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Suggested Citation:"Index." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×

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

Suggested Citation:"Index." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×

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

Suggested Citation:"Index." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×

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

Suggested Citation:"Index." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×

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

Suggested Citation:"Index." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×

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

Suggested Citation:"Index." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×

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

Suggested Citation:"Index." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×

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

Suggested Citation:"Index." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×

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

Suggested Citation:"Index." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×

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

Suggested Citation:"Index." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×

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

Suggested Citation:"Index." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×

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

Suggested Citation:"Index." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×

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

Suggested Citation:"Index." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
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Weighing the Options: Criteria for Evaluating Weight-Management Programs Get This Book
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Nearly one out of every three adults in America is obese and tens of millions of people in the United States are dieting at any one time. This has resulted in a weight-loss industry worth billions of dollars a year and growing. What are the long-term results of weight-loss programs? How can people sort through the many programs available and select one that is right for them? Weighing the Options strives to answer these questions. Despite widespread public concern about weight, few studies have examined the long-term results of weight-loss programs. One reason that evaluating obesity management is difficult is that no other treatment depends so much on an individual's own initiative and state of mind.

Now, a distinguished group of experts assembled by the Institute of Medicine addresses this compelling issue. Weighing the Options presents criteria for evaluating treatment programs for obesity and explores what these criteria mean—to health care providers, program designers, researchers, and even overweight people seeking help.

In presenting its criteria the authors offer a wealth of information about weight loss: how obesity is on the rise, what types of weight-loss programs are available, how to define obesity, how well we maintain weight loss, and what approaches and practices appear to be most successful.

Information about weight-loss programs—their clients, staff qualifications, services, and success rates—necessary to make wise program choices is discussed in detail.

The book examines how client demographics and characteristics—including health status, knowledge of weight-loss issues, and attitude toward weight and body image—affect which programs clients choose, how successful they are likely to be with their choices, and what this means for outcome measurement. Short- and long-term safety consequences of weight loss are discussed as well as clinical assessment of individual patients.

The authors document the health risks of being overweight, summarizing data indicating that even a small weight loss reduces the risk of disease and depression and increases self-esteem. At the same time, weight loss has been associated with some poor outcomes, and the book discusses the implications for program evaluation.

Prevention can be even more important than treatment. In Weighing the Options, programs for population groups, efforts targeted to specific groups at high risk for obesity, and prevention of further weight gain in obese individuals get special attention.

This book provides detailed guidance on how the weight-loss industry can improve its programs to help people be more successful at long-term weight loss. And it provides consumers with tips on selecting a program that will improve their chances of permanently losing excess weight.

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