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Biomedical subjects

A J Stunkard

Publications and source records attributed to A J Stunkard.

At least 91 records · Page 5Linked to original sources
PubMed1988

Resting energy expenditure, body composition, and excess weight in the obese.

This study investigated differences between measured and predicted resting energy expenditure (REE) in 80 women who averaged 104.6 kg in weight and were 49 kg and 88% overweight. Body composition analysis showed that 68% of the excess weight was fat and 32% was fat-free mass (FFM). Normalized for height, total body potassium (TBK) was 113 +/- 15% and total body water (TBW) was 133 +/- 21% of values in nonobese controls. The health of the FFM, defined as the potassium content per kg of FFM, was 84 +/- 13% of normal. Measured and predicted REE were only modestly related (r = +.59), and only 59% of measured REEs were within 10% of predicted values. A stepwise multiple regression indicated that weight was the single best predictor of measured REE and that the size of the FFM made a significantly greater contribution to REE than did the size of the fat mass. Commonly used equations for the prediction of REE are not appropriate for moderately or severely obese patients. Caloric prescription for weight reduction must be tailored to individuals rather than recommending the same caloric intake to persons with varying metabolic rates.

Adipose Tissue↗
PubMed1988

Body fat deposition in adult obese women. I. Patterns of fat distribution.

Fat patterning was studied in a sample of 76 obese women before and after weight reduction by principal components analysis. Circumferences were selected as variables rather than skinfolds because circumferences correlated more highly with body composition determined either by total body water or total body potassium. A separate sample of 136 males and females, measured once, was employed to validate the results. The validation sample yielded similar findings. Two significant components were found, the first contrasting upper and lower fatness and the second trunk and extremity fatness. Waist circumference was the best predictor of upper-body fat patterning. For the lower body, thigh circumference loaded more highly than did the iliac crest circumference. Arm circumference did not contribute significantly to upper-lower fat patterning.

Adipose Tissue↗
PubMed1988

Body fat deposition in adult obese women. II. Changes in fat distribution accompanying weight reduction.

This study examined changes in body fat distribution in 68 women who lost an average of 12.3 kg from an initial weight of 103.6 kg. Weight reduction was accompanied by a small but statistically significant reduction of 1.2% in the waist-to-hip ratio, suggestive of a reduction in upper-body obesity. Subjects with greater upper-body obesity tended to achieve greater reductions in the waist-to-hip ratio. Changes in five circumference measures were highly correlated with losses of fat and showed that subjects with lower-body obesity tended to lose large amounts of fat from both their upper and lower fat depots while subjects with upper-body obesity lost fat primarily from their upper depots. Women with lower-body obesity tended to lose more total body fat than did women with upper body obesity (r = -0.26, p less than 0.04).

Adipose Tissue↗
PubMed1987

Bulimia vs bulimic behaviors on a college campus.

A self-report survey of bulimic behaviors was conducted with 1965 students who were selected to provide a cross section of a large, eastern university. Follow-up interviews of a subsample of respondents were conducted to validate the survey. After correcting for false-positive responses, only 1.3% of the female and 0.1% of the male respondents met diagnostic criteria for bulimia according to either the third edition or the proposed revision of the Diagnostic and Statistical Manual of Mental Disorders. In addition, an inflection point was found in the rates of binge eating, self-induced vomiting, and their combination at a frequency of about twice per month.

Adult↗
PubMed1987

Comparison of three worksite weight-loss competitions.

Competition is an effective means of promoting weight loss in worksite programs. This study was designed to determine the most effective structure of competition through a comparison of two kinds of competition within one worksite. Two competitions were between teams and one was among individuals. While all three competitions produced significant weight loss and lower attrition than previous worksite programs, the team competitions produced significantly lower attrition rates and significantly greater weight loss than the individual competition. Patterns of loss over time and the distribution of losses for groups also differed, with a smaller proportion of successful participants in the individual competition. The results suggest that team support as well as competition is a necessary component of effective worksite weight loss competitions.

Adult↗
PubMed1987

Dieting and depression: a critical review.

Investigations of affective changes during weight reduction have produced sharply conflicting results. Studies conducted through the 1950s and 1960s indicated that weight reduction was accompanied by a high incidence of affective disturbance ranging from simple dysphoria to clinical depression and psychosis. More recently, studies of behavioral programs have suggested that weight reduction may actually improve mood. A critical and systematic review of the literature revealed that the conflicting evidence is best explained by differences in mood assessment. The method of mood assessment consistently predicted the affective changes observed in previous reports. Other variables previously thought to influence affective response to weight reduction, including duration of treatment and weight loss, did not independently predict outcome.

Body Weight↗
PubMed1987

Effect of naltrexone on food intake, hunger, and satiety in obese men.

Increasing doses of naltrexone (25 to 200 mg) given over 4 consecutive days reduced intake of laboratory luncheon meals by 30% in 17 obese men. Meal size remained suppressed in the laboratory during the week following naltrexone administration. Water intake in the laboratory and body weight were not affected. Rates of ingestion and subjective ratings suggested that naltrexone reduced appetite rather than promoted early satiation. Nausea and other side effects occurred on 1 or 2 days during the naltrexone week in seven subjects whose food intake was reduced. Food intake was also reduced in seven of the remaining 10 subjects who reported no adverse reactions. These results suggest that a conditioned taste aversion or a conditioned anorexia may have developed in some subjects.

Adolescent↗
PubMed1987

Psychopathology and obesity.

Obesity has historically been linked to emotional factors by clinicians and the lay public alike. Early psychiatric studies reinforced the popular perception that psychopathology is common among the overweight and plays an important role in the development of obesity. This notion has been challenged by recent investigations which suggest that psychological disturbances are more likely to be the consequences than the causes of obesity. Emotional difficulties faced by the obese may be largely attributable to an entrenched cultural contempt for the obese and a pervasive preoccupation with thinness.

Adolescent↗
PubMed1987

Genetic contributions to human fatness: an adoption study.

A strong relationship was found between the degree of fatness of biologic mothers and that of their adult offspring who had been separated from their mothers at birth and adopted during the first year of life. This relationship persisted even after age, height, and possible confounding environmental factors were controlled. There was little evidence for either selective placement on the basis of parental fatness or gene-environment interaction. There was no relationship between the degree of fatness of adoptive parents and that of the adoptees. Two indexes of environmental influence--rural upbringing and disturbance in the adoptive home--predicted fatness among adoptees.

Adipose Tissue↗
PubMed1987

Less food, less hunger: reports of appetite and symptoms in a controlled study of a protein-sparing modified fast.

This study compared reports of appetite and symptoms in 28 obese subjects randomly assigned to either a 500 calorie protein-sparing modified fast (PSMF) or a 1200-kcal balanced diet. During the first comparison month, subjects consuming the PSMF lost significantly more weight and reported significantly less hunger than did subjects consuming the 1200 kcal diet. Similar results were obtained for the second month, but differences in hunger were not statistically significant. There were no significant differences between conditions in subjects' ratings of their preoccupation with eating or in their ratings of the acceptability or disruptiveness of their diets. PSMF subjects reported significantly greater problems with cold intolerance, constipation, dizziness, dry skin, and fatigue. These symptoms remitted completely, however, when PSMF subjects consumed a 1200-kcal balanced diet. There were no significant differences between conditions in subjects' reports of psychological functioning. Results are discussed in terms of the need for further research to identify the characteristics of PSMF which confer anorexia.

Adult↗
PubMed1986

A twin study of human obesity.

Height, weight, and body mass index (BMI) were assessed in a sample of 1974 monozygotic and 2097 dizygotic male twin pairs. Concordance rates for different degrees of overweight were twice as high for monozygotic twins as for dizygotic twins. Classic twin methods estimated a high heritability for height, weight, and BMI, both at age 20 years (.80, .78, and .77, respectively) and at a 25-year follow-up (.80, .81, and .84, respectively). Height, weight, and BMI were highly correlated across time, and a path analysis suggested that the major part of that covariation was genetic. These results are similar to those of other twin studies of these measures and suggest that human fatness is under substantial genetic control.

Adult↗
PubMed1986

An adoption study of human obesity.

We examined the contributions of genetic factors and the family environment to human fatness in a sample of 540 adult Danish adoptees who were selected from a population of 3580 and divided into four weight classes: thin, median weight, overweight, and obese. There was a strong relation between the weight class of the adoptees and the body-mass index of their biologic parents - for the mothers, P less than 0.0001; for the fathers, P less than 0.02. There was no relation between the weight class of the adoptees and the body-mass index of their adoptive parents. Cumulative distributions of the body-mass index of parents showed similar results; there was a strong relation between the body-mass index of biologic parents and adoptee weight class and no relation between the index of adoptive parents and adoptee weight class. Furthermore, the relation between biologic parents and adoptees was not confined to the obesity weight class, but was present across the whole range of body fatness - from very thin to very fat. We conclude that genetic influences have an important role in determining human fatness in adults, whereas the family environment alone has no apparent effect.

Adoption↗
PubMed1986

Weight change in depression.

This report describes the weight changes of 109 outpatients during the course of a depressive illness and relates these changes to several potential predictors: age, gender, diagnosis, and scores on the Hamilton Rating Scale for Depression (HRSD), the Beck Depression Inventory, and the three factors on the Eating Questionnaire. Weight changes ranged from -33 to +50 pounds, with 40% of the patients reporting weight gain, 30% weight loss, and 30% no change in weight. Weight loss occurred more rapidly than did weight gain. The disinhibition factor of the Eating Questionnaire was significantly correlated with weight change during depression and, on a stepwise discriminant function analysis, differentiated weight-gaining from weight-losing patients at a high level of statistical significance. Severity of depression also differentiated weight-gaining from weight-losing patients in the discriminant function analysis, but only on the HRSD and at a level of more modest statistical significance.

Adult↗