Weight Loss Attempts Research Articles

Associations of Body Dissatisfaction With Lifestyle Behaviors and Socio-Demographic Factors Among Saudi Females Attending Fitness Centers.

ObjectiveTo examine body image perception and the associations of body dissatisfaction (BD) with socio-demographic and lifestyle factors among Saudi women attending fitness centers in Riyadh.MethodsSaudi females aged 16 years and older were recruited from 12 randomly selected fitness centers in Riyadh, using stratified clustered sampling technique (n = 460). Height and weight were measured to calculate actual body mass index (BMI). A previously validated instrument was used to collect socio-demographic and lifestyle variables including physical activity (PA), sedentary behaviors, sleep and dietary habits. Stunkard Figure Rating Scale silhouettes were used to assess perceived and desired body shape.ResultsThe participants had a mean (SD) age of 29.2 (8.2). The majority were not married (57%), with no children (66%) and had college degrees (78%). While 63% were overweight or obese, nearly 40% of women underestimated their perceived body shape. The majority of respondents (87%) were dissatisfied with their body shape including 68% of normal weight women. Females who had BD were significantly older, had higher BMI, reported more weight loss attempt and had expended less time in vigorous (p = 0.033) and total (p = 0.042) PA than those who were satisfied with their body shape. However, when adjusting for socio-demographic variables, logistic regression analysis revealed significant associations of BD with higher BMI, shorter membership duration of fitness club, and reduced dairy products and energy drinks consumption.ConclusionExcept for BMI and decreased dairy products and energy drinks consumption, many lifestyle behaviors did not associate with BD among Saudi females attending fitness centers. The findings can inform healthcare providers when intervention strategy is implicated for females with BD. Future studies should compare the associations of BD with lifestyle behaviors between males and females attending fitness centers and seeking weight loss.

Obese endometrial cancer survivors’ perceptions of weight loss strategies and characteristics that may influence participation in behavioral interventions

We aimed to evaluate obese endometrial cancer (EC) survivors' perceptions of weight loss barriers and previously attempted weight loss methods and to identify characteristics that predicted willingness to enroll in a behavioral intervention trial. We administered a 27-question baseline survey at an academic institution to EC survivors with body mass index ≥ 30 kg/m2. Survivors were asked about their lifestyles, previous weight loss attempts, perceived barriers, and were offered enrollment into an intervention trial. Data was analyzed using Fisher’s Exact, Kruskal-Wallis, and univariate and multivariate regressions. 155 of 358 (43%) eligible obese EC survivors were surveyed. Nearly all (n = 148, 96%) had considered losing weight, and 77% (n = 120) had tried two or more strategies. Few had undergone bariatric surgery (n = 5, 3%), psychologic counseling (n = 2, 1%), or met with physical therapists (n = 9, 6%). Lower income was associated with difficulty in accessing interventions. Survivors commented that negative self-perceptions and difficulties with follow-through were barriers to weight loss, and fear of complications and self-perceived lack of qualification were deterrents to bariatric surgery. 80 (52%) of those surveyed enrolled in the trial. In a multivariate model, adjusting for race and stage, survivors without recurrence were 4.3 times more likely to enroll than those with recurrence. Most obese EC survivors have tried multiple strategies to lose weight, but remain interested in weight loss interventions, especially women who have never experienced recurrence. Providers should encourage weight loss interventions early, at the time of initial diagnosis, and promote underutilized strategies such as psychological counseling, physical therapy, and bariatric surgery.

Self-reported weight loss attempts and weight-related stress in childhood: Heightening the risk of obesity in early adolescence.

Weight loss attempts occur as early as childhood. The impacts of weight loss attempts and weight-related stress on the occurrence of obesity during childhood remain unknown. We aimed to: (a) assess the prevalence of self-reported weight loss attempts and weight-related stress in 8-10 year-old children and (b) determine associations with adiposity 2 years later. Data were collected from a cohort study of 564 Canadian children aged 8-10 years, having one or both biological parents with obesity (Quebec Adipose and Lifestyle Investigation in Youth cohort). Self-reported weight loss attempts and weight-related stress were assessed at baseline in the child's questionnaire. Adiposity was measured at baseline and 2 years later using body mass index z-scores (zBMI), waist-to-height ratio (WHtR), and percentage of body fat (%BF) obtained from dual-energy x-ray absorptiometry. Linear and logistic regression analyses were used while adjusting for potential confounders. Forty-eight percent of children reported previous weight loss attempts and 20% reported weight-related stress. Self-reported weight loss attempts and weight-related stress were associated with higher zBMI, WHtR, and %BF 2 years later in adjusted models, although estimates were attenuated when including baseline adiposity measures. Self-reported weight loss attempts, but not weight-related stress, increased the risk of becoming overweight among children who were normal weight at baseline. Weight loss attempts are prevalent in children with parental obesity. Children reporting weight loss attempts and weight-related stress tend to have higher adiposity 2 years later and are more likely to become overweight.

Does moderate weight loss affect subjective health perception in obese individuals? Evidence from field experimental data

This paper analyzes whether moderate weight reduction improves subjective health perception in obese individuals. Besides simple regression models, in a simultaneous equation framework we use randomized monetary weight loss incentives as instrument for weight change, to address possible endogeneity bias. In contrast to related earlier work that also employed instrumental variables estimation, identification does not rely on long-term, between-individuals weight variation, but on short-term, within-individual weight variation. Yet, our result does not suggest that the simple regressions suffer from much endogeneity bias, since instrumental variables estimation yields similar—though far noisily estimated and statistically insignificant—estimates. In qualitative terms, our results do not contradict previous findings pointing to weight loss in obese individuals resulting in improved subjective health. Our results suggest that a reduction of body weight by one BMI unit is associated with an increase in the probability of reporting self-rated health to be ‘satisfactory’ or better by 3 to 4 percentage points. This finding may encourage obese individuals in their weight loss attempts, since they are likely to be immediately rewarded for their efforts by subjective health improvements.

The association between sleep health and weight change during a 12-month behavioral weight loss intervention.

Background:Prior research on the relationship between sleep and attempted weight loss failed to recognize the multidimensional nature of sleep. We examined the relationship between a composite measure of sleep health and change in weight and body composition among adults in a weight loss intervention.Methods:Adults (N=125) with overweight or obesity (50.3±10.6 years, 91% female, 81% white) participated in a 12-month behavioral weight loss intervention, with assessments of sleep, weight, fat mass, and fat-free mass at baseline, 6 months, and 12 months. Six sleep dimensions (regularity, satisfaction, alertness, timing, efficiency, and duration) were categorized as ‘good’ or ‘poor’ using questionnaires and actigraphy. A composite score was calculated by summing the number of ‘good’ dimensions. Obstructive sleep apnea (OSA) was assessed in a subsample (n=117), using the apnea-hypopnea index (AHI) to determine OSA severity. Linear mixed modeling was used to examine the relationships between sleep health and outcomes of percent weight, fat mass, or fat-free mass change during the subsequent 6-month interval, adjusting for age, sex, bed partner, and race; an additional model adjusted for AHI.Results:Mean baseline and 6-month sleep health was 4.5±1.1 and 4.5±1.2, respectively. Mean weight, fat mass, and fat-free mass changes from 0–6 months were −9.3±6.1%, −16.9±13.5%, and −3.4±3.4%, respectively, and 0.4±4.8%, −0.3±10.3%, and 0.7±4.1% from 6–12 months. Better sleep health was associated with greater subsequent weight loss (P=.016) and fat loss (P=.006), but not fat-free mass loss (P=.232). Following AHI adjustment, the association between sleep health and weight loss was attenuated (P=.102) but remained significant with fat loss (P=.040). Regularity, satisfaction, timing, and efficiency were each associated with weight and/or fat loss (P≤.041).Conclusions:Better sleep health was associated with greater weight and fat loss, with associations attenuated after accounting for OSA severity. Future studies should explore whether improving sleep health, OSA, or the combination improves weight loss.

Patients Desire Personalized, Specific, and Continuous Advice on Weight Management.

To deliver effective care, healthcare systems should understand patients' preferences for weight management across a spectrum of needs. Our objective was to describe patients' perceptions of what helps or hinders weight loss and maintenance. Semistructured interviews were conducted with patients who accessed weight management services at a large integrated health system in 2018. The interview guide was developed and iteratively refined through a literature search and by consulting experts. Questions included the respondent's weight history, interactions with the health system, and current health status. The analysis used a grounded theory approach, and each transcript was double-coded in 2019. Codes were sorted into themes. All discrepancies were resolved through team discussion. Fifteen patients were interviewed. The majority of respondents (87%) reported multiple weight loss attempts. Three themes were identified. First, advice should be matched to a patient's knowledge and prior experience (eg, using bariatric deck cards). As patients progressed, clinician advice also needed to advance (eg, explaining how to expand food options instead of defining a healthy diet). Second, respondents had a variety of motivating factors, and understanding where motivation is generated from can inform how to design a weight management approach. Third, patients need continual and long-term advice. Some respondents feared becoming ineligible for services if their weight dropped too much. Health systems can support patients by developing processes for identifying the extent of a patient's knowledge and giving personalized advice based on the patient's preferences and experiences. Reassessing needs at defined intervals may help patients attain and sustain their goals.

ASSOCIATION ANALYSIS OF PIOGLITAZONE EFFECTIVENESS IN TREATMENT OF NAFLD PATIENTS WITH OBESITY AND PPARG RS1801282 (PRO12ALA) GENOTYPE

The aim: To study the association between the effectiveness of treatment with pioglitazone non-alcoholic fatty liver disease (NAFLD) in patients with obesity and PPARG rs1801282 (Pro12Ala)-polymorphism in Ukrainians. Materials and methods: 123 patients with NAFLD in combination with obesity 1, 2, 3 classes were included in comprehensive weight loss program (5 visits, 12-weeks). The case group was treated with pioglitazone 15 mg / day, while the control group received only program. Ultrasound (US) steatometry and genetic testing rs1801282 polymorphism in PPARG gene were performed. Results: Pioglitazone, PPARG rs1801282 genotype, CAP before treatment, previous weight loss attempts, and duration of obesity were associated with the change in controlled attenuation parameter (CAP) during treatment. There was a significant association between the target CAP reduction achievement and pioglitazone treatment (adjusted odds ratio 0.23, 95% CI 0.07–0.73; p = 0.01) with the CC genotype of PPARG gene (adjusted odds ratio 92.9, 95% CI 7.4–1159; p < 0.001) compared to patients with the CG genotype. Conclusions: Pioglitazone and PPARG rs1801282 polymorphism could influence on dynamics of CAP reduction during treatment.

Dietary Management of Obesity: A Review of the Evidence.

Obesity is a multi-factorial disease and its prevention and management require knowledge of the complex interactions underlying it and adopting a whole system approach that addresses obesogenic environments within country specific contexts. The pathophysiology behind obesity involves a myriad of genetic, epigenetic, physiological, and macroenvironmental factors that drive food intake and appetite and increase the obesity risk for susceptible individuals. Metabolically, food intake and appetite are regulated via intricate processes and feedback systems between the brain, gastrointestinal system, adipose and endocrine tissues that aim to maintain body weight and energy homeostasis but are also responsive to environmental cues that may trigger overconsumption of food beyond homeostatic needs. Under restricted caloric intake conditions such as dieting, these processes elicit compensatory metabolic mechanisms that promote energy intake and weight regain, posing great challenges to diet adherence and weight loss attempts. To mitigate these responses and enhance diet adherence and weight loss, different dietary strategies have been suggested in the literature based on their differential effects on satiety and metabolism. In this review article, we offer an overview of the literature on obesity and its underlying pathological mechanisms, and we present an evidence based comparative analysis of the effects of different popular dietary strategies on weight loss, metabolic responses and diet adherence in obesity.

Choosing and following a very low calorie diet program in Australia: A quasi-mixed methods study to understand experiences, barriers, and facilitators in a self-initiated environment.

In Australian adults, this study seeks to describe the experiences and factors associated with the perceived outcomes of using a very low calorie diet (VLCD) program for ≥4 weeks. A mixed method study using the method perspective was conducted to analyse individual semi-structured interviews conducted via videoconference and cross-sectional survey data. Australians 18 to 65 years were eligible if they were currently consuming at least one VLCD product daily for ≥4 weeks or had ceased consumption within 4 weeks. Interviews were thematically analysed. Weight loss (19 kg [SD: 18 kg]) and duration (5 months [SD: 5 months]) of VLCD product use of the 31 participants (female: 97%, 44 [SD: 11] years, body mass index >30 kg/m2 : 84%) were strongly correlated (r = 0.73, P < .001). Participants' experiences were influenced by a journey of learning from their previous weight loss attempts, discerned the VLCD program as credible, and chose to commence the VLCD due to a convergence of internal motivators. Early health-related outcomes were a reinforcing stimulus and participants developed new health behaviours but felt dependent on the VLCD long term. Throughout these experiences the participants identified various individual, program structure, and environment related factors which either facilitated their VLCD program use or created barriers to achieving their goals. Health care professionals were minimally engaged. A model of care to support facilitators and overcome barriers would mean more meaningful engagement of health care professionals to ultimately improve the experience and adherence of the VLCD program users in Australia.

Motivation of overweight patients with atrial fibrillation to lose weight or to follow a weight loss management program: a cross-sectional study

Aims Overweight increases the risk of recurrence and progression of atrial fibrillation (AF). This study assesses the knowledge of overweight AF patients about the relation between their weight and AF, to gauge their motivation losing weight and/or following weight reduction programs. Methods A multicenter cross-sectional descriptive study was performed at three Belgian hospitals. A validated self-developed questionnaire was presented to AF patients with a body mass index (BMI) >27 kg/m2 and it addressed: motivation to reduce weight and its related factors; knowledge about the relation between weight and AF; and interest in weight reduction programs. Results One hundred and forty-three patients completed the questionnaire. 75.5% was currently motivated to reduce weight. Multivariate regression analysis showed that a higher BMI, a college/university degree, male gender, without hypertension, previous weight loss attempt(s) and living with a partner, were significantly associated with greater motivation for weight reduction. Only 69.9% of the patients was aware of the positive effect of weight reduction on the progression of AF. A completely home-based/telerehabilitation program was the preferred approach for 57.9% of the patients. Conclusions AF patients with overweight need to be better informed about overweight as a risk factor for AF. Female AF patients with a lower degree of education, hypertension, living alone, who have never attempted to reduce weight and with a lower but still elevated BMI need more external motivation to lose weight. A tailored weight reduction program (home-based) is the preferred option for patients. This will require further development and validation of telecoaching programs for this patient group.

Perceptions, attitudes and barriers to obesity management: Japanese data from the ACTION-IO study.

Aims/IntroductionThe prevalence of obesity is rising in Japan and represents a considerable unmet medical need. The Awareness, Care and Treatment in Obesity MaNagement – International Observation (ACTION‐IO) study was designed to identify the perceptions, attitudes and barriers to obesity care among people with obesity (PwO) and healthcare professionals (HCPs) in Japan.Materials and MethodsAn online, cross‐sectional survey was carried out in 11 countries, including Japan.ResultsThe survey was completed by 2,001 PwO and 302 HCPs in Japan. Fewer PwO (58%) than HCPs (85%) perceived obesity as a chronic disease. Most PwO (81%) thought that weight loss was their own responsibility, and waited a considerable time before seeking support from their HCP (mean 6 years). Most PwO (64%) had made one or more serious weight loss attempt in the past. In contrast, a serious attempt at losing weight was reported by HCPs for just 21% of their patients. Just 24% of PwO had weight discussions with an HCP in the past 5 years; of those, 56% expressed positive feelings after such a conversation, and just 2% felt offended. Lack of patient motivation (68%) and patient disinterest (61%) were reported by HCPs as barriers to weight management conversations. A higher proportion of obesity specialists (37%) than non‐specialists (22%) thought their patients were motivated to lose weight.ConclusionsOur Japanese dataset shows a need to raise awareness of the pathophysiological basis and clinical management of obesity among PwO and HCPs. The largely positive feelings expressed by PwO after weight loss conversations should encourage HCPs to initiate earlier discussions before obesity‐related complications occur.

The prognostic factors for effectiveness of the treatment of non-alcoholic fatty liver disease against the obesity background

Objective — to investigate the role of pioglitazone, PPARg Pro12Ala (rs1801282) polymorphism, primary results of steatometry and obesity anamnestic data in the effectiveness of treatment non‑alcoholic fatty liver disease (NAFLD) co‑occurring with obesity.Materials and methods. The study involved 123 patients with obesity of 1 ‑3 degree and NAFLD. The patients were randomized into two groups (and 4 groups for multiple‑pairwise comparison based on variant of PPARg gene), comparable in age and sex. The patients of the case group adhered to the basic recommendations for losing weight and received treatment with pioglitazone 15 mg/ day, patients of the comparison group receive non‑drug treatment only. All patients underwent a molecular genetic study of detecting PPARg Pro12Ala (rs1801282) polymorphism, as well as anthropometric measurements, laboratory and instrumental examinations (including Ultrasound (US) steatometry) before and after 12 weeks of treatment. In addition, weight loss history and self‑report adherence with the help of questionnaires were conducted.Results. Metabolic syndrome was found in 80.5 % of obese and NAFLD patients, impaired fasting glycaemia — in 13.82 %. The dynamics of BMI reduction was significantly the lowest –2.81 (–3.23; –2.39) kg (p < 0.001) in the comparison group of patients carrying CC genotype PPARg rs1801282 polymorphism compared among other groups. There was a significant association between the target reduction of the controlled attenuation parameter (≥ 0.33 dB/ cm) and treatment with pioglitazone 15 mg/ day (aOR 0.23; 95 % CI 0.07 — 0.73; p = 0.01) and the carries of CC genotype PPARg rs1801282 polymorphism (aOR 92.9 95 % CI 7.4 — 1159; p < 0.001) compared with the carries of CG genotype. We also identified significant associations with primary results of steatometry (0.1 dB/ cm) (aOR 0.49; 95 % CI 0.34 — 0.70; p < 0.001), duration of obesity (5 years) (aOR 2.19; 95 % CI 1.25 — 3.84; p = 0.006) and number of previous weight loss attempts (for 2) (aOR 2.51; 95 % CI 1.76 — 3.58; p = 0.002).Conclusions. The results demonstrated that the following factors have an important prognostic value for the effectiveness of NAFLD treatment against the obesity background: pioglitazone in treatment scheme, especially in patients with CG genotype PPARg rs1801282 polymorphism, higher steatosis level, shorter duration of obesity and less number of previous weight loss attempts.

Associations Between Weight Loss Attempts, Food Planning, and the Home Food Environment

ObjectiveTo evaluate whether food planning behaviors mediate the relationship between a reported weight loss attempt and the home food environment (HFE). DesignSecondary data analysis of 4 home visits, included collecting an objective home food inventory of the HFE and self-reported food planning behaviors. ParticipantsThere were 196 participants (mean age, 44.4 years; 83.7% female). Main Outcome MeasuresThe percentage of obesogenic foods and fruits and vegetables (FV). AnalysisFour regression analyses to test mediation. ResultsMeal planning and grocery list use did not explain the relationship between a weight loss attempt and obesogenic foods or FV in the home (P > 0.05). Post hoc analyses that examined participants with a body mass index of >25, >28, and >30 found that a weight loss attempt was associated with fewer obesogenic foods. In contrast, mediation analyses with planning behaviors and associations with FV in the home were nonsignificant (P > 0.05). Conclusions and ImplicationsObesity was more indicative of the HFE than making a weight loss attempt. A weight loss attempt was not associated with food planning behaviors, which may be used for multiple reasons, including organization and time management. Future studies should evaluate individual differences in strategies to create a healthy HFE in the context of a weight loss attempt.

Relationships between Body Weight Perception and Weight Management: Practices among Adolescents

Background and Objectives: Overweight and obesity are highly prevalent in western countries and growing problems in developing countries. Weight loss behaviors are highly prevalent among adolescents, and body weight perception motivates weight control practices. The aim of this study is to investigate the relationships between actual body weight, body weight perception, and weight control practices among adolescents.&#x0D; Material and methods: A questionnaire-based survey was used to collect data on anthropometric measurements, demographic information, weight perception and weight control practices from a sample of 200 male and female students (89 boys and 111 girls) aged between13 and19 year old. The association between weight loss attempts and socio demographic factors, weight status and the weight perception were analyzed. Multivariable logistic regression analyses were performed to examine the predictors of misperception and its association with weight-related behaviors. Cohen's kappa was calculated to analyze the accuracy of body weight perceptions.&#x0D; Results: This study revealed that prevalence of underweight was higher in girls than boys. In this study, 8% were underweight including 3.5% severely underweight, 23.5% were overweight, 6% were obese and the rest of the participants (59%) were of normal weight. Only 61.5% respondents perceived their weight correctly. Perception of 21.5% adolescents was underestimated and 16.5% were overestimated than their actual weight status. Almost one third of the respondents were in weight control interventions. Almost 11% boys and 33% girls attempted weight loss activities. The gender biasness was seen in weight control (statistically significant ,p value =0.003). Body weight perception was found significant (p value, 0.001) in relation to weight control behavior.&#x0D; Conclusion: Body weight perceptions are not in agreement with actual weight in adolescents. This discrepancy is more marked in females who use a variety of weight control behaviors. These behaviors are motivated more apparently by perceived weight rather than actual body mass index.

Increased frequency of intentional weight loss associated with reduced mortality: a prospective cohort analysis

BackgroundDue to the high prevalence of obesity and the difficulty in maintaining weight loss, repeated bouts of weight loss are a common occurrence. However, there are inconsistencies in epidemiological studies regarding repetitive weight fluctuations being associated with increased risk of mortality. Therefore, the purpose of this prospective cohort analysis was to determine the long-term association of the frequency of weight loss attempts on mortality.MethodsThis prospective cohort study used data collected from adult AARP members living in 6 states (California, Florida, Louisiana, New Jersey, North Carolina, or Pennsylvania) or 2 metropolitan areas (Atlanta, Georgia, or Detroit, Michigan) and participating in the National Institutes of Health–AARP Diet and Health Study between 2004 and 2006. Self-reported data were analyzed for 161,738 middle-aged adults. During an average 7 years of follow-up, 21,194 deaths were recorded. Hazard ratios of all-cause, cardiovascular, and cancer mortality were estimated adjusting for demographic, lifestyle, and behavioral risk factors.ResultsIncreased frequency of weight loss attempts of at least five pounds was associated with lower mortality (ptrend < 0.010). Multivariate hazard ratios (95% confidence intervals) for all-cause death among individuals who successfully attempted weight loss compared with those who did not make any attempts were 0.94 (0.90–0.98) for 1–2 attempts, 0.96 (0.91–1.01) for 3–4 attempts, 0.91 (0.85–0.96) for 5–6 attempts, 0.91 (0.85–0.98) for 7–8 attempts, 0.87 (0.80–0.95) for 9–10 attempts, and 0.88 (0.82–0.94) for 11+ attempts. Similar results were noted for men and women, participants with healthy weight and overweight/obesity, and even among those who gained weight over time. Protective associations were also observed for deaths due to cardiovascular disease and cancer.ConclusionsIncreased frequency of intentionally losing at least five pounds in mid-life was associated with a lower risk of future death. Repeated attempts with moderate amounts of weight loss may provide benefit in terms of longevity.Trial registration numberClinicalTrials.gov number, NCT00340015

Characteristics of adults with overweight and obesity who have not attempted weight loss in the prior 12 months

ObjectiveTo determine weight-related characteristics of adults with overweight or obesity who had not attempted weight loss in the prior 12 months. MethodsAdults from the obesity cohort of the PORTAL clinical data research network were randomly selected to complete a survey in 2015. It included topics of experiences with health care providers, weight history, and health-promoting behaviors. ResultsA total of 2811 adults completed the survey, of whom 24% reported not attempting weight loss in the previous 12 months. Controlling for sociodemographic characteristics and body mass index, respondents who reported that their health care provider never talked about weight were more likely to not attempt weight loss in the previous 12 months compared with respondents who reported providers frequently brought up weight (OR: 0.45; 95% CI: 0.24, 0.66). Respondents who perceived themselves as normal weight or underweight were 4.22 times more likely (95% CI: 3.53, 5.05) to not attempt weight loss compared with respondents who perceived themselves as overweight. Respondents who reported that they never tried to lose at least 10 lbs, ate 0−2 servings of fruits and vegetables daily, or engaged in 0−29 min of physical activity weekly were less likely to attempt weight loss. ConclusionsReceiving advice on weight loss from health care providers to improve awareness of overweight and obesity status may be important factors for a person’s weight management. Provider discussions about weight may be a strategy to motivate weight loss attempts.

Differences in treatment response to a total diet replacement intervention versus a food-based intervention: A secondary analysis of the OPTIWIN trial.

SummaryObjectiveFor every weight loss treatment, there are usually groups of people who lose less than expected. This study sought to determine if response rates to a total diet replacement (TDR) differed from those of a calorie‐restricted, food‐based (FB) diet.MethodsData from OPTIWIN, a 12‐month multicenter trial in adults with a BMI of 30–55 kg/m2, with 26‐week weight‐loss and weight‐maintenance phases, were utilized. Participants (n = 330) were randomized to the OPTIFAST programme (OP) or to a reduced‐energy FB diet. Treatment non‐responders were defined as those who lost <3% of initial weight at months 6 or 12.ResultsThere were 103 (76%) responders in the OP compared with 78 (57%) in the FB group at 12 months. The odds of treatment response at 12 months among participants who were non‐responders at 3 months was not significantly different between the OP and FB groups (p = 0.64). Race, type 2 diabetes status and previous weight loss attempts were significantly associated with responder status. OP responders had higher meal plan adherence and non‐caloric fluid intake compared with FB responders.ConclusionEarly treatment response is more likely and better sustained with TDR compared with an FB diet. Individual and treatment level factors appear to influence early treatment response to behavioural interventions for weight reduction.

Cardiovascular Health Risk Behaviors by Occupation in the NYC Labor Force.

We explored associations between occupation and cardiovascular disease (CVD) risk behaviors including: attempted weight loss, physical activity, smoking, and restaurant meal and sugary beverage consumption. We used NYC Health and Nutrition Examination Survey 2013 to 2014 data, and coded free-text, occupational question responses using 2010 US Census Bureau Classification. CVD risk behaviors were compared across occupational categories, using regression to adjust for demographics. There were health behavior differences across occupational categories. Construction/transportation/maintenance workers smoked more and were less likely than management to attempt weight loss, service workers were less likely to eat restaurant-prepared meals, sales/office workers were less likely to be physically active (all P < 0.05). Adjusting for demographics, differences in health behaviors were reduced, but remained present. Knowledge of occupational disparities may aid chronic disease prevention by identifying populations for targeted interventions.

&lt;p&gt;Lifestyle Behaviors and Socio-Demographic Factors Associated with Overweight or Obesity Among Saudi Females Attending Fitness Centers&lt;/p&gt;

ObjectiveTo examine the associations of overweight or obesity with several lifestyle and socio-demographic factors among Saudi women attending fitness centers in Riyadh.MethodsSaudi females (n = 460) aged 16 years and older were recruited from 12 randomly selected fitness centers in Riyadh, using a stratified clustered sampling technique. Bodyweight and height were measured. Lifestyle behaviors were assessed using a previously validated instrument, and included physical activity, sedentary behaviors, sleep, and dietary habits.ResultsOver 62% of the participants were either overweight or obese. Mean BMI values for females younger than age 30 years (26.4 ± 5.3) were significantly lower than those 30 years of age or older (29.2±5.6, p >0.001). There was a significant correlation (r = 0.450, p < 0.001) between BMI levels and the participant’s reason to engage in exercise for weight loss. Females who were overweight/obese are significantly older, married, have more children, have a lower educational degree, earn less income, have higher numbers of obese in the family, and had attempted to lose weight more frequently than non-overweight/non-obese females. No significant differences were detected between females who were overweight/obese and those who were not overweight/obese in the majority of the lifestyle-related variables, except that females who were not overweight or obese showed lower weekly consumption of milk and dairy products (p =0.029) and higher intakes of fast foods per week (p =0.049).ConclusionWeight loss attempts, age, number of obese in the family, and females’ education level emerged as the most important contributory factors to obesity status, explaining nearly 23% of the common variances. A better understanding of the relationships between obesity and lifestyle behaviors is necessary for effective prevention and management of obesity in Saudi females.

Food insecurity is associated with increased weight loss attempts in children and adolescents.

Household food insecurity (HFI) has been associated with adverse childhood outcomes and shares many common risk factors with obesity. Half of adolescents with overweight or obesity are actively attempting to lose weight. We aim to evaluate whether HFI is associated with weight loss attempts and unhealthy weight loss control practices in children. We examined cross-sectional data of children ages 8 to 15 years old from the National Health and Nutrition Examination Survey. Attempted weight loss was more common among children with very low food security (OR 1.50, 95% CI 1.09, 2.07). Children with a healthy weight with very low food security had increased odds of attempting weight loss (OR 1.51, 95% CI 1.00, 2.26) but there was no association in children with overweight or obesity. Very low food security was also associated with unhealthy weight control practices (OR: 1.42, 95% CI: 1.04, 1.93). Physicians should counsel all children and adolescents on healthy and unhealthy weight loss behaviours, regardless of weight or food security status.