1
|
Hagerman CJ, Onu MC, Crane NT, Butryn ML, Forman EM. Psychological and behavioral responses to daily weight gain during behavioral weight loss treatment. J Behav Med 2024; 47:492-503. [PMID: 38407728 PMCID: PMC11026204 DOI: 10.1007/s10865-024-00476-4] [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: 06/26/2023] [Accepted: 01/28/2024] [Indexed: 02/27/2024]
Abstract
Self-weighing is consistently associated with more effective weight control. However, patterns show that participants disengage from their weight control behaviors following weight gain. Women with BMIs in the overweight/obese range (N = 50) enrolled in a long-term behavioral weight loss program completed ecological momentary assessment (EMA) surveys immediately after their daily weigh-ins. Nightly EMA surveys and self-monitoring data through Fitbit measured their weight control behavior that day. On days when participants gained weight (vs. lost or maintained), they reported more negative mood, more guilt/shame, and lower confidence in weight control. Motivation following daily weight gain depended on participants' overall satisfaction with their weight loss so far: more satisfied participants had marginally higher, but less satisfied participants had marginally lower motivation in response to daily weight gain. Greater guilt/shame and lower motivation after the weigh-in predicted less effective weight control behavior that day (e.g., lower likelihood of calorie tracking, fewer minutes of physical activity). Results demonstrate that even small weight gain is distressing and demoralizing for women in BWL programs, which can lead to goal disengagement. These findings have implications for future BWL interventions, including the potential utility of just-in-time adaptive interventions to promote more adaptive responses in the moments after weigh-ins.
Collapse
Affiliation(s)
- Charlotte J Hagerman
- Department of Psychological and Brain Sciences, Center for Weight, Eating and Lifestyle Sciences (WELL Center), Drexel University, Stratton Hall, 3201 Chestnut Street, Philadelphia, PA, 19104, USA.
| | - Michael C Onu
- Department of Psychological and Brain Sciences, Center for Weight, Eating and Lifestyle Sciences (WELL Center), Drexel University, Stratton Hall, 3201 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Nicole T Crane
- Department of Psychological and Brain Sciences, Center for Weight, Eating and Lifestyle Sciences (WELL Center), Drexel University, Stratton Hall, 3201 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Meghan L Butryn
- Department of Psychological and Brain Sciences, Center for Weight, Eating and Lifestyle Sciences (WELL Center), Drexel University, Stratton Hall, 3201 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Evan M Forman
- Department of Psychological and Brain Sciences, Center for Weight, Eating and Lifestyle Sciences (WELL Center), Drexel University, Stratton Hall, 3201 Chestnut Street, Philadelphia, PA, 19104, USA
| |
Collapse
|
2
|
Huang X, Shi Y, Yao H, Li M, Lei Z, Shi J, Li B, Zhang W, Jian W. Weight Loss Using an mHealth App Among Individuals With Obesity in Different Economic Regions of China: Cohort Study. JMIR Mhealth Uhealth 2024; 12:e48675. [PMID: 38297510 PMCID: PMC10851113 DOI: 10.2196/48675] [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: 05/03/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 02/02/2024] Open
Abstract
Background With the increasing prevalence of obesity, weight loss has become a critical issue in China. Self-managed weight loss through a mobile health (mHealth) app may be a prospective method. However, its practicability in different economic regions of China is unknown. Objective This study aims to evaluate the effectiveness of self-managed weight loss through an mHealth app among individuals with obesity in different economic regions of China and to demonstrate the feasibility of online self-management for weight loss. Methods A total of 165,635 Chinese adults who signed up for the mHealth app were included to analyze the body composition characteristics of individuals from different economic regions by χ2 analyses. Furthermore, 2 types of participants with obesity using mHealth monitoring, including 74,611 participants with a BMI ≥24.0 kg/m2 and 22,903 participants with a normal BMI but an excessive percentage of body fat (PBF), were followed for 6 months to explore the weight loss and fat loss effects in different economic regions of China and to find independent predictors associated with weight loss success by 2-tailed Student t test and multivariable logistic regression analysis. Results There were 32,129 users from low-income regions and 133,506 users from high-income regions. The proportion of users with obesity in low-income regions was higher than in high-income regions, both based on BMI (15,378/32,129, 47.9% vs 59,233/133,506, 44.4%; P<.001) and PBF classification (19,146/32,129, 59.6% vs 72,033/133,506, 54%; P<.001). Follow-up analyses showed that the weight loss effect among participants with overweight or obesity in low-income regions was greater than in high-income regions (mean -4.93, SD 6.41 vs mean -4.71, SD 6.14 kg; P<.001), while there was no significant difference in fat loss (mean -2.06%, SD 3.14% vs mean -2.04%, SD 3.19%; P=.54). In the population with normal-weight obesity, the weight loss (mean -2.42, SD 4.07 vs mean -2.23, SD 4.21 kg; P=.004) and fat loss effects (mean -1.43%, SD 2.73% vs mean -1.27%, SD 2.63%; P<.001) were stronger in high-income regions than in low-income regions. In addition, multivariable logistic regression analyses showed that age, baseline PBF, skeletal muscle rate, and measurement frequency were related to weight loss, whereas gender and baseline body metabolic rate only showed a correlation with weight loss in the population in high-income regions. Conclusions This study found a high proportion of mHealth app users with obesity in low-income regions. Individuals with overweight and obesity in different economic regions of China experienced significant weight loss and fat loss using an mHealth app. Moreover, individuals in high-income regions paid more attention to body fat and had better fat reduction effects. Therefore, promoting self-monitoring of weight and PBF through an mHealth app could be an important intervention that could be implemented across all regions of China.
Collapse
Affiliation(s)
- Xinru Huang
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yefei Shi
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hongyun Yao
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Mingjie Li
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhijun Lei
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jiayun Shi
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Bo Li
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Weiwei Zhang
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Weixia Jian
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| |
Collapse
|
3
|
Brown SD, Kiernan M, Ehrlich SF, Zhu Y, Hedderson MM, Daredia S, Feng J, Millman A, Quesenberry CP, Ferrara A. Intrinsic motivation for physical activity, healthy eating, and self-weighing in association with corresponding behaviors in early pregnancy. Prev Med Rep 2023; 36:102456. [PMID: 37854666 PMCID: PMC10580041 DOI: 10.1016/j.pmedr.2023.102456] [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: 06/21/2023] [Revised: 09/18/2023] [Accepted: 10/01/2023] [Indexed: 10/20/2023] Open
Abstract
Healthy lifestyle behaviors influence maternal cardiovascular health, but motivation for them in pregnancy is poorly understood. We examined whether intrinsic motivation (assessed on 5-point scales for each behavior) is associated with three lifestyle behaviors in early pregnancy: physical activity, by intensity level; healthy eating, quantified with the Alternate Healthy Eating Index for Pregnancy (AHEI-P); and weight self-monitoring, a standard weight management technique. Participants in the Northern California Pregnancy, Lifestyle and Environment Study (PETALS) population-based cohort completed validated surveys in early pregnancy (2017-18; N = 472; 22 % Asian, 6 % Black, 30 % Hispanic, 13 % multiracial, 30 % White). Cross-sectional data were analyzed in 2021-22. Overall, 40.7 % (n = 192) met United States national physical activity guidelines; the average AHEI-P score was 62.3 out of 130 (SD 11.4); and 36.9 % reported regular self-weighing (≥once/week; n = 174). In models adjusted for participant characteristics, 1-unit increases in intrinsic motivation were associated with increased likelihood of meeting physical activity guidelines (risk ratio [95 % CI]: 1.66 [1.48, 1.86], p < 0.0001); meeting sample-specific 75th percentiles for vigorous physical activity (1.70 [1.44, 1.99], p < 0.0001) and AHEI-P (1.75 [1.33, 2.31], p < 0.0001); and regular self-weighing (2.13 [1.92, 2.37], p < 0.0001). A 1-unit increase in intrinsic motivation lowered the risk of meeting the 75th percentile for sedentary behavior (0.79 [0.67, 0.92], p < 0.003). Intrinsic motivation was not associated with reaching 75th percentiles for total, light, or moderate activity. Intrinsic motivation is associated with physical activity, healthy eating, and self-weighing among diverse individuals in early pregnancy. Results can inform intervention design to promote maternal health via increased enjoyment of lifestyle behaviors.
Collapse
Affiliation(s)
- Susan D. Brown
- Department of Internal Medicine, University of California, Davis, Sacramento, CA, USA
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
- Center for Upstream Prevention of Adiposity and Diabetes Mellitus (UPSTREAM), Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Michaela Kiernan
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Monique M. Hedderson
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
- Center for Upstream Prevention of Adiposity and Diabetes Mellitus (UPSTREAM), Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Saher Daredia
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Juanran Feng
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Andrea Millman
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | | | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- Center for Upstream Prevention of Adiposity and Diabetes Mellitus (UPSTREAM), Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| |
Collapse
|
4
|
Pacanowski CR, Dominick G, Crosby RD, Engel SG, Cao L, Linde JA. Daily self-weighing compared with an active control causes greater negative affective lability in emerging adult women: A randomized trial. Appl Psychol Health Well Being 2023; 15:1695-1713. [PMID: 37339756 DOI: 10.1111/aphw.12463] [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: 01/18/2023] [Accepted: 05/26/2023] [Indexed: 06/22/2023]
Abstract
Age-related weight gain prevention may reduce population overweight/obesity. Emerging adulthood is a crucial time to act, as rate of gain accelerates and health habits develop. Evidence supports self-weighing (SW) for preventing weight gain; however, how SW impacts psychological states and behaviors in vulnerable groups is unclear. This study assessed daily SW effects on affective lability, stress, weight-related stress, body satisfaction, and weight-control behaviors. Sixty-nine university females (aged 18-22) were randomized to daily SW or temperature-taking (TT) control. Over 2 weeks, participants completed five daily ecological momentary assessments with their intervention behavior. A graph of their data with a trendline was emailed daily, with no other intervention components. Multilevel mixed models with random effect for day assessed variability in positive/negative affect. Generalized linear mixed models assessed outcomes pre- and post-SW or TT and generalized estimating equations assessed weight-control behaviors. Negative affective lability was significantly greater for SW versus TT. While general stress did not differ between groups, weight-related stress was significantly higher and body satisfaction was significantly lower post-behavior for SW but not TT. Groups did not significantly differ in the number or probability of weight-control behaviors. Caution is advised when recommending self-weighing to prevent weight gain for emerging adults.
Collapse
Affiliation(s)
- C R Pacanowski
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA
| | - G Dominick
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA
| | - R D Crosby
- Sanford Center for Biobehavioral Research, Fargo, North Dakota, USA
| | - S G Engel
- Sanford Center for Biobehavioral Research, Fargo, North Dakota, USA
| | - L Cao
- Sanford Center for Biobehavioral Research, Fargo, North Dakota, USA
| | - J A Linde
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
5
|
Hagerman CJ, Stock ML, Post S, Macura Z, Moore PJ, Dodge T, Wirtz PW. The Effects of Implicit Theories on Body Weight Information Avoidance. Exp Psychol 2023; 70:180-191. [PMID: 37830766 DOI: 10.1027/1618-3169/a000585] [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] [Indexed: 10/14/2023]
Abstract
Regular self-weighing is associated with more effective weight control, yet many individuals avoid weight-related information. Implicit theories about weight, or perceptions of how malleable weight is, predict more effortful weight management and may also influence weight-related information avoidance. Participants (N = 209) were randomly assigned to read an article stressing an incremental theory of weight (i.e., weight is malleable), an article stressing an entity theory (i.e., weight is fixed), or to a control condition. We then examined their self-reported preference to avoid their body composition (i.e., body fat, weight, and muscle composition), their willingness to have their body composition measured during the lab visit, and their eating and exercise intentions. There were no notable differences across conditions, but higher self-reported incremental beliefs predicted less self-reported avoidance of body composition. The findings suggest that implicit theories may influence weight-related information avoidance, but a brief manipulation is not powerful enough to create meaningful change.
Collapse
Affiliation(s)
- Charlotte J Hagerman
- Department of Psychology, The George Washington University, Washington, DC, USA
- Weight, Eating, and Lifestyle (WELL) Center, Drexel University, Philadelphia, PA, USA
| | - Michelle L Stock
- Department of Psychology, The George Washington University, Washington, DC, USA
| | - Stacy Post
- Department of Psychology, The George Washington University, Washington, DC, USA
| | - Zeljka Macura
- Continuing Education Program Development and Evaluation, American Psychological Association, Washington, DC, USA
| | - Philip J Moore
- Department of Psychology, The George Washington University, Washington, DC, USA
| | - Tonya Dodge
- Department of Psychology, The George Washington University, Washington, DC, USA
| | - Philip W Wirtz
- Department of Psychology, The George Washington University, Washington, DC, USA
| |
Collapse
|
6
|
Igudesman D, Crandell J, Corbin KD, Zaharieva DP, Addala A, Thomas JM, Casu A, Kirkman MS, Pokaprakarn T, Riddell MC, Burger K, Pratley RE, Kosorok MR, Maahs DM, Mayer-Davis EJ. Weight management in young adults with type 1 diabetes: The advancing care for type 1 diabetes and obesity network sequential multiple assignment randomized trial pilot results. Diabetes Obes Metab 2023; 25:688-699. [PMID: 36314293 PMCID: PMC9898100 DOI: 10.1111/dom.14911] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 10/22/2022] [Accepted: 10/28/2022] [Indexed: 02/06/2023]
Abstract
AIMS Co-management of weight and glycaemia is critical yet challenging in type 1 diabetes (T1D). We evaluated the effect of a hypocaloric low carbohydrate, hypocaloric moderate low fat, and Mediterranean diet without calorie restriction on weight and glycaemia in young adults with T1D and overweight or obesity. MATERIALS AND METHODS We implemented a 9-month Sequential, Multiple Assignment, Randomized Trial pilot among adults aged 19-30 years with T1D for ≥1 year and body mass index 27-39.9 kg/m2 . Re-randomization occurred at 3 and 6 months if the assigned diet was not acceptable or not effective. We report results from the initial 3-month diet period and re-randomization statistics before shutdowns due to COVID-19 for primary [weight, haemoglobin A1c (HbA1c), percentage of time below range <70 mg/dl] and secondary outcomes [body fat percentage, percentage of time in range (70-180 mg/dl), and percentage of time below range <54 mg/dl]. Models adjusted for design, demographic and clinical covariates tested changes in outcomes and diet differences. RESULTS Adjusted weight and HbA1c (n = 38) changed by -2.7 kg (95% CI -3.8, -1.5, P < .0001) and -0.91 percentage points (95% CI -1.5, -0.30, P = .005), respectively, while adjusted body fat percentage remained stable, on average (P = .21). Hypoglycaemia indices remained unchanged following adjustment (n = 28, P > .05). Variability in all outcomes, including weight change, was considerable (57.9% were re-randomized primarily due to loss of <2% body weight). No outcomes varied by diet. CONCLUSIONS Three months of a diet, irrespective of macronutrient distribution or caloric restriction, resulted in weight loss while improving or maintaining HbA1c levels without increasing hypoglycaemia in adults with T1D.
Collapse
Affiliation(s)
- Daria Igudesman
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- AdventHealth Translational Research Institute, Orlando, Florida, USA
| | - Jamie Crandell
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Karen D Corbin
- AdventHealth Translational Research Institute, Orlando, Florida, USA
| | - Dessi P Zaharieva
- Department of Pediatrics, Division of Endocrinology, Stanford University, Stanford, California, USA
| | - Ananta Addala
- Department of Pediatrics, Division of Endocrinology, Stanford University, Stanford, California, USA
| | - Joan M Thomas
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Anna Casu
- AdventHealth Translational Research Institute, Orlando, Florida, USA
| | - M Sue Kirkman
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Teeranan Pokaprakarn
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Michael C Riddell
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Kyle Burger
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Richard E Pratley
- AdventHealth Translational Research Institute, Orlando, Florida, USA
| | - Michael R Kosorok
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - David M Maahs
- Department of Pediatrics, Division of Endocrinology, Stanford University, Stanford, California, USA
| | - Elizabeth J Mayer-Davis
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| |
Collapse
|
7
|
Nwayyir HA, Mutasher EM, Alabid OM, Jabbar MA, Abdulraheem Al-Kawaz WH, Alidrisi HA, Alabbood M, Chabek M, AlZubaidi M, Al-Khazrajy LA, Abd Alhaleem IS, Al-Hilfi ADA, Ali FM, AlBayati A, Al Saffar HB, Khazaal FAK. Recommendations for the prevention and management of obesity in the Iraqi population. Postgrad Med 2023:1-15. [PMID: 36803631 DOI: 10.1080/00325481.2023.2172914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Obesity is a chronic metabolic disease that has become one of the leading causes of disability and death in the world, affecting not only adults but also children and adolescents. In Iraq, one third of the adult population is overweight and another third obese. Clinical diagnosis is accomplished by measuring body mass index (BMI) and waist circumference (a marker for intra-visceral fat and higher metabolic and cardiovascular disease risk). A complex interaction between behavioral, social (rapid urbanization), environmental and genetic factors underlies the etiology of the disease. Treatment options for obesity may include a multicomponent approach, involving dietary changes to reduce calorie intake, an increase in physical activity, behavioral modification, pharmacotherapy and bariatric surgery. The purpose for these recommendations is to develop a management plan and standards of care that are relevant to the Iraqi population and that can prevent/manage obesity and obesity-related complications, for the promotion of a healthy community.
Collapse
Affiliation(s)
- Hussein Ali Nwayyir
- University of Basra, College of Medicine, Department of Endocrinology, Faiha Specialized Diabetes, Endocrine and Metabolism Centre, Iraq
| | - Esraa Majid Mutasher
- Department of Pediatric Endocrinology, Children Welfare Teaching Hospital, Medical City Complex, Iraq
| | | | | | | | | | - Majid Alabbood
- Department of Endocrinology, Almawani Hospital, Basra, Iraq
| | - Muhammed Chabek
- Consultant Obstetrics and Gynecology, Private Practice, Iraq
| | - Munib AlZubaidi
- Department of paediatrics, University of Baghdad College of Medicine, Iraq
| | - Lujain Anwar Al-Khazrajy
- Department of Family medicine, Consultant Family Physician, Al-Kindy College of Medicine, University of Baghdad, Iraq
| | | | | | | | - Ali AlBayati
- Department of Endocrinology Consultant Endocrinology, Professor of medicine, Babylon medical college, Iraq
| | | | | |
Collapse
|
8
|
Lohr AN, Hoppe KK, Mei CC, Antony KM. Does Daily Self-Weighing Contribute to Postpartum Weight Loss? A Secondary Analysis of Daily Postpartum Weights among Women with Hypertensive Disorders of Pregnancy. Am J Perinatol 2023; 40:319-325. [PMID: 33902132 PMCID: PMC11073857 DOI: 10.1055/s-0041-1727217] [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] [Indexed: 02/01/2023]
Abstract
OBJECTIVE This study was aimed to examine the impact of daily self-weighing via remote monitoring on postpartum weight loss. STUDY DESIGN This was a secondary analysis of a nonrandomized controlled trial comprised of postpartum women with diagnosed hypertensive-related disorders in pregnancy who received a tablet device linked to Bluetooth-enabled equipment including a scale and blood pressure cuff. In addition to blood pressure monitoring, participants were instructed to perform daily self-weighing. The primary outcome of this study was to determine whether postpartum women who performed daily self-weighing lost more weight than those who did not, with a 42-day endpoint based on a 6-week postpartum visit weight. RESULTS Overall, 214 women participated in this program and 214 received usual care. Median weight loss for women participating in the remote blood pressure monitoring system was 23.0 (interquartile range [IQR]: 17-30) pounds versus 23.0 (IQR: 17-29) pounds among controls. Weight loss did not vary by prepregnancy obesity (median: 20 pounds [IQR: 17-28 pounds] for nonobese and 23 [IQR: 17-30] pounds for women with obesity, p = 0.16). Women who weighed themselves more than half of follow-up days lost a median of 24 pounds (IQR: 17-30 pounds) compared with 20.5 pounds (IQR: 14-29 pounds), p = 0.06. Women who weighed themselves more than half of follow-up days lost a mean of 11.4% (standard deviation [SD] = 0.41%) of body weight compared with 9.1% (SD = 0.74%; p = 0.01). The amount of weight loss in the telehealth group was correlated with the number of daily weights performed (Pearson's correlation coefficient 0.164, p = 0.025). Postpartum weight loss for daily self-weighing participants was most notable in the first 2 weeks with ongoing weight loss up to the 42-day (6-week) endpoint of this secondary analysis. CONCLUSION Daily self-weighing alone may be insufficient to promote postpartum weight loss. However, there was a slight trend toward more weight loss with more frequent weighing. KEY POINTS · Daily self-weighing is insufficient for postpartum weight loss.. · Women who weighed themselves more lost slightly more weight.. · Weight loss was the most notable in the first 2 weeks.. · Its use as one part of a program may be worth studying..
Collapse
Affiliation(s)
- Ali N Lohr
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Wisconsin Madison, Madison, Wisconsin
| | - Kara K Hoppe
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Wisconsin Madison, Madison, Wisconsin
| | - Chaoqun C Mei
- Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wisconsin
| | - Kathleen M Antony
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Wisconsin Madison, Madison, Wisconsin
| |
Collapse
|
9
|
Nakagata T, Yoshida T, Watanabe D, Arishima-Hashii Y, Yamada Y, Sawada N, Shimada H, Nishi N, Miyachi M. Weight over-reporting is associated with low muscle mass among community-dwelling Japanese adults aged 40 years and older: a cross sectional study. J Physiol Anthropol 2022; 41:19. [PMID: 35513887 PMCID: PMC9069821 DOI: 10.1186/s40101-022-00292-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 04/26/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Weight misperception adversely affects health-related quality of life (HRQol); however, few studies have evaluated the relationship between weight misperception and muscle mass. This study aimed to examine the relationship of weight misperception with low muscle mass using skeletal muscle index (SMI) estimated by multifrequency bioelectrical impedance analysis (MF-BIA) among community-dwelling Japanese.
Methods
Participants were 525 Japanese individuals aged 40–91 years old (male 89, female 436). Misperception was calculated by subtracting measured value from self-reported weight, presented as a percentage and categorized into tertiles based on sex (under-reporters, acceptable reporters, and over-reporters). Appendicular lean mass was estimated using MF-BIA, and low muscle mass was defined using SMI values of 7.0 and 5.7 kg/m2 for males and females, respectively, based on the Asian Working Group for Sarcopenia 2019 consensus. We evaluated the association between prevalence of low muscle mass and weight misperception (under-reporters and over-reporters) using multivariate logistic regression including covariate.
Results
In total, 9.3% (49/525) of participants had low muscle mass. After adjusting for covariates, prevalence of low muscle mass was higher among over-reporters than acceptable-reporters (odds ratio [OR]; 2.37, 95% confidence interval [CI]; 1.03–5.44). Additionally, sensitivity analysis was performed on females, which confirmed that the prevalence of low muscle mass was higher in over-reporters than in acceptable-reporters (OR, 3.27; 95% CI, 1.18–9.12).
Conclusion
Weight misperception was significantly correlated with low muscle mass, especially in over-reporters.
Collapse
|
10
|
Validation of the most cost-effective nudge to promote workers’ regular self-weighing: a cluster randomized controlled trial. Sci Rep 2022; 12:15501. [PMID: 36109546 PMCID: PMC9477839 DOI: 10.1038/s41598-022-18916-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 08/22/2022] [Indexed: 11/21/2022] Open
Abstract
Regular self-weighing is useful in obesity prevention. The impact of nudge-based occupational self-weighing programs in the cluster randomized controlled trial was examined. The primary outcome was regular self-weighing after 6 months, which we used to compute cost-effectiveness. Participants were Japanese local government employees who underwent 1 h workshops after being assigned to one of the three nudge groups. Each group was designed according to the nudges’ Easy, Attractive, Social, Timely framework: quiz group (n = 26, attractive-type nudges), implementation intentions group (n = 25, social-type nudges), and growth mindset group (n = 25, timely type nudges). A reference group (n = 36, no nudges) was also formed. After 6 months, all three interventions were effective for regular self-weighing, with the growth mindset intervention (60.0%) being significantly more effective. The cost-effectiveness of the growth mindset group was 1.7 times and 1.3 times higher than that of the quiz group and the implementation intentions group, respectively. Findings from our study are expected to facilitate the use of nudges for health practitioners and employers, which in turn may promote obesity prevention.
Collapse
|
11
|
Carpenter CA, Ugwoaba UA, Cardel MI, Ross KM. Using self-monitoring technology for nutritional counseling and weight management. Digit Health 2022; 8:20552076221102774. [PMID: 35663238 PMCID: PMC9158426 DOI: 10.1177/20552076221102774] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 05/08/2022] [Indexed: 02/01/2023] Open
Abstract
Self-monitoring of weight, dietary intake, and physical activity is a key strategy for weight management in adults with obesity. Despite research suggesting consistent associations between more frequent self-monitoring and greater success with weight regulation, adherence is often suboptimal and tends to decrease over time. New technologies such as smartphone applications, e-scales, and wearable devices can help eliminate some of the barriers individuals experience with traditional self-monitoring tools, and research has demonstrated that these tools may improve self-monitoring adherence. To improve the integration of these tools in clinical practice, the current narrative review introduces the various types of self-monitoring technologies, presents current evidence regarding their use for nutrition support and weight management, and provides guidance for optimal implementation. The review ends with a discussion of barriers to the implementation of these technologies and the role that they should optimally play in nutritional counseling and weight management. Although newer self-monitoring technologies may help improve adherence to self-monitoring, these tools should not be viewed as an intervention in and of themselves and are most efficacious when implemented with ongoing clinical support.
Collapse
Affiliation(s)
| | | | - Michelle I Cardel
- University of Florida, Gainesville, FL, USA,WW International, Inc, New York, NY
| | - Kathryn M Ross
- University of Florida, Gainesville, FL, USA,Kathryn M. Ross, Department of Clinical and Health Psychology, University of Florida, PO Box 100165, Gainesville, FL 32610, USA.
| |
Collapse
|
12
|
Corbin KD, Igudesman D, Addala A, Casu A, Crandell J, Kosorok MR, Maahs DM, Pokaprakarn T, Pratley RE, Souris KJ, Thomas J, Zaharieva DP, Mayer-Davis E. Design of the advancing care for type 1 diabetes and obesity network energy metabolism and sequential multiple assignment randomized trial nutrition pilot studies: An integrated approach to develop weight management solutions for individuals with type 1 diabetes. Contemp Clin Trials 2022; 117:106765. [PMID: 35460915 DOI: 10.1016/j.cct.2022.106765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/07/2022] [Accepted: 04/14/2022] [Indexed: 11/30/2022]
Abstract
Young adults with type 1 diabetes (T1D) often have difficulty co-managing weight and glycemia. The prevalence of overweight and obesity among individuals with T1D now parallels that of the general population and contributes to dyslipidemia, insulin resistance, and risk for cardiovascular disease. There is a compelling need to develop a program of research designed to optimize two key outcomes-weight management and glycemia-and to address the underlying metabolic processes and behavioral challenges unique to people with T1D. For an intervention addressing these dual outcomes to be effective, it must be appropriate to the unique metabolic phenotype of T1D, and to biological and behavioral responses to glycemia (including hypoglycemia) that relate to weight management. The intervention must also be safe, feasible, and accepted by young adults with T1D. In 2015, we established a consortium called ACT1ON: Advancing Care for Type 1 Diabetes and Obesity Network, a transdisciplinary team of scientists at multiple institutions. The ACT1ON consortium designed a multi-phase study which, in parallel, evaluated the mechanistic aspects of the unique metabolism and energy requirements of individuals with T1D, alongside a rigorous adaptive behavioral intervention to simultaneously facilitate weight management while optimizing glycemia. This manuscript describes the design of our integrative study-comprised of an inpatient mechanistic phase and an outpatient behavioral phase-to generate metabolic, behavioral, feasibility, and acceptability data to support a future, fully powered sequential, multiple assignment, randomized trial to evaluate the best approaches to prevent and treat obesity while co-managing glycemia in people with T1D. Clinicaltrials.gov identifiers: NCT03651622 and NCT03379792. The present study references can be found here: https://clinicaltrials.gov/ct2/show/NCT03651622 https://clinicaltrials.gov/ct2/show/NCT03379792?term=NCT03379792&draw=2&rank=1 Submission Category: "Study Design, Statistical Design, Study Protocols".
Collapse
Affiliation(s)
- Karen D Corbin
- AdventHealth, Translational Research Institute, Orlando, FL, United States of America
| | - Daria Igudesman
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Ananta Addala
- Stanford Diabetes Research Center and Health Research and Policy (Epidemiology), Stanford, CA, United States of America; Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Anna Casu
- AdventHealth, Translational Research Institute, Orlando, FL, United States of America
| | - Jamie Crandell
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Michael R Kosorok
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - David M Maahs
- Stanford Diabetes Research Center and Health Research and Policy (Epidemiology), Stanford, CA, United States of America; Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Teeranan Pokaprakarn
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Richard E Pratley
- AdventHealth, Translational Research Institute, Orlando, FL, United States of America
| | - Katherine J Souris
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Joan Thomas
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Dessi P Zaharieva
- Stanford Diabetes Research Center and Health Research and Policy (Epidemiology), Stanford, CA, United States of America; Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Elizabeth Mayer-Davis
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America.
| | | |
Collapse
|
13
|
Torres L, Lee JL, Park S, Di Lorenzo RC, Branam JP, Fraser SA, Salisbury BA. Retention, Fasting Patterns, and Weight Loss With an Intermittent Fasting App: A Large-scale, 52-week Observational Study (Preprint). JMIR Mhealth Uhealth 2021; 10:e35896. [PMID: 36194463 PMCID: PMC9579929 DOI: 10.2196/35896] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 07/14/2022] [Accepted: 07/26/2022] [Indexed: 11/13/2022] Open
Abstract
Background Intermittent fasting (IF) is an increasingly popular approach to dietary control that focuses on the timing of eating rather than the quantity and content of caloric intake. IF practitioners typically seek to improve their weight and other health factors. Millions of practitioners have turned to purpose-built mobile apps to help them track and adhere to their fasts and monitor changes in their weight and other biometrics. Objective This study aimed to quantify user retention, fasting patterns, and weight loss by users of 2 IF mobile apps. We also sought to describe and model starting BMI, amount of fasting, frequency of weight tracking, and other demographics as correlates of retention and weight change. Methods We assembled height, weight, fasting, and demographic data of adult users (ages 18-100 years) of the LIFE Fasting Tracker and LIFE Extend apps from 2018 to 2020. Retention for up to 52 weeks was quantified based on recorded fasts and correlated with user demographics. Users who provided height and at least 2 readings of weight and whose first fast and weight records were contemporaneous were included in the weight loss analysis. Fasting was quantified as extended fasting hours (EFH; hours beyond 12 in a fast) averaged per day (EFH per day). Retention was modeled using a Cox proportional hazards regression. Weight loss was analyzed using linear regression. Results A total of 792,692 users were followed for retention based on 26 million recorded fasts. Of these, 132,775 (16.7%) users were retained at 13 weeks, 54,881 (6.9%) at 26 weeks, and 16,478 (2.1%) at 52 weeks, allowing 4 consecutive weeks of inactivity. The survival analysis using Cox regression indicated that retention was positively associated with age and exercise and negatively associated with stress and smoking. Weight loss in the qualifying cohort (n=161,346) was strongly correlated with starting BMI and EFH per day, which displayed a positive interaction. Users with a BMI ≥40 kg/m2 lost 13.9% of their starting weight by 52 weeks versus a slight weight gain on average for users with starting BMI <23 kg/m2. EFH per day was an approximately linear predictor of weight loss. By week 26, users lost over 1% of their starting weight per EFH per day on average. The regression analysis using all variables was highly predictive of weight change at 26 weeks (R2=0.334) with starting BMI and EFH per day as the most significant predictors. Conclusions IF with LIFE mobile apps appears to be a sustainable approach to weight reduction in the overweight and obese population. Healthy weight and underweight individuals do not lose much weight on average, even with extensive fasting. Users who are obese lose substantial weight over time, with more weight loss in those who fast more.
Collapse
Affiliation(s)
| | - Joy L Lee
- Indiana University School of Medicine, Indianapolis, IN, United States
- The Regenstrief Institute, Indianapolis, IN, United States
| | - Seho Park
- Indiana University School of Medicine, Indianapolis, IN, United States
- The Regenstrief Institute, Indianapolis, IN, United States
| | | | | | - Shelagh A Fraser
- LifeOmic, Indianapolis, IN, United States
- Priority Physicians, Carmel, IN, United States
| | - Benjamin A Salisbury
- LifeOmic, Indianapolis, IN, United States
- Program in Biomedical Sciences, Wright State University, Dayton, OH, United States
| |
Collapse
|
14
|
Borer KT. Why We Eat Too Much, Have an Easier Time Gaining Than Losing Weight, and Expend Too Little Energy: Suggestions for Counteracting or Mitigating These Problems. Nutrients 2021; 13:3812. [PMID: 34836068 PMCID: PMC8618649 DOI: 10.3390/nu13113812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/13/2021] [Accepted: 10/19/2021] [Indexed: 12/11/2022] Open
Abstract
The intent of this review is to survey physiological, psychological, and societal obstacles to the control of eating and body weight maintenance and offer some evidence-based solutions. Physiological obstacles are genetic and therefore not amenable to direct abatement. They include an absence of feedback control against gaining weight; a non-homeostatic relationship between motivations to be physically active and weight gain; dependence of hunger and satiation on the volume of food ingested by mouth and processed by the gastrointestinal tract and not on circulating metabolites and putative hunger or satiation hormones. Further, stomach size increases from overeating and binging, and there is difficulty in maintaining weight reductions due to a decline in resting metabolism, increased hunger, and enhanced efficiency of energy storage. Finally, we bear the evolutionary burden of extraordinary human capacity to store body fat. Of the psychological barriers, human craving for palatable food, tendency to overeat in company of others, and gullibility to overeat when offered large portions, can be overcome consciously. The tendency to eat an unnecessary number of meals during the wakeful period can be mitigated by time-restricted feeding to a 6-10 hour period. Social barriers of replacing individual physical work by labor-saving appliances, designing built environments more suitable for car than active transportation; government food macronutrient advice that increases insulin resistance; overabundance of inexpensive food; and profit-driven efforts by the food industry to market energy-dense and nutritionally compromised food are best overcome by informed individual macronutrient choices and appropriate timing of exercise with respect to meals, both of which can decrease insulin resistance. The best defense against overeating, weight gain, and inactivity is the understanding of factors eliciting them and of strategies that can avoid and mitigate them.
Collapse
Affiliation(s)
- Katarina T Borer
- School of Kinesiology, The University of Michigan, Ann Arbor, MI 48104, USA
| |
Collapse
|
15
|
Vuorinen AL, Helander E, Pietilä J, Korhonen I. Frequency of Self-Weighing and Weight Change: Cohort Study With 10,000 Smart Scale Users. J Med Internet Res 2021; 23:e25529. [PMID: 34075879 PMCID: PMC8277333 DOI: 10.2196/25529] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/20/2020] [Accepted: 05/17/2021] [Indexed: 01/20/2023] Open
Abstract
Background Frequent self-weighing is associated with successful weight loss and weight maintenance during and after weight loss interventions. Less is known about self-weighing behaviors and associated weight change in free-living settings. Objective This study aimed to investigate the association between the frequency of self-weighing and changes in body weight in a large international cohort of smart scale users. Methods This was an observational cohort study with 10,000 randomly selected smart scale users who had used the scale for at least 1 year. Longitudinal weight measurement data were analyzed. The association between the frequency of self-weighing and weight change over the follow-up was investigated among normal weight, overweight, and obese users using Pearson’s correlation coefficient and linear models. The association between the frequency of self-weighing and temporal weight change was analyzed using linear mixed effects models. Results The eligible sample consisted of 9768 participants (6515/9768, 66.7% men; mean age 41.5 years; mean BMI 26.8 kg/m2). Of the participants, 4003 (4003/9768, 41.0%), 3748 (3748/9768, 38.4%), and 2017 (2017/9768, 20.6%) were normal weight, overweight, and obese, respectively. During the mean follow-up time of 1085 days, the mean weight change was –0.59 kg, and the mean percentage of days with a self-weigh was 39.98%, which equals 2.8 self-weighs per week. The percentage of self-weighing days correlated inversely with weight change, r=–0.111 (P<.001). Among normal weight, overweight, and obese individuals, the correlations were r=–0.100 (P<.001), r=–0.125 (P<.001), and r=–0.148 (P<.001), respectively. Of all participants, 72.5% (7085/9768) had at least one period of ≥30 days without weight measurements. During the break, weight increased, and weight gains were more pronounced among overweight and obese individuals: 0.58 kg in the normal weight group, 0.93 kg in the overweight group, and 1.37 kg in the obese group (P<.001). Conclusions Frequent self-weighing was associated with favorable weight loss outcomes also in an uncontrolled, free-living setting, regardless of specific weight loss interventions. The beneficial associations of regular self-weighing were more pronounced for overweight or obese individuals.
Collapse
Affiliation(s)
- Anna-Leena Vuorinen
- VTT Technical Research Centre of Finland, Tampere, Finland.,Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Elina Helander
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Julia Pietilä
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Ilkka Korhonen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| |
Collapse
|
16
|
Dutton GR, Kinsey AW, Howell CR, Pisu M, Dobelstein AE, Allison DB, Xun P, Levitsky DA, Fontaine K. The daily Self-Weighing for Obesity Management in Primary Care Study: Rationale, design and methodology. Contemp Clin Trials 2021; 107:106463. [PMID: 34082075 DOI: 10.1016/j.cct.2021.106463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/18/2021] [Accepted: 05/28/2021] [Indexed: 11/17/2022]
Abstract
Background Daily self-weighing (DSW) may be an effective harm-reduction intervention to disrupt continued weight gain. Self-Weighing for Obesity Management in Primary Care (SWOP) is a 24-month randomized controlled trial in 400 adults with obesity (BMI: kg/m2 ≥ 30) receiving primary care through a clinical network affiliated with an academic medical center. Objective To test DSW as a potentially scalable way to deter age-related weight gain among primary care patients with obesity. Methods Randomized-controlled trial with two conditions: DSW (instruction to weigh daily and provision of a web-enabled digital scale with graphical weight feedback) or Standard Care (receive a monetary gift card equivalent to value of the scale). Both groups receive standardized weight management educational material. SWOP will test the causal effect of assignment to DSW (Aim 1) and adherence to DSW (Aim 2) on weight (primary outcome) and adoption of weight management practices (secondary outcomes), as well as evaluate the cost-effectiveness of DSW compared to standard care (Aim 3). Findings may inform clinical guidelines for weight management by providing evidence that DSW attenuates continued age-related weight gain among adults with obesity. This trial is registered with ClinicalTrials.gov (NCT04044794).
Collapse
Affiliation(s)
- Gareth R Dutton
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, Birmingham, AL 35205, USA.
| | - Amber W Kinsey
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, Birmingham, AL 35205, USA.
| | - Carrie R Howell
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, Birmingham, AL 35205, USA.
| | - Maria Pisu
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, Birmingham, AL 35205, USA.
| | - Amy E Dobelstein
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, Birmingham, AL 35205, USA.
| | - David B Allison
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University-Bloomington, 1025 E. 7th Street, Bloomington, IN 47405, USA.
| | - Pengcheng Xun
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University-Bloomington, 1025 E. 7th Street, Bloomington, IN 47405, USA
| | - David A Levitsky
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, 244 Garden Ave, Ithaca, NY 14853, USA.
| | - Kevin Fontaine
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL 35233, USA.
| |
Collapse
|
17
|
Bramante CT, Lee G, Amsili SS, Linde JA, Phelan SM, Appel LJ, Bennett WL, Clark JM, Gudzune KA. Minority and low-income patients are less likely to have a scale for self-weighing in their home: A survey in primary care. Clin Obes 2020; 10:e12363. [PMID: 32383356 PMCID: PMC7382396 DOI: 10.1111/cob.12363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 02/28/2020] [Accepted: 03/13/2020] [Indexed: 01/07/2023]
Abstract
Daily self-weighing is a weight management behaviour that requires a scale; however, scale ownership may be cost-prohibitive for some patients. Our objective was to understand the proportion of primary care patients with a scale at home, and factors associated with home scale access, to potentially inform future interventions that facilitate scale access. Cross sectional survey of 216 adult patients from three primary care clinics: mixed-income urban/suburban (n = 68); mixed-income urban (n = 70); low-income urban (n = 74). The dependent variable was presence of a home scale; bivariate associations were conducted with variables including demographics, insurance type, clinic setting and self-reported height/weight. Mean age was 53 years; 71% women; 71% racial minority; mean body mass index 32 kg/m2 . Overall, 56% had a home scale. Most (79%) white patients owned a scale, compared to 46% of racial minority patients (P < .01); 33% of low-income patients owned scale, compared to over 66% of patients at the clinics serving mixed-income populations (P < .01). Most low-income urban clinic patients do not own a home scale. Because self-weighing is an effective weight-management behaviour, clinicians could consider assessing scale access, and future research should assess the health impact of providing scales to patients with overweight/obesity who desire weight loss or maintenance.
Collapse
Affiliation(s)
- Carolyn T Bramante
- University of Minnesota Medical School, Division of General Internal Medicine, Minneapolis, Minnesota, USA
| | - Grace Lee
- Johns Hopkins University, Homewood Campus, Baltimore, Maryland, USA
| | - Safira S Amsili
- Johns Hopkins University, Homewood Campus, Baltimore, Maryland, USA
| | - Jennifer A Linde
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, Minnesota, USA
| | - Sean M Phelan
- Mayo Clinic, Division of Health Care Policy and Research, Rochester, Minnesota, USA
| | - Lawrence J Appel
- Johns Hopkins School of Medicine, Division of General Internal Medicine, Baltimore, Maryland, USA
- Johns Hopkins University, Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland, USA
| | - Wendy L Bennett
- Johns Hopkins School of Medicine, Division of General Internal Medicine, Baltimore, Maryland, USA
- Johns Hopkins University, Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland, USA
| | - Jeanne M Clark
- Johns Hopkins School of Medicine, Division of General Internal Medicine, Baltimore, Maryland, USA
- Johns Hopkins University, Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland, USA
| | - Kimberly A Gudzune
- Johns Hopkins School of Medicine, Division of General Internal Medicine, Baltimore, Maryland, USA
- Johns Hopkins University, Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland, USA
| |
Collapse
|
18
|
Pacanowski CR, Levitsky DA. Self-Weighing and Visual Feedback Facilitates Self-Directed Learning in Adults Who Are Overweight and Obese. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:369-376. [PMID: 31561967 DOI: 10.1016/j.jneb.2019.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 08/16/2019] [Accepted: 08/22/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Understanding how and why self-weighing works for some individuals but not others in weight management is vital. This study investigated how self-weighing and tracking of weight using a Web site facilitated a self-directed learning process in overweight or obese adults interested in losing weight. DESIGN Semistructured interviews with study completers (n = 47) and voluntary withdrawals (n = 10) about their experience after 6 and 12 months of using the program or when they withdrew. ANALYSIS Qualitative, guided by self-directed learning theory. RESULTS Although both completers and those who withdrew engaged in self-directed learning, often exemplifying the same concepts (eg, instrumental learning), experiences described a positive sense of control over weight in completers and a lack of sense of control in those who withdrew. CONCLUSIONS AND IMPLICATIONS Overall, it seemed that frequent self-weighing and visual feedback of body weight over time facilitated a self-directed learning process in both completers and those who withdrew. This research provides a rich understanding of how adults use self-weighing to facilitate self-directed learning for weight loss. Future studies assessing how self-weighing and visual displays of weight facilitate a self-directed learning process in diverse populations and age groups are necessary to better understand how self-weighing works and for whom self-weighing is beneficial.
Collapse
Affiliation(s)
- Carly R Pacanowski
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE.
| | - David A Levitsky
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY
| |
Collapse
|
19
|
Frie K, Hartmann-Boyce J, Pilbeam C, Jebb S, Aveyard P. Analysing self-regulatory behaviours in response to daily weighing: a think-aloud study with follow-up interviews. Psychol Health 2019; 35:16-35. [PMID: 31198059 PMCID: PMC6961301 DOI: 10.1080/08870446.2019.1626394] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objective: To examine the extent to which people who are trying to lose weight naturally self-regulate in response to self-weighing and to identify barriers to self-regulation. Design/Main Outcome Measures: Twenty-four participants, who were overweight and trying to lose weight, recorded their thoughts during daily weighing for eight weeks. Semi-structured follow-up interviews assessed participant experiences. Qualitative analysis identified steps of the self-regulation process and barriers to self-regulation. Exploratory regression analysis assessed the relationship between the self-regulation steps and weight loss. Results: On 90% of 498 occasions, participants compared their weight measurement to an expectation or goal, and on 58% they reflected on previous behaviour. Action planning only occurred on 20% of occasions, and specific action planning was rare (6%). Only specific action planning significantly predicted weight loss (−2.1 kg per 1 SD increase in the predictor, 95% CI = −3.9, −0.3). Thematic analysis revealed that barriers to the interpretation of daily weight changes were difficulties in understanding day-to-day fluctuations, losing the overview of trends, forgetting to weigh, and forgetting previous measurements. Conclusion: Specific action planning can lead to weight loss, but is rare in a naturalistic setting. Barriers to self-regulation relate to the interpretation of weight changes.
Collapse
Affiliation(s)
- Kerstin Frie
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Jamie Hartmann-Boyce
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Caitlin Pilbeam
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Susan Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
20
|
Kaviani S, vanDellen M, Cooper JA. Daily Self-Weighing to Prevent Holiday-Associated Weight Gain in Adults. Obesity (Silver Spring) 2019; 27:908-916. [PMID: 31119881 DOI: 10.1002/oby.22454] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 02/05/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Holiday weight gain is reported to be 0.4 to 1.5 kg and may contribute to annual weight gain. The objective of this study was to test the efficacy of daily self-weighing (DSW) using visual graphical feedback (GF) to prevent holiday weight gain. METHODS A total of 111 adults were randomly assigned into a control or DSW + GF group and completed the preholiday visit (v1; before Thanksgiving), the postholiday visit (v2; after New Year's Day), and the follow-up visit (v3; 14 weeks after v2). The participants in the DSW + GF group performed DSW with Wi-Fi scales during the holidays and were told to try not to gain weight above baseline weight. RESULTS There was no change in weight with DSW + GF, whereas the control group gained weight from v1 to v2 (-0.13 ± 0.27 kg vs. 2.65 ± 0.33 kg, P < 0.001, respectively). In the control group, weight change was similar between individuals with overweight or obesity (OW/OB) versus individuals with normal weight (2.71 ± 0.48 kg vs. 2.62 ± 0.43 kg, not significant, respectively). For DSW + GF, individuals with OW/OB lost weight whereas those with normal weight maintained weight during the holidays (-1.46 ± 0.62 kg vs. 0.33 ± 0.27 kg, P = 0.01, respectively). The control group lost weight during the follow-up (-1.14 ± 0.43 kg, P = 0.01; v2 to v3) but retained 57% of weight gain; therefore, weight gain from v1 to v3 was significant (1.51 ± 0.39 kg, P < 0.001). CONCLUSIONS DSW + GF was a successful approach to prevent holiday weight gain, with those with OW/OB responding most favorably to DSW + GF.
Collapse
Affiliation(s)
- Sepideh Kaviani
- Department of Foods & Nutrition, University of Georgia, Athens, Georgia, USA
| | | | - Jamie A Cooper
- Department of Foods & Nutrition, University of Georgia, Athens, Georgia, USA
| |
Collapse
|
21
|
Sniehotta FF, Evans EH, Sainsbury K, Adamson A, Batterham A, Becker F, Brown H, Dombrowski SU, Jackson D, Howell D, Ladha K, McColl E, Olivier P, Rothman AJ, Steel A, Vale L, Vieira R, White M, Wright P, Araújo-Soares V. Behavioural intervention for weight loss maintenance versus standard weight advice in adults with obesity: A randomised controlled trial in the UK (NULevel Trial). PLoS Med 2019; 16:e1002793. [PMID: 31063507 PMCID: PMC6504043 DOI: 10.1371/journal.pmed.1002793] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 03/28/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Scalable weight loss maintenance (WLM) interventions for adults with obesity are lacking but vital for the health and economic benefits of weight loss to be fully realised. We examined the effectiveness and cost-effectiveness of a low-intensity technology-mediated behavioural intervention to support WLM in adults with obesity after clinically significant weight loss (≥5%) compared to standard lifestyle advice. METHODS AND FINDINGS The NULevel trial was an open-label randomised controlled superiority trial in 288 adults recruited April 2014 to May 2015 with weight loss of ≥5% within the previous 12 months, from a pre-weight loss BMI of ≥30 kg/m2. Participants were self-selected, and the majority self-certified previous weight loss. We used a web-based randomisation system to assign participants to either standard lifestyle advice via newsletter (control arm) or a technology-mediated low-intensity behavioural WLM programme (intervention arm). The intervention comprised a single face-to-face goal-setting meeting, self-monitoring, and remote feedback on weight, diet, and physical activity via links embedded in short message service (SMS). All participants were provided with wirelessly connected weighing scales, but only participants in the intervention arm were instructed to weigh themselves daily and told that they would receive feedback on their weight. After 12 months, we measured the primary outcome, weight (kilograms), as well as frequency of self-weighing, objective physical activity (via accelerometry), psychological variables, and cost-effectiveness. The study was powered to detect a between-group weight difference of ±2.5 kg at follow-up. Overall, 264 participants (92%) completed the trial. Mean weight gain from baseline to 12 months was 1.8 kg (95% CI 0.5-3.1) in the intervention group (n = 131) and 1.8 kg (95% CI 0.6-3.0) in the control group (n = 133). There was no evidence of an effect on weight at 12 months (difference in adjusted mean weight change from baseline: -0.07 [95% CI 1.7 to -1.9], p = 0.9). Intervention participants weighed themselves more frequently than control participants and were more physically active. Intervention participants reported greater satisfaction with weight outcomes, more planning for dietary and physical activity goals and for managing lapses, and greater confidence for healthy eating, weight loss, and WLM. Potential limitations, such as the use of connected weighing study in both trial arms, the absence of a measurement of energy intake, and the recruitment from one region of the United Kingdom, are discussed. CONCLUSIONS There was no difference in the WLM of participants who received the NULevel intervention compared to participants who received standard lifestyle advice via newsletter. The intervention affected some, but not all, process-related secondary outcomes of the trial. TRIAL REGISTRATION This trial is registered with the ISRCTN registry (ISRCTN 14657176; registration date 20 March 2014).
Collapse
Affiliation(s)
- Falko F. Sniehotta
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
- Fuse, the UK CRC Centre for Translational Research in Public Health, Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Elizabeth H. Evans
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom
- School of Psychology, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Kirby Sainsbury
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Ashley Adamson
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
- Fuse, the UK CRC Centre for Translational Research in Public Health, Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Alan Batterham
- Centre for Rehabilitation, Exercise and Sport Sciences (CRESS), Teesside University, Middlesbrough, United Kingdom
| | - Frauke Becker
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
- Health Economics Research Centre, University of Oxford, Oxford, United Kingdom
| | - Heather Brown
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | | | - Dan Jackson
- Open Lab, School of Computing Science, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Denise Howell
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Karim Ladha
- Open Lab, School of Computing Science, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Elaine McColl
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Patrick Olivier
- Open Lab, School of Computing Science, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Alexander J. Rothman
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Alison Steel
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Luke Vale
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Rute Vieira
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Martin White
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
- Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Institute of Metabolic Science, Cambridge, United Kingdom
| | - Peter Wright
- School of Psychology, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Vera Araújo-Soares
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
- School of Psychology, Newcastle University, Newcastle upon Tyne, United Kingdom
| |
Collapse
|
22
|
Hartmann-Boyce J, Boylan AM, Jebb SA, Aveyard P. Experiences of Self-Monitoring in Self-Directed Weight Loss and Weight Loss Maintenance: Systematic Review of Qualitative Studies. QUALITATIVE HEALTH RESEARCH 2019; 29:124-134. [PMID: 29984630 DOI: 10.1177/1049732318784815] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The experience and role of self-monitoring in self-directed weight loss attempts may be distinctly different from that within formal interventions, and has yet to be fully explored. We systematically reviewed qualitative studies to examine experiences of self-monitoring as an aid to self-directed weight loss. Thematic synthesis was used to construct descriptive and analytical themes from the available data. In all, 22 studies (681 participants) were included, in which the uses of self-monitoring ranged from an aid to increase adherence to a tool for facilitating analysis. Self-monitoring also influenced and was influenced by self-perception and emotions. Feelings of shame were linked with abandonment of efforts. Findings highlight the centrality of interpretation of self-monitored data, the implications this interpretation has on sense of self, and the impact of broader discourses. Explicitly framing self-monitoring as a positive tool with which to aid analysis may encourage helpful use of this technique.
Collapse
|
23
|
Salvy SJ, Dutton GR, Borgatti A, Kim YI. Habit formation intervention to prevent obesity in low-income preschoolers and their mothers: A randomized controlled trial protocol. Contemp Clin Trials 2018; 70:88-98. [PMID: 29802965 PMCID: PMC6060620 DOI: 10.1016/j.cct.2018.05.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 05/18/2018] [Accepted: 05/22/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Low-income and racial/ethnic minority mothers and their young children are at increased risk for obesity. Lack of access to evidence-based obesity prevention and treatment services further contributes to these disparities. METHODS This two-arm, parallel, randomized controlled trial (RCT) tests the effectiveness of a simple obesity intervention (HABITS) delivered as part of ongoing home visitation services, compared to the existing home visitation services without obesity-related content on mothers' and children's obesity risks. HABITS focuses on habit formation and modifications of food and activity cues in the home to support habit formation. Habit formation is focused on improving five behaviors: 1) fruits/vegetables, 2) fried foods, 3) sugar-sweetened beverages, 4) physical activity and 5) self-monitoring. Participants will be 298 mothers (>50% African American; 100% low income) and their children (3-5yo at baseline) enrolled in a home visitation program in central Alabama. Home visitors will be randomly assigned to deliver the home visitation curriculum with or without HABITS as part of their weekly home visits for 9 months. Assessments of mothers (weight, waist circumference, and habit strength of targeted behaviors), children (rate of weight gain), and the food/activity household environment will be conducted at enrollment, post-intervention (9 month), and one year post-intervention follow-up. DISCUSSION This research is poised to have a substantial impact because the delivery modalities of current obesity efforts disproportionally restrict the reach and engagement of underserved, low-income children and their caregivers who are most at-risk for health and obesity disparities.
Collapse
Affiliation(s)
- Sarah-Jeanne Salvy
- Division of Preventive Medicine, University of Alabama at Birmingham, Medical Towers 616, 1717 11th Avenue South, Birmingham, AL 35205, United States.
| | - Gareth R Dutton
- Division of Preventive Medicine, University of Alabama at Birmingham, Medical Towers 615, 1717 11th Avenue South, Birmingham, AL 35205, United States.
| | - Alena Borgatti
- Division of Preventive Medicine, University of Alabama at Birmingham, Medical Towers 640, 1717 11th Avenue South, Birmingham, AL 35205, United States.
| | - Young-Il Kim
- Division of Preventive Medicine, University of Alabama at Birmingham, Medical Towers 616, 1717 11th Avenue South, Birmingham, AL 35205, United States.
| |
Collapse
|
24
|
Financial incentive strategies for maintenance of weight loss: results from an internet-based randomized controlled trial. Nutr Diabetes 2018; 8:33. [PMID: 29795365 PMCID: PMC5968035 DOI: 10.1038/s41387-018-0036-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 03/11/2018] [Accepted: 03/23/2018] [Indexed: 11/09/2022] Open
Abstract
Background/objective Financial incentives can improve initial weight loss; we examined whether financial incentives can improve weight loss maintenance. Subjects/methods Participants aged 30–80 years who lost at least 5 kg during the first 4–6 months in a nationally available commercial weight loss program were recruited via the internet into a three-arm randomized trial of two types of financial incentives versus active control during months 1–6 (Phase I) followed by passive monitoring during months 7–12 (Phase II). Interventions were daily self-weighing and text messaging feedback alone (control) or combined with a lottery-based incentive or a direct incentive. The primary outcome was weight change 6 months after initial weight loss. Secondary outcomes included weight change 12 months after initial weight loss (6 months after cessation of maintenance intervention), and self-reported physical activity and eating behaviors. Results Of 191 participants randomized, the mean age was 49.0 (SD = 10.5) years and weight loss prior to randomization was 11.4 (4.7) kg; 92% were women and 89% were White. Mean weight changes during the next 6 months (Phase I) were: lottery −3.0 (5.8) kg; direct −2.8 (5.8) kg; and control −1.4 (5.8) kg (all pairwise comparisons p > 0.1). Weight changes through the end of 12 months post-weight loss (Phase II) were: lottery −1.8 (10.5) kg; direct −0.7 (10.7) kg; and control −0.3 (9.4) kg (all pairwise comparisons p > 0.1). The percentages of participants who maintained their weight loss (defined as gaining ≤1.36 kg) were: lottery 79%, direct 76%, and control 67% at 6 months and lottery 66%, direct 62%, and control 59% at 12 months (all pairwise comparisons p > 0.1). At 6 and 12 months after initial weight loss, changes in self-reported physical activity or eating behaviors did not differ across arms. Conclusions Compared with the active control of daily texting based on daily home weighing, lottery-based and direct monetary incentives provided no additional benefit for weight loss maintenance.
Collapse
|
25
|
Painter SL, Ahmed R, Hill JO, Kushner RF, Lindquist R, Brunning S, Margulies A. What Matters in Weight Loss? An In-Depth Analysis of Self-Monitoring. J Med Internet Res 2017; 19:e160. [PMID: 28500022 PMCID: PMC5446667 DOI: 10.2196/jmir.7457] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 03/27/2017] [Accepted: 04/14/2017] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Using technology to self-monitor body weight, dietary intake, and physical activity is a common practice used by consumers and health companies to increase awareness of current and desired behaviors in weight loss. Understanding how to best use the information gathered by these relatively new methods needs to be further explored. OBJECTIVE The purpose of this study was to analyze the contribution of self-monitoring to weight loss in participants in a 6-month commercial weight-loss intervention administered by Retrofit and to specifically identify the significant contributors to weight loss that are associated with behavior and outcomes. METHODS A retrospective analysis was performed using 2113 participants enrolled from 2011 to 2015 in a Retrofit weight-loss program. Participants were males and females aged 18 years or older with a starting body mass index of ≥25 kg/m2, who also provided a weight measurement at the sixth month of the program. Multiple regression analysis was performed using all measures of self-monitoring behaviors involving weight measurements, dietary intake, and physical activity to predict weight loss at 6 months. Each significant predictor was analyzed in depth to reveal the impact on outcome. RESULTS Participants in the Retrofit Program lost a mean -5.58% (SE 0.12) of their baseline weight with 51.87% (1096/2113) of participants losing at least 5% of their baseline weight. Multiple regression model (R2=.197, P<0.001) identified the following measures as significant predictors of weight loss at 6 months: number of weigh-ins per week (P<.001), number of steps per day (P=.02), highly active minutes per week (P<.001), number of food log days per week (P<.001), and the percentage of weeks with five or more food logs (P<.001). Weighing in at least three times per week, having a minimum of 60 highly active minutes per week, food logging at least three days per week, and having 64% (16.6/26) or more weeks with at least five food logs were associated with clinically significant weight loss for both male and female participants. CONCLUSIONS The self-monitoring behaviors of self-weigh-in, daily steps, high-intensity activity, and persistent food logging were significant predictors of weight loss during a 6-month intervention.
Collapse
Affiliation(s)
| | | | - James O Hill
- University of Colorado, Aurora, CO, United States
| | - Robert F Kushner
- Northwestern University, Feinberg School of Medicine, Chicago, IL, United States
| | | | | | | |
Collapse
|
26
|
Wilkinson L, Pacanowski CR, Levitsky D. Three-Year Follow-Up of Participants from a Self-Weighing Randomized Controlled Trial. J Obes 2017; 2017:4956326. [PMID: 29104805 PMCID: PMC5625756 DOI: 10.1155/2017/4956326] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 07/19/2017] [Indexed: 11/18/2022] Open
Abstract
Frequent self-weighing is associated with weight loss maintenance. Several years ago, we investigated frequent self-weighing's effect on weight loss and found the participants lost a significant amount of weight. Three years after this trial's end, participants were contacted for an update on their weight and self-weighing frequency. Weight change and self-weighing frequency since the end of the study were assessed. We hypothesized that participants who maintained frequent self-weighing behavior would have maintained their weight loss. Out of 98 participants enrolled in the RCT, 37% (n = 36) participated in this follow-up study. Total weight loss during the trial for the follow-up participants was 12.7 ± 19.4 lbs (p < 0.001). Three years after intervention, participants regained 0.9 ± 4.34 lbs, a value that was not statistically different from zero (p = 0.75). This did not differ by gender (p = 0.655). Over 75% of these participants continued to weigh themselves at least once a week. Frequent self-weighing may be an effective, low-cost strategy for weight loss maintenance. Future research should further investigate the role of self-weighing in long-term weight gain prevention.
Collapse
Affiliation(s)
- Lua Wilkinson
- Division of Nutritional Sciences, University of Alabama, Birmingham, Birmingham, AL, USA
| | - Carly R. Pacanowski
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA
| | - David Levitsky
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| |
Collapse
|
27
|
Schumacher LM, Gaspar M, Remmert JE, Zhang F, Forman EM, Butryn ML. Small weight gains during obesity treatment: normative or cause for concern? Obes Sci Pract 2016; 2:366-375. [PMID: 28090341 PMCID: PMC5192548 DOI: 10.1002/osp4.73] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 09/11/2016] [Accepted: 09/13/2016] [Indexed: 11/16/2022] Open
Abstract
Objectives The objectives of the study are to characterize the frequency and size of small weight gains during behavioural weight loss treatment and to evaluate the relationship between small weight gains and weight loss outcomes. Methods Participants (n = 281) in a year‐long behavioural weight loss programme were weighed at treatment sessions, and between‐session weight gains were classified into several categories based on size. The occurrence of different gain magnitudes and their relation to weight loss were examined during both the active weight loss (months 1–6) and weight loss maintenance (months 7–12) phases of treatment. Results Weight gains were common during both phases of treatment, with smaller gains occurring more frequently than larger gains. Greater frequency of all gain magnitudes was associated with lesser weight loss during both phases. Additionally, participants who had just one or two weight gains of the smallest size examined (1.0–1.9 lb) lost less weight than those who had no gains. Conclusions Small gains appear to reflect true weight gain due to poor adherence to behavioural recommendations and are associated with worse weight loss outcomes, even when limited in number. Future research should examine how best to prevent small weight gains from occurring and how clinicians and participants should respond when a weight gain does occur to promote weight control success.
Collapse
Affiliation(s)
| | - Monika Gaspar
- Department of Psychology Drexel University Philadelphia PA USA
| | | | - Fengqing Zhang
- Department of Psychology Drexel University Philadelphia PA USA
| | - Evan M Forman
- Department of Psychology Drexel University Philadelphia PA USA
| | - Meghan L Butryn
- Department of Psychology Drexel University Philadelphia PA USA
| |
Collapse
|
28
|
Pacanowski CR, Pisetsky EM, Berg KC, Crosby RD, Crow SJ, Linde JA, Mitchell JE, Engel SG, Klein MH, Smith TL, Le Grange D, Wonderlich SA, Peterson CB. Self-weighing behavior in individuals with eating disorders. Int J Eat Disord 2016; 49:817-21. [PMID: 27188448 PMCID: PMC5604338 DOI: 10.1002/eat.22537] [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: 06/02/2015] [Revised: 02/17/2016] [Accepted: 02/22/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To describe the frequency of self-weighing and reactions to prescribed weekly weighing among individuals with eating disorder (ED) diagnoses, and to compare individuals weighing more or less frequently on mass index (BMI) and the Eating Disorder Examination (EDE) subscales. METHOD Baseline EDE and demographics from five studies (N = 758). RESULTS Self-weighing was most frequent among individuals with anorexia nervosa (AN), followed by those with bulimia nervosa (BN) and binge eating disorder (BED). On average, participants reacted moderately negative to prescribed weekly weighing. No relationship between weighing frequency and BMI was evident in any sample. There was indication of greater pathology (i.e., restraint, shape concern, weight concern, global) in AN with more frequent weighing. In BN, mixed evidence emerged to support a relationship between more frequent weighing and higher shape concern, weight concern, and global score. In BED, higher restraint was found in those who weighed versus those who did not. DISCUSSION Weighing frequency in each eating disorder (ED) sample was to some extent associated with greater ED severity, but not BMI. Future research should examine relationships between self-weighing, reactions to changing weighing frequency, and ED symptomatology in both ED and non-ED groups to understand the impact of self-weighing in heterogeneous populations. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:817-821).
Collapse
Affiliation(s)
- Carly R. Pacanowski
- Department of Psychiatry, The University of Minnesota, Minneapolis, Minnesota,Department of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota,Neuropsychiatric Research Institute, Fargo, North Dakota,Correspondence to: C. R. Pacanowski,
| | - Emily M. Pisetsky
- Department of Psychiatry, The University of Minnesota, Minneapolis, Minnesota
| | - Kelly C. Berg
- Department of Psychiatry, The University of Minnesota, Minneapolis, Minnesota
| | - Ross D. Crosby
- Neuropsychiatric Research Institute, Fargo, North Dakota,University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Scott J. Crow
- Department of Psychiatry, The University of Minnesota, Minneapolis, Minnesota,The Emily Program, St. Paul, Minnesota
| | - Jennifer A. Linde
- Department of Psychiatry, The University of Minnesota, Minneapolis, Minnesota
| | | | - Scott G. Engel
- Neuropsychiatric Research Institute, Fargo, North Dakota,University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | | | - Tracey L. Smith
- VA South Central Mental Illness Research, Education & Clinical Center; VA HSR&D Center for Innovations in Quality, Effectiveness & Safety (IQuEST), Dept. of Psychiatry, Baylor College of Medicine, Houston, Texas, United States
| | - Daniel Le Grange
- Department of Psychiatry, The University of California, San Francisco, California
| | - Stephen A. Wonderlich
- Neuropsychiatric Research Institute, Fargo, North Dakota,University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Carol B. Peterson
- Department of Psychiatry, The University of Minnesota, Minneapolis, Minnesota,The Emily Program, St. Paul, Minnesota
| |
Collapse
|
29
|
Qualitative analysis of the role of self-weighing as a strategy of weight control for weight-loss maintainers in comparison with a normal, stable weight group. Appetite 2016; 105:604-10. [PMID: 27374738 DOI: 10.1016/j.appet.2016.06.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 06/25/2016] [Accepted: 06/27/2016] [Indexed: 11/20/2022]
Abstract
Self-weighing seems to have a primary role in weight-loss maintenance. The use of this strategy may help correct even slight weight regain and contribute to long-term weight stability. However, self-weighing has also been associated with negative psychological health consequences in specific subgroups. This study aimed to explore the use and the behavioral and psychological consequences of self-weighing in a group of weight-loss maintainers (WLoMs). We chose a qualitative design to conduct this investigation. Eighteen WLoMs were interviewed and compared to a matched comparison group of 18 participants with a lifelong normal stable weight (NSW). Analyses showed that most WLoMs needed regular self-weighing to be aware of their weight. The weight displayed on the scale helped WLoMs sustain the continuous efforts needed to maintain weight loss and also at times triggered corrective actions that were sometimes drastic. Weight changes generated both negative and positive affect among WLoMs, who could experience anxiety because of self-weighing or have their self-esteem impaired in the case of weight gain. In comparison, the NSW group rarely used self-weighing. They relied on a conscious way of living to control their weight and needed fewer strategies. NSW participants simply went back to their routine when they felt a slight increase in their weight, without experiencing consequences on their mood or self-esteem. Regular self-weighing as a component of weight-loss maintenance should be encouraged to help WLoMs regulate their food and physical activity, provided that potential consequences on psychological well-being, including self-esteem, are screened and addressed when needed.
Collapse
|
30
|
Zheng Y, Burke LE, Danford CA, Ewing LJ, Terry MA, Sereika SM. Patterns of self-weighing behavior and weight change in a weight loss trial. Int J Obes (Lond) 2016; 40:1392-6. [PMID: 27113642 DOI: 10.1038/ijo.2016.68] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 02/13/2016] [Accepted: 04/01/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND/OBJECTIVES Regular self-weighing has been associated with weight loss and maintenance in adults enrolled in a behavioral weight loss intervention; however, few studies have examined the patterns of adherence to a self-weighing protocol. The study aims were to (1) identify patterns of self-weighing behavior; and (2) examine adherence to energy intake and step goals and weight change by self-weighing patterns. SUBJECTS/METHODS This was a secondary analysis of self-monitoring and assessment weight data from a 12-month behavioral weight loss intervention study. Each participant was given a scale that was Wi-Fi-enabled and transmitted the date-stamped weight data to a central server. Group-based trajectory modeling was used to identify distinct classes of trajectories based on the number of days participants self-weighed over 51 weeks. RESULTS The sample (N=148) was 90.5% female, 81.1% non-Hispanic white, with a mean (s.d.) age of 51.3 (10.1) years, had completed an average of 16.4 (2.8) years of education and had mean body mass index of 34.1 (4.6) kg m(-2). Three patterns of self-weighing were identified: high/consistent (n=111, 75.0% self-weighed over 6 days per week regularly); moderate/declined (n=24, 16.2% declined from 4-5 to 2 days per week gradually); and minimal/declined (n=13, 8.8% declined from 5-6 to 0 days per week after week 33). The high/consistent group achieved greater weight loss than either the moderate/declined and minimal/declined groups at 6 months (-10.19%±5.78%, -5.45%±4.73% and -2.00%±4.58%) and 12 months (-9.90%±8.16%, -5.62%±6.28% and 0.65%±3.58%), respectively (P<0.001). The high/consistent group had a greater mean number days per week of adherence to calorie intake goal or step goal but not higher than the moderate/declined group. CONCLUSIONS This is the first study to reveal distinct temporal patterns of self-weighing behavior. The majority of participants were able to sustain a habit of daily self-weighing with regular self-weighing leading to weight loss and maintenance as well as adherence to energy intake and step goals.
Collapse
Affiliation(s)
- Y Zheng
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA, USA
| | - L E Burke
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.,University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.,Clinical and Translational Science Institute, Pittsburgh, PA, USA
| | - C A Danford
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | - L J Ewing
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - M A Terry
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - S M Sereika
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.,University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.,Clinical and Translational Science Institute, Pittsburgh, PA, USA
| |
Collapse
|
31
|
Mhatre A, Duvall J, Ding D, Cooper R, Pearlman J. Design and focus group evaluation of a bed-integrated weight measurement system for wheelchair users. Assist Technol 2016; 28:193-201. [PMID: 26852778 DOI: 10.1080/10400435.2016.1140690] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Regular weight monitoring is known to help with weight management, which is an important part of maintaining a healthy, active lifestyle. Unfortunately, weight monitoring is challenging for wheelchair users because the few scales that are available are expensive and very large. Consequently, wheelchair users typically learn their weight at infrequent visits to their healthcare providers, which likely contributes to higher prevalence of obesity-related health risks among this population. In this article, we describe the design and development of the Embedded Scale, or E-Scale, which is a bed-integrated bodyweight measuring system that allows a user to measure and track their weight. The E-Scale team followed a standard product development approach to build the E-Scale prototype. Bench testing results indicate that the performance of the prototype is on par with commercially available wheelchair scales (capacity = 1,200 lbs, accuracy = 1.73 lbs, and precision = ± 0.35 lbs over one-fourth rated capacity). Institutional Review Board (IRB)-approved focus groups with 20 Veterans who use wheelchairs for mobility were conducted to gather feedback about the design, which was very positive. Development and testing results suggests the E-Scale technology is feasible and may provide a valuable tool to help wheelchair users manage their weight.
Collapse
Affiliation(s)
- Anand Mhatre
- a Human Engineering Research Laboratories , Department of Veterans Affairs , Pittsburgh , Pennsylvania , USA.,b Department of Rehabilitation Science and Technology , University of Pittsburgh , Pittsburgh , Pennsylvania , USA
| | - Jonathan Duvall
- a Human Engineering Research Laboratories , Department of Veterans Affairs , Pittsburgh , Pennsylvania , USA.,b Department of Rehabilitation Science and Technology , University of Pittsburgh , Pittsburgh , Pennsylvania , USA
| | - Dan Ding
- a Human Engineering Research Laboratories , Department of Veterans Affairs , Pittsburgh , Pennsylvania , USA.,b Department of Rehabilitation Science and Technology , University of Pittsburgh , Pittsburgh , Pennsylvania , USA
| | - Rory Cooper
- a Human Engineering Research Laboratories , Department of Veterans Affairs , Pittsburgh , Pennsylvania , USA.,b Department of Rehabilitation Science and Technology , University of Pittsburgh , Pittsburgh , Pennsylvania , USA
| | - Jon Pearlman
- a Human Engineering Research Laboratories , Department of Veterans Affairs , Pittsburgh , Pennsylvania , USA.,b Department of Rehabilitation Science and Technology , University of Pittsburgh , Pittsburgh , Pennsylvania , USA
| |
Collapse
|
32
|
Bertz F, Pacanowski CR, Levitsky DA. Frequent Self-Weighing with Electronic Graphic Feedback to Prevent Age-Related Weight Gain in Young Adults. Obesity (Silver Spring) 2015; 23:2009-14. [PMID: 26414563 PMCID: PMC4751025 DOI: 10.1002/oby.21211] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 06/16/2015] [Accepted: 06/16/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVE An intervention using Wi-Fi scales and graphic e-mail feedback, the caloric titration method (CTM), to reduce age-related weight gain over 1 year among college students was evaluated. METHODS First-year college students (n = 167) were randomized to CTM or control (C) groups and provided Wi-Fi scales. The CTM group was instructed to weigh daily, view a weight graph e-mailed to them after weighing, and try to maintain their weight. The C group could weigh at any time but did not receive feedback. At 6 months and 1 year, the C group provided weights. For intention to treat analysis, an adjusted mixed model was used to analyze the effect of the intervention. RESULTS Baseline body mass index was 22.9 ± 3.0 kg/m(2) . Ninety-five percent of the CTM participants weighed ≥ 3 times/week, compared to 15% in the C group (P < 0.001). After 1 year, the C group had gained 1.1 ± .4 kg whereas the CTM group lost 0.5 ± 3.7 kg (F = 3.39, P = 0.035). The difference in weight change between the two groups at 1 year was significant (P = 0.004). Retention was 81%. CONCLUSIONS CTM intervention was effective in preventing age-related weight gain in young adults over 1 year and thus offers promise to reduce overweight and obesity.
Collapse
Affiliation(s)
- Fredrik Bertz
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | - Carly R Pacanowski
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - David A Levitsky
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
- Department of Psychology, Cornell University, Ithaca, New York, USA
| |
Collapse
|
33
|
Evans EH, Araújo-Soares V, Adamson A, Batterham AM, Brown H, Campbell M, Dombrowski SU, Guest A, Jackson D, Kwasnicka D, Ladha K, McColl E, Olivier P, Rothman AJ, Sainsbury K, Steel AJ, Steen IN, Vale L, White M, Wright P, Sniehotta FF. The NULevel trial of a scalable, technology-assisted weight loss maintenance intervention for obese adults after clinically significant weight loss: study protocol for a randomised controlled trial. Trials 2015; 16:421. [PMID: 26395774 PMCID: PMC4580361 DOI: 10.1186/s13063-015-0931-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 08/27/2015] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Effective weight loss interventions are widely available but, after weight loss, most individuals regain weight. This article describes the protocol for the NULevel trial evaluating the effectiveness and cost-effectiveness of a systematically developed, inexpensive, scalable, technology-assisted, behavioural intervention for weight loss maintenance (WLM) in obese adults after initial weight loss. METHODS/DESIGN A 12-month single-centre, two-armed parallel group, participant randomised controlled superiority trial is underway, recruiting a total of 288 previously obese adults after weight loss of ≥5 % within the previous 12 months. Participants are randomly assigned to intervention or control arms, with a 1:1 allocation, stratified by sex and percentage of body weight lost (<10 % vs ≥10 %). Change in weight (kg) from baseline to 12 months is the primary outcome. Weight, other anthropometric variables and 7-day physical activity (assessed via accelerometer) measures are taken at 0 and 12 months. Questionnaires at 0, 6 and 12 months assess psychological process variables, health service use and participant costs. Participants in the intervention arm initially attend an individual face-to-face WLM consultation with an intervention facilitator and then use a mobile internet platform to self-monitor and report their diet, daily activity (via pedometer) and weight through daily weighing on wirelessly connected scales. Automated feedback via mobile phone, tailored to participants' weight regain and goal progress is provided. Participants in the control arm receive quarterly newsletters (via links embedded in text messages) and wirelessly connected scales. Qualitative process evaluation interviews are conducted with a subsample of up to 40 randomly chosen participants. Acceptability and feasibility of procedures, cost-effectiveness, and relationships among socioeconomic variables and WLM will also be assessed. DISCUSSION It is hypothesised that participants allocated to the intervention arm will show significantly lower levels of weight regain from baseline than those in the control arm. To date, this is the first WLM trial using remote real-time weight monitoring and mobile internet platforms to deliver a flexible, efficient and scalable intervention, tailored to the individual. This trial addresses a key research need and has the potential to make a vital contribution to the evidence base to inform future WLM policy and provision. TRIAL REGISTRATION http://www.isrctn.com/ISRCTN14657176 (registration date 20 March 2014).
Collapse
Affiliation(s)
- Elizabeth H Evans
- Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
| | - Vera Araújo-Soares
- Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
| | - Ashley Adamson
- Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
- Fuse, the UK CRC Centre for Translational Research in Public Health, Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
- Human Nutrition Research Centre, Institute of Health & Society, University of Newcastle, William Leech Building, Medical School, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK.
| | - Alan M Batterham
- Health and Social Care Institute, Teesside University, Parkside West, Middlesbrough, Tees Valley, TS1 3BA, UK.
| | - Heather Brown
- Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
| | - Miglena Campbell
- Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
| | - Stephan U Dombrowski
- School of Natural Sciences, Division of Psychology, University of Stirling, Stirling, FK9 4LA, UK.
| | - Alison Guest
- Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
| | - Daniel Jackson
- Open Lab, School of Computing Science, Newcastle University, 89 Sandyford Road, Newcastle upon Tyne, NE1 8HW, UK.
| | - Dominika Kwasnicka
- Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
- Fuse, the UK CRC Centre for Translational Research in Public Health, Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
| | - Karim Ladha
- Open Lab, School of Computing Science, Newcastle University, 89 Sandyford Road, Newcastle upon Tyne, NE1 8HW, UK.
| | - Elaine McColl
- Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
- Newcastle Clinical Trials Unit, Newcastle University, 1-4 Claremont Terrace, Newcastle upon Tyne, NE2 4AE, UK.
| | - Patrick Olivier
- Open Lab, School of Computing Science, Newcastle University, 89 Sandyford Road, Newcastle upon Tyne, NE1 8HW, UK.
| | - Alexander J Rothman
- Department of Psychology, University of Minnesota, 75 East River Road, Minneapolis, MN, 55455, USA.
| | - Kirby Sainsbury
- Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
| | - Alison J Steel
- Newcastle Clinical Trials Unit, Newcastle University, 1-4 Claremont Terrace, Newcastle upon Tyne, NE2 4AE, UK.
| | - Ian Nicholas Steen
- Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
| | - Luke Vale
- Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
| | - Martin White
- Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
| | - Peter Wright
- Open Lab, School of Computing Science, Newcastle University, 89 Sandyford Road, Newcastle upon Tyne, NE1 8HW, UK.
| | - Falko F Sniehotta
- Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
- Fuse, the UK CRC Centre for Translational Research in Public Health, Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
| |
Collapse
|
34
|
Pacanowski CR, Levitsky DA. Frequent Self-Weighing and Visual Feedback for Weight Loss in Overweight Adults. J Obes 2015; 2015:763680. [PMID: 26064677 PMCID: PMC4443883 DOI: 10.1155/2015/763680] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 04/08/2015] [Accepted: 04/13/2015] [Indexed: 11/24/2022] Open
Abstract
Evidence has suggested that self-weighing may be beneficial for weight control in adults, but few studies have independently assessed the contribution of this behavior to weight loss. This study experimentally tested daily self-weighing and visual feedback (the Caloric Titration Method (CTM)) as a weight loss and weight loss maintenance intervention over 2 years. 162 overweight individuals were randomized to the CTM intervention or delayed treatment control group. In year 1, weight change was compared between groups, and in year 2, the control group started using the CTM while the intervention group continued using the CTM for maintenance. A significant difference in weight loss over the first year (CTM n = 70; 2.6 ± 5.9 kg versus control n = 65; 0.5 ± 4.4 kg, p = 0.019) was qualified by a group × gender × time interaction (p = 0.002) such that men lost more weight using the CTM. In year 2, the CTM group maintained their weight and the control group lost an amount similar to the intervention group in year 1. Daily self-weighing and visual feedback facilitated a minimal amount of weight loss and maintenance of this loss. Future research investigating characteristics of those who benefit from this type of self-directed intervention is warranted.
Collapse
Affiliation(s)
- Carly R. Pacanowski
- University of Minnesota Division of Epidemiology & Community Health, 1300 S. 2nd Street, Suite 300, Minneapolis, MN 55454, USA
- Cornell University Division of Nutritional Sciences, 112 Savage Hall, Ithaca, NY 14853, USA
- *Carly R. Pacanowski:
| | - David A. Levitsky
- University of Minnesota Division of Epidemiology & Community Health, 1300 S. 2nd Street, Suite 300, Minneapolis, MN 55454, USA
- Cornell University Division of Nutritional Sciences, 112 Savage Hall, Ithaca, NY 14853, USA
| |
Collapse
|