No abstract

Diabetes is a chronic illness with significant health consequences, especially for those who are unable to adhere to the complex treatment regimen. Self-management tasks such as regular medication and insulin use, frequent blood sugar checks, strict diet management, and consistent exercise can be quite challenging. Mobile technologies, specifically mobile applications (apps), present a unique opportunity to help patients improve adherence to these behaviors. The availability of commercial diabetes self-management apps is increasing rapidly, making it difficult for patients and providers to stay informed about app options. A number of reviews have described commercial app technology and use for patients with diabetes. The aims of this article are to summarize the results and themes of those reviews, to review outcomes of apps described in the research literature, and to identify areas for further consideration in the use of mobile apps for diabetes self-management.

Recent findings have strengthened the case for food addiction. These findings may serve to validate the perception of food addiction in patients and inform psychoeducational, cognitive-behavioral, and/or pharmacological treatment for chronic food cravings, compulsive overeating, and binge eating that may represent a phenotype of obesity. Screening for food addiction has the potential to identify people with eating difficulties that seriously compromise weight management efforts. Future research should include a focus on human food addiction research; evaluating the impact of treatment on underlying neurochemistry; and prevention or reversal of food addiction in humans.

Exercise counseling with a prescription for walking at either a HardI or a HiF produced significant long-term improvements in cardiorespiratory fitness. More exercise or the combination of HardI plus HiF exercise may provide additional benefits, including larger fitness changes and improved lipid profiles.

Objective This study assessed the utility of the Binge Eating Scale (BES) as a measure of binge eating disorder (BED) in patients seeking bariatric surgery by a) determining the optimal BES cut-score for predicting BED, b) calculating concordance statistics, and c) determining the predictive value of each BES item. Method 480 patients presented for a psychological evaluation prior to Roux-en-Y gastric bypass surgery. The BES and the SCID semi-structured interview for BED were administered. Results ROC curve analyses identified an optimal BES cut-score of 17, which correctly classified 78% of patients with BED. A cut-score of 27 improved this statistic, but increased the number of false negatives. Discriminant function analyses revealed that nearly all BES items significantly predicted BED. Discussion The BES is a valid screener of BED in a bariatric surgery seeking population. Clarifying the screening process for binge eating can help improve the assessment and treatment of patients presenting for bariatric surgery.

Severe obesity (body mass index ≥40 kg/m) is a chronic disease that is associated with significantly increased risk of serious and chronic health problems as well as impaired quality of life. For those with severe obesity, bariatric surgery is the most effective treatment for significant and long-term weight loss and resolution of comorbid medical conditions, particularly diabetes. Long-term success is thought to depend to some degree on the patient's ability to adhere to a complex set of behaviors, including regular attendance at follow up appointments and following stringent dietary, exercise, and vitamin recommendations. Here, we summarize the current research on behavioral adherence in patients with severe obesity presenting for bariatric surgery and we highlight challenges and make recommendations for improved self-management before and after surgery.

Background Screening for binge eating prior to bariatric surgery is a component of recommended clinical practice for bariatric surgery candidates. The Binge Eating Scale (BES) is one of the most commonly used self-report measures of eating behaviors in pre-surgical evaluations, yet the factor structure of this measure has not been evaluated in this population. Objectives The aims of this study were to report the means, standard deviations, and reliability of the BES for patients seeking bariatric surgery; to evaluate the two-factor structure of the BES using confirmatory factor analysis; and to investigate the association between the BES and its factors with surgical weight loss. Setting Academic Medical Center. Methods 530 patients completed the BES as a component of their psychological evaluation prior to undergoing Roux-en-Y gastric bypass surgery. Results Approximately one-third of patients reported at least mild to moderate binge eating, with 9% of patients reporting severe binge eating on the BES. The BES demonstrated good internal consistency. Results of a confirmatory factor analysis indicated that a two-factor structure, consisting of Feelings/Cognitions related to binge eating and Behavioral manifestations of binge eating, was the best fit to the data. Non-significant correlations were found between the BES and its two factors with short-term post-surgical weight loss. Conclusions The BES measures two aspects of binge eating in bariatric surgery candidates, feelings/cognitions and behavioral manifestations of binge eating. Consideration of these factors in patients presenting for bariatric surgery may allow for a more detailed understanding of binge eating in this population.

No abstract