Effectiveness of cognitive-behavioral therapy based on the Mediterranean diet for the treatment of obesity. The impact of the Pathways intervention on psychosocial variables related to diet and physical activity in American Indian schoolchildren. A comparison of functional brain changes associated with surgical versus behavioral weight loss Sex-based differences in the behavioral and neuronal responses to food Predictors of weight gain in the Pound of Prevention study Health Hunters–an intervention to prevent overweight and obesity in young high-risk women Impact of providing walnut samples in a lifestyle intervention for weight loss: a secondary analysis of the HealthTrack trial Efficacy of a meal replacement diet plan compared to a food-based diet plan after a period of weight loss and weight maintenance: a randomized controlled trial Fast food restaurant use among women in the Pound of Prevention study: dietary, behavioral and demographic correlates A behavioral economic analysis of changes in food-related and food-free reinforcement during weight loss treatment. Do 6-y changes in eating behaviors predict changes in body weight? Results from the Québec Family Study The effects of exercise on the neuronal response to food cues Primary prevention of risk factors for eating disorders in adolescent girls: learning from practice. Size acceptance and intuitive eating improve health for obese, female chronic dieters. A comparison of the effect of free access to reduced fat products or their full fat equivalents on food intake, body weight, blood lipids and fat-soluble antioxidants levels and haemostasis variables Design and implementation of a randomized controlled social and mobile weight loss trial for young adults (project SMART). Use of 'light' foods and drinks in French adults: biological, anthropometric and nutritional correlates. Food-Containing Hypocaloric Diets Are As Effective As Liquid-Supplement Diets for Obese Individuals With NIDDM Credit Card Debt, Stress and Key Health Risk Behaviors among College Students
OBJECTIVE The Mediterranean dietary pattern improves cardiovascular disease factors . More research is needed on the usefulness of a Mediterranean dietary pattern in terms of weight loss . The objective of this study was to assess the effectiveness of behavioral therapy based on the Mediterranean diet for the treatment of obesity and to determine the main obstacles to weight loss . METHODS A total of 1406 obese subjects ( body mass index , 31+/-5kg/m(2 ) ) , aged 20 - 65 y , from a Mediterranean area in southeast Spain were subjected to a  weight-reduction program . To evaluate effectiveness , weight loss , body fat distribution , biochemical variables , blood pressure changes , mean duration of treatment , percentage of attrition , and the ability to fulfill a Mediterranean diet pattern were assessed . To determine the main barriers to losing weight , a " Barriers to Weight Loss " checklist was completed . RESULTS The behavioral therapy program was effective for the treatment of obesity . The average weight loss was 7.7 kg . The duration of treatment was 34 wk . Eighty-nine percent of subjects fulfilled the Mediterranean principles during the program , and all the variables studied were significantly improved . Attrition was 4 - 9 % , with the main reason being stress ( 37 % ) . Main obstacles to weight loss were " losing motivation , " being " prone to stress-related eating , " and being liable to eat when bored . Recording food intake and assisting group therapy were also important tools for losing weight ( P < or = 0.05 ) . CONCLUSIONS Dietary/behavioral treatment based on Mediterranean dietary principles is effective in clinical practice . Nutrition professionals should encourage their patients to record food intake and to attend group therapy BACKGROUND The purpose of this study was to examine the impact of the Pathways intervention on pychosocial variables related to physical activity and diet in American Indian children . METHODS Schools serving American Indian children were r and omized to a multicomponent intervention or control condition . At baseline ( fall of third grade ) and in the spring semester of third , fourth , and fifth grade s 755 boys and 692 girls completed a classroom-administered question naire . The question naire assessed self-efficacy , knowledge , and behavioral intentions related to diet and physical activity , as well as weight loss behaviors and body image . RESULTS Knowledge of nutrition and physical activity messages increased in both boys and girls in the intervention group compared to controls ; however , knowledge of which foods contained more fat did not increase consistently . Compared to controls , self-efficacy to be physically active increased among girls in intervention schools , but not among boys , whereas self-efficacy to make more healthy food choices did not increase more than in controls in either gender . In the intervention group , compared to controls , healthy food intentions and participation in physically active behaviors increased in both boys and girls . Perception of healthy body size and weight loss attempts did not differ in the intervention and control groups . CONCLUSION The Pathways intervention program had a positive impact on several aspects of obesity-related knowledge , attitudes , and behaviors Objective Few studies have examined brain changes in response to effective weight loss ; none have compared different methods of weight-loss intervention . We compared functional brain changes associated with a behavioral weight loss intervention to those associated with bariatric surgery . Methods 15 obese participants were recruited prior to adjustable gastric b and ing surgery and 16 obese participants were recruited prior to a behavioral diet intervention .  Groups were matched for demographics and amount of weight lost . fMRI scans ( visual food motivation paradigm while hungry and following a meal ) were conducted before , and 12 weeks after surgery/behavioral intervention . Results When compared to bariatric patients in the pre-meal analyses , behavioral dieters showed increased activation to food images in right medial PFC and left precuneus following weight loss . When compared to behavioral dieters , bariatric patients showed increased activation in in bilateral temporal cortex following the weight loss . Conclusions Behavioral dieters showed increased responses to food cues in medial PFC – a region associated with valuation and processing of self-referent information – when compared to bariatric patients . Bariatric patients showed increased responses to food cues in brain regions associated with higher level perception — when compared to behavioral dieters . The method of weight loss determines unique changes in brain function Sex-based differences in food intake related behaviors have been observed previously . The objective of this study was to examine sex-based differences in the behavioral and neuronal responses to food . 22 women and 21 men were studied . After 6 days of controlled eucaloric feeding , ad libitum energy intake ( EI ) was measured for 3 days . Appetite ratings using visual analog scales were obtained before and after each meal . Functional magnetic resonance imaging was performed in the overnight fasted state on the last day of eucaloric feeding while subjects were presented visual stimuli of food and neutral non-food objects . While hunger and prospect i ve consumption were not different between sexes , women had higher post-meal satiety ratings and dietary restraint than men . Images of hedonic foods result ed in significantly greater activation of lateral and dorsolateral prefrontal cortex ( DLPFC ) and parietal cortex in women as compared to men . No brain regions were more activated in men as compared to women . Men increased their EI during the ad libitum diet phase . While measures of appetite or feeding behaviors did not correlate with either neuronal activation or subsequent EI , DLPFC activation in response to hedonic foods was negatively correlated with EI . In summary , greater prefrontal neuronal responses to food cues in women may suggest increased cognitive processing related to executive function , such as planning , guidance or evaluation of behavior . Finally , increased DLPFC activation , perhaps relating to inhibitory cognitive control in response to food cues may be a better predictor of food intake than behavioral measures OBJECTIVES : This study examined cross-sectional and prospect i ve relationships between macronutrient intake , behaviors intended to limit fat intake , physical activity and body weight . DESIGN : The overall goal was to identify diet and exercise behaviors that predict and /or accompany weight gain or loss over time . Specific questions addressed included : ( a ) are habitual levels of diet or exercise predictive of weight change ; ( b ) are habitual diet and exercise levels associated cross-sectionally with body weight ; and ( c ) are changes in diet and exercise associated with changes in body weight over time ? PARTICIPANTS : Subjects were a sample of community volunteers ( n=826 women , n=218 men ) taking part in a weight gain prevention project over a 3-year period . MEASURES : Body weight was measured at baseline and annually over the study period . Self-report measures of diet and exercise behavior  were also measured annually . RESULTS : Among both men and women , the most consistent results were the positive association between dietary fat intake and weight gain and an inverse association between frequency of physical activity and weight gain . Individuals who weighed more both ate more and exercised less than those who weighed less . Individuals who increased their physical activity level and decreased their food intake over time were protected from weight gain compared to those who did not . Frequency of high-intensity physical activity was particularly important for both men and women . Additionally , women who consistently engaged in higher levels of moderate physical activity gained weight at a slower rate compared to women who were less active . CONCLUSIONS : Overall results indicated that both cross-sectionally and prospect ively , the determinants of weight and weight change are multifactorial . Attention to exercise , fat intake and total energy intake all appear important for successful long term control of body weight Aim : The aim of the study was to develop and implement an obesity and weight gain prevention program targeted to a high-risk group . Method : Women , 18–28 years old , with at least one severely obese parent , were r and omized to the intervention or control group of the ‘ Health Hunters ’ program .  During 1 year of follow-up , the intervention group received an individualized behavioral program focusing on food choice , physical activity and other lifestyle factors . Anthropometric measures , DXA-based body composition and fitness levels were measured at baseline and after 1 year . Self-reported changes in obesity-related behaviors were also assessed . Results : Baseline examinations were conducted in 40 women , of whom 30 completed follow-up examinations 1 year later . Pregnancy was the most common reason for failure to complete the study . Compared to the control group ( which gained weight ) , the intervention group displayed significant improvements in body weight , body mass index , waist circumference , waist-to-hip ratio and self-reported physical activity . Changes in body composition , although not significant , suggested that the intervention tended to be associated with improved body composition . Further analysis of changes in diet and fitness in relation to concurrent weight changes indicated that the strongest ‘ protective ’ associations were for energy percent protein , fiber density and fitness . Conclusion : Pilot data from the Health Hunters obesity prevention program indicates that it is effective in high-risk young women with familial predisposition for obesity ABSTRACT Background : Being more specific about individual food choices may be advantageous for weight loss . Including a healthy food ( e.g. walnuts ) may help to expose effects . Objective : To examine the impact of including walnuts in diets for weight loss . Design : Secondary analysis of the HealthTrack lifestyle intervention trial . Overweight and obese participants were r and omized to : usual care ( C ) , interdisciplinary intervention including individualized dietary advice ( I ) , or interdisciplinary intervention including 30 g walnuts/day ( IW ) . Changes in body weight , energy intake , intake of key foods , physical activity , and mental health over three and 12 months were explored . Results : A total of 293 participants completed the intensive three-month study period , and 175 had data available at 12 months . The IW group achieved the greatest weight loss at three months . IW reported significant improvements in healthy food choices , and decreased intakes of discretionary foods/beverages , compared to C. Weight loss remained greatest in IW at 12 months . Discussion : Significant effects were seen after three months , with the IW group achieving greater weight loss and more favorable changes in food choices . Conclusions : Including 30 grams walnuts/day in an individualized diet produced weight loss and positive changes in food choice Background Obesity has reached epidemic proportions in the United States . It is implicated in the development of a variety of chronic disease states and is associated with increased levels of inflammation and oxidative stress . The objective of this study is to examine the effect of Medifast 's meal replacement program ( MD ) on body weight , body composition , and biomarkers of inflammation and oxidative stress among obese individuals following a period of weight loss and weight maintenance compared to a an isocaloric , food-based diet ( FB ) . Methods This 40-week r and omized , controlled clinical trial included 90 obese adults with a body mass index ( BMI ) between 30 and 50 kg/m2 , r and omly assigned to one of two weight loss programs for 16 weeks and then followed for a 24-week period of weight maintenance . The dietary interventions consisted of Medifast 's meal replacement program for weight loss and weight maintenance , or a self-selected , isocaloric , food-based meal plan .  Results Weight loss at 16 weeks was significantly better in the Medifast group ( MD ) versus the food-based group ( FB ) ( 12.3 % vs. 6.9 % ) , and while significantly more weight was regained during weight maintenance on MD versus FB , overall greater weight loss was achieved on MD versus FB . Significantly more of the MD participants lost ≥ 5 % of their initial weight at week 16 ( 93 % vs. 55 % ) and week 40 ( 62 % vs. 30 % ) . There was no difference in satiety observed between the two groups during the weight loss phase . Significant improvements in body composition were also observed in MD participants compared to FB at week 16 and week 40 . At week 40 , both groups experienced improvements in biochemical outcomes and other clinical indicators . Conclusions Our data suggest that the meal replacement diet plan evaluated was an effective strategy for producing robust initial weight loss and for achieving improvements in a number of health-related parameters during weight maintenance , including inflammation and oxidative stress , two key factors more recently shown to underlie our most common chronic diseases . Trial Registration Clinical Trials.gov OBJECTIVE : To examine demographic , behavioral and dietary correlates of frequency of fast food restaurant use in a community-based sample of 891 adult women . DESIGN : A survey was administered at baseline and 3 y later as part of a r and omized , prospect i ve intervention trial on weight gain prevention . SUBJECTS : Women ( n=891 ) aged 20–45 y who enrolled in the Pound of Prevention study . MEASUREMENTS : Frequency of fast food restaurant use ,  dietary intake  , demographic and behavioral measures were self-reported . Dietary intake was measured using the 60-item Block Food Frequency Question naire . Body weight and height were directly measured . RESULTS : Twenty-one percent of the sample reported eating ≥3 fast food meals per week . Frequency of fast food restaurant use was associated with higher total energy intake , higher percentage fat energy , more frequent consumption of hamburgers , French fries and soft drinks , and less frequent consumption of fiber and fruit . Frequency of fast food restaurant use was higher among younger women , those with lower income , non-White ethnicity , greater body weight , lower dietary restraint , fewer low-fat eating behaviors , and greater television viewing . Over 3 y , increases in frequency of fast food restaurant use were associated with increases in body weight , total energy intake , percentage fat intake , intake of hamburgers , French fries and soft drinks , and with decreases in physical activity , dietary restraint and low-fat eating behaviors . Intake of several other foods , including fruits and vegetables , did not differ by frequency of fast food restaurant use . CONCLUSION : Frequency of fast food restaurant use is associated with higher energy and fat intake and greater body weight , and could be an important risk factor for excess weight gain in the population OBJECTIVE Behavioral economic theory predicts that reductions in consumption of highly valued commodities , such as drugs or palatable food items , are facilitated by increasing engagement in reinforcing substitutes . The current study prospect ively examines changes in engagement in and enjoyment of food versus food-free activities during an 18-month behavioral weight loss intervention . METHOD Participants were 202 overweight/obese individuals who took part in an 18-month behavioral weight loss treatment and were r and omly assigned to a traditional hypocaloric , low-fat diet condition or a traditional hypocaloric , low-fat diet plus a goal to limit variety in snack food consumption condition . At baseline and 6 , 12 , and 18 months , participants were weighed and completed a measure that assessed recent frequency of engagement in and enjoyment of a variety of both food and food-free activities . RESULTS Growth models revealed a statistically significant decrease in the relative percentage of food-related reinforcement ( vs. food-free ) over time ( reinforcement ratio , or RR ) , with the greatest reduction during the first 6 months of treatment . Food-related reinforcement decreased over time , and food-free reinforcement increased . Additionally , the RR change predicted change in body mass index ( BMI ) from 0 to 6 months and 0 to 18 months , such that greater changes in RR were associated with greater changes in BMI . CONCLUSIONS Findings suggest that behavioral weight loss treatment may promote a shift away from food-related reinforcement toward food-free reinforcement and that this change may predict BMI change . Future interventions may consider targeting increasing engagement in enjoyable food-free activities to help with long-term maintenance OBJECTIVE : This study was performed to examine changes in eating behaviors as assessed by the three-factor eating question naire ( TFEQ ) and to quantify the potential associations between these eating behaviors and body weight changes in a 6-follow-up study . DESIGN AND SUBJECTS : Prospect i ve study performed in men and women who were tested twice ( Visit 1=1989–1995 and Visit 2=6 y later ) in the Québec Family Study ( QFS ) . RESULTS : Women were more restrained and less hungry than men . To reduce food intake , women relied more on strategic dieting behavior  and avoided more fattening food . However , they had higher emotional and situational susceptibility to eat than men . Significant decreases in the disinhibition score were noted over time in women ( P<0.01 ) , which result ed from a decrease in habitual susceptibility behavior to increase food intake . In men , we observed an increase in the avoidance of fattening food ( P<0.05 ) . In both genders , we found that the 6-y change in restraint behavior was negatively correlated with body weight changes ( P<0.05 ) . In women , a high restraint behavior seems to promote weight gain , whereas in men , it is associated with the opposite trend . CONCLUSION : These results suggest that variables reflecting some eating behaviors are associated with body weight changes in a free-living context . However , these behaviors are expressed differently between men and women . These behaviors should be considered in clinical interventions for individuals seeking a better body weight control Increased physical activity is associated with successful long-term weight loss maintenance due to mechanisms likely more complex than simply increased energy expenditure . The impact of physical activity on the central regulation of food intake may be an important mechanism of this effect . The objective of this study was to examine the effects of exercise training and acute exercise on the neuronal response to food cues as well as eating behaviors .  fMRI was performed in the fasted state at baseline and again after a 6 month progressive exercise intervention ( supervised , 5 days/wk ) both with and without an acute exercise bout in 12 overweight/obese ( 5 women , 7 men ; BMI 33 ± 4 kg/m(2 ) ) healthy adults .  fMRI  data were acquired while subjects were presented with visual stimuli of foods of high hedonic value as compared to neutral control objects . Question naires on eating behaviors , ratings of appeal and desire for foods , and ratings of appetite ( hunger , satiety , prospect i ve intake ) using visual analog scales were also performed at baseline and again after the 6-month exercise intervention . While only a trend was observed for a reduction in body weight ( 102 ± 5 to 99 ± 6 kg , p=0.09 ) , a significant reduction in fat mass was observed ( 36.4 ± 2.8 to 33.7 ± 3.2 kg , p=0.04 ) , although as expected changes in fat mass were variable ( -10.0 to + 3.7 kg ) . Chronic exercise was associated with a reduction in the neuronal response to food , primarily in the posterior attention network and insula . A significant positive correlation between the change in fat/body mass and the change in insula response to food cues with chronic exercise was observed . An acute exercise bout attenuated the effects of chronic exercise . The exercise intervention , however , did not impact any of the measures of appetitive behavior . In summary , despite no effects on behavioral measures of  appetite , chronic exercise training was associated with attenuation in the response to visual food cues in brain regions known to be important in food intake regulation . The insula , in particular , appears to play an important role in the potential exercise-induced weight loss and weight loss maintenance OBJECTIVE This study evaluates the effectiveness and feasibility of a primary prevention program for risk factors for eating disorders in adolescent girls . METHOD Nearly 500 seventh- grade girls participated in " Full of Ourselves : Advancing Girl Power , Health , and Leadership , " and were assessed at baseline , immediately after program completion , and 6 months later on several self-report measures of knowledge , body image , and eating and weight-related behaviors . RESULTS Significant differences were found between participants and controls on measures of knowledge and weight-related body esteem , which were maintained at 6-month follow-up . Eating related behaviors , including skipping meals and dieting , appeared unaffected by program participation . DISCUSSION The program was feasible , safe , and result ed in positive and maintained changes in knowledge and weight satisfaction for adolescent girls OBJECTIVE Examine a model that encourages health at every size as opposed to weight loss . The health at every size concept supports homeostatic regulation and eating intuitively ( ie , in response to internal cues of hunger , satiety , and appetite ) . DESIGN Six-month , r and omized clinical trial ; 2-year follow-up . SUBJECTS White , obese , female chronic dieters , aged 30 to 45 years ( N=78 ) . SETTING Free-living , general community . INTERVENTIONS Six months of weekly group intervention ( health at every size program or diet program ) , followed by 6 months of monthly aftercare group support . MAIN OUTCOME MEASURES Anthropometry ( weight , body mass index ) , metabolic fitness ( blood pressure , blood lipids ) , energy expenditure , eating behavior ( restraint , eating disorder pathology ) , and psychology ( self-esteem , depression , body image ) . Attrition , attendance , and participant evaluations of treatment helpfulness were also monitored . STATISTICAL ANALYSIS PERFORMED Analysis of variance . RESULTS Cognitive restraint decreased in the health at every size group and increased in the diet group , indicating that both groups implemented their programs . Attrition ( 6 months ) was high in the diet group ( 41 % ) , compared with 8 % in the health at every size group . Fifty percent of both groups returned for 2-year evaluation . Health at every size group members maintained weight , improved in all outcome variables , and sustained improvements . Diet group participants lost weight and showed initial improvement in many variables at 1 year ; weight was regained and little improvement was sustained . CONCLUSIONS The health at every size approach enabled participants to maintain long-term behavior change ; the diet approach did not . Encouraging size acceptance , reduction in dieting behavior , and heightened awareness and response to body signals result ed in improved health risk indicators for obese women Objectives : To compare the effects of free access to reduced fat products or their full fat equivalents on fat and energy intake , body weight , plasma lipids and fat-soluble antioxidants concentrations and haemostasis variables . Design : A multicentre open r and omised controlled trial in which intervention and control groups were followed in parallel for six months . Volunteers had free access to 44 different foods either in reduced fat or full fat version , covering between 30 and 40 % of energy intake . The remainder of energy intake was covered by foods bought in regular shops . Setting : Zeist , Wageningen and Maastricht , The Netherl and s . Subjects : Two hundred and forty-one non-obese healthy volunteers who had no intention to lose weight . Main outcome measures : Food intake , body weight , plasma lipid , vitamin E , β-carotene , lycopene and fibrinogen concentrations , plasma factor VII clotting activity , and plasminogen-activator-inhibitor-I antigen level . Results : One hundred and three volunteers in the full fat group and 117 volunteers in the reduced fat group completed the study .  Energy and fat intake from the free access products was lower in the reduced fat group , but no difference in energy and fat intake of other products occurred . Body weight , energy- , fat- and vitamin E intake and percentage of energy derived from fat decreased in the reduced fat group . No other statistical significant intervention effects were observed . Blood lipid concentrations , factor VII activity and plasminogen-inhibitor-activator-1 level were reduced after consumption of reduced fat products . Conclusions : When subjects without intention to lose weight limit fat intake by switching from ad libitum consumption of full fat products to reduced fat products body weight gain is prevented , and fat and energy intake are reduced . Such a switch may have beneficial effects on biochemical cardiovascular risk factors . We concluded that reduced fat products will help in a population strategy aim ed at preventing overweight and obesity , they will also be effective in maintaining a lower body weight after slimming . Ad libitum consumption of reduced fat products will be ineffective for those individuals that want to reduce body weight because they are currently overweight or obese . Sponsorship : PURPOSE To describe the theoretical rationale , intervention design , and clinical trial of a two-year weight control intervention for young adults deployed via social and mobile media . METHODS A total of 404 overweight or obese college students from three Southern California universities ( M(age ) = 22 ( ± 4 ) years ; M ( BMI ) = 29 ( ± 2.8 ) ; 70 % female ) were r and omized to participate in the intervention or to receive an informational web-based weight loss program . The intervention is based on behavioral theory and integrates intervention elements across multiple touch points , including Facebook , text messaging , smartphone applications , blogs , and e-mail . Participants are encouraged to seek social support among their friends , self-monitor their weight weekly , post their health behaviors on Facebook , and e-mail their weight loss questions /concerns to a health coach . The intervention is adaptive because new theory-driven and iteratively tailored intervention elements are developed and released over the course of the two-year intervention in response to patterns of use and user feedback . Measures of body mass index , waist circumference , diet , physical activity , sedentary behavior , weight management practice s , smoking , alcohol , sleep , body image , self-esteem , and depression occur at 6 , 12 , 18 , and 24 months . Currently , all participants have been recruited , and all are in the final year of the trial . CONCLUSION Theory-driven , evidence -based strategies for physical activity , sedentary behavior , and dietary intake can be embedded in an intervention using social and mobile technologies to promote healthy weight-related behaviors in young adults BACKGROUND A population of over 12,000 mature subjects participated in a longitudinal study ( 8 years ) of nutrition and health ( the Su . Vi . Max Study ) . In this context , a specific cross-sectional study was carried out in a r and omly selected sub population . AIM To identify anthropometric , nutritional and biochemical correlates of spontaneous use of ' light ' foods and drinks in a free-living population . DESIGN Men ( n = 2299 ) and women ( n = 1979 ) , 45 - 60 years , reported their food intakes over six non-consecutive days . Consumers of low-fat and low-sugar foods and drinks , and artificial sweeteners , were compared with non-consumers . RESULTS Users of low-sugar products were heavier than non-users ; female consumers of low-fat products , but not males , had higher body weight and BMI than non-consumers . Users of low-sugar products had higher triacylglycerols and glycaemia than non-users while biochemical parameters were not different in users and non-users of low-fat products . Use of low-sugar products led to increased diet density of a few micronutrients , including cholesterol . Low-fat product selection was associated with increased intake of most micronutrients , both in absolute value and in density . CONCLUSIONS In mature adults , selection of fat-reduced products was associated with improved quality of the diet , while anthropometric and biological parameters appeared less favourable in consumers of low-sugar products vs. non-consumers . The longitudinal follow-up of the cohort in future years will help determine cause- and -effect relationships among these parameters OBJECTIVE This study was design ed to determine if food-containing hypocaloric diets are as effective as liquid-supplement diets in promoting weight loss for obese individuals with non-insulin-dependent diabetes mellitus ( NIDDM ) . RESEARCH DESIGN AND METHODS Forty NIDDM subjects with body mass indexes ( BMI s ) of 30–40 kg/m2 were r and omized to one of two 800-kcal diets for 12 weeks . Group A received liquid supplement only , and group B received supplement plus an evening meal . Both groups received an intensive behavioral education program .  RESULTS Weight loss and improvements in glycemic , blood lipid , and blood pressure parameters were similar for the two groups . Weight loss averaged 15.7 kg for the entire group . The need for insulin , anti-diabetes , and anti-hypertensive medication decreased significantly . No serious side effects were observed . CONCLUSIONS Both food-containing and supplement diets providing 800 kcal a day effectively promote weight loss for obese individuals with NIDDM Purpose . To examine cross-sectional associations between credit card debt , stress , and health risk behaviors among college students , focusing particularly on weight-related behaviors . Design . R and om- sample , mailed survey . Subjects/ Setting . Undergraduate and graduate students ( n = 3206 ) attending a large public university . Measures . Self-reported health indicators ( e.g. , weight , height , physical activity , diet , weight control , stress , credit card debt ) . Results . More than 23 % of students reported credit card debt ≥ $ 1000 . Using Poisson regression to predict relative risks ( RR ) of health behaviors , debt of at least $ 1000 was associated with nearly every risk indicator tested , including overweight/obesity , insufficient physical activity , excess television viewing infrequent breakfast consumption , fast food consumption , unhealthy weight control , body dissatisfaction , binge drinking , substance use , and violence . For example , adjusted RR [ ARR ] ranged from 1.09 ( 95 % Confidence interval [ CI ] : 1.02–1.17 ) for insufficient vigorous activity to 2.17 ( CI : 0.68–2.82 ) for using drugs other than marijuana in the past 30 days . Poor stress management was also a robust indicator of health risk . Conclusion . University student lifestyles may be characterized by a variety of coexisting risk factors . These findings indicate that both debt and stress were associated with wide-ranging adverse health indicators . Intervention strategies targeting at-risk student population s need to be tailored to work within the context of the many challenges of college life , which may serve as barriers to healthy lifestyles . Increased health promotion efforts targeting stress , financial management , and weight-related health behaviors may be needed to enhance wellness among young adults
RESULTS Non-diet interventions result ed in statistically significant improvements in disordered eating patterns , self-esteem , and depression .
OBJECTIVE To determine the overall effect of non-diet , weight-neutral interventions on factors such as weight , biochemical measures , food and activity behavior , body image , and mental health .