Yo-yo dieting in African American women: weight cycling and health.

OBJECTIVE: Research on the effects of weight cycling on health is mixed, strife with inconsistent definitions and the exclusion of African Americans. This study examined weight cycling prevalence among African American women prior to enrolling in a weight management program. Associations of weight cycling with physical and psychological health were conducted. DESIGN: Cross-sectional analysis. SETTING: Community-based weight-management program. PARTICIPANTS: 167 overweight or obese treatment-seeking African American women. MAIN OUTCOME MEASURES: Weight cycling was examined in relation to physiological factors, including eating pathology, mood, self esteem, and physical health, specifically current weight, ideal weight, peak weight, and blood pressure. RESULTS: Weight cycling was prevalent (63%). Cyclers had higher current and peak weights (P<.01). Blood pressure did not differ between groups. Cyclers had higher drive for thinness, less body satisfaction, and less self-esteem for appearance (P<.05). CONCLUSION: African American women are at risk for weight cycling and it may be associated with greater weight and poorer measures of psychological health.

Self-reported vs. actual energy intake in youth with and without loss of control eating.

Episodes of loss of control over eating (LOC) in children and adolescents--often characterized by the consumption of highly palatable dessert and snack-type foods--have been associated with a lack of awareness while eating that could lead to under- or over-estimation of how much food is consumed. However, little is known about the reporting accuracy of food intake in youth with and without LOC eating. One hundred fifty-six girls and boys were administered the Eating Disorder Examination to assess for the presence of LOC eating. Youth were queried regarding the amounts of foods consumed directly following a multi-item, laboratory buffet test meal. Children with LOC (n=42) did not differ significantly from youth without LOC (n=114) in reporting accuracy of total food intake (reported minus actual energy intake: 153.0 ± 59.6 vs. 96.9 ± 36.0 kcal; p=0.42). However, compared to those without LOC, children with LOC were less accurate at reporting percentage of energy intake from carbohydrate (p=0.01). Youth with LOC were also less accurate at reporting their intake of desserts (p=0.04). Findings point to the possibility that youth with LOC may have poorer recall of sweet food consumption. Future research is required to examine whether poorer recall reflects a lack of awareness while eating palatable, sweet foods.

Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: meta-analyses.

OBJECTIVE: The purpose of this meta-analysis was to investigate the effects of cognitive behavioral therapy (CBT) and patient education (PE) on commonly reported problems (depression, anxiety, pain, physical functioning, and quality of life (QOL)) in adult cancer survivors. METHODS: Meta analyses of randomized controlled trials of CBT and PE were conducted. MEDLINE, PSYCHINFO and the Cochrane Database were searched from 1993-2004. The effects of individual versus group interventions and short (<8 months) versus long (>8 months) term follow up are also reported. RESULTS: Fifteen studies met quality criteria. The sample size was 1,492 adult cancer survivors with an age range of 18-84. 790 were randomly assigned to intervention groups and 702 to control groups. CBT varied in duration from 4 weekly one-hour sessions to 55 weekly two-hour sessions. PE ranged from a single 20-minute session to 6 weekly one-hour sessions. Follow up ranged from 1 week to 14 months. CBT was effective for depression (ES = 1.2; 95% CI = 0.22-2.19), anxiety (ES = 1.99; 95% CI = 0.69-3.31), and QOL (ES = 0.91; 95% CI = 0.38-1.44). QOL was improved at both short and (ES = 1.45, 95% CI = .43-2.47) and long term (ES = .26; 95% CI = .06-.46) follow up. PE was not related to improved outcomes. CONCLUSIONS: CBT is related to short-term effects on depression and anxiety and both short and long term effects on QOL. Individual interventions were more effective than group. Various CBT approaches provided in an individual format can assist cancer survivors in reducing emotional distress and improving quality of life.

Church-based obesity treatment for African-American women improves adherence.

This study compared adherence to Behavioral Choice Treatment (BCT), a 12-week obesity treatment program that promotes weight loss and exercise, among 22 Caucasian-American and 10 African-American overweight women in a university setting to 10 African-American overweight women in a church setting. Behavioral Choice Treatment (BCT) promotes moderate behavior change that can be comfortably and therefore permanently maintained. Participants obtained feedback from computerized eating diaries and kept exercise logs. Results indicated that both university groups exhibited comparable eating pathology at pre- and post-treatment and comparable weight loss, despite the African-American sample attending fewer sessions. The African-American church group exhibited less disordered eating attitudes, less interpersonal distrust (eg, reluctance to form close relationships or sense of alienation) at pre-treatment, and experienced significantly greater weight loss than either university group. All groups lost weight and maintained these losses at 12-month follow-up. Preliminary results suggest treatment setting may play an important role in treatment adherence and sample characteristics.