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Behavior Change Obesity Interventions

Kelly Harnish , BS, CHES. Behavior Change Obesity Interventions. Outline. National obesity statistics Introduction Methods Results Behavior change obesity intervention in practice: The Weight Loss Convoy Conclusion and limitations. Background. Obesity is defined as a BMI of ≥30

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Behavior Change Obesity Interventions

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  1. Kelly Harnish, BS, CHES Behavior Change Obesity Interventions

  2. Outline • National obesity statistics • Introduction • Methods • Results • Behavior change obesity intervention in practice: The Weight Loss Convoy • Conclusion and limitations

  3. Background • Obesity is defined as a BMI of ≥30 • United States obesity rate: • 32.2% among adult men • 35.5% among adult women

  4. Obesity Trends* Among U.S. AdultsBRFSS,1990, 1999, 2008 (*BMI 30, or about 30 lbs. overweight for 5’4” person) 1999 1990 2008 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

  5. Effects of Obesity

  6. Behavior change theories …relating to health maintenance, health restoration, and health improvement. Glanz, K, Rimer, BK, Marcus Lewis, F, eds. Health Behavior and Health Education: Theory, Research, and Practice. San Francisco, CA: John Wiley & Sons, Inc.; 2002. Gochman, D.S. “Health Behavior Research: Definitions and Diversity.” In D.S. Gochman (ed.), Handbook of Health Behavior Research, Vol. I. Personal and Social Determinants. New York: Plenum Press, 1997.

  7. Comparison of studies Look AHEAD (Action for Health in Diabetes) Maintenance Tailored Therapy (MTT) vs. Standard Behavior Therapy (SBT) KEY: ILI = Intensive Lifestyle Intervention DSE = Diabetes Support and Education MTT = Maintenance-Tailored Therapy SBT = Standard Behavior Therapy

  8. Methods: Look AHEAD

  9. Methods: MTT vs. SBT

  10. Results: Look AHEAD Wadden, TA, West, DS, Neiberg, RH, Wing, RR, Ryan, DH, Johnson, KC, Foreyt, JP, Hill, JO, Trence, DL, Vitolins, MZ. One-year weight losses in the look AHEAD study: Factors associated with successes. Obesity. 2009; 17(4): 713-722.

  11. Results: Look AHEAD

  12. Results: Look AHEAD

  13. Results: Look AHEAD

  14. Results: Look AHEAD

  15. Results: Look AHEAD

  16. Results: Look AHEAD

  17. Results: Look AHEAD

  18. Results: Look AHEAD

  19. Results: Maintenance Tailored Therapy vs. Standard Behavior Therapy Jeffery, RW, Levy, RL, Langer, SL, Welsh, EM, Flood, AP, Jaeb, MA, Laqua, PS, Hotop, AM, Finch, EA. A comparison of maintenance-tailored therapy (MTT) and standard behavior therapy (SBT) for the treatment of obesity. Preventive Medicine. 2009; 49, 384-389.

  20. Results: MTT vs. SBT Study

  21. Results: MTT vs. SBT Study

  22. Results: MTT vs. SBT Study

  23. Results: MTT vs. SBT Study

  24. Results: MMT vs. SBT U1: food intake U2: walking U3: meal rplcmnt U4: aerobic U5: stoplight U6: contracting

  25. Weight Loss ConvoyA convoy is a group traveling together for mutual protection and support.

  26. How this program started

  27. Workplace Overweight & Obesity Data

  28. Weight Loss Convoy Progress 608 lbs 494 lbs n = 19 adults

  29. Conclusions • Standard behavior change interventions have been consistently shown to result in a 10% decrease in body weight over 1 year. • A reduction of 5% body weight is clinically significant. • Participants’ weight losses are related to adherence to intervention recommendations. • Challenges remain in designing programs which keep patients engaged in weight management beyond 6 months. This can result in high levels of weight regain. • Tailoring interventions to the unique needs of the target populations is a model which warrants further study.

  30. Conclusions • Oldest group in ILI of the Look AHEAD study was the most compliant. • Limitation of MTT vs. SBT study was the population’s demographics—highly educated and mostly white. • Limitation to the MTT protocol: same interventionists for each randomized group—some inadvertent crossover of information between SBT and MTT.

  31. References Centers for Disease Control and Prevention: Overweight and Obesity. http://www.cdc.gov/obesity/index.html. Updated May 3, 2010. Accessed June 6, 2010. Flegal, KM, Carroll, MD, Ogden, CL, Curtin, LR. Prevalence and trends in obesity among US adults, 1999-2008. JAMA. 2010; 303(3):235-241. Gochman, D.S. “Health Behavior Research: Definitions and Diversity.” In D.S. Gochman (ed.), Handbook of Health Behavior Research, Vol. I. Personal and Social Determinants. New York: Plenum Press, 1997. Glanz, K, Rimer, BK, Marcus Lewis, F, eds. Health Behavior and Health Education: Theory, Research, and Practice. San Francisco, CA: John Wiley & Sons, Inc.; 2002. Jeffery, RW, Levy, RL, Langer, SL, Welsh, EM, Flood, AP, Jaeb, MA, Laqua, PS, Hotop, AM, Finch, EA. A comparison of maintenance-tailored therapy (MTT) and standard behavior therapy (SBT) for the treatment of obesity. Preventive Medicine. 2009; 49, 384-389. Wadden, TA, West, DS, Neiberg, RH, Wing, RR, Ryan, DH, Johnson, KC, Foreyt, JP, Hill, JO, Trence, DL, Vitolins, MZ. One-year weight losses in the look AHEAD study: Factors associated with successes. Obesity. 2009; 17(4): 713-722.

  32. Thanks & Questions

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