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ABSTRACT: Objective: To develop and validate the Weight Control Strategies Scale (WCSS), a self-report instrument to assess use of specific behaviors thought to facilitate weight loss. Design and Methods: Factor analysis was conducted on 323 overweight and obese adults (mean age=48.7±10.9 years, mean BMI=35.4±4.9 kg/m(2) , 74% female) enrolled in three different behavioral weight loss trials who completed the WCSS prior to starting treatment. To evaluate construct validity, additional data on dietary intake, physical activity, treatment session attendance, and weight change were obtained from a subsample of participants before and after participation in a 48-week weight loss program. Results: Principal components analysis with varimax rotation revealed a four component solution for the WCSS, representing the following subscales: Dietary Choices, Self-monitoring Strategies, Physical Activity, and Psychological Coping (α's from 0.79-0.89). Longitudinal analyses showed that WCSS subscale scores increased during treatment (p's <0.01). In adjusted models, changes in WCSS total and subscale scores were associated with posttreatment weight loss (p's <0.01). Additionally, changes in WCSS Dietary Choices and Physical Activity subscales were related to posttreatment changes in total daily kilocalorie consumption (p=0.019) and weekly kilocalorie expenditure through physical activity (p<0.001), respectively. Conclusions: Findings support the validity and reliability of the WCSS in a weight loss treatment seeking sample.
Obesity 03/2013; · 4.28 Impact Factor
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ABSTRACT: The goal of this study was to compare young adults (YA) and older adults (OA) in the National Weight Control Registry on motivations for weight loss and weight loss behaviors. Participants (N=2,964, 82% female, 94% White, BMI=24.8±4.4) were divided into two age groups (18-35 vs. 36-50) and compared on motivations, strategies for weight loss, diet, physical activity (PA), and the TFEQ. YA were 28.6% of the sample (n=848). YA and OA achieved similar weight losses (p=.38) but duration of maintenance was less in YA (43 vs. 58 months, p<001). YA were more likely to cite appearance and social motivations for weight loss, were less motivated by health, and were less likely to report a medical trigger for weight loss (p's<.001). YA were more likely to use exercise classes and to lose weight on their own, and less likely to use a commercial program (p's<.001). YA reported engaging in more high intensity PA (p=.001). There were no group differences in total calories consumed (p=.47), or percent calories from fat (p=.97), alcohol (p=.52) or sugar sweetened beverages (p=.26). In sum, YA successful weight losers (SWL) are motivated more by appearance and social influences than OA, and physical activity appears to play an important role in their weight loss efforts. The differences reported by YA and OA SWL should be considered when developing weight loss programs for YA.
Obesity 10/2012; · 4.28 Impact Factor
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ABSTRACT: Young adults (YA) are at high risk for insufficient sleep and obesity. However, little research has focused on the association between sleep and obesity in this population. The present study examined the association between reported time in bed (TIB) and body mass index (BMI) in YAs. Participants were 250 18-25 year-olds who completed an online survey assessing several factors associated with weight control. After controlling for significant covariates, TIB was significantly associated with BMI. Specifically, "less than 6 hours/night" TIB was associated with increased BMI compared to the referent category (7 to <8 hours/night) (p = .01). Findings demonstrate that young adults who report shorter TIB are more likely to be classified as having higher BMI.
Behavioral Sleep Medicine 07/2012; · 1.55 Impact Factor
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ABSTRACT: Young adults (YA) are underrepresented in behavioral weight loss programs and achieve poorer outcomes than older adults (OA). There has been a call to develop programs specifically targeting this age group. This study examined the performance of YA enrolled in a low-intensity, team-based weight loss campaign and compared their outcomes to OA to determine the utility of such an approach for weight loss in this population. Shape Up Rhode Island (SURI) 2009 was a 12-week online team-based weight loss and exercise competition (N = 6,795, 81% female, 94% white, age = 44.7 ± 11.2, BMI = 29.4 ± 5.9). YA was defined as 18-35 years and OA as >35 years; YA and OA were compared on enrollment, retention, weight loss, and change in steps. A total of 1,562 YA enrolled and 715 completed the program. Fewer YA completed compared with OA (46 vs. 62%, P < 0.001). However, among completers, YA achieved greater percent weight loss (-4.5 ± 4.0 vs. -3.8 ± 3.2%) and greater daily step change (+1,578.2 ± 3,877.2 vs. +1,342.2 ± 3,645.7) than OA (P's < 0.001). Further, more YA completers achieved a ≥5% weight loss (40 vs. 29%, P < 0.001). Findings were consistent in the overweight/obese (OW/OB) subsample, and using ≤25 years of age as the cut off for YA. Weight losses among YA in this low-intensity weight loss campaign were quite promising, with over 700 YA completing the program and on average achieving a 4.5% weight loss. Indeed, the potential public health impact of such an approach is substantial; future efforts to develop programs for this age group may benefit from using a low-intensity, team-based approach.
Obesity 02/2012; · 4.28 Impact Factor
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ABSTRACT: This study assessed young adults' beliefs about weight gain with the goal of improving intervention efforts with this high-risk group. A total of 1,347 incoming freshman (45% male; 81% non-Hispanic white; 18.6 ± 1.7 years; BMI = 23.3 ± 2.3 kg/m2) at a large state university in the Northeast completed a survey designed to assess: (i) degree of concern about weight gain, (ii) level of interest in weight control programs, and (iii) the most acceptable setting for an intervention. Perceptions about freshman weight gain were consistent across gender, with men and women reporting that the average student gains 5.4 ± 1.9 kg and 5.6 ± 1.9 kg respectively. Men in general were less concerned about weight gain (P < 0.001) and reported they would have to gain 6.2 ± 4.2 kg before becoming concerned compared to 3.1 ± 1.7 kg among women (P < 0.001). Overweight (OW) men were more concerned about gaining weight than normal weight (NW) men (P < 0.001) and indicated they would have to gain less weight before becoming concerned (5.0 ± 3.0 kg vs. 6.7 ± 4.5 kg, P < 0.001). Fewer men reported they would join a program to prevent weight gain (17% men vs. 40% women, P < 0.001); the percentage of men willing to join a prevention program did not vary by weight status (P = 0.59). Both men and women were most likely to report a willingness to attend classes on a local college campus compared to other settings. Findings highlight the challenges of engaging young adults in weight gain prevention programs, particularly young men, and are discussed in terms of implications for improving recruitment efforts and intervention development with this population.
Obesity 07/2011; 19(9):1901-4. · 4.28 Impact Factor
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ABSTRACT: Even though behavioral weight loss interventions are conducted in groups, a social contingency (SC) paradigm that capitalizes on the social reinforcement potential of the weight loss group has never been tested. We tested a weight loss intervention in which participation in the weight loss group was contingent upon meeting periodic weight goals. We hypothesized that making access to the group dependent upon weight loss would improve weight outcomes. Participants (N = 62; 84% female; 94% white; age = 51.9 ± 9.0; BMI = 34.7 ± 4.5) were randomized to 6-months of standard behavioral weight loss (SBWL) or to a behavioral program that included a SC paradigm. Both groups engaged in social cohesion activities. Participants in SC who did not meet weight goals did not attend group meetings; instead, they received individual treatment with a new interventionist and returned to group once their weight goals were met. SC did not improve overall weight loss outcomes (SC: -10.0 ± 4.9 kg, SBWL: -10.8 ± 6.4 kg, P = 0.63). Similarly, overall weight loss was not significantly different in the subgroup of participants in the SC and SBWL conditions who did not meet periodic weight loss goals (-7.3 ± 4.1 kg vs. -7.1 ± 3.5 kg, P = 0.90). Surprisingly, "successful" SC participants (who met their weight goals) actually lost less weight than "successful" SBWL participants (-12.4 ± 3.2 kg vs. -14.5 ± 4.7 kg, P = 0.02). Whereas contingency-based treatments have been tested for other health behaviors (e.g., substance abuse), this is the first study to test a SC intervention for weight loss. This approach did not improve overall weight loss outcomes. Our attempt to offer appropriate clinical care by providing individual treatment to SC participants when needed may have mitigated the effects of the SC paradigm.
Obesity 05/2011; 20(2):324-9. · 4.28 Impact Factor
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ABSTRACT: Christakis and colleagues have shown that health behaviors cluster in social networks and suggest social norms may account for the clustering. This study examined: (i) whether obesity clusters among young adults and whether social norms do in fact account for the clustering, and (ii) among overweight/obese (OW/OB) young adults, whether number of social contacts trying to lose weight is associated with weight loss intentions and whether social norms for weight loss account for this effect. Normal weight (NW) and OW/OB young adults (N = 288; 66% female; 75% white) completed measures assessing number of OW social contacts and social norms for obesity. OW/OB young adults also indicated number of OW social contacts currently trying to lose weight, social norms for weight loss, and weight loss intentions. Compared to NW, OW/OB young adults were more likely to have OW romantic partners and best friends and had more OW casual friends and family members (Ps < 0.05), but social norms for obesity did not differ between groups, and social norms did not mediate the relationship between OW social contacts and participants' weight status. However, among OW/OB young adults, having more social contacts trying to lose weight was associated with greater intention to lose weight (r = 0.20, P = 0.02) and social norms for weight loss fully mediated this effect (P < 0.01). This study is the first to show that social contacts and normative beliefs influence weight status and intentions for weight control in young adults. Findings underscore the importance of targeting social influence in the treatment and prevention of obesity in this high-risk age group.
Obesity 12/2010; 19(6):1157-62. · 4.28 Impact Factor
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ABSTRACT: Weight gain in young adults is an important public health problem and few interventions have been successful.
This pilot study evaluated the preliminary efficacy of two self-regulation approaches to weight-gain prevention: Small Changes (changes in energy balance of roughly 200 kcal/day) and Large Changes (initial weight loss of 5-10 lbs to buffer against future weight gains).
Participants were enrolled in 8-week programs teaching Small or Large Changes (SC; LC). Both approaches were presented in a self-regulation framework, emphasizing daily self-weighing.
Randomized controlled pilot study.
Young adults (N=52) aged 18-35 years (25.6+/-4.7 years, BMI of 26.7+/-2.4 kg/m(2)) were recruited in Providence RI and Chapel Hill NC.
Adherence to intervention, weight change, and satisfaction/confidence in approach assessed at 0, 8, and 16 weeks. Data were collected in 2008 and analyzed in 2008-2009.
Participants attended 84% of sessions, and 86.5% and 84.5% of participants completed post-treatment and follow-up assessments, respectively. Participants adhered to their prescriptions. Daily weighing increased markedly in both groups, whereas the eating and exercise changes observed in the SC and LC reflected the specific approach taught. Weight changes were significantly different between groups at 8 weeks (SC= -0.68+/-1.5 kg, LC= -3.2+/-2.5 kg, p<0.001) and 16 weeks (SC= -1.5+/-1.8 kg, LC= -3.5+/-3.1 kg, p=0.006). Participants in both groups reported high levels of satisfaction and confidence in the efficacy of the approach they were taught.
Both Small and Large Change approaches hold promise for weight-gain prevention in young adults; a fully powered trial comparing the long-term efficacy of these approaches is warranted.
American journal of preventive medicine 07/2010; 39(1):63-8. · 4.24 Impact Factor
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Jessica Gokee-LaRose
Medicine and health, Rhode Island 03/2009; 92(2):50-2.
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ABSTRACT: To determine the feasibility of recruiting and retaining young adults in a brief behavioral weight loss intervention tailored for this age group, and to assess the preliminary efficacy of an intervention that emphasizes daily self-weighing within the context of a self-regulation model.
Forty young adults (29.1 +/- 3.9 years, range 21-35, average BMI of 33.36 +/- 3.4) were randomized to one of two brief behavioral weight loss interventions: behavioral self-regulation (BSR) or adapted standard behavioral treatment (SBT). Assessments were conducted at baseline, post-treatment (10 weeks), and follow-up (20 weeks). Intent to treat analyses were conducted using general linear modeling in SPSS version 14.0.
Participants in both groups attended an average of 8.7 out of 10 group meetings, and retention rates were 93% and 88% for post-treatment and follow-up assessments, respectively. Both groups achieved significant weight losses at post-treatment (BSR = -6.4 kg (4.0); SBT = -6.2 kg (4.5) and follow-up (BSR = -6.6 kg (5.5); SBT = -5.8 kg (5.2), p < .001; but the interaction of group x time was not statistically significant, p = .84. Across groups, there was a positive association between frequency of weighing at follow-up and overall weight change at follow-up (p = .01). Daily weighing was not associated with any adverse changes in psychological symptoms.
Young adults can be recruited and retained in a behavioral weight loss program tailored to their needs, and significant weight losses can be achieved and maintained through this brief intervention. Future research on the longer-term efficacy of a self-regulation approach using daily self-weighing for weight loss in this age group is warranted.
# NCT00488228.
International Journal of Behavioral Nutrition and Physical Activity 02/2009; 6:10. · 3.83 Impact Factor
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ABSTRACT: Weight management is a salient issue for women. Studies of behavioral, pharmacological and surgical interventions indicate that women comprise the majority of patients presenting for weight-loss treatment. In this review we discuss the health impact of obesity for women, review behavioral treatments for adult overweight and obesity, and address topics of particular relevance for women, including concerns that weight-loss treatment may precipitate the development of eating pathology, as well as time periods of high risk for weight gain such as pregnancy and menopause.
Women s Health 05/2007; 3(3):341-53.
