Publications by authors named "Jessica Gokee LaRose"

45 Publications

Making large changes or small changes to prevent weight gain in young adulthood: which is preferred and by whom?

Transl Behav Med 2021 Jul 22. Epub 2021 Jul 22.

Alpert Medical School of Brown University, Miriam Hospital, Providence, RI 02903, USA.

Knowledge of participant treatment preferences can inform decision-making regarding treatment dissemination and future participant adoption. To compare participant perceptions of two evidence-based approaches for weight gain prevention in young adults to identify the intervention with the greatest likelihood of adoption. As part of a randomized trial (Study of Novel Approaches to Weight Gain Prevention [SNAP]; n = 599) testing weight gain prevention interventions in young adults (18-35 years), individuals assigned to self-regulation interventions using either large changes or small changes reported on perceived personal effectiveness and difficulty of treatment over 3 years. Treatment satisfaction at 2-year follow-up was also reported. Pre-randomization, participants believed the large change intervention would be more personally effective than the small change intervention, although they also considered it more complex. Older age, lower body mass index (p = 0.056), and desire to maintain versus lose weight predicted greater perceived effectiveness of the small change relative to large change intervention. Over follow-up, the large change intervention was no longer perceived as more effective, but perceived effectiveness aligned with assigned treatment. The small change intervention was rated as less complex than the large change intervention at 4 months, but not at other follow-ups. At study conclusion, participants were largely satisfied with both treatments; however, in the small change intervention, individuals who were not successful at preventing weight gain were less satisfied than individuals who were successful. The large and small change interventions are both appropriate for dissemination with no clear advantages based on the participant perceptions.
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http://dx.doi.org/10.1093/tbm/ibab099DOI Listing
July 2021

Effect of a High-Intensity Dietary Intervention on Changes in Dietary Intake and Eating Pathology during a Multicomponent Adolescent Obesity Intervention.

Nutrients 2021 May 28;13(6). Epub 2021 May 28.

Department of Pediatrics, School of Medicine, Children's Hospital of Richmond at Virginia Commonwealth University, Box 980140, Richmond, VA 23298, USA.

Concerns remain about dietary changes during pediatric obesity treatment and eating pathology, which have not been investigated. This secondary data analysis from a randomized clinical trial examined associations between adolescents' changes in energy intake and diet quality during obesity treatment with post-treatment eating pathology. Adolescents (N = 82: 13.7 ± 1.2 y, 34.9 ± 7.0 kg/m, 63.4% female, 46.3% black) received TEENS+, a 4-month multicomponent intervention. TEENS+ provided individualized dietary goals (1200-1800 kcal/day; number of "Go" foods/day (low-energy, high-nutrient-dense foods)). At 0 and 4 months, 3-day food records assessed energy intake and diet quality (Healthy Eating Index 2015 (HEI-2015)). Two HEI-2015 subscores were created: components to increase (increase), and components to limit (decrease). The Eating Disorder Examination Questionnaire measured eating pathology (total score and subscales: restraint; and eating, weight, and shape concern). Corrected -values are reported as q-values. Energy intake decreased (-292 ± 418 kcal/day; q < 0.001), while diet quality improved during treatment (total HEI-2015 (4.5 ± 15.1; q = 0.034) and increase (3.3 ± 9.4; q = 0.011)). Restraint increased (+0.6 ± 1.4; q < 0.001), whereas shape (-0.5 ± 1.3; q = 0.004) and weight (-0.5 ± 1.4; q = 0.015) concerns decreased. Greater decreases in energy intake were associated with greater restraint post-treatment (F = 17.69; q < 0.001). No other significant associations were observed. Changes in adolescents' dietary intake during obesity treatment were unrelated to increased shape, weight, or eating concerns post-treatment.
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http://dx.doi.org/10.3390/nu13061850DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8228549PMC
May 2021

Behavioral weight loss in emerging adults: Design and rationale for the Richmond Emerging Adults Choosing Health (REACH) randomized clinical trial.

Contemp Clin Trials 2021 May 24;107:106426. Epub 2021 May 24.

UNC Lineberger Comprehensive Cancer Center, UNC Weight Research Center, 1700 Martin Luther King Jr. Blvd, Suite 136, Chapel Hill, NC 27514, United States of America.

Background: In the U.S., over 40% of 18-25 year olds meet criteria for overweight or obesity. Yet, no large-scale trials have targeted this age group for behavioral weight loss (BWL). Formative data revealed that existing BWL programs do not meet their unique needs and identified motivation as a fundamental barrier for weight management. The goal of the Richmond Emerging Adults Choosing Health (REACH) trial was to test the efficacy of two mHealth lifestyle interventions specifically focused on enhancing motivation, relative to adapted standard.

Methods: Participants (N = 381, 18-25 years, body mass index 25-45 kg/m) will be randomized to 1) adapted BWL (aBWL), 2) aBWL + self-determination theory (aBWL+SDT), or 3) aBWL + behavioral economics (aBWL+BE). All arms will receive a 6-month intervention, delivered via one group session and one individual session, followed by an mHealth platform. Assessments will occur at baseline, 3-months, 6-months (post-treatment) and 12-months (following a no-contact period). The primary aim is to compare weight loss outcomes at 6 months. Secondary aims include changes at 6-months in physical and behavioral cardiometabolic risk factors, as well as psychosocial measures. We will also explore weight loss maintenance, change in hypothesized mediators, and moderators of treatment response.

Discussion: REACH is the first large-scale BWL trial designed specifically for emerging adults. Further, it will be the first trial to compare a lifestyle intervention grounded in self-determination theory to one rooted in behavioral economics. If clinically significant reductions in adiposity are achieved, findings could inform a scalable treatment model to meet the needs of this vulnerable population.

Trial Registration: NCT02736981.
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http://dx.doi.org/10.1016/j.cct.2021.106426DOI Listing
May 2021

Translating evidence-based behavioral weight loss into a multi-level, community intervention within a community-based participatory research framework: the Wellness Engagement (WE) Project.

Transl Behav Med 2021 06;11(6):1235-1243

Virginia Commonwealth University School of Medicine, Department of Health Behavior and Policy, Richmond, VA, USA.

Black Americans and individuals from economically disadvantaged backgrounds are at disproportionate risk for obesity, yet are underrepresented in behavioral weight loss (BWL) trials and experience less benefit from traditional programs. The Wellness Engagement (WE) Project sought to translate evidence-based BWL within a CBPR framework to promote change across multiple domains of influence in an under-resourced, predominantly Black community. The purpose of this paper is to describe the efforts we undertook to translate data from our extensive formative phase into programming well suited to meet the needs of the Petersburg community. In addition, we present data from our pilot work on feasibility and acceptability. Formative data were collected using a variety of methods including a community-wide survey, asset mapping, house chats, focus groups, and key informant interviews. In collaboration with key stakeholders and community members, evidence-based approaches to weight loss were adapted to meet the needs of the community with respect to both content and delivery modality. Materials were adapted to focus on small, realistic changes appropriate for the specific context. Behavioral groups, experiential nutrition and exercise sessions, and walking groups leveraged existing assets and were open to all community members. Feasibility and acceptability ratings were promising. Furthermore, the WE Project appeared to contribute to a culture of wellness. CBPR might be a viable approach for engaging under-resourced Black communities in behavioral weight management; larger scale implementation and evaluation efforts are needed.
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http://dx.doi.org/10.1093/tbm/ibaa140DOI Listing
June 2021

The Weight of Racial Discrimination: Examining the Association Between Racial Discrimination and Change in Adiposity Among Emerging Adult Women Enrolled in a Behavioral Weight Loss Program.

J Racial Ethn Health Disparities 2021 Mar 29. Epub 2021 Mar 29.

Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.

Background: Non-Hispanic Black (NHB) emerging adult (EA) women are at disproportionate risk for obesity but experience limited benefit from behavioral weight loss (BWL) programs. Race-related stress could play a role; the goal of this study was to examine the association between racial discrimination (RD) and early (3 months) changes in adiposity, and to explore potential protective factors, among EA in an adapted BWL program.

Methods: This is an ancillary study of non-Hispanic White (NHW) and NHB EA women enrolled in an adapted BWL trial (N = 49; 55.1% NHB; Age 21.2 (2.1); BMI = 33.0 + 4.3 kg/m). At baseline, group- and personal-level RD (RD-group and RD-personal), racial identity (NHB women only), vigilant coping, and social support were assessed via validated questionnaires. Weight and waist circumference were measured objectively at 0 and 3 months.

Results: NHW women manifested greater reductions in waist circumference relative to NHB women (p = .004). RD-personal did not predict change in waist circumference at 3 months (p = .402); however, the association between RD-group and change in waist circumference was statistically significant (p = .015), such that reporting greater group-level discrimination predicted a smaller decrease in waist circumference; the model explained 22% of the variance. Social support and vigilant coping were not statistically significant in the model. Among NHB women only, higher racial identity-centrality predicted greater reduction in waist circumference (p = .019).

Conclusion: Findings suggest racial discrimination could contribute to greater cardiometabolic risk during this developmental period. Future research should examine how experiences of racial discrimination unfold in the daily lives of NHB women to inform mechanistic interventions to enhance health and well-being.

Trial Registration: NCT02736981. Low Intensity Weight Loss for Young Adults.
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http://dx.doi.org/10.1007/s40615-021-01030-7DOI Listing
March 2021

Promoting physical activity in young adult cancer survivors using mHealth and adaptive tailored feedback strategies: Design of the Improving Physical Activity after Cancer Treatment (IMPACT) randomized controlled trial.

Contemp Clin Trials 2021 04 27;103:106293. Epub 2021 Jan 27.

Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Introduction: Despite the health benefits of physical activity for cancer survivors, nearly 60% of young adult cancer survivors (YACS) are physically inactive. Few physical activity interventions have been designed specifically for YACS.

Purpose: To describe the rationale and design of the IMPACT (IMproving Physical Activity after Cancer Treatment) trial, which tests the efficacy of a theory-based, mobile physical activity intervention for YACS.

Methods: A total of 280 physically inactive YACS (diagnosed at ages 18-39) will be randomized to a self-help control or intervention condition. All participants will receive an activity tracker and companion mobile app, cellular-enabled scale, individual videochat session, and access to a Facebook group. Intervention participants will also receive a 6-month mobile intervention based on social cognitive theory, which targets improvements in behavioral capability, self-regulation, self-efficacy, and social support, and incorporates self-regulation strategies and behavior change techniques. The program includes: behavioral lessons; adaptive goal-setting in response to individuals' changing activity patterns; tailored feedback based on objective data and self-report measures; tailored text messages; and Facebook prompts encouraging peer support. Assessments occur at baseline, 3, 6, and 12 months. The primary outcome is total physical activity min/week at 6 months (assessed via accelerometry); secondary outcomes include total physical activity at 12 months, sedentary behavior, weight, and psychosocial measures.

Conclusions: IMPACT uniquely focuses on physical activity in YACS using an automated tailored mHealth program. Study findings could result in a high-reach, physical activity intervention for YACS that has potential to be adopted on a larger scale and reduce cancer-related morbidity. ClinicalTrials.gov Identifier: NCT03569605.
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http://dx.doi.org/10.1016/j.cct.2021.106293DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8089056PMC
April 2021

Changes in Cardiovascular Risk Factors Over 6 Years in Young Adults in a Randomized Trial of Weight Gain Prevention.

Obesity (Silver Spring) 2020 12;28(12):2323-2330

Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, Alpert Medical School, Brown University-Miriam Hospital, Providence, Rhode Island, USA.

Objective: This study aimed to determine the impact of weight gain prevention interventions on changes in cardiovascular risk factors over 6 years.

Methods: The Study of Novel Approaches to Weight Gain Prevention (SNAP) randomized 599 participants (ages 18-35; 46% with BMI 21-25; 54% with BMI 25-30) to Large Changes (produce buffer by losing 5-10 pounds initially), Small Changes (daily small changes in intake and activity) or Control and followed 355 participants with ongoing intervention and assessments through 6 years.

Results: There were no significant differences among interventions for changes in weight or cardiovascular disease (CVD) risk factors from baseline to 6 years. However, 44% of participants gained ≥5%, and only 14% lost ≥5% over 6 years. Weight changes, from baseline to year 6, were significantly associated with changes in risk factors, especially insulin and high-density lipoprotein cholesterol. Earlier weight changes (e.g., weight cycling) had no beneficial or adverse effect on changes in CVD risk factors at 6 years, independent of 6-year weight changes.

Conclusions: Despite participation in a weight gain prevention trial, almost half of these young adults gained ≥5% or more over 6 years, with significant worsening in CVD risk factors. Greater attention to long-term weight gain prevention in young adults is needed.
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http://dx.doi.org/10.1002/oby.23003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7687606PMC
December 2020

Using motivational interviewing to enhance emerging adults' engagement in weight loss: The Live Well RVA pilot randomized clinical trial.

Obes Sci Pract 2020 Oct 19;6(5):460-472. Epub 2020 Jun 19.

Department of Behavioral and Social Sciences Brown University School of Public Health Providence Rhode Island USA.

Background: Emerging adults (ages 18-25) are at high risk for overweight/obesity, yet traditional adult behavioural weight loss (BWL) interventions do not meet the needs of individuals at this developmental stage. Motivational interviewing (MI) is an evidence-based approach to promote behaviour change but has not been tested for weight loss in this population. The study aimed to test the feasibility and preliminary efficacy of an MI-enhanced weight loss programme to promote engagement, retention and weight loss in emerging adults.

Methods: Emerging adults with overweight/obesity ( = 47, 81% female, 47% racial/ethnic minority, body mass index [BMI] = 33.2 ± 4.6 kg/m) were randomized to either standard BWL or MI-enhanced BWL (MIBWL). Weight was assessed objectively at baseline and posttreatment (3 months). Engagement (in-person session attendance [weeks 1 and 2], online self-monitoring [weeks 3-12] and online content viewing [weeks 3-12]) was tracked throughout the program.

Results: Though results did not reach the level of statistical significance, participants in MIBWL demonstrated greater programme engagement (77% vs. 61.0%, = .11; Cohen = .48), retention (71% vs. 48.0%, = .10; Cohen = .47) and intent-to-treat weight loss (-3.3% vs. -2.2%, = .37; Cohen = .26) compared with those in BWL.

Conclusions: Effect sizes suggest that MI might be a viable approach to enhance engagement and retention in weight loss programmes targeting emerging adults. This finding is meaningful, given the documented challenges with engagement and retention in this vulnerable population and the relationship between engagement and better weight loss outcomes. The results of this small pilot study support efforts to replicate these findings within the context of a fully powered trial.
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http://dx.doi.org/10.1002/osp4.435DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7556426PMC
October 2020

A systematic review of weight-related communication trainings for physicians.

Transl Behav Med 2020 10;10(5):1110-1119

Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.

Obesity is a leading cause of preventable death in the USA. Given the high number of adults seeking routine health care services, physicians have an opportunity to address weight loss during routine clinical encounters. It's often reported that physicians lack the training to address weight. Training programs are implemented in medical settings to prepare physicians to have conversations with patients. Yet, the degree of consistency among training programs and factors associated with better outcomes is unclear. The purpose of this study is to systematically review literature in physician communication trainings related to weight-to compare the content, outcomes, and implementation of existing studies examining weight-related communication training programs for physicians and determine factors associated with physician and patient outcomes. Articles were extracted from PubMed, Proquest, and Embase. Search terms included: health communication, physician training, weight, and obesity. Studies implementing a training program addressing weight among physicians were included. Trainings using either motivational interviewing (MI) or 5 As (Ask, Advise, Assess, Assist, and Arrange) framework found improvements in physicians' communication skills. A small number of trainings including experiential components were also associated with improvements in positive physician outcomes. Findings suggest trainings based in MI or 5 As framework improve physicians' communication skills, but few programs affected patient outcomes. Gaps remain with trainings that can demonstrate weight loss in patients. While work is needed to enhance the effects of these trainings on patient outcomes, data suggest that trainings should be longer in duration and include an experiential component.
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http://dx.doi.org/10.1093/tbm/ibaa014DOI Listing
October 2020

Conducting a Community "Street Survey" to Inform an Obesity Intervention: The WE Project.

Fam Community Health 2021 Jul-Sep 01;44(3):117-125

Departments of Health Behavior and Policy (Drs Mosavel and LaRose), Family Medicine, Division of Epidemiology (Dr Lu), and Occupational Therapy (Dr Winship), Virginia Commonwealth University, Richmond; and Pathways, Inc, Petersburg, Virginia (Ms Ferrell).

Using a community-based participatory research approach, a citywide survey was conducted to explore perceptions of obesity and interventions to reduce obesity within an African American urban community. More than 1300 surveys were collected within 3 months; 92.9% of respondents agreed or strongly agreed that obesity was an important health issue in the community and the majority indicated that family-based interventions were the preferred pathway for improving physical activity (86.0%) and nutrition (85.2%). Engaging community members in survey development and implementation was an effective approach to build local research capacity and establish a shared agenda of reaching a diverse sample of community residents.
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http://dx.doi.org/10.1097/FCH.0000000000000271DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7902738PMC
January 2022

Parent Involvement in Adolescent Obesity Treatment: A Systematic Review.

Pediatrics 2020 09;146(3)

Department of Psychology, College of Humanities and Sciences and.

Context: Family-based lifestyle interventions are recommended for adolescent obesity treatment, yet the optimal role of parents in treatment is unclear.

Objective: To examine systematically the evidence from prospective randomized controlled and/or clinical trials (RCTs) to identify how parents have been involved in adolescent obesity treatment and to identify the optimal type of parental involvement to improve adolescent weight outcomes.

Data Sources: Data sources included PubMed, PsychINFO, and Medline (inception to July 2019).

Study Selection: RCTs evaluating adolescent (12-18 years of age) obesity treatment interventions that included parents were reviewed. Studies had to include a weight-related primary outcome (BMI and BMI score).

Data Extraction: Eligible studies were identified and reviewed, following the Preferred Reporting for Systematic Review and Meta-Analyses guidelines. Study quality and risk of bias were evaluated by using the Cochrane Collaboration risk of bias tool.

Results: This search identified 32 studies, of which 23 were unique RCTs. Only 5 trials experimentally manipulated the role of parents. There was diversity in the treatment target (parent, adolescent, or both) and format (group sessions, separate sessions, or mixed) of the behavioral weight loss interventions. Many studies lacked detail and/or assessments of parent-related behavioral strategies. In ∼40% of unique trials, no parent-related outcomes were reported, whereas parent weight was reported in 26% and associations between parent and adolescent weight change were examined in 17%.

Limitations: Only RCTs published in English in peer-reviewed journals were eligible for inclusion.

Conclusions: Further research, with detailed reporting, is needed to inform clinical guidelines related to optimizing the role of parents in adolescent obesity treatment.
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http://dx.doi.org/10.1542/peds.2019-3315DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7461263PMC
September 2020

Exercise preferences among emerging adults: Do men and women want different things?

J Am Coll Health 2020 Aug 19:1-5. Epub 2020 Aug 19.

Virginia Commonwealth University School of Medicine, Health Behavior and Policy, Richmond, Virginia, USA.

The purpose of this study was to examine exercise preferences of college students (CS), and explore potential gender differences to inform interventions. Participants ( 187, 18-25 years) completed an online survey. Descriptive statistics were conducted to characterize preferences for exercise type and mode of delivery, followed by tests to assess potential gender differences. CS preferred a combination of moderate intensity cardio and strength training. Most CS preferred exercising on their own with guidance from a program. Men preferred intense strength training at higher rates than women ( .001). Findings can inform tailored recruitment messaging and lifestyle interventions for this high-risk population.
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http://dx.doi.org/10.1080/07448481.2020.1803878DOI Listing
August 2020

An Examination of Adolescents' Values in a Motivational Interviewing-based Obesity Intervention.

Am J Health Behav 2020 07;44(4):526-533

Melanie K. Bean, Associate Professor, Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA.

In this paper, we examine values selected by adolescents as part of a motivational interviewing (MI) weight loss intervention. During a values clarification activity, adolescents (N = 52; 75.0% girls; 78.4% African-American; mean age = 13.5 ± 1.8 years; mean body mass index (BMI) = 36.8 ± 6.4 kg/m²) selected their top 5 values. Using MI, interventionists explored selected values with adolescents and related them to target behaviors to develop discrepancy and enhance motivation for engagement in behavioral weight loss behaviors. Values were categorized using thematic analysis. Frequencies of value and theme selection were examined. The majority of adolescents selected values in the Health (N = 38; 73.1%), Religion/ Spirituality (N = 36; 69.2%), Personal Achievement (N = 31; 59.6%), Virtuous (N = 28; 53.8%), and Family (N = 27; 51.9%) categories. Values selected by adolescents with obesity can inform intervention development for this difficult to engage population.
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http://dx.doi.org/10.5993/AJHB.44.4.13DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8260182PMC
July 2020

A Secondary Data Analysis Examining Young Adults' Performance in an Internet Weight Loss Program with Financial Incentives.

Obesity (Silver Spring) 2020 06 6;28(6):1062-1067. Epub 2020 May 6.

Weight Control and Diabetes Research Center, Miriam Hospital, Providence, Rhode Island, USA.

Objective: In traditional behavioral weight loss (BWL) programs, young adults fare worse than older adults with respect to engagement, retention, and weight loss, but money and use of technology have been cited as program factors that might improve outcomes for this population. This study evaluated young adult performance in internet-based BWL (IBWL) offering financial incentives for self-monitoring and weight loss.

Methods: Participants (N = 180; BMI = 33.2 ± 6.0 kg/m ) were randomly assigned to a 12-week IBWL or IBWL + incentives (IBWL + $) group. This secondary data analysis compared young adults (ages 18-35) in IBWL (n = 16) with young adults in IBWL + $ (n = 12) on percent weight loss, engagement, and retention. Young adults (n = 28) were also compared with older adults (ages 36-70; n = 152) on these outcomes.

Results: Young adult weight loss was -2.8% ± 5.2% in IBWL and -5.4% ± 5.7% in IBWL + $ (P = 0.23, partial η  = 0.06). A greater proportion of young adults in IBWL + $ achieved a 10% weight loss compared with IBWL (42% vs. 6%, P = 0.02). Compared with older adults, young adults were less engaged, but there were no differences for retention or weight loss (P values > 0.05).

Conclusions: Findings suggest that technology-based BWL has the potential to eliminate weight loss disparities observed between young adults and older adults in in-person BWL trials. Moreover, adding financial incentives holds promise for promoting clinically meaningful weight loss for young adults.
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http://dx.doi.org/10.1002/oby.22797DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7380503PMC
June 2020

Examining Heterogeneity of Outcomes in a Weight Gain Prevention Program for Young Adults.

Obesity (Silver Spring) 2020 03 6;28(3):521-528. Epub 2020 Feb 6.

Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Miriam Hospital, Providence, Rhode Island, USA.

Objective: This study aimed to characterize young adults who experienced significant weight gains (> 10%) over 3 years in a weight gain prevention program.

Methods: Secondary data analysis from the Study of Novel Approaches to Weight Gain Prevention (SNAP), a randomized trial comparing two self-regulation interventions and a control arm in young adults (18-35 years; BMI 21-30.9 kg/m ), was used. Large Gainers (≥ 10% of their body weight; n = 48), Small Gainers (2.6%-9.9%; n = 149), and Weight Stable participants (± 2.5%; n = 143) were compared on dimensions affecting weight gain.

Results: Differences in weight gain among the three groups were significant by year 1 and subsequently increased. Those who became Large Gainers were heavier at baseline and further below their highest weight, and they reported more weight cycling than Weight Stable, with Small Gainers intermediate. Neither study arm nor pregnancy explained weight change differences among the three groups. Large Gainers reported more depressive symptoms than Weight Stable at years 1 and 2. Large Gainers were less likely to weigh themselves at least weekly at 4 months, before differences in weight gain emerged, and at years 1 and 2.

Conclusions: Large Gainers (representing almost 10% of participants) could be identified early by greater weight issues at baseline and lower use of weight gain prevention strategies.
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http://dx.doi.org/10.1002/oby.22720DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7042032PMC
March 2020

Early Engagement is Associated with Better Weight Loss in Emerging Adults.

Am J Health Behav 2019 07;43(4):795-801

Postdoctoral Fellow, Children's Hospital of Richmond at Virginia Commonwealth University, Healthy Lifestyles Center, Richmond, VA.

Predictors of success among emerging adults (EAs; ages 18-25) within behavioral weight loss (BWL) trials are largely unknown. We examined whether early program engagement predicted overall engagement and weight loss in EAs. Data were pooled from 2 randomized controlled pilot trials in EAs. Participants (N = 99, 80% female, BMI = 33.7±5.1 kg/m²) received a 3-month BWL intervention. Weight was objectively assessed at 0 and 3 months; engagement was tracked weekly; retention was assessed at 3 months. Greater engagement during the initial 4 weeks of treatment predicted greater weight loss (p = .001). Compared to those who did not engage in all 4 initial weeks, participants meeting this threshold experienced greater overall engagement (9.6 vs 4.2 weeks, p < .001), weight losses (intent-to-treat = -3.8% vs -1.3%, p = .004), and retention (78% vs 53%, p = .012). Early engagement in BWL is associated with better outcomes among EAs. Monitoring engagement in real-time during the initial 4 weeks of treatment may be necessary to intervene effectively. Early engagement did not vary by sex or race; future work should identify characteristics associated with poor early engagement.
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http://dx.doi.org/10.5993/AJHB.43.4.12DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6597178PMC
July 2019

Dietary outcomes within the study of novel approaches to weight gain prevention (SNAP) randomized controlled trial.

Int J Behav Nutr Phys Act 2019 01 31;16(1):14. Epub 2019 Jan 31.

Weight Control and Diabetes Research Center at The Miriam Hospital, Providence, RI, USA.

Background: Young adults (YA) are at high-risk for unhealthy dietary behaviors and weight gain. The Study of Novel Approaches to Weight Gain Prevention (SNAP) Trial demonstrated that two self-regulation approaches were effective in reducing weight gain over 2 years compared with control. The goal of this analysis was to examine effects of intervention on dietary outcomes and the association of diet changes with weight change.

Methods: Participants were 599 YA, age 18-35 years, BMI 21.0-30.0 kg/m (27.4 ± 4.4 years; 25.4 ± 2.6 kg/m; 22% men; 73% non-Hispanic White), who were recruited in Providence, RI and Chapel Hill, NC and randomized to self-regulation with Small Changes (SC), self-regulation with Large Changes (LC) or Control (C). SC and LC emphasized frequent self-weighing to cue behavior changes (small daily changes vs. periodic large changes) and targeted high-risk dietary behaviors. Diet and weight were assessed at baseline, 4 months and 2 years.

Results: LC and SC had greater decreases in energy intake than C at 4 months but not 2 years. LC had the greatest changes in percent calories from fat at 4 months, but differences were attenuated at 2 years. No differences in diet quality were observed. Across conditions, increased total energy consumption, fast food, meals away from home, and binge drinking, and decreased dietary quality and breakfast consumption were all associated with weight gain at 2 years.

Conclusions: This study suggests the need to strengthen interventions to produce longer term changes in dietary intake and helps to identify specific behaviors associated with weight gain over time in young adults.

Trial Registration: Clinicaltrials.gov # NCT01183689 , registered August 18, 2010.
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http://dx.doi.org/10.1186/s12966-019-0771-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357348PMC
January 2019

Eating pathology and psychological outcomes in young adults in self-regulation interventions using daily self-weighing.

Health Psychol 2019 Feb 13;38(2):143-150. Epub 2018 Dec 13.

Warren Alpert Medical School.

Objective: Self-regulation interventions encouraging daily weighing prevent weight gain in young adults; however, concerns have been raised that such interventions may have undesirable effects on eating pathology, depression, and health-related quality of life (HRQL). The present study examined whether self-regulation interventions and self-weighing frequency were associated with these indices in normal weight individuals and those with overweight or obesity.

Methods: Young adults ( = 599), 18-35 years with a body mass index (BMI) 21.0-30.9 kg/m² were randomized to control, self-regulation with small changes (SC) or self-regulation with large changes (LC). Interventions taught frequent self-weighing to guide behavioral changes. SC prescribed daily small decreases in intake and increases in physical activity. LC prescribed a 5- to 10-lb weight loss to buffer against anticipated gains. Psychological indices were assessed at baseline and periodically over 2 years of follow-up.

Results: There was no evidence that the interventions increased depressive symptoms or compensatory behaviors or decreased HRQL relative to control. LC increased flexible and rigid control and SC decreased disinhibition. Results did not differ by weight status with the exception of rigid control; here, differences between LC and the other conditions were smaller among those with BMI ≥ 25. Greater self-weighing frequency over time was associated with increases in flexible and rigid control, dietary restraint, and improvements in HRQL.

Conclusions: The self-regulation interventions and increases in self-weighing had no untoward effects. Encouraging weight gain prevention in young adults through frequent weighing and self-regulation appears to be safe for normal weight young adults and those with overweight. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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http://dx.doi.org/10.1037/hea0000689DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6447368PMC
February 2019

A Cafeteria Personnel Intervention to Improve the School Food Environment.

Am J Health Behav 2019 01;43(1):158-167

Associate Professor, Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA.

In this study, we examined the impact of an intervention targeting food service personnel on Smarter Lunchroom adherence in school cafeterias. This study used a quasi-experimental design, conducted in a Virginia school district serving predominantly African-American children, all eligible for free meals. In 2014-15, cafeteria managers (N = 38) from 43 schools were trained (and tasked with training their staff) on principles of behavioral economics and choice architecture designed to enhance students' food selections via modifications to the cafeteria environment. Booster trainings were conducted in 2015-16. Cafeteria personnel completed post-intervention surveys; trained raters conducted objective cafeteria environment ratings, assessing adherence with Smarter Lunchroom principles, at baseline, post-intervention, and one-year follow-up. Sales data also were examined. Cafeteria personnel were satisfied (3.91 [of 5]±0.70) with the training and confident (4.18±0.52) in their ability to make changes. Overall adherence to Smarter Lunchroom principles increased 6.47% at post-intervention and 6.93% at follow-up (p = .001; partial eta = .21-.24), with a corresponding decrease in sugared-beverage sales at post-intervention (p = .001). This environmental-level intervention focused on training cafeteria personnel was associated with increased adherence to Smarter Lunchroom principles, sustained over 2 years. Future research should investigate the impact of this intervention on students' dietary behaviors in a rigorously designed trial.
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http://dx.doi.org/10.5993/AJHB.43.1.13DOI Listing
January 2019

A Cafeteria Personnel Intervention to Improve the School Food Environment.

Am J Health Behav 2019 01;43(1):158-167

Associate Professor, Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA.

In this study, we examined the impact of an intervention targeting food service personnel on Smarter Lunchroom adherence in school cafeterias. This study used a quasi-experimental design, conducted in a Virginia school district serving predominantly African-American children, all eligible for free meals. In 2014-15, cafeteria managers (N = 38) from 43 schools were trained (and tasked with training their staff) on principles of behavioral economics and choice architecture designed to enhance students' food selections via modifications to the cafeteria environment. Booster trainings were conducted in 2015-16. Cafeteria personnel completed post-intervention surveys; trained raters conducted objective cafeteria environment ratings, assessing adherence with Smarter Lunchroom principles, at baseline, post-intervention, and one-year follow-up. Sales data also were examined. Cafeteria personnel were satisfied (3.91 [of 5]±0.70) with the training and confident (4.18±0.52) in their ability to make changes. Overall adherence to Smarter Lunchroom principles increased 6.47% at post-intervention and 6.93% at follow-up (p = .001; partial eta = .21-.24), with a corresponding decrease in sugared-beverage sales at post-intervention (p = .001). This environmental-level intervention focused on training cafeteria personnel was associated with increased adherence to Smarter Lunchroom principles, sustained over 2 years. Future research should investigate the impact of this intervention on students' dietary behaviors in a rigorously designed trial.
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http://dx.doi.org/10.5993/AJHB.43.1.13DOI Listing
January 2019

Small Incentives Improve Weight Loss in Women From Disadvantaged Backgrounds.

Am J Prev Med 2018 03 12;54(3):e41-e47. Epub 2018 Jan 12.

Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island.

Introduction: Women from lower-income backgrounds have the highest rates of obesity. Thus, effective programs for this high-risk population are urgently needed. Evidence suggests that adding financial incentives to treatment helps to engage and promote health behavior change in lower-income populations; however, this has never been tested in women for obesity treatment. The purpose of this study was to examine whether adding small financial incentives to Internet weight loss treatment yields better weight loss outcomes in women from lower-income backgrounds compared with the same treatment without incentives. Weight losses in lower-versus higher-income women were also compared.

Methods: Data were pooled from two randomized trials in which women (N=264) received either Internet behavioral weight loss treatment (IBWL) or IBWL plus incentives (IBWL+$). Weight was objectively assessed. Data were collected and analyzed from 2011 to 2017.

Results: Women from lower-income backgrounds had significantly better weight loss outcomes in IBWL+$ compared with IBWL alone (6.4 [SD=4.9%] vs 2.6 [SD=4.6%], p=0.01). Moreover, a greater percentage achieved a ≥5% weight loss in IBWL+$ vs IBWL alone (52.6% vs 38.1%, p=0.01). Interestingly, the comparison between lower-income versus higher-income groups showed that, in IBWL alone, women with lower income achieved significantly poorer weight losses (3.4 [SD=4.2%] vs 4.9 [SD=4.0%], p=0.03). By contrast, in IBWL+$, weight loss outcomes did not differ by income status (5.0 [SD=5.6%] vs 5.3 [SD=3.8%], p=0.80), and a similar percentage of lower- versus higher-income women achieved a ≥5% weight loss (52.6% vs 53.8%, p=0.93).

Conclusions: An Internet behavioral weight loss program plus financial incentives may be an effective strategy to promote excellent weight losses in women with lower income, thereby enhancing equity in treatment outcomes in a vulnerable, high-risk population. These data also provide important evidence to support federally funded incentive initiatives for lower-income, underserved populations.
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http://dx.doi.org/10.1016/j.amepre.2017.11.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5818321PMC
March 2018

Adapting evidence-based behavioral weight loss programs for emerging adults: A pilot randomized controlled trial.

J Health Psychol 2019 06 29;24(7):870-887. Epub 2017 Jan 29.

3 The Miriam Hospital, USA.

Emerging adults are at high risk of obesity but behavioral weight loss programs do not meet their needs. Emerging adults ( N = 52, age = 22.3 ± 2 years, body mass index = 34.2 ± 5.5 kg/m, 46.2% non-Hispanic White) were randomly assigned to one of three behavioral weight loss programs adapted based on formative work: face-to-face behavioral weight loss, web-based behavioral weight loss, or web plus optional community sessions (Hybrid). Assessments occurred at 0 and 3 months. Engagement and self-monitoring were highest in Hybrid. Intent-to-treat weight losses were -2.8 ± 2.9 percent in face-to-face behavioral weight loss, -2.2 ± 4.5 percent in web-based behavioral weight loss, and 4.8 ± 4.9 percent in Hybrid. Percent achieving ⩾5 percent weight loss was highest in Hybrid (63%). Findings suggest potential for adapted behavioral weight loss to promote engagement and weight loss in emerging adults.
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http://dx.doi.org/10.1177/1359105316688951DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5623115PMC
June 2019

House Chats as a Grassroots Engagement Methodology in Community-Based Participatory Research: The WE Project, Petersburg.

Prog Community Health Partnersh 2016 ;10(3):391-400

The Wellness Engagement (WE) Project is an academic-community partnership developed to engage the community to inform the development of a pilot intervention aimed at promoting healthy eating and physical activity among residents of Petersburg, Virginia.

Objectives: To implement House Chats as a novel methodology for engaging community members in focused discussion about obesity, exercise, dietary intake, and barriers to health.

Methods: We recruited and trained laypersons as House Chat Leaders (HCLs) to host informal group discussions about obesity with members of their network in a social setting following predetermined questions.

Results: HCLs hosted 34 House Chats with 176 participants over a period of 4 months.

Conclusions: The House Chat proved to be a highly successful engagement strategy that allowed access to respondents who may not have participated in a traditional, focus group discussion.
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http://dx.doi.org/10.1353/cpr.2016.0046DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5733140PMC
June 2017

Secondary data analysis from a randomized trial examining the effects of small financial incentives on intrinsic and extrinsic motivation for weight loss.

Health Psychol Behav Med 2017 13;5(1):129-144. Epub 2017 Jan 13.

The Miriam Hospital's Weight Control and Diabetes Research Center, 196 Richmond Street, Providence, RI, 02903, USA;

Objectives: To examine whether (a) an obesity treatment involving financial incentives yields higher levels of extrinsic motivation for weight management compared to an identical intervention without incentives, (b) extrinsic motivation for weight management mediates, or accounts for, the difference in weight loss outcomes between the two interventions, and (c) there is any evidence that financial incentives and associated extrinsic motivation "crowd out" intrinsic motivation for weight control.

Methods: Participants (N=153, 80.4% Female; BMI = 33.2 ± 5.9) were randomly assigned to a 3-month Web-based behavioral weight loss program (WBWL) or the same program plus small financial incentives delivered consistent with behavioral economics and behavior change theories (WBWL+$). Weight was objectively assessed at baseline, post-treatment (month 3), and after a 9-month no-treatment follow-up phase (month 12). Intrinsic and extrinsic motivation for weight management were assessed at months 3 and 12 using a modified version of the Treatment Self-Regulation Questionnaire, with questions added to specifically target extrinsic motivation related to incentives.

Results: Compared to WBWL alone, WBWL+$ had better weight loss and higher levels of both extrinsic intrinsic motivation for weight management (p's≤.02). Moreover, during the no-treatment follow-up phase, the trajectories of weight regain did not significantly differ between WBWL and WBWL+$ (p=.58). Extrinsic motivation was not a significant mediator of treatment outcomes.

Conclusions: Modest financial incentives delivered consistent with behavioral economics and behavior change theories do not undermine intrinsic motivation for weight management during obesity treatment; in fact, they yield higher levels of both extrinsic and intrinsic motivation. Additional research is needed to better understand the mechanisms by which incentives improve outcomes in health behavior change interventions.
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http://dx.doi.org/10.1080/21642850.2016.1276460DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6521883PMC
January 2017

Recruitment of young adults for weight gain prevention: randomized comparison of direct mail strategies.

Trials 2016 06 8;17(1):282. Epub 2016 Jun 8.

Gillings School of Global Public Health, University of North Carolina Chapel Hill, Rosenau Hall, Box 7440, Chapel Hill, NC, 27599-7440, USA.

Background: Recruiting young adults (ages 18-35 years) into weight gain prevention intervention studies is challenging and men are particularly difficult to reach. This paper describes two studies designed to improve recruitment for a randomized trial of weight gain prevention interventions. Study 1 used a quasi-experimental design to test the effect of two types of direct mailings on their overall reach. Study 2 used a randomized design to test the effect of using targeted messages to increase recruitment of men into the trial.

Methods: For Study 1, 60,000 male and female young-adult households were randomly assigned to receive either a recruitment brochure or postcard. Visits to recruitment websites during each mailing period were used to assess response to each mailing. Study 2 focused on postcard recruitment only. These households received either a targeted or generic recruitment postcard, where targeted postcards included the word "Men" in the headline text. Response rates to each type of card were categorized based on participant report of mailing received.

Results: The reach of the postcards and brochures were similar (421 and 386 website visits, respectively; P = 0.22). Individuals who received the brochure were more likely to initiate the online screener than those who received a postcard (P = 0.01). In Study 2, of those who completed the telephone screening, 60.9 % of men (n = 23) had received the targeted postcard as compared to the generic postcard (39.1 %, P = 0.30). The reverse was true for women (n = 62, 38.7 vs. 61.3 %, P = 0.08).

Conclusions: These studies suggest there was little difference in the reach of postcards versus brochures. However, recipients of brochures were more likely to continue to the next stage of study participation. As expected, men's response to the weight gain prevention messages was lower than women's response; but using targeted messages appears to have modestly increased the proportion of male respondents. These studies add to the limited experimental literature on recruitment messaging and provide further indication for using targeted messages to reach underrepresented populations while providing initial evidence on the effect of mailing type on message reach.

Trial Registration: The Study of Novel Approaches to Weight Gain Prevention was registered with ClinicalTrials.gov (identifier: NCT01183689 ) on 13 August 2010.
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http://dx.doi.org/10.1186/s13063-016-1411-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4897900PMC
June 2016

Innovative Self-Regulation Strategies to Reduce Weight Gain in Young Adults: The Study of Novel Approaches to Weight Gain Prevention (SNAP) Randomized Clinical Trial.

JAMA Intern Med 2016 06;176(6):755-62

Wake Forest School of Medicine, Winston Salem, North Carolina.

Importance: Weight gain occurs commonly in young adults and has adverse effects on health.

Objective: To compare 2 self-regulation interventions vs control in reducing weight gain in young adults over a mean follow-up of 3 years.

Design, Setting, And Participants: Randomized clinical trial in 2 academic settings of 599 participants aged 18 to 35 years with body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) of 21.0 to 30.0, recruited via mailings and emails from August 2010 to February 2012. Data were analyzed from January 2015 to January 2016.

Interventions: Participants were randomized to control, self-regulation plus small changes, or self-regulation plus large changes. Both interventions focused on frequent self-weighing to cue behavior changes. "Small changes" taught participants to reduce intake and increase activity, both by approximately 100 calories per day. "Large changes" focused on losing 2.3 to 4.5 kg initially to buffer against expected weight gain.

Main Outcomes And Measures: Changes in weight from baseline over mean follow-up of 3 years. Secondary outcomes included proportion gaining at least 0.45 kg from baseline, proportion developing obesity (BMI, ≥30.0), and weight change baseline to 2 years.

Results: Among the 599 participants (22% men; 27% minority; mean [SD] age, 27.7 [4.4] years; mean [SD] BMI, 25.4 [2.6]), mean (SE) weight changes over a mean follow-up of 3 years were 0.26 (0.22), -0.56 (0.22), and -2.37 (0.22) kg in the control, small-changes, and large-changes groups, respectively (P < .001). Differences among all 3 groups were significant (large changes vs control, P < .001; small changes vs control, P = .02; large changes vs small changes, P < .001). On secondary outcomes, both interventions significantly reduced incidence of obesity relative to control (mean [SE], 8.6% [2.0%], 7.9% [2.0%], and 16.9% [2.7%] in the large-changes, small-changes, and control groups, respectively; P = .02 for large changes vs control and P = .002 for small changes vs control); a smaller percentage of participants in the large-changes group gained 0.45 kg or more (mean [SE], 23.6% [2.8%], 32.5% [3.8%], and 40.8% [4.4%], respectively; P < .001 vs control and P = .02 vs small changes) and weight change from baseline to 2 years was greater in control than in small or large changes (mean [SE], 0.54 [0.33], -0.77 [0.33], and -1.50 [0.34] kg, respectively; P = .02 vs small changes and P < .001 vs large changes).

Conclusions And Relevance: Self-regulation with large or small changes both reduced weight gain in young adults over 3 years relative to control, but the large-changes intervention was more effective.

Trial Registration: clinicaltrials.gov Identifier: NCT01183689.
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http://dx.doi.org/10.1001/jamainternmed.2016.1236DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5461816PMC
June 2016

Young Adults' Attitudes and Perceptions of Obesity and Weight Management: Implications for Treatment Development.

Curr Obes Rep 2016 Mar;5(1):14-22

Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, 830 East Main Street, 4th Floor, Richmond, VA, 23219, USA.

Young adults are underrepresented in standard behavioral weight loss trials, and evidence suggests that they differ from older adults on many weight-related constructs. The aim of this review is to explore young adults' attitudes toward obesity and weight management, with particular attention to those factors that may play a role in the development of future treatment efforts. Both intrapersonal and interpersonal considerations unique to young adulthood are assessed; in addition, we examine young adults' perceptions of specific weight-related behaviors such as dieting, physical activity, and self-weighing. Conclusions are consistent with other findings suggesting that weight management interventions should be adapted and designed specifically for this age group.
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http://dx.doi.org/10.1007/s13679-016-0188-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5621592PMC
March 2016

Frequent self-weighing as part of a constellation of healthy weight control practices in young adults.

Obesity (Silver Spring) 2015 May 10;23(5):943-9. Epub 2015 Apr 10.

The Miriam Hospital/Brown University, Providence, Rhode Island, USA.

Objective: Frequent self-weighing is linked with weight management success, but concern has been raised about its possible association with unhealthy practices. This study examined the association of self-weighing with other weight control behaviors in a sample for whom frequent weighing might be questioned--namely, normal-weight or overweight (BMI of 21-29.9) young adults (age 18-35).

Methods: Participants (N = 583; mean [SD] age = 27.7 [4.4]; BMI = 25.4 [2.6]) entering the Study of Novel Approaches to Weight Gain Prevention (SNAP) completed objective measures of weight and physical activity and self-reported weight history, use of healthy and unhealthy weight control strategies, depressive symptoms, and dietary intake.

Results: Daily self-weighing was reported by 11% of participants, and 23% weighed several times per week. Frequent weighing was not associated with current BMI, gender, or age but was associated with being further below one's highest weight, history of dieting, and perceived difficulty maintaining weight. Frequent weighing was associated with healthy weight management strategies, but not with unhealthy practices or depressive symptoms.

Conclusions: In this sample, frequent self-weighing appears to be part of a constellation of healthy weight control behaviors used to counteract a perceived tendency toward weight gain. SNAP follow-up will determine whether frequent self-weighing helps prevent weight gain.
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http://dx.doi.org/10.1002/oby.21064DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4438264PMC
May 2015

Effects of weight-focused social comparisons on diet and activity outcomes in overweight and obese young women.

Obesity (Silver Spring) 2015 Jan 19;23(1):85-9. Epub 2014 Nov 19.

Bradley/Hasbro Children's Research Center/Rhode Island Hospital and the Warren Alpert Medical School at Brown University, Providence, Rhode, Island, USA; Department of Psychology, University of South Florida, Tampa, Florida, USA.

Objective: To investigate social comparison processes as a potential mechanism by which social networks impact young women's weight control thoughts and behaviors and to examine whether social comparisons with close social ties (i.e., friends) have a greater influence on weight control outcomes relative to more emotionally distant ties.

Methods: Using Ecological Momentary Assessment, overweight young adult women (N = 46; M age = 19; M BMI = 29) reported the nature and effects of weight-focused social comparisons on dieting and exercising intentions and on behaviors during their daily routine.

Results: Relative to social comparisons to targets of the same weight, weight-focused comparisons to both thinner and heavier individuals led to increased thoughts of dieting and exercising. Moreover, comparisons to thinner targets also increased the likelihood of engaging in actual dieting and exercising behaviors. Weight comparisons to friends amplified these effects.

Conclusions: Weight-focused social comparisons may be one mechanism by which social networks impact weight control thoughts and behaviors. Obesity interventions with young adults may achieve better outcomes by harnessing social comparison processes in treatment.
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http://dx.doi.org/10.1002/oby.20953DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4276434PMC
January 2015

Daily self-weighing within a lifestyle intervention: impact on disordered eating symptoms.

Health Psychol 2014 Mar 18;33(3):297-300. Epub 2013 Nov 18.

Department of Nutrition, University of Tennessee.

Objective: To determine whether daily self-weighing (DSW) is associated with disordered eating (DE) symptoms within an adult lifestyle intervention (LI), and to examine changes in DE symptoms during the 18-month trial.

Method: One-hundred and seventy-eight adults (53% female, 90% White, 52.0 ± 8.6 years, BMI = 35.0 ± 4.4 kg/m2) were enrolled in a randomized trial testing 2 dietary prescriptions within a LI (standard vs. limited dietary variety). Both arms were taught DSW and had the same contact schedule and calorie and activity goals. Frequency of weighing and DE were assessed at 0, 6, 12, and 18 months. Analyses controlled for treatment arm.

Results: At baseline, 16.3% of participants reported weighing ≥ daily compared with 83.7%, 72.3%, and 68.2% at 6, 12, and 18 months, respectively. There was no relationship between change in frequency of self-weighing and change in DE symptoms at any time point. Further, there were no significant differences between those who weighed ≥ daily versus < daily on DE composite scores at baseline or 6 months; at 12 and 18 months participants who weighed ≥ daily reported lower DE scores compared with those who weighed < daily (p = .008 and .043 at 12 and 18 months, respectively). Participants who weighed ≥ daily achieved better weight losses than those weighing < daily at 12 and 18 months (p = .003 and <.001). There was a significant reduction over time in DE symptoms (p < .0001) and a reduction in odds of meeting criteria for Binge Eating Disorder (BED; ps < .001).

Conclusions: Daily self-weighing did not appear to be related to increased disordered eating behavior and was associated with better weight loss outcomes.
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http://dx.doi.org/10.1037/a0034218DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4046275PMC
March 2014