Redefining success in obesity intervention: the new paradigm.
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Feeding Behavior↗
Biomedical subjects
J I Robison
Publications and source records attributed to J I Robison.
Adherence to exercise programmes. Recommendations.
Despite the widespread dissemination of information concerning the negative health consequences associated with sedentary living, adult physical activity in many industrialised nations remains well below recommended levels. Approximately 50% of individuals who start an aerobic exercise programme will stop within the first 6 months, even though it is well known that to obtain the health benefits associated with physical activity, participation must be maintained. Programmes involving the use of behaviour management techniques appear to increase short term adherence to exercise. Recently, an adherence rate of greater than 95% over 6 months was achieved in a large group of university employees who participated in aerobic training using a 'behavioural treatment packages' approach. Unfortunately, inconsistencies in the literature on definitions and measurement of adherence make valid comparisons among studies difficult. Also, long term follow-up of behavioural intervention methods and their effect on exercise adherence is generally lacking. It is likely that strategies to increase physical activity participation in the general population will demand multiple levels of intervention (personal, organisational, environmental and societal) if they are to succeed in the long term.
Attitude to Health↗
Obesity, weight loss, and health.
Obesity is a multifactorial, complicated condition or group of conditions that afflicts a growing number of people in the United States. Precise etiologies are not well understood, and both commercial and medical treatment programs are characterized by high rates of recidivism. A cultural preoccupation with slimness has created a huge industry serving millions of people who are attempting continually to reduce weight. Contradictory messages from professionals have led to confusion concerning the health implications of obesity and the potential risks of repeated dieting. This review summarizes the major areas of consensus and controversy concerning the health implications of obesity and weight loss and suggests directions for treatment that take into account the complex causes and consequences of obesity.
Adolescent↗
A work-site weight management program to reinforce behavior.
This pilot weight management project addresses the efficacy of reinforcing dietary behavior change versus weight loss. This 6-month program served professional and support staff participating in the work-site wellness program at a midwestern university. Behavior-contingent program data were compared with data from the previous model where contracts were made for weight loss. In the behavior-contingent program, dropout rate and satisfaction with the program compared favorably with the old model weight loss-contingent program. Contract adherence was 93% compared with 74% in the weight loss-contingent program. Actual pounds of weight lost were lower in the behavior-contingent program, however, long-term weight management must still be studied with this population.
Adult↗
Effects of a 6-month incentive-based exercise program on adherence and work capacity.
The purpose of the study was to evaluate the effect of behavioral management techniques on exercise adherence linked to improvements in work capacity and maximal oxygen consumption (VO2max). One hundred thirty-seven participants in six different worksites on a university campus (five experimental and one comparison site) completed 6 months of a minimally supervised, incentive-based endurance exercise program. All participants in the experimental group contracted to engage in at least four bouts of 30 min of verified aerobic exercise within a prescribed target heart rate range each week for the duration of the program. Forty dollars deposited at the beginning of the program served as a response cost that could be lost as a result of failure to fulfill the weekly contracts. Individuals in the comparison group participated in a similar 6-month program but without the contracts and response cost strategies. Weekly adherence for both groups was strictly defined as verified fulfillment of all four bouts of exercise. Adherence for the experimental group was 97% by this definition, and adherence for the comparison group was 19% (P less than 0.01). VO2max increased 2.6% (P less than 0.01), and treadmill test time increased 16% (P less than 0.01) in the experimental group after the 6-month program, with no significant changes in the comparison group. Recovery heart rates at 2 and 4 min post-exercise were significantly lower at 6 months in the experimental group but not in the comparison group. These data provide evidence that adherence to a 6-month endurance exercise program can be improved significantly through the use of well conceived behavior management strategies.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗