Motivational Techniques and Hacks for Treating Childhood Obesity

Treating obesity in children and adolescents is not a cakewalk. Asking them directly to get up and run, or just serving them a four-quadrant plate won’t serve the purpose at all. An obese child is already under the repercussions of oppressive remarks by the society. If at home as well, their mental milieu is not taken care of, there are chances of them being trapped in the shackles of depression. To avoid such drastic consequences, one must be prudent enough, while conversing with their children/patients regarding their weight. Motivation enhancement is very crucial in childhood obesity management, as the required changes in diet, behavior and physical activity are difficult to carry out with an insufficient level of motivation.1 The motivational hacks presented here might be helpful for parents and health care professionals in convincing their children/patients to stride through the road to health.

Current practices in family planning: a population based study

Background: To study the knowledge, current practices of family planning methods and acceptance post motivation.Methods: Cross-sectional study conducted at family planning OPD of AIIMS, New Delhi, India. A total of 1516 couples who came for MTP at any gestation couple were enquired about knowledge, currently used contraceptive method and reason for abortion. Couple was counseled and allowed to choose contraceptive method using cafeteria approach. Mean values of continuous data were tested using t-test/ANOVA. Categorial data were compared using chi-square/ Fischers exact test.Results: Mean±SD age of the women was 28.89±5.21 years with 9.98±4.56 weeks POG. Around 81% of women had one or more living children with 62.67% women with at least one abortion previously. Majority used male condoms (42.10%) followed by natural method (21.01%), Cu-T (3.80%), OCPs (1.65%), injectable (0.30%), I-pill (0.24%). Awareness was maximum for male condoms, Cu-T, OCPs, female sterilization (100%) and least for female condoms (20%) and LNG-IUS (8.46%). Contraceptive failure (68.90%), congenital abnormality in the fetus (22.40%), maternal disease (5.90%), rape (1.60%), completed family (0.80%) and not using any method (0.30%) were the reasons of abortion. Majority of abortions were in first trimester (70%). Post-motivation around 69.30% of the couples accepted some form of contraception. Female sterilization (32.50%) method accepted by the couples as compares to temporary methods (36.70%) such as Cu-T, OCPs, Injectables etc.Conclusions: Despite of awareness the family planning programme is unsuccessful largely due to inappropriate attitude. Behavioral modification and communication goes a long way to slove the problem.

"Diabetes Education Class IPE" -Challenge to promote new IPE (interprofessional education) with real patients- / 医学教育

<p>　The WHO reported the importance of IPE (Interprofessional Education) in order to implement team-based medicine smoothly. Some Japanese medical educational institutes presented their IPE programs, which involved real patients, but most IPE programs used scenario-based or standardized patients. Moreover, few reports showed IPE programs for diabetic patient education. We created a new program, called the "Diabetes education class IPE" . Participants were 2 medical, 4 nursing, 4 pharmacy, and 3 dietician students. The students experienced the planning and management of and reflection on diabetes education classes. As a result of reflection, the "Diabetes education class IPE" was viewed as a useful IPE program.</p>

Effect of a 12-week weight management program on the clinical characteristics and dietary intake of the young obese and the contributing factors to the successful weight loss

BACKGROUND/OBJECTIVES: The objectives were to investigate the effect of a 12-wk intervention with behavioral modification on clinical characteristics and dietary intakes of young and otherwise healthy obese and to identify factors for successful weight loss. The goal was to lose 0.5 kg per week by reducing 300-500 kcal/day and by increasing physical activities. SUBJECTS AND METHODS: Forty four obese subjects (BMI > 25) and 19 normal weight subjects (BMI 18.5-23) finished the 12-week intervention. Obese subjects participated in 5 group educations and 6 individual counseling sessions. Normal weight subjects attended 6 individual counseling sessions for evaluations of dietary intake and exercise pattern. Anthropometric and clinical characteristics and 3-day dietary records were evaluated at baseline and week12. RESULTS: Weight and serum triglyceride and free fatty acid concentrations in obese group decreased significantly with intervention. Intakes of energy, fat, and cholesterol decreased significantly in the obese. Active participation, realistic weight loss goal setting, and weight gain after high school graduation not during childhood were identified as key factors for successful weight loss. CONCLUSIONS: The 12-week intervention with behavioral modification resulted in reduced energy and fat intakes and led to significant weight loss and improvements of clinical characteristics in the obese. The finding that those who became obese during childhood lost less weight indicates the importance of 'early' intervention.

Social Work Intervention for Patients with Obesity / 임상당뇨병

Obesity is a multi-factorial disease that results from a combination of genetic, biological, psychological, behavioral, and social factors. In addition, obesity causes physical, emotional, psychological, and social problems, and therefore a variety of factors and issues in the treatment of obesity must be considered. Behavioral Modification and Cognitive Behavioral Therapy are effective in the treatment of obesity with multidimensional problems.

The Stages of Change in Smoking Cessation in a Representative Sample of Korean Adult Smokers

This study reports the stages of change in smoking cessation in a representative sample of Korean adult smokers. The study subjects, all adult smokers (n=2,422), were recruited from the second Korea National Health and Nutrition Examination Survey conducted in 2001. The stages of change were categorized using demo-graphic (age and sex), socioeconomic (education, residence, and household income), and smoking characteristics (age at smoking onset, duration of smoking, and number of cigarettes smoked per day). Age-stratified analyses of the association of socioeconomic and smoking characteristics with the stages of change in male and female smokers were also conducted. According to the stages of change, the study population consisted of 37.6% (95% CI, 35.7-39.5) pre-contemplation, 56.0% (54.0-58.0) contemplation, and 6.4% (5.4-7.4) preparation. The associations between the characteristics of the smokers and the stages of change were all statistically significant. The age-stratified analyses showed that all the socioeconomic and smoking characteristics were significantly associated with the stages in males, while education and residence had significant associations in females. This study revealed that a relatively small number of Korean smokers were prepared to quit and the stage distribution might be influenced by demographic, socioeconomic, and smoking char-acteristics.

Evaluation of Short Term Weight Control Program for Female College Students

The purpose of this study was to evaluate weight control program provided by university health care center for female college students. The program was 8-week long and composed of diet, exercise, and behavioral modification. Evaluation was made on the completion of 8-week program and a follow-up survey was done at 3 - 24 months after the end of program by telephone or by e-mail. Total of 76 women completed the 8-week program and 51 for follow-up survey. On the completion of 8-week program, significant decreases in body weight, BMI, body fat (kg), % body fat, and WHR were resulted, however, no change in muscle mass was found. Even the subjects without weight change showed significant reduction in body fat (kg) and % body fat. Total food intake was decreased resulting in reduced intakes of most nutrients. Meal distribution of energy was changed; %energy from snack decreased from 22% to 14%, and proportion for breakfast increased. Blood values of hemoglobin, hematocrit, total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglyceride were within normal range, and no changes were observed by this program. The follow-up survey revealed that 88.3% of the subjects continued to lose weight after completion of the program, while only 7.8% gained weight. And 78.4% of the subjects considered the program effective. In conclusion, the weight reducing regime with education is effective for long lasting weight control and health conscious behavior for female college student. Since the subjects reduced the size of meal, instead of cutting only calories down, food selection to meet all the nutrient requirements except energy should be emphasized.

The Development of Behavioral Modification Program on Weight Reduction in Overweight Patients taking Atypical Antipsychotics: Preliminary Study

OBJECTS: SThe authors developed a behavioral modification program for overweight outpatients with schizophrenia and bipolar disorder who had been treated with atypical antipsychotics, and evaluated the applicability of this program to outpatients. METHODS: Two men and nine women who had been treated with atypical antipsychotics and who had gained at least 5 percent of their pre-treatment body weight for 10 weeks, attended a behavioral modification program. The patients' weight, body mass index and the diet-activity scale were assessed and were compared with those of a matched comparison group who did not attend the behavioral modification program. RESULTS: The body weight of patients who attended the behavioral modification program reduced with statistical significance. The treatment group showed significant improvement in diet-related items but not in activity-related items of the diet-activity scale. CONCLUSIONS: This study suggested the applicability of a behavioral modification program on weight reduction to overweight patients taking atypical antipsychotics for the first time in Korea. Additional large scale studies are needed to validate the effectiveness of this program.