Ericka M. Welsh

The Impact of Regular Self-weighing on Weight Management: A Systematic Literature Review

BackgroundRegular self-weighing has been a focus of attention recently in the obesity literature. It has received conflicting endorsement in that some researchers and practitioners recommend it as a key behavioral strategy for weight management, while others caution against its use due to its potential to cause negative psychological consequences associated with weight management failure. The evidence on frequent self-weighing, however, has not yet been synthesized. The purpose of this paper is to evaluate the evidence regarding the use of regular self-weighing for both weight loss and weight maintenance.MethodsA systematic literature review was conducted using the MEDLINE, CINAHL, and PsycINFO online databases. Reviewed studies were broken down by sample characteristics, predictors/conditions, dependent measures, findings, and evidence grade.ResultsTwelve studies met the inclusion/exclusion criteria, but nearly half received low evidence grades in terms of methodological quality. Findings from 11 of the 12 reviewed studies indicated that more frequent self-weighing was associated with greater weight loss or weight gain prevention. Specifically, individuals who reported self-weighing weekly or daily, typically over a period of several months, held a 1 to 3 kg/m2 (current) advantage over individuals who did not self-weigh frequently. The effects of self-weighing in experimental studies, especially those where self-weighing behaviors could be isolated, were less clear.ConclusionBased on the consistency of the evidence reviewed, frequent self-weighing, at the very least, seems to be a good predictor of moderate weight loss, less weight regain, or the avoidance of initial weight gain in adults. More targeted research is needed in this area to determine the causal role of frequent self-weighing in weight loss/weight gain prevention programs. Other open questions to be pursued include the optimal dose of self-weighing, as well as the risks posed for negative psychological consequences.

Household Obesity Prevention: Take Action—a Group-Randomized Trial

The purpose of the present study was to evaluate an intervention to prevent weight gain among households (HHs) in the community. Ninety HHs were randomized to intervention or control group for 1 year. Intervention consisted of six face‐to‐face group sessions, placement of a television (TV) locking device on all home TVs, and home‐based intervention activities. Measures were collected in person at baseline and 1 year. Weight, height, eating behaviors, physical activity (PA), and TV viewing were measured among HH members ages ≥12 years. Follow‐up rate at 1 year was 96%. No significant intervention effects were observed for change in HH BMI‐z score. Intervention HHs significantly reduced TV viewing, snacks/sweets intake, and dollars per person spent eating out, and increased (adults only) PA and self‐weighing frequency compared with control HHs. A 1 year obesity prevention intervention targeting entire HHs was effective in reducing TV viewing, snack/sweets intake and eating out purchases. Innovative methods are needed to strengthen the home food environment intervention component. Longer intervention durations also need to be evaluated.

Examining the Relationship Between Family Meal Frequency and Individual Dietary Intake: Does Family Cohesion Play a Role?

OBJECTIVE To confirm previously reported associations between family meal frequency and dietary intake, and to examine family cohesion as a potential mediator of this relationship. DESIGN Cross-sectional observational study. Data collected at baseline via questionnaire. SETTING Randomized, controlled household weight gain prevention trial. PARTICIPANTS Participants were 152 adults and 75 adolescents from 90 community households. VARIABLES MEASURED Family meal frequency assessed with a single question. Perceived family cohesion measured by the Family Adaptability and Cohesion Evaluation Scale-III. Usual intake of targeted food items assessed with modified food frequency questionnaire. ANALYSIS Hierarchical linear regression with mediation analysis. Statistical significance set at α-level .05. RESULTS Family meal frequency was associated with intake of fruits and vegetables in adults, and sweets and sugar-sweetened beverages in adolescents. Family meal frequency was positively correlated with perceived family cohesion (r = 0.41, P < .01). Partial mediation by family cohesion was observed for family meal frequency and sweets intake in adolescents. CONCLUSIONS AND IMPLICATIONS Results suggest that family cohesion is not a consistent mediator of relationship between family meal frequency and individual dietary intake. Future studies should assess additional plausible mediators of this relationship in order to better understand the effect of family meals on dietary intake.

Is Frequent Self-weighing Associated with Poorer Body Satisfaction? Findings from a Phone-based Weight Loss Trial

OBJECTIVE To examine the effect of self-weighing frequency on weight change and body satisfaction. DESIGN Observational study based on findings from a 6-month randomized controlled telephone-based weight loss trial. Data collected at baseline and 6 months. SETTING Metropolitan community-based sample. PARTICIPANTS Sixty-three obese adults. Mean age 49.5 years, 82% percent white, and 79% female. Mean body mass index at baseline was 34.2 kg/m(2). MAIN OUTCOME MEASURES Change in weight and body satisfaction. ANALYSIS General linear model regression was used to assess the effect of self-weighing on outcomes of interest. Statistical significance was set at alpha level .05. Treatment group and baseline values of dependent variables included as covariates in all analyses. RESULTS Participants who increased their frequency of self-weighing over the 6-month period demonstrated significantly better weight loss outcomes than those who maintained or decreased their frequency of self-weighing (-6.8 kg vs -3.1 kg, F = 8.59, P = .006). There were no significant associations between self-weighing frequency and body satisfaction at 6 months (F = 0.55, P = .58). CONCLUSIONS AND IMPLICATIONS These findings support frequent self-weighing for weight control. There appears to be little or no effect of self-weighing on body satisfaction. Future research should replicate these findings across a larger, more diverse population of overweight adults.

Profile of e-cigarette use and its relationship with cigarette quit attempts and abstinence in Kansas adults.

OBJECTIVE The aim of this study is to describe electronic cigarette use in Kansas adults and its relationship with cigarette cessation. METHODS The Kansas Adult Tobacco Survey (ATS) is a 2012-2013 phone survey of non-institutionalized Kansas adults (N=9656). The ATS was analyzed to create a profile of cigarette and e-cigarette users, and demonstrate associations between e-cigarette use and cigarette cessation attempts and cigarette abstinence. RESULTS In 2013, 45% of adult cigarette smokers had tried e-cigarettes and 14% had used e-cigarettes in the past month. The prevalence of current cigarette smoking was 76.5% among past-month e-cigarette users. Adults who only use e-cigarettes are younger and more affluent than adults who only smoke cigarettes. The prevalence of past-month e-cigarette use among smokers who made a quit attempt in the past year is more than double that of smokers who did not. E-cigarette use was negatively associated with past-month (aPOR=0.21, 95% CI: 0.11-0.38) and past-year cigarette abstinence (aPOR=0.14, 95% CI: 0.10-0.22). CONCLUSIONS E-cigarette use is common among cigarette smokers. E-cigarette use is more common among smokers who made a recent quit attempt and many smokers report using smokeless tobacco or e-cigarettes to help quit. Recent cigarette abstinence, however, is negatively associated with e-cigarette use.

A comparison of maintenance-tailored therapy (MTT) and standard behavior therapy (SBT) for the treatment of obesity

OBJECTIVE To evaluate a maintenance-tailored therapy (MTT) compared to standard behavior therapy (SBT) for treatment of obesity. MAIN OUTCOME MEASURE change in body weight. METHOD A non-blinded, randomized trial comparing effectiveness of MTT and SBT in facilitating sustained weight loss over 18 months; 213 adult volunteers> or =18 years participated. SBT had fixed behavioral goals, MTT goals varied over time. Study conducted at the University of Minnesota, School of Public Health, January 2005 through September 2007. RESULTS Mean (SD) weight losses at 6, 12, and 18 months were 5.7 (5.0) kg, 8.2 (8.6) kg and 8.3 (8.9) kg for MTT and 7.4 (3.9) kg, 10.7 (8.2) kg and 9.3 (8.8) kg for SBT. Total weight loss did not differ by group at 18 months, but the time pattern differed significantly (p<0.001). The SBT group lost more weight in the first 6 months. Both groups lost similar amounts between 6 and 12 months; MTT had stable weight between 12 and 18 months, while SBT experienced significant weight gain. CONCLUSIONS The MTT approach produced sustained weight loss for an unusually long period of time and not achieved in previous trials of behavioral treatment for weight loss. The MTT approach, therefore, deserves further study.

Annotated receipts capture household food purchases from a broad range of sources

BackgroundAccurate measurement of household food purchase behavior (HFPB) is important for understanding its association with household characteristics, individual dietary intake and neighborhood food retail outlets. However, little research has been done to develop measures of HFPB. The main objective of this paper is to describe the development of a measure of HFPB using annotated food purchase receipts.MethodsHouseholds collected and annotated food purchase receipts for a four-week period as part of the baseline assessment of a household nutrition intervention. Receipts were collected from all food sources, including grocery stores and restaurants. Households (n = 90) were recruited from the community as part of an obesity prevention intervention conducted in 2007–2008 in Minneapolis, Minnesota, USA. Household primary shoppers were trained to follow a standardized receipt collection and annotation protocol. Annotated receipts were mailed weekly to research staff. Staff coded the receipt data and entered it into a database. Total food dollars, proportion of food dollars, and ounces of food purchased were examined for different food sources and food categories. Descriptive statistics and correlations are presented.ResultsA total of 2,483 receipts were returned by 90 households. Home sources comprised 45% of receipts and eating-out sources 55%. Eating-out entrees were proportionally the largest single food category based on counts (16.6%) and dollars (

The drop it at last study: six-month results of a phone-based weight loss trial.

106 per month). Two-week expenditures were highly correlated (r = 0.83) with four-week expenditures.ConclusionReceipt data provided important quantitative information about HFPB from a wide range of sources and food categories. Two weeks may be adequate to reliably characterize HFPB using annotated receipts.

Measuring Perceived Barriers to Healthful Eating in Obese, Treatment-seeking Adults

Purpose. To address the translational research question regarding the optimal intervention “dose” to produce the most cost-effective rate of weight loss, we conducted the Drop It At Last (DIAL) study. Design. DIAL is a 6-month pilot randomized trial to examine the efficacy of phone-based weight loss programs with varying levels of treatment contact (10 vs. 20 sessions) in comparison to self-directed treatment. Setting. Participants were recruited from the community via mailings and advertisement. Subjects. Participants were 63 adults with a body mass index between 30 and 39 kg/m2. Intervention. Participants received a standard set of print materials and were randomized to either: (1) self-directed treatment; (2) 10 phone coaching sessions; or (3) 20 phone coaching sessions. Measures. Measured height, weight, and psychosocial and weight-related self-monitoring measures were collected at baseline and follow-up. Analysis. General linear models were used to examine 6-month treatment group differences in weight loss and in psychosocial and behavioral measures. Results. Weight losses were – 2.3, – 3.2, and – 4.9 kg in the self-directed, 10-session, and 20-session groups, respectively (p < .21). Participants who completed 10 or more sessions lost more weight (– 5.1 kg) compared to those completed four or fewer sessions (– .3 kg, p < .04). Conclusion. Phone-based weight loss program participation is associated with modest weight loss. The optimal dose and timing of intervention warrant further study.

Energy density and weight change in a long-term weight-loss trial

OBJECTIVE To characterize perceived barriers to healthful eating in a sample of obese, treatment-seeking adults and to examine whether changes in barriers are associated with energy intake and body weight. DESIGN Observational study based on findings from a randomized, controlled behavioral weight-loss trial. PARTICIPANTS Participants were 113 women and 100 men, mean age 48.8 years, 67% white, and mean body mass index at baseline 34.9 kg/m(2). VARIABLES MEASURED Perceived diet barriers were assessed using a 39-item questionnaire. Energy intake was assessed with the Block Food Frequency Questionnaire. Body weight (kg) and height (cm) were measured. ANALYSIS Factor-based scales constructed from exploratory factor analysis. Linear regression models regressed 12-month energy intake and body weight on baseline to 12-month factor-based score changes (α = .05). RESULTS Exploratory factor analysis yielded 3 factors: lack of knowledge, lack of control, and lack of time. Reported declines in lack of knowledge and lack of control from baseline to 12 months were associated with significantly greater energy restriction over 12 months, whereas reported declines in lack of control and lack of time were associated with significantly greater weight loss. CONCLUSIONS AND IMPLICATIONS Results suggest that declines in perceived barriers to healthful eating during treatment are associated with greater energy restriction and weight loss.