Lifestyle-related factors associated with successful weight loss

Self-identified strategies to manage intake of tempting foods: cross-sectional and prospective associations with BMI and snack intake

OBJECTIVES

Individuals often use self-directed strategies to manage intake of tempting foods, but what these strategies are and whether they are effective is not well understood. This study assessed the frequency of use and subjective effectiveness of self-directed strategies in relation to BMI and snack intake.

DESIGN

A cross-sectional and prospective study with three time points (T1: baseline, T2: 3 months and T3: 3 years). At T1, demographics, frequency of use and subjective effectiveness of forty-one identified strategies were assessed. At T2 and T3, current weight was reported, and at T2 frequency of snack intake was also recorded.

SETTING

Online study in the UK.

PARTICIPANTS

Data from 368 participants (Mage = 34·41 years; MBMI = 25·06 kg/m2) were used for analysis at T1, n = 170 (46·20 % of the total sample) at T2 and n = 51 (13·59 %) at T3.

RESULTS

Two strategy factors were identified via principal axis factoring: (1) diet, exercise, reduction of temptations, and cognitive strategies, and (2) planning, preparation and eating style. For strategy 1, frequency of use, but not subjective effectiveness, was positively related to BMI at T1. Subjective effectiveness predicted an increase in BMI from T1 and T2 to T3. No relationship to snack intake was found. For strategy 2, frequency of use was negatively related to BMI at T1. Neither frequency of use nor subjective effectiveness were related to changes in BMI over time, but subjective effectiveness was negatively correlated with unhealthy snack intake.

CONCLUSION

Self-directed strategies to reduce the intake of tempting foods are not consistently related to BMI or snack intake.

Essential dataset features in a successful obesity registry: a systematic review

BACKGROUND

The prevalence of obesity and the diversity of available treatments makes the development of a national obesity registry desirable. To do this, it is essential to design a minimal dataset to meet the needs of a registry. This review aims to identify the essential elements of a successful obesity registry.

METHODS

We conducted a systematic literature review adhering to the Preferred Reporting Items for Systematic Review and Meta-Analysis recommendations. Google Scholar, Scopus and PubMed databases and Google sites were searched to identify articles containing obesity or overweight registries or datasets of obesity. We included English articles up to January 2023.

RESULTS

A total of 82 articles were identified. Data collection of all registries was carried out via a web-based system. According to the included datasets, the important features were as follows: demographics, anthropometrics, medical history, lifestyle assessment, nutritional assessment, weight history, clinical information, medication history, family medical history, prenatal history, quality-of-life assessment and eating disorders.

CONCLUSIONS

In this study, the essential features in the obesity registry dataset were demographics, anthropometrics, medical history, lifestyle assessment, nutritional assessment, weight history and clinical analysis items.

Weight change from childhood to adulthood and cardiovascular risk factors and outcomes in adulthood: A systematic review of the literature

The magnitude of the associations between life-course change in weight status and health outcomes in adulthood has been inconsistent. This study aims to examine the associations between weight change from childhood to adulthood and cardiovascular disease (CVD) risk factors and outcomes in adulthood. PubMed, Embase and ISI Web of Science between 1 August 1953 and 13 July 2020 were searched, and a total of 52 eligible articles were included. The systematic review supported significant associations between the life-course increase in BMI and high odds of markers in adulthood. In the meta-analyses, normal weight in childhood but excess weight in adulthood or persistent excess weight was associated with increased odds of adult markers. However, those who had excess weight in childhood but were normal weight in adulthood did not have increased odds of nearly all adult markers. This systematic review and meta-analysis suggest that individuals who developed excess weight in adulthood or had excess weight in both periods had higher odds of developing CVD risk factors and outcomes in adulthood. In contrast, the probability of these adult markers could be limited or eliminated for children with excess weight who are able to become adults with normal weight.

Low body weight and involuntary weight loss are associated with Raynaud's phenomenon in both men and women

Objectives: Low body weight is an easily assessable cause of Raynaud's phenomenon (RP), and is frequently overlooked by clinicians. We aim to investigate the association of low body weight (body mass index < 18.5 kg/m²), involuntary weight loss, and nutritional restrictions with the presence of RP.Method: Participants from the Lifelines Cohort completed a validated self-administered connective tissue disease questionnaire. Subjects who reported cold-sensitive fingers and biphasic or triphasic colour changes were considered to suffer from RP. Patient characteristics, anthropometric measurements, and nutritional habits were collected. Statistical analyses was stratified for gender.Results: Altogether, 93 935 participants completed the questionnaire. The prevalence of RP was 4.2% [95% confidence interval (CI) 4.1-4.4%], and was three-fold higher in women than in men (5.7% vs 2.1%, p < 0.001). Subjects with RP had a significantly lower daily caloric intake than those without RP. Multivariate analysis, correcting for creatinine level, daily caloric intake, and other known aetiological factors associated with RP, revealed that low body weight [men: odds ratio (OR) 5.55 (95% CI 2.82-10.93); women: 3.14 (2.40-4.10)] and involuntary weight loss [men: OR 1.32 (1.17-1.48); women: 1.31 (1.20-1.44)] were significantly associated with the presence of RP. Low-fat diet was also associated with RP in women [OR 1.27 (1.15-1.44)].Conclusion: Low body weight and prior involuntary weight loss are associated with an increased risk of RP in both men and women. This study emphasizes that low body weight and weight loss are easily overlooked risk factors for RP, and should be assessed and monitored in subjects with RP.

Two-year weight, risk and health factor outcomes of a weight-reduction intervention programme: Primary prevention for overweight in a multicentre primary healthcare setting

Objective: To study the long-term effects of weight reduction, quality of life and sense of coherence in a primary health care (PHC)-based programme with two different intensities.Design: Prospective two-armed randomised intervention.Setting: Three PHC centres in south west of Sweden.Subjects: In total, 289 women and men aged 40-65 years with a BMI of 28-35 were recruited for a two-year weight-reduction programme. Participants were randomized to high-intensity or low-intensity groups. Blood samples, physical measurements and questionnaires were analysed. Participants received cookbooks and dietary lectures. The high-intensity group also received Motivational interviewing (MI), dietary advice on prescription (DAP- advice), a grocery store lecture, a website and weekly e-mails.Main outcome measures: Weight, quality of life, risks and health factors.Results: In total, 182 (64%) participants completed the 2-year follow-up. The total sample reduced their weight by 1 kg (p = 0.006). No significant differences regarding weight were found between the groups. Anxiety/depression decreased in EQ5-D (p = 0.021), EQ5-D VAS (p = 0.002) and SOC (p = 0.042). Between the groups, there were significant differences in EQ5-D usual activities (p = 0.004), anxiety/depression (p = 0.013), pain/discomfort (p = 0.041), fruit and vegetables (p = 0.005), HLV anxiety (p = 0.005), and visits to nurses (p = 0.012).Conclusion: The total population lost weight, and the high-intensity and low-intensity programmes did not result in significant differences in terms of weight. The high-intensity programme reported health benefits linked to lower levels of anxiety and depression, increased activity and intake of greens and reduced visits to physicians and nurses.Key pointsBoth groups had a consisting weight- reduction after two years.High intensity did not lead to a significant difference in weight reduction between the groups.The high-intensity group reported more health effects, such as better quality of life, reduced anxiety, and increased greenery intake. It is unknown how much support patients in a weight- reduction programme in PHC require to succeed with weight loss and a healthy lifestyle.

Successful weight loss maintenance: A systematic review of weight control registries

Weight loss maintenance is a major challenge for obesity treatment. Weight control registries can be useful in identifying psychological and behavioural factors that could contribute to better long-term success. The objective of this study is to describe the existing weight control registries and their participants and identify correlates of weight loss maintenance. A comprehensive search of peer-reviewed articles published until November 2018 was conducted in PubMed, Web of Science, and Scopus. Studies that reported results from weight control registries were considered. Fifty-two articles, corresponding to five registries (the United States, Portugal, Germany, Finland, and Greece), were included. Registries differed in inclusion criteria and procedures. Of 51 identified weight loss and maintenance strategies, grouped in 14 domains of the Oxford Food and Activity Behaviors taxonomy, the following were the most frequently reported: having healthy foods available at home, regular breakfast intake, increasing vegetable consumption, decreasing sugary and fatty foods, limiting certain foods, and reducing fat in meals. Increased physical activity was the most consistent positive correlate of weight loss maintenance. To our knowledge, this is the first systematic review of information about successful weight loss maintenance obtained from weight control registries. Key common influential characteristics of success were identified, which can inform future prospective studies and weight management initiatives.

Sex-Specific Physical Activity Patterns Differentiate Weight Loss Maintainers From Regainers: The MedWeight Study

BACKGROUND

Although plenty of evidence indicates that weight loss maintainers are highly physically active, studies focusing on the sex-specific differences in activity levels between maintainers and regainers are scarce. The authors aimed to investigate sex-specific differences in activity patterns in a cohort of Mediterranean maintainers and regainers.

METHODS

Sample includes 756 participants of the MedWeight registry (60.5% women), aged 18-65 years, who lost ≥10% of their initial weight, and either maintained their loss for ≥12 months or regained it. Participants completed a series of questionnaires, including demographics and weight history. Activity levels were evaluated with the International Physical Activity Questionnaire-short version.

RESULTS

Maintainers of both sexes were, in total, more active than their same-sex regainers. When specific activities were considered, women maintainers spent more time walking than regainers (Padjusted = .02), whereas men maintainers spent more time in vigorous activities (Padjusted = .001) and walking than regainers (Padjusted = .001). Modest increments in activity of sex-relevant intensity were associated with increased odds for maintenance.

CONCLUSIONS

Maintainers attained a more active lifestyle than their same-sex regainers, involving more walking for both sexes and more vigorous activities for men. The detected differences, according to activity intensity, support that activity patterns associated with successful weight loss are distinguishable between sexes.

Effects of a behavioural weight loss intervention in people with serious mental illness: Subgroup analyses from the ACHIEVE trial

BACKGROUND

Persons with serious mental illnesses (SMI) such as schizophrenia and bipolar disorder have an increased risk of obesity and related chronic diseases and die 10-20years earlier than the overall population, primarily due to cardiovascular disease. In the ACHIEVE trial, a behavioural weight loss intervention led to clinically significant weight loss in persons with SMI. As the field turns its attention to intervention scale-up, it is important to understand whether the effectiveness of behavioural weight loss interventions for people with SMI, like ACHIEVE, differ for specific subgroups.

METHODS

This study examined whether the effectiveness of the ACHIEVE intervention differed by participant characteristics (e.g. age, sex, race, psychiatric diagnosis, body mass index) and/or their weight-related attitudes and behaviours (e.g. eating, food preparation, and shopping habits). We used likelihood-based mixed effects models to examine whether the baseline to 18 month effects of the ACHIEVE intervention differed across subgroups.

RESULTS

No statistically significant differences were found in the effectiveness of the ACHIEVE intervention across any of the subgroups examined.

CONCLUSIONS

These findings suggest that the ACHIEVE behavioural weight loss intervention is broadly applicable to the diverse population of individuals with SMI.

Motivators, barriers and strategies of weight management: A cross-sectional study among Finnish adults

BACKGROUND

Weight management (WM) is an ongoing global challenge. The purpose of this study was to analyze motivators, barriers, and strategies of WM among Finnish adults.

METHODS

Data were collected in the 'KULUMA' (Consumers at the Weight Management Market) project among 667 community-dwelling adults in Eastern and Central Finland (Kuopio and Jyväskylä). The self-reported questionnaire collected background information and responses to motivators, barriers, and strategy items. Principal component analysis (PCA) was used to extract components of motivators, barriers, and strategies of WM, along with K-means clustering to categorize the participants.

RESULTS

About 55% of the respondents were aiming to lose weight. The PCA resulted in a 3-component model for motivators (functional aspects, sociological aspects, and psychosocial aspects), a 4-component model for barriers (life situations, food environment, personal issues, and resources) and a 2-component model for the strategies of WM (dietary strategies and life-management strategies). The components had several relationships with demographic characteristics (especially with age) but only a few with weight-related characteristics (e.g. weight loss attempts). Three clusters of participants were formed: Struggling weight managers (WMs), Independent WMs, and Determined WMs. Barriers to WM had a key role in differentiating clusters and weight satisfaction. Determined WMs were the most satisfied with their weight, whereas Struggling WMs perceived the highest level of barriers to WM.

CONCLUSIONS

WM efforts are common among Finnish adults. Generally, weight-related activities and communication in society should focus more on barriers than merely on the motivation or strategies of WM in order to support individuals' WM efforts.

Weight loss methods and changes in eating habits among successful weight losers

BACKGROUND

Changes in several lifestyle related factors are required for successful long-term weight loss. Identification of these factors is of major importance from a public health point of view.

METHODS/SUBJECTS

This study was based upon findings from the Finnish Weight Control Registry (FWCR), a web-based registry. In total, 316 people were recruited and 184 met the study inclusion criteria. The aims of this study were to assess means and typical changes in eating habits associated with successful long-term weight loss.

RESULTS

Half of the participants (48%) reported that they lost weight slowly primarily with dietary changes. Self-weighing frequency was high, 92% was weighing themselves at least once a week during the weight loss phase, and 75% during the maintenance phase. Dietary aspects associated with successful weight loss and weight maintenance included an increase in intake of vegetables, a reduction in frequency of eating candies and fast food, regular meal frequency and application of the Plate model.

CONCLUSIONS

Both slow and fast weight loss may lead to successful long-term results and weight maintenance. A decrease in energy intake was achieved by reducing intake of energy-dense food, applying the Plate model and by regular meal frequency. Key messages Successful long-term weight loss is associated with a reduction in intake of energy-dense food. A more regular meal frequency and a high frequency of self-weighing seem to be helpful.