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1.
Z Psychosom Med Psychother ; 65(3): 224-238, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31476994

RESUMO

App-controlled feedback devices can support sustainability of weight loss. Multicentre QUANT-study shows additional weight loss and gain of QoL via multiple feedback-devices in OPTIFAST®52-program Objective: Are three app-controlled feedback devices, tested against a simple pedometer in a weight reduction program, supporting sustainable therapy success and quality of life (QoL)? Methods: In this multi-centre randomised controlled study adults with obesity (n = 89, m = 46.5 years, women n = 54), achieved high weight loss (from 42.7 kg/m² to 35.2 kg/m²) while completing the first three month of the OPTIFAST®52-program. Thereafter the intervention group (IG) used feedback devices (BIA scale, blood pressure monitor, step counter), the control group a mechanical pedometer without app for another year. Intention-to-treat analysis (ITT) and As-treated analysis (AT) were carried out. Results: Feedback devices had a positive effect on fat-loss and secondary study objectives like QoL, leading to a better sustainability of these improvements. Participants in IG (AT for t2-t0) had improvements for Waist-to-Height-ratio (WHtR) and physically and mentally quality of life. Conclusion: The results are presumably based on an increase in self-efficacy and the experience of control. Future studies should be preceded by a pilot study to analyse acceptance problems.


Assuntos
Manutenção do Peso Corporal , Retroalimentação , Aplicativos Móveis , Obesidade/terapia , Qualidade de Vida , Perda de Peso , Programas de Redução de Peso/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
2.
Anim Sci J ; 90(7): 870-879, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31099149

RESUMO

Three experiments were carried out to determine the crude protein requirements for maintenance (CPm) and weight gain (CPg) of meat quail and to develop protein-requirement prediction models. Experiment 1 was conducted to determine CPm by the nitrogen-balance technique. The regression of nitrogen balance on nitrogen intake revealed a CPm requirement of 2.94 g/kg0.75 /day. Experiment 2 was aimed at determining CPm by the comparative-slaughter technique. Retained nitrogen (RN) and nitrogen intake (NI) were quantified considering the metabolic weight of the birds. The linear regression of RN on NI provided a CPm estimate of 6.63 g/kg0.75 /day. Experiment 3 was conducted to determine CPg. The regression of body nitrogen from the carcasses on fasted body weight revealed CPg estimates of 407.68 (0-7 days), 501.76 (8-14 days), 470.40 (0-14 days), 517.44 (15-21 days), 627.20 (22-28 days), 423.36 (29-35 days), and 517.44 mg/g (15-35 days). The protein-requirement prediction models developed for meat quail aged 0-7, 8-14, 0-14, 15-21, 22-28, 29-35, and 15-35 days were CP = 2.94.W0.75  + 0.408.G; CP = 2.94.W0.75  + 0.502.G; CP = 2.94.W0.75  + 0.470.G; CP = 2.94.W0.75  + 0,517.G; CP = 2.94.W0.75  + 0.627.G; CP = 2.94.W0.75  + 0.423.G; CP = 2.94.W0.75  + 0.517.G, respectively, where: W0.75  =  metabolic weight (kg), and G =  daily weight gain (g).


Assuntos
Fenômenos Fisiológicos da Nutrição Animal/fisiologia , Dieta/veterinária , Proteínas na Dieta/administração & dosagem , Modelos Estatísticos , Necessidades Nutricionais , Codorniz/fisiologia , Fatores Etários , Ração Animal , Animais , Manutenção do Peso Corporal , Proteínas na Dieta/metabolismo , Nitrogênio/metabolismo , Fatores de Tempo , Ganho de Peso
4.
Clin Obes ; 9(3): e12309, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30977293

RESUMO

Patient-centred care is an essential component of high-quality health care, shown to improve clinical outcomes and patient satisfaction, and reduce costs. While there are several authoritative models of obesity pathophysiology and treatment algorithms, a truly patient-centred model is lacking. We describe the development of a patient-centric obesity model. A disease-illness framework was selected because it emphasizes each patient's unique experience while capturing biomedical aspects of the disease. Model input was obtained from an accumulation of research including contributions from experts in obesity and patient-reported outcomes, qualitative research with adults living in the United States, and two targeted literature searches. The model places the patient with obesity at its core and links pathologic imbalances of energy intake and expenditure to environmental, sociodemographic, psychological, behavioural, physiological and medical health determinants. It highlights relationships between obesity signs and symptoms, comorbid conditions, impacts on health-related quality of life, and some barriers to obesity management that must be considered to attain better outcomes. Providers need to evaluate patients holistically, understand what changes each patient is motivated to make, and recognize what challenges might impede weight reduction, improvements in comorbid conditions, signs and symptoms, and health-related quality of life before pursuing individualized treatment goals. Patients living with obesity who do lose weight perceive benefits beyond weight loss. Ideally, this model will increase awareness of the complex, heterogeneous impacts of obesity on patients' well-being and recognition of obesity as a chronic disease, and prompt a call to action among stakeholders to improve quality of care.


Assuntos
Obesidade/psicologia , Obesidade/terapia , Assistência Centrada no Paciente/métodos , Manutenção do Peso Corporal , Ingestão de Energia , Humanos , Modelos Teóricos , Obesidade/metabolismo , Obesidade/fisiopatologia , Assistência Centrada no Paciente/economia , Pesquisa Qualitativa , Qualidade de Vida , Estados Unidos , Perda de Peso , Programas de Redução de Peso
6.
J Occup Health ; 61(2): 189-196, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30734418

RESUMO

OBJECTIVES: Worksite-based programs present a simple and effective approach to facilitate weight reduction in employees. Despite the importance of 1-year weight loss maintenance, studies have generally focused on the short-term effects of weight reduction programs. In addition, little is known about the long-term weight maintenance outcomes in Asian populations. We examined the long-term maintenance effects of a worksite-based weight reduction program among Japanese men with cardiovascular risk factors. METHODS: The study sample comprised 58 overweight men with cardiovascular risk factors who had voluntarily participated in a randomized crossover trial involving a 3-month weight reduction program. Participants were followed up for 1 year after the trial concluded, and both groups were merged for the analysis. We compared the changes in body weight before the post-trial follow-up and after 12 months to examine the long-term maintenance effects of the program. Changes in other cardiovascular risk factors (eg, waist circumference, blood pressure, lipid measures, and diabetes-related measures) were also examined. RESULTS: Both groups of study participants achieved weight loss during the weight reduction program. Total 53 participants (91.4%) completed the 12-month post-trial follow-up. There were no significant changes in mean body weight (mean: -0.11, 95% confidence interval: -0.7-0.49 kg) and other cardiovascular risk factors between the beginning and end of the follow-up period. CONCLUSIONS: This study showed that the worksite-based weight reduction program not only enabled short-term weight loss, but that the participants were able to successfully maintain their weight for 1 year after the program without any supplementary interventions.


Assuntos
Manutenção do Peso Corporal , Doenças Cardiovasculares/prevenção & controle , Doenças Profissionais/prevenção & controle , Sobrepeso/terapia , Programas de Redução de Peso/métodos , Adulto , Doenças Cardiovasculares/etiologia , Estudos Cross-Over , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/etiologia , Avaliação de Resultados (Cuidados de Saúde) , Sobrepeso/complicações , Sobrepeso/fisiopatologia , Avaliação de Programas e Projetos de Saúde , Fatores de Tempo , Local de Trabalho
7.
J Am Assoc Nurse Pract ; 31(4): 236-244, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30681653

RESUMO

BACKGROUND AND OBJECTIVES: Obesity prevalence rates for adults are at an all-time high. This systematic review of the literature aimed to examine the practice patterns of nurse practitioners (NPs) related to weight management in primary care and recommend future areas of research as it relates to the diagnosis and management of patients with obesity by NPs. DATA SOURCES: The databases CINAHL PLUS with Full Text, Cochrane Central Register of Controlled Trials, ERIC, MEDLINE, PsycINFO, and SPORTDiscuss were searched. CONCLUSIONS: The initial search resulted in 169 articles. Fifteen peer-reviewed articles from 13 studies were included in the analysis. Four themes emerged from the analysis: approach to practice; the practitioner's role within the interdisciplinary team; communication; and resources and tools. IMPLICATIONS FOR PRACTICE: This review was conducted to better understand the challenges and facilitators to the management of patients with obesity in primary care. Future research between NPs and variables related to obesity are necessary to further identify areas for education, training, and policy development.


Assuntos
Manutenção do Peso Corporal , Profissionais de Enfermagem/estatística & dados numéricos , Padrões de Prática em Enfermagem/tendências , Atenção Primária à Saúde/métodos , Promoção da Saúde/métodos , Humanos , Profissionais de Enfermagem/normas , Relações Enfermeiro-Paciente , Obesidade/terapia
8.
Nutr J ; 18(1): 3, 2019 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-30634981

RESUMO

There is not much evidence about how diet strictness during weekends and holidays influence long-term weight loss maintenance. Our aim was to examine how dieting more or less strictly during weekends and holidays (vs. weekdays and non-holiday periods) influence weight loss maintenance.Participants (n = 108) from the Portuguese Weight Control Registry indicated whether they had a more or less strict diet regimen during weekends compared to weekdays. A similar question about holiday and non-holiday period' diet regimen was answered. Weight and height were measured at baseline and 1y follow-up. A 3% maximum weight variation defined participants as "non-regainers".General level on dieting strictness on weekends vs. weekdays (r = - 0.28, p < 0.01) and holidays vs. non-holidays (r = - 0.33, p < 0.001) predicted 1y weight change.Participants who reported being less strict on weekends (OR = 0.34, 95% CI: 0.15-0.81) were more likely to be non-regainers when compared with the ones who reported being more strict on weekends. Non-significant results were found during holidays (OR = 0.47, 95% CI: 0.20-1.09).Adopting a less strict diet regimen during weekends, when compared to weekdays, was a behavioral strategy associated with long-term weight management in our sample.


Assuntos
Manutenção do Peso Corporal , Dieta , Férias e Feriados , Perda de Peso , Adulto , Índice de Massa Corporal , Dieta/psicologia , Dieta/estatística & dados numéricos , Feminino , Seguimentos , Comportamentos Relacionados com a Saúde , Férias e Feriados/psicologia , Férias e Feriados/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Portugal , Sistema de Registros , Perda de Peso/fisiologia , Programas de Redução de Peso/estatística & dados numéricos
9.
J Am Assoc Nurse Pract ; 31(5): 309-318, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30681652

RESUMO

BACKGROUND AND PURPOSE: The purpose of this study was to identify whether or not sleep behaviors mediated bioecological predictors of weight-related behaviors among college students. METHODS: This descriptive, quantitative, cross-sectional study, guided by Bronfenbrenner's bioecological model, examined bioecological characteristics and path analysis to assess model fit. CONCLUSIONS: The fit indices indicated excellent fit of the final model to the data (χ (24) = 30.33, p = .17, root-mean-square error approximation = 0.04, comparative fit index = 0.96, standardized root-mean-square residual = 0.03). Sleep duration mediated significant bioecological predictors of weight-related behaviors, but sleep quality did not. Having children significantly predicted increased sugar-sweetened beverage (SSB) consumption and decreased physical activity (PA) among college students. Conversely, eating the majority of meals at home significantly predicted decreased consumption of SSBs and increased PA. IMPLICATIONS FOR PRACTICE: Findings support inclusion of sleep duration and use of the bioecological model, when providing patient-centered healthcare focused on weight-related behaviors and weight management in college students.


Assuntos
Manutenção do Peso Corporal/fisiologia , Sono/fisiologia , Estudantes de Enfermagem/psicologia , Adolescente , Adulto , Índice de Massa Corporal , Estudos Transversais , Comportamento Alimentar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Sono-Vigília/complicações , Transtornos do Sono-Vigília/psicologia , Universidades/organização & administração
10.
Eat Behav ; 32: 60-64, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30594109

RESUMO

Identifying predictors of increases in weight (or in fat mass) is important for understanding the genesis of obesity and for the design of prevention programs. We examined the predictive utility of 6 variables that have been predictive of weight gain in past research: depression, disinhibition, family history of overweight, body dissatisfaction, self-reported dieting and weight suppression (the difference between highest past and current weight). Percentage fat gain was evaluated with DEXA. We tested these variables as predictors of fat gain two years later in 294 female first-year students who were selected to have characteristics associated with future weight gain. Participants were categorized as weight stable or weight gainers at the two-year follow-up and logistic regression was used to evaluate the independent predictive ability of the 6 variables. Baseline body fat was entered as a covariate and predicted fat gain, as expected. The only significant predictor of the 6 tested was weight suppression, with those gaining weight showing greater weight suppression at baseline. Previous research has supported weight suppression as a robust predictor of future weight gain mostly among individuals with eating disorders. The current study indicates that weight suppression is a predictor of long-term fat gain among nonclinical female first-year students who were overwhelmingly in a healthy weight range.


Assuntos
Tecido Adiposo , Manutenção do Peso Corporal , Estudantes/estatística & dados numéricos , Ganho de Peso , Adulto , Feminino , Seguimentos , Humanos , Obesidade/prevenção & controle , Fatores de Risco , Universidades , Adulto Jovem
11.
Rev Bras Enferm ; 71(suppl 6): 2604-2611, 2018.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30540034

RESUMO

OBJECTIVE: To determine the influence of socio-demographic characteristics in the self-care of people with heart failure (HF). METHOD: Cross-sectional, analytical study, held in three private hospitals in Fortaleza, Ceará, Brasil, with 57 hospitalized patients. The data were collected through a demographic characterization form and a self-care assessment scale and were analyzed with inferential statistics, using mean comparison tests. RESULTS: Self-care was best assessed in people with higher education level, higher household income and in a relationship. CONCLUSION: The socio-demographic characteristics influenced seven self-care practices: dietary control; monitoring of body weight; effort in labor activities; knowledge about HF; up-to-date vaccination record; leisure activities; and family and social support network with strong bonds. The higher prevalence of answers indicating satisfactory self-care practices among the patients occurred in the areas of health promotion and tolerance to stress.


Assuntos
Insuficiência Cardíaca/psicologia , Autocuidado , Fatores Socioeconômicos , Adulto , Idoso , Idoso de 80 Anos ou mais , Manutenção do Peso Corporal , Brasil , Estudos Transversais , Exercício/psicologia , Comportamento Alimentar/psicologia , Feminino , Alfabetização em Saúde/normas , Insuficiência Cardíaca/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Apoio Social , Vacinação/métodos , Vacinação/psicologia
12.
Mil Med Res ; 5(1): 43, 2018 12 24.
Artigo em Inglês | MEDLINE | ID: mdl-30591077

RESUMO

BACKGROUND: Research has been conducted to assess the effectiveness of weight management, dietary and physical activity interventions in military settings. However, a recent and comprehensive overview is lacking. The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition, dietary behaviors, and physical activity among active-duty military personnel. METHODS: PubMed, PsycInfo, and CINAHL were searched on the 17th of November 2017 to identify interventions that promoted diet and/or physical activity among active-duty military personnel. Studies were included if they assessed outcomes related to anthropometric measurements, dietary behaviors, or fitness/physical activity levels. There were no restrictions regarding publication date, follow-up duration, and sex. After screening, a total of 136 studies were eligible. Of these studies, 38 included an educational and/or behavioral change component, and 98 had only physical or fitness training as part of basic military training. Only studies that included an educational and/or behavioral change component were assessed for quality using the Effective Public Health Practice Project tool and included in the qualitative synthesis of the results. RESULTS: Based on consistent evidence from studies that were rated as moderate or strong, there is good evidence that military weight management interventions are effective in improving body composition for durations of up to 12 months. Effective interventions are more likely to be high intensity (have a greater number of sessions), are more often delivered by specialists, and use theoretical base/behavioral change techniques and a standardized guideline. Dietary interventions can potentially reduce total fat and saturated fat intake. Dietary interventions that target the kitchen staff and/or increase the availability of healthy food are more likely to be effective in the short term. The results regarding military physical fitness interventions were inconclusive. CONCLUSION: Despite limitations such as the diversity and heterogeneity of the included interventions, outcome measurements, and follow-up duration, this systematic review found good evidence that weight management interventions are effective, especially in terms of weight loss. More studies are needed to acquire solid evidence for effectiveness for durations longer than 12 months and to identify key components of the effective dietary and physical activity educational and/or behavioral change interventions, especially in countries outside Europe and the US.


Assuntos
Manutenção do Peso Corporal/fisiologia , Exercício/psicologia , Comportamento Alimentar/psicologia , Militares/psicologia , Exercício/fisiologia , Humanos , Militares/educação
13.
Stud Health Technol Inform ; 252: 158-163, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30040699

RESUMO

Obesity has become a public concern all over the world and weight management is of interest to consumers. Heavy intake of food and lack of exercise are the foremost factors for obese condition. Self-management programs are essential for the prevention and treatment of obesity and weight management. Mobile health (m-Health) applications for weight management can be a useful tool in monitoring behaviour and self-management programs, thus engaging consumers in lifestyle changes to mitigate the risk of obesity. The aim of this review is to identify and compare the features supported in mHealth applications for weight management.


Assuntos
Aplicativos Móveis , Obesidade/terapia , Telemedicina , Manutenção do Peso Corporal , Exercício , Humanos , Estilo de Vida
14.
Exerc Sport Sci Rev ; 46(4): 262-270, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30052546

RESUMO

The long-term efficacy of bariatric surgery is not entirely clear, and weight regain and diabetes relapse are problems for some patients. Exercise is a feasible and clinically effective adjunct therapy for bariatric surgery patients. We hypothesize that exercise is also a critical factor for long-term weight loss maintenance and lasting remission of type 2 diabetes.


Assuntos
Cirurgia Bariátrica , Diabetes Mellitus Tipo 2/prevenção & controle , Exercício , Obesidade/cirurgia , Perda de Peso , Manutenção do Peso Corporal , Terapia Combinada , Humanos , Recidiva , Resultado do Tratamento , Ganho de Peso
15.
Clin Obes ; 8(4): 258-264, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29852523

RESUMO

Having access to a scale is essential for individuals to engage in self-weighing; however, few studies examine scale access, particularly among low-income individuals. Our objectives were to (i) determine how many public housing residents have access to a scale and (ii) describe their self-weighing habits. We conducted a cross-sectional survey of public housing residents in Baltimore, MD, from August 2014 to August 2015. Participants answered questions about their access to a scale ('yes'/'no') and daily self-weighing habits ('no scale/never or hardly ever' vs. 'some/about half/much of the time/always'). We used t-tests or chi-square tests to examine the association of scale access with respondent characteristics. Overall, 266 adults participated (48% response rate). Mean age was 45 years with 86% women, 95% black and 54% with obesity. Only 32% had access to a scale; however, 78% of those with this access reported engaging in some self-weighing. Residents who lacked access to a scale were younger (P = 0.03), and more likely to be unemployed/disabled (P = 0.01) or food insecure (P < 0.01). While few public housing residents have access to a scale, those who do report daily self-weighing with some regularity. Financial hardship may influence scale access in this population, as potential proxies of this status were associated with no scale access.


Assuntos
Manutenção do Peso Corporal , Acesso aos Serviços de Saúde , Habitação Popular , Pesos e Medidas/instrumentação , Adulto , Idoso , Índice de Massa Corporal , Estudos Transversais , Feminino , Hábitos , Humanos , Masculino , Pessoa de Meia-Idade , Pobreza , Habitação Popular/economia , Recursos Humanos
16.
Int J Qual Stud Health Well-being ; 13(1): 1487762, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29947301

RESUMO

PURPOSE: Losing weight and keeping it off for the long term is difficult. Weight regain is common. Experiences of successful non-surgical weight loss after severe obesity are largely unexplored. We know little about long-term weight loss processes, and how health care services can be of help to those living them. METHODS: Drawing on in-depth interviews of 8 women and 2 men, the aim of this phenomenological study is to describe the experiences of adults who have been severely obese, who have lost weight and maintained weight loss for the long term (>5 years). RESULTS: Findings show that after severe obesity, sustained weight loss has no endpoint, yet is always easy to end. Keeping weight off means committing to oneself, continuing profound changes and cultivating sensitivity towards oneself and others. A phenomenological understanding of sustained weight loss can inform professionals who deal with health issues and challenges occurring in the life of people leaving severe obesity.


Assuntos
Adaptação Psicológica , Atitude , Manutenção do Peso Corporal , Obesidade Mórbida/psicologia , Autocuidado , Autogestão , Perda de Peso , Adulto , Cirurgia Bariátrica , Imagem Corporal , Existencialismo , Feminino , Serviços de Saúde , Humanos , Intenção , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/cirurgia , Obesidade Mórbida/terapia , Qualidade de Vida , Inquéritos e Questionários , Adulto Jovem
17.
Clin Obes ; 8(3): 203-210, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29683555

RESUMO

We aimed to describe the current state of specialist obesity services for adults with clinically severe obesity in public hospitals in Australia, and to analyse the gap in resources based on expert consensus. We conducted two surveys to collect information about current and required specialist obesity services and resources using open-ended questionnaires. Organizational level data were sought from clinician expert representatives of specialist obesity services across Australia in 2017. Fifteen of 16 representatives of current services in New South Wales (n = 8), Queensland (n = 1), Victoria (n = 2), South Australia (n = 3), and the Australian Capital Territory (n = 1) provided data. The composition of services varied substantially between hospitals, and patient access to services and effective treatments were limited by strict entry criteria (e.g. body mass index 40 kg/m2 or higher with specific complication/s), prolonged wait times, geographical location (major cities only) and out-of-pocket costs. Of these services, 47% had a multidisciplinary team (MDT), 53% had an exercise physiologist/physiotherapist, 53% had a bariatric surgeon and 33% had pharmacotherapy resources. Key gaps included staffing components of the MDT (psychologist, exercise physiologist/physiotherapist) and access to publicly funded weight loss pharmacotherapy and bariatric surgery. There was consensus on the need for significant improvements in staff, physical infrastructure, access to services, education/training in obesity medicine and targeted research funding. Based on the small number of existing, often under-resourced specialist obesity services that are located only in a few major cities, the vast majority of Australians with clinically severe obesity cannot access the specialist evidence based treatments needed.


Assuntos
Acesso aos Serviços de Saúde , Serviços de Saúde , Hospitais Públicos , Obesidade Mórbida/terapia , Especialização , Programas de Redução de Peso , Adulto , Atitude do Pessoal de Saúde , Austrália , Cirurgia Bariátrica , Índice de Massa Corporal , Manutenção do Peso Corporal , Cidades , Consenso , Exercício , Pessoal de Saúde , Recursos em Saúde , Humanos , Equipe de Assistência ao Paciente , Fisioterapeutas , Inquéritos e Questionários , Perda de Peso
18.
Obesity (Silver Spring) ; 26(5): 895-902, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29687649

RESUMO

OBJECTIVE: Weight loss maintenance is one of the biggest challenges in behavioral weight loss programs. The present study aimed to examine metabolic influences on the mesolimbic reward system in people with successful and unsuccessful long-term weight loss maintenance. METHODS: Thirty-three women with obesity at least 6 months after the completion of a diet were recruited: seventeen women were able to maintain their weight loss, whereas sixteen showed weight regain. Using functional magnetic resonance imaging in combination with the assessment of appetite-regulating hormones, neural reward processing during hunger and satiety was investigated. An incentive delay task was employed to investigate the expectation and receipt of both food-related and monetary reward. RESULTS: Only participants with successful weight loss maintenance showed a satiety-induced attenuation of brain activation during the receipt of a food-related reward. Furthermore, in successful weight loss maintenance, the attenuation of active ghrelin levels was related to brain activation in response to food-related reward anticipation during satiety. CONCLUSIONS: The findings suggest that an attenuated influence of satiety signaling on the neural processing of food-related reward contributes to unsuccessful weight loss maintenance. Thus, intact satiety signaling to the mesolimbic reward system may serve as a promising target for tackling weight cycling.


Assuntos
Manutenção do Peso Corporal/fisiologia , Imagem por Ressonância Magnética/métodos , Obesidade/fisiopatologia , Adulto , Feminino , Humanos , Masculino , Recompensa
19.
Clin Obes ; 8(3): 211-225, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29689646

RESUMO

In the UK, over one-quarter of the adult population have obesity (body mass index ≥30 kg m-2 ). This has major implications for patients' health and the National Health Service. Despite published studies showing that significant weight loss can be achieved and maintained in primary care, and guidance from the National Institute for Health and Care Excellence, weight management services are inconsistently implemented. This may be due primarily to workload and financial constraints. There is also a lack of belief that specialist weight management services and anti-obesity medications (AOMs) are a viable alternative to bariatric surgery for long-term maintenance of weight loss. This article discusses the challenges facing obesity management and explores the reasons for the lack of investment in AOMs in the UK to date. The aim of this article is to identify whether the newer AOMs, such as naltrexone/bupropion and liraglutide 3.0 mg, are likely to perform better in a real-world setting than current or withdrawn AOMs. In addition, it considers whether the equitable provision of specialist weight management services and future clinical trial design could be improved to help identify those individuals most likely to benefit from AOMs and, thus, improve outcomes for people with obesity in the UK.


Assuntos
Fármacos Antiobesidade/uso terapêutico , Manutenção do Peso Corporal , Serviços de Saúde , Obesidade/tratamento farmacológico , Perda de Peso , Cirurgia Bariátrica , Bupropiona/uso terapêutico , Humanos , Estilo de Vida , Liraglutida/uso terapêutico , Naltrexona/uso terapêutico , Atenção Primária à Saúde , Especialização , Medicina Estatal , Reino Unido , Programas de Redução de Peso
20.
Eat Behav ; 29: 91-98, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29549864

RESUMO

OBJECTIVES: To assess factors associated with successful weight maintenance over ten years in a prospective general population sample of young adults. MATERIAL AND METHODS: Our study comprised 2452 women and 2227 men born in 1975-1979 (mean age at baseline 24 years, attrition 27.1%). Weight maintenance was defined as weight maintained within ±5% of baseline body mass index (BMI). We examined the role of various sociodemographic and lifestyle factors in successful weight maintenance. RESULTS: Relatively few young adults were able to maintain their weight over ten years (28.6% of women vs. 23.0% of men); net weight loss was uncommon (7.5% and 3.8%). Most participants gained weight (mean annual weight gain was 0.9 kg in women and 1.0 kg in men). Among women, exercise was associated with successful weight maintenance, but having two or more children, frequent use of sweet drinks, irregular eating, history of dieting (intentional weight loss) and low life satisfaction were associated with weight gain. Among men, higher baseline BMI and higher education were associated with successful weight maintenance, whereas irregular eating, history of dieting and smoking were associated with weight gain. CONCLUSIONS: Only about a quarter of young adults were able to resist weight gain. Regular eating and having no history of dieting were associated with successful weight maintenance in young women and men.


Assuntos
Logro , Manutenção do Peso Corporal , Adulto , Índice de Massa Corporal , Comportamento Alimentar , Feminino , Humanos , Estilo de Vida , Estudos Longitudinais , Masculino , Estudos Prospectivos , Fatores Sexuais , Adulto Jovem
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