Bradley Waggoner, MD

Lifestyle Intervention for Overweight Patients With Diabetes Provides Long-Term Benefits

An intensive lifestyle intervention appears to help individuals with type 2 diabetes lose weight and keep it off, along with improving fitness, control of blood glucose levels and risk factors for cardiovascular disease, according to a report in the September 27 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Improving blood glucose control and cardiovascular risk factors in patients with type 2 diabetes is critical in preventing long-term complications of the disease, according to background information in the article. Emphasis has been placed on screening and pharmacologic management of these parameters. "Lifestyle-based weight loss interventions are also recommended to improve glycemic control and risk factors, but the evidence supporting the efficacy of lifestyle approaches is limited to short-term studies of typically less than one year," the authors write.

The Look AHEAD (Action for Health in Diabetes) Research Group conducted a multicenter randomized clinical trial comparing the effects of an intensive lifestyle intervention to diabetes support and education among 5,145 overweight or obese individuals (average age 58.7) with type 2 diabetes. Of these, 2,570 were assigned to the lifestyle intervention, a combination of diet modification and physical activity designed to induce a 7 percent weight loss in the first year and maintain it in subsequent years. Participants were seen and contacted by phone at least monthly for all four years. The 2,575 individuals assigned to the diabetes support and education group were invited to three group sessions each year focusing on diet, physical activity and social support.

On average, across the four-year period, individuals in the lifestyle intervention group lost a significantly larger percentage of their weight than did those in the diabetes support group (6.2 percent vs. 0.9 percent). They also experienced greater improvements in fitness, hemoglobin A1c level (a measure of blood glucose), blood pressure and levels of high-density lipoprotein (HDL, or "good" cholesterol). Individuals in the diabetes support group, on the other hand, experienced greater reductions in low-density lipoprotein (LDL, or "bad") cholesterol, owing to greater use of cholesterol-lowering medications in this group.

At the end of four years, the lifestyle intervention group maintained greater improvements in weight, fitness, hemoglobin A1c levels, systolic (top number) blood pressure and HDL levels. "Although the differences between the two groups were greatest initially and decreased over time for several measures, the differences between the groups averaged across the four years were substantial and indicate that the intensive lifestyle intervention group spent a considerable time at lower cardiovascular disease risk," the authors write.

"The critical question is whether the differences between groups in risk factors will translate into differences in the development of cardiovascular disease," they continue. "These results will not be available for several additional years. However, effects of the magnitude that we observed for fitness, HDL-C and hemoglobin A1c levels and blood pressure have been associated with decreased cardiovascular events and mortality in previous medication trials and observational studies. Moreover, there may be long-term beneficial effects from the four-year period in which intensive lifestyle intervention participants have been exposed to lower cardiovascular disease risk factors, as seen in other clinical trials."

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Source: Reprinted from materials provided by JAMA and Archives Journals. http://pubs.ama-assn.org/media/

Journal Reference: Arch Intern Med. 2010;170[17]:1566-1575l. 

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New Device Helps Monitor Low-Level Physical Activity With a Cell Phone

About two thirds of the American population is overweight or obese, putting them at higher risk for health problems such as heart disease, stroke, cancer and diabetes. The obesity epidemic in America is the result of poor eating habits, genetics, and a lack of exercise. It's therefore difficult for public health officials to get people to make a conscious effort to control their weight.

The Cell Phone Device That Helps You Exercise
This is why Chinmay Manohar in the Department Endocrinology, Nutrition and Diabetes of the Mayo Clinic is designing a device to help motivate people to be more active. His team has developed a program that helps people monitor their normal day-to-day physical activity using an every day device like a cell phone or mp3 player.

Mr. Manohar is presenting his team's work at the 2010 Experimental Biology meeting in Anaheim, CA (April 24-28). His presentation, entitled "Laboratory evaluation of the accuracy of a triaxial accelerometer embedded into a cell phone platform for measuring physical activity," is based on research performed with Shelly McCrady and James Levine of the Mayo Clinic, Rochester, MN; and Yuichi Fujiki and Ioannis Pavlidis from the Department of Computer Science at the University of Houston, Houston, TX.

Designing the Right Device
The idea took hold when a study published by Manohar's department showed that under a controlled diet, leaner people tend to spend two and a half more hours per day standing than did heavier people. The results indicated that leaner people were more active in their day-to-day activities even when they weren't exercising. According to Manohar, "If that is the case, why don't we encourage people to get out of their chairs?"

Manohar's group set out to design a device to promote more physical activity. The ideal device would be something that is affordable and commercially available. The team settled on the iPhone® and the iPod Touch® because many people already own these devices and they come with built-in motion sensors. The research group created a program called the Walk n'Play that can be downloaded for free through iTunes® to distribute the technology to a wider population. More and more Smart phones are using motion sensors and making the program compatible between platforms will not be difficult.

Walk n'Play: Designed for Everybody
The current version is fairly basic, according to Manohar. The user inputs their height and weight into the program and throughout the day, their score can be monitored. The program will tell the user if they are winning or losing against the computer. There is no pressure and the game does not ask you to do any specific exercise. But turning physical activity into a game makes people more competitive and more likely to get active.

Manohar says that most off-the-shelf devices tend to be unreliable for measuring the lower speeds detected by the Walk n'Play. This is because most of the devices on the market are used for measuring exercise like jogging or running, not for the day-to-day movement for which the Walk n'Play is designed. The program was tested for the ability to detect changes in movement as little as half a mile per hour. They tested positions from 31 volunteers like sitting, standing and lying down and tested seven speeds on the treadmill to determine how precise the program was. Using the results of these movement tests, Manohar's group developed a gold standard for typical movements used in daily activities.

The iPhone® and the iPod Touch® use motion sensors called accelerometers that detect motion. The program is designed to access the accelerometer in the phone and convert the motion that is detected into activity units as a way to measure the physical activity.

A Motivational Push
Over 10,000 people have already downloaded the Walk n'Play, but Manohar knows it will take more than a basic activity monitor to keep people's interest.

"You have to put an element of fun into the whole thing to encourage people to be more active," Manohar said, "we put people into a gaming mind-set and people unknowingly do exercise and have fun doing it."

The group further modified the program to integrate basic social networking. Fitness and weight-loss in general is easier to do with a buddy. The newer features will allow a person to play against their friends or even compete with people or top performers from other countries or time zones. Users can even post their performance as their Twitter status.

According to Manohar, most people know they need more exercise to maintain a healthy weight, but getting up the motivation for a workout plan can be daunting. Using programs like the Walk n'Play can encourage people to make incremental changes in their daily activities that can add up to better health, like promoting people to take the stairs more often to get in that extra little bit of exercise for the day.

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¹FASEB. http://www.fasebj.org

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Study Shows Exercising Just Got Easier for Busy People

If you’re the type of person who invokes the “not enough time” clause when it comes to exercising, it’s time to find a new excuse. Researchers who have been studying interval training have found that it not only takes less time than what is typically recommended, but the regimen does not have to be “all out” to be effective in helping reduce the risk of such diseases at Type 2 diabetes.

The study appears in the March issue of The Journal of Physiology.

“What we’ve been able to show is that interval training does not have to be ‘all out’ in order to be effective and time-efficient,” says Martin Gibala, professor and chair of the Department of Kinesiology at McMaster University. “While still a very demanding form of training, the exercise might be more achievable by the general public—not just elite athletes—and it certainly doesn’t require the use of specialized laboratory equipment.”

Since Gibala’s first study on interval training was published five years ago, a growing body of research has zeroed in on this particular style of exercise in which you train hard but for less time.

Previous research by the McMaster group involved 30 seconds of maximal pedaling on a special bike followed by four minutes of recovery, and repeated 4-6 times. The new study involves eight to 12 one-minute bouts of exercise on a standard stationary bicycle at a relatively lower intensity with rest intervals of 75 seconds, for a total of 20-25 minutes per session. The workload was still above most people’s comfort zone —about 95% of maximal heart rate — but only about half of what can be achieved when people sprint at an all-out pace.

“That is the trade-off for the relatively lower intensity,” says Gibala. “There is no free lunch; duration must increase as intensity decreases.”

While the total amount of exercise performed was higher than in Gibala’s previous interval training studies, the overall time commitment was still lower than what is typically recommended by public health agencies.

Subjects used in the study performed six training sessions over 14 days. After the two week training period, the subjects showed the same benefits that Gibala’s team has previously observed after traditional, long-duration endurance training: improved exercise performance and muscular adaptations that are linked to reduced risk of diseases such as Type 2 diabetes.

The study was made possible by funding from the Natural Sciences and Engineering Research Council of Canada.

Gibala is currently taking his research a step further by studying the effects of interval training on middle-aged and elderly participants who are non-traditional exercisers.

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¹McMaster University. http://www.mcmaster.ca/opr/html/opr/media/main/NewsReleases/news_releases.html

Medical Advice Disclaimer: The content of this blog entry is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, or other qualified health provider with any questions you may have regarding a medical condition.

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If you are considering weight loss surgery, you owe it to yourself to choose a physician who is not only highly skilled, but caring and compassionate as well. Many physicians out there will treat your obesity. Dr. Waggoner will treat you!

To contact us for more information and/or to reserve your seat for the next free seminar, please click here.

New Eating Device Retrains Dietary Habits and Helps Children Lose Weight

A new computerized device that tracks portion size and how fast people eat is more successful in helping obese children and adolescents lose weight than standard treatments, according to research published on bmj.com¹.

The Mandometer device, a portable computerized weighing scale, was developed at the Karolinska Institutet in Stockholm. It helps to retrain individuals to eat less and more slowly by providing real-time feedback during meal times. The device plots a graph showing the rate at which food actually disappears from the plate, compared to the ideal graph programmed in by a food therapist.

Childhood obesity is an increasing global problem and there is little evidence to support one specific treatment program. While it is unknown whether specific eating patterns are common in all obese people, in this study the patients ate large portions very quickly.

Researchers at Bristol Royal Hospital for Children and the University of Bristol, led by Professor Julian Hamilton-Shield, carried out a randomized controlled trial of 106 obese patients aged between 9-17 years.

One group of participants received Mandometer therapy to lose weight and the other were provided with standard care. Both groups were encouraged to increase their levels of physical activity to 60 minutes of exercise a day and to eat a balanced diet based on the Food Standards Agency "eatwell plate."

Participants were assessed after 12 months and followed up at 18 months. During the research period they were also regularly monitored and offered telephone support and encouragement.

After 12 months, the Mandometer group not only had a significantly lower average body mass index and body fat score than the standard care group, but their portion size was smaller and their speed of eating was reduced by 11% compared with a gain of 4% in the other group. Levels of 'good cholesterol' were also significantly higher in the Mandometer group.

The improvement in body mass index was maintained six months after the end of treatment, suggesting an element of longer term behavioral change, add the authors.

"Mandometer therapy, focusing on eating speed and meal size, seems to be a useful addition to the rather sparse options available for treating adolescent obesity effectively without recourse to pharmacotherapy," say the authors.

They acknowledge that the Mandometer requires further evaluation in other settings and with different groups of patients, but conclude that "Retraining eating behavior and reinforcing feelings of satiety, however, does seem to improve weight loss in obese adolescents."

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¹ http://www.bmj.com. Full text of this study can be found at the BMJ Journal's website.

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If you are considering weight loss surgery, you owe it to yourself to choose a physician who is not only highly skilled, but caring and compassionate as well. Many physicians out there will treat your obesity. Dr. Waggoner will treat you!

To contact us for more information and/or to reserve your seat for the next free seminar, please click here.

Exercise Counters Negative Effects of Weight Regain, MU Researchers Find

With the obesity rate rising for American adults and children, health concerns such as diabetes and cardiovascular disease are a frequent reality. Although obesity itself is a major risk factor for disease, most of the threat may be associated with a cluster of risk factors called the metabolic syndrome (MetS). Losing weight can improve health and reduce these risk factors, but many people have difficulty keeping the weight off. Now, University of Missouri researchers have found that exercising during weight regain can maintain improvements in metabolic health and disease risk.¹

In the study, individuals who didn’t exercise during weight regain experienced significant deterioration in metabolic health, while those who exercised maintained improvements in almost all areas. The MU study, led by Tom R. Thomas, professor in the Department of Nutrition and Exercise Physiology in the College of Human Environmental Sciences, is the first to examine the role of exercise in countering the negative effects of weight regain on MetS and overall health status.

“Although many people are successful at losing weight through diet and exercise, the majority of them will relapse and regain the weight,” Thomas said. “The findings of this study indicate that regaining weight is very detrimental; however, exercise can counter those negative effects. The findings support the recommendation to continue exercising after weight loss, even if weight is regained.”

In the study, overweight men and women with measured characteristics of MetS were given a diet and aerobic exercise plan that included supervised exercise five days a week, for 4-6 months. After losing weight, participants underwent programmed weight regain and were separated into two groups, one that exercised and one that didn’t. The non-exercise group experienced rapid deterioration in weight-loss induced benefits to metabolic health. The exercise group maintained improvements in almost all measures, including LDL and HDL cholesterol, oxygen consumption (VO2max), blood pressure and glucose. Exercise didn’t maintain blood cholesterol and abdominal fat loss.

“It’s clear that the message to lose weight isn’t working because so many people regain weight; a new message is to keep exercising and maintain your weight to reduce disease risk and improve overall health,” Thomas said. “Don’t worry so much about losing weight, but focus on exercising and maintaining your current weight.”

The study will be published in the Journal of Applied Physiology in April. Thomas, adjunct professor in the Department of Cardiovascular Medicine, completed the study in collaboration with MU researchers in the Department of Internal Medicine; the Department of Medical Pharmacology and Physiology; the Harry S. Truman VA Medical Center; and the Department of Educational, School and Counseling Psychology.

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¹University of Missouri News Bureau. http://munews.missouri.edu/index.php

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If you are considering weight loss surgery, you owe it to yourself to choose a physician who is not only highly skilled, but caring and compassionate as well. Many physicians out there will treat your obesity. Dr. Waggoner will treat you!

Contact Bradley Waggoner, MD:

• If you are ready to set-up an appoint to discuss your weight loss options.
• Reserve your seat at the next free informational seminar outlining your obesity surgery options (including lap-band system procedures) and meet Bradley Waggoner in person.

If you'd like to set-up an appointment to further discuss your weight loss surgical options, please contact us.

What You Eat After Exercise Matters

Many of the health benefits of aerobic exercise are due to the most recent exercise session (rather than weeks, months and even years of exercise training), and the nature of these benefits can be greatly affected by the food we eat afterwards, according to a study published in the Journal of Applied Physiology

“Differences in what you eat after exercise produce different effects on the body’s metabolism,” said the study’s senior author, Jeffrey F. Horowitz of the University of Michigan. This study follows up on several previous studies that demonstrate that many health benefits of exercise are transient: one exercise session produces benefits to the body that taper off, generally within hours or a few days.

“Many of the improvements in metabolic health associated with exercise stem largely from the most recent session of exercise, rather than from an increase in ‘fitness’ per se,” Dr. Horowitz said. “But exercise doesn’t occur in a vacuum, and it is very important to look at both the effects of exercise and what you’re eating after exercise.”

Specifically, the study found that exercise enhanced insulin sensitivity, particularly when meals eaten after the exercise session contained relatively low carbohydrate content. Enhanced insulin sensitivity means that it is easier for the body to take up sugar from the blood stream into tissues like muscles, where it can be stored or used as fuel. Impaired insulin sensitivity (i.e., “insulin resistance”) is a hallmark of Type II diabetes, as well as being a major risk factor for other chronic diseases, such as heart disease.

Interestingly, when the research subjects in this study ate relatively low-calorie meals after exercise, this did not improve insulin sensitivity any more than when they ate enough calories to match what they expended during exercise. This suggests that you don’t have to starve yourself after exercise to still reap some of the important health benefits.

The paper, “Energy deficit after exercise augments lipid mobilization but does not contribute to the exercise-induced increase in insulin sensitivity,” appears in the online edition of the journal. The authors are Sean A. Newsom, Simon Schenk, Kristin M. Thomas, Matthew P. Harber, Nicolas D. Knuth, Haila Goldenberg and Dr. Horowitz. All are at the University of Michigan. The American Physiological Society published the research.

The study included nine healthy sedentary men, all around 28-30 years old. They spent four separate sessions in the Michigan Clinical Research Unit in the University of Michigan Hospital. Each session lasted for approximately 29 hours. They fasted overnight before attending each session, which began in the morning.

The four hospital visits differed primarily by the meals eaten after exercise. The following describes the four different visits:

• They did not exercise and ate meals to match their daily calorie expenditure. This was the control trial.

• They exercised for approximately 90 min at moderate intensity, and then ate meals that matched their caloric expenditure. The carbohydrate, fat, and protein content of these meals were also appropriately balanced to match their expenditure.

• They exercised for approximately 90 min at moderate intensity and then ate meals with relatively low carbohydrate content, but they ate enough total calories to match their calorie expenditure. This reduced-carbohydrate meal contained about 200 grams of carbohydrate, less than half the carbohydrate content of the balanced meal.

• They exercised for approximately 90 min at moderate intensity and then ate relatively low-calorie meals, that is, meals that provided less energy than was expended (about one-third fewer calories than the meals in the other two exercise trials). These meals contained a relatively high carbohydrate content to replace the carbohydrate “burned” during exercise.

The exercise was performed on a stationary bicycle and a treadmill. The order in which the participants did the trials was randomized.

In the three exercise trials, there was a trend for an increase in insulin sensitivity. However, when participants ate less carbohydrate after exercise, this enhanced insulin sensitivity significantly more. Although weight loss is important for improving metabolic health in overweight and obese people, these results suggests that people can still reap some important health benefits from exercise without undereating or losing weight, Dr. Horowitz said.

The study also reinforces the growing body of evidence that each exercise session can affect the body’s physiology and also that differences in what you eat after exercise can produce different physiological changes.

The research team is now performing experiments with obese people, aimed at better identifying the minimum amount of exercise that will still improve insulin sensitivity at least into the next day.

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Story Source: Adapted from materials provided by  The American Physiological Society.

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If you are considering weight loss surgery, you owe it to yourself to choose a physician who is not only highly skilled, but caring and compassionate as well. Many physicians out there will treat your obesity. Dr. Waggoner will treat you!

Contact Bradley Waggoner, MD:

• If you are ready to set-up an appoint to discuss your weight loss options.
• Reserve your seat at the next free informational seminar outlining your obesity surgery options (including lap-band system procedures) and meet Bradley Waggoner in person.

If you'd like to set-up an appointment to further discuss your weight loss surgical options, please contact us.

Overweight in 20s could lead to serious problems in 40s

People who are obese and have type 2 diabetes in their 20s will be at higher risk of having a heart attack or stroke in their 40s if they do not change their lifestyle.

"If your blood pressure is 136/88 and you’re a man with a waist over 40 or a woman with a waist over 35 it spells trouble," said Dr. Dale J. Hamilton, diabetes clinical services chief at The Methodist Hospital in Houston. "These are two of the five symptoms of metabolic syndrome, a problem that can lead to type 2 diabetes. All you need is three to begin seeing increased atherosclerosis."

"High triglyceride levels over 150, insulin resistance and a low LDL (good cholesterol) are factors of metabolic syndrome, along with high blood pressure and central obesity. According to the American Heart Association more than 47 million Americans have it. Many of these patients will end up suffering with type 2 diabetes, which can eventually lead to coronary artery disease and stroke.

"Small changes every day can help curb big problems later on," Hamilton said. "Losing five to 10 pounds will help lower blood pressure. Reducing saturated fats, carbohydrates, and eating about two-thirds the amount you eat now will help you lose weight around the middle. Walk 45 minutes a day instead of 30."

Some experts believe replacing sugar with high fructose corn syrup in processed foods in the United States and Canada in the 1990s has played a role in the rise of type 2 diabetes cases. High fructose corn syrup is made by changing the sugar in corn starch to fructose, another form of sugar. It has become popular because it extends the shelf life of processed foods and is cheaper than sugar. It has also become a popular ingredient in many sodas and fruit-flavored drinks.

"The problem with high fructose corn syrup is that it promotes central obesity," Hamilton said. "Another problem with it is that it fools your body into thinking you are hungry. I don’t think you need to eliminate it from your diet, you just need to be aware of how much of it you are consuming on a daily basis because too much can lead to serious weight gain."

Keep in mind, he said, type 2 diabetes symptoms often go untreated because there are few or no symptoms until it is too late.

"Having three or more of the risk factors associated with type 2 diabetes over an extended period of time is the equivalent of already having a heart attack," Hamilton said. "These risk factors need to be treated aggressively in order to curb the problem and give you a better chance at a longer, healthier life."

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Story Source: Adapted from materials provided by  The Methodist Hospital - Houston.

Medical Advice Disclaimer: The content of this blog entry is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, or other qualified health provider with any questions you may have regarding a medical condition.

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If you are considering weight loss surgery, you owe it to yourself to choose a physician who is not only highly skilled, but caring and compassionate as well. Many physicians out there will treat your obesity. Dr. Waggoner will treat you!

To contact us for more information and/or to reserve your seat for the next free seminar, please click here.

Adding 30 minutes of Daily Physical Activity Should Top New Year's Resolutions List

Peter Brubaker, Director of Healthy Exercise and Lifestyle Programs (HELPS) at Wake Forest University¹ in Winston-Salem, NC, offers ten [health] tips to get moving in 2010²:

1. Set a goal of 30 minutes a day of physical activity. It doesn't need to be all at once. Five minutes here, 10 minutes there is fine. As long as it is done at moderate intensity, you will get sufficient health benefits.


2. Walk. For most people, the easiest and most efficient activity is simply walking.


3. Wear a pedometer. Recent studies have shown that people wearing pedometers increase their activity level by 25 percent.


4. Build activity into your daily routine. Get up from your desk to deliver a message. Take the stairs instead of the elevator. Add some extra steps when you are doing household chores. Find small ways to get moving.


5. Record daily physical activity in a journal. Self-monitoring is important when making a lifestyle change and journaling activity levels can be good reinforcement.


6. Don't worry so much about weight loss. If you are regularly active you can get significant health benefits even if you never lose a pound. People serious about weight loss should build in 60 minutes per day of physical activity.


7. Find activities you enjoy and feel good about doing. Try a variety of activities. Variety is good for the body — and the mind.


8. Get the support of friends and family. Challenge them to add 30 minutes of physical activity to their daily routine, and you can hold each other accountable.


9. Set realistic expectations. The biggest obstacle to successful lifestyle change is expectation. People are unrealistic about what they can achieve and how quickly they can achieve it.


10. Don't emphasis Jan. 1 too much. There is a risk in building up expectations that you'll make a change just because it's the start of the new year. Any time of year is a good time to make a commitment to change your lifestyle.

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¹Wake Forest University.  http://www.wfu.edu/

²Medical Advice Disclaimer: The Content of this blog entry is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, or other qualified health provider with any questions you may have regarding a medical condition.

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If you are considering weight loss surgery, you owe it to yourself to choose a physician who is not only highly skilled, but caring and compassionate as well. Many physicians out there will treat your obesity. Dr. Waggoner will treat you!

To contact us for more information and/or to reserve your seat for the next free seminar, please click here.

Mental Barriers Hamper Obese Women’s Efforts To Get Exercise

Tailored Programs Could Help Curb Aversion
And Improve Adherence To Weight Loss Plan

For arachnophobes, it’s difficult to kill a spider as it scurries across the floor. Those who are scared to fly might not ever set foot on a plane. While nothing physically stops people with these aversions, a mental barrier can keep them from the task at hand.

The same can be said for obese women when it comes to physical activity, according to research presented at the Obesity Society’s Annual Meeting last October.

Researchers from the Center for Obesity Research and Education and the department of kinesiology at Temple University found that obese women face a significant number of barriers when it comes to exercise—more so than those of normal weight.

“This is the first time we’ve been able to systematically look at what stops obese women from getting the activity they need,” said Melissa Napolitano, Ph.D., associate professor of kinesiology and clinical psychologist at the Center for Obesity Research and Education at Temple University.

Napolitano and her team surveyed data collected from 278 women, both normal weight and obese, enrolled in a year-long physical activity encouragement study. At baseline, and 3- and 12-month follow up tests, all participants were administered a questionnaire to determine what factors kept them from getting exercise, including:

• Self-consciousness
• Fear of failure
• Fear of injury
• Perceived poor health
• Having minor aches or pains
• Feeling too overweight to exercise

At all time points, obese women reported greater barriers to being active than normal weight women. For obese women, barriers they identified at the beginning of the study predicted how much or how little they would be exercising at the 12-month follow-up.

“These might sound like excuses to some people, but for those who have these aversions, they’re real problems,” said Napolitano.

She theorizes that tailoring programs to maneuver around these barriers is the key to curbing some of that aversion and improving adherence to a weight loss goal. She cites the popular Curves® gyms as a step in the right direction, because they offer a comforting, welcoming environment for women to exercise in.

“There is an underlying attitude about weight loss, that it’s easy if you just eat less and exercise more,” she said. “But if losing weight were easy, we wouldn’t have the obesity epidemic we have today.”

The study was co-authored by Kelley Borradaile, research assistant professor of public health at the Center for Obesity Research and Education at Temple University. Funding for this research was provided by the Robert Wood Johnson Foundation and assistance from the American Heart Association.

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¹Temple University. October 5, 2008. "Mental Barriers Hamper Obese Women's Efforts To Get Exercise" <http://www.temple.edu/newsroom/2008_2009/10/stories/mentalbarriers.htm>

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