Michelle R. Lent

Maladaptive eating patterns, quality of life, and weight outcomes following gastric bypass: results of an Internet survey.

Bariatric surgery is the most effective treatment for severe obesity. However, evidence suggests that maladaptive eating behaviors such as binge eating, grazing, and a loss of control when eating may impact postsurgical weight outcomes. The current study sought to characterize the weight outcomes, eating patterns, and perceived health‐related quality of life of individuals 3–10 years following gastric bypass (GBP) surgery and to assess the relationships between eating behaviors, weight outcomes, and quality of life. Eligible participants (N = 497) completed an Internet survey of their eating behaviors, health‐related quality of life, and weight history. Participants self‐reported a mean maximum postsurgical loss of 81% of their excess weight and maintained a mean weight loss of 70% 3–10 years following surgery (mean 4.2 years). Eighty‐seven percent reported weight regain ranging from 1 to 124 lb (mean 22.6 lb). Frequency of binge eating, a loss of control when eating, and grazing were all significantly correlated with greater weight regain (binge eating r = 0.24, P = 0.006; loss of control r = 0.36, P < 0.01; grazing r = 0.39, P < 0.001) and lesser excess weight loss (EWL) (binge eating r = −0.21, P = 0.013; loss of control r = −0.41, P < 0.001; grazing r = −0.27, P < 0.001). Poorer health‐related quality of life was associated with binge eating disorder (BED) (t[463] = 9.7, P < 0.001) and grazing two or more times per week (t[361] = 9.0, P < 0.001). These findings suggest that eating disturbances and a loss of control when eating are significant following GBP and are risk factors for diminished weight outcomes.

A randomized trial of the effects of an almond-enriched, hypocaloric diet in the treatment of obesity

Background: Increased consumption of nuts has been advocated because of their health benefits, but the role of nuts in the treatment of obesity is unclear given their high energy density. Objective: This study was designed to evaluate the effects of a hypocaloric, almond-enriched diet (AED) compared with a hypocaloric nut-free diet (NFD) on body weight and cardiovascular disease risk factors in the context of an 18-mo behavioral weight-management program. Design: Overweight and obese individuals [n = 123; age = 46.8 y, BMI (in kg/m2) = 34.0] were randomly assigned to consume an AED or NFD and instructed in traditional behavioral methods of weight control. Anthropometric and metabolic measurements were made at baseline, 6 mo, and 18 mo. Results: Those in the AED group lost slightly but significantly less weight than did those in the NFD group at 6 mo (−5.5 compared with −7.4 kg; P = 0.04), but there were no differences at 18 mo. No significant differences in body composition were found between the groups at 6 or 18 mo. The AED, compared with the NFD, was associated with greater reductions in total cholesterol (P = 0.03), total:HDL cholesterol (P = 0.02), and triglycerides (P = 0.048) at 6 mo, and no differences were observed between the groups at 18 mo. Conclusions: The AED and NFD groups experienced clinically significant and comparable weight loss at 18 mo. Despite smaller weight loss in the AED group at 6 mo, the AED group experienced greater improvements in lipid profiles. This trial was registered at clinicaltrials.gov as NCT00194428.

Relationship of food addiction to weight loss and attrition during obesity treatment.

The relationship between food addiction (FA) and weight and attrition outcomes in overweight and obese adults participating in weight loss interventions were prospectively examined in this study.

Feasibility and Preliminary Outcomes of a Scalable, Community-based Treatment of Childhood Obesity

OBJECTIVE: Clinic-based treatments of childhood obesity are effective but typically have limited reach and are costly. In this study, we evaluated the effects of a scalable weight management program for children and teenagers. METHODS: Participants were 155 children and their parent/guardian. Children had a mean ± SD age of 11.3 ± 2.8 years, BMI z score of 2.23 ± 0.41, and a percentage overweight of 72.5 ± 34.0. Most (92%) were obese, and nearly half (46.5%) were ≥99th percentile for BMI. The primary outcome was change in percentage overweight from baseline to 6 months. RESULTS: At 6 months, children experienced a 3.4 percentage point reduction in percentage overweight (P = .001). Children <13 years had a 4.3 percentage point reduction in percentage overweight, whereas those ≥13 years had a 1.0 percentage point reduction. Those who attended a greater number of face-to-face group sessions experienced greater changes in percentage overweight. There were significant improvements in child health-related quality of life as reported by both children and their parents. CONCLUSIONS: These data suggest that a scalable, community-based pediatric obesity intervention can result in clinically significant reductions in percentage overweight, as well as improvements in health-related quality of life.

Addictive personality and maladaptive eating behaviors in adults seeking bariatric surgery

This study examined the relationship between addictive personality and maladaptive eating behaviors in bariatric surgery candidates. Ninety-seven bariatric surgery candidates completed the Eysenck Personality Questionnaire (EPQ-R) Addiction Scale, the Overeating Questionnaire (OQ), binge-eating questions from the Questionnaire of Eating and Weight Patterns (QEWP-R), and the Eating Attitudes and Behaviors Questionnaire. Participants with Binge Eating Disorder (BED) displayed addictive personality scores comparable to individuals addicted to substances (M=17.5, SD=5.3). Addictive personality was associated with Overeating (r=.45, p<.001), Cravings (r=.31, p=.005), Affective Disturbances (r=.62, p<.001) and Social Isolation (r=.53, p<.001). Addictive personality was associated with maladaptive eating behaviors, suggesting the potential for addictive eating.

Corner store purchases made by adults, adolescents and children: items, nutritional characteristics and amount spent

OBJECTIVE Corner stores, also known as bodegas, are prevalent in low-income urban areas and primarily stock high-energy foods and beverages. Little is known about individual-level purchases in these locations. The purpose of the present study was to assess corner store purchases (items, nutritional characteristics and amount spent) made by children, adolescents and adults in a low-income urban environment. DESIGN Evaluation staff used 9238 intercept surveys to directly examine food and beverage purchases. SETTING Intercepts were collected at 192 corner stores in Philadelphia, PA, USA. SUBJECTS Participants were adult, adolescent and child corner store shoppers. RESULTS Among the 9238 intercept surveys, there were 20 244 items. On average, at each corner store visit, consumers purchased 2.2 (sd 2.1) items (1.3 (sd 2.0) foods and 0.9 (sd 0.9) beverages) that cost

Smoking and alcohol use in gastric bypass patients

US 2.74 (sd

Weight Change, Psychological Well-Being, and Vitality in Adults Participating in a Cognitive-Behavioral Weight Loss Program

US 3.52) and contained 2786.5 (sd 4454.2) kJ (666.0 (sd 1064.6) kcal). Whether the data were examined as a percentage of total items purchased or as a percentage of intercepts, the most common corner store purchases were beverages, chips, prepared food items, pastries and candy. Beverage purchases occurred during 65.9% of intercepts and accounted for 39.2% of all items. Regular soda was the most popular beverage purchase. Corner store purchases averaged 66.2 g of sugar, 921.1 mg of sodium and 2.5 g of fibre per intercept. Compared with children and adolescents, adults spent the most money and purchased the most energy. CONCLUSIONS Urban corner store shoppers spent almost

Internalized Weight Bias in Weight-Loss Surgery Patients: Psychosocial Correlates and Weight Loss Outcomes

US 3.00 for over 2700 kJ (650 kcal) per store visit. Obesity prevention efforts may benefit from including interventions aimed at changing corner store food environments in low-income, urban areas.

Evaluation of the Association Between Preoperative Clinical Factors and Long-term Weight Loss After Roux-en-Y Gastric Bypass

Bariatric surgery may increase the risk of substance use. The purpose of this study was to prospectively assess smoking and alcohol use before and after bariatric surgery, identify characteristics associated with alcohol use and smoking, and examine substance use and weight loss. Participants (N = 155, mean = 50.1 ± 11.3 y and 45.7 ± 7.0 kg/m(2)) were Roux-en-Y gastric bypass (RYGB) patients that completed surveys on substance use preoperatively and postoperatively. Alcohol use decreased significantly from the preoperative (72.3%) to the postoperative (63.2%) period. As preoperative alcohol quantity rose, the odds of consuming any alcohol postoperatively increased six-fold. Higher BMI increased the odds of high alcohol consumption. Older age decreased the odds of alcohol use and smoking. Smoking status did not differ pre- (19.4%) to post- (14.8%) surgery. Alcohol use and smoking were not associated with weight loss. After weight-loss surgery, alcohol use declined but smoking rates did not significantly change. Younger patients were more likely to use alcohol and smoke postoperatively. Patients with a higher BMI or a history of substance use may be more likely to use alcohol postoperatively.