Weight Management Goals Research Articles

Effect of Self-Care Education Designed Based on Bandura’s Self-efficacy Model on Patients with Hypertension: A Randomized Clinical Trial

Background: Self-care in patients with hypertension can be improved through education and implementation of learning theories. Aim: The present study aimed to determine the effect of educating self-care in patients with hypertension through the implementation of Bandura’s self-efficacy model. Method: A randomized controlled clinical trial was conducted on 60 patients with hypertension who visited a randomly selected group of health centers in Mashhad, Iran, during 2017. The intervention group participated in a self-efficacy training program designed based on the self-efficacy theory in the form of four 45-minute weekly sessions. The control group received the routine treatment provided by community health centers. Self-care was measured with the questionnaire of self-care in patients with hypertension at three stages of before the intervention, immediately after the intervention, and one month later. Data were analyzed in SPSS (version 16) software using repeated measures ANOVA. Results: The mean ages were reported at 62.0±6.9 and 59.3±9.2 in the intervention and control groups, respectively. The repeated measures ANOVA showed significant differences between the two groups after the intervention in terms of adherence to medication regimen (P=0.004), engagement in physical activity (P=0.002), adherence to weight management goals (P=0.006). Significant differences were observed between the two groups in terms of their total self-care score immediately after the intervention and one month later (P=0.002). Implications for Practice: The use of Bandura’s self-efficacy theory can improve the self-care in patients with hypertension. Therefore, it is recommended to conduct further studies to examine the long-term effects of training programs based on this theory on the self-care behaviors of patients with hypertension.

Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report.

This Consensus Report is intended to provide clinical professionals with evidence-based guidance about individualizing nutrition therapy for adults with diabetes or prediabetes. Strong evidence supports the efficacy and cost-effectiveness of nutrition therapy as a component of quality diabetes care, including its integration into the medical management of diabetes; therefore, it is important that all members of the health care team know and champion the benefits of nutrition therapy and key nutrition messages. Nutrition counseling that works toward improving or maintaining glycemic targets, achieving weight management goals, and improving cardiovascular risk factors (e.g., blood pressure, lipids, etc.) within individualized treatment goals is recommended for all adults with diabetes and prediabetes. Though it might simplify messaging, a “one-size-fits-all” eating plan is not evident for the prevention or management of diabetes, and it is an unrealistic expectation given the broad spectrum of people affected by diabetes and prediabetes, their cultural backgrounds, personal preferences, co-occurring conditions (often referred to as comorbidities), and socioeconomic settings in which they live. Research provides clarity on many food choices and eating patterns that can help people achieve health goals and quality of life. The American Diabetes Association (ADA) emphasizes that medical nutrition therapy (MNT) is fundamental in the overall diabetes management plan, and the need for MNT should be reassessed frequently by health care providers in collaboration with people with diabetes across the life span, with special attention during times of changing health status and life stages (1–3). This Consensus Report now includes information on prediabetes, and previous ADA nutrition position statements, the last of which was published in 2014 (4), did not. Unless otherwise noted, the research reviewed was limited to those studies conducted in adults diagnosed with prediabetes, type 1 diabetes, and/or type 2 diabetes. Nutrition therapy for children with diabetes or women …

Adolescents' self-perceived and actual weight: Which plays a dominant role in weight loss behaviour in Lebanon?

The decision to lose weight among adolescents is complex and is guided by a number of body-related factors. This study examined the extent of agreement between actual weight, measured as body mass index, and self-perceived weight and assessed their relative importance in weight loss behaviour among Lebanese adolescents. Data on 278 adolescents aged 13-17years were drawn from the nationwide Nutrition and Non-Communicable Disease Risk Factor Survey (Lebanon, 2009). Binary multivariable logistic regressions were conducted to test associations with "effort to lose weight" as the outcome variable, controlling for a number of potential confounders. Close to 36% reported trying to lose weight. Around 21% and 13% were overweight and obese, respectively, and 40% and 10% perceived their weight as slightly high and very high, respectively. Inaccurate perceivers, those underestimating or overestimating their weight, constituted 39%, with overall percent agreement between actual and self-perceived weight being 60.8% (kappa statistic=0.319, 95% CI [0.242, 0.396]). About a third of the overweight adolescents (30.5%) and more than half of the obese (56.8%) underestimated their weight. In the multivariable analysis, self-perceived weight was statistically significant and a stronger predictor of weight loss effort than body mass index (adjusted odds ratios=14.42 and 6.42 for slightly high and very high perceived weight, respectively, compared to odds ratios=1.47 and 2.31 for overweight and obese adolescents, respectively). Health professionals need to consider self-perceived weight in conjunction with actual weight in their pursuit of weight management goals and in planning prevention programmes that guide weight loss behaviours for adolescents.

Weight management: A concept analysis.

There is a need to develop sound healthcare practices where patients and providers are able to succeed in meeting weight management goals. The aim of this analysis is to develop a better understanding the concept of weight management. Obesity is a rapidly growing healthcare issue, reaching epidemic levels around the world. According to the World Health Organization, the current incident rate of obesity makes it the leading risk for death across the globe. Walker and Avant's model for concept analysis. A literature search was accomplished using Cumulative Index to Nursing and Allied Health, Health Source: Nursing Academic Edition, Medline, and ProQuest Health and Medical Complete. Keywords included weight management, weight control, weight loss, obesity, weight, and management. Weight management is complex concept. Strategies to develop successful weight management programs need to be multifaceted to have impact on this healthcare crisis. The critical attributes for weight management are dietary measures, physical activity, behavior modification, motivation, education, and lifelong changes. Unsuccessful weight management results in metabolic disorders and increased risk of mortality. Successful weight management practices include the prevention of weight gain, weight loss, and maintenance of ideal body weight.

Expectations for Treatment in Pediatric Weight Management and Relationship to Attrition.

Attrition in pediatric weight management negatively impacts treatment outcomes. A potentially modifiable contributor to attrition is unmet family expectations. This study aimed to evaluate the association between adolescent and parent/guardian treatment expectations and attrition. A prospective, nonrandomized, uncontrolled, single-arm pilot trial was conducted among 12 pediatric weight management programs in the Children's Hospital Association's FOCUS on a Fitter Future collaborative. Parents/guardians and adolescents completed an expectations/goals survey at their initial visit, with categories including healthier food/drinks, physical activity/exercise, family support/behavior, and weight management goals. Attrition was assessed at 3 months. From January to August 2013, 405 parents/guardians were recruited and reported about their children (203 adolescents, 202 children <12 years). Of the 203 adolescents, 160 also self-reported. Attrition rate was 42.2% at 3 months. For adolescents, greater interest in family support/behavior skills was associated with decreased odds of attrition at 3 months [odds ratio (OR) 0.75, 95% confidence interval (CI) 0.57-0.98, p = 0.04]. The more discordant the parent/adolescent dyad responses in this category, the higher the odds of attrition at 3 months (OR 1.36, 95% CI 1.04-1.78, p = 0.02). Weight loss was an important weight management goal for both adolescents and parents. For adolescents with this goal, the median weight-loss goal was 50 pounds. Attrition was associated with adolescent weight-loss goals above the desired median (50% above the median vs. 28% below the median, p = 0.02). Assessing initial expectations may help tailor treatment to meet families' needs, especially through focus on family-based change and realistic goal setting. Clinicaltrials.gov NCT01753063.

Assessment of Weight Management Practices among Adults in the United Arab Emirates.

With a rise in global incidence of overweight and obesity, the number of patients seeking weight management (WM) advice is likely to increase. Our aim was to explore the prevalence of WM practices and investigate association of WM goals with sociodemographic variables and practices among United Arab Emirates (UAE) adults. An exploratory, cross-sectional research was conducted on 1275 adult males and females, residing in UAE. A structured questionnaire was administered. WM goals to lose/maintain/gain weight were reported in 88.3% participants. WM goals were significantly associated with age, sex, marital status, education, current body weight perception, and medical condition. Out of 21 selected WM practices, popular strategies included increasing physical activity (52.9%), eating less fat (51.1%), consuming fewer calories (43.3%), joining gym (27.5%), skipping meals (26.1%), and consuming natural herbs and teas (20.7%). Visiting dietitian (12.3%) ranked ninth in the order of preference. Males focused on physical activity, gyms, and wellness centers and females on calories counting, dietitian visits, meals replacement, skipping meals, and natural herbs/teas. Married adults reported eating less fat (54.3% versus 47.3%, p = 0.020); singles opted calories counting, gyms, and meals replacement. Frequent referral sources were friends (37.8%) and Internet (32.1%). Most UAE adults had WM goals that were associated with sociodemographic variables and WM practices. Awareness about the ill-effects of unhealthy WM practices and importance of dietitian's consultation are imperative.

Body Appraisal, Weight Management Goals, and Well-Being Among Midlife Men and Women

In this paper, we assess the extent to which subjective and objective body appraisals relate to weight management goals and ultimately to life satisfaction in midlife men and women. The sample consisted of 141 midlife men and women (aged 55–59) from the Foley Longitudinal Study of Adulthood. We used both logistic and hierarchical linear regressions to examine relationships among and between variables. Both men and women expressed similar levels of body appraisal, and similar weight management goals; lower body appraisal and the presence of a weight management goal were both related to lower well-being. This study suggests that subjective and objective body appraisals may motivate the setting of weight management goals, and are significant contributors to well-being in midlife. Results are discussed in the context of aging, as well as gender.

Meeting Weight Management Goals: The Role of Partner Confirmation

ABSTRACTSocial support research suggests romantic partners could play a vital role in the success of individuals’ weight management (WM) efforts, but contradictory findings from previous research have impeded our understanding of how romantic partners influence weight management goal attainment. Employing a confirmation perspective, overweight participants (body mass index [BMI] greater than 25) who were actively trying to manage their weight (N = 53) were asked to respond to daily questionnaires for a period of 2 weeks regarding their interactions with their romantic partner. Diet, exercise, and general weight management goal accomplishment were assessed. HLM was employed to assess the independent and interactive effects of partner acceptance and challenge on each of these goals. Findings suggest that perceiving high levels of both acceptance and challenge from partners was associated with more general WM and diet goal accomplishment. However, greater attainment of exercise goals was associated with only challenge. Fluctuations in partner acceptance and challenge were also examined to determine whether consistency in confirmation behaviors was associated with WM goals. Hierarchical regressions revealed that fluctuations in acceptance, but not challenge, were linked with goal attainment. Specifically, fluctuations in acceptance were helpful for those whose partners were perceived to exhibit lower levels of acceptance, but fluctuations were detrimental for those whose partners exhibited greater acceptance. Implications for communication among couples in which one partner is attempting to lose weight are discussed.

Effects of parent-only childhood obesity prevention programs on BMIz and body image in rural preteens

This experiment compared body image (BI) and BMI changes resulting from two parent-only obesity prevention interventions aimed at 8–12 year olds. Parents in the experimental intervention attended ten face-to-face educational sessions, while parents in the minimal (control) intervention received similar mailed information. Parent-child dyads (N=150) were semi-randomly assigned to intervention groups. Children were assessed before, after, and 6 months following the interventions; children did not attend experimental intervention sessions. Child BI assessments included weight and size perception, weight management goals, body esteem, and appearance attitudes. Significant effects included small decreases in BMIz scores and overweight dissatisfaction, as well as improvements in aspects of body esteem and appearance attitudes. Some BI effects were gender-specific. Decreases in overweight dissatisfaction were greater following the experimental treatment. Neither treatment reduced body size misperception. Thus, parent-only obesity prevention interventions can reduce body weight and body image concerns among rural preteens.

Overweight Perception: Associations with Weight Control Goals, Attempts, and Practices among Chinese Female College Students

BackgroundConcurrent with the dramatic cultural and economic shifts occurring as mainland China becomes increasingly “Westernized,” the weight perceptions, ideal body weight, and weight management goals and practices of Chinese females have also undergone significant changes. ObjectiveTo investigate relationships between overweight status, weight perception patterns, and weight management goals and practices in Chinese female college students. Design/participants/settingA cross-sectional analysis was conducted with data from 902 female subjects aged 18 to 25 years participating in the China Seven Cities Study, a health promotion and smoking prevention study conducted in mainland China in 2003. Main outcome measures/statistical analysesLogistic regression models were used to explore associations between overweight status, weight perception, specific weight management goals and practices, and current levels of vigorous-intensity physical activity and food consumption. ResultsBased on World Health Organization standards for Asian adults, 16.7% of college females were overweight or obese, although 50.8% considered themselves to be “too heavy.” Among participants perceiving themselves as overweight (n=458), 69.2% (n=371) were inaccurate and did not meet criteria for overweight or obese. The percentage of participants attempting weight loss was 48.2%, and 33.1% wanted to maintain their current weight. Attempts to lose or maintain weight were related to actual and perceived weight status, but not to increased vigorous-intensity physical activity or fruit and vegetable intake, nor to decreased consumption of sweets, soda, Western fast foods, and fried foods. Only 21.5% of participants desiring weight loss or maintenance reported using a combination of vigorous-intensity physical activity and a reduced-fat and -calorie diet, whereas 20.2% tried extreme methods such as fasting, using diet pills, vomiting, or smoking. ConclusionsOur findings underscore the need to promote healthy weight management practices among Chinese female college students, with an emphasis on diet and physical activity strategies that encourage balance rather than extremes.

A Psychophysiological Mechanism Underlying Women's Weight-Management Goals: Women Desire and Strive for Greater Weight Loss Near Peak Fertility.

Three studies demonstrated that conception risk was associated with increased motivations to manage weight. Consistent with the rationale that this association is due to ovulatory processes, Studies 2 and 3 demonstrated that it was moderated by hormonal contraceptive (HC) use. Consistent with the rationale that this interactive effect should emerge when modern appearance-related concerns regarding weight are salient, Study 3 used a 14-day diary to demonstrate that the interactive effects of conception risk and HC use on daily motivations to restrict eating were further moderated by daily motivations to manage body attractiveness. Finally, providing evidence that this interactive effect has implications for real behavior, daily fluctuations in the desire to restrict eating predicted daily changes in women's self-reported eating behavior. These findings may help reconcile prior inconsistencies regarding the implications of ovulatory processes by illustrating that such implications can depend on the salience of broader social norms.

Stevia, Nature's Zero-Calorie Sustainable Sweetener: A New Player in the Fight Against Obesity.

Stevia is a plant native to South America that has been used as a sweetener for hundreds of years. Today, zero-calorie stevia, as high-purity stevia leaf extract, is being used globally to reduce energy and added sugar content in foods and beverages. This article introduces stevia, explaining its sustainable production, metabolism in the body, safety assessment, and use in foods and drinks to assist with energy reduction. The article also summarizes current thinking of the evidence for the role of nonnutritive sweeteners in energy reduction. Overall, stevia shows promise as a new tool to help achieve weight management goals.

Associations of Physical Activity and Sedentary Behaviors with Dietary Behaviors among US High School Students.

Background. Physical activity (PA), sedentary behaviors, and dietary behaviors are each associated with overweight and obesity among youth. However, the associations of PA and sedentary behaviors with dietary behaviors are complex and not well understood. Purpose. To describe the associations of PA and sedentary behaviors with dietary behaviors among a representative sample of US high school students. Methods. We analyzed data from the 2010 National Youth Physical Activity and Nutrition Study (NYPANS). Using logistic regression models which controlled for sex, race/ethnicity, grade, body weight status, and weight management goals, we compared dietary behaviors among students who did and did not meet national recommendations for PA and sedentary behaviors. Results. Students who participated in recommended levels of daily PA (DPA) and muscle strengthening PA (MSPA) were more likely than those who did not to eat fruits and vegetables. Students who exceeded recommended limits for television (TV) and computer/video game (C/VG) screen time were less likely than those who did not to consume fruits and vegetables and were more likely to consume fast food and sugar-sweetened beverages. Conclusions. Researchers may want to address PA, sedentary behaviors, and dietary behaviors jointly when developing health promotion and obesity prevention programs for youth.

Reduce temptation or resist it? Experienced temptation mediates the relationship between implicit evaluations of unhealthy snack foods and subsequent intake

A more negative implicit evaluation of unhealthy food stimuli and a more positive implicit evaluation of a weight-management goal have been shown to predict lower consumption of unhealthy food. However, the associations between these evaluations, temptation to indulge and consumption of unhealthy food remain unclear. The current study investigated whether temptation would mediate the relationship between implicit food and goal evaluations and consumption (resembling an antecedent-focused route to self-control of eating), or whether those evaluations would moderate the relationship between temptation and consumption (resembling a response-focused route). A sample of 156 women (17–25 years), who tried to manage their weight through healthy eating, completed two implicit association tasks assessing implicit food and goal evaluations, respectively. Intake of four energy-dense snack foods was measured in a task disguised as a taste test, and participants reported the strength of experienced temptation to indulge in the snacks offered. Negative implicit food evaluation was associated with lower snack intake, and temptation mediated this relationship. Implicit goal evaluation was unrelated to both temptation strength and snack consumption. The findings contribute to an understanding of how negative implicit unhealthy food evaluation relates to lower consumption, namely through the mediation of temptation to indulge in those foods.

The effect of non-caloric sweeteners on cognition, choice, and post-consumption satisfaction

Consumers often turn to non-caloric sweeteners (NCS) as a means of promoting a healthy body weight. However, several studies have now linked their long-term use to increased weight gain, raising the question of whether these products produce unintended psychological, physiological, or behavioral changes that have implications for weight management goals. In the following, we present the results of three experiments bearing on this issue, testing whether NCS-consumption influences how individuals think about and respond to food. Participants in each of our three experiments were randomly assigned to consume a sugar-sweetened beverage, an unsweetened beverage, or a beverage sweetened with NCS. We then measured their cognition (Experiment 1), product choice (Experiment 2), and subjective responses to a sugar-sweetened food (Experiment 3). Results revealed that consuming NCS-sweetened beverages influences psychological processes in ways that – over time – may increase calorie intake.

Trends in weight management goals and behaviors among 9th-12th grade students: United States, 1999-2009.

To examine trends in weight management goals and behaviors among U.S. high school students during 1999-2009. Data from six biennial cycles (1999-2009) of the national Youth Risk Behavior Survey were analyzed. Cross-sectional, nationally representative samples of 9th-12th grade students (approximately 14,000 students/cycle) completed self-administered questionnaires. Logistic regression models adjusted for grade, race/ethnicity, and obesity were used to test for trends in weight management goals and behaviors among subgroups of students. Combined prevalences and trends differed by sex and by race/ethnicity and weight status within sex. During 1999-2009, the prevalence of female students trying to gain weight decreased (7.6-5.7 %). Among female students trying to lose or stay the same weight, prevalences decreased for eating less (69.6-63.2 %); fasting (23.3-17.6 %); using diet pills/powders/liquids (13.7-7.8 %); and vomiting/laxatives (9.5-6.6 %) for weight control. During 1999-2009, the prevalence of male students trying to lose weight increased (26.1-30.5 %). Among male students trying to lose or stay the same weight, the prevalence of exercising to control weight did not change during 1999-2003 and then increased (74.0-79.1 %) while the prevalence of taking diet pills/powders/liquids for weight control decreased (6.9-5.1 %) during 1999-2009. Weight management goals and behaviors changed during 1999-2009 and differed by subgroup. To combat the use of unhealthy weight control behaviors, efforts may be needed to teach adolescents about recommended weight management strategies and avoiding the risks associated with unhealthy methods.

Resisting temptation of unhealthy food: interaction between temptation-elicited goal activation and self-control

Counteractive control theory suggests that the cognitive accessibility of a goal in response to a temptation cue predicts self-regulation of behaviour consistent with that goal. The current study provided a novel test of this effect in the eating domain, exploring the moderating role of trait self-control. A sample of 124 women (18–25 years) completed a lexical decision task to assess cognitive accessibility of the weight-management goal after food temptation priming. Eating self-regulation was operationalised as unhealthy snack food intake measured in a task disguised as a taste-test. Participants completed trait self-control and temptation experience intensity measures. Cognitive accessibility predicted lower food intake, but only among high self-control participants. The relationship was mediated by temptation experience intensity: participants with high cognitive accessibility felt less tempted, and subsequently ate less food. Results suggest that changing the processes underlying the temptation experience, rather than the cognitive accessibility of a goal may more effectively enhance self-regulation among low self-control individuals.

Association of Body Mass Index and Mortality After Acute Ischemic Stroke

The prevalence of severe obesity is rising in the United States. Although mild to moderately elevated body mass index (BMI) is associated with reduced mortality after acute ischemic stroke, less is known about severe obesity. Patients with acute ischemic stroke (n=1791) ≥45 years were identified from the biethnic population-based Brain Attack Surveillance in Corpus Christi (BASIC) study from June 1, 2005, to December 31, 2010. Median follow-up was 660 days. BMI was abstracted from the medical record. Survival was estimated by BMI category (underweight, normal weight, overweight, class 1 obesity, class 2 obesity, and severe obesity) using Kaplan-Meier methods. Hazard ratios for the relationship between BMI modeled continuously and mortality were estimated from Cox regression models after adjustment for patient factors. The median BMI was 27.1 kg/m(2) (interquartile range, 23.7-31.2 kg/m(2)), and 56% were Mexican American. A total of 625 patients (35%) died during the study period. Persons with higher baseline BMI had longer survival in unadjusted analysis (P<0.01). After adjustment for demographics, stroke severity, and stroke and mortality risk factors, the relationship between BMI and mortality was U shaped. The lowest mortality risk was observed among patients with an approximate BMI of 35 kg/m(2), whereas those with lower or higher BMI had higher mortality risk. Severe obesity is associated with increased poststroke mortality in middle-aged and older adults. Stroke patients with class 2 obesity had the lowest mortality risk. More research is needed to determine weight management goals among stroke survivors.

Clinical Practice Guidelines for Healthy Eating for the Prevention and Treatment of Metabolic and Endocrine Diseases in Adults: Cosponsored by the American Association of Clinical Endocrinologists/The American College of Endocrinology and the Obesity Society Executive Summary

J. Michael Gonzalez-Campoy, MD, PhD, FACE1; Sachiko T. St. Jeor, PhD, RD2; Kristin Castorino, DO3; Ayesha Ebrahim, MD, FACE4; Dan Hurley, MD, FACE5; Lois Jovanovic, MD, MACE6; Jeffrey I. Mechanick, MD, FACP, FACN, FACE, ECNU7; Steven M. Petak, MD, JD, MACE, FCLM8; Yi-Hao Yu, MD, PhD, FACE9; Kristina A. Harris10; Penny Kris-Etherton, PhD, RD11; Robert Kushner, MD12; Maureen Molini-Blandford, MPH, RD13; Quang T. Nguyen, DO14; Raymond Plodkowski, MD15; David B. Sarwer, PhD16; Karmella T. Thomas, RD17

Predicting Psychological Needs and Well‐Being of Individuals Engaging in Weight Management: The Role of Important Others

Using the self-determination theory (SDT) framework, we examined how significant others might support or thwart psychological needs of people with weight management goals, and in turn might affect their psychological well-being and weight control behaviors. Longitudinal design with three sets of questionnaires administered over a 6-month period. One hundred and fifty-six eligible participants (age = 31.01 ± 13.21 years) were asked to complete questionnaires of SDT-based constructs, weight management behaviors, and psychological well-being. Hypotheses were tested using Bayesian path analysis. Perceived autonomy support from significant others was related to psychological need satisfaction, while controlling behaviors by others were associated with need thwarting. In turn, need satisfaction was associated with some beneficial outcomes such as life satisfaction, and need thwarting was related to some maladaptive outcomes such as higher levels of depressive symptoms and increases in unhealthy diet behaviors. Our findings indicate that the quality of interactions between individuals engaged in weight management and their significant others matters in terms of predicting the psychological needs and well-being of the former.