Health-related quality of life and weight loss among overweight and obese U.S. adults, 2001 to 2002

Objective: To examine the prevalence and association of health‐related quality of life (HRQOL) with trying to lose weight and with weight loss practices (eating fewer calories, physical activity, and both) among overweight and obese U.S. adults ≥ 20 years of age. Research Methods and Procedures: This study used data from the 2001 to 2002 National Health and Nutrition Examination Survey, a continuous annual survey of the civilian non‐institutionalized U.S. population. This analysis included those ≥ 20 years of age with BMI ≥ 25 (n = 2578) who responded to four standard HRQOL measures that assessed general health status and recent physical health, mental health, and activity limitation. Results: Among obese men, but not women, there were significant increasing linear trends in the adjusted prevalence of trying to lose weight as physically unhealthy and activity limitation days increased. Regardless of BMI or HRQOL, reducing calories was a common weight loss practice (66% to 86%). Except for recent activity limitation, respondents with BMI ≥ 35 did not generally differ by HRQOL level in the attainment of recommended physical activity either alone or in combination with reduced calories, whereas those in the BMI 25 to 34.9 groups often differed significantly by HRQOL level. Specifically, increased unhealthy or activity limitation days were associated with reduced prevalence of attained physical activity. Discussion: Our findings indicate an association between trying to lose weight and a greater number of unhealthy days reported by obese men, suggesting that these men may be influenced by traditional clinical weight‐loss counseling that is prompted by weight and comorbidity, whereas women had a high prevalence of trying to lose weight irrespective of weight and HRQOL. Assessment of HRQOL, especially measures that evaluate physical domains, could provide subjective information to assist with weight counseling.     

Geographic Variation in the Prevalence of Obesity,Diabetes, and Obesity‐Related Behaviors**

Objective: To examine the variation in the prevalences of obesity and type 2 diabetes in weight loss counseling by health providers and in other potential obesity‐related determinants in 100 metropolitan statistical areas in the United States. Research Methods and Procedures: We performed a cross‐sectional study using data from the 2000 Behavioral Risk Factor Surveillance System, the largest telephone survey of health behaviors in the United States, of age‐adjusted prevalence of obesity, type 2 diabetes, intake of ≥five servings of fruits and vegetables per day, participation in 150 minutes of leisure‐time physical activity per week, receipt of weight management advice, and reports of trying to lose or maintain weight among men and women more than 18 years old. Results: The age‐adjusted prevalence of obesity ranged from 13.1% to 30.0% and that of type 2 diabetes from 3.3% to 9.2%. Among participants who had visited a physician for a routine checkup in the previous 12 months, 13.1% to 27.1% of all participants recalled receiving advice from a health professional about their weight, and 11.7% to 34.6% of overweight or obese participants recalled receiving advice to maintain or lose weight. Discussion: Significant differences in the prevalence of obesity and self‐reported type 2 diabetes and in medical practice patterns regarding weight management advice exist among metropolitan statistical areas. These results suggest important opportunities to investigate reasons for these variations that could potentially be used to mitigate the current epidemic of obesity and to identify areas where obesity and diabetes prevention efforts may need to be targeted.     

Weight‐Loss Practices and Asthma: Findings from the Behavioral Risk Factor Surveillance System

Objective: To describe weight‐control practices and receipt of weight‐loss advice among obese people with asthma. Research Methods and Procedures: We analyzed data from the 2000 Behavioral Risk Factor Surveillance System. Results: Among 13,953 participants with current asthma, 27.3% had a body mass index of ≥30 kg/m2. Overall, 48.1% of participants with asthma reported trying to lose weight (64.1% among overweight or obese participants and 72.9% among obese participants). Among participants with asthma who were trying to lose or maintain weight, 74.7% reported trying to reduce their energy and/or fat intake, and 57.8% reported using physical activity. Approximately 29.7% were using the recommended combination of energy and/or fat intake reduction and physical activity of ≥150 min/wk. During the 12 months before the interview, 16.2% of overweight and 44.9% of obese participants with asthma reported receiving advice to lose weight. Among obese participants receiving weight‐loss advice, 82.9% reported trying to lose weight compared to 63.8% of participants who did not receive such advice. Discussion: Health professionals can play an important role in educating their patients with asthma about the importance of weight control and assisting their overweight and obese patients in setting appropriate weight goals and helping them achieve those goals.     

Obesity and Weight Control Practices in 2000 Among Veterans Using VA Facilities

Objective: To examine obesity prevalence and weight control practices among veterans who use Department of Veterans Affairs (VA) medical facilities (VA users). Research Methods and Procedures: Data from the 2000 Behavioral Risk Factor Surveillance System, a telephone survey of 184, 450 adults, were analyzed. Outcome measures included BMI, weight control practices (the intent to manage weight, and diet and physical activity patterns), and receipt of professional weight control advice. Results: Of VA users, 44% were overweight and 25% were obese. After controlling for demographic factors, VA users were somewhat less likely to be overweight (odds ratio, 0.86; 95% confidence interval, 0.74 to 1.00) but equally likely to be obese (odds ratio, 1.08; 95% confidence interval, 0.92 to 1.27), compared with non‐VA users. Among obese VA users, 75% reported trying to lose weight, and another 17% reported trying to maintain weight. Of these, only 40% decreased both calorie and fat intake. Only 27% of obese VA users who reported increasing exercise to lose weight followed recommendations for regular and sustained physical activity. Of obese VA users, 59% were inactive or irregularly active. Only 51% of obese VA users received professional advice to lose weight. Obese VA users were more likely than obese non‐VA users to report trying to lose weight, modifying diet to lose weight by decreasing both calories and fat intake, and receiving professional weight control advice. Discussion: Interventions for weight management programs in VA facilities need to take into account the high prevalence of overweight/obesity among VA users and should emphasize effective weight control practices.     

Correlations with Self-Reported Weight Loss in Overweight U.S. Adults

The authors investigated two issues among overweight men and women in the U.S.: 1) what is the influence of the self-expressed intention to lose weight in the presence of other potential predictors of loss and 2) what are easily identifiable predictors of intentional weight loss during a 1-year recall period. The sample consisted of 1996 overweight men (body mass index (BMI ≥ 27.8 kg/m²) and 2586 overweight women (BMI ≥ 27.3 kg/m²) who answered questions regarding 1-year weight change in a Current Health Topic supplement of the population-based 1989 National Health Interview Survey. Of these overweight persons, 56.8% of men and 72.1% of women attempted to lose weight during the previous year. The most important characteristic associated with weight loss was the expressed intention itself. For any weight loss, the odds ratios (95% confidence intervals) for intention were 4.6 (3.6?5.9) for men and 3.8 (2.8?5.0) for women. Controlling for other factors reduced the odds only slightly, to 4.3 for men and 3.5 for women. Among women, older age, having a greater frequency of blood pressure checks, and being in poorer health reduced the influence of intent as a predictor of loss. To address the second objective, the identification of predictors of intentional 1-year weight loss, analysis was restricted to overweight persons who attempted to lose weight. For both sexes, statistically significant predictors (p<0.05) included never being married, smoking, higher BMI, being diabetic, and having a higher number of blood pressure checks. Being divorced or separated was predictive of weight loss in men only. Also, men were more likely to achieve weight loss than women. In conclusion, 1-year weight loss among the overweight was primarily a function of the intention to lose weight, although other factors contributed to determine whether weight loss was achieved.     

Weight-Related Attitudes and Behaviors in Fourth Grade American Indian Children

STEVENS, JUNE, MARY STORY, ALBERTA BECENTI, SIMONE A. FRENCH, JOEL GITTELSOHN, SCOTT B. GOING, JUHAERI, SARAH LEVIN, AND DAVID M. MURRAY. Obes Res. 1999;7:34–42. Objective : American Indian children have a high prevalence of obesity, yet little is known about weight-related attitudes and the prevalence of dieting in this population. This study assessed weight concerns, body size perceptions, weight reduction attempts, and weight loss methods in fourth grade American Indian children. Research Methods and Procedures : Participants (n = 304) attended one of eight schools in the Pathways Feasibility Study. Question and answer choices were read to children by trained staff, and children marked their own answers. Results : Thirty-eight percent of the children reported that they had tried to lose weight. The most common strategy for weight reduction was exercising more. Girls were more likely than boys to be dissatisfied with their body size (48% of girls vs. 34% of boys desired a slimmer body size; 22% of girls vs. 15% of boys desired a larger body size; p<0.71). Children who had tried to lose weight were more likely to indicate that the size they most desired and the most healthy size were smaller than their perceived size (p<0.71). Children who reported trying to lose weight were also more likely to want to be skinnier and to be unhappy about their weight than were children who did not report trying to lose weight (p<0.71 for both). Discussion : We conclude that weight loss attempts and weight-related concerns are prevalent in American Indian children at a young age.     

First nationwide survey of prevalence of overweight, underweight, and abdominal obesity in Iranian adults

Objective: The goal was to estimate the prevalence of overweight, obesity, underweight, and abdominal obesity among the adult population of Iran. Research Methods and Procedures: A nationwide cross‐sectional survey was conducted from December 2004 to February 2005. The selection was conducted by stratified probability cluster sampling through household family members in Iran. Weight, height, and waist circumference (WC) of 89,404 men and women 15 to 65 years of age (mean, 39.2 years) were measured. The criteria for underweight, normal‐weight, overweight, and Class I, II, and III obesity were BMI <18.5, 18.5 to 24.9, 25 to 29.9, 30 to 34.9, 35 to 39.9, and ≥40 (kg/m²), respectively. Abdominal obesity was defined as WC ≥102 cm in men and ≥88 cm in women. Results: The age‐adjusted means for BMI and WC were 24.6 kg/m² in men and 26.5 kg/m² in women and 86.6 cm in men and 89.6 cm in women, respectively. The age‐adjusted prevalence of overweight or obesity (BMI ≥25) was 42.8% in men and 57.0% in women; 11.1% of men and 25.2% of women were obese (BMI ≥30), while 6.3% of men and 5.2% of women were underweight. Age, low physical activity, low educational attainment, marriage, and residence in urban areas were strongly associated with obesity. Abdominal obesity was more common among women than men (54.5% vs. 12.9%) and greater with older age. Discussion: Excess body weight appears to be common in Iran. More women than men present with overweight and abdominal obesity. Prevention and treatment strategies are urgently needed to address the health burden of obesity.     

Prevalence of Weight Cycling and its Relation to Health Indicators in Finland

Objective: This study was performed to identify weight cyclers and to assess the prevalence of weight cycling and its relation to health indicators in Finnish adults. Research Methods and Procedures: Data for the study consisted of 3320 men and 3540 women (25 to 64 years of age). The subjects went through a health examination, and data on intentional weight losses and regains during the last 10 years were collected by a questionnaire. The subjects were divided into five groups: severe weight cyclers (weight loss ≥ 5 kg at least three times with regain), mild weight cyclers (weight loss ≥ 5 kg one to two times and regain), successful dieters (weight loss ≥ 5 kg with no regain), nonobese nondieters, and obese nondieters. Results: Approximately 7% of men and 10% of women were defined as severe weight cyclers, and an additional 11% and 19% were defined as mild weight cyclers, respectively. In men, 20% of severe weight cyclers and 15% of obese nondieters perceived their health as poor, whereas in other groups, these proportions were <10%. In both sexes, severe weight cyclers seemed to have visited a doctor more frequently than nonobese nondieters. Severe weight cyclers were also more likely to use some medication compared with other groups. Discussion: Weight cycling is more common in women than in men, and it seems to be associated with more regular visits to a doctor and poor self‐perceived health. However, because of the cross‐sectional design of the study, causal conclusions cannot be drawn.     

Weight cycling and 6-year weight change in healthy adults: The Aerobics Center Longitudinal Study

Objective: To determine the longitudinal relationship between a reported history of weight cycling and the trajectory of weight in a group of normal‐weight to obese women and men. Research Methods and Procedures: This was a clinic‐based cohort study conducted over 6 years. Subjects were healthy women (n = 141) and men (n = 797) age 20 to 78 years who completed at least four comprehensive medical exams at the Cooper Clinic (Dallas, TX) between 1987 and 2003. Weight loss history was reported, and body weight was measured at all examinations. Weight cycling status was derived from weight loss history and defined as ≥five episodes of weight loss of ≥2.3 kg/episode. Using linear mixed effects models, weight at each examination was regressed on weight cycling status separately for women and men while controlling for selected covariables. Results: Baseline BMI was 23 and 21 kg/m² among cycling and non‐cycling women and was 27 and 25 kg/m² among cycling and non‐cycling men, respectively. We observed a non‐significant difference (p = 0.09) in women by cycling status (average weight gain = 0.5 and 0.2 kg/yr among cyclers and non‐cyclers, respectively) and no difference in weight gain over time among men by cycling status (average weight gain = 0.2 kg/yr among both groups, p = 0.99). Higher baseline cardiorespiratory fitness level and increased fitness over the follow‐up were associated with attenuated weight gain in both women and men. Discussion: In healthy, middle‐aged individuals, a history of weight cycling does not seem to increase the risk of long‐term weight gain in men; however, this relation needs to be studied further in women.     

The validity of obesity based on self-reported weight and height: Implications for population studies

Objective: To validate self‐reported information on weight and height in an adult population and to find a useful algorithm to assess the prevalence of obesity based on self‐reported information. Research Methods and Procedures: This was a cross‐sectional survey consisting of 1703 participants (860 men and 843 women, 30 to 75 years old) conducted in the community of Vara, Sweden, from 2001 to 2003. Self‐reported weight, height, and corresponding BMI were compared with measured data. Obesity was defined as measured BMI ≥ 30 kg/m². Information on education, self‐rated health, smoking habits, and physical activity during leisure time was collected by a self‐administered questionnaire. Results: Mean differences between measured and self‐reported weight were 1.6 kg (95% confidence interval, 1.4; 1.8) in men and 1.8 kg (1.6; 2.0) in women (measured higher), whereas corresponding differences in height were ?0.3 cm (?0.5; ?0.2) in men and ?0.4 cm (?0.5; ?0.2) in women (measured lower). Age and body size were important factors for misreporting height, weight, and BMI in both men and women. Obesity (measured) was found in 156 men (19%) and 184 women (25%) and with self‐reported data in 114 men (14%) and 153 women (20%). For self‐reported data, the sensitivity of obesity was 70% in men and 82% in women, and when adjusted for corrected self‐reported data and age, it increased to 81% and 90%, whereas the specificity decreased from 99% in both sexes to 97% in men and 98% in women. Discussion: The prevalence of obesity based on self‐reported BMI can be estimated more accurately when using an algorithm adjusted for variables that are predictive for misreporting.     

Differences in motivations and weight loss behaviors in young adults and older adults in the national weight control registry

Objective:

The goal of this study was to compare young adults (YA) and older adults (OA) in the National Weight Control Registry on motivations for weight loss and weight‐loss behaviors.

Design and Methods:

Participants (n = 2,964, 82% female, 94% White, BMI = 24.8 ± 4.4) were divided into two age groups (18‐35 vs. 36‐50) and compared on motivations, strategies for weight loss, diet, physical activity (PA), and the three‐factor eating questionnaire.

Results:

YA were 28.6% of the sample (n = 848). YA and OA achieved similar weight losses (P = 0.38), but duration of maintenance was less in YA (43 vs. 58 months, P < 0.001). YA were more likely to cite appearance and social motivations for weight loss, were less motivated by health, and were less likely to report a medical trigger for weight loss (P's < 0.001). YA were more likely to use exercise classes and to lose weight on their own, and less likely to use a commercial program (P's < 0.001). YA reported engaging in more high‐intensity PA (P = 0.001). There were no group differences in total calories consumed (P = 0.47), or percent calories from fat (P = 0.97), alcohol (P = 0.52), or sugar‐sweetened beverages (P = 0.26).

Conclusions:

YA successful weight losers (SWL) are motivated more by appearance and social influences than OA, and physical activity appears to play an important role in their weight‐loss efforts. The differences reported by YA and OA SWL should be considered when developing weight‐loss programs for YA.     

Failure to meet weight loss expectations does not impact maintenance in successful weight losers

Objective: The objective was to examine whether having a weight loss experience that lives up to one's expectations is related to maintenance in a group of successful weight losers participating in the STOP Regain trial. Research Methods and Procedures: Participants (N = 314, 81% women, mean age, 51.3 ± 10.1 years; BMI = 28.6 ± 4.8 kg/m²) who lost ≥10% of their body weight within the past 2 years were randomly assigned to a maintenance program delivered either face‐to‐face or via the Internet or to a control group and assessed at 0, 6, 12, and 18 months. Results: At study entry, participants had lost 19% of their body weight, yet 86% of participants were currently trying to lose more weight. Further losses of 13% of body weight were needed to reach self‐selected ideal weights, with heavier participants wanting to lose more (p < 0.001). The weight loss‐related benefits participants achieved did not live up to their expectations (p ≤ 0.01). However, neither satisfaction with current weight, nor amount of further weight loss desired, nor discrepancies between actual and expected benefits predicted regain after adjusting for treatment group, gender, baseline weight, and percent weight loss before entry. Discussion: Even among very successful weight losers, expectations were not met and substantial further weight losses were desired; however, these factors were not related to subsequent weight maintenance outcomes.     

Trends and dietary determinants of overweight and obesity in a multiethnic population

Objectives : To describe trends in BMI among different ethnic groups in Hawaii and to explore the relation of nutrient and food intake with excess weight. Research Methods and Procedures : We pooled demographic, anthropometric, and nutritional data derived from a detailed diet history for 159, 683 participants of 18 population‐based epidemiological studies conducted in Hawaii over a 25‐year period. The age‐adjusted prevalence of excess weight (BMI ≥ 25 kg/m²) was estimated for 5‐year intervals. To explore dietary determinants of excess weight, we computed odds ratios using logistic regression. Results : During the study period, the prevalence of excess weight increased considerably among all ethnic groups. Native Hawaiians had the highest and Asian Americans had the lowest prevalence of excess weight at all times. Although the percentage of calories consumed from carbohydrates increased, the percentage of calories from fat decreased over time. On an individual level, fat and protein consumption predicted a higher BMI, and dietary fiber intake predicted a lower BMI. Similarly, a higher consumption of meat, poultry, and fish was related to excess weight, whereas fruit and vegetable intake were inversely associated with excess weight. After stratification by ethnicity, the associations were not materially altered among women, but carbohydrates seemed to have a stronger association with excess weight among Native Hawaiian and Japanese men than among white men. Discussion : In this large ethnically diverse population, plant‐based foods and dietary fiber emerged as a potential protective factor against excess weight regardless of ethnicity.     

Weight-Loss Strategies of Young Adults: Exercise Versus Dieting

This cross-sectional survey study examined weight control practices of 2,092 male and 1,748 female freshman students aged 18 years. For women, the desire for weight loss was observed at all levels of body weight. Most women (79%) wished to weigh less than their current weight, and 23% were following a restricted-calorie diet. In contrast, more men wished to gain (46%) rather than lose weight (32%), and only 3% were dieting at the time of the study. A comparison of weight control practices of men and women who wished to lose weight showed that women restricted calories far more frequently than did men. In contrast, although men were more likely to use exercise for weight control than were women, the differences between the sexes were small. A combined analysis of dieting and exercise behaviors showed that while men relied almost exclusively on intensive exercise as opposed to dieting, women employed exercise as well as dieting for the purpose of weight control.     

Weight Loss and Gender: An Examination of Physician Attitudes

Objective: The purpose of this study was to investigate physician attitudes toward the treatment of overweight and obese individuals and to evaluate potential gender differences in treatment recommendations. Research Methods and Procedures: A survey describing several hypothetical patients was sent to 700 randomly selected physicians; 209 (29.9%) returned the survey. Two versions of the questionnaire (one for men and one for women) described three hypothetical patients at three levels of body mass index (BMI) (32, 28, and 25 kg/m²). One‐half of the physicians received a version of the questionnaire describing the patients as women, and one‐half received a version describing the patients as men. Respondents answered questions about attitudes toward treatment and specific interventions and referrals they would view as appropriate. Results: Physicians were more likely to encourage women with a BMI of 25 kg/m² to lose weight than men with the same BMI, and indicated that they would suggest more treatment referrals for women than men. Men with a BMI of 32 kg/m² were more likely to be encouraged to lose weight than women with the identical BMI. Physicians were more likely to encourage weight loss and see treatment referrals as appropriate for patients with higher BMIs. Discussion: This study indicates that physicians treat male and female patients differently, with physicians more likely to encourage weight loss and provide referrals for women with a BMI of 25 kg/m² than for men with an identical BMI and less likely to encourage weight loss for women than men with a BMI of 32 kg/m².     

Evidence in Female Rhesus Monkeys (Macaca mulatta) that Nighttime Caloric Intake is not Associated with Weight Gain

Objective: To evaluate the hypothesis that nighttime consumption of calories leads to an increased propensity to gain weight. Research Methods and Procedures: Sixteen female rhesus monkeys (Macaca mulatta) were ovariectomized and placed on a high‐fat diet to promote weight gain, and we examined whether monkeys that ate a high percentage of calories at night were more likely to gain weight than monkeys that ate the majority of calories during the day. Results: Within 6 weeks post‐ovariectomy, calorie intake and body weight increased significantly (129 ± 14%, p = 0.04; 103 ± 0.91%, p = 0.02, respectively). Subsequent placement on high‐fat diet led to further significant increases in calorie intake and body weight (368 ± 56%, p = 0.001; 113 ± 4.0%, p = 0.03, respectively). However, there was no correlation between the increase in calorie intake and weight gain (p = 0.34). Considerable individual variation existed in the percentage of calories consumed at night (6% to 64% total daily caloric intake). However, the percentage of calorie intake occurring at night was not correlated with body weight (r = 0.04; p = 0.87) or weight gain (r = 0.07; p = 0.79) over the course of the study. Additionally, monkeys that showed the greatest nighttime calorie intake did not gain more weight (p = 0.94) than monkeys that showed the least nighttime calorie intake. Discussion: These results show that eating at night is not associated with an increased propensity to gain weight, suggesting that individuals trying to lose weight should not rely on decreasing evening calorie intake as a primary strategy for promoting weight loss.     

Prevalence of Overweight and Obesity and Weight Loss Practice among Beijing Adults, 2011

Objective

This study aims to determine the up-to-date prevalence of overweight and obesity, the distributions of body weight perception and weight loss practice in Beijing adults.

Methods

A cross-sectional study was conducted in 2011. A total of 2563 men and 4088 women aged 18–79 years from the general population were included. Data were obtained from questionnaire and physical examination.

Results

The prevalence of overweight (BMI 24–27.9 kg/m²) and obesity (BMI≥28 kg/m²) was 42.1% and 20.3% in men and 35.6% and 17.1% in women, respectively. Age was inversely associated with overweight in both sexes, and obesity in women. Education level was negatively associated with overweight and obesity in women but not in men. Only 49.1% men and 58.3% women had a correct perception of their body weight. Underestimation of body weight was more common than overestimation, especially in men, the older people, and those with low education level. The percentage of taking action to lose weight was inversely associated with men and old age, and positively associated with higher education level, higher BMI, and self-perception as “fat” (OR = 3.78 in men, OR = 2.91 in women). Only 26.1% of overweight/obese individuals took action to lose weight. The top two weight loss practices were to reduce the amount of food intake and exercise.

Conclusion

Overweight and obesity were highly prevalent with high incorrect body weight perceptions in the general adult population in Beijing. Weight loss practice was poor in overweight and obese individuals. Actions at multiple levels are needed to slow or control this overweight and obesity epidemic.     

Relationship of BMI,Waist Circumference,and Weight Change with Use of Health Services by Older Adults

Objective: To examine the relationship of BMI, waist circumference (WC), and weight change with use of health care services by older adults. Research Methods and Procedures: This was a prospective cohort study conducted from 2001 to 2003 among 2919 persons representative of the non‐institutionalized Spanish population ≥60 years of age. Analyses were performed using logistic regression, with adjustment for age, educational level, size of place of residence, tobacco use, alcohol consumption, and presence of chronic disease. Results: Obesity (BMI ≥ 30 kg/m²) and abdominal obesity (WC >102 cm in men and >88 cm in women) in 2001 were associated with greater use of certain health care services among men and women in the period 2001–2003. Compared with women with WC ≤ 88 cm, women with abdominal obesity were more likely to visit primary care physicians [odds ratio (OR): 1.36; 95% confidence limit (CL): 1.06–1.73] and receive influenza vaccination (OR: 1.30; 95% CL: 1.03–1.63). Weight gain was not associated with greater health service use by either sex, regardless of baseline BMI. Weight loss was associated with greater health service use by obese and non‐obese subjects of both sexes. In comparison with those who reported no important weight change, non‐obese women who lost weight were more likely to visit hospital specialists (OR: 1.45; 95% CL: 1.02–2.06), receive home medical visits (OR: 1.61; 95% CL: 1.06–2.45), be hospitalized (OR: 1.88; 95% CL: 1.29–2.74), and have more than one hospital admission (OR: 2.31; 95% CL: 1.19–4.47). Discussion: Obesity and weight loss are associated with greater health service use among the elderly.     

Ethnic Differences in Self‐reported and Measured Obesit

As use of self‐reported data to classify obesity continues, ethnic differences in reporting errors remain unclear. The objective of this study is to elucidate misreporting disparities between African Americans (AAs) and European Americans (EAs). The Pennington Center Longitudinal Study (PCLS) is an ongoing investigation of environmental, behavioral, and biological factors associated with obesity, diabetes, and other common diseases. Self‐reported and measured height and weight were collected during initial screening for eligibility in various studies by telephone and clinic visits. All ethnicity‐sex groups (15,656 adults aged 18–65 years, 53% obese, 34% AA, 37% men) misreported heights and weights increasingly as measured values increased (P < 0.0001). More AA vs. EA women (P < 0.001) misreported height and weight, but more EA vs. AA men misreported their weight (P < 0.02). Obesity was underestimated more in AA vs. EA women (self‐reported ? measured prevalence = ?4.0% (AA) vs. ?2.6% (EA), P < 0.0001), but less in AA vs. EA men (?3.2% (AA) vs. ?4.2% (EA), P < 0.0001)). With measured obesity prevalence equalized at 53% in all groups, the self‐reported obesity prevalence in women was 50.4% (AA) vs. 49.6% (EA), and in men 49.8% (AA) vs. 47.3 (EA). Underestimation in women was ?2.6% (AA) vs. ?3.4% (EA); in men it was ?3.2% (AA) vs. ?5.7% (EA), P < 0.003. Self‐reported height and weight portend underestimation of obesity prevalence and the effect varies by ethnicity and gender. However, comparisons depend on the true prevalence within ethnicity‐gender groups. After controlling for obesity prevalence, disparity in underestimation was greater in EA than in AA men (P < 0.003) but not women.     

Weight Control Behaviors Among Adult Men and Women: Cause for Concern?

NEUMARK-SZTAINER, DIANNE, NANCY E. SHERWOOD, SIMONE A. FRENCH, AND ROBERT W. JEFFERY. Weight control behaviors among adult men and women: cause for concern? Obes Res. Objectives To examine gender differences in weight control behaviors; their duration and the consistency of their use over a 3-year period; and variations of these behaviors by body mass index (BMI). Research Methods and Procedures The study population included 714 women and 229 men participating in a community-based weight gain prevention program who completed surveys about their weight control behaviors annually for 3 years. General dieting behaviors (e.g., current, regular, and past dieting), dietary restraint (using Restrained Eating subscale of the Three-Factor Eating Questionnaire), and specific weight control practices (e.g., increasing exercise, skipping meals, and taking laxatives) were assessed. Results Women were more likely than men to report weight control behaviors, with particularly strong associations found between gender and “history of dieting” (odds ratio = 8.1) and “participation in an organized weight loss program” (odds ratio = 11.7). Among both genders, exercise was the most frequently reported specific weight loss practice (66% of women and 53% of men), followed by decreasing fat intake (62% of women and 48% of men). The use of at least one unhealthy weight control behavior over the past year was reported by 22% of the women and 17% of the men. Gender differences were not found for duration of use of most of the specific weight control practices over the past year, or for consistency of general dieting behaviors and dietary restraint over time. Although both gender and BMI were strongly associated with dieting behaviors, interactions between gender and BMI on prevalence rates of dieting were not significant. Discussion Although weight control behaviors were more prevalent among women than men, in general, large gender differences were not found in the types of behaviors used and the duration and consistency of their use. The high percentages of adults using healthy methods of weight control was encouraging. However, there is still cause for concern, in that unhealthy weight control practices were also reported by a significant percentage of the population.