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A study of body weight concerns and weight control practices of 4th and 7th grade adolescents.

OBJECTIVE: The purpose of this study was to assess grade, race, socioeconomic status and gender differences in perceptions of body size, weight concerns, and weight control practices between 4th and 7th grade students in South Carolina. DESIGN: Two random samples, consisting of a total of 1,597 children (53.1% white, 51.97% female, 44.9% 4th graders) participated in two questionnaire surveys. Both surveys included a series of seven female and seven male body size drawings, body image and weight concern questions, and questions pertaining to weight control practices. Responses to the questionnaire were analyzed using chi-square analysis and the General Linear Model. RESULTS: Using socioeconomic status (SES), race, gender, and grade as independent variables, differences in ideal adult body size, opposite gender ideal adult body size, weight concerns, perceptions of family/peer weight concerns, perceptions of own body size and weight control practices were studied. Analyses revealed that 4th grade males select a larger ideal adult body size and opposite gender ideal adult body size when compared to 7th grade males (p < 0.0001 and p = 0.0078, respectively). Fourth grade females indicated less personal concern about their weight than 7th grade females (p = 0.0009). Fourth graders also perceived less family/peer concern about weight than 7th graders (p = 0.0027) and 7th graders described themselves as being more overweight than 4th graders (p = 0.0039). Blacks selected a significantly larger body size than white children for ideal adult (p = 0.0287) and ideal opposite gender adult body size (p < 0.0001 for males, p = 0.0030 for females). Blacks also perceived less personal and family/peer concern about weight when compared to whites (p = 0.0083). More whites reported that they were trying to lose weight, as compared to blacks (p = 0.0010). Males also selected significantly larger body size silhouettes than females for ideal adult body size (p = 0.0012). Males expressed less personal concern about weight (p < 0.0001), perceived less family/peer concern about weight (p < 0.0001), and were less likely than females to be engaged in weight loss (p < 0.0001). Females in the high SES category selected a significantly smaller ideal male adult body size than females in the low SES group (p = 0.0124) and more females in the high SES category were trying to lose weight when compared to females in the low SES group (p = 0.0055). CONCLUSION: This study indicates that early in a child's sociocultural development, grade level, gender, race, and SES are influential in the perception of ideal adult body size and opposite gender ideal adult body size. These factors are also influential in determining concerns about weight and weight control practices. The findings of this study support the need to begin health and wellness education efforts early in childhood while taking into account racial, gender, age, and SES disparities. This knowledge can also be useful in targeting interventions for both obesity and eating disorders.

Adolescent↗

Physical activity beliefs and behaviours among adults attempting weight control.

OBJECTIVE: To compare the frequency and duration of varying intensities of physical activity performed by adults trying to lose weight, avoid gaining weight and not actively trying to control their weight, and to compare these groups' beliefs about the physical activity they should perform. METHOD: Random postal survey of 2500 Victorian adults selected from the Australian electoral roll (response rate=42%). MEASURES: One-week physical activity recall (frequency and duration of walking, other moderate activity and vigorous activity), BMI (based on self-reported height and weight) and weight-control behaviour. RESULTS: At the time of the survey, 27% of respondents were actively trying to avoid gaining weight, 23. 9% trying to lose weight and 49.1% undertaking no weight control. Respondents spent a mean time of 4.0 (+/-7.1) h walking, 5.5 (+/-7. 9) h in moderate activity and 3.1(+/-5.9) h in vigorous activity during the week prior to the survey. Women trying to lose weight or avoid gaining weight engaged in vigorous activity more often than women not trying to control their weight. After adjusting for age, education and BMI, women trying to avoid gaining weight were 2.4 times more likely, and women trying to lose weight 2.5 times more likely, to have met current physical activity guidelines than women undertaking no weight control. On average, respondents believed they should spend 5.2 (+/-6.9) h walking, 6.5 (+/-8.2) h in moderate activity and 4.3 (+/-6.5) h in vigorous activity each week. Women trying to lose weight felt they should perform vigorous activity more often than other women. Weight-control behaviour was not associated with physical activity beliefs and behaviours of men. CONCLUSION: Walking is a common activity among adults attempting weight control. However, many men and women do not fully recognize the value of moderate-intensity physical activity. Future efforts should be directed at promoting the role of moderate-intensity activity in weight control, particularly activity that can be performed outside of planned activity sessions. International Journal of Obesity (2000)24, 81-87

Adult↗

Potential risk factors associated with weight control behaviors in elementary and middle school girls.

The purpose of this study was to examine the relationship between weight control behaviors and potential risk factors for disordered eating in a sample of young girls. The McKnight Risk Factor Survey was administered to 523 elementary and middle school girls. In the sample of elementary school girls, results from the multiple regression analyses indicated that frequency/severity of weight control behaviors was associated with body mass index (BMI), self-confidence, peers' weight-related pressures, ethnicity, and the interaction between having divorced/separated parents and BMI. Sensitivity to peers' weight-related pressures and BMI were also associated with weight control behaviors in the middle school girls, along with poor body image, substance use, having divorced/separated parents, and the interaction between having divorced/separated parents and father's pressure for thinness. Longitudinal research is needed to determine how risk factors change over time, beginning in elementary school and continuing through high school.

Adolescent↗

Self-reported weight, weight goals, and weight control strategies of a midwestern population.

OBJECTIVE: To elicit from individuals in a population their current weight and height, weight goals, and weight control strategies to aid in design of effective interventions to prevent and treat obesity. SUBJECTS AND METHODS: By random digit dial telephone survey, 1224 adult residents of Olmsted County, Minnesota, were contacted between February 28 and May 5, 2000. They self-reported weights and weight goals and described physical characteristics associated with their desire to lose weight. RESULTS: Among the 1224 respondents, 65.6% of men and 47.9% of women reported that they were overweight (body mass index [BMI], 25.0-29.9 kg/m2) or obese (BMI, > or =30.0 kg/m2). Only 0.4% of men and 3.7% of women reported that they were underweight (BMI, <18.5 kg/m2). Of the respondents 72.6% of men and 85.1% of women reported that they were either trying to lose or not gain weight. The average weight loss goal for individuals trying to lose weight was 23.4 pounds for men and 28.0 pounds for women. Only one third of individuals trying to lose weight and one fifth of individuals trying not to gain weight reported using the recommended approach of combining energy restriction with at least 150 minutes of exercise per week. CONCLUSIONS: The prevalence of overweight and obesity in the population and the underutilization of combining both restricting energy intake and exercising at least 150 minutes per week for weight control is high. Like the majority of people in the United States, the majority of people in Olmsted County desire to control their weight. The community has responded with plans to help residents meet their goals, although efficacy and outcomes remain to be determined.

Adult↗

Vegetarianism in young women: another means of weight control?

OBJECTIVE: To investigate the links between vegetarianism (meat avoidance) and weight control in young women. METHODS: Self-reported food habits (indicating meat avoidance and weight loss dieting) and dietary restraint (using the Dutch Eating Behavior Questionnaire [DEBQ]) were collected from 131 young adult women. Restraint scores and weight loss behavior were compared between vegetarians and nonvegetarians. In addition, reasons for meat avoidance were identified in the vegetarian subjects. RESULTS: Vegetarianism, broadly defined, was reported by 34.3% of participants. Vegetarians had significantly higher dietary restraint, but did not differ in current dieting. DISCUSSION: The relationship between vegetarianism and weight control is complex. Vegetarianism may be best seen as a method for complicating the normalization of eating rather than a simple risk factor for eating disorders.

Adult↗

The influence of parenting change on pediatric weight control.

OBJECTIVE: Parenting style was examined as a predictor of weight loss maintenance in behavioral family-based pediatric obesity treatment. RESEARCH METHODS AND PROCEDURES: Fifty obese children who participated in a behavioral family-based pediatric obesity treatment were studied. Hierarchical regression tested the incremental effect of baseline parenting and parenting during treatment on children's percentage overweight change over 12 months, beyond demographics and adherence to targeted behaviors. RESULTS: Children's percentage overweight significantly decreased at 6 (-16.3) and 12 (-11.1) months. Adherence to program goals significantly increased variance accounted for in the regression model by 10.8%, whereas adding baseline father acceptance and change in father acceptance accounted for another 20.5%. The overall model accounted for 40.6% of the variance in pediatric weight control. ANOVA showed significantly greater percentage overweight decrease from baseline for youth with fathers who increased their acceptance vs. those who decreased acceptance at 6 (-19.8 vs. -14.6) and 12 (-17.4 vs. -8.1) months. DISCUSSION: Youth who perceive an increase in father acceptance after treatment had better changes in percentage overweight over 12 months than youth with lower ratings of father acceptance. Future directions include examining how other parenting dimensions impact pediatric obesity treatment outcome and how parental acceptance can be enhanced to improve child weight control.

Attitude to Health↗

The behavior-therapeutic use of contingency contracting to control an adult behavior problem: weight control.

Items considered valuable by the subject and originally his property were surrendered to the researcher and incorporated into a contractual system of prearranged contingencies. Each subject signed a legal contract that prescribed the manner in which he could earn back or permanently lose his valuables. Specifically, a portion of each subject's valuables were returned to him contingent upon both specified weight losses and losing weight at an agreed-upon rate. Furthermore, each subject permanently lost a portion of his valuables contingent upon both specified weight gains and losing weight at a rate below the agreed-upon rate. Single-subject reversal designs were employed to determine the effectiveness of the treatment contingencies. This study demonstrated that items considered valuable by the subject and originally his property, could be used successfully to modify the subject's weight when these items were used procedurally both as reinforcing and as punishing consequences. In addition, a systematic analysis of the contingencies indicated that punishing or aversive consequences presumably were a necessary component of the treatment procedure.

Journal Article↗

Adolescents engaging in unhealthy weight control behaviors: are they at risk for other health-compromising behaviors?

OBJECTIVES: This study sought to determine whether adolescents engaging in weight control behaviors are at increased risk for tobacco, alcohol, and marijuana use; suicide ideation and attempts; and unprotected sexual activity. METHODS: Data were collected on a nationally representative sample of 16,296 adolescents taking part in the 1993 Youth Risk Behavior Survey. RESULTS: Adolescents using extreme weight control behaviors were at increased risk for health-compromising behaviors, while associations with other weight control behaviors were weak and inconsistent. CONCLUSIONS: The findings have relevance to clinical work with youth, provide a better understanding of disordered eating, and open up a number of opportunities for future research.

Adolescent↗

Weight control: a lifestyle-modification model for improving health.

The alarming increase in the prevalence of obesity in the United States is associated with many chronic health problems. Individuals need to learn how to modify their eating behaviors to control their weight and improve their health. Programs that include a combination of diet, exercise, and cognitive-behavioral strategies are effective in helping mild to moderately obese individuals modify their eating patterns. We review current findings in obesity and weight loss lifestyle modification research. The Lifestyle Modification Model, its practical implications, and implementation ideas for practitioners are presented along with suggestions for considering cultural differences.

Cognitive Behavioral Therapy↗

The therapeutic potential of nicotine and nicotinic agonists for weight control.

Transdermal nicotine patches have been successfully introduced as a safe and powerful aid to smoking cessation; this has contributed to the rising interest in additional therapeutic applications for nicotine and synthetic nicotinic agonists. Nicotine and nicotinic agonists may have a therapeutic potential for a variety of disorders, including Alzheimer's and Parkinson's diseases, depression, attention deficit disorder, Tourette's syndrome and ulcerative colitis. These interests are partially fuelled by the urgent need of the tobacco industry to find new niches for nicotine in a world bound eventually to retire from cigarette smoking. At the same time, there is an increased interest in developing drugs for fighting obesity, a growing affliction of industrialised nations. This review presents data on the potential of nicotine, and in particular synthetic nicotinic agonists, for controlling body weight. Nicotinic agonists may become relatively safe, effective and inexpensive alternatives for several optional drugs currently being developed for treating human obesity, including beta-3-adrenergic agonists, leptin and its agonists, and neuropeptide Y antagonists.

Journal Article↗

Association between socioeconomic status, weight, age and gender, and the body image and weight control practices of 6- to 19-year-old children and adolescents.

The aim of the study was to examine the effect of socioeconomic status (SES), age, weight and gender on the body image and weight control practices of children and adolescents, and to investigate whether health education about weight issues should target low socioeconomic groups. The study participants were a randomly selected group of school children who completed a questionnaire, and had their height and weight measured. Participants (n = 1131) were aged 6-19 years from 12 schools in New South Wales. SES, age, gender, body weight, body image, skipping breakfast, physical self-esteem, attempts to lose or gain weight, and dietary and weight control advice received from others were examined. Log-linear, chi 2 and MANOVA analyses were used to determine interactions between variables. Low SES children were more likely to be overweight, to skip breakfast, to perceive themselves as 'too thin', to be trying to gain weight and less likely to receive dietary or weight control advice. Physical self-esteem was lowest among overweight girls of middle/upper SES and greatest among boys of low SES, despite the latter being more likely to be overweight. Being overweight does not appear to adversely affect the physical self-esteem of children of low SES, particularly boys. Health educators should examine these issues with young people to help make health education and nutrition education most relevant and appropriate.

Adolescent↗

Energy expenditure, physical activity and body-weight control.

Regular physical exercise and endurance training are associated with low body weight and low body fat mass. The relationship between exercise and body-weight control is complex and incompletely understood. Regular exercise may decrease energy balance through an increase in energy expenditure or an increase in fat oxidation. It may also contribute to weight loss by modulating nutrient intake. An intriguing question that remains unresolved is whether changes in nutrient intake or body composition secondarily affect spontaneous physical activity. If this were the case, physical activity would represent a major adaptative mechanism for body-weight control.

Adaptation, Physiological↗

Why Americans eat what they do: taste, nutrition, cost, convenience, and weight control concerns as influences on food consumption.

OBJECTIVE: To examine the self-reported importance of taste, nutrition, cost, convenience, and weight control on personal dietary choices and whether these factors vary across demographic groups, are associated with lifestyle choices related to health (termed health lifestyle), and actually predict eating behavior. DESIGN: Data are based on responses to 2 self-administered cross-sectional surveys. The main outcomes measured were consumption of fruits and vegetables, fast foods, cheese, and breakfast cereals, which were determined on the basis of responses to questions about usual and recent consumption and a food diary. SUBJECTS/SETTING: Respondents were a national sample of 2,967 adults. Response rates were 71% to the first survey and 77% to the second survey (which was sent to people who completed the first survey). STATISTICAL ANALYSES: Univariate analyses were used to describe importance ratings, bivariate analyses (correlations and t tests) were used to examine demographic and lifestyle differences on importance measures, and multivariate analyses (general linear models) were used to predict lifestyle cluster membership and food consumption. RESULTS: Respondents reported that taste is the most important influence on their food choices, followed by cost. Demographic and health lifestyle differences were evident across all 5 importance measures. The importance of nutrition and the importance of weight control were predicted best by subject's membership in a particular health lifestyle cluster. When eating behaviors were examined, demographic measures and membership in a health lifestyle cluster predicted consumption of fruits and vegetables, fast foods, cheese, and breakfast cereal. The importance placed on taste, nutrition, cost, convenience, and weight control also predicted types of foods consumed. APPLICATIONS: Our results suggest that nutritional concerns, per sc, are of less relevance to most people than taste and cost. One implication is that nutrition education programs should attempt to design and promote nutritious diets as being tasty and inexpensive.

Adult↗

Validity of percent body fat predicted from circumferences: classification of men for weight control regulations.

Each of the military services classifies individuals in their weight control programs using percent body fat predicted by circumference-based equations. Although derived independently from service-specific samples, each of the male equations relies on waist circumference adjusted by a neck circumference. In this study, the authors examined the performance of the equations in 496 young (< 40 years) male soldiers, compared to percent body fat measured by dual-energy X-ray absorptiometry. The strength of the relationship to percent body fat improved from body mass index (weight/height2), to a waist circumference alone, to the difference between waist and neck circumferences. Overweight men who were misclassified by overestimation of total percent body fat using the equations (2.6% of the total sample) had normal neck circumferences and height but large waistlines, indicating that they were still classified appropriately to the goals of the weight control programs, all of which center on abdominal adiposity. The authors demonstrate that each of the service equations yield substantially similar results and discuss why a single equation could be easily agreed to and used by the Department of Defense for male body fat prediction.

Absorptiometry, Photon↗

Running a weight control group: experiences of a psychologist and a general practitioner.

A weight control group is described, led jointly by a general practitioner and a clinical psychologist. Approaches employed included dietary advice, behavioural advice, and group support. Of the original 16 members (including one group leader), seven dropped out at an early stage and the reasons for this are discussed. All members were re-weighed at intervals up to 18 months after the beginning of the six-month intensive period. They were also interviewed by a psychological research worker a year after the start of the group. The results suggest that a combined dietetic and psychological approach to weight control is of value.

Adult↗

[Weight-control intervention in overweight subjects at high risk of cardiovascular disease: a trial of a public health practical training program in a medical school].

OBJECTIVE: To evaluate the effectiveness of a weight-control intervention for overweight subjects at high risk of cardiovascular disease (CVD) at a worksite conducted by medical students as a public health practical training program. METHODS: A total of 45 men and women who were obese (BMI > or = 24.0 kg/m2) and found to be hypertensive (SBP > or = 140 mmHg or DBP > or = 90 mmHg) or suffering from hypercholesterolemia (total serum cholesterol > or = 220 mg/dl) in an annual health check up in November 2001 were invited to participate in a weight-control intervention program. Eight individuals agreed (intervention group) and other sixteen control subjects whose sex and age (+/- 3 years) were matched to the intervention subjects were selected. The duration of the program was three months (from July to October 2002) and a 2 kg weight reduction in that period was set as the goal. The baseline survey consisted of a dietary questionnaire and a health quiz. Subjects had two counseling sessions and received four personal letters in the three months. A semi-quantitative food frequent questionnaire, a photograph method (Diet Agent Service, Matsushita Electric Works, Ltd.) and three day food records were conducted for dietary surveys. Changes in bodyweight, BMI, blood pressure, and serum total cholesterol concentration from November 2001 to November 2002 were compared between the intervention and control groups. Food group intakes and nutrient intakes were compared between weight reduction achievers and non-achievers. RESULTS: Mean bodyweight changes from November 2001 to November 2002 were -2.3 kg (SD 3.3 kg) for the intervention group and +0.3 kg (SD 1.5 kg) for the control group, the difference being significant (p = 0.013). For the intervention group mean bodyweight change from July to October 2002 was -1.5 kg (SD 2.4 kg). For total serum cholesterol, the mean changes were -32.1 mg/dl vs. +0.5 mg/dl (p = 0.005), for SBP -9.5 mmHg vs. +4.7 mmHg (p = 0.083) and for DBP -2.8 mmHg vs. +1.4 mmHg (p = 0.438). These were thought to be consequences of weight-control intervention. From dietary surveys, weight reduction achievers increased fish intake and decreased fats, snacks and sweets. Those who answered the health quiz more correctly demonstrated more reduction of bodyweight. CONCLUSIONS: Effectiveness of a weight-control intervention for reduction of CVD risk factors was found in the present public health practical training program for medical students. Dietary advice based on various dietary surveys was indicated to be effective in the weight-control program. A population strategy to distribute health information appeared necessary for effective health education programs for high-risk subjects.

Cardiovascular Diseases↗

Long-term weight control study. V (weeks 190 to 210). Follow-up of participants after cessation of medication.

Participants who completed up to week 190 in the long-term weight control study were monitored after cessation of medication between weeks 190 and 210. Caloric restriction, behavior modification sessions, exercise reinforcement, and physician visits continued. We assessed whether or not participants had reset their weight control mechanisms and compared the effect of stopping medication under open-label conditions (weeks 190 to 210) with the results of stopping anorexiants under double-blind conditions (weeks 160 to 190). At week 210, participants were, on average, 1.4 +/- 1.0 kg (mean +/- SEM, 1.5% +/- 1.1%) below their weights at baseline (week 0). Of the 48 participants who remained in the study, 13 were still 5% or more and seven were 10% or more below their initial weights. On average, participants gained 2.7 +/- 0.5 kg (3.2%) in the period from weeks 190 to 210. Those who had been taking medication in the period from weeks 160 to 190 gained weight at a somewhat faster rate than those who had been taking placebo. However, participants who had transferred from fenfluramine plus phentermine to no medication in this phase gained at a slower rate than participants who had changed from fenfluramine plus phentermine to placebo under double-blind conditions at week 160 (0.195 kg per week versus 0.277 kg per week). The findings indicate that participants had difficulty maintaining weight loss without anorexiant medications. Despite long periods of time at weights much lower than baseline, permanent resetting of weight control mechanisms could not be shown for most participants.

Adult↗