Clinical management and treatment of obesity in China.

China has one of the largest populations with obesity in the world, and obesity has become a major challenge for the country's health-care system. Current guidelines for obesity management are not adequately supported by evidence from clinical studies in Chinese populations. Effective lifestyle interventions suitable for Chinese populations are scarce, insufficient weight-loss medications have been approved by regulatory bodies, and there is low acceptance of non-lifestyle interventions (ie, medications and surgery) among both health-care providers and the general public. Large, well designed, and well implemented clinical trials are needed to strengthen the evidence base for the clinical management of obesity in China. Obesity management can be improved through use of a tiered system involving health management centres, integrated lifestyle interventions and medical treatments, strengthened obesity education and training, and use of advanced electronic health technologies. Resource mobilisation, support from major stakeholders for people with overweight or obesity, and education and changes to social norms among the wider public are also needed. National health policies should prioritise both obesity prevention and improvement of the treatment and management of obesity.

Limited dietary interventions in rural Australian communities: A systematic review.

AIM: This review aimed to synthesise the evidence on the effectiveness of dietary interventions targeting adolescents (>13 years) and adults living in rural or remote Australia. METHODS: Six electronic databases were searched to identify dietary interventions undertaken in rural or remote communities. Studies were included if they utilised intervention and control comparisons or pre and post assessment of diet-related outcomes. If studies included metropolitan populations, dietary outcome measures had to be provided separately for rural data. RESULTS: In total, 14 articles from 12 unique studies met the criteria for inclusion and together provided incomplete coverage across all states of Australia, included intervention studies targeted diet to address obesity, cardiovascular disease, and high blood pressure or diabetes. No studies were focussed on reducing community malnutrition. All studies, with one exception, focussed specifically on rural adults, no interventions specifically targeted adolescents in rural areas. Only two studies documented the involvement of a dietitian in intervention development or delivery. All studies produced a significant outcome for either dietary intake, body mass index, waist circumference, or diet related biomedical risk factors for individuals located in rural or remote areas of Australia. CONCLUSION: Dietary interventions in rural Australia are under-studied, especially among the adolescent population. This is despite the high level of preventable diet-related disease burden in rural and remote Australia. Existing evidence shows promise in improving dietary intakes, but further, large scale intervention research, with the involvement of dietitians, is urgently needed to improve the health of rural communities.

Leveraging corporate social responsibility to improve consumer safety of dietary supplements sold for weight loss and muscle building.

The potential dangers associated with dietary supplements sold for weight loss and muscle building are well documented and increasingly garnering the attention of the media, public, and government leaders. Public health professionals have an opportunity to improve population health in the context of dietary supplement use by translating scientific evidence into action. In this commentary, we discuss the potential to motivate corporate social responsibility (CSR) among manufacturers and retailers of dietary supplements sold for weight loss and muscle building. We examine levers available to public health professionals for generating voluntary corporate self-regulation by reviewing examples from successful CSR initiatives in other domains of public health and offering recommendations highlighting effective advocacy strategies. We encourage public health professionals to use one or multiple advocacy strategies to improve consumer protections for dietary supplements sold for weight loss and muscle building.

Evaluation of the effectiveness of making Weight Watchers available to Tennessee Medicaid (TennCare) recipients.

INTRODUCTION: In 2006, Tennessee Medicaid (TennCare) offered its recipients access to Weight Watchers for a nominal fee. The aim of this study was to determine the weight change among adult participants. METHODS: This is a retrospective analysis of weight change among overweight and obese TennCare recipients who participated in the program. Weight change was calculated as the median difference from the first date of participation to the last. Weight change was also calculated as median percentage change from initial weight and categorized as weight loss or gain of 0 to 5, ≥5 to 10, and ≥10 %. RESULTS: During the study period, 1,605 individuals started the program and 1192 had at least one follow-up weight measurement and thus met the inclusion criteria for the study. Women (n = 1149) had a BMI of 39.6 kg/m(2) and men (n = 43) had a BMI of 43.0 kg/m(2). The median weight loss for all participants was 1.9 kg, or 1.8 % of initial weight. Twenty percent of participants lost 5 % or more of their initial body weight while participating in the program. Over 13 % of participants only attended two meetings; on average, these participants lost 0.5 % of initial weight. Over 23 % of participants attended 13 or more meetings, and they lost an average of 6.4 % of initial weight. DISCUSSION: Twenty percent of TennCare recipients who joined Weight Watchers lost a clinically significant amount of weight. Participants who attended more meetings lost more weight. Reimbursement for Weight Watchers has been maintained by all of the Medicaid managed care organizations in Tennessee. Partnerships that allow low-income populations to access weight loss programs may provide a valuable weight management tool.

Location, timing, and social structure patterns related to physical activity participation in weight loss programs.

Less than half of the adults in the United States meet national guidelines for physical activity. Physical activity programs can induce short-term improvements in physical activity. To develop effective interventions, researchers and practitioners should consider the timing, location, and social structure patterns of participants. Using a pretest, posttest study design, 329 adults in a weight loss program completed surveys on their patterns and physical activity participation. Men preferred weight lifting, cycling, and jogging, whereas women preferred walking and aerobics. Black participants preferred being active in the home. Additionally, participating in a mix of group and individual activities compared with individual-only activities was predictive of posttest moderate-to-vigorous intensity and total physical activity. Providing a variety of activities for adults in both location and social structure may lead to sustained physical activity participation.