WorldWideScience

Sample records for morbidly obese adolescents

  1. Gonadal dysfunction in morbidly obese adolescent girls.

    Science.gov (United States)

    Chin, Vivian; Censani, Marisa; Lerner, Shulamit; Conroy, Rushika; Oberfield, Sharon; McMahon, Donald; Zitsman, Jeffrey; Fennoy, Ilene

    2014-04-01

    To describe gonadal dysfunction and evaluate polycystic ovary syndrome (PCOS) and its association with metabolic syndrome (MeS) among girls in a morbidly obese adolescent population. In a cross-sectional study of 174 girls, height, weight, waist circumference, Tanner stage, reproductive hormones, carbohydrate and lipid markers, drug use, and menstrual history were obtained at baseline. Exclusion criteria were menarcheal age PCOS or MeS classification. University medical center outpatient clinic. Ninety-eight girls ages 13-19.6 years, Tanner 5, average body mass index of 46.6 kg/m(2), menarche at 11.4 years, and average menarcheal age of 5 years. None. Polycystic ovary syndrome and MeS. Ninety-eight girls were divided into four groups: PCOS by National Institutes of Health criteria (PCOSN, n = 24), irregular menses only (n = 25), elevated T (≥55 ng/dL) only (n = 6), and obese controls (n = 43). Metabolic syndrome by modified Cook criteria affected 32 girls or 33% overall: 6 of 24 PCOSN, 7 of 25 irregular menses only, 4 of 6 elevated T only, and 15 of 43 obese controls. Polycystic ovary syndrome by National Institutes of Health criteria and its individual components were not associated with MeS after adjusting for body mass index. Unlike obese adults, PCOSN and its individual components were not associated with MeS in the untreated morbidly obese adolescent population. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  2. Adolescent Obesity: its correlates and associated morbidity

    Directory of Open Access Journals (Sweden)

    Sonali Sain

    2013-01-01

    Full Text Available Obesity is currently one of the major public health problems, in both developed and developing countries. Obesity is a risk factor for metabolic syndrome. Increasing rates of childhood obesity and more sedentary lifestyles has led to an age shift in metabolic syndrome which now occurs at an earlier age. Thus, the present study was conducted to get an idea about the occurrence of obesity among adolescent school children, risk factors associated with the condition and the related morbidity among them. MATERIALS AND METHODS: A cross-sectional descriptive study carried out in two higher secondary government girl schools with the help of a pre- designed and pre-tested questionnaire. RESULTS: Out of 245 students 16.73% were overweight and 6.54% were obese. Among overweight students, 59.65% exercised less than 4 hours a week, 61.4% watched TV ≥ 4 hours per week, 87.72% consumed junk food ≥ 4 days per week and 45.61% skipped meals. Puberty related menstrual irregularities, hypothyroidism, acne and stria were more commonly found in overweight students CONCLUSION: The rapidly increasing prevalence of obesity accompanied by unhealthy lifestyle habits among adolescents is one of the most challenging dilemmas of public health importance.

  3. Adolescent Obesity: its correlates and associated morbidity

    Directory of Open Access Journals (Sweden)

    Sonali Sain

    2013-11-01

    Full Text Available ABSTRACT: Obesity is currently one of the major public health problems, in both developed and developing countries. Obesity is a risk factor for metabolic syndrome. Increasing rates of childhood obesity and more sedentary lifestyles has led to an age shift in metabolic syndrome which now occurs at an earlier age. Thus, the present study was conducted to get an idea about the occurrence of obesity among adolescent school children, risk factors associated with the condition and the related morbidity among them. MATERIALS AND METHODS: A cross-sectional descriptive study carried out in two higher secondary government girl schools with the help of a pre-designed and pre-tested questionnaire. RESULTS: Out of 245 students 16.73% were overweight and 6.54% were obese. Among overweight students, 59.65% exercised less than 4 hours a week, 61.4% watched TV ≥ 4 hours per week, 87.72% consumed junk food ≥ 4 days per week and 45.61% skipped meals. Puberty related menstrual irregularities, hypothyroidism, acne and stria were more commonly found in overweight students CONCLUSION: The rapidly increasing prevalence of obesity accompanied by unhealthy lifestyle habits among adolescents is one of the most challenging dilemmas of public health importance.

  4. Higher Midazolam Clearance in Obese Adolescents Compared with Morbidly Obese Adults

    NARCIS (Netherlands)

    Rongen, van A.; Brill, M.J.E.; Vaughns, J.D.; Välitalo, P.A.J.; Dongen, van E.P.A.; Ramshorst, van B.; Barrett, J.S.; Anker, van den J.N.; Knibbe, C.A.J.

    2017-01-01

    The clearance of cytochrome P450 (CYP) 3A substrates is reported to be reduced with lower age, inflammation and obesity. As it is unknown what the overall influence is of these factors in the case of obese adolescents vs. morbidly obese adults, we studied covariates influencing the clearance of the

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

    Directory of Open Access Journals (Sweden)

    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

  6. Long-Term Follow-Up Is Essential to Assess Outcome of Gastric Banding in Morbidly Obese Adolescents: A Retrospective Analysis

    NARCIS (Netherlands)

    Paulus, Givan F.; Konings, Gerdy; Bouvy, Nicole D.; van Heurn, L. W. Ernest; Greve, Jan Willem

    2016-01-01

    Background: Adolescent obesity is rapidly becoming more prevalent and is associated with chronic health conditions and psychosocial morbidity. Lifestyle intervention is often ineffective in morbidly obese adolescents, and bariatric surgery is gradually becoming an accepted treatment. However, little

  7. Individual, social and environmental predictors of physical activity in severe to morbid obese African American adolescents

    Directory of Open Access Journals (Sweden)

    Jeffrey J. Martin

    2016-12-01

    Full Text Available The purpose of this study was to predict low, moderate, hard and very hard physical activity (PA and walking/biking/jogging based PA. One-hundred and fifty-nine severe to morbid obese African-American adolescents participated. We predicted 8% of the variance in hard PA largely due to family support and 10% of the variance in very hard PA due to other support (e.g. counselor and having home PA equipment. We also predicted 10% of the variance in walking/biking/jogging due to the walkability of the neighborhood. Our findings support the value of social support and environmental supports in helping obese African American adolescents increase PA.

  8. Obesity-related juvenile form of cartilage lesions: a new affliction in the knees of morbidly obese children and adolescents

    Energy Technology Data Exchange (ETDEWEB)

    Widhalm, Harald K.; Marlovits, Stefan; Vecsei, Vilmos [Medical University of Vienna, Center for Joints and Cartilage, Department of Traumatology, Vienna (Austria); Welsch, Goetz H. [Medical University of Vienna, MR Center, Department of Radiology, Vienna (Austria); University Hospital of Erlangen, Department of Trauma Surgery, Erlangen (Germany); Dirisamer, Albert [Medical University of Vienna, Department of Radiology, Vienna (Austria); Neuhold, Andreas [Private Hospital Rudolfinerhaus, Department of Radiology, Vienna (Austria); Griensven, Martijn van [Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna (Austria); Seemann, Rudolf [Medical University of Vienna, Department of Cranio-Maxillofacial and Oral Surgery, Vienna (Austria); Widhalm, Kurt [Medical University of Vienna, Division of Nutrition and Metabolism, Department of Pediatrics, Vienna (Austria)

    2012-03-15

    Overweight and obesity are afflictions that lead to an increased risk of health problems including joint problems. The aim of the study was to assess the condition of articular cartilage in obese adolescent patients suffering from knee pain. MRI of 24 knees of 20 morbidly obese patients, mean age 14.2 years, was performed in an open 1.0 Tesla MR system, where the cartilage, the quality and structure of the menisci, and the presence or absence of surrounding changes was examined. In all patients a cartilage lesion in at least one region of the knee could be detected. Retropatellar cartilage lesions have been found in 19 knees. Ten cartilage lesions grade I, and four lesions grade II have been described in the lateral compartment of the knee, whereas the medial compartment showed in eight cases a grade I, in 13 cases a grade II and in two cases a grade III cartilage lesion. Meniscal changes were assessed in most patients. Morbidly obese children and adolescents show major abnormalities in the articular cartilage of the knee. Whether obesity alone is the causal factor for the development of the pattern of these changes, remains to be seen. (orig.)

  9. Obesity-related juvenile form of cartilage lesions: a new affliction in the knees of morbidly obese children and adolescents

    International Nuclear Information System (INIS)

    Widhalm, Harald K.; Marlovits, Stefan; Vecsei, Vilmos; Welsch, Goetz H.; Dirisamer, Albert; Neuhold, Andreas; Griensven, Martijn van; Seemann, Rudolf; Widhalm, Kurt

    2012-01-01

    Overweight and obesity are afflictions that lead to an increased risk of health problems including joint problems. The aim of the study was to assess the condition of articular cartilage in obese adolescent patients suffering from knee pain. MRI of 24 knees of 20 morbidly obese patients, mean age 14.2 years, was performed in an open 1.0 Tesla MR system, where the cartilage, the quality and structure of the menisci, and the presence or absence of surrounding changes was examined. In all patients a cartilage lesion in at least one region of the knee could be detected. Retropatellar cartilage lesions have been found in 19 knees. Ten cartilage lesions grade I, and four lesions grade II have been described in the lateral compartment of the knee, whereas the medial compartment showed in eight cases a grade I, in 13 cases a grade II and in two cases a grade III cartilage lesion. Meniscal changes were assessed in most patients. Morbidly obese children and adolescents show major abnormalities in the articular cartilage of the knee. Whether obesity alone is the causal factor for the development of the pattern of these changes, remains to be seen. (orig.)

  10. Sibutramine as an adjuvant therapy in adolescents suffering from morbid obesity.

    Science.gov (United States)

    Reisler, Gad; Tauber, Tzvia; Afriat, Rachel; Bortnik, Oxana; Goldman, Michael

    2006-01-01

    The prevalence of morbid obesity is increasing rapidly. Weight reduction is very difficult using diet restriction and physical activity alone. Sibutramine has been shown to be effective and safe as an adjuvant therapy to diet restrictions. To describe our experience using sibutramine in weight reduction treatment of adolescents suffering from morbid obesity. The study group comprised 20 young persons (13 females, mean age 15 years 4 months, range 13-18 years) with morbid obesity (body mass index above the 95th percentile for age and/or > or =30 kg/m2) who were treated with sibutramine 10 mg once a day for 1 year. Mean BMI was 40 +/- 5.6 kg/m2 (range 30.1 - 49.5 kg/m2) at the beginning of treatment. Most patients showed an early weight reduction to mean BMI 39.3 +/- 4.9 and 35.9 +/- 5.7 at 3 and 6 months respectively, but stopped losing weight over the next 6 months. During the follow-up period 17 patients discontinued the treatment. The main reason for dropout was the slow rate of weight reduction after 6 months. Patients suffering from concomitant disorders (severe asthma, hypertension, sleep obstructive apnea) showed improvement after weight reduction. Adverse reactions from the treatment were transient, mild and well tolerated. Sibutramine may help in achieving weight reduction for a short period and in improving concomitant health problems, however its long-term effect is limited.

  11. Laparoscopic sleeve gastrectomy achieves substantial weight loss in an adolescent girl with morbid obesity.

    Science.gov (United States)

    Till, H K-H; Muensterer, O; Keller, A; Körner, A; Blueher, S; Merkle, R; Kiess, W

    2008-02-01

    The European guidelines for bariatric surgery clearly define criteria for operating children with morbid obesity. However the appropriate technique for this age-group has not been identified yet. So far gastric banding and Roux-Y bypass represent the standards, but they demand life-long tolerance of either an artificial device or significant malabsorption. Although laparoscopic sleeve gastrectomy (LSG) demands neither, it has not been advocated for this age-group as a stand-alone technique. We report the outcome and the rationale for this approach in a 16-year-old girl with morbid obesity. The patient had been in an intensive weight loss programme for several years, but within the last 12 months her body weight had increased again dramatically. At referral she presented with a body mass index (BMI) of 43.1 kg/m(2) (height 169 cm, preoperative weight 121 kg) and suffered from co-morbidities as features of a developing metabolic-vascular syndrome such as dyslipidemia and arterial hypertension. Our obesity team and her parents opted for surgery at that time. The patient underwent LSG with a 5-trocar technique. With a gastroscope protecting the lesser curvature, the stomach was resected from the antrum to the fundus using an EndoGIA stapler. The operative time was 95 minutes, there were no perioperative complications and the patient was extubated immediately. An upper GI contrast study on postoperative day 4 showed a tubular gastric remnant with a volume of about 200 ml. The patient's diet was advanced as tolerated to full oral intake, and she was followed-up regularly in our special obesity outpatient clinic. After 12 months she had lost 36 kg (BMI 29 kg/m(2)) and enjoyed sports and activities with friends again. Laboratory studies ruled out malnutrition or vitamin deficiency. LSG is a safe and effective option for bariatric surgery in obese adolescents. It can be offered as a stand-alone restrictive operation and could be extended to a malabsorptive procedure at any

  12. Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review.

    Science.gov (United States)

    Reilly, J J; Kelly, J

    2011-07-01

    The last systematic review on the health consequences of child and adolescent obesity found little evidence on consequences for adult health. The present study aimed to summarize evidence on the long-term impact of child and adolescent obesity for premature mortality and physical morbidity in adulthood. Systematic review with evidence searched from January 2002 to June 2010. Studies were included if they contained a measure of overweight and/or obesity between birth and 18 years (exposure measure) and premature mortality and physical morbidity (outcome) in adulthood. Five eligible studies examined associations between overweight and/or obesity, and premature mortality: 4/5 found significantly increased risk of premature mortality with child and adolescent overweight or obesity. All 11 studies with cardiometabolic morbidity as outcomes reported that overweight and obesity were associated with significantly increased risk of later cardiometabolic morbidity (diabetes, hypertension, ischaemic heart disease, and stroke) in adult life, with hazard ratios ranging from 1.1-5.1. Nine studies examined associations of child or adolescent overweight and obesity with other adult morbidity: studies of cancer morbidity were inconsistent; child and adolescent overweight and obesity were associated with significantly increased risk of later disability pension, asthma, and polycystic ovary syndrome symptoms. A relatively large and fairly consistent body of evidence now demonstrates that overweight and obesity in childhood and adolescence have adverse consequences on premature mortality and physical morbidity in adulthood.

  13. Self-esteem in a clinical sample of morbidly obese children and adolescents

    DEFF Research Database (Denmark)

    Nowicka, P; Höglund, P; Birgerstam, P

    2009-01-01

    of primary obesity. Self-esteem was measured with a validated psychological test with five subscales: physical characteristics, talents and skills, psychological well-being, relations with the family and relations with others. A linear mixed effect model used the factors gender and adolescence group......AIM: To study self-esteem in clinical sample of obese children and adolescents. METHODS: Obese children and adolescents aged 8-19 years (n = 107, mean age 13.2 years, mean BMI 32.5 [range 22.3-50.6], mean BMI z-score 3.22 [range 2.19-4.79]; 50 boys and 57 girls) were referred for treatment...... as on the subscales, and was below the normal level in higher ages in both genders. Girls had significantly lower self-esteem on the global scale (p = 0.04) and on the two subscales physical characteristics (p psychological well-being (p

  14. Upper Gastrointestinal Function in Morbidly Obese Adolescents Before and 6 Months After Gastric Banding

    NARCIS (Netherlands)

    Singendonk, M.; Kritas, S.; Omari, T.; Feinle-Bisset, C.; Page, A. J.; Frisby, C. L.; Kentish, S. J.; Ferris, L.; McCall, L.; Kow, L.; Chisholm, J.; Khurana, S.

    2017-01-01

    The effects of laparoscopic adjustable gastric band (LAGB) placement on upper gastrointestinal tract function in obese adolescents are unknown. Therefore, our aim was to determine the short-term effects of LAGB on esophageal motility, gastroesophageal reflux, gastric emptying, appetite-regulatory

  15. Robotic-assisted gastroplication in a morbidly obese adolescent: early improvement in metabolic and neurohormonal parameters

    Directory of Open Access Journals (Sweden)

    Valeria Calcaterra

    2012-12-01

    Full Text Available Bariatric surgery has to be considered in the management of severely obese adolescents when all conservative measures have been proven to be unresponsive. Short term metabolic and neurohormonal profile changes after robotic-assisted gastroplication are evaluated. The benefits and the usefulness of this surgical-reversal procedure in adolescent need to be defined. Fiveteen years old girl with body mass index 42.2 kg/m2, hyperinsulinism, hyperandrogenism, amenorrhea, polycystic ovarian syndrome, hypertension with left ventricular hypertrophy. Gastric volume after surgical procedure reduction was 80-100 mL. One month postoperatively significant weigh loss was obtained. Insulin levels, insulin-resistance, leptin and ghrelin concentration were substantially ameliorated. We can conclude that bariatric surgery should be considered for a minority of severely obese adolescents under the supervision of a multidisciplinary pediatric team. Our experience confirmed that the gastroplication is safe, feasible and effective and furthermore is a reversible technique. The early improvement of the obesity co-morbities is allowed. The increased surgical accuracy in robotic assistance could limit postoperative complications rate in obese adolescents.

  16. Effect of Laparoscopic Adjustable Gastric Banding on Metabolic Syndrome and Its Risk Factors in Morbidly Obese Adolescents

    Directory of Open Access Journals (Sweden)

    Rushika Conroy

    2011-01-01

    Full Text Available We examined the effect of laparoscopic adjustable gastric banding (LAGB on weight loss, inflammatory markers, and components of the Metabolic Syndrome (MeS in morbidly obese adolescents and determined if those with MeS lose less weight post-LAGB than those without. Data from 14–18 yr adolescents were obtained at baseline, 6 and 12 months following LAGB. Significant weight loss and improvements in MeS components were observed 6 months and one year following LAGB. The incidence of MeS declined 56.8% after 6 months and 69.6% after 12 months. There was no significant difference in amount of weight lost post-LAGB between those with and without MeS at either timepoint. Correlations between change in weight parameters and components of MeS in those with and without MeS at baseline were examined and found to vary by diagnostic category. LAGB is effective for short-term improvement in weight, inflammatory markers, and components of MeS in morbidly obese adolescents.

  17. Plateaued national utilization of adolescent bariatric surgery despite increasing prevalence of obesity-associated co-morbidities.

    Science.gov (United States)

    Kindel, Tammy L; Lomelin, Daniel; McBride, Corrigan; Kothari, Vishal; Oleynikov, Dmitry

    2016-05-01

    The number of adolescent bariatric surgeries (ABS) performed from 2003 to 2009 has been stable despite reports of an increase in adolescent morbid obesity. We sought to determine the trend in national ABS volume and the changes in obesity-associated co-morbidities (OACM) from 2004 to 2011. The Healthcare Cost and Utilization Project National Inpatient Sample database. The National Inpatient Sample database was queried for adolescents undergoing Roux-en-Y gastric bypass, adjustable gastric banding, or sleeve gastrectomy from 2004 to 2011. Twelve OACM categories were created by ICD-9 code. From 2004 to 2011, an estimated 968 ABS cases per year were performed with no significant change in yearly volumes. There was a significant decrease in the annual volume of Roux-en-Y gastric bypasses (85.7%-54.4%, Padolescent increased significantly, from 1.44±1.3 in 2004-2005 to 1.85±1.5 in 2010-2011 (Padolescent bariatric surgical evaluation and treatment. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  18. Morbidity of severe obesity.

    Science.gov (United States)

    Kral, J G

    2001-10-01

    Although obesity is an easy diagnosis to make, its etiologies, pathophysiology, and symptomatology are extraordinarily complex. Progress in surgical technique and anesthesiological management has substantially improved the safety of performing operations on the severely obese in the last 20 years. These improvements have occurred more or less empirically, without a full understanding of etiology or pathophysiology, although this has advanced concomitantly with improvements in practice. This review has attempted to provide a framework to facilitate progress in the neglected areas of patient selection and choice of operation, in an effort to improve long-term outcome. Despite the disparate etiologies of obesity and its diverse comorbidities and complications, there are unifying interdependent pathogenetic mechanisms of great relevance to the practice of antiobesity surgery. The rate of eating, whether driven by HPA dysfunction, ambient stress, or related hereditary susceptibility factors including the increased energy demands of an expanded body fat mass, participates in a cycle that results in disordered satiety (see Fig. 3). This leads to substrate overload, causing extensive metabolic abnormalities such as atherogenesis, insulin resistance, thrombogenesis, and carcinogenesis. This interpretation of the pathophysiology of obesity ironically accords with the original meaning of the word obesity: "to overeat." The ultimate solution to the problem of obesity--preventing it--will not be forthcoming until the food industry is forced to lower production and change its marketing strategies, as the liquor and tobacco industries in the United States were compelled to do. This cannot occur until the large and fast-growing populations of industrialized nations become educated in the personal implications of the energy principle. Regardless of whether school curricula are modified to prioritize health education, the larger problems of cultural and economic change remain for

  19. Airway management and morbid obesity

    DEFF Research Database (Denmark)

    Kristensen, Michael S

    2010-01-01

    Morbidly obese patients present with excess fatty tissue externally on the breast, neck, thoracic wall and abdomen and internally in the mouth, pharynx and abdomen. This excess tissue tends to make access (intubation, tracheostomy) to and patency (during sedation or mask ventilation) of the upper...... in morbidly obese patients and should be followed by actions to counteract atelectasis formation. The decision as to weather to use a rapid sequence induction, an awake intubation or a standard induction with hypnotics should depend on the thorough airway examination and comorbidity and should not be based...... solely on whether morbid obesity is present or not. It is important to ensure sufficient depth of anaesthesia before initiating manipulation of the airway because inadequate anaesthesia depth predisposes to aspiration if airway management becomes difficult. The intubating laryngeal mask airway is more...

  20. Liver morphology in morbid obesity

    DEFF Research Database (Denmark)

    Andersen, T; Gluud, C

    1984-01-01

    Literature on liver morphology in untreated obesity reveals varying prevalences of various pathological findings. The purpose of this literature study was to summarize and evaluate the published observations and to discuss discrepant findings. A complete search was aimed at utilizing bibliographic...... methods including a computerized survey. Forty-one original articles were included, comprising information on liver morphology in 1515 morbidly obese patients. Liver biopsy was considered normal in 12 per cent of the cases. The most frequent abnormality reported was fatty change, present in 80 per cent...... of obesity, age, sex, alcohol consumption, diabetes mellitus) does not point towards a single causal factor. Co-influence of additional pathogenetic factors are likely in the development of liver changes in morbid obesity....

  1. Long-Term Follow-Up Is Essential to Assess Outcome of Gastric Banding in Morbidly Obese Adolescents: A Retrospective Analysis

    Directory of Open Access Journals (Sweden)

    Givan F. Paulus

    2016-10-01

    Full Text Available Background: Adolescent obesity is rapidly becoming more prevalent and is associated with chronic health conditions and psychosocial morbidity. Lifestyle intervention is often ineffective in morbidly obese adolescents, and bariatric surgery is gradually becoming an accepted treatment. However, little is known about long-term results. Methods: Hospital charts of patients who had undergone gastric banding more than 5 years ago at an age of 18 years or younger, were retrospectively analyzed. Weight loss, complications, reoperations, and comorbidity reduction were assessed as well as health status, food behavior, and personality. Results: BMI loss in 10 adolescents was 10.7 kg/m2 (-0.9 to 12.9 kg/m2 after a median follow-up of 64 months (52-84 months; the major part of weight loss occurred after the first year. In 4 patients the gastric band was removed after 3.5-5.5 years. Two out of 3 patients effectively lost weight after conversion to a bypass type procedure. One patient is maintaining a stable healthy weight after band removal. Conclusions: Laparoscopic adjustable gastric banding in morbidly obese adolescents had a failure rate of 40%, but was a successful therapy in the other 60% without major adverse events. Follow-up longer than 36 months was crucial for optimal evaluation of weight loss and reoperation rate.

  2. Bright light therapy versus physical exercise to prevent co-morbid depression and obesity in adolescents and young adults with attention-deficit / hyperactivity disorder: study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Mayer, J.S.; Hees, K.; Medda, J.; Grimm, O.; Asherson, P.; Bellina, M.; Colla, M.; Ibanez, P.; Koch, E.; Martinez-Nicolas, A.; Muntaner-Mas, A.; Rommel, A.; Rommelse, N.N.J.; Ruiter, S.W. de; Ebner-Priemer, U.W.; Kieser, M.; Ortega, F.B.; Thome, J.; Buitelaar, J.K.; Kuntsi, J.; Ramos-Quiroga, J.A.; Reif, A.; Freitag, C.M.

    2018-01-01

    BACKGROUND: The risk for major depression and obesity is increased in adolescents and adults with attention-deficit / hyperactivity disorder (ADHD) and adolescent ADHD predicts adult depression and obesity. Non-pharmacological interventions to treat and prevent these co-morbidities are urgently

  3. Long-Term Outcome of Bariatric Surgery in Morbidly Obese Adolescents : A Systematic Review and Meta-Analysis of 950 Patients with a Minimum of 3 years Follow-Up

    NARCIS (Netherlands)

    Shoar, Saeed; Mahmoudzadeh, Habibollah; Naderan, Mohammad; Bagheri-Hariri, Shahram; Wong, Catherine; Shahabeddin Parizi, Ahmad; Shoar, Nasrin

    2017-01-01

    Background: Obesity in pediatric and adolescent population has reached a universal pandemic. This study aimed to summarize the literature on the longest available outcome of bariatric surgery in morbidly obese adolescents. Methods :A systematic review was conducted to pool available data on the

  4. Airway management and morbid obesity

    DEFF Research Database (Denmark)

    Kristensen, Michael S

    2010-01-01

    Morbidly obese patients present with excess fatty tissue externally on the breast, neck, thoracic wall and abdomen and internally in the mouth, pharynx and abdomen. This excess tissue tends to make access (intubation, tracheostomy) to and patency (during sedation or mask ventilation) of the upper...... airway and the function of the lungs (decreased residual capacity and aggravated ventilation perfusion mismatch) worse than in lean patients. Proper planning and preparation of airway management is essential, including elevation of the patient's upper body, head and neck. Preoxygenation is mandatory...

  5. Intubation of the morbidly obese patient

    DEFF Research Database (Denmark)

    Ydemann, Mogens; Rovsing, Marie Louise; Lindekaer, A L

    2012-01-01

    Several potential problems can arise from airway management in morbidly obese patients, including difficult mask ventilation and difficult intubation. We hypothesised that endotracheal intubation of morbidly obese patients would be more rapid using the GlideScope(®) (GS) (Verathon Inc Corporate H...... Headquarters, Bothell, WA, USA) than with the Fastrach™ (FT) (The Laryngeal Mask Company Ltd, Le Rocher, Victoria, Mahe, Seychelles)....

  6. Laparoscopic surgery for morbid obesity.

    Science.gov (United States)

    Hallerbäck, B; Glise, H; Johansson, B; Johnson, E

    1998-01-01

    Morbid obesity, defined as a body mass index (BMI), i.e. weight (kg)/height (m2) over 36 for males and 38 for females, is a common condition and a threat for health, life and individual well being. Hitherto, surgery is the only effective treatment for weight reduction. Surgical methods can be malabsorptive, reducing the patients ability to absorb nutrients, or restrictive, reducing the capacity of food intake. Exclusively malabsorptive methods have been abandoned due to severe side effects. Restrictive methods, gastroplasties, reduces the compliance capacity of the stomach. Two types are performed laparoscopically, the vertical banded gastroplasty and the adjustable gastric banding. The proximal gastric by pass is also performed laparoscopically and is a combination of a restrictive proximal gastroplasty and a malabsorptive Roux-en-Y gastro-jejunal anastomosis. With laparoscopic adjustable gastric banding mean BMI was reduced from 41 kg/m2 to 33 kg/m2 (n = 43) after one year. Two years after surgery mean BMI was 30 kg/m2 (n = 16). The different operative techniques are further discussed in this paper.

  7. Maternal morbid obesity and obstetric outcomes.

    LENUS (Irish Health Repository)

    Farah, Nadine

    2012-02-01

    OBJECTIVE: The purpose of this retrospective cohort study was to review pregnancy outcomes in morbidly obese women who delivered a baby weighing 500 g or more in a large tertiary referral university hospital in Europe. METHODS: Morbid obesity was defined as a BMI > or =40.0 kg\\/m2 (WHO). Only women whose BMI was calculated at their first antenatal visit were included. The obstetric out-comes were obtained from the hospital\\'s computerised database. RESULTS: The incidence of morbid obesity was 0.6% in 5,824 women. Morbidly obese women were older and were more likely to be multigravidas than women with a normal BMI. The pregnancy was complicated by hypertension in 35.8% and diabetes mellitus in 20.0% of women. Obstetric interventions were high, with an induction rate of 42.1% and a caesarean section rate of 45.3%. CONCLUSIONS: Our findings show that maternal morbid obesity is associated with an alarmingly high incidence of medical complications and an increased level of obstetric interventions. Consideration should be given to developing specialised antenatal services for morbidly obese women. The results also highlight the need to evaluate the effectiveness of prepregnancy interventions in morbidly obese women.

  8. Pain Catastrophizing in Borderline Morbidly Obese and Morbidly Obese Individuals with Osteoarthritic Knee Pain

    Directory of Open Access Journals (Sweden)

    Tamara J Somers

    2008-01-01

    Full Text Available OBJECTIVE: There is limited information about how morbidly obese osteoarthritis (OA patients cope with the pain they experience. Pain catastrophizing is an important predictor of pain and adjustment in persons with persistent pain. This may be particularly relevant in the morbidly obese (body mass index [BMI] of 40 kg/m2 or greater OA population at risk for increased pain. The present study first examined whether borderline morbidly obese and morbidly obese OA patients report higher levels of pain catastrophizing than a sample of OA patients in the overweight and obese category (BMI between 25 kg/m2 and 34 kg/m2. Next, it examined how pain catastrophizing is related to important indexes of pain and adjustment in borderline morbidly obese and morbidly obese OA patients.

  9. Laparoscopic colectomy in the obese, morbidly obese, and super morbidly obese: when does weight matter?

    Science.gov (United States)

    Champagne, Bradley J; Nishtala, Madhuri; Brady, Justin T; Crawshaw, Benjamin P; Franklin, Morris E; Delaney, Conor P; Steele, Scott R

    2017-10-01

    Previous studies have demonstrated that obese patients (BMI >30) undergoing laparoscopic colectomy have longer operative times and increased complications when compared to non-obese cohorts. However, there is little data that specifically evaluates the outcomes of obese patients based on the degree of their obesity. The aim of this study was to evaluate the impact of increasing severity of obesity on patients undergoing laparoscopic colectomy. A retrospective review was performed of all patients undergoing laparoscopic colectomy between 1996 and 2013. Patients were classified according to their BMI as obese (BMI 30.0-39.9), morbidly obese (BMI 40.0-49.9), and super obese (BMI >50). Main outcome measures included conversion rate, operative time, estimated blood loss, post-operative complications, and length of stay. There were 923 patients who met inclusion criteria. Overall, 604 (65.4%), 257 (27.9%), and 62 (6.7%) were classified as obese (O), morbidly obese (MO), and super obese (SO), respectively. Clinicopathologic characteristics were similar among the three groups. The SO group had significantly higher conversion rates (17.7 vs. 7 vs. 4.8%; P = 0.031), longer average hospital stays (7.1 days vs. 4.9 vs. 3.4; P = 0.001), higher morbidity (40.3 vs. 16.3 vs. 12.4%; P = 0.001), and longer operative times (206 min vs. 184 vs. 163; P = 0.04) compared to the MO and O groups, respectively. The anastomotic leak rate in the SO (4.8%; P = 0.027) and MO males (4.1%; P = 0.033) was significantly higher than MO females (2.2%) and all obese patients (1.8%). Increasing severity of obesity is associated with worse perioperative outcomes following laparoscopic colectomy.

  10. Long-Term Outcome of Bariatric Surgery in Morbidly Obese Adolescents: a Systematic Review and Meta-Analysis of 950 Patients with a Minimum of 3 years Follow-Up.

    Science.gov (United States)

    Shoar, Saeed; Mahmoudzadeh, Habibollah; Naderan, Mohammad; Bagheri-Hariri, Shahram; Wong, Catherine; Parizi, Ahmad Shahabeddin; Shoar, Nasrin

    2017-12-01

    Obesity in pediatric and adolescent population has reached a universal pandemic. This study aimed to summarize the literature on the longest available outcome of bariatric surgery in morbidly obese adolescents. A systematic review was conducted to pool available data on the longest available (>3 years) weight loss and comorbidity resolution outcome in adolescent bariatric surgery. A total of 14 studies reporting the result of bariatric surgery after 3 years in 950 morbidly obese adolescents were included. Preoperative age and BMI ranged from 12 to 19 years and from 26 to 91 kg/m 2 , respectively. Females were the predominant gender (72.8%). Laparoscopic roux-en-Y gastric bypass (n = 453) and adjustable gastric banding (n = 265) were the most common bariatric procedure performed. The number of patients at the latest follow-up was 677 (range from 2 to 23 years). On average, patients lost 13.3 kg/m 2 of their BMI. Among comorbidities, only diabetes mellitus resolved or improved dramatically. Of 108 readmissions, 91 led to reoperation. There was a weight regain adolescents who underwent a bariatric procedure. Although bariatric surgery is a safe and effective procedure in the treatment of adolescent morbid obesity, long-term data is scarce regarding its nutritional and developmental complication in this growing population of patients.

  11. Thromboxane production in morbidly obese subjects.

    Science.gov (United States)

    Graziani, Francesca; Biasucci, Luigi M; Cialdella, Pio; Liuzzo, Giovanna; Giubilato, Simona; Della Bona, Roberta; Pulcinelli, Fabio M; Iaconelli, Amerigo; Mingrone, Geltrude; Crea, Filippo

    2011-06-01

    Postmortem studies have demonstrated that morbidly obese subjects, surprisingly, have less coronary atherosclerosis than obese subjects. However, the reasons for this apparent protection from atherosclerosis are not yet clear. Thromboxane A2, a marker of platelet activation, is greater in obese subjects than in lean subjects, and this might be a clue to their increased cardiovascular risk. However, data on thromboxane A2 in morbidly obese subjects are lacking; therefore, we hypothesized that lower levels of thromboxane A2 in morbidly obese subjects might play a role in their lower atherothrombotic burden. We measured the serum levels of thromboxane B2 (TxB2), a stable metabolite of thromboxane A2, high-sensitivity C-reactive protein (hs-CRP) and leptin in 17 lean subjects (body mass index [BMI] 22.9 ± 1.6 kg/m(2)), 25 obese subjects (BMI 32.6 ± 2.4 kg/m(2)), and 23 morbidly obese subjects (BMI 48.6 ± 7.1 kg/m(2)), without insulin resistance, diabetes, or overt cardiovascular disease. The serum TxB2 levels were lower in the lean subjects than in the obese subjects (p = 0.046) and in the morbidly obese subjects than in the lean and obese subjects (p = 0.015 and p lean subjects (hs-CRP, p lean subjects (p lean subjects, suggesting that reduced platelet activation could play a role in the paradoxical protection of morbidly obese subjects from atherosclerosis, despite the greater levels of leptin. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. The influence of morbid obesity on the pharmacokinetics and pharmacodynamics of drugs in adolescents and adults : focus on propofol and nadroparin.

    NARCIS (Netherlands)

    Diepstraten, Jeroen

    2013-01-01

    For most commonly used drugs in morbidly obese patients evidence based dosing guidelines are not available. Therefore, current dosing is based on experience of the prescriber rather than on clinical evidence. Pharmacokinetic and pharmacodynamics data in non-obese patients are extrapolated without

  13. Plasma fibronectin concentrations in morbidly obese patients

    DEFF Research Database (Denmark)

    Dejgaard, A; Andersen, T; Christoffersen, Pernille Yde

    1984-01-01

    Plasma fibronectin concentrations and liver morphology were investigated in 45 morbidly obese subjects (median overweight 88%) and in 42 normal weight controls, matched for sex and age. A significantly (P less than 0.01) raised plasma fibronectin concentration (median 464 mg/l, range 276-862 mg...... in their liver biopsies (r = 0.33, P less than 0.05). Significantly (P less than 0.05) elevated plasma fibronectin concentrations even in obese subjects without hepatic fatty change indicate that liver fat accumulation is no prerequisite of the obesity-related elevation of plasma fibronectin. Raised plasma...

  14. Anaesthetic and Obstetric challenges of morbid obesity in ...

    African Journals Online (AJOL)

    Anaesthetic and Obstetric challenges of morbid obesity in caesarean ... in morbidly obese parturient that had caesarean delivery in a Nigerian tertiary care centre. ... This mirrors a World Health Organisation report published in the World Health ...

  15. Morbidity, including fatal morbidity, throughout life in men entering adult life as obese

    DEFF Research Database (Denmark)

    Zimmermann, Esther; Holst, Claus; Sørensen, Thorkild I A

    2011-01-01

    The association between obesity in adults and excess morbidity and mortality is well established, but the health impact throughout adult life of being obese in early adulthood needs elucidation. We investigated somatic morbidity, including fatal morbidity, throughout adulthood in men starting adult...... life as obese....

  16. Bright light therapy versus physical exercise to prevent co-morbid depression and obesity in adolescents and young adults with attention-deficit / hyperactivity disorder: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Mayer, Jutta S; Hees, Katharina; Medda, Juliane; Grimm, Oliver; Asherson, Philip; Bellina, Mariano; Colla, Michael; Ibáñez, Pol; Koch, Elena; Martinez-Nicolas, Antonio; Muntaner-Mas, Adrià; Rommel, Anna; Rommelse, Nanda; de Ruiter, Saskia; Ebner-Priemer, Ulrich W; Kieser, Meinhard; Ortega, Francisco B; Thome, Johannes; Buitelaar, Jan K; Kuntsi, Jonna; Ramos-Quiroga, J Antoni; Reif, Andreas; Freitag, Christine M

    2018-02-26

    The risk for major depression and obesity is increased in adolescents and adults with attention-deficit / hyperactivity disorder (ADHD) and adolescent ADHD predicts adult depression and obesity. Non-pharmacological interventions to treat and prevent these co-morbidities are urgently needed. Bright light therapy (BLT) improves day-night rhythm and is an emerging therapy for major depression. Exercise intervention (EI) reduces obesity and improves depressive symptoms. To date, no randomized controlled trial (RCT) has been performed to establish feasibility and efficacy of these interventions targeting the prevention of co-morbid depression and obesity in ADHD. We hypothesize that the two manualized interventions in combination with mobile health-based monitoring and reinforcement will result in less depressive symptoms and obesity compared to treatment as usual in adolescents and young adults with ADHD. This trial is a prospective, pilot phase-IIa, parallel-group RCT with three arms (two add-on treatment groups [BLT, EI] and one treatment as usual [TAU] control group). The primary outcome variable is change in the Inventory of Depressive Symptomatology total score (observer-blinded assessment) between baseline and ten weeks of intervention. This variable is analyzed with a mixed model for repeated measures approach investigating the treatment effect with respect to all three groups. A total of 330 participants with ADHD, aged 14 - obesity, ADHD symptoms, general psychopathology, health-related quality of life, neurocognitive function, chronotype, and physical fitness are explored after the end of the intervention and at the 12-week follow-up. This is the first pilot RCT on the use of BLT and EI in combination with mobile health-based monitoring and reinforcement targeting the prevention of co-morbid depression and obesity in adolescents and young adults with ADHD. If at least medium effects can be established with regard to the prevention of depressive symptoms and

  17. Children With Morbid Obesity Benefit Equally as Children With Overweight and Obesity From an Ongoing Care Program.

    Science.gov (United States)

    Rijks, J M; Plat, J; Mensink, R P; Dorenbos, E; Buurman, W A; Vreugdenhil, A C E

    2015-09-01

    Despite stabilization of childhood overweight and obesity prevalence, there is a shift toward more severe degrees of obesity, which results in an increasing prevalence of children with morbid obesity. Prior studies demonstrated that lifestyle modification without ongoing treatment has only a modest and not sustainable effect in children with morbid obesity. This suggests that a chronic care model is necessary for long-term effects on weight management and health. This study aimed to evaluate the effect of an ongoing lifestyle intervention in children with morbid obesity in comparison with children with overweight and obesity. This was a nonrandomized prospective intervention study with 12- and 24-month followup at the Centre for Overweight Adolescent and Children's Healthcare. Children and adolescents (n = 100 females and 72 males) with overweight, obesity, or morbid obesity were given long-term, outpatient, tailored lifestyle intervention. Body mass index (BMI) z score was measured. In children with morbid obesity, 12- and 24-month interventions resulted in a decrease of BMI z score of -0.13 ± 0.25 (P = .001) and -0.23 ± 0.32 (P = .01) respectively, whereas weight status category improved to obese in 21% and 25% of the children. Cardiovascular risk parameters including serum total cholesterol, low-density lipoprotein cholesterol, glycosylated hemoglobin (HbA1c), and diastolic blood pressure significantly improved after 1-year intervention in the complete group. Most important, BMI z score as well as cardiovascular risk parameters improved to a similar degree in children with overweight, obesity, and morbid obesity. Children with overweight, obesity, and morbid obesity benefit equally from an ongoing, outpatient, tailored lifestyle intervention, and demonstrate significant weight loss and improvement of cardiovascular risk parameters.

  18. Treatment of adolescent obesity.

    Science.gov (United States)

    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.

  19. Impact of morbid obesity on medical expenditures in adults.

    Science.gov (United States)

    Arterburn, D E; Maciejewski, M L; Tsevat, J

    2005-03-01

    Morbid obesity (body mass index (BMI) > or =40 kg/m2) is associated with substantially increased morbidity and mortality from chronic health conditions and with poorer health-related quality of life; however, less is known about the impact of morbid obesity on healthcare expenditures. To examine the impact of morbid obesity on healthcare expenditures using a nationally representative sample of US adults. We performed a cross-sectional analysis of 16 262 adults from the 2000 Medical Expenditure Panel Survey, a nationally representative survey of the noninstitutionalized civilian population of the United States. Per capita healthcare expenditures were calculated for National Institutes of Health BMI categories, based on self-reported height and weight, using a two-part, multivariable model adjusted for age, gender, race, income, education level, type of health insurance, marital status, and smoking status. Odds of incurring any healthcare expenditure and per capita healthcare expenditures associated with morbid obesity in 2000. When compared with normal-weight adults, the odds of incurring any healthcare expenditure in 2000 were two-fold greater among adults with morbid obesity. Per capita healthcare expenditures for morbidly obese adults were 81% (95% confidence interval (CI): 48-121%) greater than normal-weight adults, 65% (95% CI: 37-110%) greater than overweight adults, and 47% (95% CI: 11-96%) greater than adults with class I obesity. Excess costs among morbidly obese adults resulted from greater expenditures for office-based visits, outpatient hospital care, in-patient care, and prescription drugs. Aggregate US healthcare expenditures associated with excess body weight among morbidly obese US adults exceeded $11 billion in 2000. The economic burden of morbid obesity among US adults is substantial. Further research is needed to identify interventions to reduce the incidence and prevalence of morbid obesity and improve the health and economic outcomes of morbidly

  20. Physical and Psychological Morbidity in Adolescents With Atypical Anorexia Nervosa.

    Science.gov (United States)

    Sawyer, Susan M; Whitelaw, Melissa; Le Grange, Daniel; Yeo, Michele; Hughes, Elizabeth K

    2016-04-01

    Adolescents with atypical anorexia nervosa (AN) have lost significant weight but are not underweight. This study aimed to describe the physical and psychological morbidity of adolescents diagnosed with atypical AN, and to compare them with underweight adolescents with AN. All first presentations of atypical AN (n = 42) and full-threshold AN (n = 118) to a specialist pediatric eating disorder program between July 2010 and June 2014 were examined. Diagnosis was assessed by using the Eating Disorder Examination and anthropometric measurement. Psychological morbidity measures included eating and weight concerns, bingeing, purging, compulsive exercise, and psychiatric comorbidity. Compared with AN, more adolescents with atypical AN were premorbidly overweight or obese (71% vs 12%). They had lost more weight (17.6 kg vs 11.0 kg) over a longer period (13.3 vs 10.2 months). There was no significant difference in the frequency of bradycardia (24% vs 33%;) or orthostatic instability (43% vs 38%). We found no evidence of a difference in frequency of psychiatric comorbidities (38% vs 45%) or suicidal ideation (43% vs 39%). Distress related to eating and body image was more severe in atypical AN. Atypical AN considerably affects physical and psychological functioning, despite adolescents presenting within or above the normal weight range. There was little evidence that the morbidity of adolescents with atypical AN was any less severe than that of adolescents with full-threshold AN. The findings support the need for vigilance around weight loss in adolescents, regardless of body size. Copyright © 2016 by the American Academy of Pediatrics.

  1. Victimization of Obese Adolescents

    Science.gov (United States)

    Robinson, Sabrina

    2006-01-01

    Peer victimization of obese adolescents has been associated with low self-esteem, body dissatisfaction, social isolation, marginalization, poor psychosocial adjustment, depression, eating disorders, and suicidal ideation and attempts, not to mention poor academic performance. Weight-based peer victimization is defined as unsolicited bullying and…

  2. Surgery for Gastroesophageal Reflux Disease in the Morbidly Obese Patient.

    Science.gov (United States)

    Duke, Meredith C; Farrell, Timothy M

    2017-01-01

    The prevalence of gastroesophageal reflux disease (GERD) has mirrored the increase in obesity, and GERD is now recognized as an obesity-related comorbidity. There is growing evidence that obesity, specifically central obesity, is associated with the complications of chronic reflux, including erosive esophagitis, Barrett's esophagus, and esophageal adenocarcinoma. While fundoplication is effective in creating a competent gastroesophageal junction and controlling reflux in most patients, it is less effective in morbidly obese patients. In these patients a bariatric operation has the ability to correct both the obesity and the abnormal reflux. The Roux-en-Y gastric bypass is the preferred procedure.

  3. Activity Behaviours in Lean and Morbidly Obese Pregnant Women.

    Science.gov (United States)

    Fazzi, Caterina; Mohd-Shukri, Nor; Denison, Fiona C; Saunders, David H; Norman, Jane E; Reynolds, Rebecca M

    2018-05-17

    Interventions to increase physical activity in pregnancy are challenging for morbidly obese women. Targeting sedentary behaviours may be a suitable alternative to increase energy expenditure. We aimed to determine total energy expenditure, and energy expended in sedentary activities in morbidly obese and lean pregnant women. We administered the Pregnancy Physical Activity Questionnaire PPAQ (non-objective) and the Actical accelerometer (objective) to morbidly obese (BMI≥40kg/m²) and lean (BMI≤25Kg/M²) pregnant women recruited in early (lean pregnant women. No differences were observed in the proportion of energy expended sedentary between lean and morbidly obese pregnant women. The greater total energy expenditure in morbidly obese pregnant women was corroborated by Actical accelerometer in early (n=14 per group, obese 1167.7 (313.6) Kcal; lean 781.1 (210.1) Kcal, plean 893.7 (175.9) Kcal, plean pregnant. Further studies are needed to determine whether sedentary behaviours are a suitable target for intervention in morbidly obese pregnancy. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  4. Gene polymorphisms and increased DNA damage in morbidly obese women.

    Science.gov (United States)

    Luperini, B C O; Almeida, D C; Porto, M P; Marcondes, J P C; Prado, R P; Rasera, I; Oliveira, M R M; Salvadori, D M F

    2015-06-01

    Obesity is characterized by increased adipose tissue mass resulting from a chronic imbalance between energy intake and expenditure. Furthermore, there is a clearly defined relationship among fat mass expansion, chronic low-grade systemic inflammation and reactive oxygen species (ROS) generation; leading to ROS-related pathological events. In the past years, genome-wide association studies have generated convincing evidence associating genetic variation at multiple regions of the genome with traits that reflect obesity. Therefore, the present study aimed to evaluate the relationships among the gene polymorphisms ghrelin (GHRL-rs26802), ghrelin receptor (GHSR-rs572169), leptin (LEP-rs7799039), leptin receptor (LEPR-rs1137101) and fat mass and obesity-associated (FTO-rs9939609) and obesity. The relationships among these gene variants and the amount of DNA damage were also investigated. Three hundred Caucasian morbidly obese and 300 eutrophic (controls) women were recruited. In summary, the results demonstrated that the frequencies of the GHRL, GHSR, LEP and LEPR polymorphisms were not different between Brazilian white morbidly obese and eutrophic women. Exceptions were the AA-FTO genotype and allele A, which were significantly more frequent in obese women than in the controls (0.23% vs. 0.10%; 0.46 vs. 0.36, respectively), and the TT-FTO genotype and the T allele, which were less frequent in morbidly obese women (p<0.01). Furthermore, significant differences in the amount of genetic lesions associated with FTO variants were observed only in obese women. In conclusion, this study demonstrated that the analyzed SNPs were not closely associated with morbid obesity, suggesting they are not the major contributors to obesity. Therefore, our data indicated that these gene variants are not good biomarkers for predicting risk susceptibility for obesity, whereas ROS generated by the inflammatory status might be one of the causes of DNA damage in obese women, favoring

  5. Morbidity, including fatal morbidity, throughout life in men entering adult life as obese.

    Directory of Open Access Journals (Sweden)

    Esther Zimmermann

    Full Text Available BACKGROUND: The association between obesity in adults and excess morbidity and mortality is well established, but the health impact throughout adult life of being obese in early adulthood needs elucidation. We investigated somatic morbidity, including fatal morbidity, throughout adulthood in men starting adult life as obese. METHODS: Among 362,200 Danish young men, examined for military service between 1943 and 1977, all obese (defined as BMI≥31.0 kg/m(2, and, as controls, a random 1% sample of the others was identified. In the age range of 18-25 years, there were 1,862 obese, which encompass the men above the 99.5 percentile, and 3,476 controls. Information on morbidity was obtained via national registers. Cox regression models were used to estimate the relative morbidity assessed as first incidence of disease, occurrence of disease in the year preceding death and prevalent disease at time of death. RESULTS: From age 18 through 80 years the obese had an increased risk of becoming diseased by or die from a broad range of diseases. Generally, the incidence of first event, occurrence in the year prior to death, and prevalence at time of death showed the same pattern. As an example, the relative hazard of type 2 diabetes was constant throughout life at 4.9 (95% confidence intervals [CI]: 4.1-5.9, 5.2 (95% CI: 3.6-7.5, and 6.8 (95% CI: 4.6-10.1, respectively. CONCLUSIONS: Our findings strongly support the continued need to avoid beginning adult life as obese, as obese young men experience an increased morbidity, including fatal morbidity, from many diseases throughout life.

  6. Psychological predictors of outcome after gastric banding for morbid obesity

    NARCIS (Netherlands)

    Larsen, J.K.

    2004-01-01

    Obesity has become a major public health problem in Western societies. Although surgery is considered the treatment of choice in morbid obesity, the outcome is variable and weight regain may occur in the long-term postoperative period. The aim of this thesis was to examine psychological predictors

  7. Orthopedic trauma surgery in the morbidly obese patient.

    Science.gov (United States)

    Bozzio, Anthony E; Gala, Raj J; Villasenor, Mario A; Hao, Jiandon; Mauffrey, Cyril

    2014-05-01

    The treatment of morbidly obese patients in orthopedic trauma differs in many ways compared to injured patients with normal body mass indices. This paper highlights key differences and ways to overcome obstacles. We present specific tips, as well as considerations for initial planning, positioning for surgery, intra-operative strategies, and a discussion on both anesthesia and imaging. Several treatment strategies have been shown to have better results in morbidly obese patients. Pre-operative planning is necessary for minimizing risk to the patient. The prevalence of morbid obesity has increased in the USA in the past quarter century. Treatment for orthopedic injuries in morbidly obese patients requires a multidisciplinary approach that addresses not only their orthopedic injuries, but also medical co-morbidities. A team of medicine doctors, anesthesiologists, X-ray technicians, physical and occupational therapists, respiratory therapists, and social workers is needed in addition to the orthopedic surgeon. Modifications in both pre-operative planning and intra-operative strategies may be necessary in order to accommodate the patient. This paper presents numerous technical tips that can aid in providing stable fixation for fractures, as well as addressing peri-operative issues specific to the morbidly obese.

  8. Factors contributing to adolescent obesity.

    Science.gov (United States)

    Al-Kloub, Manal I; Froelicher, Erika S

    2009-06-01

    Obesity in children is a significant public health concern. The prevalence of overweight and obesity in Jordanian children, and adolescents has increased in the last decade. The consequences of obesity to health in childhood and adulthood have both medical, and economic cost to individuals and society. This paper reviews the factors that contribute to adolescent obesity and emphasizes behavioral and environmental factors. An individual's behaviors such as increased consumption of high caloric foods, increased sedentary activity while decreasing physical activity has been identified as key issues in the development of obesity. Additionally, the current environment in homes, schools, and neighborhoods tend to discourage a healthy lifestyle. A comprehensive approach that involves the whole community is the best strategy for preventing adolescent obesity. Nurses are in a unique position to provide leadership in developing programs for healthier lifestyle choices for adolescents' and adoption of these goals into their daily lives.

  9. Impaired decision making among morbidly obese adults.

    LENUS (Irish Health Repository)

    Brogan, Amy

    2011-02-01

    The Iowa Gambling Task (IGT) measures affective decision making and has revealed decision making impairments across a wide range of eating disorders. This study aimed to investigate affective decision making in severely obese individuals.

  10. Morbid Obesity with Achalasia: A Surgical Challenge

    OpenAIRE

    Hagen, Monika E.; Sedrak, Micheal; Wagner, Oliver J.; Jacobsen, Garth; Talamini, Mark; Horgan, Santiago

    2010-01-01

    Achalasia is a relatively rare medical condition that is classically not associated with obesity. The surgical treatment of a simultaneous occurrence of these two diseases requires careful consideration, and only a few reports can be found in the literature combining a Heller myotomy with gastric bypass, duodenal switch, or gastric banding. We report the case of a 69-year-old female patient with early achalasia and obesity who underwent simultaneous laparoscopic gastric sleeve resection and r...

  11. Epidemiology, morbidity, and treatment of overweight and obesity.

    Science.gov (United States)

    Aronne, L J

    2001-01-01

    Although still considered more of a cosmetic problem by both the general public and some areas of the medical community, overweight and obesity have reached epidemic proportions worldwide. Overweight and obesity have not only a significant psychological impact but also result in an increased risk for development of numerous chronic and sometimes fatal diseases. The morbidity from obesity-associated disorders increases with higher body mass index and begins within the normal weight range. The costs (direct and indirect) associated with treating obesity and its comorbid conditions are notable and increasing. Obesity rates in patients with schizophrenia are at least as high, if not higher, than in the general population. This article reviews the epidemiology and burden of obesity and its associated comorbid disorders. The guidelines from the National Heart, Lung, and Blood Institute of the National Institutes of Health for diagnosing and treating obesity are also discussed.

  12. Laparoscopic Sleeve Gastrectomy Improves Olfaction Sensitivity in Morbidly Obese Patients.

    Science.gov (United States)

    Hancı, Deniz; Altun, Huseyin; Altun, Hasan; Batman, Burcin; Karip, Aziz Bora; Serin, Kursat Rahmi

    2016-03-01

    Olfactory abilities of the patients are known to be altered by eating and metabolic disorders, including obesity. There are only a number of studies investigating the effect of obesity on olfaction, and there is limited data on the changes in olfactory abilities of morbidly obese patients after surgical treatment. Here we investigated the changes in olfactory abilities of 54 morbidly obese patients (M/F, 22/32; age range 19-57 years; body mass index (BMI) range 30.5-63.0 kg/m(2)) after laparoscopic sleeve gastrectomy. A laparoscopic sleeve gastrectomy was performed by the same surgeon using five-port technique. Olfactory abilities were tested preoperatively and 1, 3, and 6 months after the surgery using a standardized Sniffin' Sticks Extended Test kit. Analyses of variance indicated statistically significant improvement in T, D, and I scores of morbidly obese patients within time factors (preoperative vs. 1, 3, and 6 months; 1 vs. 3 and 6 months; and 3 vs. 6 months; p < 0.001 for all). There was a statistically significant improvement in overall TDI scores with an increase from 25 to 41 during the 6 months follow-up period (p < 0.001 for all). Here, for the first time in literature, we were able to show the significant improvement in olfactory abilities of morbidly obese patients after laparoscopic sleeve gastrectomy.

  13. Interleukin-17A Gene Expression in Morbidly Obese Women

    Directory of Open Access Journals (Sweden)

    Fernando Zapata-Gonzalez

    2015-07-01

    Full Text Available Data from recent studies conducted in rodent models and humans suggest that interleukin-17A (IL-17A plays a role in the induction of inflammation in adipose tissue during obesity. The aim of this study was to assess the gene expression of IL-17A in adipose tissue of morbidly obese patients. We used RT-PCR to evaluate the expression of IL-17A and several adipo/cytokines in the visceral adipose tissue (VAT and subcutaneous adipose tissue (SAT of 10 normal-weight control women (BMI < 25 kg/m2 and 30 morbidly obese women (MO, BMI > 40 kg/m2. We measured serum levels of IL-17A and adipo/cytokines in MO and normal weight women. IL-17A expression was significantly higher in VAT than in SAT in MO patients (p = 0.0127. It was very low in normal-weight controls in both VAT and SAT tissues. We found positive correlations between IL-17A and IL-6, lipocalin-2 and resistin in VAT of MO patients. The circulating level of IL-17A was higher in the normal-weight group than the MO patients (p = 0.032, and it was significantly related to adiponectin and TNFRII levels. In conclusion, IL-17A expression in VAT is increased in morbidly obese women, which suggests a link between obesity and innate immunity in low-grade chronic inflammation in morbidly obese women.

  14. Intragastric balloon for morbid obesity causing chronic gastric dilatation

    Energy Technology Data Exchange (ETDEWEB)

    Pretolesi, F.; Derchi, L.E. [Dept. of Radiology, University of Genoa (Italy); Redaelli, G.; Papagni, L. [IRCCS, Ist. Auxologico Italiano, Milan (Italy)

    2001-04-01

    We describe the radiographic findings observed in a morbidly obese and diabetic patient with an intragastric air-filled balloon introduced as a therapeutic measure to reduce food intake. The balloon was associated with chronic gastric dilatation and had to be removed 3 months after insertion. However, together with diet and behavioural therapy, it proved effective in reducing body weight and ameliorating glycaemic control. Although rarely used, intragastric balloons for the treatment of morbid obesity are still encountered in radiological practice. Radiologists must be able to recognize them and to understand their complications. (orig.)

  15. Hepatic effects of dietary weight loss in morbidly obese subjects

    DEFF Research Database (Denmark)

    Andersen, T; Gluud, C; Franzmann, Magnus

    1991-01-01

    = 0.026). Liver biochemistry, which was of no individual diagnostic value, improved. It is concluded that morbidly obese subjects with a high degree of hepatic fatty change are at risk of developing portal inflammation and fibrosis when undergoing very fast dietary weight reductions.......This prospective study was carried out in order to evaluate the influence on liver morphology and function of a very-low-calorie formula diet. Fourty-one morbidly obese, non-alcoholic subjects had liver biopsy performed before and after a median weight loss of 34 kg. Fatty change improved (p less...

  16. The lived experiences of being physically active when morbidly obese

    DEFF Research Database (Denmark)

    Toft, Bente Skovsby; Uhrenfeldt, Lisbeth

    2015-01-01

    The aim is to identify facilitators and barriers for physical activity (PA) experienced by morbidly obese adults in the Western world. Inactivity and a sedentary lifestyle have become a major challenge for health and well-being, particularly among persons with morbid obesity. Lifestyle changes may...... lead to long-term changes in activity level, if facilitators and barriers are approached in a holistic way by professionals. To develop lifestyle interventions, the perspective and experiences of this group of patients are essential for success. The methodology of the systematic review followed...... active....

  17. Intragastric balloon for morbid obesity causing chronic gastric dilatation

    International Nuclear Information System (INIS)

    Pretolesi, F.; Derchi, L.E.; Redaelli, G.; Papagni, L.

    2001-01-01

    We describe the radiographic findings observed in a morbidly obese and diabetic patient with an intragastric air-filled balloon introduced as a therapeutic measure to reduce food intake. The balloon was associated with chronic gastric dilatation and had to be removed 3 months after insertion. However, together with diet and behavioural therapy, it proved effective in reducing body weight and ameliorating glycaemic control. Although rarely used, intragastric balloons for the treatment of morbid obesity are still encountered in radiological practice. Radiologists must be able to recognize them and to understand their complications. (orig.)

  18. Morbid obesity increases risk of morbidity and reoperation in resection of benign cranial nerve neoplasms.

    Science.gov (United States)

    Murphy, Meghan E; McCutcheon, Brandon A; Kerezoudis, Panagiotis; Porter, Amanda; Rinaldo, Lorenzo; Shepherd, Daniel; Rayan, Tarek; Maloney, Patrick R; Carter, Bob S; Bydon, Mohamad; Gompel, Jamie J Van; Link, Michael J

    2016-09-01

    Obesity has been associated with increased risk for postoperative CSF leak in patients with benign cranial nerve tumors. Other measures of postoperative morbidity associated with obesity have not been well characterized. Patients enrolled in the American College of Surgeons' National Surgical Quality Improvement Program (ACS-NSQIP) from 2007 to 2013 with a diagnosis code of a benign neoplasm of a cranial nerve were included. The primary outcome of postoperative morbidity was analyzed as well as secondary outcomes of readmission and reoperation. The main covariate of interest was body mass index (BMI). A total of 561 patients underwent surgery for a benign cranial nerve neoplasm between 2007 and 2013. Readmission data, available for 2012-2013(n=353), revealed hydrocephalus, facial nerve injury, or CSF leak requiring readmission or reoperation occurred in 0.85%, 1.42%, and 3.12%, respectively. Composite morbidity included wound complications, infection, respiratory insufficiency, transfusion requirement, stroke, venous thromboembolism, coma and cardiac arrest. On multivariable analysis patients with class I (BMI 30-34.9) and II (BMI 35-39.9) obesity showed trends towards increasing return to operating room, though not significant, but there was no trend for composite complications in class I and II obesity patients. However, class III obesity, BMI≥40, was associated with increased odds of composite morbidity (OR 4.40, 95% CI 1.24-15.88) and return to the operating room (OR 5.97, 95% CI 1.20-29.6) relative to patients with a normal BMI, 18.5-25. Obesity is an independent and important risk factor for composite morbidity in resection of benign cranial nerve neoplasms, and as such, merits discussion during preoperative counseling. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Constipation and Colonic Transit Times in Children With Morbid Obesity

    NARCIS (Netherlands)

    van der Baan-Slootweg, Olga H.; Liem, Olivia; Bekkali, Noor; van Aalderen, Wim M. C.; Rijcken, Tammo H. Pels; Di Lorenzo, Carlo; Benninga, Marc A.

    2011-01-01

    Objectives: The aim of the study was to determine the frequency of functional constipation according to the Rome III criteria in children with morbid obesity and to evaluate by measuring colonic transit times (CTTs) whether decreased colonic motility is present in these children. Patients and

  20. Renal tubular acidosis secondary to jejunoileal bypass for morbid obesity

    DEFF Research Database (Denmark)

    Schaffalitzky de Muckadell, O B; Ladefoged, Jens; Thorup, Jørgen Mogens

    1985-01-01

    Renal handling of acid and base was studied in patients with persistent metabolic acidosis 3-9 years after jejunoileal bypass for morbid obesity. Excretion of acid was studied before and after intravenous infusion of NH4Cl and excretion of bicarbonate after infusion of NaHCO3. Bypass patients...

  1. Anaesthesia for a morbidly obese patient with schizophrenia and ...

    African Journals Online (AJOL)

    We report the case of a morbidly obese woman with schizophrenia and intellectual disability who underwent dental treatment using general anaesthesia. The 38-year-old patient was 156 cm tall and weighed 140 kg, with a body mass index of 57.5 kg.m-2. Her developmental age was less than five or six years. She had ...

  2. Salivary Cortisol and Binge Eating Disorder in Obese Women After Surgery for Morbid Obesity

    OpenAIRE

    Larsen, Junilla K.; van Ramshorst, Bert; van Doornen, Lorenz J. P.; Geenen, Rinie

    2009-01-01

    Background Binge eating episodes characterized by loss of control are hypothesized to be accompanied by changes in hypothalamic pituitary adrenal (HPA) axis functioning. Cortisol is an end product of this neuroendocrine stress system. Purpose The aim of this study was to examine the cortisol levels and the awakening cortisol response (ACR) in obese persons showing binge eating after surgery for morbid obesity. Method Sixteen obese women with binge eating disorder (BED) and 18 obese women with...

  3. Musculoskeletal pain in obese adolescents.

    Science.gov (United States)

    Jannini, Suely Nóbrega; Dória-Filho, Ulysses; Damiani, Durval; Silva, Clovis Artur Almeida

    2011-01-01

    To determine the prevalence of pain, musculoskeletal syndromes, orthopedic disorders and using computers and playing videogames among obese adolescents. This was a cross-sectional study that investigated 100 consecutive obese adolescents and 100 healthy-weight controls using a confidential, self-report questionnaire covering demographic data, sports participation, painful musculoskeletal system symptoms and using computers and playing videogames. The questionnaire's test-retest reliability was tested. Physical examination covered six musculoskeletal syndromes and seven orthopedic disorders. The kappa index for test-retest was 0.724. Pain and musculoskeletal syndromes were equally prevalent in both groups (44 vs. 56%, p = 0.09; 12 vs. 16%, p = 0.541; respectively). Notwithstanding, orthopedic disorders (98 vs. 76%, p = 0.0001), tight quadriceps (89 vs. 44%, p = 0.0001) and genu valgum (87 vs. 24%, p = 0.0001) were significantly more prevalent in obese adolescents than in controls. Median time spent using a computer the day before, on Saturdays and on Sundays were all lower among the obese subjects (30 vs. 60 minutes, p = 0.0001; 1 vs. 60 minutes, p = 0.001; and 0 vs. 30 minutes, p = 0.02; respectively). Obese adolescents were less likely to play handheld videogames (2 vs. 11%, p = 0.003) and there was no difference in the two groups' use of full-sized videogames (p > 0.05). Comparing obese adolescents with pain to those free from pain revealed that pain was more frequent among females (59 vs. 39%, p = 0.048) and was associated with greater median time spent playing on Sundays [0 (0-720) vs. 0 (0-240) minutes, p = 0.028]. Obesity can cause osteoarticular system damage at the start of adolescence, particularly to the lower limbs. Programs developed specifically for obese female adolescents with musculoskeletal pain are needed.

  4. Profile of Co-morbidities in the Obese

    Directory of Open Access Journals (Sweden)

    Salati SA

    2015-07-01

    Full Text Available Objective: To study the profile of co-morbidities in obese patients reporting for bariatric surgical procedures. Methods: A retrospective study was conducted at the Bariatric Surgery Unit of Department of Surgery of the College of Medicine, Qassim University, Saudi Arabia. The records of all the obese patients (with Body Mass Index greater than 30, evaluated in the department over the period of two years from Jan 2012 to Dec 2014, were studied and co-morbidities were sought in all subjects. Results: Of the 172 subjects, 76.2% (n=131 were female and 23.8% (n=41 male. The age ranged from 17–49 years (Mean 29.9 years; Mode 28 years. The weight ranged from 82 kg–146kg and BMI ranged from 33–54 (mean BMI 44.7 kg/m. Out of the total of 172 patients, 96 (56 % including 72 females and 24 males had one or more co-morbidities. Conclusion: A wide range of co-morbidities occur in obese patients that have the potential to decrease the quality of life and the life span.

  5. Maternal Super Obesity and Neonatal Morbidity after Term Cesarean Delivery.

    Science.gov (United States)

    Smid, Marcela C; Vladutiu, Catherine J; Dotters-Katz, Sarah K; Manuck, Tracy A; Boggess, Kim A; Stamilio, David M

    2016-10-01

    Objective To estimate the association between maternal super obesity (body mass index [BMI] ≥ 50 kg/m(2)) and neonatal morbidity among neonates born via cesarean delivery (CD). Methods Retrospective cohort of singleton neonates delivered via CD ≥ 37 weeks in the Maternal-Fetal Medicine Unit Cesarean Registry. Maternal BMI at delivery was stratified as 18.5 to 29.9 kg/m(2), 30 to 39.9 kg/m(2), 40 to 49.9 kg/m(2), and ≥ 50 kg/m(2). Primary outcomes included acute (5-minute Apgar score neonatal injury, and/or transient tachypnea of the newborn) and severe (grade 3 or 4 intraventricular hemorrhage, necrotizing enterocolitis, seizure, respiratory distress syndrome, hypoxic ischemic encephalopathy, meconium aspiration, ventilator support ≥ 2 days, sepsis and/or neonatal death) neonatal morbidity. Odds of neonatal morbidity were estimated for each BMI category adjusting for clinical and operative characteristics. Results Of 41,262 maternal-neonatal dyads, 36% of women were nonobese, 49% had BMI of 30 to 39.9 kg/m(2), 12% had BMI of 40 to 49.9 kg/m(2), and 3% were super obese. Compared with nonobese women, super obese women had twofold odds of acute (5 vs. 10%; adjusted odds ratio [aOR]: 1.81, 95% confidence interval [CI]: 1.59-2.73) and severe (3 vs. 6%; aOR: 2.08; 95% CI: 1.59-2.73) neonatal morbidity. Conclusion Among term infants delivered via CD, maternal super obesity is associated with increased risk of neonatal morbidity. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  6. Influence of cortisol on zinc metabolism in morbidly obese women.

    Science.gov (United States)

    Mota Martins, Luana; Soares de Oliveira, Ana Raquel; Clímaco Cruz, Kyria Jayanne; Borges de Araújo, Camila Guedes; de Oliveira, Francisco Erasmo; Santos de Sousa, Gustavo; do Nascimento Nogueira, Nadir; do Nascimento Marreiro, Dilina

    2014-01-01

    The accumulation of visceral fat affects the metabolism of hormones and some nutrients, but these mechanisms remain unclear. To assess the influence of cortisol on the metabolism of zinc in morbidly obese women. Cross-sectional, case-control study involving 80 women aged between 20 and 59 years. The participants were divided into two groups: experimental (morbidly obese, n = 40) and control (normal weight, n = 40). Zinc concentrations were determined by atomic absorption spectroscopy and serum and urinary cortisol by chemiluminescence method. Zinc intake was significantly different between groups. Mean plasma zinc was lower in obese compared to control group. Mean values for erythrocyte zinc were 44.52 ± 7.84 µg/gHb and 40.17 ± 6.71 µg/gHb for obese and control groups, respectively. Urinary excretion of this mineral was higher in obese compared to control subjects (p cortisol were 9.58 ± 4.86 µg/dL for obese and 9.89 ± 5.61 µg/dL for control groups. Mean values for urinary cortisol were 163.00 ± 100.35 µg/dL and 109.71 ± 34.88 µg/dL for obese and control groups, respectively (p > 0.05). The correlation analysis between cortisol and zinc was not significant (p > 0.05). Obese patients have hypozincemia and high erythrocyte zinc levels. The correlation between zinc parameters and cortisol concentration showed no influence of this hormone on zinc metabolism.

  7. [Monogenic and syndromic symptoms of morbid obesity. Rare but important].

    Science.gov (United States)

    Wiegand, S; Krude, H

    2015-02-01

    Monogenic and syndromic obesity are rare diseases with variable manifestation. Therefore diagnosis is difficult and often delayed. The purpose of this work was to develop a clinical diagnostic algorithm for earlier diagnosis. Available publications for clinical symptoms and molecular defects of monogenic and syndromic obesity cases were evaluated. Monogenic and syndromic obesity can be expected in cases with early manifestation before the age of 5 years and a BMI above 40 or above the 99th percentile. Syndromic cases are mostly associated with a low IQ and dwarfism. Monogenic cases are associated with additional endocrine defects. Measurement of serum leptin proves the treatable leptin deficiency. Sequencing of the melanocortin-4 receptor gene (MC4R) allows diagnosis of the most frequent monogenic form of obesity. Treatment with a melanocyte-stimulating hormone (MSH) analog can be expected in the future. Early treatment of children with Prader-Willi syndrome can prevent severe obesity. Because in some cases treatment is available, monogenic and syndromic obesity should be diagnosed early. Based on the disease symptoms, serum leptin, and MC4R sequencing, a diagnostic algorithm is proposed, which can be used to diagnose cases of morbid obesity.

  8. Obesity and cardiovascular risk in children and adolescents

    Directory of Open Access Journals (Sweden)

    Manu Raj

    2012-01-01

    Full Text Available The global prevalence of overweight and obesity in children and adolescents has increased substantially over the past several decades. These trends are also visible in developing economies like India. Childhood obesity impacts all the major organ systems of the body and is well known to result in significant morbidity and mortality. Obesity in childhood and adolescence is associated with established risk factors for cardiovascular diseases and accelerated atherosclerotic processes, including elevated blood pressure (BP, atherogenic dyslipidemia, atherosclerosis, metabolic syndrome, type II diabetes mellitus, cardiac structural and functional changes and obstructive sleep apnea. Probable mechanisms of obesity-related hypertension include insulin resistance, sodium retention, increased sympathetic nervous system activity, activation of the renin-angiotensin-aldosterone system and altered vascular function. Adiposity promotes cardiovascular risk clustering during childhood and adolescence. Insulin resistance has a strong association with childhood obesity. A variety of proinflammatory mediators that are associated with cardiometabolic dysfunction are also known to be influenced by obesity levels. Obesity in early life promotes atherosclerotic disease in vascular structures such as the aorta and the coronary arteries. Childhood and adolescent adiposity has strong influences on the structure and function of the heart, predominantly of the left ventricle. Obesity compromises pulmonary function and increases the risk of sleep-disordered breathing and obstructive sleep apnea. Neglecting childhood and adolescent obesity will compromise the cardiovascular health of the pediatric population and is likely to result in a serious public health crisis in future.

  9. Childhood Obesity: A Review of Increased Risk for Physical and Psychological Co-morbidities

    Science.gov (United States)

    Pulgarón, Elizabeth R.

    2013-01-01

    Background Worldwide estimates of childhood overweight/obesity are as high as 43 million and rates continue to increase each year. Researchers have taken interest in the childhood obesity epidemic and the impact of this condition across health domains. The consequences of childhood and adolescent obesity are extensive, including both medical and psychosocial comorbidities. Objective The purpose of this review was to consolidate and highlight the recent literature on the comorbidities associated with childhood obesity, both nationally and internationally. Methods PubMed and PsychINFO searches were conducted on childhood obesity and co-morbidities. Results The initial search of the terms “obesity” and “comorbidity” yielded over 5000 published articles. Limits were set to include studies on children and adolescents that were published in peer-reviewed journals from 2002 to 2012. These limits narrowed the search to 938. Review of those articles resulted in 79 that are included in this review. The major medical comorbidities associated with childhood obesity in the current literature are metabolic risk factors, asthma, and dental health issues. Major psychological comorbidities include internalizing and externalizing disorders, ADHD, and sleep problems. Conclusions The high prevalence rates of childhood obesity have resulted in extensive research in this area. Limitations to the current childhood obesity literature include differential definitions of weight status and cut off levels for metabolic risk factors across studies. Additionally, some results are based on self-report of diagnoses rather than chart reviews or physician diagnosis. Even so, there is substantial support for metabolic risk factors, internalizing disorders, ADHD, and decreased health related quality of life as comorbidities to obesity in childhood. Additional investigations on other diseases and conditions that may be associated with childhood obesity are warranted and intervention research

  10. Underweight, overweight and obesity among zaboli adolescents: A comparison between international and Iranians′ national criteria

    Directory of Open Access Journals (Sweden)

    Amin Salehi-Abargouei

    2013-01-01

    Conclusions : Almost all definitions revealed coexistence of underweight, overweight, and obesity among Zaboli adolescents. Huge differences exist between different criteria. To understand the best appropriate criteria for Iranian adolescents, future studies should focus on the predictability of obesity-related co-morbidities by these criteria.

  11. Economic considerations for bariatric surgery and morbid obesity

    Directory of Open Access Journals (Sweden)

    Eldo E Frezza

    2009-12-01

    Full Text Available Eldo E Frezza, Mitchell Wacthell1, Bradley Ewing21Center for Metabolic Disease and Texas Tech University, Department of Pathology, 2Rawls Business School, Texas Tech University, Lubbock, TX, USAAbstract: The obesity epidemic is also an economic tragedy. This analysis evaluates the economic effects and the potential to improve the well-being of both individual and societal wealth. Econometric techniques should carefully assess the degree to which obesity affects declines in business output, employment, income, and tax revenues at the regional and national levels. Microeconomics assesses lost productivity and associated wages and profit. Macroeconomics assesses trends associated with employment, inflation, interest rates, money supply, and output. To decrease the adverse economic consequences of the obesity epidemic, policy makers must emphasize bariatric surgery as a cost-effective option for qualified patients. Early intervention, education, and tax rebates for obese individuals who undergo bariatric surgery and for medical centers and doctors would likely have positive economic effects on the whole economy in a few years.Keywords: bariatric surgery, morbid obesity, economics

  12. Cardiovascular Autonomic Dysfunction in Patients with Morbid Obesity

    Energy Technology Data Exchange (ETDEWEB)

    Sant Anna Junior, Maurício de [Programa de Tratamento Multidisciplinar da Obesidade do Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro - UFRJ - Rio de Janeiro, RJ (Brazil); Departamento de Fisioterapia do Centro Universitário Anhanguera Niterói - UNIAN, Niterói, RJ (Brazil); Programa de pós-graduação em Ciências Médicas, Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Instituto Federal de Educação, Ciência e Tecnologia do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Carneiro, João Regis Ivar; Carvalhal, Renata Ferreira [Programa de Tratamento Multidisciplinar da Obesidade do Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro - UFRJ - Rio de Janeiro, RJ (Brazil); Torres, Diego de Faria Magalhães [Programa de Tratamento Multidisciplinar da Obesidade do Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro - UFRJ - Rio de Janeiro, RJ (Brazil); Departamento de Fisioterapia da Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ (Brazil); Cruz, Gustavo Gavina da; Quaresma, José Carlos do Vale [Programa de Tratamento Multidisciplinar da Obesidade do Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro - UFRJ - Rio de Janeiro, RJ (Brazil); Lugon, Jocemir Ronaldo [Divisão de Nefrologia - Faculdade de Medicina da Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Guimarães, Fernando Silva, E-mail: fguimaraes_pg@yahoo.com.br [Departamento de Fisioterapia da Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ (Brazil); Programa de pós-graduação em Ciências da Reabilitação - Centro Universitário Augusto Motta, Rio de Janeiro, RJ (Brazil)

    2015-12-15

    Morbid obesity is directly related to deterioration in cardiorespiratory capacity, including changes in cardiovascular autonomic modulation. This study aimed to assess the cardiovascular autonomic function in morbidly obese individuals. Cross-sectional study, including two groups of participants: Group I, composed by 50 morbidly obese subjects, and Group II, composed by 30 nonobese subjects. The autonomic function was assessed by heart rate variability in the time domain (standard deviation of all normal RR intervals [SDNN]; standard deviation of the normal R-R intervals [SDNN]; square root of the mean squared differences of successive R-R intervals [RMSSD]; and the percentage of interval differences of successive R-R intervals greater than 50 milliseconds [pNN50] than the adjacent interval), and in the frequency domain (high frequency [HF]; low frequency [LF]: integration of power spectral density function in high frequency and low frequency ranges respectively). Between-group comparisons were performed by the Student’s t-test, with a level of significance of 5%. Obese subjects had lower values of SDNN (40.0 ± 18.0 ms vs. 70.0 ± 27.8 ms; p = 0.0004), RMSSD (23.7 ± 13.0 ms vs. 40.3 ± 22.4 ms; p = 0.0030), pNN50 (14.8 ± 10.4 % vs. 25.9 ± 7.2%; p = 0.0061) and HF (30.0 ± 17.5 Hz vs. 51.7 ± 25.5 Hz; p = 0.0023) than controls. Mean LF/HF ratio was higher in Group I (5.0 ± 2.8 vs. 1.0 ± 0.9; p = 0.0189), indicating changes in the sympathovagal balance. No statistical difference in LF was observed between Group I and Group II (50.1 ± 30.2 Hz vs. 40.9 ± 23.9 Hz; p = 0.9013). morbidly obese individuals have increased sympathetic activity and reduced parasympathetic activity, featuring cardiovascular autonomic dysfunction.

  13. Cardiovascular Autonomic Dysfunction in Patients with Morbid Obesity

    Science.gov (United States)

    de Sant Anna Junior, Maurício; Carneiro, João Regis Ivar; Carvalhal, Renata Ferreira; Torres, Diego de Faria Magalhães; da Cruz, Gustavo Gavina; Quaresma, José Carlos do Vale; Lugon, Jocemir Ronaldo; Guimarães, Fernando Silva

    2015-01-01

    Background Morbid obesity is directly related to deterioration in cardiorespiratory capacity, including changes in cardiovascular autonomic modulation. Objective This study aimed to assess the cardiovascular autonomic function in morbidly obese individuals. Methods Cross-sectional study, including two groups of participants: Group I, composed by 50 morbidly obese subjects, and Group II, composed by 30 nonobese subjects. The autonomic function was assessed by heart rate variability in the time domain (standard deviation of all normal RR intervals [SDNN]; standard deviation of the normal R-R intervals [SDNN]; square root of the mean squared differences of successive R-R intervals [RMSSD]; and the percentage of interval differences of successive R-R intervals greater than 50 milliseconds [pNN50] than the adjacent interval), and in the frequency domain (high frequency [HF]; low frequency [LF]: integration of power spectral density function in high frequency and low frequency ranges respectively). Between-group comparisons were performed by the Student’s t-test, with a level of significance of 5%. Results Obese subjects had lower values of SDNN (40.0 ± 18.0 ms vs. 70.0 ± 27.8 ms; p = 0.0004), RMSSD (23.7 ± 13.0 ms vs. 40.3 ± 22.4 ms; p = 0.0030), pNN50 (14.8 ± 10.4 % vs. 25.9 ± 7.2%; p = 0.0061) and HF (30.0 ± 17.5 Hz vs. 51.7 ± 25.5 Hz; p = 0.0023) than controls. Mean LF/HF ratio was higher in Group I (5.0 ± 2.8 vs. 1.0 ± 0.9; p = 0.0189), indicating changes in the sympathovagal balance. No statistical difference in LF was observed between Group I and Group II (50.1 ± 30.2 Hz vs. 40.9 ± 23.9 Hz; p = 0.9013). Conclusion morbidly obese individuals have increased sympathetic activity and reduced parasympathetic activity, featuring cardiovascular autonomic dysfunction. PMID:26536979

  14. Cardiovascular Autonomic Dysfunction in Patients with Morbid Obesity

    International Nuclear Information System (INIS)

    Sant Anna Junior, Maurício de; Carneiro, João Regis Ivar; Carvalhal, Renata Ferreira; Torres, Diego de Faria Magalhães; Cruz, Gustavo Gavina da; Quaresma, José Carlos do Vale; Lugon, Jocemir Ronaldo; Guimarães, Fernando Silva

    2015-01-01

    Morbid obesity is directly related to deterioration in cardiorespiratory capacity, including changes in cardiovascular autonomic modulation. This study aimed to assess the cardiovascular autonomic function in morbidly obese individuals. Cross-sectional study, including two groups of participants: Group I, composed by 50 morbidly obese subjects, and Group II, composed by 30 nonobese subjects. The autonomic function was assessed by heart rate variability in the time domain (standard deviation of all normal RR intervals [SDNN]; standard deviation of the normal R-R intervals [SDNN]; square root of the mean squared differences of successive R-R intervals [RMSSD]; and the percentage of interval differences of successive R-R intervals greater than 50 milliseconds [pNN50] than the adjacent interval), and in the frequency domain (high frequency [HF]; low frequency [LF]: integration of power spectral density function in high frequency and low frequency ranges respectively). Between-group comparisons were performed by the Student’s t-test, with a level of significance of 5%. Obese subjects had lower values of SDNN (40.0 ± 18.0 ms vs. 70.0 ± 27.8 ms; p = 0.0004), RMSSD (23.7 ± 13.0 ms vs. 40.3 ± 22.4 ms; p = 0.0030), pNN50 (14.8 ± 10.4 % vs. 25.9 ± 7.2%; p = 0.0061) and HF (30.0 ± 17.5 Hz vs. 51.7 ± 25.5 Hz; p = 0.0023) than controls. Mean LF/HF ratio was higher in Group I (5.0 ± 2.8 vs. 1.0 ± 0.9; p = 0.0189), indicating changes in the sympathovagal balance. No statistical difference in LF was observed between Group I and Group II (50.1 ± 30.2 Hz vs. 40.9 ± 23.9 Hz; p = 0.9013). morbidly obese individuals have increased sympathetic activity and reduced parasympathetic activity, featuring cardiovascular autonomic dysfunction

  15. Adolescent Obesity and Future College Degree Attainment

    OpenAIRE

    Fowler-Brown, Angela G.; Ngo, Long H.; Phillips, Russell S.; Wee, Christina C.

    2009-01-01

    The current impact of adolescent obesity on educational attainment is not clear. The objectives of our study were to determine whether adolescent obesity is associated with college degree attainment and how this association may have changed over time. We used data from a contemporary national cohort of over 4,000 persons who were adolescents (aged 14–18) in 1997 to assess the relationship between adolescent obesity and education. To assess for changes in this relationship over time, we also a...

  16. Bariatric Surgery vs. Conventional Dieting in the Morbidly Obese.

    Science.gov (United States)

    Greenstein; Rabner; Taler

    1994-02-01

    Weight loss and psychosocial events have been compared between low calorie conventional diet (n = 11) or following obesity surgery (n = 17). Interviews were >/= 9 months following initiation of treatment. After surgery significantly less hunger was experienced (surgery 76% [13/17] vs diet 18% [2/11] p employed (surgery 76% [13/17] vs diet 18% [2/11) p appearance improvements (surgery 94% [15/16] vs diet 50% [5/10] p Physical activity improved (surgery 73% [11/15] vs diet 18% [2/11] p Physical activity increases, and satisfaction with weight loss method is greater, after surgery. Employment is greater (probably self selection) in the post-surgical group. We found that comparing >/= 9 months following surgery or beginning a conventional diet, the morbidly obese have a more positive response to surgery.

  17. Radiologic findings and weight loss following gastroplasty for morbid obesity

    Energy Technology Data Exchange (ETDEWEB)

    Miskowiak, J.; Fleckenstein, P.; Andersen, B.

    Gastroplasty aimed at treatment of morbid obesity creates a small proximal pouch and a narrow stoma to the remainder of the stomach. In 11 consecutive obese patients subjected to gastroplasty radiologic examinations of the stomach were performed before operation and one week, 3 and 12 months postoperatively. All stomachs were normal before operation. A significant decrease in pouch area and increase in stoma diameter were registered over the observation period. There were no statistically significant correlations between postoperative weight loss and stoma diameter or pouch area. Nor was retention in the pouch one week after gastroplasty related to weight loss. Radiographic evidence of gastroesophageal reflux was present in only one patient. The described method of follow-up is evidently not suited to predict the outcome of gastroplasty.

  18. The liver in consecutive patients with morbid obesity

    DEFF Research Database (Denmark)

    Andersen, T; Christoffersen, Pernille Yde; Gluud, C

    1984-01-01

    consumption and only one was diabetic. Four biopsies (7 per cent) showed normal liver tissue, while fatty change was the main diagnosis in most cases (85 per cent). Increasing degrees of fatty change was significantly (P less than 0.02) associated with presence of lipogranulomas (found in 54 per cent......Liver morphology and biochemistry were investigated in 61 morbidly obese subjects selected by defined criteria. Median overweight was 82 per cent (range 61 to 170 per cent), and median duration of overweight was 20 years (range two to 45 years). No patient had more than a moderate alcohol...

  19. Pouch emptying of solid foods after gastroplasty for morbid obesity

    DEFF Research Database (Denmark)

    Andersen, T; Pedersen, B H; Henriksen, Jens Henrik Sahl

    1985-01-01

    To obtain information on possible determinants of weight loss after horizontal gastroplasty, pouch emptying was prospectively investigated in 27 morbidly obese patients. A scintigraphic method was used. Examinations were carried out every 6 months until 2 years after surgery. Pouch emptying...... was described by means of delay, time until half emptying, mean transit time, and emptying rate. The measures all showed a significant (p less than 0.05) acceleration of pouch emptying during the first 6 months after gastroplasty. Thereafter pouch emptying was unaltered. No significant association could...

  20. Disrupted functional connectivity in adolescent obesity

    Directory of Open Access Journals (Sweden)

    Laura Moreno-Lopez

    2016-01-01

    Conclusions: These findings suggest that adolescent obesity is linked to disrupted functional connectivity in brain networks relevant to maintaining balance between reward, emotional memories and cognitive control. Our findings may contribute to reconceptualization of obesity as a multi-layered brain disorder leading to compromised motivation and control, and provide a biological account to target prevention strategies for adolescent obesity.

  1. Tracheostomy in the Morbidly Obese: Difficulties and Challenges.

    Science.gov (United States)

    Fattahi, Tirbod; Chafin, Christopher; Bunnell, Anthony

    2017-07-01

    This study evaluated the difficulties and challenges associated with open tracheostomy in the morbidly obese patient (body mass index [BMI] ≥30 kg/m 2 ). Forty patients met all the inclusion criteria. A retrospective chart review was performed to evaluate indications for tracheostomy, duration of intubation before tracheostomy, history of tracheostomy, duration of operative procedure, duration in the operating room, and all perioperative complications. Complications were classified as intraoperative (5%) and postoperative (17.5%). The average BMI was 46 kg/m 2 (range, 31.1 to 75.3 kg/m 2 ). The average duration of intubation before tracheostomy was 11 days. Ten patients (25%) previously underwent tracheostomy. The average operating time was 60 minutes (range, 20 to 95 minutes). The average total time in the operating room was 100 minutes (range, 45 to 146 minutes). This study shows that although open tracheostomy in the morbidly obese patient is increasing in demand, the procedure can be predictably performed albeit at a much longer duration and a higher perioperative complication rate compared with the traditional tracheostomy. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Resistin expression correlates with steatohepatitis in morbidly obese patients.

    Science.gov (United States)

    Edwards, Claire R; Hindle, A Katharine; Latham, Patricia S; Fu, Sidney W; Brody, Fred J

    2013-04-01

    Morbidly obese patients are at risk for nonalcoholic steatohepatitis (NASH) even in the absence of risk factors for liver disease. Unfortunately, NASH is usually not clinically evident, and a definitive, noninvasive test for NASH does not exist. Resistin, a cytokine originating from adipose tissue, is involved in insulin resistance and also initiates proinflammatory signaling from hepatic stellate cells. This study explores the relationship between resistin expression and liver pathology in bariatric surgery patients. Blood samples from 30 patients undergoing bariatric surgery were collected. Total RNA was extracted and cDNA was synthesized. Quantitative RT-PCR was used to quantify relative gene expression using 18s rRNA gene as an internal control. Wedge liver biopsies from these patients were sectioned and stained. Based on a previously published scoring method, biopsies were assigned an overall NASH severity score and subscores for steatosis, inflammation, and fibrosis. Results were analyzed by using Student's t test. Resistin mRNA levels ranged from 0.5 to 9.7. A group of five patients with very high resistin expression (>4) was identified. These patients had a significantly higher average NASH score compared with the rest of the group (7.9 vs. 4.48, p = 0.019). Steatosis and inflammation scores were significantly higher in the high-resistin group (p < 0.05 for both comparisons). There also was a trend toward higher fibrosis score in this group, which approached statistical significance (p = 0.051). In morbidly obese patients, high resistin expression in serum is associated with hepatic steatosis, inflammation, and fibrosis. The development of elevated resistin expression may represent a link between obesity and the onset of steatohepatitis.

  3. Population Pharmacokinetics and Pharmacodynamics of Meropenem in Nonobese, Obese, and Morbidly Obese Patients.

    Science.gov (United States)

    Chung, Eun Kyoung; Cheatham, S Christian; Fleming, Megan R; Healy, Daniel P; Kays, Michael B

    2017-03-01

    The study objective was to evaluate meropenem population pharmacokinetics and pharmacodynamics in nonobese, obese, and morbidly obese patients. Forty adult patients-11 nonobese (body mass index [BMI] calculate probability of target attainment (PTA) for 5 dosing regimens, infused over 0.5 and 3 hours, using fT>MIC of 40%, 54%, and 100% of the dosing interval. A 2-compartment linear-elimination model best described the serum concentration-time data, and creatinine clearance was significantly associated with systemic clearance. Pharmacokinetic parameters were not significantly different among patient groups. In patients with creatinine clearances ≥50 mL/min, all simulated dosing regimens achieved >90% PTA at 40% fT>MIC in all patient groups at MICs ≤2 mg/L. Only 500 mg q8h, infused over 0.5 hour, did not achieve >90% PTA at 54% fT>MIC in nonobese and morbidly obese patients. At 100% fT>MIC, 1 g q6h and 2 g q8h, infused over 3 hours, reliably achieved >90% PTA in all patient groups. Meropenem pharmacokinetics are comparable among nonobese, obese, and morbidly obese patients. Standard dosing regimens provide adequate pharmacodynamic exposures for susceptible pathogens at 40% and 54% fT>MIC, but prolonged infusions of larger doses are needed for adequate exposures at 100% fT>MIC. Dosage adjustments based solely on body weight are unnecessary. © 2016, The American College of Clinical Pharmacology.

  4. Overweight, obesity and underweight profile among adolescent ...

    African Journals Online (AJOL)

    Overweight, obesity and underweight profile among adolescent secondary school students ... should be of concern if a healthy and productive future generation is to be ensured. Primary care providers should constantly assess adolescents for ...

  5. What is the optimal minimally invasive surgical procedure for endometrial cancer staging in the obese and morbidly obese woman?

    Science.gov (United States)

    Gehrig, Paola A; Cantrell, Leigh A; Shafer, Aaron; Abaid, Lisa N; Mendivil, Alberto; Boggess, John F

    2008-10-01

    Thirty-three percent of U.S. women are either obese or morbidly obese. This is associated with an increased risk of death from all causes and is also associated with an increased risk of endometrial carcinoma. We sought to compare minimally invasive surgical techniques for staging the obese and morbidly obese woman with endometrial cancer. Consecutive robotic endometrial cancer staging procedures were collected from 2005-2007 and were compared to consecutive laparoscopic cases (2000-2004). Demographics including age, weight, body mass index (BMI), operative time, estimated blood loss, lymph node retrieval, hospital stay and complications were collected and compared. During the study period, there were 36 obese and 13 morbidly obese women who underwent surgery with the DaVinci robotic system and 25 obese and 7 morbidly obese women who underwent traditional laparoscopy. For both the obese and morbidly obese patient, robotic surgery was associated with shorter operative time (p=0.0004), less blood loss (ptool for the comprehensive surgical staging of the obese and morbidly obese woman with endometrial cancer. As this patient population is at increased risk of death from all causes, including post-operative complications, all efforts should be made to improve their outcomes and minimally invasive surgery provides a useful platform by which this can occur.

  6. Childhood obesity as a predictor of morbidity in adulthood: a systematic review and meta-analysis.

    Science.gov (United States)

    Llewellyn, A; Simmonds, M; Owen, C G; Woolacott, N

    2016-01-01

    Obese children are at higher risk of being obese as adults, and adult obesity is associated with an increased risk of morbidity. This systematic review and meta-analysis investigates the ability of childhood body mass index (BMI) to predict obesity-related morbidities in adulthood. Thirty-seven studies were included. High childhood BMI was associated with an increased incidence of adult diabetes (OR 1.70; 95% CI 1.30-2.22), coronary heart disease (CHD) (OR 1.20; 95% CI 1.10-1.31) and a range of cancers, but not stroke or breast cancer. The accuracy of childhood BMI when predicting any adult morbidity was low. Only 31% of future diabetes and 22% of future hypertension and CHD occurred in children aged 12 or over classified as being overweight or obese. Only 20% of all adult cancers occurred in children classified as being overweight or obese. Childhood obesity is associated with moderately increased risks of adult obesity-related morbidity, but the increase in risk is not large enough for childhood BMI to be a good predictor of the incidence of adult morbidities. This is because the majority of adult obesity-related morbidity occurs in adults who were of healthy weight in childhood. Therefore, targeting obesity reduction solely at obese or overweight children may not substantially reduce the overall burden of obesity-related disease in adulthood. © 2015 World Obesity.

  7. Visceral Blood Flow Modulation: Potential Therapy for Morbid Obesity

    Energy Technology Data Exchange (ETDEWEB)

    Harris, Tyler J., E-mail: tjharris@gmail.com [University of California, Los Angeles, Department of Vascular and Interventional Radiology (United States); Murphy, Timothy P.; Jay, Bryan S. [Rhode Island Hospital, Brown University, Department of Diagnostic Imaging, Vascular Disease Research Center (United States); Hampson, Christopher O.; Zafar, Abdul M. [University of Texas Health Science Center at San Antonio, Department of Radiology (United States)

    2013-06-15

    We present this preliminary investigation into the safety and feasibility of endovascular therapy for morbid obesity in a swine model. A flow-limiting, balloon-expandable covered stent was placed in the superior mesenteric artery of three Yorkshire swine after femoral arterial cutdown. The pigs were monitored for between 15 and 51 days after the procedure and then killed, with weights obtained at 2-week increments. In the two pigs in which the stent was flow limiting, a reduced rate of weight gain (0.42 and 0.53 kg/day) was observed relative to the third pig (0.69 kg/day), associated with temporary food aversion and signs of mesenteric ischemia in one pig.

  8. Visceral Blood Flow Modulation: Potential Therapy for Morbid Obesity

    International Nuclear Information System (INIS)

    Harris, Tyler J.; Murphy, Timothy P.; Jay, Bryan S.; Hampson, Christopher O.; Zafar, Abdul M.

    2013-01-01

    We present this preliminary investigation into the safety and feasibility of endovascular therapy for morbid obesity in a swine model. A flow-limiting, balloon-expandable covered stent was placed in the superior mesenteric artery of three Yorkshire swine after femoral arterial cutdown. The pigs were monitored for between 15 and 51 days after the procedure and then killed, with weights obtained at 2-week increments. In the two pigs in which the stent was flow limiting, a reduced rate of weight gain (0.42 and 0.53 kg/day) was observed relative to the third pig (0.69 kg/day), associated with temporary food aversion and signs of mesenteric ischemia in one pig.

  9. Drug Therapy in Obese Adolescents

    Directory of Open Access Journals (Sweden)

    Zinat Salem

    2013-03-01

    Full Text Available Background: The behavior and dietary treatments are not so successful for extremely obese adolescents. Therefore, using drugs to treat extremely obese children and adolescents are among the modern approaches. This research aims to study the pharmaceutical interventions performed for treatment of obese children. Materials and Methods: The strategy of research was using of key words ‘obesity’, ‘adolescence’, ‘treatment’ and ‘anti-obesity drugs’ were searched in websites of PubMed, Iranian Medical Digital Library, SID, Iran Medex, Magiran. This study reviewed all the available published papers in English and Farsi languages during 2000-2010. The Criteria for exclusion was The papers that had been published on interventions and treatment of eating disorders, type II diabetes or the obesity caused by the secondary syndromes. Results: Twelve papers were found as short-term clinical trials and/or long-term follow-ups. In these studies, the positive effects of ‘sibutramine’ in some studies are shown; although some other side effects are reported as well. A significant weight-loss had been reported on ‘orlistat’ medicine, but digestive complications had been observed as well. None of the studies had followed up patients for more than one year. Apparently, ‘Metformin’ requires further studies.Conclusion: The FDA has only approved ‘sibutramine’ and ‘orlistat’ drugs. But side effects of long-term these drugs have already been unknown. However, it seems that ‘orlistat’ is applied for ≥12-year-old children and ‘sibutramine’ for ≥ 16-year-old children.

  10. Overweight and Obesity in Children and Adolescents

    OpenAIRE

    Koyuncuo?lu G?ng?r, 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, dyslipidem...

  11. Neuroendocrine brake for the treatment of morbid obesity. Preliminary report

    Directory of Open Access Journals (Sweden)

    Aureo Ludovico de Paula

    2005-06-01

    Full Text Available Objectives: To demonstrate the preliminary results of a newtechnique named neuroendocrine brake, for surgical treatment ofmorbid obesity. Methods: In November 2003, three patientsunderwent the neuroendocrine brake operation performed by thelaparoscopic approach. The mean age was 46.4 years; all patientswere female. Mean BMI was 42.3 kg/m2. The patients selectedpresented some relative or absolute contraindications to the useof gastrointestinal bypass techniques, including gastric ulcer anda family history of gastric malignancy(1 and chronic anemia (2.All patients had associated diseases, including type II diabetesmellitus (2, hypertension (2, obstructive sleep apnea (1,dyslipidemia (3, cholecystolithiasis (1, gastric ulcer (1 andchronic anemia (2. The laparoscopic technique consisted of anileal interposition at the proximal jejunum and longitudinalgastrectomy. Results: There was no conversion to open surgery orpostoperative complications. Sixteen months later, the meanpercentage of initial body weight loss was 44.6% and the meanBMI was 24.3 kg/m2. Glucose, triglyceride and cholesterol levelswere normalized, and sleep apnea showed remission. Conclusion:In spite of the reduced number of patients and short term followup, the good results suggest that the neuroendocrine brake maybecome an option for surgical treatment of morbid obesity in thenear future.

  12. [Overweight and obesity in childhood and adolescence].

    Science.gov (United States)

    Nitzko, Sina

    2010-01-01

    Firstly, essential developmental aspects of the focused periods of life, namely childhood and adolescence, are discussed. Furthermore, different issues of overweight and obesity in childhood and adolescence are highlighted. Besides the definition and the assessment, possibilities of classification and epidemiological aspects are of interest. Physical and psychiatric consequences, which can be associated with obesity are also presented. In the context of a model of multifactorial genesis of obesity, different causing and maintaining factors are described. In addition to genetic and biological risk factors, the significance of several psychosocial factors is illustrated. Finally, the focus is on the therapy of obesity in childhood and adolescence.

  13. [Obesity-related metabolic disorders in childhood and adolescence].

    Science.gov (United States)

    Yeste, D; Carrascosa, A

    2011-08-01

    Obesity is the most frequent nutritional disorder in childhood and adolescence. The rise in its prevalence and severity has underlined the numerous and significant obesity-related metabolic disorders. Altered glucose metabolism, manifested as impaired glucose tolerance, appears early in severely obese children and adolescents. Obese young people with glucose intolerance are characterized by marked peripheral insulin resistance and relative beta-cell failure. Lipid deposition in muscle and the visceral compartment, and not only obesity per se, is related to increased peripheral insulin resistance, the triggering factor of the metabolic syndrome. Other elements of the metabolic syndrome, such as dyslipidaemia, and hypertension, are already present in obese youngsters and worsen with the degree of obesity. The long-term impact of obesity-related insulin resistance on cardiovascular morbidity in these patients is expected to emerge as these youngsters become young adults. Copyright © 2011 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  14. The relationship between various measures of obesity and arterial stiffness in morbidly obese patients

    Directory of Open Access Journals (Sweden)

    Røislien J

    2011-02-01

    Full Text Available Abstract Background Obesity is associated with increased risk of cardiovascular disease. Arterial stiffness assessed by carotid femoral pulse wave velocity (PWV is an independent predictor of cardiovascular morbidity and mortality. We aimed to investigate how various measures of body composition affect arterial stiffness. Methods This is an analysis of cross-sectional baseline data from a controlled clinical trial addressing changes in arterial stiffness after either surgery or lifestyle intervention in a population of morbidly obese patients. High-fidelity applanation tonometry (Millar®, Sphygmocor® was used to measure pulse wave velocity (PWV. Carotid femoral PWV is a direct measure of arterial stiffness and is considered to be the gold standard method. The Inbody 720 Body Composition Analyzer was used for bioelectrical impedance analysis (BIA. Spearman's correlation, independent samples t-test, chi-square tests, Fisher's exact test and multiple linear regression analyses were used as statistical methods. Results A total of 133 patients (79 women, with a mean (SD age of 43 (11 years were included in the study. Men had a significantly higher prevalence of obesity related comorbidities and significantly higher PWV, 9.1 (2.0 m/s vs. 8.1 (1.8 m/s, p = 0.003, than women. In the female group, PWV was positively correlated with WC, WHtR, BMI and visceral fat area. In the male group, PWV was negatively correlated with BMI. Multiple linear regression analysis showed that increasing BMI, WC, WHtR, visceral fat area and fat mass were independently associated with higher PWV in women, but not in men, after adjustment for age, hypertension and type 2 diabetes. Conclusion Most measures of general and abdominal obesity were predictors of arterial stiffness in female morbidly obese patients. Trial registration ClinicalTrials.gov Identifier NCT00626964

  15. Emotion processing and regulation in women with morbid obesity who apply for bariatric surgery

    NARCIS (Netherlands)

    Zijlstra, H.; Middendorp, H. van; Devaere, L.; Larsen, J.K.; van Ramshorst, B.; Geenen, R.

    2012-01-01

    Emotional eating, the tendency to eat when experiencing negative affect, is prevalent in morbid obesity and may indicate that ways to deal with emotions are disturbed. Our aim was to compare emotion processing and regulation between 102 women with morbid obesity who apply for bariatric surgery and

  16. Mindfulness and eating behaviour styles in morbidly obese males and females

    NARCIS (Netherlands)

    Ouwens, M.A.; Schiffer, A.A.J.; Visser, L.I.; Raaijmakers, L.J.C.; Nyklicek, I.

    2015-01-01

    Background: Morbid obesity is a highly prevalent condition that is associated with a high risk of various diseases and high health care costs. Understanding determinants of eating behaviours that are characteristic of many morbidly obese persons is important for the development of new interventions

  17. Salivary cortisol and binge eating disorder in obese women after surgery for morbid obesity.

    Science.gov (United States)

    Larsen, Junilla K; van Ramshorst, Bert; van Doornen, Lorenz J P; Geenen, Rinie

    2009-01-01

    Binge eating episodes characterized by loss of control are hypothesized to be accompanied by changes in hypothalamic pituitary adrenal (HPA) axis functioning. Cortisol is an end product of this neuroendocrine stress system. The aim of this study was to examine the cortisol levels and the awakening cortisol response (ACR) in obese persons showing binge eating after surgery for morbid obesity. Sixteen obese women with binge eating disorder (BED) and 18 obese women without BED participated in the study. Means+/-SD: age 43 +/- 15, body mass index 40 +/- 8. Salivary cortisol, anthropometric assessments, and the eating disorder examination interview were taken. Women with BED showed a significantly lower waist-to-hip ratio and cortisol levels during the day than women without BED, whereas the ACR did not differ. Our cross-sectional study in a small sample generates the hypothesis that neuroendocrine regulation differs between obese women with and without BED after obesity surgery. This finding needs replication in future studies that should also examine the causal direction of the observed association.

  18. SLEEVE GASTRECTOMY IN PATIENTS WITH MORBID OBESITY AND HIV.

    Science.gov (United States)

    Pinto, José Máximo Costa; Lima, Marianna Gomes Cavalcanti Leite de; Almeida, Ana Luiza Melo Cavalcanti de; Sousa, Marcelo Gonçalves

    It is estimated that there are nearly 40 million people with the human immunodeficiency virus (HIV) worldwide. Due to the advent of antiretroviral drugs, it has been observed increasing in obesity and metabolic rates among patients undergoing treatment. Thus, numerous surgical therapies for weight loss are proposed for continuous improvement in health of patients with HIV, being the vertical gastrectomy an option for intact intestinal transit. To evaluate the applicability of the vertical gastrectomy in patients with morbid obesity and HIV. Was conducted a systematic review of the literature, in the electronic databases Scopus, Pubmed, Cinahl, Scielo, Cochrane and Lilacs, from 1998 to 2015. MeSH headings used in data collection were "Gastrectomy" and "Morbid obesity" being combined with the descriptor "HIV". Were found 2148 articles in Scopus, 1234 in PubMed and 784 in Cinahl. The articles were analyzed by the Jadad Quality Scale, being reduced to 40 articles, subsequently reassessed using an elaborated form by the Critical Appraisal Skills Programme (CASP), reaching 12 articles in the end. It was found that vertical gastrectomy constitutes a safe and effective method, with low mortality and low rate of postoperative complications, being recommended as surgical technique in patients with obesity, HIV and comorbidities. Estima-se que haja quase 40 milhões de pessoas com o vírus da imunodeficiência adquirida (HIV) no mundo. Com o advento dos antirretrovirais, observou-se aumento da obesidade e de taxas metabólicas nos pacientes em tratamento. Assim, inúmeras terapias cirúrgicas para a perda de peso estão sendo estudadas para a melhoria contínua da saúde dos pacientes com HIV, sendo a gastrectomia vertical uma opção de trânsito íntegro. Avaliar a aplicabilidade da gastrectomia vertical em pacientes com obesidade mórbida e HIV. Foi realizada revisão sistemática de literatura, de artigos publicados nas bases eletrônicas de dados Scopus, Pubmed, Cinahl

  19. Association between obesity and periodontal risk indicators in adolescents.

    Science.gov (United States)

    Modéer, Thomas; Blomberg, Cecilia; Wondimu, Biniyam; Lindberg, Tülay Yucel; Marcus, Claude

    2011-06-01

    In a cross-sectional study design we test the hypothesis of whether obesity in adolescence is associated with periodontal risk indicators or disease. Obese adolescents (n=52) and normal weight subjects (n=52) with a mean age of 14.5 years were clinically examined with respect to dental plaque, gingival inflammation, periodontal pockets and incipient alveolar bone loss. The subjects answered a questionnaire concerning medical conditions, oral hygiene habits, smoking habits and sociodemographic background. Body mass index (BMI) was calculated and adjusted for age and gender (BMI-SDS). Samples of gingival crevicular fluid (GCF) were analyzed for the levels of adiponectin, plasminogen activator inhibitor-1 (PAI-1), interleukin-1β (IL-β), interleukin-8 (IL-8) and tumor necrosis factor α (TNF-α). Obese subjects exhibited more gingival inflammation (Pperiodontal pockets (>4 mm) (Pperiodontal pockets. The study demonstrates an association between obesity and periodontal risk indicators in adolescents that in the long term may lead to oral morbidity. This result further strengthens obesity's negative effect on teenagers' periodontal health and highlights the importance of a close collaboration between dentists and pediatricians in the prevention and treatment of obesity.

  20. Obesity in childhood and adolescence, genetic factors.

    Science.gov (United States)

    Memedi, Rexhep; Tasic, Velibor; Nikolic, Erieta; Jancevska, Aleksandra; Gucev, Zoran

    2013-01-01

    Obesity and overweight are a pandemic phenomenon in the modern world. Childhood and adolescent obesity often ends up in obesity in adults. The costs of obesity and its consequences are staggering for any society, crippling for countries in development. The etiology is complex, but most often idiopathic. Hormonal, syndromic and medication-induced obesity are well investigated. Genetic causes are increasingly described. Novel technologies such as whole exome sequencing identify ever more candidate genes influencing or causing obesity. All insights into the complex problem of obesity in a team approach to treatment: diet, psychology, medications and surgery. We briefly review epidemiology, etiology, consequences and treatment approaches in childhood and adolescent obesity, with special emphasis on emerging knowledge of its genetics.

  1. Increasing socioeconomic disparities in adolescent obesity

    OpenAIRE

    Frederick, Carl B.; Snellman, Kaisa; Putnam, Robert D.

    2014-01-01

    Childhood and youth obesity represent significant US public health challenges. Recent findings that the childhood obesity ‘‘epidemic’’ may have slightly abated have been met with relief from health professionals and popular media. However, we document that the overall trend in youth obesity rates masks a significant and growing class gap between youth from upper and lower socioeconomic status (SES) backgrounds. Until 2002, obesity rates increased at similar rates for all adolescents, but sinc...

  2. Clinical aspects of obesity in childhood and adolescence.

    Science.gov (United States)

    Kiess, W; Galler, A; Reich, A; Müller, G; Kapellen, T; Deutscher, J; Raile, K; Kratzsch, J

    2001-02-01

    The level of fatness of a child at which morbidity acutely and/or later in life increases is determined on an acturial basis. Direct measurements of body fat content, e.g. hydrodensitometry, bioimpedance, or DEXA, are useful tools in scientific studies. However, body mass index (BMI) is easy to calculate and is generally accepted now to be used to define obesity in children and adolescents 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 substantially 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 (for example, MC4R). Environmental/exogenous factors largely 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, back pain and psychosocial problems. Therapeutic strategies include psychological and family therapy, lifestyle/behaviour modification and nutrition education. The role of regular exercise and exercise programmes is emphasized. Surgical procedures and drugs used in adult obesity are still not generally recommended in children and adolescents with obesity. As obesity is the most

  3. Adolescent obesity and future college degree attainment.

    Science.gov (United States)

    Fowler-Brown, Angela G; Ngo, Long H; Phillips, Russell S; Wee, Christina C

    2010-06-01

    The current impact of adolescent obesity on educational attainment is not clear. The objectives of our study were to determine whether adolescent obesity is associated with college degree attainment and how this association may have changed over time. We used data from a contemporary national cohort of over 4,000 persons who were adolescents (aged 14-18) in 1997 to assess the relationship between adolescent obesity and education. To assess for changes in this relationship over time, we also analyzed an older, similarly structured cohort of over 3,000 persons who were adolescents (aged 16-18) in 1981. Our primary outcome was college degree completion. We found that in the older cohort (adolescents in 1979), there were no differences in college degree attainment by adolescent weight status before and after adjustment. However, unadjusted analysis of the contemporary cohort (adolescents in 1997) demonstrated that those who were normal weight as adolescents had a higher prevalence of college degree attainment at follow-up compared to obese adolescents (24% vs. 10%). After adjustment for socio-demographic variables (age, sex, race, height, parental income-to-poverty ratio, parental education, aptitude test scores), obese adolescents were less likely to have attained a college degree compared to normal weight peers (adjusted risk ratio 0.61 95% confidence interval 0.38-0.83). Expectations for a future college degree did not vary by weight status and did not explain this observation. In conclusion, adolescent obesity is associated with lower likelihood of college completion. This relationship was not observed in an older cohort of adolescents.

  4. OBESITY IS ASSOCIATED WITH HYPERTENSION IN ADOLESCENTS

    Directory of Open Access Journals (Sweden)

    Hendy Hendy

    2014-12-01

    Full Text Available Obesity has become a global issue. Previous studies in Bali reveal an increase in the proportionof obesity in adolescents. Obesity causes hypertension; hence there should also be an increase inthe prevalence of hypertension as well in Bali. Hypertension in obese adolescents could be causedby various factors, hence identification of the risks factors is crucial as a preventive approach.The aim of this study was to prove an association between obesity and hypertension in adolescents,and to look for the risk factors. We used an analitical cross sectional design conducted to 12-14years old samples. We took body weight, height, waist circumference, hip circumference, andblood pressure measurements with appropriate devices and asked for information regarding lifestyle and familial history by a questionnare filled in by the samples. The association of obeseadolescents with hypertension and their risk factors was analyzed by Chi-square and multivariatetests. A total of 225 subjects from Santo Yoseph junior high school students, west Denpasar,Bali, met the inclusion criteria. The proportion of obese subjects in this study was 25.7%. Wefound that proportion in familial history of obesity was greater in obese than non-obese subjects(70.7 % vs 41.3%. Logistic regression test revealed that obese subjects with hypertension had abody mass index (BMI > 30 with odds ratio of 7.3 (CI 95% = 1.8 to 28.8 and P = 0.005. Weconcluded that there was an association between obesity and adolescents with hypertension,and BMI > 30 could be a risk factor for obese adolescents with hypertension.

  5. Bariatric surgery for severely obese adolescents.

    Science.gov (United States)

    Fitzgerald, Dominic A; Baur, Louise

    2014-09-01

    Severe obesity is increasing in adolescents and is associated with cardiovascular disease, type 2 diabetes mellitus, obstructive sleep apnoea, polycystic ovarian syndrome and a range of musculoskeletal problems. Premature death is the inevitable outcome of persistent severe obesity in adolescents. In adults with severe obesity, medical and lifestyle interventions have been shown to be expensive and less effective in terms of weight loss than has bariatric surgery. The single completed randomised controlled trial in adolescents shows the same outcome. This is supported by meta analyses of bariatric surgery in adolescent subjects. A more aggressive approach to severe obesity, utilising bariatric surgery in selected cases, within the context of a multi-disciplinary team, is required. Copyright © 2014. Published by Elsevier Ltd.

  6. Insulin resistance in obese children and adolescents

    Directory of Open Access Journals (Sweden)

    Monica Cristina dos Santos Romualdo

    2014-11-01

    Conclusion: The results confirmed that insulin resistance is present in many obese children and adolescents, and that this condition is associated with alterations that represent an increased risk for developing metabolic disorders in adulthood.

  7. Long-term effects of adolescent obesity: time to act.

    Science.gov (United States)

    Reinehr, Thomas

    2018-03-01

    Obesity in adolescence will probably have major implications not only for the affected adolescents but also for society. Those who have obesity during adolescence usually have obesity into adulthood, which causes many medical and psychological issues that can result in premature death. Furthermore, obesity in adolescents is associated with a range of social problems, including difficulties securing an apprenticeship or a job or finding a partner. Adolescents with obesity are also at increased risk of having children with obesity later in life. All these consequences lead to high costs for the health-care system. Although efficient treatment options are available that have been proven in randomized controlled trials, such as lifestyle interventions for adolescents with obesity and bariatric surgery for adolescents with severe obesity, these interventions frequently fail in clinical practice as treatment adherence is low in adolescents and most adolescents with obesity do not seek medical care. Therefore, improving treatment adherence and identifying treatment barriers are necessary.

  8. Early Maladaptive Schemas and Cognitive Distortions in Adults with Morbid Obesity: Relationships with Mental Health Status

    Directory of Open Access Journals (Sweden)

    Felipe Q. da Luz

    2017-02-01

    Full Text Available Dysfunctional cognitions may be associated with unhealthy eating behaviors seen in individuals with obesity. However, dysfunctional cognitions commonly occur in individuals with poor mental health independently of weight. We examined whether individuals with morbid obesity differed with regard to dysfunctional cognitions when compared to individuals of normal weight, when mental health status was controlled for. 111 participants—53 with morbid obesity and 58 of normal weight—were assessed with the Mini-Mental State Examination, Young Schema Questionnaire, Cognitive Distortions Questionnaire, Depression, Anxiety and Stress Scale, and a Demographic and Clinical Questionnaire. Participants with morbid obesity showed higher scores in one (insufficient self-control/self-discipline of 15 early maladaptive schemas and in one (labeling of 15 cognitive distortions compared to participants of normal weight. The difference between groups for insufficient self-control/self-discipline was not significant when mental health status was controlled for. Participants with morbid obesity showed more severe anxiety than participants of normal weight. Our findings did not show clinically meaningful differences in dysfunctional cognitions between participants with morbid obesity or of normal weight. Dysfunctional cognitions presented by individuals with morbid obesity are likely related to their individual mental health and not to their weight.

  9. Early Maladaptive Schemas and Cognitive Distortions in Adults with Morbid Obesity: Relationships with Mental Health Status

    Science.gov (United States)

    da Luz, Felipe Q.; Sainsbury, Amanda; Hay, Phillipa; Roekenes, Jessica A.; Swinbourne, Jessica; da Silva, Dhiordan C.; da S. Oliveira, Margareth

    2017-01-01

    Dysfunctional cognitions may be associated with unhealthy eating behaviors seen in individuals with obesity. However, dysfunctional cognitions commonly occur in individuals with poor mental health independently of weight. We examined whether individuals with morbid obesity differed with regard to dysfunctional cognitions when compared to individuals of normal weight, when mental health status was controlled for. 111 participants—53 with morbid obesity and 58 of normal weight—were assessed with the Mini-Mental State Examination, Young Schema Questionnaire, Cognitive Distortions Questionnaire, Depression, Anxiety and Stress Scale, and a Demographic and Clinical Questionnaire. Participants with morbid obesity showed higher scores in one (insufficient self-control/self-discipline) of 15 early maladaptive schemas and in one (labeling) of 15 cognitive distortions compared to participants of normal weight. The difference between groups for insufficient self-control/self-discipline was not significant when mental health status was controlled for. Participants with morbid obesity showed more severe anxiety than participants of normal weight. Our findings did not show clinically meaningful differences in dysfunctional cognitions between participants with morbid obesity or of normal weight. Dysfunctional cognitions presented by individuals with morbid obesity are likely related to their individual mental health and not to their weight. PMID:28264484

  10. Obesity in Childhood and Adolescence, Genetic Factors.

    Science.gov (United States)

    Kostovski, Marko; Tasic, Velibor; Laban, Nevena; Polenakovic, Momir; Danilovski, Dragan; Gucev, Zoran

    2017-12-01

    Obesity and excess weight are a pandemic phenomenon in the modern world. Childhood and adolescent obesity often ends up in obesity in adults. The costs of obesity and its consequences are staggering for any society, crippling for countries in development. Childhood obesity is also widespread in Macedonia. Metabolic syndrome, dyslipidemia and carbohydrate intolerance are found in significant numbers. Parents and grandparents are often obese. Some of the children are either dysmorphic, or slightly retarded. We have already described patients with Prader-Willi syndrome, Bardet-Biedl syndrome or WAGR syndrome. A genetic screening for mutations in monogenic obesity in children with early, rapid-onset or severe obesity, severe hyperphagia, hypogonadism, intestinal dysfunction, hypopigmentation of hair and skin, postprandial hypoglycaemia, diabetes insipidus, abnormal leptin level and coexistence of lean and obese siblings in the family discovers many genetic forms of obesity. There are about 30 monogenic forms of obesity. In addition, obesity is different in ethnic groups, and the types of monogenic obesity differ. In brief, an increasing number of genes and genetic mechanisms in children continue to be discovered. This sheds new light on the molecular mechanisms of obesity and potentially gives a target for new forms of treatment.

  11. Changes in Gallbladder Motility and Gallstone Formation Following Laparoscopic Gastric Banding for Morbid Obesity

    Directory of Open Access Journals (Sweden)

    Bilal O Al-Jiffry

    2003-01-01

    Full Text Available Morbid obesity is associated with cholesterol gallstone formation, a risk compounded by rapid weight loss. Laparoscopic gastric banding allows for a measured rate of weight loss, but the subsequent risk for developing gallstones is unknown.

  12. Relationship between Body Image and Psychological Well-being in Patients with Morbid Obesity.

    Science.gov (United States)

    Yazdani, Negar; Hosseini, Sayed Vahid; Amini, Masood; Sobhani, Zahra; Sharif, Farkhondeh; Khazraei, Hajar

    2018-04-01

    Morbid obesity is rising around the world. It can cause unpleasant appearance and body image. Most of the studies have aimed to evaluate the psychopathology of overweight and obesity and paying attention to mental well-being in morbid obese individuals is rare. Therefore, this study aimed to assess the relationship between body image and psychological well-being in morbid obese patients. This cross-sectional study, using simple random sampling method, was done on 124 morbid obese patients who referred to obesity clinic in Shiraz from 2016 to 2017. The data were collected by body image index and psychological well-being questionnaire. Results were analyzed using descriptive statistics, Pearson correlation coefficient test, ANOVA, and Regression analysis. The results showed a significant relationship between body image and psychological well-being (r=0.43) (Pimage and all the subscales of psychological well-being except autonomy and purpose in life (Pimage (Pimage and those of psychological well-being in different categories of body mass index (BMI) (P>0.05). Final results indicated that body image defects caused by obesity could lie in negative psychological well-being in all aspects. This study can promote health clinicians' knowledge in supporting of mental status of obese individuals. It is suggested that preventing and supporting intervention should be performed as effective methods for encountering and coping with psychological effects of obesity.

  13. Relationship between Body Image and Psychological Well-being in Patients with Morbid Obesity

    Directory of Open Access Journals (Sweden)

    Negar Yazdani

    2018-04-01

    Full Text Available Background: Morbid obesity is rising around the world. It can cause unpleasant appearance and body image. Most of the studies have aimed to evaluate the psychopathology of overweight and obesity and paying attention to mental well-being in morbid obese individuals is rare. Therefore, this study aimed to assess the relationship between body image and psychological well-being in morbid obese patients. Methods: This cross-sectional study, using simple random sampling method, was done on 124 morbid obese patients who referred to obesity clinic in Shiraz from 2016 to 2017. The data were collected by body image index and psychological well-being questionnaire. Results were analyzed using descriptive statistics, Pearson correlation coefficient test, ANOVA, and Regression analysis. Results: The results showed a significant relationship between body image and psychological well-being (r=0.43 (P0.05. Conclusion: Final results indicated that body image defects caused by obesity could lie in negative psychological well-being in all aspects. This study can promote health clinicians’ knowledge in supporting of mental status of obese individuals. It is suggested that preventing and supporting intervention should be performed as effective methods for encountering and coping with psychological effects of obesity.

  14. Percutaneous endovascular aneurysm repair in morbidly obese patients.

    Science.gov (United States)

    Chin, Jason A; Skrip, Laura; Sumpio, Bauer E; Cardella, Jonathan A; Indes, Jeffrey E; Sarac, Timur P; Dardik, Alan; Ochoa Chaar, Cassius I

    2017-03-01

    Endovascular aneurysm repair (EVAR) with percutaneous femoral access (PEVAR) has several potential advantages. Morbidly obese (MO) patients present unique anatomical challenges and have not been specifically studied. This study examines the trends in the use of PEVAR and its surgical outcomes compared with open femoral cutdown (CEVAR) in MO patients. The American College of Surgeons National Surgical Quality Improvement Program files for the years 2005 to 2013 were reviewed. The study included all MO patients (body mass index [BMI] ≥40 kg/m 2 ) undergoing EVAR. Patients were categorized as having CEVAR if they had any one of 11 selected Current Procedural Terminology (American Medical Association, Chicago, Ill) codes describing an open femoral procedure. The PEVAR group included any remaining patients who had only codes for EVAR and endovascular procedures. Linear correlation was used to evaluate temporal trends in the use of PEVAR among MO patients. Baseline comorbidities and surgical outcomes were compared between the PEVAR and CEVAR groups using χ 2 tests or t-tests. There were 833 MO patients (470 CEVAR and 363 PEVAR) constituting 3.0% of all patients undergoing EVAR. The use of PEVAR in MO patients significantly increased from 27.3% of total EVARs in the years 2005 to 2006 to 48.6% in 2013 (P = .039). The two groups had similar baseline characteristics, including age, BMI, comorbidities, and emergency procedures, except for history of severe chronic obstructive pulmonary disease (29.6% CEVAR vs 22.6% PEVAR; P = .024). PEVAR patients had shorter duration of anesthesia (244 vs 260 minutes; P = .048) and shorter total operation time (158 vs 174 minutes; P = .002). PEVAR patients had significantly decreased wound complications (5.5% vs 9.4%; P = .039). There was a trend towards PEVAR patients being more likely to be discharged home than to a facility (93.6% vs 87.8%; P = .060). There was no difference in any other complication or mortality. A subgroup

  15. Evidence of mitochondrial dysfunction in obese adolescents

    DEFF Research Database (Denmark)

    Wilms, L; Larsen, J; Pedersen, P L

    2010-01-01

    Abstract Aim: Although obesity and weight gain generally are anticipated to be caused by an imbalance between energy intake and energy expenditure, the significance of thyroid hormones (TH) remains unclear. Examination of mitochondrial function may reflect intracellular thyroid hormone effect...... and elucidate whether a lower metabolic rate is present. Methods: In a group of 34 obese adolescents (age ... and mitochondrial function in peripheral blood monocytes was determined by flow cytometry. Results: Significant increase in TSH (3.06 +/- 1.56 mU/L vs. 2.33 +/- 0.91 mU/L, p obese adolescents...

  16. Could the improvement of obesity-related co-morbidities depend on modified gut hormones secretion?

    Science.gov (United States)

    Finelli, Carmine; Padula, Maria Carmela; Martelli, Giuseppe; Tarantino, Giovanni

    2014-01-01

    Obesity and its associated diseases are a worldwide epidemic disease. Usual weight loss cures - as diets, physical activity, behavior therapy and pharmacotherapy - have been continuously implemented but still have relatively poor long-term success and mainly scarce adherence. Bariatric surgery is to date the most effective long term treatment for morbid obesity and it has been proven to reduce obesity-related co-morbidities, among them nonalcoholic fatty liver disease, and mortality. This article summarizes such variations in gut hormones following the current metabolic surgery procedures. The profile of gut hormonal changes after bariatric surgery represents a strategy for the individuation of the most performing surgical procedures to achieve clinical results. About this topic, experts suggest that the individuation of the crosslink among the gut hormones, microbiome, the obesity and the bariatric surgery could lead to new and more specific therapeutic interventions for severe obesity and its co-morbidities, also non surgical. PMID:25469034

  17. Modifier 22 for acetabular fractures in morbidly obese patients: does it affect reimbursement?

    Science.gov (United States)

    Bergin, Patrick F; Kneip, Christopher; Pierce, Christine; Hendrix, Stephen T; Porter, Scott E; Graves, Matthew L; Russell, George V

    2014-11-01

    Modifier 22 in the American Medical Association's Current Procedural Terminology (CPT®) book is a billing code for professional fees used to reflect an increased amount of skill, time, and work required to complete a procedure. There is little disagreement that using this code in the setting of surgery for acetabulum fractures in the obese patient is appropriate; however, to our knowledge, the degree to which payers value this additional level of complexity has not been determined. We asked whether (1) the use of Modifier 22 increased reimbursements in morbidly obese patients and (2) there was any difference between private insurance and governmental payer sources in treatment of Modifier 22. Over a 4-year period, we requested immediate adjudication with payers when using Modifier 22 for morbidly obese patients with acetabular fractures. We provided payers with evidence of the increased time and effort required in treating this population. Reimbursements were calculated for morbidly obese and nonmorbidly obese patients. Of the 346 patients we reviewed, 57 had additional CPT® codes or modifiers appended to their charges and were excluded, leaving 289 patients. Thirty (10%) were morbidly obese and were billed with Modifier 22. Fifty-three (18%) were insured by our largest private insurer and 69 (24%) by governmental programs (Medicare/Medicaid). Eight privately insured patients (15%) and seven governmentally insured patients (10%) were morbidly obese and were billed with Modifier 22. For our primary question, we compared reimbursement rates between patients with and without Modifier 22 for obesity within the 289 patients. We then performed the same comparison for the 53 privately insured patients and the 69 governmentally insured patients. Overall, there was no change in mean reimbursement when using Modifier 22 in morbidly obese patients, compared to nonmorbidly obese patients (USD 2126 versus USD 2149, p Level IV, economic and decision analyses. See Instructions

  18. Obesity Related Indices for Screening of Obesity in Adolescents

    Directory of Open Access Journals (Sweden)

    Amit Sohani

    2015-09-01

    Full Text Available Background: Obesity is a fast growing problem in the developing countries like India and is now known to be associated with increased health risk. Realizing the fact that the obesity in adolescent age group does not receive the deserved attention in the prevention and control programme, the present study was undertaken on 585 adolescent subjects studying in one college and three schools. Aims and Objectives: 1. To study the prevalence of overweight and obesity in adolescent population. 2. To find the association of body mass index (BMI with important parameters like skin fold thickness, waist circumference and waist to hip ratio. Methods: It was a cross sectional observational study. The study population was school and college going adolescents in the age group of 11-19 years. The estimated sample size for present study is 585 students. The subjects were screened by body mass index, skin fold thickness, waist circumference and waist to hip ratio. Results: The prevalence of overweight and obesity was 19.14% and 4.44% respectively. It was found that there was strong association between the waist circumference with overweight and obesity. Similarly a strong association between waist to hip ratio with overweight and obesity has been found. Also it was found that there was a strong association between skin fold thickness with overweight and obesity. Skin-fold thickness has more sensitivity as compared to waist circumference and waist to hip ratio. Waist to hip ratio has got maximum specificity amongst all but when both sensitivity and specificity criteria are considered together waist circumference stands out. Conclusion: It was found that the prevalence of overweight and obesity was 19.14% and 4.44% respectively. Skin-fold thickness has more sensitivity as compared waist circumference and waist to hip ratio. Waist to hip ratio has got maximum specificity. When sensitivity and specificity criteria are considered together waist circumference can be

  19. Cardiovascular complications of obesity in adolescents.

    Science.gov (United States)

    Orio, F; Palomba, S; Cascella, T; Savastano, S; Lombardi, G; Colao, A

    2007-01-01

    Obesity is an increasingly important worldwide health problem, representing the major risk factor for coronary heart disease. The increase in the prevalence of obesity, particularly among younger age groups, is likely to have long-term implications for cardiovascular disease (CVD) in the years to come, especially at a young age. Obesity plays a central role in the insulin resistance (IR) syndrome and increases the risk of atherosclerotic CVD. The present review will examine the relationships among cardiovascular risk (CVR) factors during the childhood-adolescence-adulthood transition. In fact, the relation between obesity, in particular visceral obesity and CVD, appears to develop at a relatively young age. The foremost physical consequence of obesity is atherosclerotic CVD, and an intriguing example of obesity-related cardiovascular complications affecting young women is the polycystic ovary syndrome (PCOS).

  20. Complications of obesity in children and adolescents.

    Science.gov (United States)

    Daniels, S R

    2009-04-01

    The increasing prevalence and severity of obesity in children and adolescents has provided greater emphasis on the wide variety of comorbid conditions and complications that can be experienced as a consequence of obesity. These complications can occur both in the short term and in the long term. Some complications, earlier thought to be long-term issues, which would only occur in adulthood, have now been shown to occur in children and adolescents. These findings have raised concerns about the overall health experience of those who develop obesity early in life and have even raised questions about whether the obesity epidemic might shorten the life span of the current generation of children. In this paper, I will examine current knowledge regarding the different organ systems that may be impacted by childhood obesity.

  1. Metabolic syndrome in patients with morbid obesity, according to different levels of serum uric acid.

    OpenAIRE

    Hordonho, Ana Adélia Cavalcante

    2009-01-01

    Although uric acid has a character antioxidant, when in increased serum levels, has been associated in several studies with various pathological conditions, particularly with obesity, cardiovascular disease, diabetes mellitus, dyslipidemia, hyperinsulinemia and insulin resistance, this being identified as the primary change of the metabolic syndrome. However, these studies were not performed on samples formed specifically for morbid obeses, where hyperuricemia is a common findi...

  2. Changes in gallbladder bile composition and crystal detection time in morbidly obese subjects after bariatric surgery

    NARCIS (Netherlands)

    Gustafsson, Ulf; Benthin, Lisbet; Granström, Lars; Groen, Albert K.; Sahlin, Staffan; Einarsson, Curt

    2005-01-01

    The aim of the present study was to elucidate the mechanisms of development of cholesterol crystals and gallstones during weight reduction in obese subjects. Twenty-five morbidly obese, gallstone-free subjects underwent vertical-banded gastroplasty. Gallbladder bile was collected at the time of the

  3. Physical activity patterns in morbidly obese and normal-weight women.

    Science.gov (United States)

    Kwon, Soyang; Mohammad, Jamal; Samuel, Isaac

    2011-01-01

    To compare physical activity patterns between morbidly obese and normal-weight women. Daily physical activity of 18 morbidly obese and 7 normal-weight women aged 30-58 years was measured for 2 days using the Intelligent Device for Energy Expenditure and Activity (IDEEA) device. The obese group spent about 2 hr/day less standing and 30 min/day less walking than did the normal-weight group. Time spent standing (standing time) was positively associated with time spent walking (walking time). Age- and walking time-adjusted standing time did not differ according to weight status. Promoting standing may be a strategy to increase walking.

  4. Unraveling the "new morbidity": adolescent parenting and developmental delays.

    Science.gov (United States)

    Borkowski, J G; Whitman, T L; Passino, A W; Rellinger, E A; Sommer, K; Keogh, D

    1992-01-01

    Baumeister's concept of the "new morbidity" pertains to the linkages between poverty, adolescent mothers, and a series of developmental delays in their children. Outlined are three possible causes of the mild mental retardation and learning disabilities that are found disproportionately among the offspring of adolescents. First, there may be a direct genetic transmission of mild mental retardation. Second, adolescent mothers are likely to have a lack of support from a social network, be unprepared cognitively and emotionally to assume responsibility for child rearing, and to look to an infant to meet their own needs. Third, the interaction of genetic and environmental deficits leads to a parenting style that deprives the child of stimulation that could potentially overcome these deficits. A secure mother-infant attachment relationship provides the foundation for the development of social, emotional, attentional, and self-regulatory processes. When this attachment relationship is insecure, as a result of the mother's unreadiness to parent, the child cannot proceed to exploration of the environment--a critical component of cognitive development. If the infant has a difficult temperament, the risk of physical and emotional abuse increases, further compromising the child's future development. By 3 years of age, many of these children are showing declines in mental functioning, delays in receptive language skills, and poor motor and social skills. Research is urged to identify events in this chain that can be targeted for early intervention.

  5. Economic considerations for bariatric surgery and morbid obesity.

    Science.gov (United States)

    Frezza, Eldo E; Wacthell, Mitchell; Ewing, Bradley

    2009-01-01

    The obesity epidemic is also an economic tragedy. This analysis evaluates the economic effects and the potential to improve the well-being of both individual and societal wealth. Econometric techniques should carefully assess the degree to which obesity affects declines in business output, employment, income, and tax revenues at the regional and national levels. Microeconomics assesses lost productivity and associated wages and profit. Macroeconomics assesses trends associated with employment, inflation, interest rates, money supply, and output. To decrease the adverse economic consequences of the obesity epidemic, policy makers must emphasize bariatric surgery as a cost-effective option for qualified patients. Early intervention, education, and tax rebates for obese individuals who undergo bariatric surgery and for medical centers and doctors would likely have positive economic effects on the whole economy in a few years.

  6. Economic considerations for bariatric surgery and morbid obesity

    Science.gov (United States)

    Frezza, Eldo E; Wacthell, Mitchell; Ewing, Bradley

    2009-01-01

    The obesity epidemic is also an economic tragedy. This analysis evaluates the economic effects and the potential to improve the well-being of both individual and societal wealth. Econometric techniques should carefully assess the degree to which obesity affects declines in business output, employment, income, and tax revenues at the regional and national levels. Microeconomics assesses lost productivity and associated wages and profit. Macroeconomics assesses trends associated with employment, inflation, interest rates, money supply, and output. To decrease the adverse economic consequences of the obesity epidemic, policy makers must emphasize bariatric surgery as a cost-effective option for qualified patients. Early intervention, education, and tax rebates for obese individuals who undergo bariatric surgery and for medical centers and doctors would likely have positive economic effects on the whole economy in a few years. PMID:21935309

  7. Cushing's Syndrome in a Morbidly Obese Patient Undergoing Evaluation before Bariatric Surgery

    Directory of Open Access Journals (Sweden)

    Livia Borsoi

    2014-06-01

    Full Text Available Objective: Cushing's syndrome (CS is extremely rare in morbidly obese patients. To date, no occurrences in obese patients with BMI above 60 kg/m2 have been reported in the literature. Case Report: This case report describes a patient who was admitted to the ward of the Clinical Division of Endocrinology and Metabolism of the Medical University of Vienna in preparation for bariatric surgery. The patient was a 49-year-old female who showed morbid obesity (BMI 61.6 kg/m2, hypertension, and substituted hypothyroidism. Preoperative work-up revealed CS due to an adrenal adenoma. Therefore, the patient underwent unilateral adrenalectomy followed by bariatric surgery 6 months later. Conclusion: Since undiagnosed CS might result in severe perioperative complications in a population already at increased risk, this case report underlines the importance of careful endocrine evaluation of morbidly obese patients. After all, even rare endocrine causes should be excluded.

  8. Lowered testosterone in male obesity: Mechanisms, morbidity and management

    Directory of Open Access Journals (Sweden)

    Mark Ng Tang Fui

    2014-04-01

    Full Text Available With increasing modernization and urbanization of Asia, much of the future focus of the obesity epidemic will be in the Asian region. Low testosterone levels are frequently encountered in obese men who do not otherwise have a recognizable hypothalamic-pituitary-testicular (HPT axis pathology. Moderate obesity predominantly decreases total testosterone due to insulin resistance-associated reductions in sex hormone binding globulin. More severe obesity is additionally associated with reductions in free testosterone levels due to suppression of the HPT axis. Low testosterone by itself leads to increasing adiposity, creating a self-perpetuating cycle of metabolic complications. Obesity-associated hypotestosteronemia is a functional, non-permanent state, which can be reversible, but this requires substantial weight loss. While testosterone treatment can lead to moderate reductions in fat mass, obesity by itself, in the absence of symptomatic androgen defi ciency, is not an established indication for testosterone therapy. Testosterone therapy may lead to a worsening of untreated sleep apnea and compromise fertility. Whether testosterone therapy augments diet- and exercise-induced weight loss requires evaluation in adequately designed randomized controlled clinical trials.

  9. in the assessment of the rate of disability in patients with morbid obesity – pilot study

    Directory of Open Access Journals (Sweden)

    Krystyn Sosada

    2017-06-01

    Full Text Available Background. Due to the constant increase in the number of morbidly obese patients, an adequate tool for assessing the functioning and disability of these patients is being sought. The International Classification of Functioning, Disability and Health (IC F could be that tool. Objectives. The aim of this study is to examine the usefulness of the IC F scale in assessing the functioning of morbidly obese patients in two selected areas in reference to recognized scales. Material and methods . The study group included 76 patients with morbid obesity qualified for bariatric treatment. The ICF was applied to assess the function and limitations of each individual. Two domains of the IC F were selected: Body Functions and Structures and Activities and Participation. The usefulness of the IC F was compared to that of the Barthel and EPQ-R scales. Results . In morbidly obese patients, a correlation between motor functions and IC F and BMI, as well as age, was observed. A significant correlation was observed between BMI and psychomotor control, appropriateness and range of emotions experienced, age and amount of sleep, quality of sleep, memory retrieval and psychomotor functions. Women’s mental functions were significantly worse than those of men. In terms of interpersonal relations, a correlation between BMI and regulating behavior within interactions was observed. Conclusions . The IC F is a useful tool for the study and description of the functioning of patients with morbid obesity. The selected domains are described better than by the previously used Barthel scale. Women with morbid obesity tend to have more impaired mental functioning than morbidly obese men.

  10. Epidemiology, trends, and morbidities of obesity and the metabolic syndrome.

    Science.gov (United States)

    Bray, George A; Bellanger, Tracy

    2006-02-01

    Obesity has been described as an epidemic because of the rapid increase in the number of overweight and obese individuals over the past 20 yr. This increasing prevalence of obesity is a worldwide phenomenon affecting both children and adults. The metabolic syndrome is a constellation of central adiposity, impaired fasting glucose, elevated blood pressure, and dyslipidemia (high triglyceride and low HDL cholesterol). When three of these five criteria are present, the risk of cardiovascular disease and diabetes is increased 1.5- to 2-fold. As body weight, expressed as the BMI, rises, there are a number of other diseases that are associated with it. First, life span is shortened and the risk of sudden death increases. Second, the risk of diabetes, gall bladder disease, hypertension, heart disease, osteoarthritis, sleep apnea, and certain forms of cancer also increase.

  11. Screening for Obesity in Children and Adolescents: US Preventive Services Task Force Recommendation Statement.

    Science.gov (United States)

    Grossman, David C; Bibbins-Domingo, Kirsten; Curry, Susan J; Barry, Michael J; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phipps, Maureen G; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

    2017-06-20

    Based on year 2000 Centers for Disease Control and Prevention growth charts, approximately 17% of children and adolescents aged 2 to 19 years in the United States have obesity, and almost 32% of children and adolescents are overweight or have obesity. Obesity in children and adolescents is associated with morbidity such as mental health and psychological issues, asthma, obstructive sleep apnea, orthopedic problems, and adverse cardiovascular and metabolic outcomes (eg, high blood pressure, abnormal lipid levels, and insulin resistance). Children and adolescents may also experience teasing and bullying behaviors based on their weight. Obesity in childhood and adolescence may continue into adulthood and lead to adverse cardiovascular outcomes or other obesity-related morbidity, such as type 2 diabetes. Although the overall rate of child and adolescent obesity has stabilized over the last decade after increasing steadily for 3 decades, obesity rates continue to increase in certain populations, such as African American girls and Hispanic boys. These racial/ethnic differences in obesity prevalence are likely a result of both genetic and nongenetic factors (eg, socioeconomic status, intake of sugar-sweetened beverages and fast food, and having a television in the bedroom). To update the 2010 US Preventive Services Task Force (USPSTF) recommendation on screening for obesity in children 6 years and older. The USPSTF reviewed the evidence on screening for obesity in children and adolescents and the benefits and harms of weight management interventions. Comprehensive, intensive behavioral interventions (≥26 contact hours) in children and adolescents 6 years and older who have obesity can result in improvements in weight status for up to 12 months; there is inadequate evidence regarding the effectiveness of less intensive interventions. The harms of behavioral interventions can be bounded as small to none, and the harms of screening are minimal. Therefore, the USPSTF

  12. Association between obesity and selected morbidities: a study of BRICS countries.

    Directory of Open Access Journals (Sweden)

    Ankita Shukla

    Full Text Available OBJECTIVE: Over the past few decades, obesity has reached epidemic proportions, and is a major contributor to the global burden of chronic diseases and disability. There is little evidence on obesity related co-morbidities in BRICS countries. The first objective is to examine the factors associated with overweight and obesity in four of the five BRICS countries (China, India, Russia and South Africa. The second is to examine the linkage of obesity with selected morbidities. METHODS: We used data from the Study on Global Ageing and Adult Health (SAGE survey conducted by the World Health Organization (WHO in China, India, Russia and South Africa during 2007-10. The morbidities included in the analysis are Hypertension, Diabetes, Angina, Stroke, Arthritis and Depression. FINDINGS: The prevalence of obesity was highest in South Africa (35% followed by Russia (22%, China (5% and India (3%. The prevalence of obesity was significantly higher in females as compared to males in all the countries. While the wealth quintile was associated with overweight in India and China, engaging in work requiring physical activity was associated with obesity in China and South Africa. Overweight/obesity was positively associated with Hypertension and Diabetes in all the four countries. Obesity was also positively associated with Arthritis and Angina in China, Russia and South Africa. In comparison, overweight/obesity was not associated with Stroke and Depression in any of the four countries. CONCLUSION: Obesity was statistically associated with Hypertension, Angina, Diabetes and Arthritis in China, Russia and South Africa. In India, obesity was associated only with Hypertension and Diabetes.

  13. Association between obesity and selected morbidities: a study of BRICS countries.

    Science.gov (United States)

    Shukla, Ankita; Kumar, Kaushalendra; Singh, Abhishek

    2014-01-01

    Over the past few decades, obesity has reached epidemic proportions, and is a major contributor to the global burden of chronic diseases and disability. There is little evidence on obesity related co-morbidities in BRICS countries. The first objective is to examine the factors associated with overweight and obesity in four of the five BRICS countries (China, India, Russia and South Africa). The second is to examine the linkage of obesity with selected morbidities. We used data from the Study on Global Ageing and Adult Health (SAGE) survey conducted by the World Health Organization (WHO) in China, India, Russia and South Africa during 2007-10. The morbidities included in the analysis are Hypertension, Diabetes, Angina, Stroke, Arthritis and Depression. The prevalence of obesity was highest in South Africa (35%) followed by Russia (22%), China (5%) and India (3%). The prevalence of obesity was significantly higher in females as compared to males in all the countries. While the wealth quintile was associated with overweight in India and China, engaging in work requiring physical activity was associated with obesity in China and South Africa. Overweight/obesity was positively associated with Hypertension and Diabetes in all the four countries. Obesity was also positively associated with Arthritis and Angina in China, Russia and South Africa. In comparison, overweight/obesity was not associated with Stroke and Depression in any of the four countries. Obesity was statistically associated with Hypertension, Angina, Diabetes and Arthritis in China, Russia and South Africa. In India, obesity was associated only with Hypertension and Diabetes.

  14. Pulmonary dysfunction in obese early adolescents

    Directory of Open Access Journals (Sweden)

    Bambang Supriyatno

    2010-08-01

    Full Text Available Aim Obesity leads to various complications, including pulmonary dysfunction. Studies on pulmonary function of obese children are limited and the results are controversial. This study was aimed to determine proportion of pulmonary dysfunction on early adolescents with obesity and to evaluate correlation between obesity degree with pulmonary dysfunction degree.Methods A cross-sectional study was conducted at the Department of Child Health, Medical School, University of Indonesia, from November 2007 to December 2008. Subjects were 10 to 12 year-old adolescents with obesity. Subjects underwent pulmonary function test (PFT to assess FEV1/FVC, FEV1, FVC, V50, and V25.Results 110 subjects fulfilled study criteria, 83 (75.5% were male and 27 (24.5% were female with median BMI 26.7 (22.6-54.7 kg/m2; 92 subjects (83.6% were superobese. History of asthma and allergic rhinitis were found in 32 (29.1% and 46 (41.8% subjects, respectively. 64 (58.2% subjects had abnormal PFT results consisting of restrictive type in 28 (25.5% subjects, obstructive in 3 (2.7%, and combined type in 33 (30%. Mean FEV1, FVC, V50, and V25 values were below normal, while mean FEV1/FVC ratio was normal. There was no statistically significant correlation between BMI and PFT parameters. No significant correlation was found between degree of obesity and the severity of pulmonary dysfunction.Conclusions Pulmonary dysfunction occurs in 58.2% obese early adolescents. The most common abnormality was combined type (30%, followed by restrictive (25.5%, and obstructive type (2.7%. There was no correlation between BMI and pulmonary function test parameters. (Med J Indones 2010;19:179-84Key words: early adolescents, obesity, pulmonary function test

  15. Panniculectomy and Cystectomy: An Approach to the Morbidly Obese Patient

    Directory of Open Access Journals (Sweden)

    Lee A. Hugar

    2016-01-01

    Full Text Available The obese patient undergoing radical cystectomy faces a unique set of challenges. We present the case of a 68-year-old gentleman who presented to our institution with Bacillus Calmette-Guerin refractory disease, a body mass index of 38.5, and a large pannus. The present paper describes our technique for performing radical cystectomy with ileal conduit urinary diversion and concomitant panniculectomy. We discuss the impact of obesity on patients undergoing radical cystectomy and how this may be mitigated by panniculectomy.

  16. Gynaecological issues affecting the obese adolescent.

    Science.gov (United States)

    Wood, Paul L; Bauman, Dvora

    2015-05-01

    The implications of obesity in childhood and adolescence resonate into adulthood and have implications at different levels that include psychosocial and health issues that impact beyond reproductive performance. This chapter explores the various facets and consequences on gynaecological issues of increased Body Mass Index in childhood, including the link with puberty, pubertal menorrhagia (also affecting children with complex needs) and the all too common problems surrounding hyperandrogenism, insulin resistance and the polycystic ovarian syndrome in particular which need to be seen in the specific context of the adolescent years. The wider ramifications of obesity on the psychosocial welfare of adolescents merits special attention. Finally management strategies are considered in the context of the needs of adolescents. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  17. Post-operative morbidity of the obese patient undergoing posterior ...

    African Journals Online (AJOL)

    Outcome measures: Post-operative morbidity measures – infection, seroma, pulmonary embolism, urinary tract infection, neurological injury and dural tears. Methods: One hundred consecutive patients undergoing posterior lumbar spine surgery were enrolled in the study. Three fellowship trained attending orthopaedic ...

  18. Social phobia and quality of life in morbidly obese patients before and after bariatric surgery.

    Science.gov (United States)

    Mirijello, Antonio; D'Angelo, Cristina; Iaconelli, Amerigo; Capristo, Esmeralda; Ferrulli, Anna; Leccesi, Laura; Cossari, Anthony; Landolfi, Raffaele; Addolorato, Giovanni

    2015-07-01

    Morbidly obesity is characterized by physical and psychological comorbidities which are associated with reduced quality of life. Bariatric surgery has been linked to a reduction of psychopathology other than to a reduction of weight and improvement in physical functioning. Aim of the present study was to compare psychological features of two groups of morbidly obese patients, before and after bariatric surgery, assessing social phobia and quality of life. A total of 46 morbidly obese patients were enrolled in the study. Of them, 20 were waiting for bilio-pancreatic diversion (group A), while 26 had already undergone surgical procedure (group B). Psychometric evaluation assessed social phobia, fear for the body-shape and quality of life, using appropriate psychometric tests. The percentage of patients showing social phobia was significantly higher compared to a sample of healthy controls (p=0.004), both in group A (p=0.003) and in group B (p=0.029). No differences in percentage of patients affected by social phobia were found between groups. A significantly higher percentage of patients affected by distress about the body (psocial phobia in a population of morbidly obese patients, both before and after surgery. A general reduction of quality of life was also observed, with a partial improvement after surgery. Future studies are needed to clarify the relationship between social phobia and quality of life in surgically-treated morbidly obese patients. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Mindfulness and eating behaviour styles in morbidly obese males and females.

    Science.gov (United States)

    Ouwens, M A; Schiffer, A A; Visser, L I; Raeijmaekers, N J C; Nyklíček, I

    2015-04-01

    Morbid obesity is a highly prevalent condition that is associated with a high risk of various diseases and high health care costs. Understanding determinants of eating behaviours that are characteristic of many morbidly obese persons is important for the development of new interventions aimed at changing eating behaviour after bariatric surgery. Dispositional mindfulness seems promising as one such potential determinant. Therefore, the association between mindfulness and eating behaviour was examined in females and males with morbid obesity. Outpatients with morbid obesity who were candidates for bariatric surgery (N = 335; 78.8% female) completed the Dutch Eating Behaviour Questionnaire (DEBQ), the Freiburg Mindfulness Inventory (FMI) and the Hospital Anxiety and Depression Scale (HADS), in addition to the collection of relevant demographic and medical data. Three separate multiple regression analyses with three eating behaviour styles (restrained, emotional, external) as dependent variables showed that mindfulness was positively associated with restrained eating behaviour (Beta = .28, p ≤ .001), and negatively associated with emotional (Beta = -.22, p ≤ .001) and external (Beta = -.32, p ≤ .001) eating behaviours, independent of sex, age, educational level, Body Mass Index and affective symptoms. Dispositional mindfulness was associated with more restrained, and less emotional and external eating behaviour in morbidly obese outpatients, above and beyond affective symptoms. Future studies, establishing the causal direction of the associations, are needed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Pretransplant cachexia and morbid obesity are predictors of increased mortality after heart transplantation.

    Science.gov (United States)

    Lietz, K; John, R; Burke, E A; Ankersmit, J H; McCue, J D; Naka, Y; Oz, M C; Mancini, D M; Edwards, N M

    2001-07-27

    Extremes in body weight are a relative contraindication to cardiac transplantation. We retrospectively reviewed 474 consecutive adult patients (377 male, 97 female, mean age 50.3+/-12.2 years), who received 444 primary and 30 heart retransplants between January of 1992 and January of 1999. Of these, 68 cachectic (body mass index [BMI]27-30 kg/m2), and 55 morbidly obese (BMI>30 kg/m2) patients were compared with 238 normal-weight recipients (BMI=20-27 kg/m2). We evaluated the influence of pretransplant BMI on morbidity and mortality after cardiac transplantation. Kaplan-Meier survival distribution and Cox proportional hazards model were used for statistical analyses. Morbidly obese as well as cachectic recipients demonstrated nearly twice the 5-year mortality of normal-weight or overweight recipients (53% vs. 27%, respectively, P=0.001). An increase in mortality was seen at 30 days for morbidly obese and cachectic recipients (12.7% and 17.7%, respectively) versus a 30-day mortality rate of 7.6% in normal-weight recipients. Morbidly obese recipients experienced a shorter time to high-grade acute rejection (P=0.004) as well as an increased annual high-grade rejection frequency when compared with normal-weight recipients (P=0.001). By multivariable analysis, the incidence of transplant-related coronary artery disease (TCAD) was not increased in morbidly obese patients but cachectic patients had a significantly lower incidence of TCAD (P=0.05). Cachectic patients receiving oversized donor hearts had a significantly higher postoperative mortality (P=0.02). The risks of cardiac transplantation are increased in both morbidly obese and cachectic patients compared with normal-weight recipients. However, the results of cardiac transplantation in overweight patients is comparable to that in normal-weight patients. Recipient size should be kept in mind while selecting patients and the use of oversized donors in cachectic recipients should be avoided.

  1. post-operative morbidity of the obese patient undergoing posterior

    African Journals Online (AJOL)

    urinary tract infection, neurological injury and dural tears. Methods: One hundred consecutive patients undergoing ... muscle mass in the human body, in which weight in kilograms is divided by height in meters2). The current .... complications with the exception of one dural tear occurred in the obese patient group. Table 3.

  2. Prader Willy’s syndrome diagnosed in extremely obese female adolescent

    Directory of Open Access Journals (Sweden)

    Lešović Snežana

    2017-01-01

    Full Text Available Introduction: Nutritional obesity is the most common cause of obesity (95% in childhood and adolescence. Morbid obesity (5%, which usually begins at an early age, can be caused by monogenic disorders, various genetic syndromes, endocrine diseases-disorders, central nervous system lesions or iatrogenic causes. Presentation of the patient: A female adolescent aged 13 is presented who was due to obesity referred to the Center for the Prevention and Treatment of Obesity in children and adolescents at the Special Hospital “Cigota” at Mt. Zlatibor. Low height/stature and dysmorphic features: a face with a narrow bifrontal diameter, almond-shaped eyes, strabismus, small hands and feet, delay in puberty development and lagging in psychomotor development have indicated the morbid obesity. Anamnestic data on hypotonia and difficulty in feeding, psychomotor lagging behind, obesity since the third year of age, triggered a suspicion of Prader Willy’s syndrome. The suspicion of this syndrome was confirmed by a molecular DNA analysis which indicated a deletion on the long arm 15q11.2. Conclusion: Obesity, endocrinolopathies, retardation in psychomotor development and behavioral disorders in people with Prader Willy’s syndrome require a complex multidisciplinary treatment. Early diagnosis and adequate treatment prevent the occurrence of complications and improve the quality and length of life of the patients.

  3. Systematic review on obesity in Brazilian adolescents

    Directory of Open Access Journals (Sweden)

    Rafael Miranda Tassitano

    2009-09-01

    Full Text Available The purpose of this study was to systematically review the Brazilian literature on the prevalence of obesity and associated factors in adolescents. The literature search was carried out in the electronic databases Pubmed and Bireme, using the keywords: obesity, overweight, BMI, adolescents and Brazil. The following inclusion criteria were considered: Brazilian adolescents, BMI-based obesity estimates, publication until 2007, and adequate methodology. After the examination of titles, abstracts and full texts, 27 papers fulfilled our inclusion criteria. For describing the studies, the following variables were used: type of survey, design, age range, sample size, place of data collection. For evaluating the evidence, the following indicators were used: methods used, independent variables studied, statistical analyses employed, and cut-off used for defining obesity. Most studies used cross-sectional designs (77.7% and were carried out through home interviews (51.7%. Only one study used a nationally-based sample and three used regional-based samples (Northeast and Southeast. Regardless the design, place, type of survey, age range and cut-off used, the prevalence of obesity tended to be higher in the following groups: adolescents living in the Southeast region, living in urban areas, from high socioeconomic level and from private schools. In terms of behavioral determinants of obesity, the paucity of prospective studies and the difficulties of adequately measuring physical activity and food consumption, make the results less clear. Although the number of studies has increased, it is still necessary to stimulate surveys in the North, Southeast and Mideast regions. Prospective studies are also necessary, in order to evaluate the association between obesity and behavioral exposures.

  4. Systematic review on obesity in Brazilian adolescents

    Directory of Open Access Journals (Sweden)

    Rafael Miranda Tassitano

    2009-01-01

    Full Text Available http://dx.doi.org/10.5007/1980-0037.2009v11n4p449 The purpose of this study was to systematically review the Brazilian literature on the prevalence of obesity and associated factors in adolescents. The literature search was carried out in the electronic databases Pubmed and Bireme, using the keywords: obesity, overweight, BMI, adolescents and Brazil. The following inclusion criteria were considered: Brazilian adolescents, BMI-based obesity estimates, publication until 2007, and adequate methodology. After the examination of titles, abstracts and full texts, 27 papers fulfilled our inclusion criteria. For describing the studies, the following variables were used: type of survey, design, age range, sample size, place of data collection. For evaluating the evidence, the following indicators were used: methods used, independent variables studied, statistical analyses employed, and cut-off used for defining obesity. Most studies used cross-sectional designs (77.7% and were carried out through home interviews (51.7%. Only one study used a nationally-based sample and three used regional-based samples (Northeast and Southeast. Regardless the design, place, type of survey, age range and cut-off used, the prevalence of obesity tended to be higher in the following groups: adolescents living in the Southeast region, living in urban areas, from high socioeconomic level and from private schools. In terms of behavioral determinants of obesity, the paucity of prospective studies and the difficulties of adequately measuring physical activity and food consumption, make the results less clear. Although the number of studies has increased, it is still necessary to stimulate surveys in the North, Southeast and Mideast regions. Prospective studies are also necessary, in order to evaluate the association between obesity and behavioral exposures.

  5. Overweight and Obesity in Children and Adolescents

    Science.gov (United States)

    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

  6. Totally tubeless percutaneous nephrolithotomy is feasible in morbidly obese patients.

    Science.gov (United States)

    Aghamir, Seyed Mohammad Kazem; Mohseni, Mohammad Ghasem; Hosseini, Seyed Reza; Salavati, Alborz; Ganjali, Hossein; Fallah, Mohammad Ali; Rezaei, Hamed; Modaresi, Seyed Saeed

    2017-06-01

    Regarding technical difficulties that obese body habitus might impose to percutaneous nephrolithotomy (PNL) success and higher risk of peri-operative complications in this group of patients, we decided to retrospectively gather data from our patients during past 8 years to determine the stone free and complication rates. Between January 2007-December 2015, seventy-eight obese patients with body mass index over 35 who had indication for PNL including stones larger than 2 cm in pelvi-calyceal system or smaller extracorporeal shock wave lithotripsy (ESWL) resistant stones or who were not a fit candidate for ESWL due to increased skin to target distance, with no contraindication of PNL (including bleeding diathesis, inability to be positioned in prone) were enrolled. They were randomly assigned to group 1 (standard PNL with nephrostomy and ureteral stent) or group 2 (totally tubeless PNL with no ureteral stent and no nephrostomy). The outcomes were compared. The transfusion rate, operation time, and the hemoglobin drop were same across the groups (p>0.05). Total analgesic use was equivalent of 33.8 vs. 14.7 mgs of morphine sulfate (18-77 mg) and was significantly lower in total tubeless group (p=0.001). Return to normal activity was described as total number of in-patient and outpatient days from time of admission to the point which the patients returns to normal life activity such as going to job or school and was 19.4 vs. 9.3 days (6-30 days, p=0.001). Totally tubeless PNL in obese subjects would have lower analgesic use and return to normal activity versus standard PNL. Totally tubeless PNL is recommended for obese patients.

  7. Bariatric surgery - effects on obesity and related co-morbidities

    DEFF Research Database (Denmark)

    Svane, Maria Saur; Madsbad, Sten

    2014-01-01

    Laparoscopic adjustable gastric banding (LAGB), laparoscopic Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (SG) are the three most commonly performed bariatric procedures. Obesity responds well to bariatric surgery, with major long-lasting weight loss that is most pronounced...... vitamins and minerals, and anemia. Some patients have dumping after meals, and a few patients will develop postprandial hypoglycemia after RYGB. About 25% of patients require plastic surgery to provide relief from excessive skin tissue....

  8. Relationship between urban sprawl and physical activity, obesity, and morbidity.

    Science.gov (United States)

    Ewing, Reid; Schmid, Tom; Killingsworth, Richard; Zlot, Amy; Raudenbush, Stephen

    2003-01-01

    To determine the relationship between urban sprawl, health, and health-related behaviors. Cross-sectional analysis using hierarchical modeling to relate characteristics of individuals and places to levels of physical activity, obesity, body mass index (BMI), hypertension, diabetes, and coronary heart disease. U.S. counties (448) and metropolitan areas (83). Adults (n = 206,992) from pooled 1998, 1999, and 2000 Behavioral Risk Factor Surveillance System (BRFSS). Sprawl indices, derived with principal components analysis from census and other data, served as independent variables. Self-reported behavior and health status from BRFSS served as dependent variables. After controlling for demographic and behavioral covariates, the county sprawl index had small but significant associations with minutes walked (p = .004), obesity (p sprawling counties were likely to walk less during leisure time, weigh more, and have greater prevalence of hypertension than residents of compact counties. At the metropolitan level, sprawl was similarly associated with minutes walked (p = .04) but not with the other variables. This ecologic study reveals that urban form could be significantly associated with some forms of physical activity and some health outcomes. More research is needed to refine measures of urban form, improve measures of physical activity, and control for other individual and environmental influences on physical activity, obesity, and related health outcomes.

  9. Co-morbid disorders and sexual risk behavior in Nigerian adolescents with bipolar disorder

    Directory of Open Access Journals (Sweden)

    Bakare Muideen O

    2009-06-01

    Full Text Available Abstract Background Adolescent onset bipolar disorder often presents with co-morbid disorders of which psychoactive substance use disorders are notable. Mania symptoms and co-morbid psychoactive substance use disorders prone adolescents with bipolar disorder to impulsivity, impaired judgment, and risk taking behavior which often includes sexual risk behavior. There are dearth of information on pattern of co-morbid disorders and sexual risk behavior in adolescent onset bipolar disorder in Nigeria. This study assessed the prevalence and pattern of co-morbid disorders and determined associated factors of sexual risk behavior among adolescents with bipolar disorder. Methods Socio-demographic information was obtained from the adolescents using socio-demographic questionnaire. Clinical interview, physical examination and laboratory investigations were employed to establish co-morbid disorders in these adolescents during the outpatient follow up visits over a one year period. Results A total of forty six (46 adolescents with bipolar disorder were followed up over a one year period. Twenty two (47.8% of the adolescents had co-morbid disorders with cannabis use disorders, alcohol use disorders, conduct disorder with or without other psychoactive substance use accounting for 23.9%, 8.7%, 13.0% respectively and HIV infection, though a chance finding accounting for 2.2%. Twenty one (45.7% of the adolescents had positive history of sexual risk behavior, which was significantly associated with presence of co-morbid disorders (p = 0.003, level of religion activities in the adolescents (p = 0.000, and marital status of the parents (p = 0.021. Conclusion When planning interventions for children and adolescents with bipolar disorder, special attention may need to be focused on group of adolescents with co-morbid disorders and propensity towards impulsivity and sexual risk behavior. This may help in improving long term outcome in this group of adolescents.

  10. Adiponectin but not leptin is involved in early hepatic disease in morbidly obese patients.

    Science.gov (United States)

    Hindle, Anna Katharine; Edwards, Claire; Mendonsa, Alisha; Rojkind, Marcos; McCaffrey, Tim; Fu, Sidney; Brody, Fred

    2010-07-01

    Pathologic changes in the liver are common in morbidly obese patients, and insulin resistance may potentiate the progression of nonalcoholic steatohepatitis to fibrosis and cirrhosis. This study investigates the impact of leptin and adiponectin in morbidly obese diabetic and nondiabetic patients with regard to histopathologic changes in the liver. Thirty-seven morbidly obese patients who underwent bariatric surgery with liver biopsies were enrolled in the study. Fourteen were diabetic and 23 were nondiabetic. Intraoperative liver tissue was sent for histopathologic analysis and extraneous intraoperative tissue was snap-frozen in liquid nitrogen. Total RNA was extracted and RNA was reverse transcribed to cDNA. Real-time quantitative PCR was performed to determine relative gene expression levels. The data were analyzed using a logarithmic transformation and normalized by 18S ribosome expression. Student's t test was used for statistical analysis with p < or = 0.05 as significant. Adiponectin expression was downregulated 4.4-fold (p < or = 0.05) in liver samples with evidence of inflammation on pathology. When hepatic inflammation was evaluated separately, there were no statistically significant differences in adiponectin levels between the diabetic and nondiabetic patients. However, overall adiponectin levels in hepatic samples of diabetic patients were 3.8-fold higher than those of nondiabetic patients (p < or = 0.05). There were no significant differences in leptin levels regardless of hepatic pathology or diabetic status. This study illustrates that there is a downregulation of adiponectin in morbidly obese patients with inflammatory infiltrates in the liver. Variations in adiponectin levels could be an indicator of disease progression since inflammatory infiltrates are commonly associated with nonalcoholic steatohepatitis (NASH) in morbidly obese patients. Currently, we are using human myofibroblasts derived from livers of morbidly obese people to further

  11. Technical aspects and complications of laparoscopic banding for morbid obesity--a radiological perspective

    Energy Technology Data Exchange (ETDEWEB)

    Roy-Choudhury, S.H.; Nelson, W.M.; EI Cast, J.; Zacharoulis, D.; Kirkwood, B.; Sedman, P.C.; Royston, C.M.S.; Breen, D.J. E-mail: david.breen@suht.swest.nhs.uk

    2004-03-01

    Morbid obesity is a significant clinical problem in the western world. Various surgical restrictive procedures have been described as an aid to weight reduction when conservative treatments fail. Adjustable laparoscopic gastric banding (LAPBAND) has been popularized as an effective, safe, minimally invasive, yet reversible technique for the treatment of morbid obesity. Radiological input is necessary in the follow-up of these patients and the diagnosis of complications peculiar to this type of surgery. In this review we will highlight the technical aspects of radiological follow-up and the lessons learnt over the last 5 years.

  12. Radiologic evaluation following Roux-en-Y gastric bypass surgery for morbid obesity

    Energy Technology Data Exchange (ETDEWEB)

    Carucci, Laura R. [Department of Radiology, Virginia Commonwealth University Medical Center, P.O. Box 980615, Richmond, VA 23298-0615 (United States)]. E-mail: lcarucci@vcu.edu; Turner, Mary Ann [Department of Radiology, Virginia Commonwealth University Medical Center, P.O. Box 980615, Richmond, VA 23298-0615 (United States)

    2005-03-01

    Morbid obesity is an increasing health problem, and bariatric surgery is becoming a popular treatment option. Radiologists must be familiar with performing and interpreting studies in this patient population. The typical postoperative findings of the Roux-en-Y gastric bypass (RYGBP) procedure for morbid obesity on upper gastrointestinal (UGI) series are presented. An overview of the potential complications that may be diagnosed with contrast studies and computed tomography (CT) is provided in addition to a description of potential pitfalls in interpreting these studies.

  13. Radiologic evaluation following Roux-en-Y gastric bypass surgery for morbid obesity

    International Nuclear Information System (INIS)

    Carucci, Laura R.; Turner, Mary Ann

    2005-01-01

    Morbid obesity is an increasing health problem, and bariatric surgery is becoming a popular treatment option. Radiologists must be familiar with performing and interpreting studies in this patient population. The typical postoperative findings of the Roux-en-Y gastric bypass (RYGBP) procedure for morbid obesity on upper gastrointestinal (UGI) series are presented. An overview of the potential complications that may be diagnosed with contrast studies and computed tomography (CT) is provided in addition to a description of potential pitfalls in interpreting these studies

  14. Relationship between Acute Phase Proteins and Serum Fatty Acid Composition in Morbidly Obese Patients

    Science.gov (United States)

    Fernandes, Ricardo; Beserra, Bruna Teles Soares; Cunha, Raphael Salles Granato; Hillesheim, Elaine; Camargo, Carolina de Quadros; Pequito, Danielle Cristina Tonello; de Castro, Isabela Coelho; Fernandes, Luiz Cláudio; Nunes, Everson Araújo; Trindade, Erasmo Benício Santos de Moraes

    2013-01-01

    Background. Obesity is considered a low-grade inflammatory state and has been associated with increased acute phase proteins as well as changes in serum fatty acids. Few studies have assessed associations between acute phase proteins and serum fatty acids in morbidly obese patients. Objective. To investigate the relationship between acute phase proteins (C-Reactive Protein, Orosomucoid, and Albumin) and serum fatty acids in morbidly obese patients. Methods. Twenty-two morbidly obese patients were enrolled in this study. Biochemical and clinical data were obtained before bariatric surgery, and fatty acids measured in preoperative serum. Results. Orosomucoid was negatively correlated with lauric acid (P = 0.027) and eicosapentaenoic acid (EPA) (P = 0.037) and positively with arachidonic acid (AA) (P = 0.035), AA/EPA ratio (P = 0.005), and n-6/n-3 polyunsaturated fatty acids ratio (P = 0.035). C-Reactive Protein (CRP) was negatively correlated with lauric acid (P = 0.048), and both CRP and CRP/Albumin ratio were negatively correlated with margaric acid (P = 0.010, P = 0.008, resp.). Albumin was positively correlated with EPA (P = 0.027) and margaric acid (P = 0.008). Other correlations were not statistically significant. Conclusion. Our findings suggest that serum fatty acids are linked to acute phase proteins in morbidly obese patients. PMID:24167354

  15. [Indications of efficacy of bariatric surgery in the management of morbid obesity].

    Science.gov (United States)

    Pascual, J M; Rodilla, E

    2006-09-01

    Its indications should only be considered in patients with morbid obesity (BMI>40 kg/m2) or severe obesity (BMI>35 kg/m2) with serious associated comorbidity. In general, significant weight loss with marked improvement of the cardiovascular comorbidity is obtained. There are still no studies that show long term survival. It must be stressed that the patients should follow a subsequent and continuous medical monitoring to prevent important secondary metabolic complications.

  16. Hypertension in obese children and adolescents

    Directory of Open Access Journals (Sweden)

    Peco-Antić Amira

    2009-01-01

    Full Text Available Obesity, especially upper body fat distribution, has become an increasingly important medical problem in children and adolescents. Outcomes related to childhood obesity include, as in adult population, hypertension, type 2 diabetes mellitus, dyslipidemia, left ventricular hypertrophy, obstructive sleep apnea, orthopedic and socio-psychological problems. Obese children are at approximately 3-fold higher risk for hypertension from non-obese ones. Obesity-hypertension appears to be characterized by a preponderance of isolated systolic hypertension, increased heart rate and blood pressure variability, increased levels of plasma catecholamine and aldosterone, and salt-sensitivity. Lifestyle changes of weight loss, healthier diet and regular physical exercise are effective in obesity-hypertension control, though pharmacological treatment is frequently necessary. Screening for dyslipidemia and impaired glucose tolerance should be performed in paediatric patients with obese hypertension on regular basis, at least once annually or semiannually to discover metabolic syndrome and to prevent its increased cardiovascular risk. Of course, prevention of obesity is the primary goal. .

  17. Binge eating disorder and morbid obesity are associated with lowered mu-opioid receptor availability in the brain.

    Science.gov (United States)

    Joutsa, Juho; Karlsson, Henry K; Majuri, Joonas; Nuutila, Pirjo; Helin, Semi; Kaasinen, Valtteri; Nummenmaa, Lauri

    2018-03-09

    Both morbid obesity and binge eating disorder (BED) have previously been linked with aberrant brain opioid function. Behaviorally these two conditions are however different suggesting also differences in neurotransmitter function. Here we directly compared mu-opioid receptor (MOR) availability between morbidly obese and BED subjects. Seven BED and nineteen morbidly obese (non-BED) patients, and thirty matched control subjects underwent positron emission tomography (PET) with MOR-specific ligand [ 11 C]carfentanil. Both subjects with morbid obesity and BED had widespread reduction in [ 11 C]carfentanil binding compared to control subjects. However, there was no significant difference in brain MOR binding between subjects with morbid obesity and BED. Thus, our results indicate that there is common brain opioid abnormality in behaviorally different eating disorders involving obesity. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. Managing social awkwardness when caring for morbidly obese patients in intensive care: A focused ethnography.

    Science.gov (United States)

    Hales, Caz; de Vries, Kay; Coombs, Maureen

    2016-06-01

    Critically ill morbidly obese patients pose considerable healthcare delivery and resource utilisation challenges in the intensive care setting. These are resultant from specific physiological responses to critical illness in this population and the nature of the interventional therapies used in the intensive care environment. An additional challenge arises for this population when considering the social stigma that is attached to being obese. Intensive care staff therefore not only attend to the physical and care needs of the critically ill morbidly obese patient but also navigate, both personally and professionally, the social terrain of stigma when providing care. To explore the culture and influences on doctors and nurses within the intensive care setting when caring for critically ill morbidly obese patients. A focused ethnographic approach was adopted to elicit the 'situated' experiences of caring for critically ill morbidly obese patients from the perspectives of intensive care staff. Participant observation of care practices and interviews with intensive care staff were undertaken over a four month period. Analysis was conducted using constant comparison technique to compare incidents applicable to each theme. An 18 bedded tertiary intensive care unit in New Zealand. Sixty-seven intensive care nurses and 13 intensive care doctors involved with the care and management of seven critically ill patients with a body mass index ≥40kg/m(2). Interactions between intensive care staff and morbidly obese patients were challenging due to the social stigma surrounding obesity. Social awkwardness and managing socially awkward moments were evident when caring for morbidly obese patients. Intensive care staff used strategies of face-work and mutual pretence to alleviate feelings of discomfort when engaged in aspects of care and caring. This was a strategy used to prevent embarrassment and distress for both the patients and staff. This study has brought new understandings

  19. Heartburn during sleep: a clinical marker of gastro-oesophageal reflux disease in morbidly obese patients.

    Science.gov (United States)

    Fornari, F; Madalosso, C A S; Callegari-Jacques, S M; Gurski, R R

    2009-02-01

    Gastro-oesophageal reflux disease (GORD) and morbid obesity are entities with increasing prevalence. New clinical strategies are cornerstones for their management. The aim of this study was to assess the prevalence of heartburn during sleep (HDS) and whether this symptom predicts the presence of objective GORD parameters and increased heartburn perception in morbidly obese patients. Ninety-one consecutive morbidly obese patients underwent clinical evaluation, upper gastrointestinal endoscopy and oesophageal pH monitoring. HDS was characterized when patients replied positively to the question, 'Does heartburn wake you from sleep?'. A General Score for Heartburn (GSH) ranging between 0 and 5 was assessed with the question 'How bad is your heartburn?'. HDS was reported by 33 patients (36%). More patients with HDS had abnormal acid contact time or reflux oesophagitis than patients without HDS (94%vs 57%, P heartburn preceded by acid reflux in diurnal (39%vs 9%; P heartburn. HDS occurs in a significant minority of patients with morbid obesity and has high positive predictive value for GORD. Symptomatic reflux during the sleep seems to be a marker of increased heartburn perception in this population.

  20. Relationships between indices of obesity and its co-morbidities in multi-ethnic Singapore

    NARCIS (Netherlands)

    Deurenberg-Yap, M.; Chew, S.K.; Lin, V.F.; Tan, B.Y.; Staveren, van W.A.; Deurenberg, P.

    2001-01-01

    Paper Relationships between indices of obesity and its co-morbidities in multi-ethnic Singapore M Deurenberg-Yap1, S K Chew2, V F P Lin1, B Y Tan2, W A van Staveren3 and P Deurenberg3,4 1Research and Information Management, Health Promotion Board, Singapore 2Department of Epidemiology and Disease

  1. Elephantiasis nostras verrucosa on the legs and abdomen with morbid obesity in an Indian lady.

    Science.gov (United States)

    Sarma, Podila S; Ghorpade, Ashok

    2008-12-15

    Elephantiasis nostras verrucosa (ENV) of the legs and abdomen in a morbidly obese woman with multiple medical problems is reported. The diagnosis was suggested by the classical clinical features and confirmed by histopathology. The patient succumbed due to her multisystem diseases. Elephantiasis nostras verrucosa involving the abdomen is uncommon and has been reported only five times in the past.

  2. Elephantiasis nostras verrucosa on the abdomen of a Turkish female patient caused by morbid obesity.

    Science.gov (United States)

    Buyuktas, D; Arslan, E; Celik, O; Tasan, E; Demirkesen, C; Gundogdu, S

    2010-08-15

    Elephantiasis Nostras Verrucosa is a rare disorder of an extremity or a body region, which is associated with chronic lymphedema. There are 7 reported cases of abdominal elephantiasis in the medical literature. Here we report a morbidly obese female patient with elephantiasis nostras verrucosa on the abdominal wall.

  3. Competence assessment in minors, illustrated by the case of bariatric surgery for morbidly obese children

    NARCIS (Netherlands)

    Bolt, L.L.E.; Summeren van, M

    Clinicians have to assess children's competence frequently. In order to do justice to children who are competent to make decisions and to protect incompetent children, valid assessment is essential. We address this issue by using bariatric surgery for morbidly obese minors as a case study. Our

  4. Cost-effectiveness of Bariatric Surgery in Adolescents With Obesity.

    Science.gov (United States)

    Klebanoff, Matthew J; Chhatwal, Jagpreet; Nudel, Jacob D; Corey, Kathleen E; Kaplan, Lee M; Hur, Chin

    2017-02-01

    Severe obesity affects 4% to 6% of US youth and is increasing in prevalence. Bariatric surgery for the treatment of adolescents with severe obesity is becoming more common, but data on cost-effectiveness are limited. To assess the cost-effectiveness of bariatric surgery for adolescents with obesity using recently published results from the Teen-Longitudinal Assessment of Bariatric Surgery study. A state-transition model was constructed to compare 2 strategies: no surgery and bariatric surgery. In the no surgery strategy, patients remained at their initial body mass index (calculated as weight in kilograms divided by height in meters squared) over time. In the bariatric surgery strategy, patients were subjected to risks of perioperative mortality and complications as well as initial morbidity but also experienced longer-term quality-of-life improvements associated with weight loss. Cohort demographic information-of the 228 patients included, the mean (SD) age was 17 (1.6) years, the mean (range) body mass index was 53 (34-88), and 171 (75.0%) were female-surgery-related outcomes, and base case time horizon (3 years) were based on data from the Teen-Longitudinal Assessment of Bariatric Surgery study. One-way and probabilistic sensitivity analyses were performed. Quality-adjusted life-years (QALYs), total costs (in US dollars adjusted to 2015-year values using the Consumer Price Index), and incremental cost-effectiveness ratios (ICERs). A willingness-to-pay threshold of $100 000 per QALY was used to assess cost-effectiveness. After 3 years, surgery led to a gain of 0.199 QALYs compared with no surgery at an incremental cost of $30 747, yielding an unfavorable ICER of $154 684 per QALY. When the clinical study results were extrapolated to 4 years, the ICER decreased to $114 078 per QALY and became cost-effective by 5 years with an ICER of $91 032 per QALY. Outcomes were robust in most 1-way and probabilistic sensitivity analyses. Bariatric surgery incurs

  5. Obesity prevention in children and adolescents.

    Science.gov (United States)

    Swinburn, Boyd

    2009-01-01

    Childhood and adolescent obesity has been increasing in most middle- and high-income countries, and, as with adult obesity, this has been driven by increasingly obesogenic environments, especially the food environment. This constitutes a "market failure," signaling the need for government interventions with policies, programs, and social marketing. Population prevention strategies are critical, and children and adolescents should be the priority populations. Food marketing to children is a central policy issue for governments to address, and comprehensive regulations are needed to provide substantive protection for children. Community-based intervention programs show some real promise in reducing childhood obesity, but the 2 big challenges ahead are to ensure that there is substantial ongoing funding so that the community capacity to promote healthy weights can be scaled up to a national level and to ensure that policies are in place to support these efforts. The social and cultural shifts that support healthy eating and physical activity occur differentially, and special efforts are needed to reduce the socioeconomic gradients associated with childhood obesity. A positive public health approach encompassing environmental, regulatory, sociocultural, and educational strategies offer the best chance of reducing obesity without increasing disordered eating patterns.

  6. Trends in a Life Threatening Condition: Morbid Obesity in Dutch, Turkish and Moroccan Children in The Netherlands

    NARCIS (Netherlands)

    Dommelen, P. van; Schönbeck, Y.; Buuren, S. van; Hirasing, R.

    2014-01-01

    Background: Morbid obesity can be a life threatening condition. The aim of our study is to assess the trend in morbid obesity in The Netherlands among children of Dutch origin since 1980, and among children of Turkish and Moroccan origin since 1997. Methods and Findings: Cross-sectional height and

  7. Trends in a life threatening condition : Morbid obesity in Dutch, Turkish and Moroccan children in the Netherlands

    NARCIS (Netherlands)

    Van Dommelen, Paula; Schönbeck, Yvonne; Van Buuren, Stef; HiraSing, Remy A.

    2014-01-01

    Background: Morbid obesity can be a life threatening condition. The aim of our study is to assess the trend in morbid obesity in The Netherlands among children of Dutch origin since 1980, and among children of Turkish and Moroccan origin since 1997. Methods and Findings: Cross-sectional height and

  8. Occurrence and significance of Mallory bodies in morbidly obese patients. An immunohistochemical study

    DEFF Research Database (Denmark)

    Gluud, C; Christoffersen, Pernille Yde; Andersen, T

    1984-01-01

    Liver biopsies from 61 consecutive patients with morbid obesity (less than 60% overweight) and from 48 patients with alcoholic liver disease were examined for the presence of Mallory bodies. For the detection both routine haematoxylin and eosin stained sections and sections exposed to an immunohi......Liver biopsies from 61 consecutive patients with morbid obesity (less than 60% overweight) and from 48 patients with alcoholic liver disease were examined for the presence of Mallory bodies. For the detection both routine haematoxylin and eosin stained sections and sections exposed...... to an immunohistochemical technique were employed. The latter uses an antiserum which recognizes antigenic determinants in Mallory bodies. Using haematoxylin and eosin staining. Mallory bodies were not detected in any of the biopsies from the obese patients, but found to be present in 63% of the patients with alcoholic...

  9. Preoperative gender differences in pulmonary gas exchange in morbidly obese subjects.

    Science.gov (United States)

    Zavorsky, Gerald S; Christou, Nicolas V; Kim, Do Jun; Carli, Franco; Mayo, Nancy E

    2008-12-01

    Morbidly obese men may have poorer pulmonary gas exchange compared to morbidly obese women (see Zavorsky et al., Chest 131:362-367, 2007). The purpose was to compare pulmonary gas exchange in morbidly obese men and women at rest and throughout exercise. Twenty-five women (age=38+/-10 years, 164+/-7 cm, body mass index or BMI = 51+/-7 kg/m(2), peak oxygen consumption or VO(2peak)=2.0+/-0.4 l/min) and 17 men (age=43+/-9 years, 178+/-7 cm, BMI=50+/-10 kg/m(2), VO(2peak)=2.6+/-0.8 l/min) were recruited to perform a graded exercise test on a cycle ergometer with temperature-corrected arterial blood-gas samples taken at rest and every minute of exercise, including peak exercise. At rest, women were 98% predicted for pulmonary diffusion compared to 88% predicted in men. At rest, women had better pulmonary gas exchange compared to the men which was related to women having a lower waist-to-hip ratio (WHR; por=25 mmHg) at peak exercise, but 75% of the subjects showed inadequate compensatory hyperventilation at peak exercise (arterial carbon dioxide pressure >35 mmHg), and both were not different between genders. At rest, morbidly obese men have poorer pulmonary gas exchange and pulmonary diffusion compared to morbidly obese women. The better gas exchange in women is related to the lower WHR in the women. During exercise, few subjects showed disturbances in pulmonary gas exchange despite demonstrating poor compensatory hyperventilation at peak exercise.

  10. Ultrasound-Guided Thrombin Injection Is a Safe and Effective Treatment for Femoral Artery Pseudoaneurysm in the Morbidly Obese.

    Science.gov (United States)

    Yoo, Taehwan; Starr, Jean E; Go, Michael R; Vaccaro, Patrick S; Satiani, Bhagwan; Haurani, Mounir J

    2017-08-01

    Ultrasound-guided thrombin injection (UGTI) is a well-established practice for the treatment of femoral artery pseudoaneurysm. This procedure is highly successful but dependent on appropriate pseudoaneurysm anatomy and adequate ultrasound visualization. Morbid obesity can present a significant technical challenge due to increased groin adiposity, resulting in poor visualization of critical structures needed to safely perform the procedure. We aim to evaluate the safety and efficacy of UGTI to treat femoral artery pseudoaneurysm in the morbidly obese. This is a retrospective cohort study in which all patients who underwent UGTI at The Ohio State University Ross Heart Hospital from 2009 to 2014 were analyzed for patient characteristics and stratified by body mass index (BMI). Patients with BMI ≥ 35 were considered morbidly obese and were compared to patients with a BMI injection. There were 41 nonmorbidly obese and 13 morbidly obese patients. Mean age was 64.5 years. The cohort was 44.4% male. There were 6 failures, of which 1 underwent successful repeat injection and 5 underwent open surgical repair. There was no statistically significant difference in failure between nonmorbidly obese and morbidly obese patients (9.8% vs 15.4%, P = .45). There were no embolic/thrombotic complications. Ultrasound-guided thrombin injection is a safe and effective therapy in the morbidly obese for the treatment of femoral artery pseudoaneurysm. In the hands of experienced sonographers and surgeons with adequate visualization of the pseudoaneurysm sac, UGTI should remain a standard therapy in the morbidly obese.

  11. Are English CT departments and radiographers prepared for the morbidly obese patient?

    International Nuclear Information System (INIS)

    Wiles, R.; Meredith, S.M.; Mullany, J.P.; Wiles, T.

    2017-01-01

    Introduction: Morbid obesity is increasing in England, as is the use of CT scanning. All CT scanners have weight and body width limits. It is imperative that the radiographer performing the scan is aware of these limits, particularly in an emergency. This study aim was to determine whether radiographers are aware of their scanner limits, where they may be able to send a patient who exceeds these limits and whether a formal protocol exists. The secondary aim of the study was to determine capacities of scanners in acute trusts throughout England. Methods: CT radiographers from 86 English Hospital Trusts with Emergency Departments were contacted and asked questions regarding their CT scanners and their practice of CT scanning morbidly obese patients. Results: 21% of CT radiographers did not know the maximum width capacity of their scanner. Only 24% knew where a nearby larger capacity scanner was located and only 3% had a formal protocol for scanning obese patients. Weight capacities ranged from 147 to 305 kg. Width capacities ranged from 55 to 100 cm. 70% had weight capacity 226 kg or less and 70% had size capacity of 78 cm or less. Conclusion: Patients over 226 kg or 78 cm may not be accommodated in most (70%) trusts in England. Lack of knowledge of scanner capacities and alternative scanners for morbidly obese patients could have consequences for these patients, particularly in an emergency. The authors advise that all acute trusts have a protocol regarding CT scanning morbidly obese to prevent delays in accessing imaging. - Highlights: • Radiographer knowledge about CT scan capacity is somewhat lacking, potentially delaying emergency management. • Most CT scanners in England will not accommodate patients over 226 kg or 78 cm. • Most centres do not have a formal protocol for CT scanning obese patients. • Animal CT scanners are not likely to be useful alternatives for most patients.

  12. Evaluation of the results of treatment of morbid obesity by the endoscopic intragastric balloon implantation method.

    Science.gov (United States)

    Żurawiński, Wojciech; Sokołowski, Dariusz; Krupa-Kotara, Karolina; Czech, Elżbieta; Sosada, Krystyn

    2017-01-01

    Overweight and obesity are ranked in the fifth place among the risk factors responsible for the greatest number of deaths in the world. To assess the effects of treatment of patients with morbid obesity using endoscopic intragastric balloon (IGB) implantation. Two hundred and seventy-two patients with obesity were treated using endoscopic intragastric balloon implantation. Upon analysis of the inclusion and exclusion criteria, the study covered a group of 63 patients with morbid obesity. The patients were implanted with the LexBal balloon. Reduction of excess body mass, changes to BMI values and ailments and complications divided into mild and severe were assessed. Before intragastric balloon treatment, the average body mass index (BMI) value was 58.3 ±10.5 kg/m 2 , whereas after 6 months of treatment it decreased to 49.5 ±8.7 kg/m 2 . The patients with postoperative BMI equal to or greater than 50.0 kg/m 2 reported nausea (69.7%), vomiting (51.5%), flatulence (45.5%), upper abdominal pain (36.4%) and general discomfort (424%) more frequently. Dehydration (9.1%) was also more frequent in this group, whereas frequency of occurrence of such ailments and complications as heartburn (23.3%) and oesophageal candidiasis (10.0%) was higher in the patients with postoperative BMI below 50.0 kg/m 2 . Endoscopic intragastric balloon implantation is an effective and safe method of excess body mass reduction in patients with morbid obesity before a planned bariatric surgical procedure. Pre-operative excess body mass and BMI value and post-operative excess weight loss in patients with morbid obesity have no impact on frequency of occurrence of ailments and complications in IGB treatment.

  13. Probiotics to adolescents with obesity

    DEFF Research Database (Denmark)

    Gøbel, Rikke Juul; Larsen, Nadja; Jakobsen, Mogens

    2012-01-01

    The connections between gut microbiota, energy homeostasis, and inflammation and its role in the pathogenesis of obesity-related disorders are increasingly recognized. We aimed to investigate the effect of the probiotic strain Lactobacillus salivarius Ls-33 on a series of biomarkers related...

  14. Bariatric surgery for obese children and adolescents: a systematic review and meta-analysis.

    Science.gov (United States)

    Black, J A; White, B; Viner, R M; Simmons, R K

    2013-08-01

    The number of obese young people continues to rise, with a corresponding increase in extreme obesity and paediatric-adolescent bariatric surgery. We aimed to (i) systematically review the literature on bariatric surgery in children and adolescents; (ii) meta-analyse change in body mass index (BMI) 1-year post-surgery and (iii) report complications, co-morbidity resolution and health-related quality of life (HRQoL). A systematic literature search (1955-2013) was performed to examine adjustable gastric band, sleeve gastrectomy, Roux-en-Y gastric bypass or biliopancreatic diversions operations among obese children and adolescents. Change in BMI a year after surgery was meta-analysed using a random effects model. In total, 637 patients from 23 studies were included in the meta-analysis. There were significant decreases in BMI at 1 year (average weighted mean BMI difference: -13.5 kg m(-2) ; 95% confidence interval [CI] -14.1 to -11.9). Complications were inconsistently reported. There was some evidence of co-morbidity resolution and improvements in HRQol post-surgery. Bariatric surgery leads to significant short-term weight loss in obese children and adolescents. However, the risks of complications are not well defined in the literature. Long-term, prospectively designed studies, with clear reporting of complications and co-morbidity resolution, alongside measures of HRQol, are needed to firmly establish the harms and benefits of bariatric surgery in children and adolescents. © 2013 The Authors. obesity reviews © 2013 International Association for the Study of Obesity.

  15. Extracorporeal shock wave lithotripsy in the treatment of renal pelvicalyceal stones in morbidly obese patients

    Directory of Open Access Journals (Sweden)

    V. A. Mezentsev

    2005-04-01

    Full Text Available INTRODUCTION: Management of urolithiasis in morbidly obese patients is usually associated with higher morbidity and mortality compared to non-obese patients. In morbidly obese patients, since the kidney and stone are at a considerable distance from the skin (compared to non-obese patients difficulty may be found in positioning the patient so that the stone is situated at the focal point of the lithotripter. OBJECTIVE: To evaluate the outcomes and cost-efficiency of extracorporeal shock wave lithotripsy (ESWL in the treatment of renal pelvicalyceal stones sized between 6 and 20 mm in morbidly obese patients. MATERIALS AND METHODS: Using various aids, such as mobile overtable module, extended shock pathway and abdominal compression 37 patients with body mass index more than 40 kg/m2 were treated using the Siemens Lithostar-plus third generation lithotripter. The size of renal pelvicalyceal stones was between 6 and 20 mm. Treatment costs for shock wave lithotripsy were calculated. RESULTS: The overall stone free rate at 3 months of 73% was achieved. The mean number of treatments per patient was 2.1. The post-lithotripsy secondary procedures rate was 5.4%. No complications, such as subcapsular haematoma or acute pyelonephritis were recorded. The most effective (87% success rate and cost-efficient treatment was in the patients with pelvic stones. The treatment of the patients with low caliceal stones was effective in 60% only. The cost of the treatment of the patients with low calyceal stones was in 1.8 times higher than in the patients with pelvic stones. CONCLUSION: We conclude that ESWL with the Siemens Lithostar-plus is the most effective and cost-efficient in morbidly obese patients with pelvic stones sized between 6 and 20 mm. 87% success rate was achieved. The increased distance from the skin surface to the stone in those patients does not decrease the success rate provided the stone is positioned in the focal point or within 3 cm of it on the

  16. Whole exome sequencing identifies RAI1 mutation in a morbidly obese child diagnosed with ROHHAD syndrome.

    Science.gov (United States)

    Thaker, Vidhu V; Esteves, Kristyn M; Towne, Meghan C; Brownstein, Catherine A; James, Philip M; Crowley, Laura; Hirschhorn, Joel N; Elsea, Sarah H; Beggs, Alan H; Picker, Jonathan; Agrawal, Pankaj B

    2015-05-01

    The current obesity epidemic is attributed to complex interactions between genetic and environmental factors. However, a limited number of cases, especially those with early-onset severe obesity, are linked to single gene defects. Rapid-onset obesity with hypothalamic dysfunction, hypoventilation and autonomic dysregulation (ROHHAD) is one of the syndromes that presents with abrupt-onset extreme weight gain with an unknown genetic basis. To identify the underlying genetic etiology in a child with morbid early-onset obesity, hypoventilation, and autonomic and behavioral disturbances who was clinically diagnosed with ROHHAD syndrome. Design/Setting/Intervention: The index patient was evaluated at an academic medical center. Whole-exome sequencing was performed on the proband and his parents. Genetic variants were validated by Sanger sequencing. We identified a novel de novo nonsense mutation, c.3265 C>T (p.R1089X), in the retinoic acid-induced 1 (RAI1) gene in the proband. Mutations in the RAI1 gene are known to cause Smith-Magenis syndrome (SMS). On further evaluation, his clinical features were not typical of either SMS or ROHHAD syndrome. This study identifies a de novo RAI1 mutation in a child with morbid obesity and a clinical diagnosis of ROHHAD syndrome. Although extreme early-onset obesity, autonomic disturbances, and hypoventilation are present in ROHHAD, several of the clinical findings are consistent with SMS. This case highlights the challenges in the diagnosis of ROHHAD syndrome and its potential overlap with SMS. We also propose RAI1 as a candidate gene for children with morbid obesity.

  17. Obesity associated behavior in adolescents of private schools in Lebanon.

    Science.gov (United States)

    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.

  18. Macrophage migration inhibitory factor is elevated in obese adolescents

    NARCIS (Netherlands)

    Kamchybekov, Uran; Figulla, Hans R.; Gerdes, Norbert; Jung, Christian

    2012-01-01

    Objectives: The prevalence of obesity in childhood and adolescence is continuing rising. Macrophage migration inhibitory factor (MIF) participates in inflammatory and immune responses as a pro-inflammatory cytokine. The present study aimed to investigate MIF in overweight adolescents. Methods:

  19. Timely Diagnosis of Malalignment of the Distal Extremities Is Crucial in Morbidly Obese Juveniles

    Directory of Open Access Journals (Sweden)

    Franz Landauer

    2013-12-01

    Full Text Available Background/Aims: To determine i whether obesity in childhood can be related to malalignment of the distal extremities, ii the proportion of genu valgum malalignment and abduction setting, and iii the respective deviation dominance in children who are morbidly obese. Methods: 31 morbidly obese Caucasian children (16 males recruited for the STYJOBS Study (ClinicalTrials.gov Identifier NCT00482924 with a mean age of 13.9 ± 0.5 years, a mean height of 162.3 ± 2.7 cm, a mean weight of 90.62 ± 5.0 kg, and a mean BMI of 33.8 ± 1.2 kg/m2 were clinically examined using the Mikulicz line in order to assess load distribution on the knee joint. 21 participants received a whole-leg X-ray because of a clinically estimated malalignment. Results: 8/31 participants examined were diagnosed with genu valgum, 1/31 with genu varum, and 22/31 did not have any malalignment of the femur or tibia. The majority of genu valgum presentation was due to femoral deviation. Of those without malalignment, 4/22 participants had an abduction setting, while 2/22 showed an adduction of the leg. Conclusion: Genu valgum as a predominant malalignment of the distal extremities is frequent in youth with morbid obesity. Timely guided correction of angular deformity of the knee seems pivotal in order to avoid osteotomy or osteoarthritis later in life.

  20. Predictors of psychological symptoms in morbidly obese patients after gastric bypass surgery.

    Science.gov (United States)

    Ortega, Joaquin; Fernandez-Canet, Regina; Alvarez-Valdeita, Sagrario; Cassinello, Norberto; Baguena-Puigcerver, Maria Jose

    2012-01-01

    Morbid obesity is associated with debilitating psychosocial consequences, such as depression, anxiety, and low self-esteem. One of the main goals of bariatric surgery should not only be reducing weight and counteracting co-morbid conditions, but also improving postoperative psychosocial functioning. The objective of our study was to determine the preoperative variables that could predict the psychological symptoms 6 and 12 months after surgery to improve the clinical outcome of morbidly obese patients undergoing bariatric surgery. The setting was a university hospital in Spain. The study group consisted of 60 morbidly obese patients (46 women and 14 men) who had undergone gastric bypass surgery for weight reduction and had ≥ 1 year of follow-up. The patients were evaluated using different questionnaires (Symptom Checklist-90-Revised, Body Shape Questionnaire, Rosenberg Self-Esteem Questionnaire, COPE, Medical Outcomes Study Social Support Survey) at 3 points: before surgery, at 6 months postoperatively, and at 1 year postoperatively. To determine the influence of preoperative variables on long-term psychological status, a step-by-step multivariate linear regression analysis was performed, taking P self-esteem, instrumental support, and coping focused in the emotions were the main preoperative predictors for psychological symptoms 6 months after surgery. Preoperative drug abuse as a strategy of problem solving and mainly body image significantly predicted most of the psychological disorders 1 year after surgery. The study of different psychosocial variables in patients before bariatric surgery is an important aid to predict postoperative psychological functioning. Self-esteem and body image were the most influential factors in the postoperative psychological outcome of morbidly obese patients in our study. Copyright © 2012 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  1. Dysregulation of gene expression within the peroxisome proliferator activated receptor pathway in morbidly obese patients.

    Science.gov (United States)

    Hindle, A Katharine; Koury, Jadd; McCaffrey, Tim; Fu, Sidney W; Brody, Fred

    2009-06-01

    The causes of obesity are multifactorial but may include dysregulation of a family of related genes, such as the peroxisome proliferator activated receptor gamma (PPARgamma). When activated, the PPARgamma pathway promotes lipid metabolism. This study used microarray technology to evaluate differential gene expression profiles in obese patients undergoing bariatric surgery. The study enrolled six morbidly obese patients with a body mass index (BMI) exceeding 35 and four nonobese individuals. Blood samples were stabilized in PaxGene tubes (PreAnalytiX), and total RNA was extracted. Next, 100 ng of total RNA was amplified and labeled using the Ovation RNA Amplification System V2 with the Ovation whole-blood reagent (NuGen) before it was hybridized to an Affymetrix (Santa Clara, CA) focus array containing more than 8,500 verified genes. The data were analyzed using an analysis of variance (ANOVA) (p < 0.05) in the GeneSpring program, and potential pathways were identified with the Ingenuity program. Real-time quantitative reverse transcriptase-polymerase chain reaction was used to validate the array data. A total of 97 upregulated genes and 125 downregulated genes were identified. More than a 1.5-fold change was identified between the morbidly obese patients and the control subjects for a cluster of dysregulated genes involving pathways regulating cell metabolism and lipid formation. Specifically, the PPARgamma pathway showed a plethora of dysregulated genes including tumor necrosis factor-alpha (TNFalpha). In morbidly obese patients, TNFalpha expression was increased (upregulated) 1.6-fold. These findings were confirmed using quantitative polymerase chain reaction with a 2.8-fold change. Microarrays are a powerful tool for identifying biomarkers indicating morbid obesity by analyzing differential gene expression profiles. This study confirms the association of PPARgamma with morbid obesity. Also, these findings in blood support previous work documented in tissue

  2. Morbidly obese patient with obstructive sleep apnoea for major spine surgery: An anaesthetic challenge

    Directory of Open Access Journals (Sweden)

    Shruti Redhu

    2016-01-01

    Full Text Available Morbidly obese patients with clinical features of obstructive sleep apnoea can present a myriad of challenges to the anaesthesiologists which must be addressed to minimise the perioperative risks. Initiation of continuous positive airway pressure (CPAP therapy early in the pre- and post-operative period along with appropriate anaesthetic planning is of paramount importance in such patients. This case report emphasises the usefulness of CPAP therapy, even for a short duration, to minimise morbidity, improve recovery and hasten early discharge from the hospital after major surgery.

  3. Pharmacokinetics in Morbid Obesity: Influence of Two Bariatric Surgery Techniques on Paracetamol and Caffeine Metabolism.

    Science.gov (United States)

    Goday Arno, Albert; Farré, Magí; Rodríguez-Morató, Jose; Ramon, Jose M; Pérez-Mañá, Clara; Papaseit, Esther; Civit, Ester; Langohr, Klaus; Lí Carbó, Marcel; Boix, David Benaiges; Nino, Olga Castañer; Le Roux, Juana Antonia Flores; Pera, Manuel; Grande, Luis; de la Torre, Rafael

    2017-12-01

    The purpose of the study was to study the impact of the two most common bariatric surgery techniques on paracetamol pharmacokinetics (a marker of gastric emptying) and caffeine metabolism (a marker of liver function). In the present prospective study, we studied 24 morbid obese patients before, at 4 weeks, and 6 months after having undergone sleeve gastrectomy (n = 10) or Roux-en-Y gastric bypass (n = 14). For comparative purposes, 28 healthy controls (14 normal weights and 14 overweights) were also included in the study. Paracetamol pharmacokinetics was altered in the obese participants leading to lower bioavailability. Bariatric surgery resulted in faster absorption and normalized pharmacokinetic parameters, prompting an increase in paracetamol bioavailability. No differences were found between surgical procedures. In the case of caffeine, the ratio paraxanthine/caffeine did not differ between morbid obese and healthy individuals. This ratio remained unmodified after surgery, indicating that the liver function (assessed by cytochrome P450 1A2 activity) was unaffected by obesity or bariatric surgery. Paracetamol pharmacokinetics and caffeine plasma levels are altered in severely obese patients. The two studied bariatric surgical techniques normalize paracetamol oral bioavailability without impairing the liver function (measured by cytochrome P450 1A2 activity).

  4. Epidemiology of ocular allergy and co-morbidities in adolescents

    Directory of Open Access Journals (Sweden)

    Marcos Geraldini

    2013-07-01

    Full Text Available Objective: The prevalence of allergic conjunctivitis (AC has not been established. Estimates suggest that ocular allergies affect 15% to 20% of the worldwide population, yet most epidemiological studies encompass nasal and ocular allergy symptoms and have not been specific to AC. The aim of this study was to verify the prevalence of ocular allergy symptoms, co-morbidities, and their impact on adolescents. Methods: Adolescents were selected from a sample of schools, and completed in classrooms a previously validated questionnaire on symptoms of AC. AC diagnosis was considered when more than three episodes of ocular itching were reported in the past 12 months. Related symptoms such as tearing, photophobia, foreign body sensation, impact on daily activities, and diagnosis of AC were analyzed. Results: Questionnaires were obtained from 3,120 adolescents (mean age 13.3 ± 1.1 years. Ocular itching in the past 12 months occurred in 1,592 (51%. The most frequently associated symptom was tearing (74%, followed by photophobia (50.1% and foreign body sensation (37.1%. The prevalence of AC was 20.7%, affecting more females than males (56.1% versus 45.9%; p = 0.01. The risks of an adolescent with ocular allergy to present asthma, rhinitis, and atopic eczema were (OR = 5.7; 95% CI: 4.5 to 7.1, (OR = 3.6; 95% CI: 3.0 to 4.3, and (OR = 2.6; 95% CI: 2.0 to 3.5, respectively. Severe interference in daily activities was reported by 30.5%. Conclusions: Symptoms of ocular allergy are common, frequently associated to other allergic diseases, and impact the daily activities of adolescents. Resumo: Objetivo: A prevalência de conjuntivite alérgica (CA não foi estabelecida. Estimativas sugerem que alergias oculares afetam de 15 a 20% da população mundial, ainda que a maioria dos estudos epidemiológicos abranjam sintomas de alergia nasal e ocular e não sejam específicos a respeito da CA. O objetivo deste estudo foi verificar a prevalência de sintomas

  5. Bariatric surgery in adolescents with severe obesity: Review and state of the art in France.

    Science.gov (United States)

    Coutant, Régis; Bouhours-Nouet, Natacha; Donzeau, Aurélie; Fauchard, Mathilde; Decrequy, Anne; Malka, Jean; Riquin, Elise; Beaumesnil, Marion; Sallé, Agnès; Briet, Claire; Topart, Philippe; Schmitt, Françoise

    2017-10-01

    Severe obesity (body mass index>120% of BMI IOTF-30 cut off) and morbid obesity (BMI>140% of BMI IOTF-30 cut off) affect 5 to 10% of obese adolescents in France. Organic complications can be found in about 50% of these patients, and depressive symptoms in one-third of them. Finally, over 70% will suffer from adult morbid obesity associated with a marked increase in morbidity and mortality. However, the reversion of obesity strongly decreases, and may even cancels, these risks. In controlled randomized studies, lifestyle interventions have limited effectiveness on BMI in children (and none in adolescents). Bariatric surgery has been shown to have short-term effectiveness in adolescents with severe and morbid obesity: the average BMI loss after gastric banding was 11.6kg/m 2 (95% confidence interval from 9.8 to 13.4), 16.6kg/m 2 (95% confidence interval from 13.4 to 19.8) after bypass, and 14.1kg/m 2 (95% confidence interval 10.8 to 17.5) after sleeve gastrectomy. The resolution of comorbidities was the main aim, as well as the improvement of quality of life. This is not a simple surgical intervention, and minor side effects have been reported in approximately 10-15% of teenagers who underwent surgery (more common with the gastric band), and severe side effects in nearly 1-5% (mainly with bypass). In France, recommendations regarding indications, the care pathway, multidisciplinary meetings, reference management structures and postoperative care have been published by the French National Health Authority (HAS) in 2016 to provide a framework for bariatric surgery in underage patients. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  6. Determinants of obesity in children and adolescents

    Directory of Open Access Journals (Sweden)

    2013-03-01

    Full Text Available Obesity is a multifactorial disease. The aim of this study was to investigate the etiological factors contributing to the formation of obesity in children and adolescents. Study included two groups of children. Main group: 101 children with obesity aged 10 to 17 years, body mass index (BMI 31,27±0,51 kg/m 2. Comparison group: of 14 children aged 10 to 17 years, without obesity, BMI 18,54±0,11 kg/m 2. In all children we evaluated perinatal and family history, lifestyle and diet, anthropometric parameters, assessed the progress of sexual development. We found that the manifestation of the disease occurred in the early school years, and in boys significantly earlier than in girls. Mothers of obese children had complications during pregnancy (such as toxaemia, the risk of miscarriage, hypertension, previous medical abortions. The children in the majority of cases were early nursed on milk formula, had violations in feeding regime, and hypokinesia. The disease was shown to run in families.

  7. Sugar intake is correlated with adiposity and obesity indicators and sedentary lifestyle in Brazilian individuals with morbid obesity.

    Science.gov (United States)

    Penatti, M I B; Lira, F S; Katashima, C K; Rosa, J C; Pimentel, G D

    2012-01-01

    Obesity is a chronic disease characterized by increased accumulation of body fat. We evaluated the socioeconomic aspects, body composition, risk of metabolic complications associated with obesity, eating habits and lifestyle in both women and men adults and elderly with body mass index (BMI) > 40 kg/m². Among the subjects studied, 79% (n = 32) are female, 5% (n = 2) smokers, 39% (n = 16) use alcohol and only 24% (n = 10) are practitioners of physical exercise. The higher food intake was breads, followed by rice. The daily intake of fruits and vegetables is low. Positive correlation between consumption of sugar and BMI and abdominal circumference (AC) was observed. In summary, was found that morbidly obese patients that looking for nutritional counseling presents increased body fat, poor eating habits and sedentary lifestyle.

  8. Changes in lipidemia during chronic care treatment of childhood obesity

    DEFF Research Database (Denmark)

    Nielsen, Tenna Ruest Haarmark; Gamborg, Michael; Fonvig, Cilius Esmann

    2012-01-01

    Childhood obesity and related co-morbidities are increasing. This intervention study assessed the associations between weight changes and lipidemia in obese children and adolescents.......Childhood obesity and related co-morbidities are increasing. This intervention study assessed the associations between weight changes and lipidemia in obese children and adolescents....

  9. Mini-gastric bypass to control morbid obesity and diabetes mellitus: What radiologists need to know

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hyun Jeong [Dept. of Radiology, Chung-Ang University Hospital, Seoul (Korea, Republic of); Hong, Seong Sook; Hwang, Ji Young; Hur, Kyung Yul [Soonchunhyang University Seoul Hospital, Seoul (Korea, Republic of)

    2015-04-15

    Laparoscopic mini-gastric bypass surgery is a safe and simple surgical intervention for treating morbid obesity and diabetes mellitus and is now being performed more frequently. Radiologists must be critical in their postoperative evaluation of these patients. In this pictorial review, we explain and illustrate the surgical technique, normal postoperative anatomy, and associated complications as seen on imaging examinations, including fluoroscopy and computed tomography.

  10. Psychometric Properties of Quality of Life Assessment Tools in Morbid Obesity: A Review of Literature

    Directory of Open Access Journals (Sweden)

    Negar Yazdani

    2018-01-01

    Full Text Available Background: Since studies have demonstrated that morbid obesity can exponentially impair quality of life, the measurement of quality of life is paramount to monitoring the effects of treatment and influences the development of clinical pathways, service provision, healthcare expenditures, and public health policy. Accordingly, clinicians, researchers, and policy makers must rely on valid instruments. Aim: This study aimed to review and critique the psychometric properties of some specific tools by COSMIN checklist and their application among morbidly obese individuals. Method: We searched PubMed, Web of Science, PsycINFO, Ovid, Elsevier, and ScienceDirect by using the keywords related to the Quality of Life Questionnaire, namely “morbid obesity”, “tool”, and “scale”, to retrieve articles published during 1989-2017. Then, the psychometric properties of the selected tools were assessed using the COSMIN checklist. Results: Most of the tools had not reported complete and desirable psychometrics properties. Demonstration of responsiveness from independent randomized controlled trials was not available in two of the eight questionnaires. These tools also did not report proper definition of interpretability. However, the data obtained by COSMIN checklist showed that Laval questionnaire is a proper scale for measuring quality of life in obese individuals, which can be recommended to researchers. Implications for Practice: Although Laval questionnaire was found a proper tool for measuring the quality of life among morbid obese patients, developing an instrument suitable for different societies with varied cultural and social characteristics is suggested because socio-cultural factors can influence the quality of life.

  11. Single injection thoracic paravertebral block (TPVB for breast surgery in morbidly obese patient

    Directory of Open Access Journals (Sweden)

    Anita Kulkarni

    2017-01-01

    Full Text Available Morbidly obese (MO patients with associated restrictive airway disease, obstructive sleep apnea, and coronary artery disease pose challenge to an anesthesiologist. Regional block combined with general anesthesia (GA is the anesthetic technique of choice as it will decrease the requirement of opioids, anesthetics, and postoperative respiratory depression. A MO patient for modified radical mastectomy was successfully managed with single-injection thoracic paravertebral block and conventional GA.

  12. Peer Victimization as a Predictor of Depression and Body Mass Index in Obese and Non-Obese Adolescents

    Science.gov (United States)

    Adams, Ryan E.; Bukowski, William M.

    2008-01-01

    Background: The current study examined the pathway from peer victimization to depressive symptoms and body mass index (BMI) as mediated by self-concept for physical appearance in both obese and non-obese adolescents. It was thought that this pathway would be particularly important for obese adolescents because, compared to non-obese adolescents,…

  13. Evaluation of common genetic variants identified by GWAS for early onset and morbid obesity in population-based samples

    DEFF Research Database (Denmark)

    den Hoed, M; Luan, J; Langenberg, C

    2013-01-01

    BACKGROUND: Meta-analysis of case-control genome-wide association studies (GWAS) for early onset and morbid obesity identified four variants in/near the PRL, PTER, MAF and NPC1 genes. OBJECTIVE: We aimed to validate association of these variants with obesity-related traits in population-based sam......BACKGROUND: Meta-analysis of case-control genome-wide association studies (GWAS) for early onset and morbid obesity identified four variants in/near the PRL, PTER, MAF and NPC1 genes. OBJECTIVE: We aimed to validate association of these variants with obesity-related traits in population......, these variants, which were identified in a GWAS for early onset and morbid obesity, do not seem to influence obesity-related traits in the general population....

  14. Argyrophil cell density in the oxyntic mucosa is higher in female than in male morbidly obese patients

    International Nuclear Information System (INIS)

    Maksud, F.A.N.; Kakehasi, A.M.; Barbosa, A.J.A.

    2013-01-01

    Obesity is a multifactorial disorder often associated with many important diseases such as diabetes, hypertension and other metabolic syndrome conditions. Argyrophil cells represent almost the total population of endocrine cells of the human gastric mucosa and some reports have described changes of specific types of these cells in patients with obesity and metabolic syndrome. The present study was designed to evaluate the global population of argyrophil cells of the gastric mucosa of morbidly obese and dyspeptic non-obese patients. Gastric biopsies of antropyloric and oxyntic mucosa were obtained from 50 morbidly obese patients (BMI >40) and 50 non-obese patients (17 dyspeptic overweight and 33 lean individuals) and processed for histology and Grimelius staining for argyrophil cell demonstration. Argyrophil cell density in the oxyntic mucosa of morbidly obese patients was higher in female (238.68 ± 83.71 cells/mm 2 ) than in male patients (179.31 ± 85.96 cells/mm 2 ) and also higher in female (214.20 ± 50.38 cells/mm 2 ) than in male (141.90 ± 61.22 cells/mm 2 ) morbidly obese patients with metabolic syndrome (P = 0.01 and P = 0.02, respectively). In antropyloric mucosa, the main difference in argyrophil cell density was observed between female morbidly obese patients with (167.00 ± 69.30 cells/mm 2 ) and without (234.00 ± 69.54 cells/mm 2 ) metabolic syndrome (P = 0.001). In conclusion, the present results show that the number of gastric argyrophil cells could be under gender influence in patients with morbid obesity. In addition, gastric argyrophil cells seem to behave differently among female morbidly obese patients with and without metabolic syndrome

  15. Argyrophil cell density in the oxyntic mucosa is higher in female than in male morbidly obese patients

    Energy Technology Data Exchange (ETDEWEB)

    Maksud, F.A.N. [Laboratório de Patologia Digestiva e Neuroendócrina, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG (Brazil); Faculdade de Medicina, Universidade Federal de Ouro Preto, Ouro Preto, MG (Brazil); Kakehasi, A.M. [Laboratório de Patologia Digestiva e Neuroendócrina, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG (Brazil); Barbosa, A.J.A. [Laboratório de Patologia Digestiva e Neuroendócrina, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG (Brazil); Instituto Alfa de Gastroenterologia, Belo Horizonte, MG (Brazil)

    2013-04-05

    Obesity is a multifactorial disorder often associated with many important diseases such as diabetes, hypertension and other metabolic syndrome conditions. Argyrophil cells represent almost the total population of endocrine cells of the human gastric mucosa and some reports have described changes of specific types of these cells in patients with obesity and metabolic syndrome. The present study was designed to evaluate the global population of argyrophil cells of the gastric mucosa of morbidly obese and dyspeptic non-obese patients. Gastric biopsies of antropyloric and oxyntic mucosa were obtained from 50 morbidly obese patients (BMI >40) and 50 non-obese patients (17 dyspeptic overweight and 33 lean individuals) and processed for histology and Grimelius staining for argyrophil cell demonstration. Argyrophil cell density in the oxyntic mucosa of morbidly obese patients was higher in female (238.68 ± 83.71 cells/mm{sup 2}) than in male patients (179.31 ± 85.96 cells/mm{sup 2}) and also higher in female (214.20 ± 50.38 cells/mm{sup 2}) than in male (141.90 ± 61.22 cells/mm{sup 2}) morbidly obese patients with metabolic syndrome (P = 0.01 and P = 0.02, respectively). In antropyloric mucosa, the main difference in argyrophil cell density was observed between female morbidly obese patients with (167.00 ± 69.30 cells/mm{sup 2}) and without (234.00 ± 69.54 cells/mm{sup 2}) metabolic syndrome (P = 0.001). In conclusion, the present results show that the number of gastric argyrophil cells could be under gender influence in patients with morbid obesity. In addition, gastric argyrophil cells seem to behave differently among female morbidly obese patients with and without metabolic syndrome.

  16. Understanding everyday life of morbidly obese adults-habits and body image

    Directory of Open Access Journals (Sweden)

    Bjørg Christiansen

    2012-07-01

    Full Text Available Background: Morbid obesity is a progressive, chronic condition associated with failed attempts at change and repeated relapses. Aim: There seems to be little previous research into the understanding of the everyday life of morbidly obese adults. We wanted to gain more knowledge about characteristics of eating habits and body image as well as motivational forces for change. Methods: A qualitative approach was chosen in order to gain insight into how morbidly obese adults experience everyday life. Qualitative interviews are well suited to provide insight into themes from the interviewee's life story from the subjects’ own perspectives. To gain insight into such processes, a narrative approach that allowed the informants to give voice to their ways of doing, thinking and feeling in daily life, was adopted. The informants comprised seven women and four men aged of 26–56 years, recruited from a population of obese individuals who had participated in a weight reduction course. A hermeneutic approach was used where the research question was the basis for a reflective interpretation. Results: The following meaning-units were identified: to be perceived as overweight; and to see oneself as overweight. Ingrained habits: the struggle between knowing and doing; acting without knowing; and eating is soothing. Conclusions: Seeing oneself as an obese person is a gradual process that implied experiencing oneself as different from significant others, such as (slim siblings and friends. To experience a gap between knowing and doing concerning food habits in everyday life indicates that informants value they have a choice. This is an important insight to consider when framing interventions to support this vulnerable group.

  17. Adolescent obesity and maternal and paternal sensitivity and monitoring.

    Science.gov (United States)

    Neal Davis, R; Ashba, Jacqueline; Appugliese, Danielle P; Kaciroti, Niko; Corwyn, Robert F; Bradley, Robert H; Lumeng, Julie C

    2011-06-01

    To determine if adolescent obesity is associated with parenting characterized by lower sensitivity and lower monitoring of adolescent activities. We used data from 744 adolescents in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. Height and weight were measured at age 15½ years and obesity defined as body mass index ≥ 95th percentile for age and sex. Maternal and paternal sensitivity were assessed by direct observation of a parent-adolescent interaction task. Maternal and paternal monitoring were assessed by parent report. Lower sensitivity and lower monitoring were each defined as the lowest quartiles. Two separate multivariate logistic regression models were created to evaluate, individually for mothers and fathers, associations of sensitivity and monitoring with adolescent obesity, controlling for adolescent sex and race, family income-to-needs ratio, and parental obesity. Fourteen percent of the adolescents were obese. Lower sensitivity was associated with adolescent obesity in the maternal parenting model (adjusted odds ratio [AOR] 2.36, 95% confidence interval [CI] 1.44-3.86, n = 709), but not paternal parenting model (AOR = 0.79, 95% CI 0.38-1.63, n = 460). Neither maternal nor paternal monitoring was associated with adolescent obesity (AOR = 1.03, 95% CI 0.63-1.68; AOR = 1.07, 95% CI 0.52-2.22, respectively). Lower maternal sensitivity, measured by direct observation of parent-adolescent interactions, was associated with adolescent obesity. Efforts to prevent and treat childhood obesity, both at the practitioner level and the community level, may be enhanced by educating parents that their reactions to their children's behaviors may have consequences related to obesity.

  18. Obesity among Black Adolescent Girls: Genetic, Psychosocial, and Cultural Influences

    Science.gov (United States)

    Alleyne, Sylvan I.; LaPoint, Velma

    2004-01-01

    This article focuses on the causes, consequences, and prevention of obesity among a subgroup of the American population, Black adolescent girls. Using an ecological perspective on obesity among Black adolescent girls, including feminist-womanist perspectives and historical and medical sociological perspectives, the authors discuss genetic,…

  19. Relationship between physical activity and obesity in children and adolescents

    DEFF Research Database (Denmark)

    Guerra, S.; Teixeira-Pinto, A.; Ribeiro, J. C.

    2006-01-01

    The purpose of the present study was to analyze the relationship between physical activity (PA) and obesity in Portuguese children and adolescents.......The purpose of the present study was to analyze the relationship between physical activity (PA) and obesity in Portuguese children and adolescents....

  20. 7th to 9th grade obese adolescents' perceptions about obesity in Tamaulipas, Mexico.

    Science.gov (United States)

    de la Luz Martínez-Aguilar, Ma; Flores-Peña, Yolanda; de las Mercedes Rizo-Baeza, Ma; Aguilar-Hernández, Rosa Ma; Vázquez-Galindo, Laura; Gutiérres-Sánchez, Gustavo

    2010-01-01

    The objective was to explore obese adolescents perceptions about obesity among students in the seventh to ninth grade of a public school in Tamaulipas, Mexico. This is a qualitative study. Participants were 24 adolescents with a body mass index equal to or greater than the 95th percentile. Semistructured interviews were conducted until data saturation was reached and the meaning was understood. The adolescents defined obesity according to standards of measurement. They identified the hereditary factor as the main obesity cause, tended to underestimate obesity and had low self-esteem. They reported problems to do physical exercise and get clothes in order to improve their image, and feel rejected by their peers in school. It was identified that these adolescents have psychological defense mechanisms against obesity and that some of them are making efforts to lose weight. Obesity entails social and psychological health implications for persons suffering from this problem. Interventions should be put in practice.

  1. Obesity and depression in adolescence and beyond: reciprocal risks.

    Science.gov (United States)

    Marmorstein, N R; Iacono, W G; Legrand, L

    2014-07-01

    Obesity and major depressive disorder (MDD) are associated, but evidence about how they relate over time is conflicting. The goal of this study was to examine prospective associations between depression and obesity from early adolescence through early adulthood. Participants were drawn from a statewide, community-based, Minnesota sample. MDD and obesity with onsets by early adolescence (by age 14), late adolescence (between 14 and 20) and early adulthood (ages 20-24) were assessed via structured interview (depression) and study-measured height and weight. Cross-sectional results indicated that depression and obesity with onsets by early adolescence were concurrently associated, but the same was not true later in development. Prospective results indicated that depression by early adolescence predicted the onset of obesity (odds ratio (OR)=3.76, confidence interval =1.33-10.59) during late adolescence among female individuals. Obesity that developed during late adolescence predicted the onset of depression (OR=5.89, confidence interval=2.31-15.01) during early adulthood among female individuals. For girls, adolescence is a high-risk period for the development of this comorbidity, with the nature of the risk varying over the course of adolescence. Early adolescent-onset depression is associated with elevated risk of later onset obesity, and obesity, particularly in late adolescence, is associated with increased odds of later depression. Further investigation into the mechanisms of these effects and the reasons for the observed gender and developmental differences is needed. Prevention programs focused on early-onset cases of depression and adolescent-onset cases of obesity, particularly among female individuals, may help in reducing risk for this form of comorbidity.

  2. Biomarkers of Morbid Obesity and Prediabetes by Metabolomic Profiling of Human Discordant Phenotypes.

    Science.gov (United States)

    Tulipani, Sara; Palau-Rodriguez, Magali; Miñarro Alonso, Antonio; Cardona, Fernando; Marco-Ramell, Anna; Zonja, Bozo; Lopez de Alda, Miren; Muñoz-Garach, Araceli; Sanchez-Pla, Alejandro; Tinahones, Francisco J; Andres-Lacueva, Cristina

    2016-12-01

    Metabolomic studies aimed to dissect the connection between the development of type 2 diabetes and obesity are still scarce. In the present study, fasting serum from sixty-four adult individuals classified into four sex-matched groups by their BMI [non-obese versus morbid obese] and the increased risk of developing diabetes [prediabetic insulin resistant state versus non-prediabetic non-insulin resistant] was analyzed by LC- and FIA-ESI-MS/MS-driven metabolomic approaches. Altered levels of [lyso]glycerophospholipids was the most specific metabolic trait associated to morbid obesity, particularly lysophosphatidylcholines acylated with margaric, oleic and linoleic acids [lysoPC C17:0: R=-0.56, p=0.0003; lysoPC C18:1: R=-0.61, p=0.0001; lysoPC C18:2 R=-0.64, pprediabetes and insulin resistance in a BMI-independent manner [fasting insulin: R=0.37, p=0.0479; HOMA-IR: R=0.37, p=0.0468]. Minority sphingolipids including specific [dihydro]ceramides and sphingomyelins also associated with the prediabetic insulin resistant state, hence deserving attention as potential targets for early diagnosis or therapeutic intervention. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Lifestyle Practices and Obesity in Malaysian Adolescents

    Science.gov (United States)

    Teo, Pey Sze; Nurul-Fadhilah, Abdullah; Aziz, Mohd Ezane; Hills, Andrew P.; Foo, Leng Huat

    2014-01-01

    Aim: To determine the influence of physical activity (PA) and sedentary behavior (SB) on obesity profiles of 454 Malaysian adolescents aged 12 to 19. Methods: Validated PA and SB questionnaires were used and body composition assessed using anthropometry and dual-energy X-ray absorptiometry (DXA). Results: Gender-specific multivariate analyses showed boys with high levels of total PA and moderate-to-vigorous physical activity (MVPA) exhibited significantly lower levels of total body fat, percent body fat and android fat mass compared with low PA and MVPA groups, after adjusting for potential confounders. Girls with high SB levels showed significantly higher BMI, waist circumference and DXA-derived body fat indices than those at lower SB level. Multiple logistic analyses indicated that boys with low levels of total PA and MVPA had significantly greater obesity risk, 3.0 (OR 3.0; 95% CI, 1.1–8.1; p obesity, 2.9 times higher than girls at low SP levels (OR 2.8; 95% CI, 1.0–7.5; p obesity risk while high screen-based sedentary behaviors significantly adversely influenced body fat mass, particularly amongst girls when the PA level was low. PMID:24886753

  4. Decreased serum glicentin concentration in patients with severe and morbid obesity.

    Science.gov (United States)

    Raffort, Juliette; Panaïa-Ferrari, Patricia; Lareyre, Fabien; Blois, Mathilde; Bayer, Pascale; Staccini, Pascal; Fénichel, Patrick; Chinetti, Giulia

    2018-03-01

    Background Proglucagon-derived hormones represent a family of peptides mainly produced in the pancreas and the intestine. While several proglucagon-derived peptides play key roles in metabolic diseases, little is known about glicentin. The aim of the present study was to investigate serum glicentin concentrations in individuals with adult obesity and to study its potential link with various metabolic parameters. Methods Fifty-two individuals with normal body mass index (BMI  35 kg/m 2 ) were prospectively included at the University Hospital of Nice between January 2014 and April 2016. Clinical data were recorded, and a fasting blood sample was collected to measure glicentin, glucose, insulin, C-peptide, total cholesterol, triglyceride, LDL and HDL-cholesterol. In addition, a homeostasis model assessment for insulin resistance (HOMA2-IR) was also calculated. Results Patients with severe and morbid obesity had significantly higher plasma glucose, together with higher serum concentrations of insulin, C-peptide, HOMA2-IR, triglyceride, LDL-cholesterol and lower serum concentrations of HDL-cholesterol compared with individuals with a normal body mass index. The obese patients displayed significantly lower fasting serum concentrations of glicentin compared with subjects with a normal body mass index (12 pmol/L vs. 24 pmol/L, P < 0.0001). In the total population, fasting glicentin concentrations did not correlate with BMI, glycaemic parameters (glucose, insulin, C-peptide, HOMA-IR) or lipid parameters (total cholesterol, triglyceride, LDL and HDL-cholesterol). Conclusion To the best of our knowledge, this is the first study reporting serum glicentin concentrations in healthy lean and obese adult subjects. We found that fasting serum glicentin concentrations are decreased in patients with severe or morbid obesity suggesting the potential interest of this peptide in obesity and metabolic-related disorders.

  5. Modulation of SHBG binding to testosterone and estradiol by sex and morbid obesity.

    Science.gov (United States)

    Grasa, María Del Mar; Gulfo, José; Camps, Núria; Alcalá, Rosa; Monserrat, Laura; Moreno-Navarrete, José María; Ortega, Francisco José; Esteve, Montserrat; Remesar, Xavier; Fernández-López, José Antonio; Fernández-Real, José Manuel; Alemany, Marià

    2017-04-01

    Sex hormone-binding globulin (SHBG) binds and transports testosterone and estradiol in plasma. The possibility that SHBG is a mixture of transporting proteins has been postulated. We analyzed in parallel the effects of obesity status on the levels and binding capacity of circulating SHBG and their relationship with testosterone and estradiol. Anthropometric measures and plasma were obtained from apparently healthy young (i.e. 35 ± 7 years) premenopausal women ( n =  32) and men ( n =  30), with normal weight and obesity (BMI >30 kg/m 2 ). SHBG protein (Western blot), as well as the plasma levels of testosterone, estradiol, cortisol and insulin (ELISA) were measured. Specific binding of estradiol and testosterone to plasma SHBG was analyzed using tritium-labeled hormones. Significant differences in SHBG were observed within the obesity status and gender, with discordant patterns of change in testosterone and estradiol. In men, testosterone occupied most of the binding sites. Estrogen binding was much lower in all subjects. Lower SHBG of morbidly obese (BMI >40 kg/m 2 ) subjects affected testosterone but not estradiol. The ratio of binding sites to SHBG protein levels was constant for testosterone, but not for estradiol. The influence of gender was maximal in morbid obesity, with men showing the highest binding / SHBG ratios. The results reported here are compatible with SHBG being a mixture of at least two functionally different hormone-binding globulins, being affected by obesity and gender and showing different structure, affinities for testosterone and estradiol and also different immunoreactivity. © 2017 European Society of Endocrinology.

  6. A description of morbidly obese state employees requesting a bariatric operation.

    Science.gov (United States)

    Martin, Louis F; Lundberg, Anna Paone; Juneau, Francine; Raum, William J; Hartman, Sandra J

    2005-10-01

    The federal government, the medical insurance industry, and the academic medical community have disagreed over what treatments are appropriate and cost effective for morbid obesity. This debate is hindered by inadequate data regarding the true costs of diseases and who chooses an operation as a treatment option. The purpose of this study was to obtain these costs and to describe this population. Louisiana's managed medical insurance program created primarily for its civil service employees contracted to offer a small random group of morbidly obese employees the option of a bariatric operation. This observational study examined the subpopulation who requested consideration for the operation. We present historic cost data from all medical expenses paid by the insurance company, a telephone survey of the volunteers in the study to determine their medical problems, and diagnostic evaluation data on those employees randomized to proceed for possible bariatric operation. A total of 911 of 189,398 adult members of the insurance plan wanted to be considered for this study. Only 397, however, completed the informed-consent process. Of the 248 employees who met the age requirement, body mass index criteria, and health criteria to be considered for a bariatric operation and were randomized, 20 withdrew before obtaining 40 committed operative candidates. The 773 morbidly obese female members had used a mean of dollar 11,145 in medical insurance expenses in the year 2003 versus a mean of dollar 8,096 for the other 106,908 adult women. Similar values for the men were dollar 16,720 for the 138 morbidly obese men versus dollar 5,943 for the other 82,490 men. The morbidly obese members of this medical insurance plan who requested a bariatric operation are costing their plan 1.4 to 2.8 times the yearly amount of the other adult members in medical expenses. The yearly mean amount the insurance plan spends on these members suggests that operative treatment would pay for itself in a

  7. Insulin resistance in obese children and adolescents.

    Science.gov (United States)

    Romualdo, Monica Cristina dos Santos; Nóbrega, Fernando José de; Escrivão, Maria Arlete Meil Schimith

    2014-01-01

    To evaluate the presence of insulin resistance and its association with other metabolic abnormalities in obese children and adolescents. Retrospective study of 220 children and adolescents aged 5-14 years. Anthropometric measurements were performed (weight, height, and waist circumference) and clinical (gender, age, pubertal stage, and degree of obesity) and biochemical (glucose, insulin, total cholesterol, and fractions, triglycerides) data were analyzed. Insulin resistance was identified by the homeostasis model assessment for insulin resistance (HOMA-IR) index. The analysis of the differences between the variables of interest and the HOMA-IR quartiles was performed by ANOVA or Kruskal-Wallis tests. Insulin resistance was diagnosed in 33.20% of the sample. It was associated with low levels of high-density lipoprotein cholesterol (HDL-C; p=0.044), waist circumference measurement (p=0.030), and the set of clinical and metabolic (p=0.000) alterations. Insulin-resistant individuals had higher mean age (p=0.000), body mass index (BMI; p=0.000), abdominal circumference (p=0.000), median triglycerides (p=0.001), total cholesterol (p≤0.042), and low-density lipoprotein cholesterol (LDL-C; p≤0.027); and lower HDL-C levels (p=0.005). There was an increase in mean BMI (p=0.000), abdominal circumference (p=0.000), and median triglycerides (p=0.002) as the values of HOMA -IR increased, with the exception of HDL-C, which decreased (p=0.001). Those with the highest number of simultaneous alterations were between the second and third quartiles of the HOMA-IR index (p=0.000). The results confirmed that insulin resistance is present in many obese children and adolescents, and that this condition is associated with alterations that represent an increased risk for developing metabolic disorders in adulthood. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  8. Household food insecurity and its association with morbidity report among school adolescent in Jimma zone, Ethiopia.

    Science.gov (United States)

    Tamiru, Dessalegn; Belachew, Tefera

    2018-01-13

    Background Household food insecurity has a substantial contribution to poor health outcomes among young children and adolescents. Food insecurity also affects optimal cognitive development and physiological function of these vulnerable groups. There is a gap of documented data regarding the association of food insecurity and morbidity among school adolescents in Ethiopia. Objective The aim of this study is to assess the interrelationship of household food insecurity and morbidity report among school adolescent in Jimma zone, Ethiopia. Methods A community based cross-sectional study was done from October to November, 2013. Data were gathered using structured questionnaires through interview of students and their caregivers. A total of 1000 students were selected by using simple random sampling methods using their rosters as a frame. Data were also checked for missing values and outliers, and analyzed using SPSS version 16.0. Regression analyses were used to see the strength of association between independent and dependent variables using odds ratios and 95% of confidence intervals. Results Adolescents from food insecure households had more reported illness (39.3%) than adolescents from food secure households (24.7%) (p insecure households were two times more exposed to morbidity [AOR = 2.04(1.32, 3.14)] than adolescents from food secure households. This study also showed that males had 48% less reported illness [AOR = 0.52(0.01, 0.23)] than females. Adolescents who had attended health education had less reported illness [AOR = 0.57(0.38, 0.86)] than those who did not ever attend. This study also showed that having a farmer [AOR = 0.46(0.28, 0.74)] and government employee [AOR = 0.33 (0.17, 0.64)] father were inversely associated with adolescent morbidity. Conclusion The findings of this study showed that household food insecurity, female gender and lack of attending health education had a significant contribution to adolescent morbidity. Therefore, there is a need

  9. [Morbidity rate of obesity in children in ukraine. Overweight as noncontagious disease risk factor].

    Science.gov (United States)

    Заболотна, Ірина Е

    The upsurge of prevalence rate of obesity and overweight that in the majority of cases traces back to childhood is a risk factor of the most common noncontagious diseases in adults. The aim was to analyze prevalence of obesity in children in Ukraine and to conduct the pilot study of medical condition of overweight children. Official state statistics of prevalence rate of obesity in kids and screening data of anthropometric characteristics, arterial tension levels, physical performance decrement and medical condition of children (boys - 50, girls - 90, average age - 15,1±0,1 years) was used in research. Data calculation performed by Statistica v. 6.0 software. Over the past few decades, the morbidity rate of obesity in children in Ukraine has greatly increased, especially in year class 15-17. Insufficient diagnosis of obesity in children is the consequence of the inadequacy of the existing system of preventive care and monitoring survey of decease risk factors. Children with body mass index (BMI) above normal have a risk of work decrement in 5,2 times (odds ratio, OR=5,2, CI95%: 1,7-10,6). Such children have higher risk of development of the diseases of the respiratory system (OR=8,1; CI95%: 3,9-13,6) and allergic dermatitis (OR=7,7; CI95%: 3,7-12,9). The odds ratio of arterial hypertension in such children is equal to 3,46±0,3 (95%CI: 2,0-5,9). According to prediction calculations, the situation with the increase of prevalence rate of obesity in children in Ukraine is unfavorable. The introduction of measures aimed at finding children with obesity, their registration and monitoring of patients' health with due regard to decease risk factors at the primary care level would conduce to improving prevention of obesity and prevention of alimentary diseases progression.

  10. Overweight and obesity status of school adolescents in Portharcourt ...

    African Journals Online (AJOL)

    Background: Adolescent overweight and obesity has been linked to obesity in adult life, with its associated risks of chronic diseases including cardiovascular diseases. Thus, prevention aimed at early screening and surveillance should be the key.The aim of this study is to determine the prevalence of overweight and obesity ...

  11. [Can family meals protect adolescents from obesity?].

    Science.gov (United States)

    Tabak, Izabela; Jodkowska, Maria; Oblacińska, Anna; Mikiel-Kostyra, Krystyna

    2012-01-01

    To analyse the relationship between the frequency of family meals and the body weight of 13-year-olds and its selected determinants. The study was conducted in 2008 as the last stage in a prospective cohort study of 605 children. Questionnaires containing questions about the frequency of family meals, the general regularity of meals, fruit and vegetable consumption, physical activity and the number of hours spent watching television or at the computer were sent to 13-year-olds by mail. School nurses performed anthropometric measurements of the pupils' weight and height. Statistical analyses were performed, i.e. Pearson's correlations, the two-step cluster analysis and the logistic regression analysis. Most of the young people (80-90%) eat each of the main meals in the company of their parents at least once a week, 21% have breakfast with their parents every day, 41% - dinner, and 45% - supper. The frequency of family meals correlated negatively with the girls' BMI and the number of hours they spent watching television or at the computer, while positively with physical activity, regular meals and vegetable consumption in adolescents of both genders. The lowest mean values of BMI were found in a group of adolescents often eating family meals, the highest - in the group of young people who rarely ate family meals (over 20% of young people in this group were overweight), but the differences were statistically significant only for girls (p=0.025). The probability of less than 2 hours of sedentary behaviour daily, physical activity of at least 60 minutes per day and everyday vegetable and fruit consumption is twice as high in adolescents often consuming meals with their parents, and with the daily consumption of all the meals in this way - more than fourfold higher than in other groups. Family meals treated as a predictor of a healthy lifestyle can indirectly protect adolescents from overweight and obesity. Promoting family meals should be an important method of

  12. The laval questionnaire: a new instrument to measure quality of life in morbid obesity.

    Science.gov (United States)

    Therrien, Fanny; Marceau, Picard; Turgeon, Nathalie; Biron, Simon; Richard, Denis; Lacasse, Yves

    2011-08-15

    Our recent review of the literature uncovered eleven obesity-specific quality of life questionnaires, all with incomplete demonstration of their measurement properties. Our objective was to validate a new self-administered questionnaire specific to morbid obesity to be used in clinical trials. The study was carried out at the bariatric surgery clinic of Laval Hospital, Quebec City, Canada. This study followed our description of health-related quality of life in morbid obesity from which we constructed the Laval Questionnaire. Its construct validity and responsiveness were tested by comparing the baseline and changes at 1-year follow-up in 6 domain scores (symptoms, activity/mobility, personal hygiene/clothing, emotions, social interactions, sexual life) with those of questionnaires measuring related constructs (SF-36, Impact of Weight on Quality of Life-Lite, Rosenberg Self-Esteem Scale and Beck Depression Inventory-II). 112 patients (67 who got bariatric surgery, 45 who remained on the waiting list during the study period) participated in this study. The analysis of the discriminative function of the questionnaire showed moderate-to-high correlations between the scores in each domain of our instrument and the corresponding questionnaires. The analysis of its evaluative function showed (1) significant differences in score changes between patients with bariatric surgery and those without, and (2) moderate-to-high correlations between the changes in scores in the new instrument and the changes in the corresponding questionnaires. Most of these correlations met the a priori predictions we had made regarding their direction and magnitude. The Laval Questionnaire is a valid measure of health-related quality of life in patients with morbid obesity and is responsive to treatment-induced changes.

  13. The laval questionnaire: a new instrument to measure quality of life in morbid obesity

    Directory of Open Access Journals (Sweden)

    Therrien Fanny

    2011-08-01

    Full Text Available Abstract Background Our recent review of the literature uncovered eleven obesity-specific quality of life questionnaires, all with incomplete demonstration of their measurement properties. Our objective was to validate a new self-administered questionnaire specific to morbid obesity to be used in clinical trials. The study was carried out at the bariatric surgery clinic of Laval Hospital, Quebec City, Canada. Methods This study followed our description of health-related quality of life in morbid obesity from which we constructed the Laval Questionnaire. Its construct validity and responsiveness were tested by comparing the baseline and changes at 1-year follow-up in 6 domain scores (symptoms, activity/mobility, personal hygiene/clothing, emotions, social interactions, sexual life with those of questionnaires measuring related constructs (SF-36, Impact of Weight on Quality of Life-Lite, Rosenberg Self-Esteem Scale and Beck Depression Inventory-II. Results 112 patients (67 who got bariatric surgery, 45 who remained on the waiting list during the study period participated in this study. The analysis of the discriminative function of the questionnaire showed moderate-to-high correlations between the scores in each domain of our instrument and the corresponding questionnaires. The analysis of its evaluative function showed (1 significant differences in score changes between patients with bariatric surgery and those without, and (2 moderate-to-high correlations between the changes in scores in the new instrument and the changes in the corresponding questionnaires. Most of these correlations met the a priori predictions we had made regarding their direction and magnitude. Conclusion The Laval Questionnaire is a valid measure of health-related quality of life in patients with morbid obesity and is responsive to treatment-induced changes.

  14. Fasting plasma glucose in the screening for type 2 diabetes in morbidly obese subjects.

    Science.gov (United States)

    Hofsø, Dag; Jenssen, Trond; Hager, Helle; Røislien, Jo; Hjelmesaeth, Jøran

    2010-03-01

    Higher mortality rates among morbidly obese (BMI of > or =40 or > or =35 kg/m2 with weight-related comorbidities) subjects are mainly explained by comorbidities such as type 2 diabetes. As bariatric surgery ameliorates diabetes, obese diabetic subjects will receive great benefits from bariatric surgery. Screening for diabetes prior to surgical referral is therefore crucial. We studied 1,253 consecutively recruited (2005-2008) morbidly obese subjects (67% women). Among subjects without known diabetes, 70% (670/961) performed an oral glucose tolerance test (OGTT). Screen-detected diabetes was defined as fasting plasma glucose (fPG) > or =7.0 mmol/l and/or 2-h glucose concentration (2hPG) > or = 11.1 mmol/l. Within the study population, 31% had diabetes, of which 8% were screen-detected. Eighty percent of those with screen-detected diabetes were diagnosed by fPG. In subjects with nondiabetic fPG concentrations, elevating the fPG cutoff value from 5.2 mmol/l to the World Health Organization's (WHO's) recommended value of 6.1 mmol/l reduced the percentage of the population needing an OGTT considerably (78-23%), but only slightly reduced the sensitivity of fPG in detecting a diabetic 2hPG concentration (100-77%). Only 7% of the patients with fPG between 6.1 and 6.9 mmol/l had a diabetic 2hPG concentration. Following the WHO's recommendations, we found that 95% of all subjects with unknown diabetes were identified. Fasting glucose identified four out of five morbidly obese subjects with unknown diabetes. A supplemental OGTT in selected persons identified the majority of the remaining diabetic cases.

  15. Gynecologic and Obstetric Consequences of Obesity in Adolescent Girls.

    Science.gov (United States)

    Elizondo-Montemayor, Leticia; Hernández-Escobar, Claudia; Lara-Torre, Eduardo; Nieblas, Bianca; Gómez-Carmona, Merith

    2017-04-01

    In the past few decades, there has been an overwhelming increase in childhood and adolescent obesity worldwide. Besides the well recognized cardiometabolic complications and other physical conditions associated with obesity, during adolescence, it causes psychological and social distress in a period of life that is already sensitive for a girl. This in turn increases their risk of low self-esteem and depression. Furthermore, obesity diminishes health-related quality of life and years of life. Overweight and obese teenagers are more likely to have gynecologic and obstetric complications, during adolescence and also later in life. Consequences of obese and overweight childhood and adolescence include sexual maturation and reproductive dysfunction, alterations in menstruation, dysmenorrhea, risky sexual behavior, and inefficient use of contraception, polycystic ovary syndrome, bone density abnormalities, macromastia, and an increased risk of breast and endometrial cancer. Obese adolescents are at greater risk of pregnancy and perinatal complications, such as preeclampsia, gestational hypertension and preeclampsia, gestational diabetes mellitus, primary cesarean delivery, and induction of labor, to mention a few. Evidence shows that infants born to obese teenagers are also more likely to have complications including preterm or post-term delivery, small-for-gestational age newborns, macrosomia, meconium aspiration, respiratory distress, and even stillbirth, among others. This comprehensive review focuses on the gynecological and obstetric consequences of obesity in adolescent girls. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  16. A 12-Week Aerobic Exercise Program Reduces Hepatic Fat Accumulation and Insulin Resistance in Obese, Hispanic Adolescents

    NARCIS (Netherlands)

    van der Heijden, Gert-Jan; Wang, Zhiyue J.; Chu, Zili D.; Sauer, Pieter J. J.; Haymond, Morey W.; Rodriguez, Luisa M.; Sunehag, Agneta L.

    2010-01-01

    The rise in obesity-related morbidity in children and adolescents requires urgent prevention and treatment strategies. Currently, only limited data are available on the effects of exercise programs on insulin resistance, and visceral, hepatic, and intramyocellular fat accumulation. We hypothesized

  17. Assessment of anti-factor Xa activity of enoxaparin for venous thromboembolism prophylaxis in morbidly obese surgical patients

    Directory of Open Access Journals (Sweden)

    Nouf Al Otaib

    2017-01-01

    Conclusions: Weight-based enoxaparin dose led to the anticipated peak anti-Xa levels (0.2–0.6 IU/mL in most of the morbidly obese study patients undergoing surgery without any evidence of major side effects. The weight-based dosing of enoxaparin was also effective in preventing VTE in all patients. Although these results are promising, further comparative trials are needed in the setting of morbidly obese surgical patients.

  18. Retinol binding protein 4, obesity, and insulin resistance in adolescents

    Directory of Open Access Journals (Sweden)

    Ronaldi Noor

    2017-02-01

    Full Text Available Background Obesity is a global problem. Even in poor and developing countries, obesity has reached alarming levels. In childhood, obesity may lead to insulin resistance. Retinol binding protein (RBP4, secreted primarily by liver and adipose tissues, was recently proposed as a link between obesity and insulin resistance. The role of RBP4 in pediatric obesity and its relationship with insulin resistance have not been well elucidated. Objective To compare RBP4 levels in obese and lean adolescents and to assess for a relationship between RBP4 levels and insulin resistance. Method This cross-sectional study was conducted in three senior high schools in Padang, West Sumatera, Indonesia. Subjects were adolescents aged 14-18 years, who were obese or normal weight (n=56. We measured subjects’ body mass index (BMI and serum RBP4 concentrations. Insulin resistance was assessed using the homeostasis model assessment of insulin resistance (HOMA-IR index. Results Similar RBP4 levels were found in the obese and normoweight groups (P>0.05. Higher RBP4 levels were found in the insulin resistant compared to the non-insulin resistant group, but the difference was not significant (P > 0.05. Conclusion There is no significant difference in mean RBP4 levels in obese adolescents compared to normoweight adolescents. Nor are mean RBP4 levels significantly different between obese adolescents with and without insulin resistance.

  19. Adolescents' perception of causes of obesity: unhealthy lifestyles or heritage?

    Science.gov (United States)

    Gonçalves, Helen; González, David A; Araújo, Cora P; Muniz, Ludmila; Tavares, Patrícia; Assunção, Maria C; Menezes, Ana M B; Hallal, Pedro C

    2012-12-01

    To evaluate adolescents' perception of the causes of obesity, with emphasis on differences according to nutritional status and socioeconomic position. We conducted qualitative research including 80 adolescents belonging to the 1993 Pelotas (Brazil) Birth Cohort Study, and their mothers. We classified adolescent boys and girls into four groups (girls-obese, girls-eutrophic, boys-obese, and boys-eutrophic) according to body mass index for age and sex, and systematically selected them according to family income at age 15 years. Research techniques included semistructured interviews and history of life. Topics covered in the interviews included early experiences with weight management, effect of weight on social relationships, family history, eating habits, and values. Low-income obese adolescents and their mothers perceive obesity as a heritage, caused by family genes, side effects of medication use, and stressful life events. However, low-income eutrophic adolescents emphasize the role of unhealthy diets on obesity development. Among the high-income adolescents, those who are obese attribute it to genetic factors and emotional problems, whereas those who are eutrophic mention unhealthy diets and lack of physical activity as the main causes of obesity. Perceptions of the causes of obesity in adolescents from a middle-income setting vary by gender, socioeconomic position, and nutritional status. Whereas some blame genetics as responsible for obesity development, others blame unhealthy diets and lifestyles, and others acknowledge the roles of early life experiences and family traditions in the process of obesity development. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  20. Impaired skeletal muscle mitochondrial function in morbidly obese patients is normalized one year after bariatric surgery.

    Science.gov (United States)

    Vijgen, Guy H E J; Bouvy, Nicole D; Hoeks, Joris; Wijers, Sander; Schrauwen, Patrick; van Marken Lichtenbelt, Wouter D

    2013-01-01

    Obesity and type 2 diabetes are associated with impaired skeletal muscle mitochondrial metabolism. As an intrinsic characteristic of an individual, skeletal muscle mitochondrial dysfunction could be a risk factor for weight gain and obesity-associated co-morbidities, such as type 2 diabetes. On the other hand, impaired skeletal muscle metabolism could be a consequence of obesity. We hypothesize that marked weight loss after bariatric surgery recovers skeletal muscle mitochondrial function. Skeletal muscle mitochondrial function as assessed by high-resolution respirometry was measured in 8 morbidly obese patients (body mass index [BMI], 41.3±4.7 kg/m(2); body fat, 48.3%±5.2%) before and 1 year after bariatric surgery (mean weight loss: 35.0±8.6 kg). The results were compared with a lean (BMI 22.8±1.1 kg/m(2); body fat, 15.6%±4.7%) and obese (BMI 33.5±4.2 kg/m(2); body fat, 34.1%±6.3%) control group. Before surgery, adenosine diphosphate (ADP)-stimulated (state 3) respiration on glutamate/succinate was decreased compared with lean patients (9.5±2.4 versus 15.6±4.4 O2 flux/mtDNA; Psurgery, mitochondrial function was comparable to that of lean controls (after weight loss, 12.3±5.5; lean, 15.6±4.4 O2 flux/mtDNA). In addition, we observed an increased state 3 respiration on a lipid substrate after weight loss (10.0±3.2 versus 14.0±6.6 O2 flux/mtDNA; Pweight loss. Copyright © 2013 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  1. Obesity and bronchodilator response in black and Hispanic children and adolescents with asthma.

    Science.gov (United States)

    McGarry, Meghan E; Castellanos, Elizabeth; Thakur, Neeta; Oh, Sam S; Eng, Celeste; Davis, Adam; Meade, Kelley; LeNoir, Michael A; Avila, Pedro C; Farber, Harold J; Serebrisky, Denise; Brigino-Buenaventura, Emerita; Rodriguez-Cintron, William; Kumar, Rajesh; Bibbins-Domingo, Kirsten; Thyne, Shannon M; Sen, Saunak; Rodriguez-Santana, Jose R; Borrell, Luisa N; Burchard, Esteban G

    2015-06-01

    Obesity is associated with poor asthma control, increased asthma morbidity, and decreased response to inhaled corticosteroids. We hypothesized that obesity would be associated with decreased bronchodilator responsiveness in children and adolescents with asthma. In addition, we hypothesized that subjects who were obese and unresponsive to bronchodilator would have worse asthma control and would require more asthma controller medications. In the Study of African Americans, Asthma, Genes, and Environments (SAGE II) and the Genes-environments and Admixture in Latino Americans (GALA II) study, two identical, parallel, case-control studies of asthma, we examined the association between obesity and bronchodilator response in 2,963 black and Latino subjects enrolled from 2008 to 2013 using multivariable logistic regression. Using bronchodilator responsiveness, we compared asthma symptoms, controller medication usage, and asthma exacerbations between nonobese (< 95th% BMI) and obese (≥ 95th% BMI) subjects. The odds of being bronchodilator unresponsive were 24% (OR, 1.24; 95% CI, 1.03-1.49) higher among obese children and adolescents compared with their not obese counterparts after adjustment for age, race/ethnicity, sex, recruitment site, baseline lung function (FEV1/FVC), and controller medication. Bronchodilator-unresponsive obese subjects were more likely to report wheezing (OR, 1.38; 95% CI, 1.13-1.70), being awakened at night (OR, 1.34; 95% CI, 1.09-1.65), using leukotriene receptor inhibitors (OR, 1.33; 95% CI, 1.05-1.70), and using inhaled corticosteroid with long-acting β2-agonist (OR, 1.37; 95% CI, 1.05-1.78) than were their nonobese counterpart. These associations were not seen in the bronchodilator-responsive group. Obesity is associated with bronchodilator unresponsiveness among black and Latino children and adolescents with asthma. The findings on obesity and bronchodilator unresponsiveness represent a unique opportunity to identify factors affecting asthma

  2. [Obesity and metabolic syndrome in adolescents].

    Science.gov (United States)

    Cárdenas Villarreal, Velia Margarita; Rizo-Baeza, María M; Cortés Castell, Ernesto

    2009-03-01

    In spite of the lack of a uniform definition for metabolic syndrome in pediatry, recent studies have shown that it develops during childhood and is highly prevalent among children and adolescents who suffer from obesity. In light of the current epidemic of obesity in this age category in western countries, and specifically in Mexico, it becomes essential to know the means to prevent, detect and treat this syndrome. Nurses play an important role in promoting childhood health with regards to metabolic syndrome. To put into practice the strategies which resolve underlying problems related with this syndrome is a priority for the well-being of this age group. These strategies should include the application and management of public policies; the collaboration by health services, social services and schools; but, furthermore, the prevention and the management of this syndrome require a family commitment, while the changes in living habits benefit the entire family. This review article proposes to introduce prevention, diagnostic and treatment strategies which nursing personnel can carry out while dealing with metabolic syndrome in adolescents.

  3. Determinants of noninvasive ventilation success or failure in morbidly obese patients in acute respiratory failure.

    Directory of Open Access Journals (Sweden)

    Malcolm Lemyze

    Full Text Available Acute respiratory failure (ARF is a common life-threatening complication in morbidly obese patients with obesity hypoventilation syndrome (OHS. We aimed to identify the determinants of noninvasive ventilation (NIV success or failure for this indication.We prospectively included 76 consecutive patients with BMI>40 kg/m2 diagnosed with OHS and treated by NIV for ARF in a 15-bed ICU of a tertiary hospital.NIV failed to reverse ARF in only 13 patients. Factors associated with NIV failure included pneumonia (n = 12/13, 92% vs n = 9/63, 14%; p<0.0001, high SOFA (10 vs 5; p<0.0001 and SAPS2 score (63 vs 39; p<0.0001 at admission. These patients often experienced poor outcome despite early resort to endotracheal intubation (in-hospital mortality, 92.3% vs 17.5%; p<0.001. The only factor significantly associated with successful response to NIV was idiopathic decompensation of OHS (n = 30, 48% vs n = 0, 0%; p = 0.001. In the NIV success group (n = 63, 33 patients (53% experienced a delayed response to NIV (with persistent hypercapnic acidosis during the first 6 hours.Multiple organ failure and pneumonia were the main factors associated with NIV failure and death in morbidly obese patients in hypoxemic ARF. On the opposite, NIV was constantly successful and could be safely pushed further in case of severe hypercapnic acute respiratory decompensation of OHS.

  4. Significantly reduced hypoxemic events in morbidly obese patients undergoing gastrointestinal endoscopy: Predictors and practice effect

    Directory of Open Access Journals (Sweden)

    Basavana Gouda Goudra

    2014-01-01

    Full Text Available Background: Providing anesthesia for gastrointestinal (GI endoscopy procedures in morbidly obese patients is a challenge for a variety of reasons. The negative impact of obesity on the respiratory system combined with a need to share the upper airway and necessity to preserve the spontaneous ventilation, together add to difficulties. Materials and Methods: This retrospective cohort study included patients with a body mass index (BMI >40 kg/m 2 that underwent out-patient GI endoscopy between September 2010 and February 2011. Patient data was analyzed for procedure, airway management technique as well as hypoxemic and cardiovascular events. Results: A total of 119 patients met the inclusion criteria. Our innovative airway management technique resulted in a lower rate of intraoperative hypoxemic events compared with any published data available. Frequency of desaturation episodes showed statistically significant relation to previous history of obstructive sleep apnea (OSA. These desaturation episodes were found to be statistically independent of increasing BMI of patients. Conclusion: Pre-operative history of OSA irrespective of associated BMI values can be potentially used as a predictor of intra-procedural desaturation. With suitable modification of anesthesia technique, it is possible to reduce the incidence of adverse respiratory events in morbidly obese patients undergoing GI endoscopy procedures, thereby avoiding the need for endotracheal intubation.

  5. Significantly reduced hypoxemic events in morbidly obese patients undergoing gastrointestinal endoscopy: Predictors and practice effect.

    Science.gov (United States)

    Goudra, Basavana Gouda; Singh, Preet Mohinder; Penugonda, Lakshmi C; Speck, Rebecca M; Sinha, Ashish C

    2014-01-01

    Providing anesthesia for gastrointestinal (GI) endoscopy procedures in morbidly obese patients is a challenge for a variety of reasons. The negative impact of obesity on the respiratory system combined with a need to share the upper airway and necessity to preserve the spontaneous ventilation, together add to difficulties. This retrospective cohort study included patients with a body mass index (BMI) >40 kg/m(2) that underwent out-patient GI endoscopy between September 2010 and February 2011. Patient data was analyzed for procedure, airway management technique as well as hypoxemic and cardiovascular events. A total of 119 patients met the inclusion criteria. Our innovative airway management technique resulted in a lower rate of intraoperative hypoxemic events compared with any published data available. Frequency of desaturation episodes showed statistically significant relation to previous history of obstructive sleep apnea (OSA). These desaturation episodes were found to be statistically independent of increasing BMI of patients. Pre-operative history of OSA irrespective of associated BMI values can be potentially used as a predictor of intra-procedural desaturation. With suitable modification of anesthesia technique, it is possible to reduce the incidence of adverse respiratory events in morbidly obese patients undergoing GI endoscopy procedures, thereby avoiding the need for endotracheal intubation.

  6. Changed adipocytokine concentrations in colorectal tumor patients and morbidly obese patients compared to healthy controls

    Directory of Open Access Journals (Sweden)

    Hillenbrand Andreas

    2012-11-01

    Full Text Available Abstract Background Obesity has been associated with increased incidence of colorectal cancer. Adipose tissue dysfunction accompanied with alterations in the release of adipocytokines has been proposed to contribute to cancer pathogenesis and progression. The aim of this study was to analyze plasma concentrations of several adipose tissue expressed hormones in colorectal cancer patients (CRC and morbidly obese (MO patients and to compare these concentrations to clinicopathological parameters. Methods Plasma concentrations of adiponectin, resistin, leptin, active plasminogen activator inhibitor (PAI-1, monocyte chemotactic protein (MCP-1, interleukin (IL-1 alpha, and tumor necrosis factor (TNF-alpha were determined in 67 patients operated on for CRC (31 rectal cancers, 36 colon cancers, 37 patients operated on for morbid obesity and 60 healthy blood donors (BD. Results Compared to BD, leptin concentrations were lowered in CRC patients whereas those of MO patients were elevated. Adiponectin concentrations were only lowered in MO patients. Concentrations of MCP-1, PAI-1, and IL-1 alpha were elevated in both CRC and MO patients, while resistin and TNF-alpha were similarly expressed in MO and CRC patients compared to BD. Resistin concentrations positively correlated with tumor staging (p Conclusions The results suggest that both MO and CRC have low-grade inflammation as part of their etiology.

  7. Determinants of noninvasive ventilation success or failure in morbidly obese patients in acute respiratory failure.

    Science.gov (United States)

    Lemyze, Malcolm; Taufour, Pauline; Duhamel, Alain; Temime, Johanna; Nigeon, Olivier; Vangrunderbeeck, Nicolas; Barrailler, Stéphanie; Gasan, Gaëlle; Pepy, Florent; Thevenin, Didier; Mallat, Jihad

    2014-01-01

    Acute respiratory failure (ARF) is a common life-threatening complication in morbidly obese patients with obesity hypoventilation syndrome (OHS). We aimed to identify the determinants of noninvasive ventilation (NIV) success or failure for this indication. We prospectively included 76 consecutive patients with BMI>40 kg/m2 diagnosed with OHS and treated by NIV for ARF in a 15-bed ICU of a tertiary hospital. NIV failed to reverse ARF in only 13 patients. Factors associated with NIV failure included pneumonia (n = 12/13, 92% vs n = 9/63, 14%; psuccessful response to NIV was idiopathic decompensation of OHS (n = 30, 48% vs n = 0, 0%; p = 0.001). In the NIV success group (n = 63), 33 patients (53%) experienced a delayed response to NIV (with persistent hypercapnic acidosis during the first 6 hours). Multiple organ failure and pneumonia were the main factors associated with NIV failure and death in morbidly obese patients in hypoxemic ARF. On the opposite, NIV was constantly successful and could be safely pushed further in case of severe hypercapnic acute respiratory decompensation of OHS.

  8. Changed adipocytokine concentrations in colorectal tumor patients and morbidly obese patients compared to healthy controls

    International Nuclear Information System (INIS)

    Hillenbrand, Andreas; Fassler, Juliane; Huber, Nadine; Xu, Pengfei; Henne-Bruns, Doris; Templin, Markus; Schrezenmeier, Hubert; Wolf, Anna Maria; Knippschild, Uwe

    2012-01-01

    Obesity has been associated with increased incidence of colorectal cancer. Adipose tissue dysfunction accompanied with alterations in the release of adipocytokines has been proposed to contribute to cancer pathogenesis and progression. The aim of this study was to analyze plasma concentrations of several adipose tissue expressed hormones in colorectal cancer patients (CRC) and morbidly obese (MO) patients and to compare these concentrations to clinicopathological parameters. Plasma concentrations of adiponectin, resistin, leptin, active plasminogen activator inhibitor (PAI)-1, monocyte chemotactic protein (MCP)-1, interleukin (IL)-1 alpha, and tumor necrosis factor (TNF)-alpha were determined in 67 patients operated on for CRC (31 rectal cancers, 36 colon cancers), 37 patients operated on for morbid obesity and 60 healthy blood donors (BD). Compared to BD, leptin concentrations were lowered in CRC patients whereas those of MO patients were elevated. Adiponectin concentrations were only lowered in MO patients. Concentrations of MCP-1, PAI-1, and IL-1 alpha were elevated in both CRC and MO patients, while resistin and TNF-alpha were similarly expressed in MO and CRC patients compared to BD. Resistin concentrations positively correlated with tumor staging (p<0.002) and grading (p=0.015) of rectal tumor patients. The results suggest that both MO and CRC have low-grade inflammation as part of their etiology

  9. Systemic Inflammation and Lung Function Impairment in Morbidly Obese Subjects with the Metabolic Syndrome

    Directory of Open Access Journals (Sweden)

    Astrid van Huisstede

    2013-01-01

    Full Text Available Background. Obesity and asthma are associated. There is a relationship between lung function impairment and the metabolic syndrome. Whether this relationship also exists in the morbidly obese patients is still unknown. Hypothesis. Low-grade systemic inflammation associated with the metabolic syndrome causes inflammation in the lungs and, hence, lung function impairment. Methods. This is cross-sectional study of morbidly obese patients undergoing preoperative screening for bariatric surgery. Metabolic syndrome was assessed according to the revised NCEP-ATP III criteria. Results. A total of 452 patients were included. Patients with the metabolic syndrome (n=293 had significantly higher blood monocyte (mean 5.3 versus 4.9, P=0.044 and eosinophil percentages (median 1.0 versus 0.8, P=0.002, while the total leukocyte count did not differ between the groups. The FEV1/FVC ratio was significantly lower in patients with the metabolic syndrome (76.7% versus 78.2%, P=0.032. Blood eosinophils were associated with FEV1/FVC ratio (adj. B −0.113, P=0.018. Conclusion. Although the difference in FEV1/FVC ratio between the groups is relatively small, in this cross-sectional study, and its clinical relevance may be limited, these data indicate that the presence of the metabolic syndrome may influence lung function impairment, through the induction of relative eosinophilia.

  10. Function of endothelium at adolescents with constitutional exogenous obesity before and after rehabilitation

    OpenAIRE

    Miroshnichenko, O.

    2011-01-01

    Function of endothelium at 43 adolescents with constitutional exogenous obesity before rehabilitation and at 33 healthy adolescents has been studied. Disorder of endothelial function has been established in 32 (74.4%) adolescents with constitutional exogenous obesity and in 7 (21.2%) healthy adolescents. We showed the efficiency of the rehabilitation program on restoration of endothelial function at adolescents with constitutional exogenous obesity.

  11. Associations between persistent organic pollutants and metabolic syndrome in morbidly obese individuals.

    Science.gov (United States)

    Dusanov, S; Ruzzin, J; Kiviranta, H; Klemsdal, T O; Retterstøl, L; Rantakokko, P; Airaksinen, R; Djurovic, S; Tonstad, S

    2018-03-13

    Persons with "metabolically healthy" obesity may develop cardiometabolic complications at a lower rate than equally obese persons with evident metabolic syndrome. Even morbidly obese individuals vary in risk profile. Persistent organic pollutants (POPs) are widespread environmental chemicals that impair metabolic homeostasis. We explored whether prevalence of metabolic syndrome in morbidly obese individuals is associated with serum concentrations of POPs. A cross-sectional study among 161 men and 270 women with BMI >35 kg/m 2 and comorbidity, or >40 kg/m 2 . Circulating concentrations of 15 POPs were stratified by number of metabolic syndrome components. In multiple logistic regression analysis odds ratios between top quartile POPs and metabolic risk factors versus POPs below the top quartile were calculated adjusting for age, gender, body mass index, smoking status, alcohol consumption and cholesterol concentrations. Age-adjusted concentrations of trans-nonachlor and dioxin-like and non-dioxin-like polychlorinated biphenyls (PCBs) increased with number of metabolic syndrome components in both genders (p metabolic syndrome as were dioxin-like and non-dioxin-like PCBs (OR 2.3 [95% CI 1.3-4.0]; OR 2.5 [95% CI 1.3-4.8] and 2.0 [95% CI 1.1-3.8], respectively). Organochlorine pesticides were associated with HDL cholesterol and glucose (OR = 2.0 [95% CI = 1.1-3.4]; 2.4 [95% CI = 1.4-4.0], respectively). Dioxin-like PCBs were associated with diastolic blood pressure, glucose and homeostatic model assessment-insulin resistance index (OR = 2.0 [95% CI = 1.1-3.6], 2.1 [95% CI = 1.2-3.6] and 2.1 [95% CI = 1.0-4.3], respectively). In subjects with morbid obesity, metabolic syndrome was related to circulating levels of organochlorine pesticides and PCBs suggesting that these compounds aggravate clinically relevant complications of obesity. Copyright © 2018 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian

  12. Role of macrophage migration inhibitory factor in obesity, insulin resistance, type 2 diabetes, and associated hepatic co-morbidities

    NARCIS (Netherlands)

    Morrison, M.C.; Kleemann, Robert

    2015-01-01

    Obesity is associated with a chronic low-grade inflammatory state that drives the -development of obesity-related co-morbidities such as insulin resistance/type 2 diabetes, non-alcoholic fatty liver disease (NAFLD), and cardiovascular disease. This metabolic inflammation is thought to originate

  13. The lived experiences of being physically active when morbidly obese: A qualitative systematic review.

    Science.gov (United States)

    Toft, Bente Skovsby; Uhrenfeldt, Lisbeth

    2015-01-01

    The aim is to identify facilitators and barriers for physical activity (PA) experienced by morbidly obese adults in the Western world. Inactivity and a sedentary lifestyle have become a major challenge for health and well-being, particularly among persons with morbid obesity. Lifestyle changes may lead to long-term changes in activity level, if facilitators and barriers are approached in a holistic way by professionals. To develop lifestyle interventions, the perspective and experiences of this group of patients are essential for success. The methodology of the systematic review followed the seven-step procedure of the Joanna Briggs Institute and was published in a protocol. Six databases were searched using keywords and index terms. Manual searches were performed in reference lists and in cited citations up until March 2015. The selected studies underwent quality appraisal in the Joanna Briggs-Qualitative Assessment and Review Instrument. Data from primary studies were extracted and were subjected to a hermeneutic text interpretation and a data-driven coding in a five-step procedure focusing on meaning and constant targeted comparison through which they were categorized and subjected into a meta-synthesis. Eight papers were included for the systematic review, representing the experiences of PA among 212 participants. One main theme developed from the meta-data analysis: "Identity" with the three subthemes: "considering weight," "being able to," and "belonging with others." The theme and subthemes were merged into a meta-synthesis: "Homecoming: a change in identity." The experiences of either suffering or well-being during PA affected the identity of adults with morbid obesity either by challenging or motivating them. A change in identity may be needed to feel a sense of "homecoming" when active.

  14. The lived experiences of being physically active when morbidly obese: A qualitative systematic review

    Directory of Open Access Journals (Sweden)

    Bente Skovsby Toft

    2015-09-01

    Full Text Available The aim is to identify facilitators and barriers for physical activity (PA experienced by morbidly obese adults in the Western world. Inactivity and a sedentary lifestyle have become a major challenge for health and well-being, particularly among persons with morbid obesity. Lifestyle changes may lead to long-term changes in activity level, if facilitators and barriers are approached in a holistic way by professionals. To develop lifestyle interventions, the perspective and experiences of this group of patients are essential for success. The methodology of the systematic review followed the seven-step procedure of the Joanna Briggs Institute and was published in a protocol. Six databases were searched using keywords and index terms. Manual searches were performed in reference lists and in cited citations up until March 2015. The selected studies underwent quality appraisal in the Joanna Briggs-Qualitative Assessment and Review Instrument. Data from primary studies were extracted and were subjected to a hermeneutic text interpretation and a data-driven coding in a five-step procedure focusing on meaning and constant targeted comparison through which they were categorized and subjected into a meta-synthesis. Eight papers were included for the systematic review, representing the experiences of PA among 212 participants. One main theme developed from the meta-data analysis: “Identity” with the three subthemes: “considering weight,” “being able to,” and “belonging with others.” The theme and subthemes were merged into a meta-synthesis: “Homecoming: a change in identity.” The experiences of either suffering or well-being during PA affected the identity of adults with morbid obesity either by challenging or motivating them. A change in identity may be needed to feel a sense of “homecoming” when active.

  15. Clinical experience with a C-section surgical technique in patients with morbid obesity: a case series

    Directory of Open Access Journals (Sweden)

    Mayra Elena Hernández Carrazco

    2014-07-01

    Full Text Available Obesity is a public health challenge that has crossed into the area of reproductive health. An obese pregnant woman has multiple complications before, during, and after pregnancy. Likewise, cesarean section is more difficult and has slower recovery times in this group of patients. This paper proposes a surgical technique adapted to the morbidly obese pregnant patient that aims to reduce cesarean section complications

  16. Lifestyle Practices and Obesity in Malaysian Adolescents

    Directory of Open Access Journals (Sweden)

    Pey Sze Teo

    2014-05-01

    Full Text Available Aim: To determine the influence of physical activity (PA and sedentary behavior (SB on obesity profiles of 454 Malaysian adolescents aged 12 to 19. Methods: Validated PA and SB questionnaires were used and body composition assessed using anthropometry and dual-energy X-ray absorptiometry (DXA. Results: Gender-specific multivariate analyses showed boys with high levels of total PA and moderate-to-vigorous physical activity (MVPA exhibited significantly lower levels of total body fat, percent body fat and android fat mass compared with low PA and MVPA groups, after adjusting for potential confounders. Girls with high SB levels showed significantly higher BMI, waist circumference and DXA-derived body fat indices than those at lower SB level. Multiple logistic analyses indicated that boys with low levels of total PA and MVPA had significantly greater obesity risk, 3.0 (OR 3.0; 95% CI, 1.1–8.1; p < 0.05 and 3.8-fold (OR 3.8; 95% CI, 1.4–10.1; p < 0.01, respectively, than more active boys. Only in girls with high SB level was there a significantly increased risk of obesity, 2.9 times higher than girls at low SP levels (OR 2.8; 95% CI, 1.0–7.5; p < 0.05.  Conclusions: The present findings indicate that higher PA duration and intensity reduced body fat and obesity risk while high screen-based sedentary behaviors significantly adversely influenced body fat mass, particularly amongst girls when the PA level was low.

  17. Prevalence of Ocular Morbidity Among School Adolescents of Gandhinagar District, Gujarat

    Directory of Open Access Journals (Sweden)

    Prakash Prajapati,

    2011-01-01

    Full Text Available Objective: To study the prevalence of ocular morbidity (abnormal condition and various factors affecting it among school attending adolescents. Methods: A cross-sectional study was conducted to study abnormal ocular conditions like refractive errors, vitamin A deficiency, conjunctivitis, trachoma, ocular trauma, blephritis, stye, color blindness and pterygium among school adolescents of 10-19 years age in rural and urban areas of Gandhinagar district from January to July, 2009. Systematic sampling was done to select 20 schools having 6th to 12th standard education including 12 schools from rural and 8 from urban areas. Six adolescents from each age year (10-19 were selected randomly to achieve sample size of 60 from each school. In total, 1206 adolescents including 691 boys and 515 girls were selected. Information was collected from selected adolescents by using proforma. Visual acuity was assessed using a Snellen’s chart and all participants underwent an ophthalmic examination carried out by a trained doctor. Results: Prevalence of ocular morbidity among school adolescents was reported 13% (7.8% in boys, 5.6% in girls; with 5.2% have moderate visual impairment. Refractive error was most common ocular morbidity (40% both among boys and girls. Almost 30% of boys and girls reported vitamin A deficiency in various forms of xerophthalmia. Prevalence of night blindness was 0.91% and of Bitot`s spot 1.74%. Various factors like, illiterate or lower parents’ education, lower socio-economic class and malnutrition were significantly associated with ocular morbidity. Conclusion: Ocular morbidity in adolescents is mainly due to refractive error, moderate visual impairment and xerophthalmia.

  18. Renal Tubular Acidosis after Jejunoileal Bypass for Morbid Obesity: role of secondary hyperparathyroidism

    DEFF Research Database (Denmark)

    Andersen, NN; Ladefoged, NN

    1991-01-01

    The effect of calcium infusion was studied in patients with renal tubular acidosis (RTA) and secondary hyperparathyroidism. Both developed after jejunoileal bypass operation (JIB) for morbid obesity. In three of four cases the acidification defect was abolished, probably due to a decrease of serum...... parathyroid hormone. As we found RTA in 9% (95% confidence limits 2-21%) of our patients, screening for acidosis is recommended in obesity patients after malabsorptive operations. RTA can be verified through an ammonium loading test. Before deciding on re-establishing bowel continuity due to RTA, we suggest...... and vitamin D supplementation. If RTA can be abolished through correction of calcium homeostasis, reoperation may be avoided. Before deciding on re-establishing bowel continuity in JIB patients with RTA, we therefore suggest that patients be evaluated for secondary hyperparathyroidism and any calcium...

  19. Dietary Protein in the Prevention of Diet-Induced Obesity and Co-Morbidities

    DEFF Research Database (Denmark)

    Tastesen, Hanne Sørup

    mice were fed obesity‐promoting diets with protein from different sources, in different forms and at different levels to evaluate the affect on development of obesity, glucose intolerance and dyslipidemia. Results: In the present study the dietary level of protein, 16 versus 32 percent energy from...... protein, was found to be negligible in development of obesity and co‐morbidities in mice. Seafood protein with high endogenous taurine and glycine contents was found to prevent diet‐induced adiposity and dyslipidemia, both in ad libitum and pair‐fed settings. The ability of seafood proteins to prevent...... that the source and form of protein has great impact on development and prevention of diet‐induced adiposity, dyslipidemia, hyperinsulinemia and impairment of glucose tolerance through modulations of voluntary locomotor activity, energy expenditure and energy substrate metabolism in mice...

  20. Robotic heller myotomy and Dor fundoplication for achalasia in a woman with morbid obesity.

    Science.gov (United States)

    Bedirli, Abdulkadir; Dogan, Ibrahim; Kozan, Ramazan

    2012-12-01

    Achalasia is a relatively rare condition with a prevalence estimated at less than 0.001 %. Laparoscopic or robotic Heller myotomy is an effective surgical treatment for achalasia. We present the first published case of a morbidly obese achalasia patient treated with robotic Heller myotomy and Dor fundoplication. The operative time was 175 min, with an estimated blood loss of 110 ml. The patient had a normal bowel transit on postoperative day 2, and he was discharged on postoperative day 4 on a liquid diet. A follow-up at 2 months showed significant resolved symptoms of achalasia.

  1. Development of obesity and polycystic ovary syndrome in adolescents

    DEFF Research Database (Denmark)

    Vilmann, Lea S; Thisted, Ebbe; Baker, Jennifer L

    2012-01-01

    Obesity in adolescents is prevalent worldwide. Polycystic ovary syndrome (PCOS) is often associated with obesity in women, and it has serious metabolic and reproductive health implications. Although PCOS does not become clinically visible until early adolescence, its origins are likely much earlier....... Therefore, we reviewed the recent literature regarding the mechanisms linking the development of PCOS and obesity in adolescent girls. We found that excess abdominal adipose tissue (AT) initiates metabolic and endocrine aberrations that are central in the progression of PCOS. As an example, abdominal...

  2. Gastric emptying studies in the morbidly obese before and after gastroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Christian, P.E.; Datz, F.L.; Moore, J.G.

    1986-11-01

    Dual isotope gastric emptying studies were performed on 16 morbidly obese patients before and after gastroplasty to determine the effect of this surgery on the rate of emptying. The solid and liquid phases of gastric emptying were compared with a normal control group. In the 900-g and 50-g meals there was a significant difference in the mean half emptying time between solid and liquid phases of emptying (p less than 0.05). Pre-operatively, the 900-g meal half emptying times of both solids and liquids and the 50-g liquid phase meal did not differ significantly between obese patients and the control group. However, in the solid phase of the 50-g meal obese patients differed significantly from a control group (p = 0.007). Three months after gastroplasty, gastric emptying of 50-g meals from the total stomach was not significantly changed from the pre-operative 50-g meal values in ten of 12 patients (p less than 0.05) and no change in total stomach emptying times were seen at 12 mo compared to the 3-mo study (p less than 0.05). Emptying of the pouch alone for both solids and liquids was significantly faster than the pre-operative and postoperative total stomach studies. Gastric emptying in the obese is normal with large meals, but is delayed in small meals. In most patients, gastroplasty does not result in slower emptying of meals.

  3. Work participation among the morbidly obese seeking bariatric surgery: an exploratory study from Norway.

    Science.gov (United States)

    Hernæs, Ulrikke J V; Andersen, John R; Norheim, Ole F; Våge, Villy

    2015-02-01

    The aim of this study is to assess the rate of work participation and disability pension, and identify predictors for sickness absence and disability pension, among morbidly obese individuals. The data were collected from the Obesity Surgery Registry at Førde Central Hospital and consists of patients undergoing bariatric surgery between April 2001 and February 2013. Multivariate logistic regression was performed to identify predictors of sickness absence and disability pension. The sample consisted of 576 patients (63.9 % females) with a mean (range, SD) age of 41.7 (18-66, 10.6) and a mean body mass index (BMI) of 47.7 (32.5-80.8, 7.7). Patients working full- or part-time comprised 55.6 % of the sample and 29.7 % received a disability pension; only 46.4 % of the sample received an income from paid work without additional benefits. Having a BMI above 50, lower levels of education, and suffering from four or more comorbidities were significant predictors of sickness absence. Female gender, psychiatric disorders, lower levels of education, asthma, heart failure and suffering from four or more comorbidities were significant predictors of disability pension. The proportion of the work participation and disability pension among this morbidly obese population is of substantial concern, as work participation has proven important for the health-related quality of life. This, combined with the fact that these patients are significantly less educated than the general population, can potentially have grave socioeconomic consequences. Increased knowledge of obesity development and the work history of these patients are needed to implement policies that ensure increased rates of work participation.

  4. 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...

  5. Attitudes of Jordanian Adolescent Students Toward Overweight and Obesity.

    Science.gov (United States)

    Abu Baker, Nesrin N; Al-Ali, Nahla; Al-Ajlouni, Ranyah

    2018-01-01

    Obesity is a serious public health problem especially among adolescents. Understanding adolescents' attitudes toward obesity and healthy lifestyle is a crucial step to develop effective health programs to treat and prevent obesity. To examine the attitudes toward overweight and obesity among Jordanian adolescent students and to identify the components of obesity prevention program that the students perceive as important. A sample of 1000 students in 8 th to 10 th grades was randomly selected from 16 schools in Irbid, Jordan. A self-reported questionnaire including attitude related questions was used in a descriptive, cross-sectional study. Generally, the students expressed positive attitudes toward obesity; which means that their attitudes were consistent with societal norms in terms of health and social functioning (mean= 3.5, SD=0.39). Furthermore, the students expressed positive attitudes toward lifestyle; which means that their attitudes were consistent with healthy behaviors (mean=3.7, SD=0.58). However, boys had significantly more positive attitudes than girls (p =0.04). The prevalence of overweight and obesity was 23.8%, while obese and non-obese students had similar attitudes toward lifestyle and obesity. Finally, around 20% to 30% of students desired a prevention program out of school time shared with their families and friends and involves eating healthy food and getting more exercise. More efforts are needed to build effective obesity prevention programs that focus on eating healthy diet and getting more exercise considering gender differences.

  6. Novel and emerging approaches to combat adolescent obesity

    Directory of Open Access Journals (Sweden)

    Manoj Sharma

    2010-02-01

    Full Text Available Manoj Sharma, Paul BranscumHealth Promotion and Education and Public Health Sciences, University of Cincinnati, Cincinnati, OH, USAAbstract: Overweight and obesity continue to be health concerns facing today’s adolescent population. Along with metabolic and physical problems associated with obesity, today’s obese adolescents also face many psychological issues such as high rates of depression, anxiety, and social discrimination. Obesity is commonly recognized as having many causes, such as genetic, lifestyle and environmental. There are four major modalities for management of overweight and obesity in adolescents: dietary management, increasing physical activity, pharmacological therapy, and bariatric surgery. The purpose of this study was to conduct a review of novel and emerging approaches for preventing and managing adolescent obesity. It was found that while not always the case, theory driven approaches are being better utilized in newer interventions especially by those directed toward prevention. New theories that are being used are the theories of reasoned action, planned behavior, intervention mapping, and social marketing. Schools are found to be the most common place for such interventions, which is appropriate since virtually all children attend some form of private or public school. Limitations found in many studies include the underuse of process evaluations, the low number of studies attempted, environmental or policy changes, and that not all studies used a similar control group for comparison.Keywords: adolescent overweight, adolescent obesity, interventions

  7. Obesity in adolescents with intellectual disability: Prevalence and associated characteristics.

    Science.gov (United States)

    Krause, Sharon; Ware, Robert; McPherson, Lyn; Lennox, Nicholas; O'Callaghan, Michael

    Studies from a number of countries have indicated an increased risk of obesity in adolescents with intellectual disability. Whether risk factors for adults with intellectual disability apply to adolescents however is uncertain. This study examines obesity in a community sample of adolescents with intellectual disability in Australia, and investigates risk factors associated with obesity and overweight. A cross-sectional survey and medical record review on 261 adolescents with intellectual disability attending special education facilities in South-East Queensland, Australia between January 2006 and September 2010 was conducted. Information on age, gender, weight, height, syndrome specific diagnoses, problematic behaviours, mobility, taking psychotropic or epileptic medication, and perceived household financial difficulties was collected. Body mass index (BMI) was calculated and participants categorised as normal/underweight, overweight or obese according to the International Obesity Taskforce definitions. Overall 22.5% (95% CI: 17.8-28.0%) of adolescents were obese, and 23.8% (95% CI: 19.0-29.4%) were overweight, a marked increase compared to Australian norms. Adolescents with Down syndrome were more likely to be obese than other participants (odds ratio=3.21; 95% CI: 1.41-7.30). No association was found with other risk factors examined. Prevalence of obesity and overweight were increased compared to general Australian adolescents. The only significant risk factor was the presence of Down syndrome. These findings reinforce the need for a health policy and practice response to obesity that is inclusive of individuals with intellectual disability. Copyright © 2015 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  8. Changes in weight and co-morbidities among adolescents undergoing bariatric surgery: 1-year results from the Bariatric Outcomes Longitudinal Database.

    Science.gov (United States)

    Messiah, Sarah E; Lopez-Mitnik, Gabriela; Winegar, Deborah; Sherif, Bintu; Arheart, Kristopher L; Reichard, Kirk W; Michalsky, Marc P; Lipshultz, Steven E; Miller, Tracie L; Livingstone, Alan S; de la Cruz-Muñoz, Nestor

    2013-01-01

    Bariatric surgery is 1 of the few effective treatments of morbid obesity. However, the weight loss and other health-related outcomes for this procedure in large, diverse adolescent patient populations have not been well characterized. Our objective was to analyze the prospective Bariatric Outcomes Longitudinal Database (BOLD) to determine the weight loss and health related outcomes in adolescents. The BOLD data are collected from 423 surgeons at 360 facilities in the United States. The main outcome measures included the anthropometric and co-morbidity status at baseline (n = 890) and at 3 (n = 786), 6 (n = 541), and 12 (n = 259) months after surgery. Adolescents (75% female; 68% non-Hispanic white, 14% Hispanic, 11% non-Hispanic black, and 6% other) aged 11 to 19 years were included in the present analyses. The overall 1-year mean weight loss for those who underwent gastric bypass surgery was more than twice that of those who underwent adjustable gastric band surgery (48.6 versus 20 kg, P surgery types (P surgery. A total of 45 readmissions occurred among gastric bypass patients and 10 among adjustable gastric band patients, with 29 and 8 reoperations required, respectively. The weight loss at 3, 6, and 12 months after surgery is approximately double in adolescent males and females who underwent gastric bypass surgery versus those who underwent adjustable gastric band surgery. Bariatric surgery can safely and substantially reduce weight and related co-morbidities in morbidly obese adolescents for ≥1 year. Copyright © 2013 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  9. Does morbid obesity negatively affect the hospital course of patients undergoing treatment of closed, lower-extremity diaphyseal long-bone fractures?

    Science.gov (United States)

    Baldwin, Keith D; Matuszewski, Paul E; Namdari, Surena; Esterhai, John L; Mehta, Samir

    2011-01-03

    Obesity is prevalent in the developed world and is associated with significant costs to the health care system. The effect of morbid obesity in patients operatively treated for long-bone fractures of the lower extremity is largely unknown. The National Trauma Data Bank was accessed to determine if morbidly obese patients (body mass index >40) with lower extremity fractures have longer length of hospital stay, higher cost, greater rehabilitation admission rates, and more complications than nonobese patients. We identified patients with operatively treated diaphyseal femur (6920) and tibia (5190) fractures. Polytrauma patients and patients younger than 16 years were excluded. Morbidly obese patients were identified by ICD-9 and database comorbidity designation (femur, 131 morbidly obese; tibia, 75 morbidly obese). Patients meeting these criteria who were not morbidly obese were used as controls. Sensitivity analyses were performed to analyze patients with isolated trauma to the tibia or femur. Morbidly obese patients were more likely to be admitted to a subacute facility. Length of stay trended higher in morbidly obese patients. There was no significant relationship between obesity and inpatient mortality or inpatient complications. These trends held true when considering patients with multiple injuries and patients who had isolated long-bone injuries. Our study showed that morbidly obese patients may have greater rehabilitation needs following long-bone fractures in the lower extremity. Our study showed no difference in mortality or complications, although further studies are needed to confirm these findings. Copyright 2011, SLACK Incorporated.

  10. Effect of sugammadex on coagulation as detected by rotational thromboelastometry in morbidly obese patients.

    Science.gov (United States)

    Carron, Michele; Bertini, Diana; Prandini, Tancredi; Fanton, Francesca; Foletto, Mirto; Ori, Carlo; Perissinotto, Egle; Simioni, Paolo

    2018-02-01

    Sugammadex, which is used to reverse rocuronium-induced neuromuscular blockade, has a limited and transient effect on activated partial thromboplastin time and prothrombin time. However, no data are available on the effects of sugammadex on coagulation in morbidly obese patients, as assessed by rotational thromboelastometry (ROTEM®). Sixty patients received sugammadex 2 mg/kg or 4 mg/kg to reverse moderate or deep rocuronium-induced neuromuscular blockade (N.=30/group) at the end of surgery under desflurane anesthesia. Arterial blood samples were collected before and 3 min and 30 min after sugammadex administration for ROTEM® analysis, including measurements of clotting time (CT), clot formation time, α angle, and maximum clot firmness in INTEM, EXTEM, and FIBTEM assays. Major and minor bleeding events were also monitored during the postoperative period. Sugammadex 2 and 4 mg/kg has a limited and transient (sugammadex dose (500 mg) on the INTEM CT (P=0.002). A regression analysis showed a positive relationship between sugammadex dose and INTEM CT value at 3 min after administration (coefficient = 0.052 s; 95% CI: 0.005-0.098 s; P=0.03). No major or minor bleeding events were observed in either group during the postoperative period. Sugammadex produces a slight effect on coagulation in morbidly obese patients, without increasing the risk for postoperative bleeding.

  11. Measurement of subcutaneous adipose tissue blood flow in the morbidly obese using a laser Doppler velocimeter

    Science.gov (United States)

    Klassen, Gerald A.; Paton, Barry E.; Maksym, Geoff; Janigan, David; Perey, Bernard

    1992-08-01

    Using a laser Doppler velocimeter (LDV) subcutaneous adipose tissue blood flow (AF) was recorded in the upright and supine positions in the upper and lower abdomen in 22 morbidly obese patients before gastroplasty. Age was 42 +/- 3 (mean +/- SEM), weight 135 +/- 7 kg, and body mass index (BMI) 51 +/- 3. Adipose flow expressed as mV was: supine, upper abdomen 647 +/- 23, lower abdomen 604 +/- 24; upright, upper abdomen 621 +/- 27, lower abdomen 607 +/- 29. AF was significantly more in the upper than lower abdomen (supine position) and AF was significantly lower in the lower abdomen upright than the upper abdomen supine. Regression analysis of age indicates that blood flow decreases in the lower abdomen so that in the supine position the difference between upper and lower abdomen AF increases. Similar analysis of BMI did not indicate significant trends. These data indicate that with morbid obesity there is lower tissue blood flow to the lower abdomen. This may explain why such patients may develop areas of painful ischemic necrosis in the dependent region of their anterior abdominal pannus.

  12. Are we prepared for a growing population? Morbid obesity and its implications in Irish emergency departments.

    LENUS (Irish Health Repository)

    2012-01-31

    Two percent of the Irish population is morbidly obese with this figure expected to rise significantly. This survey aimed to establish the present logistical capacity of Irish emergency departments (EDs) to adequately cater for the bariatric patients. A telephone survey was carried out of 37 health service executive EDs over a 5-day period in October 2008. Questions were posed to the departmental lead nurse regarding facilities (Supplemental digital content 1). No ED had adequate facilities. Two of 37 units questioned had on-site hoists designed to lift patients of more than 170 kg. Four departments had rapid access to mattresses within the hospital and three of these four had access to beds and trolleys for weighing patients. Two percent of the Irish population is morbidly obese with this figure expected to rise significantly to more than 150 kg. One department had access to commodes, chairs, wheelchairs and trolleys from inpatient services. All departments had extra-wide blood pressure cuffs and 12 had a difficult airways trolley. Necessary infrastructure and equipment for bariatric patients is deficient in the majority of Irish EDs.

  13. Health-Related Fitness Improvements in Morbid Obese Patients After Laparoscopic Sleeve Gastrectomy: a Cohort Study.

    Science.gov (United States)

    Gallart-Aragón, Tania; Fernández-Lao, Carolina; Castro-Martín, Eduardo; Cantarero-Villanueva, Irene; Cózar-Ibáñez, Antonio; Arroyo-Morales, Manuel

    2017-05-01

    Laparoscopic sleeve gastrectomy (LSG) has demonstrated high long-term effectiveness and major advantages over other techniques. The objective of this study was to analyze changes in physical fitness parameters in morbidly obese patients during 6 months after LSG. We conducted a descriptive observational study with 6-month follow-up in 72 LSG patients, evaluating changes in body mass index (BMI), functional capacity (6-min walking test), hand grip strength (manual dynamometry), flexibility (fingertip-to-floor test), balance (Flamingo test), physical activity level (International Physical Activity Questionnaire, IPAQ), and perception of general physical fitness (International Fitness Scale [IFIS] questionnaire). The ANOVA revealed significant improvements in BMI, functional capacity, flexibility, balance, and physical activity level (P fitness in most cases. No significant changes were found in dominant hand (P = 0.676) or non-dominant hand (P = 0.222) dynamometry. General physical fitness was positively correlated with BMI and distance in the 6-min test, and was negatively correlated with fingertip-to-floor distance. Morbidly obese patients showed major improvements at 6 months after LSG in functional capacity, balance, mobility, and physical activity, with no change in grip strength. These improvements were related to a better self-perception of general physical fitness.

  14. Hepatic chemerin mRNA in morbidly obese patients with nonalcoholic fatty liver disease.

    Science.gov (United States)

    Kajor, Maciej; Kukla, Michał; Waluga, Marek; Liszka, Łukasz; Dyaczyński, Michał; Kowalski, Grzegorz; Żądło, Dominika; Berdowska, Agnieszka; Chapuła, Mateusz; Kostrząb-Zdebel, Anna; Bułdak, Rafał J; Sawczyn, Tomasz; Hartleb, Marek

    The aim of this study was to investigate hepatic chemerin mRNA, serum chemerin concentration, and immunohistochemical staining for chemerin and and chemokine receptor-like 1 (CMKLR1) in hepatic tissue in 56 morbidly obese women with nonalcoholic fatty liver disease (NAFLD) and to search for a relationship with metabolic and histopathological features. Chemerin mRNA was assessed by quantitative real-time PCR, chemerin, and CMKLR1 immunohistochemical expression with specific antibodies, while serum chemerin concentration was assessed with commercially available enzyme-linked immunosorbent assays. Serum chemerin concentration reached 874.1 ±234.6 ng/ml. There was no difference in serum chemerin levels between patients with BMI steatosis, and definite nonalcoholic steatohepatitis (NASH). Liver chemerin mRNA was observed in all included patients and was markedly, but insignificantly, higher in those with BMI ≥ 40 kg/m2, hepatocyte ballooning, greater extent of steatosis, and definite NASH. Hepatic chemerin mRNA might be a predictor of hepatic steatosis, hepatocyte ballooning, and NAFLD activity score (NAS) but seemed not to be a primary driver regulating liver necroinflammatory activity and fibrosis. The lack of association between serum chemerin and hepatic chemerin mRNA may suggest that adipose tissue but not the liver is the main source of chemerin in morbidly obese women.

  15. Bariatric surgery in morbidly obese patients improves the atherogenic qualitative properties of the plasma lipoproteins.

    Science.gov (United States)

    Julve, Josep; Pardina, Eva; Pérez-Cuéllar, Montserrat; Ferrer, Roser; Rossell, Joana; Baena-Fustegueras, Juan Antonio; Fort, José Manuel; Lecube, Albert; Blanco-Vaca, Francisco; Sánchez-Quesada, José Luis; Peinado-Onsurbe, Julia

    2014-05-01

    The purpose of this study was to evaluate the effect of weight loss induced in morbidly obese subjects by Roux-en-Y gastric bypass bariatric surgery on the atherogenic features of their plasma lipoproteins. Twenty-one morbidly obese subjects undergoing bariatric surgery were followed up for up to 1 year after surgery. Plasma and lipoproteins were assayed for chemical composition and lipoprotein-associated phospholipase A2 (Lp-PLA2) activity. Lipoprotein size was assessed by non-denaturing polyacrylamide gradient gel electrophoresis, and oxidised LDL by ELISA. Liver samples were assayed for mRNA abundance of oxidative markers. Lipid profile analysis revealed a reduction in the plasma concentrations of cholesterol and triglycerides, which were mainly associated with a significant reduction in the plasma concentration of circulating apoB-containing lipoproteins rather than with changes in their relative chemical composition. All patients displayed a pattern A phenotype of LDL subfractions and a relative increase in the antiatherogenic plasma HDL-2 subfraction (>2-fold; P lipoprotein-bound Lp-PLA2. Our data indicate that the weight loss induced by bariatric surgery ameliorates the atherogenicity of plasma lipoproteins by reducing the apoB-containing Lp-PLA2 activity and oxidised LDL, as well as increasing the HDL-2 subfraction. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Acanthosis nigricans in obese adolescents: prevalence, impact, and management challenges

    Directory of Open Access Journals (Sweden)

    Ng HY

    2016-12-01

    Full Text Available Hak Yung Ng Department of Paediatrics and Adolescent Medicine, Tseung Kwan O Hospital, Tseung Kwan O, Hong Kong, China Abstract: Obesity in adolescence is a public health priority because it usually tracks into adulthood, resulting in enormous medical and social costs. This underscores the importance of early identification and intervention. Acanthosis nigricans (AN was once considered a rare paraneoplastic dermatosis, but is now frequently observed in obese adolescents. Current understanding suggests that it is associated with insulin resistance and has a unique role in secondary prevention. The purpose of this narrative review is to provide a comprehensive overview of AN in obese adolescents, covering its history, current knowledge on the condition, its clinical significance, management challenges, and the direction of future research. Keywords: Differential diagnosis, screening, insulin resistance, type 2 diabetes mellitus, metabolically healthy obesity, behavioral weight management, pharmacotherapy, bariatric surgery

  17. The influence of high versus low sodium intake on blood pressure and haemodynamics in patients with morbid obesity

    DEFF Research Database (Denmark)

    Bonfils, Peter K; Taskiran, Mustafa; Damgaard, Morten

    2013-01-01

    fluid compartments and haemodynamic responses (at rest and during exercise) after 5 days of a low-sodium diet (90 mmol/day) and 5 days of a high-sodium diet (250 mmol/day) in 12 morbidly obese, hypertensive patients; 12 morbidly obese, normotensive patients and 12 nonobese controls. RESULTS: High sodium......BACKGROUND: Many patients with morbid obesity (BMI > 40 kg/m) have hypertension. The complex pathophysiological abnormalities linking hypertension to obesity have not been fully clarified, but abnormal sodium handling could be an important mechanism. METHOD: Therefore, we examined changes in body...... intake as compared to low sodium intake was associated with an increase in plasma volume (obese, hypertensive patients: 5 ± 4%; obese, normotensive patients: 10 ± 11%; nonobese controls: 7 ± 6%), cardiac output (CO) (obese, hypertensive patients: 17 ± 12%; obese, normotensive patients: 20 ± 16%; nonobese...

  18. Lifestyle factors and co-morbidities associated with obesity and overweight in Nkonkobe Municipality of the Eastern Cape, South Africa.

    Science.gov (United States)

    Otang-Mbeng, Wilfred; Otunola, Gloria Aderonke; Afolayan, Anthony Jide

    2017-05-25

    Obesity is a global epidemic that affects 500 million people worldwide and is predicted to increase to one billion people by 2030. The prevalence of obesity is increasing across populations in South Africa. However, questions still remain surrounding the predisposing factors and obesity-related health problems especially in the rural areas. This study evaluated several lifestyle factors such as dietary habits, physical activity, smoking, alcohol intake, co-morbidities and their association with the prevalence of obesity and overweight in Nkonkobe Municipality of the Eastern Cape. A cross-sectional, population-based survey was conducted among 118 residents in four rural/sub-urban townships of the study area. Measurements including weight, height, body mass index (BMI), physical activity and dietary habits were determined using a validated questionnaire. The overall prevalence of obesity and overweight was 38 and 19%, respectively. The highest prevalence of obesity (70%) was observed among those who do not undertake any physical activity. Close to half (48.48%) of the respondents who eat fast foods always were obese, and 30.30% were overweight; when combined, the prevalence for obesity is 78.78%. A negative association with obesity was observed among regular smokers (26.92%) and consumers of alcohol (4.00%). Arthritis, hypertension and tuberculosis were co-morbidities significantly (P fast and fried foods, low fruit and vegetable consumption as well as arthritis, hypertension and tuberculosis were significant risk factors of obesity in Nkonkobe Municipality.

  19. Changes in gallbladder bile composition and crystal detection time in morbidly obese subjects after bariatric surgery.

    Science.gov (United States)

    Gustafsson, Ulf; Benthin, Lisbet; Granström, Lars; Groen, Albert K; Sahlin, Staffan; Einarsson, Curt

    2005-06-01

    The aim of the present study was to elucidate the mechanisms of development of cholesterol crystals and gallstones during weight reduction in obese subjects. Twenty-five morbidly obese, gallstone-free subjects underwent vertical-banded gastroplasty. Gallbladder bile was collected at the time of the operation via needle aspiration and 1.1-7.3 months after the operation via ultrasound-guided transhepatic puncture of the gallbladder. The mean weight loss was 17 kg. Two patients developed gallstones and 10 patients displayed cholesterol crystals in their bile. In patients with a follow-up time of less than 2 months (n = 13), cholesterol saturation increased from 90% to 114% but tended to decrease in the patients with a follow-up time of more than 2 months. The extraction of the concanavalin-A-binding fraction from gallbladder bile obtained after weight reduction in 7 patients prolonged crystallization detection time from 6 to 10 days. The hexosamine concentration, a marker for mucin, was increased by about 100% in bile obtained in 6 of 7 patients after weight reduction. In conclusion, the results indicate that crystallization-promoting compounds (mucin) are of great importance in the development of cholesterol crystals and gallstones in obese subjects during weight reduction, probably because of defective gallbladder emptying.

  20. Quality of life and sleep in obese adolescents

    Directory of Open Access Journals (Sweden)

    Giovina Turco

    Full Text Available Obesity and sleep disorders in adolescence are strongly associated, and they impact both on the health and on quality of life (QL in this age group. OBJECTIVE: To comparatively assess QL and sleep in obese and eutrophic adolescents, who are older than ten years of age. METHODS: Cross-sectional study including obese adolescents. This analysis was carried out between August 2009 and August 2010. The Control (eutrophic Group comprised schoolchildren recruited from State schools in the city of Americana, in São Paulo State, Brazil. Instruments applied included a standardized questionnaire, the Sleep Behavior Questionnaire (SBQ, and the Pediatric QL Inventory (PedsQL TM 4.0. RESULTS: The obese adolescents had poorer QL on physical (p<0.001, emotional (p=0.03, and social (p=0.002 functioning domains. A difference in mean psychosocial functioning was found between the groups (p=0.009 with obese subjects having a mean score of 69.5 (±16.0 and in eutrophic individuals of 76.2 (±16.7. A greater number of sleep problems was evident in the Obese Group (p=0.03. Conclusions: The obese adolescents had an impaired QL and a higher frequency of sleep problems compared to the eutrophic subjects.

  1. Prevalence of overall and central obesity among adolescent girls in ...

    African Journals Online (AJOL)

    2016-06-02

    Jun 2, 2016 ... overall obesity determination was obtained between ... adolescents based on age and sex. Obesity ... general characteristics was obtained by a self- adminis- ... percentile for age and sex, 17WHR>0.80 or WHtR ≥. 0.50.18.

  2. Prevalence of overall and central obesity among adolescent girls in ...

    African Journals Online (AJOL)

    There is no universally accepted criterion for classification of overall weight status and central obesity in adolescents. Several criteria have been used which include that recommended by Centre for Disease control, World Health Organization and the International Obesity Task Force. Aim: The study compared various ...

  3. The Impact of Obesity on Developmental Coordination Disorder in Adolescence

    Science.gov (United States)

    Wagner, Matthias Oliver; Kastner, Julia; Petermann, Franz; Jekauc, Darko; Worth, Annette; Bos, Klaus

    2011-01-01

    Developmental coordination disorder (DCD) as well as overweight and obesity are of increasing importance in the study of human development. Data on the relation between DCD and obesity in adolescence are of particular interest because both phenomena are unlikely to disappear with age. The objective of this study was to determine the impact of…

  4. Obesity in adolescents with celiac disease: two adolescents and two different presentations.

    Science.gov (United States)

    Balamtekin, Necati; Demir, Hülya; Baysoy, Gökhan; Uslu, Nuray; Yüce, Aysel

    2011-01-01

    Celiac disease (CD) usually presents with diarrhea and growth retardation in childhood. Obesity is one of the paradoxical conditions in children with CD. We present two adolescents with CD and obesity. One of these patients was diagnosed as CD with malnutrition. His body weight had returned to normal after a gluten-free diet, and after stopping the diet, he had become obese. The second patient was an obese adolescent presenting with dyspeptic symptoms who was diagnosed as CD. Although rare, pediatricians should remember that obesity might be seen in CD before or after the diagnosis.

  5. Quality of life in morbid obesity Calidad de vida en la obesidad mórbida

    Directory of Open Access Journals (Sweden)

    I. Poves Prim

    2005-03-01

    Full Text Available Introduction: morbid obesity (MO is a chronic disease that is reaching epidemic proportions and becoming an increasing health problem in developed countries. Obesity-related comorbidities reduce both the quality and expectancy of life. Objectives: to validate the GIQLI (Gastrointestinal Quality of Life Index test as a reliable and effective tool for the evaluation of quality of life in morbidly obese patients. Patients and methods: the GIQLI test is made up of 36 individually scored items, the addition of which give up a final score. A higher score correlates with a better quality of life. Items can be separated into five groups or dimensions: digestive symptoms, emotional status, effects of treatment, and physical as well as social dysfunction. The GIQLI test was administered to a randomized sample of 1990 morbidly obese patients who fulfilled the indication criteria for bariatric surgery, and to a control group of 100 healthy individuals with no known medical, functional or psychiatric disease. Overall test and specific dimension scores were evaluated for each group. Results: overall test and specific dimension scores were significantly lower in patients with MO when compared to the control group. The overall GIQLI score decreased as age increased, as did the number of associated comorbidities. Conclusions: the GIQLI test proved to be a rather useful tool to evaluate quality of life in morbidly obese patients. These patients present a poorer quality of life not only because of the presence of digestive symptoms but also because of their emotional, physical, and social status.Introducción: la obesidad mórbida (OM es una enfermedad crónica que alcanza dimensiones epidémicas en los países desarrollados. La OM suele acompañarse de enfermedades graves asociadas que provocan una menor expectativa y peor calidad de vida. Objetivos: validar el cuestionario GIQLI (Gastrointestinal Quality of Life Index como herramienta fiable y eficaz en la

  6. Attitudes of Jordanian Adolescent Students Toward Overweight and Obesity

    Science.gov (United States)

    Abu Baker, Nesrin N.; Al-Ali, Nahla; Al-Ajlouni, Ranyah

    2018-01-01

    Background: Obesity is a serious public health problem especially among adolescents. Understanding adolescents’ attitudes toward obesity and healthy lifestyle is a crucial step to develop effective health programs to treat and prevent obesity. Objectives: To examine the attitudes toward overweight and obesity among Jordanian adolescent students and to identify the components of obesity prevention program that the students perceive as important. Methods: A sample of 1000 students in 8th to 10th grades was randomly selected from 16 schools in Irbid, Jordan. A self-reported questionnaire including attitude related questions was used in a descriptive, cross-sectional study. Results: Generally, the students expressed positive attitudes toward obesity; which means that their attitudes were consistent with societal norms in terms of health and social functioning (mean= 3.5, SD=0.39). Furthermore, the students expressed positive attitudes toward lifestyle; which means that their attitudes were consistent with healthy behaviors (mean=3.7, SD=0.58). However, boys had significantly more positive attitudes than girls (p=0.04). The prevalence of overweight and obesity was 23.8%, while obese and non-obese students had similar attitudes toward lifestyle and obesity. Finally, around 20% to 30% of students desired a prevention program out of school time shared with their families and friends and involves eating healthy food and getting more exercise. Conclusion: More efforts are needed to build effective obesity prevention programs that focus on eating healthy diet and getting more exercise considering gender differences. PMID:29456780

  7. Monitoring and management of hypertension with obesity in adolescents

    Directory of Open Access Journals (Sweden)

    Falkner B

    2017-11-01

    Full Text Available Bonita Falkner Department of Medicine and Pediatrics, Thomas Jefferson University, Philadelphia, PA, USA Abstract: Largely due to the childhood obesity epidemic, there has been an increase in the prevalence of hypertension in children and adolescents. Obesity associated hypertension is the most common hypertension phenotype among adolescents. Approximately 30% of obese adolescents have elevated blood pressure (BP or hypertension. Updated definitions of elevated BP and hypertension in adolescents are now similar to definitions of BP status in adults. For adolescents ≥13 years of age, elevated BP is 120 to 129/<80 mm Hg. Hypertension, stage 1, is ≥130 to 139/80 to 89 mm Hg, and hypertension, stage 2, is ≥140/90 mm Hg. BP measurements over separate clinic visits are necessary to verify the diagnosis of elevated BP or hypertension. Ambulatory BP monitoring, when available, provides confirmatory data on BP status. Causal mechanisms for obesity associated hypertension include increased sympathetic nervous system activity, increased renal sodium retention secondary to insulin resistance/hyperinsulinemia, and obesity mediated inflammation. The primary treatment for obesity associated hypertension is weight reduction with lifestyle changes in diet and physical activity. Although difficult to achieve, even modest weight reduction can be beneficial. The diet should be rich in fruits, vegetables, fiber, and low-fat dairy with reduction in salt intake. When lifestyle changes are insufficient to achieve BP control, pharmacologic therapy is indicated to achieve a goal BP of <130/80 mm Hg or <90th percentile, whichever is lower. Regular BP monitoring is necessary for ongoing management of obesity associated hypertension in adolescents. Keywords: adolescents, obesity, blood pressure, hypertension

  8. Sugar-Sweetened Beverages and Obesity among Children and Adolescents

    DEFF Research Database (Denmark)

    Keller, Amélie; Bucher Della Torre, Sophie

    2015-01-01

    BACKGROUND: The prevalence of overweight and obesity among children and adolescents has increased worldwide and has reached alarming proportions. Currently, sugar-sweetened beverages (SSBs) are the primary source of added sugar in the diet of children and adolescents. Contradictive findings from...

  9. Energetic adaptations persist after bariatric surgery in severely obese adolescents

    Science.gov (United States)

    Energetic adaptations induced by bariatric surgery have not been studied in adolescents or for extended periods postsurgery. Energetic, metabolic, and neuroendocrine responses to Roux-en-Y gastric bypass (RYGB) surgery were investigated in extremely obese adolescents. At baseline and at 1.5, 6, and...

  10. Metabolic Profiles in Obese Children and Adolescents with Insulin Resistance

    Directory of Open Access Journals (Sweden)

    Marko Kostovski

    2018-03-01

    CONCLUSION: Higher percentage of insulin-resistant participants was of female gender and was adolescents. In general, insulin resistant obese children and adolescents tend to have a worse metabolic profile in comparison to individuals without insulin resistance. It is of note that the highest insulin resistance was also linked with the highest concentrations of triglycerides.

  11. 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…

  12. Psychological assessment of children and adolescents with obesity.

    Science.gov (United States)

    Pan, Liya; Li, Xiaxi; Feng, Yi; Hong, Li

    2018-01-01

    Objective This study aimed to analyse the psychological conditions and behaviour of a group of Chinese children and adolescents with obesity, and to develop an intervention for these young patients. Methods A group of 72 patients aged from 4 to 15 years were recruited from an obesity clinic. Patients, or the parents of children younger than 12 years, filled out a series of self-report questionnaires, and the responses were recorded and analysed. Results The 72 children and adolescents with obesity had a mean age of 9.14 ± 2.18 years. The body mass index-z scores of children with obesity showed a significant positive correlation with the level of impulsive behaviour, motivational impulses, and cognitive instability (inattention). Children with obesity quickly responded with extreme emotions, and these responses were positively correlated with the degree of obesity (slight, intermediate, or severe obesity). Conclusion Children and adolescents being treated for obesity have many underlying psychological problems, including emotional instability and impulsivity, and are prone to extreme emotional-psychological problems. These difficulties are positively correlated with the degree of obesity. Therefore, clinical treatment of these problems requires not only use of medication, improved nutrition, and healthy exercise, but also addressing underlying psychologic problems.

  13. Effect of Morbid Obesity on Midurethral Sling Efficacy for the Management of Stress Urinary Incontinence.

    Science.gov (United States)

    Elshatanoufy, Solafa; Matthews, Alexandra; Yousif, Mairy; Jamil, Marcus; Gutta, Sravanthi; Gill, Harmanjit; Galvin, Shelley L; Luck, Ali M

    2018-05-04

    The aim of our study was to assess midurethral sling (MUS) failure rate in the morbidly obese (body mass index [BMI] ≥40 kg/m) population as compared with normal-weight individuals. Our secondary objective was to assess the difference in complication rates. This is a retrospective cohort study. We included all patients who underwent a synthetic MUS procedure from January 1, 2008, to December 31, 2015, in our health system. Failure was defined as reported stress urinary incontinence symptoms or treatment for stress urinary incontinence. Variables collected were BMI; smoking status; comorbidities; perioperative (≤24 hours), short-term (≤30 days), and long-term (>30 days) complications; and follow-up time. Statistics include analysis of variance, χ test, logistic regression, Kaplan-Meier method, and Cox regression. There were 431 patients included in our analysis. Forty-nine patients were in class 3 with a BMI mean of 44.9 ± 5.07 kg/m. Median follow-up time was 52 months (range, 6-119 months). Class 3 obesity (BMI ≥40 kg/m) was the only group that had an increased risk of failure when compared with the normal-weight group (P = 0.03; odds ratio, 2.47; 95% confidence interval, 1.09-5.59). Obesity was not a significant predictor of perioperative, short-term, or long-term postoperative complications (P = 0.19, P = 0.28, and P = 0.089, respectively) after controlling for other comorbidities. Patients in the class 3 obesity group who are treated with an MUS are 2 times as likely to fail when compared with those in the normal-weight category on long-term follow-up with similar low complication rates.

  14. Functional abdominal pain syndrome in morbidly obese patients following laparoscopic gastric bypass surgery.

    Science.gov (United States)

    Eidy, Mohammad; Pazouki, Abdolreza; Raygan, Fahimeh; Ariyazand, Yazdan; Pishgahroudsari, Mohadeseh; Jesmi, Fatemeh

    2014-03-01

    Roux-en-Y gastric bypass surgery (RYGBP) is one of the most common bariatric surgeries, which is being performed using various techniques like gastrojejunostomy by hand swen, linear or circular stapler. Abdominal pain is a common complaint following laparoscopic gastric bypass procedure (LGBP), which has different aetiologies, such as overeating, adhesion, internal herniation, bile reflux and many more. In this study LGBP was performed in an ante-colic ante-gastric pattern in a double loop manner and the prevalence and distribution of pain in morbidly obese patients undergoing LGBP was assessed. The aim of this study was to analyze the distribution and frequency of post LGBP pain in morbidly obese patients. This study was performed on 190 morbidly obese patients referred to Hazrat Rasoul Hospital in Tehran. After LGBP, pain was measured in the following intervals: 24 hours, one week and one month after the operation. Before the operation onset, 2 mg Keflin and 5000 IU subcutaneous heparin were administered as prophylaxis. LGBP was performed using five ports including: one 11 mm port was placed 15-20 cm far from the xiphoid, one 12-mm port in mid-clavicular line at the level of camera port, one 5-mm port in subcostal area in ante-axillary region in the left, another 5-mm port in the right mid-clavicular area and a 5-mm port in sub-xyphoid. All operations were done by the same team. Staple was used for all anastomoses and hand sewn technique to close the staple insertion site. The mesenteric defect was left open and no effort was made to repair it. The results of this study showed that 99.94 % of the patients had complains of pain in the first 24 hours of post operation, about 60% after one week and 29.5 % still had pain after one month. In addition, left upper quadrant (LUQ) was found to be the most prevalent site for the pain in 53.7% of the patients in the first 24 hours, 59.6% after one week and 16.8% after one month (except for obscure pain) with a significance

  15. Optical Coherence Tomography Parameters in Morbidly Obese Patients Who Underwent Laparoscopic Sleeve Gastrectomy

    Directory of Open Access Journals (Sweden)

    Berna Dogan

    2016-01-01

    Full Text Available Purpose. To investigate changes in optical coherence tomography parameters in morbidly obese patients who had undergone laparoscopic sleeve gastrectomy (LSG. Methods. A total of 41 eyes of 41 morbidly obese patients (BMI ≥ 40 who had undergone LSG were included in study. The topographic optic disc parameters, central macular thickness (CMT, total macular volume (TMV, and retinal ganglion cell layer (RGCL were measured by spectral-domain optical coherence tomography (SD-OCT. Subfoveal choroidal thickness (SFCT was measured by enhanced deep imaging-optical coherence tomography (EDI-OCT. Results. The mean CMT was 237.4±24.5 μm, 239.3±24.1 μm, and 240.4±24.5 μm preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p<0.01. The mean TMV was 9.88±0.52 mm3, 9.96±0.56 mm3, and 9.99±0.56 mm3 preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p<0.01. The mean RGCL was 81.2±6.5 μm, 82.7±6.6 μm, and 82.9±6.5 μm preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p<0.01. The mean SFCT was 309.8±71.8 μm, 331.0±81.4 μm, and 352.7±81.4 μm preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p<0.01. No statistically significant differences were found between the preoperative values and 3- and 6-month postoperative values in rim area (p=0.34, disc area (p=0.64, vertical cup/disc ratio (p=0.39, cup volume (p=0.08, or retinal nerve fiber layer (p=0.90. Conclusions. Morbidly obese patients who undergo LSG experience a statistically significant increase in CMT, TMV, SFCT, and RGCL at 3 months and 6 months after surgery.

  16. 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

  17. The obesity epidemic and disordered sleep during childhood and adolescence.

    Science.gov (United States)

    Gozal, David; Kheirandish-Gozal, Leila

    2010-12-01

    The obesity pandemic is claiming its presence even among youngest of children and is clearly on the rise. Although the extent and implications of this massive increase in the prevalence of overweight and obese children are unclear, they are anticipated to be deleterious to global health outcomes and life expectancy. The potential interrelationships between sleep and obesity have gained recent attention. In this chapter, we initially examine the critical evidence supporting or refuting such proposed associations. In addition, the potential reciprocal roles of obesity and obstructive sleep apnea in the facilitation of their pathophysiology are also reviewed, along with their amplificatory effects on their respective morbidities.

  18. Increased Circulating Levels of Alpha-Ketoglutarate in Morbidly Obese Women with Non-Alcoholic Fatty Liver Disease.

    Directory of Open Access Journals (Sweden)

    Gemma Aragonès

    Full Text Available Non-alcoholic fatty liver disease (NAFLD causes a wide spectrum of liver damage, ranging from simple steatosis to cirrhosis. However, simple steatosis (SS and steatohepatitis (NASH cannot yet be distinguished by clinical or laboratory features. The aim of this study was to assess the relationship between alpha-ketoglutarate and the degrees of NAFLD in morbidly obese patients.We used a gas chromatography-quadruple time-of-flight-mass spectrometry analysis to quantify alpha-ketoglutarate in serum from normal-weight subjects (n = 30 and morbidly obese women (n = 97 with or without NAFLD.We found that serum levels of alpha-ketoglutarate were significantly higher in morbidly obese women than in normal-weight women. We showed that circulating levels of alpha-ketoglutarate were lower in lean controls and morbidly obese patients without NAFLD. We also found that alpha-ketoglutarate serum levels were higher in both SS and NASH than in normal liver of morbidly obese patients. However, there was no difference between SS and NASH. Moreover, we observed that circulating levels of alpha-ketoglutarate were associated with glucose metabolism parameters, lipid profile, hepatic enzymes and steatosis degree. In addition, diagnostic performance of alpha-ketoglutarate has been analyzed in NAFLD patients. The AUROC curves from patients with liver steatosis exhibited an acceptable clinical utility. Finally, we showed that the combination of biomarkers (AST, ALT and alpha-ketoglutarate had the highest accuracy in diagnosing liver steatosis.These findings suggest that alpha-ketoglutarate can determine the presence of non-alcoholic fatty liver in morbidly obese patients but it is not valid a biomarker for NASH.

  19. Plasma concentrations of retinol in obese children and adolescents: relationship to metabolic syndrome components

    Directory of Open Access Journals (Sweden)

    Marcia Teske

    2014-03-01

    Full Text Available Objective: To evaluate obese children and adolescents' retinol plasma levels and to correlate them with metabolic syndrome components. Methods: Cross-sectional study with 61 obese children and adolescents (body mass index Z score - ZBMI>+2. Pubertal development, arterial blood pressure, body weight and height for nutritional classification and waist circumference were obtained. A 15mL blood sample was collected (after a 12-hour fasting in a low luminosity room for retinol determination (cut-off inadequate if <30µg/dL, lipid profile (HDL-c, LDL-c, and triglycerides, oral glucose tolerance test (fasting and 120 minutes and for high sensitivity C-reactive protein. Spearman correlation and multiple linear regression were used in the statistical analysis. Results: Mean age was 10.7±2.7 years. There was a predominance of male gender 38/61 (62% and pre-pubertal 35/61 (57% subjects. The average plasmatic retinol was 48.5±18.6ug/dL. Retinol deficiency and severe obesity were observed in 6/61 (10% and 36/61 (59%, respectively. Glucose level at 120 minutes was the independent and predictive variable of plasma retinol levels [β=-0.286 (95%CI -0.013 - -0.001]. Conclusions: An independent and inverse association between plasma retinol levels and glucose tolerance was observed, suggesting an important contribution of this vitamin in the morbidities associated to obesity in children and adolescents.

  20. Relationship between obesity and biochemical markers in Brazilian adolescents

    Directory of Open Access Journals (Sweden)

    Alexandre Romero

    2014-03-01

    The aim of this study was to describe the prevalence of biochemical markers and associate with obesity in Brazilian adolescents enrolled in public schools in a rural area. The sample consisted of 199 adolescents between 10 to 14 years old from Piracicaba, Brazil. The obesity was measured by body mass index (BMI and according to the World Health Organization curves. We collected blood for biochemical markers analysis (total cholesterol, high density lipoprotein, low density lipoprotein, triacylglycerol, insulin and glycemia. Mann Whitney test was used to compare continuous variables between sexes. Chi-square test was used to compare proportions. To investigate the association between the independent variables and biochemical markers a multiple logistic regression model was performed. Among 199 adolescents, 23.1% was obese and 65.8% were insufficiently active. A high prevalence of dyslipidemia (71.4% was observed, whereas the low levels of high density lipoprotein (40.7% were the most prevalent. An association between obesity and undesirable values for high density lipoprotein, triacylglycerol and insulin resistance was found. Obese adolescents were less likely to present a desirable value for high density lipoprotein. It is understood that obesity is detrimental to metabolic profile and should be prevented and treated even in adolescence.

  1. Subclinical atherosclerosis in obese adolescents with normal left ventricular function.

    Science.gov (United States)

    Abdel-Wahab, Amina M; Atwa, Hoda A; El-Eraky, Azza Z; El-Aziz, Mohamed A

    2011-09-01

    To assess the impact of obesity on carotid intima media thickness and left ventricular (LV) mass in obese adolescents. The study included 52 obese adolescents (mean age 14.16+/-2.64 years) and 52 healthy adolescents who served as a control group (mean age 12+/-2.3 years), who were attended the outpatient clinic at Suez Canal University Hospital, Ismailia, Egypt. The study population was submitted for medical history, clinical examination, laboratory investigations (fasting blood sugar and lipid profile), and echocardiographic examination of LV mass and dimensions. Assessment of carotid intima-media thickness was carried out by using carotid duplex. All children had normal LV function. Obese adolescents had a significant increase in total cholesterol, triglyceride, LDL-C, and low HDL-C compared to the control group. Also, there was a significant increase in blood pressure, carotid intima media thickness, LV mass, and LV mass index. There was a significant correlation between BMI and dyslipidemia, blood pressure, carotid intima/media thickness, LV mass, and posterior wall thickness. Carotid intima-media thickness had a significant correlation with increased LDL-C and low HDL-C, blood pressure, LV mass, and posterior wall thickness. Obesity in childhood and adolescents is associated with subclinical atherosclerosis. Although obese children had no LV dysfunction, yet there are LV structure changes.

  2. Use of intubating laryngeal mask airway in a morbidly obese patient with chest trauma in an emergency setting

    Directory of Open Access Journals (Sweden)

    Tripat Bindra

    2011-01-01

    Full Text Available A morbidly obese male who sustained blunt trauma chest with bilateral pneumothorax was referred to the intensive care unit for management of his condition. Problems encountered in managing the patient were gradually increasing hypoxemia (chest trauma with multiple rib fractures with lung contusions and difficult mask ventilation and intubation (morbid obesity, heavy jaw, short and thick neck. We performed awake endotracheal intubation using an intubating laryngeal mask airway (ILMA size 4 and provided mechanical ventilation to the patient. This report suggests that ILMA can be very useful in the management of difficult airway outside the operating room and can help in preventing adverse events in an emergency setting.

  3. Combined Oocyte Retrieval and Robot-assisted Hysterectomy in a Super Morbidly Obese Patient with Endometrial Carcinoma.

    Science.gov (United States)

    Chung, Esther H; Brady, Paula C; Smith, Kimberly Keefe; Davis, Michelle R; Muto, Michael G; Ashby, Rachel K; Ginsburg, Elizabeth S

    2018-03-01

    To report on the unique, innovative management of a super morbidly obese patient presenting for fertility preservation in the setting of Grade 2 endometrioid endometrial adenocarcinoma. A back-to-back oocyte retrieval and robot-assisted total laparoscopic hysterectomy (RA-TLH) with bilateral salpingo-oophorectomy (BSO) was performed in a 37-year-old nulligravid woman with super morbid obesity (BMI 63 kg/m 2 ) with endometrial cancer. the successful retrieval of oocytes for fertility preservation and oncologic intervention via RA-TLH with BSO in the same operative and anesthetic episode. This combined procedure strategy was successful in our case and is a feasible option for similar high-risk patients in the future. Identifying safe and effective approaches for oocyte retrieval in morbidly obese patients represents a pressing need as obesity rates rise among reproductive-aged women. Back-to-back oocyte retrieval and RA-TLH with BSO are not only feasible, but could also decrease significant anesthetic risks for morbidly obese patients. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  4. Gendered dimensions of obesity in childhood and adolescence

    Directory of Open Access Journals (Sweden)

    Sweeting Helen N

    2008-01-01

    Full Text Available Abstract Background The literature on childhood and adolescent obesity is vast. In addition to producing a general overview, this paper aims to highlight gender differences or similarities, an area which has tended not to be the principal focus of this literature. Methods Databases were searched using the terms 'obesity' and 'child', 'adolescent', 'teenager', 'youth', 'young people', 'sex', 'gender', 'masculine', 'feminine', 'male', 'female', 'boy' and 'girl' (or variations on these terms. In order to limit the potential literature, the main focus is on other reviews, both general and relating to specific aspects of obesity. Results The findings of genetic studies are similar for males and females, and differences in obesity rates as defined by body mass index are generally small and inconsistent. However, differences between males and females due to biology are evident in the patterning of body fat, the fat levels at which health risks become apparent, levels of resting energy expenditure and energy requirements, ability to engage in certain physical activities and the consequences of obesity for the female reproductive system. Differences due to society or culture include food choices and dietary concerns, overall physical activity levels, body satisfaction and the long-term psychosocial consequences of childhood and adolescent obesity. Conclusion This review suggests differences between males and females in exposure and vulnerability to obesogenic environments, the consequences of child and adolescent obesity, and responses to interventions for the condition. A clearer focus on gender differences is required among both researchers and policy makers within this field.

  5. Gendered dimensions of obesity in childhood and adolescence.

    Science.gov (United States)

    Sweeting, Helen N

    2008-01-14

    The literature on childhood and adolescent obesity is vast. In addition to producing a general overview, this paper aims to highlight gender differences or similarities, an area which has tended not to be the principal focus of this literature. Databases were searched using the terms 'obesity' and 'child', 'adolescent', 'teenager', 'youth', 'young people', 'sex', 'gender', 'masculine', 'feminine', 'male', 'female', 'boy' and 'girl' (or variations on these terms). In order to limit the potential literature, the main focus is on other reviews, both general and relating to specific aspects of obesity. The findings of genetic studies are similar for males and females, and differences in obesity rates as defined by body mass index are generally small and inconsistent. However, differences between males and females due to biology are evident in the patterning of body fat, the fat levels at which health risks become apparent, levels of resting energy expenditure and energy requirements, ability to engage in certain physical activities and the consequences of obesity for the female reproductive system. Differences due to society or culture include food choices and dietary concerns, overall physical activity levels, body satisfaction and the long-term psychosocial consequences of childhood and adolescent obesity. This review suggests differences between males and females in exposure and vulnerability to obesogenic environments, the consequences of child and adolescent obesity, and responses to interventions for the condition. A clearer focus on gender differences is required among both researchers and policy makers within this field.

  6. A Comparison of the Bariatric Procedures that Are Performed in the Treatment of Super Morbid Obesity.

    Science.gov (United States)

    Uno, Kohei; Seki, Yosuke; Kasama, Kazunori; Wakamatsu, Kotaro; Umezawa, Akiko; Yanaga, Katsuhiko; Kurokawa, Yoshimochi

    2017-10-01

    We have experienced numerous cases of super morbid obesity (SMO), defined by a BMI of ≥50 kg/m 2 , in which laparoscopic sleeve gastrectomy (LSG) was not able to achieve a sufficient weight loss effect. However, the most appropriate procedure for the treatment of SMO has not yet been established. The subjects included 248 successive patients who underwent surgery at our hospital from June 2006 to December 2012. We divided the subjects into an SMO group (BMI, 50 to <70 kg/m 2 ) and a morbid obesity (MO) group (BMI, 35 to <50 kg/m 2 ). The subjects underwent LSG, LSG with duodenojejunal bypass (LSG/DJB), or laparoscopic Roux-en-Y gastric bypass (LRYGB). The weight loss effects, safety of surgery, and metabolic profile changes were compared. Sixty-two subjects were classified into the SMO group (25%). The percent excess weight loss (%EWL) after LSG among the patients in the SMO group was not significantly different from that of patients who underwent other procedures. LSG was associated with a significantly lower success rate in terms of weight loss (%EWL ≥ 50%), in comparison to the weight loss at 1 year after LRYGB and at 2 years after LSG/DJB and LRYGB. Among the patients in the MO group, the %EWL and the rate of successful weight loss did not differ to a statistically significant extent. This study demonstrated that in patients with SMO, LSG/DJB and LRYGB can achieve superior weight loss effects in comparison to LSG.

  7. Laparoscopic sleeve gastrectomy for morbid obesity with natural orifice specimen extraction (NOSE).

    Science.gov (United States)

    Gunkova, P; Gunka, I; Zonca, P; Dostalik, J; Ihnat, P

    2015-01-01

    An experience with laparoscopic sleeve gastrectomy using the natural orifice specimen extraction (NOSE) technique. Bariatric surgery is nowadays the only long term effective obesity treatment method. Twenty one consecutive patients underwent laparoscopic sleeve gastrectomy with the use of natural orifice specimen extraction (NOSE) in the Surgical Clinic of Faculty Hospital Ostrava between May 2012 and August 2012. Inclusion criteria were the body mass index (BMI) higher than 35 kg/m2 or higher than 32 kg/m2 accompanied with relevant comorbidities. Among 21 patients in this series, there were three men (14.3%) and 18 women (85.7%). Their mean age was 40.9±10.2 years. Their mean preoperative BMI was 40.4±4.6 kg/m2. No patient had previous bariatric surgery, one patient had laparoscopic fundoplication. All operations were completed laparoscopically with no conversions to an open procedure. In two cases, laparoscopic cholecystectomy was performed and the gallbladder was extracted along with the gastric specimen by transgastric approach. Laparoscopic sleeve gastrectomy is a safe and effective bariatric procedure with low morbidity and mortality. Based on our initial experiences it could be an indication for NOSE with transgastric approach. Obese patients would benefit from this approach due to the elimination of wound complications (Tab. 2, Fig. 3, Ref. 22).

  8. Neuropsychological function in individuals with morbid obesity: a cross-sectional study.

    Science.gov (United States)

    Sargénius, Hanna L; Lydersen, Stian; Hestad, Knut

    2017-01-01

    Previous research has shown cognitive dysfunction to be present in a significant number of individuals with obesity. The objective of this study was to assess the neuropsychological profile of morbidly obese patients referred to weight-loss treatment. An extensive battery of neuropsychological tests with well-known normative data covering various cognitive domains was administered to 96 patients. The test results were transformed to z-scores for comparisons with normative data. As a means of determining level of cognitive impairment within the group, deficit scores were applied. Group comparisons on the different cognitive domains were conducted between patients with depressive symptoms and patients reporting no such symptoms. As illustrated in mean z-scores, the patients demonstrated lower performance compared to normative data on visual memory (mean -.26, CI -.43 to -.09, p  = .003), speed of information processing (mean -.22, CI -.34 to -.09, p  = .001), executive functions (mean -.28, CI -.40 to -.16, p  ability, motor function, and working memory. The deficit scores, however, revealed working memory and motor function to be significantly impaired within the group as well. Patients with depressive symptoms differed from patients without such symptoms on visual memory (mean .43, CI .07 to .80, p  = .021). Some characteristic cognitive weaknesses and strengths were evident at the group level, although pronounced variation was observed. Deficits in executive functions, information processing, and attention should be taken into consideration in clinical practice.

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

    Science.gov (United States)

    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.

  10. Impact of Bariatric Surgery on Heme Oxygenase-1, Inflammation, and Insulin Resistance in Morbid Obesity with Obstructive Sleep Apnea.

    Science.gov (United States)

    Tirado, Raquel; Masdeu, Maria José; Vigil, Laura; Rigla, Mercedes; Luna, Alexis; Rebasa, Pere; Pareja, Rocío; Hurtado, Marta; Caixàs, Assumpta

    2017-09-01

    Morbid obesity and obstructive sleep apnea (OSA) interact at an inflammatory level. Bariatric surgery reduces inflammatory responses associated with obesity. Heme oxygenase-1 (HO-1) is an enzyme with anti-inflammatory properties, which might be increased in morbid obesity or OSA. We studied morbidly obese patients with OSA to determine: (a) HO-1 plasma concentrations according to OSA severity and their relationship with insulin resistance and inflammation and (b) the impact of bariatric surgery on HO-1 and parameters of insulin resistance and inflammation. We analyzed the homeostasis model insulin resistance index (HOMA) and plasma concentrations of HO-1, tumor necrosis factor alpha, interleukin-6, interleukin-1-beta, C reactive protein (CRP), and adiponectin according to polysomnography findings in 66 morbidly obese patients before bariatric surgery and 12 months after surgery. Before surgery, HO-1 plasma concentrations were similar in three groups of patients with mild, moderate, and severe OSA, and correlated with HOMA (r = 0.27, p = 0.02). Twelve months after surgery, low-grade inflammation and insulin resistance had decreased in all the groups, but HO-1 plasma concentration had decreased only in the severe OSA group (p = 0.02). In this group, the reduction in HO-1 correlated with a reduction in CRP concentrations (r = 0.43, p = 0.04) and with improved HOMA score (r = 0.37, p = 0.03). Bariatric surgery decreases HO-1 concentrations in morbid obesity with severe OSA, and this decrease is associated with decreases in insulin resistance and in inflammation.

  11. Clinical Study of Obesity and associated morbidities in patients admitted to College of Medical Sciences Teaching-Hospital, Bharatpur

    Directory of Open Access Journals (Sweden)

    Manohar Pradhan

    2015-12-01

    Full Text Available Background and Objectives: The present study was conducted with objective to study the incidence of obesity and associated co-morbidities in patients admitted to CMS-TH, Bharatpur.Materials and Methods: One hundred and fifty consecutive overweight patients from the January 2009 to December 2012 with Basal metabolic index (BMI>25 and obese patients (BMI>30 were included in this hospital based prospective study. Detailed evaluation of risk factors and family history of other diseases were taken, other obesity related indicators like WPRO, 2000 for BMI, waist circumference (NCEP ATP III and NCEP for South Asian ethnicity NCEP– National Cholesterol Education Program and waist hip ratio (WHO criteria were measured and comparison done in order to detect best method for application. These cases were evaluated for associated co-morbid condition and metabolic syndrome which were diagnosed using NCEP ATP III criteria.Results: The mean age of patients was 52.7 years. Commonest co-existing risk factors were alcohol consumption, smoking, hypertension and type 2 diabetes mellitus. Evaluation based on WHO criteria revealed that 56.7% patients were overweight, 38.7 % were obese class II and 4.6 % were class II. While 45.1% male and 69.1% female patients had central obesity. The figure was 81.7 % for males and 94.1% for females with WHO criteria using waist hip ratio. Risk factors like alcohol consumption (52.7%, smoking (52.7% and fatty liver disease (22.66% were the commonest co-morbid conditions.Conclusion: In the present study, risk factors of alcohol, smoking and hypertension and co-morbid conditions diabetes mellitus, dyslipidemia, ischemic heart disease, stroke and fatty liver were noted. Waist hip ratio was the best indicator to detect central obesity and co-morbid conditions and recommended to be used for Nepali population.JCMS Nepal. 2015;11(3:16-19

  12. Novel and emerging approaches to combat adolescent obesity.

    Science.gov (United States)

    Sharma, Manoj; Branscum, Paul

    2010-01-01

    Overweight and obesity continue to be health concerns facing today's adolescent population. Along with metabolic and physical problems associated with obesity, today's obese adolescents also face many psychological issues such as high rates of depression, anxiety, and social discrimination. Obesity is commonly recognized as having many causes, such as genetic, lifestyle and environmental. There are four major modalities for management of overweight and obesity in adolescents: dietary management, increasing physical activity, pharmacological therapy, and bariatric surgery. The purpose of this study was to conduct a review of novel and emerging approaches for preventing and managing adolescent obesity. It was found that while not always the case, theory driven approaches are being better utilized in newer interventions especially by those directed toward prevention. New theories that are being used are the theories of reasoned action, planned behavior, intervention mapping, and social marketing. Schools are found to be the most common place for such interventions, which is appropriate since virtually all children attend some form of private or public school. Limitations found in many studies include the underuse of process evaluations, the low number of studies attempted, environmental or policy changes, and that not all studies used a similar control group for comparison.

  13. Descriptive epidemiology of metabolic syndrome among obese adolescent population.

    Science.gov (United States)

    Mahbuba, Sharmin; Mohsin, Fauzia; Rahat, Farhana; Nahar, Jebun; Begum, Tahmina; Nahar, Nazmun

    2018-05-01

    The study was done to assess the magnitude of problems of metabolic syndrome among obese adolescents. It was a cross-sectional study done from January 2013 to June 2014 in paediatric endocrine outpatient department in BIRDEM General Hospital, Dhaka, Bangladesh. Total 172 adolescents having exogenous obesity aged 10-18 years were included. Impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and type 2 diabetes mellitus (DM) were defined as per WHO criteria.The adolescents having Body Mass Index (BMI) ≥95th centile were classified as obese.Waist circumference was measured at the level midway between the lower rib margin & the iliac crest, at the level of umbilicus with the person breathing out gently in centimeter. Hip circumference was measured at the maximum width over the buttocks at the level of the greater trochanters in centimeter. Among 172 obese adolescents, metabolic syndrome was found in 66 patients (38.4%). The commonest metabolic abnormality among those having metabolic syndrome was low HDL level (77.3%) followed by high triglyceride level(71.2%). Glucose intolerance (IFG and/or IGT) was found in 16.7%, Type 2 DM in 10.6%, systolic hypertension in 10.7% and diastolic hypertension in 12.1%. Triglyceride (p = 0.042) and Cholesterol level (p = 0.016) were significantly higher and HDL-cholesterol level (p = 0.000) was significantly lower among obese adolescents having metabolic syndrome. Less physical activity (p = 0.04) was significantly related to the development of metabolic syndrome. On logistic regression analysis male sex, family history of obesity and low HDL-cholesterol correlated to metabolic syndrome. The High rate of metabolic syndrome among obese adolescents is alarming. Copyright © 2018 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  14. Obesity and Hypertension among School-going Adolescents in Peru.

    Science.gov (United States)

    Nam, Eun Woo; Sharma, Bimala; Kim, Ha Yun; Paja, Doris Jackeline Vasquez; Yoon, Young Min; Lee, Sun Ha; Kim, Eun Hwan; Oh, Chung Hyeon; Kim, Yun Seop; Song, Chang Hoon; Kim, Jong Koo

    2015-09-01

    Adolescent obesity and hypertension are global public health issues. The burden of adolescent obesity and hypertension in Peru is unclear. The aim of this study was to determine the prevalence of obesity and hypertension and their relationship among school-attending adolescents and to assess the need for health-promoting school programs in the study area. A cross-sectional school-based survey was conducted in a randomly selected sample of 952 secondary school adolescents from 11 schools in Lima or Callao, Peru, in 2014. Weight, height, and blood pressure (BP) were measured and categorized. Obesity was defined as ≥ 95(th) percentile in body mass index (BMI) for age and sex. Hypertension was defined as average systolic blood pressure and/or diastolic blood pressure ≥95(th) percentile in BP for sex, age, and height. Chi-square test and univariate logistic regressions were used at a 5% significance level to determine the relationship between BMI and BP category. The mean age of subjects was 14.6 years; 46.4% were boys and 53.6% were girls. The prevalence of overweight and obesity was 20.2% and 9.5% overall, 17.4% and 11.1% for boys, and 22.5% and 8.0% for girls, respectively. The prevalence of hypertension was 26.7% overall, 34.8% for boys, and 19.6% for girls. In both sexes, BMI was strongly associated with BP (p Overweight and obesity are strongly associated with BP status among adolescents. Health-promoting school programs may reduce the burdens of obesity and hypertension among school-going adolescents.

  15. Weight loss after bariatric surgery reverses insulin-induced increases in brain glucose metabolism of the morbidly obese.

    Science.gov (United States)

    Tuulari, Jetro J; Karlsson, Henry K; Hirvonen, Jussi; Hannukainen, Jarna C; Bucci, Marco; Helmiö, Mika; Ovaska, Jari; Soinio, Minna; Salminen, Paulina; Savisto, Nina; Nummenmaa, Lauri; Nuutila, Pirjo

    2013-08-01

    Obesity and insulin resistance are associated with altered brain glucose metabolism. Here, we studied brain glucose metabolism in 22 morbidly obese patients before and 6 months after bariatric surgery. Seven healthy subjects served as control subjects. Brain glucose metabolism was measured twice per imaging session: with and without insulin stimulation (hyperinsulinemic-euglycemic clamp) using [18F]fluorodeoxyglucose scanning. We found that during fasting, brain glucose metabolism was not different between groups. However, the hyperinsulinemic clamp increased brain glucose metabolism in a widespread manner in the obese but not control subjects, and brain glucose metabolism was significantly higher during clamp in obese than in control subjects. After follow-up, 6 months postoperatively, the increase in glucose metabolism was no longer observed, and this attenuation was coupled with improved peripheral insulin sensitivity after weight loss. We conclude that obesity is associated with increased insulin-stimulated glucose metabolism in the brain and that this abnormality can be reversed by bariatric surgery.

  16. Is overweight/obesity a risk factor for periodontitis in young adults and adolescents?: a systematic review.

    Science.gov (United States)

    Khan, S; Barrington, G; Bettiol, S; Barnett, T; Crocombe, L

    2018-01-19

    Obesity in young adults and adolescents is associated with chronic co-morbidities. This project investigated whether being overweight or obese is a risk factor for periodontitis in adolescents (13-17 years) and young adults (18-34 years). A search of 12 databases was conducted using Medical Subject Headings/Index and Emtree terms. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, articles published between 2003 and 2016 were screened that reported periodontal and anthropometric measures. The Newcastle-Ottawa Scale was used to appraise the quality of studies. Of 25 eligible studies from 12 countries, 17 showed an association between obesity and periodontitis (odds ratios ranged from 1.1 to 4.5). The obesity indicators of body mass index, waist circumference, waist-hip ratio and body fat percentage were significantly associated with measures of periodontitis of bleeding on probing, plaque index, probing depths, clinical attachment loss, calculus, oral hygiene index and community periodontal index. Two prospective cohort studies in the review showed no significant association between obesity and periodontitis, but these studies had limitations of study design and used inappropriate epidemiological diagnostic measures of periodontitis. There was evidence to suggest that obesity is associated with periodontitis in adolescents and young adults. Systematic Review Registration: PROSPERO Registration Number: CRD42016046507. © 2018 World Obesity Federation.

  17. Bariatric surgery in obese adolescents: opportunities and challenges.

    Science.gov (United States)

    Wasserman, Halley; Inge, Thomas H

    2014-09-01

    Extreme obesity is defined by the Centers for Disease Control and Prevention as a body mass index (BMI) higher than 120% of the 95th percentile for age. Four to six percent of American youths fall into this subcategory and are at increased risk for developing comorbidities, including hypertension, dyslipidemia, nonalcoholic fatty liver disease, insulin resistance, sleep apnea, and bone and joint problems. Many studies have shown that nonsurgical treatment programs do not provide significant long-term improvements in BMI in adolescents with severe obesity. In adults, bariatric (weight loss) surgery has been shown to dramatically reduce BMI and to reverse or prevent many complications of obesity; thus, bariatric surgery is being used in an attempt to reverse clinically severe obesity in adolescents. This review highlights the indications for bariatric surgery in adolescents and outlines practice guidelines for adolescent surgical weight loss programs. The authors summarize available data on the effects of adolescent weight loss surgery on metabolic comorbidities and highlight the important acute and long-term complications that must be monitored by their general pediatricians. After reading this article, the general pediatrician should be able to identify adolescents who may be candidates for weight loss surgery and have the knowledge to assist in their postoperative medical management. Copyright 2014, SLACK Incorporated.

  18. Improved glucose tolerance after intensive life style intervention occurs without changes in muscle ceramide or triacylglycerol in morbidly obese subjects

    DEFF Research Database (Denmark)

    Helge, J. W.; Stallknecht, B.; Drachmann, Tue

    2011-01-01

    Aim: This study investigated the effect of a 15-week life style intervention (hypocaloric diet and regular exercise) on glucose tolerance, skeletal muscle lipids and muscle metabolic adaptations in 14 female and 9 male morbidly obese subjects (age: 32.5 +/- 2.3 years, BMI: 46.1 +/- 1.9 kg m(-2...

  19. The Association of Sleep Duration and Morbid Obesity in a Working Population: The Baptist Health South Florida Employee Study.

    Science.gov (United States)

    Aziz, Muhammad; Osondu, Chukwuemeka U; Younus, Adnan; Malik, Rehan; Rouseff, Maribeth; Das, Sankalp; Guzman, Henry; Maziak, Wasim; Virani, Salim; Feldman, Theodore; Agatston, Arthur S; Veledar, Emir; Aneni, Ehimen C; Nasir, Khurram

    2017-03-01

    The current study aimed to determine the relationship between self-reported sleep duration and morbid obesity in an employee population. Baptist Health South Florida conducts an annual Health Risk Assessment (HRA) for its employees. Data for this cross-sectional study was collected via this HRA in 2014, and included information on self-reported sleep duration, height and weight for body mass index (BMI), and other biometric measures. Average sleep duration was categorized as short sleep (employees who were sleeping for less than 6 hr compared to 13% and 14% among those sleeping for 6-7.9 hours, and 8 or more hours respectively. In regression analyses, persons who slept less than 6 hr had almost twice the odds of morbid obesity compared to those who slept 6-7.9 hr (odds ratio = 1.8; 1.5-2.2). Our finding that short sleep duration (employees, especially those who work in shift duties to reduce the risk of morbid obesity and other comorbid conditions. Future studies are needed to further explore the relationship of sleep duration and morbid obesity in employee populations.

  20. Hepatic Steatosis in Morbidly Obese Patients Undergoing Gastric Bypass Surgery: Assessment With Open-System 1H-MR Spectroscopy

    NARCIS (Netherlands)

    van Werven, Jochem R.; Schreuder, Tim C. M. A.; Aarts, Edo O.; Nederveen, Aart J.; Meijer, Jos W. R.; Berends, Frits J.; Janssen, Ignace M. C.; Mulder, Chris J.; Jansen, Peter L. M.; Stoker, Jaap

    2011-01-01

    The purpose of this study was to assess, with histopathologic control, the use of open-system 1-T (1)H MR spectroscopy for the evaluation of hepatic steatosis in morbidly obese patients undergoing gastric bypass surgery. Patients underwent (1)H MR spectroscopy (MRS) for the assessment of steatosis

  1. Epidemiological determinants of obesity in adolescent population Maharashtra, India.

    Directory of Open Access Journals (Sweden)

    Sanjeev Chincholikar

    2016-06-01

    Full Text Available Background: For establishing effective intervention, it is important to identify major determinants in an early stage of life. Effective prevention of adult obesity will require prevention and management of childhood obesity. Aims & Objectives: To study the epidemiological determinants of obesity in adolescent girls. Material & Methods: All adolescent school going boys and girls in the age group between 10 to 19 years were included as per definition of adolescent. 585 students were selected by systematic sample i.e. every 3rd student was included in the study sample. A pretested standardized questionnaire which consisted of questions related to sociodemographic data was used to screen the population for obesity. Results: When body mass index was correlated with various socioeconomic variables, it was found that prevalence of obesity was more in   males (overweight- 20.84%;obese-5.43% as compared to females (overweight- 16.92%; obese-3.14%,more  in the upper socioeconomic status (27.27% as compared to lower socioeconomic status(15%,more in  subjects with more frequency of junk food(30.97% as compared to having occasional junk food (20.93,more in  subjects with more frequency of eating sweets ( 25.73% as compared to occasional sweet eaters(13.59%. Conclusion: The dietary habits like more frequency of junk food, more sweet consumption, and socioeconomic status had a major impact on body mass index of children.

  2. A Major Chronic Disease: Obesity in Childhood and Adolescence

    Directory of Open Access Journals (Sweden)

    Safak Ergul

    2011-04-01

    Full Text Available The aim of this paper is to draw attention to obesity in adolescence and its potential risks and put forward its consequences in terms of public health as well as offer solutions. Today, obesity has become one of the most frequent chronic diseases of childhood. The tendency to obesity is at an alarming level and the annual increase in this age group is gradually rising. In the 2003 report of the International Obesity Commission, it was stated that one out of ten children aged between 5-17 worldwide was overweight or obese. In addition to social and psychological problems resulting from obesity, it is known to be closely related with very serious diseases such as hypertension, cardiovascular diseases, type 2 diabetes and metabolic syndrome. It is also known that obesity shortens life expectancy and that the process starts in the childhood period of many obese adults. Struggling with obesity actually means struggling with many other diseases. It is also of major significance for the future of our country to struggle with especially childhood obesity. In terms of public health, it is of primary importance to detect, avoid and cure obesity in this period. [TAF Prev Med Bull 2011; 10(2.000: 223-230

  3. Prevalence of Overweight, Obesity, and Abdominal Obesity among Urban Saudi Adolescents: Gender and Regional Variations

    Science.gov (United States)

    Abahussain, Nada A.; Al-Sobayel, Hana I.; Qahwaji, Dina M.; Alsulaiman, Nouf A.; Musaiger, Abdulrahman O.

    2014-01-01

    ABSTRACT The nutrition transition with associated lifestyle-related non-communicable diseases has rapidly reached many developing countries, including Saudi Arabia. Therefore, the objective of this study was to examine the prevalence of overweight, obesity, and abdominal obesity among Saudi adolescents. This school-based multicentre cross-sectional study was conducted during 2009-2010 in three major cities in Saudi Arabia: Al-Khobar, Jeddah, and Riyadh. Participants included 2,908 students of secondary schools (1,401 males and 1,507 females) aged 14 to 19 years, randomly selected using a multistage stratified cluster-sampling technique. Weight, height, and waist-circumference were measured; prevalence of overweight and obesity was determined using age- and sex-specific BMI cutoff reference standards of the International Obesity Task Force (IOTF). Abdominal obesity was determined using waist-to-height ratio (WHtR) cutoffs (above 0.5). The prevalence of overweight was 19.5% in males and 20.8% in females while that of obesity was 24.1% in males and 14% in females. The prevalence of abdominal obesity in males and females was 35.9% and 30.3% respectively. Higher prevalence of obesity was observed among adolescents in private schools. Across all ages, overweight and obesity ranged from 39.9% to 45.6% in males and from 30.4% to 38.7% in females. ANCOVA, controlling for age, showed significant interaction effects (city by gender). It is concluded that the proportions of overweight, obesity, and abdominal obesity, observed among Saudi adolescents were remarkably high. Such high prevalence of overweight and obesity is a major public-health concern. PMID:25895197

  4. [Motor Skills of Extremely Obese Children and Adolescents Based on the Multicentre Longitudinal Obesity Database (APV)].

    Science.gov (United States)

    Koch, B; Graf, C; Hoffmeister, U; Platschek, A-M; Gruber, W; Holl, R

    2016-03-01

    Obese children and adolescents often exhibit progressively declining motor skills. To support young obese patients adequately, it is necessary to assess their individual physical and motor abilities, taking the degree of obesity into account. A total of 5 924 children and adolescents (mean age: 12.7±2.5 years, range 6.0-18.0 years, 3 195 girls) were examined in a standardised multicentre evaluation survey (APV). Fitness parameters were correlated with age- and gender-specific BMI-SDS (Standard Deviation Score) Methods: Anthropometric data were collected and patients performed the modified Munich fitness test (mMFT: maximal power, coordination, trunk flexibility) and a 6-min walk-test (aerobic endurance capacity). 33% of patients were extremely obese (BMI>99.5th percentile). Mean BMI-SDS was + 2.32±0.53 (♀-Δ=+ 0.06; pmotor performance, especially maximal power (r=- 0,134), and particularly aerobic endurance capacity (r=- 0,214; all pMotor performance was significantly below average (n=27 473, 6-18 years), especially among extremely obese patients. Performance in all motor tasks was lower in girls compared to boys, except for trunk flexibility (pmotor performance. Extremely obese patients and obese girls showed the most pronounced motor deficits. These results emphasize the importance of standardized evaluation of individual motor performance in children and adolescents with obesity. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Assessment of Oral Conditions and Quality of Life in Morbid Obese and Normal Weight Individuals: A Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Joselene Martinelli Yamashita

    Full Text Available The aim of this study was to identify the impact of oral disease on the quality of life of morbid obese and normal weight individuals. Cohort was composed of 100 morbid-obese and 50 normal-weight subjects. Dental caries, community periodontal index, gingival bleeding on probing (BOP, calculus, probing pocket depth, clinical attachment level, dental wear, stimulated salivary flow, and salivary pH were used to evaluate oral diseases. Socioeconomic and the oral impacts on daily performances (OIDP questionnaires showed the quality of life in both groups. Unpaired Student, Fisher's Exact, Chi-Square, Mann-Whitney, and Multiple Regression tests were used (p<0.05. Obese showed lower socio-economic level than control group, but no differences were found considering OIDP. No significant differences were observed between groups considering the number of absent teeth, bruxism, difficult mastication, calculus, initial caries lesion, and caries. However, saliva flow was low, and the salivary pH was changed in the obese group. Enamel wear was lower and dentine wear was higher in obese. More BOP, insertion loss, and periodontal pocket, especially the deeper ones, were found in obese subjects. The regression model showed gender, smoking, salivary pH, socio-economic level, periodontal pocket, and periodontal insertion loss significantly associated to obesity. However, both OIDP and BOP did not show significant contribution to the model. The quality of life of morbid obese was more negatively influenced by oral disease and socio-economic factors than in normal weight subjects.

  6. Developmental perspectives on nutrition and obesity from gestation to adolescence.

    Science.gov (United States)

    Esposito, Layla; Fisher, Jennifer O; Mennella, Julie A; Hoelscher, Deanna M; Huang, Terry T

    2009-07-01

    Obesity results from a complex combination of factors that act at many stages throughout a person's life. Therefore, examining childhood nutrition and obesity from a developmental perspective is warranted. A developmental perspective recognizes the cumulative effects of factors that contribute to eating behavior and obesity, including biological and socioenvironmental factors that are relevant at different stages of development. A developmental perspective considers family, school, and community context. During gestation, risk factors for obesity include maternal diet, overweight, and smoking. In early childhood, feeding practices, taste acquisition, and eating in the absence of hunger must be considered. As children become more independent during middle childhood and adolescence, school nutrition, food marketing, and social networks become focal points for obesity prevention or intervention. Combining a multilevel approach with a developmental perspective can inform more effective and sustainable strategies for obesity prevention.

  7. Impact of Restricted Maternal Weight Gain on Fetal Growth and Perinatal Morbidity in Obese Women With Type 2 Diabetes

    DEFF Research Database (Denmark)

    Asbjörnsdóttir, Björg; Rasmussen, S.S.; Kelstrup, Louise

    2013-01-01

    OBJECTIVESince January 2008, obese women with type 2 diabetes were advised to gain 0-5 kg during pregnancy. The aim with this study was to evaluate fetal growth and perinatal morbidity in relation to gestational weight gain in these women.RESEARCH DESIGN AND METHODSA retrospective cohort comprised...... the records of 58 singleton pregnancies in obese women (BMI ≥30 kg/m(2)) with type 2 diabetes giving birth between 2008 and 2011. Birth weight was evaluated by SD z score to adjust for gestational age and sex.RESULTSSeventeen women (29%) gained ≤5 kg, and the remaining 41 gained >5 kg. The median (range...... with pregnancies with maternal weight gain >5 kg.CONCLUSIONIn this pilot study in obese women with type 2 diabetes, maternal gestational weight gain ≤5 kg was associated with a more proportionate birth weight and less perinatal morbidity....

  8. Improvements on Cardiovascular Diseases Risk Factors in Obese Adolescents

    DEFF Research Database (Denmark)

    Gomes Silva, Humberto José; Andersen, Lars Bo; Lofrano-Prado, Mara Cristina

    2015-01-01

    BACKGROUND: It is unclear how different exercise intensities affect cardiovascular disease (CVD) risk factors in obese adolescents. The aim of this study was to compare the effects of high intensity (HIT) vs. low intensity (LIT) aerobic training on CVD risk factors in obese adolescents. METHODS......: Forty-three obese adolescents (age: 15.7±1.3y, BMI: 34.3±4.1kg/m2) participated this study either HIT (corresponding to ventilatory threshold-I, VT1; N=20) or LIT (20% below VT1; N=23) for 12 weeks (12W). All sessions were isocaloric (350 kcal). All participants received the same nutritional......, psychological and clinical counseling. Subjects were assessed in fatness, fitness, lipid profile and glucose at baseline and after 12W. The CVD risk factors assessed were waist circumference (WC), total cholesterol (TC), HDL, glucose and fitness, which were single and clustered analyzed (Z-scores sum). RESULTS...

  9. Medical and psychosocial implications of adolescent extreme obesity – acceptance and effects of structured care, short: Youth with Extreme Obesity Study (YES)

    Science.gov (United States)

    2013-01-01

    Background Prevalence rates of overweight and obesity have increased in German children and adolescents in the last three decades. Adolescents with extreme obesity represent a distinct risk group. On the basis of data obtained by the German Child and Youth Survey (KiGGS) and the German district military offices we estimate that the group of extremely obese adolescents (BMI ≥ 35 kg/m2) currently encompasses approximately 200.000 adolescents aged 14 to 21 yrs. Conventional approaches focusing on weight reduction have largely proven futile for them. In addition, only a small percentage of adolescents with extreme obesity seek actively treatment for obesity while contributing disproportionately strong to health care costs. Because of somatic and psychiatric co-morbidities and social problems adolescents with extreme obesity require special attention within the medical care system. We have initiated the project “Medical and psychosocial implications of adolescents with extreme obesity - acceptance and effects of structured care, short: ‘Youths with Extreme Obesity Study (YES)’”, which aims at improving the medical care and social support structures for youths with extreme obesity in Germany. Methods/Design We focus on identification of these subjects (baseline examination) and their acceptance of diagnostic and subsequent treatment procedures. In a randomized controlled trial (RCT) we will investigate the effectiveness of a low key group intervention not focusing on weight loss but aimed at the provision of obesity related information, alleviation of social isolation, school and vocational integration and improvement of self-esteem in comparison to a control group treated in a conventional way with focus on weight loss. Interested individuals who fulfill current recommended criteria for weight loss surgery will be provided with a structured preparation and follow-up programs. All subjects will be monitored within a long-term observational study to

  10. Medical and psychosocial implications of adolescent extreme obesity - acceptance and effects of structured care, short: Youth with Extreme Obesity Study (YES).

    Science.gov (United States)

    Wabitsch, Martin; Moss, Anja; Reinehr, Thomas; Wiegand, Susanna; Kiess, Wieland; Scherag, André; Holl, Reinhard; Holle, Rolf; Hebebrand, Johannes

    2013-08-29

    Prevalence rates of overweight and obesity have increased in German children and adolescents in the last three decades. Adolescents with extreme obesity represent a distinct risk group. On the basis of data obtained by the German Child and Youth Survey (KiGGS) and the German district military offices we estimate that the group of extremely obese adolescents (BMI ≥ 35 kg/m2) currently encompasses approximately 200.000 adolescents aged 14 to 21 yrs. Conventional approaches focusing on weight reduction have largely proven futile for them. In addition, only a small percentage of adolescents with extreme obesity seek actively treatment for obesity while contributing disproportionately strong to health care costs. Because of somatic and psychiatric co-morbidities and social problems adolescents with extreme obesity require special attention within the medical care system. We have initiated the project "Medical and psychosocial implications of adolescents with extreme obesity--acceptance and effects of structured care, short: 'Youths with Extreme Obesity Study (YES)'", which aims at improving the medical care and social support structures for youths with extreme obesity in Germany. We focus on identification of these subjects (baseline examination) and their acceptance of diagnostic and subsequent treatment procedures. In a randomized controlled trial (RCT) we will investigate the effectiveness of a low key group intervention not focusing on weight loss but aimed at the provision of obesity related information, alleviation of social isolation, school and vocational integration and improvement of self-esteem in comparison to a control group treated in a conventional way with focus on weight loss. Interested individuals who fulfill current recommended criteria for weight loss surgery will be provided with a structured preparation and follow-up programs. All subjects will be monitored within a long-term observational study to elucidate medical and psychosocial outcomes

  11. Adherence to nutritional therapy in obese adolescents; a review.

    Science.gov (United States)

    França, Silvana Lima Guimarães; Sahade, Viviane; Nunes, Mônica; Adan, Luis F

    2013-01-01

    Considering the controversies existent on the subject, the aim of this review is to discuss adherence to diet in obese adolescents. The selection of articles was made in the SCOPUS, COCHRANE, APA Psyc Net, SciELO, LILACS, CAPES Journals, PUBMED/MEDLINE and GOOGLE ACADEMIC databases. Studies published between 2002 and 2012 were selected. There was lack of evidence of conceptual discussion about adherence to diet in obesity in the child-youth context, in addition to scarcity of data on adherence to diet itself in obese adolescents and the methods of evaluating this. Lastly, multiple interdependent factors were found which both facilitated and made the process of adherence to diet difficult for obese youngsters. The majority of these (factors) belong to the socioeconomic and cultural dimension, in addition to pointing out cognitive and psychological factors and those associated with health services and professionals. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  12. Trajectory of Adolescent Obesity: Exploring the Impact of Prenatal to Childhood Experiences.

    Science.gov (United States)

    Huang, David Y C; Lanza, H Isabella; Anglin, M Douglas

    2014-08-01

    This study examined longitudinal associations of prenatal exposures as well as childhood familial experiences with obesity status from ages 10 to 18. Hierarchical generalized linear modeling (HGLM) was applied to examine 5,156 adolescents from the child sample of the 1979 National Longitudinal Survey of Youth (NLSY79). Higher maternal weight, maternal smoking during pregnancy, lower maternal education, and lack of infant breastfeeding were contributors to elevated adolescent obesity risk in early adolescence. However, maternal age, high birth weight of child, and maternal annual income exhibited long-lasting impact on obesity risk over time throughout adolescence. Additionally, childhood familial experiences were significantly related to risk of adolescent obesity. Appropriate use of family rules in the home and parental engagement in children's daily activities lowered adolescent obesity risk, but excessive television viewing heightened adolescent obesity risk. Implementation of consistent family rules and parental engagement may benefit adolescents at risk for obesity.

  13. Contribution of temporal data to predictive performance in 30-day readmission of morbidly obese patients

    Directory of Open Access Journals (Sweden)

    Petra Povalej Brzan

    2017-04-01

    Full Text Available Background Reduction of readmissions after discharge represents an important challenge for many hospitals and has attracted the interest of many researchers in the past few years. Most of the studies in this field focus on building cross-sectional predictive models that aim to predict the occurrence of readmission within 30-days based on information from the current hospitalization. The aim of this study is demonstration of predictive performance gain obtained by inclusion of information from historical hospitalization records among morbidly obese patients. Methods The California Statewide inpatient database was used to build regularized logistic regression models for prediction of readmission in morbidly obese patients (n = 18,881. Temporal features were extracted from historical patient hospitalization records in a one-year timeframe. Five different datasets of patients were prepared based on the number of available hospitalizations per patient. Sample size of the five datasets ranged from 4,787 patients with more than five hospitalizations to 20,521 patients with at least two hospitalization records in one year. A 10-fold cross validation was repeted 100 times to assess the variability of the results. Additionally, random forest and extreme gradient boosting were used to confirm the results. Results Area under the ROC curve increased significantly when including information from up to three historical records on all datasets. The inclusion of more than three historical records was not efficient. Similar results can be observed for Brier score and PPV value. The number of selected predictors corresponded to the complexity of the dataset ranging from an average of 29.50 selected features on the smallest dataset to 184.96 on the largest dataset based on 100 repetitions of 10-fold cross-validation. Discussion The results show positive influence of adding information from historical hospitalization records on predictive performance using all

  14. Metformin for Obesity in Children and Adolescents: A Systematic Review

    OpenAIRE

    Park, Min Hae; Kinra, Sanjay; Ward, Kirsten J.; White, Billy; Viner, Russell M.

    2009-01-01

    OBJECTIVE: To summarize the efficacy of metformin in reducing BMI and cardiometabolic risk in obese children and adolescents without diabetes. RESEARCH DESIGN AND METHODS: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs). Double-blind RCTs of > or =6 months duration in obese subjects age < or =19 years without diabetes were included. Our primary outcomes of interest include changes in BMI and measures of insulin sensitivity. RESULTS: Five trials met in...

  15. Influence of psychological variables in morbidly obese patients undergoing bariatric surgery after 24 months of evolution.

    Science.gov (United States)

    Rodríguez-Hurtado, José; Ferrer-Márquez, Manuel; Fontalba-Navas, Andrés; García-Torrecillas, Juan Manuel; Olvera-Porcel, M Carmen

    Bariatric surgery is considered a more effective means of achieving weight loss than non-surgical options in morbid obesity. Rates of failure or relapse range from 20 to 30%. The study aims to analyse the influence of psychological variables (self-esteem, social support, coping strategies and personality) in the maintenance of weight loss after bariatric surgery. A cohort study was conducted involving 64 patients undergoing bariatric surgery for 24 months. At the end of the follow-up period, patients were divided into 2sub-cohorts classified as successes or failures. Success or favorable development was considered when the value of percent excess weight loss was 50 or higher. No statistically significant differences were observed between the 2groups in any variable studied. All patients had high self-esteem (87,3 those who failed and 88,1 those who are successful) and social support (90,2 and 90,9). Patients who succeed presented higher scores for cognitive restructuring (57,1) and were more introverted (47,1), while those who failed scored more highly in desiderative thinking (65,7) and were more prone to aggression (50,7) and neuroticism (51,7). High self-esteem and social support does not guarantee successful treatment. The groups differed in how they coped with obesity but the data obtained do not justify the weight evolution. In the absence of psychopathology, personality trait variability between patients is insufficient to predict the results. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Perioperative management of a morbidly obese pregnant patient undergoing cesarean section under general anesthesia - case report

    Directory of Open Access Journals (Sweden)

    Márcio Luiz Benevides

    Full Text Available Abstract Background and objectives: The increased prevalence of obesity in the general population extends to women of reproductive age. The aim of this study is to report the perioperative management of a morbidly obese pregnant woman, body mass index >50 kg/m2, who underwent cesarean section under general anesthesia. Case report: Pregnant woman in labor, 35 years of age, body mass index 59.8 kg/m2. Cesarean section was indicated due to the presumed fetal macrosomia. The patient refused spinal anesthesia. She was placed in the ramp position with cushions from back to head to facilitate tracheal intubation. Another cushion was placed on top of the right gluteus to create an angle of approximately 15° to the operating table. Immediately before induction of anesthesia, asepsis was carried out and sterile surgical fields were placed. Anesthesia was induced in rapid sequence, with Sellick maneuver and administration of remifentanil, propofol, and succinilcolina. Intubation was performed using a gum elastic bougie, and anesthesia was maintained with sevoflurane and remifentanil. The interval between skin incision and fetal extraction was 21 min, with the use of a Simpson's forceps scoop to assist in the extraction. The patient gave birth to a newborn weighing 4850 g, with Apgar scores of 2 in the 1st minute (received positive pressure ventilation by mask for about 2 min and 8 in the 5th minute. The patient was extubated uneventfully. Multimodal analgesia and prophylaxis of nausea and vomiting was performed. Mother and newborn were discharged on the 4th postoperative day.

  17. Trajectories of physical and mental health among persons with morbid obesity and persons with COPD: a longitudinal comparative study

    Directory of Open Access Journals (Sweden)

    Bonsaksen T

    2016-04-01

    Full Text Available Tore Bonsaksen,1 May Solveig Fagermoen,2 Anners Lerdal2,3 1Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, 2Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, 3Department for Patient Safety and Development, Lovisenberg Diakonale Hospital, Oslo, NorwayBackground: Morbid obesity and chronic obstructive pulmonary disease (COPD are prevalent diseases associated with impaired health-related quality of life (HRQoL. Research generally indicates that persons with morbid obesity increase their HRQoL following intervention, whereas evidence of increases in HRQoL in persons with COPD is mixed. Examining the patterns of change over time instead of merely examining whether HRQoL changes will add to the knowledge in this field.Methods: A sample of persons with morbid obesity and persons with COPD was recruited from learning and mastery courses and rehabilitation centers in Norway. The data were collected by self-report questionnaires at the start of patient education and at four subsequent time points during the 1-year follow-up. HRQoL was measured with the Short Form 12, version 2, and repeated measures analysis of variance was employed in the statistical analysis.Results: Participants with morbid obesity linearly increased their physical HRQoL during the 1-year follow-up, whereas participants with COPD showed no change. None of the groups changed their mental HRQoL during follow-up. In all subdomains of HRQoL, the participants with morbid obesity showed favorable, linearly increasing trajectories across the follow-up period. Among the participants with COPD, no change patterns occurred in the subdomains of HRQoL, except for a fluctuating pattern in the mental health domain. Age, sex, and work status did not influence the trajectories of HRQoL in any of the domains.Conclusion: A more favorable trajectory

  18. Managing adolescent obesity and the role of bariatric surgery.

    Science.gov (United States)

    McGinty, Shannon; Richmond, Tracy K; Desai, Nirav K

    2015-08-01

    This update explores the current management options for adolescent obesity with a specific focus on bariatric surgery. Research has highlighted the serious health complications associated with adolescent obesity and thus emphasized the need for effective interventions. With the increasing severity of obesity seen in younger populations, coupled with the modest effects of most behavioral and even pharmacologic interventions, there has been increased interest in, and attention on, bariatric surgery in younger populations. Recent adult-focused guidelines regarding the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient outline the importance of careful patient selection, in addition to close monitoring, with a particular focus on preventing nutritional deficiencies. Several recent publications have focused on issues specific to bariatric surgery in the adolescent patient including the relationship between a patient's physical and emotional maturity and timing of surgery. Adolescent obesity is prevalent with increasing severity and long-term health implications. To date nonsurgical interventions have had modest effects. Bariatric surgery is becoming more common and has been shown to be well tolerated and effective in adolescents, but requires careful preoperative screening and postoperative monitoring.

  19. [Bone mineral density in overweight and obese adolescents].

    Science.gov (United States)

    Cobayashi, Fernanda; Lopes, Luiz A; Taddei, José Augusto de A C

    2005-01-01

    To study bone density as a concomitant factor for obesity in post-pubertal adolescents, controlling for other variables that may interfere in such a relation. Study comprising 83 overweight and obese adolescents (BMI > or = P85) and 89 non obese ones (P5 obesity followed by multivariate analysis (logistic regression) according to a hierarchical conceptual model. The prevalence of bone density above the median was twice more frequent among cases (69.3%) than among controls (32.1%). In the bivariate analysis such prevalence resulted in an odds ratio (OR) of 4.78. The logistic regression model showed that the association between obesity and mineral density is yet more intense with an OR of 6.65 after the control of variables related to sedentary lifestyle and intake of milk and dairy products. Obese and overweight adolescents in the final stages of sexual maturity presented higher bone mineral density in relation to their normal-weight counterparts; however, cohort studies will be necessary to evaluate the influence of such characteristic on bone resistance in adulthood and, consequently, on the incidence of osteopenia and osteoporosis at older ages.

  20. Adverse family experiences during childhood and adolescent obesity.

    Science.gov (United States)

    Heerman, William J; Krishnaswami, Shanthi; Barkin, Shari L; McPheeters, Melissa

    2016-03-01

    To evaluate the association between adverse family experiences (AFEs) during childhood and adolescent obesity and to determine populations at highest risk for AFEs. A cross-sectional analysis was performed of the 2011-2012 National Survey of Children's Health, including children aged 10-17 years. Weighted estimates of 31,258,575 children were based on interviews with 42,239 caregivers. Caregiver reports of nine psychosocial risk factors measured AFEs during childhood. Adolescent overweight and obesity were derived by caregiver-reported child height and weight. Nearly one-third (30.5%) of children had experienced ≥2 AFEs, with geographic variation by state. The prevalence of obesity among children experiencing ≥2 AFEs was 20.4%, when compared with 12.5% among children with 0 AFEs. Adjusted survey regression models were controlled for child, parent, household, and neighborhood characteristics. Children with ≥2 AFEs in childhood were more likely to have obesity (AOR = 1.8; 95% CI = 1.47-2.17; P Adolescents in this national sample who were exposed to greater numbers of AFEs in childhood also had higher rates of overweight and obesity. Geographic variation and differential associations based on race/ethnicity identified children at greatest risk. © 2016 The Obesity Society.

  1. Assessment and management of obesity in childhood and adolescence.

    Science.gov (United States)

    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.

  2. [Is the morbid obesity surgery profitable in times of crisis? A cost-benefit analysis of bariatric surgery].

    Science.gov (United States)

    Sánchez-Santos, Raquel; Sabench Pereferrer, Fátima; Estévez Fernandez, Sergio; del Castillo Dejardin, Daniel; Vilarrasa, Nuria; Frutos Bernal, Dolores; Ruiz de Adana, Juan Carlos; Masdevall Noguera, Carlos; Torres García, Antonio

    2013-10-01

    Morbid obesity is a serious health problem whose prevalence is increasing. Expensive co-morbidities are associated to these patients, as well as a reduction in the survival. Bariatric surgery resolves the co-morbidities (type 2 diabetes mellitus, 86.6%; cardiovascular risk, 79.0%; obstructive sleep apnea syndrome, 83.6%; hypertension, 61.7%), reduces the mortality rate (among 31-40%), and increases the morbid obese patients survival over a 10-years period. It provides significant savings for the National Health System. The obese patients consume a 20% plus of health resources and 68% plus of drugs than general population. Bariatric surgery requires an initial investment (diagnosis-related group cost: 7,468 €), but it is recovered in a cost-effectiveness ratio of 2.5 years. Significant savings are obtained from the third year. To the direct economic benefits associated with reduced health expenditures it should be added an increase in tax collection (sick leave and unemployment reduction is estimated in 18%, with a productivity increase of 57% for self-employed people). Bariatric surgery is one of the most cost-effective procedures in the healthcare system. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

  3. [A new method of gastric shunting for treatment of patients with morbid obesity].

    Science.gov (United States)

    Grubnik, V V; Golliak, V P; Kresiun, M S

    2013-01-01

    The gastric shunting (GSH) method, permitting to control the patients body mass more effectively and promoting complete remission of diabetes mellitus type II, was elaborated. In 2008 - 2009 yrs 29 patients (9 men, 20 women) were operated on for morbid obesity, using shunting interventions. In 21 patients (the first group) a standard GSH was performed, in 8 (second group)--a modified operation. In 18-24 mo the excessive patient's body mass in patients of the first group have reduced by 62.8%, of the second group--by 89.3%. Complete compensation of diabetes mellitus type II with rejection from insulin and other antidiabetic preparations was achieved in 4 patients of the first group and in all--in the second group. Resistence for insulin have had lowered in patients of both groups, including in the first group--in 1,4 times, in the second group--in 3.2 times. Thus, preliminary results accurately demonstrate, that application of a modified GSH method is more effective, concerning the patients body mass reduction and achievement of complete compensation of diabetes mellitus type II.

  4. Psychological Profile and Quality of Life of Morbid Obese Patients Attending a Cognitive Behavioural Program

    Directory of Open Access Journals (Sweden)

    Rebecca Marzocchi

    2008-12-01

    Full Text Available The results show that 27% of cases had a BES score ≥ 17, indicative of possible binge eating, and 13% had a BES ≥ 27, largely indicative of binge eating, with a higher prevalence in females. The BDI score was above normal in 30% of males and 45% of females, and 13% of females were in the range of moderate-severe depression. BES and BDI were significantly correlated with each other. Orwell-97 was much higher in females, and similarly the generic PGWB was indicative of a poorer HRQL in females. PGWB was positively associated with age, without any effect of BMI. The association with age was maintained in female, not in males. Both the Orwell-97 and the PGWB were associated with both BES and BDI in both genders. Psychological distress is common and largely variable in patients attending CBT for morbid obesity. This data should be considered for individual treatment protocols, and should be compared with similar series of patients enrolled for bariatric surgery.

  5. Lack of effect of a moderate hypocaloric diet on visfatin levels in morbid obese patients: relationship with insulin resistance.

    Science.gov (United States)

    De Luis, D A; Gonzalez Sagrado, M; Conde, R; Aller, R; Izaola, O; Castro, M J; Romero, E

    2010-12-01

    The insulin-mimetic adipocytokine visfatin has been related to obesity. The aim of this study was to examine whether weight loss could change visfatin concentrations in morbidly obese patients and its relationship with insulin resistance. This was an interventional study analyzing a population of 41 morbidly obese patients. A biochemical analysis was realized before and after 2 months on a hypocaloric diet. After weight loss (average 4.41%), BMI, weight, fat mass, fat free mass, waist circumference, systolic blood pressure, serum glucose, total cholesterol, insulin and HOMA decreased. The serum concentrations of visfatin did not decrease (43.5 + 30.8 vs. 47.1 + 38.1 ng/ml). In the multivariate analysis visfatin concentrations as a dependent variable, only C reactive protein remained as an independent predictor in the model before diet, with an increase of 1.82 ng/ml (CI 95%: 0.02 - 3.61) basal visfatin concentrations with each increase of 1 mg/dl of CRP. Only HOMA remained as an independent predictor in the model after diet, with an increase of 11.4 ng/ml (CI 95%: 1.76 - 21.11) posttreatment visfatin concentrations with each increase of 1 unit HOMA. Weight reduction after a 2 months on a hypocaloric diet is not associated with a significant change in circulating visfatin in morbidly obese patients.

  6. Use of Enoxaparin in Obese Adolescents During Bariatric Surgery--a Pilot Study.

    Science.gov (United States)

    Mushtaq, Alvina; Vaughns, Janelle D; Ziesenitz, Victoria C; Nadler, Evan P; van den Anker, John N

    2015-10-01

    Obese patients have a higher risk of venous thromboembolism when immobilized due to surgery. The objective of this study was to assess anti-factor Xa activity in adolescent bariatric surgical patients receiving prophylactic enoxaparin. Four morbidly obese adolescents undergoing laparoscopic sleeve gastrectomy were enrolled. Enoxaparin was administered (40 mg subcutaneous (SC) if BMI ≤50 kg/m(2) or 60 mg SC if BMI >50 kg/m(2)) for prevention of venous thromboembolism every 12 h starting after induction of anesthesia until discharge. Plasma anti-factor Xa activity was assessed over 12 h after the first dose and used as a surrogate marker for enoxaparin levels. Non-compartmental analysis of anti-factor Xa activity levels was performed and compared with previously published studies. Patients recruited were 16 to 18 years of age with a mean BMI of 52.6 ± 5.8 kg/m(2) (>99th BMI percentile). Peak anti-factor Xa activity ranged from 0.20 to 0.23 IU/mL in our study population, compared to 0.38 to 0.53 IU/mL in the cited lean comparator groups. Our current dosing practice of 40 mg SC for individuals with a BMI ≤50 kg/m(2) and 60 mg for individuals with a BMI ≥50 kg/m(2) resulted in anti-factor Xa activity that was sufficient for adequate thromboprophylaxis in adolescent bariatric surgical patients. Our data also demonstrates lower drug exposures in the obese when compared to lean patients. Therefore, randomized controlled efficacy and safety studies are urgently needed to guide the use of low-molecular-weight heparins in the pediatric and adolescent obese population.

  7. The Medical Risks of Obesity

    OpenAIRE

    Pi-Sunyer, Xavier

    2009-01-01

    Obesity is at epidemic proportions in the United States and in other developed and developing countries. The prevalence of obesity is increasing not only in adults, but especially among children and adolescents. In the United States in 2003 to 2004, 17.1% of children and adolescents were overweight, and 32.2% of adults were obese. Obesity is a significant risk factor for and contributor to increased morbidity and mortality, most importantly from cardiovascular disease (CVD) and diabetes, but ...

  8. Lifestyle intervention for improving school achievement in overweight or obese children and adolescents.

    Science.gov (United States)

    Martin, Anne; Saunders, David H; Shenkin, Susan D; Sproule, John

    2014-03-14

    The prevalence of overweight and obesity in childhood and adolescence is high. Excessive body fat at a young age is likely to persist into adulthood and is associated with physical and psychosocial co-morbidities, as well as lower cognitive, school and later life achievement. Lifestyle changes, including reduced caloric intake, decreased sedentary behaviour and increased physical activity, are recommended for prevention and treatment of child and adolescent obesity. Evidence suggests that lifestyle interventions can benefit cognitive function and school achievement in children of normal weight. Similar beneficial effects may be seen in overweight or obese children and adolescents. To assess whether lifestyle interventions (in the areas of diet, physical activity, sedentary behaviour and behavioural therapy) improve school achievement, cognitive function and future success in overweight or obese children and adolescents compared with standard care, waiting list control, no treatment or attention control. We searched the following databases in May 2013: CENTRAL, MEDLINE, EMBASE, CINAHL Plus, PsycINFO, ERIC, IBSS, Cochrane Database of Systematic Reviews, DARE, ISI Conference Proceedings Citation Index, SPORTDiscus, Database on Obesity and Sedentary Behaviour Studies, Database of Promoting Health Effectiveness Reviews (DoPHER) and Database of Health Promotion Research. In addition, we searched the Network Digital Library of Theses and Dissertations (NDLTD), three trials registries and reference lists. We also contacted researchers in the field. We included (cluster) randomised and controlled clinical trials of lifestyle interventions for weight management in overweight or obese children three to 18 years of age. Studies in children with medical conditions known to affect weight status, school achievement and cognitive function were excluded. Two review authors independently selected studies, extracted data, assessed quality and risk of bias and cross-checked extracts

  9. [Excess weight and abdominal obesity in Galician children and adolescents].

    Science.gov (United States)

    Pérez-Ríos, Mónica; Santiago-Pérez, María Isolina; Leis, Rosaura; Martínez, Ana; Malvar, Alberto; Hervada, Xurxo; Suanzes, Jorge

    2017-12-06

    The excess of weight, mainly obesity, during childhood and adolescence increases morbimortality risk in adulthood. The aim of this article is to estimate both the overall prevalence, as well as according to age and gender, of underweight, overweight, obesity and abdominal obesity among schoolchildren aged between 6-15-years-old in the school year 2013-2014. Data were taken from a cross-sectional community-based study carried out on a representative sample, by gender and age, of the Galician population aged between 6 and 15 years-old. The prevalence of underweight, overweight, and obese children (Cole's cut-off criteria) and abdominal obesity (Taylor's cut-off criteria) were estimated after performing objective measurements of height, weight and waist circumference at school. A total of 7,438 students were weighed and measured in 137 schools. The prevalence of overweight and obese individuals was 24.9% and 8.2%, respectively. The prevalence of abdominal obesity was 25.8%, with 4% of children with normal weight having abdominal obesity. These data highlight the need to promote primary prevention measures at early ages in order to decrease the occurrence of the premature onset of disease in the future. The prevalence of excess weight is underestimated if abdominal obesity is not taken into consideration. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  10. Association of adipocyte genes with ASP expression: a microarray analysis of subcutaneous and omental adipose tissue in morbidly obese subjects

    Directory of Open Access Journals (Sweden)

    Lu HuiLing

    2010-01-01

    Full Text Available Abstract Background Prevalence of obesity is increasing to pandemic proportions. However, obese subjects differ in insulin resistance, adipokine production and co-morbidities. Based on fasting plasma analysis, obese subjects were grouped as Low Acylation Stimulating protein (ASP and Triglyceride (TG (LAT vs High ASP and TG (HAT. Subcutaneous (SC and omental (OM adipose tissues (n = 21 were analysed by microarray, and biologic pathways in lipid metabolism and inflammation were specifically examined. Methods LAT and HAT groups were matched in age, obesity, insulin, and glucose, and had similar expression of insulin-related genes (InsR, IRS-1. ASP related genes tended to be increased in the HAT group and were correlated (factor B, adipsin, complement C3, p Results HAT adipose tissue demonstrated increased lipid related genes for storage (CD36, DGAT1, DGAT2, SCD1, FASN, and LPL, lipolysis (HSL, CES1, perilipin, fatty acid binding proteins (FABP1, FABP3 and adipocyte differentiation markers (CEBPα, CEBPβ, PPARγ. By contrast, oxidation related genes were decreased (AMPK, UCP1, CPT1, FABP7. HAT subjects had increased anti-inflammatory genes TGFB1, TIMP1, TIMP3, and TIMP4 while proinflammatory PIG7 and MMP2 were also significantly increased; all genes, p Conclusion Taken together, the profile of C5L2 receptor, ASP gene expression and metabolic factors in adipose tissue from morbidly obese HAT subjects suggests a compensatory response associated with the increased plasma ASP and TG.

  11. Two loose screws: near-miss fall of a morbidly obese patient after an operating room table failure.

    Science.gov (United States)

    McAllister, Russell K; Booth, Robert T; Bittenbinder, Timothy M

    2016-09-01

    Operating room surgical table failure is a rare event but can lead to a dangerous situation when it does occur. The dangers can be compounded in the presence of obesity, especially in the anesthetized or sedated patient. We present a case of a near-miss fall of a morbidly obese patient while turning the patient in preparation to transfer from the operating room table to the hospital bed when 2 fractured bolts in the tilt cylinder mechanism led to an operating room table failure. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Physical Training Improves Insulin Resistance Syndrome Markers in Obese Adolescents.

    Science.gov (United States)

    Kang, Hyun-Sik; Gutin, Bernard; Barbeau, Paule; Owens, Scott; Lemmon, Christian R.; Allison, Jerry; Litaker, Mark S.; Le, Ngoc-Anh

    2002-01-01

    Tested the hypothesis that physical training (PT), especially high-intensity PT, would favorably affect components of the insulin resistance syndrome (IRS) in obese adolescents. Data on teens randomized into lifestyle education (LSE) alone, LSE plus moderate -intensity PT, and LSE plus high-intensity PT indicated that PT, especially high-intensity…

  13. Ventilatory responses to exercise training in obese adolescents.

    Science.gov (United States)

    Mendelson, Monique; Michallet, Anne-Sophie; Estève, François; Perrin, Claudine; Levy, Patrick; Wuyam, Bernard; Flore, Patrice

    2012-10-15

    The aim of this study was to examine ventilatory responses to training in obese adolescents. We assessed body composition, pulmonary function and ventilatory responses (among which expiratory flow limitation and operational lung volumes) during progressive cycling exercise in 16 obese adolescents (OB) before and after 12 weeks of exercise training and in 16 normal-weight volunteers. As expected, obese adolescents' resting expiratory reserve volume was lower and inversely correlated with thoraco-abdominal fat mass (r = -0.74, p<0.0001). OB presented lower end expiratory (EELV) and end inspiratory lung volumes (EILV) at rest and during submaximal exercise, and modest expiratory flow limitation. After training, OB increased maximal aerobic performance (+19%) and maximal inspiratory pressure (93.7±31.4 vs. 81.9±28.2 cm H2O, +14%) despite lack of decrease in trunk fat and body weight. Furthermore, EELV and EILV were greater during submaximal exercise (+11% and +9% in EELV and EILV, respectively), expiratory flow limitation delayed but was not accompanied by increased V(T). However, submaximal exertional symptoms (dyspnea and leg discomfort) were significantly decreased (-71.3% and -70.7%, respectively). Our results suggest that exercise training can improve pulmonary function at rest (static inspiratory muscle strength) and exercise (greater operating lung volumes and delayed expiratory flow limitation) but these modifications did not entirely account for improved dyspnea and exercise performance in obese adolescents. Copyright © 2012 Elsevier B.V. All rights reserved.

  14. Determinants of Adolescent Obesity: A Comparison with Anorexia Nervosa.

    Science.gov (United States)

    Brone, Ronald J.; Fisher, Celia B.

    1988-01-01

    Comparison of childhood and adolescent obesity and anorexia nervosa reveals etiological similarities between the two conditions, particularly regarding family interactional patterns. In both cases, family enmeshment and overprotectiveness resulted in a poor sense of identity and effectiveness. Some children, while compliant and dependent in…

  15. Psychological Vulnerability among Overweight/Obese Minority Adolescents

    Science.gov (United States)

    Martyn-Nemeth, Pamela A.; Penckofer, Sue

    2012-01-01

    Depression is associated with obesity among adolescents, with racial/ethnic variability noted. Psychological correlates that may influence this relationship have not been adequately explored. The primary objective of this secondary analysis was to compare levels of stress, self-esteem, coping, social support, and depressive mood between normal…

  16. Etiology, Treatment and Prevention of Obesity in Childhood and Adolescence: A Decade in Review

    OpenAIRE

    Spruijt-Metz, Donna

    2011-01-01

    Childhood obesity has become an epidemic on a worldwide scale. This article gives an overview of the progress made in childhood and adolescent obesity research in the last decade, with a particular emphasis on the transdisciplinary and complex nature of the problem. The following topics are addressed: 1) current definitions of childhood and adolescent overweight and obesity; 2) demography of childhood and adolescent obesity both in the US and globally; 3) current topics in the physiology of f...

  17. [Current Guidelines to Prevent Obesity in Childhood and Adolescence].

    Science.gov (United States)

    Blüher, S; Kromeyer-Hauschild, K; Graf, C; Grünewald-Funk, D; Widhalm, K; Korsten-Reck, U; Markert, J; Güssfeld, C; Müller, M J; Moss, A; Wabitsch, M; Wiegand, S

    2016-01-01

    Current guidelines for the prevention of obesity in childhood and adolescence are presented. A literature search was performed in Medline via PubMed, and appropriate studies were analysed. Programs to prevent childhood obesity were to date mainly school-based. Effects were limited to date. Analyses tailored to different age groups show that prevention programs have the best effects in younger children (adolescence, school-based interventions were most effective when adolescents were directly addressed. To date, obesity prevention programs have mainly focused on behavior oriented prevention. Recommendations for condition oriented prevention have been suggested by the German Alliance of Non-communicable Diseases and include one hour of physical activity at school, promotion of healthy food choices by taxing unhealthy foods, mandatory quality standards for meals at kindergarten and schools as well as a ban on unhealthy food advertisement addressing children. Behavior oriented prevention programs showed hardly any or only limited effects in the long term. Certain risk groups for the development of obesity are not reached effectively by available programs. Due to the heterogeneity of available studies, universally valid conclusions cannot be drawn. The combination with condition oriented prevention, which has to counteract on an obesogenic environment, is crucial for sustainable success of future obesity prevention programs. © Georg Thieme Verlag KG Stuttgart · New York.

  18. How prevalent and morbid are subthreshold manifestations of major depression in adolescents? A literature review.

    Science.gov (United States)

    Carrellas, Nicholas W; Biederman, Joseph; Uchida, Mai

    2017-03-01

    Major Depressive Disorder (MDD) among youth is a public health concern. Our aim was to examine the current body of knowledge to better characterize the prevalence and morbidity associated with subthreshold forms of MDD among youth. Given that MDD tends to develop gradually over time, we hypothesized a high prevalence and considerable impairment associated with youth suffering from depressive symptoms that fall short of full, syndromic status. A literature search was conducted using PubMed exclusively to identify studies assessing the prevalence and clinical characteristics of subthreshold MDD in adolescents. Six scientific papers that met our priori inclusion and exclusion criteria were identified. All papers sampled adolescents. The prevalence of subthreshold MDD ranged from 5% over the past year, to 29% over the two weeks prior to screening. These papers reported clinically significant morbidity associated with subthreshold MDD among adolescents, with evidence for elevated rates of psychiatric comorbidities, impaired functioning in social and familial domains, increased suicidality, and frequent mental health service utilization. Though we examined a sizeable and diverse sample, we only identified six cross-sectional informative studies for this review. Variability of subthreshold MDD and major outcome definitions across studies, likely limits the specificity of findings. Subthreshold MDD is prevalent among youth, and is associated with emotional and social impairments that reach the level of obtaining clinical care. These findings could lead to early intervention efforts aimed at mitigating the adverse outcomes associated with subthreshold MDD as well as the progression to full syndrome MDD. Our review documents that regardless of whether progression to full diagnostic status occurs, this condition is morbid. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Obesity in childhood and adolescence: evidence based clinical and public health perspectives

    OpenAIRE

    Reilly, J J

    2006-01-01

    A global epidemic of paediatric obesity occurred in recent years, and prevalence of obesity is continuing to rise. In the developed world obesity is now the most common disease of childhood and adolescence. Paediatric obesity is not a cosmetic issue, being associated with a significant burden of ill health both for obese children and for adults who were obese as children. Health professionals tend to underestimate the impact of paediatric obesity, and lack the skills, knowledge, and time to t...

  20. [Perception manner of mother of obese persons in adolescence].

    Science.gov (United States)

    Radoszewska, Joanna

    2007-01-01

    There are specific relation properties of mother to the obese child. The mother representation in child is understand as a experience manner of herself. Representation (mental image) include perceptions, knowledge about characteristics and behaviors of a person and evaluation and experiences that provoke in others. The aim of this article is a trial of an answer what is a mental representation of mother experienced by obese girls and boys in adolescence. 21 obese persons (12 girls and 9 boys) and 23 persons of normal body mass (15 girls and 8 boys) have been investigated. The mean age of the investigated obese persons were 14.53, and for a person of normal body mass was 15.31. All persons were investigated by a clinical interview with 6 questions concerning mental mother representation. The obtained results were analyzed in relation to mental mother representation contents: cognitive, emotional, social, sexual, certificate, behavioral and somatic. Obese persons more often than the person of the normal body mass identify to mental mother representation somatic contents, more rarely social, sexual and behavioral contents. Obese girls more rarely than girls of the normal body mass identify to social contents, more often to somatic. Obese girls more rarely than obese boys identify to mental mother representation emotional contents, more often to somatic contents. The specific relation properties of mother to obese person in adolescence could be manifested in difficulties in turn on contents of mental mother representation, in external, somatic point of concern for mental mother representation, difficulties in contact with mental contents of mother representation.

  1. The controversy over pediatric bariatric surgery: an explorative study on attitudes and normative beliefs of specialists, parents, and adolescents with obesity.

    Science.gov (United States)

    van Geelen, Stefan M; Bolt, Ineke L E; van der Baan-Slootweg, Olga H; van Summeren, Marieke J H

    2013-06-01

    Despite the reported limited success of conventional treatments and growing evidence of the effectiveness of adult bariatric surgery, weight loss operations for (morbidly) obese children and adolescents are still considered to be controversial by health care professionals and lay people alike. This paper describes an explorative, qualitative study involving obesity specialists, morbidly obese adolescents, and parents and identifies attitudes and normative beliefs regarding pediatric bariatric surgery. Views on the etiology of obesity-whether it should be considered primarily a medical condition or more a psychosocial problem-seem to affect the specialists' normative opinions concerning the acceptability of bariatric procedures as a treatment option, the parents' feelings regarding both being able to influence their child's health and their child being able to control their own condition, and the adolescents' sense of competence and motivation for treatment. Moreover, parents and adolescents who saw obesity as something that they could influence themselves were more in favor of non-surgical treatment and vice versa. Conflicting attitudes and normative views-e.g., with regard to concepts of disease, personal influence on health, motivation, and the possibility of a careful informed consent procedure-play an important role in the acceptability of bariatric surgery for childhood obesity.

  2. Personalized exercise for adolescents with diabetes or obesity.

    Science.gov (United States)

    Faulkner, Melissa Spezia; Michaliszyn, Sara Fleet; Hepworth, Joseph T; Wheeler, Mark D

    2014-01-01

    This study examined adherence to a personalized, community-based exercise intervention by sedentary adolescents with type 1 or type 2 diabetes or those with obesity. We conducted a pretest-posttest investigation to explore the application of an individualized exercise prescription based upon current fitness level for 39 adolescents (20 with type 1 diabetes, 9 with type 2 diabetes, and 10 obese) over 16 weeks in community settings. Subjects were recruited from a university-based pediatric endocrinology clinic in the southwestern United States. Adherence to the exercise prescription was monitored using accelerometers over the entire intervention period. Moderate-to-vigorous physical activity (MVPA) levels significantly increased over sedentary baseline values (p exercise is challenging. Personalized approaches that include adolescent choices with family support and ongoing motivation can improve individual exercise adherence and a sense of personal health.

  3. Obesity among adolescents: sedentary leisure time and sleeping as determinants.

    Science.gov (United States)

    Liou, Yiing Mei; Liou, Tsan-Hon; Chang, Lu-Chuan

    2010-06-01

    Over the past 30 years, the prevalence of overweight and obesity in children and adolescents has nearly tripled. Physical inactivity, unbalanced diet, and unhealthy lifestyles may cause lifelong obesity. A representative, national cross-sectional study was carried out between 2006 and 2007 with 40 middle high schools with 384 classes. We used a three-stage stratified systematic sampling design with a probability proportionate to the size from the northern, middle, southern, and eastern areas in Taiwan. Questionnaires were completed by 8640 students (51.7% boys and 48.3% girls) aged between 13 and 16 years. Obesity was identified in 7.2% of the participants and 16.1% were overweight. Using stepwise logistic regression, we found that those whose fathers or mothers were obese, watched television for more than 2 hours/day on weekdays and slept for less than 7.75 hours/day at weekends had a statistically significantly greater risk of obesity (females: ORs = 3.4, 4.2, 1.8, and 4.2, respectively; P leisure time and help them have sufficient sleep. Nurses can play a key role in health promotion in relation to childhood and adolescent obesity.

  4. PREVALENCE OF OVERWEIGHT AND OBESITY IN ADOLESCENTS IN BIRJAND

    Directory of Open Access Journals (Sweden)

    Fatemeh Taheri

    2010-12-01

    Full Text Available AbstractINTRODUCTION: This population-based study was conducted to assess the prevalenceof overweight and obesity in high schools in the city of Birjand in Khorasan Province,Eastern Iran.METHODS: In this descriptive study, we attempted to determine the prevalence ofoverweight and obesity in Iranian adolescents attending high school in Birjand in 2005.A sample of 2230 high school students (1115 boys and 1115 girls aged 15-18 years wasselected via stepwise random sampling in four districts of Birjand. Overweight andobesity were defined based on the 85th and 95th percentiles of BMI for age, respectively,as proposed by the Center for Disease Control (CDC in 2000.RESULTS: The overall prevalence rates of overweight and obesity were 6.1% and 2.3%,respectively. The prevalence of overweight was 5% in boys and 7.1% in high school girls.The prevalence of obesity was 2.8% and 1.8% in high school boys and girls, respectively.CONCLUSIONS: The prevalence of overweight and obesity in high schools in the city ofBirjand is lower than figures reported by other studies conducted in Iran and in othercountries.Key Words: Prevalence, overweight, obesity, adolescents.

  5. Screen Media Exposure and Obesity in Children and Adolescents.

    Science.gov (United States)

    Robinson, Thomas N; Banda, Jorge A; Hale, Lauren; Lu, Amy Shirong; Fleming-Milici, Frances; Calvert, Sandra L; Wartella, Ellen

    2017-11-01

    Obesity is one of the best-documented outcomes of screen media exposure. Many observational studies find relationships between screen media exposure and increased risks of obesity. Randomized controlled trials of reducing screen time in community settings have reduced weight gain in children, demonstrating a cause and effect relationship. Current evidence suggests that screen media exposure leads to obesity in children and adolescents through increased eating while viewing; exposure to high-calorie, low-nutrient food and beverage marketing that influences children's preferences, purchase requests, consumption habits; and reduced sleep duration. Some evidence also suggests promise for using interactive media to improve eating and physical activity behaviors to prevent or reduce obesity. Future interdisciplinary research is needed to examine the effects of newer mobile and other digital media exposures on obesity; to examine the effectiveness of additional interventions to mitigate the adverse effects of media exposures on obesity and possible moderators and mediators of intervention effects; to effectively use digital media interventions to prevent and reduce obesity; and to uncover the mechanisms underlying the causal relationships and interactions between obesity-related outcomes and media content, characteristics, and context. Copyright © 2017 by the American Academy of Pediatrics.

  6. Screen Media Exposure and Obesity in Children and Adolescents

    Science.gov (United States)

    Robinson, Thomas N.; Banda, Jorge A.; Hale, Lauren; Lu, Amy Shirong; Fleming-Milici, Frances; Calvert, Sandra L.; Wartella, Ellen

    2018-01-01

    Obesity is one of the best-documented outcomes of screen media exposure. Many observational studies find relationships between screen media exposure and increased risks of obesity. Randomized controlled trials of reducing screen time in community settings have reduced weight gain in children, demonstrating a cause and effect relationship. Current evidence suggests that screen media exposure leads to obesity in children and adolescents through increased eating while viewing; exposure to high-calorie, low-nutrient food and beverage marketing that influences children’s preferences, purchase requests, consumption habits; and reduced sleep duration. Some evidence also suggests promise for using interactive media to improve eating and physical activity behaviors to prevent or reduce obesity. Future interdisciplinary research is needed to examine the effects of newer mobile and other digital media exposures on obesity; to examine the effectiveness of additional interventions to mitigate the adverse effects of media exposures on obesity and possible moderators and mediators of intervention effects; to effectively use digital media interventions to prevent and reduce obesity; and to uncover the mechanisms underlying the causal relationships and interactions between obesity-related outcomes and media content, characteristics, and context. PMID:29093041

  7. Who seeks bariatric surgery? Psychosocial functioning among adolescent candidates, other treatment-seeking adolescents with obesity and healthy controls.

    Science.gov (United States)

    Call, C C; Devlin, M J; Fennoy, I; Zitsman, J L; Walsh, B T; Sysko, R

    2017-12-01

    Limited data are available on the characteristics of adolescents with obesity who seek bariatric surgery. Existing data suggest that adolescent surgery candidates have a higher body mass index (BMI) than comparison adolescents with obesity, but the limited findings regarding psychosocial functioning are mixed. This study aimed to compare BMI and psychosocial functioning among adolescent bariatric surgery candidates, outpatient medical-treatment-seeking adolescents with obesity (receiving lifestyle modification), and adolescents in the normal-weight range. All adolescents completed self-report measures of impulsivity, delay discounting, depression, anxiety, stress, eating pathology, family functioning and quality of life, and had their height and weight measured. Adolescent surgical candidates had higher BMIs than both comparison groups. Surgical candidates did not differ from medical-treatment-seeking adolescents with obesity on any measure of psychosocial functioning, but both groups of adolescents with obesity reported greater anxiety and eating pathology and poorer quality of life than normal-weight adolescents. Quality of life no longer differed across groups after controlling for BMI, suggesting that it is highly related to weight status. Adolescents with obesity may experience greater anxiety, eating pathology, and quality of life impairments than their peers in the normal-weight range regardless of whether they are seeking surgery or outpatient medical treatment. Clinical implications and directions for future research are discussed. © 2017 World Obesity Federation.

  8. Preoperative nutritional interventions in morbid obesity: impact on body weight, energy intake, and eating quality.

    Science.gov (United States)

    Melendez-Araújo, Mariana Silva; de Matos Arruda, Sérgio Lincoln; de Oliveira Kelly, Emily; de Carvalho, Kênia Mara Baiocchi

    2012-12-01

    Although the benefits of preoperative weight loss and adequacy of dietary patterns in bariatric surgery is well-recognized, the nutritional strategies in the preoperative period have been scarcely investigated. We aimed to evaluate the impact of intensive and standard nutritional interventions on body weight, energy intake, and eating quality. This is a retrospective study in which 32 patients undergoing intensive nutritional intervention, with low-calorie diet (10 kcal/kg) and biweekly visits, were pair-matched by age, sex, and body mass index with 32 patients under a standard nutritional intervention, based on a general dietary counseling. Twenty-four-hour food recall was used to assess energy intake and to derive healthy eating index (HEI). The follow-up preoperative period varied from 8 to 16 weeks. Weight loss was observed in 72% of the patients from the intensive intervention group and 75% of the patients from the standard intervention group. According to the mixed model analysis, time effect on weight loss in both groups was significant (P = 0.0002); however, no difference was found between the intervention groups (P = 0.71). The time effect was significant in both groups for energy intake reduction as well (P eating quality was expressed by the nutrient score of the HEI that increased significantly overtime (P = 0.02), also without distinction between the groups (P = 0.61). Both intensive and standard nutritional interventions promoted weight loss, energy intake reduction, and improvement of eating quality in morbidly obese patients during preoperative period.

  9. Vitamin K and other markers of micronutrient status in morbidly obese patients before bariatric surgery.

    Science.gov (United States)

    Ewang-Emukowhate, M; Harrington, D J; Botha, A; McGowan, B; Wierzbicki, A S

    2015-06-01

    Micronutrient deficiencies occur in morbidly obese patients. The aim of this study was to assess vitamin deficiencies prior to bariatric surgery including vitamin K about which there is little data in this population. A prospective assessment of 118 consecutive patients was performed. Clinical allied with haematological and biochemical variables were measured. Micronutrients measured included vitamins K1 , PIVKA-II (protein-induced in vitamin K absence factor II), vitamin D, vitamin B12 (holotranscobalamin), iron, transferrin and folate. Patients were aged 49 ± 11 [mean (SD, standard deviation)] years, body mass index (BMI) 50 ± 8 kg/m(2), 66% female and 78% Caucasian. Hypertension was present in 47% and type 2 diabetes in 32%. Vitamin D supplements had been prescribed in 8%. Micronutrient insufficiencies were found for vitamin K (40%), vitamin D (92%) and vitamin B12 (25%), and also iron (44%) and folate (18%). Normocalcaemic vitamin D insufficiency with secondary hyperparathyroidism was present in 18%. Iron and transferrin levels were associated with age, sex and estimated glomerular filtration rate. Vitamin K levels were associated with age, and inversely with BMI and diabetes mellitus; and PIVKA-II with smoking, triglycerides and liver function markers. Vitamin D levels were associated with statin use and prescription of supplements and inversely with BMI. Vitamin B12 levels were associated with ethnicity and HbA1c. Micronutrient status shows differing relationships with age, gender and BMI. Vitamin K insufficiency was present in 40% and not related to deficiencies in other vitamins or micronutrients. Vitamin D and vitamin K supplementation should be considered prebariatric surgery in patients with diabetes or severe insulin resistance. © 2014 John Wiley & Sons Ltd.

  10. Epidemiological determinants of obesity in adolescent population Maharashtra, India.

    Directory of Open Access Journals (Sweden)

    Sanjeev Chincholikar

    2016-06-01

    Full Text Available Background: For establishing effective intervention, it is important to identify major determinants in an early stage of life. Effective prevention of adult obesity will require prevention and management of childhood obesity. Aims & Objectives: To study the epidemiological determinants of obesity in adolescent girls. Material & Methods: All adolescent school going boys and girls in the age group between 10 to 19 years were included as per definition of adolescent. 585 students were selected by systematic sample i.e. every 3rd student was included in the study sample. A pretested standardized questionnaire which consisted of questions related to sociodemographic data was used to screen the population for obesity. Results: When body mass index was correlated with various socioeconomic variables, it was found that prevalence of obesity was more in   males (overweight- 20.84%;obese-5.43% as compared to females (overweight- 16.92%; obese-3.14%,more  in the upper socioeconomic status (27.27% as compared to lower socioeconomic status(15%,more in  subjects with more frequency of junk food(30.97% as compared to having occasional junk food (20.93,more in  subjects with more frequency of eating sweets ( 25.73% as compared to occasional sweet eaters(13.59%. Conclusion: The dietary habits like more frequency of junk food, more sweet consumption, and socioeconomic status had a major impact on body mass index of children.

  11. Impact of concomitant laparoscopic sleeve gastrectomy and hiatal hernia repair on gastro-oesophageal reflux disease in morbidly obese patients.

    Science.gov (United States)

    Garg, Harshit; Vigneshwaran, Balasubiramaniyan; Aggarwal, Sandeep; Ahuja, Vineet

    2017-01-01

    The aim of this study was to analyse the impact of hiatal hernia repair (HHR) on gastro-oesophageal reflux disease (GERD) in morbidly obese patients with hiatus hernia undergoing laparoscopic sleeve gastrectomy (LSG). It is a retrospective study involving ten morbidly obese patients with large hiatus hernia diagnosed on pre-operative endoscopy who underwent LSG and simultaneous HHR. The patients were assessed for symptoms of GERD using a Severity symptom score (SS) questionnaire and anti-reflux medications. Of the ten patients, five patients had GERD preoperatively. At the mean follow-up of 11.70 ± 6.07 months after surgery, four patients (80%) showed complete resolution while one patient complained of persistence of symptoms. Endoscopy in this patient revealed resolution of esophagitis indicating that the persistent symptoms were not attributable to reflux. The other five patients without GERD remained free of any symptom attributable to GERD. Thus, in all ten patients, repair of hiatal hernia (HH) during LSG led to either resolution of GERD or prevented any new onset symptom related to GER. In morbidly obese patients with HH with or without GERD undergoing LSG, repair of the hiatus hernia helps in amelioration of GERD and prevents any new onset GER. Thus, the presence of HH should not be considered as a contraindication for LSG.

  12. Impact of concomitant laparoscopic sleeve gastrectomy and hiatal hernia repair on gastro-oesophageal reflux disease in morbidly obese patients

    Directory of Open Access Journals (Sweden)

    Harshit Garg

    2017-01-01

    Full Text Available Background: The aim of this study was to analyse the impact of hiatal hernia repair (HHR on gastro-oesophageal reflux disease (GERD in morbidly obese patients with hiatus hernia undergoing laparoscopic sleeve gastrectomy (LSG. Materials and Methods: It is a retrospective study involving ten morbidly obese patients with large hiatus hernia diagnosed on pre-operative endoscopy who underwent LSG and simultaneous HHR. The patients were assessed for symptoms of GERD using a Severity symptom score (SS questionnaire and anti-reflux medications. Results: Of the ten patients, five patients had GERD preoperatively. At the mean follow-up of 11.70 ± 6.07 months after surgery, four patients (80% showed complete resolution while one patient complained of persistence of symptoms. Endoscopy in this patient revealed resolution of esophagitis indicating that the persistent symptoms were not attributable to reflux. The other five patients without GERD remained free of any symptom attributable to GERD. Thus, in all ten patients, repair of hiatal hernia (HH during LSG led to either resolution of GERD or prevented any new onset symptom related to GER. Conclusion: In morbidly obese patients with HH with or without GERD undergoing LSG, repair of the hiatus hernia helps in amelioration of GERD and prevents any new onset GER. Thus, the presence of HH should not be considered as a contraindication for LSG.

  13. Effect of Health Literacy on Help-seeking Behavior in Morbidly Obese Patients Agreeing to Bariatric Surgery.

    Science.gov (United States)

    Cayci, Haci Murat; Erdogdu, Umut Eren; Demirci, Hakan; Ardic, Aykut; Topak, Nevruz Yildirim; Taymur, İbrahim

    2018-03-01

    We aimed to evaluate the effect of health literacy on agreement for bariatric surgery among morbidly obese patients. The data of 242 morbidly obese patients (body mass index-BMI ≥ 40 kg/m 2 ) were evaluated in a cross-sectional case-control pattern. The patients were classified into two groups as those who were attending the clinic for the purpose of receiving bariatric surgery (n = 138) and those who did not (n = 104). The Turkish version of the European Health Literacy Survey Questionnaire (HLS-EU-Q47), consisting of 47 questions, was used for the health literacy evaluation. It was seen that patients who accepted bariatric surgery were younger and had higher weight and BMI values (p bariatric surgery and 26.04 (8.33:46.88) in the group who did not agree to bariatric surgery, and a statistically significant difference was determined between the two groups (p bariatric surgery and 45.2% of the group who did not (p  25-33) (respectively, 36.2%, 37.5%, p = 0.840). A sufficient level (> 33-42) and a perfect level were higher in the group who agreed to bariatric surgery (respectively, 42.8%, 18.1%, p bariatric surgery in morbidly obese patients. The higher the health literacy level, the more the agreement to bariatric surgery increased.

  14. CT-Guided Percutaneous Drainage of Infected Collections Due to Gastric Leak After Sleeve Gastrectomy for Morbid Obesity: Initial Experience

    International Nuclear Information System (INIS)

    Kelogrigoris, M.; Sotiropoulou, E.; Stathopoulos, K.; Georgiadou, V.; Philippousis, P.; Thanos, L.

    2011-01-01

    This study was designed to evaluate the efficacy and safety of computed tomography (CT)-guided drainage in treating infected collections due to gastric leak after laparoscopic sleeve gastrectomy for morbid obesity. From January 2007 to June 2009, 21 patients (9 men and 12 women; mean age, 39.2 (range, 26–52) years) with infected collections due to gastric leak after laparoscopic sleeve gastrectomy for morbid obesity underwent image-guided percutaneous drainage. All procedures were performed using CT guidance and 8- to 12-Fr pigtail drainage catheters. Immediate technical success was achieved in all 21 infected collections. In 18 of 21 collections, we obtained progressive shrinkage of the collection with consequent clinical success (success rate 86%). In three cases, the abdominal fluid collection was not resolved, and the patients were reoperated. Among the 18 patients who avoided surgery, 2 needed replacement of the catheter due to obstruction. No major complications occurred during the procedure. The results of our study support that CT-guided percutaneous drainage is an effective and safe method to treat infected abdominal fluid collections due to gastric leak in patients who had previously underwent laparoscopic sleeve gastrectomy for morbid obesity. It may be considered both as a preparatory step for surgery and a valuable alternative to open surgery. Failure of the procedure does not, however, preclude a subsequent surgical operation.

  15. Nutritional profile of the morbidly obese patients attending a bariatric clinic in a South Indian tertiary care centre

    Directory of Open Access Journals (Sweden)

    Mini Joseph

    2017-09-01

    Full Text Available Background: Obesity is sweeping across continents and is a major public health concern of the modern society. Aims: The main objective of this study was to study the demographic, anthropometric and dietary patterns of the morbidly obese and study region wise variation in their nutrient intake. Materials and Methods: The study was conducted on 101 morbidly obese individuals from different regions of India who attended the Bariatric clinic of a tertiary care hospital in India. Their socio-demographic details, anthropometric measurements were collected. The dietary assessment was done using a 24 hour dietary recall and a food frequency questionnaire. The study was approved by the Institutional review board and informed consent was obtained from them. Results: More than 3/4th of the patients were females and 61 per cent had Type 2 diabetes mellitus. The mean age of the male and female population was 41.3 + 15.5 years and 36.7 + 11.9 years respectively. Their mean BMI was 41kg/m2. The mean daily intake of calories was more than 2200kcal/day with a gross deficit in the intake of micronutrients. Bonferroni Test showed that there was region wise variation in dietary intake, South Indian female population had the lowest intake of the micronutrients and those from East India had the highest intake. In the male population, there was a significant regional difference in intake of Proteins (p=0.039 and Energy (p=0.024. Independent Sample T test showed that South Indian had the highest intake of Energy and proteins. Anthropometric measures showed positive relation with various macronutrient intakes. Conclusion: The obese patients require intense counselling by a dedicated team of an endocrinologist, psychiatrist, dietician, bariatric surgeon and a social worker to make achievable changes in the quality of life of the morbidly obese patients. Regional influences must be considered when counselling the patient.

  16. Dietary restraint and impulsivity modulate neural responses to food in adolescents with obesity and healthy adolescents.

    Science.gov (United States)

    Hofmann, Johannes; Ardelt-Gattinger, Elisabeth; Paulmichl, Katharina; Weghuber, Daniel; Blechert, Jens

    2015-11-01

    Despite alarming prevalence rates, surprisingly little is known about neural mechanisms underlying eating behavior in juveniles with obesity. To simulate reactivity to modern food environments, event-related potentials (ERP) to appetizing food images (relative to control images) were recorded in adolescents with obesity and healthy adolescents. Thirty-four adolescents with obesity (patients) and 24 matched healthy control adolescents watched and rated standardized food and object images during ERP recording. Personality (impulsivity) and eating styles (trait craving and dietary restraint) were assessed as potential moderators. Food relative to object images triggered larger early (P100) and late (P300) ERPs. More impulsive individuals had considerably larger food-specific P100 amplitudes in both groups. Controls with higher restraint scores showed reduced food-specific P300 amplitudes and subjective palatability ratings whereas patients with higher restraint scores showed increased P300 and palatability ratings. This first ERP study in adolescents with obesity and controls revealed impulsivity as a general risk factor in the current obesogenic environment by increasing food-cue salience. Dietary restraint showed paradoxical effects in patients, making them more vulnerable to visual food-cues. Salutogenic therapeutic approaches that deemphasize strict dietary restraint and foster healthy food choice might reduce such paradoxical effects. © 2015 The Obesity Society.

  17. Liver upregulation of genes involved in cortisol production and action is associated with metabolic syndrome in morbidly obese patients.

    Science.gov (United States)

    Torrecilla, Esther; Fernández-Vázquez, Gumersindo; Vicent, David; Sánchez-Franco, Franco; Barabash, Ana; Cabrerizo, Lucio; Sánchez-Pernaute, Andrés; Torres, Antonio J; Rubio, Miguel Angel

    2012-03-01

    Hepatic 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) activity, which converts cortisone (inactive) to cortisol, is downregulated in obesity. However, this compensation fails in obese with metabolic abnormalities, such as diabetes. To further characterize the tissue-specific cortisol regeneration in obesity, we have investigated the mRNA expression of genes related to local cortisol production, i.e., 11β-HSD1, hexose-6-phosphate dehydrogenase (H6PDH) and cortisol action, glucocorticoid receptor (GR) and a cortisol target gene, phosphoenolpyruvate carboxykinase (PEPCK) in the liver, and visceral (VAT) and subcutaneous (SAT) adipose tissues from morbidly obese patients with and without metabolic syndrome (MS). Fifty morbidly obese patients undergoing bariatric surgery, 14 men (mean age, 41.3 ± 3.5 years; BMI, 48.0 ± 3.6 kg/m(2)) and 36 women (mean age, 44.6 ± 1.9 years; BMI, 44.9 ± 1.2 kg/m(2)), were classified as having MS (MS+, n = 20) or not (MS-, n = 30). Tissue mRNA levels were measured by real-time polymerase chain reaction. Hepatic mRNA levels of these genes were higher in obese patients with MS (11β-HSD1, P = 0.002; H6PDH, P = 0.043; GR, P = 0.033; PEPCK, P = 0.032) and positively correlated with the number of clinical characteristics that define the MS. The expression of the four genes positively correlated among them. In contrast to the liver, these genes were not differently expressed in VAT or SAT, when MS+ and MS- obese patients were compared. Coordinated liver-specific upregulation of genes involved in local cortisol regeneration and action support the concept that local hepatic hypercortisolism contributes to development of MS in morbidly obese patients.

  18. Linkage of morbid obesity with polymorphic microsatellite markers on chromosome 1q31 in a three-generation Canadian kindred

    Energy Technology Data Exchange (ETDEWEB)

    Murray, J.D.; Bulman, D.E.; Ebers, G.C. [University Hospital, London (Canada)]|[INSERM, Paris (France)] [and others

    1994-09-01

    Obesity is the most common nutritional disorder affecting Western societies. An estimated 3.7 million Canadians are considered to be overweight, a condition associated with hypertension, accelerated atherosclerosis, diabetes and a host of other medical problems. We have identified a 3 generation kindred in which morbid obesity appears to segregate in an autosomal dominant manner. All individuals were examined. Mass (kg) and heights (m) were measured in order to determine a body mass index (BMI) for each individual. Those individuals with BMI of greater than or equal to 30.0 were designated as affected. In the pedigree studied 25 individuals met this criteria and 12 of these were morbidly obese (BMI greater or equal to 40.0). A search of candidate genes proved unfruitful. A linkage study was initiated. All individuals in the pedigree were genotyped for microsatellite markers which were spaced every 20 centimorgans (cM). Positive evidence of linkage was detected with markers which map to 1q31-32 (lod score of 3.6 at {theta} = 0.05). Notably, strong effects for fatness in pigs have been found on pig chromosome 4 which has synteny with human chromosome 1q21-32. We are currently attempting to refine the position of this gene using linkage analysis with other microsatellite markers from this region of the genome. In addition we are screening other families in which obesity segregates for linkage to 1q31.

  19. Role of routine pre-operative screening venous duplex ultrasound in morbidly obese patients undergoing bariatric surgery

    Directory of Open Access Journals (Sweden)

    P Praveen Raj

    2017-01-01

    Full Text Available Background/Aims: It is well established that obesity is a strongly associated risk factor for post-operative deep vein thrombosis (DVT. Physical effects and pro-thrombotic, pro-inflammatory and hypofibrinolytic effects of severe obesity may predispose to idiopathic DVT (pre-operatively because of which bariatric patients are routinely screened before surgery. The aim of this study was to audit the use of routine screening venous duplex ultrasound in morbidly obese patients before undergoing bariatric surgery. Methods: We retrospectively reviewed 180 patients who underwent bariatric surgery from August 2013 to August 2014 who had undergone pre-operative screening bilateral lower-extremity venous duplex ultrasound for DVT. Data were collected on patient's demographics, history of venous thromboembolism, prior surgeries and duplex ultrasound details of the status of the deep veins and superficial veins of the lower limbs. Results: No patients had symptoms or signs of DVT pre-operatively. No patient gave history of DVT. No patient was found to have iliac, femoral or popliteal vein thrombosis. Superficial venous disease was found in 17 (8%. One patient had a right lower limb venous ulcer. Conclusion: Thromboembolic problems in the morbidly obese before bariatric surgery are infrequent, and screening venous duplex ultrasound can be done in high-risk patients only.

  20. Utility of the ELF Test for Detecting Steatohepatitis in Morbid Obese Patients with Suspicion of Nonalcoholic Fatty Liver Disease.

    Science.gov (United States)

    López, Iria Cebreiros; Aroca, Florentina Guzmán; Bernal, Maria Dolores Frutos; Mompeán, Juan Antonio Luján; Bernal, Águeda Bas; Martínez, Antonio Miguel Hernández; Barba, Enrique Martínez; Velasco, Jose Antonio Noguera; Paricio, Pascual Parilla

    2017-09-01

    Morbid obese patients have a high rate of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). NASH is related to the progression and poor evolution of chronic hepatopathy in NAFLD, so that its detection makes it possible to identify the subjects who are most at risk in order to prioritize treatment. The ELF test (Enhanced Liver Fibrosis test; Siemens Diagnostics, NY, USA) has been assessed for its capacity to detect fibrosis in patients with NAFLD, but its capacity for diagnosing NASH has not been checked. Our objective is to determine the utility of the ELF test for detecting NASH in morbid obese patients with suspected NAFLD. ELF values were determined in a cohort of obese patients who underwent bariatric surgery with suspected NAFLD. Liver biopsy was used as the reference standard. The values of ELF were significantly higher in patients with NASH (p = 0.002) and in those who presented with metabolic syndrome (p = 0.047). An ELF cut-off point of 8.72 allows the detection of patients with NASH with a sensitivity of 71.4% and a specificity of 74.1% (AUC = 0.742, p = 0.002). The ELF test is efficient for the identification of obese patients with NAFLD and early signs of steatohepatitis and fibrosis.

  1. The Gradual Shift of Overweight, Obesity, and Abdominal Obesity Towards the Poor in a Multi-ethnic Developing Country: Findings From the Malaysian National Health and Morbidity Surveys.

    Science.gov (United States)

    Mariapun, Jeevitha; Ng, Chiu-Wan; Hairi, Noran N

    2018-06-05

    Economic development is known to shift the distribution of obesity from the socioeconomically more advantaged to the less advantaged. We assessed the socioeconomic trends in overweight, obesity, and abdominal obesity across a period of significant economic growth. We used the Malaysian National Health and Morbidity Survey data sets for the years 1996, 2006, and 2011 to analyze the trends among adults aged 30 years and above. The World Health Organization's Asian body mass index cut-off points of ≥23.0 kg/m 2 and ≥27.5 kg/m 2 were used to define overweight and obesity, respectively. Abdominal obesity was defined as having a waist circumference of ≥90 cm for men and ≥80 cm for women. Household per-capita income was used as a measure of socioeconomic position. As a summary measure of inequality, we computed the concentration index. Women in Peninsular Malaysia demonstrated patterns that were similar to that of developed countries in which the distributions for overweight, obesity, and abdominal obesity became concentrated among the poor. For women in East Malaysia, distributions became neither concentrated among the rich nor poor, while distributions for men were still concentrated among the rich. Chinese women, particularly from the richest quintile, had the lowest rates and lowest increase in overweight and obesity. All distributions of Chinese women were concentrated among the poor. The distributions of Malay men were still concentrated among the rich, while distributions for Chinese and Indian men and Malay and Indian women were neither concentrated among the rich nor poor. As the country continues to progress, increasing risks of overweight and obesity among the socioeconomically less advantaged is expected.

  2. The Gradual Shift of Overweight, Obesity, and Abdominal Obesity Towards the Poor in a Multi-ethnic Developing Country: Findings From the Malaysian National Health and Morbidity Surveys

    Science.gov (United States)

    Mariapun, Jeevitha; Ng, Chiu-Wan; Hairi, Noran N.

    2018-01-01

    Background Economic development is known to shift the distribution of obesity from the socioeconomically more advantaged to the less advantaged. We assessed the socioeconomic trends in overweight, obesity, and abdominal obesity across a period of significant economic growth. Methods We used the Malaysian National Health and Morbidity Survey data sets for the years 1996, 2006, and 2011 to analyze the trends among adults aged 30 years and above. The World Health Organization’s Asian body mass index cut-off points of ≥23.0 kg/m2 and ≥27.5 kg/m2 were used to define overweight and obesity, respectively. Abdominal obesity was defined as having a waist circumference of ≥90 cm for men and ≥80 cm for women. Household per-capita income was used as a measure of socioeconomic position. As a summary measure of inequality, we computed the concentration index. Results Women in Peninsular Malaysia demonstrated patterns that were similar to that of developed countries in which the distributions for overweight, obesity, and abdominal obesity became concentrated among the poor. For women in East Malaysia, distributions became neither concentrated among the rich nor poor, while distributions for men were still concentrated among the rich. Chinese women, particularly from the richest quintile, had the lowest rates and lowest increase in overweight and obesity. All distributions of Chinese women were concentrated among the poor. The distributions of Malay men were still concentrated among the rich, while distributions for Chinese and Indian men and Malay and Indian women were neither concentrated among the rich nor poor. Conclusion As the country continues to progress, increasing risks of overweight and obesity among the socioeconomically less advantaged is expected. PMID:29657257

  3. Prevalence of adolescent obesity at a high school in the City of Tshwane

    Directory of Open Access Journals (Sweden)

    Nomusa A. Ngwenya

    2017-05-01

    Conclusion: Evidence-based prevalence allowed for conceptualisation of the scope of the obesity epidemic and how children and young people are also affected. To enable proper planning for adolescent obesity interventions, the depth of consequences of obesity for the adolescent cohort should be well defined and clarified.

  4. [Bariatric and plastic surgery in obese adolescents: an alternative treatment].

    Science.gov (United States)

    Dubern, Béatrice; Tounian, Patrice

    2014-06-01

    The increased frequency of extreme forms of obesity in adolescents and the disappointing results of conventional treatments are now leading pediatricians to consider bariatric or cosmetic surgery as the only real long-term effective therapeutic alternative. The two main techniques currently used for bariatric surgery in adolescents are gastric bypass and adjustable gastric banding. Whatever the technique, weight loss is significant with improvement of comorbidities and quality of life. In addition, the complications are identical to those in adults and equally frequent. However, because of the particularities of this age, caution is still required. Adolescence is indeed characterized by specific nutritional needs, but also changes in body image in which surgery could have a negative effect. Currently, all obese teenagers making a request for bariatric surgery should have a comprehensive assessment with global care for at least 6 months. The indication is then discussed on a case-by-case basis by multidisciplinary teams and experts. To date, the type of surgery (gastric banding, gastric sleeve, or bypass) is still widely discussed. Based on experience with adults, we believe that gastric sleeve and bypass should be preferred. In addition, obesity in adolescents almost always involves psychosocial consequences, while somatic complications are rare. Thus, the care of adipo- or gynecomastia, abdominal fat excess, and concealed penis is essential and therefore justifies cosmetic surgery. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  5. Rehospitalization Through Childhood and Adolescence: Association with Neonatal Morbidities in Infants of Very Low Birth Weight.

    Science.gov (United States)

    Kuint, Jacob; Lerner-Geva, Liat; Chodick, Gabriel; Boyko, Valentina; Shalev, Varda; Reichman, Brian

    2017-09-01

    To evaluate the impact of major neonatal morbidities on the risks for rehospitalization in children and adolescents born of very low birth weight. An observational study was performed on data of the Israel Neonatal Network linked together with the Maccabi Healthcare Services medical records. After discharge from the neonatal intensive care unit, 6385 infants of very low birth weight born from 1995 to 2012 were registered with Maccabi Healthcare Services and formed the study cohort. Multivariable negative binomial regression models were calculated to estimate the adjusted relative risk (aRR) and 95% CI for hospitalization. Up to 18 years following discharge, 3956 infants were hospitalized at least once. The median age of follow-up was 10.7 years with total of follow-up of 67 454 patient years and 10 895 hospitalizations. The risks for rehospitalization were increased significantly for each of the neonatal morbidities: surgical necrotizing enterocolitis (NEC), aRR 2.71 (95% CI 2.08-3.53), intraventricular hemorrhage grades 3-4, 2.13 (1.85-2.46), periventricular leukomalacia (PVL), 1.83 (1.58-2.13), bronchopulmonary dysplasia, 1.94 (1.72-2.17), and retinopathy of prematurity stages 3-4, 1.59 (1.36-1.85). During the first 4 years, children with surgically treated NEC, intraventricular hemorrhage, PVL, or bronchopulmonary dysplasia had 1.5- to 2.5-fold greater risks for hospitalization compared with those without the specific morbidity. In the 11th-14th and 15th-18th years, respectively, surgically treated NEC was associated with a 3.05 (1.32-7.04) and 3.26 (0.99-10.7) aRR for hospitalization, and PVL was associated with a 2.67 (1.79-3.97) and 3.47 (2.03-5.92) aRR for hospitalization. Specific major neonatal morbidities as well as the number of morbidities were associated with excess risks of rehospitalization through childhood and adolescence. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. PREDICTORS OF CAROTID INTIMA MEDIA THICKNESS IN OBESE ADOLESCENTS

    Directory of Open Access Journals (Sweden)

    Dusan Paripovic

    2017-04-01

    Full Text Available Our aim was to assess cardiovascular risk factors that may predict increased carotid intima media thickness (cIMT in obese children and adolescents. Children and adolescents were included in the cross-sectional study if they were aged 9-19 years and had primary obesity. Besides anthropometric and biochemical measurements, ambulatory blood pressure monitoring, measurement of carotid intima media thickness and exercise stress test were performed. We included 103 obese patients and divided them according to the ambulatory blood pressure findings in two groups: obese patients with and without ambulatory hypertension. There were 49 obese patients with and 54 without ambulatory hypertension Univariate analysis showed that there was a significant positive correlation of cIMT with age (r = 0.334, p= 0.001, body mass index (r = 0.288, p = 0.004, waist circumference (r = 0.352, p = 0.000, hip circumference (r = 0.288, p = 0.004, night-time systolic blood pressure (r = 0.226, p = 0.027, and peak diastolic blood pressure on exercise test (r = 0.241, p = 0.018. In a stepwise model, age, waist circumference and peak diastolic blood pressure on exercise test were independent predictors of cIMT.

  7. Risk for obesity in adolescence starts in early childhood.

    Science.gov (United States)

    Shankaran, S; Bann, C; Das, A; Lester, B; Bada, H; Bauer, C R; La Gasse, L; Higgins, R D

    2011-11-01

    The objective of this study was to assess the predictive value of body mass index (BMI) at earlier ages on risk of overweight/obesity at age of 11 years. This is a longitudinal study of 907 children from birth to age of 11 years. Predictors include BMI at earlier ages and outcome is overweight/obesity status at age of 11 years. Analyses were adjusted for covariates known to affect BMI. At 11 years, 17% were overweight and 25% were obese. Children whose BMI was measured as ≥85th percentile once at preschool age had a twofold risk for overweight/obesity at 11 years of age. Risk increased by 11-fold if a child's BMI measured was noted more than once during this age. During early elementary years, if a child's BMI was>85th percentile once, risk for overweight/obesity at 11 years was fivefold and increased by 72-fold if noted more than two times. During late elementary years, if a child's BMI was>85th percentile once, risk for overweight/obesity was 26-fold and increased by 351-fold if noted more than two times. Risk of overweight/obesity at 11 years was noted with higher maternal prepregnancy weight, higher birth weight, female gender and increased television viewing. Children in higher BMI categories at young ages have a higher risk of overweight/obesity at 11 years of age. Effect size was greater for measurements taken closer to 11 years of age. Pediatricians need to identify children at-risk for adolescent obesity and initiate counseling and intervention at earlier ages.

  8. Physical activity and overweight/obesity among Malaysian adults: findings from the 2015 National Health and morbidity survey (NHMS).

    Science.gov (United States)

    Chan, Ying Ying; Lim, Kuang Kuay; Lim, Kuang Hock; Teh, Chien Huey; Kee, Chee Cheong; Cheong, Siew Man; Khoo, Yi Yi; Baharudin, Azli; Ling, Miaw Yn; Omar, Mohd Azahadi; Ahmad, Noor Ani

    2017-09-21

    Overweight and obesity are growing health problems both worldwide and in Malaysia due to such lifestyle changes as decreased physical activity (PA), increased sedentary behavior and unhealthy eating habits. This study examined the levels and patterns of PA among normal-weight and overweight/obese adults and to investigate the association between PA level and overweight/obesity in Malaysian adults. This study used data from the 2015 National Health and Morbidity Survey (NHMS), a nationwide cross-sectional survey that implemented a two-stage stratified random sampling design. Respondents aged 18 years and above (n = 17,261) were included in the analysis. The short version of International Physical Activity Questionnaire (IPAQ) was administered to assess the respondents' PA levels. The respondents' height and weight were objectively measured and body mass index (BMI) was calculated. The respondents were categorized according to BMI as either normal-weight (18.5-24.9 kg/m 2 ) or overweight/obese (≥ 25 kg/m 2 ). Descriptive and complex sample logistic regression analyses were employed as appropriate. Overall, approximately 1 in 2 respondents (51.2%) were overweight/obese, even though the majority (69.0%) reporting at least a moderate level of PA (total PA ≥ 10 MET-hours/week). In both normal-weight and overweight/obese groups, a significantly higher prevalence of high PA (total PA ≥ 50 MET-hours/week) was observed among men than women (p obese men reported a significantly lower level of vigorous-intensity PA and total PA than normal-weight men (p obesity (Adjusted OR = 1.14; 95% CI: 1.01-1.30) compared to a high level of PA among men but not among women. The levels of PA were inversely related to the risk of overweight/obesity in men but not in women. Programs designed to reduce overweight/obesity rates should encourage the practice of moderate- to vigorous-intensity PA. Future research should consider using longitudinal and prospective

  9. Early menarche and teenager pregnancy as risk factors for morbid obesity among reproductive-age women: A case-control study.

    Science.gov (United States)

    Neves, Amanda Gonçalves; Kasawara, Karina Tamy; Godoy-Miranda, Ana Carolina; Oshika, Flávio Hideki; Chaim, Elinton Adami; Surita, Fernanda Garanhani

    2017-10-01

    The aim of this study was to evaluate potential risk factors, including non-communicable diseases, for morbid obesity in women between 20 and 49 years of age. We performed a case-control study with 110 morbidly obese women and 110 women with adequate weight who were matched by age and with a 1:1 case to control ratio. All women were between 20 to 49 years old and non-menopausal. Possible risk factors were evaluated through a self-report questionnaire assessing socio-demographic, obstetric and gynecological characteristics, presence of non-communicable diseases and habits. Multiple logistic regression was used to estimate the odds ratio with respective confidence intervals. Menarche under 12 years old, teenage pregnancy and lower educational level were shown to be risk factors for morbid obesity among women of reproductive age. Incidences of non-communicable diseases (diabetes, hypertension, dyslipidemia, liver disease, lung disease, thyroid dysfunction, and joint pain) were increased in women with morbid obesity. Early menarche, teenage pregnancy and low education level are risk factors for the occurrence of morbid obesity in women of reproductive age. Some non-communicable diseases were already more prevalent in women with morbid obesity even before 50 years of age.

  10. Blood pressure and arterial stiffness in obese children and adolescents.

    Science.gov (United States)

    Hvidt, Kristian Nebelin

    2015-03-01

    Obesity, elevated blood pressure (BP) and arterial stiffness are risk factors for cardiovascular disease. A strong relationship exists between obesity and elevated BP in both children and adults. Obesity and elevated BP in childhood track into adult life increasing the risk of cardiovascular disease in adulthood. Ambulatory BP is the most precise measure to evaluate the BP burden, whereas carotid-femoral pulse wave velocity (cfPWV) is regarded as the gold standard for evaluating arterial (i.e. aortic) stiffness. These measures might contribute to a better understanding of obesity's adverse impact on the cardiovascular system, and ultimately a better prevention and treatment of childhood obesity. The overall aim of the present PhD thesis is to investigate arterial stiffness and 24-hour BP in obese children and adolescents, and evaluate whether these measures are influenced by weight reduction. The present PhD thesis is based on four scientific papers.  In a cross-sectional design, 104 severe obese children and adolescents with an age of 10-18 years were recruited when newly referred to the Children's Obesity Clinic, Holbæk University Hospital, and compared to 50 normal weighted age and gender matched control individuals. Ambulatory BP was measured, and cfPWV was investigated in two ways in respect to the distance measure of aorta; the previously recommended length - the so called subtracted distance, and the currently recommended length - the direct distance. In a longitudinal design, the obese patients were re-investigated after one-year of lifestyle intervention at the Children's Obesity Clinic in purpose of reducing the degree of obesity. In the cross-sectional design, the obese group had higher measures of obesity, while matched for age, gender and height, when compared to the control group. In the longitudinal design, 74% of the 72 followed up obese patients experienced a significant weight reduction. CfPWV was dependent on the method used to measure the

  11. Bulimic behaviours and psychopathology in obese adolescents and in their parents

    OpenAIRE

    Isnard, Pascale; Quantin, Laure; Cortese, Samuele; Falissard, Bruno; Musher-Eizenman, Dara; Guedeney, Antoine; Frelut, Marie-Laure; Mouren, Marie-Christine

    2010-01-01

    Objective. To help identify and advance the understanding of the potential mechanisms underlying the association between parents? and adolescents? psychological maladjustment in obesity, we evaluated bulimic behaviours and psychopathology in a clinical sample of obese adolescents and in their parents. Methods. This is a cross-sectional cohort study including 115 severely obese, treatment-seeking adolescents aged 12?17 years (mean age: 14.2; mean body mass index z-score: 4.32), and their paren...

  12. Association of Sun Exposure, Skin Colour and Body Mass Index with Vitamin D Status in Individuals Who Are Morbidly Obese.

    Science.gov (United States)

    Dix, Clare F; Bauer, Judith D; Martin, Ian; Rochester, Sharon; Duarte Romero, Briony; Prins, Johannes B; Wright, Olivia R L

    2017-10-04

    Vitamin D deficiency is a common issue, particularly in obese populations, and is tested by assessing serum 25(OH)D concentrations. This study aimed to identify factors that contribute to the vitamin D status in fifty morbidly obese individuals recruited prior to bariatric surgery. Data collected included serum 25(OH)D concentrations, dietary and supplement intake of vitamin D, sun exposure measures, skin colour via spectrophotometry, and genotype analysis of several single nucleotide polymorphisms in the vitamin D metabolism pathway. Results showed a significant correlation between serum 25(OH)D concentrations and age, and serum 25(OH)D and ITAC score (natural skin colour). Natural skin colour accounted for 13.5% of variation in serum 25(OH)D, with every 10° increase in ITAC score (i.e., lighter skin) leading to a 9 nmol/L decrease in serum 25(OH)D. Multiple linear regression using age, ITAC score, and average UV index in the three months prior to testing, significantly predicted serum 25(OH)D concentrations ( R ² = 29.7%). Single nucleotide polymorphisms for all vitamin D genes tested, showed lower serum 25(OH)D for those with the rare genotype compared to the common genotype; this was most pronounced for fok1 and rs4588 , where those with the rare genotype were insufficient (vitamin D status in individuals with morbid obesity requires testing of 25(OH)D, but potential risk factors for this population include natural skin colour and age.

  13. Relevance of Adipose Tissue Stiffness Evaluated by Transient Elastography (AdipoScan™) in Morbidly Obese Patients before Bariatric Surgery

    Science.gov (United States)

    Sasso, Magali; Abdennour, Meriem; Liu, Yuejun; Hazrak, Hecham; Aron-Wisnewsky, Judith; Bouillot, Jean-Luc; Le Naour, Gilles; Bedossa, Pierre; Torjman, Joan; Clément, Karine; Miette, Véronique

    Subcutaneous adipose tissue (scAT) in human obesity undergoes severe alteration such as fibrosis which is related to metabolic alterations and to less efficiency in losing weight after bariatric surgery. There is currently no non-invasive tool to assess fibrosis in scAT. Vibration Controlled Transient Elastography (VCTE) using FibroScan® is widely used to assess liver fibrosis in clinical practice. A novel device named AdipoScan™ which is based on VCTE has been developed by Echosens (Paris) so as to assess scAT. The objective of this study is to show the first AdipoScan clinical results. AdipoScan™ was assessed in vivo on 73 morbidly obese patients candidate for bariatric surgery who were enrolled in the Pitié Salpêtrière hospital. scAT shear wave speed measured by AdipoScan™ is significantly associated with scAT fibrosis, gender, hypertension status, total body fat mass assessed by DXA, hypertension status, glycemic, lipid, hepatic parameters and adiponectin. Results suggest that scAT evaluation before bariatric surgery can be useful in clinical practice since it is related to scAT fibrosis -who plays in role in weight loss resistance after bariatric surgery- and to obesity induced co-morbidities such as diabetes, hypertension liver dysfunction.

  14. Prediabetes and Cardiovascular Parameters in Obese Children and Adolescents

    Science.gov (United States)

    Eklioğlu, Beray Selver; Atabek, Mehmet Emre; Akyürek, Nesibe; Alp, Hayrullah

    2016-01-01

    Objective: In this study, our aim was to determine cardiovascular risk and cardiac function in prediabetic obese children and adolescents. Methods: The study was conducted on 198 obese children and adolescents 6-18 years of age. Anthropometric measurements, blood pressure measurements, oral glucose tolerance test, lipid profile, and HbA1c levels of patients were assessed. Prediabetes was defined according to American Diabetes Association criteria. Left ventricular mass index (LVMi), carotid intima-media thickness (c-IMT), and tissue Doppler measurements records were used. Results: LVMi was found to be significantly higher in the prediabetes group (p=0.03). There were no statistically significant differences in right ventricular tissue Doppler measurements between the prediabetic and non-prediabetic groups. Left ventricular tissue Doppler measurements were significantly higher in the prediabetes group: LVEEM (left ventricular E/e ratio) (p=0.04); LVEM (left ventricular myocardial velocity cm/s) (p=0.035). LVMi was found to positively correlate with triglyceride level, diastolic blood pressure, waist circumference, body weight standard deviation score and to negatively correlate with high-density lipoprotein cholesterol (p=0.043, r=0.15; p=0.039, r=0.15; p=0.025, r=0.17; p=0.009, r=0.19; p=0.038, r=-0.15, respectively). LVEM was correlated with glucose (p=0.046, r=0.15) and LVEEM was correlated with systolic blood pressure (p=0.035, r=0.15). In linear regression analysis for clinical cardiovascular risk factors, fasting glucose level was the best predictor of LVEM. Conclusion: In this study, deterioration of cardiac function in prediabetic obese children and adolescents was shown. We recommend determining cardiovascular risk and cardiac dysfunction at early stages in prediabetic obese children and adolescents. PMID:26759114

  15. Prediabetes and Cardiovascular Parameters in Obese Children and Adolescents.

    Science.gov (United States)

    Eklioğlu, Beray Selver; Atabek, Mehmet Emre; Akyürek, Nesibe; Alp, Hayrullah

    2016-03-05

    In this study, our aim was to determine cardiovascular risk and cardiac function in prediabetic obese children and adolescents. The study was conducted on 198 obese children and adolescents 6-18 years of age. Anthropometric measurements, blood pressure measurements, oral glucose tolerance test, lipid profile, and HbA1c levels of patients were assessed. Prediabetes was defined according to American Diabetes Association criteria. Left ventricular mass index (LVMi), carotid intima-media thickness (c-IMT), and tissue Doppler measurements records were used. LVMi was found to be significantly higher in the prediabetes group (p=0.03). There were no statistically significant differences in right ventricular tissue Doppler measurements between the prediabetic and non-prediabetic groups. Left ventricular tissue Doppler measurements were significantly higher in the prediabetes group: LVEEM (left ventricular E/e ratio) (p=0.04); LVEM (left ventricular myocardial velocity cm/s) (p=0.035). LVMi was found to positively correlate with triglyceride level, diastolic blood pressure, waist circumference, body weight standard deviation score and to negatively correlate with high-density lipoprotein cholesterol (p=0.043, r=0.15; p=0.039, r=0.15; p=0.025, r=0.17; p=0.009, r=0.19; p=0.038, r=-0.15, respectively). LVEM was correlated with glucose (p=0.046, r=0.15) and LVEEM was correlated with systolic blood pressure (p=0.035, r=0.15). In linear regression analysis for clinical cardiovascular risk factors, fasting glucose level was the best predictor of LVEM. In this study, deterioration of cardiac function in prediabetic obese children and adolescents was shown. We recommend determining cardiovascular risk and cardiac dysfunction at early stages in prediabetic obese children and adolescents.

  16. [Hyperuricaemia and metabolic syndrome in obese children and adolescents].

    Science.gov (United States)

    Castillo-Durán, Carlos; Sepúlveda A, Cecilia; Espinoza G, Aníbal; Rebollo G, María Jesús; Le Roy O, Catalina

    2016-01-01

    Hyperuricaemia has been suggested as an additional metabolic factor in adult obese patients, but it has not been sufficiently studied in paediatric. To assess the relationship between serum uric acid levels (SUAL) with the level of general and visceral obesity, and other biochemical parameters in children and adolescents of Santiago, Chile. A cross sectional study was conducted on 770 children and adolescents (ages: 6-15 y.) from a public school in Santiago, Chile, of whom 227 (29%) were obese (BMI>2 SD, WHO growth standards). Ninety subjects were randomly selected and 77 with no other chronic disease (41 males) accepted to participate. Data was collected on weight, stature, abdominal circumference (AC), visceral adiposity using ultrasound, and other biochemical measurements including fasting glucose, insulin, serum lipids, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and SUAL. The mean SUAL was 0.200±0.065 mmol/L, and was increased in children with hyperinsulinism (adjusted by age: 0.221±0.075 vs. 0.183±0.054 mmol/L; Por<26 U/mL: 0.238±0.070 vs. 0.178±0.054 mmol/L, P<.001. The logistic regression showed the increased SUAL was only associated with increased ALT. No significant differences were found in general or visceral adiposity measurements or fatty liver. Children and adolescents from Santiago, Chile have higher uric acid serum uric acid levels as well as an association with increased ALT and insulin. It is demonstrated in this study that uric acid should be measured in obese children and adolescents, and in their follow up. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Prevalence of Dyslipidemia and Associated Factors in Obese Children and Adolescents.

    Science.gov (United States)

    Elmaoğulları, Selin; Tepe, Derya; Uçaktürk, Seyit Ahmet; Karaca Kara, Fatma; Demirel, Fatma

    2015-09-01

    Childhood-onset obesity is associated with increased mortality and morbidity related to cardiovascular diseases (CVD) during adulthood. Dyslipidemia has a fundamental role in the pathogenesis of CVD. This study aimed to evaluate the prevalence of dyslipidemia and related factors among obese children and adolescents. Obese patients aged between 2 and 18 years were included in the study. Serum concentrations of total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), fasting glucose levels, insulin, thyroid-stimulating hormone (TSH), free thyroxine (fT4), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and liver ultrasound findings were evaluated retrospectively. Among 823 obese patients, 353 (42.9%) met the dyslipidemia criteria: 21.7% had hypertriglyceridemia, 19.7% had low levels of HDL-C, 18.6% had hypercholesterolemia, and 13.7% had high levels of LDL-C. Older age and/or high body mass index (BMI) were related to increased prevalence of dyslipidemia. Hepatosteatosis was more common among dyslipidemic patients. The frequency of insulin resistance (IR) and of higher levels of ALT and TSH were also detected in dyslipidemic patients. Patients with both dyslipidemia and grade 2-3 hepatosteatosis had higher levels of ALT, AST and TSH and lower levels of fT4. Prevalence of dyslipidemia is high in obese children, and hypertriglyceridemia is in the foreground. Higher levels of IR and more apparent abnormal liver function test results are observed in the context of dyslipidemia and hepatosteatosis coexistence. Metabolic and hormonal alterations related with thyroid functions may also be associated with dyslipidemia and hepatosteatosis in obese patients.

  18. Screening Obese Adolescents for Binge Eating Disorder in Primary Care: The Adolescent Binge Eating Scale.

    Science.gov (United States)

    Chamay-Weber, Catherine; Combescure, Christophe; Lanza, Lydia; Carrard, Isabelle; Haller, Dagmar M

    2017-06-01

    To investigate the performance of a simple and developmentally appropriate 10-item questionnaire (Adolescent Binge Eating Scale) for the prediction of binge eating disorder (BED) diagnosis in adolescents seen for obesity. We evaluated the performance of the questionnaire in comparison with a clinical interview, in a population of adolescents being seen for obesity. The ? 2 or Fisher exact tests were used. There were 94 adolescents aged 12-18 years (59.6% girls) who completed the study. The questionnaire demonstrated a good association with the clinical interview and distinguished different levels of risk for having a BED: participants who responded positively to questions 1 or 2 and had more than 6 positive answers to the 8 additional questions had a high risk of subclinical and clinical BED (83.3%); participants with 3 or fewer positive answers had a low risk of clinical BED (4%). The Adolescent Binge Eating Scale questionnaire is a potential screening tool to identify adolescents with obesity at high risk of BED and guide referral to a specialist to clarify the diagnosis and provide adequate care. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. [The effect of sibutramine on weight loss in obese adolescents].

    Science.gov (United States)

    Franco, Ruth Rocha; Cominato, Louise; Damiani, Durval

    2014-04-01

    To evaluate the effect of sibutramine on weight loss in obese adolescents. A double-blind controlled study lasting 13 months. The study included 73 obese adolescents of both sexes aged between 10 and 18 years. Laboratory tests and imaging studies were performed before, during wash-out, and at the end of 13 months. The percentage of patients who lost 10% of their initial weight in the placebo group was 46%, and in the sibutramine group was 75%. When placebo was used, average weight rose by 1.61 kg, and BMI decreased by 0.24 kg/m(2) whereas with the use of sibutramine, weight decreased by 4.47 kg, and average BMI decreased, 2.38 kg/m(2), with p Sibutramine induced significantly more weight loss in obese adolescents compared with placebo, without significant side effects. The weight loss curve was different depending on the moment sibutramine was introduced. This finding indicates that the best time to start sibutramine is when adhesion begins to fail.

  20. Sleep deprivation predisposes Gujarati Indian adolescents to obesity

    Directory of Open Access Journals (Sweden)

    Shaikh Wasim

    2009-01-01

    Full Text Available Background and Aim: Recent studies on various populations indicate that lack of sleep is one of the potential risk factors predisposing the youth to obesity. Since there is a significant rise in obesity among Indian youth and because research indicating the role of sleep in development of obesity among Indian population is scant, the current study was undertaken to assess the effect of sleep duration on adiposity among Gujarati Indian adolescents. Materials and Methods: A randomized cross-sectional study was done on 489 voluntarily participating Indian adolescents in the age group of 16-19 years. Participants were grouped into two categories 1. Adequate Sleep Duration at Night (more than seven hours, ASDN and 2 Inadequate Sleep Duration at Night (less than seven hours, IASDN as reported by the participants. The participants were later assessed for adiposity in terms of BMI, BF % , FM, FMI and waist circumference, meal frequency per day and physical activity status. Results: In both boys as well as girls, the BMI, BF%, FM and FMI were significantly lower in the ASDN group than the IASDN group. However, there was an insignificant difference in the meal frequency and physical activity status between the ASDN and IASDN group. Conclusion : Inadequate sleep duration increases adiposity among Gujarati Indian adolescents but further studies are required to find out the mechanisms through which sleep affects adiposity in this population.

  1. Impact of obesity and knee osteoarthritis on morbidity and mortality in older Americans.

    Science.gov (United States)

    Losina, Elena; Walensky, Rochelle P; Reichmann, William M; Holt, Holly L; Gerlovin, Hanna; Solomon, Daniel H; Jordan, Joanne M; Hunter, David J; Suter, Lisa G; Weinstein, Alexander M; Paltiel, A David; Katz, Jeffrey N

    2011-02-15

    Obesity and knee osteoarthritis are among the most frequent chronic conditions affecting Americans aged 50 to 84 years. To estimate quality-adjusted life-years lost due to obesity and knee osteoarthritis and health benefits of reducing obesity prevalence to levels observed a decade ago. The U.S. Census and obesity data from national data sources were combined with estimated prevalence of symptomatic knee osteoarthritis to assign persons aged 50 to 84 years to 4 subpopulations: nonobese without knee osteoarthritis (reference group), nonobese with knee osteoarthritis, obese without knee osteoarthritis, and obese with knee osteoarthritis. The Osteoarthritis Policy Model, a computer simulation model of knee osteoarthritis and obesity, was used to estimate quality-adjusted life-year losses due to knee osteoarthritis and obesity in comparison with the reference group. United States. U.S. population aged 50 to 84 years. Quality-adjusted life-years lost owing to knee osteoarthritis and obesity. Estimated total losses of per-person quality-adjusted life-years ranged from 1.857 in nonobese persons with knee osteoarthritis to 3.501 for persons affected by both conditions, resulting in a total of 86.0 million quality-adjusted life-years lost due to obesity, knee osteoarthritis, or both. Quality-adjusted life-years lost due to knee osteoarthritis and/or obesity represent 10% to 25% of the remaining quality-adjusted survival of persons aged 50 to 84 years. Hispanic and black women had disproportionately high losses. Model findings suggested that reversing obesity prevalence to levels seen 10 years ago would avert 178,071 cases of coronary heart disease, 889,872 cases of diabetes, and 111,206 total knee replacements. Such a reduction in obesity would increase the quantity of life by 6,318,030 years and improve life expectancy by 7,812,120 quality-adjusted years in U.S. adults aged 50 to 84 years. Comorbidity incidences were derived from prevalence estimates on the basis of life

  2. BMI changes in children and adolescents attending a specialized childhood obesity center: a cohort study

    OpenAIRE

    Maggio, Albane BR; Saunders Gasser, Catherine; Gal-Duding, Claudine; Beghetti, Maurice; Martin, Xavier E; Farpour-Lambert, Nathalie J; Chamay-Weber, Catherine

    2013-01-01

    Background Multidisciplinary group therapies for obese children and adolescents are effective but difficult to implement. There is a crucial need to evaluate simpler management programs that target the obese child and his family. This study aimed to determine changes in body mass indexes (BMI) after individual family-based obesity intervention with a pediatrician in a specialized obesity center for child and adolescent. Methods This cohort study included 283 patients (3.3 to 17.1 years, mean ...

  3. [Obesity and adolescence: psychological factors and family relationships].

    Science.gov (United States)

    Trombini, Elena

    2007-02-01

    The importance of psychological problems for children obesity and the role of the family context in favouring both pathology appearance and maintenance and eventually the failure of a correct dietetic therapy are presented. Particularly, maternal attitudes are underlined: obese children's mothers tend to make the family their exclusive centre of interest. They also tend to dedicate themselves to their children with possessiveness and hyper-protection. They seem to have an insistent requirement of idealisation of their own role as parents and reward expectations that confirm the efficiency of the care they provide their children. Moreover the psychological features of obese adolescents with anxious and depressive personality traits related to impulsivity and emotional immaturity are analysed.

  4. Role of Macrophage Migration Inhibitory Factor in Obesity, Insulin Resistance, Type 2 Diabetes, and Associated Hepatic Co-Morbidities: A Comprehensive Review of Human and Rodent Studies

    NARCIS (Netherlands)

    Morrison, M.C.; Kleemann, R.

    2015-01-01

    Obesity is associated with a chronic low-grade inflammatory state that drives the -development of obesity-related co-morbidities such as insulin resistance/type 2 diabetes, non-alcoholic fatty liver disease (NAFLD), and cardiovascular disease. This metabolic inflammation is thought to originate in

  5. Breastfeeding reduces the risk of obesity in childhood and adolescence

    Directory of Open Access Journals (Sweden)

    Eleni-Maria Papatesta

    2013-06-01

    Full Text Available Childhood obesity has increased dramatically over the last decades, representing one of the most serious public health hazards of the 21st century. Efforts must be made by healthcare professionals to prevent it, as it is associated with short- and long-term risks for physical and mental health and because of the increased possibility to persist during adulthood. From antiquity human breast milk was considered the ideal nourishment for the newborn. Breastfeeding is beneficial for the mother-child dyad. Among others, existing data suggest that it reduces the risk for childhood and adolescence obesity. The mechanisms for this are numerous and include the feeding behavior breastfeeding infants acquire, their growth rate, the ‘early protein hypothesis’, the role of leptin that is found in increased levels in human milk, the dietary choices the breastfed infants make during childhood and adolescence and finally the differences in their bowel flora. Meta-analyses provide sufficient evidence for this protective effect, with a dose-response effect as to the duration of breastfeeding. Healthcare professionals involved in the care of the mother-infant dyad must encourage and support mothers to breastfeed their infants for a long period of time, if obesity were to be prevented. Aim of this review is to provide an account of existing data on the association of breastfeeding and the reduced risk of obesity in childhood and adulthood.

  6. Metabolic effect of obesity on polycystic ovary syndrome in adolescents: a meta-analysis.

    Science.gov (United States)

    Li, Li; Feng, Qiong; Ye, Ming; He, Yaojuan; Yao, Aling; Shi, Kun

    2017-11-01

    This meta-analysis provides an updated and comprehensive estimate of the effects of obesity on metabolic disorders in adolescent polycystic ovary syndrome (PCOS). Relevant articles consistent with the search terms published up to 31 January 2014 were retrieved from PubMed, EMBASE, PsycINFO and CENTRAL. Thirteen articles (16 independent studies) conformed to the inclusion criteria. The evaluated outcomes were the metabolic parameters of obese adolescents with PCOS (case group) relative to normal-weight adolescents with PCOS, or obese adolescents without PCOS. Compared with normal-weight adolescents with PCOS, the case group had significantly lower sex hormone-binding globulin and high-density lipoprotein cholesterol, and significantly higher triglycerides, leptin, fasting insulin, low-density lipoprotein cholesterol and free testosterone levels. Relative to obese adolescents without PCOS, the case group had significantly higher fasting insulin, low-density lipoprotein cholesterol, free testosterone levels and 2-h glucose during the oral glucose tolerance test. These results indicate that metabolic disorders in adolescent PCOS are worsened by concomitant obesity. This study highlights the importance of preventing obesity during the management of adolescent PCOS. Impact statement What is already known about this subject: Obesity and PCOS share many of the same metabolic disorders, for example, hyperandrogenism and hyperinsulinemia with subsequent insulin resistance. Knowledge regarding metabolic features in obese adolescents with PCOS is limited, and there is concern whether obesity and PCOS are related. What do the results of this study add: Relative to PCOS adolescents of normal weight, obese adolescents with PCOS (the case group) had significantly lower SHBG and HDL-C, and significantly higher triglycerides, leptin, fasting insulin, LDL-C and free testosterone levels. The results indicate that metabolic disorders in adolescent PCOS are worsened by concomitant

  7. The influence of parental participation on obesity interventions in african american adolescent females: an integrative review.

    Science.gov (United States)

    Nichols, Michelle; Newman, Susan; Nemeth, Lynne S; Magwood, Gayenell

    2015-01-01

    African American adolescent females have the highest prevalence rates of obesity among those age 18 and under. The long-term health effects and associated comorbidities of obesity within this cohort threaten the health and well-being of a major section of the U.S. population. There is a need to understand the influence of parental support in reducing obesity related health disparities. Using a social ecological framework to explore parental influence on adolescent obesity interventions allows for greater insight into the complex and dynamic influences affecting the lives of African American adolescent females who are obese. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    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.

  9. Bulimic behaviours and psychopathology in obese adolescents and in their parents.

    Science.gov (United States)

    Isnard, Pascale; Quantin, Laure; Cortese, Samuele; Falissard, Bruno; Musher-Eizenman, Dara; Guedeney, Antoine; Frelut, Marie-Laure; Mouren, Marie-Christine

    2010-12-01

    To help identify and advance the understanding of the potential mechanisms underlying the association between parents' and adolescents' psychological maladjustment in obesity, we evaluated bulimic behaviours and psychopathology in a clinical sample of obese adolescents and in their parents. This is a cross-sectional cohort study including 115 severely obese, treatment-seeking adolescents aged 12-17 years (mean age: 14.2; mean body mass index z-score: 4.32), and their parents (115 mothers and 96 fathers). Adolescents filled out the Bulimic Investigatory Test, Edinburgh (BITE), the Beck Depression Inventory (BDI), and the State-Trait Anxiety Inventory for Children (STAIC). Their parents completed the General Health Questionnaire (GHQ) and the BITE. A child psychiatrist filled out the Montgomery and Asberg Depression Rating Scale (MADRS) and the Brief Scale for Anxiety (BSA) for the adolescents. Obese adolescents demonstrated significant correlations between the severity of bulimic symptoms and the degree of emotional symptomatology, such as depression and anxiety, but not with the severity of obesity. Psychopathological maladjustment and bulimic symptoms in obese adolescents were significantly associated with the maternal psychopathological disturbances, especially anxiety and somatisation in mother. In fact, maternal psychopathology, not maternal bulimic symptoms, was the factor most strongly associated with bulimic behaviours in obese adolescents. These results highlight the importance of including an adolescent and parental psychiatric assessment (bulimic, depressive and anxiety symptoms), particularly maternal psychopathology in the treatment of severely obese adolescents.

  10. Associations between severity of obesity in childhood and adolescence, obesity onset and parental BMI: a longitudinal cohort study.

    Science.gov (United States)

    Svensson, V; Jacobsson, J A; Fredriksson, R; Danielsson, P; Sobko, T; Schiöth, H B; Marcus, C

    2011-01-01

    To explore the relationship between severity of obesity at age 7 and age 15, age at onset of obesity, and parental body mass index (BMI) in obese children and adolescents. Longitudinal cohort study. Obese children (n = 231) and their parents (n = 462) from the Swedish National Childhood Obesity Centre. Multivariate regression analyses were applied with severity of obesity (BMI standard deviation score (BMI SDS)) and onset of obesity as dependent variables. The effect of parental BMI was evaluated and in the final models adjusted for gender, parental education, age at onset of obesity, severity of obesity at age 7 and obesity treatment. For severity of obesity at age 7, a positive correlation with maternal BMI was indicated (P = 0.05). Severity of obesity at this age also showed a strong negative correlation with the age at onset of obesity. Severity of obesity at age 15 was significantly correlated with both maternal and paternal BMI (P obesity at age 7 and negatively correlated with treatment. Also, a negative correlation was indicated at this age for parental education. No correlation with age at onset was found at age 15. For age at onset of obesity there was no relevant correlation with parental BMI. Children within the highest tertile of the BMI SDS range were more likely to have two obese parents. The impact of parental BMI on the severity of obesity in children is strengthened as the child grows into adolescence, whereas the age at onset is probably of less importance than previously thought. The influence of parental relative weight primarily affects the severity of childhood obesity and not the timing.

  11. Giant serous cystadenoma arising from an accessory ovary in a morbidly obese 11-year-old girl: a case report.

    Science.gov (United States)

    Sharatz, Steven M; Treviño, Taína A; Rodriguez, Luís; West, Jared H

    2008-01-18

    Ectopic ovarian tissue is an unusual entity, especially if it is an isolated finding thought to be of embryological origin. An 11-year-old, morbidly obese female presented with left flank pain, nausea, and irregular menses. Various diagnostic procedures suggested a large ovarian cyst, and surgical resection was performed. Histologically, the resected mass was not of tubal origin as suspected, but a serous cystadenoma arising from ovarian tissue. The patient's two normal, eutopic ovaries were completely uninvolved and unaffected. A tumor arising from ectopic ovarian tissue of embryological origin seems the most likely explanation. We suggest refining the descriptive nomenclature so as to more precisely characterize the various presentations of ovarian ectopia.

  12. ENU mutagenesis identifies mice with morbid obesity and severe hyperinsulinemia caused by a novel mutation in leptin.

    Directory of Open Access Journals (Sweden)

    Chen-Jee Hong

    Full Text Available BACKGROUND: Obesity is a multifactorial disease that arises from complex interactions between genetic predisposition and environmental factors. Leptin is central to the regulation of energy metabolism and control of body weight in mammals. METHODOLOGY/PRINCIPAL FINDINGS: To better recapitulate the complexity of human obesity syndrome, we applied N-ethyl-N-nitrosourea (ENU mutagenesis in combination with a set of metabolic assays in screening mice for obesity. Mapping revealed linkage to the chromosome 6 within a region containing mouse Leptin gene. Sequencing on the candidate genes identified a novel T-to-A mutation in the third exon of Leptin gene, which translates to a V145E amino acid exchange in the leptin propeptide. Homozygous Leptin(145E/145E mutant mice exhibited morbid obesity, accompanied by adipose hypertrophy, energy imbalance, and liver steatosis. This was further associated with severe insulin resistance, hyperinsulinemia, dyslipidemia, and hyperleptinemia, characteristics of human obesity syndrome. Hypothalamic leptin actions in inhibition of orexigenic peptides NPY and AgRP and induction of SOCS1 and SOCS3 were attenuated in Leptin(145E/145E mice. Administration of exogenous wild-type leptin attenuated hyperphagia and body weight increase in Leptin(145E/145E mice. However, mutant V145E leptin coimmunoprecipitated with leptin receptor, suggesting that the V145E mutation does not affect the binding of leptin to its receptor. Molecular modeling predicted that the mutated residue would form hydrogen bond with the adjacent residues, potentially affecting the structure and formation of an active complex with leptin receptor within that region. CONCLUSIONS/SIGNIFICANCE: Thus, our evolutionary, structural, and in vivo metabolic information suggests the residue 145 as of special function significance. The mouse model harboring leptin V145E mutation will provide new information on the current understanding of leptin biology and novel mouse

  13. Obesity and its cardio-metabolic co-morbidities among adult Nigerians in a primary care clinic of a tertiary hospital in South-Eastern, Nigeria

    Directory of Open Access Journals (Sweden)

    Gabriel Uche Pascal Iloh

    2013-01-01

    Full Text Available Background: Obesity once thought the medical problem of affluent countries now exist in Nigeria and has been described as a time bomb for the future explosion in the frequency of cardio-metabolic diseases. The most deleterious health consequences of obesity are on the cardiovascular system and associated disorder of lipid and glucose homeostasis. Aim: This study was designed to determine the magnitude of obesity and its cardio-metabolic co-morbidities among adult Nigerians in a primary care clinic of a tertiary hospital South-Eastern, Nigeria. Materials and Methods: A cross-sectional study carried out on 2391 adult Nigerians who were assessed for obesity using body mass index (BMI criterion. 206 patients who had BMI ΃30kg/m 2 were screened for cardio-metabolic co-morbidities. The data collected included basic demographic variables, weight, height, blood pressure; fasting plasma glucose and lipid profile. Results: The prevalence of obesity was 8.6%. Grade I obesity (67.5% was the most common pattern; others included grade II obesity (23.3% and grade III obesity (9.2%. Hypertension (42.7% was the most common cardio-metabolic morbidity. Others included low HDL-cholesterol (22.8%, diabetes mellitus (15.1%, high triglyceride (12.6%, high total cholesterol (9.2%, and high LDL-cholesterol (6.8%. Conclusion: Obesity and its cardio-metabolic morbidities exist among the study population. Anthropometric determination of obesity and screening for its associated cardio-metabolic co-morbidities should constitute clinical targets for intervention in primary care clinics.

  14. Multivariate Analysis Approach to the Serum Peptide Profile of Morbidly Obese Patients

    Directory of Open Access Journals (Sweden)

    M. Agostini

    2013-01-01

    Full Text Available Background: Obesity is currently epidemic in many countries worldwide and is strongly related to diabetes and cardiovascular disease. Mass spectrometry, in particular matrix-assisted laser desorption/ionization time of flight (MALDI-TOF is currently used for detecting different pattern of expressed protein. This study investigated the differences in low molecular weight (LMW peptide profiles between obese and normal-weight subjects in combination with multivariate statistical analysis.

  15. Gastric Fluid Volume Change After Oral Rehydration Solution Intake in Morbidly Obese and Normal Controls: A Magnetic Resonance Imaging-Based Analysis.

    Science.gov (United States)

    Shiraishi, Toshie; Kurosaki, Dai; Nakamura, Mitsuyo; Yazaki, Taiji; Kobinata, Satomi; Seki, Yosuke; Kasama, Kazunori; Taniguchi, Hideki

    2017-04-01

    Although preoperative fluid intake 2 hours before anesthesia is generally considered safe, there are concerns about delayed gastric emptying in obese subjects. In this study, the gastric fluid volume (GFV) change in morbidly obese subjects was investigated after ingesting an oral rehydration solution (ORS) and then compared with that in nonobese subjects. GFV change over time after the ingestion of 500 mL of ORS containing 2.5% carbohydrate (OS-1) was measured in 10 morbidly obese subjects (body mass index [BMI], >35) scheduled for bariatric surgery and 10 nonobese (BMI, 19-24) using magnetic resonance imaging. After 9 hours of fasting, magnetic resonance imaging scans were performed at preingestion, 0 min (just after ingestion), and every 30 minutes up to 120 minutes. GFV values were compared between morbidly obese and control groups and also between preingestion and postingestion time points. The morbidly obese group had a significantly higher body weight and BMI than the control group (mean body weight and BMI in morbidly obese, 129.6 kg and 46.3 kg/m, respectively; control, 59.5 kg and 21.6 kg/m, respectively). GFV was significantly higher in the morbidly obese subjects compared with the control group at preingestion (73 ± 30.8 mL vs 31 ± 19.9 mL, P = .001) and at 0 minutes after ingestion (561 ± 30.8 mL vs 486 ± 42.8 mL; P < .001). GFV declined rapidly in both groups and reached fasting baseline levels by 120 minutes (morbidly obese, 50 ± 29.5 mL; control, 30 ± 11.6 mL). A significant correlation was observed between preingestion residual GFV and body weight (r = .66; P = .001). Morbidly obese subjects have a higher residual gastric volume after 9 hours of fasting compared with subjects with a normal BMI. However, no differences were observed in gastric emptying after ORS ingestion in the 2 populations, and GFVs reached baseline within 2 hours after ORS ingestion. Further studies are required to confirm whether the preoperative fasting and fluid

  16. Stress and obesity/metabolic syndrome in childhood and adolescence.

    Science.gov (United States)

    Pervanidou, Panagiota; Chrousos, George P

    2011-09-01

    Chronic distress contributes to the development of obesity and comorbid states. Stress is the disturbance of the complex dynamic equilibrium that all organisms must maintain, and is associated with activation of the Stress system comprising of the hypothalamic-pituitary-adrenal axis and the arousal/sympathetic nervous systems. The stress system functions in a baseline circadian fashion and interacts with other systems of the organism to regulate a variety of behavioral, endocrine, metabolic, immune and cardiovascular functions. The experience of perceived or real uncontrollable intense and/or chronic stress (distress) may lead to several psychopathologic conditions, including anxiety, depressive and psychosomatic disorders, substance abuse, obesity and the metabolic syndrome, and osteoporosis, as well as impaired reproductive and immune functions. Developing children and adolescents are particularly vulnerable to the effects of chronic stress. Both behavioral and biological pathways are involved in the connection between chronic stress and obesity in adults and children. Emotional "comfort" eating, lack of sleep, impulsive behaviours and selection of specific foods often characterize stressed individuals. In addition to specific behaviours, dysregulation of the stress system through increased secretion of cortisol and catecholamines, especially in the evening hours, and in concert with concurrently elevated insulin concentrations, leads to development of central obesity, insulin resistance and the metabolic syndrome. In children, chronic alterations in cortisol secretion may have additional effects on cognitive and emotional development, timing of puberty and final stature. Obese children and adolescents are frequently entangled in a vicious cycle between distress, impairing self-image and distorted self-image, maintaining and worsening distress.

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

    Science.gov (United States)

    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

  18. Projected Cardiovascular Impact of Obesity in Children and Adolescents

    DEFF Research Database (Denmark)

    Baker, J.L.; Holm, J.-C.

    2012-01-01

    to the development of CVD compared with men. The risk of CVD accumulates across the lifespan of women, and without a special emphasis in terms of prophylaxis and treatment in younger girls and women, their risk of CVD is likely to equal or even surpass that of men in the future....... syndrome at young ages. When combined with exposure to other independent CVD risk factors, overweight and obese girls face an elevated risk of cardiovascular morbidity and mortality in adulthood. Additionally, due to their reproductive capacity, women face a different series of risks with regards...

  19. The association between obesity and mental rotation ability in an adolescent sample.

    Science.gov (United States)

    Kaltner, Sandra; Schulz, Anja; Jansen, Petra

    Obesity has been related to deficient mental rotation performance. We assessed object-based and egocentric MR tasks in 19 obese and 19 normal-weight participants. Results showed slower response times of obese adolescents only for high angular disparities. This finding might emerge because of impairments in working memory, motor skills or perspective taking processes in obese youth. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  20. Relationship between the gut microbiota and obesity in children and adolescents

    OpenAIRE

    Vankerckhoven, Vanessa; Bervoets, Liene; Van Hoorenbeeck, Kim; Lammens, Christine; Chapelle, Sabine; Vael, Carl; Desager, Kristine; Goossens, Herman

    2011-01-01

    Objectives Obesity is considered as one of the most important public health problems of our times. The last few decades the prevalence of obesity, especially among children and adolescents, has increased dramatically worldwide. The aim of our study was to determine whether the composition of the gut microbiota is related to obesity in childhood. Methods A cross-sectional study was set-up to examine the gut microbiota using faecal samples from 22 obese children and 33 non-obese chil...

  1. PNPLA3 Expression Is Related to Liver Steatosis in Morbidly Obese Women with Non-Alcoholic Fatty Liver Disease

    Directory of Open Access Journals (Sweden)

    Gemma Aragonès

    2016-04-01

    Full Text Available Recent reports suggest a role for the Patatin-like phospholipase domain-containing protein 3 (PNPLA3 in the pathology of non-alcoholic fatty liver disease (NAFLD. Lipid deposition in the liver seems to be a critical process in the pathogenesis of NAFLD. The aim of the present work was to evaluate the association between the liver PNPLA3 expression, key genes of lipid metabolism, and the presence of NAFLD in morbidly obese women. We used real-time polymerase chain reaction (PCR analysis to analyze the hepatic expression of PNPLA3 and lipid metabolism-related genes in 55 morbidly obese subjects with normal liver histology (NL, n = 18, simple steatosis (SS, n = 20, and non-alcoholic steatohepatitis (NASH, n = 17. Liver biopsies were collected during bariatric surgery. We observed that liver PNPLA3 expression was increased in NAFLD than in NL. It was also upregulated in SS than in NL. Interestingly, we found that the expression of PNPLA3 was significantly higher in severe than mild SS group. In addition, the expression of the transcription factors LXRα, PPARα, and SREBP2 was positively correlated with PNPLA3 liver expression. Regarding rs738409 polymorphism, GG genotype was positive correlated with the presence of NASH. In conclusion, our results show that PNPLA3 could be related to lipid accumulation in liver, mainly in the development and progression of simple steatosis.

  2. PNPLA3 Expression Is Related to Liver Steatosis in Morbidly Obese Women with Non-Alcoholic Fatty Liver Disease.

    Science.gov (United States)

    Aragonès, Gemma; Auguet, Teresa; Armengol, Sandra; Berlanga, Alba; Guiu-Jurado, Esther; Aguilar, Carmen; Martínez, Salomé; Sabench, Fátima; Porras, José Antonio; Ruiz, Maikel Daniel; Hernández, Mercé; Sirvent, Joan Josep; Del Castillo, Daniel; Richart, Cristóbal

    2016-04-27

    Recent reports suggest a role for the Patatin-like phospholipase domain-containing protein 3 (PNPLA3) in the pathology of non-alcoholic fatty liver disease (NAFLD). Lipid deposition in the liver seems to be a critical process in the pathogenesis of NAFLD. The aim of the present work was to evaluate the association between the liver PNPLA3 expression, key genes of lipid metabolism, and the presence of NAFLD in morbidly obese women. We used real-time polymerase chain reaction (PCR) analysis to analyze the hepatic expression of PNPLA3 and lipid metabolism-related genes in 55 morbidly obese subjects with normal liver histology (NL, n = 18), simple steatosis (SS, n = 20), and non-alcoholic steatohepatitis (NASH, n = 17). Liver biopsies were collected during bariatric surgery. We observed that liver PNPLA3 expression was increased in NAFLD than in NL. It was also upregulated in SS than in NL. Interestingly, we found that the expression of PNPLA3 was significantly higher in severe than mild SS group. In addition, the expression of the transcription factors LXRα, PPARα, and SREBP2 was positively correlated with PNPLA3 liver expression. Regarding rs738409 polymorphism, GG genotype was positive correlated with the presence of NASH. In conclusion, our results show that PNPLA3 could be related to lipid accumulation in liver, mainly in the development and progression of simple steatosis.

  3. Calcium and vitamin D status in morbidly obese patients and in patients after biliopancretic diversion/duodenal switch

    Directory of Open Access Journals (Sweden)

    Natalya Mazurina

    2016-10-01

    Full Text Available Objective: The objective was to estimate the prevalence of inadequate vitamin D status and secondary hyperparathyroidism (SHPT in morbidly obese patients and in patients who underwent biliopancreatic diversion/duodenal switch surgery (BPD/DS Design: 3 groups were included in the cross-sectional comparative study: group 1 - morbidly obese (MO patients with BMI > 40 and without type 2 diabetes mellitus (n=22, group 2 – patients in the long-term period after BPD/DS (n=23; group 3 – healthy normal weight controls (n=22. Results: 25(OHD levels were significantly different in the controls (21.8 ng/dl, in the MO (8.8 ng/dl and in the BPD/DS patients (8.6 ng/dl. Parathyroid hormone (PTH elevation was found in 4 (18% MO patients, in 12 (52 % patients after BPD/DS, and was not detected in the control group. The frequency of SHPT was significantly higher in the operated group (52 % in comparison with the MO group (18 % (р=0.029. Conclusions: Vitamin D deficiency and secondary hyperparathyroidism are significantly more prevalent in MO patients than in normal weight subjects. In the long-term period after BPD secondary hyperthyroidism is more frequent than in MO and is not always accompanied by vitamin D depletion. Special attention should be paid for adequate control of calcium metabolism and supplementation by calcium and vitamin D.

  4. Relationship between changes in hemoglobin glycosilated and improvement of body composition in patients with morbid obesity after tubular laparoscopic gastrectomy.

    Science.gov (United States)

    Gallart-Aragón, Tania; Fernández-Lao, Carolina; Cózar-Ibañez, Antonio; Cantarero-Villanueva, Irene; Cambil-Martín, Jacobo; Jiménez Ríos, José Antonio; Arroyo-Morales, Manuel

    2017-12-29

    The objective of our study is to analyze the possible relationship between changes in glycemic profile and body composition parameters in morbid obesity patients after tubular laparoscopic gastrectomy. A prospective observational cohort study with 69 patients was performed. The variables analyzed were body weight, blood glucose, hemoglobin, glycosylated, high density lipoprotein, low density lipoprotein, triglycerides, and waist and hip circumference. An analysis of variance of repeated measurements (ANOVA) and a correlation analysis through the Pearson test were carried out. A significant reduction in weight (p<.001 after surgery) and in glycosylated hemoglobin (p<.036) and waist hip (p<.001) were found at 6 months after surgery. There was no significant difference in the rest of the variables studied. In correlation analysis, a significant positive correlation was found between the change in concentration of hemoglobin glycosylated and hip circumference (p=.047; r=0.237), the smaller the hip circumference, the lower the concentration of glycosylated hemoglobin. Tubular laparoscopic gastrectomy is an effective technique for the treatment of morbidly obese patients with type 2 diabetes mellitus. The reduction in the perimeter of hip is related to glycosylated hemoglobin reduction 6 months after intervention. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  5. Endothelin-1 and Exercise Intensity in Sedentary Adolescents with Obesity

    Directory of Open Access Journals (Sweden)

    Brooke E. Starkoff

    2015-01-01

    Full Text Available Inactivity combined with obesity during adolescence increases the risk of future cardiovascular disease. The study purpose was to compare the influence of differing intensities of exercise on endothelial function in sedentary adolescents with obesity. Participants were randomized to one of two groups in a 6-week exercise intervention: moderate intensity (MOD or high intensity interval exercise (HIIE. Endothelial function was assessed pre- and post-intervention via fasted serum levels of endothelin-1 (ET-1. Pre-measures of ET-1 concentrations were elevated at baseline. No significant differences in ET-1 were found between or within exercise groups. However, in the HIIE group, ET-1 was inversely associated with percentages of age predicted maximal heart rate achieved during the intervention (p=0.035, r=-0.567. The exercise interventions did not positively change ET-1 levels, yet participants who exercised at higher intensities in the HIIE group experienced greater decreases in ET-1. Keywords: childhood obesity, endothelial function, high intensity interval exercise

  6. Gender-related differences in cardiometabolic risk factors and lifestyle behaviors in treatment-seeking adolescents with severe obesity.

    Science.gov (United States)

    Barstad, Lisa Ha; Júlíusson, Pétur B; Johnson, Line Kristin; Hertel, Jens Kristoffer; Lekhal, Samira; Hjelmesæth, Jøran

    2018-02-14

    Obesity during adolescence is associated with cardiovascular mortality in adulthood. The adverse obesity-related cardiometabolic risk profile is already observed in adolescence. We aimed to examine possible gender differences in cardiometabolic risk factors and lifestyle behaviors among adolescents with severe obesity, hypothesizing that boys would have both a higher prevalence of the metabolic syndrome as well as less healthy lifestyle behaviors than girls. Cross-sectional study of treatment-seeking adolescents with severe obesity who attended the Morbid Obesity Centre at Vestfold Hospital Trust and who were consecutively enrolled in the Vestfold Register of Obese Children between September 2009 and September 2015. A total of 313 adolescents aged 12 to 18 years were recruited, whereof 268 subjects (49% boys) completed a food and activity frequency questionnaire and were included in the analysis. Mean (SD) age, BMI and BMI SDS were 15 (1.6) years, 38.6 (5.9) kg/m 2 and 3.5 (0.6). Levels of LDL cholesterol, fasting insulin and glucose and diastolic blood pressure (DBP) did not differ between genders. Compared to girls, boys had significantly higher triglycerides (p = 0.037) and systolic blood pressure (SBP) (p = 0.003), as well as lower HDL cholesterol (p = 0.002). The metabolic syndrome was present in 27% of the boys and 19% of the girls (p = 0.140), and the prevalence of high DBP, dyslipidemia and dysglycemia also did not differ significantly between genders. The prevalence of high SBP was higher in boys than in girls (19% vs. 9%, p = 0.021). Gender was associated with a number of lifestyle habits, as a larger proportions of boys had higher screen time (p = 0.032), more regular breakfast eating (p = 0.023), higher intake of sugar sweetened soda (p = 0.036), and lower intake of vegetables than girls (p = 0.011). By contrast, physical activity level and intake of fruit and berries did not differ between genders. Male treatment

  7. The clinical impact of contemporary stress echocardiography in morbid obesity for the assessment of coronary artery disease.

    Science.gov (United States)

    Shah, Benoy N; Zacharias, Konstantinos; Pabla, Jatinder S; Karogiannis, Nikolaos; Calicchio, Francesca; Balaji, Gothandaraman; Alhajiri, Abdalla; Ramzy, Ihab S; Elghamaz, Ahmed; Gurunathan, Sothinathan; Khattar, Rajdeep S; Senior, Roxy

    2016-03-01

    Non-invasive cardiac imaging may suffer from poor image quality in morbidly obese individuals. This study aimed to determine the clinical value of contemporary stress echocardiography (SE) in morbidly obese patients referred for assessment of suspected coronary artery disease (CAD). This prospective, multicentre observational study was conducted in two district hospitals and one tertiary centre in London, UK. Individuals with body mass index ≥35 kg/m(2) referred for SE were evaluated. The percentage of patients with obstructive CAD on coronary angiography, following abnormal SE, was assessed. Patient outcomes were determined with follow-up for the composite end-point of all-cause mortality, myocardial infarction and late revascularisation. Over a 13-month period, 209 morbidly obese patients underwent SE, and contrast agent was used in 96% of patients. A diagnostic result was obtained in 200/209 (96%) patients. Of 32 (15%) patients with inducible ischaemia, 25 underwent angiography, 22 (88%) had corresponding significant CAD and, of these, 16 (77%) underwent revascularisation. Conversely, only 2/157 patients (1.3%) with normal SE underwent angiography, and none underwent revascularisation. Over a mean follow-up period of 17.8±5.4 months, there were nine events. The annualised cardiac event rate after a normal SE was 0.95%. Events were more frequent in patients with inducible ischaemia versus those without ischaemia (5/32 (15.6%) vs 4/153 (2.6%); p=0.002). Ejection fraction <50% (HR 9.5; 95% CI 2.4 to 38.0; p=0.002) and inducible ischaemia (HR 9.4; 95% CI 2.5 to 35.8; p=0.001) were predictors of outcome on univariable Cox regression analysis. Contemporary SE has excellent feasibility and positive predictive value and resulted in appropriate risk stratification of symptomatic patients with significant obesity. A normal SE portends an excellent outcome over the short-intermediate term in this high-risk patient population. Published by the BMJ Publishing Group

  8. Radiology of upper gastrointestinal tract with ASGB (adjustable silicone gastric banding) for morbid obesity

    International Nuclear Information System (INIS)

    Nowicki, Grzegorz; Maliborski, Artur; Żukowski, Paweł; Bogusławska, Romana

    2010-01-01

    Metabolic syndrome is a result of multiple risk factors of atherosclerosis and diabetes. Obesity is an especially well recognized etiological factor. A rapidly increasing number of obese people constitutes a major social health problem in the developed, as well as developing countries. Bariatric surgeries are among methods of obesity treatment that gain on popularity. They include adjustable silicone gastric banding (ASGB), and adjustable laparoscopic gastric banding (ALGB). The aim of our study was to analyze and present the most typical radiological images obtained during 130 upper gastrointestinal tract examinations in patients after ASGB or ALGB in the last three years. ASGB and ALGB are effective and safe. However, they are connected with some postoperative complications. Application of these surgical procedures requires periodic, long-term radiological evaluations and cooperation between surgeons and radiologists. The radiologist must be familiar with bariatric surgical techniques, their complications and typical radiological presentations

  9. Hyperphagia, lower body temperature, and reduced running wheel activity precede development of morbid obesity in New Zealand obese mice.

    Science.gov (United States)

    Jürgens, Hella S; Schürmann, Annette; Kluge, Reinhart; Ortmann, Sylvia; Klaus, Susanne; Joost, Hans-Georg; Tschöp, Matthias H

    2006-04-13

    Among polygenic mouse models of obesity, the New Zealand obese (NZO) mouse exhibits the most severe phenotype, with fat depots exceeding 40% of total body weight at the age of 6 mo. Here we dissected the components of energy balance including feeding behavior, locomotor activity, energy expenditure, and thermogenesis compared with the related lean New Zealand black (NZB) and obese B6.V-Lep(ob)/J (ob/ob) strains (11% and 65% fat at 23 wk, respectively). NZO mice exhibited a significant hyperphagia that, when food intake was expressed per metabolic body mass, was less pronounced than that of the ob/ob strain. Compared with NZB, NZO mice exhibited increased meal frequency, meal duration, and meal size. Body temperature as determined by telemetry with implanted sensors was reduced in NZO mice, but again to a lesser extent than in the ob/ob strain. In striking contrast to ob/ob mice, NZO mice were able to maintain a constant body temperature during a 20-h cold exposure, thus exhibiting a functioning cold-induced thermogenesis. No significant differences in spontaneous home cage activity were observed among NZO, NZB, and ob/ob strains. When mice had access to voluntary running wheels, however, running activity was significantly lower in NZO than NZB mice and even lower in ob/ob mice. These data indicate that obesity in NZO mice, just as in humans, is due to a combination of hyperphagia, reduced energy expenditure, and insufficient physical activity. Because NZO mice differ strikingly from the ob/ob strain in their resistance to cold stress, we suggest that the molecular defects causing hyperphagia in NZO mice are located distal from leptin and its receptor.

  10. Adiponectin expression in visceral adiposity is an important determinant of insulin resistance in morbid obesity.

    Science.gov (United States)

    Sirbu, Anca Elena; Buburuzan, Laura; Kevorkian, Steliana; Martin, Sorina; Barbu, Carmen; Copaescu, Catalin; Smeu, Bogdan; Fica, Simona

    2018-04-12

    Visceral adiposity is associated with decreased serum adiponectin levels, peripheral resistance to insulin and an increased risk of cardio-metabolic complications. However, the link between adiponectin expression in visceral adipose tissue (VAT), its serum levels and metabolic protection is controversial. The aim of this study was to investigate the relationship between the adiponectin gene expression in VAT and clinical and metabolic parameters in patients with severe obesity. This is a cross-sectional study that included 51 severely obese patients (age 43.24±11.29 years, BMI 45.13±8.67 kg/m2), extensively evaluated clinically and biologically (metabolic tests, serum adiponectin measurements, HOMA-IR) before bariatric surgery. Omental adipose tissue was sampled during the intervention and the relative quantification of adiponectin gene expression was performed by real-time PCR, using beta-actin as reference gene. Adiponectin mRNA in VAT was significantly higher in obese insulin-sensitive patients than in the rest of obese patients (p<0.05) and negatively correlated with HOMA-IR (r =-0.354, p=0.016) and uric acid (r =-0.304, p=0.045). After adjustment for gender, TG/HDL ratio and uric acid, adiponectin expresion (β= -0.439, p=0.001), waist circumference (β=0.467, p=0.001) and serum adiponectin (β =-0.339, p=0.011) remained significantly associated with HOMA-IR, together explaining more than 50% of its variation. In severely obese patients, adiponectin gene expression in VAT is negatively correlated with serum levels of uric acid and is an independent determinant, together with anthropometric parameters of visceral obesity and serum adiponectin levels, of insulin resistance.

  11. Impact of spinal anaesthesia on peri-operative lung volumes in obese and morbidly obese female patients.

    Science.gov (United States)

    Regli, A; von Ungern-Sternberg, B S; Reber, A; Schneider, M C

    2006-03-01

    Although obesity predisposes to postoperative pulmonary complications, data on the relationship between body mass index (BMI) and peri-operative respiratory performance are limited. We prospectively studied the impact of spinal anaesthesia, obesity and vaginal surgery on lung volumes measured by spirometry in 28 patients with BMI 30-40 kg.m(-2) and in 13 patients with BMI > or = 40 kg.m(-2). Vital capacity, forced vital capacity, forced expiratory volume in 1 s, mid-expiratory and peak expiratory flows were measured during the pre-operative visit (baseline), after effective spinal anaesthesia with premedication, and after the operation at 20 min, 1 h, 2 h, and 3 h (after mobilisation). Spinal anaesthesia and premedication were associated with a significant decrease in spirometric parameters. Spinal anaesthesia and premedication were associated with a significant decrease in spirometric parameters; mean (SD) vital capacities were - 19% (6.4) in patients with BMI 30-40 kg.m(-2) and - 33% (9.0) in patients with BMI > 40 kg.m(-2). The decrease of lung volumes remained constant for 2 h, whereas 3 h after the operation and after mobilisation, spirometric parameters significantly improved in all patients. This study showed that both spinal anaesthesia and obesity significantly impaired peri-operative respiratory function.

  12. Surgery for the treatment of obesity in children and adolescents (Review)

    NARCIS (Netherlands)

    Ells, Louisa J.; Mead, Emma; Atkinson, Greg; Corpeleijn, Eva; Roberts, Katharine; Viner, Russell; Baur, Louise; Metzendorf, Maria-Inti; Richter, Bernd

    2015-01-01

    Background Child and adolescent overweight and obesity have increased globally, and are associated with significant short and long term health consequences. Objectives To assess the effects of surgical interventions for treating obesity in childhood and adolescence. Search methods We searched the

  13. Clustering of obesity and dental caries with lifestyle factors among Danish adolescents

    DEFF Research Database (Denmark)

    Cinar, Ayse Basak; Christensen, Lisa Boge; Hede, Borge

    2011-01-01

    To assess any clustering between obesity, dental health, and lifestyle factors (dietary patterns, physical activity, smoking, and alcohol consumption) among adolescents.......To assess any clustering between obesity, dental health, and lifestyle factors (dietary patterns, physical activity, smoking, and alcohol consumption) among adolescents....

  14. Female Overweight and Obesity in Adolescence: Developmental Trends and Ethnic Differences in Prevalence, Incidence, and Remission

    Science.gov (United States)

    Huh, David; Stice, Eric; Shaw, Heather; Boutelle, Kerri

    2012-01-01

    Despite substantial increases in the prevalence of adolescent overweight and obesity documented in recent decades, few studies have prospectively tracked their development during the entire adolescent period. The aims of this study were to characterize developmental trends in prevalence, incidence, and remission of overweight and obesity using…

  15. Multiple Levels of Social Disadvantage and Links to Obesity in Adolescence and Young Adulthood

    Science.gov (United States)

    Lee, Hedwig; Harris, Kathleen M.; Lee, Joyce

    2013-01-01

    Background: The rise in adolescent obesity has become a public health concern, especially because of its impact on disadvantaged youth. This article examines the role of disadvantage at the family-, peer-, school-, and neighborhood-level, to determine which contexts are related to obesity in adolescence and young adulthood. Methods: We analyzed…

  16. 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,

  17. Validity of childhood adiposity classification in predicting adolescent overweight and obesity.

    Science.gov (United States)

    Huerta, Michael; Zarka, Salman; Bibi, Haim; Haviv, Jacob; Scharf, Shimon; Gdalevich, Michael

    2010-05-03

    Identification of children at risk for adolescent overweight can assist in targeting interventions. Uncertainty remains regarding the validity of current body mass index (BMI) reference values in predicting future risk on a population basis. This study aimed to assess the validity of current childhood adiposity classifications in predicting adolescent overweight and obesity among Israeli youth. Historical cohort study. School-based childhood health studies and adolescent physical examinations. A total of 3 163 subjects surveyed first at age 8-15 and again at age 17-19. Age, sex, height, weight and BMI. Sensitivity, specificity, positive and negative predictive values, and relative risk of childhood adiposity classification. Childhood overweight and obesity showed low sensitivity and high specificity for predicting adolescent overweight and obesity. Positive predictive values were low and varied by age and sex, but negative predictive values were consistently high in both sexes and all ages (range 0.85-0.99). After adjusting for age and sex, both childhood overweight and obesity substantially increased the risk of adolescent overweight (relative risk [RR] 7.03 and 7.20, respectively) and adolescent obesity (RR 24.34 and 28.41, respectively). Childhood overweight and obesity are strong risk factors for adolescent overweight and obesity among Israeli youth. Normal weight children were at very low risk for adolescent overweight. These findings suggest that population-based health promotion aimed at maintaining normal weight among children should be given preference over risk-guided approaches targeting weight reduction among obese children.

  18. Coming of age, becoming obese: a cross-sectional analysis of obesity among adolescents and young adults in Malaysia

    NARCIS (Netherlands)

    Pell, C.; Allotey, P.; Evans, N.; Hardon, A.; Imelda, J.D.; Soyiri, I.; Reidpath, D.D.

    2016-01-01

    Background Malaysians have become increasingly obese over recent years. The transition from adolescence to early adulthood is recognized as critical for the development of eating and activity habits. However, little obesity-related research focuses on this life stage. Drawing on data from a health

  19. Association of Sun Exposure, Skin Colour and Body Mass Index with Vitamin D Status in Individuals Who Are Morbidly Obese

    Directory of Open Access Journals (Sweden)

    Clare F. Dix

    2017-10-01

    Full Text Available Vitamin D deficiency is a common issue, particularly in obese populations, and is tested by assessing serum 25(OHD concentrations. This study aimed to identify factors that contribute to the vitamin D status in fifty morbidly obese individuals recruited prior to bariatric surgery. Data collected included serum 25(OHD concentrations, dietary and supplement intake of vitamin D, sun exposure measures, skin colour via spectrophotometry, and genotype analysis of several single nucleotide polymorphisms in the vitamin D metabolism pathway. Results showed a significant correlation between serum 25(OHD concentrations and age, and serum 25(OHD and ITAC score (natural skin colour. Natural skin colour accounted for 13.5% of variation in serum 25(OHD, with every 10° increase in ITAC score (i.e., lighter skin leading to a 9 nmol/L decrease in serum 25(OHD. Multiple linear regression using age, ITAC score, and average UV index in the three months prior to testing, significantly predicted serum 25(OHD concentrations (R2 = 29.7%. Single nucleotide polymorphisms for all vitamin D genes tested, showed lower serum 25(OHD for those with the rare genotype compared to the common genotype; this was most pronounced for fok1 and rs4588, where those with the rare genotype were insufficient (<50 nmol/L, and those with the common genotype were sufficient (≥50 nmol/L. Assessing vitamin D status in individuals with morbid obesity requires testing of 25(OHD, but potential risk factors for this population include natural skin colour and age.

  20. Morbidly obese women with and without endometrial cancer: are there differences in measured physical fitness, body composition, or hormones?

    Science.gov (United States)

    Modesitt, Susan C; Geffel, Dyanna L; Via, Jennifer; L Weltman, Arthur

    2012-03-01

    Exercise is potentially protective against cancer for obese women. The objectives were to examine differences in activity, body composition, and hormones in overweight/obese women with and without endometrial cancer. Women ≥ 50 years old with a body mass index (BMI) ≥ 25 kg/m(2) scheduled for abdominal hysterectomy were enrolled. Demographics, physical activity, and quality of life (QOL) data were collected. Body composition/fitness was evaluated using Air Displacement Plethysmography (BodPod) and a standardized treadmill. Adiponectin, androstenedione, leptin, estradiol, estrone, progesterone, sex hormone binding globulin, insulin and glucose were measured. Thirty-eight women enrolled in this pilot study; 22 had endometrial cancer. Mean age was 58.3 years, mean BMI, fat weight and percent body fat were 41.3 kg/m(2), 55 kg and 51% respectively. Fitness levels were poor; 90% of women had peak oxygen uptakes below the 10th percentile of population normals yet 80% still rated their fitness level as equivalent to other women. Women with and without cancer did not differ in age, BMI, co-morbidities, energy expenditures, body composition, hormones or QOL although glucose levels were higher in women with cancer (119.5 vs. 90.7 mg/dl; p=0.049). Cancer subjects scored worse on every fitness measurement, reaching statistical significance for VO(2 peak) (15.0 vs. 17.9 ml/kg/min; p=0.033). Current exercisers had a lower BMI (p=0.039), decreased fat weight (p=0.024), decreased waist circumference (p=0.05) and improved vitality compared to non-exercisers. Physical fitness levels were abysmal in these morbidly obese subjects and worse for cancer patients. Exercise correlated with improved body composition and vitality. Copyright © 2011. Published by Elsevier Inc.

  1. Obesity, sedentary lifestyle, and video games: The new thrombophilia cocktail in adolescents.

    Science.gov (United States)

    Kohorst, Mira A; Warad, Deepti M; Nageswara Rao, Amulya A; Rodriguez, Vilmarie

    2018-07-01

    Rates of venous thromboembolism have increased in the adolescent population over the last two decades, likely due to advanced diagnostics, increased use of central venous catheters, chronic medical conditions, obesity, and oral contraceptive use. Of these factors, a modifiable risk factor for adolescents is obesity. Sedentary lifestyle and prolonged immobilization are additional prothrombotic risk factors that are often associated with obesity. With ever-increasing screen time, sedentary behavior has risen accordingly, especially among gamers. We present four cases of adolescents who developed life-threatening venous thromboembolic events in the setting of obesity, sedentary lifestyle and/or immobilization, and prolonged video game use. © 2018 Wiley Periodicals, Inc.

  2. Eating styles in the morbidly obese: restraint eating, but not emotional and external eating, predicts dietary behaviour.

    Science.gov (United States)

    Brogan, Amy; Hevey, David

    2013-01-01

    The research explored (1) the relationships between self-reported eating style (restraint, emotional and external eating) and dietary intake and (2) emotional eater status as a moderator of food intake when emotional, in a morbidly obese population. A sample of 57 obese participants (BMI: M = 51.84, SD = 8.66) completed a five-day food diary together with a reflective diary, which assessed eating style and positive and negative affect daily. A dietician-scored food pyramid analysis of intake. Restraint eating was the only predictor (negative) of overall food intake and the variable most strongly associated with the consumption of top-shelf foods. Emotional and external eating were unrelated to food intake. Emotional eater status did not moderate food intake in response to positive and negative mood states. The findings indicated largely analogous relationships between eating style and dietary intake in this obese sample compared with previous results from healthy populations. The lack of predictive validity for emotional eating scales (when emotional) raises questions over people's ability to adequately assess their eating style and consequently, the overall validity of emotional eater scales.

  3. Possibly preventable cardiac arrest in a morbidly obese patient - a comment on the 2015 ERC guidelines.

    Science.gov (United States)

    Hans, Felix Patricius; Hoeren, Claudia Johanna Maria; Kellmeyer, Phillipp; Hohloch, Lisa; Busch, Hans-Jörg; Bayer, Jörg

    2016-10-04

    The incidence of overweight and obesity has been steadily on the rise and has reached epidemic proportions in various countries and this represents a well-known major health problem. Nevertheless, current guidelines for resuscitation do not include special sequences of action in this subset of patients. The aim of this letter is to bring this controversy into focus and to suggest alterations of the known standard cardiopulmonary resuscitation in the obese. An obese patient weighing 272 kg fell to the floor, afterwards being unable to get up again. Thus, emergency services were called for assistance. There were no signs or symptoms signifying that the person had been harmed in consequence of the fall. Only when brought into a supine position the patient suffered an immediate cardiac arrest. Cardiopulmonary resuscitation was performed but there was no return of a stable spontaneous circulation until the patient was brought into a full lateral position. In spite of immediate emergency care the patient ultimately suffered a lethal hypoxic brain damage. A full lateral position should be considered in obese patients having a cardiac arrest as it might help to re-establish stable circulatory conditions.

  4. Evaluation of treatment effects in obese children with co-morbid medical or psychiatric conditions

    Science.gov (United States)

    The need for effective treatments for pediatric overweight is well known. We evaluated the applicability of an evidence-based treatment in an applied clinic setting that includes children with severe obesity and comorbid medical or psychiatric conditions. Forty-eight overweight children and their fa...

  5. Overweight and obesity among adolescents in Poland: gender and regional differences.

    Science.gov (United States)

    Jodkowska, Maria; Oblacinska, Anna; Tabak, Izabela

    2010-10-01

    To examine the prevalence of overweight and obesity in Polish adolescents in 2005 using both the International Obesity Task Force (IOTF) cut-offs and a national reference; to compare this to data collected in 1995; and to assess whether there were differences in overweight or obesity by gender and place of residence in 1995-2005. BMI was calculated from measured height and weight, collected in a cross-sectional study in five regions of Poland in 2005. Adolescents were categorised as normal, overweight or obese based on IOTF cut-off values, and by national weight for stature tables, where the 90th and 97th percentiles were used as cut-off values for overweight and obesity. Population-based study set in Poland. A two-stage sampling method was used to recruit 8065 pupils (3980 boys and 4085 girls) aged 13-15 years. The prevalence of overweight and obesity was 12·5 % and 1·9 %, respectively. No significant gender differences were found, either in overweight or obesity. The prevalence of overweight and obesity in 2005 had increased 2 % compared to 1995. Overweight and obesity among adolescents were not related to urban-rural residence, but there were significant regional differences. Monitoring trends in overweight and obesity among adolescents in all regions of Poland using the same reference criteria is important. Since regional differences in overweight and obesity rates among adolescents were observed both in 1995 and 2005, future research should investigate the potential causes of these differences.

  6. Abdominal fat and metabolic risk in obese children and adolescents.

    Science.gov (United States)

    Revenga-Frauca, J; González-Gil, E M; Bueno-Lozano, G; De Miguel-Etayo, P; Velasco-Martínez, P; Rey-López, J P; Bueno-Lozano, O; Moreno, L A

    2009-12-01

    The aim of this study was to investigate fat distribution, mainly abdominal fat, and its relationship with metabolic risk variables in a group of 126 children and adolescents (60 males and 66 females) aged 5.0 to 14.9. According to IOTF criteria, 46 were classified as normal weight, 28 overweight and 52 obese. Weight, height, waist (WC) and hip circumferences were measured. The body mass index (BMI) was calculated. Total body fat, trunkal and abdominal fat were also assessed by dual energy x-ray absorptiometry (DXA). Glucose, insulin, HDL-Cholesterol, triglycerides (TG), ferritine, homocystein and C-reactive protein (CRP) were measured. Obesity status was related with insulin concentrations, CRP, TG and HDL. Obese patients had higher abdominal fat and higher CRP values than overweight and normal subjects. All markers of central body adiposity were related with insulin and lipid metabolism; however, they were not related with homocystein or ferritin. A simple anthropometric measurement, like waist circumference, seems to be a good predictor of the majority of the obesity related metabolic risk variables.

  7. Overweight and obesity in children and adolescents: The South African problem

    Directory of Open Access Journals (Sweden)

    Margaretha Viljoen

    2012-05-01

    Full Text Available Overweight and obesity in children and adolescents are on the increase worldwide.Overweight and obesity increase the risk for the development of non-communicable diseases during childhood and adolescence, and predispose the individual to the development of overweight, obesity,ardiovascular disease, and metabolic and other disorders in adulthood.In Africa the number of overweight or obese children has doubled since 1990. In South Africa,overweight and obesity in children and adolescents are on the increase, but the prevalencevaries with age, gender and population group. These differences are important when intervention programmes and policies are considered. South Africa faces a double burden of disease where undernutrition and overweight or obesity are found in the same populations, in the same households and even in the same children. Malnutrition is a major contributor to the double burden of disease in South African children and adolescents.

  8. Physical activity and overweight/obesity among Malaysian adults: findings from the 2015 National Health and morbidity survey (NHMS

    Directory of Open Access Journals (Sweden)

    Ying Ying Chan

    2017-09-01

    Full Text Available Abstract Background Overweight and obesity are growing health problems both worldwide and in Malaysia due to such lifestyle changes as decreased physical activity (PA, increased sedentary behavior and unhealthy eating habits. This study examined the levels and patterns of PA among normal-weight and overweight/obese adults and to investigate the association between PA level and overweight/obesity in Malaysian adults. Methods This study used data from the 2015 National Health and Morbidity Survey (NHMS, a nationwide cross-sectional survey that implemented a two-stage stratified random sampling design. Respondents aged 18 years and above (n = 17,261 were included in the analysis. The short version of International Physical Activity Questionnaire (IPAQ was administered to assess the respondents’ PA levels. The respondents’ height and weight were objectively measured and body mass index (BMI was calculated. The respondents were categorized according to BMI as either normal-weight (18.5–24.9 kg/m2 or overweight/obese (≥ 25 kg/m2. Descriptive and complex sample logistic regression analyses were employed as appropriate. Results Overall, approximately 1 in 2 respondents (51.2% were overweight/obese, even though the majority (69.0% reporting at least a moderate level of PA (total PA ≥ 10 MET-hours/week. In both normal-weight and overweight/obese groups, a significantly higher prevalence of high PA (total PA ≥ 50 MET-hours/week was observed among men than women (p < 0.001, but women reported a significantly higher prevalence of low and moderate PA than men (p < 0.001. Men reported significantly higher activity levels (in MET-hours/week than women with regard to walking, vigorous-intensity PA and total PA (p < 0.001. Overweight/obese men reported a significantly lower level of vigorous-intensity PA and total PA than normal-weight men (p < 0.001. A low level of PA was associated with the risk of overweight/obesity

  9. [Electronic media in obesity prevention in childhood and adolescence].

    Science.gov (United States)

    Weihrauch-Blüher, Susann; Koormann, Stefanie; Brauchmann, Jana; Wiegand, Susanna

    2016-11-01

    The increasing prevalence of childhood obesity is - amongst other factors - due to changed leisure time habits with decreased physical activity and increased media consumption. However, electronic media such as tablets and smartphones might also provide a novel intervention approach to prevent obesity in childhood and adolescence. A summary of interventions applying electronic media to prevent childhood obesity is provided to investigate short term effects as well as long term results of these interventions. A systematic literature search was performed in PubMed/Web of Science to identify randomized and/or controlled studies that have investigated the efficacy of electronic media for obesity prevention below the age of 18. A total of 909 studies were identified, and 88 studies were included in the analysis. Active video games did increase physical activity compared to inactive games when applied within a peer group. Interventions via telephone had positive effects on certain lifestyle-relevant behaviours. Interventions via mobile were shown to decrease dropout rates by sending regular SMS messages. To date, interventions via smartphones are scarce for adolescents; however, they might improve cardiorespiratory fitness. The results from internet-based interventions showed a trend towards positive effects on lifestyle-relevant behaviors. The combination of different electronic media did not show superior results compared to interventions with only one medium. Interventions via TV, DVD or video-based interventions may increase physical activity when offered as an incentive, however, effects on weight status were not observed. Children and adolescents currently grow up in a technology- and media-rich society with computers, tablets, smartphones, etc. used daily. Thus, interventions applying electronic media to prevent childhood obesity are contemporary. Available studies applying electronic media are however heterogeneous in terms of applied medium and duration

  10. High Prevalence of Obesity in Ambulatory Children and Adolescents with Intellectual Disability

    Science.gov (United States)

    Stewart, L.; Van de Ven, L.; Katsarou, V.; Rentziou, E.; Doran, M.; Jackson, P.; Reilly, J. J.; Wilson, D.

    2009-01-01

    Background: Obesity prevalence is unusually high among adults with intellectual disability (ID). There is limited and conflicting evidence on obesity prevalence among ambulatory children and adolescents with ID. The present study aimed to estimate obesity prevalence in this group and to compare with population prevalence. Methods: Survey of nine…

  11. Patterns of Obesity among Children and Adolescents with Intellectual Disabilities in Taiwan

    Science.gov (United States)

    Lin, Jin-Ding; Yen, Chia-Feng; Li, Chi-Wei; Wu, Jia-Ling

    2005-01-01

    Background: Obesity and the health problems associated with it have substantial economic consequences for health care systems. Little information is available concerning obesity-related problems among people with intellectual disabilities. The aims of this study were to analyse patterns of obesity among children and adolescents with intellectual…

  12. Predictors of Obesity in a US Sample of High School Adolescents with and without Disabilities

    Science.gov (United States)

    Papas, Mia A.; Trabulsi, Jillian C.; Axe, Michelle; Rimmer, James H.

    2016-01-01

    Background: Childhood obesity is a major public health concern. Children with disabilities have a higher prevalence of obesity. Objective: We examined factors associated with obesity within a cross-sectional study of US adolescents with and without disabilities. Methods: Data were obtained from the 2011 Youth Risk Behavior Survey. Logistic…

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

    Science.gov (United States)

    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.…

  14. Identification of obesity and cardiovascular risk factors in childhood and adolescence.

    Science.gov (United States)

    Balakrishnan, Preetha L

    2014-02-01

    Obesity in the child and adolescent population is a growing problem. This article discusses the identification of obesity and overweight youth using body mass index and anthropometry and reviews literature to show the relationship between obesity and premature cardiovascular disease. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. An Intensive Lifestyle Intervention Is an Effective Treatment of Morbid Obesity: The TRAMOMTANA Study—A Two-Year Randomized Controlled Clinical Trial

    Science.gov (United States)

    Burguera, Bartolomé; Jesús Tur, Juan; Escudero, Antonio Jorge; Alos, María; Pagán, Alberto; Cortés, Baltasar; González, Xavier Francesc; Soriano, Joan B.

    2015-01-01

    Bariatric surgery is currently the most effective therapy to induce weight loss in morbidly obese patients. Objective. This controlled, clinical trial with a two-year intervention was aimed at comparing the efficacy of two nonsurgical approaches versus bariatric surgery, on body weight changes and metabolic parameters in morbidly obese patients. Methods. Patients were randomized to an Intensive Lifestyle Intervention (ILI) (n = 60) or Conventional Obesity Therapy (COT) (n = 46). The ILI group received behavioral therapy and nutritional counseling. The COT group received standard medical treatment. They were compared with a third group, Surgical Obesity Group (SOG) (n = 37). Results. Patients who received ILI had a greater percentage of weight loss than patients receiving COT (−11.3% versus −1.6%; p < 0.0044). Interestingly 31.4% of patients included in the ILI group were no longer morbidly obese after just six months of intervention, increasing to 44.4% after 24 months of intervention. The percentage weight loss in SOG was −29.6% after that same period of time. Conclusions. ILI was associated with significant weight loss when compared to COT, in a group of patients with obesity. An ILI approach could be an alternative therapy to patients with obesity, who are not candidates to undergo bariatric surgery. This trial is registered with EudraCT 2009-013737-24. PMID:26257780

  16. An Intensive Lifestyle Intervention Is an Effective Treatment of Morbid Obesity: The TRAMOMTANA Study—A Two-Year Randomized Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Bartolomé Burguera

    2015-01-01

    Full Text Available Bariatric surgery is currently the most effective therapy to induce weight loss in morbidly obese patients. Objective. This controlled, clinical trial with a two-year intervention was aimed at comparing the efficacy of two nonsurgical approaches versus bariatric surgery, on body weight changes and metabolic parameters in morbidly obese patients. Methods. Patients were randomized to an Intensive Lifestyle Intervention (ILI (n=60 or Conventional Obesity Therapy (COT (n=46. The ILI group received behavioral therapy and nutritional counseling. The COT group received standard medical treatment. They were compared with a third group, Surgical Obesity Group (SOG (n=37. Results. Patients who received ILI had a greater percentage of weight loss than patients receiving COT (−11.3% versus −1.6%; p<0.0044. Interestingly 31.4% of patients included in the ILI group were no longer morbidly obese after just six months of intervention, increasing to 44.4% after 24 months of intervention. The percentage weight loss in SOG was −29.6% after that same period of time. Conclusions. ILI was associated with significant weight loss when compared to COT, in a group of patients with obesity. An ILI approach could be an alternative therapy to patients with obesity, who are not candidates to undergo bariatric surgery. This trial is registered with EudraCT 2009-013737-24.

  17. Bullying behaviour in schools, socioeconomic position and psychiatric morbidity: a cross-sectional study in late adolescents in Greece.

    Science.gov (United States)

    Magklara, Konstantina; Skapinakis, Petros; Gkatsa, Tatiana; Bellos, Stefanos; Araya, Ricardo; Stylianidis, Stylianos; Mavreas, Venetsanos

    2012-02-12

    Bullying is quite prevalent in the school setting and has been associated with the socioeconomic position and psychiatric morbidity of the pupils. The aim of the study was to investigate the association between bullying and socioeconomic status in a sample of Greek adolescents and to examine whether this is confounded by the presence of psychiatric morbidity, including sub-threshold forms of illness. 5,614 adolescents aged 16-18 years old and attending 25 senior high schools were screened and a stratified random sample of 2,427 were selected for a detailed interview. Psychiatric morbidity was assessed with a fully structured psychiatric interview, the revised Clinical Interview Schedule (CIS-R), while bullying was assessed with the revised Olweus bully/victim questionnaire. The following socio-economic variables were assessed: parental educational level and employment status, financial difficulties of the family and adolescents' school performance. The associations were investigated using multinomial logit models. 26.4% of the pupils were involved in bullying-related behaviours at least once monthly either as victims, perpetrators or both, while more frequent involvement (at least once weekly) was reported by 4.1%. Psychiatric morbidity was associated with all types of bullying-related behaviours. No socioeconomic associations were reported for victimization. A lower school performance and unemployment of the father were significantly more likely among perpetrators, while economic inactivity of the mother was more likely in pupils who were both victims and perpetrators. These results were largely confirmed when we focused on high frequency behaviours only. In addition, being overweight increased the risk of frequent victimization. The prevalence of bullying among Greek pupils is substantial. Perpetration was associated with some dimensions of adolescents' socioeconomic status, while victimization showed no socioeconomic associations. Our findings may add to the

  18. Bullying behaviour in schools, socioeconomic position and psychiatric morbidity: a cross-sectional study in late adolescents in Greece

    Directory of Open Access Journals (Sweden)

    Magklara Konstantina

    2012-02-01

    Full Text Available Abstract Background Bullying is quite prevalent in the school setting and has been associated with the socioeconomic position and psychiatric morbidity of the pupils. The aim of the study was to investigate the association between bullying and socioeconomic status in a sample of Greek adolescents and to examine whether this is confounded by the presence of psychiatric morbidity, including sub-threshold forms of illness. Methods 5,614 adolescents aged 16-18 years old and attending 25 senior high schools were screened and a stratified random sample of 2,427 were selected for a detailed interview. Psychiatric morbidity was assessed with a fully structured psychiatric interview, the revised Clinical Interview Schedule (CIS-R, while bullying was assessed with the revised Olweus bully/victim questionnaire. The following socio-economic variables were assessed: parental educational level and employment status, financial difficulties of the family and adolescents' school performance. The associations were investigated using multinomial logit models. Results 26.4% of the pupils were involved in bullying-related behaviours at least once monthly either as victims, perpetrators or both, while more frequent involvement (at least once weekly was reported by 4.1%. Psychiatric morbidity was associated with all types of bullying-related behaviours. No socioeconomic associations were reported for victimization. A lower school performance and unemployment of the father were significantly more likely among perpetrators, while economic inactivity of the mother was more likely in pupils who were both victims and perpetrators. These results were largely confirmed when we focused on high frequency behaviours only. In addition, being overweight increased the risk of frequent victimization. Conclusions The prevalence of bullying among Greek pupils is substantial. Perpetration was associated with some dimensions of adolescents' socioeconomic status, while victimization

  19. Roux-en-Y gastric bypass surgery of morbidly obese patients induces swift and persistent changes of the individual gut microbiota

    DEFF Research Database (Denmark)

    Palleja, Albert; Kashani, Alireza; Allin, Kristine Højgaard

    2016-01-01

    Background: Roux-en-Y gastric bypass (RYGB) is an effective means to achieve sustained weight loss for morbidly obese individuals. Besides rapid weight reduction, patients achieve major improvements of insulin sensitivity and glucose homeostasis. Dysbiosis of gut microbiota has been associated......) to assimilate multiple energy sources using transporters and phosphotransferase systems, (ii) to use aerobic respiration, (iii) to shift from protein degradation to putrefaction, and (iv) to use amino acids and fatty acids as energy sources. Conclusions: Within 3 months after morbidly obese individuals had...... with obesity and some of its co-morbidities, like type 2 diabetes, and major changes of gut microbial communities have been hypothesized to mediate part of the beneficial metabolic effects observed after RYGB. Here we describe changes in gut microbial taxonomic composition and functional potential following...

  20. Roux-en-Y gastric bypass surgery of morbidly obese patients induces swift and persistent changes of the individual gut microbiota

    DEFF Research Database (Denmark)

    Palleja, Albert; Kashani, Alireza; Allin, Kristine Højgaard

    2016-01-01

    RYGB. Methods: We recruited 13 morbidly obese patients who underwent RYGB, carefully phenotyped them, and had their gut microbiomes quantified before (n = 13) and 3 months (n = 12) and 12 months (n = 8) after RYGB. Following shotgun metagenomic sequencing of the fecal microbial DNA purified from stools......Background: Roux-en-Y gastric bypass (RYGB) is an effective means to achieve sustained weight loss for morbidly obese individuals. Besides rapid weight reduction, patients achieve major improvements of insulin sensitivity and glucose homeostasis. Dysbiosis of gut microbiota has been associated...... with obesity and some of its co-morbidities, like type 2 diabetes, and major changes of gut microbial communities have been hypothesized to mediate part of the beneficial metabolic effects observed after RYGB. Here we describe changes in gut microbial taxonomic composition and functional potential following...

  1. Relationship between urban sprawl and physical activity, obesity, and morbidity - update and refinement.

    Science.gov (United States)

    Ewing, Reid; Meakins, Gail; Hamidi, Shima; Nelson, Arthur C

    2014-03-01

    This study aims to model multiple health outcomes and behaviors in terms of the updated, refined, and validated county compactness/sprawl measures. Multiple health outcomes and behaviors are modeled using multi-level analysis. After controlling for observed confounding influences, both original and new compactness measures are negatively related to BMI, obesity, heart disease, high blood pressure, and diabetes. Indices are not significantly related to physical activity, perhaps because physical activity is not defined broadly to include active travel to work, shopping, and other destinations. Developing urban and suburban areas in a more compact manner may have some salutary effect on obesity and chronic disease trends. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Impaired HDL function in obese adolescents: impact of lifestyle intervention and bariatric surgery.

    Science.gov (United States)

    Matsuo, Yae; Oberbach, Andreas; Till, Holger; Inge, Thomas H; Wabitsch, Martin; Moss, Anja; Jehmlich, Nico; Völker, Uwe; Müller, Ulrike; Siegfried, Wolfgang; Kanesawa, Norio; Kurabayashi, Masahiko; Schuler, Gerhard; Linke, Axel; Adams, Volker

    2013-12-01

    HDL regulates endothelial function via stimulation of nitric oxide production. It is documented that endothelial function is impaired in obese adolescents, and improved by lifestyle interventions (LI). HDL function in obese adolescents and the impact of LI or Roux-en-Y gastric bypass surgery (RYGB) was assessed. HDL was isolated from 14 adolescents with normal body mass index (HDLcontrol ), 10 obese (HDLobese ) before and after 6 month LI, and five severe obese adolescents before and one year after RYGB. HDL-mediated phosphorylation of endothelial nitric oxide synthase (eNOS)-Ser(1177) , eNOS-Thr(495) , and PKC-ßII was evaluated. In addition the HDL proteome was analyzed. HDLobese -mediated eNOS-Ser(1177) phosphorylation was reduced, whereas eNOS-Thr(495) phosphorylation increased significantly when compared to HDLcontrol . No impact of obesity was observed on PKC-ßII phosphorylation. LI and RYGB had no impact on HDL-mediated phosphorylation of eNOS and PKC-ßII. A principle component plot analysis of the HDL particle separated controls and severe obese, whereas the interventions did not trigger sufficient differences to the HDL proteome to permit distinction. These results demonstrated that HDL-function is impaired in obese adolescents, and that LI or RYGB did not correct this dysfunction. This might be an argument for developing earlier prevention strategies in obese adolescents to avoid HDL dysfunction. Copyright © 2013 The Obesity Society.

  3. Lipogenic potential of liver from morbidly obese patients with and without non-insulin-dependent diabetes

    International Nuclear Information System (INIS)

    Barakat, H.A.; McLendon, V.D.; Carpenter, J.W.; Marks, R.H.; Legett, N.; O'Brien, K.; Caro, J.F.

    1991-01-01

    Intra-abdominal liver biopsies were obtained during surgery from fasted obese patients with non-insulin-dependent diabetes mellitus (NIDDM), obese normoglycemic controls, and lean controls. Lipid synthesis was studied in freshly isolated hepatocytes and liver homogenates from the three groups of subjects. Incorporation of 3H2O into the lipids of hepatocytes was determined in the absence and presence of insulin (0.1 mumol/L). The activities of five enzymes involved in fatty acid synthesis, and the incorporation of 14C-glycerol-3-phosphate into lipids were determined in liver homogenates. Basal lipid synthesis by hepatocytes was not different in the three groups of patients. Insulin stimulated lipogenesis by 8% +/- 30% in the lean controls, 33% +/- 8% in the obese controls and 17% +/- 6% in the NIDDM patients. No significant differences in the activities of the five enzymes that are involved in de novo fatty acid synthesis among the three groups of patients were observed. Similarly, incorporation of 14C-glycerol-3-phosphate by liver homogenates, in the presence of saturating or submaximal concentrations of fatty acids, did not differ among the three groups. These results show that under the experimental conditions of this study, including the fasted state of the patients, the basal capacity of liver of NIDDM patients to synthesize fatty acids or glycerides is the same as that of liver from obese and lean controls. Thus, it is likely that an increase in fatty acid flux into a liver with normal lipogenic potential may contribute to the increased synthesis of triglycerides by the liver of these patients in vivo

  4. Multiple levels of social disadvantage and links to obesity in adolescence and young adulthood.

    Science.gov (United States)

    Lee, Hedwig; Harris, Kathleen M; Lee, Joyce

    2013-03-01

    The rise in adolescent obesity has become a public health concern, especially because of its impact on disadvantaged youth. This article examines the role of disadvantage at the family-, peer-, school-, and neighborhood-level, to determine which contexts are related to obesity in adolescence and young adulthood. We analyzed longitudinal data from Waves I (1994-1995), II (1996), and III (2001-2002) of the National Longitudinal Study of Adolescent Health, a nationally representative population-based sample of adolescents in grades 7-12 in 1995 who were followed into young adulthood. We assessed the relationship between obesity in adolescence and young adulthood, and disadvantage (measured by low parent education in adolescence) at the family-, peer-, school-, and neighborhood-level using multilevel logistic regression. When all levels of disadvantage were modeled simultaneously, school-level disadvantage was significantly associated with obesity in adolescence for males and females and family-level disadvantage was significantly associated with obesity in young adulthood for females. Schools may serve as a primary setting for obesity prevention efforts. Because obesity in adolescence tracks into adulthood, it is important to consider prevention efforts at this stage in the life course, in addition to early childhood, particularly among disadvantaged populations. © 2013, American School Health Association.

  5. [Pathological gastroesophageal reflux in patients with severe, morbid and hyper obesity].

    Science.gov (United States)

    Csendes, A; Burdiles, P; Rojas, J; Burgos, A; Henríquez, A

    2001-09-01

    Overweight can be a risk factor for pathological gastroesophageal reflux or hiatal hernia. To study the prevalence of gastroesophageal reflux in patients with severe obesity. Sixty seven patients, 51 female, aged 17 to 56 years old with a body mass index over 35 kg/m2, were studied. An upper gastrointestinal endoscopy was performed in all, esophageal manometry was done in 32 and 24 h pH monitoring was done in 32 patients. Seventy nine percent of patients complained of heartburn and 66% of regurgitation. In 16 patients, endoscopy was normal. An erosive esophagitis was found in 33 patients, a short columnar epithelium in 12 and a Barret esophagus with intestinal metaplasia in six. Normal endoscopic findings and erosive esophagitis were present with a higher frequency in women. No association between the degree of obesity and esophageal lesions was observed. Lower esophageal sphincter pressure and abdominal length were significantly higher in subjects with a body mass index over 50 compared to those with a body mass index between 35 and 39.9 kg/m2. No differences were observed in 24 h pH monitoring. A high proportion of severely obese patients had symptoms and endoscopical findings of pathological gastroesophageal reflux.

  6. Bariatric surgery in morbidly obese insulin resistant humans normalises insulin signalling but not insulin-stimulated glucose disposal.

    Directory of Open Access Journals (Sweden)

    Mimi Z Chen

    Full Text Available Weight-loss after bariatric surgery improves insulin sensitivity, but the underlying molecular mechanism is not clear. To ascertain the effect of bariatric surgery on insulin signalling, we examined glucose disposal and Akt activation in morbidly obese volunteers before and after Roux-en-Y gastric bypass surgery (RYGB, and compared this to lean volunteers.The hyperinsulinaemic euglycaemic clamp, at five infusion rates, was used to determine glucose disposal rates (GDR in eight morbidly obese (body mass index, BMI=47.3 ± 2.2 kg/m(2 patients, before and after RYGB, and in eight lean volunteers (BMI=20.7 ± 0.7 kg/m2. Biopsies of brachioradialis muscle, taken at fasting and insulin concentrations that induced half-maximal (GDR50 and maximal (GDR100 GDR in each subject, were used to examine the phosphorylation of Akt-Thr308, Akt-473, and pras40, in vivo biomarkers for Akt activity.Pre-operatively, insulin-stimulated GDR was lower in the obese compared to the lean individuals (P<0.001. Weight-loss of 29.9 ± 4 kg after surgery significantly improved GDR50 (P=0.004 but not GDR100 (P=0.3. These subjects still remained significantly more insulin resistant than the lean individuals (p<0.001. Weight loss increased insulin-stimulated skeletal muscle Akt-Thr308 and Akt-Ser473 phosphorylation, P=0.02 and P=0.03 respectively (MANCOVA, and Akt activity towards the substrate PRAS40 (P=0.003, MANCOVA, and in contrast to GDR, were fully normalised after the surgery (obese vs lean, P=0.6, P=0.35, P=0.46, respectively.Our data show that although Akt activity substantially improved after surgery, it did not lead to a full restoration of insulin-stimulated glucose disposal. This suggests that a major defect downstream of, or parallel to, Akt signalling remains after significant weight-loss.

  7. "Ouch!" Recruitment of Overweight and Obese Adolescent Boys for Qualitative Research

    Science.gov (United States)

    Morrison, Zachary; Gregory, David; Thibodeau, Steven; Copeland, Jennifer

    2012-01-01

    The purpose of this study is to examine the complexities of recruiting overweight and obese adolescent boys for qualitative research, discuss specific recruitment considerations for this population, and offer guidance to researchers interested in recruiting overweight adolescent boys. Three overweight adolescent boys and six community…

  8. Adolescent Obesity and Young Adult Psychosocial Outcomes: Gender and Racial Differences

    Science.gov (United States)

    Merten, Michael J.; Wickrama, K. A. S.; Williams, Amanda L.

    2008-01-01

    Using a sample of 7,881 African American (915 males and 1,073 females) and White (2,864 males and 3,029 females) adolescents from Waves 1 and 3 of the National Longitudinal Study of Adolescent Health, this study examined the psychosocial consequences that obese adolescents encounter as they reach young adulthood. Results indicate that obesity…

  9. PREVALENCE AND GENDER CHARACTERISTICS OF OBESITY IN ADOLESCENTS IN THE CITY OF PERM

    Directory of Open Access Journals (Sweden)

    R. M. Ahmedova

    2014-01-01

    Full Text Available Background: Currently, there is a well-publicised worldwide increase in obese patients. The origins of adult obesity, in the majority of cases, are in children. Objective: Our aim was to study the prevalence and gender features of excess weight and obesity in adolescents in Perm. Methods: The study included adolescents aged 13–14, living in the city of Perm. Medical examinations were compared in statistics from 2005 and 2013. Weight, height and waist circumference were measured on all children. Body mass index was calculated, as was a standard deviation coefficient. Sexual development was evaluated according to the criteria of Tanner. Results: 828 adolescents were viewed (444 in 2005 and 384 in 2013. The prevalence of overweight adolescents in 2005 was 12.5%, including 3.1% who were obese. In 2013, 20.3% of adolescents were diagnosed as overweight, with 5.5% being diagnosed as obese. Abdominal obesity to type was diagnosed in 52.4% of obese children. Over the past 8 years, the number of adolescents who are overweight and obese has increased by more than half. A statistically significant increase has beenrecorded for overweight adolescents (ᵪ2 = 5,16; p = 0,023. In adolescents with excess body weight, growth rates were higher than in those children with either normal body weight or obesity; these differences were statistically significant in boys (p = 0.016. The total score of puberty in boys who were overweight was statistically significantly higher than adolescents with normal body weight orobesity (p = 0.0116. Conclusion: The percentage of children who are overweight and obese hasincreased by 74% and 67%, respectively over an 8-year period, resulting ina statistically significant increase in relation to overweight children. There was a significant increase in the number of teenage girls who are overweight.

  10. The usage of fasting glucose and glycated hemoglobin for the identification of unknown type 2 diabetes in high risk patients with morbid obesity.

    Science.gov (United States)

    Valderhaug, Tone G; Sharma, Archana; Kravdal, Gunnhild; Rønningen, Reidun; Nermoen, Ingrid

    2017-11-01

    In spite of increased vigilance of undiagnosed type 2 diabetes (DM2), the prevalence of unknown DM2 in subjects with morbid obesity is not known. To assess the prevalence of undiagnosed DM2 and compare the performance of glycated A1c (HbA1c) and fasting glucose (FG) for the diagnosis of DM2 and prediabetes (preDM) in patients with morbid obesity. We measured fasting glucose and HbA1c in 537 consecutive patients with morbid obesity without previously known DM2. A total of 49 (9%) patients with morbid obesity had unknown DM2 out of which 16 (33%) fulfilled both the criteria for HbA1c and FG. Out of 284 (53%) subjects with preDM, 133 (47%) fulfilled both the criteria for HbA1c and FG. Measurements of agreement for FG and HbA1c were moderate for DM2 (κ = 0.461, p obesity.

  11. Food intake in relation to pouch volume, stoma diameter, and pouch emptying after gastroplasty for morbid obesity

    DEFF Research Database (Denmark)

    Andersen, T; Pedersen, B H; Henriksen, Jens Henrik Sahl

    1988-01-01

    associated with the change of solid foods consumed (by weight, p = 0.01; by energy content, p = 0.02). The change of pouch volume was negatively associated with the change of energy from beverages (p = 0.005). In conclusion, it seems impossible to tailor the reduction of food intake through adjustments...... of the surgical dimensions, at least within the ranges of our observations. Increased food consumption and decreased energy intake with beverages may be caused by late dilations, or vice versa.......This study investigated possible determinants of food intake change after gastroplastry. Preoperatively and 6 and 12 months postoperatively, 27 morbidly obese patients were prospectively examined with 7-day food registration and radiologic measurement of pouch volume and stoma diameter. Pouch...

  12. Food intake in relation to pouch volume, stoma diameter, and pouch emptying after gastroplasty for morbid obesity

    DEFF Research Database (Denmark)

    Andersen, T; Pedersen, B H; Henriksen, Jens Henrik Sahl

    1988-01-01

    This study investigated possible determinants of food intake change after gastroplastry. Preoperatively and 6 and 12 months postoperatively, 27 morbidly obese patients were prospectively examined with 7-day food registration and radiologic measurement of pouch volume and stoma diameter. Pouch...... associated with the change of solid foods consumed (by weight, p = 0.01; by energy content, p = 0.02). The change of pouch volume was negatively associated with the change of energy from beverages (p = 0.005). In conclusion, it seems impossible to tailor the reduction of food intake through adjustments...... emptying was determined as the mean transit time by a scintigraphic method. None of the measured variables was found to influence the change in food intake taking place during the first 6 months, when most of the weight loss was observed. Between 6 and 12 months, the change of stoma diameter was positively...

  13. Giant serous cystadenoma arising from an accessory ovary in a morbidly obese 11-year-old girl: a case report

    Directory of Open Access Journals (Sweden)

    Sharatz Steven M

    2008-01-01

    Full Text Available Abstract Introduction Ectopic ovarian tissue is an unusual entity, especially if it is an isolated finding thought to be of embryological origin. Case presentation An 11-year-old, morbidly obese female presented with left flank pain, nausea, and irregular menses. Various diagnostic procedures suggested a large ovarian cyst, and surgical resection was performed. Conclusion Histologically, the resected mass was not of tubal origin as suspected, but a serous cystadenoma arising from ovarian tissue. The patient's two normal, eutopic ovaries were completely uninvolved and unaffected. A tumor arising from ectopic ovarian tissue of embryological origin seems the most likely explanation. We suggest refining the descriptive nomenclature so as to more precisely characterize the various presentations of ovarian ectopia.

  14. Macrophage activation marker soluble CD163 and non-alcoholic fatty liver disease in morbidly obese patients undergoing bariatric surgery

    DEFF Research Database (Denmark)

    Kazankov, Konstantin; Tordjman, Joan; Møller, Holger Jon

    2015-01-01

    BACKGROUND AND AIMS: Macrophages play an important role in non-alcoholic fatty liver disease (NAFLD). Soluble CD163 (sCD163) is a specific marker of macrophage activation. We aimed to measure sCD163 in morbidly obese patients with varying degrees of NAFLD before and after bariatric surgery (BS...... (NAS), Kleiner fibrosis score, and the fatty liver inhibition of progression (FLIP) algorithm. In a subset, CD163 immunohistochemistry and real-time quantitative polymerase chain reaction for CD163 mRNA were performed. RESULTS: sCD163 was higher in patients with NAS ≥ 5 compared with those with NAS ...). METHODS: Demographic, clinical, and biochemical data, and plasma sCD163 measured by enzyme-linked immunosorbent assay, of 196 patients were collected preoperatively and 3, 6, and 12 months after BS leading to significant weight loss. Peroperative liver biopsies were assessed for the NAFLD Activity Score...

  15. GLUTATHIONE PEROXIDASE-1 PRO200LEU POLYMORPHISM (RS1050450) IS ASSOCIATED WITH MORBID OBESITY INDEPENDENTLY OF THE PRESENCE OF PREDIABETES OR DIABETES IN WOMEN FROM CENTRAL MEXICO.

    Science.gov (United States)

    Hernández Guerrero, César; Hernández Chávez, Paulina; Martínez Castro, Noemí; Parra Carriedo, Alicia; García Del Rio, Sandra; Pérez Lizaur, Ana

    2015-10-01

    obesity affects more than a third of Mexican population. Oxidative stress participates actively in the etiology of this phenomenon. Glutathione peroxidase-1 (GPX-1) plays a protective role against oxidative stress. The SNP Pro200Leu (rs10504050) has been reported to affect the activity of the enzyme. to determine the frequency of rs10504050 polymorphism in women with obesity and normal weight control, asses the concentration of peripheral TBARS and evaluate the consumption of pro and antioxidants. 104 women with obesity and 70 healthy controls (CG) were included in the study. Anthropometric, biochemical, clinical and dietary features were evaluated. GPx-1 rs10504050 was determined by PCR/RFLP method. TBARS was assayed spectrophotometrically in plasma. The subjects were stratified and compared by obesity grades and by subgroups of prediabetes and diabetes condition. Statistical analysis included ANOVA of Kruskal Wallis, Xi squared and Pearson correlation. for rs10504050 polymorphism there were differences (Xi2 = 6; p = 0.01) between frequency (0.61) of obese carriers (Pro/Leu plus Leu/Leu) and CG carriers (0.42), and between (Xi2 = 8; p = 0.004) morbid (IMC > 40) obesity (0.74) and CG carriers. The obese group (OB) showed a prevalence of 66% of prediabetes plus diabetes. There were no differences in frequencies of rs10504050 in OB with pre or diabetes versus CG, or versus obese participants without diabetes. TBARS concentration was greater in all the degrees of OB versus CG. GPx-1 Pro200Leu polymorphism was associated with obesity especially with morbid obesity, but not with obese participants with prediabetes or diabetes. Oxidative stress is present in all grades of obesity significantly. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  16. POLYCYSTIC OVARY SYNDROME IN ADOLESCENCE

    Directory of Open Access Journals (Sweden)

    Diana Baptista

    2017-02-01

    Conclusion: Identification of adolescents at risk for Polycystic Ovary Syndrome is critical, not only for an appropriate therapeutic approach, but also to prevent co-morbidities associated with the syndrome, including obesity, insulin resistance, dyslipidemia and infertility.

  17. Change in levels of C-reactive protein (CRP) and serum cortisol in morbidly obese patients after laparoscopic sleeve gastrectomy.

    Science.gov (United States)

    Ruiz-Tovar, Jaime; Oller, Inmaculada; Galindo, Isabel; Llavero, Carolina; Arroyo, Antonio; Calero, Alicia; Diez, María; Zubiaga, Lorea; Calpena, Rafael

    2013-06-01

    C-Reactive protein (CRP) has been associated with the macro- and microvascular effects of hypertension and diabetes mellitus. Referring to serum cortisol, it has been proposed to contribute to the pathogenesis of metabolic syndrome, and it has been demonstrated that weight loss normalizes cortisol levels and improves insulin resistance. The aims of this study were to analyze CRP and cortisol levels pre- and postoperatively in morbidly obese patients undergoing a laparoscopic sleeve gastrectomy and to correlate them with weight loss and parameters associated with cardiovascular risk. A prospective study of all the morbidly obese patients undergoing laparoscopic sleeve gastrectomy as bariatric procedure between October 2007 and May 2011 was performed. A total of 40 patients were included in the study. CRP levels decreased significantly 12 months after surgery (median reduction of 8.9 mg/l; p = 0.001). Serum cortisol levels decreased significantly 6 months after surgery (median reduction of 34.9 μg/dl; p = 0.001). CRP values reached the normal range (cortisol, a significant association was observed with the cardiovascular risk predictor (triglyceride/high-density lipoprotein cholesterol ratio) from the 6th month after surgery onward (Pearson correlation coefficient, 0.559; p = 0.008). CRP levels are increased preoperatively and in the postoperative course up to 1 year after surgery. Serum cortisol levels remain elevated until the 6th month after surgery. From this moment onward, serum cortisol is associated with the cardiovascular risk predictor reflecting the cardiovascular risk decreasement during the weight loss.

  18. Ursodeoxycholic acid exerts farnesoid X receptor-antagonistic effects on bile acid and lipid metabolism in morbid obesity.

    Science.gov (United States)

    Mueller, Michaela; Thorell, Anders; Claudel, Thierry; Jha, Pooja; Koefeler, Harald; Lackner, Carolin; Hoesel, Bastian; Fauler, Guenter; Stojakovic, Tatjana; Einarsson, Curt; Marschall, Hanns-Ulrich; Trauner, Michael

    2015-06-01

    Bile acids (BAs) are major regulators of hepatic BA and lipid metabolism but their mechanisms of action in non-alcoholic fatty liver disease (NAFLD) are still poorly understood. Here we aimed to explore the molecular and biochemical mechanisms of ursodeoxycholic acid (UDCA) in modulating the cross-talk between liver and visceral white adipose tissue (vWAT) regarding BA and cholesterol metabolism and fatty acid/lipid partitioning in morbidly obese NAFLD patients. In this randomized controlled pharmacodynamic study, we analyzed serum, liver and vWAT samples from 40 well-matched morbidly obese patients receiving UDCA (20 mg/kg/day) or no treatment three weeks prior to bariatric surgery. Short term UDCA administration stimulated BA synthesis by reducing circulating fibroblast growth factor 19 and farnesoid X receptor (FXR) activation, resulting in cholesterol 7α-hydroxylase induction mirrored by elevated C4 and 7α-hydroxycholesterol. Enhanced BA formation depleted hepatic and LDL-cholesterol with subsequent activation of the key enzyme of cholesterol synthesis 3-hydroxy-3-methylglutaryl-CoA reductase. Blunted FXR anti-lipogenic effects induced lipogenic stearoyl-CoA desaturase (SCD) in the liver, thereby increasing hepatic triglyceride content. In addition, induced SCD activity in vWAT shifted vWAT lipid metabolism towards generation of less toxic and more lipogenic monounsaturated fatty acids such as oleic acid. These data demonstrate that by exerting FXR-antagonistic effects, UDCA treatment in NAFLD patients strongly impacts on cholesterol and BA synthesis and induces neutral lipid accumulation in both liver and vWAT. Copyright © 2015 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  19. Mid-term results of bariatric surgery in morbidly obese Japanese patients with slow progressive autoimmune diabetes.

    Science.gov (United States)

    Uno, Kohei; Seki, Yosuke; Kasama, Kazunori; Wakamatsu, Kotaro; Hashimoto, Kenkichi; Umezawa, Akiko; Yanaga, Katsuhiko; Kurokawa, Yoshimochi

    2017-12-11

    Bariatric surgery is recognized as an effective treatment for type 2 diabetes mellitus, but data on its efficacy for type 1 diabetes mellitus, especially slowly progressive insulin-dependent diabetes mellitus, are limited. We investigated five Japanese patients with slowly progressive insulin-dependent diabetes mellitus who underwent bariatric surgery at our center. Five morbidly obese glutamic acid decarboxylase antibody-positive diabetic patients underwent two different types of bariatric surgery. The mean titer of anti-glutamic acid decarboxylase antibody was 4.6 U/mL, and the mean preoperative bodyweight and BMI were 113 kg and 39.6 kg/m 2 , respectively. The mean hemoglobin A1c was 8.4%. The mean fasting serum C-peptide was 5.0 ng/mL. Laparoscopic sleeve gastrectomy was performed in two patients, while laparoscopic sleeve gastrectomy with duodenojejunal bypass was performed in three patients. At one year after surgery, the mean bodyweight and BMI significantly dropped, and the mean percentage of excess weight loss was 96.4%. The mean hemoglobin A1c was 5.7%. This favorable trend was maintained at mid-term. Bariatric surgery for morbidly obese patients with anti-glutamic acid decarboxylase antibody-positive type 1 diabetes mellitus, especially slow progressive autoimmune diabetes, seemed effective in achieving mid-term glycemic control. Longer follow-up with a larger number of patients, as well as validation with more advanced patients with slowly progressive insulin-dependent diabetes mellitus, will be needed. © 2017 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and John Wiley & Sons Australia, Ltd.

  20. The cost-effectiveness of laparoscopic adjustable gastric banding in the morbidly obese adult population of Australia.

    Directory of Open Access Journals (Sweden)

    Yong Yi Lee

    Full Text Available BACKGROUND: To examine the cost-effectiveness of providing laparoscopic adjustable gastric banding (LAGB surgery to all morbidly obese adults in the 2003 Australian population. METHODS AND FINDINGS: Analyzed costs and benefits associated with two intervention scenarios, one providing LAGB surgery to individuals with BMI >40 and another to individuals with BMI >35, with each compared relative to a 'do nothing' scenario. A multi-state, multiple cohort Markov model was used to determine the cost-effectiveness of LAGB surgery over the lifetime of each cohort. All costs and health outcomes were assessed from an Australian health sector perspective and were discounted using a 3% annual rate. Uncertainty and sensitivity analyzes were conducted to test the robustness of model outcomes. Incremental cost-effectiveness ratios (ICERs were measured in 2003 Australian dollars per disability adjusted life year (DALY averted. The ICER for the scenario providing LAGB surgery to all individuals with a BMI >40 was dominant [95% CI: dominant -$588] meaning that the intervention led to both improved health and cost savings. The ICER when providing surgery to those with a BMI >35 was $2,154/DALY averted [95% CI: dominant -$6,033]. Results were highly sensitive to changes in the likelihood of long-term complications. CONCLUSION: LAGB surgery is highly cost-effective when compared to the $50,000/DALY threshold for cost-effectiveness used in Australia. LAGB surgery also ranks highly in terms of cost-effectiveness when compared to other population-level interventions for weight loss in Australia. The results of this study are in line with other economic evaluations on LAGB surgery. This study recommends that the Australian federal government provide a full subsidy for LAGB surgery to morbidly obese Australians with a BMI >40.

  1. Interest, views and perceived barriers to bariatric surgery in patients with morbid obesity.

    Science.gov (United States)

    Wharton, S; Serodio, K J; Kuk, J L; Sivapalan, N; Craik, A; Aarts, M-A

    2016-04-01

    The objective of the study was to assess the interest, views and patient-perceived barriers to bariatric surgery among surgery-eligible patients. Surveys were completed at a weight management clinic and local hospital in Ontario, Canada. Patients were ≥18 years of age with a body mass index (BMI) >40 kg m(-2) or BMI > 35 kg m(-2) with ≥1 comorbidity. The sample included 105 participants, 73.3% female, with a mean BMI of 46.6 ± 7.1 kg m(-2) . Only 33.3% of participants were interested in surgery; 50.5% of participants were not interested and 16.2% had mixed feelings. Participants identified risks (69.5%) and side effects (57.1%) as significant surgical barriers. Interested participants were more likely to perceive themselves as obese, were unhappy with their current weight loss method and were less likely to fear surgery (P bariatric surgery, the majority of qualified patients are not interested in surgery mainly due to the perceived risk of surgery in general and satisfaction with current non-surgical weight loss efforts. The self-perception of obesity, as opposed to medical comorbidities, may be a stronger driver of the decision to have bariatric surgery. It is unclear if patients are aware of the effectiveness of bariatric surgery to help improve comorbidities or if bariatric surgery is perceived as being more cosmetic in nature. © 2016 World Obesity.

  2. Geography of Adolescent Obesity in the U.S., 2007-2011.

    Science.gov (United States)

    Kramer, Michael R; Raskind, Ilana G; Van Dyke, Miriam E; Matthews, Stephen A; Cook-Smith, Jessica N

    2016-12-01

    Obesity remains a significant threat to the current and long-term health of U.S. adolescents. The authors developed county-level estimates of adolescent obesity for the contiguous U.S., and then explored the association between 23 conceptually derived area-based correlates of adolescent obesity and ecologic obesity prevalence. Multilevel small area regression methods applied to the 2007 and 2011-2012 National Survey of Children's Health produced county-level obesity prevalence estimates for children aged 10-17 years. Exploratory multivariable Bayesian regression estimated the cross-sectional association between nutrition, activity, and macrosocial characteristics of counties and states, and county-level obesity prevalence. All analyses were conducted in 2015. Adolescent obesity varies geographically with clusters of high prevalence in the Deep South and Southern Appalachian regions. Geographic disparities and clustering in observed data are largely explained by hypothesized area-based variables. In adjusted models, activity environment, but not nutrition environment variables were associated with county-level obesity prevalence. County violent crime was associated with higher obesity, whereas recreational facility density was associated with lower obesity. Measures of the macrosocial and relational domain, including community SES, community health, and social marginalization, were the strongest correlates of county-level obesity. County-level estimates of adolescent obesity demonstrate notable geographic disparities, which are largely explained by conceptually derived area-based contextual measures. This ecologic exploratory study highlights the importance of taking a multidimensional approach to understanding the social and community context in which adolescents make obesity-relevant behavioral choices. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  3. Dual Amylin and Calcitonin Receptor Agonists: A Novel Treatment for Obesity and Related Co-Morbidities

    DEFF Research Database (Denmark)

    Gydesen, Sofie

    transaminase (AST) levels. Finally, at the histological level KBP treatment reduced hepatic steatosis, ballooning and inflammation, hence resulting in a reduced NAS score in combination with a lowered fibrosis stage. In conclusion, KBPs induce and sustain weight loss, leading to improved metabolic parameters...... including food preference, and these are beyond those observed simply by dietinduced weight loss. Additionally, these peptides are well tolerated when introduced by dose escalation. Finally, KBPs reduce liver steatosis in both obese and NASH rats, and importantly reduced inflammation and fibrosis scores...

  4. Correlates of overweight and obesity among urban adolescents in Bihar, India

    Directory of Open Access Journals (Sweden)

    Ayan Ghosh

    2015-01-01

    Full Text Available Background: For better perception of adolescent overweight and obesity as a global public health problem, systematic collection of baseline data is urgently needed in India. Objective: A community-based study was undertaken for better perception of the prevalence and correlates of obesity in an adolescent urban community in Katihar, Bihar. Materials and Methods: A cross-sectional study was conducted among urban adolescents in the eastern part of India to find out prevalence of overweight and obesity and sociodemographic correlates by interview technique followed by clinical examination with ethical consideration. Results: Out of 400 adolescent study participants, 21% were overweight or obese. The study showed that there was a significant association between less consumption of vegetable foods, fruits, meals cooked outside the home, alcohol consumption, yoga practice, socioeconomic status, and the occurrence of overweight/obesity in the adolescents. Conclusions: We attempted to find out the prevalence and risk correlates of overweight and obesity among adolescents and found it quite alarming compared to developed countries. The urban underserved population in India has difficulty to access quality healthcare and not conscious enough to seek healthcare until critically ill. Community-based studies are required to highlight the problem of obesity among urban adolescents by a comprehensive approach.

  5. The Downstart Program: a hospital-based pediatric healthy lifestyle program for obese and morbidly obese minority youth.

    Science.gov (United States)

    Sternberg, Alex; Muzumdar, Hiren; Dinkevich, Eugene; Quintos, Jose Bernardo; Austin-Leon, Galia; Owens, Terrel; Murphy, Cheryl; Dapul, Geraldine; Rao, Madu

    2006-12-01

    Although obesity affects all cultures, ethnic groups and social strata, this disorder affects African Americans, Hispanics and the poor at a disproportionate rate. The Downstart Pediatric Healthy Lifestyle Program was developed to provide a multi-disciplinary behavioral modification program for inner city families in Brooklyn, New York interested in leading a healthier, more active lifestyle. The Downstart Program uses a four-pronged approach of medical evaluation, exercise, nutritional education and lifestyle modification. A psychological evaluation is performed to determine the individual's ability and readiness to participate in group activities. Baseline physical fitness, flexibility and muscle strength are measured, followed by a twice-weekly karate/martial arts/dance program, incorporating principles established by the President's Council on Exercise. Nutritional and behavioral modification aspects of the program consist of weekly education about food groups, portion control, goal setting and appropriate rewards for attaining goals. Our preliminary results indicate that the Downstart Program may be a viable intervention for weight loss. Further study is needed to improve strategies for motivating patients and means and criteria for assessing long-term effects on health and lifestyle.

  6. Zinc nutritional status of morbidly obese patients before and after Roux-en-Y gastric bypass: a preliminary report.

    Science.gov (United States)

    Cominetti, Cristiane; Garrido, Arthur Belarmino; Cozzolino, Silvia Maria Franciscato

    2006-04-01

    Previous researchers have found that the nutritional zinc status in obese and diabetic subjects is altered: low zinc concentrations in plasma and erythrocytes with high urinary zinc excretion were observed. This study assessed the influence of the Roux-en-Y gastric bypass (RYGBP) on the plasma, erythrocyte and urinary zinc concentrations before the beginning of the mineral supplementation. 24 morbidly obese patients were studied before and 2 months after RYGBP (the period in which the patients were still not ingesting mineral supplements). Fast blood sample, 24-hour urine, and 3-day food records were collected in the pre- and postoperative phases. Zinc concentration in the samples was analyzed by flame atomic absorption spectrophotometry, and dietary analysis of the food records were performed using the software Virtual Nutri with the inclusion of zinc concentration in the database for regional foods. Pre- and postoperative results were respectively: plasma 68.0 and 66.3 microg/dL; erythrocytes 36.6 and 43.8 microg/g Hb; urine 884.7 microg/24h and 385.9 microg/24h; and zinc intake 10.5 and 6.7 mg/day. These results suggest that RYGBP changed mainly the zinc erythrocyte and urinary concentrations. As expected, the zinc intake was lower in the postoperative phase, which in the medium and long term, could cause problems for the patients.

  7. Effect of Weight Reduction Following Bariatric Surgery on Serum Visfatin and Adiponectin Levels in Morbidly Obese Subjects

    Directory of Open Access Journals (Sweden)

    Mohammad Javad Hosseinzadeh-Attar

    2013-04-01

    Full Text Available Objective: Adipokines are signaling and mediator proteins secreted from adipose tissue. A novel adipokine, visfatin, was reported as a protein which was mainly expressed in visceral adipose tissue. Controversial results have been shown regarding the changes of adipokines following weight reduction. So we investigated the effects of weight reduction on serum concentrations of adiponectin and visfatin in morbidly obese subjects. Methods: 35 severely obese patients (26 females and 9 males, aged 15-58 years, were studied. Anthropometric parameters and biochemical parameters as well as adiponectin and visfatin were analyzed before and 6 weeks after weight reduction. Results: Anthropometric indices decreased significantly. Blood levels of low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride were reduced significantly. The reduction of visfatin and the elevation of adiponectin were significant as well. However, other parameters like fasting glucose and insulin did not change. Moreover, we could not find any significant correlation between the change of serum visfatin and that of adiponectin. Conclusions: 6-week weight reduction after bariatric surgery resulted in decreased serum visfatin and increased adiponectin levels. However, we cannot find any significant correlation between changes of adiponectin, visfatin, BMI, waist circumference, and insulin resistance. Further studies with different design are suggested to clarify these associations.

  8. Anorexigenic postprandial responses of PYY and GLP1 to slow ice cream consumption: preservation in obese adolescents, but not in obese adults.

    Science.gov (United States)

    Rigamonti, A E; Agosti, F; Compri, E; Giunta, M; Marazzi, N; Muller, E E; Cella, S G; Sartorio, A

    2013-03-01

    Eating slowly increases the postprandial responses of some anorexigenic gut hormones in healthy lean subjects. As the rate of food intake is positively associated with obesity, the aim of the study was to determine whether eating the same meal at different rates evokes different postprandial anorexigenic responses in obese adolescent and adult subjects. Eighteen obese adolescents and adults were enrolled. A test meal was consumed on two different sessions by each subject, meal duration taking either 5  min (fast feeding) or 30  min (slow feeding). Circulating levels of glucagon-like peptide 1 (GLP1), peptide YY (PYY), glucose, insulin, and triglycerides were measured over 210  min. Visual analog scales were used to evaluate the subjective feelings of hunger and satiety. fast feeding did not stimulate GLP1 release in obese adolescent and adults, whereas slow feeding increased circulating levels of GLP1 only in obese adolescents. Plasma PYY concentrations increased both in obese adolescents and in adults, irrespective of the eating rate, but slow feeding was more effective in stimulating PYY release in obese adolescents than in adults. simultaneously, slow feeding evoked a higher satiety only in obese adolescents compared with fast feeding but not in obese adults. in obese adolescents, slow feeding decreased hunger (only at 210 min). irrespective of the eating rate, postprandial responses of insulin and triglycerides were higher in obese adults than in obese adolescents. Slow feeding leads to higher concentrations of anorexigenic gut peptides and favors satiety in obese adolescents, but this physiological control of food intake is lost in obese adults.

  9. Prevalence of overweight and obesity among school children and adolescents in Chennai.

    Science.gov (United States)

    Jagadesan, Sonya; Harish,