Relations Among Milk and Non-Milk Beverage Consumption, Calcium, and Relative Weight in High-Weight Status Children

Relations among weight, calcium, and milk have received considerable attention, but inconsistencies remain regarding strength and direction of associations. Calcium, milk, other beverages, and weight status associations were examined among children >75th BMI percentile from three studies. Results indicated negative relations between z-BMI and non-whole milk and calcium in one sample, with lower z-BMI and percent body fat among older children drinking any non-whole milk. In one older child sample, z-BMI and percent body fat were higher for whole milk consumers. The only significant relation observed for other beverages was the negative association between juice and percent body fat in younger children. Milk, calcium, and child weight status associations are inconsistent, and appear dependent on milk type and child age.     

肥胖症患者的行为治疗与干预

行为疗法是治疗肥胖症常用、有效地一种方法。国外行为治疗一般有评估阶段、实际治疗阶段、治疗过渡阶段和治疗保持阶段,包括认识行为改变的准备动机、认知重组、目标确定、自我监督、刺激控制、应激处理、社会支持、反弹干预等组成成份。行为治疗需和其他方法整合有效治疗肥胖症。     

Primary Care Provider Familiarity with Binge Eating Disorder and Implications for Obesity Management: A Preliminary Survey

Current guidelines for the evaluation and treatment of obesity recommend referring individuals with binge eating disorder (BED) to a mental health professional. However, it is unclear how familiar primary care providers are with BED. The purpose of this study was to assess providers' familiarity with BED diagnosis and treatment. Providers in two primary care clinics completed a questionnaire, which assessed perceived familiarity with BED and demonstrated familiarity with BED diagnosis and treatment. Results indicated that 61% of respondents demonstrated familiarity with the essential symptoms of BED, and 80% reported familiarity with the diagnosis of BED. However, 35% of respondents who perceived themselves as familiar with BED did not demonstrate familiarity with the most basic symptoms. These results demonstrate that while many providers in primary care are familiar with BED, steps to improve provider familiarity with the disorder and provide appropriate mechanisms to address BED are warranted.     

代谢综合征：动脉粥样硬化危险因素的聚集

代谢综合征是动脉粥样硬化危险因素的聚集状态,包括肥胖、高血压、血糖异常、血脂紊乱等,共同的病理基础是肥胖和胰岛素抵抗。高胰岛素血症、脂肪因子、高血糖、血脂异常和高血压导致内皮细胞损伤和血管炎症,促进动脉粥样硬化发展。提高对代谢综合征的认识有助于从整体观念出发防治肥胖带来的相关疾病。     

Development and validation of the Eating Behavior Inventory

The Eating Behavior Inventory (EBI) is a self-report instrument for assessing behaviors that have been theoretically implicated in weight loss, e.g., self-monitoring of food intake and of weight, refusing offers of food, eating at only one place, shopping from a list, eating in response to emotions. Thirty items were constructed in the form of first-person statements, e.g., I eat in the middle of the night. Each item was to be rated with a 5-point scale according to how often it was true for the respondent. Items were scored such that higher scores always reflected more appropriate (theoretically facilitative of weight control) eating patterns. Validity of individual items and total score was assessed in four studies. Twenty-six of the original items appeared valid and were retained. The resulting total score demonstrated validity in these studies and in two cross-validational comparisons. Internal consistency as measured by split-half reliability and correlations of item scores with total score was acceptable. One month test-retest reliability of item and total scores was satisfactory. Clinical and research applications of the EBI are discussed.An early version of this article was presented at the Taos International Conference on Treatment of Addictive Behaviors, Taos, New Mexico, February 1979.     

Accuracy of parents' reports of height and weight

The accuracy of parents' reports of their own height and weight and the height and weight of their obese children, who were about to enter a weight control program, was assessed. Measured height and weights of 146 mothers, 55 fathers, and 150 children who attended a screening session were compared to the heights and weights they had previously reported on a demographic questionnaire. Eighty-four percent of the reported weights were accurate within ±5 lbs.; 71% of the reported heights were accurate within ±1 in. Parents' reports of weight tended to underestimate actual weights, with the magnitude of underestimation greater for mothers than for fathers, while reported heights overestimated actual height, with the magnitude of overestimation greatest for fathers. Errors in the parents' reports of children's weight were related to the child's actual weight and body mass index (BMI), with substantial underestimation of actual weight in the heaviest decile of children in the sample.Preparation of this paper was supported in part by Grant HDMH12520-01 from the National Institute of Child Health and Human Development and Mental Health. Reprints can be obtained from Rena R. Wing, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15261.     

Treating Bulimia Nervosa and Achieving Medically Required Weight Loss: A Case Study

Eating disorder and weight loss interventions have typically been regarded as distinct or antithetical, despite a growing number of individuals with comorbid eating pathology and obesity. This siloing of research and practice has created a clinical conundrum for providers seeking to treat individuals with an eating disorder seeking to lose weight (e.g., required pre-surgical weight loss). To date, integrated treatment research targeting both eating disorders and weight loss is rare and practical guidance is lacking, especially for restrictive/binge-purge subtypes. This case example describes how an integrated approach was applied within a naturalistic outpatient clinical practice setting to successfully treat a client presenting with excess weight and severe bulimia nervosa who was medically required to lose weight for orthopedic surgery. We conclude by reviewing the benefits and challenges of integrating eating disorder and behavioral weight loss treatments and providing practical insights for treatment providers.     

The relationship among the transtheoretical model of behavioral change,psychological distress,and diet attitudes in obesity: Implications for primary care intervention

Obesity is prevalent but undertreated in primary care. Family practice volunteer outpatients (N=454) were administered the Stage of Change for Weight (URICA), the Brief Symptom Inventory (BSI), and the Diet Readiness Test (DRT) to assess the relationship between these variables and obesity. The body mass index (BMI) was used to classify obesity revealing 197 patients with elevated BMI's. There was no significant difference between the obese and the nonobese on any of the psychological measures. The obese reported significantly more difficulty setting diet goals and less control over their eating, ate more to emotional situations, and exercised less than the nonobese. The obese sample (46.7%) reported being in the Action stage of change for weight management. Implications for intervention in primary care include targeting attitudes (DRT) and dispelling physician attitudes that obese individuals have increased levels of psychological distress. Addressing Stage of Change for weight management can facilitate tailoring the appropriate intervention when used in concert with the DRT variables.     

Self-determined motivation,physical exercise and diet in obese children: A three-year follow-up study

The present study's objective was to track long term (three years intervention and six months “detraining”) the influence of an exercise program with or without diet on the motivation of sedentary obese children. The participants were 27 children (8-11 years), divided into two groups according to the program they followed. The G1 group followed a physical exercise program (three 90-minute sessions per week), and the G2 group this physical exercise program plus a low calorie diet. The participants’ motivation to engage in exercise was measured using the Behavioural Regulation in Exercise Questionnaire-2. Both groups showed improvements in amotivation in the 3rd year and in the detraining period (in the G1 and G2, respectively) and in intrinsic regulation of exercise behaviour (in the G1 and G2, respectively). There were also differences between the two groups in external regulation in the intervention and detraining periods. This appears to be indicative of the appropriateness of long-term physical exercise to generate greater autonomous motivation, and hence changes towards healthy living habits that are stable in time.