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PubMed2003

Reading magazine articles about dieting and associated weight control behaviors among adolescents.

The purpose was to examine the sociodemographic characteristics of adolescents who read magazine articles about dieting/weight loss and the relationship between reading these types of magazine articles and psychosocial well-being and weight control behaviors. Dieting-related magazine exposure was associated with indicators of psychosocial distress and unhealthy dieting; interventions that address media consumption should reach out to all youth regardless of ethnic and social backgrounds

Adolescent↗
PubMed1992

Attendance and outcome in a work site weight control program: processes and stages of change as process and predictor variables.

This naturalistic study assessed client changes during treatment and identified salient predictors of therapy attendance and outcome. Subjects were assessed on processes and stages of change, self-efficacy, social support, weight history (including expectations, goals, and reasons for losing weight), and demographics at the beginning, middle, and end of a 10-week, behaviorally oriented work site program for weight control. Significant shifts from contemplation to action occurred for clients remaining in treatment. There were also significant modifications in the use of change processes as a result of treatment: counterconditioning, contingency management, stimulus control, interpersonal control, and social liberation increased while medication use, wishful thinking, and minimizing threats decreased. Change processes employed during the early portion of the group treatment were the best predictors of treatment attendance and outcome, superior to self-efficacy, social support, weight history, and demographic variables. The results supported a transtheoretical model that emphasizes dynamic processes and stages as core dimensions for understanding how people change.

Adaptation, Psychological↗
PubMed1996

Obstructive sleep apnea presenting during infantry field exercises: does the Army Weight Control Program protect soldiers from obstructive sleep apnea?

We report two cases of obstructive sleep apnea (OSA) that presented during infantry field exercises as snoring so loud as to risk betraying the unit's position. Both patients exceeded the height-weight standards of the Army Weight Control Program (AWCP). Since high body mass is a strong risk factor for OSA, we asked whether the AWCP reduces the risk of OSA. We found that it should for women in all age groups and for men over 40, but it is less protective for younger men (who constitute a large portion of Army personnel). In light of this and of previous estimates that up to 1.5% of all Army personnel exceed the AWCP standards, we conclude that there may be a significant number of unrecognized cases of OSA in the Army. Additionally, tightening of the AWCP standards may be warranted for women under 30 and men under 50, who currently are permitted to significantly exceed ideal body weight.

Exercise↗
PubMed2003

Sugars, energy metabolism, and body weight control.

Obesity represents a major threat to health and quality of life. Although obesity has strong genetic determinants, it is generally accepted that it results from an imbalance between food intake and daily physical activity. Health guidelines have been focused on 3 particular lifestyle factors: increased levels of physical activity and reductions in the intakes of fat and sugars. The dietary guidelines, especially, are under debate. This review covers evidence from carefully controlled laboratory studies, clinical trials, studies in populations at high risk of developing obesity, and epidemiologic studies on the role of sugars, particularly sucrose, in the development of obesity. Although many environmental factors promote a positive energy balance, it is clear that the consumption of a low-carbohydrate, high-fat diet increases the likelihood of weight gain. The evidence related to carbohydrate, particularly sugars, and the type of food (solid or liquid) is less clear because the number of long-term ad libitum dietary intervention trials is very small. Data on sucrose intake in relation to metabolism and weight gain do not associate high consumption of sucrose with the prevalence of obesity. The evidence supports the current dietary guidelines for reducing fat intake. However, the effect of the carbohydrate source and class and of the form in which carbohydrate is consumed (solid or liquid) on body weight control requires further consideration.

Adult↗
PubMed2002

Weight control and physical activity in cancer prevention.

Overweight and obesity have reached epidemic dimensions worldwide, mainly due to consumption of high energy diets and increased sedentary behaviour. Overweight and insufficient physical activity are clearly associated with cardiovascular diseases and type 2 diabetes. Evidence is also accumulating that they may also increase cancer risk, particularly in the colon, breast and endometrium. This effect seems to be mediated by alterations in the metabolism of endogenous hormones, including sex steroids and insulin, and levels of insulin-like growth factor(IGF)-I and IGF-binding proteins. In light of the beneficial effects of weight control and physical activity for cancer prevention, a healthy lifestyle, keeping a low body weight and exercising most days of the week, is recommended.

Animals↗
PubMed1983

Vomiting as a learned weight-control technique in bulimia.

Twenty-seven consecutive patients presenting with binge eating and vomiting were systematically questioned about the circumstances surrounding the onset of their vomiting habit. Twenty-four were able to specify and describe a particular incident to which they attributed the idea of vomiting as a weight-control method. The nature of the reported incidents supports the hypothesis that vomiting in those patients is a learned maladaptive behavior which is frequently inadvertently taught by well-meaning friends, relatives and professionals. These findings indicate the necessity of evaluating the risks as well as the benefits of public education.

Adult↗
PubMed2006

Exercise motivation, eating, and body image variables as predictors of weight control.

PURPOSE: This study investigated changes in psychosocial variables related to exercise, eating, and body image during a weight reduction program and evaluated their association with weight loss in middle-aged overweight and obese women up to 1 yr after intervention. METHODS: The 136 participants (age, 48.1 +/- 4.4 yr; weight, 30.6 +/- 5.6 kg x m(-2)) who completed the 4-month lifestyle weight reduction program (86% retention), losing -6.2 +/- 4.6% (P < 0.001) of their initial weight, were followed up for 12 additional months. Of these, 82% completed 16-month assessments (weight change, -5.5 +/- 7.7%, P < 0.001). Psychosocial variables were assessed by validated instruments in standardized conditions at baseline and after the intervention (4 months). RESULTS: Compared with 4-month assessments, body weight did not change at 16 months (P > 0.09). Changes in eating restraint, disinhibition, and hunger; exercise, self-efficacy, and intrinsic motivation; body shape concerns; and physical self-worth were associated with weight change at 4 months (P < 0.001, except hunger, P < 0.05). Baseline-adjusted 4-month scores in all psychosocial variables also predicted weight change from baseline to 16 months (P < 0.01), except hunger (P > 0.05). After controlling for 4-month weight change and other covariates, increases in exercise intrinsic motivation remained predictive of weight loss at 16 months (P < 0.05). Multiple linear regression showed that eating variables were significant and independent correlates of short-term weight change, whereas changes in exercise variables were stronger predictors of longer term weight outcomes. CONCLUSIONS: Results highlight the importance of cognitive processes during weight control and support the notion that initial focus on diet is associated with short-term weight loss, while change in exercise-related motivational factors, with a special emphasis on intrinsic sources of motivation (e.g., interest and enjoyment in exercise), play a more important role in longer term weight management.

Adult↗
PubMed1994

Life-style modification for weight control to improve diabetes health status.

The purpose of this study was to describe the relationship among variables which are associated with life-style modification, knowledge of diabetes, social support, health practices, and body mass index, to examine their effect on health status, and to test the effectiveness of a community based life-style modification program for weight control. Adults (n = 66) with non-insulin-dependent diabetes mellitus participated in either a treatment or control group. The treatment consisted of 5 weekly 90-min sessions on modifying eating and exercise patterns. All participants completed a personal resource questionnaire (PRQ), health practices survey (HPS), and diabetes health status questionnaire (DHS) at intake, 5 weeks, and 4 months. Knowledge of diabetes was assessed only at intake. Knowledge of diabetes, social support, and health practices explained 27% of the variance in health status, but health practices explained the largest (18%) proportion of the variance and was the only study variable significantly affected by the life-style modification program.

Adult↗
PubMed1989

The association of lifetime weight and weight control patterns with diabetes among men and women in an adult community.

We examined the association of degree and duration overweight, dietary habits and exercise with non-insulin dependent diabetes mellitus risk in a defined population of 886 men and 1114 women who were aged 50 years and older when examined in 1984-1987. After an oral glucose tolerance test, 142 men and 142 women were classified as diabetic using WHO criteria. Compared to those with appropriate childhood weight, reported underweight as a child significantly increased the rate of diabetes as an adult (RR = 1.3, P less than 0.05). Underweight as a teenager was also associated with an increased rate (RR = 1.3, P less than 0.05). Underweight as a teenager was also associated with an increased rate (RR = 1.4, P less than 0.01). In adults with current body mass indices (weight/height2) greater than 26, the diabetes rate was significantly higher for those underweight as children (RR = 1.7, P less than 0.01). A multivariate logistic regression analysis of adult diet and weight behaviors, adjusting for age and current smoking, found that a weight gain or fluctuation between the ages of 40 and 60 of 10 lbs or more significantly increased the diabetes rate (RR = 1.4, P less than 0.05; RR = 1.7, P less than 0.01). Weight gain between age 18 and the 1984-1987 visit also significantly increased the rate (RR = 1.4 per 17.3 percent, P less than 0.001). Exercise as the only means to control weight was associated with a significantly reduced diabetes rate (RR = 0.05, P less than 0.05).

Aged↗
PubMedDate not supplied

Consumer preferences in format and type of community-based weight control programs.

PURPOSE: The purpose of this study was to provide further information about preferences for types and formats (e.g., correspondence vs. face to face) of eating and exercise programs, actual participation rates in a variety of offered programs, and characteristics of program participants vs. nonparticipants. DESIGN: Over a 3-year period, a large sample of community volunteers was given the opportunity to participate in various forms of diet and exercise programs as part of a weight gain prevention study. SETTING: The study was conducted at a university and three local health department sites. SUBJECTS: Subjects in the study were 616 individuals participating in the Pound of Prevention study (POP), a 3-year randomized evaluation of an intervention for preventing weight gain. MEASURES: The primary outcomes assessed were participation rates for each program offering. Program participants were also compared to those who did not participate on demographic characteristics, smoking, diet behavior, exercise behavior, and weight concern. RESULTS: Survey results indicated that correspondence formats for delivery of health education programs were rated as more desirable than face-to-face formats. Participation for program offering ranged from 0 to 16% of the study population. Participation data were consistent with survey results and showed participants' preference for correspondence formats even more strongly. Program offering attracted health-conscious participants with higher education and income levels. CONCLUSIONS: These data suggest that some community members will get interested and take part in low-cost, minimal contact programs for exercise and weight control. Future research efforts should focus on investigating ways to increase participation in brief or minimal contact programs, particularly among groups that may be difficult to reach and at high risk for the development of obesity.

Adult↗
PubMed1986

The unique merits of a low-fat diet for weight control.

The virtual freedom from obesity enjoyed by many primitive societies may be traceable to the low fat content of their traditional diets. Recent studies indicate that humans have a very limited capacity for de novo lipogenesis from dietary carbohydrate; this implies that it should be easy to achieve negative fat balance if dietary fat intake is kept low and fat oxidation is promoted by regular exercise. Overfeeding with carbohydrate--but not with fat--provokes an insulin-mediated thermogenesis which acts to retard weight gain. Low-fat starchy foods have a relatively low caloric density, resulting in lower caloric consumption with meals. Once absorbed, carbohydrate has greater satiety value than fat. These considerations suggest that avoidance of dietary fat may be a more successful approach to weight control than "calorie counting". The efficacy of low-fat diets may be promoted by supplementary carnitine, which stimulates fat oxidation, and by chromium, which aids insulin-mediated thermogenesis. An unrefined low-fat diet, eaten to satiety and accompanied by regular exercise, may be the ideal means of maintaining a trim figure throughout life while minimizing one's risk for "Western" degenerative diseases.

Basal Metabolism↗
PubMed2005

Population and virulence factor dynamics in fecal Escherichia coli from healthy adults consuming weight control diets.

Individual susceptibility to gastrointestinal infection is seen commonly in food poisoning outbreaks, but factors (such as diet) which may modulate this variability are understood poorly. Similarly, factors altering the population dynamics of enteric non-pathogenic Escherichia coli or of pathogenic E. coli containing toxin-signature DNA sequences in the colonic flora of healthy individuals are largely unknown. Feces were collected 4 times over a 12 week period from 41 healthy volunteer adults on a weight control diet (high or low in fiber). E. coli strains were examined by conventional culture followed by PCR for virulence genes stx1, stx2, eae and hlyA, and polymorphic beta-glucuronidase. Total E. coli counts ranged from undetectable to 8.75 log10 CFU/g feces and were unaffected by dietary fiber consumption or gender. Total E. coli counts were correlated positively with age (r = 0.401, P < 0.05). Fifty-eight percent (n = 24) of study individuals harboured more than 1 morph of beta-glucuronidase, indicating the presence of more than 1 strain of E. coli. Virulence genes were detected in 12 of 41 adults, comprising 10 stx1, 3 stx2, 3 eae, and 0 hlyA, but occurrence was not associated with diet, gender, or age. Factors influencing strain mobility over time did not appear to include diet or gender, while the positive relationship between total E. coli numbers and increasing age suggests that some older individuals are "more permissive" to mobile E. coli, including those with toxin genes.

Adhesins, Bacterial↗
PubMed2004

[UCP-3: regulation of genic expression on skeletal muscle and possible role on body weight control].

Uncoupling proteins constitute a subgroup of mitochondrial carrier proteins that are located in the inner mitochondrial membrane. By dissipating proton gradients, they act to uncouple respiration from oxidative phosphorylation and convert fuel to heat. Four homologous UCP isoforms have been identified. UCP-1, the first UCP to be described, is found exclusively in brown adipose tissue, UCP-2 in several tissues, UCP-3 in human skeletal muscle and rat brown adipose tissue and skeletal muscle, whereas UCP-4 is expressed in the brain. Expression of UCP-3 in the skeletal muscle and the brown adipose tissue may place these tissues as important mediators for adaptative thermogenesis. However, the role of UCP-3 in energy expenditure and as a cause of obesity has been controversial. There are evidences that UCP-3 can be regulated by energy substrates as fatty acids and glucose, by entering the muscle and stimulating UCP-3 to increase energy expenditure. Our aim in this review was to describe and discuss the available information on UCP-3 regulation and its possible relation with body weight control.

Adipose Tissue, Brown↗
PubMed2004

Amylin replacement with pramlintide as an adjunct to insulin therapy improves long-term glycaemic and weight control in Type 1 diabetes mellitus: a 1-year, randomized controlled trial.

AIMS: The autoimmune-mediated destruction of pancreatic beta-cells in Type 1 diabetes mellitus renders patients deficient in two glucoregulatory peptide hormones, insulin and amylin. With insulin replacement alone, most patients do not achieve glycaemic goals. We aimed to determine the long-term efficacy and safety of adjunctive therapy with pramlintide, a synthetic human amylin analogue, in patients with Type 1 diabetes. METHODS: In a double-blind, placebo-controlled, parallel-group, multicentre study, 651 patients with Type 1 diabetes (age 41 +/- 13 years, HbA(1c) 8.9 +/- 1.0%, mean +/- sd) were randomized to mealtime injections of placebo or varying doses of pramlintide, in addition to their insulin therapy, for 52 weeks. RESULTS: Addition of pramlintide [60 microg three times daily (TID) or four times daily (QID)] to insulin led to significant reductions in HbA(1c) from baseline to Week 52 of 0.29% (P < 0.011) and 0.34% (P < 0.001), respectively, compared with a 0.04% reduction in placebo group. Three times the proportion of pramlintide- than placebo-treated patients achieved an HbA(1c) of < 7%. The greater reduction in HbA(1c) with pramlintide was achieved without an increase in concomitant insulin use and was accompanied by a significant reduction in body weight from baseline to Week 52 of 0.4 kg in the 60 microg TID (P < 0.027) or QID (P < 0.040) pramlintide treatment groups, compared with a 0.8-kg gain in body weight in the placebo group. The most common adverse event in pramlintide-treated patients was transient, mild-to-moderate nausea. CONCLUSIONS: These results show that mealtime amylin replacement with pramlintide, as an adjunct to insulin therapy, improves long-term glycaemic and weight control in patients with Type 1 diabetes.

Adult↗
PubMed2003

Pramlintide as an adjunct to insulin therapy improves long-term glycemic and weight control in patients with type 2 diabetes: a 1-year randomized controlled trial.

OBJECTIVE: Mealtime amylin replacement with the human amylin analog pramlintide, as an adjunct to mealtime insulin replacement, reduces postprandial glucose excursions in patients with type 2 diabetes. The aim of the present study was to assess the long-term efficacy and safety of pramlintide in this patient population. RESEARCH DESIGN AND METHODS: In a 52-week, double-blind, placebo-controlled, parallel-group, multicenter study, 656 patients with type 2 diabetes (age 57 +/- 10 years, diabetes duration 12 +/- 7 years, BMI 34.0 +/- 7.0 kg/m(2), HbA(1c) 9.1 +/- 1.2%, mean +/- SD) treated with insulin (alone or in combination with sulfonylureas and/or metformin) were randomized to receive additional preprandial subcutaneous injections of either placebo or pramlintide (60 micro g TID, 90 microg BID, or 120 microg BID). RESULTS: Treatment with pramlintide 120 micro g BID led to a sustained reduction from baseline in HbA(1c) (-0.68 and -0.62% at weeks 26 and 52, respectively), which was significantly greater than that seen with placebo (P < 0.05). The proportion of patients achieving an HbA(1c) <8% was approximately twofold greater with pramlintide (120 microg BID) than with placebo (46 vs. 28%, P < 0.05). The glycemic improvement with pramlintide 120 micro g BID was accompanied by a mean weight loss (-1.4 kg vs. +0.7 kg with placebo at week 52, P < 0.05) and occurred without an overall increase in the severe hypoglycemia event rate. The most common adverse event associated with pramlintide use was transient, mild-to-moderate nausea. CONCLUSIONS: Mealtime amylin replacement with pramlintide 120 microg BID, as an adjunct to insulin therapy, improves long-term glycemic and weight control in patients with type 2 diabetes.

Aged↗
PubMed1987

Family-focused behavioral approach to weight control in children.

To treat the obese child or the child who is becoming obese appropriately, the clinician must determine if the adiposity is temporary or the beginning of a permanent trend that requires intervention. The concept of the "adiposity rebound" helps with this decision. The child's family is important and contributes to his or her body adiposity through both nature--an inherited metabolic tendency towards obesity--and nurture--the eating and activity environment and the family functioning. The activity level and energy intake, which although out of balance for the obese child, may not be low or excessive when compared to recommended amounts for children of that age or to that of peers. A child-family pattern can be defined in overweight children based on presence of a metabolic tendency, energy intake, activity level, and family functioning. In looking at the pattern rather than just the child's weight, the clinician can be much more effective with a weight control program, and with proper referral for changing family functioning prior to such a program if necessary.

Behavior Therapy↗