Renee A. Vogt

Exercise in the Treatment of Obesity Effects of Four Interventions on Body Composition, Resting Energy Expenditure, Appetite, and Mood

This study investigated changes in body composition, resting energy expenditure (REE), appetite, and mood in 128 obese women who were randomly assigned to 1 of 4 treatment conditions: diet alone, diet plus aerobic training, diet plus strength training, or diet combined with aerobic and strength training (i.e., combined training). All women received the same 48-week group behavioral program and were prescribed the same diet. Exercising participants were provided 3 supervised exercise sessions per week for the first 28 weeks and 2 sessions weekly thereafter. Participants across the 4 conditions achieved a mean weight loss of 16.5 +/- 6.8 kg at Week 24, which decreased to 15.1 +/- 8.4 kg at Week 48. There were no significant differences among conditions at any time in changes in weight or body composition. Women who received aerobic training displayed significantly smaller reductions in REE at Week 24 than did those who received strength training. There were no other significant differences among conditions at any time on this variable or in changes in appetite and mood.

The Eating Inventory in obese women: Clinical correlates and relationship to weight loss

OBJECTIVES: Describe the physical and psychological correlates of the Eating Inventory (EI) (also known as the Three-Factor Eating Questionnaire) factors in an obese sample, and determine the relationship between the three EI factors and weight loss.DESIGN: Consecutive series of obese women enrolled between 1987 and 1996 in clinical trials of weight loss treatments.PARTICIPANTS: 223 obese women with a weight of 100.7±15.5 kg, an age of 41.4±8.8 y and a body mass index (BMI) of 37.2±5.6 kg/m2.MEASURES: The EI and a variety of physical (weight, body composition and resting energy expenditure) and psychological (mood and binge eating) measures were assessed before and after 5–6 months of treatment.RESULTS: Before treatment, higher restraint scores were associated with lower body weights (P=0.02), while higher disinhibition scores were associated with greater binge eating severity (P<0.0001). Weight loss treatment was associated with significant increases in restraint and decreases in disinhibition and hunger (all Ps<0.0001). Greater increases in restraint during treatment were associated with larger weight losses (P<0.0001).CONCLUSIONS: The three factors of the EI showed clinical utility in a sample of women receiving treatment for obesity.

Body image in obese women before, during, and after weight loss treatment.

Body image, as measured by the Appearance Evaluation and Body Areas Satisfaction scales of the Multidimensional Body-Self Relations Questionnaire (T.F. Cash, 1994b), was assessed in 59 obese women before, during, and after 48 weeks of weight loss treatment. Before treatment, positive ratings of body image were associated with higher levels of self-esteem, lower levels of dysphoria, and fewer previous diets. After 24 weeks and a mean weight loss of 19.4 kg (SD = 6.5), participants showed significant (p < .0001) improvements in body image. A small weight gain from Week 24 to Week 48 was associated with a slight but significant worsening in both measures of body image. Nevertheless, after 48 weeks and a mean weight loss of 16.3 kg (SD = 7.1), body image was significantly improved from baseline (p < .0001). Changes in body image were not related to changes in weight. Future studies are needed to separate the effects of treatment and weight loss on body image in obese persons.

Behavioral treatment of obese binge eaters: do they need different care?

This study investigated the relationship between binge eating and the outcome of weight loss treatment. Participants in a 48-week trial of a structured diet combined with exercise and behavior therapy were classified into one of four groups: no overeating; episodic overeating; subthreshold binge-eating disorder(BED); and BED. Binge eating status was not associated with either dropout or adherence to the diet, but did affect weight loss and mood. The BED group lost significantly more weight at the end of treatment than all other groups, even when adjusting for initial weight. At 1-year follow-up, there were no differences among groups in weight loss or weight regain. The BED group began treatment with significantly higher BDI scores, but improvement in mood occurred by week 5. On the basis of these findings, and a review of the recent literature, we conclude that obese binge eaters respond as favorably to standard dietary and behavioral treatments as do obese nonbingers.

Psychological effects of weight loss and regain: a prospective evaluation.

This study prospectively assessed the psychological effects of weight loss and regain (i.e., weight cycling) in obese women. Measures of mood, binge eating, restraint, disinhibition, and hunger were obtained from 55 participants at baseline, after 6 months of treatment, and 58 months posttreatment. Women lost 21.1 +/- 8.4 kg after 6 months of treatment but were 3.6 +/- 10.9 kg above baseline weight at the time of the follow-up. Contrary to expectations, after this 21-kg cycle of weight loss and regain, women reported significant improvements in mood and binge eating, as well as reductions in hunger and disinhibition. Restraint was unchanged from baseline to follow-up. These data suggest that weight loss and regain are not associated with long-term adverse psychological effects. The findings also confirm earlier reports of significant weight regain after treatment and underscore the need for research to improve the maintenance of weight loss.

A comparison of two approaches to the assessment of Binge Eating in obesity

OBJECTIVE To compare two different methods of assessing binge eating in a sample of 128 obese women enrolled in a weight loss protocol. METHOD Prior to treatment, participants completed the Binge Eating Scale (BES) and the Questionnaire on Eating and Weight Patterns (QEWP), as well as measures of other relevant constructs. They were then classified as bingers and nonbingers by each method and chance-corrected agreement was calculated. RESULTS The BES and QEWP identified a small and nearly equal number of subjects as having significant binge eating, but there was only modest overlap between the two groups (kappa of .45). Subgroup comparisons revealed fundamental differences between the BES and QEWP in the assessment of the critical and associated features of binge eating. DISCUSSION The relative merits of these two approaches to classifying binge eaters and implications for the design of new methods are discussed.