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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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2
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Sanders SA, Wallace ML, Burke LE, Tapia AL, Rathbun SL, Casas AD, Gary-Webb TL, Davis EM, Méndez DD. Examining demographic and psychosocial factors related to self-weighing behavior during pregnancy and postpartum periods. Prev Med Rep 2023; 35:102320. [PMID: 37554350 PMCID: PMC10404542 DOI: 10.1016/j.pmedr.2023.102320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 08/10/2023] Open
Abstract
Black childbearing individuals in the US experience a higher risk of postpartum weight retention (PPWR) compared to their White counterparts. Given that PPWR is related to adverse health outcomes, it is important to investigate predictors of weight-related health behaviors, such as self-weighing (i.e., using a scale at home). Regular self-weighing is an evidence-based weight management strategy, but there is minimal insight into sociodemographic factors related to frequency. The Postpartum Mothers Mobile Study (PMOMS) facilitated longitudinal ambulatory weight assessments to investigate racial inequities in PPWR. Our objective for the present study was to describe self-weighing behavior during and after pregnancy in the PMOMS cohort, as well as related demographic and psychosocial factors. Applying tree modeling and multiple regression, we examined self-weighing during and after pregnancy. Participants (N = 236) were 30.2 years old on average (SD = 4.7), with the majority being college-educated (53.8%, n = 127), earning at least $30,000 annually (61.4%, n = 145), and self-identifying as non-Hispanic White (NHW; 68.2%, n = 161). Adherence to regular self-weighing (at least once weekly) was highest among participants during pregnancy, with a considerable decline after giving birth. Low-income Black participants (earning < $30,000) were significantly less likely to reach a completion rate of ≥ 80% during pregnancy (AOR = 0.10) or the postpartum period (AOR = 0.16), compared to NHW participants earning at least $30,000 annually. Increases in perceived stress were associated with decreased odds of sustained self-weighing after delivery (AOR = 0.79). Future research should consider behavioral differences across demographic intersections, such as race and socioeconomic status, and the impact on efficacy of self-weighing.
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Affiliation(s)
- Sarah Annalise Sanders
- Department of Behavioral & Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Meredith L. Wallace
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Lora E. Burke
- Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
| | - Amanda L. Tapia
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Stephen L. Rathbun
- Department of Epidemiology & Biostatistics, College of Public Health, University of Georgia, Athens, GA, United States
| | - Andrea D. Casas
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Tiffany L. Gary-Webb
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Esa M. Davis
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Dara D. Méndez
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
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Gillespie CW, Robinson EG. Habits and attitudes about eating and self-weighing among adults who are recovered, recovering, or partially recovered from eating disorders: an open-ended survey study. Eat Weight Disord 2022; 27:1223-1228. [PMID: 34185308 DOI: 10.1007/s40519-021-01248-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 06/12/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The purpose of this study was to add experiential data from individuals with lived experiences of eating disorder recovery to the existing literature, regarding daily habits and attitudes toward eating and self-weighing. METHODS An anonymous open-ended online survey was completed by 32 adults. One was excluded due to current eating disordered behaviors. Remaining participants were divided into three self-identified groups: Recovered from an eating disorder, Recovering from an eating disorder, and Partially Recovered from an eating disorder. RESULTS Results showed the Recovered group reported more years of recovery than the other two groups, named "recovered" as part of their identity, practiced intuitive or regular eating instead of a prescribed meal plan, and held negative attitudes about self-weighing. The Recovering group reported, "I will always be recovering," and either followed prescribed meal plans or weighed themselves and did not expect to change those behaviors. The Partially Recovered group did not see themselves as recovered, but aspired to become recovered, and if they followed a prescribed meal plan or self-weighed, then they expected to change these behaviors in the future. CONCLUSIONS There is a difference in years of recovery, meal planning, and scale attitudes, among people who self-identify in the recovery categories of Recovered, Recovering, and Partially Recovered. These results can (1) help providers better serve clients with eating disorders; (2) help researchers better understand individuals who have suffered from eating disorders and are in the recovery process; and (3) offer guidance and hope for those in recovery. LEVEL OF EVIDENCE Level IV, Evidence obtained from multiple time series analysis such as case studies. (NB: Dramatic results in uncontrolled trials might also be regarded as this type of evidence).
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Affiliation(s)
| | - Emelyn G Robinson
- Drake University School of Education, 2507 University Avenue, Des Moines, IA, USA
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4
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Hahn SL, Pacanowski CR, Loth KA, Miller J, Eisenberg ME, Neumark-Sztainer D. Self-weighing among young adults: who weighs themselves and for whom does weighing affect mood? A cross-sectional study of a population-based sample. J Eat Disord 2021; 9:37. [PMID: 33691780 PMCID: PMC7945352 DOI: 10.1186/s40337-021-00391-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Self-weighing is widespread among young adults and is sometimes recommended by healthcare providers for weight management. The present study aims to deepen our understanding of who is frequently self-weighing among young adults, and to examine for whom self-weighing impacts mood based on weighing frequency and other eating and weight-related characteristics. METHODS Survey data were collected from a large population-based sample of young adults (31.1 ± 1.6y) participating in Project EAT-IV (n = 1719). Cross-sectional data were stratified across sex and analyzed with chi-square, t-tests, and linear and logistic regressions controlling for age, ethnicity/race, education level, and income. RESULTS Self-weighing frequency was higher among male and female young adults with a current eating disorder, those trying to lose weight or who endorsed any disordered eating behaviors or cognition, and females with higher BMI. Young adult females were significantly more likely than males to report that self-weighing impacted their mood (53% vs 27%, p < 0.05). Among both male and female young adults, there was a higher probability of participants reporting that self-weighing impacted their mood among those who were self-weighing more frequently, had higher BMI, were trying to lose weight, and endorsed disordered eating behaviors or cognitions. CONCLUSION Findings suggest that for many young adults, particularly females and those with weight-related concerns, self-weighing is a behavior that comes with emotional valence. The emotional consequences of self-weighing should be considered when making public health and clinical recommendations regarding the usefulness of self-weighing.
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Affiliation(s)
- Samantha L Hahn
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA. .,Department of Psychiatry & Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, MN, USA.
| | - Carly R Pacanowski
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA
| | - Katie A Loth
- Department of Family Medicine and Community Health, Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Jonathan Miller
- Department of Family Medicine and Community Health, Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Marla E Eisenberg
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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5
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Ferrey AE, Astbury NM, Kenworthy Y, Mackillop L, Frie K, Jebb SA. Exploring women's thoughts on self-weighing during pregnancy: results of the Self-Weighing in Pregnancy: Experiences (SWIPE) study. BMC Pregnancy Childbirth 2021; 21:154. [PMID: 33610166 PMCID: PMC7897370 DOI: 10.1186/s12884-021-03636-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 02/10/2021] [Indexed: 11/22/2022] Open
Abstract
Background Excess gestational weight gain is common and an important risk factor for adverse pregnancy outcomes. Regular weighing can be used to assess and manage weight gain, but NICE guidelines do not recommend routine weighing during antenatal care. Trials that have tested the effectiveness of self-weighing to manage GWG have been unsuccesful in engaging women in regular self-weighing, although the reasons for lack of engagement are not fully understood. This study aimed to understand why this lack of engagement occurred by exploring the naturally occurring thoughts and feelings of pregnant women (9 to 15 weeks gestational age) who were asked to weigh themselves at home. Methods Twenty-five women were recruited to take part. Participants completed short questionnaires at their first-trimester and 20-week scans. After recruitment, participants were asked to weigh themselves at roughly the same time each week for 8 weeks. Whilst they weighed themselves they were asked to audio-record their current weight and describe any thoughts or feelings that occurred as they weighed themselves. These audio recordings were then sent to researchers using a secure messaging service. Results Most of the recruited women (56%) were unaware of guidelines for gestational weight gain, and only 40% could identify the ideal rate of GWG for their BMI group. Thematic analysis of the think-aloud recordings resulted in three main themes: “understanding weight gain in pregnancy”, “taking action to prevent weight gain” and “reactions to self-weighing”. Overall, there was a relatively positive response to self-weighing and some participants used self-weighing to reflect on the reasons for weight gain and plan actions they could take to avoid excess gain. Negative emotional responses tended to be related to a lack of guidance about what level of weight gain or loss was “healthy”, or to other worries about the pregnancy. Of the women recruited who submitted at least one think aloud recording (n 10), 80% found self-weighing to be useful, and said they would likely continue to self-weigh at home. Conclusions Women had complex emotions about self-weighing during pregnancy but overall found it useful, suggesting it could be encouraged as part of self-regulatory interventions to control GWG. Clear guidelines about appropriate gestational weight gain could help to reduce anxiety. Trial registration The study was prospectively registered with ISRCTN ISRCTN10035244. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03636-5.
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Affiliation(s)
- Anne E Ferrey
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK. .,NIHR Oxford Biomedical Research Centre, Oxford, UK.
| | - Nerys M Astbury
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.,NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Yvonne Kenworthy
- NIHR Oxford Biomedical Research Centre, Oxford, UK.,Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - Lucy Mackillop
- NIHR Oxford Biomedical Research Centre, Oxford, UK.,Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK.,Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Kerstin Frie
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Susan A Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.,NIHR Oxford Biomedical Research Centre, Oxford, UK
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Sakane N, Oshima Y, Kotani K, Suganuma A, Nirengi S, Takahashi K, Sato J, Suzuki S, Izumi K, Kato M, Noda M, Kuzuya H. Self-weighing frequency and the incidence of type 2 diabetes: post hoc analysis of a cluster-randomized controlled trial. BMC Res Notes 2020; 13:375. [PMID: 32771041 PMCID: PMC7414687 DOI: 10.1186/s13104-020-05215-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/29/2020] [Indexed: 11/18/2022] Open
Abstract
Objectives Frequent self-weighing is associated with weight loss and maintenance, but the relationship between frequent self-weighing and the incidence of type 2 diabetes (T2D) remains unclear. The study aim was to examine the association between self-weighing frequency and the incidence of T2D in people with impaired fasting glucose (IFG). Results We tested the hypothesis that self-weighing frequency and the incidence of T2D are associated in 2607 people with IFG (1240 in the intervention arm; 1367 in the self-directed control arm). Both arms received a weighing scale with storage function. Healthcare providers offered a one-year goal-focused lifestyle intervention via phone. Participants were divided into 4 categories based on self-weighing frequency (No data sent [reference group], low: < 2 times/week, middle: 3–4 times/week, and high: 5–7 times/week). The adjusted hazard ratio (AHR) and 95% confidence interval (CI) were calculated. In the intervention arm, middle- and high-frequency self-weighing were associated with a decreased incidence of T2D relative to the reference group (AHR = 0.56, 95% CI [0.32, 0.98] and AHR = 0.43, 95% CI [0.25, 0.74], respectively). In the control arm, high-frequency self-weighing was also associated with a decreased incidence of T2D relative to the reference group (AHR = 0.54, 95% CI [0.35, 0.83]). Trial registration This trial has been registered with the University Hospital Medical Information Network (UMIN000000662).
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Affiliation(s)
- Naoki Sakane
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusamukaihata-cho, Fushimi-ku, Kyoto, 612-8555, Japan.
| | - Yoshitake Oshima
- Faculty of Humanities and Social Sciences, University of Marketing and Distribution Sciences, Hyogo, Japan
| | - Kazuhiko Kotani
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusamukaihata-cho, Fushimi-ku, Kyoto, 612-8555, Japan.,Division of Community and Family Medicine, Jichi Medical University, Tochigi, Japan
| | - Akiko Suganuma
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusamukaihata-cho, Fushimi-ku, Kyoto, 612-8555, Japan
| | - Shinsuke Nirengi
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusamukaihata-cho, Fushimi-ku, Kyoto, 612-8555, Japan
| | - Kaoru Takahashi
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusamukaihata-cho, Fushimi-ku, Kyoto, 612-8555, Japan.,Hyogo Health Service Association, Hyogo, Japan
| | - Juichi Sato
- Department of General Medicine/Family & Community Medicine, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Kazuo Izumi
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Masayuki Kato
- Toranomon Hospital Health Management Center, Tokyo, Japan
| | - Mitsuhiko Noda
- Ichikawa Hospital, International University of Health and Welfare, Chiba, Japan
| | - Hideshi Kuzuya
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusamukaihata-cho, Fushimi-ku, Kyoto, 612-8555, Japan.,Koseikai Takeda Hospital, Kyoto, Japan
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Fahey MC, Klesges RC, Kocak M, Talcott GW, Krukowski RA. Seasonal fluctuations in weight and self-weighing behavior among adults in a behavioral weight loss intervention. Eat Weight Disord 2020; 25:921-928. [PMID: 31093925 PMCID: PMC6856417 DOI: 10.1007/s40519-019-00707-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 05/02/2019] [Indexed: 10/26/2022] Open
Abstract
PURPOSE The current study aimed to observe potential seasonal fluctuations in weight and self-weighing behavior among a diverse sample of adults engaged in a behavioral weight loss intervention. METHODS Active duty personnel (N = 248) were randomized to either a counselor-initiated or self-paced 12-month behavioral weight loss intervention promoting daily self-weighing. Body weight and self-weighing frequency were collected from electronic scales (e-scales) provided at baseline. RESULTS Overall, participants lost weight from winter to spring (p = 0.02) and gained weight from fall to winter (p < 0.001). No demographic differences in weight changes were observed. Participants self-weighed less frequently during summer compared to spring (p < 0.0001), less in fall compared to summer (p < 0.0001), and less in winter compared to fall (p < 0.0001). In multivariate models, weight change and self-weighing frequency during the previous season, as well as days since randomization and intervention intensity were associated with seasonal weight changes. CONCLUSIONS This study is the first to observe seasonal fluctuations of weight and self-weighing behavior among adults actively engaged in a weight loss intervention, consistent with research in the general population. Findings highlight the importance of acknowledging seasonal influence within weight loss programs and trials. LEVEL OF EVIDENCE Level I, randomized controlled trial.
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Affiliation(s)
- Margaret C Fahey
- Department of Psychology, The University of Memphis, 400 Innovation Drive, Memphis, TN, 38111, USA.
| | - Robert C Klesges
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N Pauline Street, Memphis, TN, 38105, USA
- Department of Public Health Sciences, School of Medicine, University of Virginia, 1215 Lee Street, Charlottesville, VA, 22908, USA
| | - Mehmet Kocak
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N Pauline Street, Memphis, TN, 38105, USA
| | - Gerald W Talcott
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N Pauline Street, Memphis, TN, 38105, USA
- Department of Public Health Sciences, School of Medicine, University of Virginia, 1215 Lee Street, Charlottesville, VA, 22908, USA
| | - Rebecca A Krukowski
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N Pauline Street, Memphis, TN, 38105, USA
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8
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Zheng Y, Sereika SM, Burke LE, Olgin JE, Marcus GM, Aschbacher K, Tison GH, Pletcher MJ. Temporal patterns of self-weighing behavior and weight changes assessed by consumer purchased scales in the Health eHeart Study. J Behav Med 2019; 42:873-82. [PMID: 30649648 DOI: 10.1007/s10865-018-00006-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 12/13/2018] [Indexed: 10/27/2022]
Abstract
Self-weighing may promote attainment and maintenance of healthy weight; however, the natural temporal patterns and factors associated with self-weighing behavior are unclear. The aims of this secondary analysis were to (1) identify distinct temporal patterns of self-weighing behaviors; (2) explore factors associated with temporal self-weighing patterns; and (3) examine differences in percent weight changes by patterns of self-weighing over time. We analyzed electronically collected self-weighing data from the Health eHeart Study, an ongoing longitudinal research study coordinated by the University of California, San Francisco. We selected participants with at least 12 months of data since the day of first use of a WiFi- or Bluetooth-enabled digital scale. The sample (N = 1041) was predominantly male (77.5%) and White (89.9%), with a mean age of 46.5 ± 12.3 years and a mean BMI of 28.3 ± 5.9 kg/m2 at entry. Using group-based trajectory modeling, six distinct temporal patterns of self-weighing were identified: non-users (n = 120, 11.5%), weekly users (n = 189, 18.2%), rapid decliners (n = 109, 10.5%), increasing users (n = 160, 15.4%), slow decliners (n = 182, 17.5%), and persistent daily users (n = 281, 27.0%). Individuals who were older, female, or self-weighed 6-7 days/week at week 1 were more likely to follow the self-weighing pattern of persistent daily users. Predicted self-weighing trajectory group membership was significantly associated with weight change over time (p < .001). In conclusion, we identified six distinct patterns of self-weighing behavior over the 12-month period. Persistent daily users lost more weight compared with groups with less frequent patterns of scale use.
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9
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Fahey MC, Klesges RC, Kocak M, Wang J, Talcott GW, Krukowski RA. Do the holidays impact weight and self-weighing behaviour among adults engaged in a behavioural weight loss intervention? Obes Res Clin Pract 2019; 13:395-397. [PMID: 31182293 PMCID: PMC6698213 DOI: 10.1016/j.orcp.2019.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 04/23/2019] [Accepted: 05/08/2019] [Indexed: 01/02/2023]
Abstract
We examined the U.S. holiday period impact on weight gain, self-weighing, and treatment success among adults in a weight loss intervention (N=171). Using electronic scales, body weight and self-weighing frequency were compared by time period [i.e., pre-holiday, holiday (November 15-January 1), post-holiday]. Self-weighing was less frequent during holiday period (p<.01), and longer intervention engagement was associated with weight gain (p<.0001) during this time. Enrollment during holiday period was associated with 2.3% 12-month weight loss. Holiday period enrollment might be beneficial for preventing holiday weight gain and facilitating successful intervention outcomes.
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Affiliation(s)
- Margaret C Fahey
- The University of Memphis, Department of Psychology, 400 Innovation Drive Memphis, TN, 38111, USA.
| | - Robert C Klesges
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N Pauline Street Memphis, TN, 38105, USA; University of Virginia, Department of Public Health Sciences, School of Medicine, 1215 Lee Street, Charlottesville, VA, 22908, USA
| | - Mehmet Kocak
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N Pauline Street Memphis, TN, 38105, USA
| | - Jiajing Wang
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N Pauline Street Memphis, TN, 38105, USA
| | - Gerald W Talcott
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N Pauline Street Memphis, TN, 38105, USA; University of Virginia, Department of Public Health Sciences, School of Medicine, 1215 Lee Street, Charlottesville, VA, 22908, USA
| | - Rebecca A Krukowski
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N Pauline Street Memphis, TN, 38105, USA
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10
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Abstract
Little is known about which specific weight management skills bariatric patients find most and least valuable. Participants completed a measure assessing their usage of weight management skills at a follow-up appointment one or more years after undergoing bariatric surgery. Decreased usage of skills was associated with unsuccessful weight outcome, defined as losing less than 50% of excess weight, as well as weight regain. Weighing regularly was the skill selected most often by successful participants as helpful, and was chosen by a significantly smaller percentage of unsuccessful participants and those who regained a clinically significant amount of weight. A majority of both successful and unsuccessful participants indicated that they had discontinued food journaling. Weighing regularly may be perceived as a more useful method of self-monitoring.
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Affiliation(s)
- Jamal H Essayli
- Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA.
| | - Caitlin A LaGrotte
- Center for Obesity Research and Education, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA, 19140, USA
| | - Erin L Fink-Miller
- Penn State Harrisburg, 777 West Harrisburg Pike, Middletown, PA, 17057, USA
| | - Andrea Rigby
- Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA
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11
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Rosenbaum DL, Espel HM, Butryn ML, Zhang F, Lowe MR. Daily self-weighing and weight gain prevention: a longitudinal study of college-aged women. J Behav Med 2017; 40:846-853. [PMID: 28689248 DOI: 10.1007/s10865-017-9870-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 07/03/2017] [Indexed: 11/29/2022]
Abstract
Daily self-weighing has been suggested as an important factor for weight loss maintenance among samples with obesity. This study is a secondary analysis that examined daily self-weighing in association with weight and body composition outcomes over 2 years among young women with vulnerability for weight gain. Women (N = 294) of varying weight status completed self-weighing frequency questionnaires and weight was measured in the clinic at baseline, 6 months, 1, and 2 years; DXA scans were completed at baseline, 6 months and 2 years. Multilevel models examined the relationship between daily self-weighing (at any point in the study) and trajectories of BMI and body fat percentage. Daily self-weighing was associated with significant declines in BMI and body fat percent over time. Future research is needed to examine causal relations between daily self-weighing and weight gain prevention. Nonetheless, these data extend the possibility that daily self-weighing may be important for prevention of unwanted weight gain.
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Affiliation(s)
- Diane L Rosenbaum
- Department of Psychology, Drexel University, Philadelphia, PA, USA. .,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104, USA.
| | - Hallie M Espel
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | - Meghan L Butryn
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | - Fengqing Zhang
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | - Michael R Lowe
- Department of Psychology, Drexel University, Philadelphia, PA, USA
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12
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Carrard I, Kruseman M. 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] [What about the content of this article? (0)] [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.
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Shieh C, Knisely MR, Clark D, Carpenter JS. Self-weighing in weight management interventions: A systematic review of literature. Obes Res Clin Pract 2016; 10:493-519. [PMID: 26896865 DOI: 10.1016/j.orcp.2016.01.004] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 01/30/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Self-weighing increases a person's self-awareness of current weight and weight patterns. Increased self-weighing frequency can help an individual prevent weight gain. Literature, however, is limited in describing variability in self-weighing strategies and how the variability is associated with weight management outcomes. AIM This review analyzed self-weighing in weight management interventions and the effects of self-weighing on weight and other outcomes. METHODS Twenty-two articles from PubMed, CINAHL, Medline, PsychInfo, and Academic Search Premier were extracted for review. RESULTS These 22 articles reported findings from 19 intervention trials, mostly on weight loss or weight gain prevention. The majority of the reviewed articles reported interventions that combined self-weighing with other self-monitoring strategies (64%), adopted daily self-weighing frequency (84%), and implemented interventions up to six months (59%). One-half of the articles mentioned that technology-enhanced or regular weight scales were given to study participants. Of the articles that provided efficacy data, 75% of self-weighing-only interventions and 67% of combined interventions demonstrated improved weight outcomes. No negative psychological effects were found. CONCLUSIONS Self-weighing is likely to improve weight outcomes, particularly when performed daily or weekly, without causing untoward adverse effects. Weight management interventions could consider including this strategy.
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Abstract
Many people self-weigh and many interventions addressing weight-related problems such as obesity promote self-weighing. However, while self-weighing has been associated with weight loss, there is mixed evidence regarding the psychological impact of this behaviour. The present review aimed to quantify the relationship between self-weighing and: (i) affect (e.g., anxiety, depression); (ii) psychological functioning (e.g., self-esteem); (iii) body-related attitudes and (iv) disordered eating. A computerized search of scientific databases in September 2014 and subsequent ancestry and citation searches identified 29 independent tests of the relationship between self-weighing on psychological outcomes. Meta-analysis was used to quantify the size of the association across the tests. Results indicated that there was no association between self-weighing and affect, body-related attitudes or disordered eating. There was, however, a small-sized negative association between self-weighing and psychological functioning. The age of participants, obesity status, the extent of weight loss, duration of self-weighing and study design (RCT versus correlational) were found to influence at least some of the psychological outcomes of self-weighing. The findings suggest that, for the most part, self-weighing is not associated with adverse psychological outcomes. However, in some cases the association between self-weighing and psychological outcomes may be more negative than in others.
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Affiliation(s)
- Yael Benn
- a Department of Psychology , University of Sheffield, Western Bank , Sheffield , UK
| | - Thomas L Webb
- a Department of Psychology , University of Sheffield, Western Bank , Sheffield , UK
| | - Betty P I Chang
- b Department of Psychological Sciences and Education , Universite´ Libre de Bruxelles , Brussels , Belgium
| | - Benjamin Harkin
- a Department of Psychology , University of Sheffield, Western Bank , Sheffield , UK
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Zheng Y, Sereika SM, Ewing LJ, Danford CA, Terry MA, Burke LE. Association between Self-Weighing and Percent Weight Change: Mediation Effects of Adherence to Energy Intake and Expenditure Goals. J Acad Nutr Diet 2015; 116:660-6. [PMID: 26727241 DOI: 10.1016/j.jand.2015.10.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 10/15/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND To date, no investigators have examined electronically recorded self-weighing behavior beyond 9 months or the underlying mechanisms of how self-weighing might impact weight change. OBJECTIVE Our aims were to examine electronically recorded self-weighing behavior in a weight-loss study and examine the possible mediating effects of adherence to energy intake and energy expenditure (EE) goals on the association between self-weighing and weight change. DESIGN This was a secondary analysis of the self-efficacy enhancement arm of the Self Efficacy Lifestyle Focus (SELF) trial, an 18-month randomized clinical trial. PARTICIPANTS/SETTING The study was conducted at the University of Pittsburgh (2008-2013). Overweight or obese adults with at least one additional cardiovascular risk factor were eligible. INTERVENTION Participants in the self-efficacy enhancement arm were given a scale (Carematix, Inc) and instructed to weigh themselves at least 3 days per week or every other day. The scale date- and time-stamped each weighing episode, storing up to 100 readings. MAIN OUTCOME MEASURES Weight was assessed every 6 months. Adherence to energy intake and EE goals was calculated on a weekly basis using paper diary data. STATISTICAL ANALYSES PERFORMED Linear mixed modeling and mediation analyses were used. RESULTS The sample (n=55) was 80% female, 69% non-Hispanic white, mean (standard deviation) age was 55.0 (9.6) years and body mass index (calculated as kg/m2) was 33.1 (3.7). Adherence to self-weighing declined over time (P<0.001). From baseline to 6 months, there was a significant mediation effect of adherence to energy intake (P=0.02) and EE goals (P=0.02) on the association between adherence to self-weighing and percent weight change. Mediation effects were not significant during the second and third 6-month periods of the study. CONCLUSIONS Objectively measured adherence to self-weighing declined over 18 months. During the first 6 months, self-weighing directly impacted weight change and indirectly impacted weight change through changes in energy intake and EE.
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Abstract
Conflicting views as to the helpfulness or harmfulness of self-weighing for the control of body weight have been presented in the fields of obesity and eating disorders. Because self-weighing is increasingly being considered as an intervention to promote weight loss or prevent weight gain, it is timely to consider unintended psychological outcomes and behavioral correlates of this behavior. Twenty articles from the published literature examining self-weighing and psychological outcomes or weight control behaviors were reviewed. In evaluating self-weighing and affect (ten studies), self-esteem (four studies) and body evaluation (ten studies), and eating behaviors/cognitions (13 studies), in total, most studies found a negative relationship between self-weighing and outcomes (affect: 4/10, self-esteem: 3/4, body evaluation: 4/10, eating behaviors/cognitions: 6/13). Themes that emerged included relationships between self-weighing and negative outcomes for women and younger individuals, and lack of a relationship or positive outcomes for overweight, treatment seeking individuals. Though self-weighing has shown promise in aiding weight control, the degree to which weight loss, and not self-weighing, affects psychological outcomes is not clear. Further assessment of psychological outcomes in self-weighing research may be warranted, as this review suggests the potential for adverse effects of self-weighing in some individuals.
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Affiliation(s)
- C R Pacanowski
- School of Public Health, Division of Epidemiology & Community Health, University of Minnesota, 1300 S. 2nd Street, Suite 300, Minneapolis, MN, 55454, USA.
| | - J A Linde
- School of Public Health, Division of Epidemiology & Community Health, University of Minnesota, 1300 S. 2nd Street, Suite 300, Minneapolis, MN, 55454, USA
| | - D Neumark-Sztainer
- School of Public Health, Division of Epidemiology & Community Health, University of Minnesota, 1300 S. 2nd Street, Suite 300, Minneapolis, MN, 55454, USA
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Linde JA, Jeffery RW, Crow SJ, Brelje KL, Pacanowski CR, Gavin KL, Smolenski DJ. The Tracking Study: description of a randomized controlled trial of variations on weight tracking frequency in a behavioral weight loss program. Contemp Clin Trials 2014; 40:199-211. [PMID: 25533727 DOI: 10.1016/j.cct.2014.12.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 12/11/2014] [Accepted: 12/12/2014] [Indexed: 01/22/2023]
Abstract
BACKGROUND Observational evidence from behavioral weight control trials and community studies suggests that greater frequency of weighing oneself, or tracking weight, is associated with better weight outcomes. Conversely, it has also been suggested that frequent weight tracking may have a negative impact on mental health and outcomes during weight loss, but there are minimal experimental data that address this concern in the context of an active weight loss program. To achieve the long-term goal of strengthening behavioral weight loss programs, the purpose of this randomized controlled trial (the Tracking Study) is to test variations on frequency of self-weighing during a behavioral weight loss program, and to examine psychosocial and mental health correlates of weight tracking and weight loss outcomes. This paper describes the study design, intervention features, recruitment, and baseline characteristics of participants enrolled in the Tracking Study. METHODS/DESIGN Three hundred thirty-nine overweight and obese adults were recruited and randomized to one of three variations on weight tracking frequency during a 12-month weight loss program with a 12-month follow-up: daily weight tracking, weekly weight tracking, or no weight tracking. The primary outcome is weight in kilograms at 24 months. The weight loss program integrates each weight tracking instruction with standard behavioral weight loss techniques (goal setting, self-monitoring, stimulus control, dietary and physical activity enhancements, lifestyle modifications); participants in weight tracking conditions were provided with wireless Internet technology (wi-fi-enabled digital scales and touchscreen personal devices) to facilitate weight tracking during the study. CONCLUSION This study was successful in recruiting adult male and female participants and is positioned to enhance the standard of care with regard to weight tracking recommendations.
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Affiliation(s)
- Jennifer A Linde
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300S. 2nd St, Suite 300, Minneapolis, MN 55454, USA.
| | - Robert W Jeffery
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300S. 2nd St, Suite 300, Minneapolis, MN 55454, USA
| | - Scott J Crow
- Department of Psychiatry, Medical School, University of Minnesota, 2450 Riverside Ave, Minneapolis, MN 55454, USA
| | - Kerrin L Brelje
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300S. 2nd St, Suite 300, Minneapolis, MN 55454, USA
| | - Carly R Pacanowski
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300S. 2nd St, Suite 300, Minneapolis, MN 55454, USA
| | - Kara L Gavin
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300S. 2nd St, Suite 300, Minneapolis, MN 55454, USA
| | - Derek J Smolenski
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300S. 2nd St, Suite 300, Minneapolis, MN 55454, USA
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Linde JA. A randomised pilot and feasibility study examining body weight tracking frequency and psychosocial health indicators. Obes Res Clin Pract 2014; 8:e399-402. [PMID: 25081808 DOI: 10.1016/j.orcp.2014.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 06/18/2014] [Indexed: 11/20/2022]
Abstract
Daily weight tracking may enhance weight loss, but experimental data are scarce. This study tested feasibility of delivering varying weight tracking instructions, assessed adherence, and monitored psychosocial changes. Thirty adults were enrolled and randomised to daily or weekly tracking for 6 months. Study retention was 100%. Adherence averaged 97.5% with no group differences (p=.15). There were no group differences and minimal changes for depression, anxiety, and body image (p=.41-.82). Daily trackers reported fewer barriers (p<.01) at 3 months. The study was highly successful at delivering weight tracking instructions without adverse effects or diminished adherence.
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