title: An intensive behavioral weight loss intervention and hot flushes in women.
abstract: BACKGROUND
  Higher body mass index is associated with worse hot flushes during menopause but the effect of weight loss on flushing is unclear.
  
  
  METHODS
  Self-administered questionnaires were used to assess bothersome hot flushes in a 6-month randomized controlled trial of an intensive behavioral weight loss program (intervention) vs a structured health education program (control) in 338 women who were overweight or obese and had urinary incontinence. Weight, body mass index, abdominal circumference, physical activity, calorie intake, blood pressure, and physical and mental functioning were assessed at baseline and at 6 months. Repeated-measures proportional odds models examined intervention effects on bothersome hot flushes and potential mediating factors.
  
  
  RESULTS
  Approximately half of participants (n = 154) were at least slightly bothered by hot flushes at baseline. Among these women, the intervention was associated with greater improvement in bothersome flushes vs control (odds ratio [OR] for improvement by 1 Likert category, 2.25; 95% confidence interval [CI], 1.20-4.21). Reductions in weight (OR, 1.32; 95% CI, 1.08-1.61; per 5-kg decrease), body mass index (1.17; 1.05-1.30; per 1-point decrease), and abdominal circumference (1.32; 1.07-1.64; per 5-cm decrease) were each associated with improvement in flushing, but changes in physical activity, calorie intake, blood pressure, and physical and mental functioning were not related. The effect of the intervention on flushing was modestly diminished after adjustment for multiple potential mediators (OR, 1.92; 95% CI, 0.95-3.89).
  
  
  CONCLUSIONS
  Among women who were overweight or obese and had bothersome hot flushes, an intensive behavioral weight loss intervention resulted in improvement in flushing relative to control. Trial Registration clinicaltrials.gov Identifier: NCT00091988.
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, CA 94115, USA. ahuang@ucsfmed.org
authors.forename: Alison J
authors.initials: AJ
authors.lastname: Huang
authors.forename: Leslee L
authors.initials: LL
authors.lastname: Subak
authors.forename: Rena
authors.initials: R
authors.lastname: Wing
authors.forename: Delia Smith
authors.initials: DS
authors.lastname: West
authors.forename: Alexandra L
authors.initials: AL
authors.lastname: Hernandez
authors.forename: Judy
authors.initials: J
authors.lastname: Macer
authors.forename: Deborah
authors.initials: D
authors.lastname: Grady
mesh_terms: D000407:Alabama / Q000453:epidemiology; D001521:Behavior Therapy / Q000379:methods*; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D019584:Hot Flashes / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D015994:Incidence; D008593:Menopause; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D050177:Overweight / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D012237:Rhode Island / Q000453:epidemiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D015431:Weight Loss