Attempting to lose weight: specific practices among U.S. adults

BACKGROUND: Americans spend over $33 billion annually on weight-loss products and services. Although weight-control methods are of considerable public health interest, few national data on weight-loss practices are available. This paper examines the prevalence of specific weight-loss practices among U.S. adults trying to lose weight. METHODS: Data from the 1998 National Health Interview Survey, which was conducted through face-to-face interviews of a nationally representative sample of U.S. adults (n =32,440), were analyzed in 2003. RESULTS: Twenty-four percent of men and 38% of women were trying to lose weight. Attempting weight loss was less common among normal weight (body mass index [BMI]<25 kg/m(2)) people (6% men, 24% women) than overweight (BMI>/=25 to 30 kg/m(2)) people (28%, 49%) or obese (BMI>/=30 kg/m(2)) people (50%, 58%). Among those trying to lose weight, the most common strategies were eating fewer calories (58% men, 63% women); eating less fat (49%, 56%); and exercising more (54%, 52%). Less frequent strategies were skipping meals (11% men, 9% women); eating food supplements (5%, 6%); joining a weight-loss program (3%, 5%); taking diet pills (2%, 3%); taking water pills or diuretics (1%, 2%); or fasting for >/=24 hours (0.6%, 0.7%). Only one third of all those trying to lose weight reported eating fewer calories and exercising more. CONCLUSIONS: Increased efforts are needed among all those trying to lose weight to promote effective strategies for weight loss, including the use of calorie reduction and increased physical activity.     

Weight-loss intention in the well-functioning, community-dwelling elderly: associations with diet quality, physical activity, and weight change

BACKGROUND: Many older adults desire to lose weight, yet the proportion with a health-related weight-loss indication, weight-loss strategies, and success is unknown. OBJECTIVE: We examined the associations of reported intention to lose weight with health-related indications for weight loss, diet quality, physical activity, and weight-loss success in well-functioning older adults. DESIGN: This prospective, community-based cohort included 2708 elderly persons aged 70-79 y at baseline. We determined indication for weight loss by using the modified National Institutes of Health guidelines, diet quality by using the Healthy Eating Index, and weight-loss intention and physical activity by using questionnaires. Measured weight change over 1 y was assessed. RESULTS: Twenty-seven percent of participants reported an intention to lose weight, and 67% of those participants had an indication for weight loss. Participants who reported a weight-loss intention were heavier than those who did not, had more depressive symptoms, and were more likely to be dissatisfied with their weight, regardless of weight-loss indication. Participants with an intention to lose weight reported better eating behaviors and a more active lifestyle than did participants without a weight-loss intention, independent of other health conditions. No significant difference in actual weight loss was found between participants intending and not intending to lose weight, regardless of indication for weight loss. CONCLUSIONS: Despite being associated with healthier behaviors, the intention to lose weight did not predict greater weight loss in this well-functioning elderly cohort. More attention needs to be focused on the necessity and efficacy of specific strategies for weight loss in older adults.     

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.     

Obesity, weight loss, and physician's advice

Despite the increasing prevalence and economic costs of obesity in the USA, many physicians and other health care professionals do not advise their overweight and obese patients about weight loss. Using the 2001-2003 Behavioral Risk Factor Surveillance System data the purpose of our research is to investigate the relationship between individuals' receipt of physician's advice on weight loss and their tendency to eat fewer calories and fat or to use physical activity to lose weight. We find that physician's advice to lose weight has positive effects on both the probability of eating fewer calories and fat to lose weight and on the probability of using exercise to lose weight.     

Weight-control practices among U.S. adults, 2001-2002

BACKGROUND: Approximately $50 billion a year is spent by Americans on weight-loss products and services. Despite the high cost, few national studies have described specific weight-loss and weight-maintenance practices among U.S. adults. This analysis describes the use of specific practices by U.S. adults who tried to lose weight or tried only not to gain weight during the previous 12 months. METHODS: Data were analyzed from the 2001-2002 National Health and Nutrition Examination Survey (NHANES) conducted on a nationally representative sample of the U.S. population. This study focused on adults aged 20 years or older who were both interviewed and examined (n =5027). RESULTS: Fifty-one percent of U.S. adults tried to control their weight in the previous 12 months, including those who tried to lose weight (34% of men, 48% of women) and those who tried only not to gain weight (11% vs 10%, respectively). Among 2051 adults who tried to control their weight, the top four practices were the same: ate less food (65% among those who tried to lose weight, 52% among those who tried only not to gain weight); exercised (61% vs 46%, respectively); ate less fat (46% vs 42%); and switched to foods with lower calories (37% vs 36%). Less than one fourth combined caloric restriction with the higher levels of physical activity (300 or more minutes per week) recommended in the 2005 dietary guidelines by the U.S. Department of Health and Human Services and U.S. Department of Agriculture. CONCLUSIONS: Although weight control is a common concern, most people who try do not use recommended combinations of caloric restriction and adequate levels of physical activity.     

Weight-loss practices, nutrition beliefs, and weight-loss program preferences of urban American Indian women

OBJECTIVE: To describe health beliefs, weight concern, dieting practices, and weight-loss program preferences of American Indian women residing in an urban setting. DESIGN: Face-to-face interviews using a semistructured questionnaire were conducted and height and weight were measured. SUBJECTS/SETTING: Subjects were 203 American Indian adult women in an urban community setting. STATISTICAL ANALYSIS: Frequency distributions and chi 2 analysis were performed using the Statistical Analysis System software. RESULTS: About two-thirds of the subjects were overweight. Most women were concerned about obesity and reported attempting to manage their weight. Healthful weight-loss practices (e.g., eating more fruits and vegetables, increasing physical activity) were used most frequently. However, unhealthful practices, such as skipping meals/fasting, using laxatives/diuretics, and self-induced vomiting were also mentioned. Regular bingeing was reported by 10% of respondents. APPLICATIONS: Weight-management intervention efforts should focus on helping clients modify their diet and physical activity patterns. Low-cost programs offered in convenient locations would attract more participants, as would the provision of child care. Education about the dangers and ineffectiveness of unhealthful weight-loss practices will be necessary, given the high rates of such behaviors in this population.     

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.     

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.     

Differences in eating and activity markers among normal weight, overweight, and obese rural women.

PURPOSE: The purpose of this study was to examine differences in healthy eating and physical activity behaviors and associated biomarkers among normal weight (body mass index [BMI] < 25), overweight (BMI 25-29.9), and obese (BMI > or = 30) rural women. METHODS: Random digit dialing was used to recruit 225 rural women (57.9 +/- 5.6 years). Measures of healthy eating and physical activity were completed on the computer during individual sessions at the rural sites. Research nurses then assessed a battery of biomarkers of activity and eating, including blood lipids, blood pressure, cardiorespiratory fitness (VO(2max)), and resting heart rate. RESULTS: Major findings were differences across weight categories in daily calories consumed and expended, daily fruit servings, daily meat group servings, high-density lipoprotein cholesterol, vital signs, and cardiorespiratory fitness. The obese women both consumed and expended significantly more calories daily than those in the other two weight groups. Obese women consumed significantly fewer fruit group servings than both the normal weight and overweight women. Obese women consumed significantly more meat group servings than overweight women. There also were significant differences in systolic blood pressure, diastolic blood pressure, resting heart rate, high-density lipoprotein cholesterol, and cardiorespiratory fitness across the three weight groups. CONCLUSIONS: This study provides evidence of major differences in some eating and activity behaviors and biomarkers across BMI groups. Major differences exist between the normal weight and overweight group as compared to the obese group.     

Prevalence of leisure-time physical activity among overweight adults--United States, 1998

In the United States, overweight and obesity have reached epidemic proportions among all segments of the population and regions of the country (1). Obesity is a risk factor for numerous chronic health conditions and weight loss can reduce risk factors for these conditions (2). National guidelines recommend that weight reduction should involve reducing calorie intake and increasing physical activity (3). The National Heart, Lung, and Blood Institute's clinical guidelines (3) and the federal dietary guidelines for Americans (4) recommend at least 30 minutes of physical activity on most days of the week for all healthy adults. To assess patterns of physical activity among overweight U.S. adults trying to lose weight, and to estimate the proportion who engage in leisure-time physical activity (LTPA) from selected demographic groups, CDC analyzed data from the 1998 Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of that analysis, which indicate that two thirds of overweight persons trying to lose weight reported using physical activity as a strategy for weight loss; however, only one fifth reported being active at recommended levels.     

Dieting status and its relationship to weight, dietary intake, and physical activity changes over two years in a working population

The present study prospectively examined changes in dietary intake, physical activity and weight associated with self-reported efforts to lose weight in a cohort of 3671 men and women sampled from the general population. Dieting efforts, dietary intake, physical activity and weight were measured at two points in time, 24 months apart. At baseline, current dieters reported consuming fewer dairy products, sweets, meat, soft drinks and fried potatoes (all p's < .0001), and engaging more frequently in high-intensity physical activity (p < .0001) than those not currently dieting. At follow-up, current dieters reported consuming fewer sweets (p < .0001) and fried potatoes (p < .0008), and engaging more frequently in moderate-intensity physical activity (p < .02) than those not currently dieting. Prospectively, those who initiated weight-loss diets showed the largest decrease in consumption of sweets (p < .0001), soft drinks (p < .0001), and fried potatoes (p < .01), and increase in frequency of high-intensity physical activity (p < .0001) and moderate-intensity physical activity (p < .007). Those initiating weight-loss diets were the only group to lose weight (1 lb.). Those dieting at baseline but not at follow-up gained the most weight (4 lbs.). Self-reports of current dieting correspond to reported changes in dietary intake and physical activity, and to measured changes in weight over the same time period. Individuals who report dieting to lose weight have healthier eating and exercise patterns than those who do not report dieting.     

Health Care Providers' Advice on Lifestyle Modification for Older Adults

ObjectivesTo describe the pattern of health care providers' advice on lifestyle modification to older adults, and identify correlates of receiving such advice.DesignCross-sectional survey.Setting and participantsData from the National Health and Nutrition Examination Survey study from 2007-2016 on adults ≥65 years (n = 3758) were analyzed.MethodsWe estimated the weighted prevalence and correlates of receiving advice on the following lifestyle modifications: (1) increase physical activity, (2) reduce fat/calories, (3) control/lose weight, and (4) a combination of control/lose weight and physical activity. Data were analyzed according to level of comorbidity (number of chronic conditions including high blood pressure, high blood cholesterol, type 2 diabetes mellitus, coronary heart disease, and arthritis) and body mass index (BMI).ResultsPhysical activity was the most widely prescribed lifestyle modification, reported by 15.7% of older adults free of chronic conditions and 28.9%, 35.4%, and 52.6% of older adults with 1, 2, and ≥3 comorbidities. Advice on reducing fat/calories was reported by 9.2%, 18.5%, 26.3%, and 40.9% of older adults with 0, 1, 2, and ≥3 comorbidities, respectively, and advice on weight loss/control was reported by 6.5%, 19.1%, 20.8%, and 37.5%, respectively. The combination of advice on weight loss/control and physical activity was least commonly reported: 5.1%, 13.5%, 16.6%, and 32.0%, respectively. Overall, lifestyle modifications were more frequently advised to older adults who were overweight, obese, or Hispanic.Conclusions and implicationsIn the United States, lifestyle modifications are not routinely recommended to older adults, particularly those free of chronic conditions, presenting a missed opportunity for chronic disease prevention and management. Among those advised to lose or manage weight, concurrent advice to increase physical activity is not consistently provided.     

Obesity and weight control practices in 2000 among veterans using VA facilities

OBJECTIVE: To examine obesity prevalence and weight control practices among veterans who use Department of Veterans Affairs (VA) medical facilities (VA users). RESEARCH METHODS AND PROCEDURES: Data from the 2000 Behavioral Risk Factor Surveillance System, a telephone survey of 184,450 adults, were analyzed. Outcome measures included BMI, weight control practices (the intent to manage weight, and diet and physical activity patterns), and receipt of professional weight control advice. RESULTS: Of VA users, 44% were overweight and 25% were obese. After controlling for demographic factors, VA users were somewhat less likely to be overweight (odds ratio, 0.86; 95% confidence interval, 0.74 to 1.00) but equally likely to be obese (odds ratio, 1.08; 95% confidence interval, 0.92 to 1.27), compared with non-VA users. Among obese VA users, 75% reported trying to lose weight, and another 17% reported trying to maintain weight. Of these, only 40% decreased both calorie and fat intake. Only 27% of obese VA users who reported increasing exercise to lose weight followed recommendations for regular and sustained physical activity. Of obese VA users, 59% were inactive or irregularly active. Only 51% of obese VA users received professional advice to lose weight. Obese VA users were more likely than obese non-VA users to report trying to lose weight, modifying diet to lose weight by decreasing both calories and fat intake, and receiving professional weight control advice. DISCUSSION: Interventions for weight management programs in VA facilities need to take into account the high prevalence of overweight/obesity among VA users and should emphasize effective weight control practices.     

Gender differences in body weight perception and weight-loss strategies of college students

Gender differences in college students' perceptions and satisfaction with body weight were examined. Females tended to perceive themselves as overweight when they were not, failed to see themselves as underweight when they were, and many of those who did not see themselves as even slightly overweight wanted to lose weight. Although males reported some dissatisfaction with their bodies, they tended to want to gain rather than lose weight. Females dieted more frequently than did males, and nearly one-third of the females reported either self-induced vomiting or laxative use as a weight-loss strategy. The relationship between social pressure for female slenderness, dieting, and eating disorders are discussed.     

Body size perceptions and eating attitudes in elderly men

The majority of studies on eating attitudes, dieting and body size perceptions have focused on young adults and women. This study examined these attitudes in 334 black and white men, ages 55 to 98 years, who were members of the Charleston Heart Study cohort. Associations of the eating attitude variable with race, education and weight status were examined. Eighty-two percent of the overweight white men studied had dieted to lose weight, whereas only 49% of slimmer white men had dieted. In contrast, overweight black men did not diet more than slimmer black men. Overall black men dieted less than white men (37% reported dieting). Black men who were high school graduates were 1.3 times more likely to have dieted than were less educated black men. Overweight white men were over twice as likely as slimmer white men to feel guilty after overeating. This difference was not found in overweight versus slimmer black men. Education was not associated with measured body mass index (BMI) or perceived or ideal body size. However, there were some racial differences in these variables. White men preferred to be slightly thinner than black men (ideal BMI 25.6 vs. 26.1 kg/m2), and the difference between actual and desired BMI was 0.6 kg/m2 greater in white than in black men. These results indicate that effects of race and weight status on eating restraint and body size perceptions seen in younger subjects and in women are also present, at least to some degree, in elderly men.     

Diet and other lifestyle behaviors in young college women

Data from Food Frequency Questionnaires and Health Behavior Surveys of 93 first year college women were analyzed for diet, activity, and other health behaviors. Body mass index was positively associated with saturated fat and inversely associated with fiber intake. Fifty-one percent of students took vitamin supplements; this was associated with higher iron and folate intakes and greater physical activity. Sixty-six percent of students never smoked; 10% smoked to control their weight. Smokers had lower fiber and higher alcohol intakes. Sixty-one percent of students drank and 50% had been drunk in the last month. Forty percent felt that they were overweight, 57% dieted, and 29% reported out of control eating. More than 50% of students were sexually active, and 18% had been tested for HIV infection. After adjusting for energy intake, physical activity showed a significant association with the healthy eating pattern. These findings suggest that healthful behaviors occurred together.     

Gender Differences in Body Weight Perception and Weight-Loss Strategies of College Students

Gender differences in college students' perceptions and satisfaction with body weight were examined. Females tended to perceivev themselves as overweight when they were not, failed to see themselves as underweight when they were, and many of those who did not see themselves as even slightly overweight wanted to lose weight. Although males reported some dissatisfaction with their bodies, they tended to want to gain rather than lose weight. Females dieted more frequently than did males, and nearly one-third of the females reported either self-induced vomiting or laxative use as a weight-loss strategy. The relationship between social pressure for female slenderness, dieting, and eating disorders are discussed.     

Following a Calorie-Restricted Diet May Help in Reducing Healthcare Students’ Fat-Phobia

Data from National Health and Nutrition Examination Survey 2005/2006 show that 32.7% of US adults are overweight (BMI 25.0–29.9), 34.3% are obese (BMI 30–39.9), and 5.9% are extremely obese (BMI ≥ 40). For the first time, the number of obese American adults is greater than those who are merely overweight. Negative attitudes and fat phobia toward the overweight exist not only in the general population, but also among health professionals including dietitians and dietetics students. The purpose of this study was to determine if fat phobia might be reduced among future professionals by putting students on a calorie-restricted diet for a short period. Forty dietetics and health promotion students enrolled in a university obesity course completed the Fat Phobia Scale test before and after following a calorie restricted diet for 1 week (1,200 calories and 1,500 calories for women and men, respectively). Students also reflected their thoughts about following such a diet via brief journal entries. Results showed the change in fat phobias after following a calorie-restricted diet was significant. Many journal entries reflected a newfound respect for individuals struggling to lose weight and change in prior negative attitudes. Students reported that this experience would impact their future dealings with overweight/obese clients. It may be useful to incorporate this type of activity into the training of nutrition and other health professional students to increase sensitivity and reduce existing biases and negative attitudes toward overweight/obese clients.     

Weight control practices in adults: results of a multistate telephone survey.

In this study, data collected in 1989 in a random-digit dialing telephone survey of 60,590 adults in 38 states and the District of Columbia were analyzed. Approximately 38% of women and 24% of men reported that they were currently trying to lose weight. Methods reported were counting calories (24% of women, 14% of men), participating in organized weight loss programs (10%, 3%), taking special supplements (10%, 7%), taking diet pills (4%, 2%), and fasting for 24 hours or longer (5%, 5%). Among both sexes, only half of those trying to lose weight reported using the recommended method of caloric restriction combined with physical activity.     

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.