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Physical activity is a health behavior contributing to successful weight management. Adults with overweight and obesity find it challenging to meet recommended activity guidelines because of a range of barriers, some of which are not yet fully understood. A barrier receiving limited consideration, compared with other literature within this field, is that of fear. The purpose of this scoping review was to establish the extent of literature on fear-related barriers to physical activity in adults with overweight or obesity and to identify gaps in this literature. The review followed the scoping review framework outlined by Arksey and O'Malley and adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. The findings of the identified papers were charted thematically using a framework of fears and age group. In total, 34 studies were included that identified nine different fears related to barriers to activity in this population. However, only a small number of studies (n = 5) had explicitly intended to explore fear-related barriers. There were notable knowledge gaps including activity-related fear of pain and movement in adults under 45 years of age. There is a strong rationale to further explore these fears because they may restrict health promoting behavior.

The chronic fatigue syndrome (CFS) remains a contentious and controversial presentation despite decades of systematic research from a variety of medical specialties and associated disciplines. Variously championed as a condition of immunological, neurological, neurophysiological, psychiatric or psychological origin, consensus on a cogent and evidenced-based pathway has yet to be achieved. Irrespective of the ambiguity regarding aetiology, what is incontrovertible is the experience of significant depression, which often accompanies this most distressing clinical presentation. The current paper examines the potential underlying mechanisms, which may determine and explain this relationship between CFS and depression. In doing so, it offers some insights, which may be of value in the development of evidence-based and scientifically-anchored interventions in individuals experiencing this diagnosis, to improve outcomes in relation to depression specifically and quality of life more generally.

Palliative care refers to treatment and care delivered when the disease/illness is not responsive to curative treatment. The World Health Organization defines palliative care as ‘an approach that improves the quality of life of patients and their families facing the problems associated with life threatening illness, through the prevention and relief of suffering by means of an early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual’ (WHO 2004). Palliative care and treatment strategies can also be used to manage the side effects of intrusive treatments within curative treatment. Often associated in the mind as being related to oncology and cancer, palliative care can be delivered to people experiencing any form of life-threatening illnesses such as chronic heart failure, respiratory disease, and neurological disorders such as motor neurone disease and multiple sclerosis. Palliative care can also be distinguished from end-of-life care. In the UK end-of-life care is written into clinical pathways concerned with the final days and hours of a person’s life (DoH 2008; LCP 2008). The key aims of these care pathways are to improve quality of care of the dying in the last hours and days of life and to improve knowledge related to the process of dying.

Individuals make dietary choices each time they consume food or drink, and assign labels to each item, such as un/healthy, high/low in calories, high/low in nutrients. These labels are thought to be snap judgments based on prior, and often limited nutritional knowledge. The aim of this study was to examine the perception of the caloric content of ‘healthy’ and ‘unhealthy’ foods. Participants (N=141) rated 53 food images on perceived healthiness/un-healthiness alongside the caloric content. Participants were subdivided into three groups: BMI (normal-weight, overweight, obese). Foods perceived as healthy were systematically underestimated in their caloric content, whereas foods perceived as unhealthy were consistently overestimated. Weight status influenced caloric estimations of foods perceived as healthy, but not to foods perceived as unhealthy. However, not all foods were consistently labeled as healthy or unhealthy, on these occasions weight salience appears not to have influenced estimations of caloric content. Findings suggest that weight status impacts participant's caloric estimation of foods perceived as healthy, but only marginally for unhealthy foods. Foods that confound the dichotomous labeling of healthy or unhealthy appear to gain a ‘branding’ that confers either greater or fewer calories than they actually contain, on these occasions weight salience does not appear to influence the labeling; implications are discussed.

Autistic spectrum disorders are a diverse group of complex, persistent and pervasive neurodevelopmental conditions which are characterized by impairments in social communication, social interaction, often restrictive and repetitive patterns of behaviour, interests or activities. Probiotics have been shown to influence microbiota composition, therefore may be a useful novel therapeutic tool to restore normal gut microbiota, reduce inflammation and ameliorate behavioral symptoms associated with autistic spectrum disorders. Once the gut becomes leaky it is therefore possible to increase intestinal permeability which may allow the passage of bacteria, toxins and other metabolites which may lead to immune activation. For many years theories have been developed which implicate the possible role of immune dysfunction in autistic spectrum disorder. Administration of probiotics has been known to influence neuronal functioning, and attenuate pro-inflammatory immune responses. Pro-inflammatory immune response has been attenuated by the administration of Bifidobacteria.

Phillipou et al. (2017) assert that anorexia nervosa (AN) should be thought of as a body image disorder (BID), and not as it is currently categorized as an eating disorder (ED, American Psychiatric Association, 2013). They propose that the change in description may serve as a more valuable and accurate portrayal of the illness, and suggest that conceptualizing AN as an ED is too simplistic and thus misleading. Phillipou et al. (2017) examine the view that AN is somehow different from other eating disorders such as pica, rumination disorder, avoidance/restricted food intake disorder, binge eating disorder and bulimia nervosa, because at its core AN is fundamentally an illness of ‘body image’. A parallel objective of Phillipou et al. (2017) is to alter the general public’s perception of AN, from one in which the public believe the AN patient is principally driven by disordered eating behaviour in order to reduce body fat, to one in which the patients’ overriding stimulus is actually body image.

Obesity is a heterogeneous condition with a complex and incomplete etiology; however, there is growing evidence for considering the salience of obesity for the psychiatric nomenclature. Currently, the Diagnostic and Statistical Manual of Mental Disorders (DSM; American Psychiatric Association, 2013) does not adequately categorize individuals with marked distress in relation to quantifiable aesthetic concerns such as obesity.

Body dysmorphic disorder (BDD) is a condition in which an individual perceives an area of their body to be fundamentally flawed. Individuals may notice small imperceptible blemishes that become the epicenter for obsessional repetitive ritualistic behaviors that can force them to spend many hours in front of mirrors examining and reexamining the same area. Any area of the body may become the perceived area of attention, but in general the most frequently reported areas are hair, face, breasts, stomach, and thighs. These problem areas may be explored for up to 8 hours/day. There is a strong association with obsessive–compulsive disorder, and BDD is found in 37% of those with the condition, with a lifetime prevalence of 83%. Even though the Diagnostic and Statistical Manual of Mental Disorders has no specific diagnostic category for BDD within an obese population, evidence has shown that many individuals seeking weight loss surgery report a number of psychological and physiological reasons. Body image dissatisfaction is a major contributing factor in the motivation to elect for surgical intervention. The events that occur after bariatric surgery with regards to BDD, body image, and quality-of-life (QoL) have remained largely unexplored. However, studies suggest that the antecedents to BDD, including anxiety and depression, are reported to be much improved following bariatric surgery. Individuals who have dramatic and relatively sudden weight loss following bariatric surgery often have postoperative skin folds. The skin folds can become a source of frustration and anxiety, and can even prevent further weight loss. It is suggested that the individual’s new body image may become a source of deep frustration, shame, and even humiliation.

Sexual function (SF) disorder is common among those seeking surgical intervention for excessive weight. Symptoms of sexual dysfunction (SD) can manifest in any one of the phases of the sexual response cycle, which include desire, excitement, orgasm, and finally, resolution. Females more than males have a greater impairment in sexual quality-of-life (QoL), and greater sexual difficulties prior to weight loss surgery. For example, they may report significant impairment in most domains of SF, including sexual desire, sexual arousal, lubrication, orgasm, and sexual satisfaction. Following bariatric surgery, however, women are more likely to report that their self-esteem had increased and anxiety around sex had diminished; they also report more intense feelings of desire and arousal. SD in males manifests primarily as erectile dysfunction (ED) or premature ejaculation. Following bariatric surgery, male ED and sexual QoL tend to normalize once weight is lost; a few studies have reported variations in sperm production and quality, but more research is required.

Background: Although South Asian people are a significant ethnic group at increased risk of coronary heart disease and high mortality rates and experience greater delays with respect to diagnosis, referral and treatment, comparatively little is known about their quality of life during recovery from a myocardial infarction. Objectives: We sought to determine and compare the impact of ethnicity on quality of life after myocardial infarction (MI) in a mixed ethnic population (South Asian and white people) in the UK. Methods: A 2x2 mixed-group design with repeated measures on the second factor. The independent variables were ethnic group (white/South Asian) and time since MI (2 weeks/3 months). The dependent variables were the subscale scores on the Short-Form 36-item health survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS). Results: At 2 weeks, significant differences were observed between groups on 5 of the 8 SF-36 subscale domain scores, with the white group reporting higher quality of life. Significant improvement in reported quality of life occurred in both groups over time on all domains of the SF-36, except bodily pain. There was a significantly greater improvement in favour of the white group for the role-physical domain. There was no significant difference between groups in terms of anxiety or depression at 2 weeks. Both groups showed a significant reduction in anxiety and depression by 3 months, but the degree of reduction was not significantly different between them. At 3 months, there was no significant difference between groups in terms of anxiety scores, but the South Asian group scored significantly higher on the depression scale. Conclusions: South Asian people have significantly poorer quality of life than white people after MI. While both groups showed improvement over time, South Asian people reported significantly less improvement in physical role function and were more depressed at 3 months. Identifying the factors accounting for such differences is important to develop models of care for delivering the most effective and culturally-sensitive interventions to this group.