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Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder exacerbated by obesity. Single Anastomosis Sleeve-Ileal Bypass (SASI) has emerged as a promising metabolic bariatric procedure that combines sleeve gastrectomy and ileal bypass, facilitating substantial weight loss and T2DM remission through restrictive and malabsorptive mechanisms. This study aims to evaluate the effects of SASI on T2DM remission, weight loss, and safety in one year follow-up. A retrospective cohort study analyzed 31 patients with obesity and T2DM who underwent SASI. Data collected included demographic characteristics, preoperative and postoperative BMI, HbA1c levels, and bariatric outcomes, including %TWL and T2DM changes. The mean age was 45 years, with a mean preoperative BMI of 40.7 kg/m². One year postoperatively, the mean %EWL was 85.6% and %TWL was 31.7%. T2DM remission was achieved in 24 (77.4%) patients, improvement in 4 (12.9%), and no change in 3 (9.7%). Hypertension improved in 21 (87.5%) patients, with 12 (50%) achieving remission. Significant reductions in BMI and HbA1c levels were observed (p < 0.001). Responders (R) and non-responders (NR) groups showed significant differences in postoperative BMI and %EWL (p = 0.007, p = 0.023). One patient experienced a Clavien-Dindo Grade III complication; no deaths occurred. SASI is an effective and safe procedure for treating T2DM, resulting in significant weight loss and metabolic improvements over a one-year follow-up. SASI seems to be a favorable option for T2DM management in metabolic bariatric surgery. [ABSTRACT FROM AUTHOR]

Objectives: This paper examines the relation between body weight perceptions, weight control behaviours and smoking status among a representative sample of Ontario students., Methods: Bivariate and multivariate logistic regression analysis was used to evaluate the association between smoking status and perception of being overweight, and between smoking status and specific weight control behaviours., Results: Among females, the odds of being a smoker were significantly higher among those who perceived themselves to be overweight and who had employed weight control behaviours in the last 12 months. Among males, the adjusted odds of being a smoker was higher only among those who skipped meals in the past 12 months., Conclusions: Body weight perceptions and the use of weight control behaviours were significantly associated with predictors of smoking among adolescent females. This suggests a need to incorporate discussion on body weight perception and body image in smoking prevention and cessation programs targeted toward adolescent females.

Purpose: A combined body weight loss and upper body/arm exercise programme is a potential strategy for managing Breast cancer related lymphoedema (BCRL), but there is limited data on the best method for delivery or its potential efficacy. Methods: Fifty-seven women with overweight/obesity and BCRL were randomised to a 12 week supervised (n = 12) or home-based combined weight loss and upper body/arm exercise programme (n = 16), a home-based upper-body arm exercise only programme (n = 17) or standard care (n = 12). Primary outcomes were uptake, retention and changes in weight and change in Relative Arm Volume Increase (RAVI) using analysis of covariance (ANCOVA). Results: Sixteen percent of women invited joined the study and 49 completed the trial (85% retention). Reductions in weight occurred in the supervised and home-based weight control and exercise programmes; Mean (95% CI) change compared to standard care − 1.68 (− 4.36 to − 1.00), − 2.47(− 4.99 to − 0.04) Kg. Reductions in perometer assessed RAVI were seen in the supervised and home-based combined weight control and arm exercise groups and the weight stable home-based arm exercise only group: mean (95% CI) change compared to standard care − 2.4 (− 5.0 to + 0.4),− 1.8 (− 4.3 to + 0.7), − 2.5(− 4.9 to − 0.05)%. Conclusion: Women with BCRL and overweight and obesity engaged in diet and exercise weight loss programmes. Both weight loss/arm exercise programmes led to modest changes in weight and BCRL. Comparable reductions in BCRL were reported in the weight stable group undertaking arm exercise only. The independent and combined effects of weight loss and exercise on BCRL need further study. Trial registration: ISRCTN86789850 https://doi.org/10.1186/ISRCTN86789850, registered 2011. [ABSTRACT FROM AUTHOR]

In most lifestyle, pharmacological and surgical interventions, weight loss occurs over an approximately 6- to 9-month period and is followed by a weight plateau and then weight regain. Overall, only about 15% of individuals can sustain a 10% or greater non-surgical, non-pharmacological, weight loss. A key question is the degree to which the genotypes, phenotypes and environmental correlates of success in weight loss and weight loss maintenance are continuous or dichotomous. This Perspective is a comparison of the interactions of weight loss and maintenance with genetic, behavioural, physiological and environmental homeostatic systems and a discussion of the implications of these findings for research in, and treatment of, obesity. Data suggest that weight loss and weight loss maintenance are physiologically and psychologically different in many ways. Consequently, individuals may require different interventions designed for temporarily sustaining a negative energy balance during weight loss versus permanently maintaining energy balance after weight loss., (© 2023. Springer Nature Limited.)

Although adolescence marks a vulnerable stage for peer influence on health behavior, little is known about the longitudinal and dynamic relationship between adolescent friendship and weight control. The current study aims to explain these dynamic processes among a sample of 1156 American adolescents in grades 9-11 (48.6% girls, 23.4% European American, 25.2% African American) from the National Longitudinal Study of Adolescent Health. Stochastic actor-oriented models were fit to examine changes in friendship networks and unhealthy weight control across two waves. The findings support a bidirectional relationship where weight control predicts future friendship seeking and friendship seeking predicts future weight control. The findings also indicate that adolescents prefer friends with similar weight control patterns. Taken together, the results of the current study indicate that adolescent friendships play an integral role in the development of unhealthy weight control and thus can be used to identify adolescents at risk and serve as targets within preventive interventions. [ABSTRACT FROM AUTHOR]

Several studies have reported that weight control is of paramount importance in reducing the risk of metabolic syndrome. Nevertheless, this well-known association does not provide any practical information on how much weight loss in a given period would reduce the risk of metabolic syndrome in individuals in a personalized setting. This study aimed to develop and validate a risk prediction model for metabolic syndrome in 2 years, based on an individual's baseline health status and body weight after 2 years. We recruited 3,447 and 3,874 participants from the Ansan and Anseong cohorts of the Korean Genome and Epidemiology Study, respectively. Among the former, 8636 longitudinal observations of 2,412 participants (70%) and 3,570 of 1,034 (30%) were used for training and internal validation, respectively. Among the latter, all 15,739 observations of 3,874 participants were used for external validation. Compared to logistic regression, Gaussian Naïve Bayes, random forest, and deep neural network, XGBoost showed the highest performance (area under curve of 0.879) and a significantly enhanced calibration of the predictive score with the prevalence rate. The model was ported onto an application to provide the 2-year probability of developing metabolic syndrome by simulating selected target body weights, based on an individual's baseline health profiles. Further prospective studies are required to determine whether weight-control programs could lead to favorable health outcomes. [ABSTRACT FROM AUTHOR]

Although attention-deficit/hyperactivity disorder (ADHD) is associated with eating disorders (EDs), it is unclear when ED risk emerges in children with ADHD. We compared differences in body dissatisfaction and weight control behaviour in children with/without ADHD aged 12–13 years concurrently, and when aged 8–9 and 10–11 years, to determine when risk emerges. We also examined differences by ADHD medication status at each age. This study uses waves 1–5 from the Longitudinal Study of Australian Children (n = 2323–2972). ADHD (7.7%) was defined at age 12–13 years by both parent- and teacher-reported SDQ Hyperactivity–Inattention scores > 90th percentile, parent-reported ADHD diagnosis and/or ADHD medication treatment. Children reported body dissatisfaction and weight control behaviour at 8–9, 10–11 and 12–13 years. Children with ADHD had greater odds of body dissatisfaction at ages 8–9 and 12–13 years. Comorbidities drove this relationship at 8–9 but not at 12–13 years [adjusted odds ratio (AOR): 1.6; 95 % CI 1.1–2.4; p = 0.01]. At 12–13 years, children with ADHD had greater odds of both trying to lose and gain weight, regardless of BMI status. Comorbidities drove the risk of trying to lose weight in ADHD but not of trying to gain weight (AOR 2.3; 95% CI 1.1–4.6; p = 0.03), which is likely accounted for by ADHD medication treatment. ADHD moderately increases body dissatisfaction risk in children aged 8–9 and 12–13 years. Clinicians should monitor this and weight control behaviour throughout mid-late childhood, particularly in children with comorbid conditions and those taking ADHD medication, to reduce the likelihood of later ED onset. [ABSTRACT FROM AUTHOR]

The article discusses a cross-sectional study on the weight control behaviors (WCB) of adult participants in the Portuguese Weight Control Registry. Topics mentioned include strategies used by participants for weight loss (WL) and maintenance including regular consumption of vegetables, the association of WL with level of physical activity, and the gender differences in WCB.

Introduction: In both randomized controlled trials and real-world studies, liraglutide has demonstrated glycemic and body weight benefits in patients with type 2 diabetes. However, persistence with diabetes medication can be challenging. This study compared glycated hemoglobin (HbA1c) and other outcomes in patients with type 2 diabetes who continued treatment with liraglutide for over 12 months with those who discontinued treatment earlier, in a real-life setting. Methods: This is a retrospective study of adult patients with type 2 diabetes from Maccabi Healthcare Services in Israel, who initiated treatment with liraglutide from 2010 to 2015. Mean HbA1c and body weight change from initiation to after 24 months was compared between patients who received liraglutide for at least 12 months ("continuers") and those who discontinued within the first year ("discontinuers"). Adjustment for HbA1c, body weight, and other potentially confounding factors was performed using 1:1 propensity score matching. Results: The 3580 patients comprised 2695 continuers and 885 discontinuers; 882 patients per group were matched. A significant (p < 0.001) reduction in HbA1c (– 0.80% vs – 0.32%) was seen in continuers compared with discontinuers, despite higher insulin usage (70.2% vs 59.0%; p < 0.001), and a higher proportion of patients using ≥ 3 oral glucose-lowering drugs (20.6% vs 6.2%; p < 0.001) at 24 months among discontinuers. Mean body weight reduction was greater in continuers than discontinuers (3.57 vs 1.25 kg; p < 0.001). Conclusion: In a real-world setting, persistent use of liraglutide was associated with good glycemic and body weight control. Funding: Novo Nordisk Health Care AG. [ABSTRACT FROM AUTHOR]

Crosstalk between peripheral metabolic organs and the central nervous system is essential for body weight control. At the base of the hypothalamus, β-tanycytes surround the portal capillaries and function as gatekeepers to facilitate transfer of substances from the circulation into the cerebrospinal fluid and vice versa. Here, we investigated the role of the neuroplasticity gene doublecortin-like (DCL), highly expressed by β-tanycytes, in body weight control and whole-body energy metabolism. We demonstrated that DCL-knockdown through a doxycycline-inducible shRNA expression system prevents body weight gain by reducing adiposity in mice. DCL-knockdown slightly increased whole-body energy expenditure possibly as a result of elevated circulating thyroid hormones. In white adipose tissue (WAT) triglyceride uptake was increased while the average adipocyte cell size was reduced. At histological level we observed clear signs of browning, and thus increased thermogenesis in WAT. We found no indications for stimulated thermogenesis in brown adipose tissue (BAT). Altogether, we demonstrate an important, though subtle, role of tanycytic DCL in body weight control through regulation of energy expenditure, and specifically WAT browning. Elucidating mechanisms underlying the role of DCL in regulating brain-peripheral crosstalk further might identify new treatment targets for obesity. [ABSTRACT FROM AUTHOR]

Weight loss maintenance is a complex, multifaceted process that presents a significant challenge for most individuals who lose weight. A growing body of literature indicates a strong relationship between cognitive dysfunction and excessive body weight, and suggests that a subset of high-order cognitive processes known as executive functions (EF) likely play an important role in weight management. Recent reviews cover neuropsychological correlates of weight status yet fail to address the role of executive function in the central dilemma of successful weight loss maintenance. In this paper, we provide an overview of the existing literature examining executive functions as they relate to weight status and initial weight loss. Further, we propose a novel conceptual model of the relationships between EF, initial weight loss, and weight loss maintenance, mapping specific executive functions onto strategies known to be associated with both phases of the weight control process. Implications for the development of more efficacious weight loss maintenance interventions are discussed. [ABSTRACT FROM AUTHOR]

OBJECTIVE:: To assess the association of weight cycling with weight change, weight control practices, and bulimic behaviors. METHODS:: A nested study of 2476 young and middle-aged women in the Nurses' Health Study II who provided information on intentional weight losses between 1989 and 1993. SAMPLE:: In total, 224 women who were severe cyclers, 741 women who were mild cyclers, 967 age- and BMI-matched controls (noncyclers), and 544 women who did not weight cycle and maintained their weight between 1989 and 1993 completed a questionnaire in 2000-2001 assessing recent intentional weight losses, weight control practices, and weight concerns. RESULTS:: After controlling for age and body mass index (BMI) in 1993, when weight cycling was initially assessed, mild cyclers gained an average of 6.7 pounds (lbs) more and severe cyclers gained approximately 10.3?lbs more than noncyclers between 1993 and 2001. Weight cyclers preferred to change their diet rather than to exercise to control their weight. Severe weight cyclers were less likely than noncyclers to use frequent exercise as a weight control strategy (odds ratio [OR]=0.8, 95% confidence interval (CI) 0.6-1.1). Cyclers were also more likely than noncyclers to engage in binge eating (mild cyclers: OR=1.8, 95% CI 1.4-2.4; and severe cyclers: OR=2.5, 95% CI 1.7-3.5). Independent of weight cycling status, age, and BMI, women who engaged in binge eating gained approximately 5?lbs more than their peers (P<0.001). CONCLUSIONS:: Weight cycling was associated with greater weight gain, less physical activity, and a higher prevalence of binge eating. Low levels of activity and binge eating may be partially responsible for the large amount of weight regained by weight cyclers.International Journal of Obesity (2004) 28, 1134-1142. doi:10.1038/sj.ijo.0802728 Published online 20 July 2004 [ABSTRACT FROM AUTHOR]

The importance of the relative dietary content of protein, carbohydrate and the type of carbohydrate (that is, glycemic index (GI)) for weight control under ad libitum conditions has been controversial owing to the lack of large scale studies with high diet adherence. The Diet, Obesity and Genes (DioGenes) European multicentre trial examined the importance of a slight increase in dietary protein content, reduction in carbohydrate and the importance of choosing low (LGI) vs high GI (HGI) carbohydrates for weight control in 932 obese families. Only the adults underwent a diet of 800 kcal per day for 8 weeks, and after losing ~11kg they were randomized to one of five energy ad libitum diets for 6 months. The diets differed in protein content and GI. The high-protein (HP) diet groups consumed 5.4% points more energy from protein than the normal protein (NP) groups, and the LGI diet groups achieved 5.1% lower GI than the HGI groups. The effect of HP and LGI was additive on weight loss and maintenance, and the combination was successful in preventing weight regain and reducing drop-out rate among the adults after the 11kg weight loss. This diet also reduced body fatness and prevalence of overweight and obesity among their children and had consistent beneficial effects on blood pressure, blood lipids and inflammation in both parents and children. After 1 year, mainly the HP effects were maintained. Putative genes have been identified that suggest this diet to be particularly effective in 67% of the population. In conclusion, the DioGenes diet has shown to be effective for prevention of weight regain and for weight reduction in overweight children under ad libitum conditions. The less-restrictive dietary approach fits into a normal food culture, and has been translated into popular diet and cook books in several languages. [ABSTRACT FROM AUTHOR]

Introduction: A considerable number of patients experience some long-term weight regain after bariatric surgery. Body contouring surgery (BCS) is thought to strengthen post-bariatric surgery patients in their weight control and maintenance of achieved improvements in comorbidities. Objectives: To examine the impact of BCS on long-term weight control and comorbidities after bariatric surgery. Methods: We performed a retrospective study in a prospective database. All patients who underwent primary Roux-en-Y gastric bypass (RYGB) and presented for preoperative consultation of BCS in the same hospital were included in the study. Linear and logistic mixed-effect model analyses were used to evaluate the longitudinal relationships between patients who were accepted or rejected for BCS and their weight loss outcomes or changes in comorbidities. Results: Of the 1150 patients who underwent primary RYGB between January 2010 and December 2014, 258 patients (22.4%) presented for preoperative consultation of BCS. Of these patients, 126 patients eventually underwent BCS (48.8%). Patients who were accepted for BCS demonstrated significant better ∆body mass index (BMI) on average over time (− 1.31 kg/m2/year, 95% confidence interval (CI) −2.52 − −0.10, p = 0.034) and percent total weight loss (%TWL) was significantly different at 36 months (5.79, 95%CI 1.22 – 10.37, p = 0.013) and 48 months (6.78, 95%CI 0.93 – 12.63, p = 0.023) after body contouring consultation. Patients who were accepted or rejected did not differ significantly in the maintenance of achieved improvements in comorbidities. Conclusion: BCS could not be associated with the maintenance of achieved improvements in comorbidities after bariatric surgery, whereas it could be associated with improved weight loss maintenance at 36 and 48 months after body contouring consultation. This association should be further explored in a large longitudinal study. [ABSTRACT FROM AUTHOR]

We investigated the intersection of sexual minority, gender, and Hispanic identities, and their interaction with peer victimization in predicting unhealthy weight control behaviors (UWCB) among New York City (NYC) youths. Using logistic regression with data from the 2011 NYC Youth Risk Behavior Survey, we examined the association of sexual identity, gender, ethnicity, and peer victimization (dating violence, bullying at school, electronic bullying) in predicting UWCB. Sexual minority youths, dating violence victims, and youths bullied at school had 1.97, 3.32, and 1.74 times higher odds of UWCB than their counterparts, respectively (P < 0.001). The three-way interaction terms between (i) dating violence, gender, and sexual identity and (ii) electronic bullying, gender, and sexual identity were statistically significant. The effect of dating violence on unhealthy weight control practices was strongest among sexual minority males (OR = 4.9), and the effect of electronic bullying on unhealthy weight control practices was strongest among non-sexual minority males (OR = 2.9). Sexual minority and gender identities interact with peer victimization in predicting unhealthy weight control practices among NYC youths. To limit the prevalence and effect of dating violence and electronic bullying among youths, interventions should consider that an individual's experiences are based on multiple identities that can be linked to more than one ground of discrimination. [ABSTRACT FROM AUTHOR]

Objectives:To examine the association between perceived overweight status and weight control, discrepancies between perceived and measured weight status, and opportunities for health care professionals (HCPs) to correct weight perception among US adults.Design:Population-based cross-sectional study.Subjects:In all, 16 720 non-pregnant adults from the 2003 to 2008 National Health and Nutrition Examination Survey.Results:Overall, 64% (73% women, 55% men) reported a desire to weigh less and 48% (57% women, 40% men) reported pursuing weight control. Weight control was positively associated with overweight perception (odds ratio (OR) women 3.74; 95% confidence interval (CI) 2.96, 4.73; OR men 2.82; 95% CI 2.11, 3.76) and an HCP diagnosis of overweight/obesity (OR women 2.22; 95% CI 1.69, 2.91; OR men 2.14; 95% CI 1.58, 2.91), independent of measured weight status. A large proportion of overweight individuals (23% women, 48% men) perceived themselves as having the right weight. Also, 74% of overweight and 29% of obese individuals never had an HCP diagnosis of overweight/obesity. Although the majority of overweight/obese individuals (74% women, 60% men) pursued at least one weight management strategy, fewer (39% women, 32% men) pursued both dietary change and physical activity. Among overweight/obese adults, those with an HCP diagnosis of overweight/obesity were more likely to diet (74 versus 52%), exercise (44 versus 34%), or pursue both (41 versus 30%, all P<0.01) than those who remained undiagnosed.Conclusion:HCPs have unused opportunities to motivate their patients to control and possibly lose weight by correcting weight perceptions and offering counseling on healthy weight loss strategies. [ABSTRACT FROM AUTHOR]

This study investigates the importance of weight control beliefs in increasing or decreasing one’s risk for disordered eating. Beliefs underlying weight control (“weight can and should be controlled”) and non-dieting (“strive for a healthy lifestyle and accept one’s natural weight”) approaches were measured and their relationship to disordered eating, body dissatisfaction and self-esteem examined. In study 1, a new Weight Control Beliefs Questionnaire was evaluated and the relation to disordered eating, body dissatisfaction and self-esteem was investigated in a non-clinical sample of 138 women. In study 2, the questionnaire’s ability to distinguish eating disordered ( n = 37) from non-eating disordered ( n = 37) individuals was evaluated. A belief that one should control one’s weight (BCWeight) was significantly related to disturbed eating, body dissatisfaction and poor self-esteem, whereas a belief that one should control one’s lifestyle and accept the resulting weight (BCLifestyle) showed a strong protective relationship. The questionnaire successfully discriminated eating disordered from non-eating disordered individuals. It is suggested that treatment approaches for both eating disorders and obesity should be evaluated for their impact on these beliefs. [ABSTRACT FROM AUTHOR]

OBJECTIVE:: To examine binge eating, depression, weight self-efficacy, and weight control success among obese individuals seeking treatment in a managed care organization. DESIGN:: Gender-stratified analyses of associations between binge eating, depression, weight self-efficacy, and weight change, using data from a randomized clinical trial that compared low-cost telephone-based, mail-based, and usual care interventions for weight loss. SUBJECTS:: A total of 1632 overweight individuals (460 men, 1172 women; mean age: 50.7?y; mean body mass index: 34.2?kg/m2) were recruited from a large Midwestern US managed care organization. MEASUREMENTS:: Height and weight were measured by study personnel at baseline, and self-reported weight was assessed at 6 and 12 months; self-reported depression status, binge eating, and self-efficacy for weight control were assessed at baseline. RESULTS:: Lifetime prevalence rates for depression and probable binge eating disorder were high. Weight self-efficacy was inversely related to weight in both men and women. For women, depression was associated with lower weight self-efficacy and higher body weight. Women reporting depression or lower weight self-efficacy at baseline had less weight loss success at 6 and 12 months. Depression, binge eating disorder, and weight self-efficacy were not significantly associated with weight loss success in men. CONCLUSION:: Negative emotional states are highly prevalent and predict poor treatment outcomes, particularly for obese women. As obese women with clinical depression typically are excluded from intervention studies, further research on how to address the intersection of obesity intervention and mood management may be warranted.International Journal of Obesity (2004) 28, 418-425. doi:10.1038/sj.ijo.0802570 Published online 13 January 2004 [ABSTRACT FROM AUTHOR]

Aims: Treatment strategies for obese patients with type 2 diabetes mellitus aim to increase physical activity, reduce body weight, and improve glucose control using weight-beneficial antidiabetic drugs. The objective of this study was to determine whether these strategies are implemented, and to identify factors predictive of glucose control and body weight management in a large, real-world patient population. Methods: The prospective DiaRegis cohort study included 3807 patients with type 2 diabetes in whom the treating physician decided to intensify and optimize treatment because of insufficient glucose control. Results: Antidiabetic treatment of overweight and obese patients was compared with that of normal-weight patients over a 2-years follow-up period, and multivariate analyses were performed to identify predictors of body weight loss. Among the 3807 participants, 92.5 % were overweight or obese. Normal-weight participants were more often treated with sulfonylureas or insulin, and overweight and obese patients with metformin or glucagon-like peptide (GLP)-1 analogues. Predictors of weight loss were body mass index (BMI) ≥30 kg/m and any reported physical activity. Conclusions: DiaRegis study shows that under real-world conditions, antidiabetic drug therapy is performed dependent on body weight. This strategy results in adequate glucose control and moderate weight reductions in overweight and obese patients. Weight loss is affected by treatment with weight-beneficial drugs, but also by any reported physical activity. However, only a small subgroup of patients perform physical activity. Initiation and maintenance of a physically active lifestyle remains a significant challenge for physicians, and patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Objective:Web-based treatment programs are attractive in primary care because of their ability to reach numerous individuals at low cost. Our aim of this meta-analysis is to systematically review the weight loss or maintenance effect of the Internet component in obesity treatment programs.Methods:MEDLINE and EMBASE literature searches were conducted to identify studies investigating the effect of Web-based individualized advice on lifestyle modification on weight loss. Randomized controlled trials that consisted of a Web-user experimental and non-Web user control group were included. Weight changes in the experimental group in comparison with the control group were pooled with a random-effects model.Results:A total of 23 studies comprising 8697 participants were included. Overall, using the Internet had a modest but significant additional weight-loss effect compared with non-Web user control groups (−0.68 kg, P=0.03). In comparison with the control group, stratified analysis indicated that using the Internet as an adjunct to obesity care was effective (−1.00 kg, P<0.001), but that using it as a substitute for face-to-face support was unfavorable (+1.27 kg, P=0.01). An additional effect on weight control was observed when the aim of using the Internet was initial weight loss (−1.01 kg; P=0.03), but was not observed when the aim was weight maintenance (+0.68 kg; P=0.26). The relative effect was diminished with longer educational periods (P-trend=0.04) and was insignificant (−0.20 kg; P=0.75) in studies with educational periods of 12 months or more.Conclusion:The current meta-analysis indicates that the Internet component in obesity treatment programs has a modest effect on weight control. However, the effect was inconsistent, largely depending on the type of usage of the Internet or the period of its use. [ABSTRACT FROM AUTHOR]

Objective:To examine weight loss maintenance among previous participants of a university-based behavioral weight management program and to compare behavioral strategies and perceived barriers between successful and unsuccessful maintainers.Method:Previous program participants (n=179) completed mailed surveys assessing current weight, weight control behaviors and perceived barriers to weight loss maintenance.Results:At 14.1±10.8 months following completion of treatment, survey respondents were on average 12.6±12.6 kg, or 11.3±10.7%, below baseline weight; 76.5% of respondents had successfully maintained weight, defined as maintaining a weight loss of at least 5% below baseline. Compared to unsuccessful maintainers, successful maintainers reported practicing four dietary and three physical activity weight control strategies more often and experiencing five barriers to healthy eating and exercise less often. After accounting for time since treatment and maximum weight loss while in treatment, the strongest correlates of successful weight loss maintenance were frequent exercise and perceived difficulty of weight management.Conclusions:Clinically meaningful weight loss maintenance was achieved by the majority of participants. Findings support the literature indicating that physical activity is one of the strongest predictors of successful weight loss maintenance. Findings also suggest that strategies to reduce the level of perceived effort required for long-term weight control may improve maintenance outcomes.International Journal of Obesity (2008) 32, 519–526; doi:10.1038/sj.ijo.0803769; published online 4 December 2007 [ABSTRACT FROM AUTHOR]

CONTEXT:: Although most health insurers exclude coverage of weight control therapy, one local insurer offered partial reimbursement of the cost of a weight control program, using an incentive plan. OBJECTIVE:: To determine whether outcome-driven insurer-based reimbursement improves participation in a weight control program and short-term weight loss outcomes. DESIGN:: Cohort follow-up study between January 1998 and February 2001. SETTING:: Community weight management program operated by an academic medical center. SUBJECTS:: Obese participants who had the potential for reimbursement (Group A, n=25) and participants in the same program classes (Group B, n=100) who had no possibility for reimbursement. Subjects in Group B were selected from among 206 potential participants using a propensity score to match them with subjects in Group A on age, gender, ethnicity, starting BMI, starting weight, and educational, economic, and demographic variables. INTERVENTION:: Group lifestyle-based weight management program. The insurer reimbursed half the cost of the program to obese participants who met minimum weight criteria, paid the program fee at enrollment, attended =10 of the 12 classes, and lost =6% of initial body weight after 12 weeks. MAIN OUTCOME MEASURES:: Participation rates and weight loss outcomes. RESULTS:: Group A subjects attended significantly more classes (mean±s.d.: 10.1±1.8 vs 8.2±2.5, P<0.001) and lost more weight than Group B subjects (6.1±3.1 vs 3.7±3.6%, P=0.002). While 84% of Group A subjects attended =10 classes, only 37% of Group B subjects did so (P<0.001); 56% of Group A subjects lost =6% of body weight, but only 20% of Group B subjects did so (P<0.001); 56% of Group A subjects achieved both the class attendance and weight loss goals, but only 14% of Group B subjects did so (P<0.001). Logistic regression estimated that Group A subjects had 8.2 times the odds of attending =10 classes and 4.5 times the odds of losing =6% of body weight of Group B subjects, after controlling for class attendance. CONCLUSIONS:: Insurer-based reimbursement that is contingent upon initial financial commitment on the part of the patient, consistent program participation, and successful weight loss is associated with significantly better short-term weight control outcomes.International Journal of Obesity (2003) 27, 1423-1429. doi:10.1038/sj.ijo.0802403 [ABSTRACT FROM AUTHOR]

OBJECTIVE: To study the usefulness of a mathematical index for assessing changes in body composition of obese children and adolescents who undergo a weight control program. DESIGN: A short-term longitudinal (mean of 19 months) cohort study. SUBJECTS: Sixty-seven obese children and adolescents (38 M, 29 F, age 6-16 (mean 11) y) who took part in a clinic-based weight control program. MEASUREMENTS: Percentage body fat was assessed at the start of the program by underwater weighing (UWW) and by bioelectrical impedance (BIA). Response to the program was assessed by a mathematical index (MI), based on observed and expected changes in height and weight, and by changes in percentage fat as measured by BIA. RESULTS: Adiposity, as assessed by BIA at the start of the program, was highly correlated to that obtained by UWW (r=0.96 for fat-free mass). Changes in the MI over the program were correlated fairly well (r=-0.81, SEE=3.57 kg) with changes in percentage fat as assessed by BIA. CONCLUSION: Using change in BIA as criterion, the MI is valid for assessing changes in percentage body fat of obese children and adolescents over time. This index is of use to clinicians who lack body composition equipment and need a quick method to analyze the effectiveness of a weight control program in obese children and adolescents. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To establish the association between intentional weight control and specific eating behaviours. DESIGN: An interview-based survey of a representative sample of the UK population including questions about demographic characteristics, weight and height, intentional weight control and eating behaviours. Associations among the eating behaviours, and between weight control and eating behaviours, were examined. SUBJECTS: 1894 men and women completed the interview (70% response rate). RESULTS: Approximately equal proportions of the sample were 'not bothered about weight' (30%), 'watching their weight' (36%), or 'trying to lose weight' (28%). More men were 'not bothered' and more women were 'trying to lose'. People who were trying to lose or were watching their weight were more likely to report restricting fats, sugars, snacks, and the amount eaten at meals, than those who were not bothered, but there were no differences between weight watchers and weight losers. The overall level of restriction among weight losers was modest. There were no group differences in eating breakfast, fruits or vegetables, skipping meals or fasting. CONCLUSIONS: Around two-thirds of the adult population of the UK appear to be concerned about weight control, and this is reflected in somewhat higher than average adherence to recommended restrictive dietary habits. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To compare the frequency and duration of varying intensities of physical activity performed by adults trying to lose weight, avoid gaining weight and not actively trying to control their weight, and to compare these groups' beliefs about the physical activity they should perform. METHOD: Random postal survey of 2500 Victorian adults selected from the Australian electoral roll (response rate=42%). MEASURES: One-week physical activity recall (frequency and duration of walking, other moderate activity and vigorous activity), BMI (based on self-reported height and weight) and weight-control behaviour. RESULTS: At the time of the survey, 27% of respondents were actively trying to avoid gaining weight, 23.9% trying to lose weight and 49.1% undertaking no weight control. Respondents spent a mean time of 4.0 (±7.1) h walking, 5.5 (±7.9) h in moderate activity and 3.1(±5.9) h in vigorous activity during the week prior to the survey. Women trying to lose weight or avoid gaining weight engaged in vigorous activity more often than women not trying to control their weight. After adjusting for age, education and BMI, women trying to avoid gaining weight were 2.4 times more likely, and women trying to lose weight 2.5 times more likely, to have met current physical activity guidelines than women undertaking no weight control. On average, respondents believed they should spend 5.2 (±6.9) h walking, 6.5 (±8.2) h in moderate activity and 4.3 (±6.5) h in vigorous activity each week. Women trying to lose weight felt they should perform vigorous activity more often than other women. Weight-control behaviour was not associated with physical activity beliefs and behaviours of men. CONCLUSION: Walking is a common activity among adults attempting weight control. However, many men and women do not fully recognize the value of moderate-intensity physical activity. Future efforts should be directed at promoting the role of... [ABSTRACT FROM AUTHOR]

Weight control has been major health issue in the prevention of lifestyle-related diseases especially among middle-aged working males in Japan. The computerized behavioral program is expected as an effective and feasible intervention tool. The purpose of this study is to examine two hypotheses. The first was that first month weight loss effect is obtained by a behavioral program assisted by computer-tailored advices (Kenkou-tatsujin™ [KTP]) among overweight males and maintained for 7 months; the second was that the effects in the full KTP is superior to the booklet only. Fifty-one males (body mass index [BMI] = 26.2) were randomly allocated to the KTP group (KTPG) or control group (CG). The KTPG ( n = 23) read a booklet, set target behaviors, received advises, and self-monitored their weight and the targeted behaviors for 7 months. The CG ( n = 28) read the same booklet. Weight, BMI, biological indices, and daily behaviors were compared at baseline, first, third, and seventh month. The subanalysis among 36 obese subjects was added. In KTPG, weight loss was larger at the first month (−1.1 vs. −0.3 kg), walking steps increased for the seventh month, and several biological indices tended to improve more at the third month than CG. However, the difference of weight loss was not significant at the seventh month. Among the obese subjects, weight loss in KTPG was larger than CG at the third month (−3.0 vs. −1.4 kg). Weight loss effects of KTP were significant at 1 month, walking steps increase was maintained for 7 months. [ABSTRACT FROM AUTHOR]

OBJECTIVE:: The present study examined whether long-term weight loss maintenance is enhanced by maintaining the same diet regimen across the week and year or by dieting more strictly on weekdays and nonholiday periods than at other times. METHOD:: National Weight Control Registry participants (N=1429) indicated on an eight-point scale whether they dieted more strictly on weekends than weekdays, adhered to the same diet regimen throughout the week, or dieted more strictly on weekdays. Participants responded to a similar question about holiday and vacation eating. Participants were then followed prospectively to determine whether scores on these questions were related to self-reported weight regain over the subsequent 12 months. RESULTS:: There was a linear relationship between scores on the dieting consistency questions and weight change over the 1-y period (P's <0.01), with smaller weight gains in those who reported more consistency. Participants who reported a consistent diet across the week were 1.5 times more likely to maintain their weight within 5 pounds over the subsequent year (OR=1.58, 95% CI: 1.2-2.2) than participants who dieted more strictly on weekdays. A similar relationship emerged between dieting consistency across the year and subsequent weight regain. CONCLUSION:: Dieting consistency appears to be a behavioral strategy that predicts subsequent long-term weight loss maintenance.International Journal of Obesity (2004) 28, 278-281. doi:10.1038/sj.ijo.0802550 Published online 25 November 2003 [ABSTRACT FROM AUTHOR]

OBJECTIVE:: To conduct a descriptive systematic review into the nature and effectiveness of family involvement in weight control, weight maintenance and weight-loss interventions. METHOD:: We searched Medline and Psyclit for English language papers describing randomised trials with at least 1-y follow-up that evaluated interventions incorporating a family-based component. Studies involving people with eating disorders, learning disabilities and undernutrition or malnutrition were excluded. Data were extracted on characteristics of the participants, study design, target behaviours, nature of the intervention and study outcomes. A taxonomy was developed and used to classify family involvement in behaviour change interventions. Interventions were also classified according to an existing taxonomy that characterised the behaviour change techniques employed. RESULTS:: A total of 21 papers describing 16 intervention studies were identified. Studies were small (mean sample size: 52), heterogeneous, poorly described but with few losses to follow-up (median 15%). The majority were North American and aimed at weight loss. Few studies described a theoretical underpinning to the behaviour change techniques employed. There was a suggestion that spouse involvement increased effectiveness but that adolescents achieved greater weight loss when treated alone. In studies including children, beneficial effects were seen when greater numbers of behaviour change techniques were taught to both parents and children. CONCLUSION:: Relatively few intervention studies exist in this important area, particularly studies targeting adolescents, and they highlight continued uncertainty about how best to involve family members. The studies provide limited support for the involvement of spouses. They suggest that parental involvement is associated with weight loss in children, and that use of a greater range of behaviour change techniques improves weight outcomes for both parents and children. The development of future interventions and assessment of factors influencing effectiveness may be improved by paying careful attention to which family members are targeted and how they are involved in the intervention in terms of setting goals for behaviour change, providing support and training in behaviour change techniques.International Journal of Obesity (2003) 27, 987-1005. doi:10.1038/sj.ijo.0802383 [ABSTRACT FROM AUTHOR]

Abstract Rationale: Sibutramine (Meridia) is a serotonin and norepinephrine reuptake inhibitor marketed for weight control. Previous studies demonstrated low abuse potential for 20 and 30 mg sibutramine (doses near the therapeutic range); however, no data existed on supra-therapeutic doses. This study, therefore, examined 25 and 75 mg sibutramine in humans compared to d-amphetamine (20 mg) as a positive control and placebo as a negative control. Objectives: The study examined the acute subjective, reinforcing, and physiological effects of sibutramine to assess its abuse liability. Methods: Twelve polydrug abusers with no history of drug dependence participated in this double-blind, inpatient/outpatient study. Volunteers participated in four drug sessions, in which they completed subjective effects scales including the Profile of Mood States (POMS), Visual Analog Scales (VAS), and the Addiction Research Center Inventory (ARCI). The Multiple Choice Procedure (MCP) was used to evaluate reinforcing efficacy. Results: Sibutramine 25 mg produced subjective effects that were indistinguishable from placebo. Sibutramine 75 mg produced significant unpleasant effects, such as Anxiety, Confusion, and decreased Vigor. On the MCP, volunteers chose to give up an average of $4.04 from their study pay rather than receive the higher dose of sibutramine again. In contrast, d-amphetamine 20 mg produced positive mood changes and was well liked. Conclusions: These data indicate sibutramine lacks amphetamine-type abuse liability when administered acutely. [ABSTRACT FROM AUTHOR]

Participants who receive continued coach contact following behavioral weight loss treatment are more successful in maintaining their weight loss long-term. The current study examines whether these contacts have dynamic effects, such that participants are most adherent to the prescribed weight loss behaviors in the days after the call, when motivation and goal salience may be heightened, than they are as time goes on. The current study examined the trajectory of calorie intake, physical activity, weight, and self-monitoring behavior in the fourteen days after a monthly coaching call among participants completing the maintenance phase of a behavioral weight loss trial. For physical activity outcomes, caloric intake, and weight, there were no changes across time. Participants did have the highest adherence and quality of dietary self-monitoring immediately after the call, which diminished over time. Coach contact may continually renew commitment to this burdensome but critical behavior. Likelihood of self-weighing showed an opposite trend, where participants were more likely to weigh themselves in the days more distal from the coach call. Results can inform the timing and content of future coach contact to promote weight control. [ABSTRACT FROM AUTHOR]

Objectives:To examine 9-year trends and relationships regarding misperceptions of body size and dieting for weight loss among adolescents from 24 countries, and explore the influence of country-level overweight prevalence.Methods:Sociodemographic characteristics, body size perception and dieting for weight loss were assessed in the Health Behaviour in School-aged Children survey conducted in 24 countries cross-sectionally at three time points (2001/2002, 2005/2006 and 2009/2010). Logistic regression models examined change over time in overestimation of body size in non-overweight adolescents, underestimation of body size in overweight adolescents, dieting for weight loss in non-overweight and overweight adolescents and relationships between body size perception and dieting. Analyses were stratified by weight status and sex. Covariates included country-level overweight prevalence, family affluence and country level of development. Body mass index was only included in models examining dieting for weight loss.Results:Country-level overweight prevalence increased over time (11.6-14.7%). Compared with Time 1, overweight adolescents had greater odds of body size underestimation at Time 3 (odds ratio (OR)=1.68 for girls; OR=1.10 for boys), whereas non-overweight adolescents had lower odds of body size overestimation at Time 3 (OR=0.87 for girls; OR=0.89 for boys). Controlling for country-level overweight prevalence attenuated these relationships. Compared with Time 1, overweight and non-overweight boys were 10% more likely to diet at Time 3, whereas overweight and non-overweight girls were 19% and 16%, respectively, less likely to diet at Time 3. Controlling for country-level overweight prevalence did not impact trends in dieting for weight loss. Additionally, the association of self-perceived overweight with increased odds of dieting diminished over time.Conclusions:Body size perceptions among adolescents may have changed over time concurrent with shifts in country-level body weight. However, controlling for country-level overweight prevalence did not impact trends in dieting for weight loss, suggesting a potentially stronger impact of social comparison on weight-related perceptions than on behavior. [ABSTRACT FROM AUTHOR]

Discusses energy density of foods and the implications of sweeteners to weight control. Factors which cause human obesity; Definition of energy density; Relationship between energy density and obesity; Regulation of food intake.

Bariatric/metabolic surgeries are remarkably effective in reducing weight over a sustained period of time, and they also have significant beneficial effects on glucose homeostasis. Interestingly, the metabolic benefits of these surgeries frequently occur before significant weight loss. Given these findings, it is perhaps not surprising that obesity researchers are asking, how does bariatric/metabolic surgery work? Establishing these mechanisms can offer new insights into the physiology of energy balance and the control of metabolism. In the second half of the 13th International Symposium of the Merck Frosst/CIHR Research Chair in Obesity, four papers that address the mechanisms of bariatric/metabolic surgery were presented. The papers that follow this viewpoint all make use of animal models to reveal the neurohumoral mechanisms underlying weight loss and improved glucose homeostasis after experimental bariatric surgery. The rodent models of the commonly used clinical procedures have shown that energy intake is increased, food reward is altered and that the proximal gut is important in the control of energy balance and glucose homeostasis. Taken together, these models shed light on the mechanisms of bariatric/metabolic surgery and offer new insights that, in the future, may lead to less invasive therapies. [ABSTRACT FROM AUTHOR]

Nutrient signaling has recently shown how nutraceuticals regulate specific functions of the brain and adipose tissue. In this pilot study to find an effective nutrient signaling system to cause weight loss, a double-blind placebo-controlled trial using leucine, olive oil, and fish oil was conducted on volunteers to signal metabolic and appetite effects to regulate body weight, while controls took only fiber. Men and women aged 18–26 and 39–62 years were given different dosages that they took orally twice daily for 14 days while recording body weight, followed by 2 weeks to check rebound. Most young men and women lost weight on low dose leucine and olive oil. Mature men required higher doses. Mature women’s weight was affected least, though results are consistent with a hypothesis that sufficient leucine and docosahexaenoic acid would be effective. Determining how age affects signaling pathways by nutrients will be important to reduce risk of chronic disease associated with age and obesity. This pilot study has led to hypotheses of practical strategies. [ABSTRACT FROM AUTHOR]

Bariatric surgery has evolved into multiple forms in the last decades, combining food restriction and malabsorption. The aim of this study was to develop a new technique based on food restriction and early stimulation of the distal gut, thus maintaining the alimentary tract continuity. Thirty-two Yorkshire pigs, weight 22.2 ± 5.4 kg (mean ± SD) were randomly assigned to four laparoscopic procedures: ileal transposition (IT, n = 8); sleeve gastrectomy with ileal transposition (SGIT, n = 8); Roux-en-Y gastric bypass (GBP, n = 8); sham operation (SHAM, n = 8). Firing 45-mm linear staplers over a 60-F bougie, resecting the greater curvature and fundus, constituted a sleeve gastrectomy. Ileal transposition was performed by isolating a 100-cm ileal segment proximal to the ileocecal valve and by dividing the proximal jejunum 15 cm distal to the ligament of Treitz and performing re-anastomosis. Gastric bypass consisted of creating a proximal gastric pouch and a 300 cm alimentary limb. Sham operation was performed by bowel transections and re-anastomosis in the ileum and proximal jejunum together with gastrotomy and closure. Animals were evaluated weekly for weight increase and food intake. We performed a logistic regression analysis to compare weight progression curves, and analysis of variance (ANOVA) and Bonferroni (Dunn) tests to detect differences in weight and food intake. We observed significant differences in mean weight after 18 weeks between SGIT (30.9 ± 13.4 kg) and SHAM (72.5 ± 10.7 kg) ( p = 0.0002), and GBP (28.6 ± 2.5 kg) and SHAM ( p = 0.0001), and IT (56.1 ± 13.4 kg) and SHAM ( p = 0.0081). No differences were observed between RYGB and SGIT. We also observed significant differences in food intake (grams per day) in the third month between SGIT (1668 ± 677 g) versus SHAM (3252 ± 476 g) ( p = 0.0006), and GBP (2011 ± 565 g) versus SHAM ( p = 0.039). No differences were observed in food intake between SGIT and GBP. SGIT proved to be as effective in the short term as GBP on weight progression with no bypass of the proximal gut. [ABSTRACT FROM AUTHOR]

There is a need to explore how to increase the satiating power of the diet, so that people feel full with less energy, and by this means reduce their spontaneous energy intake. A reduction of dietary fat from typically 37–27% of total calories will produce a weight loss of 3–5 kg over 6 months, depending on the amount and source of carbohydrate and protein in the diet. The weight loss is sustained as long as the diet composition is adhered to, and evidence from the large Women's Health Initiative dietary intervention trial showed that those who complied with the fat reduction without any energy restriction maintained a lower body weight over 9 years than those on a normal fat diet. The predominant mechanism for the weight loss effect is the lower energy density of the fat-reduced diet, so that this diet provides more food volume and weight for less energy, and hence greater satiating effect than a higher-fat diet. It is likely that the diet also provides a metabolic advantage in individuals susceptible to obesity by a genetically determined impaired ability to rapidly adjust fat oxidation in response to increasing the dietary fat content. The carbohydrate source is also important for the diet's effect on body weight, that is, whereas sugars in solid foods seem to have the same satiating effect than starch, sugar in drinks seems to exert a low inhibition of subsequent food intake. Newer research indicates that increasing the protein content at the expense of fat and carbohydrate might offer a way to increase the satiating and thermogenic effect of ad lib diets, and facilitate weight loss and maintenance.International Journal of Obesity (2006) 30, S4–S9. doi:10.1038/sj.ijo.0803485 [ABSTRACT FROM AUTHOR]

Objective:Young women in the United States and Western Europe are notoriously concerned about weight but less is known about attitudes to weight in other regions of the world. This study explores the associations between body mass index (BMI), weight perceptions, and attempts to lose weight in male and female university students from 22 countries.Methods:Data were collected from 18 512 university students, using standardised methods, as part of the International Health Behaviour Survey. Measures included weight, height, perception of overweight, and weight loss status. BMI was calculated from weight and height, but was categorised into gender and country-standardised deciles rather than the conventional weight categories in response to the inaccuracy of self-reports. Perceived overweight and weight loss status were plotted against country-standardised BMI deciles. The 22 countries were grouped into five geopolitical/economic areas for regional analyses: North-Western Europe and the USA, Central and Eastern Europe, the Mediterranean, Pacific Asia, South America. Perceived overweight compared across the five regions.Results:Perceived overweight increased systematically across BMI deciles in all countries. More women than men felt overweight at any decile. Women had low levels of perceived overweight in the lowest decile but rates rapidly increased to 50% by the 5th decile. Men, even in the highest deciles, were less aware that they are overweight and few of them were trying to lose weight. Women had a faster rise of weight loss attempts over the BMI deciles but nevertheless the proportion trying to lose in the highest decile did not exceed 75%. Perceived overweight profiles across BMI deciles were similar across all regions, suggesting that perceptions of overweight derive from local comparisons. The patterning for trying to lose weight was more diverse, with men and women from Asian countries showing higher levels of trying to lose weight at all deciles.Conclusions:This study shows the international consistency in perceptions of overweight in educated young men and women across diverse regions of the world. It confirms the patterning of women's overestimation of weight at lower BMI deciles and men's underestimation of weight at the higher deciles. Perceptions of overweight and attempts to lose weight were highest in the group of Asian countries where body weights are generally low, suggesting that local culture and norms could moderate attitudes to weight.International Journal of Obesity (2006) 30, 644–651. doi:10.1038/sj.ijo.0803050; published online 6 September 2005 [ABSTRACT FROM AUTHOR]

Discusses a study which investigated the effect of repeated oral administration of several 5-HT2C receptor agonists in rats. Role of serotonin in a variety of behavioral and physiological functions; Involvement of 5-HT2C in the control of food intake; Side effects of marketed antiobesity agents.

OBJECTIVE:: To compare the long-term compliance and effects of two low-fat diets differing in carbohydrate to protein ratio on body composition and biomarkers of cardiovascular disease risk in obese subjects with hyperinsulinemia. DESIGN:: Outpatient, parallel, clinical intervention study of two groups of subjects randomly assigned to either a standard protein (SP; 15% protein, 55% carbohydrate) or high-protein (HP; 30% protein, 40% carbohydrate) diet, during 12 weeks of energy restriction (~6.5?MJ/day) and 4 weeks of energy balance (~8.3?MJ/day). Subsequently, subjects were asked to maintain the same dietary pattern for the succeeding 52 weeks with minimal professional support. SUBJECTS:: A total of 58 obese, nondietetic subjects with hyperinsulinemia (13 males/45 females, mean age 50.2?y, mean body mass index (BMI) 34.0?kg/m2, mean fasting insulin 17.8?mU/l) participated in the study. MEASUREMENTS:: Body composition, blood pressure, blood lipids, fasting glucose, insulin, CRP and sICAM-1 were measured at baseline and at weeks 16 and 68. Urinary urea/creatinine ratio was measured at baseline, week 16 and at 3 monthly intervals thereafter. RESULTS:: In total, 43 subjects completed the study with similar dropouts in each group (P=0.76). At week 68, there was net weight loss (SP -2.9±3.6%, HP -4.1±5.8%; P<0.01) due entirely to fat loss (P<0.001) with no diet effect. Both diets significantly increased HDL cholesterol concentrations (P<0.001) and decreased fasting insulin, insulin resistance, sICAM-1 and CRP levels (P<0.05). Protein intake was significantly greater in HP during the initial 16 weeks (P<0.001), but decreased in HP and increased in SP during 52-week follow-up, with no difference between groups at week 68, indicating poor long-term dietary adherence behaviour to both dietary patterns. CONCLUSION:: Without active ongoing dietary advice, adherence to dietary intervention is poor. Nonetheless, both dietary patterns achieved net weight loss and improvements in cardiovascular risk factors.International Journal of Obesity (2004) 28, 661-670. doi:10.1038/sj.ijo.0802617 Published online 9 March 2004 [ABSTRACT FROM AUTHOR]

OBJECTIVES: Low-fat high-carbohydrate diets are recommended to prevent weight gain in normal weight subjects and reduce body weight in overweight and obese. However, their efficacy is controversial. We evaluated the efficacy of ad libitum low-fat diets in reducing body weight in non-diabetic individuals from the results of intervention trials. DESIGN: Studies were identified from a computerized search of the Medline database from January 1966 to July 1999 and other sources. Inclusion criteria were: controlled trials lasting more than 2 months comparing ad libitum low-fat diets as the sole intervention with a control group consuming habitual diet or a medium-fat diet ad libitum. MAIN OUTCOME MEASURES: Differences in changes in dietary fat intake, energy intake and body weight. Weighted mean differences for continuous data and 95% confidence intervals (CIs) were calculated. RESULTS: Two authors independently selected the studies meeting the inclusion criteria and extracted data from 16 trials (duration of 2-12 months) with 19 intervention groups, enrolling 1910 individuals. Fourteen were randomized. Weight loss was not the primary aim in 11 studies. Before the interventions the mean proportions of dietary energy from fat in the studies were 37.7% (95% CI, 36.9-38.5) in the low-fat groups, and 37.4% (36.4-38.4) in the control groups. The low-fat intervention produced a mean fat reduction of 10.2% (8.1-12.3). Low-fat intervention groups showed a greater weight loss than control groups (3.2 kg, 95% confidence interval 1.9-4.5 kg; P<0.0001), and a greater reduction in energy intake (1138 kJ/day, 95% confidence interval 564-1712 kJ/day, P=0.002). Having a body weight 10 kg higher than the average pre-treatment body weight was associated with a 2.6±0.8 kg (P=0.011) greater difference in weight loss. CONCLUSION: A reduction in dietary fat without intentional restriction of energy intake causes weight loss, which is more substantial in heavier subjects. [ABSTRACT FROM AUTHOR]

Purpose Of Review: Emerging adulthood (age 18-25) represents a critical period for weight control: rate of weight gain is greatest during these years and the prevalence of overweight and obesity is estimated to be at least 40% among emerging adults. Unique behavioral, psychosocial, and cognitive risk factors among this population must be specifically addressed within weight management programs. We review extant treatment approaches, including lessons learned from the nascent literature specifically targeting this population. Lastly, we provide suggestions to inform future work in this area.Recent Findings: The EARLY consortium comprises seven clinical trials targeting weight control in young adults age 18-35. Though these studies encompass a broader age range, two of the trials enrolled large numbers of 18-25-year-olds. Results from these trials and other recent pilot trials provide a foundation for next steps with respect to developing weight management interventions for emerging adults. The design of targeted weight control approaches for emerging and young adults has contributed to improved outcomes for this high-risk population. However, suboptimal engagement and variability in response pose challenges. Identifying and intervening on individual-level behavioral and psychological variables may enhance the effects of these adapted treatments. [ABSTRACT FROM AUTHOR]

Compares the effectiveness of five monetary incentive strategies in the context of a behavioral weight management program. Continuous positive reinforcement; Monetary response cost; Positive reinforcement with a lottery system; Response cost with a lottery system.

Background: Regulatory focus theory proposes two self-regulatory systems: promotion focus—related to fulfilling aspirations and maximizing positive outcomes—and prevention focus—related to fulfilling responsibilities and avoiding negative outcomes. Building on research demonstrating associations between regulatory focus and weight outcomes, a proof-of-concept weight control intervention framed intervention procedures in terms of promotion or prevention focus and descriptively examined whether the impact of the intervention conditions depended on dispositional regulatory focus. Methods: After random assignment to control (received pamphlet on diet and physical activity), promotion, or prevention conditions (1.5-hour baseline sessions; detailed manuals; 1-hour sessions at 3 months), community participants from a metropolitan area in the United States (N = 57; age M = 40; BMI M = 30.9) completed the Regulatory Focus Questionnaire and were weighed at baseline, 3 months, and 6 months. Longitudinal analysis was conducted with SAS Proc Mixed using restricted maximum likelihood estimation. Results: Estimated weight change was -2.99 kg, 95% CI [-4.65, -1.32], in the promotion condition, -1.70 kg, 95% CI [-3.29, -0.12], in the prevention condition, and -0.18 kg, 95% CI [-1.42, 1.05], in the control condition. Exploratory analyses revealed that for relatively more promotion-focused participants, estimated weight change was -1.43 kg, 95% CI [-3.38, 0.51], in the promotion condition, +0.48 kg, 95% CI [-1.01, 1.97], in the prevention condition, and -1.09 kg, 95% CI [-2.32, 0.14], in the control condition. For relatively more prevention-focused participants, estimated weight change was -5.19 kg, 95% CI [-7.14, -3.25], in the promotion condition, -3.35 kg, 95% CI [-4.83, -1.86], in the prevention condition, and +0.42 kg, 95% CI [-0.81, 1.65], in the control condition. Conclusions: Results suggest that self-directed, promotion-focused interventions may be effective and that tailoring to self-regulatory dispositions may not be of additional benefit in initiating weight loss. [ABSTRACT FROM AUTHOR]

Growing data from epidemiological studies highlight the association between excess body fat and cancer incidence, but good indicative evidence demonstrates that intentional weight loss, as well as increasing physical activity, offers much promise as a cost-effective approach for reducing the cancer burden. However, clear gaps remain in our understanding of how changes in body fat or levels of physical activity are mechanistically linked to cancer, and the magnitude of their impact on cancer risk. It is important to investigate the causal link between programmes that successfully achieve short-term modest weight loss followed by weight-loss maintenance and cancer incidence. The longer-term impact of weight loss and duration of overweight and obesity on risk reduction also need to be fully considered in trial design. These gaps in knowledge need to be urgently addressed to expedite the development and implementation of future cancer-control strategies. Comprehensive approaches to trial design, Mendelian randomisation studies and data-linkage opportunities offer real possibilities to tackle current research gaps. In this paper, we set out the case for why non-pharmacological weight-management trials are urgently needed to support cancer-risk reduction and help control the growing global burden of cancer. [ABSTRACT FROM AUTHOR]

The members of the uncoupling protein family have different purported functions, which can be either directly or indirectly related to the control of body weight. In this sense, a great part of the studies carried out on this topic have been made using male subjects, although different works with male and female subjects have shown important sex-associated differences in the regulation of these proteins; for instance, sex differences have been shown in the cold-, diet- and overweight-induced expression of brown adipose tissue UCP1 and also in the correlation of muscle UCP3 with overweight. In these kinds of studies, models of obesity such as the cafeteria diet feeding and postcafeteria have been very useful. Moreover, sex hormones have been shown to modulate UCP1 expression in brown adipocytes in vitro. All of these sex-dependent differences, as well as sex differences in body weight gain under a hypercaloric diet, could be related to the different respective biological functions of male and female subjects and taking into account the gender effect in future studies on obesity could be of interest.International Journal of Obesity (2004) 28, 327-329. doi:10.1038/sj.ijo.0802579 Published online 13 January 2004 [ABSTRACT FROM AUTHOR]

Purpose: Broad-reach (non-face-to-face) modalities offer an accessible and cost-effective means to provide behavior change programs in diverse and growing cancer survivor populations. The purpose of this systematic review is to evaluate the efficacy of physical activity, dietary, and/or weight control interventions for cancer survivors in which telephone, short-message service, print, and/or Web is the primary method of delivery.Methods: A structured search of PubMed, Embase, Web of Science, CINAHL, and CENTRAL (May 2013) was conducted. Included studies focused and reported on physical activity (PA) and dietary change and/or weight control in adult cancer survivors, delivered at least 50% of intervention contacts by broad-reach modality and included a control group. Study design, intervention features, and behavioral/weight outcomes were extracted, tabulated, and summarized.Results: Twenty-seven studies were included; 22 telephone, three Web, and two print. Sixteen studies targeted PA, two diet, and nine targeted multiple behaviors. Most studies (18/27) targeted a single survivor group, namely breast cancer (n = 12). Nineteen of 27 studies found evidence for initiation of behavior change, with only eight reporting on maintenance and one on cost-effectiveness.Conclusions: This review provides support for broad-reach modalities, particularly the telephone, in the delivery of lifestyle interventions to cancer survivors. Future research should evaluate (1) newer technologies (i.e., SMS and mobile phone applications), (2) interventions for diverse cancer survivors and those targeting multiple behaviors, (3) long-term outcomes, and 4) cost-effectiveness.Implications For Cancer Survivors: Broad-reach lifestyle interventions are effective, with further research needed to evaluate their generalizability and integration into cancer care. [ABSTRACT FROM AUTHOR]

The widespread use of body weight control agents might be related to liver enzyme elevation, but this potential association has only been documented in a few case reports. This study aimed to investigate the associations between weight loss agents and elevated liver enzymes at the population-level. We conducted a cross-sectional study using Korea National Health and Nutrition Examination Survey (KNHANES) data from 2013 to 2019. This study included 36,259 participants over 20 years of age who completed the questionnaire and had no history of hepatitis, cancer, or renal failure. In these participants, we analyzed associations between weight loss agents and elevated liver enzymes by constructing multiple logistic regression models with adjustment for confounding factors and stratified by sex, age, and body mass index. The use of weight loss agents related to liver enzyme elevation in men (adjusted odds ratio (aOR): 1.36, 95% confidence interval (CI): 1.08–1.71) and participants aged less than 40 years (aOR: 1.44, 95% CI: 1.12–1.87). Using more types of weight loss agents was associated with liver enzyme elevation (aOR: 1.31, 95% CI: 1.03–1.67 for 1 weight loss agent, aOR: 1.93, 95% CI: 0.93–3.99 for ≥ 2 weight loss agents). Elevated liver enzymes were associated with the use of traditional medicines (aOR: 1.96, 95% CI: 1.14–3.34) and dietary supplements (aOR: 1.33, 95% CI: 1.02–1.72) in men. We observed an association between weight loss agents and liver enzyme elevation in men, particularly for traditional herbal medicines and dietary supplements. To confirm the observed associations, studies higher on the evidence hierarchy are needed. [ABSTRACT FROM AUTHOR]