Willingness of female smokers to tolerate postcessation weight gain.

When asked how much weight they would be willing to gain if they quit smoking, women smokers replied 5.0 +/- 5.8 pounds (2.3 +/- 2.6 kg), compared with 10.7 +/- 7.6 pounds (4.9 +/- 3.5 kg) for men. Seventy-five percent of women, vs. 35% of men, were unwilling to gain more than 5 pounds (2.3 kg). White women were willing to gain 4.2 +/- 4.5 pounds (1.9 +/- 2.0 kg) compared with 11.1 +/- 10.7 pounds (5.0 +/- 4.9 kg) for Black women. In women under 25 years of age, 57% were unwilling to gain any weight at all, but even among women older than 40, 39% were unwilling to gain weight. Willingness to gain was negatively correlated with Body Mass Index, but even among nonoverweight women, 33% were unwilling to gain weight. Similarly, willingness to gain was negatively correlated with restrained eating, but even among low-restraint women, 22% were unwilling to gain weight. These findings suggest that unwillingness to gain is endemic among female smokers, that success in persuading them to accept a gain of more than 5 pounds (2.3 kg) as a final outcome is unlikely, and that strategies for postponing gain until cessation is well established, combined with waiting until weight stabilizes before determining what weight-management measures are needed, may be more effective.

Effects of body image on dieting, exercise, and anabolic steroid use in adolescent males.

This cross-sectional survey study examined body image, dieting and exercise variables, and steroid use in 2,088 high-school graduates aged 18 years. In contrast to women, more men wished to gain (46%) rather than loose weight (32%). Men who wished to gain weight were more satisfied with their body shape, showed no fear of fatness, and dieted and exercised less frequently than did men who wished to lose weight. The prevalence of dieting was low (4%), even among men who wished to lose weight (9%), and physical exercise was more likely to be used for both weight loss and weight gain. Contrary to expectations, anabolic steroid use was rare (0.6%) and was not associated with a desire for weight gain. Steroid users were more likely to engage in running and swimming than football. The data did not support the notion that anabolic steroid use is widespread among high-school males.

The severity of dieting and bingeing behaviors in college women: interview validation of survey data.

A combined survey and interview study was conducted to validate a categorical Dieting and Bingeing Severity Scale (DBSS), and to estimate the prevalence of eating disorders in young women. We hypothesized that assignment to the DBSS categories would be confirmed by clinical interviews such that interview-diagnosed eating disorders would be found with increasing frequency and severity at the upper end of the DBSS. Freshmen college women (n = 1367) completed a survey instrument addressing the frequency and severity of dieting, binge-eating, and other behaviors and attitudes related to weight control. Random stratified sampling procedures were used to select a subset of women (n = 306) from each DBSS category for structured clinical interviews for DSM-III-R (SCID). Survey respondents were assigned to one of six mutually exclusive DBSS categories: non-dieters (9% of sample), casual dieters (26%), moderate dieters (23%), intense dieters (21%), dieters at-risk (19%), and probable bulimia nervosa (2%). The DBSS effectively rank-ordered subjects according to the risk of having interview-diagnosed eating disorders. Women in the three most severe DBSS categories were significantly more likely to have current subthreshold and threshold level eating disorders, in particular bulimia nervosa and eating disorder not otherwise specified (EDNOS). The estimated prevalence of current bulimia nervosa was approximately 2% by both survey and interview methods. The prevalence of current EDNOS was 13%, more than six times greater than the prevalence of bulimia nervosa. The DBSS was found to be a reliable and valid measure of dieting and bingeing severity. The survey instrument may be useful in measuring the extent of, and changes in, pathological dieting in community-based samples of young women, and in studying comorbidity of dieting and bingeing severity with other psychiatric conditions including depression and substance use. The DBSS may also be useful in identifying risk factors associated with the onset of eating disorders.

Weight-loss strategies of young adults: exercise versus dieting.

This cross-sectional survey study examined weight control practices of 2,092 male and 1,748 female feshman students aged 18 years. For women, the desire for weight loss was observed at all levels of body weight. Most women (79%) wished to weigh less than their current weight, and 23% were following a restricted-calorie diet. In contrast, more men wished to gain (46%) rather than lose weight (32%), and only 3% were dieting at the time of the study. A comparison of weight control practices of men and women who wished to lose weight showed that women restricted calories far more frequently than did men. In contrast, although men were more likely to use exercise for weight control than were women, the differences between the sexes were small. A combined analysis of dieting and exercise behaviors showed that while men relied almost exclusively on intensive exercise as opposed to dieting, women employed exercise as well as dieting for the purpose of weight control.

Eating pathology and DSM-III-R bulimia nervosa: a continuum of behavior.

This longitudinal survey study of 557 college women used the new Eating Pathology Scale to classify respondents as nondieters, casual dieters, intensive dieters, dieters at risk, and bulimic. Shifts in the severity of dieting behavior over a 6-month period occurred primarily between adjacent scale categories. While new cases of bulimia were drawn from intensive dieters and dieters at risk, those women who no longer met DSM-III-R criteria for bulimia nervosa continued to engage in bulimic behavior.

Body weight and dieting in adolescence: impact of socioeconomic status.

This cross-sectional survey study examined dieting and exercise variables as a function of parental education in 2,174 male and 1,804 female college-bound high school graduates aged 18 years. Parental education is an index of socioeconomic status (SES). Higher SES was associated with lower current and desired body weight in both women and men. The prevalence of dieting, binging, and vigorous exercise for weight control increased with SES for women but not for men. These data confirm the inverse relationship between body weight, dieting, and social class, previously demonstrated with American adults.

Taste preferences in human obesity: environmental and familial factors.

Taste-response profiles influence food selection and may help distinguish among potential subgroups of obese individuals. A representative community-based sample of 61 obese and 31 lean adults tasted five sucrose solutions and nine fat-containing solid stimuli resembling cake icings. Solid stimuli contained 15-35% fat and 20-70% sucrose (by weight). No significant differences in taste responsiveness were observed between obese and lean groups. Obese subjects were then divided into subgroups based on age at onset of obesity and past fluctuations in body weight. Obese subjects characterized by large weight fluctuations showed elevated preferences for sugar and fat mixtures compared with the stable subgroup. In contrast, early age at onset of obesity (less than 10 y), thought to be a measure of familial risk, had no significant effects on taste preferences. Environmental as opposed to familial factors may be more immediate determinants of taste preferences and food choice.

Racial/Ethnic differences in smoking, drinking, and illicit drug use among American high school seniors, 1976-89.

BACKGROUND: This paper reports racial/ethnic differences in the use of licit and illicit drugs by high school seniors in the United States. METHODS: The study uses questionnaire data from annual, nationally representative surveys of seniors from 1976 through 1989. Combined sample sizes were 57,620 for 1976-79; 75,772 for 1980-84; and 73,527 for 1985-89. RESULTS: Native American had the highest prevalence rates for cigarettes, alcohol, and most illicit drugs; White students had the next highest rates for most drugs. Asian Americans had the lowest prevalence rates, and Black students had levels nearly as low except for marijuana. Prevalence rates for the Hispanic groups were mostly in the intermediate ranges except for relatively high cocaine use among the males. Trend patterns for most forms of drug use were similar across subgroups, although cigarette use declined more sharply for Black than White seniors, resulting in greater Black-White differences in recent years. CONCLUSIONS: This study, other school-based studies, and general population surveys all show relatively low levels of drug use by most non-White youth, especially Black Americans and Asian Americans. Multivariate analyses indicate that such subgroup differences in high school seniors' drug use are not primarily attributable to family composition, parents' education, region, or urban-rural distinctions.

Successful behavioral treatment of polydipsia in a schizophrenic patient.

Behavioral treatment of a 35 year old female with chronic schizophrenia and water intoxication with seizures was conducted on an inpatient psychiatric unit. Treatment included frequent daily weights, restricted fluid intake, positive reinforcement for program compliance, and time-out from reinforcement following significant weight gain or other specified program violations. The final 6 months of the 30 month treatment program were a maintenance phase during which most contingencies were faded and all fluid restrictions were removed. There was no reported recurrence of polydipsia after 18 months of community placement.

Direct mail as a prompt for follow-up care among persons at risk for hypertension.

We undertook a direct mail campaign to urge persons identified as being at risk for hypertension to seek medical advice. Those who received a single mailing displayed a 28% increase in the proportion who subsequently discussed their blood pressure with a physician and a 12% increase in the proportion who had their blood pressure rechecked, while those persons who received six mailings reported an equivalent increase in physician discussions but a smaller increase in rechecking their blood pressure. These results support the use of inexpensive social marketing strategies as follow-up methods for blood pressure screening programs.

Low-sodium, high-potassium diet: feasibility and acceptability in a normotensive population.

Sixty-nine normotensive volunteers participated in an eight-week study to test the feasibility and acceptability of two low-sodium (less than 70 mEq), high-potassium (greater than 100 mEq) diets. The diet groups differed only in the use of KCl salt substitute. Both dietary groups were able to reduce sodium and increase potassium intake compared to the control group. Urine sodium excretion decreased in the diet groups but no change was observed in potassium. Potassium chloride salt substitute was not used as recommended, suggesting its unacceptability.

Correlates of weight loss and its maintenance over two years of follow-up among middle-aged men.

This paper analyzes demographic, social, psychological, and behavioral correlates of weight loss and maintenance in a group of 89 middle-aged men. Measures were collected before and after a 15-week intervention program and at 3-month and 1-year follow-up evaluations. Associations were examined through 2 years of follow-up observation. Principal findings were (a) a strong inverse relationship between prior participation in an organized weight control program and both short- and long-term weight loss; (b) a positive association between efficacy expectations and weight loss; (c) a positive association between attendance at treatment sessions and weight loss; (d) an inverse relationship between spouse attendance and weight loss; and (e) positive associations between weight loss and perceived social support, reported improvement in eating behavior, reported improvement in exercise behavior, and affirmative response to relapse episodes following treatment.

Calorie requirements in weight loss: an estimate based on self-reported food intake in middle-aged men.

Twenty-eight men participating in a weight reduction program self-recorded foods eaten and calorie consumption for a 15-week period. These food records were examined to estimate calorie needs during weight loss as a function of age, entry weight, height and physical activity level. Only entry weight was significantly associated with calorie need. A predictive equation for calorie need is offered for setting individual calorie intake goals for patient-assessed calorie intake.