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Sample records for weight loss surgery

  1. Weight Loss Surgery

    Science.gov (United States)

    Weight loss surgery helps people with extreme obesity to lose weight. It may be an option if you cannot lose weight ... obesity. There are different types of weight loss surgery. They often limit the amount of food you ...

  2. Complications following body contouring surgery after massive weight loss

    DEFF Research Database (Denmark)

    Hasanbegovic, Emir; Sørensen, Jens Ahm

    2014-01-01

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

  3. Preoperative thyroid function and weight loss after bariatric surgery.

    Science.gov (United States)

    Neves, João Sérgio; Souteiro, Pedro; Oliveira, Sofia Castro; Pedro, Jorge; Magalhães, Daniela; Guerreiro, Vanessa; Costa, Maria Manuel; Bettencourt-Silva, Rita; Santos, Ana Cristina; Queirós, Joana; Varela, Ana; Freitas, Paula; Carvalho, Davide

    2018-05-16

    Thyroid function has an important role on body weight regulation. However, the impact of thyroid function on weight loss after bariatric surgery is still largely unknown. We evaluated the association between preoperative thyroid function and the excess weight loss 1 year after surgery, in 641 patients with morbid obesity who underwent bariatric surgery. Patients with a history of thyroid disease, treatment with thyroid hormone or antithyroid drugs and those with preoperative evaluation consistent with overt hypothyroidism or hyperthyroidism were excluded. The preoperative levels of TSH and FT4 were not associated with weight loss after bariatric surgery. The variation of FT3 within the reference range was also not associated with weight loss. In contrast, the subgroup with FT3 above the reference range (12.3% of patients) had a significantly higher excess weight loss than patients with normal FT3. This difference remained significant after adjustment for age, sex, BMI, type of surgery, TSH and FT4. In conclusion, we observed an association between high FT3 and a greater weight loss after bariatric surgery, highlighting a group of patients with an increased benefit from this intervention. Our results also suggest a novel hypothesis: the pharmacological modulation of thyroid function may be a potential therapeutic target in patients undergoing bariatric surgery.

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

    Science.gov (United States)

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

    2012-04-01

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

  5. Treatment of Obesity: Weight Loss and Bariatric Surgery

    Science.gov (United States)

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

    2016-01-01

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

  6. Weight-loss surgery and children

    Science.gov (United States)

    ... 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 ...

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

    Science.gov (United States)

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

    2015-01-01

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

  8. Weight loss in orthognathic surgery: a clinical study.

    Science.gov (United States)

    Hammond, Douglas; Williams, Rhodri W; Juj, Kiranjit; O'Connell, Susan; Isherwood, Grant; Hammond, Nichola

    2015-09-01

    To analyse weight change, body composition change and Body Mass Index change in patients undergoing orthognathic surgery. A service evaluation was undertaken in orthognathic patients pre-operatively and at 4 weeks post-surgery. Queen Elizabeth Hospital Birmingham outpatient department. Thirty-one patients scheduled for single- or two-jaw orthognathic surgery and rigid internal fixation. Immediately pre-operatively and at 4 weeks post-surgery the following information was gathered: (1) patient height; (2) patient weight (kg); (3) Patient Body Mass Index; and (4) patient body fat percentage. In the 4-week post-operative period, the average weight loss was -4·96 kg (range: -9·6 to +3·0 kg), with a body fat reduction of -3·07% (range: -5·80% to +2·30%) and an average reduction in Body Mass Index of -1·63 (range: -3·4 to +0·8). There was no statistically significant difference in weight loss (P = 0·1562) or body fat composition change (P = 0·2391) between single- or two-jaw surgery. There was no statistically significant difference in weight loss (P = 0·4858) or body fat composition change (P = 0·5321) between male and female patients. Weight loss observed was similar to that reported in studies using inter-maxillary fixation. Closer psychological and dietetic support is needed for patients who have a low normal or underweight Body Mass Index. Better and more bespoke tailored Oral Nutritional Supplementation must be provided for all orthognathic surgery patients to potentially reduce this significant weight loss.

  9. Relationship Between Tobacco Use and Weight Loss After Bariatric Surgery.

    Science.gov (United States)

    Moser, Federico; Signorini, Franco J; Maldonado, Pablo S; Lopez Sivilat, Arturo; Gorodner, Verónica; Viscido, Germán; Saleg, Patricia; Obeide, Lucio R

    2016-08-01

    Smoking cessation had been typically associated with weight gain. So far, there are no reports documenting the relationship between weight loss after bariatric surgery and smoking habit. The objective of the study was to establish the relationship between weight loss and smoking habit in patients undergoing bariatric surgery and to analyze weight loss on severe smokers and on those patients who stopped smoking during the postoperative period. All patients undergoing laparoscopic sleeve gastrectomy (LSG) with at least 2-year follow-up were included. Patients were divided into three groups: (A) smokers, (B) ex-smokers, and (C) non-smokers. Demographics and weight loss at 6, 12, and 24 months were analyzed. Smokers were subdivided for further analysis into the following: group A1: heavy smokers, group A2: non-heavy smokers, group A3: active smokers after surgery, and group A4: quitters after surgery. Chi-square test was used for statistics. One hundred eighty-four patients were included; group A: 62 patients, group B: 57 patients, and group C: 65 patients. Mean BMI was 34 ± 6, 31 ± 6, and 31 ± 6 kg/m2; mean %EWL was 63 ± 18, 76 ± 21, and 74 ± 22 % at 6, 12, and 24 months, respectively. The subgroup analysis showed the following composition: group A1: 19 patients, group A2: 43 patients, group A3: 42 patients, and group A4: 20 patients. Weight loss difference among groups and subgroups was statistically non-significant. Our study shows that weight loss evolution was independent from smoking habit. Neither smoking cessation during the postoperative period nor smoking severity could be related to weight loss after LSG.

  10. Updates in weight loss surgery and gastrointestinal peptides

    DEFF Research Database (Denmark)

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

    2015-01-01

    PURPOSE OF REVIEW: Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy are referred to as 'metabolic surgery' due to hormonal shifts with impacts on diabetes remission and weight loss. The purpose of this review is to summarize recent findings in mechanisms underlying beneficial effects...... of weight loss surgery. RECENT FINDINGS: Importantly, gut hormone secretion is altered after RYGB and sleeve gastrectomy due to accelerated transit of nutrients to distal parts of the small intestine, leading to excessive release of L-cell peptide hormones [e.g. glucagon-like peptide-1 (GLP-1), peptide YY......; as demonstrated by relapse of impaired glucose tolerance in studies blocking the GLP-1 receptor by exendin 9-39, and later after major weight loss increased peripheral insulin sensitivity. Gut hormone secretion changes towards a more anorectic profile and is likely important for less caloric intake and weight...

  11. Psychological predictors of weight loss after bariatric surgery

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sauter Edward R

    2012-01-01

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

  13. History of Smoking and Postcessation Weight Gain among Weight Loss Surgery Candidates

    OpenAIRE

    Levine, Michele D.; Kalarchian, Melissa A.; Courcoulas, Anita P.; Wisinski, Meghan S.C.; Marcus, Marsha D.

    2007-01-01

    Smoking cessation often results in weight gain. Although smoking cessation frequently is recommended to patients presenting for weight loss surgery (WLS), the relationship between smoking cessation and weight gain among WLS candidates is poorly understood. Thus, we sought to document the history and prevalence of smoking and smoking-related weight gain among WLS candidates. Subjects (N = 67) presenting for bariatric surgery provided demographic information, were interviewed about smoking, and...

  14. Systematic review of patient education practices in weight loss surgery.

    Science.gov (United States)

    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

  15. Expert panel on weight loss surgery: executive report update.

    Science.gov (United States)

    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.

  16. History of Smoking and Postcessation Weight Gain among Weight Loss Surgery Candidates

    Science.gov (United States)

    Levine, Michele D.; Kalarchian, Melissa A.; Courcoulas, Anita P.; Wisinski, Meghan S.C.; Marcus, Marsha D.

    2007-01-01

    Smoking cessation often results in weight gain. Although smoking cessation frequently is recommended to patients presenting for weight loss surgery (WLS), the relationship between smoking cessation and weight gain among WLS candidates is poorly understood. Thus, we sought to document the history and prevalence of smoking and smoking-related weight gain among WLS candidates. Subjects (N = 67) presenting for bariatric surgery provided demographic information, were interviewed about smoking, and weighed and measured prior to operation. Sixty-seven percent of patients reported a lifetime history of smoking, and 26.9% were current smokers. Among lifetime smokers who had attempted to quit, the average maximum amount of weight gained following smoking cessation was 28.1 pounds, but there was wide variability in postcessation weight gain. These data suggest that smoking among candidates for bariatric surgery is prevalent, and that previous cessation attempts were associated with considerable weight gain. Because patients often receive recommendations to quit smoking and lose weight prior to surgery, additional information on the impact of presurgical smoking cessation on long-tem weight control in this population is needed. PMID:17408868

  17. Psychiatric Factors and Weight Loss Patterns Following Gastric Bypass Surgery in a Veteran Population

    OpenAIRE

    Rutledge, Thomas; Groesz, Lisa M.; Savu, Michelle

    2009-01-01

    Background Although pre-surgical psychological evaluations are commonly administered to patients considered for weight loss surgeries, the value of these evaluations for predicting weight loss success has been questioned. In this study, we addressed this issue by examining patient’s total number of psychiatric indicators rather than individual psychological factors as predictors of weight loss/weight regain. Methods Sixty adult veterans completed gastric bypass surgery or laparoscopic gastric...

  18. Best Practice Updates for Pediatric/Adolescent Weight Loss Surgery

    Science.gov (United States)

    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

  19. Supervised Physical Training Improves Weight Loss After Roux-en-Y Gastric Bypass Surgery

    DEFF Research Database (Denmark)

    Mundbjerg, Lene Hymøller; Stolberg, Charlotte Røn; Cecere, Stefano

    2018-01-01

    Objective: Bariatric surgery results in significant weight loss and reduces cardiovascular morbidity. However, a large variation in postsurgery weight loss is seen. Physical activity promotes weight loss in nonsurgically treated subjects with obesity. The aim of this study was to investigate...

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

    Directory of Open Access Journals (Sweden)

    Margaret Husted

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    McGrice M

    2015-06-01

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

  2. 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 ...

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

    Science.gov (United States)

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

    2014-01-01

    The aim of this study was to investigate body composition changes in fat mass (FM) to lean body mass (LBM) ratios following 15% body weight loss (WL) in both integrated medical treatment and bariatric surgery groups. Obese patients (body mass index [BMI] 46.6 ± 6.5 kg/m(2)) who underwent laparoscopic gastric bypass surgery (BS), were matched with 24 patients undergoing integrated medical and behavioral treatment (MT). The BS and MT groups were evaluated for body weight, BMI, body composition, and waist circumference (WC) at baseline and after 15% WL. Following 15% body WL, there were significant decreases in %FM and increased %LBM (P 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.

  4. Awakening: a qualitative study on maintaining weight loss after bariatric surgery.

    Science.gov (United States)

    Liebl, Lori; Barnason, Susan; Brage Hudson, Diane

    2016-04-01

    To describe the experiences of adults who were successful in maintaining weight loss after bariatric surgery. The majority of studies examine a homogenous demographic group of postbariatric surgical patients who have gone through initial weight loss, which occurs within the first 12-24 months post surgery. Maintenance of weight loss begins 24 months after bariatric surgery; however, there is a paucity of research examining experiences during this period. The lack of conclusive research related to interactions between intrapersonal, behavioural and environmental influences suggests a need to develop a better understanding of patients' experiences related to weight loss maintenance post bariatric surgery. Bandura's Social Cognitive Theory provided the framework for the semi-structured interviews for this qualitative descriptive study. In-person interviews with n = 14 participants who were able to maintain weight loss at least 24 months after a bariatric surgery. Participants experienced an awakening and gained a new perspective on their life. They identified negative attitudes, influences and behaviours and modified their environment to support their desired healthy behaviour. To maintain weight loss, an individual must seek out and be surrounded by positive family and peer support influences. Positive support may provide the opportunity for an individual to place personal health needs as a priority. Therapeutic education and counselling for individuals, couples and families should occur during all phases of bariatric surgery. Communication techniques may empower clients to deflect negative comments and influences in a constructive manner. Support groups should accommodate the various phases of bariatric surgery. Clients should be prepared for how to work through emotions associated with weight fluctuations. © 2016 John Wiley & Sons Ltd.

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

    Science.gov (United States)

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

    2004-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Kathrin Schag

    2016-11-01

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

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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

  9. Cognitive function predicts 24-month weight loss success after bariatric surgery.

    Science.gov (United States)

    Spitznagel, Mary Beth; Alosco, Michael; Strain, Gladys; Devlin, Michael; Cohen, Ronald; Paul, Robert; Crosby, Ross D; Mitchell, James E; Gunstad, John

    2013-01-01

    Clinically significant cognitive impairment, particularly in attention/executive and memory function, is found in many patients undergoing bariatric surgery. These difficulties have previously been linked to decreased weight loss 12 months after surgery, but more protracted examination of this relationship has not yet been conducted. The present study prospectively examined the independent contribution of cognitive function to weight loss 24 months after bariatric surgery. Given the rapid rate of cognitive improvement observed after surgery, postoperative cognitive function (i.e., cognition 12 weeks after surgery, controlling for baseline cognition) was expected to predict lower body mass index (BMI) and higher percent total weight loss (%WL) at 24-month follow-up. Data were collected by 3 sites of the Longitudinal Assessment of Bariatric Surgery (LABS) parent project. Fifty-seven individuals enrolled in the LABS project who were undergoing bariatric surgery completed cognitive evaluation at baseline, 12 weeks, and 24 months. BMI and %WL were calculated for 24-month postoperative follow-up. Better cognitive function 12 weeks after surgery predicted higher %WL and lower BMI at 24 months, and specific domains of attention/executive and memory function were robustly related to decreased BMI and greater %WL at 24 months. Results show that cognitive performance shortly after bariatric surgery predicts greater long-term %WL and lower BMI 24 months after bariatric surgery. Further work is needed to clarify the degree to which this relationship is mediated by adherence to postoperative guidelines. Copyright © 2013 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  12. 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...

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

    Science.gov (United States)

    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.

  14. Preoperative weight loss with glucagon-like peptide-1 receptor agonist treatment predicts greater weight loss achieved by the combination of medical weight management and bariatric surgery in patients with type 2 diabetes: A longitudinal analysis.

    Science.gov (United States)

    Tang, Tien; Abbott, Sally; le Roux, Carel W; Wilson, Violet; Singhal, Rishi; Bellary, Srikanth; Tahrani, Abd A

    2018-03-01

    We examined the relationship between weight changes after preoperative glucagon-like peptide-1 receptor agonist (GLP-1RA) treatment and weight changes from the start of medical weight management (MWM) until 12 months after bariatric surgery in patients with type 2 diabetes in a retrospective cohort study. A total of 45 patients (64.4% women, median [interquartile range] age 49 [45-60] years) were included. The median (interquartile range) weight loss from start of MWM until 12 months post-surgery was 17.9% (13.0%-29.3%). GLP-1RA treatment during MWM resulted in 5.0% (1.9%-7.7%) weight loss. Weight loss during GLP-1RA treatment predicted weight loss from the start of MWM until 12 months post-surgery, but not postoperative weight loss after adjustment. The proportion of weight loss from start of MWM to 12 months post-surgery attributed to GLP-1RA treatment was negatively associated with that attributed to surgery, after adjustment. In conclusion, weight change after GLP-1RA treatment predicted the weight loss achieved by a combination of MWM and bariatric surgery, but not weight loss induced by surgery only. Failure to lose weight after GLP-1RA treatment should not be considered a barrier to undergoing bariatric surgery. © 2017 John Wiley & Sons Ltd.

  15. Weight Loss

    Science.gov (United States)

    ... 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 ...

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

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

    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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

    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.

  1. Postoperative CPAP use impacts long-term weight loss following bariatric surgery.

    Science.gov (United States)

    Collen, Jacob; Lettieri, Christopher J; Eliasson, Arn

    2015-03-15

    Obstructive sleep apnea (OSA) is common among bariatric surgery candidates. After surgical weight loss, OSA frequently persists and untreated OSA can lead to weight gain. Long-term continuous positive airway pressure (CPAP) adherence is unclear and poor adherence may worsen weight loss outcomes. We sought to determine the impact of CPAP use on long-term weight-loss outcomes in a cohort of bariatric patients. Long-term observational study of bariatric surgery patients with OSA. Patients were evaluated with polysomnography preoperatively and one-year postoperatively. The cohort was again evaluated a mean of 7.2 years later to determine the relationship between long-term CPAP use and subsequent regain of weight. Twenty-four consecutive patients (aged 48.5 ± 9.4 years at time of surgery; 73% female) were included in the initial assessment, and long-term outcome data were available on 22 subjects. Persistent OSA was documented in 21 of 22 subjects (95%) one year postoperatively. Final evaluation occurred 7.2 ± 2.3 years following surgery. Weight (213.3 ± 39.1 to 235.3 ± 47.1 lb, p = 0.10) and BMI (32.5 ± 5.4 to 37.3 ± 8.2 kg/m(2), p = 0.03) increased in most (n = 19, 86.4%) from postoperative to final evaluation. CPAP use declined from 83.3% (preoperatively) to 38.1% (one year) and to 23.8% (final evaluation). BMI increased among those not using CPAP at long-term follow-up compared to those with continued CPAP use (6.8% v -1.8%, p = 0.05). In our cohort of bariatric patients with OSA, long-term adherence to CPAP therapy was poor, and non-adherence was associated with weight gain. Ongoing follow-up of OSA in this population may help to preserve initial achievements after surgical weight loss. © 2014 American Academy of Sleep Medicine.

  2. 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...

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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

  8. 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.

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

    OpenAIRE

    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,

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

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

    2012-12-01

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

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

    Directory of Open Access Journals (Sweden)

    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

  14. 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

  15. 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

  16. 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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

  20. 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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  3. 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

  4. 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....

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

    Science.gov (United States)

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

    2017-02-01

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

  6. 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

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

    Science.gov (United States)

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

    2015-01-01

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

  8. 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

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

    Science.gov (United States)

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

    2017-03-01

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

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

    Science.gov (United States)

    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.

  11. 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...

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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

  15. Proven Weight Loss Methods

    Science.gov (United States)

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

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

    Science.gov (United States)

    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.

  17. 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...

  18. 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...

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

    Science.gov (United States)

    Amundsen, Tina; Strømmen, Magnus; Martins, Catia

    2017-05-01

    Suboptimal weight loss (SWL) and weight regain (WR) after gastric bypass surgery (GB) remains poorly understood. This study aims to compare GB patients experiencing SWL or significant WR (SigWR) with successful controls, regarding postoperative food intake, eating behavior, physical activity (PA), and psychometrics. Forty-nine patients with >1 year post-surgery were classified as either experiencing SWL (excess body weight loss, EWL, <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.

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

    Science.gov (United States)

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

    2013-08-01

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

  1. Overweight, Obesity, and Weight Loss

    Science.gov (United States)

    ... 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 ...

  2. Mechanisms of Weight Regain following Weight Loss.

    Science.gov (United States)

    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.

  3. 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.

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

    Directory of Open Access Journals (Sweden)

    Jo Gilmartin

    2014-03-01

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

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

    Science.gov (United States)

    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.

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

    NARCIS (Netherlands)

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

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

  7. 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...

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

    Science.gov (United States)

    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.

  9. 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.

  10. 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.

  11. Weight Loss Surgery

    Science.gov (United States)

    ... the stomach and the upper part of the small intestine. Since the food doesn't travel the full length of the ... people need to get used to eating very small amounts. They need to chew their food more than they used to and space meals ...

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

    Science.gov (United States)

    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.

  13. 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....

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

    OpenAIRE

    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)...

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  17. Determinants of weight regain after bariatric surgery.

    Science.gov (United States)

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

    2013-01-01

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

  18. Hypnotherapy in Weight Loss Treatment.

    Science.gov (United States)

    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)

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

    Science.gov (United States)

    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.

  20. 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.

  1. Unexplained Weight Loss

    Science.gov (United States)

    ... weight is affected by your calorie intake, activity level, overall health, age, nutrient absorption, and economic and social factors. If you're losing weight without trying and you're concerned about it, consult your doctor — as a rule of thumb, losing more than 5 ...

  2. Weight loss and alcohol

    Science.gov (United States)

    ... Maclean JC. Alcohol consumption and body weight. Health Econ . 2010;19(7):814-832. PMID: 19548203 www. ... member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www. ...

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

    Science.gov (United States)

    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

  4. 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.

  5. Remifentanil Reduces Blood Loss During Orthognathic Surgery.

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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

  7. Body contouring following massive weight loss

    Directory of Open Access Journals (Sweden)

    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.

  8. FTO genotype and weight loss

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    Carlene Johnson Stoklossa

    2013-01-01

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

  12. 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.

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

    Science.gov (United States)

    ... Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & ... it takes to make it a success: the motivation to make lifelong changes and the support of ...

  14. 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...

  15. 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 ...

  16. Osteoarthritis, obesity and weight loss

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  17. 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...

  18. 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

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  1. Weight loss and bone mineral density.

    Science.gov (United States)

    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.

  2. 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....

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

    Science.gov (United States)

    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.

  4. 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.

  5. 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...

  6. 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...

  7. FTO genotype and weight loss

    DEFF Research Database (Denmark)

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

    2016-01-01

    : Ovid Medline, Scopus, Embase, and Cochrane from inception to November 2015. ELIGIBILITY CRITERIA FOR STUDY SELECTION: Randomised controlled trials in overweight or obese adults reporting reduction in body mass index, body weight, or waist circumference by FTO genotype (rs9939609 or a proxy) after...

  8. Obesity Prevention and Weight Maintenance After Loss.

    Science.gov (United States)

    German, Alexander James

    2016-09-01

    Obesity is one of the most prevalent medical diseases in pets. Outcomes are often disappointing; many animals either fail to reach target weight or regain weight. This article discusses managing obesity, focusing on prevention. It gives guidance on establishing monitoring programs that use regular body weight and condition assessments to identify animals at risk of inappropriate weight gain, enabling early intervention. Weight management in obese animals is a lifelong process. Regular weight and body condition monitoring are key to identifying animals that rebound early, while continuing to feed a therapeutic weight loss diet can help prevent it from happening. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. 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

  10. 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

  11. 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

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

    Science.gov (United States)

    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.

  13. Goal setting: Eating, Physical activity & Weight loss

    Science.gov (United States)

    No matter what your weight loss goal is, the key to reaching your goals is to make changes to your lifestyle behaviors like eating and physical activity. This involves setting realistic expectations and making a plan.

  14. 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...

  15. 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.

  16. 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....

  17. 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

  18. Women's challenges with postpartum weight loss.

    Science.gov (United States)

    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.

  19. 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).

  20. 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...

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

    Science.gov (United States)

    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.

  2. Determinants of weight loss after vertical banded gastroplasty.

    Science.gov (United States)

    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.

  3. Posttraumatic Stress Disorder, obesity, and weight loss

    DEFF Research Database (Denmark)

    Johannessen, Kim Berg; Berntsen, Dorthe

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

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

    Directory of Open Access Journals (Sweden)

    Danielle M. Raves

    2016-10-01

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

  5. FORUM Achieving weight loss and avoiding obesity

    African Journals Online (AJOL)

    The efficacy of diets advocating extreme macronutrient manipulation has been reviewed extensively. Studies involving participation for 12 months or longer revealed that diet adherence, length of intervention and level of calorie. ISSUES IN MEDICINE. Achieving weight loss and avoiding obesity. Maria Elizabeth Catsicas.

  6. 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.

  7. Effect of weight loss on urinary incontinence in women

    Directory of Open Access Journals (Sweden)

    Whitcomb EL

    2011-08-01

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

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

    Science.gov (United States)

    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.

  9. Body image concerns amongst massive weight loss patients.

    Science.gov (United States)

    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

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    Budría, Santiago

    2012-03-01

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

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

  12. Blood-loss Management in Spine Surgery.

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    Giordano S

    2015-06-01

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

  14. 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....

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

    Directory of Open Access Journals (Sweden)

    Jeffery Robert W

    2006-02-01

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

  16. Weight Loss Surgery: An Option for Teens?

    Science.gov (United States)

    ... AAP Find a Pediatrician Health Issues Conditions Abdominal ADHD Allergies & Asthma Autism Cancer Chest & Lungs Chronic Conditions ... Updated 11/21/2015 Source Pediatric Obesity: Prevention, Intervention, and Treatment Strategies for Primary Care (Copyright © 2014 ...

  17. Life after weight-loss surgery

    Science.gov (United States)

    ... eliminate many health problems Improve your quality of life Live longer It is important to understand that there will be many other changes in your life. These include the way you eat, what you ...

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

    Science.gov (United States)

    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.

  19. Acute Vision Loss Following Endoscopic Sinus Surgery

    Directory of Open Access Journals (Sweden)

    Serena Byrd

    2017-01-01

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

  20. 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

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

  4. Obstructive Sleep Apnoea Syndrome and Weight Loss: Review

    Directory of Open Access Journals (Sweden)

    Douglas C. Cowan

    2012-01-01

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

  5. 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

  6. 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....

  7. Dietary fat intake, supplements, and weight loss

    Science.gov (United States)

    Dyck, D. J.

    2000-01-01

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

  8. 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.

  9. 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...

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  14. 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)

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

    Science.gov (United States)

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

    2016-01-01

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

  16. 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.

  17. Preoperative weight gain might increase risk of gastric bypass surgery.

    Science.gov (United States)

    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

  18. 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 ...

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

    Science.gov (United States)

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

    2016-11-01

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

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

  2. 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.

  3. 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

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

    Directory of Open Access Journals (Sweden)

    Sharlene Wedin

    2012-01-01

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

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  6. 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....

  7. 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

  8. The Impact of Acute Loss of Weight on Eustachian Tube Function

    Directory of Open Access Journals (Sweden)

    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.

  9. 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.

  10. Weight Loss: Ready to Change Your Habits?

    Science.gov (United States)

    ... calories more than you consume each day — through diet and exercise. You might lose weight more quickly if you ... yourself with regular weigh-ins and tracking your diet and activity, which is ... don't have a positive attitude about losing weight, you might not be ready — ...

  11. Weight Loss Five Years After Behavioral Treatment.

    Science.gov (United States)

    Levitz, Leonard S.; And Others

    The behaviorally-based weight control program conducted by Levitz and Jordan at the University of Pennsylvania and the Institute for Behavioral Education is tailored to patient needs and includes stimulus control, cognitive restructuring, and nutrition education. The success of patients in maintaining the clinically meaningful weight losses…

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

    Science.gov (United States)

    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.

  13. 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...

  14. 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.

  15. 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.

  16. 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.

  17. Gastric Bypass May Promote Weight Loss in Overweight Partners

    NARCIS (Netherlands)

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

    2015-01-01

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

  18. Instrumentalization of Eating Improves Weight Loss Maintenance in Obesity

    Directory of Open Access Journals (Sweden)

    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.

  19. 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.

  20. 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...

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

    Science.gov (United States)

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

    2015-04-01

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

  2. Weight-Loss and Nutrition Myths

    Science.gov (United States)

    ... kale vitamin D—cereals or soy-based beverages Myth: “Going vegetarian” will help you lose weight and be healthier. Some research shows that a healthy vegetarian eating plan may be linked to lower obesity levels. ...

  3. Selecting a Weight-Loss Program

    Science.gov (United States)

    ... should teach you how to change permanently those eating habits and lifestyle factors, such as lack of physical ... skills and techniques to make permanent changes in eating habits and levels of physical activity to prevent weight ...

  4. 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.

  5. 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 search...

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  7. Probability Weighting and Loss Aversion in Futures Hedging

    NARCIS (Netherlands)

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

    2008-01-01

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

  8. 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...

  9. Does Successful Weight Loss in an Internet-Based Worksite Weight Loss Program Improve Employee Presenteeism and Absenteeism?

    Science.gov (United States)

    Harden, Samantha M.; You, Wen; Almeida, Fabio A.; Hill, Jennie L.; Linnan, Laura A.; Allen, Kacie C.; Estabrooks, Paul A.

    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

  10. 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.

  11. 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....

  12. 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.

  13. 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.

  14. 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.

  15. Getting Past a Weight-Loss Plateau

    Science.gov (United States)

    ... America. 2018;102:49. Smethers AD, et al. Dietary management of obesity — Cornerstones of healthy eating patterns. Medical Clinics of ... and factors favouring weight regain. International Journal of Obesity. ... In: The Mayo Clinic Diet. 2nd ed. Rochester, Minn.: Mayo Foundation for Medical ...

  16. 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.

  17. 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 ...

  18. 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…

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

    Science.gov (United States)

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

    2012-01-01

    Background Bariatric surgery is one of the few effective treatments for morbid obesity but the weight loss and other health related outcomes for this procedure in large, diverse adolescent patient populations are not well characterized. Objective To analyze the prospective Bariatric Outcomes Longitudinal Database (BOLD) to determine the weight loss and health related outcomes in adolescents. Setting BOLD data is collected from 423 surgeons at 360 facilities in the United States. Methods Main outcome measures included anthropometric and comorbidity status at baseline (n=890) and at 3 (n=786), 6 (n=541), and 12 (n=259) months after surgery. Adolescents (75% female; 68% non-Hispanic white, 14% Hispanic, 11% non-Hispanic black, and 6% other) age 11-to-19 years were included in the analyses. Results The overall one year mean weight loss for those who underwent gastric bypass surgery was more than twice that of those who underwent adjustable gastric band surgery (48.6 kg versus 20 kg, 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

  20. 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.

  1. Young adults, technology, and weight loss: a focus group study.

    Science.gov (United States)

    Stephens, Janna; Moscou-Jackson, Gyasi; Allen, Jerilyn K

    2015-01-01

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

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

    OpenAIRE

    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),...

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

    Science.gov (United States)

    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.

  4. 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.

  5. 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.

  6. 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....

  7. 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

  8. Cultural conflicts in the weight loss experience of overweight Latinos.

    Science.gov (United States)

    Diaz, V A; Mainous, A G; Pope, C

    2007-02-01

    In spite of the high prevalence of obesity in the Latino population, there is limited recent information that can be used by health-care providers to develop culturally appropriate weight loss strategies for this population. Therefore, we describe weight loss experiences, attitudes and barriers in overweight Latino adults. Qualitative study using focus group methodology. Twenty-one overweight adults (body mass index >/=25, age >/=20 years) self-identified as Latinos. Subjects participated in one of three focus groups. Reccurring themes within group discussions were identified by three independent investigators, one who was ethnicity concordant. Themes included the presence of mixed messages when determining one's appropriate weight, with participants' desire to lose weight to be healthy (based on professional advice and personal experience) conflicting with the cultural idea that being overweight is healthy. Participants described discordance when adapting to the mainstream, leading to the loss of healthy traditional habits. Participants expressed interest in weight loss and familiarity with dieting and weight loss interventions. They desired culturally appropriate nutrition education and reassurance regarding healthy dieting from health-care providers. The importance of interactions with peers during education was another relevant theme, and participants were overwhelmingly positive about group education. To improve health promotion for Latinos, cultural factors distinctive to this underserved population, and barriers they articulate, should be considered when developing weight loss interventions.

  9. 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.

  10. [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.

  11. Choosing a Safe and Successful Weight-Loss Program

    Science.gov (United States)

    ... getting enough sleep, changes in work schedules, lack of motivation, and injury or illness? Is the program in ... physical activity, behavior change, and weight loss? What type of certifications, education, experience, and training do staff members ...

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

    Science.gov (United States)

    ... diabetes, heart disease or allergies? Do you have cultural or ethnic requirements or preferences regarding food? It's tempting to buy into promises of rapid and dramatic weight loss, but a slow and steady approach is easier ...

  13. Weight loss practices among newly enrolling clients in a commercial ...

    African Journals Online (AJOL)

    2016-03-01

    Mar 1, 2016 ... Background: In Ghana, obesity is showing a rising trend and there are weight loss initiatives being practised by .... tients seeking treatment in Italian medical centres, the .... Childhood Obesity: Need for a Trans-Sectoral.

  14. 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...

  15. 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...

  16. 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.

  17. 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.

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

    Directory of Open Access Journals (Sweden)

    Grzegorz Kakareko

    2017-08-01

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

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

    DEFF Research Database (Denmark)

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

    2017-01-01

    OBJECTIVE: Levels of fasting plasma glucose (FPG) and fasting insulin (FI) were studied as diet-specific prognostic markers for successful weight loss maintenance in participants with overweight. METHODS: After losing ≥ 8% of body weight, participants received one of three ad libitum diets for 6...

  20. 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.

  1. 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.

  2. 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)

  3. Rise of plasma ghrelin with weight loss is not sustained during weight maintenance

    Science.gov (United States)

    Ghrelin is postulated to be an orexigenic signal that promotes weight regain after weight loss (WL). However, it is not known whether this putative effect of ghrelin is sustained after weight stabilization. The objective of this study was to investigate the relationship of plasma ghrelin concentrati...

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

    DEFF Research Database (Denmark)

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

    2017-01-01

    OBJECTIVE: Levels of fasting plasma glucose (FPG) and fasting insulin (FI) were studied as diet-specific prognostic markers for successful weight loss maintenance in participants with overweight. METHODS: After losing ≥ 8% of body weight, participants received one of three ad libitum diets for 6.......12 to -0.43]; P = 0.020). The addition of FI strengthened these associations. CONCLUSIONS: Slightly elevated pretreatment FPG determined success in dietary weight loss maintenance among overweight patients on ad libitum diets differing in macronutrient and fiber content....

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

    Science.gov (United States)

    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.

  6. Patients' Reported Usage of Weight Management Skills Following Bariatric Surgery.

    Science.gov (United States)

    Essayli, Jamal H; LaGrotte, Caitlin A; Fink-Miller, Erin L; Rigby, Andrea

    2018-02-01

    Little is known about which specific weight management skills bariatric patients find most and least valuable. Participants completed a measure assessing their usage of weight management skills at a follow-up appointment one or more years after undergoing bariatric surgery. Decreased usage of skills was associated with unsuccessful weight outcome, defined as losing less than 50% of excess weight, as well as weight regain. Weighing regularly was the skill selected most often by successful participants as helpful, and was chosen by a significantly smaller percentage of unsuccessful participants and those who regained a clinically significant amount of weight. A majority of both successful and unsuccessful participants indicated that they had discontinued food journaling. Weighing regularly may be perceived as a more useful method of self-monitoring.

  7. 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.

  8. 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.

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

    Science.gov (United States)

    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.

  10. 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

  11. Timing of food intake predicts weight loss effectiveness.

    Science.gov (United States)

    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.

  12. 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

  13. 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.

  14. 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...

  15. 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.

  16. 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...

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

    Science.gov (United States)

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

    2015-01-01

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

  18. 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.

  19. (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.

  20. 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

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

    Science.gov (United States)

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

    2017-06-01

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

  2. 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...

  3. 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

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

    OpenAIRE

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

    2017-01-01

    Purpose The aim of this study is to explore the role of attachment styles in obesity. Material and Methods 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). Results The bariatric group reported significant...

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

    Directory of Open Access Journals (Sweden)

    Hession M

    2011-08-01

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

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

    Science.gov (United States)

    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.

  7. The role of carbohydrate in dietary prescription for weight loss

    DEFF Research Database (Denmark)

    Astrup, Arne

    content of ad libitum diets produces weight loss in both the short-term and over periods as long as 7 years. A fat-reduced diet, combined with physical activity, reduces all risk factors for cardiovascular disease, and reduces the incidence of type 2 diabetes. The combination of reduction of dietary fat...... and energy, and increased physical activity, has been shown to reduce the incidence of diabetes by 58% in two major trials. In post hoc analyses the reduction in dietary fat (energy density) and increase in fibre were the strongest predictors of weight loss and diabetes protective effects. It remains...... to be shown whether a low-glycemic index diet provides benefits beyond this. Low-carbohydrate diets may be an option for inducing weight loss in obese patients, but a very low intake of carbohydrate-rich foods is not commensurate with a healthy and palatable diet in the long term. However, there is evidence...

  8. 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.

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

    Science.gov (United States)

    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.

  10. A Clinical Trial on Weight Loss among Truck Drivers

    Directory of Open Access Journals (Sweden)

    MS Thiese

    2015-04-01

    Full Text Available Background: The high prevalence of obesity among commercial truck drivers may be related to sedentary nature of the job, lack of healthy eating choices, and lack of exercise. There may be a link between obesity and crash risk, therefore an intervention to reduce obesity in this population is needed. Objective: To assess feasibility of a 12-week weight loss intervention for truck drivers with a weight loss goal of 10% of initial body weight. Methods: Drivers were selected based on age (≥21 years and body mass index (≥30 kg/m2. The drivers participated in a before-after clinical trial. The intervention included a 12-week program that provided information on healthy diet and increasing exercise, and telephone-based coaching using SMART goals. Outcomes included change from baseline in reported energy intake, measured weight, waist, hip, and neck circumference, blood pressure, and point of care capillary blood lipids and hemoglobin A1c. Exit interviews were conducted to gain insight into driver opinions on the program features and usefulness. This study was registered with the NIH Clinical Trials Registry, number NCT02348983. Results: 12 of 13 drivers completed the study. Weight loss was statistically significant (p=0.03. Reported energy (p=0.005, total fat consumption (p=0.04, and saturated fat consumption (p=0.02 intake were also lower after the 12-week intervention. Drivers attributed their weight loss to health coaching and suggested a longer intervention so that they could reach their goal and become accustomed to the changes. Conclusion: This weight loss intervention is feasible for this difficult population. Additional research is needed to compare this intervention with a control group.

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

    Science.gov (United States)

    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.

  12. 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

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

    OpenAIRE

    Stephens, Janna; Moscou-Jackson, Gyasi; Allen, Jerilyn K.

    2015-01-01

    Overweight and obesity are a major concern in young adults. Technology has been integrated into many weight loss interventions; however little is known about the use of this technology in young adults. The purpose of this study was to explore through focus group sessions the opinions of young adults on the use of technology for weight loss. A total of 17 young adults, between 18 and 25 years of age, participated in three focus group sessions. Major results indicated that young adults have ver...

  14. Weight loss and fatigue in an elderly patient.

    Science.gov (United States)

    Waring, W S; McKnight, J A

    2005-02-01

    We report a recent clinical case of an elderly patient who presented with weight loss and fatigue and who was diagnosed with hyperthyroidism. Some time later, he was discovered to have underlying oesophageal lymphoma. The latter diagnosis was believed to contribute, at least in part, to his symptoms at the time of initial presentation. The case illustrates the potential difficulties associated with establishing the diagnosis of oesophageal lymphoma. Furthermore, symptoms of weight loss and fatigue are commonly encountered in general medical patients. This case reminded us that even when a diagnosis of hyperthyroidism has been established, these symptoms may be attributable to other pathology.

  15. Weight loss for overweight patients with knee or hip osteoarthritis

    DEFF Research Database (Denmark)

    Christensen, Robin; Hansen, Julie Bolvig; Lund, Hans

    2017-01-01

    This is a protocol for a Cochrane Review (Intervention). The objectives are as follows:  To determine the benefits and harms associated with weight loss in overweight individuals with knee or hip osteoarthritis in terms of pain, physical function, quality of life, and safety.  Further we will have...... an explicit focus on quality of the weight loss intervention (including magnitude and intensity) (Herbert 2005), to see whether there is a dose-response relationship at the trial (i.e. group) level....

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

    Science.gov (United States)

    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.

  17. Weight Gain and Hair Loss during Anti-TNF Therapy

    Directory of Open Access Journals (Sweden)

    Abdo Lutf

    2012-01-01

    Full Text Available Objectives. To investigate the incidence of weight gain and hair loss as adverse effects of anti-TNF therapy in rheumatic diseases. Methods. Patients using anti-TNF therapy, who are followed in rheumatology clinic, were interviewed using a questionnaire to investigate the side effects of anti-TNF therapy. Patients who complained of hair loss and weight gain were asked additional questions concerning the relationship of these adverse effects to anti-TNF use, whether therapy was stopped because of these adverse effects and if the adverse effects reversed after stopping therapy. The files were reviewed to follow the weight change before, during, and after discontinuation of anti-TNF. Results. One hundred fifty consecutive patients (82 RA, 34 ankylosing spondylitis, 32 psoriatic arthritis, and 4 for other indications were interviewed .Weight gain was observed in 20 patients (13.3% with average gain of 5.5 Kg. Anti-TNF was stopped in five patients because of this adverse effect. Hair loss during anti-TNf therapy was reported in five females (3.3% and anti-TNF therapy was stopped in all of them. Conclusion. Weight gain and hair loss appear to be associated with anti-TNF therapy and may be one reason for discontinuing the therapy.

  18. [The effect of sibutramine on weight loss in obese adolescents].

    Science.gov (United States)

    Franco, Ruth Rocha; Cominato, Louise; Damiani, Durval

    2014-04-01

    To evaluate the effect of sibutramine on weight loss in obese adolescents. A double-blind controlled study lasting 13 months. The study included 73 obese adolescents of both sexes aged between 10 and 18 years. Laboratory tests and imaging studies were performed before, during wash-out, and at the end of 13 months. The percentage of patients who lost 10% of their initial weight in the placebo group was 46%, and in the sibutramine group was 75%. When placebo was used, average weight rose by 1.61 kg, and BMI decreased by 0.24 kg/m(2) whereas with the use of sibutramine, weight decreased by 4.47 kg, and average BMI decreased, 2.38 kg/m(2), with p Sibutramine induced significantly more weight loss in obese adolescents compared with placebo, without significant side effects. The weight loss curve was different depending on the moment sibutramine was introduced. This finding indicates that the best time to start sibutramine is when adhesion begins to fail.

  19. Role of fermented beverages in the maintenance of weight loss

    Science.gov (United States)

    Monereo Megías, Susana; Arnoriaga Rodríguez, María; Olmedilla Ishishi, Yoko Lucía; Martínez de Icaya, Purificación

    2016-07-12

    Obesity is a very prevalent disease with multiple chronic complications that decrease or disappear after a small (5-10%) but maintained weight loss. Nevertheless, maintaining weight loss after the treatment is very difficult and it involves one of the biggest challenges to control this epidemic. Although the reasons that contribute to regain the lost weight are diverse and related to the biological response to caloric restriction and the lack of adherence to treatment, up to 20% of the patients are able to keep it off. The keys to success, involve the maintenance of healthy habits, exercise and a reasonable daily calorie intake to allow a normal way of life, without sacrificing the social life. At this point, learning to distinguish food and drink options in a society where social life often revolves around the table is very important. We review the keys to keep the weight off after a diet as well as the role of fermented beverages such as beer, in this process. In conclusion, maintenance the weight loss is harder than losing it. The mild-to-moderate consumption of fermented beverages such as beer is not associated with weight increase.

  20. 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

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

    Science.gov (United States)

    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.

  2. Surgery plus anesthesia induces loss of attention in mice

    Directory of Open Access Journals (Sweden)

    Quan eRen

    2015-09-01

    Full Text Available There is a need to develop animal models to study postoperative delirium. Inattention is one of the symptoms of delirium. Increases in the levels of α-synuclein and S100β have been reported to be associated with delirium. Therefore, we set out to determine the effects of surgery plus general anesthesia on the behavioral changes (including loss of attention in mice and on the levels of α-synuclein and S100β in the brain tissues of these mice. C57BL/6J mice (2- to 8-months-old had a simple laparotomy plus isoflurane anesthesia. The behavioral changes, including attention level and the speed of movements, were determined 12, 24 and 48 hours after the surgery plus anesthesia in the mice. The levels of α-synuclein and S100β in the cortex of these mice following the surgery plus anesthesia were determined by Western blot analysis.We found that there was a loss of attention at 24, but not 12 or 48, hours following the surgery plus anesthesia (49%+5 versus 33%+2.9, P=0.011, N=12 in the mice without significantly affecting the speed of their movements. There were increases in the levels of total α-synuclein (139%+33.5 versus 100%+13.7, P=0.037, N=6 and S100β (142%+7.7 versus 100%+6, P=0.002, N=6 in the cortex of the mice 12 hours following the surgery plus anesthesia.These findings suggested that the surgery plus isoflurane anesthesia might induce behavioral and biochemical/biochemical/cellular changes associated with delirium. We could use the surgery plus anesthesia in mice to develop an animal model to study postoperative delirium.

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

    Science.gov (United States)

    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.

  4. Fatty acid composition of adipose tissue triglycerides after weight loss and weight maintenance

    DEFF Research Database (Denmark)

    Kunešová, M; Hlavatý, P; Tvrzická, E

    2012-01-01

    Fatty acid composition of adipose tissue changes with weight loss. Palmitoleic acid as a possible marker of endogenous lipogenesis or its functions as a lipokine are under debate. Objective was to assess the predictive role of adipose triglycerides fatty acids in weight maintenance in participants...... of the DIOGENES dietary intervention study. After an 8-week low calorie diet (LCD) subjects with > 8 % weight loss were randomized to 5 ad libitum weight maintenance diets for 6 months: low protein (P)/low glycemic index (GI) (LP/LGI), low P/high GI (LP/HGI), high P/low GI (HP/LGI), high P/high GI (HP....../HGI), and a control diet. Fatty acid composition in adipose tissue triglycerides was determined by gas chromatography in 195 subjects before the LCD (baseline), after LCD and weight maintenance. Weight change after the maintenance phase was positively correlated with baseline adipose palmitoleic (16:1n-7...

  5. Changes in body composition and fat distribution in response to weight loss and weight regain

    NARCIS (Netherlands)

    Kooy, van der K.

    1993-01-01

    This thesis describes the effects of weight loss and subsequent weight regain on body composition, fat distribution and resting energy expenditure in moderately obese men and moderately obese premenopausal women. Participants were subjected to a controlled 4.2 MJ/day energy deficit diet for

  6. [Weight loss in overweight or obese patients and family functioning].

    Science.gov (United States)

    Jaramillo-Sánchez, Rosalba; Espinosa-de Santillana, Irene; Espíndola-Jaramillo, Ilia Angélica

    2012-01-01

    to determine the association between weight loss and family functioning. a cohort of 168 persons with overweight or obesity from 20-49 years, either sex, with no comorbidity was studied at the nutrition department. A sociodemographic data was obtained and FACES III instrument to measure family functioning was applied. At the third month a new assessment of the body mass index was measured. Descriptive statistical analysis and relative risk were done. obesity presented in 50.6 %, 59.53 % of them did not lose weight. Family dysfunction was present in 56.6 % of which 50 % did not lose weight. From 43.4 % of functional families, 9.52 % did not lose weight (p = 0.001). The probability or risk of not losing weight was to belong to a dysfunctional family is 4.03 % (CI = 2.60-6.25). A significant association was found between the variables: weight loss and family functioning. Belonging to a dysfunctional family may be a risk factor for not losing weight.

  7. 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.

  8. Behavioral therapy for weight loss in patients with schizophrenia.

    Science.gov (United States)

    Ganguli, Rohan

    2007-01-01

    Compared with the general population, individuals with schizophrenia demonstrate an increased prevalence of obesity. While most antipsychotics are associated with weight gain, certain second-generation antipsychotics (SGAs) appear to be especially problematic. Weight gain and obesity are highly distressing to these patients, can reduce treatment adherence, and may increase the relative risk of serious medical conditions and all-cause premature mortality. The selection of an antipsychotic on the basis of its effectiveness and relative side effect profile is recognized as an important initial consideration in the treatment of schizophrenia. However, less is known regarding the efficacy of dietary, pharmacologic, and behavioral therapy in reducing antipsychotic-related weight gain and obesity. Behavioral therapy, in particular, is understudied, and there are relatively few controlled trials of its effectiveness in reducing SGA-induced weight gain. Although weight loss resulting from behavioral therapy has been observed mostly as a result of effective short-term interventions, controlled behavioral studies do exist to suggest that weight can be controlled long term. In addition, a small pilot study in patients with schizophrenia or schizoaffective disorder recently demonstrated that behavioral therapy that utilizes stepped interventions, involving body weight self-monitoring, diet, and exercise, can prevent weight gain in patients initiating treatment with SGAs. Additional studies of behavioral therapy for long-term weight control in patients with schizophrenia and other forms of severe mental illness are warranted.

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

    Science.gov (United States)

    Minaker, Leia M; Leatherdale, Scott T

    2016-01-01

    Youth smoking and obesity may both be mediated by weight control behaviors and experiences of bullying. This study examines associations between smoking and obesity among youth, and explores whether associations are mediated by weight loss attempts or bullying experiences. Data from 24,173 grade 9 to 12 students in the COMPASS study (2012-13) were used to examine the prevalence of self-reported smoking, weight status, attempting to lose weight, and being a victim of bullying. Generalized linear mixed effects models were used to examine correlates of smoking. Among youth, 11% reported currently smoking, 20% were overweight or obese, 42% reported attempting to lose weight, and 18% reported being bullied. Girls who reported attempting to lose weight had higher odds of smoking (OR = 1.42, p = .0039), and students who reported being bullied had higher odds of smoking (OR = 1.85, p weight status. For girls, weight loss attempts were associated with smoking. For both sexes, being bullied was associated with smoking, independent of weight status. Programs attempting to reduce smoking among youth should consider the effects of weight control behaviors and bullying irrespective of weight status.

  10. Organizing a Community "Biggest Loser" Weight Loss Challenge

    Science.gov (United States)

    Jensen, Kirstin D.

    2013-01-01

    The program described here shows how Extension can be a strong collaborative partner in a rural setting in improving the overall health of the community by organizing a three month "Biggest Loser" Weight Loss Challenge. A pre-and post-fitness assessment and bi-weekly weigh-ins were administered. Three healthy lifestyle educational…

  11. Energy Drinks, Weight Loss, and Disordered Eating Behaviors

    Science.gov (United States)

    Jeffers, Amy J.; Vatalaro Hill, Katherine E.; Benotsch, Eric G.

    2014-01-01

    Objective: The present study examined energy drink consumption and relations with weight loss attempts and behaviors, body image, and eating disorders. Participants/Methods: This is a secondary analysis using data from 856 undergraduate students who completed the American College Health Association-National College Health Assessment II…

  12. Metabolism and Weight Loss: How You Burn Calories

    Science.gov (United States)

    ... energy. During this complex biochemical process, calories in food and beverages are combined with oxygen to release the energy ... Aug. 7, 2017. Obesity for Adults, Prevention and Management of. ... weight loss. Food and Drug Administration. https://www.fda.gov/ForConsumers/ ...

  13. Effective strategies for weight loss in post-partum women

    DEFF Research Database (Denmark)

    Lim, S.; O'Reilly, S.; Behrens, H.

    2015-01-01

    Post-partum weight loss is critical to preventing and managing obesity in women, but the results from lifestyle interventions are variable and the components associated with successful outcomes are not yet clearly identified. This study aimed to identify lifestyle intervention strategies associated...

  14. Abandoning weight-loss programmes | Van Staden | South African ...

    African Journals Online (AJOL)

    "ies in maintaining weight loss. A study of unsuccessful dieters focused on a group of 50 obese subjects who had previously joined a slimming organisation, but who had dropped out. They were interviewed with emphasis on factors relating to ...

  15. Weight loss in bamboo ( Bambusa vulgaris ) treated with neem seed ...

    African Journals Online (AJOL)

    Split-bamboo samples conditioned to 11.76% moisture content were converted to test specimens for Percentage Weight Loss (PWL) and treated with mechanically extracted neem seed oil at two different treatment temperature regimes by completely soaking a set in oil at ambient room temperature of 25 ± 2oC for 24 hours ...

  16. Weight loss improves biomarkers endothelial function and systemic ...

    African Journals Online (AJOL)

    Background: Although postmenopausal associated disorders are important public health problems worldwide, to date limited studies evaluated the endothelial function and systemic inflammation response to weight loss in obese postmenopausal women. Objective: This study was done to evaluate the endothelial function ...

  17. Abnormal eating attitudes and weight-loss behaviour of adolescent ...

    African Journals Online (AJOL)

    Objectives: This study aimed to determine the prevalence of abnormal eating attitudes and weight-loss behaviour in female Jewish adolescents. Teachersf awareness of these factors and their attitudes towards a school programme to address these were also investigated. Design: A cross-sectional study was conducted.

  18. Alterations of plasma lysophosphatidylcholine species in obesity and weight loss.

    Directory of Open Access Journals (Sweden)

    Susanne Heimerl

    Full Text Available Obesity and related diseases of the metabolic syndrome contribute to the major health problems in industrialized countries. Alterations in the metabolism of lipid classes and lipid species may significantly be involved in these metabolic overload diseases. However, little is known about specific lipid species in this syndrome and existing data are contradictive.In this study, we quantified plasma lipid species by electrospray ionization tandem mass spectrometry (ESI-MS/MS in obese subjects before and after 3 month weight loss as well as in a control group.The comparison of obese subjects with control subjects before weight loss revealed significantly lower lysophosphatidylcholine (LPC concentrations in obesity. LPC concentrations did not significantly increase during the observed period in the weight loss group. Analysis of LPC species revealed a decrease of most species in obesity and negative correlations with C-reactive protein (CRP and body mass index (BMI. Correlating BMI ratio before and after weight loss with the ratio of total LPC and individual LPC species revealed significant negative relationships of LPC ratios with BMI ratio.Our findings contribute to the contradictive discussion of the role of LPC in obesity and related chronic inflammation strongly supporting pre-existing data in the literature that show a decrease of LPC species in plasma of obese and a potentially anti-inflammatory role in these subjects.

  19. Intentional Weight Loss Improved Performance in Obese Ischaemic Heart Patient

    DEFF Research Database (Denmark)

    Geiker, Nina; Myint, Khin Swe; Heck, Patrick

    2014-01-01

    Aims: The risk of heart failure (HF) increases with BMI, but paradoxically obesity has been associated with reduced mortality in patients with HF. The effect of intentional or therapeutic weight loss on HF is not well known. We examined the effect of weight loss induced by low energy diet (LED......) on physical performance and cardiovascular risk factors in obese patients with moderate-to-severe HF and/or ischaemic heart disease (IHD). Methods and Results: Results from two weight loss interventions at two centres, one in Denmark (DK - 12 week intervention in 21 subjects (14 LED, 7 controls)) and one.......1 in the intervention group versus -22.1% ± 25.6 in the control group (P=0.000). Treatment also improved triglycerides (P=0.000), very low lipoprotein (P=0.001) and C-reactive protein (P=0.010). Conclusion: Weight loss induced by LED in obese patients with moderate-to-severe HF or IHD resulted in clinically significant...

  20. A worksite-based weight loss intervention for obesity prevention

    Science.gov (United States)

    Worksites are increasingly being used as locations for implementing healthy diet and weight loss interventions. Hence, there is an urgent need to identify programs that are both successful and sustainable. We conducted a 6-month pilot randomized controlled trial in overweight and obese employees a...

  1. Self-Management Patient Education and Weight Loss

    Science.gov (United States)

    Stombaugh, Angela M.

    2010-01-01

    Self-management of a disease is defined as "having or being able to obtain, the skills and resources necessary to best accommodate to the chronic disease and its consequences" (Holman & Lorig, 1992, p. 309). Self-management has been used in the management of several chronic conditions and this model may be useful in the management of weight loss.…

  2. 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...

  3. Intravitreal low molecular weight heparin in PVR surgery.

    Directory of Open Access Journals (Sweden)

    Kumar Atul

    2003-01-01

    Full Text Available Purpose: To evaluate the efficacy of low molecular weight heparin (LMWH in prevention of postoperative fibrin formation following vitreoretinal surgery with proliferative vitreoretinopathy (PVR. Material and Methods: Thirty consecutive patients of retinal detachment with advanced PVR were enrolled in the study. They were randomised to study and control groups (n = 15 each. Study group patients received vitreoretinal surgery with 5 IU/cc of LMWH in vitrectomy infusion fluid. The control group patients received vitroretinal surgery without heparin in the infusion fluid. Patients were followed up at 1 week, 1 month and 3 months after surgery. Postoperative bleeding, media clarity, best-corrected visual acuity and success of the surgery at the end of 3 months were compared between the two groups. Results: At each follow-up visit, the study group showed a better media clarity, which was statistically significant ( P = 0.0042. The study group had a 50% better chance of retinal reattachment compared to the control group. Five patients had intraoperative bleeding in the study group (33% compared to 3 patients in the control group (20%. Conclusion: Use of intravitreal LMWH prevents postoperative fibrin formation and is beneficial in repair of retinal detachments with PVR.

  4. 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.

  5. Overweight men's motivations and perceived barriers towards weight loss

    DEFF Research Database (Denmark)

    Sabinsky, Marianne; Toft, U. N.; Raben, A.

    2007-01-01

    motive for losing weight was a strong desire to become more effective and a greater asset for one's workplace. Overweight subjects were considered less effective and attractive for the labour market. Conclusion: This study indicates that if men from lower socioeconomic backgrounds are to be motivated......Objective: To explore motivation and perceived barriers towards weight loss among Danish men. Design: The study was of an explorative nature, using qualitative focus group interviews as a method. Setting: Copenhagen, Denmark. Subjects: Twenty-two overweight men, at the age of 25-44 years...... and motivated for weight loss, were recruited and distributed into four focus groups. The men were primarily unskilled workers. Overall 13 men participated and each group contained three or four participants. Intervention: The interview guide was partly structured, partly unstructured and the themes...

  6. Arrhythmogenicity of weight-loss supplements marketed on the Internet.

    Science.gov (United States)

    Nazeri, Alireza; Massumi, Ali; Wilson, James M; Frank, Christopher M; Bensler, Michael; Cheng, Jie; Saeed, Mohammad; Rasekh, Abdi; Razavi, Mehdi

    2009-05-01

    We examined nonprescription weight-loss supplements marketed on the Internet for ingredients with potential arrhythmogenic and life-threatening cardiac adverse effects. We aimed to define the risks of life-threatening cardiac adverse effects that are associated with weight-loss supplements marketed on the Internet. We entered the key words "weight-loss supplements" and "diet pills" into three popular Internet search engines. The top four nonoverlapping hits from each search engine were purchased. After receipt, the products and their ingredient lists were inspected, and Medline and the Natural Medicines Comprehensive Database were searched for reports of significant associations between each ingredient and various key words for life-threatening cardiac adverse effects. All supplements had the list of ingredients on the label. We identified 60 different ingredients (7.25 +/- 4.66 per supplement; range 1-21). Eleven ingredients representing eight different substances (because multiple names were used for some substances) were each associated with two or more reports of life-threatening cardiac complications or death. Eight of the 12 products contained one or more such ingredients, but none of these eight products had warnings about life-threatening cardiac adverse effects on the Web pages, on the labels, or in the package inserts. One product contained ma huang (Chinese ephedra), even though the marketing of ephedra-containing products is banned in the United States. The Internet provides easy access to weight-loss supplements, several of which contain ingredients with potentially life-threatening adverse effects. There is a need for increased public education and awareness regarding such weight-loss products.

  7. 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

  8. 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.

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

    Science.gov (United States)

    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.

  10. Taking Orlistat: Predicting Weight Loss over 6 Months

    Directory of Open Access Journals (Sweden)

    Amelia Hollywood

    2011-01-01

    Full Text Available This study explored the predictors of weight loss following orlistat with a focus on both baseline variables and changes in beliefs and behaviours occurring over the course of taking the drug. Patients (n=566 prescribed orlistat completed a questionnaire at baseline and after 6 months concerning their weight, beliefs and behaviours. By 6 months the majority had lost some weight and showed improvements in diet. Many had also stopped taking the drug and a large minority reported using it flexibly as a lifestyle drug. Those who lost most weight showed a decrease in beliefs in a medical solution, a decrease in unhealthy eating, an increased belief in treatment control and an increased belief that the unpleasant consequences are both due to their eating behaviour and just part of the drug. When taken with fatty food orlistat causes symptoms such as anal leakage and oily stools. These may encourage some patients to focus on the behavioural aspects of their weight problem thus promoting the dietary changes needed for both short and longer term weight loss. When prescribing orlistat, clinicians should encourage patients to see the consequences as an education as a means to promote the effectiveness of this form of medical management.

  11. 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

  12. 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.

  13. Weighing every day matters: daily weighing improves weight loss and adoption of weight control behaviors.

    Science.gov (United States)

    Steinberg, Dori M; Bennett, Gary G; Askew, Sandy; Tate, Deborah F

    2015-04-01

    Daily weighing is emerging as the recommended self-weighing frequency for weight loss. This is likely because it improves adoption of weight control behaviors. To examine whether weighing every day is associated with greater adoption of weight control behaviors compared with less frequent weighing. Longitudinal analysis of a previously conducted 6-month randomized controlled trial. Overweight men and women in Chapel Hill, NC, participated in the intervention arm (N=47). The intervention focused on daily weighing for weight loss using an e-scale that transmitted weights to a study website, along with weekly e-mailed lessons and tailored feedback on daily weighing adherence and weight loss progress. We gathered objective data on self-weighing frequency from the e-scales. At baseline and 6 months, weight change was measured in the clinic and weight control behaviors (total items=37), dietary strategies, and calorie expenditure from physical activity were assessed via questionnaires. Calorie intake was assessed using an online 24-hour recall tool. We used χ(2) tests to examine variation in discrete weight control behaviors and linear regression models to examine differences in weight, dietary strategies, and calorie intake and expenditure by self-weighing frequency. Fifty-one percent of participants weighed every day (n=24) over 6 months. The average self-weighing frequency among those weighing less than daily (n=23) was 5.4±1.2 days per week. Daily weighers lost significantly more weight compared with those weighing less than daily (mean difference=-6.1 kg; 95% CI -10.2 to -2.1; P=0.004). The total number of weight control behaviors adopted was greater among daily weighers (17.6±7.6 vs 11.2±6.4; P=0.004). There were no differences by self-weighing frequency in dietary strategies, calorie intake, or calorie expenditure. Weighing every day led to greater adoption of weight control behaviors and produced greater weight loss compared with weighing most days of the

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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

  16. 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...

  17. Does Successful Weight Loss in an Internet-Based Worksite Weight Loss Program Improve Employee Presenteeism and Absenteeism?

    Science.gov (United States)

    Harden, Samantha M.; You, Wen; Almeida, Fabio A.; Hill, Jennie L.; Linnan, Laura A.; Allen, Kacie C.; Estabrooks, Paul A.

    2015-01-01

    Certain risk factors associated with overweight and obesity may lead to reduced productivity in the workforce (i.e., increased absenteeism and presenteeism). Participants in a large, Internet-based worksite weight loss intervention, who were present at follow-up (N = 1,030), completed a self-reported productivity measure (World Health…

  18. Early weight loss while on lorcaserin, diet, and exercise as a predictor of week 52 weight-loss outcomes

    DEFF Research Database (Denmark)

    Smith, Steven R; O'Neil, Patrick M; Astrup, Arne

    2014-01-01

    OBJECTIVE: To identify an early treatment milestone that optimizes sensitivity and specificity for predicting ≥5% weight loss at Week (W) 52 in patients with and without type 2 diabetes on lorcaserin or placebo. METHODS: Post hoc area under the curve for receiver operating characteristic analyses...

  19. Clozapine-induced dysphagia with secondary substantial weight loss.

    Science.gov (United States)

    Osman, Mugtaba; Devadas, Vekneswaran

    2016-08-19

    Dysphagia is listed as a 'rare' side effect following clozapine treatment. In this case report, we describe how significant clozapine-induced dysphagia has led to significant reduction of nutritional intake with subsequent substantial weight loss. An 18-year-old single man with an established diagnosis of treatment-resistant paranoid schizophrenia recovered well on a therapeutic dose of clozapine. However, he was noted to lose weight significantly (up to 20% of his original weight) as the dose was uptitrated. This was brought about by development of dysphagia, likely to be due to clozapine. Addition of nutritional supplementary liquids and initiation of a modified behavioural dietary/swallowing programme, while repeatedly mastering the Mendelsohn manoeuvre technique, alleviated the swallowing difficulties and restored his weight. 2016 BMJ Publishing Group Ltd.

  20. Micronutrient Gaps in Three Commercial Weight-Loss Diet Plans

    Directory of Open Access Journals (Sweden)

    Matthew G. Engel

    2018-01-01

    Full Text Available Weight-loss diets restrict intakes of energy and macronutrients but overlook micronutrient profiles. Commercial diet plans may provide insufficient micronutrients. We analyzed nutrient profiles of three plans and compared their micronutrient sufficiency to Dietary Reference Intakes (DRIs for male U.S. adults. Hypocaloric vegan (Eat to Live-Vegan, Aggressive Weight Loss; ETL-VAWL, high-animal-protein low-carbohydrate (Fast Metabolism Diet; FMD and weight maintenance (Eat, Drink and Be Healthy; EDH diets were evaluated. Seven single-day menus were sampled per diet (n = 21 menus, 7 menus/diet and analyzed for 20 micronutrients with the online nutrient tracker CRON-O-Meter. Without adjustment for energy intake, the ETL-VAWL diet failed to provide 90% of recommended amounts for B12, B3, D, E, calcium, selenium and zinc. The FMD diet was low (<90% DRI in B1, D, E, calcium, magnesium and potassium. The EDH diet met >90% DRIs for all but vitamin D, calcium and potassium. Several micronutrients remained inadequate after adjustment to 2000 kcal/day: vitamin B12 in ETL-VAWL, calcium in FMD and EDH and vitamin D in all diets. Consistent with previous work, micronutrient deficits are prevalent in weight-loss diet plans. Special attention to micronutrient rich foods is required to reduce risk of micronutrient deficiency in design of commercial diets.

  1. Micronutrient Gaps in Three Commercial Weight-Loss Diet Plans

    Science.gov (United States)

    J. Kern, Hua; Brenna, J. Thomas; H. Mitmesser, Susan

    2018-01-01

    Weight-loss diets restrict intakes of energy and macronutrients but overlook micronutrient profiles. Commercial diet plans may provide insufficient micronutrients. We analyzed nutrient profiles of three plans and compared their micronutrient sufficiency to Dietary Reference Intakes (DRIs) for male U.S. adults. Hypocaloric vegan (Eat to Live-Vegan, Aggressive Weight Loss; ETL-VAWL), high-animal-protein low-carbohydrate (Fast Metabolism Diet; FMD) and weight maintenance (Eat, Drink and Be Healthy; EDH) diets were evaluated. Seven single-day menus were sampled per diet (n = 21 menus, 7 menus/diet) and analyzed for 20 micronutrients with the online nutrient tracker CRON-O-Meter. Without adjustment for energy intake, the ETL-VAWL diet failed to provide 90% of recommended amounts for B12, B3, D, E, calcium, selenium and zinc. The FMD diet was low (diet met >90% DRIs for all but vitamin D, calcium and potassium. Several micronutrients remained inadequate after adjustment to 2000 kcal/day: vitamin B12 in ETL-VAWL, calcium in FMD and EDH and vitamin D in all diets. Consistent with previous work, micronutrient deficits are prevalent in weight-loss diet plans. Special attention to micronutrient rich foods is required to reduce risk of micronutrient deficiency in design of commercial diets. PMID:29361684

  2. Micronutrient Gaps in Three Commercial Weight-Loss Diet Plans.

    Science.gov (United States)

    G Engel, Matthew; J Kern, Hua; Brenna, J Thomas; H Mitmesser, Susan

    2018-01-20

    Weight-loss diets restrict intakes of energy and macronutrients but overlook micronutrient profiles. Commercial diet plans may provide insufficient micronutrients. We analyzed nutrient profiles of three plans and compared their micronutrient sufficiency to Dietary Reference Intakes (DRIs) for male U.S. adults. Hypocaloric vegan (Eat to Live-Vegan, Aggressive Weight Loss; ETL-VAWL), high-animal-protein low-carbohydrate (Fast Metabolism Diet; FMD) and weight maintenance (Eat, Drink and Be Healthy; EDH) diets were evaluated. Seven single-day menus were sampled per diet ( n = 21 menus, 7 menus/diet) and analyzed for 20 micronutrients with the online nutrient tracker CRON-O-Meter. Without adjustment for energy intake, the ETL-VAWL diet failed to provide 90% of recommended amounts for B 12 , B₃, D, E, calcium, selenium and zinc. The FMD diet was low (90% DRIs for all but vitamin D, calcium and potassium. Several micronutrients remained inadequate after adjustment to 2000 kcal/day: vitamin B 12 in ETL-VAWL, calcium in FMD and EDH and vitamin D in all diets. Consistent with previous work, micronutrient deficits are prevalent in weight-loss diet plans. Special attention to micronutrient rich foods is required to reduce risk of micronutrient deficiency in design of commercial diets.

  3. Smartphone applications to aid weight loss and management: current perspectives

    Directory of Open Access Journals (Sweden)

    Sutton EF

    2016-07-01

    Full Text Available Elizabeth F Sutton, Leanne M Redman Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA Abstract: The development and dissemination of smart devices has cultivated a global environment of hyperconnectivity and increased our access to information. The paralleled launch and success of the Mobile Health industry has created a market of commercially available applications or “apps” along with tools or sensors, which allow the user to receive and collect personal health information. Apps and accompanying tools now allow an individual to “self-digitize” and, pertaining to weight management, monitor their body weight, caloric intake, physical activity, and more. These products possess the ability to improve the scalability of traditional in-person weight management services considering their near ubiquity, affordability, and capability to deliver information directly and personally to the user. However, similar to the dietary supplement market, the anecdotal value of these products has driven their popularity and acceptance by the general public without requirement of scientific validation or, in the area of weight management or diet/exercise, validation of the safety and efficacy by the Food and Drug Administration prior to market launch. By conducting a literature and clinical trial search, we found remarkably few active, completed, or published studies testing the efficacy of smart device applications using randomized controlled trials. Research efforts must be focused on illuminating the efficacy of behavioral interventions and remote self-monitoring for weight loss/maintenance treatment with true, randomized controlled trials. Keywords: smartphone, mobile phone, application, app, weight, weight loss, weight maintenance

  4. 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...

  5. Weight loss experiences of obese perimenopausal women with metabolic syndrome.

    Science.gov (United States)

    Su, Mei-Chen; Lin, Hung-Ru; Chu, Nain-Feng; Huang, Chih-Hsung; Tsao, Lee-Ing

    2015-07-01

    To develop a descriptive theory for the weight loss experiences of obese perimenopausal women with metabolic syndrome. Obesity and metabolic syndrome both pose a threat to the health of perimenopausal women; therefore, understanding perimenopausal women's subjective feelings and experiences is beneficial to establishing effective prevention strategies. However, studies have rarely explored these relevant experiences. A qualitative study using the grounded theory method to establish a descriptive theory. Eighteen obese perimenopausal women with metabolic syndrome aged 45-60 years participated in comprehensive interviews. 'Crossing the gaps to making life modifications' was the core category, and 'the awareness of weight gain and health alarm' was the antecedent condition. In the weight loss experience, the following three interaction categories were identified: (1) 'experiencing bad feelings,' (2) 'encountering obstacles' and (3) 'making efforts to transition to a new life.' Some women adhered to new life habits through perceiving social support and by using self-incentives. Finally, women enjoyed and mastered self-monitoring of their health in their new life, and practiced new changes as part of their life. However, some participants felt that making changes to their life was too time-consuming. Therefore, these women chose to live with their abnormal health without making changes. Obese perimenopausal women with metabolic syndrome experienced various gaps in their weight loss process. Although they struggled with many obstacles, these women were able to learn from their experiences and face their health challenges. These findings can guide healthcare professionals to provide appropriate interventions to understand the hidden health problems of this particular group of women. Healthcare professionals should develop a set of plans by which women receive a complete weight loss program and support from professionals and family. © 2015 John Wiley & Sons Ltd.

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

    Science.gov (United States)

    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.

  7. The effectiveness of breakfast recommendations on weight loss

    DEFF Research Database (Denmark)

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

    2014-01-01

    BACKGROUND: Breakfast is associated with lower body weight in observational studies. Public health authorities commonly recommend breakfast consumption to reduce obesity, but the effectiveness of adopting these recommendations for reducing body weight is unknown.OBJECTIVE: We tested the relative...... effectiveness of a recommendation to eat or skip breakfast on weight loss in adults trying to lose weight in a free-living setting. DESIGN: We conducted a multisite, 16-wk, 3-parallel-arm randomized controlled trial in otherwise healthy overweight and obese adults [body mass index (in kg/m(2)) between 25 and 40.......53 ± 1.16, -0.59 ± 1.06, and -0.71 ± 1.17 kg for the control, breakfast, and NB groups, respectively. Self-reported compliance with the recommendation was 93.6% for the breakfast group and 92.4% for the NB group.Conclusions: A recommendation to eat or skip breakfast for weight loss was effective...

  8. Motivations for Weight Loss Among Active Duty Military Personnel.

    Science.gov (United States)

    Maclin-Akinyemi, Courtney; Krukowski, Rebecca A; Kocak, Mehmet; Talcott, G Wayne; Beauvais, Alexis; Klesges, Robert C

    2017-09-01

    Rates of overweight and obesity among Active Duty Military Personnel remain high despite fitness test requirements, negative consequences of fitness test failure, and emphasis on weight and appearance standards. Specific motivating factors for weight loss influence weight loss program interest and often differ by gender, race, ethnicity, or age. This study investigates the weight loss motivations endorsed by a diverse population of Active Duty Military Personnel initiating a behavioral weight loss study, to inform the development of future recruitment efforts and program development. Active Duty Military Personnel (n = 248) completed a 16-item questionnaire of weight loss motivations before initiating a behavioral weight loss study. We evaluated endorsement patterns by demographic characteristics (body mass index [BMI], gender, race, ethnicity, age, and military rank). Data collection for this study was approved by the Institutional Review Board of Wilford Hall Ambulatory Surgical Center and acknowledged by the Institutional Review Board of the University of Tennessee Health Science Center. Results indicated that improved physical health, improved fitness, improved quality of life, and to live long were endorsed as "very important" motivations by at least three-fourths of the sample. "To pass the fitness test" was endorsed less frequently as a "very important" motivation, by 69% of the sample. A greater proportion of women as compared to men endorsed being very motivated by improving mood/well-being, quality of life, physical mobility, job performance, appearance, and sex life, as well as fitting into clothes. Participants categorized in the "Other" racial group and African Americans more frequently endorsed motivations to improve fitness and physical strength when compared to Caucasians. Moreover, participants in the "Other" race category were significantly more likely to rate their ability to physically defend themselves, improve physical mobility, and improve

  9. 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.

  10. Adverse Psychiatric Effects Associated with Herbal Weight-Loss Products

    Directory of Open Access Journals (Sweden)

    F. Saverio Bersani

    2015-01-01

    Full Text Available Obesity and overeating are among the most prevalent health concerns worldwide and individuals are increasingly using performance and image-enhancing drugs (PIEDs as an easy and fast way to control their weight. Among these, herbal weight-loss products (HWLPs often attract users due to their health claims, assumed safety, easy availability, affordable price, extensive marketing, and the perceived lack of need for professional oversight. Reports suggest that certain HWLPs may lead to onset or exacerbation of psychiatric disturbances. Here we review the available evidence on psychiatric adverse effects of HWLPs due to their intrinsic toxicity and potential for interaction with psychiatric medications.

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

    DEFF Research Database (Denmark)

    Andersen, T; Gluud, C; Franzmann, Magnus

    1991-01-01

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

  12. Weight loss in grappling combat sports: review and applied recommendations

    Directory of Open Access Journals (Sweden)

    Antonio Lancha Junior

    2006-06-01

    Full Text Available The objective of this review is to organize the main literature findings on the effects of rapid weight loss onphysiological systems and performance in grappling combat sports. Several surveys showed that most wrestlers lose significant amount of body weight few days prior to competitions by means of several harmful methods, as severe food and water restriction, or even vomiting and use of laxative and diuretics. The same weight loss patterns seems to occur among Brazilian judo athletes. Many athletes begin to lose weight frequently in puberty. In general, the weight cycles are very recurrent during seasons. A small decrease in some growth variables, followed by a rapid catch-up can be observed during a season. The rapid weight loss involves several adverse effects such as hormonal imbalance, body fat redistribution, decrease of immune system activity, impairments on cardiovascular system, imbalance on water and electrolytes homeostasis and decrease in renal function and in mental and mood state. The aerobic as well as anaerobic performance can be negatively affected by weight reduction. Depending on the kind of weight loss, diet and the recovery time after weighing, anaerobic performance may not be decreased. The weight reduction, if necessary, should be gradual and small. Athletes must consume a high carbohydrate diet during weight loss period and after weighing, prior to the beginning of the competitions. Dehydration should be avoided. Relatively simple changes in rules combined with educational programs could minimize rapid weight loss-related problems. RESUMO O objetivo desta revisão é organizar os principais achados da literatura a respeito dos efeitos das práticas de perda rápida de peso sobre os sistemas fisiológicos e sobre o desempenho em esportes de combate. Diversos levantamentos demonstraram que grande parte dos atletas norte-americanos de luta olímpica perde significativaquantidade de peso dias antes das competições, por

  13. 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

  14. 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).

  15. [A teenager presenting with vomiting, general malaise and weight loss].

    Science.gov (United States)

    Bongers, M E; Visser, R; van Vliet, W; Wielders, J P; Hogeman, P H

    2004-02-28

    A 16-year-old girl had symptoms of vomiting, malaise and weight loss for two months. Blood tests revealed an elevated activity of liver enzymes and hyperthyroidism. Although the patient at first denied the possibility of pregnancy, a pregnancy was subsequently confirmed. Hyperemesis gravidarum was diagnosed based on the combination of the clinical symptoms, pregnancy and increased serum human chorionic gonadotrophin and oestradiol. Hyperemesis gravidarum also explained the demonstrated biochemical hyperthyroidism and elevated liver enzyme levels. Rapid alleviation of all the clinical symptoms was seen after termination of this unwanted pregnancy. Although vomiting, malaise and weight loss in children can have many different causes, in girls at a sexually mature age a pregnancy with possible hyperemesis gravidarum should certainly also be considered and a gynaecological examination performed.

  16. Mindfulness as a Weight Loss Treatment for Veterans

    Directory of Open Access Journals (Sweden)

    Michael Vicente Stanton

    2016-08-01

    Full Text Available Despite substantial evidence for their effectiveness in treating disordered eating and obesity, mindfulness-based treatments have not been broadly implemented among Veterans. A number of reviews have reported mindfulness to be beneficial in promoting healthy eating behaviors and weight loss among non-Veteran samples. We discuss this approach in the context of the Veterans Affairs system, the largest integrated healthcare provider in the United States and in the context of Veterans, among whom obesity is at epidemic proportions. In this article, we discuss what is known about treating obesity using a mindfulness approach, mindfulness interventions for Veterans, a new pilot mindfulness-based weight loss program designed for Veterans, and future directions for this type of obesity treatment in Veterans. We conclude that this population may be uniquely poised to benefit from mindfulness-based treatments.

  17. Mindfulness as a Weight Loss Treatment for Veterans.

    Science.gov (United States)

    Stanton, Michael V; Matsuura, Justin; Fairchild, Jennifer Kaci; Lohnberg, Jessica A; Bayley, Peter J

    2016-01-01

    Despite substantial evidence for their effectiveness in treating disordered eating and obesity, mindfulness-based treatments have not been broadly implemented among Veterans. A number of reviews have reported mindfulness to be beneficial in promoting healthy eating behaviors and weight loss among non-Veteran samples. We discuss this approach in the context of the Veterans Affairs system, the largest integrated healthcare provider in the U.S. and in the context of Veterans, among whom obesity is at epidemic proportions. In this article, we discuss what is known about treating obesity using a mindfulness approach, mindfulness interventions for Veterans, a new pilot mindfulness-based weight loss program designed for Veterans, and future directions for this type of obesity treatment in Veterans. We conclude that this population may be uniquely poised to benefit from mindfulness-based treatments.

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

    Energy Technology Data Exchange (ETDEWEB)

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

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

  19. 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.

  20. Weight loss decreases self-reported appetite and alters food preferences in overweight and obese adults

    NARCIS (Netherlands)

    Andriessen, Charlotte; Christensen, Pia; Vestergaard Nielsen, Lone; Ritz, Christian; Astrup, Arne; Meinert Larsen, Thomas; Martinez, J.A.; Saris, Wim H.M.; Baak, van Marleen A.; Papadaki, Angeliki; Kunesova, Marie; Jebb, Susan; Blundell, John; Lawton, Clare; Raben, Anne

    2018-01-01

    People with obesity often struggle to maintain their weight loss after a weight loss period. Furthermore, the effect of weight loss on appetite and food preferences remains unclear. Hence this study investigated the effect of weight loss on subjective appetite and food preferences in healthy,

  1. Postprandial coagulation activation in overweight individuals after weight loss

    DEFF Research Database (Denmark)

    Bladbjerg, Else-Marie; Larsen, Thomas Meinert; Due, Anette Pia

    2014-01-01

    . This was tested in a parallel intervention trial on overweight individuals (aged 28.4 (SD 4.7) years) randomly assigned to a MUFA-diet (35-45% of energy as fat; >20% as MUFA, n=21) or a low-fat (LF) diet (20-30% of energy as fat, n=22) for 6months after a weight loss of ~10%. All foods were provided free...

  2. 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.

  3. 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.

  4. Weight loss and survival of Biomphalaria Glabrata deprived of water

    Directory of Open Access Journals (Sweden)

    Marc Vianey-Liaud

    1986-06-01

    Full Text Available Immature and mature Biomphalaria glabrata are kept out of water at relative humidities varying from 0 to 100%. When snails are submitted to a saturated atmosphere, they show a slow weight loss and survival may be long. If relative humidity (RH decreases, weight loss becomes important and survival is short. A reduced RH (0 to 65% produces similar effects. During desiccation, fasting has no noticeable effect; survival depends essentially on weight loss.Biomphalaria glabrata maduros ou imaturos são mantidos fora da água, variando a umidade de 0 a 100%. Quando caramujos são submetidos a uma atmosfera saturada, sofrem uma lenta perda de peso e a sobrevivência pode ser longa. Se a umidade relativa decresce, a perda de peso será importante e a sobrevida será abreviada. Uma umidade relativa de 0 a 65% pode produzir efeitos similares. Durante a dessecação, a privação de alimento não tem efeito notável, a sobrevivência dependendo essencialmente da perda de peso.

  5. Daily pattern of energy distribution and weight loss.

    Science.gov (United States)

    Raynor, Hollie A; Li, Fan; Cardoso, Chelsi

    2018-08-01

    Timing of energy intake, a temporal dietary pattern, may enhance health. Eating a greater amount of energy earlier and a smaller amount of energy later in the day, a behavioral circadian rhythm, may assist with chronoenhancement. Chronoenhancement seeks to enhance entrainment (synchronization) of biological and behavioral circadian rhythms. In humans, research reports that eating a greater amount of energy early and a smaller amount of energy later in the day increases dietary induced thermogenesis, improves cardiometabolic outcomes, and enhances weight loss. However, little human research has examined if this eating pattern enhances regularity of biological circadian rhythm. In a randomized controlled 8-week pilot study, the influence of energy distribution timing on weight loss and regularity of sleep onset and wake times (marker for biological circadian rhythm) was examined. Within an hypocaloric, three-meal prescription, participants (n = 8) were assigned to either: 1) Morning: 50%, 30%, and 20% of kcal at breakfast, lunch, and dinner, respectively; or 2) Evening: 20%, 30%, and 50% of kcal at breakfast, lunch, and dinner, respectively. Percent weight loss and regularity of sleep onset and wake times were significantly (p energy distribution timing on health, longer studies conducted in free-living participants, with dietary intake assessed using time-stamped methods, that include measures of the circadian timing system are needed. This small review is based upon a symposium presentation at the Society of the Study of Ingestive Behavior in 2017. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. Herbal Weight Loss Pill Overdose: Sibutramine Hidden in Pepper Pill

    Directory of Open Access Journals (Sweden)

    Gul Pamukcu Gunaydin

    2015-01-01

    Full Text Available Supposedly herbal weight loss pills are sold online and are widely used in the world. Some of these products are found to contain sibutramine by FDA and their sale is prohibited. We report a case of a female patient who presented to the emergency department after taking slimming pills. 17-year-old female patient presented to the emergency room with palpitations, dizziness, anxiety, and insomnia. She stated that she had taken 3 pills named La Jiao Shou Shen for slimming purposes during the day. Her vital signs revealed tachycardia. On her physical examination, she was restless, her oropharynx was dry, her pupils were mydriatic, and no other pathological findings were found. Sibutramine intoxication was suspected. She was given 5 mg IV diazepam for restlessness. After supportive therapy and observation in emergency department for 12 hours there were no complications and the patient was discharged home. Some herbal pills that are sold online for weight loss have sibutramine hidden as an active ingredient, and their sale is prohibited for this reason. For people who use herbal weight loss drugs, sibutramine excessive intake should be kept in mind at all times.

  7. Weight Loss after Sleeve Gastrectomy in Super Superobesity

    Directory of Open Access Journals (Sweden)

    J.-M. Catheline

    2012-01-01

    Full Text Available Objective. This prospective study evaluated laparoscopic sleeve gastrectomy for its safety and efficiency in excess weight loss (%EWL in super superobese patients (BMI >60 Kg/m2. Results. Thirty patients (33 women and 7 men were included, with mean age of 35 years (range 18 to 59. Mean preoperative BMI was 66 Kg/m2 (range 60 to 85. The study included one patient with complete situs inversus and 4 (14% with previous restrictive gastric banding. The mean operative time was 120 minutes (range 80 to 220 min and the mean hospital stay was 7.5 days (4 to 28 days. There was no postoperative mortality or need for a laparotomy conversion. Two subphrenic hematomas, one gastric fistula, and one pulmonary embolism, were the major complications. After 18 months 17 (77% had sufficient weight loss and six had insufficient results, leading to either re-sleeve gastrectomy (3, or gastric bypass (2. Three years after the initial laparoscopic sleeve gastrectomy, the mean EWL was 51% (range 21 to 82. Conclusion. The laparoscopic sleeve gastrectomy is a safe and efficient operating procedure for treating super superobesity. In the case of insufficient weight loss, a second-stage operation like resleeve gastrectomy or gastric bypass can be proposed.

  8. 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

  9. Maintenance of weight loss after lifestyle interventions for overweight and obesity, a systematic review

    NARCIS (Netherlands)

    Barte, J. C. M.; ter Bogt, N. C. W.; Bogers, R. P.; Teixeira, P. J.; Blissmer, B.; Mori, T. A.; Bemelmans, W. J. E.

    P>Lifestyle interventions can reduce body weight, but weight regain is common and may particularly occur with higher initial weight loss. If so, one may argue whether the 10% weight loss in clinical guidelines is preferable above a lower weight loss. This systematic review explores the relation

  10. Calorie Estimation in Adults Differing in Body Weight Class and Weight Loss Status.

    Science.gov (United States)

    Brown, Ruth E; Canning, Karissa L; Fung, Michael; Jiandani, Dishay; Riddell, Michael C; Macpherson, Alison K; Kuk, Jennifer L

    2016-03-01

    Ability to accurately estimate calories is important for weight management, yet few studies have investigated whether individuals can accurately estimate calories during exercise or in a meal. The objective of this study was to determine if accuracy of estimation of moderate or vigorous exercise energy expenditure and calories in food is associated with body weight class or weight loss status. Fifty-eight adults who were either normal weight (NW) or overweight (OW), and either attempting (WL) or not attempting weight loss (noWL), exercised on a treadmill at a moderate (60% HRmax) and a vigorous intensity (75% HRmax) for 25 min. Subsequently, participants estimated the number of calories they expended through exercise and created a meal that they believed to be calorically equivalent to the exercise energy expenditure. The mean difference between estimated and measured calories in exercise and food did not differ within or between groups after moderate exercise. After vigorous exercise, OW-noWL overestimated energy expenditure by 72% and overestimated the calories in their food by 37% (P food compared with both WL groups (P food. There was a wide range of underestimation and overestimation of calories during exercise and in a meal. Error in calorie estimation may be greater in overweight adults who are not attempting weight loss.

  11. Epigenetics in adipose tissue, obesity, weight loss, and diabetes.

    Science.gov (United States)

    Martínez, J Alfredo; Milagro, Fermín I; Claycombe, Kate J; Schalinske, Kevin L

    2014-01-01

    Given the role that diet and other environmental factors play in the development of obesity and type 2 diabetes, the implication of different epigenetic processes is being investigated. Although it is well known that external factors can cause cell type-dependent epigenetic changes, including DNA methylation, histone tail modifications, and chromatin remodeling, the regulation of these processes, the magnitude of the changes and the cell types in which they occur, the individuals more predisposed, and the more crucial stages of life remain to be elucidated. There is evidence that obese and diabetic people have a pattern of epigenetic marks different from nonobese and nondiabetic individuals. The main long-term goals in this field are the identification and understanding of the role of epigenetic marks that could be used as early predictors of metabolic risk and the development of drugs or diet-related treatments able to delay these epigenetic changes and even reverse them. But weight gain and insulin resistance/diabetes are influenced not only by epigenetic factors; different epigenetic biomarkers have also been identified as early predictors of weight loss and the maintenance of body weight after weight loss. The characterization of all the factors that are able to modify the epigenetic signatures and the determination of their real importance are hindered by the following factors: the magnitude of change produced by dietary and environmental factors is small and cumulative; there are great differences among cell types; and there are many factors involved, including age, with multiple interactions between them.

  12. Epigenetics in Adipose Tissue, Obesity, Weight Loss, and Diabetes12

    Science.gov (United States)

    Martínez, J. Alfredo; Milagro, Fermín I.; Claycombe, Kate J.; Schalinske, Kevin L.

    2014-01-01

    Given the role that diet and other environmental factors play in the development of obesity and type 2 diabetes, the implication of different epigenetic processes is being investigated. Although it is well known that external factors can cause cell type-dependent epigenetic changes, including DNA methylation, histone tail modifications, and chromatin remodeling, the regulation of these processes, the magnitude of the changes and the cell types in which they occur, the individuals more predisposed, and the more crucial stages of life remain to be elucidated. There is evidence that obese and diabetic people have a pattern of epigenetic marks different from nonobese and nondiabetic individuals. The main long-term goals in this field are the identification and understanding of the role of epigenetic marks that could be used as early predictors of metabolic risk and the development of drugs or diet-related treatments able to delay these epigenetic changes and even reverse them. But weight gain and insulin resistance/diabetes are influenced not only by epigenetic factors; different epigenetic biomarkers have also been identified as early predictors of weight loss and the maintenance of body weight after weight loss. The characterization of all the factors that are able to modify the epigenetic signatures and the determination of their real importance are hindered by the following factors: the magnitude of change produced by dietary and environmental factors is small and cumulative; there are great differences among cell types; and there are many factors involved, including age, with multiple interactions between them. PMID:24425725

  13. 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.

  14. Metabolic Benefits of Prior Weight Loss with and without Exercise on Subsequent 6-Month Weight Regain.

    Science.gov (United States)

    Ryan, Alice S; Serra, Monica C; Goldberg, Andrew P

    2018-01-01

    To determine the 6-month follow-up effects after intentional 6-month weight loss alone (WL) and after weight loss with aerobic exercise (AEX + WL) on body composition, glucose metabolism, and cardiovascular disease risk factors in older postmenopausal women and to identify the mechanisms for weight regain. Women (n = 65, BMI > 25 kg/m 2 ) underwent maximal oxygen consumption testing, dual-energy x-ray absorptiometry, computed tomography scans, and oral glucose tolerance tests before and after 6 months of AEX + WL or WL and at 12 months ad libitum follow-up. Insulin sensitivity (M) (hyperinsulinemic-euglycemic clamp) was measured at baseline and 6 months. Thirty WL and thirty-five AEX + WL women completed a follow-up at 12 months. Similar weight loss was observed (-8%) in both groups from 0 to 6 months. Total fat mass, fat-free mass, visceral fat area, subcutaneous abdominal and midthigh fat areas, fasting glucose, insulin levels, homeostatic model assessment of insulin resistance (HOMA-IR), insulin areas under the curve, and triglyceride levels decreased similarly after WL and AEX + WL and remained lower at 12 months than at baseline, despite weight regain at 12 months. Initial M was associated with weight regain (r = -0.40, P < 0.01). Weight regain was related to independent changes in leptin and HOMA-IR from 6 to 12 months in a multiple regression model (r = 0.77, P < 0.0001). Reductions in body fat and improvements in insulin sensitivity after AEX + WL and WL were maintained at 12 months despite modest weight regain. Baseline insulin resistance partially predicted the magnitude of weight regain in postmenopausal women. © 2017 The Obesity Society.

  15. The ambivalence of losing weight after bariatric surgery

    Directory of Open Access Journals (Sweden)

    Christine Warholm

    2014-01-01

    Full Text Available This study is grounded in a phenomenological lifeworld perspective. It aims at providing rich descriptions of lived experience of the process of losing weight after obesity surgery. Two women participated in in-depth interviews four times each during the first postoperative year. Based on the women's experiences, a meaning structure—the ambivalence of losing weight after obesity surgery—was identified across the women's processes of change. This consisted of five core themes: movement and activity—freedom but new demands and old restraints; eating habits and digestion—the complexity of change; appearance—smaller, but looser; social relations—stability and change; and being oneself—vulnerability and self-assurance. These core themes changed over time in terms of dominance. The experience of ambivalence is discussed according to a phenomenological perspective of the body as lived experience.

  16. Perioperative blood loss and diclofenac in major arthroplastic surgery

    Directory of Open Access Journals (Sweden)

    Ljiljana Gvozdenović

    2011-04-01

    Full Text Available Introduction: Contemporary literature indicates precaution over the perioperative use of non-steroidal anti-inflammatory drugs, since they can potentially increase perioperative blood loss related to their mechanism of action. The aim of this study was to assess the influence of non-steroidal anti-inflammatory drugs on perioperative blood loss undergoing hip arthroplasty and its correlation with general and regional anesthesia.Methods: This prospective study included 120 patients who had undergone elective unilateral total hip arthroplasty. Patients were allocated into four groups. Groups 1 and 2 were pretreated with diclofenac and operated in general and regional anesthesia. Group 3 and 4 weren’t pretreated with any non-steroidal anti-inflammatory drug and were, as well, operated in general and regional anesthesia. Diclofenac was administered orally two times a day 75 mg (total 150 mg and also as intramuscular injection (75 mg preoperatively and 12 hours later on a day of surgery.Results: The perioperative blood loss in the rst 24 hours showed an increase of 29.4% in the diclofenac group operated in general anesthesia and increase of 26.8% in patients operated in regional anesthesia (P < 0.05 compared to control group. Statistical data evaluation of patients operated in general anesthesia compared to regional anesthesia, the overall blood loss in the rst 24 h after surgery, showed an increase of 6.4% in the diclofenac group and increase of 3.6% in placebo group. This was not statistically significant.Conclusion: Pretreatment with non-steroidal anti-inflammatory drugs (diclofenac before elective unilateral total hip arthroplasty increases the perioperative blood loss signficantly. Early discontinuation of non-selective non-steroidal anti-inflammatory drugs is advised.

  17. Metabolic syndrome, circulating RBP4, testosterone, and SHBG predict weight regain at 6 months after weight loss in men

    DEFF Research Database (Denmark)

    Wang, Ping; Menheere, Paul P C A; Astrup, Arne

    2013-01-01

    OBJECTIVE: Weight loss helps reduce the symptoms of the metabolic syndrome (MetS) in the obese, but weight regain after active weight loss is common. We investigated the changes and predictive role of circulating adipokines and sex hormones for weight regain in men during dietary intervention...

  18. Nonequilibrium thermodynamics and energy efficiency in weight loss diets

    Directory of Open Access Journals (Sweden)

    Fine Eugene J

    2007-07-01

    Full Text Available Abstract Carbohydrate restriction as a strategy for control of obesity is based on two effects: a behavioral effect, spontaneous reduction in caloric intake and a metabolic effect, an apparent reduction in energy efficiency, greater weight loss per calorie consumed. Variable energy efficiency is established in many contexts (hormonal imbalance, weight regain and knock-out experiments in animal models, but in the area of the effect of macronutrient composition on weight loss, controversy remains. Resistance to the idea comes from a perception that variable weight loss on isocaloric diets would somehow violate the laws of thermodynamics, that is, only caloric intake is important ("a calorie is a calorie". Previous explanations of how the phenomenon occurs, based on equilibrium thermodynamics, emphasized the inefficiencies introduced by substrate cycling and requirements for increased gluconeogenesis. Living systems, however, are maintained far from equilibrium, and metabolism is controlled by the regulation of the rates of enzymatic reactions. The principles of nonequilibrium thermodynamics which emphasize kinetic fluxes as well as thermodynamic forces should therefore also be considered. Here we review the principles of nonequilibrium thermodynamics and provide an approach to the problem of maintenance and change in body mass by recasting the problem of TAG accumulation and breakdown in the adipocyte in the language of nonequilibrium thermodynamics. We describe adipocyte physiology in terms of cycling between an efficient storage mode and a dissipative mode. Experimentally, this is measured in the rate of fatty acid flux and fatty acid oxidation. Hormonal levels controlled by changes in dietary carbohydrate regulate the relative contributions of the efficient and dissipative parts of the cycle. While no experiment exists that measures all relevant variables, the model is supported by evidence in the literature that 1 dietary carbohydrate, via its

  19. 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.

  20. The impact of rate of weight loss on body composition and compensatory mechanisms during weight reduction

    DEFF Research Database (Denmark)

    Coutinho, Sílvia Ribeiro; With, Emilie; Rehfeld, Jens F

    2018-01-01

    BACKGROUND & AIMS: Rapid weight loss (WL) has been associated with a larger loss of fat free mass and a disproportional reduction in resting metabolic rate (RMR), but the evidence is inconclusive. We aimed to evaluate the impact of WL rate on body composition and compensatory mechanisms activated...... with WL (reduced RMR, increased exercise efficiency (ExEff) and appetite), both during negative and neutral energy balance (EB). METHODS: Thirty-five participants with obesity were randomized to lose a similar weight rapidly (4 weeks) or gradually (8 weeks), and afterwards to maintain it (4 weeks). Body...... weight and composition, RMR, ExEff (10, 25 and 50 W), appetite feelings and appetite-regulating hormones (active ghrelin, cholecystokinin, total peptide YY (PYY), active glucagon-like peptide-1 and insulin), in fasting and every 30 min up to 2.5 h, were measured at baseline and after each phase. RESULTS...

  1. The role of protein in weight loss and maintenance.

    Science.gov (United States)

    Leidy, Heather J; Clifton, Peter M; Astrup, Arne; Wycherley, Thomas P; Westerterp-Plantenga, Margriet S; Luscombe-Marsh, Natalie D; Woods, Stephen C; Mattes, Richard D

    2015-04-29

    Over the past 20 y, higher-protein diets have been touted as a successful strategy to prevent or treat obesity through improvements in body weight management. These improvements are thought to be due, in part, to modulations in energy metabolism, appetite, and energy intake. Recent evidence also supports higher-protein diets for improvements in cardiometabolic risk factors. This article provides an overview of the literature that explores the mechanisms of action after acute protein consumption and the clinical health outcomes after consumption of long-term, higher-protein diets. Several meta-analyses of shorter-term, tightly controlled feeding studies showed greater weight loss, fat mass loss, and preservation of lean mass after higher-protein energy-restriction diets than after lower-protein energy-restriction diets. Reductions in triglycerides, blood pressure, and waist circumference were also reported. In addition, a review of the acute feeding trials confirms a modest satiety effect, including greater perceived fullness and elevated satiety hormones after higher-protein meals but does not support an effect on energy intake at the next eating occasion. Although shorter-term, tightly controlled feeding studies consistently identified benefits with increased protein consumption, longer-term studies produced limited and conflicting findings; nevertheless, a recent meta-analysis showed persistent benefits of a higher-protein weight-loss diet on body weight and fat mass. Dietary compliance appears to be the primary contributor to the discrepant findings because improvements in weight management were detected in those who adhered to the prescribed higher-protein regimen, whereas those who did not adhere to the diet had no marked improvements. Collectively, these data suggest that higher-protein diets that contain between 1.2 and 1.6 g protein · kg -1 · d -1 and potentially include meal-specific protein quantities of at least ∼25-30 g protein/meal provide

  2. 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.

  3. Equivalent weight loss for weight management programs delivered by phone and clinic

    Science.gov (United States)

    Donnelly, Joseph E.; Goetz, Jeannine; Gibson, Cheryl; Sullivan, Debra K.; Lee, Robert; Smith, Bryan K.; Lambourne, Kate; Mayo, Matthew S.; Hunt, Suzanne; Lee, Jae Hoon; Honas, Jeffrey J.; Washburn, Richard A.

    2013-01-01

    Objective Face-to-face weight management is costly and presents barriers for individuals seeking treatment; thus, alternate delivery systems are needed. The objective of this study was to compare weight management delivered by face-to-face (FTF) clinic or group conference calls (phone). Design and Methods Randomized equivalency trial in 295 overweight/obese men/women (BMI = 35.1±4.9, Age = 43.8±10.2, Minority = 39.8%). Weight loss (0–6 months) was achieved by reducing energy intake between 1,200– 1,500 kcal/day and progressing physical activity to 300 minutes/week. Weight maintenance (7–18 months) provided adequate energy to maintain weight and continued 300 minutes/week of physical activity. Behavioral weight management strategies were delivered weekly for 6 months and gradually reduced during months 7–18. A cost analysis provided a comparison of expenses between groups. Results Weight change from baseline to 6 months was −13.4 ± 6.7% and −12.3 ± 7.0% for FTF clinic and phone, respectively. Weight change from 6 months to 18 months was 6.4 ± 7.0% and 6.4 ± 5.2%, for FTF clinic and phone, respectively. The cost to FTF participants was $789.58 more person. Conclusions Phone delivery provided equivalent weight loss and maintenance and reduced program cost. Ubiquitous access to phones provides a vast reach for this approach. PMID:23408579

  4. 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

  5. Determinants of Successful Weight Loss After Using a Commercial Web-Based Weight Reduction Program for Six Months: Cohort Study

    OpenAIRE

    Postrach, Elisa; Aspalter, Rosa; Elbelt, Ulf; Koller, Michael; Longin, Rita; Schulzke, J?rg-Dieter; Valentini, Luzia

    2013-01-01

    Background The Internet is widely available and commonly used for health information; therefore, Web-based weight loss programs could provide support to large parts of the population in self-guided weight loss. Previous studies showed that Web-based weight loss interventions can be effective, depending on the quality of the program. The most effective program tools are visual progress charts or tools for the self-monitoring of weight, diet, and exercises. KiloCoach, a commercial program curre...

  6. [Diagnostic value of selective anorexia in pathological weight loss].

    Science.gov (United States)

    Braquet, P; Mercier, G; Reynes, J; Jeandel, C; Pinzani, V; Guilpain, P; Rivière, S; Le Quellec, A

    2016-02-01

    The diagnostic value of selective anorexia is debated. Some authors have suggested an association between meat aversion and cancer, but most do not use it as a diagnostic tool. We aimed to characterize anorexia of different diseases to search for an association between selective aversions and diagnostic groups. All the patients admitted to three departments of a teaching hospital were included consecutively for 22months if they had more than 10 % weight loss in less than one year. Patients were excluded if history taking was not reliable, or if they suffered from anorexia nervosa. We compiled diagnoses at discharge and validated them six months later. We used logistic regression to identify independent factors associated with selective anorexia. Inclusion criteria were met in 106patients (female 44 %, median age 65years). Most frequent diagnoses were: cancer (36 %), infection (35 %), digestive diseases (19 %), non organic diseases (21 %). Recent selective anorexia was found in 46 % of the cases. It was significantly associated with female gender (P=0.002), marginally with young age (P=0.069) and long duration of weight loss (P=0.079). Opioid use at admission was negatively associated with selective anorexia (P=0.001). No specific diagnostic category was found to be associated. Selective anorexia does not appear to be a useful symptom to investigate pathological weight loss. It behaves more like a non-specific reactivation by current disease of earlier latent personal food aversions. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  7. Coaching and barriers to weight loss: an integrative review

    Directory of Open Access Journals (Sweden)

    Muñoz Obino KF

    2016-12-01

    Full Text Available Karen Fernanda Muñoz Obino,1 Caroline Aguiar Pereira,1 Rafaela Siviero Caron-Lienert2 1Nutrology/Clinical Nutrition Unit, Ernesto Dornelles Hospital, 2Nutrition of the Educational and Research Institute of Moinhos de Vento Hospital, Porto Alegre, Brazil Introduction: Coaching is proposed to raise a patient’s awareness and responsibility for their health behaviour change by transforming the professional–patient relationship.Objective: To review the scientific literature on how coaching can assist in weight loss and improve a patient’s state of health.Methodology: An integrative literature search was performed using PubMed, Latin American and Caribbean Literature in Health Sciences, and Scientific Electronic Library Online. We selected articles that were published in Portuguese, English, and Spanish over the last 10 years. Data analysis was performed using a validated data collection instrument.Results: Among the 289 articles identified in the search, 276 were excluded because they did not address the leading research question, their full texts were not available on the Internet, or they were duplicate publications. Therefore, for the analysis, we selected 13 articles that we classified as randomized clinical studies (46.15%; n=6, cohort studies (30.76%; n=4, cross-sectional studies (7.69%; n=1, case studies (7.69%; n=1, and review articles (7.69%; n=1. Joint intervention (combined in-person and telecoaching sessions constituted the majority of session types. The use of technical coaching was superior in reducing anthropometric measurements and increasing the levels of motivation and personal satisfaction compared with formal health education alone.Conclusion: Coaching is an efficient, cost-effective method for combining formal education and treatment of health in the weight-loss process. Additional randomized studies are needed to demonstrate its effectiveness with respect to chronic disease indicators. Keywords: coaching, weight loss

  8. Initial very low calorie diet (VLCD) improves ultimate weight loss

    DEFF Research Database (Denmark)

    Quaade, F; Astrup, A

    1989-01-01

    (4.1-28.8], than group 1 (8.7 kg (-1.1 to 19.1), P = 0.008; and 7.3 kg (0.9-18.2 P = 0.01). Weight losses in both groups eliminated or strongly reduced the need for a wide variety of expensive drugs: antidiabetics, diuretics, antihypertensives, analgetics, etc. It is concluded that VLCD...... for 2 months or more. The two groups were comparable with regard to height, absolute weight and percentual overweight, but group 2 was somewhat older than group 1 (49.5 vs 38.3 years, P less than 0.01). Group 2 lost significantly more weight, both totally (17.1 kg (7.8-40.1] and on VLCD alone (12.3 kg...... is an effective and encouraging way of starting a dieting program, and that it should be continued for at least two months, as the length of the initial VLCD period related significantly to the amount of weight eventually lost....

  9. 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.

  10. Effects of Greenselect Phytosome? on weight maintenance after weight loss in obese women: a randomized placebo-controlled study

    OpenAIRE

    Gilardini, Luisa; Pasqualinotto, Lucia; Di Pierro, Francesco; Risso, Paolo; Invitti, Cecilia

    2016-01-01

    Background Most subjects regain weight after weight loss due to compensatory adaptations finalized to maintain stable body energy stores. Green tea (GT) preparations, which help maintain energy expenditure while dieting could be a useful strategy to facilitate weight maintenance. The usefulness of GT preparations in weight maintenance has been poorly studied so far with conflicting results. This study evaluated if a supplement of GSP and piperine helps obese women to maintain the weight loss ...

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

    Directory of Open Access Journals (Sweden)

    Ryan C. Case

    2009-01-01

    Full Text Available Objective. Obesity is a significant contributor to oxygen demand and dynamic airway obstruction. The objective of the current study is to determine the long-term success of conservative measures directed toward weight reduction on airway management without respect to specific airway disease etiology. Methods. Patients with chronic airway obstruction secondary anatomic lesions or obstructive sleep apnea were recruited and followed prospectively. Demographics, initial and final weights, diagnosis, and followup information were recorded. Patients were referred to a registered dietician, provided counseling, and started on a weight-loss regimen. Outcome measures were change in body mass index (BMI and rate of decannulation from weight loss alone. Results. Of fourteen patients, ten remained tracheostomy-dependent and four had high-grade lesions with the potential for improvement in oxygen demand and dynamic airway collapse with weight loss. The mean follow up period was 25 months. The mean change in BMI was an increase of 1.4 kg/m2 per patient. Conclusions. Conservative measures alone were not effective in achieving weight reduction in the population studied. This may be due to comorbid disease and poor compliance. The promise of decannulation was an insufficient independent motivator for weight loss in this study. Although the theoretical benefits of weight loss support its continued recommendation, the long-term success rate of conservative measures is low. More aggressive facilitated interventions including pharmacotherapy or bariatric surgery should be considered early in the course of treating airway disease complicated by obesity.

  12. 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....

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  14. Weight loss and weight maintenance obtained with or without GLP-1 analogue treatment decrease branched chain amino acid levels

    DEFF Research Database (Denmark)

    Engelbrechtsen, Line; Iepsen, Eva Pers Winning; Galijatovic, Ehm Astrid Andersson

    2016-01-01

    increased during weight loss (p = 5.2 × 10−15) and showed inverse correlation with insulin resistance measured by HOMA–IR levels (r = −0.318, p = 0.025). Valine concentrations were lower in the control group compared to the GLP-1RA group during weight maintenance (p = 0.005). Conclusion Weight loss...

  15. Mediating Effect of Body Image Distortion on Weight Loss Efforts in Normal-Weight and Underweight Korean Adolescent Girls

    Science.gov (United States)

    Choi, Jeong-Sil; Kim, Ji-Soo

    2017-01-01

    Background: We explored the relationship between body mass index-for-age percentile, body image distortion, and unnecessary weight loss efforts in Korean adolescent girls who are underweight and normal weight and examined the mediating effect of body image distortion on weight loss efforts. Methods: This study used data from the 2013 Korea Youth…

  16. Cannabis and Δ9-tetrahydrocannabinol (THC) for weight loss?

    Science.gov (United States)

    Le Foll, Bernard; Trigo, Jose M; Sharkey, Keith A; Le Strat, Yann

    2013-05-01

    Obesity is one of the highest preventable causes of morbidity and mortality in the developed world [1]. It has been well known for a long time that exposure to cannabis produces an increase of appetite (a phenomenon referred to as the 'munchies'). This phenomenon led to an exploration of the role of the endocannabinoid system in the regulation of obesity and associated metabolic syndrome. This effort subsequently led to the development of a successful therapeutic approach for obesity that consisted of blocking the cannabinoid CB1 receptors using ligands such as Rimonabant in order to produce weight loss and improve metabolic profile [2]. Despite being efficacious, Rimonabant was associated with increased rates of depression and anxiety and therefore removed from the market. We recently discovered that the prevalence of obesity is paradoxically much lower in cannabis users as compared to non-users and that this difference is not accounted for by tobacco smoking status and is still present after adjusting for variables such as sex and age. Here, we propose that this effect is directly related to exposure to the Δ(9)-tetrahydrocannabinol (THC) present in cannabis smoke. We therefore propose the seemingly paradoxical hypothesis that THC or a THC/cannabidiol combination drug may produce weight loss and may be a useful therapeutic for the treatment of obesity and its complications. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Electrochemical and weight-loss study of carbon steel corrosion

    International Nuclear Information System (INIS)

    Thomas, V.J.; Olive, R.P.

    2007-01-01

    The Point Lepreau Generating Station (PLGS) will undergo an 18 month refurbishment project beginning in April, 2008. During this time, most of the carbon steel piping in the primary loop will be drained of water and dried. However, some water will remain during the shutdown due to the lack of drains in some lower points in the piping system. As a result, it is necessary to examine the effect of corrosion during the refurbishment. This study examined the effect of several variables on the corrosion rate of clean carbon steel. Specifically, the effect of oxygen in the system and the presence of chloride ions were evaluated. Corrosion rates were determined using both a weight-loss technique and electrochemical methods. The experiment was conducted at room temperature. The corrosion products from the experiment were analyzed using a Raman microscope. The results of the weight-loss measurements show that the corrosion rate of polished carbon steel is independent of both the presence of oxygen and chloride ions. The electrochemical method failed to yield meaningful results due to the lack of clearly interpretable data and the inherent subjectivity in the analysis. Lepidocricite was found to be the main corrosion product using the Raman microscope. (author)

  18. Coaching and barriers to weight loss: an integrative review.

    Science.gov (United States)

    Muñoz Obino, Karen Fernanda; Aguiar Pereira, Caroline; Caron-Lienert, Rafaela Siviero

    2017-01-01

    Coaching is proposed to raise a patient's awareness and responsibility for their health behaviour change by transforming the professional-patient relationship. To review the scientific literature on how coaching can assist in weight loss and improve a patient's state of health. An integrative literature search was performed using PubMed, Latin American and Caribbean Literature in Health Sciences, and Scientific Electronic Library Online. We selected articles that were published in Portuguese, English, and Spanish over the last 10 years. Data analysis was performed using a validated data collection instrument. Among the 289 articles identified in the search, 276 were excluded because they did not address the leading research question, their full texts were not available on the Internet, or they were duplicate publications. Therefore, for the analysis, we selected 13 articles that we classified as randomized clinical studies (46.15%; n=6), cohort studies (30.76%; n=4), cross-sectional studies (7.69%; n=1), case studies (7.69%; n=1), and review articles (7.69%; n=1). Joint intervention (combined in-person and telecoaching sessions) constituted the majority of session types. The use of technical coaching was superior in reducing anthropometric measurements and increasing the levels of motivation and personal satisfaction compared with formal health education alone. Coaching is an efficient, cost-effective method for combining formal education and treatment of health in the weight-loss process. Additional randomized studies are needed to demonstrate its effectiveness with respect to chronic disease indicators.

  19. 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.

  20. Weight loss in the prevention and treatment of diabetes.

    Science.gov (United States)

    Delahanty, Linda M

    2017-11-01

    The American Diabetes Association nutrition and lifestyle recommendations for prediabetes and type 2 diabetes focus on losing 7% of body weight and increasing physical activity to at least 150minperweek. This emphasis is largely based on results of the Diabetes Prevention Program (DPP) and Look AHEAD (Action for Health in Diabetes) clinical trials. DPP demonstrated that a lifestyle intervention aimed at 7% weight loss and 150min of activity per week reduced diabetes incidence by 58% after 2.8years of follow-up and resulted in sustained improvements in hemoglobinA1c, blood pressure and lipid levels. After 15years of follow-up, DPP's lifestyle intervention sustained a 27% risk reduction in progression to diabetes. Look AHEAD's lifestyle intervention significantly reduced hemoglobinA1c, blood pressure, triglycerides, and the amount and costs of medications needed to treat these conditions when compared with diabetes support and education. Other clinical and psychological benefits achieved with lifestyle intervention were greater reductions in c-reactive protein, less self-reported retinopathy, reduced risk of nephropathy, less sexual dysfunction, decreased incidence of urinary incontinence and fatty liver, remission of sleep apnea, better physical functioning, less knee pain, more remission of diabetes, reduced incidence of depression, less body image dissatisfaction and improved quality-of-life. A number of DPP translation studies have demonstrated weight losses of 4 to 7% at 6month and 1year follow-up which has led to Medicare coverage for CDC recognized DPP lifestyle programs starting in April 2018. Translation studies of Look AHEAD using a variety of delivery formats are underway. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. 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.

  2. Relationship between perilipin gene polymorphisms and body weight and body composition during weight loss and weight maintenance.

    Science.gov (United States)

    Soenen, Stijn; Mariman, Edwin C M; Vogels, Neeltje; Bouwman, Freek G; den Hoed, Marcel; Brown, Louise; Westerterp-Plantenga, Margriet S

    2009-03-23

    Genetic variation in the perilipin (PLIN) gene may play a role in the etiology and treatment of obesity. To examine different polymorphisms in the PLIN gene in relation to body-weight regulation. 118 subjects followed a 6 wk VLCD, followed by 1 year weight maintenance. Body-weight (BW), body composition, leptin concentration, and polymorphisms of the PLIN gene: PLIN1:rs2289487, PLIN4:rs894160, PLIN6:rs1052700, PLIN5:rs2304795 and PLIN7:rs 2304796 were determined. BW loss during VLCD was 7.0+/-3.1 kg (p0.9, r2=0.72; PLIN5 and PLIN7: D' >0.9, r2=0.85. In men, body weight, BMI, waist circumference, body fat, leptin concentrations were significantly lower for the haplotype of PLIN1 (C-alleles) and PLIN4 (A-alleles). In women weight loss and loss of fat mass were larger for the haplotype of PLIN1 (C-alleles) and PLIN4 (A-alleles). For PLIN6 genotypes body weight and body fat were lower for homozygotes of the minor allele (T/T) in the men; in the women leptin concentrations were lower. The haplotype of PLIN5 and PLIN7 consisting of A/G and G/G of PLIN5 and A/A of PLIN7 showed a reduction in FM: 5.9+/-0.6 kg vs 3.1+/-0.4 kg, % body fat: 5.5+/-0.6% vs 2.2+/-0.2%, and leptin: 20.5+/-10.8 ng/ml vs 12.9+/-6.7 ng/ml over time in the women (pinfluencer of obesity risk in humans.

  3. Sugammadex and Ideal Body Weight in Bariatric Surgery

    Directory of Open Access Journals (Sweden)

    Maria Sanfilippo

    2013-01-01

    Full Text Available Background. The obese patients have differences in body composition, drug distribution, and metabolism. Sugammadex at recovery in a dose of 2 mg kg−1 of real body weight (RBW can completely reverse the NMB block; in our study we investigated the safety and efficacy of Sugammadex dose based on their ideal body weight (IBW. Methods. 40 patients of both sexes undergoing laparoscopic bariatric surgery were enrolled divided into 2 groups according to the dose of Sugammadex: the first received a dose of 2 mg kg−1 of IBW and the second received a dose of 2 mg kg−1 of RBW. Both were anesthetized with doses calculated according to the IBW: fentanyl 2 μg kg−1, propofol 3 mg kg−1, rocuronium 0,6 mg kg−1, oxygen, air, and desflurane (6–8%. Maintenance doses of rocuronium were 1/4 of the intubation dose. Sugammadex was administrated at recovery. Results. The durations of intubation and maintenance doses of rocuronium were similar in both groups. In IBW group, the / value of 0.9 was reached in 151 ± 44 seconds and in 121 ± 55 seconds in RBW group (. Discussion. Recovery times to / of 0.9 are surprisingly similar in both groups without observing any postoperative residual curarization. Conclusion. Sugammadex doses calculated according to the IBW are certainly safe for a rapid recovery and absence of PORC.

  4. Salivary habituation to food stimuli in successful weight loss maintainers, obese and normal-weight adults

    Science.gov (United States)

    Bond, DS; Raynor, HA; McCaffery, JM; Wing, RR

    2017-01-01

    Objective Research shows that slower habituation of salivary responses to food stimuli is related to greater energy intake and that obese (Ob) individuals habituate slower than those of normal weight (NW). No study has examined habituation rates in weight loss maintainers (WLMs) who have reduced from obese to normal weight, relative to those who are Ob or NW. Design Salivation to two baseline water trials and 10 lemon-flavored lollipop trials were studied in 14 WLMs, 15 Ob and 18 NW individuals comparable in age, gender and ethnicity. Linear mixed models were used to compare WLMs with Ob and NW groups. Results Salivation in the WLM and NW groups decreased significantly (for both P <0.005) across trials, indicative of habituation. Salivary responses in the Ob group did not habituate (P=0.46). When compared with Ob group, WLMs showed a quicker reduction in salivation (P<0.05). WLM and NW groups did not differ in habituation rate (P=0.49). Conclusions WLMs have habituation rates that are comparable to NW individuals without previous history of obesity, and show quicker habituation than those who are currently obese. These results suggest that physiological responses to food may ‘normalize’ with successful weight loss maintenance. PMID:20010900

  5. Perfluoroalkyl substances and changes in body weight and resting metabolic rate in response to weight-loss diets

    DEFF Research Database (Denmark)

    Liu, Gang; Dhana, Klodian; Furtado, Jeremy D

    2018-01-01

    in body weight and resting metabolic rate (RMR) in a diet-induced weight-loss setting. METHODS AND FINDINGS: In the 2-year POUNDS Lost randomized clinical trial based in Boston, Massachusetts, and Baton Rouge, Louisiana, that examined the effects of energy-restricted diets on weight changes, baseline...... and 24 months. Participants lost an average of 6.4 kg of body weight during the first 6 months (weight-loss period) and subsequently regained an average of 2.7 kg of body weight during the period of 6-24 months (weight regain period). After multivariate adjustment, baseline PFAS concentrations were...... not significantly associated with concurrent body weight or weight loss during the first 6 months. In contrast, higher baseline levels of PFASs were significantly associated with a greater weight regain, primarily in women. In women, comparing the highest to the lowest tertiles of PFAS concentrations...

  6. Plastic surgery improves long-term weight control after bariatric surgery.

    Science.gov (United States)

    Balagué, Nicolas; Combescure, Christophe; Huber, Olivier; Pittet-Cuénod, Brigitte; Modarressi, Ali

    2013-10-01

    The positive impact of Roux-en-Y gastric bypass on weight, comorbidities, and health-related quality of life is well documented. However, 50 percent of patients regain some of the lost weight after 2 years with Roux-en-Y gastric bypass and present a mean weight regain of 10 to 15 percent after several years, partially losing the previously obtained benefits. The authors hypothesize that body contouring could decrease weight regain, leading to better long-term weight control after Roux-en-Y gastric bypass. In a matched control study, variations in weight for 98 patients with body contouring after Roux-en-Y gastric bypass were compared with those of 102 matched control patients with Roux-en-Y gastric bypass alone. Data were collected prospectively at 1, 3, 6, 9, 12, and 18 months after Roux-en-Y gastric bypass and then yearly until 7 years. After a massive mean weight loss of 45.2 kg during the first 2 years after Roux-en-Y gastric bypass, patients with Roux-en-Y gastric bypass alone presented a higher continuous mean weight regain than those with Roux-en-Y gastric bypass and body contouring (1.78 kg/year versus 0.51 kg/year of weight regain, respectively; p = 0.001). After 7 years, patients with Roux-en-Y gastric bypass presented significantly higher mean weight regain than patients with Roux-en-Y gastric bypass and body contouring (i.e., 10.8 percent versus 3.6 percent mean weight gain, respectively; p weight of 2.04 kg by body contouring, the weight regain was 22.9 kg for patients with Roux-en-Y gastric bypass alone and only 6.2 kg for those with Roux-en-Y gastric bypass and body contouring. The authors demonstrated that patients with body contouring present better long-term weight control after Roux-en-Y gastric bypass. Therefore, body contouring must be considered as a reconstructive operation in the treatment of morbid obesity. Therapeutic, III.

  7. 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.

  8. 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.

  9. 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.

  10. Prognostic markers for diet-induced weight loss in obese women

    DEFF Research Database (Denmark)

    Astrup, A; Buemann, B; Gluud, C

    1995-01-01

    To identify prognostic metabolic and hormonal markers for long-term weight loss outcome in obese women.......To identify prognostic metabolic and hormonal markers for long-term weight loss outcome in obese women....

  11. Weight loss versus muscle loss: re-evaluating inclusion criteria for future cancer cachexia interventional trials.

    Science.gov (United States)

    Roeland, Eric J; Ma, Joseph D; Nelson, Sandahl H; Seibert, Tyler; Heavey, Sean; Revta, Carolyn; Gallivan, Andrea; Baracos, Vickie E

    2017-02-01

    Participation in cancer cachexia clinical trials requires a defined weight loss (WL) over time. A loss in skeletal muscle mass, measured by cross-sectional computed tomography (CT) image analysis, represents a possible alternative. Our aim was to compare WL versus muscle loss in patients who were screened to participate in a cancer cachexia clinical trial. This was a single-center, retrospective analysis in metastatic colorectal cancer patients screened for an interventional cancer cachexia trial requiring a ≥5 % WL over the preceding 6 months. Concurrent CT images obtained as part of standard oncology care were analyzed for changes in total muscle and fat (visceral, subcutaneous, and total). Of patients screened (n = 36), 3 (8 %) enrolled in the trial, 17 (47 %) were excluded due to insufficient WL (20 %), and 16 (44 %) met inclusion criteria for WL. Patients who met screening criteria for WL (5-20 %) had a mean ± SD of 7.7 ± 8.7 % muscle loss, 24.4 ± 37.5 % visceral adipose loss, 21.6 ± 22.3 % subcutaneous adipose loss, and 22.1 ± 24.7 % total adipose loss. Patients excluded due to insufficient WL had 2 ± 6.4 % muscle loss, but a gain of 8.5 ± 39.8 % visceral adipose, and 4.2 ± 28.2 % subcutaneous adipose loss and 0.8 ± 28.4 % total adipose loss. Of the patients excluded due to WL 5 %. Defining cancer cachexia by WL over time may be limited as it does not capture skeletal muscle loss. Cross-sectional CT body composition analysis may improve early detection of muscle loss and patient participation in future cancer cachexia clinical trials.

  12. Bariatric surgery in patients with bipolar spectrum disorders: Selection factors, post-operative visit attendance, and weight outcomes

    Science.gov (United States)

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

    2017-01-01

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

  13. [Weight loss and healing of ulcers - case report].

    Science.gov (United States)

    Seremet, Jasmina; Laginja, Stanislava; Marinović, Marin

    2013-10-01

    Diabetes mellitus type 2 is one of the most common diseases with a prevalence increasing with age. If blood sugar is not controlled, complications arise and diabetic foot ulcer occurs. Depending on the blood vessels involved, we distinguish venous and arterial ulcers. Venous ulcers respond very well to modern methods of treatment such as compression therapy and hydrocolloid dressings, but for arterial ulcer prevention is most significant, e.g. weight loss, dietary modification, etc. The aim of this study was to show that despite all the available therapeutic options, we cannot cure ulcers completely because the patient's readiness to change his lifestyle plays a decisive role. Therefore, we present a patient having suffered from venous ulcers for several years and arterial ulcer that healed only after the patient had lost about 20 pounds.

  14. 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.

  15. 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

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

    Science.gov (United States)

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

    2013-01-01

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

  17. Impact of weight loss on markers of systemic inflammation in obese ...

    African Journals Online (AJOL)

    Background: Weight loss studies were conducted in children without asthma have demonstrated a reduction in systemic inflammation. However, the impact of weight loss in the obese paediatric population with asthma has not been investigated. Objective: To measure the effects of weight loss on markers of systemic ...

  18. [Intractable diarrhoea and severe weight loss by roflumilast].

    Science.gov (United States)

    Horna, Oihana; Toyas, Carla

    2013-08-04

    Roflumilast is a recently marketed drug, indicated for maintenance treatment of severe chronic obstructive pulmonary disease associated with chronic bronchitis in adult patients with a history of frequent exacerbations as add on to bronchodilator treatment. The safety data of this drug have always been subjected to controversy and concerns. The Food and Drug Administration rejected the drug after the first evaluation, asking the company to clarify the adverse reactions during the investigation process, the European Medicines Agency approved the drug including a Risk Management Plan, designed to promote a safe use of the drug. During the first months after the marketing process, the Spanish Pharmacovigilance System has already been acquainted of several adverse events notifications; therefore, these patients may be closely monitored, mainly because of digestive and psychiatric disorders. Here we report the case of a female patient who showed a serious digestive clinical profile and a severe weight loss, more than 25% of her initial weight, when a treatment with roflumilast was started. The suspicion of a side effect as the cause of the reported clinical profile and its resolution required 3 hospital admissions. Copyright © 2013 Elsevier España, S.L. All rights reserved.

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

    Science.gov (United States)

    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.

  20. Adipose tissue transcriptome reflects variations between subjects with continued weight loss and subjects regaining weight 6 mo after caloric restriction independent of energy intake

    DEFF Research Database (Denmark)

    Márquez-Quinõnes, Adriana; Mutch, David M.; Debard, Cyrille

    2010-01-01

    The mechanisms underlying body weight evolution after diet-induced weight loss are poorly understood.......The mechanisms underlying body weight evolution after diet-induced weight loss are poorly understood....

  1. 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.

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

    Science.gov (United States)

    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

  3. Effectiveness of tranexamic acid in reducing blood loss during cytoreductive surgery for advanced ovarian cancer.

    Science.gov (United States)

    Kietpeerakool, Chumnan; Supoken, Amornrat; Laopaiboon, Malinee; Lumbiganon, Pisake

    2016-01-23

    Ovarian cancer is the third most common gynaecological cancer worldwide, with an age-standardised incidence rate of 6.1 per 10,000 women. Standard therapy for advanced epithelial ovarian cancer (EOC) includes a combination of cytoreductive surgery and platinum-based chemotherapy. Cytoreductive surgery aims to remove as much of the visible tumour as possible. As extensive intraperitoneal metastases are typical of advanced EOC, cytoreductive surgery is usually an extensive procedure with the risk of excessive bleeding. Tranexamic acid given perioperatively is effective in reducing blood loss and allogeneic blood transfusion requirements in a variety of surgical settings. Therefore, tranexamic acid seems to be a promising agent for minimising blood loss and the need for blood transfusion among women with advanced EOC undergoing cytoreductive surgery. To assess the effects of tranexamic acid for reducing blood loss associated with cytoreductive surgery in women with advanced EOC (stage III to IV). We searched the Cochrane Gynaecological, Neuro-oncology and Orphan Cancers Trial Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 5, 2015), MEDLINE, EMBASE and conference proceedings to May 2015. We also checked registers of clinical trials, citation lists of included studies, key textbooks and previous systematic reviews for potentially relevant studies. We included randomised controlled trials (RCTs) comparing tranexamic acid given during surgery versus placebo or no treatment, in adult women diagnosed with advanced EOC. Two review authors (CK, AS) independently selected potentially relevant trials, extracted data, assessed risk of bias, compared results and resolved disagreements by discussion. We found only one study that met our inclusion criteria. This was a randomised double blind, placebo-controlled multicentre study conducted to evaluate the effectiveness of a single dose of intravenous tranexamic acid (15 mg/kg body weight) versus

  4. 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.

  5. Performance on the Iowa gambling task is related to magnitude of weight loss and salivary cortisol in a diet-induced weight loss intervention in overweight women

    Science.gov (United States)

    The overall objective of this study was to examine the relationship between executive function, specifically decision making, and weight loss. We used the Iowa Gambling Task (IGT) to characterize decision making and compared performance on this task to weight loss in obese women (n=29) participatin...

  6. 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)…

  7. 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).

  8. 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

  9. 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.

  10. Cohort Study of the Success of Controlled Weight Loss Programs for Obese Dogs.

    Science.gov (United States)

    German, A J; Titcomb, J M; Holden, S L; Queau, Y; Morris, P J; Biourge, V

    2015-01-01

    Most weight loss studies in obese dogs assess rate and percentage of weight loss in the first 2-3 months, rather than the likelihood of successfully reaching target weight. To determine outcome of controlled weight loss programs for obese dogs, and to determine the factors associated with successful completion. 143 obese dogs undergoing a controlled weight loss program. This was a cohort study of obese dogs attending a referral weight management clinic. Dogs were studied during their period of weight loss, and cases classified according to outcome as "completed" (reached target weight), "euthanized" (was euthanized before reaching target weight), or "stopped prematurely" (program stopped early for other reasons). Factors associated with successful completion were assessed using simple and multiple logistic regression. 87/143 dogs (61%) completed their weight loss program, 11 [8%] died or were euthanized, and the remaining 45 [32%] stopped prematurely. Reasons for dogs stopping prematurely included inability to contact owner, refusal to comply with weight management advice, or development of another illness. Successful weight loss was positively associated with a faster rate (P obese dogs on a controlled weight loss program reach their target weight. Future studies should better clarify reasons for success in individual cases, and also the role of factors such as activity and behavioral modification. Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  11. The Breathe Easier through Weight Loss Lifestyle (BE WELL Intervention: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Buist A

    2010-03-01

    Full Text Available Abstract Background Obesity and asthma have reached epidemic proportions in the US. Their concurrent rise over the last 30 years suggests that they may be connected. Numerous observational studies support a temporally-correct, dose-response relationship between body mass index (BMI and incident asthma. Weight loss, either induced by surgery or caloric restriction, has been reported to improve asthma symptoms and lung function. Due to methodological shortcomings of previous studies, however, well-controlled trials are needed to investigate the efficacy of weight loss strategies to improve asthma control in obese individuals. Methods/Design BE WELL is a 2-arm parallel randomized clinical trial (RCT of the efficacy of an evidence-based, comprehensive, behavioral weight loss intervention, focusing on diet, physical activity, and behavioral therapy, as adjunct therapy to usual care in the management of asthma in obese adults. Trial participants (n = 324 are patients aged 18 to 70 years who have suboptimally controlled, persistent asthma, BMI between 30.0 and 44.9 kg/m2, and who do not have serious comorbidities (e.g., diabetes, heart disease, stroke. The 12-month weight loss intervention to be studied is based on the principles of the highly successful Diabetes Prevention Program lifestyle intervention. Intervention participants will attend 13 weekly group sessions over a four-month period, followed by two monthly individual sessions, and will then receive individualized counseling primarily by phone, at least bi-monthly, for the remainder of the intervention. Follow-up assessment will occur at six and 12 months. The primary outcome variable is the overall score on the Juniper Asthma Control Questionnaire measured at 12 months. Secondary outcomes include lung function, asthma-specific and general quality of life, asthma medication use, asthma-related and total health care utilization. Potential mediators (e.g., weight loss and change in physical

  12. The Exposure Effects of Online Model Pictures and Weight-Related Persuasive Messages on Women's Weight-Loss Planned Behaviors.

    Science.gov (United States)

    Pan, Wenjing; Peña, Jorge

    2017-10-01

    This study examined how exposure to pictures of women with different body sizes (thin, obese), physical attractiveness levels (attractive, unattractive), along with exposure to weight-related messages (pro-anorexia, anti-anorexia) embedded in a fashion website affected female participants' planned behavior toward weight loss. Participants exposed to attractive model pictures showed higher intentions, attitudes, and subjective norms to lose weight compared with unattractive models. Additionally, participants exposed to thin and attractive model pictures indicated the highest attitudes and self-efficacy to lose weight, whereas those exposed to thin and unattractive model pictures indicated the lowest. Furthermore, weight-related messages moderated the effect of model appearance (body size and attractiveness) on controllability of weight-loss activities. However, website pictures' body size differences had no main effects on planned behavior toward weight loss. These effects are discussed in the light of social comparison mechanisms.

  13. Thyroid hormones and changes in body weight and metabolic parameters in response to weight loss diets: the POUNDS LOST trial.

    Science.gov (United States)

    Liu, G; Liang, L; Bray, G A; Qi, L; Hu, F B; Rood, J; Sacks, F M; Sun, Q

    2017-06-01

    The role of thyroid hormones in diet-induced weight loss and subsequent weight regain is largely unknown. To examine the associations between thyroid hormones and changes in body weight and resting metabolic rate (RMR) in a diet-induced weight loss setting. Data analysis was conducted among 569 overweight and obese participants aged 30-70 years with normal thyroid function participating in the 2-year Prevention of Obesity Using Novel Dietary Strategies (POUNDS) LOST randomized clinical trial. Changes in body weight and RMR were assessed during the 2-year intervention. Thyroid hormones (free triiodothyronine (T3), free thyroxine (T4), total T3, total T4 and thyroid-stimulating hormone (TSH)), anthropometric measurements and biochemical parameters were assessed at baseline, 6 months and 24 months. Participants lost an average of 6.6 kg of body weight during the first 6 months and subsequently regained an average of 2.7 kg of body weight over the remaining period from 6 to 24 months. Baseline free T3 and total T3 were positively associated, whereas free T4 was inversely associated, with baseline body weight, body mass index and RMR. Total T4 and TSH were not associated with these parameters. Higher baseline free T3 and free T4 levels were significantly associated with a greater weight loss during the first 6 months (Ppressure, glucose, insulin, triglycerides and leptin at 6 months and 24 months (all P<0.05). In this diet-induced weight loss setting, higher baseline free T3 and free T4 predicted more weight loss, but not weight regain among overweight and obese adults with normal thyroid function. These findings reveal a novel role of thyroid hormones in body weight regulation and may help identify individuals more responsive to weight loss diets.

  14. 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

  15. 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.

  16. Increased protein intake reduces lean body mass loss during weight loss in athletes.

    Science.gov (United States)

    Mettler, Samuel; Mitchell, Nigel; Tipton, Kevin D

    2010-02-01

    To examine the influence of dietary protein on lean body mass loss and performance during short-term hypoenergetic weight loss in athletes. In a parallel design, 20 young healthy resistance-trained athletes were examined for energy expenditure for 1 wk and fed a mixed diet (15% protein, 100% energy) in the second week followed by a hypoenergetic diet (60% of the habitual energy intake), containing either 15% (approximately 1.0 g x kg(-1)) protein (control group, n = 10; CP) or 35% (approximately 2.3 g x kg(-1)) protein (high-protein group, n = 10; HP) for 2 wk. Subjects continued their habitual training throughout the study. Total, lean body, and fat mass, performance (squat jump, maximal isometric leg extension, one-repetition maximum (1RM) bench press, muscle endurance bench press, and 30-s Wingate test) and fasting blood samples (glucose, nonesterified fatty acids (NEFA), glycerol, urea, cortisol, free testosterone, free Insulin-like growth factor-1 (IGF-1), and growth hormone), and psychologic measures were examined at the end of each of the 4 wk. Total (-3.0 +/- 0.4 and -1.5 +/- 0.3 kg for the CP and HP, respectively, P = 0.036) and lean body mass loss (-1.6 +/- 0.3 and -0.3 +/- 0.3 kg, P = 0.006) were significantly larger in the CP compared with those in the HP. Fat loss, performance, and most blood parameters were not influenced by the diet. Urea was higher in HP, and NEFA and urea showed a group x time interaction. Fatigue ratings and "worse than normal" scores on the Daily Analysis of Life Demands for Athletes were higher in HP. These results indicate that approximately 2.3 g x kg(-1) or approximately 35% protein was significantly superior to approximately 1.0 g x kg(-1) or approximately 15% energy protein for maintenance of lean body mass in young healthy athletes during short-term hypoenergetic weight loss.

  17. Weight change in a commercial web-based weight loss program and its association with website use: cohort study.

    Science.gov (United States)

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

    2011-10-12

    There is a paucity of information in the scientific literature on the effectiveness of commercial weight loss programs, including Web-based programs. The potential of Web-based weight loss programs has been acknowledged, but their ability to achieve significant weight loss has not been proven. The objectives were to evaluate the weight change achieved within a large cohort of individuals enrolled in a commercial Web-based weight loss program for 12 or 52 weeks and to describe participants' program use in relation to weight change. Participants enrolled in an Australian commercial Web-based weight loss program from August 15, 2007, through May 31, 2008. Self-reported weekly weight records were used to determine weight change after 12- and 52-week subscriptions. The primary analysis estimated weight change using generalized linear mixed models (GLMMs) for all participants who subscribed for 12 weeks and also for those who subscribed for 52 weeks. A sensitivity analysis was conducted using the last observation carried forward (LOCF) method. Website use (ie, the number of days participants logged on, made food or exercise entries to the Web-based diary, or posted to the discussion forum) was described from program enrollment to 12 and 52 weeks, and differences in website use by percentage weight change category were tested using Kruskal-Wallis test for equality of populations. Participants (n = 9599) had a mean (standard deviation [SD]) age of 35.7 (9.5) years and were predominantly female (86% or 8279/9599) and obese (61% or 5866/9599). Results from the primary GLMM analysis including all enrollees found the mean percentage weight change was -6.2% among 12-week subscribers (n = 6943) and -6.9% among 52-week subscribers (n = 2656). Sensitivity analysis using LOCF revealed an average weight change of -3.0% and -3.5% after 12 and 52 weeks respectively. The use of all website features increased significantly (P Web-based weight loss program is likely to be in the range of

  18. Maintaining a clinical weight loss after intensive lifestyle intervention is the key to cardiometabolic health

    DEFF Research Database (Denmark)

    Jørgensen, Sune Dandanell; Skovborg, Camilla; Præst, Charlotte Boslev

    2017-01-01

    OBJECTIVE: Intensive lifestyle interventions (ILI) are criticised for ineffective obesity treatment because weight loss over time is modest and thus of limited clinical relevance. However, a subgroup (5-30%) maintains a clinical weight loss >10%, but it is not clear if cardiometabolic health foll...... activity (155±6, 130±5, 113±5μmol/g/min) and VO2max (49±1, 43±1, 41±1mL/min/FFM) (p10% weight loss compared to moderate weight loss and weight regain....

  19. Variation in extracellular matrix genes is associated with weight regain after weight loss in a sex-specific manner

    DEFF Research Database (Denmark)

    Roumans, Nadia J T; Vink, Roel G; Gielen, Marij

    2015-01-01

    The extracellular matrix (ECM) of adipocytes is important for body weight regulation. Here, we investigated whether genetic variation in ECM-related genes is associated with weight regain among participants of the European DiOGenes study. Overweight and obese subjects (n = 469, 310 females, 159 m.......40-5.63). Concluding, variants of ECM genes are associated with weight regain after weight loss in a sex-specific manner....

  20. Weight loss in Oystercatchers Haematopus ostralegus on the roost and after capture

    NARCIS (Netherlands)

    Zwarts, L; Hulscher, JB; Zegers, PM

    1996-01-01

    This paper analyses the weight loss in Oystercatchers on the roost and after capture and attempts to investigate to what degree this weight loss is due to defecation of digested food, to dehydration and to utilisation of nutrient stores. The study emphasizes the need to record weight changes

  1. 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.

  2. Weight Loss at a Cost: Implications of High-Protein, Low- Carbohydrate Diets.

    Science.gov (United States)

    Gabel, Kathe A.; Lund, Robin J.

    2002-01-01

    Addresses three claims of high-protein, low-carbohydrate diets: weight loss is attributed to the composition of the diet; insulin promotes the storage of fat, thereby, by limiting carbohydrates, dieters will decrease levels of insulin and body fat; and weight loss is the result of fat loss. The paper examines relevant scientific reports and notes…

  3. Effect of weight loss on the severity of psoriasis

    DEFF Research Database (Denmark)

    Jensen, P; Zachariae, Claus; Christensen, R

    2013-01-01

    Psoriasis is associated with adiposity and weight gain increases the severity of psoriasis and the risk of incident psoriasis. Therefore, we aimed to measure the effect of weight reduction on the severity of psoriasis in obese patients with psoriasis.......Psoriasis is associated with adiposity and weight gain increases the severity of psoriasis and the risk of incident psoriasis. Therefore, we aimed to measure the effect of weight reduction on the severity of psoriasis in obese patients with psoriasis....

  4. 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...

  5. Iatrogenic Subclinical Hyperthyroidism Does Not Promote Weight Loss.

    Science.gov (United States)

    Kedia, Rohit; Lowes, Alicia; Gillis, Sarah; Markert, Ronald; Koroscil, Thomas

    2016-02-01

    Among patients who have undergone total thyroidectomy, do those with thyroid cancer being kept iatrogenically subclinical hyperthyroid (SCH) differ from euthyroid patients in long-term weight change? In a retrospective study, medical records identified 291 patients who had undergone a thyroidectomy for differentiated thyroid cancer or benign thyroid disease. Weight, thyroid-stimulating hormone, and levothyroxine dose were measured presurgery and 1, 2, and 3 years postsurgery. Of 291 patients, 147 were in the SCH group and 144 were in the euthyroid group. At all 3 years both groups gained weight from baseline, but the two groups did not differ in weight change from baseline at any time period: year 1 (SCH mean 0.4% ± 6.2% weight gain vs euthyroid group mean 2.2% ± 6.6% weight gain; P = 0.12), year 2 (SCH mean 1.1% ± 9.1% weight gain vs euthyroid mean 2.9% ± 7.8% weight gain; P = 0.22), and year 3 (SCH mean 2.6% ± 9.2% weight gain vs euthyroid mean 3.1% ± 11.1% weight gain; P = 0.49). Among total thyroidectomy patients, weight change did not differ between SCH patients and euthyroid patients at years 1 through 3. As such, the use of levothyroxine to induce SCH did not lead to long-term weight change when compared with euthyroid patients.

  6. A systematic review of the relationship between weight status perceptions and weight loss attempts, strategies, behaviours and outcomes

    Science.gov (United States)

    Kersbergen, I.; Sutin, A.; Daly, M.; Robinson, E.

    2017-01-01

    Summary It is commonly assumed that a person identifying that they are ‘overweight’ is an important prerequisite to successful weight management. However, there has been no systematic evaluation of evidence supporting this proposition. The aim of the present research was to systematically review evidence on the relationship between perceived overweight and (i) weight loss attempts, (ii) weight control strategies (healthy and unhealthy), (iii) weight‐related behaviours (physical activity and eating habits), (iv) disordered eating and (v) weight change. We synthesized evidence from 78 eligible studies and evaluated evidence linking perceived overweight with outcome variables separately according to the gender, age and objective weight status of study participants. Results indicated that perceived overweight was associated with an increased likelihood of attempting weight loss and with healthy and unhealthy weight control strategies in some participant groups. However, perceived overweight was not reliably associated with physical activity or healthy eating and was associated with greater disordered eating in some groups. Rather than being associated with improved weight management, there was consistent evidence that perceived overweight was predictive of increased weight gain over time. Individuals who perceive their weight status as overweight are more likely to report attempting weight loss but over time gain more weight. PMID:29266851

  7. Energy homeostasis and appetite regulating hormones as predictors of weight loss in men and women.

    Science.gov (United States)

    Williams, Rebecca L; Wood, Lisa G; Collins, Clare E; Morgan, Philip J; Callister, Robin

    2016-06-01

    Sex differences in weight loss are often seen despite using the same weight loss program. There has been relatively little investigation of physiological influences on weight loss success in males and females, such as energy homeostasis and appetite regulating hormones. The aims were to 1) characterise baseline plasma leptin, ghrelin and adiponectin concentrations in overweight and obese males and females, and 2) determine whether baseline concentrations of these hormones predict weight loss in males and females. Subjects were overweight or obese (BMI 25-40 kg/m(2)) adults aged 18-60 years. Weight was measured at baseline, and after three and six months participation in a weight loss program. Baseline concentrations of leptin, adiponectin and ghrelin were determined by enzyme-linked immunosorbent assay (ELISA). An independent t-test or non-parametric equivalent was used to determine any differences between sex. Linear regression determined whether baseline hormone concentrations were predictors of six-month weight change. Females had significantly higher baseline concentrations of leptin, adiponectin and unacylated ghrelin as well as ratios of leptin:adiponectin and leptin:ghrelin. The ratio of acylated:unacylated ghrelin was significantly higher in males. In males and females, a higher baseline concentration of unacylated ghrelin predicted greater weight loss at six months. Additionally in females, higher baseline total ghrelin predicted greater weight loss and a higher ratio of leptin:ghrelin predicted weight gain at six months. A higher pre-weight-loss plasma concentration of unacylated ghrelin is a modest predictor of weight loss success in males and females, while a higher leptin:ghrelin ratio is a predictor of weight loss failure in females. Further investigation is required into what combinations and concentrations of these hormones are optimal for weight loss success. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. 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.

  9. Softened food reduces weight loss in the streptozotocin-induced male mouse model of diabetic nephropathy

    DEFF Research Database (Denmark)

    Nørgaard, Sisse A; Sand, Fredrik W; Sørensen, Dorte B

    2018-01-01

    The streptozotocin (STZ)-induced diabetic mouse is a widely used model of diabetes and diabetic nephropathy (DN). However, it is a well-known issue that this model is challenged by high weight loss, which despite supportive measures often results in high euthanization rates. To overcome...... these issues, we hypothesized that supplementing STZ-induced diabetic mice with water-softened chow in addition to normal chow would reduce weight loss, lower the need for supportive treatment, and reduce the number of mice reaching the humane endpoint of 20% weight loss. In a 15 week STZ-induced DN study we...... demonstrated that diabetic male mice receiving softened chow had reduced acute weight loss following STZ treatment ( p = 0.045) and additionally fewer mice were euthanized due to weight loss. By supplementing the diabetic mice with softened chow, no mice reached 20% weight loss whereas 37.5% of the mice...

  10. An Evidence-Based Review of Fat Modifying Supplemental Weight Loss Products

    Directory of Open Access Journals (Sweden)

    Amy M. Egras

    2011-01-01

    Full Text Available Objective. To review the literature on fat modifying dietary supplements commonly used for weight loss. Methods. Recently published randomized, placebo-controlled trials were identified in PubMed, MEDLINE, International Pharmaceutical Abstracts, Cochrane Database, and Google Scholar using the search terms dietary supplement, herbal, weight loss, obesity, and individual supplement names. Discussion. Data for conjugated linoleic acid (CLA, Garcinia cambogia, chitosan, pyruvate, Irvingia gabonensis, and chia seed for weight loss were identified. CLA, chitosan, pyruvate, and Irvingia gabonensis appeared to be effective in weight loss via fat modifying mechanisms. However, the data on the use of these products is limited. Conclusion. Many obese people use dietary supplements for weight loss. To date, there is little clinical evidence to support their use. More data is necessary to determine the efficacy and safety of these supplements. Healthcare providers should assist patients in weighing the risks and benefits of dietary supplement use for weight loss.

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

    Science.gov (United States)

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

    2005-11-01

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

  12. Prandial subcutaneous injections of glucagon-like peptide-1 cause weight loss in obese human subjects

    DEFF Research Database (Denmark)

    Näslund, Erik; King, N; Mansten, S

    2004-01-01

    Recombinant glucagon-like peptide-1 (7-36)amide (rGLP-1) was recently shown to cause significant weight loss in type 2 diabetics when administered for 6 weeks as a continuous subcutaneous infusion. The mechanisms responsible for the weight loss are not clarified. In the present study, rGLP-1 was ...... as a probable mechanism of action of increased satiety, decreased hunger and, hence, reduced food intake with an ensuing weight loss....

  13. Blood profile of proteins and steroid hormones predicts weight change after weight loss with interactions of dietary protein level and glycemic index

    DEFF Research Database (Denmark)

    Wang, Ping; Holst, Claus; Andersen, Malene R

    2011-01-01

    Weight regain after weight loss is common. In the Diogenes dietary intervention study, high protein and low glycemic index (GI) diet improved weight maintenance.......Weight regain after weight loss is common. In the Diogenes dietary intervention study, high protein and low glycemic index (GI) diet improved weight maintenance....

  14. A Weight-Loss Diet Including Coffee-Derived Mannooligosaccharides Enhances Adipose Tissue Loss in Overweight Men but Not Women

    Science.gov (United States)

    St-Onge, Marie-Pierre; Salinardi, Taylor; Herron-Rubin, Kristin; Black, Richard M.

    2013-01-01

    Mannooligosaccharides (MOS), extracted from coffee, have been shown to promote a decrease in body fat when consumed as part of free-living, weight-maintaining diets. Our objective was to determine if MOS consumption (4 g/day), in conjunction with a weight-loss diet, would lead to greater reductions in adipose tissue compartments than placebo. We conducted a double-blind, placebo-controlled weight-loss study in which 60 overweight men and women consumed study beverages and received weekly group counseling for 12 weeks. Weight and blood pressure were measured weekly, and adipose tissue distribution was assessed at baseline and at end point using magnetic resonance imaging. A total of 54 subjects completed the study. Men consuming the MOS beverage had greater loss of body weight than men consuming the Placebo beverage (−6.0 ± 0.6% vs. −2.3 ± 0.5%, respectively, P coffee-derived MOS to a weight-loss diet enhanced both weight and adipose tissue losses in men, suggesting a potential functional use of MOS for weight management and improvement in adipose tissue distribution. More studies are needed to investigate the apparent gender difference in response to MOS consumption. PMID:21938072

  15. Effects of diet composition on weight loss, metabolic factors and biomarkers in a 1-year weight loss intervention in obese women examined by baseline insulin resistance status.

    Science.gov (United States)

    Rock, Cheryl L; Flatt, Shirley W; Pakiz, Bilge; Quintana, Elizabeth L; Heath, Dennis D; Rana, Brinda K; Natarajan, Loki

    2016-11-01

    Obesity is a risk factor for postmenopausal breast cancer incidence and premenopausal and postmenopausal breast cancer mortality, which may be explained by several metabolic and hormonal factors (sex hormones, insulin resistance, and inflammation) that are biologically related. Differential effects of dietary composition on weight loss and these metabolic factors may occur in insulin-sensitive vs. insulin-resistant obese women. To examine the effect of diet composition on weight loss and metabolic, hormonal and inflammatory factors in overweight/obese women stratified by insulin resistance status in a 1-year weight loss intervention. Nondiabetic women who were overweight/obese (n=245) were randomly assigned to a lower fat (20% energy), higher carbohydrate (65% energy) diet; a lower carbohydrate (45% energy), higher fat (35% energy) diet; or a walnut-rich (18% energy), higher fat (35% energy), lower carbohydrate (45% energy) diet. All groups lost weight at follow-up (Ploss of 9.2(1.1)% in lower fat, 6.5(0.9)% in lower carbohydrate, and 8.2(1.0)% in walnut-rich groups at 12months. The diet×time×insulin resistance status interaction was not statistically significant in the model for overall weight loss, although insulin sensitive women at 12months lost more weight in the lower fat vs. lower carbohydrate group (7.5kg vs. 4.3kg, P=0.06), and in the walnut-rich vs. lower carbohydrate group (8.1kg vs. 4.3kg, P=0.04). Sex hormone binding globulin increased within each group except in the lower carbohydrate group at 12months (Ploss depending on insulin resistance status. Prescribing walnuts is associated with weight loss comparable to a standard lower fat diet in a behavioral weight loss intervention. Weight loss itself may be the most critical factor for reducing the chronic inflammation associated with increased breast cancer risk and progression. Copyright © 2016. Published by Elsevier Inc.

  16. Brief Self-Efficacy Scales for use in Weight-Loss Trials: Preliminary Evidence of Validity

    Science.gov (United States)

    Wilson, Kathryn E.; Harden, Samantha M.; Almeida, Fabio A.; You, Wen; Hill, Jennie L.; Goessl, Cody; Estabrooks, Paul A.

    2015-01-01

    Self-efficacy is a commonly included cognitive variable in weight-loss trials, but there is little uniformity in its measurement. Weight-loss trials frequently focus on physical activity (PA) and eating behavior, as well as weight loss, but no survey is available that offers reliable measurement of self-efficacy as it relates to each of these targeted outcomes. The purpose of this study was to test the psychometric properties of brief, pragmatic self-efficacy scales specific to PA, healthful eating and weight-loss (4 items each). An adult sample (n=1790) from 28 worksites enrolled in a worksite weight-loss program completed the self-efficacy scale, as well as measures of PA, dietary fat intake, and weight, at baseline, 6-, and 12-months. The hypothesized factor structure was tested through confirmatory factor analysis, which supported the expected factor structure for three latent self-efficacy factors, specific to PA, healthful eating, and weight-loss. Measurement equivalence/invariance between relevant demographic groups, and over time was also supported. Parallel growth processes in self-efficacy factors and outcomes (PA, fat intake, and weight) support the predictive validity of score interpretations. Overall, this initial series of psychometric analyses supports the interpretation that scores on these scales reflect self-efficacy for PA, healthful eating, and weight-loss. The use of this instrument in large-scale weight-loss trials is encouraged. PMID:26619093

  17. Patient and Physician Characteristics Associated with the Provision of Weight Loss Counseling in Primary Care

    Science.gov (United States)

    Dutton, Gareth R.; Herman, Katharine G.; Tan, Fei; Goble, Mary; Dancer-Brown, Melissa; Van Vessem, Nancy; Ard, Jamy D.

    2013-01-01

    Background A variety of physician and patient characteristics may influence whether weight loss counseling occurs in primary care encounters. Objectives This study utilized a cross-sectional survey of primary care patients, which examined patient characteristics, physician characteristics, and characteristics of the physician-patient relationship associated with weight loss counseling and recommendations provided by physicians. Participants Participants (N=143, mean age=46.8 years, mean BMI=36.9 kg/m2, 65% Caucasian) were overweight and obese primary care patients participating in a managed care weight loss program. Measures Participants completed self-report surveys in the clinic prior to the initial weight loss session. Surveys included items assessing demographic/background characteristics, weight, height, and a health care questionnaire evaluating whether their physician had recommended weight loss, the frequency of their physicians’ weight loss counseling, and whether their physician had referred them for obesity treatment. Results Patient BMI and physician sex were most consistently associated with physicians’ weight loss counseling practices. Patients seen by female physicians were more likely to be told that they should lose weight, received more frequent obesity counseling, and were more likely to have been referred for obesity treatment by their physician. Length and frequency of physician-patient contacts were unrelated to the likelihood of counseling. Conclusions These findings add to previous evidence suggesting possible differences in the weight loss counseling practices of male and female physicians, although further research is needed to understand this potential difference between physicians. PMID:24743007

  18. TFAP2B influences the effect of dietary fat on weight loss under energy restriction

    DEFF Research Database (Denmark)

    Stocks, Tanja; Angquist, Lars; Banasik, Karina

    2012-01-01

    Numerous gene loci are related to single measures of body weight and shape. We investigated if 55 SNPs previously associated with BMI or waist measures, modify the effects of fat intake on weight loss and waist reduction under energy restriction.......Numerous gene loci are related to single measures of body weight and shape. We investigated if 55 SNPs previously associated with BMI or waist measures, modify the effects of fat intake on weight loss and waist reduction under energy restriction....

  19. Sex differences in the composition of weight gain and loss in overweight and obese adults.

    Science.gov (United States)

    Millward, D Joe; Truby, Helen; Fox, Kenneth R; Livingstone, M Barbara E; Macdonald, Ian A; Tothill, Peter

    2014-03-14

    Sex differences in the ratio of fat mass (FM):fat-free mass (FFM) during weight change should differentially affect the extent of weight change during energy imbalance in men and women. In the present study, we determined FM and FFM contents by dual-energy X-ray absorptiometry and calculated the P-ratios (protein energy/total energy) of excess weight and weight loss during a randomised controlled trial of four commercial weight loss regimens. Overweight and obese women (n 210) and men (n 77) were studied at baseline and at 2 and 6 months during weight loss on four dietary regimens: Dr Atkins' New Diet Revolution; The Slim-Fast Plan; Weight-Watchers programme; Rosemary Conley's Diet and Fitness Plan. At baseline, the percentage of FFM (%FFM) and P-ratios of excess weight were 40 % and 0·071 for men and 27 % and 0·039 for women. At 2 months, men had lost twice as much weight as women and three times more FFM than women, indicating higher FFM content and P-ratios of weight loss for men, 0·052, than for women, 0·029, with no dietary effects. Between 2 and 6 months, the rate at which weight was lost decreased and the %FFM of weight loss decreased to similar low levels in men (7 %) and women (5 %): i.e. P-ratios of 0·009 and 0·006, respectively, with no dietary effects. Thus, for men compared with women, there were greater FFM content and P-ratios of weight change, which could partly, but not completely, explain their greater weight loss at 2 months. However, protein-conserving adaptations occur with increasing weight loss and over time, more extensively in men, eventually eliminating any sex difference in the composition of weight loss.

  20. 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.

  1. Impact of weight loss on oxidative stress and inflammatory cytokines ...

    African Journals Online (AJOL)

    Background: Type 2 diabetes mellitus is associated with abnormal markers of inflammatory cytokines and oxidative stress markers. Although, these abnormalities could be modulated with weight reduction; there is limitation in clinical studies that have addressed the beneficial effects of weight reduction in modulating ...

  2. Challenges of a community based pragmatic, randomised controlled trial of weight loss maintenance.

    Science.gov (United States)

    Randell, Elizabeth; McNamara, Rachel; Shaw, Christine; Espinasse, Aude; Simpson, Sharon Anne

    2015-12-18

    Randomised controlled trials (RCTs) have a reputation for being inherently difficult to deliver as planned and often face unforeseen challenges and delays, particularly in relation to organisational and governance difficulties, participant interest, constraints due to allocation of costs, local investigator interest and lengthy bureaucracy. Recruitment is often difficult and the challenges faced often impact on the cost and delivery of a successful trial within the funded period. This paper reflects upon the challenges faced in delivering a pragmatic RCT of weight loss maintenance in a community setting and suggests some potential solutions. The weight loss maintenance in adults trial aimed to evaluate the impact of a 12 month, individually tailored weight maintenance intervention on BMI 3 years from randomisation. Participants were recruited primarily from participant identification centres (PICs)-GP surgeries, exercise on referral schemes and slimming world. The intervention was delivered in community settings. A recruitment strategy implementation plan was drafted to address and monitor poor recruitment. Delays in opening and recruitment were experienced early on. Some were beyond the control of the study team such as; disagreement over allocation of national health service costs and PIC classification as well as difficulties in securing support from research networks. That the intervention was delivered in community settings was often at the root of these issues. Key items to address at the design stage of future trials include feasibility of eligibility criteria. The most effective element of the recruitment implementation plan was to refocus sources of recruitment and target only those who could fulfil the eligibility criteria immediately. Learnings from this trial should be kept in mind by those designing similar studies in the future. Considering potential governance, cost and research network support implications at the design stage of pragmatic trials of

  3. Weight Loss and Glycemic Control after Sleeve Gastrectomy: Results from a Middle Eastern Center of Excellence.

    Science.gov (United States)

    Al Khalifa, Khalid; Al Ansari, Ahmed; Showaiter, May

    2018-02-01

    Obesity and its associated metabolic disorders are strongly linked to both morbidity and mortality. Sleeve gastrectomy (SG) has been established as an effective means of weight loss for obese patients as well as a treatment for type 2 diabetes mellitus (T2DM). This study was designed to examine the short- and midterm outcomes of patients who underwent SG in a Middle Eastern Center of Excellence, a military training teaching hospital. The clinical outcomes of 59 patients with impaired glucose tolerance and T2DM who underwent SG between 2011 and 2014 with at least one and up to four years of follow-up were studied. Data were collected and compared, including the pre- and post-surgery measures of weight, body mass index, glycosylated hemoglobin (HbA1c), and fasting blood glucose. Complete remission was defined as a fasting blood glucose level ≤100 mg/dL, an HbA1c ≤6 mg/dL, without use of antidiabetic medications. All patients showed significant reduction in body mass index following SG. Tight glycemic control was achieved among both diabetic and prediabetic patients. In this study, 88.14 per cent of all patients (diabetic and prediabetic) achieved complete resolution from their impaired glucose tolerance and T2DM and maintained normal blood glucose and HbA1C levels from one to four years postoperatively. SG is beneficial both in terms of short- and midterm weight loss and glucose control in both diabetic and prediabetic obese patients.

  4. Predictors of weight loss in young adults who are over-weight or obese and have psychosocial problems

    DEFF Research Database (Denmark)

    Lous, Jørgen; Freund, Kirsten S.

    2016-01-01

    BACKGROUND: The aim of this study is in a general practice trial setting to identify predictive factors for weight loss after 1 year among young adults who are over-weight or obese and who have several psychosocial problems. METHODS: Twenty-eight general practitioners recruited 495 patients aged 20...

  5. 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.

  6. 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

  7. Impact of weight loss on oxidative stress and inflammatory cytokines ...

    African Journals Online (AJOL)

    diet regimen, where as the control group received medical treatment only for 12 weeks. Results: The mean values of ... Keywords: Type 2 diabetes, weight reduction, oxidative stress, cytokines, obesity. ..... muscle in severely obese subjects.

  8. Weight Loss and Complementary Health Practices: What the Science Says

    Science.gov (United States)

    ... engaging in this behavior; however, evidence for any benefit on weight is mixed. A 2013 systematic review and meta-analysis of the effect of food intake memory and awareness on eating indicates that attentive eating is likely to influence ...

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

    Science.gov (United States)

    ... second update of codes and MET values. Medicine & Science in Sports & Exercise. 2011;43:1575. 2008 Physical Activity Guidelines ... second update of codes and MET values. Medicine & Science in Sports & Exercise. 2011;43:1575. Losing weight. Centers for ...

  10. Long-Lasting Improvements in Liver Fat and Metabolism Despite Body Weight Regain After Dietary Weight Loss

    OpenAIRE

    Haufe, Sven; Haas, Verena; Utz, Wolfgang; Birkenfeld, Andreas L.; Jeran, Stephanie; Böhnke, Jana; Mähler, Anja; Luft, Friedrich C.; Schulz-Menger, Jeanette; Boschmann, Michael; Jordan, Jens; Engeli, Stefan

    2013-01-01

    OBJECTIVE Weight loss reduces abdominal and intrahepatic fat, thereby improving metabolic and cardiovascular risk. Yet, many patients regain weight after successful diet-induced weight loss. Long-term changes in abdominal and liver fat, along with liver test results and insulin resistance, are not known. RESEARCH DESIGN AND METHODS We analyzed 50 overweight to obese subjects (46 ± 9 years of age; BMI, 32.5 ± 3.3 kg/m2; women, 77%) who had participated in a 6-month hypocaloric diet and were ra...

  11. Identification of factors contributing to successful self-directed weight loss: a qualitative study.

    Science.gov (United States)

    Rafiei, N; Gill, T

    2017-11-21

    Despite the number of weight management programmes and their wide promotion, most overweight and obese individuals tend to lose weight on their own. The present study aimed to understand the characteristics and strategies of those who successfully engage in self-directed weight loss, which could empower other overweight and obese individuals with information and strategies to manage their weight on their own. Men and women who had lost at least 5% of their body weight without direct interaction with professionals or weight management programmes were recruited. Demographic data were collected by questionnaire and participants' weight-loss experiences were explored using semi- structured interviews to elicit in-depth individual experiences and perspectives. Iterative thematic method data analysis was used to generate themes describing contributing factors to the success of self-directed weight loss identified by participants. Most characteristics of those who successfully self-managed their weight loss were in line with those reported by successful weight losers participating in professional-led projects. However, strategies such as early embedding of new lifestyle behaviours into daily routine, the ability to learn from previous weight-loss experiences, and not requiring social support were identified as distinctive factors that contributed to the success of self-directed weight loss by participants of the present study. Overweight or obese individuals with strong internal motivation, problem-solving skills and self-reliance are more likely to be successful at achieving self-directed weight loss. The patients identified with these characteristics could be encouraged to self-manage their weight-loss process, leaving the places available in more resource-intensive professional-led programmes to those individuals unlikely to succeed on their own. © 2017 The British Dietetic Association Ltd.

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

    Science.gov (United States)

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

    2008-02-01

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

  13. Effect of weight loss on urinary incontinence in women

    OpenAIRE

    Whitcomb, Emily L; Subak, Leslee L

    2011-01-01

    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 ob...

  14. Comparison of percentage excess weight loss after laparoscopic sleeve gastrectomy and laparoscopic adjustable gastric banding

    Science.gov (United States)

    Bobowicz, Maciej; Lech, Paweł; Orłowski, Michał; Siczewski, Wiaczesław; Pawlak, Maciej; Świetlik, Dariusz; Witzling, Mieczysław; Michalik, Maciej

    2014-01-01

    Introduction Laparoscopic sleeve gastrectomy (LSG) and laparoscopic adjustable gastric banding (LAGB) are acceptable options for primary bariatric procedures in patients with body mass index (BMI) 35–55 kg/m2. Aim The aim of this study is to compare the effects of these two bariatric procedures 6, 12 and 24 months after surgery. Material and methods Two hundred and two patients were included 72 LSG and 130 LAGB patients. The average age was 38.8 ±11.9 and 39.4 ±10.4 years in LSG and LAGB groups, with initial BMI of 44.1 kg/m2 and 45.2 kg/m2, p = NS. Results The mean percentage of excess weight loss (%EWL) at 6 months for LSG vs. LAGB was 36.3% vs. 30.1% (p = 0.01) and at 12 months was 43.8% vs. 34.6% (p = 0.005). The greatest difference in the mean %EWL at 12 months was observed in patients with initial BMI of 40–49.9 kg/m2 in favor of LSG (47.5% vs. 35.6%; p = 0.01). Two years after surgery there was no advantage of LSG and in the subgroup of patients with BMI 50–55 kg/m2 there was a trend in favor of LAGB (57.2% vs. 30%; p = 0.07). The multiple regression model of independent variables (age, gender, initial BMI and the presence of comorbidities) proved insignificant in prediction of the best outcome in means of %EWL for either operative modality. None of these factors in the logistic regression model could determine the type of surgery that should be used in particular patients. Conclusions During the first 2 years after surgery, the best results were obtained in women with lower BMI undergoing LSG surgery. The LSG provides greater %EWL after a shorter period of time though the difference decreases in time. PMID:25337157

  15. Treatment for snoring. Combined weight loss, sleeping on side, and nasal spray.

    Science.gov (United States)

    Braver, H M; Block, A J; Perri, M G

    1995-05-01

    We sought to find a combination of noninvasive treatments for snoring by adding weight loss to previously studied treatments, including the combination of sleeping on one's side and using a decongestant nasal spray. Twenty asymptomatic men who snore heavily were studied previously on a control night and on a night when they slept on their side and used a nasal spray. With these two treatments, minor improvements in apnea/hypopnea index (AHI) were seen, but no improvement occurred in snoring frequency. Nineteen of these subjects subsequently completed a 6-month weight loss program, and 12 lost weight. These 19 subjects comprise the study population of this report. At the conclusion of the weight loss program, a repeated sleep study was done from which the effect of adding weight loss to the two previously studied treatments could be assessed. Those 12 subjects who lost any amount of weight showed a very mild reduction in snores per hour from 328 using two modalities of treatment to 232 per hour with the addition of weight loss (p = 0.15). The nine subjects who lost > or = 3 kg reduced the number of snores per hour from 320 to 176 (p = 0.0496). Three subjects losing an average of only 7.6 kg showed virtual elimination of snoring after weight loss. Subjects who gained weight had no improvement in snoring. Weight loss added to the other two modalities of treatment had no effect on the AHI. In most cases, the combination of weight loss, sleeping on one's side, and the administration of a nasal decongestant significantly reduces the frequency of snoring in asymptomatic men who snore heavily. The major effect appears to be related to weight loss.

  16. Celiac Disease Presenting as Profound Diarrhea and Weight Loss ? A Celiac Crisis

    OpenAIRE

    Bul, Vadim; Sleesman, Brett; Boulay, Brian

    2016-01-01

    Patient: Male, 46 Final Diagnosis: Celiac crisis Symptoms: Abdominal pain ? chronic diarrhea ? lightheadedness ? weakness ? weight loss Medication: ? Clinical Procedure: ? Specialty: Gastroenterology and Hepatology Objective: Rare disease Background: Celiac disease is a hypersensitivity enteropathy that can have various presentations in adults. Rarely, patients can present with severe lab abnormalities, dehydration and weight loss caused by celiac disease ? a celiac crisis. Case Report: A 46-...

  17. Clinical correlates of weight loss and attrition during a 10-week dietary intervention study

    DEFF Research Database (Denmark)

    Handjieva-Darlenska, Teodora; Holst, Claus; Grau, Katrine

    2012-01-01

    clinical centres in 7 European countries, who underwent a 10-week dietary intervention study comparing two hypo-energetic (-600 kcal/day) diets varying in fat content. Results: The multiple regression model showed that weight loss at week 10 was predicted by: 6.55 + 1.27 × early weight loss (kg) at week 1...... kg weight loss at week 5 emerged as an optimal predictor for reaching at least 10% weight loss at week 10. Greater attrition likelihood was predicted by high-fat diet, decreased early and half-way weight losses. Conclusion: Early and half-way weight losses are associated with and could contribute......Objective: The aim of this study was to identify the pre-treatment subject characteristics and weight loss changes as determinants of weight loss and attrition during a 10-week dietary intervention study. Methods: A total of 771 obese subjects (BMI 35.6 kg/m(2)) of both genders were included from 8...

  18. Using Avatars to Model Weight Loss Behaviors: Participant Attitudes and Technology Development

    Science.gov (United States)

    Napolitano, Melissa A.; Hayes, Sharon; Russo, Giuseppe; Muresu, Debora; Giordano, Antonio; Foster, Gary D.

    2013-01-01

    Background: Virtual reality and other avatar-based technologies are potential methods for demonstrating and modeling weight loss behaviors. This study examined avatar-based technology as a tool for modeling weight loss behaviors. Methods: This study consisted of two phases: (1) an online survey to obtain feedback about using avatars for modeling weight loss behaviors and (2) technology development and usability testing to create an avatar-based technology program for modeling weight loss behaviors. Results: Results of phase 1 (n = 128) revealed that interest was high, with 88.3% stating that they would participate in a program that used an avatar to help practice weight loss skills in a virtual environment. In phase 2, avatars and modules to model weight loss skills were developed. Eight women were recruited to participate in a 4-week usability test, with 100% reporting they would recommend the program and that it influenced their diet/exercise behavior. Most women (87.5%) indicated that the virtual models were helpful. After 4 weeks, average weight loss was 1.6 kg (standard deviation = 1.7). Conclusion: This investigation revealed a high level of interest in an avatar-based program, with formative work indicating promise. Given the high costs associated with in vivo exposure and practice, this study demonstrates the potential use of avatar-based technology as a tool for modeling weight loss behaviors. PMID:23911189

  19. Volition and Motivation's Influence on Weight Loss Maintenance in the Period Following an Intensive Lifestyle Intervention

    DEFF Research Database (Denmark)

    Elsborg, Peter

    The prevalence of overweight and obesity in the world is growing. Because obesity is associated with a number of serious lifestyle diseases such as hearth disease, a vast amount of research has been devoted to investigate how to assist weight loss, for example through behavioural weight loss...

  20. Proteomics reveals the effects of sustained weight loss on the human plasma proteome

    DEFF Research Database (Denmark)

    Geyer, Philipp E; Wewer Albrechtsen, Nicolai J; Tyanova, Stefka

    2016-01-01

    Sustained weight loss is a preferred intervention in a wide range of metabolic conditions, but the effects on an individual's health state remain ill-defined. Here, we investigate the plasma proteomes of a cohort of 43 obese individuals that had undergone 8 weeks of 12% body weight loss followed ...

  1. Weighting of Acoustic Cues to a Manner Distinction by Children with and without Hearing Loss

    Science.gov (United States)

    Nittrouer, Susan; Lowenstein, Joanna H.

    2015-01-01

    Purpose: Children must develop optimal perceptual weighting strategies for processing speech in their first language. Hearing loss can interfere with that development, especially if cochlear implants are required. The three goals of this study were to measure, for children with and without hearing loss: (a) cue weighting for a manner distinction,…

  2. Acute effects of a weight loss supplement on resting metabolic rate ...

    African Journals Online (AJOL)

    In response to the increasing incidence of obesity, a large number of weight loss supplements (WLS) have become available that proclaim to stimulate weight loss and perceived energy. The purpose of the study was to examine a WLS containing caffeine blended with herbal extracts to elucidate the effects of the WLS on ...

  3. Use of dietary supplements for weight loss in obese patients in ...

    African Journals Online (AJOL)

    Background: Obesity is a prevalent and worldwide health problem . The most common weight loss method preferred by obese individuals is dietary supplements. This study was performed in order to determine the dietary supplements used by obese individuals for weight loss and to examine the barriers to informing health ...

  4. Herbal weight-loss products: how informed are we? | van den Berg ...

    African Journals Online (AJOL)

    Outcome measures: Structured telephonic interviews were conducted with 25 dietitians and 46 pharmacists to ascertain whether or not they had heard of the individual ingredients listed in non-prescription, weight-loss products and if they knew if each of these ingredients were scientifically proven to induce weight loss.

  5. Weight loss and elevated gluconeogenesis from alanine in lung cancer patients

    NARCIS (Netherlands)

    S. Leij-Halfwerk (Susanne); P.C. Dagnelie (Pieter); J.W.O. van den Berg (Willem); J.L.D. Wattimena (Josias); C.H. Hordijk-Luijk; J.H.P. Wilson (Paul)

    2000-01-01

    textabstractBACKGROUND: The role of gluconeogenesis from protein in the pathogenesis of weight loss in lung cancer is unclear. OBJECTIVE: Our aim was to study gluconeogenesis from alanine in lung cancer patients and to analyze its relation to the degree of weight loss.

  6. Effect of glycemic load on eating behavior self-efficacy during weight loss

    Science.gov (United States)

    High eating behavior self-efficacy may contribute to successful weight loss. Diet interventions that maximize eating behavior self-efficacy may therefore improve weight loss outcomes. However, data on the effect of diet composition on eating behavior self-efficacy are sparse. To determine the eff...

  7. 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.

  8. A Randomized Pilot Study of a Phone-Based Mindfulness and Weight Loss Program.

    Science.gov (United States)

    Carpenter, Kelly M; Vickerman, Katrina A; Salmon, Erica E; Javitz, Harold S; Epel, Elissa S; Lovejoy, Jennifer C

    2017-10-06

    This study evaluated the feasibility and efficacy of integrating mindfulness training into a phone-based weight loss program to improve outcomes in those with high levels of emotional eating. Participants were 75 enrollees into an employer-sponsored weight loss program who reported high levels of overeating in response to thoughts and feelings. Seventy-five overweight and obese participants (92% female, 65% Caucasian, aged 26 to 68 years) were randomized to the new mindfulness weight loss program (n = 50) or the standard behavioral weight loss program (n = 25). Both programs consisted of 11 coaching calls with health coaches and registered dietitians with supplemental online materials. Satisfaction, engagement, and percent weight lost did not significantly differ for intervention vs. control at six months. Intervention participants had significantly better scores at six-month follow-up on mindful eating, binge eating, experiential avoidance, and one mindfulness subscale. Exploratory analyses showed that improvements on several measures predicted more weight loss in the intervention group. This pilot study found that integrating mindfulness into a brief phone-based behavioral weight loss program was feasible and acceptable to participants, but did not produce greater weight loss on average, despite hypothesized changes in mindful eating. Only one third of intervention participants reported participating in mindfulness exercises regularly. Mechanisms of change observed within the intervention group suggest that for adults with high levels of emotional eating those who embrace mindful eating and meditation may lose more weight with a mindfulness intervention.

  9. Psychological changes following weight loss in overweight and obese adults: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Sarah E Jackson

    Full Text Available Participation in weight loss programs is often associated with improved wellbeing alongside reduced cardio-metabolic risk. In contrast, population-based analyses have found no evidence of psychological benefits of weight loss, but this may be due to inclusion of healthy-weight individuals. We therefore examined cardio-metabolic and psychological changes following weight loss in a cohort of overweight/obese adults.Data were from 1,979 overweight and obese adults (BMI ≥ 25 kg/m(2; age ≥ 50 y, free of long-standing illness or clinical depression at baseline, from the English Longitudinal Study of Ageing. Participants were grouped according to four-year weight change into those losing ≥ 5% weight, those gaining ≥ 5%, and those whose weight was stable within 5%. Logistic regression examined changes in depressed mood (eight-item Center for Epidemiologic Studies Depression score ≥ 4, low wellbeing (Satisfaction With Life Scale score <20, hypertension (systolic blood pressure ≥ 140 mmHg or anti-hypertensives, and high triglycerides (≥ 1.7 mmol/l, controlling for demographic variables, weight loss intention, and baseline characteristics.The proportion of participants with depressed mood increased more in the weight loss than weight stable or weight gain groups (+289%, +86%, +62% respectively; odds ratio [OR] for weight loss vs. weight stable = 1.78 [95% CI 1.29-2.47]. The proportion with low wellbeing also increased more in the weight loss group (+31%, +22%, -4%, but the difference was not statistically significant (OR = 1.16 [0.81-1.66]. Hypertension and high triglyceride prevalence decreased in weight losers and increased in weight gainers (-28%, 4%, +18%; OR = 0.61 [0.45-0.83]; -47%, -13%, +5%; OR = 0.41 [0.28-0.60]. All effects persisted in analyses adjusting for illness and life stress during the weight loss period.Weight loss over four years in initially healthy overweight/obese older adults was associated with reduction in cardio

  10. A Sudden Total Loss of Vision After Routine Cataract Surgery ...

    African Journals Online (AJOL)

    We share our experience of a 50-year-old controlled hypertensive woman who had routine cataract surgery in her left eye. She was given retrobulbar Xylocaine with adrenalin and postoperative gentamycin. She subsequently became blind in the operated eye after developing macular infarction by the first day post ...

  11. The role of protein in weight loss and maintenance

    DEFF Research Database (Denmark)

    Leidy, Heather J; Clifton, Peter M; Astrup, Arne

    2015-01-01

    Over the past 20 y, higher-protein diets have been touted as a successful strategy to prevent or treat obesity through improvements in body weight management. These improvements are thought to be due, in part, to modulations in energy metabolism, appetite, and energy intake. Recent evidence also...... to be the primary contributor to the discrepant findings because improvements in weight management were detected in those who adhered to the prescribed higher-protein regimen, whereas those who did not adhere to the diet had no marked improvements. Collectively, these data suggest that higher-protein diets...... that contain between 1.2 and 1.6 g protein · kg(-1) · d(-1) and potentially include meal-specific protein quantities of at least ∼25-30 g protein/meal provide improvements in appetite, body weight management, cardiometabolic risk factors, or all of these health outcomes; however, further strategies to increase...

  12. Weight loss and vascular inflammatory markers in overweight women with and without polycystic ovary syndrome.

    Science.gov (United States)

    Moran, Lisa J; Noakes, Manny; Wittert, Gary A; Clifton, Peter M; Norman, Robert J

    2012-11-01

    Polycystic ovary syndrome (PCOS) is associated with increased cardiovascular disease risk. The effect of weight loss on the vascular inflammatory markers plasminogen activator inhibitor-1 (PAI-1), asymmetric dimethylarginine (ADMA), soluble vascular cell adhesion molecule-1 (sVCAM-1) and intracellular adhesion molecule-1 (sICAM-1) is unknown. Overweight women with (n=14) and without (n=13) PCOS of comparable age and body mass index undertook an 8-week weight-loss programme. Women with PCOS had elevated PAI-1, sVCAM-1 and sICAM-1 before and after weight loss compared with the controls. For all women, sVCAM-1 (P=0.026) and sICAM-1 (P=0.04) decreased with weight loss. Women with PCOS have elevated inflammatory markers, which are partially reduced by weight loss. Copyright © 2012 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  13. How Do I Get Rid of Extra Skin After Weight Loss?

    Science.gov (United States)

    ... should keep seeing improvement, but you'll need to give it time. Some people who lose very large amounts of weight (100 pounds or more) may consider plastic surgery after they've kept the weight off for a while. The best thing you can do right now is talk to your doctor. He or she can suggest ...

  14. Attribution of weight regain to emotional reasons amongst European adults with overweight and obesity who regained weight following a weight loss attempt

    DEFF Research Database (Denmark)

    Sainsbury, Kirby; Evans, Elizabeth; Pedersen, Susanne

    2018-01-01

    Purpose: Despite the wide availability of effective weight loss programmes, maintenance of weight loss remains challenging. Difficulties in emotion regulation are associated with binge eating and may represent one barrier to long-term intervention effectiveness in obesity. The purpose of this study...... was to determine the relationship between emotion regulation difficulties and the extent of weight regain in a sample of adults who had lost, and then regained, weight, and to examine the character-istics associated with emotional difficulties. Methods: 2000 adults from three European countries (UK, Portugal...... for emotion regulation difficulties). Spearman’s correlations and logistic regression were used to assess the associa-tions between emotion regulation, weight regain, and strategy use. Results: Emotion regulation difficulties were associated with greater weight regain (N= 1594 who lost and regained weight...

  15. 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.

  16. 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.

  17. A smartphone-supported weight loss program: design of the ENGAGED randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Pellegrini Christine A

    2012-11-01

    Full Text Available Abstract Background Obesity remains a major public health challenge, demanding cost-effective and scalable weight management programs. Delivering key treatment components via mobile technology offers a potential way to reduce expensive in-person contact, thereby lowering the cost and burden of intensive weight loss programs. The ENGAGED study is a theory-guided, randomized controlled trial designed to examine the feasibility and efficacy of an abbreviated smartphone-supported weight loss program. Methods/design Ninety-six obese adults (BMI 30–39.9 kg/m2 will be randomized to one of three treatment conditions: (1 standard behavioral weight loss (STND, (2 technology-supported behavioral weight loss (TECH; or (3 self-guided behavioral weight loss (SELF. All groups will aim to achieve a 7% weight loss goal by reducing calorie and fat intake and progressively increasing moderate intensity physical activity to 175 minutes/week. STND and TECH will attend 8 group sessions and receive regular coaching calls during the first 6 months of the intervention; SELF will receive the Group Lifestyle Balance Program DVD’s and will not receive coaching calls. During months 1–6, TECH will use a specially designed smartphone application to monitor dietary intake, body weight, and objectively measured physical activity (obtained from a Blue-tooth enabled accelerometer. STND and SELF will self-monitor on paper diaries. Linear mixed modeling will be used to examine group differences on weight loss at months 3, 6, and 12. Self-monitoring adherence and diet and activity goal attainment will be tested as mediators. Discussion ENGAGED is an innovative weight loss intervention that integrates theory with emerging mobile technologies. We hypothesize that TECH, as compared to STND and SELF, will result in greater weight loss by virtue of improved behavioral adherence and goal achievement. Trial registration NCT01051713

  18. Relationship between volition, physical activity and weight loss maintenance: Study rationale, design, methods and baseline characteristics.

    Science.gov (United States)

    Dandanell, Sune; Elbe, Anne-Marie; Pfister, Gertrud; Elsborg, Peter; W Helge, Jørn

    2017-05-01

    To investigate the relationship between volition, physical activity and weight loss maintenance. We recruited 84 sedentary (maximal oxygen uptake: 25 ± 5 ml/min), overweight and obese (Body mass index (BMI) 38 ± 7 m/h 2 , fat 44 ± 7 %) women ( n = 55) and men ( n = 29) for an interdisciplinary prospective study with follow-up. The change in lifestyle and weight loss is promoted via a 3-month intensive lifestyle intervention at a private health school. The intervention consists of supervised training (1-3 hours/day), a healthy hypo-caloric diet (-500 to -700 kCal/day) and education in healthy lifestyle in classes/groups. The participants' body weight and composition (Dual Energy X-ray absorptiometry), volitional skills (questionnaire), physical activity level (heart rate accelerometer/questionnaire) and maximal oxygen uptake (indirect calorimetry) are to be monitored before, after, and 3 and 12 months after the intervention. At the 12-month follow-up, three different groups will be established: Clinical weight loss maintenance (> 10% weight loss from baseline), moderate weight loss maintenance (1-10% weight loss) and no weight loss (or weight regain). A linear mixed model analysis will be used to compare levels of volitional skills, physical activity and maximal oxygen uptake over time, between the three groups. Correlational analyses will be used to investigate possible associations between volition, maximal oxygen uptake, physical activity level and weight loss maintenance. If specific volitional skills are identified as predictors of adherence to physical activity and success in clinical weight loss maintenance, these can be trained in future intensive lifestyle interventions in order to optimize the success rate.

  19. Sugammadex by ideal body weight versus 20% and 40% corrected weight in bariatric surgery - double-blind randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Nádia Maria da Conceição Duarte

    Full Text Available Abstract Background and objectives: The weight parameters for use of sugammadex in morbidly obese patients still need to be defined. Methods: A prospective clinical trial was conducted with sixty participants with body mass index ≥ 40 kg.m-2 during bariatric surgery, randomized into three groups: ideal weight (IW, 20% corrected body weight (CW20 and 40% corrected body weight (CW40. All patients received total intravenous anesthesia. Rocuronium was administered at dose of 0.6 mg.kg-1 of Ideal weight for tracheal intubation, followed by infusion of 0.3-0.6 mg.kg-1.h-1. Train of four (TOF was used to monitor depth of blockade. After spontaneous recovery TOF-count 2 at the end of surgery, 2 mg.kg-1 of sugammadex was administered. Primary outcome was neuromuscular blockade reversal time to TOF ≥ 0.9. Secondary outcome was the occurrence of postoperative residual curarization in post-anesthesia recovery room, searching the patient's ability to pass from the surgical bed to the transport, adequacy of oxygenation, respiratory pattern, ability to swallow s