Objective: To evaluate the efficacy of a treatment programme for patients with fibromyalgia (FM) based on self management, using pool exercises and education. Methods: Randomised controlled trial with a 6 month follow up to evaluate an outpatient multidisciplinary programme; 164 patients with FM were allocated to an immediate 6 week programme (n = 84) or to a waiting list control group (n = 80). The main outcomes were changes in quality of life, functional consequences, patient satisfaction and pain, using a combination of patient questionnaires and clinical examinations. The questionnaires included the Fibromyalgia Impact Questionnaire (FIQ), Psychological General Well-Being (PGWB) index, regional pain score diagrams, and patient satisfaction measures. Results: 61 participants in the treatment group and 68 controls completed the programme and 6 month follow up examinations. Six months after programme completion, significant improvements in quality of life and functional consequences of FM were seen in the treatment group as compared with the controls and as measured by scores on both the FIQ (total score p = 0.025; fatigue p = 0.003; depression p = 0.031) and PGWB (total score p = 0.032; anxiety p = 0.011; vitality p = 0.013,). All four major areas of patient satisfaction showed greater improvement in the treatment than the control groups; between-group differences were statistically significant for ''control of symptoms'', ''psychosocial factors'', and ''physical therapy'' No change in pain was seen. Conclusion: A 6 week self management based programme of pool exercises and education can improve the quality of life of patients with FM and their satisfaction with treatment. These improvements are sustained for at least 6 months after programme completion.

Objective and methods: The desired weights and dieting behavior of a sample of 1,053 women aged 30–74 years in the general population of Geneva, Switzerland, were explored by means of a questionnaire. Multivariate analyses of variance were performed. Results: Twenty‐five percent of the women were satisfied with their weight, whereas 71% wanted to be thinner, although 73% of them were at normal weight. Among women older than 65 years, 62% wanted to lose weight, 65% of them being at normal weight. For women wanting to lose weight, mean desired weight loss amounted to 9% of their current weight. Weight dissatisfaction increased with higher education (p < .001), and with increasing current weight (p < .001). Within the last 5 years, 42% of the women had dieted for weight control, including 67% at normal weight. Thirty‐one percent of the women older than 65 years had also dieted, 62% of them being at normal weight. Discussion: A majority of middle‐age and ageing women in this general population sample expressed dissatisfaction about their weight. Many attempted dieting, even when they were at normal weight. Considering the vulnerability of the elderly to nutritional deficiencies, dieting to lose weight in normal weight ageing women should be discouraged or closely monitored. © 1998 John Wiley & Sons, Inc. Int J Eat Disord 23:287–294, 1998.

The goal of this study was to evaluate the effect of diets that were equally low in energy but widely different in relative amounts of fat and carbohydrate on body weight during a 6-wk period of hospitalization. Consequently, 43 adult, obese persons were randomly assigned to receive diets containing 4.2 MJ/d (1000 kcal/d) composed of either 32% protein, 15% carbohydrate, and 53% fat, or 29% protein, 45% carbohydrate, and 26% fat. There was no significant difference in the amount of weight loss in response to diets containing either 15% (8.9 +/- 0.6 kg) or 45% (7.5 +/- 0.5 kg) carbohydrate. Furthermore, significant decreases in total body fat and waist-to-hip circumference were seen in both groups, and the magnitude of the changes did not vary as a function of diet composition. Fasting plasma glucose, insulin, cholesterol, and triacylglycerol concentrations decreased significantly in patients eating low-energy diets that contained 15% carbohydrate, but neither plasma insulin nor triacylglycerol concentrations fell significantly in response to the higher-carbohydrate diet. The results of this study showed that it was energy intake, not nutrient composition, that determined weight loss in response to low-energy diets over a short time period.

HRQoL is globally preserved in older adults in Switzerland, even if substantial impairment is reported in very old age affecting mainly functional health dimensions. Anxiety/Depression and Pain/Discomfort did not appear to be affected by age; high rates of difficulties were reported for Pain/Discomfort but not for Anxiety/Depression.

As a whole, these results show the efficacy of an interdisciplinary approach to the long-term treatment of morbidly obese patients. It is likely that an outpatient psychological follow-up would have improved this therapeutic success.