Factors influencing women’s choice of weight-loss diet

Women's motives for weight-loss dieting and choice of method were investigated in 151 current and 182 prospective dieters. Problematically, appearance-motivated dieters preferred ‘fad’ diets with the promise of quick results, and prospective dieters preferred marketing information supporting such diets over health advice cautioning against their use.

The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation

To assess the clinical effectiveness and cost-effectiveness of bariatric surgery for obesity. Seventeen electronic databases were searched [MEDLINE; EMBASE; PreMedline In-Process & Other Non-Indexed Citations; The Cochrane Library including the Cochrane Systematic Reviews Database, Cochrane Controlled Trials Register, DARE, NHS EED and HTA databases; Web of Knowledge Science Citation Index (SCI); Web of Knowledge ISI Proceedings; PsycInfo; CRD databases; BIOSIS; and databases listing ongoing clinical trials] from inception to August 2008. Bibliographies of related papers were assessed and experts were contacted to identify additional published and unpublished references. Two reviewers independently screened titles and abstracts for eligibility. Inclusion criteria were applied to the full text using a standard form. Interventions investigated were open and laparoscopic bariatric surgical procedures in widespread current use compared with one another and with non-surgical interventions. Population comprised adult patients with body mass index (BMI) > or = 30 and young obese people. Main outcomes were at least one of the following after at least 12 months follow-up: measures of weight change; quality of life (QoL); perioperative and postoperative mortality and morbidity; change in obesity-related comorbidities; cost-effectiveness. Studies eligible for inclusion in the systematic review for comparisons of Surgery versus Surgery were RCTs. For comparisons of Surgery versus Non-surgical procedures eligible studies were RCTs, controlled clinical trials and prospective cohort studies (with a control cohort). Studies eligible for inclusion in the systematic review of cost-effectiveness were full cost-effectiveness analyses, cost-utility analyses, cost-benefit analyses and cost-consequence analyses. One reviewer performed data extraction, which was checked by two reviewers independently. Two reviewers independently applied quality assessment criteria and differences in opinion were resolved at each stage. Studies were synthesised through a narrative review with full tabulation of the results of all included studies. In the economic model the analysis was developed for three patient populations, those with BMI > or = 40; BMI > or = 30 and < 40 with Type 2 diabetes at baseline; and BMI > or = 30 and < 35. Models were applied with assumptions on costs and comorbidity.

Which measures of adiposity are related to Australian adolescent's perception of their weight?

Aim
To determine which measurement of adiposity – standardised body mass index (BMI-z), waist circumference or body fat percentage – is most closely correlated with adolescents' weight perception and whether this differs by gender.

Methods
Weight and height (used to calculate BMI-z), waist circumference and body fat percentage were measured in 2278 adolescents aged between 12 and 16 and compared with self-reported weight status.

Results
The distribution of subjects across the three weight categories (underweight, healthy weight and overweight) differed significantly between BMI-z, waist circumference and body fat percentage (p < 0.001). BMI-z was most closely aligned with perceived weight status in boys and girls, and waist circumference was also a good correlate of weight perception in boys. Boys were more likely than girls to underestimate their weight when it was defined by BMI-z; however, girls were equally likely to underestimate their weight when it was defined by waist circumference. The majority of adolescents underestimated their weight status when it was defined by BF%.

Conclusion
BMI-z is the closest correlate of self-perceived weight status. In the absence of internationally accepted reference values for waist circumference, BMI-z is the most appropriate measure to verify weight perception.

Feasibility, acceptability and potential effectiveness of a mobile health (mHealth) weight management programme for New Zealand adults

Background
Mobile health (mHealth) behaviour change programmes use mobile phones and the internet to deliver health information and behaviour change support to participants. Such programmes offer a potentially cost-effective way to reach many individuals who do not currently access weight loss services. We developed a mHealth weight management programme using proven face-to-face behaviour change techniques and incorporating target population input. Our aim was to evaluate the feasibility, acceptability and potential effectiveness of this programme for ethnically diverse adults with a view to informing a larger trial.

Results
Fifty three adults who had a BMI of ≥25 kg/m2 and wanted to lose weight (81% female, mean age 42 years, mean BMI 35.7 kg/m2, 26% Maori, 34% Pacific) received the eight-week mHealth weight loss programme. Anthropometric measures were taken at two face-to-face assessments at baseline and 12-weeks (i.e. four weeks after cessation of intervention).

Twelve-week follow-up measurements were available for 36/53 participants (68%). Non-completers were younger and more likely to be male and of Pacific ethnicity. Thirty five participants (66%) reported reading ‘all or most’ text messages sent and 96% responded to at least one text data collection question over the eight-week active intervention period. Eighty one per cent of participants logged in to the study website at least once during the eight-week study period. In the intention-to-treat analysis, mean weight change was -1.0 kg (SD 3.1) at 12 weeks (p = 0.024) and change in BMI was -0.34 kg/m2 (SD 1.1) (p = 0.026). In the completers only analysis (n = 36), mean weight change was -1.4 kg (SD 3.6) (p = 0.023) and change in BMI was -0.50 kg/m2 (SD 1.3) (p = 0.025).

Conclusions
A mHealth weight management programme is feasible to deliver to an ethnically diverse population. Changes in body weight and BMI at 12 weeks indicate that the programme could be effective in supporting people with weight loss. However, the high dropout rate indicates a need for further improvements to the programme.