Eleni Karfopoulou

Weight regaining: From statistics and behaviors to physiology and metabolism

Achieving maintenance of weight loss is crucial to combat obesity. However, most individuals tend to regain weight. Data from successful maintainers show that they remain vigilant and constantly apply techniques to oppose the course of regaining. On the other hand, current advances in obesity research show that the reduced obese state is a state of altered physiology in terms of energy balance. This review describes the physiological adaptations occurring after weight loss that predispose to regaining. Specifically, changes regarding body composition, hormonal background, energy expenditure and control of food intake are discussed. Moreover, metabolites that can act as regain predictors and dietary techniques to oppose regaining are presented.

Effect of different amounts of coffee on dietary intake and appetite of normal‐weight and overweight/obese individuals

To investigate the effects of different coffee amounts on dietary intake and appetite feelings in normal‐weight and overweight/obese individuals.

Behaviours associated with weight loss maintenance and regaining in a Mediterranean population sample. A qualitative study.

In the US, the National Weight Control Registry revealed lifestyle behaviours shared by weight loss maintainers. In the US and the UK, qualitative studies compared the experiences of weight loss maintainers and regainers. High rates of physical activity, a low‐energy/low‐fat diet, weight self‐monitoring, breakfast consumption and flexible control of eating are well‐established maintenance behaviours.

The MedWeight study: Design and preliminary results

BAGKGROUND: Weight loss maintenance contributing behaviors have not been adequately studied in Mediterranean populations. OBJECTIVE: The MedWeight study created a registry of weight loss maintainers and regainers, to assess and compare their features and lifestyle habits. METHODS: Participants had intentionally lost ≥10% of their starting weight; maintainers were keeping the weight off for one year minimum, whereas regainers had regained the loss. Volunteers answered online questionnaires, regarding medical history, body weight, diet and exercise habits, social support, and personality traits. Two telephone 24-h dietary recalls per volunteer are conducted. Questionnaire follow-up will take place one year after study entrance. RESULTS: Thus far, 169 maintainers and 57 regainers participated in the study, 43% men. Mean age was 32 years, with regainers being older than maintainers. Maintainers were sustaining a 21% loss, for over four years. Maximum weight and maximum Body Mass Index (BMI) did not differ between groups, but maintainers originally lost more weight than regainers. Maintainers lost weight mainly by themselves, whereas more regainers had consulted with a dietitian. CONCLUSIONS: Preliminary data showed no differences between groups in maximum weight and BMI ever reached, but differences were found in weight loss methods employed and initial weight loss achieved.

Breakfast consumption and weight-loss maintenance: results from the MedWeight study.

Daily breakfast consumption is a common eating behaviour among people who have maintained their weight loss after weight-loss management. However, there is not a precise definition for breakfast in the literature. The purpose of this study was to investigate potential associations between breakfast consumption (based on several definitions) and weight-loss maintenance, as well as to explore differences in breakfast quality between individuals who managed to maintain part of the weight loss and in those who regained weight loss. The study sample consisted of 354 participants of the MedWeight study (age: 32 (sd 10) years, 61 % women) who had lost ≥10 % of their initial body weight and either maintained the loss for ≥1 year (maintainers, n 257) or regained weight loss (regainers, n 97). Participants completed online questionnaires and reported their dietary intake through two telephone 24-h recalls. Breakfast consumption was evaluated using twelve different definitions. The analysis indicated that breakfast consumption was associated with weight-loss maintenance only in men, when using self-reported breakfast consumption or the following breakfast definitions: (1) the first eating episode consumed at home and (2) the first eating episode consumed at home excluding caffeinated drinks. This association remained statistically significant even after adjustment for potential confounding factors. Thus, breakfast, the first eating episode of the day, when consumed at home, may be protective against weight regaining.

Sleep quality is associated with weight loss maintenance status: the MedWeight study

Sleep duration and quality have been associated with many health outcomes, including weight management. We aimed to investigate the effect of self-reported sleep duration and quality on weight loss maintenance in participants of the MedWeight study, a registry of individuals that lost at least 10% of body weight in the past and either maintained the loss (maintainers: weight maintenance of at least 10% of initial weight loss) or regained it (regainers: weight ≥95% of their maximum body weight). Study participants included 528 volunteers (61% women). Sleep quantity referred to the reported duration of nocturnal sleep, as well as the frequency of mid-day naps during the last month. Sleep quality was assessed through the Athens Insomnia Scale (AIS). Reported sleep quantity was associated with weight maintenance status, but the association became non-significant when the AIS score entered the model. In specific, AIS was inversely associated with the likelihood of being a maintainer (OR=0.89 per AIS unit, 95% CI: 0.81 - 0.98), even after adjusting for potential confounders. Sex-specific analysis revealed that the association between the AIS score and maintenance status was evident in men but not in women. Future studies are needed to confirm these results in other population groups and reveal underlying mechanisms.

MedWeight Smart Community: A Social Approach

Smart Communities understand the potential of Internet technology, and make a conscious decision to adopt this technology to transform life and work in significant and positive ways. Smart communities could be effectively supported by social network solutions, though specific issues should be explored to efficiently model the behaviour of community member, in a way similar to the way they interact in the real world. In this chapter, we focus on MedWeight Smart Community, built to support volunteers trying to maintain weight loss. It enables them to be members of a community composed by both other volunteers and nutrition experts, taking into consideration the way support groups are formed in the real world. To support MedWeight smart community, a corresponding social network platform was built, extending the typical social network model to support roles, relations and complex content dissemination and interaction policies.

Building MedWeight smart community using social networking technology

Social networks have been established as a prominent model for communication and interaction between individuals, as well as among members of communities or organizations. However, as the need to support on-line vibrant communities constituting of different individuals, having different roles, privileges and capabilities, is constantly increasing, alternatives to the typical social network model should be explored. Smart communities could be effectively supported by social network technology, though specific issues should be explored to efficiently model community member behavior as they interact in the real- world. In the paper, we focus on MedWeight smart community, built to support volunteers trying to maintain weight loss. It enables them to be members of a community composed by both other volunteers and nutrition experts, taking into consideration the way support groups are formed in the real-world. To support Medweight smart community, a corresponding social network platform was built, extending the typical social network model to support roles, relations and complex content dissemination policies.

Presence of music while eating: Effects on energy intake, eating rate and appetite sensations

The role of music in energy and dietary intake of humans is poorly understood. The purpose of the present laboratory study was to examine the effect of background music, its presence and its intensity, on energy intake, eating rate and appetite feelings. The study had a randomized crossover design. Twenty-six normal weight and overweight/obese men participated in random order in three trials: the control trial (no music was playing), the 60dB and the 90dB music trials, while an ad libitum lunch was consumed. Visual analogue scales for hunger, fullness/satiety, as well as desire to eat were administered to the participants. Energy intake at the ad libitum lunch did not differ between trials, even when covariates were taken into account. There were no statistically significant differences between trials on meal characteristics, such as meal duration, number of servings, number of bites eaten and on appetite indices. Future studies are needed to replicate these results and investigate the effect of different types of music and/or sound.