Obese Patients' Perceptions of Treatment Outcomes and the Factors That Influence Them

Foster, Gary D.; Wadden, Thomas A.; Phelan, Suzanne; Sarwer, David B.; Sanderson, Rebecca Swain

doi:10.1001/archinte.161.17.2133

Cited by 163 publications

(136 citation statements)

References 27 publications

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“…As shown in previous studies, 2,3 we found that women, younger participants and those with a higher BMI expected and desired greater reductions. The finding that Hispanic participants had greater weight loss expectations and goals was surprising.…”

Section: Discussionsupporting

confidence: 86%

“…[1][2][3][4][5] The losses they expected after 1 year of behavioral 19,20 There was a small positive relationship between participants' expected and achieved weight losses at week 26. Thus, participants with higher expectations lost more weight in the first 6 months of treatment.…”

Section: Discussionmentioning

confidence: 97%

“…[1][2][3][4] Dieters maintain these expectations even when repeatedly informed that they are likely to lose only 5-15% of initial weight, 5 which is the size of the losses typically induced by current behavioral and pharmacological interventions. 6 Investigators disagree concerning the consequences of patients' unrealistic goals and expectations.…”

Section: Introductionmentioning

confidence: 99%

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The role of patients' expectations and goals in the behavioral and pharmacological treatment of obesity

et al. 2007

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Objective: To investigate weight loss expectations and goals among obese treatment seekers and to examine the relationships of these expectations and goals to treatment outcomes. Method: Participants were 180 obese men and women (age 43.8710.1 years; body mass index 37.674.2 kg/m 2 ) who received one of four-year-long treatments that combined behavioral and pharmacological methods. Before treatment, they reported the amount of weight they realistically expected to lose after 4, 12, 26 and 52 weeks of treatment, as well as their ultimate weight loss goals. Expectations and goals were compared across treatment groups and examined in relation to previous weight loss efforts, weight loss and regain in treatment, attrition, satisfaction with treatment and mood. Results: Participants in all treatment groups expected reductions at week 52 that were significantly greater than the 5-15% of initial weight they were told was realistic and significantly more than they had ever lost before. Weight loss expectations were unrelated to achieved weight loss in all groups but one, in which greater expectations were associated with greater losses. Failure to meet weight loss expectations for the first 26 weeks of treatment was related to lower satisfaction ratings, but was not related to weight regain or attrition over the next 26 weeks. Symptoms of depression were reduced from baseline, regardless of whether participants achieved or failed to achieve their expected weight losses. Conclusion: Across groups, we observed no negative consequences of having (and failing to meet) unrealistic expectations for weight loss.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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The role of patients' expectations and goals in the behavioral and pharmacological treatment of obesity

et al. 2007

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“…7,17 Although monotherapy treatment in clinical studies with various anorexigenic agents, whether small molecules or peptide hormone therapeutics, can significantly reduce weight, the overall magnitude of weight loss tends to be modest, plateauing in the single-digit range. 18 These modest effects have been attributed, in part, to the redundancy of feeding pathways. Combining agents with different anorexigenic mechanisms, such as a small molecule and a peptide hormone, may help mitigate some of the redundancies and facilitate additive reductions in food intake and body weight.…”

Section: Introductionmentioning

confidence: 99%

Antiobesity effects of the β-cell hormone amylin in combination with phentermine or sibutramine in diet-induced obese rats

Roth¹,

Trevaskis²,

Wilson³

et al. 2008

Int J Obes

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Objective: To characterize the interactive effects of amylin with phentermine or sibutramine on food intake, body weight/ composition and gene expression in diet-induced obese (DIO) rats. Design: DIO rats were intraperitoneally injected with a single dose of amylin (10 mg kg À1 ) and/or phentermine (1 mg kg À1 ) or chronically infused with amylin (100 mg kg À1 d À1 ) or vehicle with or without phentermine (0.5-10 mg kg À1 d À1 ) or sibutramine (3 mg kg À1 d À1 ) using two surgically implanted subcutaneous osmotic mini-pumps. Measurements: Twenty-four hour food intake, locomotor activity and components of meal microstructure (meal size, latency, duration and intermeal interval) were measured following acute administration (amylin, phentermine or amylin þ phentermine). Body weight and composition (for amylin and/or sibutramine or phentermine) and metabolism-related gene mRNA expression in the liver (fatty acid synthase, stearoyl-CoA desaturase-1 and carnitine palmitoyltransferase-1) and brown fat (b-adrenergic receptors and uncoupling protein-1) were measured (for amylin and/or phentermine) after sustained infusion (2 weeks). Results: Acute co-administration of amylin (10 mg kg À1 ) and phentermine (1 mg kg À1 ) reduced acute food intake (up to 19 h) more than either monotherapy. In two studies, sustained subcutaneous infusion of amylin for 2 weeks decreased cumulative food intake (22%) and vehicle-corrected body weight gain (B4-8%). Phentermine's anorexigenic (10-17%) and weightreducing effects (B0-5%) were only evident at the highest dose tested (10 mg kg À1 d À1 ). Combination of amylin (100 mg kg À1 d À1 ) and phentermine reduced food intake (30-43%), body weight (8-12%) and adiposity to a greater extent than either monotherapy. Amylin prevented phentermine-induced reductions in UCP-1 mRNA in brown adipose tissue. When amylin þ sibutramine were infused, mathematically additive decreases in food intake (up to 45%) and body weight (up to 12%) were evident. Similar to amylin þ phentermine treatment, amylin þ sibutramine mediated weight loss was attributable to significant reductions in fat mass. Conclusions: Combined treatment of DIO rats with the pancreatic b-cell hormone amylin and phentermine or sibutramine resulted in additive anorexigenic, weight-and fat-reducing effects.

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“…Evaluation of different programme has mainly focused on the patients' weight loss expectations and the results have indicated that the expectations are mostly unrealistic; more so for women than men (Foster et al, 1997;Foster et al, 2001;Linne et al, 2002).…”

mentioning

confidence: 99%

Consumer satisfaction with a weight-gain intervention programme for obese pregnant women

Claesson¹,

Josefsson²,

Cedergren³

et al. 2008

Midwifery

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Objective: To investigate women's attitudes and satisfaction with a weight gain intervention programme during pregnancy.Design: Exploratory descriptive study. Data were collected via interviews. with the treatment and would attend the programme if they were pregnant again. Most of the women stated that they had changed their eating and exercise habits during pregnancy, and almost all of them had continued with these new habits. Even though the weight gain goal of maximum 6.9 kg was reached by less than half of the participants, most of the women were satisfied with their weight gain. 71.4 % of the women participated in a aqua aerobic class. They stated that the most satisfactory experience was the exercise form and that it also was a good social experience. Setting: University hospital Participants Key conclusions and implications for practice:A pregnant woman herself must be actively involved in setting her own goals to prevent an excessive weight gain during pregnancy. Considerable effort and support must be placed on discussing strategies, pitfalls and risks. In order for the woman to maintain the change in attitude and habits, she must probably be given continuous feedback and reinforcement over the long term.

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Obese Patients' Perceptions of Treatment Outcomes and the Factors That Influence Them

Cited by 163 publications

References 27 publications

The role of patients' expectations and goals in the behavioral and pharmacological treatment of obesity

The role of patients' expectations and goals in the behavioral and pharmacological treatment of obesity

Antiobesity effects of the β-cell hormone amylin in combination with phentermine or sibutramine in diet-induced obese rats

Consumer satisfaction with a weight-gain intervention programme for obese pregnant women

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