***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In an experimental study of weight reduction , 62 obese men and women were administered a pretreatment question naire and r and omly assigned to three experimental treatment groups : ( a ) an external control group with a nonrefundable contingency ; ( 6 ) a self-control group with a refundable contingency ; and ( c ) a self-control group with a nonrefundable contingency . The results indicated that the self-control and external-control treatments were equally effective in producing reduction in weight . However , both self-control interventions were more effective than the external-control intervention in promoting maintenance of weight loss We have followed prospect ively , 46 obese , type 2 diabetic patients for a 55-week period , in order to evaluate the efficiency of an educational programme based on behaviour modification to enhance weight loss and changes of other cardiovascular risk factors . No patient received pharmacological treatment during the study . At the end of the follow-up the patients obtained an average weight loss of 9.250 kg ( range : 0.500 - 17.500 kg ) ; the BMI was reduced from 34.2 + /- 0.8 kg/m2 to 30.6 + /- 1.1 kg/m2 ( P less than 0.01 ) ; fasting serum glucose descended from 7.9 + /- 0.4 to 6.1 + /- 0.5 mM ( P less than 0.05 ) ; SBP ( systolic blood pressure ) decreased from 145.7 + /- 3 to 126.4 + /- 5.1 mmHg ( P less than 0.01 ) ; DBP ( diastolic blood pressure ) decreased from 83.5 + /- 2.5 to 65 + /- 2.6 mmHg ( P less than 0.01 ) ; triglyceride levels were lowered from 164.5 + /- 12 to 109.7 + /- 10 mg/dl ( P less than 0.01 ) ; HDL-cholesterol levels increased from 1.27 + /- 0.05 to 1.53 + /- 0.12 mM ( P less than 0.01 ) . Serum glucose 2 h after a 75 g glucose oral load decreased from 14.9 + /- 0.6 to 12.7 + /- 0.9 mM ( P less than 0.05 ) on week 35 of follow-up . Twelve patients no longer presented a diabetic curve ( 8 normal oral glucose tolerance test ( OGTT ) curves , and 4 impaired glucose tolerance ( IGT ) curves ) . No significant changes in the parameters studied were obtained in the group of patients on conventional treatment . ( ABSTRACT TRUNCATED AT 250 WORDS This study examined the effectiveness of the addition of a cognitive intervention based on individualized assessment to a behavioral intervention .  Sixty-three subjects who were at least 15 % overweight were r and omly assigned to a behavioral intervention or a behavioral intervention and a cognitive intervention focused on changing specific maladaptive self-statements related to weight loss . It was predicted that the behavioral and cognitive intervention would result in greater weight loss and reduction in body fat than the behavioral alone intervention at posttest and at 3-month follow-up ; results did not support this hypothesis . Support was found for the construct validity of the behavioral intervention with significant differences between time points on behavioral measures observed . On the cognitive measures , both treatment conditions showed changes over time on cognitive measures , but differences between the treatments were not significant . Based on the results of this study , it is suggested that future research examining the effectiveness of cognitive interventions in the area of weight loss include measures other than those that are weight-related , longer follow-ups to assess long-term maintenance , and sufficient amounts of cognitive therapy so that clients have fully integrated the newly learned cognitive dialogues into their everyday lives AIMS To evaluate the efficacy of interventions to promote a healthy diet and physical activity in people with impaired glucose tolerance ( IGT ) . METHODS A r and omised controlled trial in Newcastle upon Tyne , UK , 1995 - 98 . Participants included 67 adults ( 38 men ; 29 women ) aged 24 - 75 years with IGT . The intervention consisted of regular diet and physical activity counselling based on the stages of change model . Main outcome measures were changes between baseline and 6 months in nutrient intake ; physical activity ; anthropometric and physiological measurements including serum lipids ; glucose tolerance ; insulin sensitivity . RESULTS The difference in change in total fat consumption was significant between intervention and control groups ( difference -21.8 ( 95 % confidence interval ( CI ) -37.8 to -5.8 ) g/day , P=0.008 ) . A significantly larger proportion of intervention participants reported taking up vigorous activity than controls ( difference 30.1 , ( 95 % CI 4.3 - -52.7)% , P=0.021 ) . The change in body mass index was significantly different between groups ( difference -0.95 ( 95 % CI -1.5 to -0.4 ) kg/m(2 ) , P=0.001 ) . There was no significant difference in change in mean 2-h plasma glucose between groups ( difference -0.19 ( 95 % CI -1.1 to 0.71 ) mmol/l , NS ) or in serum cholesterol ( difference 0.02 ( 95 % CI -0.26 to 0.31 ) mmol/l , NS ) . The difference in change in fasting serum insulin between groups was significant ( difference -3.4 ( 95 % CI -5.8 to -1.1 ) mU/l , P=0.005 ) . CONCLUSIONS After 6 months of intensive lifestyle intervention  in participants with IGT , there were changes in diet and physical activity , some cardiovascular risk factors and insulin sensitivity , but not glucose tolerance . Further follow-up is in progress to investigate whether these changes are sustained or augmented over 2 years Medical students in a course that included instruction in patient interviewing  participated in an experiment devised to alert them to sources of bias which might influence their judgements and management of patients . Students were r and omly assigned to one of four groups and exposed to either a videotaped or audiotaped interview of the same patient presented as either normal weight or overweight . Question naire responses of students in the two audio groups indicated no detectable differences in the sound tracks of the overweight and normal weight versions of the interview , and these groups were combined for subsequent analysis . A discriminant analysis indicated that students exposed to the overweight video version formed impressions and assessed patient treatment and outcome differently from those exposed to either the video normal or audio versions of the interview . Implication s of these findings for medical education are discussed , and suggestions are made for incorporating such sensitization experiments in the medical curriculum This study investigated the effects of hypnosis as a treatment for  weight loss among women . The sample consisted of 60 women between the ages of 20 and 65 who were at least 20 % overweight and were not in any other treatment program . Six client variables ( suggestibility , self-concept , quality of family origin , age of obesity onset , education level , and socioeconomic status ) and one process variable ( multi-modal imagery ) were analyzed in relation to the dependent variable ( weight loss ) . Two experimental groups , hypnosis plus audiotapes ( Hy-T ) and hypnosis without audiotapes ( Hy ) , and the control group ( Cont ) were investigated for weight loss immediately after treatment and again after a 6-month follow-up . The primary hypothesis that hypnosis is an effective treatment for weight loss was confirmed , but the seven concomitant variables and the use of audiotapes were not significant contributors to weight loss OBJECTIVE : To evaluate a modified cognitive – behavioural treatment ( M-CBT ) for weight management which addresses both the psychosocial costs and the physiological health risks of obesity , without a focus on weight loss . DESIGN : R and omized controlled trial comparing M-CBT with st and ard cognitive – behavioural therapy (S-CBT).SUBJECTS : Sixty-three overweight women with body mass index ( BMI ) ≥28 kg/m2 , mean age=47.5 and mean BMI = 35.4 .  MEASURES : Weight , waist and hip circumference , blood lipids , blood glucose , blood pressure , psychological well-being , depression , self esteem , stress , binge eating , eating style , body image , nutrient intake , aerobic fitness , activity levels , patient satisfaction with treatment . RESULTS : Both M-CBT and S-CBT achieved improvements in a broad range of physical , psychological and behavioural variables . Weight loss in the S-CBT group was greater than in the M-CBT group immediately after treatment , but both groups lost weight . Participants in the M-CBT group continued to lose weight up to the 1 y follow-up . M-CBT was evaluated positively by participants . CONCLUSIONS : Both M-CBT and S-CBT programmes were successful at inducing modest weight loss , as well as improving emotional well-being , reducing distress , increasing activity and fitness , improving dietary quality and reducing cardio-vascular disease risk factors . The improvements were maintained or continued at 1 y follow-up . These results suggest that treatment based on the new weight-control paradigm which emphasizes sustained lifestyle change without emphasis on dieting , can produce modest benefits to health and well-being OBJECTIVE The specific aim was to determine whether a multifaceted approach to weight loss and physical readiness could be implemented onboard a deployed combatant ship of the U.S. Navy . RESEARCH METHODS AND PROCEDURES Thirty-nine men ( 31+/-6 years old , mean+/-st and ard deviation ) assigned to the USS ENTERPRISE ( CVN 65 ) during a 6-month Mediterranean deployment who had failed their previous Physical Readiness Test due to excessive body weight ( 108+/-11 kg overweight ) were r and omly assigned to nutrition , cognitive-behavioral obesity treatment plus exercise or to the Navy 's usual treatment ( control ) , which is exercise alone . RESULTS Outcomes for the treatment group were significantly better than the controls , with 8.6+/-5.0 vs. 5.0+/-4.1 kg weight loss , 8 % vs. 5 % reduction in original body weight , and body fat loss of 7 % vs. 5 % . Triglycerides declined significantly greater in the treatment group than the controls ( 145 mg/dL to 109 mg/dL vs. 146 mg/dL to 145 mg/dL , p<0.05 ) , whereas depression and eating behaviors significantly improved among treated men . Problematic environmental factors were the limited variety of heart healthy foods in the galley , short meal breaks , and long mess hall lines that led to eating snacks from vending machines and frequent port calls . DISCUSSION Although greater weight loss than would be expected of a Navy usual care group diluted the treatment effect , the treated men still fared significantly better . The physical readiness implication of this research has the potential to impact Navy health promotion programs and policy , the health and well-being of its personnel , and the Navy 's ability to meet mission requirements Twenty-four obese women were r and omly assigned to 1 of 2 group treatments : behavioral choice treatment ( BCT ) or traditional behavioral treatment ( TBT ) . BCT uses decision theory to promote moderate behavior change that can be comfortably , and therefore permanently , maintained . Groups completed a moderate-intensity walking program and obtained feedback from computerized eating dairies . The TBT group evidence d greater weight loss at posttreatment . However , the TBT group also evidence d a trend to regain weight , whereas the BCT group continued a slow weight loss during follow-up . Exercise followed a similar pattern . Both groups decreased in restraint and increased in self-esteem OBJECTIVE To assess the effects of lifestyle intervention on  cardiovascular  risk factors in general and especially on fibrinolysis . DESIGN R and omized clinical study . SUBJECTS A total of 186 subjects with impaired glucose tolerance and obesity . INTERVENTIONS The intervention programme included a low-fat , high-fibre diet and regular physical exercise . Half of the participants ( n = 93 ) took part in a one-month learning and training session using different behavioural modification techniques and conducted in a full-board wellness centre ( intense intervention group ) . The other half ( n = 93 ) was r and omized a one-hour counselling session with a specially trained nurse ( usual care group ) . Follow-up was carried out after 12 months . MAIN OUTCOME MEASURES Body weight , oxygen consumption , plasminogen activator inhibitor type 1 ( PAI-1 ) activity , tissue plasminogen activator ( tPA ) antigen , fibrinogen and fasting plasma insulin measured at the start of the programme and at follow-up after 1 year . RESULTS The intense intervention group had a mean weight decline by 1 year of 5.4 kg compared to 0.5 kg in the usual care group . Oxygen consumption in the intense group increased 10 % vs. a 1 % decline in the usual care group . In the intense group , PAI-1 activity decreased 31 % ( -10.1 U mL(-1 ) ) , which was significantly more than in the usual care group ( 12 % ; -3.0 U mL(-1 ) ) . The corresponding reductions in tPA antigen were 14 % ( -1.65 microg L(-1 ) ) and 6 % ( -0.69 microg L(-1 ) ) . CONCLUSIONS The present r and omized study shows that an intense lifestyle programme has sustained beneficial effects on fibrinolysis The association of television viewing and obesity in data collected during cycles II and III of the National Health Examination Survey was examined . Cycle II examined 6,965 children aged 6 to 11 years and cycle III examined 
    Output:
    
When behaviour therapy was combined with a diet / exercise approach and compared with diet / exercise alone , the combined intervention result ed in a greater weight reduction .
People who are overweight or obese benefit from psychological interventions , particularly behavioural and cognitive-behavioural strategies , to enhance weight reduction .
They are predominantly useful when combined with dietary and exercise strategies .
The bulk of the evidence supports the use of behavioural and cognitive-behavioural strategies .