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Reed JR, Yates BC, Houfek J, Pullen CH, Briner W, Schmid KK. Eating Self-Regulation in Overweight and Obese Adults: A Concept Analysis. Nurs Forum 2016; 51:105-116. [PMID: 25611400 DOI: 10.1111/nuf.12125] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Poor eating behaviors greatly influence the development of becoming overweight or obese. Learning to better self-regulate eating is one area in which individuals can positively influence their own health. PURPOSE The purpose of this concept analysis is to provide an in-depth analysis of the concept eating self-regulation as it pertains to overweight and obese adults using Walker and Avant's method. RESULTS The definition for eating self-regulation formulated as a result of this concept analysis and based on the critical attributes is the ability to initiate goal-related behaviors, to consistently self-monitor dietary intake, to regularly apply willpower to resist temptations, to self-evaluate where one stands in relationship to goal attainment, and finally to maintain motivation to positively change eating behaviors. Cognitive restraint, moderation, mindfulness, disinhibition, delayed gratification, emotions and moods, self-efficacy, social support, the environment, and physical activity are the antecedents that may influence eating self-regulation. CONCLUSION Examining an individual's weight, body mass index, lipid levels, or blood pressure are some ways to determine if self-regulation of eating behavior is achieved. With a consistent definition of self-regulation and a better understanding of the critical factors that influence eating behaviors, research can better explore how to help individuals change their eating behaviors more effectively.
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Affiliation(s)
- Jill R Reed
- College of Nursing, University of Nebraska Medical Center, Kearney, NE
| | - Bernice C Yates
- College of Nursing, University of Nebraska Medical Center, Omaha, NE
| | - Julia Houfek
- College of Nursing, University of Nebraska Medical Center, Omaha, NE
| | - Carol H Pullen
- College of Nursing, University of Nebraska Medical Center, Omaha, NE
| | - Wayne Briner
- Department of Psychology, Ashford University, San Diego, CA
| | - Kendra K Schmid
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE
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Mhatre A, Duvall J, Ding D, Cooper R, Pearlman J. Design and focus group evaluation of a bed-integrated weight measurement system for wheelchair users. Assist Technol 2016; 28:193-201. [PMID: 26852778 DOI: 10.1080/10400435.2016.1140690] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Regular weight monitoring is known to help with weight management, which is an important part of maintaining a healthy, active lifestyle. Unfortunately, weight monitoring is challenging for wheelchair users because the few scales that are available are expensive and very large. Consequently, wheelchair users typically learn their weight at infrequent visits to their healthcare providers, which likely contributes to higher prevalence of obesity-related health risks among this population. In this article, we describe the design and development of the Embedded Scale, or E-Scale, which is a bed-integrated bodyweight measuring system that allows a user to measure and track their weight. The E-Scale team followed a standard product development approach to build the E-Scale prototype. Bench testing results indicate that the performance of the prototype is on par with commercially available wheelchair scales (capacity = 1,200 lbs, accuracy = 1.73 lbs, and precision = ± 0.35 lbs over one-fourth rated capacity). Institutional Review Board (IRB)-approved focus groups with 20 Veterans who use wheelchairs for mobility were conducted to gather feedback about the design, which was very positive. Development and testing results suggests the E-Scale technology is feasible and may provide a valuable tool to help wheelchair users manage their weight.
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Affiliation(s)
- Anand Mhatre
- a Human Engineering Research Laboratories , Department of Veterans Affairs , Pittsburgh , Pennsylvania , USA.,b Department of Rehabilitation Science and Technology , University of Pittsburgh , Pittsburgh , Pennsylvania , USA
| | - Jonathan Duvall
- a Human Engineering Research Laboratories , Department of Veterans Affairs , Pittsburgh , Pennsylvania , USA.,b Department of Rehabilitation Science and Technology , University of Pittsburgh , Pittsburgh , Pennsylvania , USA
| | - Dan Ding
- a Human Engineering Research Laboratories , Department of Veterans Affairs , Pittsburgh , Pennsylvania , USA.,b Department of Rehabilitation Science and Technology , University of Pittsburgh , Pittsburgh , Pennsylvania , USA
| | - Rory Cooper
- a Human Engineering Research Laboratories , Department of Veterans Affairs , Pittsburgh , Pennsylvania , USA.,b Department of Rehabilitation Science and Technology , University of Pittsburgh , Pittsburgh , Pennsylvania , USA
| | - Jon Pearlman
- a Human Engineering Research Laboratories , Department of Veterans Affairs , Pittsburgh , Pennsylvania , USA.,b Department of Rehabilitation Science and Technology , University of Pittsburgh , Pittsburgh , Pennsylvania , USA
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Daley AJ, Jolly K, Jebb SA, Roalfe AK, Mackillop L, Lewis AL, Clifford S, Kenyon S, MacArthur C, Aveyard P. Effectiveness of regular weighing, weight target setting and feedback by community midwives within routine antenatal care in preventing excessive gestational weight gain: randomised controlled trial. BMC OBESITY 2016; 3:7. [PMID: 26885375 PMCID: PMC4743115 DOI: 10.1186/s40608-016-0086-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 01/27/2016] [Indexed: 11/29/2022]
Abstract
Background Many pregnant women gain excess weight during pregnancy which increases the health risks to the mother and her baby. Interventions to prevent excess weight gain need to be given to the whole population to prevent excess weight gain. The aim of this study was to assess the effectiveness of a simple and brief intervention embedded withinroutine antenatal care to prevent excessive gestation weight gain. Methods Six hundred and ten pregnant women (between 10-14 weeks gestation), aged ≥18 years with a body mass index (BMI) ≥18.5 kg/m2, planned to receive community midwife led care or shared care at the time of recruitment are eligible to take part in the study. Women will be recruited from four maternity centres in England. Community midwives complete a short training module before delivering the intervention. In the intervention, midwives weigh women, set maximum weight limits for weight gain at each antenatal appointment and ask women to monitor their weight at home. Themaximum weight limit is adjusted by the midwife at each antenatal appointment if women have exceeded their maximum weight gain limit set at their previous appointment. The intervention will be compared with usual antenatal care. The primary outcome is the proportion of women per group who exceed the Institute of Medicine guidelines for gestational weight gain at 38 weeks of pregnancy according to their early pregnancy BMI category. Discussion The proposed trial will test a brief intervention comprising regular weighing, target setting and monitoring ofweight during pregnancy that can be delivered at scale as part of routine antenatal care. Using the professional expertise of community midwives, but without specialist training in weight management, the intervention will incur minimal additionalhealthcare costs, and if effective at reducing excess weight gain, is likely to be very cost effective. Trial registration Current controlled trials ISRCTN67427351. Date assigned 29/10/2014.
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Affiliation(s)
- Amanda J Daley
- Primary Care Clinical Sciences, School of Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT UK
| | - K Jolly
- Public Health, Epidemiology and Biostatistics, School of Health and Population Sciences, University of Birmingham, Birmingham, B15 2TT UK
| | - S A Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG UK
| | - A K Roalfe
- Primary Care Clinical Sciences, School of Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT UK
| | - L Mackillop
- Women's Centre, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU UK
| | - A L Lewis
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS UK
| | - S Clifford
- Primary Care Clinical Sciences, School of Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT UK
| | - S Kenyon
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG UK
| | - C MacArthur
- Public Health, Epidemiology and Biostatistics, School of Health and Population Sciences, University of Birmingham, Birmingham, B15 2TT UK
| | - P Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG UK
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Sperrin M, Rushton H, Dixon WG, Normand A, Villard J, Chieh A, Buchan I. Who Self-Weighs and What Do They Gain From It? A Retrospective Comparison Between Smart Scale Users and the General Population in England. J Med Internet Res 2016; 18:e17. [PMID: 26794900 PMCID: PMC4742620 DOI: 10.2196/jmir.4767] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 11/16/2015] [Accepted: 01/04/2016] [Indexed: 11/24/2022] Open
Abstract
Background Digital self-monitoring, particularly of weight, is increasingly prevalent. The associated data could be reused for clinical and research purposes. Objective The aim was to compare participants who use connected smart scale technologies with the general population and explore how use of smart scale technology affects, or is affected by, weight change. Methods This was a retrospective study comparing 2 databases: (1) the longitudinal height and weight measurement database of smart scale users and (2) the Health Survey for England, a cross-sectional survey of the general population in England. Baseline comparison was of body mass index (BMI) in the 2 databases via a regression model. For exploring engagement with the technology, two analyses were performed: (1) a regression model of BMI change predicted by measures of engagement and (2) a recurrent event survival analysis with instantaneous probability of a subsequent self-weighing predicted by previous BMI change. Results Among women, users of self-weighing technology had a mean BMI of 1.62 kg/m2 (95% CI 1.03-2.22) lower than the general population (of the same age and height) (P<.001). Among men, users had a mean BMI of 1.26 kg/m2 (95% CI 0.84-1.69) greater than the general population (of the same age and height) (P<.001). Reduction in BMI was independently associated with greater engagement with self-weighing. Self-weighing events were more likely when users had recently reduced their BMI. Conclusions Users of self-weighing technology are a selected sample of the general population and this must be accounted for in studies that employ these data. Engagement with self-weighing is associated with recent weight change; more research is needed to understand the extent to which weight change encourages closer monitoring versus closer monitoring driving the weight change. The concept of isolated measures needs to give way to one of connected health metrics.
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Affiliation(s)
- Matthew Sperrin
- Health e-Research Centre, Farr Institute, Institute of Population Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom.
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Pacanowski CR, Loth KA, Hannan PJ, Linde JA, Neumark-Sztainer DR. Self-Weighing Throughout Adolescence and Young Adulthood: Implications for Well-Being. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2015; 47:506-515.e1. [PMID: 26566095 PMCID: PMC4644499 DOI: 10.1016/j.jneb.2015.08.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 08/04/2015] [Accepted: 08/10/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To describe the prevalence of self-weighing in the transition period from adolescence to young adulthood and examine cross-sectional and longitudinal associations between self-weighing and weight status, psychological, and behavioral outcomes. DESIGN Project Eating and Activity in Teens and Young Adults, a longitudinal cohort study that assessed variables 3 times over 10 years. PARTICIPANTS A total of 1,868 adolescents and young adults. MAIN OUTCOME MEASURES Weight, body mass index, weight disparity, body satisfaction, weight concern, self-esteem, depression, and unhealthy weight control behaviors. ANALYSIS Cross-sectional and longitudinal. RESULTS Significant positive correlations were found at each time point between self-weighing and weight concern for both genders. Self-weighing was significantly inversely related to self-esteem at each time point in female participants. Increases in endorsement of self-weighing were significantly related to decreases in body satisfaction and self-esteem and increases in weight concern and depression in female participants and to increases in weight concern in male participants. CONCLUSIONS AND IMPLICATIONS Findings suggest that self-weighing may not be an innocuous behavior for young people, particularly women. Interventions should assess potential harmful consequences of self-weighing in addition to any potential benefits. It may be appropriate for clinicians to ask about self-weighing, and if it is frequent, to explore motivations, perceived benefits, and potential adverse correlates or consequences.
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Affiliation(s)
- Carly R Pacanowski
- Department of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.
| | - Katie A Loth
- Department of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Peter J Hannan
- Department of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Jennifer A Linde
- Department of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Dianne R Neumark-Sztainer
- Department of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
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Bertz F, Pacanowski CR, Levitsky DA. Frequent Self-Weighing with Electronic Graphic Feedback to Prevent Age-Related Weight Gain in Young Adults. Obesity (Silver Spring) 2015; 23:2009-14. [PMID: 26414563 PMCID: PMC4751025 DOI: 10.1002/oby.21211] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 06/16/2015] [Accepted: 06/16/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVE An intervention using Wi-Fi scales and graphic e-mail feedback, the caloric titration method (CTM), to reduce age-related weight gain over 1 year among college students was evaluated. METHODS First-year college students (n = 167) were randomized to CTM or control (C) groups and provided Wi-Fi scales. The CTM group was instructed to weigh daily, view a weight graph e-mailed to them after weighing, and try to maintain their weight. The C group could weigh at any time but did not receive feedback. At 6 months and 1 year, the C group provided weights. For intention to treat analysis, an adjusted mixed model was used to analyze the effect of the intervention. RESULTS Baseline body mass index was 22.9 ± 3.0 kg/m(2) . Ninety-five percent of the CTM participants weighed ≥ 3 times/week, compared to 15% in the C group (P < 0.001). After 1 year, the C group had gained 1.1 ± .4 kg whereas the CTM group lost 0.5 ± 3.7 kg (F = 3.39, P = 0.035). The difference in weight change between the two groups at 1 year was significant (P = 0.004). Retention was 81%. CONCLUSIONS CTM intervention was effective in preventing age-related weight gain in young adults over 1 year and thus offers promise to reduce overweight and obesity.
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Affiliation(s)
- Fredrik Bertz
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | - Carly R Pacanowski
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - David A Levitsky
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
- Department of Psychology, Cornell University, Ithaca, New York, USA
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Taylor RW, Roy M, Jospe MR, Osborne HR, Meredith-Jones KJ, Williams SM, Brown RC. Determining how best to support overweight adults to adhere to lifestyle change: protocol for the SWIFT study. BMC Public Health 2015; 15:861. [PMID: 26341820 PMCID: PMC4560866 DOI: 10.1186/s12889-015-2205-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 09/02/2015] [Indexed: 01/24/2023] Open
Abstract
Background Physical activity plays a critical role in health, including for effective weight maintenance, but adherence to guidelines is often poor. Similarly, although debate continues over whether a “best” diet exists for weight control, meta-analyses suggest little difference in outcomes between diets differing markedly in macronutrient composition, particularly over the longer-term. Thus a more important question is how best to encourage adherence to appropriate lifestyle change. While brief support is effective, it has on-going cost implications. While self-monitoring (weight, diet, physical activity) is a cornerstone of effective weight management, little formal evaluation of the role that self-monitoring technology can play in enhancing adherence to change has occurred to date. People who eat in response to hunger have improved weight control, yet how best to train individuals to recognise when true physical hunger occurs and to limit consumption to those times, requires further study. Methods/design SWIFT (Support strategies for Whole-food diets, Intermittent Fasting, and Training) is a two-year randomised controlled trial in 250 overweight (body mass index of 27 or greater) adults that will examine different ways of supporting people to make appropriate changes to diet and exercise habits for long-term weight control. Participants will be randomised to one of five intervention groups: control, brief support (monthly weigh-ins and meeting), app (use of MyFitnessPal with limited support), daily self-weighing (with brief monthly feedback), or hunger training (four-week programme which trains individuals to only eat when physically hungry) for 24 months. Outcome assessments include weight, waist circumference, body composition (dual-energy x-ray absorptiometry), inflammatory markers, blood lipids, adiponectin and ghrelin, blood pressure, diet (3-day diet records), physical activity (accelerometry) and aerobic fitness, and eating behaviour. SWIFT is powered to detect clinically important differences of 4 kg in body weight and 5 cm in waist circumference. Our pragmatic trial also allows participants to choose one of several dietary (Mediterranean, modified Paleo, intermittent fasting) and exercise (current recommendations, high-intensity interval training) approaches before being randomised to a support strategy. Discussion SWIFT will compare four different ways of supporting overweight adults to lose weight while following a diet and exercise plan of their choice, an aspect we believe will enhance adherence and thus success with weight management. Trial registration Australian and New Zealand Clinical Trials Registry ACTRN12615000010594. Registered 8th January 2015.
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Affiliation(s)
- Rachael W Taylor
- Department of Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Melyssa Roy
- Department of Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Michelle R Jospe
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Hamish R Osborne
- Department of Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Kim J Meredith-Jones
- Department of Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Sheila M Williams
- Department of Preventive and Social Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Rachel C Brown
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
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Madigan CD, Daley AJ, Lewis AL, Aveyard P, Jolly K. Is self-weighing an effective tool for weight loss: a systematic literature review and meta-analysis. Int J Behav Nutr Phys Act 2015; 12:104. [PMID: 26293454 PMCID: PMC4546162 DOI: 10.1186/s12966-015-0267-4] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 08/13/2015] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND There is a need to identify effective behavioural strategies for weight loss. Self-weighing may be one such strategy. PURPOSE To examine the effectiveness of self-weighing for weight loss. METHODS A systematic review and meta-analysis of randomised controlled trials that included self-weighing as an isolated intervention or as a component within an intervention. We used sub groups to analyse differences in frequency of weighing instruction (daily and weekly) and also whether including accountability affected weight loss. RESULTS Only one study examined self-weighing as a single strategy and there was no evidence it was effective (-0.5 kg 95 % CI -1.3 to 0.3). Four trials added self-weighing/self-regulation techniques to multi-component programmes and resulted in a significant difference of -1.7 kg (95 % CI -2.6 to -0.8). Fifteen trials comparing multi-component interventions including self-weighing compared with no intervention or minimal control resulted in a significant mean difference of -3.4 kg (95 % CI -4.2 to -2.6). There was no significant difference in the interventions with weekly or daily weighing. In trials which included accountability there was significantly greater weight loss (p = 0.03). CONCLUSIONS There is a lack of evidence of whether advising self-weighing without other intervention components is effective. Adding self-weighing to a behavioural weight loss programme may improve weight loss. Behavioural weight loss programmes that include self-weighing are more effective than minimal interventions. Accountability may improve the effectiveness of interventions that include self-weighing.
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Affiliation(s)
- Claire D Madigan
- School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. .,The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Level 2 Charles Perkin Centre D17, Sydney, NSW, 2006, Australia.
| | - Amanda J Daley
- School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Amanda L Lewis
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.
| | - Kate Jolly
- School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
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Feller S, Müller A, Mayr A, Engeli S, Hilbert A, de Zwaan M. What distinguishes weight loss maintainers of the German Weight Control Registry from the general population? Obesity (Silver Spring) 2015; 23:1112-8. [PMID: 25864871 DOI: 10.1002/oby.21054] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 01/21/2015] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Differences between successful long-term weight loss maintainers and the general population with regard to eating and weighing habits, non-normative eating behaviors, and eating-related and general psychopathological parameters are unknown. METHODS Self-identified weight loss maintainers from the German Weight Control Registry (GWCR, n = 494) were compared with a representative sample of the general German population (n = 2,129). The samples did not differ in current BMI. Using the same assessment instruments in both cohorts, a variety of eating-related and psychological variables were determined. RESULTS The GWCR participants reported more self-weighing and higher eating frequency but less hot meal consumption and more eating-out-of-home. Binge eating, compensatory behaviors, and concerns about shape and weight were reported more often by successful weight loss maintainers. Scores of depression and worrying about health were slightly higher whereas severity of somatic symptoms was less pronounced in the GWCR participants. CONCLUSIONS Overall, our data suggest that successful weight loss maintainers are characterized by more concerns about shape and weight, greater binge eating frequency, and higher use of compensatory behaviors. The latter suggests that weight loss maintenance might not only be achieved by healthy strategies but also by non-normative behaviors which might increase the vulnerability for weight regain.
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Affiliation(s)
- Silke Feller
- German Institute of Human Nutrition Potsdam-Rehbruecke, Department of Epidemiology, Nuthetal, Germany
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Wing RR, Tate D, LaRose JG, Gorin AA, Erickson K, Robichaud EF, Perdue L, Bahnson J, Espeland MA. Frequent self-weighing as part of a constellation of healthy weight control practices in young adults. Obesity (Silver Spring) 2015; 23:943-9. [PMID: 25865175 PMCID: PMC4438264 DOI: 10.1002/oby.21064] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 02/01/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Frequent self-weighing is linked with weight management success, but concern has been raised about its possible association with unhealthy practices. This study examined the association of self-weighing with other weight control behaviors in a sample for whom frequent weighing might be questioned--namely, normal-weight or overweight (BMI of 21-29.9) young adults (age 18-35). METHODS Participants (N = 583; mean [SD] age = 27.7 [4.4]; BMI = 25.4 [2.6]) entering the Study of Novel Approaches to Weight Gain Prevention (SNAP) completed objective measures of weight and physical activity and self-reported weight history, use of healthy and unhealthy weight control strategies, depressive symptoms, and dietary intake. RESULTS Daily self-weighing was reported by 11% of participants, and 23% weighed several times per week. Frequent weighing was not associated with current BMI, gender, or age but was associated with being further below one's highest weight, history of dieting, and perceived difficulty maintaining weight. Frequent weighing was associated with healthy weight management strategies, but not with unhealthy practices or depressive symptoms. CONCLUSIONS In this sample, frequent self-weighing appears to be part of a constellation of healthy weight control behaviors used to counteract a perceived tendency toward weight gain. SNAP follow-up will determine whether frequent self-weighing helps prevent weight gain.
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Affiliation(s)
- Rena R. Wing
- The Miriam Hospital/Brown University, 196 Richmond Street, Providence, RI 02903, USA
| | - Deborah Tate
- Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Rosenau 318, CB 7440, Chapel Hill, NC 27559-7440, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina-Chapel Hill, Rosenau 318, CB 7440, Chapel Hill, NC 27559-7440, USA
| | - Jessica Gokee LaRose
- Virginia Commonwealth University School of Medicine, One Capitol Square, 4th Floor, 830 East Main Street, PO Box 980430, Richmond, VA 23298, USA
| | - Amy A. Gorin
- Department of Psychology, University of Connecticut, 2006 Hillside Road, Unit 1248, Storrs, CT 06269-1248, USA
| | - Karen Erickson
- Lineberger Comprehensive Cancer Center, University of North Carolina-Chapel Hill, Rosenau 318, CB 7440, Chapel Hill, NC 27559-7440, USA
| | | | - Letitia Perdue
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Judy Bahnson
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Mark A. Espeland
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
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Daily exercises and education for preventing low back pain in children: cluster randomized controlled trial. Phys Ther 2015; 95:507-16. [PMID: 25504487 DOI: 10.2522/ptj.20140273] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 11/25/2014] [Indexed: 02/09/2023]
Abstract
BACKGROUND Children report low back pain (LBP) as young as 8 years. Preventing LBP in children may prevent or delay adult incidence. OBJECTIVES The purpose of this study was to determine whether education and daily exercise affect LBP episodes in children compared with education alone. DESIGN This was a prospective, multicenter cluster randomized controlled trial. SETTING The study was conducted at 7 New Zealand primary schools. PARTICIPANTS Children (n=708), aged 8 to 11 years, from 7 schools stratified by sample size (36, 114, 151, 168, 113, 45, 83) were randomized and allocated to 2 masked groups: intervention (4 schools, n=469) or control (3 schools, n=239). INTERVENTIONS Participants in the intervention group were taught 4 spinal movements for daily practice. Both groups participated in education that emphasized "back awareness." MEASUREMENTS Low back pain history at baseline was assessed. Children reported episodes of LBP during the previous week on trial days 7, 21, 49, 105, 161, and 270. Analysis was at the individual participant level, with adjustment for school clusters. RESULTS There were no significant differences between groups in the odds of reporting no LBP in the previous week during the study period (odds ratio [OR]=0.72; 95% confidence interval [95% CI]=0.46, 1.14; P=.16). The intervention group reported significantly fewer episodes of LBP (OR=0.54; 95% CI=0.39, 0.74; P<.001) and significantly fewer lifetime first episodes of LBP (n=86 [34%]) compared with the control group (n=58 [47%]) (OR=0.60; 95% CI=0.39, 0.91; P=.02). The odds of an episode of LBP were greater in participants with a history of LBP (OR=4.21; 95% CI=3.07, 5.78; P<.001). Low back pain episodes decreased across the trial period for both groups (OR=0.89; 95% CI=0.84, 0.95; P<.001). Adherence to exercise was poor. LIMITATIONS Replication in other settings is needed. CONCLUSIONS Regular exercise and education appear to reduce LBP episodes in children aged 8 to 11 years compared with education alone.
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Endevelt R, Peled R, Azrad A, Kowen G, Valinsky L, Heymann AD. Diabetes prevention program in a Mediterranean environment: individual or group therapy? An effectiveness evaluation. Prim Care Diabetes 2015; 9:89-95. [PMID: 25151065 DOI: 10.1016/j.pcd.2014.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 06/30/2014] [Accepted: 07/13/2014] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Diabetes as a multifactorial disorder requires prevention measures based upon the modification of several risk factors simultaneously; otherwise, there is insufficient potential for prevention. Following the success of the American Diabetes Prevention Program (DPP), we implemented an intervention program in a large Israeli healthcare organization with an emphasize on Mediterranean Diet (MedDiet) and physical activity. The objective was to evaluate the effectiveness of two types of intervention, individual and group therapies, in reducing risk factors and in preventing or delaying the development of type 2 diabetes. METHODS Out of 180 primary care physicians, 85 who agreed to participate, were randomly assigned, between the years 2005 and 2006, into two groups: those who would refer pre-diabetes adult patients for individual therapy and those who would refer for group therapy. The two groups of patients consisted of 111 and 112 in each group. The intervention lasted for 6 months and discussed: the benefits of MedDiet, planning nutritional behavior and mindful eating, and the importance of physical activity. All patients were invited to participate in walking groups. Follow up lasted for 24 months and logistic, mixed models, and Cox regressions were employed. RESULTS No statistically significant differences were detected between the two intervention groups in age; gender and clinical measurements at recruitment. Thirty nine percent of both groups developed diabetes (entered the DR by 2012), including 38.7% from the individual therapy and 39.3% from the group therapy (P=0.933). The mean time from 2005 until entry to the Diabetes Registry (DR) was 2.9 and 2.5 years for the individual and group therapy respectively (P=0.542). CONCLUSION Both interventions were equally effective in achieving the desired outcomes and time until entry to the DR. For large health organizations with a high number of pre-diabetes patients and scarce resources, group therapy, where 12 people are reached out by one team member are preferable and more costly effective, than a one on one therapy.
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Affiliation(s)
- R Endevelt
- Health Promotion and Preventive Medicine, Maccabi Health Organization, Israel; School of Public Health, Haifa University, Haifa, Israel
| | - R Peled
- Health Systems Management, Ben Gurion University of the Negev, Beer Sheva, Israel.
| | - A Azrad
- Health Promotion and Preventive Medicine, Maccabi Health Organization, Israel
| | - G Kowen
- Health Promotion and Preventive Medicine, Maccabi Health Organization, Israel
| | - L Valinsky
- Department of Clinical Quality, Meuhedet Health Organization, Tel Aviv, Israel
| | - A D Heymann
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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63
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Steinberg DM, Bennett GG, Askew S, Tate DF. Weighing every day matters: daily weighing improves weight loss and adoption of weight control behaviors. J Acad Nutr Diet 2015; 115:511-8. [PMID: 25683820 PMCID: PMC4380831 DOI: 10.1016/j.jand.2014.12.011] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 12/09/2014] [Indexed: 12/25/2022]
Abstract
BACKGROUND Daily weighing is emerging as the recommended self-weighing frequency for weight loss. This is likely because it improves adoption of weight control behaviors. OBJECTIVE To examine whether weighing every day is associated with greater adoption of weight control behaviors compared with less frequent weighing. DESIGN Longitudinal analysis of a previously conducted 6-month randomized controlled trial. PARTICIPANTS/SETTING Overweight men and women in Chapel Hill, NC, participated in the intervention arm (N=47). INTERVENTION The intervention focused on daily weighing for weight loss using an e-scale that transmitted weights to a study website, along with weekly e-mailed lessons and tailored feedback on daily weighing adherence and weight loss progress. MAIN OUTCOME MEASURES We gathered objective data on self-weighing frequency from the e-scales. At baseline and 6 months, weight change was measured in the clinic and weight control behaviors (total items=37), dietary strategies, and calorie expenditure from physical activity were assessed via questionnaires. Calorie intake was assessed using an online 24-hour recall tool. STATISTICAL ANALYSES We used χ(2) tests to examine variation in discrete weight control behaviors and linear regression models to examine differences in weight, dietary strategies, and calorie intake and expenditure by self-weighing frequency. RESULTS Fifty-one percent of participants weighed every day (n=24) over 6 months. The average self-weighing frequency among those weighing less than daily (n=23) was 5.4±1.2 days per week. Daily weighers lost significantly more weight compared with those weighing less than daily (mean difference=-6.1 kg; 95% CI -10.2 to -2.1; P=0.004). The total number of weight control behaviors adopted was greater among daily weighers (17.6±7.6 vs 11.2±6.4; P=0.004). There were no differences by self-weighing frequency in dietary strategies, calorie intake, or calorie expenditure. CONCLUSIONS Weighing every day led to greater adoption of weight control behaviors and produced greater weight loss compared with weighing most days of the week. This further implicates daily weighing as an effective weight loss tool.
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Pacanowski CR, Sobal J, Levitsky DA, Sherwood NE, Keeler CL, Miller AM, Acosta AR, Hansen N, Wang PL, Guilbert SR, Paroly AL, Commesso M, Vermeylen FM. Does measuring body weight impact subsequent response to eating behavior questions? J Am Coll Nutr 2015; 34:199-204. [PMID: 25751019 DOI: 10.1080/07315724.2014.931263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES If being weighed impacts perceptions of eating behavior, it is important that the order of questionnaires and weighing be considered in research and practice. A quasi-experimental study was performed to examine whether being weighed immediately prior to completing a questionnaire affects responses to eating behavior questions. It was hypothesized that being weighed would serve as a priming stimulus and increase measures of dietary restraint, disinhibition, and hunger. METHODS Trained researchers collected a sample of volunteers (n = 355) in 8 locations in the United States on two Saturdays in the summer of 2011. Half of the participants were weighed immediately prior to completing the Three Factor Eating Questionnaire (TFEQ), with the remaining half weighed immediately after TFEQ completion. RESULTS A priori hypotheses were not supported despite replicating known relationships between weight, dietary restraint and disinhibition. Results indicated that being weighed first produced a difference in differences on disinhibition scores between low restraint score (95% CI = 4.65-6.02) and high restraint score (95% CI = 6.11-7.57) compared to being weighed after questionnaire completion (p = 0.003). However, this relationship was not significant when modeling restraint as a continuous variable, questioning the use of dichotomization. CONCLUSIONS Being weighed is unlikely to be a strong enough prime to significantly change scores on eating behavior questionnaires for everyone, but may allow differences in restraint status to become more evident. Researchers assessing dietary restraint should be wary of the possibility of producing different results when treating restraint as continuous or dichotomous, which could lead to different interpretations.
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Affiliation(s)
- Carly R Pacanowski
- a Division of Nutritional Sciences, Cornell University , Ithaca , New York
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65
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Zheng Y, Klem ML, Sereika SM, Danford CA, Ewing LJ, Burke LE. Self-weighing in weight management: a systematic literature review. Obesity (Silver Spring) 2015; 23:256-65. [PMID: 25521523 DOI: 10.1002/oby.20946] [Citation(s) in RCA: 135] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 10/01/2014] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Regular self-weighing, which in this article is defined as weighing oneself regularly over a period of time (e.g., daily, weekly), is recommended as a weight loss strategy. However, the published literature lacks a review of the recent evidence provided by prospective, longitudinal studies. Moreover, no paper has reviewed the psychological effects of self-weighing. Therefore, the objective is to review the literature related to longitudinal associations between self-weighing and weight change as well as the psychological outcomes. METHODS Electronic literature searches in PubMed, Ovid PsycINFO, and Ebscohost CINAHL were conducted. Keywords included overweight, obesity, self-weighing, etc. Inclusion criteria included trials that were published in the past 25 years in English; participants were adults seeking weight loss treatment; results were based on longitudinal data. RESULTS The results (N=17 studies) revealed that regular self-weighing was associated with more weight loss and not with adverse psychological outcomes (e.g., depression, anxiety). Findings demonstrated that the effect sizes of association between self-weighing and weight change varied across studies and also that the reported frequency of self-weighing varied across studies. CONCLUSIONS The findings from prospective, longitudinal studies provide evidence that regular self-weighing has been associated with weight loss and not with negative psychological outcomes.
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Affiliation(s)
- Yaguang Zheng
- University of Pittsburgh School of Nursing, Department of Health & Community Systems, Pittsburgh, Pennsylvania, USA
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66
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Abstract
BACKGROUND Obesity results from a chronic positive energy balance. THERAPY A reduction of energy intake is the first and most effective option for weight reduction. In recent years a variety of new nutritional concepts for weight loss have been developed and evaluated. Apart from the classical low-fat energy-restricted diet, low carbohydrate and high protein diets have also been established. RESULTS Comparative studies showed that weight loss depends on the extent of energy restriction rather than on macronutrient composition. Due to the high variability in dietary habits the management of obesity should be problem-oriented and patient-centered.
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67
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Gavin KL, Linde JA, Pacanowski CR, French SA, Jeffery RW, Ho YY. Weighing frequency among working adults: cross-sectional analysis of two community samples. Prev Med Rep 2015; 2:44-46. [PMID: 25664234 PMCID: PMC4314712 DOI: 10.1016/j.pmedr.2014.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Self-weighing frequency is associated with lower body weight and less weight gain. This study describes self-weighing frequency in two samples of working adults from different fields: office-based and transit employees. METHODS Self-weighing frequency and demographic information were self-reported at baseline measurement of two worksite interventions. Data were collected from transit employees (n= 1479) enrolled in a worksite intervention between October and December of 2005 and office based employees (n=1747) in another worksite intervention between January 2006 and April 2007 in the Minneapolis, MN and St. Paul, MN metropolitan area. Trained staff measured height and weight. Multinomial logistic regression models examined associations between self-weighing frequency and body mass index, study sample, and gender adjusting for age, race, and education. RESULTS Odds ratios showed self-weighing frequency was significantly different between overweight and obese categories and between study samples. Office-based employees self-weighed more frequently than transit employees. Overweight employees self-weighed more frequently than obese employees. CONCLUSION While self-weighing outcomes and associations with obesity prevention and weight loss are still under investigation, these results may help in improving obesity intervention planning and informing worksite weight management programs by identifying how often working adults naturally engage in this behavior prior to weight loss interventions.
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Affiliation(s)
- Kara L Gavin
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota
| | - Jennifer A Linde
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota
| | - Carly R Pacanowski
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota
| | - Simone A French
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota
| | - Robert W Jeffery
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota
| | - Yen-Yi Ho
- Division of Biostatistics, School of Public Health, University of Minnesota
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68
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Linde JA, Jeffery RW, Crow SJ, Brelje KL, Pacanowski CR, Gavin KL, Smolenski DJ. The Tracking Study: description of a randomized controlled trial of variations on weight tracking frequency in a behavioral weight loss program. Contemp Clin Trials 2014; 40:199-211. [PMID: 25533727 DOI: 10.1016/j.cct.2014.12.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 12/11/2014] [Accepted: 12/12/2014] [Indexed: 01/22/2023]
Abstract
BACKGROUND Observational evidence from behavioral weight control trials and community studies suggests that greater frequency of weighing oneself, or tracking weight, is associated with better weight outcomes. Conversely, it has also been suggested that frequent weight tracking may have a negative impact on mental health and outcomes during weight loss, but there are minimal experimental data that address this concern in the context of an active weight loss program. To achieve the long-term goal of strengthening behavioral weight loss programs, the purpose of this randomized controlled trial (the Tracking Study) is to test variations on frequency of self-weighing during a behavioral weight loss program, and to examine psychosocial and mental health correlates of weight tracking and weight loss outcomes. This paper describes the study design, intervention features, recruitment, and baseline characteristics of participants enrolled in the Tracking Study. METHODS/DESIGN Three hundred thirty-nine overweight and obese adults were recruited and randomized to one of three variations on weight tracking frequency during a 12-month weight loss program with a 12-month follow-up: daily weight tracking, weekly weight tracking, or no weight tracking. The primary outcome is weight in kilograms at 24 months. The weight loss program integrates each weight tracking instruction with standard behavioral weight loss techniques (goal setting, self-monitoring, stimulus control, dietary and physical activity enhancements, lifestyle modifications); participants in weight tracking conditions were provided with wireless Internet technology (wi-fi-enabled digital scales and touchscreen personal devices) to facilitate weight tracking during the study. CONCLUSION This study was successful in recruiting adult male and female participants and is positioned to enhance the standard of care with regard to weight tracking recommendations.
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Affiliation(s)
- Jennifer A Linde
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300S. 2nd St, Suite 300, Minneapolis, MN 55454, USA.
| | - Robert W Jeffery
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300S. 2nd St, Suite 300, Minneapolis, MN 55454, USA
| | - Scott J Crow
- Department of Psychiatry, Medical School, University of Minnesota, 2450 Riverside Ave, Minneapolis, MN 55454, USA
| | - Kerrin L Brelje
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300S. 2nd St, Suite 300, Minneapolis, MN 55454, USA
| | - Carly R Pacanowski
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300S. 2nd St, Suite 300, Minneapolis, MN 55454, USA
| | - Kara L Gavin
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300S. 2nd St, Suite 300, Minneapolis, MN 55454, USA
| | - Derek J Smolenski
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300S. 2nd St, Suite 300, Minneapolis, MN 55454, USA
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69
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Bradbury K, Dennison L, Little P, Yardley L. Using mixed methods to develop and evaluate an online weight management intervention. Br J Health Psychol 2014; 20:45-55. [PMID: 25406436 DOI: 10.1111/bjhp.12125] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 10/16/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE This article illustrates the use of mixed methods in the development and evaluation of the Positive Online Weight Reduction (POWeR) programme, an e-health intervention designed to support sustainable weight loss. The studies outlined also explore how human support might enhance intervention usage and weight loss. METHODS Mixed methods were used to develop and evaluate POWeR. In the development phase, we drew on both quantitative and qualitative findings to plan and gain feedback on the intervention. Next, a feasibility trial, with nested qualitative study, explored what level of human support might lead to the most sustainable weight loss. Finally, a large community-based trial of POWeR, with nested qualitative study, explored whether the addition of brief telephone coaching enhances usage. RESULTS Findings suggest that POWeR is acceptable and potentially effective. Providing human support enhanced usage in our trials, but was not unproblematic. Interestingly, there were some indications that more basic (brief) human support may produce more sustainable weight loss outcomes than more regular support. Qualitative interviews suggested that more regular support might foster reliance, meaning patients cannot sustain their weight losses when support ends. Qualitative findings in the community trial also suggested explanations for why many people may not take up the opportunity for human support. CONCLUSIONS Integrating findings from both our qualitative and quantitative studies provided far richer insights than would have been gained using only a single method of inquiry. Further research should investigate the optimum delivery of human support needed to maximize sustainable weight loss in online interventions. Statement of contribution What is already known on this subject? There is evidence that human support may increase the effectiveness of e-health interventions. It is unclear what level of human support might be optimal or how human support improves effectiveness. Triangulation of quantitative and qualitative methods can be used to inform the design and implementation of interventions What does this study add? This paper demonstrates the value of a mixed methods approach when developing and evaluating an intervention. Qualitative methods provided complementary insights into the optimal level of human support. Brief human support is valued by some and may enhance usage and outcomes of an e-health intervention for weight loss.
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Affiliation(s)
- Katherine Bradbury
- Centre for Applications of Health Psychology, University of Southampton, UK
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70
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Helander EE, Vuorinen AL, Wansink B, Korhonen IKJ. Are breaks in daily self-weighing associated with weight gain? PLoS One 2014; 9:e113164. [PMID: 25397613 PMCID: PMC4232563 DOI: 10.1371/journal.pone.0113164] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 10/22/2014] [Indexed: 11/19/2022] Open
Abstract
Regular self-weighing is linked to successful weight loss and maintenance. However, an individual's self-weighing frequency typically varies over time. This study examined temporal associations between time differences of consecutive weight measurements and the corresponding weight changes by analysing longitudinal self-weighing data, including 2,838 weight observations from 40 individuals attending a health-promoting programme. The relationship between temporal weighing frequency and corresponding weight change was studied primarily using a linear mixed effects model. Weight change between consecutive weight measurements was associated with the corresponding time difference (β = 0.021% per day, p<0.001). Weight loss took place during periods of daily self-weighing, whereas breaks longer than one month posed a risk of weight gain. The findings emphasize that missing data in weight management studies with a weight-monitoring component may be associated with non-adherence to the weight loss programme and an early sign of weight gain.
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Affiliation(s)
- Elina E. Helander
- Department of Signal Processing, Tampere University of Technology, Tampere, Finland
| | | | - Brian Wansink
- Charles S. Dyson School of Applied Economics and Management, Cornell University, Ithaca, New York, United States of America
| | - Ilkka K. J. Korhonen
- Department of Signal Processing, Tampere University of Technology, Tampere, Finland
- VTT Technical Research Centre of Finland, Tampere, Finland
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71
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Madigan CD, Jolly K, Lewis AL, Aveyard P, Daley AJ. A randomised controlled trial of the effectiveness of self-weighing as a weight loss intervention. Int J Behav Nutr Phys Act 2014; 11:125. [PMID: 25301251 PMCID: PMC4195875 DOI: 10.1186/s12966-014-0125-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Accepted: 09/29/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a need to find simple cost effective weight loss interventions that can be used in primary care. There is evidence that self-monitoring is an effective intervention for problem drinking and self-weighing might be an effective intervention for weight loss. PURPOSE To examine the efficacy of daily self-weighing as an intervention for weight loss. METHODS A randomised controlled trial of 183 obese adults, follow-up three months. The intervention group were given a set of weighing scales and instructed to weigh themselves daily and record their weight. Both groups received two weight loss consultations which were known to be ineffective. RESULTS 92 participants were randomised to the intervention group and 91 to the control group. The intervention group lost 0.5 kg (95% CI 0.3 to 1.3 kg) more than the control group, but this was not significant. There was no evidence that self-weighing frequency was associated with more weight loss. CONCLUSIONS As an intervention for weight loss, instruction to weigh daily is ineffective. Unlike other studies, there was no evidence that greater frequency of self-weighing is associated with greater weight loss. TRIAL REGISTRATION ISRCTN05815264.
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Affiliation(s)
- Claire D Madigan
- Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK.
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72
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Pacanowski CR, Bertz FC, Levitsky DA. Daily Self-Weighing to Control Body Weight in Adults: A Critical Review of the Literature. SAGE OPEN 2014; 4:1-16. [PMID: 27127719 PMCID: PMC4846305 DOI: 10.1177/2158244014556992] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The objective of this study is to review the history of daily self-weighing for weight control, discuss the possibility that self-weighing may cause adverse psychological symptoms, and propose mechanisms that explain how self-weighing facilitates weight control. A systematic forward (citation) tracking approach has been employed in this study. In the early literature, experimental tests did not demonstrate a benefit of adding daily self-weighing to traditional behavioral modification for weight loss. More recent studies have shown that daily self-weighing combined with personalized electronic feedback can produce and sustain weight loss with and without a traditional weight loss program. Daily self-weighing appears to be effective in preventing age-related weight gain. Apart from these experimental findings, there is considerable agreement that the frequency of self-weighing correlates with success in losing weight and sustaining the weight loss. The early literature suggested frequent self-weighing may be associated with negative psychological effects. However, more recent experimental trials do not substantiate such a causal relationship. In conclusion, daily self-weighing may be a useful strategy for certain adults to prevent weight gain, lose weight, or prevent weight regain after loss. More research is needed to better understand the role of different types of feedback, who benefits most from self-weighing, and at what frequency.
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73
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A randomised pilot and feasibility study examining body weight tracking frequency and psychosocial health indicators. Obes Res Clin Pract 2014; 8:e399-402. [PMID: 25081808 DOI: 10.1016/j.orcp.2014.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 06/18/2014] [Indexed: 11/20/2022]
Abstract
Daily weight tracking may enhance weight loss, but experimental data are scarce. This study tested feasibility of delivering varying weight tracking instructions, assessed adherence, and monitored psychosocial changes. Thirty adults were enrolled and randomised to daily or weekly tracking for 6 months. Study retention was 100%. Adherence averaged 97.5% with no group differences (p=.15). There were no group differences and minimal changes for depression, anxiety, and body image (p=.41-.82). Daily trackers reported fewer barriers (p<.01) at 3 months. The study was highly successful at delivering weight tracking instructions without adverse effects or diminished adherence.
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74
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Jaime PC, Bandoni DH, Sarno F. Impact of an education intervention using email for the prevention of weight gain among adult workers. Public Health Nutr 2014; 17:1620-7. [PMID: 23962422 PMCID: PMC10282498 DOI: 10.1017/s1368980013001936] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 05/15/2013] [Accepted: 06/12/2013] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To evaluate the impact of a worksite intervention to prevent weight gain among adult workers. DESIGN A controlled community trial was performed by dividing the workers into two groups: intervention group (IG) and control group (CG). The theoretical framework applied was Intervention Mapping Protocol and the intervention was implemented through interactive software for weight self-monitoring. To evaluate the impact of the intervention, the differences in weight, BMI and waist circumference between the IG and CG were assessed before and 6 months after the intervention by regression models. Additionally, the sustainability of the intervention was evaluated at 12 months after the intervention. Settings São Paulo, Brazil. SUBJECTS Four companies; 281 workers for the analysis of effectiveness and 427 for the analysis of sustainability. RESULTS The intervention resulted in significant reductions in weight, BMI and waist circumference in the IG compared with the CG. The impact of the intervention on IG individuals' body weight was -0·73 kg, while the weight of CG individuals increased. IG individuals with adequate initial weights did not show significant variations, while those who were overweight demonstrated a significant reduction in body weight. The intervention resulted in a reduction of 0·26 kg/m2 in BMI and 0·99 cm in waist circumference, and the sustainability analysis after 12 months showed a continued reduction in body weight (-0·72 kg). CONCLUSIONS The behavioural intervention was effective, resulting in weight maintenance among participants with adequate initial weight and in significant reductions among those who were overweight. More research on longer-term weight maintenance is needed.
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Affiliation(s)
- Patricia Constante Jaime
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr Arnaldo 715, São Paulo, Postal Code: 01246-904, SP, Brazil
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, SP, Brazil
| | - Daniel Henrique Bandoni
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, SP, Brazil
- Department of Health, Clinical and Institutions, Institute for Health and Society, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Flávio Sarno
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, SP, Brazil
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Yamada T, Kiuchi Y, Nemoto M, Yamashita S. Charting weight four times daily as an effective behavioural approach to obesity in patients with type 2 diabetes. Diab Vasc Dis Res 2014; 11:118-20. [PMID: 24227536 DOI: 10.1177/1479164113508141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Although many obese people successfully lose weight by dieting and/or behavioural therapy, most of them subsequently regain the lost weight. Thus, new therapeutic strategies are required to maintain weight loss. We report a woman with type 2 diabetes and moderate obesity who succeeded in achieving good glycaemic control and long-term weight loss with weaning from insulin therapy, while charting her weight four times daily. This charting method might be useful for long-term maintenance of weight reduction in obese diabetic patients. Obese patients can monitor their irregular weight fluctuations produced by overeating and correct both their food intake and their lifestyle. Further studies, including randomized control trials, will be needed to confirm the efficacy of this approach in patients with type 2 diabetes.
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Affiliation(s)
- Tomohide Yamada
- Department of Diabetes and Endocrinology, JR Tokyo General Hospital, Tokyo, Japan
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76
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Leahey T, Rosen J. DietBet: A Web-Based Program that Uses Social Gaming and Financial Incentives to Promote Weight Loss. JMIR Serious Games 2014; 2:e2. [PMID: 25658966 PMCID: PMC4307813 DOI: 10.2196/games.2987] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 12/11/2013] [Accepted: 01/11/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Web-based commercial weight loss programs are increasing in popularity. Despite their significant public health potential, there is limited research on the effectiveness of such programs. OBJECTIVE The objective of our study was to examine weight losses produced by DietBet and explore whether baseline and engagement variables predict weight outcomes. METHODS DietBet is a social gaming website that uses financial incentives and social influence to promote weight loss. Players bet money and join a game. All players have 4 weeks to lose 4% of their initial body weight. At enrollment, players can choose to share their participation on Facebook. During the game, players interact with one another and report their weight loss on the DietBet platform. At week 4, all players within each game who lose at least 4% of initial body weight are declared winners and split the pool of money bet at the start of the game. Official weigh-in procedures are used to verify weights at the start of the game and at the end. RESULTS From December 2012 to July 2013, 39,387 players (84.04% female, 33,101/39,387; mean weight 87.8kg, SD 22.6kg) competed in 1934 games. The average amount bet was US $27 (SD US $22). A total of 65.63% (25,849/39,387) provided a verified weight at the end of the 4-week competition. The average intention-to-treat weight loss was 2.6% (SD 2.3%). Winners (n=17,171) won an average of US $59 (SD US $35) and lost 4.9% (SD 1.0%) of initial body weight, with 30.68% (5268/17,171) losing 5% or more of their initial weight. Betting more money at game entry, sharing on Facebook, completing more weigh-ins, and having more social interactions during the game predicted greater weight loss and greater likelihood of winning (Ps<.001). In addition, weight loss clustered within games (P<.001), suggesting that players influenced each others' weight outcomes. CONCLUSIONS DietBet, a social gaming website, reached nearly 40,000 individuals in just 7 months and produced excellent 4-week weight loss results. Given its reach and potential public health impact, future research may consider examining whether a longer program promotes additional weight loss.
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Affiliation(s)
- Tricia Leahey
- Brown Medical School, Department of Psychiatry and Human Behavior, The Miriam Hospital's Weight Control and Diabetes Research Center, Providence, RI, United States.
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Affiliation(s)
- Dan Hansen
- Acuity Games, Pompton Plains, New Jersey
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Phelan S, Phipps MG, Abrams B, Darroch F, Grantham K, Schaffner A, Wing RR. Does behavioral intervention in pregnancy reduce postpartum weight retention? Twelve-month outcomes of the Fit for Delivery randomized trial. Am J Clin Nutr 2014; 99:302-11. [PMID: 24284438 PMCID: PMC3893723 DOI: 10.3945/ajcn.113.070151] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Excessive weight gain during pregnancy is a risk factor for postpartum weight retention and future weight gain and obesity. Whether a behavioral intervention in pregnancy can reduce long-term weight retention is unknown. OBJECTIVE This randomized trial tested whether a low-intensity behavioral intervention to prevent excessive gestational weight gain could increase the proportion of women who returned to prepregnancy weight by 12 mo postpartum. DESIGN Women (n = 401, 13.5 wk of gestation, 50% normal weight, 50% overweight/obese) were randomly assigned into an intervention or control group; 79% completed the 12-mo assessment. The telephone-based intervention targeted gestational weight gain, healthy eating, and exercise and was discontinued at delivery. RESULTS In modified intent-to-treat analyses that excluded women with miscarriages (n = 6), gestational diabetes (n = 32), or subsequent pregnancies (n = 32), the intervention had no significant effect on the odds of achieving prepregnancy weight at 12 mo postpartum (n = 331; 35.4% compared with 28.1%; P = 0.18). Completer analyses suggested that the intervention tended to increase the percentages of women who reached prepregnancy weight (n = 261; 45.3% compared with 35.3%; P = 0.09) and significantly reduced the magnitude of mean ± SD postpartum weight retained (1.4 ± 6.3 compared with 3.0 ± 5.7 kg; P = 0.046) at 12 mo. Women in the intervention group reported higher dietary restraint through 6 mo postpartum (P = 0.023) and more frequent self-monitoring of body weight (P < 0.02 for all) throughout the study. CONCLUSIONS A low-intensity behavioral intervention in pregnancy can reduce 12-mo postpartum weight retention and improve dietary restraint and self-weighing in study completers. Future research is needed to test the long-term effects of more intensive behavioral interventions in pregnancy. This trial was registered at clinicaltrials.gov as NCT01117961.
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Affiliation(s)
- Suzanne Phelan
- Kinesiology Department (SP) and Statistics Department (AS and KG), California Polytechnic State University, San Luis Obispo, CA; the Warren Alpert Medical School, Department of Psychiatry and Human Behavior, and The Miriam Hospital, Weight Control and Diabetes Research Center, Brown University, Providence, RI (SP, RRW, and FD); the Department of Obstetrics and Gynecology and Women & Infants Hospital of Rhode Island, Division of Research, Warren Alpert Medical School, Brown University, Providence, RI (MGP); and the University of California, Berkeley, School of Public Health, Berkeley, CA (BA)
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Daily self-weighing and adverse psychological outcomes: a randomized controlled trial. Am J Prev Med 2014; 46:24-9. [PMID: 24355668 PMCID: PMC4157390 DOI: 10.1016/j.amepre.2013.08.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 05/22/2013] [Accepted: 08/28/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Despite evidence that daily self-weighing is an effective strategy for weight control, concerns remain regarding the potential for negative psychological consequences. PURPOSE The goal of the study was to examine the impact of a daily self-weighing weight-loss intervention on relevant psychological constructs. DESIGN A 6-month RCT. SETTING/PARTICIPANTS The study sample (N=91) included overweight men and women in the Chapel Hill NC area. INTERVENTION Between February and August 2011, participants were randomly assigned to a daily self-weighing intervention or delayed-intervention control group. The 6-month intervention included daily self-weighing for self-regulation of diet and exercise behaviors using an e-scale that transmitted weights to a study website. Weekly e-mailed lessons and tailored feedback on daily self-weighing adherence and weight-loss progress were provided. MAIN OUTCOME MEASURES Self-weighing frequency was measured throughout the study using e-scales. Weight was measured in-clinic at baseline, 3 months, and 6 months. Psychological outcomes were assessed via self-report at the same time points. RESULTS In 2012, using linear mixed models and generalized estimating equation models, there were no significant differences between groups in depressive symptoms, anorectic cognitions, disinhibition, susceptibility to hunger, and binge eating. At 6 months, there was a significant group X time interaction for body dissatisfaction (p=0.007) and dietary restraint (p<0.001), with the intervention group reporting lower body dissatisfaction and greater dietary restraint compared to controls. CONCLUSIONS Results indicate that a weight-loss intervention that focuses on daily self-weighing does not cause adverse psychological outcomes. This suggests that daily self-weighing is an effective and safe weight-control strategy among overweight adults attempting to lose weight. TRIAL REGISTRATION This study is registered at clinicaltrials.gov NCT01369004.
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Carpenter KM, Lovejoy JC, Lange JM, Hapgood JE, Zbikowski SM. Outcomes and utilization of a low intensity workplace weight loss program. J Obes 2014; 2014:414987. [PMID: 24688791 PMCID: PMC3941961 DOI: 10.1155/2014/414987] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 12/12/2013] [Indexed: 02/07/2023] Open
Abstract
Obesity is related to high health care costs and lost productivity in the workplace. Employers are increasingly sponsoring weight loss and wellness programs to ameliorate these costs. We evaluated weight loss outcomes, treatment utilization, and health behavior change in a low intensity phone- and web-based, employer-sponsored weight loss program. The intervention included three proactive counseling phone calls with a registered dietician and a behavioral health coach as well as a comprehensive website. At six months, one third of those who responded to the follow-up survey had lost a clinically significant amount of weight (≥5% of body weight). Clinically significant weight loss was predicted by the use of both the counseling calls and the website. When examining specific features of the web site, the weight tracking tool was the most predictive of weight loss. Health behavior changes such as eating more fruits and vegetables, increasing physical activity, and reducing stress were all predictive of clinically significant weight loss. Although limited by the low follow-up rate, this evaluation suggests that even low intensity weight loss programs can lead to clinical weight loss for a significant number of participants.
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Affiliation(s)
- Kelly M. Carpenter
- Alere Wellbeing, 999 Third Avenue, Suite 2100, Seattle, WA 98104, USA
- *Kelly M. Carpenter:
| | - Jennifer C. Lovejoy
- Alere Wellbeing, 999 Third Avenue, Suite 2100, Seattle, WA 98104, USA
- University of Washington, Seattle, WA 98195, USA
| | | | - Jenny E. Hapgood
- Alere Wellbeing, 999 Third Avenue, Suite 2100, Seattle, WA 98104, USA
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Wright JA, Phillips B, Watson B, Newby P, Norman GJ, Adams W. Randomized trial of a family-based, automated, conversational obesity treatment program for underserved populations. Obesity (Silver Spring) 2013; 21:E369-78. [PMID: 23512915 PMCID: PMC3695059 DOI: 10.1002/oby.20388] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 12/19/2012] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To evaluate the acceptability and feasibility of a scalable obesity treatment program integrated with pediatric primary care (PC) and delivered using interactive voice technology (IVR) to families from underserved populations. DESIGN AND METHODS Fifty parent-child dyads (child 9-12 yrs, BMI > 95th percentile) were recruited from a pediatric PC clinic and randomized to either an IVR or a wait-list control (WLC) group. The majority were lower-income, African-American (72%) families. Dyads received IVR calls for 12 weeks. Call content was informed by two evidence-based interventions. Anthropometric and behavioral variables were assessed at baseline and 3-month follow-up. RESULTS Forty-three dyads completed the study. IVR parents ate one cup more fruit than WLC (P < 0.05). No other group differences were found. Children classified as high users of the IVR decreased weight, BMI, and BMI z-score compared to low users ( P < 0.05). Mean number of calls for parents and children were 9.1 (5.2 SD) and 9.0 (5.7 SD), respectively. Of those who made calls, >75% agreed that the calls were useful, made for people like them, credible, and helped them eat healthy foods. CONCLUSION An obesity treatment program delivered via IVR may be an acceptable and feasible resource for families from underserved populations.
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Affiliation(s)
- J. A. Wright
- University of Massachusetts Boston, Department of Exercise & Health Sciences College of Nursing and Health Sciences
- Boston University School of Medicine/Boston Medical Center, Department of General Internal Medicine
- Corresponding Author: Julie A. Wright, PhD, UMass Boston, 100 Morrissey Blvd, Boston, MA 02125, , 617-287-3808
| | - B.D. Phillips
- University of Massachusetts Medical School, Department of Quantitative Health Sciences
| | - B.L. Watson
- Boston University School of Medicine, Department of General Pediatrics
| | - P.K. Newby
- Boston University School of Medicine, Department of General Pediatrics
- Division of Graduate Medical Nutrition Sciences; Boston University School of Public Health, Department of Epidemiology; Boston University Metropolitan College, Program in Gastronomy, Culinary Arts, and Wine Studies
| | - G. J. Norman
- University of California, San Diego, Department of Family & Preventive Medicine
| | - W.G. Adams
- Boston University School of Medicine, Department of General Pediatrics
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Steinberg DM, Tate DF, Bennett GG, Ennett S, Samuel-Hodge C, Ward DS. The efficacy of a daily self-weighing weight loss intervention using smart scales and e-mail. Obesity (Silver Spring) 2013; 21:1789-97. [PMID: 23512320 PMCID: PMC3788086 DOI: 10.1002/oby.20396] [Citation(s) in RCA: 153] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Accepted: 01/09/2013] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To examine the impact of a weight loss intervention that focused on daily self-weighing for self-monitoring as compared to a delayed control group among 91 overweight adults. DESIGN AND METHODS The 6-month intervention included a cellular-connected "smart" scale for daily weighing, web-based weight loss graph, and weekly e-mails with tailored feedback and lessons. An objective measure of self-weighing frequency was obtained. Weight was measured in clinic at 3 and 6 months. Caloric intake and expenditure, and perceptions of daily self-weighing were also measured. RESULTS Using intent-to-treat analyses, the intervention group lost significantly more weight compared to the control group [mean (95% CI); 3 months: -4.41% (-5.5, -3.3) vs. -0.37% (-1.5, 0.76); 6 months: -6.55% (-7.7, -5.4) vs. -0.35% (-1.5, 0.79); group × time interaction: P < 0.001] and a greater percentage achieved 5% (42.6% vs. 6.8%; P < 0.0001) and 10% (27.7% vs. 0%; P < 0.0001) weight loss. On average, the intervention group self-weighed more days/week (6.1 ± 1.1 vs. 1.1 ± 1.5; P < 0.0001) and consumed fewer calories/day compared to the control group [mean (95% CI); 6 months: 1,509 (1,291, 1,728) vs. 1,856 (1,637, 2,074); group × time interaction: P = 0.006]. Among intervention participants, daily self-weighing was perceived positively. CONCLUSIONS These results indicate that an intervention focusing on daily self-weighing can produce clinically significant weight loss.
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Affiliation(s)
- Dori M. Steinberg
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Duke Global Health Institute, Duke University, Durham, NC
| | - Deborah F. Tate
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Gary G. Bennett
- Department of Psychology and Neuroscience, Duke University, Durham, NC
- Duke Global Health Institute, Duke University, Durham, NC
| | - Susan Ennett
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Carmen Samuel-Hodge
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Dianne S. Ward
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Understanding dietary monitoring and self-weighing by gastric bypass patients: a pilot study of self-monitoring behaviors and long-term weight outcomes. Obes Surg 2013; 22:1818-26. [PMID: 22855205 DOI: 10.1007/s11695-012-0705-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Weight and dietary monitoring have been associated with better weight loss outcomes among dieters using lifestyle modification, but they have rarely been studied among gastric bypass surgery patients. This exploratory study examined dietary and weight self-monitoring behaviors and their association with weight outcomes in a sample of gastric bypass patients who were at least 12 months post-surgery. METHODS A convenience sample of 32 female and 5 male patients living in Upstate New York was recruited through support group list-servs. The participants completed an anonymous on-line survey about their weight histories, surgical histories, current weights, dietary monitoring practices, weight monitoring practices, and demographic characteristics. Measures were developed to assess frequency of monitoring behaviors (recording food intake, mentally tracking food, weighing/measuring foods, and self-weighing). Weight loss outcomes, based on self-reported weights, were current body mass index (BMI), percent excess BMI lost, and percent weight loss maintained. RESULTS Mean pre-surgical BMI was 49.5 ± 6.6. The participants were at an average of 32 months post-surgery with a BMI 31.2 ± 6.6. They maintained 89.2 ± 14.1% of their weight loss and 76.3 ± 26.0% excess BMI was lost. Higher scores for dietary monitoring behaviors, being unmarried, and lower pre-surgery BMI were associated with lower current BMI and greater excess BMI lost when controlling for age, sex, and time since surgery. CONCLUSIONS This study yielded constructs, measures, and relationships that warrant further examination in a larger sample of gastric bypass patients.
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Quick V, Loth K, MacLehose R, Linde JA, Neumark-Sztainer D. Prevalence of adolescents' self-weighing behaviors and associations with weight-related behaviors and psychological well-being. J Adolesc Health 2013; 52:738-44. [PMID: 23433538 PMCID: PMC3664119 DOI: 10.1016/j.jadohealth.2012.11.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Revised: 11/16/2012] [Accepted: 11/19/2012] [Indexed: 11/19/2022]
Abstract
PURPOSE To examine the relationships between self-weighing frequency, and weight-related behaviors and psychological well-being in a population-based sample of adolescents. METHODS This study compared weight-related behaviors between infrequent and frequent self-weighers, stratified by weight status and gender. Data were from Project EAT 2010 (Eating and Activity in Teens), a population-based study of 2,778 adolescents. RESULTS Approximately 14% of girls and boys weighed themselves frequently (weekly or more). In comparison to girls who were infrequent self-weighers, girls who were frequent self-weighers were more likely to diet, engage in unhealthy and extreme weight control behaviors, use unhealthy muscle-enhancing behaviors, and have lower self-esteem and greater body dissatisfaction. In comparison to boys who were infrequent self-weighers, boys who were frequent self-weighers were more likely to diet, engage in unhealthy and extreme weight control behaviors, use unhealthy muscle-enhancing behaviors, and report greater depressive symptoms. Among overweight adolescents, in addition to being associated with these harmful outcomes, frequent self-weighing was associated with the use of healthy weight control behaviors and with higher levels of moderate-to-vigorous activity. CONCLUSIONS Findings indicate that adolescents who frequently self-weigh themselves are at increased risk for a number of problematic health behaviors and poorer psychological outcomes. For overweight adolescents, frequent self-weighing was additionally associated with a number of positive outcomes. Based upon these findings, any recommendations for weight monitoring should be made cautiously; all adolescents, including overweight adolescents, should be advised not to engage in frequent self-weighing behaviors. Furthermore, any adolescents engaging in frequent self-weighing behaviors should be monitored for problematic outcomes.
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Affiliation(s)
- Virginia Quick
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Epidemiology, Statistics and Prevention Research, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
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Klos LA. Is Weighing a “Woman’s Thing?” Associations Among Gender, Gender Role Orientation, and Self-Weighing Behavior. SEX ROLES 2013. [DOI: 10.1007/s11199-013-0290-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Self-weighing frequency is associated with weight gain prevention over 2 years among working adults. Int J Behav Med 2013; 19:351-8. [PMID: 21732212 DOI: 10.1007/s12529-011-9178-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Little is known about the association between self-weighing frequency and weight gain prevention, particularly in worksite populations. PURPOSE The degree to which self-weighing frequency predicted 2-year body weight change in working adults was examined. METHOD The association between self-weighing frequency (monthly or less, weekly, daily, or more) and 24-month weight change was analyzed in a prospective cohort analysis (n = 1,222) as part of the larger HealthWorks trial. RESULTS There was a significant interaction between follow-up self-weighing frequency and baseline body mass index. The difference in weight change ranged from -4.4 ± 0.8 kg weight loss among obese daily self-weighers to 2.1 ± 0.4 kg weight gain for participants at a healthy weight who reported monthly self-weighing. CONCLUSION More frequent self-weighing seemed to be most beneficial for obese individuals. These findings may aid in the refinement of self-weighing frequency recommendations used in the context of weight management interventions.
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Hwang KO, Ning J, Trickey AW, Sciamanna CN. Website usage and weight loss in a free commercial online weight loss program: retrospective cohort study. J Med Internet Res 2013; 15:e11. [PMID: 23322819 PMCID: PMC3636231 DOI: 10.2196/jmir.2195] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 08/29/2012] [Accepted: 11/08/2012] [Indexed: 01/07/2023] Open
Abstract
Background Online weight loss programs are increasingly popular. However, little is known about outcomes and associations with website usage among members of free online weight loss programs. Objective This retrospective cohort study examined the association between website usage and weight loss among members of a free commercial online weight loss program (SparkPeople). Methods We conducted a retrospective analysis of a systematic random sample of members who joined the program during February 1 to April 30, 2008, and included follow-up data through May 10, 2010. The main outcome was net weight change based on self-reported weight. Measures of website usage included log-ins, self-monitoring entries (weight, food, exercise), and use of social support tools (discussion forums, friendships). Results The main sample included 1258 members with at least 2 weight entries. They were 90.7% female, with mean (SD) age 33.6 (11.0) and mean (SD) BMI 31.6 (7.7). Members with at least one forum post lost an additional 1.55 kg (95% CI 0.55 kg to 2.55 kg) relative to those with no forum posts. Having at least 4 log-in days, weight entry days, or food entry days per 30 days was significantly associated with weight loss. In the multiple regression analysis, members with at least 4 weight entry days per 30 days reported 5.09 kg (95% CI 3.29 kg to 6.88 kg) more weight loss per 30 days than those with fewer weight entry days. After controlling for weight entry days, the other website usage variables were not associated with weight change. Conclusions Weekly or more frequent self-monitoring of weight is associated with greater weight loss among members of this free online weight loss program.
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Affiliation(s)
- Kevin O Hwang
- Department of Internal Medicine, The University of Texas Medical School at Houston, Houston, TX, United States.
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Ritter S, Vetter ML, Sarwer DB. Lifestyle modifications and surgical options in the treatment of patients with obesity and type 2 diabetes mellitus. Postgrad Med 2012; 124:168-80. [PMID: 22913905 DOI: 10.3810/pgm.2012.07.2578] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This article reviews recent developments in the behavioral and surgical treatment of obesity and type 2 diabetes mellitus (T2DM). Randomized controlled trials of comprehensive lifestyle-modification programs, which include dietary interventions, physical activity, and behavioral therapy, have shown weight losses of 7% to 10% of initial body weight within 4 to 6 months after treatment. These programs also reduce the likelihood of developing T2DM by 58% for individuals with impaired glucose tolerance. Long-term maintenance of these improvements requires continued implementation of the program diet, physical activity, and self-regulatory behaviors. This can be successfully facilitated by continued patient-provider contact, which is frequently delivered by phone, mail, email, or online. However, these benefits may have less impact on those with extreme obesity or more significant health problems. For these individuals, bariatric surgery may be a more appropriate treatment. Bariatric surgical procedures induce mean weight losses of 15% to 30% of initial body weight (depending on the procedure) within 2 years after surgery, as well as a 45% to 95% rate of diabetes remission. Familiarity with these developments can help physicians and patients to determine which combinations of behavioral, medical, and surgical interventions are appropriate for the treatment of obesity and T2DM.
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Affiliation(s)
- Scott Ritter
- Center for Weight and Eating Disorders and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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Quick V, Larson N, Eisenberg ME, Hannan PJ, Neumark-Sztainer D. Self-weighing behaviors in young adults: tipping the scale toward unhealthy eating behaviors? J Adolesc Health 2012; 51:468-74. [PMID: 23084168 PMCID: PMC3478783 DOI: 10.1016/j.jadohealth.2012.02.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Revised: 02/03/2012] [Accepted: 02/05/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE This study examined associations between frequency of self-weighing and healthy weight-control behaviors (WCBs), unhealthy WCBs, muscle-enhancing behaviors (e.g., steroid use, protein powders), and psychological well-being (i.e., self-esteem, depression, body satisfaction) in a community sample of young adults. METHODS Data were drawn from Project EAT-III (Eating and Activity in Teens and Young Adults), the third wave of a population-based study. Participants included young adults (n = 2,287, mean age = 25.3 years) from the Minneapolis/St. Paul metropolitan area. RESULTS Self-weighing a few times per week or more frequently was reported by 18% of young adult women and 12% of young adult men. Linear regression models, adjusted for body mass index and demographic characteristics, indicated that in both women and men, more frequent self-weighing was associated with a higher prevalence of dieting, both healthy and unhealthy WCBs, and muscle-enhancing behaviors. Additionally, young women who reported more frequent self-weighing were more likely to report binge eating. More frequent self-weighing was also associated with more depressive symptoms and lower self-esteem in women and lower body satisfaction in young men. CONCLUSIONS More frequent self-weighing is associated with healthy and unhealthy weight-control practices, muscle-enhancing behaviors, and poorer psychological well-being in young adults. Young adults engaging in self-weighing behaviors should be screened for these health indicators and counseled as appropriate. Before recommending self-weighing as a weight-monitoring tool, health care providers should ensure that young adults are not at risk for an unhealthy preoccupation with body weight or shape.
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Affiliation(s)
- Virginia Quick
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota 55454, USA.
| | - Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, USA
| | - Marla E. Eisenberg
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, USA,Division of Adolescent Health and Medicine, Department of Pediatrics, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN 55414, USA
| | - Peter J. Hannan
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, USA
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Greaney ML, Sprunck-Harrild K, Bennett GG, Puleo E, Haines J, Viswanath KV, Emmons KM. Use of email and telephone prompts to increase self-monitoring in a Web-based intervention: randomized controlled trial. J Med Internet Res 2012; 14:e96. [PMID: 22842775 PMCID: PMC3415265 DOI: 10.2196/jmir.1981] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Revised: 01/30/2012] [Accepted: 04/29/2012] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Self-monitoring is a key behavior change mechanism associated with sustained health behavior change. Although Web-based interventions can offer user-friendly approaches for self-monitoring, engagement with these tools is suboptimal. Increased use could encourage, promote, and sustain behavior change. OBJECTIVE To determine whether email prompts or email plus telephone prompts increase self-monitoring of behaviors on a website created for a multiple cancer risk reduction program. METHODS We recruited and enrolled participants (N = 100) in a Web-based intervention during a primary care well visit at an urban primary care health center. The frequency of daily self-monitoring was tracked on the study website. Participants who tracked at least one behavior 3 or more times during week 1 were classified as meeting the tracking threshold and were assigned to the observation-only group (OO, n = 14). This group was followed but did not receive prompts. Participants who did not meet the threshold during week 1 were randomly assigned to one of 2 prompting conditions: automated assistance (AA, n = 36) or automated assistance + calls (AAC, n = 50). During prompting periods (weeks 2-3), participants in the AA and AAC conditions received daily automated emails that encouraged tracking and two tailored self-monitoring reports (end of week 2, end of week 3) that provided feedback on tracking frequency. Individuals in the AAC condition also received two technical assistance calls from trained study staff. Frequency of self-monitoring was tracked from week 2 through week 17. RESULTS Self-monitoring rates increased in both intervention conditions during prompting and declined when prompting ceased. Over the 16 weeks of observation, there was a significant between-group difference in the percentage who met the self-monitoring threshold each week, with better maintenance in the AAC than in the AA condition (P < .001). Self-monitoring rates were greater in the OO group than in either the AA or AAC condition (P < .001). CONCLUSIONS Prompting can increase self-monitoring rates. The decrease in self-monitoring after the promoting period suggests that additional reminder prompts would be useful. The use of technical assistance calls appeared to have a greater effect in promoting self-monitoring at a therapeutic threshold than email reminders and the tailored self-monitoring reports alone. TRIAL REGISTRATION ClinicalTrials.gov NCT01415492; http://clinicaltrials.gov/ct2/show/NCT01415492 (Archived by WebCite at http://www.webcitation.org/68LOXOMe2).
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Affiliation(s)
- Mary L Greaney
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA, United States.
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91
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Kong A, Beresford SAA, Alfano CM, Foster-Schubert KE, Neuhouser ML, Johnson DB, Duggan C, Wang CY, Xiao L, Jeffery RW, Bain CE, McTiernan A. Self-monitoring and eating-related behaviors are associated with 12-month weight loss in postmenopausal overweight-to-obese women. J Acad Nutr Diet 2012; 112:1428-1435. [PMID: 22795495 DOI: 10.1016/j.jand.2012.05.014] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Accepted: 04/24/2012] [Indexed: 11/26/2022]
Abstract
Lifestyle-based interventions, which typically promote various behavior modification strategies, can serve as a setting for evaluating specific behaviors and strategies thought to promote or hinder weight loss. The aim of our study was to test the associations of self-monitoring (ie, self-weighing and food journal completion) and eating-related (ie, dietary intake, diet-related weight-control strategies, and meal patterns) behaviors with weight loss in a sample of postmenopausal overweight-to-obese women enrolled in a 12-month dietary weight loss intervention. Changes in body weight and adoption of self-monitoring and eating-related behaviors were assessed in 123 participants. Generalized linear models tested associations of these behaviors with 12-month weight change after adjusting for potential confounders. Mean percent weight loss was 10.7%. In the final model, completing more food journals was associated with a greater percent weight loss (interquartile range 3.7% greater weight loss; P<0.0001), whereas skipping meals (4.3% lower weight loss; P<0.05) and eating out for lunch (at least once a week, 2.5% lower weight loss; P<0.01) were associated with a lower amount of weight loss. These findings suggest that a greater focus on dietary self-monitoring, home-prepared meals, and consuming meals at regular intervals may improve 12-month weight loss among postmenopausal women enrolled in a dietary weight loss intervention.
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92
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Abstract
The majority of US adults are overweight or obese, which is a primary risk factor for type 2 diabetes and other chronic diseases. Recent advances in behavioral treatment of obesity have produced significant short- and long-term weight losses that reduce the risk of type 2 diabetes and cardiovascular disease. This article reviews key components of effective behavioral treatment interventions, including diet, exercise, and behavioral and psychosocial strategies. The authors review newer treatment modalities that may enhance dissemination (Internet, smartphone) and discuss applications to clinical practice. Practitioners face multiple barriers to effectively delivering lifestyle interventions in today’s health care setting but, nonetheless, remain powerful motivators in helping patients initiate and maintain weight loss efforts that reduce the risk of type 2 diabetes and other chronic diseases.
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Affiliation(s)
- Todd Alan Hagobian
- California Polytechnic State University, Kinesiology Department, San Luis Obispo, CA
| | - Suzanne Phelan
- California Polytechnic State University, Kinesiology Department, San Luis Obispo, CA
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93
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Kong A, Beresford SAA, Imayama I, Duggan C, Alfano CM, Foster-Schubert KE, Neuhouser ML, Johnson DB, Wang CY, Xiao L, Bain CE, McTiernan A. Adoption of diet-related self-monitoring behaviors varies by race/ethnicity, education, and baseline binge eating score among overweight-to-obese postmenopausal women in a 12-month dietary weight loss intervention. Nutr Res 2012; 32:260-5. [PMID: 22575038 DOI: 10.1016/j.nutres.2012.03.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 02/28/2012] [Accepted: 03/05/2012] [Indexed: 11/16/2022]
Abstract
Recent research has identified self-monitoring behaviors as important strategies for both initial weight loss and weight loss maintenance, but relatively little is known about adopters and nonadopters of these behaviors. To test our hypothesis that key characteristics distinguish adopters from nonadopters, we examined the demographic characteristics and eating behaviors (eg, restrained, uncontrolled, emotional, and binge eating) associated with more frequent compared with less frequent use of these behaviors. Baseline demographic characteristics and eating behaviors as well as 12-month self-monitoring behaviors (ie, self-weighing, food journaling, monitoring energy intake) were assessed in 123 postmenopausal women enrolled in a dietary weight loss intervention. Logistic regression models were used to test associations of self-monitoring use with demographic characteristics and eating behaviors. Nonwhites, compared with non-Hispanic whites, were less likely to monitor energy intake regularly (adjusted odds ratio [OR], 0.36; 95% confidence interval [CI], 0.13-0.97; P < .05), controlling for intervention arm and baseline body mass index. Participants with a college degree or higher education were less likely to self-weigh daily (adjusted OR, 0.30; 95% CI, 0.13-0.67; P < .01) compared with individuals who attended some college or less. Those with higher baseline binge eating scores were less likely to monitor energy intake (adjusted OR, 0.84; 95% CI, 0.73-0.97; P < .01) compared with participants with lower binge eating scores. In summary, use of diet-related self-monitoring behaviors varied by race/ethnicity, education, and binge eating score in postmenopausal women who completed a year-long dietary weight loss intervention. Improved recognition of groups less likely to self-monitor may be helpful in promoting these behaviors in future interventions.
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Affiliation(s)
- Angela Kong
- Cancer Education and Career Development Program, University of Illinois at Chicago, Chicago, IL 60608, USA
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94
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Phelan S, Jankovitz K, Hagobian T, Abrams B. Reducing excessive gestational weight gain: lessons from the weight control literature and avenues for future research. ACTA ACUST UNITED AC 2012; 7:641-61. [PMID: 22040207 DOI: 10.2217/whe.11.70] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Excessive gestational weight gain is a prevalent problem and an independent predictor of future obesity in both mothers and offspring. Intervention research to prevent excessive gestational weight gain is still in its infancy but results to date have been quite modest. Research in weight control outside of pregnancy over the past 30 years has been more robust and identified several key components of effective programs, including use of caloric restriction, daily diet self-monitoring, self-weighing, behavior therapy and ongoing patient-provider contact. The aim of this article is to summarize intervention components shown to be effective in promoting successful weight control outside of pregnancy and explore potential applications in pregnancy. Available evidence suggests that the strategies shown to be effective for weight control outside of pregnancy may also promote better weight control in pregnancy, but several lines for future investigation remain.
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Affiliation(s)
- Suzanne Phelan
- Kinesiology Department, California Polytechnic State University, San Luis Obispo, CA 93407-0386, USA.
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95
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Caswell S, Craigie AM, Wardle J, Stead M, Anderson A. Detailed protocol for the lifestyle intervention in the BeWEL randomised controlled trial of weight loss in adults who have had a colorectal adenoma. BMJ Open 2012; 2:bmjopen-2012-001276. [PMID: 22637376 PMCID: PMC3364449 DOI: 10.1136/bmjopen-2012-001276] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION The BeWEL study is aimed at assessing the impact of a personalised lifestyle programme on body weight in people at risk of developing colorectal adenomas. The study is a two-arm multicentre randomised controlled trial comparing the BeWEL lifestyle programme against usual care. Over 12 months, 316 people who have had a colorectal adenoma removed through the national screening programme will be randomised to provide 80% power to detect a weight loss (primary outcome) of 7% over 12 months. METHODS The 12-month intervention will be delivered by lifestyle counsellors via three face-to-face visits followed by nine monthly telephone support calls. Consultant endorsement for the study will be stressed. An individualised caloric prescription based on estimates for weight maintenance -600 kcal will be calculated. Motivational interviewing techniques will be used to identify personal motivations for weight change and ways to improve perceived self-efficacy. The programme will utilise personalised diet and physical activity data from baseline measures to set behavioural goals. A range of behavioural strategies will be employed to support lifestyle change including goal setting, identifying specific implementation intentions, self-monitoring and feedback. Emphasis will be placed on self-monitoring body weight, and weighing scales will be provided. Programme acceptability will be explored postintervention with indepth interviews. Compliance and impact will be assessed by baseline and follow-up measures of diet by self-report, activity by accelerometry and anthropometry. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Tayside Committee on Medical Research Ethics. Dissemination of results will focus on publications in peer-reviewed journals, presentations at national/international cancer meetings and NHS groups. In addition, the work will be communicated to the public through forums such at The Scottish Cancer Prevention Network (http://www.cancerpreventionscotland.co.uk/). The trial is registered with Current Controlled Trials (International Standard Randomised Controlled Trials No: ISRCTN53033856).
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Affiliation(s)
- Stephen Caswell
- Centre for Research into Cancer Prevention and Screening, Medical Research Institute, Population Health Sciences Division, University of Dundee, Dundee, UK
| | - Angela M Craigie
- Centre for Research into Cancer Prevention and Screening, Medical Research Institute, Population Health Sciences Division, University of Dundee, Dundee, UK
| | - Jane Wardle
- Health Behaviour Unit, Department of Epidemiology and Public Health, University College London, London, UK
| | - Martine Stead
- Institute for Social Marketing, Stirling Management School, University of Stirling and the Open University, Stirling, UK
| | - Annie Anderson
- Centre for Research into Cancer Prevention and Screening, Medical Research Institute, Population Health Sciences Division, University of Dundee, Dundee, UK
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96
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Behavioural factors related with successful weight loss 15 months post-enrolment in a commercial web-based weight-loss programme. Public Health Nutr 2011; 15:1299-309. [DOI: 10.1017/s1368980011003090] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
AbstractObjectiveAs further understanding is required of what behavioural factors are associated with long-term weight-loss success, the aim of the present study was to determine the prevalence of successful weight loss 15 months post-enrolment in a commercial web-based weight-loss programme and which behavioural factors were associated with success.DesignAn online survey was completed 15 months post-enrolment in a commercial web-based weight-loss programme to assess weight-related behaviours and current weight. Participants were classified as successful if they had lost ≥5 % of their starting weight after 15 months.SettingCommercial users of a web-based weight-loss programme.SubjectsParticipants enrolled in the commercial programme between August 2007 and May 2008. Six hundred and seventy-seven participants completed the survey.ResultsThe median (interquartile range) weight change was −2·7 (−8·2, 1·6) % of enrolment weight, with 37 % achieving ≥5 % weight loss. Multivariate logistic regression analysis found success was associated with frequency of weight self-monitoring, higher dietary restraint score, lower emotional eating score, not skipping meals, not keeping snack foods in the house and eating takeaway foods less frequently.ConclusionsThe findings suggest that individuals trying to achieve or maintain ≥5 % weight loss should be advised to regularly weigh themselves, avoid skipping meals or keeping snack foods in the house, limit the frequency of takeaway food consumption, manage emotional eating and strengthen dietary restraint. Strategies to assist individuals make these changes to behaviour should be incorporated within obesity treatments to improve the likelihood of successful weight loss in the long term.
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97
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French SA, Gerlach AF, Mitchell NR, Hannan PJ, Welsh EM. Household obesity prevention: Take Action--a group-randomized trial. Obesity (Silver Spring) 2011; 19:2082-8. [PMID: 21212771 PMCID: PMC5771495 DOI: 10.1038/oby.2010.328] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The purpose of the present study was to evaluate an intervention to prevent weight gain among households (HHs) in the community. Ninety HHs were randomized to intervention or control group for 1 year. Intervention consisted of six face-to-face group sessions, placement of a television (TV) locking device on all home TVs, and home-based intervention activities. Measures were collected in person at baseline and 1 year. Weight, height, eating behaviors, physical activity (PA), and TV viewing were measured among HH members ages ≥ 12 years. Follow-up rate at 1 year was 96%. No significant intervention effects were observed for change in HH BMI-z score. Intervention HHs significantly reduced TV viewing, snacks/sweets intake, and dollars per person spent eating out, and increased (adults only) PA and self-weighing frequency compared with control HHs. A 1 year obesity prevention intervention targeting entire HHs was effective in reducing TV viewing, snack/sweets intake and eating out purchases. Innovative methods are needed to strengthen the home food environment intervention component. Longer intervention durations also need to be evaluated.
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Affiliation(s)
- Simone A French
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
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98
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The Use of Telehealth Technology in Assessing the Accuracy of Self-Reported Weight and the Impact of a Daily Immediate-Feedback Intervention among Obese Employees. Int J Telemed Appl 2011; 2011:909248. [PMID: 21760782 PMCID: PMC3134252 DOI: 10.1155/2011/909248] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Revised: 03/27/2011] [Accepted: 04/19/2011] [Indexed: 11/18/2022] Open
Abstract
Objective. To determine the accuracy of self-reported body weight prior to and following a weight loss intervention including daily self-weighing among obese employees.
Methods. As part of a 6-month randomized controlled trial including a no-treatment control group, an intervention group received a series of coaching calls, daily self-weighing, and interactive telemonitoring. The primary outcome variable was the absolute discrepancy between self-reported and measured body weight at baseline and at 6 months. We used general linear mixed model regression to estimate changes and differences between study groups over time.
Results. At baseline, study participants underreported their weight by an average of 2.06 (se = 0.33) lbs. The intervention group self-reported a smaller absolute body weight discrepancy at followup than the control group.
Conclusions. The discrepancy between self-reported and measured body weight appears to be relatively small, may be improved through daily self-monitoring using immediate-feedback telehealth technology, and negligibly impacts change in body weight.
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Study protocol for BeWEL: the impact of a BodyWEight and physicaL activity intervention on adults at risk of developing colorectal adenomas. BMC Public Health 2011; 11:184. [PMID: 21439044 PMCID: PMC3071320 DOI: 10.1186/1471-2458-11-184] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2011] [Accepted: 03/25/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second highest cause of cancer death in the UK. Most cases occur in people over 50 years and CRC often co-exists with other lifestyle related disorders including obesity, type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). These diseases share risk factors related to the metabolic syndrome including large body size, abnormal lipids and markers of insulin resistance indicating common aetiological pathways. METHODS/DESIGN This 3 year study will be a two-arm, multicentre, randomised controlled trial comparing the BeWEL lifestyle (diet, physical activity and behaviour change) programme against usual care. The pre-trial development will take 6 months and participants will be recruited over a 12 month period and undertake the intervention and follow up for 12 months (total 24 months recruitment and intervention implementation) with a further 6 months for data collection, analysis and interpretation.Four hundred and fifty two participants who have had a colorectal adenoma detected and removed (through the national colorectal screening programme) will provide 80% power to detect a weight loss of 7% over 12 months.Primary outcomes are changes in body weight and waist circumference. Secondary outcomes will include cardiovascular risk factors, psycho-social measures and intervention costs. DISCUSSION The results from this study will enhance the evidence base for lifestyle change in patients at higher risk of chronic disease including obesity related cancers.International Standard Randomised Controlled Trials No: ISRCTN53033856.
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Burke LE, Wang J, Sevick MA. Self-monitoring in weight loss: a systematic review of the literature. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 2011; 111:92-102. [PMID: 21185970 PMCID: PMC3268700 DOI: 10.1016/j.jada.2010.10.008] [Citation(s) in RCA: 730] [Impact Index Per Article: 56.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Accepted: 07/06/2010] [Indexed: 01/19/2023]
Abstract
Self-monitoring is the centerpiece of behavioral weight loss intervention programs. This article presents a systematic review of the literature on three components of self-monitoring in behavioral weight loss studies: diet, exercise, and self-weighing. This review included articles that were published between 1993 and 2009 that reported on the relationship between weight loss and these self-monitoring strategies. Of the 22 studies identified, 15 focused on dietary self-monitoring, one on self-monitoring exercise, and six on self-weighing. A wide array of methods was used to perform self-monitoring; the paper diary was used most often. Adherence to self-monitoring was reported most frequently as the number of diaries completed or the frequency of log-ins or reported weights. The use of technology, which included the Internet, personal digital assistants, and electronic digital scales were reported in five studies. Descriptive designs were used in the earlier studies whereas more recent reports involved prospective studies and randomized trials that examined the effect of self-monitoring on weight loss. A significant association between self-monitoring and weight loss was consistently found; however, the level of evidence was weak because of methodologic limitations. The most significant limitations of the reviewed studies were the homogenous samples and reliance on self-report. In all but two studies, the samples were predominantly white and women. This review highlights the need for studies in more diverse populations, for objective measures of adherence to self-monitoring, and for studies that establish the required dose of self-monitoring for successful outcomes.
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Affiliation(s)
- Lora E. Burke
- University of Pittsburgh School of Nursing and Graduate School of Public Health, 415 Victoria building, 3500 Victoria Street, Pittsburgh, PA 15261, Phone: 412-624-2305, Fax: 412-383-7293
| | - Jing Wang
- University of Pittsburgh, University of Pittsburgh School of Nursing and Graduate School of Public Health, 415 Victoria building, 3500 Victoria Street, Pittsburgh, PA 15261, Phone: 412-624-2229
| | - Mary Ann Sevick
- VA Pittsburgh Healthcare System, Associate Professor of Medicine and Public Health, Center for Research on Health Care, University of Pittsburgh, 3520 Forbes Avenue, First Floor, Pittsburgh, PA 15213, Phone: (412)586-9788, FAX: (412)647-0632
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