Inpatient weight loss as a precursor to bariatric surgery for adolescents with extreme obesity: optimizing bariatric surgery.

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Koeck, Emily; Davenport, Katherine; Barefoot, Leah C; Qureshi, Faisal G; Davidow, Daniel; Nadler, Evan P

2013-07-01

As the obesity epidemic takes its toll on patients stricken with the disease and our health care system, debate continues regarding the use of weight loss surgery and its long-term consequences, especially for adolescents. One subset of patients regarding whom there is increased controversy is adolescents with extreme obesity (BMI > 60 kg/m(2)) because the risk of complications in this weight category is higher than for others undergoing bariatric surgery. Several strategies have been suggested for this patient group, including staged operations, combined operations, intragastric balloon use, and endoluminal sleeve placement. However, the device options are often not available to adolescents, and there are no data regarding staged or combined procedures in this age group. All adolescents with BMI >60 kg/m(2) referred to our program were evaluated for inpatient medical weight loss prior to laparoscopic sleeve gastrectomy. The program utilizes a multidisciplinary approach with a protein-sparing modified fast diet, exercise, and behavioral modification. Three patients completed the program, and each achieved significant preoperative weight loss through the inpatient program and successfully underwent bariatric surgery. Presurgical weight loss via an inpatient program for adolescents with a BMI >60 kg/m(2) results in total weight loss comparable to a primary surgical procedure alone, with the benefit of decreasing the perioperative risk.

Musculoskeletal findings in obese subjects before and after weight loss following bariatric surgery.

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Hooper, M M; Stellato, T A; Hallowell, P T; Seitz, B A; Moskowitz, R W

2007-01-01

To determine the point prevalence of painful musculoskeletal (MSK) conditions in obese subjects before and after weight loss following bariatric surgery. Longitudinal, interventional, unblended. Forty-eight obese subjects (47 women, one man, mean age 44+/-9 years; mean body mass index (BMI) 51+/-8 kg/m(2)) recruited from an academic medical center bariatric surgery program. Comorbid medical conditions; MSK findings; BMI; Western Ontario McMaster Osteoarthritis Index (WOMAC) for pain, stiffness and function; and SF-36 for quality of life. Consecutive subjects were recruited from the University Hospitals of Cleveland Bariatric Surgery Program. Musculoskeletal signs and symptoms and non-MSK comorbid conditions were documented at baseline and at follow-up. SUBJECTS completed the SF-36 and the WOMAC questionnaires. Analyses were carried out for each MSK site, fibromyalgia syndrome (FMS) and for the cumulative effect on the spine, upper and lower extremities. The impact of change in comorbid medical conditions, BMI, physical and mental health domains of the SF-36 on the WOMAC pain subscale score was evaluated. SF-36 outcomes were compared to normal published controls. Forty-eight subjects were available for baseline and a follow-up assessment 6-12 months after gastric bypass surgery. They lost an average of 41+/-15 kg and the mean BMI decreased from 51+/-8 to 36+/-7 kg/m(2). Baseline comorbid medical conditions were present in 96% before surgery and 23% after weight loss. There was an increased prevalence of painful MSK conditions at baseline compared to general population frequencies. Musculoskeletal complaints had been present in 100% of obese subjects before, and 23% after weight loss. The greatest improvements occurred in the cervical and lumbar spine, the foot and in FMS (decreased by 90, 83, 83 and 92%, respectively). Seventy-nine percent had upper extremity MSK conditions before and 40% after weight loss. Before surgery, 100% had lower extremity MSK conditions and

Weight loss after bariatric surgery and periodontal changes: a 12-month prospective study.

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Sales-Peres, Silvia Helena de Carvalho; Sales-Peres, Matheus de Carvalho; Ceneviva, Reginaldo; Bernabé, Eduardo

2017-04-01

Several longitudinal studies have explored the association of obesity and weight gain with periodontal disease. However, the effect of weight loss on periodontal tissues remains unclear. To explore whether weight loss after bariatric surgery was associated with changes in periodontal measures over 12 months. Two public hospitals in São Paulo, Brazil. We used data from 110 morbidly obese patients (body mass index [BMI]>40 kg/m 2 or≥35 kg/m 2 with co-morbid conditions) who underwent bariatric surgery between April 2011 and March 2013. Data on demographic factors, BMI, smoking habits, and glucose levels were extracted from medical records preoperatively and after 6 and 12 months postsurgery. A full-mouth periodontal examination was conducted by trained examiners to assess probing pocket depth, clinical attachment loss, and bleeding on probing (BOP) at baseline and 6 and 12 months after surgery. Data were analyzed using linear mixed-effects models. BMI was not significantly related to the proportion of sites with BOP at baseline, but it was negatively associated with the rate of change in the proportion of sites with BOP. The greater the BMI loss, the higher the proportion of sites with BOP, particularly 6 months after surgery. However, BMI was not associated with baseline probing pocket depth and clinical attachment loss or rates of changes in these periodontal outcomes. The findings suggest that weight loss was associated with increased gingival bleeding, showing a peak at 6 months after bariatric surgery. Periodontal pocketing and attachment loss remained unchanged during the study period. Copyright © 2017. Published by Elsevier Inc.

Breast cancer biomarkers predict weight loss after gastric bypass surgery

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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.

Preoperative predictors of adherence to dietary and physical activity recommendations and weight loss one year after surgery.

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Bergh, Irmelin; Lundin Kvalem, Ingela; Risstad, Hilde; Sniehotta, Falko F

2016-05-01

Weight loss and weight loss maintenance vary considerably between patients after bariatric surgery. Postoperative weight gain has partially been explained by lack of adherence to postoperative dietary and physical activity recommendations. However, little is known about factors related to postoperative adherence. The aim of this study was to examine psychological, behavioral, and demographic predictors of adherence to behavior recommendations and weight loss 1 year after bariatric surgery. Oslo University Hospital. In a prospective cohort study, 230 patients who underwent Roux-en-Y gastric bypass were recruited from Oslo University hospital from 2011 to 2013. They completed a comprehensive questionnaire before and 1 year after surgery. Weight was measured preoperatively, on the day of surgery, and 1-year postoperatively. Mean body mass index was 44.9 kg/m(2) (standard deviation [SD] = 6.0) preoperatively and 30.6 kg/m(2) (SD = 5.2) 1 year after surgery. Patients lost on average 29.2 % (SD = 8.2) of their initial weight. Predictors of dietary adherence were years with dieting experience, readiness to limit food intake, and night eating tendency. Preoperative physical activity and planning predicted postoperative physical activity whereas predictors of weight loss were higher frequency of snacking preoperatively, greater past weight loss, and lower age. Several preoperative psychological predictors were related to postoperative adherence to dietary and physical activity recommendations but were not associated with weight loss. Interventions targeting psychological factors facilitating behavior change during the initial postoperative phase are recommended as this might improve long-term outcomes. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Obesity and the decision tree: predictors of sustained weight loss after bariatric surgery.

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Lee, Yi-Chih; Lee, Wei-Jei; Lin, Yang-Chu; Liew, Phui-Ly; Lee, Chia Ko; Lin, Steven C H; Lee, Tian-Shyung

2009-01-01

Bariatric surgery is the only long-lasting effective treatment to reduce body weight in morbid obesity. Previous literature in using data mining techniques to predict weight loss in obese patients who have undergone bariatric surgery is limited. This study used initial evaluations before bariatric surgery and data mining techniques to predict weight outcomes in morbidly obese patients seeking surgical treatment. 251 morbidly obese patients undergoing laparoscopic mini-gastric bypass (LMGB) or adjustable gastric banding (LAGB) with complete clinical data at baseline and at two years were enrolled for analysis. Decision Tree, Logistic Regression and Discriminant analysis technologies were used to predict weight loss. Overall classification capability of the designed diagnostic models was evaluated by the misclassification costs. Two hundred fifty-one patients consisting of 68 men and 183 women was studied; with mean age 33 years. Mean +/- SD weight loss at 2 year was 74.5 +/- 16.4 kg. During two years of follow up, two-hundred and five (81.7%) patients had successful weight reduction while 46 (18.3%) were failed to reduce body weight. Operation methods, alanine transaminase (ALT), aspartate transaminase (AST), white blood cell counts (WBC), insulin and hemoglobin A1c (HbA1c) levels were the predictive factors for successful weight reduction. Decision tree model was a better classification models than traditional logistic regression and discriminant analysis in view of predictive accuracies.

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

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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

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

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Amundsen, Tina; Str?mmen, Magnus; Martins, Catia

2016-01-01

BACKGROUND: Suboptimal weight loss (SWL) and weight regain (WR) after gastric bypass surgery (GB) remains poorly understood. OBJECTIVES: 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. METHODS: Forty-nine patients with >1 year post-surgery were classified as either experiencing SWL (excess body weight loss, EWL,

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

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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.

Psychological predictors of weight loss after bariatric surgery: a review of the recent research.

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Wimmelmann, Cathrine L; Dela, Flemming; Mortensen, Erik L

2014-01-01

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 regard to a sustained long-term weight loss. Psychological factors are thought to play an important role for maintaining the surgical weight loss. However, results from prior research examining preoperative psychological predictors of weight loss outcome are inconsistent. The aim of this article was to review more recent literature on psychological predictors of surgical weight loss. We searched PubMed, PsycInfo and Web of Science, for original prospective studies with a sample size >30 and at least one year follow-up, using a combination of search terms such as 'bariatric surgery', 'morbid obesity', 'psychological predictors', and 'weight loss'. Only studies published after 2003 were included. 19 eligible studies were identified. Psychological predictors of surgical weight loss investigated in the reviewed studies include cognitive function, personality, psychiatric disorder, and eating behaviour. In general, recent research remains inconsistent, but the findings suggest that pre-surgical cognitive function, personality, mental health, composite psychological variables and binge eating may predict post-surgical weight loss to the extent that these factors influence post-operative eating behaviour. Copyright © 2013 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Executive functions predict weight loss in a medically supervised weight loss programme

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Galioto, R.; Bond, D.; Gunstad, J.; Pera, V.; Rathier, L.; Tremont, G.

2016-01-01

Summary Background Deficits in executive functions are related to poorer weight loss after bariatric surgery; however, less is known about the role that these deficits may play during participation in nonsurgical weight loss programmes. This study examined associations between objectively measured executive functions and weight loss during participation in a medically supervised weight loss programme. Methods Twenty?three adult patients (age 50.4???15.1, BMI 44.2???8.8, 68% female, 92% White)...

Preoperative psychological assessment of patients seeking weight-loss surgery: identifying challenges and solutions

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Edwards-Hampton SA

2015-11-01

Full Text Available Shenelle A Edwards-Hampton,1 Sharlene Wedin2 1Department of General Surgery, Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC, 2Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA Abstract: Preoperative psychosocial assessment is the standard of care for patients seeking weight-loss surgery (WLS. However, the assessment procedure varies widely by surgery site. Comprehensive assessments can provide a wealth of information that assists both the patient and the treatment team, anticipate and prepare for challenges associated with extensive behavioral and lifestyle changes that are required postsurgery. In this review, we provide an overview of the purpose of the preoperative psychosocial assessment and domains to be included. Challenges commonly identified in the assessment are discussed, including maladaptive eating behaviors, psychiatric comorbidities, and alcohol use. Potential solutions and approaches to these challenges are provided. Additionally, patient populations requiring special consideration are presented to include adolescents, those with cognitive vulnerabilities, and aging adults. Keywords: bariatric surgery, preoperative assessment, weight-loss surgery, challenges, adolescents, older adults, cognitive impairment, maladaptive eating, alcohol misuse

What Variables are Associated with Successful Weight Loss Outcomes for Bariatric Surgery After One Year?

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Robinson, Athena H.; Adler, Sarah; Stevens, Helen B.; Darcy, Alison M.; Morton, John M.; Safer, Debra L.

2014-01-01

Background Prior evidence indicates that predictors of weight loss outcomes after gastric bypass surgery fall within 5 domains: 1) presurgical factors; 2) postsurgical psychosocial variables (e.g., support group attendance); 3) postsurgical eating patterns; 4) postsurgical physical activity; and 5) follow-up at postsurgical clinic. However, little data exist on which specific behavioral predictors are most associated with successful outcomes (e.g., ≥50% excess weight loss) when considering the 5 domains simultaneously. Objectives Specify the behavioral variables, and their respective cutoff points, most associated with successful weight loss outcomes. Setting On-line survey. Methods Signal Detection Analysis evaluated associations between 84 pre-and postsurgical behavioral variables (within the 5 domains) and successful weight loss at ≥1 year in 274 post-gastric bypass surgery patients. Results Successful weight loss was highest (92.6%) among those reporting dietary adherence of >3 on a 9 point scale (median=5) who grazed no more than once-per-day. Among participants reporting dietary adherence <3 and grazing daily or less, success rates more than doubled when highest lifetime Body Mass Index was <53.7 kg/m2. Success rates also doubled for participants with dietary adherence =3 if attending support groups. No variables from the physical activity or postsurgical follow-up domains were significant, nor were years since surgery. The overall model’s sensitivity =.62, specificity =.92. Conclusions To our knowledge, this is the first study to simultaneously consider the relative contribution of behavioral variables within 5 domains and offer clinicians an assessment algorithm identifying cut-off points for behaviors most associated with successful postsurgical weight loss. Such data may inform prospective study designs and postsurgical interventions. PMID:24913590

Factors associated with long-term weight-loss maintenance following bariatric surgery in adolescents with severe obesity.

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Ryder, J R; Gross, A C; Fox, C K; Kaizer, A M; Rudser, K D; Jenkins, T M; Ratcliff, M B; Kelly, A S; Kirk, S; Siegel, R M; Inge, T H

2018-01-01

Bariatric surgery produces robust weight loss, however, factors associated with long-term weight-loss maintenance among adolescents undergoing Roux-en-Y gastric bypass surgery are unknown. Fifty adolescents (mean±s.d. age and body mass index (BMI)=17.1±1.7 years and 59±11 kg m -2 ) underwent Roux-en-Y gastric bypass surgery, had follow-up visits at 1 year and at a visit between 5 and 12 years following surgery (Follow-up of Adolescent Bariatric Surgery at 5 Plus years (FABS-5+) visit; mean±s.d. 8.1±1.6 years). A non-surgical comparison group (n=30; mean±s.d. age and BMI=15.3±1.7 years and BMI=52±8 kg m -2 ) was recruited to compare weight trajectories over time. Questionnaires (health-related and eating behaviors, health responsibility, impact of weight on quality of life (QOL), international physical activity questionnaire and dietary habits via surgery guidelines) were administered at the FABS-5+ visit. Post hoc, participants were split into two groups: long-term weight-loss maintainers (n=23; baseline BMI=58.2 kg m -2 ; 1-year BMI=35.8 kg m -2 ; FABS-5+ BMI=34.9 kg m -2 ) and re-gainers (n=27; baseline BMI=59.8 kg m -2 ; 1-year BMI=36.8 kg m -2 ; FABS-5+ BMI=48.0 kg m -2 ) to compare factors which might contribute to differences. Data were analyzed using generalized estimating equations adjusted for age, sex, baseline BMI, baseline diabetes status and length of follow-up. The BMI of the surgical group declined from baseline to 1 year (-38.5±6.9%), which, despite some regain, was largely maintained until FABS-5+ (-29.6±13.9% change). The BMI of the comparison group increased from baseline to the FABS-5+ visit (+10.3±20.6%). When the surgical group was split into maintainers and re-gainers, no differences in weight-related and eating behaviors, health responsibility, physical activity/inactivity, or dietary habits were observed between groups. However, at FABS-5+, maintainers had greater overall QOL scores than re

Weight Loss and Health Status 3 Years after Bariatric Surgery in Adolescents.

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Inge, Thomas H; Courcoulas, Anita P; Jenkins, Todd M; Michalsky, Marc P; Helmrath, Michael A; Brandt, Mary L; Harmon, Carroll M; Zeller, Meg H; Chen, Mike K; Xanthakos, Stavra A; Horlick, Mary; Buncher, C Ralph

2016-01-14

Bariatric surgery is increasingly considered for the treatment of adolescents with severe obesity, but few prospective adolescent-specific studies examining the efficacy and safety of weight-loss surgery are available to support clinical decision making. We prospectively enrolled 242 adolescents undergoing weight-loss surgery at five U.S. centers. Patients undergoing Roux-en-Y gastric bypass (161 participants) or sleeve gastrectomy (67) were included in the analysis. Changes in body weight, coexisting conditions, cardiometabolic risk factors, and weight-related quality of life and postoperative complications were evaluated through 3 years after the procedure. The mean (±SD) baseline age of the participants was 17±1.6 years, and the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 53; 75% of the participants were female, and 72% were white. At 3 years after the procedure, the mean weight had decreased by 27% (95% confidence interval [CI], 25 to 29) in the total cohort, by 28% (95% CI, 25 to 30) among participants who underwent gastric bypass, and by 26% (95% CI, 22 to 30) among those who underwent sleeve gastrectomy. By 3 years after the procedure, remission of type 2 diabetes occurred in 95% (95% CI, 85 to 100) of participants who had had the condition at baseline, remission of abnormal kidney function occurred in 86% (95% CI, 72 to 100), remission of prediabetes in 76% (95% CI, 56 to 97), remission of elevated blood pressure in 74% (95% CI, 64 to 84), and remission of dyslipidemia in 66% (95% CI, 57 to 74). Weight-related quality of life also improved significantly. However, at 3 years after the bariatric procedure, hypoferritinemia was found in 57% (95% CI, 50 to 65) of the participants, and 13% (95% CI, 9 to 18) of the participants had undergone one or more additional intraabdominal procedures. In this multicenter, prospective study of bariatric surgery in adolescents, we found significant improvements in weight

Diet Change After Sleeve Gastrectomy Is More Effective for Weight Loss Than Surgery Only.

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Rossell, Joana; González, Marta; Mestres, Núria; Pardina, Eva; Ricart-Jané, David; Peinado-Onsurbe, Julia; Baena-Fustegueras, Juan Antonio

2017-10-01

Bariatric surgery with or without diet change has become one of the most effective treatments for obesity. The objective of this study was to observe the effects of vertical sleeve gastrectomy (VSG) and diet change in Sprague-Dawley rats on both body and tissue weights. Eighteen rats were fed with a standard chow diet (SCD) (C group), and 36 rats were fed with a high-fat diet (HFD) (diet-induced obesity (DIO) group). After 8 weeks, the animals underwent VSG, sham surgery or no surgery (NS). After surgery, a third of the rats fed with the HFD changed to the SCD (DIO + C group). Body weight, food and energy intake were recorded daily during the experiment (12 weeks). Food efficiency (%) (FE) was determined from weekly weight gain and weekly kilocalorie consumed measurements. The DIO group had higher and significant weight gain than the C group at the time of surgery (p weight loss (WL) was observed in the DIO + C-VSG group, during the 4 weeks after surgery. Adipose tissues in the DIO + C-VSG group were drastically reduced and had a weight similar to those in the C-VSG group. VSG and the diet change combination led to a greater WL, which was maintained during the 4 weeks post-surgery, leading to a normalization of body weight. VSG and diet change also affected most of the tissues, not only adipose, showing a global change in whole body composition.

Happily-ever-after: Personal narratives in weight-loss surgery advertising.

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Groven, Karen Synne; Braithwaite, Jean

2016-11-01

Advertising for weight loss surgery (WLS) is typically but not exclusively targeted toward women. The surgery is portrayed as the most effective way to free oneself from the stigmas and health risks associated with large bodies. WLS clinics routinely feature success stories by former patients that include before and after pictures and personal narratives. Because these testimonials are cherry-picked by the clinics, naturally they do not represent the full spectrum of postsurgical patient experiences, yet they are likely to influence the decision making of prospective patients. Our findings show that these success stories do not offer adequate information to prospective patients about what to expect after the surgery. In particular, the success stories tend to speak of side-effects as self-inflicted, thus reinforcing the healthist cultural/medical message of individual responsibility that is driving the current WLS epidemic.

Weight Loss and Comorbidity Resolution 3 Years After Bariatric Surgery-an Indian Perspective.

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Nasta, Amrit Manik; Goel, Ramen; Dharia, Shefali; Goel, Madhu; Hamrapurkar, Shireen

2018-04-03

Bariatric surgery has seen a sharp rise in India in the last decade. India is one of the 10 most obese nations of the world, ranking second in number of type 2 diabetics. To evaluate clinical outcomes of bariatric surgery after 3 years of follow-up in terms of weight loss, co-morbidity resolution, complaints of gastroesophageal reflux disease and weight regain. All patients who underwent bariatric surgery from January to December 2013 with a minimum follow-up of 3 years were included in the study. Their demographic, preoperative, and postoperative data were prospectively maintained on Microsoft Office Excel and analyzed statistically. One hundred seventy-eight patients (157 lap. sleeve gastrectomy and 21 patients lap. RYGB) completed 3 years of follow-up. In the LSG group, patients had a pre-operative BMI 44.8 ± 8.33 kg/sq. m (mean ± S.D.) and excess body weight 52.3 ± 23.0 kg. In the RYGB group, pre-operative BMI was 42.7 ± 8.82 kg/sq. m and excess body weight 45 ± 18.7 kg. In the LSG group, % excess weight loss (EWL) at 1 year was 87.6 ± 24.4% and 3 years was 71.8 ± 26.7%. In the RYGB group, % EWL at 1 year was 97.2 ± 27.3% and at 3 years was 85.8 ± 25.3%. Diabetes resolution was seen in 32 (80%) in LSG group and 11 (91.7%) in RYGB group (Figs. 1, 2, 3, and 4). Our study reflects that there is no statistically significant difference between outcomes of sleeve gastrectomy and Roux-en-Y gastric bypass surgery in terms of weight loss and diabetes resolution at 3 years.

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

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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 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.

Long-term weight loss after bariatric surgery in patients visited at home outside the study environment.

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Mathus-Vliegen, Elisabeth M H

2006-11-01

Bariatric surgery results in sustained weight loss in the majority of patients. The controlled setting of a trial, however, does not necessarily reflect the everyday routine practice. Therefore, to investigate the results of bariatric surgery in a more natural setting, patients were visited at home, outside a study and hospital environment. Patients who underwent a vertical banded gastroplasty or a gastric bypass between 1980 and 1997 were eligible. Body weight and height were measured. Patients filled out general and health status questionnaires (Nottingham Health Profile (NHP)). Responses were obtained from 236/313 subjects (75%) with a mean +/- SD age of 42.9 +/- 10.2 years and a mean current body weight of 100.3 +/- 20.7 kg. A maximum weight loss of 48.2 +/- 18.4 kg or 70.8 +/- 22.4% excess weight loss was obtained after 17 +/- 15 months, of which 32.1 +/- 22.6 kg or 45.2 +/- 29.3%, respectively, was maintained at 8.2 +/- 4.5 years after the intervention. Males and females did not differ in weight loss. The type of operation had no influence. Age >50 years and a BMI >50 kg/m(2) were not related to a poor outcome, but a time lapse of >5 years since the operation resulted in a less well sustained weight loss. The subjective health status improved considerably, but less so with a smaller weight loss and longer lapse of time since the operation. Especially in females, the NHP still deviated substantially from Dutch norm values. Surgically obtained weight loss is satisfactory in patients outside a strictly controlled study setting. Health benefits are substantial, but are adversely affected by weight gain and time elapsed since the operation.

Long-term weight loss after bariatric surgery in patients visited at home outside the study environment

NARCIS (Netherlands)

Mathus-Vliegen, Elisabeth M. H.

2006-01-01

BACKGROUND: Bariatric surgery results in sustained weight loss in the majority of patients. The controlled setting of a trial, however, does not necessarily reflect the everyday routine practice. Therefore, to investigate the results of bariatric surgery in a more natural setting, patients were

Weight loss in the first month post-gastroplasty following diet progression with introduction of solid food three weeks after surgery

OpenAIRE

ANDRADE, Camila Garcia da Costa; LOBO, Amanda

2014-01-01

BACKGROUND: Bariatric surgery is an effective tool in treating severe obesity. It provides significant weight loss in morbidly obese people accompanied by improvement in comorbidities and quality of life. AIM: To investigate the weight loss outcomes in the first month after bariatric surgery after introduction of solids three weeks postoperatively. METHODS: Thirty-two charts of patients who underwent bariatric surgery were analyzed at a private nutritional clinic in São Sebastião do Para...

Weight loss in the first month post-gastroplasty following diet progression with introduction of solid food three weeks after surgery.

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Andrade, Camila Garcia da Costa; Lobo, Amanda

2014-01-01

Bariatric surgery is an effective tool in treating severe obesity. It provides significant weight loss in morbidly obese people accompanied by improvement in comorbidities and quality of life. To investigate the weight loss outcomes in the first month after bariatric surgery after introduction of solids three weeks postoperatively. Thirty-two charts of patients who underwent bariatric surgery were analyzed at a private nutritional clinic in São Sebastião do Paraíso, MG, Brazil; 93,75% of the subjects underwent Roux-en-Y gastric bypass, and 6,25% vertical gastrectomy. The subjects were 16 to 60 years. A body mass index of 30 to 69 Kg/m2 was obtained. Patients were instructed to eat small amounts several times a day, eat slowly, chew foods thoroughly, substitute sugar for sweetener, stop drinking gassy beverages, set the utensils down in between meals, drink only in between meals, avoid processed condiments and fried and greasy foods. In the first month after surgery, the mean weight loss was 9,7% and the percentage of excess weight loss was 23,9%. It was found that there was significant statistical difference in relation to initial and final weight (p=0,00; pfreedom of choice in health care once one does not have to go on food intake modifications for more than three weeks; more nutritional guidelines is followed and prospective weight loss is presented.

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

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

2014-01-01

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. PMID:25374275

Weight loss after bariatric surgery in obese adolescents: a systematic review and meta-analysis.

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Pedroso, Felipe E; Angriman, Federico; Endo, Atsushi; Dasenbrock, Hormuzdiyar; Storino, Alessandra; Castillo, Ricardo; Watkins, Ammara A; Castillo-Angeles, Manuel; Goodman, Julie E; Zitsman, Jeffrey L

2018-03-01

Of adolescents in the United States, 20% have obesity and current treatment options prioritize intensive lifestyle interventions that are largely ineffective. Bariatric surgery is increasingly being offered to obese adolescent patients; however, large-scale effectiveness data is lacking. We used MEDLINE, Embase, and Cochrane databases, and a manual search of references to conduct a systematic review and meta-analysis on overall weight loss after gastric band, gastric sleeve, and gastric bypass in obese adolescent patients (age ≤19) and young adults (age ≤21) in separate analyses. We provided estimates of absolute change in body mass index (BMI, kg/m 2 ) and percent excess weight loss across 4 postoperative time points (6, 12, 24, and 36 mo) for each surgical subgroup. Study quality was assessed using a 10 category scoring system. Data were extracted from 24 studies with 4 having multiple surgical subgroups (1 with 3, and 3 with 2 subgroups), totaling 29 surgical subgroup populations (gastric band: 16, gastric sleeve: 5, gastric bypass: 8), and 1928 patients (gastric band: 1010, gastric sleeve: 139, gastric bypass: 779). Mean preoperative BMI (kg/m 2 ) was 45.5 (95% confidence interval [CI]: 44.7, 46.3) in gastric band, 48.8 (95%CI: 44.9, 52.8) in gastric sleeve, and 53.3 (95%CI: 50.2, 56.4) in gastric bypass patients. The short-term weight loss, measured as mean (95%CI) absolute change in BMI (kg/m 2 ) at 6 months, was -5.4 (-3.0, -7.8) after gastric band, -11.5 (-8.8, -14.2) after gastric sleeve, and -18.8 (-10.9, -26.6) after gastric bypass. Weight loss at 36 months, measured as mean (95%CI) absolute change in BMI (kg/m 2 ) was -10.3 (-7.0, -13.7) after gastric band, -13.0 (-11.0, -15.0) after gastric sleeve, and -15.0 (-13.5, -16.5) after gastric bypass. Bariatric surgery in obese adolescent patients is effective in achieving short-term and sustained weight loss at 36 months; however, long-term data remains necessary to better understand its long

Hepatic and visceral adipose tissue 11βHSD1 expressions are markers of body weight loss after bariatric surgery.

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Pardina, Eva; Baena-Fustegueras, Juan Antonio; Fort, José Manuel; Ferrer, Roser; Rossell, Joana; Esteve, Montserrat; Peinado-Onsurbe, Julia; Grasa, Mar

2015-09-01

Cortisolemia and 11βHSD1 in liver and adipose tissue are altered in obesity. However, their participation in the development of obesity remains unclear. This study analyzed these parameters in the transition from morbid to type 1 obesity after bariatric surgery. A group of 34 patients with morbid obesity and 22 nonobese subjects were recruited. Initial hypothalamus-pituitary-adrenal (HPA) basal activity and 11βHSD1 mRNA expression in liver, subcutaneous (SAT), and visceral adipose tissue (VAT) were evaluated. A year after bariatric surgery (weight loss of 48 kg), these parameters were reappraised in plasma, SAT, and liver. Body weight loss was accompanied by a downshift in basal HPA activity and 11βHSD1 expression in SAT. In patients with morbid obesity, 11βHSD1 expression correlated positively with BMI in VAT and negatively in liver at 6 and 12 months after surgery. In SAT, a correlation was observed with body weight only when patients showed type 1 obesity. Insulin, glucose, and HOMA correlated positively with all the HPA indicators and 11βHSD1 expression in SAT. Body weight loss after bariatric surgery is accompanied by a downshift in basal HPA activity. Hepatic and VAT 11βHSD1 expressions in morbid obesity are predictors of body weight loss. © 2015 The Obesity Society.

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

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......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...... year were explored using multiple linear regression analysis. Mean (SD) serum fasting and 2-h glucose levels at baseline did not differ between the surgery and lifestyle groups. Weight-loss after surgical treatment and lifestyle intervention was 30 (8) and 9 (10) % (p

'Fat girls' and 'big guys': gendered meanings of weight loss surgery.

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Newhook, Julia Temple; Gregory, Deborah; Twells, Laurie

2015-06-01

Over 80% of weight loss surgery (WLS) patients are women, yet gender is overwhelmingly absent in WLS research. This article discusses the findings of 54 interviews with twenty-one women and six men waiting for WLS in Newfoundland and Labrador, Canada. We critically examine the ways that gender shapes the meaning of WLS in these narratives. We explore gendered meanings in participants' perspectives on their embodied experiences before surgery, social support as they decided to undergo the procedure, and their expectations for their lives after WLS. We draw on feminist theory to explain how these findings counter the dominant gender-neutral medical model of obesity. © 2015 Foundation for the Sociology of Health & Illness.

Determinants of weight regain after bariatric surgery.

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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.

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

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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, <50%, n = 22) or SigWR (total 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.

Mechanisms of Weight Regain following Weight Loss.

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Blomain, Erik Scott; Dirhan, Dara Anne; Valentino, Michael Anthony; Kim, Gilbert Won; Waldman, Scott Arthur

2013-01-01

Obesity is a world-wide pandemic and its incidence is on the rise along with associated comorbidities. Currently, there are few effective therapies to combat obesity. The use of lifestyle modification therapy, namely, improvements in diet and exercise, is preferable over bariatric surgery or pharmacotherapy due to surgical risks and issues with drug efficacy and safety. Although they are initially successful in producing weight loss, such lifestyle intervention strategies are generally unsuccessful in achieving long-term weight maintenance, with the vast majority of obese patients regaining their lost weight during followup. Recently, various compensatory mechanisms have been elucidated by which the body may oppose new weight loss, and this compensation may result in weight regain back to the obese baseline. The present review summarizes the available evidence on these compensatory mechanisms, with a focus on weight loss-induced changes in energy expenditure, neuroendocrine pathways, nutrient metabolism, and gut physiology. These findings have added a major focus to the field of antiobesity research. In addition to investigating pathways that induce weight loss, the present work also focuses on pathways that may instead prevent weight regain. Such strategies will be necessary for improving long-term weight loss maintenance and outcomes for patients who struggle with obesity.

Preoperative weight loss in super-obese patients: study of the rate of weight loss and its effects on surgical morbidity

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Marco Aurelio Santo

2014-01-01

Full Text Available OBJECTIVES: The incidence of obesity and particularly super obesity, has increased tremendously. At our institution, super obesity represents 30.1% of all severely obese individuals in the bariatric surgery program. In super obesity, surgical morbidity is higher and the results are worse compared with morbid obesity, independent of the surgical technique. The primary strategy for minimizing complications in these patients is to decrease the body mass index before surgery. Preoperative weight reduction can be achieved by a hypocaloric diet, drug therapy, an intragastric balloon, or hospitalization. The objective of this study was to analyze the results of a period of hospitalization for preoperative weight loss in a group of super-obese patients. METHODS: Twenty super-obese patients were submitted to a weight loss program between 2006 and 2010. The mean patient age was 46 years (range 21-59. The mean BMI was 66 kg/m2 (range 51-98 and 12 were women. The average hospital stay was 19.9 weeks and the average weight loss was 19% of the initial weight (7-37%. The average caloric intake was 5 kcal/kg/day. After the weight loss program, the patients underwent gastric bypass surgery. RESULTS: The statistical analysis revealed that after 14 weeks of treatment (15% loss of initial weight, the weight loss was not significant. All patients had satisfactory surgical recovery and were discharged after an average of 4.6 days. CONCLUSION: In super obesity, preoperative weight loss is an important method for reducing surgical risks. Hospitalization and a hypocaloric diet are safe and effective. After 14 weeks, the weight loss rate stabilized, signaling the time of surgical intervention in our study.

Further psychometric validation of the BODY-Q: ability to detect change following bariatric surgery weight gain and loss.

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Klassen, Anne F; Cano, Stefan J; Kaur, Manraj; Breitkopf, Trisia; Pusic, Andrea L

2017-11-25

Recent systematic reviews have identified that current patient-reported outcome instruments have content limitations when used to measure change following bariatric surgery. The aim of this study was to measure change after bariatric surgery using the BODY-Q, a PRO instrument designed for weight loss and body contouring. The BODY-Q is composed of 18 independently functioning scales and an obesity-specific symptom checklist that measure appearance, health-related quality of life (HR-QOL) and experience of health-care. The sample for this study included patients who were exploring or seeking bariatric surgery in Hamilton (Canada) at the time of the BODY-Q field-test study and who agreed to further contact from the research team. These patients were invited to complete 12 BODY-Q scales and the symptom checklist between 7 June 2016 and 29 November 2016. Data were collected online (REDCap) and via postal surveys. Clinical change was measured using paired t-tests with effect sizes and standardized response means. The survey was completed by 58 of 89 (65%) pre-bariatric participants from the original BODY-Q field-test sample. The non-participants did not differ from participants in terms of age, gender, ethnicity, BMI or initial BODY-Q scale scores. Participants who had undergone bariatric surgery had a mean BMI of 49 (SD = 7) at time 1 and 35 (SD = 7) at time 2. Time since bariatric surgery was on average 2 years (SD = 0.5) (range 0.4 to 3 years). Percentage total weight loss ranged from 12 to 51 (mean 31, SD = 9). The difference in the proportion of patients to report an obesity-specific symptom on the BODY-Q checklist was significantly lower at follow-up for 5 of 10 symptoms. Participants improved on BODY-Q scales measuring appearance (of abdomen, back, body, buttocks, hips/outer thighs, inner thigh), body image and physical function (p weight loss. BODY-Q scales were responsive to measuring clinical change associated with weight loss 2 years after

Executive functions predict weight loss in a medically supervised weight loss programme

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Bond, D.; Gunstad, J.; Pera, V.; Rathier, L.; Tremont, G.

2016-01-01

Summary Background Deficits in executive functions are related to poorer weight loss after bariatric surgery; however, less is known about the role that these deficits may play during participation in nonsurgical weight loss programmes. This study examined associations between objectively measured executive functions and weight loss during participation in a medically supervised weight loss programme. Methods Twenty‐three adult patients (age 50.4 ± 15.1, BMI 44.2 ± 8.8, 68% female, 92% White) enrolled in a medically supervised weight loss programme, involving prescription of a very low calorie diet and strategies to change eating and activity behaviours, underwent comprehensive computerized testing of executive functions at baseline. Weight was obtained at baseline and 8 weeks. Demographic and clinical information were obtained through medical chart review. Results Participants lost an average of 9.8 ± 3.4% of their initial body weight at 8 weeks. Fewer correct responses on a set‐shifting task and faster reaction time on a response inhibition task were associated with lower weight loss percentage at 8 weeks after adjusting for age, education and depressive symptoms. There were no associations between performance on tests of working memory or planning and weight loss. Conclusions This study shows that worse performance on a set‐shifting task (indicative of poorer cognitive flexibility) and faster reaction times on a response inhibition test (indicative of higher impulsivity) are associated with lower weight loss among participants in a medically supervised weight loss programme. Pre‐treatment assessment of executive functions may be useful in identifying individuals who may be at risk for suboptimal treatment outcomes. Future research is needed to replicate these findings in larger samples and identify underlying mechanisms. PMID:28090338

Systematic review of patient education practices in weight loss surgery.

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Groller, Karen D

2017-06-01

Education plays a key role in adherence to lifestyle modifications after weight loss surgery (WLS). Education given before and after surgery may decrease weight recidivism rates and improve outcomes. The purpose of this systematic review was to analyze educational practices in bariatric centers. The Cumulative Index to Nursing and Allied Health and PubMed databases were searched in May 2016 for English-language, peer-reviewed studies about WLS patient education practices from 1999 to 2016. Publications were: (1) rated with the Advancing Research and Clinical Practice through Close Collaboration levels of evidence hierarchy (see Melnyk's pryamid [http://guides.lib.umich.edu/c.php?g=282802&p=1888246]) and (2) analyzed according to surgical phase, curriculum, program delivery, and educator. Twenty-four publications met the study criteria. Evidence ratings for preoperative (n = 16) and postoperative studies (n = 8) were levels I to III (n = 5) and IV to VII (n = 17). Two publications were not ratable. Preoperative and postoperative education programs varied in curriculum, teaching methods, and educator. Topics varied in depth. Commonalities were surgical procedure, nutrition, activity, and psychosocial behaviors. Preoperative education was mostly provided in small groups, whereas individual sessions were used postoperatively. Lecture and discussion provided by myriad of healthcare experts from multiple disciplines were typical in both phases. Written or web-based aides supported learning needs in both phases. WLS patient education varied by curriculum and dose and commonly used passive learning methods (e.g., traditional lecture style instruction with minimal engagement from learners). Results shared can inform future bariatric education programs and accreditation standard development (e.g., Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program patient education standards). Additional study is needed, but existing evidence can guide improvements

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

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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

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

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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.

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

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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

A higher meal frequency may be associated with diminished weight loss after bariatric surgery

OpenAIRE

RIBEIRO, Angela Gadelha; COSTA, Maria José de Carvalho; FAINTUCH, Joel; DIAS, Maria Carolina Gonçalves

2009-01-01

OBJECTIVE: This study aimed to investigate the relationship between meal frequency, the occurrence of vomiting and weight loss among patients submitted to Roux-en-Y gastric bypass up to 9 months after surgery. METHODS: Female patients (n = 80) were followed at 3-month intervals for 9 months. Weight, BMI, 24-hour dietary recall, drug consumption and vomiting episodes were recorded and compared with nutritional outcome. RESULTS: The BMI values at 3, 6 and 9 months were 45.1 ± 9.7, 39.9 ± 7.6 an...

Massive Weight Loss Obtained by Bariatric Surgery Affects Semen Quality in Morbid Male Obesity: a Preliminary Prospective Double-Armed Study.

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Samavat, Jinous; Cantini, Giulia; Lotti, Francesco; Di Franco, Alessandra; Tamburrino, Lara; Degl'Innocenti, Selene; Maseroli, Elisa; Filimberti, Erminio; Facchiano, Enrico; Lucchese, Marcello; Muratori, Monica; Forti, Gianni; Baldi, Elisabetta; Maggi, Mario; Luconi, Michaela

2018-01-01

The aim of this study is to evaluate the effect of massive weight loss on the seminal parameters at 6 months from bariatric surgery. Two-armed prospective study performed in 31 morbidly obese men, undergoing laparoscopic roux-en-Y-gastric bypass (n = 23) or non-operated (n = 8), assessing sex hormones, conventional (sperm motility, morphology, number, semen volume), and non-conventional (DNA fragmentation and seminal interleukin-8), semen parameters, at baseline and after 6 months from surgery or patients' recruitment. In operated patients only, a statistically significant improvement in the sex hormones was confirmed. Similarly, a positive trend in the progressive/total sperm motility and number was observed, though only the increase in semen volume and viability was statistically significant (Δ = 0.6 ml and 10%, P semen volume (r = 0.618, P = 0.015). The massive weight loss obtained with bariatric surgery was associated with an improvement in some semen parameters. The correlations found between weight loss and semen parameter variations after surgery suggest that these might occur early downstream of the testis and more slowly than the changes in the sex hormones.

Loss of control eating and weight outcomes after bariatric surgery: a study with a Portuguese sample

OpenAIRE

Conceição, Eva Martins; Silva, Ana Isabel Pinto Bastos Leite; Brandão, Isabel; Vaz, Ana Rita Rendeiro Ribeiro; Ramalho, Sofia Marlene Marques; Arrojado, Filipa; Costa, José; Machado, Paulo P. P.

2014-01-01

The present study aim is to investigate the frequency of loss of control eating (LOC) episodes in three groups with different assessment times: one before, one at short and one at long-term after bariatric surgery; as well as to explore the association of postoperative problematic eating behaviors and weight outcomes and psychological characteristics. This cross-sectional study compared a group of preoperative bariatric surgery patients (n = 176) and two postoperative groups, one at short-ter...

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

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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

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

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....... In vivo cerebral 5-HT2A receptor and 5-HT transporter binding was determined by positron emission tomography in 21 obese [four men; body mass index (BMI), 40.1 ± 4.1 kg/m(2)] and 10 lean (three men; BMI, 24.6 ± 1.5 kg/m(2)) individuals. Fourteen obese individuals were re-examined after RYGB surgery. First...

Bariatric surgery in young adults : A multicenter study into weight loss, dietary adherence, and quality of life

NARCIS (Netherlands)

de Jong, Marjolein M. C.; Hinnen, Chris

Background: Numerous studies have demonstrated that bariatric surgery is an effective intervention for morbid obesity, but study samples are characterized by an underrepresentation of young adult patients. Objectives: The aim of this study was to evaluate weight loss, dietary adherence, and quality

Preoperative unintended weight loss and low body mass index in relation to complications and length of stay after cardiac surgery

NARCIS (Netherlands)

van Venrooij, Lenny M. W.; de Vos, Rien; Borgmeijer-Hoelen, Mieke M. M. J.; Haaring, Cees; de Mol, Bas A. J. M.

Background: Several studies reported increased adverse outcomes after cardiac surgery in patients with low body mass index (BMI; in kg/m(2)). Little is known yet, however, about the effect of preoperative unintended weight loss (UWL) in cardiac surgery patients. Objective: We explored the prevalence

Preoperative unintended weight loss and low body mass index in relation to complications and length of stay after cardiac surgery

NARCIS (Netherlands)

van Venrooij, Lenny M. W.; de Vos, Rien; Borgmeijer-Hoelen, Mieke M. M. J.; Haaring, Cees; de Mol, Bas A. J. M.

2008-01-01

BACKGROUND: Several studies reported increased adverse outcomes after cardiac surgery in patients with low body mass index (BMI; in kg/m(2)). Little is known yet, however, about the effect of preoperative unintended weight loss (UWL) in cardiac surgery patients. OBJECTIVE: We explored the prevalence

A higher meal frequency may be associated with diminished weight loss after bariatric surgery.

Science.gov (United States)

Ribeiro, Angela Gadelha; Costa, Maria José de Carvalho; Faintuch, Joel; Dias, Maria Carolina Gonçalves

2009-01-01

This study aimed to investigate the relationship between meal frequency, the occurrence of vomiting and weight loss among patients submitted to Roux-en-Y gastric bypass up to 9 months after surgery. Female patients (n = 80) were followed at 3-month intervals for 9 months. Weight, BMI, 24-hour dietary recall, drug consumption and vomiting episodes were recorded and compared with nutritional outcome. The BMI values at 3, 6 and 9 months were 45.1 +/- 9.7, 39.9 +/- 7.6 and 35.4 +/- 8.2 kg/m(2), respectively. The corresponding choleric intakes were 535.6 +/- 295.7, 677.1 +/- 314.7 and 828.6 +/- 398.2 kcal/day, and the numbers of daily meals were 5.0 +/- 2.5, 4.7 +/- 1.8 and 4.9 +/- 1.0, respectively. The peak of vomiting episodes occurred within 6 months; however, patients tolerated this complication despite its high prevalence. A significant negative correlation between weight loss and diet fractioning, but not vomiting, was observed throughout the entire postoperative period (P = 0.001). 1) Frequent small meals were associated with a reduction in weight loss after gastric bypass and a decrease in vomiting episodes at 6 months, and 2) vomiting did not interfere with nutritional outcome. Unless required because of vomiting or other reasons, multiple small meals may not be advantageous after such intervention.

Emotional eating behavior hinders body weight loss in women after Roux-en-Y gastric bypass surgery.

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Novelli, Isabelle Romero; Fonseca, Laís Gomes; Gomes, Daniela Lopes; Dutra, Eliane Said; Baiocchi de Carvalho, Kênia Mara

2018-05-01

Successful weight loss and maintenance after Roux-en-Y gastric bypass (RYGB) may be related to eating behavior. The aim of this study was to assess the eating behavior domains that prevail in women during the RYGB postoperative period and their associations with surgery outcome. This cross-sectional study investigated eating behavior in 95 women (47.3 ± 9.8 y old)  ≥ 2 y after Roux-en-Y gastric bypass. Patients were grouped according to surgery outcome: successful group (SG; n = 67), defined as having lost ≥ 50% of the preoperative excess weight loss (EWL), and an unsuccessful group (UG; n = 28). Mean postoperative time was 59.5 ± 21.2 mo (55.7 ± 19.9 in the SG and 68.6 ± 21.9 in the UG). The short version of the Three-Factor Eating Questionnaire was used to assess cognitive restraint, emotional eating, and uncontrolled eating behaviors. Multivariate analysis was used to investigate associations between eating behavior scores and EWL. The highest score in both groups was for the cognitive restraint domain, followed by emotional and uncontrolled eating. Emotional eating was negatively associated with percentage of EWL (β = -0.286; P = 0.033), regardless of age, educational attainment, and postoperative time. The cognitive restraint domain was the main type of eating behavior observed, and patients with higher emotional eating score were at a higher risk for having insufficient weight loss after RYGB. These results indicate the relevance of monitoring emotional components during the long-term nutritional follow-up of bariatric patients to achieve better surgery outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

Effect of Weight Loss, Diet, Exercise, and Bariatric Surgery on Nonalcoholic Fatty Liver Disease.

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Hannah, William N; Harrison, Stephen A

2016-05-01

Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome. NAFLD is the most common liver disease in developed countries. Weight reduction of 3% to 5% is associated with improved steatosis; reductions of 5% to 7% are necessary for decreased inflammation; with 7% to 10%, individuals may experience NAFLD/NASH remission and regression of fibrosis. No specific dietary intervention has proven beneficial beyond calorie restriction. Physical activity without weight loss seems to decrease hepatic steatosis. Bariatric surgery is associated with decreased cardiovascular risk and improved overall mortality in addition to reduction in hepatic steatosis, inflammation, and fibrosis. Published by Elsevier Inc.

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

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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.

A higher meal frequency may be associated with diminished weight loss after bariatric surgery

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Angela Gadelha Ribeiro

2009-11-01

Full Text Available OBJECTIVE: This study aimed to investigate the relationship between meal frequency, the occurrence of vomiting and weight loss among patients submitted to Roux-en-Y gastric bypass up to 9 months after surgery. METHODS: Female patients (n = 80 were followed at 3-month intervals for 9 months. Weight, BMI, 24-hour dietary recall, drug consumption and vomiting episodes were recorded and compared with nutritional outcome. RESULTS: The BMI values at 3, 6 and 9 months were 45.1 ± 9.7, 39.9 ± 7.6 and 35.4 ± 8.2 kg/m², respectively. The corresponding choleric intakes were 535.6 ± 295.7, 677.1 ± 314.7 and 828.6 ± 398.2 kcal/day, and the numbers of daily meals were 5.0 ± 2.5, 4.7 ± 1.8 and 4.9 ± 1.0, respectively. The peak of vomiting episodes occurred within 6 months; however, patients tolerated this complication despite its high prevalence. A significant negative correlation between weight loss and diet fractioning, but not vomiting, was observed throughout the entire postoperative period (P = 0.001. CONCLUSIONS: 1 Frequent small meals were associated with a reduction in weight loss after gastric bypass and a decrease in vomiting episodes at 6 months, and 2 vomiting did not interfere with nutritional outcome. Unless required because of vomiting or other reasons, multiple small meals may not be advantageous after such intervention.

Expert panel on weight loss surgery: executive report update.

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Blackburn, George L; Hutter, Matthew M; Harvey, Alan M; Apovian, Caroline M; Boulton, Hannah R W; Cummings, Susan; Fallon, John A; Greenberg, Isaac; Jiser, Michael E; Jones, Daniel B; Jones, Stephanie B; Kaplan, Lee M; Kelly, John J; Kruger, Rayford S; Lautz, David B; Lenders, Carine M; Lonigro, Robert; Luce, Helen; McNamara, Anne; Mulligan, Ann T; Paasche-Orlow, Michael K; Perna, Frank M; Pratt, Janey S A; Riley, Stancel M; Robinson, Malcolm K; Romanelli, John R; Saltzman, Edward; Schumann, Roman; Shikora, Scott A; Snow, Roger L; Sogg, Stephanie; Sullivan, Mary A; Tarnoff, Michael; Thompson, Christopher C; Wee, Christina C; Ridley, Nancy; Auerbach, John; Hu, Frank B; Kirle, Leslie; Buckley, Rita B; Annas, Catherine L

2009-05-01

Rapid shifts in the demographics and techniques of weight loss surgery (WLS) have led to new issues, new data, new concerns, and new challenges. In 2004, this journal published comprehensive evidence-based guidelines on WLS. In this issue, we've updated those guidelines to assure patient safety in this fast-changing field. WLS involves a uniquely vulnerable population in need of specialized resources and ongoing multidisciplinary care. Timely best-practice updates are required to identify new risks, develop strategies to address them, and optimize treatment. Findings in these reports are based on a comprehensive review of the most current literature on WLS; they directly link patient safety to methods for setting evidence-based guidelines developed from peer-reviewed scientific publications. Among other outcomes, these reports show that WLS reduces chronic disease risk factors, improves health, and confers a survival benefit on those who undergo it. The literature also shows that laparoscopy has displaced open surgery as the predominant approach; that government agencies and insurers only reimburse procedures performed at accredited WLS centers; that best practice care requires close collaboration between members of a multidisciplinary team; and that new and existing facilities require wide-ranging changes to accommodate growing numbers of severely obese patients. More than 100 specialists from across the state of Massachusetts and across the many disciplines involved in WLS came together to develop these new standards. We expect them to have far-reaching effects of the development of health care policy and the practice of WLS.

Does Weight Gain During the Operation Wait Time Have an Impact on Weight Loss After Laparoscopic Sleeve Gastrectomy?

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Cayci, Haci Murat; Erdogdu, Umut Eren; Karaman, Kerem; Budak, Ersin; Taymur, İbrahim; Buyukuysal, Cagatay

2017-02-01

The effect of preoperative weight changes on postoperative outcomes after bariatric surgery remains inconclusive. The aim of the present study was to evaluate the effect of preoperative weight gain on postoperative weight loss outcomes after laparoscopic sleeve gastrectomy (SG). Ninety-two morbidly obese patients undergoing SG from January 2014 to April 2016 were separated into two groups according to whether they gained weight or not during the waiting time prior to surgery. Thirty-nine patients (42.4 %) gained weight during the waiting time and 53 patients (57.6 %) did not. The median body mass index (BMI; kg/m 2 ) at surgery was significantly higher in weight-gained patients (47.8 (min-max, 40-62)) compared to patients who had not gained weight (45.10 (min-max, 41-67)), (P = 0.034). No significant difference was found between the two groups regarding the distribution of age, gender, family history of obesity, existence of comorbidity, smoking, weight gain during childhood or adulthood, preoperative Beck depression and Beck anxiety scores, waiting time period, and body weight at the initial visit (P > 0.05). The ASA I score was higher in weight-gained patients whereas ASA II score was higher in those who did not gain, and the difference was significant (P = 0.046). Postoperative % BMI loss and % weight loss were not significantly different between the two groups at the first, third, sixth months, and the end of the first year (P > 0.05). Weight gain during waiting time has no negative impact on % weight loss and % BMI loss after SG.

Patient profiling for success after weight loss surgery (GO Bypass study: An interdisciplinary study protocol

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Bodil Just Christensen

2018-06-01

Full Text Available Despite substantial research efforts, the mechanisms proposed to explain weight loss after gastric bypass (RYGB and sleeve gastrectomy (SL do not explain the large individual variation seen after these treatments. A complex set of factors are involved in the onset and development of obesity and these may also be relevant for the understanding of why success with treatments vary considerably between individuals. This calls for explanatory models that take into account not only biological determinants but also behavioral, affective and contextual factors. In this prospective study, we recruited 47 women and 8 men, aged 25–56 years old, with a BMI of 45.8 ± 7.1 kg/m2 from the waiting list for RYGB and SL at Køge hospital, Denmark. Pre-surgery and 1.5, 6 and 18 months after surgery we assessed various endpoints spanning multiple domains. Endpoints were selected on basis of previous studies and include: physiological measures: anthropometrics, vital signs, biochemical measures and appetite hormones, genetics, gut microbiota, appetite sensation, food and taste preferences, neural sensitivity, sensory perception and movement behaviors; psychological measures: general psychiatric symptom-load, depression, eating disorders, ADHD, personality disorder, impulsivity, emotion regulation, attachment pattern, general self-efficacy, alexithymia, internalization of weight bias, addiction, quality of life and trauma; and sociological and anthropological measures: sociodemographic measures, eating behavior, weight control practices and psycho-social factors.Joining these many endpoints and methodologies from different scientific disciplines and creating a multi-dimensional predictive model has not previously been attempted. Data on the primary endpoint are expected to be published in 2018. Trial registration: Clinicaltrials. gov ID NCT02070081. Keywords: Gastric bypass (RYGB, Sleeve gastrectomy, Weight loss, Interdisciplinary, Study protocol

Determinants of weight loss after vertical banded gastroplasty.

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Westerterp, K R; Saris, W H; Soeters, P B; ten Hoor, F

1991-08-01

Weight loss after gastric partition is highly variable even when the operation itself has been successful. We studied changes in body composition in relation to energy expenditure before and one year after surgery in one woman and five men, age 20-38 years, and BMI 42-62 kg/m2. Observations were performed shortly before, and 6, 12, 27 and 54 weeks after surgery. Body composition was measured with hydrostatic weighing and isotope dilution, and energy expenditure over 24 h (24EE) and during complete rest (sleeping metabolic rate (SMR)) with a respiration chamber and in five of the six subjects under daily living conditions over two-week intervals with doubly labeled water (average daily metabolic rate (ADMR). Weight loss and fat loss over the full observation period until 54 weeks after surgery was 54 +/- 8 and 43 +/- 9 kg (mean +/- s.e.m.), respectively. There was a more than three-fold difference in fat loss between the subject losing most, i.e. 70 kg, and the subject losing least, i.e. 20 kg. Fat loss was not related to initial fat mass in this group of six subjects but there was a significant negative relation with the loss of protein mass. There was a strong negative relation between fat loss and activity level of the subjects expressed as the quotient ADMR/SMR. These results show the contrary from what would be expected. Reduction of fat mass after successful gastric partition is highest in those subjects having the lowest physical activity level (before and) after surgery; these subjects lose less fat-free mass.

[Motivation for weight loss among weight loss treatment participants].

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Czeglédi, Edit

2017-12-01

Unrealistic expectations about weight goal and about weight loss-related benefits can hinder the effort for a successful long-term weight control. To explore weight loss-related goals and their background among overweight/obese patients. Study sample consisted of patients who participated in the inpatient weight loss treatment in the Lipidological Department of Szent Imre Hospital (n = 339, 19% men). Mean age: 50.2 years (SD = 13.47 years), mean BMI: 38.6 (SD = 7.58). self-reported anthropometric data, type and number of treated illnesses, Goals and Relative Weights Questionnaire, Motivations for Weight Loss Scale, Body Shape Questionnaire. Participants would feel disappointed with a possible 10% weight loss in a half-year time span. The acceptable weight loss percentage was higher among women, younger participants and among those who had more excess weight. Motivation regarding the increase in social desirability by weight loss is in association with body dissatisfaction, health related motivation is in association with the number of treated illnesses. Our results are contributing to the understanding of motivational factors behind weight reduction efforts, considering these can improve treatment success rates. Orv Hetil. 2017; 158(49): 1960-1967.

Impact of marked weight loss induced by bariatric surgery on bone mineral density and remodeling

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F.A. Pereira

2007-04-01

Full Text Available Data about the impact of bariatric surgery (BS and subsequent weight loss on bone are limited. The objective of the present study was to determine bone mineral density (BMD, bone remodeling metabolites and hormones that influence bone trophism in premenopausal women submitted to BS 9.8 months, on average, before the study (OGg, N = 16. The data were compared to those obtained for women of normal weight (CG, N = 11 and for obese women (OG, N = 12. Eight patients in each group were monitored for one year, with the determination of BMD, of serum calcium, phosphorus, magnesium, parathyroid hormone, 25-hydroxyvitamin D, insulin-like growth factor-I (IGF-I and osteocalcin, and of urinary calcium and deoxypyridinoline. The biochemical determinations were repeated every three months in the longitudinal study and BMD was measured at the end of the study. Parathyroid hormone levels were similar in the three groups. IGF-I levels (CG = 332 ± 62 vs OG = 230 ± 37 vs OGg = 128 ± 19 ng/mL were significantly lower in the operated patients compared to the non-operated obese women. Only OGg patients presented a significant fall in BMD of 6.2% at L1-L4, of 10.2% in the femoral neck, and of 5.1% in the forearm. These results suggest that the weight loss induced by BS is associated with a significant loss of bone mass even at sites that are not influenced by weight overload, with hormonal factors such as IGF-I being associated with this process.

Nutrition Care for Patients with Weight Regain after Bariatric Surgery

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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.

The Impact of Acute Loss of Weight on Eustachian Tube Function

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Pascoto, Gabriela

2014-07-01

Full Text Available Introduction The eustachian tube is one of the key structures responsible for the functional balance of the middle ear. Some clinical conditions associated with tubal malfunction can cause extremely unpleasant symptoms. These symptoms could be triggered by acute loss of weight, for example, after bariatric surgery. Objective To evaluate the frequency and intensity of auditory tube dysfunction symptoms in obese patients after bariatric surgery. Methods Nineteen patients with accepted formal indications for bariatric surgery underwent a hearing evaluation (otoscopy, tonal and vocal audiometry, and impedanceometry and a hearing questionnaire before, at the time of, 3 months after surgery (first postoperative evaluation, and 6 months (second postoperative evaluation after surgery. Patients with a history of ear disease or ear surgery were excluded. Results None of the patients reported tubal dysfunction symptoms before surgery. Postsurgical results showed that 5 (26.3% patients presented symptoms related to dysfunction of the eustachian tube at the first postoperative evaluation. After the 6-month follow-up, 9 (47.3% patients reported symptoms of tubal dysfunction. Conclusion This study suggests that bariatric surgery can cause symptoms of eustachian tube dysfunction, probably due to rapid weight loss and the consequent loss of peritubal fat.

Remifentanil Reduces Blood Loss During Orthognathic Surgery.

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Matsuura, Nobuyuki; Okamura, Taiki; Ide, Satoko; Ichinohe, Tatsuya

2017-01-01

Remifentanil is reported to reduce oral tissue blood flow. We performed a retrospective investigation using logistic regression analysis of anesthesia records to investigate whether the use of remifentanil infusion in a balanced anesthesia technique was useful as a primary technique to reduce blood loss during orthognathic surgery. Subjects were 80 patients who underwent Le Fort I osteotomy and sagittal split ramus osteotomy of the mandible. The variables included gender, age, weight, type of maintenance anesthetic, type and dose or infusion rate of opioid, mean systolic blood pressure (SBP-mean), coefficient of variation of systolic blood pressure (CVSBP) during surgery, mean heart rate (HR-mean), duration of surgery, total blood loss, volume of infusion used, amount of local anesthetic used, body temperature, and urine output. Gender, type of maintenance anesthetic, type of opioid, SBP-mean, CVSBP, HR-mean, and duration of surgery were used as candidates for independent variables. Logistic regression analysis was performed for the selected independent variables with the total blood loss as the dependent variable. The factors associated with the reduction of blood loss were the use of remifentanil (odds ratio, 3.112; 95% CI, 1.166-8.307; P = .023) and smaller CVSBP (odds ratio, 2.747; 95% CI, 1.07-7.053; P = .036). Use of remifentanil and smaller CVSBP were associated with a reduction of blood loss during orthognathic surgery.

Self-reported causes of weight gain: among prebariatric surgery patients.

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Ferguson, Sarah; Al-Rehany, Layla; Tang, Cathy; Gougeon, Lorraine; Warwick, Katie; Madill, Janet

2013-01-01

Bariatric surgery is accepted by the medical community as the most effective treatment for obesity; however, weight regain after surgery remains common. Long-term weight loss and weight maintenance may be aided when dietitians who provide perioperative care understand the causes of weight gain leading to bariatric surgery. In this study, the most common causes for weight gain were examined among prebariatric surgery patients. A retrospective chart review was conducted for 160 patients enrolled in a bariatric surgery program. Data were collected for 20 variables: puberty, pregnancy, menopause, change in living environment, change in job/career, financial problems, quitting smoking, drug or alcohol use, medical condition, surgery, injury affecting mobility, chronic pain, dieting, others' influence over diet, abuse, mental health condition, stress, death of a loved one, divorce/end of a relationship, and other causes. Frequency distribution and chi-square tests were performed using SPSS. Sixty-three percent of participants selected stress as a cause of weight gain, while 56% selected dieting. Significant differences existed between women and men in the selection of dieting and change in living environment. This information may allow dietitians to better identify causes for weight gain leading to bariatric surgery, and to address these causes appropriately before and after surgery.

Effect of bariatric surgery-induced weight loss on renal and systemic inflammation and blood pressure: a 12-month prospective study.

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Fenske, Wiebke K; Dubb, Sukhpreet; Bueter, Marco; Seyfried, Florian; Patel, Karishma; Tam, Frederick W K; Frankel, Andrew H; le Roux, Carel W

2013-01-01

Bariatric surgery improves arterial hypertension and renal function; however, the underlying mechanisms and effect of different surgical procedures are unknown. In the present prospective study, we compared the 12-month follow-up results after Roux-en-Y gastric bypass, laparoscopic adjustable gastric banding, and laparoscopic sleeve gastrectomy on weight loss, hypertension, renal function, and inflammatory status. A total of 34 morbidly obese patients were investigated before, one and 12 months after Roux-en-Y gastric bypass (n = 10), laparoscopic adjustable gastric banding (n = 13), and laparoscopic sleeve gastrectomy (n = 11) for hypertension, kidney function, urinary and serum cytokine levels of macrophage migration inhibitory factor, monocyte chemotactic protein-1, and chemokine ligand-18. At 12 months after surgery, the patients in all 3 treatment arms showed a significant decrease in the mean body mass index, mean arterial pressure, and urinary and serum inflammatory markers (all P .8 mg/L) had a marked improvement in renal function 12 months after surgery (P < .05). Surgically induced weight loss is associated with a marked decrease in renal and systemic inflammation and arterial hypertension and improvement in renal function in patients with pre-existing renal impairment. These effects appear to be independent of surgical procedure. The improvement in renal inflammation could be 1 of the mechanisms contributing to the beneficial effects of bariatric surgery on arterial blood pressure, proteinuria, and renal function. Copyright © 2013 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

The Role of Attachment in Body Weight and Weight Loss in Bariatric Patients.

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Nancarrow, Abigail; Hollywood, Amelia; Ogden, Jane; Hashemi, Majid

2018-02-01

The aim of this study is to explore the role of attachment styles in obesity. The present study explored differences in insecure attachment styles between an obese sample waiting for bariatric surgery (n = 195) and an age, sex and height matched normal weight control group (n = 195). It then explored the role of attachment styles in predicting change in BMI 1 year post bariatric surgery (n = 143). The bariatric group reported significantly higher levels of anxious attachment and lower levels of avoidant attachment than the control non-obese group. Baseline attachment styles did not, however, predict change in BMI post surgery. Attachment style is different in those that are already obese from those who are not. Attachment was not related to weight loss post surgery.

Weight loss for overweight and obese individuals with gout

DEFF Research Database (Denmark)

Nielsen, Sabrina M; Bartels, Else Marie; 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...

Body image concerns amongst massive weight loss patients.

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Gilmartin, Jo

2013-05-01

To explore body image matters amongst patients following massive weight loss. In contemporary health care, a growing number of morbidly obese patients are seeking surgical solutions such as bariatric surgery or in other cases engaging with radical lifestyle changes. Massive weight loss can leave patients with a huge excess of lax overstretched skin that in some cases can trigger major body image dissatisfaction or depression. There is a scarcity of research about the needs of this group of patients and this is important for nursing practice. A qualitative design using in-depth interviews was employed. Twenty white adults (18 women and two men) were recruited retrospectively amongst patients who had massive weight loss by undergoing bariatric surgery or radical lifestyle changes, aged 29-63 years. All of the participants gave signed informed consent. Face-to-face in-depth interviews were conducted and transcribed verbatim. The data were analysed using thematic analysis. One core theme focusing on body image ugliness and three associated subthemes were identified: the subthemes included feeling socially marginalised, feeling depressed and sexual and intimacy difficulties. Body image matters are hugely significant and appear to have a lasting effect on emotional well-being and function, contributing to psychological distress and social isolation. Greater sensitivity is required in enabling patients to work through emotional isolation and shame that has been a part of their childhood. Furthermore more, treatments need to be accessible to this growing patient population such as reconstructive surgery. Nurses who care for massive weight loss patients need to be mindful of their psychodynamic needs and be non-judgemental and accepting. Moreover, nurses need to be aware of treatment options and be able to assess body image matters and implement quality care for this particular patient group including body image acceptance programmes and support groups. © 2013 Blackwell

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...... 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...... 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....

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

Prediction model of critical weight loss in cancer patients during particle therapy.

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Zhang, Zhihong; Zhu, Yu; Zhang, Lijuan; Wang, Ziying; Wan, Hongwei

2018-01-01

The objective of this study is to investigate the predictors of critical weight loss in cancer patients receiving particle therapy, and build a prediction model based on its predictive factors. Patients receiving particle therapy were enroled between June 2015 and June 2016. Body weight was measured at the start and end of particle therapy. Association between critical weight loss (defined as >5%) during particle therapy and patients' demographic, clinical characteristic, pre-therapeutic nutrition risk screening (NRS 2002) and BMI were evaluated by logistic regression and decision tree analysis. Finally, 375 cancer patients receiving particle therapy were included. Mean weight loss was 0.55 kg, and 11.5% of patients experienced critical weight loss during particle therapy. The main predictors of critical weight loss during particle therapy were head and neck tumour location, total radiation dose ≥70 Gy on the primary tumour, and without post-surgery, as indicated by both logistic regression and decision tree analysis. Prediction model that includes tumour locations, total radiation dose and post-surgery had a good predictive ability, with the area under receiver operating characteristic curve 0.79 (95% CI: 0.71-0.88) and 0.78 (95% CI: 0.69-0.86) for decision tree and logistic regression model, respectively. Cancer patients with head and neck tumour location, total radiation dose ≥70 Gy and without post-surgery were at higher risk of critical weight loss during particle therapy, and early intensive nutrition counselling or intervention should be target at this population. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Utilization of Body Contouring Procedures Following Weight Loss Surgery: A Study of 37,806 Patients.

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Altieri, Maria S; Yang, Jie; Park, Jihye; Novikov, David; Kang, Lijuan; Spaniolas, Konstantinos; Bates, Andrew; Talamini, Mark; Pryor, Aurora

2017-11-01

Bariatric surgery has substantial health benefits; however, some patients desire body contouring (BC) procedures following rapid weight loss. There is a paucity of data regarding the true rate of BC following bariatric procedures. The purpose of our study is to examine the utilization of two common procedures, abdominoplasty, and panniculectomy, following bariatric surgery in New York State. The SPARCS longitudinal administrative database was used to identify bariatric procedures by using ICD-9 and CPT codes between 2004 and 2010. Procedures included sleeve gastrectomy, Roux-en-Y gastric bypass, and laparoscopic adjustable gastric banding. Using a unique patient identifier, we tracked those patients who subsequently underwent either abdominoplasty or panniculectomy with at least a 4-year follow-up (until 2014). Multivariable Cox proportional hazard model was used to evaluate predictors of follow-up BC surgery. 37,806 patients underwent bariatric surgery between 2004 and 2010. Only 5.58% (n = 2112) of these patients subsequently had a BC procedure, with 143 of them (6.8%) having ≥1 plastic surgery. The average time to plastic surgery after band, bypass, or sleeve was 1134.83 ± 671.09, 984.70 ± 570.53, and 903.02 ± 497.31 days, respectively (P 80%ile in yearly income were more likely to have plastic surgery after adjusting for age, race/ethnicity, comorbidities and complications (P values plastic surgery is completed by only 6% of patients following bariatric procedures. As insurance and income are associated with pursuing surgery, improved access may increase the number of patients who are able to undergo these reconstructive procedures.

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

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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.

Amiodarone-induced hyperthyroidism during massive weight loss following gastric bypass.

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Bourron, Olivier; Ciangura, Cécile; Bouillot, Jean-Luc; Massias, Laurent; Poitou, Christine; Oppert, Jean-Michel

2007-11-01

Gastric bypass is increasingly used in morbidly obese patients to achieve significant reduction of body weight and fat mass and concurrent improvement in co-morbidities. We report the case of a 53-year-old male patient (141 kg, BMI 50 kg/m2), successfully treated by amiodarone for supraventricular arrythmia, who underwent Roux-en-Y gastric bypass (RYGBP). 6 months after surgery, he had lost 45% of his preoperative weight (44.8% of weight loss was lean mass) and developed amiodarone-induced subclinical hyperthyroidism. We hypothesize the following sequence of events: weight loss after RYGBP, therefore fat loss, decrease in distribution volume of amiodarone inducing iodine overload and hyperthyroidism, reinforcing weight loss and particularly loss of lean mass. This report emphasizes the importance of careful monitoring of weight and body composition changes after RYGBP. In this situation, checking thyroid status is recommended, especially when there is a history of thyroid disease or potentially toxic thyroid medication.

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

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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.

Banding the Sleeve Improves Weight Loss in Midterm Follow-up.

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Fink, Jodok M; Hoffmann, Natalie; Kuesters, Simon; Seifert, Gabriel; Laessle, Claudia; Glatz, Torben; Hopt, Ulrich T; Konrad Karcz, W; Marjanovic, Goran

2017-04-01

Laparoscopic sleeve gastrectomy (LSG) can achieve excellent weight loss, yet sleeve dilatation with concomitant weight regain proves to be a relevant issue. Hence, additional restriction might improve results after LSG. In a retrospective matched-pair analysis, 42 patients who underwent banded LSG (BLSG) using a MiniMizer® ring between January 2012 and October 2014 were analysed regarding weight loss, complications and comorbidity. Median follow-up was 3 years. Forty-two patients who had undergone conventional LSG were selected as matched pairs. Mean preoperative BMI was 54.93 ± 7.42 kg/m 2 for BLSG and 53.46 ± 6.69 kg/m 2 for LSG (Mann-Whitney P = 0.540). Total weight loss (%TWL) was significantly greater in the BLSG group 3 years after surgery (BLSG 38.22% ± 7.26; n = 26 vs. LSG 32.69 ± 9.47; n = 26; P = 0.0154). Ring placement had no relevant impact on new-onset reflux (Fisher's exact test P = 1.0) but a tendency towards reflux improvement when reflux pre-existed (odds ratio 1.96). The major side effect of ring implantation was regurgitation with over 44% of patients presenting with regurgitation >1 per week (Fisher's exact test P = 0.0019, odds ratio 18.07). BLSG is a safe procedure showing similar comorbidity to conventional LSG. However, BLSG leads to a higher rate of postoperative regurgitation. Weight loss is significantly improved 3 years after surgery. Hence, additional ring implantation might be an option for increased restriction in LSG surgery.

Weight loss and weight loss maintenance efficacy of a novel weight loss program: The retrospective RNPC® cohort

DEFF Research Database (Denmark)

Thorning, Tanja Kongerslev; Fabre, Odile; Legrand, Rémy

2018-01-01

or obese patients treated in 54 RNPC® weight loss clinics in France. Results: A total of 10,809 (89%) patients completed the initial weight loss phase and 2996 (25%) completed the full program. Median weight loss percentage was 10.7% (Interquartile range [IQR]: 5.8; 16.5) after a median of 105 days (IQR...

Trends in Weight Regain Following Roux-en-Y Gastric Bypass (RYGB) Bariatric Surgery.

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Cooper, Timothy C; Simmons, Elizabeth B; Webb, Kirsten; Burns, James L; Kushner, Robert F

2015-08-01

The primary purpose of this study was to assess weight loss and occurrence of weight regain among patients who underwent Roux-en-Y gastric bypass (RYGB) using categorical analysis. Study participants were selected from patients who underwent RYGB from a single institution. Participants (n = 300, mean procedure age = 45.6 ± 9.9) completed surveys for self-reported preoperative weight, current weight, and subsequent weights over postoperative years. Measured weights and confirmed procedure dates were acquired from patient medical records. Mean preoperative weight and BMI were 140.8 kg ± 32.1 and 49.7 ± 9.9, respectively, and mean years since surgery was 6.9 ± 4.9. Study subjects were mostly Caucasian (56.7 %) and female (80.3 %). Participants were stratified a priori into four cohorts based on percent of weight loss at 1 year, 35 % (n = 113). General linear model analyses were conducted to assess the effect of year one weight loss on percent weight regain. The mean weight regain for all patients was 23.4 % of maximum weight loss. Using categorical analysis, mean weight regain in the 35 % weight loss cohorts was 29.1, 21.9, 20.9, and 23.8 %, respectively. Excessive weight regain, defined as ≥25 % of total lost weight, occurred in 37 % of patients. Weight gain is a common complication following RYGB surgery. Despite the percentage of weight loss over the first year, all cohort patient groups regained on average between 21 and 29 % of lost weight. Excessive weight gain was experienced by over one third of patients. Greater initial absolute weight loss leads to more successful long-term weight outcomes.

Mediation of Weight Loss and Weight Loss Maintenance through Dietary Disinhibition and Restraint.

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JaKa, Meghan M; Sherwood, Nancy E; Flatt, Shirley W; Pacanowski, Carly R; Pakiz, Bilgé; Thomson, Cynthia A; Rock, Cheryl L

2015-04-01

Understanding the degree to which eating behaviors, such as disinhibition and restraint, are associated with weight loss and weight loss maintenance could contribute to further refinement of effective weight management intervention strategies. The purpose of this analysis was to examine if these factors mediate weight loss or weight loss maintenance using data from a randomized controlled trial testing a commercial weight loss program that delivered behavioral counseling and structured meal plans including prepackaged foods. Mediation analyses were used to examine whether changes in disinhibition and restraint mediated the relationship between intervention and weight change during initial weight loss (0-6 months), continued weight loss (6-12 months), or weight loss maintenance (12-24 months) phases. Only decreases in disinhibition between baseline and 6 months mediated the intervention effect on initial weight loss. Our results suggest the mediation effects of these eating behaviors are modest and other factors contribute to a larger, more complex long-term weight loss prognosis.

Early weight loss predicts weight loss treatment response regardless of binge-eating disorder status and pretreatment weight change.

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Barnes, Rachel D; Ivezaj, Valentina; Pittman, Brian P; Grilo, Carlos M

2018-04-10

Individuals seeking weight loss treatment have diverse pretreatment weight trajectories, and once enrolled, individuals' response to weight loss treatments also varies greatly and may be influenced by the presence of binge-eating disorder (BED). Reported average weight losses may obscure these considerable differences. This study examined whether BED status and different weight-related change variables are associated with successful weight loss treatment outcomes in a controlled treatment study. Participants (N = 89) with overweight/obesity, with and without BED, participated in a 3-month weight loss trial in primary care with 3- and 12-month follow-ups. We tested the prognostic significance of four weight-related change variables (the last supper, early weight loss, pretreatment weight trajectory, weight suppression) on outcomes (weight loss-overall, weight loss-"subsequent," weight loss during second half of treatment). Early weight loss was positively associated with weight loss-overall at post-treatment, and at 3-month and 12-month follow-up. Early weight loss was positively associated with weight loss-subsequent at post-treatment only. No other weight-related variables were significantly associated with weight loss. Models including BED status and treatment condition were not significant. Participants with early weight loss were more likely to continue losing weight, regardless of BED status or treatment condition. The results highlight the importance of early dedication to weight loss treatment to increase the likelihood of positive outcomes. © 2018 Wiley Periodicals, Inc.

The Work behind Weight-Loss Surgery: A Qualitative Analysis of Food Intake after the First Two Years Post-Op.

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Geraci, Angela A; Brunt, Ardith; Marihart, Cindy

2014-01-01

Purpose. Obesity has reached epidemic proportions in the U.S. and has nearly doubled worldwide since 1980. Bariatric surgery is on the rise, but little focus has been placed on the psychosocial impacts of surgery. The purpose of this study was to explore experiences of patients who have undergone bariatric surgery at least two years before to gain an understanding of the successes and challenges they have faced since surgery. Methods. This study used a phenomenological approach, to investigate the meaning and essence of bariatric patients with food after surgery. Semi-structured interviews were conducted on a sample of nine participants who had undergone surgery at least two years prior. Findings. Two main themes regarding food intake emerged from the data: (a) food after the first year post-surgery and (b) bariatric surgery is not a magic pill. Upon further analysis, food after the first year post-surgery had four subthemes emerge: diet adherence after the first year post-surgery, food intolerances, amount of food, and tendencies toward coping with food do not magically disappear. Conclusion. Findings revealed that post-operative diet and exercise adherence becomes increasingly difficult as weight loss slows. Many participants find that only after the first year after surgery the work really begins.

Psychological, behavioral, and weight-related aspects of patients undergoing reoperative bariatric surgery after gastric band: comparison with primary surgery patients.

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Conceição, Eva; Pinto-Bastos, Ana; de Lourdes, Marta; Brandão, Isabel; Teixeira, Cristina; Machado, Paulo P P

2018-02-15

Patients experiencing insufficient weight loss or weight regain in their first bariatric surgery may represent a high-risk group with greater problematic eating and general psychopathology levels, which may compromise the success of a reoperative procedure. This study seeks to describe and compare disordered eating-related psychological and behavioral features of primary and reoperative surgery candidates after gastric band. Hospital center and university in Portugal. The baseline (preoperative) data from a longitudinal observational study are presented. Patients were interviewed by trained psychologists to identify binge-eating episodes and grazing and responded to a set of self-report measures: disordered eating, grazing, negative urgency, depression, anxiety, and stress. Two hundred twenty-five patients were undergoing primary surgery, and 166 were undergoing reoperative (REOP group) surgery. The groups did not differ in body mass index preoperatively, but the REOP group had greater weight suppression (t 387 = -5.35, P = .001), higher highest (t 387 = -3.40, P = .001) and lower lowest body mass index (t 381 = 2.22, P = .03). The main reasons for reoperative surgery were weight regain/poor weight loss (42.8%) or medical complications (32.5%). REOP patients with objective binge eating reported a higher frequency of these episodes (t 47 = 2.15, P = .04). No significant difference was found for the self-report measures assessed (only shape concern was higher for REOP group, F 1,216 = 8.30, Psurgeries, the differences in binge eating and weight-related variables may associate with postoperative difficulties. The link between binge eating, weight suppression, and weight gain found in other samples suggests that patients undergoing reoperative surgery may be at increased risk for poor weight outcomes. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Popular Weight Loss Strategies: a Review of Four Weight Loss Techniques.

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Obert, Jonathan; Pearlman, Michelle; Obert, Lois; Chapin, Sarah

2017-11-09

The purpose of this paper is to review the epidemiology of obesity and the most recent literature on popular fad diets and exercise regimens that are used for weight loss. The weight loss plans that will be discussed in this article include juicing or detoxification diets, intermittent fasting, the paleo diet, and high intensity training. Despite the growing popularity of fad diets and exercise plans for weight loss, there are limited studies that actually suggest these particular regimens are beneficial and lead to long-term weight loss. Juicing or detoxification diets tend to work because they lead to extremely low caloric intake for short periods of time, however tend to lead to weight gain once a normal diet is resumed. Both intermittent fasting and the paleo diet lead to weight loss because of overall decreased caloric intake as well. Lastly, studies on short bursts of high intensity training have shown remarkable weight loss and improvements in cardiovascular health. Review of the literature does suggest that some fad diets and exercise plans do lead to weight loss; however, the studies are quite limited and are all based on the concept of caloric restriction.

Influence of depressive and eating disorders on short- and long-term course of weight after surgical and nonsurgical weight loss treatment.

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Legenbauer, Tanja; Petrak, Frank; de Zwaan, Martina; Herpertz, Stephan

2011-01-01

To investigate the influence of depressive and eating disorders on short- and long-term weight loss after surgical and non-surgical weight-reduction treatment. Covariations between the disorders were considered. In a longitudinal naturalistic study, current diagnoses at baseline and lifetime diagnoses of depressive and eating disorders were assessed in participants who were undertaking a very-low-calorie diet (n = 250) and in bariatric surgery patients (n = 153). Lifetime diagnosis of a mental disorder was defined as presence of a mental disorder only in the past. Body weight was measured at baseline, 1 year after baseline, and 4 years after baseline. Mental comorbidity was assessed through use of standardized interviews at baseline. A structural equation modeling procedure was applied to test the associations between course of weight and mental disorders. Analyses were based on the intention to treat samples. Missing values were replaced by use of multiple imputation procedures. Neither depression nor eating disorders were associated with weight changes at the 1-year follow-up, but a specific effect emerged for bariatric surgery patients after 4 years: depression (current and lifetime) predicted smaller body mass index loss, whereas lifetime diagnosis of eating disorder was associated with greater weight loss. Individuals who report depressive disorders prior to bariatric surgery should be monitored more closely in order to identify patients who would benefit from additional therapy with the goal of improving weight-loss outcome. Copyright © 2011 Elsevier Inc. All rights reserved.

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...

Preoperative factors and 3-year weight change in the Longitudinal Assessment of Bariatric Surgery (LABS) consortium.

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Courcoulas, Anita P; Christian, Nicholas J; O'Rourke, Robert W; Dakin, Greg; Patchen Dellinger, E; Flum, David R; Melissa Kalarchian, Ph D; Mitchell, James E; Patterson, Emma; Pomp, Alfons; Pories, Walter J; Spaniolas, Konstantinos; Steffen, Kristine; Wolfe, Bruce M; Belle, Steven H

2015-01-01

Limited data guide the prediction of weight loss success or failure after bariatric surgery according to presurgery factors. There is significant variation in weight change after bariatric surgery and much interest in identifying preoperative factors that may contribute to these differences. This report evaluates the associations of a comprehensive set of baseline factors and 3-year weight change. Ten hospitals in 6 geographically diverse clinical centers in the United States. Adults undergoing a first bariatric surgical procedure as part of clinical care by participating surgeons were recruited between 2006 and 2009. Participants completed research assessments utilizing standardized and detailed data collection on over 100 preoperative and operative parameters for individuals undergoing Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric banding (LAGB). Weight was measured 3 years after surgery. Percent weight change for RYGB or LAGB from baseline to 3 years was analyzed as both a continuous and dichotomous outcome with cut points at 25% for RYGB and 10% for LAGB. Multivariable linear and logistic regression models were used to identify independent baseline predictors of the continuous and categorical outcomes, respectively. The median weight loss 3 years after surgery for RYGB (n = 1513) participants was 31.5% (IQR: 24.6%-38.4%; range, 59.2% loss to .9% gain) of baseline weight and 16.0% (IQR: 8.1%-23.1%; range, 56.1% loss to 12.5% gain) for LAGB (n = 509) participants. The median age was 46 years for RYGB and 48 years for LAGB; 80% of RYGB participants and 75% of LAGB participants were female; and the median baseline body mass index (BMI) was 46 kg/m(2) for RYGB and 44 kg/m(2) for LAGB. For RYGB, black participants lost 2.7% less weight compared with whites and participants with diabetes at baseline had 3.7% less weight loss at year 3 than those without diabetes at baseline. There were small but statistically significant differences in weight

Preoperative Factors and Three Year Weight Change in the Longitudinal Assessment of Bariatric Surgery (LABS) Consortium

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Courcoulas, Anita P.; Christian, Nicholas J.; O’Rourke, Robert W.; Dakin, Greg; Dellinger, E. Patchen; Flum, David Reed; Kalarchian, Melissa; Mitchell, James E.; Patterson, Emma; Pomp, Alfons; Pories, Walter J.; Spaniolas, Konstantinos; Steffen, Kristine; Wolfe, Bruce M.; Belle, Steven H.

2015-01-01

BACKGROUND Limited data guide the prediction of weight loss success or failure following bariatric surgery according to pre-surgery factors. There is significant variation in weight change following bariatric surgery and much interest in identifying pre-operative factors that may contribute to these differences. OBJECTIVE This report evaluates the associations of a comprehensive set of baseline factors and three-year weight change. SETTING Ten hospitals in six geographically diverse clinical centers in the United States. METHODS: PARTICIPANTS and INTERVENTIONS Adults undergoing a first bariatric surgical procedure as part of clinical care by participating surgeons were recruited between 2006 and 2009. Participants completed research assessments utilizing standardized and detailed data collection on over 100 preoperative and operative parameters for individuals undergoing Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric banding (LAGB). Weight was measured 3 years following surgery. METHODS: MAIN OUTCOME MEASURES Percent weight change for RYGB or LAGB from baseline to 3 years was analyzed as both a continuous and dichotomous outcome with cut points at 25% for RYGB and 10% for LAGB. Multivariable linear and logistic regression models were used to identify independent baseline predictors of the continuous and categorical outcomes, respectively. RESULTS The median weight loss 3 years following surgery for RYGB (n=1513) participants was 31.5% (IQR: 24.6%–38.4%; range, 59.2% loss to 0.9% gain) of baseline weight and 16.0% (IQR: 8.1%–23.1%; range, 56.1% loss to 12.5% gain) for LAGB (n=509) participants. The median age was 46 years for RYGB and 48 years for LAGB; 80% of RYGB participants and 75% of LAGB participants were female; and the median baseline Body Mass Index (BMI) was 46 kg/m2 for RYGB and 44 kg/m2 for LAGB. For RYGB, Black participants lost 2.7% less weight compared to Whites and participants with diabetes at baseline had 3.7% less weight

Body contouring following massive weight loss

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Vijay Langer

2011-01-01

Full Text Available Obesity is a global disease with epidemic proportions. Bariatric surgery or modified lifestyles go a long way in mitigating the vast weight gain. Patients following these interventions usually undergo massive weight loss. This results in redundant tissues in various parts of the body. Loose skin causes increased morbidity and psychological trauma. This demands various body contouring procedures that are usually excisional. These procedures are complex and part of a painstaking process that needs a committed patient and an industrious plastic surgeon. As complications in these patients can be quite frequent, both the patient and the surgeon need to be aware and willing to deal with them.

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

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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.

Proven Weight Loss Methods

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Fact Sheet Proven Weight Loss Methods What can weight loss do for you? Losing weight can improve your health in a number of ways. It can lower ... at www.hormone.org/Spanish . Proven Weight Loss Methods Fact Sheet www.hormone.org

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

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Leahey, Tricia M; Kumar, Rajiv; Weinberg, Brad M; Wing, Rena R

2012-07-01

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 (SURI) 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 weight loss and/or physical activity. Overweight/obese (OW/OB) individuals (N = 3,330; 76% female; age = 46.1 ± 10.8; BMI = 31.2 ± 5.3 kg/m(2)), representing 987 teams, completed the weight loss program. Multilevel modeling was used to examine whether weight loss clustered among teammates and whether percentage of teammates in the weight loss division and reported teammate influence on weight loss were associated with individual weight outcomes. OW/OB completers reported losing 4.2 ± 3.4% of initial body weight. Weight loss was similar among teammates (intraclass correlation coefficient (ICC) = 0.10, P social influence for weight loss were associated with greater percent weight loss (P's ≤ 0.002). Similarly, achieving a clinically significant (5%) weight loss tended to cluster within teams (ICC = 0.09; P social influence for weight loss were associated with increased likelihood of achieving a 5% weight loss (odds ratio (OR) = 1.06; OR = 1.20, respectively). These results suggest that teammates affect weight loss outcomes during a team-based intervention. Harnessing and maximizing teammate influence for weight loss may enhance weight outcomes in large-scale team-based programs.

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

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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.

Best Practice Updates for Pediatric/Adolescent Weight Loss Surgery

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Pratt, Janey S.A.; Lenders, Carine M.; Dionne, Emily A.; Hoppin, Alison G.; Hsu, George L.K.; Inge, Thomas H.; Lawlor, David F.; Marino, Margaret F.; Meyers, Alan F.; Rosenblum, Jennifer L.; Sanchez, Vivian M.

2011-01-01

The objective of this study is to update evidence-based best practice guidelines for pediatric/adolescent weight loss surgery (WLS). We performed a systematic search of English-language literature on WLS and pediatric, adolescent, gastric bypass, laparoscopic gastric banding, and extreme obesity published between April 2004 and May 2007 in PubMed, MEDLINE, and the Cochrane Library. Keywords were used to narrow the search for a selective review of abstracts, retrieval of full articles, and grading of evidence according to systems used in established evidence-based models. In light of evidence on the natural history of obesity and on outcomes of WLS in adolescents, guidelines for surgical treatment of obesity in this age group need to be updated. We recommend modification of selection criteria to include adolescents with BMI ≥ 35 and specific obesity-related comorbidities for which there is clear evidence of important short-term morbidity (i.e., type 2 diabetes, severe steatohepatitis, pseudotumor cerebri, and moderate-to-severe obstructive sleep apnea). In addition, WLS should be considered for adolescents with extreme obesity (BMI ≥ 40) and other comorbidities associated with long-term risks. We identified >1,085 papers; 186 of the most relevant were reviewed in detail. Regular updates of evidence-based recommendations for best practices in pediatric/adolescent WLS are required to address advances in technology and the growing evidence base in pediatric WLS. Key considerations in patient safety include carefully designed criteria for patient selection, multidisciplinary evaluation, choice of appropriate procedure, thorough screening and management of comorbidities, optimization of long-term compliance, and age-appropriate fully informed consent. PMID:19396070

Changes in Weight and Comorbidities among Adolescents Undergoing Bariatric Surgery: 1-Year Results from the Bariatric Outcomes Longitudinal Database

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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, Psurgery types (Psurgery. 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

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...

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

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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.

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

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

2013-08-01

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

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

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

2013-01-01

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

Can Hypocaloric, High-Protein Nutrition Support Be Used in Complicated Bariatric Patients to Promote Weight Loss?

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Beebe, Mara Lee; Crowley, Nina

2015-08-01

Bariatric surgery, an effective treatment for morbid obesity, may result in complications that require nutrition support. Common goals for nutrition support in post-bariatric surgery patients include nutrition repletion, avoiding overfeeding, preserving lean body mass, and promoting wound healing. It is often questioned if continued weight loss can be part of the nutrition goals and if weight loss is safe for patients who become critically ill following bariatric surgery. Recent clinical practice guidelines from both the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) and Society of Critical Care Medicine (SCCM) have recommended the use of hypocaloric, high-protein nutrition support in both critically and non-critically ill obese patients. Hypocaloric feedings of 50%-70% of estimated energy requirements based on predictive equations or obesity. Two small studies in complicated post-bariatric surgery patients requiring nutrition support have shown that the strategy of hypocaloric, high-protein feedings can result in positive outcomes, including positive nitrogen balance, wound healing, weight loss, and successful transition to oral diets. Additional research, including large, randomized studies, is still needed to validate these findings. However, based on a review of available clinical practice guidelines, predictive equations, indirect calorimetry, case studies, and systematic reviews, hypocaloric, high-protein nutrition support appears to at least be equal to eucaloric feedings and may be a useful tool for clinicians to achieve continued weight loss in complicated bariatric surgery patients requiring nutrition support. © 2015 American Society for Parenteral and Enteral Nutrition.

Quality of life among obese patients seeking weight loss surgery: the importance of obesity-related social stigma and functional status.

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Wee, Christina C; Davis, Roger B; Huskey, Karen W; Jones, Daniel B; Hamel, Mary B

2013-02-01

Obesity is a stigmatizing condition associated with adverse psychosocial consequences. The relative importance of weight stigma in reducing health utility or the value a person places on their current health state is unknown. We conducted a telephone survey of patients with obesity. All were seeking weight loss surgery at two bariatric centers (70 % response rate). We assessed patients' health utility (preference-based quality life measure) via a series of standard gamble scenarios assessing patients' willingness to risk death to lose various amounts of weight or achieve perfect health (range 0 to 1; 0 = death and 1 = most valued health/weight state). Multivariable models assessed associations among quality of life domains from the Short-form 36 (SF-36) and Impact of Weight on Quality of Life-lite (IWQOL-lite) and patients' health utility. Our study sample (n = 574) had a mean body mass index of 46.5 kg/m(2) and a mean health utility of 0.87, reflecting the group's average willingness to accept a 13 % risk of death to achieve their most desired health/weight state; utilities were highly variable, however, with 10 % reporting a utility of 1.00 and 27 % reporting a utility lower than 0.90. Among the IWQOL-lite subscales, Public Distress and Work Life were the only two subscales significantly associated with patients' utility after adjustment for sociodemographic factors. Among the SF-36 subscales, Role Physical, Physical Functioning, and Role Emotional were significantly associated with patients' utility. When the leading subscales on both IWQOL-lite and SF-36 were considered together, Role Physical, Public Distress, and to a lesser degree Role Emotional remained independently associated with patients' health utility. Patients seeking weight loss surgery report health utilities similar to those reported for people living with diabetes or with laryngeal cancer; however, utility values varied widely with more than a quarter of patients willing to accept more than a

Obstructive Sleep Apnoea Syndrome and Weight Loss: Review

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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.

The role of proximal versus distal stomach resection in the weight loss seen after vertical sleeve gastrectomy

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Kulkarni, Bhushan V.; LaSance, Kathleen; Sorrell, Joyce E.; Lemen, Lisa; Woods, Stephen C.; Seeley, Randy J.

2016-01-01

The mechanisms involved in the weight loss seen after vertical sleeve gastrectomy (VSG) are not clear. The rat stomach has two morphologically and functionally distinct proximal and distal parts. The rat model for VSG involves complete removal of the proximal part and 80% removal of the distal part along the greater curvature. The purpose of this study was to understand the potential independent contributions of removal of these distinct gastric sections to VSG outcomes. We prepared four surgical groups of male Long-Evans rats: VSG, sham surgery (control), selective proximal section removal (PR), and selective distal section removal (DR). Gastric emptying rate (GER) was highest after VSG compared with all other groups. However, PR, in turn, had significantly greater GER compared with both DR and sham groups. The surgery-induced weight loss followed the same pattern with VSG causing the greatest weight loss and PR having greater weight loss compared with DR and sham groups. The results were robust for rats fed regular chow or a high-fat diet. Body mass analysis revealed that the weight loss was due to the loss of fat mass, and there was no change in lean mass after the surgeries. In conclusion, removal of the proximal stomach contributes to most, but not all, of the physiological impact of VSG. PMID:27581811

Effectiveness of bariatric surgery in reducing weight and body mass index among Hispanic adolescents.

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De La Cruz-Muñoz, Nestor; Lopez-Mitnik, Gabriela; Arheart, Kristopher L; Miller, Tracie L; Lipshultz, Steven E; Messiah, Sarah E

2013-02-01

Ethnic minority adolescents, Hispanics in particular, are disproportionately affected by extreme obesity and its associated co-morbidities. Bariatric surgery is one of the few effective treatments for morbid obesity, yet little information about weight outcomes after surgery in this demographic are available. We determined the effectiveness of bariatric surgery in reducing weight and body mass index (BMI) in adolescents, a majority of whom were non-Mexican American Hispanic and originated from Central and/or South America and the Caribbean Basin region. Adolescents (16-to-19 years old) who had undergone gastric bypass or adjustable gastric band surgery between 2001 and 2010 and who had complete follow-up data available (91 %) were included in the analysis. Mean weight and BMI before and 1-year after surgery were compared. Among 71 adolescents (80 % Hispanic, 77 % female), mean BMI and weight, and z-scores and percentile transformations were all significantly lower after surgery for the entire sample (P surgery showed significantly better weight loss outcomes for all anthropometric measures versus adjustable gastric band surgery (P surgery. Our results show that bariatric surgery, gastric bypass procedure in particular, can markedly reduce weight among a predominantly Hispanic adolescent patient sample. These findings indicate that bariatric surgery has the potential to be safe and effective in substantially reducing weight in a group of adolescents who are at a particularly high risk for obesity-related health consequences.

Executive function in weight loss and weight loss maintenance: a conceptual review and novel neuropsychological model of weight control.

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Gettens, Katelyn M; Gorin, Amy A

2017-10-01

Weight loss maintenance is a complex, multifaceted process that presents a significant challenge for most individuals who lose weight. A growing body of literature indicates a strong relationship between cognitive dysfunction and excessive body weight, and suggests that a subset of high-order cognitive processes known as executive functions (EF) likely play an important role in weight management. Recent reviews cover neuropsychological correlates of weight status yet fail to address the role of executive function in the central dilemma of successful weight loss maintenance. In this paper, we provide an overview of the existing literature examining executive functions as they relate to weight status and initial weight loss. Further, we propose a novel conceptual model of the relationships between EF, initial weight loss, and weight loss maintenance, mapping specific executive functions onto strategies known to be associated with both phases of the weight control process. Implications for the development of more efficacious weight loss maintenance interventions are discussed.

Overweight, Obesity, and Weight Loss

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... Back to section menu Healthy Weight Weight and obesity Underweight Weight, fertility, and pregnancy Weight loss and ... section Home Healthy Weight Healthy Weight Weight and obesity Underweight Weight, fertility, and pregnancy Weight loss and ...

The longitudinal trajectory of post-surgical % total weight loss among middle-aged women who had undergone bariatric surgery

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Dong-Chul Seo

2017-03-01

Full Text Available Middle-aged women are at a higher risk of being obese. We examined the trajectory of post-surgical % total weight loss (%TWL among middle-aged female bariatric patients. We fitted sequential generalized estimating equations models to analyze a sample of women who received bariatric surgery in 1995–2012, aged 40–65 years at the time of surgery (N = 158,292 whose pre-operative body mass index (BMI was ≥30 kg/m2 in the Bariatric Outcomes Longitudinal Database. The %TWL computed by 100% × (pre-surgery BMI − post-surgery BMI / pre-surgery BMI showed different trajectories depending on type of surgery. For gastric banding, %TWL increased rapidly right after bariatric surgery and started to decrease around 1 year after surgery. For Roux-en-Y gastric bypass (RYGB and sleeve gastrectomy, %TWL overall did not show remarkable changes from around 1 year after surgery. The highest increase in %TWL was observed in patients whose pre-operative BMI was 40 or higher and those who had undergone RYGB (ps < 0.001. Whereas the trajectories of %TWL among patients with sleeve gastrectomy and gastric banding did not differ much between different pre-operative BMI groups, the trajectories for RYGB were notably different between different pre-operative BMI groups (ps < 0.001. Middle-aged female bariatric patients are likely to achieve the highest %TWL if they receive RYGB and if their pre-operative BMI is 40 or higher. Further research is warranted to corroborate the present study's finding on the long-term effect of different types of bariatric surgery on %TWL among middle-aged women.

Formal Nutritional Education Improves Weight Loss in Bariatric Patients Following Laparoscopic Sleeve Gastrectomy.

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Mangieri, Christopher Wesley; Strode, Matthew A

2016-12-01

Laparoscopic sleeve gastrectomy (LSG) is an increasingly performed procedure in the bariatric surgery armamentarium. This study evaluates our experience with LSG at Dwight D. Eisenhower Army Medical Center (DDEAMC) during the time period of 2008-2010. We found that the inclusion of formal nutritional education significantly increased our weight loss results following LSG. This is a retrospective review from our LSG caseload from 2008 to 2010. During that time, we performed 159 LSG. In our review, we performed comparative data of all operative years during 2008-2010 for up to 3 years postoperatively. Our main focus was in regard to weight loss as measured by percentage of excess body weight loss (%EWL), percentage of total weight loss (%TWL), and percentage of excess BMI loss (%EBL). We also evaluated the effect of LSG on diabetes mellitus (DM) and hypertension (HTN) postoperatively. We found an improvement in our %EWL, %TWL, and %EBL rates in our LSG cases following the inclusion of formal nutritional education. There was a mean increase in %EWL of 15 %, %TWL of 7 %, and %EBL of 21 %, which were statistically significant, that was present at all postoperative years of follow-up. We determined the only variable that changed in our bariatric program starting in 2010 was the inclusion of formal nutritional education. We also found a statistically significant improvement in resolution of HTN with the inclusion of formal nutritional education. The addition of formal nutritional education can enhance weight loss following bariatric surgery. We have shown a significant improvement in weight loss results following LSG with the implementation of formal nutritional education; this is the only study to our knowledge evaluating formal nutritional education and LSG.

Bariatric Surgery Promising in Migraine Control: a Controlled Trial on Weight Loss and Its Effect on Migraine Headache.

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Razeghi Jahromi, Soodeh; Abolhasani, Maryam; Ghorbani, Zeinab; Sadre-Jahani, Solmaz; Alizadeh, Zahra; Talebpour, Mohammad; Meysamie, Alipasha; Togha, Mansoureh

2018-01-01

There is evidence that substantial weight loss through bariatric surgery (BS) may result in short-term improvement of migraine severity. However, it still remains to be seen whether smaller amounts of weight loss have a similar effect on migraine headache. This study has been designed to compare the effects of weight reduction through BS and non-surgical modifications. Migraine characteristics were assessed at 1 month before (T0), 1 month (T1), and 6 months (T2) after BS (vertical sleeve gastrectomy (VSG) (n = 25) or behavioral therapy (BT) (n = 26) in obese women (aged 18-60 years) with migraine headache. Migraine was diagnosed using the International Classification of Headache Disorders (ICHDIIβ) criteria. There was significant reduction in the visual analog scale (VAS) from the baseline to T1 and T2 in both groups. The number of migraine-free days showed a significant increase within each group (p migraine characteristics, age, changes in weight, BMI, body fat, and fat-free mass from T0 to T2, the BS group showed statistically significant lower VAS and duration of migraine attacks and a significantly higher number of migraine-free days than the BT group at T1 and T2 (p ≤ 0.028). Our results indicated that far before significant weight reduction after BS (VSG), there was marked alleviation in the severity and duration of migraine and a significant increase in the number of migraine-free days in obese female migraineurs. However, the effects in the BT group were not comparable with the effects in the BS group.

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

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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.

[Understanding depressive symptoms after bariatric surgery: the role of weight, eating and body image].

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Sousa, Paula; Bastos, Ana Pinto; Venâncio, Carla; Vaz, Ana Rita; Brandão, Isabel; Costa, José Maia; Machado, Paulo; Conceição, Eva

2014-01-01

Depressive symptoms have been reported as prevalent after bariatric surgery. This study aims to analyze the role of weight, eating behaviors and body image in depressive symptomatology in bariatric surgery patients assessed post-operatively. This is a cross-sectional study including 52 bariatric surgery patients assessed post-operatively with a follow-up time ranging from 22 to 132 months. Psychological assessment included a clinical interview (Eating Disorder Examination) to assess eating disorders psychopathology, and three self-report measures: Outcome Questionnaire 45--general distress; Beck Depression Inventory--depressive symptoms; and Body Shape Questionnaire--body image. Our data show that depressive symptoms after surgery are associated with loss of control over eating, increased concerns with body image, and body mass index regain. Multiple linear regressions was tested including these variables and showed that body mass index regain after surgery, loss of control over eating and concerns with body image significantly explained 50% of the variance of post-operative depressive symptoms, being the concern with body image the most significant variable: greater dissatisfaction with body image was associated with more depressive symptoms. The results of this study showed that a subgroup of patients presents a significant weight gain after bariatric surgery, which is associated with episodes of loss of control over eating, concerns with body image and depressive symptoms. These results stress the relevance of body image concerns after surgery and the importance of clinically addressing these issues to optimize psychological functioning after bariatric surgery.

Two year reduction in sleep apnea symptoms and associated diabetes incidence after weight loss in severe obesity.

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Grunstein, Ronald R; Stenlöf, Kaj; Hedner, Jan A; Peltonen, Markku; Karason, Kristjan; Sjöström, Lars

2007-06-01

To evaluate the effect of bariatric surgery on sleep apnea symptoms and obesity-associated morbidity in patients with severe obesity. Prospective study. University hospitals and community centers in Sweden. We investigated the influence of weight loss surgery (n=1729) on sleep apnea symptoms and obesity-related morbidity using a conservatively treated group (n=1748) as a control. Baseline BMI in surgical group (42.2+/-4.4 kg/m(2)) and control group (40.1+/-4.6 kg/m(2)) changed -9.7+/-5 kg/m(2) and 0+/-3 kg/m(2), respectively, at 2-year follow-up. In the surgery group, there was a marked improvement in all obstructive sleep apnea (OSA) symptoms compared with the control group (P sleep apnea symptoms at 2 years. Despite adjustment for weight change and baseline central obesity, subjects reporting loss of OSA symptoms had a lower 2-year incidence of diabetes and hypertriglyceridemia. Improvement in OSA in patients losing weight may provide health benefits in addition to weight loss alone.

Nutritional Approaches to Achieve Weight Loss in Nonalcoholic Fatty Liver Disease.

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Hsu, Christine C; Ness, Erik; Kowdley, Kris V

2017-03-01

Nonalcoholic fatty liver disease (NAFLD) can range in spectrum from simple hepatic steatosis to nonalcoholic steatohepatitis (NASH), which is characterized by lipotoxicity, hepatocellular ballooning, and inflammation and can progress to cirrhosis. Weight loss is the cornerstone treatment for NAFLD and NASH. Various randomized controlled trials have shown that weight loss of ≥5-10% leads to significant improvements in hepatic steatosis. Diets high in sodium and fructose have been implicated in the pathogenesis of NAFLD. Although some clinical studies suggest that an isocaloric high-fructose diet does not worsen NAFLD, these clinical studies are often short in duration. More recently, the Dietary Approaches to Stop Hypertension diet, a sodium-restricted diet, has been associated with less prevalence of NAFLD and has been shown to improve NAFLD. In addition, the Mediterranean diet has been promising in improving hepatic steatosis, and a larger randomized controlled trial is currently enrolling subjects. For those who are unable to pursue weight loss through dietary approaches, bariatric surgery has been shown to improve hepatic steatosis and steatohepatitis. This method has been variable in improving hepatic fibrosis. In conclusion, weight loss is crucial to the improvement of NAFLD and NASH, and patients should attempt various diets in an attempt to achieve weight loss. © 2017 American Society for Nutrition.

Initial Weight Loss after Restrictive Bariatric Procedures May Predict Mid-Term Weight Maintenance: Results From a 12-Month Pilot Trial

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Nikolić, Marko; Kruljac, Ivan; Kirigin, Lora; Mirošević, Gorana; Ljubičić, Neven; Nikolić, Borka Pezo; Bekavac-Bešlin, Miroslav; Budimir, Ivan; Vrkljan, Milan

2015-01-01

Background: Bariatric procedures are effective options for weight loss (WL) in the morbidly obese. However, some patients fail to lose any weight after bariatric surgery, and mid-term weight maintenance is variable. The aim of this study was to investigate whether initial WL could predict mid-term weight maintenance. ----- Methods: Eighty patients were enrolled, of whom 44 were treated with the BioEnterics Intragastric Balloon (BIB), 21 with laparoscopic adjustable gastric lap-banding (LAGB),...

Adolescent weight history and adult cognition: before and after bariatric surgery.

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Spitznagel, Mary Beth; Alosco, Michael; Inge, Thomas H; Rochette, Amber; Strain, Gladys; Devlin, Michael; Crosby, Ross D; Mitchell, James E; Gunstad, John

2016-06-01

Cognitive deficits occur in a subset of individuals with obesity. Deficits can be reversed with bariatric surgery, though cognitive recovery is not equally exhibited across patients. Recent work has found that obesity during adolescence portends medical complications in adulthood; it is unknown if obesity in adolescence predicts adult cognition or cognitive recovery after weight loss surgery. The present study examines the relationship between weight history and cognitive function in obese adults undergoing bariatric surgery. Academic medical centers with bariatric care services. Seventy-eight bariatric surgery patients (mean age = 43.2 years) enrolled in an ancillary study to the Longitudinal Assessment of Bariatric Surgery (LABS) project completed a questionnaire recalling weight history at age 18. Cognitive testing was completed preoperatively and at 12-month follow-up. Weight status at age 18 was linked to performance in several aspects of cognition. Higher body mass index at age 18 predicted poorer preoperative verbal fluency (B = -.26, P = .045) as well as postoperative cognitive recovery in attention (B = -.30, P = .01) at 12-month follow-up. Higher body mass index at age 18 predicts verbal fluency performance in adults with obesity, as well as postoperative recovery of attention after bariatric surgery. The mechanisms underlying this connection are not fully clear, though findings may reflect effects of obesity on the brain during a crucial period of neural maturation or duration of obesity and cumulative impact of co-morbidities on cognition. Future work examining possible causal factors involved in these relationships is needed. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Hypnotherapy in Weight Loss Treatment.

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Cochrane, Gordon; Friesen, John

1986-01-01

Investigated effects of hypnosis as a treatment for weight loss among women. The primary hypothesis that hypnosis is an effective treatment for weight loss was confirmed, but seven concomitant variables and the use of audiotapes were not significant contributors to weight loss. (Author/ABB)

Comparison of glucostatic parameters after hypocaloric diet or bariatric surgery and equivalent weight loss.

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Plum, Leona; Ahmed, Leaque; Febres, Gerardo; Bessler, Marc; Inabnet, William; Kunreuther, Elizabeth; McMahon, Donald J; Korner, Judith

2011-11-01

Weight-loss independent mechanisms may play an important role in the improvement of glucose homeostasis after Roux-en-Y gastric bypass (RYGB). The objective of this analysis was to determine whether RYGB causes greater improvement in glucostatic parameters as compared with laparoscopic adjustable gastric banding (LAGB) or low calorie diet (LCD) after equivalent weight loss and independent of enteral nutrient passage. Study 1 recruited participants without type 2 diabetes mellitus (T2DM) who underwent LAGB (n = 8) or RYGB (n = 9). Study 2 recruited subjects with T2DM who underwent LCD (n = 7) or RYGB (n = 7). Insulin-supplemented frequently-sampled intravenous glucose tolerance test (fsIVGTT) was performed before and after equivalent weight reduction. MINMOD analysis of insulin sensitivity (Si), acute insulin response to glucose (AIRg) and C-peptide (ACPRg) response to glucose, and insulin secretion normalized to the degree of insulin resistance (disposition index (DI)) were analyzed. Weight loss was comparable in all groups (7.8 ± 0.4%). In Study 1, significant improvement of Si, ACPRg, and DI were observed only after LAGB. In Study 2, Si, ACPRg, and plasma adiponectin increased significantly in the RYGB-DM group but not in LCD. DI improved in both T2DM groups, but the absolute increase was greater after RYGB (258.2 ± 86.6 vs. 55.9 ± 19.9; P diet at equivalent weight loss in T2DM subjects. Such a beneficial effect was not observed in nondiabetic subjects at this early time-point.

Effects of intestinal bypass surgery on appetite, food intake, and body weight in obese and lean rats.

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Sclafani, A; Koopmans, H S; Vasselli, J R; Reichman, M

1978-04-01

Jejunoileal bypass surgery or sham surgery was performed in female rats made obese with ventromedial hypothalamic (VMH) knife cuts, and in lean control rats. After bypass surgery, the VMH rats underate and lost weight until they reached the body weight of the control sham rats, and they then maintained their weight at control levels. Bypass surgery in lean rats produced much smaller reductions in food intake and body weight. Both bypass groups initially consumed less of a sucrose solution and milk diet during 1 h/day tests, but their intakes returned to near normal levels during the second postoperative month. Reconnection of the intestinal tract in the VMH-bypass rats led to renewed hyperphagia and return to obese body weights. A second experiment revealed that bypass surgery reduces food intake and body weight in genetically obese (fatty) rats, but this effect is not as pronounced as that displayed by VMH rats. These results confirm recent clinical observations that reduced appetite and caloric intake are the major causes of the weight loss produced by intestinal bypass surgery.

Weight-loss surgery and children

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... to the extra body weight. The body mass index (BMI) measures below are used by many doctors ... Saunders; 2015:chap 29. Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the ...

Weight loss and bone mineral density.

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Hunter, Gary R; Plaisance, Eric P; Fisher, Gordon

2014-10-01

Despite evidence that energy deficit produces multiple physiological and metabolic benefits, clinicians are often reluctant to prescribe weight loss in older individuals or those with low bone mineral density (BMD), fearing BMD will be decreased. Confusion exists concerning the effects that weight loss has on bone health. Bone density is more closely associated with lean mass than total body mass and fat mass. Although rapid or large weight loss is often associated with loss of bone density, slower or smaller weight loss is much less apt to adversely affect BMD, especially when it is accompanied with high intensity resistance and/or impact loading training. Maintenance of calcium and vitamin D intake seems to positively affect BMD during weight loss. Although dual energy X-ray absorptiometry is normally used to evaluate bone density, it may overestimate BMD loss following massive weight loss. Volumetric quantitative computed tomography may be more accurate for tracking bone density changes following large weight loss. Moderate weight loss does not necessarily compromise bone health, especially when exercise training is involved. Training strategies that include heavy resistance training and high impact loading that occur with jump training may be especially productive in maintaining, or even increasing bone density with weight loss.

Effect of weight loss on urinary incontinence in women

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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

The weight-loss experience: a qualitative exploration

Directory of Open Access Journals (Sweden)

David Rogerson

2016-05-01

Full Text Available Abstract Background Long-term weight management consists of weight-loss, weight-loss maintenance, and weight-gain stages. Qualitative insights into weight management are now appearing in the literature however research appears to be biased towards explorations of weight-loss maintenance. The qualitative understanding of weight loss, which begets weight-loss maintenance and might establish the experiences and behaviours necessary for successful long-term weight management, is comparatively under-investigated. The aim of this study was to investigate the weight-loss experiences of a sample of participants not aligned to clinical intervention research, in order to understand the weight-loss experiences of a naturalistic sample. Methods Participants (n = 8 with weight-loss (n = 4 and weight-maintenance experiences (n = 4 were interviewed using a semi-structured interview to understand the weight-loss experience. Interview data was analysed thematically using Framework Analysis and was underpinned by realist meta-theory. Results Weight loss was experienced as an enduring challenge, where factors that assisted weight loss were developed and experienced dichotomously to factors that hindered it. Participants described barriers to (dichotomous thinking, environments, social pressures and weight centeredness and facilitators of (mindfulness, knowledge, exercise, readiness to change, structure, self-monitoring and social support their weight-loss goals in rich detail, highlighting that weight loss was a complex experience. Conclusions Weight loss was a difficult task, with physical, social, behavioural and environmental elements that appeared to assist and inhibit weight-loss efforts concurrently. Health professionals might need to better understand the day-to-day challenges of dieters in order to provide more effective, tailored treatments. Future research should look to investigate the psycho-social consequences of weight-loss dieting, in

Nutritional Approaches to Achieve Weight Loss in Nonalcoholic Fatty Liver Disease123

Science.gov (United States)

Hsu, Christine C; Ness, Erik; Kowdley, Kris V

2017-01-01

Nonalcoholic fatty liver disease (NAFLD) can range in spectrum from simple hepatic steatosis to nonalcoholic steatohepatitis (NASH), which is characterized by lipotoxicity, hepatocellular ballooning, and inflammation and can progress to cirrhosis. Weight loss is the cornerstone treatment for NAFLD and NASH. Various randomized controlled trials have shown that weight loss of ≥5–10% leads to significant improvements in hepatic steatosis. Diets high in sodium and fructose have been implicated in the pathogenesis of NAFLD. Although some clinical studies suggest that an isocaloric high-fructose diet does not worsen NAFLD, these clinical studies are often short in duration. More recently, the Dietary Approaches to Stop Hypertension diet, a sodium-restricted diet, has been associated with less prevalence of NAFLD and has been shown to improve NAFLD. In addition, the Mediterranean diet has been promising in improving hepatic steatosis, and a larger randomized controlled trial is currently enrolling subjects. For those who are unable to pursue weight loss through dietary approaches, bariatric surgery has been shown to improve hepatic steatosis and steatohepatitis. This method has been variable in improving hepatic fibrosis. In conclusion, weight loss is crucial to the improvement of NAFLD and NASH, and patients should attempt various diets in an attempt to achieve weight loss. PMID:28298270

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

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.......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....

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.

Improvement in Obstructive Sleep Apnea With Weight Loss is Dependent on Body Position During Sleep.

Science.gov (United States)

Joosten, Simon A; Khoo, Jun K; Edwards, Bradley A; Landry, Shane A; Naughton, Matthew T; Dixon, John B; Hamilton, Garun S

2017-05-01

Weight loss fails to resolve obstructive sleep apnea (OSA) in most patients; however, it is unknown as to whether weight loss differentially affects OSA in the supine compared with nonsupine sleeping positions. We aimed to determine if weight loss in obese patients with OSA results in a greater reduction in the nonsupine apnea/hypopnea index (AHI) compared with the supine AHI, thus converting participants into supine-predominant OSA. Post hoc analysis of data from a randomized controlled trial assessing the effect of weight loss (bariatric surgery vs. medical weight loss) on OSA in 60 participants with obesity (body mass index: >35 and sleep study at 2 years. Eight of 37 (22%) patients demonstrated a normal nonsupine AHI (sleep avoidance may cure their OSA. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

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. © 2012 The Authors. Clinical Obesity © 2012 International Association for the Study of Obesity.

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

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

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.

The Effect of Adherence to Dietary Tracking on Weight Loss: Using HLM to Model Weight Loss over Time.

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Ingels, John Spencer; Misra, Ranjita; Stewart, Jonathan; Lucke-Wold, Brandon; Shawley-Brzoska, Samantha

2017-01-01

The role of dietary tracking on weight loss remains unexplored despite being part of multiple diabetes and weight management programs. Hence, participants of the Diabetes Prevention and Management (DPM) program (12 months, 22 sessions) tracked their food intake for the duration of the study. A scatterplot of days tracked versus total weight loss revealed a nonlinear relationship. Hence, the number of possible tracking days was divided to create the 3 groups of participants: rare trackers (66% total days tracked). After controlling for initial body mass index, hemoglobin A 1c , and gender, only consistent trackers had significant weight loss (-9.99 pounds), following a linear relationship with consistent loss throughout the year. In addition, the weight loss trend for the rare and inconsistent trackers followed a nonlinear path, with the holidays slowing weight loss and the onset of summer increasing weight loss. These results show the importance of frequent dietary tracking for consistent long-term weight loss success.

The impact of selected factors on parameters of weight loss after sleeve gastrectomy.

Science.gov (United States)

Binda, Artur; Jaworski, Paweł; Kudlicka, Emilia; Ciesielski, Adam; Cabaj, Hubert; Tarnowski, Wiesław

2016-01-01

The effectiveness of sleeve gastrectomy has been confirmed in many studies. The impact of individual factors on the parameters of weight loss is still not clear. To identify important factors affecting the parameters of weight loss after sleeve gastrectomy. The impact of prognostic factors and postoperative care components on body mass index (BMI) and percentage excess weight loss (%EWL) was assessed in a group of 100 consecutive patients who underwent laparoscopic sleeve gastrectomy. The baseline BMI and body mass in patients with BMI < 30 kg/m 2 and BMI ≥ 30 kg/m 2 12 months after surgery were, respectively, 39.7 ±3.2 vs. 45.9 ±4.6 kg/m 2 , p < 0.0001, and 114.4 ±16.8 vs. 130.3 ±18.5 kg, p < 0.0001. In the group with EWL < 50%, the average age was 47.1 ±7.7 vs. 40.6 ±10.8 in the group with EWL ≥ 50%, p = 0.0025. In the group of patients with preoperative weight loss, %EWL was 61.4 ±17.2 vs. 53.3 ±19.3% in the group with no weight loss, p = 0.0496. Body mass index of the patients who started physical activities was 30.6 ±4.2 kg/m 2 vs. 34.0 ±5.6 kg/m 2 in the patients with no physical activity, p = 0.0013, and %EWL was 63.4 ±14.6 vs. 47.0 ±19.9%, p < 0.0001, respectively. In the case of patients regularly consulted by a dietician BMI was 30.6 ±4.2 kg/m 2 vs. 35.1 ±5.5 kg/m 2 in the group without systematic consultations, p < 0.0001, and %EWL was 63.1 ±15.1% vs. 42.3 ±18.2%, p < 0.0001. Lower baseline body weight parameters, younger age, preoperative weight loss, starting systematic physical activities and constant care of a dietician were conducive to achieving better results of surgery, as assessed on the basis of changes in BMI and %EWL.

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

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...

Ain't no mountain high enough? Setting high weight loss goals predict effort and short-term weight loss.

Science.gov (United States)

De Vet, Emely; Nelissen, Rob M A; Zeelenberg, Marcel; De Ridder, Denise T D

2013-05-01

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 positive psychological and behavioral outcomes. Hereto, 447 overweight and obese participants trying to lose weight completed two questionnaires with a 2-month interval. Many participants set goals that could be considered unrealistically high. However, higher weight loss goals did not predict dissatisfaction but predicted more effort in the weight loss attempt, as well as more self-reported short-term weight loss when baseline commitment and motivation were controlled for.

Weight Loss

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... Rights Employment Discrimination Health Care Professionals Law Enforcement Driver's License For Lawyers Food & Fitness Home Food MyFoodAdvisor ... Fit Types of Activity Weight Loss Assess Your Lifestyle Getting Started Food Choices In My Community Home ...

Early post-operative psychosocial and weight predictors of later outcome in bariatric surgery: a systematic literature review.

Science.gov (United States)

Hindle, A; de la Piedad Garcia, X; Brennan, L

2017-03-01

This is the first systematic review to synthesize the evidence concerning early post-operative variables predictive of later weight and psychosocial outcomes in bariatric surgery. Eight electronic databases for empirical studies were searched (1954 to 2016). Most of the 39 included studies reported solely on weight outcomes; eating and psychosocial outcomes were less common. A better early weight loss trajectory was the most consistent predictor of more successful medium-term weight outcome (≤24 months); however, its relationship to longer term weight loss maintenance is less certain. Early eating adaptation may be associated with later weight loss, but further research is needed. Evidence is lacking for associations between early adherence or early psychosocial variables and later outcome. In particular, the relationship between early post-operative depression and later weight remains unclear. Little research has considered early prediction of later eating or psychosocial outcomes. Consideration of mediating or moderating relationships is lacking. The body of evidence is limited, and synthesis is hampered by heterogeneity in the type and time at which predictors and outcomes are measured and quality of statistical reporting. Further research on prospective prediction of bariatric surgery outcome is needed to guide early post-operative intervention for those at greatest risk of poor outcomes. © 2017 World Obesity Federation.

Inflammatory status is different in relationship to insulin resistance in severely obese people and changes after bariatric surgery or diet-induced weight loss.

Science.gov (United States)

Ballesteros-Pomar, M D; Calleja, S; Díez-Rodríguez, R; Calleja-Fernández, A; Vidal-Casariego, A; Nuñez-Alonso, A; Cano-Rodríguez, I; Olcoz-Goñi, J L

2014-11-01

To assess if insulin resistance is related to a different inflammatory status (especially lymphocyte subpopulations) in severely obese people and to evaluate changes after weight loss either following a very-low calorie diet (VLCD) or bariatric surgery. Severely obese patients were consecutively recruited in our Obesity Unit. Blood lymphocyte subpopulations and inflammatory parameters were measured baseline, after a VLCD during 6 weeks and one year after biliopancreatic diversion. Insulin resistance was evaluated by Homeostasis Model Assessment (HOMA) index. After excluding diabetic patients, 58 patients were studied. HOMA index classified 63.8% of them as insulin resistant (IR). Serum baseline levels of inflammatory cytokines were not significantly different between IR and insulinsensitive (IS) patients but, regarding lymphocyte subpopulations, Natural Killer (NK) cells were higher in IR patients [(305.0 (136.7) vs. 235.0 (80.7) cells/µL, p=0.047]. NK cells showed a significant positive correlation with HOMA index (r=0.484, p=0.000) and with the carbohydrate content of the diet (r=0.420, p=0.001). After VLCD, NK cells significantly decreased, but only in IR patients and in those losing more than 10% of their initial weight. After biliopancreatic diversion, total and CD8 T Lymphocytes, B lymphocytes and NK cells also decreased but only in IR individuals. NK cells are significantly increased in IR severely obese people in respect to IS, suggesting a slightly different immune status in these patients with a probable dietary relationship. Weight loss could reverse this increase either after VLCD or after bariatric surgery. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.

Personality as a Predictor of Weight Loss Maintenance after Surgery for Morbid Obesity

NARCIS (Netherlands)

Larsen, J.K.; Geenen, R.; Maas, C.J.M.; Wit, P. de; Antwerpen, T. van; Brand, N.; Ramshorst, B. van

2004-01-01

Objective: 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. Research Methods and

Perioperative Vision Loss in Cervical Spinal Surgery.

Science.gov (United States)

Gabel, Brandon C; Lam, Arthur; Chapman, Jens R; Oskouian, Rod J; Nassr, Ahmad; Currier, Bradford L; Sebastian, Arjun S; Arnold, Paul M; Hamilton, Steven R; Fehlings, Michael G; Mroz, Thomas E; Riew, K Daniel

2017-04-01

Retrospective multicenter case series. To assess the rate of perioperative vision loss following cervical spinal surgery. Medical records for 17 625 patients from 21 high-volume surgical centers from the AOSpine North America Clinical Research Network who received cervical spine surgery (levels from C2 to C7) between January 1, 2005, and December 31, 2011, inclusive, were reviewed to identify occurrences of vision loss following surgery. Of the 17 625 patients in the registry, there were 13 946 patients assessed for the complication of blindness. There were 9591 cases that involved only anterior surgical approaches; the remaining 4355 cases were posterior and/or circumferential fusions. There were no cases of blindness or vision loss in the postoperative period reported during the sampling period. Perioperative vision loss following cervical spinal surgery is exceedingly rare.

38 CFR 4.112 - Weight loss.

Science.gov (United States)

2010-07-01

.... The term “inability to gain weight” means that there has been substantial weight loss with inability... 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...

Early-treatment weight loss predicts 6-month weight loss in women with obesity and depression: implications for stepped care.

Science.gov (United States)

Waring, Molly E; Schneider, Kristin L; Appelhans, Bradley M; Busch, Andrew M; Whited, Matthew C; Rodrigues, Stephanie; Lemon, Stephenie C; Pagoto, Sherry L

2014-05-01

Some adults with comorbid depression and obesity respond well to lifestyle interventions while others have poor outcomes. The objective of this study was to evaluate whether early-treatment weight loss progress predicts clinically significant 6-month weight loss among women with obesity and depression. We conducted a secondary analysis of data from 75 women with obesity and depression who received a standard lifestyle intervention. Relative risks (RRs) and 95% confidence intervals (CIs) for achieving ≥5% weight loss by 6 months were calculated based on whether they achieved ≥1 lb/week weight loss in weeks 2-8. Among those on target at week 3, we examined potential subsequent time points at which weight loss progress might identify additional individuals at risk for treatment failure. At week 2, women who averaged ≥1 lb/week loss were twice as likely to achieve 5% weight loss by 6 months than those who did not (RR=2.40; 95% CI: 2.32-4.29); weight loss at weeks 3-8 was similarly predictive (RRs=2.02-3.20). Examining weight loss progress at week 3 and subsequently at a time point during weeks 4-8, 52-67% of participants were not on target with their weight loss, and those on target were 2-3 times as likely to achieve 5% weight loss by 6 months (RRs=1.82-2.92). Weight loss progress as early as week 2 of treatment predicts weight loss outcomes for women with comorbid obesity and depression, which supports the feasibility of developing stepped care interventions that adjust treatment intensity based on early progress in this population. Copyright © 2014 Elsevier Inc. All rights reserved.

Bariatric Surgery and Precision Nutrition.

Science.gov (United States)

Nicoletti, Carolina F; Cortes-Oliveira, Cristiana; Pinhel, Marcela A S; Nonino, Carla B

2017-09-06

This review provides a literature overview of new findings relating nutritional genomics and bariatric surgery. It also describes the importance of nutritional genomics concepts in personalized bariatric management. It includes a discussion of the potential role bariatric surgery plays in altering the three pillars of nutritional genomics: nutrigenetics, nutrigenomics, and epigenetics. We present studies that show the effect of each patient's genetic and epigenetic variables on the response to surgical weight loss treatment. We include investigations that demonstrate the association of single nucleotide polymorphisms with obesity phenotypes and their influence on weight loss after bariatric surgery. We also present reports on how significant weight loss induced by bariatric surgery impacts telomere length, and we discuss studies on the existence of an epigenetic signature associated with surgery outcomes and specific gene methylation profile, which may help to predict weight loss after a surgical procedure. Finally, we show articles which evidence that bariatric surgery may affect expression of numerous genes involved in different metabolic pathways and consequently induce functional and taxonomic changes in gut microbial communities. The role nutritional genomics plays in responses to weight loss after bariatric surgery is evident. Better understanding of the molecular pathways involved in this process is necessary for successful weight management and maintenance.

Bariatric Surgery and Precision Nutrition

Directory of Open Access Journals (Sweden)

Carolina F. Nicoletti

2017-09-01

Full Text Available This review provides a literature overview of new findings relating nutritional genomics and bariatric surgery. It also describes the importance of nutritional genomics concepts in personalized bariatric management. It includes a discussion of the potential role bariatric surgery plays in altering the three pillars of nutritional genomics: nutrigenetics, nutrigenomics, and epigenetics. We present studies that show the effect of each patient’s genetic and epigenetic variables on the response to surgical weight loss treatment. We include investigations that demonstrate the association of single nucleotide polymorphisms with obesity phenotypes and their influence on weight loss after bariatric surgery. We also present reports on how significant weight loss induced by bariatric surgery impacts telomere length, and we discuss studies on the existence of an epigenetic signature associated with surgery outcomes and specific gene methylation profile, which may help to predict weight loss after a surgical procedure. Finally, we show articles which evidence that bariatric surgery may affect expression of numerous genes involved in different metabolic pathways and consequently induce functional and taxonomic changes in gut microbial communities. The role nutritional genomics plays in responses to weight loss after bariatric surgery is evident. Better understanding of the molecular pathways involved in this process is necessary for successful weight management and maintenance.

Bariatric Surgery and Precision Nutrition

Science.gov (United States)

Nicoletti, Carolina F.; Cortes-Oliveira, Cristiana; Pinhel, Marcela A. S.; Nonino, Carla B.

2017-01-01

This review provides a literature overview of new findings relating nutritional genomics and bariatric surgery. It also describes the importance of nutritional genomics concepts in personalized bariatric management. It includes a discussion of the potential role bariatric surgery plays in altering the three pillars of nutritional genomics: nutrigenetics, nutrigenomics, and epigenetics. We present studies that show the effect of each patient’s genetic and epigenetic variables on the response to surgical weight loss treatment. We include investigations that demonstrate the association of single nucleotide polymorphisms with obesity phenotypes and their influence on weight loss after bariatric surgery. We also present reports on how significant weight loss induced by bariatric surgery impacts telomere length, and we discuss studies on the existence of an epigenetic signature associated with surgery outcomes and specific gene methylation profile, which may help to predict weight loss after a surgical procedure. Finally, we show articles which evidence that bariatric surgery may affect expression of numerous genes involved in different metabolic pathways and consequently induce functional and taxonomic changes in gut microbial communities. The role nutritional genomics plays in responses to weight loss after bariatric surgery is evident. Better understanding of the molecular pathways involved in this process is necessary for successful weight management and maintenance. PMID:28878180

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.

2017-01-01

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 Organization’s Health and Work Performance Questionnaire) at baseline and postintervention. Twenty-two percent of the participants lost a clinically meaningful amount of weight (≥5% weight loss). There were no statistically significant (p absenteeism or for absolute or relative presenteeism. Within a modestly successful Internet-based, worksite weight loss intervention, weight loss did not improve self-reported absenteeism or presenteeism. Further studies are needed to explore the sensitivity of the World Health Organization’s Health and Work Performance Questionnaire and the long-term effects of weight loss on productivity. PMID:25842385

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

2015-12-01

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 Organization's Health and Work Performance Questionnaire) at baseline and postintervention. Twenty-two percent of the participants lost a clinically meaningful amount of weight (≥5% weight loss). There were no statistically significant (p absenteeism or for absolute or relative presenteeism. Within a modestly successful Internet-based, worksite weight loss intervention, weight loss did not improve self-reported absenteeism or presenteeism. Further studies are needed to explore the sensitivity of the World Health Organization's Health and Work Performance Questionnaire and the long-term effects of weight loss on productivity. © 2015 Society for Public Health Education.

Loss of control eating and eating disorders in adolescents before bariatric surgery.

Science.gov (United States)

Utzinger, Linsey M; Gowey, Marissa A; Zeller, Meg; Jenkins, Todd M; Engel, Scott G; Rofey, Dana L; Inge, Thomas H; Mitchell, James E

2016-10-01

This study assessed loss of control (LOC) eating and eating disorders (EDs) in adolescents undergoing bariatric surgery for severe obesity. Preoperative baseline data from the Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) multisite observational study (n = 242; median BMI = 51 kg/m 2 ; mean age= 17; 76% female adolescents; 72% Caucasian) included anthropometric and self-report questionnaires, including the Questionnaire of Eating and Weight Patterns-Revised (QEWP-R), the Night Eating Questionnaire (NEQ), the Beck Depression Inventory (BDI-II), and the Impact of Weight on Quality of Life-Kids (IWQOL-Kids) RESULTS: LOC eating (27%) was common and ED diagnoses included binge-eating disorder (7%), night eating syndrome (5%), and bulimia nervosa (1%). Compared to those without LOC eating, those with LOC eating reported greater depressive symptomatology and greater impairment in weight-related quality of life. Before undergoing bariatric surgery, adolescents with severe obesity present with problematic disordered eating behaviors and meet diagnostic criteria for EDs. LOC eating, in particular, was associated with several negative psychosocial factors. Findings highlight targets for assessment and intervention in adolescents before bariatric surgery. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2016; 49:947-952). © 2016 Wiley Periodicals, Inc.

Effect of weight loss on sympatho-vagal balance in subjects with grade-3 obesity: restrictive surgery versus hypocaloric diet.

Science.gov (United States)

Pontiroli, Antonio E; Merlotti, Claudia; Veronelli, Annamaria; Lombardi, Federico

2013-12-01

Few and mostly uncontrolled studies indicate that weight loss improves heart rate variability (HRV) in grade-3 obesity. The aim of this study was to compare in grade-3 obesity surgery and hypocaloric diet on clinical and metabolic variables and on autonomic indices of HRV. Twenty-four subjects (body mass index, BMI 45.5 ± 9.13 kg/m(2)) underwent surgery (n = 12, gastric banding, LAGB) or received hypocaloric diet (n = 12, 1,000-1,200 kg/day). Clinical [BMI, systolic blood pressure (SBP) and diastolic blood pressure (DBP), heart rate] and metabolic variables [glucose, cholesterol, HDL- and LDL-cholesterol, triglycerides, AST and ALT transaminases] and 24-h Holter electrocardiographic-derived HRV parameters [R-R interval, standard deviation of R-R intervals (SDNN); low/high-frequency (LF/HF) ratio, and QT interval] were measured at baseline and after 6 months. The two groups were identical at baseline. BMI (-7.5 ± 3.57 kg/m(2), mean ± SD), glucose (-24.1 ± 26.77 mg/dL), SBP (-16.7 ± 22.19 mmHg) and DBP (-6.2 ± 8.56 mmHg) decreased in LAGB subjects (p < 0.05) and remained unchanged in controls. At 6 months, SDNN increased in LAGB subjects (+25.0 ± 37.19 ms, p < 0.05) and LF/HF ratio diminished (2.9 ± 1.84 vs. 4.9 ± 2.78; p = 0.01), with no change in controls; LF (daytime) and HF (24 h and daytime) increased in LAGB subjects, with no change in controls. Decrease in BMI correlated with SBP and DBP decrease (p < 0.05), and DBP decrease correlated with HR decrease (p < 0.05) and QT shortening (p < 0.05). Weight loss is associated with improvement of glucose metabolism, of blood pressure, and with changes in time and frequency domain parameters of HRV; all these changes indicate recovery of a more physiological autonomic control, with increase in parasympathetic and reduction in sympathetic indices of HRV.

Surgically Induced Interpregnancy Weight Loss and Prevalence of Overweight and Obesity in Offspring

DEFF Research Database (Denmark)

Willmer, Mikaela; Berglind, Daniel; Sørensen, Thorkild I.A.

2013-01-01

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....

Tailoring dietary approaches for weight loss.

Science.gov (United States)

Gardner, C D

2012-07-01

Although the 'Low-Fat' diet was the predominant public health recommendation for weight loss and weight control for the past several decades, the obesity epidemic continued to grow during this time period. An alternative 'low-carbohydrate' (Low-Carb) approach, although originally dismissed and even vilified, was comparatively tested in a series of studies over the past decade, and has been found in general to be as effective, if not more, as the Low-Fat approach for weight loss and for several related metabolic health measures. From a glass half full perspective, this suggests that there is more than one choice for a dietary approach to lose weight, and that Low-Fat and Low-Carb diets may be equally effective. From a glass half empty perspective, the average amount of weight lost on either of these two dietary approaches under the conditions studied, particularly when followed beyond 1 year, has been modest at best and negligible at worst, suggesting that the two approaches may be equally ineffective. One could resign themselves at this point to focusing on calories and energy intake restriction, regardless of macronutrient distributions. However, before throwing out the half-glass of water, it is worthwhile to consider that focusing on average results may mask important subgroup successes and failures. In all weight-loss studies, without exception, the range of individual differences in weight change within any particular diet groups is orders of magnitude greater than the average group differences between diet groups. Several studies have now reported that adults with greater insulin resistance are more successful with weight loss on a lower-carbohydrate diet compared with a lower-fat diet, whereas adults with greater insulin sensitivity are equally or more successful with weight loss on a lower-fat diet compared with a lower-carbohydrate diet. Other preliminary findings suggest that there may be some promise with matching individuals with certain genotypes to

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. Copyright © 2013 Elsevier Ltd. All rights reserved.

Air pollution, weight loss and metabolic benefits of bariatric surgery: a potential model for study of metabolic effects of environmental exposures.

Science.gov (United States)

Ghosh, R; Gauderman, W J; Minor, H; Youn, H A; Lurmann, F; Cromar, K R; Chatzi, L; Belcher, B; Fielding, C R; McConnell, R

2018-05-01

Emerging experimental evidence suggests that air pollution may contribute to development of obesity and diabetes, but studies of children are limited. We hypothesized that pollution effects would be magnified after bariatric surgery for treatment of obesity, reducing benefits of surgery. In 75 obese adolescents, excess weight loss (EWL), high-density lipoprotein (HDL) cholesterol, triglycerides, alkaline phosphatase (ALP) and hemoglobin A1c (HbA 1c ) were measured prospectively at baseline and following laparoscopic adjustable gastric banding (LAGB). Residential distances to major roads and the average two-year follow-up exposure to particulate matter <2.5 μm (PM 2.5 ), nitrogen dioxide (NO 2 ) and ozone were estimated. Associations of exposure with change in outcome and with attained outcome two years post-surgery were examined. Major-roadway proximity was associated with reduced EWL and less improvement in lipid profile and ALP after surgery. NO 2 was associated with less improvement in HbA 1c and lower attained HDL levels and change in triglycerides over two years post-surgery. PM 2.5 was associated with reduced EWL and reduced beneficial change or attained levels for all outcomes except HbA 1c . Near-roadway, PM 2.5 and NO 2 exposures at levels common in developed countries were associated with reduced EWL and metabolic benefits of LAGB. This novel approach provides a model for investigating metabolic effects of other exposures. © 2017 World Obesity Federation.

Small Intestinal Bypass Induces a Persistent Weight-Loss Effect and Improves Glucose Tolerance in Obese Rats.

Science.gov (United States)

Cao, Jiaqing; Ren, Quan; Tan, Cai; Duan, Jinyuan

2017-07-01

This study investigated the role of proximal small intestinal bypass (PSIB) and distal small intestinal bypass (DSIB) as well as their long-term effects on weight loss and glucose metabolism in high-sugar and high-fat diet-induced obese rats. Sprague-Dawley rats were divided into four groups: PSIB, bypassing 60% of the proximal small intestine length; DSIB, bypassing 60% of the distal small intestine length; sham-operated (Sham) animals; and control animals. All rats were fed a high-sugar and high-fat diet after surgery. The primary outcome measures were body weight, food intake, fasting blood glucose (FBG) levels, oral glucose tolerance test (OGTT), and the insulin tolerance test (ITT). Global body weight (BW) and food intake in the PSIB and DSIB groups were lower than those in the Sham group at postoperative week 2. BW and food intake in the PSIB group were lower than those in the DSIB group at postoperative week 24. The PSIB and DSIB groups exhibited improvement in glucose tolerance at postoperative weeks 4, 8, and 24. The PSIB and DSIB groups exhibited improvement in FBG at postoperative week 24, and only the DSIB group exhibited improvement in insulin sensitivity. This study provides experimental evidence that PSIB surgery induced a better and more persistent weight loss effect than DSIB surgery and that the two types of intestinal bypass surgeries yielded equivalent and stable long-term improvement in glucose tolerance in an obese rat model.

First-day newborn weight loss predicts in-hospital weight nadir for breastfeeding infants.

Science.gov (United States)

Flaherman, Valerie J; Bokser, Seth; Newman, Thomas B

2010-08-01

Exclusive breastfeeding reduces infant infectious disease. Losing > or =10% birth weight may lead to formula use. The predictive value of first-day weight loss for subsequent weight loss has not been studied. The objective of the present study was to evaluate the relationship between weight loss at or =10%. For 1,049 infants, we extracted gestational age, gender, delivery method, feeding type, and weights from medical records. Weight nadir was defined as the lowest weight recorded during birth hospitalization. We used multivariate logistic regression to assess the effect of first-day weight loss on subsequent in-hospital weight loss. Mean in-hospital weight nadir was 6.0 +/- 2.6%, and mean age at in-hospital weight nadir was 38.7 +/- 18.5 hours. While in the hospital 6.4% of infants lost > or =10% of birth weight. Infants losing > or =4.5% birth weight at or =10% (adjusted odds ratio 3.57 [1.75, 7.28]). In this cohort, 798 (76.1%) infants did not have documented weight gain while in the hospital. Early weight loss predicts higher risk of > or =10% in-hospital weight loss. Infants with high first-day weight loss could be targeted for further research into improved interventions to promote breastfeeding.

Behavioural factors related with successful weight loss 15 months post-enrolment in a commercial web-based weight-loss programme.

Science.gov (United States)

Neve, Melinda J; Morgan, Philip J; Collins, Clare E

2012-07-01

As further understanding is required of what behavioural factors are associated with long-term weight-loss success, the aim of the present study was to determine the prevalence of successful weight loss 15 months post-enrolment in a commercial web-based weight-loss programme and which behavioural factors were associated with success. An online survey was completed 15 months post-enrolment in a commercial web-based weight-loss programme to assess weight-related behaviours and current weight. Participants were classified as successful if they had lost ≥5 % of their starting weight after 15 months. Commercial users of a web-based weight-loss programme. Participants enrolled in the commercial programme between August 2007 and May 2008. Six hundred and seventy-seven participants completed the survey. The median (interquartile range) weight change was -2·7 (-8·2, 1·6) % of enrolment weight, with 37 % achieving ≥5 % weight loss. Multivariate logistic regression analysis found success was associated with frequency of weight self-monitoring, higher dietary restraint score, lower emotional eating score, not skipping meals, not keeping snack foods in the house and eating takeaway foods less frequently. The findings suggest that individuals trying to achieve or maintain ≥5 % weight loss should be advised to regularly weigh themselves, avoid skipping meals or keeping snack foods in the house, limit the frequency of takeaway food consumption, manage emotional eating and strengthen dietary restraint. Strategies to assist individuals make these changes to behaviour should be incorporated within obesity treatments to improve the likelihood of successful weight loss in the long term.

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

, 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 FFM) and 58·4 % fat mass. The weight loss was accompanied by a decrease in systolic and diastolic blood...... in TAG (P FFM and fat mass continued to decrease from week 7 to 11 (all P .... However, the considerable reduction in FFM in severely obese subjects needs further investigation....

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

Early Laparoscopic Sleeve Gastrectomy Outcomes in Terms of Weight Loss

International Nuclear Information System (INIS)

Siddiq, G.; Aziz, W.; Pervez, M. B.; Haider, M. I.; Hussain, S. V.; Khan, N.

2016-01-01

Objective: To investigate the outcomes of laparoscopic sleeve gastrectomy (LSG) in terms of weight loss. Study Design: Descriptive cohort study. Place and Duration of Study: Department of Surgery, Shifa International Hospital, Islamabad, from January 2009 to January 2015. Methodology: A total of 100 consecutive patients were included in the study through retrospective chart review. A 5-port technique was utilized with the gastric sleeve being created using endostapler. Postoperatively, patients gradually progressed from clear liquid diet and oral rehydration salts to nutritional supplements over three days. By two weeks postoperatively, patients had progressed to a solid diet. SPSS was used for data entry and analysis. Body mass index (BMI) and weight in kg were determined. Results: From 100 patients, 17 were lost to follow-up less than a week into the postoperative period. Of the remaining, average age of the patients was 34.7 ±11.3 years at the time of surgery. The majority of patients were females (72 percentage). Mean preoperative and postoperative BMI was 45.3 ±10.4 kg/m2 and 35.0 ±10 kg/m2, respectively. Of the 83 patients, 62 were followed-up for longer than 1 month (average 419 days). For patients in this category, mean reduction in BMI was 10.3 ±6.5 kg/m2 with average weight loss of 34.3 ±18.2 kg. There were no mortalities associated with LSG. Conclusion: Laparoscopic sleeve gastrectomy is a safe and effective intervention in young Pakistani females with encouraging outcomes at a mean follow-up of over one year. (author)

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

Preserving Healthy Muscle during Weight Loss123

Science.gov (United States)

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

2017-01-01

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. PMID:28507015

Weight loss for overweight and obese individuals with gout: a systematic review of longitudinal studies.

Science.gov (United States)

Nielsen, Sabrina M; Bartels, Else M; Henriksen, Marius; Wæhrens, Eva E; Gudbergsen, Henrik; Bliddal, Henning; Astrup, Arne; Knop, Filip K; Carmona, Loreto; Taylor, William J; Singh, Jasvinder A; Perez-Ruiz, Fernando; Kristensen, Lars E; Christensen, Robin

2017-11-01

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. 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. 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 heterogeneity in study characteristics precluded meta-analysis. The effect on serum uric acid (sUA) ranged from -168 to 30 μmol/L, and 0%-60% patients achieving sUA target (gout attacks. Two studies indicated dose-response relationship for sUA, achieving sUA target and gout attacks. At short term, temporary increased sUA and gout attacks tended to occur after bariatric surgery. The available evidence is in favour of weight loss for overweight/obese gout patients, with low, moderate and low quality of evidence for effects on sUA, achieving sUA target and gout attacks, respectively. At short term, unfavourable effects may occur. Since the current evidence consists of a few studies (mostly observational) of low methodological quality, there is an urgent need to initiate rigorous prospective studies (preferably randomised controlled trials). PROSPERO, CRD42016037937. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effects of Weight Loss, Weight Cycling, and Weight Loss Maintenance on Diabetes Incidence and Change in Cardiometabolic Traits in the Diabetes Prevention Program

Science.gov (United States)

Pan, Qing; Jablonski, Kathleen A.; Aroda, Vanita R.; Watson, Karol E.; Bray, George A.; Kahn, Steven E.; Florez, Jose C.; Perreault, Leigh; Franks, Paul W.

2014-01-01

OBJECTIVE This study examined specific measures of weight loss in relation to incident diabetes and improvement in cardiometabolic risk factors. RESEARCH DESIGN AND METHODS This prospective, observational study analyzed nine weight measures, characterizing baseline weight, short- versus long-term weight loss, short- versus long-term weight regain, and weight cycling, within the Diabetes Prevention Program (DPP) lifestyle intervention arm (n = 1,000) for predictors of incident diabetes and improvement in cardiometabolic risk factors over 2 years. RESULTS Although weight loss in the first 6 months was protective of diabetes (hazard ratio [HR] 0.94 per kg, 95% CI 0.90, 0.98; P weight loss from 0 to 2 years was the strongest predictor of reduced diabetes incidence (HR 0.90 per kg, 95% CI 0.87, 0.93; P Weight cycling (defined as number of 5-lb [2.25-kg] weight cycles) ranged 0–6 times per participant and was positively associated with incident diabetes (HR 1.33, 95% CI 1.12, 1.58; P weight, the effect of weight cycling remained statistically significant for diabetes risk (HR 1.22, 95% CI 1.02, 1.47; P = 0.03) but not for cardiometabolic traits. CONCLUSIONS Two-year weight loss was the strongest predictor of reduced diabetes risk and improvements in cardiometabolic traits. PMID:25024396

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

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).

Ineffectiveness of commercial weight-loss programs for achieving modest but meaningful weight loss: Systematic review and meta-analysis.

Science.gov (United States)

McEvedy, Samantha M; Sullivan-Mort, Gillian; McLean, Siân A; Pascoe, Michaela C; Paxton, Susan J

2017-10-01

This study collates existing evidence regarding weight loss among overweight but otherwise healthy adults who use commercial weight-loss programs. Systematic search of 3 databases identified 11 randomized controlled trials and 14 observational studies of commercial meal-replacement, calorie-counting, or pre-packaged meal programs which met inclusion criteria. In meta-analysis using intention-to-treat data, 57 percent of individuals who commenced a commercial weight program lost less than 5 percent of their initial body weight. One in two (49%) studies reported attrition ≥30 percent. A second meta-analysis found that 37 percent of program completers lost less than 5 percent of initial body weight. We conclude that commercial weight-loss programs frequently fail to produce modest but clinically meaningful weight loss with high rates of attrition suggesting that many consumers find dietary changes required by these programs unsustainable.

Expert Coaching in Weight Loss: Retrospective Analysis

Science.gov (United States)

Kushner, Robert F; Hill, James O; Lindquist, Richard; Brunning, Scott; Margulies, Amy

2018-01-01

Background Providing coaches as part of a weight management program is a common practice to increase participant engagement and weight loss success. Understanding coach and participant interactions and how these interactions impact weight loss success needs to be further explored for coaching best practices. Objective The purpose of this study was to analyze the coach and participant interaction in a 6-month weight loss intervention administered by Retrofit, a personalized weight management and Web-based disease prevention solution. The study specifically examined the association between different methods of coach-participant interaction and weight loss and tried to understand the level of coaching impact on weight loss outcome. Methods A retrospective analysis was performed using 1432 participants enrolled from 2011 to 2016 in the Retrofit weight loss program. Participants were males and females aged 18 years or older with a baseline body mass index of ≥25 kg/m², who also provided at least one weight measurement beyond baseline. First, a detailed analysis of different coach-participant interaction was performed using both intent-to-treat and completer populations. Next, a multiple regression analysis was performed using all measures associated with coach-participant interactions involving expert coaching sessions, live weekly expert-led Web-based classes, and electronic messaging and feedback. Finally, 3 significant predictors (Pcoaching session attendance (Pcoaching sessions, attending 60% of live weekly Web-based classes, and receiving a minimum of 1 food log feedback day per week were associated with clinically significant weight loss. Conclusions Participant’s one-on-one expert coaching session attendance, live weekly expert-led interactive Web-based class attendance, and the number of food log feedback days per week from expert coach were significant predictors of weight loss in a 6-month intervention. PMID:29535082

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. Copyright © 2016 Elsevier B.V. All rights reserved.

An anthropometric classification of body contour deformities after massive weight loss.

Science.gov (United States)

Iglesias, Martin; Butron, Patricia; Abarca, Leonardo; Perez-Monzo, Mario F; de Rienzo-Madero, Beatriz

2010-08-01

Deformities caused by massive weight loss were originally subsidized at the Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán." This caused great economical losses, which led to the development of a classification to select patients with functional problems secondary to massive weight loss. The parameter used is the size of the pannus in relation to fixed anatomic structures within the following anatomic regions: abdomen, arms, thighs, mammary glands, lateral thoracic area, back, lumbar region, gluteal region, sacrum, and mons pubis. Grade 3 deformities are candidates for body contouring surgery because they constitute a functional problem. Grade 2 deformities reevaluated whether the patient has comorbidities. Lesser grades are considered aesthetic procedures and are not candidates for surgical rehabilitation at the Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán." This classification allowed an improvement in communication between the different surgical-medical specialties; therefore, we suggest its application not only for surgical-administrative reasons but also for academic purposes.

Weight loss methods and changes in eating habits among successful weight losers.

Science.gov (United States)

Soini, Sirpa; Mustajoki, Pertti; Eriksson, Johan G

2016-01-01

Changes in several lifestyle related factors are required for successful long-term weight loss. Identification of these factors is of major importance from a public health point of view. This study was based upon findings from the Finnish Weight Control Registry (FWCR), a web-based registry. In total, 316 people were recruited and 184 met the study inclusion criteria. The aims of this study were to assess means and typical changes in eating habits associated with successful long-term weight loss. Half of the participants (48%) reported that they lost weight slowly primarily with dietary changes. Self-weighing frequency was high, 92% was weighing themselves at least once a week during the weight loss phase, and 75% during the maintenance phase. Dietary aspects associated with successful weight loss and weight maintenance included an increase in intake of vegetables, a reduction in frequency of eating candies and fast food, regular meal frequency and application of the Plate model. Both slow and fast weight loss may lead to successful long-term results and weight maintenance. A decrease in energy intake was achieved by reducing intake of energy-dense food, applying the Plate model and by regular meal frequency. Key messages Successful long-term weight loss is associated with a reduction in intake of energy-dense food. A more regular meal frequency and a high frequency of self-weighing seem to be helpful.

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.

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

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

NARCIS (Netherlands)

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

Perceived Self-Efficacy and Financial Incentives: Factors Affecting Health Behaviors and Weight Loss in a Workplace Weight Loss Intervention.

Science.gov (United States)

Faghri, Pouran D; Simon, Julia; Huedo-Medina, Tania; Gorin, Amy

2017-05-01

To evaluate if self-efficacy (SE) and financial incentives (FI) mediate the effect of health behavior on weight loss in a group of overweight and obese nursing-home employees participating in a 16-week weight-loss intervention with 12-week follow-up. Ninety nine overweight/obese (body mass index [BMI] > 25) employees from four nursing-homes participated, with a mean age of 46.98 years and BMI of 35.33. Nursing-homes were randomized to receiving an incentive-based intervention (n = 51) and no incentive (n = 48). Participants' health behaviors and eating and exercise self-efficacy (Ex-SE) were assessed at week 1, 16, and 28 using a self-reported questionnaire. Mediation and moderated mediation analysis assessed relationships among these variables. Eating self-efficacy (Eat-SE) and Ex-SE were significant mediators between health behaviors and weight loss (P self-efficacy (P = 0.00) on weight loss. Self-efficacy and FI may affect weight loss and play a role in weight-loss interventions.

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....

Prediction model to predict critical weight loss in patients with head and neck cancer during (chemo)radiotherapy.

Science.gov (United States)

Langius, Jacqueline A E; Twisk, Jos; Kampman, Martine; Doornaert, Patricia; Kramer, Mark H H; Weijs, Peter J M; Leemans, C René

2016-01-01

Patients with head and neck cancer (HNC) frequently encounter weight loss with multiple negative outcomes as a consequence. Adequate treatment is best achieved by early identification of patients at risk for critical weight loss. The objective of this study was to detect predictive factors for critical weight loss in patients with HNC receiving (chemo)radiotherapy ((C)RT). In this cohort study, 910 patients with HNC were included receiving RT (±surgery/concurrent chemotherapy) with curative intent. Body weight was measured at the start and end of (C)RT. Logistic regression and classification and regression tree (CART) analyses were used to analyse predictive factors for critical weight loss (defined as >5%) during (C)RT. Possible predictors included gender, age, WHO performance status, tumour location, TNM classification, treatment modality, RT technique (three-dimensional conformal RT (3D-RT) vs intensity-modulated RT (IMRT)), total dose on the primary tumour and RT on the elective or macroscopic lymph nodes. At the end of (C)RT, mean weight loss was 5.1±4.9%. Fifty percent of patients had critical weight loss during (C)RT. The main predictors for critical weight loss during (C)RT by both logistic and CART analyses were RT on the lymph nodes, higher RT dose on the primary tumour, receiving 3D-RT instead of IMRT, and younger age. Critical weight loss during (C)RT was prevalent in half of HNC patients. To predict critical weight loss, a practical prediction tree for adequate nutritional advice was developed, including the risk factors RT to the neck, higher RT dose, 3D-RT, and younger age. Copyright © 2015 Elsevier Ltd. All rights reserved.

Expert Coaching in Weight Loss: Retrospective Analysis.

Science.gov (United States)

Painter, Stefanie Lynn; Ahmed, Rezwan; Kushner, Robert F; Hill, James O; Lindquist, Richard; Brunning, Scott; Margulies, Amy

2018-03-13

Providing coaches as part of a weight management program is a common practice to increase participant engagement and weight loss success. Understanding coach and participant interactions and how these interactions impact weight loss success needs to be further explored for coaching best practices. The purpose of this study was to analyze the coach and participant interaction in a 6-month weight loss intervention administered by Retrofit, a personalized weight management and Web-based disease prevention solution. The study specifically examined the association between different methods of coach-participant interaction and weight loss and tried to understand the level of coaching impact on weight loss outcome. A retrospective analysis was performed using 1432 participants enrolled from 2011 to 2016 in the Retrofit weight loss program. Participants were males and females aged 18 years or older with a baseline body mass index of ≥25 kg/m², who also provided at least one weight measurement beyond baseline. First, a detailed analysis of different coach-participant interaction was performed using both intent-to-treat and completer populations. Next, a multiple regression analysis was performed using all measures associated with coach-participant interactions involving expert coaching sessions, live weekly expert-led Web-based classes, and electronic messaging and feedback. Finally, 3 significant predictors (Pcoaching session attendance (Pcoaching sessions, attending 60% of live weekly Web-based classes, and receiving a minimum of 1 food log feedback day per week were associated with clinically significant weight loss. Participant's one-on-one expert coaching session attendance, live weekly expert-led interactive Web-based class attendance, and the number of food log feedback days per week from expert coach were significant predictors of weight loss in a 6-month intervention. ©Stefanie Lynn Painter, Rezwan Ahmed, Robert F Kushner, James O Hill, Richard Lindquist, Scott

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

DEFF Research Database (Denmark)

Hansen, Merethe; Lund, Michael T.; Gregers, Emilie

2015-01-01

OBJECTIVE: To study adipose tissue mitochondrial respiration and lipolysis following a massive weight loss. METHODS: 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). RESULTS: 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 ... 2DM, visceral fat mass was always higher relative to the body fat mass (%) compared to OB. CONCLUSIONS: Adipose tissue mitochondrial respiratory capacity increases with RYGB. Adipocytes adapt to massive weight...

Weight control behaviors of highly successful weight loss maintainers: the Portuguese Weight Control Registry.

Science.gov (United States)

Santos, Inês; Vieira, Paulo N; Silva, Marlene N; Sardinha, Luís B; Teixeira, Pedro J

2017-04-01

To describe key behaviors reported by participants in the Portuguese Weight Control Registry and to determine associations between these behaviors and weight loss maintenance. A total of 388 adults participated in this cross-sectional study. Assessments included demographic information, weight history, weight loss and weight maintenance strategies, dietary intake, and physical activity. Participants lost on average 18 kg, which they had maintained for ~28 months. Their average dietary intake was 2199 kcal/day, with 33 % of energy coming from fat. About 78 % of participants engaged in levels of moderate-plus-vigorous physical activity exceeding 150 min/week (51 % above 250 min/week), with men accumulating 82 more minutes than women (p breakfast. Greater weight loss maintenance was associated with higher levels of physical activity, walking, weight self-monitoring, establishing specific goals, and with reduced portion size use, reduced consumption of carbohydrates, and increased consumption of protein, (p < 0.05). Results indicate that weight loss maintenance is possible through the adoption of a nutritionally-balanced diet and regular participation in physical activity, but also suggest that adopting different (and, to a degree, individualized) set of behavioral strategies is key for achieving success.

Weight loss maintenance in relation to locus of control: The MedWeight study.

Science.gov (United States)

Anastasiou, Costas A; Fappa, Evaggelia; Karfopoulou, Eleni; Gkza, Anastasia; Yannakoulia, Mary

2015-08-01

Locus of control, i.e. the degree of an individual's belief on the control of his/her life, has been related to many health outcomes, including weight loss in overweight/obese individuals. No information is available on the impact of locus of control in maintaining weight loss. We aimed to investigate the effect of locus of control in weight loss maintenance and explore potential associations with lifestyle factors. Study participants included 239 individuals (41% males) who had lost at least 10% of body weight in the past and either maintained the loss (maintainers: weight maintenance of at least 10% of initial weight) or regained it (regainers). Locus of control was defined by a relevant multi-dimensional scale; participants were categorised to internals and externals, based on "internal" and "others" sub-scales. A significant interaction was found between locus of control and weight loss maintenance status (p locus of control. Individualised treatment, according to locus of control, may increase weight loss maintenance rates in former overweight/obese individuals. Copyright © 2015 Elsevier Ltd. All rights reserved.

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.

Relationship of cravings with weight loss and hunger: results from a 6 month worksite weight loss intervention

Science.gov (United States)

We examined the association of food cravings with weight loss and eating behaviors in a 6 month worksite lifestyle weight loss program. This randomized controlled trial of the intervention versus a wait-listed control was conducted at 4 worksites, and 95 participants completed outcome assessments ...

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...

How adolescent girls interpret weight-loss advertising.

Science.gov (United States)

Hobbs, Renee; Broder, Sharon; Pope, Holly; Rowe, Jonelle

2006-10-01

While they demonstrate some ability to critically analyze the more obvious forms of deceptive weight-loss advertising, many girls do not recognize how advertising evokes emotional responses or how visual and narrative techniques are used to increase identification in weight-loss advertising. This study examined how girls aged 9-17 years interpreted magazine advertising, television (TV) advertising and infomercials for weight-loss products in order to determine whether deceptive advertising techniques were recognized and to assess pre-existing media-literacy skills. A total of 42 participants were interviewed in seven geographic regions of the United States. In groups of three, participants were shown seven print and TV advertisements (ads) for weight-loss products and asked to share their interpretations of each ad. Common factors in girls' interpretation of weight-loss advertising included responding to texts emotionally by identifying with characters; comparing and contrasting persuasive messages with real-life experiences with family members; using prior knowledge about nutrition management and recognizing obvious deceptive claims like 'rapid' or 'permanent' weight loss. Girls were less able to demonstrate skills including recognizing persuasive construction strategies including message purpose, target audience and subtext and awareness of economic factors including financial motives, credibility enhancement and branding.

Nature versus nurture: identical twins and bariatric surgery.

Science.gov (United States)

Hagedorn, Judith C; Morton, John M

2007-06-01

Genetics and environment both play a role in weight maintenance. Twin studies may help clarify the influence of nature vs nurture in weight loss. We present the largest U.S. experience with monozygotic (MZ) twins undergoing bariatric surgery. We retrospectively reviewed the charts of four sets of MZ twins who underwent Roux-en-Y gastric bypass (RYGBP) surgery and laparoscopic adjustable gastric band (LAGB) placement at three different institutions. BMI and co-morbidities were examined pre- and postoperatively, and laboratory values were recorded. All four sets of twins are female, live together, and have similar professions. Twin cohort 1 had near identical weight loss patterns after open RYGBP surgery in 1996 (preop 146/142 kg; 2 years 82/82; and 10 years 108/107). Twin cohort 1 also both underwent cholecystectomies within the first year postoperatively. Twin cohort 2 underwent laparoscopic RYGBP surgery and also required cholecystectomies in the first postoperative year. Cohort 2 also experienced nearly identical weight loss at 1 year (36.7% vs 37.0% BMI loss). Twin cohort 3 underwent LAGB placement with two different surgeons with differing amounts of weight loss at 6 months (6.5% vs 15.7% BMI loss). Finally, twin cohort 4 underwent laparoscopic RYGBP with 2-year BMI loss of 39% vs 34%. In twin cohort 4, the twin who lost less weight lived apart from her twin and extended family, and her weight loss was less than the twin living with her family. Two sets of MZ twins had identical responses to bariatric surgery. The other two sets of identical twins had differential weight loss results, possibly due to differences in surgical approach and social support. While genetics do exert a strong influence on weight loss and maintenance, this case series demonstrates the potential effect of social support and postoperative management upon postoperative weight loss in the presence of identical genetics.

How family interactions about lifestyle changes affect adolescents' possibilities for maintaining weight loss after a weight loss intervention

DEFF Research Database (Denmark)

Eg, Marianne; Frederiksen, Kirsten; Vamosi, Marianne

2017-01-01

-loss programme. Three rounds of semi-structured interviews stretching over 5 years (2010-2015) were transcribed verbatim, then analyzed using Kvale and Brinkmann's framework for working with qualitative research interviews. FINDINGS: Five years after the intervention ended, we found that a family's interactions...... support is crucial if adolescents are to benefit from weight-loss intervention. DESIGN: Qualitative research interviews with families who participated in a weight-loss programme. METHODS: The sample consisted of 10 families selected among participants in a 1-year multidisciplinary family-based weight...

Herbal remedies and supplements for weight loss

Science.gov (United States)

Weight loss - herbal remedies and supplements; Obesity - herbal remedies; Overweight - herbal remedies ... health care provider. Nearly all over-the-counter supplements with claims of weight-loss properties contain some ...

Obesogenic memory can confer long-term increases in adipose tissue but not liver inflammation and insulin resistance after weight loss.

Science.gov (United States)

Schmitz, J; Evers, N; Awazawa, M; Nicholls, H T; Brönneke, H S; Dietrich, A; Mauer, J; Blüher, M; Brüning, J C

2016-05-01

Obesity represents a major risk factor for the development of type 2 diabetes mellitus, atherosclerosis and certain cancer entities. Treatment of obesity is hindered by the long-term maintenance of initially reduced body weight, and it remains unclear whether all pathologies associated with obesity are fully reversible even upon successfully maintained weight loss. We compared high fat diet-fed, weight reduced and lean mice in terms of body weight development, adipose tissue and liver insulin sensitivity as well as inflammatory gene expression. Moreover, we assessed similar parameters in a human cohort before and after bariatric surgery. Compared to lean animals, mice that demonstrated successful weight reduction showed increased weight gain following exposure to ad libitum control diet. However, pair-feeding weight-reduced mice with lean controls efficiently stabilized body weight, indicating that hyperphagia was the predominant cause for the observed weight regain. Additionally, whereas glucose tolerance improved rapidly after weight loss, systemic insulin resistance was retained and ameliorated only upon prolonged pair-feeding. Weight loss enhanced insulin action and resolved pro-inflammatory gene expression exclusively in the liver, whereas visceral adipose tissue displayed no significant improvement of metabolic and inflammatory parameters compared to obese mice. Similarly, bariatric surgery in humans (n = 55) resulted in massive weight reduction, improved hepatic inflammation and systemic glucose homeostasis, while adipose tissue inflammation remained unaffected and adipocyte-autonomous insulin action only exhibit minor improvements in a subgroup of patients (42%). These results demonstrate that although sustained weight loss improves systemic glucose homeostasis, primarily through improved inflammation and insulin action in liver, a remarkable obesogenic memory can confer long-term increases in adipose tissue inflammation and insulin resistance in mice as

Repeated lifestyle interventions lead to progressive weight loss

DEFF Research Database (Denmark)

Dandanell, Sune; Ritz, Christian; Verdich, Elisabeth

2017-01-01

in one to four 11-12 week lifestyle interventions (residential weight loss programme, mixed activities). Weight loss was promoted through a hypocaloric diet (-500 to -700 kcal/day) and daily physical activity (1-3 hours/day). Primary outcomes were weight loss and change in body composition (bioimpedance...

Instrumentalization of eating improves weight loss maintenance in obesity

DEFF Research Database (Denmark)

Christensen, Bodil Just; Iepsen, Eva Pers Winning; Lundgren, Julie Rehné

2017-01-01

Aim: The purpose of this study was to identify psychosocial determinants for maintaining weight loss. Methods: 42 obese individuals who achieved a 12% weight loss before entering a 52-week weight maintenance program were interviewed qualitatively. Psychosocial factors related to weight loss...... weight loss maintenance was associated with an interplay between behavioral, affective and contextual changes. ‘Instrumentalization of eating behavior' seems to be an important element in long-term weight maintenance....

Effects of an Oral Elemental Nutritional Supplement on Post-gastrectomy Body Weight Loss in Gastric Cancer Patients: A Randomized Controlled Clinical Trial.

Science.gov (United States)

Imamura, Hiroshi; Nishikawa, Kazuhiro; Kishi, Kentaro; Inoue, Kentaro; Matsuyama, Jin; Akamaru, Yusuke; Kimura, Yutaka; Tamura, Shigeyuki; Kawabata, Ryohei; Kawada, Junji; Fujiwara, Yoshiyuki; Kawase, Tomono; Fukui, Junichi; Takagi, Mari; Takeno, Atsushi; Shimokawa, Toshio

2016-09-01

Post-gastrectomy weight loss is associated with deterioration in quality of life, and influences the long-term prognosis of gastric cancer patients. We conducted a prospective, randomized controlled, open-label study to examine whether an oral elemental diet (Elental(®), Ajinomoto Pharmaceuticals, Tokyo, Japan; hereafter referred to as ED) prevents postoperative weight loss in post-gastrectomy patients. Patients were randomly divided to receive the ED or control diet. The ED group received 300 kcal of ED plus their regular diet for 6-8 weeks after surgery, starting from the day the patient started a soft rice or equivalent diet after surgery, while the control group received the regular diet alone. The primary endpoint was the percentage of body weight loss (%BWL) from the presurgical body weight to that at 6-8 weeks after surgery. Secondary endpoints were dietary adherence, nutrition-related blood parameters, and adverse events. This study included 112 patients in eight hospitals. The mean treatment compliance rate in the ED group was 68.7 ± 30.4 % (median 81.2 %). The %BWL was significantly different between the ED and control groups (4.86 ± 3.72 vs. 6.60 ± 4.90 %, respectively; p = 0.047). In patients who underwent total gastrectomy, the %BWL was significantly different between the two groups (5.03 ± 3.65 vs. 9.13 ± 5.43 %, respectively; p = 0.012). In multivariate analysis, ED treatment, surgery type, and preoperative performance status were independently associated with %BWL. No significant differences were observed in the other clinical variables. ED supplementation reduced postoperative weight loss in gastric cancer patients undergoing gastrectomy.

Early Weight Loss with Liraglutide 3.0 mg Predicts 1-Year Weight Loss and is Associated with Improvements in Clinical Markers.

Science.gov (United States)

Fujioka, Ken; O'Neil, Patrick M; Davies, Melanie; Greenway, Frank; C W Lau, David; Claudius, Birgitte; Skjøth, Trine Vang; Bjørn Jensen, Christine; P H Wilding, John

2016-11-01

To identify an early response criterion for predicting ≥5% weight loss with liraglutide 3.0 mg at week 56 and to compare efficacy outcomes in early responders (ERs) and early nonresponders (ENRs). Using pooled data from the SCALE Obesity and Prediabetes and SCALE Diabetes trials, weight loss of ≥4% at 16 weeks best predicted ≥5% weight loss after 56 weeks. Weight loss and changes in cardiometabolic risk factors and health-related quality of life were evaluated in ERs (≥4% weight loss at week 16) and ENRs (3.0 mg were 77.3%/22.7% (individuals without type 2 diabetes, T2D) and 62.7%/37.3% (those with T2D). Greater mean weight loss was observed in ERs versus ENRs: 10.8% versus 3.0% (without T2D) and 8.5% versus 3.1% (T2D). In both trials, greater proportions of ERs versus ENRs achieved ≥5%, >10%, and >15% weight loss at week 56 with liraglutide 3.0 mg. Greater improvements in cardiometabolic risk factors and health-related quality of life scores were observed in ERs versus ENRs. The early response criterion was clinically useful to identify individuals who would achieve clinically meaningful weight loss at 56 weeks. © 2016 The Authors Obesity published by Wiley Periodicals, Inc. on behalf of The Obesity Society (TOS).

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. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Patient profiling for success after weight loss surgery (GO Bypass study)

DEFF Research Database (Denmark)

Christensen, Bodil Just; Schmidt, Julie Berg; Nielsen, Mette Søndergaard

2018-01-01

Despite substantial research efforts, the mechanisms proposed to explain weight loss after gastric bypass (RYGB) and sleeve gastrectomy (SL) do not explain the large individual variation seen after these treatments. A complex set of factors are involved in the onset and development of obesity...... and these may also be relevant for the understanding of why success with treatments vary considerably between individuals. This calls for explanatory models that take into account not only biological determinants but also behavioral, affective and contextual factors. In this prospective study, we recruited 47...... and include: physiological measures: anthropometrics, vital signs, biochemical measures and appetite hormones, genetics, gut microbiota, appetite sensation, food and taste preferences, neural sensitivity, sensory perception and movement behaviors; psychological measures: general psychiatric symptom...

Low-maintenance energy requirements of obese dogs after weight loss.

Science.gov (United States)

German, Alexander J; Holden, Shelley L; Mather, Nicola J; Morris, Penelope J; Biourge, Vincent

2011-10-01

Weight rebound after successful weight loss is a well-known phenomenon in humans and dogs, possibly due to the fact that energy restriction improves metabolic efficiency, reducing post-weight-loss maintenance energy requirements (MER). The aim of the present study was to estimate post-weight-loss MER in obese pet dogs that had successfully lost weight and did not subsequently rebound. A total of twenty-four obese dogs, successfully completing a weight management programme at the Royal Canin Weight Management Clinic, University of Liverpool (Wirral, UK), were included. In all dogs, a period of >14 d of stable weight ( lean tissue lost was negatively associated with post-weight-loss MER. MER are low after weight loss in obese pet dogs (typically only 10 % more than required during weight-loss MER), which has implications for what should constitute the optimal diet during this period. Preserving lean tissue during weight loss may maximise post-weight-loss MER and help prevent rebound.

Multifocal Gastric Ulcers Caused by Diffuse Large B Cell Lymphoma in a Patient With Significant Weight Loss

Directory of Open Access Journals (Sweden)

Mark A. Gromski MD

2016-12-01

Full Text Available Primary gastrointestinal (GI lymphoma is a heterogeneous disease with varied clinical presentations. The stomach is the most common GI site and accounts for 70% to 75% of GI lymphomas. We present a patient with gastric diffuse large B cell lymphoma (DLBCL who presented with significant weight loss, early satiety, and multifocal ulcerated gastric lesions. Esophagoduodenoscopy should be performed in patients presenting with warning symptoms as in our case. Diagnosis is usually made by endoscopic biopsies. Multiple treatment modalities including surgery, radiotherapy, and chemotherapy have been used. Advancements in endoscopic and pathologic technology decrease turnaround time for diagnosis and treatment initiation, thus reducing the need for surgery. Health care providers should maintain a high level of suspicion and consider gastric DLBCL as part of the differential diagnosis, especially in those with warning symptoms such as weight loss and early satiety with abnormal endoscopic findings.

Changes in weight control behaviors and hedonic hunger during a 12-week commercial weight loss program.

Science.gov (United States)

O'Neil, Patrick M; Theim, Kelly R; Boeka, Abbe; Johnson, Gail; Miller-Kovach, Karen

2012-12-01

Greater use of key self-regulatory behaviors (e.g., self-monitoring of food intake and weight) is associated with greater weight loss within behavioral weight loss treatments, although this association is less established within widely-available commercial weight loss programs. Further, high hedonic hunger (i.e., susceptibility to environmental food cues) may present a barrier to successful behavior change and weight loss, although this has not yet been examined. Adult men and women (N=111, body mass index M±SD=31.5±2.7kg/m(2)) were assessed before and after participating in a 12-week commercial weight loss program. From pre- to post-treatment, reported usage of weight control behaviors improved and hedonic hunger decreased, and these changes were inversely associated. A decrease in hedonic hunger was associated with better weight loss. An improvement in reported weight control behaviors (e.g., self-regulatory behaviors) was associated with better weight loss, and this association was even stronger among individuals with high baseline hedonic hunger. Findings highlight the importance of specific self-regulatory behaviors within weight loss treatment, including a commercial weight loss program developed for widespread community implementation. Assessment of weight control behavioral skills usage and hedonic hunger may be useful to further identify mediators of weight loss within commercial weight loss programs. Future interventions might specifically target high hedonic hunger and prospectively examine changes in hedonic hunger during other types of weight loss treatment to inform its potential impact on sustained behavior change and weight control. Copyright © 2012 Elsevier Ltd. All rights reserved.

Response of recurrent binge eating and weight gain to topiramate in patients with binge eating disorder after bariatric surgery.

Science.gov (United States)

Guerdjikova, Anna I; Kotwal, Renu; McElroy, Susan L

2005-02-01

The effectiveness of topiramate was evaluated in the treatment of recurrent binge eating and weight gain in patients with binge eating disorder (BED) and obesity who had undergone initially successful bariatric surgery. The records of 3 consecutive patients with BED and obesity who presented to our clinic with recurrent binge eating and weight gain after undergoing initially successful bariatric surgery were reviewed. They were treated with topiramate for an average of 10 months. All three patients reported complete amelioration of their binge eating symptoms and displayed weight loss (31.7 kg in 17 months, 14.5 kg in 9 months, 2 kg in 4 months, respectively) in response to topiramate (mean dose 541 mg). Although anecdotal, these observations suggest that topiramate may be an effective treatment for patients with BED and obesity who experience recurrent binge eating and weight gain after initially successful bariatric surgery.

Does gastric bypass surgery change body weight set point?

Science.gov (United States)

Hao, Z; Mumphrey, M B; Morrison, C D; Münzberg, H; Ye, J; Berthoud, H R

2016-12-01

The relatively stable body weight during adulthood is attributed to a homeostatic regulatory mechanism residing in the brain which uses feedback from the body to control energy intake and expenditure. This mechanism guarantees that if perturbed up or down by design, body weight will return to pre-perturbation levels, defined as the defended level or set point. The fact that weight re-gain is common after dieting suggests that obese subjects defend a higher level of body weight. Thus, the set point for body weight is flexible and likely determined by the complex interaction of genetic, epigenetic and environmental factors. Unlike dieting, bariatric surgery does a much better job in producing sustained suppression of food intake and body weight, and an intensive search for the underlying mechanisms has started. Although one explanation for this lasting effect of particularly Roux-en-Y gastric bypass surgery (RYGB) is simple physical restriction due to the invasive surgery, a more exciting explanation is that the surgery physiologically reprograms the body weight defense mechanism. In this non-systematic review, we present behavioral evidence from our own and other studies that defended body weight is lowered after RYGB and sleeve gastrectomy. After these surgeries, rodents return to their preferred lower body weight if over- or underfed for a period of time, and the ability to drastically increase food intake during the anabolic phase strongly argues against the physical restriction hypothesis. However, the underlying mechanisms remain obscure. Although the mechanism involves central leptin and melanocortin signaling pathways, other peripheral signals such as gut hormones and their neural effector pathways likely contribute. Future research using both targeted and non-targeted 'omics' techniques in both humans and rodents as well as modern, genetically targeted, neuronal manipulation techniques in rodents will be necessary.

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

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Elbelt, Ulf; Schuetz, Tatjana; Knoll, Nina; Burkert, Silke

2015-07-16

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. Energy expenditure and physical activity patterns were measured with a portable armband device. Nutritional habits were assessed with a food frequency questionnaire. 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. 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.

Predictors of Weight Loss Maintenance following an Insurance-Sponsored Weight Management Program

OpenAIRE

Christiaan G. Abildso; Olivier Schmid; Megan Byrd; Sam Zizzi; Alessandro Quartiroli; Sean J. Fitzpatrick

2014-01-01

Intentional weight loss among overweight and obese adults (body mass index ≥ 25 kg/m2) is associated with numerous health benefits, but weight loss maintenance (WLM) following participation in weight management programming has proven to be elusive. Many individuals attempting to lose weight join formal programs, especially women, but these programs vary widely in focus, as do postprogram weight regain results. We surveyed 2,106 former participants in a community-based, insurance-sponsored wei...

Early Weight Loss with Liraglutide 3.0 mg Predicts 1‐Year Weight Loss and is Associated with Improvements in Clinical Markers

Science.gov (United States)

O'Neil, Patrick M.; Davies, Melanie; Greenway, Frank; C.W. Lau, David; Claudius, Birgitte; Skjøth, Trine Vang; Bjørn Jensen, Christine; P.H. Wilding, John

2016-01-01

Objective To identify an early response criterion for predicting ≥5% weight loss with liraglutide 3.0 mg at week 56 and to compare efficacy outcomes in early responders (ERs) and early nonresponders (ENRs). Methods Using pooled data from the SCALE Obesity and Prediabetes and SCALE Diabetes trials, weight loss of ≥4% at 16 weeks best predicted ≥5% weight loss after 56 weeks. Weight loss and changes in cardiometabolic risk factors and health‐related quality of life were evaluated in ERs (≥4% weight loss at week 16) and ENRs (3.0 mg were 77.3%/22.7% (individuals without type 2 diabetes, T2D) and 62.7%/37.3% (those with T2D). Greater mean weight loss was observed in ERs versus ENRs: 10.8% versus 3.0% (without T2D) and 8.5% versus 3.1% (T2D). In both trials, greater proportions of ERs versus ENRs achieved ≥5%, >10%, and >15% weight loss at week 56 with liraglutide 3.0 mg. Greater improvements in cardiometabolic risk factors and health‐related quality of life scores were observed in ERs versus ENRs. Conclusions The early response criterion was clinically useful to identify individuals who would achieve clinically meaningful weight loss at 56 weeks. PMID:27804269

Psychological Outcomes and Predictors of Initial Weight Loss Outcomes among Severely Obese Adolescents Receiving Laparoscopic Adjustable Gastric Banding

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Sysko, Robyn; Devlin, Michael J.; Hildebrandt, Tom B.; Brewer, Stephanie K.; Zitsman, Jeffrey L.; Walsh, B. Timothy

2013-01-01

Objective Elevated rates of psychopathology are noted among severely obese youth presenting for weight loss surgery. The role of mental health providers in this population is not well defined, and the selection of candidates is often the result of clinical judgment alone. The purpose of this study was to comprehensively evaluate psychiatric symptoms among a large sample of adolescents receiving laparoscopic adjustable gastric banding (LAGB) by: (1) examining changes in depressive symptoms and quality of life in the year following surgery, (2) evaluating the interaction between patterns of change in depression, quality of life, and weight post-surgery, and (3) identifying pre-surgical psychological predictors of initial weight change. Method Participants were 101 severely obese adolescents aged 14 to 18. Measures of height, weight, depressive symptoms, and quality of life were obtained in the first year following surgery. Changes in the Beck Depression Inventory (BDI), Pediatric Quality of Life Inventory (PedsQL), and body mass index were analyzed using latent growth curve modeling. Results Significant changes in total BDI [βslope=−0.885 SE=0.279, psurgery (pAdolescents experienced notable improvements in initial depressive symptoms and quality of life after LAGB, and measures of pre-operative binge eating and family conflict affected post-surgery body mass index among youth. PMID:23140654

Efficacy of a Conservative Weight Loss Program in the Long-Term Management of Chronic Upper Airway Obstruction

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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.

Dietary patterns in weight loss maintenance: results from the MedWeight study.

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Karfopoulou, Eleni; Brikou, Dora; Mamalaki, Eirini; Bersimis, Fragiskos; Anastasiou, Costas A; Hill, James O; Yannakoulia, Mary

2017-04-01

The dietary habits contributing to weight loss maintenance are not sufficiently understood. We studied weight loss maintainers in comparison with regainers, to identify the differentiating behaviors. The MedWeight study is a Greek registry of weight loss maintainers and regainers. Participants had intentionally lost ≥10 % of their weight and either had maintained this loss for over a year, or had regained weight. Questionnaires on demographics and lifestyle habits were completed online. Dietary assessment was carried out by two telephone 24-h recalls. Present analysis focused on 361 participants (32 years old, 39 % men): 264 maintainers and 97 regainers. Energy and macronutrient intake did not differ by maintenance status (1770 ± 651 kcal in maintainers vs. 1845 ± 678 kcal in regainers, p = 0.338), although protein intake per kg of body weight was higher in maintainers (1.02 ± 0.39 vs. 0.83 ± 0.28 g/kg in regainers, p meal preparation and eating at home for men, and a higher eating frequency and slower eating rate for women. Men maintaining weight loss were much more likely to adhere to a healthy eating pattern. Eating at home, involvement in meal preparation, higher eating frequency and slower eating rate were also associated with maintenance. These lifestyle habits of successful maintainers provide target behaviors to improve obesity treatment.

Instrumentalization of Eating Improves Weight Loss Maintenance in Obesity

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Bodil Just Christensen

2017-12-01

Full Text Available Aim: The purpose of this study was to identify psychosocial determinants for maintaining weight loss. Methods: 42 obese individuals who achieved a 12% weight loss before entering a 52-week weight maintenance program were interviewed qualitatively. Psychosocial factors related to weight loss maintenance were identified in two contrasting groups: weight reducers and weight regainers. Groups were defined by health-relevant weight maintenance (additional weight loss > 3% at week 52, n = 9 versus weight gain > 3%, at week 52, n = 20. Results: Weight reducers reported structured meal patterns (p = 0.008, no comfort eating (p = 0.016 and less psychosocial stress (p = 0.04 compared to weight regainers. The ability to instrumentalize eating behavior emerged as an important factor (p = 0.007. Nutritional knowledge, motivation or exercise level did not differ between groups (p > 0.05. Conclusions: Successful weight loss maintenance was associated with an interplay between behavioral, affective and contextual changes. ‘Instrumentalization of eating behavior' seems to be an important element in long-term weight maintenance.

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.

Metabolic Surgery

DEFF Research Database (Denmark)

Pareek, Manan; Schauer, Philip R; Kaplan, Lee M

2018-01-01

The alarming rise in the worldwide prevalence of obesity is paralleled by an increasing burden of type 2 diabetes mellitus. Metabolic surgery is the most effective means of obtaining substantial and durable weight loss in individuals with obesity. Randomized trials have recently shown...... the superiority of surgery over medical treatment alone in achieving improved glycemic control, as well as a reduction in cardiovascular risk factors. The mechanisms seem to extend beyond the magnitude of weight loss alone and include improvements in incretin profiles, insulin secretion, and insulin sensitivity....... Moreover, observational data suggest that the reduction in cardiovascular risk factors translates to better patient outcomes. This review describes commonly used metabolic surgical procedures and their current indications and summarizes the evidence related to weight loss and glycemic outcomes. It further...

Preoperative weight gain might increase risk of gastric bypass surgery.

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Istfan, Nawfal W; Anderson, Wendy A; Apovian, Caroline M; Hess, Donald T; Forse, R Armour

2011-01-01

Weight loss improves the cardiovascular and metabolic risk associated with obesity. However, insufficient data are available about the health effects of weight gain, separate from the obesity itself. We sought to determine whether the changes in body weight before open gastric bypass surgery (OGB) would have a significant effect on the immediate perioperative hospital course. A retrospective chart review of 100 consecutive patients was performed to examine the effects of co-morbidities and body weight changes in the immediate preoperative period on the hospital length of stay and the rate of admission to the surgical intensive care unit (SICU). Of our class III obese patients undergoing OGB, 95% had ≥1 co-morbid condition and an overall SICU admission rate of 18%. Compared with the patients with no perioperative SICU admission, the patients admitted to the SICU had a greater degree of insulin resistance (homeostatic model analysis-insulin resistance 10.8 ± 1.3 versus 5.9 ± 0.5, P = .001), greater serum triglyceride levels (225 ± 47 versus 143 ± 8 mg/dL, P = .003), and had gained more weight preoperatively (.52 ± .13 versus .06 ± .06 lb/wk, P = .003). The multivariate analyses showed that preoperative weight gain was a risk factor for a longer length of stay and more SICU admissions lasting ≥3 days, as were a diagnosis of sleep apnea and an elevated serum triglyceride concentration. The results of the present retrospective study suggest that weight gain increases the risk of perioperative SICU admission associated with OGB, independent of the body mass index. Sleep apnea and elevated serum triglyceride levels were also important determinants of perioperative morbidity. In view of the increasing epidemic of obesity and the popularity of bariatric surgical procedures, we propose that additional clinical and metabolic research focusing on the understanding of the complex relationship among obesity, positive energy balance, weight gain, and perioperative

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

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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.

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.

Bariatric Surgery for Obesity.

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le Roux, Carel W; Heneghan, Helen M

2018-01-01

In this review, the authors discuss the indications for and the published outcomes of commonly performed bariatric procedures, including weight loss, perioperative morbidity and mortality, late complications, as well as the impact of bariatric surgery on comorbidities, cardiovascular risk, and mortality. They also briefly discuss the mechanisms by which bariatric/metabolic surgery causes such significant weight loss and health gain. Copyright © 2017 Elsevier Inc. All rights reserved.

A randomized controlled trial of behavioral weight loss treatment versus combined weight loss/depression treatment among women with comorbid obesity and depression.

Science.gov (United States)

Linde, Jennifer A; Simon, Gregory E; Ludman, Evette J; Ichikawa, Laura E; Operskalski, Belinda H; Arterburn, David; Rohde, Paul; Finch, Emily A; Jeffery, Robert W

2011-02-01

Obesity is associated with clinical depression among women. However, depressed women are often excluded from weight loss trials. This study examined treatment outcomes among women with comorbid obesity and depression. Two hundred three (203) women were randomized to behavioral weight loss (n = 102) or behavioral weight loss combined with cognitive-behavioral depression management (n = 101). Average participant age was 52 years; mean baseline body mass index was 39 kg/m(2). Mean Patient Health Questionnaire and Hopkins Symptom Checklist (SCL-20) scores indicated moderate to severe baseline depression. Weight loss and SCL-20 changes did not differ between groups at 6 or 12 months in intent-to-treat analyses (p = 0.26 and 0.55 for weight, p = 0.70 and 0.25 for depressive symptoms). Depressed obese women lost weight and demonstrated improved mood in both treatment programs. Future weight loss trials are encouraged to enroll depressed women.

Predicting successful long-term weight loss from short-term weight-loss outcomes: new insights from a dynamic energy balance model (the POUNDS Lost study).

Science.gov (United States)

Thomas, Diana M; Ivanescu, Andrada E; Martin, Corby K; Heymsfield, Steven B; Marshall, Kaitlyn; Bodrato, Victoria E; Williamson, Donald A; Anton, Stephen D; Sacks, Frank M; Ryan, Donna; Bray, George A

2015-03-01

Currently, early weight-loss predictions of long-term weight-loss success rely on fixed percent-weight-loss thresholds. The objective was to develop thresholds during the first 3 mo of intervention that include the influence of age, sex, baseline weight, percent weight loss, and deviations from expected weight to predict whether a participant is likely to lose 5% or more body weight by year 1. Data consisting of month 1, 2, 3, and 12 treatment weights were obtained from the 2-y Preventing Obesity Using Novel Dietary Strategies (POUNDS Lost) intervention. Logistic regression models that included covariates of age, height, sex, baseline weight, target energy intake, percent weight loss, and deviation of actual weight from expected were developed for months 1, 2, and 3 that predicted the probability of losing model. The AUC statistic quantified the ROC curve's capacity to classify participants likely to lose models yielding the highest AUC were retained as optimal. For comparison with current practice, ROC curves relying solely on percent weight loss were also calculated. Optimal models for months 1, 2, and 3 yielded ROC curves with AUCs of 0.68 (95% CI: 0.63, 0.74), 0.75 (95% CI: 0.71, 0.81), and 0.79 (95% CI: 0.74, 0.84), respectively. Percent weight loss alone was not better at identifying true positives than random chance (AUC ≤0.50). The newly derived models provide a personalized prediction of long-term success from early weight-loss variables. The predictions improve on existing fixed percent-weight-loss thresholds. Future research is needed to explore model application for informing treatment approaches during early intervention. © 2015 American Society for Nutrition.

Women's challenges with postpartum weight loss.

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Montgomery, Kristen S; Bushee, Tracy D; Phillips, Jennifer D; Kirkpatrick, Terrie; Catledge, Courtney; Braveboy, Kristin; O'Rourke, Carol; Patel, Neema; Prophet, Malshundria; Cooper, Anita; Mosley, Lori; Parker, Christie; Douglas, Gaye M

2011-11-01

This study was designed to examine women's experiences of weight loss during the postpartum period. Understanding women's positive and negative experiences can assist health care providers to successfully intervene in helping women lose weight following pregnancy and avoid long-term weight gain and obesity development. Phenomenology, according to Husserl's perspective. Private location of the women's choosing. Twenty-six women, who ranged in age from 25 to 35 years, and had given birth within the last 5 years, were interviewed regarding their experiences with postpartum weight loss. The majority of the sample was Caucasian. Interviews were transcribed and themes were identified from each of the interviews. Comparisons were made between interviews to identify common experiences between women. Data were analyzed according to the Giorgi method. The women in the study had a wide range of experiences. Themes that emerged from the interviews related to women's challenges with return to prepregnancy weight. These included: time and motivation issues, the need for support, and weight and other struggles. This study provides a look inside the lives of women faced with the reality of losing weight after childbirth. Losing weight after delivery is multi-faceted and influenced by many factors. Interventions to assist women with weight loss should target the challenges described in this paper. When effective strategies are developed, education can be done during pregnancy to prepare for the postpartum period. Ultimately, future research efforts can help us to eliminate pregnancy as a risk factor for obesity in women.

A case of severe anorexia, excessive weight loss and high peptide YY levels after sleeve gastrectomy.

Science.gov (United States)

Pucci, Andrea; Cheung, Wui Hang; Jones, Jenny; Manning, Sean; Kingett, Helen; Adamo, Marco; Elkalaawy, Mohamed; Jenkinson, Andrew; Finer, Nicholas; Doyle, Jacqueline; Hashemi, Majid; Batterham, Rachel L

2015-01-01

Sleeve gastrectomy (SG) is the second most commonly performed bariatric procedure worldwide. Altered circulating gut hormones have been suggested to contribute post-operatively to appetite suppression, decreased caloric intake and weight reduction. In the present study, we report a 22-year-old woman who underwent laparoscopic SG for obesity (BMI 46 kg/m(2)). Post-operatively, she reported marked appetite reduction, which resulted in excessive weight loss (1-year post-SG: BMI 22 kg/m(2), weight loss 52%, >99th centile of 1-year percentage of weight loss from 453 SG patients). Gastrointestinal (GI) imaging, GI physiology/motility studies and endoscopy revealed no anatomical cause for her symptoms, and psychological assessments excluded an eating disorder. Despite nutritional supplements and anti-emetics, her weight loss continued (BMI 19 kg/m(2)), and she required nasogastric feeding. A random gut hormone assessment revealed high plasma peptide YY (PYY) levels. She underwent a 3 h meal study following an overnight fast to assess her subjective appetite and circulating gut hormone levels. Her fasted nausea scores were high, with low hunger, and these worsened with nutrient ingestion. Compared to ten other post-SG female patients, her fasted circulating PYY and nutrient-stimulated PYY and active glucagon-like peptide 1 (GLP1) levels were markedly elevated. Octreotide treatment was associated with suppressed circulating PYY and GLP1 levels, increased appetite, increased caloric intake and weight gain (BMI 22 kg/m(2) after 6 months). The present case highlights the value of measuring gut hormones in patients following bariatric surgery who present with anorexia and excessive weight loss and suggests that octreotide treatment can produce symptomatic relief and weight regain in this setting. Roux-en-Y gastric bypass and SG produce marked sustained weight reduction. However, there is a marked individual variability in this reduction, and post-operative weight loss

Liraglutide 3.0 mg for weight management: weight-loss dependent and independent effects.

Science.gov (United States)

Bays, Harold; Pi-Sunyer, Xavier; Hemmingsson, Joanna Uddén; Claudius, Birgitte; Jensen, Christine B; Van Gaal, Luc

2017-02-01

As an adjunct to a reduced-calorie diet and increased physical activity, treatment with liraglutide 3.0 mg for weight management provides a statistically significant and clinically meaningful weight loss of 5.7%-8.0% compared to 1.6%-2.6% with placebo. The objective of this post hoc analysis was to quantify the relative contribution of weight loss to the treatment effects of liraglutide 3.0 mg on key efficacy endpoints. The analysis utilized data from 4725 participants across three randomized, placebo-controlled, double-blind trials that evaluated the efficacy and safety of liraglutide 3.0 mg versus placebo, as an adjunct to a reduced-calorie diet and increased physical activity (ClinicalTrials.gov identifiers: NCT01272219, NCT01272232 and NCT01557166). The duration of two of the trials was 56 weeks; one trial was of 32 weeks' duration. A mediation analysis was performed, which ranked the relative contribution of weight loss to the treatment effects of liraglutide 3.0 mg on key cardiometabolic efficacy endpoints, Apnea-Hypopnea Index (AHI) and health-related quality of life (QoL). A limitation of this type of analysis is that it cannot conclusively prove a causal relationship. In individuals without type 2 diabetes mellitus (T2DM), endpoints predominantly driven by liraglutide-induced weight loss included waist circumference, diastolic blood pressure, triglycerides, high density lipoprotein cholesterol, AHI, and Impact of Weight on Quality of Life-Lite total and physical function scores. Endpoints predominantly independent of weight loss included the glycemic endpoints hemoglobin A1c and fasting plasma glucose in individuals with and without T2DM. Regardless of the degree of dependence on weight loss according to the mediation analysis, greater weight loss was associated with greater improvement in all endpoints. Treatment with liraglutide 3.0 mg contributes to improved cardiometabolic parameters, AHI and health-related QoL through both weight-loss

Effects of Weight Loss and Exercise on Apelin Serum Concentrations and Adipose Tissue Expression in Human Obesity

Directory of Open Access Journals (Sweden)

Joanna Krist

2013-02-01

Full Text Available Objective: Apelin is an adipokine which plays a role in the regulation of glucose homeostasis and may contribute to the link between increased adipose tissue mass and obesity related metabolic diseases. Here we investigate the role of omental and subcutaneous (SC adipose tissue apelin and its receptor APJ mRNA expression in human obesity and test the hypothesis that changes in circulating apelin are associated with reduced fat mass in three weight loss intervention studies. Methods: Apelin serum concentration was measured in 740 individuals in a cross-sectional (n = 629 study including a subgroup (n = 161 for which omental and SC apelin mRNA expression has been analyzed and in three interventions: 12 weeks exercise (n = 60, 6 months calorie-restricted diet (n = 19, 12 months after bariatric surgery (n = 32. Results: Apelin mRNA is significantly higher expressed in adipose tissue of patients with type 2 diabetes and correlates with circulating apelin, BMI, body fat, C-reactive protein, and insulin sensitivity. Obesity surgery-induced weight loss causes a significant reduction in omental and SC apelin expression. All interventions led to significantly reduced apelin serum concentrations which significantly correlate with improved insulin sensitivity, independently of changes in BMI. Conclusions: Reduced apelin expression and serum concentration may contribute to improved insulin sensitivity beyond significant weight loss.

Weight loss and skin manifestations in obese patients with psoriasis

DEFF Research Database (Denmark)

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

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...... % 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....

Diabesity: are weight loss medications effective?

Science.gov (United States)

Halpern, Alfredo; Mancini, Marcio C

2005-01-01

Weight reduction has been shown to improve glycemic control and cardiovascular risk factors associated with insulin resistance in obese individuals with type 2 diabetes mellitus. Therapeutic options for these patients include promoting weight loss (non-pharmacologic and pharmacologic treatment) and improving glycemic control, as well as treating common associated risk factors such as arterial hypertension and dyslipidemias. This article provides an overview of anti-obesity drugs used in the treatment of obese individuals with type 2 diabetes. The most widely investigated drugs, sibutramine and orlistat, result in modest, clinically worthwhile weight loss, with demonstrable improvements in many co-morbidities, among them, type 2 diabetes. Clinical trials with these anti-obesity medications in cohorts of obese diabetic patients have been reviewed as well as cathecolaminergic agents (diethylpropion [amfepramone], fenproporex, mazindol, ephedrine-caffeine combination), serotoninergic drugs (fenfluramine, dexfenfluramine, fluoxetine), and other drugs that have some action on weight loss (the antidiabetic agent metformin, anti-epileptic agents topiramate and zonisamide, and the antidepressive bupropion [amfebutamone]). These trials show variable benefits in terms of effects on glucose profiles.

Weight-loss surgery - after - what to ask your doctor

Science.gov (United States)

... Accessed February 2, 2017. Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the ... Elsevier; 2017:chap 47. Read More Body mass index Coronary heart disease Gastric bypass surgery Laparoscopic gastric ...

Mindfulness Approaches and Weight Loss, Weight Maintenance, and Weight Regain.

Science.gov (United States)

Dunn, Carolyn; Haubenreiser, Megan; Johnson, Madison; Nordby, Kelly; Aggarwal, Surabhi; Myer, Sarah; Thomas, Cathy

2018-03-01

There is an urgent need for effective weight management techniques, as more than one third of US adults are overweight or obese. Recommendations for weight loss include a combination of reducing caloric intake, increasing physical activity, and behavior modification. Behavior modification includes mindful eating or eating with awareness. The purpose of this review was to summarize the literature and examine the impact of mindful eating on weight management. The practice of mindful eating has been applied to the reduction of food cravings, portion control, body mass index, and body weight. Past reviews evaluating the relationship between mindfulness and weight management did not focus on change in mindful eating as the primary outcome or mindful eating as a measured variable. This review demonstrates strong support for inclusion of mindful eating as a component of weight management programs and may provide substantial benefit to the treatment of overweight and obesity.

Baby-Friendly Practices Minimize Newborn Infants Weight Loss.

Science.gov (United States)

Procaccini, Diane; Curley, Ann L Cupp; Goldman, Martha

2018-04-01

It is accepted that newborns lose weight in the first few days of life. Baby-Friendly practices that support breastfeeding may affect newborn weight loss. The objective of this study were: 1) To determine whether Baby-Friendly practices are associated with term newborn weight loss day 0-2 in three feeding categories (exclusively breastfed, mixed formula fed and breastfed, and formula fed). 2) To determine whether Baby-Friendly practices increase exclusive breast feeding rates in different ethnic populations. This was a retrospective case-control study. Term newborn birth weight, neonatal weights days 0-2, feeding type, type of birth, and demographic information were collected for 1,000 births for the year before Baby-Friendly designation (2010) and 1,000 in 2013 (after designation). Ultimately 683 in the first group and 518 in the second met the inclusion criteria. Mean weight loss decreased day 0-2 for infants in all feeding types after the initiation of Baby-Friendly practices. There was a statistically significant effect of Baby-Friendly designation on weight loss for day 0-2 in exclusively breastfed infants (p Baby-Friendly practices were put in place. There was a decrease in mean weight loss day 0-2 regardless of feeding type after Baby-Friendly designation. Exclusive breast feeding increased in the presence of Baby-Friendly practices.

Weight Loss Expectations and Attrition in Treatment-Seeking Obese Women

Directory of Open Access Journals (Sweden)

Riccardo Dalle Grave

2015-10-01

Full Text Available Objective: The analysis of the relation between weight loss goals and attrition in the treatment of obesity has produced conflicting results. The aim of the present study was to investigate the role of weight loss goals on attrition in a cohort of obese women seeking treatment at 8 Italian medical centres. Methods: 634 women with obesity, consecutively enrolled in weight loss programmes, were included in the study. Weight loss goals were evaluated with the Goals and Relative Weights Questionnaire (GRWQ, reporting a sequence of unrealistic (‘dream' and ‘happy' and more realistic (‘acceptable' and ‘disappointing' weight loss goals. Attrition was assessed at 12 months on the basis of patients' medical records. Results: At 12 months, 205/634 patients (32.3% had interrupted their programme and were lost to follow-up. After adjustment for age, baseline weight, education and employment status, attrition was significantly associated with higher percent acceptable and disappointing weight loss targets, not with dream and happy weight loss. Conclusion: In ‘real world' clinical settings, only realistic expectations might favour attrition whenever too challenging, whereas unrealistic weight loss goals have no effect. Future studies should assess the effect of interventions aimed at coping with too challenging weight goals on attrition.

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....

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…

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

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

2015-01-01

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

Weight gain after bariatric surgery as a result of a large gastric stoma: endotherapy with sodium morrhuate may prevent the need for surgical revision.

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Catalano, Marc F; Rudic, Goran; Anderson, Alfred J; Chua, Thomas Y

2007-08-01

Obesity affects more than 30% of the U.S. population and is associated with the development of life-threatening complications. Numerous therapeutic approaches to the problem have been advocated, including low-calorie diets, anoretic drugs, behavior modifications, and exercise therapy. The only treatment proven to be effective in the long-term management of morbid obesity is surgical intervention. Complications of bariatric surgery include stomal stenosis and/or ulcer and stomal dilation (secondary to overeating). The latter complication can result in a gain of previously lost weight. To determine the effect of endoscopic injection by using a sclerosant (sodium morrhuate) to induce stomal stenosis in patients who present with stomal dilatation complicated by weight gain. Bariatric patients with a large gastric stoma were treated with sodium morrhuate stomal injection. Diameters of the stoma were followed at repeat endoscopy. Weight loss at scheduled clinic visits were compared with pretherapy weights. Twenty-eight patients (10 men, 18 women; age range, 27-58 years), after bariatric surgery with GI bypass, were referred with weight gain after initial weight loss. Weight gain was believed to be the result of a large gastric stoma. Treatment included injection of sodium morrhuate (1-2 mL circumferentially) surrounding the stoma. A total of 1 to 3 injection sessions were performed in an attempt to achieve a stoma diameter of 1.2 cm or smaller. Treatment success was defined as a decrease of stoma size to weight loss >or=75% of the weight the patient gained after establishing a steady state post bariatric surgery weight. A total of 2.3 injection sessions were performed. Successful endotherapy was achieved in 18 of 28 patients (64%). One patient developed symptoms of stomal stenosis, which required 2 separate balloon dilating sessions. No other complications were encountered. Retrospective case series. Endoscopic injection of sodium morrhuate surrounding the dilated

Weight Control: MedlinePlus Health Topic

Science.gov (United States)

... loss medications Show More Show Less Related Health Topics Body Weight Diets Eating Disorders Exercise and Physical Fitness Nutrition Obesity Weight Loss Surgery National Institutes of Health The primary NIH organization for research on Weight Control is the National Institute of ...

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.

Telephone based weight loss intervention: Relevance for developing countries.

Science.gov (United States)

Ayisi Addo, Sandra; Steiner-Asiedu, Matilda

2018-02-08

Obesity is a major public health challenge not only for developed but developing countries as well. The World Health Organization recommends the immediate use of effective, efficient and widely accessible weight loss interventions. Telephone based weight loss intervention could provide a cheaper and wider reach of obese participants. Previous systematic reviews on telephone based weight loss interventions either excluded studies that had obese participants with co-morbidities or were silent on their inclusion. Obese/overweight individuals with co-morbidities constitute an important population in any weight loss intervention study due to the strong association of obesity with major chronic health conditions. This paper, reviews the efficacy of telephone based weight loss intervention solely in overweight/obese individuals with obesity related diseases and discusses its relevance for developing countries.

DOES BARIATRIC SURGERY AFFECT SEXUALITY: A SYSTEMATIC REVIEW

Directory of Open Access Journals (Sweden)

Dilek Aygin

2017-09-01

Full Text Available Obesity affects sexual health negatively due to several reasons such as impaired body image, psychological disorders and hormonal changes. Bariatric surgery is frequently used in the treatment of obesity. Besides positive effects such as an increase in physical activity due to weight loss and hormonal changes after surgery, there are some adverse effects of bariatric surgery such as sagging and wrinkling of skin due to rapid weight loss. The purpose of this study is to determine the effects of bariatric surgery on sexual function. The literature between 2004 and 2015 was reviewed by searching Scopus, Science Direct, PubMed, Ebsco, Coochrane, Medline Complete, Ovid, Springer Link, Google Scholar, Taylor & Francis, PsychInfo databases, national thesis center and Ulakbim databases; ten studies appropriate to the criteria were included in the study. A total of 524 patients (152 males underwent bariatric surgery were included in study. Sexual function has been found to improve in all the studies. Also weight loss has been shown to have positive effects on reproductive hormones in both sexes. Bariatric surgery has positive effects on weight-loss and consequently on sexual function and reproductive hormones. [J Contemp Med 2017; 7(3.000: 284-296

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...

Timing of food intake predicts weight loss effectiveness.

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Garaulet, M; Gómez-Abellán, P; Alburquerque-Béjar, J J; Lee, Y-C; Ordovás, J M; Scheer, F A J L

2013-04-01

There is emerging literature demonstrating a relationship between the timing of feeding and weight regulation in animals. However, whether the timing of food intake influences the success of a weight-loss diet in humans is unknown. To evaluate the role of food timing in weight-loss effectiveness in a sample of 420 individuals who followed a 20-week weight-loss treatment. Participants (49.5% female subjects; age (mean ± s.d.): 42 ± 11 years; BMI: 31.4 ± 5.4 kg m(-2)) were grouped in early eaters and late eaters, according to the timing of the main meal (lunch in this Mediterranean population). 51% of the subjects were early eaters and 49% were late eaters (lunch time before and after 1500 hours, respectively), energy intake and expenditure, appetite hormones, CLOCK genotype, sleep duration and chronotype were studied. Late lunch eaters lost less weight and displayed a slower weight-loss rate during the 20 weeks of treatment than early eaters (P=0.002). Surprisingly, energy intake, dietary composition, estimated energy expenditure, appetite hormones and sleep duration was similar between both groups. Nevertheless, late eaters were more evening types, had less energetic breakfasts and skipped breakfast more frequently that early eaters (all; Pmeal (P=0.015) with a higher frequency of minor allele (C) carriers among the late eaters (P=0.041). Neither sleep duration, nor CLOCK SNPs or morning/evening chronotype was independently associated with weight loss (all; P>0.05). Eating late may influence the success of weight-loss therapy. Novel therapeutic strategies should incorporate not only the caloric intake and macronutrient distribution - as is classically done - but also the timing of food.

Chili pepper as a body weight-loss food.

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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.

[Clinical Practice after Bariatric Surgery: Problems and Complications].

Science.gov (United States)

Gebhart, Martina

2015-12-09

The number of patients undergoing bariatric surgery because of morbid obesity is increasing rapidly. Therefore, it is an important issue to be aware of outcome and complications after bariatric surgery. This mini-review presents a compilation of important gastrointestinal symptoms, as pain, diarrhea and dumping, and includes treatment options. It characterizes possible micronutrient deficiencies, gives instructions concerning the adaptation of drugs and illustrates possible adverse outcomes, such as excessive weight loss, insufficient weight loss and weight gain after bariatric surgery.

Diet in the management of weight loss

OpenAIRE

Strychar, Irene

2006-01-01

Obesity is an established risk factor for numerous chronic diseases, and successful treatment will have an important impact on medical resources utilization, health care costs, and patient quality of life. With over 60% of our population being overweight, physicians face a major challenge in assisting patients in the process of weight loss and weight-loss maintenance. Low-calorie diets can lower total body weight by an average of 8% in the short term. These diets are well-tolerated and charac...

Green tea for weight loss and weight maintenance in overweight or obese adults.

Science.gov (United States)

Jurgens, Tannis M; Whelan, Anne Marie; Killian, Lara; Doucette, Steve; Kirk, Sara; Foy, Elizabeth

2012-12-12

Preparations of green tea are used as aids in weight loss and weight maintenance. Catechins and caffeine, both contained in green tea, are each believed to have a role in increasing energy metabolism, which may lead to weight loss. A number of randomised controlled trials (RCTs) evaluating the role of green tea in weight loss have been published; however, the efficacy of green tea preparations in weight loss remains unclear. To assess the efficacy and safety of green tea preparations for weight loss and weight maintenance in overweight or obese adults. We searched the following databases from inception to specified date as well as reference lists of relevant articles: The Cochrane Library (Issue 12, 2011), MEDLINE (December 2011), EMBASE (December 2011), CINAHL (January 2012), AMED (January 2012), Biological Abstracts (January 2012), IBIDS (August 2010), Obesity+ (January 2012), IPA (January 2012) and Web of Science (December 2011). Current Controlled Trials with links to other databases of ongoing trials was also searched. RCTs of at least 12 weeks' duration comparing green tea preparations to a control in overweight or obese adults. Three authors independently extracted data, assessed studies for risk of bias and quality, with differences resolved by consensus. Heterogeneity of included studies was assessed visually using forest plots and quantified using the I(2) statistic. We synthesised data using meta-analysis and descriptive analysis as appropriate; subgroup and sensitivity analyses were conducted. Adverse effects reported in studies were recorded. Due to the level of heterogeneity among studies, studies were divided into two groups; those conducted in Japan and those conducted outside Japan. Study length ranged between 12 and 13 weeks. Meta-analysis of six studies conducted outside Japan showed a mean difference (MD) in weight loss of -0.04 kg (95% CI -0.5 to 0.4; P = 0.88; I(2) = 18%; 532 participants). The eight studies conducted in Japan were not similar

Perceptions relating to body size, weight loss and weight-loss interventions in black South African women: a qualitative study.

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Draper, Catherine E; Davidowitz, Kesiah J; Goedecke, Julia H

2016-02-01

A higher tolerance for a larger body size has been associated with obesity in black South African (SA) women. The aim of the present study was to explore perceptions regarding body size and weight loss in a sample of black women from a low-income community in Cape Town, SA. Qualitative pilot study including five focus groups. Data were analysed using thematic analysis. Khayelitsha, Cape Town, SA. Twenty-one black SA women. The majority of participants had positive perceptions of overweight/obesity, which were influenced by community and cultural perceptions, but some inconsistencies were observed as overweight/obesity was also associated with ill health. Participants identified many benefits to weight loss, but due to the association with sickness, they were concerned about being stigmatised in their community. Although participants had knowledge about healthy eating, the main barrier to eating healthily included the perceived higher cost of healthier food and food insecurity. All participants saw exercise as a strategy to lose weight and improve health, and were interested in participating in a community-based exercise intervention, but negative community perceptions and conflicting views regarding who should lead the intervention were identified as barriers. These findings highlight the complexities surrounding participants' perceptions regarding body size, weight loss and weight-loss interventions, and emphasise low socio-economic status as a barrier to change. The study also highlights the strong influence of cultural ideals and community perceptions on personal perceptions. These findings underscore the necessity for culturally appropriate weight-loss interventions in low-income, transitioning communities.

Preoperative lifestyle intervention in bariatric surgery: a randomized clinical trial.

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Kalarchian, Melissa A; Marcus, Marsha D; Courcoulas, Anita P; Cheng, Yu; Levine, Michele D

2016-01-01

Studies on the impact of presurgery weight loss and lifestyle preparation on outcomes following bariatric surgery are needed. To evaluate whether a presurgery behavioral lifestyle intervention improves weight loss through a 24-month postsurgery period. Bariatric Center of Excellence at a large, urban medical center. Candidates for bariatric surgery were randomized to a 6-month behavioral lifestyle intervention or to 6 months of usual presurgical care. The lifestyle intervention consisted of 8 weekly face-to-face sessions, followed by 16 weeks of face-to-face and telephone sessions before surgery; the intervention also included 3 monthly telephone contacts after surgery. Assessments were conducted 6, 12, and 24 months after surgery. Participants who underwent surgery (n = 143) were 90.2% female and 86.7% White. Average age was 44.9 years, and average body mass index was 47.5 kg/m(2) at study enrollment. At follow-up, 131 (91.6%), 126 (88.1%), 117 (81.8%) patients participated in the 6-, 12-, and 24-month assessments, respectively. Percent weight loss from study enrollment to 6 and 12 months after surgery was comparable for both groups, but at 24 months after surgery, the lifestyle group had significantly smaller percent weight loss compared with the usual care group (26.5% versus 29.5%, respectively, P = .02). Presurgery lifestyle intervention did not improve weight loss at 24 months after surgery. The findings from this study raise questions about the utility and timing of adjunctive lifestyle interventions for bariatric surgery patients. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Metabolic syndrome after laparoscopic bariatric surgery.

Science.gov (United States)

Nugent, Clare; Bai, Chunhong; Elariny, Hazem; Gopalakrishnan, Priya; Quigley, Caitlin; Garone, Michael; Afendy, Mariam; Chan, Oscar; Wheeler, Angela; Afendy, Arian; Younossi, Zobair M

2008-10-01

Metabolic syndrome (MS) is common among morbidly obese patients undergoing bariatric surgery. The aim of this study was to assess the impact and predictors of bariatric surgery on the resolution of MS. Subjects included 286 patients [age 44.0 +/- 11.5, female 78.2%, BMI 48.7 +/- 9.4, waist circumference 139 +/- 20 cm, AST 23.5 +/- 14.9, ALT 30.0 +/- 20.1, type 2 diabetes mellitus (DM) 30.1% and MS 39.2%] who underwent bariatric surgery. Of the entire cohort, 27.3% underwent malabsorptive surgery, 55.9% underwent restrictive surgery, and 16.8% had combination restrictive-malabsorptive surgery. Mean weight loss was 33.7 +/- 20.1 kg after restrictive surgery (follow up period 298 +/- 271 days), 39.4 +/- 22.9 kg after malabsorptive surgery (follow-up period 306 +/- 290 days), and 28.3 +/- 14.1 kg after combination surgery (follow-up period 281 +/- 239 days). Regardless of the type of bariatric surgery, significant improvements were noted in MS (p values from <0.0001-0.01) as well as its components such as DM (p values from <0.0001-0.0005), waist circumference (p values <0.0001), BMI (p values <0.0001), fasting serum triglycerides (p values <0.0001 to 0.001), and fasting serum glucose (p values <0.0001). Additionally, a significant improvement in AST/ALT ratio (p value = 0.0002) was noted in those undergoing restrictive surgery. Multivariate analysis showed that patients who underwent malabsorptive bariatric procedures experienced a significantly greater percent excess weight loss than patients who underwent restrictive procedures (p value = 0.0451). Percent excess weight loss increased with longer postoperative follow-up (p value <0.0001). Weight loss after bariatric surgery is associated with a significant improvement in MS and other metabolic factors.

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...... (difference: -0.21 [95%CI -0.40:-0.03]) and "no attention" (difference: -0.26 [95%CI -0.44:-0.07]) groups. CONCLUSION: In this 1 year follow-up after weight-loss in obese knee OA patients, we found a potentially increased number of BMLs in the exercise group compared to the diet and no attention groups...

Should providers encourage realistic weight expectations and satisfaction with lost weight in commercial weight loss programs? a preliminary study.

Science.gov (United States)

Ames, Gretchen E; Thomas, Colleen S; Patel, Roshni H; McMullen, Jillian S; Lutes, Lesley D

2014-01-01

Attrition is a problem among patients who participate in commercial weight loss programs. One possible explanation is that if patients are unable to reach a weight that they expect to achieve, they may be more likely to drop out of treatment. This study investigated variables associated with attrition among 30 obese patients who completed a liquid meal replacement program (LMR) and enrolled in a 52-week Small Changes Maintenance intervention (SCM). Patients lost a median 18% of body weight during LMR and completed assessments about weight expectations and weight satisfaction pre- and post-SCM. Of the 30 patients who started SCM, 8 (27%) were lost to attrition. Odds of SCM attrition were higher in patients who lost ≤ 18.2% of pre-LMR weight (OR: 12.25, P = 0.035), had lower satisfaction (≤7) pre-SCM (OR: 10.11, P = 0.040), and who expected further weight loss of 9.1 kg or more pre-SCM (OR: 10.11, P = 0.040). SCM completers significantly increased weight loss expectations by a median of 2.3 kg from pre-SCM to post-SCM (WSR P = 0.049) that paralleled weight regained post-SCM (2.7 kg). After completion of a medically-supervised commercial weight loss program, patients with the greatest expectations for further weight loss and the lowest weight satisfaction were more likely to drop out of SCM. Failure to participate in maintenance treatment may lead to regain of greater than half of lost weight over the next year. Among SCM completers, lower expectations for further weight loss and greater weight satisfaction appeared to be associated with continued engagement in maintenance treatment.

Sex differences in the relation of weight loss self-efficacy, binge eating, and depressive symptoms to weight loss success in a residential obesity treatment program.

Science.gov (United States)

Presnell, Katherine; Pells, Jennifer; Stout, Anna; Musante, Gerard

2008-04-01

The aim of the current study was to examine whether weight loss self-efficacy, binge eating, and depressive symptoms predicted weight loss during treatment, and whether gender moderates these associations with prospective data from 297 participants (223 women and 74 men) enrolled in a residential obesity treatment program. Men reported higher initial levels of self-efficacy than women, whereas women reported greater pre-treatment levels of binge eating and depressive symptoms. Higher pre-treatment levels of weight control self-efficacy, binge eating, and depressive symptoms predicted greater weight loss in men, but not in women. Results suggest that certain psychological and behavioral factors should be considered when implementing weight loss interventions, and indicate a need to consider gender differences in predictors of weight loss treatment. Future research should seek to identify predictors of weight loss among women.

Bariatric surgery: a viable treatment option for patients with severe mental illness.

Science.gov (United States)

Shelby, Sarah R; Labott, Susan; Stout, Rebecca A

2015-01-01

Although bariatric surgery has become a recognized treatment for obesity, its utility among patients with severe psychiatric disorders has not been extensively studied. A few studies have reported similar weight loss outcomes in these patients, but psychiatric status after bariatric surgery has been studied only minimally, and it is unknown if exacerbation of the mental illness affects weight loss. The aim of this study was to shed greater light on the issue of serious mental illness and bariatric surgery. Specifically, do patients with a diagnosis of schizophrenia, bipolar I, and bipolar II have poorer weight loss outcomes postbariatric surgery than the general bariatric surgery population? Also, do patients with these diagnoses experience an exacerbation of psychiatric symptoms after bariatric surgery, and if so, is the exacerbation of these disorders linked to poorer weight loss results? Midwest university medical center. A medical record review of approximately 1500 bariatric patients in a Midwest university medical center was conducted to identify those patients with diagnoses of schizophrenia, bipolar I, and bipolar II. Information was gathered on bariatric surgery outcomes and changes in psychiatric status postsurgery. Eighteen patients were identified as undergoing bariatric surgery and having a diagnosis of schizophrenia, bipolar I, or bipolar II. Weight loss in this group was significant and comparable to expected outcomes of absolute weight lost, changes in body mass index, and percentage excess weight loss for patients in the typical bariatric population. Postsurgery psychiatric status was known on 10 patients. All 10 patients experienced some exacerbation of psychiatric problems yet weight loss outcomes were still as expected. Bariatric surgery is a viable obesity treatment option for patients with schizophrenia, bipolar I, and bipolar II disorders. Symptom exacerbations occurred postsurgery, although it is not clear if these were due to the surgery or

A "small-changes" workplace weight loss and maintenance program: examination of weight and health outcomes.

Science.gov (United States)

Zinn, Caryn; Schofield, Grant M; Hopkins, Will G

2012-10-01

To compare the effect of "small-changes" and "usual care" workplace interventions on weight loss and to investigate the effect of small changes with or without maintenance on weight and health outcomes. Overweight/obese employees at two New Zealand worksites received a 12-month usual-care intervention (n = 53), followed by a 12-month small-changes intervention (n = 102). Small changes comprised a 12-week component, followed by 9 months of maintenance, implemented at only one worksite. Magnitudes of effects were assessed via a threshold of -5% (weight loss) and standardization (health outcomes). Small changes showed beneficial weight loss relative to usual care in both worksites. For small-changes interventions, worksites reduced weight (12 weeks) and maintained lost weight (12 months). One in every three participants lost 5% or more weight. Some improvements in health outcomes were shown. Regardless of maintenance, the small-changes intervention was successful in sustaining weight loss.

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

Weight loss and quality of life in patients surviving 2 years after gastric cancer resection.

Science.gov (United States)

Climent, M; Munarriz, M; Blazeby, J M; Dorcaratto, D; Ramón, J M; Carrera, M J; Fontane, L; Grande, L; Pera, M

2017-07-01

Malnutrition is common in patients undergoing gastric cancer resection, leading to weight loss, although little is known about how this impacts on health-related quality of life (HRQL). This study aimed to explore the association between HRQL and weight loss in patients 2 years after curative gastric cancer resection. Consecutive patients undergoing curative gastric cancer resection and surviving at least 2 years without disease recurrence were recruited. Patients completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the specific module for gastric cancer (STO22) before and 2 years postoperatively and associations between HRQL scores and patients with and without ≥ 10% body weight loss (BWL) were examined. A total of 76 patients were included, of whom 51 (67%) had BWL ≥10%. At 2 years postoperatively, BWL ≥10% was associated with deterioration of all functional aspects of quality of life, with persistent pain (21.6%), diarrhoea (13.7%) and nausea/vomiting (13.7%). By contrast, none of the patients with BWL patients with ≥10% BWL than in those with Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Bariatric surgery is associated with renal function improvement.

Science.gov (United States)

Holcomb, Carla N; Goss, Lauren E; Almehmi, Ammar; Grams, Jayleen M; Corey, Britney L

2018-01-01

Weight loss after bariatric surgery improves both blood pressure and glycemic control following surgery. The effect of bariatric surgery on renal function is not well characterized. In this study, we sought to quantify the change in renal function over time following surgery. We retrospectively reviewed all patients who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) between 2012 and 2014 at our institution. The glomerular filtration rate (GFR, mL/min) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Body mass index (BMI, kg/m 2 ) and percent weight loss (%WL) were calculated following the surgery. A total of 149 patients who underwent bariatric surgery were included in this study: LRYGB (n = 86 and LSG (n = 63). In LRYGB group, baseline BMI (kg/m 2 , ±SD) and GFR (mL/min, ±SD) were 48.5 ± 6.8 and 94.7 ± 23.8, respectively. In comparison, BMI and GFR were 49.1 ± 11.9 kg/m 2 and 93.1 ± 28.0 mL/min in the LSG group, respectively. Over the follow-up period (19.89 ± 10.93 months), the patients who underwent LRGYB lost a larger percentage of weight as compared to those in the LSG group (29.9 ± 11.7% vs 22.3 ± 10.7%; p = weight loss surgery (n = 62), 42% had improvement of their GFR to > 90 mL/min postoperatively (p weight loss percentage and GFR improvement (p = 0.8703). Bariatric surgery was associated with improvement in postoperative renal function at almost two years following surgery but was not different for LRYGB versus LSG. The gain in GFR was independent of percentage of weight lost suggesting an alternate mechanism in the improvement of renal function other than weight loss alone.

Predicting successful long-term weight loss from short-term weight-loss outcomes: new insights from a dynamic energy balance model (the POUNDS Lost study)123

Science.gov (United States)

Ivanescu, Andrada E; Martin, Corby K; Heymsfield, Steven B; Marshall, Kaitlyn; Bodrato, Victoria E; Williamson, Donald A; Anton, Stephen D; Sacks, Frank M; Ryan, Donna; Bray, George A

2015-01-01

Background: Currently, early weight-loss predictions of long-term weight-loss success rely on fixed percent-weight-loss thresholds. Objective: The objective was to develop thresholds during the first 3 mo of intervention that include the influence of age, sex, baseline weight, percent weight loss, and deviations from expected weight to predict whether a participant is likely to lose 5% or more body weight by year 1. Design: Data consisting of month 1, 2, 3, and 12 treatment weights were obtained from the 2-y Preventing Obesity Using Novel Dietary Strategies (POUNDS Lost) intervention. Logistic regression models that included covariates of age, height, sex, baseline weight, target energy intake, percent weight loss, and deviation of actual weight from expected were developed for months 1, 2, and 3 that predicted the probability of losing <5% of body weight in 1 y. Receiver operating characteristic (ROC) curves, area under the curve (AUC), and thresholds were calculated for each model. The AUC statistic quantified the ROC curve’s capacity to classify participants likely to lose <5% of their body weight at the end of 1 y. The models yielding the highest AUC were retained as optimal. For comparison with current practice, ROC curves relying solely on percent weight loss were also calculated. Results: Optimal models for months 1, 2, and 3 yielded ROC curves with AUCs of 0.68 (95% CI: 0.63, 0.74), 0.75 (95% CI: 0.71, 0.81), and 0.79 (95% CI: 0.74, 0.84), respectively. Percent weight loss alone was not better at identifying true positives than random chance (AUC ≤0.50). Conclusions: The newly derived models provide a personalized prediction of long-term success from early weight-loss variables. The predictions improve on existing fixed percent-weight-loss thresholds. Future research is needed to explore model application for informing treatment approaches during early intervention. The POUNDS Lost study was registered at clinicaltrials.gov as NCT00072995. PMID:25733628

Distinctive microbiomes and metabolites linked with weight loss after gastric bypass, but not gastric banding

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Ilhan, Zehra Esra; DiBaise, John K.; Isern, Nancy G.; Hoyt, David W.; Marcus, Andrew K.; Kang, Dae-Wook; Crowell, Michael D.; Rittmann, Bruce E.; Krajmalnik-Brown, Rosa

2017-05-26

Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric banding (LAGB) are anatomically different bariatric operations. RYGB achieves greater weight loss compared with LAGB. Changes in the gut microbiome have been documented after RYGB, but not LAGB, and the microbial contribution to sustainable surgical weight loss warrants further evaluation. We hypothesized that RYGB imposes greater changes on the microbiota and its metabolism than LAGB, and that the altered microbiota may contribute to greater weight loss. Using multi-omic approaches, we analyzed fecal microbial community structure and metabolites of pre-bariatric surgery morbidly obese (PreB-Ob), normal weight (NW), post-RYGB, and post-LAGB participants. RYGB microbiomes were significantly different from those from NW, LAGB and PreB-Ob. Microbiome differences between RYGB and PreB- Ob populations were mirrored in their metabolomes. Diversity was higher in RYGB compared with LAGB, possibly because of an increase in the abundance of facultative anaerobic, bile-tolerant and acid-sensible microorganisms in the former. Possibly because of lower gastric acid exposure, phylotypes from the oral cavity, such as Escherichia, Veillonella and Streptococcus, were in greater abundance in the RYGB group, and their abundances positively correlated with percent excess weight loss. Many of these post-RYGB microorganisms are capable of amino-acid fermentation. Amino-acid and carbohydrate fermentation products—isovalerate, isobutyrate, butyrate and propionate—were prevalent in RYGB participants, but not in LAGB participants. RYGB resulted in greater alteration of the gut microbiome and metabolome than LAGB, and RYGB group exhibited unique microbiome composed of many amino-acid fermenters, compared with nonsurgical controls.

Gender Differences in Weight Loss: Evidence from a NHS Weight Management Service

OpenAIRE

BHOGAL, Manpal Singh; Langford, Robert

2014-01-01

Provides evidence that men lose more weight than women when enrolled on a weight loss intervention.\\ud •\\ud Men lose more weight than women from their initial assessment up to 12-months.\\ud •\\ud Men maintain their weight and continue to lose more weight postintervention compared to women.

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.

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

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.

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

Zonisamide-induced weight loss in schizophrenia: case series.

Science.gov (United States)

Yang, Jaewon; Lee, Moon-Soo; Joe, Sook-Haeng; Jung, In-Kwa; Kim, Seung-Hyun

2010-01-01

Weight gain and metabolic disturbances constitute bothersome problems in schizophrenic patients treated with atypical antipsychotics. Several medications, exercise regimens, and lifestyle changes have been used in attempts to ameliorate these problems. We describe 3 patients with schizophrenia who manifested distinct weight loss and reduction in waist circumference during medication with zonisamide. This report suggests that zonisamide might be associated with weight loss in patients with schizophrenia.

What distinguishes weight loss maintainers of the German Weight Control Registry from the general population?

Science.gov (United States)

Feller, Silke; Müller, Astrid; Mayr, Andreas; Engeli, Stefan; Hilbert, Anja; de Zwaan, Martina

2015-05-01

Differences between successful long-term weight loss maintainers and the general population with regard to eating and weighing habits, non-normative eating behaviors, and eating-related and general psychopathological parameters are unknown. Self-identified weight loss maintainers from the German Weight Control Registry (GWCR, n = 494) were compared with a representative sample of the general German population (n = 2,129). The samples did not differ in current BMI. Using the same assessment instruments in both cohorts, a variety of eating-related and psychological variables were determined. The GWCR participants reported more self-weighing and higher eating frequency but less hot meal consumption and more eating-out-of-home. Binge eating, compensatory behaviors, and concerns about shape and weight were reported more often by successful weight loss maintainers. Scores of depression and worrying about health were slightly higher whereas severity of somatic symptoms was less pronounced in the GWCR participants. Overall, our data suggest that successful weight loss maintainers are characterized by more concerns about shape and weight, greater binge eating frequency, and higher use of compensatory behaviors. The latter suggests that weight loss maintenance might not only be achieved by healthy strategies but also by non-normative behaviors which might increase the vulnerability for weight regain. © 2015 The Obesity Society.

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 subjects (N = 10 744), =55 years with cardiovascular disease and/or type 2 diabetes mellitus, received sibutramine plus weight management during a 6-week Lead-in Period before randomization to continue sibutramine (N = 4906) or to receive placebo (N = 4898). The primary endpoint was the time from...... randomization to first occurrence of a primary outcome event (non-fatal myocardial infarction, non-fatal stroke, resuscitated cardiac arrest or cardiovascular death). Results: For the total population, mean weight change during Lead-in Period (sibutramine) was -2.54 kg. Post-randomization, mean total weight...

The Role of Stigma in Weight Loss Maintenance Among U.S. Adults.

Science.gov (United States)

Puhl, Rebecca M; Quinn, Diane M; Weisz, Bradley M; Suh, Young J

2017-10-01

Challenges of maintaining long-term weight loss are well-established and present significant obstacles in obesity prevention and treatment. A neglected but potentially important barrier to weight-loss maintenance is weight stigmatization. We examined the role of weight stigma-experienced and internalized-as a contributor to weight-loss maintenance and weight regain in adults. A diverse, national sample of 2702 American adults completed an online battery of questionnaires assessing demographics, weight-loss history, subjective weight category, experienced and internalized weight stigma, weight-monitoring behaviors, physical activity, perceived stress, and physical health. Analyses focused exclusively on participants who indicated that their body weight a year ago was at least 10% less than their highest weight ever (excluding pregnancy), the weight loss was intentional, and that attempts to lose or maintain weight occurred during the past year (n = 549). Participants were further classified as weight regainers (n = 235) or weight-loss maintainers (n = 314) based on subsequent weight loss/gain. Data were collected in 2015 and analyzed in 2016. Hierarchical logistic regression models showed that internalized weight stigma and subjective weight category made significant individual contributions to prediction of weight-loss maintenance, even after accounting for demographics, perceived stress, experienced stigma, physical health, and weight-loss behaviors. For every one-unit increase in internalized weight stigma, the odds of maintaining weight loss decreased by 28% (95% CI: 14-40%, p < .001). Findings provide initial evidence that overlooked psychosocial factors, like weight stigma, may hinder weight-loss maintenance. Implications for addressing stigma in obesity-focused clinical interventions are highlighted.

(Dis-)solving the Weight Problem in Binge-Eating Disorder: Systemic Insights From Three Treatment Contexts With Weight Stability, Weight Loss, and Weight Acceptance.

Science.gov (United States)

Meyer, Lene Bomholt; Waaddegaard, Mette; Lau, Marianne Engelbrecht; Tjørnhøj-Thomsen, Tine

2018-04-01

Binge-eating disorder (BED) is a severe eating disorder strongly associated with obesity. Treatments struggle to provide safe and effective ways of addressing weight in a BED context. This study explored a two-phased treatment for BED developed at a major out-patient eating disorder service in Denmark. The study used interviews and participant observations to gain insight into experiences and processes related to weight and body issues in three treatment contexts that addressed weight stability, weight acceptance, and weight loss. Using systems theory, the study proposed a relational weight problem that embeds feelings of non-acceptance due to weight, a merge of weight and identity, and an internalized body- and weight-critical gaze of others. Contrary to critical claims that weight acceptance discourages people with obesity from engaging in weight loss efforts, this study suggests that acceptance and a disentanglement of weight and identity are prerequisites for weight loss for this group.

Endoluminal weight loss and metabolic therapies: current and future techniques.

Science.gov (United States)

Hill, Christine; Khashab, Mouen A; Kalloo, Anthony N; Kumbhari, Vivek

2018-01-01

Obesity is a public health epidemic associated with a number of comorbidities, most notably type 2 diabetes and hypertension, as well as elevated all-cause mortality. The treatment for obesity and its associated comorbidities has most recently expanded into the field of bariatric endoscopy. This field bridges a gap between lifestyle counseling with or without pharmaceutical treatment and the most effective treatment of obesity, bariatric surgery. Because of its minimally invasive nature, bariatric endoscopic therapy has the potential to appeal to the large sector of the obese population that resists surgery, as well as those early in the onset of obesity. To date, five endoscopic devices have been approved by the U.S. Food and Drug Administration for the treatment of obesity, and many more are in development, undergoing clinical trials, or being used around the world. Here, we present the current state of the field, highlight recent developments, and describe the clinical outcomes of these minimally invasive procedures in terms of weight loss, improvement in metabolic profile, and reduction in comorbidities. © 2017 New York Academy of Sciences.

[Etiological and exacerbation factors for COPD. Body weight loss].

Science.gov (United States)

Yokoyama, Akihito

2016-05-01

Hunger or malnutrition is not only a historical issue but also a current problem worldwide. Biological responses to hunger are evolutionary prepared in our body, including energy generation by degradation of body proteins. Extreme weight loss (malnutrition) can cause air space enlargement in human and rodents. However, the changes in rodents could be reversible, since refeeding could repair the pathology. On the other hand, weight loss is a common feature in patients with more severe COPD. Complex factors, such as increased energy consumption, decreased food uptake by low grade inflammation, socio-economic factors and so on, are involved in weight loss. Weight loss in patients with COPD also increases the risk of exacerbation, hospitalization, and death.

Gestational Weight Gain and Post-Partum Weight Loss Among Young, Low-Income, Ethnic Minority Women

Science.gov (United States)

ROTHBERG, Bonnie E. Gould; MAGRIPLES, Urania; KERSHAW, Trace S.; RISING, Sharon Schindler; ICKOVICS, Jeannette R.

2010-01-01

Objective Document weight change trajectories that lead to gestational weight gain or postpartum weight loss outside clinical recommendations established by Institute of Medicine (IOM). Methods Women aged 14-25 receiving prenatal care and delivering singleton infants at term (N=427). Medical record review and four structured interviews conducted: second and third trimester, 6- and 12-months postpartum. Longitudinal mixed modeling to evaluate weight change trajectories. Results Only 22% of participants gained gestational weight within IOM guidelines. 62% exceeded maximum recommendations -- more common among those overweight/obese (BMI≥25.0; phypertension; breastfeeding promoted postpartum weight loss (all p<.02). BMI by race interaction suggested healthier outcomes for Latinas (p=0.02). Conclusion Excessive pregnancy weight gain and inadequate postpartum weight loss are highly prevalent among young low-income ethnic minority women. Pregnancy and postpartum are critical junctures for weight management interventions. PMID:20974459

N-of-1 study of weight loss maintenance assessing predictors of physical activity, adherence to weight loss plan and weight change.

Science.gov (United States)

Kwasnicka, Dominika; Dombrowski, Stephan U; White, Martin; Sniehotta, Falko F

2017-06-01

Behaviour change interventions are effective in supporting individuals to achieve clinically significant weight loss, but weight loss maintenance (WLM) is less often attained. This study examined predictive variables associated with WLM. N-of-1 study with daily ecological momentary assessment combined with objective measurement of weight and physical activity, collected with wireless devices (Fitbit™) for six months. Eight previously obese adults who had lost over 5% of their body weight in the past year took part. Data were analysed using time series methods. Predictor variables were based on five theoretical themes: maintenance motives, self-regulation, personal resources, habits, and environmental influences. Dependent variables were: objectively estimated step count and weight, and self-reported WLM plan adherence. For all participants, daily fluctuations in self-reported adherence to their WLM plan were significantly associated with most of the explanatory variables, including maintenance motivation and satisfaction with outcomes, self-regulation, habit, and stable environment. Personal resources were not a consistent predictor of plan adherence. This is the first study to assess theoretical predictions of WLM within individuals. WLM is a dynamic process including the interplay of motivation, self-regulation, habit, resources, and perceptions of environmental context. Individuals maintaining their weight have unique psychological profiles which could be accounted for in interventions.

Dramatic weight loss associated with commencing clozapine.

Science.gov (United States)

Lally, John; McDonald, Colm

2011-11-08

The authors report the case of a 44-year-old man with a long history of chronic enduring schizophrenia who experienced dramatic weight loss after commencing treatment with clozapine, an antipsychotic medication characteristically associated with the greatest degree of weight gain among medical treatments for schizophrenia. He was obese with a body mass index (BMI) of 41.5 kg/m(2), but after commencing clozapine therapy he experienced an improvement in psychotic symptoms and 40% loss of his body weight attained through an altered diet and exercise regime, which resulted in him attaining a normal BMI of 24.8 kg/m(2).

Psychosocial Predictors of Change in Depressive Symptoms Following Gastric Banding Surgery.

Science.gov (United States)

Preiss, Kymberlie; Clarke, David; O'Brien, Paul; de la Piedad Garcia, Xochitl; Hindle, Annemarie; Brennan, Leah

2018-02-08

The aim of this study is to identify psychosocial variables associated with the relationship between weight loss and change in depressive symptoms following gastric banding surgery. Ninety-nine adults completed self-report questionnaires assessing depressive symptoms and other psychosocial variables (self-esteem, body image dissatisfaction, perceived physical health, and perceived weight-based stigmatisation) prior to gastric-band surgery and monthly for 6-month post-surgery. Weight, depressive symptoms, and other psychosocial variables improved significantly 1-month post-surgery and remained lower to 6 months. Weight loss from baseline to 1- and 6-months post-surgery significantly correlated with change in depressive symptoms. Body image dissatisfaction and self-esteem accounted for some of the variance in change in depressive symptoms from baseline to 1-month and baseline to 6-months post-surgery. Depressive symptoms improved significantly and rapidly after bariatric surgery, and body image dissatisfaction and self-esteem predicted change in depressive symptoms. Interventions targeting body image and self-esteem may improve depressive symptoms for those undergoing weight loss interventions.

Amino Acid Signatures to Evaluate the Beneficial Effects of Weight Loss

Directory of Open Access Journals (Sweden)

Nina Geidenstam

2017-01-01

Full Text Available Aims. We investigated the relationship between circulating amino acid levels and obesity; to what extent weight loss followed by weight maintenance can correct amino acid abnormalities; and whether amino acids are related to weight loss. Methods. Amino acids associated with waist circumference (WC and BMI were studied in 804 participants from the Malmö Diet and Cancer Cardiovascular Cohort (MDC-CC. Changes in amino acid levels were analyzed after weight loss and weight maintenance in 12 obese subjects and evaluated in a replication cohort (n=83. Results. Out of the eight identified BMI-associated amino acids from the MDC-CC, alanine, isoleucine, tyrosine, phenylalanine, and glutamate decreased after weight loss, while asparagine increased after weight maintenance. These changes were validated in the replication cohort. Scores that were constructed based on obesity-associated amino acids and known risk factors decreased in the ≥10% weight loss group with an associated change in BMI (R2=0.16–0.22, p<0.002, whereas the scores increased in the <10% weight loss group (p<0.0004. Conclusions. Weight loss followed by weight maintenance leads to differential changes in amino acid levels associated with obesity. Treatment modifiable scores based on epidemiological and interventional data may be used to evaluate the potential metabolic benefit of weight loss.

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

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

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.

Changes in lifestyle habits and behaviours are associated with weight loss maintenance in members of a commercial weight loss organisation

OpenAIRE

Stubbs, RJ; McConnon, A; Gibbs, M; Raats, M; Whybrow, S

2012-01-01

This analysis examined the lifestyle correlates of weight loss maintenance in 1428 participants of a slimming organisation, who had been members for a mean SD of 16 16 months, had lost 13.8% 9.2% weight and were trying to maintain, or increase, their weight loss during a subsequent 6 month study period. Data were collected as part of the DiOGenes study(1). Ethical approval was given by the University of Surrey Ethics Committee. Adults were recruited between August 2006 and July 2008 from Slim...

Dramatic weight loss associated with commencing clozapine

OpenAIRE

Lally, John; McDonald, Colm

2011-01-01

The authors report the case of a 44-year-old man with a long history of chronic enduring schizophrenia who experienced dramatic weight loss after commencing treatment with clozapine, an antipsychotic medication characteristically associated with the greatest degree of weight gain among medical treatments for schizophrenia. He was obese with a body mass index (BMI) of 41.5 kg/m2, but after commencing clozapine therapy he experienced an improvement in psychotic symptoms and 40% loss of his body...

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......-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....

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...

Weight loss in obese women - exercise v. dietary education ...

African Journals Online (AJOL)

Weight loss, body fat loss (%) and daily energy intake reductions were equally reduced in the subjects in all three groups who completed the programme. There was, however, a significantly higher dropout rate in the control group. Taking this into account, the weight loss in the two test groups was similar and greater than ...

Vaping to lose weight: Predictors of adult e-cigarette use for weight loss or control.

Science.gov (United States)

Morean, Meghan E; Wedel, Amelia V

2017-03-01

Some traditional cigarette smokers are motivated to smoke to lose weight or control their weight. The current study evaluated whether a subset of adult e-cigarette users reported vaping to lose or control their weight and examined potential predictors of vaping for weight management. Adult e-cigarette users (n=459) who reported wanting to lose weight or maintain their weight completed an anonymous online survey. Participants reported on demographics, vaping frequency, e-cigarette nicotine content, cigarette smoking status, preferred e-cigarette/e-liquid flavors, current weight status (i.e., overweight, underweight), use of dieting strategies associated with anorexia and bulimia, lifetime history of binge eating, self-discipline, and impulse control. Binary logistic regression was used to examine whether vaping for weight loss/control was associated with the aforementioned variables. Participants who reported vaping for weight loss/control (13.5%) were more likely to vape frequently (adjOR=1.15; 95% CI [1.00, 1.31]); be overweight (adjOR=2.80; [1.33, 5.90]); restrict calories (adjOR=2.23; [1.13, 4.42]); have poor impulse control (adjOR=0.59; [0.41, 0.86]); and prefer coffee- (adjOR=2.92; [1.47, 5.80]) or vanilla-flavored e-liquid (adjOR=7.44; [1.56, 36.08]). A subset of adult e-cigarette users reported vaping for weight loss/control, raising concerns about expanded, scientifically unsubstantiated uses of e-cigarettes. Identifying where individuals obtain information about vaping for weight loss (e.g., e-cigarette ads, Internet) and whether weight-related motives promote e-cigarette initiation among e-cigarette naïve individuals is important to informing regulatory efforts. Further research also is needed to better understand the link between e-liquid flavors and weight loss motivations. Copyright © 2016 Elsevier Ltd. All rights reserved.

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.

Bariatric surgery in obese adolescents: opportunities and challenges.

Science.gov (United States)

Wasserman, Halley; Inge, Thomas H

2014-09-01

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

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...... 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....

Blood-loss Management in Spine Surgery.

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Bible, Jesse E; Mirza, Muhammad; Knaub, Mark A

2018-01-15

Substantial blood loss during spine surgery can result in increased patient morbidity and mortality. Proper preoperative planning and communication with the patient, anesthesia team, and operating room staff can lessen perioperative blood loss. Advances in intraoperative antifibrinolytic agents and modified anesthesia techniques have shown promising results in safely reducing blood loss. The surgeon's attention to intraoperative hemostasis and the concurrent use of local hemostatic agents also can lessen intraoperative bleeding. Conversely, the use of intraoperative blood salvage has come into question, both for its potential inability to reduce the need for allogeneic transfusions as well as its cost-effectiveness. Allogeneic blood transfusion is associated with elevated risks, including surgical site infection. Thus, desirable transfusion thresholds should remain restrictive.

Motivation and Its Relationship to Adherence to Self-Monitoring and Weight Loss in a 16-Week Internet Behavioral Weight Loss Intervention

Science.gov (United States)

Webber, Kelly H.; Tate, Deborah F.; Ward, Dianne S.; Bowling, J. Michael

2010-01-01

Objective: To examine changes in motivation and the relationship of motivation to adherence to self-monitoring and weight loss in a 16-week Internet behavioral weight-loss intervention. Design: Two-group randomized design. Setting: This study was conducted over the Internet. Participants: Sixty-six women, ages 22-65, with a body mass index (BMI)…

Resistant starch and energy balance: impact on weight loss and maintenance.

Science.gov (United States)

Higgins, Janine A

2014-01-01

The obesity epidemic has prompted researchers to find effective weight-loss and maintenance tools. Weight loss and subsequent maintenance are reliant on energy balance--the net difference between energy intake and energy expenditure. Negative energy balance, lower intake than expenditure, results in weight loss whereas positive energy balance, greater intake than expenditure, results in weight gain. Resistant starch has many attributes, which could promote weight loss and/or maintenance including reduced postprandial insulinemia, increased release of gut satiety peptides, increased fat oxidation, lower fat storage in adipocytes, and preservation of lean body mass. Retention of lean body mass during weight loss or maintenance would prevent the decrease in basal metabolic rate and, therefore, the decrease in total energy expenditure, that occurs with weight loss. In addition, the fiber-like properties of resistant starch may increase the thermic effect of food, thereby increasing total energy expenditure. Due to its ability to increase fat oxidation and reduce fat storage in adipocytes, resistant starch has recently been promoted in the popular press as a "weight loss wonder food". This review focuses on data describing the effects of resistant starch on body weight, energy intake, energy expenditure, and body composition to determine if there is sufficient evidence to warrant these claims.

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.

Effect of weight loss on urinary incontinence in women

Science.gov (United States)

Whitcomb, Emily L; Subak, Leslee L

2011-01-01

Background 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 approaches is effective in reducing urinary incontinence symptoms and should be strongly considered as a first line treatment for overweight and obese women with urinary incontinence. PMID:24198645

Weight-Loss Expectancies, Relative Weight, and Symptoms of Bulimia in Young Women.

Science.gov (United States)

Thombs, Dennis L.; And Others

1996-01-01

A canonical correlation analysis of various weight concerns in a sample of college women revealed that strong expectations of weight loss benefits and a high relative body weight were positively correlated with the four major symptoms of bulimia. Expectations of increased self-worth and social confidence were linked to eating problems. (RJM)

Efficacy of a "small-changes" workplace weight loss initiative on weight and productivity outcomes.

Science.gov (United States)

Zinn, Caryn; Schofield, Grant M; Hopkins, Will G

2012-10-01

The effect of weight reduction on workplace productivity is unknown. We have investigated a "small-changes" workplace weight loss intervention on weight and productivity outcomes. Overweight/obese employees at two New Zealand worksites (n = 102) received the 12-week intervention. One site received an extra 9-month weight-maintenance component. Magnitudes of effects on weight and productivity were assessed via standardization. Both groups reduced weight at 12 weeks and maintained lost weight at 12 months. There were small possible improvements in productivity at one worksite and trivial reductions at the other by 12 weeks, with little subsequent change during maintenance in either group. At an individual level, weight change was associated with at most only small improvements or small reductions in productivity. Workplace weight loss initiatives may need to be more intensive or multidimensional to enhance productivity.

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...

Patient-Reported Outcomes in Weight Loss and Body Contouring Surgery

DEFF Research Database (Denmark)

Poulsen, Lotte; Klassen, Anne; Rose, Michael

2017-01-01

BACKGROUND: Health-related quality of life and satisfaction with appearance are important outcomes in bariatric and body contouring surgery. To investigate these outcomes, scientifically sound and clinically meaningful patient-reported outcome instruments are needed. The authors measured health-r...

Using data mining to predict success in a weight loss trial.

Science.gov (United States)

Batterham, M; Tapsell, L; Charlton, K; O'Shea, J; Thorne, R

2017-08-01

Traditional methods for predicting weight loss success use regression approaches, which make the assumption that the relationships between the independent and dependent (or logit of the dependent) variable are linear. The aim of the present study was to investigate the relationship between common demographic and early weight loss variables to predict weight loss success at 12 months without making this assumption. Data mining methods (decision trees, generalised additive models and multivariate adaptive regression splines), in addition to logistic regression, were employed to predict: (i) weight loss success (defined as ≥5%) at the end of a 12-month dietary intervention using demographic variables [body mass index (BMI), sex and age]; percentage weight loss at 1 month; and (iii) the difference between actual and predicted weight loss using an energy balance model. The methods were compared by assessing model parsimony and the area under the curve (AUC). The decision tree provided the most clinically useful model and had a good accuracy (AUC 0.720 95% confidence interval = 0.600-0.840). Percentage weight loss at 1 month (≥0.75%) was the strongest predictor for successful weight loss. Within those individuals losing ≥0.75%, individuals with a BMI (≥27 kg m -2 ) were more likely to be successful than those with a BMI between 25 and 27 kg m -2 . Data mining methods can provide a more accurate way of assessing relationships when conventional assumptions are not met. In the present study, a decision tree provided the most parsimonious model. Given that early weight loss cannot be predicted before randomisation, incorporating this information into a post randomisation trial design may give better weight loss results. © 2017 The British Dietetic Association Ltd.

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

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...... that was tailored to metabolic changes of the menstrual cycle (Menstralean) or to undergo simple energy restriction (control). RESULTS: Thirty-one women (19 Menstralean and 12 control women) completed the study [mean ± SD body mass index (in kg/m(2)): 32.0 ± 5.2]. Both groups lost weight during the study....... 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...

Overnight weight loss: relationship with sleep structure and heart rate variability

OpenAIRE

Walter Moraes; Dalva Poyares; Christian Guilleminault; Agostinho Rosa; Marco Tulio Mello; Adriana Rueda; Sergio Tufik

2008-01-01

Background: Weight loss can be caused by a loss of body mass due to metabolism and by water loss as unsensible water loss, sweating, or excretion in feces and urine. Although weight loss during sleep is a well-known phenomenon, it has not yet been studied in relation to sleep structure or autonomic tonus during sleep. Our study is proposed to be a first step in assessing the relationship between overnight weight loss, sleep structure, and HRV (heart rate variability) parameters.Methods: Twent...

Cancer Cachexia: Beyond Weight Loss.

Science.gov (United States)

Bruggeman, Andrew R; Kamal, Arif H; LeBlanc, Thomas W; Ma, Joseph D; Baracos, Vickie E; Roeland, Eric J

2016-11-01

Cancer cachexia is a multifactorial syndrome characterized by skeletal muscle loss leading to progressive functional impairment. Despite the ubiquity of cachexia in clinical practice, prevention, early identification, and intervention remain challenging. The impact of cancer cachexia on quality of life, treatment-related toxicity, physical function, and mortality are well established; however, establishing a clinically meaningful definition has proven challenging because of the focus on weight loss alone. Attempts to more comprehensively define cachexia through body composition, physical functioning, and molecular biomarkers, while promising, are yet to be routinely incorporated into clinical practice. Pharmacologic agents that have not been approved by the US Food and Drug Administration but that are currently used in cancer cachexia (ie, megestrol, dronabinol) may improve weight but not outcomes of interest such as muscle mass, physical activity, or mortality. Their routine use is limited by adverse effects. For the practicing oncologist, early identification and management of cachexia is critical. Oncologists must recognize cachexia beyond weight loss alone, focusing instead on body composition and physical functioning. In fact, becoming emaciated is a late sign of cachexia that characterizes its refractory stage. Given that cachexia is a multifactorial syndrome, it requires early identification and polymodal intervention, including optimal cancer therapy, symptom management, nutrition, exercise, and psychosocial support. Consequently, oncologists have a role in ensuring that these resources are available to their patients. In addition, in light of the promising investigational agents, it remains imperative to refer patients with cachexia to clinical trials so that available options can be expanded to effectively treat this pervasive problem.

Metabolic Changes After Roux-N-Y Bariatric Surgery In Hispanics.

Science.gov (United States)

Hernández-Gil de Lamadrid, José; Nieves-Rivera, Juan J; Mora, Laura; Corretjer, Lisa; Altieri, Pablo I; Suárez, Albert; Banchs, Héctor L; Muñiz, Jesús; Soto, Marie Ivelisse; Escobales, Nelson; Crespo, María

2015-01-01

The objective was to describe the metabolic outcomes 12 months after bariatric surgery (Roux-N-Y) in morbidly obese Hispanic patients, and evaluate the correlation between weight loss and the observed changes. Medical records from a hundred-and-two Hispanic obese patients who underwent bariatric surgery were identified at the University of Puerto Rico (UPR) Hospital. The following variables were obtained before and 12 months after surgery: Body Mass Index (BMI), body weight, total cholesterol (TC), triglycerides, high density lipoprotein (HDL), low density lipoprotein (LDL), and fasting blood sugar (FBS). Ninety-seven percent of patients underwent Roux-N-Y surgery; 79.4% were females and 44% were diabetics. We observed statistically significant reductions (p N-Y significantly improves the lipid profile and FBS levels in obese Hispanic patients. The poor correlation factor between weight loss and these variables suggests that other mechanisms, independent from weight loss, are responsible for these changes.

Factors Related to Weight Gain/Loss among Emerging Adults with Obesity.

Science.gov (United States)

Johnson, Ping H; Annesi, James J

2018-05-01

We examined the reasons for weight gain and barriers to weight loss among emerging adults with obesity. Eighty-one female undergraduate students with obesity completed 4-open ended questions in 2015-2016. Qualitative responses were analyzed using NVivo 11 Pro software. Most participants experienced weight gain prior to attending college. The most commonly reported reasons for weight gain include a lack of ability to control one's behaviors or overcome barriers (ie, poor eating habits, lack of physical activity, lack of time, easy access to food), emotional/mental health issues, physical health, and influence of significant others. Nearly half reported having a weight loss goal. Most reported having used one or more weight loss methods. Few reached short-term weight loss but quickly regained the lost weight. Major reported barriers reflect a lack of self-regulation skills, negative mood and stress, and lack of self-efficacy for healthy eating or physical activity. Results suggest that the perceived ability to control one's behaviors and overcome barriers, self-efficacy, and mood are important in weight-related behaviors, weight, and weight loss success among emerging adults, especially those enrolled in college.

Diabetes, Obesity, and Other Medical Diseases - Is Surgery the Answer?

Science.gov (United States)

Pohl, Dieter; Bloomenthal, Aaron

2017-03-01

For many physicians, the concept of surgery as the best treatment for a medical disease such as diabetes, cardiovascular problems, hyperlipidemia, sleep apnea, hepatosteatosis, GERD, osteoarthritis, psoriasis, rheumatoid arthritis, or infertility, still sounds wrong and just a ploy by surgeons to increase their business. Since 2011, however, several non-surgical societies have recommended Weight Loss Surgery - The International Diabetes Federation, The American Diabetes Association, American Heart Association, and Obesity Society in 2015 for patients with body mass index (BMI) greater than 35 and diabetes, and to decrease cardiovascular risk factors.1 The concept is to treat the common underlying problem, which is obesity, with the most effective method for immediate and long-term weight loss, which is surgery. The term "metabolic" surgery was therefore coined to accurately describe the effects of weight loss (bariatric) surgery. Our specialty society named itself the American Society for Metabolic and Bariatric Surgery (ASMBS). [Full article available at http://rimed.org/rimedicaljournal-2017-03.asp].

Your diet after gastric bypass surgery

Science.gov (United States)

Gastric bypass surgery - your diet; Obesity - diet after bypass; Weight loss - diet after bypass ... You had gastric bypass surgery. This surgery made your stomach smaller by closing off most of your stomach with staples. It changed the way your ...

Association between Weight and Smoking Not Mediated by Weight Loss Attempts or Bullying.