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Effects of body weight control on changes in blood pressure: three-year follow-up study in young Japanese individuals.

Numerous epidemiological studies have shown a close relationship between obesity and hypertension. However, there have been few reports on the relationship between changes in the body weight and blood pressure of lean to normal-weight young subjects. The purpose of this study was to investigate the effects of body weight control on blood pressure in lean to obese young Japanese individuals in a 3-year follow-up study. University students (3,558 males and 1,418 females, aged 18.6+/-0.8 in 1994) were classified into 4 groups according to the baseline body mass index (BMI), and were followed up for 3 years. Among male students, changes in body weight were significantly correlated with changes in blood pressure during the 3 years in all 4 BMI groups, and the correlation coefficient was larger in the group with higher baseline BMI. Positive correlations between changes in body weight and changes in heart rate were noted only in the obese and mildly-obese groups. Also in female students, positive correlations were observed between changes in body weight and changes in blood pressure in lean to obese groups. However, no correlations between changes in body weight and changes in heart rate were noted in any of the female groups. To summarize, close correlations were observed between changes in body weight and those in blood pressure during the 3 years in both male and female university students. These findings suggest the importance of body weight control not only in obese but also in normal to mildly-obese young subjects in reducing or preventing an increase in blood pressure. There could be, however, a gender difference in the effects of body weight change on heart rate.

Adolescent↗

The role of weight control as a motivation for cocaine abuse.

Heavy use of cocaine and alcohol in female cocaine abusers with eating disorders has been reported, but the prevalence and motivation for concurrent substance use has not been well investigated. This study of 37 female and 40 male cocaine abusers demonstrated that almost half of the women used cocaine and/or alcohol as a weight control measure, and 13% of the males did the same. Thirteen (72%) of 18 females endorsing weight-related use of cocaine had a current diagnosis of an eating disorder. Only two males (5%) had a past history of an eating disorder. Eleven (85%) of those women with a current eating disorder endorsed using alcohol as an appetite suppressant. These findings support the need to evaluate weight control motivation in cocaine users and to provide specific treatment aimed at addressing the interaction between the eating disorder and the substance abuse problem.

Adult↗

Attitude correlates of weight control among secondary school boys and girls.

A study of the psychological correlates of weight control, sex, and actual and desired weight was performed. A regression analysis of the attitudes of 240 Australian high school students showed that the girls' responses reflected a significantly different concern with how they look, dieting and appearance from the boys. The implications of these findings for identifying those at risk to weight-related illnesses, including anorexia nervosa, are explored.

Adolescent↗

Weight control and appetite--a genetic perspective.

It is proposed that weight control and appetite are more strongly inherited than currently acknowledged. This view, based on evidence from a wide range of animal species, applies to the normal range of variability and to the more extreme eating disorders of obesity and anorexia. Diet choice and activity are seen as triggering factors uncovering hidden layers of the genome. If the hypothesis is accepted it suggests several modifications to our current understanding of eating disorders and indicates changes in methods of prevention and control in practice.

Journal Article↗

Increasing obesity in school children in a transitional society and the effect of the weight control program.

Childhood obesity is an increasing problem in developed countries. Its persistence into adulthood with accompanied health risks has raised many concerns. In a country with rapid growing economy and changing life styles such as Thailand, the natural history of obesity in school children aged 6-12 years was investigated. Yearly weight and height measurements were performed from 1991 onwards. Of 1,156 primary school children enrolled in 1991, two year follow-up was possible in 1,106 cases. Prevalence of obesity, as diagnosed by weight-for-height > 120% of the Bangkok reference, rose from 12.2% in 1991 to 13.5% in 1992 and 15.6% in 1993. In two years, 74 non-obese children became obese while 28 obese children showed the opposite trend. For those obese children who attended the weight control program, their body mass indices and triceps skinfold thickness increased significantly less than those of the non-attendees in the first year. These findings persisted in the second year but were of a smaller magnitude. Results of this study demonstrate the trend of increasing obesity in school children in the transitional society and the short term benefit of a weight control program.

Body Mass Index↗

A comparison of maladaptive schemata in treatment-seeking obese adults and normal-weight control subjects.

OBJECTIVES: The aims of this study were to determine whether treatment-seeking obese adults display a greater severity of maladaptive schemata than normal-weight adults and to investigate the possible correlates of maladaptive schemata among obese individuals. METHODS: The sample included 52 obese adults participating in a weight loss treatment and 39 normal-weight adults. Participants in the obese and normal-weight control groups completed standardized self-report questionnaires designed to assess attitudes and behaviors regarding eating and weight (Questionnaire on Eating and Weight Patterns-Revised and Binge Eating Scale), maladaptive schemata (Young Schema Questionnaire-Short Version), mood disturbance (Profile of Mood States-Adolescents) and socially desirable responding (Balanced Inventory of Desirable Responding). RESULTS: The obese patients reported a significantly greater severity of maladaptive schemata (after controlling for demographic variables and binge eating disorder status) than the normal-weight control subjects. In addition, within the obese group, there were significant positive correlations between the severity of maladaptive schema scores and both mood disturbance and problem eating scores. CONCLUSION: The present findings suggest that obesity may be associated with a higher severity of maladaptive schemata, at least among those obese individuals who have sought treatment. Possible etiological and treatment implications of the findings are discussed.

Adaptation, Psychological↗

Long-term weight loss and breakfast in subjects in the National Weight Control Registry.

OBJECTIVE: To examine breakfast consumption in subjects maintaining a weight loss in the National Weight Control Registry (NWCR). RESEARCH METHODS AND PROCEDURES: A cross-sectional study in which 2959 subjects in the NWCR completed demographic and weight history questionnaires as well as questions about their current breakfast consumption. All subjects had maintained a weight loss of at least 13.6 kg (30 lb) for at least 1 year; on average these subjects had lost 32 kg and kept it off for 6 years. RESULTS: A large proportion of NWCR subjects (2313 or 78%) reported regularly eating breakfast every day of the week. Only 114 subjects (4%) reported never eating breakfast. There was no difference in reported energy intake between breakfast eaters and non-eaters, but breakfast eaters reported slightly more physical activity than non-breakfast eaters (p = 0.05). DISCUSSION: Eating breakfast is a characteristic common to successful weight loss maintainers and may be a factor in their success.

Adult↗

Worksite intervention for weight control: a review of the literature.

PURPOSE: Published research on worksite weight-control programs is reviewed with the objective of assessing success in (1) reaching populations in need, (2) achieving sustained weight loss, and (3) improving employee health and productivity. SEARCH METHOD: Reviewed are 44 data-based articles published between 1968 and 1994. The initial search was part of a larger review on the health impact of worksite health promotion programs conducted by Centers for Disease Control and described in the introduction to this issue. We supplemented the resulting list with articles found in a search of our own reference files. IMPORTANT FINDINGS: Methodologically the literature is relatively weak, consisting largely of uncontrolled case studies. Worksite interventions appear to be successful in reaching large numbers of people: the median participation rate among overweight employees was 39% in the six studies that provided this type of information. Worksite programs produced reasonable short-term weight loss: typically 1 to 2 pounds per week. Long-term weight loss, reductions in sitewide obesity prevalence, and health or productivity benefits have yet to be demonstrated. MAJOR CONCLUSIONS: Recommendations for future research include improved methods, more attention to recruitment and secondary outcomes, more direct comparison of different programs, and more creative use of worksites as environments and social units in designing programs.

Health Promotion↗

2.5 years follow-up of weight and Body Mass Index values in the Weight Control for Life! program: a descriptive analysis.

This descriptive study monitored weight, Body Mass Index, and percent excess weight changes in 60 clients, (44 women, 16 men) at about 1 year and 2.5 years following participation in the Weight Control for Life! program. The program integrates the habit reversal treatment model with contingency management and operant reinforcement principles; nutrition education; physical activity; stress management; cognitive-restructuring; relapse prevention; social support; intensive, on-going maintenance; self-monitoring; and the use of a medically supervised very-low-calorie diet or low-calorie-diet. Clients' pretreatment and posttreatment weights averaged 104.28 kg (229.42 lb) and 79.89 kg (175.76 lb), respectively, representing a 68% reduction in excess body weight at the end of the weight loss phase of the program. Mean weight loss at about 1 year and 2.5 years post weight loss was 19.28 kg (42.42 lb) and 13.09 kg (28.80 lb), indicating subjects maintained 75% and 52% of their weight losses at these two time periods. Men lost more weight and maintained better losses than women. Overall, there was a 41% reduction in excess body weight at the end of 2.5 years.

Adolescent↗

Dating violence against adolescent girls and associated substance use, unhealthy weight control, sexual risk behavior, pregnancy, and suicidality.

CONTEXT: Intimate partner violence against women is a major public health concern. Research among adults has shown that younger age is a consistent risk factor for experiencing and perpetrating intimate partner violence. However, no representative epidemiologic studies of lifetime prevalence of dating violence among adolescents have been conducted. OBJECTIVE: To assess lifetime prevalence of physical and sexual violence from dating partners among adolescent girls and associations of these forms of violence with specific health risks. DESIGN, SETTING, AND PARTICIPANTS: Female 9th through 12th-grade students who participated in the 1997 and 1999 Massachusetts Youth Risk Behavior Surveys (n = 1977 and 2186, respectively). MAIN OUTCOME MEASURES: Lifetime prevalence rates of physical and sexual dating violence and whether such violence is independently associated with substance use, unhealthy weight control, sexual risk behavior, pregnancy, and suicidality. RESULTS: Approximately 1 in 5 female students (20.2% in 1997 and 18.0% in 1999) reported being physically and/or sexually abused by a dating partner. After controlling for the effects of potentially confounding demographics and risk behaviors, data from both surveys indicate that physical and sexual dating violence against adolescent girls is associated with increased risk of substance use (eg, cocaine use for 1997, odds ratio [OR], 4.7; 95% confidence interval [CI], 2.3-9.6; for 1999, OR, 3.4; 95% CI, 1.7-6.7), unhealthy weight control behaviors (eg, use of laxatives and/or vomiting [for 1997, OR, 3.2; 95% CI, 1.8-5.5; for 1999, OR, 3.7; 95% CI, 2.2-6.5]), sexual risk behaviors (eg, first intercourse before age 15 years [for 1997, OR, 8.2; 95% CI, 5.1-13.4; for 1999, OR, 2.4; 95% CI, 1.4-4.2]), pregnancy (for 1997, OR, 6.3; 95% CI, 3.4-11.7; for 1999, OR, 3.9; 95% CI, 1.9-7.8), and suicidality (eg, attempted suicide [for 1997, OR, 7.6; 95% CI, 4.7-12.3; for 1999, OR, 8.6; 95% CI, 5.2-14.4]). CONCLUSION: Dating violence is extremely prevalent among this population, and adolescent girls who report a history of experiencing dating violence are more likely to exhibit other serious health risk behaviors.

Adolescent↗

Eating behavior and weight control among women using smokeless tobacco, cigarettes, and normal controls.

Although considerable research has investigated the use of cigarette smoking for weight management, the potential role of smokeless tobacco (ST) use in dieting behavior has not been explored. Several measures designed to assess dieting behavior, attitudes toward eating, and tobacco use were administered to adult women using ST (n = 18), cigarettes (n = 20), and no tobacco (n = 20). Use of tobacco for weight loss was prevalent among the women smoking cigarettes. Nearly half the women in the cigarette-smoking group (45%) reported use of cigarettes to assist in weight loss, and only three (16.6%) of the women in the ST groups indicated use of ST for such purposes. No significant differences were observed across groups on measures of dietary restraint or attitudes toward eating. Issues of dieting and weight control may not be important factors in prompting ST use. Implications and areas for further research are discussed.

Adolescent↗

The National Weight Control Registry: is it useful in helping deal with our obesity epidemic?

The National Weight Control Registry (NWCR) consists of over 4800 individuals who have been successful in long-term weight loss maintenance. The purpose of establishing the NWCR was to identify the common characteristics of those who succeed in long-term weight loss maintenance. We found very little similarity in how these individuals lost weight but some common behaviors in how they are keeping their weight off. To maintain their weight loss NWCR participants report eating a relatively low-fat diet, eating breakfast almost every day, weighing themselves regularly, and engaging in high levels (about 1 hour/day) of physical activity. Because this is not a random sample of those who attempt weight loss, the results have limited generalizability to the entire population of overweight and obese individuals. The value of this project lies in identifying potential strategies that may help others be more successful in keeping weight off.

Diet, Reducing↗

Determining the amount of physical activity needed for long-term weight control.

OBJECTIVE: To evaluate prospectively the influence of habitual physical activity on body weight of men and women and to develop a model that defines the role of physical activity on longitudinal weight change. DESIGN AND SETTING: Occupational cohort study conducted for a mean of 5.5 y. SUBJECTS: A total of 496 (341 male and 155 female) NASA/Johnson Space Center employees who completed the 3 month education component of the employee health-related fitness program and remained involved for a minimum of 2 y. MEASUREMENTS: Body weights were measured at baseline (T1) and follow-up (T2), and habitual physical activity was obtained from the mean of multiple ratings of the 11-point (0-10) NASA Activity Scale (NAS) recorded quarterly between T1 and T2. Other measures included age, gender, VO(2 max) obtained from maximal treadmill testing, body mass index (BMI), and body fat percentage. RESULTS: Multiple regression demonstrated that mean NAS, T1 weight, aging and gender all influence long-term T2 weight. T1 age was significant for the men only. Independently, each increase in mean NAS significantly (P<0.01) reduced T2 weight in men (b=-0.91 kg; 95% CI:-1.4 to-0.42 kg) and women (b=-2.14 kg; 95% CI:-2.93 to-1.35 kg). Mean NAS had a greater effect on T2 weight as T1 weight increased, and the relationship was dose-dependent. CONCLUSIONS: Habitual physical activity is a significant source of long-term weight change. The use of self-reported activity level is helpful in predicting long-term weight changes and may be used by health care professionals when counseling patients about the value of physical activity for weight control.

Adult↗

Effects of mastery criteria and contingent reinforcement for family-based child weight control.

This study tested the effects of mastery criteria and contingent reinforcement in a family-based behavioral weight control program for obese children and their parents over two years. Families with obese children were randomized to one of two groups. The experimental group was targeted and reinforced for mastery of diet, exercise, weight loss, and parenting skills. The control group was taught behavior-change strategies and provided noncontingent reinforcement at a pace yoked to the experimental group. Both groups received the same behavioral family-based educational components over 6 months of weekly meetings and six monthly follow-up meetings. Results showed significantly better relative weight change at 6 months and 1 year for children in the experimental compared to the control group, but these effects were not maintained at 2 years. These results suggest the introduction of mastery criteria and contingent reinforcement for mastery can improve outcome during treatment in behavioral treatments for childhood obesity.

Analysis of Variance↗

Weight concerns and weight control behaviors of adolescents and their mothers.

OBJECTIVE: To assess the association between weight concerns and weight control practices of adolescents and their mothers. DESIGN AND PARTICIPANTS: Cross-sectional study of 5331 adolescent girls and 3881 adolescent boys (age range, 11.8-18.4 years) in an ongoing cohort study and their mothers. Participants were included in the analysis if both the adolescent and his or her mother returned a questionnaire mailed in 1999 and provided information on weight, height, and weight concerns. RESULTS: More adolescent girls (33.0%) than boys (8.1%) thought frequently about wanting to be thinner. Compared with adolescent girls who accurately perceived that their thinness was not important to their mother, girls who misperceived (odds ratio [OR] = 1.9; 95% confidence interval [CI], 1.3-2.8) or accurately perceived (OR = 2.85; 95% CI, 1.0-8.4) that it was important to their mother that they be thin were significantly more likely to think frequently about wanting to be thinner. Among the adolescent boys, only those who accurately perceived that it was important to their mother that they not be fat were more likely than their peers to think frequently about wanting to be thinner (OR = 3.8; 95% CI, 2.3-6.2). Adolescents who accurately perceived that it was important to their mother to be thin or not fat were significantly more likely to be frequent dieters than their peers who accurately perceived that their weight was not important to their mother. CONCLUSION: Among adolescents, an accurate perception that weight status is important to their mother is associated with thinking frequently about wanting to be thinner and about frequent dieting.

Adolescent↗

Body fat distribution, blood pressure and blood glucose in Egyptian obese women undergoing a weight control program.

In a sample of 92 obese healthy women, 35 of them were chosen to follow a weight control program comprising both caloric restriction and exercise for three months. They were matched for age and weight with the remaining 57 women who also served as a control group. The entire sample was further stratified according to age into two categories of 20-34 and 35-50 years. The caloric supply was restricted to about 1000 kcal/day, in addition to a 1-h session of mild exercise which was performed twice weekly; the subjects' energy expenditure was 2200 kcal/day. Only the mean values of the biceps, triceps, and supra-iliac skinfold measurements were significantly decreased (p < 0.05) in the younger trained dieters when compared to their counterpart sedentary controls. On the other hand, obvious group variations appeared between body fat distribution when related to body weight and to blood pressure. Blood glucose revealed normal levels in the whole sample. Mean values were numerically lower in the older trained dieters than their matched sedentary controls, while they were significantly lower (p < 0.05) in the younger trained dieters. Although blood pressure was in the normal range for all participants, a nonsignificant decrease was recorded for both age groups of the obese trained dieters upon completion of the program. The systolic blood pressure decreased by 5.4% and the diastolic by 6.7% regarding the younger age, while the decrease in the older age was 3.5% for the systolic and 4.8% for the diastolic blood pressure. It was concluded that, although the trained dieters were still obese, the caloric restriction was promoted synergistically by exercise, leading to a more harmonious fat distribution and to lower normal levels of blood pressure and blood glucose.

Adipose Tissue↗

Role of physical activity and eating behaviour in weight control after treatment in severely obese children and adolescents.

AIM: To investigate the role of physical activity and eating behaviour in weight control 1.5 y after a weight-reduction programme in severely obese children. METHODS: Forty-seven children (13.4 +/- 2.1 y) were measured 1.5 y after the completion of a 10-mo residential treatment programme. Stature and body mass were measured; physical activity, fat and fibre intake, and self-efficacy in relation to physical activity and healthy eating behaviour were assessed using validated structured interviews. The total sample was divided into four subgroups according to unhealthy versus healthy physical activity and eating behaviour at follow-up. RESULTS: One-and-a-half years after treatment, subjects had regained 34 +/- 19% overweight, but were on average still 20 +/- 19% less overweight than before treatment (p < 0.001). The four subgroups did not differ in level of overweight at the beginning or end of treatment. At follow-up, there was a significant difference in overweight between the four subgroups (p < 0.05). The least healthy group (unhealthy physical activity and unhealthy eating behaviour) had a significantly higher level of overweight 1.5 y after treatment (183 +/- 36%) in comparison with the other groups (unhealthy physical activity and healthy eating: 150 +/- 21%; healthy physical activity and unhealthy eating: 156 +/- 14%; healthy physical activity and healthy eating: 138 +/- 16%) (p < 0.05), whilst the healthiest group showed the lowest level of overweight after treatment when compared to the other groups (p < 0.05). CONCLUSION: Results suggest that both physical activity and nutritional habits play an important role in weight maintenance after initial weight loss in obese children and that one healthy behaviour can not compensate for another unhealthy behaviour.

Adolescent↗

The National Weight Control Registry: a critique.

This article is a critique of the claim that the National Weight Control Registry provides data showing that a significant number of adults in the United States have achieved permanent weight loss. We believe that promoting calorie-restricted dieting for the purpose of weight loss is misleading and futile. We advocate the adoption of a health-at-every-size (HAES) approach to weight management, focusing on the achievement and maintenance of lifestyle changes that improve metabolic indicators of health.

Diet, Reducing↗