Index

A

Adult Behavior Knowledge Scale, 184

African-Americans, 51, 129-130, 214

Age

considerations in treatment strategies, 223

weight-gain patterns, 49

weight-loss patterns, 128

Alcoholism, 94-95

Anorexia, 177, 222

Assessment

body fat, 120

classification of obesity, 44-45

for drug therapy, 86

eating and dieting behaviors, 15-16, 105, 177-187, 200-204

for gastric surgery, 88-89

minimum expectations of programs, 10, 12, 103-105, 117, 140, 142, 143-144

obesity measures, 39-44

obesity-related comorbidities, 132-133

pediatric obesity, 115-116, 211-212

physical activity, 181, 187-197, 204-205

psychosocial, 15, 103, 117, 121, 133, 142, 173-184

state regulatory guidelines, 34

for treatment matching, 7, 95-98, 100, 140, 141

See also Monitoring for adverse events

B

Beck Depression Inventory, 182

Behavior modification

cognitive-behavioral strategies, 24, 84

contingency management, 83-84

group therapy, 122-123

in indicated prevention programs, 161-162

in pediatric obesity, 227

self-monitoring, 83, 124

situational factors, 7, 100

social support systems, 84

stimulus control, 83



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Weighing the Options: Criteria for Evaluating Weight-Management Programs Index A Adult Behavior Knowledge Scale, 184 African-Americans, 51, 129-130, 214 Age considerations in treatment strategies, 223 weight-gain patterns, 49 weight-loss patterns, 128 Alcoholism, 94-95 Anorexia, 177, 222 Assessment body fat, 120 classification of obesity, 44-45 for drug therapy, 86 eating and dieting behaviors, 15-16, 105, 177-187, 200-204 for gastric surgery, 88-89 minimum expectations of programs, 10, 12, 103-105, 117, 140, 142, 143-144 obesity measures, 39-44 obesity-related comorbidities, 132-133 pediatric obesity, 115-116, 211-212 physical activity, 181, 187-197, 204-205 psychosocial, 15, 103, 117, 121, 133, 142, 173-184 state regulatory guidelines, 34 for treatment matching, 7, 95-98, 100, 140, 141 See also Monitoring for adverse events B Beck Depression Inventory, 182 Behavior modification cognitive-behavioral strategies, 24, 84 contingency management, 83-84 group therapy, 122-123 in indicated prevention programs, 161-162 in pediatric obesity, 227 self-monitoring, 83, 124 situational factors, 7, 100 social support systems, 84 stimulus control, 83

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Weighing the Options: Criteria for Evaluating Weight-Management Programs stress management, 84 treatment goals, 83 Benefits of weight loss health status, 2, 55-58, 62, 63 long-term, 58-61 Binge eating, 117, 177, 179, 222 Binge Eating Scale, 179 Bioelectric impedance analysis, 40 Blood pressure, 2, 27, 38, 50-51, 97 pediatric obesity and, 219 reduction in weight loss, 56-57 response to exercise, 196-197 Body-Cathexis and Self-Cathexis Scale, 176 Body fat dietary fat and, 107-110 distribution of, 44-45 in obesity measurement, 40 pediatric assessment, 211 weight loss patterns, 120 Body mass index calculation, 40 in defining obesity, 44, 169 healthy ranges, 2, 142 indications for surgical intervention, 88, 90 mortality risk, 58-59 as outcome indicator, 120 pediatric, 211-212 as risk indicator, 43, 50, 142 tables, 41-42 in treatment matching, 95 Body Parts Satisfaction Scale, 177 Body Satisfaction Scale, 176 Body Shape Questionnaire, 176-177 Bulimia nervosa, 177, 222 C Caffeine, 122 Cancer, 38 CARDIA questionnaire, 193 Cardiovascular disorders, 2, 27, 38 benefits of weight loss in, 57 costs, 57 pediatric obesity and, 219 risk reduction program, 158 Causes of obesity, 38 biological, 53, 153 in children, 214-219, 231-232 dietary fat consumption, 107-110 environmental, 53 obesity trends and, 52 psychological dysfunction in, 174 research opportunities, 23-24, 164-165 Cerebrovascular disease, 38 Child Behavior Knowledge Scale, 184 Children and adolescents, 3 causes of obesity, 214-219, 231-232 definition of obesity, 210-212, 231 ethnicity in obesity patterns, 213-214 health risks in dieting, 221-222 health risks in obesity, 219-220 obesity treatment, 222-227, 231, 232 outcomes research, 227-230 physical activity assessment, 194-195 prevalence of obesity among, 210, 212-213 preventive interventions, 23, 159, 160, 161-162, 230-231, 233 safety precautions, 115-116 Cholesterol levels, 2 meal size and frequency and, 110 national trends, 51-52 Clinical programs characteristics, 3-4, 66 dietary program in, 132 health assessment in, 12, 15, 17, 19, 142, 143-144 outcomes evaluation in, 17, 145-146, 147 popular programs, features of, 73-80 staff qualifications, 12, 143 subcategories, 66 treatment matching in, 8, 140 very-low-calorie diets in, 82-83 Cognitive-behavioral interventions, 24, 84

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Weighing the Options: Criteria for Evaluating Weight-Management Programs Comorbidities anti-obesity drug therapy and, 86 assessment for, 10, 103-104 assessment for surgery and, 88-89 benefits of physical activity, 11 benefits of weight loss, 2, 55-58, 62, 63 definition, 44 health costs, 61 low-calorie diets and, 82 in obesity trends, 50-52 as outcome measure, 16, 131-132, 145, 146 research opportunities, 165 as target of preventive interventions, 153 treatment matching consideration, 8, 96-97, 100, 101, 140 See also specific condition Costs of obesity with cardiovascular complications, 57 with comorbid diabetes, 55 economic, 61, 163 health-related, 2, 61 insurance issues, 62 research spending, 163, 170 socioeconomic factors, 61-62 spending on weight-loss programs, 2, 27, 61 Cuban-Americans, 214 Cystic fibrosis, 164 D Definition of obesity, 40, 44-45, 169 in children, 210-212, 231 Depression, 2, 116-117 assessment for, 182 pediatric obesity and, 220 Diabetes, 2, 27, 38 benefits of weight loss, 55-56 health-related costs, 55 pediatric obesity and, 220 prevalence, 55 Dietary recommendations, 11, 105-107, 110-111, 132 Dieter's Inventory of Eating Temptations, 180 Dieting behaviors age-related patterns, 128 in children and adolescents, 219 food-intake assessment, 185-187 national trends, 1 outcomes assessment, 132, 133 psychological assessment, 179-184 self-directed programs, 27-28 sociocultural factors in, 54 See also Eating behaviors Dieting programs antidieting movement, 62-63 balanced-deficit diets, 81 in clinical settings, 132 commercial meal replacement, 54, 81 good design/practice, 10-11, 111, 142-143 health risks in, 12, 31, 116-117, 143 low-calorie diets, 81-82 medical supervision, 11, 82, 111, 143 for pediatric obesity, 221-222, 225-227 protein-sparing modified fast, 225-226 research opportunities, 165 very-low-calorie diets, 82-83, 226 Dieting Readiness and Self-Efficacy, 179-180 Dieting Readiness Scale, 180 Dieting Readiness Test, 16, 104, 133, 142, 144, 198-205 Discrimination, 2, 39, 62-63, 174 Documentation disclosure of program information, 20-22, 148-150 food intake, 186-187 outcomes, 17 Do-it-yourself programs assessment in, 15, 17, 19, 20, 103, 141, 143, 144, 145

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Weighing the Options: Criteria for Evaluating Weight-Management Programs characteristics, 3, 65 credentials of plan designer(s), 12, 143, 144-145 outcomes evaluation, 17, 146-147 popular programs, features of, 66-68 safety precautions, 12, 15, 117, 144-145 subcategories, 65 treatment matching in, 8-10, 140-141 truth and full disclosure in, 21, 148 Drop-out risk, 122-123 demographic variables, 129 Drug therapies current status, 4, 38 evaluation standards, 86-87 for hypertension, 56 individual responses in, 84, 87-88 informed consent issues, 144 outcomes, 84 over-the-counter/prescription, 54 for prevention, 167 research opportunities, 24, 165 Dual-energy X-ray absorptiometry, 40 E Eating Attitudes Test, 178 Eating behaviors assessment, 15-16, 105, 177-179, 185-187, 200-204 dietary recommendations, 11, 105-107, 110-111 eating disorders, 2, 17, 103, 117, 166, 177, 221-222 fat consumption, 107-110 gender differences, 127 meal size and frequency, 110 modification techniques, 83-84 as outcome measure, 16-17, 132 outcome predictors in, 124 in pediatric obesity, 214-215, 232-233 research opportunities, 165 trends, 53-54 weight-loss practices, 54-55 see also Dieting behaviors Eating disorders, 2 assessment for, 103, 177 binge eating, 117, 177 dieting and, 177, 221-222 outcomes assessment, 17 research opportunities, 166 Eating Disorders Examination, 178 Eating Disorders Inventory, 177 Eating Inventory/Three-Factor Eating Questionnaire, 177-178 Education as obesity outcome predictor, 130 as obesity risk factor, 47 preventive interventions, 157 public policy goals, 169 recommendations, 24, 169 school-based interventions, 228-230 Energy metabolism dietary fat in, 107-110 doubly-labeled water method of measuring, 190, 196 good dietary practice, 10-11, 142-143 measurement, 106 metabolic-equivalent units, 188-189 in obesity, 38 as outcome indicator, 120 in pediatric obesity, 214-217 perceived energy, 122 physical activity and, 114 physical activity assessment, 187-197 socioeconomic status and, 52-53 as treatment goal, 105 in weight regain, 125 Environmental factors in pediatric obesity, 217-218 in preventive interventions, 158-159 research needs, 24 in treatment matching, 7, 100 Ethical practice, 20

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Weighing the Options: Criteria for Evaluating Weight-Management Programs Evaluation of weight-loss programs conceptual basis, 5, 91-92, 135 criteria for, 5, 28, 91, 92, 137 model for, 5, 29 NIH guidelines, 34-36 obstacles to, 21 outcome measures, 16-20, 28, 118, 130-131, 135-137, 145-148 role of recommendations, 22-23, 150-151 soundness and safety criteria, 10-16, 28, 102-117, 141-145 state efforts, 30-34 technique for, in drug therapy, 86-88 treatment matching, 7-10, 94-101 truth and full disclosure, 20-22, 148-150 See also Weighing the Options model Exercise Specific Self-Efficacy Scale, 181 F Families assessment, 50, 53 obesity patterns, 230 pediatric obesity and, 217, 218, 233 in pediatric obesity treatment, 223-224, 225 preventive intervention in, 157, 161-162 Federal Trade Commission, 4, 20, 34, 138, 148 Fenfluramine, 86-87 Fluoxetine, 84, 87 Food and Drug Administration, 4, 138 Food Guide Pyramid, 11, 107, 142 Franchised programs clinical, 66 nonclinical, 65 outcomes evaluation, 17, 146 G Gall bladder disease, 12 Gallstones, 116 Gastric bypass surgery, 62, 88-89 See also Surgical interventions Gender differences obesity patterns, 49 obesity prevalence, 47 pediatric obesity, 213 race/ethnicity as obesity variable and, 128, 129 in weight-loss outcomes, 127 in weight-loss strategies, 127 General Well-Being Schedule, 14, 15, 17, 133, 142, 175, 198, 205-209 Genetics in obesity risk, 53, 152 in pediatric obesity, 217 research opportunities, 23-24 research support, 169 Glucose metabolism weight loss in diabetic patients, 55-56 Government health goals, 1, 37, 231 classification of obesity, 44 Group programs drop-out risk in, 122-123 peer influence in, 124 H Hamilton Psychiatric Rating Scale for Depression, 182 Harvard Alumni Study, 191 Health care costs diabetes mellitus, 55 obesity-related, 2, 61 very-low-calorie diets, 83 See also Costs of obesity Health care professionals in administration of very-low-calorie diets, 82 in administration of weight-loss programs, 3-4, 65, 66

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Weighing the Options: Criteria for Evaluating Weight-Management Programs knowledge of obesity, 104-105, 170 in public education effort, 169 Health risks benefits of weight loss, 55-61, 62, 63 consumer right to know, 15, 31, 144 death, 58-61, 219, 220 demographic factors, 159-160 in dieting, 12, 15, 31, 116, 143 gallstones, 116 in gastric surgery, 89 individual assessment for, 160-161 low-calorie diets, 82 obesity, 27, 37-38, 44 pediatric obesity, 219-220 in physical activity program, 113 See also Monitoring for adverse events Healthy People 2000, 37, 231 Hispanic-Americans, 130 Human genome mapping, 165 Hypertension, 2, 27, 38 benefits of weight loss in, 56-57 definition, 56 national trends, 50-51 stepped care treatment models, 97 Hyperthyroidism, 38 I Ideal body weight, 43-44 Implementation of recommendations, 22-23, 137-138, 150-151 Individual differences energy metabolism, 105 outcome prediction, 120-122 in pharmacotherapy, 84, 87-88 physical activity plan, 11-12, 83, 115 weight goals, 44 Informed consent, 144 See also Truth and disclosure in programs Insurance system, 62, 169-170 Intestinal bypass surgery, 88 L Large-Scale Integrated Motor Activity Monitor, 193 Licensure, 234-235 Life Events Checklist, 183-184 Life Experiences Survey, 183 Long-term weight management benefits of, 55, 58-61 definition, 16 drug therapy in, 87, 90 as outcome measure, 16, 118, 131, 145, 146, 147 outcome predictors, 124-126, 134 pediatric obesity and, 227-228 as program evaluation criterion, 91 program performance, disclosure of, 22, 34, 149 in stepped care model, 98 traditional conceptualization, 29 M Managed care, 62 Mazindol, 84 Menopause, 127 Metabolic-equivalent units, 188-189 Metropolitan Life Insurance Company, 43, 44 Mexican-Americans, 47, 51, 52, 130 Michigan, 20, 32-34, 148 Minnesota Leisure-Time Physical Activity questionnaire, 191, 195 Monitoring for adverse events as evaluation criterion, 16, 17, 145-148 low-calorie diets, 11, 82, 111, 143 need for, 12, 20, 115-116, 133, 143-144 psychological, 116-117

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Weighing the Options: Criteria for Evaluating Weight-Management Programs self-monitoring, 15-16, 140, 144, 145, 147 treatment matching considerations, 8, 101, 140 Mortality risk, 58-61 in gastric surgery, 89 in pediatric obesity, 219, 220 Motivation for weight loss, 27, 53 age-related patterns, 128 assessment of, 104, 142, 199-200 economic factors in, 123 gender differences, 127 as outcome predictor, 122 public policy initiatives for, 170 in treatment matching, 7, 100, 141 N National Center for Health Statistics, 43 National Health and Nutrition Examination Survey III, 46-47 National Health Survey Interview, 53-54 National Institutes of Health on choosing a program, 35-36 obesity research spending, 163 program evaluation guidelines, 20, 34-35, 148 Native American, 213 New York City regulations, 20, 30-31, 148 Nonclinical programs assessment in, 10, 12, 15, 17, 19, 20, 103, 140, 142, 143-144 characteristics, 3, 65 outcomes evaluation, 17, 65, 145-146 popular programs, features of, 68-73 safety precautions in, 12, 15, 117, 140 staff qualifications, 12, 143 treatment matching in, 8, 10, 140, 141 Nutrition in balanced-deficit diets, 81 dietary recommendations, 11, 105-107, 110-111, 132 eating behaviors assessment, 185-187 gastric surgery and, 88 in low-calorie diets, 81-82 outcome assessment, 132 in very-low-calorie diets, 82, 226 O Obesity as disease, 24, 38-39, 139 assessment, 40 definition of obesity, 40, 44-45 drug therapy and, 84, 86, 87 etiology, 38, 52, 53 as public health policy issue, 168-169 as psychopathology, 174 risk factors, 39-40 Osteoarthritis, 2, 27 benefits of weight loss, 58 health-related costs, 61 Outcome predictors age, 128 educational attainments, 130 gender, 127 in group treatment, 122-123 personal factors, 120-122 population characteristics, 126-127 process factors, 122-123 race/ethnicity, 129-130 research opportunities, 166 treatment factors, 124 of weight-loss maintenance, 17, 124-126 Outcomes evaluation consumer perspective, 19-20, 147-148 data presentation, 149-150 definitional issues, 169 drug therapy, 84-87 health as measure of, 5, 28-29, 92, 130-131

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Weighing the Options: Criteria for Evaluating Weight-Management Programs health benefits of weight loss, 55-58, 63 health practices, 16-17, 132-133, 145, 146 for indicated prevention programs, 161 long-term measures, 16, 28, 58-61, 118, 131, 145, 146, 147 NIH guidelines, 35 obesity-related comorbidities, 16, 131-132, 145, 146 obstacles to, 118-120, 169 pediatric obesity, 227-228 for preventive interventions, 152-153 in program evaluation, 16-20, 28-29, 92, 118, 130-131, 145-148 program perspective, 17-19, 145-147 program-specific, 135-137 regulatory standardization, 31 for selective prevention programs, 160 surgical interventions, 59-60, 89 for universal prevention programs, 156 Overweight, vs. obese, 40, 43, 169 P Peer influence, 124 Phentermine, 84 Physical activity assessment, 181, 187-197, 204-205 barriers to, 113-114 benefits of, 112-113 blood pressure response, 196-197 definition, 132, 143 duration and frequency, 113 gender differences, 127 as improved health practice, 16 individual planning, 11-12, 83, 115 metabolic-equivalent units, 188-189 as outcome predictor, 124, 132, 146 pediatric obesity, 215-217, 224-225 in preventing weight regain, 112, 125-126 research opportunities, 166 risk in, 113 role in weight-loss, 111, 114 in schools, 157 trends, 52-53, 54, 112 Physical Self-Efficacy Scale, 181 Prevalence of obesity, 1, 27, 46-47 age-related patterns, 49 among children and adolescents, 210, 212-213 with comorbid diabetes, 55 data sources, 46 demographic variables, 47, 128 as epidemic, 47 relevant comorbidities and, 50-52 socioeconomic factors and, 27, 47, 52-53 as target of preventive interventions, 153 trends, 37, 47-48 Preventive interventions classification of, 153, 155 cost considerations, 23, 156 current state, 29-30, 154 definition of success, 152-153, 155, 162 genetic predisposition to obesity and, 53, 152 goals of, 155 harm reduction model, 167 indicated programs, 154, 155, 160-162 as maintenance intervention, 155 outcomes evaluation, 156 pediatric obesity, 230-231, 233 pharmacotherapy in, 167 prospects for success, 152 research cycle, 153-154 research opportunities, 23, 162, 166-168 risk reduction in, 153 selective programs, 154-155, 159-160

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Weighing the Options: Criteria for Evaluating Weight-Management Programs settings for, 157-158, 168 terminology, 154-155 universal programs, 154, 155-159 Promotional claims, 4-5, 24-25, 138 consumer caution in evaluating, 36 federal regulation, 34, 138 outcomes data in, 19-20, 147 professional accreditation and, 235 state regulation, 20, 30-31, 138 Protein-sparing modified fast, 225-226 Psychological factors assessment of, 15, 103, 142, 144, 173-174 behavioral factors in dieting, assessment of, 177-179 body image assessment, 175-177 as costs of obesity, 2 in dieting behaviors, 54 distress in dieting, 116-117 in effects of dieting, assessment of, 179-184 outcome assessment, 132, 133 pediatric obesity and, 219, 220 perceived energy, 122 perceived self-efficacy as outcome predictor, 120-121 self-esteem assessment, 175 sociocultural stress factors, 128-129 in treatment matching, 7, 100 in weight regain, 17, 125, 126 Public Health Service, 170 Public opinion, bias against obese persons, 2, 39, 62-63, 174 Public policy concept of obesity in, 168-169 health care reform, 170 obesity prevention in, 158-159 obesity research in, 168, 169 recommendations, 24, 168-170 role of, 24, 168 Puerto Ricans, 214 Q Quality control, 17 Questionnaire on Eating and Weight Patterns, 178-179 Quetelet Index. See Body mass index R Race/ethnicity obesity patterns, 128, 129 as outcome predictor, 128-129 pediatric obesity patterns, 213-214 prevalence of obesity and, 47 stress as obesity factor, 128-129 Recent Life Changes Questionnaire, 183 Recommended Dietary Allowances, 107 Regain of weight in gastric surgery, 89 likelihood, 37 low-calorie diets and, 82, 83 outcome predictors, 124-126 physical activity in prevention of, 112, 125-126 psychological factors in, 125, 126 psychosocial factors in, 17 as weight-loss program outcome, 1 Regulatory oversight accreditation of services, 234-235 disclosure requirements in programs, 4-5, 20, 30-31, 148 drug therapy evaluations, 86, 90 drug therapy guidelines, 4 federal efforts, 34 historical efforts, 30 preventive interventions, 158-159 of program practice, 32-34 Research on obesity biological markers, 161 cellular processes, 169 comorbidities, 165 etiology, 164-165

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Weighing the Options: Criteria for Evaluating Weight-Management Programs gender differences, 127 goals, 2-3 longitudinal studies, 48-49 need for, 23-24, 25, 36, 48-49, 101, 170 outcome measures, 118-120 pediatric obesity, 230-233 pharmacotherapy, 24, 38, 84, 165 physical activity in weight regain, 112 preventive interventions, 153-154, 162, 166-168 public policy support, 168, 169 qualified practitioners for, 169 recommendations, 24, 163-164 reimbursement systems, 170 risk identification, 40, 43 treatment, 2-3, 165-166 Respiratory disease, 219 Risk factors body mass index, 50 body weight, 43-44 categorizing, 39-40 comorbidities, 50 distribution of body fat, 44-45 family history, 50, 53 genetics, 53, 152, 217 identification of, methodology for, 40, 43 sociocultural, 134 stress, 128-129 in treatment matching assessment, 7, 100 Rosenberg Self-Esteem Scale, 175 S Self-efficacy, 120-121, 130 assessment instruments, 179-181 Self-Efficacy for Eating Behaviors Scale, 180-181 Self-Efficacy for Exercise Behaviors Scale, 181 Self-esteem, 2, 27, 54, 174-175 antidieting movement and, 62-63 pediatric obesity, 220, 222 Severity of obesity environmental influences in, 53 national trends, 50 as target of preventive interventions, 153 Sleep apnea, 2, 27 benefits of weight loss, 57-58 definition, 57-58 identification of, 58 Smoking cessation, 48, 59 Social Readjustment Rating Scale, 183 Social support systems, 84, 182-184 Sociocultural/socioeconomic factors costs of obesity, 61-62 in obesity risk, 134, 152 as outcome predictors, 130 in pediatric obesity, 218 in physical activity patterns, 112 in prevalence of obesity, 27, 47, 52-53, 128 in self-perception of weight, 54 in treatment matching, 7, 100 Soundness and safety of programs assessment of client health, 10-11, 103-105, 142 consumer perspective, 15-16, 144-145 dieting plans, 10-11, 116-117, 142-143 good practice, 12-15, 28, 102, 115-116, 117, 143-144 physical activity plan, 11-12, 143 as program evaluation criterion, 5, 10, 28, 141-143 program perspective, 12-15, 143-144 Staff qualifications, 12, 21, 143 in clinical programs, 66 in nonclinical programs, 65 program accreditation, 234-235 Stanford Eating Behavior Questionnaire, 179 State regulation truth and full disclosure, 20, 148 of weight-loss industry practice, 30-34 Stepped care models, 97-98, 137

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Weighing the Options: Criteria for Evaluating Weight-Management Programs Steroid use, 38 Stress assessment, 182-184 socioeconomic factors in obesity and, 128-129 Surgical interventions, 39 current status, 4 informed consent issues, 144 long-term benefits, 59-60 racial/ethnic differences in outcome, 129-130 research opportunities, 24, 165 risk-benefit analysis, 88-89 third-party reimbursement, 62 types of, 88 Swedish Obesity Study, 56, 59-60, 89 T Television, 218 Tennessee Self-Concept Scale, 175 Total body electrical conductivity, 40 Treatment matching, 92 conceptual development, 94-95 consumer perspective, 8-10, 141 decision-making factors, 7, 28, 90, 100-101, 139 good practice, 137 likelihood of success in, 7-8, 140-141 mismatching, 7, 101 models, 95-98 program perspective, 8, 140-141 in regulatory guidelines, 34 research in, 166, 281 stepped care models, 97-98, 137 Treatment of obesity for children and adolescents, 222-230, 231, 232 current status, 38-39 duration and frequency, 165 energy balance in, 10-11, 105 future of, 23-25, 30, 53 goals of, 5, 20, 29, 98, 105, 131, 222-223 health as outcome measure, 28-29, 131 for hypertension, 56-57 reimbursement issues, 62, 170 research, 2-3, 165-166 sleep apnea identification in, 58 types of, 4 See also Dieting programs; Drug therapies; Surgical interventions; Weight-loss programs Trends in obesity, 156 dieting outcomes, 1, 27 government health goals and, 37 prevalence of obesity, 47-48 smoking cessation and, 48 socioeconomic factors, 52-53 weight-loss practices, 53-55 Triglyceride levels, 2, 57 Truth and disclosure in programs in do-it-yourself programs, 21, 148 long-term weight management outcomes, 22, 34, 149 NIH guidelines, 35 recommended practice, 15, 20-22, 144, 148-150 regulatory requirement, 4-5, 20, 30-31, 34 W Waist-to-hip ratio, 2, 44-45, 46, 120, 150 Walking, 11, 115 Weighing the Options model conceptual basis, 5, 135 evaluation criteria, 5, 137 implementation, 22-23, 137-138, 150-151 role of, 5, 29, 90, 135 See also Evaluation of weight-loss programs Weight cycling, 59, 60 Weight-for-height ratios, 43, 44, 211 Weight Loss Practices Survey, 54 Weight-loss programs accreditation of, 234-235 definition of success, 5, 130-131

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Weighing the Options: Criteria for Evaluating Weight-Management Programs drop-out risk, 122-123 enrollment patterns, 54 inappropriate candidates, 8, 140 minimum expectations, 10-15, 102, 117 need for scrutiny, 4, 22-23, 138-139 popular programs, features of, 66-80 prevention in, 159-160 refundable deposits, 123 spending, 2, 27, 61 types of, 3-4, 28, 64 as weight-management programs, 5, 29, 131 Weight-loss strategies categories of, 4, 28, 64, 81 in clinical programs, 66 gender differences, 127 individual practices, 53-55 racial/ethnic differences, 129-130 See also Dieting programs; Weight-loss programs Weight-management concept, 5, 55, 131 Workplace interventions, 157