Search

The article presents a study which examined the reasons for vaping nicotine among eighth-, 10th-, and 12th-grade U.S. students, focusing on differences by vaping frequency and grade, from 2021 to 2023. Topics discussed include prevalence levels for near-daily vaping in the past 30 days, reasons for the behavior of U.S. adolescents who vaped nicotine, and a shift in adolescent vaping reasons over the past decade.

Background: Obesity is a growing epidemic with non-surgical/non-pharmacological interventions having only nominal and transient effects on excess weight. Those persistent shortcomings are associated with minimal understandings of impacts of treatment-associated changes in psychological variables and their relationships. Women of lower incomes have high rates of obesity and might have increased difficulties accessing evidence-based programs. Methods: Women with obesity of lower- to lower-middle incomes participated in 6-month community-based treatments in the United States emphasizing either self-regulatory skills development (behavioral methods group: n = 63) or typical education in exercise and healthy dietary practices (education group: n = 48). Results: There were significant 6-month improvements in self-regulation, self-efficacy, mood, physical activity/exercise, dietary behaviors, and weight in both groups. All improvements were significantly greater in the behavioral group. Based on the incorporation of multiple behavioral theories, separate multiple regression models were fit for prediction of the weight-loss behavior changes. Stepwise entry of changes in self-regulation, self-efficacy, and mood each significantly contributed to the explained variance in physical activity/exercise change. Change in self-efficacy was most relevant in the prediction of change in dietary behaviors. Change in physical activity/exercise was significantly related to change in dietary behaviors; however, a regression analysis indicated that only physical activity/exercise change was a significant independent contributor to the overall accounted-for variance in lost weight. Conclusion: By incorporating key tenets of social cognitive theory, self-efficacy theory, self-regulation theory, coaction theory, and the mood-behavior model in an additive manner, suggestions and emphases for addressing psychological variables for improved weight-loss behaviors within scalable obesity treatments were advanced. [ABSTRACT FROM AUTHOR]

Background: Weight stigma is the social devaluation and denigration of individuals because of their excess body weight, resulting in poorer physical and mental health and healthcare avoidance. Attribution Theory and Goffman's theory of spoiled identity provided a general overarching framework for understanding weight stigma experiences. Objective: Our purpose was to explore weight stigma experiences from a broad range of perspectives emphasizing identities typically excluded in the weight stigma literature. Design: We conducted a qualitative descriptive study with data drawn from 73 substantive narrative comments from participants who responded to a larger survey. Results: Analysis developed five themes: Working on weight, Not being overweight, Lack of help and empathy, Exposure and embarrassment and Positive experiences. Individuals who would be clinically assessed as overweight, especially men, often did not identify with having a weight problem and found the framing of personal responsibility for weight empowering. Participants with larger body sizes more often attributed embarrassment and shame about weight to treatment in the clinical setting. Older participants were more likely to have positive experiences. Conclusions: The findings suggest ongoing tension between the framing of weight as a personal responsibility as opposed to a multifactorial condition with many uncontrollable aspects. Gender, age and body size shaped respondent perspectives, with some young male respondents finding empowerment through perceived personal control of weight. The healthcare system perpetuates weight stigma through lack of adequate equipment and excessively weight‐centric medical counselling. Recommending a healthy lifestyle to patients without support or personalized medical assessment may perpetuate weight stigma and associated detrimental health outcomes. Patient or Public Contribution: Patients with obesity and overweight were integral to this study, providing comments for our qualitative analyses. [ABSTRACT FROM AUTHOR]

Objective: To examine whether sexual assault prospectively predicts unhealthy weight management behaviors in college women. Method: Participants were female college students (N = 483) with monthly assessments across the first year, including the frequency and severity of sexual assault and unhealthy weight management behaviors. Results: Frequency of sexual assault prior to college predicted dieting, purging, and diet pill use, over the first year. Severity of those experiences predicted dieting and diet pill use. Frequency of sexual assault during the first semester predicted purging and diet pill use during the second semester. Severity predicted all three unhealthy weight management behaviors. Findings held consistently when controlling for socioeconomic status (SES), race/ethnicity, body mass index (BMI), and pre-college mood, anxiety, and eating disorders, as well as unhealthy weight management behaviors during the first semester in longitudinal analyses. Reverse models were non-significant. Conclusions: This research documents the detrimental effects of sexual assault on unhealthy weight management behaviors in college women, and highlights the importance of prevention and intervention. [ABSTRACT FROM AUTHOR]

Obesity is a disease of epidemic proportions in the United States and contributes to morbidity and mortality for a large part of the population. In addition, the financial costs of this disease to society are high. Lifestyle modifications are key to prevention and treatment but adherence and long‐term success have been challenging. Bariatric surgery has been available and pharmacologic approaches, first developed in the 1950s, continue to be an option; however, existing formulations have not provided optimal clinical efficacy and have had many concerning adverse effects. Over the last decade, glucagon‐like peptide‐1 (GLP‐1) receptor agonists, a novel group of medications for the treatment of type 2 diabetes, were found to produce significant weight loss. Several formulations, at higher doses, received FDA approval for the treatment of obesity or those overweight with weight‐related co‐morbidities. More hormone‐based therapies were and are being developed, some with dual or triple‐receptor agonist activity. Their use, however, is not without questions and concerns as to long‐term safety and efficacy, problems with cost and reimbursement, and how their use may intersect with public health efforts to manage the obesity epidemic. This review will focus on the GLP‐1 receptor agonists currently used for weight loss and discuss their pharmacology, pertinent research findings establishing their benefits and risks, issues with prescribing these medications, and a perspective from a public health point of view. [ABSTRACT FROM AUTHOR]

Background: The complex work of public health nurses (PHNs) specifically related to mental health assessment, intervention, and outcomes makes it difficult to quantify and evaluate the improvement in client outcomes attributable to their interventions. Objectives: We examined heterogeneity across parents of infants served by PHNs receiving different interventions, compared the ability of traditional propensity scoringmethods versus energy-balancing weight (EBW) techniques to adjust for the complex and stark differences in baseline characteristics among those receiving different interventions, and evaluated the causal effects of the quantity and variety of PHN interventions on client health and social outcomes. Methods: This retrospective study of 4,109 clients used existing Omaha System data generated during the routine documentation of PHNhome visit data. We estimated the effects of intervention by computing and comparing weighted averages of the outcomes within the different treatment groups using two weighting methods: (a) inverse probability of treatment (propensity score) weighting and (b) EBWs. Results: Clients served by PHNs differed in baseline characteristics with clients with more signs/symptoms. Both weighting methods reduced heterogeneity in the sample. EBWs were more effective than inverse probability of treatment weighting in adjusting for multifaceted confounding and resulted in close balance of 105 baseline characteristics. Weighting the sample changed outcome patterns, especially when using EBWs. Clients who received more PHN interventions and a wider variety of them had improved knowledge, behavior, and status outcomes with no plateau over time, whereas the unweighted sample showed plateaus in outcomes over the course of home-visiting services. Discussion: Causal analysis of PHN-generated data demonstrated PHN intervention effectiveness for clients with mental health signs/symptoms. EBWs are a promising tool for evaluating the true causal effect of PHN home-visiting interventions. [ABSTRACT FROM AUTHOR]

Investigate the influence of physical readiness tests (PRTs) on eating behaviors among US Navy Sailors. Focused ethnography using interviews and military policies. Three US Naval installations. Active-duty enlisted Sailors (n = 32). Eating behaviors. Authors analyzed data iteratively with data collection using domain, taxonomy, and thematic analysis to identify culturally relevant codes, domains, and themes. Five themes corresponded with PRT timing and Sailors' perceived ability to meet standards: (1) maintain usual eating habits, (2) get ready and switch it up, (3) make weight—damage control, (4) return to baseline—PRT is over, and (5) eat whatever—PRT is canceled. In contrast to the PRT policy's goal for Sailors to maintain standards and a healthy lifestyle, many Sailors modified their usual eating behaviors to pass the test. Changes in eating behaviors during PRT cycles highlight a culture of getting ready vs staying ready, suggesting many Sailors do not eat a nutrient-dense diet to maintain the minimum physical fitness and body composition standards. There is a need for nutrition education for healthy weight maintenance, weight gain prevention, and healthy weight loss among military personnel. [ABSTRACT FROM AUTHOR]

Time-restricted eating (TRE), a type of intermittent fasting in which all daily calories are consumed within a window of ≤12 hours, is hypothesized to promote long-term weight management because of its relative simplicity. This study reports correlates of adherence among community-dwelling adults currently or formerly following a TRE dietary strategy. A 25-minute cross-sectional online survey was developed, including questions about TRE perceptions, behaviors, motivators and drivers, and demographics. The survey was administered in February 2021 via Prolific, an online platform for sample recruitment and survey dissemination. Eligibility criteria included US adult ages 18+ who currently or formerly (past 3 months) followed TRE (ie, consumed all daily calories within a window of ≤12 hours) for a minimum of 1 week. χ2 tests and analysis of covariance (ANCOVA; adjusting for sex and age) compared responses between current and former followers. Current followers (n = 296, mean [SD]: 34.2 ± 12.2y) were older than former followers (n = 295, mean [SD]: 31.1 ± 10.9 y) and practiced TRE for longer (median: 395 vs 90 days, P < 0.001). Current followers reported more success with meeting TRE goals (P ≤ 0.015), were less likely to report TRE concerns (P < 0.001), and more likely to report TRE satisfaction (P < 0.001). Four TRE motivators were more important among current (vs former) followers: weight maintenance, health (not weight), improved sleep, and preventing disease (P ≤ 0.017); weight loss was more important among former (vs current) followers (P = 0.003). Among adherence drivers, ability to work from home and the impact of COVID-19 were reported as more helpful for TRE adherence among current compared with former followers (P ≤ 0.028). TRE motivators and drivers differed between current and former followers; interventions tailored to individuals' preferences and circumstances may benefit TRE adherence. [ABSTRACT FROM AUTHOR]

Summary: Background: Anti‐obesity medications (AOMs) are promising lifestyle modification (LSM) adjuncts for obesity treatment, and phentermine is commonly prescribed in paediatric weight management clinics. Determining 'real‐world' AOM effectiveness and characteristics predicting response is important. Objectives: We sought to describe phentermine plus LSM effectiveness and identify baseline characteristics predicting response. Methods: This was a retrospective cohort study among youth seen in a US academic‐based weight management clinic from 2012 to 2020. Baseline characteristics (e.g., body mass index (BMI), liver transaminases, eating‐related behaviours) and outcomes (%BMI of 95th percentile (%BMIp95), BMI, %BMI change, weight) were determined through electronic health records and intake surveys. Results: Among 91 youth prescribed phentermine plus LSM over 8 years (mean %BMIp95 150%), %BMIp95 was statistically significantly reduced at 1.5, 3, 6 and 12 months (peak reduction 10.9 percentage points at 6 months; p < 0.001). Considering multiple comparisons, the presence of baseline elevated alanine aminotransferase was associated with statistically significant smaller 1.5‐month %BMIp95 reductions (p = 0.001) and higher food responsiveness with smaller 3‐ (p = 0.001) and 6‐month (p < 0.001) reductions. Conclusions: Phentermine plus LSM reduced %BMIp95 among youth in a weight management clinic, and baseline characteristics may help determine those more or less likely to respond. Prospective studies are needed to further characterize effectiveness and confirm response predictors. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to explore between‐group differences across different stages of gender‐affirming care, and associations between appearance congruence, gender‐related motivations for weight loss, and disordered eating in transgender and gender expansive (TGE) individuals. Method: A total of 160 TGE adults (aged 18–30) were recruited across the United States. Participants completed a comprehensive online survey. Data were analyzed using generalized linear models and bivariate correlations. Results: Significant differences in appearance congruence among participants at different transition stages were revealed, with the group that achieved their desired transition reporting the highest appearance congruence compared to all other groups. Furthermore, gender‐related motivations for weight loss were significantly lower in individuals who achieved their desired transition compared to those with no plans to transition. Discussion: Findings suggest significantly higher appearance congruence in those who achieved their desired transition compared to other groups, and individuals who attained their desired transition exhibited significantly reduced gender‐related motivations for weight loss compared to those with no plans to transition. These findings underscore the potential psychological benefits associated with successful gender‐affirming care, highlighting its role not only in fostering appearance congruence but also in mitigating gender‐related motivations for weight loss among TGE individuals. Future research should include larger and more diverse samples, longitudinal designs, and considerations of other factors influencing body image outcomes in this population. Public Significance: This study sheds light on the crucial relationship between gender‐affirming care and body image outcomes in TGE individuals. Understanding how appearance congruence and gender‐related motivations for weight loss are associated with disordered eating can inform tailored support and interventions. By recognizing the association of gender affirming care and well‐being, healthcare providers can enhance care for TGE individuals. [ABSTRACT FROM AUTHOR]

Obesity in the United States has risen to 42 percent of its adult population and is similarly problematic in many other countries. Although the U.S. government has provided education on healthy eating and the need to exercise regularly, behavioral obesity treatments have largely failed to sustain reductions in weight. Self-regulation, and the incorporation of exercise for its psychological impacts on eating, has sometimes been targeted. While there has been sporadic investigation into the carry-over of exercise-related self-regulation to eating-related self-regulation, the present aim is to further inquiry in that area to inform future treatment content for improved effects. Women enrolled in community-based obesity treatments with either a self-regulation (n = 106) or education (n = 54) focus were assessed on changes in exercise- and eating-related self-regulation, negative mood, completed exercise, and weight. Improvements were significantly greater in the self-regulation-focused group. After controlling for initial change in eating-related self-regulation, change in that measure from Month 3 to 6 was significantly predicted by change in exercise-related self-regulation during the initial 3 treatment months. This suggested a carry-over effect. A stronger predictive relationship was associated with the self-regulation-focused treatment. In further analyses, paths from changes in exercise→negative mood→self-regulation of both exercise and eating were significant. Increase in eating-related self-regulation was significantly associated with weight loss over 6, 12, and 24 months. The self-regulation-focused group had stronger relationships, again. Findings suggested utility in targeting exercise-related self-regulation to impact later change in eating-related self-regulation, and the use of exercise-associated mood improvement to bolster participants' self-regulation capabilities. [ABSTRACT FROM AUTHOR]

Bariatric surgery (BS) is a leading treatment for obesity; however, adverse side effects (e.g., pain and infection) can deter patients or affect weight maintenance. This study investigates how a post-operative virtual health coaching lifestyle program, monitoring virtual weekly goal progress made by patients, affects weight loss after BS, specifically sleeve gastrectomy. Patients recruited for this 6-month study were classified with a BMI > 30 kg/m2 90 days post-operatively. Patients were prescribed lifestyle support delivered by certified health and wellness coaches (InHealth Lifestyle Therapeutics™). Demographic variables (e.g., age, weight, height, and gender) were obtained and compared according to initial, 3-, 6-month, and current weight through repeated measures ANOVA and post hoc comparison. Thirty-eight adult participants were included, with a mean age of 52 years ± 12.9 and with a majority (n = 35; 97%) of them being female. There were significant differences in weight reported across all five time points (p < 0.05), with the greatest weight difference seen between the initial (250.3 ± 45.5 lbs.) and final time points (226.7± 40.4 lbs.). This study suggests post-operative virtual health coaching can enhance weight loss outcomes after sleeve gastrectomy. Further research is needed to assess the long-term effects and cost-effectiveness of such a form of coaching for bariatric surgery patients. [ABSTRACT FROM AUTHOR]

Policy PointsHealth policymakers have insufficiently addressed care for people with obesity (body mass index ≥ 30 kg/m2) in the United States. Current federal policies targeting obesity medications reflect this unfortunate reality.We argue for a novel policy framework to increase access to effective obesity therapeutics and care, recognizing that, though prevention is critical, the epidemic proportions of obesity in the United States warrant immediate interventions to augment care.Reducing barriers to and improving the quality of existing anti‐obesity medications, intensive behavioral therapy, weight management nutrition and dietary counseling, and bariatric surgery are critical. Moreover, to ensure continuity of care and patient–clinician trust, combating physician and broader weight stigma must represent a central component of any viable obesity care agenda. [ABSTRACT FROM AUTHOR]

Children with autism spectrum disorder and developmental disabilities (ASD/DD) face barriers to participation in health promotion programs due to the lack of available and/or affordable programs and trained staff at recreation centers. Children with ASD/DD in Korean immigrant families are one of the most underserved minority groups due to language, racial/ethnic discrimination, and stigma and shame within their own ethnic community. However, little research is available on development, implementation, and evaluation of a culturally adapted community health promotion program in this population. The purpose of this study is to assess effectiveness of a pilot program for children with ASD/DD from first-generation Korean immigrant families. The pilot study used a quantitative, quasiexperimental design (one-group design with pre- and posttest) following a seven-week health promotion program. We recruited 15 children with ASD/DD, ages nine through 16, from first-generation Korean immigrant families. The findings of the study suggest that the pilot program was effective in gaining nutrition knowledge and increasing physical involvement among participants. Given the fact that Asian immigrants are a fast-growing population and that nearly 75 percent of them were born abroad, development and evaluation of a community-based, culturally adapted health promotion program is urgently needed. [ABSTRACT FROM AUTHOR]

Residential treatment programs for eating disorders (EDs) have gained popularity in recent years, expanding beyond the United States to countries such as Canada, Italy, and the United Kingdom. These programs offer a "home-like" environment where individuals reside for several weeks or months, emphasising both physical restoration and psychological recovery. This scoping review aimed to provide an update since the most recent reviews on the literature regarding outcomes of residential treatment programs for EDs and to explore clinical features that were associated with these outcomes. Methods used followed the Joanna Briggs Institute guidelines for scoping reviews. A systematic search of electronic databases was conducted, and 12 studies met the inclusion criteria. All studies reported improvements in various outcomes from admission to discharge, including changes in eating psychopathology, weight restoration, depression, anxiety, and quality of life. Additionally, three studies reported positive outcomes at intervals after discharge and three predictive factors (self-compassion, personality organisation, and resistance to emotional vulnerability) were reported in a small number of studies. While residential treatment facilities consistently showed positive outcomes, the review highlights the need for randomised controlled studies to establish the efficacy of these programs for EDs. Future research should include controlled studies comparing residential facilities to other treatment settings and incorporate long-term follow-up outcomes and further studies of emergent predictive factors identified in this review. [ABSTRACT FROM AUTHOR]

Background: Regulatory focus theory proposes two self-regulatory systems: promotion focus—related to fulfilling aspirations and maximizing positive outcomes—and prevention focus—related to fulfilling responsibilities and avoiding negative outcomes. Building on research demonstrating associations between regulatory focus and weight outcomes, a proof-of-concept weight control intervention framed intervention procedures in terms of promotion or prevention focus and descriptively examined whether the impact of the intervention conditions depended on dispositional regulatory focus. Methods: After random assignment to control (received pamphlet on diet and physical activity), promotion, or prevention conditions (1.5-hour baseline sessions; detailed manuals; 1-hour sessions at 3 months), community participants from a metropolitan area in the United States (N = 57; age M = 40; BMI M = 30.9) completed the Regulatory Focus Questionnaire and were weighed at baseline, 3 months, and 6 months. Longitudinal analysis was conducted with SAS Proc Mixed using restricted maximum likelihood estimation. Results: Estimated weight change was -2.99 kg, 95% CI [-4.65, -1.32], in the promotion condition, -1.70 kg, 95% CI [-3.29, -0.12], in the prevention condition, and -0.18 kg, 95% CI [-1.42, 1.05], in the control condition. Exploratory analyses revealed that for relatively more promotion-focused participants, estimated weight change was -1.43 kg, 95% CI [-3.38, 0.51], in the promotion condition, +0.48 kg, 95% CI [-1.01, 1.97], in the prevention condition, and -1.09 kg, 95% CI [-2.32, 0.14], in the control condition. For relatively more prevention-focused participants, estimated weight change was -5.19 kg, 95% CI [-7.14, -3.25], in the promotion condition, -3.35 kg, 95% CI [-4.83, -1.86], in the prevention condition, and +0.42 kg, 95% CI [-0.81, 1.65], in the control condition. Conclusions: Results suggest that self-directed, promotion-focused interventions may be effective and that tailoring to self-regulatory dispositions may not be of additional benefit in initiating weight loss. [ABSTRACT FROM AUTHOR]

Summary: Objective: Rising prevalence of obesity has led to increased rates of prediabetes and diabetes mellitus (DM) in children. This study compares rates of prediabetes and diabetes using two recommended screening tests (fasting plasma glucose [FPG] and haemoglobin A1c [HbA1c]). Study Design: Data were collected prospectively from 37 multi‐component paediatric weight management programs in POWER (Paediatric Obesity Weight Evaluation Registry). Results: For this study, 3962 children with obesity without a known diagnosis of DM at presentation and for whom concurrent measurement of FPG and HbA1c were available were evaluated (median age 12.0 years [interquartile range, IQR 9.8, 14.6]; 48% males; median body mass index 95th percentile [%BMIp95] 134% [IQR 120, 151]). Notably, 10.7% had prediabetes based on FPG criteria (100–125 mg/dL), 18.6% had prediabetes based on HbA1c criteria (5.7%–6.4%), 0.9% had DM by FPG abnormality (≥126 mg/dL) and 1.1% had DM by HbA1c abnormality (≥6.5%). Discordance between the tests was observed for youth in both age groups (10–18 years [n = 2915] and age 2–9 years [n = 1047]). Conclusion: There is discordance between FPG and HbA1c for the diagnosis of prediabetes and DM in youth with obesity. Further studies are needed to understand the predictive capability of these tests for development of DM (in those diagnosed with prediabetes) and cardiometabolic risk. [ABSTRACT FROM AUTHOR]

Depression is a prevalent concern in Latinas; thus, it is critical that we examine the associations between negative eating and weight messages from mothers, fathers, and sisters, and depressive symptoms in Latinas. We utilized a sample of 195 Latina/Hispanic young women (M age = 23.25 years; range = 18–25; SD = 1.93; 67.4% Mexican-origin) to explore the moderating role of Latinas' internalization of U.S. beauty ideals on the associations between negative eating and weight messages from mothers, fathers, and sisters, and Latinas' depressive symptoms. We conducted three hierarchical regression analyses and found that negative messages from each family member (i.e., mothers, fathers, and sisters) and Latinas' internalization of U.S. beauty ideals were significantly and positively associated with Latinas' depressive symptoms. Further, we found that under both high and low internalization of U.S. beauty ideals, there was a positive association between negative messages from sisters and depressive symptoms. However, this association was stronger for those with high internalization of U.S. beauty ideals. Findings from this study further solidify the importance of family members' negative eating and weight messages for Latinas' well-being. Additionally, our study demonstrates that internalizing U.S. beauty ideals is associated with Latinas' mental health. [ABSTRACT FROM AUTHOR]

Purpose: Research shows peer health education programs on university campuses can support students in pursuing sustainable health-related behavior changes. However, few programs deliver peer health education through a nondiet, weight-inclusive framework. Research shows that health educators who challenge the status quo of diet culture and weight-focused health interventions may face unique challenges when sharing this perspective with others. Thus, the purpose of this study was to examine the experiences of peer educators who provided critical health education by introducing a nondiet, weight-inclusive approach to health. Design/methodology/approach: Five health coaches from a university health coaching program at a mid-sized southwestern university participated in a semi-structured interview. The data were analyzed through interpretative phenomenological analysis. Findings: Peer educators faced numerous challenges when introducing nondiet, weight-inclusive approaches such as lacking credibility as a peer to challenge weight-centric messages, feeling conflicted about honoring clients' autonomy when clients are resistant to a weight-inclusive approach and feeling uncomfortable when discussing client vulnerabilities. Peer educators also identified several strategies that helped them navigate these challenges such as being intentional with social media, using motivational interviewing to unpack clients' concerns about weight, and seeking group supervision. Originality/value: Given the reality that health coaches will face challenges sharing weight-inclusive health approaches, educators and supervisors should explicitly incorporate strategies and training methods to help peer health coaches prepare for and cope with such challenges. More research is also needed to examine effective ways to introduce weight-inclusive approaches to college students. [ABSTRACT FROM AUTHOR]

Summary: Background: An approved therapy for nonalcoholic steatohepatitis (NASH) and fibrosis remains a major unmet medical need. Aim: To investigate the histological and metabolic benefits of pegozafermin, a glycoPEGylated FGF21 analogue, in subjects with biopsy‐confirmed NASH. Methods: This proof‐of‐concept, open‐label, single‐cohort study, part 2 of a phase 1b/2a clinical trial, was conducted at 16 centres in the United States. Adults (age 21–75 years) with NASH (stage 2 or 3 fibrosis, NAS≥4) and magnetic resonance imaging proton density fat fraction (MRI‐PDFF) ≥8% received subcutaneous pegozafermin 27 mg once weekly for 20 weeks. Primary outcomes were improvements in liver histology, and safety and tolerability. Results: Of 20 enrolled subjects, 19 completed the study. Twelve subjects (63%) met the primary endpoint of ≥2‐point improvement in NAFLD activity score with ≥1‐point improvement in ballooning or lobular inflammation and no worsening of fibrosis. Improvement of fibrosis without worsening of NASH was observed in 26% of subjects, and NASH resolution without worsening of fibrosis in 32%. Least‐squares mean relative change from baseline in MRI‐PDFF was −64.7% (95% CI: −71.7, −57.7; p < 0.0001). Significant improvements from baseline were also seen in serum aminotransferases, noninvasive fibrosis tests, serum lipids, glycaemic control and body weight. Adverse events (AEs) were reported in 18 subjects (90%). The most frequently reported AEs were mild/moderate nausea and diarrhoea. There were no serious AEs, discontinuations due to AEs, or deaths. Conclusions: Pegozafermin treatment for 20 weeks had beneficial effects on hepatic and metabolic parameters and was well tolerated in subjects with NASH. ClinicalTrials.gov: NCT04048135. [ABSTRACT FROM AUTHOR]

We examined weight management counseling practices of Health Resources and Services Administration-funded health center (HC) providers for patients with overweight (POW) and obesity (POB) status, focusing on weight-related conditions, risk factors, and health care utilization. We used a nationally representative cross-sectional survey of HC patients and multilevel generalized structural equation logistic regression models to assess the association of provider counseling practices for POW and POB and by three obesity classes. Dependent variables included being told by the HC provider that weight was a problem, receiving a diet or exercise recommendation, referral to a nutritionist, or receiving weight loss prescriptions. Independent variables included weight-related conditions such as diabetes and hypertension, risk factors such as smoking, and health service utilization such as five or more primary care visits. All POB classes had higher odds of receiving all five counseling interventions than POW. Patients with diabetes and high cholesterol had higher odds of diet recommendations (OR = 1.8) and nutritionist referrals (OR = 2.3), while patients with cardiovascular disease had higher odds of nutritionist referral (OR = 2.0) and receiving weight loss prescriptions (OR = 2.6). Respondents with POB class III and diabetes had higher odds of receiving exercise recommendations (OR = 3.4), while POB class 1 and had hypertension had lower odds of nutritionist referral (OR = 0.3). Variations in HC primary care providers' weight management counseling practices between POW and POB present missed opportunities for consistent practice and early intervention. Assessing providers' counseling practices for patients with comorbid conditions is essential to the successful management of the obesity crisis. [ABSTRACT FROM AUTHOR]

Objective: Though prevalent, weight‐based discrimination is understudied and has been linked to disordered eating behaviors (DEB) among adolescents and adults. Sexual minority populations experience elevated risk of DEB, but little is known about the role of weight discrimination in this elevated risk. Methods: Participants were 1257 sexual minority women and men (ages 18–31 years) in the US Growing Up Today Study cohort. We examined cross‐sectional associations between weight discrimination victimization and three DEB in the past year: unhealthy weight control behaviors, overeating, and binge eating. Generalized estimating equations, adjusted for potential confounders, were used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs). Results: Three in 10 participants (31%) reported weight‐based discrimination victimization. Sexual minority young adults who reported weight‐based discrimination had greater relative prevalence of unhealthy weight control behaviors (PR [95% CI]: 1.92 [1.35, 2.74]), overeating (3.15 [2.24, 4.44]), and binge eating (3.92 [2.51, 6.13]), compared with those who reported no weight‐based discrimination. Associations with overeating and binge eating remained significant after adjusting for BMI. Discussion: The role of weight‐based discrimination, and its intersections with other forms of stressors for sexual minority young adults, must be included in efforts to advance eating disorder prevention for this underserved population. Public Significance: Three in 10 sexual minority young adults in this study had experienced weight‐based discrimination, a common but understudied form of discrimination. Sexual minority young adults who experienced weight‐based discrimination were at greater risk of disordered eating behaviors than those who had not experienced weight‐based discrimination. These findings suggest that weight‐based discrimination may be an important—and preventable—risk factor for disordered eating behaviors among sexual minority young adults. [ABSTRACT FROM AUTHOR]

Individuals who smoke report higher body dissatisfaction and engage in weight control smoking more than the general population. The effects that stigmatizing weight-related attitudes and body mass index have on smoking remain unclear. Via an online survey, this exploratory study examined whether endorsing anti-fat attitudes is associated with higher smoking frequency with BMI as a moderator. Participants were recruited via posts on a social news and discussion website, as well as a subject pool from a U.S. university. The sample consisted of 118 participants (62.5% female; Mage = 24.19, SD = 6.73). The Anti-Fat Attitudes Test was used to measure anti-fat beliefs. BMI and monthly smoking frequency were also measured. Multiple regression analyses were used to test the relationship between anti-fat attitudes and smoking frequency with BMI as a moderator. Although anti-fat attitudes overall were not associated with smoking frequency, the interaction between anti-fat attitudes specific to weight control and blame and BMI was significantly associated with smoking frequency. Individuals with average or lower BMIs who attribute weight status to a lack of willpower and self-control may smoke at higher rates. Addressing specific forms of anti-fat beliefs in smoking prevention and cessation programs may help mitigate smoking-related risks. [ABSTRACT FROM AUTHOR]

Background and Purpose: Sarcopenic obesity is associated with loss of independence among older adults, but the epidemiology of sarcopenic obesity and associated geriatric vulnerabilities are poorly understood. Thus, our objectives were to: (1) estimate the prevalence of older adults with sarcopenic obesity and (2) examine rates of geriatric vulnerabilities among obese older adults, with and without sarcopenia. Methods: A nationally representative sample of 1600 community-dwelling older adults 65 years and older with obesity and documented measures of muscle function from the National Health and Aging Trends Study (NHATS) was identified as sarcopenic using sex-adjusted grip strength and Short Physical Performance Battery scores. Differences in the prevalence of geriatric vulnerabilities (including pain, depression, disability, and social isolation) were compared between obese older adults with and without sarcopenia. Results and Discussion: Among obese older adults, 18% (n = 318/1600) were sarcopenic. After adjusting for age and sex, sarcopenic obese older adults had 3.7 times the odds of having 2 or more comorbid conditions (odds ratio [OR] = 3.7; 95% CI 2.2-5.0) and 6.4 times the odds of being frail (OR = 6.4; 95% CI 4.4-9.5) as compared with nonsarcopenic obese older adults. Sarcopenic obese older adults were also more likely to have 1 or more activities of daily living disabilities (OR = 3.7; 95% CI 2.5-5.4), be socially isolated (OR = 2.1; 95% CI 1.3-3.2), and report activity-limiting pain (OR = 2.0; 95% CI 1.5-2.7) as compared with nonsarcopenic obese older adults. These findings, in a nationally representative cohort, suggest obese older adults who are sarcopenic have higher rates of geriatric vulnerabilities that could impact delivery and outcomes of exercise and nutrition interventions. Conclusions: Concomitant obesity and sarcopenia are associated with higher rates of geriatric vulnerabilities among a nationally representative sample of older adults. More comprehensive interventions, beyond exercise and diet modifications, may be necessary to additionally address these newly identified social and physiological risks. [ABSTRACT FROM AUTHOR]

Summary: Paediatric weight management (PWM) programs in the United States (US) face challenges in providing sustainable multidisciplinary care for patients. The aim of this study was to report PWM program approaches to sustaining program delivery. A survey of 39 PWM programs was administered to identify challenges and solutions to program sustainability. Common and useful strategies for optimizing reimbursement for services included the use of applicable reimbursable diagnostic codes and management, billing for assessments and non‐medical personnel services, and the use of hospital outpatient department clinic billing. Increasing clinical breadth and capacity was achieved by offering telemedicine and other services, such as psychotherapy, pharmacotherapy, and metabolic and bariatric surgery, as well as active management of schedules. Securing institutional and extramural funding was also reported. One of the positive changes during the pandemic was the fast adoption of telemedicine services. Although delivering sustainable evidence‐based multidisciplinary PWM under the current US payment models has its challenges, PWM programs implement practical operational strategies to support this work. [ABSTRACT FROM AUTHOR]

Introduction: Relapse following acute treatment for anorexia nervosa (AN) is common. Evidence suggests cognitive‐behavioral therapy (CBT) may be useful in the post‐acute period, but few patients have access to trained providers. mHealth technologies have potential to increase access to high‐quality care for AN, including in the post‐acute period. The aim of this study is to estimate the preliminary feasibility and effectiveness of a CBT‐based mobile intervention plus treatment as usual (TAU), offered with and without an accompanying social networking feature. Method: In the current pilot randomized controlled trial, women with AN who have been discharged from acute treatment in the past 2 months (N = 90) will be randomly assigned to a CBT‐based mobile intervention plus treatment as usual (TAU), a CBT‐based mobile intervention including social networking plus TAU, or TAU alone. We will examine feasibility, acceptability, and preliminary effectiveness of the three conditions in terms of reducing eating disorder psychopathology, reducing frequency of eating disorder behaviors, achieving weight maintenance, reducing depression and suicidal ideation, and reducing clinical impairment. We will examine rehospitalization and full recovery rates in an exploratory fashion. We will also examine whether the mobile intervention and social networking feature change the proposed targets and whether changes in targets are associated with benefit, as well as conduct exploratory analyses to identify within‐mobile intervention predictors and moderators of outcome. Discussion: Ultimately, this research may lead to increased access to evidence‐based treatment for individuals with AN and prevention of the extreme negative consequences that can result from this serious disorder. Public Significance: Relapse after acute treatment for anorexia nervosa is common, and few patients have access to trained providers to support them following acute care. This study will pilot a coached mobile app, including a social networking component, for this population. If ultimately successful, our approach could greatly increase access to evidence‐based treatment for individuals with anorexia nervosa and ultimately prevent the extreme negative consequences that can result from this serious disorder. [ABSTRACT FROM AUTHOR]

Purpose/Objective: To explore the impact of the COVID-19 pandemic as experienced and reported by individuals living with a spinal cord injury (SCI). Research Method/Design: Descriptive qualitative design using in-depth semistructured interviews with individuals with SCI (n = 33) followed by thematic analysis. Results: Three main themes described impacts of the COVID-19 pandemic. (a) Impact on health care use; subthemes elaborated that this was attributable to in-person health care facility restrictions or individual decisions to delay care. Individuals with SCI experienced lapses in primary and SCI-specialty care, rehabilitation/therapy services, and home care, but some made use of telehealth services. (b) Impact on weight and/or weight management lifestyle behaviors; subthemes discussed that engagement in physical activity declined because of fitness center closures, recreational activity cancellations, and safety precautions limiting community-based and outdoor activities. The pandemic disrupted participants' independence in purchasing and making preferred food selections which impacted healthy eating. Participants ate due to boredom, at nonmealtimes, and consumed unhealthy foods during the pandemic. (c) Impact on psychosocial factors; included subthemes noting reduced social interactions, social participation, and ability to pursue pastimes with family, friends, and groups they belonged to. The pandemic also triggered emotional reactions such as worry, fear, doubt, demotivation, and feelings of social isolation. Conclusions: Our findings highlight the magnitude of consequences faced by individuals with SCI when restrictions to health care, healthy lifestyle endeavors, and social participation occurred during the COVID-19 pandemic. Findings may inform SCI health care providers on what is needed in response to future public health or natural disaster crises. Impact and Implications: As one of few studies to use qualitative interviews with in-depth thematic analysis, this article offers a novel method of examining the impact of the COVID-19 pandemic from the perspectives of individuals with SCI. Individuals with SCI offered insights on ways in which the pandemic disrupted their receipt of routine health care (including home care and rehabilitation/therapy), engagement in healthy eating and physical activity, and social participation. Other research indicates that the general population faced similar barriers; however, owing to several biopsychosocial realities related to function and disability, the obstacles appeared to be intensified for persons with SCI, for example reliance on home health caregivers for regular range of motion exercises, and perceptions of increased risk of virus exposure due to immunocompromised bodily systems in persons with SCI. Negative impacts from obstacles to receiving health care, engaging in healthy weight management lifestyle behaviors, and social participation may have both short- and long-term effects on increased risk for and management of chronic disease, particularly cardiometabolic conditions and SCI-related secondary conditions, as well as poor social health and emotional well-being. [ABSTRACT FROM AUTHOR]

This study investigated the clinical and economic impact of anti-obesity medications (AOMs; orlistat, liraglutide, phentermine/topiramate extended-release [ER], naltrexone ER/bupropion ER) among United States Veterans with obesity participating in Motivating Overweight/Obese Veterans Everywhere! (MOVE!), a government-initiated weight management program. The study population was identified from electronic medical records of the Veterans Health Administration (2010–2020). Clinical indices of obesity and health care resource utilization and costs were evaluated at 6, 12, and 24 months after the initial dispensing of an AOM in the AOM+MOVE! cohort (N = 3732, mean age 57 years, 79% male) or on the corresponding date of an inpatient or outpatient encounter in the MOVE! cohort (N = 7883, mean age 58 years, 81% male). At 6 months postindex, the AOM+MOVE! cohort had better cardiometabolic indices (eg, systolic blood pressure, diastolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, hemoglobin A1c) than the MOVE! cohort, with the trends persisting at 12 and 24 months. The AOM+MOVE! cohort was significantly more likely than the MOVE! cohort to have weight decreases of 5%–10%, 10%–15%, and >15% and lower body mass index at 6, 12, and 24 months. The AOM+MOVE! cohort also had fewer inpatient and emergency department visits than the MOVE! cohort, which was associated with lower mean total medical costs including inpatient costs. These results suggest that combining AOM treatment with the MOVE! program could yield long-term cost savings for the Veterans Affairs network and meaningful clinical improvements for Veterans with obesity. [ABSTRACT FROM AUTHOR]

The article focuses on obesity which imposes a substantial health burden and has increased in prevalence in recent years. Topics include examines despite its health impacts, obesity remains undertreated in primary care settings because of a variety of barriers and considered recommended approaches to the clinical management of obesity required an understanding of the physiology of the condition.

Summary: Background: The literature evaluating multi‐component interventions for long‐term weight loss in adolescents with intellectual disabilities (ID) is extremely limited. Objectives: To compare the effectiveness of two delivery strategies, face‐to‐face (FTF) or remote delivery (RD), and two diets, enhanced Stop Light diet (eSLD) or conventional diet (CD) on weight change across 12 and 18 months. in response to an 18 months. weight management intervention (6 months Weight loss/12 months. Weight maintenance) in adolescents with ID. Methods: Adolescents with ID were randomized to one of three arms: FTF /CD, RD/CD, RD/eSLD and asked to attend individual education sessions with a health educator which were delivered during FTF home visits or remotely using video conferencing. The CD followed the US dietary guidelines. The eSLD utilized the Stop Light guide and was enhanced with portion‐controlled meals. Participants were also asked to increase their physical activity (PA) and to self‐monitor diet, PA and body weight across the 18‐month. intervention. Results: Weight was obtained from 92(84%) and 89(81%) randomized adolescents at 12 and 18 months, respectively. Weight change across 12 months. Differed significantly by diet (RD/eSLD: −7.0% vs. RD/CD: −1.1%, p = 0.002) but not by delivery strategy (FTF/CD: +1.1% vs. RD/CD: −1.1%, p = 0.21). Weight change across 18 months. Was minimal in all intervention arms and did not differ by diet (RD/eSLD: −2.6% vs. RD/CD: −0.5%; p = 0.28) or delivery strategy (FTF/CD: +1.6% vs. RD/CD: −0.5%; p = 0.47). Conclusions: Additional research is required to identify effective strategies to improve long‐term weight loss in adolescents with ID. [ABSTRACT FROM AUTHOR]

This study aimed to determine the breadth to which obesity education is included in US dietetic internships, how it is prioritized, and the perceived barriers to providing optimal obesity curricula in dietetic internships. A 27-item, cross-sectional survey was emailed to 335 dietetic internship program administrators in the United States and Puerto Rico. Data were analyzed using general descriptive statistics. A total of 83 administrators (25%) participated. Only 26 dietetic internship programs (34%) reported their interns were "very prepared" to manage patients with obesity. Thirty-six percent had no obesity education programs in place, and 65% noted obesity education is not taught as a specific clinical rotation. Forty percent of administrators believed obesity education to be a specific competency for dietetic internships, and 33% viewed expansion of obesity education as a low priority. Lack of room in the current curriculum was the predominant barrier (22%) to integrating obesity education, whereas lack of interest was not (74%). Administrators reported their interns generally had "some to great extent" of knowledge on comorbidities of obesity (60%), but knowledge of obesity etiology and assessment was low (33%). Fifty-eight percent of dietetic internship programs did not provide weight bias training. Despite the expectation that registered dietitian nutritionists are primary educators in obesity management, US dietetic internships may not be adequately preparing their students to manage patients with obesity. Contributing factors to this disconnect should be recognized, and barriers minimized, so that optimal obesity training is provided in dietetic internships. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To examine the association of caregivers' concern about children's overweight and obesity status with family structure (grandparent versus parent-headed households). METHODS: Caregivers reported their relation to the child aged 10 to 17 years and the child's weight and height (National Survey of Children's Health 2016-20). Overweight/obesity was calculated using Centers for Disease Control and Prevention growth charts. We estimated associations (prevalence odds ratio) of residing in a grandparent-headed household with lack of weight concern (responding "Yes, it's too low"or"No, not concerned"to"Are you concerned about this child's weight?") among propensity score-matched children with overweight and obesity. Covariates included child's sex, race, ethnicity, age, family poverty ratio, primary household language, highest level of education among reported adults, caregiver mental and emotional health, usual source of care and survey year. RESULTS: The prevalence of child overweight/obesity was higher in grandparent-headed households. Among children with overweight/obesity, 64.65 (SE = 3.27)% of grandparents and 66.55 (SE = 0.81)% of parents did not express concern about the child's weight status. Among children with obesity, it was 52.42 (SE = 4.63)% and 49.04 (SE = 1.28)%, respectively. Family structure was not associated with caregiver lack of weight concern in propensity score-matched samples. CONCLUSIONS: Appropriate caregiver concern about child's weight status was low in both grandparent and parent-headed households in the United States. [ABSTRACT FROM AUTHOR]

Two guidelines--one by the American College of Cardiology (ACC)/ American Heart Association (AHA)/The Obesity Society (TOS), and the other by the American Association of Clinical Endocrinologists (AACE)/ American College of Endocrinology (ACE)--remain the standard of care in the management of overweight and obesity in adults. However, since the publication of the ACC/AHA/TOS document, several relevant pharmacotherapies have been approved by the FDA, a medication was withdrawn from the market, and several procedures and device types for weight loss have been recommended or FDA-approved. Simultaneously, research in obesity treatment has advanced, and leaders in the field have issued complementary guidance. This article summarizes and synthesizes the 2013 ACC/AHA/TOS and the 2016 AACE/ACE guidelines and includes updates from more recent professional association guidance. Measurement of body mass index is recommended to initiate evaluation for overweight and obesity and determine disease classification. To stage disease severity, weight-related conditions should be assessed. Although lifestyle therapy remains the cornerstone of treatment for this disease, both pharmacotherapy and metabolic and bariatric surgery produce greater and more sustained weight loss in treatment-approved populations as compared with lifestyle modifications alone. An ongoing partnership between the patient and clinician is highly recommended to manage this serious, progressive, chronic disease. [ABSTRACT FROM AUTHOR]

Adolescents often practice unhealthy behaviors to lose weight or keep from gaining weight. Centers for Disease Control and Prevention has conducted biennial Youth Risk Behavior Survey (YRBS) of various health risk behaviors since 1991 using U.S. representative samples of high school students and is therefore best for us to identify risk/preventive factors associated with unhealthy weight control behaviors (UWCB). We quantitatively assessed the association between various health risk behaviors with UWCB by gender using YRBS data. Due to the absence of UWCB items since 2015, we analyzed the latest (2013) data using binary multiple logistic regression. Among the 13,583 participants, 22.7% of girls and 10.1% of boys engaged in UWCB. Among girls and boys separately, the common significant factors included suicidal behaviors, alcohol drinking, misused prescription drug, feeling depressed, skipping breakfast, and attending physical education class. School nurses are suggested to have knowledge about the aforementioned risk factors and provide assessment, consultation, and education to help reduce UWCB. [ABSTRACT FROM AUTHOR]

The article reports on the increased number of adolescents and young adults in the U.S. who were prescribed with glucagon-like peptide 1 (GLP-1) receptor agonist, including semaglutide, tirzepatide, exenatide and liragluide, from 2020 to 2023. It provides an overview of findings from a clinical trial on semaglutide for the treatment of obesity and type 2 diabetes in pediatric patients. Analysis reveals the trend of GLP-1 dispenses based on patient sex during the period.

The role that the superwoman schema (SWS) plays in U.S. Black women's perceptions of barriers (biological, psychological, and sociological) to healthy weight management is unknown. This exploratory study examined whether 122 women classified as normal weight, overweight or obese differed in their perceptions of types of barriers and if the SWS predicted perceived barriers to weight management. Women classified as obese reported more barriers than those classified as normal weight. The SWS uniquely positively predicted perceived psychological and sociological barriers. Our findings suggest that the SWS may play a vital role in the self-management of weight in U.S. Black women. [ABSTRACT FROM AUTHOR]

Objectives: Primary care is an opportune setting to promote healthy behaviors for children and families. In 2007, an expert committee recommended that pediatric primary care clinicians assess nutrition and physical activity at wellness visits and offer recommendations; however, little is known about what pediatric primary care clinicians perceive their role as in childhood weight management. This qualitative study aimed to describe the perceived role of pediatric primary care clinicians in the prevention and treatment of childhood obesity in South Carolina, a state in the southern United States with high rates of childhood obesity.Methods: Pediatric primary care clinicians (n = 23) from South Carolina were recruited for two focus groups. Participants were asked semistructured, open-ended questions, and audio recordings were transcribed verbatim. Themes and subthemes were identified through an iterative coding and consensus-building process with two coders. Excerpts coded under the parent code of "clinician role" centered on three themes: conducting assessments, making referrals, and providing education.Results: Pediatric primary care clinicians in South Carolina coalesced around the important role of addressing childhood obesity within primary care. Notably, clinicians primarily discussed treatment rather than prevention strategies and described changes in the scope of their practice over time as a result of the increasing numbers of pediatric patients with obesity.Conclusions: Addressing childhood obesity within primary care is a critical component of obesity prevention and treatment in the southern United States. Effective, sustainable prevention and treatment within primary care will depend on the involvement of pediatric clinicians, thus emphasizing the importance of understanding how they perceive their role within this setting. [ABSTRACT FROM AUTHOR]

Objective: Disordered eating behaviors (DEBs) have long‐term, deleterious effects on health and are more prevalent among socially marginalized groups, likely as a result of systemic inequities across social determinants of health (SDoH). This exploratory study aimed to identify subgroups of emerging adults characterized by main and interactive associations between SDoH and two forms of DEB (binge eating, extreme unhealthy weight control behaviors). Method: Participants (n = 1568; age 22.2 ± 2.1 years) from the United States were drawn from the EAT 2010–2018 longitudinal study. Conditional inference tree (CIT) analyses derived main and intersecting SDoH related to DEB across 33 input variables collected during adolescence and emerging adulthood. Results: The binge eating CIT revealed five subgroups (prevalence: 6.3–23.2%) shaped by variables collected during emerging adulthood: appearance‐based teasing (p <.001), financial difficulty (p =.003), gender (p <.001), and everyday discrimination (p =.008). The CIT results for extreme unhealthy weight control behaviors derived six subgroups (prevalence: 2.3–45.5%) shaped by weight teasing (p <.001) and gender (p <.001) during emerging adulthood and public assistance (p =.008) and neighborhood safety (p =.007) in adolescence. Discussion: This exploratory study revealed distinct subgroups of emerging adults with varying DEB prevalence, suggesting that variability in DEB prevalence may be partially explained by intersecting SDoH during adolescence and emerging adulthood. Hypothesis‐driven research and replication studies are needed to further explore the associations between SDoH and DEB during emerging adulthood. Public Significance Statement: Disordered eating behaviors are common among young people in the United States and have long‐term health consequences. This exploratory study identified subgroups of young people, characterized by combinations of social inequities (e.g., financial difficulties, teasing). Results highlight high‐risk subgroups of emerging adults that should be examined further in hypothesis‐driven research. [ABSTRACT FROM AUTHOR]

Understanding the relationship between the perceived body weight, body mass index (BMI), and weight management-related behaviors is critical to preventing obesity in young adults. To explore the relationship between perceived body weight and weight management-related behaviors and to assess the mediating effects of BMI between perceived body weight and weight management-related behaviors among young adults. Using data (n = 4882) from the National Longitudinal Study of Adolescent to Adult Health, multiple linear regression and a series of mediation analyses were applied to analyze the data. Both perceived body weight and BMI were significantly associated with breakfast consumption and sleep for overall participants (p <.001; p <.001). Perceived body weight and BMI were significantly associated with breakfast consumption among young female adults (p <.001). Perceived body weight and BMI were significantly associated with sleep among young male adults (p =.03). BMI is found to mediate the relationship between perceived body weight and breakfast consumption. The study demonstrated both perceived body weight and BMI contribute to certain weight management-related behaviors. BMI could be the inflammatory mechanism of health behavior change. Development of tailored interventions or culturally appropriate weight management educational programs are needed for young adults. Findings of this study could have implications for public health education. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) [ABSTRACT FROM AUTHOR]

Introduction/Objectives: Patient activation describes the knowledge, skills, and confidence that allow patients to actively engage in managing their health. Prior studies have found a strong relationship between patient activation and clinical outcomes, costs of care, and patient experience. Patients who are obese or overweight may be less engaged than normal weight patients due to lower confidence or stigma associated with their weight. The objective of this study is to examine whether weight status is associated with patient activation and its sub-domains (confidence, communication, information-seeking behavior). Methods: This repeated cross-sectional study of the 2011 to 2013 Medicare Current Beneficiary Survey (MCBS) included a nationally representative sample of 13,721 Medicare beneficiaries. Weight categories (normal, overweight, obese) were based on body mass index. Patient activation (high, medium, low) was based on responses to the MCBS Patient Activation Supplement. Results: We found no differences in overall patient activation by weight categories. However, compared to those with normal weight, people with obesity had a higher relative risk (RRR 1.24; CI 1.09-1.42) of "low" rather than "high" confidence. Respondents with obesity had a lower relative risk (RRR 0.82; CI 0.73-0.92) of "low" rather than "high" ratings of communication with their doctor. Discussion and Conclusions: Though patients with obesity may be less confident in their ability to manage their health, they are more likely to view their communication with physicians as conducive to self-care management. Given the high receptivity among patients with obesity toward physician communication, physicians may be uniquely situated to guide and support patients in gaining the confidence they need to reach weight loss goals. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to examine motivations for food choice among long‐term weight loss maintainers (WLM) in a widely used commercial weight management program. Methods: A cross‐sectional study was employed where determinants of food choice were measured in the USA using validated scales: Food Choice Questionnaire, Consideration of Future Consequences, and Eating in the Absence of Hunger. Participants were 3806 WLM following a commercial weight management program (WW International, Inc.) who had maintained a weight loss ≥ 9.1 kg (mean 24.7 kg) for 3.3 years and had a body mass index (BMI) of 27.6 kg m2. A control group of weight stable individuals with obesity (controls; n = 519) had a BMI of 38.9 kg m2 and a weight change < 2.3 kg over the previous 5 years. Results: WLM vs. controls made food decisions more based on health (18.9 vs. 16.3; ηp2 = 0.052) and weight control (9.9 vs. 7.5; ηp2 = 0.16) and less based on price (8.4 vs. 9.1; ηp2 = 0.10). WLM also scored higher than controls with respect to considering future consequences of behaviours (44.3 vs. 38.4; ηp2 = 0.060) and reported less external eating in the absence of hunger (7.1 vs. 7.5; ηp2 = 0.058). Standard canonical coefficients indicated that making food choices based on weight (0.717) with less value placed on price (−0.33) and greater consideration of future consequences (0.262) contributed independently and most (overall r = 0.593; p = 0.0001) to discriminating WLM from controls. Conclusions: In a widely used commercial weight management program, successful WLM reported food decisions based more on weight and less on price and considered future consequences of current behaviours. Key points: Long‐term weight loss maintainers consume a diet that is low in calories and micronutrient rich, although the diverse factors that govern these food choices remain unclear.The present study examined diverse factors associated with food choice among weight loss maintainers in a widely used commercial weight management program (WW International, Inc.) compared to weight stable individuals with obesity ("controls").Weight loss maintainers more than controls made food decisions based on health and weight control and less based on price. Both groups scored similarly in the role of convenience, mood, sensory appeal, natural content, familiarity and ethical concerns.Weight loss maintainers were overall more likely to consider future consequences.In a widely used commercial weight management program (WW International, Inc.), successful weight loss maintainers reported food decisions based more on weight and health and less on price. They also considered future consequences of current behaviours. [ABSTRACT FROM AUTHOR]

Health providers often focus on secondary conditions and spend less time prioritising overweight/obesity care. Informal caregivers are well positioned to facilitate health‐promoting behaviours of healthy eating and physical activity among community‐dwelling care recipients with spinal cord injury (SCI) for prevention and management of overweight/obesity. Literature has typically focused on caregiver adjustment post‐injury and burden related to their roles in secondary condition care. The novel objective of this study was to describe informal caregivers' perspectives of their roles in facilitating health‐promoting weight management behaviours, healthy eating and physical activity, for care recipients with SCI. This was a qualitative study that used semi‐structured interviews with informal caregivers for data collection in 2019. Braun & Clarke's established thematic phases were used for analysis. Participants included informal caregivers of individuals with SCI living in the community (n = 24). Caregivers identified eight themes to describe their role in facilitating weight management for care recipients. Themes included: (1) meal planning/shopping, (2) meal preparation/cooking, (3) using portion control, (4) serving/feeding, (5) helping the care recipient with physical activity and/or leisure activities, (6) mutually participating in weight management activities, (7) providing motivation and encouragement and (8) being an information liaison. In summary, informal caregivers have an intimate understanding of care recipients' needs and have insights on obstacles and enablers to health‐promoting behaviours, making their involvement in facilitating weight management in individuals with SCI vital. Caregivers self‐identified several significant roles for promoting weight management. This is especially valuable for conditions such as overweight/obesity for which prevention and treatment involve health‐promoting behaviours that need consistent attention in the community setting. It is important to ensure that informal caregivers and care recipients have the information required in order to facilitate healthy eating and physical activity in persons with SCI and have opportunities for mutual dyadic participation when both partners are interested. [ABSTRACT FROM AUTHOR]

The article reports that Weight cycling is prevalent in sports/professions with body composition standards, and has been associated with weight management behaviours that may contribute to suboptimal diet quality and weight gain. US Army Soldiers may be at increased risk of weight cycling relative to civilians due to mandated body composition standards.

This study examined mediating effects of body weight control behaviors in the relationship between body weight perception and health-related behaviors among 11,458 U.S. adolescents from the 2010 National Youth Physical Activity and Nutrition Survey. Parallel multiple mediation analysis was performed for the secondary data analysis. Nearly one third of adolescents (32.5%) had overweight or obesity; one quarter (25.0%) perceived themselves as slightly overweight and 5.1% thought they were very overweight. More girls (58.6%) had tried to lose weight than boys (32.3%), while boys were more physically active than girls. Healthy and unhealthy weight control behaviors significantly mediated the relationship between adolescents' body weight perception and health-related behaviors (physical activity and screen time). Teachers and parents should help adolescents have accurate weight perception and utilize reliable and healthy weight control strategies. Future studies should consider the intercorrelated relationships among adolescents' perceptions and behaviors regarding weight to provide successful weight control intervention programs. [ABSTRACT FROM AUTHOR]

Metabolic and bariatric surgery is the most effective therapy for weight loss and improving obesity-related comorbidities, comprising the Roux-en-Y gastric bypass (RYGB), gastric banding, sleeve gastrectomy (SG), and biliopancreatic diversion with duodenal switch. While the effectiveness of weight loss surgery is well-rooted in existing literature, weight recurrence (WR) following bariatric surgery is a concern. Endoscopic bariatric therapy presents an anatomy-preserving and minimally invasive option for managing WR in select cases. In this review article, we will highlight the endoscopic management techniques for WR for the most commonly performed bariatric surgeries in the United States -RYGB and SG. For each endoscopic technique, we will review weight loss outcomes in the short and mid-terms and discuss safety and known adverse events. While there are multiple endoscopic options to help address anatomical issues, patients should be managed in a multidisciplinary approach to address anatomical, nutritional, psychological, and social factors contributing to WR. [ABSTRACT FROM AUTHOR]

Objective: Does engaging in dietary restraint due to weight/shape concerns versus economic hardship differentially relate to disordered eating? Method: The sample consisted of 582 adults experiencing food insecurity (FI) who completed online measures assessing severity of FI, disordered eating, loss of control over eating, and dietary restraint. Participants reported their motivation for dietary restraint with options consisting of weight/shape concerns, economic hardship (i.e., insufficient funds and prioritizing others' needs), mixed reasons, and other/I do not know. Results: In the sample, 18% reported engaging in dietary restraint primarily due to weight/shape concerns, 33% due to economic hardship, 18% other/do not know, and 30% due to a mix of reasons. There were positive correlations between FI, economic hardship, dietary restraint, disordered eating, and loss of control over eating. Regression analyses revealed the association between dietary restraint and disordered eating does not differ across individuals who endorse economic hardship as a motivator for dietary restraint. Findings replicated with loss of control. However, the association between dietary restraint and disordered eating grew stronger as more dietary restraint due to weight/shape concerns was endorsed. No significant association emerged with loss of control. Discussion: Research is needed to replicate findings and examine how patterns of food scarcity impacts disordered eating in food insecure populations with and without weight/shape concerns. Findings suggest that motivation for dietary restraint may influence associations with dietary restraint and the cognitive components of disordered eating, but not the behavioral components of disordered eating. Public Significance Statement: Disordered eating due to dietary restraint is most commonly associated with weight and shape concerns; however, even when dietary restraint is due to economic reasons, it can still be associated with disordered eating. [ABSTRACT FROM AUTHOR]