Biomedical subjects

T A Wadden

Publications and source records attributed to T A Wadden.

At least 55 records · Page 3Linked to original sources

PubMed1997

Body image in obese women before, during, and after weight loss treatment.

Body image, as measured by the Appearance Evaluation and Body Areas Satisfaction scales of the Multidimensional Body-Self Relations Questionnaire (T.F. Cash, 1994b), was assessed in 59 obese women before, during, and after 48 weeks of weight loss treatment. Before treatment, positive ratings of body image were associated with higher levels of self-esteem, lower levels of dysphoria, and fewer previous diets. After 24 weeks and a mean weight loss of 19.4 kg (SD = 6.5), participants showed significant (p < .0001) improvements in body image. A small weight gain from Week 24 to Week 48 was associated with a slight but significant worsening in both measures of body image. Nevertheless, after 48 weeks and a mean weight loss of 16.3 kg (SD = 7.1), body image was significantly improved from baseline (p < .0001). Changes in body image were not related to changes in weight. Future studies are needed to separate the effects of treatment and weight loss on body image in obese persons.

Adult↗

PubMed1996

Effects of weight cycling on the resting energy expenditure and body composition of obese women.

OBJECTIVE: Numerous reports have suggested that cycles of weight loss and regain (i.e., weight cycling) are associated with adverse health consequences, a concern that may lead some obese individuals to forgo weight control efforts. The present study examined whether weight cycling was associated with a reduction in resting energy expenditure (REE) and with increases in both total and upper body fat. METHOD: REE, body composition, and body fat distribution were measured before and after weight loss, and following full weight regain, in 12 women who before treatment had a mean (+/- SEM) age of 38.8 +/- 3.4 years and weight of 98.0 +/- 3.2 kg. RESULTS: At the end of treatment, patients lost 18.9 +/- 2.6 kg which was comprised of significant decreases in body fat and fat-free mass of 15.2 +/- 2.2 and 3.7 +/- 0.8 kg, respectively (both ps < .001). REE also fell during this time from 1,631 +/- 82 to 1,501 +/- 51 kcal/d (p < .03). All of these measures, however, returned to their baseline values when patients regained their lost weight. Body fat distribution was unchanged throughout the study. DISCUSSION: These results do not support claims that weight cycling adversely affects REE, body composition, or body fat distribution.

Adipose Tissue↗

PubMed1996

Are obese adolescent boys ignoring an important health risk?

OBJECTIVE: The present study assessed satisfaction with weight, shape, and physical appearance, as well as the frequency of weight reduction efforts, in four well-defined groups of adolescents: (1) normal-weight girls; (2) normal-weight boys; (3) obese girls; and (4) obese boys. METHOD: Subjects were selected from 453 females and 355 males from a parochial school. In addition to the measurements of height and weight, adolescents completed a series of questionnaires on weight and dieting, weight and figure satisfaction, parents' attitudes toward weight, and anxiety. RESULTS: Only 49% of obese boys had tried to lose weight over the past year as compared to 90% of the obese girls (p < .001). Only 13% of the obese boys were currently dieting as compared to 62% of the obese girls (p < .001). Despite the relative equivalence of weight in the obese boys and girls, the boys perceived themselves to be less overweight (p < .05) and happier with their looks (p < .001) than obese girls. Thirty-three percent of normal-weight girls were dieting, and 70% had attempted weight loss over the past year. They were significantly less happy with their weight and figure than were average-weight boys (p < .001) and, remarkably, did not differ significantly from overweight boys on these measures. DISCUSSION: Obese adolescent males, in particular, need to be educated about the potential liabilities of their excess weight and encouraged to take appropriate action to correct it.

Adolescent↗

PubMed1996

Psychosocial consequences of weight cycling.

Participants were 130 obese women with a mean age of 41.1 +/- 8.4 years and a mean weight of 97.9 +/- 13.5 kg, who reported having undertaken a mean lifetime total of 4.7 +/- 1.2 major diets on which they had lost a mean total of 45.9 +/- 21.4 kg. Participants with a severe history of weight cycling had a significantly younger age of onset of their obesity than did mild cyclers and reported initiating dieting at a significantly younger age and lower weight. No evidence, however, was found that weight cycling was associated with greater reports of depression or other psychopathology; nor was it associated with a significantly greater frequency of binge eating disorder. The results are discussed in terms of the need to use additional measures of psychological functioning.

Adaptation, Psychological↗

PubMed1996

Psychological effects of weight loss and regain: a prospective evaluation.

This study prospectively assessed the psychological effects of weight loss and regain (i.e., weight cycling) in obese women. Measures of mood, binge eating, restraint, disinhibition, and hunger were obtained from 55 participants at baseline, after 6 months of treatment, and 58 months posttreatment. Women lost 21.1 +/- 8.4 kg after 6 months of treatment but were 3.6 +/- 10.9 kg above baseline weight at the time of the follow-up. Contrary to expectations, after this 21-kg cycle of weight loss and regain, women reported significant improvements in mood and binge eating, as well as reductions in hunger and disinhibition. Restraint was unchanged from baseline to follow-up. These data suggest that weight loss and regain are not associated with long-term adverse psychological effects. The findings also confirm earlier reports of significant weight regain after treatment and underscore the need for research to improve the maintenance of weight loss.

Feeding Behavior↗

PubMed1996

Psychosocial consequences of weight reduction: how much weight loss is enough?

We reviewed the psychosocial consequences of weight reduction and concluded that weight loss is usually associated with improvements in mood in significantly obese individuals (> or = 20% overweight) who are treated by diet and lifestyle modification. Less is known about the psychologic effects of weight loss in mildly overweight individuals who reduce their weight on their own but the limited data suggest similarly positive effects. We recommend that significantly obese individuals seek a 10% reduction in body weight, a loss that is likely to be associated with improvements in psychologic as well as physical health. A loss of this magnitude is typically produced by 16-20 wk of treatment by diet and behavior modification. Persons who ae mildly overweight (particularly those with health complications) are encouraged to reduce their weight by increasing their physical activity. Exercise is associated with modest but long-term weight losses and with improvements in mood and physical health. The recommendation that overweight Americans seek a healthier weight should be combined with efforts to promote healthier attitudes toward weight and shape in normal-weight women and girls.

Affect↗

PubMed1995

Sertraline and relapse prevention training following treatment by very-low-calorie diet: a controlled clinical trial.

This study examined the combination of sertraline, a selective serotonin reuptake inhibitor, and relapse prevention training in the maintenance of weight loss following treatment by a very-low-calorie diet. A total of 53 women who had lost a mean (+/- SD) of 22.9 +/- 7.1 kg from a pretreatment weight of 103.1 +/- 17.8 kg were randomly assigned to a 54-week weight maintenance program that was combined with either: 1) 200 mg/d of sertraline; or 2) placebo. During the first 6 weeks, sertraline subjects lost significantly more weight and reported significantly greater reductions in hunger and preoccupation with food than did subjects on placebo. After this time, however, women in both conditions regained weight steadily. The 13 sertraline subjects who completed the 54-week study regained 17.7 +/- 10.6 kg of their original 26.3 +/- 7.6 kg loss, equal to a regain of 70.9 +/- 41.7%. The 17 placebo completers regained 11.8 +/- 9.0 kg of their 23.4 +/- 7.8 kg loss, equal to a 46.5 +/- 34.6% regain. End-of-treatment differences between groups in weight change were not statistically significant. Nor were there significant differences between the two conditions at any time in changes in fat-free mass, resting metabolic rate or dysphoria, all of which tended to increase with weight regain. The results are discussed in relation to findings from other long-term studies that combined diet and medication.

1-Naphthylamine↗

PubMed1995

Relation of weight loss to changes in serum lipids and lipoproteins in obese women.

Several reports have suggested that modest weight losses, as little as 10% of initial weight, are sufficient to control many of the health complications of obesity. This study examined the relation between changes in weight and those in serum lipids and lipoproteins in obese women who participated in a 48-wk weight-reduction study. Subjects were 66 obese women who were prescribed a 3870-kJ (925-kcal)/d diet for the first 16 wk and a balanced-deficit diet of 5029-6279 kJ (1200-1500 kcal)/d thereafter. Anthropometric measures were assessed at baseline and weeks 8, 24, and 48, as were serum triacylglycerols (triglycerides), total cholesterol, and low-density-lipoprotein- and high-density-lipoprotein-cholesterol concentrations. Weight decreased 11.1% during the first 8 wk, during which time triacylglycerols and total cholesterol fell 22.7% and 15.7%, respectively. Subjects lost an additional 4.7 kg (equal to a total reduction of 16.4%) between weeks 8 and 24 but triacylglycerols and total and low-density-lipoprotein cholesterol increased by 5.2%, 4.2%, and 4.5%, respectively during this time. Multiple-regression analyses showed that at no time did weight loss account for > 6% of the variance in the reductions in triacylglycerol and cholesterol concentrations. These findings indicate that modest weight losses are associated with significant improvements in serum lipids, but that factors including the energy and macronutrient content of the diet prescribed contribute significantly to the improvements observed.

Adult↗

PubMed1995

Dietary intake of female collegiate heavyweight rowers.

The purpose of this study was to evaluate the adequacy of dietary intake in 16 female heavyweight rowers during the sprint racing phase of the season. Caloric intake for the rowers was 2,633 kcal/day, lower than expected given the training regimen of these athletes. On average, rowers consumed below-optimal levels of carbohydrate. Protein intake was satisfactory but fat intake was higher than recommended. For the majority of rowers, micronutrient intake met the RDA. However, calcium, zinc, B6, and B12 fell short of meeting two-thirds of the RDA for a significant percentage of rowers. The preevent meal consumed both 15 hr and 2 hr before the event provided less carbohydrate and fluid but more fat than desirable. Female heavyweight rowers would benefit from nutritional counseling that provides strategies for increasing complex carbohydrates, calcium, zinc, B6, and B12 while reducing dietary fat. Adequate fluid intake is also essential.

Adult↗

PubMed1995

Gallstone formation in obese women treated by a low-calorie diet.

This study assessed the incidence of gallstone formation in 47 obese women who consumed a low-calorie diet (LCD) for the first 16 weeks of a 26-week weight loss program. The LCD consisted of four daily servings of a liquid diet combined with an evening meal of a pre-packaged dinner entrée and provided approximately 925 kcal/d. Six of the 47 patients (12.8%) displayed gallstones at week 17, as determined by sonography. Five patients were asymptomatic when followed for up to 48 weeks. The sixth, however, reported severe abdominal pain 30 weeks after beginning treatment and required a cholecystectomy. Patients who developed gallstones, as compared with those who did not, had significantly higher baseline triglyceride and total cholesterol levels and had a significantly greater rate of weight loss. Results of this study indicate that an increased risk of gallstones is not limited to very-low-calorie diets and that the incidence of this complication should be assessed in persons who consume popular over-the-counter meal replacement plans.

Adult↗

PubMed1995

The energy cost of walking before and after significant weight loss.

The purpose of this study was to determine whether significant weight loss reduced the energy cost of activity more than that expected based on decreased body weight. Standing energy expenditure was measured and subtracted from the total energy cost of walking to determine ambulatory energy expenditure (AEE). The energy cost of walking was determined in 11 obese women at baseline, week 9 [after 8 wk of a 1758-3349 kJ.d-1 diet], and week 22 (after 2 wk of weight stability). AEE accounted for 80% of the energy cost of walking. Body weight was the principal determinant of AEE, but the relationship was not 1:1. Subjects reduced body weight by 13% at week 9 and 21% at week 22. Analyses which controlled for the relationship between AEE and weight at baseline, showed no change in AEE at week 9. By contrast, at week 22, AEE was reduced more than expected based on a lower body weight. These findings suggest that after significant weight loss, reduced-obese persons will expend less energy for the same activity, even after accounting for the decrease in body weight. These data also suggest that weight-based estimates of exercise energy expenditure may be inappropriate after significant weight loss.

Adult↗

PubMed1995

Validation of a cycle ergometry equation for predicting steady-rate VO2 in obese women.

The purpose of this study was to determine the accuracy of equations developed by the American College of Sports Medicine and by Latin et al. (Med. Sci. Sports Exerc. 25:970-974, 1993) for estimating the oxygen cost of cycle ergometry in obese women. Fifty-six deconditioned subjects, aged 23-60 yr, performed a three-stage (0, 50, and 100 W) submaximal cycle ergometry test while their oxygen uptake was measured. Results indicated that the ACSM equation significantly (P < 0.05) underestimated oxygen consumption at all three workloads. The Latin equation, by contrast, correctly predicted oxygen consumption at the 50- and 100-W workloads, although not at 0 load. The mean bias for all three workloads was 287.6 ml.min-1 for the ACSM equation and 58.3 ml.min-1 for the Latin equation. These data suggest that the Latin equation is more accurate than the ACSM formula for estimating oxygen consumption of loaded cycling in obese women. However, caution must be used when attempting to predict the caloric cost of unloaded cycling.

Adult↗

PubMed1994

Binge eating disorder, weight cycling, and psychopathology.

This study examined differences among a total of 70 obese binge eaters, nonbingers, and problem eaters in depression, cognitive function, weight- and eating-related disturbances, and weight cycling. Subjects diagnosed with binge eating disorder (BED) scored significantly higher on depression and on several measures of cognitive dysfunction than did subjects in the other two groups. In addition, they reported significantly greater preoccupation with thinness and feelings of ineffectiveness, as well as a greater likelihood of eating in response to negative emotions. No relationship, however, was found between binge eating and weight cycling. Comparison of subjects identified as low- and high-weight cyclers revealed no significant differences between these two groups on depression, cognitive dysfunction, or the majority of the other measures of weight- and eating-related disturbance. The findings are discussed in terms of the implications for treating persons with BED and/or a history of weight cycling.

Adaptation, Psychological↗

PubMed1994

One-year behavioral treatment of obesity: comparison of moderate and severe caloric restriction and the effects of weight maintenance therapy.

This study compared the weight losses of 49 obese women randomly assigned to a 52-week behavioral program combined with either moderate or severe caloric restriction. Subjects in the balanced deficit diet (BDD) condition were prescribed a 1,200-kcal/day diet throughout treatment, and those in the very-low-calorie diet (VLCD) condition were given a 420-kcal/day liquid diet for 16 weeks and a 1,200-kcal/day diet thereafter. The VLCD subjects lost significantly more weight than the BDD subjects at all periods through Week 26, at which time mean losses were 21.45 and 11.86 kg, respectively. VLCD subjects, however, regained weight during the next 26 weeks of weekly therapy and during a 26-week weight maintenance program that provided biweekly meetings. Mean weight losses at the end of the maintenance program were 10.94 and 12.18 kg, respectively. Reports of binge eating declined in both groups, and no relationship was observed between binge eating and weight loss or attrition.

Adult↗

PubMed1994

Decline in delayed-type hypersensitivity response in obese women following weight reduction.

The effect of weight loss on immuno function was evaluated in 14 middle-aged obese women. Cutaneous delayed-type hypersensitivity to five recall antigens was measured before a weight loss of 21 kg and again after weight had been stabilized. Weight loss was associated with a decrease in both number and magnitude of delayed-type hypersensitivity responses. The number of positive skin tests decreased from 3.1 +/- 0.2 to 2.4 +/- 0.3 per subject, and the mean cutaneous induration size decreased by 38%. The decrease in induration size was positively correlated with the decrease in body mass index (r = 0.63), weight (r = 0.59), and fat mass (r = 0.52). These preliminary findings suggest that large weight losses may result in decreased expression of immune function.

Adult↗

PubMed1993

Treatment of obesity by moderate and severe caloric restriction. Results of clinical research trials.

Recent studies of the treatment of obesity by moderate and severe caloric restriction show that patients treated in randomized trials using a conventional 1200 kcal/d reducing diet, combined with behavior modification, lose approximately 8.5 kg in 20 weeks. They maintain approximately two thirds of this weight loss 1 year later. Patients treated under medical supervision using a very-low-calorie diet (400 to 800 kcal/d) lose approximately 20 kg in 12 to 16 weeks and maintain one half to two thirds of this loss in the following year. Both dietary interventions are associated with increasing weight regain over time, although regain can be minimized with the recognition that obesity, in many cases, is a chronic condition that requires continuing care. Patients who participate in a formal weight-loss maintenance program, exercise regularly, or both are likely to achieve the best long-term results.

Behavior Therapy↗

PubMed1993

Metabolic, anthropometric, and psychological characteristics of obese binge eaters.

This study examined the relationship of binge eating to a variety of metabolic, anthropometric, and psychological characteristics in 132 obese women seeking weight reduction. Contrary to findings of a reduced resting metabolic rate (RMR) in persons with bulimia nervosa, no significant differences were observed between obese bingers and nonbingers in RMR or thyroid hormones. Nor did the two groups differ significantly in weight, percentage body fat, body fat distribution, or serum lipid levels. Consistent with previous findings, however, binge eaters did score significantly higher in depression and other measures of psychopathology, as assessed by the Minnesota Multiphasic Personality Inventory. They also scored significantly higher in disinhibition and hunger but significantly lower in cognitive restraint. All of these findings await confirmation in subjects diagnosed according to criteria proposed for a new binge eating disorder. The present results, however, provide little support for the hypothesis that binge eating in obese individuals is related to reduced resting energy requirements.

Adult↗

PubMed1992

Etiology and treatment of obesity: understanding a serious, prevalent, and refractory disorder.

Obesity remains a leading public health problem because of its complications, prevalence, and resistance to change, despite record rates of dieting. Risk factors exist at both population and individual levels, thus obesity has diverse etiologies and consequences. Dieting is often grounded in the notion that the body can be molded at will and that the rewards justify the effort, creating a drive for unrealistic goals. This article argues for establishing a "reasonable weight," which may differ from health and aesthetic ideals. Intervention is less a matter of finding a "best" treatment but of finding the approach with "best fit" for the individual. Advances in treatment are most likely when research is driven by theory on the etiology of weight gain, the relapse process, and methods for permanent behavior change. This article integrates information on etiology, social beliefs about body weight, theory, and treatment into a comprehensive and compassionate model for intervention.

Adaptation, Psychological↗