Body mass index and weight change attempts among adult women. The Norwegian Women and Cancer Study.

BACKGROUND: Based on concern about the widespread increase in being overweight and obesity along with a substantial demand for leanness, we wanted to estimate body mass index (BMI) and the prevalence of weight change attempts in a population-based sample of Norwegian women. Furthermore, we wanted to examine how weight loss attempts are related to BMI and to age, socioeconomic status, reproductive factors, lifestyle and diet. METHODS: A nationwide, cross-sectional study applying a mailed questionnaire was used. Out of a random sample of 20,000 women aged 45-69 years 10,249 women participated. RESULTS: Based on self-reported data, the mean BMI was 24.6 kg m-2 and 40% of the women had a BMI of > or = 25 kg m-2. More than 50% of the women were trying to lose weight and weight loss attempts were very strongly associated with BMI. Age, education, income, smoking status and perception of diet's importance to health were also significant predictors of weight loss attempts. The effect of age, education and income on weight loss attempts was modified by the level of BMI. Women trying to lose weight reported a different diet than those not trying to lose weight, irrespective of BMI. CONCLUSION: A large proportion of middle-aged women are trying to lose weight. BMI is predominant in explaining weight loss attempts. After adjusting for BMI, age, lifestyle and socioeconomic status also contribute to explaining weight loss attempts.     

Weight control measures among university students in a developing country: a cultural association or a risk behavior

OBJECTIVE: The purpose of the study was to determine the prevalence of university students, in Lebanon, trying to lose weight and assess the relation of trying to lose weight with demographic, scholastic and health behavioral factors. METHODS: The study was cross-sectional conducted in the academic year 2000-2001. A proportionate random sample of 2,013 students was selected among five public and private universities in Beirut. Participants completed a self-administered anonymous questionnaire that included questions on trying to lose weight, demographic, scholastic, and health behavioral factors including smoking, alcohol, and seat belt use. Bivariate and stepwise logistic regression analyses were performed to examine the association between trying to lose weight and the above-mentioned characteristics. RESULTS: The overall prevalence of students trying to lose weight was 30%, with 71% of them being under weight or normal weight. Use of medications and inducement of vomiting constituted 12% and 11%, respectively. Stepwise logistic regression analysis showed that the variables significantly associated with trying to lose weight were socio-economical factors rather than risky behaviors. Students who were at increased odds of performing such methods were females OR = (2.08, 95% CI = 1.6-2.5), employed (OR = 1.36, 95% CI = 1.01-1.8), and registered in a private university (OR = 1.69, 95% CI = 1.25-2.0). The major of students was also a significant predictor. CONCLUSION: In Lebanon, weight reduction could be re-enforced by socio-economical factors and not necessarily be an adolescent risk behavior.     

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.     

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.     

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.     

Associations of Trying to Lose Weight, Weight Control Behaviors, and Current Cigarette Use Among US High School Students

BACKGROUND: Approximately one-quarter of high school students currently use cigarettes. Previous research has suggested some youth use smoking as a method for losing weight. The purpose of this study was to describe the association of current cigarette use with specific healthy and unhealthy weight control practices among 9th–12th grade students in the United States.
METHODS: Youth Risk Behavior Survey data (2005) were analyzed. Behaviors included current cigarette use, trying to lose weight, and current use of 2 healthy and 3 unhealthy behaviors to lose weight or to keep from gaining weight. Separate logistic regression models calculated adjusted odds ratios (AORs) for associations of current cigarette use with trying to lose weight (Model 1) and the 5 weight control behaviors, controlling for trying to lose weight (Model 2).
RESULTS: In Model 1, compared with students who were not trying to lose weight, students who were trying to lose weight had higher odds of current cigarette use (AOR = 1.30, 95% CI: 1.15–1.49). In Model 2, the association of current cigarette use with the 2 healthy weight control behaviors was not statistically significant. Each of the 3 unhealthy weight control practices was significantly associated with current cigarette use, with AORs for each behavior approximately 2 times as high among those who engaged in the behavior, compared with those who did not.
CONCLUSION: Some students may smoke cigarettes as a method of weight control. Inclusion of smoking prevention messages into existing weight management interventions may be beneficial.     

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.     

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 status, quality of life, and cigarette smoking among adolescents in Washington State

Purpose

We examine age- and sex-specific associations between weight status and intensity of cigarette smoking in a large sample of adolescents. Additionally, we test whether quality of life (QOL) and weight control behaviors (i.e., trying to lose, gain, or stay the same weight) mediate the association.

Methods

We used cross-sectional data from the 2010 Washington State Healthy Youth Survey collected in grades 8, 10, and 12 (n = 11,222). Multinomial logistic regression was used to model cigarette smoking (none, light, frequent) as a function of weight status, weight control behaviors, and QOL by sex and age. Indirect effects of presumed mediators were assessed using the product of coefficients approach.

Results

Weight status was not associated with smoking. Trying to stay the same weight was associated with lower odds of light smoking for younger girls (OR = 0.25; 95 % CI = 0.08, 0.84), whereas trying to lose weight was associated with higher odds of light smoking for older girls (OR = 1.73; 95 % CI = 1.11, 2.70). Low QOL was associated with higher odds of light and frequent smoking for both girls and boys (P < 0.001). The mediation effects of weight control behavior and QOL combined were significant in the associations between body mass index percentile and smoking among older girls.

Conclusion

Targeted interventions designed to promote QOL and healthy weight control behaviors among youth may help to decrease the prevalence of smoking.     

Cancer prevention among urban southwestern American Indian women: comparison to selected Year 2000 national health objectives.

PURPOSE: The health issues which have historically faced American Indians are related to infectious disease, but today many chronic diseases play a large role in the health status of this special population. For example, existing data indicate that American Indians have the poorest cancer survival of any group in the U.S. (34% vs. 50% for U.S. Whites). Regular participation in cancer screening and lifestyle factors such as smoking, diet, and alcohol have been found to significantly contribute to cancer risk. However, available information about these behaviors is sparse and suffers from limitations. The purpose of this study was to assess the prevalence of cancer risk behaviors and provider recommendation for cancer screening among urban American Indian women. METHODS: A random household cross-sectional survey was administered to 519 adult American Indian women in Phoenix, Arizona. Smoking and weight status, alcohol consumption, physical activity, and provider referral were assessed by self-report. RESULTS: The results indicate that weight (69.6% were overweight) and excessive alcohol consumption (12.1 reported chronic drinking) were significant health issues in this population. The prevalence of provider referral for smoking cessation (14.9% among ever smokers) and breast as well as cervical cancer screening (30.1% and 55.5%, respectively) were below the 75% level set forth in the Year 2000 Goals. CONCLUSIONS: The results of this study suggest that increased cancer prevention and control efforts are needed in this special population to address the link between diet, weight, and long-term disease prevention.     

Americans on diet: results from the 1994-1996 Continuing Survey of Food Intakes by Individuals

OBJECTIVE: To examine the prevalence of dieting to lose weight or for a health reason in a representative sample of US adults. DESIGN: Cross-sectional study design. SUBJECTS/SETTING: Data from 10,144 participants of the 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII 1994-1996) were used in the analysis. All data were self-reported. STATISTICAL ANALYSIS: Analysis included: cross-tabulation of dieting status by sociodemographic characteristics; comparison of the type of diet, the reason for dieting, and the source of diet used by men and women; comparison of the nutrient intake and health status of dieters and nondieters. RESULTS: Prevalence of dieting varied by gender and race, being highest in white women (21%) and lowest in Hispanic men (8%). About 71% of all dieters reported that they were dieting to improve health, and 50% reported that they were dieting to lose weight. Dieters reported lower intakes of total fat, saturated fat, cholesterol, sodium, monounsaturated fat, polyunsaturated fat, calcium, and selenium compared with nondieters. The rate of chronic health conditions was higher among dieters than nondieters. Self-reported physical activity was similar in both groups. CONCLUSIONS: The prevalence of dieting varies according to sociodemographic characteristics. The reason for dieting and the type of diet used by dieters also vary and need to be studied further. Our results suggest that the dieters generally consumed a more nutrient-dense diet than the nondieters but still low in certain nutrients.     

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.     

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.     

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.     

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.     

Body mass index, menarche, and perception of dieting among peripubertal adolescent females

OBJECTIVE: To examine perceptions of dieting among pre and postmenarchial female school students. METHOD: All 51 female students of mean (SD) age 12.6 (0.6) years from a state school volunteered to complete a questionnaire about general health, eating and weight control behaviors, and menstrual status. Height and weight were measured. Focus groups using structured questions and discussion were used to elicit responses about the meaning of dieting and its association with menarche. RESULTS: Postmenarchial females were significantly more likely than the same age premenarchial students to have increased their body mass index (BMI), to clearly articulate the meaning of dieting, to report trying to lose weight, and to use diet and exercise to lose weight. Premenarchial females did not have a clear perception of dieting. Premenarchial females who reported trying to lose weight equated dieting with healthy eating and did not include losing weight or the behaviors and feeling associated with the concept of dieting unless their BMI had increased and menarche was imminent. DISCUSSION: The concept of dieting that may result in weight loss and the behaviors and feelings associated with dieting did not develop until menarche and is likely to be associated with the rapid increase in height, weight, and body fat that precedes menarche. Educational interventions aimed at preventing eating disorders among premenarchial adolescents may therefore be inappropriate, ineffective, and potentially dangerous.     

Patterns and correlates of physical activity and nutrition behaviors in adolescents

BACKGROUND: Knowledge of the prevalence, clustering, and correlates of multiple adolescent health behaviors can inform the design of health promotion interventions. METHODS: A cross-sectional design was used to assess 878 adolescents aged 11 to 15 years (53.6% girls, 58% non-Hispanic white) recruited in primary care clinics in 2001-2002. Adolescent physical activity (assessed with accelerometers), television viewing time (reported), percent calories from fat, and servings of fruits and vegetables (assessed with multiple 24-hour recalls) were dichotomized into meeting or not meeting national guidelines. Parent health behaviors were assessed with self-reported measures. Analyses were conducted in 2006. RESULTS: Fifty-five percent of adolescents did not meet the physical activity guideline, and 30% exceeded 2 hours daily of television viewing time, with boys more active and less sedentary than girls (p <0.01). The majority of the adolescents did not meet dietary guidelines. Nearly 80% had multiple risk behaviors and only 2% met all four guidelines. The number of risk behaviors was associated with being older and being at risk for overweight or being overweight, for boys and girls (p <0.05). Two parent health behaviors-history of smoking and failure to meet the fruits and vegetables guideline-were significantly associated with a higher number of risk behaviors for girls (p <0.05). CONCLUSIONS: Eight of ten adolescents in this sample failed to meet guidelines for two or more diet, physical activity, and sedentary risk behaviors. Some parent health behaviors, along with the adolescent's weight status and age, were associated with a higher number of adolescent health risk behaviors.     

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.     

Weight concerns, dieting behavior, and smoking initiation among adolescents: a prospective study.

Students (n = 1705) in grades 7 through 10 were surveyed at baseline and 1 year later about their weight concerns, dieting behaviors, and smoking behavior. Three of six weight concerns and dieting behaviors assessed at baseline were prospectively related to smoking initiation in girls (trying to lose weight, eating disorder symptoms, constant thoughts about weight). Four of six weight concerns and dieting behaviors were cross-sectionally related to current smoking at baseline in girls (trying to lose weight, eating disorder symptoms, fear of weight gain, desire to be thin). Weight concerns and dieting behaviors were largely unrelated to current smoking in boys. Implications for smoking prevention efforts are discussed.     

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.