Behavioral Weight Loss Research Articles

Overvaluation of shape/weight at posttreatment predicts relapse at 12-month follow-up after successful behaviorally-based treatment of binge-eating disorder.

To test whether overvaluation of shape/weight at the end of treatment prospectively predicts relapse at 12-month follow-up in patients with binge-eating disorder (BED). Participants were 129 patients with BED who achieved abstinence from binge eating after 6 months of behaviorally-based weight-loss treatments in a clinical trial. Independent assessments conducted at posttreatment and at 12-month follow-up included the Eating Disorder Examination interview, the Beck Depression Inventory, and weight measurements. Of the 129 participants who attained abstinence from binge-eating at posttreatment, 46 (36%) were categorized with clinical overvaluation and 83 (64%) with subclinical overvaluation; 115 (89%) were re-assessed at 12-month follow-up. Participants with overvaluation at posttreatment were significantly more likely than those without to relapse at 12-months to non-abstinence from binge eating (54% vs. 28%) and to diagnosis-level binge-eating frequency of once weekly or greater (31% vs. 13%). Overvaluation at posttreatment predicted significantly higher eating-disorder psychopathology and depression scores at 12-month follow-up but were unrelated to weight and weight changes. Treatment groups did not have main or interaction effects; posttreatment overvaluation effects were observed regardless of treatment and of covarying for posttreatment value of dependent variables. Our findings suggest that overvaluation of shape/weight at the end of treatment predicts relapse and heightened eating-disorder psychopathology and depression scores 1 year later in patients who achieved abstinence from binge eating with behaviorally-based treatments. Overvaluation of shape/weight has significant clinical implications and warrants consideration as a diagnostic specifier for BED as it provides important prospective prognostic information. Although effective treatments are available for binge-eating disorder, relapse following successful treatments is not uncommon. Almost nothing is known about what predicts relapse following treatments for binge-eating disorder. Our study found that overvaluation of shape/weight (i.e., body image concerns that overly impact self-worth) at posttreatment prospectively predicted relapse and higher eating-disorder psychopathology and depression 1 year later in patients who achieved binge-eating abstinence with behaviorally based treatments. gov registration: NCT00829283. (Treatment of obesity and binge eating: Behavioral weight loss vs. stepped care.).

Influence of WC-12Co reinforcement on sliding wear performance of stainless steel-based MMC processed in a microwave oven

The high hardness, corrosion resistance, excellent resistance to wear of WC-12Co, and good formability of nickel-based EWAC make these materials suitable candidates used as a reinforcement in stainless steel SS316 for manufacturing various automobiles and anti-wear parts. In this study, the composite castings of SS316+15% Ni-based (EWAC)+WC-12Co (5%–15%) have been developed by microwave hybrid heating. The tribological performance of cast composite samples has been assessed by a Pin-on-disc sliding wear tester. The behavior of cumulative weight loss, wear rate, and coefficient of friction of the cast surface at variable WC-12Co was investigated. The maximum cumulative weight loss, of 12.2 mg occurred at a 4 kg normal load and 1.5 m/s of sliding speed for 5%WC-12Co reinforcement. The minimum cumulative weight loss of 2.1 mg for the 15%WC-12Co at a speed of 1.0 m/s and a normal load of 2 kg. The 5.8 times anti-wear properties have been developed at 15%WC-12Co than 5%WC-12Co. The lower wear rate of 0.002 mg/s was observed at 0.5 m/s and a load of 2 kg. The delamination, shear, de-bonding of particles, pitting, formation of cavities, craters, plastic deformation, and smeared oxide layer were the causes of wear. The MMC microhardness was improved. The microstructure morphology was free from visual defects.

Characterization of early non-responders within behavioral weight loss treatment.

Given that low early (4 weeks) weight loss (WL) predicts longer-term WL, the purpose of this study was to identify factors associated with poor early WL. 438 adults with overweight/obesity participating in an Internet-delivered behavioral WL program provided weights at baseline and 4 weeks. Participants were stratified by percent WL at 4 weeks: LOW: <2% WL, MEDIUM: 2 to <4% WL, HIGH: ≥4% WL and groups were compared on baseline variables (demographics, physical activity, and psychosocial measures) and 4-week intervention adherence. 37.4%, 40.9%, and 21.7% of participants had LOW, MEDIUM, and HIGH early WL respectively. LOW was more likely to be female compared to HIGH and less likely to be non-Hispanic White compared to MEDIUM and HIGH (p's<0.05). After controlling for demographic differences, LOW had lower baseline physical activity compared to HIGH and watched fewer video lessons, self-monitored calorie intake and weight on fewer days, and were less likely to achieve the exercise goal compared to MEDIUM and HIGH (p's<0.05). Findings can inform future adaptive interventions which tailor treatment based upon early WL to improve WL outcomes for more individuals.

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

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

Conventional weight loss therapy in morbid obesity during COVID-19 pandemic: degree of burdens at baseline and treatment efficacy.

COVID-19 affected global physical and psychological health. The purpose of this study was to explore the pandemics impact on health-related quality of life (HRQoL), mental health (anxiety, depression, and perceived stress) and eating behavior in people with severe obesity participating in a multimodal conservative behavioral weight loss (BWL) program conducted via videoconferencing. Additionally, the efficacy of the six-month BWL program in a virtual video-based setting during the pandemic was examined. 297 participants of a face-to-face multimodal behavioral weight loss program prior to the pandemic (PrePAN, May 2014-September 2019) and 146 participants of the in terms of content same intervention in a videoconference-based setting during the pandemic (PAN, July 2020-April 2022) were questioned and compared using standardized questionnaires for HRQoL, symptoms of depressive and anxiety disorders, perceived stress, and eating behavior at baseline and at the end of treatment. Symptoms for anxiety, depression and perceived stress were similar between PrePAN and PAN at baseline. In addition, PAN tended to show lower disinhibition of eating behavior and feelings of hunger than PrePAN. During the pandemic, the BWL intervention resulted in body weight loss (67%) or stabilization (16%) in most of the participants. It also contributed by improving physical HRQoL, lower worries, and improved eating behaviors compared to baseline. During the COVID-19 pandemic, baseline mental health of people with morbid obesity was not worse than before the pandemic. Additionally, the BWL intervention in the virtual video-based setting stabilized and improved physical and mental health during the COVID-19 pandemic.

Intraday relations between physical activity and energy intake among behavioral weight loss participants.

Weight loss results from a negative energy balance, when energy intake (EI) is less than energy expended, e.g., from physical activity (PA). However, PA may impact energy balance beyond energy expenditure alone, through indirect effects on eating behavior. Yet, no research has examined if engaging in PA-a central component of most weight loss programs-is associated with same-day EI among individuals with overweight/obesity pursuing weight loss. Adults (N = 101) with overweight/obesity in a weight loss program were prescribed a reduced-calorie diet and PA regimen (250 min of moderate-to-vigorous PA at midtreatment). For 3 weeks at midtreatment, PA and EI were measured via an accelerometer and self-monitoring app, respectively. Multilevel models examined within-person relations between PA and EI preceding PA ("pre-PA"), acutely following PA ("acute post-PA," the 2 hr following PA), in the time following the acute post-PA period ("remaining time in day"), and across entire PA days ("full-day"), relative to non-PA matched time periods. EI was higher in the pre-PA and acute post-PA periods. There were no reliable differences in EI during the remaining time in day nor across the full-day on PA days versus within-subject matched non-PA days. There also was insufficient evidence to suggest EI pre-PA, post-PA, or across entire PA days, relative to non-PA matched time periods, was associated with percent weight change. Findings suggest that engaging in PA was associated with different within-person EI patterns compared to non-PA days, though there was little evidence to support that these patterns relate to weight change. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effect of surgical, medical, and behavioral weight loss on hormonal and sexual function in men: a contemporary narrative review.

This review explores the mechanisms and ramifications of weight loss achieved through lifestyle modifications, medical treatments, and bariatric surgery on testosterone levels and sexual health. Obesity significantly affects the hypothalamic-pituitary-gonadal axis in men, leading to diminished libido and erectile dysfunction. Here, we delve into the physiological disruptions caused by this imbalance and the intricate interplay of hormonal factors contributing to the dysregulation associated with obesity to comprehensively grasp the consequences of weight loss via diverse mechanisms. Lifestyle modifications involving dietary adjustments and regular exercise represent a widely employed and efficacious means of weight loss. While adherence demands discipline, our review scrutinizes various studies specifically investigating the impact of weight loss, attained through lifestyle modifications, on serum hormone levels and sexual function. Notably, several randomized controlled trials within the existing body of literature corroborate the enhancement of testosterone levels and sexual function consequent to weight loss through lifestyle modifications. The realm of medical management in addressing obesity is growing, notably propelled by the popularity of pharmacotherapy. Despite its prevalence, the current literature exploring the effects of weight loss medications on men remains insufficient. Nonetheless, we examine available studies on the medical management of obesity and its implications for sexual health, emphasizing pivotal avenues requiring further investigation. Bariatric surgery stands as an effective approach for individuals seeking substantial weight loss. Our review assesses existing literature that evaluates the impact of various surgical techniques on serum hormone levels, sexual function, and semen parameters. Despite certain limitations, the available body of evidence suggests enhancements in hormone levels and sexual function post-surgery, with semen parameters generally exhibiting minimal changes. This review critically evaluates the landscape of weight loss and its correlation with sexual function, while highlighting crucial areas necessitating future research endeavors.

Thermal investigation of NbSe2 nanoparticles synthesized through a temperature-dependent sonochemical method.

Due to their unique size-dependent properties, transition metal di-chalcogenide nanoparticles are trending in research for their potential to revolutionize next-generation electronics, energy storage, and catalytic processes. This study addresses the effect of temperature when synthesizing NbSe2 nanoparticles via the sonochemical method at three different temperatures, room temperature (R.T.), 70 °C, and 100 °C. Energy Dispersive X-ray Analysis (EDAX) confirmed the high purity of NbSe2, with the sample synthesized at 70 °C, displaying the accurate stoichiometric ratio. X-ray diffraction (XRD) analysis revealed that all samples maintained the hexagonal phase of NbSe2, with 70 °C exhibiting superior crystallinity due to their crystallite size, lowest dislocation density, and minimal internal strain. Thermogravimetric analysis (TGA) and differential thermogravimetric (DTG) analyses, demonstrated that the sample synthesized at 70 °C had the highest thermal stability, with the lowest total weight loss and most consistent mass loss behavior. Kinetic parameters were evaluated using the Kissinger-Akahira-Sunose (KAS) and Flynn-Wall-Ozawa (FWO) methods, determining activation energy (E a), pre-exponential factor (A), change in activation enthalpy (ΔH*), change in activation entropy (ΔS*), and Gibbs free energy change (ΔG*). Also, the sample synthesized at 70 °C exhibited the highest E a, indicating superior thermal stability and favorable reaction kinetics. The findings underscore the significant impact of synthesis temperature on the structural and thermal properties of NbSe2 nanoparticles, with the sample synthesized at 70 °C demonstrating optimal characteristics. This study provides valuable insights into temperature-dependent synthesis and the thermal behavior of NbSe2 nanoparticles, highlighting their potential in various technological applications.

The relationship between sleep quantity, sleep quality and weight loss in adults: A scoping review.

Sleep is hypothesized to interact with weight gain and loss; however, modelling this relationship remains elusive. Poor sleep perpetuates a cascade of cardiovascular and metabolic consequences that may not only increase risk of adiposity, but also confound weight loss efforts. We conducted a scoping review to assess the research on sleep and weight loss interventions. We searched six databases for studies of behavioural weight loss interventions that included assessments of sleep in the general, non-clinical adult human population. Our synthesis focused on dimensions of Population, Intervention, Control, and Outcomes (PICO) to identify research and knowledge gaps. We identified 35 studies that fell into one of four categories: (a) sleep at baseline as a predictor of subsequent weight loss during an intervention, (b) sleep assessments after a history of successful weight loss, (c) concomitant changes in sleep associated with weight loss and (d) experimental manipulation of sleep and resulting weight loss. There was some evidence of improvements in sleep in response to weight-loss interventions; however, randomized controlled trials of weight loss interventions tended not to report improvements in sleep when compared to controls. We conclude that baseline sleep characteristics may predict weight loss in studies of dietary interventions and that sleep does not improve because of weight loss alone. Future studies should enrol large and diverse, normal, overweight and obese short sleepers in trials to assess the efficacy of sleep as a behavioural weight loss treatment.

Associations between marital status and weight loss trajectories entering into early adulthood: a Teen-LABS study

BackgroundAmong adolescents who underwent metabolic and bariatric surgery (MBS), it is unclear how relationships and specifically marital status (MS) may be associated with long-term weight loss. ObjectiveIn this analysis, we tested for associations between the MS of adolescents who underwent MBS and the MS of their primary caregiver and weight loss trajectory over 8 years. SettingTeen-LABS participating sites. MethodsThis sample included 231 participants (75.3% female, 71.4% White, 68.0% Roux-en-Y gastric bypass, 27.7% vertical sleeve gastrectomy, 4.3% laparoscopic adjustable gastric band). A linear mixed model was conducted with the dependent variable percent body mass index (BMI) change from preoperatively through 8 years with between-participant factors (1) participant MS, (2) caregiver MS, and (3) interaction between caregiver and participant MS. ResultsOne third of participants and 87% of caregivers were ever married (EM). Compared with never-married (NM) participants and caregivers (–14.6%), EM participants and caregivers (–20.6%), EM participants and NM caregivers (–25.9%), and NM participants and EM caregivers (–19.8%), each had significantly greater BMI loss at 8 years (each P < .05). No other group comparisons achieved statistical significance. ConclusionsNM participants with NM caregivers had less favorable long-term BMI. Additional research is needed to better understand how relationships affect behavior change and weight loss after MBS.

A Systematic Review of Interventions for Obesity Among Adults With Food Insecurity.

Food insecurity is associated with reduced dietary quality and excess weight gain. However, interventions that are effective for obesity among individuals with food insecurity are unclear. The purpose of this systematic review was to synthesize studies in which authors examined interventions for obesity among adults with food insecurity. PubMed, PsycINFO, CINAHL, and EMBASE were searched from inception to October 2022. Studies were included if their authors reported on nonpharmacological and nonsurgical interventions that focused on adults with food insecurity and overweight/obesity and reported weight loss. A total of 1360 titles were reviewed during the electronic search, and only 5 studies met inclusion criteria. There were 2 primary types of interventions that have been tested: first, behavioral weight loss counseling with or without tailoring for individuals with food insecurity and, second, subsidies for food. Findings of the benefits of one type of intervention over another are mixed. This systematic review highlights that the current evidence for interventions that address food insecurity and obesity is mixed and limited in scope. There is a need for rigorous controlled trials to examine the effectiveness and cost-effectiveness of interventions for weight management among individuals with food insecurity and obesity while considering sustainability.

Black Feminism and Womanism: A Narrative Review of the Weight Loss Literature.

Black Feminism and Womanism offers an interdisciplinary lens and practice to center Black women's health, engage relevant health, and create Black women-informed solutions to address obesity. The purpose of this review article is to employ Black Feminism and Womanism to examine approaches and results of Black women-centered behavioral weight loss interventions. A narrative review of Black women-centered behavioral weight loss interventions was conducted. To be included, articles met the following criteria: published between 2012 and 2022, standard behavioral treatment for weight loss, randomized design, weight loss outcomes stratified by race and gender, sample size of at least 75 individuals, adults at least 18 years of age, and at least 51% Black women in the sample. Eight studies met the inclusion criteria for a Black women-centered behavioral weight loss intervention and were evaluated. Findings indicate that weight loss among Black women was mostly low, below the clinical target of 5 to 10% weight loss. Intervention designs ranged widely in their approach to respond to the context of Black women's lives, with little consistency between designs. To make meaningful improvement in the effectiveness of behavioral weight loss interventions for Black women, new approaches are critical. Approaches grounded in Black Feminism and Womanism can provide the essential foundation to generate new knowledge, novel hypotheses, and intervention designs that fully attend to the lived context of Black women, including consideration of the potential health effects of gendered racism.

Modifying diet and exercise in multiple sclerosis (MoDEMS): A randomized controlled trial for behavioral weight loss in adults with multiple sclerosis and obesity

Background: Obesity is a risk factor for developing multiple sclerosis (MS) and MS-related disability. The efficacy of behavioral weight loss interventions among people with MS (pwMS) remains largely unknown. Objective: Examine whether a group-based telehealth weight loss intervention produces clinically significant weight loss in pwMS and obesity. Methods: Seventy-one pwMS were randomized to the weight loss intervention or treatment-as-usual (TAU). The 6-month program promoted established guidelines for calorie reduction and increased physical activity. Anthropometric measurements, mobility tasks, self-report questionnaires, and accelerometry were used to assess changes at follow-up. Results: Mean percent weight loss in the treatment group was 8.6% compared to 0.7% in the TAU group (p < .001). Sixty-five percent of participants in the intervention achieved clinically meaningful weight loss (⩾ 5%). Participants in the treatment group engaged in 46.2 minutes/week more moderate-to-vigorous physical activity than TAU participants (p = .017) and showed improvements in quality of life (p = .012). Weight loss was associated with improved mobility (p = .003) and reduced fatiguability (p = .008). Conclusion: Findings demonstrate the efficacy of a behavioral intervention for pwMS and obesity, with clinically significant weight loss for two-thirds of participants in the treatment condition. Weight loss may also lead to improved mobility and quality of life.

Associations of daily weight management-focused social support with weight loss, activity behaviors, and eating regulation in the context of metabolic and bariatric surgery.

Greater perceived social support (PSS) is associated with more favorable changes in weight loss, activity behaviors, and eating regulation after metabolic and bariatric surgery (MBS). However, studies have relied on generic, retrospective PSS measures, and stability of PSS levels and relations with weight loss and weight-related behaviors over time is unknown. Using smartphone-based Ecological Momentary Assessment, this study evaluated pre-to 1-year post-MBS changes in daily weight management-focused PSS and associations with weight loss, device-measured activity behaviors, and eating regulation before and during the initial year after MBS. Adult MBS patients (n=71) received (1) an accelerometer to measure daily moderate-to-vigorous intensity physical activity (MVPA) and sedentary time (ST) minutes/day, and (2) a smartphone to complete morning weight-focused PSS ratings and eating regulation (dietary restraint/disinhibition) ratings at four semi-random times daily for 10days at pre- and 3, 6, and 12-month postoperative. Generalized linear mixed models analyzed the associations of PSS with total weight loss (%TWL) and activity/eating outcomes. Participants on average reported relatively stable moderate-to-high PSS (3.98 on one to five scale) across assessments. Perceived social support was not related to %TWL, MVPA, or ST. Participants with higher PSS reported lower disinhibition and higher restraint than those with lower PSS (ps<0.05); however, participants reported higher restraint on days that PSS was lower than their usual levels (p=0.009). MBS patients on average had stable PSS levels across time. Higher PSS levels were associated with greater resistance to overeating cues (disinhibition) and cognitive control to restrict food intake (restraint) over time. Additionally, participants reported higher restraint when PSS levels were lower than usual. Overall, weight-focused PSS appeared tohold greater importance in relation to regulating eating behavior than engaging in activity behaviors or weight loss among MBS patients during the initial postoperative year. NCT02777177.

Automated Messaging Delivered Alongside Behavioral Treatment for Weight Loss: Qualitative Study.

Mobile health interventions for weight loss frequently use automated messaging. However, this intervention modality appears to have limited weight loss efficacy. Furthermore, data on users' subjective experiences while receiving automated messaging-based interventions for weight loss are scarce, especially for more advanced messaging systems providing users with individually tailored, data-informed feedback. The purpose of this study was to characterize the experiences of individuals with overweight or obesity who received automated messages for 6-12 months as part of a behavioral weight loss trial. Participants (n=40) provided Likert-scale ratings of messaging acceptability and completed a structured qualitative interview (n=39) focused on their experiences with the messaging system and generating suggestions for improvement. Interview data were analyzed using thematic analysis. Participants found the messages most useful for summarizing goal progress and least useful for suggesting new behavioral strategies. Overall message acceptability was moderate (2.67 out of 5). From the interviews, 2 meta-themes emerged. Participants indicated that although the messages provided useful reminders of intervention goals and skills, they did not adequately capture their lived experiences while losing weight. Many participants found the automated messages insufficiently tailored to their personal weight loss experiences. Future studies should explore alternative methods for message tailoring (eg, allowing for a higher degree of participant input and interactivity) that may boost treatment engagement and efficacy. ClinicalTrials.gov NCT05231824; https://clinicaltrials.gov/study/NCT05231824.

What matters for weight loss in behavioral trials in the Latinx community: Learnings from three randomized controlled trials

BackgroundNearly half of Latinx adults in the US are obese, making effective weight loss interventions crucial to prevent associated chronic conditions. ObjectiveTo identify factors associated with increased session attendance and clinically significant weight loss among Latinx adults. ParticipantsLatinx participants from the Vivamos Activos (n = 207), Vida Sana (n = 191), and HOMBRE (n = 424 Latinx men) randomized clinical trials. DesignPost-hoc analysis of randomized controlled trial data. InterventionCulturally-adapted behavioral weight loss interventions based on the Diabetes Prevention Program among Latinx adults over 12 months. Main outcome measureDemographic, clinical, and psychosocial predictors of session attendance and 5% weight loss at 12-months. Statistical analysis performedBi-variable associations between baseline characteristics and outcomes were tested with chi-square and t-tests. Those with p-value< 0.15 were then included in stepwise logistic regressions. ResultsParticipants (N = 822) were middle age with diverse socioeconomic backgrounds. Older age in the Vivamos Activos and Vida Sana trials, and lower acculturation in the HOMBRE trial were significant predictors of increased session attendance. Factors associated with 5% weight loss varied by trials. These included younger age (OR 0.96 95% CI 0.92, 0.99) in Vivamos Activos, higher acculturation (OR 1.88 95% CI 1.05, 3.37) in Vida Sana, and higher education (OR 3.20 95% CI 1.3, 7.03) and greater body image dissatisfaction (OR 1.29, 95% CI 1.04, 1.6), and lower acculturation (0.69 95% CI 0.5, 0.96) in HOMBRE. ConclusionsFew and conflicting baseline characteristics were associated with session attendance and clinically significant weight loss, suggesting that alternative approaches to optimizing interventions are needed.

Behavioral Weight Loss Interventions for Overweight and Obese Cardiac Rehabilitation Patients: A Systematic Review.

The purpose of this systematic review was to identify evidence pertaining to the effectiveness of behavioral weight loss interventions for overweight and obese cardiac rehabilitation participants. A database search of PUBMED, CINAHL, PsycINFO, and PROSPERO yielded 10 eligible studies. Quantitative studies implementing behavioral weight loss interventions for overweight and obese adult cardiac rehabilitation participants were reviewed. Evidence supported the usefulness and effectiveness of behavioral weight loss interventions for overweight cardiac rehabilitation participants. With the limited number of studies and inclusion of quasi-experimental studies with comparative groups, it was not possible to determine the relative power of behavioral weight loss interventions across studies. In conclusion, behavioral weight loss interventions can be incorporated into cardiac rehabilitation or offered following cardiac rehabilitation to improve weight loss of overweight and obese cardiac rehabilitation participants. Findings reinforce national guidelines emphasizing the role of cardiac rehabilitation to address secondary cardiovascular disease risk factor modification, including integrating behavioral weight loss programs in cardiac rehabilitation, or referring overweight patients to weight management programs following completion of cardiac rehabilitation.

Characterization of the First Case of Classical Scrapie in a Sheep in Tunisia

Classical scrapie is a contagious prion disease of sheep and goats. It is endemic in many countries in Europe, North America, and Asia. In Africa, imported scrapie cases have been described in South Africa and Kenia in the past. More recently, several cases have been reported from different regions of Libya, based on clinical signs and histological lesions. Here, we report the results of thorough investigations carried out on a suspect case of scrapie in a 6-year-old Barbarine sheep, born, and bred in Tunisia, showing behavioral changes, weight loss, itching, skin lesions, wool loss, and motor incoordination. Histopathology and immunohistochemistry revealed spongiform change in several brain areas with associated pathological prion protein deposition. Western blotting confirmed the diagnosis and showed a classical scrapie-like molecular pattern of PrPres, different from atypical scrapie and bovine spongiform encephalopathy (BSE) in small ruminants. Sequence analysis of the prion protein gene showed that the animal carried the ARQ/ARQ genotype, one of the most susceptible to classical scrapie. The inoculation of sheep brain homogenate in a susceptible rodent model proved the experimental transmissibility of the disease. These results demonstrate the circulation of classical scrapie in Tunisia and confirm its presence in North Africa, indicating the need to improve epidemiological surveillance and diagnostic capacity for prion diseases in the region.

Long-term spaceflight composite stress induces depressive behaviors in model rats through disrupting hippocampus synaptic plasticity.

Long-term spaceflight composite stress (LSCS) can cause adverse effects on human systems, including the central nervous system, which could trigger anxiety and depression. This study aimed to identify changes in hippocampus synaptic plasticity under LSCS. The present study simulated the real long-term space station environment by conducting a 42-day experiment that involved simulating microgravity, isolation, noise, circadian rhythm disruptions, and low pressure. The mood and behavior of the rats were assessed by behavior test. Transmission electron microscopy and patch-clamp were used to detect the changes in synapse morphology and electrophysiology, and finally, the expression of NMDA receptor channel proteins was detected by western blotting. The results showed that significant weight loss, anxiety, and depressive behaviors in rats were observed after being exposed to LSCS environment for 42 days. The synaptic structure was severely damaged, manifested as an obvious decrease in postsynaptic density thickness and synaptic interface curvature (p < 0.05; p < 0.05, respectively). Meanwhile, LTP was significantly impaired (p < 0.0001), and currents in the NMDAR channel were also significantly reduced (p < 0.0001). Further analysis found that LSCS decreased the expression of two key subtype proteins on this channel. These results suggested that LSCS-induced depressive behaviors by impairing synaptic plasticity in rat hippocampus.

Factors associated with weight loss and health gains in a structured lifestyle modification programme for adults with severe obesity: a prospective cohort study.

Individual responses to behavioural weight loss interventions can vary significantly, and a better understanding of the factors associated with successful treatment might help to target interventions for those who will benefit the most. We sought to identify demographic and clinical characteristics that predicted intervention "success" (defined as ≥5% weight loss) and other health gains in patients with severe obesity attending a ten-week structured lifestyle modification programme. We conducted a prospective cohort study of all 1122 patients (751 (66.9%) female, mean age 47.3 ± 11.9 years, mean body mass index (BMI) 46.7 ± 7.8 kgm-2) referred from our hospital-based obesity clinic, who started the structured lifestyle programme between 2012-2019. We compared routine clinical measures such as weight, fitness, blood pressure, lipids and HbA1c at baseline and follow-up. We also used validated questionnaires to quantify anxiety, depression and health-related quality of life. Of 1122 patients who started, 877 (78.2%) completed the programme and attended for follow up. Of these, 12.8% lost ≥5% body weight. The amount of weight lost was a strong and consistent predictor of improvements in metabolic, cardiovascular, and mental health, even after adjusting for age, sex, programme attendance and baseline fitness. Older age, male sex, being physically active and having lower anxiety and depression scores at baseline predicted greater weight loss. Younger age, depression and longer wait time to start the intervention were associated with drop-out. In adults with severe obesity completing a structured lifestyle modification programme, older age and good mental health were associated with programme completion and attaining ≥5% weight loss. The magnitude of weight lost was a strong predictor of improvements in cardiovascular, metabolic and mental health associated with programme completion.