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1.
Clin Obes ; 10(6): e12406, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32885595

RESUMEN

Obesity is emerging as a risk factor for COVID-19 disease severity. The impact of the pandemic and knowledge of obesity as a risk factor on the lived experience of people with obesity is not fully understood. The aim of this study was to investigate the impact of the COVID-19 pandemic on people living with severe obesity (BMI ≥35 kg/m2 ), currently engaged in multi-modal treatment. The primary objectives were to examine the impact of the pandemic on their lived experience from a treatment and psychosocial standpoint and additionally explore their awareness of obesity as a risk factor for COVID-19 disease severity. An in-depth qualitative study was adopted employing semi-structured interviews with open-ended questions. Interpretive thematic analysis was adopted to analyse the data and identify key themes taking a grounded approach. Themes that emerged from the perspective of impact on lived experience were (a) challenge sustaining treatment and (b) psychosocial impact. There was an even split regarding awareness and lack of awareness of obesity as risk factor which itself contributes towards a negative psychosocial impact in most patients. The COVID-19 pandemic is posing a diverse challenge to people with obesity. This has implications for their on-going treatment. From an ethical standpoint, there is a need to fully elucidate the link between obesity and COVID-19, disseminate this information using people friendly language and imagery in a manner that does not exacerbate a harmful psychosocial response or lead to stigmatization.


Asunto(s)
Infecciones por Coronavirus/psicología , Conocimientos, Actitudes y Práctica en Salud , Obesidad/psicología , Neumonía Viral/psicología , Adulto , Anciano , Ansiedad , Betacoronavirus , Dieta , Ejercicio Físico , Miedo , Femenino , Humanos , Entrevistas como Asunto , Masculino , Salud Mental , Persona de Mediana Edad , Pandemias , Investigación Cualitativa , Factores de Riesgo , Estrés Psicológico
2.
PLoS One ; 15(9): e0238458, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32911507

RESUMEN

BACKGROUND: Western dietary habits, coupled with a sedentary lifestyle, are potential contributors to the prevalence and rapid increase in the incidence of obesity in Saudi Arabia. This study aimed to investigate the association between students' weight status and their eating behaviors and practices. Another aim was to assess students' awareness of the health risks associated with obesity. METHODS: A cross-sectional survey was conducted among a sample of 416 (53% male and 47% female) undergraduate students, aged 18-26 years old, between January 6 and April 6, 2019, from colleges of Health Sciences at Jazan University in the Kingdom of Saudi Arabia (K.S.A). Students completed a self-administered questionnaire and recorded their measured anthropometric parameters. RESULTS: The prevalence of overweight (20.4%) and obesity (14.9%) were relatively high among the participants. There were statistically significant associations between Body Mass Index (BMI) and the different settings of food consumption (i.e., dining on a table (or) in the Islamic way: squatting on the ground) (p<0.001)). BMI was also associated with students' dietary habits regarding consuming food, snacks, and drinking carbonated beverages while watching television (p<0.001), as well as consuming the same pattern of food/drink while watching television, playing video games on mobile phones or computers (p<0.001). Nearly most of the students were oblivious to the fact that metabolic syndrome, reproductive disorders, respiratory disorders along with liver and gallbladder diseases are some of the health risks associated with obesity. CONCLUSION: The prevalence of obesity and overweight were reasonably high in our study sample and were affected by several factors related to students' eating behaviors and practices. This warrants the need for rigorous and frequent health education interventions on healthy eating behaviors, dietary practices, with an emphasis on the importance of adopting an active, healthy lifestyle.


Asunto(s)
Conducta Alimentaria/psicología , Obesidad/psicología , Estudiantes/psicología , Adolescente , Adulto , Índice de Masa Corporal , Computadores , Estudios Transversales , Dieta/estadística & datos numéricos , Femenino , Educación en Salud , Humanos , Incidencia , Masculino , Obesidad/epidemiología , Sobrepeso/epidemiología , Prevalencia , Arabia Saudita/epidemiología , Conducta Sedentaria , Estudiantes/estadística & datos numéricos , Encuestas y Cuestionarios , Televisión , Universidades , Adulto Joven
3.
PLoS One ; 15(9): e0239402, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32997681

RESUMEN

BACKGROUND: Evidence indicates that early life is critical for determining future obesity risk. A sharper policy focus on pregnancy and early childhood could help improve obesity prevention efforts. This study aimed to systematically identify and categorise policy levers used in England with potential to influence early life course (pregnancy, 0-5 years) and identify how these interface with energy balance behaviours. The objective is to identify gaps and where further policy actions could most effectively focus. METHODS: A behavioural science approach was taken using the Capability-Opportunity-Motivation-Behaviour (COM-B) model and Behaviour Change Wheel (BCW) framework. The key determinants of energy balance in the early years were identified from the Foresight Systems Map. Policy actions were scoped systematically from available literature, including any health or non-health policies which could impact on energy balance behaviours. Foresight variables and policy actions were considered in terms of COM-B and the BCW to determine approaches likely to be effective for obesity prevention and treatment. Existing policies were overlaid across the map of key risk factors to identify gaps in obesity prevention and treatment provision. RESULTS: A wide range of policy actions were identified (n = 115) to address obesity-relevant risk factors. These were most commonly educational or guidelines relating to environmental restructuring (i.e. changing the physical or social context). Scope for strengthening policies relating to the food system (e.g. the market price of food) and psychological factors contributing to obesity were identified. Policies acted via all aspects of the COM-B model, but there was scope for improving policies to increase capability through skills acquisition and both reflective and automatic motivation. CONCLUSIONS: There is substantial policy activity to address early years obesity but much is focused on education. Scope exists to strengthen actions relating to upstream policies which act on food systems and those targeting psychological factors contributing to obesity risk.


Asunto(s)
Conductas Relacionadas con la Salud , Promoción de la Salud/métodos , Obesidad/prevención & control , Políticas , Ciencias de la Conducta , Inglaterra , Humanos , Motivación , Obesidad/psicología
4.
Ann Behav Med ; 54(10): 738-746, 2020 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-32909031

RESUMEN

BACKGROUND: Weight stigma is common for people with obesity and harmful to health. Links between obesity and complications from COVID-19 have been identified, but it is unknown whether weight stigma poses adverse health implications during this pandemic. PURPOSE: We examined longitudinal associations between prepandemic experiences of weight stigma and eating behaviors, psychological distress, and physical activity during the COVID-19 pandemic in a diverse sample of emerging adults. METHODS: Participants (N = 584, 64% female, mean age = 24.6 ± 2.0 years, mean body mass index [BMI] = 28.2) in the COVID-19 Eating and Activity over Time (C-EAT) study were cohort members of the population-based longitudinal study EAT 2010-2018. Weight stigma reported by participants in 2018 was examined as a predictor of binge eating, eating to cope, physical activity, depressive symptoms, and stress during COVID-19. Data were collected via online surveys during the U.S. outbreak of COVID-19 in 2020. RESULTS: Prepandemic experiences of weight stigma predicted higher levels of depressive symptoms (ß = 0.15, p < .001), stress (ß = 0.15, p = .001), eating as a coping strategy (ß = 0.16, p < .001), and an increased likelihood of binge eating (odds ratio = 2.88, p < .001) among young adults during the COVID-19 pandemic but were unrelated to physical activity. Although associations remained after accounting for demographic characteristics and BMI, the magnitude of longitudinal associations was attenuated after adjusting for prior levels of the outcome variables. CONCLUSIONS: Young adults who have experienced weight stigma may have increased vulnerability to distress and maladaptive eating during this pandemic. Public health messaging could be improved to support people of diverse body sizes and reduce the harmful consequences of weight stigma.


Asunto(s)
Peso Corporal , Infecciones por Coronavirus/psicología , Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Neumonía Viral/psicología , Distrés Psicológico , Estigma Social , Betacoronavirus , Ejercicio Físico/psicología , Femenino , Humanos , Estudios Longitudinales , Masculino , Obesidad/psicología , Pandemias , Adulto Joven
5.
PLoS Med ; 17(9): e1003245, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32898152

RESUMEN

BACKGROUND: Beverages, especially sugar-sweetened beverages (SSBs), have been increasingly subject to policies aimed at reducing their consumption as part of measures to tackle obesity. However, precision targeting of policies is difficult as information on what types of consumers they might affect, and to what degree, is missing. We fill this gap by creating a typology of beverage consumers in Great Britain (GB) based on observed beverage purchasing behaviour to determine what distinct types of beverage consumers exist, and what their socio-demographic (household) characteristics, dietary behaviours, and weight status are. METHODS AND FINDINGS: We used cross-sectional latent class analysis to characterise patterns of beverage purchases. We used data from the 2016 GB Kantar Fast-Moving Consumer Goods (FMCG) panel, a large representative household purchase panel of food and beverages brought home, and restricted our analyses to consumers who purchase beverages regularly (i.e., >52 l per household member annually) (n = 8,675). Six categories of beverages were used to classify households into latent classes: SSBs; diet beverages; fruit juices and milk-based beverages; beer and cider; wine; and bottled water. Multinomial logistic regression and linear regression were used to relate class membership to household characteristics, self-reported weight status, and other dietary behaviours, derived from GB Kantar FMCG. Seven latent classes were identified, characterised primarily by higher purchases of 1 or 2 categories of beverages: 'SSB' (18% of the sample; median SSB volume = 49.4 l/household member/year; median diet beverage volume = 38.0 l), 'Diet' (16%; median diet beverage volume = 94.4 l), 'Fruit & Milk' (6%; median fruit juice/milk-based beverage volume = 30.0 l), 'Beer & Cider' (7%; median beer and cider volume = 36.3 l; median diet beverage volume = 55.6 l), 'Wine' (18%; median wine volume = 25.5 l; median diet beverage volume = 34.3 l), 'Water' (4%; median water volume = 46.9 l), and 'Diverse' (30%; diversity of purchases, including median SSB volume = 22.4 l). Income was positively associated with being classified in the Diverse class, whereas low social grade was more likely for households in the classes SSB, Diet, and Beer & Cider. Obesity (BMI > 30 kg/m2) was more prevalent in the class Diet (41.2%, 95% CI 37.7%-44.7%) despite households obtaining little energy from beverages in that class (17.9 kcal/household member/day, 95% CI 16.2-19.7). Overweight/obesity (BMI > 25 kg/m2) was above average in the class SSB (66.8%, 95% CI 63.7%-69.9%). When looking at all groceries, households from the class SSB had higher total energy purchases (1,943.6 kcal/household member/day, 95% CI 1,901.7-1,985.6), a smaller proportion of energy from fruits and vegetables (6.0%, 95% CI 5.8%-6.3%), and a greater proportion of energy from less healthy food and beverages (54.6%, 95% CI 54.0%-55.1%) than other classes. A greater proportion of energy from sweet snacks was observed for households in the classes SSB (18.5%, 95% CI 18.1%-19.0%) and Diet (18.8%, 95% CI 18.3%-19.3%). The main limitation of our analyses, in common with other studies, is that our data do not include information on food and beverage purchases that are consumed outside the home. CONCLUSIONS: Amongst households that regularly purchase beverages, those that mainly purchased high volumes of SSBs or diet beverages were at greater risk of obesity and tended to purchase less healthy foods, including a high proportion of energy from sweet snacks. These households might additionally benefit from policies targeting unhealthy foods, such as sweet snacks, as a way of reducing excess energy intake.


Asunto(s)
Bebidas/economía , Comercio/tendencias , Comportamiento del Consumidor/economía , Adulto , Animales , Bebidas Endulzadas Artificialmente , Cerveza , Peso Corporal , Comportamiento del Consumidor/estadística & datos numéricos , Estudios Transversales , Agua Potable , Composición Familiar , Femenino , Jugos de Frutas y Vegetales , Humanos , Renta , Análisis de Clases Latentes , Masculino , Leche , Encuestas Nutricionales , Obesidad/psicología , Reino Unido , Vino
6.
PLoS One ; 15(9): e0239004, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32915921

RESUMEN

As the prevalence of overweight and obesity have risen over the past few decades, so have weight control attempts. Research has shown, however, that intentional weight loss results are often short-lived, with people regaining the weight over time. This can lead to weight cycling-losing and gaining weight repeatedly. Previous research, mostly done over two decades ago, concluded there was no relationship between weight cycling and psychological health. The goal of the current paper was to re-examine the relationship between weight cycling and depressive symptoms in a national sample of American adults (N = 2702; 50.7% female; mean age = 44.8 years). If, as hypothesized, there is a relationship between more frequent weight cycling and depressive symptoms, then internalized weight stigma will be examined as a potential mediator of the relationship. Results of a cross-sectional survey showed that 74.6% of adults report they have intentionally tried to lose weight. Amongst those who have tried to lose to weight, the average number of weight cycles over the lifetime was 7.82 cycles. Simultaneous regression showed that greater weight cycling was related to greater reported depressive symptoms (ß = .15, p < .001), controlling for age, gender, education, income, and body mass index. Internalized weight stigma was a partial mediator of this relationship. Discussion focuses on the potential implications for weight cycling and mental health.


Asunto(s)
Trayectoria del Peso Corporal , Depresión/etiología , Programas de Reducción de Peso , Adulto , Estudios Transversales , Depresión/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/patología , Obesidad/psicología , Sobrepeso/complicaciones , Sobrepeso/patología , Sobrepeso/psicología , Estigma Social , Encuestas y Cuestionarios , Estados Unidos , Aumento de Peso , Pérdida de Peso
7.
Artículo en Inglés | MEDLINE | ID: mdl-32854200

RESUMEN

Obesity is currently becoming a serious global public health problem due to its high prevalence and continuous increase. This condition is associated with different physical and mental health problems. The presence of emotional disorders (anxiety, depression and related disorders) among candidates for bariatric surgery is very high and predicts worse physical and psychological results. The present study aims to explore the feasibility and clinical usefulness of the Unified Protocol, a transdiagnostic emotion regulation-based intervention, delivered in an online group format to patients with emotional disorder diagnosis or symptoms, who are waiting for bariatric surgery. We will conduct a pilot study with a repeated single-case experimental design (multiple baseline design) in a public mental health service. The sample will consist of 60 participants, who will be randomized to three baseline conditions: 8, 12 or 15 evaluation days before the intervention. Diagnostic criteria, symptomatology and body mass index are the primary outcome measures, and we will include affectivity, personality, quality of life, body image, eating behavior and surgical complications like secondary measures. An analysis of treatment satisfaction will be also performed. Assessment points will include pre-treatment, baseline, treatment, post-treatment, and follow-ups every three months until two years after post-treatment. The results obtained in this study may have important clinical, social and economic implications for public mental health.


Asunto(s)
Trastornos de Ansiedad/terapia , Cirugía Bariátrica/psicología , Prestación de Atención de Salud , Trastorno Depresivo/terapia , Internet , Obesidad/psicología , Psicoterapia/métodos , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/psicología , Protocolos Clínicos , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/psicología , Emociones , Estudios de Factibilidad , Humanos , Obesidad/cirugía , Proyectos Piloto , Calidad de Vida , Proyectos de Investigación
8.
Public Health ; 186: 57-62, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32781285

RESUMEN

OBJECTIVES: Some studies reveal that socio-economic status, behavioural factors, accessibility to supermarket or food store, are associated with the prevalence of obesity and overweight. In this study, we aimed to examine to what extent socio-economic, behavioural and built environment characteristics can contribute to spatial disparities in adult obesity. STUDY DESIGN: The spatial analysis was undertaken to understand the association of spatial disparities in adult obesity and spatial disparities in socio-economic, behavioural and built environment characteristics. METHODS: A spatial regression model which can remove the impact of auto-correlation in the residuals of conventionally regression models was applied to modelling local-scale rate of adult obesity (N = 59). RESULTS: Owing to the presence of residual spatial auto-correlation in the non-spatial regression model estimated, a spatial regression model was set up successfully to model local-scale rate of adult obesity across New York City (R2 = 0.8353, N = 59). Compared with socio-economic and built environment factors, behavioural factors make statistically significant contributions to spatial disparities in the prevalence of adult obesity (POAO). Particularly, two behavioural factors ('sugary drinks consumption' and 'fruits and vegetable consumption') can explain more than 70% of the variance of POAO (adjusted R2 = 0.7323, N = 59). Surprisingly, physical activity prevalence (percent of physically active adults) makes no statistically significant contributions. CONCLUSIONS: The results further suggest that the reduction of adult obesity prevalence could benefit more from decreasing intake of sugary drinks than increasing physical activity. The local government and policy are advised to prioritise decreasing exposure of residents to sugary drinks through restricting advertising or increasing taxes rather than increasing neighbourhoods' walkability through urban planning.


Asunto(s)
Entorno Construido/estadística & datos numéricos , Obesidad/epidemiología , Sobrepeso/epidemiología , Características de la Residencia/estadística & datos numéricos , Adolescente , Adulto , Anciano , Índice de Masa Corporal , Ejercicio Físico , Conducta Alimentaria , Humanos , Persona de Mediana Edad , Ciudad de Nueva York/epidemiología , Obesidad/psicología , Sobrepeso/psicología , Prevalencia , Clase Social , Factores Socioeconómicos , Análisis Espacial , Caminata , Adulto Joven
9.
Medicine (Baltimore) ; 99(31): e21159, 2020 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-32756093

RESUMEN

Being overweight and obese is a serious public health issues in China. However, the effects of substance use and mental factors on weight changes remain unclear. In this study, we aimed to investigate the association among self-perceived stress, history of smoking and drinking, and weight status by using data from the China Health and Nutrition Survey in 2015.A total of 8028 adults were selected from China Health and Nutrition Survey in 2015. The self-reported data primarily included sociodemographic data, self-perceived stress scores, and history of smoking and drinking. Physical measurements including height and weight were logged to calculate body mass index. Multivariate and multinomial regression models were used to estimate effects of substance and perceived stress on weight status.The prevalence of underweight and overweight/obese people were 4.52% and 51.51% in Chinese adults, respectively. Adults with high perceived stress were negatively associated with being overweight and obese (OR = 0.80, 95% CI = 0.66-0.97 in the middle level and OR = 0.69, 95%CI = 0.55-0.88 in the high level). Adults with history of smoking had low risk of being overweight/obese (OR = 0.71, 95% CI = 0.62-0.82). Adults with history of drinking had high risk of overweight/obese (OR = 1.22, 95% CI = 1.06-1.40). In addition, the association between drinking and overweight/obese was affected by different levels of perceived stress (OR = 1.15, 95%CI = 0.83-1.59 in low-stress group and OR = 1.42, 95%CI = 1.04-1.94 in high-stress group).The effects of self-perceived stress and history of smoking as well as drinking on weight status were significant in this study. The government and healthcare policymakers should strengthen early psychological factor and behavioral intervention to decrease the prevalence of abnormal-weight status.


Asunto(s)
Consumo de Bebidas Alcohólicas , Obesidad/epidemiología , Fumar , Estrés Psicológico , Adulto , China/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , Obesidad/etiología , Obesidad/psicología , Prevalencia , Factores Socioeconómicos
10.
Artículo en Inglés | MEDLINE | ID: mdl-32645883

RESUMEN

Sexual minority women are disproportionately impacted by obesity yet are underrepresented in weight stigma research. This Ecological Momentary Assessment (EMA) study is a secondary analysis that aimed to elucidate the frequency and contextual characteristics of perceived experiences of lifetime and momentary weight stigma among sexual minority women with overweight/obesity. Participants were 55 sexual minority women ages 18-60 with a body mass index ≥25 kg/m2. Perceived lifetime weight stigma events were assessed at baseline. For the subsequent five days, participants used a smartphone to complete five daily, random EMA prompts assessing the frequency/characteristics of perceived weight stigma events in daily life. All participants reported at least one lifetime weight stigma event. During the EMA period, participants reported 44 momentary weight stigma events (M = 0.80), with 24% of participants reporting at least one event. During most instances of weight stigma, women perceived the stigma's cause to be their weight and another minority identity (e.g., sexual orientation). Findings showing high rates of perceived lifetime weight stigma in this sample and frequent co-occurrence of perceived weight stigma with stigma due to other marginalized identities in daily life underscore the need for future, larger studies investigating weight stigma through an intersectional lens in sexual minority women with overweight/obesity.


Asunto(s)
Obesidad/psicología , Calidad de Vida/psicología , Minorías Sexuales y de Género/psicología , Estigma Social , Prejuicio de Peso/estadística & datos numéricos , Adolescente , Adulto , Peso Corporal , Femenino , Identidad de Género , Humanos , Masculino , Persona de Mediana Edad , Sobrepeso/psicología , Minorías Sexuales y de Género/estadística & datos numéricos , Prejuicio de Peso/psicología , Adulto Joven
11.
Nutrients ; 12(7)2020 Jul 07.
Artículo en Inglés | MEDLINE | ID: mdl-32645970

RESUMEN

Our aim is evaluating the changes in weight and dietary habits in a sample of outpatients with obesity after 1 month of enforced lockdown during the COVID-19 pandemic in Northern Italy. In this observational retrospective study, the patients of our Obesity Unit were invited to answer to a 12-question multiple-choice questionnaire relative to weight changes, working activity, exercise, dietary habits, and conditions potentially impacting on nutritional choices. A multivariate regression analysis was performed to evaluate the associations among weight/BMI changes and the analyzed variables. A total of 150 subjects (91.5%) completed the questionnaire. Mean self-reported weight gain was ≈1.5 kg (p < 0.001). Lower exercise, self-reported boredom/solitude, anxiety/depression, enhanced eating, consumption of snacks, unhealthy foods, cereals, and sweets were correlated with a significantly higher weight gain. Multiple regression analyses showed that increased education (inversely, ß = -1.15; 95%CI -2.13, -0.17, p = 0.022), self-reported anxiety/depression (ß = 1.61; 0.53, 2.69, p = 0.004), and not consuming healthy foods (ß = 1.48; 0.19, 2.77, p = 0.026) were significantly associated with increased weight gain. The estimated direct effect of self-reported anxiety/depression on weight was 2.07 kg (1.07, 3.07, p < 0.001). Individuals with obesity significantly gained weight 1 month after the beginning of the quarantine. The adverse mental burden linked to the COVID-19 pandemic was greatly associated with increased weight gain.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Conducta Alimentaria/psicología , Obesidad/psicología , Pandemias/prevención & control , Neumonía Viral/prevención & control , Cuarentena/psicología , Aumento de Peso , Adulto , Betacoronavirus , Índice de Masa Corporal , Infecciones por Coronavirus/epidemiología , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Obesidad/fisiopatología , Obesidad/virología , Neumonía Viral/epidemiología , Análisis de Regresión , Estudios Retrospectivos
13.
Eur J Endocrinol ; 183(1): 1-11, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32503005

RESUMEN

Objective: Little is known about how lifestyle affects psychological well-being in overweight women with polycystic ovary syndrome (PCOS). We investigated the effects of behavioral modification on psychological well-being and the impact of well-being and personality traits on successful weight loss. Design: A 4-month randomized controlled trial with a 12-month follow-up at a University Hospital. Methods: Sixty-eight women with PCOS, aged 18 to 40 years with a BMI ≥27 kg/m2, were randomized (1:1) into a behavioral modification program (intervention) or minimal intervention (control). The outcome measures were the psychological well being index and the Swedish universities scales of personality. Results: At baseline, 60% had a global psychological well being index corresponding to severe distress and 40% to moderate distress. There was no significant change in mean global well-being score at 4 months within or between groups. However, after 4 months, the intervention group expressed less anxiety (P = .035), higher general health (P = .012) and lower depressed mood (P = .033). Anxiety and general health tended to differ between groups (P = .06, respectively) favoring intervention. In the whole population, women achieving ≥5% weight loss at 12 months (n = 18) were less anxious at baseline compared to those who had not (P = .004). Personality trait-analysis showed that the weight-loss group had higher social desirability (P = .033) and lower embitterment (P = .023). Conclusions: Psychological well-being is severely impacted in overweight women with PCOS. Behavioral modification can positively impact dimensions of well-being, although not fully significant, compared to control treatment. Personality factors could contribute to the understanding of successful weight loss.


Asunto(s)
Obesidad/psicología , Obesidad/terapia , Personalidad , Síndrome del Ovario Poliquístico/psicología , Síndrome del Ovario Poliquístico/terapia , Programas de Reducción de Peso , Adolescente , Adulto , Femenino , Humanos , Estilo de Vida , Obesidad/complicaciones , Síndrome del Ovario Poliquístico/complicaciones , Estrés Psicológico/complicaciones , Resultado del Tratamiento , Pérdida de Peso , Adulto Joven
14.
Nutr Metab Cardiovasc Dis ; 30(8): 1299-1305, 2020 07 24.
Artículo en Inglés | MEDLINE | ID: mdl-32513578

RESUMEN

BACKGROUND AND AIMS: Dietary choices are influenced by several factors including physiological, social, or genetic factors. Among these, flavor is the most important determinant modulating food preferences. The aim of the present study was to assess flavor identification abilities in patients with obesity (Ob) in comparison with matched normal weight (NW) and over-weight (OW) subjects using a specific and validated chemosensory test. METHODS AND RESULTS: The flavor test was administered to 140 Ob patients recruited in the obesity outpatient Unit at the Federico II University hospital and to the same number of NW and OW subjects matched by sex, age, and smoking habit. Flavor score (FS) inversely correlated with BMI. Median [Q1; Q3] FS was significantly higher in NW (14.5 [12; 16]) than in Ob (13 [10; 15] p < 0.001) and not significantly different from OW (14 [12; 16]) individuals. FS was also higher in OW than in Ob subjects (p < 0.005). When separated according to age quartiles, the BMI-related differences in FS were still significant in younger quartiles, while they were abolished in the older. CONCLUSIONS: BMI is a critical factor modulating flavor identification, particularly in young subjects. Further investigations are needed to explore the precise mechanism and the causal relationship between body weight and olfactory dysfunctions. CLINICALTRIAL ID: NCT03506074.


Asunto(s)
Índice de Masa Corporal , Obesidad/fisiopatología , Odorantes , Percepción Olfatoria , Reconocimiento en Psicología , Olfato , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/diagnóstico , Obesidad/psicología
15.
JAMA Netw Open ; 3(6): e206764, 2020 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-32539150

RESUMEN

Importance: Lifestyle interventions for obesity produce reductions in body weight that can decrease risk for diabetes and cardiovascular disease but are limited by suboptimal maintenance of lost weight and inadequate dissemination in low-resource communities. Objective: To evaluate the effectiveness of extended care programs for obesity management delivered remotely in rural communities through the US Cooperative Extension System. Design, Setting, and Participants: This randomized clinical trial was conducted from October 21, 2013, to December 21, 2018, in Cooperative Extension Service offices of 14 counties in Florida. A total of 851 individuals were screened for participation; 220 individuals did not meet eligibility criteria, and 103 individuals declined to participate. Of 528 individuals who initiated a 4-month lifestyle intervention, 445 qualified for randomization. Data were analyzed from August 22 to October 21, 2019. Interventions: Participants were randomly assigned to extended care delivered via individual or group telephone counseling or an education control program delivered via email. All participants received 18 modules with posttreatment recommendations for maintaining lost weight. In the telephone-based interventions, health coaches provided participants with 18 individual or group sessions focused on problem solving for obstacles to the maintenance of weight loss. Main Outcomes and Measures: The primary outcome was change in body weight from the conclusion of initial intervention (month 4) to final follow-up (month 22). An additional outcome was the proportion of participants achieving at least 10% body weight reduction at follow-up. Results: Among 445 participants (mean [SD] age, 55.4 [10.2] years; 368 [82.7%] women; 329 [73.9%] white), 149 participants (33.5%) were randomized to individual telephone counseling, 143 participants (32.1%) were randomized to group telephone counseling, and 153 participants (34.4%) were randomized to the email education control. Mean (SD) baseline weight was 99.9 (14.6) kg, and mean (SD) weight loss after the initial intervention was 8.3 (4.9) kg. Mean weight regains at follow-up were 2.3 (95% credible interval [CrI], 1.2-3.4) kg in the individual telephone counseling group, 2.8 (95% CrI, 1.4-4.2) kg for the group telephone counseling group, and 4.1 (95% CrI, 3.1-5.0) kg for the education control group, with a significantly smaller weight regain observed in the individual telephone counseling group vs control group (posterior probability >.99). A larger proportion of participants in the individual telephone counseling group achieved at least 10% weight reductions (31.5% [95% CrI, 24.1%-40.0%]) than in the control group (19.1% [95% CrI, 14.1%-24.9%]) (posterior probability >.99). Conclusions and Relevance: This randomized clinical trial found that providing extended care for obesity management in rural communities via individual telephone counseling decreased weight regain and increased the proportion of participants who sustained clinically meaningful weight losses. Trial Registration: ClinicalTrials.gov Identifier: NCT02054624.


Asunto(s)
Obesidad/psicología , Población Rural/estadística & datos numéricos , Telemedicina/estadística & datos numéricos , Pérdida de Peso/fisiología , Anciano , Enfermedades Cardiovasculares/prevención & control , Estudios de Casos y Controles , Consejo/métodos , Diabetes Mellitus/prevención & control , Correo Electrónico/instrumentación , Femenino , Florida/epidemiología , Humanos , Estilo de Vida , Cuidados a Largo Plazo/tendencias , Masculino , Persona de Mediana Edad , Manejo de Atención al Paciente/tendencias , Educación del Paciente como Asunto/métodos , Conducta de Reducción del Riesgo , Telemedicina/instrumentación , Teléfono/instrumentación
16.
Int J Public Health ; 65(5): 559-570, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32561963

RESUMEN

OBJECTIVES: This study aims to characterize the consumption of sweetened beverages (SB) among young people in Germany in terms of individual and interpersonal-environmental correlates. METHODS: A representative sample of children and adolescents from Germany was assessed twice, 6 years apart (total longitudinal sample n = 11,691 children and adolescents aged between 0 and 17 years old; weighted). The relations between individual and interpersonal-environmental factors at baseline with SB intake 6 years later were analysed using bivariate and multivariate methods. RESULTS: The majority of children and adolescents in Germany consume sweetened beverages weekly, 23% daily. SB consumption is particularly high in boys and often accompanied by other unhealthy lifestyle behaviours including a high level of tobacco and media consumption with a concurrent deficiency in fruit and vegetable consumption. Interpersonal factors associated with higher sweetened beverage consumption include low socio-economic status, tobacco consumption of parents, and older maternal age. CONCLUSIONS: Research on factors that correlate with sweetened beverage consumption is crucial to design effective interventions. Our findings underline the importance of complex, multi-level interventions to target sweetened beverage intake and obesity.


Asunto(s)
Bebidas/estadística & datos numéricos , Dieta Saludable/psicología , Dieta Saludable/estadística & datos numéricos , Encuestas Nutricionales , Obesidad/psicología , Bebidas Azucaradas/estadística & datos numéricos , Adolescente , Niño , Preescolar , Interpretación Estadística de Datos , Femenino , Alemania , Humanos , Lactante , Recién Nacido , Estudios Longitudinales , Masculino
17.
PLoS One ; 15(6): e0234355, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32555712

RESUMEN

Snacks, while widely consumed in the United States (U.S.), do not have a standard definition, complicating research to understand associations, if any, with weight status. Therefore, the purpose of this study was to examine the association between snacking frequency and weight status using various snacking definitions that exist in the scientific literature among U.S. adults (NHANES 2013-2016; ≥20y n = 9,711). Four event-based snacking definitions were operationalized including participant-defined snacks, eating events outside of meals, and operationally defined snacks based on absolute thresholds of energy consumed (>50 kcal). Weight status was examined using body mass index (BMI), waist circumference, and sagittal abdominal diameter risk. Logistic regression models examined snacking frequency and associations with weight status. Outcomes varied by the definition of a snack employed, but the majority of findings were null. Mean energy from snacks was significantly higher among women with obesity compared to women with normal weight when a snack was defined as any event outside of a typical mealtime (i.e. other than breakfast, lunch, dinner, super, brunch), regardless of whether or not it contributed ≥50 kcal. Further investigation into ingestive behaviors that may influence the relationship between snacking frequency and weight status is needed.


Asunto(s)
Conducta Alimentaria/psicología , Bocadillos/clasificación , Adulto , Índice de Masa Corporal , Peso Corporal , Dieta/psicología , Ingestión de Energía , Femenino , Humanos , Masculino , Comidas , Persona de Mediana Edad , Encuestas Nutricionales , Obesidad/psicología , Sobrepeso/psicología , Bocadillos/psicología , Estados Unidos , Circunferencia de la Cintura
18.
BMC Psychol ; 8(1): 67, 2020 Jun 25.
Artículo en Inglés | MEDLINE | ID: mdl-32586401

RESUMEN

BACKGROUND: Obesity is a multi-dimensional condition with causal factors beyond the physiological into the behavioural, dietetic and psychological. Understanding the lived experience of those who are overweight and obese and self-perceived barriers to access and engagement in intervention are imperative to formulating a systemic response to the complex problem of obesity. This study aims to identify the social, psychological and systemic factors impeding engagement with weight-loss behaviour and interventions, and to formulate a framework for responding to these. METHODS: We conducted an exploratory qualitative study using focus groups and interviews with people who have lived experienced of being overweight or obese. Data were analysed using an inductive thematic approach. Following the thematic analysis, further interpretation of the data was achieved by applying the epistemological foundations of the Lifeworld Led Care paradigm, recognising its philosophy of the person and of care based on the individual's experiences. Eight men and 17 women participated. RESULTS: Three overarching themes were identified: Complexity and Battle, Impediments, and Positive Re-orientation. The subthemes of these were found to represent the dimensions of the Lifeworld: Identify, Inter-subjectivity, Mood and Embodiment. Further interpretation of the themed data identified six polarised dichotomies representing the opposing lived dimensions of the obesity experience: Failure Double-Bind; Think-Feel Conflict; Negative-Positive Orientation; Impeding-Facilitating Health Professional; Knowledge as Deficit-Insight; and Internal-External Orientation. CONCLUSION: Obesity manifests as constraints and challenges across six polarised dichotomies, active in the lived experience of obesity. This study provides a unique way of conceptualising and understanding the complex and interacting meanings of the lived experience of obesity through the construction of polarised dichotomies. The polarities signify the oscillating experiences that people with obesity encounter, which may be either helpful or destructive in both their lifeworld experience and their capacity to address obesity towards improved social, psychological and physical outcomes. Understanding the dichotomies allows a reconceptualisation of obesity from a quantification of the individual to a more respectful, humane, compassionate and utilitarian conceptualisation of the experiencing person and the phenomenon itself. Further, these lived polarised dichotomies of obesity present the opportunity for health professionals to reconceptualise obesity in care and interventions.


Asunto(s)
Obesidad/psicología , Adulto , Anciano , Femenino , Humanos , Entrevistas como Asunto , Acontecimientos que Cambian la Vida , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Autoimagen
19.
PLoS One ; 15(6): e0235219, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32579592

RESUMEN

The obesity epidemic is a pervasive health issue affecting all population groups in developed countries. The purpose of this research was to ascertain obesity risk reduction behaviors and their psychosocial determinants in young adult Americans residing in New Jersey state. A cross-sectional survey design was implemented in which a convenience sample of 174 participants (18 to 40 years) completed a validated online self-administered questionnaire. Nineteen obesity risk reduction behaviors, self-efficacy and psychosocial constructs derived from the Theory of Planned Behavior were measured. Statistical analyses were conducted using frequency distributions, t-tests and regression analysis. Regression analysis indicated that 37.5% of the variance in obesity risk reduction behavior was accounted by self-efficacy alone. T-test comparisons indicated greater frequency of adoption of 17 health behaviors among individuals categorized in the 'high self-efficacy' group (p<0.05). These behaviors included limiting portion sizes of food, eating fruits and vegetables, engaging in physical activity, and monitoring stress and body weight. Nutrition professionals working with young adult Americans need to assess their self-efficacy to engage in obesity risk reduction behaviors. In fostering confidence in adopting these behaviors, executing skill building nutrition interventions is critical for obesity prevention.


Asunto(s)
Obesidad/patología , Conducta de Reducción del Riesgo , Autoeficacia , Adolescente , Adulto , Peso Corporal , Estudios Transversales , Grupo de Ascendencia Continental Europea , Ejercicio Físico , Conducta Alimentaria , Femenino , Humanos , Masculino , Obesidad/psicología , Estrés Psicológico , Encuestas y Cuestionarios , Estados Unidos , Adulto Joven
20.
Clin Obes ; 10(5): e12386, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32515555

RESUMEN

How the impact of the COVID-19 stay-at-home orders is influencing physical, mental and financial health among vulnerable populations, including those with obesity is unknown. The aim of the current study was to explore the health implications of COVID-19 among a sample of adults with obesity. A retrospective medical chart review identified patients with obesity from an obesity medicine clinic and a bariatric surgery (MBS) practice. Patients completed an online survey from April 15, 2020 to May 31, 2020 to assess COVID-19 status and health behaviours during stay-at-home orders. Logistic regression models examined the impact of these orders on anxiety and depression by ethnic group. A total of 123 patients (87% female, mean age 51.2 years [SD 13.0]), mean BMI 40.2 [SD 6.7], 49.2% non-Hispanic white (NHW), 28.7% non-Hispanic black, 16.4% Hispanic, 7% other ethnicity and 33.1% completed MBS were included. Two patients tested positive for severe acute respiratory syndrome coronavirus 2 and 14.6% reported symptoms. Then, 72.8% reported increased anxiety and 83.6% increased depression since stay-at-home orders were initiated. Also 69.6% reported more difficultly in achieving weight loss goals, less exercise time (47.9%) and intensity (55.8%), increased stockpiling of food (49.6%) and stress eating (61.2%). Hispanics were less likely to report anxiety vs NHWs (adjusted odds ratios 0.16; 95% CI, 0.05-0.49; P = .009). Results here showed the COVID-19 pandemic is having a significant impact on patients with obesity regardless of infection status. These results can inform clinicians and healthcare professionals about effective strategies to minimize COVID-19 negative outcomes for this vulnerable population now and in post-COVID-19 recovery efforts.


Asunto(s)
Ansiedad/psicología , Infecciones por Coronavirus/epidemiología , Depresión/psicología , Ejercicio Físico , Conducta Alimentaria/psicología , Conductas Relacionadas con la Salud , Obesidad/terapia , Neumonía Viral/epidemiología , Pérdida de Peso , Adulto , Afroamericanos/psicología , Afroamericanos/estadística & datos numéricos , Ansiedad/epidemiología , Medicina Bariátrica , Cirugía Bariátrica , Betacoronavirus , Depresión/epidemiología , Grupo de Ascendencia Continental Europea/psicología , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Hispanoamericanos/psicología , Hispanoamericanos/estadística & datos numéricos , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Obesidad/psicología , Pandemias , Estrés Psicológico/epidemiología , Estrés Psicológico/psicología , Encuestas y Cuestionarios
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