As the prevalence of obesity sky rockets worldwide, the search for successful weight- management strategies follows. For select individuals, surgical intervention is the most appropriate weight-management intervention for sustained weight loss. Surgical procedures, such as the Roux-en-Y gastric bypass, sleeve gastrectomy, and laparoscopic adjustable gastric banding, bring about both dramatic weight loss and the ability to provide the patient with marked improvement in obesity-related conditions such as diabetes, arthritis, hypertension, and obstructive sleep apnea. In this article the authors will address the incidence of obesity and the criteria for weight-loss (bariatric) surgery; describe the preoperative evaluation and selection of the appropriate surgical procedure; discuss postoperative complications and required nursing care; and give readers a preview of future options for surgical weight loss.
Classical motivation theories assumed that the probability of success in goal striving process (including weight loss) depended on two factors: likelihood of success and attractiveness of the result. However, research referring to obesity showed that motivational factors are not sufficient in effective weight loss. In other words, obese people value anticipated weight loss but still do not succeed in this process. It is implied by the fact that effectiveness and persistence of this process depend also on volitional factor. This factor refers to self-control mechanisms, which mediate between intention to reach the goal and its enactment. The current empirical data suggest that implementation intentions and mental simulations are especially beneficial techniques of self-control enhancement. This chapter will unveil main theories and research concerning self-control mechanisms and influence of various mental simulations and implementation intentions in weight loss process and weight-related behaviors. Moreover, our empirical data concerning individual differences in self-control of weight loss process are presented.
Purpose: Despite evidence demonstrating that health-care providers (HCPs) can effectively promote health behaviors and weight loss among their patients, the extent to which HCPs promote weight loss among overweight and obese adults is not fully understood as the studies on this topic have mostly been conducted in convenience samples. Therefore, the purpose of this study was to examine the extent to which HCPs promote weight loss among overweight and obese adults. Design: Cross-sectional. Setting: National Health and Nutrition Examination Survey 2011-2012. Participants: A total of 2291 overweight or obese adults (males 46%, females 54%) of varying racial/ethnic backgrounds. Measures: Weight loss/maintenance promotion from HCP was assessed via patient self-report, with weight status assessed via measured body mass index. Analysis: Descriptive statistics and regression. Results: Among those receiving health care in the past 12 months, 19.4% of overweight, 46.8% of obese class 1, 62.8% of obese class 2, and 76.9% of obese class 3 adults were advised to lose/control their weight, and the odds of being advised to control/lose weight by HCP increased accordingly. These results were similar when evaluated across various subpopulations (eg, age, gender). Those who received advice to lose/control weight had 3 times the odds of adopting weight loss/control behaviors (odds ratio = 3.1). Conclusions: Additional weight loss promotion among overweight and all classes of obese adults is needed from HCP.
Das RWI untersucht in dieser Pilotstudie im Rahmen eines randomisierten Experiments, ob Bonuszahlungen für das Abnehmen und Halten des Gewichts ein wirksames Instrument zur Bekämpfung von Übergewicht sein können. Die Ergebnisse sind für Bonusprogramme von Krankenkassen sowie im betrieblichen Gesundheitsmanagement von großer Bedeutung. Übergewicht ist zu einer der häufigsten und am schnellsten wachsenden gesundheitlichen Bedrohungen geworden. Bei Krankheits- und Todesursachen nimmt es in Deutschland die führende Rolle ein. Neuere Studien schätzen die direkten Kosten von Übergewicht in Deutschland auf jährlich 530 Mill. Euro, die durch Folgeerkrankungen hervorgerufenen Kosten auf jährlich sogar 5 Mrd. Euro. Die meisten Folgekrankheiten lassen sich mit einer relativ geringen Gewichtsabnahme von 10-15% beheben. Allerdings sind Anstrengungen zur Gewichtsreduktion zumeist wenig erfolgreich. Die Erfolgsrate kann möglicherweise durch eine finanzielle Prämie für Abnehmen erhöht werden. Mit dieser Studie soll deren Wirksamkeit erforscht werden. Dazu erhalten übergewichtige Patienten aus vier baden-württembergischen Rehabilitationskliniken der Deutschen Rentenversicherung mit einem Body-Mass-Index von über 30 am Ende ihres Klinikaufenthalts ein persönliches Gewichtsreduktionsziel, das sie innerhalb von vier Monaten erreichen sollen. Sie werden per Zufallsziehung einer von drei Gruppen zugeordnet: Ein Drittel der Patienten bekommt für das Erreichen ihres Ziels eine Prämie von 300 Euro in Aussicht gestellt, ein weiteres Drittel 150 Euro, das übrige Drittel keine Prämie. Nach vier Monaten sollen die Patienten eine Apotheke aufsuchen, die zur Erfolgskontrolle das Körpergewicht, den Blutzuckerspiegel und den Gesamtcholesterinwert misst. In den darauf folgenden sechs und nach weiteren zwölf Monaten sollen die Patienten das Gewicht halten. Erneut können sie je nach Gruppenzugehörigkeit und Zielerreichung eine Prämienzahlung erhalten. Die Daten werden vom RWI statistisch ausgewertet. Drei Typen von Daten: (1) Daten aus medizinischen Erhebungsbögen, die durch medizinisches Fachpersonal in den Reha-Kliniken und in Apotheken ausgefüllt wurden. (2) Daten aus vier verschiedenen Fragebögen zu sozio-ökonomischen Hintergund und Gesundheitszustand, die von den Studienteilnehmern selbst ausgefüllt wurden. (3) Administrative Daten, die von den Autoren zwecks Identifizierung der Studienteilnehmer generiert wurden und darüber hinaus zusätzliche Informationen enthalten.
Purpose. To assess whether forming general behavioral intentions and implementing intentions through action plans promotes weight loss and is moderated by weight loss goals and self-efficacy. Design. A quasi-experimental study comparing change in body mass index (BMI) for 15 months between a behavioral intentions condition (BIC), an implementation intentions condition (IIC), and a comparison condition (CC). Setting. Ten-week weight loss program delivered in weekly group meetings at community medical centers. Subjects. Six hundred thirty-two attendants at the weight loss program (80% of program attendants participated in the study). Intervention. Weight loss program focused on lifestyle changes, augmented by two experimental conditions (vs. a comparison condition): BIC, intended use of weight loss techniques; IIC, intended use and detailed plans for two techniques. Phone follow-up was conducted 3 and 12 months later. Measures. Main outcome: BMI during the program (computed on the basis of weight and height measured on a mechanical medical scale). Experimental manipulations included exposure to list of techniques (BIC/IIC) and structured planning form (IIC); independent variables were assessed with questionnaires (eating self efficacy, weight loss goal, demographics). Analysis. Linear mixed models estimating changes in BMI and their interactions with the planning interventions, goals, and self-efficacy. Results. Participants in the BIC and IIC lost 40% more weight during the 10-week program than those in the CC (1.10 and 1.11 BMI points compared with. 79; ts < −2.76, ps < .01). Weight loss goals interacted with implementation intentions (t = 2.98, p < .01). Self-efficacy was unrelated to weight loss. No differences were found between conditions at 3 and 12 months after the program. Conclusion. Findings revealed that forming implementation intentions promotes weight loss within a weekly program at a field setting and that its effectiveness depends on initial high goals.
The dramatic increase in obesity has captured the attention of the government, private foundations, and the media for several years. One media outlet, reality television, a social phenomenon, has pushed the epidemic into the public eye (Finklestein, Brown, & Evans, 2008). One of the most popular weight loss programs on television is the Biggest Loser. The popularity of the television show has been a possible catalyst of the epidemic of similar weight loss programs in community gyms, recreation settings, and even within universities around the United States. The purpose of this study was to conduct a follow up assessment with participants who had formerly participated in the Spring 2008 or Fall 2008 weight loss program. By conducting a follow up study exercise adherence could be measured, and the reasons for continuing or discontinuing exercise were analyzed. There were 11 participants in this study (n=9, females; n=2, males) whose ages ranged from 26 to 67 years of age. Participants completed semi-structured focus group sessions, a demographic questionnaire, fitness assessment follow up, Rosenberg Self-Esteem Scale, Self-Efficacy Measure, Social Physique Anxiety Scale, Temptation Not to Exercise Scale, and an Exercise Staging Algorithm. The follow up of the fitness assessment revealed significant changes in the following circumferences: neck, arm, forearm, waist, abdomen, hips/buttocks (p < 0.01). There was a significant difference between the initial completion of the weight loss program and present (p < 0. 01). Results of the psychological instruments supported the focus groups discussions that issues such as time management, family circumstances, and work related issues can cause an individual to have lack of confidence in their ability to exercise. The focus groups results supported results found in the psychological instruments. Many participants expressed reasons for not exercising such as excuses that related to time management, loss of support from the group and trainers, and a feeling that they knew they could exercise but this did not result in long term adherence. The results of this study demonstrated that participants do not typically continue exercise adherence following a short term weight loss program.
INTRODUCTION: People who do not perceive themselves as overweight or obese are less likely to use weight loss treatments. However, little is known about weight perceptions and their association with weight loss attempts among people who have served in the military. They represent a special population with regard to weight perceptions as military personnel must meet strict weight standards to remain in military service. MATERIALS AND METHODS: Using data from the U.S.-based 2013–2014 and 2015–2016 National Health and Nutrition Examination Surveys, we fit logistic regression models to determine whether people with overweight or obesity were: (1) more or less likely to underestimate their weight if they reported military service and (2) less likely to attempt weight loss if they underestimated their weight (stratifying by military status). Estimates were adjusted for sociodemographic factors, including objective weight class, gender, age, race/ethnicity, income ratio, comorbidities, and education. This work received exempt status from the Stanford University institutional review board. RESULTS: Among 6,776 participants, those reporting military service had higher odds of underestimating their weight compared to those not reporting military service [OR (odds ratio): 1.44; 95% confidence interval (CI): 1.15, 1.79]. Underestimating weight was associated with lower odds of attempting weight loss among those reporting military service (OR: 0.20; CI: 0.11, 0.36) and those not reporting military service (OR: 0.27; CI: 0.22, 0.34). CONCLUSIONS: This study offers the new finding that underestimating weight is more likely among people reporting military service compared to those not reporting military service. Findings are consistent with past work demonstrating that underestimating weight is associated with a lower likelihood of pursuing weight loss. To combat weight misperceptions, clinicians may need to spend additional time discussing weight-related perceptions and beliefs with patients. The present findings suggest such ...
This reports the results of a retrospective clinical study evaluating the role of dentures on weight maintenance in an institutionalized demented population. Records of 57 demented long‐term (greater than 3 months) residents of the Department of Veterans Affairs Medical Center, Washington, DC, Nursing Home Care Unit were evaluated to determine body weight, mental acuity, independence in daily living, and dental condition. Fourteen (24%) of the patients possessed dentures, 19 (33%) were edentulous and functioned without dentures, while 24 patients (42%) were dentate. Overall mean weight change was ‐2.03 lbs ± 0.81 lbs in 3 months. There was no significant difference in weight loss based on dental condition. There was, however, an apparent correlation of weight loss and mental acuity. Thus, it was concluded that dentures did not influence weight maintenance among institutionalized demented patients.
