Determinants of weight loss maintenance: a systematic review. Perceived personal, social and environmental barriers to weight maintenance among young women: A community survey Effects of workplace-based dietary and/or physical activity interventions for weight management targeting healthcare professionals: a systematic review of randomised controlled trials Football Fans in Training: the development and optimization of an intervention delivered through professional sports clubs to help men lose weight, become more active and adopt healthier eating habits Physical Activity Predicts Weight Loss Following Gastric Bypass Surgery: Findings from a Support Group Survey Coronary Heart Disease Risk Reduction Intervention Among Overweight Smokers with a Psychotic Disorder: Pilot Trial Drivers for successful long-term lifestyle change, the role of e-health: a qualitative interview study Effectiveness of parent‐centred interventions for the prevention and treatment of childhood overweight and obesity in community settings: a systematic review The influence of a behavioral weight management program on disordered eating attitudes and behaviors in children with overweight. The effect of weight management interventions that include a diet component on weight‐related outcomes in pregnant and postpartum women: a systematic review protocol The impact of self-efficacy on behavior change and weight change among overweight participants in a weight loss trial. Prevalence of attempting weight loss and strategies for controlling weight. An evidence-based gamified mHealth intervention for overweight young adults with maladaptive eating habits: study protocol for a randomized controlled trial The National Weight Control Registry: is it useful in helping deal with our obesity epidemic? Energy balance-related behaviours associated with overweight and obesity in preschool children: a systematic review of prospective studies. Short- and long-term eating habit modification predicts weight change in overweight, postmenopausal women: results from the WOMAN study. Who in America Is Trying To Lose Weight? The relationship between parent and child self-reported adherence and weight loss. Selected nutritional habits of teenagers associated with overweight and obesity Behavioral weight control for overweight adolescents initiated in primary care. A family-based intervention targeting parents of preschool children with overweight and obesity: conceptual framework and study design of LOOPS- Lund overweight and obesity preschool study Effectiveness of a universal parental support programme to promote health behaviours and prevent overweight and obesity in 6-year-old children in disadvantaged areas, the Healthy School Start Study II, a cluster-randomised controlled trial Systematic review of interventions in the management of overweight and obese children which include a dietary component
BACKGROUND Discerning the determinants of weight loss maintenance is important in the planning of future interventions and policies regarding overweight and obesity . We have therefore systematic ally synthesized recent literature on determinants of weight loss maintenance for individuals with overweight and obesity . METHODS With the use of the Preferred Reporting Items for Systematic Review s and Meta-Analyses statement , prospect i ve studies were identified from search es in PubMed and PsycINFO from 2006 to 2016 . We included articles investigating adults with overweight and obesity undergoing weight loss without surgery or medication .  Included articles were scored on their method ological quality , and a best- evidence synthesis was applied to summarize the results . RESULTS Our search result ed in 8,222 articles of which 67 articles were selected . In total , 124 determinants were identified of which 5 were demographic , 59 were behavioural , 51 were psychological/cognitive and 9 were social and physical environmental determinants . We found consistent evidence that demographic determinants were not predictive of weight loss maintenance . Behavioural and cognitive determinants that promote a reduction in energy intake , an increase in energy expenditure and monitoring of this balance are predictive determinants . CONCLUSION This review identifies key determinants in weight loss maintenance . However , more research regarding cognitive and environmental determinants of weight loss maintenance is needed to advance our knowledge on determinants of weight loss maintenance Background Young women are a group at high risk of weight gain . This study examined a range of perceived personal , social and environmental barriers to physical activity and healthy eating for weight maintenance among young women , and how these varied by socioeconomic status ( SES ) , overweight status and domestic situation . Methods In October-December 2001 , a total of 445 women aged 18–32 years , selected r and omly from the Australian electoral roll , completed a mailed self-report survey that included questions on 11 barriers to physical activity and 11 barriers to healthy eating ( relating to personal , social and environmental factors ) . Height , weight and socio-demographic details were also obtained . Statistical analyses were conducted mid-2003 . Results The most common perceived barriers to physical activity and healthy eating encountered by young women were related to motivation , time and cost .  Women with children were particularly likely to report a lack of social support as an important barrier to physical activity , and lack of social support and time as important barriers to healthy eating . Perceived barriers did not differ by SES or overweight status . Conclusions Health promotion strategies aim ed at preventing weight gain should take into account the specific perceived barriers to physical activity and healthy eating faced by women in this age group , particularly lack of motivation , lack of time , and cost . Strategies targeting perceived lack of time and lack of social support are particularly required for young women with children Background The prevalence of overweight and obesity is high amongst healthcare professionals and there is growing interest in delivering weight loss interventions in the workplace . We conducted a systematic review to ( i ) examine the effectiveness of workplace-based diet and /or physical activity interventions aim ed at healthcare professionals and to ( ii ) identify and describe key components of effective interventions . Seven electronic data bases were systematic ally search ed . Results Thirteen r and omised controlled trials met the inclusion criteria , of which seven had data available for meta- analysis . Where meta- analysis was possible , studies were grouped according to length of follow-up ( < 12 months and ≥12 months ) and behavioural target ( diet only , physical activity only or diet and physical activity ) , with outcome data pooled using a weighted r and om effects model . Nine studies reported statistically significant ( between-group ) differences . Four studies reported being informed by a behaviour change theory . Meta- analysis of all trials reporting weight data demonstrated healthcare professionals allocated to dietary and physical activity interventions lost significantly more body weight ( −3.95 Kg , [ 95 % CI −4.96 to- 2.95 Kg ] ) than controls up to 12 months follow up . Conclusions Workplace diet and /or physical activity interventions targeting healthcare professionals are limited in number and are heterogeneous . To improve the evidence base , we recommend additional evaluations of theory-based interventions and adequate reporting of intervention content Background The prevalence of obesity in men is rising , but they are less likely than women to engage in existing weight management programmes . The potential of professional sports club setting s to engage men in health promotion activities is being increasingly recognised . This paper describes the development and optimization of the  Football Fans in Training ( FFIT ) programme , which aims to help overweight men ( many of them football supporters ) lose weight through becoming more active and adopting healthier eating habits . Methods The MRC Framework for the design and evaluation of complex interventions was used to guide programme development in two phases . In Phase 1 , a multidisciplinary working group developed the pilot programme ( p-FFIT ) and used a scoping review to summarize previous research and identify the target population . Phase 2 involved a process evaluation of p-FFIT  in 11 Scottish Premier League ( SPL ) clubs . Participant and coach feedback , focus group discussion s and interviews explored the utility/acceptability of programme components and suggestions for changes . Programme session observations identified examples of good practice and problems/issues with delivery . Together , these findings informed redevelopment of the optimized programme ( FFIT ) , whose components were mapped onto specific behaviour change techniques using an evidence -based taxonomy . Results p-FFIT comprised 12 , weekly , gender-sensitised , group-based weight management classroom and ‘ pitch-side ’ physical activity sessions . These in-stadia sessions were complemented by an incremental , pedometer-based walking programme . p-FFIT was targeted at men aged 35 - 65 years with body mass index ≥ 27 kg/m2 . Phase 2 demonstrated that participants in p-FFIT were enthusiastic about both the classroom and physical activity components , and valued the camaraderie and peer-support offered by the programme . Coaches appreciated the simplicity of the key healthy eating and physical activity messages . Suggestions for improvements that were incorporated into the optimized FFIT programme included : more varied in-stadia physical activity with football-related components ; post-programme weight management support ( emails and a reunion session ) ; and additional training for coaches in SMART goal setting and the pedometer-based walking programme . Conclusions The Football Fans in Training programme is highly acceptable to participants and SPL coaches , and is appropriate for evaluation in a r and omised controlled trial Background Patient adherence to recommended eating and physical activity behaviors is considered important to weight loss outcomes following gastric bypass surgery , but there has been little systematic research in this area to investigate behavioral predictors of weight loss . Method We developed a measure of postsurgical behaviors , the bariatric surgery self-management question naire ( BSSQ ) . A survey was conducted of 200 patients attending postsurgical support groups ( mean time since surgery 14 months , mean age 40 years , 85 % female , presurgical weight 150 kg ) . Patients completed the BSSQ  and measures of treatment regimen distress , perceived benefits of weight loss , and weight-related physical symptoms . Results Mean BSSQ adherence was in the 70 % range , with subscale scores varying considerably . Distress levels associated with the new lifestyle were consistently low ( ≈20 % ) and perceived benefits of weight loss were high early on and maintained consistently ( 70–90 % ) . A final predictive model showed premorbid weight , time since surgery , and BSSQ physical activity subscale were significant predictors of weight loss , accounting for 73 % of variance .  Conclusions Physical activity adherence was the sole significant behavioral predictor of weight loss , although maladaptive dietary habits and patient selection issues were identified for future research . It will be important to replicate the current study in prospect i ve , longitudinal studies with representative patient cohorts . A challenge for research ers will be to develop novel , intensive recruiting and retention strategies to allow closer examination of these issues Objective : The aim of the present pilot study was to test the feasibility and short-term impact of a multi-component risk factor intervention for reducing ( i ) coronary heart disease ( CHD ) risk ; ( ii ) smoking ; and ( iii ) weight among smokers with psychosis . Secondary dependent variables included physical activity , unhealthy eating , substance use , psychiatric symptomatology , treatment retention , general functioning , and quality of life . Method : This was a feasibility study utilizing a pre – post-treatment design with  no control group ( n=43 ) . All participants provided written informed consent and were assessed before treatment and again a mean of 19.6weeks later . The treatment consisted of nine individual 1h sessions of motivational interviewing and cognitive behaviour therapy plus nicotine replacement therapy , in addition to treatment as usual . Research assistants who had not been involved in the delivery of the treatment programme conducted post-treatment assessment s. Results : The intervention was associated with significant reductions in CHD risk scores , smoking and weight . A significant improvement was also reported in level of moderate physical activity , and a small change in the unhealthy eating index was reported . No improvement in biological measures ( cholesterol and blood pressure ) was evident . Conclusions : A multi-component CHD risk factor intervention among smokers with psychosis appears to be feasible and effective in the short-term . A r and omized controlled trial replicating and extending these findings is warranted Objectives Assisting patients in lifestyle change using collaborative e-health tools can be an efficient treatment for non-communicable diseases like diabetes , cardiovascular disease and chronic obstructive lung disease that are caused or aggravated by unhealthy living in the form of unhealthy diet , physical inactivity or tobacco smoking . In a prospect i ve pilot study , we tested an online collaborative e-health tool in general practice . The aim of this study was to identify drivers of importance for long-term personal lifestyle changes from a patient perspective when using a collaborative e-health tool , including the support of peers and healthcare professionals . Setting General practice clinics in the Region of Southern Denmark . Participants 10 overweight patients who had previously successfully used a hybrid online collaborative e-health tool with both face-to-face and online consultations  to lose weight . Results The main themes identified were facilitators , barriers and support from family and peers . Establishment of a trustworthy relationship with the healthcare professionals was of paramount importance . It was important for the patients to monitor the measurable outcomes with realistic goals and feedback from a trusted person . Often , significant life events were identified as catalysts for successful long-term lifestyle changes . Dominant barriers to change were perception of insurmountable obstacles , experience of lack of self-efficacy and excess eating of high-calorie food . Finally , experiencing of trustworthy person-to-person forums , need for acknowledgement from referent others and support from family and peers were important drivers for long-term lifestyle change . Conclusion The most important driver in long-term weight loss was a strong relationship with a healthcare professional . Collaborative e-health tools can support the relationship and behavioural changes through monitoring and providing relevant feedback . The support from family and peers also matters , and long-term success depends on the ability to establish strong , positive support on a day-to-day basis Background Worldwide in 2000 , 10 % of children aged five to 17 years were reported as being overweight with an additional 2‐3 % being obese . Overweight and obesity in childhood can adversely impact on both physical and psychological health . The rise in the prevalence of childhood obesity is a complex issue but widely recognised contributors include increased energy intake , decreased levels of physical activity and greater time spent in sedentary pursuits . A large number of environmental and cultural factors have also been identified as contributing to the problem . Evidence to support an optimal approach to treating childhood obesity is limited with many studies showing only modest results at best in the long‐term . However , the importance of family‐based treatment that combines diet , physical activity and behavioral components has been acknowledged in a recent Cochrane Systematic Review . It has also been suggested that interventions offered in the community setting may help overcome barriers to participation , by making programs more accessible and allowing the targeting of specific sub‐groups of the population . Objectives The objective of this review was to identify the effectiveness of parent‐centred interventions implemented in the community setting in modifying eating and physical activity behaviors or weight‐related outcomes of children . Inclusion criteria Types of participants This review considered studies that included free‐living children of pre‐school , primary and secondary school age and /or their parents/guardians aged > 18 years . Types of intervention(s)/phenomena of interest Intervention programs were required to have a parental component , to target eating and /or exercise behaviors for the prevention or treatment of obesity , and child weight status reported . Types of studies All intervention studies were included in the review including : r and omized controlled trials ( RCTs ) ; non‐r and omized controlled trials , longitudinal studies , cohort ( both retrospective and prospect i ve ) , case control and time series studies which had been conducted in a community setting . Types of outcomes This review considered studies that included overweight/obesity related outcomes , eating behavior outcomes , physical activity behaviour outcomes , and sedentary behavior outcomes and constructs . Search strategy A literature search of community‐based parent‐centred intervention studies to promote nutrition and physical activity for the prevention and treatment and of childhood overweight and obesity was performed in eight electronic data bases dating from 1975 to April 2009 . Method ological quality Studies were critically appraised for method ological quality using st and ardized tools . Data collection Data was extracted by one review er using a st and ardized data extraction form developed by the research ers and checked for accuracy and consistency by a second review er . Data synthesis Data in relation to setting , methodology , intervention components and effect on weight , dietary intake and physical activity was extracted , and described in a narrative synthesis . Where possible a meta‐ analysis was undertaken . Results Of the home‐based interventions , five of nine studies reported statistically significant changes in anthropometric outcomes post intervention . Of the 10 studies in the before and after school care setting , seven reported a significant decrease in a weight‐related outcome post intervention , with only one reporting an increase . Conclusions Results from the review support the after‐school setting as the most promising for community intervention setting for targeting parents as agents of change within child obesity prevention and treatment programs . Implication s for practice At this stage , interventions to support parents should target the after‐school environment as opposed to being conducted in the home , summer camps , leisure centers or churches . Targeting a decrease in energy intake and sweetened beverages in parallel with increasing number of daily steps and decreasing screen time use . Implication s for research Future studies of high quality are needed across the full range of community setting s. Given that currently most of the higher quality RCTs and the studies showing positive impacts of weight change are in the after‐school setting , further studies in this area using similar method ologies to those already published will facilitate future meta‐analyses in this area BACKGROUND Behavioral interventions targeting children with overweight have been successful in facilitating weight loss ; however , there is concern that these programs produce disordered eating attitudes among youth . OBJECTIVE The purpose of this research was to determine whether youth with overweight receiving one of two behavioral interventions  were more likely to report an increase in disordered eating attitudes over time compared to a waitlist control and to determine psychosocial predictors of eating-disordered attitudes at 6-month follow-up . DESIGN Participants were r and omized to one of two behavioral lifestyle interventions or a waitlist control . Data were collected at baseline , post-treatment , and 6-month follow-up . PARTICIPANTS / SETTING Participants were 68 youths with overweight , aged 8 to 13 years , and their parent(s ) who lived in rural north central Florida . The project ran from January 2006 to January 2008 . INTERVENTION Each treatment condition consisted of 12 group sessions over 16 weeks . MAIN OUTCOME MEASURES Parents completed a demographic form and the Child Feeding Question naire . Children completed the Children 's Eating Attitudes Test , Schwartz Peer Victimization Scale , and Children 's Body Image Scale . STATISTICAL ANALYSES PERFORMED Mixed 2 × 2 analyses of variance were used to examine the effect of treatment on eating attitudes . Hierarchical linear regression was used to assess whether baseline levels of psychosocial variables predicted disordered eating attitudes at follow-up , controlling for baseline eating attitudes and treatment condition . RESULTS Youth who participated in the behavioral interventions did not report significant increases in disordered eating attitudes over time compared to the waitlist control . Across all conditions , higher levels of body dissatisfaction , peer victimization , parent restrictive feeding practice s , and concern for child weight at baseline predicted higher levels of disordered eating attitudes at follow-up . CONCLUSIONS These findings do not provide evidence that behavioral interventions lead to an increase in unhealthy eating attitudes and behaviors . Future research should examine the effects of incorporating eating disorder prevention in pediatric weight management programs Review question / objective What are the effects of weight management interventions that include a diet component on weight‐related outcomes in pregnant and postpartum women ? The primary objective of this systematic review is to evaluate the effectiveness of weight management interventions which include a diet component and are aim ed at limiting gestational weight gain and postpartum weight retention in women . The second objective of this systematic review is to investigate included intervention components with respect to effect on weight‐related outcomes . This may include , but is not limited to : length of intervention , use of face‐to‐face counselling , group or individual consultations , use of other interventions components including exercise , use of goals and use of support tools like food diaries , coaching , including email or text message support . Background Around half of all women of reproductive age are either overweight or obese,1,2,3 with women aged 25‐34 years having a greater risk of substantial weight gain compared with men of all ages.1,4 Excessive gestational weight gain ( GWG ) and postpartum weight retention ( PPWR ) may play a significant role in long term obesity . Having one child doubles the five‐ and 10‐year obesity incidence for women , with many women who gain excessive weight during pregnancy remaining obese permanently.5 Excessive GWG and /or PPWR can also significantly contribute to short‐ and long‐term adverse health outcomes for mother , baby and future pregnancies.6,7 Maternal obesity increases the risk of pregnancy related complications such as pre‐eclampsia , gestational diabetes mellitus , stillbirth and the rate of caesarean section.8 Childhood obesity is a further long term complication of maternal obesity for offspring , which may persist in to adulthood.9 Excess GWG is also a risk factor for PPWR both in the short and long‐term.10,11 Nehring et al. conducted a meta‐ analysis with over 65,000 women showing that , compared to women who gained weight within recommendations during pregnancy , women with GWG above Institute of Medicine weight gain recommendations , 12 retained an additional 3.1 kg and 4.7 kg after three and greater than or equal to 15 years postpartum , respectively.13 The health risk associated with PPWR is highlighted in a study of 151,025 Swedish women followed between 1992 and 2001.The study identified the risk of adverse pregnancy outcomes for those who gained three or more units of Body Mass Index ( kg/m2 ) between consecutive pregnancies ( an average of two years ) was much higher compared with women whose BMI changed from ‐1.0 and 0.9 units.14 Long‐term chronic disease risk may also be affected by PPWR as weight retention at the end of the first year post‐partum has been found to be a predictor of maternal overweight 15 years later.15With around 14‐20 % of women retaining 5 kg or more 12 months postpartum,16,5 the risk of developing conditions like diabetes , metabolic syndrome and cardiovascular disease may be increased.17 It becomes evident that interventions which aim to support attainment of healthy weight both in the antenatal and postpartum periods are key health priorities for women during this life stage . Lifestyle factors of overweight , having poor diet quality , and not undertaking enough moderate‐to‐vigorous physical activity are amongst the top five predictors of mortality in women.18 Additionally it is noted that , for many women , pregnancy and the postpartum period are associated with a reduction in physical activity.19 It is known that a combination of poor dietary choices , an increase in sedentary time and reduction in physical activity are all contributors to the development of overweight and obesity . With this in mind , current research has focused on lifestyle interventions to limit GWG and PPWR . Thangaratinam et al. review ed 44 r and omized controlled trials ( 7278 women ) where interventions including diet , physical activity or both were evaluated for their influence on maternal weight during  pregnancy.20 Results indicate that all were significantly effective in reducing GWG compared with the control group . More specifically , dietary interventions were the most effective in reducing weight gain , with a mean weight loss of ‐3.84 kg compared with ‐0.72 kg and ‐1.06 kg for physical activity and the mixed ( diet plus physical activity ) approach , respectively.20 This finding is supported by Hill and colleagues ' recent systematic review of theory based interventions to limit GWG.21 Included studies in this review reported an underpinning theory base and were classified as adopting a dietary , physical activity or mixed approach . Hill et al. concluded that studies which included a diet intervention were significantly more effective at limiting GWG.21 In 2011 Tanentsapf et al. review ed the effect of dietary interventions alone for reducing GWG in normal weight , overweight and obese pregnant women.22 This review analysed 13 r and omized controlled trials and quasi‐r and omized controlled trials with a dietary intervention to prevent excessive GWG in women . The review concluded that dietary interventions during pregnancy were effective in reducing GWG with an effect of ‐1.92 kg ( n=1434 ) compared with the control group.22 Tanentsapf et al. identified that trials differed in the conduct of the interventions with various diet and non‐diet related components utilised . Dietary approaches were highly variable with some trials focusing only on calorie restriction and others included additional target macronutrient distribution for intake . Some trials further provided feedback based on maternal weight gain guidelines .12 Interventions also varied in delivery method with a variety of modes used , including face‐to‐face , individual or group consultations and /or written correspondence . The frequency of communication , despite the type or mix , also changed from trial to trial with additional methods via telephone , posted material s , feedback or food diaries utilised . The inclusion of physical activity in addition to diet intervention was also common . Whilst the recent review by Tanentsapf et al.22 identified that dietary interventions are effective in reducing GWG , the review did not investigate the impact that different intervention components , delivery methods or dietary counselling approaches had on gestational weight management . It remains unclear as to which intervention components optimize GWG in women . The impact of lifestyle interventions has also been investigated in the postpartum period . The recent systematic review from van der Pligt et al. reported seven of 11 studies review ed were successful in limiting PPWR.23 As with studies aim ed at limiting GWG , interventions included in van der Pligt et al. 's review differed greatly in their conduct . Six of these seven studies included both dietary and physical activity components for the intervention , with the final successful study including a diet only intervention . Five of the successful studies recruited overweight or obese women only . Intervention time varied considerably in successful studies with some running for as little at ten days , and others up to six months . Bertz et al. demonstrated that their 12‐week behavior modification intervention which targeted diet alone or diet and exercise , including two individual sessions with a dietitian and physical therapist , provision of scales for weight self‐monitoring and bi‐weekly text messages was successful in achieving significant weight loss following the intervention , and sustained at one year.24 The diet intervention and the diet and exercise intervention  yielded significant weight loss compared to the control . Following 12 weeks a reduction of ‐8.3 + /‐ 4.2 kg for diet intervention and ‐6.9 + /‐ 3.0 kg for diet and exercise was observed . Additionally after one year , the diet intervention showed ‐10.2 + /‐ 5.7 kg reduction and ‐7.3 + /‐ 6.3 kg for the diet and exercise intervention (p<0.001).24 Colleran et al. also found significant weight change results by implementing a 16‐week intervention which consisted of weekly individual sessions with a dietitian regarding calorie restriction , two additional home visits regarding exercise , weekly food diary completion and email support.25 The intervention group had greater weight loss compared to the control group ( ‐5.8 kg + /‐ 3.5 kg vs ‐1.6 kg + /‐ 5.4 kg ) . It can be seen that various methods have been utilized in investigating the impact of diet and physical activity interventions on PPWR . The review by van der Pligt et al.23 highlights the impact successful lifestyle interventions can have on postpartum weight change . However , this review did not investigate the different intervention strategies utilized . It remains unclear as to the optimal setting , delivery method , diet strategy , contact frequency or intervention length to limit PPWR . Previous systematic review s for both GWG and PPWR have focused on the effectiveness of lifestyle interventions as a whole for weight management in pregnant and postpartum women.20,23 And despite Tanentsapf et al. 's focus on dietary interventions for GWG,22 much is still unknown about the effectiveness of differing diet interventions over the antenatal and postpartum period . Specifically , the impact of differing diet intervention strategies on maternal weight gain is not known . Firstly , this systematic review will focus on whether  weight management interventions which include a dietary component  are effective in pregnant and postpartum women . In addition to this , this review will investigate the different intervention strategies utilized and their effectiveness in maternal weight management . A search of systematic review protocol data bases has shown that there is no current review underway for this topic Despite considerable clinical interest , attempts to link perceived self-efficacy with successful weight control have had mixed success . Definitive data on prospect i ve associations between self-efficacy and weight loss are particularly sparse . This study examined relationships between self-efficacy beliefs , weight control behaviors , and weight change among individuals participating in a weight loss trial ( N = 349 , 87 % women ) . Cross-sectionally , eating and exercise self-efficacy beliefs were strongly associated with corresponding weight loss behaviors . Self-efficacy beliefs prospect ively predicted weight control behavior and weight change during active treatment but not during follow-up . Mediational models indicate that people 's weight control behaviors mediate the impact of self-efficacy on weight change CONTEXT Overweight and obesity are increasing in the United States . Changes in diet and physical activity are important for weight control . OBJECTIVES To examine the prevalence of attempting to lose or to maintain weight and to describe weight control strategies among US adults . DESIGN The Behavioral Risk Factor Surveillance System , a r and om-digit telephone survey conducted in 1996 by state health departments . Setting The 49 states ( and the District of Columbia ) that participated in the survey . PARTICIPANTS Adults aged 18 years and older ( N = 107 804 ) . MAIN OUTCOME MEASURES Reported current weights and goal weights , prevalence of weight loss or maintenance attempts , and strategies used to control weight ( eating fewer calories , eating less fat , or using physical activity )  by population subgroup . RESULTS The prevalence of attempting to lose and maintain weight was 28.8 % and 35.1 % among men and 43.6 % and 34.4 % among women , respectively . Among those attempting to lose weight , a common strategy was to consume less fat but not fewer calories ( 34.9 % of men and 40.0 % of women ) ; only 21.5 % of men and 19.4 % of women reported using the recommended combination of eating fewer calories and engaging in at least 150 minutes of leisure-time physical activity per week . Among men trying to lose weight , the median weight was 90.4 kg with a goal weight of 81.4 kg . Among women , the median weight was 70.3 kg with a goal weight of 59.0 kg . CONCLUSIONS Weight loss and weight maintenance are common concerns for US men and women . Most persons trying to lose weight are not using the recommended combination of reducing calorie intake and engaging in leisure-time physical activity 150 minutes or more per week Background Cognitive behavior therapy ( CBT ) is the first-line of treatment for overweight and obesity patients whose problems originate in maladaptive eating habits ( e.g. , emotional eating ) . However , in-person CBT is currently difficult to access by large segments of the population . The proposed SIGMA intervention ( i.e. , the Self-help , Integrated , and Gamified Mobile-phone Application ) is a mHealth intervention based on CBT principles . It specifically targets overweight young adults with underlying maladaptive behaviors and cognitions regarding food . The SIGMA app was design ed as a serious game and intended to work as a st and alone app for weight maintenance or alongside a calorie-restrictive diet for weight loss . It uses a complex and novel scoring system that allows points earned within the game to be supplemented by points earned during outdoor activities with the help of an embedded pedometer . Methods / design The efficacy of the SIGMA mHealth intervention will be investigated within a r and omized , placebo-controlled trial . The intervention will be set to last 2 months with a 3-month follow-up . Selected participants will be young overweight adults with non- clinical maladaptive eating habits embodied by food cravings , binge eating , and emotional eating . The primary outcomes will be represented by changes in ( 1 ) self-reported maladaptive thoughts related to eating and body weight , ( 2 ) self-reported maladaptive eating behaviors in the range of urgent food cravings , emotional eating or binge eating , ( 3 ) as well as biased attentional processing of food items as indexed by reaction times . Secondary outcomes will be represented by changes in weight , Body Mass Index , general mood , and physical activity as indexed by the number of steps per day . Discussion Through an evidence -based cognitive behavioral approach and a user-friendly game interface , the SIGMA intervention offers a significant contribution to the development of a cost-effective and preventive self-help tool for young overweight adults with maladaptive eating habits . Trial registration IS RCT N , ID : 70907354 . Registered on 6 February 2017 . The IS RCT N registration is in line with the World Health Organization Trial Registration Data Set . The present paper represents the original version of the protocol . Any changes to the protocol will be communicated to IS RCT The National Weight Control Registry ( NWCR ) consists of over 4800 individuals who have been successful in long-term weight loss maintenance . The purpose of establishing the NWCR was to identify the common characteristics of those who succeed in long-term weight loss maintenance . We found very little similarity in how these individuals lost weight but some common behaviors in how they are keeping their weight off . To maintain their weight loss NWCR participants report eating a relatively low-fat diet , eating breakfast almost every day , weighing themselves regularly , and engaging in high levels ( about 1 hour/day ) of physical activity . Because this is not a r and om sample of those who attempt weight loss , the results have limited generalizability to the entire population of overweight and obese individuals . The value of this project lies in identifying potential strategies that may help others be more successful in keeping weight off The current review aim ed to systematic ally identify dietary , physical activity and sedentary behaviours in preschool children ( 4 - 6 years of age ) that are prospect ively related to overweight or obesity later in childhood . Prospect i ve studies published between January 1990 and June 2010 were selected from search es in PubMed , EMBASE , PsycINFO , CINAHL and Cochrane Library . Studies examining the prospect i ve association between at least one relevant behaviour measured during preschool period ( children aged 4 - 6 years at baseline ) in relation to at least one anthropometric measurement at follow-up ( age < 18 years ) were included . Harvest plots were used to summarize the results and draw conclusions from the evidence . Of the 8,718 retrieved papers , 23 papers reporting on 15 different study sample s were included in this review . Strong evidence was found for an inverse association between total physical activity and overweight . Moderate evidence was observed for a positive association between television viewing and overweight . Because of the heterogeneity in the assessed dietary behaviours , insufficient evidence was found for an association between  dietary intake or specific dietary behaviours and overweight . These results suggest that interventions aim ing to prevent overweight among preschool children should focus on promotion of total physical activity and limitation of screen time and that further research is needed to establish whether and which dietary behaviours are important for obesity prevention in this age group . However , despite the lack of evidence for dietary behaviours from the present review , future interventions may already target specific dietary behaviours that are highly prevalent and for which there a clear rationale as well as preliminary evidence that these behaviours are associated with overweight BACKGROUND St and ard behavioral obesity treatment produces poor long-term results . Focusing on healthy eating behaviors rather than energy intake may be an alternative strategy . In addition , important behaviors might differ for short- vs long-term weight control . OBJECTIVE Our aim was to describe and compare associations between changes in eating behaviors and weight after 6 and 48 months . DESIGN We performed secondary analysis of data collected during a r and omized weight-loss intervention trial with 48-month follow-up . PARTICIPANTS We studied 481 overweight and obese postmenopausal women enrolled in the Women on the Move through Activity and Nutrition ( WOMAN ) Study . MAIN OUTCOME MEASURES We measured changes in weight from baseline to 6 and 48 months . STATISTICAL ANALYSES PERFORMED Linear regression models were used to examine the associations between 6- and 48-month changes in eating habits assessed by the Conner Diet Habit Survey and changes in weight . Analyses were conducted in the combined study population and stratified by r and omization group . RESULTS At 6 months in the combined population , weight loss was independently associated with decreased desserts ( P<0.001 ) , restaurant eating ( P=0.042 ) , sugar-sweetened beverages ( P=0.009 ) , and fried foods ( P<0.001 ) , and increased fish consumption ( P=0.003 ) . Results were similar in intervention participants ; only reduced desserts and fried foods associated with weight loss in controls . At 48 months in the combined population , weight loss was again associated with decreased desserts ( P=0.003 ) and sugar-sweetened beverages ( P=0.011 ) , but also decreased meats/cheeses ( P=0.024 ) and increased fruits/vegetables ( P<0.001 ) . Decreased meats/cheeses predicted weight loss in intervention participants ; desserts , sugar-sweetened beverages , and fruits/vegetables were independently associated in controls . CONCLUSIONS Changes in eating behaviors were associated with weight change , although important behaviors differed for short- and long-term weight change and by r and omization group . Future studies should determine whether interventions targeting these behaviors could improve long-term obesity treatment outcomes More than one quarter of American adults are estimated to be overweight , with the highest prevalence among those 45 years and older [ 1 ] . The health dangers associated with overweight have been well documented in numerous studies , making these statistics particularly troublesome . Given the enormity of the problem , more effective public health efforts are needed to target at-risk population s. The Year 2000 Health Objectives recommend a weight loss strategy of increased physical activity combined with a reduction in dietary fat [ 2 ] . Although wide variability exists in the definition of these two recommendations , they are more likely to be heeded by persons of higher socioeconomic status [ 3 ] . This fact may partially explain one phenomenon of the overweight population : the very high prevalence of overweight among black women . Many questions remain unanswered , however , as Americans struggle with what appears to be a perpetual weight control problem . What are the sociodemographic characteristics of the overweight population , what do overweight persons know about weight-loss methods , and what are their weight loss practice s ? The National Health Interview Survey ( NHIS ) , a nationally based annual survey , included questions regarding  weight loss , diet , and exercise  in both 1985 and 1990 . This study investigated which groups of persons are likely to feel that they are overweight , which persons are trying to lose weight , and what methods they think are most effective in weight reduction . Further , we examined changes in these categories for the 5-year period from 1985 to 1990 . Methods The NHIS is an annual , nationally representative survey of about 45 000 households [ 4 ] . Each year , the NHIS comprises a core question naire that addresses basic demographic and health information such as acute and chronic conditions and doctor visits for each member of the selected households . In addition , one or more supplements containing items of current health interest are administered to r and omly selected members of the household . In 1985 , and again in 1990 , the Health Promotion and Disease Prevention ( HPDP ) supplements [ 5 , 6 ] were design ed to yield information to assist in monitoring the health status of the nation as we move toward the year 2000 . The HPDP supplements contain , among other items , several questions design ed to elicit information on respondents ' self-perceived weight status ( overweight , underweight , or about right ) , on those persons who are trying to lose weight , and on the methods Americans use in attempting to lose weight . Additional sociodemographic information on age , race , sex , education , and income is routinely collected in the NHIS . In both 1985 and 1990 , r and omly selected adult persons 18 years and older were administered the HPDP question naire . In 1985 , 33 630 persons ( 90 % of those eligible ) responded to the question naire . In 1990 , 41 104 persons ( 86.3 % of those eligible ) were successfully interviewed for the HPDP Current Health Topics supplement . We excluded persons who had been advised by a physician to lose weight due to hypertension or diabetes . Because education was one of our stratification variables , we also limited our analysis to persons 25 years and older . Thus , for the 1985 data we excluded 4823 persons ( 14.3 % ) because of age , 3593 persons ( 10.7 % ) because they were advised by a physician to lose weight , and 1043 persons ( 3.1 % ) because of inadequate sociodemographic information . After these exclusions , 24 171 persons ( 71.9 % ) remained eligible for analysis in 1985 . From the 1990 data , 5170 persons ( 12.6 % ) were excluded because of age , 2911 persons ( 7.1 % ) were excluded because they had been advised by a physician to lose weight , and 1676 persons ( 4.1 % ) were excluded because of inadequate sociodemographic information . After these exclusions , 31 347 persons ( 76.3 % ) remained eligible for further analysis in 1990 . The NHIS is a multistage survey with clustering and oversampling of selected population groups [ 4 ] . Statistical methods appropriate for a complex sample survey were used to estimate the variances and , hence , the st and ard errors . The computer program SUDAAN [ 7 , 8 ] was used to conduct these analyses . Data were weighted to reflect the probability of selection and other factors . Results In 1990 , 45 % of Americans considered themselves overweight : 36.7 % of men and 52.0 % of women ( Table 1 ) . Persons of lower socioeconomic status were generally more likely to consider themselves underweight than were those of higher socioeconomic status . Of the racial-ethnic groups considered , black persons were least likely to consider themselves to be overweight and most likely to consider themselves to be about right ; however , actual measurements have shown that black persons , especially black women , are more likely to be overweight compared with the general population [ 1 ] . Persons with less than a high school education were least likely to see themselves as overweight and were most likely to consider themselves underweight compared with high school graduates and those with more than a high school education . Similarly , those with a family income greater than $ 20 000 per year were more likely to think of themselves as overweight . Table 1 . How Americans See Themselves with Regard to Their Weight : 1990 * Persons between 45 and 64 years were most likely to think of themselves as overweight , followed by persons 25 to 44 years old . Persons older than 65 years were the least likely to think of themselves as overweight ( 35.7 % ) . Widowed and never-married persons were least likely to consider themselves overweight ( < 37 % ) , whereas currently married persons were most likely to think of themselves as overweight . The self-perceived weight categories had a similar demographic distribution in 1985 ( data not shown ) . Between 1985 and 1990 , few differences were seen in the proportion of people trying to lose weight when viewed in terms of sociodemographic characteristics ( Table 2 ) . In both years , about 23 % of men and 40 % of women were trying to lose weight . Of the three self-perceived weight items examined , the only difference found between 1985 and 1990 was in the self-perception of those persons trying to lose weight . Among those considering themselves underweight , the percentage of those trying to lose weight increased significantly from 0.7 % in 1985 to 4.0 % in 1990 ( P < 0.001 ) . Table 2 . Persons 25 Years and Older Voluntarily Trying To Lose Weight : 1985 and 1990 * Few differences were seen between 1985 and 1990 among those trying to lose weight by eating less ( Table 3 ) . Smaller proportions of blacks and those with an annual family income less than $ 20 000 who were trying to lose weight said they were doing so by eating less in 1990 than in 1985 . A larger proportion of Hispanics in 1990 than in 1985 said they were trying to lose weight by eating less . Table 3 . How Americans Are Trying To Lose Weight : 1985 and 1990 * In every sociodemographic category , statistically significant increases were found between 1985 and 1990 in the proportion of those who were trying to lose weight by increasing their physical activity ( Table 3 ) . The only instance in which we found a decrease in physical activity between 1985 and 1990 was among persons with a family income less than $ 20 000 . Of those who were trying to lose weight , several large and statistically significant differences were found between 1985 and 1990 for the first and second best ways to lose weight ( Table 4 ) . In 1990 , fewer persons than in 1985 thought the best way to lose weight was by not eating before going to bed or by eating fewer calories . However , more persons in 1990 than in 1985 thought the best way to lose weight was by increasing their physical activity or by eating no fat . In 1990 , the most frequently chosen response for the best way to lose weight was to eat fewer calories followed by not eating before going to bed . Increasing physical activity was the third most frequently mentioned best way to lose weight . Table 4 . Knowledge and Practice s of Americans Voluntarily Trying To Lose Weight and Those Not Trying To Lose Weight : 1985 and 1990 * After respondents were asked for their perceptions of the best way to lose weight , they were asked for their opinion of the second best way to lose weight . A greater proportion of persons in 1990 than in 1985 chose eating no fat , not eating before going to bed , and eating fewer calories as the second best way to lose weight . Fewer persons in 1990 than in 1985 chose increasing physical activity and eating grapefruit before every meal . Discussion These data are encouraging because they suggest that , over time , American adults are becoming more educated about strategies for weight loss . People are now more likely to think that eating fewer calories and increasing physical activity are the best methods to institute weight loss . However , the alarming fact that most women and a large proportion of men consider thenselves overweight remains . Also disturbing is the fact that those persons wh1990 were more likely to feel that they were very overweight compared with 1985 responses . This finding suggests an increase in the incidence of obesity or changes over time in the st and ards people use to assess their weight . In either case , it suggests that many people consider themselves to have a weight problem and that much work is needed in promoting n It was most surprising to find that , in 1990 , a greater proportion of those persons trying to lose weight actually considered themselves underweight . Although this proportion was small ( 4.0 % ) , it was significantly greater than the 0.7 % noted in 1985 . We acknowledge the inherent sex-based differences that are believed to exist with self-reported weight and height measurements ( that is , women are more likely to under-report their weight and men to over-report their height ) [ 10 ] . In an unpublished study by us , however , body mass index ( BMI ) ( kg/m2 ) was computed from self-reported heights and weights using 1990 HPDP data OBJECTIVE Better adherence to treatment strategies in family-based behavioral weight control programs may lead to greater weight reduction and improved weight maintenance in youth . This study assessed the influence of child and parent self-reported adherence to behavioral strategies on changes in 2-year child and parent percentage overweight . RESEARCH METHODS AND PROCEDURES Participants included 8- to 12-year-old children in > or= 85th BMI percentile and their parents from 110 families taking part in two family-based r and omized controlled weight control studies . This study examined whether self-reported adherence to behavioral strategies measured at 24 months increased prediction of child and parent percentage overweight change through 24-month follow-up after accounting for other factors that may influence weight change . RESULTS Child adherence to weighing and to preplanning for celebrations where high-fat foods are served and parent adherence to praising the child and modeling healthy eating habits predicted 24-month child percentage overweight change ( p<0.001 ) . Child adherence to recording food and calories and parent adherence to modeling healthy eating habits predicted 24-month parent percentage overweight change ( p<0.001 ) . In hierarchical regression models , child weighing and preplanning and parent modeling were significant ( p<0.01 ) incremental predictors ( r2 of 24.8 % ) of 24-month child percentage overweight . Child recording and parent modeling were significant ( p<0.01 ) incremental predictors ( r2 of 14 % ) of parent 24-month percentage overweight change . DISCUSSION Child and parent adherence to specific components of family-based behavioral weight control treatment are independent predictors of long-term child and parent percentage overweight change Introduction A balanced diet is at the heart of healthy growth and development of children and youth , whereas inappropriate eating habits considerably influence the incidence of disorders connected with nutrition , including overweight and obesity . This paper aims at study ing nutritional factors of 18-year-old secondary school youth in the urban environment and their effect on the incidence of overweight and obesity . Material s and methods The survey was conducted among 1,999 secondary school students chosen at r and om . The research tool consisted an original survey question naire . The measurements of respondents ’ height and body mass provided data for calculating the body mass index . Results and conclusion The percentage of youth with deficient body mass was estimated at 8.4 % . The percentage of normal weight students in the surveyed group was estimated at 77.6 % . Overweight and obesity characterized 14.0 % of the total number . As many as 21.8 % of overweight and obese respondents would eat one or two meals as opposed to 16.8 % of normal weight students . Three-fourths of the surveyed students would eat breakfast regardless of their nutritional habits . Lunch is eaten by 52.9 % of normal weight 18-year-olds and 46.1 % of overweight and obese students . The analysis of mealtimes suggests that overweight and obese students would have their breakfast and dinner at later hours than the rest of the surveyed . More than half of the participating students failed to eat lunch ( 53.9 % ) , and one in four students within this group resigned from supper . Girls would eat fruit and vegetables more frequently than boys several times a day . The percentage of persons in the surveyed groups who would eat fast foods on a daily basis was similar regardless of their nutritional status . Sweetened carbonated beverages would be drunk more often by overweight and obese boys ( 81.2 % ) as compared with boys with proper body mass ( 75.8 % ) . The same type of beverages would be popular with two-thirds of girls , and this result was similar regardless of their nutritional status . About 44.2 % of overweight and obese girls and 20 % of girls with proper body mass attempted to lose weight , and 5.7 % of boys tried to go on a diet . Eating limitations were declared by 16.5 % of overweight and obese boys and ca . 3 % of normal weight boys . Conclusion Within the surveyed group of youth , it was possible to indicate eating errors primarily consisting in irregular eating , too low a number of meals during the day , particularly skipping breakfast , which took place more frequently among overweight and obese students rather than normal weight ones . The survey points to the insufficient intake of vegetables and fruit as opposed to salty and sweet meals . It is essential to convey the knowledge on the causes of overweight and obesity as well as rules of a healthy diet as factors preventing civilization diseases OBJECTIVE This study evaluates the post-treatment and short-term follow-up efficacy of , as well as participant satisfaction for , a 4-month behavioral weight control program for overweight adolescents initiated in a primary care setting and extended through telephone and mail contact . RESEARCH METHODS AND PROCEDURES 44 overweight adolescents were r and omly assigned to either a multiple component behavioral weight control intervention ( Healthy Habits [ HH ] ; n = 23 ) or a single session of physician weight counseling ( typical care [ TC ] ; n = 21 ) . Weight , height , dietary intake , physical activity , sedentary behavior , and problematic weight-related and eating behaviors and beliefs were assessed before treatment , after the 4-month treatment , and at 3-month follow-up . Participant satisfaction and behavioral skills use were measured . RESULTS HH adolescents evidence d better change in body mass index z scores to post-treatment than TC adolescents . Body mass index z scores changed similarly in the conditions from post-treatment through follow-up . Behavioral skills use was higher among HH than TC adolescents , and higher behavioral skills use was related to better weight outcome . Energy intake , percentage of calories from fat , physical activity , sedentary behavior , and problematic weight-related or eating behaviors/beliefs did not differ by condition or significantly change over time independent of condition . The behavioral intervention evidence d good feasibility and participant satisfaction . DISCUSSION A telephone- and mail-based behavioral intervention initiated in primary care result ed in better weight control efficacy relative to care typically provided to overweight adolescents . Innovative and efficacious weight control intervention delivery approaches could decrease provider and participant burden and improve dissemination to the increasing population of overweight youth Background As the rate of overweight among children is rising there is a need for evidence -based research that will clarify what the best interventional strategies to normalize weight development are . The overall aim of the Lund Overweight and Obesity Preschool Study ( LOOPS ) is to evaluate if a family-based intervention , targeting parents of preschool children with overweight and obesity , has a long-term positive effect on weight development of the children . The hypothesis is that preschool children with overweight and obesity , whose parents participate in a one-year intervention , both at completion of the one-year intervention and at long term follow up ( 2- , 3- and 5-years ) will have reduced their BMI -for-age z-score . Methods / Design The study is a r and omized controlled trial , including overweight ( n=160 ) and obese ( n=80 ) children 4 - 6-years-old . The intervention is targeting the parents , who get general information about nutrition and exercise recommendations through a website and are invited to participate in a group intervention with the purpose of supporting them to accomplish preferred lifestyle changes , both in the short and long term . To evaluate the effect of various supports , the parents are r and omized to different interventions with the main focus of : 1 ) supporting the parents in limit setting by emphasizing the importance of positive interactions between parents and children and 2 ) influencing the patterns of daily activities to induce alterations of everyday life that will lead to healthier lifestyle . The primary outcome variable , child BMI -for-age z-score will be measured at referral , inclusion , after 6 months , at the end of intervention and at 2- , 3- and 5-years post intervention . Secondary outcome variables , measured at inclusion and at the end of intervention , are child activity pattern , eating habits and biochemical markers as well as parent BMI , exercise habits , perception of health , experience of parenthood and level of parental stress . Discussion The LOOPS project will provide valuable information on how to build effective interventions to influence an unhealthy weight development to prevent the negative long-term effects of childhood obesity . Trial registration Clinical Trials.gov Background There is increasing evidence for the effectiveness of parental support programmes to promote healthy behaviours and prevent obesity in children , but only few studies have been conducted among groups with low socio-economic status . The aim of this study was to develop and evaluate the effectiveness of a parental support programme to promote healthy dietary and physical activity habits and to prevent overweight and obesity in six-year-old children in disadvantaged areas . Methods A cluster-r and omised controlled trial was carried out in disadvantaged areas in Stockholm . Participants were six-year-old children ( n = 378 ) and their parents . Thirty-one school classes from 13 schools were r and omly assigned to intervention ( n = 16 ) and control groups ( n = 15 ) . The intervention lasted for 6 months and included : 1 ) Health information for parents , 2 ) Motivational Interviewing with parents and 3 ) Teacher-led classroom activities with children .  Physical activity was measured by accelerometry , dietary intake and screen time with a question naire , body weight and height were measured and BMI st and ard deviation score was calculated . Measurements were conducted at baseline , post-intervention and at 5months follow-up . Group effects were examined using Mixed-effect Regression analyses adjusted for sex , parental education and baseline values . Results Fidelity to all three intervention components was satisfactory . Significant intervention effects were found regarding consumption of unhealthy foods ( p = 0.01 ) and unhealthy drinks ( p = 0.01 ) . At follow-up , the effect on intake of unhealthy foods was sustained for boys ( p = 0.03 ) . There was no intervention effect on physical activity . Further , the intervention had no apparent effect on BMI sds for the whole sample , but a significant difference between groups was detected among children who were obese at baseline ( p = 0.03 ) which was not sustained at follow-up . Conclusions The Healthy School Start study shows that it is possible to influence intake of unhealthy foods and drinks and weight development in obese children by providing individual parental support in a school context . However , the effects were short-lived . Therefore , the programme needs to be prolonged and /or intensified in order to obtain stronger and sustainable effects . This study is an important contribution to the further development of evidence -based parental support programmes to prevent overweight and obesity in children in disadvantaged areas Background The prevalence of overweight and obesity in children and adolescents is increasing at an alarming rate around the world and prevention has become a key public health objective . Treatment and management of those already overweight and obese must be aligned with the best available evidence on effectiveness , if the risk of obesity‐related morbidity and mortality is yet be reduced . Diet plays a pivotal role in successful treatment of obesity but to date , there is limited evidence on which to base practice . Objectives To identify and present the best available evidence on the optimal dietetic treatment and management of children and adolescent who are overweight or obese . Search strategy Published English language literature was search ed using the electronic data bases CINAHL , MEDLINE , PRE‐ MEDLINE , DARE , COCHRANE , EMBASE , AUSTROM , Current Concepts and Dissertation Abstract s. The data bases were limited to English Language from 1975 until 2003 . Government reports from the UK , USA and Australian were also search ed and a h and search performed for the Journal of the Dietitians Association of Australia , International Journal of Obesity and the Journal of Human Nutrition and Dietetics and the bibliographies of retrieved articles . Selection criteria ( i ) Interventions that evaluated the effectiveness of nutrition or dietary interventions to treat or manage overweight and obesity ; ( ii ) Children aged less than 18 years ; and ( iii ) Participants were defined as overweight or obese by relative weight or a measure of body weight status , studies that reported body weight per se were excluded . Data collection and analysis An experienced professional librarian search ed the data bases , and two trained research assistants independently identified studies for retrieval and assessed each article for inclusion . The included studies were critically appraised for method ological quality by two people independently . Data were extracted from the appropriate articles and when a discrepancy arose , a third party would arbitrate . Main results There were 116 articles that met the inclusion criteria . While 49 articles described r and omised controlled trials , they arose from 37 separate studies . There were 67 non‐r and omised trials . Meta‐analyses were performed on eight studies that included both a dietary intervention component and an adequate control group and on four studies that had follow‐up data . There was a high degree of heterogeneity between studies and this made comparisons between studies problematic . Interventions that include diet therapy generally result in significant weight loss , at least in the short term . Many studies were poorly design ed and had no or only minimal follow up . The details of the dietary intervention were often inadequately described and dietary outcomes rarely reported , making repetition of the studies difficult . Review ers ' conclusions There is an urgent need for high quality studies investigating the optimal dietary approach to management of paediatric  overweight and obesity . These studies require adequate follow up to ascertain if weight loss can be sustained in the long term . Details of the dietary prescription , adherence to the dietary intervention and diet‐specific outcomes need to be reported in order to inform best practice
Results indicated that perceived overweight was associated with an increased likelihood of attempting weight loss and with healthy and unhealthy weight control strategies in some participant groups .
However , perceived overweight was not reliably associated with physical activity or healthy eating and was associated with greater disordered eating in some groups .
Rather than being associated with improved weight management , there was consistent evidence that perceived overweight was predictive of increased weight gain over time .
Individuals who perceive their weight status as overweight are more likely to report attempting weight loss but over time gain more weight
It is commonly assumed that a person identifying that they are ' overweight ' is an important prerequisite to successful weight management .
However , there has been no systematic evaluation of evidence supporting this proposition .
The aim of the present research was to systematic ally review evidence on the relationship between perceived overweight and ( i ) weight loss attempts , ( ii )  weight control strategies ( healthy and unhealthy )  , ( iii ) weight-related behaviours ( physical activity and eating habits ) , ( iv ) disordered eating and ( v ) weight change .