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Research Articles

The epidemiology of overweight and obesity: public health crisis or moral panic? 

Paul Campos Abigail Saguy Paul Ernsberger Eric Oliver Glenn Gaesser

International Journal of Epidemiology, Volume 35, Issue 1, February 2006, Pages 55–60,

https://doi.org/10.1093/ije/dyi254

 

This article evaluates four central claims made by those who are calling for intensifying the war on fat: that obesity is an epidemic; that overweight and obesity are major contributors to mortality; that higher than average adiposity is pathological and a primary direct cause of disease; and that significant long-term weight loss is both medically beneficial and a practical goal. Given the limited scientific evidence for any of these claims, we suggest that the current rhetoric about an obesity-driven health crisis is being driven more by cultural and political factors than by any threat increasing body weight may pose to public health.

Weight Science: Evaluating the Evidence for a Paradigm Shift

Linda Bacon and Lucy Aphramor

Nutrition Journal 2011 10:9

https://doi.org/10.1186/1475-2891-10-9

Randomized controlled clinical trials indicate that a HAES approach is associated with statistically and clinically relevant improvements in physiological measures (e.g., blood pressure, blood lipids), health behaviors (e.g., eating and activity habits, dietary quality), and psychosocial outcomes (such as self-esteem and body image), and that HAES achieves these health outcomes more successfully than weight loss treatment and without the contraindications associated with a weight focus.

Healthy lifestyle habits and mortality in overweight and obese individuals

Matheson EM1, King DEEverett CJ.

Journal of the American Board of Family Medicine. 2012 Jan-Feb;25(1):9-15.

doi: 10.3122/jabfm.2012.01.110164.

When stratified into normal weight, overweight, and obese groups, all groups benefited from the adoption of healthy habits, with the greatest benefit seen within the obese group. Healthy lifestyle habits are associated with a significant decrease in mortality regardless of baseline body mass index.

Impact of non-diet approaches on attitudes, behaviours, and health outcomes: a systematic review.

Clifford D1, Ozier A2, Bundros J3, Moore J3, Kreiser A2, Morris MN3.

Journal of Nutrition Education Behaviour 2015 Mar-Apr;47(2):143-55.e1.

doi: 10.1016/j.jneb.2014.12.002.

Non-diet interventions resulted in statistically significant improvements in disordered eating patterns, self-esteem, and depression. None of the interventions resulted in significant weight gain or worsening of blood pressure, blood glucose, or cholesterol, and in 2 studies biochemical measures improved significantly compared with the control or diet group. Primary limitations were inconsistent definitions of non-diet approaches and the use of different assessment instruments for measuring outcomes.

The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss.

Tracy L. Tylka,1 Rachel A. Annunziato,2 Deb Burgard,3 Sigrún Daníelsdóttir,4 Ellen Shuman,5 Chad Davis,2 and Rachel M. Calogero6

Journal of Obesity Volume 2014, Article ID 983495, 18 pages

doi: 10.1155/2014/983495

Non-diet interventions resulted in statistically significant improvements in disordered eating patterns, self-esteem, and depression. None of the interventions resulted in significant weight gain or worsening of blood pressure, blood glucose, or cholesterol, and in 2 studies biochemical measures improved significantly compared with the control or diet group. Primary limitations were inconsistent definitions of non-diet approaches and the use of different assessment instruments for measuring outcomes.

An Internet-Based Childhood Obesity Prevention Program (Time2bHealthy) for Parents of Preschool-Aged Children: Randomized Controlled Trial

Megan L Hammersley1, PhD Anthony D Okely1, EdD Marijka J Batterham2, PhD ; ​Rachel A Jones1, PhD 

Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia

Statistical Consulting Service, National Institute for Applied Statistics Research Australia, School of Mathematics and Applied Statistics, University of Wollongong, Wollongong, Australia

The trial demonstrated that a parent-focused eHealth childhood obesity prevention program can provide support to improve dietary-related practices and self-efficacy but was not successful in reducing BMI. The target sample size was not achieved, which would have affected statistical power.

References

The Evidence

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Ash, S.; Reeves, M.M.; Yeo, S.; Morrison, G.; Carey, D.; Capra, S. Effect of intensive dietetic interventions on weight and glycaemic control in overweight men with type II diabetes: A randomised trial. Int. J. Obes. 2003, 27, 797–802.

 

Clifford, D., Ozier, A., Bundros, J., Moore, J., Kreiser, A., & Morris, M (2015). Impact of non-diet approaches on attitudes, behaviors, and health outcomes: a systematic review. J Nutr Educ Behav. Mar-Apr;47(2):143-55.e1. doi: 10.1016/j.jneb.2014.12.002.

 

da Luz, FQ, Sainsbury, A, Mannan, H, Touyz, S, Mitchison, D, and Hay, P. Prevalence of obesity and comorbid eating disorder behaviors in South Australia from 1995 to 2015. International Journal of Obesity. (2017) 41. 10.1038/ijo.2017.79. 11

 

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Headland, M., Clifton, P., Carter, S., & Keogh, J. Weight-Loss Outcomes: A Systematic Review and Meta-Analysis of Intermittent Energy Restriction Trials Lasting a Minimum of 6 Months. Nutrients, 2016; 8(6), 354; doi:10.3390/nu8060354

 

Keogh, J.B.; Pedersen, E.; Petersen, K.S.; Clifton, P.M. Effects of intermittent compared to continuous energy restriction on short-term weight loss and long-term weight loss maintenance. Clin. Obes. 2014, 4, 150–156.

 

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Mensinger, JL, Calogero, RM, Stranges, S, & Tylka, T (2016). .A weight-neutral versus weight-loss approach for health promotion in women with high BMI: A randomized-controlled trial. Appetite, Oct 1;105:364-74. doi: 10.1016/j.appet.2016.06.006. Epub 2016 Jun 8.

 

Micali, N., Hagberg, K. W., Petersen, I., & Treasure, J. L. (2013). The incidence of eating disorders in the UK in 2000-2009: Findings from the General Practice Research Database. BMJ Open, 3(5), e002646.

 

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National Health and Medical Research Council (2018). Australian Code for Responsible Conduct of Research.

 

National Health & Medical Research Council. The National Statement on Ethical Conduct in Human Research (2007, updated 2018)

 

National Health and Medical Research Council. Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. Melbourne: NHMRC; 2013

 

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Royal Australian College of Physicians (RACP). Position Statement on Obesity (2018)

 

Siahpush, Tibbits, Raees, Singh, Kessler & Huang, Dieting Increases the Likelihood of Subsequent Obesity and BMI Gain: Results from a Prospective Study of an Australian National Sample.Int J Behav Med. 2015 Oct;22(5):662-71. doi: 10.1007/s12529-015-9463-5.

 

Stice E, Cameron RP, Killen JD, Hayward C, Taylor CB. Naturalistic weight-reduction efforts prospectively predict growth in relative weight and onset of obesity among female adolescents. J Consult Clin Psychol. 1999;67(6):967–974 pmid:10596518

 

Stice E, Presnell K, Shaw H, Rohde P. Psychological and behavioral risk factors for obesity onset in adolescent girls: a prospective study. J Consult Clin Psychol. 2005;73(2):195–202 pmid:15796626

 

Tracy L. Tylka, Rachel A. Annunziato, Deb Burgard, et al., “The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss,” Journal of Obesity, vol. 2014, Article ID 983495, 18 pages, 2014. https://doi.org/10.1155/2014/983495.

 

Trepanowski, JF, Kroeger, CM, Barnosky, A., Klempel, MC, Bhutani, S., Hoddy, KK., Gabel, K., Freels, S., Rigdon, J., Rood, J., Ravussin, E., & Varady, KA. Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults: A Randomized Clinical Trial. JAMA Intern Med. 2017 Jul 1;177(7):930-938. doi: 10.1001/jamainternmed.2017.0936.

 

Wing, R.R.; Jeffery, R.W. Prescribed “breaks” as a means to disrupt weight control efforts. Obes. Res. 2003, 11, 287–291.

 

Wing, R.R.; Blair, E.; Marcus, M.; Epstein, L.H.; Harvey, J. Year-long weight loss treatment for obese patients with type II diabetes: Does including an intermittent very-low-calorie diet improve outcome? Am. J. Med. 1994, 97, 354–362.

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