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Mehlig K, Sliwa P, Blomstrand A, Farhan L, Hällström T, Hange D. Eating Behaviors and Adiposity Indicators - Observations from the 2016/17 Examination of the Population Study of Women in Gothenburg. Int J Gen Med 2024; 17:2101-2111. [PMID: 38766600 PMCID: PMC11100506 DOI: 10.2147/ijgm.s457731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/23/2024] [Indexed: 05/22/2024] Open
Abstract
Purpose To determine the cross-sectional association between eating behavior in terms of the three-factor eating questionnaire (TFEQ) and adiposity measures. Methods The TFEQ-R21 was administered to 573 women aged 38 and 50 who participated in the population study of women in Gothenburg 2016/17. Three domains, emotional eating (EE), uncontrolled eating (UE), and cognitive restraint (CR) were examined as outcomes as well as predictors of adiposity outcomes. Multiple linear and logistic regression models were adjusted for age, education, lifestyle factors, and dieting behavior. Results All TFEQ domains were positively associated with dieting. EE and UE were associated with higher consumption of sweets and CR with lower consumption of sweets. Wellbeing was negatively associated with EE and UE. In mutually adjusted models, EE and CR but not UE were positively associated with BMI, waist circumference (WC), waist-to-hip ratio, waist-to-height ratio, and skinfold. One standard deviation higher EE was associated with obesity, BMI ≥ 30 kg/m2, OR = 1.62 (1.26, 2.10), and abdominal fatness, WC > 88 cm, OR = 1.57 (1.26, 1.95). Former and current dieting were positively associated with these outcomes, too, but UE and CR were not associated in mutually adjusted models. Conclusion This study shows that emotional eating behavior is associated with adiposity in a population of middle-aged women, over a large range of values for body fatness, and independent of dieting behavior. The results imply that treatment of obesity should include psychological support to restrict the risk for emotional eating in response to states of negative mood.
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Affiliation(s)
- Kirsten Mehlig
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Pawel Sliwa
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ann Blomstrand
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lena Farhan
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Tore Hällström
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Dominique Hange
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research, Education, Development & Innovation, Primary Health Care, Region Västra Götaland, Gothenburg, Sweden
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2
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Alur-Gupta S, Dokras A, Cooney LG. Management of polycystic ovary syndrome must include assessment and treatment of mental health symptoms. Fertil Steril 2024; 121:384-399. [PMID: 38244713 DOI: 10.1016/j.fertnstert.2024.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/22/2024]
Abstract
Polycystic ovary syndrome (PCOS) is an endocrine disorder with reproductive and metabolic manifestations affecting millions of women worldwide. The health risks associated with PCOS, however, go beyond physical health. Over the past decade, data have emerged demonstrating a high risk of concurrent mental health conditions, specifically depression and anxiety, but extending into other aspects of psychological health, including body image distress, eating disorders, and sexual dysfunction. International surveys suggest physician knowledge about the mental health associations with PCOS is poor and that patients are often dissatisfied regarding counseling-related psychological issues. We performed a review of mental health comorbidities in individuals with PCOS, including depression, anxiety, body image distress, eating disorders, psychosexual dysfunction, and decreased quality of life, as well as evaluated the impact of common PCOS treatments on these conditions. Most meta-analyses in reproductive age women demonstrate increased risks of these conditions, although data are more limited in adolescents and older adults. In addition, the impact of PCOS treatments on these conditions as well as data on first-line treatments in the PCOS population is limited. All providers involved in the multidimensional care of individuals with PCOS should be aware of these mental health risks to provide appropriate screening, counseling and referral options. Future studies should be designed to evaluate targeted treatment for individuals with PCOS.
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Affiliation(s)
- Snigdha Alur-Gupta
- Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York.
| | - Anuja Dokras
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Laura G Cooney
- Department of Obstetrics and Gynecology, University of Wisconsin, Middleton, Wisconsin
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3
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Tang HB, Jalil NIBA, Tan CS, He L, Zhang SJ. Why more successful? An analysis of participants' self-monitoring data in an online weight loss intervention. BMC Public Health 2024; 24:322. [PMID: 38287333 PMCID: PMC10826064 DOI: 10.1186/s12889-024-17848-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 01/22/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Self-monitoring is crucial for behavioral weight loss. However, few studies have examined the role of self-monitoring using mixed methods, which may hinder our understanding of its impact. METHODS This study examined self-monitoring data from 61 Chinese adults who participated in a 5-week online group intervention for weight loss. Participants reported their baseline Body Mass Index (BMI), weight loss motivation, and engaged in both daily quantitative self-monitoring (e.g., caloric intake, mood, sedentary behavior, etc.) and qualitative self-monitoring (e.g., daily log that summarizes the progress of weight loss). The timeliness of participants' daily self-monitoring data filling was assessed using a scoring rule. One-way repeated measurement ANOVA was employed to analyze the dynamics of each self-monitoring indicator. Correlation and regression analyses were used to reveal the relationship between baseline data, self-monitoring indicators, and weight change. Content analysis was utilized to analyze participants' qualitative self-monitoring data. Participants were categorized into three groups based on their weight loss outcomes, and a chi-square test was used to compare the frequency distribution between these groups. RESULTS After the intervention, participants achieved an average weight loss of 2.52 kg (SD = 1.36) and 3.99% (SD = 1.96%) of their initial weight. Daily caloric intake, weight loss satisfaction, frequency of daily log, and the speed of weight loss showed a downward trend, but daily sedentary time gradually increased. Moreover, regression analysis showed that baseline BMI, weight loss motivation, and timeliness of daily filling predicted final weight loss. Qualitative self-monitoring data analysis revealed four categories and nineteen subcategories. A significant difference in the frequency of qualitative data was observed, with the excellent group reporting a greater number of daily logs than expected in all categories and most subcategories, and the moderate and poor groups reporting less than expected in all categories and most subcategories. CONCLUSION The self-monitoring data in short-term online group intervention exhibited fluctuations. Participants with higher baseline BMI, higher levels of weight loss motivation, and timely self-monitoring achieved more weight loss. Participants who achieved greater weight loss reported a higher quantity of qualitative self-monitoring data. Practitioners should focus on enhancing dieters' weight loss motivation and promote adherence to self-monitoring practices.
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Affiliation(s)
- Hai-Bo Tang
- Faculty of Education, Yibin University, Yibin, 644000, China.
- Department of Psychology and Counselling, Universiti Tunku Abdul Rahman, Kampar, 31900, Malaysia.
| | | | - Chee-Seng Tan
- School of Psychology, College of Liberal Arts Wenzhou-Kean University, Wenzhou, Zhejiang province, 325060, China
| | - Ling He
- Faculty of Education, Yibin University, Yibin, 644000, China
- Department of Psychology and Counselling, Universiti Tunku Abdul Rahman, Kampar, 31900, Malaysia
| | - Shu-Juan Zhang
- , Sichuan Tianfu New District No. 3 Middle School, Chengdu, 610213, China
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4
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Kudlek L, Mueller J, Eustacio Colombo P, Sharp SJ, Griffin SJ, Ahern A. The moderating and mediating role of eating behaviour traits in acceptance and commitment therapy-based weight management interventions: protocol for an individual participant data meta-analysis. BMJ Open 2023; 13:e076411. [PMID: 38081662 PMCID: PMC10729174 DOI: 10.1136/bmjopen-2023-076411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Precision medicine approaches to obesity aim to maximise treatment effectiveness by matching weight management interventions (WMIs) to characteristics of individuals, such as eating behaviour traits (EBTs). Acceptance and commitment therapy (ACT)-based WMIs may address EBTs such as emotional and uncontrolled eating more effectively than standard interventions, and might be most effective in people with high levels of these traits. However, few studies have examined this directly. We will examine (a) whether ACT-based interventions are more effective for people with certain levels of EBTs (ie, moderation) and (b) whether ACT-based interventions operate through changes in EBTs (ie, mediation). METHODS AND ANALYSIS This individual participant data (IPD) meta-analysis will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Individual Participant Data guidance. We will include studies on ACT-based WMIs that assessed EBTs in people with a body mass index ≥25 kg/m2. We identified studies by screening studies included in a previous review of third wave cognitive behavioural interventions, and updating the search to 20 June 2022. We will request IPD from eligible published and unpublished studies. We will harmonise and re-analyse data using a two-stage random effects meta-analysis pooling within-trial interactions to investigate moderating effects and using a one-stage simultaneous equation model to examine mediating effects. We will assess the risk of bias in included studies using the Cochrane Risk of Bias tool 2 and the Risk of Bias in Non-randomised Studies of Interventions tool. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Cambridge Psychology Research Ethics Committee (Application No: PRE.2023.121). Data sharing will follow data transfer agreements and coauthorship will be offered to investigators contributing data. Findings will be disseminated through peer-reviewed journals and conferences and will contribute to the lead author's PhD thesis. PROSPERO REGISTRATION NUMBER CRD42022359691.
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Affiliation(s)
- Laura Kudlek
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Julia Mueller
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | | | - Stephen J Sharp
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Simon J Griffin
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Primary Care Unit, University of Cambridge, Cambridge, UK
| | - Amy Ahern
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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Tan ST, Kannan TM. Comparison of eating behaviour by relative weight change status of young adults throughout the COVID-19 pandemic. DIALOGUES IN HEALTH 2023; 2:100094. [PMID: 36568862 PMCID: PMC9767657 DOI: 10.1016/j.dialog.2022.100094] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 12/17/2022] [Accepted: 12/18/2022] [Indexed: 12/26/2022]
Abstract
Background and purpose The enforcement of nationwide lockdowns has worsened the obesity epidemic in Malaysia. Therefore, this study aims to compare eating behaviour by relative weight change status among young adults in Malaysia throughout the COVID-19 pandemic. Design/methodology/approach Socio-demographics, body height, pre-pandemic body weight, and post-lockdown body weight were self-reported by the young adults. The eating behaviour was assessed using the validated Three-Factor Eating Questionnaire-Revised 18-item (TFEQ-R18). The mean difference in eating behaviour subscales was analysed using MANCOVA with a Bonferroni-adjusted post-hoc test. Findings One-third of the young adults put on body weight due to the lockdowns, with an average relative weight gain of 12.44 ± 9.67%. Conversely, about one-fifth of the young adults reported having lighter body weight in the post-lockdown pandemic phase, with an average relative weight loss of 10.10 ± 4.66%. Young adults in the weight loss category had a significantly higher standardised raw score in cognitive restraints than those in the sustained weight and weight gain categories. In addition, young adults in the weight gain category had statistically higher standardised raw scores in uncontrolled eating and emotional eating compared to those in the sustained weight category. Weight trajectory during the COVID-19 pandemic is linked to disordered eating behaviour among young adults in Malaysia. Originality/value The findings presented in this study can be potentially valuable in formulating weight management strategies in the post-COVID-19 era.
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6
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Noh E, Won J, Jo S, Hahm DH, Lee H. Conversational Agents for Body Weight Management: Systematic Review. J Med Internet Res 2023; 25:e42238. [PMID: 37234029 DOI: 10.2196/42238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 03/20/2023] [Accepted: 04/14/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Obesity is a public health issue worldwide. Conversational agents (CAs), also frequently called chatbots, are computer programs that simulate dialogue between people. Owing to better accessibility, cost-effectiveness, personalization, and compassionate patient-centered treatments, CAs are expected to have the potential to provide sustainable lifestyle counseling for weight management. OBJECTIVE This systematic review aimed to critically summarize and evaluate clinical studies on the effectiveness and feasibility of CAs with unconstrained natural language input for weight management. METHODS PubMed, Embase, the Cochrane Library (CENTRAL), PsycINFO, and ACM Digital Library were searched up to December 2022. Studies were included if CAs were used for weight management and had a capability for unconstrained natural language input. No restrictions were imposed on study design, language, or publication type. The quality of the included studies was assessed using the Cochrane risk-of-bias assessment tool or the Critical Appraisal Skills Programme checklist. The extracted data from the included studies were tabulated and narratively summarized as substantial heterogeneity was expected. RESULTS In total, 8 studies met the eligibility criteria: 3 (38%) randomized controlled trials and 5 (62%) uncontrolled before-and-after studies. The CAs in the included studies were aimed at behavior changes through education, advice on food choices, or counseling via psychological approaches. Of the included studies, only 38% (3/8) reported a substantial weight loss outcome (1.3-2.4 kg decrease at 12-15 weeks of CA use). The overall quality of the included studies was judged as low. CONCLUSIONS The findings of this systematic review suggest that CAs with unconstrained natural language input can be used as a feasible interpersonal weight management intervention by promoting engagement in psychiatric intervention-based conversations simulating treatments by health care professionals, but currently there is a paucity of evidence. Well-designed rigorous randomized controlled trials with larger sample sizes, longer treatment duration, and follow-up focusing on CAs' acceptability, efficacy, and safety are warranted.
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Affiliation(s)
- Eunyoung Noh
- Department of Medical Science of Meridian, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jiyoon Won
- Department of Meridian & Acupoint, College of Korean Medicine, Dong-eui University, Busan, Republic of Korea
| | - Sua Jo
- Department of Medical Science of Meridian, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Dae-Hyun Hahm
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Hyangsook Lee
- Department of Medical Science of Meridian, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
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7
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Yu Y, Yeh KL, Kalarchian MA, Groth S. Experiences of loss of control eating in women after bariatric surgery: A qualitative study. Int J Eat Disord 2023. [PMID: 36786350 DOI: 10.1002/eat.23912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVE Loss of control (LOC) eating following bariatric surgery remains insufficiently understood, reflected in a lack of clear conceptualization, valid measurements, and effective treatments. This study explored patients' perspectives on LOC eating post-bariatric surgery, focusing on the relevance of the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) indicators of impaired control, and patients' experiences before (precipitating factors), during (eating patterns, perpetuating factors), and after the episodes (strategies used to stop eating). METHODS This was a qualitative study using descriptive phenomenology. Participants were adults who have undergone gastric bypass or sleeve gastrectomy and self-reported recent LOC eating. Data were collected by semi-structured interviews and analyzed using a combined inductive and deductive approach. RESULTS Participants were all women (N = 15; age: 34.5 ± 9.2 years). Results suggested that (1) except for feeling disgusted, guilty, or depressed after eating, other DSM-5 indicators did not seem to be highly relevant to this bariatric cohort; (2) LOC eating could occur across contexts, with food access, boredom, and food craving being consistent triggers; (3) the food amount consumed during a LOC episode was not necessarily considered excessive; (4) "mindlessness" and "satisfying hedonic, physiological, and mental needs" were the main perpetuating factors of LOC eating; and (5) self-talk and distracting attention were the most adopted strategies to stop eating. DISCUSSION Study findings have implications concerning the conceptualization, measurement, and intervention of LOC eating among bariatric patients. For example, results suggested the need for more data to determine the appropriate indicators of LOC eating and the inclusion of boredom as an intervention target in bariatric patients. PUBLIC SIGNIFICANCE Loss of control (LOC) eating is characterized by a sense of being unable to stop while eating. LOC eating is prevalent in patients who have undergone weight loss surgery and is associated with worse surgical outcomes. This qualitative study that explored post-bariatric surgery patients' experiences of LOC eating will inform efforts to better assess and intervene in this disordered eating behavior, thus ultimately optimizing patients' health following weight loss surgery.
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Affiliation(s)
- Yang Yu
- School of Nursing, University of Rochester, Rochester, New York, USA
| | - Kuan-Lin Yeh
- School of Nursing, University of Rochester, Rochester, New York, USA
| | | | - Susan Groth
- School of Nursing, University of Rochester, Rochester, New York, USA
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8
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Remotely delivered and clinic-delivered lifestyle interventions produced similar effects on the diet quality of participants. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-023-01835-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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9
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Jalo E, Konttinen H, Westerterp-Plantenga M, Adam T, Drummen M, Huttunen-Lenz M, Siig Vestentoft P, Martinez JA, Handjiev S, Macdonald I, Brand-Miller J, Poppitt S, Swindell N, Lam T, Navas-Carretero S, Handjieva-Darlenska T, Taylor M, Muirhead R, Silvestre MP, Raben A, Fogelholm M. Perceived stress as a predictor of eating behavior during the 3-year PREVIEW lifestyle intervention. Nutr Diabetes 2022; 12:47. [PMID: 36335092 PMCID: PMC9637180 DOI: 10.1038/s41387-022-00224-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 10/12/2022] [Accepted: 10/18/2022] [Indexed: 11/07/2022] Open
Abstract
Background To better support participants to achieve long-lasting results within interventions aiming for weight loss and maintenance, more information is needed about the maintenance of behavioral changes. Therefore, we examined whether perceived stress predicts the maintenance of changes in eating behavior (flexible and rigid restraint of eating, disinhibition, and hunger). Methods The present study was a secondary analysis of the PREVIEW intervention including participants with overweight (BMI ≥ 25 kg/m2) at baseline and high risk of type 2 diabetes (n = 1311). Intervention included a 2-month low-energy diet phase and a 34-month subsequent weight maintenance phase. The first 6 months were considered an active behavior change stage and the remaining 2.5 years were considered a behavior maintenance stage. Eating behavior was measured using the Three Factor Eating Questionnaire and stress using the Perceived Stress Scale. The associations between stress and eating behavior were analyzed using linear mixed effects models for repeated measurements. Results Perceived stress measured after the active behavior change stage (at 6 months) did not predict changes in eating behavior during the behavior maintenance stage. However, frequent high stress during this period was associated with greater lapse of improved flexible restraint (p = 0.026). The mean (SD) change in flexible restraint from 6 to 36 months was −1.1 (2.1) in participants with frequent stress and −0.7 (1.8) in participants without frequent stress (Cohen’s ds (95% CI) = 0.24 (0.04–0.43)). Higher perceived stress at 6 months was associated with less flexible restraint and more disinhibition and hunger throughout the behavior maintenance stage (all p < 0.001). Conclusions Perceived stress was associated with features of eating behavior that may impair successful weight loss maintenance. Future interventions should investigate, whether incorporating stress reduction techniques results in more effective treatment, particularly for participants experiencing a high stress level.
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Affiliation(s)
- Elli Jalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland.
| | - Hanna Konttinen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland.,Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Margriet Westerterp-Plantenga
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Tanja Adam
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Mathijs Drummen
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Maija Huttunen-Lenz
- Institute of Nursing Science, University of Education Schwäbisch Gmünd, Schwäbisch, Gmünd, Germany
| | - Pia Siig Vestentoft
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
| | - J Alfredo Martinez
- Centre for Nutrition Research, School of Pharmacy and Nutrition, University of Navarra, Pamplona, Navarra, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Navarra, Spain.,Precision Nutrition and Cardiometabolic Health Program. IMDEA-Food Institute (Madrid Institute for Advanced Studies), CEI UAM + CSIC, Madrid, Spain
| | - Svetoslav Handjiev
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria
| | - Ian Macdonald
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK.,MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK
| | - Jennie Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Sally Poppitt
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Nils Swindell
- Applied Sports Technology, Exercise, and Medicine (A-STEM) Research Centre, College of Engineering, Swansea University, Swansea, UK
| | - Tony Lam
- NetUnion SARL, Lausanne, Switzerland
| | - Santiago Navas-Carretero
- Centre for Nutrition Research, School of Pharmacy and Nutrition, University of Navarra, Pamplona, Navarra, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Navarra, Spain
| | | | - Moira Taylor
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK
| | - Roslyn Muirhead
- MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK
| | - Marta P Silvestre
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand.,Centro de Investigaçao em Tecnologias e Serciços de Saûde (CINTESIS), NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark.,Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
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10
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Butryn ML, Crane NT, Lufburrow E, Hagerman CJ, Forman EM, Zhang F. The Role of Physical Activity in Long-term Weight Loss: 36-month Results From a Randomized Controlled Trial. Ann Behav Med 2022; 57:146-154. [PMID: 35640225 PMCID: PMC9899066 DOI: 10.1093/abm/kaac028] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Physical activity (PA) may promote long-term weight loss, but facilitating high levels of PA in behavioral weight loss programs is challenging. PURPOSE This study reports the 36-month follow-up of a behavioral weight loss trial that tested the efficacy of increasing the emphasis on PA during treatment and using traditional or acceptance-based therapy (ABT) for this purpose. We also examined the extent to which long-term weight loss differed by PA pattern and tested if individual differences in eating behavior moderated this relationship. METHODS Participants (N = 320) were randomized to (1) standard behavioral weight loss treatment (BT), (2) BT with a focus on PA, or (3) ABT with a focus on PA. Weight loss and PA were measured at 24- and 36-month follow-up. RESULTS There were no differences between conditions in weight loss or PA at 24 or 36 months. Participants consistently engaging in high PA experienced the greatest weight losses. The positive impact of PA on weight loss was more pronounced among those with low emotional eating and those who believed that exercise did not affect their appetite. CONCLUSIONS Findings emphasize the difficulty of improving long-term PA among adults with overweight/obesity beyond what standard behavioral weight loss treatment achieves. This study highlights the need to develop new PA treatment strategies, and suggests that ABT for weight loss may be more effective when applied to eating behavior versus PA. Results also demonstrate the importance of addressing problematic eating behavior and cognitions to fully realize the benefits of PA for weight loss. CLINICAL TRIAL INFORMATION ClinicalTrials.gov identifier: NCT02363010.
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Affiliation(s)
| | - Nicole T Crane
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA,Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
| | - Emily Lufburrow
- Department of Medicine, Drexel University, Philadelphia, PA, USA
| | - Charlotte J Hagerman
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA
| | - Evan M Forman
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA,Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
| | - Fengqing Zhang
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
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11
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Jiskoot G, de Loos AD, Timman R, Beerthuizen A, Laven J, Busschbach J. Changes in eating behavior through lifestyle treatment in women with polycystic ovary syndrome (PCOS): a randomized controlled trial. J Eat Disord 2022; 10:69. [PMID: 35581616 PMCID: PMC9116037 DOI: 10.1186/s40337-022-00593-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Eating behaviors like emotional eating, external eating and restrained eating play an important role in weight gain and weight loss in the general population. Improvements in eating behavior are important for long-term weight. This has not yet been studied in women with Polycystic Ovary Syndrome (PCOS). The aim of this study is to examine if a three-component lifestyle intervention (LI) is effective for improving disordered eating behavior in women with PCOS. METHODS Women diagnosed with PCOS (N = 183), with a body mass index (BMI) > 25 kg/m2 and trying to achieve a pregnancy were either assigned to 1 year of 20 group sessions of cognitive behavioral therapy (CBT) combined with nutritional advice and exercise with or without additional feedback through Short Message Service (SMS) or Care As Usual (CAU), which includes the advice to lose weight using publicly available services. RESULTS The Eating Disorder Examination Questionnaire (EDEQ) scores worsened in CAU (47.5%) and improved in the LI (4.2%) at 12 months. The difference between the LI and CAU was significant (P = 0.007) and resulted in a medium to large effect size (Cohen's d: - 0.72). No significant differences were observed in EDEQ scores between LI with SMS compared to LI without SMS (Cohen's d: 0.28; P = 0.399). Also, weight loss did not mediate the changes in eating behavior. An overall completion rate of 67/183 (36.6%) was observed. CONCLUSIONS A three-component CBT lifestyle program resulted in significant improvements in disordered eating behavior compared to CAU. Changes in disordered eating behavior are important for long-term weight loss and mental health. TRIAL REGISTRATION NTR, NTR2450. Registered 2 August 2010, https://www.trialregister.nl/trial/2344.
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Affiliation(s)
- Geranne Jiskoot
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. .,Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Alexandra Dietz de Loos
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Reinier Timman
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Annemerle Beerthuizen
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Joop Laven
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Jan Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
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12
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Chew HSJ, Lau ST, Lau Y. Weight-loss interventions for improving emotional eating among adults with high body mass index: A systematic review with meta-analysis and meta-regression. EUROPEAN EATING DISORDERS REVIEW 2022; 30:304-327. [PMID: 35460323 PMCID: PMC9320927 DOI: 10.1002/erv.2906] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 03/15/2022] [Accepted: 04/04/2022] [Indexed: 11/15/2022]
Abstract
Objectives To evaluate the effectiveness of weight‐loss interventions on emotional eating among adults with high body mass index (BMI). Methods A systematic review, meta‐analysis and meta‐regression were performed on randomized controlled trials published from inception until 19 March 2021. Results Thirty‐one studies were included, representing 1203 participants with mean ages ranging from 21.8 to 57.3 years old and BMI 27.2–43.5 kg/m2. We found small‐to‐medium interventional effects on emotional eating (n = 18; Hedges' g = 0.22; p = 0.01, I2 = 61.7%), uncontrolled eating (n = 16; Hedges' g = 0.46; p < 0.001, I2 = 71.6%) and cognitive restraint (n = 18; Hedges' g = 0.42; p < 0.001, I2 = 75.8%). Small‐to‐medium interventional effects were only found for emotional eating (n = 8; Hedges' g = 0.45; p = 0.02, I2 = 74.3%) 3‐month post‐intervention, and on BMI (n = 4; Hedges' g = 0.43; p < 0.05, I2 = 33.4%) and weight (n = 6; Hedges' g = 0.36; p < 0.01, I2 < 10.4%) 12‐month post‐intervention. Age, male proportion, baseline BMI, attrition rate and intervention length were not significant moderators of the heterogeneity between studies. Conclusion Interventions improved emotional eating and weight loss along a year‐long trajectory. Weight‐loss interventions such as Cognitive Behaviour Therapy (CBT), diet and exercise, and mindfulness are effective in improving emotional eating, uncontrolled eating/external eating and cognitive restraint/restrained eating. Purely mindfulness‐based interventions showed a higher interventional effect size over a combination of CBT and mindfulness, CBT and diet and/or exercise. Small‐to‐medium interventional effect size on body mass index and weight was only observed 12‐month post‐intervention.
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Affiliation(s)
- Han Shi Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Siew Tiang Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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13
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Papini NM, Foster RNS, Lopez NV, Ptomey LT, Herrmann SD, Donnelly JE. Examination of three-factor eating questionnaire subscale scores on weight loss and weight loss maintenance in a clinical intervention. BMC Psychol 2022; 10:101. [PMID: 35428328 PMCID: PMC9013121 DOI: 10.1186/s40359-022-00806-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 04/02/2022] [Indexed: 11/17/2022] Open
Abstract
Background The purpose of this study is to examine three-factor eating questionnaire (TFEQ) scores at baseline and post-intervention (6 months) on successful weight loss and weight maintenance in an 18-month behavioral weight management intervention for adults with overweight and obesity. Methods TFEQ and weight were assessed at baseline, 6, and 18 months. Logistic regression models were used to examine scores at baseline on disinhibition, restraint, and perceived hunger factors in the TFEQ on 5% body weight loss at 6 months and 6-month scores to predict 5% weight maintenance at 18 months while controlling for age, sex, and baseline weight.
Results Participants (n = 287; age = 43.8 ± 10.36 years; female = 64.1%; weight = 222.5 ± 39.02 pounds; BMI = 34.73 ± 4.56) were included for analysis. Dietary restraint at baseline was the only significant predictor of 5% weight loss at 6 months. None of the TFEQ subscale scores at 6 months predicted 5% weight maintenance at 18 months. The model examining weight loss at 6 months accounted for 7% of the variance of the outcome and 11% of the variance of weight maintenance at 18 months. Conclusion Dietary restraint is a unique eating behavior associated with weight loss at 6 months beyond other eating behaviors measured by the TFEQ in an adult sample enrolled in a weight loss intervention. No other subscale scores were significant at 6 months or at 18 months. Future research should consider how to promote flexible control and discourage adoption of rigid restraint behaviors since the latter is associated with disordered eating patterns.
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14
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Benzerouk F, Guénin M, Gierski F, Raucher-Chéné D, Barrière S, Bertin E, Kaladjian A. Contributing roles of depression, anxiety, and impulsivity dimensions in eating behaviors styles in surgery candidates. J Eat Disord 2021; 9:148. [PMID: 34749827 PMCID: PMC8573893 DOI: 10.1186/s40337-021-00503-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 10/21/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Even if bariatric surgery is considered the most effective therapeutic approach, it is not equally successful among individuals suffering from severe obesity and candidates for this weight loss surgery. Among the factors that influence postsurgical outcomes, eating behaviors styles are known to play a key role in relapses. The aim of our study was to assess eating behaviors styles and several modulating psychopathological factors in patients suffering from severe obesity. METHODS Patients seeking bariatric surgery (N = 127) completed a set of standardized tools assessing eating behaviors (Dutch Eating Behavior Questionnaire), comorbid psychiatric conditions (Mini International Neuropsychiatric Interview), depression, and anxiety scores (Beck Depression Inventory, State-Trait Anxiety Inventory), and impulsivity scores (UPPS-P Impulsive Behavior Scale). RESULTS We detected significant correlations between DEBQ Emotional Eating (EmoE) and depression, state and trait anxiety, and all dimensions of impulsivity. Significant correlations were also present between DEBQ External Eating (ExtE) and depression, state and trait anxiety and UPPS-P positive urgency, lack of perseverance and sensation seeking. Regression analyses identified sex (female), trait anxiety, and lack of perseverance as explanatory factors for EmoE, and depression severity score and positive urgency for ExtE. CONCLUSIONS EmoE might be a means of dealing with negative emotions and/or intrusive thoughts, while ExtE might result from a mechanism associated with depression. These results should help to improve patients' outcomes by defining specific therapeutic targets in psychological interventions. After bariatric surgery, some patients regain weight. This is likely due to various factors, including a return of maladaptive eating styles, such as emotional eating (which occurs as a response to negative emotions, like depression, anxiety, anger, sadness, and discouragement), external eating (which refers to the tendency to eat in response to positive external cues, regardless of internal signals of hunger and satiety), and restraint eating (implying to make efforts to develop and maintain strategies to control calories intake, associated with weight loss after lifestyle intervention). Our goal in this research project was to explore associated factors (particularly depression, anxiety, and impulsivity) to these eating styles in patients suffering from obesity prior to bariatric surgery. Individuals seeking bariatric surgery were asked questions about their eating styles and their levels of depression, anxiety, and impulsivity using standardized questionnaires. We found that emotional eating might be a means of dealing with negative emotions and/or intrusive thoughts (e.g. about food or body dissatisfaction), while external eating might result from a mechanism associated with depression. We detected no association between restraint eating and any of the dimensions of impulsivity, nor depression and anxiety. Therapies aimed at improving patients' abilities to regulate negative affects seem promising among subjects suffering from obesity and those seeking bariatric surgery. If well learned, these therapies might also help them to maintain weight loss after surgery by limiting maladaptive eating styles.
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Affiliation(s)
- Farid Benzerouk
- Psychiatry Department, Reims University Hospital, EPSM Marne, 51100, Reims, France. .,Cognition Health and Society Laboratory (EA 6291), Université de Reims Champagne-Ardenne, 51100, Reims, France. .,Champagne Ardenne Specialized Center in Obesity, University Hospital Center, 51100, Reims, France.
| | - Monique Guénin
- Psychiatry Department, Reims University Hospital, EPSM Marne, 51100, Reims, France
| | - Fabien Gierski
- Psychiatry Department, Reims University Hospital, EPSM Marne, 51100, Reims, France.,Cognition Health and Society Laboratory (EA 6291), Université de Reims Champagne-Ardenne, 51100, Reims, France.,Reims Champagne-Ardenne University, Reims, France
| | - Delphine Raucher-Chéné
- Psychiatry Department, Reims University Hospital, EPSM Marne, 51100, Reims, France.,Cognition Health and Society Laboratory (EA 6291), Université de Reims Champagne-Ardenne, 51100, Reims, France
| | - Sarah Barrière
- Psychiatry Department, Reims University Hospital, EPSM Marne, 51100, Reims, France
| | - Eric Bertin
- Reims Champagne-Ardenne University, Reims, France.,Champagne Ardenne Specialized Center in Obesity, University Hospital Center, 51100, Reims, France
| | - Arthur Kaladjian
- Psychiatry Department, Reims University Hospital, EPSM Marne, 51100, Reims, France.,Cognition Health and Society Laboratory (EA 6291), Université de Reims Champagne-Ardenne, 51100, Reims, France.,Reims Champagne-Ardenne University, Reims, France
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15
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Jones RA, Lawlor ER, Birch JM, Patel MI, Werneck A, Hoare E, Griffin SJ, van Sluijs EM, Sharp SJ, Ahern AL. The impact of adult behavioural weight management interventions on mental health: A systematic review and meta-analysis. Obes Rev 2021; 22:e13150. [PMID: 33103340 PMCID: PMC7116866 DOI: 10.1111/obr.13150] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/04/2020] [Accepted: 09/14/2020] [Indexed: 12/27/2022]
Abstract
There is good evidence that behavioural weight management interventions improve physical health; however, the impact on mental health remains unclear. We evaluated the impact of behavioural weight management interventions on mental health-related outcomes in adults with overweight or obesity at intervention-end and 12 months from baseline. Eligible studies were randomized controlled trials (RCTs) or cluster RCTs of adult behavioural weight loss interventions reporting affect, anxiety, binge eating, body image, depression, emotional eating, quality of life, self-esteem and stress. We searched seven databases from inception to 7 May 2019 and included 43 articles reporting 42 RCTs. Eighteen studies were deemed to be at high risk of bias. We conducted random-effects meta-analyses, stratified analyses and meta-regression using Stata. Interventions generated greater improvements than comparators for depression, mental health-related quality of life and self-efficacy at intervention-end and 12 months from baseline. There was no difference between groups for anxiety, overall quality of life, self-esteem or stress at intervention-end. There was insufficient evidence to assess the impact on anxiety, binge eating, body image, emotional eating, affect, life satisfaction, self-esteem or stress at intervention-end and/or 12 months from baseline. Although evidence suggests that interventions benefit some aspects of mental health, high-quality, transparently reported RCTs measuring a range of mental health outcomes over longer durations are required to strengthen the evidence base.
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Affiliation(s)
| | - Emma R. Lawlor
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
| | - Jack M. Birch
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Manal I. Patel
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Andre Werneck
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Department of Nutrition, School of Public Health, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Erin Hoare
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Food and Mood Centre, Centre for Innovation in Mental and Physical Health and Clinical Treatment, School of Medicine, Faculty of Health, Deakin University, Melbourne, VIC 3004, Australia
| | - Simon J. Griffin
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Esther M.F. van Sluijs
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
| | | | - Amy L. Ahern
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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16
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Herhaus B, Petrowski K. The effect of restrained eating on acute stress-induced food intake in people with obesity. Appetite 2020; 159:105045. [PMID: 33227382 DOI: 10.1016/j.appet.2020.105045] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 11/05/2020] [Accepted: 11/11/2020] [Indexed: 10/22/2022]
Abstract
Restrained eating, defined as a form of intense dieting or restrictive food intake of specific macronutrients or types of food with sporadic episodes of overeating, results in an increased risk of overweight and obesity. Acute stress situations cause irregular eating patterns and are connected to restrained eating. Therefore, the present study investigates the effect of high/low restrained eating on eating behavior in people with obesity after standardized acute stress induction as well as resting condition. Fifty men and women with obesity (BMI: 33.62 ± 3.93 kg/m2) were categorized into high restrained eaters (HRE) and low restrained eaters (LRE). The total energy intake was measured during a standardized laboratory meal after a resting and stress condition (Trier Social Stress Test) on two separate days. HRE and LRE showed differences in the total energy intake in response to acute stress but not after resting condition (F(1, 47) = 9.188, p = .004, η2 = 0.164). Lower total energy intake after stress compared to resting condition could be observed in HRE (t (23) = -2.617, p = .015). LRE showed higher total energy intake after stress than after resting condition (t (25) = 2.155, p = .041). The present data suggest that restrained eating behavior might be an influencing factor for stress-induced eating in obesity. It is highly necessary to understand the association between restrained eating behavior, acute stress and obesity for the improvement of the behavioral intervention of dietary restriction.
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Affiliation(s)
- Benedict Herhaus
- Medical Psychology & Medical Sociology, University Medical Center Mainz, Johannes Gutenberg University of Mainz, Mainz, Germany.
| | - Katja Petrowski
- Medical Psychology & Medical Sociology, University Medical Center Mainz, Johannes Gutenberg University of Mainz, Mainz, Germany
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17
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Röhling M, Martin K, Ellinger S, Schreiber M, Martin S, Kempf K. Weight Reduction by the Low-Insulin-Method-A Randomized Controlled Trial. Nutrients 2020; 12:nu12103004. [PMID: 33007918 PMCID: PMC7601801 DOI: 10.3390/nu12103004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 09/24/2020] [Accepted: 09/28/2020] [Indexed: 12/14/2022] Open
Abstract
Continuous high insulin levels are associated with weight gain and lead to cardiometabolic diseases. Therefore, we have developed the Low-Insulin-Method and integrated it into the multi-component, occupational healthcare program SHAPE-AND-MOTION-Medical-Accompanied-Slimming (SAMMAS) to reduce daily insulin levels for long-term weight reduction in overweight or obesity. Employees were randomized into a starting intervention group (SI, n = 15) or waiting list control group (WL, n = 15). SAMMAS consisted of group-based seminars, low-carbohydrate nutrition including formula diet, continuous glucose monitoring, telemetric monitoring, and telemedical coaching. Both groups received telemetric devices at baseline. Intention-to-treat analyses were performed after 12, 26, and 52 weeks. The estimated treatment difference in weight reduction after 12 weeks, which is the primary endpoint of the study, showed a pronounced effect in favour of SI (−6.3 kg with (95% confidence interval) (−7.4; −4.5) (p < 0.001)) after 12 weeks. Furthermore, SI improved fasting blood glucose, HbA1c, quality of life, fasting insulin, blood pressure, and eating behaviour (all p < 0.05) in the within-group analysis, while WL did not. After 26 and 52 weeks, weight reduction could be maintained in the whole group (both groups together) by −6.7 kg (−9.5; −3.8) (p < 0.001) and −6.1 kg (−9.2; −2.7) (p < 0.01). SAMMAS supports clinically relevant weight reduction and long-term weight loss maintenance in individuals with overweight or obesity.
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Affiliation(s)
- Martin Röhling
- West-German Centre of Diabetes and Health, Dusseldorf Catholic Hospital Group, 40591 Dusseldorf, Germany; (S.M.); (K.K.)
- Correspondence: ; Tel.: +49-(0)-2115-6603-6066
| | - Katharina Martin
- Hochschule Niederrhein, University of Applied Sciences, 41065 Mönchengladbach, Germany; (K.M.); (S.E.)
| | - Sabine Ellinger
- Hochschule Niederrhein, University of Applied Sciences, 41065 Mönchengladbach, Germany; (K.M.); (S.E.)
| | - Michael Schreiber
- Psychiatric-Psychotherapeutic Day-Care Hospital, Dusseldorf Catholic Hospital Group, 40591 Dusseldorf, Germany;
| | - Stephan Martin
- West-German Centre of Diabetes and Health, Dusseldorf Catholic Hospital Group, 40591 Dusseldorf, Germany; (S.M.); (K.K.)
- Faculty of Medicine, Heinrich Heine University Dusseldorf, 40225 Dusseldorf, Germany
| | - Kerstin Kempf
- West-German Centre of Diabetes and Health, Dusseldorf Catholic Hospital Group, 40591 Dusseldorf, Germany; (S.M.); (K.K.)
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18
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Biagio LD, Moreira P, Amaral CK. Comportamento alimentar em obesos e sua correlação com o tratamento nutricional. JORNAL BRASILEIRO DE PSIQUIATRIA 2020. [DOI: 10.1590/0047-2085000000280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
RESUMO Objetivo Avaliar os tipos de comportamentos alimentares em indivíduos com obesidade e correlacionar com a adesão ao tratamento proposto. Métodos Estudo transversal desenvolvido em instituição de cardiologia em indivíduos com obesidade. Os tipos de comportamentos alimentares foram analisados pela escala The Three Factor Eating Questionnaire – R21 (TFEQ-21) – versão traduzida e adaptada para brasileiros. Nela são abordadas três subescalas: restrição cognitiva (RC), alimentação emocional (AE) e descontrole alimentar (DA). A adesão ao tratamento nutricional foi verificada pelo instrumento desenvolvido pela instituição, baseado nas principais diretrizes de doenças crônicas. Resultados Analisaram-se 100 indivíduos, com maior prevalência do sexo feminino (68%). Em relação à adesão, somente 25% apresentam boa aderência (escore > 60%). Foi possível identificar a relação entre o IMC e a RC; quanto maior o IMC, menor foi a intensidade da RC (p = 0,02). Observou-se correlação positiva entre a RC e adesão ao consumo de gorduras (p = 0,02) e fibra alimentar (p = 0,004). A subescala AE apresentou correlação negativa com a adesão ao consumo de gorduras (p = 0,03) e correlação positiva com a DA (p < 0,01). Conclusões O tipo de comportamento alimentar mais frequente na amostra foi a restrição cognitiva, que não foi correlacionada com o escore total de adesão. A AE foi associada com maior consumo de gorduras, similar ao encontrado em estudos nacionais e internacionais. Nota-se uma lacuna de estudos que relacionam o comportamento alimentar com a adesão ao tratamento nutricional.
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Giusti EM, Spatola CA, Brunani A, Kumbhare D, Oral A, Ilieva E, Kiekens C, Pietrabissa G, Manzoni GM, Imamura M, Castelnuovo G, Capodaglio P. ISPRM/ESPRM guidelines on Physical and Rehabilitation Medicine professional practice for adults with obesity and related comorbidities. Eur J Phys Rehabil Med 2020; 56:496-507. [PMID: 32293813 DOI: 10.23736/s1973-9087.20.06232-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The World Health Organization (WHO) has declared obesity as the largest global chronic health problem in adults. In the last years, attention has been drawn to rehabilitative interventions for patients with obesity. AIM The aim of this manuscript is to provide Physical and Rehabilitation Medicine (PRM) physicians with evidence-based recommendations for the rehabilitation of patients with overweight or obesity and related comorbidities. DESIGN Evidence-based guidelines. POPULATION Adults with overweight or obesity. METHODS Guidelines were based on GRADE and WHO recommendations. A comprehensive search of the available evidence about rehabilitation treatments for obesity was performed, and 17 separate systematic literature reviews were conducted. For each outcome, estimates of the effects of rehabilitation treatments were computed and employed along with an assessment of quality of evidence, desirable and undesirable effects, values and preferences to formulate the recommendations. Recommendations were reviewed by a consensus expert panel using a modified Delphi process. RESULTS We strongly recommend providing comprehensive multiprofessional and multidisciplinary interventions including exercise, diet and behavioral or cognitive-behavioral therapy. The nutritional component of these treatments should include diets with either a high-protein or a low-fat content. It is strongly recommended to prescribe frequent moderate aerobic exercise. We strongly recommend providing cognitive-behavioral interventions as the behavioral component of rehabilitation programs. CONCLUSIONS PRM physicians should lead multidisciplinary teams providing comprehensive and individualized rehabilitation programs for patients with overweight or obesity. These guidelines were endorsed by the International Society of Physical and Rehabilitation Medicine (ISPRM) and by the European Society of Physical and Rehabilitation Medicine (ESPRM).
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Affiliation(s)
- Emanuele M Giusti
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy - .,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy -
| | - Chiara A Spatola
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy.,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy
| | - Amelia Brunani
- Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy
| | - Dinesh Kumbhare
- Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, ON, Canada
| | - Aydan Oral
- Department of Physical and Rehabilitation Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Elena Ilieva
- Department of Physical and Rehabilitation Medicine, Sv. Georgi University Hospital, Plovdiv, Bulgaria
| | - Carlotte Kiekens
- Department of Physical and Rehabilitation Medicine, University Hospitals Leuven, Leuven Belgium.,Spinal Unit, Montecatone Rehabilitation Institute, Imola, Italy
| | - Giada Pietrabissa
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy.,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy
| | - Gian Mauro Manzoni
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy.,Faculty of Psychology, eCampus University, Novedrate, Como, Italy
| | - Marta Imamura
- Institute of Physical and Rehabilitation Medicine, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy.,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy
| | - Paolo Capodaglio
- Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy
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20
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Halali F, Lapveteläinen A, Karhunen L, Kantanen T. Eating behavior tendencies among Finnish adults in relation to previous weight loss attempts. Appetite 2020; 150:104650. [PMID: 32145371 DOI: 10.1016/j.appet.2020.104650] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 02/28/2020] [Accepted: 02/28/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND The number of weight loss attempts may be associated with higher weight status and unfavorable health behaviors as well as dysfunctional eating behaviors. We aimed to study eating behavior tendencies, i.e., cognitive restraint, uncontrolled eating and emotional eating among a sample of Finnish adults who had engaged in a different number of attempts to lose weight during their lifetime. METHODS Data were collected through a web-based survey. Participants completed a background questionnaire (including questions on weight, height, number of attempts to lose weight) and the Three-Factor Eating Questionnaire (TFEQ-R18). Out of 1985 individuals, 1679 with complete data were included in the study. The TFEQ-R18 was tested for its reliability and fit to our study population using Cronbach's alpha and Confirmatory Factor Analysis (CFA). RESULTS Subscales of the TFEQ-R18 had acceptable reliability except for that of 'cognitive restraint', which reached acceptable reliability when three items were deleted (items 15, 16, 18). The revised version of the questionnaire was designated as the TFEQ-R15, which showed good fit based on CFA fit indices. Participants who had attempted to lose weight during their lifetime (n = 1229), especially those with ≥3 weight loss attempts (n = 499), had greater cognitive restraint, uncontrolled eating, emotional eating, and higher body mass index (BMI) than those with no previous weight loss attempts (n = 132). CONCLUSIONS Our findings suggest that eating behavior tendencies, i.e., decreasing tendencies of uncontrolled and emotional eating should receive more emphasis to support successful weight management.
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Affiliation(s)
- Faranak Halali
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland (UEF), Kuopio, Finland.
| | - Anja Lapveteläinen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland (UEF), Kuopio, Finland
| | - Leila Karhunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland (UEF), Kuopio, Finland
| | - Teuvo Kantanen
- Department of Business, Faculty of Social Sciences and Business Studies, University of Eastern Finland (UEF), Kuopio, Finland
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Giusti E, Spatola CM, Brunani A, Kumbhare D, Oral A, Ilieva E, Kiekens C, Pietrabissa G, Manzoni G, Imamura M, Castelnuovo G, Capodaglio P. International society of physical and rehabilitation medicine/European society of physical and rehabilitation medicine guidelines on physical and rehabilitation medicine professional practice for adults with obesity and related comorbidities. THE JOURNAL OF THE INTERNATIONAL SOCIETY OF PHYSICAL AND REHABILITATION MEDICINE 2020. [DOI: 10.4103/jisprm.jisprm_6_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
PURPOSE OF REVIEW Literature from the past five years exploring roles of Three-Factor Eating Questionnaire (TFEQ) Restraint and Disinhibition in relation to adult obesity and eating disturbance (ED) was reviewed. RECENT FINDINGS Restraint has a mixed impact on weight regulation, diet quality, and vulnerability to ED, where it is related detrimentally to weight regulation, diet, and psychopathology, yet can serve as a protective factor. The impact of Disinhibition is potently related to increased obesity, poorer diet, hedonically driven food choices, and a higher susceptibility to ED. Restraint and Disinhibition have distinct influences on obesity and ED and should be targeted differently in interventions. Further work is required to elucidate the mechanisms underlying TFEQ eating behavior traits.
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Affiliation(s)
- Eleanor J Bryant
- Division of Psychology, Faculty of Management, Law and Social Sciences, University of Bradford, Bradford, UK.
| | - Javairia Rehman
- Division of Psychology, Faculty of Management, Law and Social Sciences, University of Bradford, Bradford, UK
| | - Lisa B Pepper
- Division of Psychology, Faculty of Management, Law and Social Sciences, University of Bradford, Bradford, UK
| | - Elizabeth R Walters
- Division of Psychology, Faculty of Management, Law and Social Sciences, University of Bradford, Bradford, UK
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Eating Behavior Traits, Weight Loss Attempts, and Vertebral Dimensions Among the General Northern Finnish Population. Spine (Phila Pa 1976) 2019; 44:E1264-E1271. [PMID: 31205179 DOI: 10.1097/brs.0000000000003123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A population-based birth cohort study. OBJECTIVE To evaluate the associations of eating behavior traits and weight loss attempts with vertebral size among the general Northern Finnish population. SUMMARY OF BACKGROUND DATA Vertebral fragility fractures are a typical manifestation of osteoporosis, and small vertebral dimensions are a well-established risk factor for vertebral fracturing. Previous studies have associated cognitive eating restraint and diet-induced weight loss with deteriorated bone quality at various skeletal sites, but data on vertebral geometry are lacking. METHODS This study of 1338 middle-aged Northern Finns evaluated the associations of eating behavior traits (flexible and rigid cognitive restraint of eating, uncontrolled eating, emotional eating; assessed by the Three-Factor Eating Questionnaire-18) and weight loss attempts (assessed by a separate questionnaire item) with magnetic resonance imaging-derived vertebral cross-sectional area (CSA). Sex-stratified linear regression models were used to analyze the data, taking body mass index, leisure-time physical activity, general diet, smoking, and socioeconomic status as potential confounders. RESULTS Women with rigid or rigid-and-flexible cognitive eating restraints had 3.2% to 3.4% smaller vertebral CSA than those with no cognitive restraint (P ≤ 0.05). Similarly, the women who reported multiple weight loss attempts in adulthood and midlife had 3.5% smaller vertebral size than those who did not (P = 0.03). Other consistent findings were not obtained from either sex. CONCLUSION Rigid cognitive eating restraint and multiple weight loss attempts predict small vertebral size and thus decreased spinal health among middle-aged women, but not among men. Future longitudinal studies should confirm these findings. LEVEL OF EVIDENCE 3.
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Abstract
BACKGROUND Weight loss is traditionally viewed as straightforward counting of calories in and calories out, with little regard to the role of the adipocytes tasked with storing said calories. However, the body executes a complex compensatory response to any intervention that depletes its energy stores. Here, the authors discuss the methods used to attain weight loss, the body's response to this weight loss, and the difficulties in maintaining weight loss. Furthermore, the authors provide an overview of the literature on the physiological effects of liposuction. OBJECTIVE To describe the role of adipose tissue in energy homeostasis, methods of weight loss, weight regain, and the effect of liposuction on endocrine signaling. METHODS The authors conducted a narrative review of representative studies. CONCLUSION A variety of strategies for weight loss exist, and optimizing one's weight status may in turn optimize the aesthetic outcomes of liposuction. This is most apparent in the preferential reaccumulation of fat in certain areas after liposuction and the ability to avoid this with a negative energy balance.
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Affiliation(s)
- William Davis
- Cooper Medical School of Rowan University, Marlton, New Jersey
| | - Naomi Lawrence
- Cooper Medical School of Rowan University, Marlton, New Jersey.,Section of Procedural Dermatology, Cooper University Hospital, Marlton, New Jersey
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25
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Rasouli A, Moludi J, Foroumandi E, Shahsavari S, Ebrahimi B. Emotional eating in relation to anthropometric indices and dietary energy intake based on gender. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2019. [DOI: 10.3233/mnm-180247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ahmadreza Rasouli
- Student Research Committee, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Jalal Moludi
- Nutritional Sciences Department, Faculty of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Elaheh Foroumandi
- Department of Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeed Shahsavari
- Instructor of Biostatistics, Health Products Safety Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Behzad Ebrahimi
- Department of Food Science and Technology, Maragheh University of Medical Sciences, Maragheh, Iran
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Abstract
PURPOSE OF REVIEW The purpose of this review was to examine different forms of disordered eating among individuals with excess weight, including their rates, correlates, and psychosocial treatments. RECENT FINDINGS Binge eating/binge eating disorder, loss of control eating, emotional eating, and food addiction are all fairly prevalent among individuals with excess weight. They appear to share many of the same correlates, including broader eating disorder psychopathology, body/shape/weight concerns, depression, anxiety, and low self-esteem. Behavioral, cognitive-behavioral, and third-wave (e.g., acceptance, mindfulness) therapies appear effective in improving binge eating, loss of control eating, emotional eating, associated features (e.g., weight and shape concerns), and psychological distress (e.g., depression). Certain forms of disordered eating are elevated among individuals with excess weight, and psychosocial interventions have been found effective in improving symptomatology. Empirical research examining the efficacy of treatments for food addiction is lacking, and greatly needed given both its rate and controversy.
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Affiliation(s)
- Bethany A Nightingale
- Department of Psychology, Ryerson University, 350 Victoria St., Toronto, ON, M5B 2K3, Canada.
| | - Stephanie E Cassin
- Department of Psychology, Ryerson University, 350 Victoria St., Toronto, ON, M5B 2K3, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
- Centre for Mental Health, University Health Network, Toronto, ON, Canada.
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Pentikäinen S, Tanner H, Karhunen L, Kolehmainen M, Poutanen K, Pennanen K. Mobile Phone App for Self-Monitoring of Eating Rhythm: Field Experiment. JMIR Mhealth Uhealth 2019; 7:e11490. [PMID: 30916657 PMCID: PMC6456829 DOI: 10.2196/11490] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 09/26/2018] [Accepted: 12/12/2018] [Indexed: 01/15/2023] Open
Abstract
Background Temporal aspects of eating are an integral part of healthy eating, and regular eating has been associated with good diet quality and more successful weight control. Unfortunately, irregular eating is becoming more common. Self-monitoring of behavior has been found to be an efficient behavioral change technique, but the solution should be simple enough to ensure long-lasting adherence. Objective This study aimed to explore the influence of self-monitoring of daily eating pattern with mobile phone app on eating rhythm, eating behavior tendencies, and the underlying motives and attitudes related to eating. Methods A mobile phone app, Button, was developed for effortless self-monitoring of eating rhythm. The feasibility of the app was tested in a 30-day intervention. The participants (N=74) recorded their eating occasions during the intervention by pressing a button in the app widget. Results The average interval between meals increased (96 [SD 24] min during the first 10 days vs 109.1[SD 36.4] during the last 10 days) and the number of daily eating occasions decreased (4.9 [SD 0.9] during the first 10 days vs 4.4 [SD 0.9] during the last 10 days). The tendencies for cognitive restraint, emotional eating, and uncontrolled eating increased. Eating-related attitudes and motives remained largely unchanged. Conclusions These results indicate that a simple self-monitoring tool is able to draw a user’s attention to eating and is a potential tool to aid people to change their eating rhythm.
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Affiliation(s)
| | - Hannu Tanner
- VTT Technical Research Centre of Finland Ltd, Oulu, Finland
| | - Leila Karhunen
- Institute of Public Health and Clinical Nutrition, Department of Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Marjukka Kolehmainen
- Institute of Public Health and Clinical Nutrition, Department of Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Kaisa Poutanen
- VTT Technical Research Centre of Finland Ltd, Espoo, Finland
| | - Kyösti Pennanen
- VTT Technical Research Centre of Finland Ltd, Espoo, Finland
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28
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Varkevisser RDM, van Stralen MM, Kroeze W, Ket JCF, Steenhuis IHM. Determinants of weight loss maintenance: a systematic review. Obes Rev 2019; 20:171-211. [PMID: 30324651 PMCID: PMC7416131 DOI: 10.1111/obr.12772] [Citation(s) in RCA: 140] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 08/21/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Discerning the determinants of weight loss maintenance is important in the planning of future interventions and policies regarding overweight and obesity. We have therefore systematically synthesized recent literature on determinants of weight loss maintenance for individuals with overweight and obesity. METHODS With the use of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, prospective studies were identified from searches in PubMed and PsycINFO from 2006 to 2016. We included articles investigating adults with overweight and obesity undergoing weight loss without surgery or medication. Included articles were scored on their methodological quality, and a best-evidence synthesis was applied to summarize the results. RESULTS Our search resulted in 8,222 articles of which 67 articles were selected. In total, 124 determinants were identified of which 5 were demographic, 59 were behavioural, 51 were psychological/cognitive and 9 were social and physical environmental determinants. We found consistent evidence that demographic determinants were not predictive of weight loss maintenance. Behavioural and cognitive determinants that promote a reduction in energy intake, an increase in energy expenditure and monitoring of this balance are predictive determinants. CONCLUSION This review identifies key determinants in weight loss maintenance. However, more research regarding cognitive and environmental determinants of weight loss maintenance is needed to advance our knowledge on determinants of weight loss maintenance.
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Affiliation(s)
- R D M Varkevisser
- Faculty of Science, Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M M van Stralen
- Faculty of Science, Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - W Kroeze
- Faculty of Science, Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - J C F Ket
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - I H M Steenhuis
- Faculty of Science, Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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29
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Effects of intermittent versus continuous energy restriction for weight loss on diet quality and eating behavior. A randomized trial. Eur J Clin Nutr 2018; 73:1006-1014. [PMID: 30514879 DOI: 10.1038/s41430-018-0370-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 11/15/2018] [Accepted: 11/20/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND/OBJECTIVES Weight loss diets affect food choices and control of eating. We evaluated the effects of intermittent energy restriction (IER) vs. continuous energy restriction (CER) on nutritional composition and eating behavior. SUBJECT/METHODS Individuals with BMI 30-45 kg/m2, abdominal obesity and ≥1 additional metabolic syndrome component were randomized to IER vs. CER with similar energy restriction. Of 112 participants, 98 completed weighed dietary records and the Three Factor Eating Questionnaire at baseline and three months. In statistical analysis, changes were adjusted for baseline values. RESULTS Weight loss, energy intake, and macronutrient composition were similar in the IER and CER groups. The CER group reported a greater increase in fruit and berries (45 g/day [95% CI 21, 71] vs. 2 g/day [-28, 33]; p = 0.047) and vegetables (135 g/day [91, 179] vs. 65 g/day [35, 96]; p = 0.010) than the IER group. Fiber intake increased in the CER compared to the IER group (1.0 g/MJ/day [0.8, 1.2] vs. 0.2 [0.0, 0.4]; p < 0.001). Sugar intake was reduced in the CER compared to the IER group (-2.2E% [-3.2, -2.2] vs. -0.1E% [-1.2, 1.0]; p = 0.007). Intakes of folate, potassium, and magnesium decreased more in the IER than the CER group, while vitamin C increased more in the CER group (all p-values <0.014). Both diets improved eating behavior scores, but cognitive restraint increased more in the CER than the IER group (34 [30, 39] vs. 17 [12, 22]; p = 0.013). CONCLUSIONS Men and women with obesity had more favorable changes in nutritional composition and eating behavior with CER than IER.
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Morin I, Bégin C, Maltais-Giguère J, Bédard A, Tchernof A, Lemieux S. Impact of Experimentally Induced Cognitive Dietary Restraint on Eating Behavior Traits, Appetite Sensations, and Markers of Stress during Energy Restriction in Overweight/Obese Women. J Obes 2018; 2018:4259389. [PMID: 30123582 PMCID: PMC6079586 DOI: 10.1155/2018/4259389] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 04/30/2018] [Accepted: 05/20/2018] [Indexed: 02/07/2023] Open
Abstract
Weight loss has been associated with changes in eating behaviors and appetite sensations that favor a regain in body weight. Since traditional weight loss approaches emphasize the importance of increasing cognitive dietary restraint (CDR) to achieve negative energy imbalance, it is difficult to untangle the respective contributions of energy restriction and increases in CDR on factors that can eventually lead to body weight regain. The present study aimed at comparing the effects of energy restriction alone or in combination with experimentally induced CDR on eating behavior traits, appetite sensations, and markers of stress in overweight and obese women. We hypothesized that the combination of energy restriction and induced CDR would lead to more prevalent food cravings, increased appetite sensations, and higher cortisol concentrations than when energy restriction is not coupled with induced CDR. A total of 60 premenopausal women (mean BMI: 32.0 kg/m2; mean age: 39.4 y) were provided with a low energy density diet corresponding to 85% of their energy needs during a 4-week fully controlled period. At the same time, women were randomized to either a condition inducing an increase in CDR (CDR+ group) or a condition in which CDR was not induced (CRD- group). Eating behavior traits (Three-Factor Eating Questionnaire and Food Craving Questionnaire), appetite sensations (after standardized breakfast), and markers of stress (Perceived Stress Scale; postawakening salivary cortisol) were measured before (T = 0 week) and after (T = 4 weeks) the 4-week energy restriction, as well as 3 months later. There was an increase in CDR in the CDR+ group while no such change was observed in the CDR- group (p=0.0037). No between-group differences were observed for disinhibition, hunger, cravings, appetite sensations, perceived stress, and cortisol concentrations. These results suggest that a slight increase in CDR has no negative impact on factors regulating energy balance in the context of energy restriction.
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Affiliation(s)
- Isabelle Morin
- Institute of Nutrition and Functional Foods (INAF), Pavillon des Services, Laval University, 2440 Boulevard Hochelaga, Québec, QC, Canada G1V 0A6
- School of Nutrition, Pavillon Paul-Comtois, Laval University, 2425 Rue de l'Agriculture, Québec, QC, Canada G1V 0A6
| | - Catherine Bégin
- School of Psychology, Pavillon Félix-Antoine-Savard, Laval University, 2325 Rue des Bibliothèques, Québec, QC, Canada G1V 0A6
| | - Julie Maltais-Giguère
- Institute of Nutrition and Functional Foods (INAF), Pavillon des Services, Laval University, 2440 Boulevard Hochelaga, Québec, QC, Canada G1V 0A6
| | - Alexandra Bédard
- Institute of Nutrition and Functional Foods (INAF), Pavillon des Services, Laval University, 2440 Boulevard Hochelaga, Québec, QC, Canada G1V 0A6
| | - André Tchernof
- School of Nutrition, Pavillon Paul-Comtois, Laval University, 2425 Rue de l'Agriculture, Québec, QC, Canada G1V 0A6
- Endocrinology and Nephrology, CHU de Québec, Laval University Medical Center, 2705 Boulevard Laurier, Québec, QC, Canada G1V 4G2
- Quebec Heart and Lung Institute, Laval University, 2725 Chemin Ste-Foy, Québec, QC, Canada G1V 4G5
| | - Simone Lemieux
- Institute of Nutrition and Functional Foods (INAF), Pavillon des Services, Laval University, 2440 Boulevard Hochelaga, Québec, QC, Canada G1V 0A6
- School of Nutrition, Pavillon Paul-Comtois, Laval University, 2425 Rue de l'Agriculture, Québec, QC, Canada G1V 0A6
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Arena R, Daugherty J, Bond S, Lavie CJ, Phillips S, Borghi-Silva A. The combination of obesity and hypertension: a highly unfavorable phenotype requiring attention. Curr Opin Cardiol 2018; 31:394-401. [PMID: 27070650 DOI: 10.1097/hco.0000000000000294] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Body habitus is a key lifestyle characteristic whose current status and future projections are disconcerting. The percentage of the global population who are either overweight or obese has substantially increased, with no indication that any country has a solution to this issue. Hypertension is a key unfavorable health metric that, like obesity, has disastrous health implications if left uncontrolled. Poor lifestyle characteristics and health metrics often cluster together to create complex and difficult to treat phenotypes. Excess body mass is such an example, creating an obesity-hypertension phenotype, which is the focus of this review. RECENT FINDINGS An increased risk for hypertension is clearly linked to obesity, indicating that the two conditions are intimately linked. The cascade of obesity-induced pathophysiologic adaptations creates a clear path to hypertension. Adopting a healthy lifestyle is a primary intervention for the prevention as well as treatment of the obesity-hypertension phenotype. SUMMARY The obesity-hypertension phenotype is highly prevalent and has disastrous health implications. A primordial prevention strategy, focused on lifelong healthy lifestyle patterns, is the optimal approach for this condition. For those individuals already afflicted by the obesity-hypertension phenotype, interventions must aggressively focus on weight loss and blood pressure control.
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Affiliation(s)
- Ross Arena
- aDepartment of Physical Therapy and the Integrative Physiology Laboratory, College of Applied Health Sciences bDepartment of Biomedical and Health Information Sciences, College of Applied Science, University of Illinois, Chicago, Illinois cDepartment of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine; New Orleans, Louisiana, USA dCardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, São Paulo, Brazil
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The relationship between obesity and hypertension: an updated comprehensive overview on vicious twins. Hypertens Res 2017; 40:947-963. [DOI: 10.1038/hr.2017.75] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/07/2017] [Accepted: 04/14/2017] [Indexed: 02/07/2023]
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Martín-Mariscal V. A systematic review and narrative synthesis of interventions for uncomplicated obesity: weight loss, well-being and impact on eating disorder. ENFERMERIA CLINICA 2017; 28:212-213. [PMID: 28889945 DOI: 10.1016/j.enfcli.2017.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 08/02/2017] [Indexed: 11/15/2022]
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Prehn K, Jumpertz von Schwartzenberg R, Mai K, Zeitz U, Witte AV, Hampel D, Szela AM, Fabian S, Grittner U, Spranger J, Flöel A. Caloric Restriction in Older Adults-Differential Effects of Weight Loss and Reduced Weight on Brain Structure and Function. Cereb Cortex 2017; 27:1765-1778. [PMID: 26838769 DOI: 10.1093/cercor/bhw008] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Dietary modifications such as caloric restriction (CR) have been suggested as a means to improve memory and prevent age-related decline. However, it is unclear whether those effects remain stable over time or are related specifically to negative energy balance during the weight loss phase of CR. Using a randomized interventional design, we investigated changes in recognition memory and neural correlates in postmenopausal obese women (n = 19): 1) after intense weight loss in the course of a 12-week low-caloric diet (reduced body weight and negative energy balance) and 2) after having sustained the reduced weight over 4 more weeks (reduced body weight, but energy balance equilibrium). Participants were contrasted to a control group (n = 18) instructed not to change dietary habits. In the CR group, we found improved recognition memory, paralleled by increased gray matter volume in inferior frontal gyrus and hippocampus, and augmented hippocampal resting-state functional connectivity to parietal areas. Moreover, effects were specific for transient negative energy balance and could not be detected after subsequent weight maintenance. Our data demonstrate for the first time in humans that beneficial effects of CR on brain structure and function are due to weight loss rather than an overall reduced weight.
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Affiliation(s)
- Kristin Prehn
- Department of Neurology and NeuroCure Clinical Research Center, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Reiner Jumpertz von Schwartzenberg
- Department of Endocrinology, Diabetes and Nutrition, Experimental and Clinical Research Center and Center for Cardiovascular Research, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Knut Mai
- Department of Endocrinology, Diabetes and Nutrition, Experimental and Clinical Research Center and Center for Cardiovascular Research, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Ulrike Zeitz
- Department of Endocrinology, Diabetes and Nutrition, Experimental and Clinical Research Center and Center for Cardiovascular Research, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - A Veronica Witte
- Department of Neurology and NeuroCure Clinical Research Center, Charité Universitätsmedizin Berlin, Berlin, Germany.,Department of Neurology, Aging and Obesity Group, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Dierk Hampel
- Department of Endocrinology, Diabetes and Nutrition, Experimental and Clinical Research Center and Center for Cardiovascular Research, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Anna-Maria Szela
- Department of Neurology and NeuroCure Clinical Research Center, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Sonja Fabian
- Department of Neurology and NeuroCure Clinical Research Center, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Ulrike Grittner
- Department of Biostatistics and Clinical Epidemiology, Charité Universitätsmedizin Berlin, Berlin, Germany.,Center for Stroke Research, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Joachim Spranger
- Department of Endocrinology, Diabetes and Nutrition, Experimental and Clinical Research Center and Center for Cardiovascular Research, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Agnes Flöel
- Department of Neurology and NeuroCure Clinical Research Center, Charité Universitätsmedizin Berlin, Berlin, Germany
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Peckmezian T, Hay P. A systematic review and narrative synthesis of interventions for uncomplicated obesity: weight loss, well-being and impact on eating disorders. J Eat Disord 2017; 5:15. [PMID: 28469914 PMCID: PMC5410702 DOI: 10.1186/s40337-017-0143-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 03/22/2017] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Most weight loss research focuses on weight as the primary outcome, often to the exclusion of other physiological or psychological measures. This study aims to provide a holistic evaluation of the effects from weight loss interventions for individuals with obesity by examining the physiological, psychological and eating disorders outcomes from these interventions. METHODS Databases Medline, PsycInfo and Cochrane Library (2011-2016) were searched for randomised controlled trials and systematic reviews of obesity treatments (dietary, exercise, behavioural, psychological, pharmacological or surgical). Data extracted included study features, risk of bias, study outcomes, and an assessment of treatment impacts on physical, psychological or eating disorder outcomes. RESULTS From 3628 novel records, 134 studies met all inclusion criteria and were evaluated in this review. Lifestyle interventions had the strongest evidence base as a first-line approach, with escalation to pharmacotherapy and bariatric surgery in more severe or complicated cases. Quality of life was the most common psychological outcome measure, and improved in all cases where it was assessed, across all intervention types. Behavioural, psychological and lifestyle interventions for weight loss led to improvements in cognitive restraint, control over eating and binge eating, while bariatric surgery led to improvements in eating behaviour and body image that were not sustained over the long-term. DISCUSSION Numerous treatment strategies have been trialled to assist people to lose weight and many of these are effective over the short-term. Quality of life, and to a lesser degree depression, anxiety and psychosocial function, often improve alongside weight loss. Weight loss is also associated with improvements in eating disorder psychopathology and related measures, although overall, eating disorder outcomes are rarely assessed. Further research and between-sector collaboration is required to address the significant overlap in risk factors, diagnoses and treatment outcomes between obesity and eating disorders.
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Affiliation(s)
| | - Phillipa Hay
- Foundation Chair of Mental Health and Centre for Health Research, School of Medicine, Western Sydney University, Parramatta, Australia
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Santos MVLD, Melo CMD, Rosa JPP, Silva EVAD, Lima GHO, Del Re MP, Tufik S, Mello MTD. Emotional eating is related to carbohydrate intake in active women. MOTRIZ: REVISTA DE EDUCACAO FISICA 2016. [DOI: 10.1590/s1980-6574201600040020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | - Marco Túlio de Mello
- Universidade Federal de São Paulo, Brasil; Universidade Federal de Minas Gerais, Brasil
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Varghese S, Kubatka P, Rodrigo L, Gazdikova K, Caprnda M, Fedotova J, Zulli A, Kruzliak P, Büsselberg D. Chili pepper as a body weight-loss food. Int J Food Sci Nutr 2016; 68:392-401. [PMID: 27899046 DOI: 10.1080/09637486.2016.1258044] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Chili has culinary as well as medical importance. Studies in humans, using a wide range of doses of chili intake (varying from a single meal to a continuous uptake for up to 12 weeks), concluded that it facilitates weight loss. In regard to this, the main targets of chili are fat metabolism, energy expenditure, and thermogenesis. To induce weight loss, the active substance of chili, capsaicin, activates Transient Receptor Potential Cation Channel sub-family V member 1 (TRPV1) channels) receptors causing an increase in intracellular calcium levels and triggering the sympathetic nervous system. Apart from TRPV1, chili directly reduces energy expenditure by activating Brown Adipose Tissue. Weight loss by chili is also the result of an improved control of insulin, which supports weight management and has positive effects for treatment for diseases like obesity, diabetes and cardiovascular disorders. This review summarizes the major pathways by which chili contributes to ameliorating parameters that help weight management and how the consumption of chili can help in accelerating weight loss through dietary modifications.
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Affiliation(s)
- Sharon Varghese
- a Weill Cornell Medicine in Qatar , Qatar Foundation-Education City , Doha , Qatar
| | - Peter Kubatka
- b Department of Medical Biology, Jessenius Faculty of Medicine , Comenius University in Bratislava , Martin , Slovakia
| | - Luis Rodrigo
- c Department of Gastroenterology, Faculty of Medicine , University of Oviedo, Central University Hospital of Asturias (HUCA) , Oviedo , Spain
| | - Katarina Gazdikova
- d Department of Nutrition, Faculty of Nursing and Professional Health Studies, Faculty of Medicine , Slovak Medical University , Bratislava , Slovakia.,e Department of General Medicine, Faculty of Medicine , Slovak Medical University , Bratislava , Slovakia
| | - Martin Caprnda
- f 2nd Department of Internal Medicine, Faculty of Medicine , Comenius University and University Hospital , Bratislava , Slovakia
| | - Julia Fedotova
- g Laboratory of Neuroendocrinology , I.P. Pavlov Institute of Physiology, Russian Academy of Sciences , St. Petersburg , Russia.,h Laboratory of Comparative Somnology and Neuroendocrinology , I.M. Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences , St. Petersburg , Russia.,i International Research Centre «Biotechnologies of the Third Millennium» , ITMO University , St. Petersburg , Russia
| | - Anthony Zulli
- j Centre for Chronic Disease, College of Health and Biomedicine , Victoria University , Werribee , Australia
| | - Peter Kruzliak
- k Department of Chemical Drugs, Faculty of Pharmacy , University of Veterinary and Pharmaceutical Sciences , Brno , Czech Republic.,l Department of Surgery, Center for Vascular Disease , St. Anne?s University Hospital, Faculty of Medicine, Masaryk University , Brno , Czech Republic
| | - Dietrich Büsselberg
- a Weill Cornell Medicine in Qatar , Qatar Foundation-Education City , Doha , Qatar
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Wada S, Goto T, Fujimoto K, Watanabe M, Nagao K, Nakamichi A, Ichikawa T. Changes in food bolus texture during mastication. J Texture Stud 2016; 48:171-177. [DOI: 10.1111/jtxs.12228] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 07/24/2016] [Accepted: 08/15/2016] [Indexed: 01/09/2023]
Affiliation(s)
- Sachie Wada
- Department of Oral & Maxillofacial Prosthodontics; Institute of Biomedical Sciences, Tokushima University Graduate School; 3-18-15 Kuramoto Tokushima Japan
| | - Takaharu Goto
- Department of Oral & Maxillofacial Prosthodontics; Institute of Biomedical Sciences, Tokushima University Graduate School; 3-18-15 Kuramoto Tokushima Japan
| | - Keiko Fujimoto
- Department of Oral & Maxillofacial Prosthodontics; Institute of Biomedical Sciences, Tokushima University Graduate School; 3-18-15 Kuramoto Tokushima Japan
| | - Megumi Watanabe
- Department of Oral & Maxillofacial Prosthodontics; Institute of Biomedical Sciences, Tokushima University Graduate School; 3-18-15 Kuramoto Tokushima Japan
| | - Kan Nagao
- Department of Oral & Maxillofacial Prosthodontics; Institute of Biomedical Sciences, Tokushima University Graduate School; 3-18-15 Kuramoto Tokushima Japan
| | - Atsuko Nakamichi
- Department of Oral Functional Management, School of Oral Health Sciences, Faculty of Dentistry; Kyushu Dental University; 2-6-1 Manazuru Kokurakita-ku, Kitakyusyu Fukuoka Japan
| | - Tetsuo Ichikawa
- Department of Oral & Maxillofacial Prosthodontics; Institute of Biomedical Sciences, Tokushima University Graduate School; 3-18-15 Kuramoto Tokushima Japan
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Ariel AH, Perri MG. Effect of dose of behavioral treatment for obesity on binge eating severity. Eat Behav 2016; 22:55-61. [PMID: 27086049 PMCID: PMC4983214 DOI: 10.1016/j.eatbeh.2016.03.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 03/27/2016] [Accepted: 03/30/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVES We evaluated the effects of three doses of a behavioral intervention for obesity (High dose=24 sessions, Moderate=16 sessions, Low=8 sessions) compared with a nutrition education control group (Control) on binge eating. We also examined whether participants with clinically significant improvements in binge eating had better treatment adherence and weight-loss outcomes than those who did not experience clinically significant improvements in binge eating. Finally, we examined the relation of pretreatment binge eating severity to changes at six months. METHODS Participants included 572 adults (female=78.7%; baseline mean±SD: age=52.7±11.2years, BMI=36.4±3.9kg/m(2)) who provided binge eating data at baseline. We evaluated binge eating severity (assessed via the Binge Eating Scale) and weight status at baseline and six months, as well as treatment adherence over six months. RESULTS At six months, participants in the Moderate and High treatment conditions reported greater reductions in binge eating severity than participants in the Low and Control conditions, ps<.02. Participants who demonstrated improvements in binge eating severity reported greater dietary self-monitoring adherence and attained larger weight losses than those who did not experience clinically significant reductions, ps<.001. Pretreatment binge eating severity predicted less improvement in binge eating severity over six months and fewer days with dietary self-monitoring records completed, ps≤.002. CONCLUSION A moderate or high dose of behavioral weight-loss treatment may be required to produce clinically significant reductions in binge eating severity in adults with obesity.
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Affiliation(s)
- Aviva H. Ariel
- Department of Clinical and Health Psychology, University of Florida
| | - Michael G. Perri
- Department of Clinical and Health Psychology, University of Florida
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Swartz MC, Basen-Engquist KM, Markham C, Lyons EJ, Cox M, Chandra J, Ater JL, Askins MA, Scheurer ME, Lupo PJ, Hill R, Murray J, Chan W, Swank PR. Psychometric Analysis of the Three-Factor Eating Questionnaire-R18V2 in Adolescent and Young Adult-Aged Central Nervous System Tumor Survivors. J Adolesc Young Adult Oncol 2016; 5:278-85. [PMID: 27042872 DOI: 10.1089/jayao.2015.0058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Adolescent and young adult (AYA)-aged central nervous system (CNS) tumor survivors are an understudied population that is at risk of developing adverse health outcomes, such as obesity. Long-term follow-up guidelines recommend monitoring those at risk of obesity, thus motivating the need for an eating behavior questionnaire. An abbreviated online version of the Three-Factor Eating Questionnaire (TFEQ-R18v2) has been developed, but its applicability to this population is not yet known. This study investigated the instrument's factor structure and reliability in this population. METHODS AYA-aged CNS tumor survivors (n = 114) aged 15-39 years completed the TFEQ-R18V2 questionnaire online. Confirmatory factor analysis was used to examine the fit of the three-factor structure (uncontrollable eating, cognitive restraint, and emotional eating [EE]) and reliability (internal consistency of the TFEQ-R18v2). Associations between the three factors and body mass index (BMI) were assessed by linear regression. RESULTS The theorized three-factor structure was supported in our population (RMSEA = 0.056 and CFI = 0.98) and demonstrated good reliability (α of 0.81-0.93). EE (β = 0.07, 95% CI 0.02-0.13) was positively associated with BMI, whereas the other two subscale scores were not. CONCLUSION The TFEQ-R18v2 instrument holds promise for research and clinical use among AYA-aged CNS tumor survivors. The instrument may be a useful tool for researchers to develop tailored weight management strategies. It also may be a valuable tool for clinicians to monitor survivors who are at risk of obesity and to facilitate referral. Our results also suggest that EE in this population should be further investigated as a potential target for intervention.
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Affiliation(s)
- Maria C Swartz
- 1 Division of Rehabilitation Sciences, The University of Texas Medical Branch , Galveston, Texas
| | - Karen M Basen-Engquist
- 2 Department of Behavioral Science, The University of Texas MD Anderson Cancer Center , Houston, Texas
| | - Christine Markham
- 3 Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas
| | - Elizabeth J Lyons
- 1 Division of Rehabilitation Sciences, The University of Texas Medical Branch , Galveston, Texas
| | - Matthew Cox
- 2 Department of Behavioral Science, The University of Texas MD Anderson Cancer Center , Houston, Texas
| | - Joya Chandra
- 4 Division of Pediatrics, The University of Texas MD Anderson Cancer Center , Houston, Texas
| | - Joann L Ater
- 4 Division of Pediatrics, The University of Texas MD Anderson Cancer Center , Houston, Texas
| | - Martha A Askins
- 4 Division of Pediatrics, The University of Texas MD Anderson Cancer Center , Houston, Texas
| | | | - Philip J Lupo
- 5 Department of Pediatrics, Baylor College of Medicine , Houston, Texas
| | - Rachel Hill
- 6 Department of Hematology & Oncology, Cook Children's Medical Center , Fort Worth, Texas
| | - Jeffrey Murray
- 6 Department of Hematology & Oncology, Cook Children's Medical Center , Fort Worth, Texas
| | - Wenyaw Chan
- 7 Department of Biostatistics, The University of Texas Health Science Center at Houston School of Public Health , Houston, Texas
| | - Paul R Swank
- 3 Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas
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