Maureen T. McGuire

Understanding Weight Stigmatization: A Focus Group Study

OBJECTIVES The purpose of this research was to investigate, in a nonclinical sample of adults, thoughts on and experiences with weight stigmatization. DESIGN Focus groups were used to collect information. Participants were recruited through a newspaper advertisement and flyers posted in public places in Minneapolis and St. Paul. During the focus groups, participants were led in a discussion about their thoughts on weight stigmatization and personal experiences of being treated differently or poorly because of their weight. SUBJECTS Six gender-specific focus groups consisted of 31 adult volunteers (17 women and 14 men). VARIABLES MEASURED Perceptions of weight-based stereotypes and weight stigmatization and personal reports of having been treated differently or poorly owing to weight were measured. RESULTS Participants reported a variety of experiences of being treated differently or poorly because of their weight. These included teasing, harassment, slurs and insults, negative judgments and assumptions, and perceived discrimination. Participants reported that such experiences occurred at home, among friends and strangers, at work, and in health care settings. Women reported a greater number and a greater variety of negative experiences than men. IMPLICATIONS The results indicated that participants experienced weight-based stigmatization in many aspects of their lives. Awareness of these experiences may assist in the development of treatments for overweight individuals.

Interventions for weight loss and weight gain prevention among youth: current issues.

AbstractThe recent increase in the prevalence of paediatric obesity is one of the most pressing public health concerns today because of the immediate and long term health consequences associated with this often intractable disease. Efforts are currently being made to reduce the prevalence of paediatric obesity.Youth weight loss studies have produced significant long term results. Most of these programmes included behaviour modification, diet and exercise. Studies have suggested that lifestyle exercise programmes may produce the best long term results. Effective components of these programmes appear to be parental involvement, reduced intake of foods having high energy density and reductions in physical inactivity. Future weight loss studies need to determine the type, intensity, and duration of exercise that will produce acceptable adherence and consequent long term weight loss, and to ascertain the reinforcing factors that determine youth behaviour choice.Weight gain prevention interventions for youth are clearly in their infancy. This review describes 3 completed and 2 ongoing weight gain prevention trials. One study showed reductions in the prevalence of obesity among junior high school girls, but not among boys. Another study among elementary school students showed significant mean decreases in body mass index in boys and girls following an intervention specifically to reduce time spent viewing television. Whether these studies altered food intake or increased physical activity remains unclear.A combination of weight loss treatment and weight gain prevention strategies employed in parallel is likely to yield the greatest benefits. Development and testing of novel intervention strategies, using innovative behavioural approaches to increase the likelihood that children will adopt healthy dietary, physical activity, and sedentary behaviour patterns, holds great promise to significantly reduce the epidemic of obesity.

The relationship between restraint and weight and weight-related behaviors among individuals in a community weight gain prevention trial.

PURPOSE: The present study evaluated the cross-section and prospective associations between the Eating Inventorys (EI) total, flexible and rigid dietary restraint scales and changes in weight and behaviors in a community sample of adults enrolled in a 3 y weight gain prevention study.METHODS: Subjects were participants in the Pound of Prevention (POP) study, a community-based weight gain prevention trial.RESULTS: Higher levels of baseline total, flexible and rigid dietary restraint were related to lower weight and more weight-controlling behaviors at the baseline assessment. Baseline restraint measures positively predicted increases in weighing frequency over the 3 y follow-up. Increases in restraint over the follow-up period were related to decreases in weight, energy intake and television watching, and increases in self-weighing and physical activity.CONCLUSION: The EIs total, flexible and rigid restraint scales were not differently associated with weight and behaviors in this heterogeneous sample of adults who were attempting to lose weight. Developing methods to increase behavioral and cognitive strategies to control weight may help to prevent weight gain in clinical and community samples.International Journal of Obesity (2001) 25, 574–580

Prevalence and correlates of large weight gains and losses.

Objective: To examine the prevalence and correlates of large weight gains and losses over a 3 y period in a heterogeneous population of participants in a study of weight gain prevention.Design and Measures: Analyses based on a cohort of 823 participants in a weight gain prevention study whose weight was measured on at least two of four annual examinations.Results: Weight gains and losses of ≥5% body weight over 1 y were observed in 9.3 and 15% of the population, respectively. Weight gains among those initially losing weight were significantly greater (3.9 kg) than among those experiencing stable weight (0.8 kg) or a large weight gain (1.5 kg) over the following 2 y. Cumulative weight changes over 3 y were −2.6, 1.0 and 7.6 kg among large loss, weight stable and large gain groups, respectively. Large weight loss was more common in smokers, large gains were more common in younger people and in those with a more extensive weight loss history, and stable weight was observed more often in individuals with less extensive histories of weight loss.Conclusion: The high prevalence of large short-term weight gains and losses in this heterogeneous population, their apparent resistance to short-term reversal, and the strength of their relationship to longer-term weight trends suggest that rapid weight change over relatively short time intervals is a phenomenon that deserves more research attention. Short periods of rapid weight gain may contribute importantly to rapidly rising obesity rates.

Reduction of right ventricular pacing in patients with dual-chamber ICDs.

Background: Unnecessary right ventricular (RV) pacing in patients with implantable cardioverter defibrillators (ICD) may adversely affect heart failure morbidity and total mortality. Inhibition of Unnecessary RV Pacing with AV Search Hysteresis in ICDs (INTRINSIC RV) is a prospective, multicenter, randomized trial evaluating outcomes in ICD recipients programmed to single‐chamber pacing (VVI) versus dual‐chamber (DDDR) pacing with AV search hysteresis (AVSH).

Inhibition of unnecessary RV pacing with AV search hysteresis in ICDs (INTRINSIC RV) : Design and clinical protocol

Implantable cardioverter defibrillators (ICDs) reduce sudden arrhythmic death risk but when these devices are programmed DDD and pace in the right ventricle (RV), they can be associated with increased mortality and heart failure morbidity compared to an ICD programmed to back‐up RV. An ideal ICD would provide effective treatment for life‐threatening tachyarrhythmias, reduce unnecessary RV pacing and maintain AV synchrony. The Inhibition of Unnecessary RV Pacing with AV Search Hysteresis (AVSH) in ICDs (INTRINSIC RV) study will assess whether an ICD programmed to DDDR with AVSH is equal to an ICD programmed to VVI with regard to mortality, heart failure hospitalizations, and several predefined secondary enpoints. AVSH allows intrinsic AV conduction beyond the programmed AV delay to help minimize ventricular pacing. INTRINSIC RV, a multi‐center, randomized, prospective trial will enroll >1,200 participants who receive a Guidant VITALITY AVT ICD. ICDs are programmed initially to DDDR AVSH 60–130. Then, after a week, if the %RV pacing <20%, patients are randomized to VVI‐40 or DDDR 60–130 with AVSH. Those with RV pacing ≥20% are placed in an obvservational arm and programmed ad libitum by the treating physician. Patients are followed for one year. This large, randomized, controlled, clinical trial will address whether DDDR with AVSH programming is equivalent to VVI programming in an ICD with regard to mortality and heart failure hospitalization.

Prevalence and correlates of weight-control behaviors among Caribbean adolescent students

Adolescent students from nine English-speaking Caribbean countries completed a survey that assessed weight-control behaviors. Weight-control behaviors were prevalent and similar across gender. Extreme weight-control behaviors were related to several psychosocial factors and compromising health behaviors. Future interventions should target adolescents who are using weight-controlling behaviors to prevent future eating disturbances and psychosocial and health morbidities.