Beliefs about the causes of weight change in the Australian population

OBJECTIVE: To describe self-reported weight change and beliefs about the causes of weight change and to examine whether these vary by sex and weight status.
DESIGN: This cross-sectional population study examined data from the 1995 Australian National Health and Nutrition Surveys.
SUBJECTS: A total of 10 624 randomly-selected adults provided data.
MEASURES: Objectively measured height and weight, perceptions of current weight status, self-reported weight change over the past year, and reasons for weight change.
RESULTS: Thirty-five percent of participants reported a weight gain in the last 12 months, with females, and those already overweight more likely to report a recent increase in weight. Approximately one in five participants reported a recent weight loss. Those who had recently gained weight were more likely to perceive themselves as overweight regardless of actual weight status. Commonly reported reasons for weight gain included a change in physical activity level (52% males and 35% females) and a change in the amount of food/drink consumed (30% males, 27% females). Similar reasons were given for weight loss.
CONCLUSIONS: Findings of widespread reported weight gain, particularly among those already overweight, suggest Australia's obesity epidemic may be worsening. Strategies are urgently required to better inform individuals about the factors impacting on their weight in order to prevent further weight gain.

The role of puberty, media and popularity with peers on strategies to increase weight, decrease weight and increase muscle tone among adolescent boys and girls

The present study was concerned with the impact of pubertal development, relationships with peers and perceived pressure from the media on body dissatisfaction and body change behaviors among adolescent boys and girls. In particular, the study investigated the underresearched area of strategies to increase weight and muscle. The exploration of body change strategies among adolescent boys has been a neglected area of research. Methods: Respondents were 1185 adolescents (527 males, 598 females) who were enrolled in Grades 7 and 9. Participants completed measures of pubertal development, media and peer influence, body dissatisfaction and strategies to lose weight, increase weight and to increase muscle. Results: The findings demonstrated that girls were more likely than boys to adopt strategies to lose weight, whereas boys were more likely to adopt strategies to increase muscle tone (but not weight). For boys in both Years 7 and 9, the main predictors of body change strategies were puberty and, to a lesser extent, perceived popularity with peers. The major influences for Years 7 and 9 girls were puberty and the media, but these mainly focused on weight loss. For Year 9 girls, perceived popularity with opposite-sex peers also predicted body dissatisfaction and strategies to increase muscle tone. Conclusion: The implications of these findings for understanding factors related to a range of body change strategies for adolescent boys and girls are discussed.

A longitudinal study of body image and strategies to lose weight and increase muscles in children

A longitudinal study was used to examine age differences in the role of body mass index (BMI) and sociocultural pressures in predicting changes in body image and strategies to both lose weight and increase muscles among 443 children aged between 8 and 12 years (207 boys, 236 girls) over a 16-month period. The strongest predictors of body image and these strategies were BMI, the media and mothers, and to a lesser extent fathers and best friends. Girls were focused on losing weight, whereas boys were focused on both increasing muscle and losing weight. Surprisingly, there was a reduction in strategies both to lose weight and increase muscles as children approached adolescence. The implications of these findings for preventative educational programs for boys and girls are discussed.

A prospective study of pressures from parents, peers, and the media on extreme weight change behaviors among adolescent boys and girls

The current study was designed to evaluate the role of sociocultural influences over a 16 month period on strategies to lose weight, extreme weight loss strategies, and strategies to increase muscles among adolescent boys (n=344) and girls (n=246). All participants completed measures of body dissatisfaction, body image importance, strategies to lose weight, extreme weight loss strategies, and strategies to increase muscles. Measures of perceived pressure to lose weight or increase muscles from mother, father, best male friend, best female friend and the media were also evaluated. Data were gathered on three occasions, 8 months apart. The results demonstrated that boys showed a decrease in strategies to lose weight and increase muscles over time, whereas girls showed an increase. Both boys and girls showed an increase in extreme weight loss strategies with girls demonstrating a greater increase than boys. The sociocultural influences generally were perceived by girls to relate to messages to lose weight, whereas for boys they were perceived to relate to increasing muscles. Messages from parents, particularly fathers, were strong predictors of both strategies to lose weight and increase muscles among boys, with the media and best male friend playing a limited role. For girls, the strongest influences were mothers and best female friends, with few influences from fathers or the media. The results of this study are discussed in terms of the importance of the various sociocultural influences in shaping body change strategies among young adolescent boys and girls, and the implications of these findings for intervention programs for adolescents.

Role of personal factors in women's self-reported weight management behaviour.

The aim of this study was to investigate the role of motivation, anxiety and self-efficacy in self-reported behaviour that may be important for weight loss and weight maintenance. One hundred and twenty-nine females aged 18–81 years were recruited from a variety of social, sporting venues and work places within a local community. Participants completed questionnaires assessing their levels of participation and perseverance in weight management activities, their motivation levels, their anxiety levels (State Anxiety Inventory) and their levels of self-efficacy for weight management behaviours. Motivation was found to play a major role in participation in weight management activities. Anxiety and self-efficacy played no significant role. The findings are discussed in relation to previous studies, and directions for future studies are indicated. It is argued that the level of motivation is a key factor that should be taken into account for each individual engaging in women's weight management programmes, and that further research should be undertaken to identify other relevant factors.

A longitudinal investigation of the development of weight and muscle concerns among preadolescent boys

The study examined the impact of body mass index (BMI), negative affect, self-esteem, and sociocultural influences in the development of weight and muscle concerns among preadolescent boys. Body dissatisfaction, importance placed on weight and muscles, weight loss strategies, and strategies to increase muscles were evaluated. Participants were 237 boys aged between 8 and 11 years who were tested at three assessment periods 8 months apart. The main predictor of boys’ body change strategies was their perceived pressures to modify weight and muscles from parents, peers, and the media. The other main predictor of boys’ body change strategies and the sole predictor of body dissatisfaction was BMI. Self-esteem and negative affect were found to be weak and generally nonsignificant predictors of boys’ body image concerns and body change strategies. Additional studies that examine the risk and protective factors associated with boys’ weight and muscle concerns are needed to assist in the development of prevention programs for preadolescent boys.

Evaluation of a brief pilot nutrition and exercise intervention for the prevention of weight gain in general practice patients

Objective To pilot-test a brief written prescription recommending lifestyle changes delivered by general practitioners (GPs) to their patients.

Design The Active Nutrition Script (ANS) included five nutrition messages and personalised exercise advice for a healthy lifestyle and/or the prevention of weight gain. GPs were asked to administer 10 scripts over 4 weeks to 10 adult patients with a body mass index (BMI) of between 23 and 30 kg m− 2. Information recorded on the script consisted of patients' weight, height, waist circumference, gender and date of birth, type and frequency of physical activity prescribed, and the selected nutrition messages. GPs also recorded reasons for administering the script. Interviews recorded GPs views on using the script.

Setting General practices located across greater Melbourne.

Subjects and results Nineteen GPs (63% female) provided a median of nine scripts over 4 weeks. Scripts were administered to 145 patients (mean age: 54 ± 13.2 years, mean BMI: 31.7 ± 6.3 kg m− 2; 57% female), 52% of whom were classified as obese (BMI >30 kg m− 2). GPs cited ‘weight reduction’ as a reason for writing the script for 78% of patients. All interviewed GPs (90%, n = 17) indicated that the messages were clear and simple to deliver.

Conclusions GPs found the ANS provided clear nutrition messages that were simple to deliver. However, GPs administered the script to obese patients for weight loss rather than to prevent weight gain among the target group. This has important implications for future health promotion interventions designed for general practice.

The relationship between quality of life and perceived body weight an dieting history in Dutch men and women

OBJECTIVES: (1) To study the relationship between quality of life (QoL) and measured and perceived weight and dieting history in Dutch men and women; (2) to assess the effect of weight loss over a 5 y period on QoL.

DESIGN: A cross-sectional study, in a sub-sample longitudinal over 5 y.

SUBJECTS: A total of 2155 men and 2446 women, aged 20-59 and recruited from the general population from three towns in The Netherlands.

MEASUREMENTS: Body weight, height, self-administered questionnaire including questions concerning demographic variables and weight loss practices as part of the Dutch Monitoring project on Risk Factors for Chronic Disease (MORGEN). The Rand-36 questionnaire was used as the QoL measure.

RESULTS: In men, measured overweight (body mass index, BMI>25 kg=m2) was not associated with any dimension of QoL after adjustment for age, educational level and perceived overweight. Perceived overweight was related to reduced scores for general health and vitality. This relationship was independent of measured obesity. A history of repeated weight loss was associated with reduced scores for role functioning due to both physical and emotional problems. In women, measured overweight was significantly associated with lower scores for five out of eight QoL dimensions and perceived overweight with three: general health, vitality and physical functioning. A history of frequent weight loss was related to significantly reduced scores in six dimensions. However, only with history of frequent weight loss, and uniquely in women, was there a significant reduction in
scores on mental health and limited emotional role functioning. Measured and perceived overweight and frequent weight loss were all related to reduced scores for physical functioning. Longitudinal data indicate that in older women weight gain of 10% body weight or more was associated with a significant deterioration in QoL.

CONCLUSIONS: When looking at measures of QoL in relation to overweight it is important to separate the effects of perception of weight status and history of weight loss. We observed that the latter two factors were associated with reduced scores on several dimensions of QoL, particularly in women. These associations were observed to be independent of body weight. International Journal of Obesity (2001) 25, 1386 – 1392

Multiple types of dieting prospectively predict weight gain during the freshman year of college.

The freshman year of college is a period of heightened risk for weight gain. This study examined measures of restrained eating, disinhibition, and emotional eating as predictors of weight gain during the freshman year. Using Lowe's multi-factorial model of dieting, it also examined three different types of dieting as predictors of weight gain. Sixty-nine females were assessed at three points during the school year. Weight gain during the freshman year averaged 2.1 kg. None of the traditional self-report measures of restraint, disinhibition, or emotional eating were predictive of weight gain. However, both a history of weight loss dieting and weight suppression (discrepancy between highest weight ever and current weight) predicted greater weight gain, and these effects appeared to be largely independent of one another. Individuals who said they were currently dieting to lose weight gained twice as much (5.0 kg) as former dieters (2.5 kg) and three times as much as never dieters (1.6 kg), but the import of this finding was unclear because there was only a small number of current dieters (N=7). Overall the results indicate that specific subtypes of dieting predicts weight gain during the freshman year better than more global measures of restraint or overeating.

A cross-sectional study of weight-and shape-related beliefs, behaviours and concerns of north Queensland adolescents

The purpose of this study was to examine differences in weight- and shape-related beliefs, behaviours and concerns across a high school population. Data were collected by questionnaire from 902 high school students from private schools in Townsville. Concerns about weight and shape were more apparent in students from the higher school years. More girls in higher than lower school years were dissatisfied with their bodies, concerned that many parts of their bodies were too fat and more of them attempted weight loss. More boys in higher than lower school years were satisfied with their bodies but they wanted to 'bulk up'. Societal expectations of weight and shape may adversely affect both males and females but in different ways. Thus, interventions aiming to promote the maintenance of a healthy body weight may need to account for the desire of the majority of young women to be thinner, while the majority of young men would like to be larger.

Weight, physical activity and dietary behavior change in young mothers : short term results of the HeLP-her cluster randomized controlled trial

Background
Preventing weight gain rather than treating established obesity is an important economic and public health response to the rapidly increasing rates of obesity worldwide. Treatment of established obesity is complex and costly requiring multiple resources. Preventing weight gain potentially requires fewer resources to reach broad population groups, yet there is little evidence for successful interventions to prevent weight gain in the community. Women with children are an important target group because of high rates of weight gain and the potential to influence the health behaviors in family members.

Methods
The aim of this cluster randomized controlled trial was to evaluate the short term effect of a community-based self-management intervention to prevent weight gain. Two hundred and fifty mothers of young children (mean age 40 years ± 4.5, BMI 27.9 kg/m2 ± 5.6) were recruited from the community in Melbourne, Australia. The intervention group (n = 127) attended four interactive group sessions over 4 months, held in 12 local primary schools in 2006, and was compared to a group (n = 123) receiving a single, non-interactive, health education session. Data collection included self-reported weight (both groups), measured weight (intervention only), self-efficacy, dietary intake and physical activity.

Results
Mean measured weight decreased significantly in the intervention group (-0.78 kg 95% CI; -1.22 to -0.34, p < 0.001). Comparing groups using self-reported weight, both the intervention and comparison groups decreased weight, -0.75 kg (95% CI; -1.57 to 0.07, p = 0.07) and -0.72 kg (95% CI; -1.59 to 0.14 p = 0.10) respectively with no significant difference between groups (-0.03 kg, 95% CI; -1.32 to 1.26, p = 0.95). More women lost or maintained weight in the intervention group. The intervention group tended to have the greatest effect in those who were overweight at baseline and in those who weighed themselves regularly. Intervention women who rarely self-weighed gained weight (+0.07 kg) and regular self-weighers lost weight (-1.66 kg) a difference of -1.73 kg (95% CI; -3.35 to -0.11 p = 0.04). The intervention reported increased physical activity although the difference between groups did not reach significance. Both groups reported replacing high fat foods with low fat alternatives and self-efficacy deteriorated in the comparison group only.

Conclusion
Both a single health education session and interactive behavioral intervention will result in a similar weight loss in the short term, although more participants in the interactive intervention lost or maintained weight. There were small non-significant changes to physical activity and changes to fat intake specifically replacing high fat foods with low fat alternatives such as fruit and vegetables. Self-monitoring appears to enhance weight loss when part of an intervention.

Relationship of body condition score, live weight, stocking rate and grazing system to the mortality of Angora goats from hypothermia and their use in the assessment of welfare risks

Body condition scoring is widely used for sheep and cattle but the practice is included in only one Code of Practice for the welfare of goats in Australia. There is no published scientific evidence to support or defend its use in the assessment of welfare risks to farmed goats.

PROCEDURE: The significance of stocking rate, grazing system, body condition score (CS) and live weight were investigated in explaining the risk of mortality of individual and flocks of grazing Angora goats from hypothermia following a severe weather event in April. This event occurred 5 weeks after shearing the goats. Angora goats and Saxon Merino sheep were grazed alone, or mixed together in equal numbers at each of three stocking rates.

RESULTS: There was no mortality amongst Angora goats provided they grazed at the lowest stocking rate even when their CS was < or = 2.0. Mortality in flocks of Angora goats was most related to the CS reached during the preceding 2 months. For flocks of Angora goats there was no mortality at CS > or = 2.5 and mortality increased sharply at mean CS < 2.0. For individual Angora goats, mortality increased as CS declined and stocking rate and grazing combinations were additive in effect on mortality. Grazing with sheep increased mortality of Angora goats at higher stocking rates. The individual goat mortality rate was not dependent on individual plot effects suggesting that these results are applicable widely. Live weight loss was not related to mortality rates of goats once CS had been accounted for.
CONCLUSION: It was concluded that CS and stocking rate were highly significant determinants of welfare risk in Angora goats.

Arterial compliance, blood pressure, plasma leptin, and plasma lipids in women are improved with weight reduction equally with a meat-based diet and a plant-based diet

Obesity, strongly associated with the risk for coronary heart disease (CHD), is becoming increasingly prevalent. This study was designed to establish first whether systemic arterial compliance (SAC), an index of arterial function, is improved with weight loss and second, whether cardiovascular risk factors that improve with weight loss are reduced equally with lean meat or with an equivalent amount of plant protein in the diet. Thirty-six women, mostly overweight or obess, aged 40 ± 9 years, were allocated nonrandomly to a 16-week parallel-design trial of two equienergetic diets designed to lead to weight loss, with one arm of the study emphasizing red meat and the other soybeans as the major protein source. Body weight, waist and hip circumference, and plasma lipids, glucose, insulin, and leptin levels were measured, and SAC was calculated from ultrasound measurement of aortic flow velocity and aortic root driving pressure. Subjects lost weight (9% of body weight in 16 weeks) and showed decreased plasma total and low-density lipoprotein (LDL) cholesterol (12% and 14%, P < .0001, respectively), triacylglycerol (17%, P < .05), and leptin (24%, P < .01) concentrations. However, lipoprotein(a) [Lp(a)] levels did not change significantly. Mean arterial pressure (MAP) decreased 7% and SAC increased 28% (P < .001 for both). However, only the decrease in arterial pressure correlated significantly with the reduction in the waist to hip ratio (WHR), and the improvement in SAC correlated inversely with the blood pressure reduction (P < .001 for both). Further, weight loss and the metabolic benefits of weight loss occurred equally with the meat-based and plant-based diets. We conclude that moderate weight loss in women leads to a substantial reduction in the cardiovascular risk, including SAC.

A low intensity, community based lifestyle programme to prevent weight gain in women with young children : cluster randomised controlled trial

Objective To develop and evaluate the effectiveness of a community behavioural intervention to prevent weight gain and improve health related behaviours in women with young children.
Design Cluster randomised controlled trial.
Setting A community setting in urban Australia. 
Participants 250 adult women with a mean age of 40. 39 years (SD 4.77, range 25-51) and a mean body mass index of 27.82 kg/m2 (SD 5.42, range 18-47) were recruited as clusters through 12 primary (elementary) schools. Intervention Schools were randomly assigned to the intervention or the control. Mothers whose schools fell in the intervention group (n=127) attended four interactive group sessions that involved simple health messages, behaviour change strategies, and group discussion, and received monthly support using mobile telephone text messages for 12 months. The control group (n=123)
attended one non-interactive information session based on population dietary and physical activity guidelines. 
Main outcome measures The main outcome measures were weight change and difference in weight change between the intervention group and the control group at 12 months. Secondary outcomes were changes in serum concentrations of fasting lipids and glucose, and changes in dietary behaviours, physical activity, and self management behaviours.
Results All analyses were adjusted for baseline values and the possible clustering effect. Women in the control group gained weight over the 12 month study period (0.83 kg, 95% confidence interval (CI) 0.12 to 1.54), whereas those in the intervention group lost weight (−0.20 kg, −0.90 to 0.49). The difference in weight change between the intervention group and the control group at 12 months was −1.13 kg (−2.03 to −0.24 kg; P<0.05) on the basis of observed values and −1.11 kg (−2.17 to −0.04) after multiple imputation to account for possible bias created by missing values. Secondary analyses after multiple imputation showed a difference in the intervention group compared with the control group for total cholesterol concentration (−0.35 mmol/l, −0.70 to −0.001), self management behaviours (diet score 0.18, 0.13 to 0.33; physical activity score 0.24, 0.05 to 0.43), and confidence to control weight (0.40, 0.11 to 0.69). Regular self weighing was associated with weight loss in the intervention group only (−1.98 kg, −3.75 to −0.23).
Conclusions Weight gain in women with young children could be prevented using a low intensity self management intervention delivered in a community setting. Self management of health behaviours improved with the intervention. The response rate of 12%, although comparable with that in other community studies, might limit the ability to generalise to other populations.    
Trial registration Australian New Zealand Clinical Trials Registry number ACTRN12608000110381.