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Background: Few reports of weight maintenance following body contouring (BC) surgery present weight measurements as percentage weight change, and most of these studies do not isolate BC to specific body areas. This study analyzed weight control in the trunk-based BC population and further compared BC outcomes in postbariatric and nonbariatric patients., Methods: The authors performed a retrospective cohort study of consecutive postbariatric and nonbariatric patients who underwent trunk-based BC (abdominoplasty, panniculectomy, and circumferential lipectomy) from January 1, 2009, through July 31, 2020, at West Virginia University. A minimum 12-month follow-up was required for inclusion. With BC surgery date as the reference point, percentage total weight loss was assessed at 6-month intervals for 2 years following BC and every year thereafter. Change over time was compared between postbariatric and nonbariatric patients., Results: Within the 12-year timeframe, 121 patients meeting criteria underwent trunk-based BC. Average follow-up from date of BC was 42.9 months. Sixty patients (49.6%) had previously undergone bariatric surgery. From before BC to endpoint follow-up, postbariatric and nonbariatric patients experienced a 4.39% ± 10.93% and 0.25% ± 9.43% increase in weight from baseline, respectively ( P = 0.0273). Once nadir weight loss was attained, weight regain occurred through endpoint follow-up in both groups (11.81% in the postbariatric cohort and 7.56% in the nonbariatric BC cohort; P = 0.0106)., Conclusions: Long-term weight regain is common following trunk-based BC operations-specifically, in postbariatric patients. Although this should not contend with the psychological benefit of removing this excess tissue, it is important to report results with ideal weight metrics to optimally assess outcomes in this population., Clinical Question/level of Evidence: Risk, II., (Copyright © 2023 by the American Society of Plastic Surgeons.)

Background: Overweight and obesity characterized by abnormal or excessive fat accumulation, can cause many complications. Auriculotherapy, as the traditional Chinese technique, is widely applied in clinical trials for the management of body weight. The program aims to evaluate the effect and safety of auriculotherapy therapy and intervention types on weight control., Methods: All randomized controlled trials related to auriculotherapy targeting overweight and obesity will be searched in online databases, such as Medline, EMbase, Cochrane Central Register of Controlled Trials, AMED, CBM, Wanfang Data, and other databases from their inception to July 2019. The primary outcome is the difference in BMI from baseline to the end of studies. Secondary outcomes include the change of weight, percentage of body fat, waist circumference, serum lipid before and after treatment. Study selection, data extraction, and assessment of risk of bias will be performed independently by 2 reviewers. Comprehensive Meta-Analysis software (Version 3; Biostat Inc.) will be used for data synthesis., Results: This study will provide a comprehensive review of the available evidence for the treatment of obesity with auriculotherapy., Conclusion: The conclusion of this study will provide evidence to judge whether auriculotherapy is an effective therapeutic intervention for obesity., Prospero Registration Number: CRD42019136827.

The article presents a study concerning successful weight loss by the National Weight Control Registry (NWCR) in the U.S. It notes that there is a need to improve weight loss maintenance since is it considered as the weakness of behavioral weight loss treatment programs. It cites that NWCR has educated the public on the health consequences of obesity. It mentions that most of the members of NWCR have used the combination of diet and physical activities for weight loss.

The article discusses how proper timing of energy and fluid intake can improve hydration and contribute to weight control. The author recommends to readers to eat small, frequent meals as well as consume fluid at regular intervals because it can sustain the body's hydration state. This eating and drinking paradigm will also prevent systematic shifts in within-day energy balance as well as aid in fatigue resistance and attainment of a desired body composition and weight.

Introduction: Acupoint embedment, a modified acupuncture technique, is gaining its popularity in weight control in adult obesity or overweight nowadays. The objective of this study was to investigate the clinical efficacy of acupoint embedment in weight control of adult obesity or overweight by systematically assess available randomized controlled trials (RCTs) and analyze the integrated findings. A total of 529 literatures were initially searched from the databases. Five RCTs in assessing the effect of acupoint embedment versus sham control group were identified., Results: A total of 219 subjects in the intervention group and 206 subjects in the control group from 5 eligible studies were eventually included in this meta-analysis. Mean body mass index (BMI) decreased 0.94 kg/m (95% confidence interval [CI]: -1.56 to -0.32, P = .003) more in acupoint embedment group than the sham control group. Meanwhile, subjects received acupoint embedment had 2.97 kg (95% CI: -4.44 to -1.49, P < .0001) decrease in mean body weight more than in sham control group. Both parameters were statistically significant. Adverse events including bruise, soreness and cramp, patchy skin induration, erythema were reported, yet none involved hospitalization or mortality. Interestingly, stomach meridian and spleen meridian involved in all 5 studies., Conclusion: This meta-analysis showed that acupoint embedment was more effective in weight control than the sham control group. Together with its convenience and low cost, acupoint embedment may be considered as an alternative treatment in weight control.

The article presents a study which examines the impact of physical activities on the different hormone responses of men and women which regulate energy intake and appetite. It states that body weight loss is more effective in men than in women because of their diverse physical activities. It concludes that there is a greater body fat loss in men with no dietary changes, but with regular physical activities.

PURPOSE OF THE REVIEW: The Atkins diet has been criticized and vilified by much of the scientific community since it was proposed 30 years ago, because it challenged nutritional recommendations and dietary guidelines for a healthy diet. However, in spite of such recommendations the prevalence of obesity continues to rise. The present review evaluates recent scientific evidence and attempts to reach consensus on the confusion of weight-reducing diets. RECENT FINDINGS: Many dietary macronutrient paradigms have been proposed for the treatment of obesity. Since obesity in its dynamic phase is the result of energy intake exceeding energy expenditure, intuitively to lose weight energy intake should be less than energy expenditure, and one might expect that the macronutrient composition of the diet would have very little, if any, effect. However, short- and long-term therapies with low-carbohydrate or high-protein diets appear to offer advantages over conventional weight-loss regimens for weight loss, body composition and cardiovascular risk factors. SUMMARY: Low-carbohydrate, Atkins-type diets have been demonstrated to have positive effects on weight loss and biomarkers of cardiovascular risk, which has prompted some researchers to question the validity of present-day dietary guidelines. Although evidence is accumulating in their favour, the safety and efficacy of low-carbohydrate, high-protein diets needs further long-term verification. [ABSTRACT FROM AUTHOR]

Presents information on a study that explored the relationship between frequency of smoking and weight loss strategies among a sample of high school females. Methodology of the study; Results and discussion on the study.

Objective: Youth attempting to lose weight may engage in a variety of weight control behaviors (WCBs), some of which are viewed as healthy WCBs (HWCBs), whereas others are viewed as unhealthy WCBs (UWCBs). This study sought to examine youth perceptions of which WCBs are safe versus unsafe ways to lose weight. Furthermore, youth safety perceptions of WCBs and body mass index (BMI) z-scores were examined in relation to how often youth engage in these WCBs., Method: Participants were 219 youth (aged 10-17 years) attending a primary care clinic appointment. Participants completed questionnaires about the frequency of their own WCB use and whether they perceived each WCB as a safe way to lose weight., Results: Results revealed differences in safety perceptions across weight status groups for certain HWCBs and UWCBs. Youth perception of WCBs as safe ways to lose weight was associated with more frequent engagement in WCBs. Furthermore, an interaction between youth safety perception of HWCBs and youth BMI z-scores was related to greater engagement in HWCBs, such that the relationship between safety perception and engagement was only significant for youth who are overweight/obese. The moderation model explained 36.95% of the variance in engagement in HWCBs. The moderation model was also significant for UWCBs (r = .35)., Conclusion: This study identifies youth safety perception of WCBs as a mechanism that may lead to increased youth engagement in WCBs. Health care providers should educate both youth and family members about safe versus unsafe WCBs.

Purpose of Review: The purpose of this review was to highlight recent research developments on effects of the dietary fibre polydextrose (PDX) on appetite, satiety and energy intake and glucose metabolism. For this purpose, clinically relevant human studies were reviewed and putative mechanisms and pathways were discussed., Recent Findings: A number of acute human intervention studies provide strong indications for an energy and glucose metabolism-regulating role of PDX. These effects might be mediated via a reduced gastro-intestinal transit reducing glycaemia and insulinemia after PDX ingestion and the potential of PDX as soluble dietary fibre to alter the intestinal microbial composition, which might lead to changes in signalling in both peripheral and central pathways involved in energy metabolism and glucose homeostasis., Summary: In acute studies, PDX seems to have an inhibiting effect on energy intake and satiety and to reduce glycaemic and insulinemic response through effect on gastro-intestinal transit time and macronutrient absorption as well as through effects of the microbial products such as short-chain fatty acids on energy and substrate metabolism. In particular, well controlled human intervention studies are required to confirm these effects in the long term. Overall, supplement PDX to the daily diet may be a promising approach for the management and treatment of obesity and associated metabolic disorders.

Objective: Youth indoor tanning rates remain high despite the potential for increased melanoma risk. No previous study has assessed the prevalence of unhealthy weight control behaviors in both male and female adolescent indoor tanning users using a nationally representative survey., Methods: Pooled data on high school students from the 2009 and 2011 Youth Risk Behavior Survey were used (n = 26,951). Multivariate logistic regression was used to assess associations between the recent indoor tanning use and recently doing the following to lose weight: fasting for more than 24 hours; taking a pill, powder, or liquid without a doctor's consent; and vomiting or taking a laxative., Results: Pooled data showed 23.3% of females reported indoor tanning within the past year; 6.5% of males did so as well. Adjusted multivariate results show that females who indoor tan were, on average, more likely to have fasted (odds ratio [OR], 1.2; 95% confidence interval [CI], 1.0-1.5), taken a pill, powder, or liquid (OR, 2.4; 95% CI, 1.9-3.0), and vomited or taken a laxative to lose weight (OR, 1.4; 95% CI, 1.1-1.7) within the past 30 days than those who did not. Males who indoor tanned within the past year were, on average, more likely to have fasted (OR, 2.3; 95% CI, 1.7-3.1), taken a pill, powder, or liquid (OR, 4.4; 95% CI, 3.3-6.0), and vomited or taken a laxative to lose weight (OR, 7.1; 95% CI, 4.4-11.4) within the past 30 days., Conclusions: Significant associations between indoor tanning use and unhealthy weight control behaviors exist for both male and female adolescents, with a stronger association observed among males.

The article presents a study which examines the variability of physical activity levels and its effect on weight control status among adults in the U.S. The four years data of the National Health and Nutrition Examination Survey (NHANES) from 1999-2002 were utilized to evaluate the leisure-time physical activity patterns and the weight control practices of these individuals. Results revealed that the prevalence of regular physical exertion was 32.6% among persons seeking to lose weight, 37.9% among people trying to maintain weight and 21.8% among those not attempting to either lose or keep weight. It is stated that the most common activities for those trying to lessen there body mass were walking, yard work, biking and running.

Purpose: This study investigated changes in psychosocial variables related to exercise, eating. and body image during a weight reduction program and evaluated their association with weight loss in middle-aged overweight and obese women up to 1 yr after intervention. Methods: The 136 participants (age, 48.1 ± 4.4 yr; weight, 30.6 ± 5.6 kg·m-2) who completed the 4-month lifestyle weight reduction program (86% retention), losing -6.2 ± 4.6% (P < 0.001) of their initial weight, were followed up for 12 additional months. Of these, 82% completed 16-month assessments (weight change, -5.5 ± 7.7%. P < 0.001). Psychosocial variables were assessed by validated instruments in standardized conditions at baseline and after the intervention (4 months). Results: Compared with 4-month assessments, body weight did not change at 16 months (P > 0.09). Changes in eating restraint, disinhibition, and hunger; exercise, self-efficacy. and intrinsic motivation; body shape concerns; and physical self-worth were associated with weight change at 4 months (P < 0.001, except hunger. P < 0.05). Baseline-adjusted 4-month scores in all psychosocial variables also predicted weight change from baseline to 16 months (P < 0.01), except hunger (P > 0.05). After controlling for 4-month weight change and other covariates, increases in exercise intrinsic motivation remained predictive of weight loss at 16 months (P < 0.05). Multiple linear regression showed that eating variables were significant and independent correlates of short-term weight change, whereas changes in exercise variables were stronger predictors of longer term weight outcomes. Conclusions: Results highlight the importance of cognitive processes during weight control and support the notion that initial focus on diet is associated with short-term weight loss, white change in exercise-related motivational factors, with a special emphasis on intrinsic sources of motivation (e.g., interest and enjoyment in exercise), play a more important role in longer term weight management. [ABSTRACT FROM AUTHOR]

Background: The positive impact of Roux-en-Y gastric bypass on weight, comorbidities, and health-related quality of life is well documented. However, 50 percent of patients regain some of the lost weight after 2 years with Roux-en-Y gastric bypass and present a mean weight regain of 10 to 15 percent after several years, partially losing the previously obtained benefits. The authors hypothesize that body contouring could decrease weight regain, leading to better long-term weight control after Roux-en-Y gastric bypass., Methods: In a matched control study, variations in weight for 98 patients with body contouring after Roux-en-Y gastric bypass were compared with those of 102 matched control patients with Roux-en-Y gastric bypass alone. Data were collected prospectively at 1, 3, 6, 9, 12, and 18 months after Roux-en-Y gastric bypass and then yearly until 7 years., Results: After a massive mean weight loss of 45.2 kg during the first 2 years after Roux-en-Y gastric bypass, patients with Roux-en-Y gastric bypass alone presented a higher continuous mean weight regain than those with Roux-en-Y gastric bypass and body contouring (1.78 kg/year versus 0.51 kg/year of weight regain, respectively; p = 0.001). After 7 years, patients with Roux-en-Y gastric bypass presented significantly higher mean weight regain than patients with Roux-en-Y gastric bypass and body contouring (i.e., 10.8 percent versus 3.6 percent mean weight gain, respectively; p < 0.001). Netting out mean skin excision weight of 2.04 kg by body contouring, the weight regain was 22.9 kg for patients with Roux-en-Y gastric bypass alone and only 6.2 kg for those with Roux-en-Y gastric bypass and body contouring., Conclusions: The authors demonstrated that patients with body contouring present better long-term weight control after Roux-en-Y gastric bypass. Therefore, body contouring must be considered as a reconstructive operation in the treatment of morbid obesity., Clinical Question/level of Evidence: Therapeutic, III.

Purpose of Review: It is often hypothesized that increasing the volume of physical activity in the American lifestyle will slow and possibly even reverse the epidemic of obesity. Herein, we review the evidence pertaining to the role of physical activity in weight control from interventions performed in adults., Recent Findings: Evidence exists both for and against the role of physical activity in weight control. High levels of physical activity and successful maintenance of body weight may be a result of better coupling between energy intake and energy expenditure, potentially mediated by physiological changes in appetite, albeit in the presence of large interindividual variability. Prospective studies, however, find little evidence of the more physically active members of a population gaining less excess weight than those who are the least physically active., Summary: When considering the impact of physical activity on body weight regulation, it is important to keep in mind that there are multiple hormones that acutely suppress (or stimulate) food intake and that the integration of these signals influence overall energy balance in a manner that is not yet fully understood. Moreover, cognitive and social influences may override these signals. Even though the impact of physical activity for weight control is still controversial, little doubt exists that increasing regular physical activity, particularly energy expended during structured exercise, is important for improving physical fitness and cardiovascular health.

Objectives: To determine the effectiveness of a weight-management program with personal counseling by phone or e-mail., Methods: A randomized controlled trial of a 6-month program comparing two modes of intervention delivery (phone, n = 462; Internet, n = 464) with self-directed materials (control, n = 460), among overweight employees. Change in body weight after 2 years was the main outcome., Results: Among complete cases, weight loss in the Internet group was 1.2 kg (95% confidence interval [CI], -1.9 to -0.4) and in the phone group 0.8 kg (95% CI, -1.5 to 0.03), compared with the control group. Multiple imputation of missing body weight resulted in comparative weight losses of -0.9 kg (95% CI, -2.0 to 0.3) and -0.4 kg (95% CI, -1.4 to 0.7)., Conclusions: Among complete cases, the Internet intervention showed modest long-term weight loss, but among all participants neither program version was more effective than self-help.

Purpose of Review: To examine the relationship between energy intake, appetite control and exercise, with particular reference to longer term exercise studies. This approach is necessary when exploring the benefits of exercise for weight control, as changes in body weight and energy intake are variable and reflect diversity in weight loss., Recent Findings: Recent evidence indicates that longer term exercise is characterized by a highly variable response in eating behaviour. Individuals display susceptibility or resistance to exercise-induced weight loss, with changes in energy intake playing a key role in determining the degree of weight loss achieved. Marked differences in hunger and energy intake exist between those who are capable of tolerating periods of exercise-induced energy deficit, and those who are not. Exercise-induced weight loss can increase the orexigenic drive in the fasted state, but for some this is offset by improved postprandial satiety signalling., Summary: The biological and behavioural responses to acute and long-term exercise are highly variable, and these responses interact to determine the propensity for weight change. For some people, long-term exercise stimulates compensatory increases in energy intake that attenuate weight loss. However, favourable changes in body composition and health markers still exist in the absence of weight loss. The physiological mechanisms that confer susceptibility to compensatory overconsumption still need to be determined.

As obesity rates continue to rise, it is clear that more holistic and homeostasis-friendly alternatives to dieting are needed. Dieting and restraint disrupt homeostasis and cause physical, emotional, and spiritual distress. Intuitive eating is an alternative that focuses on body's internal cues of hunger and fullness to guide how much to eat.

Purpose: Recent recommendations advise 30-60 min of physical activity per day to prevent weight gain and 60-90 min to prevent weight regain. No studies have used objective measures of physical activity to verify these public health recommendations. The purpose of this study was to use objective measures to quantify the amount and intensity of physical activity in a weight-loss-maintainer group and an always-normal-weight group, and, thus,empirically evaluate the recommendations for prevention of weight gain versus regain., Methods: The weight-loss-maintainer group (N = 135) lost >or= 30.6 kg, maintained >or= 10% weight loss for 14.2 yr, and had a BMI of 22.0 kg.m(-2). The always-normal-weight group (N = 102) had a BMI of 21.1 kg.m(-2) and no history of overweight. Accelerometry was used to assess the amount and intensity of physical activity., Results: The weight-loss-maintainer group spent significantly more minutes per day than the always-normal-weight group in physical activity (58.6 vs 52.1; P = 0.0001), largely because of more time spent in higher-intensity activities (24.4 vs 16.9; P = 0.02). The majority of individuals in the always-normal-weight group engaged in 30-60 min.d(-1) of physical activity, whereas a greater proportion of individuals in the weight-loss-maintainer group engaged in > 60 min (P = 0.002)., Conclusions: Findings support current recommendations that more activity may be needed to prevent weight regain than to prevent weight gain. Including some higher-intensity activity may also be advisable for weight-loss maintenance.

Purpose of the Review: The Atkins diet has been criticized and vilified by much of the scientific community since it was proposed 30 years ago, because it challenged nutritional recommendations and dietary guidelines for a healthy diet. However, in spite of such recommendations the prevalence of obesity continues to rise. The present review evaluates recent scientific evidence and attempts to reach consensus on the confusion of weight-reducing diets., Recent Findings: Many dietary macronutrient paradigms have been proposed for the treatment of obesity. Since obesity in its dynamic phase is the result of energy intake exceeding energy expenditure, intuitively to lose weight energy intake should be less than energy expenditure, and one might expect that the macronutrient composition of the diet would have very little, if any, effect. However, short- and long-term therapies with low-carbohydrate or high-protein diets appear to offer advantages over conventional weight-loss regimens for weight loss, body composition and cardiovascular risk factors., Summary: Low-carbohydrate, Atkins-type diets have been demonstrated to have positive effects on weight loss and biomarkers of cardiovascular risk, which has prompted some researchers to question the validity of present-day dietary guidelines. Although evidence is accumulating in their favour, the safety and efficacy of low-carbohydrate, high-protein diets needs further long-term verification.

The article focuses on the study that examines the body weight misperception among U.S. adolescents, their racial and ethnic differences, and the influence of sociodemographic factors on their perception. It states that the study was conducted to 2,195 adolescents who were asked about their perception on weight status, weight goals, and weight loss attempts. The study concluded that the differences in the perception among racial and ethnic groups call for obesity control efforts.

While multiple risk factors are associated with smoking, body weight concern is a significant risk factor for smoking among young women, including adolescents. This article explores the relationship between frequency of smoking and weight loss strategies among a nationally representative sample of high school females (n = 7,828). Adjusted odds ratios were generated for smoking, weight goals, and weight loss strategies, controlling for demographics. Daily smokers were two to four times more likely to fast, use pills, and purge to control their weight than nonsmokers. Tobacco control efforts for young women must address the influence of weight concern on smoking in this population.

Unlabelled: The purpose of this study was to investigate the weight-control behavior of obese children, to understand parents' supervision and to explore related factors that influenced the weight-control behavior. A structured questionnaire was employed in this study. A random sample of 287 children and their parents was recruited from six elementary schools in Shihlin and Peitou districts of Taipei City. Criteria employed for recruitment of subjects were: third and fourth grade in elementary schools, and weight-for-length index > or = 1.2., Results: Fifty-six percent of the obese children were mildly obese and eleven percent were severely obese. Ninety-seven percent of the subjects adopted weight-control behavior, the most frequent one being avoiding fried food. The exercise frequency and time duration consistency were generally insufficient. Twenty-seven percent of the obese children were not in the habit of exercising. Factors that influenced the execution of weight-control behavior by the obese children included obesity level, mother's education, family structure, socioeconomic status of the family, parents' perception of their children's weight, parents' concern, and supervision. Our study found that severely obese children attempted to lose weight with inappropriate methods. Children staying in foster families or with grandparents, or from families of low socioeconomic status, had poorer weight-control behavior. Children whose parents were more concerned about their weight problem tended to have better weight-control behavior. Therefore, it is important to assist the parents of obese children to confront the issue of obesity and help the children solve their weight problem. It is also important to help foster families with low income to make the most of social resources to reinforce the family function.

The article presents a study on weather the physical fitness strategy employed by olympic athletes yields optimum leanness or not. The study reveals that the strategy is considered to be suboptimal. Moreover, male athletes were reported to have higher incidents of eating disorders. Furthermore, individualized medical counseling is believed to be the best tool in combating health risks and to better performance of athletes. Two-hundred twenty-three of the Swedish team from the 2002 and 2004 olympic games were chosen to be the participants of the study.

To evaluate the evidence for the role of weight control and physical activity in cancer prevention and to identify priorities for research and for public health action in relation to the primary prevention of cancer, an international working group of experts was convened in Lyon in February 2001 by the International Agency for Research on Cancer of the World Health Organization. The expert group concluded that limiting weight gain during adult life, thereby avoiding overweight and obesity, reduces the risk of postmenopausal breast cancer and cancers of the colon, endometrium, kidney (renal cell) and esophagus (adenocarcinoma). Limiting weight gain possibly reduces risk of cancer of the thyroid. Weight loss among overweight or obese persons possibly reduces risks of these cancers, but no definite conclusion can be drawn because of the paucity of the epidemiological evidence. The working group also concluded that there was sufficient evidence for the role of physical activity in preventing colon and breast cancers, and limited evidence for the cancers of the prostate and endometrium. Some of these effects were independent of that of the weight control. Taken together, the working group considered that excess body weight and physical inactivity account for approximately a quarter to one-third of cancers of the colon, breast, endometrium, kidney (renal cell) and esophagus (adenocarcinoma). Thus adiposity and physical inactivity appear to be the most important avoidable causes of these cancers.

Serotonin (5-hydroxytryptamine; 5-HT) is a regulator of feeding behavior. The effect of serotonin on food intake is believed to be primarily mediated via 5-HT(1A) and 5-HT(2C) receptors, which both are expressed in hypothalamic regions implicated in regulation of feeding behavior. Using an antiserum to the 5-HT(1A) receptor, immunoreactive neurons were observed in the rat supraoptic, paraventricular, arcuate and ventromedial nuclei and lateral hypothalamic area. 5-HT(1A) receptor immunoreactivity was demonstrated in neuropeptide Y-, agouti-related peptide-, proopiomelanocortin- and cocaine- and amphetamine-regulated transcript-containing neurons of the arcuate nucleus. In the lateral hypothalamus, 5-HT(1A) receptor immunoreactivity was observed in melanin-concentrating hormone- and orexin-containing neurons. The results suggest that serotonin via postsynaptic 5-HT(1A) receptors affects the release of peptides regulating food intake.

Purpose: Several recent studies have pointed out that the weight loss techniques used by wrestlers to make weight are similar to the behavior of bulimics. The purpose of this study was to determine whether an increased risk of bulimia nervosa existed for a group of junior high and high school wrestlers., Methods: Wrestlers (N = 85) completed the Eating Disorder Inventory (EDI) once during the season, and once during the off-season. A comparison group of nonwrestlers (N = 75) also completed the questionnaire., Results: No significant differences were found between the number of in-season wrestlers and nonwrestlers classified as "at risk" for bulimia nervosa. Significant differences were revealed, however, between in-season wrestlers and nonwrestlers, and between in-season wrestlers and off-season wrestlers, on the Drive for Thinness subscale. In both cases, significantly more in-season wrestlers scored above the "at risk" cutoff on the subscale., Conclusions: These results indicate that although in-season wrestlers are more weight conscious than nonwrestlers, these feelings and attitudes are transient. All subjects classified as "at risk" also participated in an interview which followed the format of the Eating Disorder Examination. Interviews with in-season wrestlers revealed that their concerns with weight were due entirely to the demands of wrestling, and did not meet the severity level required for a diagnosis of bulimia nervosa.

Obesity is a major problem in American women, and there is great concern with regard to weight control among both the obese and the nonobese. Vast sums of money are spent in the area of weight reduction, often with little or no benefit. Although obesity affects longevity adversely, weight loss has not been clearly associated with a decrease in mortality risk. Reduction in weight, however, can decrease risk factors for certain diseases and improve the quality of life. Current methods of weight control include diet, exercise, surgery, and medication. Several studies have shown that, in contrast to previous supposition, medical management should be long term. Recent investigations into the basic mechanisms of appetite control, moreover, suggest that more physiologic management methods will be available in the near future.

In 1989, the Wisconsin Interscholastic Athletic Association implemented a project including new rules and an educational program, consistent with ACSM and AMA guidelines, to curtail "weight cutting" among high-school wrestlers. The project included skinfold estimates of body fatness to determine a minimum competitive weight, a limit on weekly weight loss, and presentation of nutrition education information to help wrestlers diet effectively. Implementation of the project has overcome a variety of obstacles and has received widespread endorsement from parents, teachers, wrestlers, and coaches. The success of this project offers a model for other states to emulate and should encourage clinicians in other sports to initiate interventions addressing these unhealthy weight loss behaviors.

The objective of this research was to investigate the weight control practices of lightweight football players. In addition, the importance of several variables was examined for their clinical importance and ability to identify individuals at high risk for pathogenic eating behaviors. Male college lightweight football players (N = 131) were administered a 45-item version of the Diagnostic Survey For Eating Disorders (9). Results revealed that 74% had experienced binge eating, and 17% had experienced self-induced vomiting. During the month preceding questionnaire administration, 66% had fasted, nearly 4% had used laxatives, while less than 2.5% had used diet pills, diuretics, or enemas for the purpose of weight control. Furthermore, the "teacher/coach" seemed to be the individual who motivated dieting behavior, and more than 20% of the sample reported that their weight control practices interfered with their thoughts and extracurricular activities "often" or "always." Most importantly, 42% of the sample evidenced a pattern of dysfunctional eating, while 9.9% of the sample engaged in binge-purge behavior to the degree that it might represent an eating disorder. Finally, discriminant the degree that it might represent an eating disorder. Finally, discriminant analysis yielded several variables that might be useful in identifying individuals at risk for pathogenic eating behaviors.

Several important questions need to be answered to increase the likelihood that exercise will be accepted by the millions in the population who are obese. What is the minimum exercise "dose" (intensity, duration, frequency) and what is the optimal mode to bring about substantial fat weight loss, with minimal loss of lean mass? What is the best nutritional plan to optimize fat utilization during exercise, without impairing performance or loss of lean mass? Which diet and exercise programs maximally increase utilization of centrally deposited fat and how can hyperplastic obesity best be treated? Also of interest is the potential role of resistance exercise for weight loss, and the predictors of weight loss success. For instance, do individuals with gynoid obesity really differ from individuals with android obesity in their utilization and loss of body fat during exercise? The potential advantages of exercise include: stimulation of fat as opposed to carbohydrate oxidation; increased energy use during the exercise itself and in the postexercise period; protection of lean body mass; possible reversal of the diet-induced suppression of BMR; and other health benefits. Among other parameters, the effectiveness of exercise on weight loss may be influenced by the type, intensity, frequency, and duration of exercise bouts and the duration of the training program, the nature of the excess fat stores, i.e., whether the person has obesity characterized by hyperplastic or hypertrophic adipose tissue or central (with large-intra-abdominal depot) or peripheral obesity, the composition and caloric content of the diet, and behavioral aspects that affect adherence to the program. With respect to this latter concern, even if a person has been very successful at weight loss in a metabolic ward or intensive program, he/she must eventually return to the outside world and figure out for himself/herself how to eat real food and/or maintain an activity level that promotes weight maintenance. Because diet and exercise habits are difficult to assess and to quantify in free-living populations, it continues to be difficult to evaluate the success of diet and/or exercise prescriptions for weight loss accurately and we continue to be plagued with questions regarding the effectiveness vs. efficacy of exercise as a means to control body weight. It would seem that the wide range of health benefits derived from regular exercise would justify emphasizing increased activity for inactive people, particularly for obese, sedentary individuals, whether or not ideal body weight or significant weight loss is achieved.

This study represents a limited application of Cox's Interaction Model of Client Health Behavior in a weight control program for enlisted US Army soldiers. Relationships of client singularity variables (demographic characteristics, motivation, psychological distress, and designation as overweight or normal weight) to one another and to preintervention measures of client outcomes (health status, health risk) were examined in a sample of 154 soldiers. Hypotheses deduced from the model were tested using multiple regression. The Cox model received partial support, in that some client singularity variables were interrelated; they explained nearly half of the variance in health status, but less than 25% of the variance in health risk. Demographic characteristics were not effective predictors in the present study, perhaps because of the homogeneous sample. The model has potential utility for providing baseline information for preventive health programs in occupational settings.

Reports on the National Obesity and Weight Control Symposium in April 1993. Sponsorship by components of the Columbia-Presbyterian Medical Center; Evolutionary aspects of diet; Concern over relaxation of weight standards for Americans; Genetic component of obesity; Inheritable characteristics that could predispose individuals to obesity; Failure of behavior therapy in practice; Obesity in children.