Perceived Weight Gain Research Articles

Perceived Weight Change and Contributing Factors among College Students

ABSTRACT The purpose of this study was to examine the association between perceived weight change since high school and perceived factors contributing to weight change, or lack thereof, among college students. Students from a large university in the Northeast of the United States self-reported socio-demographic characteristics, and perceived factors contributing weight change (or lack thereof) via an online survey; and, completed an objective health assessment that included the anthropometric measurements. Of all participants (n = 183), most were men (61.2%), juniors/seniors (89.5%), non-Hispanic white (65.9%). Most participants reported gaining weight since high school (n = 113, 62.1%), and these participants had significantly greater abdominal girth, weight, and body fat percentage than those who maintained their weight (p < 0.005). Perceived factors contributing to weight change explained a significant portion of the variance in perceived weight change, and perceived factors contributing to weight change differed significantly between those who perceived that they had lost or gained weight. In summary, perceived weight gain despite awareness of contributing health behaviors among some students reinforces that supporting/facilitating actual health behavior changes, rather than mere awareness of healthy behaviors, should be the focus of health promotion efforts.

Acceptability and continuation of use of the subdermal contraceptive implant among adolescents and young women in Argentina: a retrospective cohort study

A new public policy was instituted in Argentina for free distribution of subdermal contraceptive implants to women aged 15–24 years old in the public healthcare system. The objective of this study is to determine the extent to which this population adhered to the implant, as well as predictors of continuation. The retrospective cohort study was based on a telephone survey of a random sample of 1101 Ministry of Health-registered implant users concerning the continuation of use, satisfaction with the method and side-effects, and reasons for removal. Descriptive statistics and multivariate regression analysis were used to explore the association between adherence and having received contraceptive counselling, satisfaction, and side effects. We found high levels of adherence (87%) and satisfaction (94%). Common reported side effects were amenorrhoea or infrequent bleeding, perceived weight gain, increased menstrual bleeding and headaches. Multivariate regression analysis indicates that, among adolescents, having received contraceptive counselling increased comfort, while frequent bleeding at six months hindered trust. Participants who had a history of a prior delivery or who had themselves primarily chosen the method were less likely to request the removal of the implant. Our results support the public policy of free implant distribution in the public health sector. This is a sustainable public policy that contributes to equity and access to effective contraception. It is appropriate for adolescents and young women and will also reduce unintended pregnancies. Our results suggest that counselling patients is key prior to insertion of the implant, as it improves acceptability and continuation.

Norms and attributions about weight gain during the COVID-19 pandemic

Objective. Weight gain was common during the first year of the COVID-19 pandemic, potentially creating a new descriptive norm about weight gain. The unique context of a global pandemic may have influenced situational attributions for weight gain that were not typical prior to the pandemic. We examined the effects of the new norm on people’s views about responsibility and blame for weight gain. Methods. In two preregistered surveys, we aimed to manipulate the salience of weight gain during COVID-19, and measured views about responsibility and blame for weight gain. Results. Among participants who gained weight, the more common they perceived weight gain to be, the more they felt their own weight gain was understandable (b = 0.09, se = 0.04, p = 0.02), but perceived commonness didn’t relate to their feelings of responsibility and blame for weight gain. For participants who didn't gain weight, the perceived commonness of weight gain was associated with less blame towards people who gained weight (b = 0.11, se= 1.46, p = 0.044), but not with responsibility for weight gain. Conclusion. Participants believed weight gain was common during COVID, but this descriptive norm had mixed associations with attributions for one's own and others’ weight gain.

MUDANÇA DO PADRÃO E COMPORTAMENTO ALIMENTAR DE TRABALHADORES DA ÁREA DA SAÚDE EM UM HOSPITAL PÚBLICO FRENTE À PANDEMIA DE COVID-19

OBJECTIVE: Identify changes in the eating pattern and behavior of health professionals faced with the COVID-19 pandemic. METHODS: This is a field study, quantitative, descriptive, and exploratory, with a sample composed of 23 health professionals from different categories working in the Intensive Care and Emergency sector. The collection instrument consisted of an electronic questionnaire with objective questions, structured in four parts: Personal Information, Eating Habits and Food Frequency Questionnaire, Life Habits, Self-Assessment and Body Image. RESULTS: In total, 8.7% of the participants did not change their diet after the pandemic began, 13% reported increased consumption of homemade meals and natural foods, 39.1% increased the number of meals eaten outside the home, and 52.2% increased their consumption of ready meals, fast food, and delivery. The following groups stand out: reduced consumption of salad and cooked vegetables, legumes and oilseeds; maintenance in the consumption of meat and eggs, sweets, and tubers; and increased consumption of dairy products, fried foods, and sausages. In the Physical Activity category, the majority of participants (43.5%) claim to have stopped or reduced their practice. In the Alcohol Consumption category, 52.2% reported maintaining their habits, and 39.1% claimed to have increased or started alcohol consumption. In addition, 52.2% perceived weight gain and 56.5% presented worsening eating habits during the pandemic. CONCLUSION: The dietary profile and lifestyle habits being established are an important risk factor for the development of obesity, heart disease, diabetes, and high blood pressure, all of which are related to complications from COVID-19.

Lifestyle pattern changes, eating disorders, and sleep quality in diabetes: how are the effects of 18months of COVID-19 pandemic being felt?

The pandemic resulted in a lifestyle crisis which may negatively affect patients with diabetes. Despite current knowledge, there is a lack of longitudinal studies evaluating this effect. To assess patients' perceptions about changes in lifestyle, and eating and sleeping patterns after 18months of the COVID-19 pandemic, and to identify if aspects related to the pandemic (social distancing, COVID-19 infection, behavioral changes, and financial difficulties) are predictors of worsening in eating and sleeping parameters. This was a longitudinal study that followed patients with diabetes from April 2020 to July 2021 in Southern Brazil. Individuals with type 1 or type 2 diabetes, aged ≥ 18years, were included. The outcome of this study was the assessment of daily habits during a 18-month period of theCOVID-19 pandemic. Specific questionnaires were applied once participants were included in this study (3months after the onset of the pandemic) and at the 18-month follow-up, which included the Eating Attitudes Test-26 (EAT-26), the Mini-Sleep Questionnaire (MSQ), and a specific questionnaire on diet, physical activity, and sleeppattern. Data were compared within and between groups (type 1 and type 2 diabetes), and multivariable models were used to identify subgroups of worse outcomes. A total of 118 (78.6%) participants remained in the study at follow-up (mean age 54.6 ± 13.9years, 41.3% male). In total, 33.9% of participants perceived weight gain during the pandemic, especially those with type 1 diabetes (43.1% vs 25.0% in type 2 diabetes, P = 0.04). About one in four participants reported emotional eating and changes in their eating habits for financial reasons. Regarding sleep patterns, more than half the participants reported taking naps during the day, out of which 30.5% of them perceived worse sleep quality, with no difference between type 1 and type 2 diabetes groups. There were no within-group differences in MSQ and EAT-26 scores. Among participants with type 2 diabetes, age ≥ 60years (OR 27.6, 95%CI 2.2-345.7), diabetes duration ≥ 15years (OR 28.9, 95%CI 1.4-597.9), and perceived emotional eating (OR 10.9, 95%CI 1.1-107.5) were associated with worsened food quality. Worse sleep quality during the pandemic was associated with age ≥ 60years for both type 2 diabetes (OR 5.6, 95%CI 1.1-31.5) and type 1 diabetes (OR 5.5, 95%CI 1.0-29.9). Follow-up data from a cohort of patients with diabetes indicate that at the end of 18months of social distancing, some lifestyle aspects worsened and some improved, showing that these patients responded differently to the adversities of this period. The evidence of clinical features associated with worsening in food and sleep quality provides new insights to prioritizing actions in crisis situations.

Effect of Perceived Weight Gain on Hormonal Contraception Choice for Women: A Review

Abstract&#x0D; Background: Hormonal contraception plays a pivotal role in protecting against unintended pregnancies and has been developed to provide options that best fit women's lifestyles. However, negative perceptions can alter women's attitudes, which can prohibit the usage of hormonal contraception. This review aimed to collect information surrounding perceptions of hormonal contraception side effects, specifically weight gain and women's contraceptive choice.&#x0D; &#x0D; Methods: 703 articles were found through searching three electronic databases; EBSCO, PubMed, and Web of Science, in addition to Google Scholar. Articles were included if they were published between 2009-2020, could be translated to English, included any form of hormonal contraception, and reported perceived weight gain. A total of 39 articles met the inclusion criteria and are included in the review.&#x0D; &#x0D; Results: Within those articles, there were six overarching themes: (1) negative perception of weight gain, (2) fear of weight gain, (3) contraception decision based on obesity concerns, (4) avoidance and discontinuation of method due to concerns of weight gain, (5) limited contraceptive knowledge, and (6) lack of counseling. It was found that negative perceptions of weight gain influence women’s hormonal contraception perception and attitude.&#x0D; &#x0D; Conclusion: Negative perceptions are derived from experience, misconception, and lack of knowledge, leading to fear, avoidance, or discontinuation. Understanding women's perceived weight gain and perception towards contraceptives can help assess its effect on women's choice of contraception. This information can aid health care professionals in educating and discussing methods that would best fit women and improve hormonal contraception adherence.&#x0D;

Understanding daily life experiences of women who smoke: The role of smoking-related weight control expectancies

Smoking-related weight control expectancies are a motivational factor for maintaining cigarette use, particularly among women. Yet, less research has investigated the physiological and behavioral daily life weight-related experiences of women with smoking-related weight control expectancies. Increased research could contribute to understanding of maintenance factors for this group of smokers as well as unique intervention targets. Female smokers completed a baseline survey of smoking-related weight control expectancies and 35-days of ecological momentary assessment of physiological (i.e., smoking-related reduction in hunger, end-of-day perceived weight gain and bloating) and behavioral (i.e., daily exercise and sitting) weight-related experiences. Higher smoking-related weight control expectancies were associated with perceived smoking-related reductions in hunger and end-of-day perceived weight gain. Smoking-related weight control expectancies did not significantly associate with end-of-day bloating, daily exercise, or sitting. Given these findings, smoking-related weight control expectancies may maintain smoking in order to reduce hunger and to cope with perceived fluctuations in weight in daily life. It is critical for smoking cessation programs to assess smoking-related weight control expectancies and implement targeted treatments for these women.

Reasons for Early Removal of the Etonogestrel Subdermal Implant in Obese Women [A35

INTRODUCTION: To evaluate women's reasons for electing early removal of the etonogestrel subdermal implant (EI) across body mass index (BMI) classes. METHODS: This is a retrospective chart review between January 2010 and December 2019 in a large health system which evaluated women’s reasons for early removal of the EI. Early removal was defined as removal less than 2.5 years after insertion. The reasons for removal as documented by providers were manually abstracted from the electronic health record. Listed reasons included abnormal uterine bleeding (AUB), desire to conceive (DTC), perceived weight gain, and implant complications. The subjects were grouped by BMI class and a test of trend analysis was performed for each of the reasons for removal. RESULTS: The cohort included 1,433 women, of whom 36% were normal/underweight, 25% were overweight, and 39% were obese. The trend for early removal secondary to AUB decreased with increasing BMI class: 64.0% in the normal/underweight group, 60.6% in overweight, 45.9% in class I obese, 41.7% in class II obese, and 40.5% in class III obese group (P&lt;.0001). The trend for early removal secondary to perceived weight gain, desire to conceive, and implant complications increased with increasing BMI. CONCLUSION: Women with obesity were less likely to have the EI removed early due to AUB, but they were more likely to have it removed early because of the desire to conceive, perceived weight gain, and implant complications. This information will be helpful in counseling women with obesity regarding the use of the EI for long-acting reversible contraception.

Study of the Knowledge, Awareness, Compliance of Patients with Hypothyroidism

The main objective of this study was to assess the practices and knowledge in the patients of Hypothyroidism. A simple random study was conducted in an Endocrinologist outpatient department in Mumbai. A Questionnaire was circulated online to the patients who visited Endocrinologist. The questionnaire was validated by Dr Ameya Joshi expert endocrinologist before giving it out to the patients. The form was given to 100 patients at clinics of which 72 were filled. Of which 81.5% were female and almost 40% hypothyroid patients were graduate. 50% hypothyroid patients knew the meaning of thyroid. 52% patients thought obese were at a major risk for getting hypothyroidism. 94% patients knew the location of thyroid gland, 62.5% knew the meaning of hypothyroidism, 84.7 % knew they had to visit an endocrinologist for consultation, 93.1% patients took the medicine on time. 72.2% understood that they had to continue the medicine even with normal thyroid levels, 73.6% patients were taking vitamin D and iron supplements,65.3% thought they might lose weight even with hypothyroidism. Around 52.8% people took their medicine in the gap of 30-45 minutes,43.1% assumed iodized salt can cure their thyroid troubles, 50% do not have cruciferous vegetables at all due to hypothyroidism.93.6% perceived weight gain as a major symptom of hypothyroidism. Majority of the people belonged to Metro cities and were well qualified and educated yet lacked basic knowledge about their disease condition. At the end of the survey all the patients were given a patient education booklet regarding Hypothyroidism and General guidelines on Diet. Keywords : Thyroid, hypothyroidism, knowledge, practices, awareness.

Weight Gain in Children during the COVID-19 Pandemic and the Protective Effect of Lifestyle Intervention in Children with Obesity

Introduction: School closures due to the COVID-19 pandemic affect children’s daily structure, mealtimes, physical activity, and sleeping habits, possibly exacerbating weight gain, particularly in vulnerable children with overweight and obesity. This study aimed to evaluate both perceived and objectively measured weight gain in children in the Netherlands during the COVID-19 pandemic and the effect of prior lifestyle intervention. Methods: A total of 150 children of the Children, Obesity and Lifestyle during COVID-19 (COLC) study (cohort A) reported perceptions of weight change during the COVID-19 pandemic. Anthropometric data of 65 children with overweight and obesity were collected at the expertise Centre for Overweight Adolescent and Children’s Healthcare in the same period (COACH; cohort B). Results: In cohort A, 43% of children with overweight and obesity perceived weight gain during the pandemic, compared to 15% of lean children. In cohort B, the BMI z-score increased significantly (+0.065 SD) within 5 months. Participation in a lifestyle intervention for >1 year and having parents with Dutch background was associated with less weight gain, specifically in children with obesity. Discussion/Conclusion: In particular, children with overweight and obesity seem to be at risk for accelerated weight gain during the COVID-19 pandemic. Prior long-term participation in a lifestyle intervention protects against this weight gain, which emphasizes the importance of strong support for vulnerable populations during health crises and pleads for wide implementation of lifestyle interventions for children.

Considerations in Adolescent Use of the Etonogestrel Subdermal Implant: A Cohort Study

Objectives: To describe bleeding patterns and other side effects in adolescent implant users and characterize their impact on early discontinuation of the implant.Study Design: This is a retrospective cohort study of female patients under 18 years who had an implant placed from 2013 to 2018. Data were collected on demographics, medical history, and side effects.Results: Of 212 adolescents, the average age at insertion was 16 years and 84% desired placement for contraception. Common side effects included AUB (80%), mood changes (10%), and perceived weight gain (9%). Most (76%) used the implant for at least 12 months. Average time to removal was 22.1 months (SD 13.0 months) and this did not depend on presence of side effects. Twenty-seven percent of teens were able to achieve amenorrhea. Adolescents with frequent or prolonged bleeding were more likely to have implant removal prior to 12 months than those with other bleeding patterns (p = 0.003). Early removal was also more common in girls reporting weight or mood issues than those who did not (p < 0.001 and p = 0.045, respectively). BMI increased in 64% of adolescents. Average percentage change in BMI was 3.2% (0.87 kg/m2). There was no difference in baseline use of any mood-modulating medications in patients who did and did not complain of mood side effects following implant placement (p = 0.801).Conclusion: Characterization of bleeding patterns following implant placement in adolescents have not previously been reported. Prolonged or heavy bleeding, mood issues, and perceived weight gain were associated with earlier removal of the implant. A relatively small number had early removal of the implant due to weight or mood complaints. Therefore, a history of obesity, depression, or other mood disorders should not be a deterrent to implant placement.

The Impact of the COVID-19-Induced Lockdown on SRR College Undergraduate Student’s Nutrition, Health and Lifestyle Patterns

COVID-19 is a worldwide emergency of public health that leads to lockouts, changes in the dietary pattern and life-style of the population. To assess the impact of COVID-19 mediated lockdown on nutrition, health and lifestyle patterns among teenagers aged ?18 years. A standardized questionnaire was used to collect data on demographics (age, gender and place of residence), food system dimensions, dietary intake, physical activity, stress and anxiety, body image attitudes, lifestyle behaviours such as smoking, alcohol consumption, screentime and ease of access to health services. Most of the participants (n=537) were women (53.9%) aged 16 to 24. The lockdown has led to an increase in food prices (81.4%) and a decrease in the rate of physical activity (67.4%). Additionally, there is an increased intake of fruits (68.7%), meat (60%), eggs (75%) and leafy vegetables (49.9%). Around 44.5% of the people reported stress for some days. The majority of the students have increased their weight by 53.8%, weight loss by 10.6% and no change in weight by 30.2%. Approximately half (52.3%) reported challenging access to pharmaceuticals and 66.7% had medical emergency services. An increase in food price, decreased dietary diversification, unhealthy eating patterns, lack of physical activity and perceived weight gain were demonstrated during the COVID-19 induced lockdown period. Further research is needed from various socioeconomic backgrounds to obtain more definitive results which may improve the quality of life of the people.

Perceived weight gain and eating disorder symptoms among LGBTQ+\u2009adults during the COVID-19 pandemic: a convergent mixed-method study

BackgroundIn this study, we further explore the role of COVID-19 pandemic-related stress, social support, and resilience on self-reported eating disorder symptoms (using the EDE-QS) and perceived weight gain among lesbian, gay, bisexual, transgender, and/or queer (LGBTQ+ adults) in the US context during the COVID-19 pandemic.MethodsEmploying a convergent mixed method design, we surveyed 411 individuals, and conducted qualitative semi-structured follow-up interviews with 43 LGBTQ+ -identifying survey respondents. Using OLS regression and multinomial logistic regression, we modeled eating disorder symptoms and perceived weight gain among LGBTQ+ individuals (n = 120) and cisgender and heterosexual-identifying women (n = 230), to cisgender and heterosexual-identifying men (n = 61). We also explored complementary interview narratives among LGBTQ+ people by employing selective coding strategies.ResultsStudy results suggest that LGBTQ+ individuals are likely experiencing uniquely high levels of pandemic-related stress, and secondly, that pandemic-related stress is associated with elevated eating disorder symptoms and higher risk of perceived weight gain. Nearly 1 in 3 participants reported eating disorder symptoms of potentially clinical significance. Social support, but not resilient coping, was found to be protective against increased eating disorder symptoms. Qualitative analyses revealed that LGBTQ+ individuals situated physical exercise constraints, challenging eating patterns, and weight concerns within their pandemic experiences.ConclusionsClinicians of diverse specialties should screen for eating disorder symptoms and actively engage patients in conversations about their COVID-19-related weight gain and eating behaviors, particularly with LGBTQ+ -identifying adults.

School absenteeism during menstruation among adolescent girls in resettlement colonies of Delhi: a community-based cross-sectional study

Background: School absenteeism during menstruation and its related effects are preventable through identification of factors associated with it and implementation of region specific appropriate public health measures. Objectives: To assess the prevalence of school absenteeism during menstruation and its associated factors among adolescent girls residing in the resettlement colonies of Delhi. Methods: A community-based cross-sectional study was conducted in the urban resettlement colonies of Delhi during 2019 in which 712 school going adolescent girls were interviewed. The details about school absenteeism, its perceived reasons, various socio-demographic details, menstrual hygiene practices were assessed using pretested semi structured questionnaire. The data were entered in MS Excel and analysed using STATA statistical software version 14. Results: The prevalence of school absenteeism during menstruation among adolescent girls of resettlement colony was 43.1%(95% CI:39.5 – 46.7). Out of 307 girls who had school absenteeism, 285(92.8%) had missed for 1-3days. The most common self-reported reasons for school absenteeism during menstruation were pain during menstruation (75.6%) followed by staining of cloths(43.6%) and uncomfortable feeling(39.4%). Studying in government school (PR=1.4, 95% CI:1.1-2.0), suffering from menstruation-related problems(aPR=1.9, 95% CI:1.5-2.4) and pads being provided from schools(PR=1.3, 95% CI:1.1-1.7) were significantly associated with school absenteeism. Conclusions: Almost half of the adolescent girls in resettlement colonies had school absenteeism. The characteristics like government school, pads being provided from school, menstruation related problems like weakness, irritation, perceived weight gain and breast pain was significantly associated with school absenteeism. The factors associated with school absenteeism needs to be addressed with appropriate public health interventions.

32. Considerations in adolescent use of the etonogestrel subdermal implant

<h3>Background</h3> There are many reasons for choosing the etonogestrel subdermal implant (hereafter "implant"). Limited data exists on outcomes of implant use in adolescents, and specifically, on the management of abnormal uterine bleeding (AUB). The goals of this study include characterize the purpose of implant placement in adolescents, describe rates and management of side effects, and identify reasons for early discontinuation of the implant. <h3>Methods</h3> This is a retrospective cohort study of females less than 18 years who had the implant placed from 2013-2018, identified using Current Procedural Terminology codes. Data were collected on contraceptive history, bleeding profiles, side effects, and outcomes. Descriptive statistics, analysis of variance tests, Fisher's exact test, and chi-square test data are reported. This study was IRB approved. <h3>Results</h3> A total of 272 patients were included in this study. The average age of menarche was 12 years and average age at insertion was 16 years. The majority of patients (90%) were nulliparous, 65% had been sexually active prior to implant placement, and 84% desired the implant for contraception. Of 241 patients who had at least one follow up visit, 187 reported AUB. On average, adolescents reported AUB starting 2.7 months after placement, which they managed expectantly for 10.3 months prior to desiring removal or trial of medication to resolve AUB. Of the 187 patients who reported AUB, 59% had no documented discussion of options for management and 24% had only one option offered. Trials of different medications for the treatment of AUB had varying effects on bleeding patterns (Table 1). Average time of removal for those with AUB was 22.1 months after implant placement, similar to 21.5 months for those without AUB. Most patients (76%) had the implant in place for at least 12 months. Adolescents with frequent or prolonged bleeding were more likely to have the implant removed prior to 12 months than those with other bleeding patterns (p=0.001). Patients complaining of weight gain and mood issues were also more likely to have early removal (p<0.001 and p=0.049, respectively). There was no significant difference in average percentage change in BMI between adolescents who did and did not complain of weight changes. <h3>Conclusions</h3> Adolescents mostly chose the implant for contraceptive efficacy and, although AUB was common, three-quarters chose to continue for at least 12 months. Prolonged or heavy bleeding, mood issues, and perceived weight gain were associated with earlier removal. Several options exist to treat implant-related AUB, and improved use of these medications may make bleeding patterns more tolerable. Additional studies are needed to optimize treatment of AUB and address other bothersome side effects.

A preliminary study on the psychosocial impact of COVID-19 lockdown in post-bariatric surgery women: the importance of eating behavior, health care access, and social support.

This study aims to characterize the psychosocial impact of COVID-19 lockdown for post-bariatric surgery (≥ 36 months) women and its association with disordered eating and psychological distress. The medium to long-time follow up is a period of increased susceptibility for poorer weight outcomes which might be triggered by the lockdown. Twenty-four participants responded to an online questionnaire and a telephone interview. About half (n = 14; 58.3%) reported perceived weight gain during the lockdown, 13 (54.1%) limited access to social support, and 12 (50%) limited access to medical care. Co-habiting with a higher number of persons during lockdown was associated with fewer difficulties in dealing with emotionally activating situations, less fear of gaining weight, less fear of losing control over eating, and less disordered eating. The global perceived psychosocial impact of lockdown was significantly correlated with difficulties in dealing with emotionally activating situations and stress symptoms. Results highlight the need to monitor post-bariatric patients, facilitate health care access, and promote social support during the lockdown period.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12144-021-01529-6.

Idiopathic "Cyclic" Edema: A Frustrating and Poorly Understood Clinical Problem.

Idiopathic Edema (IE), is a syndrome involving real or perceived weight gain secondary to the pathological retention of fluid. This syndrome of generalized edema is almost solely reported in women. The diagnosis of IE is one of exclusion and requires a careful history, physical exam, and clinical suspicion. The aim of this article is to provide a comprehensive review of the available literature in order to attempt to define IE, identify the possible causes, review the proposed pathophysiology, and discuss potential treatment options.

Intentions to Prevent Weight Gain in Older and Younger Adults; The Importance of Perceived Health and Appearance Consequences

Objectives: This study investigates whether health and appearance consequences predict intentions to prevent weight gain and whether these relationships differ in younger versus older adults and in men versus women. Methods: UK adults aged 18-26 years (younger adults; n = 584) or >45 years (older adults; n = 107) participated in an online survey. Logistic regression assessed associations between intentions to avoid gaining weight and age, gender as well as perceived negative consequences of weight gain for health and appearance. Co-variates were ethnicity, education, weight perception and perceived weight gain vulnerability. Interactions between age, gender and perceived health and appearance consequences of weight gain were also tested. Results: Perceived negative appearance consequences of weight gain predicted weight gain prevention intentions (OR = 9.3, p < 0.001). Health concerns were not a significant predictor of intentions overall but were a strong predictor for older adults (age × health concern interaction: OR = 13.6, p > 0.01). Conclusion: Concerns about feeling unattractive predict intentions to prevent weight gain. However, health consequences of weight gain are only important motivators for older adults. Future research should identify ways to shift the focus of young people from appearance concerns towards the health benefits of maintaining a healthy weight.

Initiation of Basal Insulin Analog Treatment for Type 2 Diabetes and Reasons Behind Patients' Treatment Persistence Behavior: Real-World Data from Germany.

Poor treatment persistence can affect the real-world effectiveness of insulin therapy. A cross-sectional online survey in 942 patients with type 2 diabetes from 7 different countries evaluated patient experience when initiating basal insulin and the reasons behind insulin persistence patterns. Here, we report the quantitative results for the subset of patients from Germany. Adults with type 2 diabetes who had initiated basal insulin during the last 3-24 months, identified from market-research panels, participated in the survey. Patients were asked if they had ≥7-day gaps in basal insulin treatment, and were then classified as "continuers" (no gap since starting insulin), "interrupters" (≥1 gap within the first 6 months after starting insulin and subsequently restarted insulin), or "discontinuers" (stopped insulin within the first 6 months after starting and had not restarted at the time of the survey). For each country, 50 participants were planned per persistence category. Enrollment ended if the target quota was reached or enrollment plateaued. Data were analyzed overall and separately for each persistence cohort. The 131 participants from Germany included 55 (42.0%) continuers, 50 (38.2%) interrupters and 26 (19.9%) discontinuers. The most common motivations to initiate basal insulin therapy were encouragement by physician or other healthcare provider (HCP; 54.2%) and expectation to improve glycemic control (42.0%). More than 95% of participants received training before and during insulin initiation (considered as helpful by 81.7%); most (67.2%) preferred in-person training. Continuers more frequently felt that insulin would help to manage diabetes and that their own views were considered when initiating insulin, they reported less concerns and challenges before and during insulin initiation than interrupters or discontinuers. The most common motivations to continue basal insulin were improved glycemic control (72.7%), improved physical well-being (49.1%), and instruction by physician or other HCP (45.5%). The most common reasons contributing to interruption/discontinuation were perceived weight gain (52.0%/50.0%), hypoglycemia (22.0%/38.5%), and potential adverse effects (30.0%/26.9%). Quality interactions between physicians or other HCPs and their patients before and during the initiation of basal insulin may help to manage patient expectations and to improve persistence to insulin therapy.

What growth should we aim for in preterm neonates?

Abstract Growth is a characteristic of all mammals and implies a progression from infancy to adulthood, as well as being an indication of nutritional adequacy. Growth is therefore important as a ‘marker’ of health and disease, rather than being a functional outcome in itself. Knowing the weight of a baby is essential in the neonatal intensive care unit (NICU) because it determines a whole range of practices, including estimation of daily fluid and nutrient intake needs, and determining drug doses. Weight thresholds may indicate changes in other management, such as when the baby can be moved from an incubator to an open cot, or perhaps when the baby is ready for discharge. Parents and families perceive weight gain as clear tangible proof that their baby is getting better. Parents are delighted when they see their baby has gained weight, and are generally concerned when they do not. The use of growth charts to plot growth with lines indicating apparent ‘normal’ growth trajectories may suggest to parents (and perhaps staff) that we know what is best. However, the optimal speed of weight gain, or growth, remains a matter of uncertainty: rapid growth may be harmful, slow growth might sometimes be acceptable. Growth must be seen in the context of optimising nutritional status, rather than simply achieving increases in auxological parameters. In this review we describe the science underpinning current thinking in nutritional management of babies on the neonatal care unit, give guidance for optimal nutrition and outline the short, medium and long term consequences of early nutritional care.