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Vol. 14 No. 3 ~ May/June 2000
AUTHOR: Marchessault, Gail, RD, PHEc, PhD (Cand)
TITLE: Is New Death Figure New Information?
SOURCE: Healthy Weight Journal, May/June 2000; Vol 14:3
ABSTRACT: A report in the October 27, 1999, issue of JAMA suggests that the estimated number of annual deaths attributable to obesity among U.S. adults is approximately 280,000 based on hazard ratios from all subjects, compared to the previous estimates of 300,000 deaths per year wrongly attributed to obesity. The authors of that report write that the calculations assume that all excess death in obese people is due to obesity. They acknowledge that it has not been established that if currently obese people were to lose weight of never become obese in the first place, they would have a lower death rate; they suggest studying this by determining the impact of intentional weight loss on mortality. Many see exercise and eating habits as more appropriate concerns than weight. 

AUTHOR: Kline, Gregory, PhD, MPH
TITLE: Does BMI Measure Body Fat and Health Risk?
SOURCE: Healthy Weight Journal, May/June 2000; Vol 14:3
ABSTRACT: The first federal guidelines on the identification, evaluation, and treatment of overweight and obesity in adults were released in 1998 by the National Health, Lung, and Blood Institute. The guidelines' definition of overweight is based on research that relates body mass index (BMI) to risk of death and illness. The guidelines assume that BMI is a good predictor/indicator of body fat, and that BMI is associated with increased disease risk. Critics of the report suggest that the recommendations may do more harm than good, and that vast amounts of money spent annually on losing weight is wasted. Studies show that BMI is a poor predictor of fitness level and blood pressure, and fails to distinguish between lean and fat tissue. Without knowing more information about a person's health behaviors, lifestyle, and metabolic profile, the potential for BMI misclassification is high. 

AUTHOR: Berg, Frances, MS
TITLE: Mapping U.S. Obesity
SOURCE: Healthy Weight Journal, May/June 2000; Vol 14:3
ABSTRACT: Americans are gaining weight by every measure, even by their own account. The latest data to confirm this comes from the U.S. Behavioral Risk Factor Surveillance System, a random-digit telephone survey of adults conducted by the Centers for Disease Control and Prevention and state health departments. The latest report from this survey shows an increase in obesity from 12 percent in 1991 to nearly 18 percent in 1998. The results from the survey reveals a steady increase in obesity in all states, in both sexes, across all age groups, races, educational levels, and regardless of smoking status. The authors of this report observe that rarely does a chronic condition spread with this speed. It implies that sweeping changes have contributed to weight gain and energy imbalance, and speculate that this rapidity may give clues both to origin and to measures needed to control the spread of obesity. 

AUTHOR: Gast, Julie A., PhD, CHES and Hawks, Steven R., EdD, CHES
TITLE: Examining Intuitive Eating as a Weight Loss Program
SOURCE: Healthy Weight Journal, May/June 2000; Vol 14:3
ABSTRACT: The basic premise of the intuitive eating paradigm is that people become obese because they eat for nonphysiological reasons. It is argued that individuals eat for three reasons: due only to physical hunger cues, due to environmental and social cues, and for emotional reasons. For individuals to become intuitive eaters they must learn to pay attention to body signals and eat appropriate amounts of food for their physiological needs. The proponents of the intuitive eating paradigm believe that examining why an individual eats is an important starting point to weight loss. The underlying assumption of the intuitive eating paradigm is that the body wants to eat healthy food, and once diet restrictions have been removed the individual will crave and eat primarily nutritious foods. The intuitive eating paradigm is unique from other weight loss paradigms in that calories, fat, and physical activity are not central concerns. This paradigm may be especially useful for obese individuals who eat compulsively or for those whose excess weight is related to eating for nonphysiological reasons. 

AUTHOR: Marchessault, Gail, RD, PHEc, PhD (Cand)
TITLE: New Study on BMI and Mortality
SOURCE: Healthy Weight Journal, May/June 2000; Vol 14:3
ABSTRACT: Another new large study of weight and mortality confirms that the lowest mortality appears to be at moderate body weights at all ages for both men and women, but findings by race are labelled "enigmatic" in an accompanying editorial. Results come from the Cancer Prevention Study II, a study that followed over a million people from 1982 to 1996, as reported by Eugenia E. Calle, PhD, and her colleagues at the American Cancer Society in the October 1999 issue of the New England Journal of Medicine. The results of the study especially contribute to our understanding of the effects of smoking and pre-existing disease. Some evidence is presented suggestive of racial differences, but there are also many potential confounding factors.

Vol. 14 No. 2 ~ March/April 2000
NOT AVAILABLE YET

Vol. 14 No. 1 ~ January/February 2000
AUTHOR: Cogan, Jeanine C., PhD
TITLE: Research on Weight Supports a Paradigm Shift
SOURCE: Healthy Weight Journal, Jan/Feb 2000; Vol 14:1:4
ABSTRACT: Obesity is commonly defined as a medical condition because of its associated health risks. The monolithic focus on the elimination of obesity through weight loss has led to a high rate of dieting and other areas of concern for many health professionals. Evidence suggests that weight loss through restrictive dieting has not cured obesity in a significant portion of participants, may cause health problems, and is not critical for improving health in obese patients. The pursuit of thinness is a growing social problem and public health threat. The evidence compels a shift in paradigm. Body weight and size are not solely determined by individual behaviours and therefore are not easily changeable. Research shows that extreme thinness is associated with increased mortality, and that certain weight loss strategies can be life threatening.

AUTHOR: Ernsberger, Paul. PhD and Koletsky, Richard J., MD
TITLE: Part 1: Rationale for a Wellness Approach to Obesity
SOURCE: Healthy Weight Journal, Jan/Feb 2000; Vol 14:1:7
ABSTRACT: The prevailing view of obesity as a major threat to public health is based on incomplete consideration of the evidence. Most prospective studies have found that obese persons are more likely to develop type 2 diabetes, yet studies have consistently found that the disease is genetic in origin. Thus, the evidence suggests that the genes causing diabetes also facilitate weight gain. The cause of hypertension in obese people might be the cycles of weight loss they undergo, rather than a direct influence of fat tissue. Cholesterol levels are only weakly associated with body weight. Two comprehensive reviews have concluded that there is no consistent relationship between body weight and coronary heart disease. 

AUTHOR: Berg, Frances M., MS and Marchessault, Gail, RD, PHEc, PhD (Cand)
TITLE: Naming the Revolution
SOURCE: Healthy Weight Journal, Jan/Feb 2000; Vol 14:1:10
ABSTRACT: In April, 1999, the editors of Healthy Weight Journal asked online contacts to rename the revolution, suggesting that it had moved past its roots in the anti-diet movement. Comments generated reflected diverse opinions and concerns. Many correspondents suggested a more comprehensive health slogan. It may be that size needs to be part of the pro-health msessage to take the focus off of size. Health at Any Size recognizes that people can be healthy at their natural size and weight. It moves people away from diets, external control, and the traditional model. Health at Any Size has been used for years with good results; it uses conversational English, making it easy to remember. It is compatible with other national and international nutrition messages. 

AUTHOR: Ikeda, Joanne P., MA, RD
TITLE: Health Promotion: A Size Acceptance Approach
SOURCE: Healthy Weight Journal, Jan/Feb 2000; Vol 14:1:12
ABSTRACT: Scientific studies document that 95 to 97 percent of people who lose weight by restricting caloric intake regain the weight within 5 years. Some health professionals have concluded that research does not support the traditional advice to restrict calories and increase exercise as a way to achieve permanent weight loss and are recommending a new paradigm. The "Tenets of Size Acceptance" were developed to guide recognition of what constitutes a nondiet, size-acceptance approach to health. They encourage diversity, self-esteem, respect, and good health. 

AUTHOR: Ernsberger, Paul. PhD and Koletsky, Richard J., MD
TITLE: Part 2: Rationale for a Wellness Approach to Obesity
SOURCE: Healthy Weight Journal, March/April 2000; Vol. 14:2:20
ABSTRACT: Continued from Jan/Feb issue, page 7. To establish if obesity shortens life expectancy, it must be shown that obese people consistently die sooner than appropriate controls. Most studies have shown a U-shaped relationship between BMI and mortality, with both low and high body weights associated with increased risk of death. Adjusting the mortality data for smoking has no effect on its relationship to body weight. Low body weight is a reliable harbinger of decline and death in persons over 60 years of age, while the net adverse impact of obesity on median life expectancy is minimal to nonexistent. There are advantages as well as disadvantages to being heavy: obese persons are less likely to later develop cancer and various infectious diseases. These health benefits of obesity might potentially offset its hazards. Much of the increased risk of disease and death in obese people is the result of repeated cycles of weight loss and regain. Equal time should be devoted to treating underweight as overweight. 

AUTHOR: Byfield, Cindy, RD, PhD (Cand)
TITLE: The New Paradigm in Action
SOURCE: Healthy Weight Journal, March/April 2000; Vol 14:2:27
ABSTRACT: Despite agreeing with the basic tenets of Health at Any Size, health professionals may still be tempted to advise obese clients to follow traditional, weight-centered approaches. However, since the majority of those treatments result in the patient gaining the weight back, it is in the patient's best interest to implement the new paradigm. Patients who have recently suffered from a heart attack or undergone surgery may want to lose weight immediately to avoid another cardiac event, but making realistic, heart-healthy changes in diet and activity represent a means to improving health. Patients must learn to become more aware of their own hunger and satiety, and focus on eating food that is heart-healthy rather than low-fat, which tends to encourage a diet mentality. 

AUTHOR: Hawks, Steve R., EdD, CHES and Gast, Julie A., PhD, CHES
TITLE: The Ethics of Promoting Weight Loss
SOURCE: Healthy Weight Journal, March/April 2000; Vol 14:2:25
ABSTRACT: Since health-based educational efforts to reduce body weight have been largely unsuccessful and, in fact, may have contributed to unhealthy weight cycling, eating disorders, and lowered self-esteem, it is necessary to consider the ethical implications of weight control paradigms. The individual is often held responsible for their body size despite the fact that the condition is largely due to factors beyond their control. The contribution of the social environment to the prevalence of obesity must be examined. Health educators must publicize the fact that body size is less important for holistic health than activity level, diet composition, spiritual well-being, and emotional health. The culture of thinness puts large people at risk by exposing them to potentially harmful methods of rapid weight loss and the unscrupulous motives of weight loss promoters. 

AUTHOR: Berg, Frances M., MS
TITLE: Comparing Two Weight Paradigms
SOURCE: Healthy Weight Journal, March/April 2000; Vol 14:2:29
ABSTRACT: The weight-centered paradigm, which has dominated the last two decades of the 20th century, leads to restriction, rigidity, and unhappiness. The Health at Any Size approach focuses on positive behaviours and attitudes. Two charts compare and contrast these two approaches. The Weight-Centered Paradigm entails counting calories, weight cycling, dysfunctional eating, and eating disorders; exercise as work, to burn calories, with high drop-out rates and feelings of failure; unrealistic goals for body shape and size, self-hatred, and body image fears. The Health at Any Size Revolution encourages being active for the sheer joy and fun of it, eating well for pleasure, and respect for yourself and others. 

AUTHOR: Macdonald, Sharon M., MD, FRCPC
TITLE: Obesity: Worldwide Prevalence and Trends
SOURCE: Healthy Weight Journal, Nov/Dec 1999; Vol 13:6:84
ABSTRACT: Three recent publications review worldwide trends in body weight: The World Health Organization (WHO) MONICA (Monitoring of Trends and Determinants in CArdiovascular Diseases) study; the US National Health and Nutrition Examination Survey III (NHANES III); and Canada's Heart Health Surveys. Some findings are consistent, despite difficulties in examining reports from around the world. There is a worldwide trend to increasing body weight. Children and adolescents in the U.S. And Japan have higher body weights now than a decade ago. Members of minority groups, those with a low socioeconomic status, and other members of disenfranchised subgroups have higher body weights than white men and women in Canada and the U.S. In Africa and Asia, obesity is still relatively uncommon, but is more prevalent in urban than rural populations. Obesity co-exists with undernutrition in many developing countries. 

AUTHOR: Berg, Frances M., MS
TITLE: Starvation Syndrome in Africa: Part II
SOURCE: Healthy Weight Journal, Nov/Dec 1999; Vol 13:6:90
ABSTRACT: Continued from xxx issue, page 73-74. The dehumanizing effects of starvation were reported in The Mountain People by anthropologist Colin M. Turnbull, who studied the Ik, a tribe of hunters in Uganda, between 1964 and 1967. At first, starvation was confined to the aged, who were thrown out of their children's homes or confined to abandoned huts and given nothing to eat. However, by the second year of the drought, it was not uncommon to see children prying open the mouths of the very old and pulling out food they had been chewing. When they found food, the Ik hid it from others. Acute hunger and the physical hardship of hunting food dampened sexual appetite, and in so doing deprived the Ik of a major drive toward sociality. When Turnbull returned a year later, the rains had come at last and famine relief was available. However, the Ik had not recovered any kind of friendly, generous spirit.

AUTHOR: Berg, Frances M., MS
TITLE: World Report on Obesity: Prevention
SOURCE: Healthy Weight Journal, Nov/Dec 1999; Vol 13:6:87
ABSTRACT: "Obesity: Preventing and Managing the Global Epidemic," the report published in 1988 by the World Health Organization (WHO), reviews current information on obesity and offers recommendations for developing health policies to deal with what is emerging as a global health problem. Prevention is the main focus of the WHO report. However, it focuses on addressing the risks of obesity rather than overweight. The increases seen in most countries are blamed on environmental and behavioral changes, primarily sedentary lifestyles due to a decrease in spontaneous and work-related physical activity, and over-consumption of high-fat, energy-dense foods. It emphasizes the poor long-term efficacy, high dropout rates, and weight cycling typical of weight loss programs. Effective prevention will require structural changes in societies, says the report. It emphasizes the need to begin preventing overweight and obesity early in life. Prevention programs are recommended at three levels: universal public health prevention programs; selective prevention directed at subgroups within more risk of developing obesity; and targeted prevention directed at high-risk individuals who are not yet obese. 

AUTHOR: Schulz, Leslie O., Ph.D. 
TITLE:  Traditional Environment Protects Against Diabetes in Pima Indians
SOURCE: Healthy Weight Journal Sep/Oct 1999; Vol. 13 No. 5 1999 
ABSTRACT: Until recently, it was assumed that the high incidence of type 2 diabetes and obesity observed in the Pima Indians of Arizona was primarily genetic in origin. The discovery of a tribe of Pima Indians living in Mexico and following a traditional lifestyle has proven this theory to be wrong and shown that diet and activity levels are the villains. The Mexican Pima are more physically active and follow a diet lower in fat and higher in fiber than their Arizona relatives. 

AUTHOR: Marchessault, Gail, R.D., P.H.Ec., Ph.D (Cand.). 
TITLE:  Weight Perceptions and Practices in Native Youth
SOURCE: Healthy Weight Journal Sep/Oct 1999; Vol. 13 No. 5 1999 
ABSTRACT: Overweight is much more prevalent among Native children of all ages than white children. Studies indicate that a significant proportion of Native youth commonly follow unhealthy weight control practices. Primary interventions should promote healthy lifestyles without focusing on weight control as the measure of success. The community as a whole must decide what changes need to be made. Findings reinforce the need to return to traditional Native teachings with their emphasis on a holistic approach to life. 

AUTHOR: Berg, Frances M., M.S. 
TITLE:  The Integrated Approach: Health at any Size
SOURCE: Healthy Weight Journal Sep/Oct 1999; Vol. 13 No. 5 1999 
ABSTRACT: Overweight, eating disorders, dysfunctional eating, and size prejudice are interrelated issues that must be considered when designing an integrated approach to healthy living. The goal of the new paradigm is the health and well being of all children of all sizes. To achieve this goal, children must receive consistent messages that encourage eating well, living actively, and feeling good about themselves. Obesity and its risks, failure of weight loss programs, dysfunctional eating, and malnutrition are just some of the problems that must be addressed. 

AUTHOR: Joe, Jennie R., Ph.D., M.P.H. 
TITLE:  Recommendations for Health Care Providers Working with Native Children
SOURCE: Healthy Weight Journal Sep/Oct 1999; Vol. 13 No. 5 1999 
ABSTRACT: Counseling practices for Native children and their families are the same as those used for other children. However, it is important to include the extended family (e.g., grandparents) in counseling sessions. An understanding of tribal beliefs is important when deciding how to present information. A basic knowledge of Native foods is important for nutritional assessments, keeping in mind that meeting the basic food requirements of the family and survival are major issues. It is vital that the provider conveys respect for the child, the family, and the local culture. 

AUTHOR: Fisher, Elizabeth, B.G.S. 
TITLE:  Honda says "No" to Seat Belt Extenders: Larger Passengers at Risk
SOURCE: Healthy Weight Journal Sep/Oct 1999; Vol. 13 No. 5 1999 
ABSTRACT: Most automobile manufacturers provide seat belt extenders to accommodate larger passengers in their vehicles. One exception to this rule is Honda and despite the efforts of the author, the company refuses to change their policy. Honda claims that seat belt extenders are not safe, but will not publish their research findings. According to General Motors, a seat belt extender is better than no seat belt. Automobile manufacturers should be required to provide seat belts that accommodate all passengers, since state laws require everyone to use a seat belt. 

AUTHOR: Hammer, Roger L, Ph.D. 
TITLE:  Health and Fitness for the Obese Person
SOURCE: Healthy Weight Journal Jul/Aug 1999; Vol. 13 No. 4 1999 
ABSTRACT: The benefits of regular exercise include increased aerobic exercise capacity and cardiovascular endurance, a small change in weight and fat loss, slight preservation of fat-free mass, prevention of significant weight gain, improved maintenance of weight loss, an improved blood profile, decreased risk of disease, and possibly an improved psychological state. 

AUTHOR: Glass, Jolie, M.S. 
TITLE:  Exercise for Women: Reshaping Attitudes
SOURCE: Healthy Weight Journal Jul/Aug 1999; Vol. 13 No. 4 1999 
ABSTRACT: Article suggests that not all women will significantly reduce body weight in response to an exercise program. However, the potential health benefits of regular exercise (improved aerobic fitness, strength, and flexibility, blood pressure and cholesterol profiles, and reduced risk for diabetes, cardiovascular disease, osteoporosis, and premature death) far outweight the need for weight loss. 

AUTHOR: Miller, Wayne M., PhD. 
TITLE:  Practical Excercise for the Large Person
SOURCE: Healthy Weight Journal Jul/Aug 1999; Vol. 13 No. 4 1999 
ABSTRACT: The author recommends an exercise program for large persons that includes performance of a baseline fitness evaluation; selection of exercises that are enjoyable, easily accessible, and within the funcational capacity of the individual; exercise intensity appropriate for the individual; addition of strength and flexibility training as adjuncts to aerobic activity; and focusing the excercise plan on improved overall health and quality of life. 

AUTHOR: Bruno, Joseph, M.S.Ed. 
TITLE:  SIZE ACCEPTANCE: The Potbelly Cycling Association
SOURCE: Healthy Weight Journal Jul/Aug 1999; Vol. 13 No. 4 1999 
ABSTRACT: The Potbelly Cycling Association was founded in 1995 by the author, a cancer survivor who was temporarily unable to drive and decided to rediscover cycling as a means of transportation. The goals of the society are simple: to make it acceptable among the general public for potbellied people to cycle, and to encourage those with potbellies to take up the sport. Suggestions are included to help choose the appropriate "fit" of bicycle for the individual. 

AUTHOR: Petersmarck, Karen, Ph.D, M.P.H., R.D. 
TITLE:  What are Federal Leaders Saying about Childhood Obesity?
SOURCE: Healthy Weight Journal May/Jun 1999; Vol. 13 No. 3 1999 
ABSTRACT: A steady increase in pediatric obesity over the past 30 years has put government agencies under increasing pressure to do something about children and weight. In 1998, the U.S. Department of Agriculture sponsored a symposium to examine the causes and prevention of childhood obesity. The Surgeon General, the Director of the Department of Agriculture, and the Director of the CDC Nutrition and Physical Activity Program agree that changing eating habits and increasing activity levels are key factors to change this trend.  There is an emerging consensus for the prevention of obesity. A national philosophy is also needed to help those who are already large without damaging these children further. 

AUTHOR: Malina, Robert, Ph.D. 
TITLE:  Changes in Height and Weight in Growing Children: Normal Patterns
SOURCE: Healthy Weight Journal May/Jun 1999; Vol. 13 No. 3 1999 
ABSTRACT: Height and weight are used to monitor growth in children and adolescents. Article describes body weight, defines body mass index, and discusses changes in fat distribution as children mature. 

AUTHOR: Crawford, Patricia, Ph.D, Drury Allison, Stern, Sheila, M.A. 
TITLE:  Impact of Demographic Factors on Childhood Obesity Differs by Race
SOURCE: Healthy Weight Journal May/Jun 1999; Vol. 13 No. 3 1999 
ABSTRACT: Until recently it was assumed that childhood obesity is generally more common in families of lower socioeconomic status (SES). It has now been determined that, for African-American girls, there is no significant correlation between SES and obesity. However, similarities were found between African-American and white girls when the focus was shifted to other demographic factors such as family structure. The risk for childhood obesity is higher for first-born children and decreases with an increasing number of siblings in the home in both races. Sociodemographic factors are important in the development of childhood obesity and in the development of prevention strategies. 

AUTHOR: Ikeda, Joanne, M.A., R.D., Brainen-Rodriguez, Laura, M.P.H., R.D. 
TITLE:  Helping Physicians Learn how to Promote Body Satisfaction in Children
SOURCE: Healthy Weight Journal May/Jun 1999; Vol. 13 No. 3 1999 
ABSTRACT: Article provides an overview of a one-day seminar developed in California by nutritionists from the University of California and the State Department of Health. The seminar helps health care providers and other professionals involved in childhood obesity recognize the important role that they play in promoting body satisfaction and a positive body image among young people.  All of the doctors and most of the other participants came away from the seminar with plans to change the way in which they interact with children to promote improved body satisfaction. The program will soon be available at cost to health professionals outside of California. 

AUTHOR: Petersmarck, Karen, Ph.D, M.P.H., R.D. 
TITLE:  SIZE ACCEPTANCE: Shaming Heavy Kids at School  Body Composition as Part of Fitness Testing
SOURCE: Healthy Weight Journal May/Jun 1999; Vol. 13 No. 3 1999 
ABSTRACT: Fitness testing is now part of the physical education program in many U.S. schools to evaluate the program and to provide each child with reasonable goals for improvement. Article questions the validity of including body mass as an evaluation tool. Body composition is included because of the false assumption that only slender individuals can be fit. Testing is done to measure "health-related fitness," however, there is no consensus on the definition of this term. Children must be given realistic goals that can be met through hard work, with praise given when they achieve these goals. 

AUTHOR: Satter, Ellyn, M.S., R.D., C.I.C.S.W., B.C.D. 
TITLE:  A Lesson to Raise a Healthy Eater
SOURCE: Healthy Weight Journal May/Jun 1999; Vol. 13 No. 3 1999 
ABSTRACT: A prepublication excerpt from Ellyn Satter's newest book "Secrets of Feeding a Healthy Family," which shows parents, teachers, and nutritionists how to help children develop healthy eating habits. Concepts include reinforcement of a child's inborn ability to regulate food intake, acceptance of the fact that everyone is different, and guidance for children who have lost their intuitive ability to regulate food intake. 

BOOK REVIEWS
SOURCE: Healthy Weight Journal May/Jun 1999; Vol. 13 No. 3 1999 
The Unofficial Guide to Dieting by Janis Jibrin, M.S., R.D. 
Despite its title this book does not advocate  dieting, but does discuss healthy ways to change eating and activity patterns. There is no need to become thin or lose weight if it is not harming you physically or emotionally. Sound nutrition principles, vegetarianism, the Mediterranean pyramid, supplements, set point, weight loss myths, the benefits of physical activity, etc. are discussed in detail as well as the pros and cons of the many different programs available. 

SOURCE: Healthy Weight Journal May/Jun 1999; Vol. 13 No. 3 1999 
Worth Your Weight: What You Can Do About a Weight Problem by Barbara Altman Bruno, Ph.D. 
A self-help guide that leads readers through the maze of making peace with their bodies, appetite, and eating. Bruno, a psychotherapist who treats food and weight problems through her Weight Release program, helps people end the cycle of obsessive dieting and self-hatred in which many are trapped by advising balance. Self-confidence is the norm regardless of size. Although recommended for self-help, the book provides valuable insights for therapists and can be used as an adjunct to treatment. 

AUTHOR: NIH 
TITLE:  NIH Guidelines on Obesity: A Summary
SOURCE: Healthy Weight Journal Mar/Apr 1999; Vol. 13 No. 2 1999 
ABSTRACT: Article summarizes the guidelines, which are based on an evaluation of published information on overweight and obesity by a panel of experts. The guidelines state that obesity is a chronic disease that is linked to genotype and the environment. Obesity is defined, risk groups are identified, and reasons for treatment are discussed. Patient motivation and goals for weight loss and management are examined. Six weight loss regimens and weight loss maintenance are reviewed. 

AUTHOR: Berg, Frances M., M.S. 
TITLE:  NIH Guidelines: Internal Contradictions
SOURCE: Healthy Weight Journal Mar/Apr 1999; Vol. 13 No. 2 1999 
ABSTRACT: Article identifies controversies within the NIH guidelines that provide evidence against their claim that the healthiest BMI is between 18.5 and 24.9. Published epidemiologic studies in fact suggest that mortality rates may be elevated in persons with BMIs in the range suggested. The recommendations do not take into account differences in obesity risk for ethnic and racial minorities. They also overlook recent findings related to the significance of obesity in older adults and the effects of weight loss for individuals over the age of 65. 

AUTHOR: Berg, Frances M., M.S. 
TITLE:  NIH Guidelines: An Evaluation
SOURCE: Healthy Weight Journal Mar/Apr 1999; Vol. 13 No. 2 1999 
ABSTRACT: Purpose of guidelines is to provide health professionals with the best information on risk groups and most appropriate treatment. Many experts in the field believe that the guidelines are based on two false assumptions - that a BMI above 25 constitutes a health risk and that safe and effective weight loss therapy exists. Focus of guidelines is weight loss not health with no evaluation of research on risks of dieting and weight loss, dysfunctional eating, eating disorders, weight cycling, etc. They appear to assist the weight loss industry more than health professionals and consumers. 

AUTHOR: Berg, Frances M., M.S. 
TITLE:  Slenderstrip claims to increase metabolism
SOURCE: Healthy Weight Journal Mar/Apr 1999; Vol. 13 No. 2 1999 
ABSTRACT: Slenderstrip is another magical cure for weight loss. The "special ingredient" in the patch is a natural plant extract, Fucus vesiculosus, that increases metabolism, helping to burn away excess fat. According to the author, it is ineffective. 

AUTHOR: Berg, Frances M., M.S. 
TITLE:  Cellulift creates fat "cellumotion"
SOURCE: Healthy Weight Journal Mar/Apr 1999; Vol. 13 No. 2 1999 
ABSTRACT: The advertisement for the Cellulift Massage system is cautious and claims that the gadget will temporarily reduce the appearance of fat cells, then goes on to suggest permanence. Tests by the author found it to be totally ineffective. 

AUTHOR: Johnson, Carol A., M.A. 
TITLE:  SIZE ACCEPTANCE: Do-it-yourself self-esteem repair
SOURCE: Healthy Weight Journal Mar/Apr 1999; Vol. 13 No. 2 1999 
ABSTRACT: A list if 23 points to help large people improve their self-esteem. Reprinted with permission from "Self-Esteem Comes in all Sizes." The list focuses on individual seeing herself as a total person and assessing her self-worth on the basis of how she treats others and herself, and contributions to family, friends, and community. List and frequently review strengths. Maintain a positive focus, avoiding self- criticism. 

BOOK REVIEWS
SOURCE: Healthy Weight Journal Mar/Apr 1999; Vol. 13 No. 2 1999 
Active for Life Program by Shirley Dzikowski and Brenda Sue Black. A community physical activity program that works in West Virginia is being offered nationwide by the West Virginia University extension service. The program is designed for seniors and relies on volunteers as program coordinators and wellness directors. Sponsorship by a local group is advised, with support from business and industry. Program provides three support pieces; an individualized exercise manual, a 24-minute video, and a Resource guide with step-by-step instructions for setting up the program. 

TITLE: Exploding the myth: Weight loss does not make you healthier
AUTHOR: Ernsberger, Paul, Ph.D. 
SOURCE:   Healthy Weight Journal Jan/Feb 1999; Vol. 13:1:4 
ABSTRACT: Weight loss plays a major role in the medical management of diabetes type 2, hypertension, and hypercholesterolemia. The author explores the effects of weight loss programs on these diseases. Rapid drops in risk factors may be a biologic response to the state of mild starvation rather than loss of body fat stores. Overall benefits of weight loss in reducing risk factors are short-term and can lead to more serious problems. Modern drugs combined with sustainable lifestyle changes are more reliable and effective treatments. 

TITLE:  Exploding the myth: Dieting makes you thin
AUTHORS: Heatherton, Todd and Tickle Jennifer 
SOURCE:   Healthy Weight Journal Jan/Feb 1999; Vol. 13:1:7 
ABSTRACT: Most people who successfully lose weight through diet programs eventually gain it back. The reasons for the failure of diet programs are examined. Genetic predisposition, environmental conditions, the eating habits of chronic dieters (restrained eaters), and lifestyles are examined. The effects of millions of years of evolutionary pressure also are considered. The storage of adipose tissue allowed humans to survive when food was scarce. Our sedentary lifestyles further contribute to the problem. Body weight is best controlled by following a nutritionally balanced diet combined with moderate levels of physical activity. 

TITLE:  Exploding the myth: Dieting makes you happier
AUTHORS:  Mills, Jennifer S., M.A., McCabe Randi E., M.A., and Polivy, Janet, Ph.D. 
SOURCE:   Healthy Weight Journal Jan/Feb 1999; Vol. 13:1:9 
ABSTRACT: Dieters typically believe that dieting will make them happier by making them feel better about themselves. This does occur in the early stages of dieting because of the perception of rapid weight loss induced by an empty stomach and fluid loss. As the diet continues, self-imposed restrictions on what, how much, when, and where they can eat, cause dieters to become irritable and less energetic. Dietary restraint is significantly correlated with depression, social anxiety, stress, neuroticism, maladjustment, and emotional instability. Repeated diet failures exacerbate feelings of insecurity and body dissatisfaction and ultimately lead to a downward spiral of negative self-esteem. 

TITLE: Exploding the myth:  Dieters eat less than nondieters
AUTHORS: McCabe Randi E., M.A., Mills, Jennifer S., M.A., and Polivy, Janet, Ph.D. 
SOURCE:   Healthy Weight Journal Jan/Feb 1999; Vol. 13:1:11 
ABSTRACT:  Dieters (restrained eaters) do try to restrict their food intake, however, under many conditions, they actually eat as much or more than nondieters. Maintenance of control in the restrained eater is rare, because of a multitude of "diet disrupters" that trigger overeating (e.g., anxiety, distress, depression, strong positive affect, alcohol, and actual or anticipated consumption of "diet-breaking" foods). Dieting can lead to eating disorders, especially binge eating. The authors recommend an "undiet" program as the best approach for these individuals. If there is no diet there is no room for failure. Focus on other aspects of the self to derive esteem and satisfaction. 

TITLE: Size Acceptance: 1999 Women's Healthy Weight Day Awards
AUTHOR:  Berg, Frances M., R.D. 
SOURCE:   Healthy Weight Journal Jan/Feb 1999; Vol. 13:1:15 
ABSTRACT:  The positive message of Women's Health Weight Day on January 21, 1999, is that beauty, health, and strength comes in all sizes. Winners of this year's awards are Camryn Manheim, star of ABC's The Practice, who is an advocate for size acceptance; The Gym, a fitness center in Seattle that supports size diversity; Kellog's, which launched a Special K cereal "Reshape your Attitude" promotion by assuring women that accepting themselves is a sign of intelligence and looks beautiful on everyone; and finally, the teen magazine, JUMP, which features stories on self acceptance, size acceptance, or accepting less-than-perfect physical traits. 

TITLE: 1999 Slim Chance Awards
AUTHOR: Berg, Frances M., R.D. 
SOURCE:   Healthy Weight Journal Jan/Feb 1999; Vol. 13:1:14 
ABSTRACT:  Winners of the 10th annual Slim Chance awards are announced: Worst Product: Herbal Weight Loss Tea, which contains potent laxatives, diuretics, or other drugs that can cause serious side effects, including death; Most Outrageous: Slim America, which ran full page ads in major newspapers claiming the wonders of their Super-Formula pills; Worst Claim: Calorad, which claims that you lose fat while gaining muscle; and Worst Gadget: Ace bandage wrap which claims that you will lose inches while cleansing "environmental poisons" from your body.