Obesity affects approximately one-third of all U.S. adults, presenting a large economic and public health burden. Long work hours may be contributing to the rising obesity problem by reducing time for physical activity, particularly for individuals working in sedentary occupations. This study sought to investigate the association between long work hours, leisure-time physical activity (LTPA), and obesity across levels of occupational activity in order to identify potentially vulnerable groups. Cross sectional analysis was performed in 2017 using data from the 2015 Georgia Behavioral Risk Factor Surveillance System and prevalence ratios were estimated across work hour and occupational activity groups. Ability to meet guidelines for LTPA did not differ significantly across work hour categories overall. Those working in low activity occupations were more likely to meet aerobic guidelines for LTPA compared to those in intermediate and high activity occupations (χ2: 19.3; P-value: <0.01). Results of interaction assessment demonstrate that the effects of work hours on obesity risk and meeting aerobic guidelines are significantly different across OA categories, indicating OA to be an effect modifier of the relationship between long work hours and obesity (χ2: 13.33; P-value: <0.001; χ2: 4.42; P-value: <0.05). Employees in intermediate activity occupations working long hours were found to be at the greatest risk for obesity. Further research is required to better understand the mechanisms impacting the relationship between long work hours, domains of physical activity, and obesity risk as well as to identify effective intervention and prevention programs for employees in intermediate activity occupations.

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Objective This 6-month pilot trial compared two strategies for weight loss in older adults with BMI’s ≥ 35 kg/m2 to assess weight loss response, safety, and impact on physical function. Methods We randomized 28 volunteers to a balanced deficit diet (BDD, 500 kcal/d below estimated energy needs) or an intensive low calorie meal replacement diet (ILCD, 960 kcal/day). Behavioral interventions and physical activity prescriptions were similar for both groups. Primary outcomes were change in body weight and adverse event frequency; secondary outcomes included measures of physical function and body composition. Results ILCD average weight change was −19.1±2.2 kg or 15.9±4.6% of initial body weight compared to −9.1±2.7 kg or 7.2±1.9% for BDD. ILCD lost more fat mass (−7.7 kg, 95%CI [−11.9, −3.5]) but had similar loss of lean mass (−1.7 kg, 95%CI [−4.1, 0.6]) compared to BDD. There were no significant differences in change in physical function or adverse event frequency. Conclusions Compared to a traditional balanced deficit diet intervention, older adults with severe obesity treated with intensive medical weight loss had greater weight loss and decreases in fat mass without a higher frequency of adverse events. In the short-term however, this did not translate into greater improvements in physical function.

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Data from an academic medical weight management program suggest that individuals with access to insurance coverage for nonsurgical obesity treatment have lower levels of attrition and similar levels of participation and outcomes as those who pay out of pocket.