Obesity Treatment Program Research Articles

Long-Term Weight-Loss Maintenance by a Meal Replacement Based Weight Management Program in Primary Care

Objective: Structured obesity treatment programs at primary care level are becoming increasingly important. However, evidence from current treatment approaches in the long term is lacking. In view of this fact we evaluated a standardized, meal replacement-based weight loss program (myLINE®; AENGUS, Graz, Austria) according to the currently applicable guidelines. Methods: Data of overweight and obese individuals (n = 70) who participated at least 36 months in the program were analyzed. Data were collected at baseline (T0) as well as after 1, 3, 6, 12, 24, and 36 (T1-T36) months. Body composition was measured by conventional anthropometry and bioelectrical impedance analysis. Results: Compared to T0, a maximum weight, BMI, fat mass, absolute body cell mass (BCM) reduction and an increase of relative BCM could be seen at T6. Subsequently, the findings reveal a significant reduction of body weight and body fat and a satisfying development of body cell mass during the observation period of 36 months. Conclusion: The evaluated program complies with national and international guidelines for the therapy of obesity in adults and is efficient and meaningful for a long-term therapeutic use in primary care..

COMPARISON OF FASTING BLOOD SUGAR, HEMOGLOBIN A1C AND SERUM FERRITIN LEVEL ACCORDING TO OBESITY IN KOREAN ADOLESCENTS

Ponte Academic JournalJul 2017, Volume 73, Issue 7 COMPARISON OF FASTING BLOOD SUGAR, HEMOGLOBIN A1C AND SERUM FERRITIN LEVEL ACCORDING TO OBESITY IN KOREAN ADOLESCENTSAuthor(s): Hea Shoon LeeJ. Ponte - Jul 2017 - Volume 73 - Issue 7 doi: 10.21506/j.ponte.2017.7.48 Abstract:The purpose of this study is to compare Korean adolescents' fasting blood sugar(FBS), hemoglobin A1c(HbA1c) and serum ferritin according to their body mass index(BMI). This study conducted a secondary analysis using a raw data of The Fifth Korea National Health and Nutrition Examination Survey (KNHANES V-3), 2015 which researched by Korea Centers for Disease Control and Prevention. Then this study classified adolescents(13-18y) in obese group(?25.0kg/m�) 63people (21.1%) and normal group(18.5?22.9kg/m�) 236people(78.9%), then analyzed survey and blood test of total of 299 people. Data were analyzed using descriptive statistics, Chi-square test, t-test and Pearson correlation coefficient (SPSS 24.0). The major findings of this study were as follows. Frist, male(65.1%) appeared to be more in obese group than female(34.9%). Second, obese group(5.48%) showed higher rate of HbA1c than normal group(5.40%) also obese group(52.06?U/L) showed higher rate of serum ferritin than normal group(39.43?U/L). Third, BMI has statically significant correlation between FBS, HbA1c and serum ferritin. We want to provide a basis data for the prevention of obesity intervention program for adolescents. Download full text:Check if you have access through your login credentials or your institution Username Password

Community based childhood obesity intervention programme: Working with parents and schools in Birmingham, UK; challenges and opportunities

Community based childhood obesity intervention programme: Working with parents and schools in Birmingham, UK; challenges and opportunities

Grip on health: A complex systems approach to transform health care.

This article addresses the urgent need for a transition in health care to deal with the increasing prevalence of chronic diseases and associated rapid rise of health care costs. Chronic diseases evolve and are predominantly related to lifestyle and environment. A shift is needed from a reductionist repair mode of thinking, toward a more integrated biopsychosocial way of thinking about health. The aim of this article is to discuss the opportunities that complexity science offer for transforming health care toward optimal treatment and prevention of chronic lifestyle diseases. Health and health care is discussed from a complexity science perspective. The benefits of concepts developed in the field of complexity science for stimulating transitions in health care are explored. Complexity science supports the elucidation of the essence of health processes. It provides a unique perspective on health with a focus on the relationships within networks of dynamically interacting factors and the emergence of health out of the organization of those relationships. Novel types of complexity science-based intervention strategies are being developed. The first application in practice is the integrated obesity treatment program currently piloted in the Netherlands, focusing on health awareness and healing relationships. Complexity science offers various theories and methods to capture the path toward unhealthy and healthy states, facilitating the development of a dynamic integrated biopsychosocial perspective on health. This perspective offers unique insights into health processes for patients and citizens. In addition, dynamic models driven by personal data provide simulations of health processes and the ability to detect transitions between health states. Such models are essential for aligning and reconnecting the many institutions and disciplines involved in the health care sector and evolve toward an integrated health care ecosystem.

The application of the theory of planned behavior to understand the intention of weight loss practice among overweight adolescents

Introduction: Overweight adolescents have been reported to struggle in losing weight. However, their intention to engage in weight loss practice remains unclear. Therefore, the aim of this qualitative study was to understand the factors that lead to the intention of weight loss practice among overweight adolescents using the Theory of Planned Behavior (TPB). Methods: Thirty-three overweight adolescents aged between 13 to 17 years old were recruited from three secondary schools in Selangor. They responded to a semistructured interview based on TPB that has three core antecedents; i) Attitude toward the behavior, ii) Subjective norm, and iii) Perceived behavioral control. Results: There is a high possibility that overweight adolescents will perform weight loss practice if the diet plans they followed, or physical activity they performed, or slimming product they consumed prove to make them lose some kilograms (Attitude). Besides that, the social pressure received from social interactions with parents and peers in a form of weightrelated criticisms and weight-related teasing may encourage overweight adolescents to be thin and reducing weight (Subjective norm). Finally, the emergence of intention that subsequently lead to weight loss practice is either driven by social interactions and media influences, or limited by some of the identified barriers (Perceived behavior control). Conclusions: The TPB is suggested to be an effective framework to understand the intention of weight loss practice among overweight adolescents, allowing for the development of obesity intervention program.

Camp-based family treatment of childhood obesity: randomised controlled trial

ObjectiveTo compare the effectiveness of a 2-year camp-based family treatment programme and an outpatient programme on obesity in two generations.DesignPragmatic randomised controlled trial.SettingRehabilitation clinic, tertiary care hospital and primary care.PatientsFamilies...

Public Health, Historical and Moral Lessons for the Preparation of School Health Educators: The Case of Childhood Obesity and the Need for Social Responsibility

Background: The health conditions of working-class children during the Industrial Revolution in England documented the relationships among poverty, unsanitary conditions, and disease. This evidence helped to establish how the context of people's lives greatly influences their health and how social reform and public policy play key roles in improving children's health. The replication of these actions that are based on the ideology and need for social responsibility can be implemented by modern-day Health Educators as they address the problems of noncommunicable diseases (NCDs), including the problem of childhood obesity. Methods: A systematic review and analysis of historical documents and an analysis and application of egalitarian views of justice were used to demonstrate a need for social responsibility in the field of school health education. Results: Historical and epidemiological evidence illustrate the need for social responsibility. In addition, Health Educators have a moral obligation and justification for attending to their social responsibility. Conclusions: Obesity is an impediment to the health of children as it is to justice for children. Health Educators in school site settings are professionally and morally obligated to attend to their social responsibilities when implementing childhood obesity intervention programs.

Do individual, online motivational interviewing chat sessions enhance weight loss in a group-based, online weight control program?

To examine whether the addition of online motivational interviewing (MI) chats to a Web-based, group behavioral obesity treatment program augments weight loss outcomes relative to the Web-based weight control program alone. Healthy individuals (N = 398, 24% minority) with overweight/obesity were randomized to a 36-session group Internet behavioral weight control treatment (BT) or the same group Internet treatment plus six individual MI chat sessions (BT + MI). Both conditions received weekly synchronous online chat group sessions for 6 months followed by 12 monthly group chats. Participants in both groups received identical behavioral lessons and individualized therapist feedback on progress toward meeting exercise and calorie goals. BT + MI also received six individual MI sessions delivered by a separate MI counselor via Web chat. Weight loss was measured at 6 and 18 months. There were no significant differences in weight loss between BT (-5.5 ± 6.0 kg) and BT + MI (-5.1 ± 6.3 kg) at 6 months or at 18 months (-3.3 ± 7.1 kg vs. -3.5 ± 7.7 kg for BT and BT + MI, respectively). Attendance at group chats did not differ between groups, nor did self-monitoring patterns, suggesting comparable engagement in the weight control program in both conditions. Online MI chat sessions were not a viable strategy to enhance Web-based weight control treatment outcomes.

Moral Fiber: Breakfast as a Symbol of ‘a Good Start’ in an Australian Obesity Intervention

ABSTRACTWhat are the symbolic meanings of breakfast in the context of one of Australia’s largest childhood obesity intervention programs? Utilizing a range of theoretical insights into the morality of food and eating and the anthropology of food, we trace how breakfast is packaged and promoted to families in an Australian community as a ‘healthy start’ to the day. Through ethnographic and historic investigation, we argue that eating breakfast and certain types of breakfast foods are symbolic of a classed, healthy lifestyle pattern, embodying parental knowledge and bodily regulation to routinely structure daily life. In communities where poverty and unemployment are harsh realities, well-intentioned programs that encourage people to eat a healthy breakfast are encoded with an assemblage of moral values—of knowledge, foods, families, and times and spaces—that are often difficult to reconcile with the wider sociocultural context in which many people live.

A Call to Action: Building a Translational Inclusion Team Science in Physical Activity, Nutrition, and Obesity Management for Children with Disabilities.

The growing evidence base of childhood obesity prevention and treatment programs do not adequately consider how to adapt these programs for children with disabilities. We propose a Call to Action for health researchers who conduct studies focused on the general population (i.e., without a disability) to work closely with disability researchers to adapt their programs (e.g., obesity management, increased physical activity, and caregiver training in diet and nutrition) to be relevant to both groups. We refer to this approach as inclusion team science. The hope for this Call to Action is that there will be greater synergy between researchers who have high levels of expertise in a specialty area of health (but little or no knowledge of how to adapt their program for children with disabilities) to work more closely with researchers who have a high level of expertise in adapting evidence-based health promotion recommendations and strategies for children with disabilities. Together, these two areas of expertise will lead to inclusive physical activity and nutrition programs for all children.

Childhood Overweight and Obesity: Maternal and Family Factors

Treatment programs for childhood overweight and obesity have highlighted the importance of the family in treatment. Considering this, it is surprising that few studies have examined the role of family factors in the development of childhood overweight and obesity. The objective of this study was to examine which family and maternal factors predict increases in weight in boys and girls during middle to late childhood. This study used longitudinal data from the childhood growth and development (GAD) Study. The GAD Study involved 286 healthy weight, overweight and obese children, aged 6–13 years at baseline, who completed baseline, 1-year follow-up and 2-year follow-up assessments. Overweight/obese children were recruited from clinical and community settings. A broad range of maternal and family factors were assessed. Linear mixed models were used to identify which factors predicted child Body Mass Index (BMI) z-scores over time. For community-based children, maternal BMI and single-parent family structure were significant longitudinal predictors of child BMI z-scores. For the clinical participants, low family income was the only significant multivariate predictor of child BMI z-scores. The strong association between child BMI, maternal BMI and family structure confirms the need to target prevention and intervention efforts for childhood overweight and obesity towards families with overweight parents, particularly single-parent families.

Psychosocial predictors and moderators of weight management programme outcomes in ethnically diverse obese youth.

An important area of research in childhood obesity is the identification of factors that predict or moderate the responses to obesity intervention programmes, yet few studies have examined the impact of self-esteem and family functioning on obesity treatment outcomes. We sought to determine whether baseline self-esteem and family functioning predicted or moderated childhood obesity intervention outcomes at 6 months. From 2009 to 2011, seventy-five 10-16 year old, racially/ethnically diverse obese youths with abnormal glucose tolerance were randomized to 6 months of an intensive family-based obesity lifestyle intervention (Bright Bodies) or routine outpatient Clinic Care. We examined youth self-concept, parent-rated family functioning and 6-month outcomes (youths' glucose tolerance, weight, body mass index and percent fat). We set the significance threshold as P ≤ 0.05 for moderator and predictor analyzes. Having poor family functioning and self-concept scores indicating high anxiety and low self-esteem at baseline predicted poor 6-month outcomes overall (Bright Bodies and Clinic Care groups combined). Additionally, baseline self-esteem and family functioning moderated treatment effects such that Bright Bodies outperformed Clinic Care in youths with low self-esteem and poorly functioning families, whereas youths with high self-esteem and high-functioning families did similarly well with either intervention. Our findings suggest intensive family-based lifestyle programmes are particularly beneficial for youth with low self-esteem and poorly functioning families.

The influence of non-pharmacological management of obesity on a diurnal blood pressure profile

Background. Obesity is one of the main factors increasing mortality and the incidence of diseases of the cardiovascular system. The base treatment is a non-pharmacological approach: diet and physical training. We see hypertension in obese people more often than in people of normal weight. The aim of this study was to answer the question of whether or not a 3-month comprehensive program of non-pharmacological treatment of obesity affects the circadian blood pressure profile. Material and methods. The study was performed with 60 obese women aged 20–37 years who had an average body mass index (BMI) of 36 ± 4.9 kg/m2 and who declared their willingness to participate in the treatment of obesity. Qualified researchers proposed participation in the comprehensive, outpatient, non-pharmacological treatment program for obesity. The program included activities with a dietician, physiotherapist and physician. Patients performed blood pressure measurements using 24-hour ambulatory monitoring (ABPM). Results. After 3 months of treatment, the participants had a significant decrease in BMI and waist circumference. These changes were accompanied by a significant reduction in fasting insulin concentrations and a decrease in the insulin resistance index. Findings also showed a small but significant reduction in systolic blood pressure — circadian, daytime and nighttime — and a reduction in the incidence characteristics of of ‘non-dipper’ pattern. In the study group significant positive correlations were found between the change in fasting insulin concentration and the change in circadian systolic blood pressure. Conclusion. A non-pharmacological, comprehensive treatment program for obesity through weight reduction and a reduction of insulin resistance improves the profile of circadian systolic blood pressure and leads to the conversion of ‘non-dipper’ pattern to favourable ‘dipper’ pattern.

Elementary School-Based Obesity Intervention Using an Educational Curriculum.

Pediatric obesity is a significant public health problem with a prevalence of 16.9% among US children. School-based obesity interventions show promise for reducing adiposity in elementary age children. This pilot study evaluated the impact of the Let's Go! 5-2-1-0 pediatric obesity intervention program in an elementary school setting. This was a cluster randomized controlled field trial comprising 8 classrooms of second- and third-grade children. The impact of implementation of a standardized 5-2-1-0 curriculum was evaluated in the classrooms by looking at health behavior (self-reported fruit and vegetable and sugar-containing beverage intake, and screen time), physical activity (steps measured by pedometer), and body mass index (BMI). Half of the classrooms were given 5-2-1-0 teaching over a 4-month period. There was no statistical difference in improvement of healthy habits, BMI, or physical activity in the intervention group compared with the control group. The 5-2-1-0 intervention used in this study was feasible. There was no significant change in healthy habits, likely due to the small number of participants in the study. The intervention and control sites were in different classrooms and there could be factors such as teacher enthusiasm, socioeconomic factors, and individual traits affecting habits. Future studies could use pre- and post-intervention quizzes to assess healthy habits knowledge retention, involving the environments the child participates in outside of school, using research-grade pedometers or accelerometers for measuring activity data collection, and recruiting larger samples to ensure adequate statistical power.

Weight self-stigma and its association with quality of life and psychological distress among overweight and obese women.

There are limiting studies evaluating the weight self-stigma and its association with eating disorders and health concerns. However, no study is available evaluating weight self-stigma and its determinants among reproductive age women in Iran. The aim of this study was to evaluate weight self-stigma and its association with quality of life and psychological distress among overweight and obese Iranian women. The current cross-sectional study was performed among 170 women aged 17-45years referring to health centers of Tabriz-Iran. Anthropometric assessments were performed. Weight self-stigma was assessed by weight self-stigma questionnaire (WSSQ). Evaluation of quality of life and psychological distress was performed using SF-12 and general health questionnaires (GHQ-12), respectively. Analysis of data was performed by multivariate hierarchical regression analysis using SPSS 18 software. In this study, the multivariate hierarchical regression analysis revealed that being married and having low total weight self-stigma and fear of enacted stigma (FES) scores were associated with better physical component summary scores (p<0.05). Whereas, younger ages and lower total weight self-stigma scores were associated with better mental component summary scores. In addition, lower weight self-stigma total scores and lower self-devaluation scores were predictors of lower psychological distress. Our results indicated the negative impacts of weight self-stigma on quality of life and psychological distress among overweight and obese women. Since weight stigma might be a potent barrier of obese individuals to engage in health promoting behaviors, therefore, the results of the current study further warrants the need for developing interventional strategies to reduce the adverse impacts of weight stigma on quality of life via including the reduction of weight self-stigma as a key therapeutic goal in obesity treatment programs.

FamilyPower: A Referral-Based Pediatric Obesity Treatment Program that Connects Clinic to Family

familyPower: A Referral-Based Pediatric Obesity Treatment Program that Connects Clinic to Family

Social influence in childhood obesity interventions: a systematic review.

The objective of this study is to understand the pathways through which social influence at the family level moderates the impact of childhood obesity interventions. We conducted a systematic review of obesity interventions in which parents' behaviours are targeted to change children's obesity outcomes, because of the potential social and environmental influence of parents on the nutrition and physical activity behaviours of children. PubMed (1966-2013) and the Web of Science (1900-2013) were searched, and 32 studies satisfied our inclusion criteria. Results for existing mechanisms that moderate parents' influence on children's behaviour are discussed, and a causal pathway diagram is developed to map out social influence mechanisms that affect childhood obesity. We provide health professionals and researchers with recommendations for leveraging family-based social influence mechanisms to increase the efficacy of obesity intervention programmes. © 2016 World Obesity.

Measuring body composition in dogs using multifrequency bioelectrical impedance analysis and dual energy X-ray absorptiometry

Thirty-five healthy, neutered, mixed breed dogs were used to determine the ability of multifrequency bioelectrical impedance analysis (MFBIA) to predict accurately fat-free mass (FFM) in dogs using dual energy X-ray absorptiometry (DXA)-measured FFM as reference. A second aim was to compare MFBIA predictions with morphometric predictions.MFBIA-based predictors provided an accurate measure of FFM, within 1.5% when compared to DXA-derived FFM, in normal weight dogs. FFM estimates were most highly correlated with DXA-measured FFM when the prediction equation included resistance quotient, bodyweight, and body condition score. At the population level, the inclusion of impedance as a predictor variable did not add substantially to the predictive power achieved with morphometric variables alone; in individual dogs, impedance predictors were more valuable than morphometric predictors. These results indicate that, following further validation, MFBIA could provide a useful tool in clinical practice to objectively measure FFM in canine patients and help improve compliance with prevention and treatment programs for obesity in dogs.

Inequality and childhood overweight and obesity: a commentary.

Statements on childhood overweight and obesity (COO) have focused on different avenues for prevention and treatment, critical stages of the life cycle, including pregnancy and lactation, individual, family, school and community-based interventions, multidisciplinary family programmes and multicomponent interventions. This commentary is concerned with the less-addressed relationship between COO and inequality. It describes current global patterns of inequality and COO and the ways in which those inequalities are linked to COO at micro-level, meso-level and macro-level. It then describes current programmatic approaches for COO inequality, preventive and medical, and considers important pitfalls in the framing of the problem of COO and inequality. It ends with describing how childhood and adolescent overweight and obesity prevention and treatment programmes might be formulated within broader socio-political frameworks to influence outcomes.

Medical neglect and pediatric obesity: Insights from tertiary care obesity treatment programs

ABSTRACTInterprofessional pediatric obesity treatment teams may consider filing a report for medical neglect with their state child protection agency when a child’s family is consistently non-adherent to treatment recommendations and the child is medically at risk. The multifactorial nature of the etiology and treatment of obesity makes this a challenging issue to navigate with families and child protection agencies. The aims of this article are to (a) highlight common challenges faced by teams when addressing medical neglect, and (b) offer insights on navigating the medical protection of children with obesity and associated medical conditions in a way that minimizes adverse outcomes.