Behavior Modification In The Treatment Of Obesity

2018 ◽  
Author(s):  
Paul Davidson
Keyword(s):  
Weight Loss ◽  
Stages Of Change ◽  
Sense Of Self ◽  
Relevant Literature ◽  
Caloric Intake ◽  
Control Treatment ◽  
Patient Specific ◽  
Self Monitoring ◽  
Treatment Of Obesity ◽  
Change Stimulus

This review addresses the three most common components used in helping individuals deal with weight loss from a behavioral perspective. Relevant literature and recent findings are reviewed and summarized, showing that programs containing behavioral techniques, along with an emphasis on diet and exercise, tend to lead to improved results. Factors related to better weight loss outcomes include assessing empathically, setting reasonable goals, enhancing a sense of self-determination, seeing a patient more frequently, focusing on decreasing caloric intake, and encouraging regular physical activity. Newer technologies, such as Internet- and smartphone-based interventions, seem promising but lack sufficient research evidence at this point. It is also clear that just as reasons for weight gain are patient specific, treatments likely do best when they are more highly individualized. This review contains 3 figures, 2 tables and 33 references Key words: behavior, cognitive restructuring, decision tree, 5As, intervention, mindfulness, modification, motivation, obesity, relapse prevention, self-monitoring, stages of change, stimulus control, treatment, weight loss

Infant Obesity, Weight Reduction with Normal Increase in Linear Growth and Fat-free Body Mass

PEDIATRICS ◽  
1992 ◽  
Vol 89 (1) ◽  
pp. 143-145
Author(s):  
JOYCE M. PEIPERT ◽  
VIRGINIA A. STALLINGS ◽  
GERARD T. BERRY ◽  
JULE ANNE D. HENSTENBURG
Keyword(s):  
Weight Loss ◽  
Body Mass ◽  
Weight Maintenance ◽  
Caloric Intake ◽  
Resting Energy Expenditure ◽  
Induce Weight Loss ◽  
Infant Obesity ◽  
Normal Increase ◽  
Free Body ◽  
Treatment Of Obesity

Dietary caloric restriction, as a means to induce weight loss, is seldom used as a treatment of obesity in infancy for fear that permanent stunting of growth may result.1-4 Thus, there is little information on controlled weight loss as the treatment for infant obesity or, more importantly, its effect on growth in length, head circumference, and fat-free body mass during weight loss.5 We present a case of an obese infant who, secondary to a metabolic disorder, required nutritional support both intravenously and by nasogastric tube. During 15 months, the patient's resting energy expenditure (REE) was measured to determine an appropriate caloric intake to promote weight loss and later weight maintenance.

Endoscopic Approaches to Obesity Management

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Russell D. Dolan ◽  
Allison R. Schulman
Keyword(s):  
Metabolic Disease ◽  
Weight Loss ◽  
Small Bowel ◽  
Weight Regain ◽  
Caloric Intake ◽  
Annual Review ◽  
Publication Date ◽  
Obesity Management ◽  
Surgical Interventions ◽  
Treatment Of Obesity

The field of endoscopic bariatric and metabolic therapy has rapidly evolved from offering endoscopic treatment of weight regain following bariatric surgery to providing primary weight loss options as alternatives to pharmacologic and surgical interventions. Gastric devices and remodeling procedures were initially designed to work through a mechanism of volume restriction, leading to earlier satiety and reduced caloric intake. As the field continues to grow, small bowel interventions are evolving that may have some effect on weight loss but focus on the treatment of obesity-related comorbidities. Future implementation of combination therapy that utilizes both gastric and small bowel interventions offers an exciting option to further augment weight loss and alleviate metabolic disease. This review considers gastric devices and techniques including space-occupying intragastric balloons, aspiration therapy, endoscopic tissue suturing, and plication interventions, followed by a review of small bowel interventions including endoluminal bypass liners, duodenal mucosal resurfacing, and endoscopically delivered devices to create incisionless anastomoses. Expected final online publication date for the Annual Review of Medicine, Volume 73 is January 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

scholarly journals Experiences of Self-Monitoring in Self-Directed Weight Loss and Weight Loss Maintenance: Systematic Review of Qualitative Studies

2018 ◽  
Vol 29 (1) ◽  
pp. 124-134 ◽  
Author(s):  
Jamie Hartmann-Boyce ◽  
Anne-Marie Boylan ◽  
Susan A. Jebb ◽  
Paul Aveyard
Keyword(s):  
Systematic Review ◽  
Weight Loss ◽  
Sense Of Self ◽  
Weight Loss Maintenance ◽  
Qualitative Studies ◽  
Self Perception ◽  
Self Monitoring ◽  
Thematic Synthesis ◽  
The Impact

The experience and role of self-monitoring in self-directed weight loss attempts may be distinctly different from that within formal interventions, and has yet to be fully explored. We systematically reviewed qualitative studies to examine experiences of self-monitoring as an aid to self-directed weight loss. Thematic synthesis was used to construct descriptive and analytical themes from the available data. In all, 22 studies (681 participants) were included, in which the uses of self-monitoring ranged from an aid to increase adherence to a tool for facilitating analysis. Self-monitoring also influenced and was influenced by self-perception and emotions. Feelings of shame were linked with abandonment of efforts. Findings highlight the centrality of interpretation of self-monitored data, the implications this interpretation has on sense of self, and the impact of broader discourses. Explicitly framing self-monitoring as a positive tool with which to aid analysis may encourage helpful use of this technique.

scholarly journals Delivering a Group-Mediated Weight Loss and Activity Program to Older Adults With Chronic Pain in the MORPH Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 281-282
Author(s):  
Amber Brooks ◽  
Barbara Nicklas ◽  
W Jack Rejeski ◽  
Jason Fanning
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Weight Loss ◽  
Sedentary Behavior ◽  
Interpersonal Communication ◽  
Group Intervention ◽  
Caloric Intake ◽  
Self Monitoring ◽  
Intervention Delivery ◽  
The Impact

Abstract Chronic pain in aging is a potent cause and consequence of obesity, inactivity, and prolonged sedentary behavior, making these especially important targets for behavioral intervention. This study aimed to refine a theory-based group-mediated diet and sedentary behavior intervention for older adults with chronic pain. Participants (N=28) attended 12 weekly group meetings generally in home via WebEx and used an mHealth self-monitoring app as they attempted to move more often and reduce caloric intake. Relative to a control condition, the program produced improvements in physical function (η^2=.08), pain intensity (η^2=.12), sedentary time (η^2=.07), and weight loss (η^2=.21). Key findings related to effective remote group intervention delivery included: (1) the importance of a self-efficacy-enhancing technology orientation; (2) the value of small group bonding activities to seed communication; and (3) the impact of software choice on interpersonal communication. We will discuss the value of these findings for future remote intervention design.

scholarly journals Assessing the Contribution of Self-Monitoring Through a Commercial Weight Loss App: Mediation and Predictive Modeling Study

10.2196/18741 ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. e18741
Author(s):  
Gregory Farage ◽  
Courtney Simmons ◽  
Mehmet Kocak ◽  
Robert C Klesges ◽  
G Wayne Talcott ◽  
...  
Keyword(s):  
Weight Loss ◽  
Linear Regression ◽  
Controlled Trial ◽  
Caloric Intake ◽  
Secondary Analysis ◽  
Principal Component ◽  
Exercise Frequency ◽  
Self Monitoring ◽  
Substantial Impact ◽  
Predict Weight Loss

Background Electronic self-monitoring technology has the potential to provide unique insights into important behaviors for inducing weight loss. Objective The aim of this study is to investigate the effects of electronic self-monitoring behavior (using the commercial Lose It! app) and weight loss interventions (with differing amounts of counselor feedback and support) on 4- and 12-month weight loss. Methods In this secondary analysis of the Fit Blue study, we compared the results of two interventions of a randomized controlled trial. Counselor-initiated participants received consistent support from the interventionists, and self-paced participants received assistance upon request. The participants (N=191), who were active duty military personnel, were encouraged to self-monitor their diet and exercise with the Lose It! app or website. We examined the associations between intervention assignment and self-monitoring behaviors. We conducted a mediation analysis of the intervention assignment for weight loss through multiple mediators—app use (calculated from the first principal component [PC] of electronically collected variables), number of weigh-ins, and 4-month weight change. We used linear regression to predict weight loss at 4 and 12 months, and the accuracy was measured using cross-validation. Results On average, the counselor-initiated–treatment participants used the app more frequently than the self-paced–treatment participants. The first PC represented app use frequencies, the second represented calories recorded, and the third represented reported exercise frequency and exercise caloric expenditure. We found that 4-month weight loss was partially mediated through app use (ie, the first PC; 60.3%) and the number of weigh-ins (55.8%). However, the 12-month weight loss was almost fully mediated by 4-month weight loss (94.8%). Linear regression using app data from the first 8 weeks, the number of self–weigh-ins at 8 weeks, and baseline data explained approximately 30% of the variance in 4-month weight loss. App use frequency (first PC; P=.001), self-monitored caloric intake (second PC; P=.001), and the frequency of self-weighing at 8 weeks (P=.008) were important predictors of 4-month weight loss. Predictions for 12-month weight with the same variables produced an R2 value of 5%; only the number of self–weigh-ins was a significant predictor of 12-month weight loss. The R2 value using 4-month weight loss as a predictor was 31%. Self-reported exercise did not contribute to either model (4 months: P=.77; 12 months: P=.15). Conclusions We found that app use and daily reported caloric intake had a substantial impact on weight loss prediction at 4 months. Our analysis did not find evidence of an association between participant self-monitoring exercise information and weight loss. As 12-month weight loss was completely mediated by 4-month weight loss, intervention targets should focus on promoting early and frequent dietary intake self-monitoring and self-weighing to promote early weight loss, which leads to long-term success. Trial Registration ClinicalTrials.gov NCT02063178; https://clinicaltrials.gov/ct2/show/NCT02063178

scholarly journals Assessing the Contribution of Self-Monitoring Through a Commercial Weight Loss App: Mediation and Predictive Modeling Study (Preprint)

2020 ◽  
Author(s):  
Gregory Farage ◽  
Courtney Simmons ◽  
Mehmet Kocak ◽  
Robert C Klesges ◽  
G Wayne Talcott ◽  
...  
Keyword(s):  
Weight Loss ◽  
Linear Regression ◽  
Controlled Trial ◽  
Caloric Intake ◽  
Secondary Analysis ◽  
Principal Component ◽  
Exercise Frequency ◽  
Self Monitoring ◽  
Substantial Impact ◽  
Predict Weight Loss

BACKGROUND Electronic self-monitoring technology has the potential to provide unique insights into important behaviors for inducing weight loss. OBJECTIVE The aim of this study is to investigate the effects of electronic self-monitoring behavior (using the commercial <i>Lose It!</i> app) and weight loss interventions (with differing amounts of counselor feedback and support) on 4- and 12-month weight loss. METHODS In this secondary analysis of the Fit Blue study, we compared the results of two interventions of a randomized controlled trial. Counselor-initiated participants received consistent support from the interventionists, and self-paced participants received assistance upon request. The participants (N=191), who were active duty military personnel, were encouraged to self-monitor their diet and exercise with the Lose It! app or website. We examined the associations between intervention assignment and self-monitoring behaviors. We conducted a mediation analysis of the intervention assignment for weight loss through multiple mediators—app use (calculated from the first principal component [PC] of electronically collected variables), number of weigh-ins, and 4-month weight change. We used linear regression to predict weight loss at 4 and 12 months, and the accuracy was measured using cross-validation. RESULTS On average, the counselor-initiated–treatment participants used the app more frequently than the self-paced–treatment participants. The first PC represented app use frequencies, the second represented calories recorded, and the third represented reported exercise frequency and exercise caloric expenditure. We found that 4-month weight loss was partially mediated through app use (ie, the first PC; 60.3%) and the number of weigh-ins (55.8%). However, the 12-month weight loss was almost fully mediated by 4-month weight loss (94.8%). Linear regression using app data from the first 8 weeks, the number of self–weigh-ins at 8 weeks, and baseline data explained approximately 30% of the variance in 4-month weight loss. App use frequency (first PC; <i>P</i>=.001), self-monitored caloric intake (second PC; <i>P</i>=.001), and the frequency of self-weighing at 8 weeks (<i>P</i>=.008) were important predictors of 4-month weight loss. Predictions for 12-month weight with the same variables produced an <i>R</i><sup>2</sup> value of 5%; only the number of self–weigh-ins was a significant predictor of 12-month weight loss. The <i>R</i><sup>2</sup> value using 4-month weight loss as a predictor was 31%. Self-reported exercise did not contribute to either model (4 months: <i>P</i>=.77; 12 months: <i>P</i>=.15). CONCLUSIONS We found that app use and daily reported caloric intake had a substantial impact on weight loss prediction at 4 months. Our analysis did not find evidence of an association between participant self-monitoring exercise information and weight loss. As 12-month weight loss was completely mediated by 4-month weight loss, intervention targets should focus on promoting early and frequent dietary intake self-monitoring and self-weighing to promote early weight loss, which leads to long-term success. CLINICALTRIAL ClinicalTrials.gov NCT02063178; https://clinicaltrials.gov/ct2/show/NCT02063178

scholarly journals Examination of Nutrition Literacy and Quality of Self-monitoring in Behavioral Weight Loss

2018 ◽  
Vol 52 (9) ◽  
pp. 809-816 ◽  
Author(s):  
Diane L Rosenbaum ◽  
Margaret H Clark ◽  
Alexandra D Convertino ◽  
Christine C Call ◽  
Evan M Forman ◽  
...  
Keyword(s):  
Weight Loss ◽  
Caloric Intake ◽  
Secondary Analysis ◽  
Behavioral Weight Loss ◽  
Food Record ◽  
Obese Adults ◽  
Baseline Measure ◽  
Self Monitoring ◽  
Session Attendance

Abstract Background Few have examined nutrition literacy (i.e., capacity to process and make informed nutritional decisions) in behavioral weight loss. Nutrition literacy (NL) may impact necessary skills for weight loss, contributing to outcome disparities. Purpose The study sets out to identify correlates of NL; evaluate whether NL predicted weight loss, food record completion and quality, and session attendance; and investigate whether the relations of race and education to weight loss were mediated by NL and self-monitoring. Methods This is a secondary analysis of 6-month behavioral weight loss program in which overweight/obese adults (N = 320) completed a baseline measure of NL (i.e., Newest Vital Sign). Participants self-monitored caloric intake via food records. Results NL was lower for black participants (p < .001) and participants with less education (p = .002). Better NL predicted better 6-month weight loss (b = −.63, p = .04) and food record quality (r = .37, p < .001), but not food record completion or attendance (ps > 0.05). Black participants had lower NL, which was associated with poorer food record quality, which adversely affected weight loss. There was no indirect effect of education on weight loss through NL and food record quality. Conclusions Overall, results suggest that lower NL is problematic for weight loss. For black participants, NL may indirectly impact weight loss through quality of self-monitoring. This might be one explanation for poorer behavioral weight loss outcomes among black participants. Additional research should investigate whether addressing these skills through enhanced treatment improves outcomes. Clinical trial information NCT02363010.

Abstract 399: Addressing Weight Goals In Patients With Coronary Artery Disease: A Dilemma At Resident Physician Clinic

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Sana Ahmad ◽  
Rosaline Ma ◽  
Rebecca Mazurkiewicz
Keyword(s):  
Weight Loss ◽  
Chart Review ◽  
Caloric Intake ◽  
Retrospective Chart Review ◽  
Specific Weight ◽  
Normal Weight ◽  
Resident Physician ◽  
Patient Specific ◽  
Missed Opportunities ◽  
Increased Risk

Background: Adults diagnosed as overweight (BMI 25-29.9 kg/m 2 ) or obese (BMI ≥30 kg/m 2 ) are at increased risk of ASCVD, heart failure, and atrial fibrillation compared with those of a normal weight. According to the 2011 ACC/AHA guidelines for secondary prevention of CAD, BMI should be assessed at every visit and clinicians should consistently encourage weight loss to their patients by promoting exercise, caloric intake and formal behavioral programs. Objective: To evaluate whether residents are following the 2011 ACC/AHA guidelines by identifying patients with CAD that are overweight/obese and counseling them regarding weight loss. Methods: We performed a retrospective chart review of patients with known diagnosis of CAD from January 2019-June 2019 at Lenox Hill Medical Associates. The inclusion criteria for this study was patients of all ages with a known diagnosis of CAD and BMI ≥ 25 who had at least 1 annual physical exam performed and had an assigned resident physician. We excluded patients who only visited the clinic for acute visits. We reviewed progress notes to see if patients’ weights were addressed and whether there was a plan discussed with the patient regarding weight loss. A survey was sent to PGY1-PGY3 residents to identify barriers to weight management. Results: Between January 2019-June 2019, a total of 87 patients with CAD and BMI ≥ 25 were evaluated in clinic. Out of these patients, only 23% (20 of 87) had their BMI addressed during the visit and most notes (12/20) did not document a weight loss plan for patients. For those patients who received weight loss counseling, 13 out of 20 of them had BMI above 35. Based on an anonymous survey sent to PGY1-PGY3 residents, only 19% (7 of 36) residents reported that they addressed patients' weight at an annual visit. More than 60% of our residents identified time as the biggest barrier to accomplishing weight goals in CAD patients. Conclusion: This retrospective chart review showed that less than a quarter of our patients with the diagnosis of CAD and BMI ≥25 had their weight addressed during their visits at our resident physician clinic. Overall, patients with a higher BMI were more likely to be identified as obese with a higher likelihood of getting counseled on weight loss. Based on our survey, the biggest barrier to counseling patients is time. Due to these missed opportunities of educating our patients on weight goals, we are increasing their risk of complications in the future. We are currently developing time efficient strategies to help residents improve the process of educating and documenting patient specific weight loss plans.

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