The Influence of Body Mass Index on the Perceived Quality of Life during Pregnancy

Obesity contributes to various pregnancy complications and therefore, may compromise maternal quality of life. The study aim was to investigate the relationship between body mass index (BMI) and health-related quality of life (HRQoL) during pregnancy. Study involved every 6th woman who gave birth in the Clinic for Obstetrics and Gynecology Clinical Center of Serbia during the year 2010. Initial and end pregnancy BMIs were calculated for every woman. The parturients (604) completed the SF36 questionnaire (physical-PHC; mental-MHC; total quality of life-TQL), Beck’s Depression Inventory, Fatigue Severity Scale, Pregnancy Symptom Scale, Multidimensional Personal Support Scale, and Acceptance of Illness Scale. Before pregnancy most women had normal or decreased weight, while at the end of pregnancy the majority were overweight or obese (p?=?0.000). Initial and end pregnancy weights (p?<?0.05) and BMIs (p?<?0.05) were positively correlated with depression. Depression was significantly lower in overweight compared to mildly or morbidly obese women during pregnancy (p?<?0.05). Pregnancy weight change correlated negatively with PHC (p?=?0.029), and positively with fatigue (p?=?0.030), and symptoms (p?=?0.011). Of all BMI categories, morbidly obese women had the worst feeling of social support (p?<?0.05). Pregnancy symptoms were significantly less problematic in women with normal weight compared to overweight and obese women during pregnancy (p?<?0.05). Assessing the impact of all investigated parameters together, we established significant models for PHC (p?=?0.036), depression (p?=?0.030), and fatigue (p?=?0.038). Pregnant women should be advised to keep their gestational weight gain within the normal recommended range to have a good pregnancy outcome and HRQoL.     

Body Image and Depression in Women With Early and Late Onset Obesity

Three groups of women (N = 27 in each group) were compared: women of normal weight and asymptomatic for eating disorders (M = 125.5 lb); women with early onset obesity—before 13 years (M = 182.4 lb); and women with adult onset obesity—17 years or over (M = 172.4 lb). Subjects (M age = 40.7 years) were obtained through church and business groups. Body image and depression were assessed, respectively, by three scales of the Body-Self Relations Questionnaire (Winstead & Cash, 1983) and by the Beck Depression Inventory (Beck, 1967). The combined group of obese subjects rated their bodies as less fit than normal weight subjects (p<.01). However, there were no other significant differences between obese and normal weight subjects. Also, no significant differences were found between the early and late onset groups. Results showed that (a) there is a subpopulation of obese women who are relatively satisfied with their bodies and whose psychological adjustment is no different from that of other women, and that (b) an early onset of obesity does not necessarily have more serious psychological consequences than late onset.     

Ghrelin level negatively predicts quality of life in obese women

A cross-sectional cohort study was conducted to investigate whether ghrelin level in obese women predicts the quality of life (QOL). A total of 307 subjects fulfilled the criteria: (1) age between 20 and 65 years old, (2) body mass index ≥27 kg/m² (3) waist circumference ≥80 cm were enrolled in the study. All subjects were assigned to one of the plasma ghrelin level categories according to the quartiles. The median of age and BMI of the 307 obese women were 45 ± 18 years and 29.9 ± 4.1 kg/m², respectively. The main outcome evaluated is the associations of plasma ghrelin level and QOL, which were evaluated using multiple linear regression analysis. Results of linear trend test show significant statistical difference in plasma lipoproteins (triglyceride, cholesterol, HDL-cholestero and LDL-cholesterol = and levels of obesity-related hormone peptides, including leptin, adiponectin, insulin among quartiles of ghrelin. Multiple liner regression analysis of serum obesity-related hormone peptide level and QOL using stepwise method shows ghrelin concentration was the only predictor of QOL, including PCS-12 level (β = ?0.18, p = 0.001), MCS-12 level (β = ?0.14, p = 0.009), WHOQOL-BREF scores: physical (β = ?0.13, p = 0.03), psychological (β = ?0.16, p = 0.007), social (β = ?0.21, p?= < 0.001), and environmental (β = ?0.22, p?= <0.001), after adjusting other factors for obese female subjects. This study demonstrated that ghrelin concentration is strongly associated with QOL level among obese women. Hence, ghrelin concentration might be a valuable marker to be monitored in obese women.     

Bi-Directional Relationship Between Self-Regulation and Improved Eating: Temporal Associations With Exercise,Reduced Fatigue,and Weight Loss

ABSTRACT. Severely obese men and women (body mass index ≥ 35 ≤ 55 kg/m²; M_age = 44.8 years, SD = 9.3) were randomly assigned to a 6-month physical activity support treatment paired with either nutrition education (n = 83) or cognitive-behavioral nutrition (n = 82) methods for weight loss. Both groups had significant improvements in physical activity, fatigue, self-regulation for eating, and fruit and vegetable intake. Compared to those in the nutrition education group, participants in the behavioral group demonstrated greater overall increases in fruit and vegetable intake and physical activity. These group differences were associated with changes that occurred after Month 3. Increased physical activity predicted reduced fatigue, β = ?.19, p =.01. A reciprocal relationship between the mediators of that relationship, which were changes in self-regulation and fruit and vegetable intake, was identified. There was significantly greater weight loss over six months in the behavioral nutrition group when contrasted with the nutrition education group. Self-regulation for eating and fruit and vegetable intake were significant predictors of weight loss over both three and six months. Findings enabled a better understanding of psychosocial effects on temporal aspects of weight loss and may lead to more effective behavioral treatments for weight loss.     

The effect of couples training and partner co-operativeness in the behavioral treatment of obesity

To evaluate the influence of spouse co-operativeness and couples training in the treatment of obesity, 29 obese men and women were assigned to three experimental conditions: (1) Co-operative spouse-couples training: subjects attended all meetings with spouses. Spouses were trained in modeling, monitoring, and reinforcement techniques; (2) Co-operative spouse-subject alone: subjects attended meetings alone even though their partners had agreed to become involved in treatment; (3) Non-cooperative spouse: subjects had spouses refusing to participate in the program, and attended sessions alone. At the 3-month and 6-month maintenance assessments. subjects in the spouse training condition lost significantly more weight than subjects in the other two conditions. Weight losses compared favorably to those of any controlled study with subjects in the couples training group averaging nearly 30 lbs lost after 8$\text{1}\text{2}$ months of treatment. In the absence of spouse training, subjects with co-operative spouses did no better than subjects with non-co-operative spouses. The findings suggest that spouse training may have a potent facilitative effect in weight reduction, and that this effect may promote long-term maintenance of weight loss.     

Predictors of attrition and weight loss success: Results from a randomized controlled trial

Attrition is a common problem in weight loss trials. The present analysis examined several baseline and early-treatment process variables, as predictors of attrition and outcome in a clinical trial that combined pharmacotherapy and behavior therapy for weight loss. Participants were 224 obese adults who were treated with sibutramine alone, lifestyle modification alone, combined therapy, or sibutramine plus brief lifestyle modification. Predictors included baseline characteristics (e.g., demographic, weight-related, psychological, and consumption-related variables), plus attendance, adherence, and weight loss in the early weeks of treatment. Outcomes were attrition and weight loss success (i.e., ≥5% reduction in body weight) at 1 year. Multivariable models, adjusting for other relevant variables, found that younger age and greater baseline depressive symptoms were related to increased odds of attrition (ps ≤ 0.003). Greater early weight loss marginally reduced the odds of attrition (p = 0.06). Predictors of weight loss success at 1 year were Caucasian ethnicity (p = 0.04), lower baseline depressive symptoms (p = 0.04), and weight loss during the first 3 weeks of treatment (p < 0.001). Thus, depressive symptoms at baseline were a significant predictor of both attrition and weight loss success. As a process variable, early weight loss appears to have more predictive value than early attendance at treatment sessions or early adherence.     

Mediation of self‐regulation and mood in the relationship of changes in high emotional eating and nutritional behaviors: Moderating effects of physical activity

High emotional eating (EE) is prevalent in women with obesity. A previous study's subsample of obese women classified as high emotional eaters participated in either a physical activity‐focused experimental (n = 29) or an educationally focused comparison (n = 22) behavioral treatment and was assessed over phases of expected weight loss (baseline–month 6) and short‐ and long‐term regain (months 6–12 and 6–24, respectively). The study's aim was to assess theory‐based psychological and behavioral mediation and moderation of changes in nutritional behaviors via emotional eating change in order to inform behavioral weight‐loss treatments. During the weight‐loss phase, significant improvements in eating self‐regulation and mood significantly mediated the relationship of reduced EE and intake of both fruits and vegetables (FV) and sweets. Self‐regulation was a significant independent mediator. Physical activity significantly moderated the relationship between EE and self‐regulation changes. All variables demonstrated large positive effects and significant time × group interactions favoring the experimental group. During the short and long‐term phases of expected weight regain, there were no significant changes in FV intake, although consumption of sweets significantly increased during months 6–24. Change in FV and sweets significantly predicted weight change, which was significantly greater in the experimental vs. comparison group over both the initial 6 months (?6.1% vs. ?2.6%) and full 24 months of the study (?7.6% vs. ?1.3%). Findings suggest that behavioral treatments should address EE through improvements in self‐regulation and mood, and supported physical activity will aid in that process. The need for an improved understanding of weight‐loss maintenance remains.     

Psychophysiological correlates of organizational change and threat of unemployment among police inspectors

The study examined psychosocial work-conditions and physiological reactions among thirty-six police inspectors (median age 45 years, 81% males) who participated in a reorganization. At this time, subjects were threatened by unemployment and had to reapply for their positions in a new police district. Data were collected during the reorganization and at three years follow-up, by means of questionnaires (Stress Profile) and blood samples. The blood samples were used to determine serum levels of gammaglutamyltransferase (GGT), glucose, lipids, prolactin, testosterone and cortisol. The results show a positive association betweenworry about employment and symptoms ofburnout during the reorganization. Mean scores for the Stress Profile sub-scalesworry about employment (p<.01) andwork-load (p<.05) decreased between measurements but an impairment inrelationships with management was noticed (p<.05). No significant changes were observed in terms of self-rated health complaints. Significant decreases in total cholesterol (p<.0001), LDL-cholesterol (p<.0001), LDL/HDL-ratio (p<.01), prolactin (p<.0001), as well as increases in testosterone (p<.01) and cortisol (p<.001) were observed for the whole sample. Glucose decreased with marginal significance (<.07). Controlling for age and gender, multivariate regression analyses showed that subjects who reported deteriorations insatisfaction with work manifested the most modest decreases in prolactin (p<.05). Also, the decrease in glucose was larger for subjects who experienced impairments in,satisfaction with work (p<.05), information (p<.05), task-oriented leadership, (p<.05), andrespect and dignity (p<.05). Subjects who perceived deteriorations in theethical and moral standards of the organization increased their cortisol level to a lower degree than their counterparts (p<.05). Favorable changes in employment status and psychosocial work environment seem to be related to improved physiological functioning.     

Computer-assisted dieting: Effects of a randomised controlled intervention

In this pilot study, the effects of two computer-assisted dieting (CAD) interventions on weight loss and blood chemistry were examined among overweight and obese adults. Participants (91 community members, average age 42.6 years) were randomly assigned to CAD-only (a single-session introduction and provision of a dieting software, n = 30), CAD plus an additional four-session self-management group training (CAD+G, n = 31) and a waitlist control group whose members were randomised into the two interventions at the 3-month follow-up (n = 30). A three (group)-by-two (time) repeated measures ANOVA revealed no significant group by time interaction during the initial 3-month period. However, the two intervention groups combined showed a significant, though moderate weight loss relative to the control group. Further, although a general improvement was found with regard to the lipid panel results during the first 3 months of the trial, the treatment by time interaction was not significant. A comparison of the developments in the two intervention groups during the 3- to 6-month follow-up time period revealed a tendency towards greater weight regain in the CAD-only condition. The evidence suggests that CAD supports initial weight loss; however, additional self-management training might be necessary to support maintenance.     

Step-down approach to behavioural weight loss treatment: a pilot of a randomised clinical trial

Background: In a stepped-down approach, patients begin with a more intensive treatment and are stepped down to a less intensive treatment based on achieving treatment goals. This study compared a standard behavioural weight loss programme (BWLP) to a stepped-down approach to treatment.

Methods: Fifty-two overweight/obese adults (Age: M?=?47?years, SD?=?13.5; female?=?67%) participated in an 18-week BWLP. Half of them were randomly assigned to be stepped down from weekly group meetings based on completion of weight loss goals (3%) every 6?weeks, while the other half remained in their groups regardless of weight loss.

Results: There was a significant difference favouring the BWLP in the proportion of participants who met or exceeded their 3% weight loss goal during the first six weeks. While not statistically significant by the end of treatment, the BWLP participants lost nearly 3% more body weight than stepped-down participants (SC?=?4.9% vs. BWLP?=?7.8%; p?=?.10). Greater self-monitoring was associated with increased likelihood of stepped-care eligibility and higher percent weight loss at the end of treatment (p?<?.01).

Conclusion: There was little evidence to support the efficacy of the stepped-down approach for behavioural weight loss treatment employed in this investigation.     

Religiosity and Marital Satisfaction

This study examined the association between religiosity and marital satisfaction among first-married and remarried adults. Seven hundred and eighty-seven heterosexually married adults from the Flanders region in Belgium completed the Maudsley Marital Questionnaire (MMQ) and a four-item religiosity scale, measuring marital satisfaction and religiosity respectively. This study found the effect of gender and marital status statistically significant (p < .0001) on religiosity. For marital satisfaction, the effect of gender and marital status statistically significant only for MMQ-S (p < .0001) and MMQ-M (p < .0001) respectively. Religiosity had a significant positive correlation (r = .19, p < .0001) with sexual-adjustment problems (MMQ-S). The ultimate aim of this study was to inform marital and relational therapists the value of a possible association religiosity has on marital satisfaction.This study was conducted at the Institute for the Family and Sexuality Sciences, Katholieke Universiteit Leuven, as part of doctoral research.     

Unilateral Stability and Visual Feedback Body Control Improves After Three-Month Resistance Training in Overweight Individuals

The authors evaluated the effect of 3 months of resistance and aerobic training (3 sessions/week) on body balance in a group of 25 overweight and obese individuals. Prior to and after the training, they performed static and task-oriented balance tests under various conditions. Mean center of pressure (CoP) velocity and mean trace length of the CoP in the y-axis registered during a one-legged stance significantly decreased after the resistance training (19.1%, p = .024; 29.3%, p = .009). Mean trace length of the CoP in the y-axis decreased significantly also during a bipedal stance on a foam surface with eyes open and closed (10.9%, p = .040; 18.2%, p = .027). In addition, mean CoP distance and mean squared CoP distance in the anteroposterior direction during a visually guided center of mass (CoM) tracking task significantly improved (14.7%, p = .033; 28.2%, p = .016). However, only mean trace length of the CoP in the y-axis during a bipedal stance on a foam surface with eyes open and closed significantly decreased after the aerobic training (10.3%, p = .047; 16.5%, p = .029). It may be concluded that resistance training is more efficient for the improvement of the anteroposterior unilateral stability and the accuracy of the regulation of the CoM anteroposterior position than aerobic training in overweight and obese individuals.     

Adolescent Perception of Peer Success: A Gendered Perspective over Time

Adolescent males and females (grades 6–12) (n = 552) were presented with nine brief vignettes from the Teen Apperception Scale, describing high-achieving hypothetical female (or male) peers, across nine domains: leadership, academics, athleticism (two), musicianship, art, popularity, humor, and multitalentedness. Teens rated likability, popularity, and attractiveness of vignette subjects in each domain. The sample was roughly evenly divided by gender (47% male and 53% female); students ranged in age from 11 to 18 years. The sample was ethnically diverse, and the socioeconomic status of the students' families ranged from lower middle to upper middle class. MANOVA analyses showed female vignette subjects to be rated significantly higher than male subjects by both genders and all grade groupings, at p < .0001 overall, and at values ranging from p < .05 to p < .0001 for six of nine subscales. Results are contrasted with those from highly similar studies 30 years ago, and used to reflect a possible shift in attitudes toward high achievement in women.     

Impact of outpatient non-myeloablative haematopoietic stem cell transplantation in quality of life vs. conventional therapy

The role of outpatient hematopoietic stem cell transplantation (HSCT) as a therapeutic tool has been strengthened significantly because of the increasing number of patients undergoing this treatment. Due the very nature of this procedure, one of the aspects that should not be overlooked is the quality of life (QOL) of patients undergoing HSCT. Thus, one must consider not only health status after treatment, but also, the psychosocial implications for the patient. This is an observational, longitudinal, and prospective study to assess QOL in patients undergoing outpatient HSCT vs. similar patients receiving medical treatment (MxTx). By applying the COOP/WONKA charts on five occasions (pre-HSCT/initial, post-HSCT/first month, and at 3, 6, and 9 months), thirty-eight patients were analysed, 19 with HSCT and 19 with MxTx with no differences in age, gender or diagnosis. The initial survey found significant differences only in pain perception, which was higher in the HSCT group (p = .08); at the first month, there was a greater tendency for feelings of depression or anxiety in the HSCT group (p = .016), with more limitations in social (p = .003) and daily (p = .044) activities. From 3 months post-HSCT, the results were very similar. The differences persisted only in the area of social activities. Four patients developed graft-versus-host disease with no significant difference in the scores obtained compared to other transplant patients at 3, 6, and 9 months (p = .26) of follow-up.     

Eating behaviors and emotional distress are predicted by treatment and adverse outcome in patients with type 2 diabetes

Depression and anxiety are hightly prevalent among patients with Type 2 Diabetes (T2D), however not commonly related to outcomes, treatment and comorbidities. Eating behaviors could also have an implication. To evaluate the relation between mood and eating behaviors with demographic, physical, treatment, biochemical profiles and chronic comorbidities in T2D we conducted this exploratory cross sectional study in a population from Mexico. Hospital Anxiety and Depression Scale and the Three Factor Eating Questionnaire Revised 21 (TFEQ-R21) were correlated with age, gender, blood pressure, treatment and comorbidities (nephropathy, neuropathy, retinopathy and cardiopathy). Multi-linear regression models and 2^k factorial analyses were conducted. Sixty-one patients (31 male) 55 years old (SD 13) with at least 5 years of T2D were included. Anxiety correlated with depression (r = 0.25, p < 0.05). Gender (women) (std B 0.026, p < 0.001), insulin therapy (std B 0.3, p = 0.11), systolic blood pressure (std B 0.263, p = 0.02) and cardiovascular disease (std B 0.232, p = 0.035) predicted depression. Insulin therapy had a positive effect in cognitive restraint. (std B 0.32, p = 0.001). Age (std B 0.37, p = 0.003) and systolic blood pressure (std B 0.237, p = 0.048) predicted positively emotional eating (not previously published). 2^k factorial analyses proved additive interaction between complications and insulin therapy with depression. This study supports the relation between mood disorders and eating behaviors with demographic, physical, treatment, biochemical profiles and chronic comorbidities in T2D and the additive interaction between factors and mood disorders.     

Behavior therapy for obesity: Booster sessions and long-term maintenance of weight loss

Following 8 weekly sessions of group behavioral self-control treatment, 75 obese women were assigned to one of five different maintenance conditions: (a) structured behavioral booster sessions held every two weeks; (b) structured behavioral booster sessions held every month; (c) unstructured nonspecific booster sessions held every two weeks; (d) unstructured nonspecific booster sessions held every month; and (e) a control group that received no booster sessions. Follow-ups were conducted at 3, 6, 9 and 12 month intervals. The study was completed in two replications. Results failed to show a significant effect of either booster session content or frequency. All groups continued to lose weight during the first three months of follow-up. Thereafter subjects in Replication 1 showed significant increases in weight over the next 9 months, whereas subjects in Replication 2 maintained their treatment-produced weight loss. The data do not support the view that booster sessions facilitate maintenance.     

Clinical Effectiveness of the LE<Superscript>3</Superscript>AN Program: A Military Healthy Lifestyle Program

For several decades, obesity has been a major health concern within the general population of the United States as well as within the unique military population. Unlike the civilian sector, military service requires individuals to meet weight and body fat standards. In order to assist overweight military personnel return to standards, Tripler Army Medical Center initiated the LE³AN Program. LE³AN is a one-week, day-treatment, cognitive-behavioral weight management program coupled with 12 months of weekly follow-up. Baseline data was collected on 387 consecutive participants. Despite physical fitness training and required standards in each military service, the average BMIs for men and women were in the obese range, with male participants’ BMIs significantly higher than women’s (34.3 vs 31.9, p<.005). One year outcome data was collected from 167 participants, i.e. 43.2% of treatment initiators. Among participants who completed treatment, men maintained a 6.56% loss of their initial weight while women maintained a 7.35% loss. Over a quarter, 26.6%, of those who started the program (but did not complete it) maintained at least a 5% weight loss at one year, while 61.6% of treatment completers maintained 5% weight losses. The opinions expressed in this article reflect the views of the authors and not those of the Department of Defense or the U.S. Army.     

Predictors of improvement in an open-trial multisite evaluation of emotion regulation group therapy

Emotion regulation group therapy (ERGT) is a novel treatment specifically targeting deliberate non-suicidal self-harm (DSH) in individuals with borderline personality disorder (BPD). Identifying robust predictors of positive response to ERGT could aid clinicians in treatment selection; however, to date, only one such study has been conducted. Thus, we aimed to replicate previously identified predictors of treatment response to ERGT by investigating demographic, clinical, and diagnostic predictors in 95 women with BPD or subclinical BPD who had participated in an open-trial evaluation of ERGT. Outcomes evaluated were frequency of DSH and emotion dysregulation. Assessments were conducted at pretreatment, post-treatment, and 6-month follow-up. Multilevel mixed linear models and multilevel negative binomial generalized estimated equations were used to identify significant interactions between the predictors and outcomes.

We found that greater pretreatment DSH frequency was associated with greater improvements in DSH during treatment (b = 0.998, SE = 0.00, p = 0.03) and follow-up (b = 0.997, SE = 0.00, p < 0.01) and that greater BPD severity was associated with greater improvements in DSH during treatment (b = 0.84, SE = 0.06, p = 0.02) and in emotion dysregulation at follow-up (b = ?3.05, SE = 1.47, p = 0.04). Co-occurring disorders were associated with poorer treatment response during follow-up. Results were generally consistent with a previous study of the predictors of response to ERGT. The findings provide further support for the utility of this treatment across a range of BPD patients, including patients with severe DSH and BPD.     

A Healthy Lifestyle Program for the Treatment of Obesity in Minority Men

Historically, minority males have had limited success in programs designed to reduce weight. Twenty-five obese minority males participated in a healthy lifestyle program designed to treat essential hypertension, hyperlipidemia, type II diabetes, obesity, and hypothyroidism. Coined the LE ³ AN Lifestyle Program (emphasizing healthy lifestyles, realistic exercise, reasonable expectations and emotions, attitudes, and nutrition), the program offered a treatment model that involved reasonable low-intensity short exercise regimens, instruction, and extensive practice in making healthy food choices, behavior modification, and self-monitoring techniques coupled with guidance on realistic weight loss and exercise expectations. The participants were able to lose 13 Ib during the inpatient plus day treatment phases of the program and continued to maintain a 19-lb weight loss at 12 months. A program overview, case examples, and suggestions to improve outcome efficacy with difficult to manage obese, minority, male patients are provided.     

Psychological Correlates of the Transmission and Acceptance of Rumors About AIDS1

The present investigation was intended to identify the emotional and cognitive factors associated with the transmission and acceptance of widely disseminated misconceptions about AIDS. A rumor questionnaire listing 10 prevalent misconceptions about AIDS was completed by 229 college students. Consistent with predictions derived from current rumor theory (Rosnow, 1980, 1988), anxiety elicited by AIDS rumors was found to be the factor most strongly related to rumor transmission. The subjects who reported having changed their behavior as a result of the AIDS crisis also were likely to transmit AIDS rumors. Regression analysis revealed that, together, personal anxiety elicited by specific rumors and behavior change represented the strongest predictors of AIDS rumor transmission (R²= .24, p < .0001). Anxiety-provoking rumors perceived as important and personally consequential were most likely to be believed (R²= .56, p < .0001). A minority of subjects (12%) reported behavior changes that actually reduce the risk of AIDS. Implications of this research for AIDS public education campaigns are discussed.