1. Physiological and Behavioral Outcomes of Weight Loss in Postmenopausal Women
Jonathan W. Decker, MSN, ARNP, PhD-c
Karen E. Dennis, PhD, RN, FAAN
UNIVERSITY OF CENTRAL FLORIDA
College of Nursing
Orlando, Florida
PROBLEM
Aging in women is associated with an increase in metabolic risk factors for CVD and numerous contributors to an upset in weight stability and body fat distribution
PURPOSE
In women:
Postmenopausal
Overweight and obese
Examine the effects of lifestyle modification through:
Nutrition
Exercise
Gender-specific weight management strategies
In order to:
Promote weight loss
Reduce CVD risk factors
Improve concomitant behaviors
METHODS
6-month multi-faceted weight loss intervention
Participants:
67 postmenopausal women
Mostly Caucasian
Baseline and post-treatment measures of:
Cognitions
Emotions
Behaviors
CVD risk factors
At post-treatment, women were grouped by ≥10% weight loss (n=28) or <10% (n=39) weight loss
MANOVA and ANCOVA used for data analysis
FINDINGS
Both weight loss groups significantly improved on nearly all parameters
Some significant interaction effects:
Between groups
Across time
Significantly greater improvement for women with ≥10% weight loss than <10%, weight loss using baseline measures as covariates for:
Anthropometry
Binge eating
Some mood states
CONCLUSIONS & IMPLICATIONS
≥10% weight loss in these women significantly improved physiological risk factors for CVD and behaviors associated with the obese state
<10% weight loss also demonstrated significant improvement in these parameters but to a lesser magnitude
≥10% weight loss, achieved by 40% of these postmenopausal women, was supported as an optimal, initial target
<10% weight loss still had positive outcomes, and but likely was a more realistic goal for 60% of these women who did not reach the 10% demarcation point
RESULTS
Baseline and post-treatment measures by weight loss group
Measure
Weight loss group
<10%
≥10%
Baseline
Post-treatment
Weight (kg)
84 ± 13
80 ± 13 ***
88 ± 13
76 ± 11 *** †††
BMI (kg/m2)
32± 4
30 ± 4 ***
32 ± 5
28 ± 4 *** †††
Waist (cm)
97± 11
94 ± 12 ***
100 ± 11
91 ± 9 *** †††
Hip (cm)
118.± 10
114 ± 10 ***
119 ± 10
110 ± 8 *** †††
Triglycerides (mg/dL)
117.± 47
107 ± 40 **
143 ± 56 ‡
125 ± 40 *
Cholesterol (mg/dL)
218 ± 34
204 ± 38 ***
218 ± 32
191 ± 32 *** ††
LDL-C (mg/dL)
132.± 29
125 ± 32 **
134 ± 30
117 ± 28 *** ††
HDL-C (mg/dL)
63 ± 13
58 ± 12 ***
52 ± 9 ‡
49 ± 8 *** †
Glucose (mg/dL)
91 ± 10
91 ± 9
86 ± 7 ** †
Eating Behaviors for Weight Loss (EBI)
69 ± 10
88 ± 10 ***
71 ± 10
84 ± 20 **
Binge Eating (BE)
14 ± 8
9 ± 7 ***
6 ± 4 *** †
Eating Self-Efficacy Scale (ESES)
97 ± 36
68 ± 27 ***
92 ± 25
62 ± 30 ***
Affect
53 ± 25
36 ± 16 ***
51 ± 20
34 ± 21 **
Social
43 ± 13
32 ± 14 ***
41 ± 10
27 ± 12 ***
Profile of Mood States (POMS)
21 ± 23
19 ± 22
21 ± 30
7 ± 18 ** †
Tension
11 ± 5
9 ± 4
8 ± 4 †
Vigor
17 ± 6
19 ± 7
16 ± 7
20± 6 **
Fatigue
7 ± 6
6 ± 5
5 ± 3 **
Confusion
8.± 4
8 ± 3
7 ± 5
6 ± 3 †
Anger
6 ± 6
7 ± 7
4 ± 4 ** †
‡<0.05 Significant at baseline between groups
*<0.5, **<0.01, ***<0.001 Significant across time within group
†<0.05, ††<0.01, †††< Significant at post-treatment between groups with baseline as covariate
Higher scores are better: EBI, POMS Vigor
Lower scores are better: BE, ESES, POMS Tension, Fatigue, Confusion, Anger