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PubMedDate not supplied

To lose, to maintain, to ignore: weight management among women.

The purpose of this study was to describe the process of weight management and the factors that influence this process in a sample of 37 middle-class and working-class white women of varied body size. A naturalistic study design, with a cultural-ecological theoretical orientation and ethnographic interviewing techniques, was used. The findings indicated that there were five stages through which women moved, repeatedly, as they managed weight: appraising, deemphasizing, mobilizing, enacting, and maintaining. Each stage consisted of multiple processes characterized by the use of personally developed tactics and strategies. Concern about appearance rather than health was a more salient factor in the initiation of weight-loss efforts. Progression through the five-stage pathway for weight management was influenced by time and informants' weight. Implications for practice include helping clients reduce the difficulty of altering cultural routines of eating and exercise and eliciting clients' own norms for body size.

Adaptation, Psychological↗
PubMed1992

Outcome of a multicenter outpatient weight-management program including very-low-calorie diet and exercise.

A 12-wk weight-management program was conducted to test the effectiveness of a combined very-low-calorie diet (VLCD) [2.0 MJ/d (470 kcal/d)] (week 1-5) and exercise (E) program supervised by each patient's general practitioner and dietitian. Throughout the program, patients [body mass index measured in kg/m2 (BMI) 27-35] were encouraged to take part in an individually graded E program of walking (W), cycling (C), running (R), or swimming (S) (Van Baak and Binkhorst 1981). Ninety-four patients (65 female and 29 male, weight: 87.7 kg, BMI: 30.7, age: 39.8 y) completed the program (delta: -10.6 kg). At the start, 46% were not involved in any type of physical exercise. After 12 wk only 8% were inactive (Drop out group (n = 14): 47%). Weight loss over 12 wk was significantly (P less than 0.01) related to participation rate in the E program. Also, 24-wk follow-up showed a significantly better (P less than 0.05) weight maintenance for patients who continued the E program (+0.4 vs +1.8 kg). These data demonstrate the effectiveness of a weight-management program including exercise in primary health care.

Adult↗
PubMed1991

Body-weight perceptions and selected weight-management goals and practices of high school students--United States, 1990.

Among adults, overweight is associated with elevated serum cholesterol levels, elevated blood pressure, and noninsulin-dependent diabetes and is an independent risk factor for coronary heart disease. Youth who are overweight and remain overweight as adults may increase their risk for certain chronic diseases in adulthood. However, overemphasis on thinness during adolescence may contribute to potentially harmful weight-management practices and eating disorders such as anorexia nervosa and bulimia nervosa. This report presents self-reported body-weight perceptions and selected weight-management goals and practices among high school students in the United States.

Adolescent↗
PubMed2026

Men's experiences of multiple long-term conditions and/or disability in the UK Game of Stones weight management trial: a mixed-methods evaluation.

OBJECTIVES: To explore experiences, health outcomes and retention of men with multiple long-term conditions (MLTCs) and/or disability within the Game of Stones weight management randomised controlled trial (RCT). DESIGN: Mixed-methods process evaluation within an RCT where secondary outcomes included the Weight Self-Stigma Questionnaire, EuroQol 5-Dimension 5-Level (EQ-5D-5L), EQ-5D-5L anxiety and depression subscale, Patient Health Questionnaire-4 and retention. Semistructured interviews were conducted at 12 months and analysed using the framework method. SETTING: Conducted across three UK trial centres: Belfast, Bristol and Glasgow. PARTICIPANTS: 585 men with obesity (mean (SD) age, 50.7 (13.3) years) were randomised to one of three groups: behavioural text messages with financial incentives, texts alone or waiting-list control. Interviews were conducted with 54 participants from the two intervention groups. RESULTS: 235 (40%) participants lived with MLTCs, 181 (31%) had a single condition, 167 (29%) had no conditions and 165 (29%) had a disability. Of those with MLTCs, 99 were disabled and 93 were living in deprived areas. Participants with MLTCs and/or disability were older, fewer had a degree-level qualification and fewer were in full-time work. Retention at 12 months was higher for men with disability (76%) or no long-term conditions (75%) and lower for men with diabetes (65%). Self-reported weight stigma, well-being and quality-of-life scores improved or stayed the same for men living with MLTCs in the intervention groups; however, results for anxiety and depression screening scores were inconsistent. Participant experiences indicated complex dynamic health, social and life situations which could provide motivation to lose weight for some but not others. Hospitalisation and poor mobility, with inability to exercise, were demotivating for making changes to reach weight loss targets. CONCLUSIONS: Men living with MLTCs and/or disability varied from very successful weight loss and improved health to not prioritising or feeling helped by the programme or disengagement due to immobility or diabetes. TRIAL REGISTRATION NUMBER: isrctn.org Identifier: ISRCTN91974895.

Humans↗
PubMed1992

Fiber and weight management.

Fiber is the portion of plant cells not digested in the human small intestine. Benefits of fiber consumption have been documented in treatment of obesity and obesity-related risk factors. In the last century carbohydrate intake and, thus, fiber intake have declined in the U.S. diet at the same time obesity has increased. Higher fiber intake can be achieved by adding high fiber foods or supplements to the diet. A combination of water soluble and water insoluble fiber sources offer the greatest health and weight control benefits. A high fiber weight-reducing diet is most beneficial as part of a lifestyle modification program for weight management.

Body Weight↗
PubMed1990

Bioelectrical impedance in the Air Force Weight Management Program.

Thousands of active-duty soldiers undergo weight evaluations each year and are subjected to disciplinary action if they fail to comply with established weight standards. This regulation consumes scarce available resources by requiring medical appointments. This study focuses on the use of bioelectrical impedance to determine body fat. It compared the physician's assistants with technicians for correlation of body fat percentage determinations. The correlation was r = .939 (p less than .0151) between the two groups. The use of technicians to determine body fat percentages using bioelectrical impedance appears to be a reasonable way to recover thousands of lost medical appointment slots.

Adult↗
PubMed1991

Self-efficacy in weight management.

Self-efficacy is an important mediating mechanism in advancing understanding of the treatment of obesity. This study developed and validated the Weight Efficacy Life-Style Questionnaire (WEL), improving on previous studies by the use of clinical populations, cross-validation of the initial factor analysis, exploration of the best fitting theoretical model of self-efficacy, and examination of change in treatment. The resulting 20-item WEL consists of five situational factors: Negative Emotions, Availability, Social Pressure, Physical Discomfort, and Positive Activities. A hierarchical model was found to provide the best fit to the data. Results from two separate clinical treatment studies (total N = 382) show that the WEL is sensitive to changes in global scores as well as to a subset of the five situational factor scores. Treatment programs may be incomplete if they change only a subset of the situational dimensions of self-efficacy. Theoretical and clinical implications are discussed.

Adult↗
PubMed1992

Repeated use of the very-low-calorie diet in a structured multidisciplinary weight-management program.

Forty-eight obese patients (mean body mass index = 36.4) were retreated with a very-low-calorie diet (VLCD) at a mean of 104-wk after first VLCD. Mean weight regain was 23 kg or 86% regain of initial loss. Retreatment with VLCD required weekly physician monitoring and indepth psychotherapy group attendance. Five patients (10%) lost an average of 4.55 kg and withdrew within the first 4 wk (group AO. Thirteen patients (27%) lost 13.8 kg over 11.5 wk, an average weight loss of 1.2 kg/wk and enrolled in maintenance (group B). Thirty patients (63%) lost 10.2 kg over 20 wk, an average weight loss of 0.5 kg/wk and did not enroll in the maintenance program (group C). Although weight loss occurs in patients retreated with the VLCD, adherence to the VLCD and commitment to the maintenance program are not optimal.

Adult↗
PubMed1990

Nutritional management and weight changes during hospitalization of Brazilian infants with diarrhoea: primary reliance on oral feeding or continuous nasogastric drip with locally made, modulated minced chicken formula.

The nutritional management of infants admitted with diarrhoea to the University Hospital of Botucatu includes a change from bolus feeding of a modulated minced-chicken formula to a continuous nasogastric drip (NGD) feeding, whenever the required calorie intake is not achieved or the diarrhoea does not subside. To evaluate this approach, the clinical course and weight changes of 63 children, aged 1-20 months, were reviewed; most (81 per cent) were below the third percentile for weight at admission and 76 per cent had a total duration of diarrhoea greater than or equal to 10 days. Associated infections, mainly systemic, were present at or after admission in 70 per cent of them. Twenty-five survivors needed nutritional support (NS), predominantly NGD, for a median duration of 30 per cent of their admission time, and were compared to 31 survivors managed without NS. Those who necessitated NS lost weight for a significantly longer median time (12 x 4 days, p less than 0.005), but their total weight loss was similar (5 x 4 per cent) as well as diarrhoea's duration (8 x 7 days). There was a tendency for a longer hospitalization (21 x 16 days 0.05 less than P less than 0.10) and a longer span to begin weight gain after diarrhoea's end for the group with NS (p less than 0.05), but subsequent growth quotient and daily weight gain during admission were similar for both groups. Both groups of survivors received similar amounts of energy, although the initial increase was delayed for those who needed the NGD.(ABSTRACT TRUNCATED AT 250 WORDS)

Brazil↗
PubMed1991

Management of weight problems and obesity: knowledge, attitudes and current practice of general practitioners.

A postal questionnaire was used to assess general practitioners' knowledge, attitudes and current practice of treatment regarding obesity and weight problems. Overall, 299 responses (75%) were received from general practitioners randomly selected from family practitioner committee lists in Portsmouth and Norwich. Currently 27% of the doctors were overweight and a further 3% obese. Many doctors (69%) had tried to lose weight at some time and 40% had been overweight and a further 12% obese in the past. The most popular methods used to educate overweight and obese patients were one to one counselling and giving out diet sheets and leaflets on healthy eating. The treatment advice to patients from the majority of doctors was to eat less in general (78%) (specifically to eat fewer calories 75%); to exercise (77%); or to attend a slimmers group (54%). Doctors thought that they were less effective than the media or the family in persuading overweight patients to lose weight. Doctors said they were prepared to counsel on weight reduction but felt they had little success in achieving weight loss in patients. Experience was ranked as the most important contributor to knowledge about managing obesity, and medical school was rated as least important. Further study is needed to discover how different practices and attitudes affect patient management and which ones are associated with greatest success. Medical schools and postgraduate centres could play a more important role in educating doctors about nutrition.

Adult↗
PubMed1991

Ethics of obesity treatment: implications for dietitians.

Dietitians face both a responsibility and an opportunity to address the ethical issues of obesity treatment and to promote weight management strategies that are beneficial and effective. The Code of Ethics for the Profession of Dietetics, which was adopted in 1989 to provide guidance to dietetics practitioners in their professional practice and conduct, can serve as a guide in an evaluation of current obesity treatments. Dietitians must help clients be realistic about their weight loss goals and address emotional conflicts that may be undermining weight management efforts. Referrals to therapists may be indicated, and dietitians must be prepared to recognize the need and make the recommendations. Dietitians should take the lead in developing more ethical and beneficial treatments by collaborating with government and industry to protect the consumer from ineffective or potentially harmful practices.

Behavior Control↗
PubMed1991

Status report: foods for calorie control.

Low-calorie foods cannot offer quick fixes or serve as "magic bullets" for weight loss or weight control. However, attractive, goodtasting, low-calorie, low-fat foods can fit into a nutritionally balanced weight-reduction or weight-control regimen. Many of these items can reduce the trauma of "doing without", thus enabling successful, sustained control of energy consumption with less emotional support than is generally required for strict dietary regimens. Although diet alone is rarely a complete solution to the problem of obesity, low-calorie foods can play a significant role in weight management and thus health promotion.

Energy Intake↗
PubMed1992

Strategies to minimize weight gain after smoking cessation: psychological and pharmacological intervention with specific reference to dexfenfluramine.

Cigarette smoking suppresses body weight, discouraging many smokers from trying to quit. Behavioural therapies have so far proved unsuccessful in preventing post-cessation weight gain, and have in fact tended to undercut abstinence from smoking. The mental demands of implementing behavioural weight management strategies may compete with the concentration needed to maintain abstinence from smoking. Consequently, a pharmacological approach offers potential treatment advantages by minimizing the effort needed to achieve weight control. Of the agents found effective in minimizing weight gain, serotoninergic drugs, particularly dexfenfluramine, show special promise because they prevent an increase in caloric intake but do not decrease energy intake below pre-cessation levels.

Behavior↗
PubMed1992

The problem of obesity: fundamental concepts of energy metabolism gone awry.

The growing prevalence and complex issues related to obesity continue to draw the interest and concern of health researchers and practitioners. This review summarizes pertinent background information on the multiple factors involved in the causes of obesity. Factors such as percentage of body fat, upper- vs. lower-body obesity, family history, past dieting history, and underlying medical conditions should be assessed on an individual basis and applied in the development of successful weight-reducing strategies. The recommended approach to nonpharmacologic intervention for weight loss is to first educate individuals about fat storage and energy balance and then focus on the development of positive behavioral skills such as wise food selections, favorable eating patterns, and regular physical activity. Although preventive measures such as positive eating patterns and exercise habits are ideally acquired in childhood and adolescence, successful weight management can still be achieved in adulthood. The information presented in the following sections provides clinicians with essential material to assist individuals in developing realistic goals at the outset of a weight-control program.

Diet, Reducing↗