Weight Control Interventions Research Articles

A randomized controlled trial of a “Small Changes” behavioral weight loss treatment delivered in cardiac rehabilitation for patients with atrial fibrillation and obesity: study protocol for the BE-WEL in CR-AF study

BackgroundAtrial fibrillation (AF) represents a global epidemic. Although international AF practice guidelines indicate weight loss for patients with AF and comorbid obesity (BMI ≥ 30 kg/m2) to alleviate symptom burden and improve prognosis, few cardiac rehabilitation (CR) programs include targeted weight loss treatment.AimsThis RCT protocol will evaluate the efficacy of a “Small Changes” behavioral weight loss treatment (BWLT) to produce clinically relevant (≥ 10%) weight loss among patients with AF and obesity undergoing CR, relative to CR alone. Secondary aims are to establish efficacy of CR + BWLT for improving AF symptoms, AF risk factors, and health-related quality of life.MethodsAdults (18 +) with AF and obesity will be recruited and randomized to receive CR + BWLT (intervention) or CR-only (control). Controls will receive CR consisting of supervised exercise and risk factor self-management for 12 weeks. The intervention group will receive CR plus BWLT (12 weekly, group-based virtual sessions, followed by 12 weeks of follow-up support). Weight and AF-risk factors will be assessed at pre-randomization, 12 weeks, 24 weeks, and 52 weeks. AF burden will be assessed using 30-s ECGs recorded bidaily and with AF symptoms. The primary endpoint of weight loss will be calculated from baseline to 52 weeks as a percentage of starting weight. Intention-to-treat analyses will compare the proportion in each group achieving ≥ 10% weight loss. Assuming success rates of 5% and 30% among controls and intervention groups, respectively, and a 30% loss to follow-up, 120 patients (60 per group) will provide 80% power to detect a difference using a two-sided independent test of proportions (alpha = 5%).ImpactThis clinical trial will be the first to demonstrate that adding BWLT to CR promotes clinically meaningful weight loss among patients with AF and comorbid obesity. Findings will inform design and execution of a large efficacy trial of long-term (e.g., 5-year) clinical endpoints (e.g., AF severity, mortality). Implementing weight control interventions designed to target the AF substrate in CR could dramatically reduce morbidity and enhance quality of life among patients living with AF in Canada.Trial registrationClinicalTrials.gov registration number: NCT05600829. Registered October 31, 2022.

Weight Loss Trajectories and Short-Term Prediction in an Online Weight Management Program.

The extent to which early weight loss in behavioral weight control interventions predicts long-term success remains unclear. In this study, we developed an algorithm aimed at classifying weight change trajectories and examined its ability to predict long-term weight loss based on weight early change. We utilized data from 667 de-identified individuals who participated in a commercial weight loss program (Instinct Health Science), comprising 69,363 weight records. Sequential polynomial regression models were employed to classify participants into distinct weight trajectory patterns based on key model parameters. Next, we applied multinomial logistic models to evaluate if early weight loss in the first 14 days and prolonged duration of participation were significantly associated with long-term weight loss patterns. The mean percentage of weight loss was 7.9 ± 5.1% over 133 ± 69 days. Our analysis revealed four main weight loss trajectory patterns: a steady decrease over time (30.6%), a decrease to a plateau with subsequent decline (15.8%), a decrease to a plateau with subsequent increase (46.9%), and no substantial decrease (6.7%). Early weight change rate and total participating duration emerged as significant factors in differentiating long-term weight loss patterns. These findings contribute to support the provision of tailored advice in the early phase of behavioral interventions for weight loss.

Abstract P190: Association of Meal Timing With Measures of Obesity: The Hispanic Community Health Study/Study of Latinos

Introduction: Time-restricted feeding has been associated with healthier weight, and as a weight-control intervention, can reduce caloric intake without calorie counting. Previous research showed that individuals with overweight who shortened their eating duration (time between first and last food intake of the day) experienced beneficial weight reduction. We explored this association in understudied US Hispanic/Latino individuals, as they experience a high prevalence of overweight and obesity. Hypothesis: We assessed the hypothesis that shorter eating duration is associated with healthier body mass index (BMI), percent body fat, or waist to hip ratio. Methods: We analyzed cross-sectional data from n=12079 Hispanic/Latino participants from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) who were not pregnant, not underweight, had reliable 24-hour dietary recall data, and had at least 3 accelerometer wear days. For each participant, we calculated eating duration, defined as the time between the first and last food intake of the day averaged over two 24-hour dietary recalls. We modeled eating duration in hours as the primary exposure in linear regression models with baseline measured BMI, percent body fat, or waist to hip ratio as outcomes of interest. We adjusted for age, sex, Hispanic background, field center, socioeconomic factors, sleep duration, glycemic status, diet quality, measured physical activity, and energy balance (ratio of energy intake to estimated energy needs). BMI was log transformed to help meet assumptions. Analyses accounted for complex survey design, missing accelerometer data, and accelerometer wear time. Results: Mean (SE) eating duration was 11.9 (0.04) hours. Those with longer eating duration tended to have higher energy intake (though less apparent for those with BMI at least 30), spend more time in moderate or vigorous physical activity, and were more likely to be employed full-time and perform shift work. After adjusting for energy balance and socioeconomic, medical and lifestyle factors, we found a significant positive association between eating duration and log-transformed BMI (regression coefficient 0.003 for eating duration in hours, SE 0.001, p=0.02). This significant association emerged only after adjusting for energy balance, demonstrating the importance of controlling for confounding between eating duration and intake. In sensitivity analysis, we excluded those with prevalent heart disease or diabetes, and obtained similar results. No statistically significant associations were noted between eating duration and the other obesity measures. Conclusions: Longer eating duration was associated with higher BMI in Hispanic/Latino persons after adjusting for covariates and energy balance from self-reported intake.

A randomized pilot trial of a text messaging intervention for sleep improvement and weight control in emerging adults.

A randomized pilot trial of a text messaging intervention for sleep improvement and weight control in emerging adults.

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.

Impact of Anthropometric Indices of Obesity on the Risk of Incident Hypertension in Adults with Prehypertension: A Secondary Analysis of a Cohort Study

This study aimed to investigate the impact of anthropometric indices of obesity (body mass index [BMI], waist circumference, waist hip ratio, and body fat percentage) on the incidence of hypertension in adults with prehypertension. A longitudinal study design using secondary data form the Korean Genome and Epidemiology Study was employed. The study included 1,838 adults with prehypertension tracked every two years from 2001 to 2018. Statistical analyses, including frequency assessments, number of cases per 1,000 person-years, log-rank tests, Kaplan-Meier curves, and Cox's proportional hazards regression, were conducted using SPSS version 25. Over the observation period (15,783.6 person-years), 1,136 individuals developed hypertension. The incidence of hypertension was significantly higher in the obesity groups defined by BMI (hazard ratio [HR] = 1.33), waist circumference (HR = 1.34), waist hip ratio (HR = 1.29), and body fat percentage (HR = 1.31) compared to the non-obese group. These findings indicate an increased risk of hypertension associated with obesity as measured by these indices. The study underscores the importance of avoiding obesity to prevent hypertension in individuals with prehypertension. Specifically, BMI, waist circumference, waist hip circumference, and body fat percentage were identified as significant risk factors for hypertension. The results suggest the need for individualized weight control interventions, emphasizing the role of health professionals in addressing the heightened hypertension risk in this population.

Effect of Weight Control Intervention on Body Mass Index among Adolescents with Overweight: A Systematic Review and Meta-Analysis.

Due to the dramatic rise in overweight and obesity, adolescent weight management interventions are required. Therefore, this study aimed to study the components and the effect size of weight control programs for adolescents with overweight and obese. Following the PRISMA 2020 guidelines, we systematically searched electronic databases (PubMed, Google Scholar, ThaiJo, ThaiLis, and Embase) through December 2021 published in English and Thai, samples aged 15-22 years, and presenting the mean, SD a sample size of both experimental and control groups. However, we excluded articles other than full-text articles. In addition, a risk of bias assessment was performed according to the Cochrane Collaboration's quality assessment tool. Finally, this meta-analysis included six studies that met the criteria. The meta-analysis used a fixed-effects model with a forest plot to compute effect sizes and Cochran's Q and I2 statistics as measures of heterogeneity. We found six primary studies which included 721 overweight adolescents. The analysis of the effectiveness of weight control programs for overweight adolescents revealed that 360 adolescents with overweight and obese (49.93%) who underwent the weight control programs changed body weight and body mass index values with the effect size of -0.80 (-1.03, -0.56) and I2 was 56.00%. The results indicate further studies should focus on constructing programs that consider adolescents' changes in technology and lifestyles. Additionally, social and mobile tools should motivate and educate adolescents about body weight control to help them adapt to a healthy lifestyle and maintain weight control over time.

Effects of Indigenous Saudi Herbals on Weight Control in High Fat Diet-fed STZ Induced Diabetic Rats

Introduction: Obesity, a critical global issue, involves the accumulation of excessive body fat, elevating the risk of diabetes, hypertension, and other severe health conditions. This widespread concern is particularly pronounced in nations like Saudi Arabia, demanding urgent and efficient management approaches. Addressing weight control necessitates comprehensive interventions encompassing education, dietary modifications, and increased physical activity. By following healthier lifestyles and fostering a supportive environment, improvement can be made on healthcare systems. Collaboration between governments, healthcare professionals, and communities is pivotal to reduce obesity's impact and fostering a healthier generations.
 Methods: Research Design and Objectives: This study aimed to fill the existing void in excessive body weight treatments by investigating viable herbal interventions that are safe, readily accessible, and economically viable. Wistar albino rats were grouped to 5 groups with 5 animals each. Diabetics were induced by intraperitoneal injection of streptozotocin for all groups except group 1. Then respective groups were fed with fat diets for 12 weeks and herbals Zingiber officinale (ginger), Nigella sativa (black seeds) and Allium sativum (Garlic) from 7th to 12th weeks along with high fat diet. Mean Body weight and Lee's obesity index were calculated for each group.
 Results and Discussion: In the realm of herbal efficacy, a striking trend surfaces. Among the diverse materials scrutinized, one distinct name rises—Garlic (Allium sativum). Its prowess in diminishing both body weight and fat content stands out prominently. Across the tested spectrum, a consistent and impressive reduction in weight prevails. Particularly, Garlic asserts its dominance as a singularly remarkable performer, showcasing unparalleled effectiveness. This herbal gem not only underscores its potency but also solidifies its position as a preeminent agent for weight and fat reduction. The findings unequivocally spotlight Garlic's exceptional role in promoting healthier body composition.
 Conclusions: Herbals as Adjunctive Therapy for Obesity The findings underscore the potential of herbal interventions, particularly Garlic, in the management of weight control. These natural remedies hold promise as adjunctive therapeutic agents. However, further rigorous human trials and animal studies with large sample size and different methodology are essential to validate their efficacy and integration into obesity / weight control treatment regimens.

Association of diet quality and weight increase in adult heart transplant recipients.

Understanding the quality of the diet of heart transplant recipients (HTRs) is essential to developing effective dietary interventions for weight control, but relevant evidence is scarce. We investigated diet quality and its association with post-transplant increase in weight adjusted for height (body mass index [BMI]) in Australian HTRs. We recruited adult HTRs from Queensland's thoracic transplant clinic, 2020-2021. Study participants completed a 3-day food diary using a smart-phone app. Socio-demographic information was collected by self-administered questionnaire, and height, serial weight and clinical information were obtained from medical records. We calculated the Dietary Approaches to Stop Hypertension (DASH) index based on nine food groups and nutrients (index of 90 indicates highest possible quality), and any changes in BMI (≤ 0 kg m-2 or >0 kg m-2) post-transplantation. Median DASH index values were assessed in relation to sex and BMI change using Mann-Whitney U test. Among 49 consented HTRs, 25 (51%) completed the food diary (median age 48 years, 52% females). Median BMI at enrolment was 27.2 kg m-2; median BMI change since transplant was +3.7 kg m-2. Fruit, vegetable, and whole grain intakes were generally lower than recommended, giving a low overall median DASH index of 30 with no sex differences. HTRs for which the BMI increased post-transplant had significantly lower median DASH indices than those whose BMI did not increase (30 vs. 45, p = 0.013). The diet quality of HTRs appears suboptimal overall, with fruit and vegetable intakes especially low. HTRs whose BMI increased post-transplant had substantially lower quality diets than HTRs whose BMI did not increase.

Changes in leukocyte telomere length among children with obesity participating in a behavioural weight control program.

To examine changes in leukocyte telomere length (LTL) during and after a behavioural weight control program for children with obesity. We measured LTL among a cohort of 158 children 8-12 years of age with a body mass index greater than or equal to the 95th percentile for age and sex. Children were 55% female, 29% white, 52% Latinx, 8% Asian and 11% Pacific Islander, other or multiethnic. All children participated in a 6-month, family-based, group behavioural weight control program and were assessed before treatment, after treatment and 1 year after the end of treatment. To test the sample population slope of LTL over the intervention and maintenance time periods, we fit spline mixed-effect regression models. LTL increased an average of 0.09 T/S units per year (95% confidence interval [CI] 0.04 to 0.13; p = 0.0001) during the weight control program intervention period, followed by an average decline of -0.05 T/S units per year (95% CI -0.08 to -0.03; p < 0.0001) during the 1 year of follow-up after the completion of the intervention. Among 26 social, psychological, behavioural and physiological factors we examined, we did not find any predictors of these changes. LTL increased in response to a behavioural weight control program among children with obesity, suggesting an impact on biological health and cellular aging from participation in a behavioural weight control intervention. LTL may be a useful biomarker for assessing changes in response to behavioural interventions.

Relations between forms of dietary restraint, restriction, and loss-of-control eating among adolescents seeking weight control: An ecological momentary assessment study

ObjectiveThis study aimed to: 1) compare rates of dietary restraint and restriction between adolescents with and without loss-of-control (LOC) eating who were seeking weight control and 2) examine temporal relations between restraint/restriction and LOC eating. Method37 adolescents seeking weight control (mean age: 15.4 ± 1.5; 62 % White; 57 % female; mean BMI percentile = 97.3 ± 3.1) completed a one-week ecological momentary assessment protocol and reported on dietary restraint/restriction and eating behavior prior to beginning a weight control intervention. Chi-square tests examined differences in frequency of restraint/restriction between participants with and without LOC eating. Multilevel models examined associations between dietary restraint/restriction and LOC eating at the next survey and on the next day. ResultsOf 37 participants, 15 (41 %) reported engaging in LOC eating. Participants with LOC eating more frequently endorsed several forms of restraint and restriction versus participants without LOC eating. Attempting to avoid enjoyable foods and attempting to limit eating at one survey predicted greater likelihood of LOC eating at the next survey. ConclusionsFindings suggest that attempted restraint, but not actual restriction, was associated with LOC eating. Research should explore additional factors that may influence these relationships, which could inform weight control treatments that address restraint/restriction.

Nurse-led lifestyle intervention in a cohort of schizophrenia patients treated with clozapine

Patients diagnosed with schizophrenia are characterized by early mortality compared to the general population. The main cause of this premature death reflects medical complications linked to metabolic syndrome (MetS). The use of antipsychotics such as clozapine is associated with weight gain and metabolic disturbances in certain predisposed individuals. Non-pharmacological interventions for weight control have become a key element for secondary prevention in the health of patients diagnosed with schizophrenia. Here, we aim to evaluate the physical health effects of a nurse-led non-pharmacological intervention program in patients with a diagnosis of schizophrenia treated with clozapine.Thirty-one outpatients from the outpatient clinical facility of Hospital Clinic in Barcelona, Spain diagnosed with schizophrenia and other psychotic disorders receiving clozapine treatment were enrolled in a prospective interventional study, comprising an 8-week group program of therapeutic education in a healthy lifestyle. MetS factors, physical activity, diet, and lifestyle were evaluated at baseline, post-intervention (8 weeks), and 3 months after the program. Weight, body mass index, high-density lipoprotein cholesterol, and diet patterns displayed significant differences post-intervention and after 3 months, while only waist, hip perimeter, and lifestyle improved post-intervention.Our results suggest the effectiveness of the lifestyle intervention in patients under clozapine treatment despite its long-time differential effect. Strategies to prevent weight gain and metabolic decline will help prevent premature cardiometabolic disease in this vulnerable population.

373-OR: Repetitive Transcranial Magnetic Stimulation—A Potential Antiobesity Approach for Long-Term Maintenance of Weight Loss

Current anti-obesity interventions result in early rapid weight loss, but long-term maintenance of lost weight is much more challenging. Initial weight loss is typically followed by a weight plateau and progressive regain. We demonstrated the efficacy of repetitive Transcranial Magnetic Stimulation (rTMS) in inducing long-term weight loss (up to 1 year) in individuals with obesity by modulating the brain dopaminergic system and the prefrontal cortex. In a post-hoc analysis, we re-evaluated body weight loss up to 3 years after, in 44 individuals treated with a 5-week high frequency rTMS or sham stimulation, for obesity. Out of 44 subjects, 30 individuals (21 F/9 M, BMI 35.3±2.8, age 49.9±9.3) did not undergo any further weight loss treatments (except diet), 9 subjects (5 F/4 M, BMI 40.4±4.7, age 44.7±.6.1) underwent bariatric surgery, and 5 patients were treated for persistent obesity with a GLP-1 receptor agonist (GLP1-RA) (5 F/0 M, BMI 36.8±6.5, age 53.2±13.9). Out of 30 subject who did not undergo any further weight loss intervention, the 16 patients who received real rTMS (10 F/6 M, BMI 34.6±3.2, age 49.2±7.5) reported a significant body weight loss compared to the Sham group (11 F/3M, BMI 36.1±2.0, age 50.7±2.0) at the end of the 5-week intervention (BMI:-4.5±1.7% vs -1.6±1.8%, p=0.0001). Crucially, they continued to lose body weight compared to the Sham even 3 years after the end of intervention (BMI: -9.5±7.6% vs -3.6±8.4%, p=0.056). As expected, during the 3-year follow-up, bariatric surgery was more effective in promoting weight loss compared to the rTMS and the GLP1-RA (p=0.0001), but rTMS has not been shown to be less effective than GLP1-RA in maintaining lost weight (p=0.621). This preliminary evidence of efficacy of rTMS in promoting long-term weight loss (over one year) may be explained via neuronal neuroplasticity. TMS alone or in combination with other anti-obesity approaches may open new ways to sustain the efficacy of weight control interventions. Disclosure A.Ferrulli: None. S.Massarini: None. C.Macrì: None. P.Senesi: None. I.Terruzzi: None. D.Cannavaro: None. L.Luzi: Advisory Panel; Eli Lilly and Company, Medtronic, Research Support; Gelesis, Speaker's Bureau; A. Menarini Diagnostics, Amgen Inc., Boehringer Ingelheim and Eli Lilly Alliance, Eli Lilly and Company, Novo Nordisk, Novartis. Funding IRCCS MultiMedica (Ricerca Corrente)

#4061 PHARMACOKINETICS OF SETMELANOTIDE IN INDIVIDUALS WITH RENAL IMPAIRMENT: RESULTS FROM A PHASE 1, OPEN-LABEL, SINGLE-DOSE STUDY

Abstract Background and Aims Setmelanotide is an approved treatment for chronic weight management and control of hunger in patients aged ≥6 years with specific forms of obesity including Bardet-Biedl syndrome (BBS). Setmelanotide may be considered for patients with renal impairment, including those with BBS, who often experience impaired renal function as a primary feature of the syndrome. This study evaluated the pharmacokinetics (PK) and safety of a single dose of setmelanotide in individuals without BBS who have renal impairment. Method This Phase 1, open-label study (NCT04348175) was conducted in 3 centers in the United States. Eligible individuals were aged 18-83 years and had general obesity with a body mass index (BMI) of 22-40 kg/m2. Individuals were assigned to a study cohort according to renal function, determined by estimated glomerular filtration rate (normal renal function [healthy volunteers]: ≥90 mL/min/1.73 m2; mild renal impairment: 60-89 mL/min/1.73 m2; moderate renal impairment: 30-59 mL/min/1.73 m2; severe renal impairment: 15-29 mL/min/1.73 m2). A single dose of 2.0 mg of setmelanotide was administered subcutaneously; however, 1.0 or 0.5 mg was administered to most patients with severe renal impairment following safety review of the patient cohorts with mild and moderate renal impairment because of the potential impacts of nausea and vomiting, and consequential dehydration, on renal function. Blood samples were collected for PK analysis from hour 0 up to hour 96 after setmelanotide administration. Patients with renal impairment and healthy volunteers were matched according to sex, age, and BMI. PK parameters in individuals who received &amp;lt;2.0 mg setmelanotide were dose normalized for comparisons across renal function groups. Safety and tolerability were monitored and evaluated. Results In total, 32 individuals were included. Age, sex, and BMI were generally similar across cohorts. Setmelanotide PK parameters were comparable regardless of renal function (Table 1). Mean area under the concentration-time curve was higher in individuals with renal impairment compared with healthy volunteers and increased with worsening renal function. Mean clearance was lower in individuals with renal impairment compared with healthy volunteers and decreased with worsening renal function. Thirty individuals (94%) experienced a treatment-emergent adverse event (TEAE), with gastrointestinal disorders (n=22; 69%) having the highest incidence. There were no severe, serious, or fatal TEAEs and no TEAEs leading to withdrawal. There were no meaningful differences in incidence of the most common TEAEs across cohorts. Conclusion Minimal differences in PK parameters were observed in individuals with mild and moderate renal impairment compared with healthy volunteers. Findings from this study are consistent with current setmelanotide dosing recommendations, which suggest a modified dosing regimen in patients with severe renal impairment.

Applying Regulatory Focus Theory to Encourage Weight Loss in a Self-directed Intervention.

Regulatory focus theory proposes two self-regulatory systems: promotion focus-related to fulfilling aspirations and maximizing positive outcomes-and prevention focus-related to fulfilling responsibilities and avoiding negative outcomes. Building on research demonstrating associations between regulatory focus and weight outcomes, a proof-of-concept weight control intervention framed intervention procedures in terms of promotion or prevention focus and descriptively examined whether the impact of the intervention conditions depended on dispositional regulatory focus. After random assignment to control (received pamphlet on diet and physical activity), promotion, or prevention conditions (1.5-hour baseline sessions; detailed manuals; 1-hour sessions at 3 months), community participants from a metropolitan area in the United States (N = 57; age M = 40; BMI M = 30.9) completed the Regulatory Focus Questionnaire and were weighed at baseline, 3 months, and 6 months. Longitudinal analysis was conducted with SAS Proc Mixed using restricted maximum likelihood estimation. Estimated weight change was -2.99 kg, 95% CI [-4.65, -1.32], in the promotion condition, -1.70 kg, 95% CI [-3.29, -0.12], in the prevention condition, and -0.18 kg, 95% CI [-1.42, 1.05], in the control condition. Exploratory analyses revealed that for relatively more promotion-focused participants, estimated weight change was -1.43 kg, 95% CI [-3.38, 0.51], in the promotion condition, +0.48 kg, 95% CI [-1.01, 1.97], in the prevention condition, and -1.09 kg, 95% CI [-2.32, 0.14], in the control condition. For relatively more prevention-focused participants, estimated weight change was -5.19 kg, 95% CI [-7.14, -3.25], in the promotion condition, -3.35 kg, 95% CI [-4.83, -1.86], in the prevention condition, and +0.42 kg, 95% CI [-0.81, 1.65], in the control condition. Results suggest that self-directed, promotion-focused interventions may be effective and that tailoring to self-regulatory dispositions may not be of additional benefit in initiating weight loss.

Effect of a novel telehealth device for dietary cognitive behavioral intervention in overweight or obesity care

Obesity has become a major public health issue which relate to numerous physical problems and highly comorbid with depression and anxiety. Recently, some studies of technology-based interventions for weight reduction emerged to overcome the barriers from time, cost and distance. Mood component and eating behavior related to obesity are less discussed so far with technology-based intervention though. This pilot study was aimed to investigate the effect of telehealth assisted intervention on weight reduction, mood status, and eating behavior change under a smartphone application (app) with novel 3D food picture recognition and incorporated with cognitive behavioral training programs. Adult aged 30–60 years old with overweight were recruited and randomly assigned to control-first group and intervention-first group. In period 1, control-first group had regular life and intervention-first group underwent app intervention; in period 2, two groups went crossover. Body composition and psychological/behavioral questionnaires were collected at baseline, end of period 1, and end of period 2. Nonparametric statistics was performed for data analyzing. A total of 20 participants were enrolled. In control-first group, there were statistically significant reduction in body weight (− 0.55 kg, p = 0.02) and change of body weight percentage (− 0.6%, p = 0.02) after App use. In intervention-first group, the fat percentage decreased by 0.4% after App use in period 1, and increased by 0.05% in period 2. The integrated crossover data revealed that subjects of App group had significant improvements in mindful eating behavior. This pilot study showed the effectiveness in using CogniNU app for weight control and eating behavior. The difference of short-term and long-term effectiveness of technology-based weight control intervention deserves more investigation in the future.Clinical Trial Registration: ISRCTN16082909.

Correction: Assessment of the Efficacy, Safety, and Effectiveness of Weight Control and Obesity Management Mobile Health Interventions: Systematic Review

[This corrects the article DOI: 10.2196/12612.].

Body-Size Misperception among Overweight Children and Adolescents in Greece: A Cross-Sectional Study.

Childhood obesity can affect both physical and mental health. Body-size misperception may lead to a lack of motivation to make healthy changes or to engage in unhealthy weight loss behaviors, increasing the possibility for obese children to become obese adults. To estimate the frequency of body-size misperception among children and adolescents, we conducted a cross-sectional study within another study on eating disorders in youth in Greece (National Institute of Educational Policy, act no. 04/2018). Between January and December 2019, two trained assistants visited 83 primary and secondary schools of the Region of Western Greece and interviewed 3504 children aged 10-16 years (CL 99%) and performed anthropometric measurements. Among the 3504 surveyed children, 1097 were overweight, including 424 obese, and 51 were underweight. The "perceived" BMI was not computed in 875 children (25%), who did not state their weight or height and were classified as non-responders. Weight bias was inversely related to BMI, the obese and overweight non-obese children underestimated their weight, while the underweight children overestimated it. Conversely, height bias was positively related to BMI bias. BMI bias was not related to sex, age, parental education, or place of residence. In conclusion, our study lends robust support to the existing evidence on unrealistic body images among overweight children and adolescents. Prompt recognition of such misperceptions may help in increasing motivation towards healthier eating habits, systematic physical activity, and weight-control interventions.

Supplemental Material for A Randomized Pilot Trial of a Text Messaging Intervention for Sleep Improvement and Weight Control in Emerging Adults

Supplemental Material for A Randomized Pilot Trial of a Text Messaging Intervention for Sleep Improvement and Weight Control in Emerging Adults

Impact of Early Life Factors on Metabolic Phenotypes of Obesity in Preschool Children.

To investigate the impact of factors in the first 1,000 days of life on metabolic phenotypes of obesity in preschool children in a cohort study. We recruited 3-year-old children for the study. Early life factors included maternal age at delivery, maternal education, prepregnancy BMI, gestational weight gain, gravidity, history of gestational diabetes mellitus, delivery mode, gestational age, family history of metabolic disorders, paternal education, annual family income, child sex, birth weight, and breastfeeding duration. According to BMI and metabolic status, children were classified as metabolically healthy (no metabolic risk factors) with normal weight (MHNW), metabolically unhealthy (one or more metabolic risk factors) with normal weight (MUNW), metabolically healthy with overweight or obesity (MHO), and metabolically unhealthy with overweight or obesity (MUO). We recruited 3,822 children for the study, with 3,015 analyzed. Accelerated BMI z score growth rate between 6 and 24 months was associated with MHO (β = 0.022; 95% CI 0.009, 0.036) and MUO (β = 0.037; 95% CI 0.018, 0.056). Maternal overweight (odds ratio [OR] 3.16; 95% CI 1.55, 6.42) and obesity (OR 8.14; 95% CI 3.73, 17.76) before pregnancy and macrosomia (OR 2.47; 95% CI 1.32, 4.59) were associated with MHO, and maternal obesity before pregnancy (OR 6.35; 95% CI 2.17, 18.52) increased the risk of MUO. Early life factors, such as maternal obesity and accelerated BMI growth rate between 6 and 24 months, were related not only to MHO but also to MUO. Children with these early life factors should be given interventions for weight control to prevent metabolic abnormalities.