The motivation to be sedentary predicts weight change when sedentary behaviors are reduced

Background  

Obesity is correlated with a sedentary lifestyle, and the motivation to be active or sedentary is correlated with obesity. The present study tests the hypothesis that the motivation to be active or sedentary is correlated with weight change when children reduce their sedentary behavior.     

Physicians' use of the 5As in counseling obese patients: is the quality of counseling associated with patients' motivation and intention to lose weight?

Background  

Physicians are encouraged to counsel obese patients to lose weight, but studies measuring the quality of physicians' counseling are rare. We sought to describe the quality of physicians' obesity counseling and to determine associations between the quality of counseling and obese patients' motivation and intentions to lose weight, key predictors of behavior change.     

Impact of an informed choice invitation on uptake of screening for diabetes in primary care (DICISION): trial protocol

Background  

Screening invitations have traditionally been brief, providing information only about population benefits. Presenting information about the limited individual benefits and potential harms of screening to inform choice may reduce attendance, particularly in the more socially deprived. At the same time, amongst those who attend, it might increase motivation to change behavior to reduce risks. This trial assesses the impact on attendance and motivation to change behavior of an invitation that facilitates informed choices about participating in diabetes screening in general practice. Three hypotheses are tested:     

Exploring the mechanisms of weight loss in the SHED-IT intervention for overweight men: a mediation analysis

Background  

Statistical mediation analysis can be used to improve the design of obesity prevention and treatment programs by identifying the possible mechanisms through which an intervention achieved its effects. The aim of this study was to identify mediators of weight loss in an Internet-based weight-loss program specifically designed for overweight men.     

Weight loss maintenance in women two to eleven years after participating in a commercial program: a survey

Background  

After 5 years, most reports show that less than 10% of people maintain a 5% loss from initial body weight. Weight maintenance after 10 years is rarely assessed, especially in commercial programs. The current article reports weight maintenance in individuals who had participated 2 to 11 years earlier in a popular commercial weight loss program based on Canada's Food Guide called Mincavi.     

Evaluation of a commercial web-based weight loss and weight loss maintenance program in overweight and obese adults: a randomized controlled trial

Background  

Obesity rates in adults continue to rise and effective treatment programs with a broad reach are urgently required. This paper describes the study protocol for a web-based randomized controlled trial (RCT) of a commercially available program for overweight and obese adult males and females. The aim of this RCT was to determine and compare the efficacy of two web-based interventions for weight loss and maintenance of lost weight.     

Participants’ Explanatory Model of Being Overweight and Their Experiences of 2 Weight Loss Interventions

PURPOSE

We explored participants’ accounts of weight loss interventions to illuminate the reasons behind the greater weight loss observed among those attending a commercial program compared with those receiving standard care in a recent large-scale trial. We further wanted to examine how participants’ general explanatory model of being overweight related to the 2 different interventions.

METHODS

Our study was based on thematic analysis of semistructured telephone interviews with a purposeful sample of 16 female participants from the UK center of a randomized controlled trial of weight loss in primary care.

RESULTS

The commercial provider delivered weight management in a nonmedical context, which mirrors how participants regard being overweight. Participants felt they needed support and motivation rather than education, and valued the ease of access and frequent contact the commercial provider offered. Some participants preferred individual level support with their primary care clinician, and all were positive about the opportunity to access support through the primary care setting.

CONCLUSIONS

Primary care referral to a commercial weight loss program for people who do not require specific clinical care appears to be in accord with their general explanatory model about being overweight, offering motivation and support to lose weight outside a strictly medical context. This approach may not be effective or acceptable for everyone, however, and there are likely to be considerable variations in the explanatory models held. Findings support the argument that a range of evidence-based options for weight management should be available in primary care.     

Circulating TNF alpha receptor levels identify older adults who fail to regain weight after acute weight loss

Objective  

Some healthy older adults have difficulty regaining weight after acute weight loss, and the reason for this failure to regain weight is unknown. The objective of this study was to determine if elevated leptin or pro-inflammatory cytokine levels are associated with failure to regain weight over two years after an acute weight loss intervention.     

Adipocyte fatty acid binding protein during refeeding of female patients with anorexia nervosa

Background  

Adipocyte fatty acid binding protein (A-FABP) has been suggested to play an important role in fat metabolism linking obesity and the metabolic syndrome. Increasing A-FABP plasma levels were observed during greatest weight loss after bariatric surgery suggesting that A-FABP may indicate changes in fat mass in dynamic situations.     

Weight cycling is associated with body weight excess and abdominal fat accumulation: A cross-sectional study

Background & aims

To investigate the association between history of multiple weight loss diets followed by weight regain, namely weight cycling (WCy), and both body weight excess and abdominal fat accumulation.

Methods

A one-day cross-sectional survey (“Obesity-Day”) including 914 participants (605F:309M). Anthropometric variables (body mass index [BMI], waist circumference [WC] and waist-to-height ratio [WtHR]), covariates and WCy (≥5 intentional weight loss episodes of ≥5 kg followed by rapid return to pre-diet or higher body weight) were assessed by a self-administered questionnaire, interview and physical examination.

Results

Data on central fat accumulation (by WC and WtHR) were available in a representative sub-group (n = 600). WCy was reported by 119 participants (13.0%) of total population and by 79 (13.2%) of those with available data on central fat accumulation. At multivariable linear regressions WCy was independently associated with higher BMI (P = .004), WC (P = .011) and WtHR (P = .008). Sensitivity analyses, performed after excluding those being on a diet at the time of assessment, confirmed these findings.

Conclusions

A history of WCy appears related to body weight excess and abdominal fat accumulation. These findings support the importance of designing adequate weight loss programs to achieve long-term weight maintenance and to prevent undesirable and unhealthy weight accumulation.     

Improved nutrient intake in older obese adults undergoing a structured diet and exercise intentional weight loss program

Objectives  

Physicians are often reluctant to advise older obese patients to lose weight for fear of compromised nutrition and excessive loss of muscle mass and strength, all of which may lead to a loss of independence and accelerate disability. Therefore, the purpose of this study was to examine nutrient intake in older obese adults undergoing a weight loss intervention.     

PDA+: A Personal Digital Assistant for Obesity Treatment - An RCT testing the use of technology to enhance weight loss treatment for veterans

Background  

Obese adults struggle to make the changes necessary to achieve even modest weight loss, though a decrease in weight by as little as 10% can have significant health benefits. Failure to meet weight loss goals may in part be associated with barriers to obesity treatment. Wide-spread dissemination of evidence-based obesity treatment faces multiple challenges including cost, access, and implementing the programmatic characteristics on a large scale.     

Predicting vitamin E and C consumption intentions and behaviors among factory workers based on protection motivation theory

Background

Study of antioxidant vitamin consumption behavior, especially in high-risk groups with high exposure to toxic metals to reduce metal toxicity, is emphasized. This study aims to examine the structural relationships between knowledge, protection motivation theory constructs, and vitamin E and C consumption behavior among cement factory workers.

Methods

Protection motivation theory and food frequency questionnaires were completed by 420 factory workers. Data were subjected to structural equation modeling to examine associations between knowledge, protection motivation theory constructs, and vitamin E and C consumption behavior. Efficacy of current recommended models was also explored.

Results

Structural equation modeling showed high explained variance within the constructs of protection motivation theory for vitamin E and C consumption behavior and intention (56–76%). The overall fit of the structural models was acceptable for both vitamin E and C behavior. Knowledge, self-efficacy, response efficacy, and perceived vulnerability predicted intention, which in turn predicted vitamin consumption behavior. Significant relationships between knowledge and self-efficacy, response efficacy, perceived vulnerability, and perceived severity were also found, while self-efficacy and response efficacy showed significant relationships with vitamin E and C consumption behavior.

Conclusions

Considering that response efficacy, self-efficacy, and intention showed as strong predictors of vitamin E and C consumption behavior, specific attention should be paid to coping appraisals and intention when designing intervention plans. Additionally, establishing the predicting role of knowledge for protection motivation theory constructs and protective behaviors should be integrated into intervention programs.

     

Effectiveness of a Structured Intensive Weight Loss Program Using Health Educators

Background

Primary care providers may refer their patients to a variety of weight loss programs and diet plans. However, the relative effectiveness of the available options is not well understood. This retrospective study compared weight loss in an intensive structured (IS) program using health educators versus weight loss in the general population of primary care patients seeking to lose weight using less intensive (LI) methods.

Methods

The IS program in this study is operated by Luther Midelfort Weight Management Services in Eau Claire, WI, USA, which is a part of the Mayo Health System. All consecutive patients enrolled in the IS program who met inclusion criteria were included in the sample. The LI group was a convenience sample of patients drawn from other Mayo Clinic locations who were surveyed to determine what, if any, approach to weight loss they were using. Weight loss strategies reported by potential LI participants included LA Weight Loss, Nutri-System®, SlimFast, Weight Watchers®, ‘own approach’, and other. Those who were not using a weight loss approach were excluded. The selection criteria for the study were that patients had a body mass index (BMI) of 35–50 kg/m² and were aged 17–65 years. Weights were measured in clinic. The baseline year was 2005 and the follow-up year was 2006.

Results

A total of 126 patients met the selection criteria: 71 in the IS group and 55 in the LI group. Outcome weights were available for 103 patients: 58 and 45 in the IS and LI groups, respectively. The mean weight changes were ?18.8 (±15.7) kg and 0.87 (±5.9) kg for the IS and LI groups, respectively (p < 0.001). These results were confirmed using ordinary least squares regression analysis.

Conclusion

IS weight loss programs staffed by health educators may be effective for selected patients. Despite its limitations, this small study encourages further investigations into the effectiveness of high-intensity weight loss programs in patient populations of different race, ethnicity, socioeconomic status, and genetic background, after appropriate adjustments to assure cultural sensitivity. Further refinement and testing of moderate intensity programs is also warranted.

     

Exercise motivation: a cross-sectional analysis examining its relationships with frequency,intensity, and duration of exercise

Background  

It is important to engage in regular physical activity in order to maintain a healthy lifestyle however a large portion of the population is insufficiently active. Understanding how different types of motivation contribute to exercise behavior is an important first step in identifying ways to increase exercise among individuals. The current study employs self-determination theory as a framework from which to examine how motivation contributes to various characteristics of exercise behavior.     

The relationship between prevalence and duration of weight loss strategies and weight loss among overweight managed care organization members enrolled in a weight loss trial

Background  

Many adults in the United States report engaging in weight loss behaviors. The current study examined weight loss strategies among managed care organization members, to determine the prevalence and impact of weight loss behaviors in this population. We hypothesized that greater engagement in weight loss strategies would be associated with greater weight loss success.     

The role of motivation to eat in the prediction of weight control behaviors in female and male adolescents

ObjectiveTo examine whether motivation to eat variables predict changes in dieting and weight control behaviors in both gender groups over time.MethodGreek adolescents (n = 247), aged 14–18 years, completed questionnaires measuring different dimensions of motivation to eat, dieting, healthy and unhealthy weight control behaviors. Dieting and weight control behaviors were measured five months later.ResultsCompliance motivation positively predicted changes in dieting in males and a number of unhealthy weight control behaviors in females. Coping motivation negatively predicted meal skipping in both genders and was associated with a lower risk of vomiting in females. Social motivation positively predicted eating less high fat food in males while pleasure motivation was associated with a reduced likelihood of eating more fruits and vegetables in females and a reduced risk of fasting in males.ConclusionIntervention programs designed to facilitate healthy and circumvent unhealthy weight control practices in adolescents should attend to gender differences in motivational factors shown to predict dieting and weight control behaviors. For females it may be important to minimize compliance motivation whereas for males, programs that foster social motivation to eat might be appropriate.     

Peer Reviewed: Sociodemographic and Health Characteristics Associated With Attempting Weight Loss During Pregnancy

Introduction

Approximately 40% of women of childbearing age report that they are attempting to lose weight. No professional medical organization recommends attempting to lose weight during pregnancy because of the possible risks to both mother and baby. Since half of all pregnancies are unintended, women may attempt to lose weight before they know they are pregnant, and some women may continue or initiate weight loss attempts even after they know they are pregnant. This study examines the extent to which pregnant women report attempting to lose weight and associated sociodemographic and health characteristics.

Methods

We used aggregated multiple-year data (1996-2003) from the Behavioral Risk Factor Surveillance System to assess the prevalence of attempting to lose weight among pregnant women and the extent to which sociodemographic and health characteristics are associated with the behavior.

Results

The prevalence of attempting to lose weight during pregnancy was 8.1%. Attempting to lose weight during pregnancy was associated with age 35-44 years, Hispanic ethnicity, obesity, alcohol consumption, and mental distress during the previous month.

Conclusion

A substantial proportion of pregnant women attempt to lose weight. Preconception and prenatal care should include counseling women to achieve a healthy weight before becoming pregnant, to maintain healthy weight during pregnancy, and not to attempt weight loss during pregnancy. Further research should be conducted to understand how attempting weight loss during pregnancy translates into dietary change and weight loss and associated maternal and fetal outcomes.     

A Prospective Examination of Physical Activity Predictors in Pregnant Women with Normal Weight and Overweight/Obesity

Background

Scant research has examined the relationship between exercise behavior and weight status in pregnant women.

Who is maintaining weight in a middle-aged population in Sweden? A longitudinal analysis over 10 years

Background  

Obesity has primarily been addressed with interventions to promote weight loss and these have been largely unsuccessful. Primary prevention of obesity through support of weight maintenance may be a preferable strategy although to date this has not been the main focus of public health interventions. The aim of this study is to characterize who is not gaining weight during a 10 year period in Sweden.