Mobile apps for diabetes self-management: An updated review of app features and effectiveness.

Self-management of diabetes is extremely challenging and non-adherence is common. Health consequences are significant for those unable to adhere to the complex treatment regimen, which includes regular oral medication and/or insulin use, frequent blood sugar checks, strict dietary management, and regular physical activity. Mobile applications (apps) present a tremendous opportunity to help patients improve adherence to these behaviors.

Remotely Delivered Interventions for Obesity Treatment.

Purpose Of Review: This review synthesizes recent research on remotely delivered interventions for obesity treatment, including summarizing outcomes and challenges to implementing these treatments as well as outlining recommendations for clinical implementation and future research.

Recent Findings: There are a wide range of technologies used for delivering obesity treatment remotely. Generally, these treatments appear to be acceptable and feasible, though weight loss outcomes are mixed.

Remote assessments and behavioral interventions in post-bariatric surgery patients.

Sustained weight loss and health improvements after bariatric surgery require long-term monitoring and, for a significant minority of patients, postoperative intervention. Unfortunately, many patients demonstrate difficulty engaging in long-term follow-up and treatment due to time restrictions, geographic limitations, and financial burden. Conducting assessments and interventions remotely may help to mitigate these barriers, allowing for greater access to care and improved outcomes.

Measurement of adherence in bariatric surgery: a systematic review.

After bariatric surgery, rates of adherence to behavioral recommendations, including attending regular appointments and following specific dietary, physical activity, and vitamin use recommendations, tend to be highly variable across studies. Lack of consistency in measurement of adherence is a likely contributor to this variability, making it challenging to determine the prevalence and impact of nonadherence in this population. PubMed was searched for articles measuring behavioral adherence or compliance in patients after bariatric surgery, resulting in 85 articles.

Managing severe obesity: understanding and improving treatment adherence in bariatric surgery.

Severe obesity (body mass index ≥40 kg/m) is a chronic disease that is associated with significantly increased risk of serious and chronic health problems as well as impaired quality of life. For those with severe obesity, bariatric surgery is the most effective treatment for significant and long-term weight loss and resolution of comorbid medical conditions, particularly diabetes. Long-term success is thought to depend to some degree on the patient's ability to adhere to a complex set of behaviors, including regular attendance at follow up appointments and following stringent dietary, exercise, and vitamin recommendations.

What do we know about mobile applications for diabetes self-management? A review of reviews.

Diabetes is a chronic illness with significant health consequences, especially for those who are unable to adhere to the complex treatment regimen. Self-management tasks such as regular medication and insulin use, frequent blood sugar checks, strict diet management, and consistent exercise can be quite challenging. Mobile technologies, specifically mobile applications (apps), present a unique opportunity to help patients improve adherence to these behaviors.

Development of a novel mindfulness and cognitive behavioral intervention for stress-eating: a comparative pilot study.

Stress-related eating is increasingly cited as a difficulty in managing healthy eating behaviors and weight. However few interventions have been designed to specifically target stress-related eating. In addition, the optimal target of such an intervention is unclear, as the target might be conceptualized as overall stress reduction or changing emotional eating-related thoughts and behaviors.

Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: a systematic review.

Mindfulness-based approaches are growing in popularity as interventions for disordered eating and weight loss. Initial research suggests that mindfulness meditation may be an effective intervention for binge eating; however, no systematic review has examined interventions where mindfulness meditation was the primary intervention and no review has examined its effect on subclinical disordered eating or weight. Using the PRISMA method for systematic reviews, we reviewed 14 studies that investigated mindfulness meditation as the primary intervention and assessed binge eating, emotional eating, and/or weight change.

Dietary self-monitoring in patients with obstructive sleep apnea.

Self-monitoring of food intake is a cornerstone of behavioral weight loss interventions, but its use has not been evaluated in the treatment of obese patients with obstructive sleep apnea (OSA). This pilot study described patterns of adherence to dietary self-monitoring in obese patients with OSA and determined associations between self-monitoring and weight loss, psychosocial functioning, and adherence to continuous positive airway pressure treatment. Participants completed a 6-week behavioral weight loss intervention focused on dietary self-monitoring.

Impact of a brief dietary self-monitoring intervention on weight change and CPAP adherence in patients with obstructive sleep apnea.

Objective: Weight loss can decrease the severity of obstructive sleep apnea (OSA) in many obese individuals; however, very few studies have investigated the effects of behavioral weight loss interventions for patients with OSA. The aims of this pilot study were to determine the feasibility and initial effects on weight and continuous positive airway pressure (CPAP) use of a brief minimal-contact self-monitoring-based weight loss intervention (SM). An additional aim was to investigate the association between weight loss and CPAP adherence.

Examining the Binge Eating Scale in screening for binge eating disorder in bariatric surgery candidates.

Background: This study assessed the utility of the Binge Eating Scale (BES) as a measure of binge eating disorder (BED) in a bariatric surgery-seeking population by (a) determining the optimal BES cut score for predicting BED, (b) calculating concordance statistics, and (c) determining the predictive value of each BES item.

Methods: Four hundred seventy-three patients presented for a psychological evaluation prior to Roux-en-Y gastric bypass surgery. The BES and the SCID semi-structured interview for BED were administered.

Confirmatory factor analysis of the Beck Depression Inventory-II in bariatric surgery candidates.

Screening for depression is an integral part of psychological evaluations conducted prior to bariatric surgery. The Beck Depression Inventory-II (BDI-II) is the most commonly used measure of depression in these treatment evaluations. The reliability and validity of the BDI-II has not yet been evaluated within bariatric surgery-seeking samples, evidencing a significant gap in the present literature.

Factor structure and predictive utility of the Binge Eating Scale in bariatric surgery candidates.

Background: Screening for binge eating before bariatric surgery is a component of the recommended clinical practice for bariatric surgery candidates. The Binge Eating Scale (BES) is 1 of the most commonly used self-report measures of eating behaviors in preoperative evaluations; however, the factor structure of this measure has not been evaluated in the bariatric population. The aims of the present study were to report the mean, standard deviation, and reliability of the BES for patients seeking bariatric surgery; to evaluate the 2-factor structure of the BES using confirmatory factor analysis; and to investigate the association between the BES and its factors with surgical weight loss.

Revisiting the revised master questionnaire for the psychological evaluation of bariatric surgery candidates.

Background: This study aims to evaluate the Revised Master Questionnaire (MQR), a measure of cognitive and behavioral difficulties related to weight management, for use in bariatric surgery evaluations. The MQR's five domains include stimulus control, hopelessness, motivation, physical attribution, and energy balance knowledge, all of which are relevant to bariatric surgery evaluation.

Methods: Participants were 790 bariatric surgery candidates presenting for psychological evaluation in an urban medical center.

Do patients seeking laparoscopic adjustable gastric banding surgery differ from those seeking gastric bypass surgery? A comparison of psychological profiles across ethnic groups.

Background: Understanding presurgical psychological functioning is important in determining whether patients may benefit from psychological support before or after undergoing bariatric surgery. However, few studies have directly explored whether presurgical psychosocial profiles differ for patients presenting for different bariatric surgeries and what, if any, impact ethnic background might have. The present study compared presurgical depressive symptomatology, binge eating symptoms, and psychopathology in Caucasian and African American laparoscopic adjustable gastric banding (LAGB) and gastric bypass (RYGB) patients.

Psychosocial correlates of binge eating in Hispanic, African American, and Caucasian women presenting for bariatric surgery.

Research suggests that that binge eating, stress, and depression are prevalent among individuals seeking bariatric surgery. However, ethnic differences in the prevalence of binge eating and binge eating disorder (BED) in this population remain unclear, as does the impact of depression and stress on any such relationship. Further, no studies to date have examined the prevalence of binge eating in Hispanic women presenting for bariatric surgery.

Food addiction: true or false?

Purpose Of Review: Food addiction has been implicated as a putative causal factor in chronic overeating, binge eating, and obesity. The concept of food addiction has been controversial historically due to definitional and conceptual difficulties and to a lack of rigorous scientific data.

Recent Findings: Support for the food addiction hypothesis comes from alterations in neurochemistry (dopamine, endogenous opioids), neuroanatomy (limbic system), and self-medication behaviors.

The Personality Assessment Inventory: clinical utility, psychometric properties, and normative data for bariatric surgery candidates.

Background: The Personality Assessment Inventory (PAI), an overall measure of personality and psychopathology, features a number of dimensions that may be useful in the psychological assessment of bariatric surgery candidates. However, its clinical utility is limited because psychometric properties of the PAI with bariatric surgery candidates have never been evaluated, and normative data for this population have never been published.

Methods: We examined the psychometric properties and clinical utility of the PAI with a large sample of bariatric surgery candidates (n = 546) presenting for evaluation in an urban medical center.

Carbohydrate craving: a double-blind, placebo-controlled test of the self-medication hypothesis.

Carbohydrate craving, the overwhelming desire to consume carbohydrate-rich foods in an attempt to improve mood, remains a scientifically controversial construct. We tested whether carbohydrate preference and mood enhancement could be demonstrated in a double-blind, placebo-controlled self-administration trial. Overweight females who met strict operational criteria for carbohydrate craving participated in two 3-day discrete choice trials over a 2-week period.

Effect of tryptophan depletion on smokers and nonsmokers with and without history of major depression.

Background: Serotonergic dysregulation is posited to contribute to comorbidity between nicotine dependence and depression. We tested whether acute tryptophan depletion (ATD) triggers depressive symptoms in euthymic, unmedicated smokers and nonsmokers with and without history of major depressive disorder (MDD).

Methods: Acute tryptophan depletion and taste-matched placebo challenges were administered double-blind in counter-balanced order.