Obesity

A Health Psychology Perspective
  • Matthew M. Clark
  • Michael G. Goldstein
Part of the Springer Series in Rehabilitation and Health book series (SSRH)

Abstract

Obesity is a public health problem because of the medical complications associated with it, its prevalence, and recidivism following treatment (Brownell & Wadden, 1992). Presence of obesity correlates with hypertension, diabetes mellitus, certain forms of cancer, cardiovascular disease, sleep apnea, arthritis, gout, and gall bladder disease (Hubert, Feinleib, McNamara, & Castelli, 1983). Approximately 25% of the American population is obese, and obesity is rapidly becoming the most common form of nutritional imbalance in some Third World countries, such as Kenya (Atkinson, 1990). Treatment studies have yielded high attrition rates and poor long-term results (Hovell et al., 1988; Wadden, Stunkard, & Liebschutz, 1988). Obesity involves a complex interaction of physiological, genetic, psychological, sociocultural, and environmental factors. Recently, individual differences that may influence patient treatment-matching recommendations have received attention (Brownell & Wadden, 1992). This chapter reviews the literature and discusses guidelines for patient—treatment matching for obese adults.

Keywords

Eating Disorder Obese Individual Binge Eating Binge Eating Disorder Rest Metabolic Rate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Agras, W. S. (1991, March). Overweight people are not all the same: How types and differences should guide interventions. Paper presented at the Annual Convention of the Society of Behavioral Medicine, Washington, DC.Google Scholar
  2. Andres, R., Elahi, D., Tobin, J. D., Muller, D. C., & Brant, L (1985). Impact of age on weight goals. Annals of Internal Medicine, 103, 1030–1033.PubMedCrossRefGoogle Scholar
  3. Atkinson, R. (1990, November). Cost-effectiveness of the treatment of obesity. Paper presented at a Conference on Treatment of the Patient with Medically Significant Obesity, Atlanta, GA.Google Scholar
  4. Blackburn, G. L., & Kanders, B. S. (1987). Medical evaluation and treatment of the obese patient with cardiovascular disease. American Journal of Cardiology, 60, 55G–58G.PubMedCrossRefGoogle Scholar
  5. Blackburn, G. L., Lynch, M. E., & Wong, S. L (1986). The very-low-calorie diet: A weight-reduction technique. In K. D. Brownell & J. P. Foreyt (Eds.), Handbook of eating disorders (pp. 198–212). New York: Basic Books.Google Scholar
  6. Bouchard, C., Tremblay, A., Despres, J.P., Nadeau, A., Lupien, P. J., Theriault, G., Dussault, J., Moorjani, S., Pinault, S., & Föurnier, G. (1990). The response to long-term overfeeding in identical twins. New England Journal of Medicine, 322, 1477–1482.PubMedCrossRefGoogle Scholar
  7. Bray, G. A. (1989). Classification and evaluation of the obesities. Medical Clinics of North America, 73, 161–183.PubMedGoogle Scholar
  8. Bray, G. A. (1991). Barriers to the treatment of obesity. Annals of Internal Medicine, 115, 152–153.PubMedCrossRefGoogle Scholar
  9. Bray, G. A. (1992). Drug treatment of obesity. American Journal of Clinical Nutrition, 55, 538S–544S.PubMedGoogle Scholar
  10. Brownell, K. D. (1984). Behavioral, psychological, and environmental predictors of obesity and success at weight reduction. International Journal of Obesity, 8, 543–550.PubMedGoogle Scholar
  11. Brownell, K. D. (1991). Dieting and the search for the perfect body: Where physiology and culture collide. Behavioral Assessment, 22, 1–12.Google Scholar
  12. Brownell, K. D., & Wadden, T. A. (1986). Behavior therapy for obesity: Modern approaches and better results. In K. D. Brownell & J. P. Foreyt (Eds.), Handbook of eating disorders (pp. 180–197). New York: Basic Books.Google Scholar
  13. Brownell, K. D., & Wadden, T. A. (1991). The heterogeneity of obesity: Fitting treatments to individuals. Behavior Therapy, 22, 153–177.CrossRefGoogle Scholar
  14. Brownell, K. D., & Wadden, T. A. (1992). Etiology and treatment of obesity: Understanding a serious, prevalent, and refractory disorder. Journal of Consulting and Clinical Psychology, 60, 505–517.PubMedCrossRefGoogle Scholar
  15. Clark, M. M., Ruggiero, L., Pera, V., Goldstein, M. G., & Abrams, D. B. (1993). Assessment, classification and treatment of obesity: A behavioral medicine perspective. In A. Stoudemire & B. S. Fogel (Eds.), Principles of medical psychiatry (2nd ed., pp. 903–926). New York: Oxford University Press.Google Scholar
  16. Consensus Development Conference Panel. (1991). Gastrointestinal surgery for severe obesity: Consensus Development Conference statement. Annals of Internal Medicine, 115, 956–961.CrossRefGoogle Scholar
  17. Courtois, C. (1988). Healing the incest wound: Adult survivors in therapy. New York: Norton.Google Scholar
  18. Craighead, L. W., & Blum, M. D. (1989). Supervised exercise in behavioral treatment for moderate obesity. Behavior Therapy, 20, 49–59.CrossRefGoogle Scholar
  19. Craighead, L M., Stunkard, A. J., & O’Brien, R. (1981). Behavior therapy and pharmacotherapy of obesity. Archives of General Psychiatry, 38, 763–768.PubMedCrossRefGoogle Scholar
  20. Curb, J. D., & Marcus, E. B. (1991). Body fat and obesity in Japanese Americans. American Journal of Clinical Nutrition, 53, 1552S–1555S.PubMedGoogle Scholar
  21. Dahlstrom, W. G., Welch, G. S., & Dahlstrom, L E. (1972). An MMPI handbook: VoL 1. Clinical interpretation (2nd ed.). Minneapolis: University of Minnesota Press.Google Scholar
  22. Doyne, E. J., Ossip-Klein, D. J., Bowman, E. D., Osborn, K. M., McDouglass-Wilson, I. B., & Neimeyer, R. A. (1987). Running versus weight lifting in the treatment of depression. Journal of Consulting and Clinical Psychology, 5, 748–754.CrossRefGoogle Scholar
  23. Dreon, D. M., Frey-Hewitt, B., Ellsworth, N., Williams, P. T., Terry, R. B., & Wood, P. D. (1988). Dietary fat: Carbohydrate ratio and obesity in middle-aged men. American Journal of Clinical Nutrition, 47, 995–1000.PubMedGoogle Scholar
  24. Fitzgibbon, M. L., & Kirschenbaum, D. S. (1991). Distressed binge eaters as a distinct subgroup among obese individuals. Addictive Behaviors, 16, 441–451.PubMedCrossRefGoogle Scholar
  25. Foreyt, J. P. (1987). Issues in the assessment and treatment of obesity. Journal of Consulting and Clinical Psychology, 55, 677–684.PubMedCrossRefGoogle Scholar
  26. Garner, D. M., & Wooley, S. C. (1991). Confronting the failure of behavioral and dietary treatments for obesity. Clinical Psychology Review, 11, 729–780.CrossRefGoogle Scholar
  27. Guare, J. G., Wing, R. R., Marcus, M. D., Epstein, L H., Burton, L. R., & Gooding, W. E. (1989). Analysis of changes in eating behavior and weight loss in type II diabetic patients. Diabetes Care, 12, 500–503.PubMedCrossRefGoogle Scholar
  28. Haffner, S. M., Mitchell, B. D., Stem, M. P., Hazuda, H. P., & Patterson, J. K. (1992). Public health significance of upper body adiposity for non-insulin-dependent diabetes mellitus in Mexican Americans. International Journal of Obesity, 16, 177–184.PubMedGoogle Scholar
  29. Hall, J. C., Watts, J. M., O’Brien, P. E., Dunstan, R. E., Walsh, J. F., Slavotinek, A. H., Elmslie, R. G. (1990). Gastric surgery for morbid obesity: The Adelaide study. Annals of Surgery, 211, 419–427.PubMedCrossRefGoogle Scholar
  30. Hovell, M. F., Koch, A., Hofstetter, R., Sipan, G., Faucher, P., Dellinger, A., Borok, G., Forsythe, A., & Felitti, V. J. (1988). Long-term weight loss maintenance: Assessment of a behavioral and supplemented fasting regimen. American Journal of Public Health, 78, 665–666.CrossRefGoogle Scholar
  31. Hubert, H. B., Feinleib, M., McNamara, P. M., & Castelli, W. P. (1983). Obesity as an independent risk factor for cardiovascular disease: A 26-year follow-up of participants in the Framingham Heart Study. Circulation, 67, 968–977.PubMedCrossRefGoogle Scholar
  32. Kayman, S., Bruvold, W., & Stern, J. S. (1990). Maintenance and relapse after weight loss in women: Behavioral aspects. American Journal of Clinical Nutrition, 52, 800–807.PubMedGoogle Scholar
  33. Keefe, P. H., Wychogrod, D., Weinberger, E., & Argas, W S. (1984). Binge eating and outcome of behavioral treatment of obesity: A preliminary report. Behaviour Research and Therapy, 22, 319–321.PubMedCrossRefGoogle Scholar
  34. Klesges, R. C., Benowitz, N. L., & Meyers, A. W. (1991). Behavioral and biobehavioral aspects of smoking and smoking cessation: The problem of postcessation weight gain. Behavior Therapy, 22, 179–199.CrossRefGoogle Scholar
  35. Klesges, R G., Hanson, G L., Eck, L H., & Durff, A. C. (1988). Accuracy of self-reports of food intake in obese and normal-weight individuals: Effects of parental obesity on reports of children’s dietary intake. American Journal of Clinical Nutrition, 48, 1252–1256.PubMedGoogle Scholar
  36. Kraemer, H. C., Berkowitz, R. I., & Hammer, L. D. (1990). Methodological difficulties in studies of obesity: I. Measurement issues. Annals of Behavioral Medicine, 12, 112–118.CrossRefGoogle Scholar
  37. Krai, J. G. (1989). Surgical treatment of obesity. Medical Clinics of North America, 73, 251–264.Google Scholar
  38. Marcus, B. H., Selby, V. C., Niaura, R. S., & Rossi, J. S. (1992). Self-efficacy and the stages of exercise behavior change. Research Quarterly for Exercise and Sport, 63, 60–66.PubMedCrossRefGoogle Scholar
  39. Marcus, M. D., Wing, R. R., & Hopkins, J. (1988). Obese binge eaters: Affect, cognitions, and response to behavioral weight control. Journal of Consulting and Clinical Psychology, 56, 433–439.PubMedCrossRefGoogle Scholar
  40. Melby, G L., Schmidt, W. D., & Corrigan, D. (1990). Resting metabolic rate in weight-cycling collegiate wrestlers compared with physically active noncycling control subjects. American Journal of Clinical Nutrition, 52, 409–414.PubMedGoogle Scholar
  41. Miller, W. G (1991). Diet composition, energy intake, and nutritional status in relation to obesity in men and women. Medicine and Science in Sports and Exercise, 23, 280–284.PubMedGoogle Scholar
  42. Moore, R. S., & Roden, J. (1986). The influence of psychological variables in obesity. In K. D. Brownell & J. P. Foreyt (Eds.), Handbook of eating disorders (pp. 99–121). New York: Basic Books.Google Scholar
  43. National Institutes of Health Consensus Development Panel on the Health Implications of Obesity. (1985). Health implications of obesity: National Institutes of Health Consensus Development Conference statement. Annals of Internal Medicine, 103, 1073–1077.CrossRefGoogle Scholar
  44. National Institutes of Health Technology Assessment Conference Panel. (1992). Methods for voluntary weight loss and control. Annals of Internal Medicine, 116, 942–949.CrossRefGoogle Scholar
  45. Nauss-Karol, G., & Sullivan, A. C. (1988). Pharmacological approaches to the treatment of obesity. In R. T. Frankle & M.-U. Yang (Eds.), Obesity and weight control: The health professional’s guide to understanding and treatment (pp. 275–296). Rockville, MD: Aspen.Google Scholar
  46. Paffenbarger, R. S., Hyde, R. T., Wing, A. L., & Hsieh, C.-C. (1986). Physical activity, all-cause mortality, and longevity of college alumni. New England Journal of Medicine, 314, 605–613.PubMedCrossRefGoogle Scholar
  47. Paffenbarger, R. S., Hyde, R. T., Wing, A. L., & Steinmetz, C. H. (1984). A natural history of athleticism and cardiovascular health. Journal of the American Medical Association, 252, 491–495.PubMedCrossRefGoogle Scholar
  48. Pavlou, K. N., Krey, S., & Steffee, W. P. (1989a). Exercise as an adjunct to weight loss and maintenance in moderately obese subjects. American Journal of Clinical Nutrition, 49, 1115–1123.PubMedGoogle Scholar
  49. Pavlou, K. N., Whatley, J. E., Jannace, P. W., DiBartolomeo, J. J., Burrows, B. A., Duthie, E.A.M., & Lerman, R. H. (1989b). Physical activity as a supplement to a weight-loss dietary regimen. American Journal of Clinical Nutrition, 49, 1110–1114.PubMedGoogle Scholar
  50. Perri, M. G., McAllister, D. A., Gange, J.J., Jordan, R. G., McAdoo, W. G., & Nezu, A. M. (1988). Effects of four maintenance programs on the long-term management of obesity. Journal of Consulting and Clinical Psychology, 56, 529–534.PubMedCrossRefGoogle Scholar
  51. Ravussin, E., & Bogardus, C. (1992). A brief overview of human energy metabolism and its relationship to essential obesity. American Journal of Clinical Nutrition, 55, 242S–245S.PubMedGoogle Scholar
  52. Ravussin, E., Lillioja, S., Knowler, W. C., Christin, L., Freymond, D., Abbott, W.G.H., Boyce, V., Howard, B. V., & Bogardus, C. (1988). Reduced rate of energy expenditure as a risk factor for body-weight gain. New England Journal of Medicine, 318, 467–472.PubMedCrossRefGoogle Scholar
  53. Rodin, J., Radke-Sharpe, N., Rebuffe-Scrive, M., & Greenwood, M.R.C. (1990). Weight cycling and fat distribution. International Journal of Obesity, 14, 303–310.PubMedGoogle Scholar
  54. Romieu, I., Willett, W. C., Stampfer, M. J., Colditz, G. A., Sampson, L., Rosner, B., Hennekens, C. H., & Speizer, F. E. (1988). Energy intake and other determinants of relative weight. American Journal of Clinical Nutrition, 47, 406–412.PubMedGoogle Scholar
  55. Sallade, J. (1973). A comparison of the psychological adjustment of obese vs. nonobese children. Journal of Psychosomatic Research, 7, 89–96.CrossRefGoogle Scholar
  56. Schotte, D. E., Cohen, E., & Singh, S. P. (1990). Effects of weight cycling on metabolic control in male outpatients with non-insulin-dependent diabetes mellitus. Health Psychology, 9, 599–605.PubMedCrossRefGoogle Scholar
  57. Segal, K. R., Lacayanga, I., Dunaif, A., Gutin, B., & Pi-Sunyer, F. X. (1989). Impact of body fat mass and percent fat on metabolic rate and thermogenesis in men. American Journal of Physiology, 256, E573–E579.PubMedGoogle Scholar
  58. Sichieri, R., Everhart, J. E., & Hubbard, V. S. (1992). Relative weight classifications in the assessment of underweight and overweight in the United States. International Journal of Obesity, 16, 303–312.PubMedGoogle Scholar
  59. Spitzer, R. L., Yanouski, S., Wadden, T., Wing, R., Marcus, M. M., Stunkard, A., Devlin, ML., Mitchell, J., Hasin, D., & Home, R. L. (1993). Binge Eating Disorder: Its further validation in a multisite study. International Journal of Eating Disorders, 13, 137–153.PubMedCrossRefGoogle Scholar
  60. Steen, S. N., Oppliger, R. A., & Brownell, K. D. (1988). Metabolic effects of repeated weight loss and regain in adolescent wrestlers. Journal of American Medical Association, 260, 47–50.CrossRefGoogle Scholar
  61. Stunkard, A. J. (1986). Obesity. In R. Michels, A. M. Cooper, S. B. Guze, L. L. Juddy, G. L Klerman, A. J. Solnit, & A. J. Stunkard (Eds.), Psychiatry (pp. 1–13). Philadelphia: Lippincott.Google Scholar
  62. Stunkard, A. J., Harris, J. R., Pedersen, N. L., & McClearn, G. E. (1990). The body-mass index of twins who have been reared apart. New England Journal of Medicine, 322, 1483–1487.PubMedCrossRefGoogle Scholar
  63. Stunkard, A. J., & Wadden, T. A. (1992). Psychological aspects of severe obesity. American Journal of Clinical Nutrition, 55, 524S–532S.PubMedGoogle Scholar
  64. Surgeon General’s Report on Nutrition and Health: Summary and Recommendations. (1988). Rhode Island Medical Journal, 71, 391–401.Google Scholar
  65. Telch, C. F., Agras, W. S., Rossiter, E. M., Wilfley, D., & Kenardy, J. (1990). Group cognitive-behavioral treatment for the non-purging bulimic: An initial evaluation. Journal of Consulting and Clinical Psychology, 58, 629–635.PubMedCrossRefGoogle Scholar
  66. Vasselli, J. R., & Maggio, C. A. (1988). Mechanisms of appetite and body-weight regulation. In R. T. Frankle & M.-U. Yang (Eds.), Obesity and weight control: The health professional’s guide to understanding and treatment (pp. 17–34). Rockville, MD: Aspen.Google Scholar
  67. Wadden, T. A., & Stunkard, A. J. (1985). Social and psychological consequences of obesity. Annals of Internal Medicine, 103, 1062–1067.PubMedCrossRefGoogle Scholar
  68. Wadden, T. A., Stunkard, A. J., & Brownell, K. D. (1983). Very low calorie diets: Their efficacy, safety, and future. Annals of Internal Medicine, 99, 675–684.PubMedCrossRefGoogle Scholar
  69. Wadden, T. A., Stunkard, A. J., Brownell, K. D., & Day, S. C. (1985). A comparison of two very-low-calorie diets: Protein-sparing-modified fast versus protein-formula-liquid diet. American Journal of Clinical Nutrition, 41, 533–539.PubMedGoogle Scholar
  70. Wadden, T. A., Stunkard, A. J., & Iiebschutz, J. (1988). Three-year follow-up of the treatment of obesity by very low calorie diet, behavior therapy, and their combination. Journal of Consulting and Clinical Psychology, 56, 925–928.PubMedCrossRefGoogle Scholar
  71. Wadden, T. A., Van Itallie, T. B., & Blackburn, G. L (1990). Responsible and irresponsible use of very-low-calorie diets in the treatment of obesity. Journal of the American Medical Association, 263, 83–85.PubMedCrossRefGoogle Scholar
  72. Weintraub, M. T., & Bray, G. A. (1989). Drug treatment of obesity. Medical Clinics of North America, 73, 237–249.PubMedGoogle Scholar
  73. Wilson, G. T., Nonas, C. A., & Rosenblum, G. (1993). Assessment of binge-eating in obese patients. International Journal of Eating Disorders, 13, 25–33.PubMedCrossRefGoogle Scholar
  74. Wing, R. R., Epstein, L H., Paternostro-Bayles, M., Kriska, A., Nowalk, M. P., & Gooding, W. (1988). Exercise in a behavioral weight control programme for obese patients with type 2 (non-insulin-dependent) diabetes. Diabetologia, 31, 902–909.PubMedCrossRefGoogle Scholar
  75. Wing, R. R., Marcus, M. D., Epstein, L. H., Jawad, A. (1991). A “family-based” approach to the treatment of obese type II diabetic patients. Journal of Consulting and Clinical Psychology, 59, 156–162.PubMedCrossRefGoogle Scholar
  76. Wing, R. R., Shoemaker, M., Marcus, M. D., McDermott, M., & Gooding, W. (1990). Variables associated with weight loss and improvements in glycemic control in type II diabetic patients in behavioral weight control programs. International Journal of Obesity, 14, 495–503.PubMedGoogle Scholar
  77. Wise, T. N., & Gordon, J. (1977). Sexual functioning in the hyperobese. Obesity/Bariatric Medicine, 6, 84–87.Google Scholar
  78. Wright, E. J., & Whitehead, T. L. (1987). Perceptions of body size and obesity: A selected review of the literature. Journal of Community Health, 12, 117–129.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1995

Authors and Affiliations

  • Matthew M. Clark
    • 1
  • Michael G. Goldstein
    • 1
  1. 1.Department of Psychiatry and Human BehaviorThe Miriam Hospital, and Brown University School of MedicineProvidenceUSA

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