Weight Loss Services Research Articles

Apply Influence Diagrams for Utility Analysis of Paying the Weight-Reducing Expenses: A Case Study in Taiwan

To effectively control the growth of medical expenditure, Bureau of National Health Insurance (NHI) of Taiwan has taken many measures, including the Reasonable Number of Outpatient Services, Ceiling Price, Global Budgets, Strategic Analysis and the Excellence Plan; however, these measures can only scratch the surface. Due to the change of life style and the deteriorating condition of over-nutrition and obesity, people now have a higher risk of diabetes, hypertension, hyperlipidemia, cardiovascular disease, gallbladder disease, cancer, gout, arthritis, and so on, which leads to higher medical expenditure. Therefore, good civil preventive health care is regarded as the solution of surging medical expenditure. According to NHI's statistics, the annual medical expenditure of diabetes is about 13 billion NT dollars. Among these diabetics, over 95% are affected by type 2 diabetes mellitus; at least two-thirds--over 80% according to some researches--are overweight or obese. The research says, losing 5% to 10% of the original body weight can lower the risk of chronic diseases effectively; also, giving early therapy for obesity can reduce the complication probability, thus for avoiding the waste of medical resources. By applying influence diagrams of Bayesian Network and Utility Expect of statistics, this paper evaluates the medical expenditure of Taiwan's NHI under the circumstances of providing and not providing benefit for weight-loss outpatient services. The result of this research is that the cost of not providing benefit for weight-loss outpatient services is 3.4 times of the contrary. Therefore, if Taiwan's NHI provides reasonable benefit for weight-loss outpatient services, not only the risk of people suffering from diabetes, hypertension, hyperlipidemia, cardiovascular disease, gallbladder disease, cancer, gout, arthritis, etc. will go down; but also the medical expenditure can be effectively reduced.

Pediatric Obesity Attitudes, Services, and Information Among Rural Parents: A Qualitative Study

The objective of this study was to learn more about the attitudes concerning pediatric obesity among rural parents, the barriers these parents face in trying to help their children attain a healthy weight status, and the pediatric weight loss services currently available in small rural communities. A series of eight qualitative focus groups were conducted with 21 parents of overweight rural children in third through fifth grade. Eight saturated themes resulted indicating that parents (i) believe overweight children are lazy, (ii) are concerned about the weight of their children, (iii) believe that some individuals will be overweight no matter what they do, and (iv) have tried a variety of techniques to help their children lose weight. Barriers to helping their children lose weight unique to their rural status included lack of weight loss resources in their community, lack of exercise facilities, and lack of low-fat or low-calorie options in grocery stores. Rural families of overweight children encounter many barriers to healthier living, some of which are unique to their rural status.

Weight Watchers: Social Event Centered Marketing

ABSTRACT This article looks at an international weight loss service company known as Weight Watchers and evaluates the promotional effectiveness of their social event focused business. Secondary research highlights their approach to the marketing mix and the significance of perception within this particular market and the marketing mix per se. Research of their traditional social event based business is reported in terms of the effect of the promotional tools used by Weight Watchers, influences on consumer decision making, consumer behavior, and internal and external factors which influence marketing decisions. The conclusions drawn are that there are significant issues for Weight Watchers to consider in terms of their future approach to the weight loss market. Firstly, the need for Weight Watchers to differentiate themselves further from their competitors and, secondly, to ensure they have distinct differentiation strategies for their social event and online businesses.

P007: Auriculotherapy Complications: Ear Stapling Gone Bad

P007: Auriculotherapy Complications: Ear Stapling Gone Bad

Using the Wellness Benefit for Insurance Reimbursement of Weight Loss Services at a Medically Supervised Weight Management Center

Using the Wellness Benefit for Insurance Reimbursement of Weight Loss Services at a Medically Supervised Weight Management Center

Continuation of weight loss treatment is associated with the number of self-selected treatment modalities.

Abstract Behavior therapy is a cornerstone of weight loss treatment and behaviorists help direct patients' treatment. A novel design was used that allowed participants to choose different treatment modalities during behavioral weight loss treatment. The association between the selection of different treatment modalities and program completion was examined (N=58). Participants could choose five additional treatments options (two medications with or without meal replacements, or meal replacements alone). Participants changed treatments 3.5 times on average. Participants who completed the study changed treatments significantly more times than dropouts. Dropouts, however, tried more treatment options early in treatment compared to completers. Over time, participants chose more effective treatments. The results provide behaviorists with data on the benefits and costs of patients changing treatment modalities during treatment. Keywords: Behavior therapy, Phenylpropanolamine, Caffeine, Ephedrine, Meal replacement, treatment preference. ********** The guidelines for the treatment of obesity suggest that behavior therapy, diet, and increased physical activity are cornerstones of weight loss treatment (NHLBI, 1998). Behavioral psychologists play a critical role in delivering and directing weight loss treatment in multidisciplinary settings. Therefore, behavioral psychologists must consider the benefits and costs of patients' desires to add various treatment modalities to behavior therapy. Other treatment modalities include meal replacements and medication. There is substantial variability of weight loss in response to these treatments and predicting weight loss success remains difficult (Martin, 2002). Nevertheless, patients who seek fee-for-service weight loss services must consider a number of treatment modalities and few studies have examined if patient preference for, and choice of, treatment modalities affects outcome. Providing patients with the best possible care involves entering into a partnership with the patient, in which the patient and provider review treatment options and arrive at treatment strategies together. It appears that engaging the patient in treatment and fostering the patient's commitment contributes to a positive treatment outcome (e.g., motivational interviewing) (Ingersoll et al., 2005). Few studies, however, have studied the effects of treatment preference on weight loss. In a randomized trial, Renjilian et al. (2001) found that weight loss was not affected by assigning participants to their preferred or non-preferred treatment modality (group vs. individual therapy), and Burke et al. (2006) describe the design of a randomized trial that assigns participants to a preferred dietary approach, though weight loss data were not reported. To our knowledge, no study has examined: 1) the degree to which participants would change treatment modalities, if given the choice, 2) whether the number of times that people self-select different treatment options is associated with program continuation and completion, and 3) if participants choose more effective treatment options as treatment progresses. The primary aim of this study was to conduct a unique group-based weight loss program that allowed participants to choose freely among a number of treatment options on a weekly basis, and to observe the number of times that treatments were changed. All participants were provided with behavior therapy and they had the choice to add treatment options to this standard treatment regimen. It was hypothesized that participants who tried more treatment options would be more likely to complete treatment. This hypothesis was based on the following assumptions: 1) the efficacy of weight loss treatments will vary among participants, and participants who try more treatment options have a greater chance of finding one that works for them, thus increasing satisfaction with therapy and decreasing the likelihood of dropping out of treatment, 2) most participants will experience set-backs during treatment and those participants who are willing to try additional treatment options will be less likely to become discouraged and discontinue treatment, and 3) vicarious or social learning (Bandura, 1965) will allow participants to learn from the success and failure of other group members; therefore, participants will choose more successful weight loss treatments over time. …

Mail and phone interventions for weight loss in a managed-care setting: weigh-to-be 2-year outcomes

Evaluate effectiveness of weight-loss interventions in a managed care setting. Three-arm randomized clinical trial: usual care, mail, and phone intervention. Participants were 1801 overweight managed care organization (MCO) members. Measures included baseline height, weight at baseline and 24 months, self-reported weight at 18 months. Intervention and participation in other weight-related programs was monitored across 24 months. Weight losses were 2.2, 2.4, and 1.9 kg at 18 months in the mail, phone, and usual care groups, respectively. Mail and phone group weight changes were not significantly different from usual care (P<0.35). Weight losses at 24 months did not differ by condition (0.7 kg mail, 1.0 kg phone, and 0.6 kg usual care, P=0.55). Despite treatment availability over 24 months, participation diminished after 6 months. Participation was a significant predictor of outcomes in the mail and phone groups at 18 months and the mail group at 24 months. Cost-effectiveness of phone counseling was $132 per 1 kg of weight loss with mail and usual care achieving similar cost-efficiency of $72 per 1 kg of weight loss. Although mail- and phone-based weight-loss programs are a reasonably efficient way to deliver weight-loss services, additional work is needed to enhance their short- and long-term efficacy.

Media treatment of messages on weight loss products by the Association for Public Health of Quebec and its reception

The results of a study on weight loss products and services were released during a press conference organized by the Association pour la santé publique du Québec (ASPQ). The media widely covered this press conference. The purpose of this article is to answer the question: "How are messages emitted by public health institutions transmitted by the media and received by the population?" The transcripts of the press conference, the press release as well as 43 documents from the print and broadcast media were evaluated according to a press analysis method. The analysis of these documents was based on the concept of the information unit. The compilation of these information units was used to produce charts which include data such as the frequency, partiality, weight tendency ("poids-tendance") and tendency-impact ("tendance-impact"). Furthermore, two focus groups of persons using weight loss products and services were conducted. In this article, we compare the emitted message with the one transmitted. The analysis of the message emitted by the ASPQ and that conveyed by the media revealed that for almost all subjects dealt with during the press conference, the media have been more partial than the ASPQ. The media not only expanded on the emitted message but also gave a negative image of weight loss products and services. Furthermore, the message transmitted by the media was very similar to the initial message. The focus groups on how the message was received by persons using weight loss products and services also revealed that the message was lost in the flow of information on weight loss products and services. This analysis of the emitted, transmitted and received messages has given us some indications on how to readjust the initial message and on what to emphasize in future press conferences.

Medicare reform opens door for preventive nutrition services

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and recent Internal Revenue Service (IRS) rulings have made it easier for Americans to get some tax relief for weight loss and other preventive services so desperately needed. With two thirds of Americans overweight or obese and 400,000 preventable deaths annually attributed to obesity, this action by the federal government is timely. Section 1201 of the MMA added section 223 to the Internal Revenue Code to permit individuals to establish Health Savings Accounts (HSAs) for taxable years after December 31, 2003 (1). These accounts are like 401(K) investment plans but are specifically setup for health care; HSAs allow individuals to set aside pretax income for medical expenses within a calendar year and to rollover to accumulate the unused dollars to spend on future health care costs.

Overweight and obesity: helping clients to take action.

This article presents the results of a qualitative research project to explore factors that encourage or discourage overweight people from low income groups to access weight loss services. Semi-structured interviews were conducted with 16 people attending a commercial slimming organization in South Yorkshire. The study revealed weight loss decisions to be complex and fragile. The experiences reported mirror the 'stages of change' model described by Prochaska and DiClemente (1992). Triggers to action occurred cumulatively and decisions were reached gradually. The triggers included embarrassment and humiliation, health, fear, critical events and image. Disincentives to action were denial, previous bad experiences, previous failure and money. Decisions were linked to low self-esteem and confidence, making people vulnerable at the point they take action. The implications of this for nursing practice and services in primary care are considered.

Do Internet interventions for consumers cause more harm than good? A systematic review.

To systematically review the effect of consumer use of online health information on decision-making, attitudes, knowledge, satisfaction and health outcomes and utilization. Electronic databases searched included the Cochrane Controlled Trials Register, MEDLINE, PREMEDLINE (to 14 March 2001), CINAHL, Australian Medical Index, Health and Society, National Institutes of Health Clinical Trials Database and CenterWatch. All post-1995 comparative studies (including controlled studies, before and after studies, and interrupted time series analyses) of Internet users vs. non-Internet users and other communications mediums, and Internet characteristics such as e-mail vs. other communication mediums, were included. Outcomes included consumer decision-making, attitudes, knowledge, satisfaction and measurable changes in health status or health utilization. One reviewer screened all papers then two reviewers independently assessed studies against the selection criteria and any discrepancies were resolved by discussion with a third reviewer. No attempt was made to combine the data for further statistical analysis. We identified 10 comparative studies. Studies evaluated the effectiveness of using the Internet to deliver a smoking cessation programme, cardiac and nutrition educational programmes, behavioural interventions for headache and weight loss, and pharmacy and augmentative services. All studies showed some positive effects on health outcomes, although the methodological quality of many studies was poor. Despite widespread consumer Internet use to obtain health-care information, there is almost a complete lack of evidence of any effects this may have on health outcomes.

An Initial Evaluation of a Commercial Weight Loss Program: Short Term Effects on Weight, Eating Behavior, and Mood

An initial, short term evaluation of a commercial weight loss program was undertaken by comparing individuals attending Weight Watchers to individuals trying to lose weight on their own (self-help). The Weight Watchers program is of particular relevance since it is the largest provider of commercial weight loss services in the US. The self-help group served as controls, but they were also a relevant comparison group because the majority of obese people who try to lose weight do so on their own. Respondents ( n =985) to newspaper advertisements in 2 metropolitan areas were assigned at random to 4 weeks of either the Weight Watchers ® Program or to a self-help condition. Those in the Weight Watchers group were asked to attend weekly Weight Watchers meetings (free of charge). Individuals in the self-help group were instructed to use the method of their choice to lose weight, as long as they did not attend a structured weight loss program or take a prescription weight loss drug. Weight loss, psychological vitality and eating behavior were evaluated before & after the 4-week intervention. Weight Watchers participants showed significantly greater improvements on all measures; weight losses averaged 1.8 kg for the Weight Watchers group and 0.9 kg for the self-help group. Superior outcomes on measures of vitality and eating behavior were shown by Weight Watchers participants, and these outcomes were still evident when amount of weight loss was controlled. This suggests the Weight Watchers Program has psychological benefits above and apart from the greater weight losses achieved. Although this pilot study's intervention and outcome assessments were short-term, the promising results obtained suggest that longer-term studies should be undertaken.

Costs of swine diseases to producers in Ohio

Thirteen Ohio swine operations were surveyed monthly for economic and epidemiologic information during a 12-month period as part of the National Animal Health Monitoring System. The total reported costs of specific diseases averaged $18.98 per pig-year, with pneumonia accounting for 28%, followed by stillbirths 11%, overlaying 8%, scours 8%, starvation 6%, death 3%, cold exposure 3%, and mastitis 2%. Of the total reported costs, $13.32 per pig-year were costs associated with disease occurrence: deaths, culling, and stillbirths (78%), body weight loss (13%), drugs, biologicals, and veterinary services (5%), and producer labor and carcass disposal (4%). Of the $5.66 per pig-year spent on disease prevention, 90% was for drugs and biologicals, followed by producer labor (9.5%) and veterinary services (<1%). Pneumonia had the highest annual estimated prevalence (35 cases per 100 pig-years) followed by scours (18 cases per 100 pig-years), stillbirths (16 cases per 100 pig-years), and overlaying (10 cases per 100 pig-years). When preventive expenditures not attributed to a specific disease were included, the total health-related cost was $20.22 per pig-year.