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Sample records for weight loss surgery

  1. Weight Loss Surgery

    Science.gov (United States)

    Weight loss surgery helps people with extreme obesity to lose weight. It may be an option if you ... caused by obesity. There are different types of weight loss surgery. They often limit the amount of food ...

  2. Weight Loss Surgery (Bariatric Surgery) (For Parents)

    Science.gov (United States)

    ... to Be Smart About Social Media Weight Loss Surgery (Bariatric Surgery) KidsHealth > For Parents > Weight Loss Surgery (Bariatric Surgery) ... bariatric surgery might be an option. About Bariatric Surgery Bariatric surgery had its beginnings in the 1960s, ...

  3. Weight Loss Surgery (Bariatric Surgery) (For Parents)

    Science.gov (United States)

    ... Health Growth & Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & ... Surgery Types of Surgery Gastric Bypass ... or intestines removed due to ulcers or cancer tended to lose a lot of weight after ...

  4. Weight-loss surgery and children

    Science.gov (United States)

    ... more likely to have problems such as: Low self-esteem Poor grades in school Depression ... weight-loss surgery should receive care at an adolescent bariatric surgery center. There, a team of experts ...

  5. Internalized weight bias in weight-loss surgery patients: psychosocial correlates and weight loss outcomes.

    Science.gov (United States)

    Lent, Michelle R; Napolitano, Melissa A; Wood, G Craig; Argyropoulos, George; Gerhard, Glenn S; Hayes, Sharon; Foster, Gary D; Collins, Charlotte A; Still, Christopher D

    2014-12-01

    In this study, we examined the relationship between pre-operative internalized weight bias and 12-month post-operative weight loss in adult bariatric surgery patients. Bariatric surgery patients (n=170) from one urban and one rural medical center completed an internalized weight bias measure (the weight bias internalization scale, WBIS) and a depression survey (Beck depression inventory-II, BDI-II) before surgery, and provided consent to access their medical records. Participants (BMI=47.8 kg/m2, age=45.7 years) were mostly female (82.0 %), White (89.5 %), and underwent gastric bypass (83.6 %). The average WBIS score by item was 4.54 ± 1.3. Higher pre-operative WBIS scores were associated with diminished weight loss at 12 months after surgery (p=0.035). Pre-operative WBIS scores were positively associated with depressive symptoms (p<0.001). Greater internalized weight bias was associated with more depressive symptoms before surgery and less weight loss 1 year after surgery.

  6. Complications following body contouring surgery after massive weight loss

    DEFF Research Database (Denmark)

    Hasanbegovic, Emir; Sørensen, Jens Ahm

    2014-01-01

    Bariatric surgery is a way to achieve lasting weight loss in the obese. Body contouring surgery seeks to alleviate some of the discomfort caused by the excessive loose skin following massive weight loss. Higher complication rates are described in this type of surgery when done post......-bariatric. The purpose of this article is to compare complication rates of body contouring surgery when performed on patients with weight loss due to bariatric surgery compared to patients who lost weight due to dietary changes and/or exercise....

  7. Weight-Loss Surgery Sheds Pounds Long Term

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_160719.html Weight-Loss Surgery Sheds Pounds Long Term 10-year follow- ... 31, 2016 WEDNESDAY, Aug. 31, 2016 (HealthDay News) -- Weight-loss surgery helps people drop a significant amount of ...

  8. Could Weight-Loss Surgery Boost Odds of Preemie Birth?

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_160596.html Could Weight-Loss Surgery Boost Odds of Preemie Birth? Monitoring is ... HealthDay News) -- Mothers-to-be who've had weight-loss surgery may have increased odds for premature delivery, ...

  9. Weight-Loss Surgery Pays Off for Severely Obese Teens

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_161700.html Weight-Loss Surgery Pays Off for Severely Obese Teens Boosts ... 26, 2016 WEDNESDAY, Oct. 26, 2016 (HealthDay News) -- Weight-loss surgeries can help severely obese teens shed pounds. ...

  10. Weight-Loss Surgery May Lower Risk of Pregnancy Complications

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_161748.html Weight-Loss Surgery May Lower Risk of Pregnancy Complications Women ... Oct. 28, 2016 (HealthDay News) -- Women who undergo weight-loss surgery gain major benefits when it comes to ...

  11. Could a Weight-Loss Surgery Lead to Alcohol Abuse?

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_165663.html Could a Weight-Loss Surgery Lead to Alcohol Abuse? Patients who undergo ... 2017 (HealthDay News) -- After a popular type of weight-loss surgery, nearly 21 percent of patients develop a ...

  12. Preoperative predictors of weight loss following bariatric surgery: systematic review.

    Science.gov (United States)

    Livhits, Masha; Mercado, Cheryl; Yermilov, Irina; Parikh, Janak A; Dutson, Erik; Mehran, Amir; Ko, Clifford Y; Gibbons, Melinda Maggard

    2012-01-01

    Obesity affects 32% of adults in the USA. Surgery generates substantial weight loss, but 20-30% fails to achieve successful weight loss. Our objective was to identify preoperative psychosocial factors associated with weight loss following bariatric surgery. We performed a literature search of PubMed® and the Cochrane Database of Reviews of Effectiveness between 1988 and April 2010. Articles were screened for bariatric surgery and weight loss if they included a preoperative predictor of weight loss: body mass index (BMI), preoperative weight loss, eating disorders, or psychiatric disorder/substance abuse. One thousand seven titles were reviewed, 534 articles screened, and 115 included in the review. Factors that may be positively associated with weight loss after surgery include mandatory preoperative weight loss (7 of 14 studies with positive association). Factors that may be negatively associated with weight loss include preoperative BMI (37 out of 62 studies with negative association), super-obesity (24 out of 33 studies), and personality disorders (7 out of 14 studies). Meta-analysis revealed a decrease of 10.1% excess weight loss (EWL) for super-obese patients (95% confidence interval (CI) [3.7-16.5%]), though there was significant heterogeneity in the meta-analysis, and an increase of 5.9% EWL for patients with binge eating at 12 months after surgery (95% CI [1.9-9.8%]). Further studies are necessary to investigate whether preoperative factors can predict a clinically meaningful difference in weight loss after bariatric surgery. The identification of predictive factors may improve patient selection and help develop interventions targeting specific needs of patients.

  13. Gut Bacteria Changes After Some Weight-Loss Surgeries

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_165987.html Gut Bacteria Changes After Some Weight-Loss Surgeries Better diversity ... Specifically, the procedure leads to increased diversity of bacteria in the gut, and a microbial population distinct ...

  14. After massive weight loss: patients' expectations of body contouring surgery.

    Science.gov (United States)

    Kitzinger, Hugo B; Abayev, Sara; Pittermann, Anna; Karle, Birgit; Bohdjalian, Arthur; Langer, Felix B; Prager, Gerhard; Frey, Manfred

    2012-04-01

    Massive weight loss following bariatric surgery leads to excess skin with functional and aesthetic impairments. Surplus skin can then contribute to problems with additional weight loss or gain. The aims of the current study were to evaluate the frequency of massive soft tissue development in gastric bypass patients, to determine whether males and females experience similar post-bypass body changes, and to learn about the expectations and impairments related to body contouring surgery. A questionnaire addressing information on the satisfaction of body image, quality of life, and expectation of body contouring surgery following massive weight loss was mailed to 425 patients who had undergone gastric bypass surgery between 2003 and 2009. Of these 425 individuals, 252 (59%) patients completed the survey. Ninety percent of women and 88% of men surveyed rated their appearance following massive weight loss as satisfactory, good, or very good. However, 96% of all patients developed surplus skin, which caused intertriginous dermatitis and itching. In addition, patients reported problems with physical activity (playing sports) and finding clothing that fit appropriately. Moreover, 75% of female and 68% of male patients reported desiring body contouring surgery. The most important expectation of body contouring surgery was improved appearance, followed by improved self-confidence and quality of life. Surplus skin resulting from gastric bypass surgery is a common issue that causes functional and aesthetic impairments in patients. Consequently, this increases the desire for body contouring surgery with high expectations for the aesthetic outcome as well as improved life satisfaction.

  15. Treatment of Obesity: Weight Loss and Bariatric Surgery

    Science.gov (United States)

    Wolfe, Bruce M.; Kvach, Elizaveta; Eckel, Robert H.

    2016-01-01

    This review focuses on the mechanisms underlying, and indications for, bariatric surgery in the reduction of cardiovascular disease (CVD) as well as other expected benefits of this intervention. The fundamental basis for bariatric surgery for the purpose of accomplishing weight loss is the determination that severe obesity is a disease associated with multiple adverse effects on health which can be reversed or improved by successful weight loss in patients who have been unable to sustain weight loss by non-surgical means. An explanation of possible indications for weight loss surgery as well as specific bariatric surgical procedures is presented, along with review of the safety literature of such procedures. Procedures that are less invasive or those that involve less gastrointestinal rearrangement accomplish considerably less weight loss but have substantially lower perioperative and longer-term risk. The ultimate benefit of weight reduction relates to the reduction of the co-morbidities, quality of life and all-cause mortality. With weight loss being the underlying justification for bariatric surgery in ameliorating CVD risk, current evidence-based research is discussed concerning body fat distribution, dyslipidemia, hypertension, diabetes, inflammation, obstructive sleep apnea and others. The rationale for bariatric surgery reducing CVD events is discussed and juxtaposed with impacts on all-cause mortalities. Given the improvement of established obesity-related CVD risk factors following weight loss, it is reasonable to expect a reduction of CVD events and related mortality following weight loss in populations with obesity. The quality of the current evidence is reviewed and future research opportunities and summaries are stated. PMID:27230645

  16. Mandatory weight loss during the wait for bariatric surgery.

    Science.gov (United States)

    Glenn, Nicole M; Raine, Kim D; Spence, John C

    2015-01-01

    Mandatory presurgical, behavior-induced weight loss, although not standard, is a relatively common practice among bariatric surgical clinics. We explore the patient's experience of this practice using phenomenology. We gathered experiential accounts from 7 individuals waiting to have the procedure at a large publically funded clinic in western Canada. In writing this article, we focused on four phenomenological themes: "just nod your head and carry on"-silencing through the ideal; waiting and weighing-promoting weight consciousness to the weight conscious; paying for surgical approval through weight loss; and presurgical weight loss and questioning the need for weight loss surgery altogether. We contrast the experiential findings with the clinical literature to question the impact and possible (unintended or unexpected) effects the practice might have, particularly on patients' lives. We situate this article within a larger discussion about the possible contribution of experiential knowledge to clinical guidelines, practices, and pedagogies. © The Author(s) 2014.

  17. Updates in weight loss surgery and gastrointestinal peptides

    DEFF Research Database (Denmark)

    Svane, Maria Saur; Bojsen-Møller, Kirstine N; Madsbad, Sten

    2015-01-01

    PURPOSE OF REVIEW: Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy are referred to as 'metabolic surgery' due to hormonal shifts with impacts on diabetes remission and weight loss. The purpose of this review is to summarize recent findings in mechanisms underlying beneficial effects...... of weight loss surgery. RECENT FINDINGS: Importantly, gut hormone secretion is altered after RYGB and sleeve gastrectomy due to accelerated transit of nutrients to distal parts of the small intestine, leading to excessive release of L-cell peptide hormones [e.g. glucagon-like peptide-1 (GLP-1), peptide YY...

  18. Exploring media representations of weight-loss surgery.

    Science.gov (United States)

    Glenn, Nicole M; McGannon, Kerry R; Spence, John C

    2013-05-01

    Scholars have problematized popular culture and media (re)presentations of obesity/overweight. However, few have considered the ways bariatric surgery, a rapidly growing treatment for morbid obesity, fits within the discussion. In this article, we explore news media (re)presentations of bariatric surgery using an eclectic approach to critical discourse analysis. Our findings reveal dominant discourses about bariatric surgery and the surgical population, providing an understanding of media (re)presentations as possible contributors to bias, stigmatization, and discrimination. Novel in our findings was our identification of subject positions in the dominant discourses (which were biomedical and benevolent government). We argue that existing (re)presentations of bariatric surgery are highly problematic because they reinforce oversimplistic and binary understandings of weight-loss surgery and obesity, weaving a highly gendered fairy-tale narrative and ultimately promoting weight-based stigmatization.

  19. Mechanisms of weight loss and improved metabolism following bariatric surgery.

    Science.gov (United States)

    Mulla, Christopher M; Middelbeek, Roeland J W; Patti, Mary-Elizabeth

    2017-09-03

    Bariatric surgery is increasingly recognized as one of the most effective interventions to help patients achieve significant and sustained weight loss, as well as improved metabolic and overall health. Unfortunately, the cellular and physiological mechanisms by which bariatric surgery achieves weight loss have not been fully elucidated, yet are critical to understanding the central role of the intestinal tract in whole-body metabolism and to developing novel strategies for the treatment of obesity. In this review, we provide an overview of potential mechanisms contributing to weight loss, including effects on regulation of energy balance and both central and peripheral nervous system regulation of appetite and metabolism. Moreover, we highlight the importance of the gastrointestinal tract, including alterations in bile acid physiology, secretion of intestinally derived hormones, and the microbiome, as a potent mediator of improved metabolism in postbariatric patients. © 2017 New York Academy of Sciences.

  20. Updates in weight loss surgery and gastrointestinal peptides.

    Science.gov (United States)

    Svane, Maria Saur; Bojsen-Møller, Kirstine Nyvold; Madsbad, Sten; Holst, Jens Juul

    2015-02-01

    Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy are referred to as 'metabolic surgery' due to hormonal shifts with impacts on diabetes remission and weight loss. The purpose of this review is to summarize recent findings in mechanisms underlying beneficial effects of weight loss surgery. Importantly, gut hormone secretion is altered after RYGB and sleeve gastrectomy due to accelerated transit of nutrients to distal parts of the small intestine, leading to excessive release of L-cell peptide hormones [e.g. glucagon-like peptide-1 (GLP-1), peptide YY].Improved glucose metabolism after RYGB and sleeve gastrectomy involves several mechanisms: early increased hepatic insulin sensitivity, resulting from reduced liver fat content in response to the postoperative caloric restriction, improved beta-cell function mediated by exaggerated postprandial GLP-1 secretion; as demonstrated by relapse of impaired glucose tolerance in studies blocking the GLP-1 receptor by exendin 9-39, and later after major weight loss increased peripheral insulin sensitivity. Gut hormone secretion changes towards a more anorectic profile and is likely important for less caloric intake and weight loss. Changes in gut hormone secretion after RYGB and sleeve gastrectomy surgery induce the beneficial effects on weight and glycemic control through the influence on appetite regulation and insulin secretion.

  1. Psychological predictors of weight loss after bariatric surgery

    DEFF Research Database (Denmark)

    Wimmelmann, Cathrine Lawaetz; Dela, Flemming; Mortensen, Erik Lykke

    2014-01-01

    Background: Morbid obesity is the fastest growing BMI group in the U.S. and the prevalence of morbid obesity worldwide has never been higher. Bariatric surgery is the most effective treatment for severe forms of obesity especially with regardto a sustained long-term weight loss. Psychological...... factors are thought to play animportant role for maintaining the surgical weight loss. However, results from priorresearch examining preoperative psychological predictors of weight loss outcomeare inconsistent. The aim of this article was to review more recent literature onpsychological predictors...... studies published after 2003 were included.Results: 19 eligible studies were identified. Psychological predictors of surgicalweight loss investigated in the reviewed studies include cognitive function, per-sonality, psychiatric disorder, and eating behaviour....

  2. Breast cancer biomarkers predict weight loss after gastric bypass surgery

    Directory of Open Access Journals (Sweden)

    Sauter Edward R

    2012-01-01

    Full Text Available Abstract Background Obesity has long been associated with postmenopausal breast cancer risk and more recently with premenopausal breast cancer risk. We previously observed that nipple aspirate fluid (n levels of prostate specific antigen (PSA were associated with obesity. Serum (s levels of adiponectin are lower in women with higher body mass index (BMI and with breast cancer. We conducted a prospective study of obese women who underwent gastric bypass surgery to determine: 1 change in n- and s-adiponectin and nPSA after surgery and 2 if biomarker change is related to change in BMI. Samples (30-s, 28-n and BMI were obtained from women 0, 3, 6 and 12 months after surgery. Findings There was a significant increase after surgery in pre- but not postmenopausal women at all time points in s-adiponectin and at 3 and 6 months in n-adiponectin. Low n-PSA and high s-adiponectin values were highly correlated with decrease in BMI from baseline. Conclusions Adiponectin increases locally in the breast and systemically in premenopausal women after gastric bypass. s-adiponectin in pre- and nPSA in postmenopausal women correlated with greater weight loss. This study provides preliminary evidence for biologic markers to predict weight loss after gastric bypass surgery.

  3. Having Baby Too Soon After Weight-Loss Surgery May Raise Risks

    Science.gov (United States)

    ... fullstory_161572.html Having Baby Too Soon After Weight-Loss Surgery May Raise Risks A suitable interval, plus ... News) -- Infants born to mothers who've had weight-loss surgery have a higher risk for complications, and ...

  4. The utility of weight loss medications after bariatric surgery for weight regain or inadequate weight loss: A multi-center study.

    Science.gov (United States)

    Stanford, Fatima Cody; Alfaris, Nasreen; Gomez, Gricelda; Ricks, Elizabeth T; Shukla, Alpana P; Corey, Kathleen E; Pratt, Janey S; Pomp, Alfons; Rubino, Francesco; Aronne, Louis J

    2017-03-01

    Patients who undergo bariatric surgery often have inadequate weight loss or weight regain. We sought to discern the utility of weight loss pharmacotherapy as an adjunct to bariatric surgery in patients with inadequate weight loss or weight regain. Two academic medical centers. We completed a retrospective study to identify patients who had undergone bariatric surgery in the form of a Roux-en-Y gastric bypass (RYGB) or a sleeve gastrectomy from 2000-2014. From this cohort, we identified patients who were placed on weight loss pharmacotherapy postoperatively for inadequate weight loss or weight regain. We extracted key demographic data, medical history, and examined weight loss in response to surgery and after the initiation of weight loss pharmacotherapy. A total of 319 patients (RYGB = 258; sleeve gastrectomy = 61) met inclusion criteria for analysis. More than half (54%; n = 172) of all study patients lost≥5% (7.2 to 195.2 lbs) of their total weight with medications after surgery. There were several high responders with 30.3% of patients (n = 96) and 15% (n = 49) losing≥10% (16.7 to 195.2 lbs) and≥15% (25 to 195.2 lbs) of their total weight, respectively, Topiramate was the only medication that demonstrated a statistically significant response for weight loss with patients being twice as likely to lose at least 10% of their weight when placed on this medication (odds ratio = 1.9; P = .018). Regardless of the postoperative body mass index, patients who underwent RYGB were significantly more likely to lose≥5% of their total weight with the aid of weight loss medications. Weight loss pharmacotherapy serves as a useful adjunct to bariatric surgery in patients with inadequate weight loss or weight regain. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  5. Does weight loss immediately before bariatric surgery improve outcomes: a systematic review.

    Science.gov (United States)

    Livhits, Masha; Mercado, Cheryl; Yermilov, Irina; Parikh, Janak A; Dutson, Erik; Mehran, Amir; Ko, Clifford Y; Gibbons, Melinda Maggard

    2009-01-01

    Preoperative weight loss before bariatric surgery has been proposed as a predictive factor for improved patient compliance and the degree of excess weight loss achieved after surgery. In the present study, we sought to determine the effect of preoperative weight loss on postoperative outcomes. A search of MEDLINE was completed to identify the patient factors associated with weight loss after bariatric surgery. Of the 909 screened reports, 15 had reported on preoperative weight loss and the degree of postoperative weight loss achieved. A meta-analysis was performed that compared the postoperative weight loss and perioperative outcomes in patients who had lost weight preoperatively compared to those who had not. Of the 15 articles (n = 3404 patients) identified, 5 found a positive effect of preoperative weight loss on postoperative weight loss, 2 found a positive short-term effect that was not sustained long term, 5 did not find an effect difference, and 1 found a negative effect. A meta-analysis revealed a significant increase in the 1-year postoperative weight loss (mean difference of 5% EWL, 95% confidence interval 2.68-7.32) for patients who had lost weight preoperatively. A meta-analysis of other outcomes revealed a decreased operative time for patients who had lost weight preoperatively (mean difference 23.3 minutes, 95% confidence interval 13.8-32.8). Preoperative weight loss before bariatric surgery appears to be associated with greater weight loss postoperatively and might help to identify patients who would have better compliance after surgery.

  6. 1 in 5 Weight-Loss Surgery Patients Using Opioids Years Later

    Science.gov (United States)

    ... gov/news/fullstory_166311.html 1 in 5 Weight-Loss Surgery Patients Using Opioids Years Later Though procedure ... 2017 (HealthDay News) -- About 20 percent of U.S. weight-loss surgery patients are still using prescription opioid painkillers ...

  7. Don't Put Off Weight-Loss Surgery Till You're Heavier

    Science.gov (United States)

    ... news/fullstory_167433.html Don't Put Off Weight-Loss Surgery Till You're Heavier Best results seen ... 2017 WEDNESDAY, July 26, 2017 (HealthDay News) -- Having weight-loss surgery before you become severely obese tends to ...

  8. Translating weight loss into agency: Men's experiences 5 years after bariatric surgery

    Directory of Open Access Journals (Sweden)

    Eli Natvik

    2015-06-01

    Full Text Available Fewer men than women with severe obesity undergo bariatric surgery for weight loss, and knowledge about men's situation after surgery, beyond medical status, is lacking. Our aim was to explore men's experiences with life after bariatric surgery from a long-term perspective. We conducted in-depth interviews with 13 men, aged 28–60 years, between 5 and 7 years after surgery. The analysis was inspired by Giorgi's phenomenological method. We found that agency was pivotal for how the men understood themselves and their lives after surgery. Weight loss meant regaining opportunities for living and acting in unrestricted and independent daily lives, yet surgery remained a radical treatment with complex consequences. Turning to surgery had involved conceptualizing their own body size as illness, which the men had resisted doing for years. After surgery, the rapid and major weight loss and the feelings of being exhausted, weak, and helpless were intertwined. The profound intensity of the weight loss process took the men by surprise. Embodying weight loss and change involved an inevitable renegotiating of experiences connected to the large body. Having bariatric surgery was a long-term process that seemed unfinished 5 years after surgery. Restrictions and insecurity connected to health and illness persist, despite successful weight loss and embodied change. Bariatric surgery initiated a complex and long-lasting life-changing process, involving both increased capacity for agency and illness-like experiences.

  9. Is social support associated with greater weight loss after bariatric surgery?: a systematic review.

    Science.gov (United States)

    Livhits, M; Mercado, C; Yermilov, I; Parikh, J A; Dutson, E; Mehran, A; Ko, C Y; Shekelle, P G; Gibbons, M M

    2011-02-01

    Social support may be associated with increased weight loss after bariatric surgery. The objective of this article is to determine impact of post-operative support groups and other forms of social support on weight loss after bariatric surgery. MEDLINE search (1988-2009) was completed using MeSH terms including bariatric procedures and a spectrum of patient factors with potential relationship to weight loss outcomes. Of the 934 screened studies, 10 reported on social support and weight loss outcomes. Five studies reported on support groups and five studies reported on other forms of social support (such as perceived family support or number of confidants) and degree of post-operative weight loss (total n = 735 patients). All studies found a positive association between post-operative support groups and weight loss. One study found a positive association between marital status (being single) and weight loss, while three studies found a non-significant positive trend and one study was inconclusive. Support group attendance after bariatric surgery is associated with greater post-operative weight loss. Further research is necessary to determine the impact of other forms of social support. These factors should be addressed in prospective studies of weight loss following bariatric surgery, as they may represent ways to improve post-operative outcomes. © 2010 The Authors. obesity reviews © 2010 International Association for the Study of Obesity.

  10. Weight loss by calorie restriction versus bariatric surgery differentially regulates the HPA axis in male rats

    Science.gov (United States)

    Grayson, Bernadette E.; Hakala-Finch, Andrew P.; Kekulawala, Melani; Laub, Holly; Egan, Ann E.; Ressler, Ilana B.; Woods, Stephen C.; Herman, James P.; Seeley, Randy J.; Benoit, Stephen C.; Ulrich-Lai, Yvonne M.

    2015-01-01

    Behavioral modifications for the treatment of obesity, including caloric restriction, have notoriously low long-term success rates relative to bariatric weight-loss surgery. The reasons for the difference in sustained weight loss are not clear. One possibility is that caloric restriction alone activates the stress-responsive hypothalamo-pituitary-adrenocortical (HPA) axis, undermining the long-term maintenance of weight loss, and that this is abrogated after bariatric surgery. Accordingly, we compared the HPA response to weight loss in 5 groups of male rats: (1) high-fat diet-induced obese (DIO) rats treated with Roux-en-Y gastric bypass surgery (RYGB, n=7), (2) DIO rats treated with vertical sleeve gastrectomy (VSG, n=11), (3) DIO rats given sham surgery and subsequently restricted to the food intake of the VSG/RYGB groups (Pair-fed, n=11), (4) ad libitum-fed DIO rats given sham surgery (Obese, n=11) and (5) ad libitum chow-fed rats given sham surgery (Lean, n=12). Compared to Lean controls, food-restricted rats exhibited elevated morning (nadir) non-stress plasma corticosterone concentrations and increased hypothalamic corticotropin releasing hormone and vasopressin mRNA expression, indicative of basal HPA activation. This was largely prevented when weight loss was achieved by bariatric surgery. DIO increased HPA activation by acute (novel environment) stress and this was diminished by bariatric surgery-, but not pair-feeding-, induced weight loss. These results suggest that the HPA axis is differentially affected by weight loss from caloric restriction versus bariatric surgery, and this may contribute to the differing long-term effectiveness of these two weight-loss approaches. PMID:25238021

  11. Medical weight loss versus bariatric surgery: does method affect body composition and weight maintenance after 15% reduction in body weight?

    Science.gov (United States)

    Kulovitz, Michelle G; Kolkmeyer, Deborah; Conn, Carole A; Cohen, Deborah A; Ferraro, Robert T

    2014-01-01

    The aim of this study was to investigate body composition changes in fat mass (FM) to lean body mass (LBM) ratios following 15% body weight loss (WL) in both integrated medical treatment and bariatric surgery groups. Obese patients (body mass index [BMI] 46.6 ± 6.5 kg/m(2)) who underwent laparoscopic gastric bypass surgery (BS), were matched with 24 patients undergoing integrated medical and behavioral treatment (MT). The BS and MT groups were evaluated for body weight, BMI, body composition, and waist circumference (WC) at baseline and after 15% WL. Following 15% body WL, there were significant decreases in %FM and increased %LBM (P loss during the first 15% reduction in body weight. Finally, no significant differences (P = 0.103) between groups for maintenance of WL at 1 y were found. For both groups, baseline FM was found to be negatively correlated with percentage of weight regained (%WR) at 1 y post-WL (r = -0.457; P = 0.007). Baseline WC and rate of WL to 15% were significant predictors of %WR only in the BS group (r = 0.713; P = 0.020). If followed closely by professionals during the first 15% body WL, patients losing 15% weight by either medical or surgical treatments can attain similar FM:LBM loss ratios and can maintain WL for 1 y. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Emphasising Personal Investment Effects Weight Loss and Hedonic Thoughts about Food after Obesity Surgery

    Directory of Open Access Journals (Sweden)

    Margaret Husted

    2014-01-01

    Full Text Available Obesity surgery is the most effective treatment method for the severely obese but does not work for everyone. Indications are that weight-loss success may be related to individuals’ sense of investment in surgery, with failure linked to higher automatic hedonic motivations to consume food and greater susceptibility to food in the environment. A pilot study using an independent experimental design recruited bariatric surgery patients (n=91 via a UK obesity-surgery charity website who were randomly allocated to either the intervention or the control condition. The intervention involved raising the salience of the personal investment made in having weight-loss surgery in an attempt to reduce automatic hedonic thoughts about food and aid weight loss. Data was collected initially with subsequent weight loss measured at 3 months of follow-up. Following the intervention, participants reported significantly reduced hedonic thoughts, increased liking for low-fat foods, reduced liking of high-fat food, and higher self-efficacy for achieving sustained weight loss than controls. By 3 months, this was translated into significant differences in mean weight losses of 6.77 kg for the intervention group and 0.91 kg for control participants. To conclude, a quick simple cost-effective intervention encouraging participants to focus on investment helped weight loss and changed hedonic thoughts about food in bariatric patients.

  13. Interventions to improve long-term weight loss in patients following bariatric surgery: challenges and solutions

    Directory of Open Access Journals (Sweden)

    McGrice M

    2015-06-01

    Full Text Available Melanie McGrice, Kathlene Don Paul Nutrition Plus Enterprises, Melbourne, VIC, Australia Abstract: Bariatric surgery aims to provide long-term weight loss and improvement in weight-related comorbidities. Unfortunately, some patients do not achieve predicted weight loss targets and many regain a portion of their lost weight within 2–10 years postsurgery. A review of the literature found that behavioral, dietary, psychological, physical, and medical considerations can all play a role in suboptimal long-term weight loss. Recommendations to optimize long-term weight loss include ensuring that the patient understands how the procedure works, preoperative and postoperative education sessions, tailored nutritional supplements, restraint with liquid kilojoules, pureed foods, grazing and eating out of the home, an average of 60 minutes of physical activity per day, and lifelong annual medical, psychological, and dietary assessments.Keywords: weight, bariatric, surgery

  14. The effects of weight loss surgery on blood rheology in severely obese patients.

    Science.gov (United States)

    Wiewiora, Maciej; Piecuch, Jerzy; Glűck, Marek; Slowinska-Lozynska, Ludmila; Sosada, Krystyn

    2015-01-01

    The effects of dieting on blood rheology in obese individuals suggest that improving the rheologic profiles depends on the amount of weight lost and its long-term maintenance. The aim of this study was to evaluate the effects of weight loss after surgery on blood rheology at 12-month follow-up. We studied 38 obese patients who underwent laparoscopic weight loss surgery, 22 of whom had sleeve gastrectomy (SG) and 16 of whom had gastric banding (LAGB). We evaluated rheologic parameters such as blood viscosity, plasma viscosity, and erythrocyte deformability (as measured by elongation index [EI]) preoperatively and 12 months after surgery. Whole blood viscosity at 150 s(-1) shear rate (Prheology in obese patients at 12 months after surgery. The increased red blood cell rigidity after surgery requires further study because the physiologic importance of this change has not yet been established. Copyright © 2015 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  15. Bariatric surgery-induced weight loss causes remission of food addiction in extreme obesity.

    Science.gov (United States)

    Pepino, Marta Yanina; Stein, Richard I; Eagon, J Christopher; Klein, Samuel

    2014-08-01

    To test the hypotheses that bariatric surgery-induced weight loss: induces remission of food addiction (FA), and normalizes other eating behaviors associated with FA. Forty-four obese subjects (BMI= 48 ± 8 kg/m(2) ) were studied before and after ∼20% weight loss induced by bariatric surgery (25 Roux-en-Y gastric bypass, 11 laparoscopic adjustable gastric banding, and eight sleeve gastrectomy). We assessed: FA (Yale Food Addiction Scale), food cravings (Food Craving Inventory), and restrictive, emotional and external eating behaviors (Dutch Eating Behavior Questionnaire). FA was identified in 32% of subjects before surgery. Compared with non-FA subjects, those with FA craved foods more frequently, and had higher scores for emotional and external eating behaviors (all P-values 0.8). Surgery-induced weight loss resulted in remission of FA in 93% of FA subjects; no new cases of FA developed after surgery. Surgery-induced weight loss decreased food cravings, and emotional and external eating behaviors in both groups (all P-values 1.1). Bariatric surgery-induced weight loss induces remission of FA and improves several eating behaviors that are associated with FA. Copyright © 2014 The Obesity Society.

  16. Postoperative Follow-up After Bariatric Surgery: Effect on Weight Loss.

    Science.gov (United States)

    Spaniolas, Konstantinos; Kasten, Kevin R; Celio, Adam; Burruss, Matthew B; Pories, Walter J

    2016-04-01

    While adherence to long-term follow-up after bariatric surgery is a mandate for center of excellence certification, the effect of attrition on weight loss is not well understood. The aim of this study was to assess the effect of postoperative follow-up on 12-month weight loss using the Bariatric Outcomes Longitudinal Database (BOLD) dataset. Patients with complete follow-up (3, 6, and 12 months) were compared to patients who had one or more prior missed visits. There were 51,081 patients with 12-month follow-up data available. After controlling for baseline characteristics, complete follow-up was independently associated with excess weight loss ≥50%, and total weight loss ≥30%. Adherence to postoperative follow-up is independently associated with improved 12-month weight loss after bariatric surgery. Bariatric programs should strive to achieve complete follow-up for all patients.

  17. Weight-loss surgery - before - what to ask your doctor

    Science.gov (United States)

    Gastric bypass - before - what to ask your doctor; Roux-en-Y gastric bypass - before - what to ask your doctor; Gastric banding - before - what to ask your doctor; Vertical sleeve surgery - before - ...

  18. Efficacy of a Required Preoperative Weight Loss Program for Patients Undergoing Bariatric Surgery.

    Science.gov (United States)

    Conaty, Eliza A; Bonamici, Nicolas J; Gitelis, Matthew E; Johnson, Brandon J; DeAsis, Francis; Carbray, JoAnn M; Lapin, Brittany; Joehl, Raymond; Denham, Woody; Linn, John G; Haggerty, Stephen P; Ujiki, Michael B

    2016-04-01

    The efficacy of mandatory medically supervised preoperative weight loss (MPWL) prior to bariatric surgery continues to be a controversial topic. The purpose of this observational study was to assess the efficacy of a MPWL program in a single institution, which mandated at least 10% excess body weight loss before surgery, by comparing outcomes of patients undergoing primary bariatric surgery with and without a compulsory preoperative weight loss regimen. We analyzed our database of 757 patients who underwent primary bariatric surgery between March 2008 and January 2015. Patients were placed into two cohorts based on their participation in a MPWL program requiring at least 10% excess weight loss (EWL) prior to surgery. Patients were evaluated at 3, 6, 12, and 24 months after surgery for weight loss, comorbidity resolution, and the occurrences of hospital readmissions. A total of 717 patients met the inclusion criteria of whom 465 underwent surgery without a preoperative weight loss requirement and 252 participated in the MPWL program. One year after surgery, 67.1% of non-participants and 62.5% of MPWL participants showed a resolution of at least one of five associated comorbidities (p = 0.45). Non-participants showed an average of 58.6% EWL, while MPWL participants showed 59.1% EWL at 1 year postoperatively (p = 0.84). Readmission rates, excluding those which were ulcer-related, at 30 days (3.4 vs. 6.40%, p = 0.11) and 90 days (9.9 vs. 7.5%, p = 0.29) postoperatively were not significantly different between the non-participants and MPWL patients, respectively. A mandatory preoperative weight loss program prior to bariatric surgery did not result in significantly greater %EWL or comorbidity resolution 1 year after surgery compared to patients not required to lose weight preoperatively. Additionally, the program did not result in significantly lower 30- or 90-day readmission rates for these patients. The value of a MPWL program must be weighed against

  19. Health-related quality of life changes and weight reduction after bariatric surgery vs. a weight-loss program.

    Science.gov (United States)

    Canetti, Laura; Elizur, Yoel; Karni, Yair; Berry, Elliot M

    2013-01-01

    The present study compared the outcome of bariatric surgery against a uniform high-level weightloss program which included vigorous physical exercises, behavior modification and nutritional advice. 44 subjects who underwent bariatric surgery and 47 subjects participating in a weight-loss program completed the Medical Outcomes Study Short Form- 36 (SF-36), the Mental Health Inventory (MHI) and the Rosenberg Self-Esteem scale, prior to surgery/diet and one year afterwards. Post-surgery subjects had a greater mean weight loss (34.70% ± 11.94) than subjects in the weight-loss program, even though their weight reduction was also clinically significant (9.23% ± 8.31). Post-surgery subjects showed significant improvements in SF-36, MHI, and selfesteem. The diet group improved in SF-36 total score, physical functioning, health perceptions, and vitality scales. Differences in background variables and short follow-up. Surgery outcomes were significantly better in terms of both weight reduction and psychological adjustment compared to highly motivated participants in a prestigious, cutting edge weight-loss program.

  20. Gastro Issues May Be Downside to Weight-Loss Surgery

    Science.gov (United States)

    ... hunger pain and acid regurgitation, compared with non-surgical patients. In terms of food intolerance, 176 surgery patients ( ... Still, less than 17 percent of the non-surgical group reported experiencing any ... what are bypass patients to do? "In general, it is advisable for ...

  1. Body contouring after obesity surgery is associated with a weight loss benefit among patients.

    Science.gov (United States)

    Agarwal, Shailesh; Shenaq, Deana; Teven, Chad M; Prachand, Vivek; Roughton, Michelle; Zachary, Lawrence

    2017-09-01

    Patients who undergo obesity surgery often require body contouring procedures to eliminate excess skin. Recent studies suggest that body contouring surgery may provide psychological benefits to patients after obesity surgery. However, it remains unclear how body contouring may affect weight loss maintenance after obesity surgery. This is a retrospective review of patients who underwent obesity surgery with or without body contouring at a single institution from 2000 to 2005. Charts were reviewed for demographic, medical, and surgical information. The primary outcome of interest was the difference in weight loss maintenance among patients who underwent body contouring versus those who did not. A total of 318 patients were included for analysis in this study, of which 70 underwent obesity surgery with body contouring and 248 underwent obesity surgery without body contouring. The mean change in BMI among patients who did not undergo body contouring was 19.7 kg/m(2). The mean change in BMI among patients who underwent body contouring was 22.1 kg/m(2). Among patients who underwent body contouring surgery, 2.9% (2/70) of patients did not maintain at least a 20% decrease in body weight during the entire follow-up period (mean follow-up time 92.2 months). Among patients who did not undergo body contouring surgery, 10% (25/248) of patients did not maintain at least a 20% decrease in body weight during the entire follow-up period (mean follow-up time 39.0 months) (χ(2) = 3.67, p = 0.055). Body contouring surgery may have a positive effect on weight loss maintenance after body contouring determined from the mean weight change and on percentage of patients who maintain at least a 20% decrease in body weight. Copyright © 2017. Published by Elsevier Ltd.

  2. Personality as a predictor of weight loss maintenance after surgery for morbid obesity.

    Science.gov (United States)

    Larsen, Junilla K; Geenen, Rinie; Maas, Cora; de Wit, Pieter; van Antwerpen, Tiny; Brand, Nico; van Ramshorst, Bert

    2004-11-01

    Personality characteristics are assumed to underlie health behaviors and, thus, a variety of health outcomes. Our aim was to examine prospectively whether personality traits predict short- and long-term weight loss after laparoscopic adjustable gastric banding. Of patients undergoing laparoscopic adjustable gastric banding, 168 (143 women, 25 men, 18 to 58 years old, mean 37 years, preoperative BMI 45.9 +/- 5.6 kg/m(2)) completed the Dutch Personality Questionnaire on average 1.5 years before the operation. The relationship between preoperative personality and short- and long-term postoperative weight loss was determined using multilevel regression analysis. The average weight loss of patients progressively increased to 10 BMI points until 18 months after surgery and stabilized thereafter. A lower baseline BMI, being a man, and a higher educational level were associated with a lower weight loss. None of the personality variables was associated with weight outcome at short-term follow-up. Six of seven personality variables did not predict long-term weight outcome. Egoism was associated with less weight loss in the long-term postoperative period. The effect sizes of the significant predictions were small. None of the personality variables predicted short-term weight outcome, and only one variable showed a small and unexpected association with long-term weight outcome that needs confirmation. This suggests that personality assessment as intake psychological screening is of little use for the prediction of a poor or successful weight outcome after bariatric surgery.

  3. The Impact of Impulsivity on Weight Loss Four Years after Bariatric Surgery

    Directory of Open Access Journals (Sweden)

    Kathrin Schag

    2016-11-01

    Full Text Available Bariatric surgery has serious implications on metabolic health. The reasons for a failure of bariatric surgery, i.e., limited weight loss, are multifactorial and include psychological factors. We established a theoretical model of how impulsivity is related to weight loss outcome. We propose that depressive symptoms act as a mediator between impulsivity and pathological eating behavior, and that pathological eating behavior has a direct impact on weight loss outcome. We calculated excessive weight loss (%EWL and assessed self-reported impulsivity (using the Baratt Impulsiveness Scale (BIS-15 total score, depressive symptoms (the Patient Health Questionnaire (PHQ-9 score, and pathological eating behavior (the Eating Disorder Inventory 2 (EDI-2 total score in 65 patients four years after laparoscopic sleeve gastrectomy. Regression and mediation analyses were computed to validate the theoretical model. The BIS-15, PHQ-9, and EDI-2 have medium to high correlations between each other, and EDI-2 correlated with %EWL. The mediation analysis yielded that the PHQ-9 represents a significant mediator between BIS-15 and EDI-2. The regression model between EDI-2 and %EWL was also significant. These results support our theoretical model, i.e., suggest that impulsivity has an indirect impact on weight loss outcome after bariatric surgery, mediated by depression and transferred through pathological eating behavior. Thus, the underlying psychological factors should be addressed in post-operative care to optimize weight loss outcome.

  4. Should This Patient Have Weight Loss Surgery?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center.

    Science.gov (United States)

    Smetana, Gerald W; Jones, Daniel B; Wee, Christina C

    2017-06-06

    Obesity is an important public health priority in the United States. One third of U.S. adults are obese and therefore can expect higher rates of diabetes mellitus, other obesity-related comorbidities, and mortality. In 2013, the American Association of Clinical Endocrinologists, the Obesity Society, and the American Society for Metabolic and Bariatric Surgery issued a guideline that recommended weight loss (bariatric) surgery for all patients with a body mass index (BMI) of 40 kg/m2 or higher and for those with a BMI of 35 kg/m2 or greater in the presence of at least 1 obesity-related comorbidity. Among the 3 most commonly performed surgeries, the amount of excess weight reduction ranges from 49% for laparoscopic adjustable gastric banding to 76% for Roux-en-Y gastric bypass. In accredited centers, perioperative mortality averages 0.3%. In this Beyond the Guidelines, 2 experts in obesity management, a bariatric surgeon and a general internist, discuss the role of weight loss surgery versus dietary and lifestyle modification, both in general and for a specific patient who is eligible for surgery. Ethnic and age-related variability in the effects of obesity on mortality, as well as potential long-term benefits and risks of weight loss surgery for patient subgroups, are discussed.

  5. The Role of Hormonal Factors in Weight Loss and Recidivism after Bariatric Surgery

    Directory of Open Access Journals (Sweden)

    S. D. Pedersen

    2013-01-01

    Full Text Available Substantial heterogeneity exists in weight loss trajectories amongst patients following bariatric surgery. Hormonal factors are postulated to be amongst the contributors to the variation seen. Several hormones involved in hunger, satiety, and energy balance are affected by bariatric surgery, with the alteration in hormonal milieu varying by procedure. Limited research has been conducted to examine potential hormonal mediators of weight loss failure or recidivism following bariatric surgery. While hormonal factors that influence weight loss success following gastric banding have not been identified, data suggest that hormonal factors may be involved in modulating weight loss success following gastric bypass. There may be hormonal mediators involved in determining the weight trajectory following sleeve gastrectomy, though the extremely limited data currently available prohibits definitive conclusions from being drawn. There is great need for future research studies to explore this knowledge gap, as improving this knowledge base could be of benefit to guide clinicians toward understanding the hormonal contributors to a patient’s postoperative weight loss failure or recidivism or perhaps be of value in selecting the most appropriate bariatric procedure based on the preoperative hormone milieu. Integrative interdisciplinary approaches exploring these complex interrelationships could potentially increase the explanatory power of such investigations.

  6. Systematic review and retrospective validation of prediction models for weight loss after bariatric surgery.

    Science.gov (United States)

    Sharples, Alistair J; Mahawar, Kamal; Cheruvu, Chandra V N

    2017-08-12

    Patients often have less than realistic expectations of the weight loss they are likely to achieve after bariatric surgery. It would be useful to have a well-validated prediction tool that could give patients a realistic estimate of their expected weight loss. To perform a systematic review of the literature to identify existing prediction models and attempt to validate these models. University hospital, United Kingdom. A systematic review was performed. All English language studies were included if they used data to create a prediction model for postoperative weight loss after bariatric surgery. These models were then tested on patients undergoing bariatric surgery between January 1, 2013 and December 31, 2014 within our unit. An initial literature search produced 446 results, of which only 4 were included in the final review. Our study population included 317 patients. Mean preoperative body mass index was 46.1 ± 7.1. For 257 (81.1%) patients, 12-month follow-up was available, and mean body mass index and percentage excess weight loss at 12 months was 33.0 ± 6.7 and 66.1% ± 23.7%, respectively. All 4 of the prediction models significantly overestimated the amount of weight loss achieved by patients. The best performing prediction model in our series produced a correlation coefficient (R(2)) of .61 and an area under the curve of .71 on receiver operating curve analysis. All prediction models overestimated weight loss after bariatric surgery in our cohort. There is a need to develop better procedures and patient-specific models for better patient counselling. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  7. Bariatric Surgery in Obese Patients with Type 1 Diabetes: Effects on Weight Loss and Metabolic Control.

    Science.gov (United States)

    Faucher, Pauline; Poitou, Christine; Carette, Claire; Tezenas du Montcel, Sophie; Barsamian, Charles; Touati, Eliabelle; Bouillot, Jean-Luc; Torcivia, Adriana; Czernichow, Sébastien; Oppert, Jean-Michel; Ciangura, Cécile

    2016-10-01

    Type 1 diabetes patients, although typically lean, experience an increased prevalence of obesity, and bariatric surgery is considered in severe cases. Bariatric surgery in such patients leads to significant weight loss and decreased insulin requirements; however, effects on glycemic control remain discussed. We assessed, in obese patients with type 1 diabetes, the effects of bariatric surgery upon body weight, body composition, and glycemic control, including the occurrence of hypoglycemic events. Thirteen obese patients with type 1 diabetes who underwent bariatric surgery (Roux-en-Y gastric bypass n = 6, sleeve gastrectomy n = 7) were matched with obese patients without diabetes and with type 2 diabetes patients during 12 months of follow-up. Outcomes included body weight, DXA-assessed body composition, HbA1c, and incidence of hypoglycemia. At 12 months, median surgery-induced weight loss was 27.9 % (21.1-33.3), 26.1 % (24.8-29.7), and 27.5 % (21.8-32.1) in patients with type 1 diabetes, type 2 diabetes, and without diabetes, respectively, with no significant differences across the groups. Similar findings were observed for body fat changes. At 12 months, median HbA1c decreased from 8.3 to 7.6 % in type 1 diabetes patients versus 8.0 to 5.9 % in type 2 diabetes patients (P = 0.04 between the groups). In type 1 diabetes patients, the number of reported minor hypoglycemia increased transiently only at 6 months. Two patients reported severe hypoglycemia (one episode each). Type 1 diabetes patients benefit from bariatric surgery in terms of weight loss and glycemic control. Close monitoring of insulin therapy appears warranted to prevent minor hypoglycemia in the first months post-surgery.

  8. Collateral Weight Loss in Children Living with Adult Bariatric Surgery Patients: A Case Control Study

    Science.gov (United States)

    Hirsch, Annemarie G.; Wood, G. Craig; Bailey-Davis, Lisa; Lent, Michelle R.; Gerhard, Glenn S.; Still, Christopher D.

    2014-01-01

    Objective To evaluate the impact of adult bariatric surgery on the Body Mass Index (BMI) of children living in the same household. Design and Methods A retrospective case-control study. Case dyads (n=128) were composed of one adult who had bariatric surgery and one child at the same address. Control dyads (n=384) were composed of an adult with obesity but no bariatric surgery and a child at the same address. We used a two-sample t-test to determine whether the differences between actual and expected BMI at follow-up (post-surgery) differed between children in the case and control dyads. Results Among boys who were overweight, boys who lived with a surgery patient had a lower than expected BMI post-surgery, while boys who did not live with a surgery patient had a higher than expected BMI at follow-up (p=0.045). Differences between actual and expected BMIs of children were not significantly different between cases and controls in girls or in children in other weight classes. Conclusions Overweight boys who lived with an adult bariatric surgery patient had a lower than expected BMI after surgery as compared to controls. Future studies may be warranted to determine the mechanisms by which these children experience collateral weight loss. PMID:24989939

  9. Post-bariatric surgery satisfaction and body-contouring consideration after massive weight loss

    Directory of Open Access Journals (Sweden)

    Saleh M Aldaqal

    2013-01-01

    Full Text Available Background: Following a bariatric surgery and massive weight-loss, the outcome is usually sullied by consequences on the body′s contour and redundant skin. Aims: We aimed to record the frequency of contour irregularities and quantify patients′ satisfaction with appearance and anticipations from body contouring surgery. Materials and Methods: The ethical committee at King Abdulaziz University Hospital approved the study, and patients were consented. A cross-sectional study targeting the post-bariatric patients from May 2011 to April 2012 was conducted at our hospital. We used post-massive weight loss Satisfaction Questionnaire. Results: The total numbers of patients were 64 (51 women and 13 men, of which 57 patients (89.2% developed sagging skin. Most patients were dissatisfied with their appearance after weight loss. The most common zones were the upper arms (50% and abdomen (45%. Considerably more women (36.2% than men (24% were dissatisfied with certain body areas. The most noticeable expectation of patients from body contouring surgery was improved cosmetic appearance (65.6% and self-confidence (64.1%. More women (70.58% than men (46.15% expected a better cosmetic appearance after body contouring (P = 0.003. Conclusion: After bariatric surgery, sagging excess skin is an unsatisfactory problem. Therefore, body contouring surgery must be included in morbid obesity management.

  10. Central 5-HT Neurotransmission Modulates Weight Loss following Gastric Bypass Surgery in Obese Individuals

    DEFF Research Database (Denmark)

    Haahr, M. E.; Hansen, D. L.; Fisher, P. M.

    2015-01-01

    , it was confirmed that obese individuals have higher cerebral 5-HT2A receptor binding than lean individuals. Importantly, we found that higher presurgical 5-HT2A receptor binding predicted greater weight loss after RYGB and that the change in 5-HT2A receptor and 5-HT transporter binding correlated with weight loss......The cerebral serotonin (5-HT) system shows distinct differences in obesity compared with the lean state. Here, it was investigated whether serotonergic neurotransmission in obesity is a stable trait or changes in association with weight loss induced by Roux-in-Y gastric bypass (RYGB) surgery...... after RYGB. The changes in the 5-HT neurotransmission before and after RYGB are in accordance with a model wherein the cerebral extracellular 5-HT level modulates the regulation of body weight. Our findings support that the cerebral 5-HT system contributes both to establish the obese condition...

  11. Psychosocial predictors of weight loss and psychological adjustment following bariatric surgery and a weight-loss program: the mediating role of emotional eating.

    Science.gov (United States)

    Canetti, Laura; Berry, Elliot M; Elizur, Yoel

    2009-03-01

    To examine a structural equation model of the effects of personal and interpersonal factors on treatment outcome of bariatric surgery and weight-loss program. Forty-four participants of the surgery group and 47 participants of the diet group completed questionnaires before treatment and 1 year afterward. Predictor measures are as follows: social support, motivation for control, sense of control, self-esteem, neuroticism, fear of intimacy, and emotional eating (EE). Weight loss, quality of life, and mental health. Neurotic predisposition (NP), a latent variable indicated by neuroticism, low self-esteem, and fear of intimacy, had an effect on weight loss that was fully mediated by EE. NP also had an effect on quality of life improvement that was fully mediated by EE and weight loss in both treatment groups. Both NP and EE predict outcome of obesity treatments, but EE is the more proximal variable that mediates the effect of NP.

  12. Changes in taste perception and eating behavior after bariatric surgery-induced weight loss in women

    Science.gov (United States)

    Pepino, Marta Yanina; Bradley, David; Eagon, J. Christopher; Sullivan, Shelby; Abumrad, Nada A.; Klein, Samuel

    2013-01-01

    Objective Roux-en-Y gastric bypass (RYGB) surgery causes greater weight loss than laparoscopic adjustable gastric banding (LAGB). We tested the hypothesis that RYGB has weight loss-independent effects on taste perception which influence eating behavior and contribute to the greater weight loss. Design and Methods Subjects were studied before and after ~20% weight loss induced by RYGB (n=17) or LAGB (n=10). We evaluated: taste sensitivity for sweet, salty and savory stimuli; sucrose and monosodium glutamate (MSG) preferences; sweetness palatability; eating behavior; and expression of taste-related genes in biopsies of fungiform papillae. Results Weight loss induced by both procedures caused the same decrease in: preferred sucrose concentration (−12±10%), perceived sweetness of sucrose (−7±5%), cravings for sweets and fast-foods (−22 ±5%), influence of emotions (−27±5%) and external food cues (−30±4%) on eating behavior, and expression of α-gustducin in fungiform papillae (all P-values <0.05). RYGB, but not LAGB, shifted sweetness palatability from pleasant to unpleasant when repetitively tasting sucrose (P=0.05). Neither procedure affected taste detection thresholds or MSG preferences. Conclusions LAGB and RYGB cause similar alterations in eating behaviors, when weight loss is matched. These changes in eating behavior were not associated with changes in taste sensitivity, suggesting other, as yet unknown, mechanisms are involved. PMID:24167016

  13. Changes in taste perception and eating behavior after bariatric surgery-induced weight loss in women.

    Science.gov (United States)

    Pepino, Marta Yanina; Bradley, David; Eagon, J Christopher; Sullivan, Shelby; Abumrad, Nada A; Klein, Samuel

    2014-05-01

    Roux-en-Y gastric bypass (RYGB) surgery causes greater weight loss than laparoscopic adjustable gastric banding (LAGB). We tested the hypothesis that RYGB has weight loss-independent effects on taste perception, which influence eating behavior and contribute to the greater weight loss. Subjects were studied before and after ∼20% weight loss induced by RYGB (n = 17) or LAGB (n = 10). The following have been evaluated: taste sensitivity for sweet, salty and savory stimuli, sucrose and monosodium glutamate (MSG) preferences, sweetness palatability, eating behavior, and expression of taste-related genes in biopsies of fungiform papillae. Weight loss induced by both procedures caused the same decrease in: preferred sucrose concentration (-12 ± 10%), perceived sweetness of sucrose (-7 ± 5%), cravings for sweets and fast-foods (-22 ± 5%), influence of emotions (-27 ± 5%), and external food cues (-30 ± 4%) on eating behavior, and expression of α-gustducin in fungiform papillae (all P values <0.05). RYGB, but not LAGB, shifted sweetness palatability from pleasant to unpleasant when repetitively tasting sucrose (P = 0.05). Neither procedure affected taste detection thresholds nor MSG preferences. LAGB and RYGB cause similar alterations in eating behaviors, when weight loss is matched. These changes in eating behavior were not associated with changes in taste sensitivity, suggesting other, as yet unknown, mechanisms are involved. Copyright © 2013 The Obesity Society.

  14. Family factors that characterize adolescents with severe obesity and their role in weight loss surgery outcomes.

    Science.gov (United States)

    Zeller, Meg H; Hunsaker, Sanita; Mikhail, Carmen; Reiter-Purtill, Jennifer; McCullough, Mary Beth; Garland, Beth; Austin, Heather; Washington, Gia; Baughcum, Amy; Rofey, Dana; Smith, Kevin

    2016-12-01

    To comprehensively assess family characteristics of adolescents with severe obesity and whether family factors impact weight loss outcomes following weight loss surgery (WLS). Multisite prospective data from 138 adolescents undergoing WLS and primary caregivers (adolescent: Mage  = 16.9; MBMI = 51.5 kg/m(2) ; caregiver: Mage  = 44.5; 93% female) and 83 nonsurgical comparators (NSComp: adolescent: Mage  = 16.1; MBMI = 46.9 kg/m(2) ; caregiver: Mage  = 43.9; 94% female) were collected using standardized measures at presurgery/baseline and at 1 and 2 years. The majority (77.3%) of caregivers had obesity, with rates of caregiver WLS significantly higher in the WLS (23.8%) versus NSComp group (3.7%, P Family dysfunction was prevalent (≈1 in every two to three families), with rates higher for NSComp than the WLS group. For the WLS group, preoperative family factors (i.e., caregiver BMI or WLS history, dysfunction, social support) were not significant predictors of adolescent weight loss at 1 and 2 years postoperatively, although change in family functioning over time emerged as a significant correlate of percent weight loss. Rates of severe obesity in caregivers as well as family dysfunction were clinically noteworthy, although not related to adolescent weight loss success following WLS. However, change in family communication and emotional climate over time emerged as potential targets to optimize weight loss outcomes. © 2016 The Obesity Society.

  15. Mechanisms underlying weight loss and metabolic improvements in rodent models of bariatric surgery.

    Science.gov (United States)

    Arble, Deanna M; Sandoval, Darleen A; Seeley, Randy J

    2015-02-01

    Obesity is a growing health risk with few successful treatment options and fewer still that target both obesity and obesity-associated comorbidities. Despite ongoing scientific efforts, the most effective treatment option to date was not developed from basic research but by surgeons observing outcomes in the clinic. Bariatric surgery is the most successful treatment for significant weight loss, resolution of type 2 diabetes and the prevention of future weight gain. Recent work with animal models has shed considerable light on the molecular underpinnings of the potent effects of these 'metabolic' surgical procedures. Here we review data from animal models and how these studies have evolved our understanding of the critical signalling systems that mediate the effects of bariatric surgery. These insights could lead to alternative therapies able to accomplish effects similar to bariatric surgery in a less invasive manner.

  16. Effect of ethnicity on weight loss among adolescents 1 year after bariatric surgery

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

    AIM:To investigate whether or not bariatric surgeryweight outcomes vary by ethnicity in a large,nationally representative sample of adolescents.METHODS:The Bariatric Outcomes Longitudinal Database was used for analysis and contains data on surgeries performed on adolescents from 2004 to 2010from 423 surgeons at 360 facilities across the United States Adolescents(n=827)between 11 and 19 years old who underwent either gastric bypass or adjustable gastric banding surgery were included in the analysis.Outcome measures included changes in anthropometric measurements[weight(kg)and body mass index]from baseline to 3(n=739),6(n=512),and 12(n=247)mo after surgery.RESULTS:A year after patients underwent either gastric bypass(51%)or adjustable gastric banding(49%)surgery,mean estimated weight loss for all ethnic groups differed by a maximum of only 1.5 kg,being34.3 kg(95%CI:30.0-38.5 kg)for Hispanics,33.8 kg(95%CI:27.3-40.3 kg)for non-Hispanic blacks,and32.8 kg(95%CI:30.9-34.7 kg)for non-Hispanic whites.No overall pairwise group comparisons were significant,indicating that no ethnic group had better weight loss outcomes than did another.CONCLUSION:Bariatric surgery substantially reduces the weight of severely obese adolescents at 1 year post-procedure with little variation by ethnicity and/or gender.These results suggest that bariatric surgery is a safe and reasonable treatment for all severely obese adolescents with the appropriate indications.

  17. Assessing the need for a protocol in monitoring weight loss and nutritional status in orthognathic surgery based on patients experiences.

    Science.gov (United States)

    Ruslin, Muhammad; Dekker, Hannah; Tuinzing, Dirk B; Forouzanfar, Tymour

    2017-02-01

    To investigate retrospectively the orthognathic surgery (OGS) patients experience in weight loss and the influence of gender, age, duration of the surgical procedure, length of hospital stay, location of surgery and use of intermaxillary fixation (IMF) or without IMF on postoperative weight loss. A total of 4487 patients treated by OGS where all patients visited the outpatient clinic one, three and six weeks after the surgical procedure. After six weeks, patients filled out a questionnaire in which weight loss was addressed. The patients were asked to give an estimate of their experiences weight loss. The population was first divided in two groups weight loss and no weight loss. In the weight loss group there is no significant difference in weight loss between patients with IMF and patients without IMF. In the weight loss group there were significantly more females then males. Further, in the subgroup IMF the operation time was significantly longer compared with the subgroup without IMF. The other parameters including age and hospital stay were not different in the groups. IMF in orthognathic treatment does not result in a difference self-reported loss of body weight compared to patients without IMF. Treatment protocols should include pre- and post-operative dietician consultations and possible indications for medical nutrition and vitamins. Key words:Assessing, protocol, weight loss, experiences, orthognathic surgery.

  18. Assessing the need for a protocol in monitoring weight loss and nutritional status in orthognathic surgery based on patients experiences

    Science.gov (United States)

    Dekker, Hannah; Tuinzing, Dirk B.; Forouzanfar, Tymour

    2017-01-01

    Background To investigate retrospectively the orthognathic surgery (OGS) patients experience in weight loss and the influence of gender, age, duration of the surgical procedure, length of hospital stay, location of surgery and use of intermaxillary fixation (IMF) or without IMF on postoperative weight loss. Material and Methods A total of 4487 patients treated by OGS where all patients visited the outpatient clinic one, three and six weeks after the surgical procedure. After six weeks, patients filled out a questionnaire in which weight loss was addressed. The patients were asked to give an estimate of their experiences weight loss. The population was first divided in two groups weight loss and no weight loss. Results In the weight loss group there is no significant difference in weight loss between patients with IMF and patients without IMF. In the weight loss group there were significantly more females then males. Further, in the subgroup IMF the operation time was significantly longer compared with the subgroup without IMF. The other parameters including age and hospital stay were not different in the groups. Conclusions IMF in orthognathic treatment does not result in a difference self-reported loss of body weight compared to patients without IMF. Treatment protocols should include pre- and post-operative dietician consultations and possible indications for medical nutrition and vitamins. Key words:Assessing, protocol, weight loss, experiences, orthognathic surgery. PMID:28210448

  19. Continued Loss in Visceral and Intermuscular Adipose Tissue in Weight-Stable Women Following Bariatric Surgery

    Science.gov (United States)

    Toro-Ramos, Tatiana; Goodpaster, Bret H.; Janumala, Isaiah; Lin, Susan; Strain, Gladys W.; Thornton, John C.; Kang, Patrick; Courcoulas, Anita P.; Pomp, Alfons; Gallagher, Dympna

    2014-01-01

    Objective To assess changes in total adipose tissue (TAT), subcutaneous (SAT), visceral (VAT), and intermuscular (IMAT) by whole-body MRI before surgery, at 12 months and 24 months post-surgery in a subset of participants of the Longitudinal Assessment of Bariatric Surgery-2. Design and Methods From 0 to 12 months, n=20F and 3M; from 12 to 24 months, n=42F and 7M. Paired t-tests and GLM repeated measures examined changes in TAT, SAT, VAT, and IMAT at 12 and 24 months, with sex and age as covariates. Results Changes from 0 to 12 months, included weight (−41.9±12.1kg; −36%), TAT (−33.5±9.6kg; −56%), SAT (−29.2±8.2kg; −55%), VAT (−3.3±1.6kg; −73%), and IMAT (−0.99±0.68kg; −50%), all pBariatric surgery continues to induce favorable changes in body composition, i.e., persistent adipose tissue loss at 24 months in the absence of further significant weight loss. PMID:25384375

  20. Deterioration of mental health in bariatric surgery after 10 years despite successful weight loss.

    Science.gov (United States)

    Canetti, L; Bachar, E; Bonne, O

    2016-01-01

    The present study evaluated the mental health and psychological functioning of bariatric patients before surgery, and after 1 year and 10 year follow-ups, and compared them with participants in a dietary program. Such long follow-up is rare, but strongly recommended by the American Association of Bariatric Surgeons. Thirty-six bariatric surgery patients and 34 participants of a weight loss program were weighed and assessed at all 3 points in time. Participants were administered the mental health inventory, neuroticism, sense of control and fear of intimacy scales. Along with these mental and psychological measurements, the medical outcome short form (SF-36) was used. The surgery group achieved successful weight loss outcomes (27% reduction of pre-operative weight) after 10 years and better than baseline health-related quality-of-life scores. However, their general mental health, neuroticism, sense of control and fear of intimacy scores showed significant deterioration in comparison to pre-operative levels after 10 years. The dietary group participants remained psychologically stable among all three points in time. This study highlights the importance of identifying a risk group among bariatric patients for which the dietary and psychological follow-up may be of special significance.

  1. Preoperative weight loss in patients with indication of bariatric surgery: which is the best method?

    Directory of Open Access Journals (Sweden)

    M. Adrianzén Vargas

    Full Text Available Background: Surgery is the only effective treatment for people with a body mass index (BMI greater than 40 Kg/m² or even greater than 35 Kg/m² when some diseases like diabetes or hypertension appear. In order to minimize surgical risk and improve postoperative results, preoperative preparation it's very important. "Acute" preoperative weight loss just before surgery plays a crucial role in that preparation and can be achieved through different ways like a low calorie diet, a very low calorie diet or with the use of an intragastric balloon. The advantages or particularities of every one of them will be summarized in this article. Material and methods: Literature review of the benefits, risks and complications of preoperative weight loss through a low calorie diet, a very low calorie diet or intragastric balloon placement. Results: Seven of thirteen initially selected reports from Medline search were considered relevant, including a total 371 patients (240 patients treated with low calorie diet, 90 with very low calorie diet and 41 cases of intragastric balloon placement. We found that weight loss was greater in patients with very low calorie diets and intragastric balloon groups but with a slightly increase in morbidity and cost. Conclusion: Although there are no comparative studies, data from the literature results show that diets very low in calories are more effective and require less time than low-calorie diets and cheaper with fewer side effects than the intragastric balloon.

  2. Usefulness of Baltasar's expected body mass index as an indicator of bariatric weight loss surgery.

    Science.gov (United States)

    Molina López, Alicia; Sabench Pereferrer, Fàtima; Vives Espelta, Margarida; Bonada Sanjaume, Anna; Blanco Blasco, Santiago; Raga Carceller, Esther; Hernández González, Mercè; Sánchez Marín, Antonio; Salas Salvadó, Jordi; Del Castillo Déjardin, Daniel

    2016-11-01

    Determining the best indicator to report weight loss takes on special relevance following bariatric surgery. Our objective is to apply a method proposed by Baltasar et al. to express weight loss results following bariatric surgery. Anthropometric data were collected from 265 patients who had undergone Sleeve gastrectomy (SG, n = 172) and Roux-en-Y gastric bypass (RYGBP, n = 93) with a 2-year follow-up period. Initial BMI was calculated as well as BMI 2 years after, percentage of excess BMI loss (PEBMIL), expected BMI (EBMI), and corrected PEBMIL. In SG group, average BMI 2 years after surgery fell within a 95 % CI of expected BMI, with an average BMI of 31.58 ± 4.05 kg/m(2) in 35-45 BMI group, an average BMI of 33.62 ± 4.96 kg/m(2) in 45-55 BMI group, and an average BMI of 37.40 ± 5.93 kg/m(2) in 55-65 BMI group. In RYGBP group, average BMI 2 years after the surgery was below than average expected BMI (28.76 ± 3.20 kg/m(2) in 35-45 BMI group and 29.71 ± 3.30 kg/m(2) in 45-55 BMI group). Results are considered excellent for the group with an initial BMI of above 45 kg/m(2). EBMI is a good weight loss indicator, mainly when 95 % CI is taken into account. EBMI is consistent with the results obtained 2 years after surgery in our patients who underwent SG and RYGBP. Corrected PEBMIL is a good indicator for expressing the percentage of BMI loss and offers more realistic values than conventional formula with a cut-off point of 25 points.

  3. Bariatric surgery-mediated weight loss and its metabolic consequences for type-2 diabetes.

    Science.gov (United States)

    Raghow, Rajendra

    2013-06-15

    The worldwide epidemic of obesity and its medical complications are being dealt with a combination of life style changes (e.g., healthier diet and exercise), medications and a variety of surgical interventions. The Roux-en Y gastric bypass (RYGB) and laparoscopic adjustable gastric banding (LAGB) are two of the most common weight loss surgeries for morbid obesity-associated metabolic syndrome and insulin resistance. A vast majority of patients that undergo RYGB and LAGB are known to experience marked weight loss and attenuation of diabetes. A number of recent studies have indicated that the rates of remission in glycemic control and insulin sensitivity are significantly greater in patients that have undergone RYGB. A plausible hypothesis to explain this observation is that the gastric bypass surgery as opposed to the gastric banding procedure impinges on glucose homeostasis by a weight loss-independent mechanism. In a recent paper, Bradley et al have experimentally explored this hypothesis. The authors compared several clinical and laboratory parameters of insulin sensitivity and β-cell function in cohorts of RYGB and LAGB patients before and after they lost approximately 20% of their body mass. After weight loss, both groups of patients underwent similar changes in their intra-abdominal and total adipose tissue volume, hepatic triglyceride and circulating leptin levels. The RYGB patients who lost 20% body mass, manifested higher postprandial output of glucose, insulin and glucagon-like peptide-1; these laboratory parameters remained unchanged in LABG patients. Irrespective of the observed differences in transient responses of RYGB and LAGB patients to mixed meal, the overall glycemic control as judged by glucose tolerance, multi-organ insulin sensitivity and β-cell function were nearly identical in the two groups. Both RYGB and LAGB patient cohorts also experienced similar changes in the expression of a number of pro- and anti-inflammatory markers. Based on

  4. Through Thick and Thin: Identifying Barriers to Bariatric Surgery, Weight Loss Maintenance, and Tailoring Obesity Treatment for the Future

    Directory of Open Access Journals (Sweden)

    Donevan Westerveld

    2016-01-01

    Full Text Available More than one-third of the adults in the United States are obese. This complex metabolic disorder is associated with multiple comorbidities and increased all-cause mortality. Bariatric surgery has been shown to be more effective than medical therapy and has been associated with weight loss maintenance and decreased mortality. In spite of these well-established benefits, less than 1% of candidates undergo surgery due to multiple factors, such as patient and physician perceptions and attitudes, patient-physician interaction, lack of resources, and cost burden. Furthermore, even in patients who do undergo bariatric surgery and/or alternate weight loss interventions, long-term weight control is associated with high-risk failure and weight regain. In this review, we highlight some of the current barriers to bariatric surgery and long-term weight loss maintenance and underscore the importance of an individualized multidisciplinary longitudinal strategy for the treatment of obesity.

  5. Psychological and Personality Predictors of Weight Loss and Comorbid Metabolic Changes After Bariatric Surgery.

    Science.gov (United States)

    Agüera, Zaida; García-Ruiz-de-Gordejuela, Amador; Vilarrasa, Nuria; Sanchez, Isabel; Baño, Marta; Camacho, Lucía; Granero, Roser; Jiménez-Murcia, Susana; Virgili, Nuria; Lopez-Urdiales, Rafael; de Bernabe, Mónica Montserrat-Gil; Garrido, Pilar; Monasterio, Carmen; Steward, Trevor; Pujol-Gebelli, Jordi; Fernández-Aranda, Fernando; Menchón, Jose M

    2015-11-01

    Bariatric surgery (BS) has proven to be the most effective treatment for weight loss and for improving comorbidities in severe obesity. A comprehensive psychological assessment prior to surgery is proposed to prepare patients for a successful post-surgical outcome. Therefore, the main aim of the present study was to assess psychological and personality predictors of BS outcome. The sample comprised 139 severely obese patients who underwent BS. Assessment measures included the Eating Disorders Inventory-2, the Symptom Checklist-Revised and the Temperament and Character Inventory-Revised. Our results show that favourable BS outcome, after 2 years follow up, was associated with younger age, less depression, moderate anxiety symptoms and high cooperativeness levels. Likewise, metabolic improvements were found to be linked to younger age and certain psychopathological factors. In conclusion, our findings suggest that age, baseline body mass index, psychopathological indexes and personality traits predict successful BS outcome. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

  6. Mechanisms of weight loss, diabetes control and changes in food choices after gastrointestinal surgery.

    Science.gov (United States)

    Papamargaritis, Dimitrios; Panteliou, Eleftheria; Miras, Alexander D; le Roux, Carel W

    2012-12-01

    The long-term effects of lifestyle changes, diet and medical therapy on obesity are limited. Bariatric surgery is the most effective long-term treatment with the greatest chances for amelioration of obesity-associated complications, including type 2 diabetes mellitus (T2DM). There is increasing evidence in the literature that bariatric operations have a profound effect on human physiology, by reducing hunger, increasing satiety, paradoxically increasing energy expenditure, and even promoting healthy food preferences. Some of these operations improve glucose homeostasis in patients with T2DM independently of weight loss. Changes in the gut hormone levels of glucagon-like peptide 1, peptide YY and ghrelin have been proposed as some of the mediators implicated in changing physiology. The aim of this review is to critically explore the current knowledge on the putative mechanisms of the change in weight and improvement in T2DM glycaemic control after the most commonly performed bariatric operations.

  7. [Comparison of body weight loss in gastrectomy patients who underwent only surgery and those who underwent surgery followed up with S-1 adjuvant chemotherapy].

    Science.gov (United States)

    Aoyama, Toru; Yoshikawa, Takaki; Shirai, Junya; Hayashi, Tsutomu; Ogata, Takashi; Cho, Haruhiko; Yukawa, Norio; Oshima, Takashi; Rino, Yasushi; Ozawa, Yukihiro; Kitani, Yuichi; Wada, Hiroo; Masuda, Munetaka; Tsuburaya, Akira

    2012-11-01

    Body weight loss is a common outcome in patients with gastric cancer who have undergone gastrectomy. However, the rate of body weight loss after surgery is unknown. In this retrospective study, we selected patients who underwent radical gastrectomy for gastric cancer and were diagnosed with Stage II or III disease. Further, we compared the body weight loss after surgery between patients in the surgery alone group and the S-1 adjuvant chemotherapy group. We evaluated 163 patients, of which 81 underwent only surgery, and 82 underwent surgery followed up with S-1 adjuvant chemotherapy. The body weight loss rate at 1, 3, and 6 months in the surgery alone group were 93.1%, 92.9%, and 94.9%, while those in the S-1 adjuvant group were 92.9%, 90.4%,and 91.9%, which was a significant difference. Body weight loss after gastrectomy was higher in the S-1 adjuvant group than in the surgery alone group. Further, nutritional support is required for these patients to maintain body weight after surgery.

  8. Negotiating options in weight-loss surgery : "Actually I didn't have any other option".

    Science.gov (United States)

    Groven, Karen Synne; Engelsrud, Gunn

    2016-09-01

    In this study we explore how a selection of Norwegian women account for their decision to undergo weight loss surgery (WLS). We argue that women's descriptions of their experiences leading up to this choice of action illuminate issues regarding social norms of bodily appearance and personal responsibility. The starting point is women's own experiences within a cultural context in which opting for WLS often attracts moral scrutiny. Inspired by Merleau-Ponty's notion of consciousness as embodied and de Beauvoir's ideas concerning women's situation, we argue that bodily as well as socio-cultural aspects intertwine with women's choice of surgery as a means of losing weight. Although society's stigmatization of women with obesity has been well challenged by scholars in the field of critical fat studies, women with obesity still experience the bodily hindrances associated with being overweight in an intense and subjective way. The findings suggest that women confronting the option of WLS do so in a context of pain, dysfunction and social stigma, a combination which illuminates the intricate ambiguity of the obese body as both subject (of agency) and object (of moral and medical scrutiny).

  9. Pediatric health care provider perceptions of weight loss surgery in adolescents.

    Science.gov (United States)

    Vanguri, Poornima; Lanning, David; Wickham, Edmond P; Anbazhagan, Aruna; Bean, Melanie K

    2014-01-01

    This study explored pediatric health care providers' obesity treatment practices and perceptions about adolescent weight loss surgery (WLS). Surveys were e-mailed to pediatric listservs. After descriptive analyses, correlations, chi-squares, and one-way analyses of variance compared responses by provider characteristics. Surveys were completed by 109 providers. Almost half do not routinely measure body mass index. Providers typically counsel patients about lifestyle change, with limited perceived benefit; pediatrics" (17%) as reasons. However, when presented with patient scenarios of different ages and comorbidities, likeliness to refer for WLS increased substantially. Surgeons, younger providers and those with fewer years of experience were more likely to refer for WLS (P pediatric provider resistance to refer obese adolescents remains. Improved referral and management practices are needed.

  10. Qualitative content analysis of online news media coverage of weight loss surgery and related reader comments.

    Science.gov (United States)

    Glenn, N M; Champion, C C; Spence, J C

    2012-10-01

    The media has the ability to affect public opinion and policy direction. Prevalence of morbid obesity in Canada is increasing; as is the only effective long-term treatment, weight loss surgery (WLS). Limited research has explored media re/presentations of WLS. The purpose of this study was to examine national online news coverage (and reader comments) of WLS using content analysis. We sought to understand the dominant messages being conveyed within the news texts and reader comments, specifically whose voice was represented, who was the intended audience and what was the overall tone. Articles and comments were retrieved from the Canadian Broadcasting Corporation news web site and analysed using line-by-line techniques. Articles were predominantly 'positive/supportive' (63%) in tone and frequently presented the voices and opinions of 'experts' conveying a biomedical perspective. Comments were overwhelmingly 'negative' (56%) and often derogatory including such language as 'piggy' and 'fatty'. Comments were almost exclusively anonymous (99%) and were frequently directed at other commenters (33%) and 'fat' people (6%). The potentially problematic nature of media framing and reader comments, particularly as they could relate to weight-based stigmatization and discrimination is discussed.

  11. Subcutaneous fat loss is greater than visceral fat loss with diet and exercise, weight-loss promoting drugs and bariatric surgery: a critical review and meta-analysis.

    Science.gov (United States)

    Merlotti, C; Ceriani, V; Morabito, A; Pontiroli, A E

    2017-05-01

    Aim of this review is to compare visceral and subcutaneous fat loss with all available strategies (diet and exercise, weight-loss promoting agents and bariatric surgery). Eighty-nine studies, all full papers, were analyzed to evaluate visceral and subcutaneous fat changes, measured through ultrasound, computerized tomography, magnetic resonance imaging and expressed as thickness, weight, area and volume. Studies were included in a meta-analysis (random-effects model). Intervention effect (absolute and percent changes of visceral and subcutaneous fat) was expressed as standardized mean differences, with 95% confidence intervals. Publication bias was formally assessed. The result was that subcutaneous fat was greater than visceral fat when measured as area, volume and weight, not as thickness; decrease of subcutaneous fat was greater than visceral fat when measured as area, volume and weight, not as thickness; percent decrease of visceral fat was always greater than percent decrease of subcutaneous fat, with no differences between different strategies. No intervention preferentially targets visceral fat. Basal visceral fat depots are smaller than basal subcutaneous fat depots. Visceral fat loss is linked to subcutaneous fat loss. With all strategies, percent decrease of visceral fat prevails on subcutaneous fat loss.

  12. High allelic burden of four obesity SNPs is associated with poorer weight loss outcomes following gastric bypass surgery.

    Science.gov (United States)

    Still, Christopher D; Wood, G Craig; Chu, Xin; Erdman, Robert; Manney, Christina H; Benotti, Peter N; Petrick, Anthony T; Strodel, William E; Mirshahi, Uyenlinh L; Mirshahi, Tooraj; Carey, David J; Gerhard, Glenn S

    2011-08-01

    Genome-wide association and linkage studies have identified multiple susceptibility loci for obesity. We hypothesized that such loci may affect weight loss outcomes following dietary or surgical weight loss interventions. A total of 1,001 white individuals with extreme obesity (BMI >35 kg/m(2)) who underwent a preoperative diet/behavioral weight loss intervention and Roux-en-Y gastric bypass surgery were genotyped for single-nucleotide polymorphisms (SNPs) in or near the fat mass and obesity-associated (FTO), insulin induced gene 2 (INSIG2), melanocortin 4 receptor (MC4R), and proprotein convertase subtilisin/kexin type 1 (PCSK1) obesity genes. Association analysis was performed using recessive and additive models with pre- and postoperative weight loss data. An increasing number of obesity SNP alleles or homozygous SNP genotypes was associated with increased BMI (P weight (P weight lost from a short-term dietary intervention and any individual obesity SNP or cumulative number of obesity SNP alleles or homozygous SNP genotypes was observed. Linear mixed regression analysis revealed significant differences in postoperative weight loss trajectories across groups with low, intermediate, and high numbers of obesity SNP alleles or numbers of homozygous SNP genotypes (P weight loss with initial BMI metabolic rate, binge eating behavior, and other clinical parameters were not associated with genotype. These data suggest that response to a surgical weight loss intervention is influenced by genetic susceptibility and BMI.

  13. Reduction of Macrophage Infiltration and Chemoattractant Gene Expression Changes in White Adipose Tissue of Morbidly Obese Subjects After Surgery-Induced Weight Loss

    National Research Council Canada - National Science Library

    Raffaella Cancello; Corneliu Henegar; Nathalie Viguerie; Soraya Taleb; Christine Poitou; Christine Rouault; Muriel Coupaye; Veronique Pelloux; Danielle Hugol; Jean-Luc Bouillot; Anne Bouloumié; Giorgio Barbatelli; Saverio Cinti; Per-Arne Svensson; Gregory S. Barsh; Jean-Daniel Zucker; Arnaud Basdevant; Dominique Langin; Karine Clément

    2005-01-01

    Reduction of Macrophage Infiltration and Chemoattractant Gene Expression Changes in White Adipose Tissue of Morbidly Obese Subjects After Surgery-Induced Weight Loss Raffaella Cancello 1 , Corneliu...

  14. Weight loss after gastric bypass surgery in human obesity remodels promoter methylation

    DEFF Research Database (Denmark)

    Barres, Romain; Kirchner, Henriette; Rasmussen, Morten

    2013-01-01

    observed in the normal-weight, healthy subjects. Using bisulfite sequencing, we show that promoter methylation of PGC-1a and PDK4 is altered with obesity and restored to nonobese levels after RYGB-induced weight loss. A genome-wide DNA methylation analysis of skeletal muscle revealed that obesity...... is associated with hypermethylation at CpG shores and exonic regions close to transcription start sites. Our results provide evidence that obesity and RYGB-induced weight loss have a dynamic effect on the epigenome....... of genes enriched in metabolic process and mitochondrial function. After weight loss, the expression of the majority of the identified genes was normalized to levels observed in normal-weight, healthy controls. Among the 14 metabolic genes analyzed, promoter methylation of 11 genes was normalized to levels...

  15. Whey Protein Supplementation Enhances Body Fat and Weight Loss in Women Long After Bariatric Surgery: a Randomized Controlled Trial.

    Science.gov (United States)

    Lopes Gomes, Daniela; Moehlecke, Milene; Lopes da Silva, Fernanda Bassan; Dutra, Eliane Said; D'Agord Schaan, Beatriz; Baiocchi de Carvalho, Kenia Mara

    2017-02-01

    The ideal nutritional approach for weight regain after bariatric surgery remains unclear. The objective of this study is to assess the effect of whey protein supplementation on weight loss and body composition of women who regained weight 24 or more months after bariatric surgery. This is a 16-week open-label, parallel-group, randomized controlled trial of women who regained at least 5 % of their lowest postoperative weight after a Roux-en-Y gastric bypass (RYGB). A total of 34 participants were treated with hypocaloric diet and randomized (1:1) to receive or not supplementation with whey protein, 0.5 g/kg of the ideal body weight. The primary outcomes were changes in body weight, fat free mass (FFM), and fat mass (FM), evaluated by tetrapolar bioelectrical impedance analysis (BIA). Secondary outcomes included resting energy expenditure, blood glucose, lipids, adiponectin, interleukin 6 (IL-6), and cholecystokinin levels. Statistical analyses included generalized estimating equations adjusted for age and physical activity. Fifteen patients in each group were evaluated: mean age was 45 ± 11 years, body mass index (BMI) was 35.7 ± 5.2 kg/m(2), and time since surgery was 69 ± 23 months. Protein intake during follow-up increased by approximately 75 % in the intervention group (p = 0.01). The intervention group presented more body weight loss (1.86 kg, p = 0.017), accounted for FM loss (2.78, p = 0.021) and no change in FFM, as compared to controls (gain of 0.42 kg of body weight and 0.6 kg of FM). No differences in secondary outcomes were observed between groups. Whey protein supplementation promoted body weight and FM loss in women with long-term weight regain following RYGB.

  16. Determinants of Weight Loss following Laparoscopic Sleeve Gastrectomy: The Role of Psychological Burden, Coping Style, and Motivation to Undergo Surgery

    Directory of Open Access Journals (Sweden)

    Andrea Figura

    2015-01-01

    Full Text Available Background. The amount of excess weight loss (%EWL among obese patients after bariatric surgery varies greatly. However, reliable predictors have not been established yet. The present study evaluated the preoperative psychological burden, coping style, and motivation to lose weight as factors determining postoperative treatment success. Methods. The sample included 64 morbidly obese patients with a preoperative BMI of 51±8 kg/m2 who had undergone laparoscopic sleeve gastrectomy (LSG. Well-established questionnaires were applied before surgery to assess the psychological burden in terms of “perceived stress” (PSQ-20, “depression” (PHQ-9, “anxiety” (GAD-7, and “mental impairment” (ISR as well as coping style (Brief COPE and motivation to lose weight. %EWL as an indicator for treatment success was assessed on average 20 months after surgery. Results. Based on the %EWL distribution, patients were classified into three %EWL groups: low (14–39%, moderate (40–59%, and high (60–115%. LSG patients with high %EWL reported significantly more “active coping” behavior prior to surgery than patients with moderate and low %EWL. Patients’ preoperative psychological burden and motivation to lose weight were not associated with %EWL. Conclusion. An “active coping” style might be of predictive value for better weight loss outcomes in patients following LSG intervention.

  17. Bariatric Surgery in the United Kingdom: A Cohort Study of Weight Loss and Clinical Outcomes in Routine Clinical Care.

    Directory of Open Access Journals (Sweden)

    Ian J Douglas

    2015-12-01

    Full Text Available Bariatric surgery is becoming a more widespread treatment for obesity. Comprehensive evidence of the long-term effects of contemporary surgery on a broad range of clinical outcomes in large populations treated in routine clinical practice is lacking. The objective of this study was to measure the association between bariatric surgery, weight, body mass index, and obesity-related co-morbidities.This was an observational retrospective cohort study using data from the United Kingdom Clinical Practice Research Datalink. All 3,882 patients registered in the database and with bariatric surgery on or before 31 December 2014 were included and matched by propensity score to 3,882 obese patients without surgery. The main outcome measures were change in weight and body mass index over 4 y; incident diagnoses of type 2 diabetes mellitus (T2DM, hypertension, angina, myocardial infarction (MI, stroke, fractures, obstructive sleep apnoea, and cancer; mortality; and resolution of hypertension and T2DM. Weight measures were available for 3,847 patients between 1 and 4 mo, 2,884 patients between 5 and 12 mo, and 2,258 patients between 13 and 48 mo post-procedure. Bariatric surgery patients exhibited rapid weight loss for the first four postoperative months, at a rate of 4.98 kg/mo (95% CI 4.88-5.08. Slower weight loss was sustained to the end of 4 y. Gastric bypass (6.56 kg/mo and sleeve gastrectomy (6.29 kg/mo were associated with greater initial weight reduction than gastric banding (2.77 kg/mo. Protective hazard ratios (HRs were detected for bariatric surgery for incident T2DM, 0.68 (95% CI 0.55-0.83; hypertension, 0.35 (95% CI 0.27-0.45; angina, 0.59 (95% CI 0.40-0.87;MI, 0.28 (95% CI 0.10-0.74; and obstructive sleep apnoea, 0.55 (95% CI 0.40-0.87. Strong associations were found between bariatric surgery and the resolution of T2DM, with a HR of 9.29 (95% CI 6.84-12.62, and between bariatric surgery and the resolution of hypertension, with a HR of 5.64 (95% CI

  18. Bariatric Surgery in the United Kingdom: A Cohort Study of Weight Loss and Clinical Outcomes in Routine Clinical Care

    Science.gov (United States)

    Douglas, Ian J.; Bhaskaran, Krishnan; Batterham, Rachel L.; Smeeth, Liam

    2015-01-01

    Background Bariatric surgery is becoming a more widespread treatment for obesity. Comprehensive evidence of the long-term effects of contemporary surgery on a broad range of clinical outcomes in large populations treated in routine clinical practice is lacking. The objective of this study was to measure the association between bariatric surgery, weight, body mass index, and obesity-related co-morbidities. Methods and Findings This was an observational retrospective cohort study using data from the United Kingdom Clinical Practice Research Datalink. All 3,882 patients registered in the database and with bariatric surgery on or before 31 December 2014 were included and matched by propensity score to 3,882 obese patients without surgery. The main outcome measures were change in weight and body mass index over 4 y; incident diagnoses of type 2 diabetes mellitus (T2DM), hypertension, angina, myocardial infarction (MI), stroke, fractures, obstructive sleep apnoea, and cancer; mortality; and resolution of hypertension and T2DM. Weight measures were available for 3,847 patients between 1 and 4 mo, 2,884 patients between 5 and 12 mo, and 2,258 patients between 13 and 48 mo post-procedure. Bariatric surgery patients exhibited rapid weight loss for the first four postoperative months, at a rate of 4.98 kg/mo (95% CI 4.88–5.08). Slower weight loss was sustained to the end of 4 y. Gastric bypass (6.56 kg/mo) and sleeve gastrectomy (6.29 kg/mo) were associated with greater initial weight reduction than gastric banding (2.77 kg/mo). Protective hazard ratios (HRs) were detected for bariatric surgery for incident T2DM, 0.68 (95% CI 0.55–0.83); hypertension, 0.35 (95% CI 0.27–0.45); angina, 0.59 (95% CI 0.40–0.87);MI, 0.28 (95% CI 0.10–0.74); and obstructive sleep apnoea, 0.55 (95% CI 0.40–0.87). Strong associations were found between bariatric surgery and the resolution of T2DM, with a HR of 9.29 (95% CI 6.84–12.62), and between bariatric surgery and the resolution of

  19. Not 'Taking the Easy Way Out': Reframing Bariatric Surgery from Low-effort Weight Loss to Hard Work.

    Science.gov (United States)

    Trainer, Sarah; Brewis, Alexandra; Wutich, Amber

    2017-04-01

    Cultural notions equating greater morality and virtue with hard work and productive output are deeply embedded in American value systems. This is exemplified in how people understand and execute personal body projects, including efforts to become slim. Bariatric surgery is commonly viewed as a 'low-effort' means of losing weight, and individuals who opt for this surgery are often perceived to be 'cheating.' This extended ethnographic study within one bariatric program in the Southwestern United States shows how patients conscientiously perform this productivity. By prioritizing discourses that focus on their own hard work and the inherent value and necessity of their surgery, patients and practitioners alike contest the dominant public views of surgically-induced weight loss.

  20. 减重手术的治疗进展%The Progress of Treatment for Weight Loss Surgery

    Institute of Scientific and Technical Information of China (English)

    张府桓; 雷正明

    2013-01-01

    At present,obesity has been seriously endanger the human health and life.With the improvement of human living standards,obesity become a serious problem.Weight-loss surgery is severely obese,with obesity related diseases is the most effective and lasting weight loss therapy,also known as bariatric surgery.%  目前,肥胖已严重危及到人类的健康和生命。随着人类生活水平等方面的提高,肥胖成为严峻的问题。减重手术是重度肥胖且合并有肥胖相关疾病者最有效且持久的减重治疗方法,又名减肥手术。

  1. Benefits of bariatric surgery before elective total joint arthroplasty: is there a role for weight loss optimization?

    Science.gov (United States)

    Nearing, Emanuel E; Santos, Tyler M; Topolski, Mark S; Borgert, Andrew J; Kallies, Kara J; Kothari, Shanu N

    2017-03-01

    The association between obesity and osteoarthritis is well established, as is the increased risk of postoperative complications after total knee arthroplasty (TKA) and total hip arthroplasty (THA) among patients with obesity. To evaluate the outcomes after TKA/THA based on whether the surgery was performed before or after bariatric surgery. Integrated, multispecialty, community teaching hospital. The medical records of all patients who underwent bariatric surgery from 2001 to 2014 were reviewed. Statistical analysis included χ(2) test and t tests. A P valuebariatric procedure, 66 underwent TKA/THA after their bariatric procedure. TKAs/THAs were performed at a mean of 4.9±3.2 years before and 4.3±3.3 years after bariatric surgery. Body mass index for those undergoing TKA/THA after bariatric surgery was lower than those with TKA/THA before bariatric surgery (37.6±7.4 versus 43.7±5.7 kg/m(2); Pbariatric surgery: 81.7±33.9 min versus 117±38.1 min; Pbariatric surgery. Patients who underwent TKA/THA after bariatric surgery had lower body mass index before and 1 year after TKA/THA. Postoperative complication rates were similar. Benefits of bariatric surgery and subsequent weight loss should be considered among patients with obesity requiring TKA/THA. Optimal timing of TKA/THA and bariatric surgery has yet to be established. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  2. Efficacy of a liquid low-energy formula diet in achieving preoperative target weight loss before bariatric surgery

    DEFF Research Database (Denmark)

    Nielsen, Lone Vestergaard; Nielsen, Mette Søndergaard; Schmidt, Julie Berg

    2016-01-01

    A preoperative weight loss of 8 % is a prerequisite to undergo bariatric surgery (BS) in Denmark. The aim of the present study was to evaluate the efficacy of a 7- or an 11-week low-energy diet (LCD) for achieving preoperative target weight before BS. A total of thirty obese patients (BMI 46·0 (sd......, the majority of patients (77 %) had reached their target weight, and this was achieved after 5·4 (sem 0·3) weeks. Mean weight loss was 9·3 (sem 0·5) % (P weight loss was accompanied by a decrease in systolic and diastolic blood...... 4·4) kg/m2) followed an LCD (Cambridge Weight Plan®, 4184 kJ/d (1000 kcal/d)) for 7 or 11 weeks as preparation for BS. Anthropometric measurements including body composition (dual-energy X-ray absorptiometry), blood parameters and blood pressure were assessed at weeks 0, 7 and 11. At week 7...

  3. Proven Weight Loss Methods

    Science.gov (United States)

    Fact Sheet Proven Weight Loss Methods What can weight loss do for you? Losing weight can improve your health in a number of ways. ... limiting calories) usually isn’t enough to cause weight loss. But exercise plays an important part in helping ...

  4. The Effects of Bariatric Surgery Weight Loss on Knee Pain in Patients with Osteoarthritis of the Knee

    Directory of Open Access Journals (Sweden)

    Christopher Edwards

    2012-01-01

    Full Text Available Studies have shown that osteoarthritis (OA is highly associated with obesity, and individuals clinically defined as obese (BMI > 30.0 kg/m2 are four times more likely to have knee OA over the general population. The purpose of this research was to examine if isolated weight loss improved knee symptoms in patients with osteoarthritis. Adult patients (n=24; age 18–70; BMI > 35 kg/m2 with clinical and radiographic evidence of knee OA participated in a one-year trial in which WOMAC and KOOS surveys were administered at a presurgery baseline and six and twelve months postsurgery. Statistical analysis was performed using Student's t and Wilcoxon Signed Rank tests. Weight loss six and twelve months following bariatric surgery was statistically significant (P<0.05 compared to presurgery measurements. All variables from both KOOS and WOMAC assessments were significantly improved (P<0.05 when compared to baseline. Isolated weight loss occurring via bariatric surgery resulted in statistically significant improvement in patient’s knee arthritis symptoms at both six and twelve months. Further research will need to be done to determine if symptom relief continues over time, and if the benefits are also applicable to individuals with symptomatic knee arthritis that are overweight but not obese.

  5. Do Postoperative Psychotherapeutic Interventions and Support Groups Influence Weight Loss Following Bariatric Surgery? A Systematic Review and Meta-analysis of Randomized and Nonrandomized Trials

    DEFF Research Database (Denmark)

    Beck, Nina N.; Johannsen, Maja; Støvring, René K.

    2012-01-01

    Bariatric surgery is currently considered the most effective treatment of severe obesity, but considerable individual variations in weight loss results have been reported. We therefore conducted a systematic review and meta-analysis of studies investigating the effect of psychotherapeutic...... interventions and support groups on weight loss following bariatric surgery. A literature search was conducted in the databases PubMed and PsycINFO, identifying nine eligible studies reporting results of the effect of psychotherapeutic interventions and support groups on weight loss following bariatric surgery...

  6. Psychosocial predictors of quality of life and weight loss two years after bariatric surgery: Results from the Toronto Bari-PSYCH study.

    Science.gov (United States)

    Sockalingam, Sanjeev; Hawa, Raed; Wnuk, Susan; Santiago, Vincent; Kowgier, Matthew; Jackson, Timothy; Okrainec, Allan; Cassin, Stephanie

    2017-07-01

    Studies exploring the impact of pre-surgery psychiatric status as a predictor of health related quality of life (QOL) after bariatric surgery have been limited to short-term follow-up and variable use of psychosocial measures. We examined the effect of pre-operative psychiatric factors on QOL and weight loss 2-years after surgery. 156 patients participated in this prospective cohort study, the Toronto Bariatric Psychosocial Cohort Study, between 2010 and 2014. Patients were assessed pre-surgery for demographic factors, weight, psychiatric diagnosis using the MINI International Neuropsychiatric Interview and symptom measures for QOL, depression and anxiety at pre-surgery and at 1 and 2years post-surgery. At 2-years post-bariatric surgery, patients experienced a significant decrease in mean weight (-48.43kg, 95% [-51.1, -45.76]) and an increase only in physical QOL (+18.91, 95% [17.01, 20.82]) scores as compared to pre-surgery. Multivariate regression analysis identified pre-surgery physical QOL score (psurgery weight (psurgery. Bariatric surgery had a sustained impact on physical QOL but not mental QOL at 2-years post-surgery. A history of mood disorder unexpectedly increased physical QOL scores and weight loss following surgery. Further research is needed to determine if these results are due to bariatric surgery candidate selection within this program. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. The Food Craving Questionnaire-Trait in a bariatric surgery seeking population and ability to predict post-surgery weight loss at six months.

    Science.gov (United States)

    Crowley, Nina M; LePage, Marie L; Goldman, Rachel L; O'Neil, Patrick M; Borckardt, Jeffrey J; Byrne, T Karl

    2012-12-01

    Food cravings have been understudied in bariatric surgery patients and the Food Craving Questionnaire-Trait has not been validated in this population. Reliability and validity of the FCQ-T were examined and a regression analysis was run to determine whether or not preoperative scores on individual subscales of the instrument could predict weight loss at 6 months. The FCQ-T demonstrated excellent internal consistency in bariatric surgery-seeking patients, and individual subscales measuring emotion and mood were correlated with other measures of depression and anxiety. Endorsement of binge eating or emotional eating behaviors during a clinical interview was correlated with similar subscales on the FCQ-T. Higher scores on the subscale 'cues that may trigger food cravings' were associated with greater weight loss at 6 months post-surgery and higher scores on the subscale 'guilt from cravings and/or giving into them' was associated with less weight loss. Management of external cues may predict successful outcomes while emotional impact of cravings may indicate the need for further intervention to help manage specific food craving traits.

  8. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation.

    Science.gov (United States)

    Picot, J; Jones, J; Colquitt, J L; Gospodarevskaya, E; Loveman, E; Baxter, L; Clegg, A J

    2009-09-01

    opinion were resolved at each stage. Studies were synthesised through a narrative review with full tabulation of the results of all included studies. In the economic model the analysis was developed for three patient populations, those with BMI > or = 40; BMI > or = 30 and or = 30 and costs and comorbidity. A total of 5386 references were identified of which 26 were included in the clinical effectiveness review: three randomised controlled trials (RCTs) and three cohort studies compared surgery with non-surgical interventions and 20 RCTs compared different surgical procedures. Bariatric surgery was a more effective intervention for weight loss than non-surgical options. In one large cohort study weight loss was still apparent 10 years after surgery, whereas patients receiving conventional treatment had gained weight. Some measures of QoL improved after surgery, but not others. After surgery statistically fewer people had metabolic syndrome and there was higher remission of Type 2 diabetes than in non-surgical groups. In one large cohort study the incidence of three out of six comorbidities assessed 10 years after surgery was significantly reduced compared with conventional therapy. Gastric bypass (GBP) was more effective for weight loss than vertical banded gastroplasty (VBG) and adjustable gastric banding (AGB). Laparoscopic isolated sleeve gastrectomy (LISG) was more effective than AGB in one study. GBP and banded GBP led to similar weight loss and results for GBP versus LISG and VBG versus AGB were equivocal. All comparisons of open versus laparoscopic surgeries found similar weight losses in each group. Comorbidities after surgery improved in all groups, but with no significant differences between different surgical interventions. Adverse event reporting varied; mortality ranged from none to 10%. Adverse events from conventional therapy included intolerance to medication, acute cholecystitis and gastrointestinal problems. Major adverse events following surgery, some

  9. Weight-loss medications

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000346.htm Weight-loss medicines To use the sharing features on this page, please enable JavaScript. Several weight-loss medicines are available. Ask your health care provider ...

  10. Efficacy of a liquid low-energy formula diet in achieving preoperative target weight loss before bariatric surgery

    DEFF Research Database (Denmark)

    Nielsen, Lone Vestergaard; Nielsen, Mette Søndergaard; Schmidt, Julie Berg;

    2016-01-01

    A preoperative weight loss of 8 % is a prerequisite to undergo bariatric surgery (BS) in Denmark. The aim of the present study was to evaluate the efficacy of a 7- or an 11-week low-energy diet (LCD) for achieving preoperative target weight before BS. A total of thirty obese patients (BMI 46·0 (sd...... 4·4) kg/m2) followed an LCD (Cambridge Weight Plan®, 4184 kJ/d (1000 kcal/d)) for 7 or 11 weeks as preparation for BS. Anthropometric measurements including body composition (dual-energy X-ray absorptiometry), blood parameters and blood pressure were assessed at weeks 0, 7 and 11. At week 7...... in TAG (P LCD within 7 weeks as part of preparation for BS...

  11. Gastric bypass surgery has a weight-loss independent effect on post-challenge serum glucose levels

    DEFF Research Database (Denmark)

    Hofsø, Dag; Birkeland, Kåre I; Holst, Jens J;

    2015-01-01

    BACKGROUND: Gastric bypass surgery seems to have an effect on glucose metabolism beyond what is mediated through weight reduction. The magnitude of this effect on fasting and post-challenge glucose levels remains unknown. RESULTS: Morbidly obese subjects without known diabetes performed a 75 g oral...... glucose tolerance test before and after either gastric bypass surgery (n = 64) or an intensive lifestyle intervention programme (n = 55), ClinicalTrials.gov identifier NCT00273104. The age-adjusted effects of the therapeutic procedures and percentage weight change on fasting and 2-h glucose levels at 1......-h glucose levels were significantly lower in the surgery group than in the lifestyle group, 4.7 (0.4) versus 5.4 (0.7) mmol/l and 3.4 (0.8) versus 6.0 (2.4) mmol/l, respectively (both p Gastric bypass and weight-loss had both independent glucose-lowering effects on 2-h glucose levels [B...

  12. Differential adaptation of human gut microbiota to bariatric surgery-induced weight loss: links with metabolic and low-grade inflammation markers

    National Research Council Canada - National Science Library

    Furet, Jean-Pierre; Kong, Ling-Chun; Tap, Julien; Poitou, Christine; Basdevant, Arnaud; Bouillot, Jean-Luc; Mariat, Denis; Corthier, Gérard; Doré, Joël; Henegar, Corneliu; Rizkalla, Salwa; Clément, Karine

    2010-01-01

    .... Roux-en-Y gastric bypass (RYGB) surgery is one of the most efficient procedures for the treatment of morbid obesity resulting in drastic weight loss and improvement of metabolic and inflammatory status...

  13. Suboptimal Weight Loss and Weight Regain after Gastric Bypass Surgery-Postoperative Status of Energy Intake, Eating Behavior, Physical Activity, and Psychometrics.

    Science.gov (United States)

    Amundsen, Tina; Strømmen, Magnus; Martins, Catia

    2017-05-01

    Suboptimal weight loss (SWL) and weight regain (WR) after gastric bypass surgery (GB) remains poorly understood. This study aims to compare GB patients experiencing SWL or significant WR (SigWR) with successful controls, regarding postoperative food intake, eating behavior, physical activity (PA), and psychometrics. Forty-nine patients with >1 year post-surgery were classified as either experiencing SWL (excess body weight loss, EWL, weight regain ≥15%, n = 38), with respective control groups. Energy intake (EI) was measured with a Food Frequency Questionnaire, eating behavior using the Dutch Eating Behavior Questionnaire and the Three-Factor Eating Questionnaire, and PA using both SenseWear Armbands and the International Physical Activity Questionnaire. Eating disorders, depression, and quality of life (QoL) were measured using the Eating Disorder Examination Questionnaire, Beck Depression Inventory II, and Impact of Weight on Quality of Life, respectively. EI, macronutrient distribution, and meal frequency were similar among groups. However, disinhibited eating behavior score was higher, while most subcategories from IWQOL were significantly lower in both SWL and SigWR groups compared with their respective controls. PA was significantly lower in the SWL and SigWR groups compared with the respective controls. There were no differences between groups regarding depression. Lower PA levels, disordered eating behavior and lower QoL are associated with unsuccessful weigh loss outcome after GB surgery. Longitudinal studies are needed to clarify the potential causal relationship between the previously described variables and SWL/SigWR after GB.

  14. Dis-appearance and dys-appearance anew: living with excess skin and intestinal changes following weight loss surgery.

    Science.gov (United States)

    Groven, Karen Synne; Råheim, Målfrid; Engelsrud, Gunn

    2013-08-01

    The aim of this article is to explore bodily changes following weight loss surgery. Our empirical material is based on individual interviews with 22 Norwegian women. To further analyze their experiences, we build primarily on the phenomenologist Drew Leder`s distinction between bodily dis-appearance and dys-appearance. Additionally, our analysis is inspired by Simone de Beauvoir, Merleau-Ponty and Julia Kristeva. Although these scholars have not directed their attention to obesity operations, they occupy a prime framework for shedding light on different dimensions of bodily change. In doing so, we were able to identify two main themes: The felt "inner" body versus the visible "surface" body and the "old" body versus the "new" body. In different, though interconnected ways, these main themes encompass tensions between changes the women experienced as contributing to a more "normal" and active life, feeling more accepted, and changes that generated ambivalence. In particular, their skin became increasingly problematic because it did not "shrink" like the rest of the body. On the contrary, it became looser and looser. Moreover, badsmelling folds of skin that wobbled, sweated and chafed at the smallest movement, aprons of fat hanging in front of their stomachs, batwing arms, thick flabby thighs and sagging breasts were described as a huge contrast to the positive response they received to their changed body shape when they were out and about with their clothes on. At the same time, they expressed ambivalence with regards to removing the excess skin by means of plastic surgery. Through their own and other women`s experiences they learned removing the excess skin by means of surgery could be a double-edged sword. By illuminating the experiences of the ones undergoing such changes our article offers new insight in a scholarly debate predominated by medical research documenting the positive outcomes of weight loss surgery.

  15. No more broken hearts: weight loss after bariatric surgery returns patients' postoperative risk to baseline following coronary surgery.

    Science.gov (United States)

    Baimas-George, Maria; Hennings, Dietric L; Al-Qurayshi, Zaid; Emad Kandil; DuCoin, Christopher

    2017-06-01

    The obesity epidemic is associated with a rise in coronary surgeries because obesity is a risk factor for coronary artery disease. Bariatric surgery is linked to improvement in cardiovascular co-morbidities and left ventricular function. No studies have investigated survival advantage in postoperative bariatric patients after coronary surgery. To determine if there is a benefit after coronary surgery in patients who have previously undergone bariatric surgery. National Inpatient Sample. We performed a retrospective, cross-sectional analysis of the National Inpatient Sample database from 2003 to 2010. We selected bariatric surgical patients who later underwent coronary surgery (n = 257). A comparison of postoperative complications and mortality after coronary surgery were compared with controls (n = 1442) using χ(2) tests, linear regression analysis, and multivariate logistical regression models. A subset population was identified as having undergone coronary surgery (n = 1699); of this population, 257 patients had previously undergone bariatric surgery. They were compared with 1442 controls. The majority was male (67.2%), white (82.6%), and treated in an urban environment (96.8%). Patients with bariatric surgery assumed the risk of postoperative complications after coronary surgery that was associated with their new body mass index (BMI) (BMI999.9, 95% CI .18 to>999.9, P = .07). Length of stay was significantly longer in postbariatric patients (BMIbariatric patients have a return to baseline risk of morbidity and mortality after coronary surgery. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  16. Changing Body Image and Well-Being: Following the Experience of Massive Weight Loss and Body Contouring Surgery

    Directory of Open Access Journals (Sweden)

    Jo Gilmartin

    2014-03-01

    Full Text Available This paper reports on the perception of changing body image and well-being for patients who had undergone plastic surgery following massive weight loss. The exploratory, qualitative study was undertaken with 20 patients from one teaching hospital in the south of England. Semi-structured interviews were carried out and a thematic analysis of the data undertaken. The results provide important insights regarding body contouring influencing body image change and the adjustment process involved. The ability to pursue self-esteem and the accruing social benefits is emphasized in the interrelated sub themes including social acceptance, undoing depression and sexual vitality. Body contouring surgery following massive weight loss appears to facilitate improvement in body image and well-being. Adjustment to the changing body image is both empowering and challenging. Supportive educational programmes need to be developed to assist this transition to a more positive body image and appreciation; these could usefully include access to and involvement with patient support groups.

  17. Patient-Reported Outcomes in Weight Loss and Body Contouring Surgery

    DEFF Research Database (Denmark)

    Poulsen, Lotte; Klassen, Anne; Rose, Michael

    2017-01-01

    to the post-body contouring surgery period. Data were collected using REDCap, and analyzed using SPSS software. RESULTS: For all appearance and health-related quality-of-life scales, the mean score was significantly lower in the pre-bariatric surgery group compared with the post-body contouring group...

  18. Daily high doses of fluoxetine for weight loss and improvement in lifestyle before bariatric surgery

    NARCIS (Netherlands)

    Dolfing, JG; Wolffenbuttel, BHR; Oei, HI; ten Hoor-Aukerna, NM; Schweitzer, DH

    2005-01-01

    Background: The number of gastric restrictive bariatric operations is increasing each year, but about one-fifth of patients will become disappointed due to unsatisfactory weight reduction or annoying complications. We questioned whether weight reduction by taking high doses of fluoxetine improves li

  19. Prizes for weight loss.

    Science.gov (United States)

    Englberger, L.

    1999-01-01

    A programme of weight loss competitions and associated activities in Tonga, intended to combat obesity and the noncommunicable diseases linked to it, has popular support and the potential to effect significant improvements in health. PMID:10063662

  20. Weight loss - unintentional

    Science.gov (United States)

    ... of your weight loss. When to Contact a Medical Professional Call your health care provider if: You or a family member loses more ... to Expect at Your Office Visit The ... be asked questions about your medical history and symptoms, including: How much weight have ...

  1. The Effect of Bariatric Surgery Type on Lipid Profile: An Age, Sex, Body Mass Index and Excess Weight Loss Matched Study.

    Science.gov (United States)

    Cunha, Filipe M; Oliveira, Joana; Preto, John; Saavedra, Ana; Costa, Maria M; Magalhães, Daniela; Lau, Eva; Bettencourt-Silva, Rita; Freitas, Paula; Varela, Ana; Carvalho, Davide

    2016-05-01

    Bariatric surgery improves lipid profile. A still unanswered question is whether this improvement is merely weight-dependent or also results from factors inherent to specificities of the bariatric procedure. We aimed to study lipid profile 1 year after bariatric surgery and compare its changes between the different procedures in patients matched for initial weight and weight loss. We retrospectively analysed patients submitted to Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (AGB) or sleeve gastrectomy (SG) between 2010 and 2013. Patients were matched for age (±5 years), sex, pre-surgery body mass index (BMI) (±2 Kg/m(2)) and excess weight loss (EWL) (±5%). Baseline and 1-year lipid profile, its variation and percentage of variation was compared between surgeries. We analysed 229 patients: 72 pairs RYGB-AGB, 47 pairs RYGB-SG and 33 pairs AGB-SG. The median age was 41 (35-52) years and 11.8% were male. Pre-operative BMI was 44.0 ± 4.6 and 32.1 ± 4.4 Kg/m(2) at 1 year. EWL at 1 year was 64.2 ± 18.9%. There were no differences in baseline lipid profile between patients submitted to different types of bariatric surgery. At 1 year, high-density lipoprotein cholesterol (HDL) and triglycerides (TG) improved similarly with all surgeries. Total cholesterol (TC) and low-density lipoprotein cholesterol (LDL) at 1 year decreased significantly more in patients submitted to RYGB than in weight-matched patients undergoing AGB or SG. RYGB is the only bariatric surgery that reduces TC and LDL in age-, sex-, BMI- and EWL-matched patients. All three procedures improved TG and HDL similarly when the confounding effect of weight loss is eliminated.

  2. Weight Loss Nutritional Supplements

    Science.gov (United States)

    Eckerson, Joan M.

    Obesity has reached what may be considered epidemic proportions in the United States, not only for adults but for children. Because of the medical implications and health care costs associated with obesity, as well as the negative social and psychological impacts, many individuals turn to nonprescription nutritional weight loss supplements hoping for a quick fix, and the weight loss industry has responded by offering a variety of products that generates billions of dollars each year in sales. Most nutritional weight loss supplements are purported to work by increasing energy expenditure, modulating carbohydrate or fat metabolism, increasing satiety, inducing diuresis, or blocking fat absorption. To review the literally hundreds of nutritional weight loss supplements available on the market today is well beyond the scope of this chapter. Therefore, several of the most commonly used supplements were selected for critical review, and practical recommendations are provided based on the findings of well controlled, randomized clinical trials that examined their efficacy. In most cases, the nutritional supplements reviewed either elicited no meaningful effect or resulted in changes in body weight and composition that are similar to what occurs through a restricted diet and exercise program. Although there is some evidence to suggest that herbal forms of ephedrine, such as ma huang, combined with caffeine or caffeine and aspirin (i.e., ECA stack) is effective for inducing moderate weight loss in overweight adults, because of the recent ban on ephedra manufacturers must now use ephedra-free ingredients, such as bitter orange, which do not appear to be as effective. The dietary fiber, glucomannan, also appears to hold some promise as a possible treatment for weight loss, but other related forms of dietary fiber, including guar gum and psyllium, are ineffective.

  3. A randomised control trial assessing the impact of an investment based intervention on weight-loss, beliefs and behaviour after bariatric surgery: study protocol.

    Science.gov (United States)

    Hollywood, Amelia; Ogden, Jane; Hashemi, Majid

    2015-01-01

    Although obesity surgery is currently the most effective method for achieving weight loss, not all patients lose the desired amount of weight and some show weight regain. Previous research shows that successful weight loss may be associated with the amount of investment the patient feels that they have made in their operation. For example, those who feel that it has taken more time and effort to organise, has cost more money, has been more disruptive to their lives and has caused pain are more likely to lose weight after their operation. Therefore, it seems as if the greater the sense of investment, the greater the motivation to make the operation a success. The present study aims to build on these findings by encouraging weight loss surgery patients to focus on the investment they have made, thus making their investment more salient to them and a means to improve weight loss outcomes. The study involves an open randomised parallel group control trial with patients allocated either to the control or investment intervention group. Using third party blinded randomization, half the patients will be asked to rate and describe the investment they have made in their operation just before surgery then 3 and 6 months after surgery. All patients will record their weight, beliefs about food, intentions to change and actual eating and exercise behaviour at baseline then 3, 6 and 12 months follow up. Patients will be recruited from the bariatric surgery pre-assessment clinic at University College Hospital, London. The primary outcome is to explore the impact of the investment based intervention on patient's weight and BMI, with secondary outcomes of patients' beliefs about foods, behavioural intentions and diet and exercise behaviours. It is predicted that the investment intervention will improve excess weight loss post-surgery, together with beliefs about food, intentions to change and actual change in diet and exercise behaviour. This has cost implications for the NHS and

  4. Overweight, Obesity, and Weight Loss

    Science.gov (United States)

    ... Overweight, obesity, and weight loss fact sheet ePublications Overweight, obesity, and weight loss fact sheet Print this fact sheet Overweight, obesity, and weight loss fact sheet (full version) ( ...

  5. Semiphysiologically based pharmacokinetic model for midazolam and CYP3A mediated metabolite 1-OH-midazolam in morbidly obese and weight loss surgery patients.

    Science.gov (United States)

    Brill, M J E; Välitalo, P A J; Darwich, A S; van Ramshorst, B; van Dongen, H P A; Rostami-Hodjegan, A; Danhof, M; Knibbe, C A J

    2016-01-01

    This study aimed to describe the pharmacokinetics of midazolam and its cytochrome P450 3A (CYP3A) mediated metabolite 1-OH-midazolam in morbidly obese patients receiving oral and i.v. midazolam before (n = 20) and one year after weight loss surgery (n = 18), thereby providing insight into the influence of weight loss surgery on CYP3A activity in the gut wall and liver. In a semiphysiologically based pharmacokinetic (semi-PBPK) model in which different blood flow scenarios were evaluated, intrinsic hepatic clearance of midazolam (CLint,H) was 2 (95% CI 1.40-1.64) times higher compared to morbidly obese patients before surgery (P Midazolam gut wall clearance (CLint,G) was slightly lower in patients after surgery (P > 0.05), with low values for both groups. The results of the semi-PBPK model suggest that, in patients after weight loss surgery, CYP3A hepatic metabolizing capacity seems to recover compared to morbidly obese patients, whereas CYP3A mediated CLint,G was low for both populations and showed large interindividual variability.

  6. Roux-En-Y Gastric Bypass Vs. Sleeve Gastrectomy: Balancing the Risks of Surgery with the Benefits of Weight Loss.

    Science.gov (United States)

    Lager, Corey J; Esfandiari, Nazanene H; Subauste, Angela R; Kraftson, Andrew T; Brown, Morton B; Cassidy, Ruth B; Nay, Catherine K; Lockwood, Amy L; Varban, Oliver A; Oral, Elif A

    2017-01-01

    The purpose of the study was to compare weight loss, metabolic parameters, and postoperative complications in patients undergoing Roux-en-Y gastric bypass (GB) and sleeve gastrectomy (SG). We retrospectively studied 30-day postoperative complications as well as change in weight, blood pressure, cholesterol, hemoglobin, hemoglobin A1C, and creatinine from baseline to 2, 6, 12, and 24 months postoperatively in 383 patients undergoing GB and 336 patients undergoing SG at the University of Michigan from January 2008 to November 2013. For a study population which typically has high attrition rates, there were excellent follow-up rates (706/719 at 2 months, 566/719 at 6 months, 519/719 at 12 months, and 382/719 at 24 months). Baseline characteristics were similar in both groups except for higher weight and BMI in the SG group. The GB group experienced greater total body weight loss at 6, 12, and 24 months (41.9 vs. 34.6 kg at 24 months, p weight loss was 69.7 and 51.7 % following GB and SG respectively at 24 months (p after GB (10.1 vs. 3.5 %, p = 0.0007) with no significant difference in life-threatening or potentially life-threatening complications. Weight loss was greater following GB compared to SG at 2 years. The risk for surgical complications was greater following GB. Surgical intervention should be tailored to surgical risk, comorbidities, and desired weight loss.

  7. Do gallstones found before sleeve gastrectomy behave the same as those formed after surgery due to weight loss?

    Science.gov (United States)

    Conley, Alexandria; Tarboush, Moayad; Manatsathit, Wuttiporn; Meguid, Ahmed; Szpunar, Suzanna; Hawasli, Abdelkader

    2016-11-01

    Gallstone formation is prevalent in the bariatric population and after weight loss. We believe that gallstones found preoperatively behave differently and may not cause significant complications as those developing after weight loss. Thus, prophylactic cholecystectomy before or during sleeve gastrectomy (SG) may not be necessary. Patients undergoing SG from January 2011 to May 2012 were evaluated for the presence of gallstones and development of symptoms or need for cholecystectomy postoperatively. Group 1 (n = 18) had gallstones preoperatively. Group 2 (n = 29) developed gallstones after weight loss. Both groups' demographics were similar. Symptomatic gallstones occurred in 1 patient (5.6%) in group 1 and in 9 patients (31.0%) in group 2 (P = .19). Percent excess body mass index loss (%EBL) was 58 ± 24% vs 70 ± 22% (P = .11) with a mean follow-up of 8.9 ± 6.2 and 14.7 ± 3.9 months for group 1 and group 2, respectively (P = .005). Asymptomatic gallstones found before SG tend to have less risk of becoming symptomatic than those formed after weight loss. There was no statistical significant difference because of small sample. Prophylactic cholecystectomy, however, may not be warranted in these patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Book review: media and the rhetoric of body perfection:\\ud cosmetic surgery, weight loss and beauty in popular culture\\ud by Deborah Harris-Moore

    OpenAIRE

    Monson, Olivia

    2014-01-01

    Against the background of the so-called ‘obesity epidemic’, Media and the Rhetoric of Body Perfection critically examines the discourses of physical perfection that pervade Western societies, aiming to shed new light on the rhetorical forces behind body anxieties and extreme methods of weight loss and beautification. Drawing on interview material with cosmetic surgery patients and offering fresh analyses of various texts from popular culture, this book examines the ways in which the media cap...

  9. Gastric stimulation for weight loss

    Institute of Scientific and Technical Information of China (English)

    Meir Mizrahi; Ami Ben Ya'acov; Yaron Ilan

    2012-01-01

    The prevalence of obesity is growing to epidemic proportions,and there is clearly a need for minimally invasive therapies with few adverse effects that allow for sustained weight loss.Behavior and lifestyle therapy are safe treatments for obesity in the short term,but the durability of the weight loss is limited.Although promising obesity drugs are in development,the currently available drugs lack efficacy or have unacceptable side effects.Surgery leads to long-term weight loss,but it is associated with morbidity and mortality.Gastric electrical stimulation (GES) has received increasing attention as a potential tool for treating obesity and gastrointestinal dysmotility disorders.GES is a promising,minimally invasive,safe,and effective method for treating obesity.External gastric pacing is aimed at alteration of the motility of the gastrointestinal tract in a way that will alter absorption due to alteration of transit time.In addition,data from animal models and preliminary data from human trials suggest a role for the gut-brain axis in the mechanism of GES.This may involve alteration of secretion of hormones associated with hunger or satiety.Patient selection for gastric stimulation therapy seems to be an important determinant of the treatment's outcome.Here,we review the current status,potential mechanisms of action,and possible future applications of gastric stimulation for obesity.

  10. Gastric stimulation for weight loss

    Science.gov (United States)

    Mizrahi, Meir; Ben Ya'acov, Ami; Ilan, Yaron

    2012-01-01

    The prevalence of obesity is growing to epidemic proportions, and there is clearly a need for minimally invasive therapies with few adverse effects that allow for sustained weight loss. Behavior and lifestyle therapy are safe treatments for obesity in the short term, but the durability of the weight loss is limited. Although promising obesity drugs are in development, the currently available drugs lack efficacy or have unacceptable side effects. Surgery leads to long-term weight loss, but it is associated with morbidity and mortality. Gastric electrical stimulation (GES) has received increasing attention as a potential tool for treating obesity and gastrointestinal dysmotility disorders. GES is a promising, minimally invasive, safe, and effective method for treating obesity. External gastric pacing is aimed at alteration of the motility of the gastrointestinal tract in a way that will alter absorption due to alteration of transit time. In addition, data from animal models and preliminary data from human trials suggest a role for the gut-brain axis in the mechanism of GES. This may involve alteration of secretion of hormones associated with hunger or satiety. Patient selection for gastric stimulation therapy seems to be an important determinant of the treatment’s outcome. Here, we review the current status, potential mechanisms of action, and possible future applications of gastric stimulation for obesity. PMID:22654422

  11. Determinants of weight regain after bariatric surgery.

    Science.gov (United States)

    Bastos, Emanuelle Cristina Lins; Barbosa, Emília Maria Wanderley Gusmão; Soriano, Graziele Moreira Silva; dos Santos, Ewerton Amorim; Vasconcelos, Sandra Mary Lima

    2013-01-01

    Bariatric surgery leads to an average loss of 60-75% of excess body weight with maximum weight loss in the period between 18 and 24 months postoperatively. However, several studies show that weight is regained from two years of operation. To identify the determinants of weight regain in post-bariatric surgery users. Prospective cross-sectional study with 64 patients who underwent bariatric surgery with postoperative time > 2 years valued at significant weight regain. The variables analyzed were age, sex, education, socioeconomic status, work activity related to food, time after surgery, BMI, percentage of excess weight loss, weight gain, attendance monitoring nutrition, lifestyle, eating habits, self-perception of appetite, daily use of nutritional supplements and quality of life. There were 57 (89%) women and 7 (11%) men, aged 41.76 ± 7.93 years and mean postoperative period of 53.4 ± 18.4 months. The average weight and BMI were respectively 127.48 ± 24.2 kg and 49.56 ± 6.7 kg/m2 at surgery. The minimum weight and BMI were achieved 73.0 ± 18.6 kg and 28.3 ± 5.5 kg/m2, reached in 23.7 ± 12 months postoperatively. Regained significant weight occurred in 18 (28.1%) cases. The mean postoperative period of 66 ± 8.3 months and work activities related to food showed statistical significance (p=000 and p=0.003) for the regained weight. Bariatric surgery promotes adequate reduction of excess body weight, with significant weight regain observed after five years; post-operative time and work activity related to eating out as determining factors for the occurrence of weight regain.

  12. Healthy habits for weight loss

    Science.gov (United States)

    ... gov/ency/patientinstructions/000733.htm Healthy habits for weight loss To use the sharing features on this page, ... to think about it. People who succeed at weight loss, turn healthy eating into a habit. These healthy ...

  13. Weight loss, weight regain and bone health.

    Science.gov (United States)

    Pines, Amos

    2012-08-01

    The ideal body image for women these days is being slim but, in the real world, obesity becomes a major health problem even in the developing countries. Overweight, but also underweight, may have associated adverse outcomes in many bodily systems, including the bone. Only a few studies have investigated the consequences of intentional weight loss, then weight regain, on bone metabolism and bone density. It seems that the negative impact of bone loss is not reversed when weight partially rebounds following the end of active intervention programs. Thus the benefits and risks of any weight loss program should be addressed individually, and monitoring of bone parameters is recommended.

  14. Reduction of macrophage infiltration and chemoattractant gene expression changes in white adipose tissue of morbidly obese subjects after surgery-induced weight loss.

    Science.gov (United States)

    Cancello, Raffaella; Henegar, Corneliu; Viguerie, Nathalie; Taleb, Soraya; Poitou, Christine; Rouault, Christine; Coupaye, Muriel; Pelloux, Veronique; Hugol, Danielle; Bouillot, Jean-Luc; Bouloumié, Anne; Barbatelli, Giorgio; Cinti, Saverio; Svensson, Per-Arne; Barsh, Gregory S; Zucker, Jean-Daniel; Basdevant, Arnaud; Langin, Dominique; Clément, Karine

    2005-08-01

    In human obesity, the stroma vascular fraction (SVF) of white adipose tissue (WAT) is enriched in macrophages. These cells may contribute to low-grade inflammation and to its metabolic complications. Little is known about the effect of weight loss on macrophages and genes involved in macrophage attraction. We examined subcutaneous WAT (scWAT) of 7 lean and 17 morbidly obese subjects before and 3 months after bypass surgery. Immunomorphological changes of the number of scWAT-infiltrating macrophages were evaluated, along with concomitant changes in expression of SVF-overexpressed genes. The number of scWAT-infiltrating macrophages before surgery was higher in obese than in lean subjects (HAM56+/CD68+; 22.6 +/- 4.3 vs. 1.4 +/- 0.6%, P attraction (monocyte chemotactic protein [MCP]-1, plasminogen activator urokinase receptor [PLAUR], and colony-stimulating factor [CSF]-3) and hypoxia (hypoxia-inducible factor-1alpha [HIF-1alpha]), expression of which increases in obesity and decreases after surgery, were predominantly expressed in the SVF. We show that improvement of the inflammatory profile after weight loss is related to a reduced number of macrophages in scWAT. MCP-1, PLAUR, CSF-3, and HIF-1alpha may play roles in the attraction of macrophages in scWAT.

  15. Prevention of Weight Regain Following Bariatric Surgery.

    Science.gov (United States)

    Kushner, Robert F; Sorensen, Kirsten Webb

    2015-06-01

    Bariatric surgery is an effective treatment for patients with severe or moderate obesity; however, long-term studies have identified that weight regain occurs post-operatively among a portion of patients. The underlying factors that influence weight regain following bariatric surgery are multifactorial and include endocrine/metabolic alterations, anatomic surgical failure, nutritional indiscretion, mental health issues, and physical inactivity. The extent and significance of these factors is currently uncertain and likely varies between individuals and the operative procedure performed. Multiple observational and non-randomized studies and a few randomized controlled trials have been reported that focus on improving post-operative weight loss. Across all of the behavioral and group support studies, patients in the treatment groups showed either no benefit or modestly greater weight loss than patients in the control groups. There are no randomized controlled trials that have specifically targeted weight regain. Additional clinical research is needed to identify etiological factors and interventional strategies.

  16. Abandoning weight-loss programmes

    African Journals Online (AJOL)

    emphasis on factors relating to reasons why the weight loss programmes had ... the increase according to a National Health and Nutrition .... classes after weight gain. 7. 14. 26 .... 'slow metabolism' (8%), and a chronic problem of premenstrual.

  17. Physiological adaptations to weight loss and factors favouring weight regain.

    Science.gov (United States)

    Greenway, F L

    2015-08-01

    Obesity is a major global health problem and predisposes individuals to several comorbidities that can affect life expectancy. Interventions based on lifestyle modification (for example, improved diet and exercise) are integral components in the management of obesity. However, although weight loss can be achieved through dietary restriction and/or increased physical activity, over the long term many individuals regain weight. The aim of this article is to review the research into the processes and mechanisms that underpin weight regain after weight loss and comment on future strategies to address them. Maintenance of body weight is regulated by the interaction of a number of processes, encompassing homoeostatic, environmental and behavioural factors. In homoeostatic regulation, the hypothalamus has a central role in integrating signals regarding food intake, energy balance and body weight, while an 'obesogenic' environment and behavioural patterns exert effects on the amount and type of food intake and physical activity. The roles of other environmental factors are also now being considered, including sleep debt and iatrogenic effects of medications, many of which warrant further investigation. Unfortunately, physiological adaptations to weight loss favour weight regain. These changes include perturbations in the levels of circulating appetite-related hormones and energy homoeostasis, in addition to alterations in nutrient metabolism and subjective appetite. To maintain weight loss, individuals must adhere to behaviours that counteract physiological adaptations and other factors favouring weight regain. It is difficult to overcome physiology with behaviour. Weight loss medications and surgery change the physiology of body weight regulation and are the best chance for long-term success. An increased understanding of the physiology of weight loss and regain will underpin the development of future strategies to support overweight and obese individuals in their efforts

  18. Dietary protein, weight loss, and weight maintenance.

    Science.gov (United States)

    Westerterp-Plantenga, M S; Nieuwenhuizen, A; Tomé, D; Soenen, S; Westerterp, K R

    2009-01-01

    The role of dietary protein in weight loss and weight maintenance encompasses influences on crucial targets for body weight regulation, namely satiety, thermogenesis, energy efficiency, and body composition. Protein-induced satiety may be mainly due to oxidation of amino acids fed in excess, especially in diets with "incomplete" proteins. Protein-induced energy expenditure may be due to protein and urea synthesis and to gluconeogenesis; "complete" proteins having all essential amino acids show larger increases in energy expenditure than do lower-quality proteins. With respect to adverse effects, no protein-induced effects are observed on net bone balance or on calcium balance in young adults and elderly persons. Dietary protein even increases bone mineral mass and reduces incidence of osteoporotic fracture. During weight loss, nitrogen intake positively affects calcium balance and consequent preservation of bone mineral content. Sulphur-containing amino acids cause a blood pressure-raising effect by loss of nephron mass. Subjects with obesity, metabolic syndrome, and type 2 diabetes are particularly susceptible groups. This review provides an overview of how sustaining absolute protein intake affects metabolic targets for weight loss and weight maintenance during negative energy balance, i.e., sustaining satiety and energy expenditure and sparing fat-free mass, resulting in energy inefficiency. However, the long-term relationship between net protein synthesis and sparing fat-free mass remains to be elucidated.

  19. Weight loss, weight maintenance, and adaptive thermogenesis.

    Science.gov (United States)

    Camps, Stefan G J A; Verhoef, Sanne P M; Westerterp, Klaas R

    2013-05-01

    Diet-induced weight loss is accompanied by adaptive thermogenesis, ie, a disproportional or greater than expected reduction of resting metabolic rate (RMR). The aim of this study was to investigate whether adaptive thermogenesis is sustained during weight maintenance after weight loss. Subjects were 22 men and 69 women [mean ± SD age: 40 ± 9 y; body mass index (BMI; in kg/m(2)): 31.9 ± 3.0]. They followed a very-low-energy diet for 8 wk, followed by a 44-wk period of weight maintenance. Body composition was assessed with a 3-compartment model based on body weight, total body water (deuterium dilution), and body volume. RMR was measured (RMRm) with a ventilated hood. In addition, RMR was predicted (RMRp) on the basis of the measured body composition: RMRp (MJ/d) = 0.024 × fat mass (kg) + 0.102 × fat-free mass (kg) + 0.85. Measurements took place before the diet and 8, 20, and 52 wk after the start of the diet. The ratio of RMRm to RMRp decreased from 1.004 ± 0.077 before the diet to 0.963 ± 0.073 after the diet (P after 20 wk (0.983 ± 0.063; P weight loss after 8 wk (P Weight loss results in adaptive thermogenesis, and there is no indication for a change in adaptive thermogenesis up to 1 y, when weight loss is maintained. This trial was registered at clinicaltrials.gov as NCT01015508.

  20. A genetic variant in proximity to the gene LYPLAL1 is associated with lower hunger feelings and increased weight loss following Roux-en-Y gastric bypass surgery

    Science.gov (United States)

    Bandstein, Marcus; Mwinyi, Jessica; Ernst, Barbara; Thurnheer, Martin; Schultes, Bernd; Schiöth, Helgi B.

    2016-01-01

    Abstract Objective: Bariatric surgery is the most efficient treatment of severe obesity. We investigated to what extent BMI- or waist-hip ratio (WHR)-related genetic variants are associated with excess BMI loss (EBMIL) two years after Roux-en-Y gastric bypass (RYGB) surgery, and elucidated the affected biological pathways. Methods: Two-hundred fifty-one obese patients (age: 43 ± 10.7, preoperative BMI: 45.1 ± 6.1 kg/m2, 186 women) underwent RYGB surgery and were followed up after two years with regard to BMI. Patients were genotyped for 32 single-nucleotide polymorphisms (SNPs) that were investigated with regard to their impact on response to RYGB and preoperatively measured Three Factor Eating Questionnaire (TFEQ) scores. Results: Homozygous T carriers of the SNP rs4846567 in proximity to the Lysophospholipase-like 1 (LYPLAL1) gene showed a 7% higher EBMIL compared to wild-type and heterozygous carriers (p = 0.031). TT-allele carriers showed furthermore lower scores for Hunger (74%, p < 0.001), lower Disinhibition (53%, p < 0.001), and higher Cognitive restraint (21%, p = 0.017) than GG/GT carriers in the TFEQ. Patients within the lowest quartile of Hunger scores had a 32% greater EBMIL compared to patients in the highest quartile (p < 0.001). Conclusion: The LYPLAL1 genotype is associated with differences in eating behavior and loss of extensive body weight following RYGB surgery. Genotyping and the use of eating behavior-related questionnaires may help to estimate the RYGB-associated therapy success. PMID:27181159

  1. Assessing Improvement in Quality of Life and Patient Satisfaction following Body Contouring Surgery in Patients with Massive Weight Loss: A Critical Review of Outcome Measures Employed

    Directory of Open Access Journals (Sweden)

    Shehab Jabir

    2013-01-01

    Full Text Available Body contouring following massive weight loss is a rapidly expanding field in plastic surgery. However, healthcare payers are reluctant to fund such procedures, viewing them as purely cosmetic. This has resulted in a flurry of studies assessing quality of life (QoL and patient satisfaction following body contouring surgery in this cohort of patients to establish an evidence base to support the idea that body contouring is as much (or even more a functional procedure as it is cosmetic. However, the methods employed in these studies are seldom ideal, and hence the conclusions are unreliable. The gold standard to assess QoL and patient satisfaction is to use patient specific psychometrically validated patient reported outcome (PRO measures. Developing such measures consists of a three-step process which includes a review of the current literature, qualitative patient interviews to determine what patients consider the most important, and expert opinion. This study aims to appraise the currently available literature on assessment of QoL and patient satisfaction in body contouring surgery patients. This will hopefully provide an understanding of methodological weaknesses in current studies and inform future investigators of the design of ideal instruments for assessing QoL and patient satisfaction in body contouring patients.

  2. Dramatic weight loss with rufinamide.

    Science.gov (United States)

    Mourand, Isabelle; Crespel, Arielle; Gelisse, Philippe

    2013-01-01

    Rufinamide (RUF) is a novel antiepileptic drug considered as second-line therapy in the treatment of Lennox-Gastaut syndrome. Treatment-emergent adverse events (AEs) have consisted mainly of drowsiness, irritability, vomiting, and loss of appetite. RUF is considered as a "weight-neutral" drug. We found clinically significant weight loss in 7 of 15 consecutive adult patients (47%; 3 male, 4 female, aged 18-31 years) treated with RUF as add-on therapy (800-2,400 mg/day: 23.5-57.1 mg/kg/day). The body mass index (BMI) decreased by 7.3-18.7%. Two patients were obese class I before RUF. Five patients (71%) were underweight before RUF (mild in one case, moderate in two cases, and severe in two cases). Four of these patients stopped RUF because of this adverse effect. RUF was recommenced in two patients using a lower and slower dosing strategy; one patient showed improvement in seizure control and no weight loss but RUF was re-stopped in the second patient because of continued weight loss. Despite of weight loss, RUF was continued in two other patients because it reduced seizure activity. We primarily related weight loss to reduced food intake, that is, loss of appetite and nausea, although in two patients no obvious loss of appetite was reported. RUF can cause clinically significant weight loss in adult patients, even at low dose. This AE can affect patients who are already underweight. There is a possibility that lower starting doses and slower escalation might minimize weight loss, but further information is required to determine whether this is the case.

  3. Geophysical weight loss diet

    Science.gov (United States)

    Schatten, Kenneth

    1984-04-01

    Having for numerous reasons acquired a three digit kilogram mass, the author is experienced at the painful struggles that the gourmand must suffer to reduce weight, particularly if he/she enjoys reasonably large amounts of good food. To the avant-garde geophysicist, utilizing the following approach could be pleasurable, rewarding, and may even enable the accomplishment of what Ghengis Khan, Alexander the Great, Napolean, and Hitler could not!The basic approach is the full utilization of Newton's formula for the attraction of two massive bodies: F=GM1M2/r2, where G, is the gravitational constant; r, the distance between the two bodies; and M1 and M2, the masses of the two bodies. Although one usually chooses M1 to be the earth's mass ME and M2 to be the mass of a small object, this unnecessarily restricts the realm of phenomena. The less restrictive assumption is M1 + M2 = ME.

  4. Comparative physiogenomic analyses of weight loss in response to 2 modes of bariatric surgery: demonstration with candidate neuropsychiatric and cardiometabolic genes.

    Science.gov (United States)

    Seip, Richard L; Papasavas, Pavlos; Stone, Andrea; Thompson, Stephen; Ng, Janet; Tishler, Darren S; Ruaño, Gualberto

    2016-02-01

    Surgical weight loss response is variable, with suboptimal outcomes in some patients. We hypothesized that genetic biomarkers may be related to weight change. We tested 330 single nucleotide polymorphisms (SNPs) in genes relevant to metabolic regulation in 161 patients whose decrease in body mass index (BMI), 1 year after laparoscopic adjustable gastric banding (LAGB) or Roux-en-Y gastric bypass (RYGB), was small (lowest quartile response) or large (highest quartile response). LAGB patients whose BMI decreased≤4.7 or≥10.2 units comprised groups I (n = 43) and II (n = 40), respectively. RYGB patients whose BMI decreased≤13.6 or≥19.8 units comprised groups III (n = 39) and IV (n = 39), respectively. Within each surgery, SNPs with large differences in reference allele frequency (z score>2, corresponding to values displaced 2 standard deviations [SD] from the mean for all SNPs) in low versus high quartiles, were identified. We compared reference allele frequencies, within surgical procedure, using the χ(2) test (using Bonferroni correction for multiple testing). The mean percent excess weight losses (±SD) corresponding to groups I, II, III, and IV were: 16 (±12), 64 (±30), 55 (±16), and 75 (±17), respectively. SNPs with z score>2 were identified in genes involved in LAGB response, lipid metabolic regulation (APOE, rs439401; APOC4, rs2288911), neural processes (DRD3, rs167771; HTR3 B, rs3758987), and xeno- or endobiotic metabolism (CYP3 A4, rs12333983); and for RYGB response, in lipid transport (SCARB1, rs10846744), folate metabolism (MTHFR, rs2066470), regulation of glycolysis in immune cells (HIF1 A, rs1951795), vitamin K cycling (VKORC1, rs2359612), and xeno- or endobiotic metabolism (CYP3 A4, rs2242480). For LAGB response, APOE SNP frequencies were significantly different. With further validation, information derived from patient DNA may be useful to predict surgical weight loss outcomes and guide selection of surgical approach. Copyright © 2016

  5. Diet for rapid weight loss

    Science.gov (United States)

    Academy of Nutrition and Dietetics. Staying away from fad diets. Updated January 4, 2016. www.eatright.org/resource/health/weight-loss/fad-diets/staying-away-from-fad-diets . Accessed May 25, 2016. Cowley MA, Brown WA, Considine ...

  6. Weight loss history as a predictor of weight loss: results from Phase I of the weight loss maintenance trial

    OpenAIRE

    Myers, Valerie H.; McVay, Megan A.; Champagne, Catherine M.; Hollis, Jack F.; Coughlin, Janelle W.; Funk, Kristine L.; Gullion, Christina M.; Jerome, Gerald J.; Loria, Catherine M.; Samuel-Hodge, Carmen D; Stevens, Victor J; Svetkey, Laura P; Brantley, Phillip J.

    2012-01-01

    Past studies have suggested that weight loss history is associated with subsequent weight loss. However, questions remain whether method and amount of weight lost in previous attempts impacts current weight loss efforts. This study utilized data from the Weight Loss Maintenance Trial to examine the association between weight loss history and weight loss outcomes in a diverse sample of high-risk individuals. Multivariate regression analysis was conducted to determine which specific aspects of ...

  7. Supporting your child with weight loss

    Science.gov (United States)

    ... health care provider can set healthy goals for weight-loss and help with monitoring and support. Getting support ... to get the whole family to join a weight-loss plan, even if weight loss is not the ...

  8. FTO genotype and weight loss

    DEFF Research Database (Denmark)

    Livingstone, Katherine M; Celis-Morales, Carlos; Papandonatos, George D

    2016-01-01

    OBJECTIVE: To assess the effect of the FTO genotype on weight loss after dietary, physical activity, or drug based interventions in randomised controlled trials. DESIGN: Systematic review and random effects meta-analysis of individual participant data from randomised controlled trials. DATA SOURC...

  9. FTO genotype and weight loss

    DEFF Research Database (Denmark)

    Livingstone, Katherine M; Celis-Morales, Carlos; Papandonatos, George D;

    2016-01-01

    OBJECTIVE: To assess the effect of the FTO genotype on weight loss after dietary, physical activity, or drug based interventions in randomised controlled trials. DESIGN: Systematic review and random effects meta-analysis of individual participant data from randomised controlled trials. DATA SOURC...

  10. FTO genotype and weight loss

    DEFF Research Database (Denmark)

    Livingstone, Katherine M; Celis-Morales, Carlos; Papandonatos, George D;

    2016-01-01

    OBJECTIVE: To assess the effect of the FTO genotype on weight loss after dietary, physical activity, or drug based interventions in randomised controlled trials. DESIGN: Systematic review and random effects meta-analysis of individual participant data from randomised controlled trials. DATA SOURCES...... well to dietary, physical activity, or drug based weight loss interventions and thus genetic predisposition to obesity associated with the FTO minor allele can be at least partly counteracted through such interventions. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42015015969.......: Ovid Medline, Scopus, Embase, and Cochrane from inception to November 2015. ELIGIBILITY CRITERIA FOR STUDY SELECTION: Randomised controlled trials in overweight or obese adults reporting reduction in body mass index, body weight, or waist circumference by FTO genotype (rs9939609 or a proxy) after...

  11. Implementation of national body contouring surgery guidelines following massive weight loss: A national cross-sectional survey of commissioning in England.

    Science.gov (United States)

    Dunne, Jonathan A; Wormald, Justin C R; Ghedia, Reshma; Soldin, Mark

    2017-01-01

    National guidelines for commissioning of body contouring surgery (BCS) following massive weight loss (MWL) in England were published in 2014. Nearly three-quarters of patients who have MWL seek BCS; however, access is known to vary according to the region. The aim of national guidelines was to standardise access. The purpose of this study was to determine implementation of the national guidelines by clinical commissioning groups (CCGs) in England. A cross-sectional, web-based survey was sent to all CCG chairs in England. Of 211 potential respondents, 108 completed the survey or provided funding guidelines (response rate = 52%). Eight CCGs (7%) had implemented the guidelines. A total of 69 CCGs were aware of the new guidelines (64%), and 66 CCGs stated that they fund BCS after MWL (61%). A total of 81 CCGs (75%) identified local funding guidelines, while 15 CCGs (14%) cited individual funding requests (IFRs) as the means of accessing funding. To improve patient access to BCS; 58 of 65 respondents (89%) stated cost-effectiveness, whereas 56 of 75 respondents (75%) thought patient-reported outcome measures were key. Qualitative data to improve access included an integrated pathway from bariatric surgery to BCS, an improved evidence base and greater CCG finances. One CCG stated that it cannot afford to fund cosmetic procedures. The purpose of national guidelines was to simplify the pathway to BCS after MWL and create fair distribution of funds across the country to needy patients; however, their uptake has been poor. Access to funding for BCS across England varies according to the location. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  12. Nutrition Care for Patients with Weight Regain after Bariatric Surgery

    Directory of Open Access Journals (Sweden)

    Carlene Johnson Stoklossa

    2013-01-01

    Full Text Available Achieving optimal weight outcomes for patients with obesity is important to the management of their chronic disease. All interventions present risks for weight regain. Bariatric surgery is the most efficacious treatment, producing greater weight losses that are sustained over more time compared to lifestyle interventions. However, approximately 20–30% of patients do not achieve successful weight outcomes, and patients may experience a regain of 20–25% of their lost weight. This paper reviews several factors that influence weight regain after bariatric surgery, including type of surgery, food tolerance, energy requirements, drivers to eat, errors in estimating intake, adherence, food and beverage choices, and patient knowledge. A comprehensive multidisciplinary approach can provide the best care for patients with weight regain. Nutrition care by a registered dietitian is recommended for all bariatric surgery patients. Nutrition diagnoses and interventions are discussed. Regular monitoring of weight status and early intervention may help prevent significant weight regain.

  13. Thermodynamics of weight loss diets.

    Science.gov (United States)

    Fine, Eugene J; Feinman, Richard D

    2004-12-08

    BACKGROUND: It is commonly held that "a calorie is a calorie", i.e. that diets of equal caloric content will result in identical weight change independent of macronutrient composition, and appeal is frequently made to the laws of thermodynamics. We have previously shown that thermodynamics does not support such a view and that diets of different macronutrient content may be expected to induce different changes in body mass. Low carbohydrate diets in particular have claimed a "metabolic advantage" meaning more weight loss than in isocaloric diets of higher carbohydrate content. In this review, for pedagogic clarity, we reframe the theoretical discussion to directly link thermodynamic inefficiency to weight change. The problem in outline: Is metabolic advantage theoretically possible? If so, what biochemical mechanisms might plausibly explain it? Finally, what experimental evidence exists to determine whether it does or does not occur? RESULTS: Reduced thermodynamic efficiency will result in increased weight loss. The laws of thermodynamics are silent on the existence of variable thermodynamic efficiency in metabolic processes. Therefore such variability is permitted and can be related to differences in weight lost. The existence of variable efficiency and metabolic advantage is therefore an empiric question rather than a theoretical one, confirmed by many experimental isocaloric studies, pending a properly performed meta-analysis. Mechanisms are as yet unknown, but plausible mechanisms at the metabolic level are proposed. CONCLUSIONS: Variable thermodynamic efficiency due to dietary manipulation is permitted by physical laws, is supported by much experimental data, and may be reasonably explained by plausible mechanisms.

  14. Thermodynamics of weight loss diets

    Directory of Open Access Journals (Sweden)

    Fine Eugene J

    2004-12-01

    Full Text Available Abstract Background It is commonly held that "a calorie is a calorie", i.e. that diets of equal caloric content will result in identical weight change independent of macronutrient composition, and appeal is frequently made to the laws of thermodynamics. We have previously shown that thermodynamics does not support such a view and that diets of different macronutrient content may be expected to induce different changes in body mass. Low carbohydrate diets in particular have claimed a "metabolic advantage" meaning more weight loss than in isocaloric diets of higher carbohydrate content. In this review, for pedagogic clarity, we reframe the theoretical discussion to directly link thermodynamic inefficiency to weight change. The problem in outline: Is metabolic advantage theoretically possible? If so, what biochemical mechanisms might plausibly explain it? Finally, what experimental evidence exists to determine whether it does or does not occur? Results Reduced thermodynamic efficiency will result in increased weight loss. The laws of thermodynamics are silent on the existence of variable thermodynamic efficiency in metabolic processes. Therefore such variability is permitted and can be related to differences in weight lost. The existence of variable efficiency and metabolic advantage is therefore an empiric question rather than a theoretical one, confirmed by many experimental isocaloric studies, pending a properly performed meta-analysis. Mechanisms are as yet unknown, but plausible mechanisms at the metabolic level are proposed. Conclusions Variable thermodynamic efficiency due to dietary manipulation is permitted by physical laws, is supported by much experimental data, and may be reasonably explained by plausible mechanisms.

  15. Obesity Epidemic: Pharmaceutical Weight Loss.

    Science.gov (United States)

    Curry, Stephanie A

    2017-03-01

    Obesity is a chronic disease universally defined as an excess of adipose tissue resulting in body mass index (BMI) > 30.0 kg/m2. Over the past few years, the concept of prevention has gained increased awareness, thus leading to the development of additional pharmaceutical options for the treatment of obesity since 2012. Treating obesity revolves around an individualized, multi-disciplinary approach with additional focus on a healthy and supportive lifestyle to maintain the weight loss. [Full article available at http://rimed.org/rimedicaljournal-2017-03.asp].

  16. Weighing Portions Adds Up to Weight Loss

    Science.gov (United States)

    ... fullstory_167159.html Weighing Portions Adds Up to Weight Loss Put an end to guesstimating calories with simple ... of calories a day. And that can slow weight loss to a snail's pace. The answer is to ...

  17. Ways to Track Weight Loss Success

    Science.gov (United States)

    ... gov/news/fullstory_165874.html Ways to Track Weight Loss Success There's more to it than the scale ... News) -- Self-monitoring is part of virtually every weight loss plan, and weighing yourself is a key part ...

  18. Osteoarthritis, obesity and weight loss

    DEFF Research Database (Denmark)

    Bliddal, Henning; Leeds, A R; Christensen, Robin Daniel Kjersgaard

    2014-01-01

    Obesity is widely acknowledged as a risk factor for both the incidence and progression of osteoarthritis, and has a negative influence on outcomes. Loss of at least 10% of body weight, coupled with exercise, is recognized as a cornerstone in the management of obese patients with osteoarthritis......, and can lead to significant improvement in symptoms, pain relief, physical function and health-related quality of life. However, questions still remain surrounding optimal management. Given the significant health, social and economic burden of osteoarthritis, especially in obese patients, it is imperative...... to advance our knowledge of osteoarthritis and obesity, and apply this to improving care and outcomes. This paper overviews what is already known about osteoarthritis and obesity, discusses current key challenges and ongoing hypotheses arising from research in these areas, and finally, postulates what...

  19. The Influence of Weight-Loss Expectations on Weight Loss and of Weight-Loss Satisfaction on Weight Maintenance in Severe Obesity.

    Science.gov (United States)

    Calugi, Simona; Marchesini, Giulio; El Ghoch, Marwan; Gavasso, Ilaria; Dalle Grave, Riccardo

    2017-01-01

    Conflicting evidence exists as to whether cognitive mechanisms contribute to weight loss and maintenance. To assess the influence of weight-loss expectations on weight loss, and of weight-loss satisfaction on weight maintenance, in individuals with severe obesity. A randomized controlled trial comparing two types of energy-restricted diets (high protein vs high carbohydrate) combined with weight-loss cognitive behavioral therapy, conducted over 51 weeks and divided into two phases: weight-loss phase (3 weeks of inpatient treatment and 24 weeks of outpatient treatment) and weight maintenance phase (24 weeks of outpatient treatment). Eighty-eight participants with severe obesity (mean age=46.7 years and mean body mass index=45.6), referred to an eating and weight disorders clinical service, were studied. Body weight was assessed at baseline, and after 3, 27 (end of weight-loss phase), and 51 weeks (end of weight maintenance phase). Weight loss expectations were assessed at the time of enrollment, and weight-loss satisfaction was assessed after 27 weeks. The relationship between weight-loss expectations and weight loss was assessed using a linear mixed model. The association between weight-loss satisfaction and final outcomes was tested by linear regression. The two groups had similar weight-loss expectations and satisfaction, and their results were therefore pooled. In general, the total amount of expected weight loss (in kilograms), but not the percentage of expected weight loss, predicted weight loss, and both satisfaction with weight loss and the amount of weight lost (in kilograms) were independent predictors of weight maintenance. Higher expected weight loss improves weight loss, and both the total amount of weight lost and satisfaction with weight loss are associated with weight-loss maintenance at 1-year follow-up. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  20. 38 CFR 4.112 - Weight loss.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Weight loss. 4.112... DISABILITIES Disability Ratings The Digestive System § 4.112 Weight loss. For purposes of evaluating conditions in § 4.114, the term “substantial weight loss” means a loss of greater than 20 percent of...

  1. Effect on Nitrogen Balance, Thermogenesis, Body Composition, Satiety, and Circulating Branched Chain Amino Acid Levels up to One Year after Surgery: Protocol of a Randomized Controlled Trial on Dietary Protein During Surgical Weight Loss

    Science.gov (United States)

    Pi-Sunyer, Xavier; Vidal, Josep; Miner, Patricia; Boirie, Yves; Laferrère, Blandine

    2016-01-01

    Background Bariatric surgery (BS), the most effective treatment for severe obesity, typically results in 40-50 kg weight loss in the year following the surgery. Beyond its action on protein metabolism, dietary protein intake (PI) affects satiety, thermogenesis, energy efficiency, and body composition (BC). However, the required amount of PI after surgical weight loss is not known. The current daily PI recommendation for diet-induced weight loss is 0.8 g/kg ideal body weight (IBW) per day, but whether this amount is sufficient to preserve fat-free mass during active surgical weight loss is unknown. Objective To evaluate the effect of a 3-month dietary protein supplementation (PS) on nitrogen balance (NB), BC, energy expenditure, and satiety in women undergoing either gastric bypass or vertical sleeve gastrectomy. Methods In this randomized prospective study, participants will be randomized to a high protein supplementation group (1.2 g/kg IBW per day) or standard protein supplementation group (0.8 g/kg IBW per day) based on current guidelines. Outcome measures including NB, BC, circulating branched chain amino acids, and satiety, which will be assessed presurgery, and at 3-months and 12-months postsurgery. Results To date, no studies have examined the effect of dietary PS after BS. Current guidelines for PI after surgery are based on weak evidence. Conclusions The results of this study will contribute to the development of evidence-based data regarding the safe and optimal dietary PI and supplementation after BS. Trial Registration Clinicaltrials.gov NCT02269410; http://clinicaltrials.gov/ct2/show/NCT02269410 (Archived by WebCite at http://www.webcitation.org/6m2f2QLeg). PMID:27895003

  2. Massive weight loss-induced mechanical plasticity in obese gait

    NARCIS (Netherlands)

    Hortobagyi, Tibor; Herring, Cortney; Pories, Walter J.; Rider, Patrick; DeVita, Paul

    2011-01-01

    Hortobagyi T, Herring C, Pories WJ, Rider P, DeVita P. Massive weight loss-induced mechanical plasticity in obese gait. J Appl Physiol 111: 1391-1399, 2011. First published August 18, 2011; doi:10.1152/japplphysiol.00291.2011.-We examined the hypothesis that metabolic surgery-induced massive weight

  3. Massive weight loss-induced mechanical plasticity in obese gait

    NARCIS (Netherlands)

    Hortobagyi, Tibor; Herring, Cortney; Pories, Walter J.; Rider, Patrick; DeVita, Paul

    2011-01-01

    Hortobagyi T, Herring C, Pories WJ, Rider P, DeVita P. Massive weight loss-induced mechanical plasticity in obese gait. J Appl Physiol 111: 1391-1399, 2011. First published August 18, 2011; doi:10.1152/japplphysiol.00291.2011.-We examined the hypothesis that metabolic surgery-induced massive weight

  4. Ectopic fat storage in the pancreas using 1H-MRS: importance of diabetic status and modulation with bariatric surgery-induced weight loss.

    Science.gov (United States)

    Gaborit, B; Abdesselam, I; Kober, F; Jacquier, A; Ronsin, O; Emungania, O; Lesavre, N; Alessi, M-C; Martin, J C; Bernard, M; Dutour, A

    2015-03-01

    Recent literature suggests that ectopic fat deposition in the pancreas may contribute to endocrine and exocrine organ dysfunction, such as type 2 diabetes (T2D), pancreatitis or pancreatic cancer. The aim of this study was to determine factors associated with pancreatic triglyceride content (PTGC), and to investigate the impact of bariatric surgery on ectopic fat pads, pancreatic fat (PTGC) and hepatic fat (HTGC). In all, 45 subjects (13 lean, 13 obese nondiabetics and 19 T2D, matched for age and gender) underwent 1H-magnetic resonance spectroscopy, computed tomography of the visceral abdominal fat, metabolic and lipidomic analysis, including insulin-resistance homeostasis model assessment (HOMA-IR), insulin-secretion homeostasis model assessment (HOMA-B) and plasma fatty-acid composition. Twenty obese subjects were reassessed 6 months after the bariatric surgery. PTGC was significantly higher in type 2 diabetic subjects (23.8±3.2%) compared with obese (14.0±3.3; P=0.03) and lean subjects (7.5±0.9%; P=0.0002). PTGC remained significantly associated with T2D after adjusting for age and sex (β=0.47; P=0.004) or even after adjusting for waist circumference, triglycerides and HOMA-IR (β=0.32; P=0.04). T2D, C18:1n-9 (oleic acid), uric acid, triglycerides and plasminogen activator inhibitor-1 were the five more important parameters involved in PTGC prediction (explained 80% of PTGC variance). Bariatric surgery induced a huge reduction of both HTGC (-51.2±7.9%) and PTGC (-43.8±7.0%) reaching lean levels, whereas body mass index remained greatly elevated. An improvement of insulin resistance HOMA-IR and no change in HOMA-B were observed after bariatric surgery. The PTGC or HTGC losses were not correlated, suggesting tissue-specific mobilization of these ectopic fat stores. Pancreatic fat increased with T2D and drastically decreased after the bariatric surgery. This suggests that decreased PTGC may contribute to improved beta cell function seen after the bariatric

  5. Family support and weight-loss strategies among adolescents reporting sustained weight loss.

    Science.gov (United States)

    Utter, Jennifer; Denny, Simon; Dixon, Robyn; Ameratunga, Shanthi; Teevale, Tasileta

    2013-03-01

    The current research aims to describe the weight-control strategies and family support for young people reporting sustained weight loss in a large, population-based sample. Data were collected as part of Youth'07, a nationally representative survey of the health and well-being of New Zealand youth. New Zealand secondary schools, 2007. Secondary-school students (n 9107). Among young people who attempted weight loss in the previous year, 51% reported long-term weight loss (lost weight and maintained weight loss for 6 months). Students reporting long-term weight loss were more likely to be male, but did not differ by age, ethnicity, socio-economic deprivation or measured weight status from students who reported temporary/recent weight loss or no weight loss. Students with long-term weight loss also reported healthier weight-control strategies (e.g., exercising, eating fewer fatty foods, eating fewer sweets), high parental support for healthy eating/activity and were less likely to report being teased about their weight by their family and having junk food available at home than students with temporary/recent weight loss or no weight loss. Approximately 50% of young people attempting weight loss reported sustained weight loss. Young people who reported sustained weight loss appeared to have more family support than those who did not achieve this, suggesting the importance for weight-control services and interventions in adolescents of actively engaging the family.

  6. Surgical solutions to the problem of massive weight loss

    Institute of Scientific and Technical Information of China (English)

    Jason A Spector; Steven M Levine; Nolan S Karp

    2006-01-01

    In response to the global rise in obesity, bariatric surgery has become increasingly more popular and successful.As a result, the demand for body contouring following massive weight loss is rapidly growing. Although bariatric procedures may produce impressive weight loss, people who achieve massive weight loss are often unhappy with the hanging folds of skin and subcutaneous tissue that remain. This review examines the nature of the post-bariatric deformity in each body region and briefly reviews common approaches to their treatment.

  7. Psychological characteristics and associations with weight outcomes two years after gastric bypass surgery

    DEFF Research Database (Denmark)

    Beck, Nina N; Mehlsen, Mimi; Støving, René Klinkby

    2012-01-01

    distrust in comparison with a Danish norm group (p≤0.05). The weight losses obtained after surgery varied from 12 to 60% of the starting weights. Binge eating and ineffectiveness were found to significantly correlate with weight loss variations after surgery (p≤0.05). The results of this study indicate...

  8. Positive response to binge eating intervention enhances postoperative weight loss.

    Science.gov (United States)

    Ashton, Kathleen; Heinberg, Leslie; Windover, Amy; Merrell, Julie

    2011-01-01

    Binge eating disorder has been suggested as a predictor of negative outcomes, including weight regain and poorer weight loss, particularly if the symptoms (e.g., loss of control eating) remain after surgery. Binge eating disorder has been viewed by some as a contraindication for weight loss surgery, and preoperative treatment has been recommended to help reduce binge eating behaviors. The objective of the present study was to evaluate whether the response to a preoperative binge eating intervention related to differential postoperative weight loss at an academic medical center. A total of 128 bariatric surgery candidates completed a brief cognitive behavioral group treatment for binge eating behaviors. The patients were categorized as positive responders or nonresponders according to the postintervention outcomes, including binge eating symptoms and episodes. The percentage of excess body weight loss (%EBWL) was measured at 6 and 12 months after surgery. Across all bariatric procedures, the positive responders to the brief binge eating intervention had lost significantly more weight at 6 months (46% EBWL versus 38% EBWL) and 12 months (59% EBWL versus 50% EBWL) postoperatively. The results for a subsample of Roux-en-Y gastric bypass patients (n = 89) were also significant, with 53% EBWL for the responders and 42% EBWL for the nonresponders at 6 months and 68% EBWL versus 54% EBWL at 12 months postoperatively, respectively. The response to binge eating treatment could be an important predictor of postoperative weight loss. The results from the present study provide support for patients who respond to preoperative binge eating treatment having enhanced surgical outcomes. Copyright © 2011 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  9. Effect of sibutramine on weight maintenance after weight loss

    DEFF Research Database (Denmark)

    James, W P; Astrup, A; Finer, Nicholas

    2000-01-01

    Sibutramine is a tertiary amine that has been shown to induce dose-dependent weight loss and to enhance the effects of a low-calorie diet for up to a year. We did a randomised, double-blind trial to assess the usefulness of sibutramine in maintaining substantial weight loss over 2 years....

  10. Effect of sibutramine on weight maintenance after weight loss

    DEFF Research Database (Denmark)

    James, W P; Astrup, A; Finer, Nicholas

    2000-01-01

    Sibutramine is a tertiary amine that has been shown to induce dose-dependent weight loss and to enhance the effects of a low-calorie diet for up to a year. We did a randomised, double-blind trial to assess the usefulness of sibutramine in maintaining substantial weight loss over 2 years....

  11. Abandoning weight-loss programmes

    African Journals Online (AJOL)

    of self, interpersonal/social and situational constraints, ... patterns sanctioned by cultural and social norms and styles.II ... tage, namely 61%, was reponed by the National Adolescent .... Having to disclose one's actual weight to other members.

  12. Preserving Healthy Muscle during Weight Loss.

    Science.gov (United States)

    Cava, Edda; Yeat, Nai Chien; Mittendorfer, Bettina

    2017-05-01

    Weight loss is the cornerstone of therapy for people with obesity because it can ameliorate or completely resolve the metabolic risk factors for diabetes, coronary artery disease, and obesity-associated cancers. The potential health benefits of diet-induced weight loss are thought to be compromised by the weight-loss-associated loss of lean body mass, which could increase the risk of sarcopenia (low muscle mass and impaired muscle function). The objective of this review is to provide an overview of what is known about weight-loss-induced muscle loss and its implications for overall physical function (e.g., ability to lift items, walk, and climb stairs). The currently available data in the literature show the following: 1) compared with persons with normal weight, those with obesity have more muscle mass but poor muscle quality; 2) diet-induced weight loss reduces muscle mass without adversely affecting muscle strength; 3) weight loss improves global physical function, most likely because of reduced fat mass; 4) high protein intake helps preserve lean body and muscle mass during weight loss but does not improve muscle strength and could have adverse effects on metabolic function; 5) both endurance- and resistance-type exercise help preserve muscle mass during weight loss, and resistance-type exercise also improves muscle strength. We therefore conclude that weight-loss therapy, including a hypocaloric diet with adequate (but not excessive) protein intake and increased physical activity (particularly resistance-type exercise), should be promoted to maintain muscle mass and improve muscle strength and physical function in persons with obesity. © 2017 American Society for Nutrition.

  13. Maintained intentional weight loss reduces cardiovascular outcomes

    DEFF Research Database (Denmark)

    Caterson, I D; Finer, N; Coutinho, W

    2012-01-01

    Aim: The Sibutramine Cardiovascular OUTcomes trial showed that sibutramine produced greater mean weight loss than placebo but increased cardiovascular morbidity but not mortality. The relationship between 12-month weight loss and subsequent cardiovascular outcomes is explored. Methods: Overweight/obese...... change to Month 12 was -4.18 kg (sibutramine) or -1.87 kg (placebo). Degree of weight loss during Lead-in Period or through Month 12 was associated with a progressive reduction in risk for the total population in primary outcome events and cardiovascular mortality over the 5-year assessment. Although...... more events occurred in the randomized sibutramine group, on an average, a modest weight loss of approximately 3 kg achieved in the Lead-in Period appeared to offset this increased event rate. Moderate weight loss (3-10 kg) reduced cardiovascular deaths in those with severe, moderate or mild...

  14. Weight loss for overweight and obese individuals with gout

    DEFF Research Database (Denmark)

    Nielsen, Sabrina M; Bartels, Else M; Henriksen, Marius

    2017-01-01

    OBJECTIVES: Weight loss is commonly recommended for gout, but the magnitude of the effect has not been evaluated in a systematic review. The aim of this systematic review was to determine benefits and harms associated with weight loss in overweight and obese patients with gout. METHODS: We searched...... six databases for longitudinal studies, reporting the effect of weight loss in overweight/obese gout patients. Risk of bias was assessed using the tool Risk of Bias in Non-Randomised Studies of Interventions. The quality of evidence was assessed using the Grading of Recommendations Assessment......, Development and Evaluation. RESULTS: From 3991 potentially eligible studies, 10 were included (including one randomised trial). Interventions included diet with/without physical activity, bariatric surgery, diuretics, metformin or no intervention. Mean weight losses ranged from 3 kg to 34 kg. Clinical...

  15. Obesity Prevention and Weight Maintenance After Loss.

    Science.gov (United States)

    German, Alexander James

    2016-09-01

    Obesity is one of the most prevalent medical diseases in pets. Outcomes are often disappointing; many animals either fail to reach target weight or regain weight. This article discusses managing obesity, focusing on prevention. It gives guidance on establishing monitoring programs that use regular body weight and condition assessments to identify animals at risk of inappropriate weight gain, enabling early intervention. Weight management in obese animals is a lifelong process. Regular weight and body condition monitoring are key to identifying animals that rebound early, while continuing to feed a therapeutic weight loss diet can help prevent it from happening.

  16. Posttraumatic Stress Disorder obesity and weight loss

    DEFF Research Database (Denmark)

    Johannessen, Kim Berg; Berntsen, Dorthe

    directional. The purpose of the present study was to examine whether the level of PTSD symptoms decrease as a result of weight loss in 30 obese participants during a 16 week stay at a weight loss facility. During the 16 weeks participants’ Body Mass Index (BMI) decreased significantly. Concurrently...... of depression also declined, whereas perceived social support was stable. The fact that the level of PTSD symptoms decreases simultaneously with weight loss is an interesting and positive side effect that has not been reported previously. The findings are discussed in term of cognitive theories of PTSD....

  17. Circulating omentin concentration increases after weight loss

    Directory of Open Access Journals (Sweden)

    Ricart Wifredo

    2010-04-01

    Full Text Available Abstract Background Omentin-1 is a novel adipokine expressed in visceral adipose tissue and negatively associated with insulin resistance and obesity. We aimed to study the effects of weight loss-induced improved insulin sensitivity on circulating omentin concentrations. Methods Circulating omentin-1 (ELISA concentration in association with metabolic variables was measured in 35 obese subjects (18 men, 17 women before and after hypocaloric weight loss. Results Baseline circulating omentin-1 concentrations correlated negatively with BMI (r = -0.58, p Conclusion As previously described with adiponectin, circulating omentin-1 concentrations increase after weight loss-induced improvement of insulin sensitivity.

  18. Visual loss after spine surgery

    Directory of Open Access Journals (Sweden)

    Kapil Mohan

    2012-01-01

    Full Text Available Incidence of perioperative visual loss ranges from 0.06% to 0.2% with the most common cause as ischemic optic neuropathy. We report one-year follow up of a 50-years-old hypertensive housewife who underwent lumbar decompression and fusion for degenerative scoliosis, but woke up with painless unilateral visual loss. Fundus examination was normal. Her visual acuity improved from initial finger counting close to face to finger counting at 3 m at 1 year. Identification of high risk patients may help in appropriate preoperative counselling, prevention and early recognition of this devastating complication.

  19. Massive weight loss-induced mechanical plasticity in obese gait.

    Science.gov (United States)

    Hortobágyi, Tibor; Herring, Cortney; Pories, Walter J; Rider, Patrick; Devita, Paul

    2011-11-01

    We examined the hypothesis that metabolic surgery-induced massive weight loss causes mass-driven and behavioral adaptations in the kinematics and kinetics of obese gait. Gait analyses were performed at three time points over ∼1 yr in initially morbidly obese (mass: 125.7 kg; body mass index: 43.2 kg/m(2)) but otherwise healthy adults. Ten obese adults lost 27.1% ± 5.1 (34.0 ± 9.4 kg) weight by the first follow-up at 7.0 mo (±0.7) and 6.5 ± 4.2% (8.2 ± 6.0 kg) more by the second follow-up at 12.8 mo (±0.9), with a total weight loss of 33.6 ± 8.1% (42.2 ± 14.1 kg; P = 0.001). Subjects walked at a self-selected and a standard 1.5 m/s speed at the three time points and were also compared with an age- and gender-matched comparison group at the second follow-up. Weight loss increased swing time, stride length, gait speed, hip range of motion, maximal knee flexion, and ankle plantarflexion. Weight loss of 27% led to 3.9% increase in gait speed. An additional 6.5% weight loss led to an additional 7.3% increase in gait speed. Sagittal plane normalized knee torque increased and absolute ankle and frontal plane knee torques decreased after weight loss. We conclude that large weight loss produced mechanical plasticity by modifying ankle and knee torques and gait behavior. There may be a weight loss threshold of 30 kg limiting changes in gait kinematics. Implications for exercise prescription are also discussed.

  20. Ventricular tachycardia induced by weight loss pills

    DEFF Research Database (Denmark)

    Pareek, Manan; Hansson, Nils Henrik; Grove, Erik Lerkevang

    2013-01-01

    A previously healthy 29-year-old man was admitted with palpitations, dizziness, and near-syncope after he had recently started taking weight loss pills purchased on the internet. The pills contained caffeine and ephedrine. An electrocardiogram and telemetry revealed multiple episodes of non-susta......-sustained monomorphic ventricular tachycardia, which was successfully treated with amiodarone. In conclusion, unauthorized weight loss pills can be harmful. In particular, ephedrine-containing drugs carry a risk of ventricular tachycardia and should be discouraged....

  1. Ischemic Colitis after Weight-Loss Medication

    Directory of Open Access Journals (Sweden)

    Dan Comay

    2003-01-01

    Full Text Available BACKGROUND: Previous weight-loss medications have received cautious support due to their association with pulmonary hypertension and valvular heart disease. However, newer drugs are increasingly being recommended as potentially safer and more efficacious. We report a case of ischemic colitis possibly linked to the use of a weight-loss drug, and review the literature to highlight an important latent consequence of these medications.

  2. Weight loss and its relation to fat aspiration yields in liposuction: a survey in 48 patients.

    Science.gov (United States)

    Boeni, R

    2012-01-01

    Liposuction surgeons often observe individually fluctuating amounts of aspirated fat. In patients with sagging skin due to previous weight loss there is a tendency of decreased fat aspiration volumes. To study the influence of weight loss on fat aspiration volumes in a series of 48 patients. We matched individuals of the same gender, but with a different weight history from a vast number of patients who had undergone liposuction surgery. The aspirated fat to wetting solution ratio (FWR) of the circumferential abdominal region was evaluated in three groups: A - patients with no weight loss (n = 16; 8 males/ 8 females), B - patients with a history of moderate weight loss (weight loss 5-10% of body weight; n = 16; 8 males/8 females), and C - patients who had a massive weight loss prior to surgery (weight loss exceeding 15% of body weight; n = 16; 8 males/8 females). The aspirated FWR was 3.4 ± 0.5, 1.0 ± 0.3 and 0.4 ± 0.2 in groups A, B and C, respectively. The differences between the groups were statistically significant (p loss in regard to fat aspiration volumes compared to patients without prior weight loss. These findings point to the importance of a weight loss history prior to surgery. Regardless of lower fat aspiration yields in patients with massive weight loss, good results are still achievable. This is not only due to volume reduction but to skin tightening. Copyright © 2012 S. Karger AG, Basel.

  3. Effect of weight loss on cellulite: gynoid lypodystrophy.

    Science.gov (United States)

    Smalls, Lola K; Hicks, Matthew; Passeretti, David; Gersin, Keith; Kitzmiller, W John; Bakhsh, Adel; Wickett, R Randall; Whitestone, Jennifer; Visscher, Marty O

    2006-08-01

    Gynoid lipodystrophy (cellulite) affects most women, and many seek plastic surgery consultation to improve appearance. Various products are offered, but the literature on the cause and treatment is limited. Understanding the biological and biophysical factors that affect severity may facilitate the development of effective therapies. There has been a dramatic increase in the number of people who have lost significant weight as a result of bariatric surgery or medically supervised weight programs. The effect of weight loss on cellulite severity has not been systematically studied and remains a common patient concern. The authors hypothesized that cellulite severity would decrease with weight loss and subsequent decrease in subcutaneous fat in most subjects. The authors examined the cellulite changes in female subjects who were enrolled in medically supervised weight loss programs using quantitative surface roughness by three-dimensional laser surface scanning, tissue composition by dual energy x-ray absorptiometry, dermal-subcutaneous structure with three-dimensional ultrasound, and tissue elasticity with biomechanical measurements. The majority of subjects had an improvement in cellulite with weight loss, but the condition worsened for others. Improvement was associated with significant reductions in weight and percentage of thigh fat, significantly higher starting body mass index, and significantly greater initial severity. Cellulite worsened with a significantly smaller starting body mass index, smaller reductions in weight accompanied by no change in percentage of thigh fat, and significant increases in tissue compliance. Cellulite is a complex condition, and treatments such as weight loss have variable effects on the improvement or worsening of this condition. Additional studies are required to understand how the factors that influence and modulate cellulite severity, particularly those at the level of the subcutaneous tissue septa, can be manipulated to

  4. Blogging for weight loss: personal accountability, writing selves, and the weight-loss blogosphere.

    Science.gov (United States)

    Leggatt-Cook, Chez; Chamberlain, Kerry

    2012-09-01

    Body weight is a key concern in contemporary society, with large proportions of the population attempting to control their weight. However, losing weight and maintaining weight loss is notoriously difficult, and new strategies for weight loss attract significant interest. Writing about experiences of weight loss in online journals, or blogging, has recently expanded rapidly. Weight-loss bloggers typically write about daily successes and failures, report calorie consumption and exercise output, and post photographs of their changing bodies. Many bloggers openly court the surveillance of blog readers as a motivation for accountability to their weight-loss goals. Drawing from a sample of weight-loss blogs authored by women, we explore three issues arising from this practice of disclosing a conventionally private activity within an online public domain. First, we examine motivations for blogging, focusing on accountability. Secondly, we consider the online construction of self, exploring how weight-loss bloggers negotiate discourses around fatness, and rework selves as their bodies transform. Finally, we consider the communities of interest that form around weight-loss blogs. This 'blogosphere' provides mutual support for weight loss. However, participating in online social spaces is complicated and bloggers must carefully manage issues of privacy and disclosure.

  5. Effects of metformin on weight loss: potential mechanisms.

    Science.gov (United States)

    Malin, Steven K; Kashyap, Sangeeta R

    2014-10-01

    Despite the known glucose-lowering effects of metformin, more recent clinical interest lies in its potential as a weight loss drug. Herein, we discuss the potential mechanisms by which metformin decreases appetite and opposes unfavorable fat storage in peripheral tissues. Many individuals struggle to maintain clinically relevant weight loss from lifestyle and bariatric surgery interventions. Long-term follow-up from the Diabetes Prevention Program demonstrates that metformin produces durable weight loss, and decreased food intake by metformin is the primary weight loss mechanism. Although the effect of metformin on appetite is likely to be multifactorial, changes in hypothalamic physiology, including leptin and insulin sensitivity, have been documented. In addition, novel work in obesity highlights the gastrointestinal physiology and circadian rhythm changes by metformin as not only affecting food intake, but also the regulation of fat oxidation and storage in liver, skeletal muscle, and adipose tissue. Metformin induces modest weight loss in overweight and obese individuals at risk for diabetes. A more detailed understanding of how metformin induces weight loss will likely lead to optimal co-prescription of lifestyle modification with pharmacology for the treatment of obesity independent of diabetes.

  6. Weight loss intervention before total knee arthroplasty-feasibility and safety

    DEFF Research Database (Denmark)

    Liljensøe, A.; Laursen, J. O.; Bliddal, H.

    2015-01-01

    to implement an intensive weight loss program in order to reduce preoperative body weight of obese patients before TKA surgery. The primary aim of the Weight Loss Intervention before Total Knee Arthroplasty (WITKA) study is to investigate whether weight loss interventions before total knee arthroplasty (TKA...... or a weight loss group that followed a low-energy diet (810 kcal/day) 8 weeks before surgery. Outcomes were assessed before intervention for the weight loss group, and within 1 week preoperatively for both the weight loss group and the control group. The primary outcome in the WITKA study was the Short......-Form 36 (SF-36). Secondary outcomes were Knee injury and Osteoarthritis Outcome Score (KOOS), 6 Minutes' Walk Test, and body composition. Results: Included were 77 patients (weight loss group n=38; control group n=39), 71% were females, the mean age was 65 years (range 46-85), and the average BMI was 31...

  7. The weight loss blogosphere: an online survey of weight loss bloggers.

    Science.gov (United States)

    Evans, Martinus; Faghri, Pouran D; Pagoto, Sherry L; Schneider, Kristin L; Waring, Molly E; Whited, Matthew C; Appelhans, Bradley M; Busch, Andrew; Coleman, Ailton S

    2016-09-01

    Blogging is a form of online journaling that has been increasingly used to document an attempt in weight loss. Despite the prevalence of weight loss bloggers, few studies have examined this population. We examined characteristics of weight loss bloggers and their blogs, including blogging habits, reasons for blogging, like and dislikes of blogging, and associations between blogging activity and weight loss. Participants (N = 194, 92.3 % female, mean age = 35) were recruited from Twitter and Facebook to complete an online survey. Participants reported an average weight loss of 42.3 pounds since starting to blog about their weight loss attempt. Blogging duration significantly predicted greater weight loss during blogging (β = -3.65, t(185) = -2.97, p = .003). Findings suggest that bloggers are generally successful with their weight loss attempt. Future research should explore what determines weight loss success/failure in bloggers and whether individuals desiring to lose weight would benefit from blogging.

  8. Teammates and social influence affect weight loss outcomes in a team-based weight loss competition

    OpenAIRE

    Leahey, Tricia M.; KUMAR, Rajiv; Weinberg, Brad M.; Wing, Rena R.

    2012-01-01

    Team-based Internet interventions are increasing in popularity as a way of promoting weight loss in large numbers of individuals. Given that social networks influence health behavior change, this study investigated the effects of teammates and social influence on individual weight loss during a team-based weight loss competition. Shape Up Rhode Island 2009 was a 12-week online program open to adult residents of Rhode Island. Participants joined with a team and competed with other teams on wei...

  9. [Fatigue and weight loss in Parkinson's disease].

    Science.gov (United States)

    Okuma, Yasuyuki

    2012-04-01

    Fatigue is a common, under recognized, and poorly understood nonmotor symptom in Parkinson's disease (PD). Fatigue frequently presents early in PD, and its prevalence increases with disease progression, affecting up to 60% of patients. Fatigue has a negative impact on quality of life. Fatigue is often associated with other nonmotor symptoms, including sleep disturbance, excessive daytime sleepiness, and depression. Only a few reports have been published on the treatment of fatigue in PD (methylphenidate, levodopa, and pramipexole). Further well-designed studies, including physiotherapy, are necessary to develop more effective treatments for PD-associated fatigue. A number of patients with PD lose weight because of loss of fat. However, the evolution and determinants of weight loss are not well established. Possible determinants of weight loss in PD include loss of appetite, impaired hand-mouth coordination, difficulty in chewing and dysphagia, nausea, intestinal hypomotility, and increased energy requirements because of muscular rigidity and involuntary movements. Noticeable weight gain has repeatedly been reported after subthalamic or pallidal deep brain stimulation. Because low body weight is associated with negative health effects and a poor prognosis, monitoring weight and nutritional status should be part of PD management.

  10. Gene–diet interaction and weight loss

    Science.gov (United States)

    Qi, Lu

    2017-01-01

    Purpose of review The purpose of this review is to summarize recent advances in investigations of dietary factors, genetic factors, and their interactive effects on obesity and weight loss. Recent findings Even with a tremendous body of research conducted, controversy still abounds regarding the relative effectiveness of various weight-loss diets. Recent advances in genome-wide association studies have made great strides in unraveling the genetic basis of regulation of body weight. In prospective cohorts, reproducible evidence is emerging to show interactions between genetic factors and dietary factors such as sugar-sweetened beverage on obesity. In randomized clinical trials, individuals’ genotypes have also been found to modify diet interventions on weight loss, weight maintenance, and changes in related metabolic traits such as lipids, insulin resistance, and blood pressure. However, replication, functional exploration, and translation of the findings into personalized diet interventions remain the chief challenges. Summary Preliminary but promising data have emerged to lend support to gene–diet interaction in determining weight loss and maintenance; and studies in the area hold great promise to inform future personalized diet interventions on the reduction of obesity and related health problems. PMID:24345984

  11. Perioperative visual loss after spine surgery.

    Science.gov (United States)

    Nickels, Travis J; Manlapaz, Mariel R; Farag, Ehab

    2014-04-18

    Perioperative visual loss (POVL) is an uncommon, but devastating complication that remains primarily associated with spine and cardiac surgery. The incidence and mechanisms of visual loss after surgery remain difficult to determine. According to the American Society of Anesthesiologists Postoperative Visual Loss Registry, the most common causes of POVL in spine procedures are the two different forms of ischemic optic neuropathy: anterior ischemic optic neuropathy and posterior ischemic optic neuropathy, accounting for 89% of the cases. Retinal ischemia, cortical blindness, and posterior reversible encephalopathy are also observed, but in a small minority of cases. A recent multicenter case control study has identified risk factors associated with ischemic optic neuropathy for patients undergoing prone spinal fusion surgery. These include obesity, male sex, Wilson frame use, longer anesthetic duration, greater estimated blood loss, and decreased percent colloid administration. These risk factors are thought to contribute to the elevation of venous pressure and interstitial edema, resulting in damage to the optic nerve by compression of the vessels that feed the optic nerve, venous infarction or direct mechanical compression. This review will expand on these findings as well as the recently updated American Society of Anesthesiologists practice advisory on POVL. There are no effective treatment options for POVL and the diagnosis is often irreversible, so efforts must focus on prevention and risk factor modification. The role of crystalloids versus colloids and the use of α-2 agonists to decrease intraocular pressure during prone spine surgery will also be discussed as a potential preventative strategy.

  12. Posttraumatic Stress Disorder obesity and weight loss

    DEFF Research Database (Denmark)

    Johannessen, Kim Berg; Berntsen, Dorthe

    directional. The purpose of the present study was to examine whether the level of PTSD symptoms decrease as a result of weight loss in 30 obese participants during a 16 week stay at a weight loss facility. During the 16 weeks participants’ Body Mass Index (BMI) decreased significantly. Concurrently...... of depression also declined, whereas perceived social support was stable. The fact that the level of PTSD symptoms decreases simultaneously with weight loss is an interesting and positive side effect that has not been reported previously. The findings are discussed in term of cognitive theories of PTSD.......Posttraumatic Stress Disorder (PTSD) has frequently been found to have a significant impact on the development of obesity. Yet, while a reciprocal relationship has been found between obesity and depression, the relationship between past traumatic episodes and obesity is usually thought of as uni...

  13. Quick weight loss: sorting fad from fact.

    Science.gov (United States)

    Roberts, D C

    This article reviews popular diets for their ability to produce effective weight loss. Most of the "evidence" for fad diets is based on anecdotal findings, theories and testimonials of short term results. The most prominent elements of fad diets are those of ritual and sacrifice. These diets offer quick and painless weight loss while allowing consumption of favourite or tasty foods, but place severe restrictions on certain other foods or food categories. Fad diets often work in the short term because they are low-kilojoule diets in disguise; that is, energy intake as a result of the diet is lower than the person's requirements. Successful long term weight loss depends on the consumption over a long period of time of less energy than is expended. The ideal approach is to increase physical activity while modifying eating behaviour to achieve a nutritionally balanced intake.

  14. Bariatric surgery patients’ perceptions of weight-related stigma in healthcare settings impair post-surgery dietary adherence

    Directory of Open Access Journals (Sweden)

    Danielle M. Raves

    2016-10-01

    Full Text Available Background: Weight-related stigma is reported frequently by higher body-weight patients in healthcare settings. Bariatric surgery triggers profound weight loss. This weight loss may therefore alleviate patients’ experiences of weight-related stigma within healthcare settings. In non-clinical settings, weight-related stigma is associated with weight-inducing eating patterns. Dietary adherence is a major challenge after bariatric surgery.Objectives: (1 Evaluate the relationship between weight-related stigma and post-surgical dietary adherence; (2 understand if weight loss reduces weight-related stigma, thereby improving post-surgical dietary adherence; and (3 explore provider and patient perspectives on adherence and stigma in healthcare settings. Design: This mixed methods study contrasts survey responses from 300 postoperative bariatric patients with ethnographic data based on interviews with 35 patients and extensive multi-year participant-observation within a clinic setting. The survey measured experiences of weight-related stigma, including from healthcare professionals, on the Interpersonal Sources of Weight Stigma scale and internalized stigma based on the Weight Bias Internalization Scale. Dietary adherence measures included patient self-reports, non-disordered eating patterns reported on the Disordered Eating after Bariatric Surgery scale, and food frequencies. Regression was used to assess the relationships among post-surgical stigma, dietary adherence, and weight loss. Qualitative analyses consisted of thematic analysis.Results: The quantitative data show that internalized stigma and general experiences of weight-related stigma predict worse dietary adherence, even after weight is lost. The qualitative data show patients did not generally recognize this connection, and health professionals explained it as poor patient compliance.Conclusion: Reducing perceptions of weight-related stigma in healthcare settings and weight bias

  15. Does bone loss begin after weight loss ends? Results 2 years after weight loss or regain in postmenopausal women.

    Science.gov (United States)

    Von Thun, Nancy L; Sukumar, Deeptha; Heymsfield, Steven B; Shapses, Sue A

    2014-05-01

    Short-term weight loss is accompanied by bone loss in postmenopausal women. The longer-term impact of weight loss on bone in reduced overweight/obese women compared with women who regained their weight was examined in this study using a case-control design. Postmenopausal women (N = 42; mean [SD] body mass index, 28.3 [2.8] kg/m; mean [SD] age, 60.7 [5.5] y) were recruited 2 years after the start of a 6-month weight loss trial; those who maintained their weight (weight loss maintainer [WL-M] group) were matched to a cohort of women who regained their weight (weight loss regainer [WL-R] group). Serum hormones and bone markers were measured in a subset. Bone mineral density (BMD) at the femoral neck, trochanter, spine, radius, and total body, and soft-tissue composition were taken at baseline, 0.5 years, and 2 years. During weight loss, both groups lost 9.3% (3.4%) of body weight, with no significant difference between the groups. After weight loss, weight change was -0.1% (2.7%) and 6.0% (3.3%) in the WL-M (n = 22) and WL-R (n = 20) groups, respectively. After 2 years, both groups lost BMD at the femoral neck and trochanter (P ≤ 0.01), whereas only the WL-M group reduced BMD at the 1/3 radius (P weight reduction-induced bone loss, irrespective of weight regain. These data suggest that the period after weight loss may be an important point in time to prevent bone loss for those who maintain weight and those who regain weight.

  16. 消化道恶性肿瘤手术后体重下降的原因与护理对策%The Digestive Tract Malignant Tumor the Causes and Nursing Countermeasures of Weight Loss after the Surgery

    Institute of Scientific and Technical Information of China (English)

    张桂凌

    2015-01-01

    Objective To observe the analysis of the digestive tract malignant tumor weight loss, the cause of postoperative nursing countermeasures are put forward. Methods General care for two groups of the same. Observation group to develop special psychological nursing, diet guidance plan. Results Observation group: weight loss < 2 kg10 cases (15.87%), 2 ~ 5 kg48 cases (76.14%), more than 5 kg in 5 cases (7.93%). Control group:weight loss < 2 kg 5 cases (7.93%), 2 ~ 5 kg 50 cases (79.35%), more than 5 kg of 8 cases (12.69%); After statistics processing, there was a significant difference (P < 0.01). Conclusion (1)The digestive tract malignant tumor weight loss after the surgery and psychological factors, surgical trauma, poor diet and so on; (2)Strengthen the psychological nursing, diet guidance to patients recovery.%目的:观察分析消化道恶性肿瘤术后体重下降的原因,提出护理对策。方法两组一般护理相同。观察组制定特殊心理护理,饮食指导计划。结果观察组:体重下降<2 kg 10例(15.87%),2~5 kg 48例(76.14%),5 kg 以上5例(7.93%);对照组:体重下降<2 kg 5例(7.93%), 2~5 kg 50例(79.35%),5 kg 以上 8例(12.69%);经统计学处理,有显著差异性(P<0.01)。结论(1)消化道恶性肿瘤手术后体重下降与心理因素,手术创伤、饮食欠佳等有关;(2)加强心理护理,饮食指导有利于患者体能恢复。

  17. Posttraumatic Stress Disorder, obesity, and weight loss

    DEFF Research Database (Denmark)

    Johannessen, Kim Berg; Berntsen, Dorthe

    -symptoms would decrease as a result of weight loss in obese participants during a 16 week stay at a weight loss facility. During the 16 weeks participants’ Body Mass Index (BMI) decreased significantly. Concurrently, a significant decline in the level of PTSD symptoms was also reported. During the first week......Posttraumatic Stress Disorder (PTSD) has frequently been found to have an impact on the development of obesity, with the relationship between past traumatic episodes and obesity usually thought of as uni-directional. The purpose of the present study was to examine whether the level of PTSD...

  18. Ventricular Tachycardia Induced by Weight Loss Pills

    Directory of Open Access Journals (Sweden)

    Manan Pareek

    2013-01-01

    Full Text Available A previously healthy 29-year-old man was admitted with palpitations, dizziness, and near-syncope after he had recently started taking weight loss pills purchased on the internet. The pills contained caffeine and ephedrine. An electrocardiogram and telemetry revealed multiple episodes of non-sustained monomorphic ventricular tachycardia, which was successfully treated with amiodarone. In conclusion, unauthorized weight loss pills can be harmful. In particular, ephedrine-containing drugs carry a risk of ventricular tachycardia and should be discouraged.

  19. Fasting glycemia: a good predictor of weight loss after RYGB.

    Science.gov (United States)

    Faria, Gil; Preto, John; Almeida, Ana Beatriz; Guimarães, João Tiago; Calhau, Conceição; Taveira-Gomes, António

    2014-01-01

    Preoperative prediction of weight loss after Roux-en-Y gastric bypass (RYGB) could help surgeons in managing surgical lists and patients' expectations. The objective of this study was to understand if preoperative metabolic control might improve surgical results. Prospective cohort of 163 consecutive patients who underwent RYGB with at least 1 year of follow-up. Most patients were female (90.2%), with a mean age of 38 (19-60) and a BMI of 46.0 (34.3-59.9) kg/m(2). After 12 months, the mean body mass index (BMI) was 29.7 kg/m(2) (21.5-39.9) with a corresponding percentage of excess weight lost (%EWL) of 78.8% and a percentage of weight loss (%WL) of 35.1%. Patients with the highest preoperative fasting blood glucose (FBG) were older (42 versus 36; Pmetabolic syndrome (89% versus 25%; Presponse effect with increasing FBG (100, were the only variables related (inversely) with the probability of achieving a %EWL>80 or %WL>35. This effect was not detected in patients receiving oral antidiabetic medications. Higher preoperative FBG is independently related to a poorer weight loss 12 months after RYGB; this suggests the need to offer earlier surgical intervention for severely obese patients with impairment of glucose metabolism. The potential for less weight loss in patients with a higher FBG should not discourage RYGB, given the significant metabolic improvement after surgery. © 2013 American Society for Bariatric Surgery Published by American Society for Metabolic and Bariatric Surgery All rights reserved.

  20. Visual loss after spine surgery: Case report.

    Science.gov (United States)

    Cobar-Bustamante, Andrés E; Cahueque, Mario A; Caldera, Gustavo

    2016-12-01

    The presence of postoperative visual loss is a well-known complication, and described in various reports, its low incidence (0.028-0.2%) makes it extremely rare. Two main causes have been determined: Posterior Ischemic Optic Neuropathy and central Retinal Artery Oclusion. The following is a case report of a 52-year-old patient that presented visual loss after elective spine surgery that had no complications that could initially explain this complication. Studies were performed and evaluations by ophthalmologists determined that the cause of Posterior Ischemic Optic Neuropathy due to multiple risk factors that the patient had previously and during the surgery. After 3 year follow-up the patient still has total visual loss and no other complications were reported.

  1. Weight Loss Leads to Strong Increase in Appetite

    Science.gov (United States)

    ... News Releases Media Advisory Friday, October 14, 2016 Weight loss leads to strong increase in appetite Study with ... changes in caloric expenditure that typically accompany weight loss — and weight loss plateau. Findings from the analyses suggest that ...

  2. Cumulative Weight Exposure Is Associated with Different Weight Loss Strategies and Weight Loss Success in Adults Age 50 or Above

    OpenAIRE

    Martin Sénéchal; Jana Slaght; Bouchard, Danielle R.

    2015-01-01

    Objectives. To evaluate if cumulative weight exposure is associated with weight loss strategy choices and weight loss success. Methods. Data from the National Health and Nutrition Examination Survey were used; a total of 4,562 people age 50 years or older who reported trying to lose weight in the last year were studied. Cumulative weight exposure (CWE) score was defined as the sum of body mass index points above 25 kg/m2 at the age of 25, 10 years ago, 1 year ago, and now. Weight loss strateg...

  3. The defence of body weight: a physiological basis for weight regain after weight loss.

    Science.gov (United States)

    Sumithran, Priya; Proietto, Joseph

    2013-02-01

    Although weight loss can usually be achieved by restricting food intake, the majority of dieters regain weight over the long-term. In the hypothalamus, hormonal signals from the gastrointestinal tract, adipose tissue and other peripheral sites are integrated to influence appetite and energy expenditure. Diet-induced weight loss is accompanied by several physiological changes which encourage weight regain, including alterations in energy expenditure, substrate metabolism and hormone pathways involved in appetite regulation, many of which persist beyond the initial weight loss period. Safe effective long-term strategies to overcome these physiological changes are needed to help facilitate maintenance of weight loss. The present review, which focuses on data from human studies, begins with an outline of body weight regulation to provide the context for the subsequent discussion of short- and long-term physiological changes which accompany diet-induced weight loss.

  4. Bariatric surgery, bone loss, obesity and possible mechanisms.

    Science.gov (United States)

    Brzozowska, M M; Sainsbury, A; Eisman, J A; Baldock, P A; Center, J R

    2013-01-01

    Bariatric surgery remains the most effective treatment for severely obese patients. However, the potential long-term effects of bariatric surgical procedures on health, including bone health, are only partially understood. The goal of this review was to present data on the impact of bariatric surgery on bone metabolism and to analyse possible reasons for the loss of bone mass that frequently occurs after bariatric surgery. Such factors include nutritional deficiencies, rapid weight loss per se, effects of fat-derived adipokines and gut-derived appetite-regulatory hormones. However, the relative roles of these factors in skeletal regulation and the mechanisms by which they work are not yet fully defined. Our review was focussed on the complex relationship between body weight, fat mass and bone mass, as well as peripheral and central mediators potentially involved in the dual regulation of both energy and bone homeostasis. We also review the data on the inverse relationship between central obesity, bone marrow fat and osteoporosis. As the number of bariatric operations increases, it is imperative to recognize mechanisms responsible for bariatric surgery-induced bone loss, with careful monitoring of bone health including long-term fracture incidence in patients undergoing these procedures. © 2012 The Authors. obesity reviews © 2012 International Association for the Study of Obesity.

  5. Global warming: is weight loss a solution?

    Science.gov (United States)

    Gryka, A; Broom, J; Rolland, C

    2012-03-01

    The current climate change has been most likely caused by the increased greenhouse gas emissions. We have looked at the major greenhouse gas, carbon dioxide (CO(2)), and estimated the reduction in the CO(2) emissions that would occur with the theoretical global weight loss. The calculations were based on our previous weight loss study, investigating the effects of a low-carbohydrate diet on body weight, body composition and resting metabolic rate of obese volunteers with type 2 diabetes. At 6 months, we observed decreases in weight, fat mass, fat free mass and CO(2) production. We estimated that a 10 kg weight loss of all obese and overweight people would result in a decrease of 49.560 Mt of CO(2) per year, which would equal to 0.2% of the CO(2) emitted globally in 2007. This reduction could help meet the CO(2) emission reduction targets and unquestionably would be of a great benefit to the global health.

  6. Effect of weight loss on urinary incontinence in women

    Directory of Open Access Journals (Sweden)

    Whitcomb EL

    2011-08-01

    Full Text Available Emily L Whitcomb1, Leslee L Subak21Southern California Permanente Medical Group, Female Pelvic Medicine and Reconstructive Surgery, Orange County-Irvine Medical Center, Irvine, CA, USA; 2University of California San Francisco, UCSF Departments of Obstetrics, Gynecology and Reproductive Sciences, and Urology, and Epidemiology and Biostatistics, SF Veterans Affairs Medical Center, San Francisco, CA, USABackground: The purpose of this research was review the epidemiology of the association of obesity and urinary incontinence, and to summarize the published data on the effect of weight loss on urinary incontinence.Methods: A literature review of the association between urinary incontinence and overweight/obesity in women was performed. Case series and clinical trials reporting the effect of surgical, behavioral, and/or pharmacological weight loss on urinary incontinence are summarized.Results: Epidemiological studies demonstrate that obesity is a strong and independent risk factor for prevalent and incident urinary incontinence. There is a clear dose-response effect of weight on urinary incontinence, with each 5-unit increase in body mass index associated with a 20%–70% increase in risk of urinary incontinence. The maximum effect of weight on urinary incontinence has an odds ratio of 4–5. The odds of incident urinary incontinence over 5–10 years increase by approximately 30%–60% for each 5-unit increase in body mass index. There appears to be a stronger association between increasing weight and prevalent and incident stress incontinence (including mixed incontinence than for urge incontinence. Weight loss studies indicate that both surgical and nonsurgical weight loss leads to significant improvements in prevalence, frequency, and/or symptoms of urinary incontinence.Conclusion: Epidemiological studies document overweight and obesity as important risk factors for urinary incontinence. Weight loss by both surgical and more conservative

  7. PREDICTORS FOR WEIGHT LOSS FAILURE FOLLOWING ROUX-EN-Y GASTRIC BYPASS

    Directory of Open Access Journals (Sweden)

    Everton CAZZO

    2014-12-01

    Full Text Available Context Weight loss failure is a widely recognized occurrence following Roux-en-Y gastric bypass. Objectives This study aims to identify predictors associated with weight loss failure. Methods It is a retrospective cohort which enrolled 187 subjects who underwent RYGB. Comparisons were made between patients’ features at baseline and 24 months after surgery. Results A weight loss failure rate of 11.2% was found. Advanced age and diabetes were statistically associated with failure. Conclusions The results found were close to previous reports. As weight loss failure represents an important concern, there is the possibility to perform revisional surgeries, which may emphasize the restrictive or malabsorptive characteristics of RYGB, leading to varied results. It is reinforced that weight loss cannot be used as the unique outcome to evaluate the success of surgery.

  8. Food addiction in adults seeking weight loss treatment. Implications for psychosocial health and weight loss.

    Science.gov (United States)

    Burmeister, Jacob M; Hinman, Nova; Koball, Afton; Hoffmann, Debra A; Carels, Robert A

    2013-01-01

    The present study examined food addiction symptomology and its relationship to eating pathology and psychological distress among adults seeking weight loss treatment. A primary interest was an examination of the relationship between food addiction symptoms and short-term weight loss. Adults beginning a behavioral weight loss program (N=57) were given the Yale Food Addiction Scale (YFAS) as well as measures of psychological distress, disordered eating, weight bias, and weight-focused attitudes. Weight loss was measured after 7 weeks. Severity of food addiction was related to increased depression, emotional eating, binge eating, anti-fat attitudes, internalized weight bias, body shame, and low eating self-efficacy, but not body satisfaction. Increased food addiction symptomology was also related to less weight lost at 7 weeks. Findings suggest that individuals attempting to lose weight while combating symptoms of food addiction may be especially prone to eating-related pathologies, internalized weight bias, and body shame. Importantly, findings provide evidence that food addiction may undermine efforts to lose weight. The pathology associated with addiction (e.g., tolerance, withdrawal) could make the adoption of more healthful eating habits especially difficult.

  9. When obese people are more patient than non-obese people. A study of post-surgery individuals in a weight loss association

    Directory of Open Access Journals (Sweden)

    Budría, Santiago

    2012-03-01

    Full Text Available The main goal of this article is to investigate the rates of delay discounting among obese people treated surgically and belonging to an association of those interested in controlling their weight. We also analyze whether socio-economic status and personality traits explain the existing differences. rates of delay discounting are elicited using real monetary incentives in an economic experiment where subjects are asked to make several choices between a smaller, more immediate reward and larger, more delayed rewards. personality traits are examined using the Five Factor model. interestingly, our results show that obese people display lower discount rates than the reference group. these differences can not be explained by personality traits. We argue that obese people do not have to show larger discount rates. in fact, awareness and commitment, rather than their current bmi, seem to play a more important role in determining this parameter.

    El objetivo principal de este artículo es investigar las tasas de descuento temporal entre los individuos obesos tratados quirúrgicamente y que pertenecen a una asociación de personas interesadas en controlar su peso. también se analiza si el nivel socio-económico y los rasgos de la personalidad explican las diferencias existentes. las tasas de descuento diferido se obtuvieron utilizando los incentivos monetarios reales en un experimento económico donde a los sujetos se les pide elegir entre una menor y más inmediata recompensa o una recompensa mayor diferida. los rasgos de personalidad son examinados usando el modelo de cinco factores. Curiosamente, nuestros resultados muestran que las personas obesas muestran tasa de descuento menores al grupo de referencia. estas diferencias no pueden explicarse por los rasgos de personalidad. Nosotros sostenemos que la gente obesa no debería mostrar mayores tasas de descuento. De hecho, la conciencia y el compromiso, en lugar de su actual índice de masa

  10. Obesity, growth hormone and weight loss

    DEFF Research Database (Denmark)

    Rasmussen, Michael Højby

    2009-01-01

    in particular results in a secondary reduction in GH secretion and subnormal insulin-like growth factor-I (IGF-I) levels. The recovery of the GH IGF-I axis after weight loss suggest an acquired defect, however, the pathophysiologic role of GH in obesity is yet to be fully understood. In clinical studies...... examining the efficacy of GH in obese subjects very little or no effect are observed with respect to weight loss, whereas GH seems to reduce total and abdominal fat mass in obese subjects. The observed reductions in abdominal fat mass are modest and similar to what can be achieved by diet or exercise...... profile and bone mineral density. It is well established that adult GHD usually is accompanied by an increase in fat accumulation and GH replacement in adult patients with GHD results in reduction of fat mass and abdominal fat mass in particular. It is also recognized that obesity and abdominal obesity...

  11. Does Spirituality Predict Weight Loss In A Behavioral Weight Loss Program?

    Science.gov (United States)

    2009-01-01

    body mass” (CDC, 2002; Stunkard & Wadden, 1993, p. 14). Excess body fat can be assessed by a variety of methods including skinfold thickness ...African American women. SPIRITUALITY AND WEIGHT LOSS 6 Table of Contents Abstract...45 Tables & Figures

  12. Major depression and severe weight loss

    Directory of Open Access Journals (Sweden)

    Ntrogkounta Α.

    2015-10-01

    Full Text Available Α 25-year old patient was referred to the casualty department of the Community Mental Health Center of Central Sector of Thessaloniki from the emergency department of the Psychiatric Hospital of Thessaloniki, in order to manage symptoms of depression as long as her life- threating loss of weight. A. appeared to have depressive feelings, lack of appetite, lack of interest, withdrawal, sleep disorders, sexual disorders, low self-esteem and ideas of guilt. There were held 27 conferences. In the beginning there were supportive intervations in order to improve the depressive symptoms and to gain weight. Moreover we applied medication (SSRI's that after 6 months was stopped gradually, without any setback. There was an increase of weight, about 10 kg, which remained until the follow up one year later.

  13. Body weight loss reverts obesity-associated hypogonadotropic hypogonadism: a systematic review and meta-analysis.

    Science.gov (United States)

    Corona, Giovanni; Rastrelli, Giulia; Monami, Matteo; Saad, Farid; Luconi, Michaela; Lucchese, Marcello; Facchiano, Enrico; Sforza, Alessandra; Forti, Gianni; Mannucci, Edoardo; Maggi, Mario

    2013-06-01

    Few randomized clinical studies have evaluated the impact of diet and physical activity on testosterone levels in obese men with conflicting results. Conversely, studies on bariatric surgery in men generally have shown an increase in testosterone levels. The aim of this study is to perform a systematic review and meta-analysis of available trials on the effect of body weight loss on sex hormones levels. Meta-analysis. An extensive Medline search was performed including the following words: 'testosterone', 'diet', 'weight loss', 'bariatric surgery', and 'males'. The search was restricted to data from January 1, 1969 up to August 31, 2012. Out of 266 retrieved articles, 24 were included in the study. Of the latter, 22 evaluated the effect of diet or bariatric surgery, whereas two compared diet and bariatric surgery. Overall, both a low-calorie diet and bariatric surgery are associated with a significant (Pweight as well as in younger, non-diabetic subjects with a greater degree of obesity. Body weight loss is also associated with a decrease in estradiol and an increase in gonadotropins levels. Multiple regression analysis shows that the degree of body weight loss is the best determinant of TT rise (B=2.50±0.98, P=0.029). These data show that weight loss is associated with an increase in both bound and unbound testosterone levels. The normalization of sex hormones induced by body weight loss is a possible mechanism contributing to the beneficial effects of surgery in morbid obesity.

  14. Removal of excess skin after massive weight loss: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Giordano S

    2015-06-01

    Full Text Available Salvatore Giordano Department of Plastic and General Surgery, Turku University Hospital, Turku, Finland Abstract: The advent of bariatric surgery has led to a subspecialty in plastic surgery for skin and fat contouring which remain after massive weight loss. The author discusses the preoperative assessment, surgical treatment plan, postoperative management, possible complications, and benefits of postbariatric surgery. Preoperative planning includes medical history and patient assessment. Surgical procedures for brachioplasty, upper back lift, breast reshaping, abdominoplasty, panniculectomy, lower back lift, and thigh lift are discussed. Indications, postoperative complications, and benefits are also discussed. The best candidates for postbariatric plastic surgery are those who have achieved weight loss stability with a BMI of 32 or less and who have adequate nutrition in order to heal the surgical excisions. Abdominal and truncal deformity are the most common presenting complaints in massive weight loss patients, and the procedure of choice to address this region is a body lift. Postoperative care focuses on patient safety, prioritizing in deep venous thrombosis (DVT prophylaxis and seroma prevention. Postbariatric body contouring aims to correct the deformity due to the excess of skin after massive weight loss and to restore a sense of normalcy. Keywords: morbid obesity, bariatric surgery, weight loss, massive weight loss, body contouring, panniculectomy

  15. Human colonic microbiota associated with diet, obesity and weight loss

    National Research Council Canada - National Science Library

    Duncan, S H; Lobley, G E; Holtrop, G; Ince, J; Johnstone, A M; Louis, P; Flint, H J

    2008-01-01

    ...) in obese and non-obese subjects under conditions of weight maintenance, and in obese male volunteers undergoing weight loss on two different reduced carbohydrate weight-loss diets given successively for 4 weeks each...

  16. Vegetable and fruit consumption during weight loss is positively correlated with weight and fat loss

    Science.gov (United States)

    Background: Recommendations to increase vegetable and fruit consumption often accompany guidelines for weight loss. A previous study indicated that people who were instructed to count calories lost more weight than those simply instructed to increase vegetable and fruit intake. Objective: The object...

  17. Increased vegetable and fruit consumption during weight loss effort correlates with increased weight and fat loss

    Science.gov (United States)

    Recommendations to increase vegetable and fruit consumption often accompany guidelines for weight loss. A previous study indicated that people who were instructed to count calories lost more weight than those simply instructed to increase vegetable and fruit intake. The objective was to determine if...

  18. The relationship between prevalence and duration of weight loss strategies and weight loss among overweight managed care organization members enrolled in a weight loss trial

    Directory of Open Access Journals (Sweden)

    Jeffery Robert W

    2006-02-01

    Full Text Available Abstract Background Many adults in the United States report engaging in weight loss behaviors. The current study examined weight loss strategies among managed care organization members, to determine the prevalence and impact of weight loss behaviors in this population. We hypothesized that greater engagement in weight loss strategies would be associated with greater weight loss success. Methods Data were taken from Weigh-to-Be (WTB, a two-year weight loss trial (N = 1801, 72% female, mean age = 50.7 years, mean weight = 95.9 kg, mean BMI = 34.2 kg/m2. Every six months, participants completed a questionnaire assessing frequency and duration of weight loss strategies (calorie reduction, fat reduction, increased fruit/vegetable intake, increased exercise, elimination of sweets, consumption of less food. General linear models and structural equation methods were used to examine associations between weight loss strategy use and weight change over time. Results Weight loss strategy prevalence rates ranged from 68% to 76% over two years. For all dietary strategies, any use of the strategy between baseline and 24 months was associated with weight loss at 24 months; those who did not engage in the strategy showed weight gains during that period. Results of general linear models and structural equation models indicated that increased use of weight loss strategies was significantly associated with greater 24-month weight loss. Conclusion The prevalence of weight loss strategies in this obese adult managed care population was quite high, and use of these strategies was associated in dose-response fashion with better weight loss. Future interventions may benefit from emphasis on persistence of similar strategies to achieve more successful outcomes.

  19. Life after weight-loss surgery

    Science.gov (United States)

    ... changes in your life. These include the way you eat, what you eat, when you eat, how you feel about yourself, and much more. ... foods may cause some pain or discomfort when you eat them if they are not chewed well. These ...

  20. Weight Loss Surgery: An Option for Teens?

    Science.gov (United States)

    ... Genitals and Urinary Tract Glands & Growth Head Neck & Nervous System Heart Infections Learning Disabilities Obesity Orthopedic Prevention Sexually Transmitted Skin Tobacco Treatments Injuries & ...

  1. Adherence to a behavioral weight loss treatment program enhances weight loss and improvements in biomarkers.

    Science.gov (United States)

    Acharya, Sushama D; Elci, Okan U; Sereika, Susan M; Music, Edvin; Styn, Mindi A; Turk, Melanie Warziski; Burke, Lora E

    2009-11-03

    To describe participants' adherence to multiple components (attendance, energy intake, fat gram, exercise goals, and self-monitoring eating and exercise behaviors) of a standard behavioral treatment program (SBT) for weight loss and how adherence to these components may influence weight loss and biomarkers (triglycerides, low density lipoproteins [LDL], high density lipoprotein, and insulin) during the intensive and less-intensive intervention phases. A secondary analysis of a randomized clinical trial consisting of a SBT with either fat-restricted standard or lacto-ovo vegetarian diet. The 12-month intervention was delivered in 33 group sessions. The first six months reflected the intensive phase; the second six months, the less-intensive intervention phase. We conducted the analysis without regard to treatment assignment. Eligible participants included overweight/obese adults (N = 176; mean body mass index = 34.0 kg/m(2)). The sample was 86.9% female, 70.5% White, and 44.4 +/- 8.6 years old. The outcome measures included weight and biomarkers. There was a significant decline in adherence to each treatment component over time (P adherence to attendance, self-monitoring and the energy goal were significantly associated with greater weight loss (P Adherence to attendance and exercise remained significantly associated with weight loss in the second six months (P Adherence to attendance, self-monitoring and exercise had indirect effects through weight loss on LDL, triglycerides, and insulin (P adherence to each treatment component as the intervention intensity was reduced. Adherence to multiple treatment components was associated with greater weight loss and improvements in biomarkers. Future research needs to focus on improving and maintaining adherence to all components of the treatment protocol to promote weight loss and maintenance.

  2. Brain responses to food and weight loss.

    Science.gov (United States)

    Behary, Preeshila; Miras, Alexander D

    2014-09-01

    In this symposium report, we examine how functional neuroimaging has revolutionized the study of human eating behaviour. In the last 20 years, functional magnetic resonance and positron emission tomography techniques have enabled researchers to understand how the human brain regions that control homeostatic and hedonic eating respond to food in physiological and pathological states. Hypothalamic, brainstem, limbic and cortical brain areas form part of a well-co-ordinated brain system that responds to central and peripheral neuronal, hormonal and nutrient signals. Even in physiological conditions, it promotes the consumption of energy-dense food, because this is advantageous in evolutionary terms. Its function is dysregulated in the context of obesity so as to promote weight gain and resist weight loss. Pharmacological and bariatric surgical interventions might be more successful than lifestyle interventions in inducing weight loss and maintenance because, unlike dieting, they reduce not only hunger but also the reward value of food through their actions in homeostatic and hedonic brain regions. Functional neuroimaging is a research tool that cannot be used in isolation; its findings become meaningful and useful only when combined with data from direct measures of eating behaviour. The neuroimaging technology is continuously improving and is expected to contribute further to the in-depth understanding of the obesity phenotype and accelerate the development of more effective and safer treatments for the condition.

  3. Bariatric Surgery

    Science.gov (United States)

    ... Metabolic and Bariatric Surgery MedlinePlus What is bariatric surgery? Bariatric surgery helps people who are very obese to ... What are the endocrine-related benefits of bariatric surgery? Bariatric surgery and the weight loss that results can: ...

  4. Acute Vision Loss Following Endoscopic Sinus Surgery

    Science.gov (United States)

    Antisdel, Jastin

    2017-01-01

    A 41-year-old female with a history of uterine cancer and Celiac and Raynaud's Disease presented to our institution with frequent migraines and nasal congestion. She underwent functional endoscopic sinus surgery (FESS) and experienced acute unilateral vision loss postoperatively. Rapid recognition of the etiology and effective treatment are paramount given the permanent and irreversible vision loss that can result. Arterial vasospasm following FESS is rare. Patients with autoimmune diseases have perhaps an increased risk for vasospasm secondary to an increased vasoreactive profile. We present the first documented case of nitroglycerin sublingual therapy to successfully treat ophthalmic artery vasospasm following FESS. Nitroglycerin sublingual therapy is a promising treatment for ophthalmic vasospasm secondary to its ability to cross the blood-ocular barrier, its rapid onset of action, and its ability to promote relaxation of vascular smooth muscle.

  5. Acute Vision Loss Following Endoscopic Sinus Surgery

    Directory of Open Access Journals (Sweden)

    Serena Byrd

    2017-01-01

    Full Text Available A 41-year-old female with a history of uterine cancer and Celiac and Raynaud’s Disease presented to our institution with frequent migraines and nasal congestion. She underwent functional endoscopic sinus surgery (FESS and experienced acute unilateral vision loss postoperatively. Rapid recognition of the etiology and effective treatment are paramount given the permanent and irreversible vision loss that can result. Arterial vasospasm following FESS is rare. Patients with autoimmune diseases have perhaps an increased risk for vasospasm secondary to an increased vasoreactive profile. We present the first documented case of nitroglycerin sublingual therapy to successfully treat ophthalmic artery vasospasm following FESS. Nitroglycerin sublingual therapy is a promising treatment for ophthalmic vasospasm secondary to its ability to cross the blood-ocular barrier, its rapid onset of action, and its ability to promote relaxation of vascular smooth muscle.

  6. Psychological characteristics, eating behavior, and quality of life assessment of obese patients undergoing weight loss interventions.

    Science.gov (United States)

    Miras, A D; Al-Najim, W; Jackson, S N; McGirr, J; Cotter, L; Tharakan, G; Vusirikala, A; le Roux, C W; Prechtl, C G; Scholtz, S

    2015-03-01

    Bariatric surgery is the most effective treatment for obesity. However, not all patients have similar weight loss following surgery and many researchers have attributed this to different pre-operative psychological, eating behavior, or quality-of-life factors. The aim of this study was to determine whether there are any differences in these factors between patients electing to have bariatric surgery compared to less invasive non-surgical weight loss treatments, between patients choosing a particular bariatric surgery procedure, and to identify whether these factors predict weight loss after bariatric surgery. This was a prospective study of 90 patients undergoing gastric bypass, vertical sleeve gastrectomy, or adjustable gastric banding and 36 patients undergoing pharmacotherapy or lifestyle interventions. All patients completed seven multi-factorial psychological, eating behavior, and quality-of-life questionnaires prior to choosing their weight loss treatment. Questionnaire scores, baseline body mass index, and percent weight loss at 1 year after surgical interventions were recorded. Surgical patients were younger, had a higher body mass index, and obesity had a higher impact on their quality of life than on non-surgical patients, but they did not differ in the majority of eating behavior and psychological parameters studied. Patients opting for adjustable gastric banding surgery were more anxious, depressed, and had more problems with energy levels than those choosing vertical sleeve gastrectomy, and more work problems compared to those undergoing gastric bypass. Weight loss after bariatric surgery was predicted by pre-operative scores of dietary restraint, disinhibition, and pre-surgery energy levels. The results of this study generate a number of hypotheses that can be explored in future studies and accelerate the development of personalized weight loss treatments. © The Finnish Surgical Society 2014.

  7. Determinants of Weight Loss prior to Diagnosis in Inflammatory Bowel Disease: A Retrospective Observational Study

    Directory of Open Access Journals (Sweden)

    Yasser Elsherif

    2014-01-01

    Full Text Available Aims. To identify prevalence, severity, and environmental determinants of weight loss in inflammatory bowel disease (IBD patients just prior to time of formal diagnosis. Methodology. IBD patients attending outpatient clinic were questioned about weight loss prior to diagnosis and other environmental and demographic variables. The percentage BMI loss was calculated for each subject and factors associated with weight loss were determined. Results. Four hundred and ninety-four subjects were recruited (237 cases of Crohn’s disease (CD and 257 cases of ulcerative colitis (UC. Overall, 57% of subjects with CD and 51% of subjects with UC experienced significant weight loss prior to diagnosis (>5% BMI loss. Younger age at diagnosis and history of previous IBD surgery were significantly associated with both lower BMI at diagnosis and increased weight loss prior to diagnosis. In CD patients, increasing age at diagnosis was inversely associated with weight loss prior to diagnosis. Ileal disease was a risk factor of weight loss, whereas prior appendectomy was associated with reduced risk of weight loss. Conclusions. Weight loss is a significant problem for many IBD patients at presentation, especially in younger age and CD with ileal involvement. Appendectomy is associated with diminished weight loss.

  8. Exercise for Weight Loss: Calories Burned in One Hour

    Science.gov (United States)

    Healthy Lifestyle Weight loss By Mayo Clinic Staff Being active is an important part of any weight-loss or weight-maintenance program. When you're active, ... may need to be decreased further to continue weight loss. Both are important. However, while diet has a ...

  9. Obesity, growth hormone and weight loss.

    Science.gov (United States)

    Rasmussen, Michael Højby

    2010-03-25

    Growth hormone (GH) is the most important hormonal regulator of postnatal longitudinal growth in man. In adults GH is no longer needed for longitudinal growth. Adults with growth hormone deficiency (GHD) are characterised by perturbations in body composition, lipid metabolism, cardiovascular risk profile and bone mineral density. It is well established that adult GHD usually is accompanied by an increase in fat accumulation and GH replacement in adult patients with GHD results in reduction of fat mass and abdominal fat mass in particular. It is also recognized that obesity and abdominal obesity in particular results in a secondary reduction in GH secretion and subnormal insulin-like growth factor-I (IGF-I) levels. The recovery of the GH IGF-I axis after weight loss suggest an acquired defect, however, the pathophysiologic role of GH in obesity is yet to be fully understood. In clinical studies examining the efficacy of GH in obese subjects very little or no effect are observed with respect to weight loss, whereas GH seems to reduce total and abdominal fat mass in obese subjects. The observed reductions in abdominal fat mass are modest and similar to what can be achieved by diet or exercise interventions.

  10. Delay discounting and utility for money or weight loss.

    Science.gov (United States)

    Sze, Y Y; Slaven, E M; Bickel, W K; Epstein, L H

    2017-03-01

    Obesity is related to a bias towards smaller immediate over larger delayed rewards. This bias is typically examined by studying single commodity discounting. However, weight loss often involves choices among multiple commodities. To our knowledge, no research has examined delay discounting of delayed weight loss compared with other commodities. We examined single commodity discounting of money and cross commodity discounting of money and weight loss in a sample of 84 adults with obesity or overweight statuses interested in weight loss. The exchange rate between money and weight loss was calculated, and participants completed two delay discounting tasks: money now versus money later and money now versus weight loss later. Participants discounted weight loss more than money (p commodity discounting, and greater discounting of weight loss across all participants provide insight on important challenges for weight control.

  11. Superior appetite hormone profile after equivalent weight loss by gastric bypass compared to gastric banding.

    Science.gov (United States)

    Bose, Mousumi; Machineni, Sriram; Oliván, Blanca; Teixeira, Julio; McGinty, James J; Bawa, Baani; Koshy, Ninan; Colarusso, Antonia; Laferrère, Blandine

    2010-06-01

    The goal of this study was to understand the mechanisms of greater weight loss by gastric bypass (GBP) compared to gastric banding (GB) surgery. Obese weight- and age-matched subjects were studied before (T0), after a 12 kg weight loss (T1) by GBP (n = 11) or GB (n = 9), and at 1 year after surgery (T2). peptide YY(3-36) (PYY(3-36)), ghrelin, glucagon-like peptide-1 (GLP-1), leptin, and amylin were measured after an oral glucose challenge. At T1, glucose-stimulated GLP-1 and PYY levels increased significantly after GBP but not GB. Ghrelin levels did not change significantly after either surgery. In spite of equivalent weight loss, leptin and amylin decreased after GBP, but not after GB. At T2, weight loss was greater after GBP than GB (P = 0.003). GLP-1, PYY, and amylin levels did not significantly change from T1 to T2; leptin levels continued to decrease after GBP, but not after GB at T2. Surprisingly, ghrelin area under the curve (AUC) increased 1 year after GBP (P = 0.03). These data show that, at equivalent weight loss, favorable GLP-1 and PYY changes occur after GBP, but not GB, and could explain the difference in weight loss at 1 year. Mechanisms other than weight loss may explain changes of leptin and amylin after GBP.

  12. Metabolic adaptation to weight loss: implications for the athlete

    National Research Council Canada - National Science Library

    Trexler, Eric T; Smith-Ryan, Abbie E; Norton, Layne E

    2014-01-01

    .... Energy restriction is accompanied by changes in circulating hormones, mitochondrial efficiency, and energy expenditure that serve to minimize the energy deficit, attenuate weight loss, and promote weight regain...

  13. Healthy Weight: Healthy Weight Loss Starts With a Plan You Can Stick To

    Science.gov (United States)

    ... Home Current Issue Past Issues Healthy Weight Healthy Weight Loss Starts With a Plan You Can Stick To ... have more questions or need help. Responsible, Safe Weight Loss If your health-care provider says you should ...

  14. Obstructive Sleep Apnoea Syndrome and Weight Loss: Review

    Directory of Open Access Journals (Sweden)

    Douglas C. Cowan

    2012-01-01

    Full Text Available Obstructive sleep apnoea (OSA syndrome is common, and obesity is a major risk factor. Increased peripharyngeal and central adiposity result in increased pharyngeal collapsibility, through increased mechanical loading around the upper airway, reduced tracheal traction on the pharynx, and reduced neuromuscular activity, particularly during sleep. Significant and sustained weight loss, if achieved, is likely to be a useful therapeutic option in the management of OSA and may be attempted by behavioural, pharmacological, and surgical approaches. Behavioural therapy programs that focus on aspects such as dietary intervention, exercise prescription patients and general lifestyle counselling have been tested. Bariatric surgery is an option in the severely obese when nonsurgical measures have failed, and laparoscopic adjustable gastric banding and Roux-en-Y gastric bypass are the most commonly employed techniques in the United Kingdom. Most evidence for efficacy of surgery comes from cohort studies. The role of sibutramine in OSA in the obese patients has been investigated, however, there are concerns regarding associated cardiovascular risk. In this paper the links between obesity and OSA are discussed, and the recent studies evaluating the behavioural, pharmacological and surgical approaches to weight loss in OSA are reviewed.

  15. Surgical vs conventional therapy for weight loss treatment of obstructive sleep apnea: a randomized controlled trial.

    Science.gov (United States)

    Dixon, John B; Schachter, Linda M; O'Brien, Paul E; Jones, Kay; Grima, Mariee; Lambert, Gavin; Brown, Wendy; Bailey, Michael; Naughton, Matthew T

    2012-09-19

    Obstructive sleep apnea (OSA) is strongly related to obesity. Weight loss is recommended as part of the overall management plan for obese patients diagnosed with OSA. To determine whether surgically induced weight loss is more effective than conventional weight loss therapy in the management of OSA. A randomized controlled trial of 60 obese patients (body mass index: >35 and obesity hypoventilation syndrome, previous bariatric surgery, contraindications to bariatric surgery, or significant cardiopulmonary, neurological, vascular, gastrointestinal, or neoplastic disease were excluded. Patients were randomized to a conventional weight loss program that included regular consultations with a dietitian and physician, and the use of very low-calorie diets as necessary (n = 30) or to bariatric surgery (laparoscopic adjustable gastric banding; n = 30). The primary outcome was baseline to 2-year change in AHI on diagnostic polysomnography scored by staff blinded to randomization. Secondary outcomes were changes in weight, CPAP adherence, and functional status. Patients lost a mean of 5.1 kg (95% CI, 0.8 to 9.3 kg) in the conventional weight loss program compared with 27.8 kg (95% CI, 20.9 to 34.7 kg) in the bariatric surgery group (P adherence did not differ between the groups. The bariatric surgery group had greater improvement in the Short Form 36 physical component summary score (mean, 9.3 [95% CI, 0.5 to 18.0]; P = .04). Among a group of obese patients with OSA, the use of bariatric surgery compared with conventional weight loss therapy did not result in a statistically greater reduction in AHI despite major differences in weight loss. anzctr.org Identifier: 12605000161628.

  16. Self-Reported Hedonism Predicts 12-Month Weight Loss After Roux-en-Y Gastric Bypass.

    Science.gov (United States)

    Alfonsson, Sven; Weineland-Strandskov, Sandra; Sundbom, Magnus

    2017-08-01

    Research regarding psychological risk factors for reduced weight loss after bariatric surgery has yielded mixed results, especially for variables measured prior to surgery. More profound personality factors have shown better promise and one such factor that may be relevant in this context is time perspective, i.e., the tendency to focus on present or future consequences. The aim of this study was to investigate the predictive value of time perspective for 12-month weight loss after Roux-en-Y gastric bypass surgery. A total of 158 patients were included and completed self-report instruments prior to surgery. Weight loss was measured after 12 months by medical staff. Background variables as well as self-reported disordered eating, psychological distress, and time perspective were analyzed with regression analysis to identify significant predictors for 12-month weight loss. The mean BMI loss at 12 months was 14 units, from 45 to 30 kg/m(2). Age, sex, and time perspective could significantly predict weight loss but only male sex and self-reported hedonism were independent risk factors for reduced weight loss in the final regression model. In this study, self-reported hedonistic time perspective proved to be a better predictor for 12-month weight loss than symptoms of disordered eating and psychological distress. It is possible that a hedonistic tendency of focusing on immediate consequences and rewards is analogous to the impaired delay discounting seen in previous studies of bariatric surgery candidates. Further studies are needed to identify whether these patients may benefit from extended care and support after surgery.

  17. Weight Loss May Ease Psoriasis Symptoms, Study Finds

    Science.gov (United States)

    ... news/fullstory_162876.html Weight Loss May Ease Psoriasis Symptoms, Study Finds Quality-of-life boost seen ... 4, 2017 (HealthDay News) -- Could weight loss combat psoriasis? Danish researchers are reporting that obese people with ...

  18. Adherence to a behavioral weight loss treatment program enhances weight loss and improvements in biomarkers

    Directory of Open Access Journals (Sweden)

    Sushama D Acharya

    2009-06-01

    Full Text Available Sushama D Acharya3, Okan U Elci3, Susan M Sereika1,2,3, Edvin Music3, Mindi A Styn3, Melanie Warziski Turk3, Lora E Burke2,31Department of Biostatistics, Graduate School of Public Health, 2Department of Epidemiology, Graduate School of Public Health, 3School of Nursing, University of Pittsburgh, Pittsburgh, PA, USAObjectives: To describe participants’ adherence to multiple components (attendance, energy intake, fat gram, exercise goals, and self-monitoring eating and exercise behaviors of a standard behavioral treatment program (SBT for weight loss and how adherence to these components may influence weight loss and biomarkers (triglycerides, low density lipoproteins [LDL], high density lipoprotein, and insulin during the intensive and less-intensive intervention phases. Methods: A secondary analysis of a randomized clinical trial consisting of a SBT with either fat-restricted standard or lacto-ovo vegetarian diet. The 12-month intervention was delivered in 33 group sessions. The first six months reflected the intensive phase; the second six months, the less-intensive intervention phase. We conducted the analysis without regard to treatment assignment. Eligible participants included overweight/obese adults (N = 176; mean body mass index = 34.0 kg/m2. The sample was 86.9% female, 70.5% White, and 44.4 ± 8.6 years old. The outcome measures included weight and biomarkers. Results: There was a significant decline in adherence to each treatment component over time (P < 0.0001. In the first six months, adherence to attendance, self-monitoring and the energy goal were significantly associated with greater weight loss (P < 0.05. Adherence to attendance and exercise remained significantly associated with weight loss in the second six months (P < 0.05. Adherence to attendance, self-monitoring and exercise had indirect effects through weight loss on LDL, triglycerides, and insulin (P < 0.05.Conclusions: We observed a decline in adherence to each

  19. Weight loss and skin manifestations in obese patients with psoriasis

    DEFF Research Database (Denmark)

    Geiker, Nina Rica Wium; Jensen, Peter; Kirchner Larsson, Lena

    2010-01-01

    % of their body weight following calorie restriction for 12 weeks. Taken together with recent literature the findings suggest that weight loss has a potential to reduce skin manifestations. Weight loss might also attenuate the increased cardiovascular and diabetes risks posed by obese psoriatric patients.......Objective To examine if psoriatic patients can achieve a weight loss to the same extent as non-psoriatic patients To describe the effect of weight loss on the cutaneous manifestations. Conclusion Patients with psoriasis achieved a weight loss, similar to non-psoriatic patients, of 12...

  20. Dietary fat intake, supplements, and weight loss

    Science.gov (United States)

    Dyck, D. J.

    2000-01-01

    Although there remains controversy regarding the role of macronutrient balance in the etiology of obesity, the consumption of high-fat diets appears to be strongly implicated in its development. Evidence that fat oxidation does not adjust rapidly to acute increases in dietary fat, as well as a decreased capacity to oxidize fat in the postprandial state in the obese, suggest that diets high in fat may lead to the accumulation of fat stores. Novel data is also presented suggesting that in rodents, high-fat diets may lead to the development of leptin resistance in skeletal muscle and subsequent accumulations of muscle triacylglycerol. Nevertheless, several current fad diets recommend drastically reduced carbohydrate intake, with a concurrent increase in fat content. Such recommendations are based on the underlying assumption that by reducing circulating insulin levels, lipolysis and lipid oxidation will be enhanced and fat storage reduced. Numerous supplements are purported to increase fat oxidation (carnitine, conjugated linoleic acid), increase metabolic rate (ephedrine, pyruvate), or inhibit hepatic lipogenesis (hydroxycitrate). All of these compounds are currently marketed in supplemental form to increase weight loss, but few have actually been shown to be effective in scientific studies. To date, there is little or no evidence supporting that carnitine or hydroxycitrate supplementation are of any value for weight loss in humans. Supplements such as pyruvate have been shown to be effective at high dosages, but there is little mechanistic information to explain its purported effect or data to indicate its effectiveness at lower dosages. Conjugated linoleic acid has been shown to stimulate fat utilization and decrease body fat content in mice but has not been tested in humans. The effects of ephedrine, in conjunction with methylxanthines and aspirin, in humans appears unequivocal but includes various cardiovascular side effects. None of these compounds have been

  1. Dietary fat intake, supplements, and weight loss

    Science.gov (United States)

    Dyck, D. J.

    2000-01-01

    Although there remains controversy regarding the role of macronutrient balance in the etiology of obesity, the consumption of high-fat diets appears to be strongly implicated in its development. Evidence that fat oxidation does not adjust rapidly to acute increases in dietary fat, as well as a decreased capacity to oxidize fat in the postprandial state in the obese, suggest that diets high in fat may lead to the accumulation of fat stores. Novel data is also presented suggesting that in rodents, high-fat diets may lead to the development of leptin resistance in skeletal muscle and subsequent accumulations of muscle triacylglycerol. Nevertheless, several current fad diets recommend drastically reduced carbohydrate intake, with a concurrent increase in fat content. Such recommendations are based on the underlying assumption that by reducing circulating insulin levels, lipolysis and lipid oxidation will be enhanced and fat storage reduced. Numerous supplements are purported to increase fat oxidation (carnitine, conjugated linoleic acid), increase metabolic rate (ephedrine, pyruvate), or inhibit hepatic lipogenesis (hydroxycitrate). All of these compounds are currently marketed in supplemental form to increase weight loss, but few have actually been shown to be effective in scientific studies. To date, there is little or no evidence supporting that carnitine or hydroxycitrate supplementation are of any value for weight loss in humans. Supplements such as pyruvate have been shown to be effective at high dosages, but there is little mechanistic information to explain its purported effect or data to indicate its effectiveness at lower dosages. Conjugated linoleic acid has been shown to stimulate fat utilization and decrease body fat content in mice but has not been tested in humans. The effects of ephedrine, in conjunction with methylxanthines and aspirin, in humans appears unequivocal but includes various cardiovascular side effects. None of these compounds have been

  2. Weight Loss in Microemulsion with Eugenol Oil

    Directory of Open Access Journals (Sweden)

    C. R Laili

    2016-10-01

    Full Text Available Essential oil has been widely used in many products. In this work, the location of the microemulsion region with eugenol was studied in two different surfactants namely sodium dodecyl sulphate, SDS (ionic and Tween 80 (non-ionic. The phase diagrams were constructed for water/SDS:hexanol (30:70/eugenol oil and water/ Tween 80/ eugenol oil systems by titrating to turbidity. The result showed that microemulsion regions were present in both systems with the SDS:hexanol system formed a larger water-in-oil microemulsion region compared to Tween 80 system. In order to study the behaviour of the microemulsion with eugenol oil subjected to several conditions such as evaporation and rheology test, several weight ratios of eugenol oil to surfactants were studied. The weight loss during evaporation was carried under ambient condition. The rheological behaviour was also observed in both systems. The evaporation rate for the microemulsion with SDS was found to be higher than the equivalent counterpart but with Tween 80. The rheology study showed that the flow is of Newtonian behaviour with little or no shear thinning

  3. Weight-loss practices among university students in Mexico.

    Science.gov (United States)

    Méndez-Hernández, Pablo; Dosamantes-Carrasco, Darina; Lamure, Michel; López-Loyo, Perla; Hernández-Palafox, Corín; Pineda-Pérez, Dayana; Flores, Yvonne; Salmerón, Jorge

    2010-06-01

    To evaluate the prevalence of weight-loss practices among university students from Tlaxcala, Mexico. A cross-sectional study of 2,651 university students was conducted. Logistic regression tests were used to estimate the probability of students trying to lose weight and successfully achieving weight loss. Nearly 40% of students attempted to lose weight, though only about 7% lost more than 10% of their body weight and maintained this weight loss during the time of the study. The methods used most were exercise and dieting, and those who dieted were more successful at losing weight. The high prevalence of weight-loss attempts and the poor outcomes with these weight-loss methods among this sample of university students is a public health concern. Universities should provide students with healthy weight-control approaches, which include offering information about healthier lifestyles, access to healthy food and opportunities to be physically active.

  4. Roux-en-Y Gastric Bypass Surgery, but Not Calorie Restriction, Reduces Plasma Branched-Chain Amino Acids in Obese Women Independent of Weight Loss or the Presence of Type 2 Diabetes

    NARCIS (Netherlands)

    Lips, M.A.; Klinken, J.B. van; Harmelen, V. van; Dharuri, H.K.; Hoen, P.A.C. 't; Laros, J.F.; Ommen, G.J.B. van; Janssen, I.M; Ramshorst, B. van; Wagensveld, B.A. van; Swank, D.J.; Dielen, F. Van; Dane, A.; Harms, A.; Vreeken, R.; Hankemeier, T.; Smit, J.W.A.; Pijl, H.; Dijk, K van

    2014-01-01

    OBJECTIVE: Obesity and type 2 diabetes mellitus (T2DM) have been associated with increased levels of circulating branched-chain amino acids (BCAAs) that may be involved in the pathogenesis of insulin resistance. However, weight loss has not been consistently associated with the reduction of BCAA

  5. Roux-en-Y Gastric Bypass Surgery, but Not Calorie Restriction, Reduces Plasma Branched-Chain Amino Acids in Obese Women Independent of Weight Loss or the Presence of Type 2 Diabetes

    NARCIS (Netherlands)

    Lips, M.A.; Klinken, J.B. van; Harmelen, V. van; Dharuri, H.K.; Hoen, P.A.C. 't; Laros, J.F.; Ommen, G.J.B. van; Janssen, I.M; Ramshorst, B. van; Wagensveld, B.A. van; Swank, D.J.; Dielen, F. Van; Dane, A.; Harms, A.; Vreeken, R.; Hankemeier, T.; Smit, J.W.A.; Pijl, H.; Dijk, K van

    2014-01-01

    OBJECTIVE: Obesity and type 2 diabetes mellitus (T2DM) have been associated with increased levels of circulating branched-chain amino acids (BCAAs) that may be involved in the pathogenesis of insulin resistance. However, weight loss has not been consistently associated with the reduction of BCAA lev

  6. Preoperative weight loss program targeting women with overweight and hypertrophy of the breast - a pilot study

    DEFF Research Database (Denmark)

    Geiker, Nina Rica Wium; Horn, J; Astrup, Arne

    2017-01-01

    of a formula-based diet supplying 800 kcal daily, in the subsequent 4 weeks regular foods were reintroduced increasing the intake to 1200 kcal daily. Five women completed the trial, and achieved a median (range) weight loss of 10.2 (6.5; 19) kg. Initial breast volume was 1100-2500 mL per breast......Among women with hypertrophic breasts, the clear majority are overweight or obese. Owing to increased risk of complications, women with a body mass index (BMI) above 25 kg m (-2) are precluded from reduction mammaplasty. The primary aim was to investigate if intensive weight loss could ready women....... Surgeries were performed 2 months thereafter. A 12-week intensive preoperative weight loss program enabled women with obesity for breast reduction surgery. Breast size was reduced proportionally more than total weight loss among women with hypertrophy....

  7. Promoting weight loss methods in parenting magazines: Implications for women.

    Science.gov (United States)

    Basch, Corey H; Roberts, Katherine J; Samayoa-Kozlowsky, Sandra; Glaser, Debra B

    2016-01-01

    Weight gain before and after pregnancy is important for women's health. The purpose of this study was to assess articles and advertisements related to weight loss in three widely read parenting magazines, "Parenting School Years," "Parenting Early Years," and "Parenting," which have an estimated combined readership of approximately 24 million (mainly women readers). Almost a quarter (23.7%, n = 32) of the 135 magazine issues over a four year period included at least one feature article on weight loss. A variety of topics were covered in the featured articles, with the most frequent topics being on losing weight to please yourself (25.2%), healthy ways to lose weight (21.1%), and how to keep the weight off (14.7%). Less than half (45.9%) of the articles displayed author credentials, such as their degree, qualifications, or expertise. A fifth (20.0%, n = 27) of the magazines included at least one prominent advertisement for weight loss products. Almost half (46.9%) of the weight loss advertisements were for weight loss programs followed by weight loss food products (25.0%), weight loss aids (21.9%), and only 6.2% of the advertisements for weight loss were on fitness. Parenting magazines should advocate for healthy weight loss, including lifestyle changes for sustained health.

  8. Use of SERI Surgical Scaffold for Soft-tissue Support in a Massive Weight Loss Patient

    Directory of Open Access Journals (Sweden)

    John E. Gross, MD, FACS

    2013-12-01

    Full Text Available Summary: Patients with a history of massive weight loss have compromised and poor-quality skin and fascia. Various body contouring surgeries aim to improve appearance and shape of the trunk and restore fascial integrity. These patients may be at increased risk of recurrent fascial laxity or bulges after conventional techniques. Here, the author presents a case where a silk-based bioresorbable scaffold was used prophylactically in a massive weight loss patient undergoing a circumferential body lift.

  9. Effectiveness of male-only weight loss and weight loss maintenance interventions: a systematic review with meta-analysis.

    Science.gov (United States)

    Young, M D; Morgan, P J; Plotnikoff, R C; Callister, R; Collins, C E

    2012-05-01

    The objectives of this systematic review were to investigate the effectiveness of male-only weight loss and weight loss maintenance interventions and to identify intervention characteristics associated with effectiveness. In May 2011, a systematic literature search with no date restrictions was conducted across eight databases. Twenty-four articles describing 23 studies met the eligibility criteria. All studies included a weight loss intervention and four studies included an additional weight loss maintenance intervention. Study quality was mostly poor for weight loss studies (median = 3/10, range = 1-9) and weight loss maintenance studies (median = 3.5/10, range = 1-6). Twenty-three of 31 individual weight loss interventions (74%) from the eligible studies were considered effective. Meta-analysis revealed a significant difference in weight change favouring weight loss interventions over no-intervention controls at the last reported assessment (weighted mean difference -5.66 kg [-6.35, -4.97], Z = 16.04 [P 2.7 contacts/month), group face-to-face contact and inclusion of a prescribed energy restriction. Preliminary evidence suggests men-only weight loss programmes may effectively engage and assist men with weight loss. However, more high-quality studies are urgently needed to improve the evidence base, particularly for maintenance studies.

  10. Predictors of weight regain in patients who underwent Roux-en-Y gastric bypass surgery.

    Science.gov (United States)

    Shantavasinkul, Prapimporn Chattranukulchai; Omotosho, Philip; Corsino, Leonor; Portenier, Dana; Torquati, Alfonso

    2016-11-01

    Roux-en-Y gastric bypass (RYGB) is a highly effective treatment for obesity and results in long-term weight loss and resolution of co-morbidities. However, weight regain may occur as soon as 1-2 years after surgery. This retrospective study aimed to investigate the prevalence of weight regain and possible preoperative predictors of this phenomenon after RYGB. An academic medical center in the United States. A total of 1426 obese patients (15.8% male) who underwent RYGB during January 2000 to 2012 and had at least a 2-year follow-up were reviewed. We included only patients who were initially successful, having achieved at least 50% excess weight loss at 1 year postoperatively. Patients were then categorized into either the weight regain group (WR) or sustained weight loss (SWL) group based upon whether they gained≥15% of their 1-year postoperative weight. Weight regain was observed in 244 patients (17.1%). Preoperative body mass index was similar between groups. Body mass index was significantly higher and percent excess weight loss was significantly lower in the WR group (Pweight regain was 19.5±9.3 kg and-.8±8.5 in the WR and SWL groups, respectively (Pweight loss. Moreover, a longer duration after RYGB was associated with weight regain. Multivariate analysis revealed that younger age was a significant predictor of weight regain even after adjusting for time since RYGB. The present study confirmed that a longer interval after RYGB was associated with weight regain. Younger age was a significant predictor of weight regain even after adjusting for time since RYGB. The findings of this study underscore the complexity of the mechanisms underlying weight loss and regain after RYGB. Future prospective studies are needed to further explore the prevalence, predictors, and mechanisms of weight regain after RYGB. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  11. Perioperative visual loss in ocular and nonocular surgery

    Directory of Open Access Journals (Sweden)

    Kathleen T Berg

    2010-06-01

    Full Text Available Kathleen T Berg, Andrew R Harrison, Michael S LeeDepartment of Ophthalmology, University of Minnesota, Minneapolis, MN, USAAbstract: Incidence estimates for perioperative vision loss (POVL after nonocular surgery range from 0.013% for all surgeries up to 0.2% following spine surgery. The most common neuro-ophthalmologic causes of POVL are the ischemic optic neuropathies (ION, either anterior (AION or posterior (PION. We identified 111 case reports of AION following nonocular surgery in the literature, with most occurring after cardiac surgery, and 165 case reports of PION following nonocular surgery, with most occurring after spine surgery or radical neck dissection. There were an additional 526 cases of ION that did not specify if the diagnosis was AION or PION. We also identified 933 case reports of central retinal artery occlusion (CRAO, 33 cases of pituitary apoplexy, and 245 cases of cortical blindness following nonocular surgery. The incidence of POVL following ocular surgery appears to be much lower than that seen following nonocular surgery. We identified five cases in the literature of direct optic nerve trauma, 47 cases of AION, and five cases of PION following ocular surgery. The specific pathogenesis and risk factors underlying these neuro-ophthalmic complications remain unknown, and physicians should be alert to the potential for loss of vision in the postoperative period.Keywords: perioperative, postoperative, vision loss, ocular surgery, nonocular surgery

  12. Presurgical Weight Is Associated with Pain, Functional Impairment, and Anxiety among Gastric Bypass Surgery Patients

    Directory of Open Access Journals (Sweden)

    Sharlene Wedin

    2012-01-01

    Full Text Available Chronic pain and obesity are significant public health concerns in the United States associated with significant levels of health-care expenses and lost productivity. Previous research suggests that obesity is a risk factor for chronic pain, mainly due to excessive weight placed on the joints. However, the obesity-pain relationship appears to be complex and reciprocal. Little work to date has focused on the relationship between weight and pain among patients undergoing gastric bypass surgery for weight loss. Patients scheduled to undergo bariatric surgery for weight loss at a large southeastern academic medical center ( completed the Brief Pain Inventory (BPI, the Center for Epidemiological Studies 10-item Depression scale (CESD-10, and the Beck Anxiety Inventory (BAI. Higher presurgical weight was associated with higher pain-on-average ratings, higher functional impairment due to pain across the domains of physical activity, mood, walking ability, relationships, and enjoyment of life. Higher presurgical weight was associated with higher BAI scores, but weight was not related to depression. Findings suggest that bariatric surgery candidates report a moderate amount of pain prior to surgery and that presurgical weight is associated with higher pain, increased functional impairment due to pain, and increased anxiety. Anxiety was found to mediate the relationship between increased weight and pain.

  13. Weight loss and skin manifestations in obese patients with psoriasis

    DEFF Research Database (Denmark)

    Geiker, Nina; Jensen, Peter; Kirchner Larsson, Lena

    2010-01-01

    % of their body weight following calorie restriction for 12 weeks. Taken together with recent literature the findings suggest that weight loss has a potential to reduce skin manifestations. Weight loss might also attenuate the increased cardiovascular and diabetes risks posed by obese psoriatric patients....

  14. Weight loss maintenance: A review on dietary related strategies

    OpenAIRE

    Fatemeh Azizi Soeliman; Leila Azadbakht

    2014-01-01

    Background: Weight regain after weight loss is a common problem for all those obese or overweight who have had a recent weight loss. Different cures such as diet therapy, behavioral therapy, exercise or a mixture of them have been advised as solutions. The purpose of this review is to find the best diet or eating pattern to maintain a recent weight loss. Materials and Methods: We searched in PubMed and SCOPUS by using the following key words: Overweight, obesity, weight maintenance, weight re...

  15. A Simpler Method for Predicting Weight Loss in the First Year after Roux-en-Y Gastric Bypass

    Directory of Open Access Journals (Sweden)

    John P. Sczepaniak

    2012-01-01

    Full Text Available Factors postulated to predict weight loss after gastric bypass surgery, include race, age, gender, technique, height, and initial weight. This paper contained 1551 gastric bypass patients (85.9% female. Operations were performed by one surgeon (MLO at community hospitals in Southern California from 1989 to 2008 with 314 being laparoscopic and 1237 open. We created the following equation: In[percent weight] =2−, where was the time after operation (days and and are constants. Analysis was completed on R-software. The model fits with 2 value 0.93 and gives patients a realistic mean target weight with a confidence interval of 95% for the first year. Conclusion. We created a curve predicting weight loss after surgery as a percentage of initial weight. Initial weight was the single most important predictor of weight loss after surgery. Other recorded variables accounted for less than 1% of variability. Unknown factors account for the remaining 6-7%.

  16. Using personality as a predictor of diet induced weight loss and weight management

    Directory of Open Access Journals (Sweden)

    Munro Irene A

    2011-11-01

    Full Text Available Abstract Background A major challenge for successful weight management is tailoring weight loss programs to individual needs. The aim of this study was to investigate whether personality traits could be used to match individuals to a compatible weight loss program that would maximize weight loss. Method Two different weight loss trials were conducted, both with a weight loss greater than 5% the measure of success. Fifty-four individuals, BMI 30-40 kg/m2, either followed a slow, healthy eating weight loss diet (HEWLD of 5000-6000 kJ/day for 12 weeks (n = 22, or a fast, very low energy diet (VLED of 3000 kJ/day for 4 weeks (n = 32. Anthropometric measurements were recorded at baseline, at the end of the weight loss period and, for VLED, at the end of 10 weeks of weight maintenance. Personality traits were measured at baseline using the Tangney Self Control Scale plus 3 of the scales from the Five Factor Model - Neuroticism, Conscientiousness and Extraversion. Results The percentage weight loss was significantly greater in VLED (-7.38% compared to HEWLD (-4.11%, (p Conclusion The personality factor, Neuroticism, was linked to successful weight loss (that is ≥ 5% with a particular weight loss treatment, suggesting that there is a potential to use measures of personality to identify appropriate weight loss/management strategies for individuals. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR: ACTRN12611000716965

  17. Sudden sensorineural hearing loss after non-otologic surgery.

    Science.gov (United States)

    Page, Joshua Cody; Peters, Bob

    2015-01-01

    Sudden sensorineural hearing loss following non-otologic surgery is a rare event described in the medical literature. Cardiopulmonary bypass surgery is most commonly associated with this type of hearing loss. Our case report and review of the literature describe two cases with postoperative hearing loss - neither of which are cardiac surgeries - making them exceedingly rare in the medical literature. Regardless of the rarity of this unfortunate event, the possibility for permanent hearing loss is a potentially devastating unanticipated complication and one that all surgeons should be aware.

  18. Weight loss goals of patients in a health maintenance organization.

    Science.gov (United States)

    Dutton, Gareth R; Perri, Michael G; Dancer-Brown, Melissa; Goble, Mary; Van Vessem, Nancy

    2010-04-01

    Individuals seeking weight loss treatment endorse unrealistic expectations regarding their goals for weight loss, although these conclusions are primarily based on research conducted in obesity specialty clinics and/or controlled clinical trials. This study examined the weight loss goals and predictors of these goals among patients participating in obesity treatment in an applied, clinical setting (i.e., managed care organization). Managed care patients enrolled in a behavioral weight loss program (N=143; mean age=46.8 years; mean BMI=36.9 kg/m(2); 89.5% female; 64.5% Caucasian) completed a self-report survey during an initial weight loss session. The survey included items assessing patients' weight loss expectations, including goals for dream, happy, acceptable, and disappointed weights. Participants completed questions regarding contacts with their primary care physician and physician provision of weight loss counseling and/or referrals. They also provided values for current height and weight. BMI's and weight loss associated with dream, happy, acceptable, and disappointed weight goals were 24.8 kg/m(2) (30.9% loss), 27.1 kg/m(2) (25.2% loss), 29.3 kg/m(2) (19.7% loss), and 33.0 kg/m(2) (10.4% loss), respectively. There were significant gender differences in weight loss goals, with women endorsing more unrealistic goals than men for dream and happy weights, ps<0.001. Significant predictors of all four weight loss goals included baseline BMI, gender, ethnicity, and frequency of visits with one's primary care physician, ps<0.01. Consistent with previous research, patients participating in a weight loss program implemented in a managed care setting endorsed unrealistic expectations for weight loss. However, more frequent contact with one's primary care physician was associated with more realistic goals. Future, longitudinal research is needed to document the discrepancy between these goals and actual weight loss achieved in such settings as well as to determine

  19. Surgery Videos: MedlinePlus

    Science.gov (United States)

    ... Winston-Salem, NC, 1/15/2009) Weight Loss Surgery Laparoscopic Gastric Bypass Surgery (University of Miami Hospital ... Boston, Boston, MA, 6/08/2010) Weight Loss Surgery Laparoscopic Gastric Bypass Surgery (University of Miami Hospital ...

  20. Hidden blood loss after surgery for hip fracture

    DEFF Research Database (Denmark)

    Foss, Nicolai Bang; Kehlet, H

    2006-01-01

    with aspirin, intra-operative hypotension and gastro-intestinal bleeding or ulceration were all independent predictors of blood loss. We conclude that total blood loss after surgery for hip fracture is much greater than that observed intra-operatively. Frequent post-operative measurements of haemoglobin......Our aim was to determine the total blood loss associated with surgery for fracture of the hip and to identify risk factors for increased blood loss. We prospectively studied 546 patients with hip fracture. The total blood loss was calculated on the basis of the haemoglobin difference, the number...... of transfusions and the estimated blood volume. The hidden blood loss, in excess of that observed during surgery, varied from 547 ml (screws/ pins) to 1473 ml (intramedullary hip nail and screw) and was significantly associated with medical complications and increased hospital stay. The type of surgery, treatment...

  1. Hidden blood loss after surgery for hip fracture

    DEFF Research Database (Denmark)

    Foss, N B; Kehlet, H

    2006-01-01

    Our aim was to determine the total blood loss associated with surgery for fracture of the hip and to identify risk factors for increased blood loss. We prospectively studied 546 patients with hip fracture. The total blood loss was calculated on the basis of the haemoglobin difference, the number...... of transfusions and the estimated blood volume. The hidden blood loss, in excess of that observed during surgery, varied from 547 ml (screws/ pins) to 1473 ml (intramedullary hip nail and screw) and was significantly associated with medical complications and increased hospital stay. The type of surgery, treatment...... with aspirin, intra-operative hypotension and gastro-intestinal bleeding or ulceration were all independent predictors of blood loss. We conclude that total blood loss after surgery for hip fracture is much greater than that observed intra-operatively. Frequent post-operative measurements of haemoglobin...

  2. Weight Loss Practices and Body Weight Perceptions among US College Students

    Science.gov (United States)

    Wharton, Christopher M.; Adams, Troy; Hampl, Jeffrey S.

    2008-01-01

    Objective: The authors assessed associations between body weight perception and weight loss strategies. Participants: They randomly selected male and female college students (N = 38,204). Methods: The authors conducted a secondary data analysis of the rates of weight loss strategies and body weight perception among students who completed the…

  3. Weight Loss Practices and Body Weight Perceptions among US College Students

    Science.gov (United States)

    Wharton, Christopher M.; Adams, Troy; Hampl, Jeffrey S.

    2008-01-01

    Objective: The authors assessed associations between body weight perception and weight loss strategies. Participants: They randomly selected male and female college students (N = 38,204). Methods: The authors conducted a secondary data analysis of the rates of weight loss strategies and body weight perception among students who completed the…

  4. Initial weight loss on an 800-kcal diet as a predictor of weight loss success after 8 weeks

    DEFF Research Database (Denmark)

    Handjieva-Darlenska, T.; Handjiev, S.; Larsen, Thomas Meinert

    2010-01-01

    The purpose of this study was to investigate whether pre-treatment subject characteristics and weight change during the first weeks of a low-calorie diet (LCD) can predict weight loss outcomes at the end of a controlled 8-week weight loss period in overweight and obese adults....

  5. Ain’t no mountain high enough? Setting high weight loss goals predicts effort and short-term weight loss

    NARCIS (Netherlands)

    Vet, de E.; Nelissen, R.M.A.; Zeelenberg, M.; Ridder, de D.T.D.

    2013-01-01

    Although psychological theories outline that it might be beneficial to set more challenging goals, people attempting to lose weight are generally recommended to set modest weight loss goals. The present study explores whether the amount of weight loss individuals strive for is associated with more p

  6. Ain’t no mountain high enough? Setting high weight loss goals predicts effort and short-term weight loss

    NARCIS (Netherlands)

    Vet, de E.; Nelissen, R.M.A.; Zeelenberg, M.; Ridder, de D.T.D.

    2013-01-01

    Although psychological theories outline that it might be beneficial to set more challenging goals, people attempting to lose weight are generally recommended to set modest weight loss goals. The present study explores whether the amount of weight loss individuals strive for is associated with more

  7. "Guaranteed in Just Six Weeks...". Weight Loss Fads and Fantasies.

    Science.gov (United States)

    Price, James H.; Allensworth, Diane D.

    1980-01-01

    The most popular fad diets, weight control devices, salons, and diet clubs are examined and the claims of each are evaluated in relation to their long-term success in producing weight loss and control. (JMF)

  8. Physiological response of adipocytes to weight loss and maintenance.

    Directory of Open Access Journals (Sweden)

    Sanne P M Verhoef

    Full Text Available BACKGROUND: Metabolic processes in adipose tissue are dysregulated in obese subjects and, in response to weight loss, either normalize or change in favor of weight regain. OBJECTIVE: To determine changes in adipocyte glucose and fatty acid metabolism in relation to changes in adipocyte size during weight loss and maintenance. METHODS: Twenty-eight healthy subjects (12 males, age 20-50 y, and BMI 28-35 kg/m(2, followed a very low energy diet for 2 months, followed by a 10-month period of weight maintenance. Body weight, body composition (deuterium dilution and BodPod, protein levels (Western blot and adipocyte size were assessed prior to and after weight loss and after the 10-month follow-up. RESULTS: A 10% weight loss resulted in a 16% decrease in adipocyte size. A marker for glycolysis decreased (AldoC during weight loss in association with adipocyte shrinking, and remained decreased during follow-up in association with weight maintenance. A marker for fatty acid transport increased (FABP4 during weight loss and remained increased during follow-up. Markers for mitochondrial beta-oxidation (HADHsc and lipolysis (ATGL were only increased after the 10-month follow-up. During weight loss HADHsc and ATGL were coordinately regulated, which became weaker during follow-up due to adipocyte size-related changes in HADHsc expression. AldoC was the major denominator of adipocyte size and body weight, whereas changes in ATGL during weight loss contributed to body weight during follow-up. Upregulation of ATGL and HADHsc occured in the absence of a negative energy balance and was triggered by adipocyte shrinkage or indicated preadipocyte differentiation. CONCLUSION: Markers for adipocyte glucose and fatty acid metabolism are changed in response to weight loss in line with normalization from a dysregulated obese status to an improved metabolic status. TRIAL REGISTRATION: ClinicalTrials.gov NCT01015508.

  9. Physiological response of adipocytes to weight loss and maintenance.

    Science.gov (United States)

    Verhoef, Sanne P M; Camps, Stefan G J A; Bouwman, Freek G; Mariman, Edwin C M; Westerterp, Klaas R

    2013-01-01

    Metabolic processes in adipose tissue are dysregulated in obese subjects and, in response to weight loss, either normalize or change in favor of weight regain. To determine changes in adipocyte glucose and fatty acid metabolism in relation to changes in adipocyte size during weight loss and maintenance. Twenty-eight healthy subjects (12 males), age 20-50 y, and BMI 28-35 kg/m(2), followed a very low energy diet for 2 months, followed by a 10-month period of weight maintenance. Body weight, body composition (deuterium dilution and BodPod), protein levels (Western blot) and adipocyte size were assessed prior to and after weight loss and after the 10-month follow-up. A 10% weight loss resulted in a 16% decrease in adipocyte size. A marker for glycolysis decreased (AldoC) during weight loss in association with adipocyte shrinking, and remained decreased during follow-up in association with weight maintenance. A marker for fatty acid transport increased (FABP4) during weight loss and remained increased during follow-up. Markers for mitochondrial beta-oxidation (HADHsc) and lipolysis (ATGL) were only increased after the 10-month follow-up. During weight loss HADHsc and ATGL were coordinately regulated, which became weaker during follow-up due to adipocyte size-related changes in HADHsc expression. AldoC was the major denominator of adipocyte size and body weight, whereas changes in ATGL during weight loss contributed to body weight during follow-up. Upregulation of ATGL and HADHsc occured in the absence of a negative energy balance and was triggered by adipocyte shrinkage or indicated preadipocyte differentiation. Markers for adipocyte glucose and fatty acid metabolism are changed in response to weight loss in line with normalization from a dysregulated obese status to an improved metabolic status. ClinicalTrials.gov NCT01015508.

  10. Collagen metabolism in obesity: the effect of weight loss

    DEFF Research Database (Denmark)

    Rasmussen, M H; Jensen, L T; Andersen, T

    1995-01-01

    OBJECTIVE: To investigate the impact of obesity, fat distribution and weight loss on collagen turnover using serum concentrations of the carboxyterminal propeptide of type I procollagen (S-PICP) and the aminoterminal propeptide of type III pro-collagen (S-PIIINP) as markers for collagen turnover...... restriction (P weight loss (r = 0.32; P obesity and associated with body fat distribution, suggesting...... an increased turnover of type III collagen related to obesity in general and to abdominal obesity in particular. S-PIIINP levels decreases during weight loss in obese subjects, whereas S-PICP levels seems un-related to obesity and weight loss....

  11. Tier 3 multidisciplinary medical weight management improves outcome of Roux-en-Y gastric bypass surgery.

    Science.gov (United States)

    Patel, P; Hartland, A; Hollis, A; Ali, R; Elshaw, A; Jain, S; Khan, A; Mirza, S

    2015-04-01

    In 2013 the Department of Health specified eligibility for bariatric surgery funded by the National Health Service. This included a mandatory specification that patients first complete a Tier 3 medical weight management programme. The clinical effectiveness of this recommendation has not been evaluated previously. Our bariatric centre has provided a Tier 3 programme six months prior to bariatric surgery since 2009. The aim of our retrospective study was to compare weight loss in two cohorts: Roux-en-Y gastric bypass only (RYGB only cohort) versus Tier 3 weight management followed by RYGB (Tier 3 cohort). A total of 110 patients were selected for the study: 66 in the RYGB only cohort and 44 in the Tier 3 cohort. Patients in both cohorts were matched for age, sex, preoperative body mass index and pre-existing co-morbidities. The principal variable was therefore whether they undertook the weight management programme prior to RYGB. Patients from both cohorts were followed up at 6 and 12 months to assess weight loss. The mean weight loss at 6 months for the Tier 3 cohort was 31% (range: 18-69%, standard deviation [SD]: 0.10 percentage points) compared with 23% (range: 4-93%, SD: 0.12 percentage points) for the RYGB only cohort (p=0.0002). The mean weight loss at 12 months for the Tier 3 cohort was 34% (range: 17-51%, SD: 0.09 percentage points) compared with 27% (range: 14-48%, SD: 0.87 percentage points) in the RYGB only cohort (p=0.0037). Our study revealed that in our matched cohorts, patients receiving Tier 3 specialist medical weight management input prior to RYGB lost significantly more weight at 6 and 12 months than RYGB only patients. This confirms the clinical efficacy of such a weight management programme prior to gastric bypass surgery and supports its inclusion in eligibility criteria for bariatric surgery.

  12. Attachment anxiety predicts poor adherence to dietary recommendations : an indirect effect on weight change one year after gastric bypass surgery

    NARCIS (Netherlands)

    Aarts, F.; Geenen, R.; Gerdes, V.E.A.; Van de Laar, A., A.; Brandjes, D.P.M.; Hinnen, C.

    BACKGROUND: Weight loss after gastric bypass surgery depends on the adoption of healthy dietary recommendations, which may be influenced by psychological issues and patients' attachment representations (habitual states of mind with respect to interpersonal relations). The present study tests (1)

  13. Attachment Anxiety Predicts Poor Adherence to Dietary Recommendations : an Indirect Effect on Weight Change 1 Year After Gastric Bypass Surgery

    NARCIS (Netherlands)

    Aarts, Floor; Geenen, Rinie; Gerdes, Victor E. A.; van de Laar, Arnold; Brandjes, Dees P. M.; Hinnen, Chris

    Weight loss after gastric bypass surgery depends on the adoption of healthy dietary recommendations, which may be influenced by psychological issues and patients' attachment representations (habitual states of mind with respect to interpersonal relations). The present study tests (1) whether

  14. Gastric bypass may promote weight loss in overweight partners

    NARCIS (Netherlands)

    Aarts, F.; Radhakishun, N.N.E.; van Vliet, M.; Geenen, R.; von Rosenstiel, I.A.; Hinnen, C.; Beijnen, Jacob; Brandjes, D.P.M.; Diamant, M.; Gerdes, V.E.A.

    2015-01-01

    INTRODUCTION: Following bariatric surgery, patients are expected to implement diet and lifestyle changes that may be imitated by cohabitating family members. We hypothesize that cohabitating family members will lose weight and improve their eating behavior within 1 year after surgery. METHODS: In

  15. Gastric Bypass May Promote Weight Loss in Overweight Partners

    NARCIS (Netherlands)

    Aarts, Floor; Radhakishun, Nalini N. E.; van Vliet, Mariska; Geenen, Rinie; von Rosenstiel, Ines A.; Hinnen, Chris; Beijnen, Jos H.; Brandjes, Dees P. M.; Diamant, Michaela; Gerdes, Victor E. A.

    2015-01-01

    Introduction: Following bariatric surgery, patients are expected to implement diet and lifestyle changes that may be imitated by cohabitating family members. We hypothesize that cohabitating family members will lose weight and improve their eating behavior within 1 year after surgery. Methods: In

  16. Gastric bypass may promote weight loss in overweight partners

    NARCIS (Netherlands)

    Aarts, F.; Radhakishun, N.N.E.; van Vliet, M.; Geenen, R.; von Rosenstiel, I.A.; Hinnen, C.; Beijnen, Jacob; Brandjes, D.P.M.; Diamant, M.; Gerdes, V.E.A.

    2015-01-01

    INTRODUCTION: Following bariatric surgery, patients are expected to implement diet and lifestyle changes that may be imitated by cohabitating family members. We hypothesize that cohabitating family members will lose weight and improve their eating behavior within 1 year after surgery. METHODS: In th

  17. Gastric Bypass May Promote Weight Loss in Overweight Partners

    NARCIS (Netherlands)

    Aarts, Floor; Radhakishun, Nalini N. E.; van Vliet, Mariska; Geenen, Rinie; von Rosenstiel, Ines A.; Hinnen, Chris; Beijnen, Jos H.; Brandjes, Dees P. M.; Diamant, Michaela; Gerdes, Victor E. A.

    2015-01-01

    Introduction: Following bariatric surgery, patients are expected to implement diet and lifestyle changes that may be imitated by cohabitating family members. We hypothesize that cohabitating family members will lose weight and improve their eating behavior within 1 year after surgery. Methods: In th

  18. Weight loss maintenance: A review on dietary related strategies

    Directory of Open Access Journals (Sweden)

    Fatemeh Azizi Soeliman

    2014-01-01

    Full Text Available Background: Weight regain after weight loss is a common problem for all those obese or overweight who have had a recent weight loss. Different cures such as diet therapy, behavioral therapy, exercise or a mixture of them have been advised as solutions. The purpose of this review is to find the best diet or eating pattern to maintain a recent weight loss. Materials and Methods: We searched in PubMed and SCOPUS by using the following key words: Overweight, obesity, weight maintenance, weight regain, and diet therapy. Finally, we assessed 26 articles in the present article. Results: Meal replacement, low carbohydrate-low glycemic index (GI diet, high protein intake, and moderate fat consumption have shown some positive effects on weight maintenance. However, the results are controversial. A Dietary Approach to Stop Hypertension (DASH-type diet seems helpful for weight maintenance although the need for more study has remained. Some special behaviors were associated with less weight regain, such as, not being awake late at night, drinking lower amount of sugar-sweetened beverages, and following a healthy pattern. Some special foods have been suggested for weight maintenance. However, the roles of specific foods are not confirmed. Conclusion: Healthy diets recommend low carbohydrate, low GI, and moderate fat foods, but it is not clear whether they are useful in preventing weight gain. It seems that consuming fewer calories helps people to keep weight loss. Further research to find strategies in obesity management focusing on successful maintenance of weight loss is needed.

  19. Improvement of Health-Related Quality of Life After Roux-en-Y Gastric Bypass Related to Weight Loss

    NARCIS (Netherlands)

    Monpellier, Valerie M; Antoniou, Evangelia E; Aarts, Edo O; Janssen, Ignace M C; Jansen, Anita T M

    2016-01-01

    INTRODUCTION: Effect of bariatric surgery on health-related quality of life (HRQOL) varies greatly. This might be caused by the diversity in questionnaires used to assess HRQOL and the weight loss of the studied population. This study assesses the relationship between weight loss and HRQOL in primar

  20. Hidden blood loss after surgery for hip fracture

    DEFF Research Database (Denmark)

    Foss, Nicolai Bang; Kehlet, H

    2006-01-01

    Our aim was to determine the total blood loss associated with surgery for fracture of the hip and to identify risk factors for increased blood loss. We prospectively studied 546 patients with hip fracture. The total blood loss was calculated on the basis of the haemoglobin difference, the number ...

  1. Longitudinal Analysis of Leptin Variation during Weight Regain after Weight Loss in Obese Children

    DEFF Research Database (Denmark)

    Holm, Jens-Christian; Gamborg, Michael; Ward, Leigh

    2009-01-01

    Objective: This study assessed if lower than predicted serum leptin concentrations seen during weight loss persisted during weight regain, with possible implications for weight control. Methods: 115 children were investigated during a 12-week weight loss program. 90 children completed the program....... Results: Children with the greatest increases in BMI standard deviation score (SDS) exhibited the largest leptin increments. The disproportionate reduction of leptin seen during weight loss recovered after weight loss. Leptin increases mirrored increases in BMI SDS during weight regain, and the leptin......-BMI SDS relationship seen during follow-up resembled the baseline leptin-BMI SDS relationship. Conclusion: Proportional increases of leptin and BMI SDS during weight regain suggests an intact leptin response during re-accumulation of fat. Following the pronounced reduction of leptin during weight loss...

  2. A summer day camp approach to adolescent weight loss.

    Science.gov (United States)

    Southam, M A; Kirkley, B G; Murchison, A; Berkowitz, R I

    1984-01-01

    Twenty-five overweight adolescents completed a summer weight loss day camp program on the Stanford University campus. All participants attended camp four days per week for four hours to learn and practice eating and exercise skills conducive to weight loss. Parents met weekly to discuss the program content and to explore their role in their adolescent's weight management. At posttreatment, reductions were achieved in weight, percent overweight, and skinfold, with greater changes observed for the eight-week group than for the four-week group. Improvements were also evident in participants' self-reported habits and knowledge of weight management concepts. Parent and participant assessment of the camp experience was very positive. The results of the summer weight loss day camp suggest that an intensive program of eating and exercise habit instruction, practice, and monitoring, which allows the participants to remain in the home setting, may provide benefits not found in other more traditional approaches to adolescent weight loss.

  3. Getting Past a Weight-Loss Plateau

    Science.gov (United States)

    ... lose weight, you lose some muscle along with fat. Muscle helps keep the rate at which you burn ... more calories. Adding exercises such as weightlifting to increase your muscle mass will help you burn more calories. Pack ...

  4. Internet-Based Weight Control: The Relationship Between Web Features and Weight Loss

    OpenAIRE

    Krukowski, Rebecca A.; Harvey-Berino, Jean; Ashikaga, Takamaru; Thomas, Colleen S.; Micco, Nicci

    2008-01-01

    Internet-based weight control programs have been showing promising results; however, as of yet, it is unclear which website components are critical for producing and maintaining weight loss. The aim of this study is to examine the utilization patterns of a weight control website and the relationship of the Web features to weight loss and maintenance. One hundred and twenty three (N = 123) participants took part in a 12-month behavioral weight control program over the Internet and their websit...

  5. Personalized weight loss strategies - the role of macronutrient distribution

    DEFF Research Database (Denmark)

    Martinez, J Alfredo; Navas-Carretero, Santiago; Saris, Wim H M

    2014-01-01

    A large number of different dietary approaches have been studied in an attempt to achieve healthy, sustainable weight loss among individuals with overweight and obesity. Restriction of energy intake is the primary method of producing a negative energy balance leading to weight loss. However, owin...

  6. Autonomy Support, Self-Regulation, and Weight Loss

    Science.gov (United States)

    Gorin, Amy A.; Powers, Theodore A.; Koestner, Richard; Wing, Rena R.; Raynor, Hollie A.

    2015-01-01

    Objective Social support is believed to contribute to weight loss success, yet the type of support received is rarely assessed. To develop more effective weight loss interventions, examinations of the types of support that are associated with positive outcomes are needed. Self-Determination Theory suggests that support for an individual’s autonomy is beneficial and facilitates internalization of autonomous self-regulation. We examined whether autonomy support and directive forms of support were associated with weight loss outcomes in a larger randomized controlled trial. Method Adults (N = 201; 48.9 ± 10.5 years; 78.1% women) participating in a weight loss trial were assessed at 0, 6, and 18 months. Autonomy support (AS), directive support, and autonomous self-regulation (ASR) were measured at 0 and 6 months and examined in relation to 18-month weight loss outcomes. Results Baseline AS and ASR did not predict outcomes; however, AS and ASR at 6 months positively predicted 18-month weight losses (ps Autonomy support predicted better weight loss outcomes while some forms of directive support hindered progress. Weight loss trials are needed to determine whether family members and friends can be trained to provide autonomy support and whether this is more effective than programs targeting more general or directive forms of support. PMID:23730718

  7. Probability Weighting and Loss Aversion in Futures Hedging

    NARCIS (Netherlands)

    Mattos, F.; Garcia, P.; Pennings, J.M.E.

    2008-01-01

    We analyze how the introduction of probability weighting and loss aversion in a futures hedging model affects decision making. Analytical findings indicate that probability weighting alone always affects optimal hedge ratios, while loss and risk aversion only have an impact when probability

  8. Do weight loss and adherence cluster within behavioral treatment groups?

    Science.gov (United States)

    Objective: Weight loss programs are often conducted in a group format, but it is unclear whether weight losses or adherence cluster within treatment group and whether characteristics of the group (e.g., size or homogeneity) affect outcomes. We examined these questions within Look AHEAD, a multicente...

  9. Effectiveness of weight loss interventions for obese older adults.

    Science.gov (United States)

    Felix, Holly C; West, Delia S

    2013-01-01

    The consequences of obesity among older adults are significant, yet few obesity interventions target this group. Unfamiliarity with weight loss intervention effectiveness and concerns that weight loss negatively affects older adults may be inhibiting targeting this group. This paper reviews the evidence on intentional weight loss and effective weight loss interventions for obese older adults to help dispel concerns and guide health promotion practice. PubMed articles. Randomized controlled trials examining behavioral and pharmaceutical weight loss strategies with 1-year follow-up targeting obese (body mass index ≥ 30) older adults (mean age ≥ 60 years), and studies with quasi-experimental designs examining surgical weight loss strategies targeting older adults were examined. Abstracts were reviewed for study objective relevancy, with relevant articles extracted and reviewed. Data were inserted into an analysis matrix. Evidence indicates behavioral strategies are effective in producing significant (all p obese older adults, but effectiveness evidence for surgical and pharmaceutical strategies for obese older adults is lacking, primarily because this group has not been targeted in trials or analyses did not isolate this group. These findings support the promotion of intentional weight loss among obese older adults and provide guidance to health promotion practitioners on effective weight loss interventions to use with this group.

  10. Extensive weight loss reveals distinct gene expression changes in human subcutaneous and visceral adipose tissue

    Science.gov (United States)

    Mardinoglu, Adil; Heiker, John T.; Gärtner, Daniel; Björnson, Elias; Schön, Michael R.; Flehmig, Gesine; Klöting, Nora; Krohn, Knut; Fasshauer, Mathias; Stumvoll, Michael; Nielsen, Jens; Blüher, Matthias

    2015-01-01

    Weight loss has been shown to significantly improve Adipose tissue (AT) function, however changes in AT gene expression profiles particularly in visceral AT (VAT) have not been systematically studied. Here, we tested the hypothesis that extensive weight loss in response to bariatric surgery (BS) causes AT gene expression changes, which may affect energy and lipid metabolism, inflammation and secretory function of AT. We assessed gene expression changes by whole genome expression chips in AT samples obtained from six morbidly obese individuals, who underwent a two step BS strategy with sleeve gastrectomy as initial and a Roux-en-Y gastric bypass as second step surgery after 12 ± 2 months. Global gene expression differences in VAT and subcutaneous (S)AT were analyzed through the use of genome-scale metabolic model (GEM) for adipocytes. Significantly altered gene expressions were PCR-validated in 16 individuals, which also underwent a two-step surgery intervention. We found increased expression of cell death-inducing DFFA-like effector a (CIDEA), involved in formation of lipid droplets in both fat depots in response to significant weight loss. We observed that expression of the genes associated with metabolic reactions involved in NAD+, glutathione and branched chain amino acid metabolism are significantly increased in AT depots after surgery-induced weight loss. PMID:26434764

  11. Extensive weight loss reveals distinct gene expression changes in human subcutaneous and visceral adipose tissue.

    Science.gov (United States)

    Mardinoglu, Adil; Heiker, John T; Gärtner, Daniel; Björnson, Elias; Schön, Michael R; Flehmig, Gesine; Klöting, Nora; Krohn, Knut; Fasshauer, Mathias; Stumvoll, Michael; Nielsen, Jens; Blüher, Matthias

    2015-10-05

    Weight loss has been shown to significantly improve Adipose tissue (AT) function, however changes in AT gene expression profiles particularly in visceral AT (VAT) have not been systematically studied. Here, we tested the hypothesis that extensive weight loss in response to bariatric surgery (BS) causes AT gene expression changes, which may affect energy and lipid metabolism, inflammation and secretory function of AT. We assessed gene expression changes by whole genome expression chips in AT samples obtained from six morbidly obese individuals, who underwent a two step BS strategy with sleeve gastrectomy as initial and a Roux-en-Y gastric bypass as second step surgery after 12 ± 2 months. Global gene expression differences in VAT and subcutaneous (S)AT were analyzed through the use of genome-scale metabolic model (GEM) for adipocytes. Significantly altered gene expressions were PCR-validated in 16 individuals, which also underwent a two-step surgery intervention. We found increased expression of cell death-inducing DFFA-like effector a (CIDEA), involved in formation of lipid droplets in both fat depots in response to significant weight loss. We observed that expression of the genes associated with metabolic reactions involved in NAD+, glutathione and branched chain amino acid metabolism are significantly increased in AT depots after surgery-induced weight loss.

  12. A Pilot Study of an Acceptance-Based Behavioral Intervention for Weight Regain After Bariatric Surgery.

    Science.gov (United States)

    Bradley, Lauren E; Forman, Evan M; Kerrigan, Stephanie G; Butryn, Meghan L; Herbert, James D; Sarwer, David B

    2016-10-01

    Tens of thousands of bariatric surgery patients each year experience sub-optimal weight loss, significant regain, or both. Weight regain can contribute to a worsening of weight-related co-morbidities, and for some, leads to secondary surgical procedures. Poor weight outcomes have been associated with decreased compliance to the recommended postoperative diet. Decreased compliance may be partially due to a lack of psychological skills necessary to engage in healthy eating behaviors over the long term, especially as the effects of surgery (on appetite, hunger, and desire for food) decrease. Many behavioral interventions do not sufficiently address these challenges and often have limited effectiveness. The study aimed to evaluate the feasibility, acceptability, and preliminary effectiveness of a novel 10-week acceptance-based behavioral intervention to stop postoperative weight regain. A sample of bariatric surgery patients (n = 11) who regained at least 10 % of their maximum lost postoperative weight was recruited. All participants received the intervention, which emphasized psychological skills thought to be integral to successful weight control post-surgery. The intervention was shown to be feasible and acceptable, with 72 % retention and high mean rating (4.25 out of 5.00) of program satisfaction among completers. Weight regain was stopped, and even reversed, with a mean total body weight loss of 3.58 ± 3.02 % throughout the 10-week intervention. There were also significant improvements in eating-related and acceptance-related variables. These findings provide initial support for the use of a psychological acceptance-based intervention for weight regain in bariatric surgery patients.

  13. Carotid artery remodelling in relation to body fat distribution, inflammation and sustained weight loss in obesity.

    Science.gov (United States)

    Kardassis, D; Schönander, M; Sjöström, L; Karason, K

    2014-05-01

    Obesity is known to be associated with carotid artery remodelling, but less is known about how body fat distribution, inflammation and weight loss may affect this relation. Ultrasonography, dual-energy X-ray absorptiometry and computed tomography were performed to evaluate carotid artery intima-media thickness (IMT), body composition and fat distribution, respectively. Participants were divided into three matched study groups (n = 44 per group): obese patients with sustained weight loss 10 years after bariatric surgery [surgery group, body mass index (BMI) 31.5 kg m(-2)]; obese patients who maintained stable weight during the same time period (obese group, BMI 42.5 kg m(-2)); and normal weight subjects (lean group, BMI 24.4 kg m(-2)). Patients in the surgery group, compared with those in the obese group, had slightly lower common carotid artery (CCA) IMT (0.75 ± 0.18 vs. 0.78 ± 0.17 mm) and common carotid bulb (CCB) IMT (0.92 ± 0.32 vs. 0.97 ± 0.32 mm); however, these differences were not statistically significant. Lean individuals, compared with those in the surgery group, had significantly lower CCA and CCB IMT values (P loss did not have thinner carotid artery walls compared with their weight-stable obese counterparts. © 2013 The Association for the Publication of the Journal of Internal Medicine.

  14. Body distortions after massive weight loss: lack of updating of the body schema hypothesis.

    Science.gov (United States)

    Guardia, D; Metral, M; Pigeyre, M; Bauwens, I; Cottencin, O; Luyat, M

    2013-09-01

    Behavioural therapy and bariatric surgery often produce rapid, massive body weight loss that may impact a patient's ability to gauge his/her new body shape. Although the patient is aware of the weight loss, he/she continues to feel obese, as if there was a conflict between the previous body schema and the new one. Here, we report the case of a 40-year-old woman who developed major body distortions after massive weight loss. Psychometric and behavioural assessments revealed strong disturbances in several tasks involving body representation. In particular, we observed abnormal behaviour in a body-scaled action task. Our findings suggest that the rapidity of our patient's weight loss prevented her central nervous system from correctly updating the body schema.

  15. Increased post-operative cardiopulmonary fitness in gastric bypass patients is explained by weight loss

    DEFF Research Database (Denmark)

    Lund, M. T.; Hansen, M.; Wimmelmann, C. L.

    2016-01-01

    Roux-en-Y gastric bypass (RYGB) leads to a major weight loss in obese patients. However, given that most patients remain obese after the weight loss, regular exercise should be part of a healthier lifestyle. The primary aim of this study was to investigate the cardiopulmonary fitness in obese......-perceived physical fitness increased after RYGB. Self-reported low- and high-intensity physical activity did not change. With weight loss, self-rated fitness level increased and the limitations to perform exercise decreased in RYGB patients. Nevertheless, as shown by the lower absolute VO2max, RYGB patients do...... patients before and after RYGB. Thirty-four patients had body composition and cardiopulmonary fitness (VO2max) assessed and completed questionnaires regarding physical activity and function twice before RYGB (time points A and B) and 4 and 18 months after surgery (time points C and D). Weight loss was 37...

  16. Preoperative weight loss program targeting women with overweight and hypertrophy of the breast - a pilot study.

    Science.gov (United States)

    Geiker, N R W; Horn, J; Astrup, A

    2017-04-01

    Among women with hypertrophic breasts, the clear majority are overweight or obese. Owing to increased risk of complications, women with a body mass index (BMI) above 25 kg m (-2) are precluded from reduction mammaplasty. The primary aim was to investigate if intensive weight loss could ready women with overweight for breast reduction surgery. Six women, all overweight [BMI 30.9 {28.5; 35.8} kg m (-2) ] with symptomatic hypertrophy of the breast, were included a 12-week weight loss program. All women desired reduction mammaplasty and were motivated for preoperational weight loss. The first 8 weeks consisted of a formula-based diet supplying 800 kcal daily, in the subsequent 4 weeks regular foods were reintroduced increasing the intake to 1200 kcal daily. Five women completed the trial, and achieved a median (range) weight loss of 10.2 (6.5; 19) kg. Initial breast volume was 1100-2500 mL per breast, this was reduced by 300 (200; 500) mL after the intervention; equivalent to approximately 19%. Waist, hip, upper arm and thorax circumference were significantly reduced following weight loss. At end of study, all the women still suffered from symptomatic breast hypertrophy to substantiate reduction mammaplasty. Surgeries were performed 2 months thereafter. A 12-week intensive preoperative weight loss program enabled women with obesity for breast reduction surgery. Breast size was reduced proportionally more than total weight loss among women with hypertrophy. © 2017 World Obesity Federation.

  17. Relationship of cravings with weight loss and hunger. Results from a 6 month worksite weight loss intervention.

    Science.gov (United States)

    Batra, Payal; Das, Sai Krupa; Salinardi, Taylor; Robinson, Lisa; Saltzman, Edward; Scott, Tammy; Pittas, Anastassios G; Roberts, Susan B

    2013-10-01

    We examined the association of food cravings with weight loss and eating behaviors in a lifestyle intervention for weight loss in worksites. This research was part of a randomized controlled trial of a 6-month weight loss intervention versus a wait-listed control in 4 Massachusetts worksites. The intervention emphasized reducing energy intake by adherence to portion-controlled menu suggestions, and assessments were obtained in 95 participants at baseline and 6 months including non-fasting body weight, food cravings (Craving Inventory and Food Craving Questionnaire for state and trait) and the eating behavior constructs restraint, disinhibition and hunger (Eating Inventory). There were statistically significant reductions in all craving variables in the intervention group compared to the controls. Within the intervention group, changes in craving-trait were significantly associated with weight loss after controlling for baseline weight, age, gender and worksite. However, in a multivariate model with craving-trait and eating behaviors (restraint, disinhibition and hunger), hunger was the only significant predictor of weight change. In contrast to some previous reports of increased food cravings with weight loss in lifestyle interventions, this study observed a broad reduction in cravings associated with weight loss. In addition, greater reductions in craving-trait were associated with greater weight change, but craving-trait was not a significant independent correlate of weight change when hunger was included in statistical models. Studies are needed to examine the effectiveness of hunger suppressing versus craving-suppressing strategies in lifestyle interventions for obesity.

  18. Indicadores de calidad en cirugía bariátrica: Valoración de la pérdida de peso Quality indicators in bariatric surgery: Weight loss valoration

    Directory of Open Access Journals (Sweden)

    P. Menéndez

    2009-02-01

    /m².The medical management of MO may be effective in the short and intermediate terms, although it usually fails then leading to surgical management. Our goal is to assess Capella's surgical technique by means of quality indicators including weight loss. The present work has been performed with surgical MO patients at the 12 de Octubre University Hospital during 2000-2001, and registering the follow-up checkups for the period 2000-2001/2003-2004. We reviewed the clinical charts of 23 patients. The average Body Mass Index (BMI was 52.24 ± 10.07 kg/m², (range, 41-74.41. When compiling the statistical results, we observed statistically significant post-surgical decreases with no differences whether the PEIMCP outcome was excellent (≥ 65%, fair (= 50-65% or failure (≤ 50% in the following parameters: BMI (p ≤ 0.001; Comorbidities (p ≤ 0.001; Hemoglobinemia (p ≤ 0.005; Glycemia (p ≤ 0.001; Triglyceridemia (p ≤ 0.001; Total cholesterolemia (p ≤ 0.001; Sideraemia (p ≤ 0.001; and serum cianocobalamine (p ≤ 0.001. We could not demonstrate statistically significant changes in the remaining parameters. However, under the presumption that the lack of evidence does not mean the evidence of the absence, that is to say, the results have been obtained from a small sample (N = 23 so that they may not be considered definitely conclusive. Considering the percentage of the loss of Body Mass Index excess as one of the quality indexes in bariatric surgery, we may state that Capella's gastric by-pass is efficient in obese patients with BMI ≤ 50 kg/m², doubtfully effective in patients with BMI 50-60 kg/m², and ineffective in super obese patients with BMI ≥ 60 kg/m².

  19. Weight-loss programs still fatten profits despite competition.

    Science.gov (United States)

    Larkin, H

    1990-04-01

    Why are hospitals interested in weight-loss programs? Low start-up costs, combined with a high demand for services, mean almost instant profits in some cases. And in an increasingly competitive market, hospital affiliation seems to be an advantage. But experts say that word of mouth is the best promotion for weight-loss programs, which means that patients must lose weight and keep the pounds off. That's why hospitals have found that patient education is integral to a successful program.

  20. Consequences of obesity and weight loss: a devil's advocate position

    Science.gov (United States)

    Brown, R E; Kuk, J L

    2015-01-01

    Obesity is associated with multiple negative health consequences and current weight management guidelines recommend all obese persons to lose weight. However, recent evidence suggests that not all obese persons are negatively affected by their weight and that weight loss does not necessarily always improve health. The purpose of this review is not to trivialize the significant health risks associated with obesity, but to discuss subpopulations of obese people who are not adversely affected, or may even benefit from higher adiposity, and in who weight loss per se may not always be the most appropriate recommendation. More specifically, this review will take a devil's advocate position when discussing the consequences of obesity and weight loss for adults with established cardiovascular disease and type 2 diabetes, weight cyclers, metabolically healthy obese adults, youth, older adults and obese individuals who are highly fit. PMID:25410935

  1. Physiogenomic analysis of weight loss induced by dietary carbohydrate restriction.

    Science.gov (United States)

    Ruaño, Gualberto; Windemuth, Andreas; Kocherla, Mohan; Holford, Theodore; Fernandez, Maria Luz; Forsythe, Cassandra E; Wood, Richard J; Kraemer, William J; Volek, Jeff S

    2006-05-15

    Diets that restrict carbohydrate (CHO) have proven to be a successful dietary treatment of obesity for many people, but the degree of weight loss varies across individuals. The extent to which genetic factors associate with the magnitude of weight loss induced by CHO restriction is unknown. We examined associations among polymorphisms in candidate genes and weight loss in order to understand the physiological factors influencing body weight responses to CHO restriction. We screened for genetic associations with weight loss in 86 healthy adults who were instructed to restrict CHO to a level that induced a small level of ketosis (CHO approximately 10% of total energy). A total of 27 single nucleotide polymorphisms (SNPs) were selected from 15 candidate genes involved in fat digestion/metabolism, intracellular glucose metabolism, lipoprotein remodeling, and appetite regulation. Multiple linear regression was used to rank the SNPs according to probability of association, and the most significant associations were analyzed in greater detail. Mean weight loss was 6.4 kg. SNPs in the gastric lipase (LIPF), hepatic glycogen synthase (GYS2), cholesteryl ester transfer protein (CETP) and galanin (GAL) genes were significantly associated with weight loss. A strong association between weight loss induced by dietary CHO restriction and variability in genes regulating fat digestion, hepatic glucose metabolism, intravascular lipoprotein remodeling, and appetite were detected. These discoveries could provide clues to important physiologic adaptations underlying the body mass response to CHO restriction.

  2. Physiogenomic analysis of weight loss induced by dietary carbohydrate restriction

    Directory of Open Access Journals (Sweden)

    Wood Richard J

    2006-05-01

    Full Text Available Abstract Background Diets that restrict carbohydrate (CHO have proven to be a successful dietary treatment of obesity for many people, but the degree of weight loss varies across individuals. The extent to which genetic factors associate with the magnitude of weight loss induced by CHO restriction is unknown. We examined associations among polymorphisms in candidate genes and weight loss in order to understand the physiological factors influencing body weight responses to CHO restriction. Methods We screened for genetic associations with weight loss in 86 healthy adults who were instructed to restrict CHO to a level that induced a small level of ketosis (CHO ~10% of total energy. A total of 27 single nucleotide polymorphisms (SNPs were selected from 15 candidate genes involved in fat digestion/metabolism, intracellular glucose metabolism, lipoprotein remodeling, and appetite regulation. Multiple linear regression was used to rank the SNPs according to probability of association, and the most significant associations were analyzed in greater detail. Results Mean weight loss was 6.4 kg. SNPs in the gastric lipase (LIPF, hepatic glycogen synthase (GYS2, cholesteryl ester transfer protein (CETP and galanin (GAL genes were significantly associated with weight loss. Conclusion A strong association between weight loss induced by dietary CHO restriction and variability in genes regulating fat digestion, hepatic glucose metabolism, intravascular lipoprotein remodeling, and appetite were detected. These discoveries could provide clues to important physiologic adaptations underlying the body mass response to CHO restriction.

  3. Significant weight loss in breastfed term infants readmitted for hyperbilirubinemia

    Directory of Open Access Journals (Sweden)

    De-Villegas Carlos A

    2009-12-01

    Full Text Available Abstract Background Weight loss of greater than 7% from birth weight indicates possible feeding problems. Inadequate oral intake causes weight loss and increases the bilirubin enterohepatic circulation. The objective of this study was to describe the association between total serum bilirubin (TSB levels and weight loss in healthy term infants readmitted for hyperbilirubinemia after birth hospitalization. Methods We reviewed medical records of breastfed term infants who received phototherapy according to TSB levels readmitted to Caja Petrolera de Salud Clinic in La Paz, Bolivia during January 2005 through October 2008. Results Seventy-nine infants were studied (64.6% were males. The hyperbilirubinemia readmission rate was 5% among breastfed infants. Term infants were readmitted at a median age of 4 days. Mean TSB level was 18.6 ± 3 mg/dL. Thirty (38% had significant weight loss. A weak correlation between TSB levels and percent of weight loss was identified (r = 0.20; p 20 mg/dL was notably higher among infants with significant weight loss (46.7% vs. 18.4%; p Conclusions Significant weight loss could be a useful parameter to identify breastfed term infants at risk of severe hyperbilirubinemia either during birth hospitalization or outpatient follow-up visits in settings where routine pre-discharge TSB levels have not been implemented yet.

  4. Behavior Change Strategies for Successful Long-Term Weight Loss: Focusing on Dietary and Physical Activity Adherence, Not Weight Loss

    Science.gov (United States)

    Hongu, Nobuko; Kataura, Martha P.; Block, Linda M.

    2011-01-01

    This article helps Extension professionals guide individuals in a successful long-term weight loss program. A program should focus on behavioral changes (improving eating habits and physical activity), not just weight loss. In order to do this, Extension professionals should implement behavior change strategies that motivate individuals to…

  5. Behavior Change Strategies for Successful Long-Term Weight Loss: Focusing on Dietary and Physical Activity Adherence, Not Weight Loss

    Science.gov (United States)

    Hongu, Nobuko; Kataura, Martha P.; Block, Linda M.

    2011-01-01

    This article helps Extension professionals guide individuals in a successful long-term weight loss program. A program should focus on behavioral changes (improving eating habits and physical activity), not just weight loss. In order to do this, Extension professionals should implement behavior change strategies that motivate individuals to…

  6. Cirurgia do contorno corporal no paciente após perda ponderal maciça: experiência de três anos em hospital público secundário Body contour surgery in the massive weight loss patient: three year-experience in a secondary public hospital

    Directory of Open Access Journals (Sweden)

    Simone Cristina Orpheu

    2009-01-01

    Full Text Available OBJETIVO: Apresentar a experiência clínico-cirúrgica de três anos relacionada às cirurgias de contorno corporal no paciente após perda ponderal maciça, realizadas pela equipe de Cirurgia Plástica do Hospital Estadual de Sapopemba. MÉTODOS: Estudo retrospectivo realizado no Hospital Estadual de Sapopemba, vinculado ao Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, no período de julho de 2005 a julho de 2008. Foram operados 98 pacientes submetidos a tratamento de obesidade mórbida por meio de gastroplastia redutora, com sucesso para a técnica, ou emagrecimento por método não-cirúrgico. Os critérios de exclusão foram tabagismo, intenção gestacional e instabilidade ponderal, exigindo-se peso estável por pelo menos seis meses após atingido a perda ponderal satisfatória. RESULTADOS: Dos 98 pacientes operados, 97% eram do sexo feminino, com idade média de 40,5 anos e o método de emagrecimento foi cirúrgico em 88% deles. Das 177 cirurgias plásticas realizadas, 46% foram abdominoplastias, seguidas por mastoplastias (15%, suspensões de coxa (13% e braquioplastias (12%. O período médio de internação foi dois dias e as principais complicações diagnosticadas foram: seroma (28%, necroses/deiscências de pequeno porte (18%, necroses/ deiscências de grande porte (4%, hematomas (4%, tromboflebite superficial de veia safena (2% e trombose venosa profunda (1%. CONCLUSÃO: O desejo de cirurgias para melhora do contorno corporal após perda ponderal maciça constitui demanda crescente. Cabe ao cirurgião plástico conhecer as peculiaridades clínicas e os riscos maiores de complicações desses pacientes, ponderar suas expectativas, analisar os resultados e manter a busca constante pelo aperfeiçoamento das técnicas cirúrgicas.OBJECTIVE: To present the clinical-surgical three year-experience related to body contour surgery in the massive weight loss patient, performed by the Plastic Surgery team of

  7. The downside of weight loss: realistic intervention in body-weight trajectory.

    Science.gov (United States)

    Bosomworth, N John

    2012-05-01

    To explore the reasons why long-term weight loss is seldom achieved and to evaluate the consequences of various weight trajectories, including stability, loss, and gain. Studies evaluating population weight metrics were mainly observational. Level I evidence was available to evaluate the influence of weight interventions on mortality and quality of life. Sustained weight loss is achieved by a small percentage of those intending to lose weight. Mortality is lowest in the high-normal and overweight range. The safest body-size trajectory is stable weight with optimization of physical and metabolic fitness. With weight loss there is evidence for lower mortality in those with obesity-related comorbidities. There is also evidence for improved health-related quality of life in obese individuals who lose weight. Weight loss in the healthy obese, however, is associated with increased mortality. Weight loss is advisable only for those with obesity-related comorbidities. Healthy obese people wishing to lose weight should be informed that there might be associated risks. A strategy that leads to a stable body mass index with optimized physical and metabolic fitness at any size is the safest weight intervention option.

  8. Longitudinal Analysis of Leptin Variation during Weight Regain after Weight Loss in Obese Children

    DEFF Research Database (Denmark)

    Jens-Christian, Holm; Michael, Gamborg; Leigh, Ward

    2009-01-01

    Objective: This study assessed if lower than predicted serum leptin concentrations seen during weight loss persisted during weight regain, with possible implications for weight control. Methods: 115 children were investigated during a 12-week weight loss program. 90 children completed the program......, and 68 children entered a follow-up program spanning 28 months. Measurements were performed at baseline and day 82 as well as at months 10, 16, and 28. Height, weight, body composition, Tanner stages, testicular size, and serum concentrations of leptin, and insulin were measured at all time points....... Results: Children with the greatest increases in BMI standard deviation score (SDS) exhibited the largest leptin increments. The disproportionate reduction of leptin seen during weight loss recovered after weight loss. Leptin increases mirrored increases in BMI SDS during weight regain, and the leptin...

  9. Evidence-based strategies in weight-loss mobile apps.

    Science.gov (United States)

    Pagoto, Sherry; Schneider, Kristin; Jojic, Mirjana; DeBiasse, Michele; Mann, Devin

    2013-11-01

    Physicians have limited time for weight-loss counseling, and there is a lack of resources to which they can refer patients for assistance with weight loss. Weight-loss mobile applications (apps) have the potential to be a helpful tool, but the extent to which they include the behavioral strategies included in evidence-based interventions is unknown. The primary aims of the study were to determine the degree to which commercial weight-loss mobile apps include the behavioral strategies included in evidence-based weight-loss interventions, and to identify features that enhance behavioral strategies via technology. Thirty weight-loss mobile apps, available on iPhone and/or Android platforms, were coded for whether they included any of 20 behavioral strategies derived from an evidence-based weight-loss program (i.e., Diabetes Prevention Program). Data on available apps were collected in January 2012; data were analyzed in June 2012. The apps included on average 18.83% (SD=13.24; range=0%-65%) of the 20 strategies. Seven of the strategies were not found in any app. The most common technology-enhanced features were barcode scanners (56.7%) and a social network (46.7%). Weight-loss mobile apps typically included only a minority of the behavioral strategies found in evidence-based weight-loss interventions. Behavioral strategies that help improve motivation, reduce stress, and assist with problem solving were missing across apps. Inclusion of additional strategies could make apps more helpful to users who have motivational challenges. © 2013 American Journal of Preventive Medicine.

  10. Resistance to exercise-induced weight loss: compensatory behavioral adaptations.

    Science.gov (United States)

    Melanson, Edward L; Keadle, Sarah Kozey; Donnelly, Joseph E; Braun, Barry; King, Neil A

    2013-08-01

    In many interventions that are based on an exercise program intended to induce weight loss, the mean weight loss observed is modest and sometimes far less than what the individual expected. The individual responses are also widely variable, with some individuals losing a substantial amount of weight, others maintaining weight, and a few actually gaining weight. The media have focused on the subpopulation that loses little weight, contributing to a public perception that exercise has limited utility to cause weight loss. The purpose of the symposium was to present recent, novel data that help explain how compensatory behaviors contribute to a wide discrepancy in exercise-induced weight loss. The presentations provide evidence that some individuals adopt compensatory behaviors, that is, increased energy intake and/or reduced activity, that offset the exercise energy expenditure and limit weight loss. The challenge for both scientists and clinicians is to develop effective tools to identify which individuals are susceptible to such behaviors and to develop strategies to minimize their effect.

  11. The effectiveness of breakfast recommendations on weight loss

    DEFF Research Database (Denmark)

    Dhurandhar, Emily J; Dawson, John; Alcorn, Amy

    2014-01-01

    effectiveness of a recommendation to eat or skip breakfast on weight loss in adults trying to lose weight in a free-living setting. DESIGN: We conducted a multisite, 16-wk, 3-parallel-arm randomized controlled trial in otherwise healthy overweight and obese adults [body mass index (in kg/m(2)) between 25 and 40......] aged 20-65 y. Our primary outcome was weight change. We compared weight change in a control group with weight loss in experimental groups told to eat breakfast or to skip breakfast [no breakfast (NB)]. Randomization was stratified by prerandomization breakfast eating habits. A total of 309 participants...... were randomly assigned.RESULTS: A total of 283 of the 309 participants who were randomly assigned completed the intervention. Treatment assignment did not have a significant effect on weight loss, and there was no interaction between initial breakfast eating status and treatment. Among skippers, mean...

  12. Behavioral Weight Loss Treatments for Individuals with Migraine and Obesity.

    Science.gov (United States)

    Cervoni, Cynthia; Bond, Dale S; Seng, Elizabeth K

    2016-02-01

    Migraine and obesity are each prevalent disorders involving significant personal and societal burden. Epidemiologic research demonstrates a link between migraine and obesity that is further substantiated by putative behavioral, psychosocial, and physiological mechanisms. As obesity is considered a modifiable risk factor for exacerbation of migraine, weight loss may be a particularly useful treatment option for people with comorbid migraine and obesity. Behavioral weight loss interventions complement existing behavioral treatments for migraine and offer patients evidence-based effective strategies for achieving weight loss that could help reduce frequency, severity, and impact of migraine attacks.

  13. Acute liver injury induced by weight-loss herbal supplements.

    Science.gov (United States)

    Chen, Gary C; Ramanathan, Vivek S; Law, David; Funchain, Pauline; Chen, George C; French, Samuel; Shlopov, Boris; Eysselein, Viktor; Chung, David; Reicher, Sonya; Pham, Binh V

    2010-11-27

    We report three cases of patients with acute liver injury induced by weight-loss herbal supplements. One patient took Hydroxycut while the other two took Herbalife supplements. Liver biopsies for all patients demonstrated findings consistent with drug-induced acute liver injury. To our knowledge, we are the first institute to report acute liver injury from both of these two types of weight-loss herbal supplements together as a case series. The series emphasizes the importance of taking a cautious approach when consuming herbal supplements for the purpose of weight loss.

  14. Physician Communication Techniques and Weight Loss in Adults

    Science.gov (United States)

    Pollak, Kathryn I.; Alexander, Stewart C.; Coffman, Cynthia J.; Tulsky, James A.; Lyna, Pauline; Dolor, Rowena J.; James, Iguehi E.; Namenek Brouwer, Rebecca J.; Manusov, Justin R.E.; Østbye, Truls

    2010-01-01

    Background Physicians are encouraged to counsel overweight and obese patients to lose weight. Purpose It was examined whether discussing weight and use of motivational-interviewing techniques (e.g., collaborating, reflective listening) while discussing weight predicted weight loss 3 months after the encounter. Methods 40 primary care physicians and 461 of their overweight or obese patient visits were audio recorded between December 2006 and June 2008. Patient actual weight at the encounter and 3 months after the encounter (n=426), whether weight was discussed, physicians’ use of Motivational-Interviewing techniques, and patient, physician and visit covariates (e.g., race, age, specialty) were assessed. This was an observational study and data were analyzed in April 2009. Results No differences in weight loss were found between patients whose physicians discussed weight or did not. Patients whose physicians used motivational interviewing–consistent techniques during weight-related discussions lost weight 3 months post-encounter; those whose physician used motivational interviewing–inconsistent techniques gained or maintained weight. The estimated difference in weight change between patients whose physician had a higher global “motivational interviewing–Spirit” score (e.g., collaborated with patient) and those whose physician had a lower score was 1.6 kg (95% CI=−2.9, −0.3, p=.02). The same was true for patients whose physician used reflective statements 0.9 kg (95% CI=−1.8, −0.1, p=.03). Similarly, patients whose physicians expressed only motivational interviewing–consistent behaviors had a difference in weight change of 1.1 kg (95% CI=−2.3, 0.1, p=.07) compared to those whose physician expressed only motivational interviewing–inconsistent behaviors (e.g., judging, confronting). Conclusions In this small observational study, use of motivational-interviewing techniques during weight loss discussions predicted patient weight loss. PMID

  15. Randomized trial of tapas acupressure technique for weight loss maintenance

    Directory of Open Access Journals (Sweden)

    Elder Charles R

    2012-03-01

    Full Text Available Abstract Background Obesity is an urgent public health problem, yet only a few clinical trials have systematically tested the efficacy of long-term weight-loss maintenance interventions. This randomized clinical trial tested the efficacy of a novel mind and body technique for weight-loss maintenance. Methods Participants were obese adults who had completed a six-month behavioral weight-loss program prior to randomization. Those who successfully lost weight were randomized into either an experimental weight-loss maintenance intervention, Tapas Acupressure Technique (TAT®, or a control intervention comprised of social-support group meetings (SS led by professional facilitators. TAT combines self-applied light pressure to specific acupressure points accompanied by a prescribed sequence of mental steps. Participants in both maintenance conditions attended eight group sessions over six months of active weight loss maintenance intervention, followed by an additional 6 months of no intervention. The main outcome measure was change in weight from the beginning of the weight loss maintenance intervention to 12 months later. Secondary outcomes were change in depression, stress, insomnia, and quality of life. We used analysis of covariance as the primary analysis method. Missing values were replaced using multiple imputation. Results Among 285 randomized participants, 79% were female, mean age was 56 (standard deviation (sd = 11, mean BMI at randomization was 34 (sd = 5, and mean initial weight loss was 9.8 kg (sd = 5. In the primary outcome model, there was no significant difference in weight regain between the two arms (1.72 kg (se 0.85 weight regain for TAT and 2.96 kg (se 0.96 weight regain for SS, p post hoc tests showing that greater initial weight loss was associated with more weight regain for SS but less weight regain for TAT. Conclusions The primary analysis showed no significant difference in weight regain between TAT and SS, while secondary

  16. Involuntary weight loss in elderly individuals: assessment and treatment

    Directory of Open Access Journals (Sweden)

    Julio Cesar Moriguti

    Full Text Available CONTEXT: The loss of body weight and fat late in life is associated with premature death and increased risk of disability, even after excluding elderly subjects who have a preexisting disease. Although it is important to recognize that periods of substantially positive or negative energy balance and body weight fluctuation occur as a normal part of life, weight losses greater than 5% over 6 months should be investigated. We can divide the major causes of weight loss in the elderly into 4 categories: social, psychiatric, due to medical conditions, and age-related. The clinical evaluation should include a careful history and physical examination. If these fail to provide clues to the weight loss, simple diagnostic tests are indicated. A period of watchful waiting is preferable to blind pursuit of additional diagnostic testing that may yield few useful data, if the results of these initial tests are normal. The first step in managing patients with weight loss is to identify and treat any specific causative or contributing conditions and to provide nutritional support when indicated. Non-orexigenic drugs have found an established place in the management of protein-energy malnutrition. Early attention to nutrition and prevention of weight loss during periods of acute stress, particularly during hospitalization, may be extremely important, as efforts directed at re-feeding are often unsuccessful. DESIGN: Narrative review.

  17. Baseline circulating ghrelin does not predict weight regain neither maintenance of weight loss after gastric bypass at long term.

    Science.gov (United States)

    Pellitero, Silvia; Pérez-Romero, Noelia; Martínez, Eva; Granada, María L; Moreno, Pau; Balibrea, Jose M; Tarascó, Jordi; Lucas, Anna; Puig-Domingo, Manel

    2015-08-01

    Predictors of weight loss (WL) or weight regain (WR) after Roux-en-Y gastric bypass (RYGBP) are not established. The aim of this study was to analyze the usefulness of some baseline peptides (leptin, insulin, and ghrelin) as biomarkers of WL and WR in morbid obese patients after RYGBP at long term. Seventy-six morbid obese (47 women, age 41.6 ± 9.6 years, body mass index [BMI] 52.1 ± 8 kg/m(2)) patients were evaluated at baseline and at 1, 2, and 6 years after surgery. Excess body weight loss after 6 years was of 63.9%. Age, BMI, and studied hormones at baseline or their changes over time did not predict long-term excess body weight loss. WR greater than 10% was observed in 36.8% of patients between 2 and 6 years of follow-up, but it was not correlated with BMI, age, or baseline peptide concentrations. Measurement of ghrelin, insulin, and leptin before surgery is not useful as predictors of WL or WR at long term after RYGBP. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Outcomes associated with preoperative weight loss after laparoscopic Roux-en-Y gastric bypass.

    Science.gov (United States)

    Blackledge, Camille; Graham, Laura A; Gullick, Allison A; Richman, Joshua; Stahl, Richard; Grams, Jayleen

    2016-11-01

    Laparoscopic Roux-en-Y gastric bypass (LRYGB) is an effective treatment for achieving and maintaining weight loss and for improving obesity-related comorbidities. As part of the approval process for bariatric surgery, many insurance companies require patients to have documented recent participation in a supervised weight loss program. The goal of this study was to evaluate the relationship of preoperative weight changes with outcomes following LRYGB. A retrospective review was conducted of adult patients undergoing LRYGB between 2008 and 2012 at a single institution. Patients were stratified into quartiles based on % excess weight gain (0-4.99 % and ≥5 % EWG) and % excess weight loss (0-4.99 % and ≥5 % EWL). Generalized linear models were used to examine differences in postoperative weight outcomes at 6, 12, and 24 months. Covariates included in the final adjusted models were determined using backwards stepwise selection. Of the 300 patients included in the study, there were no significant demographic differences among the quartiles. However, there was an increased time to operation for patients who gained or lost ≥5 % excess body weight (p models showed no statistically significant association between preoperative % excess weight change and weight loss outcomes at 24 months. Patients with the greatest % preoperative excess weight change had the longest intervals from initial visit to operation. No significant differences were seen in perioperative and postoperative outcomes. This study suggests preoperative weight loss requirements may delay the time to operation without improving postoperative outcomes or weight loss.

  19. Weight loss and African-American women: a systematic review of the behavioural weight loss intervention literature.

    Science.gov (United States)

    Fitzgibbon, M L; Tussing-Humphreys, L M; Porter, J S; Martin, I K; Odoms-Young, A; Sharp, L K

    2012-03-01

    The excess burden of obesity among African-American women is well documented. However, the behavioural weight loss intervention literature often does not report results by ethnic group or gender. The purpose of this article is to conduct a systematic review of all behavioural weight loss intervention trials published between 1990 and 2010 that included and reported results separately for African-American women. The criteria for inclusion included (i) participants age ≥18 years; (ii) a behavioural weight loss intervention; (iii) weight as an outcome variable; (iv) inclusion of African-American women; and (v) weight loss results reported separately by ethnicity and gender. The literature search identified 25 studies that met inclusion criteria. Our findings suggest that more intensive randomized behavioural weight loss trials with medically at-risk populations yield better results. Well-designed and more intensive multi-site trials with medically at-risk populations currently offer the most promising results for African-American women. Still, African-American women lose less weight than other subgroups in behavioural weight loss interventions. It is now critical to expand on individual-level approaches and incorporate the biological, social and environmental factors that influence obesity. This will help enable the adoption of healthier behaviours for this group of women disproportionately affected by obesity.

  20. Biochemical parameters response to weight loss in patients with non ...

    African Journals Online (AJOL)

    Conclusion: Weight loss modulates insulin resistance, adiponectin, leptin, inflammatory cytokine levels and markers of ..... had significant change in levels of AST and ALT from baseline .... World Health Organization: Diet, Nutrition and the.

  1. Weight Loss: Choosing a Diet That's Right for You

    Science.gov (United States)

    ... Examples: Ornish, Pritikin Flexible? No. Total fat and saturated fat are limited. Because even lean cuts of meat, ... of 4 popular diets on weight loss and cardiovascular risk factors: A systematic review of randomized controlled ...

  2. Plant-Based Diets Score Big for Healthy Weight Loss

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_162874.html Plant-Based Diets Score Big for Healthy Weight Loss ... row, U.S. News & World Report has named the plant-based eating plan as the best choice overall, ...

  3. Major rapid weight loss induces changes in cardiac repolarization

    DEFF Research Database (Denmark)

    Vedel-Larsen, Esben; Iepsen, Eva Winning; Lundgren, Julie

    2016-01-01

    INTRODUCTION: Obesity is associated with increased all-cause mortality, but weight loss may not decrease cardiovascular events. In fact, very low calorie diets have been linked to arrhythmias and sudden death. The QT interval is the standard marker for cardiac repolarization, but T-wave morphology...... analysis has been suggested as a more sensitive method to identify changes in cardiac repolarization. We examined the effect of a major and rapid weight loss on T-wave morphology. METHODS AND RESULTS: Twenty-six individuals had electrocardiograms (ECG) taken before and after eight weeks of weight loss......A1c (pweight loss induces changes in cardiac repolarization. Monitoring of MCS during calorie restriction makes it possible to detect repolarization changes with higher discriminative power than the QT-interval during major rapid weight...

  4. Can Weight Loss Reduce the Need for Blood Pressure Medication?

    Science.gov (United States)

    ... weight loss reduce the need for blood pressure medication? Answers from Sheldon G. Sheps, M.D. If ... possible to reduce your dose of blood pressure medication — or stop taking your blood pressure medication completely. ...

  5. Myocardial oxygen consumption change predicts left ventricular relaxation improvement in obese humans after weight loss.

    Science.gov (United States)

    Lin, C Huie; Kurup, Suraj; Herrero, Pilar; Schechtman, Kenneth B; Eagon, J Christopher; Klein, Samuel; Dávila-Román, Víctor G; Stein, Richard I; Dorn, Gerald W; Gropler, Robert J; Waggoner, Alan D; Peterson, Linda R

    2011-09-01

    Obesity adversely affects myocardial metabolism, efficiency, and diastolic function. Our objective was to determine whether weight loss can ameliorate obesity-related myocardial metabolism and efficiency derangements and that these improvements directly relate to improved diastolic function in humans. We studied 30 obese (BMI >30 kg/m2) subjects with positron emission tomography (PET) (myocardial metabolism, blood flow) and echocardiography (structure, function) before and after marked weight loss from gastric bypass surgery (N = 10) or moderate weight loss from diet (N = 20). Baseline BMI, insulin resistance, hemodynamics, left ventricular (LV) mass, systolic function, myocardial oxygen consumption (MVO2), and fatty acid (FA) metabolism were similar between the groups. MVO2/g decreased after diet-induced weight loss (P = 0.009). Total MVO2 decreased after dietary (P = 0.02) and surgical weight loss (P = 0.0006) and was related to decreased BMI (P = 0.006). Total myocardial FA utilization decreased (P = 0.03), and FA oxidation trended lower (P = 0.06) only after surgery. FA esterification and LV efficiency were unchanged. After surgical weight loss, LV mass decreased by 23% (Doppler-derived) E/E' by 33%, and relaxation increased (improved) by 28%. Improved LV relaxation related significantly to decreased BMI, insulin resistance, total MVO2, and LV mass but not FA utilization. Decreased total MVO(2) predicted LV relaxation improvement independent of BMI change (P = 0.02). Weight loss can ameliorate the obesity-related derangements in myocardial metabolism and LV structure and diastolic function. Decreased total MVO2 independently predicted improved LV relaxation, suggesting that myocardial oxygen metabolism may be mechanistically important in determining cardiac relaxation.

  6. Bariatric surgery versus lifestyle interventions for morbid obesity--changes in body weight, risk factors and comorbidities at 1 year.

    Science.gov (United States)

    Martins, Catia; Strømmen, Magnus; Stavne, Ola A; Nossum, Randi; Mårvik, Ronald; Kulseng, Bård

    2011-07-01

    Few studies have looked at non-surgical alternatives for morbid obese patients. This study aims to compare 1-year weight loss and changes in risk factors and comorbidities after bariatric surgery and three conservative treatments. Patients with morbid obesity (BMI > 40 or BMI > 35 kg/m(2) plus comorbidities) on waiting list for bariatric surgery, were non-randomly allocated to (A) bariatric surgery or to one of three conservative treatments; (B) residential intermittent program; (C) commercial weight loss camp and (D) hospital outpatient program. Body weight, risk factors and comorbidities were assessed at baseline and 1 year. Of 206 participants, 179 completed the study. All treatments resulted in significant weight loss, but bariatric surgery (40 ± 14 kg, 31 ± 9%) led to the largest weight loss (P < 0.0001). There were no differences in weight loss between B and C (22 ± 13 kg, 15 ± 8% vs. 18 ± 12 kg, 13 ± 8%), but these resulted in larger weight loss compared with D (7 ± 10 kg, 5 ± 8%). There were no differences in changes in total or LDL cholesterol, triacylglycerols or glucose between groups; however, the increase in HDL cholesterol was significantly larger in groups A and C. There were no differences in comorbidities resolution between groups A and B, C and D combined (except hypertension, which was better in group A). In conclusion, although bariatric surgery leads to a greater weight loss at 1 year compared with conservative treatment, in patients with morbid obesity, clinical significant weight loss and similar improvements in risk factors and comorbidities resolution can also be achieved with lifestyle interventions.

  7. Weight Loss Is Still an Essential Intervention in Obesity and its Complications: A Review

    Directory of Open Access Journals (Sweden)

    Jianzhong Xiao

    2012-01-01

    Full Text Available The prevalence of obesity is more than 20% in many developed countries and it increases in developing countries. Obesity is associated with metabolic disorders, cardiovascular diseases, pulmonary diseases, digestive diseases, and cancers. Although other specific treatments for these complications exist, weight loss is still an essential intervention in obesity and its complications. Therapeutic life change, behavior modification, pharmacotherapy, and surgery are major approaches to weight loss. In addition, medicine used in diabetes such as Glucagon-like peptide-1 analogues may be a new type of medicine for obesity, at least for those obese patients with diabetes.

  8. Potential Mechanisms Mediating Sustained Weight Loss Following Roux-en-Y Gastric Bypass and Sleeve Gastrectomy.

    Science.gov (United States)

    Makaronidis, Janine M; Batterham, Rachel L

    2016-09-01

    Bariatric surgery is the only effective treatment for severe obesity. Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), the most commonly performed procedures, lead to sustained weight loss, improvements in obesity-related comorbidities and reduced mortality. In humans, the main driver for weight loss following RYGB and SG is reduced energy intake. Reduced appetite, changes in subjective taste and food preference, and altered neural response to food cues are thought to drive altered eating behavior. The biological mediators underlying these changes remain incompletely understood but changes in gut-derived signals, as a consequence of altered nutrient and/or biliary flow, are key candidates.

  9. The impact of weight loss among seniors on Medicare spending

    OpenAIRE

    Thorpe, Kenneth E.; Yang, Zhou; Long, Kathleen M.; Garvey, W. Timothy

    2013-01-01

    Objective: To examine the impact of temporary and permanent weight loss of 10% and 15% on 10-year and lifetime Medicare spending among adults with overweight and obesity aged 65 years and older. Weight loss of this magnitude is consistent with next generation anti-obesity medications recently approved by the Food and Drug Administration. Methods: We follow the approach of a longitudinal dynamic aging process model developed by our research team. This model considers the dynamic relationships ...

  10. Supplementation with carnitine for weight loss: a biochemical approach

    Directory of Open Access Journals (Sweden)

    José Henry Osorio

    2011-11-01

    Full Text Available Carnitine is a molecule involved in transporting activated fatty acids among different cellular compartments, which is mostlikely present in all animal species, and in numerous microorganisms and plants. Recently the trend in the field of weightcontrol is to include carnitine in the diet as an agent responsible for weight loss. In the present review, some findings arediscussed from a biochemical point of view to illustrate if the use of carnitine for weight loss can be considered fiction orreality.

  11. Supplementation with carnitine for weight loss: a biochemical approach

    OpenAIRE

    José Henry Osorio

    2011-01-01

    Carnitine is a molecule involved in transporting activated fatty acids among different cellular compartments, which is mostlikely present in all animal species, and in numerous microorganisms and plants. Recently the trend in the field of weightcontrol is to include carnitine in the diet as an agent responsible for weight loss. In the present review, some findings arediscussed from a biochemical point of view to illustrate if the use of carnitine for weight loss can be considered fiction orre...

  12. The Relationship Between Intuitive Eating and Postpartum Weight Loss.

    Science.gov (United States)

    Leahy, Katie; Berlin, Kristoffer S; Banks, Gabrielle G; Bachman, Jessica

    2017-08-01

    Objective Postpartum weight loss is challenging for new mothers who report limited time and difficulties following traditional weight loss methods. Intuitive eating (IE) is a behavior that includes eating based on physical hunger and fullness and may have a role in encouraging weight loss. The purpose of this study was to examine the relationship between IE and postpartum weight loss. Methods Women 12-18 months postpartum completed a questionnaire regarding weight changes surrounding pregnancy, exercise, breastfeeding and intuitive eating using the Intuitive Eating Scale. Latent growth curve modeling was utilized to determine the relationship between IE, breastfeeding, weight gain during pregnancy, and postpartum weight trajectories. Results Participants (n = 50) were 28.5 ± 4.9 years old, had an average pre-pregnancy BMI of 26.4 ± 6.8 and the majority were married, and non-Hispanic white. The conditional model revealed that more intuitive eating practices predicted greater postpartum BMI decreases (Est. = -0.10, p < .05) when controlling for breastfeeding duration, exercise duration, and initial BMI and pregnancy BMI changes. Greater pregnancy BMI increases were associated with more rapid postpartum BMI decreases (Est. = -0.34, p < .001) while breastfeeding duration, exercise and initial BMI were not related. Conclusions for Practice Postpartum weight retention is a challenge for many women. Following a more intuitive eating approach to food consumption may encourage postpartum weight loss without the required weighing, measuring, recording and assessing dietary intake that is required of traditional weight loss programs. IE could offer an alternative approach that may be less arduous for new mothers.

  13. A twin study of weight loss and metabolic efficiency.

    Science.gov (United States)

    Hainer, V; Stunkard, A; Kunesová, M; Parízková, J; Stich, V; Allison, D B

    2001-04-01

    To assess the genetic contribution to determinants of therapeutic weight loss in obese female identical twins. Subjects were studied for 40 days on an inpatient unit in three phases: 7 baseline days; 28 days of weight reduction by a very low calorie diet (1.6 MJ per day); and 5 days after weight reduction. Fourteen pairs of premenopausal obese female identical twins (age: 39.0+/-1.7 y; body weight (BW): 93.9+/-21.2 kg; body mass index (BMI): 34.2+/-7.8 kg/m2). : Body composition by hydrodensitometry and resting metabolic rate by indirect calorimetry were assessed before and after weight loss. : There was great variability among pairs in loss of weight (5.9-12.4 kg) and body fat (3.1-12.4 kg). By contrast, the intraclass correlation (ICC) within twin pairs was 0.85, P<0.001 for weight and 0.88, P<0.001 for body fat. A measure of metabolic efficiency, calculated as the difference between 'estimated' and 'measured' energy deficit showed high intrapair correlation (ICC=0.77; P<0.001). The high correlation in metabolic efficiency within twin pairs in response to therapeutic weight loss suggests a strong genetic contribution.

  14. Hurricane Loss Analysis Based on the Population-Weighted Index

    Directory of Open Access Journals (Sweden)

    Grzegorz Kakareko

    2017-08-01

    Full Text Available This paper discusses different measures for quantifying regional hurricane loss. The main measures used in the past are normalized percentage loss and dollar value loss. In this research, we show that these measures are useful but may not properly reflect the size of the population influenced by hurricanes. A new loss measure is proposed that reflects the hurricane impact on people occupying the structure. For demonstrating the differences among these metrics, regional loss analysis was conducted for Florida. The regional analysis was composed of three modules: the hazard module stochastically modeled the wind occurrence in the region; the vulnerability module utilized vulnerability functions developed in this research to calculate the loss; and the financial module quantified the hurricane loss. In the financial module, we calculated three loss metrics for certain region. The first metric is the average annual loss (AAL which represents the expected loss per year in percentage. The second is the average annual dollar loss which represents the expected dollar amount loss per year. The third is the average annual population-weighted loss (AAPL—a new measure proposed in this research. Compared with the AAL, the AAPL reflects the number of people influenced by the hurricane. The advantages of the AAPL are illustrated using three different analysis examples: (1 conventional regional loss analysis, (2 mitigation potential analysis, and (3 forecasted future loss analysis due to the change in population.

  15. The impact of weight loss among seniors on Medicare spending.

    Science.gov (United States)

    Thorpe, Kenneth E; Yang, Zhou; Long, Kathleen M; Garvey, W Timothy

    2013-03-20

    To examine the impact of temporary and permanent weight loss of 10% and 15% on 10-year and lifetime Medicare spending among adults with overweight and obesity aged 65 years and older. Weight loss of this magnitude is consistent with next generation anti-obesity medications recently approved by the Food and Drug Administration. We follow the approach of a longitudinal dynamic aging process model developed by our research team. This model considers the dynamic relationships between weight, chronic disease, acute medical events, functional status, mortality, health care utilization and spending among Medicare beneficiaries from age 65 until death. Using this model, we estimate baseline Medicare spending over the next decade and then over the lifetime of seniors with a body mass index (BMI) ≥ 27 with at least one weight-related comorbidity (overweight), and seniors with obesity having a BMI ≥ 30 and ≥ 35. We then estimate Medicare spending for this population between ages 65 and 70 over the course of a year, assuming 10% and 15% weight loss under alternative scenarios: with and without weight regain. (Weight regain is assumed to be 90% over a 10-year period.) The difference in spending between baseline (no weight-loss intervention) and the alternative scenarios represent potential gross savings to the Medicare program. Permanent weight loss of 10 to 15% will yield $9,445 to $15,987 in gross per capita savings throughout their lifetime, and $8,070 to $13,474 over ten years. Similarly, initial weight loss of 10 to 15% followed by 90% weight regain will result in gross per capita savings of $7,556 to $11,109 over their lifetime, and $6,456 to $8,911 over ten years. Targeting weight loss medications to adults with obesity (BMI ≥ 30) produces greater savings to the Medicare program. Medicare can realize significant cost savings through anti-obesity medications that produce substantial weight loss, and as a result, reduce the progression to type 2 diabetes, and

  16. Weight loss before conception: A systematic literature review

    Directory of Open Access Journals (Sweden)

    Elisabet Forsum

    2013-03-01

    Full Text Available The prevalence of overweight and obesity in women has increased during the last decades. This is a serious concern since a high BMI before conception is an independent risk factor for many adverse outcomes of pregnancy. Therefore, dietary counseling, intended to stimulate weight loss in overweight and obese women prior to conception has recently been recommended. However, dieting with the purpose to lose weight may involve health risks for mother and offspring. We conducted a systematic literature review to identify papers investigating the effects of weight loss due to dietary interventions before conception. The objective of this study is to assess the effect of weight loss prior to conception in overweight or obese women on a number of health-related outcomes in mother and offspring using studies published between January 2000 and December 2011. Our first literature search produced 486 citations and, based on predefined eligibility criteria, 58 were selected and ordered in full text. Two group members read each paper. Fifteen studies were selected for quality assessment and two of them were considered appropriate for inclusion in evidence tables. A complementary search identified 168 citations with four papers being ordered in full text. The two selected studies provided data for overweight and obese women. One showed a positive effect of weight loss before pregnancy on the risk of gestational diabetes and one demonstrated a reduced risk for large-for-gestational-age infants in women with a BMI above 25 who lost weight before pregnancy. No study investigated the effect of weight loss due to a dietary intervention before conception. There is a lack of studies on overweight and obese women investigating the effect of dietary-induced weight loss prior to conception on health-related variables in mother and offspring. Such studies are probably lacking since they are difficult to conduct. Therefore, alternative strategies to control the body

  17. Concomitant changes in sleep duration and body weight and body composition during weight loss and 3-mo weight maintenance.

    Science.gov (United States)

    Verhoef, Sanne P M; Camps, Stefan G J A; Gonnissen, Hanne K J; Westerterp, Klaas R; Westerterp-Plantenga, Margriet S

    2013-07-01

    An inverse relation between sleep duration and body mass index (BMI) has been shown. We assessed the relation between changes in sleep duration and changes in body weight and body composition during weight loss. A total of 98 healthy subjects (25 men), aged 20-50 y and with BMI (in kg/m(2)) from 28 to 35, followed a 2-mo very-low-energy diet that was followed by a 10-mo period of weight maintenance. Body weight, body composition (measured by using deuterium dilution and air-displacement plethysmography), eating behavior (measured by using a 3-factor eating questionnaire), physical activity (measured by using the validated Baecke's questionnaire), and sleep (estimated by using a questionnaire with the Epworth Sleepiness Scale) were assessed before and immediately after weight loss and 3- and 10-mo follow-ups. The average weight loss was 10% after 2 mo of dieting and 9% and 6% after 3- and 10-mo follow-ups, respectively. Daytime sleepiness and time to fall asleep decreased during weight loss. Short (≤7 h) and average (>7 to weight loss. This change in sleep duration was concomitantly negatively correlated with the change in BMI during weight loss and after the 3-mo follow-up and with the change in fat mass after the 3-mo follow-up. Sleep duration benefits from weight loss or vice versa. Successful weight loss, loss of body fat, and 3-mo weight maintenance in short and average sleepers are underscored by an increase in sleep duration or vice versa. This trial was registered at clinicaltrials.gov as NCT01015508.

  18. Biological mechanisms that promote weight regain following weight loss in obese humans.

    Science.gov (United States)

    Ochner, Christopher N; Barrios, Dulce M; Lee, Clement D; Pi-Sunyer, F Xavier

    2013-08-15

    Weight loss dieting remains the treatment of choice for the vast majority of obese individuals, despite the limited long-term success of behavioral weight loss interventions. The reasons for the near universal unsustainability of behavioral weight loss in [formerly] obese individuals have not been fully elucidated, relegating researchers to making educated guesses about how to improve obesity treatment, as opposed to developing interventions targeting the causes of weight regain. This article discusses research on several factors that may contribute to weight regain following weight loss achieved through behavioral interventions, including adipose cellularity, endocrine function, energy metabolism, neural responsivity, and addiction-like neural mechanisms. All of these mechanisms are engaged prior to weight loss, suggesting that these so called "anti-starvation" mechanisms are activated via reductions in energy intake, rather than depletion of energy stores. Evidence suggests that these mechanisms are not necessarily part of a homeostatic feedback system designed to regulate body weight, or even anti-starvation mechanisms per se. Although they may have evolved to prevent starvation, they appear to be more accurately described as anti-weight loss mechanisms, engaged with caloric restriction irrespective of the adequacy of energy stores. It is hypothesized that these factors may combine to create a biological disposition that fosters the maintenance of an elevated body weight and works to restore the highest sustained body weight, thus precluding the long-term success of behavioral weight loss. It may be necessary to develop interventions that attenuate these biological mechanisms in order to achieve long-term weight reduction in obese individuals. © 2013 Elsevier Inc. All rights reserved.

  19. Can't wait to lose weight? Characterizing temporal discounting parameters for weight-loss.

    Science.gov (United States)

    Lim, Seung-Lark; Bruce, Amanda S

    2015-02-01

    Obesity is often related to steeper temporal discounting, that is, higher decision impulsivity for immediate rewards over delayed rewards. However, previous studies have measured temporal discounting parameters through monetary rewards. The aim of this study was to develop a temporal discounting measure based on weight-loss rewards, which may help to understand decision-making mechanisms more closely related to body weight regulation. After having their heights and weights measured, healthy young adults completed the Monetary Choice Questionnaire (MCQ), and an adapted version of the MCQ, with weight-loss as a reward. Participants also completed self-reports that measure obesity-related cognitive variables. For 42 participants who expressed a desire to lose weight, weight-loss rewards were discounted over time and had a positive correlation with temporal discounting for monetary rewards. Higher temporal discounting for weight loss rewards (i.e., preference for immediate weight loss) showed correlations with beliefs that obesity is under obese persons' control and largely due to lack of willpower, while temporal discounting parameters for monetary rewards did not. Taken together, our weight loss temporal discounting measure demonstrated both convergent and divergent validity, which can be utilized for future obesity research and interventions.

  20. Relationship between sleep quality and quantity and weight loss in women participating in a weight-loss intervention trial.

    Science.gov (United States)

    Thomson, Cynthia A; Morrow, Kelly L; Flatt, Shirley W; Wertheim, Betsy C; Perfect, Michelle M; Ravia, Jennifer J; Sherwood, Nancy E; Karanja, Njeri; Rock, Cheryl L

    2012-07-01

    Evidence suggests that individuals who report fewer total hours of sleep are more likely to be overweight or obese. Few studies have prospectively evaluated weight-loss success in relation to reported sleep quality and quantity. This analysis sought to determine the association between sleep characteristics and weight loss in overweight or obese women enrolled in a randomized clinical trial of a weight-loss program. We hypothesized that in overweight/obese women, significant weight loss would be demonstrated more frequently in women who report a better Pittsburgh Sleep Quality Index (PSQI) Global Score or sleep >7 h/night as compared to women who report a worse PSQI score or sleep ≤7 h/night. Women of ages 45.5 ± 10.4 (mean ± SD) years and BMI of 33.9 ± 3.3 (n = 245) were randomized and completed PSQI at baseline and 6 months; 198 had weight change assessed through 24 months. At baseline, 52.7% reported PSQI scores above the clinical cutoff of 5. Better subjective sleep quality increased the likelihood of weight-loss success by 33% (relative risk (RR), 0.67; 95% confidence interval (CI), 0.52-0.86), as did sleeping >7 h/night. A worse Global Score at 6 months was associated with a 28% lower likelihood of continued successful weight loss at 18 months, but unassociated by 24 months. These results suggest that sleep quality and quantity may contribute to weight loss in intervention-based studies designed to promote weight control in overweight/obese adult women.

  1. The cancer anorexia/weight loss syndrome: therapeutic challenges.

    Science.gov (United States)

    Giordano, Karin F; Jatoi, Aminah

    2005-07-01

    The cancer anorexia/weight loss syndrome is characterized by loss of weight, loss of appetite, overall decline in quality of life, and shortened survival in patients with advanced incurable cancer. It is highly prevalent. To date, treatment options that have been firmly established with good scientific evidence are limited to progestational agents and corticosteroids, both of which have been demonstrated to improve appetite but have otherwise failed to have a favorable impact on some of the other aspects of this syndrome. As the mechanisms behind this syndrome are further elucidated, more effective therapeutic strategies will likely emerge.

  2. Factors predictive of drop-out and weight loss success in weight management of obese patients.

    Science.gov (United States)

    Hadžiabdić, M Ortner; Mucalo, I; Hrabač, P; Matić, T; Rahelić, D; Božikov, V

    2015-02-01

    The prevention and treatment of overweight and obese individuals on a population-wide basis is challenging because patients have difficulties with adhering to weight loss programmes. The present study aimed to evaluate patients' adherence to the weight reduction programme by identifying factors predictive of both drop-out rate and weight loss success. One-hundred and twenty-four obese patients participated in a 12-month weight reduction programme, involving group therapy during an intensive 5-day educational intervention, followed by five, 2-h follow-up visits. The primary outcome measures included drop-out rate and percentage weight loss. Sociodemographic and clinical characteristics, as well as type of diet, were explored as potential predictive factors. Type of diet was assigned based on randomisation. Regression analyses were conducted to identify predictive variables of drop-out and weight loss success. In total, 33.1% of all recruited participants were deemed successful because they reduced the initial weight by more than 5% after the 12-month intervention. The overall attrition rate was 32.3%. In a multiple regression model, initial weight loss and marital status were the strongest predictors of weight loss success after 1-year period (r(2) = 0.481, P drop-out were those with a lower educational level [odds ratio (OR) = 3.26, 95% confidence interval (CI) = 1.22-8.70, P = 0.018] and a higher level of obesity (OR = 0.974, 95% CI = 0.95-0.99, P = 0.010). The present study demonstrates that initial weight loss at 1 month made the strongest unique contribution to the prediction of percentage weight loss after 12 months, whereas being married was a negative predictor. Those with a lower educational level and a higher level of obesity were more likely to drop-out. © 2014 The British Dietetic Association Ltd.

  3. Radiofrequency ablation for the treatment of weight regain after Roux-en-Y gastric bypass surgery.

    Science.gov (United States)

    Abrams, Julian A; Komanduri, Sri; Shaheen, Nicholas J; Wang, Zengri; Rothstein, Richard I

    2017-07-13

    Roux-en-Y gastric bypass (RYGB) surgery is an established modality for the treatment of morbid obesity. However, approximately one-quarter of patients experience weight regain after initially successful weight loss. Endoscopic therapy targeting the gastric remnant pouch represents a novel potential strategy to re-induce weight loss in this population. We performed a pilot trial of radiofrequency ablation (RFA) of the gastric remnant pouch after RYGB to determine feasibility, safety, and efficacy for weight loss. We identified patients who had undergone RYGB, achieved >40% excess body weight loss (EBWL), and then regained >25% of lost weight. RFA was applied to the gastrojejunal anastomosis and the entire surface area of the gastric remnant pouch. Treatment was repeated at 4 and 8 months if patients did not meet specified weight loss targets. Weekly weights were obtained for 12 months. The primary efficacy outcome was percent EBWL at 12 months, compared with baseline. Twenty-five patients were enrolled at 4 centers. Mean (± standard deviation [SD]) age was 45.4 ± 9.1 years, and 84% (21/25) were female. Mean (± SD) baseline body mass index was 40.2 ± 7.8. Twenty-two of 25 patients completed 12 months of follow-up. At 12 months, median (± SD) EBWL was 18.4% (interquartile ratio 10.8, 33.7; P weight loss was seen at 3.5 months (P weight loss over the 12-month period (P = .013). Two patients had serious adverse events requiring hospitalization. RFA of the gastric remnant pouch in patients with weight regain after RYGB resulted in significant reductions in excess body weight with an acceptable safety profile. Continued weight loss was observed after each RFA treatment. Further clinical trials in well-selected populations are warranted to determine the optimal number and frequency of RFA treatments and to assess durability of weight loss. (Clinical trial registration number: NCT01910688.). Copyright © 2017 American Society for Gastrointestinal Endoscopy

  4. Self-Directed Weight Loss Strategies: Energy Expenditure Due to Physical Activity Is Not Increased to Achieve Intended Weight Loss

    Directory of Open Access Journals (Sweden)

    Ulf Elbelt

    2015-07-01

    Full Text Available Reduced physical activity and almost unlimited availability of food are major contributors to the development of obesity. With the decline of strenuous work, energy expenditure due to spontaneous physical activity has attracted increasing attention. Our aim was to assess changes in energy expenditure, physical activity patterns and nutritional habits in obese subjects aiming at self-directed weight loss. Methods: Energy expenditure and physical activity patterns were measured with a portable armband device. Nutritional habits were assessed with a food frequency questionnaire. Results: Data on weight development, energy expenditure, physical activity patterns and nutritional habits were obtained for 105 patients over a six-month period from an initial cohort of 160 outpatients aiming at weight loss. Mean weight loss was −1.5 ± 7.0 kg (p = 0.028. Patients with weight maintenance (n = 75, with substantial weight loss (>5% body weight, n = 20 and with substantial weight gain (>5% body weight, n = 10 did not differ in regard to changes of body weight adjusted energy expenditure components (total energy expenditure: −0.2 kcal/kg/day; non-exercise activity thermogenesis: −0.3 kcal/kg/day; exercise-related activity thermogenesis (EAT: −0.2 kcal/kg/day or patterns of physical activity (duration of EAT: −2 min/day; steps/day: −156; metabolic equivalent unchanged measured objectively with a portable armband device. Self-reported consumption frequency of unfavorable food decreased significantly (p = 0.019 over the six-month period. Conclusions: An increase in energy expenditure or changes of physical activity patterns (objectively assessed with a portable armband device are not employed by obese subjects to achieve self-directed weight loss. However, modified nutritional habits could be detected with the use of a food frequency questionnaire.

  5. The role for adipose tissue in weight regain after weight loss

    Science.gov (United States)

    MacLean, P S; Higgins, J A; Giles, E D; Sherk, V D; Jackman, M R

    2015-01-01

    Weight regain after weight loss is a substantial challenge in obesity therapeutics. Dieting leads to significant adaptations in the homeostatic system that controls body weight, which promotes overeating and the relapse to obesity. In this review, we focus specifically on the adaptations in white adipose tissues that contribute to the biological drive to regain weight after weight loss. Weight loss leads to a reduction in size of adipocytes and this decline in size alters their metabolic and inflammatory characteristics in a manner that facilitates the clearance and storage of ingested energy. We present the hypothesis whereby the long-term signals reflecting stored energy and short-term signals reflecting nutrient availability are derived from the cellularity characteristics of adipose tissues. These signals are received and integrated in the hypothalamus and hindbrain and an energy gap between appetite and metabolic requirements emerges and promotes a positive energy imbalance and weight regain. In this paradigm, the cellularity and metabolic characteristics of adipose tissues after energy-restricted weight loss could explain the persistence of a biological drive to regain weight during both weight maintenance and the dynamic period of weight regain. PMID:25614203

  6. The role for adipose tissue in weight regain after weight loss.

    Science.gov (United States)

    MacLean, P S; Higgins, J A; Giles, E D; Sherk, V D; Jackman, M R

    2015-02-01

    Weight regain after weight loss is a substantial challenge in obesity therapeutics. Dieting leads to significant adaptations in the homeostatic system that controls body weight, which promotes overeating and the relapse to obesity. In this review, we focus specifically on the adaptations in white adipose tissues that contribute to the biological drive to regain weight after weight loss. Weight loss leads to a reduction in size of adipocytes and this decline in size alters their metabolic and inflammatory characteristics in a manner that facilitates the clearance and storage of ingested energy. We present the hypothesis whereby the long-term signals reflecting stored energy and short-term signals reflecting nutrient availability are derived from the cellularity characteristics of adipose tissues. These signals are received and integrated in the hypothalamus and hindbrain and an energy gap between appetite and metabolic requirements emerges and promotes a positive energy imbalance and weight regain. In this paradigm, the cellularity and metabolic characteristics of adipose tissues after energy-restricted weight loss could explain the persistence of a biological drive to regain weight during both weight maintenance and the dynamic period of weight regain. © 2015 The Authors. Obesity reviews © 2015 International Association for the Study of Obesity.

  7. Factors influencing intraoperative blood loss in orthognathic surgery.

    Science.gov (United States)

    Thastum, M; Andersen, K; Rude, K; Nørholt, S E; Blomlöf, J

    2016-09-01

    This retrospective study aimed to identify factors of importance for intraoperative blood loss relative to total blood volume in patients undergoing orthognathic surgery. The study included 356 patients treated consecutively at a Danish university hospital between 1 January 2010 and 31 December 2012. Inclusion criteria were (1) patient age ≥18 years and (2) patient undergoing a three-piece Le Fort I osteotomy, a bilateral sagittal split osteotomy, or a combination of the two. The patient-specific relative blood loss was calculated as a percentage by dividing the intraoperative blood loss by the estimated preoperative total blood volume, and then correlated with body mass index (BMI), age, sex, operating time, and treatment modality in a multivariate stepwise regression analysis. Operating time (Psurgery, a prolonged operating time, and reduced BMI significantly increase the intraoperative relative blood loss in patients undergoing orthognathic surgery.

  8. The effect of weight loss on the outcome after coronary artery bypass grafting in obese patients

    Directory of Open Access Journals (Sweden)

    Remez Kocz

    2012-01-01

    Full Text Available The role of body mass index (BMI in the setting of coronary artery bypass graft (CABG surgery has been a focus of past studies. However, the effects of postoperative weight loss in patients after CABG is yet to be known. We performed a retrospective study of 899 patients who underwent CABG at our institution. Perioperative patient information was collected from an onsite electronic record system. Patients were grouped into four BMI categories: normal controls, overweight, obese and morbidly obese. Based on the postoperative BMI changes, patients were then grouped into three categories: gainers, no change and losers. Statistical analyses were performed using analysis of variance and linear regression to establish an association among the data. Hazard ratios (HR and cumulative survival were obtained by the Cox-Mantel and Kaplan-Meier analyses, respectively. The normal controls exhibited a markedly higher mortality postoperatively, at 27.9%, especially when compared with the obese individuals (16.1%. Patients who lost weight faced a significantly increased risk of mortality than those who experienced no changes or gained weight after surgery. This trend was especially salient among the obese patients, who more than tripled their mortality risk (HR = 3.24 versus individuals who gained weight, and more than doubled their risk (HR = 2.87 versus those who had no changes. We conclude that obesity confers a survival advantage in the setting of the CABG surgery. Weight loss among all BMI categories of patients studied results in an adverse effect on postoperative survival.

  9. Changes in Weight and Comorbidities 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

    2012-01-01

    Background Bariatric surgery is one of the few effective treatments for morbid obesity but the weight loss and other health related outcomes for this procedure in large, diverse adolescent patient populations are not well characterized. Objective To analyze the prospective Bariatric Outcomes Longitudinal Database (BOLD) to determine the weight loss and health related outcomes in adolescents. Setting BOLD data is collected from 423 surgeons at 360 facilities in the United States. Methods Main outcome measures included anthropometric and comorbidity 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) age 11-to-19 years were included in the analyses. Results The overall one 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 kg versus 20 kg, P<0.001). Similar results were found for all other anthropometric changes and comparisons over one year between surgery types (P<0.001). In general, gastric bypass patients reported more improvement versus adjustable gastric band patients in comorbidities one year after surgery. There were a total of 45 readmissions among gastric bypass patients and 10 among adjustable gastric band patients with 29 and 8 reoperations required, respectively. Conclusions 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 comorbidities in morbidly obese adolescents for at least 1 year. PMID:22542199

  10. Weight loss-induced stress in subcutaneous adipose tissue is related to weight regain.

    Science.gov (United States)

    Roumans, Nadia J T; Camps, Stefan G; Renes, Johan; Bouwman, Freek G; Westerterp, Klaas R; Mariman, Edwin C M

    2016-03-14

    Initial successful weight loss is often followed by weight regain after the dietary intervention. Compared with lean people, cellular stress in adipose tissue is increased in obese subjects. However, the relation between cellular stress and the risk for weight regain after weight loss is unclear. Therefore, we determined the expression levels of stress proteins during weight loss and weight maintenance in relation to weight regain. In vivo findings were compared with results from in vitro cultured human Simpson-Golabi-Behmel syndrome (SGBS) adipocytes. In total, eighteen healthy subjects underwent an 8-week diet programme with a 10-month follow-up. Participants were categorised as weight maintainers or weight regainers (WR) depending on their weight changes during the intervention. Abdominal subcutaneous adipose tissue biopsies were obtained before and after the diet and after the follow-up. In vitro differentiated SGBS adipocytes were starved for 96 h with low (0·55 mm) glucose. Levels of stress proteins were determined by Western blotting. WR showed increased expressions of β-actin, calnexin, heat shock protein (HSP) 27, HSP60 and HSP70. Changes of β-actin, HSP27 and HSP70 are linked to HSP60, a proposed key factor in weight regain after weight loss. SGBS adipocytes showed increased levels of β-actin and HSP60 after 96 h of glucose restriction. The increased level of cellular stress proteins in the adipose tissue of WR probably resides in the adipocytes as shown by in vitro experiments. Cellular stress accumulated in adipose tissue during weight loss may be a risk factor for weight regain.

  11. A Losing Battle: Weight Regain Does Not Restore Weight Loss-Induced Bone Loss in Postmenopausal Women

    Science.gov (United States)

    Villalon, Karen L.; Gozansky, Wendolyn S.; Van Pelt, Rachael E.; Wolfe, Pam; Jankowski, Catherine M.; Schwartz, Robert S.; Kohrt, Wendy M.

    2013-01-01

    Previously, we reported significant bone mineral density (BMD) loss in postmenopausal women after modest weight loss. It remains unclear whether the magnitude of BMD change in response to weight loss is appropriate (i.e., proportional to weight loss) and whether BMD is recovered with weight regain. We now report changes in BMD after a 1-year follow-up. Subjects (n = 23) in this secondary analysis were postmenopausal women randomized to placebo as part of a larger trial. They completed a 6-month exercise-based weight loss program and returned for follow-up at 18 months. Dual-energy X-ray absorptiometry (DXA) was performed at baseline, 6, and 18 months. At baseline, subjects were aged 56.8 ± 5.4 years (mean ± s.d.), 10.0 ± 9.2 years postmenopausal, and BMI was 29.6 ± 4.0 kg/m2. They lost 3.9 ± 3.5 kg during the weight loss intervention. During follow-up, they regained 2.9 ± 3.9 kg. Six months of weight loss resulted in a significant decrease in lumbar spine (LS) (−1.7 ± 3.5%; P = 0.002) and hip (−0.04 ± 3.5%; P = 0.03) BMD that was accompanied by an increase in a biomarker of bone resorption (serum C-terminal telopeptide of type I collagen, CTX: 34 ± 54%; P = 0.08). However, weight regain was not associated with LS (0.05 ± 3.8%; P = 0.15) or hip (−0.6 ± 3.0%; P = 0.81) bone regain or decreased bone resorption (CTX: −3 ± 37%; P = 0.73). The findings suggest that BMD lost during weight reduction may not be fully recovered with weight regain in hormone-deficient, postmenopausal women. Future studies are needed to identify effective strategies to prevent bone loss during periods of weight loss. PMID:21852813

  12. Asthma and obesity: does weight loss improve asthma control? a systematic review

    Directory of Open Access Journals (Sweden)

    Juel CTB

    2012-06-01

    Full Text Available Caroline Trunk-Black Juel,1 Zarqa Ali,1 Lisbeth Nilas,2 Charlotte Suppli Ulrik11Respiratory Section, Internal Medicine Unit, 2Department of Obstetrics and Gynaecology, Hvidovre Hospital and University of Copenhagen, Hvidovre, DenmarkAim and methods: Obesity is a major health problem, and obesity is associated with a high incidence of asthma and poor asthma control. The aim of the present paper is to systematically review the current knowledge of the effect on overall asthma control of weight reduction in overweight and obese adults with asthma.Results: Weight loss in obese individuals with doctor-diagnosed asthma is associated with a 48%–100% remission of asthma symptoms and use of asthma medication. Published studies, furthermore, reveal that weight loss in obese asthmatics improves asthma control, and that especially surgically induced weight loss results in significant improvements in asthma severity, use of asthma medication, dyspnoea, exercise tolerance, and acute exacerbations, including hospitalizations due to asthma. Furthermore, weight loss in obese asthmatics is associated with improvements in level of lung function and airway responsiveness to inhaled methacholine, whereas no significant improvements have been observed in exhaled nitric oxide or other markers of eosinophilic airway inflammation.Conclusion: Overweight and obese adults with asthma experience a high symptomatic remission rate and significant improvements in asthma control, including objective measures of disease activity, after weight loss. Although these positive effects of weight loss on asthma-related health outcomes seem not to be accompanied by remission or improvements in markers of eosinophilic airway inflammation, it has potentially important implications for the future burden of asthma.Keywords: asthma, weight loss, diet, bariatric surgery, asthma control

  13. Gastrointestinal symptoms and weight loss in cancer patients receiving chemotherapy.

    Science.gov (United States)

    Sánchez-Lara, Karla; Ugalde-Morales, Emilio; Motola-Kuba, Daniel; Green, Dan

    2013-03-14

    Cancer patients receiving chemotherapy have a high risk of malnutrition secondary to the disease and treatment, and 40-80 % of cancer patients suffer from different degrees of malnutrition, depending on tumour subtype, location, staging and treatment strategy. Malnutrition in cancer patients affects the patient's overall condition, and it increases the number of complications, the adverse effects of chemotherapy and reduces the quality of life. The aim of the present study was to evaluate weight-loss prevalence depending on the tumour site and the gastrointestinal (GI) symptoms of oncology patients receiving chemotherapy. We included 191 cancer patients receiving chemotherapy. Files of all patients were reviewed to identify symptoms that might potentially influence weight loss. The nutritional status of all patients was also determined. The cancer sites in the patients were as follows: breast (31·9 %); non-colorectal GI (18·3 %); colorectal (10·4 %); lung (5·8 %); haematological (13·1 %); others (20·5 %). Of these patients, 58 % experienced some degree of weight loss, and its prevalence was higher among the non-colorectal GI and lung cancer patients. Common symptoms included nausea (59·6 %), anorexia (46 %) and constipation (31·9 %). A higher proportion of patients with ≥ 5 % weight loss experienced anorexia, nausea and vomiting (OR 9·5, 2·15 and 6·1, respectively). In conclusion, these results indicate that GI symptoms can influence weight loss in cancer patients, and they should be included in early nutritional evaluations.

  14. Changes in Energy Expenditure with Weight Gain and Weight Loss in Humans.

    Science.gov (United States)

    Müller, Manfred J; Enderle, Janna; Bosy-Westphal, Anja

    2016-12-01

    Metabolic adaptation to weight changes relates to body weight control, obesity and malnutrition. Adaptive thermogenesis (AT) refers to changes in resting and non-resting energy expenditure (REE and nREE) which are independent from changes in fat-free mass (FFM) and FFM composition. AT differs in response to changes in energy balance. With negative energy balance, AT is directed towards energy sparing. It relates to a reset of biological defence of body weight and mainly refers to REE. After weight loss, AT of nREE adds to weight maintenance. During overfeeding, energy dissipation is explained by AT of the nREE component only. As to body weight regulation during weight loss, AT relates to two different set points with a settling between them. During early weight loss, the first set is related to depleted glycogen stores associated with the fall in insulin secretion where AT adds to meet brain's energy needs. During maintenance of reduced weight, the second set is related to low leptin levels keeping energy expenditure low to prevent triglyceride stores getting too low which is a risk for some basic biological functions (e.g., reproduction). Innovative topics of AT in humans are on its definition and assessment, its dynamics related to weight loss and its constitutional and neuro-endocrine determinants.

  15. Chili pepper as a body weight-loss food.

    Science.gov (United States)

    Varghese, Sharon; Kubatka, Peter; Rodrigo, Luis; Gazdikova, Katarina; Caprnda, Martin; Fedotova, Julia; Zulli, Anthony; Kruzliak, Peter; Büsselberg, Dietrich

    2017-06-01

    Chili has culinary as well as medical importance. Studies in humans, using a wide range of doses of chili intake (varying from a single meal to a continuous uptake for up to 12 weeks), concluded that it facilitates weight loss. In regard to this, the main targets of chili are fat metabolism, energy expenditure, and thermogenesis. To induce weight loss, the active substance of chili, capsaicin, activates Transient Receptor Potential Cation Channel sub-family V member 1 (TRPV1) channels) receptors causing an increase in intracellular calcium levels and triggering the sympathetic nervous system. Apart from TRPV1, chili directly reduces energy expenditure by activating Brown Adipose Tissue. Weight loss by chili is also the result of an improved control of insulin, which supports weight management and has positive effects for treatment for diseases like obesity, diabetes and cardiovascular disorders. This review summarizes the major pathways by which chili contributes to ameliorating parameters that help weight management and how the consumption of chili can help in accelerating weight loss through dietary modifications.

  16. Repeated lifestyle interventions lead to progressive weight loss

    DEFF Research Database (Denmark)

    Dandanell, Sune; Ritz, Christian; Verdich, Elisabeth

    2017-01-01

    AIMS: This study aimed to investigate whether repeated lifestyle interventions lead to progressive weight loss or to weight cycling. METHODS: A retrospective review chart study with follow-up on 2120 participants (mean±SD age 36±15 years; body weight 116±28 kg; fat 43±6%). All had participated...... lost to follow-up after one to four interventions, respectively. The cumulated weight loss at follow-up increased with the number of interventions from one to four: 12.2±0.1, 15.9±0.7, 16.1±1.2 and 18.5±2.0 kg ( ploss of fat and fat free mass after one to four...... interventions in a selected and motivated group can be an efficient method for weight loss maintenance with only limited body weight cycling in the interim periods. However, the relationship between loss of fat and fat free mass might change in an unfavourable direction....

  17. Adipose tissue mitochondrial respiration and lipolysis before and after a weight loss by diet and RYGB.

    Science.gov (United States)

    Hansen, Merethe; Lund, Michael T; Gregers, Emilie; Kraunsøe, Regitze; Van Hall, Gerrit; Helge, Jørn W; Dela, Flemming

    2015-10-01

    To study adipose tissue mitochondrial respiration and lipolysis following a massive weight loss. High resolution respirometry of adipose tissue biopsies and tracer determined whole body lipolysis. Sixteen obese patients with type 2 diabetes (T2DM) and 27 without (OB) were studied following a massive weight loss by diet and Roux-en-Y gastric bypass (RYGB). The mitochondrial respiratory rates were similar in OB and T2DM, and the mass-specific oxygen flux increased significantly 4 and 18 months post-surgery (P Lipolysis per fat mass was similar in the two groups and was increased (P Lipolysis increases in the short term post-surgery, and insulin sensitivity for suppression of lipolysis increases with RYGB. © 2015 The Obesity Society.

  18. Bariatric surgery in patients with bipolar spectrum disorders: Selection factors, postoperative visit attendance, and weight outcomes.

    Science.gov (United States)

    Friedman, Kelli E; Applegate, Katherine; Portenier, Dana; McVay, Megan A

    2017-04-01

    As many as 3% of bariatric surgery candidates are diagnosed with a bipolar spectrum disorder. 1) To describe differences between patients with bipolar spectrum disorders who are approved and not approved for surgery by the mental health evaluator and 2) to examine surgical outcomes of patients with bipolar spectrum disorders. Academic medical center, United States. A retrospective record review was conducted of consecutive patients who applied for bariatric surgery between 2004 and 2009. Patients diagnosed with bipolar spectrum disorders who were approved for surgery (n = 42) were compared with patients with a bipolar spectrum disorder who were not approved (n = 31) and to matched control surgical patients without a bipolar spectrum diagnosis (n = 29) on a variety of characteristics and surgical outcomes. Of bariatric surgery candidates diagnosed with a bipolar spectrum disorder who applied for surgery, 57% were approved by the psychologist and 48% ultimately had surgery. Patients with a bipolar spectrum disorder who were approved for surgery were less likely to have had a previous psychiatric hospitalization than those who were not approved for surgery. Bariatric surgery patients diagnosed with a bipolar spectrum disorder were less likely to attend follow-up care appointments 2 or more years postsurgery compared to matched patients without bipolar disorder. Among patients with available data, those with a bipolar spectrum disorder and matched patients had similar weight loss at 12 months (n = 21 for bipolar; n = 24 for matched controls) and at 2 or more years (mean = 51 mo; n = 11 for bipolar; n = 20 for matched controls). Patients diagnosed with a bipolar spectrum disorder have a high rate of delay/denial for bariatric surgery based on the psychosocial evaluation and are less likely to attend medical follow-up care 2 or more years postsurgery. Carefully screened patients with bipolar disorder who engage in long-term follow-up care may benefit from bariatric

  19. Effect of weight loss on adipokine levels in obese patients

    Directory of Open Access Journals (Sweden)

    Hession M

    2011-08-01

    Full Text Available Catherine Rolland, Michelle Hession, Iain BroomCentre for Obesity Research and Epidemiology, Robert Gordon University, Aberdeen, Scotland, UKBackground: Adipose tissue functions as an endocrine organ by releasing adipokines which have important roles in the regulation of inflammation and insulin sensitivity. Although there is evidence of improvement in circulating levels of adipokines with weight loss, few studies relate such changes to specific diets. We investigated the effects of weight loss achieved by two different diets on circulating adipokine levels in obese individuals.Methods: A total of 120 obese patients (body mass index ≥ 35 kg/m2 underwent a three-month screening period on a low-fat, reduced-calorie diet. Patients failing to achieve a 5% weight loss using this approach were randomly allocated to either a low carbohydrate/high protein diet (n = 17 or to a commercial very low calorie diet (LighterLife®, n = 14 for a period of nine months.Results: At nine months, a significant weight loss was only maintained for LighterLife® (−32.3 ± 22.7 kg, P < 0.0001 but not on the low carbohydrate/high protein diet. Changes in adiponectin (15.8 ± 17.1 ng/mL versus −0.8 ± 6.2 ng/mL, P = 0.003 and leptin (−17.6 ± 24.3 ng/mL versus −3.0 ± 9.2 ng/mL, P = 0.049 at nine months were significantly greater for LighterLife® than for the low carbohydrate/high protein diet, which may reflect greater weight loss and decrease in fat mass. Changes in tumor necrosis factor-alpha, interleukin-6, and plasminogen activator inhibitor type 1 did not differ significantly between the dietary interventions at nine months.Conclusion: A significant weight loss of 23.8% from baseline weight was observed using a very low calorie diet and resulted in significant improvements in circulating levels of leptin, plasminogen activator inhibitor type 1, and adiponectin, which are likely to be due to weight loss and not macronutrient intake.Keywords: weight loss

  20. Weight gain since menopause and its associations with weight loss maintenance in obese postmenopausal women

    Directory of Open Access Journals (Sweden)

    Sénéchal M

    2011-08-01

    Full Text Available M Sénéchal1,2, H Arguin6, DR Bouchard4,5, AC Carpentier3, JL Ardilouze3, IJ Dionne1,2, M Brochu1,21Research Centre on Aging, Health and Social Services Centre, University Institute of Geriatrics of Sherbrooke, 2Faculty of Physical Education and Sports, University of Sherbrooke, 3Clinical Research Centre, Sherbrooke University Hospital Centre, Sherbrooke, QC; 4Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB; 5Health, Leisure & Human Performance Research Institute, Winnipeg, MB; 6Division of Kinesiology, Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, QC, CanadaObjective: To examine the association between weight gain since menopause and weight regain after a weight loss program.Methods: Participants were 19 obese women who participated in a 15-week weight loss program and a 12-month follow-up. Main outcomes were: body composition, resting metabolic rate, energy intake, energy expenditure, and weight regain at follow-up.Results: All body composition measures significantly decreased after intervention (all P ≤ 0.01 while all measures of fatness increased significantly after the 12-month follow-up (P ≤ 0.01. Body weight gain since menopause was associated with body weight regain (r = 0.65; P = 0.003 after follow-up even after adjustment for confounders.Conclusion: Weight gain since menopause is associated with body weight regain following the weight loss program. Therefore, weight gain since menopause should be considered as a factor influencing weight loss maintenance in older women.Keywords: obesity, body weight, weight regain, postmenopausal women, aging

  1. Cardiometabolic risk after weight loss and subsequent weight regain in overweight and obese postmenopausal women.

    Science.gov (United States)

    Beavers, Daniel P; Beavers, Kristen M; Lyles, Mary F; Nicklas, Barbara J

    2013-06-01

    Little is known about the effect of intentional weight loss and subsequent weight regain on cardiometabolic risk factors in older adults. The objective of this study was to determine how cardiometabolic risk factors change in the year following significant intentional weight loss in postmenopausal women, and if observed changes were affected by weight and fat regain. Eighty, overweight and obese, older women (age = 58.8±5.1 years) were followed through a 5-month weight loss intervention and a subsequent 12-month nonintervention period. Body weight/composition and cardiometabolic risk factors (blood pressure; total, high-density lipoprotein, and low-density lipoprotein cholesterol; triglycerides; fasting glucose and insulin; and Homeostatic Model Assessment of Insulin Resistance) were analyzed at baseline, immediately postintervention, and 6- and 12-months postintervention. Average weight loss during the 5-month intervention was 11.4±4.1kg and 31.4% of lost weight was regained during the 12-month follow-up. On average, all risk factor variables were significantly improved with weight loss but regressed toward baseline values during the year subsequent to weight loss. Increases in total cholesterol, triglycerides, glucose, insulin, and Homeostatic Model Assessment of Insulin Resistance during the postintervention follow-up were significantly (p weight and fat mass regain. Among women who regained weight, model-adjusted total cholesterol (205.8±4.0 vs 199.7±2.9mg/dL), low-density lipoprotein cholesterol (128.4±3.4 vs 122.7±2.4mg/dL), insulin (12.6±0.7 vs 11.4±0.7mg/dL), and Homeostatic Model Assessment of Insulin Resistance (55.8±3.5 vs 50.9±3.7mg/dL) were higher at follow-up compared with baseline. For postmenopausal women, even partial weight regain following intentional weight loss is associated with increased cardiometabolic risk. Conversely, maintenance of or continued weight loss is associated with sustained improvement in the cardiometabolic profile.

  2. Relative blood loss and operative time can predict length of stay following orthognathic surgery.

    Science.gov (United States)

    Andersen, K; Thastum, M; Nørholt, S E; Blomlöf, J

    2016-10-01

    The aim of this study was to investigate the length of stay (LOS) following orthognathic surgery and thereby to establish a benchmark. The secondary aim was to identify predictors of postoperative LOS following orthognathic surgery. Patients were treated consecutively during the period 2010 to 2012. Inclusion criteria were (1) patient age ≥18 years, and (2) surgery involving a three-piece Le Fort I osteotomy, or a bilateral sagittal split osteotomy (BSSO), or bimaxillary surgery. A total of 335 patients were included. The following data were recorded: height, weight, body mass index (BMI), age, sex, operative time, intraoperative blood loss, and type of surgery. LOS was defined as the duration of time from date of surgery to date of discharge. The average LOS was 1.3 days following Le Fort I osteotomy, 1.3 days following BSSO, and 1.8 days following bimaxillary surgery. In the multivariate regression model (R(2)=0.11), predictors of a prolonged LOS were operative time (P<0.001) and relative blood loss (P=0.002). No significant effect of age, BMI, sex, or treatment on LOS was observed. The short duration of LOS found in this study supports the possibility of increasing outpatient pathways for selected patients.

  3. Pretreatment fasting plasma glucose modifies dietary weight loss maintenance success

    DEFF Research Database (Denmark)

    Hjorth, Mads Fiil; Due, Anette; Larsen, Thomas Meinert

    2017-01-01

    OBJECTIVE: Levels of fasting plasma glucose (FPG) and fasting insulin (FI) were studied as diet-specific prognostic markers for successful weight loss maintenance in participants with overweight. METHODS: After losing ≥ 8% of body weight, participants received one of three ad libitum diets for 6...... regained 2.73 kg (95% CI 1.33 to 4.13; P weight regain on NNR compared to ADD (-4.21 kg [95% CI -6.83 to -1.59]; P = 0.002) and MUFA (95% CI -2.77 kg [-5.......12 to -0.43]; P = 0.020). The addition of FI strengthened these associations. CONCLUSIONS: Slightly elevated pretreatment FPG determined success in dietary weight loss maintenance among overweight patients on ad libitum diets differing in macronutrient and fiber content....

  4. Bariatric Surgery Procedures

    Science.gov (United States)

    ... Center Access to Care Toolkit EHB Access Toolkit Bariatric Surgery Procedures Bariatric surgical procedures cause weight loss by ... Bariatric procedures also often cause hormonal changes. Most weight loss surgeries today are performed using minimally invasive techniques (laparoscopic ...

  5. Weight-loss supplements: what is the evidence?

    Science.gov (United States)

    Huntington, Mark K; Shewmake, Roger A

    2010-06-01

    Obesity has reached epidemic proportions in this country. In an effort to address this major public health problem, people have adopted a variety of strategies. These include medical and surgical interventions, both rational and fad diets, exercise and assorted weight-loss dietary supplements. Recent U.S. Food & Drug Administration (FDA) action involving some of these proprietary supplements raises questions of both their safety and efficacy. This article reviews the evidence behind the components of many of these supplements and discusses the role of nutrition in weight loss.

  6. Weight loss and related behavior changes among lesbians.

    Science.gov (United States)

    Fogel, Sarah; Young, Laura; Dietrich, Mary; Blakemore, Dana

    2012-01-01

    Overweight and obesity are known risk factors for several modifiable, if not preventable diseases. Growing evidence suggests that lesbians may have higher rates of obesity than other women. This study was designed to describe weight loss and behavior changes related to food choices and exercise habits among lesbians who participated in a predominantly lesbian, mainstream, commercial weight loss program. Behavioral changes were recorded in exercise, quality of food choices, and number of times dining out. Although there were several limitations based on sample size and heterogeneity, the impact of a lesbian-supportive environment for behavior change was upheld.

  7. Young Adults, Technology, and Weight Loss: A Focus Group Study

    Directory of Open Access Journals (Sweden)

    Janna Stephens

    2015-01-01

    Full Text Available Overweight and obesity are a major concern in young adults. Technology has been integrated into many weight loss interventions; however little is known about the use of this technology in young adults. The purpose of this study was to explore through focus group sessions the opinions of young adults on the use of technology for weight loss. A total of 17 young adults, between 18 and 25 years of age, participated in three focus group sessions. Major results indicated that young adults have very little knowledge on the use of Smartphone technology for weight loss but would like to use this type of technology to help them lose weight. Results also indicated that young adults struggle to make healthy food choices and have priorities that outweigh exercise and they need support and guidance to make better decisions. In conclusion, young adults would be open to using Smartphone technology for weight loss but also need feedback and guidance to help make healthy decisions.

  8. Lower weight loss expectations and healthier eating attitudes in older overweight and obese women attempting weight loss.

    Science.gov (United States)

    Evans, E H; Boothroyd, L G; Muscariello, E; Stephan, B C M; Nasti, G; Colantuoni, A; Siervo, M

    2015-06-01

    Weight loss outcomes in overweight and obese individuals may be influenced by individual weight loss expectations (WLEs). Research on these phenomena in older women is lacking. This cross-sectional study compared groups of younger and older women on their WLEs and related attitudes (body dissatisfaction and disordered eating). Twenty-six younger (18-38 years) and 33 older (60-78 years) overweight and obese women were recruited from a weight loss clinic, prior to treatment. Disordered eating attitudes and body dissatisfaction were assessed using validated questionnaires and a pictorial figure-choice scale. Participants reported 10 WLEs categorized according to personal, lifestyle and social factors. Overall, women with a higher body mass index had greater WLEs. Older women reported lower WLEs than younger women (-14.5 kg vs. -22.4 kg) in all categories except past weight. Older women perceived that career success would necessitate the greatest level of weight loss (-18.5 kg), whereas younger women derived their greatest WLEs from mass media (-28.5 kg). Both older and younger groups perceived that their families would be supportive of the smallest amount of weight loss (-8.4 and -17.6 kg, respectively). The groups did not differ on body dissatisfaction, but younger women's disordered eating attitudes were significantly higher (p obese women have lower WLEs than younger women but experience similar levels of body dissatisfaction and healthier eating attitudes. The attitudinal constructs underlying these differences may be useful in clinical practice to tailor age-specific weight loss interventions.

  9. Obesity, intentional weight loss and physical disability in older adults.

    Science.gov (United States)

    Rejeski, W J; Marsh, A P; Chmelo, E; Rejeski, J J

    2010-09-01

    We examine obesity, intentional weight loss and physical disability in older adults. Based on prospective epidemiological studies, body mass index exhibits a curvilinear relationship with physical disability; there appears to be some protective effect associated with older adults being overweight. Whereas the greatest risk for physical disability occurs in older adults who are ≥class II obesity, the effects of obesity on physical disability appears to be moderated by both sex and race. Obesity at age 30 years constitutes a greater risk for disability later in life than when obesity develops at age 50 years or later; however, physical activity may buffer the adverse effects obesity has on late life physical disability. Data from a limited number of randomized clinical trials reinforce the important role that physical activity plays in weight loss programmes for older adults. Furthermore, short-term studies have found that resistance training may be particularly beneficial in these programmes as this mode of exercise attenuates the loss of fat-free mass during caloric restriction. Multi-year randomized clinical trials are needed to examine whether weight loss can alter the course of physical disablement in aging and to determine the long-term feasibility and effects of combining resistance exercise with weight loss in older adults. © 2009 The Authors. obesity reviews © 2009 International Association for the Study of Obesity.

  10. Community-based behavioral weight-loss treatment: long-term maintenance of weight loss, physiological, and psychological outcomes.

    Science.gov (United States)

    Latner, Janet D; Ciao, Anna C; Wendicke, Annemarie U; Murakami, Jessica M; Durso, Laura E

    2013-08-01

    Obesity is a significant public health problem, and sustainable long-term treatments are needed. This study examined a community-based model of weight-loss treatment. Ninety participants were recruited from eight community organizations (mean age: 49.65 years, mean body mass index: 35.80 kg/m(2); 64% female). Treatment groups were randomly assigned to two maintenance conditions: 1) self-help continuing care, or 2) assessment-only. Both received the same initial 20-session group behavioral treatment. Those randomized to continuing care were additionally instructed to meet as self-sustaining groups for 18 months post-treatment. Weight, physiological, behavioral, and psychological outcomes were assessed at baseline, post-treatment, and at six-month and 18-month follow-up. Eighty-seven percent of participants completed treatment. Participant treatment satisfaction and therapist adherence to treatment protocol were high. No group differences or time by group interaction effects emerged. Participants achieved significant weight losses at post-treatment, with no significant weight regain at six-month or 18-month follow-up. Treatment produced sustained changes in waist circumference, cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, insulin, eating patterns, physical activity, quality of life, and body image. A community-based treatment program may be an effective form of behavioral-weight-loss treatment for overweight/obese adults. Weight losses, along with physiological and psychological benefits, were sustained over time. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Assessing the effect of weight and weight loss in obese persons with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Bradley Curtis

    2008-10-01

    Full Text Available Bradley Curtis1, Risa P Hayes1, Sheri Fehnel2, Laurie Zografos21Global Health Outcomes, Eli Lilly and Co, Indianapolis, IN, USA; 2RTI Health Solutions, Research Triangle Park, NC, USAAbstract: The objective of this study was to assess specific areas of life in which obesity affects individuals with type 2 diabetes mellitus (T2DM, and changes that obese persons with T2DM experience with weight loss of varying degrees. Thirty in-depth interviews were conducted in persons identified as: age ≥40 years, diagnosed with T2DM for ≥2 years, on oral antihyperglycemic medications >3 months, BMI 30–35 kg/m2, having attempted to lose weight in the last 2 years. Participants (60% female, mean age 53 years, 53% Caucasian, mean BMI 32.2 kg/m2 agreed that 5% weight loss, while not reflective of an ultimate goal, would be meaningful and important; benefits were expected to accrue in physical functioning, self-confidence, blood glucose levels, and motivation to keep losing weight. Participants reported the greatest effect of weight loss on energy, physical activity, mobility, pain, and clothes/appearance. Participants reported weight affecting mood, with feelings of depression and frustration most commonly described. This research indicates that weight loss is likely to affect health-related quality of life in obese individuals with T2DM. Given the purported weight loss benefits of many emerging diabetic medications, it will be important to include measures of weight-related quality of life in future clinical trials of these agents.Keywords: health-related quality of life, obesity, type 2 diabetes, weight loss, patient-reported outcomes

  12. Role of fermented beverages in the maintenance of weight loss

    Science.gov (United States)

    Monereo Megías, Susana; Arnoriaga Rodríguez, María; Olmedilla Ishishi, Yoko Lucía; Martínez de Icaya, Purificación

    2016-07-12

    Obesity is a very prevalent disease with multiple chronic complications that decrease or disappear after a small (5-10%) but maintained weight loss. Nevertheless, maintaining weight loss after the treatment is very difficult and it involves one of the biggest challenges to control this epidemic. Although the reasons that contribute to regain the lost weight are diverse and related to the biological response to caloric restriction and the lack of adherence to treatment, up to 20% of the patients are able to keep it off. The keys to success, involve the maintenance of healthy habits, exercise and a reasonable daily calorie intake to allow a normal way of life, without sacrificing the social life. At this point, learning to distinguish food and drink options in a society where social life often revolves around the table is very important. We review the keys to keep the weight off after a diet as well as the role of fermented beverages such as beer, in this process. In conclusion, maintenance the weight loss is harder than losing it. The mild-to-moderate consumption of fermented beverages such as beer is not associated with weight increase.

  13. Fatty acid composition of adipose tissue triglycerides after weight loss and weight maintenance

    DEFF Research Database (Denmark)

    Kunešová, M; Hlavatý, P; Tvrzická, E

    2012-01-01

    of the DIOGENES dietary intervention study. After an 8-week low calorie diet (LCD) subjects with > 8 % weight loss were randomized to 5 ad libitum weight maintenance diets for 6 months: low protein (P)/low glycemic index (GI) (LP/LGI), low P/high GI (LP/HGI), high P/low GI (HP/LGI), high P/high GI (HP......Fatty acid composition of adipose tissue changes with weight loss. Palmitoleic acid as a possible marker of endogenous lipogenesis or its functions as a lipokine are under debate. Objective was to assess the predictive role of adipose triglycerides fatty acids in weight maintenance in participants....../HGI), and a control diet. Fatty acid composition in adipose tissue triglycerides was determined by gas chromatography in 195 subjects before the LCD (baseline), after LCD and weight maintenance. Weight change after the maintenance phase was positively correlated with baseline adipose palmitoleic (16:1n-7...

  14. Intravitreal low molecular weight heparin in PVR surgery.

    Directory of Open Access Journals (Sweden)

    Kumar Atul

    2003-01-01

    Full Text Available Purpose: To evaluate the efficacy of low molecular weight heparin (LMWH in prevention of postoperative fibrin formation following vitreoretinal surgery with proliferative vitreoretinopathy (PVR. Material and Methods: Thirty consecutive patients of retinal detachment with advanced PVR were enrolled in the study. They were randomised to study and control groups (n = 15 each. Study group patients received vitreoretinal surgery with 5 IU/cc of LMWH in vitrectomy infusion fluid. The control group patients received vitroretinal surgery without heparin in the infusion fluid. Patients were followed up at 1 week, 1 month and 3 months after surgery. Postoperative bleeding, media clarity, best-corrected visual acuity and success of the surgery at the end of 3 months were compared between the two groups. Results: At each follow-up visit, the study group showed a better media clarity, which was statistically significant ( P = 0.0042. The study group had a 50% better chance of retinal reattachment compared to the control group. Five patients had intraoperative bleeding in the study group (33% compared to 3 patients in the control group (20%. Conclusion: Use of intravitreal LMWH prevents postoperative fibrin formation and is beneficial in repair of retinal detachments with PVR.

  15. Fatty acid composition of adipose tissue triglycerides after weight loss and weight maintenance: the DIOGENES study.

    NARCIS (Netherlands)

    Kunesova, M.; Hlavaty, P.; Tvrzicka, E.; Stankova, B.; Kalouskova, P.; Viguerie, N.; Larsen, T.M.; van Baak, M.A.; Jebb, S.A.; Martinez, J.A.; Pfeiffer, A.F.; Kafatos, A.; Handjieva Darlenska, T.; Hill, M.; Langin, D.; Zak, A.; Astrup, A.; Saris, W.H.

    2013-01-01

    Fatty acid composition of adipose tissue changes with weight loss. Palmitoleic acid as a possible marker of endogenous lipogenesis or its functions as a lipokine are under debate. To assess the predictive role of adipose triglycerides fatty acids in weight maintenance in participants of the DIOGENES

  16. Changes in body composition and fat distribution in response to weight loss and weight regain

    NARCIS (Netherlands)

    Kooy, van der K.

    1993-01-01

    This thesis describes the effects of weight loss and subsequent weight regain on body composition, fat distribution and resting energy expenditure in moderately obese men and moderately obese premenopausal women. Participants were subjected to a controlled 4.2 MJ/day energy deficit diet for

  17. Exercise and Weight Loss%运动与减肥

    Institute of Scientific and Technical Information of China (English)

    李新华

    2014-01-01

    By analyzing the etiology of obesity, exercise to lose weight principle concluded that regular exercise and non-drug resistance has an economic, effective, no side effects, etc., in favor of people of all age’s lipid weight loss, and can inhibit weight rebound.%通过分析肥胖的病因学、运动减肥原理得出,非药物性的适量运动具有经济、有效、无副作用等优点,有利于各年龄段的人降脂减重,并能抑制体重反弹。

  18. A weight-loss program adapted to the menstrual cycle increases weight loss in healthy, overweight, premenopausal women

    DEFF Research Database (Denmark)

    Geiker, Nina R W; Ritz, Christian; Pedersen, Sue D

    2016-01-01

    BACKGROUND: Hormonal fluctuations during the menstrual cycle influence energy intake and expenditure as well as eating preferences and behavior. OBJECTIVE: We examined the impact of a diet and exercise weight-loss program that was designed to target and moderate the effects of the menstrual cycle...... compared with the effect of simple energy restriction. DESIGN: A total of 60 healthy, overweight, premenopausal women were included in a 6-mo weight-loss program in which each subject consumed a diet of 1600 kcal/d. Subjects were randomly assigned to either a combined diet and exercise program....... CONCLUSION: A differentiated diet and exercise program that is tailored to counteract food cravings and metabolic changes throughout the menstrual cycle may increase weight loss above that achieved with a traditional diet and exercise program in women who can comply with the program. This trial...

  19. Influences of general self-efficacy and weight bias internalization on physical activity in bariatric surgery candidates.

    Science.gov (United States)

    Hübner, Claudia; Baldofski, Sabrina; Zenger, Markus; Tigges, Wolfgang; Herbig, Beate; Jurowich, Christian; Kaiser, Stefan; Dietrich, Arne; Hilbert, Anja

    2015-01-01

    Physical activity (PA) seems to be important for long-term weight loss after bariatric surgery; however, studies provide evidence for insufficient PA levels in bariatric patients. Research found self-efficacy to be associated with PA and weight bias internalization, for which an influence on mental and physical health has been shown in recent studies. The purpose of the present study was to investigate the influence of general self-efficacy on PA, mediated by weight bias internalization. In 179 bariatric surgery candidates, general self-efficacy, weight bias internalization, and different intensities of PA were assessed by self-report questionnaires. Structural equation modeling was used to analyze the assumed mediational relationship. After controlling for sociodemographic variables, weight bias internalization fully mediated the association between general self-efficacy and moderate-intense as well as vigorous-intense PA. Lower general self-efficacy predicted greater weight bias internalization, which in turn predicted lower levels of moderate-intense and vigorous-intense PA. The results suggest an influence of weight bias internalization on preoperative PA in bariatric surgery candidates. Subsequently, implementation of interventions addressing weight bias internalization in the usual treatment of bariatric surgery candidates might enhance patients' preoperative PA, while longitudinal analyses are needed to further examine its predictive value on PA after bariatric surgery. Copyright © 2015 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  20. Upper Arm Contouring with Brachioplasty after Massive Weight Loss

    Directory of Open Access Journals (Sweden)

    Hyun Ho Han

    2014-05-01

    Full Text Available Background As the obese population increases in Korea, the number of patients who are trying to lose weight has been increasing steadily. In these patients, skin laxity and deformation of the body contour occurs, which could possibly be corrected by various body contouring surgeries. Here, we introduce the brachioplasty method and our experience of various body contouring surgeries performed in our center. Methods From November 2009 to August 2011, five cases of brachioplasty were performed. When the patient presented with sagging of the lateral inframammary crease and bat wing deformity in the axilla, extended brachioplasty was performed; in this case, the deformation of the axilla and lateral chest was corrected at the same time. A traditional brachioplasty was performed when contouring was needed only for skin laxity in the upper arm. Results Complications, such as hematomas or nerve injuries, were not evident. Some patients experienced partial wound dehiscence due to tension or hypertrophic scars found during the follow-up. In general, all of the patients were satisfied with the improvement in their upper arm contour. Conclusions Given the demands for body contouring surgery, the number of brachioplasty surgical procedures is expected to increase significantly, with abdominoplasty comprising a large portion of these surgeries. For the brachioplasty procedure, preparation and preoperative consultation regarding design of the surgery by experienced surgeons was important to prevent complications such as nerve damage or hematoma formation.

  1. Weight loss and P wave dispersion: a preliminary study.

    Science.gov (United States)

    Falchi, Anna Giulia; Grecchi, Ilaria; Muggia, Chiara; Tinelli, Carmine

    2014-01-01

    The aim of this study is to investigate if therapeutic weight loss reduces P wave dispersion. 20 obese patients (10 males and 10 females), part of a randomized clinical trial, were examined over a 6 month period. They were treated with a diet, aiming at 5% weight loss at the 6th month. After physical examination, they underwent laboratory tests, bioelectrical impedance analysis and a electrocardiogram (ECG). ECGs were transferred to a personal computer via a scanner and then magnified 400 times. We examined at baseline and at the 6th month, maximum and minimum P-wave duration, P-wave dispersion and heart rate. Comparing responders (patients who lost 5% of weight at t6) and not responders (who lost less than 5%), responders showed a significant reduction of P wave dispersion value (-0.38 [SD: 0.35] mm equal to -32.3 [SD: 11.3] % p=0.00001). All responders present a reduction of P wave dispersion, while for not-responders this is no longer evident. Finally, a good degree of correlation (r=0.54) between P wave dispersion difference and the decrease of weight was noticed. Females have a better response in P dispersion reduction strictly connected with their weight loss with a good correlation, (r=0.7, p=0.002), versus a moderate correlation evidenced in males (r=0.5, p=0.011). P wave duration and dispersion are significantly reduced in patients who lost more than 5% of weight and this decrease is highly related to the extent of weight loss. Copyright © 2014 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  2. Epigenetic patterns in successful weight loss maintainers: a pilot study.

    Science.gov (United States)

    Huang, Yen-Tsung; Maccani, Jennifer Z J; Hawley, Nicola L; Wing, Rena R; Kelsey, Karl T; McCaffery, Jeanne M

    2015-05-01

    DNA methylation changes occur in animal models of calorie restriction, simulating human dieting, and in human subjects undergoing behavioral weight loss interventions. This suggests that obese (OB) individuals may possess unique epigenetic patterns that may vary with weight loss. Here, we examine whether methylation patterns in leukocytes differ in individuals who lost sufficient weight to go from OB to normal weight (NW; successful weight loss maintainers; SWLMs) vs currently OB or NW individuals. This study examined peripheral blood mononuclear cell (PBMC) methylation patterns in NW (n=16, current/lifetime BMI 18.5-24.9) and OB individuals (n=16, current body mass index (BMI)⩾30), and SWLM (n=16, current BMI 18.5-24.9, lifetime maximum BMI ⩾30, average weight loss 57.4 lbs) using an Illumina Infinium HumanMethylation450 BeadArray. No leukocyte population-adjusted epigenome-wide analyses were significant; however, potentially differentially methylated loci across the groups were observed in ryanodine receptor-1 (RYR1; P=1.54E-6), myelin protein zero-like 3 (MPZL3; P=4.70E-6) and alpha 3c tubulin (TUBA3C; P=4.78E-6). In 32 obesity-related candidate genes, differential methylation patterns were found in brain-derived neurotrophic factor (BDNF; gene-wide P=0.00018). In RYR1, TUBA3C and BDNF, SWLM differed from OB but not NW. In this preliminary investigation, leukocyte SWLM DNA methylation patterns more closely resembled NW than OB individuals in three gene regions. These results suggest that PBMC methylation is associated with weight status.

  3. Internalized weight stigma and its ideological correlates among weight loss treatment seeking adults.

    Science.gov (United States)

    Carels, R A; Young, K M; Wott, C B; Harper, J; Gumble, A; Hobbs, M Wagner; Clayton, A M

    2009-01-01

    There are significant economic and psychological costs associated with the negative weight-based social stigma that exists in American society. This pervasive anti-fat bias has been strongly internalized among the overweight/obese. While the etiology of weight stigma is complex, research suggests that it is often greater among individuals who embrace certain etiological views of obesity or ideological views of the world. This investigation examined 1) the level of internalized weight stigma among overweight/obese treatment seeking adults, and 2) the association between internalized weight stigma and perceived weight controllability and ideological beliefs about the world ('just world beliefs', Protestant work ethic). Forty-six overweight or obese adults (BMI >or=27 kg/m2) participating in an 18- week behavioral weight loss program completed implicit (Implicit Associations Test) and explicit (Obese Person's Trait Survey) measures of weight stigma. Participants also completed two measures of ideological beliefs about the world ("Just World Beliefs", Protestant Ethic Scale) and one measure of beliefs about weight controllability (Beliefs about Obese Persons). Significant implicit and explicit weight bias was observed. Greater weight stigma was consistently associated with greater endorsement of just world beliefs, Protestant ethic beliefs and beliefs about weight controllability. Results suggest that the overweight/obese treatment seeking adults have internalized the negative weight-based social stigma that exists in American society. Internalized weight stigma may be greater among those holding specific etiological and ideological beliefs about weight and the world.

  4. Relations of hedonic hunger and behavioral change to weight loss among adults in a behavioral weight loss program utilizing meal-replacement products.

    Science.gov (United States)

    Theim, Kelly R; Brown, Joshua D; Juarascio, Adrienne S; Malcolm, Robert R; O'Neil, Patrick M

    2013-11-01

    Greater self-regulatory behavior usage is associated with greater weight loss within behavioral weight loss treatments. Hedonic hunger (i.e., susceptibility to environmental food cues) may impede successful behavior change and weight loss. Adult men and women (N = 111, body mass index M ± SD = 35.89 ± 6.97 kg/m(2)) were assessed before and after a 15-week lifestyle change weight loss program with a partial meal-replacement diet. From pre- to post-treatment, reported weight control behavior usage improved and hedonic hunger decreased, and these changes were inversely related. Individuals with higher hedonic hunger scores at baseline showed the greatest weight loss. Similarly, participants with lower baseline use of weight control behaviors lost more weight, and increased weight control behavior usage was associated with greater weight loss-particularly among individuals with low baseline hedonic hunger. Further study is warranted regarding the significance of hedonic hunger in weight loss treatments.

  5. Organizing a Community "Biggest Loser" Weight Loss Challenge

    Science.gov (United States)

    Jensen, Kirstin D.

    2013-01-01

    The program described here shows how Extension can be a strong collaborative partner in a rural setting in improving the overall health of the community by organizing a three month "Biggest Loser" Weight Loss Challenge. A pre-and post-fitness assessment and bi-weekly weigh-ins were administered. Three healthy lifestyle educational…

  6. Self-Management Patient Education and Weight Loss

    Science.gov (United States)

    Stombaugh, Angela M.

    2010-01-01

    Self-management of a disease is defined as "having or being able to obtain, the skills and resources necessary to best accommodate to the chronic disease and its consequences" (Holman & Lorig, 1992, p. 309). Self-management has been used in the management of several chronic conditions and this model may be useful in the management of weight loss.…

  7. Support Needs of Overweight African American Women for Weight Loss

    Science.gov (United States)

    Thomas, Janet L.; Stewart, Diana W.; Lynam, Ian M.; Daley, Christine M.; Befort, Christie; Scherber, Robyn M.; Mercurio, Andrea E.; Okuyemi, Kolawole S.; Ahluwalia, Jasjit S.

    2009-01-01

    Objectives: To examine social support needs of obese and overweight African American women for weight loss. Methods: Focus groups were conducted with overweight and obese African American women. Data were analyzed using standard grounded theory text analysis. Results: Our middle-aged (45.7 years; SD = 12.6) women (N = 66) were interested in…

  8. Energy Drinks, Weight Loss, and Disordered Eating Behaviors

    Science.gov (United States)

    Jeffers, Amy J.; Vatalaro Hill, Katherine E.; Benotsch, Eric G.

    2014-01-01

    Objective: The present study examined energy drink consumption and relations with weight loss attempts and behaviors, body image, and eating disorders. Participants/Methods: This is a secondary analysis using data from 856 undergraduate students who completed the American College Health Association-National College Health Assessment II…

  9. Intentional Weight Loss Improved Performance in Obese Ischaemic Heart Patient

    DEFF Research Database (Denmark)

    Geiker, Nina; Myint, Khin Swe; Heck, Patrick

    2014-01-01

    Aims: The risk of heart failure (HF) increases with BMI, but paradoxically obesity has been associated with reduced mortality in patients with HF. The effect of intentional or therapeutic weight loss on HF is not well known. We examined the effect of weight loss induced by low energy diet (LED......) on physical performance and cardiovascular risk factors in obese patients with moderate-to-severe HF and/or ischaemic heart disease (IHD). Methods and Results: Results from two weight loss interventions at two centres, one in Denmark (DK - 12 week intervention in 21 subjects (14 LED, 7 controls)) and one.......1 in the intervention group versus -22.1% ± 25.6 in the control group (P=0.000). Treatment also improved triglycerides (P=0.000), very low lipoprotein (P=0.001) and C-reactive protein (P=0.010). Conclusion: Weight loss induced by LED in obese patients with moderate-to-severe HF or IHD resulted in clinically significant...

  10. Support Needs of Overweight African American Women for Weight Loss

    Science.gov (United States)

    Thomas, Janet L.; Stewart, Diana W.; Lynam, Ian M.; Daley, Christine M.; Befort, Christie; Scherber, Robyn M.; Mercurio, Andrea E.; Okuyemi, Kolawole S.; Ahluwalia, Jasjit S.

    2009-01-01

    Objectives: To examine social support needs of obese and overweight African American women for weight loss. Methods: Focus groups were conducted with overweight and obese African American women. Data were analyzed using standard grounded theory text analysis. Results: Our middle-aged (45.7 years; SD = 12.6) women (N = 66) were interested in…

  11. Organizing a Community "Biggest Loser" Weight Loss Challenge

    Science.gov (United States)

    Jensen, Kirstin D.

    2013-01-01

    The program described here shows how Extension can be a strong collaborative partner in a rural setting in improving the overall health of the community by organizing a three month "Biggest Loser" Weight Loss Challenge. A pre-and post-fitness assessment and bi-weekly weigh-ins were administered. Three healthy lifestyle educational…

  12. Self-Management Patient Education and Weight Loss

    Science.gov (United States)

    Stombaugh, Angela M.

    2010-01-01

    Self-management of a disease is defined as "having or being able to obtain, the skills and resources necessary to best accommodate to the chronic disease and its consequences" (Holman & Lorig, 1992, p. 309). Self-management has been used in the management of several chronic conditions and this model may be useful in the management of weight loss.…

  13. Energy Drinks, Weight Loss, and Disordered Eating Behaviors

    Science.gov (United States)

    Jeffers, Amy J.; Vatalaro Hill, Katherine E.; Benotsch, Eric G.

    2014-01-01

    Objective: The present study examined energy drink consumption and relations with weight loss attempts and behaviors, body image, and eating disorders. Participants/Methods: This is a secondary analysis using data from 856 undergraduate students who completed the American College Health Association-National College Health Assessment II…

  14. Obese patients lose weight independently of nutritional follow-up after bariatric surgery

    Directory of Open Access Journals (Sweden)

    Beatriz Helena Tess

    2015-04-01

    Full Text Available Summary Objective: to examine the association between preoperative body weight, adherence to postsurgical nutritional follow-up, length of postoperative period, and weight loss during the first 18 months among adults who have undergone bariatric surgery. Methods: a retrospective cohort study was conducted on 241 consecutive patients who underwent open Roux-en-Y gastric bypass (RYGBP from January 2006 to December 2008, in a teaching hospital in São Paulo (Brazil. Data were collected through hospital records review and the variables analyzed included sex, age, immediate preoperative weight, adherence to postsurgical nutritional visits and length of postoperative period. Proportional body weight reductions during the 18-month follow-up period were examined using generalized estimating equations. Results: 81% (n=195 of participants were female, with overall mean age of 44.4 ± 11.6 years, mean preoperative weight of 123.1± 21.2 kg and mean preoperative body mass index of 47.2± 6.2 kg/m2. The overall adherence to postoperative follow- up schedule was 51% (95%CI: 44.5-57.5%. Preoperative body weight and adherence were not associated with proportional weight reduction (Wald’s test p > 0.18. Weight loss leveled off at the end of the 18-month follow-up period for both compliant and non-compliant patients (Wald’s test p = 0.00. Conclusions: our study showed that weight loss occurred steadily over the first 18 months after RYGBP, leveling off at around 40% weight reduction. It was associated with neither presurgical weight, nor nutritional follow-up and it may be primarily dependent on the surgical body alterations themselves. This finding may have implications for intervention strategies aimed at motivating patients to comply with early postsurgical and life-long follow-up.

  15. Who will lose weight? A reexamination of predictors of weight loss in women

    Directory of Open Access Journals (Sweden)

    Barata José T

    2004-08-01

    Full Text Available Abstract Background The purpose of this study was to analyze pretreatment predictors of short-term weight loss in Portuguese overweight and obese women involved in a weight management program. Behavioral and psychosocial predictors were selected a priori from previous results reported in American women who participated in a similar program. Methods Subjects were 140 healthy overweight/obese women (age, 38.3 ± 5.9 y; BMI, 30.3 ± 3.7 kg/m2 who participated in a 4-month lifestyle weight loss program consisting of group-based behavior therapy to improve diet and increase physical activity. At baseline, all women completed a comprehensive behavioral and psychosocial battery, in standardized conditions. Results Of all starting participants, 3.5% (5 subjects did not finish the program. By treatment's end, more than half of all women had met the recomended weight loss goals, despite a large variability in individual results (range for weight loss = 19 kg. In bivariate and multivariate correlation/regression analysis fewer previous diets and weight outcome evaluations, and to a lesser extent self-motivation and body image were significant and independent predictors of weight reduction, before and after adjustment for baseline weight. A negative and slightly curvilinear relationship best described the association between outcome evaluations and weight change, revealing that persons with very accepting evaluations (that would accept or be happy with minimal weight change lost the least amount of weight while positive but moderate evaluations of outcomes (i.e., neither low nor extremely demanding were more predictive of success. Among those subjects who reported having initiated more than 3–4 diets in the year before the study, very few were found to be in the most successful group after treatment. Quality of life, self-esteem, and exercise variables did not predict outcomes. Conclusions Several variables were confirmed as predictors of success in short

  16. The role of carbohydrate in dietary prescription for weight loss

    DEFF Research Database (Denmark)

    Astrup, Arne

    to be shown whether a low-glycemic index diet provides benefits beyond this. Low-carbohydrate diets may be an option for inducing weight loss in obese patients, but a very low intake of carbohydrate-rich foods is not commensurate with a healthy and palatable diet in the long term. However, there is evidence......The optimal diet for prevention of weight gain, obesity, metabolic syndrome, and type 2 diabetes is fat-reduced, fibre-rich, high in lowenergy density carbohydrates (fruit, vegetables, and whole grain products), and intake of energy-containing drinks is restricted. The reduction of the total fat...... content of ad libitum diets produces weight loss in both the short-term and over periods as long as 7 years. A fat-reduced diet, combined with physical activity, reduces all risk factors for cardiovascular disease, and reduces the incidence of type 2 diabetes. The combination of reduction of dietary fat...

  17. Hearing loss in low-birth-weight infants.

    Science.gov (United States)

    Anagnostakis, D; Petmezakis, J; Papazissis, G; Messaritakis, J; Matsaniotis, N

    1982-07-01

    The hearing of 98 perinatal intensive care survivors with a mean birth weight of 1,540 g was assessed at a mean age of 6 1/2 years. They represented 73% of the long-term survivors with birth weights of 1,800 g or less who had been cared for in our neonatal unit during the three-year period 1971 through 1973. Nine of the 98 infants had sensorineural hearing loss, and 14 had exudative otitis media. During their neonatal period, the infants with hearing loss experienced more frequent apneic attacks, hyperbilirubinemia (serum bilirubin level, greater than 14 mg/dL), and hypothermia compared with their healthy counterparts. There was no evidence that the duration of stay in the incubator or the use of stay in the incubator or the use of ototoxic drugs had affected the hearing of these low-birth-weight infants.

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

    DEFF Research Database (Denmark)

    Andersen, T; Gluud, C; Franzmann, Magnus

    1991-01-01

    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...... than 0.001), but 24% of the patients developed slight portal inflammation (p = 0.039) or slight portal fibrosis (p = 0.063). Patients developing portal fibrosis had a higher degree of fatty change at entry (p = 0.029), a more pronounced reduction of fatty change (p = 0.014) and a faster weight loss (p...... = 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....

  19. Exercise Training and Energy Expenditure following Weight Loss.

    Science.gov (United States)

    Hunter, Gary R; Fisher, Gordon; Neumeier, William H; Carter, Stephen J; Plaisance, Eric P

    2015-09-01

    This study aims to determine the effects of aerobic or resistance training on activity-related energy expenditure (AEE; kcal·d(-1)) and physical activity index (activity-related time equivalent (ARTE)) following weight loss. It was hypothesized that weight loss without exercise training would be accompanied by decreases in AEE, ARTE, and nontraining physical activity energy expenditure (nonexercise activity thermogenesis (NEAT)) and that exercise training would prevent decreases in free-living energy expenditure. One hundred forty premenopausal women had an average weight loss of 25 lb during a diet (800 kcal·d(-1)) of furnished food. One group aerobically trained 3 times per week (40 min·d(-1)), another group resistance-trained 3 times per week (10 exercises/2 sets × 10 repetitions), and the third group did not exercise. Dual-energy x-ray absorptiometry was used to measure body composition, indirect calorimetry was used to measure resting energy expenditure (REE) and walking energy expenditure, and doubly labeled water was used to measure total energy expenditure (TEE). AEE, ARTE, and nontraining physical activity energy expenditure (NEAT) were calculated. TEE, REE, and NEAT all decreased following weight loss for the no-exercise group, but not for aerobic and resistance trainers. Only REE decreased in the two exercise groups. Resistance trainers increased ARTE. HR and oxygen uptake while walking on the flat and up a grade were consistently related to TEE, AEE, NEAT, and ARTE. Exercise training prevents a decrease in energy expenditure, including free-living energy expenditure separate from exercise training, following weight loss. Resistance training increases physical activity, whereas economy/ease of walking is associated with increased TEE, AEE, NEAT, and ARTE.

  20. Effects of weight gain and weight loss on regional fat distribution.

    Science.gov (United States)

    Singh, Prachi; Somers, Virend K; Romero-Corral, Abel; Sert-Kuniyoshi, Fatima H; Pusalavidyasagar, Snigdha; Davison, Diane E; Jensen, Michael D

    2012-08-01

    Normal-weight adults gain lower-body fat via adipocyte hyperplasia and upper-body subcutaneous (UBSQ) fat via adipocyte hypertrophy. We investigated whether regional fat loss mirrors fat gain and whether the loss of lower-body fat is attributed to decreased adipocyte number or size. We assessed UBSQ, lower-body, and visceral fat gains and losses in response to overfeeding and underfeeding in 23 normal-weight adults (15 men) by using dual-energy X-ray absorptiometry and abdominal computed tomography scans. Participants gained ∼5% of weight in 8 wk and lost ∼80% of gained fat in 8 wk. We measured abdominal subcutaneous and femoral adipocyte sizes and numbers after weight gain and loss. Volunteers gained 3.1 ± 2.1 (mean ± SD) kg body fat with overfeeding and lost 2.4 ± 1.7 kg body fat with underfeeding. Although UBSQ and visceral fat gains were completely reversed after 8 wk of underfeeding, lower-body fat had not yet returned to baseline values. Abdominal and femoral adipocyte sizes, but not numbers, decreased with weight loss. Decreases in abdominal adipocyte size and UBSQ fat mass were correlated (ρ = 0.76, P = 0.001), as were decreases in femoral adipocyte size and lower-body fat (ρ = 0.49, P = 0.05). UBSQ and visceral fat increase and decrease proportionately with a short-term weight gain and loss, whereas a gain of lower-body fat does not relate to the loss of lower-body fat. The loss of lower-body fat is attributed to a reduced fat cell size, but not number, which may result in long-term increases in fat cell numbers.

  1. Effects of weight gain and weight loss on regional fat distribution1234

    Science.gov (United States)

    Singh, Prachi; Somers, Virend K; Romero-Corral, Abel; Sert-Kuniyoshi, Fatima H; Pusalavidyasagar, Snigdha; Davison, Diane E

    2012-01-01

    Background: Normal-weight adults gain lower-body fat via adipocyte hyperplasia and upper-body subcutaneous (UBSQ) fat via adipocyte hypertrophy. Objectives: We investigated whether regional fat loss mirrors fat gain and whether the loss of lower-body fat is attributed to decreased adipocyte number or size. Design: We assessed UBSQ, lower-body, and visceral fat gains and losses in response to overfeeding and underfeeding in 23 normal-weight adults (15 men) by using dual-energy X-ray absorptiometry and abdominal computed tomography scans. Participants gained ∼5% of weight in 8 wk and lost ∼80% of gained fat in 8 wk. We measured abdominal subcutaneous and femoral adipocyte sizes and numbers after weight gain and loss. Results: Volunteers gained 3.1 ± 2.1 (mean ± SD) kg body fat with overfeeding and lost 2.4 ± 1.7 kg body fat with underfeeding. Although UBSQ and visceral fat gains were completely reversed after 8 wk of underfeeding, lower-body fat had not yet returned to baseline values. Abdominal and femoral adipocyte sizes, but not numbers, decreased with weight loss. Decreases in abdominal adipocyte size and UBSQ fat mass were correlated (ρ = 0.76, P = 0.001), as were decreases in femoral adipocyte size and lower-body fat (ρ = 0.49, P = 0.05). Conclusions: UBSQ and visceral fat increase and decrease proportionately with a short-term weight gain and loss, whereas a gain of lower-body fat does not relate to the loss of lower-body fat. The loss of lower-body fat is attributed to a reduced fat cell size, but not number, which may result in long-term increases in fat cell numbers. PMID:22760561

  2. Long-term weight loss maintenance for obesity: a multidisciplinary approach

    Directory of Open Access Journals (Sweden)

    Montesi L

    2016-02-01

    Full Text Available Luca Montesi,1 Marwan El Ghoch,2 Lucia Brodosi,1 Simona Calugi,2 Giulio Marchesini,1 Riccardo Dalle Grave2 1Unit of Metabolic Diseases, S Orsola-Malpighi Hospital, “Alma Mater Studiorum” University, Bologna, Italy; 2Department of Eating and Weight Disorders, Villa Garda Hospital, Verona, Italy Abstract: The long-term weight management of obesity remains a very difficult task, associated with a high risk of failure and weight regain. However, many people report that they have successfully managed weight loss maintenance in the long term. Several factors have been associated with better weight loss maintenance in long-term observational and randomized studies. A few pertain to the behavioral area (eg, high levels of physical activity, eating a low-calorie, low-fat diet; frequent self-monitoring of weight, a few to the cognitive component (eg, reduced disinhibition, satisfaction with results achieved, confidence in being able to lose weight without professional help, and a few to personality traits (eg, low novelty seeking and patient–therapist interaction. Trials based on the most recent protocols of lifestyle modification, with a prolonged extended treatment after the weight loss phase, have also shown promising long-term weight loss results. These data should stimulate the adoption of a lifestyle modification-based approach for the management of obesity, featuring a nonphysician lifestyle counselor (also called “lifestyle trainer” or “healthy lifestyle practitioner” as a pivotal component of the multidisciplinary team. The obesity physicians maintain a primary role in engaging patients, in team coordination and supervision, in managing the complications associated with obesity and, in selected cases, in the decision for drug treatment or bariatric surgery, as possible more intensive, add-on interventions to lifestyle treatment. Keywords: obesity, lifestyle modification, cognitive behavior therapy, multidisciplinary treatment

  3. Taking Orlistat: Predicting Weight Loss over 6 Months

    Directory of Open Access Journals (Sweden)

    Amelia Hollywood

    2011-01-01

    Full Text Available This study explored the predictors of weight loss following orlistat with a focus on both baseline variables and changes in beliefs and behaviours occurring over the course of taking the drug. Patients (n=566 prescribed orlistat completed a questionnaire at baseline and after 6 months concerning their weight, beliefs and behaviours. By 6 months the majority had lost some weight and showed improvements in diet. Many had also stopped taking the drug and a large minority reported using it flexibly as a lifestyle drug. Those who lost most weight showed a decrease in beliefs in a medical solution, a decrease in unhealthy eating, an increased belief in treatment control and an increased belief that the unpleasant consequences are both due to their eating behaviour and just part of the drug. When taken with fatty food orlistat causes symptoms such as anal leakage and oily stools. These may encourage some patients to focus on the behavioural aspects of their weight problem thus promoting the dietary changes needed for both short and longer term weight loss. When prescribing orlistat, clinicians should encourage patients to see the consequences as an education as a means to promote the effectiveness of this form of medical management.

  4. Perioperative Vision Loss in Spine Surgery and Other Orthopaedic Procedures.

    Science.gov (United States)

    Su, Alvin W; Lin, Shuai-Chun; Larson, A Noelle

    2016-10-01

    Perioperative vision loss is a rare complication of orthopaedic surgery and has been documented after spine, knee, hip, and shoulder procedures. It is associated with several ophthalmologic diagnoses, most commonly ischemic optic neuropathy. Although the pathophysiology remains unclear, current evidence suggests that systemic hemodynamic compromise and altered balance of intraocular perfusion contribute to the development of ischemic optic neuropathy. Although vision recovery has been reported, the prognosis of perioperative vision loss is poor, and no proven effective treatment is available. Perioperative vision loss is unpredictable and can occur in healthy patients. Associated risk factors include pediatric or elderly age, male sex, obesity, anemia, hypotension or hypertension, perioperative blood loss, prolonged surgical time, and prone positioning. Preventive strategies include avoiding direct pressure to the eye, elevating the head, optimizing perioperative hemodynamic status, and minimizing surgical time with staged surgical procedures as appropriate.

  5. BILATERAL SENSORINEURAL HEARING LOSS FOLLOWING NON OTOLOGIC SURGERY

    Directory of Open Access Journals (Sweden)

    Poonam K

    2014-09-01

    Full Text Available A 58 years old man with a no history of hearing loss was admitted with comminuted fracture tibia and fibula (right, sustained in a road traffic accident [Fig. 1]. He had no known comorbidity. The pre-operative history and physical examination, blood test investigations, chest radiograph [Fig. 2] and ECG were unremarkable. He was taken up for open reduction and pinning of fractured segments [Fig. 3]. The orthopedic surgery itself was uneventful with the patient being under general anesthesia for a total of one hour. Induction of anesthesia was uncomplicated, and blood loss was minimal. The blood pressure and pulse remained stable, with minimum diastolic and systolic pressure during surgery being 70 mmHg and 130 mmHg respectively. Oxygen saturation remained over 95 percent.

  6. Weight loss practices in Taekwondo athletes of different competitive levels.

    Science.gov (United States)

    da Silva Santos, Jonatas Ferreira; Takito, Monica Yuri; Artioli, Guilherme Giannini; Franchini, Emerson

    2016-06-01

    This study investigated the prevalence, magnitude, and methods of rap-id weight loss among male and female Taekwondo athletes from all competitive levels. A questionnaire was administered to 72 men (regional/state level, n=31; national/international level, n=41) and 44 women (regional/state level, n=9; national/international, n=35). Among the male athletes, 77.4% of the regional/state level and 75.6% of the national/international athletes declared to have reduced weight to compete in lighter weight categories. Among women, 88.9% of regional/state level and 88.6% of national/international level reported the use of rapid weight loss strategies. Athletes reported to usually lose ~3% of their body weight, with some athletes reaching ~7% of their body weight. The methods used to achieve weight loss are potentially dangerous to health and no difference between sexes was found. Four methods were more frequently used by men athletes in higher competitive levels as compared to lower levels, as follows: skipping meals (Z=2.28, P=0.023, η(2)=0.21), fasting (Z=2.337, P=0.019, η(2)=0.22), restricting fluids (Z=2.633, P=0.009, η(2)=0.24) and spitting (Z=2.363, P=0.018, η(2)=0.22). Taekwondo athletes lost ~3% of their body mass, using methods potentially dangerous for their health. Although no difference was found between sexes, lower level athletes more frequently used methods such as skipping meals, fasting, restricting fluids and spitting. Considering that these health-threating methods are more commonly used by lower level athletes, specific education programs should be directed to them.

  7. The effects of diet- and RYGB-induced weight loss on insulin sensitivity in obese patients with and without type 2 diabetes

    DEFF Research Database (Denmark)

    Hansen, Merethe; Lund, Michael Taulo; Jørgensen, Anne Line Kjærholm

    2016-01-01

    AIMS: The impact of diet-induced weight loss and weight loss due to RYGB in patients with (T2DM, N = 16) and without (OB, N = 27) type 2 diabetes was studied. METHODS: At inclusion (A), after diet-induced weight loss (B), 4 months post-surgery (C) and 18 months post-surgery (D) body composition......, and approximately one-third of the total improvement in GIR in T2DM was observed after the diet-induced weight loss of only ~6 kg (B). Insulin clearance, visceral fat and fasting plasma insulin also improved significantly after the diet (P ... not change significantly, but IMTG decreased significantly consistent with significant increases in GIR. Metabolic flexibility and hepatic insulin sensitivity improved after RYGB. CONCLUSIONS: Metabolic improvements of RYGB are present already after the diet-induced weight loss prior to surgery. GLUT4...

  8. Does Successful Weight Loss in an Internet-Based Worksite Weight Loss Program Improve Employee Presenteeism and Absenteeism?

    Science.gov (United States)

    Harden, Samantha M.; You, Wen; Almeida, Fabio A.; Hill, Jennie L.; Linnan, Laura A.; Allen, Kacie C.; Estabrooks, Paul A.

    2015-01-01

    Certain risk factors associated with overweight and obesity may lead to reduced productivity in the workforce (i.e., increased absenteeism and presenteeism). Participants in a large, Internet-based worksite weight loss intervention, who were present at follow-up (N = 1,030), completed a self-reported productivity measure (World Health…

  9. Does Successful Weight Loss in an Internet-Based Worksite Weight Loss Program Improve Employee Presenteeism and Absenteeism?

    Science.gov (United States)

    Harden, Samantha M.; You, Wen; Almeida, Fabio A.; Hill, Jennie L.; Linnan, Laura A.; Allen, Kacie C.; Estabrooks, Paul A.

    2015-01-01

    Certain risk factors associated with overweight and obesity may lead to reduced productivity in the workforce (i.e., increased absenteeism and presenteeism). Participants in a large, Internet-based worksite weight loss intervention, who were present at follow-up (N = 1,030), completed a self-reported productivity measure (World Health…

  10. Storage Period Affects Weight Loss of Japanese Quail Eggs

    Directory of Open Access Journals (Sweden)

    BC Roriz

    Full Text Available ABSTRACT Long storage periods may increase embryo mortality. The objective of this study was to evaluate the effects of storage period on the weight loss, eggshell surface temperature, hatchability, and embryonic mortality of Japanese quail eggs. Two hundred fertile eggs were collected from a flock of 30-week-old Japanese quails (Coturnix coturnix japonica. The eggs were collected for 10 consecutive days after lay, and immediately incubated. A completely randomized experimental design with 10 treatments, corresponding to the number of days eggs were stored between egg collection and setting, with 20 replicates each, was applied. Egg weight loss increased with storage period duration, starting on day 6 (2.1%, on average and reached 3.26%, on average, in eggs stored for 10 days. The highest hatchability (p>0.05 was obtained in eggs stored for two days, which also lost the least weight (1.20%. Storage period did not influence eggshell surface temperature (p>0.05 during incubation, but higher temperatures (p<0.05 were measured on days 10 and 15 of incubation compared with day 5. Eggs stored for ten days presented the highest weight loss, and therefore, a storage period of up to five days is recommended to maintain the quality of incubated Japanese quail eggs. Furthermore, egg surface temperature increases during the second half of the incubation period as a result of increasing embryonic metabolic rate.

  11. Smartphone applications to aid weight loss and management: current perspectives

    Directory of Open Access Journals (Sweden)

    Sutton EF

    2016-07-01

    Full Text Available Elizabeth F Sutton, Leanne M Redman Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA Abstract: The development and dissemination of smart devices has cultivated a global environment of hyperconnectivity and increased our access to information. The paralleled launch and success of the Mobile Health industry has created a market of commercially available applications or “apps” along with tools or sensors, which allow the user to receive and collect personal health information. Apps and accompanying tools now allow an individual to “self-digitize” and, pertaining to weight management, monitor their body weight, caloric intake, physical activity, and more. These products possess the ability to improve the scalability of traditional in-person weight management services considering their near ubiquity, affordability, and capability to deliver information directly and personally to the user. However, similar to the dietary supplement market, the anecdotal value of these products has driven their popularity and acceptance by the general public without requirement of scientific validation or, in the area of weight management or diet/exercise, validation of the safety and efficacy by the Food and Drug Administration prior to market launch. By conducting a literature and clinical trial search, we found remarkably few active, completed, or published studies testing the efficacy of smart device applications using randomized controlled trials. Research efforts must be focused on illuminating the efficacy of behavioral interventions and remote self-monitoring for weight loss/maintenance treatment with true, randomized controlled trials. Keywords: smartphone, mobile phone, application, app, weight, weight loss, weight maintenance

  12. Structural changes in the knee during weight loss maintenance after a significant weight loss in obese patients with osteoarthritis

    DEFF Research Database (Denmark)

    Henriksen, M; Christensen, R; Hunter, D J

    2014-01-01

    OBJECTIVE: To compare structural knee joint changes in obese patients with knee osteoarthritis (OA) that after an intensive weight loss therapy were randomized to continuous dietetic support, a specialized knee exercise program, or 'no attention' for 1 year. METHODS: 192 obese individuals with knee...... OA underwent an intensive 16-week weight loss program with subsequent randomization to one of the three treatment groups. Changes in cartilage loss, bone marrow lesions (BMLs), synovitis, and effusion were assessed using semi quantitative assessments of magnetic resonance imaging (MRI) obtained...... at weeks 0 and 68 applying the BLOKS score. RESULTS: During the 52 weeks maintenance period the continuous dietary maintenance group support on average gained 1.1 kg (95% CI: -0.3:2.5) body mass, the exercise group gained 6.6 kg (95% CI 5.4:7.8) and the no-attention group gained 4.8 kg (95% CI: 2...

  13. Development of 'Twazon': An Arabic App for Weight Loss.

    Science.gov (United States)

    Alnasser, Aroub; Sathiaseelan, Arjuna; Al-Khalifa, Abdulrahman; Marais, Debbi

    2016-05-16

    Weight gain and its related illnesses have become a major public health issue across the world, with Saudi Arabia and other Gulf countries seeing dramatic increases in obesity and overweight, and yet there is very little information on how to intervene with this demographic due to cultural and linguistic barriers. As the use of smartphones and apps has also increased in the region, information communication technologies could be a cost-effective means of facilitating the delivery of behavior-modification interventions directly to the target population. Although there are existing apps that offer lifestyle-modification tools, they do not give consideration to the evidence-based practices for weight management. This offers an opportunity to create an Arabic language weight loss app that offers localized content and adheres to evidence-informed practices that are needed for effective weight loss. This paper describes the process of developing an Arabic weight loss app designed to facilitate the modification of key nutritional and physical activity behaviors among Saudi adults, while taking into consideration cultural norms. The development of the Twazon app involved: (1) reviewing all available Arabic weight loss apps and compared with evidence-based practices for weight loss, (2) conducting a qualitative study with overweight and obese Saudi women to ascertain their preferences, (3) selecting which behavioral change strategies and guidelines to be used in the app, (4) creating the Saudi Food Database, (5) deciding on graphic design for both iPhone operating system and Android platforms, including user interface, relational database, and programming code, and (6) testing the beta version of the app with health professionals and potential users. The Twazon app took 23 months to develop and included the compilation of an original Saudi Food database. Eight subjects gave feedback regarding the content validity and usability of the app and its features during a pilot

  14. Role of Mental Simulations in the Weight Loss Process.

    Science.gov (United States)

    Marszał-Wiśniewska, Magdalena; Jarczewska-Gerc, Ewa

    2016-01-01

    Two experiments were conducted to verify the influence of various mental simulations on the effectiveness and persistence of weight loss processes. In study one, 40 female students (aged 19-27, M = 23) who were eager to lose weight were randomly assigned to one of four groups: positive outcome simulation, process simulations, mixed simulations (process followed by negative outcome), and control (no simulations). Students from the mixed and process simulation groups lost significantly more weight after five weeks than participants from the outcome simulation and control groups. A total of 106 females (aged 19-45, M = 29) participated in study two, in which five types of mental simulations were tested. Besides the images used in study one, process followed by positive outcome simulations and negative outcome simulations were implemented. Results showed that process followed by positive outcome simulations lead to the highest persistence in the weight loss process, while process followed by negative outcome simulations induced the greatest reduction in weight. Both studies revealed self-regulatory benefits from mental simulations in difficult and long-term personal goal attainment.

  15. Importance of emotional regulation in obesity and weight loss treatment

    Directory of Open Access Journals (Sweden)

    Isabel Silva

    2015-12-01

    Full Text Available Abstract This theoretical study discusses the importance of emotional regulation process in obesity and in the success/failure of weight loss treatment, systematizing results of empirical studies and theoretical developments that have occurred in this field. Although there has been a substantial interest about this theme, it is difficult to achieve a consensual formulation to explain the relation between emotional regulation and weight because of the huge variability in the methodologies adopted and of the complexity of this phenomenon. In spite of all efforts, more than definite answers, studies have been revealing new research paths to be followed in this complex field.

  16. [Unhealthy weight loss. Erosion by apple cider vinegar].

    Science.gov (United States)

    Gambon, D L; Brand, H S; Veerman, E C I

    2012-12-01

    Erosive tooth wear was diagnosed in the dentition of a 15-year-old girl with a Moroccan background. After an anamnesis, extensive analysis of possible risk factors and a study of the pattern of erosion, it was concluded that the erosive tooth wear was induced by daily consumption of a glass of apple cider vinegar Further investigation revealed that in North-African culture, women have used apple cider vinegar to achieve weight loss for generations. Bodybuilders are also known to make use of this method of weight reduction.

  17. Adverse Psychiatric Effects Associated with Herbal Weight-Loss Products

    Directory of Open Access Journals (Sweden)

    F. Saverio Bersani

    2015-01-01

    Full Text Available Obesity and overeating are among the most prevalent health concerns worldwide and individuals are increasingly using performance and image-enhancing drugs (PIEDs as an easy and fast way to control their weight. Among these, herbal weight-loss products (HWLPs often attract users due to their health claims, assumed safety, easy availability, affordable price, extensive marketing, and the perceived lack of need for professional oversight. Reports suggest that certain HWLPs may lead to onset or exacerbation of psychiatric disturbances. Here we review the available evidence on psychiatric adverse effects of HWLPs due to their intrinsic toxicity and potential for interaction with psychiatric medications.

  18. Adverse Psychiatric Effects Associated with Herbal Weight-Loss Products

    Science.gov (United States)

    Bersani, F. Saverio; Coviello, Marialuce; Imperatori, Claudio; Francesconi, Marta; Hough, Christina M.; Valeriani, Giuseppe; De Stefano, Gianfranco; Bolzan Mariotti Posocco, Flaminia; Santacroce, Rita; Minichino, Amedeo; Corazza, Ornella

    2015-01-01

    Obesity and overeating are among the most prevalent health concerns worldwide and individuals are increasingly using performance and image-enhancing drugs (PIEDs) as an easy and fast way to control their weight. Among these, herbal weight-loss products (HWLPs) often attract users due to their health claims, assumed safety, easy availability, affordable price, extensive marketing, and the perceived lack of need for professional oversight. Reports suggest that certain HWLPs may lead to onset or exacerbation of psychiatric disturbances. Here we review the available evidence on psychiatric adverse effects of HWLPs due to their intrinsic toxicity and potential for interaction with psychiatric medications. PMID:26457296

  19. Overweight men's motivations and perceived barriers towards weight loss

    DEFF Research Database (Denmark)

    Sabinsky, Marianne; Toft, U. N.; Raben, A.

    2007-01-01

    motive for losing weight was a strong desire to become more effective and a greater asset for one's workplace. Overweight subjects were considered less effective and attractive for the labour market. Conclusion: This study indicates that if men from lower socioeconomic backgrounds are to be motivated...... to weight loss the focus should not be on leanness and good health but rather on increased effectiveness and performance, and the arena should include the working place. Sponsorship: The Royal Veterinary and Agricultural University supplied the necessary equipment and conference rooms....

  20. Weight loss reduces circulating asymmetrical dimethylarginine concentrations in morbidly obese women.

    Science.gov (United States)

    Krzyzanowska, Katarzyna; Mittermayer, Friedrich; Kopp, Hans-Peter; Wolzt, Michael; Schernthaner, Guntram

    2004-12-01

    The endogenous nitric oxide-synthase inhibitor asymmetrical dimethyl-L-arginine (ADMA) is elevated in patients with increased risk for arteriosclerosis. Obesity is a risk factor for cardiovascular disease. We measured plasma ADMA concentrations in morbidly obese women before and after weight loss following gastroplastic surgery. ADMA and symmetrical dimethyl-L-arginine concentrations were analyzed by HPLC from 34 female patients (age 41 +/- 7 yr) with a body mass index (BMI) of 49 +/- 1 kg/m2 before and 14 months after vertical ring gastroplasty. Age-matched healthy women (BMI < 25 kg/m2; n = 24) were studied as controls. After gastroplastic surgery, BMI decreased to 34 +/- 1 kg/m2 in obese women (P < 0.00001), and ADMA concentrations were reduced from 1.06 +/- 0.06 micromol/liter at baseline to 0.81 +/- 0.04 micromol/liter after weight loss (P < 0.00001). Symmetrical dimethyl-L-arginine plasma levels were not affected. ADMA correlated with high-sensitivity C-reactive protein at baseline (r = 0.42; P < 0.05) and after weight loss (r = 0.56; P < 0.005). No association with blood pressure or plasma lipids could be observed. ADMA concentrations were lower in controls (0.68 +/- 0.04 micromol/liter; P < 0.05) compared with obese patients before or after weight reduction. The decrease of highly elevated ADMA concentrations in morbidly obese patients is paralleled by improvement of parameters associated with the metabolic syndrome after weight loss.

  1. Weight loss in grappling combat sports: review and applied recommendations

    Directory of Open Access Journals (Sweden)

    Antonio Lancha Junior

    2006-06-01

    Full Text Available The objective of this review is to organize the main literature findings on the effects of rapid weight loss onphysiological systems and performance in grappling combat sports. Several surveys showed that most wrestlers lose significant amount of body weight few days prior to competitions by means of several harmful methods, as severe food and water restriction, or even vomiting and use of laxative and diuretics. The same weight loss patterns seems to occur among Brazilian judo athletes. Many athletes begin to lose weight frequently in puberty. In general, the weight cycles are very recurrent during seasons. A small decrease in some growth variables, followed by a rapid catch-up can be observed during a season. The rapid weight loss involves several adverse effects such as hormonal imbalance, body fat redistribution, decrease of immune system activity, impairments on cardiovascular system, imbalance on water and electrolytes homeostasis and decrease in renal function and in mental and mood state. The aerobic as well as anaerobic performance can be negatively affected by weight reduction. Depending on the kind of weight loss, diet and the recovery time after weighing, anaerobic performance may not be decreased. The weight reduction, if necessary, should be gradual and small. Athletes must consume a high carbohydrate diet during weight loss period and after weighing, prior to the beginning of the competitions. Dehydration should be avoided. Relatively simple changes in rules combined with educational programs could minimize rapid weight loss-related problems. RESUMO O objetivo desta revisão é organizar os principais achados da literatura a respeito dos efeitos das práticas de perda rápida de peso sobre os sistemas fisiológicos e sobre o desempenho em esportes de combate. Diversos levantamentos demonstraram que grande parte dos atletas norte-americanos de luta olímpica perde significativaquantidade de peso dias antes das competições, por

  2. Perceived Social Support for Exercise and Weight Loss in Adolescents Undergoing Sleeve Gastrectomy.

    Science.gov (United States)

    Mackey, Eleanor Race; Olson, Alexandra; Merwin, Stephanie; Wang, Jichuan; Nadler, Evan P

    2017-08-02

    Bariatric surgery is an effective treatment for youth with severe obesity. However, outcomes are variable and there remains sparse understanding of predictors of weight loss following surgery. The current study examines the role of adolescent-reported pre-operative social support around exercise, binge eating, and exercise to predict excess body mass index (EBMI) loss from 3 to 12 months post-surgery. Participants were 101 adolescents ages 12-21 (M age = 16.6, SD = 1.8). Pre-operative body mass index (BMI) ranged from 35 to 87 (M = 50.3, SD = 8.6). Structural equation modeling (SEM) was used to evaluate a model of the association of adolescent report of perceived social support for exercise with less binge eating (items from the Eating Disorder Diagnostic Scale) and more self-reported exercise (items from the Youth Risk Behavior Surveillance System). The model was used to predict EBMI loss at 3, 6, 9, and 12 months post-surgery. Social support significantly predicted exercise and demonstrated a trend for predicting binge eating, such that more social support was associated with more exercise and a trend for less binge eating. Binge eating was associated with less EBMI loss. However, there was no association of exercise with EBMI loss. Pre-operative binge eating should be a target for identification and treatment prior to sleeve gastrectomy in adolescents. Although not directly or indirectly associated with EBMI loss, perceived social support around exercise was associated with increased exercise, which may make it a consideration for a target for intervention as well.

  3. Detection of risk factors that influence weight loss in patients undergoing radiotherapy.

    Science.gov (United States)

    Cacicedo, Jon; Casquero, Francisco; Martinez-Indart, Lorea; Del Hoyo, Olga; Iturriaga, Alfonso Gómez de; Muruzabal, Irma; Carvajal, Claudia; Bóveda, Elsira; Ruiz, Blanca; Loayza, Armando; Usategui, Begoña; Lasso, Aurora; Hortelano, Eduardo; Bilbao, Pedro

    2012-09-01

    To identify risk factors that influence weight loss in patients receiving radiotherapy. It is a well-known fact that cancer patients can be affected by malnutrition at the onset of the disease and during treatment due to the toxicity. Pretreatment weight loss alone does not predict those who will need nutritional supplementation. Instead, a variety of nutritional and tumor related factors needs to be taken into account. A retrospective study was conducted on 129 patients with different tumor locations. Weight loss was evaluated during radiotherapy and one month after treatment. The impact of age, ECOG, chemotherapy, pretreatment weight loss, tumor location, previous surgery and TNM were analyzed. We aimed to identify a high-risk group of patients before starting treatment. The average net weight loss during radiotherapy and one month after treatment for this group of patients was 0.68 kg and 1.6 kg, respectively. Median weight loss during radiotherapy was 2.6 kg for head and neck (HN) patients and 0.27  kg for other tumor sites (p = 0.028). Median weight loss one month after radiotherapy was 3.7 kg for HN patients and 1.1 kg for the rest of the patients (p = 0.034). The median weight loss one month after treatment was 3.2 kg for patients receiving chemotherapy and 0.5 kg for those patients who did not receive chemotherapy (p < 0.001). A regression analysis determined that HN tumor location and the use of chemotherapy were independent risk factors. Nutritional status must be monitored and managed before, during and after treatment. A variety of nutritional and tumor-related factors must be considered. According to our results, head and neck tumors and the use of chemotherapy are the only two factors considered statistically significant. Because patients continue to lose weight after treatment, we recommend close surveillance after radiotherapy.

  4. Initiation and Maintenance of Weight Loss after Laparoscopic Adjustable Gastric Banding. The role of Outcome Expectation and Satisfaction with the Psychosocial Outcome

    NARCIS (Netherlands)

    Zijlstra, H.; Larsen, J.K.; Ridder, D.T.D. de; Ramshorst, B. van; Geenen, R.

    2009-01-01

    A premise of this study was that different psychological processes would predict the initiation and maintenance of weight loss after surgery for morbid obesity. Our aim was to examine whether more favorable preoperative expectations of psychosocial outcomes predict weight loss in the first year afte

  5. Initiation and Maintenance of Weight Loss after Laparoscopic Adjustable Gastric Banding. The role of Outcome Expectation and Satisfaction with the Psychosocial Outcome

    NARCIS (Netherlands)

    Zijlstra, H.; Larsen, J.K.; Ridder, D.T.D. de; Ramshorst, B. van; Geenen, R.

    2008-01-01

    Background: A premise of this study was that different psychological processes would predict the initiation and maintenance of weight loss after surgery for morbid obesity. Our aim was to examine whether more favorable preoperative expectations of psychosocial outcomes predict weight loss in the fir

  6. Sustained weight loss and improvement of quality of life after laparoscopic adjustable gastric banding for morbid obesity: a single surgeon experience in Ireland.

    LENUS (Irish Health Repository)

    Chang, K H

    2010-03-01

    Although substantial weight loss is the primary outcome following bariatric surgery, changes in obesity-related morbidity and quality of life (QoL) are equally important. This study reports on weight loss, QoL and health outcomes following laparoscopic adjustable gastric banding (LAGB).

  7. Salivary habituation to food stimuli in successful weight loss maintainers, obese and normal-weight adults

    Science.gov (United States)

    Bond, DS; Raynor, HA; McCaffery, JM; Wing, RR

    2017-01-01

    Objective Research shows that slower habituation of salivary responses to food stimuli is related to greater energy intake and that obese (Ob) individuals habituate slower than those of normal weight (NW). No study has examined habituation rates in weight loss maintainers (WLMs) who have reduced from obese to normal weight, relative to those who are Ob or NW. Design Salivation to two baseline water trials and 10 lemon-flavored lollipop trials were studied in 14 WLMs, 15 Ob and 18 NW individuals comparable in age, gender and ethnicity. Linear mixed models were used to compare WLMs with Ob and NW groups. Results Salivation in the WLM and NW groups decreased significantly (for both P obesity, and show quicker habituation than those who are currently obese. These results suggest that physiological responses to food may ‘normalize’ with successful weight loss maintenance. PMID:20010900

  8. Effect of Bariatric Weight Loss on the Adipose Lipolytic Transcriptome in Obese Humans

    Directory of Open Access Journals (Sweden)

    Shakun Karki

    2015-01-01

    Full Text Available Background. Dysregulated lipolysis has been implicated in mechanisms of cardiometabolic disease and inflammation in obesity. Purpose. We sought to examine the effect of bariatric weight loss on adipose tissue lipolytic gene expression and their relationship to systemic metabolic parameters in obese subjects. Methods/Results. We biopsied subcutaneous adipose tissue in 19 obese individuals (BMI 42 ± 5 kg/m2, 79% female at baseline and after a mean period of 8 ± 5 months (range 3–15 months following bariatric surgery. We performed adipose tissue mRNA expression of proteins involved in triglyceride hydrolysis and correlated their weight loss induced alterations with systemic parameters associated with cardiovascular disease risk. mRNA transcripts of adipose triglyceride lipase (ATGL, hormone-sensitive lipase (HSL, and lipid droplet proteins comparative gene identification 58 (CGI-58 and perilipin increased significantly after weight loss (p<0.05 for all. ATGL expression correlated inversely with plasma triglyceride (TG, hemoglobin A1C (HbA1C, and glucose, and HSL expression correlated negatively with glucose, while CGI-58 was inversely associated with HbA1C. Conclusion. We observed increased expression of adipose tissue lipolytic genes following bariatric weight loss which correlated inversely with systemic markers of lipid and glucose metabolism. Functional alterations in lipolysis in human adipose tissue may play a role in shaping cardiometabolic phenotypes in human obesity.

  9. The ambivalence of losing weight after bariatric surgery

    Directory of Open Access Journals (Sweden)

    Christine Warholm

    2014-01-01

    Full Text Available This study is grounded in a phenomenological lifeworld perspective. It aims at providing rich descriptions of lived experience of the process of losing weight after obesity surgery. Two women participated in in-depth interviews four times each during the first postoperative year. Based on the women's experiences, a meaning structure—the ambivalence of losing weight after obesity surgery—was identified across the women's processes of change. This consisted of five core themes: movement and activity—freedom but new demands and old restraints; eating habits and digestion—the complexity of change; appearance—smaller, but looser; social relations—stability and change; and being oneself—vulnerability and self-assurance. These core themes changed over time in terms of dominance. The experience of ambivalence is discussed according to a phenomenological perspective of the body as lived experience.

  10. Reductions in knee joint forces with weight loss are attenuated by gait adaptations in class III obesity.

    Science.gov (United States)

    DeVita, Paul; Rider, Patrick; Hortobágyi, Tibor

    2016-03-01

    A consensus exists that high knee joint forces are a precursor to knee osteoarthritis and weight loss reduces these forces. Because large weight loss also leads to increased step length and walking velocity, knee contact forces may be reduced less than predicted by the magnitude of weight loss. The purpose was to determine the effects of weight loss on knee muscle and joint loads during walking in Class III obese adults. We determined through motion capture, force platform measures and biomechanical modeling the effects of weight loss produced by gastric bypass surgery over one year on knee muscle and joint loads during walking at a standard, controlled velocity and at self-selected walking velocities. Weight loss equaling 412 N or 34% of initial body weight reduced maximum knee compressive force by 824 N or 67% of initial body weight when walking at the controlled velocity. These changes represent a 2:1 reduction in knee force relative to weight loss when walking velocity is constrained to the baseline value. However, behavioral adaptations including increased stride length and walking velocity in the self-selected velocity condition attenuated this effect by ∼50% leading to a 392 N or 32% initial body weight reduction in compressive force in the knee joint. Thus, unconstrained walking elicited approximately 1:1 ratio of reduction in knee force relative to weight loss and is more indicative of walking behavior than the standard velocity condition. In conclusion, massive weight loss produces dramatic reductions in knee forces during walking but when patients stride out and walk faster, these favorable reductions become substantially attenuated.

  11. Resolution of NASH with weight loss documented by hepatic MRI.

    Science.gov (United States)

    Singh, Vasvi; Luthra, Saurav; Elajami, Tarec K; Welty, Francine K

    2015-01-06

    A 57-year-old Asian woman with type 2 diabetes mellitus, hypertension, obesity, dyslipidaemia and history of breast cancer, was referred to the cardiovascular health and lipid centre for evaluation and management of dyslipidaemia and NASH (Non-alcoholic steatohepatitis) in 2010. She originally had a detailed work up at the liver clinic for elevated liver enzymes, with no associated symptoms. Initial hepatic MRI on 22 January 2007 showed diffuse fatty infiltration quantitated at 15%. We counselled her on lifestyle modifications, including dietary measures and exercise, geared toward weight loss. Over the next 2 years, she lost 24.5 lbs; repeat hepatic MRI on 22 December 2011 showed 6% hepatic fat, which is within the normal range. This case demonstrates the efficacy of significant weight loss in the improvement and resolution of NASH. We believe that this is the first case report documenting this through liver MRI. 2015 BMJ Publishing Group Ltd.

  12. Self-regulatory theory and weight-loss maintenance.

    Science.gov (United States)

    Testa, Rylan J; Brown, Ronald T

    2015-03-01

    We examined the relationships between promotion and prevention focus and caloric consumption in reaction to a dietary lapse scenario among weight loss maintainers. Participants were 65 adult females who had attained and maintained a weight loss of 10 % or more for at least 1 month. After engaging in a dietary lapse in a feeding laboratory, participants completed a "bogus" taste test, during which they could consume as much food as they liked. It was hypothesized that promotion and prevention focus would predict caloric consumption, mediated by depressive and anxious affect. Prevention focus, but not promotion focus, was positively associated with proportion of daily calories consumed. Affect was not a mediator. Prevention focus may be deleterious for dietary maintenance following dietary lapses. Theoretical and clinical implications are discussed in light of prior research. Limitations of the study and recommendations for future research also are presented.

  13. Mindfulness as a Weight Loss Treatment for Veterans

    Directory of Open Access Journals (Sweden)

    Michael Vicente Stanton

    2016-08-01

    Full Text Available Despite substantial evidence for their effectiveness in treating disordered eating and obesity, mindfulness-based treatments have not been broadly implemented among Veterans. A number of reviews have reported mindfulness to be beneficial in promoting healthy eating behaviors and weight loss among non-Veteran samples. We discuss this approach in the context of the Veterans Affairs system, the largest integrated healthcare provider in the United States and in the context of Veterans, among whom obesity is at epidemic proportions. In this article, we discuss what is known about treating obesity using a mindfulness approach, mindfulness interventions for Veterans, a new pilot mindfulness-based weight loss program designed for Veterans, and future directions for this type of obesity treatment in Veterans. We conclude that this population may be uniquely poised to benefit from mindfulness-based treatments.

  14. Managing anemia and blood loss in elective gynecologic surgery patients.

    Science.gov (United States)

    Rock, W A; Meeks, G R

    2001-05-01

    Hysterectomy is the second-most-common surgical procedure among premenopausal women. The conditions that lead to the need for a hysterectomy often are accompanied by chronic blood loss that can lead to anemia. Moreover, hysterectomy and myomectomy may result in significant blood loss, which exacerbates the anemia. The presence of fatigue associated with anemia has a substantially negative impact on quality of life and the ability to perform activities of daily living. Options for alleviating perioperative anemia include minimizing surgical blood loss, blood transfusion, supplementation with hematinics, such as iron and folic acid, and treatment with recombinant human erythropoietin. Treating preoperative anemia is expected to help correct anemia prior to surgery and may have a positive impact on anemia-related symptoms and surgical outcomes.

  15. Weight loss expectations and body dissatisfaction in young women attempting to lose weight.

    Science.gov (United States)

    Siervo, M; Montagnese, C; Muscariello, E; Evans, E; Stephan, B C M; Nasti, G; Papa, A; Iannetti, E; Colantuoni, A

    2014-04-01

    Unrealistic weight loss expectations (WLEs) and greater body dissatisfaction may be associated with the poor long-term outcomes of dietary and lifestyle weight loss treatments. We evaluated the association between body size, WLEs and body dissatisfaction in young women attempting to lose weight. Forty-four young healthy women [age range 18-35 years, body mass index (BMI) range 23-40 kg/m2] were recruited. Women were classified as obese (BMI ≥ 30.0 kg/m2) and non-obese (BMI social (career, family acceptance, peer acceptance, mass media, social pressure) factors. Individual WLEs were compared with recommended clinical targets (5%, 10% and 20%) for weight loss. Body dissatisfaction was lower in non-obese subjects and was directly associated with BMI (P media, whereas they perceived that family and friends were supportive of a lesser degree of weight loss. We observed a mismatch between clinical and personal expectations, and social pressure and interpersonal relationships appear to have a prominent role with respect to influencing the association. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

  16. Postprandial coagulation activation in overweight individuals after weight loss

    DEFF Research Database (Denmark)

    Bladbjerg, Else-Marie; Larsen, Thomas Meinert; Due, Anette Pia

    2014-01-01

    . This was tested in a parallel intervention trial on overweight individuals (aged 28.4 (SD 4.7) years) randomly assigned to a MUFA-diet (35-45% of energy as fat; >20% as MUFA, n=21) or a low-fat (LF) diet (20-30% of energy as fat, n=22) for 6months after a weight loss of ~10%. All foods were provided free...

  17. Obesity, Intentional Weight Loss, and Physical Disability in Older Adults

    OpenAIRE

    Rejeski, W. Jack; Marsh, Anthony P.; Chmelo, Elizabeth; Rejeski, Jared J.

    2010-01-01

    We examine obesity, intentional weight loss, and physical disability in older adults. Based on prospective epidemiological studies, BMI exhibits a curvilinear relationship with physical disability; there appears to be some protective effect associated with older adults being overweight. Whereas the greatest risk for physical disability occurs in older adults who are ≥class II obesity, the effects of obesity on physical disability appears to be moderated by both sex and race. Obesity at age 30...

  18. Reprogramming of defended body weight after Roux-En-Y gastric bypass surgery in diet-induced obese mice.

    Science.gov (United States)

    Hao, Zheng; Mumphrey, Michael B; Townsend, R Leigh; Morrison, Christopher D; Münzberg, Heike; Ye, Jianping; Berthoud, Hans-Rudolf

    2016-03-01

    Roux-en-Y gastric bypass surgery (RYGB) results in sustained lowering of body weight in most patients, but the mechanisms involved are poorly understood. The aim of this study was to obtain support for the notion that reprogramming of defended body weight, rather than passive restriction of energy intake, is a fundamental mechanism of RYGB. Male C57BL6J mice reaching different degrees of obesity on a high-fat diet either with ad libitum access or with caloric restriction (weight-reduced) were subjected to RYGB. RYGB-induced weight loss and fat mass loss were proportional to pre-surgical levels, with moderately obese mice losing less body weight and fat compared with very obese mice. Remarkably, mice that were weight-reduced to the level of chow controls before surgery immediately gained weight after surgery, exclusively accounted for by lean mass gain. The results provide additional evidence for reprogramming of a new defended body weight as an important principle by which RYGB lastingly suppresses body weight. RYGB appears to selectively abolish defense of a higher fat mass level, while remaining sensitive to the defense of lean mass. The molecular and physiological mechanisms underlying this reprogramming remain to be elucidated. © 2016 The Obesity Society.

  19. The impact of a bariatric rehabilitation service on weight loss and psychological adjustment - study protocol

    Directory of Open Access Journals (Sweden)

    Hollywood Amelia

    2012-04-01

    Full Text Available Abstract Background Bariatric surgery is currently the most effective form of obesity management for those whose BMI is greater than 40 (or 35 with co morbidities. A minority of patients, however, either do not show the desired loss of excess weight or show weight regain by follow up. Research highlights some of the reasons for this variability, most of which centres on the absence of any psychological support with patients describing how although surgery fixes their body, psychological issues relating to dietary control, self esteem, coping and emotional eating remain neglected. The present study aims to evaluate the impact of a health psychology led bariatric rehabilitation service (BRS on patient health outcomes. The bariatric rehabilitation service will provide information, support and mentoring pre and post surgery and will address psychological issues such as dietary control, self esteem, coping and emotional eating. The package reflects the rehabilitation services now common place for patients post heart attack and stroke which have been shown to improve patient health outcomes. Methods/Design The study is a randomised control trial and patients will be allocated to receive either usual care or the bariatric rehabilitation service pre and post bariatric surgery. Follow up measures of weight loss and psychological issues will be taken at baseline (2 weeks preoperatively, 3, 6 and 12 months postoperatively. The contents of the bariatric service and the follow up measures are based on previous pilot work and have been developed further by the research team working closely with two patient support groups (BOSPA & WLSinfo. This study will take place in St Richard's Hospital in Chichester in the UK. Discussion It is predicted that a bariatric rehabilitation service will improve weight loss following surgery and will also facilitate changes in other psychological variables such as quality of life, dietary control, self esteem, coping and

  20. Weight loss and survival of Biomphalaria Glabrata deprived of water

    Directory of Open Access Journals (Sweden)

    Marc Vianey-Liaud

    1986-06-01

    Full Text Available Immature and mature Biomphalaria glabrata are kept out of water at relative humidities varying from 0 to 100%. When snails are submitted to a saturated atmosphere, they show a slow weight loss and survival may be long. If relative humidity (RH decreases, weight loss becomes important and survival is short. A reduced RH (0 to 65% produces similar effects. During desiccation, fasting has no noticeable effect; survival depends essentially on weight loss.Biomphalaria glabrata maduros ou imaturos são mantidos fora da água, variando a umidade de 0 a 100%. Quando caramujos são submetidos a uma atmosfera saturada, sofrem uma lenta perda de peso e a sobrevivência pode ser longa. Se a umidade relativa decresce, a perda de peso será importante e a sobrevida será abreviada. Uma umidade relativa de 0 a 65% pode produzir efeitos similares. Durante a dessecação, a privação de alimento não tem efeito notável, a sobrevivência dependendo essencialmente da perda de peso.

  1. Weight Loss after Sleeve Gastrectomy in Super Superobesity

    Directory of Open Access Journals (Sweden)

    J.-M. Catheline

    2012-01-01

    Full Text Available Objective. This prospective study evaluated laparoscopic sleeve gastrectomy for its safety and efficiency in excess weight loss (%EWL in super superobese patients (BMI >60 Kg/m2. Results. Thirty patients (33 women and 7 men were included, with mean age of 35 years (range 18 to 59. Mean preoperative BMI was 66 Kg/m2 (range 60 to 85. The study included one patient with complete situs inversus and 4 (14% with previous restrictive gastric banding. The mean operative time was 120 minutes (range 80 to 220 min and the mean hospital stay was 7.5 days (4 to 28 days. There was no postoperative mortality or need for a laparotomy conversion. Two subphrenic hematomas, one gastric fistula, and one pulmonary embolism, were the major complications. After 18 months 17 (77% had sufficient weight loss and six had insufficient results, leading to either re-sleeve gastrectomy (3, or gastric bypass (2. Three years after the initial laparoscopic sleeve gastrectomy, the mean EWL was 51% (range 21 to 82. Conclusion. The laparoscopic sleeve gastrectomy is a safe and efficient operating procedure for treating super superobesity. In the case of insufficient weight loss, a second-stage operation like resleeve gastrectomy or gastric bypass can be proposed.

  2. Herbal Weight Loss Pill Overdose: Sibutramine Hidden in Pepper Pill

    Directory of Open Access Journals (Sweden)

    Gul Pamukcu Gunaydin

    2015-01-01

    Full Text Available Supposedly herbal weight loss pills are sold online and are widely used in the world. Some of these products are found to contain sibutramine by FDA and their sale is prohibited. We report a case of a female patient who presented to the emergency department after taking slimming pills. 17-year-old female patient presented to the emergency room with palpitations, dizziness, anxiety, and insomnia. She stated that she had taken 3 pills named La Jiao Shou Shen for slimming purposes during the day. Her vital signs revealed tachycardia. On her physical examination, she was restless, her oropharynx was dry, her pupils were mydriatic, and no other pathological findings were found. Sibutramine intoxication was suspected. She was given 5 mg IV diazepam for restlessness. After supportive therapy and observation in emergency department for 12 hours there were no complications and the patient was discharged home. Some herbal pills that are sold online for weight loss have sibutramine hidden as an active ingredient, and their sale is prohibited for this reason. For people who use herbal weight loss drugs, sibutramine excessive intake should be kept in mind at all times.

  3. Predictive factors for body weight loss and its impact on quality of life following gastrectomy.

    Science.gov (United States)

    Tanabe, Kazuaki; Takahashi, Masazumi; Urushihara, Takashi; Nakamura, Yoichi; Yamada, Makoto; Lee, Sang-Woong; Tanaka, Shinnosuke; Miki, Akira; Ikeda, Masami; Nakada, Koji

    2017-07-14

    To determine the predictive factors and impact of body weight loss on postgastrectomy quality of life (QOL). We applied the newly developed integrated questionnaire postgastrectomy syndrome assessment scale-45, which consists of 45 items including those from the Short Form-8 and Gastrointestinal Symptom Rating Scale instruments, in addition to 22 newly selected items. Between July 2009 and December 2010, completed questionnaires were received from 2520 patients with curative resection at 1 year or more after having undergone one of six types of gastrectomy for Stage I gastric cancer at one of 52 participating institutions. Of those, we analyzed 1777 eligible questionnaires from patients who underwent total gastrectomy with Roux-en-Y procedure (TGRY) or distal gastrectomy with Billroth-I (DGBI) or Roux-en-Y (DGRY) procedures. A total of 393, 475 and 909 patients underwent TGRY, DGRY, and DGBI, respectively. The mean age of patients was 62.1 ± 9.2 years. The mean time interval between surgery and retrieval of the questionnaires was 37.0 ± 26.8 mo. On multiple regression analysis, higher preoperative body mass index, total gastrectomy, and female sex, in that order, were independent predictors of greater body weight loss after gastrectomy. There was a significant difference in the degree of weight loss (P 25 kg/m(2)). Multiple linear regression analysis identified lower postoperative body mass index, rather than greater body weight loss postoperatively, as a certain factor for worse QOL (P weight after gastrectomy, the impact of body weight loss on QOL is unexpectedly small.

  4. Impact of body-composition methodology on the composition of weight loss and weight gain.

    Science.gov (United States)

    Pourhassan, M; Schautz, B; Braun, W; Gluer, C-C; Bosy-Westphal, A; Müller, M J

    2013-05-01

    We intended to (i) to compare the composition of weight loss and weight gain using densitometry, deuterium dilution (D₂O), dual-energy X-ray absorptiometry (DXA), magnetic resonance imaging (MRI) and the four-compartment (4C) model and (ii) to compare regional changes in fat mass (FM), fat-free mass (FFM) and skeletal muscle as assessed by DXA and MRI. Eighty-three study participants aged between 21 and 58 years with a body mass index range of 20.2-46.8 kg/m(2) had been assessed at two different occasions with a mean follow-up between 23.5 and 43.5 months. Body-weight changes within weight stable, a gain or a loss of >3% of initial weight was considered as a significant weight change. There was a considerable bias between the body-composition data obtained by the individual methods. When compared with the 4C model, mean bias of D₂O and densitometry was explained by the erroneous assumption of a constant hydration of FFM, thus, changes in FM were underestimated by D₂O but overestimated by densitometry. Because hydration does not normalize after weight loss, all two-component models have a systematic error in weight-reduced subjects. The bias between 4C model and DXA was mainly explained by FM% at baseline, whereas FFM hydration contributed to additional 5%. As to the regional changes in body composition, DXA data had a considerable bias and, thus, cannot replace MRI. To assess changes in body composition associated with weight changes, only the 4C model and MRI can be used with confidence.

  5. Maintenance of weight loss after lifestyle interventions for overweight and obesity, a systematic review

    NARCIS (Netherlands)

    Barte, J. C. M.; ter Bogt, N. C. W.; Bogers, R. P.; Teixeira, P. J.; Blissmer, B.; Mori, T. A.; Bemelmans, W. J. E.

    2010-01-01

    P>Lifestyle interventions can reduce body weight, but weight regain is common and may particularly occur with higher initial weight loss. If so, one may argue whether the 10% weight loss in clinical guidelines is preferable above a lower weight loss. This systematic review explores the relation betw

  6. Maintenance of weight loss after lifestyle interventions for overweight and obesity, a systematic review

    NARCIS (Netherlands)

    Barte, J. C. M.; ter Bogt, N. C. W.; Bogers, R. P.; Teixeira, P. J.; Blissmer, B.; Mori, T. A.; Bemelmans, W. J. E.

    2010-01-01

    P>Lifestyle interventions can reduce body weight, but weight regain is common and may particularly occur with higher initial weight loss. If so, one may argue whether the 10% weight loss in clinical guidelines is preferable above a lower weight loss. This systematic review explores the relation

  7. Evidence-based practices for the prevention of weight loss in nursing home residents.

    Science.gov (United States)

    Dyck, Mary J; Schumacher, Julie Raeder

    2011-03-01

    Weight loss is common among nursing home residents. Food intake is often inadequate for elderly residents but is only one of several factors contributing to potential weight loss. Three common issues resulting in weight loss include starvation (or wasting), cachexia, and sarcopenia. Significant weight loss leads to increased mortality, increased morbidity, and decreased quality of life. The purpose of this article is to discuss the geriatric syndrome of weight loss in elderly nursing home residents and provide recommendations to decrease and prevent weight loss. A list of available evidence-based protocols related to weight loss issues is provided.

  8. Epigenetics in adipose tissue, obesity, weight loss, and diabetes.

    Science.gov (United States)

    Martínez, J Alfredo; Milagro, Fermín I; Claycombe, Kate J; Schalinske, Kevin L

    2014-01-01

    Given the role that diet and other environmental factors play in the development of obesity and type 2 diabetes, the implication of different epigenetic processes is being investigated. Although it is well known that external factors can cause cell type-dependent epigenetic changes, including DNA methylation, histone tail modifications, and chromatin remodeling, the regulation of these processes, the magnitude of the changes and the cell types in which they occur, the individuals more predisposed, and the more crucial stages of life remain to be elucidated. There is evidence that obese and diabetic people have a pattern of epigenetic marks different from nonobese and nondiabetic individuals. The main long-term goals in this field are the identification and understanding of the role of epigenetic marks that could be used as early predictors of metabolic risk and the development of drugs or diet-related treatments able to delay these epigenetic changes and even reverse them. But weight gain and insulin resistance/diabetes are influenced not only by epigenetic factors; different epigenetic biomarkers have also been identified as early predictors of weight loss and the maintenance of body weight after weight loss. The characterization of all the factors that are able to modify the epigenetic signatures and the determination of their real importance are hindered by the following factors: the magnitude of change produced by dietary and environmental factors is small and cumulative; there are great differences among cell types; and there are many factors involved, including age, with multiple interactions between them.

  9. Epigenetics in Adipose Tissue, Obesity, Weight Loss, and Diabetes12

    Science.gov (United States)

    Martínez, J. Alfredo; Milagro, Fermín I.; Claycombe, Kate J.; Schalinske, Kevin L.

    2014-01-01

    Given the role that diet and other environmental factors play in the development of obesity and type 2 diabetes, the implication of different epigenetic processes is being investigated. Although it is well known that external factors can cause cell type-dependent epigenetic changes, including DNA methylation, histone tail modifications, and chromatin remodeling, the regulation of these processes, the magnitude of the changes and the cell types in which they occur, the individuals more predisposed, and the more crucial stages of life remain to be elucidated. There is evidence that obese and diabetic people have a pattern of epigenetic marks different from nonobese and nondiabetic individuals. The main long-term goals in this field are the identification and understanding of the role of epigenetic marks that could be used as early predictors of metabolic risk and the development of drugs or diet-related treatments able to delay these epigenetic changes and even reverse them. But weight gain and insulin resistance/diabetes are influenced not only by epigenetic factors; different epigenetic biomarkers have also been identified as early predictors of weight loss and the maintenance of body weight after weight loss. The characterization of all the factors that are able to modify the epigenetic signatures and the determination of their real importance are hindered by the following factors: the magnitude of change produced by dietary and environmental factors is small and cumulative; there are great differences among cell types; and there are many factors involved, including age, with multiple interactions between them. PMID:24425725

  10. Lifestyle medicine consulting walking meetings for sustained weight loss.

    Science.gov (United States)

    Frates, Elizabeth Pegg; Crane, Margaret E

    2016-02-01

    With rates of obesity and diabetes rising worldwide, effective ways of managing weight are becoming more important. We present the case study of a middle-aged Caucasian-American woman (body mass index (BMI) 27.8, overweight category) who wanted to lose weight. The patient participated in a behaviour modification programme with a physician trained in lifestyle medicine as well as health and wellness coaching. After the 14-week programme, which included 9, 1 h long walking sessions with the clinician, the patient lost 11 Ibs (BMI 24.7, normal category). The programme included a combination of increasing physical activity, eating appropriate quantities of healthy foods, goal setting and a positive attitude. The patient has kept her BMI at or below 24.1 for over 2 years. This case demonstrates a novel approach to weight loss management--walking therapeutic sessions--and also outlines critical components of lifestyle medicine counselling that facilitate the process of sustainable weight loss and lasting change.

  11. Longitudinal changes in blood pressure during weight loss and regain of weight in obese boys and girls

    DEFF Research Database (Denmark)

    Holm, Jens-Christian; Gamborg, Michael; Neland, Mette

    2012-01-01

    To investigate blood pressure (BP) in relation to changes in body mass index (BMI) in obese children during weight loss and subsequent weight regain.......To investigate blood pressure (BP) in relation to changes in body mass index (BMI) in obese children during weight loss and subsequent weight regain....

  12. Attachment anxiety predicts poor adherence to dietary recommendations : an indirect effect on weight change 1 year after gastric bypass surgery

    NARCIS (Netherlands)

    Hinnen, C.; Aarts, F.; Geenen, R.

    2014-01-01

    BACKGROUND: Weight loss after gastric bypass surgery depends on the adoption of healthy dietary recommendations, which may be influenced by psychological issues and patients' attachment representations (habitual states of mind with respect to interpersonal relations). The present study tests (1) whe

  13. Attachment Anxiety Predicts Poor Adherence to Dietary Recommendations : an Indirect Effect on Weight Change 1 Year After Gastric Bypass Surgery

    NARCIS (Netherlands)

    Aarts, Floor; Geenen, Rinie; Gerdes, Victor E. A.; van de Laar, Arnold; Brandjes, Dees P. M.; Hinnen, Chris

    2015-01-01

    Weight loss after gastric bypass surgery depends on the adoption of healthy dietary recommendations, which may be influenced by psychological issues and patients' attachment representations (habitual states of mind with respect to interpersonal relations). The present study tests (1) whether attachm

  14. Attachment anxiety predicts poor adherence to dietary recommendations : an indirect effect on weight change one year after gastric bypass surgery

    NARCIS (Netherlands)

    Aarts, F.; Geenen, R.; Gerdes, V.E.A.; Van de Laar, A., A.; Brandjes, D.P.M.; Hinnen, C.

    2015-01-01

    BACKGROUND: Weight loss after gastric bypass surgery depends on the adoption of healthy dietary recommendations, which may be influenced by psychological issues and patients' attachment representations (habitual states of mind with respect to interpersonal relations). The present study tests (1) whe

  15. The paradox of obesity cardiomyopathy and the potential for weight loss as a therapy.

    Science.gov (United States)

    Rayner, J J; Neubauer, S; Rider, O J

    2015-08-01

    Obesity is an independent risk factor for developing heart failure and the combination of the two disease states will prove to be a significant health burden over the coming years. Obesity is likely to contribute to the development of heart failure through a variety of mechanisms, including structural and functional changes, lipotoxicity and steatosis and altered substrate selection. However, once heart failure has developed, it seems that obesity confers a beneficial influence on prognosis in what has been termed the 'obesity paradox'. This may be a statistical phenomenon, but it should be considered that there is truly a protective state in the physiology of obesity. There is little evidence regarding the impact of weight loss in obese heart failure and whether or not this is beneficial. There have been small studies regarding the cardiovascular effects of both dietary weight loss and bariatric surgery, but few in heart failure. This is an important and increasingly relevant clinical question which must be addressed.

  16. Nonequilibrium thermodynamics and energy efficiency in weight loss diets.

    Science.gov (United States)

    Feinman, Richard D; Fine, Eugene J

    2007-07-30

    Carbohydrate restriction as a strategy for control of obesity is based on two effects: a behavioral effect, spontaneous reduction in caloric intake and a metabolic effect, an apparent reduction in energy efficiency, greater weight loss per calorie consumed. Variable energy efficiency is established in many contexts (hormonal imbalance, weight regain and knock-out experiments in animal models), but in the area of the effect of macronutrient composition on weight loss, controversy remains. Resistance to the idea comes from a perception that variable weight loss on isocaloric diets would somehow violate the laws of thermodynamics, that is, only caloric intake is important ("a calorie is a calorie"). Previous explanations of how the phenomenon occurs, based on equilibrium thermodynamics, emphasized the inefficiencies introduced by substrate cycling and requirements for increased gluconeogenesis. Living systems, however, are maintained far from equilibrium, and metabolism is controlled by the regulation of the rates of enzymatic reactions. The principles of nonequilibrium thermodynamics which emphasize kinetic fluxes as well as thermodynamic forces should therefore also be considered. Here we review the principles of nonequilibrium thermodynamics and provide an approach to the problem of maintenance and change in body mass by recasting the problem of TAG accumulation and breakdown in the adipocyte in the language of nonequilibrium thermodynamics. We describe adipocyte physiology in terms of cycling between an efficient storage mode and a dissipative mode. Experimentally, this is measured in the rate of fatty acid flux and fatty acid oxidation. Hormonal levels controlled by changes in dietary carbohydrate regulate the relative contributions of the efficient and dissipative parts of the cycle. While no experiment exists that measures all relevant variables, the model is supported by evidence in the literature that 1) dietary carbohydrate, via its effect on hormone levels

  17. Nonequilibrium thermodynamics and energy efficiency in weight loss diets

    Directory of Open Access Journals (Sweden)

    Fine Eugene J

    2007-07-01

    Full Text Available Abstract Carbohydrate restriction as a strategy for control of obesity is based on two effects: a behavioral effect, spontaneous reduction in caloric intake and a metabolic effect, an apparent reduction in energy efficiency, greater weight loss per calorie consumed. Variable energy efficiency is established in many contexts (hormonal imbalance, weight regain and knock-out experiments in animal models, but in the area of the effect of macronutrient composition on weight loss, controversy remains. Resistance to the idea comes from a perception that variable weight loss on isocaloric diets would somehow violate the laws of thermodynamics, that is, only caloric intake is important ("a calorie is a calorie". Previous explanations of how the phenomenon occurs, based on equilibrium thermodynamics, emphasized the inefficiencies introduced by substrate cycling and requirements for increased gluconeogenesis. Living systems, however, are maintained far from equilibrium, and metabolism is controlled by the regulation of the rates of enzymatic reactions. The principles of nonequilibrium thermodynamics which emphasize kinetic fluxes as well as thermodynamic forces should therefore also be considered. Here we review the principles of nonequilibrium thermodynamics and provide an approach to the problem of maintenance and change in body mass by recasting the problem of TAG accumulation and breakdown in the adipocyte in the language of nonequilibrium thermodynamics. We describe adipocyte physiology in terms of cycling between an efficient storage mode and a dissipative mode. Experimentally, this is measured in the rate of fatty acid flux and fatty acid oxidation. Hormonal levels controlled by changes in dietary carbohydrate regulate the relative contributions of the efficient and dissipative parts of the cycle. While no experiment exists that measures all relevant variables, the model is supported by evidence in the literature that 1 dietary carbohydrate, via its

  18. Association between Weight and Smoking Not Mediated by Weight Loss Attempts or Bullying.

    Science.gov (United States)

    Minaker, Leia M; Leatherdale, Scott T

    2016-01-01

    Youth smoking and obesity may both be mediated by weight control behaviors and experiences of bullying. This study examines associations between smoking and obesity among youth, and explores whether associations are mediated by weight loss attempts or bullying experiences. Data from 24,173 grade 9 to 12 students in the COMPASS study (2012-13) were used to examine the prevalence of self-reported smoking, weight status, attempting to lose weight, and being a victim of bullying. Generalized linear mixed effects models were used to examine correlates of smoking. Among youth, 11% reported currently smoking, 20% were overweight or obese, 42% reported attempting to lose weight, and 18% reported being bullied. Girls who reported attempting to lose weight had higher odds of smoking (OR = 1.42, p = .0039), and students who reported being bullied had higher odds of smoking (OR = 1.85, p bullied was associated with smoking, independent of weight status. Programs attempting to reduce smoking among youth should consider the effects of weight control behaviors and bullying irrespective of weight status.

  19. Perioperative blood loss and diclofenac in major arthroplastic surgery

    Directory of Open Access Journals (Sweden)

    Ljiljana Gvozdenović

    2011-04-01

    Full Text Available Introduction: Contemporary literature indicates precaution over the perioperative use of non-steroidal anti-inflammatory drugs, since they can potentially increase perioperative blood loss related to their mechanism of action. The aim of this study was to assess the influence of non-steroidal anti-inflammatory drugs on perioperative blood loss undergoing hip arthroplasty and its correlation with general and regional anesthesia.Methods: This prospective study included 120 patients who had undergone elective unilateral total hip arthroplasty. Patients were allocated into four groups. Groups 1 and 2 were pretreated with diclofenac and operated in general and regional anesthesia. Group 3 and 4 weren’t pretreated with any non-steroidal anti-inflammatory drug and were, as well, operated in general and regional anesthesia. Diclofenac was administered orally two times a day 75 mg (total 150 mg and also as intramuscular injection (75 mg preoperatively and 12 hours later on a day of surgery.Results: The perioperative blood loss in the rst 24 hours showed an increase of 29.4% in the diclofenac group operated in general anesthesia and increase of 26.8% in patients operated in regional anesthesia (P < 0.05 compared to control group. Statistical data evaluation of patients operated in general anesthesia compared to regional anesthesia, the overall blood loss in the rst 24 h after surgery, showed an increase of 6.4% in the diclofenac group and increase of 3.6% in placebo group. This was not statistically significant.Conclusion: Pretreatment with non-steroidal anti-inflammatory drugs (diclofenac before elective unilateral total hip arthroplasty increases the perioperative blood loss signficantly. Early discontinuation of non-selective non-steroidal anti-inflammatory drugs is advised.

  20. Perioperative visual loss following prone spinal surgery: A review

    Science.gov (United States)

    Epstein, Nancy E.

    2016-01-01

    Background: Postoperative visual loss (POVL) following prone spine surgery occurs in from 0.013% to 1% of cases and is variously attributed to ischemic optic neuropathy (ION: anterior ION or posterior ION [reported in 1.9/10,000 cases: constitutes 89% of all POVL cases], central retinal artery occlusion [CRAO], central retinal vein occlusion [CRVO], cortical blindness [CB], direct compression [horseshoe, prone pillows, and eye protectors Dupaco Opti-Gard]), and acute angle closure glaucoma (AACG). Methods: Risk factors for ION include prolonged operative times, long-segment spinal instrumentation, anemia, intraoperative hypotension, diabetes, obesity, male sex, using the Wilson frame, microvascular pathology, decreased the percent of colloid administration, and extensive intraoperative blood loss. Risk factors for CRAO more typically include improper positioning during the surgery (e.g., cervical rotation), while those for CB included prone positioning and obesity. Results: POVL may be avoided by greater utilization of crystalloids versus colloids, administration of α-2 agonists (e.g., decreases intraocular pressure), avoidance of catecholamines (e.g., avoid vasoconstrictors), avoiding intraoperative hypotension, and averting anemia. Patients with glaucoma or glaucoma suspects may undergo preoperative evaluation by ophthalmologists to determine whether they require prophylactic treatment prior to prone spinal surgery and whether and if prophylactic treatment is warranted. Conclusions: The best way to avoid POVL is to recognize its multiple etiologies and limit the various risk factors that contribute to this devastating complication of prone spinal surgery. Furthermore, routinely utilizing a 3-pin head holder will completely avoid ophthalmic compression, while maintaining the neck in a neutral posture, largely avoiding the risk of jugular vein and/or carotid artery compromise and thus avoiding increasing IOP. PMID:27274409

  1. Initial weight loss on an 800-kcal diet as a predictor of weight loss success after 8 weeks: the Diogenes study

    DEFF Research Database (Denmark)

    Handjieva-Darlenska, T; Handjiev, S; Larsen, Thomas Meinert

    2010-01-01

    The purpose of this study was to investigate whether pre-treatment subject characteristics and weight change during the first weeks of a low-calorie diet (LCD) can predict weight loss outcomes at the end of a controlled 8-week weight loss period in overweight and obese adults.......The purpose of this study was to investigate whether pre-treatment subject characteristics and weight change during the first weeks of a low-calorie diet (LCD) can predict weight loss outcomes at the end of a controlled 8-week weight loss period in overweight and obese adults....

  2. Smartphone applications to aid weight loss and management: current perspectives.

    Science.gov (United States)

    Sutton, Elizabeth F; Redman, Leanne M

    2016-01-01

    The development and dissemination of smart devices has cultivated a global environment of hyperconnectivity and increased our access to information. The paralleled launch and success of the Mobile Health industry has created a market of commercially available applications or "apps" along with tools or sensors, which allow the user to receive and collect personal health information. Apps and accompanying tools now allow an individual to "self-digitize" and, pertaining to weight management, monitor their body weight, caloric intake, physical activity, and more. These products possess the ability to improve the scalability of traditional in-person weight management services considering their near ubiquity, affordability, and capability to deliver information directly and personally to the user. However, similar to the dietary supplement market, the anecdotal value of these products has driven their popularity and acceptance by the general public without requirement of scientific validation or, in the area of weight management or diet/exercise, validation of the safety and efficacy by the Food and Drug Administration prior to market launch. By conducting a literature and clinical trial search, we found remarkably few active, completed, or published studies testing the efficacy of smart device applications using randomized controlled trials. Research efforts must be focused on illuminating the efficacy of behavioral interventions and remote self-monitoring for weight loss/maintenance treatment with true, randomized controlled trials.

  3. CB(1) blockade-induced weight loss over 48 weeks decreases liver fat in proportion to weight loss in humans.

    Science.gov (United States)

    Bergholm, R; Sevastianova, K; Santos, A; Kotronen, A; Urjansson, M; Hakkarainen, A; Lundbom, J; Tiikkainen, M; Rissanen, A; Lundbom, N; Yki-Järvinen, H

    2013-05-01

    Studies in mice have suggested that endocannabinoid blockade using the cannabinoid receptor type 1 (CB1) blocker rimonabant prevents obesity-induced hepatic steatosis. To determine effects of rimonabant on liver fat in humans, we measured liver fat content by proton magnetic resonance spectroscopy in 37 subjects who used either a CB1 blocker rimonabant or placebo in a double-blind, randomized manner. This was retrospectively compared with a historical hypocaloric diet weight loss group (n=23). Weight loss averaged 8.5±1.4 kg in the rimonabant, 1.7±1.0 kg in the placebo and 7.5±0.2 kg in the hypocaloric diet group (Pfat decreased more in the rimonabant (5.9% (2.5-14.6%) vs 1.8% (0.9-3.5%), before vs after) than in the placebo group (6.8% (2.2-15.7%) vs 4.9% (1.6-7.8%), before vs after, Ploss of liver fat (r=0.70, P>0.0001). The decreases in liver fat were comparable between the rimonabant and the young historical hypocaloric diet groups. We conclude that, unlike in mice, in humans rimonabant decreases liver fat in proportion to weight loss.

  4. Fat mass loss predicts gain in physical function with intentional weight loss in older adults.

    Science.gov (United States)

    Beavers, Kristen M; Miller, Michael E; Rejeski, W Jack; Nicklas, Barbara J; Krichevsky, Stephen B; Kritchevsky, Stephen B

    2013-01-01

    Clinical recommendation of weight loss (WL) in older adults remains controversial, partially due to concerns regarding lean mass loss and potential loss of physical function. The purpose of this study is to determine the independent associations between changes in fat and lean mass and changes in physical function in older, overweight, and obese adults undergoing intentional WL. Data from three randomized-controlled trials of intentional WL in older adults with similar functional outcomes (short physical performance battery and Pepper assessment tool for disability) were combined. Analyses of covariance models were used to investigate relationships between changes in weight, fat, and lean mass (acquired using dual-energy x-ray absorptiometry) and changes in physical function. Overall loss of body weight was -7.8 ± 6.1 kg (-5.6 ± 4.1 kg and -2.7 ± 2.4 kg of fat and lean mass, respectively). In all studies combined, after adjustment for age, sex, and height, overall WL was associated with significant improvements in self-reported mobility disability (p fat and lean mass as independent variables found only the change in fat mass to significantly predict change in mobility disability (β[fat] = 0.04; p fat] = -0.01; p loss of body weight, following intentional WL, is associated with significant improvement in self-reported mobility disability and walking speed in overweight and obese older adults. Importantly, fat mass loss was found to be a more significant predictor of change in physical function than lean mass loss.

  5. Comparison of the impact of rivaroxaban and low molecular weight heparin on hidden blood loss after unilateral first half artificial hip replacement surgery%初次单侧人工半髋置换术后利伐沙班与低分子肝素对隐性失血的影响比较

    Institute of Scientific and Technical Information of China (English)

    杨东靕; 裘兴栋; 吕存贤

    2015-01-01

    目的 探讨利伐沙班与低分子肝素对初次单侧人工半髋置换术后隐性失血的影响.方法 收集因股骨颈骨折行单侧人工半髋置换术老年患者共80例,术后按随机数字表法分为利伐沙班组40例和低分子肝素组40例.两组均在术后12 h开始每天分别口服利伐沙班10 mg和皮下注射低分子肝素5000u,比较两组围手术期实际失血总量、显性失血量、隐性失血量及隐性失血量占实际失血总量百分比;并记录35 d内出血事件.结果 利伐沙班组实际失血总量、显性失血量、隐性失血、隐性失血量占实际失血总量百分比分别为(671.00±55.61) mL、(313.88±14.53)mL、(350.00±29.41)mL、(52.00±5.22)%,低分子肝素组分别为(662.00±30.19)mL、(288.87±15.33) mL、(372.00±35.10)mL、(56.00±6.71)%,两组差异均无统计学意义(t =0.93、0.93、0.83、1.03,均P>0.05).结论 对于初次行单侧人工半髋置换术的患者,围手术期使用利伐沙班与低分子肝素后隐性出血风险及出血事件发生率无明显差异.%Objective To investigate the impact of rivaroxaban and low molecular weight heparin on hidden blood loss after unilateral first half artificial hip replacement surgery.Methods According to the digital table,a total of 80 cases because of femoral neck fractures in elderly patients with unilateral arthroplasty artificial hip and a half after surgery were randomly divided into the rivaroxaban group and low molecular weight heparin (LMWH) group,40 cases in each group.In both groups,respectively,after 12 h begin daily oral rivaroxaban 10 mg and subcutaneous low molecular weight heparin 5 000 u,compared the two groups around the actual amount of perioperative blood loss,blood loss was dominant,recessive blood loss and hidden blood loss accounts,the actual percentage of total blood loss,and recorded 35d bleeding events.Results The total amount of blood loss,dominant blood loss,hidden blood loss and the hidden

  6. Effects of rapid weight loss and regain on body composition and energy expenditure.

    Science.gov (United States)

    Sagayama, Hiroyuki; Yoshimura, Eiichi; Yamada, Yosuke; Ichikawa, Mamiko; Ebine, Naoyuki; Higaki, Yasuki; Kiyonaga, Akira; Tanaka, Hiroaki

    2014-01-01

    Weight-classified athletes need an energy intake plan to accomplish target weight reduction. They have to consider body composition and energy metabolism during rapid weight loss followed by rapid weight regain to achieve their energy intake plan. We investigated the effects of rapid weight loss, followed by weight regain, on body composition and energy expenditure. Ten weight-classified athletes were instructed to reduce their body weight by 5% in 7 days. Following the weight loss, they were asked to try to regain all of their lost weight with an ad libitum diet for 12 h. Food intake was recorded during the baseline, weight loss, and regain periods. Fat mass, total body water, and fat-free dry solids were estimated by underwater weighing and stable isotope dilution methods. A three-component model was calculated using Siri's equation. Basal and sleeping metabolic rates were measured by indirect calorimetry. Body composition and energy expenditure were measured before and after weight loss and after weight regain. Body weight, total body water, and fat-free dry solids were decreased after the weight loss period but recovered after weight regain (p weight loss but recovered after weight regain. Changes in total body water greatly affect body weight during rapid weight loss and regain. In addition, rapid weight loss and regain did not greatly affect the basal metabolic rate in weight-classified athletes.

  7. Weight Loss After RYGB Is Independent of and Complementary to Serotonin 2C Receptor Signaling in Male Mice

    OpenAIRE

    Carmody, Jill S.; Ahmad, Nadia N.; Machineni, Sriram; Lajoie, Scott; Kaplan, Lee M.

    2015-01-01

    Roux-en-Y gastric bypass (RYGB) typically leads to substantial, long-term weight loss (WL) and diabetes remission, although there is a wide variation in response to RYGB among individual patients. Defining the pathways through which RYGB works should aid in the development of less invasive anti-obesity treatments, whereas identifying weight-regulatory pathways unengaged by RYGB could facilitate the development of therapies that complement the beneficial effects of surgery. Activation of serot...

  8. Increased blood levels of persistent organic pollutants (POP) in obese individuals after weight loss-A review.

    Science.gov (United States)

    Jansen, Aina; Lyche, Jan L; Polder, Anuschka; Aaseth, Jan; Skaug, Marit Aralt

    2017-01-01

    Lipophilic persistent organic pollutants (POP) are stored in adipose tissue. Following rapid weight loss such as when induced by bariatric surgery, an increased release of potential harmful lipophilic compounds into the blood circulation may occur. Weight reduction is recommended for overweight and obese individuals in order to decrease risk of weight-related health problems. However, in cases of significant weight reduction POP become mobilized chemicals and consequently may adversely affect health, including endocrine disruption. The objective of the present investigation was to estimate quantitatively the level of mobilization of POP following weight loss over time. According to literature search criteria, 17 studies were identified with 2061 participants. Data from 5 of the studies with 270 participants were used to assess the change in blood levels of POP in percent per kilogram weight loss. Weight loss in the included studies varied from 4.4 to 64.8 kg. In all studies, the majority of POP concentrations in blood were found to rise following weight reduction. Blood concentrations following weight reduction were elevated by 2-4% per kilogram weight loss for most POP examined. The increased POP levels were still elevated 12 mo after intervention. Most research in this field, including animal studies, is carried out on a single compound or group of selected compounds, not taking the "cocktail effect" into consideration. This does not reflect the true range of POP to which humans are actually exposed. Few chronic investigations have been published and, in particular, few studies were available that compared the increase in POP concentrations with clinical consequences as individuals lost weight. These limitations call for caution in interpreting results. The benefits of losing weight still far outweigh the potential adverse health risks. However, further studies are recommended to determine the clinical significance of increased blood levels of POPs following

  9. The role of exercise and physical activity in weight loss and maintenance.

    Science.gov (United States)

    Swift, Damon L; Johannsen, Neil M; Lavie, Carl J; Earnest, Conrad P; Church, Timothy S

    2014-01-01

    This review explores the role of physical activity (PA) and exercise training (ET) in the prevention of weight gain, initial weight loss, weight maintenance, and the obesity paradox. In particular, we will focus the discussion on the expected initial weight loss from different ET programs, and explore intensity/volume relationships. Based on the present literature, unless the overall volume of aerobic ET is very high, clinically significant weight loss is unlikely to occur. Also, ET also has an important role in weight regain after initial weight loss. Overall, aerobic ET programs consistent with public health recommendations may promote up to modest weight loss (~2 kg), however the weight loss on an individual level is highly heterogeneous. Clinicians should educate their patients on reasonable expectations of weight loss based on their physical activity program and emphasize that numerous health benefits occur from PA programs in the absence of weight loss. © 2014.

  10. Lifestyle interventions for weight loss in adults with severe obesity: a systematic review.

    Science.gov (United States)

    Hassan, Y; Head, V; Jacob, D; Bachmann, M O; Diu, S; Ford, J

    2016-12-01

    Severe obesity is an increasingly prevalent condition and is often associated with long-term comorbidities, reduced survival and higher healthcare costs. Non-surgical methods avoid the side effects, complications and costs of surgery, but it is unclear which non-surgical method is most effective. The objective of this article was to systematically review the effectiveness of lifestyle interventions compared to standard or minimal care for weight loss in adults with severe obesity. MEDLINE, EMBASE, CENTRAL, databases of on-going studies, reference lists of any relevant systematic reviews and the Cochrane Library database were searched from inception to February 2016 for relevant randomized controlled trials (RCTs). Inclusion criteria were participants with severe obesity (body mass index [BMI] > 40 kg/m(2) or BMI > 35 kg/m(2) with comorbidity) and interventions with a minimal duration of 12 weeks that were multi-component combinations of diet, exercise and behavioural therapy. Risk of bias was evaluated using the Cochrane risk of bias criteria. Meta-analysis was not possible because of methodological heterogeneity. Seventeen RCTs met the inclusion criteria. Weight change in kilograms of participants from baseline to follow-up was reported for 14 studies. Participants receiving the lifestyle intervention had a greater decrease in weight than participants in the control group for all studies (1.0-11.5 kg). Lifestyle interventions varied greatly between the studies. Overall lifestyle interventions with combined diet and exercise components achieved the greatest weight loss. Lifestyle interventions for weight loss in adults with severe obesity were found to result in increased weight loss when compared to minimal or standard care, especially those with combined diet and exercise components. © 2016 World Obesity Federation.

  11. Changes in subcutaneous fat cell volume and insulin sensitivity after weight loss.

    Science.gov (United States)

    Andersson, Daniel P; Eriksson Hogling, Daniel; Thorell, Anders; Toft, Eva; Qvisth, Veronica; Näslund, Erik; Thörne, Anders; Wirén, Mikael; Löfgren, Patrik; Hoffstedt, Johan; Dahlman, Ingrid; Mejhert, Niklas; Rydén, Mikael; Arner, Erik; Arner, Peter

    2014-07-01

    Large subcutaneous fat cells associate with insulin resistance and high risk of developing type 2 diabetes. We investigated if changes in fat cell volume and fat mass correlate with improvements in the metabolic risk profile after bariatric surgery in obese patients. Fat cell volume and number were measured in abdominal subcutaneous adipose tissue in 62 obese women before and 2 years after Roux-en-Y gastric bypass (RYGB). Regional body fat mass by dual-energy X-ray absorptiometry; insulin sensitivity by hyperinsulinemic-euglycemic clamp; and plasma glucose, insulin, and lipid profile were assessed. RYGB decreased body weight by 33%, which was accompanied by decreased adipocyte volume but not number. Fat mass in the measured regions decreased and all metabolic parameters were improved after RYGB (P fat cell size correlated strongly with improved insulin sensitivity (P = 0.0057), regional changes in fat mass did not, except for a weak correlation between changes in visceral fat mass and insulin sensitivity and triglycerides. The curve-linear relationship between fat cell size and fat mass was altered after weight loss (P = 0.03). After bariatric surgery in obese women, a reduction in subcutaneous fat cell volume associates more strongly with improvement of insulin sensitivity than fat mass reduction per se. An altered relationship between adipocyte size and fat mass may be important for improving insulin sensitivity after weight loss. Fat cell size reduction could constitute a target to improve insulin sensitivity. © 2014 by the American Diabetes Association.

  12. Mechanism Underlying the Weight Loss and Complications of Roux-en-Y Gastric Bypass. Review.

    Science.gov (United States)

    Abdeen, G; le Roux, C W

    2016-02-01

    Various bariatric surgical procedures are effective at improving health in patients with obesity associated co-morbidities, but the aim of this review is to specifically describe the mechanisms through which Roux-en-Y gastric bypass (RYGB) surgery enables weight loss for obese patients using observations from both human and animal studies. Perhaps most but not all clinicians would agree that the beneficial effects outweigh the harm of RYGB; however, the mechanisms for both the beneficial and deleterious (for example postprandial hypoglycaemia, vitamin deficiency and bone loss) effects are ill understood. The exaggerated release of the satiety gut hormones, such as GLP-1 and PYY, with their central and peripheral effects on food intake has given new insight into the physiological changes that happen after surgery. The initial enthusiasm after the discovery of the role of the gut hormones following RYGB may need to be tempered as the magnitude of the effects of these hormonal responses on weight loss may have been overestimated. The physiological changes after RYGB are unlikely to be due to a single hormone, or single mechanism, but most likely involve complex gut-brain signalling. Understanding the mechanisms involved with the beneficial and deleterious effects of RYGB will speed up the development of effective, cheaper and safer surgical and non-surgical treatments for obesity.

  13. Surgically Induced Interpregnancy Weight Loss and Prevalence of Overweight and Obesity in Offspring

    Science.gov (United States)

    Willmer, Mikaela; Berglind, Daniel; Sørensen, Thorkild I. A.; Näslund, Erik; Tynelius, Per; Rasmussen, Finn

    2013-01-01

    Introduction According to the fetal overnutrition hypothesis, obesity in pregnancy predisposes the offspring to obesity. Previous studies have suggested that after biliopancreatic surgery for obesity, the offspring is less likely to be obese. This study aims to further compare the BMI development of children born before and after maternal surgical weight loss. Method Women with at least one child born before and one child born after bariatric surgery were identified by record-linkage. Information about maternal BMI was extracted from medical records, as was information about the children's BMI from birth to 10 years of age. We retrieved BMI data at four years of age for 340 children, born to 223 women (164 children born before surgery (BS), 176 children born after surgery (AS)). We evaluated prevalence of overweight/obesity and mean BMI in children born BS and AS at the ages of four, six and ten using GEE regression models. For 71 families, where we had complete data on mother and both children, we used a fixed-effects regression model to explore the association between differences in maternal BMI in w10 of the pre- and post-operative pregnancies with siblings' BMI differences at age four. Results In no age group did we see a significantly reduced prevalence of overweight/obesity AS. For 10-year-old girls, the AS group had significantly higher rates of obesity. There was no association between differences in maternal BMI in early pregnancy and differences in siblings' BMI at four years of age (β = −0.01, CI 95% = −0.11; 0.09). Conclusions We have been unable to demonstrate any effect of bariatric surgery on weight development in offspring. It seems unlikely that restrictive bariatric surgery conveys a protective effect in offspring with regards to obesity. PMID:24349234

  14. Weight loss from maximum body weight and mortality: the Third National Health and Nutrition Examination Survey Linked Mortality File.

    Science.gov (United States)

    Ingram, D D; Mussolino, M E

    2010-06-01

    The aim of this longitudinal study is to examine the relationship between weight loss from maximum body weight, body mass index (BMI), and mortality in a nationally representative sample of men and women. Longitudinal cohort study. In all, 6117 whites, blacks, and Mexican-Americans 50 years and over at baseline who survived at least 3 years of follow-up, from the Third National Health and Nutrition Examination Survey Linked Mortality Files (1988-1994 with passive mortality follow-up through 2000), were included. Measured body weight and self-reported maximum body weight obtained at baseline. Weight loss (maximum body weight minus baseline weight) was categorized as or=15%. Maximum BMI (reported maximum weight (kg)/measured baseline height (m)(2)) was categorized as healthy weight (18.5-24.9), overweight (25.0-29.9), and obese (>or=30.0). In all, 1602 deaths were identified. After adjusting for age, race, smoking, health status, and preexisting illness, overweight men with weight loss of 15% or more, overweight women with weight loss of 5-weight loss of 15% or more were at increased risk of death from all causes compared with those in the same BMI category who lost Weight loss of 5-Weight loss of 15% or more from maximum body weight is associated with increased risk of death from all causes among overweight men and among women regardless of maximum BMI.

  15. Body weight perception and weight loss practices among Sri Lankan adults.

    Science.gov (United States)

    Jayawardena, Ranil; Byrne, Nuala M; Soares, Mario J; Katulanda, Prasad; Hills, Andrew P

    2014-01-01

    The purpose of the present study was to evaluate the association between self-perception of body weight, weight loss approaches and measured body mass index (BMI) and waist circumference (WC) among Sri Lankan adults. A nationally representative sample of 600 adults aged ≥18 years was selected using a multi-stage random cluster sampling technique. An interviewer-administrated questionnaire was used to assess demographic characteristics, body weight perception, abdominal obesity perception and details of weight losing practices. Weight, height and waist circumference (WC) were measured and Asian anthropometric cut-offs for BMI and WC were applied. Body weight mis-perception was common among Sri Lankan adults. Two-thirds of overweight males and 44.7% females considered themselves as ‘about right weight’, moreover, 4.1% and 7.6% overweight men and women reported themselves as being ‘underweight’. Over one third of both male and female obese subjects perceived themselves as ‘about right weight’ or ‘underweight’. Nearly 32% of centrally obese men and women perceived that their WC is about right. People who perceived themselves as overweight or very overweight (n = 154) only 63.6% tried to lose weight (n = 98), and one quarter of adults sought advice from professionals (n = 39). Body weight misperception was common among underweight, healthy weight, overweight, and obese adults in Sri Lanka. Over 2/3 of overweight and 1/3 of obese Sri Lankan adults believe they are in right weight category or are under weight. © 2014 Asian Oceanian Association for the Study of Obesity . All rights reserved.

  16. Coaching and barriers to weight loss: an integrative review

    Directory of Open Access Journals (Sweden)

    Muñoz Obino KF

    2016-12-01

    Full Text Available Karen Fernanda Muñoz Obino,1 Caroline Aguiar Pereira,1 Rafaela Siviero Caron-Lienert2 1Nutrology/Clinical Nutrition Unit, Ernesto Dornelles Hospital, 2Nutrition of the Educational and Research Institute of Moinhos de Vento Hospital, Porto Alegre, Brazil Introduction: Coaching is proposed to raise a patient’s awareness and responsibility for their health behaviour change by transforming the professional–patient relationship.Objective: To review the scientific literature on how coaching can assist in weight loss and improve a patient’s state of health.Methodology: An integrative literature search was performed using PubMed, Latin American and Caribbean Literature in Health Sciences, and Scientific Electronic Library Online. We selected articles that were published in Portuguese, English, and Spanish over the last 10 years. Data analysis was performed using a validated data collection instrument.Results: Among the 289 articles identified in the search, 276 were excluded because they did not address the leading research question, their full texts were not available on the Internet, or they were duplicate publications. Therefore, for the analysis, we selected 13 articles that we classified as randomized clinical studies (46.15%; n=6, cohort studies (30.76%; n=4, cross-sectional studies (7.69%; n=1, case studies (7.69%; n=1, and review articles (7.69%; n=1. Joint intervention (combined in-person and telecoaching sessions constituted the majority of session types. The use of technical coaching was superior in reducing anthropometric measurements and increasing the levels of motivation and personal satisfaction compared with formal health education alone.Conclusion: Coaching is an efficient, cost-effective method for combining formal education and treatment of health in the weight-loss process. Additional randomized studies are needed to demonstrate its effectiveness with respect to chronic disease indicators. Keywords: coaching, weight loss

  17. [Diagnostic value of selective anorexia in pathological weight loss].

    Science.gov (United States)

    Braquet, P; Mercier, G; Reynes, J; Jeandel, C; Pinzani, V; Guilpain, P; Rivière, S; Le Quellec, A

    2016-02-01

    The diagnostic value of selective anorexia is debated. Some authors have suggested an association between meat aversion and cancer, but most do not use it as a diagnostic tool. We aimed to characterize anorexia of different diseases to search for an association between selective aversions and diagnostic groups. All the patients admitted to three departments of a teaching hospital were included consecutively for 22months if they had more than 10 % weight loss in less than one year. Patients were excluded if history taking was not reliable, or if they suffered from anorexia nervosa. We compiled diagnoses at discharge and validated them six months later. We used logistic regression to identify independent factors associated with selective anorexia. Inclusion criteria were met in 106patients (female 44 %, median age 65years). Most frequent diagnoses were: cancer (36 %), infection (35 %), digestive diseases (19 %), non organic diseases (21 %). Recent selective anorexia was found in 46 % of the cases. It was significantly associated with female gender (P=0.002), marginally with young age (P=0.069) and long duration of weight loss (P=0.079). Opioid use at admission was negatively associated with selective anorexia (P=0.001). No specific diagnostic category was found to be associated. Selective anorexia does not appear to be a useful symptom to investigate pathological weight loss. It behaves more like a non-specific reactivation by current disease of earlier latent personal food aversions. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  18. Complications of vision loss and ophthalmoplegia during endoscopic sinus surgery

    Directory of Open Access Journals (Sweden)

    Maharshak I

    2013-03-01

    Full Text Available Idit Maharshak,1,2 Jenny K Hoang,3 M Tariq Bhatti2,4 1Department of Ophthalmology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; 2Department of Ophthalmology, 3Department of Radiology (Division of Neuroradiology, 4Department of Medicine (Division of Neurology, Duke Eye Center and Duke University Medical Center, Durham, NC, USA Objective: To describe two rare cases of concurrent vision loss and external ophthalmoplegia following powered endoscopic sinus surgery (ESS. Design: Observational case report. Results: The records of two patients who underwent powered ESS and developed multiple concurrent ophthalmic complications were retrospectively reviewed for clinical history, neuro-ophthalmologic examination, and imaging findings. Patient 1 developed a retinal vascular occlusion and complete loss of adduction. Patient 2 developed an orbital hemorrhage, optic neuropathy, and a restrictive global ophthalmoplegia. Similar published case reports were also reviewed. Conclusion: Despite advances in powered ESS technique and instrumentation, serious ophthalmic complications can still occur. Inadvertent entry into the medial orbital wall can result in a combination of blindness and ocular motility dysfunction. The variety of mechanisms responsible for these complications underscores the importance of thorough pre- and postoperative clinical examination and review of imaging studies. Keywords: sinus surgery, orbit, extra ocular muscle injury, blindness

  19. Pivotal Role for the Visceral Fat Compartment in the Release of Persistent Organic Pollutants During Weight Loss.

    Science.gov (United States)

    Dirinck, E; Dirtu, A C; Jorens, P G; Malarvannan, G; Covaci, A; Van Gaal, L F

    2015-12-01

    Polychlorinated biphenyls (PCBs), are implicated as potential endocrine disruptors and obesogens. These lipophilic substances are preferentially stored in the fat compartment and released into the circulation during weight loss. The aim of this study was to examine the contribution of abdominal adiposity, and visceral adiposity in particular, to the increase of serum PCB levels during weight loss. Fourty-five obese women were prospectively recruited. Twenty individuals received dietary counseling and 25 underwent bariatric surgery. Anthropometric data were collected and intra-abdominal adiposity was assessed by measurement computed tomography scanning of the abdominal fat compartment, delineating the visceral and subcutaneous compartment. Serum levels of 27 PCBs were determined and the sum of all PCBs (ΣPCBs) calculated. Follow-up measurements of anthropometric data, computed tomography scanning, and PCB levels were performed after 6 months in all patients. In patients who lost weight, serum ΣPCB levels displayed an increase after 6 months of approximately 50%. Both correlation and regression analysis, focusing on the relative contribution of the visceral vs the subcutaneous fat compartment, suggested that the increase in ΣPCB serum levels after 6 months of weight loss was more pronounced in patients losing relatively more visceral adipose tissue. This trend could be established in the diet-treated, but not the surgery-treated subgroup. Our study suggests that the contribution of PCBs released from the visceral fat compartment might be more pronounced compared with the subcutaneous fat compartment during weight loss. These findings are present in the entire study group whereas subanalysis of the diet vs surgery groups suggested the same effect in the diet group but failed to reach statistical significance in the surgery group. This suggests a possible weight-loss method-specific effect.

  20. Prevalence and Risk Factors for the Weight Loss during Hospitalization in Children: A Single Korean Children’s Hospital Experience

    Science.gov (United States)

    Hwang, Eun Ha; Park, Jae Hong; Chun, Peter

    2016-01-01

    Purpose Undernutrition during hospitalization increases the risk of nosocomial infection and lengthens the disease courses. The aim of this study was to evaluate the risk factors of weight loss during hospitalization in children. Methods All the patients who were admitted in general wards between April and May 2014 were enrolled. Patients aged >18 years and discharged within 2 days were excluded. Weight loss during hospitalization was defined as a decrease in body weight of >2% in 8 hospital days or on the day of discharge. Patients who lost body weight during hospitalization were compared with patients who maintained their body weights. Significant parameters were evaluated by using the multivariate logistic regression analysis. Results We enrolled 602 patients, of whom 149 (24.8%) lost >2% of their body weight. Complaint of pain (p=0.004), admission to the surgical department (p=0.001), undergoing surgery (p=0.044), undergoing abdominal surgery (p=0.034), and nil per os (NPO) durations (p=0.003) were related to weight loss during hospitalization. The patients who had high weight-for-age tended to lose more body weight (p=0.001). Admission to the surgical department (odds ratio [OR], 1.668; 95% confidence interval [CI], 1.054-2.637; p=0.029) and long NPO durations (OR, 1.496; 95% CI, 1.102-2.031; p=0.010) were independent risk factors of weight loss during hospitalization. The patients with high weight-for-age tended to lose more weight during hospitalization (OR, 1.188; 95% CI, 1.029-1.371; p=0.019). Conclusion Greater care in terms of nutrition should be taken for patients who are admitted in the surgical department and have prolonged duration of nothing by mouth. PMID:28090472

  1. Influence of maximal fat oxidation on long-term weight loss maintenance in humans

    DEFF Research Database (Denmark)

    Dandanell, Sune; Husted, Karina; Amdisen, Signe

    2017-01-01

    Impaired maximal fat oxidation has been linked to obesity and weight regain after weight loss. The aim was to investigate the relationship between maximal fat oxidation (MFO) and long-term weight loss maintenance. Eighty subjects [means (SD): age, 36(13) yrs; BMI, 38(1) kg/m2] were recruited from...... composition (dual X-ray absorptiometry) and fat oxidation (indirect calorimetry) during incremental exercise were measured at follow-up. Blood and a muscle biopsy were sampled. At follow-up, a U-shaped parabolic relationship between MFO and percent weight loss was observed (r = 0.448; P ... a total of 2,420 former participants of an 11- to 12-wk lifestyle intervention. Three groups were established based on percent weight loss at follow-up [5.3(3.3) yr]: clinical weight loss maintenance (CWL), >10% weight loss; moderate weight loss (MWL), 1–10% weight loss; and weight regain (WR). Body...

  2. How to avoid perioperative visual loss following prone spinal surgery

    Science.gov (United States)

    Epstein, Nancy E.

    2016-01-01

    Background: In a prior article, “Perioperative visual loss (POVL) following prone spinal surgery: A review,” Epstein documented that postoperative visual loss (POVL) occurs in from 0.013% to 0.2% of spine procedures performed in the prone position. POVL is largely attributed to ischemic optic neuropathy (ION), central retinal artery occlusion (CRAO), cortical blindness (CB), direct compression (prone pillows/horseshoe, eye protectors), and rarely, acute angle closure glaucoma. Methods: Risk factors for ION include prolonged surgery, extensive fusions, anemia, hypotension, hypovolemia, diabetes, obesity, use of the Wilson frame, male sex, and microvascular pathology. CRAO may result from improper prone positioning (e.g., eye compression or rotation contributing to jugular/venous or carotid compression), while CB more typically results from both direct compression and obesity. Results: Several preventive/prophylactic measures should limit the risk of POVL. The routine use of an arterial line and continuous intraoperative monitoring document intraoperative hypotension/hypovolemia/anemia that can be immediately corrected with appropriate resuscitative measures. Application of a 3-pin head holder completely eliminates direct eye compression and maintains the neck in a neutral posture, thus avoiding rotation that can contribute to jugular/venous obstruction and/or inadvertent carotid compression. In addition, elevating the head 10° from the horizontal directly reduces intraocular pressure. Conclusions: The best way to avoid POVL following prone spine surgery is to prevent it. Routine use of an arterial line, intraoperative monitoring, a 3-pin head holder, and elevation of the head 10° from the horizontal should limit the risk of encountering POVL after spinal procedures performed in the prone position. PMID:27274406

  3. Regular exercise attenuates the metabolic drive to regain weight after long-term weight loss.

    Science.gov (United States)

    MacLean, Paul S; Higgins, Janine A; Wyatt, Holly R; Melanson, Edward L; Johnson, Ginger C; Jackman, Matthew R; Giles, Erin D; Brown, Ian E; Hill, James O

    2009-09-01

    Weight loss is accompanied by several metabolic adaptations that work together to promote rapid, efficient regain. We employed a rodent model of regain to examine the effects of a regular bout of treadmill exercise on these adaptations. Obesity was induced in obesity-prone rats with 16 wk of high-fat feeding and limited physical activity. Obese rats were then weight reduced (approximately 14% of body wt) with a calorie-restricted, low-fat diet and maintained at that reduced weight for 8 wk by providing limited provisions of the diet with (EX) or without (SED) a daily bout of treadmill exercise (15 m/min, 30 min/day, 6 days/wk). Weight regain, energy balance, fuel utilization, adipocyte cellularity, and humoral signals of adiposity were monitored during eight subsequent weeks of ad libitum feeding while the rats maintained their respective regimens of physical activity. Regular exercise decreased the rate of regain early in relapse and lowered the defended body weight. During weight maintenance, regular exercise reduced the biological drive to eat so that it came closer to matching the suppressed level of energy expenditure. The diurnal extremes in fuel preference observed in weight-reduced rats were blunted, since exercise promoted the oxidation of fat during periods of feeding (dark cycle) and promoted the oxidation of carbohydrate (CHO) later in the day during periods of deprivation (light cycle) . At the end of relapse, exercise reestablished the homeostatic steady state between intake and expenditure to defend a lower body weight. Compared with SED rats, relapsed EX rats exhibited a reduced turnover of energy, a lower 24-h oxidation of CHO, fewer adipocytes in abdominal fat pads, and peripheral signals that overestimated their adiposity. These observations indicate that regimented exercise altered several metabolic adaptations to weight reduction in a manner that would coordinately attenuate the propensity to regain lost weight.

  4. Efficacy of a Conservative Weight Loss Program in the Long-Term Management of Chronic Upper Airway Obstruction

    Directory of Open Access Journals (Sweden)

    Ryan C. Case

    2009-01-01

    Full Text Available Objective. Obesity is a significant contributor to oxygen demand and dynamic airway obstruction. The objective of the current study is to determine the long-term success of conservative measures directed toward weight reduction on airway management without respect to specific airway disease etiology. Methods. Patients with chronic airway obstruction secondary anatomic lesions or obstructive sleep apnea were recruited and followed prospectively. Demographics, initial and final weights, diagnosis, and followup information were recorded. Patients were referred to a registered dietician, provided counseling, and started on a weight-loss regimen. Outcome measures were change in body mass index (BMI and rate of decannulation from weight loss alone. Results. Of fourteen patients, ten remained tracheostomy-dependent and four had high-grade lesions with the potential for improvement in oxygen demand and dynamic airway collapse with weight loss. The mean follow up period was 25 months. The mean change in BMI was an increase of 1.4 kg/m2 per patient. Conclusions. Conservative measures alone were not effective in achieving weight reduction in the population studied. This may be due to comorbid disease and poor compliance. The promise of decannulation was an insufficient independent motivator for weight loss in this study. Although the theoretical benefits of weight loss support its continued recommendation, the long-term success rate of conservative measures is low. More aggressive facilitated interventions including pharmacotherapy or bariatric surgery should be considered early in the course of treating airway disease complicated by obesity.

  5. Sleeve gastrectomy induces loss of weight and fat mass in obese rats, but does not affect leptin sensitivity.

    Science.gov (United States)

    Stefater, Margaret A; Pérez-Tilve, Diego; Chambers, Adam P; Wilson-Pérez, Hilary E; Sandoval, Darleen A; Berger, José; Toure, Mouhamadoul; Tschöp, Matthias; Woods, Stephen C; Seeley, Randy J

    2010-06-01

    Surgical intervention produces sustainable weight loss and metabolic improvement in obese individuals. Vertical sleeve gastrectomy (VSG) produces dramatic, sustained weight loss; we investigated whether these changes result from improved sensitivity to leptin. VSG was performed in Long-Evans rats with diet-induced obesity. Naïve or sham-operated rats, fed either ad libitum or pair-fed with the VSG group, were used as controls. Following surgery, body weights and food intake were monitored. We investigated energy expenditure, meal patterns, leptin sensitivity, and expression of pro-opiomelanocortin/agouti-related peptide/neuropeptide Y in the hypothalamus of the rats. We observed sustained losses in weight and body fat in male and female rats after VSG. Weight loss persisted after the disappearance of a transient, postsurgical food intake reduction. Resting energy expenditure was similar between control and VSG rats. VSG rats maintained their reduced body weights. However, they responded to a chronic food restriction challenge by overeating, which resulted in prerestriction, rather than pre-VSG, body weights. Consistent with lower adiposity, VSG decreased plasma leptin levels. Although VSG slightly improved leptin's anorectic action, the response was comparable to that observed in controls matched for adiposity by caloric restriction. Changes in hypothalamic neuropeptide expression were consistent with the lower body weight and lower leptin levels but cannot account for the sustained weight loss. VSG causes sustained reduction in body weight, which results from loss of fat mass. The maintenance of weight loss observed did not result from changes in sensitivity to leptin. Copyright 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.

  6. Mediating Effect of Body Image Distortion on Weight Loss Efforts in Normal-Weight and Underweight Korean Adolescent Girls

    Science.gov (United States)

    Choi, Jeong-Sil; Kim, Ji-Soo

    2017-01-01

    Background: We explored the relationship between body mass index-for-age percentile, body image distortion, and unnecessary weight loss efforts in Korean adolescent girls who are underweight and normal weight and examined the mediating effect of body image distortion on weight loss efforts. Methods: This study used data from the 2013 Korea Youth…

  7. Mediating Effect of Body Image Distortion on Weight Loss Efforts in Normal-Weight and Underweight Korean Adolescent Girls

    Science.gov (United States)

    Choi, Jeong-Sil; Kim, Ji-Soo

    2017-01-01

    Background: We explored the relationship between body mass index-for-age percentile, body image distortion, and unnecessary weight loss efforts in Korean adolescent girls who are underweight and normal weight and examined the mediating effect of body image distortion on weight loss efforts. Methods: This study used data from the 2013 Korea Youth…

  8. Sugammadex and Ideal Body Weight in Bariatric Surgery

    Directory of Open Access Journals (Sweden)

    Maria Sanfilippo

    2013-01-01

    Full Text Available Background. The obese patients have differences in body composition, drug distribution, and metabolism. Sugammadex at recovery in a dose of 2 mg kg−1 of real body weight (RBW can completely reverse the NMB block; in our study we investigated the safety and efficacy of Sugammadex dose based on their ideal body weight (IBW. Methods. 40 patients of both sexes undergoing laparoscopic bariatric surgery were enrolled divided into 2 groups according to the dose of Sugammadex: the first received a dose of 2 mg kg−1 of IBW and the second received a dose of 2 mg kg−1 of RBW. Both were anesthetized with doses calculated according to the IBW: fentanyl 2 μg kg−1, propofol 3 mg kg−1, rocuronium 0,6 mg kg−1, oxygen, air, and desflurane (6–8%. Maintenance doses of rocuronium were 1/4 of the intubation dose. Sugammadex was administrated at recovery. Results. The durations of intubation and maintenance doses of rocuronium were similar in both groups. In IBW group, the / value of 0.9 was reached in 151 ± 44 seconds and in 121 ± 55 seconds in RBW group (. Discussion. Recovery times to / of 0.9 are surprisingly similar in both groups without observing any postoperative residual curarization. Conclusion. Sugammadex doses calculated according to the IBW are certainly safe for a rapid recovery and absence of PORC.

  9. Weight loss diets advertised in non-scientific publications

    Directory of Open Access Journals (Sweden)

    Olga Maria Silverio Amancio

    Full Text Available Weight-loss diets advertised in mainstream non-scientific publications and targeting the adult female public were evaluated in relation to total energy value, macronutrients, calcium, iron, vitamins A and E, and cholesterol content, as well as the presence of information regarding the duration of diets, fluid intake, physical activity, and maintenance diets. Two publications were selected, considering periodicity, circulation, readership, and years in publication. The Virtual Nutri software was used to evaluate the nutrients of 112 diets. Micronutrient content was compared to the Dietary Reference Intakes. All diets were inadequate in at least one of the evaluated items. Less than 25.0% of the diets presented adequate macronutrient distribution. Calcium, iron, and vitamin E were also predominantly inadequate (85.7, 97.3, and 91.9%, respectively. Non-scientific publications should not be allowed to advertise weight-loss diets. In addition, their chemical composition is inadequate and they are not accompanied by important instructions for such therapy.

  10. Thermodynamics and metabolic advantage of weight loss diets.

    Science.gov (United States)

    Feinman, Richard D; Fine, Eugene J

    2003-09-01

    Published reports show that low carbohydrate weight loss diets provide a metabolic advantage, a greater weight loss per calorie consumed compared to isocaloric high carbohydrate diets. These reports have not been refuted but rather largely ignored, presumably because of the apparent violation of the laws of thermodynamics ("a calorie is a calorie"). In this review, we show that there is no such violation of thermodynamic laws. Energy utilization of different diets depends on the chemical pathway taken and a metabolic analysis of the efficiency of different pathways reveals large differences. Likewise, thermogenesis produced by diets of different macronutrient composition varies widely. We present a plausible mechanism that depends on the inefficiency of metabolic cycles and, in particular, protein turnover. A low carbohydrate diet makes demands on protein turnover for gluconeogenesis. From a theoretical point of view,energy balance between two diets is to be expected only if the subjects have the same final physiologic state, and only if all of the changes contributing to the energy, heat, work and chemical effects are known. Most diet experiments do not conform to this ideal. There is no theoretical contradiction in metabolic advantage and no theoretical barrier to accepting reports describing this effect.

  11. Update on bariatric surgical procedures and an introduction to the implantable weight loss device: the Maestro Rechargeable System

    Directory of Open Access Journals (Sweden)

    Hwang SS

    2016-08-01

    Full Text Available Stephanie S Hwang,1 Mark C Takata,1 Ken Fujioka,2 William Fuller1 1Division of General/Bariatric Surgery, Scripps Clinic Weight Management, 2Division of Diabetes and Endocrinology, Scripps Clinic, La Jolla, CA, USA Abstract: There are many different methods of treating obesity, ranging from various medical options to several surgical therapies. This paper briefly summarizes current surgical options for weight loss with a focus on one of the newest US Food and Drug Administration-approved devices for surgical weight loss therapy, the Maestro Rechargeable System. Also known as the vagal blocking for obesity control implantable device, this tool blocks vagal nerve activity to induce weight loss. Keywords: VBLOC device, vagal, vagus, obesity

  12. Modeling and simulation of orlistat to predict weight loss and weight maintenance in obesity patients.

    Science.gov (United States)

    Nakai, Kiyohiko; Wada, Russell; Iida, Satofumi; Kawanishi, Takehiko; Matsumoto, Yoshiaki

    2014-01-01

    Orlistat is used clinically worldwide as anti-obesity drug. It is a chemically synthesized hydrogenated derivative of lipstatin and is an inhibitor of gastric and pancreatic lipases. It has been found to reduce the absorption of dietary fat in the gastrointestinal tract. Modeling and simulation based on pharmacokinetic/pharmacodynamic analysis is becoming increasingly used in the design of clinical trials to assure that the trials are of high quality and are conducted efficiently. We developed a clinical trial simulation model for orlistat based on Phase III clinical study data. This innovative weight loss model includes the relationships between orlistat dose, changes in fecal fat excretion, and weight loss, and also incorporates a dropout function. The model guided the dose-finding strategy and allowed simulation of long-term clinical outcomes of orlistat.

  13. Bariatric Surgery Procedures

    Science.gov (United States)

    ... Center Access to Care Toolkit EHB Access Toolkit Bariatric Surgery Procedures Bariatric surgical procedures cause weight loss by restricting the ... Online Education Directory Search Patient Learning Center Bariatric Surgery ... Surgery Procedures BMI Calculator Childhood and Adolescent Obesity ...

  14. Laparoscopic hand-sewn revisional gastrojejunal plication for weight loss failure after Roux-en-Y gastric bypass.

    Science.gov (United States)

    León, Felipe; Maiz, Cristóbal; Daroch, David; Quezada, Nicolás; Gabrielli, Mauricio; Muñoz, César; Boza, Camilo

    2015-04-01

    Revisional surgery has become a widely accepted alternative for weight loss failure/regain after bariatric surgery. However, it is associated to higher morbi-mortality and lesser weight loss than primary bariatric procedure. Our aims are to present a novel technique for weight loss treatment after failed laparoscopic Roux-en-Y gastric bypass (LRYGB) and to report its short-term results. This is a retrospective analysis of patients submitted to a revisional hand-sewn double-layer gastrojejunal plication (GJP) for treatment of weight loss failure/regain after LRYGB. Analysis of demographics, body mass index (BMI), and percentage of excess weight loss (%EWL) at the 6th month complications, and financial costs involved was included. Four patients were submitted to revisional GJP. Three patients were female and the mean age at revision was 30 ± 9 years (21-44). The median time interval between LRYGB and GJP was 51 months (24-120). The median BMI at the moment of GJP and the 3rd and 6th month was 35.6 kg/m2 (32.0-37.8), 32.2 kg/m2 (29.7-34.1), and 30.7 kg/m2 (28.1-32.1), respectively. The median %EWL at the 3rd and 6th month was 35.4% (13.6-38.9) and 46.2 % (45.1-55.5), respectively, reaching a cumulative (combined surgeries) %EWL of 62.9% (16.5-67.9) and 71.7% (65.1-77.6), respectively. There were no complications or mortality. Financial costs were significantly lower compared to revisional gastrojejunal stapled reduction (US $1400 cheaper). Revisional GJP is a feasible, safe, and cost-effective novel procedure for treatment of weight loss failure/regain after LRYGB. Mid- and long-term results are necessary in order to establish its real effectiveness.

  15. Relationship between perilipin gene polymorphisms and body weight and body composition during weight loss and weight maintenance.

    Science.gov (United States)

    Soenen, Stijn; Mariman, Edwin C M; Vogels, Neeltje; Bouwman, Freek G; den Hoed, Marcel; Brown, Louise; Westerterp-Plantenga, Margriet S

    2009-03-23

    Genetic variation in the perilipin (PLIN) gene may play a role in the etiology and treatment of obesity. To examine different polymorphisms in the PLIN gene in relation to body-weight regulation. 118 subjects followed a 6 wk VLCD, followed by 1 year weight maintenance. Body-weight (BW), body composition, leptin concentration, and polymorphisms of the PLIN gene: PLIN1:rs2289487, PLIN4:rs894160, PLIN6:rs1052700, PLIN5:rs2304795 and PLIN7:rs 2304796 were determined. BW loss during VLCD was 7.0+/-3.1 kg (p0.9, r2=0.72; PLIN5 and PLIN7: D' >0.9, r2=0.85. In men, body weight, BMI, waist circumference, body fat, leptin concentrations were significantly lower for the haplotype of PLIN1 (C-alleles) and PLIN4 (A-alleles). In women weight loss and loss of fat mass were larger for the haplotype of PLIN1 (C-alleles) and PLIN4 (A-alleles). For PLIN6 genotypes body weight and body fat were lower for homozygotes of the minor allele (T/T) in the men; in the women leptin concentrations were lower. The haplotype of PLIN5 and PLIN7 consisting of A/G and G/G of PLIN5 and A/A of PLIN7 showed a reduction in FM: 5.9+/-0.6 kg vs 3.1+/-0.4 kg, % body fat: 5.5+/-0.6% vs 2.2+/-0.2%, and leptin: 20.5+/-10.8 ng/ml vs 12.9+/-6.7 ng/ml over time in the women (pinfluencer of obesity risk in humans.

  16. Caffeine treatment prevented from weight regain after calorie shifting diet induced weight loss.

    Science.gov (United States)

    Davoodi, Sayed Hossein; Hajimiresmaiel, Seyed Javad; Ajami, Marjan; Mohseni-Bandpei, Anoushiravan; Ayatollahi, Seyyed Abdulmajid; Dowlatshahi, Kamran; Javedan, Gholamali; Pazoki-Toroudi, Hamidreza

    2014-01-01

    Low calorie diets are always difficult for obese subjects to follow and lead to metabolic and behavioral adaptation. Therefore, we evaluated the effect of caffeine treatment with calorie shifting diet (CSD) on weight loss. Female subjects (n=60; BMI≥25) completed 4-weeks control diet, 6-weeks CSD (3 repeated phases; each 2-weeks) and 4-weeks follow-up diet, with or without caffeine treatment (5 mg/Kg/day). The first 11 days of each phase included calorie restriction with four meals every day and 4 hours intervals. Significant weight and fat loss were observed after 4-weeks of CSD (5.7 ± 1.24 Kg and 4.84 ± 1.53 Kg) or CSD+Caffeine (7.57 ± 2.33 Kg and 5.24 ± 2.07 Kg) which was consistent for one month of the follow-up (CSD: 5.24 ± 1.83 Kg and 4.3 ± 1.62 Kg, CSD+Caffeine: 12.11 ± 2.31 Kg and 9.85 ± 1.6 Kg, p Caffeine treatments, significantly decreased plasma glucose, total-cholesterol, and triacylglycerol (p after 4-weeks of CSD (p after week 7 (p caffeine treatment with CSD could be an effective alternative approach to weight and fat loss with small changes in RMR and improved tolerance of subjects to the new diet.

  17. Initial very low calorie diet (VLCD) improves ultimate weight loss

    DEFF Research Database (Denmark)

    Quaade, F; Astrup, A

    1989-01-01

    (4.1-28.8], than group 1 (8.7 kg (-1.1 to 19.1), P = 0.008; and 7.3 kg (0.9-18.2 P = 0.01). Weight losses in both groups eliminated or strongly reduced the need for a wide variety of expensive drugs: antidiabetics, diuretics, antihypertensives, analgetics, etc. It is concluded that VLCD......Thirty-eight consecutive obese persons were treated as outpatients. The treatment commenced with VLCD formula diet NUPO (females 388 kcal, 1600 kJ, 56 g protein; males 446 kcal, 1864 kJ, 69 g protein). VLCD had no untoward effects and was continued for as long as the patient would accept. After...... for 2 months or more. The two groups were comparable with regard to height, absolute weight and percentual overweight, but group 2 was somewhat older than group 1 (49.5 vs 38.3 years, P less than 0.01). Group 2 lost significantly more weight, both totally (17.1 kg (7.8-40.1] and on VLCD alone (12.3 kg...

  18. Weight-loss surgery - after - what to ask your doctor

    Science.gov (United States)

    Gastric bypass - after - what to ask your doctor; Roux-en-Y gastric bypass - after - what to ask your doctor; Gastric banding - ... stomach? If I am throwing up? What extra vitamins or minerals I will need to take? Will ...

  19. Roux-en-Y stomach surgery for weight loss (image)

    Science.gov (United States)

    ... stomach and attaching it directly to the small intestine, bypassing a large part of the stomach and duodenum. Not only is the stomach pouch too small to hold large amounts of food, but by skipping the duodenum, fat absorption is substantially reduced.

  20. Enhanced amylin-mediated body weight loss in estradiol-deficient diet-induced obese rats.

    Science.gov (United States)

    Trevaskis, James L; Turek, Victoria F; Wittmer, Carrie; Griffin, Peter S; Wilson, Julie K; Reynolds, James M; Zhao, Yu; Mack, Christine M; Parkes, David G; Roth, Jonathan D

    2010-12-01

    In rodents, ovariectomy (OVX) elicits weight gain and diminished responsiveness to homeostatic signals. Here we characterized the response of obese OVX rats to peripheral amylin. Rats received sham surgery (SHAM), OVX, or OVX with hormonal replacement (17β-estradiol, 2 μg per 4 d; OVX+E) and were infused with vehicle or amylin (50 μg/kg · d) for 28 d. Amylin reduced body weight (5.1 ± 1.1%) and food intake (10.9 ± 3.4%) in SHAM rats but was twice as efficacious in OVX rats in reducing weight (11.2 ± 1.9%) and food intake (23.0 ± 2.0%). There were no differences between amylin-treated SHAM and OVX+E rats. OVX decreased metabolic rate (∼24%) and increased respiratory exchange ratio relative to SHAM. Amylin partially normalized metabolic rate (13% increase) in OVX rats and decreased respiratory exchange ratio in OVX and SHAM rats. Regarding central mechanisms, amylin infusion corrected the OVX-induced decrease in hippocampal neurogenesis and increased immobility in the forced swim test. Additionally, amylin increased neurogenesis (∼2-fold) within the area postrema of OVX rats. To assess the contribution of endogenous leptin to amylin-mediated weight loss in OVX rats, amylin was administered to SHAM or OVX Zucker diabetic fatty rats. In SHAM rats, amylin infusion reduced food intake but not body weight, whereas in OVX Zucker diabetic fatty rats, food intake, body weight, and insulin were reduced. Overall, amylin induced greater body weight loss in the absence of estradiol via central and peripheral actions that did not require leptin. These findings support the clinical investigation of amylin in low estradiol (e.g. postmenopausal) states.

  1. Rapid weight loss followed by recovery time does not affect judo-related performance.

    Science.gov (United States)

    Artioli, Guilherme G; Iglesias, Rodrigo T; Franchini, Emerson; Gualano, Bruno; Kashiwagura, Daniel B; Solis, Marina Y; Benatti, Fabiana B; Fuchs, Marina; Lancha Junior, Antonio H

    2010-01-01

    In this study, we investigated the effects of rapid weight loss followed by a 4-h recovery on judo-related performance. Seven weight-cycler athletes were assigned to a weight loss group (5% body weight reduction by self-selected regime) and seven non-weight-cyclers to a control group (no weight reduction). Body composition, performance, glucose, and lactate were assessed before and after weight reduction (5-7 days apart; control group kept weight stable). The weight loss group had 4 h to re-feed and rehydrate after the weigh-in. Food intake was recorded during the weight loss period and recovery after the weigh-in. Performance was evaluated through a specific judo exercise, followed by a 5-min judo combat and by three bouts of the Wingate test. Both groups significantly improved performance after the weight loss period. No interaction effects were observed. The energy and macronutrient intake of the weight loss group were significantly lower than for the control group. The weight loss group consumed large amounts of food and carbohydrate during the 4-h recovery period. No changes were observed in lactate concentration, but a significant decrease in glucose during rest was observed in the weight loss group. In conclusion, rapid weight loss did not affect judo-related performance in experienced weight-cyclers when the athletes had 4 h to recover. These results should not be extrapolated to inexperienced weight-cyclers.

  2. Gut microbiome and serum metabolome alterations in obesity and after weight-loss intervention.

    Science.gov (United States)

    Liu, Ruixin; Hong, Jie; Xu, Xiaoqiang; Feng, Qiang; Zhang, Dongya; Gu, Yanyun; Shi, Juan; Zhao, Shaoqian; Liu, Wen; Wang, Xiaokai; Xia, Huihua; Liu, Zhipeng; Cui, Bin; Liang, Peiwen; Xi, Liuqing; Jin, Jiabin; Ying, Xiayang; Wang, Xiaolin; Zhao, Xinjie; Li, Wanyu; Jia, Huijue; Lan, Zhou; Li, Fengyu; Wang, Rui; Sun, Yingkai; Yang, Minglan; Shen, Yuxin; Jie, Zhuye; Li, Junhua; Chen, Xiaomin; Zhong, Huanzi; Xie, Hailiang; Zhang, Yifei; Gu, Weiqiong; Deng, Xiaxing; Shen, Baiyong; Xu, Xun; Yang, Huanming; Xu, Guowang; Bi, Yufang; Lai, Shenghan; Wang, Jian; Qi, Lu; Madsen, Lise; Wang, Jiqiu; Ning, Guang; Kristiansen, Karsten; Wang, Weiqing

    2017-07-01

    Emerging evidence has linked the gut microbiome to human obesity. We performed a metagenome-wide association study and serum metabolomics profiling in a cohort of lean and obese, young, Chinese individuals. We identified obesity-associated gut microbial species linked to changes in circulating metabolites. The abundance of Bacteroides thetaiotaomicron, a glutamate-fermenting commensal, was markedly decreased in obese individuals and was inversely correlated with serum glutamate concentration. Consistently, gavage with B. thetaiotaomicron reduced plasma glutamate concentration and alleviated diet-induced body-weight gain and adiposity in mice. Furthermore, weight-loss intervention by bariatric surgery partially reversed obesity-associated microbial and metabolic alterations in obese individuals, including the decreased abundance of B. thetaiotaomicron and the elevated serum glutamate concentration. Our findings identify previously unknown links between intestinal microbiota alterations, circulating amino acids and obesity, suggesting that it may be possible to intervene in obesity by targeting the gut microbiota.

  3. Metabolic syndrome, circulating RBP4, testosterone, and SHBG predict weight regain at 6 months after weight loss in men

    DEFF Research Database (Denmark)

    Wang, Ping; Menheere, Paul P C A; Astrup, Arne

    2013-01-01

    , adiponectin, retinol-binding protein 4 (RBP4), luteinizing hormone, prolactin, progesterone, total and free testosterone, and sex hormone-binding globulin (SHBG) were measured at baseline, after 8-week low-calorie diet-induced active weight loss, and after a subsequent 26-week ad libitum weight maintenance...... diet, and analyzed together with anthropometrical and physiological parameters. RESULTS AND CONCLUSIONS: Overweight and obese men with MetS at baseline had higher risk to regain weight (odds ratio=2.8, P=0.015). High baseline RBP4, and low total testosterone and low SHBG are predictors of weight loss......OBJECTIVE: Weight loss helps reduce the symptoms of the metabolic syndrome (MetS) in the obese, but weight regain after active weight loss is common. We investigated the changes and predictive role of circulating adipokines and sex hormones for weight regain in men during dietary intervention...

  4. Cardiometabolic results from an armband-based weight loss trial

    Directory of Open Access Journals (Sweden)

    Sieverdes JC

    2011-05-01

    Full Text Available John C Sieverdes, Xuemei Sui, Gregory A Hand, Vaughn W Barry, Sara Wilcox, Rebecca A Meriwether, James W Hardin, Amanda C McClain, Steven N BlairDepartment of Exercise Science, University of South Carolina, Columbia, SC, USAPurpose: This report examines the blood chemistry and blood pressure (BP results from the Lifestyle Education for Activity and Nutrition (LEAN study, a randomized weight loss trial. A primary purpose of the study was to evaluate the effects of real-time self-monitoring of energy balance (using the SenseWearTM Armband, BodyMedia, Inc Pittsburgh, PA on these health factors.Methods: 164 sedentary overweight or obese adults (46.8 ± 10.8 years; BMI 33.3 ± 5.2 kg/m2; 80% women took part in the 9-month study. Participants were randomized into 4 conditions: a standard care condition with an evidence-based weight loss manual (n = 40, a group-based behavioral weight loss program (n = 44, an armband alone condition (n = 41, and a group plus armband (n = 39 condition. BP, fasting blood lipids and glucose were measured at baseline and 9 months.Results: 99 participants (60% completed both baseline and follow-up measurements for BP and blood chemistry analysis. Missing data were handled by baseline carried forward. None of the intervention groups had significant changes in blood lipids or BP when compared to standard care after adjustment for covariates, though within-group lowering was found for systolic BP in group and group + armband conditions, a rise in total cholesterol and LDL were found in standard care and group conditions, and a lowering of triglycerides was found in the two armband conditions. Compared with the standard care condition, fasting glucose decreased significantly for participants in the group, armband, and group + armband conditions (all P < 0.05, respectively.Conclusion: Our results suggest that using an armband program is an effective strategy to decrease fasting blood glucose. This indicates that devices, such as

  5. Body mass index and weight loss in overweight and obese korean women: the mediating role of body weight perception.

    Science.gov (United States)

    Boo, Sunjoo

    2013-12-01

    This study were to assess the relationships among BMI, body weight perception, and efforts to lose weight in a public sample of Korean women who are overweight and obese and to examine the mediating role of body weight perception on the relationship between BMI and weight loss efforts. This cross-sectional study used data from the 2008 Korea National Health and Nutrition Examination Survey. The sample was 1,739 Korean women 20 years old or older wit