BACKGROUND Many beliefs about obesity persist in the absence of supporting scientific evidence (presumptions); some persist despite contradicting evidence (myths). The promulgation of unsupported beliefs may yield poorly informed policy decisions, inaccurate clinical and public health recommendations, and an unproductive allocation of research resources and may divert attention away from useful, evidence-based information. METHODS Using Internet searches of popular media and scientific literature, we identified, reviewed, and classified obesity-related myths and presumptions. We also examined facts that are well supported by evidence, with an emphasis on those that have practical implications for public health, policy, or clinical recommendations. RESULTS We identified seven obesity-related myths concerning the effects of small sustained increases in energy intake or expenditure, establishment of realistic goals for weight loss, rapid weight loss, weight-loss readiness, physical-education classes, breast-feeding, and energy expended during sexual activity. We also identified six presumptions about the purported effects of regularly eating breakfast, early childhood experiences, eating fruits and vegetables, weight cycling, snacking, and the built (i.e., human-made) environment. Finally, we identified nine evidence-supported facts that are relevant for the formulation of sound public health, policy, or clinical recommendations. CONCLUSIONS False and scientifically unsupported beliefs about obesity are pervasive in both scientific literature and the popular press. (Funded by the National Institutes of Health.)

Earlier studies associated the first year of college with a dramatic increase in body weight, termed the "freshman 15". However, recent studies showed that weight gain might be smaller. The purpose of this review was to evaluate the extent of observed weight/body composition changes, including factors associated with them, among students entering university. Searches were conducted for studies examining weight/body composition changes during freshman semesters. Most studies were not comprehensive in assessing numerous potential causative factors for weight gain. Methods for assessing diet, physical activity, and behavioral factors varied among studies. Weight changes were often not quantified by measures of body composition (lean/fat) to ascertain that changes were limited just to gains in fat mass. Overall, weight changes ranged from 0.7-3.1 kg, but among individuals who gained weight, the range was narrower, 3.1-3.4 kg. There may be specific groups of students with a greater predisposition for weight gain and future research should focus on identifying those groups.

Objective Examine the relationship between 1- and 2-month weight loss (WL) and 8-year WL among participants enrolled in a lifestyle intervention. Design & Methods 2290 Look AHEAD participants (BMI: 35.65±5.93kg/m2) with type 2 diabetes received an intensive behavioral WL intervention. Results 1 and 2-month WL were associated with yearly WL through Year 8 (p’s<0.0001). At Month 1, participants losing 2-4% and >4% had 1.62 (95% CI:1.32,1.98) and 2.79 (95% CI:2.21,3.52) times higher odds of achieving a ≥5% WL at Year 4 and 1.28 (95% CI:1.05,1.58) and 1.77 (95% CI:1.40,2.24) times higher odds of achieving a ≥5% at Year 8, compared to those losing <2% initially. At Month 2, a 3-6% WL resulted in greater odds of achieving a ≥5% WL at Year 4 (OR=1.85; CI:1.48,2.32) and a >6% WL resulted in the greatest odds of achieving a ≥5% WL at Year 4 (OR=3.85; CI:3.05,4.88) and Year 8 (OR=2.28; CI:1.81,2.89), compared to those losing <3%. Differences in adherence between WL categories were observed as early as Month 2. Conclusions 1 and 2-month WL was associated with 8-year WL. Future studies should examine whether alternative treatment strategies can be employed to improve treatment outcomes among those with low initial WL.

Although the primary care setting offers an innovative option for weight loss interventions, there is minimal research examining this type of intervention with low-income minority women. Further, there is a lack of research on the long-term effects of these programs. The purpose of this investigation was to examine the weight loss maintenance of low-income African-American women participating in a primary care weight management intervention. A randomized controlled trial was conducted with overweight and obese women (N = 144) enrolled at two primary care clinics. Women received a 6-month tailored weight loss intervention delivered by their primary care physician and completed follow-up assessments 9, 12, and 18 months following randomization. The weight loss maintenance of the tailored intervention was compared to a standard care comparison group. The weight loss of intervention participants (−1.52 ± 3.72 kg) was significantly greater than that of standard care participants (0.61 ± 3.37 kg) at month 9 (P = 0.01). However, there was no difference between the groups at the 12-month or 18-month follow-ups. Participants receiving a tailored weight loss intervention from their physician were able to maintain their modest weight loss up to 3-6 months following treatment. Women demonstrated weight regain at the 18-month follow-up assessment, suggesting that more intensive follow-up in the primary care setting may be needed to obtain successful long-term weight loss maintenance.

The psychometric properties of the Beck Depression Inventory-II (BDI-II) are well established with primarily Caucasian samples. However, little is known about its reliability and validity with minority groups. This study evaluated the psychometric properties of the BDI-II in a sample of low-income African American medical outpatients (N=220). Reliability was demonstrated with high internal consistency (.90) and good item-total intercorrelations. Criterion-related validity was demonstrated. A confirmatory factor analysis supported a hierarchical factor structure in which the BDI-II reflected 2 first-order factors (Cognitive and Somatic) that in turn reflected a second-order factor (Depression). These results are consistent with previous findings and thus support the use of the BDI-II in assessing depressive symptoms for African American patients in a medical setting.

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Surprisingly few studies have explored the intuitive connection between self-control and weight loss. We tracked participants’ diet, exercise and weight loss during a 12-week weight loss program. Participants higher in self-control weighed less and reported exercising more than their lower self-control counterparts at baseline. Independent of baseline differences, individuals high in dispositional self-control ate fewer calories overall and fewer calories from fat, burned marginally more calories through exercise, and lost more weight during the program than did those lower in self-control. These data suggest that trait self-control is, indeed, an important predictor of health behaviors.

Weight losses in lifestyle interventions are variable, yet prediction of long-term success is difficult. Objective We examined the utility of using various weight loss thresholds in the first 2 months of treatment for predicting 1-year outcomes. Design and Methods Participants included 2327 adults with type 2 diabetes (BMI:35.8±6.0) randomized to the intensive lifestyle intervention (ILI) of the Look AHEAD trial. ILI included weekly behavioral sessions designed to increase physical activity and reduce caloric intake. 1-month, 2-month, and 1-year weight changes were calculated. Results Participants failing to achieve a ≥2% weight loss at Month 1 were 5.6 (95% CI:4.5,7.0) times more likely to also not achieve a ≥10% weight loss at Year 1, compared to those losing ≥2% initially. These odds were increased to 11.6 (95% CI:8.6,15.6) when using a 3% weight loss threshold at Month 2. Only 15.2% and 8.2% of individuals failing to achieve the ≥2% and ≥3% thresholds at Months 1 and 2 respectively, go on to achieve a ≥10% weight loss at Year 1. Conclusions Given the association between initial and 1-year weight loss, the first few months of treatment may be an opportune time to identify those who are unsuccessful and utilize rescue efforts.