Taking control of your personal eating and exercise environment: a weight maintenance program.

The current investigation examined the impact of a weight maintenance intervention (MI) designed to empower people to create a personal healthy food and physical activity environment on weight loss treatment outcomes. It was hypothesized that behavioral weight loss program (BWLP) participants who received an additional MI would evidence superior weight loss maintenance compared to participants who received a BWLP alone (no contact [NC]). Fifty-one obese adults were randomly assigned to participate in a 16-week weight loss intervention followed by NC or a 6-week MI. Thirty-eight participants completed the six-month follow-up. Body weight, percent body fat, cardiorespiratory fitness, self-reported physical activity, and self-reported diet (i.e., calories, percent daily intake of fat, protein, and carbohydrates) were assessed. Participants significantly decreased their weight, increased physical activity/fitness, and improved dietary intake (ps<.05). MI participants had significantly greater weight loss maintenance than NC participants (ps<.05). Helping obese individuals to modify their personal eating and physical activity environment in order to reduce exposure to "obesogenic" cues may contribute to long-term weight loss maintenance.

Can following the caloric restriction recommendations from the Dietary Guidelines for Americans help individuals lose weight?

BACKGROUND: The Dietary Guidelines for Americans recommend creating an energy deficit of at least 500 kcal a day to facilitate weight loss. This investigation examined the relationship between creating a consistent, self-reported energy deficit of at least 500 kcal a day and weight loss. The relationship between self-monitoring adherence and daily energy intake and expenditure and weight loss was also examined. METHODS: Fifty-four overweight or obese adults (BMI>or=27 kg/m(2)) participating in a 14-week weight loss program were given a 5% total body weight loss goal and instructed to create an energy deficit of at least 500 kcal a day to facilitate weight loss. Participants provided daily records of total energy intake and expenditure, physical activity, and weekly and overall weight loss during treatment. RESULTS: Individuals who averaged an energy deficit in excess of 500 kcal per day lost nearly four times the weight as individuals whose average energy deficit was below 500 kcal per day (p<.01). Individuals who lost 5% of their body weight during the intervention self-monitored more than twice as many days than individuals who failed to lose 5% of their body weight (p<.01). CONCLUSION: Individuals interested in losing weight should continue to be advised to regularly self-monitor energy intake and expenditure as well as to create a consistent daily energy deficit (e.g., 500 kcal day).

Using motivational interviewing as a supplement to obesity treatment: a stepped-care approach.

OBJECTIVE: This investigation was designed to improve behavioral weight loss program (BWLP) treatment outcomes by providing stepped care (SC) to individuals experiencing difficulties with weight loss during treatment. SC entails transition to more intensive treatments when less intensive treatments fail to meet treatment goals. In a BWLP, motivational interviewing (MI) may increase participants' motivation toward behavioral change and thus complement the acquisition of behavioral change skills. It was hypothesized that BWLP+SC (MI) participants (i.e., participants who failed to meet weight loss goals and received MI) would demonstrate superior treatment outcomes when compared with BWLP (SC matched) participants (i.e., participants who failed to meet weight loss goals but did not receive MI). DESIGN: Fifty-five obese, sedentary adults were randomly assigned to a BWLP+SC or a BWLP. MAIN OUTCOME MEASURES: Changes in weight, cardiorespiratory fitness, self-reported physical activity, and diet (i.e., calories, percentage daily intake of fat, protein, and carbohydrates) in response to treatment were assessed. RESULTS: Participants significantly decreased their weight, increased physical activity/fitness, and improved dietary intake (ps<.05). BWLP+SC (MI) participants lost more weight and engaged in greater weekly exercise than BWLP (SC matched) participants who did not receive MI (ps<.05). CONCLUSION: For individuals experiencing weight loss difficulties during a BWLP, MI may have considerable promise.

Skipping meals and alcohol consumption. The regulation of energy intake and expenditure among weight loss participants.

Research suggests that specific eating patterns (e.g., eating breakfast) may be related to favorable weight status. This investigation examined the relationship between eating patterns (i.e., skipping meals; consuming alcohol) and weight loss treatment outcomes (weight loss, energy intake, energy expenditure, and duration of exercise). Fifty-four overweight or obese adults (BMI> or =27 kg/m(2)) participated in a self-help or therapist-assisted weight loss program. Daily energy intake from breakfast, lunch, dinner, and alcoholic beverages, total daily energy intake, total daily energy expenditure, physical activity, and weekly weight loss were assessed. On days that breakfast or dinner was skipped, or alcoholic beverages were not consumed, less total daily energy was consumed compared to days that breakfast, dinner, or alcoholic beverages were consumed. On days that breakfast or alcohol was consumed, daily energy expenditure (breakfast only) and duration of exercise were higher compared to days that breakfast or alcohol was not consumed. Individuals who skipped dinner or lunch more often had lower energy expenditure and exercise duration than individuals who skipped dinner or lunch less often. Individuals who consumed alcohol more often had high daily energy expenditure than individuals who consumed alcohol less often. Skipping meals or consuming alcoholic beverages was not associated with weekly weight loss. In this investigation, weight loss program participants may have compensated for excess energy intake from alcoholic beverages and meals with greater daily energy expenditure and longer exercise duration.

The failure of therapist assistance and stepped-care to improve weight loss outcomes.

OBJECTIVE: This investigation was designed to examine whether: (i) individuals could successfully lose 5% of their body weight with minimal assistance, (ii) weight loss would be improved by the addition of therapist assistance, and (iii) individuals unsuccessful at losing 5% total body weight during the minimal assistance phase (with or without therapist assistance) would benefit from a weekly weight loss group. METHODS AND PROCEDURES: Fifty-four overweight or obese adults (BMI > 27 kg/m(2)) initially participated in a 14-week self-help (SH) or therapist-assisted SH (TASH) weight loss program. Participants who were unsuccessful at losing 5% total body weight were stepped-up to a 3-month, group-based behavioral weight loss program (BWLP) with weekly weigh-ins. RESULTS: Although approximately 60% of the participants were successful at losing 5% of their total body weight (lb) during the minimal assistance phase (M = 10.6; s.d. = 11.5; P < 0.01), treatment outcome was not improved by the addition of therapist assistance. For individuals who were unsuccessful at losing 5% of total body weight during a minimal assistance phase, the addition of a group-based BWLP did not improve their weight loss. DISCUSSION: While many individuals were quite successful at losing weight with minimal assistance, other individuals evidenced difficulties losing weight, even when participating in a greater intensity intervention (i.e., BWLP group).

Exercise makes you feel good, but does feeling good make you exercise?: an examination of obese dieters.

Whereas exercise-induced mood enhancement has been well documented, the relationship between mood and exercise participation is less well understood. Mood states influence evaluative judgments that could plausibly influence a decision to exercise. Further, most exercise-mood research is limited to normal weight adults in response to a single exercise session. The current investigation examines the influence of (a) morning mood on exercise, (b) exercise intensity/duration on mood enhancement, and (c) daily change in mood on exercise days compared with nonexercise days in obese behavioral weight loss program (BWLP) participants. Participants (N = 36) recorded morning, evening, and pre-and postexercise mood, as well as the type, duration, and intensity of exercise. Within-person analyses indicated that (a) morning mood was associated with an increased likelihood of exercising, (b) mood ratings were higher following exercise of greater intensity and duration, and (c) daily mood enhancement was associated with greater exercise initiation and greater exercise intensity. Measuring mood before and after exercise may yield important clinical information that can be used to promote physical activity in obese adults.