Page 578 - Encyclopedia of Nursing Research

WeIGhT MAnAGeMenT n 545

choices, and when to eat offer temporary minutes daily difficult and unrealistic over
modifications that are unrealistic for the long the long term. Jakicic, Winters, Lang, and
term and often are accompanied by rebound Wing (1999) found that 10-minute exercise W–Z
weight gain and detrimental psychological bouts done three to six times daily can be
consequences (Popkess-Vawter et al., 2005). effective for weight management and more
Strategies that concentrate on modifying practical for busy people’s lifestyles. Small
behavior by differentiating stimuli before, targeted behavioral changes (e.g., walking
during, and after eating are a healthy start 15–20 minutes daily) can significantly con-
toward lasting weight management (i.e., tribute toward sustained weight loss. There
identifying stimuli other than hunger that is growing evidence that 5% to 7% of max-
trigger eating, monitoring amounts and con- imum weight lost is associated with lower
ditions during eating, and rewarding appro- incidence of diabetes, reduced blood pres-
priate actions). One reason why behavioral sure, and improved dyslipidemia (yanovski
techniques have limited success is because & yanovski, 2002). Modest weight loss and
they seek to control the diet and environ- improved fitness can lower comorbidity risk
ment without considering eating as a coping and ultimately lead to sustained weight man-
mechanism to manage unpleasant feelings agement (Blackburn et al., 2010).
(Popkess-Vawter, Brandau, & Straub, 1998). Convenient and practical means to
Few current weight management behav- offer multidimensional weight management
ioral approaches, cognitive restructuring, or approaches include use of telehealth video-
combinations thereof directly address how conferencing, telephone, and the Internet,
negative beliefs about self and irrational per- which in turn offer greater access for study
ceptions of the world can trigger negative self- participants and future applications for for-
talk with resultant responses of overeating, mal programs (enwald & huotari, 2010; Kim
skipping regular exercise, and feeling bad et al., 2010). Research is needed to develop and
about self (Popkess-Vawter, 2008). Increasing test community-structured and work-related
numbers of researchers have reported find- multidimensional programs (Apovian, 2010;
ings from weight management studies based Greener, Douglas, & vanTeijlingen, 2010).
on psychosocial theories such as self-efficacy, Collaboration among researchers, health pro-
transtheoretical model, self-determination fessionals, policy makers, and community
theory, and health belief model, which sug- leaders is essential for tailoring meaningful
gest progress in using holistic strategies for research (Flegal et al., 2010).
eating, exercise, and psychosocial aspects. The ultimate goal of weight manage-
Stringent recommendations of the past ment is to prevent obesity and its comorbidi-
have only fueled the obesity epidemic (hill ties (Serdula, Khan, & Dietz, 2003). Research
et al., 2003). nhLBI weight management pro- agendas must include the refractory nature
grams like “America on the Move” and the and high recidivism to assure long-term
2005 Dietary Guidelines for Americans are weight management. Primary care clinics
national initiatives that have accommodated are frontline settings to approach people
people’s busy lives by suggesting “real world, about weight management, but structured
do-able” eating and exercise goals for revers- and practical treatments are still lacking.
ing the obesity epidemic. Consistent research Providers may not be aware of their power-
findings have shown that 60 to 90 minutes ful influence in helping patients with weight
per day of moderate intensity physical activ- management (Clark et al., 2010; heintze et al.,
ity is needed to maintain a significant weight 2010). health professionals and patients need
loss (hill & Wyatt, 2005). Despite these prom- to be educated about the benefits of modest
ising findings, most people, normal weight weight loss using evidence-based methods
or overweight, will find exercising 60 to 90 (Phelan, nallari, Darroch, & Wing, 2009). To