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      Do images of a personalised future body shape help with weight loss? A randomised controlled study

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          Abstract

          Background

          This randomised controlled study evaluated a computer-generated future self-image as a personalised, visual motivational tool for weight loss in adults.

          Methods

          One hundred and forty-five people (age 18–79 years) with a Body Mass Index (BMI) of at least 25 kg/m 2 were randomised to receive a hard copy future self-image at recruitment (early image) or after 8 weeks (delayed image). Participants received general healthy lifestyle information at recruitment and were weighed at 4-weekly intervals for 24 weeks. The image was created using an iPad app called ‘Future Me’. A second randomisation at 16 weeks allocated either an additional future self-image or no additional image.

          Results

          Seventy-four participants were allocated to receive their image at commencement, and 71 to the delayed-image group. Regarding to weight loss, the delayed-image group did consistently better in all analyses. Twenty-four recruits were deemed non-starters, comprising 15 (21%) in the delayed-image group and 9 (12%) in the early-image group (χ 2(1) = 2.1, p = 0.15). At 24 weeks there was a significant change in weight overall ( p < 0.0001), and a difference in rate of change between groups (delayed-image group: −0.60 kg, early-image group: −0.42 kg, p = 0.01). Men lost weight faster than women. The group into which participants were allocated at week 16 (second image or not) appeared not to influence the outcome ( p = 0.31). Analysis of all completers and withdrawals showed a strong trend over time ( p < 0.0001), and a difference in rate of change between groups (delayed-image: −0.50 kg, early-image: −0.27 kg, p = 0.0008).

          Conclusion

          One in five participants in the delayed-image group completing the 24-week intervention achieved a clinically significant weight loss, having received only future self-images and general lifestyle advice. Timing the provision of future self-images appears to be significant, and promising for future research to clarify their efficacy.

          Trial Registration

          Australian Clinical Trials Registry, identifier: ACTRN12613000883718. Registered on 8 August 2013.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s13063-017-1907-6) contains supplementary material, which is available to authorized users.

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          Most cited references14

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          Predictors of dropout in weight loss interventions: a systematic review of the literature.

          Attendance and completion of weight loss intervention is associated with better weight loss outcomes; however, attrition is neither consistently reported nor comprehensively explored in the weight loss literature. A systematic review was undertaken to identify factors associated with attrition in weight loss interventions involving overweight or obese (body mass index ≥ 25) adults (18-65 years). Sixty-one studies published before May 2011 and addressing factors associated with weight loss programme attrition were identified. Conclusions were limited by the large number of variables explored, the small number of studies exploring each variable, the large variety of study settings and methodologies used, the inconsistent reporting of results, and the conflicting findings across studies. A consistent set of predictors has not yet been identified. The majority of studies relied on pre-treatment routinely collected data rather than variables selected because of their theoretical and/or empirical relationship with attrition. However, psychological and behavioural patient factors and processes associated with the treatment were more commonly associated with attrition than patient background characteristics. Future research should consider theoretically grounded social-psychological and behavioural processes as potential predictors of dropout. Identification of patients at risk of dropout will contribute to both the effectiveness and the cost-effectiveness of weight loss interventions. © 2011 The Authors. obesity reviews © 2011 International Association for the Study of Obesity.
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            Stages of change and decisional balance for 12 problem behaviors.

            This integrative study investigated the generalization of the transtheoretical model across 12 problem behaviors. The cross-sectional comparisons involved relationships between two key constructs of the model, the stages of change and decisional balance. The behaviors studied were smoking cessation, quitting cocaine, weight control, high-fat diets, adolescent delinquent behaviors, safer sex, condom use, sunscreen use, radon gas exposure, exercise acquisition, mammography screening, and physicians' preventive practices with smokers. Clear commonalities were observed across the 12 areas, including both the internal structure of the measures and the pattern of changes in decisional balance across stages.
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              Low-fat dietary pattern and weight change over 7 years: the Women's Health Initiative Dietary Modification Trial.

              Obesity in the United States has increased dramatically during the past several decades. There is debate about optimum calorie balance for prevention of weight gain, and proponents of some low-carbohydrate diet regimens have suggested that the increasing obesity may be attributed, in part, to low-fat, high-carbohydrate diets. To report data on body weight in a long-term, low-fat diet trial for which the primary end points were breast and colorectal cancer and to examine the relationships between weight changes and changes in dietary components. Randomized intervention trial of 48,835 postmenopausal women in the United States who were of diverse backgrounds and ethnicities and participated in the Women's Health Initiative Dietary Modification Trial; 40% (19,541) were randomized to the intervention and 60% (29,294) to a control group. Study enrollment was between 1993 and 1998, and this analysis includes a mean follow-up of 7.5 years (through August 31, 2004). The intervention included group and individual sessions to promote a decrease in fat intake and increases in vegetable, fruit, and grain consumption and did not include weight loss or caloric restriction goals. The control group received diet-related education materials. Change in body weight from baseline to follow-up. Women in the intervention group lost weight in the first year (mean of 2.2 kg, P<.001) and maintained lower weight than control women during an average 7.5 years of follow-up (difference, 1.9 kg, P<.001 at 1 year and 0.4 kg, P = .01 at 7.5 years). No tendency toward weight gain was observed in intervention group women overall or when stratified by age, ethnicity, or body mass index. Weight loss was greatest among women in either group who decreased their percentage of energy from fat. A similar but lesser trend was observed with increases in vegetable and fruit servings, and a nonsignificant trend toward weight loss occurred with increasing intake of fiber. A low-fat eating pattern does not result in weight gain in postmenopausal women. Clinical Trial Registration ClinicalTrials.gov, NCT00000611.
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                Author and article information

                Contributors
                +61 8 9266 2115 , gemma.ossolinski@gmail.com
                moyez.jiwa@nd.edu.au
                A.Mcmanus@curtin.edu.au
                R.Parsons@curtin.edu.au
                Journal
                Trials
                Trials
                Trials
                BioMed Central (London )
                1745-6215
                18 April 2017
                18 April 2017
                2017
                : 18
                : 180
                Affiliations
                [1 ]ISNI 0000 0004 0375 4078, GRID grid.1032.0, Department of Medical Education, , Curtin University, ; Perth, WA 3845 Australia
                [2 ]ISNI 0000 0004 0402 6494, GRID grid.266886.4, Melbourne Clinical School, School of Medicine Sydney, , The University of Notre Dame Australia, ; Werribee, VIC Australia
                [3 ]ISNI 0000 0004 0375 4078, GRID grid.1032.0, Faculty of Health Sciences, , Curtin University, ; Perth, WA Australia
                [4 ]ISNI 0000 0004 0375 4078, GRID grid.1032.0, School of Occupational Therapy and Social Work and School of Pharmacy, , Curtin University, ; Perth, WA Australia
                Article
                1907
                10.1186/s13063-017-1907-6
                5395810
                28420417
                be070aa9-3290-42fe-b9d6-80af37c534b1
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 6 January 2016
                : 16 March 2017
                Funding
                Funded by: General Practice Education and Training Registrar Research Fund
                Award ID: No award number
                Award Recipient :
                Funded by: Department of Medical Education, Curtin University
                Award ID: None
                Categories
                Research
                Custom metadata
                © The Author(s) 2017

                Medicine
                weight loss,medical informatics applications,obesity,intervention study,health promotion
                Medicine
                weight loss, medical informatics applications, obesity, intervention study, health promotion

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