Medicare's search for effective obesity treatments: Diets are not the answer.

Mann, Traci; Tomiyama, A. Janet; Westling, Erika; Lew, Ann Marie; Samuels, Barbra; Chatman, Jason

doi:10.1037/0003-066x.62.3.220

Cited by 996 publications

(777 citation statements)

References 89 publications

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“…'go on a diet') and exercise more. Such an approach, however, is generally unsuccessful in decreasing body mass in the long term (4)(5)(6) . Moreover, there is evidence that dieting, and particularly repeated dieting attempts (i.e.…”

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Review Article Relationships between intuitive eating and health indicators: literature review

Dyke¹,

Drinkwater

2013

Public Health Nutr.

220

148

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Objective: To review the peer-reviewed literature on relationships between intuitive eating and health indicators and suggest areas of inquiry for future research. We define the fundamental principles of intuitive eating as: (i) eating when hungry; (ii) stopping eating when no longer hungry/full; and (iii) no restrictions on types of food eaten unless for medical reasons. Design: We include articles cited by PubMed, PsycInfo and Science Direct published in peer-reviewed journals or theses that include 'intuitive eating' or related concepts in the title or abstract and that test relationships between intuitive eating and physical or mental health indicators. Results: We found twenty-six articles that met our criteria: seventeen cross-sectional survey studies and nine clinical studies, eight of which were randomised controlled trials. The cross-sectional surveys indicate that intuitive eating is negatively associated with BMI, positively associated with various psychological health indicators, and possibly positively associated with improved dietary intake and/or eating behaviours, but not associated with higher levels of physical activity. From the clinical studies, we conclude that the implementation of intuitive eating results in weight maintenance but perhaps not weight loss, improved psychological health, possibly improved physical health indicators other than BMI (e.g. blood pressure; cholesterol levels) and dietary intake and/or eating behaviours, but probably not higher levels of physical activity. Conclusions: Research on intuitive eating has increased in recent years. Extant research demonstrates substantial and consistent associations between intuitive eating and both lower BMI and better psychological health. Additional research can add to the breadth and depth of these findings. The article concludes with several suggestions for future research.

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confidence: 99%

Review Article Relationships between intuitive eating and health indicators: literature review

Dyke¹,

Drinkwater

2013

Public Health Nutr.

220

148

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“…Overweight and obesity currently affect billions of people worldwide, particularly those in developed nations, and are now becoming increasingly prevalent in developing countries also (WHO, 2013). As the rates of this epidemic are rising alarmingly (WHO, 2013), with lifestyle interventions having low success rates (Mann et al, 2007) and surgery being the only effective treatment (Picot et al, 2009), albeit with side effects and not being suitable for everyone, the search for an elusive drug cure is rife.…”

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confidence: 99%

Double deletion of orexigenic neuropeptide Y and dynorphin results in paradoxical obesity in mice

et al. 2014

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ObjectiveOrexigenic neuropeptide Y (NPY) and dynorphin (DYN) regulate energy homeostasis. Single NPY or dynorphin deletion reduces food intake or increases fat loss. Future developments of obesity therapeutics involve targeting multiple pathways. We hypothesised that NPY and dynorphin regulate energy homeostasis independently, thus double NPY and dynorphin ablation would result in greater weight and/or fat loss than the absence of NPY or dynorphin alone. Design and methodsWe generated single and double NPY and dynorphin knockout mice (NPYΔ, DYNΔ, NPYDYNΔ) and compared body weight, adiposity, feeding behaviour, glucose homeostasis and brown adipose tissue uncoupling protein-1 (UCP-1) expression to wildtype counterparts. Results Body weight and adiposity were significantly increased in NPYDYNΔ, but not in NPYΔ or DYNΔ. This was not due to increased food intake or altered UCP-1 expression, which were not significantly altered in double knockouts. NPYDYNΔ mice demonstrated increased body weight loss after a 24-h fast, with no effect on serum glucose levels after glucose injection. Conclusions Contrary to the predicted phenotype delineated from single knockouts, double NPY and dynorphin deletion resulted in heavier mice, with increased adiposity, despite no significant changes in food intake or UCP-1 activity. This indicates that combining long-term opioid antagonism with blockade of NPY-ergic systems may not produce anti-obesity effects.

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“…Although as little as 3 % weight loss can have health benefits [4,5], from one third to two third regain of weight is expected over 2 years [2,6]. Often, regain will continue beyond a participant's initial weight [1]. Repeating a pattern of weight loss and regain might increase individuals' health risks [7].…”

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confidence: 99%

“…Although behavioral (non-pharmacological/nonsurgical) treatments have consistently been associated with a 5-8 % loss in initial body weight, even more consistent has been a gradual climb toward baseline weight after approximately 6 months [1][2][3]. Although as little as 3 % weight loss can have health benefits [4,5], from one third to two third regain of weight is expected over 2 years [2,6].…”

mentioning

confidence: 99%

“…In a recent trial incorporating a yearlong, state-of-the-science behavioral weight management protocol directed primarily at reductions in energy intake [9], an initial weight loss of 9 % demonstrated a 91 % regain of baseline weight over the subsequent 3 years [10]. Because of the failure of this seemingly comprehensive protocol that was highly focused upon maintaining weight loss from its outset, along with the long history of behavioral treatments' association with weight regain [1][2][3], its developers questioned the merits of any further pursuits of such weight management interventions [10]. Although other researchers disagreed [11][12][13], it seemed clear that new and different approaches were needed.…”

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confidence: 99%

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Psychosocial predictors of decay in healthy eating and physical activity improvements in obese women regaining lost weight: translation of behavioral theory into treatment suggestions

Annesi

2016

Behav. Med. Pract. Policy Res.

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Regain of lost weight is a universal problem for behavioral treatments. An increased understanding of theory-based psychosocial predictors of decay in behavioral correlates of weight loss might improve treatments. Data were derived from a previous weight loss investigation of 110 women with obesity. A subsample from the experimental treatment who lost ≥3 % body weight and regained at least one third of that over 24 months (N = 36) was assessed. During months 6 through 24, there were unfavorable changes in behavioral (fruit/vegetable and sweet intake; physical activity) and psychosocial variables. Mood change predicted change in fruit/vegetable and sweet intake, with emotional eating change mediating the latter relationship. Change in self-regulation predicted changes in sweet and fruit/vegetable intake and physical activity, with self-efficacy mediating the self-regulationfruit/vegetable intake and self-regulation-physical activity relationships. Findings suggest that after treatmentinduced weight loss, addressing indicated theory-based psychosocial variables might mitigate decay in behavioral predictors of healthier weight. KEYWORDSWeight loss, Maintenance, Treatment, Self-regulation, Self-efficacy, Physical activity Although behavioral (non-pharmacological/nonsurgical) treatments have consistently been associated with a 5-8 % loss in initial body weight, even more consistent has been a gradual climb toward baseline weight after approximately 6 months [1][2][3]. Although as little as 3 % weight loss can have health benefits [4,5], from one third to two third regain of weight is expected over 2 years [2,6]. Often, regain will continue beyond a participant's initial weight [1]. Repeating a pattern of weight loss and regain might increase individuals' health risks [7]. Researchers suggest that weight loss maintenance differs considerably from weight loss and thus should be distinctly studied and addressed [8]. In a recent trial incorporating a yearlong, state-of-the-science behavioral weight management protocol directed primarily at reductions in energy intake [9], an initial weight loss of 9 % demonstrated a 91 % regain of baseline weight over the subsequent 3 years [10]. Because of the failure of this seemingly comprehensive protocol that was highly focused upon maintaining weight loss from its outset, along with the long history of behavioral treatments' association with weight regain [1-3], its developers questioned the merits of any further pursuits of such weight management interventions [10]. Although other researchers disagreed [11][12][13], it seemed clear that new and different approaches were needed.As a reaction to this and (a) a consensus that exercise is a primary predictor of maintained weight loss [6,14,15], (b) suggestions that the development of self-regulation prior to pursuing reductions in energy intake is advisable [8], (c) proposed behavioral models of the relationship between exercise and weight loss [11,16,17], and (d) indications that physical activity affects weight loss more thr...

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Medicare's search for effective obesity treatments: Diets are not the answer.

Cited by 996 publications

References 89 publications

Review Article Relationships between intuitive eating and health indicators: literature review

Review Article Relationships between intuitive eating and health indicators: literature review

Double deletion of orexigenic neuropeptide Y and dynorphin results in paradoxical obesity in mice

Psychosocial predictors of decay in healthy eating and physical activity improvements in obese women regaining lost weight: translation of behavioral theory into treatment suggestions

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