Psychological symptoms in individuals successful at long-term maintenance of weight loss

Set point theory suggests that successful maintenance of weight loss ("weight suppression") may be associated with psychological distress. This study examined the association between psychological symptoms and body weight suppression by using a registry of 629 women and 155 men who lost at least 13.6 kg (mean loss = 30 +/- 15 kg) and maintained the loss for at least 1 year (mean duration = 5.5 +/- 6.8 years). Participants completed measures of mood, distress, restraint, disinhibition, bingeing, and purging. Maintainers' levels of distress and depression were lower than those of psychiatric samples and resembled those of community-based samples. Binge-eating and purging rates were comparable to rates of community samples. Maintainers' levels of restraint and disinhibition were markedly different from those of eating-disordered samples, resembling levels found in patients recently treated for obesity. There was no evidence that long-term suppression of body weight is associated with psychological distress.     

The PATHWAYS church-based weight loss program for urban African-American women at risk for diabetes

OBJECTIVE: This study was carried out to test the effectiveness of PATHWAYS, a weight loss program designed specifically for urban African-American women, when administered in urban churches by trained lay facilitators. RESEARCH DESIGN AND METHODS: Thirty-nine obese women were recruited from three urban African-American churches. After randomization and the collection of baseline data on weight and lifestyle practices, subjects in the experimental group (n = 19) were assigned to receive a 14-week weight loss program (PATHWAYS) conducted by trained lay volunteers; control group subjects (n = 20) were put on a waiting list to receive the program at the conclusion of the study period. RESULTS: Of the 39 women enrolled, 15 experimental group subjects and 18 control group subjects were available for posttreatment data collection. After completing the program, PATHWAYS participants lost an average of 10.0 lb, and the control group subjects gained an average of 1.9 lb. Posttreatment difference in weight loss between the groups was statistically significant (P < 0.0001). Waist circumference among PATHWAYS participants decreased 2.5 inches, while waist circumference among control group subjects remained relatively the same. This difference between the groups was statistically significant (P < 0.05). CONCLUSIONS: A weight loss program administered by trained lay volunteers was effective in producing significant and clinically meaningful weight loss among African-American women who often do not benefit from typical weight loss programs. Ongoing research is focusing on whether the weight loss can be maintained or enhanced through monthly reinforcement sessions.     

The effects of a stress-management training program in individuals at risk in the community at large

In this study we examine the effects of a stress-management training program on individuals without serious (mental) health complaints but with an increased chance of developing them as a consequence of stress. Potential subjects were randomly selected from the community at large and, then screened for participation in the training program if some of several (mental) health risk factors could be attributed to them: past life-events, neuroticism, inassertiveness, avoidant coping style and lack of social support. The control group, which did not take part in the training program, consisted of individuals with a similar risk profile as those in the training group. The training program consisted of several stress-management techniques: changing unhealthy life-style, relaxation training, problem-solving training and social skills-training. Multivariate analyses of variance showed that the training group, as compared to the control group, reported significantly less distress, less trait anxiety, less daily hassles, more assertiveness and more satisfaction with social support at follow-up. There were, however, no significant changes found in the coping skills of either group.     

Significance of intentional weight loss on health

The aim of the present study was critically to review how intentional weight loss in overweight and obesity influences mortality. No randomized weight loss intervention trial has included mortality as an end-point. However, even minor weight loss causes beneficial changes in risk factors for cardiovascular disease, whereas the vast majority of observational studies have linked weight loss to excess mortality. Most observational studies do not have information on intentionality of weight loss and suffer from other methodological limitations making inferences from these studies difficult. Given the available observational evidence, the possibility that intended weight loss may cause some increased mortality cannot be excluded. However, considering the totality of the evidence on effects of intended weight loss among overweight and obese subjects, there may be other benefits, such as: psycho-social and physical well-being, risk factor improvement, decreased morbidity, and in certain high-risk subgroups decreased mortality. Treatment of obesity is therefore recommended, particularly in the presence of risk factors or complications.     

Relationship between weight change in young adulthood and the risk of NIDDM. The Sotetsu Study

OBJECTIVE: To investigate the independent effect of weight change in young adulthood on the risk of prevalent NIDDM among middle-aged Japanese men. RESEARCH DESIGN AND METHODS: A case-control study was carried out in 895 male employees aged > or = 30 years of a railway company located in the vicinity of Tokyo. Adjusted odds ratios (ORs) were calculated for prevalent diabetes in each category of weight change (obtained from subjects' medical records) in young adulthood and adulthood. Adjustment for current age, initial BMI, and weight change in each age stratum was performed by the Mantel-Haenszel method or multiple logistic regression analysis. RESULTS: Weight change between 20 years of age and the age at maximum weight was not associated with the risk of NIDDM. Weight gain between 20 and 25 years of age was significantly and positively associated with the risk of NIDDM (OR 3.87 for gains > or = 10.0 kg, 2.53 for gains of 5.0-9.9%, and 3.73 for gains > or = 10.0%). On the other hand, moderate weight gain after 30 years of age was significantly inversely associated with NIDDM (OR 0.44 for gains of 5.0-9.9 kg, 0.15 for gains of 10.0-19.9%, and 0.38 for gains of 20.0-29.9%). CONCLUSIONS: Extreme weight gain between 20 and 25 years of age is a significant predictor of NIDDM, independent of current age, BMI at 20 years of age, and weight change within other age strata.     

Mortality risk by body weight and weight change in people with NIDDM. The WHO Multinational Study of Vascular Disease in Diabetes

OBJECTIVE: Care guidelines for people with non-insulin-dependent diabetes mellitus (NIDDM) emphasize the importance of weight loss in reducing mortality risk. However, existing evidence regarding the relationship between weight and mortality and the effects of weight change is conflicting. We examined these relationships in the World Health Organization Multinational Study of Vascular Disease in Diabetes. RESEARCH DESIGN AND METHODS: This was a cohort study of 1,416 men and 1,544 women. Baseline examinations were performed in 1975 through 1977, a morbidity follow-up was performed in 1983, and a mortality follow-up continued until 1988. Data were analyzed according to geographical groups: Europeans, East Asians, and Native Americans. The relationship between weight change and mortality was analyzed for Europeans only. RESULTS: Generally, body mass index (BMI) was positively associated with age, blood pressure, and cholesterol but was negatively associated with duration of diabetes, prevalence of retinopathy, and use of insulin. There was no clear relationship between BMI and mortality across the geographical groups. In Europeans, weight loss in the leanest subjects at baseline (BMI < 26 kg/m2) was associated with a threefold increase in mortality risk compared with those who had maintained a steady weight (relative risk [RR] 3.05, 95% confidence interval [CI] 1.26-7.36). Only in the most obese group was weight loss associated with a reduction in mortality risk (BMI > 29 kg/m2, RR 0.84, 95% CI 0.40-1.74). CONCLUSIONS: The positive association of BMI with age, blood pressure, and cholesterol and the negative association with duration of diabetes, retinopathy, and use of insulin may explain why there is no strong relationship between BMI and mortality in NIDDM. Weight loss, particularly in the relatively lean diabetic person, may be associated with an increased mortality risk.     

The individual at high risk for endometrial carcinoma

The relative frequency of gonorrhea and nongonococcal urethritis was studied among all active duty US Navy and Marine Corps personnel. Between 1966 and 1974, the incidence of the two diseases increased in parallel fashion, reaching 80.2 cases of gonorrhea and 61.8 cases of nongonococcal urethritis per 1000 average strength in 1974. The 56,457 cases of gonorrhea and 43,538 cases of nongonococcal urethritis reported in 1974 were unevenly distributed geographically. In the United States that year, nongonococcal urethritis was the more commonly reported condition, with 32.9 cases per 1000 average strength per year compared to 28.6 for gonorrhea; and, for the last four years, the ratio of the two was 1.05 cases of nongonococcal urethritis for each case of gonorrhea. These findings imply that nongonococcal urethritis is a significantly greater problem than has been generally recognized.     

Attention-related effects on somatosensory evoked potentials in college students at high risk for psychopathology.

Determined whether a deviation from normal amplitude in the evoked potential in response to attention directed to a stimulus would occur in 10 undergraduates with high scores on a measure of physical anhedonia (AN) and 9 undergraduates with a high score on a measure of perceptual aberration (PA). Ss were compared with 10 control undergraduates and 7 schizophrenics (mean age 25.6 yrs). Previous studies have shown low amplitudes for schizophrenics. Somatosensory evoked potentials (SEPs) were recorded from 5 scalp locations while Ss counted stimuli to 1 of 4 randomly stimulated fingers; SEPs to counted stimuli contained the attention-related late positive wave (P400). P400 amplitudes of AN Ss were lower than those of normal controls, whereas P400 amplitudes of PA Ss and their matched controls did not differ. P400 amplitudes of AN Ss did not differ significantly from those of schizophrenics, although AN means were somewhat higher. P400 amplitude may provide information that is different from the associated behavioral response and a more sensitive indication of central mechanism dysfunction. (40 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Looking at dietary effects on weight loss and diarrhea in HIV seropositive patients: a pilot project

This was a pilot study and therefore only gives us information as to the direction that we can continue looking towards. There were two factors that could have skewed the results. One is the small size of the sample group and the other is that in the Nutritionist III program, not every nutrient, especially in the case of a trace mineral such as selenium, is listed in all foods. Further research is certainly warranted in this area to advance the study of the long term effects of a nutritional intervention on long-term survival of HIV/AIDS persons. A theory was published by the Journal of Medicinal Chemistry (Aug. 1994) that the HIV virus slowly depletes the body of the trace mineral selenium, which it uses to erupt into uninfected cells. The theory proposes that the HIV virus needs selenium, which preserves the elasticity of body tissue and slows the aging process, to trigger its growth. Once the virus uses up all the selenium in one cell, then it breaks out in search of more, spreading the infection to new cells. The researchers at the University of Georgia suggested that the latency period may be attributed to the period of time it takes to deplete the body of selenium storage. (NY Times, Aug. 20, 1994)     

The effects of health beliefs on screening mammography utilization among a diverse sample of older women

Screening mammography is particularly effective in detecting breast cancer in elderly women. Yet, although half of all breast cancers are diagnosed in older women, statistics show that women aged 65 and over tend to underutilize screening mammography. Prior research has used the constructs of the Health Belief Model to explore attitudes and beliefs relative to breast cancer screening. Prior studies have also identified health beliefs and concerns relative to screening mammography and race/ethnicity as some of the patient-related predictors of screening mammography utilization among younger women. This study uses the theoretical framework of the Health Belief Model to explore the effects of these variables on utilization in a multiracial, multiethnic, random sample of 1011 women, aged 65 and over. Race/ethnicity, belief that mammograms detect cancer, ease the mind, and provide accurate results; concern over the radiation, pain, and cost associated with receiving a mammogram; and other independent variables were tested as predictors of screening mammography utilization. Regression analysis identified that the belief that having a mammogram eases recipients minds was the most significant predictor of screening mammography utilization. None of the other health beliefs or health concerns were significant predictors. Race/ethnicity had no direct effects on utilization nor was it a confounder in the relationship between health beliefs, concerns and utilization. These results indicate that, along with emphasizing the importance of mammograms in early detection of breast cancer, stressing the reassurance that mammography brings recipients may be an effective health education strategy for elderly women of different racial/ethnic backgrounds.     

Otoacoustic emissions in full-term newborns at risk for hearing loss

Distortion product otoacoustic emissions (DPOEs) and click-evoked otoacoustic emissions (CEOEs) characteristics of the normal newborn population have been previously reported in the literature. There is little information about DPOE evaluations in the newborn population at risk for hearing loss. The authors now report the DPOE and/or CEOE data from six full-term subjects at risk for hearing loss or with highly suspected hearing loss. These subjects were less than 1 year of age and at risk for hearing loss secondary to a history of hereditary hearing loss, meningitis, hyperbilirubinemia, and ototoxic drug exposure. Audiometric evaluation included auditory brainstem responses (ABR), behavioral observation audiometry, and tympanometry. The CEOEs and DPOEs were found to be decreased or absent in the subjects with suspected hearing loss secondary to cochlear pathology; they were found to be normal in a subject with a suspected central hearing loss. This study's data suggest that otoacoustic emissions when combined with ABR can provide a frequency-specific evaluation of cochlear function and help determine the anatomic site of a pathologic lesion.     

Prospective incidence of first onsets and recurrences of depression in individuals at high and low cognitive risk for depression.

Do negative cognitive styles provide similar vulnerability to first onsets versus recurrences of depressive disorders, and are these associations specific to depression? The authors followed for 2.5 years prospectively college freshmen (N = 347) with no initial psychiatric disorders at high-risk (HR) versus low-risk (LR) for depression on the basis of their cognitive styles. HR participants had odds of major, minor, and hopelessness depression that were 3.5-6.8 times greater than the odds for LR individuals. Negative cognitive styles were similarly predictive of first onsets and recurrences of major depression and hopelessness depression but predicted first onsets of minor depression more strongly than recurrences. The risk groups did not differ in incidence of anxiety disorders not comorbid with depression or other disorders, but HR participants were more likely to have an onset of anxiety comorbid with depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of ethanol on temporal recovery of auditory-evoked potentials in individuals at risk for alcoholism

The present investigation examined the effects of placebo (P), low dose (LD), and high dose (HD) ethanol on auditory event-related potential (AEP) recovery functions in a group of males at high risk to develop alcoholism (HR; n = 23, mean = 22.3 years) and a low risk (LR; n = 27, mean = 23.0 years) control group. Condition order was randomized, with one condition (P, LD, or HD) per day and a minimum 1-day interval between conditions. For each subject, both blood alcohol levels (BALs) measured via breathalyzer, and event-related potentials recorded with the entire 10/20 International System, were assessed prior to and at mean intervals of 20, 60, 90, and 130 min after P, LD, or HD administration. A series of binaural auditory stimuli with randomly interposed interstimulus intervals of 0.5, 1.0, and 10.0 sec were used to elicit the N100 and P200 components of the AEP. Between-groups comparisons indicated that ethanol elicited risk group differences in recovery functions not present at baseline. The differences were manifested in the HR group as larger decrements in P200 amplitude during the ascending blood alcohol curve (acute sensitivity) and more rapid returns of both N100 and P200 to baseline levels during the descending blood alcohol curve (acute tolerance). These findings support Newlin and Thomson's (1990) Differentiator Model, suggesting that LR and HR individuals are differentially sensitive to the effects of ethanol.     

Matching individuals to weight loss treatments: A survey of obesity experts.

For identification of factors for matching individuals to treatments, experts in the field of obesity were surveyed about the indications and contraindications for 11 common approaches to weight loss. The experts provided 170 client characteristics as possible matching factors, yet only 5 factors were matched to specific programs by 50% or more of the respondents. The results are discussed with regard to potential variables for studies on matching individuals to treatments, working hypotheses to be tested, and the value of matching information for clinical decision making. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of memory beliefs in individuals with traumatic brain injury.

Objective: To explore metamemory (memory beliefs) and affective functioning in individuals with traumatic brain injury (TBI). Participants: Twenty-six individuals with mild TBI (MTBI), 16 individuals with severe TBI (STBI), and 42 uninjured adults. Outcome Measures: Metamemory in Adulthood questionnaire, Postconcussion Syndrome Checklist, Perceived Stress Scale, Beck Depression Inventory (2nd ed.), Beck Anxiety Inventory. Results: The control group endorsed higher memory self-efficacy, fewer depressive symptoms, fewer memory strategies, and fewer postconcussion symptoms than the MTBI or STBI group. The MTBI group placed high importance on success in memory tasks. Memory self-efficacy and memory-strategies use mediated the relation between TBI and depression. Conclusion: Individuals with brain injury hold negative beliefs about their memory functioning, and such beliefs contribute to depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Temple-Wisconsin Cognitive Vulnerability to Depression Project: Lifetime history of Axis I psychopathology in individuals at high and low cognitive risk for depression.

The authors tested the cognitive vulnerability hypotheses of depression with a retrospective behavioral high-risk design. Individuals without current Axis I diagnoses who exhibited either negative or positive cognitive styles were compared on lifetime prevalence of depressive and other disorders and the clinical parameters of depressive episodes. Consistent with predictions, cognitively high-risk participants had higher lifetime prevalence than low-risk participants of major and hopelessness depression and marginally higher prevalence of minor depression. These group differences were specific to depressive disorders. The high-risk group also had more severe depressions than the low-risk group, but not longer duration or earlier onset depressions. The risk group differences in prevalence of depressive disorders were not mediated by current depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Genetic counseling for families at high cancer risk

About 5-10% of the most common cancers, such as breast, colon and melanoma, result from mutations in inherited predisposition genes. Recently some of these genes have been mapped or even cloned. These advances in cancer genetics have made more precise genetic counseling possible for cancer patients and their families. In our clinic for specific genetic counseling 180 families with a history of cancer were seen during a 10-month period. In counseling sessions, the family history was confirmed and interpreted, personal risk was estimated and the availability of molecular genetic testing was presented. Blood samples for DNA testing were drawn from those with certain criteria who wished to be tested. Instructions for early detection were also given, depending on the personal risk of cancer as compared to that of the general population.     

A prospective replication of the protective effects of IQ in subjects at high risk for juvenile delinquency.

The purpose of the study was to test the replicability of a protective effect of high IQ against criminality. Support has been found in prior studies for the hypotheses that Ss at high risk would have an elevated risk of serious criminal involvement, that seriously criminal Ss would have a lower mean IQ score than noncriminal Ss, and that Ss at high risk who had not become involved in serious criminal behavior would have the highest IQs. This report tests these hypotheses in a prospective design. Subjects were 1,037 members of a longitudinal investigation of a New Zealand birth cohort. IQs were examined for male and female Ss who were divided into 4 groups formed on the basis of risk status at age 5 years and delinquency outcome at ages 13 and 15. Analyses were conducted with and without mild delinquents excluded from the nondelinquent groups. We found that male and female delinquents showed significantly lower IQ scores than nondelinquents. By varying S selection procedures, we also found that a very high IQ may help boys, even those at risk, to stay free of delinquency altogether. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of parent weight on weight loss in obese children.

Assessed the effect of parent weight (obese/nonobese parent) and parent control vs child self-control on the weight loss of 41 obese 8–12 yr olds over a 3-yr period. Children of nonobese parents had significantly greater decrease in relative weight after 1 yr, but not after 3 yrs, than children of obese parents. Locus of control was not related to treatment outcome over the 3 yrs. Results suggest that parent weight was related to weight loss, but not weight maintenance, in obese children. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of increasing initial weight loss with the Scarsdale Diet on subsequent weight loss in a behavioral treatment program.

20 overweight Ss (aged 20–65 yrs) who participated in a behavioral weight control program that included 2 wks on the Scarsdale diet lost more weight during that period than did 19 Ss in a behavioral group without the diet. The experimental manipulation of initial weight loss did not significantly affect subsequent or overall weight loss. At 1 yr, the average weight losses of the Scarsdale and behavioral conditions were not significantly different. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)