Obesity with Comorbid Eating Disorders: Associated Health Risks and Treatment Approaches

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Felipe Q. da Luz

2018-06-01

Full Text Available Obesity and eating disorders are each associated with severe physical and mental health consequences, and individuals with obesity as well as comorbid eating disorders are at higher risk of these than individuals with either condition alone. Moreover, obesity can contribute to eating disorder behaviors and vice-versa. Here, we comment on the health complications and treatment options for individuals with obesity and comorbid eating disorder behaviors. It appears that in order to improve the healthcare provided to these individuals, there is a need for greater exchange of experiences and specialized knowledge between healthcare professionals working in the obesity field with those working in the field of eating disorders, and vice-versa. Additionally, nutritional and/or behavioral interventions simultaneously addressing weight management and reduction of eating disorder behaviors in individuals with obesity and comorbid eating disorders may be required. Future research investigating the effects of integrated medical, psychological and nutritional treatment programs addressing weight management and eating disorder psychopathology in individuals with obesity and comorbid eating disorder behaviors—such as binge eating—is necessary.

The effect of family-based multidisciplinary cognitive behavioral treatment in children with obesity: study protocol for a randomized controlled trial.

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Vos, Rimke C; Wit, Jan M; Pijl, Hanno; Kruyff, Carolien C; Houdijk, Euphemia C A M

2011-05-06

The prevalence of childhood obesity has increased rapidly during the last three decades in the Netherlands. It is assumed that mainly environmental factors have contributed to this trend. Parental overweight and low social economic status are risk factors for childhood obesity. Childhood obesity affects self-esteem and has negative consequences on cognitive and social development. Obese children tend to become obese adults, which increases the risk for developing cardiovascular complications, type 2 diabetes mellitus, and psychosocial problems. Additionally, the secretion of several gastrointestinal hormones, responsible for appetite and food intake, is impaired in obese subjects. Weight reduction through lifestyle changes in order to change health risks is, until now, suggested as the preferred treatment for childhood obesity.The objective of this study is the effect evaluation of a family-based cognitive behavioral multidisciplinary lifestyle treatment. The intervention aims to establish long-term weight reduction and stabilization, reduction of obesity-related health consequences and improvement of self-image by change of lifestyle and learning cognitive behavioral techniques. In this randomized clinical trial newly presented children with obesity (8-17 years old) are divided, by randomization, in an intervention and control group, both consisting of 40 obese children. The intervention is carried out in groups of 8-11 children, and consists of respectively 7 and 5 separate group meetings for the children and their parents and 1 joint group meeting of 2 ½ hours. Main topics are education on nutrition, self-control techniques, social skills, physical activity and improvement of self-esteem. The control group is given advice on physical activity and nutrition. For normal data comparison, data were collected of 40 normal-weight children, 8-17 years old. Because of the increasing prevalence of childhood obesity and the impact on the individual as well as on society

Pica and rumination behavior among individuals seeking treatment for eating disorders or obesity.

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Delaney, Charlotte B; Eddy, Kamryn T; Hartmann, Andrea S; Becker, Anne E; Murray, Helen B; Thomas, Jennifer J

2015-03-01

Pica and rumination disorder (RD)-formerly classified within DSM-IV Feeding and Eating Disorders of Infancy or Early Childhood-are now classified within DSM-5 Feeding and Eating Disorders. Though pica and RD have been studied in select populations (e.g., pregnant women, intellectually disabled persons), their typical features and overall prevalence remain unknown. This study examined the clinical characteristics and frequency of DSM-5 pica and RD among individuals seeking treatment for eating disorders and obesity. We conducted structured interviews with adolescent and young adult females from a residential eating disorder center (N = 149), and adult males and females with overweight or obesity from an outpatient weight-loss clinic (N = 100). Several participants reported ingesting non-nutritive substances (e.g., ice) for weight-control purposes. However, only 1.3% (n = 2; 95% CI: .06% to 5.1%) at the residential eating disorder center and 0% at the weight-loss clinic met DSM-5 criteria for pica, consuming gum and plastic. Although no eating disorder participants were eligible for an RD diagnosis due to DSM-5 trumping rules, 7.4% (n = 11; 95% CI: 4.0% to 12.9%) endorsed rumination behavior under varying degrees of volitional control. At the weight-loss clinic, 2.0% (n = 2; 95% CI: 0.1% to 7.4%) had RD. DSM-5 pica and RD were rare in our sample of individuals seeking treatment for eating disorders and obesity, but related behaviors were more common. The wide range of pica and rumination presentations highlights the challenges of differential diagnosis with other forms of disordered eating. © 2014 Wiley Periodicals, Inc.

Mechanisms of Action in Cognitive-Behavioral and Pharmacological Interventions for Obesity and Bulimia Nervosa.

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Craighead, Linda W.; Agras, W. Stewart

1991-01-01

Summarizes data pertaining to separate and combined effects of cognitive-behavioral and psychopharmacologic treatments for obesity and bulimia nervosa. Anorexiant medication appears to enhance restraint and facilitates weight loss with behavioral interventions in the treatment of obesity, but relapse occurs once medication is withdrawn.…

Study Protocol: A randomized controlled trial evaluating the effect of family-based behavioral treatment of childhood and adolescent obesity-The FABO-study.

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Skjåkødegård, Hanna F; Danielsen, Yngvild S; Morken, Mette; Linde, Sara-Rebekka F; Kolko, Rachel P; Balantekin, Katherine N; Wilfley, Denise E; Júlíusson, Pétur B

2016-10-21

The purpose of the FABO-study is to evaluate the effect of family-based behavioral social facilitation treatment (FBSFT), designed to target children's family and social support networks to enhance weight loss outcomes, compared to the standard treatment (treatment as usual, TAU) given to children and adolescents with obesity in a routine clinical practice. Randomized controlled trial (RCT), in which families (n = 120) are recruited from the children and adolescents (ages 6-18 years) referred to the Obesity Outpatient Clinic (OOC), Haukeland University Hospital, Norway. Criteria for admission to the OOC are BMI above the International Obesity Task Force (IOTF) cut-off ≥ 35, or IOTF ≥ 30 with obesity related co-morbidity. Families are randomized to receive FBSFT immediately or following one year of TAU. All participants receive a multidisciplinary assessment. For TAU this assessment results in a plan and a contract for chancing specific lifestyle behaviors. Thereafter each family participates in monthly counselling sessions with their primary health care nurse to work on implementing these goals, including measuring their weight change, and also meet every third month for sessions at the OOC. In FBSFT, following assessment, families participate in 17 weekly sessions at the OOC, in which each family works on changing lifestyle behaviors using a structured cognitive-behavioral, socio-ecological approach targeting both parents and children with strategies for behavioral maintenance and sustainable weight change. Outcome variables include body mass index (BMI; kg/m 2 ), BMI standard deviation score (SDS) and percentage above the IOTF definition of overweight, waist-circumference, body composition (bioelectric impedance (BIA) and dual-X-ray-absorptiometry (DXA)), blood tests, blood pressure, activity/inactivity and sleep pattern (measured by accelerometer), as well as questionnaires measuring depression, general psychological symptomatology, self

The effect of family-based multidisciplinary cognitive behavioral treatment in children with obesity: study protocol for a randomized controlled trial

Directory of Open Access Journals (Sweden)

Kruyff Carolien C

2011-05-01

Full Text Available Abstract Background The prevalence of childhood obesity has increased rapidly during the last three decades in the Netherlands. It is assumed that mainly environmental factors have contributed to this trend. Parental overweight and low social economic status are risk factors for childhood obesity. Childhood obesity affects self-esteem and has negative consequences on cognitive and social development. Obese children tend to become obese adults, which increases the risk for developing cardiovascular complications, type 2 diabetes mellitus, and psychosocial problems. Additionally, the secretion of several gastrointestinal hormones, responsible for appetite and food intake, is impaired in obese subjects. Weight reduction through lifestyle changes in order to change health risks is, until now, suggested as the preferred treatment for childhood obesity. The objective of this study is the effect evaluation of a family-based cognitive behavioral multidisciplinary lifestyle treatment. The intervention aims to establish long-term weight reduction and stabilization, reduction of obesity-related health consequences and improvement of self-image by change of lifestyle and learning cognitive behavioral techniques. Study design/Methods In this randomized clinical trial newly presented children with obesity (8-17 years old are divided, by randomization, in an intervention and control group, both consisting of 40 obese children. The intervention is carried out in groups of 8-11 children, and consists of respectively 7 and 5 separate group meetings for the children and their parents and 1 joint group meeting of 2 ½ hours. Main topics are education on nutrition, self-control techniques, social skills, physical activity and improvement of self-esteem. The control group is given advice on physical activity and nutrition. For normal data comparison, data were collected of 40 normal-weight children, 8-17 years old. Discussion Because of the increasing prevalence of

Examination of the association between lifestyle behavior changes and weight outcomes in preschoolers receiving treatment for obesity.

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Kuhl, Elizabeth S; Clifford, Lisa M; Bandstra, Nancy F; Filigno, Stephanie S; Yeomans-Maldonado, Gloria; Rausch, Joseph R; Stark, Lori J

2014-01-01

Preschoolers (ages 2-5 years) have been significantly underrepresented in the obesity treatment outcome literature, despite estimates that 12.1% are already obese. As such, little is known about the most important intervention targets for weight management within this age group. The aims of this study were (a) to examine lifestyle behavior changes for 30 obese preschoolers participating in a weight-control intervention and (b) to explore which lifestyle behavior changes predicted changes in body mass index (BMI) z score. Preschooler height, weight, diet (three 24-hr recalls), physical activity (accelerometry), and television use (parent report) were measured at baseline and posttreatment (6 months). A linear regression was conducted to examine pre- to posttreatment changes in diet (i.e., intake of calories, sugar-sweetened beverages, fruits and vegetables, and sweet and salty snacks) and activity (i.e., moderate-to-vigorous activity and television use) behaviors on changes in BMI z score. Despite significant reductions in sugar-sweetened beverage intake and television use, and increases in fruit and vegetable intake, only reductions in absolute caloric intake significantly predicted reductions in BMI z score. Our findings suggest that attaining healthy caloric goals may be the most important component of weight-control interventions for preschoolers. Future research using innovative methodologies, such as the Multiphase Optimization Strategy, may be helpful to prospectively identifying the lifestyle behavior changes that are most effective in helping families to achieve healthy weight outcomes for preschoolers and thereby improve intervention efficiency and decrease treatment burden for families. 2014 APA, all rights reserved

Behavior Modification for Obesity: The Evaluation of Exercise, Contingency Management, and Program Adherence.

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And Others; Stalonas, Peter M., Jr.

1978-01-01

Investigated behavioral programs for obesity. Exercise and self-managed contingency components were compared using obese subjects who were evaluated after treatment and follow-up. Significant weight loss was observed at termination. The influence of exercise at follow-up was noticeable. Subjects engaged in behaviors, yet behaviors were not related…

Obesity and its relationship to addictions: is overeating a form of addictive behavior?

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Barry, Danielle; Clarke, Megan; Petry, Nancy M

2009-01-01

Obesity is a major public health problem and notoriously difficult to treat. There are many parallels between obesity/overeating and addictions to alcohol and drugs. This paper discusses similarities between obesity and addictive disorders, including common personality characteristics, disruptive behavior syndromes, and brain mechanisms. Although there are important differences between overeating and other addictive behaviors, an addiction model of overeating may effectively inform prevention and treatment of obesity.

Accumulating Data to Optimally Predict Obesity Treatment (ADOPT): Recommendations from the Biological Domain.

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Rosenbaum, Michael; Agurs-Collins, Tanya; Bray, Molly S; Hall, Kevin D; Hopkins, Mark; Laughlin, Maren; MacLean, Paul S; Maruvada, Padma; Savage, Cary R; Small, Dana M; Stoeckel, Luke

2018-04-01

The responses to behavioral, pharmacological, or surgical obesity treatments are highly individualized. The Accumulating Data to Optimally Predict obesity Treatment (ADOPT) project provides a framework for how obesity researchers, working collectively, can generate the evidence base needed to guide the development of tailored, and potentially more effective, strategies for obesity treatment. The objective of the ADOPT biological domain subgroup is to create a list of high-priority biological measures for weight-loss studies that will advance the understanding of individual variability in response to adult obesity treatments. This list includes measures of body composition, energy homeostasis (energy intake and output), brain structure and function, and biomarkers, as well as biobanking procedures, which could feasibly be included in most, if not all, studies of obesity treatment. The recommended high-priority measures are selected to balance needs for sensitivity, specificity, and/or comprehensiveness with feasibility to achieve a commonality of usage and increase the breadth and impact of obesity research. The accumulation of data on key biological factors, along with behavioral, psychosocial, and environmental factors, can generate a more precise description of the interplay and synergy among them and their impact on treatment responses, which can ultimately inform the design and delivery of effective, tailored obesity treatments. © 2018 The Obesity Society.

Randomized controlled trial of a good practice approach to treatment of childhood obesity in Malaysia: Malaysian Childhood Obesity Treatment Trial (MASCOT).

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Wafa, Sharifah W; Talib, Ruzita A; Hamzaid, Nur H; McColl, John H; Rajikan, Roslee; Ng, Lai O; Ramli, Ayiesah H; Reilly, John J

2011-06-01

Few randomized controlled trials (RCTs) of interventions for the treatment of childhood obesity have taken place outside the Western world. To test whether a good practice intervention for the treatment of childhood obesity would have a greater impact on weight status and other outcomes than a control condition in Kuala Lumpur, Malaysia. Assessor-blinded RCT of a treatment intervention in 107 obese 7- to 11-year olds. The intervention was relatively low intensity (8 hours contact over 26 weeks, group based), aiming to change child sedentary behavior, physical activity, and diet using behavior change counselling. Outcomes were measured at baseline and six months after the start of the intervention. Primary outcome was BMI z-score, other outcomes were weight change, health-related quality of life (Peds QL), objectively measured physical activity and sedentary behavior (Actigraph accelerometry over 5 days). The intervention had no significant effect on BMI z score relative to control. Weight gain was reduced significantly in the intervention group compared to the control group (+1.5 kg vs. +3.5 kg, respectively, t-test p < 0.01). Changes in health-related quality of life and objectively measured physical activity and sedentary behavior favored the intervention group. Treatment was associated with reduced rate of weight gain, and improvements in physical activity and quality of life. More substantial benefits may require longer term and more intensive interventions which aim for more substantive lifestyle changes.

Neuromodulation for the treatment of eating disorders and obesity.

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Lee, Darrin J; Elias, Gavin J B; Lozano, Andres M

2018-02-01

Eating disorders and obesity adversely affect individuals both medically and psychologically, leading to reduced life expectancy and poor quality of life. While there exist a number of treatments for anorexia, morbid obesity and bulimia, many patients do not respond favorably to current behavioral, medical or bariatric surgical management. Neuromodulation has been postulated as a potential treatment for eating disorders and obesity. In particular, deep brain stimulation and transcranial non-invasive brain stimulation have been studied for these indications across a variety of brain targets. Here, we review the neurobiology behind eating and eating disorders as well as the current status of preclinical and clinical neuromodulation trials for eating disorders and obesity.

Prevalence of overweight and obesity in The Netherlands in relation to sociodemographic variables, lifestyle and eating behavior: starting points for the prevention and treatment of obesity.

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Deurenberg, P; Hautvast, J G

1989-01-01

The prevalence and incidence of overweight and obesity has been studied in a young adult population aged 19-35 years. Special attention was given to the relation with psychosociological variables and life-style. The prevalence of overweight and obesity was also studied in a representative population for The Netherlands, in which population also the relation with self-reported illness and subjective health was studied. In the patient population of four general practices the relation of overweight and obesity with disease was investigated in a retrospective design. Also the influence of the body fat distribution was studied. The prevalence of overweight (BMI greater than 25 kg/m2) in the Dutch adult population was 34% in men and 24% in women. The prevalence of obesity (BMI greater than 30 kg/m2) was 4 and 6% in men and women, respectively. The prevalence of overweight and obesity was negatively related with social class and increased with age. Also, life-style variables such as coffee consumption, alcohol consumption, smoking and amount of hours sleep (CASS behavior), physical activity during leisure time, slimming behavior and health-conscious behavior were correlated with the prevalence of overweight. Life events caused an increase in body weight, but in women (not in men) this gain was suppressed by following slimming periods. Thus, emotional eating seems to be an important factor in the etiology of obesity. The results of our studies on the relation of overweight and obesity with morbidity aspects show a clear relation of some diseases and subjective health with overweight, especially in men and women with an abdominal fat distribution. From the results of this study starting points for the prevention and treatment of obesity are proposed.

Neurocognitive correlates of obesity and obesity-related behaviors in children and adolescents

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Liang, J.; Matheson, BE.; Kaye, WH.; Boutelle, KN.

2015-01-01

Childhood obesity rates have risen dramatically over the past few decades. Although obesity has been linked to poorer neurocognitive functioning in adults, much less is known about this relationship in children and adolescents. Therefore, we conducted a systematic review to examine the relationship between obesity and obesity-related behaviors with neurocognitive functioning in youth. We reviewed articles from 1976 to 2013 using PsycInfo, PubMed, Medline and Google Scholar. Search terms included cognitive function, neurocognitive function/performance, executive function, impulsivity, self-regulation, effortful control, cognitive control, inhibition, delayed gratification, memory, attention, language, motor, visuo-spatial, academic achievement, obesity, overweight, body mass index, waist-hip ratio, adiposity and body fat. Articles were excluded if participants had health problems known to affect cognitive functioning, the study used imaging as the only outcome measure, they were non-peer-reviewed dissertations, theses, review papers, commentaries, or they were non-English articles. Sixty-seven studies met inclusion criteria for this review. Overall, we found data that support a negative relationship between obesity and various aspects of neurocognitive functioning, such as executive functioning, attention, visuo-spatial performance, and motor skill. The existing literature is mixed on the effects among obesity, general cognitive functioning, language, learning, memory, and academic achievement. Executive dysfunction is associated with obesity-related behaviors, such as increased intake, disinhibited eating, and less physical activity. Physical activity is positively linked with motor skill. More longitudinal research is needed to determine the directionality of such relationships, to point towards crucial intervention time periods in the development of children, and to inform effective treatment programs. PMID:23913029

Telemedicine and Pediatric Obesity Treatment: Review of the literature and lessons learned

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Cohen, Gail M.; Irby, Megan B.; Boles, Katie; Jordan, Christine; Skelton, Joseph A.

2012-01-01

Pediatric obesity is more prevalent in rural areas, yet rural families may not have access to pediatric obesity treatment programs. Use of new technologies, particularly telemedicine, has proven effective in other behavioral fields, such as psychiatry. This paper reviews the literature on the use of telemedicine in pediatric obesity treatment, and describes one tertiary-care pediatric obesity telemedicine program. We performed a systematic review of the literature from 1990–2011 using the fol...

Neuromodulation for the treatment of eating disorders and obesity

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Lee, Darrin J.; Elias, Gavin J.B.; Lozano, Andres M.

2017-01-01

Eating disorders and obesity adversely affect individuals both medically and psychologically, leading to reduced life expectancy and poor quality of life. While there exist a number of treatments for anorexia, morbid obesity and bulimia, many patients do not respond favorably to current behavioral, medical or bariatric surgical management. Neuromodulation has been postulated as a potential treatment for eating disorders and obesity. In particular, deep brain stimulation and transcranial non-invasive brain stimulation have been studied for these indications across a variety of brain targets. Here, we review the neurobiology behind eating and eating disorders as well as the current status of preclinical and clinical neuromodulation trials for eating disorders and obesity. PMID:29399320

Behavioral Variables Associated with Obesity in Police Officers

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CAN, S. Hakan; HENDY, Helen M.

2014-01-01

Past research has documented that non-behavioral variables (such as long work hours, exposure to police stressors) are associated with obesity risk in police officers, but limited research has examined behavioral variables that might be targeted by Employee Assistance Programs for police weight management. The present study compared non-obese and obese officers for behavioral variables found associated with obesity in other adult samples: physical activity (cardiovascular, strength-training, stretching), sleep duration, and consumption of alcohol, fruit and vegetables, and snack foods. Participants included 172 male police officers who completed questionnaires to report height and weight, used to calculate body mass index (BMI = kg/m2) and to divide them into “non-obese” and “obese” groups. They also reported the above behaviors and six non-behavioral variables found associated with obesity risk: age, health problems, family support, police work hours, police stressors, police support. ANCOVAs compared each behavioral variable across obesity status (non-obese, obese), with the six non-behavioral variables used as covariates. Results revealed that cardiovascular and strength-training physical activity were the only behavioral variables that differed significantly between non-obese and obese police officers. The use of self-reported height and weight values may provide Employee Assistance Program with improved cost, time, and officer participation. PMID:24694574

Differences in eating behaviors and masticatory performances by gender and obesity status.

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Park, Soojin; Shin, Weon-Sun

2015-01-01

This study aimed to determine whether there might be differences in masticatory performance and eating behaviors by gender and obesity status. Forty eight (24 males; 24 females) non-obese and pre-obese young adults were matched for age, gender, and dental health. Eating behaviors were assessed using the Three-Factor Eating Questionnaire (TFEQ), and chewing performance while eating 152g of boiled rice was measured using electromyography (EMG). Compared with non-obese participants, pre-obese participants had significantly higher levels of disinhibition according to the TFEQ (Pdifferent by gender but not by obesity status. Males had a greater bite size (Pobese) and chewing power (r=-0.581, Pobese and r=-0.446, Pobese) were negatively associated with disinhibition score. Results suggest that the effects of gender and, in part, obesity on eating responses may be explained as chewing performance. Therefore, gender-specific interventions and counseling aimed at slowing the rate of ingestion could be promising behavioral treatments for obese persons. Copyright © 2014 Elsevier Inc. All rights reserved.

Cognitive behavioral therapy to aid weight loss in obese patients: current perspectives.

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Castelnuovo, Gianluca; Pietrabissa, Giada; Manzoni, Gian Mauro; Cattivelli, Roberto; Rossi, Alessandro; Novelli, Margherita; Varallo, Giorgia; Molinari, Enrico

2017-01-01

Obesity is a chronic condition associated with risk factors for many medical complications and comorbidities such as cardiovascular diseases, some types of cancer, osteoarthritis, hypertension, dyslipidemia, hypercholesterolemia, type-2 diabetes, obstructive sleep apnea syndrome, and different psychosocial issues and psychopathological disorders. Obesity is a highly complex, multifactorial disease: genetic, biological, psychological, behavioral, familial, social, cultural, and environmental factors can influence in different ways. Evidence-based strategies to improve weight loss, maintain a healthy weight, and reduce related comorbidities typically integrate different interventions: dietetic, nutritional, physical, behavioral, psychological, and if necessary, pharmacological and surgical ones. Such treatments are implemented in a multidisciplinary context with a clinical team composed of endocrinologists, nutritionists, dietitians, physiotherapists, psychiatrists, psychologists, and sometimes surgeons. Cognitive behavioral therapy (CBT) is traditionally recognized as the best established treatment for binge eating disorder and the most preferred intervention for obesity, and could be considered as the first-line treatment among psychological approaches, especially in a long-term perspective; however, it does not necessarily produce a successful weight loss. Traditional CBT for weight loss and other protocols, such as enhanced CBT, enhanced focused CBT, behavioral weight loss treatment, therapeutic education, acceptance and commitment therapy, and sequential binge, are discussed in this review. The issue of long-term weight management of obesity, the real challenge in outpatient settings and in lifestyle modification, is discussed taking into account the possible contribution of mHealth and the stepped-care approach in health care.

Psychological aspects of eating behavior as predictors of 10-y weight changes after surgical and conventional treatment of severe obesity: results from the Swedish Obese Subjects intervention study.

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Konttinen, Hanna; Peltonen, Markku; Sjöström, Lars; Carlsson, Lena; Karlsson, Jan

2015-01-01

There is a need for a better understanding of the factors that influence long-term weight outcomes after bariatric surgery. We examined whether pretreatment and posttreatment levels of cognitive restraint, disinhibition, and hunger and 1-y changes in these eating behaviors predict short- and long-term weight changes after surgical and conventional treatments of severe obesity. Participants were from an ongoing, matched (nonrandomized) prospective intervention trial of the Swedish Obese Subjects (SOS) study. The current analyses included 2010 obese subjects who underwent bariatric surgery and 1916 contemporaneously matched obese controls who received conventional treatment. Physical measurements (e.g., weight and height) and questionnaires (e.g., Three-Factor Eating Questionnaire) were completed before the intervention and 0.5, 1, 2, 3, 4, 6, 8, and 10 y after the start of the treatment. Structural equation modeling was used as the main analytic strategy. The surgery group lost more weight and reported greater decreases in disinhibition and hunger at 1- and 10-y follow-ups (all P women) and experienced larger 1-y decreases in these behaviors (β = 0.31-0.48, P women) lost more weight 2, 6, and 10 y after surgery. In control patients, larger 1-y increases in cognitive restraint predicted a greater 2-y weight loss in both sexes. A higher tendency to eat in response to various internal and external cues shortly after surgery predicted less-successful short- and long-term weight outcomes, making postoperative susceptibility for uncontrolled eating an important indicator of targeted interventions. © 2015 American Society for Nutrition.

Obesity Treatment Strategies

Directory of Open Access Journals (Sweden)

Simona Ianosi Edith

2015-12-01

Full Text Available Obesity is a disease with severe health consequences and increased risk of mortality. The most commonly used criteria to assess the presence and the severity of obesity are body mass index, waist circumference, waist-to-height ratio and the presence of the health conditions caused or worsened by obesity. Worldwide obesity has more than doubled in the last 4 decades. Obesity is the second of the leading preventable causes of death worldwide (after smoking. Obesity has a plurifactorial pathogenesis. The central perturbation consists in the imbalance between calories intake and calories consumption (by inappropriate diet and sedentary lifestyle. Identification of all the ethiological factors is important for treatment and prophylaxis. Weight loss benefits are multiple and important: improvement in glicemic control and in plasma lipid levels, blood presure control, obstructiv sleep apneea reduction, improvement in management of daily activities and profesional performances, increase quality of life, reduction in mortality. Overweight or obese patient will complete a diagnostic and a treatment program. Treatment of obesity claims a targeted multidimensional therapy: weight and lifestyle management, diet, sustained physical activity in daily life, exercise, decrease life stressors, smoking cessation, drug therapy, bariatric surgery psichological, familial and social suport. Weight loss program must be carefully planned, adapted to the patient’s abilities and comorbidities and supervised by a nutritionist and a physiotherapist.

Behavioral management of the obese patient

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Despite countless diets, exercise regimens, drugs, and behavior modification strategies, the prevalence of obesity continues its relentless increase in both developed and developing nations. Although many necessary components to treat obesity have been identified, behavior modification remains the b...

[Options for stress management in obesity treatment].

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Czeglédi, Edit

2016-02-14

Overeating and physical inactivity are of great importance in the etiology of obesity. Psychological factors are often found in the background of life style. Chronic stress can contribute to physical inactivity and behaviors that hinder the keeping of a diet (e.g., irregular eating pattern, emotional eating). Results of randomized controlled trials show that relaxation can reduce emotional eating, improve cognitive restraint, and thereby reduce weight. However, stress management is more than relaxation. It consists of adaptive emotion-focused and problem-focused coping strategies and skills to improve relationships. Deflection skills may help in replacing emotional eating with other behaviors. Cognitive restructuring, saying no, and problem solving help to prevent or manage conflicts and difficulties otherwise would result in overeating due to distress. Developing stress management skills may result in greater compliance with the treatment. The techniques presented in the study can be easily applied by general practitioners or specialists, and provide tools for optimizing obesity treatment.

Behavioral intervention in the treatment of obesity in children and adolescents: implications for Mexico.

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Jelalian, Elissa; Evans, E Whitney

2017-01-01

Pediatric obesity is a worldwide health epidemic affecting both developed and developing countries. Mexico ranks second to the United States in rates of pediatric obesity. Obesity among youth has immediate and long-term consequences on physical and psychosocial development, including cardiovascular, respiratory, and health-related quality of life. Eventual amelioration of this epidemic will require change at the level of the family and community, along with policy initiatives to support healthier eating and activity habits. Evidence-based interventions for overweight/obese youth include family-based lifestyle programs that incorporate attention to diet quantity and quality, physical activity, sedentary behavior, and behavioral strategies to support change. While much of this research has been conducted in the United States, several recent studies suggest the efficacy of similar approaches for youth in Mexico. © The Author(s) 2016. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Randomized Controlled Comparison of Two Cognitive Behavioral Therapies for Obese Children: Mother versus Mother-Child Cognitive Behavioral Therapy

OpenAIRE

Munsch, Simone; Roth, Binia; Michael, Tanja; Meyer, Andrea Hans; Biedert, Esther; Roth, Sandra; Speck, Vanessa; Zumsteg, Urs; Isler, Emanuel; Margraf, Jürgen

2008-01-01

BACKGROUND: Parent-child treatments have been shown to be superior to child-focused treatments of childhood obesity. Yet until now, the comparative effectiveness of parent-only and parent-child approaches has been little studied. METHOD: Fifty-six obese children and their families were randomly assigned to a 16-session cognitive behavioral therapy (CBT) for the parents only or for a combined treatment of parents and children. Children's percent overweight, the body mass index of their mothers...

Pediatric obesity: Causes, symptoms, prevention and treatment.

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Xu, Shumei; Xue, Ying

2016-01-01

Pediatric or childhood obesity is the most prevalent nutritional disorder among children and adolescents worldwide. Approximately 43 million individuals are obese, 21-24% children and adolescents are overweight, and 16-18% of individuals have abdominal obesity. The prevalence of obesity is highest among specific ethnic groups. Obesity increases the risk of heart diseases in children and adults. Childhood obesity predisposes the individual to insulin resistance and type 2 diabetes, hypertension, hyperlipidemia, liver and kidney diseases and causes reproductive dysfunction in adults. Obesity in children is a major health concern of the developed world. The National Health and Nutrition Examination Survey has reported that the prevalence of obesity is on the increase in all the pediatric age groups, in males and females, and in various ethnic and racial groups. Factors, such as eating habits, genetics, environment, metabolism, and lifestyle play an important role in the development of obesity. Over 90% of obesity cases are idiopathic and less than 10% are associated with genetic and hormonal causes. Obesity occurs when the body consumes more calories than it burns, through overeating and underexercising. The symptoms of obesity include breathing disorders, sleep apnea, chronic obstructive pulmonary disease, certain types of cancer such as prostate, bowel, breast and uterine, coronary heart disease, diabetes (type 2 in children), depression, liver and gallbladder problems, gastro-esophageal reflux disease, high blood pressure, high cholesterol, stroke, and joint diseases such as osteoarthritis, pain in knees and lower back. Environmental, behavioral such as consumption of convenience foods, genetic, and family factors contribute to pediatric obesity. Obesity can be countered through lower calorie consumption, weight loss and diet programs, as well as increased physical activity. A number of endogenous molecules including leptin, hypothalamic melanocortin 4 receptor

Current nutritional treatments of obesity.

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Greenwald, Ashli

2006-01-01

Obesity in our country is a growing concern. There are several different options for weight loss; however, individuals must be self-motivated and amendable to change in order to achieve success with their weight loss goals. Several strategies used by professionals in the US today to treat overweight and obesity, include diet therapy, exercise, behavior modification, pharmacotherapy, and surgery. The focus of the American Dietetic Association (ADA) Weight Management Position Statement is no longer just on weight loss but now on weight management. Reaching one's ideal body weight is recommended but not often realistic. Frequently, the goal of treatment shifts to maintenance of ones current weight or attempts at moderate weight loss. Lifestyle modification or behavioral modification interventions rely on analyzing behavior to identify events that are associated with appropriate vs. inappropriate eating, exercise, or thinking habits. Certain primary strategies that have been found to be useful for helping people change their behaviors so that they can lose weight and maintain their weight loss, include self-monitoring, stimulus control, cognitive restructuring, stress management, social support, physical activity, and relapse prevention. Weight loss programs should strive to combine a nutritionally balanced dietary regimen with exercise and lifestyle modifications at the lowest possible cost. There are several different methods used for dietary modifications; low calorie diets, very low calorie diets, fasting, formula diets and meal replacement programs, and popular diets. Bariatric surgery is gaining popularity as it has been an effective way to treat obesity. Following gastric bypass surgery, the patients must be prepared to modify their eating behaviors and dietary selections to assist with weight loss and prevent potential complications. Patients should be educated on the dietary guidelines extensively prior to surgery and again post-operatively.

Effect of Subliminal Stimulation of Symbiotic Fantasies on Behavior Modification Treatment of Obesity.

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And Others; Silverman, Lloyd H.

1978-01-01

Obese women were treated in behavior modification programs for overeating. Behavior programs were accompanied by subliminal stimulation and by symbiotic and control messages. The symbiotic condition gave evidence of enhancing weight loss. This finding supports the proposition that subliminal stimulation of symbiotic fantasies can enhance the…

Behavioral Variables Associated with Obesity in Police Officers

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CAN, S. Hakan; HENDY, Helen M.

2014-01-01

Past research has documented that non-behavioral variables (such as long work hours, exposure to police stressors) are associated with obesity risk in police officers, but limited research has examined behavioral variables that might be targeted by Employee Assistance Programs for police weight management. The present study compared non-obese and obese officers for behavioral variables found associated with obesity in other adult samples: physical activity (cardiovascular, strength-training, ...

Virtual reality for enhancing the cognitive behavioral treatment of obesity with binge eating disorder: randomized controlled study with one-year follow-up.

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Cesa, Gian Luca; Manzoni, Gian Mauro; Bacchetta, Monica; Castelnuovo, Gianluca; Conti, Sara; Gaggioli, Andrea; Mantovani, Fabrizia; Molinari, Enrico; Cárdenas-López, Georgina; Riva, Giuseppe

2013-06-12

Recent research identifies unhealthful weight-control behaviors (fasting, vomiting, or laxative abuse) induced by a negative experience of the body, as the common antecedents of both obesity and eating disorders. In particular, according to the allocentric lock hypothesis, individuals with obesity may be locked to an allocentric (observer view) negative memory of the body that is no longer updated by contrasting egocentric representations driven by perception. In other words, these patients may be locked to an allocentric negative representation of their body that their sensory inputs are no longer able to update even after a demanding diet and a significant weight loss. To test the brief and long-term clinical efficacy of an enhanced cognitive-behavioral therapy including a virtual reality protocol aimed at unlocking the negative memory of the body (ECT) in morbidly obese patients with binge eating disorders (BED) compared with standard cognitive behavior therapy (CBT) and an inpatient multimodal treatment (IP) on weight loss, weight loss maintenance, BED remission, and body satisfaction improvement, including psychonutritional groups, a low-calorie diet (1200 kcal/day), and physical training. 90 obese (BMI>40) female patients with BED upon referral to an obesity rehabilitation center were randomly assigned to conditions (31 to ECT, 30 to CBT, and 29 to IP). Before treatment completion, 24 patients discharged themselves from hospital (4 in ECT, 10 in CBT, and 10 in IP). The remaining 66 inpatients received either 15 sessions of ECT, 15 sessions of CBT, or no additional treatment over a 5-week usual care inpatient regimen (IP). ECT and CBT treatments were administered by 3 licensed psychotherapists, and patients were blinded to conditions. At start, upon completion of the inpatient treatment, and at 1-year follow-up, patients' weight, number of binge eating episodes during the previous month, and body satisfaction were assessed by self-report questionnaires and

Assessment and treatment of binge eating in obese patients

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Walmir Ferreira Coutinho

2006-03-01

Full Text Available Binge eating is a frequent disorder among obese patient, specialythose undergoing weight loss treatment. Binge eating disorder(BED is a newly defined diagnostic category, usually associatedwith psychopathology and overweight. Several clinical trialsinvolving psychoterapeutical interventions have shown thatcognitive beahavior therapy and interpersonal therapy can beeffective for the treatment of obese patients with BED.Pharmacotherapy can be also an useful tool for the control ofbinge eating, as part of a multidimensional therapeutic approach,associated to psychotherapy and eating behavior modification.Although the investigation of pharmacological agents for thetreatment of BED is still in its preliminary stages, somemedications have shown promising results in randomized clinicaltrials. Currently, three main classes of drugs have been evaluatedin randomized controlled trials: antidepressants, anti-obesityagents and anticonvulsants. The most studied drugs were theserotonina selective reuptake inhibitors (SSRIs. Fluoxetine,fluvoxamine, sertralina and citalopram have been shown to causemodest, but significant reduction in the frequency of bingeepisodes and body weight over the short term of the trials. Morerecently, sibutramina and topiramate have been shown tosignificantly reduce the binge eating behavior and the body weightin patients with obesity and binge eating.

[Eating behavior and childhood obesity: family influences].

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Domínguez-Vásquez, P; Olivares, S; Santos, J L

2008-09-01

Eating behavior involves all actions that define the relation between human beings and food. It is accepted that feeding habits are acquired through eating experiences and practices learned from the familiar and social context in early childhood. Besides the role of the social context, it is also assumed that familiar factors, both common family environment and genetic inheritance, have an important influence on food intake and eating behavior linked with childhood obesity. Research on food intake and childhood obesity has been traditionally focused on the amount and type of foods in the usual diet. However, it is an increasing interest to understand the link between eating behavior and obesity using questionnaires. There are several psychometric tools that have been developed specifically to deal with human eating behavior. This review summarizes the family influences, both genetic and non-genetic, on childhood feeding behavior and their relation to childhood obesity.

Effect of a multidisciplinary treatment program on eating behavior in overweight and obese preschool children.

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Bocca, Gianni; Kuitert, Mirije W B; Sauer, Pieter J J; Corpeleijn, Eva

2018-04-25

The effects of multidisciplinary treatment programs on eating behavior in overweight preschool-aged children are largely unknown. We evaluated a multidisciplinary intervention program on eating behavior in 3- to 5-year-old overweight children, comparing them with children given standard treatment. We also assessed the parental eating behavior changes and investigated associations between parents and children. We randomized 75 children to a multidisciplinary intervention or to a standard care program. During a 16-week period, children and parents in the multidisciplinary group were given dietary advice, physical activity sessions and, for parents only, psychological counseling. Children and parents in the standard group visited a pediatrician 3 times and were given information on a healthy lifestyle. At baseline, after 16 weeks, and after 12 months, children were measured and parents completed the Dutch Child Eating Behavior Questionnaire (DEBQ-C) for their children and the DEBQ for themselves. At the three time points, 70 (93.3%), 57 (91.9%), and 42 (73.7%) DEBQ-Cs were analyzed. We found no differences in the changes in eating behavior between the two groups over time. In both groups, there was a significant increase in restrained eating behavior present at 16 weeks, however, this was no longer present at 12 months. We found no associations between changes in eating behavior between the children and their parents. A multidisciplinary obesity intervention program in preschool-aged children induced more restrained eating behavior between baseline and 16 weeks. However, there was no difference with the children in the standard care group.

Does maternal obesity have an influence on feeding behavior of obese children?

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Cebeci, A N; Guven, A

2015-12-01

Although the pathogenesis of childhood obesity is multi factorial, maternal obesity and parenting have major roles. The aim of this study was to evaluate the influence of maternal obesity on feeding practices toward their obese school children. Obese children and adolescents referred to the pediatric endocrinology department were enrolled consecutively. Height and weight of all children and their mothers were measured. Maternal feeding practices were measured using an adapted version of the Child Feeding Questionnaire (CFQ). Answers were compared between obese (Body Mass Index [BMI] ≥ 30 kg/m2) and non-obese mothers. A total of 491 obese subjects (292 girls, mean age 12.0 ± 2.8 years) and their mothers participated in this study. A direct correlation between children's BMI and their mothers' BMI was found (Pobese in the study, only half of them consider themselves as obese. No difference were found in the scores of the subscales "perceived responsibility", "restriction", "concern for child's weight" and "monitoring" between obese and non-obese mothers. Child's BMI-SDS positively correlated with mothers' personal weight perception, concern for child's weight and restriction after adjustment for child's age (P obesity increases mothers' concern and food restriction behavior. While mothers of obese children have a high prevalence of obesity, maternal obesity was found to have no significant influence on feeding behavior of obese school children.

Treatment of adolescents with morbid obesity with bariatric procedures and anti-obesity pharmacological agents

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Um SS

2011-12-01

Full Text Available Scott S Um1, Wendelin Slusser2, Daniel A DeUgarte11Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; 2Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USAAbstract: Adolescent obesity is a growing health concern that can have immense physical and psychological impact. Treatment of morbidly obese adolescents should include a multidisciplinary team to address medical comorbidities, diet, physical activity, mental health, and behavior modification. Anti-obesity pharmacologic agents have a limited role in the treatment of adolescents because of concerns with side effects, safety, and efficacy. Orlistat (GlaxoSmithKline, Moon Township, PA is the only approved medication for weight-loss in adolescents. However, it is associated with gastrointestinal side effects and its long-term efficacy is unknown. Bariatric surgery is the most effective therapy to treat morbid obesity. However, adolescents must meet rigorous criteria and have appropriate cognitive, psychological, and social clearance before being considered for surgical intervention. Gastric bypass remains the gold standard bariatric operation. The adjustable gastric band is not FDA-approved for use in patients under 18 years of age. Sleeve gastrectomy is a promising procedure for adolescents because it avoids an intestinal bypass and the implantation of a foreign body. Prospective longitudinal assessment of bariatric surgery procedures is required to determine long-term outcomes. In this manuscript, we review the treatment options, efficacy, and impact on quality of life for morbidly obese adolescents.Keywords: bariatric surgery, morbid obesity, weight loss, adolescent

Surgical treatment of obesity.

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Bult, Mariëlle J F; van Dalen, Thijs; Muller, Alex F

2008-02-01

More than half of the European population are overweight (body mass index (BMI) > 25 and or = 30 kg/m2). Being overweight and obesity are becoming endemic, particularly because of increasing nourishment and a decrease in physical exercise. Insulin resistance, type 2 diabetes, dyslipidemia, hypertension, cholelithiasis, certain forms of cancer, steatosis hepatis, gastroesophageal reflux, obstructive sleep apnea, degenerative joint disease, gout, lower back pain, and polycystic ovary syndrome are all associated with overweight and obesity. The endemic extent of overweight and obesity with its associated comorbidities has led to the development of therapies aimed at weight loss. The long-term effects of diet, exercise, and medical therapy on weight are relatively poor. With respect to durable weight reduction, bariatric surgery is the most effective long-term treatment for obesity with the greatest chances for amelioration and even resolution of obesity-associated complications. Recent evidence shows that bariatric surgery for severe obesity is associated with decreased overall mortality. However, serious complications can occur and therefore a careful selection of patients is of utmost importance. Bariatric surgery should at least be considered for all patients with a BMI of more than 40 kg/m2 and for those with a BMI of more than 35 kg/m2 with concomitant obesity-related conditions after failure of conventional treatment. The importance of weight loss and results of conventional treatment will be discussed first. Currently used operative treatments for obesity and their effectiveness and complications are described. Proposed criteria for bariatric surgery are given. Also, some attention is devoted to more basic insights that bariatric surgery has provided. Finally we deal with unsolved questions and future directions for research.

Study Protocol: A randomized controlled trial evaluating the effect of family-based behavioral treatment of childhood and adolescent obesity?The FABO-study

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Skj?k?deg?rd, Hanna F.; Danielsen, Yngvild S.; Morken, Mette; Linde, Sara-Rebekka F.; Kolko, Rachel P.; Balantekin, Katherine N.; Wilfley, Denise E.; J?l?usson, P?tur B.

2016-01-01

Background The purpose of the FABO-study is to evaluate the effect of family-based behavioral social facilitation treatment (FBSFT), designed to target children?s family and social support networks to enhance weight loss outcomes, compared to the standard treatment (treatment as usual, TAU) given to children and adolescents with obesity in a routine clinical practice. Methods Randomized controlled trial (RCT), in which families (n?=?120) are recruited from the children and adolescents (ages 6...

Association between eating behavior scores and obesity in Chilean children.

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Santos, José L; Ho-Urriola, Judith A; González, Andrea; Smalley, Susan V; Domínguez-Vásquez, Patricia; Cataldo, Rodrigo; Obregón, Ana M; Amador, Paola; Weisstaub, Gerardo; Hodgson, M Isabel

2011-10-11

Inadequate eating behavior and physical inactivity contribute to the current epidemic of childhood obesity. The aim of this study was to assess the association between eating behavior scores and childhood obesity in Chilean children. We recruited 126 obese, 44 overweight and 124 normal-weight Chilean children (6-12 years-old; both genders) according to the International Obesity Task Force (IOTF) criteria. Eating behavior scores were calculated using the Child Eating Behavior Questionnaire (CEBQ). Factorial analysis in the culturally-adapted questionnaire for Chilean population was used to confirm the original eight-factor structure of CEBQ. The Cronbach's alpha statistic (>0.7 in most subscales) was used to assess internal consistency. Non-parametric methods were used to assess case-control associations. Eating behavior scores were strongly associated with childhood obesity in Chilean children. Childhood obesity was directly associated with high scores in the subscales "enjoyment of food" (P food responsiveness" (P Food-avoidant subscales "satiety responsiveness" and "slowness in eating" were inversely associated with childhood obesity (P < 0.001). There was a graded relation between the magnitude of these eating behavior scores across groups of normal-weight, overweight and obesity groups. Our study shows a strong and graded association between specific eating behavior scores and childhood obesity in Chile.

Comparing Active Pediatric Obesity Treatments Using Meta-Analysis

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Gilles, Allyson; Cassano, Michael; Shepherd, Elizabeth J.; Higgins, Diana; Hecker, Jeffrey E.; Nangle, Douglas W.

2008-01-01

The current meta-analysis reviews research on the treatment of pediatric obesity focusing on studies that have been published since 1994. Eleven studies (22 comparisons, 115 effect sizes, N = 447) were included in the present meta-analysis. Results indicated that comprehensive behavioral interventions may be improved in at least two ways:…

Treatment of adolescent obesity.

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Steinbeck, Katharine S; Lister, Natalie B; Gow, Megan L; Baur, Louise A

2018-04-13

The increased prevalence of adolescent obesity and associated short-term and long-term complications emphasize the need for effective treatment. In this Review, we aim to describe the evidence for, and elements of, behaviour management and adjunctive therapies and highlight the opportunities and challenges presented by obesity management in adolescence. The broad principles of treatment include management of obesity-associated complications; a developmentally appropriate approach; long-term behaviour modification (dietary change, increased physical activity, decreased sedentary behaviours and improved sleep patterns); long-term weight maintenance strategies; and consideration of the use of pharmacotherapy, more intensive dietary therapies and bariatric surgery. Bariatric surgery should be considered in those with severe obesity and be undertaken by skilled bariatric surgeons affiliated with teams experienced in the medical and psychosocial management of adolescents. Adolescent obesity management strategies are more reliant on active participation than those for childhood obesity and should recognize the emerging autonomy of the patient. The challenges in adolescent obesity relate primarily to the often competing demands of developing autonomy and not yet having attained neurocognitive maturity.

Interreality: The Experiential Use of Technology in the Treatment of Obesity

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G, Riva; B.K, Wiederhold; F, Mantovani; A, Gaggioli

2011-01-01

For many of us, obesity is the outcome of an energy imbalance: more energy input than expenditure. However, our waistlines are growing in spite of the huge amount of diets and fat-free/low-calorie products available to cope with this issue. Even when we are able to reduce our waistlines, maintaining the new size is very difficult: in the year after the end of a nutritional and/or behavioral treatment obese persons typically regain from 30% to 50% of their initial losses. A possible strategy for improving the treatment of obesity is the use of advanced information technologies. In the past, different technologies (internet, virtual reality, mobile phones) have shown promising effects in producing a healthy lifestyle in obese patients. Here we suggest that a new technological paradigm - Interreality – that integrates assessment and treatment within a hybrid experiential environment - including both virtual and real worlds - has the potential to improve the clinical outcome of obesity treatments. The potential advantages offered by this approach are: (a) an extended sense of presence: Interreality uses advanced simulations (virtual experiences) to transform health guidelines and provisions in experiences; (b) an extended sense of community: Interreality uses virtual communities to provide users with targeted – but also anonymous, if required - social support in both real and virtual worlds; (c) real-time feedback between physical and virtual worlds: Interreality uses bio and activity sensors and devices (smartphones) both to track in real time the behavior/health status of the user, and to provide targeted suggestions and guidelines. This paper describes in detail the different technologies involved in the Interreality vision. In order to illustrate the concept of Interreality in practice, a clinical scenario is also presented and discussed: Daniela, a 35-year-old fast-food worker with obesity problems. PMID:21559236

Surgical treatment for obesity: ensuring success.

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Andris, Deborah A

2005-01-01

In the United States, obesity has reached epidemic proportions. Serious medical complications, impaired quality of life, and premature mortality are all associated with obesity. Medical conditions such as type 2 diabetes mellitus, hypertension, hyperlipidemia, or sleep apnea can improve or be cured with weight loss. Medical treatment programs focused on diet, behavior modification, and/or pharmacologic intervention have met with limited long-term success. Although surgical treatments for obesity have become popular in recent years, they should only be used as a last resort for weight loss. Not all patients can be considered appropriate candidates for surgery; therefore, guidelines based on criteria from the National Institutes of Health should be used preoperatively to help identify suitable persons. Most individuals who opt for weight-loss surgery have usually struggled for many years with losing weight and keeping it off, but surgery alone will not ensure successful weight loss. Patient education is imperative for long-term success. Moreover, any such educational regimen should include information on diet, vitamin and mineral supplementation, and lifestyle changes, as well as expected weight-loss results and improvements in comorbid conditions. Patients must be willing to commit to a long-term follow-up program intended to promote successful weight loss and weight maintenance and to prevent metabolic and nutritional complications.

Behavioral Intention and Behavior toward the Obese on a College Campus: An Exploratory Analysis of Discriminatory Behavior

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Irwin, Carol; Symons, Cynthia W.; Kerr, Dianne L.

2009-01-01

Background: Discriminatory behavior toward the obese is ubiquitous, which can lead to psychological conditions that exacerbate physical repercussions. Purpose: Using the Theory of Planned Behavior (TPB), this study examined the link between college students' behavioral intention and self-reported behavior toward the obese. Possible connections…

Association between eating behavior scores and obesity in Chilean children

Directory of Open Access Journals (Sweden)

Amador Paola

2011-10-01

Full Text Available Abstract Background Inadequate eating behavior and physical inactivity contribute to the current epidemic of childhood obesity. The aim of this study was to assess the association between eating behavior scores and childhood obesity in Chilean children. Design and methods We recruited 126 obese, 44 overweight and 124 normal-weight Chilean children (6-12 years-old; both genders according to the International Obesity Task Force (IOTF criteria. Eating behavior scores were calculated using the Child Eating Behavior Questionnaire (CEBQ. Factorial analysis in the culturally-adapted questionnaire for Chilean population was used to confirm the original eight-factor structure of CEBQ. The Cronbach's alpha statistic (>0.7 in most subscales was used to assess internal consistency. Non-parametric methods were used to assess case-control associations. Results Eating behavior scores were strongly associated with childhood obesity in Chilean children. Childhood obesity was directly associated with high scores in the subscales "enjoyment of food" (P Conclusion Our study shows a strong and graded association between specific eating behavior scores and childhood obesity in Chile.

Cognitive behavioral therapy to aid weight loss in obese patients: current perspectives

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Castelnuovo G

2017-06-01

Full Text Available Gianluca Castelnuovo,1,2 Giada Pietrabissa,1,2 Gian Mauro Manzoni,1,3 Roberto Cattivelli,1,2 Alessandro Rossi,1 Margherita Novelli,1 Giorgia Varallo,1 Enrico Molinari1,2 1Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, 2Department of Psychology, Catholic University of Milan, Milan, 3Faculty of Psychology, eCampus University, Novedrate, Italy Abstract: Obesity is a chronic condition associated with risk factors for many medical ­complications and comorbidities such as cardiovascular diseases, some types of cancer, osteoarthritis, hypertension, dyslipidemia, hypercholesterolemia, type-2 diabetes, obstructive sleep apnea syndrome, and different psychosocial issues and psychopathological disorders. Obesity is a highly complex, multifactorial disease: genetic, biological, psychological, behavioral, familial, social, cultural, and environmental factors can influence in different ways. Evidence-based strategies to improve weight loss, maintain a healthy weight, and reduce related comorbidities typically integrate different interventions: dietetic, nutritional, physical, behavioral, psychological, and if necessary, pharmacological and surgical ones. Such treatments are implemented in a multidisciplinary context with a clinical team composed of endocrinologists, nutritionists, dietitians, physiotherapists, psychiatrists, psychologists, and sometimes surgeons. Cognitive behavioral therapy (CBT is traditionally recognized as the best established treatment for binge eating disorder and the most preferred intervention for obesity, and could be considered as the first-line treatment among psychological approaches, especially in a long-term perspective; however, it does not necessarily produce a successful weight loss. Traditional CBT for weight loss and other protocols, such as enhanced CBT, enhanced focused CBT, behavioral weight loss treatment, therapeutic education, acceptance and commitment therapy

The Metabolic Syndrome and Behavioral Correlates in Obese Patients With Binge Eating Disorder

OpenAIRE

Roehrig, Megan; Masheb, Robin M.; White, Marney A.; Grilo, Carlos M.

2008-01-01

This study examined the frequency of the metabolic syndrome (MetSyn) and explored behavioral eating- and weight-related correlates in obese patients with binge eating disorder (BED). Ninety-three treatment-seeking obese BED patients (22 men and 71 women) with and without the MetSyn were compared on demographic features and a number of current and historical eating and weight variables. Sixty percent of the obese patients with BED met criteria for the MetSyn, with men and whites having signifi...

Beyond Parenting Practices: Family Context and the Treatment of Pediatric Obesity

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Kitzmann, Katherine M.; Dalton, William T., III; Buscemi, Joanna

2008-01-01

Many family-based treatments for pediatric obesity teach specific parenting practices related to weight management. Although youth in these programs show increases in positive health behaviors and reductions in the extent to which they are overweight, most remain overweight after treatment. A recent trend is to create tailored programs for…

The Status of Billing and Reimbursement in Pediatric Obesity Treatment Programs

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Gray, Jane Simpson; Filigno, Stephanie Spear; Santos, Melissa; Ward, Wendy L.; Davis, Ann M.

2014-01-01

Pediatric psychologists provide behavioral health services to children and adolescents diagnosed with medical conditions. Billing and reimbursement have been problematic throughout the history of pediatric psychology, and pediatric obesity is no exception. The challenges and practices of pediatric psychologists working with obesity are not well understood. Health and behavior codes were developed as one potential solution to aid in the reimbursement of pediatric psychologists who treat the behavioral health needs of children with medical conditions. This commentary discusses the current state of billing and reimbursement in pediatric obesity treatment programs and presents themes that have emerged from discussions with colleagues. These themes include variability in billing practices from program to program, challenges with specific billing codes, variability in reimbursement from state to state and insurance plan to insurance plan, and a general lack of practitioner awareness of code issues or reimbursement rates. Implications and future directions are discussed in terms of research, training, and clinical service. PMID:23224661

The status of billing and reimbursement in pediatric obesity treatment programs.

Science.gov (United States)

Gray, Jane Simpson; Spear Filigno, Stephanie; Santos, Melissa; Ward, Wendy L; Davis, Ann M

2013-07-01

Pediatric psychologists provide behavioral health services to children and adolescents diagnosed with medical conditions. Billing and reimbursement have been problematic throughout the history of pediatric psychology, and pediatric obesity is no exception. The challenges and practices of pediatric psychologists working with obesity are not well understood. Health and behavior codes were developed as one potential solution to aid in the reimbursement of pediatric psychologists who treat the behavioral health needs of children with medical conditions. This commentary discusses the current state of billing and reimbursement in pediatric obesity treatment programs and presents themes that have emerged from discussions with colleagues. These themes include variability in billing practices from program to program, challenges with specific billing codes, variability in reimbursement from state to state and insurance plan to insurance plan, and a general lack of practitioner awareness of code issues or reimbursement rates. Implications and future directions are discussed in terms of research, training, and clinical service.

Effects of anti-obesity drugs, phentermine and mahuang, on the behavioral patterns in Sprague-Dawley rat model.

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Go, Ryeo-Eun; Hwang, Kyung-A; Kim, Seung-Hee; Lee, Min-Young; Kim, Cho-Won; Jeon, So-Ye; Kim, Yun-Bae; Choi, Kyung-Chul

2014-06-01

According to WHO global estimates from 2008, more than 1.4 billion adults were overweight and among them, over 200 million men and 300 million women were obese. Although the main treatment modalities for overweight and obese individuals remain dieting and physical exercise, the synthetic anti-obesity medications have been increasingly used due to their perceived convenience. Generally, anti-obesity medications are classified as appetite suppressants or fat absorption blockers. In the present study, we examined the adverse side-effects in respect of behavior changes of phentermine and Ephedra sinica (mahuang) that are anti-obesity drugs currently distributed to domestic consumers. Phentermine is mainly classified as an anorexing agent and mahuang a thermogenic agent. Because phentermine and mahuang are considered to display effectiveness through the regulation of nerve system, their potential influences of on behavioral changes were examined employing animal experiments. From the results of experiments testing locomotor activity through the use of treadmill, rota-rod, and open field system, phentermine and mahuang were commonly revealed to induce behavioral changes of rats by reducing a motor ability, an ability to cope with an external stimulus, and a sense of balance or by augmenting wariness or excitement. These adverse effects of phenternime and mahuang in behavioral changes need to be identified in humans and anti-obesity medications such as phentermine and mahuang should be prescribed for only obesity where it is anticipated that the benefits of the treatment outweigh their potential risks.

A "Family-Based" Approach to the Treatment of Obese Type II Diabetic Patients.

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Wing, Rena R.; And Others

1991-01-01

Assigned 49 obese diabetic patients with obese spouses (diabetic or nondiabetic) to an alone or together (with spouses) treatment condition of behavioral weight control program. Found no significant differences in weight losses of patients at posttreatment or one-year followup, but did find that women did better when treated with their spouses,…

Randomized controlled trial of behavioral treatment for comorbid obesity and depression in women: the Be Active Trial.

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Pagoto, S; Schneider, K L; Whited, M C; Oleski, J L; Merriam, P; Appelhans, B; Ma, Y; Olendzki, B; Waring, M E; Busch, A M; Lemon, S; Ockene, I; Crawford, S

2013-11-01

Depression is associated with increased risk for obesity and worse weight loss treatment outcomes. The purpose of the present study was to test the hypothesis that delivering evidence-based behavior therapy for depression before a lifestyle weight loss intervention improves both weight loss and depression. In a randomized controlled trial, obese women with major depressive disorder (N=161, mean age=45.9 (s.d.: 10.8) years) were randomized to brief behavior therapy for depression treatment followed by a lifestyle intervention (BA) or a lifestyle intervention only (LI). Follow-up occurred at 6 and 12 months. Main outcome measures included weight loss and depression symptoms. Intention-to-treat analyses revealed both conditions lost significant weight, but no differences between conditions in weight change at 6 months (BA=-3.0%, s.e.=-0.65%; LI=-3.7%, s.e.=0.63%; P=0.48) or 12 months (BA=-2.6%, s.e.=0.77%; LI=-3.1%, s.e.=0.74%; P=0.72). However, the BA condition evidenced significantly greater improvement in Beck Depression Inventory-II scores relative to the LI condition at both 6 months (BA mean change=-12.5, s.d.=0.85; LI mean change=-9.2, s.d.=0.80, P=0.005) and 12 months (BA mean change=-12.6, s.d.=0.97; LI mean change=-9.9, s.d.=0.93; P=0.045). Participants who experienced depression remission by 6 months (61.2%) lost greater weight (mean=-4.31%; s.e.=0.052) than those who did not (39.7%; mean=-2.47%, s.e.=0.53; P=.001). Adding behavior therapy to a lifestyle intervention results in greater depression remission but does not improve weight loss within 1 year. Improvement in depression is associated with greater weight loss.

Neurocognitive correlates of obesity and obesity-related behaviors in children and adolescents

OpenAIRE

Liang, J.; Matheson, BE.; Kaye, WH.; Boutelle, KN.

2013-01-01

Childhood obesity rates have risen dramatically over the past few decades. Although obesity has been linked to poorer neurocognitive functioning in adults, much less is known about this relationship in children and adolescents. Therefore, we conducted a systematic review to examine the relationship between obesity and obesity-related behaviors with neurocognitive functioning in youth. We reviewed articles from 1976 to 2013 using PsycInfo, PubMed, Medline and Google Scholar. Search terms inclu...

Obesity and Type 2 Diabetes in Children: Epidemiology and Treatment

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Pulgaron, Elizabeth R.; Delamater, Alan M.

2014-01-01

The incidence of overweight and obesity among children has increased dramatically in recent decades, with about one-third of children in the U.S. currently being either overweight or obese. Being overweight in early childhood increases risk for later obesity. There is evidence for the efficacy of family-based behavioral treatment to control weight and improve health outcomes. Obesity-related health risks have been documented, including metabolic syndrome. There is also increasing incidence of type 2 diabetes (T2D) among youth in recent years, with obesity and family history of T2D generally present. Lower income and ethnic minority status are associated with both obesity and T2D in youth. Most youth with T2D do not achieve optimal glycemic control, and are at high risk for later health complications. Obesity and T2D represent significant public health issues with potentially great personal and societal cost. Research addressing the prevention of obesity and T2D among youth is urgently needed. PMID:24919749

Psychiatric disorders of patients seeking obesity treatment

Directory of Open Access Journals (Sweden)

Lin Hung-Yen

2013-01-01

Full Text Available Abstract Background Obese and overweight people have a higher risk of both chronic physical illness and mental illness. Obesity is reported to be positively associated with psychiatric disorders, especially in people who seek obesity treatment. At the same time, obesity treatment may be influenced by psychological factors or personality characteristics. This study aimed to understand the prevalence of mental disorders among ethnic Chinese who sought obesity treatment. Methods Subjects were retrospectively recruited from an obesity treatment center in Taiwan. The obesity treatments included bariatric surgery and non-surgery treatment. All subjects underwent a standardized clinical evaluation with two questionnaires and a psychiatric referral when needed. The psychiatric diagnosis was made thorough psychiatric clinic interviews using the SCID. A total of 841 patients were recruited. We compared the difference in psychiatric disorder prevalence between patients with surgical and non-surgical treatment. Results Of the 841 patients, 42% had at least one psychiatric disorder. Mood disorders, anxiety disorders and eating disorders were the most prevalent categories of psychiatric disorders. Females had more mood disorders and eating disorders than males. The surgical group had more binge-eating disorder, adjustment disorder, and sleep disorders than the non-surgical group. Conclusion A high prevalence of psychiatric disorders was found among ethnic Chinese seeking obesity treatment. This is consistent with study results in the US and Europe.

Chronic care treatment of obese children and adolescents

DEFF Research Database (Denmark)

Holm, Jens-Christian; Gamborg, Michael; Bille, Dorthe S

2011-01-01

Clinically-relevant protocols for the treatment of childhood obesity are lacking. This study report results for a clinic-based structured treatment program for chronic childhood obesity.......Clinically-relevant protocols for the treatment of childhood obesity are lacking. This study report results for a clinic-based structured treatment program for chronic childhood obesity....

Attitudes to publicly funded obesity treatment and prevention

DEFF Research Database (Denmark)

Lund, Thomas Bøker; Sandøe, Peter; Lassen, Jesper

2011-01-01

The aim of this study was to investigate the Danish public’s support for publicly funded obesity treatment and prevention. It was also examined whether levels of support could be explained by dislike of obese people and / or the belief that those who are obese are personally responsible......, the perceived controllability of obesity, self-reported BMI, and additional attitudinal and sociodemographic characteristics. Public funding of some obesity treatments, such as weight-loss surgery, attracted only limited public support. A majority of the Danish public did support ‘softer’ treatment...... interventions and preventive initiatives. Attitudes to the treatment of obesity were clearly best predicted by the belief that individuals are personally responsible for their own obesity. Dislike of obese persons had no direct effect on the preference for collective treatment initiatives and only a small...

BEHAVIORAL PECULIARITIES IN PATIENTS WITH SURPLUS BODY MASS AND OBESITY

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A. E. Bobrov

2014-01-01

Full Text Available Background: Eating in obesity represents behavioral systems more powerful than conscious self-control. Aim: To study the obese patients’ behavior with the help of clinical-psychopathological and personal style criteria. Materials and methods: A total of 149 patients (aged 19-69 years, who sought medical help due to obesity or overweight were examined. Their physical condition was satisfactory and concomitant somatic diseases were compensated. Patients’ behavior was assessed by diagnostic criteria ICD-10 as well as with a Minnesota Multiphasic Personality Inventory (psychological testing. Results: It was established that psychical impairments existed in 98 (65.8% patients. The anxiety disorders (in 65 patients, 43.6% and affective ones (in 41 patients, 31.5% were noted most frequently. Factor analysis of the psychological test data revealed 5 main styles of behavior in patients with overweight and obesity: borderline, hyperthymic, dysthymic, sensitive, and undifferentiated. Neither these behavioral styles nor the frequency of disorders corresponded to the degree of obesity. Conclusion: Disturbances of eating self-regulation in obesity are associated with different behavioral styles, which are not specific for mental disorders only. These behavioral styles are described in the study as well as corresponding psychological mechanisms of overeating.

Evaluating eating behavior treatments by FDA standards

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A. Janet eTomiyama

2014-01-01

Full Text Available Behavioral treatments for obesity are not evaluated by the same criteria as pharmaceutical drugs, even though treatments such as low-calorie dieting are widely prescribed, require the patients’ time and investment, and may have risks. The Food and Drug Administration (FDA has a procedure for evaluating drugs, in which drugmakers must answer the following questions: (1 Is the treatment safe? (2 How dangerous is the condition the intervention is treating? (3 Is the treatment effective? (4 Is the treatment safe and effective for large numbers of people? We argue that using this framework to evaluate behavioral interventions could help identify unanswered research questions on their efficacy and effectiveness, and we use the example of low-calorie dieting to illustrate how FDA criteria might be applied in the context of behavioral medicine.

Obesity associated behavior in adolescents of private schools in Lebanon.

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Salameh, Pascale; Barbour, Bernadette; Issa, Carine; Rachidi, Samar

2011-01-01

Since adolescence obesity is becoming an international concern, our objective was to evaluate obesity-related behavior in Lebanese adolescents. We performed a cross-sectional study in 19 Lebanese private schools, using a random multistage cluster sampling process. Dietary and physical activity behaviors were assessed in 1933 adolescents aged 12 to 18 years, stressing on differences between boys and girls and obesity categories. We found that boys were more obese than girls (72% versus 3.7% ; p changes in adolescents' behavior, stressing on physical activity for girls and healthier eating for boys.

Topiramate in the treatment of compulsive sexual behavior: case report

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Zullino Daniele

2006-05-01

Full Text Available Abstract Background Among the multiple mechanisms of action of topiramate, AMPA/kainate antagonism may be particularly interesting for the treatment of disorders characterized by conditioned cognitive and behavioral cue reactivity. Case presentation We report the case of a patient consulting primarily for obesity and cue triggered snacking, who responded well on topiramate at doses up to 50 mg. Coincidentally he reported on an improvement of compulsive nonparaphilic sexual behaviors (consumption of prostitution, which was also strongly triggered by environmental cues. Both addictive behaviors (snacking and consumption of prostitution reoccurred after discontinuation of topiramate and again responded reintroduction of the drug. Conclusion The present case report of topiramate's effect on comorbid obesity and nonparaphilic addiction could be interpreted as a further indication that topiramate acts on the common pathway underlying conditioned behaviors and seems to be a treatment of behavioral disorders associated with environmental cues.

Treatment of Obesity by Behavior Therapy and Very Low Calorie Diet: A Pilot Investigation.

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Wadden, Thomas A.; And Others

1984-01-01

Explored the effectiveness of a very low calorie diet to induce rapid weight loss, combined with behavioral techniques to maintain this loss in 17 obese women. Results showed a substantial and sustained weight loss. Subjects did not experience increased anxiety or depression. (JAC)

Ondansetron attenuates depression co-morbid with obesity in obese mice subjected to chronic unpredictable mild stress; an approach using behavioral battery tests.

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Kurhe, Yeshwant; Radhakrishnan, Mahesh; Gupta, Deepali

2014-09-01

The aim of the present work was to investigate the role of ondansetron on the high fat diet (HFD) induced obese mice for behavioral and biochemical alterations using chronic unpredictable mild stress (CUMS) model of depression. Animals were fed with high fat diet for 14 weeks and subjected to different stress procedures for 4 weeks. Treatment with ondansetron was started on day 15. After day 28 behavioral assays and biochemical estimations were performed. Behavioral paradigms viz. sucrose preference test, locomotor score, forced swim test (FST) and elevated plus maze (EPM), whereas biochemical parameters like plasma glucose, total cholesterol, triglycerides and total proteins were estimated. Results examines that in behavioral assays, ondansetron significantly (P glucose, total cholesterol, triglycerides and total proteins were significantly (P glucose level indicates that, it could be "altered glucose level" playing an important role in depression co-morbid with obesity. Ondansetron through allosteric modulation of serotonergic system elevates the serotonin level and thereby regulates the insulin secretion and hence, reversing the "altered glucose level", could be the possible antidepressive-like mechanism against depression co-morbid with obesity.

The Accumulating Data to Optimally Predict Obesity Treatment (ADOPT) Core Measures Project: Rationale and Approach.

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MacLean, Paul S; Rothman, Alexander J; Nicastro, Holly L; Czajkowski, Susan M; Agurs-Collins, Tanya; Rice, Elise L; Courcoulas, Anita P; Ryan, Donna H; Bessesen, Daniel H; Loria, Catherine M

2018-04-01

Individual variability in response to multiple modalities of obesity treatment is well documented, yet our understanding of why some individuals respond while others do not is limited. The etiology of this variability is multifactorial; however, at present, we lack a comprehensive evidence base to identify which factors or combination of factors influence treatment response. This paper provides an overview and rationale of the Accumulating Data to Optimally Predict obesity Treatment (ADOPT) Core Measures Project, which aims to advance the understanding of individual variability in response to adult obesity treatment. This project provides an integrated model for how factors in the behavioral, biological, environmental, and psychosocial domains may influence obesity treatment responses and identify a core set of measures to be used consistently across adult weight-loss trials. This paper provides the foundation for four companion papers that describe the core measures in detail. The accumulation of data on factors across the four ADOPT domains can inform the design and delivery of effective, tailored obesity treatments. ADOPT provides a framework for how obesity researchers can collectively generate this evidence base and is a first step in an ongoing process that can be refined as the science advances. © 2018 The Obesity Society.

Pediatric Obesity: Etiology and Treatment

OpenAIRE

Crocker, Melissa K.; Yanovski, Jack A.

2009-01-01

This paper reviews factors that contribute to excessive weight gain in children and outlines current knowledge regarding approaches for treating pediatric obesity. Virtually all of the known genetic causes of obesity primarily increase energy intake. Genes regulating the leptin signaling pathway are particularly important for human energy homeostasis. Obesity is a chronic disorder that requires long-term strategies for management. The foundation for all treatments for pediatric obesity remain...

Behavioral management of obesity

Science.gov (United States)

The behavioral management of obesity is an approach designed to provide individuals with a set of skills that promote a healthier weight. A number of strategies are used to assist individuals in making gradual changes that can realistically be incorporated into their lives. Evidence is promising f...

Controversies in Obesity Treatment

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Majid Karandish

2015-06-01

Full Text Available The markedly high prevalence of obesity contributes to the increased incidence of chronic diseases, such as diabetes, hypertension, sleep apnea, and heart disease. Because of high prevalence of obesity in almost all countries, it has been the focus of many researches throughout the world during the recent decades. Along with increasing researches, new concepts and controversies have been emerged. The existing controversies on the topic are so deep that some researches argue on absolutely philosophical questions such as “Is obesity a disease?” or “Is it correct to treat obesity?” These questions are based on a few theories and real data that explain obesity as a biological adaptation and also the final results of weight loss programs. Many people attempt to lose weight by diet therapy, physical activity and lifestyle modifications. Importantly, weight loss strategies in the long term are ineffective and may have unintended consequences including decreasing energy expenditure, complicated appetite control, eating disorders, reducing self-esteem, increasing the plasma and tissue levels of persistent organic pollutants that promote metabolic complications, and consequently, higher risk of repeated cycles of weight loss and weight regain. In this review, major paradoxes and controversies on obesity including classic obesity paradox, pre-obesity; fat-but-fit theory, and healthy obesity are explained. In addition, the relevant strategies like “Health at Every Size” that emphasize on promotion of global health behaviors rather than weight loss programs are explained.

The effect of family-based multidisciplinary cognitive behavioral treatment on health-related quality of life in childhood obesity

NARCIS (Netherlands)

Vos, R.C.; Huisman, S.D.; Houdijk, E.C.A.M.; Pijl, H.; Wit, J.M.

2012-01-01

Purpose To evaluate the effect of multidisciplinary treatment on obesity and health-related quality of life (HRQOL). Methods Obese children were randomized to a multidisciplinary lifestyle treatment, including medical, nutritional, physical, and psychological counseling during 3 months, (n = 40,

Contemporary pharmacological obesity treatments

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Kaszubska Katarzyna

2016-06-01

Full Text Available In the last few years, obesity has become a global epidemic. Consequently, worldwide costs associated with managing obesity and obesity-related comorbidities are huge. Numerous studies have focused on discerning the appropriate proper treatment of weight related problems such as overweight and obesity. Moreover, many clinical trials have been conducted for many years in order to introduce effective anti-obesity drugs. The aim of the present review is to provide an overview of current and future pharmacotherapy for obesity, and to provide the reader with a determination of the concentration and composition of long and short term anti-obesity drugs, doing so by placing emphasis on pharmacotherapy and up-to-day solutions. It should be noted that, currently, the worldwide pharmacotherapy is represented by phendimetrazine, benzphetamine and diethylpropion, as well as by orlistat, lorcaserin, phentermine/topiramate, naltrexone/bupropion and liraglutide. In our paper, individual cases of patients’ needs are thoroughly illustrated by way of examples. Medical prescriptions and contraindications are also described.

The Treatment of Achalasia in Obese Patients.

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Wesp, Julie A; Farrell, Timothy M

2018-04-01

Epidemiological studies have demonstrated that obesity is frequently associated with esophageal motility disorders. Morbid obesity and achalasia may coexist in the same patient. The management of the morbidly obese patient with achalasia is complex and the most effective treatment remains controversial. The aim of this study is to review the pathophysiology, clinical presentation, diagnostic evaluation, and treatment of achalasia in morbidly obese patients. PubMed search from January 1990 to July 2017, including the following terms: achalasia, morbid obesity, bariatric, and treatment. Achalasia in the setting of morbid obesity may be successfully treated by endoscopic or surgical methods. Surgeons may choose to add a bariatric procedure, with various strategies present in the literature. A review of the present literature suggests that the preferred approach to achalasia in the morbidly obese patient is to address both disease processes simultaneously with a laparoscopic Heller myotomy and a Roux-en-Y gastric bypass. Roux-en-Y gastric bypass is cited by most experts as the bariatric procedure of choice, given its antireflux benefits. A well-powered study, comparing the various approaches to the treatment of achalasia in the setting of morbid obesity, is required to establish a consensus.

An evolving scientific basis for the prevention and treatment of pediatric obesity.

Science.gov (United States)

Katzmarzyk, P T; Barlow, S; Bouchard, C; Catalano, P M; Hsia, D S; Inge, T H; Lovelady, C; Raynor, H; Redman, L M; Staiano, A E; Spruijt-Metz, D; Symonds, M E; Vickers, M; Wilfley, D; Yanovski, J A

2014-07-01

The 2013 Pennington Biomedical Research Center's Scientific Symposium focused on the treatment and management of pediatric obesity and was designed to (i) review recent scientific advances in the prevention, clinical treatment and management of pediatric obesity, (ii) integrate the latest published and unpublished findings and (iii) explore how these advances can be integrated into clinical and public health approaches. The symposium provided an overview of important new advances in the field, which led to several recommendations for incorporating the scientific evidence into practice. The science presented covered a range of topics related to pediatric obesity, including the role of genetic differences, epigenetic events influenced by in utero development, pre-pregnancy maternal obesity status, maternal nutrition and maternal weight gain on developmental programming of adiposity in offspring. Finally, the relative merits of a range of various behavioral approaches targeted at pediatric obesity were covered, together with the specific roles of pharmacotherapy and bariatric surgery in pediatric populations. In summary, pediatric obesity is a very challenging problem that is unprecedented in evolutionary terms; one which has the capacity to negate many of the health benefits that have contributed to the increased longevity observed in the developed world.

Improving Access and Systems of Care for Evidence-Based Childhood Obesity Treatment: Conference Key Findings and Next Steps

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Wilfley, Denise E.; Staiano, Amanda E.; Altman, Myra; Lindros, Jeanne; Lima, Angela; Hassink, Sandra G.; Dietz, William H.; Cook, Stephen

2017-01-01

Objectives To improve systems of care to advance implementation of the U.S. Preventive Services Task Force recommendations for childhood obesity treatment (i.e. clinicians offer/refer children with obesity to intensive, multicomponent behavioral interventions of >25 hours over 6–12 months to improve weight status) and to expand payment for these services. Methods In July 2015, forty-three cross-sector stakeholders attended a conference supported by the Agency for Healthcare Research and Quality, American Academy of Pediatrics Institute for Healthy Childhood Weight, and The Obesity Society. Plenary sessions presenting scientific evidence and clinical and payment practices were interspersed with breakout sessions to identify consensus recommendations. Results Consensus recommendations for childhood obesity treatment included: family-based multicomponent behavioral therapy; integrated care model; and multi-disciplinary care team. The use of evidence-based protocols, a well-trained healthcare team, medical oversight, and treatment at or above the minimum dose (e.g. >25 hours) are critical components to ensure effective delivery of high-quality care and to achieve clinically meaningful weight loss. Approaches to secure reimbursement for evidence-based obesity treatment within payment models were recommended. Conclusion Continued cross-sector collaboration is crucial to ensure a unified approach to increase payment and access for childhood obesity treatment and to scale-up training to ensure quality of care. PMID:27925451

[Extensive conservative treatment of obesity].

Science.gov (United States)

Buri, Caroline; Laederach, Kurt

2013-02-01

The treatment of obesity is complex due to the multifactorial etiology. A modern therapy concept must therefore be tailored to the individual needs and problems and depends on various factors such as degree of obesity, the presence of physical complications, psychological co-morbidities, any treatment measures the patient underwent up to now as well as on motivational factors. Before deciding on a therapeutic measure a structured multidisciplinary cooperation is essential including psychosomatic medicine/psychiatry/psychotherapy, endocrinology, sports medicine, nutritional medicine and surgery as well. The treatment must be carried out in a multidisciplinary team and includes an adequate therapy of comorbidities and sometimes a psychopharmacological support. The success of a conservative treatment of obesity is remarkable and long-lasting and can be straightforwardly compared to bariatric surgery in financial as well as ethical terms, although for patients and their physicians the latter often carries the allure of quick success.

Examination of the Obesity Epidemic from a Behavioral Perspective

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Shields, A. Tamlyn

2009-01-01

Obesity prevalence has doubled among adults and overweight has tripled among children since 1980. This article discusses behavioral approaches to the obesity epidemic, focusing on recent environmental changes, the resulting behaviors, and possible solutions. Over the last 4 decades, time spent in sedentary activities, the consumption of fast food,…

Prevalence and Predictors of Bullying Behavior among Overweight and Obese Youth in a Nationally Representative Sample.

Science.gov (United States)

Odar Stough, Cathleen; Merianos, Ashley; Nabors, Laura; Peugh, James

2016-08-01

Child and adolescent overweight and obesity are independent risk factors for poor social outcomes. Whether children who are overweight display greater bullying behaviors than normal weight peers, controlling for demographic and other social-ecological factors, was examined. The influence of child (e.g., mental health), family (e.g., income, parent mental health, and exposure to domestic violence), and community (e.g., exposure to neighborhood violence, unfair treatment based on race or ethnic group) factors on bullying risk in the subset of children who are overweight and obese was explored. We conducted a secondary data analysis of the 2011-2012 National Survey of Children's Health, a cross-sectional study providing a nationally representative sample of participants, using a series of multinomial logistic regressions in Mplus software (Muthén & Muthén, Los Angeles, CA). Participants were 41,361 youth ages 10-17 years. Despite statistically significant differences in unadjusted analyses, no differences were found in bullying behavior by weight status once controlling for other factors. Child, family, and neighborhood factors predicted bullying behavior in both the overall sample and the subset of overweight and obese youth. However, some risk factors were unique to children who were overweight or obese. Children who are overweight or obese are not at greater risk for engaging in bullying behavior than normal weight peers. Health professionals targeting bullying behavior should be aware of the impact child, family, and neighborhood factors have on bullying by overweight and obese children and adolescents.

Sedentary behavior at obese children and youth

Directory of Open Access Journals (Sweden)

Milanović Jasmina

2012-01-01

Full Text Available This work presents a research of sedentary behavior at obese children and youth, which was examined considering the amount of time spent on activities that include computers and television, and the amount of children's physical engagement. The sample is made of 375 obese children and adolescents, aged 12-18 years, 47.7% of which are male, and 52.1% female. They all filled in the questionnaire designed for the purpose of 'Cigotica' program. The questionnaire examined the amount of time spent on sedentary behavior. The children's perception of the amount of time spent watching television and using the computer is 4.9 hours, and it is lower than parent's perception, 5.2 hours . The frequency analysis shows that 79.9% of these children do not practice regular sports activities, and also that only 30.7% of them has hobbies, most of which include sedentary behavior. Differences between males and females were found by comparing means of the amount of time spent using television and computer, as well as the amount of physical engagement through sport activities and hobbies. These results are coherent to the results of previous research of effect of sedentary behavior on obesity.

[Pharmacological treatment of obesity].

Science.gov (United States)

Gomis Barbará, R

2004-01-01

The pharmacological treatment of obesity should be considered when cannot be achieved a 10% weight loss with diet therapy and physical activity. The drugs effective in obesity treatment may act by different mechanisms such as reduction in food intake, inhibition of fat absorption, increase of thermogenesis and stimulation of adipocyte apoptosis. At present, we only have two marketed drugs for obesity treatment. Sibutramine is an inhibitor of norepinephrine, dopamine and serotonina reuptake which inhibits food intake and increases thermogenesis. Sibutramine administration for a year can induce a weight loss of 4-7%. Its main side effects are hypertension, headache, insomnia and constipation. Orlistat is an inhibitor of pancreatic lipase which is able to block the absorption of 30% of ingested fat. Its administration induces weight loss and reduction of ulterior weight regain. Also, this drug improves hypertension dyslipdaemia and helps to prevent diabetes in 52% of cases when administered over four years. The increase in frequency of stools and interference with vitamin absorption are its main side effects. Glucagon-like peptide 1, which increases insulin sensitivity and satiety, adiponectin and PPAR-gamma agonists which reduce insulin resistance and modulates adipocyte generation are the basis for future therapeutic approaches of obesity. Phosphatase inhibitors induce PPAR-gamma phosphorylation and UCP-1 expression leading to an increase in thermogenesis and reduction in appetite.

Adoption of the children's obesity clinic's treatment (TCOCT) protocol into another Danish pediatric obesity treatment clinic

DEFF Research Database (Denmark)

Most, Sebastian W; Højgaard, Birgitte; Teilmann, Grete Katrine

2015-01-01

BACKGROUND: Treating severe childhood obesity has proven difficult with inconsistent treatment results. This study reports the results of the implementation of a childhood obesity chronic care treatment protocol. METHODS: Patients aged 5 to 18 years with a body mass index (BMI) above the 99th......, but independent of baseline BMI SDS, age, co-morbidity, SES, pubertal stage, place of referral, hours of treatment per year, and mean visit interval time. CONCLUSIONS: The systematic use of the TCOCT protocol reduced the degree of childhood obesity with acceptable retention rates with a modest time...... percentile for sex and age were eligible for inclusion. At baseline patients' height, weight, and tanner stages were measured, as well as parents' socioeconomic status (SES) and family structure. Parental weight and height were self-reported. An individualised treatment plan including numerous advices...

Stigmatizing Images in Obesity Health Campaign Messages and Healthy Behavioral Intentions.

Science.gov (United States)

Young, Rachel; Subramanian, Roma; Hinnant, Amanda

2016-08-01

Background Antiobesity campaigns blaming individual behaviors for obesity have sparked concern that an emphasis on individual behavior may lead to stigmatization of overweight or obese people. Past studies have shown that perpetuating stigma is not effective for influencing behavior. Purpose This study examined whether stigmatizing or nonstigmatizing images and text in antiobesity advertisements led to differences in health-related behavioral intentions. Method Participants in this experiment were 161 American adults. Measures included self-reported body mass index, weight satisfaction, antifat attitudes, and intention to increase healthy behaviors. Results Images in particular prompted intention to increase healthy behavior, but only among participants who were not overweight or obese. Conclusion Images and text emphasizing individual responsibility for obesity may influence behavioral intention among those who are not overweight, but they do not seem to be effective at altering behavioral intentions among overweight people, the target audience for many antiobesity messages. Images in antiobesity messages intended to alter behavior are influential and should be selected carefully. © 2015 Society for Public Health Education.

Empowerment in the Treatment of Diabetes and Obesity.

Science.gov (United States)

Łuczyński, Włodzimierz; Głowińska-Olszewska, Barbara; Bossowski, Artur

2016-01-01

As the available therapies for diabetes and obesity are not effective enough, diabetologists and educators search for new methods to collaborate with patients in order to support their health behaviors. The aim of this review is to discuss perspectives for the development of new empowerment-type therapies in the treatment of diabetes/obesity. Empowerment is a process whereby patients gain the necessary knowledge to influence their own behavior to improve the quality of their lives. It is carried out in five stages: (1) identify the problem, (2) explain the feelings and meanings, (3) build a plan, (4) act, and (5) experience and assess the execution. Although many years have passed since the advent and popularization of the concept of empowerment, the area remains controversial, mainly with regard to the methodology of therapy. Some previous studies have confirmed the positive effect of empowerment on body weight, metabolic control, and quality of life of patients with type 2 diabetes; however, few studies have been conducted in patients with type 1 diabetes. There is still a need to confirm the effectiveness of empowerment in accordance with Evidence Based Medicine by performing long-term observational studies in a large group of patients. In future, empowerment may become part of the standard of care for patients with diabetes and/or obesity.

Innovative interventions to promote behavioral change in overweight or obese individuals: A review of the literature.

Science.gov (United States)

Okorodudu, Daniel E; Bosworth, Hayden B; Corsino, Leonor

2015-05-01

The overweight and obesity trends have risen over the past few decades, placing significant burdens on health care in terms of increased morbidity and cost. Behavioral change therapy is an effective treatment strategy and includes goal setting, self-monitoring, problem solving, and reinforcement tactics. Traditionally, behavior change therapy has been delivered using face-to-face counseling along with paper and pen recording of dietary intake and physical activity. The current advances in technology provide opportunities to deliver interventions using cellphones, internet, and active video games. These new methods to deliver behavior change for the management and prevention of obesity are being developed in order to increase access, improve convenience, decrease cost, and increase participant engagement. In this review, we present new approaches to promote behavior changes in the management of obesity. Currently available data show promising results. However, future research is needed to address study limitations and implementation challenges of these innovative interventions.

Oxytocin and potential benefits for obesity treatment.

Science.gov (United States)

Olszewski, Pawel K; Klockars, Anica; Levine, Allen S

2017-10-01

Laboratory animal experiments have consistently shown that oxytocin causes early termination of food intake, thereby promoting a decrease in body weight in a long term. Recent studies have also assessed some of oxytocin's effects on appetite and energy balance in humans. The present study examines the findings of the key basic research and of the few clinical studies published thus far in the context of potential benefits and challenges stemming from the use of oxytocin in obese patients. Basic research indicates the involvement of oxytocin in satiety, processing, in reducing a drive to eat for pleasure and because of psychosocial factors. Although the results of clinical studies are very scarce, they suggest that oxytocin administered intranasally in humans decreases energy-induced and reward-induced eating, supports cognitive control of food choices, and improves glucose homeostasis, and its effectiveness may be BMI dependent. Despite the wealth of basic research showing broad anorexigenic effects of oxytocin, clinical studies on oxytocin's therapeutic potential in obesity, are still in their infancy. Future implementation of oxytocin-based pharmacological strategies in controlling energy balance will likely depend on our ability to integrate diverse behavioral and metabolic effects of oxytocin in obesity treatment regimens.

Emerging drugs for the treatment of obesity

DEFF Research Database (Denmark)

Martinussen, Christoffer; Bojsen-Møller, Kirstine Nyvold; Svane, Maria Saur

2017-01-01

INTRODUCTION: The increasing prevalence of obesity represents a huge threat to public health and the current pharmacological treatment options are limited. Bariatric surgery is by far the most effective treatment for severe obesity, highlighting the urgent need for new and improved drug therapies....... Areas covered: Based on the physiological regulation of energy homeostasis, pharmacological strategies to treat obesity are evaluated with focus on drugs in phase 2 and 3 clinical development. The potential impact of these drugs on current treatment standards and the barriers for development...... are discussed and set in a historical perspective of previous antiobesity medications. Expert opinion: The radical effects of bariatric surgery have extended our understanding of the mechanisms controlling appetite and boosted the search for new drug targets in obesity treatment. Accordingly, several compounds...

Obesity - an indication for GLP-1 treatment?

DEFF Research Database (Denmark)

Torekov, S S; Madsbad, S; Holst, Jens Juul

2011-01-01

Obesity is common and associated with a high rate of morbidity and mortality; therefore, treatment is of great interest. At present, bariatric surgery is the only truly successful treatment of severe obesity. Mimicking one of the effects of bariatric surgery, namely the increased secretion...... of glucagon-like peptide (GLP)-1, by artificially increasing the levels of GLP-1 might prove successful as obesity treatment. Recent studies have shown that GLP-1 is a physiological regulator of appetite and food intake. The effect on food intake and satiety is preserved in obese subjects and GLP-1 may...... therefore have a therapeutic potential. The GLP-1 analogues result in a moderate average weight loss, which is clinically relevant in relation to reducing the risk of type 2 diabetes and cardiovascular disease. Inspired by the hormone profile after gastric bypass, a future strategy in obesity drug...

Reducing Societal Obesity: Establishing a Separate Exercise Model through Studies of Group Behavior.

Science.gov (United States)

Puterbaugh, J S

2016-01-01

The past 50 years has brought attention to high and increasing levels of human obesity in most of the industrialized world. The medical profession has noticed, has evaluated, and has developed models for studying, preventing, and reversing obesity. The current model prescribes activity in specific quantities such as days, minutes, heart rates, and footfalls. Although decreased levels of activity have come from changes revolving around built environments and social networks, the existing medical model to lower body weights by increasing activity remains individually prescriptive. It is not working. The study of societal obesity precludes the individual and must involve group behavioral studies. Such studies necessitate acquiring separate tools and, therefore, require a significant change in the evaluation and treatment of obesity. Finding groups with common activities and lower levels of obesity would allow the development of new models of land use and encourage active lifestyles through shared interests.

Stigmatizing Images in Obesity Health Campaign Messages and Healthy Behavioral Intentions

Science.gov (United States)

Young, Rachel; Subramanian, Roma; Hinnant, Amanda

2016-01-01

Background: Antiobesity campaigns blaming individual behaviors for obesity have sparked concern that an emphasis on individual behavior may lead to stigmatization of overweight or obese people. Past studies have shown that perpetuating stigma is not effective for influencing behavior. Purpose: This study examined whether stigmatizing or…

Fertility treatment in obese women

NARCIS (Netherlands)

Koning, A.M.H.

2015-01-01

Overweight and obesity are increasing worldwide. This has major adverse consequences for health in general and fertility in women in particular. With the increasing number of women in reproductive age being obese, there is also an increasing need for fertility treatment. And with more pregnant women

A Conceptual Framework for the Expansion of Behavioral Interventions for Youth Obesity: A Family-Based Mindful Eating Approach.

Science.gov (United States)

Dalen, Jeanne; Brody, Janet L; Staples, Julie K; Sedillo, Donna

2015-10-01

Currently, over 30% of US youth are overweight and 1 in 6 have metabolic syndrome, making youth obesity one of the major global health challenges of the 21st century. Few enduring treatment strategies have been identified in youth populations, and the majority of standard weight loss programs fail to adequately address the impact of psychological factors on eating behavior and the beneficial contribution of parental involvement in youth behavior change. A critical need exists to expand treatment development efforts beyond traditional education and cognitive-behavioral programs and explore alternative treatment models for youth obesity. Meditation-based mindful eating programs represent a unique and novel scientific approach to the current youth obesity epidemic given that they address key psychological variables affecting weight. The recent expansion of mindfulness programs to include family relationships shows the immense potential for broadening the customarily individual focus of this intervention to include contextual factors thought to influence youth health outcomes. This article provides an overview of how both mindful eating and family systems theory fits within a conceptual framework in order to guide development of a comprehensive family-based mindful eating program for overweight youth.

Current obesity drug treatment

Directory of Open Access Journals (Sweden)

Marcio C. Mancini

2006-03-01

Full Text Available Pharmacological treatment of obesity is an area of sudden changes,development of new drugs and treatment propositions. This articlepresents information on physiological agents that are currentlybeing used as well as drugs that were widely used but are nomore available.

Obesity-related behaviors among poor adolescents and young adults: Is social position associated with risk behaviors?

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Miranda Lucia Ritterman Weintraub

2015-10-01

Full Text Available This cross-sectional study examines multiple dimensions of social position in relation to obesity-related behaviors in an adolescent and young adult population. In addition to using conventional measures of social position, including parental education and household expenditures, we explore the usefulness of three youth-specific measures of social position—community and society subjective social status and school dropout status. Data is taken from a 2004 house-to-house survey of urban households within the bottom 20th percentile of income distribution within seven states in Mexico. A total of 5,321 Mexican adolescents, aged 12-22 years, provided information on obesity-related behaviors (e.g. diet, physical activity, sedentary behavior and indicators of subjective and objective social position. A parent in each household provided information on socioeconomic status of the parent and household. Ordinal logistic regressions are used to estimate the associations of parental, household and adolescent indicators of social position and obesity-related risk behaviors. Those adolescents with the highest odds of adopting obesity risk behaviors were the ones who perceived themselves as lower in social status in reference to their peer community and those who had dropped out of school. We found no significant associations between parental education or household expenditures and obesity-related risk behaviors. Immediate social factors in adolescents' lives may have a strong influence on their health-related behaviors. This study provides evidence for the usefulness of two particular measures, both of which are youth-specific. Adolescents and young adults who have dropped out of school and those with lower perceived relative social position within their community are more likely to be at-risk for obesity-related behaviors than those with higher relative social position. We conclude that youth-specific measures may be important in identifying the most at

The fast food and obesity link: consumption patterns and severity of obesity.

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Garcia, Ginny; Sunil, Thankam S; Hinojosa, Pedro

2012-05-01

Rates of extreme forms of obesity are rapidly rising, as is the use of bariatric surgery for its treatment. The aim of the present study was to examine selected behavioral factors associated with severity of obesity among preoperative bariatric surgery patients in the San Antonio area, focusing specifically on the effects of fast food consumption. We used ordered logistic regression to model behavioral and attitudinal effects on obesity outcomes among 270 patients. These outcomes were based on the severity of obesity and were measured on the basis of body mass index. Our results indicated that, among the behavioral factors, fast food consumption exerted the largest influence on higher levels of obesity. These remained after controlling for several social and demographic characteristics. Our findings suggest that higher rates of fast food consumption are connected to the increasing rates of severe obesity. Given that morbid and super morbid obesity rates are growing at a more advanced pace than moderate obesity, it is necessary to explore the behavioral characteristics associated with these trends.

The Association between Obesity and Symptoms of Psychopathology and its Relationship with Sedentary Behavior and Mediterranean Diet.

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Dimitriadis, Dimitrios; Mamplekou, Efterpi; Dimitriadis, Panayiotis; Komessidou, Vasso; Dimitriadis, George; Papageorgiou, Charalambos

2016-01-01

Recent research indicates an association between obesity and symptoms of psychopathology, the nature of which remains obscure. This study examined the confounding role of behavioral factors on this association. One hundred and forty-two overweight/obese subjects who sought treatment for obesity, of both genders (51 males and 91 females), 18 to 64 years old and 139 normal-weight controls of both genders (41 males and 98 females), 18 to 63 years old, were enrolled in this study. We measured psychopathology features, using the Symptom Checklist 90-Revised (SCL-90-R), dietary habits, using the MedDietScore (MDS) questionnaire, and physical activity, using the International Physical Activity Questionnaire (IPAQ). A series of regression models were used to estimate the mediation of dietary patterns and physical activity on the obesity-psychopathology association. The associations between obesity and depression (β=0.32/β=0.15), obsession-compulsion (β=0.03/β=-0.13), anxiety (β=-0.25/β=-0.12), interpersonal sensitivity (β=0.08/β=-0.04) and psychoticism (β=-0.01/ β=0.025) are accounted for by sedentary behavior and Mediterranean diet. Our data suggest that modifiable behavioral factors such as sedentary time and dietary patterns positively affect the association between obesity and symptoms of psychopathology.

Objectively measured sedentary behavior, physical activity, and plasma lipids in overweight and obese children.

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Cliff, Dylan P; Okely, Anthony D; Burrows, Tracy L; Jones, Rachel A; Morgan, Philip J; Collins, Clare E; Baur, Louise A

2013-02-01

This study examines the associations between objectively measured sedentary behavior, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA), and plasma lipids in overweight and obese children. Cross-sectional analyses were conducted among 126 children aged 5.5-9.9 years. Sedentary behavior, LPA, and MVPA were assessed using accelerometry. Fasting blood samples were analyzed for plasma lipids (high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], total cholesterol [TC], and triglycerides [TG]). MVPA was not related to plasma lipids (P > 0.05). Independent of age, sex, energy intake, and waist circumference z-score, sedentary behavior and LPA were associated with HDL-C (β = -0.23, 95% CI -0.42 to -0.04, P = 0.020; β = 0.20, 95% CI 0.14 to 0.39, P = 0.036, respectively). The strength of the associations remained after additionally adjusting for MVPA (sedentary behavior: β = -0.22, 95% CI -0.44 to 0.006, P = 0.056; LPA: β = 0.19, 95% CI -0.005 to 0.38, P = 0.056, respectively). Substituting at least LPA for sedentary time may contribute to the development of healthy HDL-C levels among overweight and obese children, independent of their adiposity. Comprehensive prevention and treatment strategies to improve plasma HDL-C among overweight and obese children should target reductions in total sedentary time and promote the benefits of LPA, in addition to promoting healthy levels of adiposity, healthy dietary behaviors, and MVPA. Copyright © 2012 The Obesity Society.

Treatment of Obesity among Youth with Intellectual and Developmental Disabilities: An Emerging Role for Telenursing

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Bennett, Elizabeth Anne; Kolko, Rachel; Chia, Lichun; Elliott, Jennifer Padden; Kalarchian, Melissa Ann

2018-01-01

Childhood obesity is a serious health issue, associated with medical comorbidity and psychosocial impairment that can persist into adulthood. In the United States, youth with intellectual and developmental disabilities are more likely to be obese than youth without disabilities. A large body of evidence supports the efficacy of family-based treatment of childhood obesity, including diet, physical activity, and behavior modification, but few interventions have been developed and evaluated specifically for this population. We highlight studies on treatment of obesity among youth with intellectual and developmental disabilities, including both residential/educational settings as well as outpatient/hospital settings. All interventions were delivered in-person, and further development of promising approaches and delivery via telenursing may increase access by youth and families. Nursing scientists can assume an important role in overcoming barriers to care for this vulnerable and underserved population. PMID:28349744

Inhibition of the methionine aminopeptidase 2 enzyme for the treatment of obesity

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Joharapurkar AA

2014-02-01

Full Text Available Amit A Joharapurkar, Nirav A Dhanesha, Mukul R Jain Department of Pharmacology and Toxicology, Zydus Research Centre, Cadila Healthcare Limited, Ahmedabad, India Abstract: Worldwide prevalence of obesity has nearly doubled since 1980. Obesity is the result of interactions among the environmental factors, genetic predisposition, and human behavior. Even modest weight reduction in obese patients provides beneficial health outcomes. For effective weight reduction, a drug should either increase energy expenditure or decrease energy intake without causing serious adverse effects. To overcome lack of efficacy and central nervous system related side effects, exploitation of the peripheral mechanism of anti-obesity action is needed. Inhibition of pathological angiogenesis in adipose tissue is one such peripheral mechanism that has attracted the attention of researchers in this area. Although originally developed as anti-cancer agents, methionine aminopeptidase (MetAP2 inhibitors induce significant and sustained weight reduction. Here, we review preclinical and clinical pharmacology of MetAP2 inhibitors. Beloranib is a prototype MetAP2 inhibitor, and currently in advanced clinical trials for the treatment of obesity. Clinical data of beloranib indicate that MetAP2 inhibitors could be a future treatment option for weight reduction without serious adverse effects. Further clinical data from Phase III trials will add to our growing knowledge of MetAP2 inhibitor potential for anti-obesity therapy. Keywords: angiogenesis, beloranib, body weight, MetAP2, anti-obesity

Challenges and successes of a multidisciplinary pediatric obesity treatment program.

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Walsh, Stephanie M; Palmer, Wendy; Welsh, Jean A; Vos, Miriam B

2014-12-01

Despite the well-documented need for multidisciplinary pediatric obesity treatment programs, few programs exist and best practices are not clearly defined. We describe the design and initial quality-related outcomes of the Strong4Life multidisciplinary pediatric obesity treatment program along with some challenges and solutions implemented over the first 2 years. The purpose of this report is to inform others interested in designing similar programs. The Strong4Life Clinic obesity program was designed to provide children with the medical care, as well as the behavior change guidance and support needed to reverse their obesity and/or minimize the related health risks. This low-intensity program is designed to provide approximately 6 hours of care over 12 months from a medical provider, psychologist, registered dietitian nutritionist, exercise physiologist, and nurse. Between August 2011 and February 2014, the Strong4Life clinic served 781 high-risk (mean sex- and age-adjusted body mass index [BMI] percentile 98.8) and racially/ethnically diverse (45% non-Hispanic black and 24% Hispanic) patients. Of the 781 patients seen, 66% returned for at least 1 visit. Nearly all returning Strong4Life patients stabilized or improved their BMI (90% of those who participated 6 months, but longer follow-up and assessment of comorbidities are needed. © 2014 American Society for Parenteral and Enteral Nutrition.

Obesity and PCOS: Implications for Diagnosis and Treatment

Science.gov (United States)

Legro, Richard S.

2013-01-01

There appears to be an epidemic of both obesity and polycystic ovary syndrome (PCOS) in the world today. However, obesity per se is not a part of the phenotype in many parts of the world. Obesity is likely not a cause of PCOS, as the high prevalence of PCOS among relatively thin populations demonstrates. However, obesity does exacerbate many aspects of the phenotype, especially cardiovascular risk factors such as glucose intolerance and dyslipidemia. It is also associated with a poor response to infertility treatment and likely an increased risk for pregnancy complications in those women who do conceive. Although most treatments of obesity, with the exception of bariatric surgery, achieve modest reductions in weight and improvements in the PCOS phenotype, encouraging weight loss in the obese patient remains one of the front-line therapies. However, further studies are needed to identify the best treatments, and the role of lifestyle therapies in women of normal weight with PCOS is uncertain. PMID:23074008

Treatment of Childhood Obesity: A Systematic Review

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Staniford, Leanne J.; Breckon, Jeff D.; Copeland, Robert J.

2012-01-01

Childhood obesity trends have increased dramatically over the past three decade's. The purpose of this quantitative systematic review is to provide an update of the evidence, illustrating the efficacy of childhood obesity treatment, considering whether treatment fidelity has been measured and/or reported and whether this related to the treatment…

Causal beliefs about obesity and associated health behaviors: results from a population-based survey

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Coups Elliot J

2010-03-01

Full Text Available Abstract Background Several genetic variants are associated with obesity risk. Promoting the notion of genes as a cause for obesity may increase genetically deterministic beliefs and decrease motivation to engage in healthy lifestyle behaviors. Little is known about whether causal beliefs about obesity are associated with lifestyle behaviors. Study objectives were as follows: 1 to document the prevalence of various causal beliefs about obesity (i.e., genes versus lifestyle behaviors, and 2 to determine the association between obesity causal beliefs and self-reported dietary and physical activity behaviors. Methods The study data were drawn from the 2007 Health Information National Trends Survey (HINTS. A total of 3,534 individuals were included in the present study. Results Overall, 72% of respondents endorsed the belief that lifestyle behaviors have 'a lot' to do with causing obesity, whereas 19% indicated that inheritance has 'a lot' to do with causing obesity. Multinomial logistic regression analyses indicated that the belief that obesity is inherited was associated with lower reported levels of physical activity (OR = 0.87, 95% CI: 0.77-0.99 and fruit and vegetable consumption (OR = 0.87, 95% CI: 0.76-0.99. In contrast, the belief that obesity is caused by lifestyle behaviors was associated with greater reported levels of physical activity (OR = 1.29, 95% CI: 1.03-1.62, but was not associated with fruit and vegetable intake (OR = 1.07, 95% CI: 0.90-1.28. Conclusions Causal beliefs about obesity are associated with some lifestyle behaviors. Additional research is needed to determine whether promoting awareness of the genetic determinants of obesity will decrease the extent to which individuals will engage in the lifestyle behaviors essential to healthy weight management.

Cognitive and Self-regulatory Mechanisms of Obesity Study (COSMOS): Study protocol for a randomized controlled weight loss trial examining change in biomarkers, cognition, and self-regulation across two behavioral treatments.

Science.gov (United States)

Hawkins, M A W; Colaizzi, Janna; Gunstad, John; Hughes, Joel W; Mullins, Larry L; Betts, Nancy; Smith, Caitlin E; Keirns, Natalie G; Vohs, Kathleen D; Moore, Shirley M; Forman, Evan M; Lovallo, William R

2018-03-01

Obesity is a global epidemic, yet successful interventions are rare. Up to 60% of people fail to achieve clinically meaningful, short-term weight loss (5-10% of start weight), whereas up to 72% are unsuccessful at achieving long-term weight loss (5-10% loss for ≥5years). Understanding how biological, cognitive, and self-regulatory factors work together to promote or to impede weight loss is clearly needed to optimize obesity treatment. This paper describes the methodology of the Cognitive and Self-regulatory Mechanisms of Obesity Study (the COSMOS trial). COSMOS is the first randomized controlled trial to investigate how changes in multiple biopsychosocial and cognitive factors relate to weight loss and one another across two weight loss treatments. The specific aims are to: 1) Confirm that baseline obesity-related physiological dysregulation is linked to cognitive deficits and poorer self-regulation, 2) Evaluate pre- to post-treatment change across time to assess individual differences in biomarkers, cognition, and self-regulation, and 3) Evaluate whether the acceptance-based treatment (ABT) group has greater improvements in outcomes (e.g., greater weight loss and less weight regain, improvements in biomarkers, cognition, and self-regulation), than the standard behavioral treatment group (SBT) from pre- to post-treatment and 1-year follow-up. The results of COSMOS will provide critical information about how dysregulation in biomarkers, cognition, and/or self-regulation is related to weight loss and whether weight loss treatments are differentially associated with these factors. This information will be used to identify promising treatment targets that are informed by biological, cognitive, and self-regulatory factors in order to advance obesity treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

Snacking Behavior and Obesity among Female Adolescents in Isfahan, Iran.

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Azadbakht, Leila; Hajishafiee, Maryam; Golshahi, Jafar; Esmaillzadeh, Ahmad

2016-07-01

The high prevalence of obesity in the pediatric age groups draws attention to lifestyle factors including diet and physical activity. Data on obesity in adolescents and their snacking behavior are conflicting. This study aimed to assess the association of snacking behavior and obesity among female adolescents in Isfahan, Iran. This cross-sectional study was carried out on 265 female Isfahanian students who were chosen by systematic cluster random sampling. Dietary intake was assessed using a validated self-administered semiquantitative food frequency questionnaire that included 53 food items. Snacking behavior was defined by healthy snack score in combination with the frequency of snack intake. Individuals who consumed more healthy snacks and those with snacking frequency of 4 times a day or more had significantly lower weight, body mass index (BMI), and waist circumference (p associated with a greater chance of being overweight, generally obese, and abdominally obese among adolescents (odds ratio [OR] = 1.98; 95% confidence interval [CI], 1.00-3.14, ptrend = 0.04 and OR = 2.10; 95% CI, 1.01-3.13, ptrend = 0.04, respectively). Frequency of snack intake was inversely related to overweight, general obesity, and abdominal obesity (OR = 3.23; 95% CI, 1.73-5.61, ptrend = 0.03 and OR = 1.84; 95% CI, 1.05-3.20, ptrend = 0.04, respectively). Healthy snack score in combination with frequency of snacking showed that those in the lowest tertile of snacking who consumed snacks less than 4 times/day had the highest risk of obesity compared to other categories (OR = 2.09, 95% CI, 1.11-3.20, p associated with decreased prevalence of overweight, general obesity, and abdominal obesity in adolescents. Further studies, in particular of a prospective nature, are required to examine this association in other populations.

Exploring occupational and health behavioral causes of firefighter obesity: a qualitative study.

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Dobson, Marnie; Choi, BongKyoo; Schnall, Peter L; Wigger, Erin; Garcia-Rivas, Javier; Israel, Leslie; Baker, Dean B

2013-07-01

Firefighters, as an occupational group, have one of the highest prevalence rates of obesity. A qualitative study investigated occupational and health behavioral determinants of obesity among firefighters. Four focus groups were conducted with firefighters of every rank as Phase I of the FORWARD study which was designed to assess health behavioral and occupational characteristics related to obesity in firefighters. Analysis revealed five main themes of central importance to firefighters: (1) fire station eating culture; (2) night calls and sleep interruption; (3) supervisor leadership and physical fitness; (4) sedentary work; and (5) age and generational influences. The results showed a strong interrelationship between occupational and health behavioral causes of obesity in firefighters. The relevance of these qualitative findings are discussed along with the implications for future obesity interventions with firefighters. Copyright © 2013 Wiley Periodicals, Inc.

Fat Mass and Obesity-Associated (FTO) Gene Polymorphisms Are Associated with Physical Activity, Food Intake, Eating Behaviors, Psychological Health, and Modeled Change in Body Mass Index in Overweight/Obese Caucasian Adults

OpenAIRE

Harbron, Janetta; Merwe, Lize van der; Zaahl, Monique; Kotze, Maritha; Senekal, Marjanne

2014-01-01

The fat mass and obesity-associated (FTO) gene is currently recognized as the most robust predictor of polygenic obesity. We investigated associations between the FTO rs1421085 and rs17817449 polymorphisms and the FTO rs1421085–rs17817449 haplotype and dietary intake, eating behavior, physical activity, and psychological health, as well as the effect of these associations on BMI. N = 133 treatment seeking overweight/obese Caucasian adults participated in this study. Genotyping was performed ...

Perspectives of drug treatment of obesity

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Alfredo Halpern

2006-03-01

Full Text Available The perspectives in the pharmacological treatment of obesitycan be classified in two classes: drugs already in the market,in advanced clinical trial or in final approval, or drugs in earlydevelopment. Among the first class are antiepileptic drugslike topiramate (although it was studied for obesity treatmentit was descontinued for this indication because of the highdrop-out rate in clinical trials and zonisamide (with someshort term studies in obese adults; antidepressives likebupropion (that leads to weight reduction and also diminishesthe weight gain associated to smoking cessation andradafaxine (a bupropion metabolite, without reported trials inobese subjects; glucagon-like peptide-1 analogues like exenatide(exendin-4, pramlintide and liraglutide (with studiesin type 2 diabetic obese subjects and the selective blockerof the cannabinoid-1 receptor, rimonabant, with a large bodyof studies (Rimonabant in Obesity, RIO-Europe, RIO-NorthAmerica, RIO-Lipids and RIO-Diabetes, involving more than6.600 patients with obesity, with and without diabetes, beingan important perspective of treatment for obesity andmetabolic syndrome. In early phase of development, we canreport some energy balance modulators like neuropeptide Yantagonists, melanocortin agonists, leptine and its analoguesand ciliary neurotrophic factor (axokine; termogenic agentslike agonists of the beta-3 adrenergic receptor, uncouplingagents of the mithocondrial membrane and peripheralmodulators of the energy balance (cholecystokinine.

School-based obesity policy, social capital, and gender differences in weight control behaviors.

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Zhu, Ling; Thomas, Breanca

2013-06-01

We examined the associations among school-based obesity policies, social capital, and adolescents' self-reported weight control behaviors, focusing on how the collective roles of community and adopted policies affect gender groups differently. We estimated state-level ecologic models using 1-way random effects seemingly unrelated regressions derived from panel data for 43 states from 1991 to 2009, which we obtained from the Centers for Disease Control and Prevention's Youth Risk Behavior Surveillance System. We used multiplicative interaction terms to assess how social capital moderates the effects of school-based obesity policies. School-based obesity policies in active communities were mixed in improving weight control behaviors. They increased both healthy and unhealthy weight control behaviors among boys but did not increase healthy weight control behaviors among girls. Social capital is an important contextual factor that conditions policy effectiveness in large contexts. Heterogeneous behavioral responses are associated with both school-based obesity policies and social capital. Building social capital and developing policy programs to balance outcomes for both gender groups may be challenging in managing childhood obesity.

Associations between childhood overweight, obesity, abdominal obesity and obesogenic behaviors and practices in Australian homes

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Seema Mihrshahi

2017-07-01

Full Text Available Abstract Background Despite emerging research about the role of the family and home environment on early childhood obesity, little is known on how weight-related behaviors, parent practices and the home environment influence overweight/obesity in older children and adolescents. Methods This analysis used data from a cross-sectional, representative population survey of Australian children age 5–16 years conducted in 2015. Data included measured anthropometry to calculate body mass index (BMI; kg/m2 and waist-to-height ratio (WHtR; waist circumference/height. Information on home-based weight-related behaviors (individual eating and screen time behaviors, parent influences including rules and home environment factors were measured using established short questions, with parental proxy reporting for children in up to grade 4, and self-report for students in grades 6, 8 and 10. Logistic regression models were used to examine associations between weight status and home-based weight-related behaviors. Results Both children and adolescents who did not consume breakfast daily were more likely to be overweight/obese OR (95% CI = 1.39 (1.07–1.81 p = 0.015, OR (95% CI =1.42 (1.16–1.74 p = 0.001, respectively, adjusted for age, gender, socio-economic status, rural/urban residence and physical activity. There was also a significant positive association with higher waist-to-height ratio in both children and adolescents. Among children, having a TV in the bedroom was also associated with overweight and obesity OR (95% CI = 1.54 (1.13–2.09 p = 0.006 and higher waist-to-height ratio. For adolescents, parenting practices such as having no rules on screen-time, OR (95% CI = 1.29 (1.07–1.55 p = 0.008, and rewarding good behavior with sweets, OR (95% CI = 2.18 (1.05–4.52 p = 0.036, were significant factors associated with overweight and obesity. The prevalence of these obesogenic behaviors were higher in certain sub-groups of children

Obesity Severity, Dietary Behaviors, and Lifestyle Risks Vary by Race/Ethnicity and Age in a Northern California Cohort of Children with Obesity

OpenAIRE

Ford, Margaret C.; Gordon, Nancy P.; Howell, Amanda; Green, Cheryl E.; Greenspan, Louise C.; Chandra, Malini; Mellor, R. Grant; Lo, Joan C.

2016-01-01

Identification of modifiable behaviors is important for pediatric weight management and obesity prevention programs. This study examined obesogenic behaviors in children with obesity in a Northern California obesity intervention program using data from a parent/teen-completed intake questionnaire covering dietary and lifestyle behaviors (frequency of breakfast, family meals, unhealthy snacking and beverages, fruit/vegetable intake, sleep, screen time, and exercise). Among 7956 children with B...

Obesity and PCOS: implications for diagnosis and treatment.

Science.gov (United States)

Legro, Richard S

2012-12-01

There appears to be an epidemic of both obesity and polycystic ovary syndrome (PCOS) in the world today. However, obesity per se is not a part of the phenotype in many parts of the world. Obesity is likely not a cause of PCOS, as the high prevalence of PCOS among relatively thin populations demonstrates. However, obesity does exacerbate many aspects of the phenotype, especially cardiovascular risk factors such as glucose intolerance and dyslipidemia. It is also associated with a poor response to infertility treatment and likely an increased risk for pregnancy complications in those women who do conceive. Although most treatments of obesity, with the exception of bariatric surgery, achieve modest reductions in weight and improvements in the PCOS phenotype, encouraging weight loss in the obese patient remains one of the front-line therapies. However, further studies are needed to identify the best treatments, and the role of lifestyle therapies in women of normal weight with PCOS is uncertain. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Obesity Severity, Dietary Behaviors, and Lifestyle Risks Vary by Race/Ethnicity and Age in a Northern California Cohort of Children with Obesity.

Science.gov (United States)

Ford, Margaret C; Gordon, Nancy P; Howell, Amanda; Green, Cheryl E; Greenspan, Louise C; Chandra, Malini; Mellor, R Grant; Lo, Joan C

2016-01-01

Identification of modifiable behaviors is important for pediatric weight management and obesity prevention programs. This study examined obesogenic behaviors in children with obesity in a Northern California obesity intervention program using data from a parent/teen-completed intake questionnaire covering dietary and lifestyle behaviors (frequency of breakfast, family meals, unhealthy snacking and beverages, fruit/vegetable intake, sleep, screen time, and exercise). Among 7956 children with BMI ≥ 95th percentile, 45.5% were females and 14.2% were 3-5, 44.2% were 6-11, and 41.6% were 12-17 years old. One-quarter (24.9%) were non-Hispanic white, 11.3% were black, 43.5% were Hispanic, and 12.0% were Asian/Pacific Islander. Severe obesity was prevalent (37.4%), especially among blacks, Hispanics, and older children, and was associated with less frequent breakfast and exercise and excess screen time, and in young children it was associated with consumption of sweetened beverages or juice. Unhealthy dietary behaviors, screen time, limited exercise, and sleep were more prevalent in older children and in selected black, Hispanic, and Asian subgroups, where consumption of sweetened beverages or juice was especially high. Overall, obesity severity and obesogenic behaviors increased with age and varied by gender and race/ethnicity. We identified several key prevalent modifiable behaviors that can be targeted by healthcare professionals to reduce obesity when counseling children with obesity and their parents.

Virtual Reality-Enhanced Cognitive-Behavioral Therapy for Morbid Obesity: A Randomized Controlled Study with 1 Year Follow-Up.

Science.gov (United States)

Manzoni, Gian Mauro; Cesa, Gian Luca; Bacchetta, Monica; Castelnuovo, Gianluca; Conti, Sara; Gaggioli, Andrea; Mantovani, Fabrizia; Molinari, Enrico; Cárdenas-López, Georgina; Riva, Giuseppe

2016-02-01

It is well known that obesity has a multifactorial etiology, including biological, environmental, and psychological causes. For this reason, obesity treatment requires a more integrated approach than the standard behavioral treatment based on dietary and physical activity only. To test the long-term efficacy of an enhanced cognitive-behavioral therapy (CBT) of obesity, including a virtual reality (VR) module aimed at both unlocking the negative memory of the body and to modify its behavioral and emotional correlates, 163 female morbidly obese inpatients (body mass index >40) were randomly assigned to three conditions: a standard behavioral inpatient program (SBP), SBP plus standard CBT, and SBP plus VR-enhanced CBT. Patients' weight, eating behavior, and body dissatisfaction were measured at the start and upon completion of the inpatient program. Weight was assessed also at 1 year follow-up. All measures improved significantly at discharge from the inpatient program, and no significant difference was found among the conditions. However, odds ratios showed that patients in the VR condition had a greater probability of maintaining or improving weight loss at 1 year follow-up than SBP patients had (48% vs. 11%, p = 0.004) and, to a lesser extent, than CBT patients had (48% vs. 29%, p = 0.08). Indeed, only the VR-enhanced CBT was effective in further improving weight loss at 1 year follow-up. On the contrary, participants who received only the inpatient program regained back, on average, most of the weight they had lost. Findings support the hypothesis that a VR module addressing the locked negative memory of the body may enhance the long-term efficacy of standard CBT.

Current Approaches to the Management of Pediatric Overweight and Obesity

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Ridolfi, Danielle R.; Hayes, Jacqueline F.; St Paul, Michelle; Wilfley, Denise E.

2015-01-01

Opinion Statement Family-based behavioral intervention has been demonstrated to be an effective and safe treatment for childhood obesity and should be considered a first-line treatment option. However, access to such intensive evidence-based treatment is limited and, currently, obesity care is dominated by high intensity behavioral treatment implemented in specialty clinics or less effective, low intensity treatments implemented in primary care. However, capitalizing on the established and ongoing relationship between primary care providers and families, primary care providers hold an invaluable role in early identification of overweight and obesity, and subsequent referral to an evidence-based treatment. key aspects of effective treatment include: early intervention, moderate- to high-intensity intervention of sufficient duration, multi-component intervention targeting dietary modification, physical activity and behavioral strategies, family involvement and goals targeting family members, and follow-up contact during maintenance. The purpose of this review is to present the current empirically supported treatment options for pediatric obesity including primary care-based interventions and diagnostic tools, multi-component behavioral intervention with a focus on family-based behavioral intervention, immersion treatment, and pharmacologic and surgical management. PMID:25205083

Executive function training with game elements for obese children: A novel treatment to enhance self-regulatory abilities for weight-control

NARCIS (Netherlands)

Verbeken, S.; Braet, C.; Goossens, L.; van der Oord, S.

2013-01-01

For obese children behavioral treatment results in only small changes in relative weight and frequent relapse. The current study investigated the effects of an Executive Functioning (EF) training with game-elements on weight loss maintenance in obese children, over and above the care as usual in an

[Effect of poor dietary behaviors on the overweight and obesity of school-aged children].

Science.gov (United States)

Xue, Yong; Yun, Chen; Zhao, Ai; Wang, Peiyu; Zhang, Yumei; Mu, Zhishen

2014-09-01

To explore the rate of overweight and obesity, and the association between unhealthy dietary behaviors and overweight and obesity among Chinese school-aged children from 9 areas. By multiple stage stratified cluster sampling, 814 children aged 7 - 12 years old were chosen, provided with questionnaire and anthropometric measurements. According to the definition from Working Group on Obesity in China, children,were divided into different group, univariate logistic regression and multivariate logistic regression were used to analyze the associations between unhealthy dietary behaviors and overweight and obesity. The rates of overweight and obesity of school-aged children were 22. 88% and 9. 90%, respectively. The rates were higher in urban areas, and second-tier cities were similar with first-tier city. Influence factor analysis revealed skipping breakfast behavior was the influence factor (OR =1. 65, Pchildren’s overweight and obesity has been an increasingly serious health problem, which were correlated with genetic factor, environmental factor, and dietary behaviors and so on, poor dietary behavior might be influence factor for overweight and obesity, so it is necessary to provide earlier intervention strategies for parents to promote children’s good dietary habits.

Obesity-related differences between women and men in brain structure and goal-directed behavior

Directory of Open Access Journals (Sweden)

Annette eHorstmann

2011-06-01

Full Text Available Gender differences in the regulation of body weight are well documented. Here, we assessed obesity-related influences of gender on brain structure as well as performance in the Iowa Gambling Task. This task requires evaluation of both immediate rewards and long-term outcomes and thus mirrors the trade-off between immediate reward from eating and the long-term effect of overeating on body weight. In women, but not in men, we show that the preference for salient immediate rewards in the face of negative long-term consequences is higher in obese than in lean subjects. In addition, we report structural differences in the left dorsal striatum (i.e. putamen and right dorsolateral prefrontal cortex for women only. Functionally, both regions are known to play complimentary roles in habitual and goal-directed control of behavior in motivational contexts. For women as well as men, gray matter volume correlates positively with measures of obesity in regions coding the value and saliency of food (i.e. nucleus accumbens, orbitofrontal cortex as well as in the hypothalamus (i.e. the brain's central homeostatic centre. These differences between lean and obese subjects in hedonic and homeostatic control systems may reflect a bias in eating behavior towards energy intake exceeding the actual homeostatic demand. Although we cannot infer from our results the etiology of the observed structural differences, our results resemble neural and behavioral differences well known from other forms of addiction, however, with marked differences between women and men. These findings are important for designing gender-appropriate treatments of obesity and possibly its recognition as a form of addiction.

Barriers and facilitators of obesity management in families of youth with emotional and behavioral disorders.

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Bourassa, Katelynn A; McKibbin, Christine L; Hartung, Cynthia M; Bartholomew, Kay L; Lee, Aaron A; Stevens, Anne E; Buxton, Yvette; Slosser, Andrea E; Andren, Katherine A Kitchen

2017-09-01

While youth with emotional and behavioral disorders experience increased rates of obesity, few obesity interventions exist that are tailored to their needs. Qualitative methods were employed to elucidate obesity management practices in this population. In all, 56 participants (i.e. 21 youths with emotional and behavioral disorders, 20 caregivers of youth with emotional and behavioral disorders, and 15 mental health providers) were recruited from community mental health centers. Participants completed a demographic form and semi-structured interview regarding obesity-related behaviors. Barriers (e.g. psychiatric symptoms) and facilitators (e.g. social support) to obesity management were identified. These results highlight preferred intervention components for this unique population.

Obesity Severity, Dietary Behaviors, and Lifestyle Risks Vary by Race/Ethnicity and Age in a Northern California Cohort of Children with Obesity

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Margaret C. Ford

2016-01-01

Full Text Available Identification of modifiable behaviors is important for pediatric weight management and obesity prevention programs. This study examined obesogenic behaviors in children with obesity in a Northern California obesity intervention program using data from a parent/teen-completed intake questionnaire covering dietary and lifestyle behaviors (frequency of breakfast, family meals, unhealthy snacking and beverages, fruit/vegetable intake, sleep, screen time, and exercise. Among 7956 children with BMI ≥ 95th percentile, 45.5% were females and 14.2% were 3–5, 44.2% were 6–11, and 41.6% were 12–17 years old. One-quarter (24.9% were non-Hispanic white, 11.3% were black, 43.5% were Hispanic, and 12.0% were Asian/Pacific Islander. Severe obesity was prevalent (37.4%, especially among blacks, Hispanics, and older children, and was associated with less frequent breakfast and exercise and excess screen time, and in young children it was associated with consumption of sweetened beverages or juice. Unhealthy dietary behaviors, screen time, limited exercise, and sleep were more prevalent in older children and in selected black, Hispanic, and Asian subgroups, where consumption of sweetened beverages or juice was especially high. Overall, obesity severity and obesogenic behaviors increased with age and varied by gender and race/ethnicity. We identified several key prevalent modifiable behaviors that can be targeted by healthcare professionals to reduce obesity when counseling children with obesity and their parents.

Reducing TV watching during adult obesity treatment: two pilot randomized controlled trials.

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Raynor, Hollie A; Steeves, Elizabeth Anderson; Bassett, David R; Thompson, Dixie L; Gorin, Amy A; Bond, Dale S

2013-12-01

The more time adults spend being sedentary, the greater the risk of obesity. The effect of reducing television (TV) watching, a prominent sedentary behavior, on weight loss has not been tested in an adult standard behavioral obesity intervention, and the mechanisms by which reducing TV watching influences energy balance behaviors are not well understood. Two, 8-week, pilot, randomized controlled trials were conducted examining the effect of a reduced TV watching prescription on energy balance behaviors and weight loss within an adult standard behavioral obesity intervention. In the first study, participants (n=24) were randomized into one of two conditions: (a) reduce energy intake and increase moderate to vigorous physical activity (MVPA) (INCREASE PA); or (b) reduce energy intake and decrease TV watching (DECREASE TV). As findings from the first pilot study did not show an increase in MVPA in the DECREASE TV group, the second study was designed to examine the effect of adding a reduced TV prescription to a standard intervention to optimize outcomes. In Pilot Study 2, participants (n=28) were randomized to INCREASE PA or to INCREASE PA+DECREASE TV. Outcomes included objectively measured TV watching and MVPA, self-reported light physical activity (LPA-Pilot Study 2 only), self-reported dietary intake while watching TV, and weight. Conditions with TV watching prescriptions significantly reduced TV watching. Both studies showed medium to large effect sizes for conditions with TV watching prescriptions to show greater reductions in dietary intake while watching TV. Pilot Study 1 found a trend for an increase in MVPA in INCREASE PA and Pilot Study 2 found significant increases in MVPA in both conditions. Pilot Study 2 found a significant increase in LPA in the INCREASE PA+DECREASE TV. Results indicate adding a TV watching prescription to a standard obesity intervention did not enhance increases in MVPA, but may assist with reducing dietary intake while TV watching and

The Future of Pediatric Obesity.

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Hutchinson, Jeff; Emerick, Jill; Saxena, Harshita

2016-03-01

The National Health and Nutrition Examination Survey from the Centers for Disease Control and Prevention reports a steady increase in obesity over the last 30 years. The greatest increase was seen in 15 to 19 year olds, whose obesity prevalence almost doubled from 10.5% to 19.4%. The solution to pediatric obesity requires a multidisciplinary approach addressing cultural norms, technologic advances, and family engagement. Future treatment strategies to combat the obesity epidemic will have to extend beyond the health care provider's office. Behavior modification remains the key component to pediatric obesity prevention and treatment. Published by Elsevier Inc.

Effects of diet-induced obesity on motivation and pain behavior in an operant assay.

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Rossi, H L; Luu, A K S; Kothari, S D; Kuburas, A; Neubert, J K; Caudle, R M; Recober, A

2013-04-03

Obesity has been associated with multiple chronic pain disorders, including migraine. We hypothesized that diet-induced obesity would be associated with a reduced threshold for thermal nociception in the trigeminal system. In this study, we sought to examine the effect of diet-induced obesity on facial pain behavior. Mice of two different strains were fed high-fat or regular diet (RD) and tested using a well-established operant facial pain assay. We found that the effects of diet on behavior in this assay were strain and reward dependent. Obesity-prone C57BL/6J mice fed a high-fat diet (HFD) display lower number of licks of a caloric, palatable reward (33% sweetened condensed milk or 30% sucrose) than control mice. This occurred at all temperatures, in both sexes, and was evident even before the onset of obesity. This diminished reward-seeking behavior was not observed in obesity-resistant SKH1-E (SK) mice. These findings suggest that diet and strain interact to modulate reward-seeking behavior. Furthermore, we observed a difference between diet groups in operant behavior with caloric, palatable rewards, but not with a non-caloric neutral reward (water). Importantly, we found no effect of diet-induced obesity on acute thermal nociception in the absence of inflammation or injury. This indicates that thermal sensation in the face is not affected by obesity-associated peripheral neuropathy as it occurs when studying pain behaviors in the rodent hindpaw. Future studies using this model may reveal whether obesity facilitates the development of chronic pain after injury or inflammation. Copyright © 2013 IBRO. Published by Elsevier Ltd. All rights reserved.

Pharmacotherapy in the Treatment of Obesity

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Ionică Floriana Elvira

2016-12-01

Full Text Available Background and Aims: In the last three decades, obesity and its related co morbidities has quickly increased. Sometime, obesity was viewed as a serious health issue in developed countries alone, but now is recognized as a worldwide epidemic, and its associated costs are enormous. Obesity is related with various diseases, like hypertension, type 2 diabetes mellitus (T2DM, dyslipidemia, chronic cardiovascular diseases, respiratory conditions, alongside chronic liver diseases, including nonalcoholic fatty liver disease (NAFLD and non-alcoholic steatohepatitis (NASH. This review purpose is to provide data on the current anti-obesity drugs, also available and in the development. Material and Methods: We searched MEDLINE from 2006 to the present to collect information on the anti-obesity pharmacotherapy. Results and Conclusions: In the patients with obesity related comorbidities, there may be an adaptation of the anti-obesity pharmacotherapy to the patients’ needs, in respect to the improvements of the cardiometabolic parameters. Although their efficacy was proven, the anti-obesity pharmacotherapies have presented adverse events that require a careful monitoring during treatment. The main obstacle for approve new drugs seems to be the ratio between the risks and the benefits, because of a long-time background of perilous anti-obesity drugs.

Obesity and Its Relationship to Addictions: Is Overeating a Form of Addictive Behavior?

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Barry, Danielle; Clarke, Megan; Petry, Nancy M.

2009-01-01

Obesity is a major public health problem and notoriously difficult to treat. There are many parallels between obesity/overeating and addictions to alcohol and drugs. This paper discusses similarities between obesity and addictive disorders, including common personality characteristics, disruptive behavior syndromes, and brain mechanisms. Although there are important differences between overeating and other addictive behaviors, an addiction model of overeating may effectively inform prevention...

Attachment Style and Obesity: Disordered Eating Behaviors as a Mediator in a Community Sample of Canadian Youth.

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Maras, Danijela; Obeid, Nicole; Flament, Martine; Buchholz, Annick; Henderson, Katherine A; Gick, Mary; Goldfield, Gary S

Obesity and overweight are associated with many negative health outcomes. Attachment style has been implicated in the development of obesity in youth. The present study examined if disordered eating behaviors mediate the relationship between attachment style and body mass index (BMI) in a large community sample of Canadian youth. A total of 3,043 participants (1,254 males and 1,789 females, Mage = 14.20 years) completed self-report questionnaires including the Relationship Questionnaire and the Dutch Eating Behavior Questionnaire, and BMI was objectively measured. Disordered eating behaviors (restrained, emotional, and external) were examined as possible mediating mechanisms in the relationship between attachment style and BMI z-score, using a multiple mediation model using bootstrapping while controlling for socio-demographic covariates. Insecure attachment was significantly associated with higher BMI, and disordered eating mediated this relationship. Restrained eating was the strongest mediator of this pathway. Results suggest that it may be important to take attachment history and restrained eating into account when designing treatment and prevention strategies for obesity in youth.

No influence of sugar, snacks and fast food intake on the degree of obesity or treatment effect in childhood obesity.

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Trier, C; Fonvig, C E; Bøjsøe, C; Mollerup, P M; Gamborg, M; Pedersen, O; Hansen, T; Holm, J-C

2016-12-01

Increased consumption of sweetened beverages has previously been linked to the degree of childhood obesity. The aim of the present study was to assess whether the intake of sweetened beverages, candy, snacks or fast food at baseline in a multidisciplinary childhood obesity treatment program was associated with the baseline degree of obesity or the treatment effect. This prospective study included 1349 overweight and obese children (body mass index standard deviation scores (BMI SDS) ≥ 1.64) enrolled in treatment at The Children's Obesity Clinic, Copenhagen University Hospital Holbaek. The children were evaluated at baseline and after up to 5.9 years of treatment (median 1.3 years). Both boys and girls decreased their BMI SDS during treatment with a mean decrease in boys of 0.35 (p fast food and BMI SDS at baseline or the change in BMI SDS during treatment. The intake of sweetened beverages, candy, snacks or fast food when entering a childhood obesity treatment program was not associated with the degree of obesity at baseline or the degree of weight loss during treatment. © 2016 World Obesity Federation.

Obesity among Saudi Female University Students: Dietary Habits and Health Behaviors.

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Al Qauhiz, Norah M

2010-01-01

The remarkable economic growth in Saudi Arabia has affected the population life style negatively. The increasing problem of obesity has been reported from different regions in the kingdom. The rate of overweight and obesity reached 65.4% in the eastern region among females aged 18-74 years old. Although there is considerable amount of data on prevalence of obesity, yet, data on dietary habits and food consumption pattern are limited. The present study is a cross- sectional descriptive study aimed at exploring the BMI distribution among university female students. Food consumption pattern and health related behaviors were also assessed. 799 students participated in the study; data were collected using self administered questionnaire. Body weight and height were measured to calculate the BMI. Among the study participants, overweight and obesity reached 47.9%. Marriage, presence of obesity among family members, frequency of drinking aerated beverages increased the risk of obesity significantly. Misperception of body image was reported by 17.4% and 54.2% of obese and overweight students respectively. Analysis of dietary habits and life styles indicated the predominance of unhealthy behaviors. The study results mandate the need for a national strategy to adopt healthy dietary habits and life styles.

Psychological, behavioral and familial factors in obese Cuban children and adolescents.

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Pérez, Lourdes M; García, Keytel; Herrera, Raúl

2013-10-01

The global prevalence of obesity has reached alarming proportions. In Cuba, the rise in numbers of children who are overweight or obese, especially preschoolers and adolescents, is similar to that observed in developed countries. Beyond the physical risk factors, there is evidence that obesity has negative psychological, social, academic and economic effects. Describe the psychological, behavioral and familial factors present in a group of obese children and adolescents in Cuba. This is a qualitative cross-sectional study of 202 obese children and adolescents aged 3-18 years, with an average age of 9.9 years, seen at the Medical-Surgical Research Center (Havana) psychology service from January 2009 through December 2012. Techniques included interviews of patients and parents, projective drawings and the Rotter Incomplete Sentence Blank. Unhealthy eating habits were reported in 96% of obese children and adolescents, and sedentary lifestyles in 88.1%. Emotional state was affected in 80.2%, and in 72.3% there were family attitudes with potential to produce psychological disturbances in children. Psychological, behavioral, and familial factors known to foster development and perpetuation of obesity were observed in the majority of cases. This is a first diagnostic stage that will aid in design and implementation of a psychological intervention program for obese and overweight children and their families.

Prenatal Exposure to Maternal Obesity Alters Anxiety and Stress Coping Behaviors in Aged Mice.

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Balsevich, Georgia; Baumann, Valentin; Uribe, Andres; Chen, Alon; Schmidt, Mathias V

2016-01-01

There is growing evidence that maternal obesity and prenatal exposure to a high-fat diet program fetal development to regulate the physiology and behavior of the offspring in adulthood. Yet the extent to which the maternal dietary environment contributes to adult disease vulnerability remains unclear. In the current study we tested whether prenatal exposure to maternal obesity increases the offspring's vulnerability to stress-related psychiatric disorders. We used a mouse model of maternal diet-induced obesity to investigate whether maternal obesity affects the response to adult chronic stress exposure in young adult (3-month-old) and aged adult (12-month-old) offspring. Long-lasting, delayed impairments to anxiety-like behaviors and stress coping strategies resulted on account of prenatal exposure to maternal obesity. Although maternal obesity did not change the offspring's behavioral response to chronic stress per se, we demonstrate that the behavioral outcomes induced by prenatal exposure to maternal obesity parallel the deleterious effects of adult chronic stress exposure in aged male mice. We found that the glucocorticoid receptor (GR, Nr3c1) is upregulated in various hypothalamic nuclei on account of maternal obesity. In addition, gene expression of a known regulator of the GR, FKBP51, is increased specifically within the paraventricular nucleus. These findings indicate that maternal obesity parallels the deleterious effects of adult chronic stress exposure, and furthermore identifies GR/FKBP51 signaling as a novel candidate pathway regulated by maternal obesity. © 2015 S. Karger AG, Basel.

The relation of the dynamics of anthropometric data in obese women of childbearing age with treatment type

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S.I. Ismailov

2017-03-01

Full Text Available Background. The aim was to study efficiency of pathogenetic therapy and dynamics of anthropometric indexes in obese women of childbearing age having different endocrine patho­logy before and 6 months later after treatment. Materials and methods. Under an etiologic factor the obese patients were divided into three groups: with polycystic syndrome of ovaries (PCOS (n = 30, hypothalamic obesity (n = 21 and with obesity and primary hypothyroidism (n = 20. All patients were examined using biochemical, hormonal methods of research, magnetic resonance tomography of pituitary. Results. The patients of the first and second groups had significant decrease of body mass index (BMI after 6 months of treatment, while patients of the third group did not attain significant decrease of BMI over 6 months of treatment. In addition, 10 patients of the first group became pregnant (19.5 %. The patients of the first and second groups had significant improvement of indexes as compared to average data of waist circumference and waist — hip ratio against the treatment, while the patients of the third group did not find significant changes of those indexes over 6 months of treatment. Conclusions. The treatment with metformine in obese patients significantly improves clinical indices and declines BMI. Optimization of treatment of obesity in women of reproductive age is based on the individual programs, the choice of which is determined by the values of anthropometric indices, hormonal and metabolic status, features of food behavior and personality-emotional sphere, menstrual and reproductive functioning. Realization of curative measures complex considering the worked out algorithm of individual selection of obesity therapy allows reduce effectively and retain the attained body weight, improves somatic and reproductive health for the women of reproductive age.

Position of the Academy of Nutrition and Dietetics: interventions for the prevention and treatment of pediatric overweight and obesity.

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Hoelscher, Deanna M; Kirk, Shelley; Ritchie, Lorrene; Cunningham-Sabo, Leslie

2013-10-01

It is the position of the Academy of Nutrition and Dietetics that prevention and treatment of pediatric overweight and obesity require systems-level approaches that include the skills of registered dietitians, as well as consistent and integrated messages and environmental support across all sectors of society to achieve sustained dietary and physical-activity behavior change. This position paper provides guidance and recommendations for levels of intervention targeting overweight and obesity prevention and treatment from preschool age through adolescence. Methods included a review of the literature from 2009 to April 2012, including the Academy's 2009 evidence analysis school-based reviews. Multicomponent interventions show the greatest impact for primary prevention; thus, early childhood and school-based interventions should integrate behavioral and environmental approaches that focus on dietary intake and physical activity using a systems-level approach targeting the multilevel structure of the socioecological model as well as interactions and relationships between levels. Secondary prevention and tertiary prevention/treatment should emphasize sustained family-based, developmentally appropriate approaches that include nutrition education, dietary counseling, parenting skills, behavioral strategies, and physical-activity promotion. For obese youth with concomitant serious comorbidities, structured dietary approaches and pharmacologic agents should be considered, and weight-loss surgery can be considered for severely obese adolescents. Policy and environmental interventions are recommended as feasible and sustainable ways to support healthful lifestyles for children and families. The Academy supports commitment of resources for interventions, policies, and research that promote healthful eating and physical-activity behaviors to ensure that all youth have the opportunity to achieve and maintain a weight that is optimal for health. Copyright © 2013 Academy of

A systematic review of environmental correlates of obesity-related dietary behaviors in youth

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K. van der Horst (Klazine); A. Oenema (Anke); A. Ferreira (Isabel); G.C.W. Wendel-Vos (Wanda); K. Giskes (Katrina); F.J. van Lenthe (Frank); J. Brug (Hans)

2007-01-01

textabstractThere is increasing interest in the role the environment plays in shaping the dietary behavior of youth, particularly in the context of obesity prevention. An overview of environmental factors associated with obesity-related dietary behaviors among youth is needed to inform the

Association between obesity and behavioral/emotional disorders in primary school-aged children: a cross-sectional study

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Clarissa J. Aditya

2017-05-01

Full Text Available Background: Obesity in children can increase the risks of various chronic diseases. Mental disorders associated with obesity in children include: depression, anxiety, low self-esteem, hyperkinetic disorders, and increased aggressiveness. This relationship is estimated due to vulnerable genetic expressions in obese individuals. This study aimed to find the association between obesity and behavioral/emotional disorder in primary school-aged children.Methods: This cross-sectional study was conducted on 384 children at Menteng 1 Elementary School, Jakarta from July to September 2015. The study was conducted to find the association between the children’s nutritional status and behavioral/emotional disorders screened by the 17-item Pediatric Symptom Checklist (PSC-17. Chi square analysis was applied in this study.Results: The prevalence of obese children at Menteng 1 Elementary School, Jakarta reached 23.2%, which is higher than Jakarta’s prevalence (14%. 8.7% of the subjects were obese and 13.6% of them were having behavioral/emotional disorders. 20.0% of the obese subjects had behavioral/emotional disorders. The prevalence was higher for internalizing sub-scale, which was consistent with other studies. Association between obesity and behavioral/emotional disorders was significant for externalizing sub-scale (p=0.036. Externalizing problems caused by obesity might be affected by the social stigma of their peer group. However, obesity in children did not have a statistically significant relationship in internalization sub-scale, attention, and PSC-17 total score (p>0.05. No significant associations towards those sub-scales were thought to be influenced by other factors, playing a role in causing mental disorders in children.Conclusion: In general, obesity was not associated with behavioral and emotional disorders in children, but obesity was related to externalizing behavioral/emotional disorders.

Impact of obesity treatment on gastroesophageal reflux disease.

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Khan, Abraham; Kim, Aram; Sanossian, Cassandra; Francois, Fritz

2016-01-28

Gastroesophageal reflux disease (GERD) is a frequently encountered disorder. Obesity is an important risk factor for GERD, and there are several pathophysiologic mechanisms linking the two conditions. For obese patients with GERD, much of the treatment effort is focused on weight loss and its consistent benefit to symptoms, while there is a relative lack of evidence regarding outcomes after novel or even standard medical therapy is offered to this population. Physicians are hesitant to recommend operative anti-reflux therapy to obese patients due to the potentially higher risks and decreased efficacy, and these patients instead are often considered for bariatric surgery. Bariatric surgical approaches are broadening, and each technique has emerging evidence regarding its effect on both the risk and outcome of GERD. Furthermore, combined anti-reflux and bariatric options are now being offered to obese patients with GERD. However, currently Roux-en-Y gastric bypass remains the most effective surgical treatment option in this population, due to its consistent benefits in both weight loss and GERD itself. This article aims to review the impact of both conservative and aggressive approaches of obesity treatment on GERD.

Group behavioral activation for patients with severe obesity and binge eating disorder: a randomized controlled trial.

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Alfonsson, Sven; Parling, Thomas; Ghaderi, Ata

2015-03-01

The aim of the present study was to assess whether behavioral activation (BA) is an efficacious treatment for decreasing eating disorder symptoms in patients with obesity and binge eating disorder (BED). Ninety-six patients with severe obesity and BED were randomized to either 10 sessions of group BA or wait-list control. The study was conducted at an obesity clinic in a regular hospital setting. The treatment improved some aspects of disordered eating and had a positive effect on depressive symptoms but there was no significant difference between the groups regarding binge eating and most other symptoms. Improved mood but lack of effect on binge eating suggests that dysfunctional eating (including BED) is maintained by other mechanisms than low activation and negative mood. However, future studies need to investigate whether effects of BA on binge eating might emerge later than at post-assessment, as in interpersonal psychotherapy for bulimia nervosa. © The Author(s) 2014.

Behavior change is not one size fits all: psychosocial phenotypes of childhood obesity prevention intervention participants.

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Burgermaster, Marissa; Contento, Isobel; Koch, Pamela; Mamykina, Lena

2018-01-17

Variability in individuals' responses to interventions may contribute to small average treatment effects of childhood obesity prevention interventions. But, neither the causes of this individual variability nor the mechanism by which it influences behavior are clear. We used qualitative methods to characterize variability in students' responses to participating in a childhood obesity prevention intervention and psychosocial characteristics related to the behavior change process. We interviewed 18 students participating in a school-based curriculum and policy behavior change intervention. Descriptive coding, summary, and case-ordered descriptive meta-matrices were used to group participants by their psychosocial responses to the intervention and associated behavior changes. Four psychosocial phenotypes of responses emerged: (a) Activated-successful behavior-changers with strong internal supports; (b) Inspired-motivated, but not fully successful behavior-changers with some internal supports, whose taste preferences and food environment overwhelmed their motivation; (c) Reinforced-already practiced target behaviors, were motivated, and had strong family support; and (d) Indifferent-uninterested in behavior change and only did target behaviors if family insisted. Our findings contribute to the field of behavioral medicine by suggesting the presence of specific subgroups of participants who respond differently to behavior change interventions and salient psychosocial characteristics that differentiate among these phenotypes. Future research should examine the utility of prospectively identifying psychosocial phenotypes for improving the tailoring of nutrition behavior change interventions. © Society of Behavioral Medicine 2018.

Surgical treatment of pathological obesity

International Nuclear Information System (INIS)

Portie Felix, Antonio; Navarro Sanchez, Gustavo; Hernandez Solar, Abel; Grass Baldoquin, Jorge Alberto; Domloge Fernandez, Joana

2011-01-01

The obesity is the chronic non-communicable disease with a higher rate of growth in past 20 years. It is a risk factor for type 2 diabetes mellitus, high blood pressure, cardiovascular and respiratory affections, infertility, sexual and functional impotence, metabolic syndrome, load joint disorders and some types of cancer (breast, colon, prostate). The metabolic bariatric surgery is the surgical treatment more effective for the morbid obesity at long -and medium- term and not the pharmacologic treatment and the isolated diets. The aim of present historical review of the international literature on the evolution of surgical techniques of the bariatric surgery (malabsorption techniques, gastric restrictive techniques and mixed techniques), is to make available to those interested in this subject, a valuable therapeutic tool to be rationally used. (author)

Obesity prevention and obesogenic behavior interventions in child care: A systematic review.

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Sisson, Susan B; Krampe, Megan; Anundson, Katherine; Castle, Sherri

2016-06-01

Review peer-reviewed interventions designed to reduce obesity and improve obesogenic behaviors, including physical activity, diet, and screen time, at child care centers. Interventions components and outcomes, study design, duration, use of behavioral theory, and level of social ecological influence are detailed. Article searches were conducted from March 2014, October 2014, March 2015, January 2016 across three databases. Eligible interventions were conducted in child care settings, included 3-to-5-year-old children, included an outcome measure of obesity or obesogenic behavior, and published in English. Study design quality was assessed using Stetler's Level of Quantitative Evidence. All unique records were screened (n=4589): 237 articles were assessed for eligibility. Of these, 97 articles describing 71 interventions met inclusion criteria. Forty-four articles included multi-level interventions. Twenty-nine interventions included an outcome measure of obesity. Forty-one interventions included physical activity. Forty-five included diet. Eight included screen time. Fifty-five percent of interventions were Level II (randomized controlled trials), while 37% were Level III (quasi-experimental or pre-post only study design), and 8% were Level IV (non-experimental or natural experiments). Most interventions had the intended effect on the target: obesity 48% (n=14), physical activity 73% (n=30), diet 87% (n=39), and screen time 63% (n=5). Summarizing intervention strategies and assessing their effectiveness contributes to the existing literature and may provide direction for practitioners and researchers working with young children in child care. Most interventions produced the targeted changes in obesity and obesity-associated behaviors, supporting current and future efforts to collaborate with early-care centers and professionals for obesity prevention. Copyright © 2016 Elsevier Inc. All rights reserved.

Obesity as a chronic disease: modern medical and lifestyle management.

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Rippe, J M; Crossley, S; Ringer, R

1998-10-01

The United States is in the midst of an epidemic of obesity involving more than one third of the adult population. The prevalence of obesity increased by 40% between 1980 and 1990. Obesity is a chronic disease with a multifactorial etiology including genetics, environment, metabolism, lifestyle, and behavioral components. A chronic disease treatment model involving both lifestyle interventions and, when appropriate, additional medical therapies delivered by an interdisciplinary team including physicians, dietitians, exercise specialists, and behavior therapists offers the best chance for effective obesity treatment. Lifestyle factors such as proper nutrition, regular physical activity, and changes in eating behaviors should be coordinated by this team. This review addresses the modern epidemic of obesity, the strong association between obesity and comorbidities such as coronary heart disease, type 2 diabetes, hypertension, and dyslipidemia. In addition to obesity, the health risks of abdominal obesity and adult weight gain are discussed. The evidence that supports health benefits from modest weight loss (between 5% and 10% of body weight) is evaluated and the 5 key principles of effective obesity therapy are put forward. Obesity is a therapeutic challenge best met by teams of health care professionals, including dietitians and physicians, working together to deliver optimal treatment.

Does cognitive behavioral therapy strengthen the effect of bariatric surgery for obesity? Design and methods of a randomized and controlled study.

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Paul, Linda; van Rongen, Sofie; van Hoeken, Daphne; Deen, Mathijs; Klaassen, René; Biter, L Ulas; Hoek, Hans W; van der Heiden, Colin

2015-05-01

(Extreme) obesity is a chronic harmful condition with high risk of medical comorbidities and negative social and emotional consequences. Bariatric surgery is an effective intervention for obesity, but approximately 20 to 30% of the patients experience adverse outcomes after surgery and there is a need for augmentation of current treatment strategies. This study examines the added value of pre-operative cognitive behavioral therapy (CBT) focused on modification of thoughts and behaviors in terms of eating behavior and physical exercise as well as preparation for surgery and postoperative life style. We hypothesize that pre-operative CBT will result in better weight loss maintenance, reduction of maladaptive eating behavior and better adherence to postoperative lifestyle on the long term as compared to bariatric surgery alone. One hundred and twenty eight patients that are on a waiting list for bariatric surgery are randomly assigned to the control or treatment condition. Patients in the treatment condition receive 10 sessions of CBT before surgery aimed at modifying dysfunctional eating habits and behaviors and developing more rational weight and body-related beliefs in order to enable long term maintenance of a healthier lifestyle after surgery. Weight loss, eating behavior, eating disorders, depression, quality of life and psychological distress are assessed before and after treatment, as well as 1, 3, and 5 year following surgery. Copyright © 2015 Elsevier Inc. All rights reserved.

Profiles of sociodemographic, behavioral, clinical and psychosocial characteristics among primary care patients with comorbid obesity and depression

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Jun Ma

2017-12-01

Full Text Available The objective of this study is to characterize profiles of obese depressed participants using baseline data collected from October 2014 through December 2016 for an ongoing randomized controlled trial (n=409 in Bay Area, California, USA. Four comorbidity severity categories were defined by interaction of the binary levels of body mass index (BMI and depression Symptom Checklist 20 (SCL20 scores. Sociodemographic, behavioral, clinical and psychosocial characteristics were measured. Mean (SD age was 51 (12.1 years, BMI 36.7 (6.4 kg/m2, and SCL20 1.5 (0.5. Participants in the 4 comorbidity severity categories had similar sociodemographic characteristics, but differed significantly in the other characteristics. Two statistically significant canonical dimensions were identified. Participants with BMI≥35 and SCL20≥1.5 differed significantly from those with BMI<35 and SCL20<1.5 on dimension 1, which primarily featured high physical health (e.g., central obesity, high blood pressure and impaired sleep and mental health comorbidities (e.g., post-traumatic stress and anxiety, poor health-related quality of life (in general and problems specifically with obesity, anxiety, depression, and usual daily activities, and an avoidance problem-solving style. Participants with BMI<35 and SCL20≥1.5 differed significantly from those with BMI≥35 and SCL20<1.5 on dimension 2, which primarily included fewer Hispanics, less central obesity, and more leisure-time physical activity, but greater anxiety and post-traumatic stress and poorer obesity- or mental health-related quality of life. In conclusion, patients with comorbid obesity and depression of varying severity have different profiles of behavioral, clinical and psychosocial characteristics. This insight may inform analysis of treatment heterogeneity and development of targeted intervention strategies.Trial registration: ClinicalTrials.gov #NCT02246413 Keywords: Obesity, Depression, Behavior, Clinical

From genetics and epigenetics to the future of precision treatment for obesity.

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Sun, Xulong; Li, Pengzhou; Yang, Xiangwu; Li, Weizheng; Qiu, Xianjie; Zhu, Shaihong

2017-11-01

Obesity has become a major global health problem, epitomized by excess accumulation of body fat resulting from an imbalance between energy intake and expenditure. The treatments for obesity range from modified nutrition and additional physical activity, to drugs or surgery. But the curative effect of each method seems to vary between individuals. With progress in the genetics and epigenetics of obesity, personalization of the clinical management of obesity may be at our doorstep. This review presents an overview of our current understanding of the genetics and epigenetics of obesity and how these findings influence responses to treatments. As bariatric surgery is the most effective long-term treatment for morbid obesity, we pay special attention to the association between genetic factors and clinical outcomes of bariatric surgery. Finally, we discuss the prospects for precision obesity treatment.

No influence of sugar, snacks and fast food intake on the degree of obesity or treatment effect in childhood obesity

DEFF Research Database (Denmark)

Trier, C; Fonvig, Cilius Esmann; Bøjsøe, C

2016-01-01

. There were no associations between the baseline intake of sweetened beverages, candy, snacks, and/or fast food and BMI SDS at baseline or the change in BMI SDS during treatment. CONCLUSIONS: The intake of sweetened beverages, candy, snacks or fast food when entering a childhood obesity treatment program......BACKGROUND: Increased consumption of sweetened beverages has previously been linked to the degree of childhood obesity. OBJECTIVE: The aim of the present study was to assess whether the intake of sweetened beverages, candy, snacks or fast food at baseline in a multidisciplinary childhood obesity...... treatment program was associated with the baseline degree of obesity or the treatment effect. METHODS: This prospective study included 1349 overweight and obese children (body mass index standard deviation scores (BMI SDS) ≥ 1.64) enrolled in treatment at The Children's Obesity Clinic, Copenhagen University...

In Search of New Therapeutic Targets in Obesity Treatment: Sirtuins

Directory of Open Access Journals (Sweden)

Alina Kurylowicz

2016-04-01

Full Text Available Most of the available non-invasive medical therapies for obesity are non-efficient in a long-term evaluation; therefore there is a constant need for new methods of treatment. Research on calorie restriction has led to the discovery of sirtuins (silent information regulators, SIRTs, enzymes regulating different cellular pathways that may constitute potential targets in the treatment of obesity. This review paper presents the role of SIRTs in the regulation of glucose and lipid metabolism as well as in the differentiation of adipocytes. How disturbances of SIRTs’ expression and activity may lead to the development of obesity and related complications is discussed. A special emphasis is placed on polymorphisms in genes encoding SIRTs and their possible association with susceptibility to obesity and metabolic complications, as well as on data regarding altered expression of SIRTs in human obesity. Finally, the therapeutic potential of SIRTs-targeted strategies in the treatment of obesity and related disorders is discussed.

Childhood obesity for pediatric gastroenterologists.

Science.gov (United States)

Huang, Jeannie S; Barlow, Sarah E; Quiros-Tejeira, Ruben E; Scheimann, Ann; Skelton, Joseph; Suskind, David; Tsai, Patrika; Uko, Victor; Warolin, Joshua P; Xanthakos, Stavra A

2013-01-01

Obesity in childhood is one of the major health issues in pediatric health care today. As expected, the prevalence of obesity-related comorbidities has risen in parallel with that of obesity. Consultation regarding these concomitant diseases and subsequent management by subspecialists, including pediatric gastroenterologists, is now common and has resulted in obesity being recognized as a chronic disease requiring coordination of care. Although medications and even surgery may provide effective, though often temporary, treatments for obesity and its comorbidities, behavioral interventions addressing healthy dietary and physical activity habits remain a mainstay in the obesity treatment paradigm. Therefore, the issue of weight management must be addressed by both general practitioner and subspecialist alike. In this report, we review select aspects of pediatric obesity and obesity-related management issues because it relates in particular to the field of pediatric gastroenterology and hepatology.

A Systematic Review of Environmental Correlates of Obesity-Related Dietary Behaviors in Youth

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van der Horst, Klazine; Oenema, A.; Ferreira, I.; Wendel-Vos, W.; Giskes, K.; van Lenthe, F.; Brug, J.

2007-01-01

There is increasing interest in the role the environment plays in shaping the dietary behavior of youth, particularly in the context of obesity prevention. An overview of environmental factors associated with obesity-related dietary behaviors among youth is needed to inform the development of interventions. A systematic review of observational…

Overweight and Obese Status in Children with Autism Spectrum Disorder and Disruptive Behavior

Science.gov (United States)

Criado, Kristen K.; Sharp, William G.; McCracken, Courtney E.; De Vinck-Baroody, Oana; Dong, Liansai; Aman, Michael G.; McDougle, Christopher J.; McCracken, James T.; Eugene Arnold, L.; Weitzman, Carol; Leventhal, John M.; Vitiello, Benedetto; Scahill, Lawrence

2018-01-01

Overweight and obesity are common in pediatric populations. Children with autism spectrum disorder and disruptive behavior may be at higher risk. This study examined whether children with autism spectrum disorder and disruptive behavior are more likely to be overweight or obese than matched controls. Baseline data from medication-free children…

Physical activity and sedentary behavior in metabolically healthy obese young women

Science.gov (United States)

Studies of physical activity (PA) and sedentary behavior (SB) in metabolically healthy obese (MHO) have been limited to postmenopausal white women. We sought to determine whether PA and SB differ between MHO and metabolically abnormal obese (MAO), in young black and white women....

Application of social cognitive theory in predicting childhood obesity prevention behaviors in overweight and obese Iranian adolescents.

Science.gov (United States)

Bagherniya, Mohammad; Sharma, Manoj; Mostafavi, Firoozeh; Keshavarz, Seyed Ali

2015-01-01

The aim of this cross-sectional study was to use social cognitive theory to predict overweight and obesity behaviors in adolescent girls in Iran. Valid and reliable questionnaires about nutritional and physical activity regarding social cognitive theory constructs (self-efficacy, social support, outcome expectations, and outcome expectancies), dietary habits, and physical activity were filled by 172 overweight and obese girl adolescents. The mean age and body mass index were 13.4 ± 0.6 years and 28.2 ± 3.6 kg/m(2), respectively. Body mass index was significantly related to hours of television viewing (p = .003) and grams of junk food (p = .001). None of the social cognitive theory constructs were found to be significant predictors for servings of fruits and vegetables, grams of junk foods, minutes of physical activity, and hours of sedentary behaviors. In future, more culturally appropriate models need to be developed in Iran that can explain and predict prevention behaviors of obesity in Iranian adolescents. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

A pilot study of the effects of behavioral weight loss treatment on fibromyalgia symptoms.

Science.gov (United States)

Shapiro, Jennifer R; Anderson, Drew A; Danoff-Burg, Sharon

2005-11-01

Previous studies have found a relation between weight loss and pain severity in various chronic pain populations. However, there has been little research examining the relation between body mass index (BMI) and fibromyalgia syndrome (FMS). The purpose of this pilot study was to investigate the relationship between BMI and FMS symptoms and to determine if FMS symptoms would decrease following weight loss. Overweight and obese women participated in a 20-week behavioral weight loss treatment. Participants, on average, lost 9.2 lbs (4.4% of their initial weight), and there were significant pre-postimprovements on several outcome measures. Although weight was not significantly related to pain at baseline, weight loss significantly predicted a reduction in FMS, pain interference, body satisfaction, and quality of life (QOL). Findings suggest that behavioral weight loss treatment could be included in the treatment for overweight/obese women with FMS.

[Association between feeding behavior, and genetic polymorphism of leptin and its receptor in obese Chilean children].

Science.gov (United States)

Valladares, Macarena; Obregón, Ana María; Weisstaub, Gerardo; Burrows, Raquel; Patiño, Ana; Ho-Urriola, Judith; Santos, José Luis

2014-09-12

Leptin (LEP) is mainly produced in adipose tissue and acts in the hypothalamus to regulate energy intake. Mutations in the LEP gene or its receptor (LEPR) that produce monogenic obesity are infrequent. However, LEP and LEPR polymorphisms have been associated with obesity multifactorial, due to the association found with body weight and eating behavior. Measure the association between LEP and LEPR polymorphisms with childhood obesity and eating behavior. 221 Chilean obese children (BMI above the 95th percentile) were recruited. Parents of 134 of these children were also recruited to determine the association between LEP and LEPR polymorphisms with obesity in a case study-parent trio. Eating behavior was measured through the questionnaire of three factors progenitors' version (TFEQ-P19) and eating behavior in children (CEBQ). No significant difference between the studied polymorphisms and childhood obesity, after correction for multiple comparisons, was observed. The dimensions; "Slow eating", "emotional eating", "enjoyment of food" and "uncontrolling eating" were significant associated with certain polymorphisms of LEP and LEPR. There would be an association between polymorphisms of the LEP and LEPR genes with eating behavior in Chilean obese children. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Mindfulness-Based Interventions for Obesity-Related Eating Behaviors: A Literature Review

Science.gov (United States)

O’Reilly, Gillian A.; Cook, Lauren; Spruijt-Metz, Donna; Black, David S.

2014-01-01

Mindfulness-based interventions (MBIs) targeting eating behaviors have gained popularity in recent years. A literature review was conducted to determine the effectiveness of MBIs for treating obesity-related eating behaviors, such as binge eating, emotional eating, and external eating. A search protocol was conducted using the online databases Google Scholar, PubMed, PsycINFO, and Ovid Healthstar. Articles were required to meet the following criteria to be included in this review: (1) describe a MBI or the use of mindfulness exercises as part of an intervention, (2) include at least one obesity-related eating behavior as an outcome, (3) include quantitative outcomes, and (4) be published in English in a peer-reviewed journal. A total of N=21 articles were included in this review. Interventions used a variety of approaches to implement mindfulness training, including combined mindfulness and cognitive behavioral therapies, mindfulness-based stress reduction, acceptance-based therapies, mindful eating programs, and combinations of mindfulness exercises. Targeted eating behavior outcomes included binge eating, emotional eating, external eating, and dietary intake. Eighteen (86%) of the reviewed studies reported improvements in the targeted eating behaviors. Overall, the results of this first review on the topic support the efficacy of mindfulness-based interventions for changing obesity-related eating behaviors, specifically binge eating, emotional eating, and external eating. PMID:24636206

The prevalence of obesity and influence of early life and behavioral factors on obesity in Chinese children in Guangzhou.

Science.gov (United States)

Zhang, Ting; Cai, Li; Ma, Lu; Jing, Jin; Chen, Yajun; Ma, Jun

2016-09-09

Childhood obesity has become a public health concern in many countries. In Southern China, the prevalence of childhood obesity increased from 6.2 to 7.5 % between 2007 and 2011. This study aimed to report the current prevalence of overweight and obesity, analyzed the early life and behavioral determinants of obesity, and investigated the weight-loss practices among Chinese children in Guangzhou. Three thousand seven hundred sixty-six primary school students aged 7-12 years were recruited in Guangzhou, China in 2013. Questionnaires were used to assess (1) early life factors: birth weight, delivery mode, gestational age and feeding patterns; (2) behavioral factors: dietary intake, eating speed, sedentary time, physical activities and sleep duration; and (3) weight-loss practices: improving diet, increasing exercise, taking weight-loss drugs and undergoing a diet. The criteria of Working Group of Obesity in China were applied to classify overweight and obesity based on measured weight and height. Multivariable logistic regression analyses were performed to examine the determinants of overweight/obesity and adoption of weight-loss practices. The prevalence of childhood overweight and obesity were 11.2 and 10.0 %, respectively. High birth weight (≥4.0 kg versus 2.5 ~ 4.0 kg, odd ratio [OR]: 2.34; 95 % confidence interval [CI]: 1.53-3.58), sugar-sweetened beverages (SSBs) intake (OR: 1.39; 95 % CI: 1.05-1.85), vegetable intake (OR: 1.12; 95 % CI: 1.01-1.24), and doing homework (OR: 1.24; 95 % CI: 1.08-1.43) were positively associated with obesity. Eating speed faster than peers was positively associated with obesity and yielded the highest OR (versus "as fast as peers", OR: 3.18; 95 % CI: 2.28-4.44). Approximately 57, 81 and 87 % of normal-weight, overweight and obese children, respectively, reported weight-loss practices. Self-perception of weight status presented as the strongest determinant for weight-loss practices. The prevalence of overweight and

A comparison of behavioral and psychological characteristics of patients opting for surgical and conservative treatment for morbid obesity.

Science.gov (United States)

Kvalem, Ingela Lundin; Bergh, Irmelin; von Soest, Tilmann; Rosenvinge, Jan H; Johnsen, Tina Avantis; Martinsen, Egil W; Mala, Tom; Kristinsson, Jon A

2015-01-01

Little is known about the psychological prerequisites for weight loss maintenance after bariatric surgery. A first step in investigating whether existing knowledge of conservative weight loss treatment is applicable for lifestyle interventions postoperatively is to compare specific psychological characteristics at baseline. The aim of this study was to compare patients scheduled for bariatric surgery with patients receiving conservative treatment for morbid obesity on measures of behavioral and psychosocial characteristics considered predictors of their adoption of and adherence to long-term lifestyle recommendations. Baseline clinical and questionnaire data from the prospective "Oslo Bariatric Surgery Study" were used to examine potential differences between bariatric surgery patients (n = 301) and patients receiving conservative weight loss treatment (n = 261). The surgical group was characterized by their younger age (43.8 vs. 46.2 years, p changing their eating behaviors (OR = 1.80, 95 % CI 1.06, 1.93). The surgical patients were also less ready to change physical activity levels (OR = 0.59, 95 % CI 0.48, 0.73), had tried more types of unhealthy weight loss methods in the past (OR = 1.16, 95 % CI 1.01, 1.33), drank soda more frequently (OR = 1.24, 95 % CI 1.02, 1.50), had fewer binge eating episodes (OR = 0.38, 95 % CI 0.20, 0.71), and had more depressive symptoms (OR = 1.19, 95 % CI 1.09, 1.29). Patients opting for bariatric surgery had more positive expectations of the treatment outcomes and stronger beliefs in their ability to achieve these outcomes. Those starting conservative treatment had stronger beliefs in readiness to change physical activity levels. Future studies should explore the effect of interventions for bariatric surgery patients, promoting postoperative physical activity and stress realistic outcome expectations. The potential effects of incorporating this knowledge in intervention strategies remain to be

Practical approaches to the treatment of severe pediatric obesity.

Science.gov (United States)

Lenders, C M; Gorman, K; Lim-Miller, A; Puklin, S; Pratt, J

2011-12-01

Pediatric obesity is a major public health threat. Obese children and adolescents are at increased risk for many medical and surgical conditions. These conditions may affect their quality of life and life expectancy. The rapidly progressive nature of type 2 diabetes mellitus within the first 5 years of obesity diagnosis is particularly concerning. Because health risk increases with degree of obesity, adolescents who may be eligible for more aggressive obesity treatment should be identified and counseled. Published by Elsevier Inc.

Involvement of Fathers in Pediatric Obesity Treatment and Prevention Trials: A Systematic Review.

Science.gov (United States)

Morgan, Philip J; Young, Myles D; Lloyd, Adam B; Wang, Monica L; Eather, Narelle; Miller, Andrew; Murtagh, Elaine M; Barnes, Alyce T; Pagoto, Sherry L

2017-02-01

Despite their important influence on child health, it is assumed that fathers are less likely than mothers to participate in pediatric obesity treatment and prevention research. This review investigated the involvement of fathers in obesity treatment and prevention programs targeting children and adolescents (0-18 years). A systematic review of English, peer-reviewed articles across 7 databases. Retrieved records included at least 1 search term from 2 groups: "participants" (eg, child*, parent*) and "outcomes": (eg, obes*, diet*). Randomized controlled trials (RCTs) assessing behavioral interventions to prevent or treat obesity in pediatric samples were eligible. Parents must have "actively participated" in the study. Two authors independently extracted data using a predefined template. The search retrieved 213 eligible RCTs. Of the RCTs that limited participation to 1 parent only (n = 80), fathers represented only 6% of parents. In RCTs in which participation was open to both parents (n = 133), 92% did not report objective data on father involvement. No study characteristics moderated the level of father involvement, with fathers underrepresented across all study types. Only 4 studies (2%) suggested that a lack of fathers was a possible limitation. Two studies (1%) reported explicit attempts to increase father involvement. The review was limited to RCTs published in English peer-reviewed journals over a 10-year period. Existing pediatric obesity treatment or prevention programs with parent involvement have not engaged fathers. Innovative strategies are needed to make participation more accessible and engaging for fathers. Copyright © 2017 by the American Academy of Pediatrics.

Binge eating and weight loss behaviors of overweight and obese college students.

Science.gov (United States)

Kelly-Weeder, Susan; Phillips, Kathryn; Leonard, Kelly; Veroneau, Margaret

2014-08-01

To investigate binge eating (BE) and weight-related behaviors in overweight and obese college students. This was a secondary analysis of data from 487 overweight and obese college-age students from a private university in the northeastern United States. BE was reported by 34.9% of students. Only 6.2% of participants reported the use of compensatory behaviors (i.e., self-induced vomiting, laxative, or diuretic use) to prevent weight gain. BE was associated with smoking and exercising to lose weight. Gender differences emerged from the data as women were more likely to report being obese, the use of compensatory behaviors, and to perceive themselves as moderately or extremely overweight. BE is a significant problem on college campuses and is associated with the development of obesity and eating disorders. Nurse practitioners (NPs) are in an excellent position to effect change in this population through their frequent contact with young adults in community and school-based venues. NPs are well-prepared to identify at-risk college students and provide them with individualized care, education, and support. ©2013 American Association of Nurse Practitioners.

Unimolecular Polypharmacy for Treatment of Diabetes and Obesity

DEFF Research Database (Denmark)

Tschöp, Matthias H; Finan, Brian; Clemmensen, Christoffer

2016-01-01

Many complex diseases have historically proven to be defiant to the best mono-therapeutic approaches. Several examples of combination therapies have largely overcome such challenges, notably for the treatment of severe hypertension and tuberculosis. Obesity and its consequences, such as type 2...... diabetes, have proven to be equally resistant to therapeutic approaches based on single medicines. Proper management of type 2 diabetes often requires adjunctive medications, and the recent registration of a few compound mixtures has set the precedent for combinatorial treatment of obesity. On the other...... to reverse obesity and type 2 diabetes. Here, we summarize the discovery, pre-clinical validation, and first clinical test of such peptide hormone poly-agonist drug candidates....

Diet-induced obesity exacerbates metabolic and behavioral effects of polycystic ovary syndrome in a rodent model.

Science.gov (United States)

Ressler, Ilana B; Grayson, Bernadette E; Ulrich-Lai, Yvonne M; Seeley, Randy J

2015-06-15

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting women of reproductive age. Although a comorbidity of PCOS is obesity, many are lean. We hypothesized that increased saturated fat consumption and obesity would exacerbate metabolic and stress indices in a rodent model of PCOS. Female rats were implanted with the nonaromatizable androgen dihydrotestosterone (DHT) or placebo pellets prior to puberty. Half of each group was maintained ad libitum on either a high-fat diet (HFD; 40% butter fat calories) or nutrient-matched low-fat diet (LFD). Irrespective of diet, DHT-treated animals gained more body weight, had irregular cycles, and were glucose intolerant compared with controls on both diets. HFD/DHT animals had the highest levels of fat mass and insulin resistance. DHT animals demonstrated increased anxiety-related behavior in the elevated plus maze by decreased distance traveled and time in the open arms. HFD consumption increased immobility during the forced-swim test. DHT treatment suppressed diurnal corticosterone measurements in both diet groups. In parallel, DHT treatment significantly dampened stress responsivity to a mild stressor. Brains of DHT animals showed attenuated c-Fos activation in the ventromedial hypothalamus and arcuate nucleus; irrespective of DHT-treatment, however, all HFD animals had elevated hypothalamic paraventricular nucleus c-Fos activation. Whereas hyperandrogenism drives overall body weight gain, glucose intolerance, anxiety behaviors, and stress responsivity, HFD consumption exacerbates the effect of androgens on adiposity, insulin resistance, and depressive behaviors. Copyright © 2015 the American Physiological Society.

Economic Recession and Obesity-Related Internet Search Behavior in Taiwan: Analysis of Google Trends Data.

Science.gov (United States)

Wang, Ho-Wei; Chen, Duan-Rung

2018-04-06

Obesity is highly correlated with the development of chronic diseases and has become a critical public health issue that must be countered by aggressive action. This study determined whether data from Google Trends could provide insight into trends in obesity-related search behaviors in Taiwan. Using Google Trends, we examined how changes in economic conditions-using business cycle indicators as a proxy-were associated with people's internet search behaviors related to obesity awareness, health behaviors, and fast food restaurants. Monthly business cycle indicators were obtained from the Taiwan National Development Council. Weekly Taiwan Stock Exchange (TWSE) weighted index data were accessed and downloaded from Yahoo Finance. The weekly relative search volumes (RSV) of obesity-related terms were downloaded from Google Trends. RSVs of obesity-related terms and the TWSE from January 2007 to December 2011 (60 months) were analyzed using correlation analysis. During an economic recession, the RSV of obesity awareness and health behaviors declined (r=.441, P<.001; r=.593, P<.001, respectively); however, the RSV for fast food restaurants increased (r=-.437, P<.001). Findings indicated that when the economy was faltering, people tended to be less likely to search for information related to health behaviors and obesity awareness; moreover, they were more likely to search for fast food restaurants. Macroeconomic conditions can have an impact on people's health-related internet searches. ©Ho-Wei Wang, Duan-Rung Chen. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 06.04.2018.

Present and Future: Pharmacologic Treatment of Obesity

Directory of Open Access Journals (Sweden)

Mariela Glandt

2011-01-01

Full Text Available Obesity now presents one of the biggest health problems of our times. Diet and exercise are best for both prevention and treatment; unfortunately, both require much discipline and are difficult to maintain. Medications offer a possible adjunct, but their effect is modest, they are limited by side effects, and the weight loss lasts only as long as the drug is being taken, since as soon as treatment is stopped, the weight is regained. Sibutramine, a sympathomimetic medication which was available for long-term treatment, is the most recent of the drugs to be withdrawn from the market due to side effects; in this case it was an increased risk of cardiovascular events. This paper reviews those medications which are available for treatment of obesity, including many of those recently taken off the market. It also discusses some of the newer treatments that are currently being investigated.

Hypothalamic obesity after treatment for craniopharyngioma: the importance of the home environment

NARCIS (Netherlands)

Meijneke, Ruud W. H.; Schouten-van Meeteren, Antoinette Y. N.; de Boer, Nienke Y.; van Zundert, Suzanne; van Trotsenburg, Paul A. S.; Stoelinga, Femke; van Santen, Hanneke M.

2015-01-01

Abstract Hypothalamic obesity after treatment for craniopharyngioma is a well-recognized, severe problem. Treatment of hypothalamic obesity is difficult and often frustrating for the patient, the parents and the professional care-giver. Because hypothalamic obesity is caused by an underlying medical

The Treatment of Obesity and Its Co-occurrence with Substance Use Disorders

OpenAIRE

VanBuskirk, Katherine A.; Potenza, Marc N.

2010-01-01

Obesity and binge eating disorder are detrimental health conditions that are associated with lower qualities of life. Individuals with obesity often face societal discrimination and frequently experience related medical disorders such as diabetes, hypertension, and hyperlipidemia. Current research suggests neurobiological similarities between obesity, binge eating disorder, and substance dependence. In addition, behavioral similarities link the two conditions; obese and substance dependent in...

The Potential Effects of Obesity on Social Security Claiming Behavior and Retirement Benefits.

Science.gov (United States)

Knoll, Melissa A Z; Shoffner, Dave; O'Leary, Samantha

2018-04-16

Obesity prevalence among Americans has increased for nearly three decades. We explore the relationship between the rise in obesity and Social Security retirement benefit claiming, a decision impacting nearly all aging Americans. Specifically, we investigate whether obesity can affect individuals' decision to claim benefits early, a choice that has important implications for financial security in retirement, particularly for those with lower socioeconomic status (SES). We use a microsimulation model called MINT6 (Modeling Income in the Near Term, version 6) to demonstrate the potential effects of obesity on subjective life expectancy and claiming behavior. We impute obesity status using data from the National Health and Nutrition Examination Survey (NHANES), which describes the distribution of obesity prevalence within the United States by gender, poverty status, and race/ethnicity. We find that the rise in obesity and the consequent incidence of obesity-related diseases may lead some individuals to make claiming decisions that lead to lower monthly and lifetime Social Security retirement benefits. Further, we find that the potential economic impact of this decision is larger for those with lower SES. We present a behavioral perspective by addressing the potential effects that obesity can have on individuals' retirement decisions and their resulting Social Security retirement benefits.

Active ingredients from natural botanicals in the treatment of obesity.

Science.gov (United States)

Zhang, W-L; Zhu, L; Jiang, J-G

2014-12-01

Obesity is considered as a chronic disease that can induce a series of comorbidities and complications. Chinese medicine has long clinical experiences in the treatment of obesity. This review summarizes the natural products from traditional Chinese medicine (TCM) that are reported to have anti-obesity effects in the past two decades. Botanic TCM comprises 90% of total Chinese crude drugs, and generally contains various active ingredients, in which the effective anti-obesity ingredients identified can be divided into saponins, polysaccharides, alkaloids, polyphenols and others. Astragaloside IV, glycyrrhizin, macrostemonoside A, berberine, betaine, capsaicin, matrine, methyl piperate, piperine, rutaecarpine, asimilobine, epigallocatechingallate, magnolol, resveratrol, soybean-isoflavone, α-linolenic acid, emodin, geniposide, phillyrin, salidroside and ursolic acid are specified in this review, and their sources, models, efficacy are described. It is concluded that the mechanisms of these components for the treatment of obesity include: (i) suppression of appetite, increase of satiety, reduction of energy intake; (ii) reduction in the digestion and absorption of exogenous lipid; (iii) attenuation of the synthesis of endogenous lipid; (iv) promotion of the oxidation and expenditure of lipid and (v) improvement of lipid metabolism disorder. Authors believe that the effective compounds from TCM will provide an alternative and hopeful way for the treatment of obesity. © 2014 World Obesity.

GLP-1 and Amylin in the Treatment of Obesity

DEFF Research Database (Denmark)

Jorsal, T; Rungby, J; Knop, F K

2016-01-01

for treatment of diabetes and obesity. This review will outline the physiology and pharmacological potential of amylin and GLP-1, respectively, and focus on innovative peptide drug development leading to drugs acting on two or more distinct receptors, such as an amylin and GLP-1 peptide hybrid, potentially...... producing a more effective treatment strategy to combat the rapidly increasing global obesity....

Clinical aspects of obesity in childhood and adolescence--diagnosis, treatment and prevention.

Science.gov (United States)

Kiess, W; Reich, A; Müller, G; Meyer, K; Galler, A; Bennek, J; Kratzsch, J

2001-05-01

The level of fatness at which morbidity increases is determined on an acturial basis. Direct measurements of body fat content, eg hydrodensitometry, bioimpedance or DEXA, are useful tools in scientific studies. However, body mass index (BMI) is easy to calculate and is frequently used to define obesity clinically. An increased risk of death from cardiovascular disease in adults has been found in subjects whose BMI had been greater than the 75th percentile as adolescents. Childhood obesity seems to increase the risk of subsequent morbidity whether or not obesity persists into adulthood. The genetic basis of childhood obesity has been elucidated to some extent through the discovery of leptin, the ob gene product, and the increasing knowledge on the role of neuropeptides such as POMC, neuropeptide Y (NPY) and the melanocyte concentrating hormone receptors (MC4R). Environmental/exogenous factors contribute to the development of a high degree of body fatness early in life. Twin studies suggest that approximately 50% of the tendency toward obesity is inherited. There are numerous disorders including a number of endocrine disorders (Cushing's syndrome, hypothyroidism, etc) and genetic syndromes (Prader-Labhard-Willi syndrome, Bardet-Biedl syndrome etc) that can present with obesity. A simple diagnostic algorithm allows for the differentiation between primary or secondary obesity. Among the most common sequelae of primary childhood obesity are hypertension, dyslipidemia and psychosocial problems. Therapeutic strategies include psychological and family therapy, lifestyle/behavior modification and nutrition education. The role of regular exercise and exercise programs is emphasized. Surgical procedures and drugs used as treatments for adult obesity are still not recommended for children and adolescents with obesity. As obesity is the most common chronic disorder in the industrialized societies, its impact on individual lives as well as on health economics has to be

The prevalence of obesity and influence of early life and behavioral factors on obesity in Chinese children in Guangzhou

Directory of Open Access Journals (Sweden)

Ting Zhang

2016-09-01

Full Text Available Abstract Background Childhood obesity has become a public health concern in many countries. In Southern China, the prevalence of childhood obesity increased from 6.2 to 7.5 % between 2007 and 2011. This study aimed to report the current prevalence of overweight and obesity, analyzed the early life and behavioral determinants of obesity, and investigated the weight-loss practices among Chinese children in Guangzhou. Methods Three thousand seven hundred sixty-six primary school students aged 7–12 years were recruited in Guangzhou, China in 2013. Questionnaires were used to assess (1 early life factors: birth weight, delivery mode, gestational age and feeding patterns; (2 behavioral factors: dietary intake, eating speed, sedentary time, physical activities and sleep duration; and (3 weight-loss practices: improving diet, increasing exercise, taking weight-loss drugs and undergoing a diet. The criteria of Working Group of Obesity in China were applied to classify overweight and obesity based on measured weight and height. Multivariable logistic regression analyses were performed to examine the determinants of overweight/obesity and adoption of weight-loss practices. Results The prevalence of childhood overweight and obesity were 11.2 and 10.0 %, respectively. High birth weight (≥4.0 kg versus 2.5 ~ 4.0 kg, odd ratio [OR]: 2.34; 95 % confidence interval [CI]: 1.53–3.58, sugar-sweetened beverages (SSBs intake (OR: 1.39; 95 % CI: 1.05–1.85, vegetable intake (OR: 1.12; 95 % CI: 1.01–1.24, and doing homework (OR: 1.24; 95 % CI: 1.08–1.43 were positively associated with obesity. Eating speed faster than peers was positively associated with obesity and yielded the highest OR (versus “as fast as peers”, OR: 3.18; 95 % CI: 2.28–4.44. Approximately 57, 81 and 87 % of normal-weight, overweight and obese children, respectively, reported weight-loss practices. Self-perception of weight status presented as the strongest determinant

The Influence of Familial Predisposition to Cardiovascular Complications upon Childhood Obesity Treatment

DEFF Research Database (Denmark)

Nielsen, Louise A; Bøjsøe, Christine; Kloppenborg, Julie T

2015-01-01

INTRODUCTION: The aim was to investigate whether a familial predisposition to obesity related cardiovascular complications was associated with the degree of obesity at baseline and/or changes in the degree of obesity during a multidisciplinary childhood obesity treatment program. METHODS: The study...... included 1421 obese children (634 boys) with a median age of 11.5 years (range 3.1-17.9 years), enrolled in treatment for 0.04 to 5.90 years (median 1.3 years) at the Children's Obesity Clinic, Denmark. At baseline, weight and height were measured, body mass index (BMI) standard deviation score (SDS......) calculated, and self-reported information on familial predisposition to obesity, hypertension, type 2 diabetes mellitus (T2DM), thromboembolic events, and dyslipidaemia were obtained. A familial predisposition included events in biological parents, siblings, grandparents, uncles, and aunts. The treatment...

Obesity: Prevalence, Theories, Medical Consequences, Management, and Research Directions

Directory of Open Access Journals (Sweden)

Nassar Erika

2005-12-01

Full Text Available Abstract Obesity and its associated disorders are a growing epidemic across the world. Many genetic, physiological, and behavioral factors play a role in the etiology of obesity. Diet and exercise are known to play a valuable role in the treatment and prevention of obesity and associated disorders such as hypertension, heart disease, and diabetes. Therefore, the purpose of this review is to examine the prevalence, etiology, consequences, and treatment of obesity.

Virtual Reality for Enhancing the Cognitive Behavioral Treatment of Obesity With Binge Eating Disorder: Randomized Controlled Study With One-Year Follow-up

OpenAIRE

Cesa, Gian Luca; Manzoni, Gian Mauro; Bacchetta, Monica; Castelnuovo, Gianluca; Conti, Sara; Gaggioli, Andrea; Mantovani, Fabrizia; Molinari, Enrico; C?rdenas-L?pez, Georgina; Riva, Giuseppe

2013-01-01

Background Recent research identifies unhealthful weight-control behaviors (fasting, vomiting, or laxative abuse) induced by a negative experience of the body, as the common antecedents of both obesity and eating disorders. In particular, according to the allocentric lock hypothesis, individuals with obesity may be locked to an allocentric (observer view) negative memory of the body that is no longer updated by contrasting egocentric representations driven by perception. In other words, these...

A Pilot Intervention Designed to Address Behavioral Factors That Place Overweight/Obese Young Children at Risk for Later-Life Obesity.

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Small, Leigh; Thacker, Leroy; Aldrich, Heather; Bonds-McClain, Darya; Melnyk, Bernadette

2017-08-01

The purpose of this pilot randomized controlled trial (RCT) was to intervene with parents of overweight/obese 4- to 8-year-old children to improve child internalizing and externalizing behaviors. Parent-child dyads ( N = 60) were randomly assigned to treatment or comparison conditions. Parents attended four intervention sessions at their child's primary health care office over 3 months. Child behaviors were assessed at 0, 3, 6, and 12 months post intervention. Parental beliefs in their skills/abilities increased in the experimental group parents, but there was no statistical difference between groups at any time. Child externalizing behaviors significantly decreased from baseline to postintervention for both groups ( F = 3.26, p = .020). Post hoc model testing suggests that this change was more pronounced in the intervention group ( F = 0.56, p = .692). Child somatic symptoms significantly decreased over time ( F = 4.55, p = .004), and there were group differences in child depressive behaviors ( F = 6.19, p = .020). These findings suggest that a parent-focused intervention program demonstrated positive preliminary effects on children's behaviors.

Identification of emotional and behavior problems in obese children using Child Behavior Checklist (CBCL and 17-items Pediatric Symptom Checklist (PSC-17

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Dwi Fachri Harahap

2010-03-01

Conclusions The prevalence of emotional and behavior problems detected using CBCL and PSC-17 in obese children was 28% and 22%, respectively. The PSC-17 has moderate sensitivity to screen emotional and behavior problem in obese children.[Paediatr Indones. 2010;50:42-8].

The ENDORSE study: Research into environmental determinants of obesity related behaviors in Rotterdam schoolchildren

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Looij-Jansen Petra

2008-04-01

Full Text Available Abstract Background Children and adolescents are important target groups for prevention of overweight and obesity as overweight is often developed early in life and tracks into adulthood. Research into behaviors related to overweight (energy balance-related behaviors and the personal and environmental determinants of these behaviors is fundamental to inform prevention interventions. In the Netherlands and in other countries systematic research into environmental determinants of energy balance related behaviors in younger adolescents is largely lacking. This protocol paper describes the design, the components and the methods of the ENDORSE study (Environmental Determinants of Obesity in Rotterdam SchoolchildrEn, that aims to identify important individual and environmental determinants of behaviors related to overweight and obesity and the interactions between these determinants among adolescents. Methods The ENDORSE study is a longitudinal study with a two-year follow-up of a cohort of adolescents aged 12–15 years. Data will be collected at baseline (2005/2006 and at two years follow-up (2007/2008. Outcome measures are body mass index (BMI, waist circumference, time spent in physical activity and sedentary behaviors, and soft drink, snack and breakfast consumption. The ENDORSE study consists of two phases, first employing qualitative research methods to inform the development of a theoretical framework to examine important energy balance related behaviors and their determinants, and to inform questionnaire development. Subsequently, the hypothetical relationships between behavioral determinants, energy balance related behaviors and BMI will be tested in a quantitative study combining school-based surveys and measurements of anthropometrical characteristics at baseline and two-year follow-up. Discussion The ENDORSE project is a comprehensive longitudinal study that enables investigation of specific environmental and individual determinants of

Group dialectical behavior therapy adapted for obese emotional eaters; a pilot study

NARCIS (Netherlands)

Roosen, M.A.; Safer, D.; Adler, S.; Cebolla, A.; Strien, T. van

2012-01-01

Dialectical Behavior Therapy (DBT) has been shown to effectively target binge eating disorder (BED). This study pilots the effectiveness of group DIVE for obese "emotional eaters" to reduce eating psychopathology and achieve weight maintenance. Thirty-five obese male and female emotional eaters

Group dialectical behavior therapy adapted for obese emotional eaters; a pilot study

NARCIS (Netherlands)

Roosen, M A; Safer, D; Adler, S.N.; Cebolla, A.; van Strien, T

2012-01-01

Dialectical Behavior Therapy (DBT) has been shown to effectively target binge eating disorder (BED). This study pilots the effectiveness of group DBT for obese "emotional eaters" to reduce eating psychopathology and achieve weight maintenance. Thirty-five obese male and female emotional eaters

Theory-based psychosocial factors that discriminate between weight-loss success and failure over 6 months in women with morbid obesity receiving behavioral treatments.

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Annesi, James J; Johnson, Ping H

2015-06-01

To improve success rates of behavioral weight-loss treatments, a better understanding of psychosocial factors that discriminate between weight-loss success and failure is required. The inclusion of cognitive-behavioral methods and manageable amounts of exercise might induce greater improvements than traditional methods of education in healthy eating practices. Women with morbid obesity [body mass index (BMI) ≥40 kg/m(2)] were recruited for a treatment of supported exercise paired with either a cognitive-behavioral or an educational approach to eating change over 6 months. They were classified as either successful with (i.e., at least 5 % loss; n = 40) or failed at (no loss, or weight gain; n = 43) weight loss. Discriminate function analysis incorporated theory-based models of 1 (self-efficacy), 5 (self-efficacy, self-regulation, mood, physical self-concept, body satisfaction), and 3 (self-efficacy, self-regulation, mood) psychosocial predictors at both month 6, and change from baseline-month 6. All three models significantly discriminated weight-loss success/failure (66, 88, and 87 % for success; and 81, 87, and 88 % for failure, respectively). Self-regulation had the strongest correlations within the multi-predictor models (0.90-0.96), and all variables entered were above the standard of 0.30 set for relevance. Participants in the cognitive-behavioral nutrition group demonstrated significantly greater improvements in all psychosocial variables and success with weight loss. Completing at least two sessions of exercise per week predicted success/failure with weight loss better than overall volume of exercise. New and relevant findings regarding treatment-induced psychosocial changes might be useful in the architecture of more successful behavioral weight-loss interventions.

Assessment and treatment of binge eating in obese patients

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Walmir Ferreira Coutinho

2006-01-01

Binge eating is a frequent disorder among obese patient, specialythose undergoing weight loss treatment. Binge eating disorder(BED) is a newly defined diagnostic category, usually associatedwith psychopathology and overweight. Several clinical trialsinvolving psychoterapeutical interventions have shown thatcognitive beahavior therapy and interpersonal therapy can beeffective for the treatment of obese patients with BED.Pharmacotherapy can be also an useful tool for the control ofbinge eating,...

Cortisol stress response is positively correlated with central obesity in obese women with binge eating disorder (BED) before and after cognitive-behavioral treatment.

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Gluck, Marci E; Geliebter, Allan; Lorence, Margarita

2004-12-01

Stress is the most commonly reported trigger of binge eating, and high cortisol levels are positively related to both central body fat and food intake after laboratory stress. We therefore examined waist circumference (WHR) and cortisol stress responsivity after a cold pressor stress test (CPT) in 22 obese (BMI > 27) women (11 BED, 11 non-BED). BMI and WHR did not differ between groups. The BED group had higher morning basal cortisol than the non-BED group (P = .03) and greater AUC cortisol after CPT, after controlling for AUC insulin (P = .04). In the BED group, WHR was related to AUC cortisol (P = .002) and peak cortisol stress responsivity (P = .003). Twenty (10 non-BED, 10 BED) were randomized to a 6-week treatment program (CBT + Diet) or Wait-List (WL) control group. There were no BED group or treatment-group differences in WHR, morning basal cortisol, or AUC cortisol after CPT. The relationship between WHR and both AUC cortisol (P = .002) and peak cortisol stress responsivity after CPT (P = .008) remained significant in the BED group. In BED, there is a hyperactive HPA axis related to abdominal obesity that persists even after treatment, suggesting that cortisol might be a primary factor in the disorder.

Childhood obesity treatment and prevention. Psychological perspectives of clinical approaches

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Maria Catena Quattropani; Teresa Buccheri

2013-01-01

Objective: This work focuses on clinical psychologist’ presence within childhood obesity prevention programmes in several countries. Method: The Authors collected articles considering psychological, biological and social aspects linked to childhood obesity. Results: Studies reveal that childhood obesity prevention programmes are based on biological, medical and educational aspects; clinical psychologists up until now have been engaged almost exclusively in the treatment of obesity. Conclusion...

Prevalence of attention deficit/hyperactivity disorder among adults in obesity treatment

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Altfas Jules R

2002-09-01

Full Text Available Abstract Background Bariatric patients showing poor "focus" during treatment more often failed to lose weight or maintain reduced weight. Evaluation of these patients identified a number having attention deficit/hyperactivity disorder (ADHD, evidently a potent factor limiting successful weight control. After searches found no published reports describing comorbid ADHD and obesity, this report was conceived to begin exploring the prevalence and characteristics of these patients. Method Clinical records of 215 patients receiving obesity treatment during 2000 were reviewed. Data collected and analyzed included age, sex, beginning and ending body mass index (BMI, number of clinic visits, months of treatment, and diagnostic category (ADHD, some ADHD symptoms, non-ADHD. DSM-IV criteria were used, except age of onset was modified to Results Whole sample ADHD prevalence was 27.4% (CI:21.1,32.9, but 42.6% (CI: 36.3% to 48.9% for BMI >= 40. Mean weight loss among obese patients with ADHD (OB+ADHD was 2.6 BMI (kg/m2 vs. 4.0 for non-ADHD (NAD (p = 40, OB+ADHD had BMI loss 2.9 vs. 7.0 (NAD (p Conclusions ADHD was highly prevalent among obese patients and highest in those with extreme obesity. Comorbid obesity and ADHD symptoms rendered treatment less successful compared to NAD counterparts. Reasons for the comorbidity are unknown, but may involve brain dopamine or insulin receptor activity. If replicated in further studies, these findings have important implications for treatment of severe and extreme obesity.

Sex differences in biopsychosocial correlates of binge eating disorder: a study of treatment-seeking obese adults in primary care setting.

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Udo, Tomoko; McKee, Sherry A; White, Marney A; Masheb, Robin M; Barnes, Rachel D; Grilo, Carlos M

2013-01-01

Although community-based studies suggest equivalent levels of physical and psychological impairment by binge eating disorder (BED) in men and women, men with BED are still underrepresented in clinical studies. This study aimed to provide a comprehensive analysis of sex differences in biopsychosocial correlates of treatment-seeking obese patients with BED in primary care. One hundred-ninety obese adults (26% men) were recruited in primary care settings for a treatment study for obesity and BED. Very few significant sex differences were found in the developmental history and in current levels of eating disorder features, as well as psychosocial factors. Women reported significantly earlier age at onset of overweight and dieting and greater frequency of dieting. Men reported more frequent strenuous exercise. Men were more likely than women to meet criteria for metabolic syndrome; men were more likely to show clinically elevated levels of triglycerides, blood pressure, and fasting glucose levels. Despite few sex differences in behavioral and psychosocial factors, metabolic problems associated with obesity were more common among treatment-seeking obese men with BED than women. The findings highlight the importance of including men in clinical studies of BED and active screening of BED in obese men at primary care settings. © 2013.

Treating Pediatric Obesity Using an Empirically Supported Treatment: A Case Report

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Cunningham, Phillippe B.; Ellis, Deborah A.; Naar-King, Sylvie

2010-01-01

Overweight and obesity are increasing dramatically in the United States of America, especially among children. Effective treatment of the multiple risk factors that promote youth obesity requires treatment approaches that are flexible and comprehensive enough to address each of these factors. One such treatment approach is Multisystemic Therapy…

Behavioral risk factors for obesity during health transition in Vanuatu, South Pacific.

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Dancause, Kelsey Needham; Vilar, Miguel; Wilson, Michelle; Soloway, Laura E; DeHuff, Christa; Chan, Chim; Tarivonda, Len; Regenvanu, Ralph; Kaneko, Akira; Lum, J Koji; Garruto, Ralph M

2013-01-01

The South Pacific archipelago of Vanuatu, like many developing countries, is currently experiencing a shift in disease burdens from infectious to chronic diseases with economic development. A rapid increase in obesity prevalence represents one component of this "health transition." To identify behaviors associated with measures of obesity in Vanuatu. Five hundred and thirty four adults from three islands varying in level of economic development were surveyed. Height, weight, waist, and hip circumferences; triceps, subscapular and suprailiac skinfolds; and percent body fat (%BF) by bioelectrical impedance were measured. Diet through 24-h dietary recall and physical activity patterns using a survey were assessed. We analyzed prevalence of obesity and central obesity based on multiple indicators (body mass index, %BF, waist circumference, and waist-to-height ratio), and analyzed differences among islands and associations with behavioral patterns. Obesity prevalence was lowest among rural and highest among suburban participants. Prevalence of central obesity was particularly high among women (up to 73.9%), even in rural areas (ranging from 14.7 to 41.2% depending on the measure used). Heavier reliance on animal protein and incorporation of Western foods in the diet-specifically, tinned fish and instant noodles-was significantly associated with increased obesity risk. Even in rural areas where diets and lifestyles remain largely traditional, modest incorporation of Western foods in the diet can contribute to increased risk of obesity. Early prevention efforts are thus particularly important during health transition. Where public health resources are limited, education about dietary change could be the best target for prevention. Copyright © 2013 The Obesity Society.

The endocannabinoid system: a new pharmacological target for obesity treatment?

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Hu, Jia; Zhu, Chao; Huang, Mao

2009-06-01

Being a great threaten for human health, obesity has become a pandemic chronic disease. There have been several therapeutic treatments for this social health issue, including diet and exercise therapy, medication and surgery, among which the diet is still the most common way. However, none of these therapeutic measures available is ideal, making it necessary to find an effective medical treatment. The endocannabinoid system, which is well known for its contributions in certain mental processes such as relaxation, amelioration of pain and anxiety, and sedation initiation, has been recently reported to play an essential role in regulating appetite and metabolism to maintain energy balance, leading to the belief that endocannabinoid system is closely related to obesity. This new discovery deepens our understanding of obesity, and provides us with a new direction for clinical obesity treatment. Rimonabant is an antagonist for CB1, and has entered the market in some countries. However, although effective as an anti-obesity drug, rimonabant also causes obviously adverse side-effects, thus is being doubted and denied for medical usage.

Danish clinical guidelines for examination and treatment of overweight and obese children and adolescents in a pediatric setting.

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Johansen, Anders; Holm, Jens-Christian; Pearson, Seija; Kjærsgaard, Mimi; Larsen, Lone Marie; Højgaard, Birgitte; Cortes, Dina

2015-05-01

Overweight children are at an increased risk of becoming obese adults, which may lead to shorter life expectancies in the current generation of children as compared to their parents. Furthermore, being an overweight child has a negative psycho-social impact. We consider obesity in children and adolescents a chronic illness, which is in line with the American Medical Society. We summarize the evidence for the efficacy of a combination of diet, physical activity and behavior-focused interventions in a family-based setting. The present guidelines propose a multidisciplinary service implemented as a "chronic care model" based on "best clinical practice" inspired by an American expert committee and the daily practice of The Children's Obesity Clinic at Copenhagen University Hospital Holbaek. Children and adolescents should be referred for examination and treatment in a pediatric setting when BMI corresponds to an isoBMI of minimum 30 or BMI corresponds to an isoBMI of 25 and complex obesity is suspected. Obtaining a thorough medical history is pivotal. We propose a structured interview to ensure collection of all relevant information. We recommend physical examination focused on BMI, waist circumference, growth, pubertal stage, blood pressure, neurology and skin and provide comprehensive paraclinical investigations for obesity and obesity related conditions. Treatment of obesity in children and adolescents is fully dependent on the combined effort of the entire family. This cannot be overemphasized! The main principle of the treatment is developing an individual detailed plan for every patient to reduce caloric intake whilst increasing physical activity, leaving no ambiguity with the recommendations.

Comportamento de restrição alimentar e obesidade Restrained eating behavior and obesity

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Fabiana Bernardi

2005-02-01

Full Text Available A obesidade é uma doença de alta prevalência no mundo e é responsável por sérias repercussões orgânicas e psicossociais, desde a infância até a vida adulta. O comportamento alimentar tem bases biológicas e sociais e, associado, à obesidade, torna-se um processo ainda mais complexo pelos aspectos psicológicos envolvidos, os quais se expressam por meio de humor depressivo, ansiedade, sentimento de culpa e, também, por mecanismos fisiológicos, como a resistência ao jejum na vigência de dietas restritivas. Há evidências de que, em indivíduos obesos, comportamentos de compulsão alimentar e ou restrição são mais freqüentes e parecem ser, em parte, responsáveis pelos fracassos observados no tratamento da obesidade. As restrições e auto-imposições das pessoas que fazem dieta, parecem ter um efeito rebote, resultando em compulsão alimentar, a qual pode associar-se a conseqüências psicológicas, como a perda da auto-estima, mudanças de humor e distração. As reflexões desta revisão sugerem que os programas para redução de peso corporal devem enfocar as bases do comportamento alimentar e desenvolver, efetivamente, ações interdisciplinares que permitam obter resultados eficazes no tratamento da obesidade.Obesity is a widespread disease in the world, responsible for serious organic and psychosocial repercussions, from infancy to adulthood. Eating behavior has biological as well as social bases. Associated to obesity, it becomes an even more complex process, since it is accompanied by psychological aspects showing symptoms such as depressive moods, anxiety, feelings of guilt, and physiological mechanisms as, for instance, the resistance to fast during restrictive diets. Obese individuals prevalently present behaviors such as binge or restrained eating, both leading to failure in the treatment of obesity. Restrained eating refers to the tendency to restrict food intake consciously, in order to prevent weight gain or to

Decreasing food fussiness in children with obesity leads to greater weight loss in family-based treatment.

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Hayes, Jacqueline F; Altman, Myra; Kolko, Rachel P; Balantekin, Katherine N; Holland, Jodi Cahill; Stein, Richard I; Saelens, Brian E; Welch, R Robinson; Perri, Michael G; Schechtman, Kenneth B; Epstein, Leonard H; Wilfley, Denise E

2016-10-01

Food fussiness (FF), or the frequent rejection of both familiar and unfamiliar foods, is common among children and, given its link to poor diet quality, may contribute to the onset and/or maintenance of childhood obesity. This study examined child FF in association with anthropometric variables and diet in children with overweight/obesity participating in family-based behavioral weight loss treatment (FBT). Change in FF was assessed in relation to FBT outcome, including whether change in diet quality mediated the relation between change in FF and change in child weight. Child (N = 170; age = 9.41 ± 1.23) height and weight were measured, and parents completed FF questionnaires and three 24-h recalls of child diet at baseline and post-treatment. Healthy Eating Index-2005 scores were calculated. At baseline, child FF was related to lower vegetable intake. Average child FF decreased from start to end of FBT. Greater decreases in FF were associated with greater reductions in child body mass index and improved overall diet quality. Overall, diet quality change through FBT mediated the relation between child FF change and child body mass index change. Children with high FF can benefit from FBT, and addressing FF may be important in childhood obesity treatment to maximize weight outcomes. © 2016 The Obesity Society.

Are Graduating Pediatric Residents Prepared to Engage in Obesity Prevention and Treatment?

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Frintner, Mary Pat; Liebhart, Janice L; Lindros, Jeanne; Baker, Alison; Hassink, Sandra G

2016-01-01

Little information is available to gauge residents' perceived receipt of comprehensive training and preparedness to manage children with obesity in practice. A national, random sample of 1000 graduating pediatric residents were surveyed in 2013 on childhood overweight/obesity and preparedness to prevent and treat obesity. A composite training measure was created by summing the number of areas (10 possible) where training on overweight/obesity was received. Multivariable logistic regression explored relationships of resident and training characteristics to residents' belief that their own counseling on prevention and treatment of overweight/obesity is very effective (vs somewhat/slightly/not effective). Of 625 survey respondents (63% response), most (68-92%) reported receipt of training in each of 10 assessed areas on overweight/obesity prevention, assessment, and treatment. Most residents did not desire more training in the assessed areas; however, 54% wanted more training in motivational interviewing. About one-fourth believed that their own counseling on the prevention of overweight/obesity (26%) and treatment of obesity (22%) was very effective. Residents who rated their ability to use motivational interviewing as very good/excellent were more likely to rate their counseling on both the prevention and treatment of overweight/obesity as very effective (adjusted odds ratio [aOR] 4.33, 95% confidence interval [CI] 2.63-7.13; and aOR 4.69, 95% CI 2.72-8.07, respectively). Residents who received training in all 10 assessed areas were also more likely to rate their counseling on both prevention and treatment as very effective (aOR 2.58, 95% CI 1.61-4.14; aOR 2.41, 95% CI 1.46-3.97, respectively). Comprehensive training on overweight/obesity and inclusion of training in motivational interviewing may help residents feel better prepared to care for children with overweight/obesity. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights

Fat Mass and Obesity-Associated (FTO Gene Polymorphisms Are Associated with Physical Activity, Food Intake, Eating Behaviors, Psychological Health, and Modeled Change in Body Mass Index in Overweight/Obese Caucasian Adults

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Janetta Harbron

2014-08-01

Full Text Available The fat mass and obesity-associated (FTO gene is currently recognized as the most robust predictor of polygenic obesity. We investigated associations between the FTO rs1421085 and rs17817449 polymorphisms and the FTO rs1421085–rs17817449 haplotype and dietary intake, eating behavior, physical activity, and psychological health, as well as the effect of these associations on BMI. N = 133 treatment seeking overweight/obese Caucasian adults participated in this study. Genotyping was performed from whole blood samples. Weight and height was measured and a non-quantified food frequency questionnaire was completed to assess food group intake. Validated questionnaires were completed to assess physical activity (Baecke questionnaire, psychological health (General Health questionnaire, Rosenburg self-esteem scale and Beck Depression Inventory, and eating behavior (Three Factor Eating questionnaire. The risk alleles of the FTO polymorphisms were associated with poorer eating behaviors (higher hunger, internal locus for hunger, and emotional disinhibition scores, a higher intake of high fat foods and refined starches and more depressive symptoms. The modeled results indicate that interactions between the FTO polymorphisms or haplotypes and eating behavior, psychological health, and physical activity levels may be associated with BMI. The clinical significance of these results for implementation as part of weight management interventions needs further investigation.

Group or Individual treatment: What is More Effective in Childhood and Juvenile Obesity?

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Rita de Cássia Garcia Pereira

2015-01-01

Full Text Available Objective: the objective was to compare the efficacy of individual treatment (consulting and group treatment combined with individualized care, in childhood and juvenile obesity situations. Methodology: The study was carried out in 2 different places: in the Nutrition Clinic of the Integrated Health Clinic of UNIARA and in another clinical school. In both places there was a treatment with individual consultations, however, in the Integrated Health Clinic of UNIARA treatment was also done in group care. The target individuals were composed of children and adolescents of both sexes who participated in the consultations, however, only patients who were above the 85th percentile for BMI, according to the international reference population (NCHS, 2000, were included in the sample which was composed of 58 individuals. The choice of clinical records occurred at random in both places. Results: the most effective program in the positive change in dietary habits was group together with individual treatment, where 20 patients (68.96% showed some change in eating behavior. In individual treatment, 11 patients (37.93% showed some change in dietary habits existing before treatment. There was a reduction in the rate of obesity of 24% for patients in groups, however, both types of treatment were favorable to changes in dietary habits and weight reduction. The findings showed that the strategy of individualized care together with group care is an alternative for the treatment of overweight.

A series of studies examining Internet treatment of obesity to inform Internet interventions for substance use and misuse.

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Tate, Deborah F

2011-01-01

The feasibility and efficacy of Internet treatment programs for overweight and obese people have been demonstrated in a series of randomized trials. Initial studies examined various approaches to Internet behavioral treatment. Other studies have examined delivery of group behavioral counseling using Internet chat rooms, using the Internet for long-term maintenance of weight loss, and enhancing motivation in Internet programs. These interventions have produced weight losses of 4-7 kg over 6 months to 1 year when support via e-mail, automated messages, or chat rooms is provided. Outcomes and lessons learned with application to the treatment of substance use and misuse are provided.

Influence of stress in parents on child obesity and related behaviors.

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Parks, Elizabeth P; Kumanyika, Shiriki; Moore, Reneé H; Stettler, Nicolas; Wrotniak, Brian H; Kazak, Anne

2012-11-01

To assess associations of the number of parent stressors and parent-perceived stress with obesity and related behaviors in their children. This cross-sectional analysis used data from the 2006 Southeastern Pennsylvania Household Health Survey in which 2119 parents/caregivers answered questions about themselves and their children (ages 3-17 years). Survey data were used to assess the main exposure variables: the number of stressors (measured using a stressor index) and parent-perceived stress (the response to a general stress question); child covariates (age, race/ethnicity, health quality, and gender); adult covariates (education, BMI, gender, poor sleep quality) and study outcomes (child obesity, fast-food consumption, fruit and vegetable consumption, and physical activity). To account for developmental differences, analyses were also stratified by age group (3-5, 6-8, 9-12, and 13-17 years). Analyses used multiple logistic regression, with results expressed as odds ratios and 95% confidence intervals. The number of parent stressors was related to child obesity in unadjusted (1.12, 1.03-1.22, P = .007) and adjusted models (1.12, 1.03-1.23, P = .010). Parent-perceived stress was related to fast-food consumption in unadjusted (1.07, 1.03-1.10, P child obesity. Parent-perceived stress was directly related to child fast-food consumption, an important behavioral indicator of obesity risk. Clinical care models and future research that address child obesity should explore the potential benefits of addressing parent stressors and parent-perceived stress.

Eating Behaviors and Obesity in African American and Caucasian Women

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2010-08-16

August 16,20 10 APPROVAL SHEET Title of Thesis: "Eahng Behaviors and Obesity in Afncan Amelican and Caucasian Women " Name of Candidate: Elena A...AND OBESITY IN AFRICAN AMERICAN AND CAUCASIAN WOMEN " is appropriately acknowledged and, beyond brief excerpts, is with the permission of the copyright...Caucasian Women Elena A. Spieker1,2,3, Robyn Osborn1,2, and Tracy Sbrocco1,2 1 Department of Medical and Clinical Psychology, Uniformed Services

Where are family theories in family-based obesity treatment?: conceptualizing the study of families in pediatric weight management

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Skelton, JA; Buehler, C; Irby, MB; Grzywacz, JG

2014-01-01

Family-based approaches to pediatric obesity treatment are considered the ‘gold-standard,’ and are recommended for facilitating behavior change to improve child weight status and health. If family-based approaches are to be truly rooted in the family, clinicians and researchers must consider family process and function in designing effective interventions. To bring a better understanding of family complexities to family-based treatment, two relevant reviews were conducted and are presented: (1) a review of prominent and established theories of the family that may provide a more comprehensive and in-depth approach for addressing pediatric obesity; and (2) a systematic review of the literature to identify the use of prominent family theories in pediatric obesity research, which found little use of theories in intervention studies. Overlapping concepts across theories include: families are a system, with interdependence of units; the idea that families are goal-directed and seek balance; and the physical and social environment imposes demands on families. Family-focused theories provide valuable insight into the complexities of families. Increased use of these theories in both research and practice may identify key leverage points in family process and function to prevent the development of or more effectively treat obesity. The field of family studies provides an innovative approach to the difficult problem of pediatric obesity, building on the long-established approach of family-based treatment. PMID:22531090

Racial/Ethnic Differences in the Relationship between Obesity and Depression Treatment.

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Abdus, Salam; Zuvekas, Samuel H

2015-10-01

Using data from the 2004 to 2008 Medical Expenditure Panel Survey (MEPS), this study examined the relationship between obesity and the treatment of depression across racial/ethnic subgroups, controlling for depressive symptoms, self-rated mental health, health status, and socioeconomic characteristics. The association between obesity and depression-related medication was significant for white women but not for black or Hispanic women. Similarly, the association between obesity and depression-related ambulatory visits was significant for white women but not for black or Hispanic women. The results for men were, in general, mixed and inconsistent. The significant racial/ethnic differences found in the relationship between obesity and depression treatment among women suggest that social and cultural factors might play important roles in depression treatment among women.

Gender differences in physiologic markers and health behaviors associated with childhood obesity.

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Govindan, Morgen; Gurm, Roopa; Mohan, Sathish; Kline-Rogers, Eva; Corriveau, Nicole; Goldberg, Caren; Durussel-Weston, Jean; Eagle, Kim A; Jackson, Elizabeth A

2013-09-01

Previous studies have demonstrated gender-related differences in body composition, physical activity, and diet. This observational study assesses gender variance in independent predictors for obesity to determine targeted areas for intervention. Data from 1714 sixth-grade students enrolled in Project Healthy Schools were compared by using health behaviors and physiologic markers (lipids, random glucose, blood pressure, and resting and recovery heart rates). Students were stratified by gender and obesity (BMI ≥95th percentile by age and gender). Physiologic markers and behaviors were compared by using χ(2) analysis. Univariate associations with P gender. Nonobese students (both boys and girls) showed significantly healthier physiologic parameters compared with their obese counterparts. Two behaviors independently correlated with obesity in both boys and girls: regularly eating school lunches (odds ratio [OR] 1.29, 95% confidence interval [CI] 1.01-1.64; OR 1.27, 95% CI 1.00-1.62, respectively) and watching ≥2 hours of television per day (OR 1.19, 95% CI 1.07-1.32; OR 1.19, 95% CI 1.06-1.34, respectively). Vigorous physical activity and involvement in school sports teams appeared to be protective against obesity in boys (OR 0.90, 95% CI 0.82-0.98; OR 0.77, 95% CI 0.64-0.94, respectively), whereas milk consumption appeared protective in girls (OR 0.81, 95% CI 0.67-0.98). Among middle-school children, we observed gender-related differences in factors associated with obesity. Additional research is warranted to determine the beneficial impact of improving school lunches and decreasing screen time, while improving our understanding of gender-related differences in milk consumption and physical activities in relation to BMI.

The new era of treatment for obesity: evidence and expectations for gut microbiome transplantation

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Thilini N Jayasinghe

2016-02-01

Full Text Available Obesity has reached epidemic proportions. Despite a better understanding of the underlying pathophysiology and growing treatment options, a significant proportion of obese patients do not respond to treatment. Recently, microbes residing in the human gastrointestinal tract have been found to act as an endocrine organ, whose composition and functionality may contribute to the development of obesity. Therefore, faecal/gut microbiome transplantation (GMT, which involves the transfer of faeces from a healthy donor to a recipient, is increasingly drawing attention as a potential treatment for obesity. Currently the evidence for GMT effectiveness in the treatment of obesity is preliminary. Here, we summarize benefits, procedures, and issues associated with GMT, with a special focus on obesity.

The effect of poverty-influenced, food-related consumer behaviors on obesity: An analysis of the NHANES flexible consumer behavioral module.

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O'Dare Wilson, Kellie

2017-01-01

Despite extensive research investigating obesity, the problem continues to increase, particularly in poor, minority, and under-resourced communities. However, the literature continues to demonstrate many obesity-predicating variables are outside of personal volitional control, such as food-related consumer behaviors, which are strongly influenced by income and environment. This cross-sectional study (n = 5,109) employed secondary data analysis to quantitatively examine the effect of food-related consumer variables on obesity while controlling for covariates. Participants answered questions regarding money spent on food, time preparing meals, number of meals eaten at home and away from home, and types of food products consumed (frozen/fast foods, sodas, salty snacks, etc.) In this study, 48.9% of respondents were either overweight or obese. No significant differences were noted between the contextual variables examined and BMI scores. However, given the sample's limitations illuminated in the study, further research regarding the relationship between obesity and poverty-influenced, food-related consumer behaviors is warranted.

Randomized Trial of a Family-based, Automated, Conversational Obesity Treatment Program for Underserved Populations

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Wright, J. A.; Phillips, B.D.; Watson, B.L.; Newby, P.K.; Norman, G. J.; Adams, W.G.

2013-01-01

Objective To evaluate the acceptability and feasibility of a scalable obesity treatment program integrated with pediatric primary care and delivered using interactive voice technology (IVR) to families from underserved populations. Design and Methods Fifty parent-child dyads (child 9–12 yrs, BMI >95th percentile) were recruited from a pediatric primary care clinic and randomized to either an IVR or a wait-list control (WLC) group. The majority were lower-income, African-American (72%) families. Dyads received IVR calls for 12 weeks. Call content was informed by two evidenced-based interventions. Anthropometric and behavioral variables were assessed at baseline and 3 mo follow-up. Results Forty-three dyads completed the study. IVR parents ate 1 cup more fruit than WLC (p 75% agreed that the calls were useful, made for people like them, credible, and helped them eat healthy foods. Conclusion An obesity treatment program delivered via IVR may be an acceptable and feasible resource for families from underserved populations. PMID:23512915

An update in prevention and treatment of pediatric obesity.

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Moya, Manuel

2008-08-01

Obesity prevalence is growing as well as its severity with increasing morbidity and mortality. This "globesity" also affects developing countries where under nutrition and stunting frequently coexist with overweight and obesity. One third of obese adults began to be so in the pediatric ages. There are two main types of prevention: general one representing greater actions from health authorities and the individual one carried out by the pediatrician and the patient at risk. Once the state of obesity is reached (relative body mass index, rBMI >121%) the longer lasting care becomes more complex and frequently unsuccessful. The treatment of obesity is aimed to care for the present and silent disorders and for preventing its further tracking to adulthood. Identification of pediatric population at risk which is the one with an rBMI of 111%-120% plus other risk factors. Specific individual actions include reduction of food intake, increase of energy expenditure, involvement of parents, and the child-adolescent himself in the prevention. Therapy is based on some principles plus the important medical and emotional approach. A Cochrane study based on only 10 appropriate studies showed a predominant poor efficacy of the undergone preventive action. Treatment guides are presented after our own experience with a group of 400 kids with an average follow-up of 7 years and other individual prevention studies. Involving motivated pediatricians with a minimum of time for visits and better follow-up in the frame of a general national preventive programme could be a rational outcome. Treatment of obesity should never be postponed whatever the clinical care is.

Splitting, impulsivity, and intimate partnerships in young obese women seeking bariatric treatment

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Zmolikova J

2016-09-01

Full Text Available Jana Zmolikova,1,2 Dita Pichlerova,3 Petr Bob,1,4 Denisa Schückova,5 Jitka Herlesova,3 Petr Weiss6 1Department of Psychiatry, First Faculty of Medicine, Center for Neuropsychiatric Research of Traumatic Stress, Charles University, 2Department of Clinical Psychology, Na Homolce Hospital, 3OB Clinic, Prague, 4Faculty of Medicine, Central European Institute of Technology, Masaryk University, Brno, 5Iscare Clinical Centre, 6Institute of Sexology, First Faculty of Medicine, Charles University, Prague, Czech Republic Background: Splitting represents a defense mechanism that describes fragmentation of conscious experience that may occur in various psychopathological conditions. The purpose of this study was to examine the relationship of splitting with disturbed cognitive and affective functions related to impulsivity and intimate partnerships in a group of obese patients indicated for bariatric treatment and compare the results with other obese patients and patients with bulimia nervosa. Methods: In this clinical study, we assessed 102 young women. The sample was divided into three subgroups: obese women (N=30, obese women indicated for bariatric treatment (N=48, and patients with bulimia nervosa (N=24. The patients were assessed using Splitting Index and Barratt Impulsivity Scale, and selected information about their intimate partnership was documented for all the participants.Results: The main results of this study indicate significant differences in the relationship of splitting and impulsivity with difficulties in intimate partnerships. These differences discriminate obese patients indicated for bariatric treatment from other obese patients and patients with bulimia nervosa.Conclusion: These findings may have significant implications for treatment of the obese patients indicated for bariatric treatment and their presurgery psychological evaluations. Keywords: splitting, impulsivity, obesity, bulimia nervosa, bariatric treatment

Obesity and orthodontic treatment: is there any direct relationship?

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Alberto Consolaro

Full Text Available ABSTRACT Obesity is a wide-spread condition directly or indirectly connected with an increase in the prevalence of a variety of human diseases. It affects over 50% of the western overall population. In 2017, a thorough analysis of 204 studies on obesity and cancer revealed that the condition increases the risk of the following types of cancer: stomach, colon, rectal, bile duct, pancreatic, esophagus, breast, endometrial, ovarian, kidney and multiple myeloma. The first study aiming at establishing a connection between obesity and the rate of induced orthodontic tooth movement was conducted by Saloom et al; however, it could not effectively nor significantly reveal any direct influence or effect. Despite being identified during the first week, differences could not be explained and treatment time remained unchanged. In spite of lack of studies in the literature on the connection between obesity and the rate of induced tooth movement, in clinical practice, courses or specialized training, we should not have protocols changed nor adopt any measures or expect significant differences between normal-weight and obese individuals. It should be emphasized that unsuccessful cases or cases of root resorption associated with treatment should not be assigned to obesity, since scientific data is insufficient to do so.

Socioeconomic and Behavioral Characteristics Associated With Metabolic Syndrome Among Overweight/Obese School-age Children.

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Ham, Ok Kyung

Obesity in children comprises a significant public health concern in Korea. As with increased prevalence of overweight and obesity among children, risk factors for metabolic syndrome (MetS) have also increased in this population. The purpose was to examine behavioral and socioeconomic factors that were associated with biomarkers of MetS among overweight/obese school-age children. A cross-sectional study was conducted, and a convenience sample of 75 overweight/obese school-age children participated. Socioeconomic and behavioral characteristics, anthropometric measurements, and physiologic examinations were studied. The data were analyzed using an analysis of covariance and logistic regression. Metabolic syndrome was diagnosed in 27.8% of our population. Severe stress was significantly associated with elevated systolic blood pressure (P family characteristics, children's perception of family income (wealthy and very wealthy) and mother's education level (high school or less) were associated with diagnoses of MetS in children (P < .05). The results indicated that certain socioeconomic and behavioral characteristics were associated with risk factors of MetS, and therefore, interventions to modify these risk factors are needed to promote the healthy development of overweight/obese school-age children.

Microbial-Host Co-metabolites Are Prodromal Markers Predicting Phenotypic Heterogeneity in Behavior, Obesity, and Impaired Glucose Tolerance

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Marc-Emmanuel Dumas

2017-07-01

Full Text Available The influence of the gut microbiome on metabolic and behavioral traits is widely accepted, though the microbiome-derived metabolites involved remain unclear. We carried out untargeted urine 1H-NMR spectroscopy-based metabolic phenotyping in an isogenic C57BL/6J mouse population (n = 50 and show that microbial-host co-metabolites are prodromal (i.e., early markers predicting future divergence in metabolic (obesity and glucose homeostasis and behavioral (anxiety and activity outcomes with 94%–100% accuracy. Some of these metabolites also modulate disease phenotypes, best illustrated by trimethylamine-N-oxide (TMAO, a product of microbial-host co-metabolism predicting future obesity, impaired glucose tolerance (IGT, and behavior while reducing endoplasmic reticulum stress and lipogenesis in 3T3-L1 adipocytes. Chronic in vivo TMAO treatment limits IGT in HFD-fed mice and isolated pancreatic islets by increasing insulin secretion. We highlight the prodromal potential of microbial metabolites to predict disease outcomes and their potential in shaping mammalian phenotypic heterogeneity.

Collective behavior in the spatial spreading of obesity

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Gallos, Lazaros K.; Barttfeld, Pablo; Havlin, Shlomo; Sigman, Mariano; Makse, Hernán A.

2012-06-01

Obesity prevalence is increasing in many countries at alarming levels. A difficulty in the conception of policies to reverse these trends is the identification of the drivers behind the obesity epidemics. Here, we implement a spatial spreading analysis to investigate whether obesity shows spatial correlations, revealing the effect of collective and global factors acting above individual choices. We find a regularity in the spatial fluctuations of their prevalence revealed by a pattern of scale-free long-range correlations. The fluctuations are anomalous, deviating in a fundamental way from the weaker correlations found in the underlying population distribution indicating the presence of collective behavior, i.e., individual habits may have negligible influence in shaping the patterns of spreading. Interestingly, we find the same scale-free correlations in economic activities associated with food production. These results motivate future interventions to investigate the causality of this relation providing guidance for the implementation of preventive health policies.

Destroying God's Temple? Physical Inactivity, Poor Diet, Obesity, and Other "Sin" Behaviors.

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Faries, Mark D; McClendon, Megan; Jones, Eric J

2017-02-17

On average, our participants (N = 112), who self-proclaimed to be Christians, believed that physically inactive lifestyles, unhealthy eating, overeating, and being obese destroy the body, God's temple. However, these beliefs were less definitive, than those of other common "sin" behaviors, such as drug use, smoking, and excessive drinking of alcohol. In addition, destroying the body with physical inactivity or poor diet was not necessarily viewed as sinful. Subsequently, these beliefs did not relate to self-reported physical activity, dietary behavior, or body mass index. It is possible that inactivity, poor dietary habits, and obesity are not internalized into the spiritual perspective as destroying the body, God's temple, in the same way as other "sin" behaviors.

Study Protocol: A randomized controlled trial evaluating the effect of family-based behavioral treatment of childhood and adolescent obesity–The FABO-study

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Hanna F. Skjåkødegård

2016-10-01

Full Text Available Abstract Background The purpose of the FABO-study is to evaluate the effect of family-based behavioral social facilitation treatment (FBSFT, designed to target children’s family and social support networks to enhance weight loss outcomes, compared to the standard treatment (treatment as usual, TAU given to children and adolescents with obesity in a routine clinical practice. Methods Randomized controlled trial (RCT, in which families (n = 120 are recruited from the children and adolescents (ages 6–18 years referred to the Obesity Outpatient Clinic (OOC, Haukeland University Hospital, Norway. Criteria for admission to the OOC are BMI above the International Obesity Task Force (IOTF cut-off ≥ 35, or IOTF ≥ 30 with obesity related co-morbidity. Families are randomized to receive FBSFT immediately or following one year of TAU. All participants receive a multidisciplinary assessment. For TAU this assessment results in a plan and a contract for chancing specific lifestyle behaviors. Thereafter each family participates in monthly counselling sessions with their primary health care nurse to work on implementing these goals, including measuring their weight change, and also meet every third month for sessions at the OOC. In FBSFT, following assessment, families participate in 17 weekly sessions at the OOC, in which each family works on changing lifestyle behaviors using a structured cognitive-behavioral, socio-ecological approach targeting both parents and children with strategies for behavioral maintenance and sustainable weight change. Outcome variables include body mass index (BMI; kg/m2, BMI standard deviation score (SDS and percentage above the IOTF definition of overweight, waist-circumference, body composition (bioelectric impedance (BIA and dual-X-ray-absorptiometry (DXA, blood tests, blood pressure, activity/inactivity and sleep pattern (measured by accelerometer, as well as questionnaires measuring depression, general

Exploring occupational and behavioral risk factors for obesity in firefighters: A theoretical framework and study design

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Choi, BK; Schnall, P; Dobson, M; Israel, L; Landsbergis, P; Galassetti, P; Pontello, A; Kojaku, S; Baker, D

2011-01-01

Firefighters and police officers have the third highest prevalence of obesity among 41 male occupational groups in the United States (US). However, few studies have examined the relationship of firefighter working conditions and health behaviors with obesity. This paper presents a theoretical framework describing the relationship between working conditions, health behaviors, and obesity in firefighters. In addition, the paper describes a detailed study plan for exploring the role of occupatio...

Differences in Health Behaviors of Overweight or Obese College Students Compared to Healthy Weight Students

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Harrington, M. Rachel; Ickes, Melinda J.

2016-01-01

Background: Obesity continues to be an epidemic in college students, yet research is warranted to determine whether obesity increases the likelihood of risky health behaviors in this population. Purpose: The purpose of this study was to examine the association between body mass index (BMI) and health behaviors in college students. Methods: A…

Maternal androgen excess and obesity induce sexually dimorphic anxiety-like behavior in the offspring.

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Manti, Maria; Fornes, Romina; Qi, Xiaojuan; Folmerz, Elin; Lindén Hirschberg, Angelica; de Castro Barbosa, Thais; Maliqueo, Manuel; Benrick, Anna; Stener-Victorin, Elisabet

2018-03-22

Maternal polycystic ovary syndrome (PCOS), a condition associated with hyperandrogenism, is suggested to increase anxiety-like behavior in the offspring. Because PCOS is closely linked to obesity, we investigated the impact of an adverse hormonal or metabolic maternal environment and offspring obesity on anxiety in the offspring. The obese PCOS phenotype was induced by chronic high-fat-high-sucrose (HFHS) consumption together with prenatal dihydrotestosterone exposure in mouse dams. Anxiety-like behavior was assessed in adult offspring with the elevated-plus maze and open-field tests. The influence of maternal androgens and maternal and offspring diet on genes implicated in anxiety were analyzed in the amygdala and hypothalamus with real-time PCR ( n = 47). Independent of diet, female offspring exposed to maternal androgens were more anxious and displayed up-regulation of adrenoceptor α 1B in the amygdala and up-regulation of hypothalamic corticotropin-releasing hormone ( Crh). By contrast, male offspring exposed to a HFHS maternal diet had increased anxiety-like behavior and showed up-regulation of epigenetic markers in the amygdala and up-regulation of hypothalamic Crh. Overall, there were substantial sex differences in gene expression in the brain. These findings provide novel insight into how maternal androgens and obesity exert sex-specific effects on behavior and gene expression in the offspring of a PCOS mouse model.-Manti, M., Fornes, R., Qi, X., Folmerz, E., Lindén Hirschberg, A., de Castro Barbosa, T., Maliqueo, M., Benrick, A., Stener-Victorin, E. Maternal androgen excess and obesity induce sexually dimorphic anxiety-like behavior in the offspring.

Weight control behaviors in overweight/obese U.S. adults with diagnosed hypertension and diabetes

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Li Chaoyang

2009-03-01

Full Text Available Abstract Background Obesity is a major risk factor for development and progression of hypertension and diabetes, which often coexist in obese patients. Losing weight by means of energy restriction and physical activity has been effective in preventing and managing these diseases. However, weight control behaviors among overweight/obese adults with these conditions are poorly understood. Methods Using self-reported data from 143,386 overweight/obese participants (aged ≥ 18 years in the 2003 Behavioral Risk Factor Surveillance System, we examined the proportion of overweight/obese adults who tried to lose weight and their weight control strategies by hypertension and/or diabetes status. Results Among all participants, 58% of those with hypertension, 60% of those with diabetes, and 72% of those with both diseases tried to lose weight, significantly higher than the 50% of those with neither condition (Bonferroni corrected P Conclusion The proportion of overweight/obese patients with diagnosed hypertension and/or diabetes who attempted to lose weight remains suboptimal and the weight control strategies varied significantly among these patients.

Healthy-lifestyle behaviors associated with overweight and obesity in US rural children

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Tovar Alison

2012-07-01

Full Text Available Abstract Background There are disproportionately higher rates of overweight and obesity in poor rural communities but studies exploring children’s health-related behaviors that may assist in designing effective interventions are limited. We examined the association between overweight and obesity prevalence of 401 ethnically/racially diverse, rural school-aged children and healthy-lifestyle behaviors: improving diet quality, obtaining adequate sleep, limiting screen-time viewing, and consulting a physician about a child’s weight. Methods A cross-sectional analysis was conducted on a sample of school-aged children (6–11 years in rural regions of California, Kentucky, Mississippi, and South Carolina participating in CHANGE (Creating Healthy, Active, and Nurturing Growing-up Environments Program, created by Save the Children, an independent organization that works with communities to improve overall child health, with the objective to reduce unhealthy weight gain in these school-aged children (grades 1–6 in rural America. After measuring children’s height and weight, we17 assessed overweight and obesity (BMI ≥ 85th percentile associations with these behaviors: improving diet quality18 (≥ 2 servings of fruits and vegetables/day, reducing whole milk, sweetened beverage consumption/day; obtaining19 adequate night-time sleep on weekdays (≥ 10 hours/night; limiting screen-time (i.e., television, video, computer,20 videogame viewing on weekdays (≤ 2 hours/day; and consulting a physician about weight. Analyses were adjusted 21 for state of residence, children's race/ethnicity, gender, age, and government assistance. Results Overweight or obesity prevalence was 37 percent in Mississippi and nearly 60 percent in Kentucky. Adjusting for covariates, obese children were twice as likely to eat ≥ 2 servings of vegetables per day (OR=2.0,95% CI 1.1-3.4, less likely to consume whole milk (OR=0.4,95% CI 0.2-0.70, Their parents are more likely to

Young children and obesity : development and evaluation of familiy-oriented treatment

NARCIS (Netherlands)

Hoek, van E.

2015-01-01

Thesis: Young Children and Obesity – Development and Evaluation of Family-oriented Treatment, Esther van Hoek

Introduction

The prevalence of childhood obesity has increased rapidly during the last decades. Childhood obesity is a multisystem disease with serious consequences such as

Correlates of Healthy Lifestyle Beliefs and Behaviors in Parents of Overweight or Obese Preschool Children Before and After a Cognitive Behavioral Therapy Intervention With Text Messaging.

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Militello, Lisa K; Melnyk, Bernadette Mazurek; Hekler, Eric; Small, Leigh; Jacobson, Diana

2016-01-01

Significant gaps exist in the published literature regarding the treatment of overweight/obesity in preschool-aged children, especially in primary care settings. Parental influence plays an important factor in the development of healthy behaviors in children, yet there is no consensus about why some behavior change intervention strategies for parents of young children are more influential and effective than others. The purpose of this secondary data analysis was to assess correlations among the study variables (healthy lifestyle beliefs, perceived difficulty, and healthy lifestyle behaviors) in parents of overweight/obese preschool children. A second aim explored if the parent's level of cognitive beliefs and perceived difficulty of engaging in healthy lifestyle behaviors correlated with text messaging cognitive behavioral support. Fifteen preschool-parent dyads from primary care clinics completed a 7-week cognitive behavioral skills building intervention. Beck's Cognitive Theory guided the intervention content, and Fogg's Behavior Model guided the implementation. The intervention was delivered using a combination of face-to-face clinic visits and ecological momentary interventions using text messaging. Supported are the interconnected relationships among the study variables, that is, parental healthy lifestyle beliefs, thoughts, and behaviors. At baseline, parental healthy lifestyle belief scores significantly correlated with perceived difficulty (rs = 0.598, p behaviors (rs = 0.545, p cognitive behavioral skills building and tailored text messaging, the need for general support via text messaging lessened, warranting additional research. Published by Elsevier Inc.

Inhibition of the methionine aminopeptidase 2 enzyme for the treatment of obesity

OpenAIRE

Joharapurkar, Amit A; Dhanesha, Nirav A; Jain, Mukul R

2014-01-01

Amit A Joharapurkar, Nirav A Dhanesha, Mukul R Jain Department of Pharmacology and Toxicology, Zydus Research Centre, Cadila Healthcare Limited, Ahmedabad, India Abstract: Worldwide prevalence of obesity has nearly doubled since 1980. Obesity is the result of interactions among the environmental factors, genetic predisposition, and human behavior. Even modest weight reduction in obese patients provides beneficial health outcomes. For effective weight reduction, a drug should either increase ...

The Association of Dietary Behaviors and Physical Activity Levels with General and Central Obesity among ASEAN University Students

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Karl Peltzer

2017-06-01

Full Text Available Objective: To quantify the prevalence of obesity and obesity-related factors (dietary behaviors and physical activity levels in a cross-sectional, observational study of ASEAN undergraduate students. Material and Methods: A total of 6783 (35.5% male and 64.5% female undergraduate students (Mean age: 20.5, SD = 2.0 from eight ASEAN countries completed questionnaires and anthropometric measurements. Multivariable logistic regression was used to estimate odds ratios (ORs for the association of nutrition behaviors with prevalence of general obesity (body mass index ≥ 25 kg/m², elevated waist-to-height ratio (WHtR (>0.50, and high waist circumference (WC (≥80 cm in females, ≥90 cm in males. Covariates included sociodemographic factors, dietary behavior, physical activity and sitting time (using the “International Physical Activity Questionnaire”. Results: There was a higher prevalence of general obesity (24.2% versus 9.3%, and high WHtR (16.6% versus 12.1 in males relative to females, while high WC (9.4% versus 10.4% did not significantly differ between genders. In multivariable logistic regression analyses, compared to females, males had higher odds of obesity (odds-ratio, OR: 2.13, confidence interval, CI: 1.80, 2.77, and high WHtR (OR: 1.90, CI: 1.48, 2.43 (P < 0.001 for both. Snacking frequency and avoiding fatty foods were associated with all three obesity indicators; obesity (OR: 1.16, CI: 1.05, 1.28 and OR: 1.54, CI: 1.24, 1.92, respectively, WHtR (OR: 1.17, CI: 1.04, 1.32 and OR: 1.46, CI: 1.04, 1.54, and high WC (OR: 1.16, CI: 2.01, 1.33 and OR 1.52, CI: 1.14, 2.04, respectively. Physical activity and sedentary behavior were not significantly associated with any obesity measure. Conclusions: There was a low prevalence of healthy behaviors and a high prevalence of obesity in this sample of ASEAN young adults. Specific dietary behaviors but not physical activity nor sedentary behavior were associated with obesity.

Invited Commentary: Childhood and Adolescent Obesity--Psychological and Behavioral Issues in Weight Loss Treatment

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Sarwer, David B.; Dilks, Rebecca J.

2012-01-01

The prevalence of childhood and adolescent obesity has tripled in the past three decades. This increase has been accompanied by a dramatic rise in obesity-related health complications among American youth. Thus, many obese youth are now experiencing illnesses that will threaten their life expectancy in the absence of significant weight loss.…

Young Adults' Attitudes and Perceptions of Obesity and Weight Management: Implications for Treatment Development.

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Lanoye, Autumn; Gorin, Amy A; LaRose, Jessica Gokee

2016-03-01

Young adults are underrepresented in standard behavioral weight loss trials, and evidence suggests that they differ from older adults on many weight-related constructs. The aim of this review is to explore young adults' attitudes toward obesity and weight management, with particular attention to those factors that may play a role in the development of future treatment efforts. Both intrapersonal and interpersonal considerations unique to young adulthood are assessed; in addition, we examine young adults' perceptions of specific weight-related behaviors such as dieting, physical activity, and self-weighing. Conclusions are consistent with other findings suggesting that weight management interventions should be adapted and designed specifically for this age group.

Young Adults’ Attitudes and Perceptions of Obesity and Weight Management: Implications for Treatment Development

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Lanoye, Autumn; Gorin, Amy A.; LaRose, Jessica Gokee

2017-01-01

Young adults are underrepresented in standard behavioral weight loss trials, and evidence suggests that they differ from older adults on many weight related constructs. The aim of this review is to explore young adults’ attitudes toward obesity and weight management, with particular attention to those factors that may play a role in development of future treatment efforts. Both intrapersonal and interpersonal considerations unique to young adulthood are assessed; in addition, we examine young adults’ perceptions of specific weight-related behaviors such as dieting, physical activity, and self-weighing. Conclusions are consistent with other findings suggesting that weight management interventions should be adapted and designed specifically for this age group. PMID:26923688

One-Year Behavioral Treatment of Obesity: Comparison of Moderate and Severe Caloric Restriction and the Effects of Weight Maintenance Therapy.

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Wadden, Thomas A.; And Others

1994-01-01

Compared weight losses of 49 obese women assigned to 52-week behavioral program combined with moderate or severe caloric restriction. Those in severe caloric restriction group lost significantly more weight during first 26 weeks but regained some weight. Reports of binge eating declined in both groups, and no relationship was observed between…

[Treatment of obesity in a hospital endocrinology clinic. Influence of parental body mass index].

Science.gov (United States)

Regueras Santos, L; Díaz Moro, A; Iglesias Blázquez, C; Rodríguez Fernández, C; Quiroga González, R; de Paz Fernández, J A; Rodríguez Fernández, L M

2015-11-01

Parental obesity is a risk factor for childhood obesity. The aim of this study was to determine if parental obesity influences the adherence and success of obesity treatment in a hospital paediatric endocrinology clinic. An analytical, prospective, longitudinal study was conducted on obese children aged 4-14. An initial body mass index (BMI), and again at 6 months after receiving health, hygiene and dietary recommendations. Success was considered as a decrease of 0.5 in the BMI Z-score, and adherence to attending the 6-month review. Parental BMI was determined to identify overweight. The χ(2) test was used for qualitative variables and the T-Student test for quantitative (significance, p3). More than half (59%) of the children had one or both parents obese (41 fathers and 37 mothers were obese). Treatment was not adhered to by 25 children. Adherence was worse if both parents were obese OR 3.65 (1.3 to 10.5) (P<=.01) and adherence was better if the mother was not obese, although the father was (P=.01). The treatment had significant success in 40 patients. If the mother was the only obese one in the family, the possibility of treatment failure was greater OR 5.6 (1.4 to 22.4) (P<.01) CONCLUSIONS: A high percentage of children with severe obesity have obese parents. The mother has an important influence on adherence and response to treatment for the severely obese child. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

Obesity Moderates the Effects of Motivational Interviewing Treatment Outcomes in Fibromyalgia.

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Kaleth, Anthony S; Slaven, James E; Ang, Dennis C

2018-01-01

Obesity is a common comorbid condition among patients with fibromyalgia (FM). Our objective was to assess if obesity moderates the treatment benefits of exercise-based motivational interviewing (MI) for FM. This is a secondary data analysis of a completed clinical trial of 198 FM patients who were randomized to receive either MI or attention control (AC). Using body mass index (BMI) to divide participants into obese (BMI≥30 kg/m) and nonobese (BMIFibromyalgia Impact Questionnaire, FIQ). Secondary measures included pain intensity (Brief Pain Inventory), 6-Minute Walk Test, and self-reported physical activity (Community Health Activities Model Program for Seniors). Of the 198 participants, 91 (46%) were nonobese and 107 (54%) were obese. On global FM symptom severity (FIQ), the interaction between treatment arms and obesity status was significant (P=0.02). In the nonobese group, MI was associated with a greater improvement in FIQ than AC. In the obese group, MI participants reported less improvement in FIQ compared with AC. The interaction analysis was also significant for Brief Pain Inventory pain intensity (P=0.01), but not for the walk test and self-reported physical activity. This is the first study to show that obesity negatively affects the treatment efficacy of MI in patients with FM. Our findings suggest that exercise-based MI may be more effective if initiated after weight loss is achieved.

[Association of physical activities, sedentary behaviors with overweight/obesity in 9-11 year-old Chinese primary school students].

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Chen, L; Li, Q; Song, Y; Ma, J; Wang, H J

2016-06-18

To explore the association of physical activities, sedentary behaviors with overweight/obesity in Chinese children aged 9-11 years, analyze the gender difference and heterogeneity of the association across different provinces, and provide evidence for prevention and control of overweight and obesity. Using the data of 40 692 children aged 9-11 years from Chinese National Survey on Students' Constitution and Health in 2010, the height and weight were measured and the time spent in physical activities, screen behaviors and homework were collected. We analyzed the associations among physical activities, sedentary behaviors and overweight/obesity in boys and girls separately, and assessed the heterogeneity of associations across different provinces with Meta-analysis. The prevalence of overweight/obesity of the boys (27.1%) was higher than that of the girls (12.9%), compared with the rural students (15.6%), the situation of overweight/obesity of the urban students (23.8%) was more serious, the prevalences of overweight/obesity were separately 22.6%, 19.2% and 17.5% among developed, middle-developed and undeveloped social economic status subgroups. The boys with physical activities no more than 1 hour per day were more likely to be overweight/obese, with the OR of 1.09 (95%CI: 1.02, 1.17). The girls with screen time more than 1 hour per day or homework time more than 2 hours per day were more likely to be overweight/obese, with the ORs of 1.13 (95%CI: 1.02, 1.26) and 1.18 (95%CI: 1.03, 1.35) respectively. The high level of sedentary behaviors (more than 135 min per day) was associated with overweight/obese in the girls, and the OR was 1.19 (95%CI: 1.08, 1.33). There was no significant heterogeneity of effect values between physical activities and overweight/obesity in the boys and between sedentary behaviors and overweight/obesity in the girls across the different provinces (P> 0.05). The associations among physical activities, sedentary behaviors and overweight/obesity

School-Based Obesity-Prevention Policies and Practices and Weight-Control Behaviors among Adolescents.

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Larson, Nicole; Davey, Cynthia S; Caspi, Caitlin E; Kubik, Martha Y; Nanney, Marilyn S

2017-02-01

The promotion of healthy eating and physical activity within school settings is an important component of population-based strategies to prevent obesity; however, adolescents may be vulnerable to weight-related messages, as rapid development during this life stage often leads to preoccupation with body size and shape. This study examines secular trends in secondary school curricula topics relevant to the prevention of unhealthy weight-control behaviors; describes cross-sectional associations between weight-related curricula content and students' use of weight-control behaviors; and assesses whether implementation of school-based obesity-prevention policies/practices is longitudinally related to students' weight-control behaviors. The Minnesota School Health Profiles and Minnesota Student Survey (grades 9 and 12) data were used along with National Center for Education Statistics data to examine secular trends, cross-sectional associations (n=141 schools), and longitudinal associations (n=42 schools). Students self-reported their height and weight along with past-year use of healthy (eg, exercise), unhealthy (eg, fasting), and extreme (eg, use laxatives) weight-control behaviors. Descriptive statistics, generalized estimating equations, and generalized linear regression models accounting for school-level demographics. There was no observable pattern during the years 2008 to 2014 in the mean number of curricula topics addressing unhealthy weight-control behaviors, despite an increase in the prevalence of curricula addressing acceptance of body-size differences. Including three vs fewer weight-control topics and specifically including the topic of eating disorders in the curricula was related to a lower school-level percent of students using any extreme weight-control behaviors. In contrast, an overall measure of implementing school-based obesity-prevention policies/practices (eg, prohibited advertising) was unrelated to use of unhealthy or extreme behaviors

Treatment-Associated Changes in Body Composition, Health Behaviors, and Mood as Predictors of Change in Body Satisfaction in Obese Women: Effects of Age and Race/Ethnicity

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Annesi, James J.; Tennant, Gisèle A.; Mareno, Nicole

2014-01-01

A lack of satisfaction with one's body is common among women with obesity, often prompting unhealthy "dieting." Beyond typically slow improvements in weight and body composition, behavioral factors might also affect change in body satisfaction. Age and race/ethnicity (African American vs. White) might moderate such change. Obese women (N…

Hypothalamic obesity after craniopharyngioma: mechanisms, diagnosis, and treatment

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Robert H. Lustig

2011-11-01

Full Text Available Obesity is a common complication after craniopharyngioma therapy, occurring in up to 75% of survivors. Its weight gain is unlike that of normal obesity, in that it occurs even with caloric restriction, and attempts at lifestyle modification are useless to prevent or treat the obesity. The pathogenesis of this condition involves the inability to transduce afferent hormonal signals of adiposity, in effect mimicking a state of CNS starvation. Efferent sympathetic activity drops, resulting in malaise and reduced energy expenditure, and vagal activity increases, resulting in increased insulin secretion and adipogenesis. Lifestyle intervention is essentially useless in this syndrome, termed hypothalamic obesity. Pharmacologic treatment is also difficult, consisting of adrenergics to mimic sympathetic activity, or suppression of insulin secretion with octreotide, or both. Recently, bariatric surgery (Roux-en-Y gastric bypass, laparoscopic gastric banding, truncal vagotomy have also been attempted with variable results. Early and intensive management is required to mitigate the obesity and its negative consequences.

Sedentary behavior and psychiatric symptoms in overweight and obese adults with schizophrenia and schizoaffective disorders (WAIST Study).

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Janney, Carol A; Ganguli, Rohan; Richardson, Caroline R; Holleman, Rob G; Tang, Gong; Cauley, Jane A; Kriska, Andrea M

2013-04-01

Examine the association between sedentary behavior and psychiatric symptoms among overweight and obese adults with schizophrenia or schizoaffective disorders (SZO/SA). Randomized clinical trial; Weight Assessment and Intervention in Schizophrenia Treatment (WAIST) Study: baseline data collected 2005-2008. University of Pittsburgh Medical Center, Pittsburgh, PA, USA. Community-dwelling adults diagnosed with SZO/SA, with mild symptom severity [Positive and Negative Syndrome Scale (PANSS)losing weight, age 18-70years, BMI>27kg/m(2). Objectively measured sedentary behavior by accelerometry, and psychopathology assessed by PANSS. Participants wore the actigraphs for 7 consecutive days during their waking hours. Sedentary behavior was defined as ≤100 counts per minute during wear-time and excluded sleep and non-wear time. On average, 81% of the participant's monitoring time or 756min/day was classified as sedentary behavior using accelerometry. No association was observed between sedentary behaviors and PANSS psychiatric symptoms [total (p≥0.75), positive (p≥0.81), negative (p≥0.59) and general psychopathology (p≥0.65) subscales]. No association was observed between sedentary behaviors and age, race, gender and BMI. From a clinical and public health perspective, the amount of time (approximately 13h) and percentage of time (81% excluding non-wear time associated with sleeping) engaged in sedentary behavior among overweight and obese adults in this population is alarming, and points to an urgent need for interventions to decrease sedentary behaviors. The lack of associations between sedentary behavior and psychiatric symptoms may be due to a ceiling effect for sedentary behavior. Copyright © 2013 Elsevier B.V. All rights reserved.

Overweight and Obesity in Children and Adolescents

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Koyuncuoğlu Güngör, Neslihan

2014-01-01

Obesity among children, adolescents and adults has emerged as one of the most serious public health concerns in the 21st century. The worldwide prevalence of childhood obesity has increased remarkably over the past 3 decades. The growing prevalence of childhood obesity has also led to appearance of obesity-related comorbid disease entities at an early age. Childhood obesity can adversely affect nearly every organ system and often causes serious consequences, including hypertension, dyslipidemia, insulin resistance, dysglycemia, fatty liver disease and psychosocial complications. It is also a major contributor to increasing healthcare expenditures. For all these reasons, it is important to prevent childhood obesity as well as to identify overweight and obese children at an early stage so they can begin treatment and attain and maintain a healthy weight. At present, pharmacotherapy options for treatment of pediatric obesity are very limited. Therefore, establishing a comprehensive management program that emphasizes appropriate nutrition, exercise and behavioral modification is crucial. The physician’s role should expand beyond the clinical setting to the community to serve as a role model and to advocate for prevention and early treatment of obesity. PMID:25241606

CARDIAC AND BEHAVIORAL-RESPONSES OF LONG-TERM OBESE AND LEAN ZUCKER RATS TO EMOTIONAL-STRESS

NARCIS (Netherlands)

NYAKAS, C; BALKAN, B; STEFFENS, AB; BOHUS, B

1995-01-01

Obesity is known as a risk factor in stress-related cardiovascular pathology in man. The length of obesity can be an important interacting variable. Therefore, cardiac and behavioral responses to emotional stress were studied in 1-year-old, genetically obese (fa/fa) and lean (Fa/-) male Zucker rats,

Effectiveness of Parents-Focused Cognitive-Behavioral Therapy on Attention Deficit Hyperactivity Disorder Symptoms, Obesity and Self-Esteem of Overweight Children with Attention Deficient Hyperactivity Disorder.

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Karbasi Amel, Afsaneh; Karbasi Amel, Saeed; Erfan, Arefeh

2018-01-01

Attention deficit hyperactivity disorder (ADHD) is the most common behavioral problems that cause hyperactivity, attention deficits, academic failure, and emotional and behavioral problems in preschool and elementary school that is often hidden from the parents' eyes. The aim of this study was to determine the effectiveness of parent-based cognitive-behavioral therapy (CBT) on ADHD symptoms (including attention deficit disorder, restlessness, and impulsivity), overweight and self-esteem of 6-11-year-old obese children with attention deficit hyperactivity in Isfahan. This quasi-experimental study was carried out on 40 children aged 6-11 years with ADHD and overweight or obesity (above the 85 th percentile in weight for age, height, and sex diagram) that their parents referred to Isfahan child and adolescent psychiatric clinic of Ali Asghar Hospital in 2015. For twenty patients, only ADHD treatment was applied, and they received no other intervention, but the others in experimental group participated in CBT sessions. Analysis tools were Coppersmith Self-Esteem Scale, ADHD conners' test, and the body mass index (BMI). Data were analyzed using analysis of variance with repeated measurements. CBT by teaching parents had a significant effect on ADHD symptoms, the self-esteem of overweight and obese children with ADHD in posttest and follow-up. The results also showed that had a significant effect on ADHD symptoms, overweight and self-esteem of the obese children with ADHD ( P < 0.001). Parents focused CBT can be considered as a complementary treatment for reducing ADHD symptoms and BMI and increased self-esteem in the obese ADHD children.

The Role of Sympatho-Inhibition in Combination Treatment of Obesity-Related Hypertension.

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Carnagarin, Revathy; Gregory, Cynthia; Azzam, Omar; Hillis, Graham S; Schultz, Carl; Watts, Gerald F; Bell, Damon; Matthews, Vance; Schlaich, Markus P

2017-10-28

Obesity-related hypertension is commonly characterized by increased sympathetic nerve activity and is therefore acknowledged as a predominantly neurogenic form of hypertension. The sustained sympatho-excitation not only contributes to the rise in blood pressure but also elicits a vicious cycle which facilitates further weight gain and progression of associated co-morbidities. While weight loss and exercise remain at the forefront of therapy for obesity and obesity-related hypertension, the difficulties in achieving and maintaining long-term weight loss with lifestyle measures and the variable blood pressure response to weight loss often necessitate prescription of antihypertensive drug therapy. Remarkably, there are no specific recommendations for pharmacologic treatment for obese patients with arterial hypertension in any of the current guidelines and general principles of antihypertensive treatment are applied. The use of β-blockers and diuretics is commonly discouraged as first- or second-line therapy due to their unfavorable metabolic effects. This review explores evolving therapeutic strategies which based on their interference with pathophysiologic mechanism relevant in the context of obesity may guide optimized treatment of obesity-related hypertension.

Mediation and modification of genetic susceptibility to obesity by eating behaviors.

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de Lauzon-Guillain, Blandine; Clifton, Emma Ad; Day, Felix R; Clément, Karine; Brage, Soren; Forouhi, Nita G; Griffin, Simon J; Koudou, Yves Akoli; Pelloux, Véronique; Wareham, Nicholas J; Charles, Marie-Aline; Heude, Barbara; Ong, Ken K

2017-10-01

Background: Many genetic variants show highly robust associations with body mass index (BMI). However, the mechanisms through which genetic susceptibility to obesity operates are not well understood. Potentially modifiable mechanisms, including eating behaviors, are of particular interest to public health. Objective: Here we explore whether eating behaviors mediate or modify genetic susceptibility to obesity. Design: Genetic risk scores for BMI (BMI-GRSs) were calculated for 3515 and 2154 adults in the Fenland and EDEN (Etude des déterminants pré et postnatals de la santé et du développement de l'enfant) population-based cohort studies, respectively. The eating behaviors-emotional eating, uncontrolled eating, and cognitive restraint-were measured through the use of a validated questionnaire. The mediating effect of each eating behavior on the association between the BMI-GRS and measured BMI was assessed by using the Sobel test. In addition, we tested for interactions between each eating behavior and the BMI-GRS on BMI. Results: The association between the BMI-GRS and BMI was mediated by both emotional eating (EDEN: P- Sobel = 0.01; Fenland: P- Sobel = 0.02) and uncontrolled eating (EDEN: P- Sobel = 0.04; Fenland: P -Sobel = 0.0006) in both sexes combined. Cognitive restraint did not mediate this association ( P -Sobel > 0.10), except among EDEN women ( P -Sobel = 0.0009). Cognitive restraint modified the relation between the BMI-GRS and BMI among men (EDEN: P -interaction = 0.0001; Fenland: P -interaction = 0.04) and Fenland women ( P -interaction = 0.0004). By tertiles of cognitive restraint, the association between the BMI-GRS and BMI was strongest in the lowest tertile of cognitive restraint, and weakest in the highest tertile. Conclusions: Genetic susceptibility to obesity was partially mediated by the "appetitive" eating behavior traits (uncontrolled and emotional eating) and, in 3 of the 4 population groups studied, was modified by cognitive restraint

Obesity and Surgical Treatment – A Cost-Effectiveness Assessment for Sweden

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Sixten Borg

2014-07-01

Full Text Available Background:The rising trend in the prevalence of obesity has during the past decades become a major public health concern in many countries, as obesity may lead to comorbidities and death. A frequent used marker for obesity is the Body Mass Index (BMI. The cost of treatment for obesity related diseases has become a heavy burden on national health care budget in many countries. While diet and exercise are the cornerstones of weight management, pharmaco­therapy is often needed to achieve and maintain desired weight loss.  In some cases of extreme obesity, bariatric surgery may be recommended. It is expected to increase by 50% in Sweden.Objective: The overall objective was to develop a cost-effectiveness model using the best available evidence to assess the cost-effectiveness of gastric bypass (GBP surgical treatments for obesity in adult patients, in comparison with conventional treatment (CT, in Sweden from a healthcare perspective. With the model we also seeked to identify the lower cut-off point using BMI criteria, for the surgical intervention to be cost-effective. Methods:A micro-simulation model with an underlying Markov methodology was developed, that simulates individual patients. It simulates the outcomes of the patients in terms of treatment costs, life years, and quality adjusted life years (QALY over his/her remaining lifetime. The costs are presented in SEK in the year 2006 price level (1 SEK ≈ 0.11 EUR ≈ 0.14 USD.Results: We estimated that the incremental cost per QALY gained will not exceed SEK 33,000 per QALY in patients with BMI < 35. In patients with BMI > 35 kg/m2, gastric bypass surgery has lower costs compared to conventional treatment. Conclusion: Gastric bypass surgery is a cost-effective intervention compared to conventional treatment consisting of watchful waiting, diet and exercise.

Eating behaviors in obese children with pseudohypoparathyroidism type 1a: a cross-sectional study.

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Wang, Lulu; Shoemaker, Ashley H

2014-01-01

Children with pseudohypoparathyroidism type 1a (PHP-1a) develop early-onset obesity. These children have decreased resting energy expenditure but it is unknown if hyperphagia contributes to their obesity. We conducted a survey assessment of patients 2 to 12 years old with PHP-1a and matched controls using the Hyperphagia Questionnaire (HQ) and Children's Eating Behavior Questionnaire (CEBQ). Results of the PHP-1a group were also compared with an obese control group and normal weight sibling group. We enrolled 10 patients with PHP-1a and 9 matched controls. There was not a significant difference between the PHP-1a group and matched controls for total HQ score (p = 0.72), Behavior (p = 0.91), Drive (p = 0.48) or Severity (p = 0.73) subset scores. There was also no difference between the PHP-1a group and matched controls on the CEBQ. In a secondary analysis, the PHP-1a group was compared with obese controls (n = 30) and normal weight siblings (n = 6). Caregivers reported an increased interest in food before age 2 years in 6 of 10 PHP-1a patients (60%), 9 of 30 obese controls (30%) and none of the siblings (p = 0.04). The sibling group had a significantly lower Positive Eating Behavior score than the PHP-1a group (2.6 [2.4, 2.9] vs. 3.5 [3.1, 4.0], p PHP-1a and obese controls (p = 0.35). The sibling group had a lower Desire to Drink score than both the PHP-1a group (1.8 [1.6, 2.7] vs. 4.3 [3.3, 5.0], p PHP-1a and obese control Desire to Drink scores (p = 0.11). Patients with PHP-1a demonstrate hyperphagic symptoms similar to matched obese controls.

Exploring Occupational and Behavioral Risk Factors for Obesity in Firefighters: A Theoretical Framework and Study Design

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BongKyoo Choi

2011-12-01

Full Text Available Firefighters and police officers have the third highest prevalence of obesity among 41 male occupational groups in the United States (US. However, few studies have examined the relationship of firefighter working conditions and health behaviors with obesity. This paper presents a theoretical framework describing the relationship between working conditions, health behaviors, and obesity in firefighters. In addition, the paper describes a detailed study plan for exploring the role of occupational and behavioral risk factors in the development of obesity in firefighters enrolled in the Orange County Fire Authority Wellness Fitness Program. The study plan will be described with emphasis on its methodological merits: adopting a participatory action research approach, developing a firefighter-specific work and health questionnaire, conducting both a cross-sectional epidemiological study using the questionnaire and a sub-study to assess the validity of the questionnaire with dietary intake and physical activity measures, and evaluating the strengths and weaknesses of the body mass index as an obesity measure in comparison to skinfold-based percent body fat. The study plan based on a theoretical framework can be an essential first step for establishing effective intervention programs for obesity among professional and voluntary firefighters.

A parent focused child obesity prevention intervention improves some mother obesity risk behaviors: the Melbourne infant program

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Lioret Sandrine

2012-08-01

Full Text Available Abstract Background The diets, physical activity and sedentary behavior levels of both children and adults in Australia are suboptimal. The family environment, as the first ecological niche of children, exerts an important influence on the onset of children’s habits. Parent modeling is one part of this environment and a logical focus for child obesity prevention initiatives. The focus on parent’s own behaviors provides a potential opportunity to decrease obesity risk behaviors in parents as well. Objective To assess the effect of a parent-focused early childhood obesity prevention intervention on first-time mothers’ diets, physical activity and TV viewing time. Methods The Melbourne InFANT Program is a cluster-randomized controlled trial which involved 542 mothers over their newborn’s first 18 months of life. The intervention focused on parenting skills and strategies, including parental modeling, and aimed to promote development of healthy child and parent behaviors from birth, including healthy diet, increased physical activity and reduced TV viewing time. Data regarding mothers’ diet (food frequency questionnaire, physical activity and TV viewing times (self-reported questionnaire were collected using validated tools at both baseline and post-intervention. Four dietary patterns were derived at baseline using principal components analyses including frequencies of 55 food groups. Analysis of covariance was used to measure the impact of the intervention. Results The scores of both the "High-energy snack and processed foods" and the "High-fat foods" dietary patterns decreased more in the intervention group: -0.22 (−0.42;-0.02 and −0.25 (−0.50;-0.01, respectively. No other significant intervention vs. control effects were observed regarding total physical activity, TV viewing time, and the two other dietary patterns, i.e. “Fruits and vegetables” and “Cereals and sweet foods”. Conclusions These findings suggest that

Effects of a Family-Based Childhood Obesity Treatment Program on Parental Weight Status.

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Trier, Cæcilie; Dahl, Maria; Stjernholm, Theresa; Nielsen, Tenna R H; Bøjsøe, Christine; Fonvig, Cilius E; Pedersen, Oluf; Hansen, Torben; Holm, Jens-Christian

2016-01-01

The aim of this study was to investigate the prevalence of overweight/obesity among parents of children entering childhood obesity treatment and to evaluate changes in the parents' weight statuses during their child's treatment. The study included parents of 1,125 children and adolescents aged 3-22 years, who were enrolled in a multidisciplinary childhood obesity treatment program. At baseline, weight and height of the parents were obtained by self-reported information and parental body mass index (BMI) was calculated. Weight and height of the children were measured in the clinic and BMI standard deviation scores were calculated. Furthermore, anthropometric data from parents of 664 children were obtained by telephone interview after a mean of 2.5 years of treatment (ranging 16 days to 7 years), and changes in parental BMI were analyzed. Data on changes in BMI were available in 606 mothers and 479 fathers. At baseline, the median BMI of the mothers was 28.1 kg/m2 (range: 16.9-66.6), and the median BMI of the fathers was 28.9 kg/m2 (range: 17.2-48.1). Seventy percent of the mothers and 80% of the fathers were overweight or obese at the time of their child's treatment initiation. Both the mothers and fathers lost weight during their child's treatment with a mean decrease in BMI in the mothers of 0.5 (95% CI: 0.2-0.8, p = 0.0006) and in the fathers of 0.4 (95% CI: 0.2-0.6, p = 0.0007). Of the overweight/obese parents, 60% of the mothers and 58% of the fathers lost weight during their child's treatment. There is a high prevalence of overweight/obesity among parents of children entering childhood obesity treatment. Family-based childhood obesity treatment with a focus on the child has a positive effect on parental BMI with both mothers and fathers losing weight. ClinicalTrials.gov NCT00928473.

Patterns of movement behaviors and their association with overweight and obesity in youth.

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Carson, Valerie; Faulkner, Guy; Sabiston, Catherine M; Tremblay, Mark S; Leatherdale, Scott T

2015-07-01

To identify underlying subgroups based on patterns of physical activity, screen-based sedentary behavior, and sleep in a large sample of Canadian youth and to examine the associations between the identified subgroups and overweight and obesity. The study is based on 19,831 youth aged 13-18 years from across Ontario, Canada in the COMPASS study. Participants self-reported their movement behaviors (i.e., physical activity, sedentary behavior and sleep), height and weight, and demographics. Latent class analysis and logistic regression models were conducted. Three underlying subgroups were identified in the total sample and male and female subsamples (i.e., unhealthiest movers, active screenies, healthiest movers). In the total sample, the active screenies subgroup was 1.19 (95 % CI 1.09-1.29) times and the unhealthiest movers subgroup was 1.24 (1.14-1.36) times more likely to be classified as overweight/obese compared to the healthiest movers subgroup. Similar associations were observed in the female subsample but not in the male subsample. Public health interventions targeting youth subgroups at increased risk of overweight and obesity through integrated approaches accounting for multiple movement behaviors should be considered, especially for females.

Pathogenesis and pharmacologic treatment of obesity: the role of energy regulatory mechanism.

Science.gov (United States)

Manulu, Mangatas S M; Sutanegara, I N Dwi

2006-01-01

Obesity has become a worldwide public health problem affecting millions of people. This is a chronic, stigmatized, and costly disease, rarely curable and is increasing in prevalence to a point today where we define obesity as an epidemic disease that not only in developed but also on developing countries. The pathogenesis of obesity is largely unknown, especially about energy regulatory mechanism that involved wide area of neuroendocrinology that is very interesting but very complex and makes internists "refuse" to learn. Obesity occurs through a longstanding imbalance between energy intake and energy expenditure, influenced by a complex biologic system that regulates appetite and adiposity. Obesity influences the pathogenesis of hypertension, type 2 diabetes, dyslipidemia, kidney, heart, and cerebrovascular disease. It is very wise for every internist to learn the pathogenesis and treatment of this worldwide diseases. Until now, the available treatments, including drugs, are palliative and are effective only while the treatment is being actively used; and besides so many side effects reported.

THE ROLE OF MULTIFACTORIAL APPROACH TO TREATMENT OF OBESITY IN FEMALES

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O. L. Andrianova

2015-01-01

Full Text Available Background: Obesity is characterized by an increased risk of diabetes mellitus, coronary heart disease, arterial hypertension and reproductive system disorders, which makes it necessary to implement multifactorial correction of metabolic disturbances.Aim: To analyze diet intake structure of patients with obesity, efficacy and safety of sibutramine monotherapy and sibutramine/metformin combination therapy in the formation of adequate nutritional stereotypes and reduction of bodyweight.Materials and methods: Eighty-two obese women aged 18 to 49 years (mean age 29.7±5.7 years were included into this observational study. Inclusion criteria: women aged 18 to 49 years, with waist circumference>80 cm, body mass index (BMI>27 kg/m², triglyceride level>1.7  mmol/L and/or low-density lipoprotein cholesterol>3.8  mmol/L, and/or high-density lipoprotein cholesterol<1.29 mmol/L. Exclusion criteria in this study were presence of severe somatic and endocrine disorders. The control group consisted of 35 healthy women aged 18 to 49 years (mean age 28.7±5.6 years. All patients were recruited within the observational program PrimaVera. Results: Analysis of dietary intake in female obese patients showed an excess of daily energy intake of 650±250 kcal compared to that in subjects with normal BMI and normal waist circumference. Seventy one percent of patients had excessive expectations from treatment duration and desired weight loss. For control of their eating behavior, 52 patients were administered Reduxin® (sibutramine+cellulose microcristallic 10 mg daily. Other 30 patients (24 women with a history of carbohydrate metabolism disturbances during pregnancy and 6 women who had delivered babies with birth weight of above4 kg were administered Reduxin® 10 mg and metformin 500  mg daily, with weekly dose increase by 500  mg to the final dose of 1500 mg daily. The treatment lasted for 24  weeks. Daily caloric intake decreased by 24±4% from baseline (p<0

Features of eating behavior, emotional state and metabolic parameters in obese patients with insomnia

Directory of Open Access Journals (Sweden)

2014-06-01

Full Text Available Aim. The aim of this study was to investigate the influence of insomnia on eating behavior, anxiety, depression, metabolic and hormonal parameters in obese patients. Materials and Methods. The study involved 104 patients with primary obesity from 20 to 55 years old: 47 men and 57 women, mean age 39 years, mean body weight 118 kg, BMI 39.6. Patients were divided into 2 groups: the first group consisted of patients with complaints of insomnia (n=45, the second (control group (n=59 were patients without sleep disorders. Results. Mean levels of anxiety and depression were significantly higher in the first group. The results of research showed a statistically significant association emotional eating and insomnia. Patients with chronic insomnia without obstructive sleep apnea had low levels of free cortisol in 24-hour urinary compared with patients without sleep disorders (169 [145, 194] vs. 324 [244, 330], respectively, p=0.001, positive correlation with total sleep time, sleep efficiency, and negative with wake time during sleep period time. Conclusions. Sleep disorders in obese patients are one of the factors contributing to the increase in food intake in response to changes in emotional state on the background of "hidden" anxiety and depressive disorders. It is possible that the data eating disorders and psychological status may have a negative impact on the dynamics of weight during the treatment of obesity.

Effects of a family-based childhood obesity treatment program on parental weight status

DEFF Research Database (Denmark)

Trier, Cæcilie; Dahl, Maria; Stjernholm, Theresa

2016-01-01

during their child's treatment. Conclusion: There is a high prevalence of overweight/obesity among parents of children entering childhood obesity treatment. Family-based childhood obesity treatment with a focus on the child has a positive effect on parental BMI with both mothers and fathers losing weight...... available in 606 mothers and 479 fathers. At baseline, the median BMI of the mothers was 28.1 kg/m2 (range: 16.9-66.6), and the median BMI of the fathers was 28.9 kg/m2 (range: 17.2-48.1). Seventy percent of the mothers and 80% of the fathers were overweight or obese at the time of their child's treatment...... initiation. Both the mothers and fathers lost weight during their child's treatment with a mean decrease in BMI in the mothers of 0.5 (95% CI: 0.2-0.8, p = 0.0006) and in the fathers of 0.4 (95% CI: 0.2-0.6, p = 0.0007). Of the overweight/obese parents, 60% of the mothers and 58% of the fathers lost weight...

Unhealthy weight control behaviors mediate the association between weight status and weight-specific health-related quality of life in treatment-seeking youth who are obese.

Science.gov (United States)

Lim, Crystal S; Gowey, Marissa A; Cohen, Megan J; Silverstein, Janet; Janicke, David M

2017-03-01

Examine whether unhealthy and extreme weight control behaviors (WCBs) mediate the relationship between youth weight status and disease-specific health-related quality of life (HRQOL) in treatment-seeking youth who are overweight and obese (OV/OB). 82 youth 10-17 years of age who were OV/OB and attending an outpatient obesity-related medical appointment completed measures assessing unhealthy and extreme WCBs and disease-specific HRQOL. Parents completed a demographic questionnaire and medical staff measured youth height and weight. Regression analyses revealed that unhealthy WCBs mediated the associations between youth weight status and emotional and social avoidance disease-specific HRQOL, such that higher body mass index (BMI) predicted unhealthy WCBs, which were ultimately associated with poorer emotional and social HRQOL. Mediation analyses were not significant for total, physical, teasing/marginalization, and positive attributes disease-specific HRQOL. In addition, extreme WCBs did not mediate the association between youth weight status and any subscales of the disease-specific HRQOL measure. Weight status is an important predictor of disease-specific HRQOL in OV/OB youth; however, the association with emotional and social HRQOL is partially accounted for by youth engagement in unhealthy WCBs. Clinicians and researchers should assess WCBs and further research should explore and evaluate appropriate intervention strategies to address unhealthy WCBs in pediatric weight management prevention and treatment efforts.

New insights into the field of children and adolescents' obesity

DEFF Research Database (Denmark)

Flodmark, C-E; Lissau, I; Moreno, L A

2004-01-01

information about healthy nutrition and to avoid the marketing of unhealthy foods including sweet drinks, for example, in TV. Many different approaches of treatments of obesity have been investigated, including diet, exercise, behavioral therapy, surgery, and medication. None have been found to be effective......EDITOR'S NOTE: The problem of childhood obesity is accelerating throughout the world. The following is a position paper from The European Childhood Obesity Group (ECOG) that outlines the nature of the problem of childhood obesity along with treatment and prevention methods available today....... The paucity of literature on prevention and treatment of obesity in children as documented in this paper points out the need for much additional research on obesity in children. OBJECTIVES: The awareness of childhood obesity as a major health problem and an uncontrolled worldwide epidemic has to be increased...

Physical exercise ameliorates mood disorder-like behavior on high fat diet-induced obesity in mice.

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Park, Hye-Sang; Lee, Jae-Min; Cho, Han-Sam; Park, Sang-Seo; Kim, Tae-Woon

2017-04-01

Obesity is associated with mood disorders such as depression and anxiety. The aim of this study was to investigate whether treadmill exercise had any benefits on mood disorder by high fat diet (HFD) induced obesity. Mice were randomly divided into four groups: control, control and exercise, high fat diet (HFD), and HFD and exercise. Obesity was induced by a 20-week HFD (60%). In the exercise groups, exercise was performed 6 times a week for 12 weeks, with the exercise duration and intensity gradually increasing at 4-week intervals. Mice were tested in tail suspension and elevated plus maze tasks in order to verify the mood disorder like behavior such as depression and anxiety on obesity. In the present study, the number of 5-HT- and TPH-positive cells, and expression of 5-HT 1A and 5-HTT protein decreased in dorsal raphe, and depression and anxiety like behavior increased in HFD group compared with the CON group. In contrast, treadmill exercise ameliorated mood disorder like behavior by HFD induced obesity and enhanced expression of the serotonergic system in the dorsal raphe. We concluded that exercise increases the capacity of the serotonergic system in the dorsal raphe, which improves the mood disorders associated with HFD-induced obesity. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Inpatient treatment of children and adolescents with severe obesity in the Netherlands: a randomized clinical trial.

Science.gov (United States)

van der Baan-Slootweg, Olga; Benninga, Marc A; Beelen, Anita; van der Palen, Job; Tamminga-Smeulders, Christine; Tijssen, Jan G P; van Aalderen, Wim M C

2014-09-01

Severe childhood obesity has become a major health problem, and effective, evidence-based interventions are needed. The relative effectiveness of inpatient compared with ambulatory treatment remains unknown. To determine whether an inpatient treatment program is more effective than an ambulatory treatment program at achieving a sustained weight loss in children and adolescents with severe obesity. We conducted a randomized clinical trial with a 2-year follow-up at a tertiary referral center for pediatric obesity in the Netherlands. We recruited 90 children and adolescents aged 8 to 18 years with severe obesity (body mass index [BMI] z score, ≥3.0 or >2.3 with obesity-related health problems). Patients were randomly assigned to an inpatient (6 months of hospitalization on working days) or an ambulatory (12 days of hospital visits at increasing intervals during a 6-month period) treatment program. Both treatment programs involved an intensive, family-based, lifestyle intervention, including exercise, nutritional education, and behavior modification for the patients and their caregiver(s). Change in BMI z score. Secondary outcomes included fasting insulin, fasting plasma glucose, 2-hour plasma glucose, and lipid levels, insulin sensitivity, liver function test results, waist circumference, blood pressure, body composition, and aerobic fitness (peak oxygen consumption, Vo₂). Outcomes were analyzed by intention to treat. Immediately after treatment, reductions in the BMI z score were significantly larger for the inpatient than the ambulatory groups (mean [SE] difference, -0.26 [0.12; 95% CI, -0.59 to -0.01]; P = .04). Change from baseline for the BMI z score in the inpatient group was -18.0% (P = .001) immediately after treatment, -8.5% (P = .008) at 18 months, and -6.3% (P = .38) at 30 months; in the ambulatory group, changes from baseline were -10.5% (P = .001), -6.2% (P = .39), and -1.5% (P > .99), respectively. The favorable outcomes

Treatment of obese patients with binge eating disorder using topiramate: a review

Directory of Open Access Journals (Sweden)

Paolo Leombruni

2009-07-01

Full Text Available Paolo Leombruni, Luca Lavagnino, Secondo FassinoDepartment of Neurosciences, Psychiatry Section, University of Torino, Centre for Eating Disorders and Obesity, Torino, ItalyAbstract: Topiramate is an anticonvulsant drug used for the treatment of epilepsy and prophylaxis of migraine. Some authors have proposed its use as a mood stabilizer and have reported its efficacy in reducing impulsiveness and improving mood regulation, possibly via its antagonism to glutamatergic transmission in the lateral hypothalamus, although this indication is still controversial. Weight loss is a side effect consistently reported in the medical literature in patients treated with topiramate. Given its potential role in stabilizing mood and reducing impulse control problems and weight, topiramate has been proposed as a treatment for obese patients with binge eating disorder (BED. The aim of this paper is to review published data on the efficacy and safety of topiramate for the treatment of obese subjects with BED. Although the evidence is preliminary, topiramate appears to be a relatively safe and effective treatment for obese subjects with BED. Limitations of the studies and future directions for research are discussed.Keywords: topiramate, binge eating disorder, obesity

Personal Network Characteristics as Predictors of Change in Obesity Risk Behaviors in Early Adolescence.

Science.gov (United States)

Marks, Jennifer; de la Haye, Kayla; Barnett, Lisa M; Allender, Steven

2018-05-17

The potential for peers to influence obesity risk behavior increases in adolescence, yet there are knowledge gaps of how behaviors are modified in response to peers over time. This study examined how personal friendship network characteristics were associated with obesity-related behaviors from late childhood to early adolescence. Two waves of friendship, physical activity, screen time, and dietary recall data were collected from 11- to 13-year-old students (99% retention) in Australia (n = 308) over a five- to eight-month period. Regression models identified friendship network characteristics that predicted later health behaviors which varied by gender and behavior type, such as the number of friends positively associated with physical activity intensity (males) and screen time (females). The need for considering context to influence behavior change is discussed. © 2018 Society for Research on Adolescence.

A functional neuroimaging review of obesity, appetitive hormones and ingestive behavior.

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Burger, Kyle S; Berner, Laura A

2014-09-01

Adequate energy intake is vital for the survival of humans and is regulated by complex homeostatic and hedonic mechanisms. Supported by functional MRI (fMRI) studies that consistently demonstrate differences in brain response as a function of weight status during exposure to appetizing food stimuli, it has been posited that hedonically driven food intake contributes to weight gain and obesity maintenance. These food reward theories of obesity are reliant on the notion that the aberrant brain response to food stimuli relates directly to ingestive behavior, specifically, excess food intake. Importantly, functioning of homeostatic neuroendocrine regulators of food intake, such as leptin and ghrelin, are impacted by weight status. Thus, data from studies that evaluate the effect on weight status on brain response to food may be a result of differences in neuroendocrine functioning and/or behavior. In the present review, we examine the influence of weight and weight change, exogenous administration of appetitive hormones, and ingestive behavior on BOLD response to food stimuli. Published by Elsevier Inc.

Bariatric Surgery in Hypothalamic Obesity

OpenAIRE

Bingham, Nathan C.; Rose, Susan R.; Inge, Thomas H.

2012-01-01

Craniopharyngiomas (CP) are epithelial neoplasms generally found in the area of the pituitary and hypothalamus. Despite benign histology, these tumors and/or their treatment often result in significant, debilitating disorders of endocrine, neurological, behavioral, and metabolic systems. Severe obesity is observed in a high percentage of patients with CP resulting in significant comorbidities and negatively impacting quality of life. Obesity occurs as a result of hypothalamic damage and disru...

Socioeconomic Status, Health Behaviors, Obesity and Self-Rated Health among Older Arabs in Israel.

Science.gov (United States)

Khalaila, R N Rabia

2017-03-01

Socioeconomic inequalities in health are well documented. Recently, researchers have shown interest in exploring the mechanisms by which measures of SES operate through it to impact SRH, such as material, psychosocial and behavioral factors. To examine the relationships between SES indicators and self-rated health (SRH); and to determine whether health behaviors and obesity mediate the association between SES indicators and SRH. A secondary analysis of data previously collected through the third survey of socioeconomic and health status of the Arab population in Israel, in which the SRH of 878 Arab-Israelis age 50 or older were analyzed using logistic regression. The results showed that higher education level and current employment in old age are associated with better SRH. However, neither subjective economic status nor family income was associated with SRH. Greater physical activity was found to be related to good\\very good SRH, while obesity was associated with less than good SRH. Finally, health behaviors (physical activity) and obesity were revealed as mediators between SES indicators (education and employment status) and SRH. The results highlight the importance of high education level and employment status in old age to reduce health inequalities. The findings also show that the relationship between SES and SRH can operate through behavioral mechanisms (i.e., physical activity) and their consequences (i.e., obesity), that can, however, be changed in old age.

Obesity, Physical Activity, and Sedentary Behavior of Youth With Learning Disabilities and ADHD.

Science.gov (United States)

Cook, Bryan G; Li, Dongmei; Heinrich, Katie M

2015-01-01

Obesity, physical activity, and sedentary behavior in childhood are important indicators of present and future health and are associated with school-related outcomes such as academic achievement, behavior, peer relationships, and self-esteem. Using logistic regression models that controlled for gender, age, ethnicity/race, and socioeconomic status, we investigated the likelihood that youth with learning disabilities (LD) and attention-deficit/hyperactivity disorder (ADHD) are obese, physically active, and sedentary using a nationally representative sample of 45,897 youth in the United States from 10 to 17 years of age. Results indicated that youth with comorbid LD/ADHD were significantly more likely than peers without LD or ADHD to be obese; that youth with LD only, ADHD only, and comorbid LD/ADHD were significantly less likely to meet recommended levels of physical activity; and that youth with LD only were significantly more likely to exceed recommended levels of sedentary behavior. Medication status mediated outcomes for youth with ADHD. We offer school-based recommendations for improving health-related outcomes for students with LD and ADHD. © Hammill Institute on Disabilities 2014.

Stress-related cortisol response and laboratory eating behavior in obese women.

Science.gov (United States)

Lorig, Fabian; Kießl, Gundula Rebecca Raphaela; Laessle, Reinhold Gustav

2016-06-01

Stress-related cortisol secretion has been linked to increased appetite and subsequent food intake in overweight individuals. The present study addresses this relationship in a repeated-measures randomized controlled laboratory experiment. Nineteen obese women were compared to 36 normal weight controls with respect to stress-induced salivary cortisol and laboratory eating behavior, measured by a universal eating monitor. The trier social stress test served as stressor. Stress-induced cortisol levels were significantly higher in the obese compared to the normal weight controls. Unexpectedly, a corresponding increase in laboratory food intake was not detected. The results are interpreted and discussed with regard to restrained eating, which was found to be present to a significant degree in the obese women.

A hospital-based child and adolescent overweight and obesity treatment protocol transferred into a community healthcare setting

DEFF Research Database (Denmark)

Mollerup, Pernille Maria; Gamborg, Michael Orland; Trier, Cæcilie

2017-01-01

BACKGROUND: Due to the pandemic of child and adolescent overweight and obesity, improvements in overweight and obesity treatment availability and accessibility are needed. METHODS: In this prospective study, we investigated if reductions in body mass index (BMI) standard deviation scores (SDS......) and waist circumference (WC) would occur during 1.5 years of community-based overweight and obesity treatment based upon an effective hospital-based overweight and obesity treatment protocol, The Children's Obesity Clinics' Treatment protocol. Height, weight, and WC were measured at all consultations...... was invested per child per year. CONCLUSION: BMI SDS and WC were reduced after 1.5 years of treatment. Hence, this community-based overweight and obesity treatment program may help accommodate the need for improvements in treatment availability and accessibility....

Accumulating Data to Optimally Predict Obesity Treatment (ADOPT) Core Measures: Environmental Domain.

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Saelens, Brian E; Arteaga, S Sonia; Berrigan, David; Ballard, Rachel M; Gorin, Amy A; Powell-Wiley, Tiffany M; Pratt, Charlotte; Reedy, Jill; Zenk, Shannon N

2018-04-01

There is growing interest in how environment is related to adults' weight and activity and eating behaviors. However, little is known about whether environmental factors are related to the individual variability seen in adults' intentional weight loss or maintenance outcomes. The environmental domain subgroup of the Accumulating Data to Optimally Predict obesity Treatment (ADOPT) Core Measures Project sought to identify a parsimonious set of objective and perceived neighborhood and social environment constructs and corresponding measures to include in the assessment of response to adult weight-loss treatment. Starting with the home address, the environmental domain subgroup recommended for inclusion in future weight-loss or maintenance studies constructs and measures related to walkability, perceived land use mix, food outlet accessibility (perceived and objective), perceived food availability, socioeconomics, and crime-related safety (perceived and objective) to characterize the home neighborhood environment. The subgroup also recommended constructs and measures related to social norms (perceived and objective) and perceived support to characterize an individual's social environment. The 12 neighborhood and social environment constructs and corresponding measures provide a succinct and comprehensive set to allow for more systematic examination of the impact of environment on adults' weight loss and maintenance. © 2018 The Obesity Society.

Childhood obesity treatment; Effects on BMI SDS, body composition, and fasting plasma lipid concentrations

DEFF Research Database (Denmark)

Nielsen, Tenna Ruest Haarmark; Fonvig, Cilius Esmann; Dahl, Maria

2018-01-01

Objective The body mass index (BMI) standard deviation score (SDS) may not adequately reflect changes in fat mass during childhood obesity treatment. This study aimed to investigate associations between BMI SDS, body composition, and fasting plasma lipid concentrations at baseline and during......, and 80% improved their lipid concentrations. Conclusion Reductions in the degree of obesity during multidisciplinary childhood obesity treatment are accompanied by improvements in body composition and fasting plasma lipid concentrations. Even in individuals increasing their BMI SDS, body composition...... childhood obesity treatment. Methods 876 children and adolescents (498 girls) with overweight/obesity, median age 11.2 years (range 1.6±21.7), and median BMI SDS 2.8 (range 1.3±5.7) were enrolled in a multidisciplinary outpatient treatment program and followed for a median of 1.8 years (range 0...

Effectiveness of Parents-Focused Cognitive-Behavioral Therapy on Attention Deficit Hyperactivity Disorder Symptoms, Obesity and Self-Esteem of Overweight Children with Attention Deficient Hyperactivity Disorder

Directory of Open Access Journals (Sweden)

Afsaneh Karbasi Amel

2018-01-01

Full Text Available Background: Attention deficit hyperactivity disorder (ADHD is the most common behavioral problems that cause hyperactivity, attention deficits, academic failure, and emotional and behavioral problems in preschool and elementary school that is often hidden from the parents' eyes. The aim of this study was to determine the effectiveness of parent-based cognitive-behavioral therapy (CBT on ADHD symptoms (including attention deficit disorder, restlessness, and impulsivity, overweight and self-esteem of 6–11-year-old obese children with attention deficit hyperactivity in Isfahan. Materials and Methods: This quasi-experimental study was carried out on 40 children aged 6–11 years with ADHD and overweight or obesity (above the 85th percentile in weight for age, height, and sex diagram that their parents referred to Isfahan child and adolescent psychiatric clinic of Ali Asghar Hospital in 2015. For twenty patients, only ADHD treatment was applied, and they received no other intervention, but the others in experimental group participated in CBT sessions. Analysis tools were Coppersmith Self-Esteem Scale, ADHD conners' test, and the body mass index (BMI. Data were analyzed using analysis of variance with repeated measurements. Results: CBT by teaching parents had a significant effect on ADHD symptoms, the self-esteem of overweight and obese children with ADHD in posttest and follow-up. The results also showed that had a significant effect on ADHD symptoms, overweight and self-esteem of the obese children with ADHD (P < 0.001. Conclusions: Parents focused CBT can be considered as a complementary treatment for reducing ADHD symptoms and BMI and increased self-esteem in the obese ADHD children.

The Association of Dietary Behaviors and Physical Activity Levels with General and Central Obesity among ASEAN University Students.

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Peltzer, Karl; Pengpid, Supa

2017-01-01

To quantify the prevalence of obesity and obesity-related factors (dietary behaviors and physical activity levels) in a cross-sectional, observational study of ASEAN undergraduate students. A total of 6783 (35.5% male and 64.5% female) undergraduate students (Mean age: 20.5, SD = 2.0) from eight ASEAN countries completed questionnaires and anthropometric measurements. Multivariable logistic regression was used to estimate odds ratios (ORs) for the association of nutrition behaviors with prevalence of general obesity (body mass index ≥ 25 kg/m 2 ), elevated waist-to-height ratio (WHtR) (>0.50), and high waist circumference (WC) (≥80 cm in females, ≥90 cm in males). Covariates included sociodemographic factors, dietary behavior, physical activity and sitting time (using the "International Physical Activity Questionnaire"). There was a higher prevalence of general obesity (24.2% versus 9.3%), and high WHtR (16.6% versus 12.1) in males relative to females, while high WC (9.4% versus 10.4%) did not significantly differ between genders. In multivariable logistic regression analyses, compared to females, males had higher odds of obesity (odds-ratio, OR: 2.13, confidence interval, CI: 1.80, 2.77), and high WHtR (OR: 1.90, CI: 1.48, 2.43) ( P ASEAN young adults. Specific dietary behaviors but not physical activity nor sedentary behavior were associated with obesity.

The effect of childrens' eating behaviors and parental feeding style on childhood obesity.

Science.gov (United States)

Demir, Dilek; Bektas, Murat

2017-08-01

In is important to determine the factors that affect obesity in childhood, in order to raise generations of healthy children. This study aims to determine the effect of primary school students' eating behaviors and parental feeding styles on obesity in childhood. This descriptive cross-sectional study was conducted with 1201 children and their parents between September 2014 and March 2015. The data were collected using the socio-demographic data collection form for children and parents, the Children's Eating Behavior Questionnaire and the Parental Feeding Style Questionnaire. The data were analyzed using percentage calculators, mean, Spearman's correlation analysis, Pearson's correlation analysis and multiple regression analysis. Of the children, 16.9% were found to be obese. Three models were created considering the relationships between the variables in this study and the occurrence of obesity. In the first model, the factors that affect childhood obesity were found to be enjoyment of food, emotional overeating, food responsiveness, satiety responsiveness and food fussiness. In the second model, the factors were prompting/encouragement and control over eating. Enjoyment of food, emotional overeating, food responsiveness, satiety responsiveness, emotional feeding and food fussiness were also found to be the factors in the third model (pobesity in childhood. Copyright © 2017 Elsevier Ltd. All rights reserved.

High-frequency binge eating predicts weight gain among veterans receiving behavioral weight loss treatments.

Science.gov (United States)

Masheb, Robin M; Lutes, Lesley D; Kim, Hyungjin Myra; Holleman, Robert G; Goodrich, David E; Janney, Carol A; Kirsh, Susan; Richardson, Caroline R; Damschroder, Laura J

2015-01-01

To assess for the frequency of binge eating behavior and its association with weight loss in an overweight/obese sample of veterans. This study is a secondary analysis of data from the ASPIRE study, a randomized effectiveness trial of weight loss among veterans. Of the 481 enrolled veterans with overweight/obesity, binge eating frequency was obtained by survey for 392 (82%). The majority (77.6%) reported binge eating, and 6.1% reported high-frequency binge eating. Those reporting any binge eating lost 1.4% of body weight, decreased waist circumference by 2.0 cm, and had significantly worse outcomes than those reporting never binge eating who lost about double the weight (2.7%) and reduced waist circumference by twice as much (4.2 cm). The high-frequency binge group gained 1.4% of body weight and increased waist circumference by 0.3 cm. High rates of binge eating were observed in an overweight/obese sample of veterans enrolled in weight loss treatment. The presence of binge eating predicted poorer weight loss outcomes. Furthermore, high-frequency binge eating was associated with weight gain. These findings have operational and policy implications for developing effective strategies to address binge eating in the context of behavioral weight loss programs for veterans. © 2014 The Obesity Society.

Perspectives of obese children and their parents on lifestyle behavior change: a qualitative study

NARCIS (Netherlands)

Schalkwijk, A.A.H.; Bot, S.D.M.; de Vries, L.; Westerman, M.J.; Nijpels, G.; Elders, P.J.M.

2015-01-01

Background: In order to improve and optimize future behavioral family lifestyle intervention programs, more information on the perceptions of obese children and their parents of these programs is needed. As such, the aim of this qualitative study is 1) to explore the expectations of obese children

A parent focused child obesity prevention intervention improves some mother obesity risk behaviors: the Melbourne inFANT program.

Science.gov (United States)

Lioret, Sandrine; Campbell, Karen J; Crawford, David; Spence, Alison C; Hesketh, Kylie; McNaughton, Sarah A

2012-08-28

The diets, physical activity and sedentary behavior levels of both children and adults in Australia are suboptimal. The family environment, as the first ecological niche of children, exerts an important influence on the onset of children's habits. Parent modeling is one part of this environment and a logical focus for child obesity prevention initiatives. The focus on parent's own behaviors provides a potential opportunity to decrease obesity risk behaviors in parents as well. To assess the effect of a parent-focused early childhood obesity prevention intervention on first-time mothers' diets, physical activity and TV viewing time. The Melbourne InFANT Program is a cluster-randomized controlled trial which involved 542 mothers over their newborn's first 18 months of life. The intervention focused on parenting skills and strategies, including parental modeling, and aimed to promote development of healthy child and parent behaviors from birth, including healthy diet, increased physical activity and reduced TV viewing time. Data regarding mothers' diet (food frequency questionnaire), physical activity and TV viewing times (self-reported questionnaire) were collected using validated tools at both baseline and post-intervention. Four dietary patterns were derived at baseline using principal components analyses including frequencies of 55 food groups. Analysis of covariance was used to measure the impact of the intervention. The scores of both the "High-energy snack and processed foods" and the "High-fat foods" dietary patterns decreased more in the intervention group: -0.22 (-0.42;-0.02) and -0.25 (-0.50;-0.01), respectively. No other significant intervention vs. control effects were observed regarding total physical activity, TV viewing time, and the two other dietary patterns, i.e. "Fruits and vegetables" and "Cereals and sweet foods". These findings suggest that supporting first-time mothers to promote healthy lifestyle behaviors in their infants impacts maternal

Binge Eating Disorder and Bipolar Spectrum disorders in obesity: Psychopathological and eating behaviors differences according to comorbidities.

Science.gov (United States)

Segura-Garcia, Cristina; Caroleo, Mariarita; Rania, Marianna; Barbuto, Elvira; Sinopoli, Flora; Aloi, Matteo; Arturi, Franco; De Fazio, Pasquale

2017-01-15

Obesity is not a mental disorder, yet DSM-5 recognizes a strong association between obesity and psychiatric syndromes. Disorders within the Bipolar Spectrum (BSD) and Binge Eating Disorder (BED) are the most frequent psychiatric disorders among obese patients. The aim of this research is to investigate the psychopathological differences and the distinctive eating behaviors that accompany these comorbidities in obese patients. One hundred and nineteen obese patients (40 males; 79 females) underwent psychological evaluation and psychiatric interview, and a dietitian evaluated their eating habits. Patients were divided into four groups according to comorbidities, and comparisons were run accordingly. Forty-one percent of participants presented BED+BSD comorbidity (Group 1), 21% BED (Group 2) and 8% BSD (Group 3); only 29% obese participants had no comorbidity (Group 4). Female gender was overrepresented among Groups 1 and 2. BSD diagnosis varied according to comorbidities: Type II Bipolar Disorder and Other Specified and Related Bipolar Disorder (OSR BD) were more frequent in Group 1 and Type I Bipolar Disorder in Group 3. A trend of decreasing severity in eating behaviors and psychopathology was evident according to comorbidities (Group 1=Group2>Group3>Group 4). Limitations include the small sample size and the cross-sectional design of the study. BED and BSD are frequent comorbidities in obesity. Type II Bipolar Disorder and OSR BD are more frequent in the group with double comorbidity. The double comorbidity seems associated to more severe eating behaviors and psychopathology. Distinctive pathological eating behaviors could be considered as warning signals, symptomatic of psychiatric comorbidities in Obesity. Copyright © 2016 Elsevier B.V. All rights reserved.

Kidney disease and obesity: epidemiology, mechanisms and treatment.

Science.gov (United States)

Câmara, Niels Olsen Saraiva; Iseki, Kunitoshi; Kramer, Holly; Liu, Zhi-Hong; Sharma, Kumar

2017-03-01

The theme of World Kidney Day 2017 is 'kidney disease and obesity: healthy lifestyle for healthy kidneys'. To mark this event, Nature Reviews Nephrology invited five leading researchers to describe changes in the epidemiology of obesity-related kidney disease, advances in current understanding of the mechanisms and current approaches to the management of affected patients. The researchers also highlight new advances that could lead to the development of novel treatments and identify areas in which further basic and clinical studies are needed.

A systematic review of pediatric obesity and family communication through the lens of addiction literature.

Science.gov (United States)

Mogul, Ashley; Irby, Megan B; Skelton, Joseph A

2014-06-01

Both treatment of addiction and treatment of pediatric obesity often integrate the family unit. Thus, addiction therapies may provide a model to guide treatment of pediatric obesity, particularly issues of family communication, weight, and weight-related behaviors. The aim of this systematic review is to assess what knowledge in the field of addiction treatment can be translated to pediatric weight management, particularly in relation to family-based approaches and communication. A systematic review of family communication and food addiction in obese children was conducted using MEDLINE and other databases, including all English-language studies published after 1990 meeting search criteria and related to family factors or family communication, and addiction treatment strategies used in obesity interventions. Three reviews, two survey studies, and two observational studies were included. Most focused on family communication; less-healthy communication patterns and parental restriction were related to maladaptive eating behaviors in children and attrition from weight management programs. A few studies suggested family communication interventions to improve unhealthy eating patterns in children, using therapies common in family treatment of addiction (e.g., motivational interviewing and cognitive behavioral therapy). No studies presented concrete suggestions to aid family communication around issues of food and weight management. Potential contributions of addiction therapies are discussed. Though the addictive properties of food have not been fully delineated and obesity is not classified as a disease of addiction, the field of addiction offers many approaches that may prove useful in the treatment of obesity.

An Obesity Dietary Quality Index Predicts Abdominal Obesity in Women: Potential Opportunity for New Prevention and Treatment Paradigms

Directory of Open Access Journals (Sweden)

Dolores M. Wolongevicz

2010-01-01

Full Text Available Background. Links between dietary quality and abdominal obesity are poorly understood. Objective. To examine the association between an obesity-specific dietary quality index and abdominal obesity risk in women. Methods. Over 12 years, we followed 288 Framingham Offspring/Spouse Study women, aged 30–69 years, without metabolic syndrome risk factors, cardiovascular disease, cancer, or diabetes at baseline. An 11-nutrient obesity-specific dietary quality index was derived using mean ranks of nutrient intakes from 3-day dietary records. Abdominal obesity (waist circumference >88 cm was assessed during follow-up. Results. Using multiple logistic regression, women with poorer dietary quality were more likely to develop abdominal obesity compared to those with higher dietary quality (OR 1.87; 95% CI, 1.01, 3.47; P for trend =.048 independent of age, physical activity, smoking, and menopausal status. Conclusions. An obesity-specific dietary quality index predicted abdominal obesity in women, suggesting targets for dietary quality assessment, intervention, and treatment to address abdominal adiposity.

Behavioral science and the study of gene-nutrition and gene-physical activity interactions in obesity research.

Science.gov (United States)

Faith, Myles S

2008-12-01

This report summarizes emerging opportunities for behavioral science to help advance the field of gene-environment and gene-behavior interactions, based on presentations at The National Cancer Institute (NCI) Workshop, "Gene-Nutrition and Gene-Physical Activity Interactions in the Etiology of Obesity." Three opportunities are highlighted: (i) designing potent behavioral "challenges" in experiments, (ii) determining viable behavioral phenotypes for genetics studies, and (iii) identifying specific measures of the environment or environmental exposures. Additional points are underscored, including the need to incorporate novel findings from neuroimaging studies regarding motivation and drive for eating and physical activity. Advances in behavioral science theory and methods can play an important role in advancing understanding of gene-brain-behavior relationships in obesity onset.

Physical Activity, Sedentary Behavior and the Risk of Overweight and Obesity in School-Aged Children.

Science.gov (United States)

Keane, Eimear; Li, Xia; Harrington, Janas M; Fitzgerald, Anthony P; Perry, Ivan J; Kearney, Patricia M

2017-08-01

Globally, public health policies are targeting modifiable lifestyle behaviors. We explore the independent association of moderate-to-vigorous physical activity (MVPA) and sedentary behavior on the risk of childhood overweight/obesity. A cross-sectional survey of children aged 8-11 years (N = 826). Objective body mass index was used to classify children as normal weight or overweight/obese. Children wore wrist-worn Geneactiv accelerometers for 7-days and thresholds were applied to categorize MVPA and sedentary time. Screen time (ST) was parent reported. Poisson regression examined the independent association of (1) MVPA (2), objective sedentary time and (3) ST on the risk of overweight/obesity. Overall, 23.7% (95% CI, 20.8-26.6%) of children were overweight/obese. On average, children spent 10.8% of waking time at MVPA and 61.3% sedentary. One-fifth (22.1%, 95% CI, 19.3-25.0%) of children achieved MVPA recommendations (≥ 60 min each day) and 17.5% (95% CI, 14.9-20.1%) met ST recommendations (overweight/obese independent of total sedentary time. Total time spent sedentary was not associated with overweight/obese independent of MVPA. ST was associated with an increased risk of overweight/obese independent of physical activity. Few schoolchildren met physical activity and screen time recommendations suggesting population based measures are needed.

Prevalence, etiological factors and the treatment of infant exogenous obesity

OpenAIRE

Edio Luiz Petroski; Ludmila Dalben Soares

2003-01-01

In the last few years, there has been considerable interest in the effects of excessive weight gain during childhood, due to the fact that the development of fat tissue in this period is a determinant of adult body composition. The objective of this study was to investigate the prevalence of infant obesity, to identify possible etiological factors, and to highlight treatments that have been used to reduce and/or prevent child obesity. Results have shown that obesity has increased more than an...

Dog obesity: can dog caregivers' (owners') feeding and exercise intentions and behaviors be predicted from attitudes?

Science.gov (United States)

Rohlf, Vanessa I; Toukhsati, Samia; Coleman, Grahame J; Bennett, Pauleen C

2010-01-01

Dog obesity is a common nutritional disorder affecting up to 40% of the companion animal (pet) dog population in Australia and other developed nations. A clear understanding of factors determining relevant caregiver (owner) behaviors underpins effective treatment for this disorder. The theory of planned behavior can be used to understand factors contributing to human behavior. This article describes research informed by this theory. The research examined relationships between owners' behavioral beliefs and barriers, normative beliefs and perceptions of control, owners' feeding and exercise behaviors toward their dogs, and the body condition scores (BCSs) of dogs. The study recruited a sample of 182 dog and owner dyads. The researcher independently assessed BCSs. Owners completed a questionnaire measuring relevant feeding and exercise beliefs and behaviors. This revealed significant correlations between many psychological variables and BCSs and between psychological variables and specific owner behaviors: for example, the relationship of low levels of intentions to feed appropriately to ambivalent beliefs toward feeding appropriately and low perceived control. Careful consideration of the specific variables identified will permit the development of more effective interventions.

Neighborhood Environments: Links to Health Behaviors and Obesity Status in Vulnerable Children.

Science.gov (United States)

Choo, Jina; Kim, Hye-Jin; Park, Sooyeon

2017-08-01

This study aimed to identify the actual and perceived features of neighborhood environments linked to health behaviors and obesity status in vulnerable children by using geographic information systems, walking surveys, and focus group interviews. The participants were 126 children registered at community child centers and 10 mothers of study participants. Increased availability of fast food outlets and convenience stores was significantly and positively associated with fast food and sugar-sweetened beverage consumption and inversely with physical activity. Reduced availability of physical activity outlets was significantly and positively associated with sedentary behaviors. Mothers' perceptions of their neighborhoods fell into three content categories: (a) changed to be unfriendly for children, (b) adapted to fast food and convenience eating, and (c) confined to physically inactive living. Based on these findings, community-level environmental strategies for reducing unhealthy behaviors linked to neighborhood environments should be prioritized to prevent childhood obesity in vulnerable populations.

Danish clinical guidelines for examination and treatment of overweight and obese children and adolescents in a pediatric setting

DEFF Research Database (Denmark)

Johansen, Anders; Holm, Jens-Christian; Pearson, Seija

2015-01-01

as a "chronic care model" based on "best clinical practice" inspired by an American expert committee and the daily practice of The Children's Obesity Clinic at Copenhagen University Hospital Holbaek. Children and adolescents should be referred for examination and treatment in a pediatric setting when BMI......Overweight children are at an increased risk of becoming obese adults, which may lead to shorter life expectancies in the current generation of children as compared to their parents. Furthermore, being an overweight child has a negative psycho-social impact. We consider obesity in children...... and adolescents a chronic illness, which is in line with the American Medical Society. We summarize the evidence for the efficacy of a combination of diet, physical activity and behavior-focused interventions in a family-based setting. The present guidelines propose a multidisciplinary service implemented...

The effect of impaired glucose metabolism on weight loss in multidisciplinary childhood obesity treatment

DEFF Research Database (Denmark)

Kloppenborg, Julie T; Gamborg, Michael; Fonvig, Cilius E

2017-01-01

and adolescents from the Children's Obesity Clinic, Holbaek, Denmark. Anthropometrics, pubertal development, socioeconomic status (SES), and fasting concentrations of plasma glucose, serum insulin, serum C-peptide, and whole blood glycosylated hemoglobin (HbA1c) were collected at treatment entry and at follow......OBJECTIVE: To investigate whether children and adolescents exhibiting an impaired glucose metabolism are more obese at treatment entry and less likely to reduce their degree of obesity during treatment. METHODS: The present study is a longitudinal observational study, including children...... mass index (BMI) z-score 2.94 (range 1.34-5.54) were included. The mean BMI z-score reduction was 0.31 (±0.46) after 13 months (range 6-18) of treatment. At treatment entry, patients with impaired estimates of glucose metabolism were more obese than normoglycemic patients. Baseline concentration of C...

Isolated Subclinical Hyperthyrotropinemia in Obese Children: Does Levothyroxine (LT4 Improve Weight Reduction during Combined Behavioral Therapy?

Directory of Open Access Journals (Sweden)

Pawel Matusik

2015-01-01

Full Text Available Objective. The study aim was to analyze whether anthropometrical parameters and TSH values in obese children with isolated subclinical hypothyroidism (IsHT treated with levothyroxine (LT4 and weight reduction program differ from those managed by dietary and behavior counselling only. Material and Methods. 51 obese children with IsHT, who were treated according to the same weight reduction program, were retrospectively analyzed. They were divided into two groups: Group 1, n=26, and Group 2, n=25, without or with LT4 therapy, respectively. Changes in anthropometrical (delta BMI z-score and hormonal (delta TSH status were analyzed at the first follow-up visit. Results. In both groups significant decrease of TSH and BMI z-score values were noted. TSH normalized in 80.9% of children from Group 1 versus 90.5% from Group 2, p = NS. Delta BMI z-score was insignificantly higher in Group 1 compared to Group 2. Delta TSH was significantly related to initial TSH level in children treated by lifestyle intervention program only. Conclusions. In obese children with sHT dietary-behavioral management intervention contributed to reduction of body mass index, irrespective of levothyroxine use. This finding suggests that moderately elevated levels of TSH are a consequence rather than cause of overweight and pharmacological treatment should be avoided.

Eating behaviors, mental health, and food intake are associated with obesity in older congregate meal participants.

Science.gov (United States)

Porter Starr, Kathryn; Fischer, Joan G; Johnson, Mary Ann

2014-01-01

The relationship between eating behaviors, food intake, and mental health and the occurrence of obesity in older adults has rarely been investigated. Therefore, the objective of this study was to establish the associative links of these factors with two measures of obesity: class I obesity as indicated by body mass index (OB-BMI; BMI ≥ 30 kg/m²) and class I obesity as indicated by waist circumference (OB-WC; WC ≥ 43 inches for men and ≥ 42 inches for women). Older adults participating in the Older American's Act congregate meal program (N = 113, mean age = 74 years, 74% female, 45% African American) were assessed. Eating behaviors (cognitive restraint, uncontrolled eating, and emotional eating), food group choices (sweets, salty snacks, and fruits), and mental health indices (depression, anxiety, and stress) were recorded by questionnaire and related to measured occurrence of OB-BMI and OB-WC. In a series of multivariate logistical regression models, we found cognitive restraint to be consistently and robustly associated with both measures of obesity. In the fully adjusted model, cognitive restraint, consumption of sweets, anxiety, and lack of depression were associated with OB-WC. In summary, we found an association of obesity with abnormal eating behaviors, certain food group intakes, and mental health symptoms in this population. These findings may guide the development of future weight management interventions in a congregate meal setting.

Treatment Options for Severe Obesity in the Pediatric Population: Current Limitations and Future Opportunities.

Science.gov (United States)

Ryder, Justin R; Fox, Claudia K; Kelly, Aaron S

2018-06-01

Severe obesity is the only obesity classification increasing in prevalence among children and adolescents. Treatment options that produce meaningful and sustained weight loss and comorbidity resolution are urgently needed. The purpose of this review is to provide a brief overview of the current treatment options for pediatric severe obesity and offer suggestions regarding future opportunities for accelerating the development and evaluation of innovative treatment strategies. At present, there are three treatment options for youth with severe obesity: lifestyle modification therapy, pharmacotherapy, and bariatric surgery. Lifestyle modification therapy can be useful for improving many chronic disease risk factors and comorbid conditions but often fails to achieve clinically meaningful and sustainable weight loss. Pharmacotherapy holds promise as an effective adjunctive treatment but remains in the primordial stages of development in the pediatric population. Bariatric surgery provides robust weight loss and risk factor/comorbidity improvements but is accompanied by higher risks and lower uptake compared to lifestyle modification therapy and pharmacotherapy. New areas worth pursuing include combination pharmacotherapy, device therapy, identification of predictors of response aimed at precision treatment, and interventions in the postbariatric surgical setting to improve long-term outcomes. Treating pediatric severe obesity effectively and safely is extremely challenging. Some progress has been made, but substantially more effort and innovation are needed in the future to combat this serious and ongoing medical and public health issue. © 2018 The Obesity Society.

Developmental Trajectories of Childhood Obesity and Risk Behaviors in Adolescence

Science.gov (United States)

Huang, David Y. C.; Lanza, H. Isabella; Wright-Volel, Kynna; Anglin, M. Douglas

2013-01-01

Using group-based trajectory modeling, this study examined 5156 adolescents from the child sample of the 1979 National Longitudinal Survey of Youth to identify developmental trajectories of obesity from ages 6-18 and evaluate associations of such trajectories with risk behaviors and psychosocial health in adolescence. Four distinctive obesity…

VIVA LA SALUD INFANTILE: Pediatric obesity treatment in an underserved Hispanic community

Science.gov (United States)

Pediatric obesity in the US disproportionately impacts minority populations who face socioeconomic and cultural barriers to weight management programs. The specific aim of this pilot study was to test the effectiveness of diet behavior modification or diet behavior modification plus structured aerob...

Childhood Obesity: Causes, Consequences, and Management.

Science.gov (United States)

Gurnani, Muskaan; Birken, Catherine; Hamilton, Jill

2015-08-01

One-third of North American children are overweight or obese. Pathologic obesity accounts for only a small percentage of these cases. The vast majority are the result of a complex interaction of genetic and hormonal, nutritional, physical activity, and physical and social environmental factors. Obesity increases the risk for various cardiometabolic, pulmonary, and psychosocial complications for children, which often continues into adulthood. Multidisciplinary care, focusing on family-centered behavior change, is an evidence-based, essential part of the treatment, along with pharmacologic and surgical options for more complex cases. Prevention and early intervention strategies are key to reversing the obesity epidemic. Copyright © 2015 Elsevier Inc. All rights reserved.

Drug interventions for the treatment of obesity in children and adolescents

NARCIS (Netherlands)

Mead, Emma; Atkinson, Greg; Richter, Bernd; Metzendorf, Maria-Inti; Baur, Louise; Finer, Nicholas; Corpeleijn, Eva; O'Malley, Claire; Ells, Louisa J.

2016-01-01

BACKGROUND: Child and adolescent obesity has increased globally, and can be associated with significant short- and long-term health consequences. OBJECTIVES: To assess the efficacy of drug interventions for the treatment of obesity in children and adolescents. SEARCH METHODS: We searched CENTRAL,

Risk factors associated with treatment abandonment by overweight or obese children and adolescents.

Science.gov (United States)

Soares Mariz, Larissa; Campos Muniz Medeiros, Carla; Cruz Enders, Bertha; Nascimento Kluczynik Vieira, Caroline Evelin; Aires Silva Medeiros, Kaio Keomma; Silva Coura, Alexsandro

2016-06-01

To evaluate the risk factors associated with treatment abandonment by overweight or obese children and adolescents. A cross-sectional study, conducted in 2011, at the Childhood Obesity Center, in Campina Grande, Brazil, with the records of 208 children and adolescents, between three and 18 years of age, divided into two groups: Group I included those who abandoned treatment, and Group II included those who did not abandon treatment. Non-adherence was significantly associated with higher income (OR=5.8), high maternal education (OR=2.4), white skin color (OR=2.9), and obesity (OR=3.6). Despite the new academic-care approach, the non-adherence to treatment rate was high, and was associated with sociodemographic and nutritional factors.

From genetics and epigenetics to the future of precision treatment for obesity

OpenAIRE

Sun, Xulong; Li, Pengzhou; Yang, Xiangwu; Li, Weizheng; Qiu, Xianjie; Zhu, Shaihong

2017-01-01

Abstract Obesity has become a major global health problem, epitomized by excess accumulation of body fat resulting from an imbalance between energy intake and expenditure. The treatments for obesity range from modified nutrition and additional physical activity, to drugs or surgery. But the curative effect of each method seems to vary between individuals. With progress in the genetics and epigenetics of obesity, personalization of the clinical management of obesity may be at our doorstep. Thi...

Personality, attrition and weight loss in treatment seeking women with obesity.

Science.gov (United States)

Dalle Grave, R; Calugi, S; Compare, A; El Ghoch, M; Petroni, M L; Colombari, S; Minniti, A; Marchesini, G

2015-10-01

Studies on small samples or in single units applying specific treatment programmes found an association between some personality traits and attrition and weight loss in individuals treated for obesity. We aimed to investigate whether pre-treatment personality traits were associated with weight loss outcomes in the general population of women with obesity. Attrition and weight loss outcomes after 12 months were measured in 634 women with obesity (mean age, 48; body mass index (BMI), 37.8 kg m(-2)) seeking treatment at eight Italian medical centres, applying different medical/cognitive behavioural programmes. Personality traits were assessed with the Temperament and Character Inventory (TCI), eating disorder features with the Binge Eating Scale (BES) and Night Eating Questionnaire (NEQ). Within the 12-month observation period, 32.3% of cases were lost to follow-up. After adjustment for demographic confounders and the severity of eating disorders, no TCI personality traits were significantly associated with attrition, while low scores of the novelty seeking temperament scale remained significantly associated with weight loss ≥ 10% (odds ratio, 0.983; 95% confidence interval, 0.975-0.992). Additional adjustment for education and job did not change the results. We conclude that personality does not systematically influence attrition in women with obesity enrolled into weight loss programmes in the community, whereas an association is maintained between novelty seeking and weight loss outcome. Studies adapting obesity interventions on the basis of individual novelty seeking scores might be warranted to maximize the results on body weight. © 2015 World Obesity.

Obesity, Physical Activity, and Sedentary Behavior of Youth with Learning Disabilities and ADHD

Science.gov (United States)

Cook, Bryan G.; Li, Dongmei; Heinrich, Katie M.

2015-01-01

Obesity, physical activity, and sedentary behavior in childhood are important indicators of present and future health and are associated with school-related outcomes such as academic achievement, behavior, peer relationships, and self-esteem. Using logistic regression models that controlled for gender, age, ethnicity/race, and socioeconomic…

Perceived Expressed Emotion, Emotional and Behavioral Problems and Self Esteem in Obese Adolescents: A Case-Control Study.

Science.gov (United States)

Çolpan, Merve; Eray, Şafak; Eren, Erdal; Vural, Ayşe Pınar

2018-05-23

Obesity is a chronic disease which causes medical and psychiatric complications. Family climate is also a critical factor in the presence and treatment of obesity and comorbid psychiatric disorders. In our study, perceived expressed emotion (EE), psychopathology, self-esteem and emotional and behavioural problems among obese adolescents will be investigated by comparison with their non-obese peers. This study was carried out with 49 obese adolescents and 47 non-obese adolescents as a control group. All participants were requested to fill out the Socio-demographic Data Form, Shortened Level of Expressed Emotion Scale, Rosenberg Self-Esteem Scale, Strength and Difficulties Questionnaire-Adolescent Form. In our study, obese adolescents showed a significant difference in perceived EE (pself-esteem (pself esteem. A higher rate of perceived EE, psychopathology and low self-esteem among obese adolescents showed that obesity prevention and treatment are also crucial for mental health in adolescents. With the help of our study results, we aimed to emphasize the role of the family in obese adolescent's mental health and their treatment. By the help of our results we try to identifying risk factors in childhood that promote obesity in order to help develop targeted intervention and prevention programs.

Appearance vs. health reasons for seeking treatment among obese patients with binge eating disorder.

Science.gov (United States)

Reas, Deborah L; Masheb, Robin M; Grilo, Carlos M

2004-05-01

This study examined reasons for seeking treatment reported by obese patients diagnosed with binge eating disorder (BED). Participants were 248 adults (58 men and 190 women) who met DSM criteria for BED. Participants were recruited through advertisements for treatment studies looking for persons who wanted to "stop binge eating and lose weight." Patients' reasons for seeking treatment were examined with respect to demography (gender and age), obesity (BMI and age of onset), features of eating disorders, and associated psychological functioning (depression and self-esteem). Of the 248 participants, 64% reported health concerns and 36% reported appearance concerns as their primary reason for seeking treatment. Reasons for seeking treatment did not differ significantly by gender. Patients seeking treatment because of appearance-related reasons had lower BMIs than those reporting health-related reasons (34.8 vs. 38.5, respectively), but they reported greater body dissatisfaction, more features of eating disorders, and lower self-esteem. Reasons that prompt treatment seeking among obese individuals with BED reflect meaningful patient characteristics and, therefore, warrant assessment and consideration during treatment planning. Further research is needed to determine whether reasons for treatment seeking among different obese patient groups affect treatment outcomes. Copyright 2004 NAASO

Health behaviors of Korean female nursing students in relation to obesity and osteoporosis.

Science.gov (United States)

Park, Da-In; Choi-Kwon, Smi; Han, Kihye

2015-01-01

It has been reported that young adults' dietary habits and health behaviors have significant effects on obesity and bone health. However, there is a lack of thorough understanding of the prevalence of unhealthy behaviors and potential relationships to obesity and osteoporosis among young females. This cross-sectional study examined dietary habits, health behaviors, anthropometric measurements, and bone mineral density of 160 female nursing students. A relatively large number of students had vitamin D (n = 104, 65%) and calcium (n = 84, 52.5%) deficiencies but displayed excessive cholesterol (n = 86, 53.8%) and sodium (n = 137, 85.6%) intakes. Unhealthy dietary and health habits such as nighttime snacking, coffee drinking, low milk drinking, and lack of exercise were also noted. Despite their knowledge on health, a large portion of nursing students displayed unhealthy dietary habits and health. Tailored strategies and education to narrow the gap between health behavioral knowledge and practice are urgently needed. Copyright © 2015 Elsevier Inc. All rights reserved.

Obesity and dissociable forms of impulsivity in young adults.

Science.gov (United States)

Chamberlain, Samuel R; Derbyshire, Katherine L; Leppink, Eric; Grant, Jon E

2015-10-01

Obesity is one of the leading causes of preventable morbidity and mortality, and young people are increasingly affected. The aim of this study was to examine relationships between obesity and dissociable forms of impulsivity in young adults. A group of young adults (511) was recruited from city areas in the United States using media advertisements. These young adults were administered careful and extensive clinical and neurocognitive assessment in order to quantify different aspects of impulsivity (behavioral/phenomenological-, cognitive-, and personality-related measures). Associations between obesity and impulsivity were explored using multivariate analysis of variance and discriminant function analysis. 10.8% of the sample was obese, and 21.5% was overweight. Compared to controls, subjects with obesity showed significantly elevated rates of maladaptive gambling behaviors, monetary amounts lost to gambling, nicotine consumption, impulsive action (prolonged stop-signal reaction times in the Stop-Signal Test), and impulsive decision-making (reduced modulation of behavior as a function of risk in the Cambridge Gamble Test). Even accounting for potential confounding variables, obesity was significantly predicted by female gender, older age, more maladaptive gambling behaviors, and worse inhibitory control (stop-signal reaction times). Obesity is associated with several dissociable forms of impulsivity in young people, especially gambling and impulse dyscontrol. Family doctors should screen for gambling problems in obese young adults. Successful treatment of nicotine dependence in young obese people is likely to require intensive weight management support. Neuropsychological deficits relating to impulsivity occur in obese people in early adulthood, and may represent vulnerability markers rather than being due to chronic untoward metabolic effects on brain function.

Leisure-Time Physical Activity Does not Attenuate the Association Between Occupational Sedentary Behavior and Obesity: Results From Alberta's Tomorrow Project.

Science.gov (United States)

Nicholas, Joshua A; Lo Siou, Geraldine; Lynch, Brigid M; Robson, Paula J; Friedenreich, Christine M; Csizmadi, Ilona

2015-12-01

Sedentary behavior has been proposed as a risk factor for obesity that is distinct from physical inactivity. This study aimed to examine the association between occupational sedentary behavior and obesity, and to determine if this association is independent of leisure-time physical activity (LTPA). Fully employed participants enrolled between 2001 and 2008 to Alberta's Tomorrow Project, a prospective cohort study in Alberta, Canada, were studied (n = 12,409). Associations between occupational sedentary behavior and waist circumference (WC), waist-to-hip ratio (WHR), and body mass index (BMI) were examined using multiple binary and multinomial logistic regressions. In men, a positive association was observed between daily occupational sedentary hours and WC, WHR, BMI, and with high risk profiles that incorporated both BMI and WC (P < .01). Controlling for vigorous-intensity LTPA in all models strengthened associations between sedentary behavior and measures of obesity. In contrast, inverse associations were observed for occupational sedentary hours and WHR for women (P < .05). In fully employed men, occupational sedentary behavior was positively associated with obesity risk that was not attenuated by physical activity. In women, an increase in obesity risk was not observed with sedentary behavior. Gender differences in the health effects of sedentary behavior require further study.

Psychological and Behavioral Risk Factors for Obesity Onset in Adolescent Girls: A Prospective Study

Science.gov (United States)

Stice, Eric; Presnell, Katherine; Shaw, Heather; Rohde, Paul

2005-01-01

Because little is known about risk factors for obesity, the authors tested whether certain psychological and behavioral variables predicted future onset of obesity. The authors used data from a prospective study of 496 adolescent girls who completed a baseline assessment at age 11-15 years and 4 annual follow-ups. Self-reported dietary restraint,…

Guided self-help for the treatment of pediatric obesity.

Science.gov (United States)

Boutelle, Kerri N; Norman, Gregory J; Rock, Cheryl L; Rhee, Kyung E; Crow, Scott J

2013-05-01

Clinic-based programs for childhood obesity are not available to a large proportion of the population. The purpose of this study was to evaluate the efficacy of a guided self-help treatment of pediatric obesity (GSH-PO) compared with a delayed treatment control and to evaluate the impact of GSH-PO 6-months posttreatment. Fifty overweight or obese 8- to 12-year-old children and their parents were randomly assigned to immediate treatment or to delayed treatment. The GSH-PO includes 12 visits over 5 months and addresses key components included in more intensive clinic-based programs. Children and parents in the immediate treatment arm were assessed at time 1 (T1), participated in GSH-PO between T1 and T2, and completed their 6-month posttreatment assessment at T3. Children and parents in the delayed treatment arm were assessed at T1, participated in GSH-PO between T2 and T3, and completed their 6-month posttreatment assessment at T4. The main outcome measures were BMI, BMI z score, and percentage overweight (%OW). Children in the immediate treatment GSH-PO arm decreased their BMI significantly more than did the delayed treatment arm (BMI group × time = -1.39; P < .001). Similar results were found for BMI z score and %OW. At the 6-month posttreatment assessment, changes resulting from GSH-PO were maintained for BMI z score and %OW but not BMI (BMI time effect = -0.06, not significant; BMI z score time effect = -0.10, P < .001; %OW time effect = -4.86, P < .05). The GSH-PO showed initial efficacy in decreasing BMI for children in this study. Additional efficacy and translational studies are needed to additionally evaluate GSH-PO.

Situational cues and momentary food environment predict everyday eating behavior in adults with overweight and obesity.

Science.gov (United States)

Elliston, Katherine G; Ferguson, Stuart G; Schüz, Natalie; Schüz, Benjamin

2017-04-01

Individual eating behavior is a risk factor for obesity and highly dependent on internal and external cues. Many studies also suggest that the food environment (i.e., food outlets) influences eating behavior. This study therefore examines the momentary food environment (at the time of eating) and the role of cues simultaneously in predicting everyday eating behavior in adults with overweight and obesity. Intensive longitudinal study using ecological momentary assessment (EMA) over 14 days in 51 adults with overweight and obesity (average body mass index = 30.77; SD = 4.85) with a total of 745 participant days of data. Multiple daily assessments of eating (meals, high- or low-energy snacks) and randomly timed assessments. Cues and the momentary food environment were assessed during both assessment types. Random effects multinomial logistic regression shows that both internal (affect) and external (food availability, social situation, observing others eat) cues were associated with increased likelihood of eating. The momentary food environment predicted meals and snacking on top of cues, with a higher likelihood of high-energy snacks when fast food restaurants were close by (odds ratio [OR] = 1.89, 95% confidence interval [CI] = 1.22, 2.93) and a higher likelihood of low-energy snacks in proximity to supermarkets (OR = 2.29, 95% CI = 1.38, 3.82). Real-time eating behavior, both in terms of main meals and snacks, is associated with internal and external cues in adults with overweight and obesity. In addition, perceptions of the momentary food environment influence eating choices, emphasizing the importance of an integrated perspective on eating behavior and obesity prevention. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Eating behavior and stress: a pathway to obesity

OpenAIRE

Sominsky, Luba; Spencer, Sarah J.

2014-01-01

Stress causes or contributes to a huge variety of diseases and disorders. Recent evidence suggests obesity and other eating-related disorders may be among these. Immediately after a stressful event is experienced, there is a corticotropin-releasing-hormone (CRH)-mediated suppression of food intake. This diverts the body’s resources away from the less pressing need to find and consume food, prioritizing fight, flight, or withdrawal behaviors so the stressful event can be dealt with. In the hou...

Current pharmacotherapies for obesity: A practical perspective.

Science.gov (United States)

Golden, Angela

2017-10-01

To review the currently available pharmacotherapies for obesity management with a particular focus on the United States. Narrative review based on literature searches and the latest prescribing information (up to July 2017). Obesity pharmacotherapies may assist those individuals who have obesity, or overweight with comorbidities, who have failed to maintain weight loss with lifestyle modifications alone (caloric restriction and increased physical activity). Currently approved options in the United States include phentermine for short-term use and five obesity pharmacotherapies that can be used long-term (orlistat, lorcaserin, phentermine-topiramate, naltrexone-bupropion, and liraglutide 3.0 mg). If the use of an obesity pharmacotherapy is indicated, treatment should be selected to provide the most appropriate option for each individual and their circumstances. Variables such as contraindications, individual comorbidities, patient choice, patient readiness to incorporate additional behavioral changes (e.g., alcohol prohibition), and cost should guide choices. Each of the obesity pharmacotherapies has advantages and disadvantages that can help guide treatment choice. Those receiving treatment may also have individual preferences based on factors such as administration route, frequency of dosing, and/or safety profile. In addition, some options may be particularly appropriate for patients with common obesity-related complications such as depression or diabetes. ©2017 American Association of Nurse Practitioners.

Social networks and future direction for obesity research: A scoping review.

Science.gov (United States)

Nam, Soohyun; Redeker, Nancy; Whittemore, Robin

2015-01-01

Despite significant efforts to decrease obesity rates, the prevalence of obesity continues to increase in the United States. Obesity risk behaviors including physical inactivity, unhealthy eating, and sleep deprivation are intertwined during daily life and are difficult to improve in the current social environment. Studies show that social networks-the thick webs of social relations and interactions-influence various health outcomes, such as HIV risk behaviors, alcohol consumption, smoking, depression, and cardiovascular mortality; however, there is limited information on the influences of social networks on obesity and obesity risk behaviors. Given the complexities of the biobehavioral pathology of obesity and the lack of clear evidence of effectiveness and sustainability of existing interventions that are usually focused on an individual approach, targeting change in an individual's health behaviors or attitude may not take sociocontextual factors into account; there is a pressing need for a new perspective on this problem. In this review, we evaluate the literature on social networks as a potential approach for obesity prevention and treatment (i.e., how social networks affect various health outcomes), present two major social network data analyses (i.e., egocentric and sociometric analysis), and discuss implications and the future direction for obesity research using social networks. Copyright © 2015 Elsevier Inc. All rights reserved.

Risk factors associated with treatment abandonment by overweight or obese children and adolescents

Directory of Open Access Journals (Sweden)

Larissa Soares Mariz

Full Text Available Objective.To evaluate the risk factors associated with treatment abandonment by overweight or obese children and adolescents. Methods. A cross-sectional study, conducted in 2011, at the Childhood Obesity Center, in Campina Grande, Brazil, with the records of 208 children and adolescents, between three and 18 years of age, divided into two groups: Group I included those who abandoned treatment, and Group II included those who did not abandon treatment. Results. Non-adherence was significantly associated with higher income (OR=5.8, high maternal education (OR=2.4, white skin color (OR=2.9, and obesity (OR=3.6. Conclusion. Despite the new academic-care approach, the non-adherence to treatment rate was high, and was associated with sociodemographic and nutritional factors.

Risky Sexual Behavior: A Race-Specific Social Consequence of Obesity

Science.gov (United States)

Leech, Tamara G. J.; Dias, Janice Johnson

2012-01-01

Scant attention has been given to the consequence of actual weight status for adolescents' sexual wellbeing. In this article, we investigate the race-specific connection between obesity and risky sexual behavior among adolescent girls. Propensity scores and radius matching are used to analyze a sample of 340 adolescents aged 16-17 who participated…

The ENDORSE study: Research into environmental determinants of obesity related behaviors in Rotterdam schoolchildren

NARCIS (Netherlands)

K.A. van der Horst-Nachtegaal (Klazine); A. Oenema (Anke); P.M. van de Looij-Jansen (Petra); J. Brug (Hans)

2008-01-01

textabstractBackground: Children and adolescents are important target groups for prevention of overweight and obesity as overweight is often developed early in life and tracks into adulthood. Research into behaviors related to overweight (energy balance-related behaviors) and the personal

Track: A randomized controlled trial of a digital health obesity treatment intervention for medically vulnerable primary care patients.

Science.gov (United States)

Foley, Perry; Steinberg, Dori; Levine, Erica; Askew, Sandy; Batch, Bryan C; Puleo, Elaine M; Svetkey, Laura P; Bosworth, Hayden B; DeVries, Abigail; Miranda, Heather; Bennett, Gary G

2016-05-01

Obesity continues to disproportionately affect medically vulnerable populations. Digital health interventions may be effective for delivering obesity treatment in low-resource primary care settings. Track is a 12-month randomized controlled trial of a digital health weight loss intervention in a community health center system. Participants are 351 obese men and women aged 21 to 65years with an obesity-related comorbidity. Track participants are randomized to usual primary care or to a 12-month intervention consisting of algorithm-generated tailored behavior change goals, self-monitoring via mobile technologies, daily self-weighing using a network-connected scale, skills training materials, 18 counseling phone calls with a Track coach, and primary care provider counseling. Participants are followed over 12months, with study visits at baseline, 6, and 12months. Anthropometric data, blood pressure, fasting lipids, glucose and HbA1C and self-administered surveys are collected. Follow-up data will be collected from the medical record at 24months. Participants are 68% female and on average 50.7years old with a mean BMI of 35.9kg/m(2). Participants are mainly black (54%) or white (33%); 12.5% are Hispanic. Participants are mostly employed and low-income. Over 20% of the sample has hypertension, diabetes and hyperlipidemia. Almost 27% of participants currently smoke and almost 20% score above the clinical threshold for depression. Track utilizes an innovative, digital health approach to reduce obesity and chronic disease risk among medically vulnerable adults in the primary care setting. Baseline characteristics reflect a socioeconomically disadvantaged, high-risk patient population in need of evidence-based obesity treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

Leptin - a link between obesity and osteoarthritis. applications for prevention and treatment.

Science.gov (United States)

Vuolteenaho, Katriina; Koskinen, Anna; Moilanen, Eeva

2014-01-01

Osteoarthritis (OA) is the most common cause of musculoskeletal disability and pain in the world. The current drug treatment for OA is symptom relieving, and there is an urgent need for treatments that could retard, prevent or repair cartilage destruction in OA. Obesity is a major risk factor for OA. Traditionally, it has been thought to contribute to the development of OA by increasing the load on weight-bearing joints. However, this appears to be an over-simplification, because obesity is also linked to OA in the hand and finger joints. Recent studies have shown that adipocytokine leptin is a possible link between obesity and OA: Leptin levels in synovial fluid are increased in obese patients, leptin receptor (Ob-R) is expressed in cartilage, and leptin induces the production of matrix metalloproteinases (MMPs), pro-inflammatory mediators and nitric oxide (NO) in chondrocytes. Furthermore, according to the very recent findings, not only leptin levels in the joint but also leptin sensitivity in the cartilage are enhanced in obese OA patients. The findings supporting leptin as a causative link between obesity and OA offer leptin as a potential target to the development of disease-modifying drugs for osteoarthritis (DMOAD), especially for obese patients. © 2013 Nordic Pharmacological Society. Published by John Wiley & Sons Ltd.

Diabetes and obesity treatment based on dual incretin receptor activation

DEFF Research Database (Denmark)

Skow, M A; Bergmann, N C; Knop, F K

2016-01-01

, whereas GIP seems to affect lipid metabolism. The introduction of selective GLP-1 receptor (GLP-1R) agonists for the treatment of type 2 diabetes and obesity has increased the scientific and clinical interest in incretins. Combining the body weight-lowering and glucose-lowering effects of GLP-1...... with a more potent improvement of β cell function through additional GIP action could potentially offer a more effective treatment of diabetes and obesity, with fewer adverse effects than selective GLP-1R agonists; therefore, new drugs designed to co-activate both the GIP receptor (GIPR) and the GLP-1R...

Quality of life improves in children and adolescents during a community-based overweight and obesity treatment

DEFF Research Database (Denmark)

Mollerup, Pernille M; Nielsen, Tenna R H; Bøjsøe, Christine

2017-01-01

PURPOSE: The quality of life is compromised in children and adolescents with overweight or obesity. The aim of this study was to evaluate whether the quality of life improves during a community-based overweight and obesity treatment, and whether improvements depend on reductions in the degree...... of obesity. METHODS: Quality of life was assessed using the Pediatric Quality of Life Inventory (PedsQL) 4.0 in children and adolescents aged 3-18 years with overweight or obesity [body mass index (BMI) ≥85th percentile] upon entry into a community-based chronic care overweight and obesity treatment based...... upon The Children's Obesity Clinic's Treatment protocol, and upon follow-up after 10-30 months of treatment. Height and weight were measured at each consultation and converted into a BMI standard deviation score (SDS). RESULTS: Upon entry, 477 children (212 boys) completed a PedsQL, and 317 (143 boys...

Mindfulness-Based Interventions for Obesity-Related Eating Behaviors: A Literature Review

OpenAIRE

O’Reilly, Gillian A.; Cook, Lauren; Spruijt-Metz, Donna; Black, David S.

2014-01-01

Mindfulness-based interventions (MBIs) targeting eating behaviors have gained popularity in recent years. A literature review was conducted to determine the effectiveness of MBIs for treating obesity-related eating behaviors, such as binge eating, emotional eating, and external eating. A search protocol was conducted using the online databases Google Scholar, PubMed, PsycINFO, and Ovid Healthstar. Articles were required to meet the following criteria to be included in this review: (1) describ...

School environment and policies, child eating behavior and overweight/obesity in urban China: the childhood obesity study in China megacities.

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Jia, P; Li, M; Xue, H; Lu, L; Xu, F; Wang, Y

2017-05-01

Childhood obesity is rising rapidly in China, especially in urban areas. Knowledge about how school environment and policies (SEPs) may have contributed to the epidemic remains limited. We examined SEP and their associations with students' eating behaviors and overweight/obesity in urban China. Data were collected from 1648 students (plus their parents and schools) in 16 primary and middle schools (4 schools per city) in four megacities across China: Beijing, Shanghai, Nanjing and Xi'an. We examined nutrition-related SEP such as unhealthy food restriction, healthy food promotion, price control and nutrition guideline in school cafeterias (SCs), campus food stores (CFS), school vicinity food stalls (SVFS); SEP on physical activity, physical education (PE) and physical examination. Cluster robust regression models were fit to assess associations of SEP with child eating behaviors and overweight/obesity (defined based on body mass index, from measured weight and height). All 16 schools had regular PE classes and annual physical examination. Most schools (n=12; 75%) had food policies in SC; few had policies on CFS (n=1; 6.25%) or SVFS (n=4; 25%). Local governments had a major role in regulating food prices, setting nutrition guidelines and regulating SVFS. Policies on CFS and SVFS were associated with less frequent intake of sugary beverage (odds ratio (OR)=0.54 (0.47-0.61); OR=0.70 (0.61-0.80)), snack (OR=0.84 (0.74-0.95); OR=0.78 (0.67-0.92)) and fast food (OR=0.58 (0.42-0.81); OR=0.56 (0.39-0.80)). The associations were stronger for boys. Policies on SC, CFS and SVFS were associated with lower likelihood for overweight/obesity (OR=0.60 (0.46-0.79); OR=0.74 (0.62-0.90); OR=0.51 (0.35-0.73)) and central obesity (OR=0.79 (0.70-0.89); OR=0.67 (0.48-0.92); OR=0.63 (0.48-0.84)) in boys. Policies on SC were associated with lower overweight/obesity odds (OR=0.48 (0.28-0.82)) for girls. SEP are heterogeneous in the four Chinese megacities, high-income areas. They affect

Behavioral and body size correlates of energy intake underreporting by obese and normal-weight women.

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Kretsch, M J; Fong, A K; Green, M W

1999-03-01

To examine behavioral and body size influences on the underreporting of energy intake by obese and normal-weight women. Seven-day estimated food records were kept by subjects before they participated in a 49-day residential study. Self-reported energy intake was compared with energy intake required to maintain a stable body weight during the residential study (reference standard). Energy intake bias and its relationship to various body size and behavioral measures were examined. Twenty-two, healthy, normal-weight (mean body mass index [BMI] = 21.3) and obese (mean BMI = 34.2) women aged 22 to 42 years were studied. Analysis of variance, paired t test, simple linear regression, and Pearson correlation analyses were conducted. Mean energy intake from self-reported food records was underreported by normal-weight (-9.7%) and obese (-19.4%) women. BMI correlated inversely with the energy intake difference for normal-weight women (r = -.67, P = .02), whereas the Beck Depression Inventory correlated positively with the energy intake difference for obese women (r = .73, P behavioral traits play a role in the ability of women to accurately self-report energy intake. BMI appears to be predictive of underreporting of energy intake by normal-weight women, whereas emotional factors related to depression appear to be more determinant of underreporting for obese women. Understanding causative factors of the underreporting phenomenon will help practicing dietitians to devise appropriate and realistic diet intervention plans that clients can follow to achieve meaningful change.

Relations of mood with body mass index changes in severely obese women enrolled in a supported physical activity treatment.

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Annesi, James J

2008-01-01

It has been suggested that physical activity may affect weight reduction outcomes through associated improvements in mood. Relations of physical activity, mood, and weight change are not well understood in persons classified as severely obese (BMI > or = 40 kg/m(2)), however. This research tested these relationships in women with severe obesity. 57 women with a mean BMI of 43.8 kg/m(2) were enrolled in a cognitive-behavioral exercise support treatment with group-based nutrition information. Measurement of depression, tension, overall mood, and BMI was taken at baseline and month 6, and exercise session attendance was recorded. The treatment was associated with significant improvements in depression, tension and total mood disturbance scores as well as in BMI over 6 months. Changes in mood scores that were more positive were correlated with a greater reduction in BMI. Mean attendance in the prescribed 3 session/week exercise regimen was 46.0%, and attendance was significantly correlated with changes in tension and total mood disturbance scores, and approached significance with changes in depression scores. Findings suggested significant relations of mood and weight change as well as of physical activity and mood in severely obese women associated with a treatment of moderate physical activity. With extensions of this research, weight loss theory and treatment may benefit. Copyright 2008 S. Karger AG, Basel.

[Practice clinical guideline. Prevention, diagnosis and treatment of overweight and obesity].

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Barrera-Cruz, Antonio; Avila-Jiménez, Laura; Cano-Pérez, Evaluz; Molina-Ayala, Mario Antonio; Parrilla-Ortiz, Juan Ismael; Ramos-Hernández, Rosa Isela; Sosa-Caballero, Alejandro; Sosa-Ruiz, María del Rosario; Gutiérrez-Aguilar, Judith

2013-01-01

Excess body weight (overweight and obesity) is currently recognized as one of the most important challenges of public health in the world, due to its size, speed of growth and the negative effect on health. Currently, Mexico and United States have the highest prevalence of obesity in the adult population (30 %), which is nearly ten times higher than that of Japan or Korea (4 %). In our country, the trends of overweight and obesity in different national surveys show steady increase in prevalence over time. According to the results of the National Survey of Health and Nutrition 2012 (ENSANUT, according to its initials in Spanish), the combined prevalence of overweight or obese (BMI = 25 kg/m(2)) in the population over 20 years is higher in women (73.0 %) than men (69.4 %), while the prevalence of obesity (BMI = 30 kg/m(2)) is almost higher in females than in males. Global experience shows that proper care of obesity and overweight requires formulating and coordinating comprehensive and efficient multilevel strategies for enhancing protective factors to health, particularly to modify individual, family and community behavior. It is unlikely that a single intervention can modify the incidence or natural history of overweight and obesity.

Effects of MC4R, FTO, and NMB gene variants to obesity, physical activity, and eating behavior phenotypes.

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Kirac, Deniz; Kasimay Cakir, Ozgur; Avcilar, Tuba; Deyneli, Oguzhan; Kurtel, Hizir; Yazici, Dilek; Kaspar, Elif Cigdem; Celik, Nurgul; Guney, Ahmet Ilter

2016-10-01

Obesity is a major contributory factor of morbidity and mortality. It has been suggested that biological systems may be involved in the tendency to be and to remain physically inactive also behaviors such as food and beverage preferences and nutrient intake may at least partially genetically determined. Consequently, besides environment, genetic factors may also contribute to the level of physical activity and eating behaviors thus effect obesity. Therefore the aim of this study is to investigate the effect of various gene mutations on obesity, physical activity levels and eating behavior phenotypes. One hundred patients and 100 controls were enrolled to the study. Physical activity levels were measured with an actical acceloremeter device. Eating behaviors were evaluated using Three-Factor Eating questionnaire (TFEQ). Associations between eating behavior scores and physical characteristics were also evaluated. The information about other obesity risk factors were also collected. Mutations were investigated with PCR, direct sequencing and Real-Time PCR. rs1051168, rs8050146 -2778C > T mutations were found statistically significant in patients, rs1121980 was found statistically significant in controls. 21 mutations were found in MC4R and near MC4R of which 18 of them are novel and 8 of them cause amino acid change. In addition, it was found that, some obesity related factors and questions of TFEQ are associated with various investigated gene mutations. Any relation between gene mutations and physical activity levels were not detected. It is thought that, due to the genotype data and eating behaviors, it may be possible to recommend patients for proper eating patterns to prevent obesity. © 2016 IUBMB Life, 68(10):806-816, 2016. © 2016 International Union of Biochemistry and Molecular Biology.

A systematic review of satisfaction and pediatric obesity treatment: new avenues for addressing attrition.

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Skelton, Joseph A; Irby, Megan Bennett; Geiger, Ann M

2014-01-01

Pediatric obesity treatment programs report high attrition rates, but it is unknown if family experience and satisfaction contributes. This review surveys the literature regarding satisfaction in pediatric obesity and questions used in measurement. A systematic review of the literature was conducted using Medline, PsychINFO, and CINAHL. Studies of satisfaction in pediatric weight management were reviewed, and related studies of obesity were included. Satisfaction survey questions were obtained from the articles or from the authors. Eighteen studies were included; 14 quantitative and 4 qualitative. Only one study linked satisfaction to attrition, and none investigated the association of satisfaction and weight outcomes. Most investigations included satisfaction as a secondary aim or used single-item questions of overall satisfaction; only one assessed satisfaction in noncompleters. Overall, participants expressed high levels of satisfaction with obesity treatment or prevention programs. Surveys focused predominantly on overall satisfaction or specific components of the program. Few in-depth studies of satisfaction with pediatric obesity treatment have been conducted. Increased focus on family satisfaction with obesity treatment may provide an avenue to lower attrition rates and improve outcomes. Enhancing measurement of satisfaction to yield actionable responses could positively influence outcomes, and a framework, via patient-centered care principles, is provided. © 2013 National Association for Healthcare Quality.

Subjective evaluation of psychosocial well-being in children and youths with overweight or obesity: the impact of multidisciplinary obesity treatment.

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Fonvig, Cilius Esmann; Hamann, Sophie Amalie; Nielsen, Tenna Ruest Haarmark; Johansen, Mia Østergaard; Grønbæk, Helle Nergaard; Mollerup, Pernille Maria; Holm, Jens-Christian

2017-12-01

To investigate the effects of a multidisciplinary childhood obesity treatment programme on subjective evaluations of psychosocial well-being and quality of life. This longitudinal observational study included 1291 children, adolescents and young adults, 6-22 years of age, with overweight or obesity. At entry and after 2-82 months of obesity treatment, the patients evaluated the following domains of psychosocial well-being on a visual analogue scale: quality of life, mood, appetite, bullying, motivation for weight loss and body image satisfaction. The degree of overweight was calculated using a body mass index (BMI) standard deviation score (SDS) at each visit. At entry, the mean BMI SDS was 2.81 (range: 1.35-6.65, 95% confidence interval (95% CI): 2.44-3.18). After a median of 14 months of treatment, the median reduction in BMI SDS was 0.29 (95% CI: 0.26-0.31, p bullying and body image satisfaction (p < 0.0001). Larger reductions in BMI SDS were associated with greater improvements in the domains of quality of life (p = 0.001), mood (p = 0.04) and body image satisfaction (p < 0.0001), independent of BMI SDS at entry. However, improvements in psychosocial well-being were also observed in those increasing their BMI SDS (n = 315). In a large group of children and youths, psychosocial well-being improved during a multidisciplinary childhood obesity treatment programme, irrespective of the degree of obesity at treatment entry. Greater reductions in BMI SDS were associated with greater improvements in psychosocial well-being, but even in the group increasing their BMI SDS improvements were observed.

Neural correlates to food-related behavior in normal-weight and overweight/obese participants.

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Alan Ho

Full Text Available Two thirds of US adults are either obese or overweight and this rate is rising. Although the etiology of obesity is not yet fully understood, neuroimaging studies have demonstrated that the central nervous system has a principal role in regulating eating behavior. In this study, functional magnetic resonance imaging and survey data were evaluated for correlations between food-related problem behaviors and the neural regions underlying responses to visual food cues before and after eating in normal-weight individuals and overweight/obese individuals. In normal-weight individuals, activity in the left amygdala in response to high-calorie food vs. nonfood object cues was positively correlated with impaired satiety scores during fasting, suggesting that those with impaired satiety scores may have an abnormal anticipatory reward response. In overweight/obese individuals, activity in the dorsolateral prefrontal cortex (DLPFC in response to low-calorie food cues was negatively correlated with impaired satiety during fasting, suggesting that individuals scoring lower in satiety impairment were more likely to activate the DLPFC inhibitory system. After eating, activity in both the putamen and the amygdala was positively correlated with impaired satiety scores among obese/overweight participants. While these individuals may volitionally suggest they are full, their functional response to food cues suggests food continues to be salient. These findings suggest brain regions involved in the evaluation of visual food cues may be mediated by satiety-related problems, dependent on calorie content, state of satiation, and body mass index.

DGAT and triglyceride synthesis: a new target for obesity treatment?

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Chen, H C; Farese, R V

2000-07-01

Because triglycerides are considered essential for survival and their synthesis has been thought to occur through a single mechanism, inhibiting triglyceride synthesis has been largely unexplored as a possible target for obesity treatment. However, recent studies indicate that mice lacking acyl CoA:diacylglycerol acyltransferase (DGAT), a key enzyme in triglyceride synthesis, are viable and resistant to diet-induced obesity. Unexpectedly, this resistance is caused by a mechanism involving increased energy expenditure. These findings suggest that inhibiting specific components of triglyceride synthesis, such as DGAT, is feasible and may represent a novel approach to treating obesity.

Eating-related Behaviors and Appetite During Energy Imbalance in Obese-Prone and Obese-Resistant Individuals

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Thomas, Elizabeth A.; Bechtell, Jaime L.; Vestal, Brian E.; Johnson, Susan L.; Bessesen, Daniel H.; Tregellas, Jason R.; Cornier, Marc-Andre

2013-01-01

While the majority of Americans are now overweight, some individuals maintain their weight with minimal effort. This study investigated behavioral differences between 58 individuals recruited as either obese-resistant (OR) or obese-prone (OP) based on self-identification, BMI, and personal/family weight history. Subjects were studied during Eucaloric (EU), Overfed (OF), and Underfed (UF) phases which included a run-in diet, 1 day intervention diet, and a study day. At baseline, subjects completed the Three Factor Eating Questionnaire (TFEQ) and Power of Food Scale (PFS). On the study day, ratings of appetite, food appeal and desire, and food cravings were performed in response to a breakfast shake. OF resulted in reduced hunger and food desire while UF resulted in increased hunger and food appeal and desire. While hunger did not differ between groups, OP had higher scores for TFEQ measures (hunger, restraint and disinhibition), higher “hedonic hunger” as measured by the PFS, and greater food cravings and ratings of food appeal and desire. These results suggest that subjective hunger and desire for food change significantly after only one day of over- or underfeeding. Additionally, we found several behavioral differences between groups that are likely to promote weight gain over time in the OP. PMID:23402714

How does obesity affect fertility in men - and what are the treatment options?

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Stokes, Victoria J; Anderson, Richard A; George, Jyothis T

2015-05-01

Adiposity is associated with reduced fertility in men. The aetiology is multifactorial, with obese men at greater risk of suffering from impaired spermatogenesis, reduced circulating testosterone levels, erectile dysfunction and poor libido. The diagnosis and treatment of reduced fertility observed in obese men therefore requires insight into the underlying pathology, which has hormonal, mechanical and psychosocial aspects. This article summarises the current epidemiological, experimental and clinical trial evidence from the perspective of a practicing clinician. The following conclusions and recommendations can be drawn: Obesity is associated with low serum testosterone concentrations, but treatment with exogenous testosterone is likely to adversely impact on fertility. It is important to discuss this with men prior to initiation of testosterone therapy. Obesity adversely affects sperm concentration and may affect sperm quality. However, whether or not weight loss will correct these factors remain to be established. Oestrogen receptor modulators (and aromatase inhibitors) are unlicensed in the treatment for male hypogonadism and/or infertility. These treatments should hence be considered experimental approach until ongoing clinical trials report their outcomes. © 2014 John Wiley & Sons Ltd.

Treatment outcomes of obstructive sleep apnoea in obese community-dwelling children: the NANOS study.

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Alonso-Álvarez, María Luz; Terán-Santos, Joaquin; Navazo-Egüia, Ana Isabel; Martinez, Mónica Gonzalez; Jurado-Luque, María José; Corral-Peñafiel, Jaime; Duran-Cantolla, Joaquin; Cordero-Guevara, José Aurelio; Kheirandish-Gozal, Leila; Gozal, David

2015-09-01

The first line of treatment of obstructive sleep apnoea syndrome (OSAS) in children consists of adenotonsillectomy (T&A). The aim of the present study was to evaluate treatment outcomes of OSAS among obese children recruited from the community.A cross-sectional, prospective, multicentre study of Spanish obese children aged 3-14 years, with four groups available for follow-up: group 1: non-OSAS with no treatment; group 2: dietary treatment; group 3: surgical treatment; and group 4: continuous positive airway pressure treatment.117 obese children (60 boys, 57 girls) with a mean age of 11.3±2.9 years completed the initial (T0) and follow-up (T1) assessments. Their mean body mass index (BMI) at T1 was 27.6±4.7 kg·m(-2), corresponding to a BMI Z-score of 1.34±0.59. Mean respiratory disturbance index (RDI) at follow-up was 3.3±3.9 events·h(-1). Among group 1 children, 21.2% had an RDI ≥3 events·h(-1) at T1, the latter being present in 50% of group 2, and 43.5% in group 3. In the binary logistic regression model, age emerged as a significant risk factor for residual OSAS (odds ratio 1.49, 95% confidence interval 1.01-2.23; p<0.05) in obese children surgically treated, and RDI at T0 as well as an increase in BMI emerged as significant risk factors for persistent OSAS in obese children with dietary treatment (OR 1.82, 95% CI 1.09-3.02 (p<0.03) and OR 8.71, 95% CI 1.24-61.17 (p=0.03)).Age, RDI at diagnosis and obesity are risk factors for relatively unfavourable OSAS treatment outcomes at follow-up. Copyright ©ERS 2015.

Locally Induced Adipose Tissue Browning by Microneedle Patch for Obesity Treatment.

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Zhang, Yuqi; Liu, Qiongming; Yu, Jicheng; Yu, Shuangjiang; Wang, Jinqiang; Qiang, Li; Gu, Zhen

2017-09-26

Obesity is one of the most serious public health problems in the 21st century that may lead to many comorbidities such as type-2 diabetes, cardiovascular diseases, and cancer. Current treatments toward obesity including diet, physical exercise, pharmacological therapy, as well as surgeries are always associated with low effectiveness or undesired systematical side effects. In order to enhance treatment efficiency with minimized side effects, we developed a transcutaneous browning agent patch to locally induce adipose tissue transformation. This microneedle-based patch can effectively deliver browning agents to the subcutaneous adipocytes in a sustained manner and switch on the "browning" at the targeted region. It is demonstrated that this patch reduces treated fat pad size, increases whole body energy expenditure, and improves type-2 diabetes in vivo in a diet-induced obesity mouse model.

Obesity-related glomerulopathy: pathogenesis, pathologic, clinical characteristics and treatment.

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Xu, Tianhua; Sheng, Zitong; Yao, Li

2017-09-01

In light of the rapid increase in the number of obesity incidences worldwide, obesity has become an independent risk factor for chronic kidney disease. Obesity-related glomerulopathy (ORG) is characterized by glomerulomegaly in the presence or absence of focal and segmental glomerulosclerosis lesions. IgM and complement 3 (C3) nonspecifically deposit in lesions without immune-complex-type deposits during ORG immunofluorescence. ORG-associated glomerulomegaly and focal and segmental glomerulosclerosis can superimpose on other renal pathologies. The mechanisms under ORG are complex, especially hemodynamic changes, inflammation, oxidative stress, apoptosis, and reduced functioning nephrons. These mechanisms synergize with obesity to induce end-stage renal disease. A slow increase of subnephrotic proteinuria ( < 3.5 g/d) is the most common clinical manifestation of ORG. Several treatment methods for ORG have been developed. Of these methods, renin-angiotensin-aldosterone system blockade and weight loss are proven effective. Targeting mitochondria may offer a novel strategy for ORG therapy. Nevertheless, more research is needed to further understand ORG.

Quality of life improves in children and adolescents during a community-based overweight and obesity treatment.

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Mollerup, Pernille M; Nielsen, Tenna R H; Bøjsøe, Christine; Kloppenborg, Julie T; Baker, Jennifer L; Holm, Jens-Christian

2017-06-01

The quality of life is compromised in children and adolescents with overweight or obesity. The aim of this study was to evaluate whether the quality of life improves during a community-based overweight and obesity treatment, and whether improvements depend on reductions in the degree of obesity. Quality of life was assessed using the Pediatric Quality of Life Inventory (PedsQL) 4.0 in children and adolescents aged 3-18 years with overweight or obesity [body mass index (BMI) ≥85th percentile] upon entry into a community-based chronic care overweight and obesity treatment based upon The Children's Obesity Clinic's Treatment protocol, and upon follow-up after 10-30 months of treatment. Height and weight were measured at each consultation and converted into a BMI standard deviation score (SDS). Upon entry, 477 children (212 boys) completed a PedsQL, and 317 (143 boys) completed another PedsQL after a median of 13 months of treatment. Quality of life improved (p quality of life (p ≤ 0.047). However, improvements also occurred in children and adolescents with low socioeconomic status or who increased their BMI SDS (p quality of life occurred in children and adolescents during a community-based overweight and obesity treatment, even in children and adolescents who increased their BMI SDS. Thus, improvements may be due to the treatment itself and not exclusively to reductions in BMI SDS. Clinicaltrials.gov, ID-no.: NCT02013843.

Behavioural therapy in the treatment of obesity (II): role of the Mediterranean diet.

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Garaulet, Marta; Pérez de Heredia, F

2010-01-01

Obesity is the consequence of an imbalance between energy intake and expenditure, food intake being affected by multiple factors -psychological, social, work-related, etc. This revision discusses the role of diet in the behavioural treatment (BT) of obesity, which faces multiple approaches and focuses on patients' behaviour rather than their mere energy intake. Recent literature has been revised that deals with the health benefits of Mediterranean diet in order to assess its suitability for obesity treatment based on BT. BT helps patients to develop skills and techniques in order to adopt proper habits and attain their healthiest weight. Patients learn to establish realistic goals, both as regards weight and behaviour, and to evaluate their progress in modifying eating and exercising habits. The application of the Mediterranean diet in obesity treatment presents various advantages which are based on the principles of this diet -wide variety of food, high carbohydrate content, or high satiating capacity, which prevents specific hunger and ketogenesis-, and has been demonstrated to be effective in reducing body weight. BT based on the Mediterranean diet is a useful tool for obesity treatment. The Mediterranean diet provides the patients with a diet established on widely recognised nutritional benefits, suitable to their social and daily life, and that can be easily followed in the long term, according to the objectives of BT. For these reasons, Mediterranean diet-based BT helps to prolong both the treatment and maintenance periods and therefore contributes to a more stable weight loss.

Assessment of obesity management in medical examination

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Treyzon Leo

2005-03-01

Full Text Available Abstract Obesity is a growing international health problem that has already reached epidemic proportions, particularly within the United States where a majority of the population is overweight or obese. Effective methods of treatment are needed, and should be taught to physicians by efficient means. There exists a disconnect between the rising obesity prevalence with its high toll on medical resources, and the lack of obesity education provided to practitioners in the course of their training. One particular shortfall is the lack of representation of obesity on standardized medical examinations. Physician attitudes toward obesity are influenced by their lack of familiarity with the management of the disease. This may include dietary restriction, increasing physical activity, behavior modification, pharmacotherapy, and surgical interventions. Thus, curricular changes in the medical education of obesity could help reduce morbidity and mortality associated with this disease.

A Values-Based Motivational Interviewing (MI) Intervention for Pediatric Obesity: Study Design and Methods for MI Values

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Bean, Melanie K.; Mazzeo, Suzanne E.; Stern, Marilyn; Bowen, Deborah; Ingersoll, Karen

2011-01-01

To reduce pediatric obesity in clinical settings, multidisciplinary behaviorally-based treatment programs are recommended. High attrition and poor compliance are two difficulties frequently encountered in such programs. A brief, empathic and directive clinical intervention, Motivational Interviewing (MI), might help address these motivational and behavioral issues, ultimately resulting in more positive health outcomes. The efficacy of MI as an adjunct in the treatment of pediatric obesity rem...

Hypothalamic obesity after treatment for craniopharyngioma: the importance of the home environment.

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Meijneke, Ruud W H; Schouten-van Meeteren, Antoinette Y N; de Boer, Nienke Y; van Zundert, Suzanne; van Trotsenburg, Paul A S; Stoelinga, Femke; van Santen, Hanneke M

2015-01-01

Hypothalamic obesity after treatment for craniopharyngioma is a well-recognized, severe problem. Treatment of hypothalamic obesity is difficult and often frustrating for the patient, the parents and the professional care-giver. Because hypothalamic obesity is caused by an underlying medical disorder, it is often assumed that regular diet and exercise are not beneficial to reduce the extraordinarily high body mass index, and in fact, lifestyle interventions have been shown to be insufficient in case of extreme hypothalamic obesity. Nevertheless, it is important to realize that also in this situation, informal care delivered by the family and appropriate parenting styles are required to minimize the obesity problem. We present a case in which weight gain in the home situation was considered unstoppable, and a very early mortality due to complications of the severe increasing obesity was considered inevitable. A permissive approach toward food intake became leading with rapid weight increase since a restrictive lifestyle was considered a senseless burden for the child. By admission to our hospital for a longer period of time, weight reduction was realized, and the merely permissive approach could be changed into active purposeful care by adequate information, instruction, guidance and encouragement of the affected child and her parents. This case illustrates that, although this type of obesity has a pathological origin, parental and environmental influences remain of extreme importance.

The influence of a behavior modification interventional program on body mass index in obese adolescents

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Tahereh Toulabi

2012-03-01

Conclusion: The ‘‘behavior modification’’ interventional program is effective in reducing BMI in obese students, and therefore, school principals and planners can play an important role in controlling obesity by implementing this program via the students, their parents, and the school staff.

Reasons for non-adherence to obesity treatment in children and adolescents

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Thaïs Florence D. Nogueira

2013-09-01

Full Text Available OBJECTIVE To analyze the reasons for non-adherence to follow-up at a specialized outpatient clinic for obese children and adolescents. METHODS Descriptive study of 41 patients, including information from medical records and phone recorded questionnaires which included two open questions and eight closed ones: reason for abandonment, financial and structural difficulties (distance and transport costs, relationship with professionals, obesity evolution, treatment continuity, knowledge of difficulties and obesity complications. RESULTS Among the interviewees, 29.3% reported that adherence to the program spent too much time and it was difficult to adjust consultations to patientsâ€(tm and parentsâ€(tm schedules. Other reasons were: childrenâ€(tms refusal to follow treatment (29.3%, dissatisfaction with the result (17.0%, treatment in another health service (12.2%, difficulty in schedule return (7.3% and delay in attendance (4.9%. All denied any relationship problems with professionals. Among the respondents, 85.4% said they are still overweight. They reported hurdles to appropriate nutrition and physical activity (financial difficulty, lack of parentsâ€(tm time, physical limitation and insecure neighborhood. Among the 33 respondents that reported difficulties with obesity, 78.8% had emotional disorders such as bullying, anxiety and irritability; 24.2% presented fatigue, 15.1% had difficulty in dressing up and 15.1% referred pain. The knowledge of the following complications prevailed: cardicac (97.6%, aesthetic (90.2%, psychological (90.2%, presence of obesity in adulthood (90.2%, diabetes (85.4% and cancer (31.4%. CONCLUSIONS According to the results, it is possible to create weight control public programs that are easier to access, encouraging appropriate nutrition and physical activities in order to achieve obesity prevention.

Optimal Control Problem of Treatment for Obesity in a Closed Population

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D. Aldila

2014-01-01

Full Text Available Variety of intervention programs for controlling the obesity epidemic has been done worldwide. However, it is still not yet available a scientific tool to measure the effectiveness of those programs. This is due to the difficulty in parameterizing the human interaction and transition process of obesity. A dynamical model for simulating the interaction between healthy people, overweight people, and obese people in a randomly mixed population is discussed in here. Two scenarios of intervention programs were implemented in the model, dietary program for overweight people with healthy life campaign and treatment program for obese people. Assuming all control rates are constant, disease free equilibrium point, endemic equilibrium point, and basic reproductive ratio (ℛ0 as the epidemic indicator were shown analytically. We find that the disease free equilibrium point is locally asymptotical stable if and only if ℛ0<1. From sensitivity analysis of ℛ0, we obtain that larger rate of dietary program and treatment program will reduce ℛ0 significantly. With control rates are continuous in time, an optimal control approach was applied into the model to find the best way to minimize the number of overweight and obese people. Some numerical analysis and simulations for optimal control of the intervention were shown to support the analytical results.

Individuals with Smith-Magenis syndrome display profound neurodevelopmental behavioral deficiencies and exhibit food-related behaviors equivalent to Prader-Willi syndrome.

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Alaimo, Joseph T; Barton, Laura V; Mullegama, Sureni V; Wills, Rachel D; Foster, Rebecca H; Elsea, Sarah H

2015-12-01

Smith-Magenis syndrome (SMS) is a neurodevelopmental disorder associated with intellectual disability, sleep disturbances, early onset obesity and vast behavioral deficits. We used the Behavior Problems Inventory-01 to categorize the frequency and severity of behavioral abnormalities in a SMS cohort relative to individuals with intellectual disability of heterogeneous etiology. Self-injurious, stereotyped, and aggressive/destructive behavioral scores indicated that both frequency and severity were significantly higher among individuals with SMS relative to those with intellectual disability. Next, we categorized food behaviors in our SMS cohort across age using the Food Related Problems Questionnaire (FRPQ) and found that problems began to occur in SMS children as early as 5-11 years old, but children 12-18 years old and adults manifested the most severe problems. Furthermore, we evaluated the similarities of SMS adult food-related behaviors to those with intellectual disability and found that SMS adults had more severe behavioral problems. Many neurodevelopmental disorders exhibit syndromic obesity including SMS. Prader-Willi syndrome (PWS) is the most frequent neurodevelopmental disorder with syndromic obesity and has a well-established management and treatment plan. Using the FRPQ we found that SMS adults had similar scores relative to PWS adults. Both syndromes manifest weight gain early in development, and the FRPQ scores highlight specific areas in which behavioral similarities exist, including preoccupation with food, impaired satiety, and negative behavioral responses. SMS food-related behavior treatment paradigms are not as refined as PWS, suggesting that current PWS treatments for prevention of obesity may be beneficial for individuals with SMS. Copyright © 2015 Elsevier Ltd. All rights reserved.

The association of parental characteristics and psychological problems in obese youngsters.

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Decaluwé, V; Braet, C; Moens, E; Van Vlierberghe, L

2006-12-01

The aim of the present study was to examine to what extent parental psychological characteristics and parental behavior are related to psychological problems in obese youngsters. Data were collected from 196 families having an overweight youngster (range 10-16 years old) (mean body mass index (BMI)=31.2; s.d.=5.3) seeking weight-loss treatment and compared with data from normal weight samples. Behavior problems were measured using the Child Behavior Checklist; the Child version of the Eating Disorder Examination was used to assess eating disorder psychopathology. Parental psychopathology was measured using the Symptom Checklist-90; parenting behavior was assessed with the Ghent Parental Behavior Scale. Parental psychopathology was prevalent in 59.6% of mothers and 35.7% of fathers. Youngsters exceeding the cutoff for problem behavior ranged between 41.4 and 53.1%. Children's problem behavior was most associated with psychopathology in the mother (r=0.40 for Internalizing and r=0.37 for Externalizing; both Pparenting behavior, namely Inconsistent discipline, although the effect was stronger for Externalizing behavior (explained variance: 10%) than for Internalizing behavior (explained variance: 4%). No evidence was found for a mediator effect from parenting behavior on the eating disorder symptoms of the obese youngsters. However, several direct relations emerged, suggesting a negative association between a child's eating disorder symptoms and Positive parenting behavior by the mother (r= -0.20 for Eating concern; r= -0.18 for Restraint eating; r= -0.16 for Shape concern; all PParental characteristics were associated with psychological problems in obese youngsters, not only in a direct way but also indirectly. The effects were partly mediated by a particular ineffective parenting style, namely inconsistent discipline on the part of the mother. Pediatric obesity treatments should focus more on parenting behaviors and parental characteristics.

Herbal Medicine for the Treatment of Obesity: An Overview of Scientific Evidence from 2007 to 2017

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Yanfei Liu

2017-01-01

Full Text Available Obesity is a very common global health problem, and it is known to be linked to cardiovascular and cerebrovascular diseases. Western medical treatments for obesity have many drawbacks, including effects on monoamine neurotransmitters and the potential for drug abuse and dependency. The safety of these medications requires improvement. Herbal medicine has been used for treatment of disease for more than 2000 years, and it has proven efficacy. Many studies have confirmed that herbal medicine is effective in the treatment of obesity, but the mechanisms are not clear. This article will discuss the possible effects and mechanisms of herbal medicine treatments for obesity that have been reported in the past decade.

Obesity and Cardiovascular Disease in Children

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Mellova Amir Masrizal

2004-04-01

Full Text Available Obesity is performed by genetic, environmental, and complex interaction between genetic and environmental factors. Fatness levels in obese children are indicative of increased risk for elevated blood pressure, cholesterol, and lipoprotein ratios children and adolescents. Serum cholesterol and blood pressure are related to raise atherosclerotic lesion. Certain cardiovascular disease risk factors in obese children are related to the earliest stages of atherosclerosis disease. Obese children have the high risk factors of certain cardiovascular disease. Genetic factors affecting metabolic rate can be successfully managed by the introduction of environmental factors such as decrease caloric intake and increase physical activity. The treatment of obesity and of atherosclerotic patients should include dietary restriction (protein sparing modified fast and hypocaloric balanced diet, nutrition education, increased physical activity, behavior modification, and familial support. Success fully management of obesity can improve the quality of life and reduce the risk of morbidity and mortality associated with obesity.

Anti-Obesity Drugs: A Review about Their Effects and Safety

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Jun Goo Kang

2012-02-01

Full Text Available The current recommendations for the treatment of obese people include increased physical activity and reduced calories intake. When the behavioral approach is not sufficient, a pharmacologic treatment is recommended. In past years, numerous drugs have been approved for the treatment of obesity; however, most of them have been withdrawn from the market because of their adverse effects. In fact, amphetamine, rimonabant and sibutramine licenses have been withdrawn due to an increased risk of psychiatric disorders and non-fatal myocardial infarction or stroke. Even if orlistat is not as effective as other drugs in reducing body weight, orlistat is presently the only available choice for the treatment of obesity because of its safety for cardiovascular events and positive effects on diabetic control. Hopefully, more effective and better tolerated anti-obesity drugs will be developed through an improved understanding of the multiple mechanisms and complex physiological systems targeting appetite.

A Behavioral Weight Loss Program and Nonurinary Incontinence Lower Urinary Tract Symptoms in Overweight and Obese Women with Urinary Incontinence: A Secondary Data Analysis of PRIDE.

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Breyer, Benjamin N; Creasman, Jennifer M; Richter, Holly E; Myers, Deborah; Burgio, Kathryn L; Wing, Rena R; West, Delia Smith; Kusek, John W; Subak, Leslee L

2018-01-01

We sought to determine whether a behavioral weight reduction intervention would improve nonurinary incontinence lower urinary tract storage symptoms at 6 months, including urinary frequency, nocturia and urgency, compared to a structured education program serving as the control group among overweight and obese women with urinary incontinence. PRIDE (Program to Reduce Incontinence by Diet and Exercise) was a randomized clinical trial performed in 338 overweight or obese women with urinary incontinence. Participants were randomized, including 226 to 6-month behavioral weight loss intervention and 112 to the control group. All participants received a self-help behavioral treatment booklet to improve bladder control. On this secondary data analysis we examined changes in nonurinary incontinence lower urinary tract storage symptoms from baseline to 6 months and the impact of treatment allocation (intervention vs control), weight loss and physical activity. Nonurinary incontinence lower urinary tract storage symptoms were common at baseline, varying from 48% to 62%. In the 2 groups combined women experienced significant improvement in nocturia, urgency and International Prostate Symptom Score at 6 months (all p urinary tract storage symptom outcomes at 6 months did not differ between the intervention and control groups. Similarly no difference was observed in the amount of weight lost (5% or greater vs less than 5%) or physical activity (1,500 kcal or greater expenditure per week compared to less than 1,500 kcal). Lower urinary tract storage symptoms were common among overweight and obese women with urinary incontinence. The prevalence decreased significantly after 6 months independent of treatment group assignment, amount of weight lost or physical activity. These improvements may have been due to self-help behavioral educational materials, trial participation or repeat assessment of symptoms. Copyright © 2018 American Urological Association Education and Research, Inc

National Institutes of Health Update: Translating Basic Behavioral Science into New Pediatric Obesity Interventions.

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Czajkowski, Susan M

2016-06-01

Pediatric obesity increases the risk of later-life obesity and chronic diseases. Basic research to better understand factors associated with excessive weight gain in early life and studies translating research findings into preventive and therapeutic strategies are essential to our ability to better prevent and treat childhood obesity. This overview describes several National Institutes of Health efforts designed to stimulate basic and translational research in childhood obesity prevention and treatment. These examples demonstrate the value of research in early phase translational pediatric obesity research and highlight some promising directions for this important area of research. Published by Elsevier Inc.

Obesity evaluation and treatment: Expert Committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services.

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Barlow, S E; Dietz, W H

1998-09-01

The development of recommendations for physicians, nurse practitioners, and nutritionists to guide the evaluation and treatment of overweight children and adolescents. The Maternal and Child Health Bureau, Health Resources and Services Administration, the Department of Health and Human Services convened a committee of pediatric obesity experts to develop the recommendations. The Committee recommended that children with a body mass index (BMI) greater than or equal to the 85th percentile with complications of obesity or with a BMI greater than or equal to the 95th percentile, with or without complications, undergo evaluation and possible treatment. Clinicians should be aware of signs of the rare exogenous causes of obesity, including genetic syndromes, endocrinologic diseases, and psychologic disorders. They should screen for complications of obesity, including hypertension, dyslipidemias, orthopedic disorders, sleep disorders, gall bladder disease, and insulin resistance. Conditions that indicate consultation with a pediatric obesity specialist include pseudotumor cerebri, obesity-related sleep disorders, orthopedic problems, massive obesity, and obesity in children younger than 2 years of age. Recommendations for treatment evaluation included an assessment of patient and family readiness to engage in a weight-management program and a focused assessment of diet and physical activity habits. The primary goal of obesity therapy should be healthy eating and activity. The use of weight maintenance versus weight loss to achieve weight goals depends on each patient's age, baseline BMI percentile, and presence of medical complications. The Committee recommended treatment that begins early, involves the family, and institutes permanent changes in a stepwise manner. Parenting skills are the foundation for successful intervention that puts in place gradual, targeted increases in activity and targeted reductions in high-fat, high-calorie foods. Ongoing support for families

Influence of menopause on dietary treatment of obesity

NARCIS (Netherlands)

Andersson, B.; Seidell, J; Terning, K; Björntorp, P

Obese women (n = 104) were treated with an energy reduced diet (1100 kcal d-1) in a strictly standardized outpatient regime. Body composition, regional adipose tissue distribution, regional fat cell sizes and metabolic variables were followed before treatment, after 5% weight loss and at the stage

Investing in Obesity Treatment: Kaiser Permanente's Approach to Chronic Disease Management.

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Tsai, Adam G; Histon, Trina; Donahoo, W Troy; Hashmi, Shahid; Murali, Sameer; Latare, Peggy; Oliver, Lajune; Slovis, Jennifer; Grall, Sarah; Fisher, David; Solomon, Loel

2016-09-01

Kaiser Permanente, an integrated health care delivery system in the USA, takes a "whole systems" approach to the chronic disease of obesity that begins with efforts to prevent it by modifying the environment in communities and schools. Aggressive case-finding and substantial investment in intensive lifestyle modification programs target individuals at high risk of diabetes and other weight-related conditions. Kaiser Permanente regions are increasingly standardizing their approach when patients with obesity require treatment intensification using medically supervised diets, prescription medication to treat obesity, or weight loss surgery.

New Approaches in Obesity Treatment

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J.E. de Niet (Judith)

2010-01-01

textabstractObesity has become a global epidemic among all age groups. A number of countries have even experienced a notable shift from under- to over nutrition in youngsters or a double burden of both malnutrition and obesity. The World Health Organization (WHO) defines overweight and obesity as

Limited availability of childhood overweight and obesity treatment programmes in Danish paediatric departments

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Eg, Marianne; Cortes, Dina; Johansen, Anders

2016-01-01

INTRODUCTION: The prevalence of children and adolescents with overweight and obesity has tripled over the past 30 years. One in five children in Denmark is overweight, a condition which is accompanied by serious medical and psychosocial complications. So far, an overview of the Danish treatment...... of departments offered less comprehensive programmes. The final third offered no multidisciplinary treatment programme for the target group. The criteria for referral to the paediatric departments that offered obesity programmes were heterogeneous. FUNDING: Funding for this study was received from Region...... of childhood overweight and obesity has been lacking. METHODS: Telephone interviews with all Danish paediatric departments were conducted in 2014. The results, constituting a baseline, were analysed using the clinical guidelines for overweight and obesity published by the Danish Paediatric Society's Overweight...

Limited availability of childhood overweight and obesity treatment programmes in Danish paediatric departments

DEFF Research Database (Denmark)

Eg, Marianne; Cortes, Dina; Johansen, Anders

2016-01-01

INTRODUCTION: The prevalence of children and adolescents with overweight and obesity has tripled over the past 30 years. One in five children in Denmark is overweight, a condition which is accompanied by serious medical and psychosocial complications. So far, an overview of the Danish treatment...... of departments offered less comprehensive programmes. The final third offered no multidisciplinary treatment programme for the target group. The criteria for referral to the paediatric departments that offered obesity programmes were heterogeneous. FUNDING: Funding for this study was received from Region...... of childhood overweight and obesity has been lacking. METHODS: Telephone interviews with all Danish paediatric departments were conducted in 2014. The results, constituting a baseline, were analysed using the clinical guidelines for overweight and obesity published by the Danish Paediatric Society’s Overweight...

A reciprocal interaction between food-motivated behavior and diet-induced obesity

NARCIS (Netherlands)

La Fleur, S. E.; Vanderschuren, L. J. M. J.; Luijendijk, M. C.; Kloeze, B. M.; Tiesjema, B.; Adan, R. A. H.

2007-01-01

OBJECTIVES: One of the main causes of obesity is overconsumption of diets high in fat and sugar. We studied the metabolic changes and food-motivated behavior when rats were subjected to a choice diet with chow, lard and a 30% sucrose solution (high fat high sugar (HFHS)-choice diet). Because rats

Behavioral and Psychological Phenotyping of Physical Activity and Sedentary Behavior: Implications for Weight Management.

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Bryan, Angela D; Jakicic, John M; Hunter, Christine M; Evans, Mary E; Yanovski, Susan Z; Epstein, Leonard H

2017-10-01

Risk for obesity is determined by a complex mix of genetics and lifetime exposures at multiple levels, from the metabolic milieu to psychosocial and environmental influences. These phenotypic differences underlie the variability in risk for obesity and response to weight management interventions, including differences in physical activity and sedentary behavior. As part of a broader effort focused on behavioral and psychological phenotyping in obesity research, the National Institutes of Health convened a multidisciplinary workshop to explore the state of the science in behavioral and psychological phenotyping in humans to explain individual differences in physical activity, both as a risk factor for obesity development and in response to activity-enhancing interventions. Understanding the behavioral and psychological phenotypes that contribute to differences in physical activity and sedentary behavior could allow for improved treatment matching and inform new targets for tailored, innovative, and effective weight management interventions. This summary provides the rationale for identifying psychological and behavioral phenotypes relevant to physical activity and identifies opportunities for future research to better understand, define, measure, and validate putative phenotypic factors and characterize emerging phenotypes that are empirically associated with initiation of physical activity, response to intervention, and sustained changes in physical activity. © 2017 The Obesity Society.

Family involvement in the treatment of childhood obesity

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Grønbæk, Helle Nergaard; Madsen, Svend Aage Lykke; Michaelsen, Kim F.

2009-01-01

INTRODUCTION: The objective of this study was to assess the impacts of a family-based childhood obesity treatment on anthropometry and predictors of dropout and successful weight loss. MATERIALS AND METHODS: The 18-month treatment consisted of a intensive period (IP) including physical exercise...... had limited education and in immigrant families. CONCLUSIONS: This treatment with a psychological approach is feasible and results in significant weight loss during the programme. Future research should focus on how to improve the results of families with limited education and immigrants with non...

OB CITY-Definition of a Family-Based Intervention for Childhood Obesity Supported by Information and Communication Technologies.

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Hu, Ruofei; Cancela, Jorge; Arredondo Waldmeyer, Maria Teresa; Cea, Gloria; Vlachopapadopoulou, Elpis-Athina; Fotiadis, Dimitrios I; Fico, Giuseppe

2016-01-01

Childhood obesity is becoming one of the 21st century's most important public health problems. Nowadays, the main treatment of childhood obesity is behavior intervention that aims at improve children's lifestyle to arrest the disease. Information and communication technologies (ICTs) have not been widely employed in this intervention, and most of existing ICTs systems are not having a long-term effect. The purpose of this paper is to define a system to support family-based intervention through a state-of-the-art analysis of family-based interventions and related technological solutions first, and then using the analytic hierarchy process to derive a childhood obesity family-based behavior intervention model, and finally to provide a prototype of a system called OB CITY. The system makes use of applied behavior analysis, affective computing technologies, as well as serious game and gamification techniques, to offer long term services in all care dimensions of the family-based behavioral intervention aiming to provide positive effects to the treatment of childhood obesity.

Clinical utility of phentermine/topiramate (Qsymia™ combination for the treatment of obesity

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Shin JH

2013-04-01

Full Text Available Jin Hee Shin,1 Kishore M Gadde2 1Department of Community and Family Medicine, Duke University Medical Center, 2Obesity Clinical Trials Program, Duke University Medical Center, Durham, NC, USA Abstract: Qsymia™ (Vivus Inc, Mountain View, CA, USA, a combination of phentermine and delayed-release topiramate, has been available in the US since September 2012 for the treatment of obesity. Phentermine is an anorexigenic agent, which is approved for the short-term treatment of obesity, while topiramate is approved for nonweight loss indications – seizure disorders and migraine prophylaxis. The amount of weight loss achieved with combination therapy is of a greater magnitude than what could be achieved with either agent alone. Adverse events that occur with the combination therapy are in line with the known side effect profiles of the constituent drugs; teratogenicity, a slight increase in heart rate, psychiatric and cognitive adverse effects, and metabolic acidosis are concerns. Keywords: Qsymia, combination drug, antiobesity drugs, phentermine, topiramate, obesity, weight loss

Physical Fitness, Physical Activity, Sedentary Behavior, or Diet—What Are the Correlates of Obesity in Polish School Children?

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Czyż, Stanisław H.; Toriola, Abel L.; Starościak, Wojciech; Lewandowski, Marek; Paul, Yvonne; Oyeyemi, Adewale L.

2017-01-01

There is substantial evidence of rising prevalence of overweight and obesity and its co-morbidities among children in western-high income developed countries. In the European Union, the prevalence of overweight and obesity is increasing fastest among Polish children. Yet, there is paucity of evidence on the relationship of behavioral factors with body weight status of children in Poland. This study examined the association of obesity with physical fitness, physical activity, sedentary behavior and diet among Polish children. A total of 641 children (10–15 years) recruited from the Lower Silesia region of Poland participated in this cross-sectional study. Participants’ anthropometrics, physical fitness, physical activity, sedentary behavior and dietary intake were assessed. Outcome variables were weight categories (according to body mass index [BMI], waist-to-hip ratio [WHR], and percentage body fat [% BF]). The strongest negative correlation was found between VO2max and %BF (r = −0.39, p children by 13%, 26% and 19%, respectively as compared to the group of obese children. VO2max and weight and obesity indices were strongly correlated in both gender and age groups. Education and intervention programs to increase physical fitness (VO2max) through aerobic training are recommended for Physical Education teachers, parents and children in order to reduce the rate of overweight and obesity among children in the Lower Silesia region of Poland. PMID:28632175

Assessment and management of obesity in childhood and adolescence.

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Baur, Louise A; Hazelton, Briony; Shrewsbury, Vanessa A

2011-10-04

The increased prevalence of obesity in childhood and adolescence highlights the need for effective treatment approaches. Initial assessments of these patients should include taking a careful history (investigating comorbidities, family history and potentially modifiable behaviors) and physical examination with BMI plotted on a BMI-for-age chart. The degree of investigation is dependent on the patient's age and severity of obesity, the findings on history and physical examination, and associated familial risk factors. There are several broad principles of conventional management: management of comorbidities; family involvement; taking a developmentally appropriate approach; the use of a range of behavior change techniques; long-term dietary change; increased physical activity; and decreased sedentary behaviors. Orlistat can be useful as an adjunct to lifestyle changes in severely obese adolescents and metformin can be used in older children and adolescents with clinical insulin resistance. Bariatric surgery should be considered in those who are severely obese, with recognition of the need for management in centers with multidisciplinary weight management teams and for surgery to be performed in tertiary institutions experienced in bariatric surgery. Finally, given the high prevalence and chronic nature of obesity, coordinated models of care for health-service delivery for the management of pediatric obesity are needed.

Prevalence of severe obesity among New Zealand adolescents and associations with health risk behaviors and emotional well-being.

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Farrant, Bridget; Utter, Jennifer; Ameratunga, Shanthi; Clark, Terryann; Fleming, Theresa; Denny, Simon

2013-07-01

To describe the prevalence of severe obesity among New Zealand young people attending secondary school and the associations of severe obesity with health risk behaviors and emotional well-being. A random sample of 9107 secondary school students in New Zealand participated in a 2007 health survey. Participants had their height and weight measured and answered an anonymous survey on multiple aspects of their health and well-being. Overall, 2.5% of students met the International Obesity Task Force definition of severe obesity. Students with severe obesity had more weight-related concerns, were more likely to have used unhealthy weight control strategies, and were more likely to experience bullying compared with healthy weight students. For example, students with severe obesity were 1.7 times more likely to have been bullied at school (95% CI 1.2-2.7) and 1.9 times more likely to vomit for weight loss (95% CI 1.1-3.3) than were healthy weight students. Indicators of emotional well-being and most health risk behaviors were similar among young people with severe obesity and a healthy weight. Clinicians who work with young people with severe obesity should prioritize discussing issues of bullying and healthy weight control strategies with families and their children. Copyright © 2013 Mosby, Inc. All rights reserved.

Cost-effectiveness of intensive inpatient treatments for severely obese children and adolescents in the Netherlands; a randomized controlled trial (HELIOS

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van der Baan-Slootweg Olga H

2011-06-01

Full Text Available Abstract Background Intensive combined lifestyle interventions are the recommended treatment for severely obese children and adolescents, but there is a lack of studies and their cost-effectiveness. The objective of this study is to compare the cost-effectiveness of two intensive one-year inpatient treatments and usual care for severely obese children and adolescents. Methods/Design Participants are 40 children aged 8-13 and 40 adolescents aged 13-18 with severe obesity (SDS-BMI ≥ 3.0 or SDS-BMI ≥ 2.3 with obesity related co-morbidity. They will be randomized into two groups that will receive a comprehensive treatment program of 12 months that focuses on nutrition, physical activity and behavior change of the participant and their parents. The two programs are the same in total duration (12 months, but differ in inpatient treatment duration. Group A will participate in a 6 month intensive inpatient treatment program during weekdays, followed by six monthly return visits of 2 days. Group B will participate in a 2 month intensive inpatient treatment program during weekdays, followed by biweekly return visits of 2 days during the next four months, followed by six monthly return visits of 2 days. Several different health care professionals are involved, such as pediatricians, dieticians, psychologists, social workers, nurses and physiotherapists. Results will also be compared to a control group that receives usual care. The primary outcome is SDS-BMI. Secondary outcomes include quality of life using the EQ-5D and cardiovascular risk factors. Data will be collected at baseline and after 6, 12 and 24 months. An economic evaluation will be conducted alongside this study. Healthcare consumption will be based on actual resource use, using prospective data collection during 2 years through cost diaries. Quality Adjusted Life Years (QALYs will be calculated using the EQ-5D. Discussion This study will provide useful information on the effectiveness and

Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities.

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Jakobsen, Gunn Signe; Småstuen, Milada Cvancarova; Sandbu, Rune; Nordstrand, Njord; Hofsø, Dag; Lindberg, Morten; Hertel, Jens Kristoffer; Hjelmesæth, Jøran

2018-01-16

The association of bariatric surgery and specialized medical obesity treatment with beneficial and detrimental outcomes remains uncertain. To compare changes in obesity-related comorbidities in patients with severe obesity (body mass index ≥40 or ≥35 and at least 1 comorbidity) undergoing bariatric surgery or specialized medical treatment. Cohort study with baseline data of exposures from November 2005 through July 2010 and follow-up data from 2006 until death or through December 2015 at a tertiary care outpatient center, Vestfold Hospital Trust, Norway. Consecutive treatment-seeking adult patients (n = 2109) with severe obesity assessed (221 patients excluded and 1888 patients included). Bariatric surgery (n = 932, 92% gastric bypass) or specialized medical treatment (n = 956) including individual or group-based lifestyle intervention programs. Primary outcomes included remission and new onset of hypertension based on drugs dispensed according to the Norwegian Prescription Database. Prespecified secondary outcomes included changes in comorbidities. Adverse events included complications retrieved from the Norwegian Patient Registry and a local laboratory database. Among 1888 patients included in the study, the mean (SD) age was 43.5 (12.3) years (1249 women [66%]; mean [SD] baseline BMI, 44.2 [6.1]; 100% completed follow-up at a median of 6.5 years [range, 0.2-10.1]). Surgically treated patients had a greater likelihood of remission and lesser likelihood for new onset of hypertension (remission: absolute risk [AR], 31.9% vs 12.4%); risk difference [RD], 19.5% [95% CI, 15.8%-23.2%], relative risk [RR], 2.1 [95% CI, 2.0-2.2]; new onset: AR, 3.5% vs 12.2%, RD, 8.7% [95% CI, 6.7%-10.7%], RR, 0.4 [95% CI, 0.3-0.5]; greater likelihood of diabetes remission: AR, 57.5% vs 14.8%; RD, 42.7% [95% CI, 35.8%-49.7%], RR, 3.9 [95% CI, 2.8-5.4]; greater risk of new-onset depression: AR, 8.9% vs 6.5%; RD, 2.4% [95% CI, 1.3%-3.5%], RR, 1.5 [95% CI, 1.4-1.7]; and