Search

To evaluate the rate of remission of metabolic syndrome (Met Syn) among patients undergoing a brief, low-calorie lifestyle change weight loss intervention and to compare the baseline characteristics of patients who were remitted and not remitted from Met Syn at post-treatment.Obese adults (N=36) meeting criteria for Met Syn enrolled in an outpatient fee-for-service behavioral weight loss intervention. Participants were assessed on key Met Syn variables (waist circumference, blood pressure, triglycerides, high-density lipoprotein (HDL) cholesterol and fasting blood glucose) at pre- and post-treatment.The majority of patients (61%) responded to treatment after a 9.9% mean weight loss. Although Met Syn responders did not differ significantly from Met Syn non-responders on any baseline Met Syn criterion variable, responders had significantly lower baseline body mass indices (BMI; kg/m(2)) and met criteria for fewer baseline Met Syn variables. As expected, Met Syn responders, compared with Met Syn non-responders, had significantly lower post-treatment waist circumference, systolic and diastolic blood pressures, triglycerides and fasting blood glucose. Patient groups did not differ significantly on weight lost (kg or %), or on the proportion of patients losingor =10% of initial body weight.In a community population, Met Syn responds to weight loss through a low-calorie lifestyle intervention; for some patients, however, the recommended 10% weight loss may not be enough for Met Syn remission.

To examine the characteristics and outcomes of physician-referred weight management patients relative to self-referred patients.Review of clinic records of all individuals contacting a weight control program during a 2-year period with follow-up throughout consecutive levels of treatment (i.e., enrollment, completion, and outcome).Medical school weight management center.A consecutive sample (N = 1,392) of overweight and obese callers was categorized as physician-initiated (n = 345), media (n = 653), or personal (n = 394) referrals. Attendees at initial consultation (n = 571) were age 41.7 +/- 12.8 years, weight 113.9 +/- 36.1 kilograms, and body mass index (BMI) 40.3 +/- 11.3 kg/m(2) (data expressed as mean +/- standard deviation).Low-calorie-diet and very-low-calorie-diet programs.Gender comparisons, attendance at initial consultation, body mass index, motivation, comorbidities, enrollment and completion rates, and weight loss.Compared to callers from other referral sources, physician referrals included a larger minority of males (25.2%) and were more likely to attend an initial consultation (63.5%; P.001). Among consultation attendees, physician referrals were heavier (mean BMI = 44.8), reported more comorbidities, were less likely to join programs (16.9%), and scored as less motivated than other referrals (P.007). Completion rates for physician referrals were higher than for self-referrals in the very-low-calorie-diet program (85.7%; P.04) but not in the low-calorie-diet program (P.05). Among completers, physician referrals did not differ on weight loss in either program (P.05).Compared to self-referrals, physician-referred individuals are in greater need of weight loss, less motivated, less likely to enter treatment, but equally likely to profit from it. Therefore, physician referral for weight loss is beneficial for at least some patients and should be encouraged.

To identify three groups of obese people entering weight loss treatment, who have distinctly different cognitive appraisals of dietary transgressions and to compare these groups on self-report inventories of eating patterns, dieting, and depression, as well as on treatment completion rates and weight loss.Retrospective review of clinical records. Using a measure which evaluates eating-related cognitive appraisals, participants were categorized into one of three cognitive groups (All-or-None, Rationalization, Matter-of-Degree).289 treatment-seeking obese women (age: 40.9 y, body mass index (BMI): 34.7 kg/m2).Self-reported eating and dieting behavior (Three-Factor Eating Questionnaire and Eating Behavior Inventory); depression (Beck Depression Inventory); attendance information and body weight obtained during treatment.The cognitive group representing objective thinkers (Matter-of-Degree) reported significantly fewer problems with overeating and more personal control over eating than did the rigid, dichotomous thinkers (All-or-None). In addition, the Matter-of-Degree (MAT) group endorsed significantly less subjective hunger and fewer depressive symptoms than the other two cognitive groups. The Rationalization group was more likely to complete a treatment program than was the All-or-None group, with the MAT group not differing from either. Despite these findings, there were no significant differences among cognitive groups on total weight loss.Cognitive appraisals of weight-control lapses appear to be associated with self-reported eating behavior, depressive symptoms and treatment completion rates, but not with treatment-induced weight loss. The relationship between long-term weight loss and cognitive appraisals of dieting lapses is yet to be determined. It appears necessary to assess empirically the validity of assumptions regarding factors associated with treatment outcome.

Third year medical students on core psychiatry clinical rotations received expanded alcoholism training via inclusion of a programmed text on alcoholism, the Alcohol Learning Program (ALP), as required reading. Effects of use of the ALP on alcoholism-related knowledge and attitudes were assessed within a pretest-posttest control group design. Students on alternate rotations received the ALP and constituted the experimental group (n = 60). The control group (n = 66) comprised students on the remaining rotations who received the less extensive alcoholism exposure usually provided. Assessment instruments, completed on the first and last days of rotations, included two alcoholism knowledge tests and a semantic differential completed under six sets of instructions to assess attitudes toward groups differing in use and/or abuse of beverage alcohol. Students receiving the ALP displayed a significantly higher level of knowledge than did controls. Although attitude change associated with use of the ALP was minimal, attitudes toward the different categories of persons rated varied considerably; for example, students viewed alcoholics least favorably and recovered alcoholics most favorably. Discussion focuses on potential advantages of programmed self-instructional training about alcoholism and on implications of attitude findings for design of alcoholism educational efforts for medical students.

Male alcoholic veterans (N=194) were divided into four groups on the basis of their scores on the MacAndrew scale (MAC) of the Minnesota Multiphasic Personality Inventory (MMPI) and compared on psychological and sociodemographic measures and self-reported alcohol, drug, and legal histories. Nineteen subjects scored in the “nonalcoholic” (NA) range of the MAC (i.e., false negatives, MAC≤23). Remaining subjects, scoring in the “alcoholic” range of the MAC, were divided into thirds by MAC scores (lowest third, L-MAC=24–28,n=53; middle third, M-MAC=29–31,n=63; highest third, H-MAC>31,n=59). Groups did not differ on age, any important sociodemographic variables, or scores on the Profile of Mood States, State-Trait Anxiety Inventory, Symptom Checklist-90, or Rod and Frame Test. Significant group differences were obtained on several MMPI scales. Lower MAC scores were associated with higher scores onL, K, D, andR, and lower scores onMa. There was also a tendency for subjects with lower MAC scores to score higher onSi. NA subjects began drinking and heavy drinking later than other subjects, although groups did not differ on duration, quantity, or frequency of drinking. Subjects with higher MAC scores more often reported drinking in bars, drinking liquor straight, alcohol-related job disruptions, and previous use of marijuana, hallucinogens, and barbiturates. Subjects with higher MAC scores had more often been arrested, convicted, fined, and jailed for alcohol-related offenses but not for other offenses. Results are examined with respect to MacAndrew's distinction between primary and secondary alcoholics and with respect to the possible relations of MAC to important person variables such as sensation seeking.

The Eating Behavior Inventory (EBI) is a self-report instrument for assessing behaviors that have been theoretically implicated in weight loss, e.g., self-monitoring of food intake and of weight, refusing offers of food, eating at only one place, shopping from a list, eating in response to emotions. Thirty items were constructed in the form of first-person statements, e.g., “I eat in the middle of the night.” Each item was to be rated with a 5-point scale according to how often it was true for the respondent. Items were scored such that higher scores always reflected more “appropriate” (theoretically facilitative of weight control) eating patterns. Validity of individual items and total score was assessed in four studies. Twenty-six of the original items appeared valid and were retained. The resulting total score demonstrated validity in these studies and in two cross-validational comparisons. Internal consistency as measured by split-half reliability and correlations of item scores with total score was acceptable. One month test-retest reliability of item and total scores was satisfactory. Clinical and research applications of the EBI are discussed.