Sedentary Behaviors,Physical Activity,and Metabolic Syndrome in Middle‐aged French Subjects

Objective: To study the relationships of time spent in sedentary occupations with the National Cholesterol Education Program—defined metabolic syndrome (MS), taking into account the habitual level of physical activity (PA). Research Methods and Procedures: This was a cross‐sectional analysis in 1902 men and 1932 women 50 to 69 years of age participating in the French Supplementation with Antioxidant Vitamins and Minerals study. We assessed past‐year PA, television watching or computer use, and reading during leisure with the Modifiable Activity Questionnaire. Subjects who performed at least 150 min/wk of moderate‐intensity PA (3 to 6 metabolic equivalent tasks) or 60 min/wk of vigorous PA (>6 metabolic equivalent tasks) were considered as meeting recommended levels. Results: The frequency of most MS components increased with time spent in front of a screen and decreased with increasing PA levels. The likelihood to have MS, adjusted for age, education, and smoking, was decreased by one‐third in subjects meeting moderate PA guidelines and by two‐thirds in subjects meeting vigorous PA recommendations [odds ratio (95% CI), 0.34 (0.17 to 0.66) in women, 0.44 (0.28 to 0.68) in men] compared with those with insufficient PA. Independently of PA levels, time spent in front of a screen was positively associated with the likelihood to have the MS in women [odds ratio (95% CI), 3.30 (2.04 to 5.34)], whereas in both sexes, no association was found with time spent reading. Discussion: The relationship of the MS with a sedentary lifestyle differs according to sex and type of sedentary occupation. These results suggest the need to assess selected indicators of sedentary behavior in preventive programs.     

Prevalence,Characteristics, and Correlates of Teasing Experiences among Overweight Children vs. Non‐overweight Peers

Objective: Information regarding the prevalence, nature, sources, and psychosocial correlates of teasing was obtained for overweight (OV) children (10 to 14 years of age) vs. non‐overweight (non‐OV) peers. It was hypothesized that weight‐related teasing would be negatively correlated with self‐esteem in specific domains and with enjoyment of physical/social activities and positively correlated with loneliness, bulimic behaviors, body dissatisfaction, and enjoyment of sedentary/isolative activities. Research Methods and Procedures: Teasing experiences and psychosocial correlates were assessed among OV children from a fitness camp and a demographically similar school sample of non‐OV children. Results: Among the OV children, appearance‐related teasing was more prevalent, frequent, and upsetting, involved disparaging nicknames focusing more on weight rather than less stigmatized aspects of appearance, and more often perpetrated by peers in general rather than a specific peer. Degree of teasing within the full sample was significantly associated with higher weight concerns, more loneliness, poorer self‐perception of one's physical appearance, higher preference for sedentary/isolative activities, and lower preference for active/social activities, all but the latter association holding up above and beyond actual weight status and demographics. Among OV children, teasing was associated with bulimic behaviors. Associations with type of teasing showed specificity, with weight‐related teasing predicting weight and appearance variables and competency‐related teasing related to social domain factors. Discussion: When frequency, intensity, emotional impact, and stigmatized content are examined, findings indicate that teasing is more severe for OV children. Effective interventions are needed to help victims cope with and prevent further weight‐related teasing, which may improve peer functioning, enhance weight control efforts, and reduce risk for future eating disturbance.     

Baseline Correlates of Insulin Resistance in Inner City High‐BMI African‐American Children

To characterize the influence of diet‐, physical activity–, and self‐esteem‐related factors on insulin resistance in 8–10‐year‐old African‐American (AA) children with BMI greater than the 85th percentile who were screened to participate in a community‐based type 2 diabetes mellitus (T2DM) prevention trial. In 165 subjects, fasting glucose‐ and insulin‐derived values for homeostasis model assessment of insulin resistance (HOMA‐IR) assessed insulin resistance. Body fatness was calculated following bioelectrical impedance analysis, and fitness was measured using laps from a 20‐m shuttle run. Child questionnaires assessed physical activity, dietary habits, and self‐esteem. Pubertal staging was assessed using serum levels of sex hormones. Parent questionnaires assessed family demographics, family health, and family food and physical activity habits. Girls had significantly higher percent body fat but similar anthropometric measures compared with boys, whereas boys spent more time in high‐intensity activities than girls. Scores for self‐perceived behavior were higher for girls than for boys; and girls desired a more slender body. Girls had significantly higher insulin resistance (HOMA‐IR), compared with boys (P < 0.01). Adjusting for age, sex, pubertal stage, socioeconomic index (SE index), and family history of diabetes, multivariate regression analysis showed that children with higher waist circumference (WC) (P < 0.001) and lower Harter's scholastic competence (SC) scale (P = 0.044) had higher insulin resistance. WC and selected self‐esteem parameters predicted insulin resistance in high‐BMI AA children. The risk of T2DM may be reduced in these children by targeting these factors.     

Effects of weight status and barriers on physical activity adoption among previously inactive women

This study examined self‐reported physical activity (PA) barriers, and their effects on PA behavior change at 3 and 12 months among 280 previously inactive women enrolled in a PA promotion trial. Effect modification of baseline barriers by baseline weight status on PA behavior change was also examined. At baseline and month 12, obese women reported significantly greater PA barriers compared with normal and overweight women (P < 0.05). Individual barriers that were more likely to be elevated for obese vs. normal and overweight participants at baseline were feeling too overweight, feeling self‐conscious, reporting minor aches and pains, and lack of self‐discipline. Also, weight status moderated the effect of PA barriers on PA behavior change from baseline to month 3 (P < 0.05), but not to month 12 (P = 0.637), with obese participants reporting high barriers achieving 70 min/week fewer than those with low barriers (P < 0.05). Finally, the interaction between barriers (high vs. low) and weight status (obese vs. normal), shows PA barriers had a detrimental PA effect among obese participants that was 122.5 min/week (95% confidence interval (CI) = 15.7, 229.4; P < 0.05) lower than their effect on normal‐weight participants. These results suggest that for obese women, PA barriers have quantifiable effects on PA behavior change. This study has implications for the design of future weight loss and PA interventions, suggesting that a comprehensive assessment of PA barriers is a prerequisite for appropriate tailoring of behavioral PA interventions.     

Short‐Term Effects of Dietary Fatty Acids on Muscle Lipid Composition and Serum Acylcarnitine Profile in Human Subjects

In cultured cells, palmitic acid (PA) and oleic acid (OA) confer distinct metabolic effects, yet, unclear, is whether changes in dietary fat intake impact cellular fatty acid (FA) composition. We hypothesized that short‐term increases in dietary PA or OA would result in corresponding changes in the FA composition of skeletal muscle diacylglycerol (DAG) and triacylglycerol (TAG) and/or the specific FA selected for β‐oxidation. Healthy males (N = 12) and females (N = 12) ingested a low‐PA diet for 7 days. After fasting measurements of the serum acylcarnitine (AC) profile, subjects were randomized to either high‐PA (HI PA) or low‐PA/high‐OA (HI OA) diets. After 7 days, the fasting AC measurement was repeated and a muscle/fat biopsy obtained. FA composition of intramyocellular DAG and TAG and serum AC was measured. HI PA increased, whereas HI OA decreased, serum concentration of 16:0 AC (P < 0.001). HI OA increased 18:1 AC (P = 0.005). HI PA was associated with a higher PA/OA ratio in muscle DAG and TAG (DAG: 1.03 ± 0.24 vs. 0.46 ± 0.08, P = 0.04; TAG: 0.63 ± 0.07 vs. 0.41 ± 0.03, P = 0.01). The PA concentration in the adipose tissue DAG (µg/mg adipose tissue) was 0.17 ± 0.02 in those receiving the HI PA diet (n = 6), compared to 0.11 ± 0.02 in the HI oa group (n = 4) (P = 0.067). The relative PA concentration in muscle DAG and TAG and the serum palmitoylcarnitine concentration was higher in those fed the high‐PA diet.     

Increased Food Intake and Energy Expenditure Following Administration of Olanzapine to Healthy Men

Atypical antipsychotic medications like olanzapine (OLZ) induce weight gain and increase the risk of diabetes in patients with schizophrenia. The goal of this study was to assess potential mechanisms of OLZ‐induced weight gain and accompanying metabolic effects. Healthy, lean, male volunteers received OLZ and placebo (PBO) in a randomized, double‐blind, crossover study. In periods 1 and 2, subjects received OLZ (5 mg for 3 days then OLZ 10 mg for 12 days) or matching PBO separated by a minimum 12‐day washout. Twenty‐four hour food intake (FI), resting energy expenditure (REE), activity level, metabolic markers, and insulin sensitivity (IS) were assessed. In total, 30 subjects were enrolled and 21 completed both periods. Mean age and BMI were 27 years (range: 18–49 years) and 22.6 ± 2.2 kg/m², respectively. Relative to PBO, OLZ resulted in a 2.62 vs. 0.08 kg increase in body weight (P < 0.001) and 18% (P = 0.052 or 345 kcal) increase in FI. Excluding one subject with nausea and dizziness on the day of OLZ FI measurement, the increase in FI was 547 kcal, (P < 0.05). OLZ increased REE relative to PBO (113 kcal/day, P = 0.003). Significant increases in triglycerides, plasminogen activator inhibitor‐I (PAI‐I), leptin, and tumor necrosis factor‐α (TNF‐α) were observed. No significant differences in activity level or IS were observed. This study provides evidence that OLZ pharmacology drives the early increase in weight through increased FI, without evidence of decreased energy expenditure (EE), activity level, or short‐term perturbations in IS.     

Weight‐Bearing Physical Activity among Girls and Mothers: Relationships to Girls’ Weight Status

Objective: To assess weight‐bearing physical activity (WBPA) barriers, benefits, self‐efficacy, social influence, and behaviors [WBPA and physical activity (PA)] among girls and their mothers according to girls’ weight status (nonoverweight vs. overweight). Research Methods and Procedures: Participants were 9‐ to 11‐year‐old girls (n = 295) and their mothers who participated in the baseline assessment of a nutrition and PA intervention trial. Girls’ and mothers’ WBPA attitudes and mothers’ WBPA behaviors were self‐reported on questionnaires. Girls’ WBPA and total PA behaviors were self‐reported using a structured interview (Physical Activity Checklist Interview). Stature and weight were measured by standardized anthropometrics. Overweight status was based on BMI. Results: Compared with nonoverweight girls, overweight girls were significantly more likely to report barriers to WBPA participation and perceive social influence from family and friends to do more WBPA. They were also significantly less likely to report self‐efficacy regarding WBPA and to believe that they did enough WBPA. Compared with mothers of nonoverweight girls, mothers of overweight girls were significantly more likely to report that it is difficult to persuade their daughters to do more WBPA and significantly less likely to report that WBPA was fun for their daughters. Girls’ overweight status was not associated with girls’ reports of minutes spent per week in PA or WBPA. Discussion: The present study's findings of lower WBPA self‐efficacy, lack of enjoyment of WBPA, and higher perceived social influence to do WBPA among overweight girls suggest that efforts are needed to promote physical competencies and positive perceptions of PA among overweight girls.     

Ten months of exercise improves general and visceral adiposity, bone, and fitness in black girls

Objective: The goal of this study was to evaluate the impact of a 10‐month after‐school physical activity (PA) program on body composition and cardiovascular (CV) fitness in young black girls. Research Methods and Procedures: Subjects were 8‐ to 12‐year‐olds recruited from elementary schools. Body composition was measured using anthropometrics {waist circumference and BMI, DXA [percentage body fat (%BF)] and bone mineral density (BMD)}, and magnetic resonance imaging [visceral adipose tissue (VAT)]. CV fitness was measured using a graded treadmill test. The intervention consisted of 30 minutes homework/healthy snack time and 80 minutes PA (i.e., 25 minutes skills instruction, 35 minutes aerobic PA, and 20 minutes strengthening/stretching). Analyses were adjusted for age, baseline value of the dependent variable, and sexual maturation (pediatrician observation). Results: Mean attendance was 54%. Compared with the control group, the intervention group had a relative decrease in %BF (p < 0.0001), BMI (p < 0.01), and VAT (p < 0.01) and a relative increase in BMD (p < 0.0001) and CV fitness (p < 0.05). Higher attendance was associated with greater increases in BMD (p < 0.05) and greater decreases in %BF (p < 0.01) and BMI (p < 0.05). Higher heart rate during PA was associated with greater increases in BMD (p < 0.05) and greater decreases in %BF (p < 0.005). Discussion: An after‐school PA program can lead to beneficial changes in body composition and CV fitness in young black girls. It is noteworthy that the control and intervention groups differed in change in VAT but not waist circumference. This suggests that changes in central adiposity can occur in response to PA, even in young children, but that waist circumference may not be a good indicator of central adiposity.     

Changes in obesity-related attitudes in women seeking weight reduction

Objective: To examine changes in obesity‐related attitudes in a sample of obese women who participated in either dieting or non‐dieting interventions. Research Methods and Procedures: A total of 123 obese women were randomly assigned to one of three weight control programs: meal replacement diet, balanced deficit diet, or a non‐dieting program. (The first two groups were combined as a single dieting condition.) Participants completed questionnaires (at baseline, Week 20, and Week 40) to assess beliefs and attitudes about obesity, along with measures of self‐esteem, depression, and body image. Results: At Weeks 20 and 40, participants in the non‐dieting condition reported significantly less negativity about obesity than those in the dieting group. Women in the dieting condition did not report an increase in negative attitudes toward obesity, despite losing significantly more weight than non‐dieting participants. Both groups experienced improvements in self‐esteem, body image, and depressive symptoms. Improvement in self‐esteem was associated with a reduction in negativity about obesity and with improvements in body image. Discussion: The non‐dieting program produced greater reductions in negative attitudes toward obesity than the dieting intervention. Dieting (with successful weight loss), however, did not result in greater negativity toward obesity. Non‐dieting programs seem to be useful in obese women for improving self‐esteem, body image, and internalized negative attitudes about obesity.     

Fatness, fitness, and insulin sensitivity among 7- to 9-year-old children

Objective: The purpose of this study was to examine the relationships among fatness and aerobic fitness on indices of insulin resistance and sensitivity in children. Research Design and Methods: A total of 375 children (193 girls and 182 boys) 7 to 9 years of age were categorized by weight as normal‐weight, overweight, or obese and by aerobic fitness based on a submaximal physical working capacity test (PWC). Fasting blood glucose (GLU) and insulin (INS) were used to calculate various indices of insulin sensitivity (GLU/INS), the homeostasis model assessment (HOMA), and the quantitative insulin sensitivity check index (QUICKI). Surrogate measures of pancreatic β cell function included the insulinogenic index (INS/GLU) and the HOMA estimate of pancreatic β‐cell function (HOMA %B). Results: Insulin sensitivity and secretion variables were significantly different between the normal‐weight children and the overweight and obese subjects. Fasting insulin (FI), HOMA, QUICKI, and INS/GLU were significantly different between the overweight and obese subjects. Likewise, the high fitness group possessed a better insulin sensitivity profile. In general, the normal‐weight–high fit group possessed the best insulin sensitivity profile and the obese‐unfit group possessed the worst insulin sensitivity profile. Several significant differences existed among the six fat‐fit groups. Of particular note are the differences within BMI groups by fitness level and the comparison of values between the normal‐weight–unfit subjects and the overweight and obese subjects with high fitness. Conclusions: The results indicate that aerobic fitness attenuates the difference in insulin sensitivity within BMI categories, thus emphasizing the role of fitness even among overweight and obese children.     

An Environmental Approach to Obesity Prevention in Children: Medical College of Georgia FitKid Project Year 1 Results

Objective: To test the hypothesis that third grade children (mean age = 8.7, SD = 0.5) who attended an 8‐month after‐school program would exhibit favorable changes in body composition, cardiovascular fitness, blood pressure, total cholesterol, and high‐density lipoprotein‐cholesterol compared with children in control condition. Research Methods and Procedures: Subjects were 61% African‐American, 31% white, and 8% other racial background from 18 public schools. Sixty‐eight percent were eligible for free or reduced price lunch. Percentage body fat and bone mineral density were assessed by DXA, cardiovascular fitness by heart rate response to a step test, resting blood pressure with a Dinamap, and non‐fasting total cholesterol and high‐density lipoprotein‐cholesterol by finger stick. Data pre‐ and post‐intervention were available for 447 children. Children in the nine intervention schools who attended at least 40% of the after‐school sessions were compared with control subjects. Results: Compared with the control subjects and after controlling for race, sex, free/reduced price lunch status, and school‐level covariates, youths in the intervention group showed a relative reduction of percentage body fat [?0.76 (95% confidence interval (CI), ?1.42, ?0.09)], a greater relative gain in bone mineral density [0.008 (95% CI, 0.001, 0.005)], and a greater relative reduction in heart rate response to the step test [?4.4 (95% CI, ?8.2, 0.6)]. The other outcome variables showed non‐significant trends in favor of the intervention subjects. Discussion: These results are promising in light of the potential impact on the emerging childhood obesity epidemic. The Medical College of Georgia FitKid Project has the potential to be institutionalized because it is built on the existing infrastructure in most public schools in the U.S.     

Sedentary behavior, recreational physical activity, and 7-year weight gain among postmenopausal U.S. women

Objective: To assess the relationship among recreational physical activity (PA), non‐occupational sedentary behavior, and 7‐year weight gain among postmenopausal U.S. women 40 to 69 years old. Research Methods and Procedures: In 1992 and 1999, 18,583 healthy female participants from the Cancer Prevention Study II Nutrition Cohort completed questionnaires on anthropometric characteristics and lifestyle factors. The associations between recreational PA [in metabolic equivalent (MET) hours per week] and non‐occupational sedentary behavior (in hours per day) at baseline and risk for 7‐year weight gain (5 to 9 or ≥10 vs. ±4 pounds) were assessed using multivariate logistic regression analysis. Results: Neither PA nor sedentary behavior was associated with a 5‐ to 9‐pound weight gain. Among women who were not overweight at baseline (BMI <25.0), the odds of ≥10‐pound weight gain were 12% lower (odds ratio, 0.88; 95% confidence interval, 0.77 to 0.99) for those in the highest category of recreational PA (≥18 MET h/wk) compared with >0 to <4 MET h/wk; odds were 47% higher (odds ratio, 1.47; 95% confidence interval, 1.21 to 1.79) for non‐overweight women who reported ≥6 h/d of non‐occupational sedentary behavior compared with <3 h/d. Neither PA nor sedentary behavior were associated with risk of ≥10‐pound weight gain weight among women who were overweight at baseline (BMI ≥25.0). Discussion: Both recreational PA and non‐occupational sedentary behavior independently predicted risk of ≥10‐pound weight gain among postmenopausal women who were not overweight at baseline. Public health messages to prevent weight gain among normal‐weight postmenopausal women may need to focus on decreasing time spent in sedentary behaviors and increasing the amount of time spent on PA.     

Night Eating Syndrome Is Associated with Depression,Low Self‐Esteem,Reduced Daytime Hunger,and Less Weight Loss in Obese Outpatients

Objective: The objective of this study was to assess the relationship between the night eating syndrome (NES), measures of depression and self‐esteem, test meal intake, and weight loss in obese participants. Research Methods and Procedures: The study included 76 overweight (body mass index = 36.7 ± 6.5 SD) outpatients (53 women and 23 men; aged 43.5 ± 9.5 years) entering a weight loss program. They completed a Night Eating Questionnaire, the Zung Depression Inventory, and the Rosenberg Self‐Esteem Scale. Based on criteria by Stunkard et al. (Stunkard A, Berkowitz R, Wadden T, Tanrikut C, Reiss E, Young L. Binge eating disorder and the night eating syndrome. Int J Obes Relat Metab Disord. 1996;20:1–6), participants had NES if they reported: (1) skipping breakfast ≥4 d/wk, interpreted as morning anorexia; (2) consuming more than 50% of total daily calories after 7 pm ; and (3) difficulty falling asleep or staying asleep ≥4 d/wk. Eleven (14%) participants met the criteria for NES. After an 8‐hour fast, all participants ingested a nutritionally complete liquid meal through a straw from a large opaque cooler until extremely full. They also completed ratings of hunger and fullness before and after this meal. Results: Night eaters had higher depression (p = 0.04), lower self‐esteem (p = 0.003), and less hunger (p = 0.005), and a trend for more fullness (p = 0.06) before the daytime test meal than the others. However, there were no significant differences in test‐meal intake between groups. Nevertheless, test‐meal intake was greater later in the day only for the night eaters (p = 0.01). Over a 1‐month period, the night eaters lost less weight (4.4 ± 3.2 kg) than the others (7.3 ± 3.2 kg; p = 0.04), after controlling for body mass index. Discussion: NES is a syndrome with distinct psychopathology and increased food intake later in the day, both of which may contribute to poorer weight loss outcome. NES criteria need to be better quantified and NES deserves consideration as a diagnostic eating disorder.     

Measurement of Human Daily Physical Activity

Objectives: To validate a new device, Intelligent Device for Energy Expenditure and Activity (IDEEA), for the measurement of duration, frequency, and intensity of various types of human physical activity (PA). Research Methods and Procedures: The ability of IDEEA to identify and quantify 32 types of PA, including the most common daily exercise and nonexercise PA, was tested in 76 subjects: Subjects included males (N = 33) and females (N = 43) ranging in age from 13 to 72 years with a mean body mass index (BMI) of 24.7 kg/m² (range: 18.4 to 41.0) [43 females: 13 to 72 years old and BMI 18.4 to ～41.0 kg/m² (mean = 24.7 kg/m² ); 33 males: 15 to ～72 years old and BMI 21.0 to ～38.4 kg/m² (mean = 25.9 kg/m²)]. Postures, limb movements, and jumping were tested using a timed protocol of specific activities. Walking and running were tested using a 60‐meter track, on which subjects walked and ran at 6 self‐selected speeds. Stair climbing and descending were tested by timing subjects who climbed and descended a flight of stairs at two different speeds. Results: Correct identification rates averaged 98.9% for posture and limb movement type and 98.5% for gait type. Pooled correlation between predicted and actual speeds of walking and running was high (r = 0.986, p ≤ 0.0001). Discussion: IDEEA accurately measured duration, frequency, type, and intensity of a variety of daily PAs.     

Effects of palmitate and oleate on the respiratory quotient during acute feeding

Objective: Using tracers, we showed, over 9 hours, that palmitic acid (PA) is oxidized at a lower rate than oleic acid (OA). Our subsequent clinical trial showed that enriching the diet for 28 days with PA, relative to OA, lowered fatty acid (FA) oxidation. However, because this conclusion was based on indirect calorimetry for 7 hours after a test meal, transient differences in the kinetics of oxidation of OA and PA could explain these results. Thus, we hypothesized that increasing PA vs. OA would decrease FA oxidation during the first day of feeding the diets. Research Methods and Procedures: A double‐masked trial was conducted in 20 adults, who, after a baseline diet, were randomized to one of two experimental formula diets: high (HI) OA (PA = 1.7% kcal, OA = 31.4% kcal; N = 11) or HI PA (PA = 16.8% kcal, OA = 16.4% kcal; N = 9). Respiratory quotient (RQ) was measured over the first 14 hours of feeding the experimental diets (7:00 am to 9:00 pm ). To determine whether these subjects were representative of the subjects in the previous trial, we assessed RQ 28 days after beginning either diet. Results: During the first 14 hours of feeding the diets, time (p = 0.026) but not diet group had an effect on the difference between the RQ post‐feeding and the fasting pre‐value. However, RQ in the fed state was significantly higher in the HI PA group after 28 days of feeding. Discussion: Chronically increasing dietary PA for 28 days, but not acute meal feeding, lowers total FA oxidation.     

Factors associated with dental anxiety among older people in Britain

Objective: This paper reports on a study of denial anxiety among adults aged 60 years living independently in Britain. Design: A national cross‐sectional study carried out with the assistance of the Office for National Statistics' Omnibus Surveys in 1999. Setting: Data was collected by face to face interviews with older people in their homes Measurements : Data on dental anxiety were collected from 973 subjects by means of face to face interviews and was measured by the Dental Anxiety Scale (DAS) (Corah, 1969). In addition, data on dental service use and oral health status (self‐reported) was collected. Results: The mean DAS score was 8.4 (sd 3.5), and 13% (129) of subjects were classified as dentally anxious (DAS ≥ 13). DAS scores were associated with numerous socio‐demographic factors (P<0.01), self‐reported oral health status (P<0.01) and dental service (P<0.01) factors. A series of regression analyses revealed that dental anxiety was a significant predictor of a number of behavioural and oral health outcomes. Conclusion: One in eight older people in Britain are dentally anxious and this is associated with their use of services and oral health status (self‐reported).     

Teasing History,Onset of Obesity,Current Eating Disorder Psychopathology,Body Dissatisfaction,and Psychological Functioning in Binge Eating Disorder

Objective: The primary goal of this study was to examine associations among teasing history, onset of obesity, current eating disorder psychopathology, body dissatisfaction, and psychological functioning in women with Binge Eating Disorder (BED). Research Methods and Procedures: Subjects were 115 female adults who met DSM‐IV criteria for BED. Measurements assessing teasing history (general appearance [GAT] and weight and size [WST] teasing), current eating disorder psychopathology (binge frequency, eating restraint, and concerns regarding eating, shape, and weight), body dissatisfaction, and psychological functioning (depression and self‐esteem) were obtained. Results: History of GAT, but not WST, was associated with current weight concerns and body dissatisfaction, whereas both GAT and WST were significantly associated with current psychological functioning. Patients with earlier onset of obesity reported more WST than patients with later onset of obesity, but the groups did not differ significantly in GAT, current eating disorder psychopathology, body dissatisfaction, or psychological functioning. Obese women reported more WST than non‐obese women, but no differences in GAT or the other outcome variables were observed. Higher frequency of GAT was associated with greater binge frequency in obese women, and with greater eating restraint in non‐obese women. Discussion: Although physical appearance teasing history is not associated with variability in most eating disorder psychopathology, it is associated with related functioning, most notably body dissatisfaction, depression, and self‐esteem. Our findings also suggest that the age of onset of obesity and current body mass index status in isolation are not associated with eating psychopathology or associated psychological functioning in adult patients with BED.     

Treatment of Morbid Obesity in Low‐income Adolescents: Effects of Parental Self‐monitoring

Objective: This study examined the extent to which consistency of self‐monitoring by participants and their parents was related to weight control over an initial period of 3 months within the context of a treatment program for morbidly obese low‐income minority adolescents. Research Methods and Procedures: Eighty‐three obese adolescents (mean age, 13.0 years; 51% boys; 92% African American; mean BMI, 43.0 kg/m²; mean BMI z‐score, 6.0) and at least one parent participated in a long‐term treatment program that included a very‐low‐fat dietary focus, weekly group cognitive‐behavior therapy, monthly nutrition education classes, a 12‐week physical therapy class, and medical monitoring. Results: Participants who self‐monitored on the majority of days compared with those who did not self‐monitor at all or who self‐monitored infrequently attended more sessions and generally lost more weight over the first 3 months. Although parents signed behavioral contracts committing to self‐monitor their own eating and exercising over the first month, only 12% did so. Nonetheless, participants whose parents self‐monitored were much more likely to self‐monitor consistently and lose weight during the first 3 months. Discussion: These results indicate that self‐monitoring is a cornerstone of successful weight control even for morbidly obese low‐income minority adolescents; targeting consistency of self‐monitoring among these high‐risk weight controllers and their parents should be just as important as it is for more affluent and less overweight adolescents.     

Appearance vs. Health Reasons for Seeking Treatment Among Obese Patients with Binge Eating Disorder

Objectives : This study examined reasons for seeking treatment reported by obese patients diagnosed with binge eating disorder (BED). Research Methods and Procedures : Participants were 248 adults (58 men and 190 women) who met DSM criteria for BED. Participants were recruited through advertisements for treatment studies looking for persons who wanted to “stop binge eating and lose weight.” Patients’ reasons for seeking treatment were examined with respect to demography (gender and age), obesity (BMI and age of onset), features of eating disorders, and associated psychological functioning (depression and self‐esteem). Results : Of the 248 participants, 64% reported health concerns and 36% reported appearance concerns as their primary reason for seeking treatment. Reasons for seeking treatment did not differ significantly by gender. Patients seeking treatment because of appearance‐related reasons had lower BMIs than those reporting health‐related reasons (34.8 vs. 38.5, respectively), but they reported greater body dissatisfaction, more features of eating disorders, and lower self‐esteem. Discussion : Reasons that prompt treatment seeking among obese individuals with BED reflect meaningful patient characteristics and, therefore, warrant assessment and consideration during treatment planning. Further research is needed to determine whether reasons for treatment seeking among different obese patient groups affect treatment outcomes.     

Obese subjects respond to the stimulatory effect of the ghrelin agonist growth hormone-releasing peptide-2 on food intake

Objective: The administration of the growth hormone (GH) secretagogue GH‐releasing peptide (GHRP)‐2, like ghrelin, increases food intake (FI) in lean healthy men. The aim of this study was to investigate whether this effect occurs in obese subjects and whether it is dose‐dependent. Research Methods and Procedures: Nineteen subjects (10 lean and nine obese), all healthy and weight stable, received a double‐blind randomized subcutaneous infusion of GHRP‐2 at high dose (HD; 1 μg/kg per hour), low dose (0.1 μg/kg per hour), or placebo for 270 minutes over three study visits. Blood for hormone assays was collected through an intravenous forearm catheter. Hunger and fullness were rated on visual analog scales before and after a fixed breakfast (320 kcal at 120 minutes) and a buffet lunch at 240 minutes. Before lunch, subjects received taped instructions to eat as much as they wanted. Results: GHRP‐2 infusion significantly increased ad libitum FI in a dose‐dependent manner by 10.2 ± 3.9% at low dose (p = 0.011) and by 33.5 ± 5.8% at HD (p = 0.000) compared with placebo. Obesity status did not influence the effect of GHRP‐2 on FI. All subjects had greater ratings of appetite before but similar levels of fullness after the meal with the HD GHRP‐2. Serum GH levels increased dose dependently in all subjects. Discussion: The dual stimulatory effect of GHRP‐2 on FI and human GH is dose dependent. Obese individuals retain their ability to respond to GHRP‐2 both in terms of FI and human GH.