The combination of medication and group lifestyle modification resulted in more weight loss than either medication or lifestyle modification alone. The results underscore the importance of prescribing weight-loss medications in combination with, rather than in lieu of, lifestyle modification.

EWING. A randomized controlled trial of a commercial Internet weight loss program. Obes Res. 2004;12: 1011-1018. Objective: To assess, in a 1-year randomized controlled trial, the efficacy of eDiets.com (a commercial Internet weight loss program) in improving weight, cardiovascular health, and quality of life. Research Methods and Procedures: Participants were 47 women with a mean age of 43.7 Ϯ 10.2 (SD) years and a mean BMI of 33.5 Ϯ 3.1 kg/m 2 . They were randomly assigned to either: 1) eDiets.com, a commercial Internetbased program available to the public; or 2) a weight loss manual (i.e., LEARN Program for Weight Control 2000). At baseline, participants in both groups met briefly with a psychologist who instructed them to follow the components of their program as closely as possible. Additional brief visits were provided at weeks 8, 16, 26, and 52 to review their progress. Change in weight was the main outcome measure. Results: At week 16, participants in eDiets.com lost 0.9 Ϯ 3.2% of initial weight compared with 3.6 Ϯ 4.0% for women assigned to the weight loss manual. At week 52, losses increased to 1.1 Ϯ 4.0% and 4.0 Ϯ 5.1%, respectively. Results of a last-observation-carried-forward analysis found that women in the manual group lost significantly (p Ͻ 0.05) more weight (at both times) than those treated by eDiets.com. (Results, however, of baseline-carried-forward and completers analyses did not reach statistical significance.) There were no significant differences between groups in changes in cardiovascular risk factors or quality of life. Discussion: This study provides consumers with important information about the probable benefits they can expect from participating in a popular Internet-based weight loss program.

The eating disorders, as defined by DSM-IV, can be conceptualized as having three latent features. Taxometric tests found empirical support for conceptualizing bulimia nervosa and binge eating disorder as discrete syndromes.

Objective: To investigate weight loss expectations and goals among obese treatment seekers and to examine the relationships of these expectations and goals to treatment outcomes. Method: Participants were 180 obese men and women (age 43.8710.1 years; body mass index 37.674.2 kg/m 2 ) who received one of four-year-long treatments that combined behavioral and pharmacological methods. Before treatment, they reported the amount of weight they realistically expected to lose after 4, 12, 26 and 52 weeks of treatment, as well as their ultimate weight loss goals. Expectations and goals were compared across treatment groups and examined in relation to previous weight loss efforts, weight loss and regain in treatment, attrition, satisfaction with treatment and mood. Results: Participants in all treatment groups expected reductions at week 52 that were significantly greater than the 5-15% of initial weight they were told was realistic and significantly more than they had ever lost before. Weight loss expectations were unrelated to achieved weight loss in all groups but one, in which greater expectations were associated with greater losses. Failure to meet weight loss expectations for the first 26 weeks of treatment was related to lower satisfaction ratings, but was not related to weight regain or attrition over the next 26 weeks. Symptoms of depression were reduced from baseline, regardless of whether participants achieved or failed to achieve their expected weight losses. Conclusion: Across groups, we observed no negative consequences of having (and failing to meet) unrealistic expectations for weight loss.

Research Methods and Procedures:A total of 1069 fourth to sixth graders from nine elementary schools in the inner city of Philadelphia, PA, were part of an ongoing randomized control trial to assess prevention strategies for obesity. The mean rate of students eligible for free/reduced meals was 82.9 Ϯ 11.5%. Weight was measured in the second semester of the academic year. Absentee data for the entire academic year were recorded by homeroom teachers. Participants were classified into relative weight categories described by the Institute of Medicine: underweight, normalweight, overweight, and obese. Results: ANOVA showed that overweight children were absent significantly more than normal-weight children (12.2 Ϯ 11.7 days vs.10.1 Ϯ 10.5 days) (p Ͻ 0.05). Linear regression showed that the obese category remained a significant contributor to the number of days absent even after adjusting for age, race/ethnicity, and gender. Discussion: These data suggest that in addition to the medical and psychosocial consequences of being overweight, heavier children have greater risk for school absenteeism than their normal-weight peers. As the rate of childhood obesity increases, parallel increases in school absenteeism should be expected.