Weight Loss Goals Research Articles

The weight-loss experience: a qualitative exploration.

BackgroundLong-term weight management consists of weight-loss, weight-loss maintenance, and weight-gain stages. Qualitative insights into weight management are now appearing in the literature however research appears to be biased towards explorations of weight-loss maintenance. The qualitative understanding of weight loss, which begets weight-loss maintenance and might establish the experiences and behaviours necessary for successful long-term weight management, is comparatively under-investigated. The aim of this study was to investigate the weight-loss experiences of a sample of participants not aligned to clinical intervention research, in order to understand the weight-loss experiences of a naturalistic sample.MethodsParticipants (n = 8) with weight-loss (n = 4) and weight-maintenance experiences (n = 4) were interviewed using a semi-structured interview to understand the weight-loss experience. Interview data was analysed thematically using Framework Analysis and was underpinned by realist meta-theory.ResultsWeight loss was experienced as an enduring challenge, where factors that assisted weight loss were developed and experienced dichotomously to factors that hindered it. Participants described barriers to (dichotomous thinking, environments, social pressures and weight centeredness) and facilitators of (mindfulness, knowledge, exercise, readiness to change, structure, self-monitoring and social support) their weight-loss goals in rich detail, highlighting that weight loss was a complex experience.ConclusionsWeight loss was a difficult task, with physical, social, behavioural and environmental elements that appeared to assist and inhibit weight-loss efforts concurrently. Health professionals might need to better understand the day-to-day challenges of dieters in order to provide more effective, tailored treatments. Future research should look to investigate the psycho-social consequences of weight-loss dieting, in particular self-imposed social exclusion and spousal sabotage and flexible approaches to treatment.

Energy Expenditure Overestimation Bias in Elliptical Trainer Machine

Elliptical trainers are a common mode of aerobic exercise in recreationally active populations. Those with a weight loss goal might rely upon the energy expenditure (EE) estimation that many elliptical brands provide to keep track of calories (kcals) burned and make nutritional decisions. For this reason, it is important to evaluate the accuracy of the algorithms used by elliptical trainers to estimate EE. PURPOSE:To compare EE estimates by a common brand of elliptical trainer to that measured using open circuit spirometry, at different combinations of resistance and pedal speed. METHODS:Twenty subjects (10 male, 10 female; 34 ± 12 yr; 175.3 ± 10.7 cm; 77.1 ± 14.1 kg) consented to participate. Each completed three 15-min bouts of elliptical exercise on the same elliptical trainer, with at least 24 hr between exercise bouts. Pedal rates were held constant throughout each bout at 50, 60, or 70 RPM, and resistance was increased incrementally every 5 min from level 5 to 10 to 15. The different cadences were completed in a randomized order between participants. Expired gases were collected continuously throughout the 15 min. Heart rate, distance (mi), and EE from the elliptical readout were recorded every 1 min. RPE was collected twice per resistance level. A two-tailed paired samples t-test was used to compare elliptical EE to measured EE. A linear regression model was used to evaluate the ability of the elliptical EE to predict measured EE. Significance for all statistical measures was held at an alpha level of 0.05. RESULTS:The difference between EE estimates from the elliptical and measured VO2 was significant (p<0.0001), with the elliptical machine overestimating EE during a 15 minute session by an average of 10.21 kcals. Measured EE in kcals as derived from open circuit spirometry was significantly predicted by elliptical EE according to the equation: Measured EE = 0.95*(Elliptical EE) - 3.161 CONCLUSIONS:The elliptical trainer used demonstrated a bias to overestimate EE. This should be taken into account by health/fitness professionals using these estimations to program for clients. There may be some variation in the EE correction regression depending on elliptical model, and proper machine calibration should be ensured.

Food Thought Suppression Inventory: Test–retest reliability and relationship to weight loss treatment outcomes

This study examined the test–retest reliability of the Food Thought Suppression Inventory (FTSI) and its relationship with weight loss during weight loss treatment. Participants were 89 adults with and without binge eating disorder (BED) recruited through primary care for weight loss treatment who completed the FTSI twice prior to starting treatment. Intra-class correlations for the FTSI ranged from .74–.93. Participants with BED scored significantly higher on the FTSI than those without BED at baseline only. Percent weight loss from baseline to mid-treatment was significantly negatively correlated with the FTSI at baseline and at post-treatment. Participants reaching 5% loss of original body weight by post-treatment had significantly lower FTSI scores at post assessment when compared to those who did not reach this weight loss goal. While baseline binge-eating episodes were significantly positively correlated with baseline FTSI scores, change in binge-eating episodes during treatment were not significantly related to FTSI scores. The FTSI showed satisfactory one week test–retest reliability. Higher levels of food thought suppression may impair individuals' ability to lose weight while receiving weight loss treatment.

Changes in Body Weight Among People With Type 2 Diabetes Mellitus in the United States, NHANES 2005-2012.

To understand weight loss strategies, weight changes, goals, and behaviors in people with type 2 diabetes mellitus (T2DM) and whether these differ by ethnicity. T2DM was identified by self-reported diagnosis using the NHANES 2005-2012 data, which also included measured and self-reported current body weight and height, self-reported weight the prior year, and self-reported aspired weight. Nineteen weight loss strategies were evaluated for association with ≥5% weight loss or weight gain versus <5% weight change. Among people with T2DM, 88.0% were overweight/obese (body mass index [BMI] ≥25 kg/m(2)) in the prior year and 86.1% the current year. About 60% of the overweight/obese took weight loss actions, mostly using diet-related methods with average weight lost <5%. Two most "effective" methods reported (smoking, taking laxatives/vomiting) are also potentially most harmful. Similar BMI distributions but different goals and behaviors about weight and weight loss were observed across ethnicity. Only physical activity meeting the recommended level and changing eating habits were consistently associated with favorable and statistically significant weight change. Weight management in T2DM is an ongoing challenge, regardless of ethnicity/race. Among overweight/obese T2DM subjects, recommended level of physical activity and changing eating habits were associated with statistically significant favorable weight change.

Doctor, How Much Weight Will I Lose?-a New Individualized Predictive Model for Weight Loss.

Bariatric surgery is an effective treatment for weight loss, but the patient's ability to reach a sustained weight loss depends upon several technical and individual factors. Creating an easy model that adapts bariatric surgery's weight loss goals for each patient is very important for pre-surgery and follow-up evaluations.

Deliberate choices or strong motives: Exploring the mechanisms underlying the bias of organic claims on leniency judgments

Organic claims can influence how a product is perceived in dimensions that are unrelated with the food production method (e.g., organic food is perceived as more healthful and less caloric than conventional food). Such claims can also bias how the consumers of organic food are perceived and how other people judge their behavior. Schuldt and Schwarz (2010) have shown that individuals evaluating a target with a weight-loss goal are more lenient in judging the target forgoing exercise when the target had an organic (vs. conventional) dessert. This impact of organic claims on leniency judgments has been interpreted either as a halo or a licensing effect. In the current research we aim to replicate and extend Schuldt and Schwarz's (2010) results by examining the mechanisms that are more likely to explain the observed leniency judgments. In Experiment 1, we observed that leniency towards a target that has consumed an organic meal is only observed when the target intentionally chooses such organic meal (vs. choice determined by the situation). These findings suggest that the impact of organic claims on leniency judgments is not merely based on a halo effect. Instead, a licensing account emerges as the most probable mechanism. In Experiment 2, we further found that stronger (vs. weaker) motives for forgoing exercise influenced leniency judgments to the same extent as having had an organic meal. Understanding the mechanisms that shape consumers' decisions may have important implications to prevent bias in their judgments about food and exercise.

Quality of life and psychological well-being in obesity management: improving the odds of success by managing distress.

SummaryBackgroundObesity is increasing in prevalence and placing an ever‐greater burden on individuals and healthcare resources alike. Obesity management is complex and, for many, elusive.Aims and methodsThis paper reviews the major factors that influence psychological well‐being in individuals with obesity and describes the means by which their impact on distress and other aspects of quality of life (QoL) can be quantified. The goal is to enable healthcare providers to set reasonable, achievable, maintainable weight loss targets that will improve the psychological well‐being and QoL of individuals living with obesity. PubMed and Web of Science searches were conducted to identify literature that addresses the key question: How can distress over obesity be measured and taken into account when tailoring weight loss interventions for a particular patient?Discussion and conclusions‘Distress over obesity’ is a key parameter that illustrates the psychological consequences of excess weight. Healthcare providers can draw on a range of obesity‐specific and non‐specific assessment tools to quantify distress as well as the other contributions of obesity to QoL and mental/emotional health. When physicians consider the psychological/QoL aspects of obesity and how these change with successful weight loss, it becomes possible to set achievable, realistic weight loss goals and develop a manageable plan to achieve them. Any future developments that make it easier to achieve these goals should be made widely available to all patients in need, in order to help them turn a vicious cycle of failure into a virtuous cycle of success.

A Second Chance at Health: How a 3D Virtual World Can Improve Health Self-Efficacy for Weight Loss Management Among Adults.

Health self-efficacy, or the beliefs in one's capabilities to perform health behaviors, is a significant factor in eliciting health behavior change, such as weight loss. Research has demonstrated that virtual embodiment has the potential to alter one's psychology and physicality, particularly in health contexts; however, little is known about the impacts embodiment in a virtual world has on health self-efficacy. The present research is a randomized controlled trial (N = 90) examining the effectiveness of virtual embodiment and play in a social virtual world (Second Life [SL]) for increasing health self-efficacy (exercise and nutrition efficacy) among overweight adults. Participants were randomly assigned to a 3D social virtual world (avatar virtual interaction experimental condition), 2D social networking site (no avatar virtual interaction control condition), or no intervention (no virtual interaction control condition). The findings of this study provide initial evidence for the use of SL to improve exercise efficacy and to support weight loss. Results also suggest that individuals who have higher self-presence with their avatar reap more benefits. Finally, quantitative findings are triangulated with qualitative data to increase confidence in the results and provide richer insight into the perceived effectiveness and limitations of SL for meeting weight loss goals. Themes resulting from the qualitative analysis indicate that participation in SL can improve motivation and efficacy to try new physical activities; however, individuals who have a dislike for video games may not be benefitted by avatar-based virtual interventions. Implications for research on the transformative potential of virtual embodiment and self-presence in general are discussed.

Can we Introduce an Effective Lifestyle Modification Intervention among Children at Risk of Overweight and Obesity in the Conditions of Family Practice?

Background: Diet and physical activity are crucial in management of pediatric overweight and obesity, however family involvement has not been adequately studied in primary care. Goal: Assessment of the effectiveness of lifestyle modification intervention among overweight and obese children, addressing parental adherence. Methods: During the period of the study (from October 2013 until June 2014) 588 children have visited the family practice involved in the study because of many different reasons. Each child of this group of 588 children was screened for the risk of abdominal obesity. 106 children have matched the criteria of the risk of abdominal obesity. An intervention - “3-color signaling diet and increased physical activity was implemented for 24 weeks in a group of 106 subjects, aged 2-17, with waist circumference (WC) ≥ 75 percentile (in industrial region of Poland). Anthropometric parameters (BM, BMI and WC), blood pressure, fasting lipid fractions (TG, HDL-C) and plasma glucose (FPG) levels were measured before and after the intervention, and parents were filling out the survey, assessing their adherence to the program. Results: After 24 weeks, in all the subjects, regardless of their age and gender, the mean values of BMI, WC, and BP were statistically significantly lower (p<0.01) than their baseline parameters, and the HDL-C levels were higher. The parental survey revealed that 77.3% were adherent to the dietary (20.7% for 24 weeks), and 55.7% – to the physical activity recommendations (25.5% continuously). Conclusions: Lifestyle modification intervention that targets overweight and obese children and adolescents and their families, reinforcing weight loss goals is helpful in improving anthropometric and HDL-C results. The whole family needs to accept and adhere to the recommended diet and physical activity changes for at least 6 months. A parental perspective of barriers to compliance needs to be considered in designing an effective weight management intervention in primary care.

Evidence Based Prevention of Type 2 Diabetes: Role of Lifestyle Intervention as Compared to Pharmacological Agents

Background: The global epidemic of type 2 Diabetes Mellitus (T2DM) presents significant challenges to world health both in terms of financial costs as well as morbidity. Thus, considerable research has been focussed on the prevention or delay of the onset of T2DM. Aim: The aim of this article is to review published studies that evaluate lifestyle and pharmacological interventions aimed at preventing T2DM and to compare both these interventions. Methods: We undertook an electronic search of MEDLINE, PubMed, EMBASE and Cochrane Register of Controlled Trials, with the English language restriction and published until May 2015. Five major diabetes prevention trials using lifestyle intervention (LSI) and five using pharmacological intervention were identified. We reviewed the study design, key components, and outcomes for each study aimed to delay T2DM. Results: Both LSI and pharmacological intervention were found to be effective to reduce the risk of developing T2DM in at risk population. LSI with modest goals of weight loss and physical activity is safe, cost saving and prevents or delays the onset of diabetes, even after discontinuation of the treatment providing long term benefits. A Considerable effort from well-trained, multidisciplinary staff is needed to achieve these modest goals. For patients who are unable to achieve the lifestyle goals or those who progress to T2DM despite being on LSI, pharmacological intervention has shown to be effective, especially in younger obese patients. Adverse effects with pharmacological intervention were common. Conclusion: Strong evidence exists for the prevention or delay of type 2 diabetes through lifestyle and pharmacological intervention. LSI with weight loss and increased physical activity are safe, costeffective and are currently recommended for the prevention of diabetes.

Design and baseline characteristics of participants in the Enhancing Physical Activity and Reducing Obesity through Smartcare and Financial Incentives (EPAROSFI): A pilot randomized controlled trial

BackgroundAn activity tracker combined with a smartphone application (smartcare) may help people track and receive feedback on their own activities. However, activity trackers themselves generally fail to drive long-term sustained engagement for a majority of users. One potential strategy for increasing the effectiveness of smartcare is through the use of incentives. The purpose of this pilot randomized trial is to test the feasibility of our intervention and to assess the extent to which smartcare with or without financial incentives can increase physical activity levels and reduce weight over a 12-week period. Methods/designThis study employs a three-arm, open-label randomized controlled trial design: control (standard basic education), smartcare, and smartcare plus financial incentives. Male university students with body mass index≥27 are enrolled. Our primary and secondary endpoints are the amount of weight loss and the level of physical activity respectively. The weight loss goal is 3% of baseline at week 4, 5% at week 8, and 7% at week 12. The daily physical activity goal was individualized according to the participants' weight. Process incentives are accumulated when participants met daily physical activity goals, and outcome incentives are provided when they met weight reduction goals. DiscussionGiven the global increase in physical inactivity and obesity, there is a growing need for effective, scalable, and affordable health promotion strategies. Our proof-of-concept study will provide the evidence for the combination of rising health promotion technology of activity trackers and smartphone applications with the modern concept of behavioral economics using financial incentives.

Weight Management for Athletes and Active Individuals: A Brief Review.

Weight management for athletes and active individuals is unique because of their high daily energy expenditure; thus, the emphasis is usually placed on changing the diet side of the energy balance equation. When dieting for weight loss, active individuals also want to preserve lean tissue, which means that energy restriction cannot be too severe or lean tissue is lost. First, this brief review addresses the issues of weight management in athletes and active individuals and factors to consider when determining a weight-loss goal. Second, the concept of dynamic energy balance is reviewed, including two mathematical models developed to improve weight-loss predictions based on changes in diet and exercise. These models are now available on the Internet. Finally, dietary strategies for weight loss/maintenance that can be successfully used with active individuals are given. Emphasis is placed on teaching the benefits of consuming a low-ED diet (e.g., high-fiber, high-water, low-fat foods), which allows for the consumption of a greater volume of food to increase satiety while reducing energy intake. Health professionals and sport dietitians need to understand dynamic energy balance and be prepared with effective and evidence-based dietary approaches to help athletes and active individuals achieve their body-weight goals.

Cognitive processing of food rewards

Cues associated with tasty foods, such as their smell or taste, are strong motivators of eating, but the power of food cues on behaviour varies from moment to moment and from person to person. Variation in the rewarding value of a food with metabolic state explains why food cues are more attractive when hungry. However, cognitive processes are also important determinants of our responses to food cues. An urge to consume a tempting food may be resisted if, for example, a person has a longer term goal of weight loss. There is also evidence that responses to food cues can be facilitated or inhibited by memory processes. The aim of this review is to add to the literature on cognitive control of eating by reviewing recent evidence on the influence of working memory and episodic memory processes on responses to food cues. It is argued that processing of food information in working memory affects how much attention is paid to food cues in the environment and promotes the motivation to seek out food in the absence of direct contact with food cues. It is further argued that memories of specific recent eating episodes play an important role in directing food choices and influencing when and how much we eat. However, these memory processes are prone to disruption. When this happens, eating behaviour may become more cue-driven and less flexible. In the modern food environment, disruption of cognitive processing of food reward cues may lead to overconsumption and obesity.

Obesity Education Strategies for Cancer Prevention in Women's Health.

Obesity is the cause of up to one-third of all cancers affecting women today, most notably endometrial, colon and breast cancer. Women's health providers are poised to advise women on obesity's link to cancer development, but often lack resources or training to provide appropriate counseling. Here, we review obesity's role in increasing the risk of several common reproductive system conditions faced by women, including polycystic ovarian syndrome, infertility, gynecologic surgical complications, and pregnancy complications. These events can be used as teachable moments to help frame the discussion of weight management and promote cancer prevention. We also review national guidelines and existing tangible weight-loss strategies that can be employed within the outpatient women's health setting to help women achieve weight loss goals and affect cancer prevention.

The motivational properties of hope in goal striving

ABSTRACTWe argue that hope is not an expectancy based on beliefs about pathways to desired goals and personal capacities to act on them, but an experience of the mere possibility of a desired outcome. We propose that in the latter sense, hope has unique motivational consequences for goal striving. Specifically, we predicted that hope buffers against the detrimental impact of negative feedback on goal-progress. The results of the two studies confirmed this prediction. In Study 1, we measured participants’ hopes of attaining a weight-loss goal. In Study 2, we induced hope at solving an unsolvable mathematical puzzle. In both studies, receiving negative feedback on goal-progress resulted in lower levels of success (Study 1) and persistence (Study 2) in goal-striving, but not for participants who experienced hope. We discuss the role of hope as an affective mechanism that functions to regulate energy expenditure in goal-striving.

Con: Weight loss prior to transplant: no.

In large registries of hemodialysis patients, higher body mass index (BMI) is known to be associated with lower mortality rates, while weight loss associates with reduced survival. This so-called 'obesity paradox' includes patients categorized as overweight and obese. Transplantation in the obese patient population has been shown to improve quality of life and reduce mortality when compared with obese recipient candidates remaining on dialysis. Most transplant centers, however, restrict access to transplant based upon predetermined BMI cutoffs. This policy effectively mandates weight loss for many obese transplant candidates. However, BMI, though easily measured, is an inadequate assessment of nutritional status and lean muscle mass in obese patients. Regimens designed to prevent protein-energy wasting may include dietary recommendations and exercise programs that result in favorable changes in body composition without significantly impacting weight. The goal of weight loss is not achievable for many if not most obese dialysis patients. The consequence to the patient is reduced access to life improving transplantation. Patients are forced to pursue dietary, behavioral and possibly surgical interventions to accomplish weight loss despite limited evidence regarding the safety and utility of these interventions. The delay in transplantation also hinders the achievement of improved exercise capacity after successful transplant, a time when weight loss regimens may be safer and more effective.

Meal replacements as a weight loss tool in a population with severe mental illness

Weight gain and worsening metabolic parameters are often side effects of antipsychotic medications used by individuals with severe mental illness. To address this, a randomized, controlled research study of a behavioral weight management program for individuals with severe mental illness was undertaken to assess its efficacy. Patients unable to meet weight loss goals during the first portion of the year-long study were given the option of using meal replacement shakes in an effort to assist with weight loss. Specific requirements for use of meal replacement shakes were specified in the study protocol; only five patients were able to use the shakes in accordance with the protocol and lose weight while improving metabolic parameters. Case studies of two subjects are presented, illustrating the challenges and obstacles they faced, as well as their successes. Taking responsibility for their own weight loss, remaining motivated through the end of the study, and incorporating the meal replacement shakes into a daily routine were factors found in common with these patients. Use of meal replacements shakes with this population may be effective.

Pharmacist interventions for obesity: improving treatment adherence and patient outcomes.

Obesity is currently a worldwide pandemic, with overweight (body mass index [BMI] ≥25 kg/m2) and obesity (BMI ≥30 kg/m2) estimated at 35% and 12% of the global adult population, respectively. According to data collected from the United States National Health and Nutrition Examination Survey, approximately 68.8% of US adults are overweight or obese. Additionally, a large burden of health care costs can be attributed directly to obesity as well as multiple, potentially preventable, comorbidities such as cancer, cardiovascular disease, and diabetes. As a result, national and international organizations, such as the US Centers for Disease Control and World Health Organization, have made halting the rise of the obesity epidemic a top priority. Pharmacists, commonly considered one of the most trustworthy and accessible health care professionals, are ideally situated to provide counseling for weight and lifestyle management. This review presents examples of pharmacist-led as well as collaborative practices that have been somewhat successful in educating and monitoring patient progress in attaining weight-loss goals. Common barriers and potential solutions to administration of lifestyle counseling and monitoring programs, such as limited pharmacist time and resources, lack of expertise and/or confidence in program administration, and patient perception and awareness, are also discussed.

Weight Management in Type 2 Diabetes: Current and Emerging Approaches to Treatment

Diabetes is a growing global health concern, as is obesity. Diabetes and obesity are intrinsically linked: obesity increases the risk of diabetes and also contributes to disease progression and cardiovascular disease. Although the benefits of weight loss in the prevention of diabetes and as a critical component of managing the condition are well established, weight reduction remains challenging for individuals with type 2 diabetes due to a host of metabolic and psychological factors. For many patients, lifestyle intervention is not enough to achieve weight loss, and alternative options, such as pharmacotherapy, need to be considered. However, many traditional glucose-lowering medications may lead to weight gain. This article focuses on the potential of currently available pharmacological strategies and on emerging approaches in development to support the glycemic and weight-loss goals of individuals with type 2 diabetes. Two pharmacotherapy types are considered: those developed primarily for blood glucose control that have a favorable effect on body weight and those developed primarily to induce weight loss that have a favorable effect on blood glucose control. Finally, the potential of combination therapies for the management of obese patients with type 2 diabetes is discussed.

No effect of caloric restriction or exercise on radiation repair capacity.

Maintenance of normal weight and higher levels of physical activity are associated with a reduced risk of several types of cancer. Because genomic instability is regarded as a hallmark of cancer development, one proposed mechanism is improvement of DNA repair function. We investigated links between dietary weight loss, exercise, and strand break rejoining in an ancillary study to a randomized-controlled trial. Overweight/obese postmenopausal women (n = 439) were randomized to the following: a) reduced calorie weight loss diet ("diet," n = 118), b) moderate- to vigorous-intensity aerobic exercise ("exercise," n = 117), c) a combination ("diet + exercise," n = 117), or d) control (n = 87). The reduced calorie diet had a 10% weight loss goal. The exercise intervention consisted of 45 min of moderate to vigorous aerobic activity 5 d·wk for 12 months. DNA repair capacity was measured in a subset of 226 women at baseline and 12 months from cryopreserved peripheral mononuclear cells using the comet assay. Anthropometric and body composition measures were performed at baseline and 12 months. DNA repair capacity did not change significantly with any of the 12-month interventions compared with control; there were also no significant changes when stratified by changes in body composition or aerobic fitness (V˙O2max). At baseline, DNA repair capacity was positively associated with weight, body mass index, and fat mass (r = 0.20, P = 0.003; r = 0.19, P = 0.004; r = 0.13, P = 0.04, respectively) and inversely with lean body mass (r = -0.14, P = 0.04). In conclusion, DNA repair capacity in cryopreserved PBMCs (Comet Assay) did not change with dietary weight loss or exercise interventions in postmenopausal women within a period of 12 months. Other assays that capture different facets of DNA repair function may be needed.