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The purpose of this project was to design a concise weight loss and exercise program that could be incorporated into a typical family physician's office utilizing routine personnel and physician time commitments. The program was developed to include caloric restriction, diet instructions, behavioral modification, and patient education. It also included outlining an exercise program that was specific enough to allow patients to have a concrete amount of exercise to do but flexible enough to be applicable to all patients. The accompanying manual can serve as a general guide to all physicians who wish to instruct patients on weight loss and exercise. Where the physicians did not agree with the specific information offered in the manual they could substitute their own information but still follow the same general guidelines for use in handling patients. If used properly this program could be quite helpful for handling a very difficult and common problem for the busy family practitioner.

Restraint theory was originally developed to explain differences in eating behaviour between normal-weight and obese individuals. It represented a development from explanations based on obesity per se, and instead proposed the activity of dieting as the causal predictor of eating behaviour. Research has demonstrated that highly restrained individuals are more likely than unrestrained individuals to overeat under certain disinhibiting circumstances. The present thesis aims to investigate some of the functional effects of dietary restraint. Chapter 2 evaluates two different rationales for short-term starvation and the interpretation of the results in terms of the relative importance of the internal versus external cues suggests that external cues are very important in determining (over)eating behaviour. Chapter 3 assesses the functional role of restraint in the adolescent population and provides evidence of a restraint x disinhibitor (anxiety) interaction. Restraint is therefore functional in predicting eating behaviour even in the young adolescent population. Chapter 4 evaluates the role of imagining eating food as a potential disinhibitor and results provide an insight into the determination of highly restrained individuals when faced with a situation where it is possible to maintain high levels of restraint, and I have termed this phenomenon "superinhibition". Chapter 5 psychometrically assesses the various techniques of measuring restraint and results provide clear evidence for the use of the Restraint Scale for identifying chronic dieters. The results of this thesis are analysed in terms of current Restraint Theory, and implications for further research are discussed.

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Questionnaires were constructed to measure dieter's beliefs in their abilities to (1) adhere to a diet in eating situations, (2) perform various dieting behaviors, and (3) reach their dieting goals. The three questionnaires were called the Situation-, Behavior-, and Goal-Based Dieting Self-Efficacy Scales. / Preliminary work examined the reliability of the three scales. The Situtation-Based scale demonstrated a high level of test-retest reliability over a two to four week period in the two college samples. Examination of scale intercorrelations in the clinical sample indicated that the scales were correlated at only a low level, suggesting that the scales measure different aspects of the construct of dieting self-efficacy. / Results of the laboratory studies demonstrated that the Situation-Based scale was a significant predictor of how much dieters ate in response to two different types of challenges to their diets, high calorie preloads and a depressed mood induction. / The ability of the three scales to predict weight changes was examined in the clinical sample. Only the Goal-Based scale was found to predict weight change. / In summary, the present study adds to the body of literature supporting goal-based dieting self-efficacy as a significant predictor of weight change during dieting attempts. Suggestions were offered about ways to apply this finding to clinical practice, in the areas of patient selection and treatment prescription. / The present research was limited in the following ways. The laboratory studies were limited by the narrow range of subjects, and the artificiality of the eating situation. Future research should extend this finding with other populations, as well as methodologies for examining the relation between dieting self-efficacy and eating in real-life situations. The clinical study was limited by the absence of a follow-up assessment. Future research must examine the ability of dieting self-efficacy to predict weight change over longer periods of time. Finally, suggestions were made concerning the importance of future research attempting to clarify the construct of dieting self-efficacy, particularly research aimed at determining the relation between responses to these questionnaires and the actual cognitive processes engaged in by dieters in eating situations, and over the course of their weight control efforts. (Abstract shortened with permission of author.)

Our first objective was to compare deuterium incorporation and mass isotopomer distribution analysis in the measurement of in vivo cholesterol biosynthesis in humans. Twelve healthy subjects were recruited to participate in a 24 h stable isotope infusion study which mimicked temporal conditions typical of both deuterium incorporation and mass isotopomer distribution analysis techniques. Data suggest both deuterium incorporation and mass isotopomer distribution analysis accurately define cholesterol synthesis in humans when measured over a period of 24 h. / Our second objective was to examine the effects of weight loss through energy restriction upon human in vivo circulating cholesterol concentrations and synthesis using the deuterium incorporation methodology. Seven overweight subjects with a mean BMI of 30.6 +/- 1.6 kg·m-2 were recruited into a 2-phase prospective clinical trial including 3 mo on a weight stable American Heart Association Step I diet and 6 mo on an energy-reduced American Heart Association Step I diet. Data suggest that deuterium incorporation and mass isotopomer distribution analysis are equally effective methods for measuring cholesterol biosynthesis in humans, and that energy restriction resulting in modest weight loss effectively reduces endogenous cholesterol synthesis thus decreasing the risk of CVD development in obese and overweight men. (Abstract shortened by UMI.)