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PubMed2005

Smoking cessation for weight-concerned women: group vs. individually tailored, dietary, and weight-control follow-up sessions.

Postcessation weight gain is of concern to many female cigarette smokers. A multidisciplinary treatment combining psychological, dietary, and exercise components followed a 2-week smoking cessation program. Participants were randomly assigned to receive six follow-up relapse prevention sessions (in a group format or in an individually tailored format) directed by trained representatives from clinical psychology, dietary counseling, and exercise physiology. As predicted, abstinence rates were significantly higher among the individually tailored follow-up participants than among those assigned to the group follow-up condition at 3 and 6 months posttreatment. Differences between conditions in postcessation weight gain were not significant. However, the postcessation weight gain that did occur was significantly associated with subsequent smoking relapse in the group follow-up condition only.

Adult↗
PubMed2005

Choosing an operation for weight control, and the transected banded gastric bypass.

Obesity and particularly morbid obesity is a lifelong problem that currently cannot be cured but can be controlled. Attempted control of obesity non-surgically results in 98% recividism. Weight loss is readily attainable, but weight loss maintenance is recalcitrant. Surgery currently provides the only long-term control of obesity. Surgery at best is a tool that the patient can use to effect the weight loss and weight loss maintenance. We have celebrated the golden anniversary of bariatric surgery in 2004. Obesity surgery is thus a relatively young field which is evolving. Operations currently used for the treatment of obesity fall into 3 categories: 1) restrictive operations such as vertical banded gastroplasty, silastic ring gastroplasty and gastric banding; 2) malabsorptive operations which include all the variations of the intestinal bypass; and 3) combined operations which utilize both restriction and malabsorption which include all the variations of short-limb gastric bypass, long-limb or distal gastric bypass and biliopancreatic diversion. The choice of the operation will be guided by the extent of the patient's obesity, the age of the patient, other co-morbid conditions of the patient, the cost of the operation, the patient's choice, and the surgeon's choice based on training, experience and geographical location. First and foremost, the operation chosen should be effective in causing weight loss and providing long-term weight loss maintenance with acceptable morbidity and mortality. Recommendations are made for choosing an operation for weight control based on effectiveness and safety.

Adult↗
PubMed2003

Prescribed "breaks" as a means to disrupt weight control efforts.

OBJECTIVE: Research on long-term maintenance of weight loss is hampered by the fact that relapse typically does not occur until after 6 months. We sought to determine whether relapses could be induced earlier by intentionally interrupting the momentum of weight loss during a treatment program and thus provide a model for weight maintenance research. RESEARCH METHODS AND PROCEDURES: Subjects (N = 142) were recruited at two centers and randomly assigned to a control group, a long break group (LB), or a short break group (SB). The control group received a standard behavioral weight loss program with 14 weekly sessions; the LB and SB groups received the same. However, the LB group took a 6-week break after lesson 7, and the SB group took a 2-week break after lessons 3, 6, and 9. Participants were instructed to stop all weight loss efforts during breaks. RESULTS: Participants seemed to take breaks as prescribed, with interruptions in self-monitoring, dietary adherence, and self-weighing (but not in exercise). However, participants quickly resumed these behaviors after the break. Breaks produced a slowing of weight loss or slight regain, but weight losses during the breaks were not significantly different from the control group. Importantly, overall weight losses (0 to 5 months or 0 to 11 months) did not differ between conditions. DISCUSSION: This study was not successful in developing a method to experimentally produce weight loss relapses. However, the finding that prescribed breaks do not have adverse effects may have clinical application.

Adult↗
PubMed1986

[Clinical approach to weight control].

In defining the therapeutic strategy the clinical evaluation of obesity relies on ideal body weight tables and the calculation of the body weight index (kg/m2). The distribution of fat tissue must also be considered, since the increased risk of cardiovascular disease appears to be associated with the android type of obesity. A number of factors influence the development of obesity, including heredity, energy balance and appetite, which is under physiologic and psychological control. A balanced hypocaloric diet remains the basic approach to weight control as it alone provides nutritional education. Under medical supervision, unbalanced diets, such as the protein-sparing modified fast, have been shown to be very effective. The surgical treatment of morbid obesity is controversial, although good results are claimed for gastroplasty. Whatever the approach, appropriate supportive measures must be included in order to modify behavior towards food and maintain weight loss.

Adult↗
PubMed2004

'Healthy weight' at what cost? 'Bulimia' and a discourse of weight control.

Public health messages emphasizing 'healthy weight' link good health to a narrow range of body weights and stress energy regulation to achieve this. We examined whether women who practise bulimia deploy notions of 'healthy weight' in their talk about body management activities. Analysis is based on interviews with 15 women who practise bulimia and on material collected from cultural locations containing 'health promotion' advice. Poststructuralist discourse analysis revealed that slenderness was constituted as healthy in both sites and that the careful regulation of energy intake and output was similarly reified as a healthy practice. We conclude that a discourse of 'healthy weight' cannot be unhinged from a cultural imperative of slenderness for women, and that paradoxically 'health' practices provide a rationality that supports the practices of binge eating and compensating.

Adolescent↗
PubMed2005

Energetics of obesity and weight control: does diet composition matter?

Greater average weight losses (2.5 kg over 12 weeks) have been reported for low-carbohydrate diets (<90 g/day) compared with traditional low-fat (<25% of energy), hypocaloric diets, implying a 233 kcal/day greater energy deficit. It has therefore been suggested that a low-carbohydrate diet may provide a metabolic advantage (an increase in energy expenditure), resulting in a positive effect on weight loss and maintenance. However, a review of studies in which 24-hour energy expenditure was measured did not provide evidence to support a metabolic advantage of low-carbohydrate diets and showed little evidence of a metabolic advantage of high-protein (>25% of energy) diets. Nonetheless, diets high in protein, but either low or modest in carbohydrate, have resulted in greater weight losses than traditional low-fat diets. We speculate that it is the protein, and not carbohydrate, content that is important in promoting short-term weight loss and that this effect is likely due to increased satiety caused by increased dietary protein. It has been suggested that the increased satiety might help persons to be more compliant with a hypocaloric diet and achieve greater weight loss. The current evidence, combined with the need to meet all nutrient requirements, suggests that hypocaloric weight-loss diets should be moderate in carbohydrate (35% to 50% of energy), moderate in fat (25% to 35% of energy), and protein should contribute 25% to 30% of energy intake. More studies of the efficacy of weight-loss and weight-maintenance diets that address protein content are needed. In addition, controlled studies of total energy expenditure or physical activity measured under free-living conditions that directly compare high-protein diets with those containing low and moderate carbohydrate content should also be performed.

Diet, Reducing↗
PubMed1983

Self-modelling and weight control.

This study investigated the use of self-modelling in the treatment of obesity or overweight. Thirty-two females enrolled in a private slimming club volunteered to participate in this study which was conducted over a period of 10 weeks. The experimental and control groups were similar as far as their pre-treatment mean weights and desired mean weights were concerned. Analysis of the data indicated that towards the end of the study the experimental group lost significantly more weight than the control groups. At the end of the study, the average weight loss for the experimental group was 4.27 pounds, for the control group I, 2.45 pounds, and for control group II, 3.66 pounds. Analysis of follow-up data collected six weeks after the end of the study confirmed this finding. At follow-up data collected six weeks after the end of the study confirmed this finding. At follow-up the mean weight loss was 8.27 pounds, 2.00 pounds for the experimental group, control group I and control group II, respectively. The data suggest that self-modelling can be used in the control of addictive behaviours.

Adolescent↗
PubMed1985

Weight control.

Explore the source record for details and available documents.

Body Weight↗
PubMed1984

A multiple factor study of body weight control.

A multiple factor approach toward body weight regulation was proposed which uses elements of self-perception theory to integrate seemingly unrelated or conflicting findings on the etiology of human obesity. Four factors--cue responsiveness, incidence of eating related to emotional distress, dietary restraint, and activity level--were hypothesized to influence the likelihood of obesity, with eating style being the most important variable. The existence of subgroups--normal weight and overweight individuals differing with respect to eating style, emotional-distress-related eating, dieting, and activity level--were proposed. In experimental tests on 90 Ss, predictions about the relationship of independent variables to obesity and the existence of subgroups of obese and normal weight individuals received support.

Adult↗
PubMed1990

Weight-control training-models for obese pupils in Bangkok.

The increased prevalence of obese children in schools in Bangkok from 12.7 to 14.3 per cent between 1986-1987, and the health risk of obesity of cardiovascular diseases, requires effective training models for behavior modification. The effects of 4 training models: problem-solving, lecturing, lecturing + reward and self-learning developed by the researchers, on the changes of knowledge and weight/height of 90 obese pupils, were compared with those of other 20 obese pupils in the control group. The comparison of height, weight and weight/height, including knowledge of the obese pupils, before training, between training and control groups, showed no significant difference. At the end of the 3-month training period, pupils' knowledge of obesity had increased significantly by all training models, without any difference among groups. The change of weight during the training period showed no significant difference, both within and among groups, except within the lecturing + reward group which had decreased significantly. At the end of 6 months' follow-up, the increase of weight/height (after-before), differed significantly, both within and among groups, with the highest increase in the control group, followed by self-learning, lecturing, problem-solving, and lecturing + reward. The weight-increase that had not differed significantly, was found in the problem-solving group only. If the percentages of the obese pupils whose weight/height were reduced, were considered, the highest reduction was in the problem-solving (31.8%), lecturing (28.6%), lecturing + reward (22.7%), and self-learning (20%). There was no obese pupil in the control group whose weight/height was reduced, throughout the study.(ABSTRACT TRUNCATED AT 250 WORDS)

Behavior Therapy↗
PubMed1983

Psychological and behavioral characteristics of normal-weight bulimics and normal-weight controls.

This study compares psychological traits, physical traits, behavior, demographic data, incidence of family pathology, incidence of life stress, and scores on eating disorder scales in a sample of normal-weight female bulimics with a sample of normal-weight female controls. The groups, matched for age, socioeconomic status, and I.Q. were found to have comparable physical traits, family demographics, incidence of family pathology, and incidence of life stress. However, bulimics demonstrated significantly higher levels of psychological pathology and impulsive behavior. There were significantly more suicide attempts, psychiatric hospitalizations, episodes of stealing, use of drugs, and menstrual disturbances among the bulimics than the controls. The bulimics consistently rated themselves sicker than the controls on all psychometric scales. Most notable were the depression, anxiety, obsessive-compulsive, and interpersonal sensitivity factors on the Symptom Checklist 90, and the internal control score on the Nowicki-Strickland Locus of Control Scale. The discussion includes a brief description of weight set-point theory and its role in the maintenance of bulimia.

Adult↗
PubMed2003

Dietary fat and body weight control.

The global obesity epidemic has heightened the debate about dietary factors contributing to weight gain. Media stories have promulgated the notion that obesity has increased despite reductions in dietary fat intake. Some have even speculated that lower dietary fat levels may be driving the rapid rise in weight gain within the population. A close examination of the science reveals a different picture and supports the hypothesis that dietary fat, within the context of the total dietary composition consumed by many populations, promotes obesity. Hence, dietary fat control is still an important strategy as part of an overall approach to body weight management in our modern environment. Dietary fat increases the energy density of foods. Abundant evidence from preclinical and clinical studies indicates that fat promotes excess energy intake and positive energy balance. Dietary fat does not promote its own oxidation in the body and is stored efficiently, promoting a positive fat balance. Thus, both the behavioral and metabolic responses to dietary fat increase the probability of positive energy balance and body fat gain. Restoring fat balance when consuming diets rich in fat requires increasing the size of the body fat mass, increasing physical activity, or reducing dietary fat intake. Numerous epidemiologic, preclinical, and controlled clinical studies have shown that body fat is positively associated with dietary fat intake and that dietary fat manipulation leads to appropriate changes in body fat mass. Finally, data from the National Weight Control Registry, a database of > 3000 individuals who have successfully maintained a substantial weight loss, indicate that moderating dietary fat intake is a key strategy for long-term management of body weight.

Animals↗
PubMed1998

Effect of hydrolyzed guar fiber on fasting and postprandial satiety and satiety hormones: a double-blind, placebo-controlled trial during controlled weight loss.

OBJECTIVE: To evaluate the effects of a completely soluble fiber on fasting and postprandial hormone levels, respiratory quotient (RQ) and subjective ratings of satiety during a controlled weight-loss program. DESIGN: In a five-week prospective, randomized, double-blind study, a 3.3 MJ (800 kcal)/d diet was provided during a two-week wash-in period. Then, during the intervention weeks, separated by a one-week wash-out period, a 3.3 MJ (800 kcal) formula containing either 20 g fiber or placebo daily, was given in a cross-over design and on days 1, 3 and 7 of the intervention weeks (weeks 3 and 5) measurements were taken after an overnight fast. SUBJECTS: 25 obese but otherwise healthy females (age: 46+/-6 y, body mass index (BMI): 35+/-6 kg/m2) were studied. MEASUREMENTS: Body weight; hunger/satiety ratings; glucose, insulin, cholecystokinin (CCK) and leptin concentrations; RQ during the intervention weeks. RESULTS: In the fasting state, the supplement had no effect on any of the measured parameters, including blood concentrations of glucose, insulin, CCK, and leptin, RQ and satiety ratings. In the 2 h postprandial period following the test meal, none of the measured parameters differed significantly from that following the non-fiber-supplemented meal, except for the CCK response. CCK demonstrated an overall higher concentration after the fiber-supplemented meal (P=0.007), even after adjustment for age, weight, height and treatment sequence. The postprandial peak in CCK also occurred earlier (at 15 min vs 30 min) after completion of the fiber-supplemented meal. CONCLUSIONS: The results indicated that a hydrolyzed guar gum fiber supplement produced a heightened postprandial CCK response, but did not alter other satiety hormones or increase satiety ratings, in either the fasting or the postprandial state.

Adult↗
PubMed1993

The association of lifetime weight and weight control patterns with bone mineral density in an adult community.

We examined the association of lifetime weight and weight change to bone mineral density (BMD) at four skeletal sites, the radial shaft, the ultradistal wrist, the total hip and lumbar spine, in a community-based population of 1043 older white men and women. In those currently overweight (body mass indices (BMI) > 26), the age-adjusted mean BMD at all sites was significantly higher than in those with BMI less than 26. Lifetime maximum BMI was also positively and significantly associated with a higher age-adjusted BMD at all sites except the ultradistal wrist in men. Weight gain or fluctuation of 10 lbs or more between the ages of 40 and 60 was associated with significantly higher age-adjusted mean BMD at all sites compared to weight loss or no weight change in both men and women. Weight at age 18 was unassociated with BMD but weight gain after age 18 was associated with significantly higher age-adjusted mean BMD at all sites. Conversely, dieting, weight loss or a lifetime maximum BMI of less than 24 were all associated with markedly lower BMD at all sites in both sexes. Weight patterns were closely correlated with current BMI; most of these trends persisted but were no longer statistically significant after controlling for current weight.

Adolescent↗
PubMed2005

Raw vegetable food containing high cyclo (his-pro) improved insulin sensitivity and body weight control.

Cyclo (his-pro), controlled-energy diet, soy protein hydrolysate (SPH), and raw vegetable food (RVF) are known to improve insulin sensitivity and body weight (BW) control. Enhancement of high cyclo (his-pro) content in SPH (HCS) was performed by refluxing SPH with 1 N KH(2)CO(3) dissolved in 70% ethanol for 2 weeks at room temperature. Using this material, we examined the effects of HCS plus RVF on glucose metabolism and BW control in genetically diabetic Goto-Kakizaki (G-K) and insulin-resistant aged overweight Sprague-Dawley (S-D) rats. Thirty 7-week-old G-K rats and 18 16- to 18-month-old S-D rats were divided into 3 groups and treated with normal chow (NC), RVF diet, or HCS diet for 8 weeks. Raw vegetable food diet was made of 1:3 RVF and 2:3 NC; HCS diet was made of 1:27 portion HCS, 8:27 RVF, and 2:3 NC. Oral glucose tolerance significantly improved in both RVF- (P<.01) and HCS-treated (P<.001) G-K rats and worsened in NC-fed rats compared with the baseline values. Similarly, oral glucose tolerance also improved in aged overweight S-D rats when treated with RVF (P<.05) and with HCS (P<.01), compared with the baseline values. Although HCS diet treatment very significantly lowered fed plasma insulin levels compared with NC diet treatment in G-K rats (P<.01), RVF diet treatment alone did not decrease plasma insulin levels. In contrast, there was no change of insulin levels in overweight aged S-D rats after either RVF or HCS diet treatment. Postfeeding glucose levels in G-K rats fed RVF or HCS significantly fell, compared with the rats fed NC (P<.05). Interestingly, fasting blood glucose levels in RVF- or HCS-fed rats were very significantly lower than in NC-fed rats (P<.001). There was no change of blood glucose levels in S-D rats due to treatments with different diet. In G-K rats, food intake did not decrease during the first 3 weeks but fell very significantly from the fifth to eighth weeks with RVF (P<.01) and HCS (P<.001) treatments in G-K rats. However, food intake reduction in aged S-D rats was shown only for the HCS-treated rat group (P<.05). Water intake slightly decreased in G-K rats with either RVF or HCS treatment (P<.05) but very significantly decreased in S-D rats with HCS treatment (P<.01). Body weight gain in young G-K rats and BW in aged S-D rats significantly decreased only when rats were treated with HCS diet (P<.05). These data suggest that regular consumption of HCS diet helps to control blood glucose metabolism in diabetic G-K rats and BW control in aged obese S-D rats.

Aging↗
PubMed2006

Dietary and body weight control: therapeutic education, motivational interviewing and cognitive-behavioral approaches for long-term weight loss maintenance.

A diet always induces weight loss in the short term. The loss does not depend on the dietary composition but rather on the caloric deficit. However, a drastic diet often induces binge eating disorders and can lead to a weight gain in the long term. A cognitive-behavioral-nutritional approach allows lasting weight loss and best results with low fat diets in the long term. Therapeutic education is a patient-centered humanistic approach which allows patients to be actors in their own treatment and own diet to improve their success in losing weight and their quality of life. Motivational interviewing and cognitive-behavioral approaches are perfect complements to therapeutic education for long-term weight loss maintenance. Finally, the best diet is the one that the patient can follow in the long term.

Behavior Therapy↗