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Introduction

Nearly 7% of the world population is obese1 and about 66% of the adults in the United States are overweight or obese.2 Obesity is associated with a number of adverse medical conditions including increased risk of gallbladder disease, hypertension, type 2 diabetes mellitus, coronary heart disease (CHD), osteoarthritis, cancer death and reduced life expectancy.3–8 Obesity is also associated with adverse social and psychological consequences, including bias, discrimination and decreased quality of life.9,10

More effective treatment strategies are urgently needed for obesity management. The total caloric intake or energy density of one’s diet appears to be associated with obesity11–14 and a diet that induces a negative energy balance continues to be an important part of obesity management. Strategies to achieve the difficult task of eating less than desired include reduction of the energy density of foods by increasing food volume by the addition of fluids,15,16 bulk17–19 or their combination;20 or by increasing satiety by various anorectic drugs or macronutrient combinations of high satiety value.

Satiety is positively associated with the protein, fiber and water content of foods and negatively with fat and palatability ratings.21,22 However, within food groups, there may be as much as a twofold difference in satiety values, suggesting that certain foods promote greater satiety independent of macronutrient content or energy density. An egg is an example of such a food that has a 50% greater satiety index compared to white bread or ready-to-eat breakfast cereal.21 Compared to an isocaloric bagel breakfast of equal weight, an egg breakfast had a greater satiating effect, which translated into a lower caloric intake at lunch.23 The resulting decrease in energy consumption lasted for at least 24 h after the egg breakfast.

This study was undertaken to exploit the short-term satiating benefits of an egg breakfast23 for weight loss in a longer-term trial. The objectives were to determine if the incorporation of an egg breakfast in the diet by overweight or obese subjects would (1) induce reduced energy intake and unintentional weight loss, even when not attempting weight reduction; or (2) enhance weight loss when following a reduced energy diet. We compared the effects of an egg vs isocaloric bagel breakfast of equal weight on weight loss, indices of body size and composition, dietary compliance, food cravings and health-specific quality of life.Materials and methods

The study was approved by the institutional review boards at Pennington Biomedical Research Center and at Saint Louis University. Written informed consent was obtained from the participants. We certify that all applicable institutional and governmental regulations regarding the ethical use of human volunteers were followed during this research.

Participants

Of the 160 participants enrolled, 8 did not complete the trial. The final study sample included 152 participants (131 women and 21 men; mean age 45.0±9.4 years; black participants 47.7% and white participants 52.3%). Demographic characteristics of the participants are provided inTable 1



The Songkran Festival is a traditional Thai New Year's celebration that takes place annually from April 13th to 15th. It is known for its water-throwing festivities, where people pour water on each other as a symbol of purification and the washing away of sins and bad luck.

The name Songkran comes from the Sanskrit word saṃkrānti, which means "astrological passage," and marks the end of the dry season and the beginning of the rainy season in Thailand.

During the festival, people also visit temples, offer food to Buddhist monks, and participate in cultural activities such as parades and traditional dances. The holiday is an important time for families to come together and pay respect to their elders, as well as for friends to reunite and celebrate the start of a new year.

In recent years, the water-throwing aspect of Songkran has become more of a party atmosphere, with many young people taking to the streets to splash water on each other and engage in friendly water fights. Despite this shift in tone, the festival remains an important cultural tradition in Thailand, and is recognized as a public holiday across the country.

In addition to the water-throwing festivities, Songkran also involves other traditional customs and practices. One of the most important is the pouring of scented water on Buddha images, which symbolizes the washing away of bad luck and the accumulation of merit. This practice is known as "Rod Nam Dum Hua" and is considered a way to pay respect to one's ancestors and elders.

Another important aspect of Songkran is the creation of sand pagodas. Thai people often visit the beach during the holiday to build intricate sand structures that are believed to bring good luck and blessings. These pagodas are adorned with flowers, incense, and candles, and are seen as a way to honor Buddha and the teachings of Buddhism.

Songkran is also a time for delicious food and traditional sweets, such as "kanom tom," a sweet dessert made of sticky rice and coconut milk, and "khanom krok," a small cake made from rice flour and coconut milk. Additionally, many Thai people wear traditional clothing during the festival, such as "chut thai," which consists of a long-sleeved shirt, pants, and a wrap-around skirt for women.

Overall, the Songkran Festival is a time for joy, happiness, and togetherness. It is an opportunity for Thai people to reconnect with their cultural roots, pay respect to their elders, and celebrate the start of a new year with family and friends.

The practice of counseling psychology encompasses a broad range of culturally sensitive practices that help people improve their well-being, alleviate distress and maladjustment, resolve crises and increase their ability to function better in their lives. With its attention both to normal developmental issues and problems associated with physical, emotional and mental disorders, the specialization holds a unique perspective in the broader practice-based areas of psychology. While both counseling and clinical psychologists practice psychotherapy, counseling psychology differs from clinical in that its practitioners tend to focus on overall well-being across the lifespan, compared to clinical clients who often are experiencing more severe symptoms of mental illness.