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Biomedical subjects

A Geliebter

Publications and source records attributed to A Geliebter.

At least 19 recordsLinked to original sources

Comparison of psychological characteristics of binging and nonbinging obese, adult, female outpatients.

OBJECTIVE: This study compared levels of depression, anxiety and self-esteem in binging and nonbinging obese, adult females in a hospital weight-loss program. METHOD: Participants (n=43; mean age=43.5 yrs) completed the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Coopersmith Self-Esteem Inventory (CSEI) upon entering the program (Week 0). A subgroup (n=15) completed the same inventories on Week 4 and Week 8. RESULTS: Binge eaters had significantly higher levels of depression (p<0.002) and lower levels of self-esteem (p<0.001) on Week 0. For the subgroup that remained in the program through Week 8, significantly higher depression levels (p<0.01) and anxiety levels (p<0.05) persisted for the binge eaters. DISCUSSION: Results indicate that obese binge eaters have more psychological distress than nonbingers, and that these differences tend to persist even during weight loss.

Adult↗

Test meal intake in obese binge eaters in relation to mood and gender.

OBJECTIVE: We assessed test meal intake in men and women with and without binge eating disorder (BED) in relation to mood score (Zung scale). METHODS: Eighty-five overweight subjects (24 males and 61 females) participated; 30 subjects with BED and 55 without BED. Following an 8-hr fast, subjects consumed a liquid test meal until extremely full. RESULTS: BED subjects consumed significantly more (p =.009) of the test meal (1,032 g +/- 429) than the non-binge eaters (737 g +/- 399). The men ingested more than the women (p =.002). BED subjects also had higher depression scores (p =.01), without differing by gender. However, depression scores were unrelated to test meal intakes (r = -.01). DISCUSSION: The larger meal intakes of the BED group may be due to the larger stomach capacity previously found in both bulimics and obese subjects. The findings also support the premise that BED, listed in the DSM-IV appendix for further study, is found in a distinct subgroup of overweight individuals.

Adult↗

Night eating syndrome is associated with depression, low self-esteem, reduced daytime hunger, and less weight loss in obese outpatients.

OBJECTIVE: The objective of this study was to assess the relationship between the night eating syndrome (NES), measures of depression and self-esteem, test meal intake, and weight loss in obese participants. RESEARCH METHODS AND PROCEDURES: The study included 76 overweight (body mass index = 36.7 +/- 6.5 SD) outpatients (53 women and 23 men; aged 43.5 +/- 9.5 years) entering a weight loss program. They completed a Night Eating Questionnaire, the Zung Depression Inventory, and the Rosenberg Self-Esteem SCALE: Based on criteria by Stunkard et al. (Stunkard A, Berkowitz R, Wadden T, Tanrikut C, Reiss E, Young L. Binge eating disorder and the night eating syndrome. Int J Obes Relat Metab DISORD: 1996;20:1-6), participants had NES if they reported: (1) skipping breakfast > or =4 d/wk, interpreted as morning anorexia; (2) consuming more than 50% of total daily calories after 7 PM; and (3) difficulty falling asleep or staying asleep > or =4 d/wk. Eleven (14%) participants met the criteria for NES. After an 8-hour fast, all participants ingested a nutritionally complete liquid meal through a straw from a large opaque cooler until extremely full. They also completed ratings of hunger and fullness before and after this meal. RESULTS: Night eaters had higher depression (p = 0.04), lower self-esteem (p = 0.003), and less hunger (p = 0.005), and a trend for more fullness (p = 0.06) before the daytime test meal than the others. However, there were no significant differences in test-meal intake between groups. Nevertheless, test-meal intake was greater later in the day only for the night eaters (p = 0.01). Over a 1-month period, the night eaters lost less weight (4.4 +/- 3.2 kg) than the others (7.3 +/- 3.2 kg; p = 0.04), after controlling for body mass index. DISCUSSION: NES is a syndrome with distinct psychopathology and increased food intake later in the day, both of which may contribute to poorer weight loss outcome. NES criteria need to be better quantified and NES deserves consideration as a diagnostic eating disorder.

Adult↗

Work-shift period and weight change.

The present study was done to determine whether weight gain was more prevalent in workers on late shifts than in those on day shifts. A questionnaire about changes in weight, food intake, exercise, and sleep since starting the job on the current shift was given to day-shift and late-shift (evening and night) hospital workers. Data were analyzed for 85 subjects, 36 of whom worked during the day shift and 49 the late shift. The late-shift group reported a mean weight gain of 4.3 kg, which was greater than the mean weight gain of 0.9 kg for the day-shift group (P = 0.02). There were, however, no significant differences in current body mass index (26.7 +/- 5.4 SD) between groups. There was a trend for late-shift workers to report eating more since beginning the later shift (P = 0.06). When combined with those reporting exercising less (P = NS), this trend became significant (P = 0.04). Late-shift workers reported eating fewer meals (1.9 +/- 0.9 SD) than the day-shift workers (2.5 +/- 0.9; P = 0.002). In addition, late-shift workers reported eating the last daily meal later (mean = 22:27, or 10:27 PM) than day-shift workers (17:52 or 5:52 PM; P < 0.00005). Late-shift workers also reported more naps (P = 0.01) and longer naps (P = 0.05) during the work week than did day-shift workers. The reported changes in eating, exercise, and sleep may contribute to the increased weight gain of late-shift workers.

Adult↗

Effects of strength or aerobic training on body composition, resting metabolic rate, and peak oxygen consumption in obese dieting subjects.

Given that resting metabolic rate (RMR) is related largely to the amount of fat-free mass (FFM), the hypothesis was that strength training, which stimulates muscle hypertrophy, would help preserve both FFM and RMR during dieting. In a randomized controlled intervention trial, moderately obese subjects (aged 19-48 y) were assigned to one of three groups: diet plus strength training, diet plus aerobic training, or diet only. Sixty-five subjects (25 men and 40 women) completed the study. They received a formula diet with an energy content of 70% of RMR or 5150 +/- 1070 kJ/d (x +/- SD) during the 8-wk intervention. They were seen weekly for individual nutritional counseling. Subjects in the two exercise groups, designed to be isoenergetic, trained three times per week under supervision. Those in the strength-training group performed progressive weight-resistance exercises for the upper and lower body. Those in the aerobic group performed alternate leg and arm cycling. After 8 wk, the mean amount of weight lost, 9.0 kg, did not differ significantly among groups. The strength-training group, however, lost significantly less FFM (P < 0.05) than the aerobic and diet-only groups. The strength-training group also showed significant increases (P < 0.05) in anthropometrically measured flexed arm muscle mass and grip strength. Mean RMR declined significantly, without differing among groups. Peak oxygen consumption increased the most for the aerobic group (P = 0.03). In conclusion, strength training significantly reduced the loss of FFM during dieting but did not prevent the decline in RMR.

Adult↗

Reduced stomach capacity in obese subjects after dieting.

The objective of the study was to assess the change in gastric capacity of obese subjects consuming a hypoenergetic diet. Otherwise healthy, obese subjects participated in a prospective controlled study as hospital outpatients. Fourteen (11 females, 3 males) subjects were assigned to the diet group and 9 (7 females, 2 males) were assigned to the control group. Subjects in the diet group were provided a 2508-kJ/d(600 kcal/d) formula diet for 4 wk. Subjects in the control group ate ad libitum for 4 wk. Gastric capacity was determined before the study and 4 wk later by oral insertion of a latex gastric balloon after an overnight fast. The balloon was infused with water at a rate of 100 mL/min, with pauses for measuring intragastric pressure, until no further distension was tolerated. Two indexes for estimating gastric capacity were used based on subjective and objective criteria: 1) the maximal volume that could be tolerated, and 2) the volume required to produce a rise in water pressure of 5 cm. Subjects in the diet group, who lost a mean of 9.1 kg, showed a 27% reduction in gastric capacity based on the first index (P = 0.004) and a 36% reduction based on the second index (P = 0.006). For the control subjects, gastric capacity did not change significantly with use of either index. The results demonstrate a reduction in gastric capacity in obese subjects after a restricted diet.

Adult↗

Decreased resting metabolic rate among persons with Down Syndrome.

OBJECTIVE: To compare the resting metabolic rates (RMRs) of adults with and without DS while controlling for potential confounds. DESIGN: Observational, cross-sectional study. SETTING: Outpatient core of the New York Obesity Research Center. SUBJECTS: Thirteen adults (nine males and four females) with DS were compared to 77 adults without DS. MEASUREMENTS: RMR was measured by indirect calorimetry. Fat mass (FM) and fat free mass (FFM) were determined using dual energy X-ray absorptiometry (DXA). Thyroid function (thyroxin, T3 uptake, and free T4) were determined from fasting blood samples for all DS subjects and a subset of the controls. RESULTS: An analysis of covariance was conducted in which DS status was the independent variable. Covariates were sex, FFM, FM, age, and T4. After controlling for sex, FFM, FM, age, and height, persons with DS had lower RMRs than persons without DS (F(1,83) = 7.697, P = 0.007; eta = 0.29). In terms of kcalories, the adjusted means were 1333.5 for DS subjects and 1670.1 for non-DS subjects, a difference of 20.8% relative to the grand mean. When thyroxine was added to the regression the effect of DS on RMR was of questionable significance. CONCLUSION: This research demonstrates that persons with DS have lower RMRs than do persons without DS. This difference persists after controlling for obvious confounds and was of a moderate magnitude.

Absorptiometry, Photon↗

The relationship between daytime and nighttime food intake in an obese night-eater.

Some obese individuals consume food during awakenings from nighttime sleep. Three studies were conducted on a 28-year-old morbidly obese male with chronic sleeping complaints and insignificant weight loss, despite self-reported daily caloric restriction: I. For 3 mo, the subject recorded food intake for 24-h periods. Mean daytime intake was 1286 kcal +/- 386 (SD), and mean nighttime intake was 1036 kcal +/- 487 (SD). Caloric values of daytime and nighttime intake were negatively correlated, r = -0.22, df= 82, p < .05. II. Seven consecutive 24-h food intake recordings were obtained with an automated formula dispenser when the subject was an inpatient on a metabolic ward and received ad libitum formula as his sole food source. Mean daytime intake was 1245 +/- 662 (SD), and mean nighttime intake was 231 +/- 236 (SD). There was a non-significant negative correlation between daytime and nighttime intake, r = -0.32, df = 5, NS. III. The subject underwent polysomnographic studies on 2 non-consecutive nights, following the administration of either a low (600 kcal) or high (1800 kcal) daytime caloric condition. The subject, upon awakening from nighttime sleep, could eat from a platter of sandwich quarters placed at his bedside. The addition of 1200 kcal to daytime intake decreased nighttime intake by 654 kcal, or by 55% of the additional calories delivered during the day. The three studies (I, II, and III) show that daytime food intake can be negatively correlated with nighttime intake, and that daytime intake can influence nighttime intake in a documented obese night-eater.

Adult↗

Gastric capacity, gastric emptying, and test-meal intake in normal and bulimic women.

The role of the stomach in regulating appetite in bulimia nervosa was examined. Subjects were nine normal and nine bulimic women of similar age, height, and weight. Gastric capacity was estimated by filling a balloon in the stomach. The mean stomach capacity of bulimic subjects was significantly larger than that of normal subjects, as revealed by the larger balloon volume tolerated (P less than 0.01) and by the larger volume needed to produce a 5 cm H2O increase in intragastric pressure (P = 0.07). The intake of a liquid meal was also significantly larger for the bulimic subjects. Gastric-emptying rate of a liquid meal was significantly delayed in the bulimic subjects during the initial 5-15 min. In all subjects, test-meal intake correlated significantly with gastric capacity (r = 0.53). In the bulimic subjects, self-reported binge intake (J) also correlated significantly with gastric capacity (r = 0.75). Binge eating in bulimic subjects may enlarge gastric capacity, which could then promote even larger binges through positive feedback.

Adult↗

Clinical trial of silicone-rubber gastric balloon to treat obesity.

A study was conducted to test the efficacy and safety of a 300 ml silicone-rubber gastric balloon for weight reduction. Eighty-six obese subjects were distributed into four groups: (1) gastric balloon only, (2) gastric balloon and prescribed 1000 kcal/day (239 kJ) diet, (3) 1000 kcal/day diet only, and (4) no treatment. The intervention period was 3 months. The balloon only group lost 3.2 kg +/- 0.9 (s.e.), the balloon and diet group lost 5.1 +/- 1.0 kg, the diet group lost 6.9 +/- 1.4 kg and the control group gained 0.6 +/- 0.5 kg. The three intervention groups each lost significantly more weight than the control group. The diet only group lost significantly more weight than the balloon only group. Body densitometry showed that the treatment groups lost a significant amount of body fat. Gastroscopy revealed three ulcers and two superficial erosions at balloon removal. The gastric balloons were well tolerated despite gastric spasms and nausea which abated after the initial 24-48 hours. Gastric capacity was determined in a subset of 19 subjects from the two balloon groups before the intervention by distending the stomach with a balloon and calculating the volume required to produce an increase in intragastric pressure of 5 cm H2O. Subjects with a smaller gastric capacity lost more weight with the balloon than subjects with a large capacity (r = 0.45, P less than 0.05). These results suggest that for improved efficacy, balloon volume may need to be larger than 300 ml or adjusted to the individual's gastric capacity.(ABSTRACT TRUNCATED AT 250 WORDS)

Body Composition↗

Gastric balloon to treat obesity: a double-blind study in nondieting subjects.

To determine its efficacy and safety in treating obesity, a silicone-rubber balloon was passed into the stomach of 10 nondieting, obese subjects. In a counterbalanced sequence, the balloon was inflated with 400 mL for 1 mo and deflated for 1 mo. Lower intakes of solid and liquid test meals (NS), significantly slower gastric emptying, and concomitant changes in glucose, insulin, glucagon, and cholecystokinin concentrations consistent with slower emptying resulted during balloon inflation. After balloon inflation, one small gastric ulcer developed, which subsequently healed. Significant weight loss occurred during the second and third week of the inflation period (F[1,9] = 5.0, p less than 0.05). However, the weight loss was small and the significant effect did not continue through the fourth week.

Adult↗

Gastric distension and gastric capacity in relation to food intake in humans.

Two studies were performed in the same subjects to explore the relationship between stomach capacity and food intake. In the first study, a balloon was passed orally into the stomach of four lean and four obese subjects before they ingested a liquid lunch meal. The balloon was filled with 0, 200, 400, 600, and 800 ml of water in a random sequence on different days. The balloon was kept inflated during ingestion then deflated and removed. Food intake was significantly reduced (p less than 0.01) by a balloon volume of greater than or equal to 400 ml. In the second study, another balloon was inserted into the stomach of these subjects to estimate stomach capacity. The balloon was gradually filled at the rate of 100 ml/min with 30 sec pauses. The subjects rated their discomfort as 1 to 10, from no discomfort to extreme discomfort. A rating of 10 was the main index for stomach capacity. Mean capacity (ml) for the lean subjects was 1100 +/- 185 (SE) and for the obese 1925 +/- 175 (SE), t = 3.24, p less than 0.02. When stomach capacity from the second study was correlated to spontaneous food intake at 0 balloon volume from the first study, r = .44, n.s. However, the relationship between stomach capacity and the balloon volume needed to suppress 50% of spontaneous intake was significant, r = .66, p less than 0.05. This may have implications for treatment of obesity with a gastric balloon.

Adult↗

Gastric distention by balloon and test-meal intake in obese and lean subjects.

A study was conducted to determine the effects of various levels of gastric distension on spontaneous meal intake. A balloon was inserted into the stomach of four lean and four obese subjects before consumption of a lunch meal. On different days the balloon was filled with 0, 200, 400, 600, and 800 mL water in a random sequence. As balloon volume increased, food intake decreased, with a balloon volume of greater than or equal to 400 mL significantly reducing intake (p less than 0.01). There was no significant difference between lean and obese subjects. Because gastric emptying rate was not significantly slowed by a volume of 800 mL, between emptying was probably not a factor in inducing satiety. Discomfort was probably also not a factor because it was experienced by only two lean subjects at 800 mL. Most likely gastric distension itself triggered satiety signals.

Adult↗

Gastric balloon reduces food intake and body weight in obese rats.

A less invasive method than gastric reduction surgery for treating obesity was tested by inserting balloons into the stomachs of obese rats. Male Sprague-Dawley rats were placed on a high fat diet. After 4 months, the rats weighed an average of 750 g or 23% more than rats on a chow diet. Balloons were then passed orally into the stomach, inflated with 10 ml of water, and detached from the inflating tube. Eight rats had inflated balloons; six rats had no balloons. The balloons, which could be palpated, remained inflated for 12 to 49 days with a mean of 25 days. During the period of inflation, rats with balloons consumed significantly less food (p less than 0.001) relative to rats without balloons. Gastric emptying rate was significantly slowed (p less than 0.0025) in rats with inflated balloons compared to rats with balloons that had deflated and rats with no balloons. Histology of the stomachs that held inflated balloons did not reveal pathology.

Animals↗