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Weight control during the holidays: Highly consistent self-monitoring as a potentially useful coping mechanism
Abstract
The study examined the extent to which trait self-monitoring (the systematic observation and recording of target behaviors) was related to weight control during the high-risk holiday season. The participants (32 women, 6 men) averaged 223.1 lbs (101.41 kg), 57.2% overweight, 50.2 weeks of participation, and 21.3 lbs (9.68 kg) lost at the beginning of the study. Consistency of self-monitoring and weight changes were assessed for 3 holiday versus 7 nonholiday weeks. Analyses of variance (Consistency of Self-Monitoring Groups x Holiday/Nonholiday Weeks) revealed that participants gained 500% more weight per week during holiday compared with nonholiday weeks. Only participants in the most consistent self-monitoring quartile averaged any weight loss over the 10 weeks of the study and during the holiday weeks.
... We found January to be associated with the highest admission rate. This may be related to temperature among other factors such as failure to acquire care in time, overeating, stress and lack of exercise may also contribute during this time period [16,[28][29][30]. Prior studies have demonstrated a weight gain among subjects during the holiday weeks compared to nonholiday weeks [28][29][30]. ...
... This may be related to temperature among other factors such as failure to acquire care in time, overeating, stress and lack of exercise may also contribute during this time period [16,[28][29][30]. Prior studies have demonstrated a weight gain among subjects during the holiday weeks compared to nonholiday weeks [28][29][30]. The study by Yanovsky et al. showed an increase in weight among 195 adults specifically during the holiday season (from mid-November to early or mid-January), with the 6 week period accounting for more than 50 % of weight gain for the given year [29]. ...
... We hypothesize that patients with HF would be at the greatest health risk from this weight gain. Baker et al. showed consistent self-monitoring during this period acts as a potential coping mechanism in preventing this weight gain [30]. No prior studies have specifically looked at Independence day or even Thanksgiving, when it is relatively warmer but other risks directly attributed to holidays remain relevant. ...
Introduction
Studies suggest increased cardiac morbidity and heart failure exacerbations during winter months with a peak around the holiday season. Major sporting events and intense encounters in sports have been shown to affect cardiovascular outcomes amongst its fans.
Methods
All patients admitted to Einstein Medical Center between January 1, 2003 and December 31, 2013 with a diagnosis of congestive heart failure were included in the study. They were included on the basis of the presence of an ICD-9CM code representing congestive heart failure as the primary diagnosis. Comparisons were made between the rates of heart failure admissions on the holiday, 4 days following the holiday and the rest of the month for 5 specific days: Christmas day, New Year’s day, Independence day, Thanksgiving day and Super Bowl Sunday.
Results
Our study included 22,727 heart failure admissions at an average of 5.65 admissions per day. The mean patient age was 68 ± 15 years. There was a significant increase in daily heart failure admissions following Independence day (5.65 vs. 5; p = 0.027) and Christmas day (6.5 vs. 5.5; p = 0.046) when compared to the rest of the month. A history of alcohol abuse or dependence did not correlate with the reported+ rise in heart failure admissions immediately following the holidays. The mean number of daily admissions on the holidays were significantly lower for all holidays compared to the following 4 days. All holidays apart from Super Bowl Sunday demonstrated lower admission rates on the holiday compared to the rest of the month.
Conclusion
Christmas and Independence day were associated with increased heart failure admissions immediately following the holidays. The holidays themselves saw lower admission rates. Overeating on holidays, associated emotional stressors, lesser exercise and postponing medical around holidays may be among the factors responsible for the findings.
... Studies that have examined the results of standard behavioral weight loss programs report participants who consistently track eating and exercise behaviors have greater weight loss than those who self-monitor less regularly [35]. However, programs traditionally have clients record these behaviors in great detail [16,36] which can be a time-consuming process. Consequently, individuals find it difficult to maintain consistent eating and exercise records over time [34]. ...
... Additional factors that interfere with active self-monitoring are those that disrupt a person's typical daily routine (e.g. travel, schedule changes, interpersonal conflicts, holidays, and celebrations) [36]. Although these barriers are unavoidable in most people's lives, when they appear in conjunction with an individual's attempt to monitor eating and exercise behaviors in a detailed and often cumbersome manner, the process may become a burden too great for most people to maintain. ...
... Repeatedly, studies show weight loss is more successful when individuals self-monitor eating and exercise behaviors [34][35][36][37][38]; therefore overweight and obese individuals should be taught how to self-monitor such behaviors to improve overall weight loss [33]. Self-monitoring has been shown to correlate significantly with short-and long-term weight loss, and as such is considered to be one of the most important elements of treatment [16]. ...
COMPARISON OF SELF-MONITORING TECHNIQUES FOR TRACKING EATING AND EXERCISE BEHAVIORSDiane Lynn Helsel, PhDUniversity of Pittsburgh, 2005Self-monitoring of eating and exercise behaviors has traditionally been done in a detailed manner. Finding ways to simplify this approach would decrease the time involved in the recording process, which may improve long-term adherence to tracking eating and exercise behaviors during weight loss. The purpose of this study was to investigate the effect of two self-monitoring methods for tracking eating and exercise behaviors within the context of a 16 week correspondence-based weight loss intervention. Subjects for this investigation were forty-two overweight adult men and women, ages 21 to 45 with a BMI of 25 to 35 kg/m2. Subjects were randomized to one of two self-monitoring conditions: 1) detailed self-monitoring (DSM) and 2) detailed self-monitoring transitioning to abbreviated self-monitoring (TSM). Participants in both groups recorded eating and exercise behaviors in diaries that were completed daily and returned to investigators each week for review. Participants in the DSM group recorded detailed information about the type, quantity, calories and fat grams of food consumed and type, duration, and rating of perceived exertion (RPE) of exercise. Participants in the transitional (TSM) group self-monitored eating and exercise behaviors using the detailed (DSM) approach during weeks 1-8, but transitioned to an abbreviated diary during weeks 9-16. This diary allowed participants to simplify self-monitoring by using check marks to estimate the quality and quantity of foods eaten, and amount of exercise completed daily. Unlike the DSM group, specific details of eating and exercise were not recorded. A repeated measures design was utilized for this study. The independent variable was type of self-monitoring. The primary dependent variable was completion of eating and exercise diaries; secondary dependent variables were body weight, dietary intake and physical activity. The major finding of this investigation was that both groups were similar with regard to the amount of weight lost, food diary completion scores and changes in eating and exercise behavior. Consequently, this study identified an alternative tracking method (i.e., TSM) that may be less effortful, and provides a similar outcome as detailed self-monitoring.
... Look AHEAD investigators believed that participants' keeping food records during the run-in would predict record keeping during treatment. Keeping food records during treatment, in turn, is positively correlated with weight loss (7)(8)(9)(10)(11)(12). Thus, in the current study, we assessed performance of a specific behavior, expected to be related to weight loss, rather than asking about general readiness to lose weight. ...
... As described above, the behavioral task assessed was a key component of the therapy provided during the intervention. At least six studies have shown that self-monitoring during the treatment phase is positively correlated with greater weight loss (7)(8)(9)(10)(11)(12). Of these studies, three studies simply counted the number of food records completed=turned in, and showed that more records completed was associated with greater weight loss (7,9,10). ...
... Of these studies, three studies simply counted the number of food records completed=turned in, and showed that more records completed was associated with greater weight loss (7,9,10). Three other studies, all by Kirschenbaum and coworkers, evaluated the quality of food records (e.g., number of eating occasions recorded, time food was eaten) (8,11,12). All three of these studies found that higher quality of record keeping was associated with greater weight loss. ...
Objective:
Predicting outcome in weight loss trials from baseline characteristics has proved difficult. Readiness to change is typically measured by self-report.
Methods:
Performance of a behavioral task, completion of food records, from the screening period in the Look AHEAD study (n = 549 at four clinical centers) was assessed. Completeness of records was measured by the number of words and Arabic numerals (numbers) recorded per day, the number of eating episodes per day, and days per week where physical activity was noted. The primary outcome was weight loss at one year.
Results:
In univariable analysis, both the number of words recorded and the number of numbers recorded were associated with greater weight loss. In multivariable analysis, individuals who recorded 20-26, 27-33, and ≥34 words per day lost 9.12%, 11.40%, and 12.08% of initial weight, compared to 8.98% for individuals who recorded less than 20 words per day (P values of 0.87, 0.008, and <0.001, respectively, compared to <20 words per day).
Conclusions:
Participants who kept more detailed food records at screening lost more weight after 1 year than individuals who kept sparser records. The use of objective behavioral screening tools may improve the assessment of weight loss readiness.
... To identify records relevant to our research aim, a comprehensive search strategy was developed using the PEO (Population; Exposure; Outcome) format. The search terms and subject headings were derived from narrative reviews [12,16] and landmark studies published on the topic [11,[17][18][19]. The three search concepts included (i) healthy populations (ii) feasting, celebrations and holidays and (iii) weightrelated outcomes. ...
... [32], 0.4 kg [29••] and 1.1 kg [30••, 40] or did not significantly change weight [45]. In relation to self-weighing, the observational study by Baker et al. noted that weight increased most in the least frequent self-monitors compared to highly consistent self-monitors during Christmas and New Year [19]. In addition to weight changes, regular self-weighing was also found to improve cognitive restraint [29••] and decrease total and LDL cholesterol [30••]. ...
Purpose of review:
Whilst evidence indicates that weight gain occurs over holidays, the contribution of specific festive periods and celebrations to eating behaviour and weight gain is unclear. We aimed to synthesise literature on how festive periods and celebrations contribute to population weight gain and weight-related outcomes.
Recent findings:
Thirty-nine studies examining (i) body weight changes, (ii) determinants of eating behaviour or (iii) weight-gain prevention interventions during festive periods were systematically reviewed. Of the 23 observational studies examining changes in body weight during festive periods, 70% found significant increases (mean 0.7 kg). Only four studies investigated exposure to food cues and overeating during these periods, with heterogeneous results. All six intervention studies found that weight gain can be mitigated by self-weighing/self-monitoring and intermittent fasting. Interventions targeting festive periods could have a significant impact on population weight gain. The scalability and sustainability of such interventions require further investigation, as do the broader socioecological factors driving unhealthy eating during festive periods.
... Self-monitoring food intake is considered the cornerstone of behavioral treatment of obesity and other chronic disorders that can be managed by dietary modification, such as end-stage renal disease (ESRD), diabetes, and dyslipidemia [34]. Previous studies have shown that people who are aware of their current behavior are more likely to lose weight [3,31]. In this sense, the automation of food journaling may not be the answer, since it may eliminate the positive effects of selfmonitoring [11]. ...
... Food journaling, especially by paper, is an arduous task that leads to fatigue [4,13], and therefore, continuous recording is highly unlikely. Research has shown that adherence to self-monitoring is less than ideal [3], and others have reported that adherence deteriorates over time [7]. Therefore, self-logging studies try to minimize the burden of users to encourage long-term usage. ...
By enabling people to track their lifestyles, including activity level, sleeping, and diet, technology helps clinicians to treat patients suffering from "lifestyle diseases." However, despite its importance compared to other lifestyle factors, it is not easy to record food intake consistently. Although researchers have attempted to solve this problem, most have not considered its applicability in the clinical context. In this paper, we aim to (1) understand food-journaling practices and (2) explore the applicability of lifestyle data in the clinical context. By observing 20 patients who recorded data including food logs, steps, and sleeping time, we found that patients recorded their food logs diligently, as they were conscious of clinicians. Clinicians were surprised by the high adherence rate of journaling and tried to overlap food data with other data, such as steps, sleeping time, etc. This paper contributes by providing qualitative insights for designing applicable strategies utilizing lifestyle data in the clinical context.
... It is well known that an increased awareness of factors affecting weight helps individuals better manage their weight. Simple weight monitoring has been shown to be linked with weight loss both in observational studies [8][9][10], and randomized control trials [11][12][13]. In addition, studies have shown that monitoring eating habits [14,15] and exercise levels [16] are also conducive of weight loss. ...
... doi:10.1371/journal.pone.0152504.t005 moderate to low for all activities has the additional benefit of making effect sizes comparable across activities.The food logging analysis shows that users who log food with moderate frequency lost an additional 0.63% (CI [0.55, 0.72]; p < .001) of their body weight per month relative to low frequency loggers. ...
We study the association between weight fluctuation and activity tracking in an on-line population of thousands of individuals using digital health trackers (1,749 ≤ N ≤ 14,411, depending on the activity tracker considered) with millions of recorded activities (119,292 ≤ N ≤ 2,221,382) over the years 2013-2015. In a first between-subject analysis, we found a positive association between activity tracking frequency and weight loss. Users who log food with moderate frequency lost an additional 0.63% (CI [0.55, 0.72]; p < .001) of their body weight per month relative to low frequency loggers. Frequent workout loggers lost an additional 0.38% (CI [0.20, 0.56]; p < .001) and frequent weight loggers lost an additional 0.40% (CI [0.33, 0.47]; p < .001) as compared to infrequent loggers. In a subsequent within-subject analysis on a subset of the population (799 ≤ N ≤ 6,052) with sufficient longitudinal data, we used fixed effect models to explore the temporal relationship between a change in tracking adherence and weight change. We found that for the same individual, weight loss is significantly higher during periods of high adherence to tracking vs. periods of low adherence: +2.74% of body weight lost per month (CI [2.68, 2.81]; p < .001) during adherent weight tracking, +1.35% per month (CI [1.26, 1.43]; p < .001) during adherent food tracking, and +0.60% per month (CI [0.44, 0.76]; p < .001) during adherent workout tracking. The findings suggest that adherence to activity tracking can be utilized as a convenient real-time predictor of weight fluctuations, enabling large-scale, personalized intervention strategies.
... Recent obesity research [1], [2] has shown that dietary monitoring can significantly help people lose weight. Several works have developed self-monitoring techniques for diet, such as manual paper-based records (food diaries) and 24-hour dietary recalls that assess the amount and type of food eaten. ...
... Based on the properties of the thermal camera we decide that any intensity value less than 150 is background. In Equation (1), the thermal image with background cancellation (rBP) given by Equation 1. ...
Diet monitoring is an important intervention for obesity, which affects over one third of US adults. According to recent surveys, camera based applications that automatically extract type and quantity of food from an image of the food plate, increase monitoring adherence and can potentially increase accuracy in computing caloric intake with inputs from the user. State-of-the-art systems, however, have fairly low accuracy for identifying cooked food (only 63% accuracy) and require significant manual intervention from the user. In this paper, we propose MT-Diet, a smartphone-based automated diet monitoring system that interfaces a thermal sensor with a smartphone and identifies types of food consumed at the click of a button. The system uses thermal maps of a food plate to increase accuracy of segmentation and extraction of food parts, and combines thermal and visual images to improve accuracy in the detection of cooked food. Test results on 80 different types of cooked food (first frozen and then heated in a microwave) show that MT-Diet can isolate food parts with an accuracy of 97.5% and determine the type of food with an accuracy of 88.93%, which is a significant improvement (nearly 25%) from the current state-of-the-art.
... In childhood obesity, self-monitoring techniques are used for management of dietary and physical activity and for successful weight management 3,4 . It has been found a consistent relationship between self-monitoring and success in both losing weight and maintaining weight loss 5 . Evidence show that participants loose more weight during the weeks they self-monitor. ...
... Evidence show that participants loose more weight during the weeks they self-monitor. The consistency and completeness of self-monitoring are relevant in the process of weight loss [5][6][7][8][9] . A very common approach to self-monitoring is selfregister. ...
Recently, the prevalence of childhood obesity is increasing significantly. Dietary and physical activity registers are frequently referred to as the "cornerstone" of behavioral weight control programs. Mobile devices such as Personal Digital Assistants (PDAs) are showing their usefulness to facilitate these self-registers.
This study is aimed to analyze and compare the efficiency and feasibility of a PDA and Paper and Pencil (P&P) registers to record dietary and physical activity in a sample of Spanish adolescents with overweight.
Sample was composed by 30 overweight participants aged 9-15 years seeking for obesity treatment. This is a counterbalance study, all participants completing both experimental conditions: PDA and P&P registers.
For dietary records, participants filled out more records using P&P than PDA when "total" number of self-registers was considered, but when "complete" records were taken into account, these differences disappeared, and when percentages of "complete" records were analyzed, PDA produced more accurate registers than P&P. For physical activity, PDA produced more records than P&P. PDA was the preferred system. According to participants, the PDA´s strengths are the comfort, easiness to use and to transport.
Results showed that P&P produced more incomplete dietary records than PDA. PDA is a reliable system that allows the clinician to be confident in the data recorded. Recently, several applications for mobile devices have been developed, but there are few studies supporting evidence of their efficacy and feasibility in assessment and treatment of childhood obesity. This study tries to provide some evidence in this field.
... It specifies context and procedure for an individual to follow to maintain weight-loss action. Coping planning is equally important as it offers the individual with alternative plans to overcome potential barriers encountered over the weight-loss process [21]. Although action planning and coping planning work differently, they both play crucial roles in keeping an individual moving forward with planned behaviors rather than reverting back to original behaviors [22]. ...
Objectives: Given the high pressure of weight-loss face by Chinese female college students and the lack of studies on the psychological mechanism of the weight-loss behaviors of this particular group, the present study investigated the interrelationships among the planning, self-regulation, and volitional self-efficacy, which were identified as the most significant three factors influencing the weight-loss of this population.Methods: Five hundred (n=500) female college students were recruited from three colleges in China. The collected data include participants’ planning, self-regulation, volitional self-efficacy, and weight-loss result. Wen, Zhang, Hou, & Liu’s (2004) three-step procedure was adopted to test the mediating effects of self-regulation and volitional self-efficacy, respectively, between planning and weight-loss result.Results: The mediating effects of self-regulation and volitional self-efficacy were confirmed. Based upon those, a recursive model was proposed to show a joint impact from the interrelated planning, self-regulation, and volitional self-efficacy to weight-loss result.Discussion: This study gained an in-depth understanding of both direct and indirect influences between planning to weight-loss. The recursive model sheds light on the potential promoting effect of the planning to weight-loss result through an enhanced self-regulation and volitional self-efficacy. The found psychological mechanism of Chinese female college students’ weight-loss behaviors pave the road for the studies of intervention.
... Further, it is stated that the variability in weight change was significantly greater in obese subjects who had previously lost weight than in controls (maximal increases in weight, 6.1 and 2.2 Kg, respectively (Andersson and Rossner, 1992). Others have described a lowering of the efficacy of weight-reduction or weight-maintenance programs during the winter season (Boutelle et al., 1999;Kirschenbaum, 1998 andZahorska, 1980). In present study it was found that the mean bodyweight gain was 1.89 ±1.90 Kg; simultaneously during lockdown period a significant proportion of overweight and obese also reduced their weight from 0.1 to 9.6 Kg. ...
... Participants are provided with a wireless scale (Aria) to allow for centralized collection of body weight measures. Frequent selfmonitoring of weight and food intake is associated with greater weight loss and intervention adherence (69)(70)(71). Participants and coaches review completeness of self-monitoring records and daily totals and weekly averages for calories, fat, and physical activity minutes. The website displays graphs of weight change over time, daily calories, and physical activity minutes and steps, which coaches and participants review on each call. ...
The Breast Cancer Weight Loss (BWEL) trial is a randomized controlled trial designed to determine whether weight loss after a breast cancer diagnosis can reduce the risk of cancer recurrence in women with overweight or obesity. The BWEL trial will compare the efficacy of a telephone-based weight-loss intervention plus health education materials versus health education materials alone on invasive disease-free survival in 3,181 women with stage II or III breast cancer and BMI > 27 kg/m². This report provides a detailed description of the goals and methods of the lifestyle intervention and the evidence supporting the intervention used in the BWEL trial. The intervention’s primary goal for participants is to achieve and maintain a weight loss ≥ 10% of baseline weight through increased physical activity and caloric restriction. The evidence supporting the diet, physical activity, and behavioral components of this telephone-based weight-loss intervention, as well as strategies to promote participant engagement and retention, is described. The intervention is provided through 42 sessions delivered by trained health coaches over a 2-year period. If the BWEL lifestyle intervention is successful in improving cancer outcomes, then weight loss will be incorporated into the care of thousands of breast cancer patients.
... Key elements of behavior therapy are provided in GSH, including stimulus control, self-monitoring, goal setting and contracting, strategies for managing high-risk situations, relapse prevention skills, and parent management skills training [58]. Self-monitoring is a fundamental aspect of self-regulation and includes observing and recording of eating and exercise behavior, and has been related to weight loss in children and adults [59][60][61][62][63]. In GSH, parents and children will receive "Habit Books," and are instructed to record their dietary intake and physical activity each day. ...
Currently one-third of children in the United States have overweight or obesity (OW/OB). The goal of Healthy People 2020 is to reduce the proportion of children with OW/OB and increase the proportion of primary care visits that include nutrition and weight-related counseling. Unfortunately, many health care providers find it difficult to offer effective weight-related counseling and treatment in the primary care setting. Therefore, new models of care are needed that allow a greater proportion of children with OW/OB and their parents to access care and receive quality weight management treatment. The current paper describes the GOT Doc study which is designed to test the effectiveness of a Guided Self-Help (GSH) model of obesity treatment that can be delivered in the primary care setting compared to a traditional Family-Based Behavioral weight loss treatment (FBT) delivered at an academic center. We will assess the impact of this program on attendance (access to care) and changes in child BMI percentile/z-score. We will also examine the impact of this treatment model on change in child lifestyle behaviors, parent support behaviors, and parent self-efficacy and empowerment to make behavior change. Finally, we will assess the cost-effectiveness of this model on changes in child BMI percentile/z-score. We believe the GSH intervention will be a cost-effective model of obesity management that can be implemented in community practices around the country, thereby increasing access to treatment for a broader proportion of our population and decreasing rates of childhood obesity.
... Women were subsequently randomised to one of three conditions for a 14-week maintenance phase: a ED was calculated using two methods: 'Foods Only' and 'Foods + Caloric Beverages' (>20 kcal/serve). Self-monitoring of food intake, such as that used in the 'EMFA' programme, has been found to be one of the most consistent methods of weight control (Baker & Kirschenbaum, 1998;Boutelle & Kirschenbaum, 1998;Kirschenbaum, Germann, & Rich, 2005). Therefore, it was hypothesised the EFMA+REDE group would have the least weight regain, due to the reinforcement of self-monitoring, combined with a low ED diet providing higher satiety on fewer kilojoules. ...
Background:
Obesity is a key modifiable risk factor for non-communicable diseases. The modern food environment provides easy access to inexpensive, highly palatable, energy-dense and nutrient-poor foods and beverages, which are associated with increased BMI and reduced dietary quality. The NEEDNT Food List™, comprising ‘non-essential, energy-dense, nutritionally-deficient’ foods and beverages, was developed to help patients and consumers to clearly distinguish non-essential foods from core foods required for good health. In the present study, the original NEEDNT Food List™ was incorporated into preliminary ‘Moderation Guidelines’, which aim to provide quantified guidance for implementing the concept of dietary moderation, in the context of NEEDNT food and beverage intake.
Objectives: The aims of the present study were to create a points and quota system for quantifying and monitoring energy intake from NEEDNT foods and beverages; to pre-test preliminary Moderation Guidelines among a representative group of potential users; and to make recommendations to further develop the Moderation Guidelines as a weight loss tool.
Design: This study utilised an observational design and qualitative methods to obtain information-rich verbal data from study participants. Twelve people, aged 22 to 57 years, with a BMI ≥30 and a history of repeated weight loss attempts, were selected to pre-test the Moderation Guidelines over a 4-week period, and subsequently participated in one-on-one, semi-structured interviews. Interviews comprised eight open-ended questions, to explore participants’ views and experiences of the Moderation Guidelines, along with information relating to historical weight loss attempts and thoughts on dietary moderation. Interview data were recorded, transcribed verbatim and coded using NVivo software. Coded data were categorised and evaluated by thematic analysis using a general inductive approach.
Results: Preliminary NEEDNT Foods Moderation Guidelines were presented in an A5 booklet format, with NEEDNT foods and beverages assigned 1 NEF (‘non-essential food’ value) per 100 kcal portion. Participants were allocated up to 19 NEFs weekly, representing around 1900 kcal. Participants varied in the extent of their previous dieting experiences. All expressed uncertainty around applying personal concepts of dietary moderation. Nine participants found the Moderation Guidelines usable and beneficial. Five participants self-reported weight losses of 2-4 kg during the 4-week period. Three participants found the Moderation Guidelines less appealing, unusable, or incomplete. All participants reported an improved understanding of dietary moderation generally. Seven participants intended to continue using the Moderation Guidelines. Suggested changes to the print booklet included revision of NEEDNT food and beverage categories, modification of terminology, integration of colour and graphics, clarification of serving sizes, and culture-specific versions. Most participants emphasised the need for support from a Dietitian or other health professional, for dietary guidance around core food groups, and behavioural change techniques. Participants said a NEEDNT-based smartphone app would increase functionality and appeal. Māori and Pacific participants requested culturally tailored NEEDNT-based education.
Conclusion: Preliminary NEEDNT Foods Moderation Guidelines show potential for assisting obese persons to lose weight by moderating consumption of NEEDNT foods and beverages. Revision and retesting would further develop the Moderation Guidelines, and should incorporate participants’ recommendations, design principles, behavioural change theories, and best practices in nutrition education. An intervention trial is warranted, to evaluate the effectiveness of revised Moderation Guidelines as a dietary quality and weight loss tool. Further research opportunities include the development of a Moderation Guidelines smartphone app and website, tailored adaptation of the Moderation Guidelines for Māori and Pacific individuals and community groups, and a NEEDNT-based public health campaign.
Keywords: NEEDNT Food List, NEEDNT Foods Moderation Guidelines, Moderation Guidelines, NEF, NEEDNT-FFQ, dietary moderation, energy density, nutrient density, overweight, obesity, qualitative research, qualitative evaluation, nutrition education.
... Christmas is a challenge 75 . One study reported the weight change of participants undergoing treatment for obesity who were already consistently utilising behavioural strategies proven to support weight management, to ascertain whether they were able to continue to successfully manage their weight (or prevent weight gain) during the Christmas holiday period 91 ...
Weight is increasing in the population and holidays, such as Christmas, have been identified
as high-risk periods. This thesis presents the development of a behavioural intervention to
prevent weight gain over the Christmas period, its evaluation in a Randomised Controlled
Trial (The Winter Weight Watch study), and an exploration of participant experiences of the
intervention. The possible mechanisms of action of the intervention are also explored.
The intervention consisted of encouragement to regularly self-weigh and record weight,
physical activity calorie equivalent (PACE) information about commonly consumed festive
foods and drinks and weight management tips. The hypothesised main mechanism of action
was that each component would promote restraint of energy intake, preventing weight gain
over Christmas.
The RCT showed the intervention to be effective in preventing weight gain. At follow up the
difference in weight between intervention and control groups (adjusting for baseline weight)
was -0.49kg. Conscious energy restraint scores increased in the intervention group. The
qualitative study showed that participants found the concept of weight gain prevention at
Christmas acceptable. Self-weighing and PACE information were key drivers in encouraging
restraint of energy intake. PACE information mainly prompted participants to restrain energy
intake rather than increase physical activity
In conclusion, the developed intervention prevented weight gain during the Christmas period
and was acceptable to participants. PACE information and self-weighing were found to be
key drivers of self-regulatory behaviours. These findings hold promise for preventing weight
gain during high risk periods.
... But there are many circumstances that can interfere with our plans and lead us to eat more. As mentioned, holiday celebrations tend to result in overeating and even weight gain (43)(44)(45)(46). Even being distracted while eating can result in increased intake, especially among restrained eaters, who may not even be aware that they have eaten more than usual [e.g., (25,(47)(48)(49)(50)]. ...
... However, given the vastly different operationalizations of self-monitoring consistency across behavioral weight loss trials, we are unable to make direct comparisons with other trials as to whether the standalone GoalTracker intervention resulted in a comparable proportion of participants who consistently self-monitored. For instance, while we operationalized Consistent Trackers as individuals who completed all required self-monitoring entries at least 6 days a week for C 75% of weeks of the intervention, prior trials defined consistency with lower thresholds, including C 3 days per week or once per week, and earlier studies defined consistency as what is now referred to as frequency (i.e., the number of days of self-monitoring entries) (Baker & Kirschenbaum, 1998;Boutelle & Kirschenbaum, 1998). Direct comparisons are further complicated by variation in the number of days participants are instructed to track in different studies (e.g., daily, a few days per week, weekly, or optional tracking). ...
Self-monitoring is the strongest predictor of success in lifestyle interventions for obesity. In this secondary analysis of the GoalTracker trial, we describe outcomes of consistently self-monitoring in a standalone weight loss intervention. The 12-week intervention focused on daily self-monitoring of diet and/or body weight in a commercial app (MyFitnessPal). Participants (N = 100; 21-65y; BMI 25-45 kg/m^2) were categorized as Consistent Trackers if they tracked ≥6 out of 7 days for at least 75% of the targeted weeks.
One-fourth of participants were Consistent Trackers. This subset was more likely to be married or living with a partner, be non-Hispanic White, and have higher health literacy than Inconsistent Trackers (ps<.05). Consistent tracking was associated with greater weight change than inconsistent tracking at 1 month (mean difference [95%CI]: -1.11 kg [-2.12, -0.10]), 3 months (-2.42 kg [-3.80, -1.04]), and 6 months (-2.13 kg [-3.99, -0.27]). Over 3 times as many Consistent Trackers as Inconsistent Trackers achieved ≥5% weight loss at 3 months (48% vs. 13%) and at 6 months (54% vs 15%; ps<.001).
Though causality cannot be determined by the present study, tracking weight and/or diet nearly every day per week for 12 weeks in a commercial app may serve as an effective strategy for weight loss. Strategies are needed to promote greater consistency in tracking. View article here: https://rdcu.be/bN2kI.
... Some previous research found that adults engaged in weight maintenance programs did not significantly gain weight during the holiday period [16,19]. However, Baker et al. [20] found that only adults who adhered most consistently to selfmonitoring protocol in a weight management intervention did not gain weight during this time. In addition to these 1 3 inconsistent findings, previous studies on weight loss seeking adults measured weight change only during the holiday period, rather than measuring weight fluctuations across all four seasons. ...
Purpose
The current study aimed to observe potential seasonal fluctuations in weight and self-weighing behavior among a diverse sample of adults engaged in a behavioral weight loss intervention.
Methods
Active duty personnel (N = 248) were randomized to either a counselor-initiated or self-paced 12-month behavioral weight loss intervention promoting daily self-weighing. Body weight and self-weighing frequency were collected from electronic scales (e-scales) provided at baseline.
Results
Overall, participants lost weight from winter to spring (p = 0.02) and gained weight from fall to winter (p < 0.001). No demographic differences in weight changes were observed. Participants self-weighed less frequently during summer compared to spring (p < 0.0001), less in fall compared to summer (p < 0.0001), and less in winter compared to fall (p < 0.0001). In multivariate models, weight change and self-weighing frequency during the previous season, as well as days since randomization and intervention intensity were associated with seasonal weight changes.
Conclusions
This study is the first to observe seasonal fluctuations of weight and self-weighing behavior among adults actively engaged in a weight loss intervention, consistent with research in the general population. Findings highlight the importance of acknowledging seasonal influence within weight loss programs and trials.
Level of evidence
Level I, randomized controlled trial.
... Some BCTs with evidence of effectiveness in other behavioral domains were used infrequently. For example, "Self-monitoring of behavior," defined as "Establish a method for the person to monitor and record their behavior(s) as part of a behavior change strategy" [30] has been found effective for a variety of health behaviors [39,[83][84][85][86][87][88]. A reanalysis of a Cochrane review of face-to-face brief alcohol interventions found that interventions which included self-monitoring were associated with larger effect sizes [44]. ...
Background
Digital behavior change interventions (DBCIs) appear to reduce alcohol consumption, but greater understanding is needed of their mechanisms of action.
Purpose
To describe the behavior change techniques (BCTs) used in DBCIs and examine whether individual BCTs, the inclusion of more BCTs or more Control Theory congruent BCTs is associated with increased effectiveness.
Methods
Forty-one randomized control trials were extracted from a Cochrane review of alcohol reduction DBCIs and coded for up to 93 BCTs using an established and reliable method. Random effects unadjusted and adjusted meta-regression models were performed to assess associations between BCTs and intervention effectiveness.
Results
Interventions used a mean of 9.1 BCTs (range 1–22), 23 different BCTs were used in four or more trials. Trials that used “Behavior substitution” (−95.112 grams per week [gpw], 95% CI: −162.90, −27.34), “Problem solving” (−45.92 gpw, 95% CI: −90.97, −0.87) and “Credible source” (−32.09 gpw, 95% CI: −60.64, −3.55) were significantly associated with greater alcohol reduction than trials without these BCTs. The “Behavior substitution” result should be treated as preliminary because it was reported in only four trials, three of which were conducted by the same research group. “Feedback” was used in 98% of trials (n = 41); other Control Theory congruent BCTs were used less frequently: for example, “Goal setting” 43% (n = 18) and “Self-monitoring” 29%, (n = 12).
Conclusions
“Behavior substitution,” “Problem solving,” and “Credible source” were associated with greater alcohol reduction. Many BCTs were used infrequently in DBCIs, including BCTs with evidence of effectiveness in other domains, such as “Self-monitoring” and “Goal setting.”
... A previous study by Baker and Kirschenbaum showed that individuals participating (50 weeks) in a behavioral intervention had a mean weight loss of 12 kg but increased 500% more weight per week during holidays in comparison with nonholiday weeks. Also, only individuals in the high quartile of self-monitoring were able to successfully lose weight during this period [31]. ...
Several studies suggest that the holiday season, starting from the last week of November to the first or second week of January, could be critical to gaining weight. This study aims to review the literature to determine the effects of the holidays on body weight. In studies of adults, a significant weight gain was consistently observed during this period (0.4 to 0.9 kg, p<0.05 ). The only study in college students found an effect on body fat but not on weight (0.1 kg, p=0.71 ). The only study found in children did not show an effect on BMI percentile (−0.4%, p>0.05 ) during this period. Among individuals with obesity who attempt to lose weight, an increase in weight was observed (0.3 to 0.9 kg, significant in some but not in all studies), as well as increase in weight in motivated self-monitoring people (0.4 to 0.6%, p<0.001 ). Programs focused on self-monitoring during the holidays (phone calls and daily mailing) appeared to prevent weight gain, but information is limited. The holiday season seems to increase body weight in adults, even in participants seeking to lose weight and in motivated self-monitoring people, whereas in children, adolescents, and college students, very few studies were found to make accurate conclusions.
... Adherence to self-register procedures is an important indicator of successful weight management. A consistent relationship has been found between self-register adherence and success in both losing weight and maintaining weight loss (Baker and Kirschenbaum 1998;Collins, Kashdan, and Gollnish 2003). However, the large amount of data recorded throughout the treatment makes it necessary to use analysis procedures that can take many variables into account. ...
Data collected in psychological studies are mainly characterized by containing a large number of variables (multidimensional data sets). Analyzing multidimensional data can be a difficult task, especially if only classical approaches are used (hypothesis tests, analyses of variance, linear models, etc.). Regarding multidimensional models, visual techniques play an important role because they can show the relationships among variables in a data set. Parallel coordinates and Chernoff faces are good examples of this. This article presents self-organizing maps (SOM), a multivariate visual data mining technique used to provide global visualizations of all the data. This technique is presented as a tutorial with the aim of showing its capabilities, how it works, and how to interpret its results. Specifically, SOM analysis has been applied to analyze the data collected in a study on the efficacy of a cognitive and behavioral treatment (CBT) for childhood obesity. The objective of the CBT was to modify the eating habits and level of physical activity in a sample of children with overweight and obesity. Children were randomized into two treatment conditions: CBT traditional procedure (face-to-face sessions) and CBT supported by a web platform. In order to analyze their progress in the acquisition of healthier habits, self-register techniques were used to record dietary behavior and physical activity. In the traditional CBT condition, children completed the self-register using a paper-and-pencil procedure, while in the web platform condition, participants completed the self-register using an electronic personal digital assistant. Results showed the potential of SOM for analyzing the large amount of data necessary to study the acquisition of new habits in a childhood obesity treatment. Currently, the high prevalence of childhood obesity points to the need to develop strategies to manage a large number of data in order to design procedures adapted to personal characteristics and increase treatment efficacy.
... Az életmódterápia, testtömegcsökkentés sikerességének feltétele, hogy a páciens kézbe tudja venni saját betegségének menedzselését, aminek része az önmonitorozás, életmódnapló vezetése [3,4]. Az étrendi napló vezetésének hatékonyságát több vizsgálat is igazolta [5][6][7]. Az önmenedzselés támogatásában az online vagy mobilfelületen működő alkalmazások penetrációja és hatékonysága egyre kifejezettebb. A Diabeo applikáció hatékonyságát vizsgáló 6 hónapos klinikai vizsgálat során kimutatták, hogy az alkalmazást használó csoport 0,67%-os HbA 1cjavulást ért el a kontrollcsoporthoz képest, és amelyik vizsgálati karban telekonzultációval is kiegészítették a kezelést, ott 0,91%-os HbA 1c -csökkenést tapasztaltak [8]. ...
The key components of successful diabetes therapy are pharmacotherapy, hospital care and lifestyle education. Lifestyle education, self-management, and composing the right diet can be effectively supported with mobile applications. In this paper Hungarian mobile applications are reviewed and compared to some international competitors. Besides plenty of useful functions some deficiencies are identified, based on dietary recommendations. The related improvements together with clinical trials validating effectiveness and reliability can strengthen medical evidence as well as the penetration of such mobile applications. Orv. Hetil., 2016, 157(29), 1147-1153.
... They are also related to core elements of Control Theory [48], which posits that behaviour is goal-driven and that feedback enables people to assess their performance in relation to their goals and make adjustments toward it accordingly. Selfmonitoring has been found to be effective for controlling weight and blood-glucose levels [49][50][51][52]; increasing academic performance [53,54] and improving healthy eating and physical activity [55]. In the formal consensus-building study with behaviour change or alcohol experts, self-monitoring was ranked the most likely intervention component to be effective in a smartphone app to reduce excessive alcohol consumption [45]. ...
Background:
Excessive alcohol consumption is a leading cause of death and morbidity worldwide and interventions to help people reduce their consumption are needed. Interventions delivered by smartphone apps have the potential to help harmful and hazardous drinkers reduce their consumption of alcohol. However, there has been little evaluation of the effectiveness of existing smartphone interventions. A systematic review, amongst other methodologies, identified promising modular content that could be delivered by an app: self-monitoring and feedback; action planning; normative feedback; cognitive bias re-training; and identity change. This protocol reports a factorial randomised controlled trial to assess the comparative potential of these five intervention modules to reduce excessive alcohol consumption.
Methods:
A between-subject factorial randomised controlled trial. Hazardous and harmful drinkers aged 18 or over who are making a serious attempt to reduce their drinking will be randomised to one of 32 (2(5)) experimental conditions after downloading the 'Drink Less' app. Participants complete baseline measures on downloading the app and are contacted after 1-month with a follow-up questionnaire. The primary outcome measure is change in past week consumption of alcohol. Secondary outcome measures are change in AUDIT score, app usage data and usability ratings for the app. A factorial between-subjects ANOVA will be conducted to assess main and interactive effects of the five intervention modules for the primary and secondary outcome measures.
Discussion:
This study will establish the extent to which the five intervention modules offered in this app can help reduce hazardous and harmful drinking. This is the first step in optimising and understanding what component parts of an app could help to reduce excessive alcohol consumption. The findings from this study will be used to inform the content of a future integrated treatment app and evaluated against a minimal control in a definitive randomised control trial with long-term outcomes.
Trial registration:
ISRCTN40104069 Date of registration: 10/2/2016.
... Researchers agree that self-tracking or self-monitoring weight, diet, and/or exercise contributed to weight loss and maintenance (Butryn, Phelan, Hill, & Wing, 2007;Grave et al., 2013;Linde, Jeffery, French, Pronk, & Boyle, 2005;O'Neil & Brown, 2005;Spring et al., 2013;Wing & Hill, 2001). These findings have been validated in randomized con- trolled trials (Burke, Wang, et al., 2011;Butryn et al., 2007;Spring et al., 2013;Wing & Phelan, 2005) and for individuals of different sizes (Baker & Kirschenbaum, 1998;King, Taylor, Haskell, & Debusk, 1988). ...
For individuals trying to lose or maintain weight, self-tracking their weight, diet, or exercise is important. In the past, different tracking modes have been examined, like paper and pencil, memory, or personal digital assistants. But the recent advancement and adoption of mobile technologies could also result in easier and simpler self-tracking. However, little is known about self-trackers, their tracking modes, and the absolute or relative contribution of each tracking mode at the population level. This study fills this gap by (a) comparing self-trackers' characteristics across tracking modes and against nontrackers and (b) testing the relationship between mobile self-tracking and tracking outcomes using a representative sample of data from the Pew Internet and American Life Project from 2012. Controls in the model include demographics, technology use, and health indicators. Results suggest that mobile self-trackers are younger and more educated and that mobile self-tracking is a positive contributor and the best tracking mode.
... [10][11][12] Mobile devices afford in-the-moment decision support by enabling users to check the energy value of foods and activities and track energy balance in real time. 13,14 Studies 15,16 of technology-supported weight loss interventions indicate that digital tools are more effective and acceptable to participants when they supplement rather than replace contact with human interventionists. Therefore, the current trial tested whether a connective mobile technology system, telephone coaching, and the standardof-care obesity treatment improved weight loss outcomes compared with standard-of-care group obesity treatment alone. ...
... Thus, these interventions attempt to both provide self-knowledge of where problem behaviors originate and teach the skills for changing them (30,31). In our clinical opinion, self-monitoring may be one of the most important techniques taught (32,33). Since people tend to underestimate energy intake and overestimate energy expenditure, participants are taught to use measurement tools (e.g. ...
Individuals with a diagnosis of mental illness have an increased risk for obesity and its related co-morbidities. Several factors contribute to obesity risk in this population: psychotropic medications, psychiatric symptoms, cognitive impairment, and motivation issues. Lifestyle or behavioral modification interventions rely on several techniques that can be implemented during psychiatric care to help manage body weight and improve quality of life. In this paper, we discuss behavioral changes necessary for weight reduction and review the available evidence on the efficacy of lifestyle interventions for obesity in patients with severe mental illness.
... Thus, although regular self-monitoring has been reported by some to be successful, its current efficacy as a general form of behaviour intervention is far from clear. For example, while some weight loss studies generally report success (Baker and Kirschenbaum, 1998;Boutelle et al., 1999;Boutelle and Kirschenbaum, 1998), its ability to increase levels of physical activity has been less clear; some report a positive effect (e.g. Aittasalo et al., 2005;Speck and Looney, 2001), while others report no significant increase (e.g. ...
Self-monitoring, by which individuals record and appraise ongoing information about the status of their body in order to improve their health, has been a key element in the personal management of conditions such as diabetes, but it is now also increasingly used in relation to health-associated behaviours. The introduction of self-monitoring as an intervention to change behaviour is intended to provide feedback that can be used by individuals to both assess their status and provide ongoing support towards a goal that may be formally set or remains implicit. However, little attention has been paid to how individuals actually engage in the process or act upon the information they receive. This article addresses this by exploring how participants in a particular trial ('Get Moving') experienced the process and nature of feedback. Although the trial aimed to compare the potential efficacy of three different monitoring activities designed to encourage greater physical activity, participants did not present distinctly different accounts of each intervention and the specifics of the feedback provided. Instead, their accounts took the form of much more extended and personal narratives that included other people and features of the environment. We draw on these broader descriptions to problematise the notion of self-monitoring and conclude that self-monitoring is neither solely about 'self' nor is it exclusively about 'monitoring'. We suggest that a more expansive social and material understanding of feedback can give insight into the ways information is made active and meaningful for individuals in their everyday contexts.
... In this regard, these programmes can support participants by identifying dietary patterns and can also be used for collecting precise long-term and comprehensive nutrition data (25) . Moreover, weight self-monitoring has been documented as an impactful tool for weight loss and control (26)(27)(28) . Additionally, recording dietary intake, physical activity and body weight is associated with successful weight loss and weight control (27,(29)(30)(31) . ...
Objective
To examine the weight-loss success associated with distinct dietary patterns and to determine changes of these dietary patterns during participation in a web-based weight-reduction programme.
Design
Factor analysis was used to identify the dietary patterns of twenty-two food groups that were administered in 14 d dietary protocols at baseline and after 3 months. Successful weight loss (≥5 % of initial weight) and BMI were calculated. Logistic regression analyses were used to assess the rates of weight-loss success from each dietary pattern and changing or remaining in the initial dietary pattern. A generalised linear mixed model was used to estimate the effects of changing or staying in a dietary pattern on change in BMI.
Subjects
Adults (
n
1635) aged 18–81 years.
Setting
Users of a web-based weight-reduction programme (2006–2012).
Results
Participants who aligned to a healthful dietary pattern at baseline (OR=1·8; 95 % CI 1·5, 2·3) and after 3 months (OR=1·5; 95 % CI 1·2, 1·9) had a greater chance of successfully losing weight. After adjusting for age, sex, initial dietary pattern and BMI, participants who started with or changed to the healthful dietary pattern had a greater chance of being successful (OR=1·4; 95 % CI 1·1, 1·7) and a higher BMI reduction of 0·30 (95 % CI 0·2, 0·5) kg/m
2
compared with those who started with or changed to the energy-dense or high-carbohydrate dietary pattern.
Conclusions
A favourable healthful dietary pattern at the beginning and after 3 months was positively associated with anthropometry. However, successful weight loss was feasible in each dietary pattern.
... Although, underreporting and/or inaccurate reporting of energy intake is common [79], selfmonitoring is considered a key component of any behavioral change or weight loss program [77]. Research has shown that individuals who consistently self-monitor their eating and exercise behaviors lose more weight than those who fail to consistently self-monitor behaviors [80,81]. ...
Behavioral weight loss interventions are the standard approach to weight loss for overweight adults; however, adherence to the components of these programs is a challenge and an area of extensive interest in the field of obesity prevention and treatment. Purpose: This study examined whether perceived importance of and willingness to engage in weight loss behaviors predicted weight loss in overweight, previously sedentary adult men and women. In addition, these variables were examined in relation to actual engagement in weight loss behaviors, namely self-monitoring and attendance. Methods: Data from 30 overweight (body mass index (BMI) = 32.4 + 2.7 kg/m2) men and women (age = 42.5 + 8.1 years) who participated in a standard behavioral weight loss intervention that included behavioral modification strategies, moderate caloric restriction, and progressive exercise prescriptions. Body weight, perceived importance, and willingness were assessed at 0 and 12 weeks. Results: The intervention resulted in a decrease in body weight, body mass index, caloric intake, and fat intake (p < 0.05) and an increase in energy expenditure (kcal/week) (p < 0.05). Individuals reported lower total perceived importance and willingness scores at week 12 (p < 0.05). Perceived importance and willingness for self-monitoring, eating, and exercise behaviors were correlated at both baseline and week 12. However, neither perceived importance of or willingness to engage in self-monitoring and eating behaviors at baseline were found to be predictive of weight loss. Willingness to self-monitor at week 12 was positively correlated with weight loss (r = 0.40, p = 0.03). In addition, negative correlations were found for perceived importance of exercise behaviors at week 12 and weight loss and willingness to engage in exercise behaviors at baseline and weight loss. Conclusion: The present study provides preliminary support for the relationship between perceived importance of and willingness to engage in weight loss behaviors; however, the ability of these two variables to predict weight loss is unclear. Further understanding of perceived importance of and willingness to engage in behavioral weight loss strategies among adults participating in weight reduction programs may allow for personalized interventions. More tailored approaches to behavioral modification may result in improved adherence to behavioral change strategies ultimately leading to more successful weight losses in overweight adults.
... 64 Definitions and measurement of adherence to selfmonitoring vary across studies. It has been defined as the numbers of records submitted, 38,63 therapists' ratings of the completeness of records, 65 the amount of food recorded that is at least more than 50% of weekly energy goal, 26 scores on a survey of selfmonitoring, 66 and the percentage of weeks recorded. 49 When Do People Stop Tracking? ...
... Baker y cols. observaron una ganancia de peso del 500% en las semanas vacacionales frente a las no vacacionales 24 . Todos estos estudios, junto con el nuestro, reflejan que el periodo vacacional contribuye a un aumento de peso. ...
Introducción: El sobrepeso y la obesidad constituyen, tanto en Europa como en España, uno de los mayores problemas de Salud Pública puesto que se asocian a factores de riesgo cardiovascular y a la aparición de otras patologías. Según la SEEDO la prevalencia de obesidad en la sociedad española está cerca del 25%. Además del estudio de nuestro estilo de vida y hábitos incorporados a las costumbres cotidianas, resultaría interesante evaluar cómo influyen en la ganancia de peso total anual los excesos realizados durante muchas festividades, que en muchos casos se suelen prolongar más allá de los días oficialmente festivos. Material y métodos: Estudio prospectivo, de carácter descriptivo a un total de 258 pacientes (95 varones y 163 mujeres) correspondientes a personas con un tratamiento para la reducción del peso corporal, como mínimo, de un mes. Se estudiaron siete periodos festivos. Resultados: Considerando todos los pacientes, se observó una correlación lineal significativa (p < 0,05) entre la diferencia de pérdida de peso y el tiempo vacacio-nal estudiado con mayor prevalencia en el periodo de Navidades. No se observó relación estadística entre pérdida de peso y edad o sexo.
... The consistent and frequent self-monitoring of energy intake is also one of the most critical components of behavioral interventions for the treatment of obesity (Burke et al., 2009). Numerous studies have found that compliance with the use of self-monitoring tools, such as food diaries, contributes significantly to weight loss (Baker & Kirschenbaum, 1998;Burke et al., 2009;Helsel et al., 2007). ...
Self-monitoring of energy intake is a critical element of a successful weight loss plan. However, current methods to monitor energy intake are cumbersome and prone to under reporting. The present study examined how individuals used a new energy intake monitoring tool, the Bite Counter to adjust their eating behavior to a targeted bite limit. Data were collected from 30 female participants examining their compliance with using the device as well as their adherence to eating limits based on bite count. Three distinct compliance personas were developed based on the shared behaviors and traits of device users: Committed Cathy (the rapid adopter, seldom misses tracking eating activities), Reluctant Rita (often forgets device, always has an excuse) and Negative Nancy (will not wear or use the device). These personas will inform future experimenters on how to improve usage instructions in order to increase participant compliance with using technology-based eating behavior monitoring tools.
... iod. It is only slightly concerning that people were not able to lose this weight throughout the year, so the holiday weight probably adds up, thereby contributing to the overall increase in body weight. " So is there any way to prevent the weight gain? " , Santa asks. The answers from researchers are neither convincing nor do they sound enjoyable. Baker and Kirschenbaum (1998) …nd that weight control through self-monitoring to prevent weight gain over the holiday period does not work very well. It only works for the participants in the most consistent self-monitoring quartile. It would even take much more e¤ort to get used to the proposal of Silverstein et al. (1996). They …nd that, overall, a liquid meal rep ...
Do you believe that at Christmas time the gas prices, the economy and the number of suicides peak? Do you think that the value of presents you are giving to your beloved is of importance? We show in this paper that conventional wisdom about Christmas is often doubtful. Furthermore, we give an idea of how Santa Claus -- and maybe you -- is able to finance Christmas celebrations, why emergency departments are a place to especially avoid during this time of the year and why Christmas tree growers might care to explain the differences across species to you this year. We cannot clearly establish whether Christmas entails a welfare loss or gain, however, we give you an idea as to which institutional settings might reduce a potential welfare loss. Also, we give advice about which behaviours might get you more Christmas presents from Santa this year. Finally, we find that more research is needed to give conclusive reasons why Santa Claus actually brings presents to (nearly) everyone.
... The answers from researchers are neither convincing nor do they sound enjoyable. Baker and Kirschenbaum (1998) …nd that weight control through self-monitoring to prevent weight gain over the holiday period does not work very well. It only works for the participants in the most consistent self-monitoring quartile. ...
Do you believe that at Christmas time the gas prices, the economy and the number of suicides peak? Do you think that the value of presents you are giving to your beloved is of importance? We show in this paper that conventional wisdom about Christmas is often doubtful. Furthermore, we give an idea of how Santa Claus –and maybe you –is able to finance Christmas celebrations, why emergency departments are a place to especially avoid during this time of the year and why Christmas tree growers might care to explain the differences across species to you this year. We cannot clearly establish whether Christmas entails a welfare loss or gain, however, we give you an idea as to which institutional settings might reduce a potential welfare loss. Also, we give advice about which behaviors might get you more Christmas presents from Santa this year. Finally, we find that more research is needed to give conclusive reasons why Santa Claus actually brings presents to (nearly) everyone.
... Self-monitoring has been found to be associated with weight loss success. For instance, individuals who consistently selfmonitor lose significantly more weight than those who do not self-monitor, or are not consistent [31][32]73 . Over an 8-week period, Boutelle and Kirschenbaum 32 found that subjects who consistently self-monitored food intake lost approximately 2.56 kg more than those who did not consistently self-monitor. ...
Standard behavioral weight loss programs typically result in a weight reduction of approximately 10%. These programs are generally intensive and therefore it is important to examine alternative methods, which may have the ability to enhance or produce similar outcomes. PURPOSE: To compare changes in body weight and physical activity between a technology-based system, an in-person behavioral weight loss intervention, and a combination of both over a 6-month period in overweight and obese adults. METHODS: Fifty-one subjects (Age: 44.2±8.7 years, BMI: 33.7±3.6 kg/m2) participated in a 6-month behavioral weight loss program and were randomized to one of three groups: Standard Behavioral Weight Loss (SBWL), SBWL Plus Technology-Based System (SBWL+FIT), or Technology-Based System alone (FIT). SBWL attended weekly group or individual meetings, were prescribed a diet of 1200-1800 kcal/day, and progressed from 100-300 minutes/week of moderate intensity physical activity. SBWL+FIT received the same components as SBWL plus the use of the BodyMedia FIT System that included an armband, display, and website to monitor energy expenditure and caloric intake. FIT was given the BodyMedia FIT System and received monthly telephone calls. Body weight and physical activity were assessed at 0 and 6 months. RESULTS: A total of 39 out of 51 subjects completed the 6 month assessments, with significant differences in retention rates between groups (SBWL: 53%, SBWL+FIT: 100%, and FIT: 77%) (p<0.05). Intent-to-treat analysis revealed significant weight losses at 6 months in SBWL+FIT (-8.8±5.0kg, -8.7±4.7%), SBWL (-3.7±5.7kg, -4.1±6.3%), and FIT (-5.8±6.6kg, -6.3±7.1%) (p<0.001), with a trend for greater weight loss in SBWL+FIT compared to SBWL (p=0.09). Self-report physical activity increased significantly in SBWL (473.9±800.7 kcal/week), SBWL+FIT (713.9±1278.8 kcal/week), and FIT (1066.2±1371 kcal/week) (p<0.001), with no differences between groups (p=0.25). DISCUSSION: The technology-based system used in conjunction with monthly telephone calls, produced similar, if not greater weight losses and changes in physical activity than the standard in-person behavioral program at 6 months. Furthermore, the addition of the technology system enhanced participant retention. Thus the use of this technology may reduce participant attrition as well provide an effective alternative to the standard in-person behavioral weight loss intervention.
... A series of self-monitoring intervention studies had participants record their eating behaviors, food intake, and physical activity using a paper-and-pencil self-monitoring booklet and found that more frequent self-monitoring is related to greater weight loss (Baker & Kirschenbaum, 1993;Baker & Kirschenbaum, 1998;Boutelle & Kirschenbaum, 1998). Boutelle and Kirschenbaum (1998) suggested self-monitoring all foods eaten on 75% or more of days in order to successfully lose weight. ...
... Baker y cols. observaron una ganancia de peso del 500% en las semanas vacacionales frente a las no vacacionales 24 . Todos estos estudios, junto con el nuestro, reflejan que el periodo vacacional contribuye a un aumento de peso. ...
Introduction:
Overweight and obesity are both in Europe and in Spain, one of the major public health problems since they are associated with cardiovascular risk factors and the occurrence of other diseases. Nowadays, the prevalence of obesity SEEDO in Spanish society is about 25%. In addition to evaluating how our lifestyle habits influence in our weight, it would be interesting to assess how the festivity days, which in many cases are often extended beyond officially holidays, can influence the total annual weight gain.
Methods:
A prospective and descriptive study was conducted in a total of 258 patients (95 men and 163 women) undergoing a treatment for weight reduction, at least during one month ago. We studied seven holiday periods.
Results:
In all patients, there was a significant linear correlation (p < 0.05) difference between weight loss and vacational time studied with greater prevalence in the Christmas period. No statistically significant association was found between weight loss and age or sex.
... Regular feedback and monitoring have shown promise in helping to support ongoing behavioral change and management. 4,5 Primary care practices are well positioned to deliver effective brief interventions to support healthy lifestyle choices. 6 The American Academy of Family Physicians developed a public health initiative, Americans in Motion-Healthy Interventions (AIM-HI), to promote healthy lifestyle choices related to nutrition, physical activity, and emotional well-being. ...
Purpose: The purpose of this article was to test whether physical activity, healthy eating, and emotional well-being would improve if patients received feedback about biomarkers that have been shown to be responsive to changes in weight and fitness.
Patients were randomized to limited feedback (weight, body mass index [BMI], and blood pressure at 4 and 10 months) or enhanced feedback (weight, BMI, blood pressure, homeostatic insulin resistance, and nuclear magnetic resonance lipoprotein profiles at 2, 4, 7, and 10 months). Repeated measures mixed effects multivariate regression models were used to determine whether BMI, fitness, diet, and quality of life changed over time.
Major parameters were similar in both groups at baseline. BMI, measures of fitness, healthy eating, quality of life, and health state improved in both patient groups, but there was no difference between patient groups at 4 or 10 months. Systolic blood pressure improved in the enhanced feedback group, and there was a difference between the enhanced and limited feedback groups at 10 months (95% confidence interval, -6.011 to -0.5113).
Providing patients with enhanced feedback did not dramatically change outcomes. However, across groups, many patients maintained or lost weight, suggesting the need for more study of nondiet interventions.
Objectives:
There is a trend toward an increase in body mass index (BMI) among adolescents over the course of the year. This increase in BMI is more pronounced during vacation periods, when healthy habits are relaxed due to the increase in number of social, family, and festive events, with summer being the period with the greatest increase. The objective of this study was to evaluate changes in weight during Christmas vacation. Changes in weight, BMI, and waist circumference were evaluated in association with adherence to the Mediterranean diet or a low-fat diet.
Methods:
A total of 67 university students participated in this pilot study, 10 men (14.9%) and 57 women (85.1%), with a mean age of 20.37 y (±4.07 y). The first weigh-in was on the day before the start of vacation; there were two more during the vacation and a final one when students returned to the course.
Results:
In general, a significant increase (P < 0.05) in body weight was found between the first measurement and the ensuing measurements during the holidays. The students with a high-fat diet presented with a more pronounced change in weight, with significant differences being found between weights 1 and 3 and between weights 1 and 4 (P < 0.05).
Conclusions:
The data show that students gained a significant amount of weight during the Christmas holidays. Although the weight gain was not alarming, it does point to the possibility of weight gain among young adults during vacation periods and may reflect what happens in other social strata.
Many psychological inclinations, such as maladaptive beliefs, can diminish the capacity of individuals to manage their weight effectively and sustainably. Yet, interventions that purportedly address these psychological inclinations and improve weight management are not always beneficial. To be effective, these interventions should offer participants several choices, should be devoid of features that have not been validated in isolation, and should arrange the various activities in an efficient and effective sequence. Few if any programs fulfill these criteria. The aim of this paper was to construct an intervention that assimilates all the validated features of interventions that overcome the psychological impediments to weight loss. To achieve this goal, we blended a technique called intervention component analysis with thematic analysis. Specifically, we extracted refereed journal articles about weight loss from PsycInfo, distilled the practical recommendations from these articles, excluded recommendations that had not been validated in isolation of other features, integrated overlapping recommendations, and applied several principles to arrange these recommendations into the most effective sequence. This procedure generated an intervention that could comprise up to 43 features and activities, including self-affirmation to foster openness to change, anecdotes about dramatic improvements, ambitious rather than modest targets, an emphasis on strategies rather than targets, rewards for attempts, implementation intentions with partners, self-hypnosis, cognitive reframing, and distancing. If these features are unsuccessful, practices that demand more resources—such as group disclosure, virtual environments, motivational interviewing, and customized programs—were also recommended.
We examined the U.S. holiday period impact on weight gain, self-weighing, and treatment success among adults in a weight loss intervention (N=171). Using electronic scales, body weight and self-weighing frequency were compared by time period [i.e., pre-holiday, holiday (November 15-January 1), post-holiday]. Self-weighing was less frequent during holiday period (p<.01), and longer intervention engagement was associated with weight gain (p<.0001) during this time. Enrollment during holiday period was associated with 2.3% 12-month weight loss. Holiday period enrollment might be beneficial for preventing holiday weight gain and facilitating successful intervention outcomes.
В статье исследуется психологическая помощь при расстройствах пищевого поведения как поддерживающий процесс для постановки приоритетов и целей, а также создания индивидуализированных планов действия. Подчеркивается, что бихевиоральная теория и когнитивно-бихевиоральная теория основаны на предположении, что всякое поведение является научаемым, и что внутренние и внешние факторы влияют на поведение личности. Эти теории поощряют такие стратегии, как самонаблюдение и решение проблем, которое делает людей внимательнее к внутренним и внешним факторам и своим реакциям на эти факторы. Проверяется терапевтическая эффективность этих теорий в разных эмпирических исследованиях. Анализируются основные положения относительно того, что консультирование по проблемам пищевого поведения, осуществляемое специалистами, имеет способность улучшить потерю веса, стабилизацию веса, уровни сахара в крови для людей с диабетом второго типа и рисками сердечно-сосудистых болезней. Очень многие экспериментальные данные подтверждают гипотезу о том, что когнитивно-бихевиоральная терапия облегчает поведенческие изменения, нацеленные на снижение риска сердечно-сосудистых болезней, предупреждение и лечение диабета, потерю веса. Убедительные эмпирические данные подтверждают эффективность самонаблюдения, мотивационного опроса (в частности, в сочетании с когнитивно-бихевиоральной терапией), замена еды и структурированные планы питания как стратегии в психологической помощи людям с расстройствами пищевого поведения.
State-of-the-art techniques for eating activities
analysis in dietary monitoring require significant user intervention,
which is reported to be one of the major reasons for
low adherence. There are limited works using wearables for
fine-grained analysis of eating activities in terms of the eating
speed, the type of food consumed, and the portion sizes. In
this paper, we propose FIT-EVE&ADAM, an armband based
diet monitoring system that provides such fine-grained analysis,
triggered by a single hand gesture. The system collects the
user’s gesture using sensors such as electromyogram embedded
in the armband device, along with food image data using color
and thermal cameras. Finally, a novel feature selection method
is applied on the data features to estimate eating speed and
caloric intake with high accuracy (0.96 F1 score).
Objective:
To examine within-person variation in dietary self-monitoring during a 6-month technology-supported weight loss trial as a function of time-varying factors including time in the study, day of the week, and month of the year.
Methods:
Smartphone self-monitoring data were examined from 31 obese adults (aged 18-60 years) who participated in a 6-month technology-supported weight loss program. Multilevel regression modeling was used to examine within-person variation in dietary self-monitoring.
Results:
Participants recorded less as time in the study progressed. Fewer foods were reported on the weekends compared with weekdays. More foods were self-monitored in January compared with October; however, a seasonal effect was not observed.
Conclusions and implications:
The amount of time in a study and day of the week were associated with dietary self-monitoring but not season. Future studies should examine factors that influence variations in self-monitoring and identify methods to improve technology-supported dietary self-monitoring adherence.
New tools have been developed to automate the study of human eating behavior. This research examined three aspects of a participant’s usage habits of a new energy intake monitoring tool, the Bite Counter. Research questions pertaining to immediate and long term compliance of the device and adherence to the alarm were examined based on data collected from 30 female participants. Participants adapted to using the device quite easily. 80% were compliant immediately from the start of use, increasing to 90% of participants within the first two weeks of the study. However, 23% of participants never attained or failed to maintain compliance standards with the Bite Counter. Finally, compliant participants stopped eating when the Bite Counter alarm sounded approximately 69% of the time. These findings show that the Bite Counter is easily adopted and functionally easy to operate for novice users.
In a cross-sectional pilot study, we examined eating behaviors in patients (N = 24) approximately 6 years after gastric bypass surgery. Anthropometric measures, personal interviews, and 7 days of food records were collected. A mean body mass index of 33.7 ± 8 was reported, with 75% (18/24) sustaining a weight loss 50% or more of their excess body weight. A mean total caloric intake of 1429 ± 411 cal was reported: 43% carbohydrate, 17% protein, and 39% fat. Subjects reported “returning to old eating habits” with a diet high in liquid calories (soda, coffee drinks, sports drinks, alcohol), sweets (chocolate, cookies), convenience foods, and fast food consumption.
With two-thirds of the U.S. population being either overweight or obese, accurate tools for self-monitoring eating behaviors are needed for both research and personal purposes. To increase user compliance, these tools should be easy to use and impose a minimal burden on the user. The present study compares user preferences and compliance with the Bite Counter, a wrist-worn device designed to monitor eating behavior by counting bites, to the Internet-based Automated Self-Administered 24-hour dietary recall (ASA24). Eighty-three participants used the Bite Counter and the ASA24 for two weeks. At the end of the two-week period, participants were asked to rate their preference, compliance, and the ease of use for the two tools. 76% of the participants preferred the Bite Counter to the ASA24. Participants consistently used both tools. The Bite Counter was significantly easier to use, according to subjective ratings. These results indicate that users may be more likely to use the Bite Counter consistently than 24-hour dietary recalls.
抄録
よりよい妊娠転帰と児の健全な発育のためには，妊娠期から産褥期にかけて，十分な栄養摂取と食生活および体重管理を確立するための継続的なフォローアップが不可欠である。そこで，料理ベースである“妊産婦のための食事バランスガイド”が，妊婦に対する栄養教育において有効なセルフモニタリングのツールになりうるかどうか検討した。
東京都内の産科施設に通院していた妊娠18週までの42名の健康な妊婦から，2007年12月から2008年9月までに，本研究への参加について文書にて同意が得られた。そのうち，妊娠初期・中期・末期の計3回の24時間思い出し法による食事調査と質問紙調査を完了した36名を分析の対象とした。対象者はブロックランダム化割付により，栄養素・食物レベルで指導を行う介入群Aと料理レベルで指導を行う介入群Bに割り付けた。身体状況及び食物摂取状況の変化を検討した。介入群Bでは副菜のサービング数に有意な増加が示され，3回目調査時には望ましい摂取量の範囲にあった。食事のバランスを整えることに対する行動変容ステージ及びセルフエフィカシーは，介入群Bにおいてのみ有意に改善した。本研究により，個別指導に加えて“妊産婦のための食事バランスガイド”を用いたセルフモニタリングは，健康な妊婦における望ましい食行動の確立に有効であることが示唆された。
（オンラインのみ掲載）
The question of how affect arises and what affect indicates is examined from a feedback-based viewpoint on self-regulation. Using the analogy of action control as the attempt to diminish distance to a goal, a second feedback system is postulated that senses and regulates the rate at which the action-guiding system is functioning. This second system is seen as responsible for affect. Implications of these assertions and issues that arise from them are addressed in the remainder of the article. Several issues relate to the emotion model itself; others concern the relation between negative emotion and disengagement from goals. Relations to 3 other emotion theories are also addressed. The authors conclude that this view on affect is a useful supplement to other theories and that the concept of emotion is easily assimilated to feedback models of self-regulation. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The question of how affect arises and what affect indicates is examined from a feedback-based viewpoint on self-regulation. Using the analogy of action control as the attempt to diminish distance to a goal, a second feedback system is postulated that senses and regulates the rate at which the action-guiding system is functioning. This second system is seen as responsible for affect. Implications of these assertions and issues that arise from them are addressed in the remainder of the article. Several issues relate to the emotion model itself; others concern the relation between negative emotion and disengagement from goals. Relations to 3 other emotion theories are also addressed. The authors conclude that this view on affect is a useful supplement to other theories and that the concept of emotion is easily assimilated to feedback models of self-regulation.
The relationship between self-monitoring and weight control was examined closely by analyzing 18 weeks of data for 56 participants in a long-term cognitive behavioral weight-loss program. The percentage of subjects who monitored consistently, which monitoring variables were most related to weight change, and the effect of variability in monitoring on weight change were examined. Approximately 2/3 of the subjects monitored food consumption for the entire day more than half of the days; approximately 1/4 did not monitor on most days. Monitoring—any food eaten, all foods eaten, time food was eaten, quantity of food eaten, and grams of fat consumed—was positively correlated with weight change. Not monitoring at all was negatively associated with weight change. More consistent monitors lost more weight and participants lost much more weight during their best, compared to their worst, weeks of monitoring. These results support the notions that self-monitoring, and perhaps “obsessive-compulsive self-regulation,” are necessary for successful weight control.
The concept of ‘self-control,” until recently embedded in intrapsychic personality theories and banished from strict behavioral accounts of human activity, is considered from the perspective of a closed-loop learning paradigm. In considering self-regulatory and self-control behavior, an attempt is made (1) to extricate these concepts from the realm of philosophical debate on the image of man, (2) to point to their growing relevance in the context of rapidly changing environments, (3) to provide behavioral definitions and a tentative and testable process model, and (4) to outline their clinical (therapeutic) implications. The current conceptualization emphasizes (a) the contractual elements in self-control, (b) the critical importance of insuring the link between intentions (often of a verbal variety) and behavioral execution, and (c) the interdependence of external and internal controlling variables. In a larger context, the paper seeks to show how man's “selfreflectiveness” can be incorporated within an empirically based behavior theory. Suggestions for research are presented.
Empirical evaluations of therapies designed to improve self-regulatory skills have not as yet demonstrated their success as methods of ensuring long-lasting behavior change. The clinical use of concepts and procedures derived more from assumptions about the nature of self-regulation than from empirical evidence may be responsible for some of these outcomes. This paper demonstrates that a fine-grained, empirically-based, analysis of the active elements of “self-regulatory failure” is both possible and useful. Based on an examination of three literatures (successful vs. unsuccessful self-regulation; the relapse process; attention in self-regulation), eight components of self-regulatory failure are identified: depressogenic cognitions; difficulties coping with emotional Stressors; disengagement from habit change; social pressure; initial relapse episode; physiological pressure; problematic attentional focusing; and disengagement from self-monitoring. It is noted that further empirical work is necessary to specify probable patterns of interaction between these elements. One exception is discussed: it appears that many of the proposed elements can lead to disengagement of self-monitoring which, in turn, often precipitates a rapid failure to sustain effective self-regulation. Finally, a general strategy to prevent self-regulatory failure is discussed that accords well with this conceptualization—engaging in “obsessive-compulsive self-regulation.”
Recent commentaries by health professionals call into serious question the adequacy of extant rationales for treating anything less than severe obesity. They also raise doubts about the efficacy of any treatments for obesity and the likelihood of achieving significant progress in treating this disorder. The present writers view in an entirely different light the health consequences of obesity, the effectiveness of professionally conducted long-term and intensive treatments, and the future of the field. The purpose of this article is to examine the scientific basis of the current controversy. This analysis encourages further evaluations of intensive state-of-the-art/science treatments of obesity, considerations of possible cognitive biases against research on the treatment of obesity, and a cautiously optimistic perspective about the future of such endeavors.
The aim of this study was to compare the effects of weight loss treatment, cognitive-behavioral treatment, and desipramine on binge eating and weight in a three group additive design involving 108 overweight participants with binge eating disorder. Subjects were allocated at random to either 9-months weight-loss-only treatment; 3-months of cognitive-behavioral treatment followed by weight loss treatment for 6-months; or the combination treatment with desipramine added for the last 6-months. After 3-months of treatment, those receiving cognitive-behavioral therapy had reduced binge eating significantly more than participants receiving weight loss therapy only, and the weight loss only group had lost significantly more weight than those in the cognitive-behavioral groups. The addition of medication did not lead to greater reductions in the frequency of binge eating. Hence, there was no evidence that either cognitive-behavioral therapy or desipramine added to the effectiveness of weight loss therapy. However, those receiving medication lost significantly more weight than the comparable group without medication at follow-up. Abstinence from binge eating was associated with significantly greater weight losses. Overall, however, the achieved weight losses were small and the abstinence rates low. Moreover, there were no differences between the three groups either at the end of treatment or at follow-up. Suggestions for further research aimed at improving the therapeutic results for this difficult clinical problem are discussed.
This study evaluated the effectiveness of a comprehensive obesity treatment program which incorporated open-ended treatment duration, pre-treatment assessments, protein-sparing modified fasts (PSMFs), and the use of six a priori outcome categories to analyse outcomes. Subjects were the first 291 obese individuals (mean weight = 235 lb, 66% overweight) to participate in the program's intake procedures. Data obtained after 55 weeks of treatment (on average) showed that the program seemed quite effective for 65% of those who participated for at least 12 weeks (mean = 62 and 30 lb lost in the two successful groups). Analyses supported the continued use of pre-treatment assessments, extended treatment times, and a priori categorizations of outcomes. In addition, correlational analyses showed that binge eating, high levels of psychological distress, and low income levels were associated with poorer outcomes.
This study examined attrition and weight loss in 235 female obese binge eaters, episodic overeaters, and nonbingers treated by a 26-week program of behavior modification and very low calorie diet. No significant differences were observed among conditions in the number of Ss who completed treatment. Episodic overeaters, however, were more likely than Ss in the other 2 conditions to drop out during the last 7 weeks of treatment, when Ss resumed consumption of a conventional diet. End-of-treatment weight losses for the 3 conditions, which did not differ significantly, averaged 21.5, 19.4, and 21.7 kg, respectively. No significant differences were observed among conditions in weight regain (which averaged 8.8 kg) in the year following treatment, although small sample sizes prevented an adequate evaluation.
It is clear from the data available that weight loss of varying degrees can be produced by treatments now available. With jejuno-ileal bypass, the most risky, weight loss of 30% of initial body weight can be produced and maintained for extended periods of time. However, this is produced with significant potential side-effects. Weight loss averaging 10 kg has been associated with the use of fenfluramine, but this treatment illustrates the problem of palliation versus cure since when drug treatment was stopped, weight was regained. The most promising results have been those utilizing a combination of nutritional and behavioral approaches. With this technique, weight losses reducing overweight by 30% or more have been demonstrated to be effective for up to 4 years following initiation of treatment. It is thus possible to offer significant help to a major group of people with weight problems, using techniques currently available. Weight loss which is regained may carry significant added disadvantages and must be weighed against the effects of weight loss. Weight loss produces a reduction in hyperglycemia, blood pressure, and triglycerides, and may produce a reduction in cholesterol. These reductions in risk factors are beneficial. However, during weight regain, which occurs in a significant number of individuals, impairment in glucose tolerance, a rise in triglycerides, and a rise in blood pressure may more than offset the benefits of the weight reduction itself. In considering treatment, these problems must be borne in mind.
Although behavior modification of obesity is usually described as a behavior change procedure, measurement is most often limited to the outcome variable of weight loss. The present investigation employed detailed behavior monitoring forms in half of 16 obesity groups (n = 173) matched across four different therapists. The percentage of compliance for nine specific treatment behaviors was charted from these monitoring forms. At the end of treatment, the eight groups that had the behavior monitoring treatment averaged over 6 pounds more weight lost than the matched control groups as well as showing significantly better attendance. The between group weight loss differences were still evident 3 months after treatment.
It must be remembered that ideal body weight is an abstract rather than an absolute concept. Height-weight tables are merely gross estimates. Nutrition is a multifaceted issue, as is client assessment, especially in the area of weight management. Health care professionals should use height-weight tables with caution and in conjunction with other parameters to assist in nutritional status assessments.
Before starting a behavioral weight control program and after 6 months of treatment, 93 participants were asked to listen to 4 scenarios describing typical high risk situations for dieters (family celebration, watching TV, tension at work, argument). The number of coping responses generated, latency of responses, and perceived risk of lapsing were assessed; participants also identified which situation would be most difficult for them. Telephone interviews were conducted during the weight loss program to assess situations surrounding actual dietary lapses. Participants who rated the negative affect situations as most difficult were more likely to lapse in situations involving negative affect; 87% of these participants lapsed in association with negative affect. Moreover, participants who generated coping responses to more of the situations subsequently lost more weight. Thus, baseline performance on a hypothetical high risk task predicts subsequent performances in a behavioral weight loss program.
We examined dieters' attempts to cope with dietary relapse crises (Immediate coping) and their aftermath (Restorative coping). We analyzed posttreatment interviews with 57 obese subjects with Type-II diabetes, comparing coping in situations in which subjects lapsed with those in which they survived temptations to overeat. Performance of Immediate coping predicted survival but the particular type of coping made little difference. Eight types of Immediate cognitive coping were equally associated with survival: each was significantly more effective than no coping and equal to the aggregate of the other types. A similar pattern held for 5 types of Immediate behavioral coping, except that social support was no more effective than no coping and restraint was less effective than the other types. Restorative behavioral coping was elicited as a response to overeating, while Restorative cognitive coping seemed elicited by the negative thoughts and feelings that sometimes accompany lapses or temptations. Implications for treatment and future research on relapse crises and coping are discussed.
Improving relapse-prevention strategies for weight loss. Paper presented at the meeting of the Society of Behavioral Medicine
- S Head
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Reinforcement and structural support of maintained risk reduction
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- Jr
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