Motivation For Weight Loss Research Articles

Elements of Weight Management Among Pre-Kidney Transplant Candidates: The Patient Perspective

Obesity and related comorbidities heighten risks for complications in kidney transplant settings. While pre-transplant patients often have access to nutrition counseling and health support, literature is limited on patients' perceptions of weight and motivation to lose weight prior to transplantation. We conducted a survey among ≥18-year-old patients on the kidney transplant waitlist at a single center. Questions addressed weight perception, motivation for weight loss, available resources, and engagement in physical activity. Medical records provided demographic and clinical data. Statistical tests analyzed quantitative data, while free-text responses were thematically grouped and described. Of 1055 patients, 291 responded and were matched with demographic data. Perceived weight changes correlated with actual changes in body mass index (BMI) (<24.9) were more receptive to weight center resources (<30 kg/m2) are most interested in weight loss resources and demonstrate motivation. Furthermore, pre-transplant nutrition counseling correlates with healthier behaviors. Integrating patients’ perspectives enhances pre-transplant protocols by encouraging active involvement in health decisions.

Facilitators and Barriers to Weight Loss Among Patients With Idiopathic Intracranial Hypertension.

Little is known about motivation for weight loss and barriers to weight loss among patients with idiopathic intracranial hypertension (IIH). Such information is crucial for developing tailored weight management recommendations and novel interventions. We administered a survey to patients with IIH presenting to neuro-ophthalmology clinics at The University of Michigan Kellogg Eye Center (Michigan, USA) and St. Thomas' Hospital (London, England). Participants rated importance and motivation to lose weight (1-10 scale; 10 = extremely important/motivated). Facilitators and barriers to weight loss were assessed using open-ended survey questions informed by motivational interviewing methodology. Open-ended responses were coded by 2 team members independently using a modified grounded theory approach. Demographic data were extracted from medical records. Descriptive statistics were used to analyze quantitative responses. Of the 221 (43 Michigan and 178 London) patients with IIH (Table 1), most were female (n = 40 [93.0%] Michigan and n = 167 [94.9%] London). The majority of patients in the United States were White (n = 35 [81.4%] Michigan), and the plurality were Black in the United Kingdom (n = 67 [37.6%] London]) with a mean (SD) BMI of 38.9 kg/m2 (10.6 kg/m2) Michigan and 37.5 kg/m2 (7.7 kg/m2) London. Participants' mean (SD) level of importance to lose weight was 8.5 (2.2) (8.1 [2.3] Michigan and 8.8 [2.1] London), but their mean (SD) level of motivation to lose weight was 7.2 (2.2) (6.8 [2.4] Michigan and 7.4 [2.1] London). Nine themes emerged from the 992 open-ended coded survey responses grouped into 3 actionable categories: self-efficacy, professional resources (weight loss tools, diet, physical activity level, mental health, and physical health), and external factors (physical/environmental conditions, social influences, and time constraints). Most responses (55.6%; n = 551) were about barriers to weight loss. Lack of self-efficacy was the most discussed single barrier (N = 126; 22.9% total, 28.9% Michigan, and 20.4% London) and facilitator (N = 77; 17.5% total, 15.9% Michigan, and 18.7% London) to weight loss. Other common barriers were related to physical activity level (N = 79; 14.3% total, 13.2% Michigan, and 14.8% London) and diet (N = 79; 14.3% total, 9.4% Michigan, and 16.3% London). Commonly reported facilitators included improvements in physical activity level (N = 73; 16.6% total, 18.5% Michigan, and 15.1% London) and dietary changes (N = 76; 17.2% total, 16.4% Michigan, and 17.9% London). Patients with IIH believe weight loss is important. Self-efficacy was the single most mentioned important patient-identified barrier or facilitator of weight loss, but professional resource needs and external factors vary widely at the individual level. These factors should be assessed to guide selection of weight loss interventions that are tailored to individual patients with IIH.

The association between gender-affirming care and disordered eating in transgender and gender diverse individuals: Exploring appearance congruence and gender-related motivating factors for weight loss.

The objective of this study is to explore between-group differences across different stages of gender-affirming care, and associations between appearance congruence, gender-related motivations for weight loss, and disordered eating in transgender and gender expansive (TGE) individuals. A total of 160 TGE adults (aged 18-30) were recruited across the United States. Participants completed a comprehensive online survey. Data were analyzed using generalized linear models and bivariate correlations. Significant differences in appearance congruence among participants at different transition stages were revealed, with the group that achieved their desired transition reporting the highest appearance congruence compared to all other groups. Furthermore, gender-related motivations for weight loss were significantly lower in individuals who achieved their desired transition compared to those with no plans to transition. Findings suggest significantly higher appearance congruence in those who achieved their desired transition compared to other groups, and individuals who attained their desired transition exhibited significantly reduced gender-related motivations for weight loss compared to those with no plans to transition. These findings underscore the potential psychological benefits associated with successful gender-affirming care, highlighting its role not only in fostering appearance congruence but also in mitigating gender-related motivations for weight loss among TGE individuals. Future research should include larger and more diverse samples, longitudinal designs, and considerations of other factors influencing body image outcomes in this population. This study sheds light on the crucial relationship between gender-affirming care and body image outcomes in TGE individuals. Understanding how appearance congruence and gender-related motivations for weight loss are associated with disordered eating can inform tailored support and interventions. By recognizing the association of gender affirming care and well-being, healthcare providers can enhance care for TGE individuals.

The social and environmental factors impacting the motivation of adolescents for weight control, why and how? A qualitative study

IntroductionOverweight and obesity are common problems among teenagers regardless of ethnicity, race, and socio-economic status. Therefore, this study aims to explore the social and environmental factors impacting adolescents motivation for weight control in Gilan province, Iran.MethodologyFollowing a qualitative design, a content analysis approach was used to analyze the data. A total of 79 interviews were conducted with Adolescents (n = 23), Friends and Peers (n = 15), Parents (n = 12), Managers (n = 16), and Health care providers (n = 13), regarding adolescents obesity during 2019. MAXQDA V.10 software was used for our analysis.FindingsThe main categories of environmental and social factors affecting adolescents motivation for weight control were external factors (the relative success of weight control intervention programs, the lack of environmental and social support, and the lack of family support for teenagers) that each one had some subcategories, and internal factors (competence, relatedness, and autonomy).ConclusionThis study demonstrated the necessity of identifying environmental and social factors that are effective in reducing adolescents’ motivation for weight loss. These factors are so influential that teenagers can’t overcome them without receiving support from their environment and the government health-related policies. So, it seems that we need integrated multisectoral approaches and we suggest that health policymakers develop practical policies to control adolescents obesity by focusing on factors that have been mentioned in this study.

Why more successful? An analysis of participants’ self-monitoring data in an online weight loss intervention

BackgroundSelf-monitoring is crucial for behavioral weight loss. However, few studies have examined the role of self-monitoring using mixed methods, which may hinder our understanding of its impact.MethodsThis study examined self-monitoring data from 61 Chinese adults who participated in a 5-week online group intervention for weight loss. Participants reported their baseline Body Mass Index (BMI), weight loss motivation, and engaged in both daily quantitative self-monitoring (e.g., caloric intake, mood, sedentary behavior, etc.) and qualitative self-monitoring (e.g., daily log that summarizes the progress of weight loss). The timeliness of participants’ daily self-monitoring data filling was assessed using a scoring rule. One-way repeated measurement ANOVA was employed to analyze the dynamics of each self-monitoring indicator. Correlation and regression analyses were used to reveal the relationship between baseline data, self-monitoring indicators, and weight change. Content analysis was utilized to analyze participants’ qualitative self-monitoring data. Participants were categorized into three groups based on their weight loss outcomes, and a chi-square test was used to compare the frequency distribution between these groups.ResultsAfter the intervention, participants achieved an average weight loss of 2.52 kg (SD = 1.36) and 3.99% (SD = 1.96%) of their initial weight. Daily caloric intake, weight loss satisfaction, frequency of daily log, and the speed of weight loss showed a downward trend, but daily sedentary time gradually increased. Moreover, regression analysis showed that baseline BMI, weight loss motivation, and timeliness of daily filling predicted final weight loss. Qualitative self-monitoring data analysis revealed four categories and nineteen subcategories. A significant difference in the frequency of qualitative data was observed, with the excellent group reporting a greater number of daily logs than expected in all categories and most subcategories, and the moderate and poor groups reporting less than expected in all categories and most subcategories.ConclusionThe self-monitoring data in short-term online group intervention exhibited fluctuations. Participants with higher baseline BMI, higher levels of weight loss motivation, and timely self-monitoring achieved more weight loss. Participants who achieved greater weight loss reported a higher quantity of qualitative self-monitoring data. Practitioners should focus on enhancing dieters’ weight loss motivation and promote adherence to self-monitoring practices.

Testing replicability of the relationship between weight suppression and binge eating in three non-clinical samples varying in lifetime weight history

ObjectiveIncreased weight suppression, the difference between an individual's highest and current weight at present height, predicts binge eating among eating disorder samples. Less is known about this relationship in non-clinical samples of individuals with a history of higher weight. MethodsLifetime highest BMI was tested as a moderator of the relationship between weight suppression and binge eating in three independent samples (N = 1740). ResultsAt the bivariate level, weight suppression was not associated with binge eating in any sample (p's ≥ 0.20). Lifetime highest BMI moderated the relationship between weight suppression and binge eating in Sample 1 (p = .04), such that greater weight suppression was associated with lower binge eating among those with a history of higher weight (i.e., BMI = 40 kg/m2). In Samples 2 and 3, the lifetime highest BMI by weight suppression interaction term was not significant and dropped from the model (p's = 0.10–0.12). Accounting for age, gender, and lifetime highest BMI, greater weight suppression was associated with lower binge eating scores (p's < 0.04). A meta-analysis combining results revealed a small but significant interaction effect (r = 0.07, p = .02). ConclusionsFindings highlight the importance of investigating the generalizability of eating disorder risk and maintenance theories across the weight spectrum. Weight loss may not increase risk for binge eating among those with a history of higher weight. Future work should replicate and extend this finding using longitudinal designs. More research is needed to elucidate which weight loss motivations and/or behaviors are most closely linked to binge eating.

A Slim Majority: The Influence of Sex Ratio on Women's Body Dissatisfaction and Weight Loss Motivations.

The current investigation examined whether women's perceptions of the sex ratio (ratio of women to men) in the local population influence their body dissatisfaction and weight loss motivations. A higher ratio of women to men in a given population signifies a relative abundance of same-sex mating competitors, intensifying female intrasexual competition. Five studies (N = 1,776) tested the hypotheses that women's perceptions of a female-skewed sex ratio would correspond to increased feelings of intrasexual competitiveness and perceptions of unfavorable mating prospects, which would, in turn, be associated with heightened body dissatisfaction and weight loss motivations. Among university and community women (Studies 1and 2), perceptions of a female-skewed sex ratio corresponded to greater intrasexual competitiveness, increased body dissatisfaction, and increased dieting inclinations. Among single women, assessments of a female-skewed sex ratio corresponded to perceptions of unfavorable mating prospects, increased romantic pressure to alter their appearance, and higher body dissatisfaction (Study 3). Studies 4 and 5 experimentally manipulated perceived sex ratio. Women in the female-skewed condition felt less satisfied with their weights and shapes, but only if they believed the manipulation (Study 4). In Study 5, using a within-subjects design, women who evaluated a male-skewed (vs. female-skewed) dating profile array subsequently desired to lose less weight. Findings suggest women's perceptions of their social environments may contribute to body image and dieting motivations.

The Association Between Goal Setting and Weight Loss: Prospective Analysis of a Community Weight Loss Program.

Goal setting aids health-related behavior changes; however, the influence of different types of goals on weight loss remains unclear. We aimed to investigate the association of 3 aspects of goal setting with weight and program dropout over a 24-week period. This study was a prospective longitudinal analysis of participants in a 12-week digital behavioral weight loss program. Weight and engagement data for eligible participants (N=36,794) were extracted from the database. Eligible participants were adults in the United Kingdom who had enrolled in the program, had a BMI ≥25 kg/m2, and a weight reading recorded at baseline. Three aspects of goal setting were self-reported at enrollment: weight loss motivation (appearance, health, fitness, or self-efficacy), overall goal preference (low, medium, or high), and percentage weight loss goal (<5%, 5%-10%, or >10%). Weight was measured at 4, 12, and 24 weeks. Mixed models for repeated measures were used to explore the association between goals and weight across the 24-week period. To measure sustained weight change, the primary outcome was weight at 24 weeks. We explored dropout rates over the 24-week period by goal and whether engagement mediated the association between goals and weight loss. Of the 36,794 participants (mean 46.7, SD 11.1 years; 33,902/36,794, 92.14% female) included in the cohort, 13.09% (n=4818) reported weight at 24 weeks. Most participants set goals of 5%-10% weight loss (23,629/36,794, 64.22%), but setting goals for >10% was associated with greater weight loss (mean difference 5.21 kg, 95% CI 5.01-5.41; P<.001). There was no difference between goals of 5%-10% and <5% (mean difference 0.59 kg, 95% CI 0.00-1.18; P=.05). Appearance was the most prevalent motivational factor (14,736/36,794, 40.05%), but health and fitness were associated with greater weight losses (mean difference health vs appearance 1.40 kg, 95% CI 1.15-1.65; P<.001 and mean difference fitness vs appearance 0.38 kg, 95% CI 0.05-0.70; P=.03). Goal preference had no association with weight. Engagement was an independent predictor of weight loss but not a mediator of the effect of goal setting. At 24 weeks, those who set goals of >10% were less likely to drop out compared with 5%-10% goals (odds ratio [OR] 0.40, 95% CI 0.38-0.42; P<.001); those who liked to set overall high goals were more likely to drop out compared with medium goals (OR 1.20, 95% CI 1.11-1.29; P<.001); and those motivated by fitness or health were less likely to drop out compared with appearance (OR 0.92, 95% CI 0.85-0.995; P=.04 and OR 0.84, 95% CI 0.78-0.89; P<.001, respectively). Setting higher weight loss goals and being motivated by health or fitness were associated with greater weight loss and lower likelihood of dropout. Randomized trials for setting these types of goals are required to confirm causality.

Understanding the patient perspective of weight management while on the liver transplant waitlist

IntroductionObesity-associated comorbidities increase risks for patients undergoing liver transplant. In this study, we explore patient perspectives and motivation for healthy weight management among patients on the liver transplant waiting list. MethodsThis is a cross-sectional, observational, electronic survey-based study. A survey on weight management was administered to patients on the liver transplant waiting list. Demographic and clinical data were collected from patients’ medical records. Data was analyzed using Pearson's chi-squared, Fisher's exact, and Student's t-tests. ResultsRespondents had a mean age of 54.4 years, were predominately male (62.0%) with a mean BMI of 29.2 kg/m2 with alcoholic cirrhosis as the leading etiology of liver disease (33.9%). Among patients with a BMI≥30 kg/m2, 59.0% perceived that they were overweight and 23.1% believed they were underweight. Among patients with BMI≥30 kg/m2 who perceived they were overweight, 39.1% were actively trying to lose weight and 60.9% were trying to keep from gaining weight. Regardless of current weight, there was a median increase in BMI for patients who categorized themselves as having lost weight or maintained weight since being waitlisted. ConclusionMany patients with a BMI≥30 kg/m2 did not perceive themselves as overweight and were not actively trying to lose weight. Weight perception was not consistent with actual weight change while waitlisted for liver transplant. Further research is needed to understand how weight awareness and weight perception impacts motivation for weight loss.

GP delivered brief weight loss advice: associations between in-consultation behaviour change techniques and patient weight loss in recorded primary care discussions

ABSTRACT Background Primary care clinicians are encouraged to intervene opportunistically, offering weight-loss advice to people living with obesity. The BWeL trial showed patients receiving brief weight-loss advice from their general practitioner lost weight at one year follow-up. We examined the behaviour change techniques (BCTs) clinicians used to identify which BCTs are associated with this weight loss. Methods We coded 224 audio recorded interventions from the BWeL trial using the behavioural change techniques version one taxonomy (BCTTv1) and the ‘refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours’ (CALOR-RE taxonomy). Linear and logistic regressions were performed to analyse associations between behaviour change techniques used in these taxonomies and patient weight loss. Results Mean intervention length was 86 s. We identified 28 different BCTs BCTTv1 and 22 from CALOR-RE. No BCTs or BCT domains were associated with mean weight loss at 12 months, loss of 5% bodyweight, or action taken at 3 months. The BCT ‘Feedback on outcomes of behaviour (future)’ was associated with an increased likelihood that the patient reported taking action to lose weight by 12 months (OR = 6.10, 95%CI = 1.20, 31.0). Conclusion Although we found no evidence to support the use of particular BCTs, our results suggest that it is the brief intervention itself, rather than specific content, which may motivate weight loss. This can support clinicians to confidently intervene without needing complex training. Offering follow-up appointments can support positive changes to health behaviours, even if these are not associated with weight loss.

Body Compression Corrective Garment and Eating Behavioural Change for Weight Reduction: The Mutsu City Randomised Controlled Trial.

Affordable and accessible behaviour-based interventions that do not overwhelm or demoralise overweight/obese individuals are needed. Combining clothing with behaviour change techniques might be an option. This is because clothing is a social norm, and clothing and motivation for weight loss are associated with the common desire to look better. Therefore, we conducted a single-blind randomised controlled trial to examine the effect of an intervention that combined behaviour change techniques, including simplified goal setting and self-monitoring, with a body compression corrective garment (BCCG), which exerts continuous but minimal tactile pressure on the hips and abdomen. We enrolled healthy community-dwelling adults with a body mass index ≥ 25 kg/m2 and assigned 35 and 34 participants to the intervention and control groups, respectively. The reduction in body weight was 1.3 kg more in the intervention group than in the control group after the 12-week intervention period (p < 0.05, repeated-measures mixed model). In addition, eating behaviour and body appreciation showed significant improvement in the intervention group compared with the control group. Our newly developed intervention improved eating behaviour and body appreciation and reduced the body weight of overweight/obese participants. Wearing a BCCG seems to facilitate behavioural changes and lead to weight loss.

Engaging with Brown Buttabean Motivation for Sustained Weight Loss.

Context Brown Buttabean Motivation (BBM) is a grassroot Pacific-led organisation aiming to reduce obesity amongst Pasifika (Pacific people in Aotearoa New Zealand) and Indigenous Maori, helping them choose a healthy and active life-style for themselves, their children and their wider family. BBM offers a holistic approach to weight loss, recognising that mental health, family and cultural factors all play essential and critical roles in nutrition and physical activity patterns. Objective To understand how participants experience and engage with BBM. Study Design &; Analysis Qualitative study conducted by our co-design research team within a broader BBM research project. Initial inductive thematic approach followed by theoretical deductive analysis of coded data guided by Pacific Fonofale and Māori Te Whare Tapa Whā health models. In this meeting-house metaphor, the floor is family, roof is culture, house-posts are physical, mental, spiritual and socio-demographic health and well-being, surrounded by environment, time and context. Setting South Auckland, New Zealand 2021 Population Studied BBM participants Instrument Semi-structured interviews Outcome Measures Narrative data Results 22 interviewees (50% female) aged 24-60 years of mixed Pacific and Māori ethnicities. Majority self-reported weight loss (between three and 135kg) since starting BBM. Two researchers independently coded data with adjudication (kappa=0.61) Participants identified the interactive holistic nature of health and wellbeing from BBM. As well as physical, mental and spiritual benefits, BBM helped many re-connect with both their family and their culture. BBM is seen as a new way of life. Participants "immediately belong to BBM family" regardless of culture or size, "with no judgements" and adopt the BBM motto "no excuses". Conclusions Many weight loss studies provide programmes to improve physical exercise and nutrition, but seldom address sustainability and other core factors such as mental health and motivation. BBM is a community-embedded Maori and Pasifika-led intervention, with no reliance on researchers nor external authorities for its ongoing implementation. It addresses factors impacting participants' lives and social determinants of health, including vaccination drives, food parcels and adapting to the COVID-19 pandemic and lockdowns. Our three-year longitudinal cohort study assessing sustained weight loss is ongoing.

Motivating Weight Loss Among Black Adults in Relationships: Recommendations for Weight Loss Interventions.

Black men and women have the highest rates of obesity in the United States. Behavioral weight loss programs incorporating intimate partners may be effective in combating obesity among this population. Yet, current participation in these programs is low. Identifying motivations and triggers to weight loss may provide insight in designing programs to increase participation. To determine triggers and motivations for weight loss among Black men and women in committed relationships to inform development of weight loss interventions. Twenty semi-structured interviews, based on an integrated theoretical framework of interdependence and communal coping and the social cognitive theory, were conducted among Black heterosexual couples where one or both individuals intentionally lost ≥5% of their body weight in the last 6 months in a metropolitan region in a southern state. Interviews were transcribed and coded. Themes were identified following multi-rater coding and direct and conventional content analysis. Recommendations were developed from emergent themes. Among individuals with recent weight loss, personal relevancy and awareness (health awareness and self-awareness) were identified as personal triggers for weight loss initiation. Health concerns and appearance were general motivations among the total sample. Emphasizing the impact of weight on daily functioning and quality of life, and increasing awareness of personal weight status and health consequences, may increase weight loss initiation and participation in weight loss programs among Black men and women in committed relationships. Findings also highlight strategies to improve recruitment and retention and guide intervention development and implementation for this population.

Motivation for weight loss among completers of a free community-based weight loss program in a US-Mexico border region: A self-determination theory perspective.

This study explores the perceptions and motivation for weight loss among participants who completed a free community-based weight loss program in a predominantly Hispanic and low-income region along the US-Mexico border using a Self-Determination Theory (SDT) perspective. This manuscript is timely as qualitative research on the effect of motivation as a factor in behavioral interventions to reduce overweight or obesity is currently lacking. Individual semi-structured interviews were conducted with 20 participants (80%, n = 16 female) who completed a community weight-loss intervention to assess motivation for weight loss and participating, and the role of social support and self-efficacy in weight loss. Directed content analysis was used with SDT guiding the questions and subsequent theme analysis. The findings communicate perspectives of participants relevant to 8 prominent themes. The regulation types and constructs related to SDT included: non-regulation, external regulation, introjected regulation, identified regulation, integrated regulation, and intrinsic regulation as well as competence and relatedness. Participants mentioned external sources of motivation, such as wanting to improve their physical appearance, and motivation due to financial incentives. Fewer participants reported intrinsic motivators, which the literature suggests are more likely to create lasting change and improved health behaviors. Understanding the motivation for behavior change and completion of weight loss programs is essential to help participants reach their goals effectively and sustain weight loss. A greater emphasis during weight loss programs on the motives for individuals to lose weight may help improve outcomes in weight-loss interventions. Additionally, increasing strategies targeted at enhancing intrinsic motivation for weight loss may be beneficial.

Effects Of An Online Weight Management Program On Weight And Physical Activity Changes.

PURPOSE: To compare the effectiveness of an online weight management program through only online education(OO) or tailored video feedback with online education (OF) or control(CO). METHODS: This intervention included 60 overweight and obese Korean women aged 19 -39 years old. Participants are randomly allocated to one of three groups: (1) 20 women in OO group (online education video and self-monitoring application), (2) 20 women in OF group (online education video, self-monitoring application, and 1:1 tailored video feedback), and (3) 20 women in CO group (only self-monitoring application). Online education included nutrition, physical activity, psychological factors, and medical knowledge for weight loss, goal-setting, and cognitive/behavioral strategies. Tailored feedback helped to motivate weight loss and give solutions for weight loss through real-time video coaching once a week for 10 minutes per session. Effectiveness was assessed using repeated measure ANOVA to compare outcome changes between groups and Tukey’s post-hoc tests were performed. RESULTS: After 6-weeks, a total of 17(85%) of OO group, 17(85%) of OF group, and 19(95%) of CO group completed the post-measurement at 6 weeks. In the intention-to-treat analysis including all 60 participants, there was a significant difference in weight change at 6 weeks in OO and OF groups with a mean weight change of -0.86 kg (95%CI, -1.72 to -0.1) in OO group and -2.23 kg (95%CI, -2.93 to -1.52) in OF group, while no significant change was observed in CO group with a mean weight change of 0.08 kg (95%CI, -0.65 to 0.8). Changes in waist circumference were -2.29 cm (95% CI, -3.48 to -1.11) in OF group, -1.64 cm (95 CI, -3.14 to -0.09) in OO group, and 0.03 cm (95% CI, -1.05 to 1.11) in CO group. In the post-hoc analysis, there was a significant difference only between OF group and CO group in body weight and waist circumference (P > 0.001, P = 0.039, respectively). However, no significant group × time effects were found for the moderate to vigorous physical activity and sedentary behavior (P = 0.979, P = 0.578, respectively). CONCLUSION: Our online weight management program showed significant weight loss and waist circumference reduction in overweight or obese Korean women. Further research is needed to track the long term effects.

Evaluation eines online-basierten Motivations- und Dokumentationsprogramms zur Gewichtsreduktion

Evaluation of an online-based motivation and documentation programme for weight loss. Results of a randomised controlled study Objectives: The objective of the study was to examine whether the use of an online-based motivation and documentation programme leads to weight loss within one year in overweight employees, compared to a control group. Methods: This is a randomised controlled trial conducted from 2018 to 2019 in Ludwigshafen. Members of the intervention and control groups received a measuring tape and a pedometer at the start of the study. Subjects in the intervention group also received access to a website with a motivational programme. At study inclusion, after 6 and 12 months, all study participants received a questionnaire regarding subjective assessment of fitness status, dietary behaviour, and evaluation of the website and pedometer. All study participants also received a monthly newsletter with information on health topics. Results: A total of 279 subjects participated in the study, with information on the primary study endpoint available for 165 (59 %) after 12 months. After 12 months, weight was reduced by 0.73 kg and 1.16 kg in the intervention and control group respectively (mean difference: 0.43 kg; 95% CI: –1.06 kg to 1.92 kg; p = 0.571). Abdominal circumference was reduced by 1.27 cm and 1.74 cm in the intervention and control group respectively (mean difference: 0.47 cm; 95 % CI: –0.96 cm to 1.91 cm; p = 0.521). Regarding subjective assessment of physical activity and dietary behaviour, there were also no statistically significant differences between the groups. Of those who participated in the final survey and, in relation to the website, logged in at least once, the website and pedometer were predominantly rated positively. Conclusions: The study did not show a weight-reducing effect of intervention through the online app. Further studies on digital applications (apps) with adapted or additional functions are needed to evaluate whether they can be a component on the path to desired permanent weight loss in the future. Keywords: randomised controlled trial (RCT) – app – weight loss – fitness

EFFECTIVENESS OF ONLINE-INTERVENTIONS AIMED TO CORRECT EATING DISORDERS AND CHANGE WEIGHT: ASSESSMENT AND RECOMMENDATIONS FOR STUDYING AND IMPROVING EFFECTIVENESS

The paper summarizes the experience of Russian and foreign researchers in studying the effectiveness of online interventions to correct eating behavior and weight change. It formulates the scientific problem of the ambiguity of the quality of existing programs to work with multifactorial eating disorders. The research notes differences between the categories of efficacy and effectiveness, which consist of the quality assessment breadth degree. A meta-analysis evaluated the effectiveness of structured in-person and online eating behavior interventions without specifying a behavior change model. The paper outlines research limitations on the effectiveness of intervention programs in the eating disorders area (small sample size, which reduces the probability of detecting differences; unrepresented observation period for weight maintenance; different levels and types of motivation for weight loss among participants; high cost of participation in the program; highlighting weight loss as the main parameter; lack of data on the program’s duration). It develops recommendations for overcoming these limitations (researching a sample of 60 or more people; performing measurements of body parameters before, during, after, and six months after the end of the program; consideration of participants’ motivations; establishing a reasonable price for the program; including psychological indicators in the program; specifying the duration of the program and forms of work), respectively. The analysis of online programs developed recommendations to improve the effectiveness of online interventions to correct weight and eating disorders, considering the factors affecting the effectiveness of online programs (personalized feedback, social support, the use of a large number of technologies for communication (video, audio, text), the opportunity for self-disclosure, the complexity of treatment, etc.).

An integrated approach for obesity management: the effectiveness of glucagon-like peptide 1 agonist and life-style interventions for obesity management

Background. The obesity is found in 24.8% (approximately 10 million people) and overweight in 34.3% of the population of Ukraine, mainly in females. Obesity is associated with hereditary factors, overeating as well as a sedentary lifestyle. An integrated approach is applied to treat obesity such as combination of adequate eating behavior, high physical activity and administration of pharmacological correction, including glucagon-like peptide 1 agonist (GLP-1). Currently, the little is known about utility and effectiveness of GLP-1 in combination with adequate physical activity for obesity management among Ukrainian patients. The purpose of this study was to determine and evaluate the role of GLP-1 in combination with high physical activity for weight loss in obese patients and to compare with obese patients receiving treatment with metformin and sodium-glucose cotransporter 2 inhibitors (SGLT2i). Materials and methods. A prospective study included 155 obese patients, and follow-up data were available of 49 patients. The study group GLP-1 consisted of 30 patients receiving combination therapy GLP-1 liraglutide in daily doses of 1.2 to 3 mg per day. The control group consisted of 19 patients receiving complex therapy with metformin in daily doses from 500 to 2000 mg, and SGLT2i in daily doses from 10 to 12.5mg. Body mass index (BMI), waist circumference (WC), hip circumference (HC), and WC/HC ratio were evaluated. Number of daily steps was determined using pedometers built into smartphones or smartwatches. Evaluation of the obtained data was performed using non-parametric statistical methods. Results. In study group GLP-1 the mean weight before the treatment was 104.6kg, after treatment 96.36 kg (p=0.000007), the mean weight lost was 7.8% (range 1–23.71%) of initial body weight. Mean BMI before treatment was 37.1 kg/m2, after treatment 34.11kg/m2 (p=0.000006). In the control group, the mean weight before the treatment was 99.4 kg, after treatment 91.74 kg (p=0.000196), the mean weight lost was 7.73% (range 0–16.9%) of initial body weight. Mean BMI before treatment was 35.6kg/m2, after treatment 34.11 kg/m2 (p=0.000196). Analyses of the entrie chorot showed that before treatment, the daily number of steps &gt;5000/day was determined in 25 (51%) patients, after treatment in 48 (98%); the daily number of steps &gt;10,000/day before treatment was determined in 6 (11%) patients, after treatment it was 5 times more frequent in 31 (63%) patients. These results indicate a significant intensification of physical activity, and high motivation for weight loss in both study groups. Conclusions. Our findings suggest that weight loss in obese people is effective in case of administration of GLP-1, metformin, SGLT2i in combination with high physical activities of daily steps &gt;5000, which is part of life style intervention.

“Mend this fractured family”: sin, redemption, and familial citizenship on NBC’s “The Biggest Loser”

Reality television has featured over 15 years of weight loss competitions reflecting American obsession with obesity and weight loss. Qualitative content analysis was performed on 16 premiere and finale episode pairs for six seasons of NBC’s The Biggest Loser (TBL) using a Foucauldian confessional framework. Analysis shows how TBL presents contestants as sinful, fat bodies in need of redemption with the show and the viewing audience as the confessional stage. Contestants frame their motivations for weight loss in gendered ways related to family responsibility. Women felt like role model failures, while men worried about early death and family abandonment. Season finales were the settings of redemption through extreme weight loss where women were now able to be the thin parent role models, shepherding their whole family into weight loss and men were reborn, on a path toward living forever for their families.

Understanding engagement with Brown Buttabean Motivation, an Auckland grassroots, Pacific-led holistic health programme: a qualitative study

ObjectivesThe aim was to understand how participants engage with Brown Buttabean Motivation (BBM) a grassroots, Pacific-led holistic health programme and the meaning it has in their lives. The objectives were...