PubMed Health⌕ Search

Biomedical subjects

Stephan Rössner

Publications and source records attributed to Stephan Rössner.

At least 37 records · Page 2Linked to original sources
PubMed2004

Long-term weight development in women: a 15-year follow-up of the effects of pregnancy.

OBJECTIVE: The aim of this study was to evaluate how well prepregnancy BMI, gestational weight gain, and postpartum weight retention predict retention of weight 15 years later among parous women. RESEARCH METHODS AND PROCEDURES: The Stockholm Pregnancy and Women's Nutrition (SPAWN) study is a long-term follow-up study of women who delivered children in 1984 to 1985 (n = 2342). The participants initially filled out questionnaires about their eating and exercise habits, social circumstances, etc. before, during, and at 1 year after pregnancy. Anthropometric data were also sampled. Fifteen years later, these women were invited to take part in the follow-up study. Anthropometric measurements were collected, and similar questions were asked. Five hundred sixty-three women participated in the SPAWN 15-year follow-up study. The sample was divided into groups to examine three presumably critical time periods: 1) overweight and normal weight before pregnancy; 2) low, intermediate, and high weight gainers during pregnancy; and 3) low, intermediate, and high weight retainers at 1 year after pregnancy. RESULTS: The overweight women did not gain more weight during pregnancy or retain more weight at 1 year follow-up. High weight gainers during pregnancy retained more weight at the 1-year and the 15-year follow-ups. High weight retainers had gained more during pregnancy and retained it at the 15-year follow-up. Fifty-six percent of the high weight gainers during pregnancy ended up in the high weight retainers group. DISCUSSION: Women who are overweight before pregnancy do not have a higher risk of postpartum weight retention than normal weight women. Thus, it is not necessarily the initially overweight woman who should be the target or focus of weight control programs during or after pregnancy. Both high weight gainers and high weight retainers had higher BMI at the 15-year follow-up, although only 56% of the high weight gainers during pregnancy were also classified as high weight retainers at the 1-year follow-up. Weight retention at the end of the postpartum year predicts future overweight 15 years later.

Body Mass Index↗
PubMed2004

Are sexual dissatisfaction and sexual abuse associated with obesity? A population-based study.

OBJECTIVE: To investigate whether there is any association between obesity and sexual satisfaction and sexual abuse in a normal population. RESEARCH METHODS AND PROCEDURES: A representative sample of 2810 subjects from a population study was interviewed about sexual satisfaction, sexual abuse, and life satisfaction. The answers from normal weight, overweight, and obese participants were compared. Univariate and multivariate analyses were performed. RESULTS: Data were presented separately for two age groups, 18 to 49 and 50 to 74 years, and gender. The older group of obese men reported a greater decrease of sexual desire compared with 5 years prior than normal weight men [odds ratios (OR), 2.44; 95% confidence interval (CI), 1.4 to 4.3]. The older group of overweight men reported involuntary participation in sexual activities more often than normal weight men (OR, 2.06; 95% CI, 1.1 to 3.8). Although older overweight and obese women were diagnosed with a lingering disease (defined as >1 month) more often than normal weight women (overweight: OR, 2.41; 95% CI, 1.3 to 4.4; obese: OR, 4.45; 95% CI, 1.7 to 11.5), there was no difference between BMI groups in satisfaction with physical health. DISCUSSION: Overweight and obese groups seem to be heterogeneous with respect to sexual satisfaction and experiences of sexual abuse. No significant differences were detected between BMI groups, which does not exclude the possibility of significant differences between BMI groups among patients seeking medical attention.

Adolescent↗
PubMed2003

[Easy to remain overweight after pregnancy].

For some women pregnancy is a trigger factor for developing overweight and obesity. 73% of patients at the Obesity Unit, Huddinge University Hospital, indicated that they had retained more than 10 kg after each of their pregnancies; for this subgroup weight development after pregnancy was of obvious importance for their future health. However, in most studies mean weight retention after pregnancy is modest: 0.5-3.5 kg up to one year after delivery. Numerous studies have analysed factors explaining weight development after pregnancy and delivery, with a wide range of subjects, but overall it has been surprisingly difficult to identify strong predictors for weight development. The strongest factor is weight gain during pregnancy, but smoking cessation, a sedentary lifestyle and socio-economic factors also play a role. Pregnancy and weight development are intertwined in a complex pattern, which includes a change in lifestyle factors, such as eating behaviour, physical activity, smoking cessation and degree of lactation, but which are still not fully understood.

Female↗
PubMed2003

Practical clinical behavioral treatment of obesity.

The objective was to create a method/model that works in practical clinical treatment for health care personnel as well as for the patients, to educate and supervise health care staff according to this model and to initiate long-term treatment of obese patients in a health care setting. The hypothesis was that it is possible to successfully initiate behavior-modified treatment in the form of a structured treatment program as a method and a tool adapted to use in health care. The aim of this article is to describe an extensive structural cognitive behavioral treatment program for patients. The treatment program is documented in a handbook for supervisors and a self-monitoring book for patients. This handbook is used in the education of the health care personnel and supports the supervisor in the clinical work with the patients. The main purpose of all individual or group treatment is to bring about reduction of body weight or weight control. To obtain weight control through lifestyle changes a balance has to be found between eating behavior, physical activity and body weight control. To reach this kind of balance it is important to have treatment programs where the aim and goals are clearly declared. The structure and the content of the program shall motivate and create interest for changes in the overweight person's behavior. This treatment program includes a schematic survey and an example of a structured treatment program. Over the last few years, 850 nurses, dietitians and other health care personnel have been educated, representing 400 primary health care centers and hospitals within Sweden. Overall these participants find their education and supervision meaningful and valuable.

Clinical Competence↗
PubMed2003

Sibutramine treatment in obesity: predictors of weight loss including rorschach personality data.

OBJECTIVE: To study personality and clinical factors in weight loss by sibutramine (Meridia and Reductil), an anti-obesity drug enhancing satiety. RESEARCH METHODS AND PROCEDURES: The subjects were 30 obese patients [43 +/- 12 years (mean +/- SD), BMI 40 +/- 4 kg/m(2)]. The treatment comprised 15 mg of sibutramine administered daily and monthly dietary advice. Weight loss after 6 months of treatment was evaluated. For psychological assessment, the Rorschach method (Comprehensive System) and the Beck Depression Inventory were used. RESULTS: A multiple linear regression model including the Rorschach predictors' physical demand states (animal movement, designated as FM) being intrusive or difficult to hold and a dependency orientation (food contents) could explain 47% of 6 months of weight loss. A model including initial weight loss in addition to the Rorschach predictors explained 58% of the 6-month weight loss. DISCUSSION: The personality factors predicted greater weight loss. In particular, patients with difficulties concerning physical demand states, which would include hunger, could have reduced their eating behavior with enhanced satiety, resulting in greater weight loss. Enhanced satiety could also have helped patients with a dependent need for food to limit food intake. Being enrolled in a treatment program could also have provided essential support for patients with dependency needs. Furthermore, initial weight loss was a predictor of greater weight loss in sibutramine treatment, in accordance with prior research.

Adult↗
PubMed2003

Subgrouping in obesity based on Rorschach personality characteristics.

Conceptual (a priori) subgroups in obesity based on personality findings from the Rorschach Comprehensive System were suggested for 100 obese patients. The subgroups were further compared in terms of general anamnestic and behavioral data. The largest subgroup was Rorschach characterized by difficulties with emotions and a tendency towards depression. Demographic and behavioral data for this subgroup revealed intermediate or higher education, regular meals, eating disorders like binge eating, periodic variations in eating during the year and experiencing body size as having a psychological meaning. The other subgroup was characterized by coping liabilities and was further associated with a lower socio-economic level and irregular or chaotic meal patterns. For the group with emotional difficulties, the results suggest a more complex psychological pattern, where eating and emotions could be closely related. The group with coping liabilities could have difficulties other than emotional ones concerning food and eating, such as finding a structure for eating and making changes in lifestyle and habits.

Adaptation, Psychological↗
PubMed2003

Interrelationships between weight development and weight retention in subsequent pregnancies: the SPAWN study.

BACKGROUND: Pregnancy is frequently associated with post-delivery weight retention in women. Most studies suggest weight retention associated with pregnancy of between 0.5 to 3.8 kg with up to 2.5 years of follow-up. However, 73% of the female patients at our obesity clinic report that their pregnancies have been important trigger factors for marked weight gain and that they had gained more than 10 kg after each pregnancy. The aim of this study was to examine correlations in weight gain and weight retention after pregnancy in the long-term perspective. METHOD AND SUBJECTS: The SPAWN (Stockholm Pregnancy and Women's Nutrition) study is a long-term follow-up study of women who delivered children in 1984-85 in Stockholm (n = 2342). The participants filled out questionnaires about their eating and exercise habits, social condition, etc. before, during and up to 1 year after pregnancy. Antropometric data were also sampled. One thousand four hundred and twenty-three women completed the study and filled out all questionnaires up to 1 year after pregnancy. Fifteen years later, these 1423 women were invited to the follow-up study. Five hundred and sixty-three women participated and filled out extended questionnaires, and antropometric data were also sampled. Data from the Swedish Medical Birth Register (MBR) about weight before and weight gain during pregnancy were collected. The sample was divided into groups regarding four critical time periods: (1) Time interval between first and second pregnancy, less and more than 2 years. (2) Overweight and normal weights before first pregnancy based on initial body mass index (BMI). (3) Low and high weight gainers during pregnancy by mean split. (4) Low and high weight retainers at 1 year after first pregnancy by mean split. RESULTS: 1) There were no differences between those women who have more than 2 years between their pregnancies regarding weight gain during and weight retention after the first and second pregnancy. (2) Overweight women did not gain more weight during pregnancy or retain more weight at 1 year of follow-up after the first and second pregnancy. (3) High weight gainers retained more weight at 1 year after both the first and second pregnancy. (4) High weight retainers had gained more during pregnancy and retained it into the second pregnancy, and also gained more during and retained more after the second pregnancy. DISCUSSION: To our knowledge, the SPAWN study is the longest follow-up study of factors affecting weight development after pregnancy. Women overweight before pregnancy did not have any higher risks of postpartum weight retention than normal weight women. Weight gain during pregnancy and weight retention up to 1 year after delivery is of predictive value for the weight development in the second pregnancy. Obviously the environmental variation is an important determinant of the differences in weight increase, which follow a pregnancy. Pregnancies time interval does not seem to be of any importance. There are practical implications of these findings: Women who plan their later pregnancy several years after the first pregnancy have no reason to assume that the weight development during subsequent pregnancies will be worse than before. On the other hand, women who have increased considerably in weight during the first pregnancy or retained weight after delivery have a higher risk of doing so in the subsequent pregnancies and should receive appropriate advise and support.

Adult↗
PubMed2003

Leisure-time activity is an important determinant of long-term weight maintenance after weight loss in the Sibutramine Trial on Obesity Reduction and Maintenance (STORM trial).

BACKGROUND: The success rate of long-term maintenance of weight loss in obese patients is usually low. To improve the success rate, determinants of long-term weight maintenance must be identified. OBJECTIVE: The objective of the study was to identify determinants of long-term success in weight maintenance in obese subjects who completed the Sibutramine Trial on Obesity Reduction and Maintenance (n = 261), a multicenter European study of weight loss and weight maintenance in obesity that combines sibutramine treatment with dietary restriction and advice on exercise and behavior. DESIGN: We studied weight maintenance over 18 mo in subjects who had completed a 6-mo weight-loss phase. Factors included in the analysis were initial body weight, the percentage of initial body weight lost, dietary intake, various components of physical activity (measured with the Baecke questionnaire), the type of treatment (sibutramine or placebo), age, and sex. RESULTS: Multiple regression analysis identified treatment group (sibutramine or placebo), the percentage of the initial body weight that was lost during the 6-mo weight-loss phase, and the leisure-time physical activity index as significant determinants of weight maintenance. Together, these 3 factors explained 20% of the variation in weight maintenance (P < 0.001). Dietary factors, age, and sex were not significant predictors of weight-maintenance success in this study. CONCLUSIONS: Weight-maintenance success after weight loss is positively influenced by sibutramine treatment during weight maintenance, by a greater initial weight loss, and by a higher leisure-time physical activity index, which reflects higher levels of activities such as walking and cycling and lower levels of television viewing.

Adolescent↗