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Biomedical subjects

T A Wadden

Publications and source records attributed to T A Wadden.

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

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

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

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

Childhood obesity and self-esteem.

To explore the relationship between obesity and self-esteem, the Piers-Harris Self-Esteem Inventory was administered to black inner-city children (grades 4 through 12). Those with chronic illnesses or in special education were excluded, yielding 851 for the study. Body mass index (BMI) served to estimate adiposity, and Ten State Nutrition Survey (TSNS) data yielded reference growth curves. BMI and BMI relative to TSNS ideals were calculated for each child. Using analysis of variance to compare groups based on relative BMI, small differences in mean self-esteem scores were detected (3 to 4 units or one-third standard deviation). These statistically significant differences are unlikely to be clinically significant. The correlation between BMI and self-esteem was small: BMI accounted for only 1% of the variance in self-esteem score. Moreover, all self-esteem scores fell within the normal range. Neither age nor sex affected the relationship. The consequences of childhood obesity may be less harmful than formerly assumed. Our findings may explain why the promise of enhanced self-esteem fails to motivate weight loss in many children.

Adolescent↗
PubMed1985

A comparison of two very-low-calorie diets: protein-sparing-modified fast versus protein-formula-liquid diet.

This study investigated the acceptability of two very-low-calorie diets in 16 moderately overweight persons participating in a weight reduction program. Subjects were prescribed a 1000-1200 kcal balanced diet the first month and asked to complete appetite and mood scales on a weekly basis. They were then randomly assigned to either a protein-sparing-modified fast (PSMF) or a protein-formula-liquid diet, each of which provided about 400 kcal daily. Analysis of the appetite data showed that PSMF subjects reported significantly less hunger and preoccupation with eating than did liquid diet subjects during 2 of the 4 weeks on a very-low-calorie diet. Subjects in both conditions reported significant reductions in anxiety. Results are discussed in terms of possible advantages of PSMF.

Adult↗
PubMed1985

Social and psychological consequences of obesity.

The strong prejudice in this country against obese persons is evident in children as young as 6 years of age. There is discrimination against obese persons in both academic and work settings. Despite this discrimination, overweight persons in the general population show no greater psychological disturbance than do non-obese persons. Similarly, obese patients seen for medical or surgical procedures generally show no more psychopathology than do non-obese patients. Serious psychiatric disturbances associated with obesity include disparagement of body image and negative emotional reactions to dieting. Dieting may also be responsible for the increased incidence of bulimia observed in this country in recent years. Women, adolescent girls, and the morbidly obese appear to suffer the most deleterious consequences of society's contempt for the obese.

Adolescent↗
PubMed1984

Relaxation therapy for essential hypertension: specific or nonspecific effects?

This study investigated the role of nonspecific treatment factors in the behavioral control of essential hypertension. Forty-eight subjects with mild hypertension were randomly assigned to one of three conditions: (1) subject-alone relaxation therapy; (2) couples-relaxation therapy; or (3) couples-cognitive therapy. The third condition, which provided instruction in cognitive methods of stress reduction, controlled for the effects of positive treatment expectancy and other nonspecific factors. At the end of 8 weeks, subjects in all three conditions showed significant reductions in systolic and diastolic blood pressure, which were maintained at 1 and 5 months post-treatment. However, no significant differences in effectiveness were observed among conditions at any assessment period. Although the results of this study did not unequivocally demonstrate that a positive treatment expectancy is a sufficient condition for blood pressure reduction, they do raise questions concerning whether relaxation therapy is a necessary condition.

Adult↗