Industry-Sponsored Weight Loss Programs: Description, Cost, and Effectiveness

Healthy choices, healthy changes: A randomized trial of incentives to promote healthy eating and exercise in people with schizophrenia and other serious mental illnesses

INTRODUCTION

People with schizophrenia and other serious mental illnesses (SMI) represent a concerning health disparity population, with 10-30 fewer years of life compared to the general population, mainly from high rates of cardiovascular disease (CVD). Preventing CVD is possible with exercise and diet interventions, but only 50 % of participants in clinical trials achieve reduction in CVD risk. This study assessed whether cash incentives improved weight loss, cardiovascular endurance, and/or mortality risk when added to one of four healthy lifestyle programs (gym membership, Weight Watchers membership, the InSHAPE program, InSHAPE + Weight Watchers).

METHODS

From 2012 to 2015, 1348 overweight or obese adults with SMI enrolled in a study using equipoise stratified randomization. Participants were randomly assigned to intervention, then to cash incentives, or not, for participation (gym and/or Weight Watchers), with baseline and quarterly assessments for 12 months. We examined effects of the interventions, key covariates, and incentives, using generalized linear models.

RESULTS

Main effects of randomization to receive cash incentives was not significant for any outcome; whereas total amount of incentives was significantly associated with all three primary outcomes (weight loss, cardiovascular endurance, mortality risk), mainly for participants in the InSHAPE+WW group who received additional cash incentives.

CONCLUSIONS

Incentives may be effective at preventing CVD and improving health outcomes for people with SMI, especially in the context of intensive support for healthy lifestyle behaviors. Policy changes are required to increase access to healthy lifestyle programming and more research is needed to establish the optimal amount of incentives for people with SMI.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT02515981.

Text messaging as adjunct to community-based weight management program

Increasing obesity rates are still a public health priority. The primary aim of this study was to evaluate the effect of tailored text messages on body weight change in overweight and obese adults in a community-based weight management program. A secondary aim was to detect behavioral changes in the same population. The study design was quasi-experimental with pretest and posttest analysis, conducted over 12 weeks. A total of 28 participants were included in the analysis. Body weight, eating behaviors, exercise and nutrition self-efficacy, attitude toward mobile technology, social support, and physical activity were assessed at baseline and at 12 weeks. Text messages were sent biweekly to the intervention but not to the control group. At 12 weeks, the intervention group had lost significant weight as compared with the control group. There was a trend toward an improvement in eating behaviors, exercise, and nutrition self-efficacy in the intervention group, with no significant difference between groups. A total of 79% of participants stated that text messages helped in adopting healthy behaviors. Tailored text messages appear to enhance weight loss in a weight management program at a community setting. Large-scale and long-term intervention studies are needed to confirm these findings.

Adult weight management: translating research and guidelines into practice

PURPOSE

To provide a practical approach to managing overweight and obese adult patients based on data from research and recommendations from established guidelines.

DATA SOURCES

Comprehensive review articles and original research articles identified through Medline and the Cumulative Index to Nursing and Allied Health Literature (CINAHL).

CONCLUSIONS

There is a great deal of research being conducted on new ways to treat obesity; however, despite all this new information, many primary care providers continue to report that they do not address weight or weight control strategies with their patients. Reasons include too little time, not enough training, lack of financial incentive, and failure to believe that patients can be successful.

IMPLICATIONS FOR PRACTICE

Weight management essentially comes down to one key concept: negative energy balance (fewer calories in and/or more calories out). Patients can be taught how to achieve a negative energy balance by using a food/exercise diary to track their daily caloric goal to achieve a 1-2 pound weight loss per week. Nurse practitioners (NPs) can implement safe and effective weight management plans for their patients by teaching them how to self-monitor, eat healthy, and exercise. This method is similar to what NPs commonly use for patients with diabetes mellitus.

Disordered eating cognitions and behaviours among slimming organization competition winners

BACKGROUND

Long-term success in weight loss treatments for obesity is elusive. The most widely used approach after diet books is slimming clubs. A percentage of members achieve dramatic and lasting weight losses. The study aimed to evaluate the prevalence of binge eating and unhealthy eating-related thought patterns among a group of highly successful weight losers.

METHODS

Sixty-five slimming competition winners self reported their weight history and eating habits in a semi-structured questionnaire. The Eating Disorders Examination Questionnaire (EDE-Q) and the Emotional Eating Scale (EES) were also administered.

RESULTS

Despite substantial weight loss (mean = 38%, SD = 10%) and widespread maintenance of losses, participants evidenced high levels of dietary restraint and weight, shape and eating overconcern. Emotional eating levels were significantly higher than those seen in noneating disordered populations on two of three subscales. Seventy-one per cent also reported bingeing in the past 3 months.

CONCLUSIONS

Commercial slimming organizations should engage with broader psychological and behavioural features of obesity, including bingeing and eating-related cognitive patterns.

Physician-assisted weight loss and maintenance in the elderly

Although commonly addressed in magazines, across airwaves, and within gyms nationwide, health care providers must now face the growing epidemic of obesity in their daily practice. With the graying of America, it is all the more important to realize that weight increases the risk for disease and mortality in the elderly. Despite overwhelming evidence that weight loss can reduce health risks, many patients who are overweight never receive needed advice from their primary care physicians. This article addresses the barriers to physician intervention, methods to assess obesity risk, and readiness to change. Effective approaches for assisting in successful weight loss and maintenance are discussed.