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Biomedical subjects

A J Stunkard

Publications and source records attributed to A J Stunkard.

At least 127 records · Page 7Linked to original sources
PubMed1983

Treatment of obese children with and without their mothers: changes in weight and blood pressure.

Weight and blood pressure changes were evaluated in a 16-month controlled trial comparing three methods of involving mothers in the treatment of their obese adolescents (aged 12 to 16 years). The treatments were: (1) Mother-Child Separately--children and mothers attended separate groups; (2) Mother-Child Together--the children and mothers met together in the same group; and (3) Child Alone--the children met in groups and mothers were not involved. The program consisted of behavior modification, social support, nutrition, and exercise. The Mother-Child Separately group lost more weight (8.4 kg) during treatment than did the other two groups (5.3 and 3.3 kg). Differences between the groups increased at the 1-year follow-up: compared to pretreatment weight, the Mother-Child Separately group lost 7.7 kg compared with gains of approximately 3 kg in the other two groups. Blood pressures of children with the highest initial pressures decreased by 16/9 mm Hg at the end of treatment and by 16/5 mm Hg at the 1-year follow-up. These results suggest that a program of behavior modification and parent involvement can lead to significant weight losses in obese children, and that the nature of parent involvement may be important.

Adolescent↗
PubMed1983

The accuracy of reports of weight: children's recall of their parents' weights 15 years earlier.

This report describes the accuracy with which adults can recall the weights of their parents as they were 15 yr before. In 1962-65, measurements of height, weight and skinfold thickness were made in the Tecumseh Community Health Study. In 1979, 134 children of 96 mothers and 117 children of 79 fathers were asked to recall their parents' heights and weights at the earlier time and to select one of nine outline drawings, ranging from very thin to very fat, which best represented the parents at the time they were measured. The correlation between body mass index [weight in (kg)/height2 in (m)] as reported and as measured was 0.82 for mothers and 0.56 for fathers. Similar correlations were found between the selected figure and the measured body mass index: 0.74 for mothers and 0.63 for fathers. Measured values in the high range were underestimated, those in the low range were overestimated. Adding the figure selection to the report of height and weight increased the accuracy of estimation, particularly for fathers. Reports of height and weight and of figure selection were more highly correlated with measured body mass index than with skinfold thickness. None of several characteristics of the offspring had any major influence on the accuracy of their reports: age, sex, height, body mass index, skinfold thickness or the confidence of the subject in his ability to remember. Accuracy of the reports was similarly not related to age or height of the parent or to the report of the other parent's weight. We conclude that offspring reports of their parents' past weight may be a useful epidemiological tool.

Adolescent↗
PubMed1983

Nutrition, aging and obesity: a critical review of a complex relationship.

Long-standing beliefs about the ill-effects of mild to moderate obesity have been called into question by recent epidemiological studies and by critical review of older studies. A review of these studies reveals that the effects of obesity on health and longevity is more complex than we had realized. An attempt is made to throw light on this relationship by reviewing the large number of laboratory studies on nutrition, aging and obesity. The first series of such studies showed that restriction of food intake, beginning early in life, greatly increased longevity. A second series of studies revealed that longevity could still be extended even if restriction of food intake did not occur until maturity. The third series of studies showed that dietary constituents as well as total calories influenced longevity. High-fat diets produce obesity and a shortened life span and there are significant differences in the effects of other dietary constituents at different times in the life cycle. The fourth series of studies, on dietary self-selection. are beginning to elucidate the role of food preferences in determining both obesity and longevity. Potential mechanisms of action include both body weight and immunological processes.

Actuarial Analysis↗
PubMed1982

Absence of naloxone sensitivity in obese humans.

Studies in rodents suggest the possibility of an association between elevated endogenous opiate activity and overeating and obesity. One measure of elevated opiate activity is sensitivity to the opiate antagonist naloxone. Seven massively obese human subjects showed no subjective or physiological sensitivity to large intravenous doses of naloxone. This finding fails to support a relationship between elevated endorphin activity and human obesity.

Arousal↗
PubMed1982

The double-blind in danger: untoward consequences of informed consent.

Patients and physicians correctly identified medication assignments in 70% of the cases in a double-blind trial of an appetite suppressant. The breach of the double-blind design may have had therapeutic consequences; correct identification was associated with favorable outcome. These findings suggest that requirements for describing the side effects of medications to patients before they give informed consent may help them guess which medication they receive and thus may influence the integrity of double-blind studies and the results of controLled trials.

Adult↗
PubMed1981

Behavior therapy and pharmacotherapy for obesity.

The effects of behavior therapy, pharmacotherapy, and their combination were compared in 120 women during six months of treatment of obesity and one year after treatment. Patients who received fenfluramine hydrochloride alone lost 14.5 kg, ad those who had combined pharmacotherapy and behavior therapy lost 15.3 kg; both losses were significantly greater than that of those who had behavior therapy alone (10.9 kg). A waiting-list control group gained 1.3 kg. One-year follow-up of all living patients who completed treatment showed a striking reversal in the relative efficacy of the treatments. Behavior-therapy patients regained significantly less than pharmacotherapy and combined-treatment patients. Accordingly, at follow-up, these groups did not differ significantly in weight loss. Thus, pharmacotherapy produced more rapid regaining of weight after treatment. Furthermore, adding pharmacotherapy to behavior therapy apparently compromised the long-term effects of the latter treatment.

Adult↗
PubMed1981

Couples training, pharmacotherapy, and behavior therapy in the treatment of obesity.

The effects of behavior therapy with and without either pharmacotherapy or couples training were studied in 124 obese adults. In a 16-week behavioral weight-reduction program, patients were assigned to medication (fenfluramine hydrochloride) and no-medication conditions and to three spouse conditions in a 2 x 3 design. Two conditions consisted of patients with "cooperative" spouses; in one, patients were treated with their spouses, and in the other they were treated alone. In the third, patients with "uncooperative" spouses were treated alone. Fenfluramine produced significantly greater weight losses than no medication, but patients in the medication group regained weight much more rapidly during a 12-month maintenance period. The spouse conditions did not differ in weight change during treatment or follow-up. Obese spouses lost as much weight as the patients and were slightly more successful than the patients at maintaining their losses. Patients with obese spouses lost more weight than patients with nonobese spouses. Depression decreased in proportion to decrease in weight.

Adult↗
PubMed1981

The accuracy of self-reported weights.

The accuracy of self-reported weights was assessed by comparing reported weights with measured weights of 1302 subjects at eight different medical and nonmedical sites across two countries (United States and Denmark), across ages, sexes, and different purposes for the weight measurements. Self-reported weights were remarkably accurate across all these variables in the American sample, even among obese people, and may obviate the need for measured weights in epidemiological investigations. Danish reports were somewhat less accurate, particularly among women over 40 yr of age.

Adult↗
PubMed1981

Accuracy of self-reports of food intake.

Six boys reported their food intake with a surprising degree of accuracy, although they tended to overestimate at low levels and underestimate at high levels. Stimulated by this finding, the authors reviewed the literature and found six validated self-reports of food intake among adults and five among children. Most studies were small, but they reported similar findings. Because of the important policy implications, research is needed with larger and more representative samples to determine if self-reports of food intake are as accurate as they seem.

Adolescent↗
PubMed1981

High attrition rates in commercial weight reduction programs.

The management of obesity is increasingly dominated by nonprofessional self-helping groups. Little information about the efficacy of these groups is available from independent sources. In a study of 108 women enrolled in a commercial weight reduction program, we found very high attrition rates; 50% of the members dropped out in six weeks and 70% in 12 weeks. Similar attrition rates have been reported in five other programs in three different countries. Very high attrition rates diminish the effectiveness of commercial weight reduction programs, and they suggest caution in the interpretation of data based on weight losses of persons who remain in these programs.

Adult↗
PubMed1981

Differential changes in plasma high-density lipoprotein-cholesterol levels in obese men and women during weight reduction.

Levels of high-density lipoprotein-cholesterol (HDL-cholesterol) and other lipoproteins of 73 obese men and women were measured before and after a 16-week weight reduction program. There were significant differences between men and women. In men, a 10.7-kg weight loss was associated with a 5% increase in the HDL-cholesterol level, a 15.8% decrease in the low-density lipoprotein-cholesterol (LDL-cholesterol) level, and a 30.1% increase in the HDL-LDL ratio. Women, in contrast, showed an 8.9-kg weight loss, a 3.3% decrease in the HDL-cholesterol level, a 4.7% decrease in the LDL-cholesterol level, and no significant change in the HDL-LDL ratio. These differences suggest that weight raeduction may be an important means of improving plasma lipoprotein patterns in men but may be of more limited value in women.

Adult↗
PubMed1980

Controlled trial of behaviour therapy, pharmacotherapy, and their combination in the treatment of obesity.

Behaviour therapy, pharmacotherapy, and a combination of the two were compared in 120 obese women and 14 obese men during six months of treatment for obesity and at one-year follow-up. Patients who received the appetite suppressant fenfluramine lost 14.5 kg and those who received the combined treatment lost 15.3 kg, both significantly more than those who received only behaviour therapy (10.9 kg). One-year follow-up of all living patients who completed treatment showed a striking reversal of these effects: behaviour-therapy patients regained only 1.9 kg, significantly less than pharmacotherapy patients (8.2 kg) and combined-therapy patients (10.7 kg). Weight changes of the 14 men did not differ from those of the women. Although pharmacotherapy produced more rapid initial weight loss than behaviour therapy, it was followed by more rapid weight gain after treatment. Addition of pharmacotherapy apparently compromised the long-term effects of behaviour therapy. Better maintenance of weight loss and lower costs favour behaviour therapy over pharmacotherapy for the treatment of obesity.

Behavior Therapy↗
PubMed1980

Food accessibility and food choice. A test of Schachter's externality hypothesis.

A set of naturalistic observations was conducted to examine Schachter's theory that obese individuals are more responsive to external food cues than persons of normal weight. During six days of observation at a large hospital cafeteria, experimenters manipulated the accessibility of high- and low-calorie desserts. No differences in selection by obese, overweight, and normal-weight individuals of meals or desserts were observed. All weight groups were equally responsive to the experimental manipulation of food cues.

Cues↗