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PubMed1994

The behavioural epidemiology of weight control.

Excess body weight is associated with increased health risk, but there are also risks to health related to weight-control practices. While representative population data are available on the anthropometry of body weight and its sociodemographic correlates in Australia, less is known about the population prevalence and correlates of weight-control behaviours. We examine the prevalence of overweight and obesity, and low body weight, in the Australian population, using data from studies in which height and weight have been objectively measured; we describe the sociodemographic correlates of overweight and obesity; we outline relevant aspects of Australian health-system and private-sector approaches to body weight control; and we describe the findings of Australian studies of weight-control practices and related beliefs and attitudes. These findings relate mainly to women, particularly younger women, and little is known about the weight-control practices of Australian men. We suggest research which may promote a better understanding of weight-control practices in the Australian population.

Adult↗
PubMed1985

Controlling weight by purgation and vomiting: a comparative study of bulimics.

This study assessed the efficacy of self-induced vomiting and purgation, respectively, in attempts at preventing weight gain in patients with bulimia. It was found that the vomiters ate significantly more yet weighed less: the purgers ate less but weighed significantly more. Such findings strongly suggest that excess purgation has little impact on intestinal absorption even at the doses used in bulimia. Weight control appears to be exercised by dietary restraint not by the pharmacological action of the laxatives used.

Adolescent↗
PubMed1999

Prevalence of attempting weight loss and strategies for controlling weight.

CONTEXT: Overweight and obesity are increasing in the United States. Changes in diet and physical activity are important for weight control. OBJECTIVES: To examine the prevalence of attempting to lose or to maintain weight and to describe weight control strategies among US adults. DESIGN: The Behavioral Risk Factor Surveillance System, a random-digit telephone survey conducted in 1996 by state health departments. Setting The 49 states (and the District of Columbia) that participated in the survey. PARTICIPANTS: Adults aged 18 years and older (N = 107 804). MAIN OUTCOME MEASURES: Reported current weights and goal weights, prevalence of weight loss or maintenance attempts, and strategies used to control weight (eating fewer calories, eating less fat, or using physical activity) by population subgroup. RESULTS: The prevalence of attempting to lose and maintain weight was 28.8% and 35.1 % among men and 43.6% and 34.4% among women, respectively. Among those attempting to lose weight, a common strategy was to consume less fat but not fewer calories (34.9% of men and 40.0% of women); only 21.5% of men and 19.4% of women reported using the recommended combination of eating fewer calories and engaging in at least 150 minutes of leisure-time physical activity per week. Among men trying to lose weight, the median weight was 90.4 kg with a goal weight of 81.4 kg. Among women, the median weight was 70.3 kg with a goal weight of 59.0 kg. CONCLUSIONS: Weight loss and weight maintenance are common concerns for US men and women. Most persons trying to lose weight are not using the recommended combination of reducing calorie intake and engaging in leisure-time physical activity 150 minutes or more per week.

Adult↗
PubMed2004

Smoking as a weight-control strategy among adolescent girls and young women: a reconsideration.

Many studies have reported that adolescent girls and young women smoke to control their weight. The majority of these studies are cross-sectional and report on correlational data from quantitative surveys. This article presents data from ethnographic interviews with 60 smokers, interviewed in high school and in follow-up interviews at age 21. Contrary to previous research, this study found little evidence for the sustained use of smoking as a weight-control strategy. In high school, smokers were no more likely than nonsmokers to be trying to lose weight. In the follow-up study, 85 percent of informants replied that they had never smoked as a way to control their weight. One-half of informants at age 21 believed that smoking as a weight-control strategy would be ineffective, while the other one-half had no idea whether it would work or not. Researchers need to exert caution in propagating the idea that smoking is commonly used as a conscious and sustained weight-control strategy among adolescent females and young women.

Adolescent↗
PubMed1999

Stage of change as a predictor of success in weight control in adult women.

Weight change over 3 years was examined in a large and heterogeneous sample of women as a function of stage of change for weight control. Women were classified into Precontemplation, Contemplation, Preparation, and Action stages on the basis of reports of current and past weight control behaviors and future intentions. Stage of change did not predict success in weight control. Mean weight changes over 3 years were 1.1 kg, 1.0 kg, 2.1 kg, and 2.3 kg for Precontemplation, Contemplation, Preparation, and Action stages, respectively. The findings call into question the generality of the stages-of-change classification system across behavioral domains.

Adult↗
PubMed1999

Resting energy expenditure in reduced-obese subjects in the National Weight Control Registry.

BACKGROUND: Weight loss in obese subjects is associated with a reduction in resting metabolic rate (RMR). Whether the reduction can be explained solely by a reduction in lean body mass remains controversial. OBJECTIVE: Our objective was to determine whether the reduction in RMR after weight loss was proportional to the decrease in lean mass alone or was greater than could be explained by body composition. DESIGN: We measured the RMR, fasting respiratory quotient (RQ), and body composition in 40 reduced-obese subjects [ie, 7 men and 33 women who had lost > or = 13.6 kg (30 lb) and maintained the loss for > or = 1 y] enrolled in the National Weight Control Registry and 46 weight-matched control subjects (9 men, 37 women). RESULTS: A stepwise multiple regression found lean mass, fat mass, age, and sex to be the best predictors of RMR in both groups. After adjusting RMR for these variables, we found no significant difference in RMR (5926 +/- 106 and 6015 +/- 104 kJ/d) between the 2 groups (P = 0.35). When we adjusted fasting RQ for percentage body fat and age, the reduced-obese group had a slightly higher (0.807 +/- 0.006) RQ than the control group (0.791 +/- 0.005, P = 0.05). This may have been due to the consumption of a diet lower in fat or to a reduced capacity for fat oxidation in the reduced-obese group. CONCLUSION: These results show that in at least some reduced-obese individuals there does not seem to be a permanent obligatory reduction in RMR beyond the expected reduction for a reduced lean mass.

Basal Metabolism↗
PubMed2006

Smoking for weight control: effect of priming for body image in female restrained eaters.

Women are more likely than men to believe that smoking helps to control their weight, and this relationship may be more pronounced in those with eating disturbances, such as eating restraint. Restrained eaters have been shown to be more susceptible to media portrayals of idealized body image, like those used in tobacco advertising. The primary aim of this study was to examine the effect of an implicit prime for body image on expectations that smoking can control weight in restrained and non-restrained eaters. Participants were 40 females, who smoked an average of 7.65 (S.D.=4.38) cigarettes per day. Participants were presented with a bogus task of rating slides; either participants viewed 30 slides of nature scenes (neutral prime); or viewed 30 slides depicting fashion models (body image prime). Participants then completed questionnaires that assessed smoking expectancies, smoking history, and eating restraint. As hypothesized, restrained eaters who viewed the slides depicting models had greater likelihood ratings that smoking helps to control appetite and manage weight, in comparison to restrained eaters who viewed the control slides and non-restrained eaters who viewed either type of slides. There were no other group differences across the remaining smoking expectancy factors. Images similar to those used in tobacco advertising targeting women had the ability to elicit stronger beliefs that smoking is beneficial for weight control in a group of women who are at heightened risk for such beliefs.

Adult↗
PubMed1989

Conversion surgery for morbid obesity: complications and long-term weight control.

Some operations for morbid obesity fail--for a variety of reasons. To better understand the risk and efficacy of converting, during a single operation, a failed procedure to a second type of operation for morbid obesity, a review was made of all 120 patients who underwent this type of conversion surgery at one university hospital during a 10-year period. The initial operations of 62 patients were converted to a gastric bypass with a Roux-en-Y gastrojejunostomy, 11 to an unbanded gastrogastrostomy, and 47 to a vertical banded gastroplasty. Four patients are dead (three of unrelated causes), 11 have undergone a third operation for morbid obesity, and five (4.2%) are lost to follow-up. For 69 of 86 patients, 3- to 5-year follow-up data are available. Serious early complications occurred in 5.8% of the patients. Almost 80% of the patients who received an unbanded gastrogastroplasty did not control their weight, whereas most of those who received a Roux-en-Y gastrojejunostomy or a vertical banded gastroplasty had satisfactory long-term weight control 3 to 5 years later, maintaining an average weight loss of 30% of their original weight or 55% of their excess weight. Conversion surgery is safe and effective.

Adult↗
PubMed1987

Weight control in university students.

A total of 1858 students of United Kingdom origin aged between 18 and 20 years of age completed questionnaires which investigated present weight, bingeing, vomiting and weight control. Men were significantly more likely than women to be overweight, while women were significantly more likely to be underweight. One-third of the women were actively controlling weight, with dieting as the preferred method, while over half had attempted weight control in the past three years. Daily or more frequent bingeing was reported by 1.9% of men and 1.2% of women. There was a statistically significant relationship between weight control and bingeing. Eleven percent of men and 24% of women thought they had a problem with weight control, although amongst both men and women the proportion who felt they were overweight was in excess of the proportion who actually were overweight. It is suggested that health education programmes should take account of the pressures upon young women to conform to predetermined ideals in terms of body weight.

Adolescent↗
PubMed1994

A processes of change model for weight control for participants in community-based weight loss programs.

The processes of change model has been successful in predicting behavior change across a wide range of both addictive and nonaddictive problem behaviors. This study was designed to examine the application of the processes of change model to weight control. Study participants included 285 women and men enrolled in three community-based weight loss programs. Results based on structural equation analyses showed that the processes of change model fit the data better than several plausible alternative models. In addition, structural analyses revealed the existence of two general (higher order) processes of change for weight control, the experiential and behavioral processes. These results are similar to those previously reported for eight other problem behaviors. Limitations of the current work and future directions for this line of research are discussed.

Adolescent↗
PubMedDate not supplied

Weight control self-efficacy types and transitions affect weight-loss outcomes in obese women.

Matching obesity treatments to heterogeneous clients is a recent evolution in the development of more effective weight-control programs, yet most interventions emphasize the external features of treatments rather than the internal belief structures of individuals. The purpose of this study was to determine whether Q methodology would identify distinct types of weight-control self-efficacy beliefs in obese women that would be linked to outcomes of a weight-loss program. Fifty-four women (45 +/- 9 yrs, Mean +/- SD) 136 +/- 10% over ideal body weight participated in a 9-month nutritional/behavioral weight loss program. Two major self-efficacy categories emerged through factor analysis of Q sorts: assureds and disbelievers. The assureds (n = 28) had the strongest self-efficacy beliefs and at baseline reported significantly (p < .01) greater self-esteem and less depression than the disbelievers (n = 26). By posttreatment, the assureds had lost significantly more weight (10 +/- 6 vs. 7 +/- 7 kg). Regrouping the data for analysis by posttreatment self-efficacy types demonstrated transitions in the self-efficacy beliefs of the women during treatment. Those who were disbelievers at baseline but became assureds posttreatment (n = 7) lost twice as much weight as the women who started and finished as disbelievers (n = 19) (10 +/- 7 kg vs. 5 +/- 5 kg). The posttreatment assureds (n = 32) lost significantly more weight than the disbelievers (n = 22) (10 +/- 6 vs. 6 +/- 5 kg), and reported better self esteem, mood, and eating patterns. Thus, assessment of intrinsic belief systems, particularly weight-control self-efficacy, may provide new directions for designing interventions that target distinctly different needs of obese women to affect greater weight loss and more positive affective states.

Adult↗
PubMed2006

ALIFE@Work: a randomised controlled trial of a distance counselling lifestyle programme for weight control among an overweight working population [ISRCTN04265725].

BACKGROUND: The prevalence of overweight is increasing and its consequences will cause a major public health burden in the near future. Cost-effective interventions for weight control among the general population are therefore needed. The ALIFE@Work study is investigating a novel lifestyle intervention, aimed at the working population, with individual counselling through either phone or e-mail. This article describes the design of the study and the participant flow up to and including randomisation. METHODS/DESIGN: ALIFE@Work is a controlled trial, with randomisation to three arms: a control group, a phone based intervention group and an internet based intervention group. The intervention takes six months and is based on a cognitive behavioural approach, addressing physical activity and diet. It consists of 10 lessons with feedback from a personal counsellor, either by phone or e-mail, between each lesson. Lessons contain educational content combined with behaviour change strategies. Assignments in each lesson teach the participant to apply these strategies to every day life. The study population consists of employees from seven Dutch companies. The most important inclusion criteria are having a body mass index (BMI) > or = 25 kg/m2 and being an employed adult. Primary outcomes of the study are body weight and BMI, diet and physical activity. Other outcomes are: perceived health; empowerment; stage of change and self-efficacy concerning weight control, physical activity and eating habits; work performance/productivity; waist circumference, sum of skin folds, blood pressure, total blood cholesterol level and aerobic fitness. A cost-utility- and a cost-effectiveness analysis will be performed as well. Physiological outcomes are measured at baseline and after six and 24 months. Other outcomes are measured by questionnaire at baseline and after six, 12, 18 and 24 months. Statistical analyses for short term (six month) results are performed with multiple linear regression. Analyses for long term (two year) results are performed with multiple longitudinal regression. Analyses for cost-effectiveness and cost-utility are done at one and two years, using bootstrapping techniques. DISCUSSION: ALIFE@Work will make a substantial contribution to the development of cost-effective weight control- and lifestyle interventions that are applicable to and attractive for the large population at risk.

Adult↗
PubMed1986

Self-help group behavioural treatment for obesity. An evaluation of Weight Control Workshops.

A study of a self-help weight control programme (Weight Control Workshops) in Sydney followed 168 women and four men from the beginning of the 12-week programme until six months after the end of the programme. The average subject was a 42-year-old woman who was moderately overweight with a starting weight of 74 kg and wished to lose 13 kg. Although 90% of subjects lost weight during the programme, weight losses were modest, with a mean loss of 4.3 kg. Weight loss was not well maintained, with 52% gaining weight in the follow-up period, to give a mean weight gain of 0.4 kg. The Weight Control Workshop programme represents a group treatment for obesity based on standard behaviour therapy, and appears to be as effective as similar programmes that have been reported in the literature.

Behavior Therapy↗
PubMed2000

Role of dietary carbohydrate and frequent eating in body-weight control.

Despite widespread interest in body-weight control, the prevalence of obesity continues to rise worldwide. Current public health advice for obesity prevention is clearly failing. The present paper examines the appropriateness of current public health advice for body-weight control, i.e. to reduce consumption of fatty foods, to reduce consumption of sugar and to avoid snacking between meals. An increase in carbohydrate: fat ratio should improve body-weight control, as high-carbohydrate low-fat diets are less likely to lead to overeating, and if overeating does occur, less of the excess energy is likely to be stored as fat. However, it is suggested that for the long-term prevention of weight gain, advice to increase consumption of carbohydrate-rich foods may be more effective than advice which focuses on reducing consumption of fatty food. Moreover, in view of the inverse relationship between fat and sugar intakes, sugar may have a positive role to play in body-weight control in facilitating an increase in carbohydrate: fat ratio. Snacking for most individuals appears not to adversely affect body-weight control, and for some it may improve control. This situation may exist because frequent eating helps appetite control, thus preventing overeating at meals, and as snacks overall tend to be higher in carbohydrate and lower in fat than meals, frequent eating may be a strategy for increasing carbohydrate: fat ratio. It is also suggested that eating 'little and often' may be a more compatible pattern of eating for a physically-active lifestyle than eating large meals. Perhaps the most appropriate advice on food intake that would work synergistically with concurrent advice to increase physical activity is to eat more carbohydrate, and to eat frequently.

Appetite↗
PubMed1988

Weight control methods in high school wrestlers.

Severe weight control methods used by high school wrestlers have caused concern about these students' growth and athletic performance. There are minimal prevalence data on a few methods of weight control used by wrestlers and no information on the relationship to body fat measurements. Weight control methods and the percent body fat of wrestlers (n = 49) were compared to competitive squash players (n = 20) and noncompetitive jogging and fitness students (n = 38) at an independent secondary school. Wrestlers used dieting (p = 0.0002), binging (p = 0.026, vomiting (p = 0.046), sweating (p = 0.0001), and fluid restriction to less than 2 cups/day (p = 0.0014) significantly more often than controls (squash players and jogging/fitness students). There was no difference between the wrestlers' and controls' use of fasting (p = 0.5) or exercising (p = 0.1). Neither group reported using a diuretic or laxative during the sports seasons. Although the wrestlers' percent body fat was lower than controls (mean for wrestlers = 10.3 +/- 3.5%, mean for controls = 12.4 +/- 3.7%, p = 0.01), wrestlers perceived their mean ideal weight to be less than their present weight (wrestlers = -1.56 +/- 6.20 lb, controls = +1.92 +/- 9.49 lb, p = 0.03). The methods of weight control practiced could potentially impair an adolescent's growth and development as well as increase the risk of dehydration or electrolyte imbalance during competition.

Adolescent↗
PubMed2003

Schizophrenia and weight management: a systematic review of interventions to control weight.

OBJECTIVE: Weight gain is a frequent side effect of antipsychotic medication which has serious implications for a patient's health and well being. This study systematically reviews the literature on the effectiveness of interventions designed to control weight gain in schizophrenia. METHOD: A systematic search strategy was conducted of major databases in addition to citation searches. Study quality was rated. RESULTS: Sixteen studies met the inclusion criteria. Five of eight pharmacological intervention studies reported small reductions in weight (<5% baseline body weight). All behavioural (including diet and/or exercise) interventions reported small reductions in, or maintenance of, weight. CONCLUSION: Weight loss may be difficult but it is not impossible. Given the inconsistent results, the widespread use of pharmacological interventions cannot be recommended. Both dietary and exercise counselling set within a behavioural modification programme is necessary for sustained weight control.

Antipsychotic Agents↗