SUNDAY, OCTOBER 20

Research & Practice Innovations: Strategies for Lifestyle Changes Part 1

Adolescent Six-Month Weight Maintenance Efforts Following Daily SibutramineCessation

Author(s): R.E. Cole1, M.C. Trust II2, J.L. Cabrera3; 1Graduate Program in Nutrition, AMEDDCtr. & Sch., Joint Base San Antonio - Fort Sam Houston, TX, 2Dept of Nutritional Medicine,Brooke Army Med. Ctr., Joint Base San Antonio - Fort Sam Houston, TX, 3Dept of FamilyMedicine, Madigan Army Med. Ctr., Joint Base Lewis McChord, WA

Learning Outcome: Describe lifestyle behaviors associated with weight regain within6 months of successful weight loss.

Objectives: To assess the obese adolescent patient's ability to maintain lost weightfollowing cessation of a 6-month daily sibutramine treatment.

Design & Methods: A two-phased prospective study, in which adolescents received10 mg of sibutramine daily for 6-months (Phase 1) to promote a 5-10% BMI reduction.Adolescent who lost �5% BMI at six-month sibutramine cessation continued onto Phase2 with no weight loss adjuvant for an additional six month follow-up. Patients completeda 6-month behavior survey and attended two family medicine appointments (9 &12 months) in an effort to maintain lost. Changes in BMI and correlations with BMImaintenance to 6-month self-reported behaviors were assessed.

Participants: Military adolescent dependents ages 12-18 years (74% female), with BMI-for-age and sex greater than 95th percentile and in good health were enrolled (n¼95);n¼61 qualified for Phase 2.

Results: The mean participant BMI reduction (n¼77) was 3.1 kg/m2 (-9.3%) (P<0.001; 95%CI: -10.5to -7.9%) after 6 months of sibutramine treatment. Upon sibutramine cessation,participants experienced a mean BMI increase of +1.8 kg/m2 at 9 months (P<0.001; n¼46)and +2.1 kg/m2 at 12 months (P<0.001; n¼29). Correlations were identified betweenseveral 6-month behaviors and weight regain: fruit intake (r¼ -0.376; p¼0.044), sweet-ened beverage intake (r¼ 0.424; p¼0.022); amount of physical activity (r¼ -0.377;p¼0.044); and amount of TV time (r¼ 0.458; p¼0.013).

Conclusions& Implications:Adolescent patients may require additional multi-disciplinaryattention from nutrition and behavioral healthcare providers following successful weightloss to prevent behavior regression, promote healthy habits and minimize weight regain.

Funding Disclosure: Telemedicine & Advanced Technology Research Center

Registered Dietitian Gender for Adult Weight Loss Counseling

Author(s): B. Bertrand1, J. Pryor1, J. Brinkley2, O. Babatunde1; 1NutritionScience, East Carolina Univ., Greenville, NC, 2Biostatistics, East CarolinaUniv., Greenville, NC

Learning Outcome: Identify congruency for gender-biased barriers to changeand weight loss counseling practices.

Although the obesity epidemic is not gender specific, an emerging trend inthe commercial weight loss industry is gender-tailored programs for adultconsumers. Research is needed to better understand, among the variouscounseling practices available, those that are most effective, and if gender-specific practices are warranted. The purpose of this study was to identify ifRegistered Dietitians use different counseling practices for their adult maleand female weight loss clients (i.e. gender-bias). A web-based quantitativequestionnaire was used to evaluate perceptions of best weight loss practicesand client barriers to change by client gender among Registered Dietitianmembers of the Weight Management Dietetic Practice Group (WMDPG). AllWMDPG members were invited to complete the questionnaire anonymouslyon-line from November to December 2011. Using McNemar's test, a simple2-by-2 table of agreement was used to identify gender bias for counselingpractices and perceived client barriers to change. Among the final sample of86 Registered Dietitians, statistically significant gender-based disagreementswere identified for 13 of the 20 weight loss counseling practices, and for 5 ofthe 9 perceived barriers to change that were assessed. A multitude of as-sumptions can be made as to why a Registered Dietitian perceives a particularcounseling practice as more effective for promoting weight loss for one butnot the other gender. We identified counselor gender bias for manycounseling practices, as well as for perceived client barriers to change.Gender-biased barriers to change sometimes, but not always, supportedgender-biased counseling practices.

Funding Disclosure: None

September 2013 Suppl 3—Abstracts Volume 113 Number 9

Investigating the Feasibility and Efficacy of a Brief Version of BELI(Brief Biofeedback Enhanced Lifestyle Intervention) for Weight Loss

Author(s): T. Ledoux1, M.R. Gallagher2, M. Sampson3, N. Saher1, B. McFarlin1; 1Departmentof Health and Human Performance, Univ. of Houston, Houston, TX, 2School of Nursing,Univ. of Texas Hlth. Sci. Ctr., Houston, TX, 3College of Social Work, Univ. of Houston,Houston, TX

Learning Outcome: Learners will be able to describe the role of internally regulatedeating in weight management among uninhibited eaters.

Background: Teaching overweight or obese (OW/Ob) individuals to use internal cues toinform eating rather than diets, improves psychological status and reduces loss-of-controlovereating but not weight. These treatments assume participants can identify physicalhunger; however, OW/Ob individuals confuse emotions or food cravings for hunger. Usingthe validated hunger biofeedback (HB) technique daily leads to increased ability torecognize hunger within weeks. In this study, the Biofeedback Enhanced Lifestyle Inter-vention (BELI) was piloted. BELI's goal was weight loss by addressing emotional andexternal overeating, encouraging internally regulated eating, and teaching accurate iden-tification of physical hunger using HB.

Methods: 10 OW/Ob women with loss-of-control overeating were recruited. BELI included5 weekly counseling sessions and HB, which involved using one's blood glucose (BG) levelsto identify hunger (i.e., 60-85 mg/dl). Questionnaires, BMI, and fasting BG measures weretaken at baseline and post. Exit focus groups were conducted and process variables tracked.

Results: BELI had 30% attrition and 100% of BELI completers reported being satisfied withall aspects of the intervention. Independent t-tests comparing pre and post measures showmoderate to large effects for reducing BMI (p¼.015; Eta Sq¼.59) and external overeating(p¼.007; Eta Sq¼.70) and improving hunger recognition (p¼.022; Eta Sq¼.55), but noeffects on emotional overeating (p¼.28). In focus groups participants reported highcompliance with HB, high perceived value of HB, and desire for more sessions on copingwith emotional overeating.

Conclusions: BELI is feasible with preliminary effects on overeating and weight statusamong OW/Ob women with unsuccessful dietary control tendencies.

Funding Disclosure: Health and Human Performance Summer Research Program, Uni-versity of Houston

General Public Interpretations of MyPlate

Author(s): J.L. Bachman, D. Cuy Castellanos, J. Christaldi, A. Tomasko;Marywood Univ., Scranton, PA

Learning Outcome: Participants will understand what variables predict howaccurately individuals can plan a diet that meets the dietary recommenda-tions using national nutrition icons MyPlate and MyPyramid.

The objective of this study was to determine how accurately individuals canplan a diet that meets the 2010 Dietary Guidelines (DGs) using MyPlate as aguide. Participants were students, faculty, and staff recruited in Scranton,PA. Data were collected from March - October 2012. Participants (n ¼ 73)were 38.9�17.0 years old, 97% Non-Hispanic White, 40% married, 45% nevermarried, 95% at least some college education, and had an average BodyMass Index (BMI) of 26.7�5.9 (51% were overweight or obese). Participantswere instructed to use the MyPlate poster to plan a menu for 1 day usingfood models. Other variables assessed were nutrition literacy, nutritionscanning behavior, and nutrition information-seeking experience. Theparticipant menus were analyzed using Nutrition Data Systems forResearch and were compared to height, weight, and physical activitycalculated energy recommendations from the DGs. An energy differencescore was calculated by subtracting the energy from the selected diet fromthe DG energy recommendations. Overall participants selected a menu thatwas 744 � 578kcals lower than the DG recommendation. A multiple linearregression was conducted to determine what individual characteristicspredicted difference scores. The model was significant (R2¼0.23; p<0.01)with sex (B¼-385.67;p<0.05), nutrition information-seeking experience(B¼45.45;p<0.05), and BMI (B¼29.26; p<0.05) significantly predicting en-ergy difference score. Overall, being male, experiencing more frustrationduring nutrition information-seeking and having a higher BMI wasassociated with higher energy difference scores. In conclusion, a sample ofwell-education individuals had difficulty using MyPlate to plan a diet thatmeets the DGs.

Funding Disclosure: Marywood University Research Initiation funds

JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS A-9