Weight bias among dietetics students: implications for treatment practices. The psychological consequences of weight gain prevention in healthy, premenopausal women. A behavioral economic analysis of changes in food-related and food-free reinforcement during weight loss treatment. Evaluation of an 8-week mailed healthy-weight intervention. A preliminary controlled evaluation of an eating disturbance psychoeducational intervention for college students. Evaluation of Two Nondieting Interventions for Obese Women Psychobehavioural Factors Are More Strongly Associated with Successful Weight Management Than Predetermined Satiety Effect or Other Characteristics of Diet Characteristics of participating and nonparticipating men in a randomized, controlled diet and exercise intervention trial. Brief intervention effective in reducing weight bias in medical students. Effects of a Multidisciplinary Lifestyle Intervention for Obesity on Mental and Physical Components of Quality of Life: The Mediatory Role of Depression Evaluation of a school-based program designed to improve body image satisfaction, global self-esteem, and eating attitudes and behaviors: a replication study. An experimental test of the effect of weight-loss dieting on bulimic pathology: tipping the scales in a different direction. Patient profiling for success after weight loss surgery (GO Bypass study): An interdisciplinary study protocol Implicit and explicit affect toward food and weight stimuli in anorexia nervosa. Health promotion in individuals with mental disorders: a cluster preference randomized controlled trial The influence of physical activity-induced energy expenditure on the variance in body weight change among individuals during a diet intervention. Evaluation of a school-based teen obesity prevention minimal intervention.
BACKGROUND Several studies have examined attitudes about obesity among food and nutrition professionals , yielding mixed results , and no experimental research has tested the impact of dietitians ' attitudes on their treatment practice s or health evaluations with obese patients . OBJECTIVE This study investigated attitudes of dietetics students toward obese persons and tested whether a patient 's body weight influences students ' treatment decisions and health evaluations within a r and omized experiment . DESIGN Between the months of September and December 2007 , a convenience sample of 182 dietetics undergraduate students ( 92 % women ; mean age 23.1+/-5.4 years ) from colleges throughout the United States completed online self-report surveys to assess weight bias ( using the Fat Phobia Scale ) . Participants were also r and omly assigned to read one of four mock health profiles of patients who varied only by weight-related characteristics ( eg , obese or average weight ) and sex ( male or female ) , and asked to make judgments about the patient 's health status and participation in treatment . STATISTICAL ANALYSES PERFORMED To compare group data , multiple analysis of variance was used to test for an effect of the patient 's body mass index on participants ' health evaluations and their perceptions of patients in each of the four experimental conditions . Correlations were calculated between mean fat phobia scores and perceptions of patients . RESULTS Participants in all conditions expressed a moderate amount of fat phobia ( mean=3.7 ) , and students rated obese patients as being less likely to comply with treatment recommendations compared with nonobese patients ( P<0.05 ) . Results from multivariate analysis of variance tests showed students also evaluated obese patients ' diet quality and health status to be poorer than nonobese patients , despite equivalent nutritional and health information across weight categories for each sex in patient profiles . In contrast , obese and nonobese patients were rated to be similarly motivated , receptive , and successful in treatment . CONCLUSION Implication s of these findings for education and intervention in dietetics training are discussed , with emphasis on increasing awareness of weight bias in existing dietetics curricula OBJECTIVE This study examined the psychological consequences of a modest weight loss in a sample of healthy women aged 44 to 50 . METHOD Five hundred and thirty-five women , with body mass indices ( BMI s ) ranging from 20 to 34 , were r and omly assigned either to an intensive behavioral lifestyle intervention or to a no-treatment control group . Women in the lifestyle intervention received weight loss goals of 5 to 15 lb , depending on baseline BMI , and attended 20 weekly group meetings during which they received information on lowering dietary fat intake and increasing physical activity levels . Psychological measures administered at baseline and at a 6-month examination assessed perceived stress , mood , dietary restraint , and binge eating behaviors . RESULTS Intervention subjects showed significant decreases in depressive symptoms over time , relative to control subjects , and this effect was observed for normal-weight , as well as heavier , subjects . Binge eating scores for all subjects declined significantly over time , with heavier subjects in the intervention showing the greatest decrease in scores . DISCUSSION The current study found no evidence of negative psychological sequelae of participation in a behavioral lifestyle change program , regardless of weight status . Results further suggest that participation in these types of programs may exert a positive influence on the psychological status of both normal-weight and heavier women OBJECTIVE Behavioral economic theory predicts that reductions in consumption of highly valued commodities , such as drugs or palatable food items , are facilitated by increasing engagement in reinforcing substitutes . The current study prospect ively examines changes in engagement in and enjoyment of food versus food-free activities during an 18-month behavioral weight loss intervention . METHOD Participants were 202 overweight/obese individuals who took part in an 18-month behavioral weight loss treatment and were r and omly assigned to a traditional hypocaloric , low-fat diet condition or a traditional hypocaloric , low-fat diet plus a goal to limit variety in snack food consumption condition . At baseline and 6 , 12 , and 18 months , participants were weighed and completed a measure that assessed recent frequency of engagement in and enjoyment of a variety of both food and food-free activities . RESULTS Growth models revealed a statistically significant decrease in the relative percentage of food-related reinforcement ( vs. food-free ) over time ( reinforcement ratio , or RR ) , with the greatest reduction during the first 6 months of treatment . Food-related reinforcement decreased over time , and food-free reinforcement increased . Additionally , the RR change predicted change in body mass index ( BMI ) from 0 to 6 months and 0 to 18 months , such that greater changes in RR were associated with greater changes in BMI . CONCLUSIONS Findings suggest that behavioral weight loss treatment may promote a shift away from food-related reinforcement toward food-free reinforcement and that this change may predict BMI change . Future interventions may consider targeting increasing engagement in enjoyable food-free activities to help with long-term maintenance BACKGROUND This study investigated the impact of a low-intensity , healthy-weight intervention among adult volunteers in a low-income , inner-city neighborhood . The intervention , which comprised 18 pamphlets mailed to participants ' homes over 8 weeks , focused on increasing awareness of healthy weight ranges , increasing self-acceptance and satisfaction with weight , and improving eating habits , while downplaying dieting and weight loss . METHODS Subjects were recruited from households r and omly selected from residential telephone subscriber lists . The 188 volunteers ( 23.0 % of 816 persons contacted ) were r and omly assigned to intervention or control status . Psychosocial and behavioral measures were administered by telephone 1 week before and 2 weeks after the intervention . RESULTS After exposure to the pamphlets , intervention subjects were more likely than controls to know how to control their weight . They were more satisfied with their weight and less likely to report they were too heavy . They reported less high-fat/junk food consumption , more improvements in their eating habits , and more frequent exercise . CONCLUSION This inexpensive , low-intensity intervention was effective in supporting change processes among volunteers who wanted to learn about weight control , to improve eating habits , and to improve health OBJECTIVE Because conventional preventive interventions have had little success in reducing eating pathology , we developed and evaluated a more intensive psychoeducational intervention . METHOD Female college students who underwent this intervention and a matched control sample of students ( N = 66 ) completed pretest and posttest surveys . RESULTS Intervention participants showed significant decreases in thin-ideal internalization , body dissatisfaction , dieting , eating disorder symptoms , and weight over the 4-month study period , whereas matched control participants did not show changes in these outcomes with the exception that they gained weight . DISCUSSION These preliminary findings suggest that this intervention may prove useful in reducing eating disturbances and overweight among college students , as well as the risk factors for this serious mental and physical health problem A r and omized trial was conducted to see if there could be effective alternatives to dieting for obese women . It compared a 12-week ( I h/week ) education intervention , a 12-week ( 2 h/week ) psychoeducational intervention , and a control group on self-esteem , body dissatisfaction , and restrained eating  of obese women . Secondary variables of interest were social adjustment , symptoms of depression , scores on bulimia , and drive for thinness , weight , and blood pressure . Complete data were available at pre- and posttest time for 78 women . A MANCOVA indicated that the psychoeducation group improved over the control group on self-esteem , restraint , and body dissatisfaction . The education group did not differ statistically from the control group at posttest . Means of weight and blood pressure did not change . A nondieting approach can be beneficial to the emotional health of obese women without changing weight and blood pressure risk factors for other morbidity This study aim ed to investigate factors associated with weight management , especially whether satiety value of food as a part of a weight-maintenance diet would affect self-regulation of food intake and weight management . Altogether 82 obese subjects completed the study consisting of weight-loss and weight-maintenance ( WM ) periods . During the WM , subjects were r and omized into higher- and lower-satiety food groups . No differences were observed in the changes in body weight , energy intake , or eating behaviour between the groups , even despite the different macronutrient compositions of the diets . However , when regarding all study subjects , success in WM was most strongly associated with a greater increase in the flexible control of eating and experience of greater easiness of WM and control of food intake and a greater decrease in uncontrollable eating and psychological distress . Psychobehavioural factors seem to be more strongly associated with successful weight management than the predetermined satiety effect or other characteristics of the diet OBJECTIVE To study characteristics of importance for participation in a diet and physical exercise prevention programme . SETTING Primary Health Care , Sollentuna , and the Karolinska Hospital , Stockholm , Sweden . SUBJECTS A sample of 187 men , aged 35 - 60 , with increased risk factors for CHD , were invited to a 6-month  prevention programme .  Participants ( n = 158 ) were r and omized into a  diet group , a physical exercise group , a diet and physical exercise group , and a control group . Twenty-seven men , who declined participation , formed the group of non participants . DESIGN Participants and non participants were compared with respect to health beliefs , health knowledge , CHD risk factors , demographic and personality factors . MAIN OUTCOME MEASURES Characteristics of men participating and not participating in the intervention trial . RESULTS Non participants , compared with participants , believed less in the benefits of dietary change  and perceived the health threat of stroke and myocardial infa rct ion as less serious . Non participants had a better knowledge of a number of risk factors for cardiovascular disease . CONCLUSION Belief in treatment efficacy and perceived health threat , rather than health knowledge , predicted initial participation in a non-pharmacological intervention trial BACKGROUND Medical students are exposed to a growing number of obese patients in clinical encounters . Many medical students harbor negative attitudes and stereotypes regarding obese patients , which lead to negative interpersonal behaviors . This study pilot tested the effectiveness of an educational intervention in reducing bias toward obese patients . METHODS Second- and third-year medical students ( n=64 ) watched a 17- minute video , " Weight Bias in Health Care , " and participated in interactive discussion to share experiences with encountering obese patients . The  Beliefs About Obese Persons ( BAOP ) , Attitudes Toward Obese Persons ( ATOP ) , and Fat Phobia Scales ( FPS ) were administered before and after intervention . Change in mean scores from before to after the intervention was tested for statistical significance using the paired sample s t test . General linear models were used to examine associations of subject characteristics with mean scores for each scale . RESULTS The intervention increased beliefs that genetic and environmental factors play an important role in the cause of obesity as opposed to lack of personal control ( mean BAOP increased from 16.53 to 19.27 ) . It also decreased students ' negative stereotypes regarding obese patients ( mean FPS decreased from 3.65 to 3.45 ) . There were independent associations of subject characteristics with post-intervention ATOP scores , with more positive attitudes in younger , male , and white participants . CONCLUSIONS Implementing a short educational intervention was effective in improving medical students ' beliefs and stereotypes regarding obese patients . This widely accessible and easily replicable program can serve as a model and springboard for further development of educational interventions to reduce weight bias among medical students The current study investigates the effects of a multidisciplinary lifestyle intervention for obesity on Health Related Quality of Life ( HRQoL ) . In this study , 92 adults with obesity were weighed and completed the Short Form Health Survey ( SF–36 ) and the Center for Epidemiologic Studies Depression Scale ( CES – D ) at the baseline and at the end of a 3-month intervention . Repeated measures analysis of variance ( ANOVA ) , a series of hierarchical regressions , and the statistical mediation analysis of Baron and Kenny were conducted . ( a ) Over 3 months , changes in weight and the mental and physical scales of the SF–36 and depression were all significant . ( b ) The results indicate a significant mediation of changes in depression scores for the association between weight loss and enhancement on the General Health scale of the SF–36 . Improvements to HRQoL from a multidisciplinary lifestyle intervention seem to affect both the physical and mental components of the SF–36 score and to reduce depression , contributing to enhanced self-perceptions of well-being OBJECTIVE The purpose of the current study was to evaluate the effectiveness of a life-skills promotion program design ed to improve body image satisfaction and global self-esteem , while reducing negative eating attitudes and behaviors and feelings of perfectionism , all of which have been identified as predisposing factors to disordered eating . METHOD A total of 258 girls with a mean age of 11.8 years ( intervention group = 182 and control group = 76 ) completed question naires before , and 1 week after , the six-session school-based program , and again 6 and 12 months later . RESULTS The intervention was successful in improving body image satisfaction and global self-esteem and in reducing dieting attitude scores at post intervention only . The gains were not maintained at the 12-month follow-up . DISCUSSION The need to assess the influence of health promotion programs on predisposing risk factors , compared with problem-based outcome measures , is discussed Although it is widely accepted that dieting increases the risk for bulimic pathology , this hypothesis has not been tested in a r and omized experiment . Accordingly , the authors conducted an experimental test of the dietary restraint model by r and omly assigning nonobese women ( N = 82 ) to either a 6-week , low-calorie diet or a waitlist control condition . The diet intervention result ed in significant weight loss , confirming that dieting was successfully manipulated . Contrary to the restraint model , dieting result ed in significant decreases in bulimic symptoms relative to the control condition . Results converge with past findings from r and omized obesity prevention and treatment trials and provide evidence that dieting does not promote bulimic pathology ; rather , effective decreases in caloric intake appear to reduce bulimic symptoms Despite substantial research efforts , the mechanisms proposed to explain weight loss after gastric bypass ( RYGB ) and sleeve gastrectomy ( SL ) do not explain the large individual variation seen after these treatments . A complex set of factors are involved in the onset and development of obesity and these may also be relevant for the underst and ing of why success with treatments vary considerably between individuals . This calls for explanatory models that take into account not only biological determinants but also behavioral , affective and context ual factors . In this prospect i ve study , we recruited 47 women and 8 men , aged 25–56 years old , with a BMI of 45.8 ± 7.1 kg/m2 from the waiting list for RYGB and SL at Køge hospital , Denmark . Pre-surgery and 1.5 , 6 and 18 months after surgery we assessed various endpoints spanning multiple domains . Endpoints were selected on basis of previous studies and include : physiological measures : anthropometrics , vital signs , biochemical measures and appetite hormones , genetics , gut microbiota , appetite sensation , food and taste preferences , neural sensitivity , sensory perception and movement behaviors ; psychological measures : general psychiatric symptom-load , depression , eating disorders , ADHD , personality disorder , impulsivity , emotion regulation , attachment pattern , general self-efficacy , alexithymia , internalization of weight bias , addiction , quality of life and trauma ; and sociological and anthropological measures : sociodemographic measures , eating behavior , weight control practice s and psycho-social factors . Joining these many endpoints and method ologies from different scientific disciplines and creating a multi-dimensional predictive model has not previously been attempted . Data on the primary endpoint are expected to be published in 2018 . Trial registration Clinical trials . gov ID NCT02070081 We know strikingly little about the core affective processes that drive the development and maintenance of , and recovery from anorexia nervosa ( AN ) . To partially address this knowledge gap , we measured implicit and explicit affect toward pleasant , neutral , unpleasant , food-relevant , and weight-relevant images in three groups : in patients with acute AN , individuals recovered from AN , and healthy controls with no history of AN . Compared with the other two groups , acutely ill AN participants displayed significantly greater implicit positive affect toward pleasant images and significantly greater implicit negative affect toward unpleasant , high-calorie food , and overweight body type images .  Recovered participants did not differ significantly from controls on any implicit affect measure . Explicit affective patterns were similar to implicit , but explicit measures yielded much smaller effect sizes and failed to detect certain group differences . Overall , negative implicit affect toward high-calorie foods and overweight body types may represent core affective processes that are operative during acute AN Background The existing literature on weight management interventions targeting physical activity and healthy eating in mental health care appears to provide only limited evidence . The aim of the study was to examine the effectiveness of a 10-week health promotion intervention , followed by a 6-month follow-up period in individuals with mental disorders living in sheltered housing in the Fl and ers region ( Belgium ) . Methods The study had a cluster preference r and omized controlled design . Twenty-five sheltered housing organisations agreed to participate ( 16 in the intervention group , nine in the control group ) . In the intervention group , 225 individuals agreed to participate , while in the control group 99 individuals entered into the study . The main outcomes were changes in body weight , Body Mass Index , waist circumference and fat mass . Secondary outcomes consisted of changes in physical activity levels , eating habits , health-related quality of life and psychiatric symptom severity . Results A significant difference was found between the intervention group and the control group regarding body weight ( −0.35 vs. + 0.22 kg ; p=0.04 ) , Body Mass Index ( −0.12 vs. + 0.08 kg/m2 ; p=0.04 ) , waist circumference ( −0.29 vs. + 0.55 cm ; p<0.01 ) , and fat mass ( −0.99 vs. −0.12 % ; p<0.01 ) . The decrease in these outcomes in the intervention group disappeared during the follow up period , except for fat mass . Within the intervention group , a larger decrease in the primary outcomes was found in the participants who completed the intervention . No significant differences between the two groups in changes in the secondary outcomes were found , except for the pedometer-determined steps/day . In the intervention group , the mean number of daily steps increased , while it decreased in the control group . Conclusions The study demonstrated that small significant improvements in the primary outcomes are possible in individuals with mental disorders .  Integration of health promotion activities targeting physical activity and healthy eating into daily care are , however , necessary to maintain the promising results .Trial registration This study is registered at Clinical Trials.gov SUMMARY OBJECTIVE We investigated the relationship between the variability in body weight change among individuals and diet restriction or physical activity during a 14-week intervention . DESIGN A prospect i ve clinical trial with a 14-week weight reduction intervention design . In total , 90 middle aged , Japanese , obese women enrolled as subjects . MEASUREMENTS The outcome variable was the change in body weight during the intervention period . Other primary variables were total energy intake , carbohydrate intake , fat intake , protein intake , total energy expenditure ( TEE ) , and activity energy expenditure ( AEE ) . Diet intake  was assessed by 3 days , weighed dietary records and dietary recall interviews . Physical activity  was assessed by a uniaxial accelerometry sensor and a diary of exercise . RESULTS Significant reductions were observed in body weight ( -8.5 kg ) as a result of intervention . When the subjects were assigned to three categories depending on AEE during intervention , the loss of body weight was significantly greater for subjects within the upper ( -9.6 kg ) AEE category than for those in the middle ( -8.5 kg ) or lower AEE ( -7.5 kg ) categories . In addition , a significant correlation ( r = 0.57 , p < 0.0001 ) was observed between a subject 's AEE before and during the intervention . On the other h and , no significant correlation was observed between body weight reduction and energy intake , indicating that strict diet restriction does not always result in a large weight loss . CONCLUSION Activity energy expenditure , not only through voluntary exercise but also through spontaneous , daily , physical activities can have a positive effect on reducing body weight OBJECTIVE A school-based nutrition education minimal intervention ( MI ) was evaluated . DESIGN The design was experimental , with r and om assignment at the school level . SETTING Seven schools were r and omly assigned as experimental , and 7 as delayed-treatment . PARTICIPANTS The experimental group included 551 teens , and the delayed treatment group included 329 teens . INTERVENTION The minimal intervention was Present and Prevent , a commercially available PowerPoint program presented in two 30-minute time slots over 1 week . MAIN OUTCOME MEASURES The dependent variables were nutrition knowledge , attitudes , peer and family influences , behavioral intentions , and program satisfaction . The independent variable was group assignment . ANALYSES A matched-pairs and 2- sample t test were used respectively to assess within-group and between-group changes . RESULTS Significant experimental posttest improvements occurred in the following : knowledge ( P < .001 ) ; intention to maintain a healthy body weight because of importance to friends ( P < .001 ) ; and intention to eat fewer fried foods , eat fewer sweets , look more at food labels , and limit TV watching ( all P < .001 ) . Program satisfaction measures were significantly associated with each of the healthy weight maintenance behavioral intentions . CONCLUSIONS AND IMPLICATION S The MI teen obesity prevention program made an impact on nutrition knowledge and positive behavioral intentions in only 2 classroom sessions and was well received by participants
RESULTS Non-diet interventions result ed in statistically significant improvements in disordered eating patterns , self-esteem , and depression .
OBJECTIVE To determine the overall effect of non-diet , weight-neutral interventions on factors such as weight , biochemical measures , food and activity behavior , body image , and mental health .