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Biomedical subjects

T A Wadden

Publications and source records attributed to T A Wadden.

At least 109 records · Page 6Linked to original sources
PubMed1984

Recommended therapeutic guidelines for professional weight control programs.

At the present time there are no established guidelines to serve as standards for the operation of weight control programs. This increases the possibility that some programs may be conducted in a fashion that is unethical, jeopardizes patient health, and lacks credibility. As a first step toward developing such standards, a panel was organized by the International Congress on Obesity to describe minimum recommended features of professional weight control programs. The present report served as a supporting document for the summary statement and describes recommended guidelines for the treatment of obesity encompassing diet, physical activity, and behavior modification with psychological support. The role of drugs and surgery is not considered in this report. For the average patient it is suggested that three components of therapy--diet, exercise, and behavioral/psychological support--be prescribed together since they are closely interrelated, interdependent and mutually supportive.

Behavior Therapy↗
PubMed1984

Confronting obesity in children: behavioral and psychological factors.

The problem of obesity in children must be taken seriously and treated aggressively. The long-term psychological, social, and medical consequences of childhood obesity can be quite serious. Behavior modification has shown new promise compared to the discouraging results of traditional approaches such as inpatient starvation, the use of appetite suppressants, and dietary counseling. The behavioral program involves a systematic approach to nutrition, exercise, eating patterns, attitudes, and family support.

Attitude↗
PubMed1983

The Jenkins activity survey: does it measure psychopathology?

Previous studies have reached opposite conclusions concerning whether the Jenkins Activity Survey (JAS), a questionnaire measuring the Type A coronary-prone behavior pattern, correlates positively with measures of psychopathology. The present study investigated this question by administering the JAS, the Minnesota Personality Inventory (MMPI) and the State-Trait Anxiety Inventory (STAI) to 85 subjects. No significant correlations were found between the JAS Type A scale and the four MMPI scales measuring neurotic functioning. The Type A scale did correlate significantly with other MMPI scales, but all correlations indicated an inverse relationship between Type A behavior and psychopathology. The Speed and Impatience subscale of the JAS correlated positively with both state and trait anxiety, as found in an earlier study. Results of the present study indicate that the factors assessed by the JAS scales are generally unrelated to factors assessed by traditional measures of psychopathology.

Adult↗
PubMed1983

Predicting treatment response to relaxation therapy for essential hypertension.

This study investigated the relationship of relaxation practice to blood pressure reduction in 31 hypertensive subjects who participated in an 8-week treatment program. Subjects achieved significant post-treatment reductions in systolic and diastolic blood pressure, which were maintained at 5 months follow-up and were found to generalize to the subjects' home environment. Subjects who practiced relaxation with their spouses showed significantly better treatment adherence than those who practiced relaxation alone. No differences were found in blood pressure reduction between the two groups, however, due to the fact that pressure reduction was only modestly correlated with degree of relaxation practice. A significant, inverse relationship was found between blood pressure reduction and two measures associated with the Type A behavior pattern. Results of this study provide further evidence that relaxation training is effective in the treatment of some persons with mild, essential hypertension; however, further efforts are needed to identify predictors of treatment response.

Adult↗
PubMed1983

Very low calorie diets: their efficacy, safety, and future.

Very low calorie diets used to treat moderate and severe obesity produce average weight losses of 20 kg in 12 weeks. This paper reviews the development of very low calorie diets from research on fasting in the late 1950s and examines data on the amount of dietary protein needed to achieve positive nitrogen balance. The desirability of including carbohydrate in the diet, the choice of protein sources (formula versus animal protein), and the anorectic value of ketosis are discussed, as are patient selection and the clinical course of the diet. As contrasted to the earlier "liquid protein" diets that were associated with at least 60 deaths, very low calorie diets of high-quality protein appear safe when limited to 3 months or less under careful medical supervision. Evidence of this safety is provided by the results of 24-hour Holter monitoring and the fact that no diet-related fatalities have been reported in over 10 000 cases. The major problem to be resolved is the maintenance of the large weight losses achieved with these diets.

Arrhythmias, Cardiac↗
PubMed1980

Relaxation therapy as an adjunct treatment for essential hypertension.

Essential hypertension is one of the leading problems seen by a family physician, and it is not easily treated. In some instances, a behavioral therapy may serve as a useful adjunct to the pharmacological treatment of this disease. Evidence indicates that relaxation therapy in combination with medical treatment results in significantly greater reductions in systolic and diastolic blood pressure than the use of medical treatment alone. Progressive muscle relaxation, Benson's "relaxation response," hypnosis, and blood pressure biofeedback are the four most common behavioral treatments for essential hypertension. The first two of these are both effective and well suited to use in a family practice.

Antihypertensive Agents↗
PubMedDate not supplied

Treating the obese patient. Suggestions for primary care practice.

Obesity is a major health problem in America. Weight loss is associated with improvements in obesity-related health complications, but patients and practitioners are frequently disappointed by the long-term results of weight control efforts. Recent research has yielded new findings concerning the causes of obesity, as well as new goals for obesity treatment. Traditionally, the goal of therapy has been reduction to ideal weight. Several scientific bodies, however, now recommend a more modest 5% to 15% reduction in initial weight. Current options for weight loss include behavioral or pharmacological management provided during primary care visits, self-help and commercial programs, hospital-based interventions, and bariatric surgery. Regardless of the approach selected, long-term care usually is required to facilitate the maintenance of weight loss.

Behavior Therapy↗
PubMedDate not supplied

Obese women's perceptions of their physicians' weight management attitudes and practices.

BACKGROUND: Obesity has reached epidemic proportions in the United States. Primary care physicians will see increasing numbers of patients with long-term weight management problems. OBJECTIVE: To examine obese women's perceptions of their physicians' weight management attitudes and practices. DESIGN AND SETTING: Women who participated in obesity trials at a university clinic completed a questionnaire that assessed their views of weight control provided by their primary care physician. PARTICIPANTS: The patients were 259 women whose age was 44.0 +/- 10.0 years; weight, 96.7 +/- 13.2 kg; and body mass index (calculated as weight in kilograms divided by the square of height in meters), 35.2 +/- 4.5 (all data given as mean +/- SD). MAIN OUTCOME MEASURES: Using 7-point scales (1 indicates low; and 7, high), patients rated their satisfaction with care provided for their general health and that for their obesity. They also identified methods their physician recommended for weight management and the frequency of negative interactions with their physician concerning weight control. RESULTS: Participants were generally satisfied with the care they received for their general health and with their physicians' medical expertise (mean scores, 6. 1 and 6.2, respectively). They were significantly (P<.001) less satisfied with care for their obesity and with their physicians' expertise in this area (mean scores, 4.1 and 4.3, respectively). Almost 50% reported that their physician had not recommended any of 10 common weight loss methods, and 75% indicated they looked to their physician a "slight amount" or "not at all" for help with weight control. Only a small minority of patients (0.4%-8.0%) reported frequent, negative interactions with physicians concerning their weight. CONCLUSIONS: The last finding helps allay concerns that obese patients are routinely treated disrespectfully by physicians when discussing weight. The challenge, however, for primary care physicians appears to be providing patients better assistance with weight management.

Adult↗
PubMedDate not supplied

Diet and exercise in the treatment of obesity: effects of 3 interventions on insulin resistance.

BACKGROUND: In short-term studies, diet and exercise both improve insulin sensitivity. OBJECTIVE: To determine the effects of a 48-week supervised diet and exercise program on weight and insulin sensitivity after initial weight loss and weight maintenance, and then subsequent weight regain over 96 weeks. METHODS: Forty-five obese women were randomly assigned to 1 of 3 treatment groups: (1) diet alone, (2) diet and aerobic training, and (3) diet and strength training. All subjects received the same 48-week group behavior modification program and diet (approximately 3879 kJ/d [approximately 925 kcal/d] for the first 16 weeks; approximately 6276 kJ/d [approximately 1500 kca/d] thereafter). Exercising subjects were provided 3 supervised exercise sessions per week for the first 28 weeks and 2 sessions weekly until week 48. During weeks 48 to 96, subjects were unsupervised. Oral glucose tolerance tests were performed at baseline and weeks 16, 24, 44, and 96. RESULTS: Subjects across the 3 conditions achieved a mean weight loss of 13.8 kg by week 16, which was associated with decreased insulin levels (61.8% of baseline) There were no significant differences among groups in changes in body mass index, which is a measure of weight in kilograms divided by the square of the height in meters, weight, glucose tolerance, or insulin levels at weeks 16, 24, and 44. No additional beneficial effect of aerobic or strength exercise on insulin resistance, as reflected by serum insulin levels before and after a glucose load, was demonstrated. The 22 subjects who were studied at week 96 maintained a loss of approximately 10% of initial weight. Insulin levels, however, had returned to pretreatment levels. CONCLUSIONS: This study confirms the beneficial effect of weight reduction on hyperinsulinemia in obese individuals. Participation in supervised exercise did not result in additional improvement in weight loss or insulin sensitivity. We also observed a marked increase in insulin levels with only partial weight regain. Determining the amount of sustained weight loss necessary for continued improvement in insulin sensitivity will require further study.

Adult↗
PubMedDate not supplied

Body image dissatisfaction in male cosmetic surgery patients.

This study was the first empirical investigation of body image dissatisfaction in male cosmetic surgery patients. Thirty men completed two body image measures prior to their initial consultation. Results were compared to the norms for each of the measures and with a sample of 30 women seeking similar cosmetic procedures. Results indicated that patients did not demonstrate greater dissatisfaction with their overall appearance than men in a normative sample. However, when asked about the bodily feature they were considering for surgery, they reported significantly greater levels of dissatisfaction than the normative sample. As compared to male patients, female patients reported a greater investment in their physical appearance. Implications of these findings are discussed with respect to the nature of body image dissatisfaction and the relevance of body image in the psychology of male plastic surgery patients.

Adult↗
PubMedDate not supplied

Behavioral treatment of obese binge eaters: do they need different care?

This study investigated the relationship between binge eating and the outcome of weight loss treatment. Participants in a 48-week trial of a structured diet combined with exercise and behavior therapy were classified into one of four groups: no overeating; episodic overeating; subthreshold binge-eating disorder(BED); and BED. Binge eating status was not associated with either dropout or adherence to the diet, but did affect weight loss and mood. The BED group lost significantly more weight at the end of treatment than all other groups, even when adjusting for initial weight. At 1-year follow-up, there were no differences among groups in weight loss or weight regain. The BED group began treatment with significantly higher BDI scores, but improvement in mood occurred by week 5. On the basis of these findings, and a review of the recent literature, we conclude that obese binge eaters respond as favorably to standard dietary and behavioral treatments as do obese nonbingers.

Adult↗
PubMedDate not supplied

Restrictive dieting vs. "undieting" effects on eating regulation in obese clinic attenders.

This study tested predictions from restraint theory [Herman & Polivy (1984). A boundary model for the regulation of eating. In: A. J. Stunkard, & E. Stellar (Eds.), Eating and its disorders (pp. 141-156) New York: Raven Press.] and the three-factor model of dieting [Psychol. Bull. 114 (1993) 100.] using an eating regulation paradigm. Participants were 42 obese, nonbinge eaters assigned to either a weight loss group (restrictive dieters or RDs) or a group designed to eliminate dieting ("undieters" or UDs). Participants took part in an ostensible ice cream taste test with or without a preload, both before and after the weight control intervention. At pretest, restraint theory's prediction that participants would engage in counter-regulatory eating was not supported. At posttest, after 8 weeks of the dieting interventions, RDs increased and UDs decreased their intake following a preload, a pattern most consistent with the predictions of restraint theory. This counter-regulatory trend was observed in spite of a significant decrease in RDs' Disinhibition scale scores following treatment. Implications of these findings for restraint theory, the three-factor model of dieting, and relapse in obesity treatment were discussed.

Adult↗