Objective Evaluate the association between pre-treatment and during-treatment weight change. Evaluate differences in self-regulation between those who gain weight, remain weight stable, and lose weight pre-treatment. Methods Data from the first six months of a behavioral weight loss study were used. Participants (n=283) were weighed at two assessment points (screening visit and baseline) prior to the start of treatment and at every treatment session. Participants were divided into those who gained weight, remained weight stable, or lost weight between screening visit and the first treatment session. Results Pre-treatment weight change was not significantly associated with during-treatment change. Weight change from screening visit to month six was significantly different by category, with losses of 11% and 7% for those who lost and gained weight pre-treatment respectively. Weight change from first treatment session to month six was not different by category. Poorer self-regulation was associated with pre-treatment weight gain and better self-regulation with pre-treatment weight loss. Conclusions Pre-treatment weight change may not relate to success during behavioral weight loss treatment. Researchers should carefully consider when the “baseline” assessment takes place to reduce bias introduced by weight change during pre-treatment. Poorer self-regulation may place individuals at risk for weight gain prior to treatment.

Little comparative research examines which community-based preschool intervention placements produce the best outcomes for which children with autism spectrum disorders (ASD). Autism-specific placements can provide intensive evidence-based care; however, inclusion settings provide interaction with typically developing peers, the importance of which is increasingly recognized. This study examined the association between early intervention (EI) placement in three settings (autism-only, mixed disabilities or inclusive) and cognitive outcomes upon entry into elementary school in an urban school district for 98 preschool-aged children with ASD. Initial child and demographic characteristics were similar among the three placements. Controlling for initial cognitive scores and other covariates, cognitive outcomes for children in inclusive placements were better than those of children in mixed disabilities settings. A consistent pattern emerged that suggested the particular importance of inclusive placements for children with initially greater social impairments, greater adaptive behavior impairments, and for those with at least a baseline level of language skills. Opportunities to interact with typically developing peers may be particularly beneficial for certain subgroups of young children with ASD. The results provide preliminary insight into important child characteristics to consider when parents and providers make preschool EI placement decisions.

Many racial and ethnic minority groups (minorities) are disproportionately affected by overweight and obesity; however, minorities are often under-represented in clinical trials of behavioural weight loss (BWL) treatment, potentially limiting the generalizability of these trials' conclusions. Interventions involving technology may be particularly well suited to overcoming the barriers to minority enrollment in BWL trials, such as demanding or unpredictable work schedules, caregiving responsibilities and travel burdens. Thus, this systematic review aimed to describe minority enrollment in trials utilizing technology in interventions, as well as to identify which form(s) of technology yield the highest minority enrollment. Results indicated relatively low enrollment of minorities. Trials integrating smartphone use exhibited significantly greater racial minority enrollment than trials that did not; trials with both smartphone and in-person components exhibited the highest racial minority enrollment. This review is the first to explore how the inclusion of technology in BWL trials relates to minority enrollment and can help address the need to improve minority enrollment in weight loss research.

Despite common wisdom that reducing alcohol intake will facilitate weight loss, little research has examined whether participants in behavioral weight loss treatments actually decrease their alcohol intake, or whether reduced alcohol intake relates to weight loss outcomes in this context. This study examined the relationship of alcohol use to energy intake excluding alcohol and to weight in 283 overweight and obese adults participating in a 26-session behavioral weight loss treatment. The majority of participants consumed low to moderate levels of alcohol at baseline. Participants who consumed alcohol at baseline meaningfully reduced their alcohol intake by end-of-treatment. Alcohol use did not relate to weight at baseline or end-of-treatment when controlling for relevant demographic variables, and change in alcohol use was unrelated to weight change in the overall sample during treatment. However, end-of-treatment alcohol intake did relate to end-of-treatment energy intake excluding alcohol. In addition, behavioral impulsivity and change in alcohol intake interacted to predict weight loss, such that decreases in alcohol intake were associated with greater percent weight loss at end-of-treatment for participants with higher levels of impulsivity. Alcohol consumption may lead to overeating episodes, and highly impulsive individuals may be at risk for increased energy intake during or after episodes of drinking. Therefore, the recommendation to reduce alcohol intake in the context of behavioral weight loss treatment seems warranted, particularly for individuals with high levels of impulsivity.

Objectives Eating-related disinhibition (i.e. a tendency to overeat in response to various stimuli) is associated with weight gain and poorer long-term weight loss success. Theoretically, experiential avoidance (i.e., the desire or attempts to avoid uncomfortable internal experiences), may predispose individuals to developing negative reinforcement eating expectancies (i.e., the belief that eating will help to mitigate distress), which in turn promote disinhibition. Such relationships are consistent with an acquired preparedness model, which posits that dispositions influence learning and subsequent behavior. Drawing from this framework, the current study represents the first investigation of relations between negative reinforcement eating expectancies, experiential avoidance (both general and food-specific) and disinhibited eating. In particular, the mediating role of negative reinforcement eating expectancies in the relation between experiential avoidance and disinhibited eating was examined. Method Participants (N = 107) were overweight and obese individuals presenting for behavioral weight loss treatment who completed measures of general and food-related experiential avoidance, negative reinforcement eating expectancies, and disinhibition. Results Experiential avoidance and negative reinforcement eating expectancies significantly related to disinhibition. Furthermore, the relation between experiential avoidance and disinhibition was mediated by negative reinforcement eating expectancies. Discussion The current study supports an acquired preparedness model for disinhibition, such that the relation between experiential avoidance and disinhibition is accounted for by expectations that eating will alleviate distress. Findings highlight the potential role of eating expectancies in models accounting for obesity risk, and identify negative reinforcement eating expectancies as a potential treatment target for reducing disinhibition.