Taking control of your personal eating and exercise environment: a weight maintenance program.

The current investigation examined the impact of a weight maintenance intervention (MI) designed to empower people to create a personal healthy food and physical activity environment on weight loss treatment outcomes. It was hypothesized that behavioral weight loss program (BWLP) participants who received an additional MI would evidence superior weight loss maintenance compared to participants who received a BWLP alone (no contact [NC]). Fifty-one obese adults were randomly assigned to participate in a 16-week weight loss intervention followed by NC or a 6-week MI. Thirty-eight participants completed the six-month follow-up. Body weight, percent body fat, cardiorespiratory fitness, self-reported physical activity, and self-reported diet (i.e., calories, percent daily intake of fat, protein, and carbohydrates) were assessed. Participants significantly decreased their weight, increased physical activity/fitness, and improved dietary intake (ps<.05). MI participants had significantly greater weight loss maintenance than NC participants (ps<.05). Helping obese individuals to modify their personal eating and physical activity environment in order to reduce exposure to "obesogenic" cues may contribute to long-term weight loss maintenance.

Using motivational interviewing as a supplement to obesity treatment: a stepped-care approach.

OBJECTIVE: This investigation was designed to improve behavioral weight loss program (BWLP) treatment outcomes by providing stepped care (SC) to individuals experiencing difficulties with weight loss during treatment. SC entails transition to more intensive treatments when less intensive treatments fail to meet treatment goals. In a BWLP, motivational interviewing (MI) may increase participants' motivation toward behavioral change and thus complement the acquisition of behavioral change skills. It was hypothesized that BWLP+SC (MI) participants (i.e., participants who failed to meet weight loss goals and received MI) would demonstrate superior treatment outcomes when compared with BWLP (SC matched) participants (i.e., participants who failed to meet weight loss goals but did not receive MI). DESIGN: Fifty-five obese, sedentary adults were randomly assigned to a BWLP+SC or a BWLP. MAIN OUTCOME MEASURES: Changes in weight, cardiorespiratory fitness, self-reported physical activity, and diet (i.e., calories, percentage daily intake of fat, protein, and carbohydrates) in response to treatment were assessed. RESULTS: Participants significantly decreased their weight, increased physical activity/fitness, and improved dietary intake (ps<.05). BWLP+SC (MI) participants lost more weight and engaged in greater weekly exercise than BWLP (SC matched) participants who did not receive MI (ps<.05). CONCLUSION: For individuals experiencing weight loss difficulties during a BWLP, MI may have considerable promise.

Individual differences in food perceptions and calorie estimation: an examination of dieting status, weight, and gender.

People frequently place foods into "health" or "diet" categories. This study examined whether (1) evaluations of "healthiness/unhealthiness" influence "caloric" estimation accuracy, (2) people evaluate foods for "healthiness/unhealthiness" or "weight gain/loss" differently, and (3) food evaluations differ by gender, diet status, and weight. Also, undergraduate dieters attempting to lose weight on their own were compared to obese weight loss program participants. Undergraduate students (N=101) rated eight "healthy" and "unhealthy" foods on perceived "healthiness/unhealthiness," "weight loss/gain capacity" and "caloric" content. Open-ended questions inquiring why a food was "healthy/unhealthy" or would "contribute to weight gain/loss" were coded into independent food categories (e.g., high fat). Results indicate that calories were systematically underestimated in healthy/weight loss foods, while they were systematically overestimated in unhealthy/weight gain foods. Dieters were more accurate at estimating "calories" of healthy foods and more attentive to the foods' fat, "calorie", and sugar content than non-dieters. Overweight participants commented more on fat and sugar content than normal weight participants. Undergraduate dieters used fewer categories for evaluating foods than weight loss program participants. Individual difference characteristics, such as diet-status, weight, and gender, influence people's perceptions of foods' healthiness or capacity to influence weight, and in some instances systematically bias their estimates of the caloric content of foods.

Qualitative perceptions and caloric estimations of healthy and unhealthy foods by behavioral weight loss participants.

People are inundated with messages about foods' healthiness/unhealthiness and capacity for weight gain/loss. This study examined how people evaluate foods for 'healthiness/unhealthiness' or 'capacity for weight gain/loss' and whether these evaluations influence 'caloric' estimation accuracy. Fifty-five participants in a behavioral weight loss program rated eight 'healthy' and eight 'unhealthy' foods on perceived 'healthiness/unhealthiness', 'capacity to influence weight loss or gain' and 'caloric' content. Open-ended questions inquired why a food was 'healthy/unhealthy' or would 'contribute to weight gain/loss'. Open-ended questions were coded into 29 independent food categories (e.g. high fat). While similar foods were often judged as 'healthy' and 'contributing to weight loss' or 'unhealthy' and 'contributing to weight gain', participants provided different explanations for their 'health' and 'weight' ratings. Healthy/weight loss foods were systematically underestimated in 'calories', while unhealthy/weight gain foods were systematically overestimated in 'calories'. Errors in 'caloric' estimation decreased from pre- to post-weight loss treatment, but were not associated with weight loss. Higher baseline BMI was associated with greater inaccuracy in 'caloric' estimation. Fat content was the most common category used for evaluating foods. Participant evaluations of healthy/weight loss foods or unhealthy/weight gain foods were systematically associated with 'caloric' estimation.

Applying a stepped-care approach to the treatment of obesity.

OBJECTIVE: In a stepped-care (SC) approach to treatment, more intensive interventions are implemented when less intensive interventions prove to be insufficient. It was hypothesized that a behavioral weight loss program with SC (BWLP+SC) would evidence superior treatment outcomes when compared with a BWLP without SC (BWLP). METHODS: Forty-four obese, sedentary adults were randomly assigned to a BWLP+SC [i.e., problem-solving therapy (PST)] or a BWLP. RESULTS: Participants in the BWLP+SC lost significantly more weight and body fat, reported greater physical activity and greater improvements in diet, and were more likely to achieve their within-treatment weight loss goals than BWLP participants. Participants in the BWLP+SC who received PST (BWLP+SC [PST]) also evidenced superior treatment outcomes including superior weight loss maintenance (through 12 months posttreatment) compared with BWLP participants matched on SC eligibility [BWLP (SC matched)]. CONCLUSION: BWLP+SC may improve treatment outcomes and participant motivation to achieve preestablished weight loss goals.