Predictors of Lowest Weight and Long-Term Weight Regain Among Roux-en-Y Gastric Bypass Patients.

BACKGROUND: Weight loss surgery (WLS) outcomes are poorly understood. This study aimed to evaluate the relationship of well-documented (e.g., health, diet, physical activity) and theoretically relevant variables (e.g., substance use and "food addiction") with both weight nadir and weight regain (WR) following WLS. METHODS: A sample of 97 Roux-en-Y gastric bypass patients (M time since surgery = 8.86 years) were surveyed about pre- and post-WLS weight, health, self-management behaviors, alcohol problems, and clinical symptoms. RESULTS: Patients lost a mean of 42 % (SD = 10.71 %) of total weight at weight nadir, but 26 % (SD = 19.66 %) of the lost weight was regained by the time of the survey. Correlates of lower weight nadir and WR differed considerably, with minor overlap. Weight nadir was associated with pre-WLS drug use and post-WLS medical comorbidities. WR, on the other hand, was associated with post-WLS adherence to dietary and physical activity modification. Post-WLS nocturnal eating, depression, and problematic alcohol use were also associated with WR. With all associated variables in regression models, number of post-WLS medical comorbidities (ß = -.313, p < 0.01) and post-WLS depression (ß = 0.325, p < 0.01) accounted for the most variance and remained as significant predictors of weight nadir and WR, respectively. CONCLUSIONS: While weight nadir was associated with relatively few and largely nonmodifiable variables, WR was significantly associated with adherence-related behaviors, mood symptoms, and pathological patterns of food and alcohol use, all of which are potentially modifiable. These findings underscore the importance of long-term behavioral and psychosocial monitoring after surgery.

Persuading students to exercise: what is the best way to frame messages for normal-weight versus overweight/obese university students?

OBJECTIVE: The authors investigated the effect of gain-framed (GF) compared with loss-framed (LF) messages on exercise behaviors in normal weight and among overweight/class I obese. The authors also examined which groups would have significantly improved exercise behaviors over time. PARTICIPANTS: Sixty-four undergraduates were randomized to the 4 groups by message type and weight category from September 2008 to December 2011. METHODS: After screening, students received messages and attended an exercise instruction session. RESULTS: There were no significant differences between GF or LF message groups among normal weight or overweight/obese on the primary outcomes at posttest. After receiving the GF messages, the overweight/obese group was the only group to have a significant increase on all 3 primary outcomes: fitness center attendance (p = .038), combined moderate- and vigorous-intensity activity (p = .005), and strength training (p = .037). CONCLUSIONS: The exercise behaviors of undergraduate students who are overweight or obese can benefit from GF messages.