Biomedical subjects

Jennifer R Shapiro

Publications and source records attributed to Jennifer R Shapiro.

13 recordsLinked to original sources

PubMed2007

Evaluating binge eating disorder in children: development of the children's binge eating disorder scale (C-BEDS).

OBJECTIVE: Binge eating disorder (BED) may manifest itself differently in children than adults. Recently researchers have proposed provisional criteria for measuring BED in children. The purpose of this study was to develop a brief, simple, structured, interviewer-administered scale (C-BEDS) to measure BED in children according to the provisional criteria and to compare diagnostic results with SCID diagnoses. METHOD: A total of 55 children between the ages of 5 and 13 were interviewed with both the SCID and the C-BEDS. RESULTS: There was a significant association between the two measures (p = .001). Both measures adequately identified children with binge eating behaviors. CONCLUSION: Both the provisional criteria and the C-BEDS may be developmentally appropriate for use with children, although the C-BEDS may be a better screening instrument as it quickly identified children with subsyndromal BED. If used by physicians and other health providers, this brief measure may assist with identifying early onset binge eating behaviors and avoiding the associated consequences, including adult BED, obesity, and other comorbidities.

Adolescent↗

PubMed2005

"Structure-size me:" weight and health changes in a four week residential program.

The prevalence of obesity has been drastically increasing over the past 20 years. Other obesity related conditions, including type 2 diabetes mellitus, have also increased in a corresponding manner and, in 2005, the American Diabetes Association (ADA) reduced the cut-off for defining impaired blood glucose. Evidence suggests that just a modest amount of weight loss can improve obesity related co-morbidities. The present study first, investigated changes in health measures after participation in a four week residential weight loss program. Second, individuals were classified according to the 2005 criteria for the diagnosis of type 2 diabetes to determine if glucose regulation changed after weight loss. A total of 93 individuals were categorized as normal glucose (n=56), impaired fasting glucose (n=23) or diabetic range (n=14) after initial blood laboratory screening. After four weeks and a 6.5% weight reduction, participants showed significant improvements in health risks. Further, most participants with elevated fasting glucose shifted into a healthier range. Findings are discussed in terms of health improvements that occur after weight loss within a four week lifestyle intervention.

Adult↗

PubMed2005

Counterregulatory eating behavior in multiple item test meals.

Restrained eaters have been shown to disinhibit their eating when under stressful situations. However, the majority of laboratory studies that have demonstrated this effect utilized a single test food, typically ice cream. There is a lack of research investigating if this interaction is still evident when multiple foods are offered, and if so, the food choices that restrained and non-restrained eaters make when under stressful situations. The present study examined the impact of stress on food choices in individuals with varying degrees of restraint. Several classes of foods were offered (i.e., high fat/high sugar; low fat/high sugar; high fat/low sugar; low fat/low sugar). A total of 153 females were randomly assigned to either a stress or no-stress situation, and then both groups participated in a taste test. There was no significant difference in total amount of consumption between restrained and non-restrained eaters when under stress. However, further analyses found that restrained eaters under stress consumed more potato chips than those who were not under stress. Findings are discussed in terms of possible limitations of the stress-induced eating paradigm for restrained eaters.

Adult↗

PubMed2005

A pilot study of the effects of behavioral weight loss treatment on fibromyalgia symptoms.

OBJECTIVE: Previous studies have found a relation between weight loss and pain severity in various chronic pain populations. However, there has been little research examining the relation between body mass index (BMI) and fibromyalgia syndrome (FMS). The purpose of this pilot study was to investigate the relationship between BMI and FMS symptoms and to determine if FMS symptoms would decrease following weight loss. METHODS: Overweight and obese women participated in a 20-week behavioral weight loss treatment. RESULTS: Participants, on average, lost 9.2 lbs (4.4% of their initial weight), and there were significant pre-postimprovements on several outcome measures. Although weight was not significantly related to pain at baseline, weight loss significantly predicted a reduction in FMS, pain interference, body satisfaction, and quality of life (QOL). CONCLUSION: Findings suggest that behavioral weight loss treatment could be included in the treatment for overweight/obese women with FMS.

Adult↗

PubMed2004

Assessment of eating disorders: review and recommendations for clinical use.

Practitioners have come under increasing pressure to provide objective data on assessment and treatment outcome of clients. This article provides a brief summary of assessment of eating disorders for the practicing clinician, with an emphasis on well-validated assessment instruments. The critical domains that should be covered in a thorough assessment of eating disorders are reviewed, as are some shortcomings in the current assessment literature, and also discussed is which assessment instruments for the eating disorders are most useful in a clinical context. Using well-validated, standardized assessment instruments in all phases of the treatment process is a critical part of justifying a treatment plan and providing objective data on client progress and outcome.

Body Weight↗

PubMed2003

The effects of restraint, gender, and body mass index on the accuracy of self-reported weight.

OBJECTIVE: Previous research has shown that women, restrained eaters, and overweight/obese individuals have a tendency to underreport their weight. This study investigated gender, dietary restraint, and BMI to determine which is the best predictor of errors in self-reported weight. METHOD: A total of 241 college students completed questionnaires pertaining to height and weight and then were weighed in the laboratory. RESULTS: Although overall students were fairly accurate in reporting their weight, restraint status was the best predictor of weight underestimation. DISCUSSION: These results suggest that restrained eaters, regardless of gender or BMI, have a tendency to underestimate their weight.

Adolescent↗

PubMed2003

The freshman year of college as a critical period for weight gain: an initial evaluation.

Prevention of obesity and weight maintenance have become important public health issues. One strategy for prevention of obesity is to identify critical periods of weight gain across the life span. The purpose of this initial evaluation was to determine whether the transition from high school to college is such a critical period. A total of 135 college students were weighed in September and December of their freshman year and a subset also provided data in May. Results showed that statistically significant but modest weight increases occurred during the freshman year for most participants. However, one quarter of participants gained at least 2.3 kg during the first semester of college, and the proportion of participants classified as overweight or obese increased markedly. For this subset of participants, the freshman year of college could be considered a critical period for weight gain. Identifying critical periods for weight gain may be an important first step towards the development of effective obesity prevention programs.

Journal Article↗

PubMed2003

Weight goals in a college-age population.

OBJECTIVE: Although a growing body of literature has found unrealistic weight loss goals to be common among older, primarily female, subjects, little is known about weight loss goals of younger adults. RESEARCH METHODS AND PROCEDURES: Three hundred seventy-nine college students had their height and weight taken and reported their "goal," "dream," "happy," "acceptable," and "disappointed" weights. A series of 2 (gender) x 2 (nonoverweight vs. overweight) ANOVAs were conducted with both absolute weight goals and percentage of weight loss needed to obtain those goals as dependent variables. RESULTS: When examined in terms of absolute weight goals, women generally had lower body mass index (BMI) goals than men, and nonoverweight participants had lower BMI goals than overweight participants. Surprisingly, most overweight participants would accept a weight loss that would still place them in the overweight BMI range. When examined in terms of percentage loss needed to reach those goals, only overweight women chose goal and dream weights that would require a loss greater than can be expected from nonsurgical weight-loss treatments, and all overweight participants chose happy and acceptable weights within 15% of current weight. DISCUSSION: Participants in this study had generally reasonable weight-loss goals, and even the most extreme weight loss goals were much more moderate than those found in previous studies. These results are surprising given the extreme social pressures for thinness facing young adults. Future studies should examine the variables that influence selection of goal weights and how goal weights affect actual dieting behavior.

Adolescent↗

PubMed2003

Evaluation of the ESRD managed care demonstration operations.

Individuals with end stage renal disease (ESRD), most of whom are insured by Medicare, are generally prohibited from enrolling in Medicare managed care plans (MCPs). CMS offered ESRD patients the opportunity to participate in an ESRD managed care demonstration mandated by Congress. The demonstration tested whether managed care systems would be of interest to ESRD patients and whether these approaches would be operationally feasible and efficient for treating ESRD patients. This article examines the structure, implementation, and operational outcomes of the three demonstration sites, focusing on: the structure of these managed care programs for ESRD patients, requirements needed to attract and enroll patients, and the challenges of introducing managed care programs in the ESRD arena.

California↗

PubMed2003

Patient selection in the ESRD managed care demonstration.

The Centers for Medicare & Medicaid Service's (CMS') end stage renal disease (ESRD) managed care demonstration offered an opportunity to assess patient selection among a chronically ill and inherently costly population. Patient selection refers to the phenomenon whereby those Medicare beneficiaries who choose to enroll or stay in health maintenance organizations (HMOs) are, on average, younger, healthier, and less costly to treat than beneficiaries who remain in the traditional Medicare fee-for-service (FFS) sector. The results presented in this article show that enrollees into the demonstration were generally younger and healthier than a representative group of comparison patients from the same geographic areas.

Adult↗

PubMed2003

Quality of life and patient satisfaction: ESRD managed care demonstration.

To study the effects of managed care on dialysis patients, we compared the quality of life and patient satisfaction of patients in a managed care demonstration with three comparison samples: fee-for-service (FFS) patients, managed care patients outside the demonstration, and patients in a separate national study. Managed care patients were less satisfied than FFS patients about access to health care providers, but more satisfied with the financial benefits (copayment coverage, prescription drugs, and nutritional supplements) provided under the demonstration managed care plan (MCP). After 1 year in the demonstration, patients exhibited statistically and clinically significant increases in quality of life scores.

California↗

PubMed2003

ESRD managed care demonstration: financial implications.

In 1996, CMS launched the end stage renal disease (ESRD) managed care demonstration to study the experience of offering managed care to ESRD patients. This article analyzes the financial impact of the demonstration, which sought to assess its economic impact on the Federal Government, the sites, and the ESRD Medicare beneficiaries. Medicare's costs for demonstration enrollees were greater than they would have been if these enrollees had remained in the fee-for-service (FFS) system. This loss was driven by the lower than average predicted Medicare spending given the demonstration patients' conditions. The sites experienced losses or only modest gains, primarily because they provided a larger benefit package than traditional Medicare coverage, including no patient obligations and other benefits, especially prescription drugs. Patient financial benefits were approximately $9,000 annually.

Adolescent↗

PubMed2002

Self-reported dietary restraint is associated with elevated levels of salivary cortisol.

Previous studies have found inconsistent relationships between restrained eating, dieting, and cortisol. The present study was designed to clarify the relationship between self-reported restrained eating and cortisol using multiple measures of dietary restraint. Eighty-five college-age women completed the Restraint Scale (RS) and the Cognitive Restraint Scale of the Three Factor Eating Questionnaire (TFEQ-R) and provided a saliva sample for analysis of cortisol. Both measures of restraint were positively associated with elevated levels of salivary cortisol, although the TFEQ-R was more strongly associated than the RS. Restrained eating, characterized by largely unsuccessful efforts to control eating, may lead to elevated cortisol levels.

Adolescent↗