Determinants of weight loss maintenance: a systematic review. Perceived personal, social and environmental barriers to weight maintenance among young women: A community survey Effects of workplace-based dietary and/or physical activity interventions for weight management targeting healthcare professionals: a systematic review of randomised controlled trials Football Fans in Training: the development and optimization of an intervention delivered through professional sports clubs to help men lose weight, become more active and adopt healthier eating habits Physical Activity Predicts Weight Loss Following Gastric Bypass Surgery: Findings from a Support Group Survey Coronary Heart Disease Risk Reduction Intervention Among Overweight Smokers with a Psychotic Disorder: Pilot Trial Drivers for successful long-term lifestyle change, the role of e-health: a qualitative interview study Effectiveness of parent‐centred interventions for the prevention and treatment of childhood overweight and obesity in community settings: a systematic review The influence of a behavioral weight management program on disordered eating attitudes and behaviors in children with overweight. The effect of weight management interventions that include a diet component on weight‐related outcomes in pregnant and postpartum women: a systematic review protocol The impact of self-efficacy on behavior change and weight change among overweight participants in a weight loss trial. Prevalence of attempting weight loss and strategies for controlling weight. An evidence-based gamified mHealth intervention for overweight young adults with maladaptive eating habits: study protocol for a randomized controlled trial The National Weight Control Registry: is it useful in helping deal with our obesity epidemic? Energy balance-related behaviours associated with overweight and obesity in preschool children: a systematic review of prospective studies. Short- and long-term eating habit modification predicts weight change in overweight, postmenopausal women: results from the WOMAN study.
BACKGROUND Discerning the determinants of weight loss maintenance is important in the planning of future interventions and policies regarding overweight and obesity . We have therefore systematic ally synthesized recent literature on determinants of weight loss maintenance for individuals with overweight and obesity . METHODS With the use of the Preferred Reporting Items for Systematic Review s and Meta-Analyses statement , prospect i ve studies were identified from search es in PubMed and PsycINFO from 2006 to 2016 . We included articles investigating adults with overweight and obesity undergoing weight loss without surgery or medication .  Included articles were scored on their method ological quality , and a best- evidence synthesis was applied to summarize the results . RESULTS Our search result ed in 8,222 articles of which 67 articles were selected . In total , 124 determinants were identified of which 5 were demographic , 59 were behavioural , 51 were psychological/cognitive and 9 were social and physical environmental determinants . We found consistent evidence that demographic determinants were not predictive of weight loss maintenance . Behavioural and cognitive determinants that promote a reduction in energy intake , an increase in energy expenditure and monitoring of this balance are predictive determinants . CONCLUSION This review identifies key determinants in weight loss maintenance . However , more research regarding cognitive and environmental determinants of weight loss maintenance is needed to advance our knowledge on determinants of weight loss maintenance Background Young women are a group at high risk of weight gain . This study examined a range of perceived personal , social and environmental barriers to physical activity and healthy eating for weight maintenance among young women , and how these varied by socioeconomic status ( SES ) , overweight status and domestic situation . Methods In October-December 2001 , a total of 445 women aged 18–32 years , selected r and omly from the Australian electoral roll , completed a mailed self-report survey that included questions on 11 barriers to physical activity and 11 barriers to healthy eating ( relating to personal , social and environmental factors ) . Height , weight and socio-demographic details were also obtained . Statistical analyses were conducted mid-2003 . Results The most common perceived barriers to physical activity and healthy eating encountered by young women were related to motivation , time and cost .  Women with children were particularly likely to report a lack of social support as an important barrier to physical activity , and lack of social support and time as important barriers to healthy eating . Perceived barriers did not differ by SES or overweight status . Conclusions Health promotion strategies aim ed at preventing weight gain should take into account the specific perceived barriers to physical activity and healthy eating faced by women in this age group , particularly lack of motivation , lack of time , and cost . Strategies targeting perceived lack of time and lack of social support are particularly required for young women with children Background The prevalence of overweight and obesity is high amongst healthcare professionals and there is growing interest in delivering weight loss interventions in the workplace . We conducted a systematic review to ( i ) examine the effectiveness of workplace-based diet and /or physical activity interventions aim ed at healthcare professionals and to ( ii ) identify and describe key components of effective interventions . Seven electronic data bases were systematic ally search ed . Results Thirteen r and omised controlled trials met the inclusion criteria , of which seven had data available for meta- analysis . Where meta- analysis was possible , studies were grouped according to length of follow-up ( < 12 months and ≥12 months ) and behavioural target ( diet only , physical activity only or diet and physical activity ) , with outcome data pooled using a weighted r and om effects model . Nine studies reported statistically significant ( between-group ) differences . Four studies reported being informed by a behaviour change theory . Meta- analysis of all trials reporting weight data demonstrated healthcare professionals allocated to dietary and physical activity interventions lost significantly more body weight ( −3.95 Kg , [ 95 % CI −4.96 to- 2.95 Kg ] ) than controls up to 12 months follow up . Conclusions Workplace diet and /or physical activity interventions targeting healthcare professionals are limited in number and are heterogeneous . To improve the evidence base , we recommend additional evaluations of theory-based interventions and adequate reporting of intervention content Background The prevalence of obesity in men is rising , but they are less likely than women to engage in existing weight management programmes . The potential of professional sports club setting s to engage men in health promotion activities is being increasingly recognised . This paper describes the development and optimization of the  Football Fans in Training ( FFIT ) programme , which aims to help overweight men ( many of them football supporters ) lose weight through becoming more active and adopting healthier eating habits . Methods The MRC Framework for the design and evaluation of complex interventions was used to guide programme development in two phases . In Phase 1 , a multidisciplinary working group developed the pilot programme ( p-FFIT ) and used a scoping review to summarize previous research and identify the target population . Phase 2 involved a process evaluation of p-FFIT  in 11 Scottish Premier League ( SPL ) clubs . Participant and coach feedback , focus group discussion s and interviews explored the utility/acceptability of programme components and suggestions for changes . Programme session observations identified examples of good practice and problems/issues with delivery . Together , these findings informed redevelopment of the optimized programme ( FFIT ) , whose components were mapped onto specific behaviour change techniques using an evidence -based taxonomy . Results p-FFIT comprised 12 , weekly , gender-sensitised , group-based weight management classroom and ‘ pitch-side ’ physical activity sessions . These in-stadia sessions were complemented by an incremental , pedometer-based walking programme . p-FFIT was targeted at men aged 35 - 65 years with body mass index ≥ 27 kg/m2 . Phase 2 demonstrated that participants in p-FFIT were enthusiastic about both the classroom and physical activity components , and valued the camaraderie and peer-support offered by the programme . Coaches appreciated the simplicity of the key healthy eating and physical activity messages . Suggestions for improvements that were incorporated into the optimized FFIT programme included : more varied in-stadia physical activity with football-related components ; post-programme weight management support ( emails and a reunion session ) ; and additional training for coaches in SMART goal setting and the pedometer-based walking programme . Conclusions The Football Fans in Training programme is highly acceptable to participants and SPL coaches , and is appropriate for evaluation in a r and omised controlled trial Background Patient adherence to recommended eating and physical activity behaviors is considered important to weight loss outcomes following gastric bypass surgery , but there has been little systematic research in this area to investigate behavioral predictors of weight loss . Method We developed a measure of postsurgical behaviors , the bariatric surgery self-management question naire ( BSSQ ) . A survey was conducted of 200 patients attending postsurgical support groups ( mean time since surgery 14 months , mean age 40 years , 85 % female , presurgical weight 150 kg ) . Patients completed the BSSQ  and measures of treatment regimen distress , perceived benefits of weight loss , and weight-related physical symptoms . Results Mean BSSQ adherence was in the 70 % range , with subscale scores varying considerably . Distress levels associated with the new lifestyle were consistently low ( ≈20 % ) and perceived benefits of weight loss were high early on and maintained consistently ( 70–90 % ) . A final predictive model showed premorbid weight , time since surgery , and BSSQ physical activity subscale were significant predictors of weight loss , accounting for 73 % of variance .  Conclusions Physical activity adherence was the sole significant behavioral predictor of weight loss , although maladaptive dietary habits and patient selection issues were identified for future research . It will be important to replicate the current study in prospect i ve , longitudinal studies with representative patient cohorts . A challenge for research ers will be to develop novel , intensive recruiting and retention strategies to allow closer examination of these issues Objective : The aim of the present pilot study was to test the feasibility and short-term impact of a multi-component risk factor intervention for reducing ( i ) coronary heart disease ( CHD ) risk ; ( ii ) smoking ; and ( iii ) weight among smokers with psychosis . Secondary dependent variables included physical activity , unhealthy eating , substance use , psychiatric symptomatology , treatment retention , general functioning , and quality of life . Method : This was a feasibility study utilizing a pre – post-treatment design with  no control group ( n=43 ) . All participants provided written informed consent and were assessed before treatment and again a mean of 19.6weeks later . The treatment consisted of nine individual 1h sessions of motivational interviewing and cognitive behaviour therapy plus nicotine replacement therapy , in addition to treatment as usual . Research assistants who had not been involved in the delivery of the treatment programme conducted post-treatment assessment s. Results : The intervention was associated with significant reductions in CHD risk scores , smoking and weight . A significant improvement was also reported in level of moderate physical activity , and a small change in the unhealthy eating index was reported . No improvement in biological measures ( cholesterol and blood pressure ) was evident . Conclusions : A multi-component CHD risk factor intervention among smokers with psychosis appears to be feasible and effective in the short-term . A r and omized controlled trial replicating and extending these findings is warranted Objectives Assisting patients in lifestyle change using collaborative e-health tools can be an efficient treatment for non-communicable diseases like diabetes , cardiovascular disease and chronic obstructive lung disease that are caused or aggravated by unhealthy living in the form of unhealthy diet , physical inactivity or tobacco smoking . In a prospect i ve pilot study , we tested an online collaborative e-health tool in general practice . The aim of this study was to identify drivers of importance for long-term personal lifestyle changes from a patient perspective when using a collaborative e-health tool , including the support of peers and healthcare professionals . Setting General practice clinics in the Region of Southern Denmark . Participants 10 overweight patients who had previously successfully used a hybrid online collaborative e-health tool with both face-to-face and online consultations  to lose weight . Results The main themes identified were facilitators , barriers and support from family and peers . Establishment of a trustworthy relationship with the healthcare professionals was of paramount importance . It was important for the patients to monitor the measurable outcomes with realistic goals and feedback from a trusted person . Often , significant life events were identified as catalysts for successful long-term lifestyle changes . Dominant barriers to change were perception of insurmountable obstacles , experience of lack of self-efficacy and excess eating of high-calorie food . Finally , experiencing of trustworthy person-to-person forums , need for acknowledgement from referent others and support from family and peers were important drivers for long-term lifestyle change . Conclusion The most important driver in long-term weight loss was a strong relationship with a healthcare professional . Collaborative e-health tools can support the relationship and behavioural changes through monitoring and providing relevant feedback . The support from family and peers also matters , and long-term success depends on the ability to establish strong , positive support on a day-to-day basis Background Worldwide in 2000 , 10 % of children aged five to 17 years were reported as being overweight with an additional 2‐3 % being obese . Overweight and obesity in childhood can adversely impact on both physical and psychological health . The rise in the prevalence of childhood obesity is a complex issue but widely recognised contributors include increased energy intake , decreased levels of physical activity and greater time spent in sedentary pursuits . A large number of environmental and cultural factors have also been identified as contributing to the problem . Evidence to support an optimal approach to treating childhood obesity is limited with many studies showing only modest results at best in the long‐term . However , the importance of family‐based treatment that combines diet , physical activity and behavioral components has been acknowledged in a recent Cochrane Systematic Review . It has also been suggested that interventions offered in the community setting may help overcome barriers to participation , by making programs more accessible and allowing the targeting of specific sub‐groups of the population . Objectives The objective of this review was to identify the effectiveness of parent‐centred interventions implemented in the community setting in modifying eating and physical activity behaviors or weight‐related outcomes of children . Inclusion criteria Types of participants This review considered studies that included free‐living children of pre‐school , primary and secondary school age and /or their parents/guardians aged > 18 years . Types of intervention(s)/phenomena of interest Intervention programs were required to have a parental component , to target eating and /or exercise behaviors for the prevention or treatment of obesity , and child weight status reported . Types of studies All intervention studies were included in the review including : r and omized controlled trials ( RCTs ) ; non‐r and omized controlled trials , longitudinal studies , cohort ( both retrospective and prospect i ve ) , case control and time series studies which had been conducted in a community setting . Types of outcomes This review considered studies that included overweight/obesity related outcomes , eating behavior outcomes , physical activity behaviour outcomes , and sedentary behavior outcomes and constructs . Search strategy A literature search of community‐based parent‐centred intervention studies to promote nutrition and physical activity for the prevention and treatment and of childhood overweight and obesity was performed in eight electronic data bases dating from 1975 to April 2009 . Method ological quality Studies were critically appraised for method ological quality using st and ardized tools . Data collection Data was extracted by one review er using a st and ardized data extraction form developed by the research ers and checked for accuracy and consistency by a second review er . Data synthesis Data in relation to setting , methodology , intervention components and effect on weight , dietary intake and physical activity was extracted , and described in a narrative synthesis . Where possible a meta‐ analysis was undertaken . Results Of the home‐based interventions , five of nine studies reported statistically significant changes in anthropometric outcomes post intervention . Of the 10 studies in the before and after school care setting , seven reported a significant decrease in a weight‐related outcome post intervention , with only one reporting an increase . Conclusions Results from the review support the after‐school setting as the most promising for community intervention setting for targeting parents as agents of change within child obesity prevention and treatment programs . Implication s for practice At this stage , interventions to support parents should target the after‐school environment as opposed to being conducted in the home , summer camps , leisure centers or churches . Targeting a decrease in energy intake and sweetened beverages in parallel with increasing number of daily steps and decreasing screen time use . Implication s for research Future studies of high quality are needed across the full range of community setting s. Given that currently most of the higher quality RCTs and the studies showing positive impacts of weight change are in the after‐school setting , further studies in this area using similar method ologies to those already published will facilitate future meta‐analyses in this area BACKGROUND Behavioral interventions targeting children with overweight have been successful in facilitating weight loss ; however , there is concern that these programs produce disordered eating attitudes among youth . OBJECTIVE The purpose of this research was to determine whether youth with overweight receiving one of two behavioral interventions  were more likely to report an increase in disordered eating attitudes over time compared to a waitlist control and to determine psychosocial predictors of eating-disordered attitudes at 6-month follow-up . DESIGN Participants were r and omized to one of two behavioral lifestyle interventions or a waitlist control . Data were collected at baseline , post-treatment , and 6-month follow-up . PARTICIPANTS / SETTING Participants were 68 youths with overweight , aged 8 to 13 years , and their parent(s ) who lived in rural north central Florida . The project ran from January 2006 to January 2008 . INTERVENTION Each treatment condition consisted of 12 group sessions over 16 weeks . MAIN OUTCOME MEASURES Parents completed a demographic form and the Child Feeding Question naire . Children completed the Children 's Eating Attitudes Test , Schwartz Peer Victimization Scale , and Children 's Body Image Scale . STATISTICAL ANALYSES PERFORMED Mixed 2 × 2 analyses of variance were used to examine the effect of treatment on eating attitudes . Hierarchical linear regression was used to assess whether baseline levels of psychosocial variables predicted disordered eating attitudes at follow-up , controlling for baseline eating attitudes and treatment condition . RESULTS Youth who participated in the behavioral interventions did not report significant increases in disordered eating attitudes over time compared to the waitlist control . Across all conditions , higher levels of body dissatisfaction , peer victimization , parent restrictive feeding practice s , and concern for child weight at baseline predicted higher levels of disordered eating attitudes at follow-up . CONCLUSIONS These findings do not provide evidence that behavioral interventions lead to an increase in unhealthy eating attitudes and behaviors . Future research should examine the effects of incorporating eating disorder prevention in pediatric weight management programs Review question / objective What are the effects of weight management interventions that include a diet component on weight‐related outcomes in pregnant and postpartum women ? The primary objective of this systematic review is to evaluate the effectiveness of weight management interventions which include a diet component and are aim ed at limiting gestational weight gain and postpartum weight retention in women . The second objective of this systematic review is to investigate included intervention components with respect to effect on weight‐related outcomes . This may include , but is not limited to : length of intervention , use of face‐to‐face counselling , group or individual consultations , use of other interventions components including exercise , use of goals and use of support tools like food diaries , coaching , including email or text message support . Background Around half of all women of reproductive age are either overweight or obese,1,2,3 with women aged 25‐34 years having a greater risk of substantial weight gain compared with men of all ages.1,4 Excessive gestational weight gain ( GWG ) and postpartum weight retention ( PPWR ) may play a significant role in long term obesity . Having one child doubles the five‐ and 10‐year obesity incidence for women , with many women who gain excessive weight during pregnancy remaining obese permanently.5 Excessive GWG and /or PPWR can also significantly contribute to short‐ and long‐term adverse health outcomes for mother , baby and future pregnancies.6,7 Maternal obesity increases the risk of pregnancy related complications such as pre‐eclampsia , gestational diabetes mellitus , stillbirth and the rate of caesarean section.8 Childhood obesity is a further long term complication of maternal obesity for offspring , which may persist in to adulthood.9 Excess GWG is also a risk factor for PPWR both in the short and long‐term.10,11 Nehring et al. conducted a meta‐ analysis with over 65,000 women showing that , compared to women who gained weight within recommendations during pregnancy , women with GWG above Institute of Medicine weight gain recommendations , 12 retained an additional 3.1 kg and 4.7 kg after three and greater than or equal to 15 years postpartum , respectively.13 The health risk associated with PPWR is highlighted in a study of 151,025 Swedish women followed between 1992 and 2001.The study identified the risk of adverse pregnancy outcomes for those who gained three or more units of Body Mass Index ( kg/m2 ) between consecutive pregnancies ( an average of two years ) was much higher compared with women whose BMI changed from ‐1.0 and 0.9 units.14 Long‐term chronic disease risk may also be affected by PPWR as weight retention at the end of the first year post‐partum has been found to be a predictor of maternal overweight 15 years later.15With around 14‐20 % of women retaining 5 kg or more 12 months postpartum,16,5 the risk of developing conditions like diabetes , metabolic syndrome and cardiovascular disease may be increased.17 It becomes evident that interventions which aim to support attainment of healthy weight both in the antenatal and postpartum periods are key health priorities for women during this life stage . Lifestyle factors of overweight , having poor diet quality , and not undertaking enough moderate‐to‐vigorous physical activity are amongst the top five predictors of mortality in women.18 Additionally it is noted that , for many women , pregnancy and the postpartum period are associated with a reduction in physical activity.19 It is known that a combination of poor dietary choices , an increase in sedentary time and reduction in physical activity are all contributors to the development of overweight and obesity . With this in mind , current research has focused on lifestyle interventions to limit GWG and PPWR . Thangaratinam et al. review ed 44 r and omized controlled trials ( 7278 women ) where interventions including diet , physical activity or both were evaluated for their influence on maternal weight during  pregnancy.20 Results indicate that all were significantly effective in reducing GWG compared with the control group . More specifically , dietary interventions were the most effective in reducing weight gain , with a mean weight loss of ‐3.84 kg compared with ‐0.72 kg and ‐1.06 kg for physical activity and the mixed ( diet plus physical activity ) approach , respectively.20 This finding is supported by Hill and colleagues ' recent systematic review of theory based interventions to limit GWG.21 Included studies in this review reported an underpinning theory base and were classified as adopting a dietary , physical activity or mixed approach . Hill et al. concluded that studies which included a diet intervention were significantly more effective at limiting GWG.21 In 2011 Tanentsapf et al. review ed the effect of dietary interventions alone for reducing GWG in normal weight , overweight and obese pregnant women.22 This review analysed 13 r and omized controlled trials and quasi‐r and omized controlled trials with a dietary intervention to prevent excessive GWG in women . The review concluded that dietary interventions during pregnancy were effective in reducing GWG with an effect of ‐1.92 kg ( n=1434 ) compared with the control group.22 Tanentsapf et al. identified that trials differed in the conduct of the interventions with various diet and non‐diet related components utilised . Dietary approaches were highly variable with some trials focusing only on calorie restriction and others included additional target macronutrient distribution for intake . Some trials further provided feedback based on maternal weight gain guidelines .12 Interventions also varied in delivery method with a variety of modes used , including face‐to‐face , individual or group consultations and /or written correspondence . The frequency of communication , despite the type or mix , also changed from trial to trial with additional methods via telephone , posted material s , feedback or food diaries utilised . The inclusion of physical activity in addition to diet intervention was also common . Whilst the recent review by Tanentsapf et al.22 identified that dietary interventions are effective in reducing GWG , the review did not investigate the impact that different intervention components , delivery methods or dietary counselling approaches had on gestational weight management . It remains unclear as to which intervention components optimize GWG in women . The impact of lifestyle interventions has also been investigated in the postpartum period . The recent systematic review from van der Pligt et al. reported seven of 11 studies review ed were successful in limiting PPWR.23 As with studies aim ed at limiting GWG , interventions included in van der Pligt et al. 's review differed greatly in their conduct . Six of these seven studies included both dietary and physical activity components for the intervention , with the final successful study including a diet only intervention . Five of the successful studies recruited overweight or obese women only . Intervention time varied considerably in successful studies with some running for as little at ten days , and others up to six months . Bertz et al. demonstrated that their 12‐week behavior modification intervention which targeted diet alone or diet and exercise , including two individual sessions with a dietitian and physical therapist , provision of scales for weight self‐monitoring and bi‐weekly text messages was successful in achieving significant weight loss following the intervention , and sustained at one year.24 The diet intervention and the diet and exercise intervention  yielded significant weight loss compared to the control . Following 12 weeks a reduction of ‐8.3 + /‐ 4.2 kg for diet intervention and ‐6.9 + /‐ 3.0 kg for diet and exercise was observed . Additionally after one year , the diet intervention showed ‐10.2 + /‐ 5.7 kg reduction and ‐7.3 + /‐ 6.3 kg for the diet and exercise intervention (p<0.001).24 Colleran et al. also found significant weight change results by implementing a 16‐week intervention which consisted of weekly individual sessions with a dietitian regarding calorie restriction , two additional home visits regarding exercise , weekly food diary completion and email support.25 The intervention group had greater weight loss compared to the control group ( ‐5.8 kg + /‐ 3.5 kg vs ‐1.6 kg + /‐ 5.4 kg ) . It can be seen that various methods have been utilized in investigating the impact of diet and physical activity interventions on PPWR . The review by van der Pligt et al.23 highlights the impact successful lifestyle interventions can have on postpartum weight change . However , this review did not investigate the different intervention strategies utilized . It remains unclear as to the optimal setting , delivery method , diet strategy , contact frequency or intervention length to limit PPWR . Previous systematic review s for both GWG and PPWR have focused on the effectiveness of lifestyle interventions as a whole for weight management in pregnant and postpartum women.20,23 And despite Tanentsapf et al. 's focus on dietary interventions for GWG,22 much is still unknown about the effectiveness of differing diet interventions over the antenatal and postpartum period . Specifically , the impact of differing diet intervention strategies on maternal weight gain is not known . Firstly , this systematic review will focus on whether  weight management interventions which include a dietary component  are effective in pregnant and postpartum women . In addition to this , this review will investigate the different intervention strategies utilized and their effectiveness in maternal weight management . A search of systematic review protocol data bases has shown that there is no current review underway for this topic Despite considerable clinical interest , attempts to link perceived self-efficacy with successful weight control have had mixed success . Definitive data on prospect i ve associations between self-efficacy and weight loss are particularly sparse . This study examined relationships between self-efficacy beliefs , weight control behaviors , and weight change among individuals participating in a weight loss trial ( N = 349 , 87 % women ) . Cross-sectionally , eating and exercise self-efficacy beliefs were strongly associated with corresponding weight loss behaviors . Self-efficacy beliefs prospect ively predicted weight control behavior and weight change during active treatment but not during follow-up . Mediational models indicate that people 's weight control behaviors mediate the impact of self-efficacy on weight change CONTEXT Overweight and obesity are increasing in the United States . Changes in diet and physical activity are important for weight control . OBJECTIVES To examine the prevalence of attempting to lose or to maintain weight and to describe weight control strategies among US adults . DESIGN The Behavioral Risk Factor Surveillance System , a r and om-digit telephone survey conducted in 1996 by state health departments . Setting The 49 states ( and the District of Columbia ) that participated in the survey . PARTICIPANTS Adults aged 18 years and older ( N = 107 804 ) . MAIN OUTCOME MEASURES Reported current weights and goal weights , prevalence of weight loss or maintenance attempts , and strategies used to control weight ( eating fewer calories , eating less fat , or using physical activity )  by population subgroup . RESULTS The prevalence of attempting to lose and maintain weight was 28.8 % and 35.1 % among men and 43.6 % and 34.4 % among women , respectively . Among those attempting to lose weight , a common strategy was to consume less fat but not fewer calories ( 34.9 % of men and 40.0 % of women ) ; only 21.5 % of men and 19.4 % of women reported using the recommended combination of eating fewer calories and engaging in at least 150 minutes of leisure-time physical activity per week . Among men trying to lose weight , the median weight was 90.4 kg with a goal weight of 81.4 kg . Among women , the median weight was 70.3 kg with a goal weight of 59.0 kg . CONCLUSIONS Weight loss and weight maintenance are common concerns for US men and women . Most persons trying to lose weight are not using the recommended combination of reducing calorie intake and engaging in leisure-time physical activity 150 minutes or more per week Background Cognitive behavior therapy ( CBT ) is the first-line of treatment for overweight and obesity patients whose problems originate in maladaptive eating habits ( e.g. , emotional eating ) . However , in-person CBT is currently difficult to access by large segments of the population . The proposed SIGMA intervention ( i.e. , the Self-help , Integrated , and Gamified Mobile-phone Application ) is a mHealth intervention based on CBT principles . It specifically targets overweight young adults with underlying maladaptive behaviors and cognitions regarding food . The SIGMA app was design ed as a serious game and intended to work as a st and alone app for weight maintenance or alongside a calorie-restrictive diet for weight loss . It uses a complex and novel scoring system that allows points earned within the game to be supplemented by points earned during outdoor activities with the help of an embedded pedometer . Methods / design The efficacy of the SIGMA mHealth intervention will be investigated within a r and omized , placebo-controlled trial . The intervention will be set to last 2 months with a 3-month follow-up . Selected participants will be young overweight adults with non- clinical maladaptive eating habits embodied by food cravings , binge eating , and emotional eating . The primary outcomes will be represented by changes in ( 1 ) self-reported maladaptive thoughts related to eating and body weight , ( 2 ) self-reported maladaptive eating behaviors in the range of urgent food cravings , emotional eating or binge eating , ( 3 ) as well as biased attentional processing of food items as indexed by reaction times . Secondary outcomes will be represented by changes in weight , Body Mass Index , general mood , and physical activity as indexed by the number of steps per day . Discussion Through an evidence -based cognitive behavioral approach and a user-friendly game interface , the SIGMA intervention offers a significant contribution to the development of a cost-effective and preventive self-help tool for young overweight adults with maladaptive eating habits . Trial registration IS RCT N , ID : 70907354 . Registered on 6 February 2017 . The IS RCT N registration is in line with the World Health Organization Trial Registration Data Set . The present paper represents the original version of the protocol . Any changes to the protocol will be communicated to IS RCT The National Weight Control Registry ( NWCR ) consists of over 4800 individuals who have been successful in long-term weight loss maintenance . The purpose of establishing the NWCR was to identify the common characteristics of those who succeed in long-term weight loss maintenance . We found very little similarity in how these individuals lost weight but some common behaviors in how they are keeping their weight off . To maintain their weight loss NWCR participants report eating a relatively low-fat diet , eating breakfast almost every day , weighing themselves regularly , and engaging in high levels ( about 1 hour/day ) of physical activity . Because this is not a r and om sample of those who attempt weight loss , the results have limited generalizability to the entire population of overweight and obese individuals . The value of this project lies in identifying potential strategies that may help others be more successful in keeping weight off The current review aim ed to systematic ally identify dietary , physical activity and sedentary behaviours in preschool children ( 4 - 6 years of age ) that are prospect ively related to overweight or obesity later in childhood . Prospect i ve studies published between January 1990 and June 2010 were selected from search es in PubMed , EMBASE , PsycINFO , CINAHL and Cochrane Library . Studies examining the prospect i ve association between at least one relevant behaviour measured during preschool period ( children aged 4 - 6 years at baseline ) in relation to at least one anthropometric measurement at follow-up ( age < 18 years ) were included . Harvest plots were used to summarize the results and draw conclusions from the evidence . Of the 8,718 retrieved papers , 23 papers reporting on 15 different study sample s were included in this review . Strong evidence was found for an inverse association between total physical activity and overweight . Moderate evidence was observed for a positive association between television viewing and overweight . Because of the heterogeneity in the assessed dietary behaviours , insufficient evidence was found for an association between  dietary intake or specific dietary behaviours and overweight . These results suggest that interventions aim ing to prevent overweight among preschool children should focus on promotion of total physical activity and limitation of screen time and that further research is needed to establish whether and which dietary behaviours are important for obesity prevention in this age group . However , despite the lack of evidence for dietary behaviours from the present review , future interventions may already target specific dietary behaviours that are highly prevalent and for which there a clear rationale as well as preliminary evidence that these behaviours are associated with overweight BACKGROUND St and ard behavioral obesity treatment produces poor long-term results . Focusing on healthy eating behaviors rather than energy intake may be an alternative strategy . In addition , important behaviors might differ for short- vs long-term weight control . OBJECTIVE Our aim was to describe and compare associations between changes in eating behaviors and weight after 6 and 48 months . DESIGN We performed secondary analysis of data collected during a r and omized weight-loss intervention trial with 48-month follow-up . PARTICIPANTS We studied 481 overweight and obese postmenopausal women enrolled in the Women on the Move through Activity and Nutrition ( WOMAN ) Study . MAIN OUTCOME MEASURES We measured changes in weight from baseline to 6 and 48 months . STATISTICAL ANALYSES PERFORMED Linear regression models were used to examine the associations between 6- and 48-month changes in eating habits assessed by the Conner Diet Habit Survey and changes in weight . Analyses were conducted in the combined study population and stratified by r and omization group . RESULTS At 6 months in the combined population , weight loss was independently associated with decreased desserts ( P<0.001 ) , restaurant eating ( P=0.042 ) , sugar-sweetened beverages ( P=0.009 ) , and fried foods ( P<0.001 ) , and increased fish consumption ( P=0.003 ) . Results were similar in intervention participants ; only reduced desserts and fried foods associated with weight loss in controls . At 48 months in the combined population , weight loss was again associated with decreased desserts ( P=0.003 ) and sugar-sweetened beverages ( P=0.011 ) , but also decreased meats/cheeses ( P=0.024 ) and increased fruits/vegetables ( P<0.001 ) . Decreased meats/cheeses predicted weight loss in intervention participants ; desserts , sugar-sweetened beverages , and fruits/vegetables were independently associated in controls . CONCLUSIONS Changes in eating behaviors were associated with weight change , although important behaviors differed for short- and long-term weight change and by r and omization group . Future studies should determine whether interventions targeting these behaviors could improve long-term obesity treatment outcomes
Results indicated that perceived overweight was associated with an increased likelihood of attempting weight loss and with healthy and unhealthy weight control strategies in some participant groups .
However , perceived overweight was not reliably associated with physical activity or healthy eating and was associated with greater disordered eating in some groups .
Rather than being associated with improved weight management , there was consistent evidence that perceived overweight was predictive of increased weight gain over time .
Individuals who perceive their weight status as overweight are more likely to report attempting weight loss but over time gain more weight
It is commonly assumed that a person identifying that they are ' overweight ' is an important prerequisite to successful weight management .
However , there has been no systematic evaluation of evidence supporting this proposition .
The aim of the present research was to systematic ally review evidence on the relationship between perceived overweight and ( i ) weight loss attempts , ( ii )  weight control strategies ( healthy and unhealthy )  , ( iii ) weight-related behaviours ( physical activity and eating habits ) , ( iv ) disordered eating and ( v ) weight change .