measurement of weight and height; interview on weight perceptions and weight control practices. RESULTS: Body mass index (BMI) was calculated and used as an indicator of overweight. The BMIs of the Swiss children were compared with US, UK, French and Swiss reference data. Depending on which reference data were used, the prevalence of obesity varied between 9.7 and 16.1% and the prevalence of overweight varied between 21.7 and 34.2%. Girls were significantly more likely to consider themselves too fat (26% and 15%, respectively) and to report currently trying to lose weight (30% and 18%, respectively) compared to boys (P<0.05). CONCLUSIONS: The prevalence of overweight in Swiss children, and its attendant health and social consequences, are important public health concerns. SPONSORSHIP: The Swiss Foundation for Nutrition Research, Zürich, Switzerland.     

Trying to Lose or Maintain Weight During Pregnancy—United States, 2003

Objectives Current pregnancy weight gain recommendations are for women to gain between 15 and 40 pounds; weight loss or weight maintenance is not recommended. However, for many women, overweight and obesity are chronic conditions, and commitment to weight loss or maintenance could override advice to gain weight during pregnancy. Our objective was to determine the prevalence of trying to lose or maintain weight among U.S. women during pregnancy. Methods The Behavioral Risk Factor Surveillance System is a state-based, random-digit-dialed telephone survey of noninstitutionalized, U.S. civilians aged ≥18 years. We identified women aged 18–44 years who reported being pregnant during 2003 (n = 2,464), assessed the prevalence of trying to lose or maintain weight and assessed independent associations with selected demographic, clinical, and behavioral factors using multinomial logistic regression. Results Among women who reported being pregnant, 7.5% (confidence interval [CI] = 5.7–9.8%) and 34.3% (CI = 31.0–37.7%) were trying to lose or maintain weight, respectively. Among women who reported trying to lose or maintain weight, exercise was a more prevalent weight control strategy than dietary change. After adjustment, women who drank alcohol during the past 30 days (Odds ratio [OR] = 8.86, CI: 4.51–17.42) or women who received advice in the past year to lose weight (OR = 9.10, CI: 3.20–25.87) were more likely to report trying to lose weight; women advised to maintain (OR = 0.20, CI: 0.07–0.60) or gain (OR = 0.04, CI: 0.01–0.23) weight were less likely to report trying to lose weight. Conclusions Despite guidelines to gain weight during pregnancy, about 8% and 34% of U.S. pregnant women reported trying to lose or maintain weight, respectively. Providers may encounter an increasing number of pregnant women whose weight control intentions conflict with current guidelines for pregnancy weight gain. Further research in this area is warranted. The conclusions in this report are those of the authors and do not necessarily reflect those of the Centers for Disease Control and Prevention.     

Weight-loss strategies and beliefs in high and low socioeconomic areas of Melbourne

Abstract: Overweight is a serious health risk and is prevalent in Australia. This study explored sex, socioeconomic status and age differences in body mass index, the perceived effectiveness of weight-loss strategies and the frequency of their use, and awareness of the risks of obesity in a random sample of adult men (n = 457) and women (n = 537) from higher and lower socioeconomic areas. According to self-reports, 37 per cent of the sample were overweight or obese. More men than women, and more older than younger respondents, were overweight. There were no sex differences in the frequency of obesity. There were significantly more obese individuals in the lower than in the higher socioeconomic area. Women more frequently put themselves in a higher weight category while men more frequently put themselves in a lower weight category. Fifty-eight per cent of respondents reported the desire to lose weight and 24 per cent of the sample were trying to lose weight on the survey day; 46.9 per cent had attempted to lose weight in the previous 12 months, and these were more likely to be female, younger and obese or overweight. Only minor differences according to sex or socioeconomic status were found in beliefs about the effectiveness of different weight-loss strategies. However, older respondents were less likely to have exercised recently as a means of weight reduction. There was good recognition of diseases made worse by being overweight, although the health risk of male fat distribution patterns was not widely known.     

Overweight and obesity: knowledge, attitudes, and practices of general practitioners in france

OBJECTIVE: To describe the current knowledge, attitudes, and practices of French general practitioners (GPs) in the field of adult overweight and obesity management. RESEARCH METHODS AND PROCEDURES: A cross-sectional telephone survey interviewed a sample of 600 GPs, representative of the private GPs in southeastern France. A four-part questionnaire assessed personal and professional characteristics, attitudes and opinions about overweight and obesity, relevant knowledge and training, and practices (diagnostic methods, clinical assessments, weight loss objectives, types of counseling). RESULTS: Most GPs knew that weight problems are health-threatening, and 79% agreed that managing these problems is part of their role. Nevertheless, 58% did not feel they perform this role effectively, and one-third did not find it professionally gratifying. Approximately 30% had negative attitudes toward overweight and obese patients; 57% were pessimistic about patients' ability to lose weight; 64% often set weight loss objectives more demanding than guidelines call for; and neither food diaries nor nutritional education were used systematically. GPs' feelings of effectiveness and attitudes toward obese patients were associated with some professional (training) and personal (BMI, personal diet experience) characteristics. DISCUSSION: GPs' feelings of ineffectiveness may stem from an underlying conflict between practitioners' and patients' representations of weight problems and the relationship problems this causes. Inadequate practices and health care system organization may also play a role.     

Who is Counseled to Lose Weight? Survey Results and Anthropometric Data from 3,149 Lower Socioeconomic Women

Because obesity is a grave public health concern, this study examined the percentage of disadvantaged women who recalled ever having received weight loss advice from a healthcare provider and factors associated with such advice. This study was part of a 5-clinic, cervical cancer prevention trial. Patients not immediately post-partum completed a Spanish/English survey; height and weight were also obtained. Of the 3,149 respondents (response rate 83%), 2,138 (68%) were overweight or obese (body mass index (BMI) ≥ 25); 94% reported a household income of <$35,000/year; 69% were Hispanic; 10% non-Hispanic black; and 40% completed the survey in Spanish. Only one-third reported ever having been told to lose weight. Based on BMI, these rates were 15% in the 25–29.9 range (overweight); 34% within 30–34.9; 57% within 35–39.9; and 73% ≥ 40. In univariate analyses, among overweight women, diabetes or English-speaking was associated with weight loss advice. In multivariate analyses, being older, more educated, and diabetic were associated with such advice. 48% of non-Hispanic whites, 31% of non-Hispanic blacks, and 29% of Hispanic had a home scale. Among disadvantaged women, obesity alone does not determine who recalls weight loss advice. Language barriers and lack of a home scale merit further study to address obesity.     

Socioeconomic status and weight control practices in British adults

STUDY OBJECTIVE: Attitudes and practices concerning weight control in British adults were examined to test the hypothesis that variation in concern about weight and deliberate weight control might partly explain the socioeconomic status (SES) gradient in obesity. Higher SES groups were hypothesised to show more weight concern and higher levels of dieting. SETTING: Data were collected as part of the monthly Omnibus Survey of the Office of National Statistics in March 1999. PARTICIPANTS: A stratified, probability sample of 2690 households was selected by random sampling of addresses in Britain. One randomly selected person in each household was interviewed at their home. MAIN RESULTS: As predicted, higher SES men and women had higher levels of perceived overweight, monitored their weight more closely, and were more likely to be trying to lose weight. Higher SES groups also reported more restrictive dietary practices and more vigorous physical activity. CONCLUSIONS: The results are consistent with the idea that part of the protection against weight gain in higher SES groups could be a higher frequency of weight monitoring, a lower threshold for defining themselves as overweight, and a greater likelihood of deliberate efforts at weight control.     

Weight loss attempts and attitudes toward body size, eating, and physical activity in American Indian children: relationship to weight status and gender

OBJECTIVE: This study examined dieting, weight perceptions, and self-efficacy to eat healthy foods and engage in physical activity and their relationships to weight status and gender among American Indian elementary schoolchildren. RESEARCH METHODS AND PROCEDURES: Data for this study were collected as part of the baseline examination for the Pathways study. Participants were 1441 second- through third-grade American Indian children in 41 schools representing seven tribes in Arizona, New Mexico, and South Dakota who filled out a questionnaire and had heights and weights taken. RESULTS: Forty-two percent of the children were overweight or obese. No differences were found between overweight/obese and normal weight children for healthy food intentions or self-efficacy. Heavier children (especially those with body mass index > 95th percentile) were more likely to have tried to lose weight or were currently trying to lose weight. No gender differences were found. Normal weight children chose a slightly heavier body size as most healthy compared with overweight/obese children. DISCUSSION: The results indicate that children are concerned about their weight and that weight modification efforts are common among overweight American Indian children. School, community, and family-based programs are needed to help young people adopt lifelong healthful eating and physical activity practices.