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Results for “Weight Reduction Programs”

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At least 181 records · Page 10Linked to original sources

PubMed1988

Dietary considerations for obese diabetic subjects.

Individuals with an upper-body form of obesity show greater associations with higher glucose excursions, exacerbated insulin resistance, increased abnormality of lipoprotein profile, and higher cardiovascular risk. Individuals with obesity and diabetes are at great risk for cardiovascular disease. Weight reduction and improvement in blood glucose control through dietary interventions for the obese person with non-insulin-dependent diabetes mellitus (NIDDM) hold the greatest potential for reducing morbidity and mortality. The relative merits of different weight-reduction programs are unclear, but regimens should be nutritionally complete, easy to follow, and include a program for maintaining the reduced weight level. Improvement in insulin action and the possibility of slowing development of clinical nephropathy or end-stage renal disease in NIDDM through weight loss have been found. Very low calorie diets, when used with medical supervision, may lead to significant weight loss, improved metabolic status, and even reduction or elimination of the need for oral hypoglycemic agents or insulin; however, further studies are needed to examine possible negative outcomes in people with NIDDM before very low calorie diets can be recommended. The causes of obesity and its connection with diabetes are unclear, but even modest calorie restriction may be beneficial to obese diabetic patients because of the positive effects on blood glucose levels and requirements for insulin and oral antidiabetic agents.

Body Weight↗

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

Improving attendance in weight-control programs.

This field study evaluated the use of a food dairy as a screening device for admission to a behaviorally oriented weight-reduction program for its effectiveness in improving attendance. All study participants were required (1) to attend an orientation meeting where the program was described and questions were solicited and (2) to pay a $25, nonrefundable fee. During the orientation experimental-group attendees were told that a 2-week food dairy was a requirement for admission to the series. It was expected the experimental requirement would decrease the number of less motivated enrollees, thereby reducing early termination and improving attendance. Keeping the record was in itself expected to modify eating behavior. This would have the effect of adding 2 weeks to the program and, therefore, weight loss at the end of the program was expected to be greater. In general, the hypotheses were confirmed. A smaller proportion of those who had the food-dairy requirement enrolled. a significantly larger proportion of experimental-group women enrollees attended at least three-quarters of the sessions. The attendance records of control-group and experimental-group men were not significantly different. Mean weight loss at the end of the program was greater for those enrolled under the experimental condition. Achievement of a weight loss of at least 8 pounds was found to be positively related to attendance.

Adult↗

PubMedDate not supplied

Weight loss counseling in primary care.

Caring for the overweight client requires a multifaceted approach. The nurse practitioner can help clients lose weight by providing them with strategies for reducing calorie intake, maintaining a healthy, balanced diet, exercising more, and developing positive behavioral and attitudinal changes. Weight reduction programs need to be individualized and clients should be periodically reassessed for changes in behaviors, eating patterns, and goals. Success in weight loss and maintenance requires a lifelong commitment to behavioral and nutritional changes. The goal of this article is to improve the clinician's understanding of the overweight person and to assist health care providers in counseling clients in weight reduction and maintenance.

Attitude to Health↗

PubMedDate not supplied

Starvation diet and very-low-calorie diets may induce insulin resistance and overt diabetes mellitus.

We have observed seven initially obese individuals who, during the course of a strenuous weight-reduction program, developed diabetes mellitus: non-insulin-dependent diabetes mellitus in five cases and insulin-dependent diabetes mellitus in two cases. None had any sign of prior diabetic symptoms. Although weight reduction is encouraged in obesity, crash diets without proper medical surveillance may have deleterious effects. This sequence of induction of diabetes has not previously been reported in the medical literature. The metabolic situation in extremely low-calorie diets may be comparable to that in starvation. An attempt is made to explain our observation concerning the induction of a diabetic state during such diets, on the basis of increased insulin resistance in states of starvation and anorexia nervosa, with a concomitant role in stress hormones.

Adult↗

PubMed1987

Early and late effects of weight loss on lipoprotein metabolism in severe obesity.

In a group of grossly obese patients serum lipoproteins and the intravenous fat tolerance test were analysed before a weight reduction program (n = 98), after 6 weeks (n = 58) and 1 year (n = 15). At one year follow-up the mean weight had fallen from 120 to 105 to 100 kg, respectively. In spite of severe overweight, only a moderate hypertriglyceridaemia (males mean fasting concentration of plasma triglycerides (TG) 2.50 +/- 1.36, females 2.03 +/- 1.94 mmol/l) was found before treatment. After 6 weeks significant reductions were found in VLDL-TG, -cholesterol, LDL-cholesterol and HDL-cholesterol (P less than 0.05 at least). After one year VLDL-TG was still below pretreatment level, LDL-cholesterol had increased above pretreatment level, whereas HDL-cholesterol was significantly higher compared to pretreatment (P less than 0.05). Some previous studies suggest that weight loss may lead to HDL-cholesterol reductions, which would be undesirable. The present study indicates that after sustained weight loss and at a stable lower body weight, HDL-cholesterol levels may increase above pretreatment levels after an initial drop during the catabolic weight reduction phase.

Adult↗

PubMed1980

Effect of glycerol on weight loss and hunger in obese patients.

The effectiveness of oral glycerol as a dietary component or as a supplement to a 1000-kcal/day diet was examined in two studies involving obese patients. Glycerol did not differ from an equicaloric dose of glucose in its effect on hunger ratings, diet compliance or overall weight loss. We conclude that oral glycerol is not a useful adjunct to weight reduction programs.

Adult↗

PubMed1984

Behavioral treatment of obesity with monetary contracting: two-year follow-up.

Reported is a 2-year follow-up of a behavioral weight reduction program for men using monetary contracts of varying size and group versus individual contingencies. Although initial weight losses were large, in the absence of an effective maintenance program weight losses at two years were modest, similar to those obtained with less effective initial weight loss procedures. Group contracts were significantly more effective in producing long term loss than individual contracts. Reported behaviors associated with weight loss at 2 years are presented.

Behavior Therapy↗

PubMed2005

Ghrelin levels before and after reduction of overweight due to a low-fat high-carbohydrate diet in obese children and adolescents.

BACKGROUND: There are conflicting results for ghrelin changes in reduction of overweight. Increasing ghrelin levels in weight reduction are considered to be responsible for compensatory mechanisms that make the reduction of overweight unlikely to be sustained. METHODS: We have analyzed fasting serum ghrelin levels, weighed dietary record and, as biochemical markers of clinically relevant reduction of overweight, leptin, adiponectin and insulin levels and insulin resistance measured by homeostasis model assessment (HOMA) at baseline and after a 1-y outpatient weight reduction program based on a high-carbohydrate and low-fat diet in 37 obese children (median age 10 y). We divided these children into two subgroups according to their degree of weight loss (substantial reduction of overweight: decrease in SDS-BMI > or = 0.5). Furthermore, we analyzed ghrelin levels in 16 normal-weight children. RESULTS: Obese children demonstrated significant (P<0.001) lower ghrelin levels compared to normal-weight children. Daily caloric intake (P = 0.004) and percentage fat content decreased significantly (P<0.001), while percentage carbohydrate content increased significantly (P = 0.003) between baseline and 1-y follow-up in the obese children. The substantial reduction of overweight in 16 children (median SDS-BMI = -0.7) was associated with significant changes in insulin resistance (median decrease of HOMA 27%; P = 0.013), insulin (median decrease 25%, P = 0.036), adiponectin (median increase 15%; P = 0.003), and leptin levels (median decrease 19%; P = 0.023), while there were no significant changes in ghrelin levels (median increase 4%; P = 0.326). In the 21 children without substantial reduction of overweight (median SDS-BMI = -0.3), there were no significant changes in insulin resistance and in insulin, adiponectin, leptin and ghrelin levels. CONCLUSIONS: We conclude that in obese children, low-fat high-carbohydrate diet-induced weight loss does not change ghrelin secretion, but significantly decreases leptin levels, increases adiponectin levels and improves insulin resistance determined by significantly decreased insulin resistance indices as well as lowered serum insulin levels.

Adiponectin↗

PubMed1996

Psychiatric symptoms in clients presenting for commercial weight reduction treatment.

OBJECTIVE: To study the prevalence and severity of psychiatric symptoms in a group of clients presenting to a commercial weight reduction program, compared with a group of patients seeking outpatient medical treatment. METHOD: Sixty-six clients presenting for commercial weight loss treatment and 52 patients presenting for general outpatient medical treatment were given self-report measures of anxiety (Spielberger State and Trait Inventory), depression (Beck Depression Inventory), body dissatisfaction (Body Shape Questionnaire), and overall impairment in functioning (Sheehan Disability Scale). RESULTS: Weight loss clients had significantly higher rates of depressive symptomatology and psychosocial disability than patients presenting for medical treatment. Weight loss clients were also more likely to demonstrate body dissatisfaction regardless of actual weight. Levels of anxiety were not significantly different, despite the medical group reporting themselves to be in poorer health as compared with the weight loss group. DISCUSSION: Regular screening for psychiatric symptoms in clients presenting for commercial weight reduction treatment may be valuable as this group may constitute an as yet unidentified cohort requiring psychiatric intervention.

Adult↗

PubMed1992

The role of breakfast in the treatment of obesity: a randomized clinical trial.

Fifty-two moderately obese adult women were stratified according to their baseline breakfast-eating habits and randomly assigned a weight-loss program. The no-breakfast group ate two meals per day and the breakfast group ate three meals per day. The energy content of the two weight-loss programs was identical. After the 12-wk treatment, baseline breakfast eaters lost 8.9 kg in the no-breakfast treatment and 6.2 kg in the breakfast treatment. Baseline breakfast skippers lost 7.7 kg in the breakfast treatment and 6.0 kg in the no-breakfast treatment. This treatment-by-strata-by-time interaction effect (P less than 0.06) suggests that those who had to make the most substantial changes in eating habits to comply with the program achieved better results. Analyses of behavioral data suggested that eating breakfast helped reduce dietary fat and minimize impulsive snacking and therefore may be an important part of a weight-reduction program.

Adolescent↗

PubMed1980

Husband involvement in the behavioral treatment of overweight women: initial effects and long-term follow-up.

This study investigated whether husband participation would augment the effectieness of the Sturart & Davis (1972) weight-reduction program for 37 obese women. Following a five-week baseline period, participants were taught behavioral weight-control techniques in eight 90-minute sessions over a 16-week period. Random assignment was made to conditions that required husbands to participate in all treatment sessions, the first four sessions, or not at all. Results indicated that although women in all three conditions lost significant amounts of weight and developed more adaptive eating habits, husband involvement fostered reliably greater weight loss, which was maintained through a six-week post-treatment assessment. Participant husbands became more accurate observers of changes in their wives' eating habits and were viewed as being more helpful than were noninvolved husbands. A three-year follow-up indicated that the wives had maintained their initial weight losses and reported changes in eating habits, while the effects engendered by husband involvement had dissipated.

Adult↗

PubMed1976

Effects of physical activity on weight reduction in obese middle-aged women.

Increased physical activity consisting of jog-walking 2.5 miles and 1 hr of calisthenics/week was the primary focus of a 17-week weight reduction program in 22 obese (X = 40% body fat) women ages 30 to 52, many of whom had failed at previous attempts to lose weight by dieting alone. Regular exercise was also increased substantially on an individual basis. Caloric restriction was self-determined and was generally moderate, accounting for about 60% of the total mean energy deficit. Initial and final evaluations included body composition by hydrostatic weighing, progressive multistage exercise testing, and plasma lipid and lipoprotein analyses. A mean relative body fat reduction of 5% (P less than or equal to 0.001) was achieved by a drop in fat body weight (X = 5.4 kg; P less than or equal to 0.001) which closely paralleled that of total body weight (X = 4.2 kg; P less than or equal to 0.001). Mean heart rates and systolic blood pressures at identical submaximal exercise intensities were significantly lower at the time of reevaluation. Mean plasma triglyceride and total cholesterol concentrations did not change significantly (P greater than 0.05). However, the high-density lipoprotein cholesterol/low-density lipoprotein cholesterol ratio increased significantly (P less than or equal to 0.05). Increased physical activity combined with moderate dieting is a feasible approach to weight reduction in middle-aged women.

Adult↗

PubMed1991

Diminished weight loss and behavioral compliance during repeated diets in obese patients with type II diabetes.

Compared weight losses during first and second bouts of a very low calorie diet (VLCD) and examined whether decreased compliance might in part explain the decrease in weight loss during the second bout. Forty-five Type II diabetic patients participated in a year-long behavioral weight-reduction program that incorporated a VLCD (400 to 500 kcal/day) during Weeks 1 to 12 and 28 to 40. Weight losses decreased dramatically from the first to the second VLCD (15.54 vs. 1.42 kg, p less than .0001). There was also markedly diminished adherence as assessed by weeks ketonuric, attendance, and completeness of self-monitoring records. The percentage of weeks subjects were in ketosis dropped from 61% during VLCD 1 to 13% during VLCD 2 (p less than .0001). Similarly, subjects attended significantly fewer treatment meetings during VLCD 2 and self-monitored less during VLCD 2 than during VLCD 1. Weeks ketonuric and initial weight accounted for 63% of the variance in weight loss during VLCD 1 (p less than .0001); weeks ketonuric and attendance predicted weight loss during VLCD 2 (p less than .0001), accounting for 54% of the variance. These results suggest the importance of behavioral factors in explaining poorer performance on a repeated diet.

Adult↗

PubMed2003

Impact of weight loss and regain on quality of life: mirror image or differential effect?

OBJECTIVE: To compare the impact of weight regain and weight loss on health-related quality of life. RESEARCH METHODS AND PROCEDURES: Subjects were 122 (106 women, 16 men) overweight and obese participants in a weight reduction program (phentermine-fenfluramine and dietary counseling) who had initially lost at least 5% of their total body weight and then regained at least 5% of their weight during the follow-up period. Follow-up periods ranged from 10 to 41 months (mean, 28 months). Participants completed the Impact of Weight on Quality of Life-Lite, an obesity-specific health-related quality of life (HRQOL) measure, at 3-month intervals. RESULTS: Mean BMI at baseline was 40.9 +/- 6.6 kg/m(2) (range, 29.2 to 63.7 kg/m(2)). Average weight loss from entry was 18.8 +/- 6.7% (range, 6.0% to 43.7%), and average regain was 10.1 +/-4.4% of baseline weight (range, 5.0% to 30.6%). The effects of weight regain on HRQOL mirrored the effects of weight loss-rates of HRQOL change were similar in magnitude but different in direction for comparable weight loss and regain. Those with more severe initial impairments in HRQOL experienced greater improvements in HRQOL during weight loss as well as greater deterioration during weight regain than those with less severe impairments. DISCUSSION: Weight loss and regain produced mirror image changes in HRQOL. The initial severity of HRQOL impairment had a greater impact on the magnitude of HRQOL change than the direction of weight change. Findings underscore the importance of maintaining weight loss for the purposes of retaining obesity-specific HRQOL benefits.

Adult↗

PubMed1983

Prediction of the resting metabolic rate in obese patients.

Resting metabolic rate (RMR) was measured in 154 women and 48 men before the beginning of a weight reduction program. In both sexes there were significant univariate correlations between RMR and fat-free mass, body fat, weight, fat cell weight, and fat cell number (from total body water). Women also showed significant correlations between RMR and fat cell number (from total body potassium), free triiodothyronine index, and fasting and postglucose insulin levels. Multiple regression analysis showed that both fat-free mass and fat cell weight and number were significant predictors of RMR. The contribution of fat-free mass was three to five times greater per kg than that of body fat. There was no significant contribution of thyroid hormones or insulin to the prediction of RMR. Fat cell number and fat cell weight were significant predictors of RMR, whether determined from body water, body potassium, or a formula using both water and potassium. There was no significant difference in regression coefficients between men and women. Thus the difference in RMR between the sexes is probably caused by the higher proportion of fat-free mass in men. The effect of age was small and not statistically significant.

Adipose Tissue↗

PubMed2002

Gastric bypass surgery for severe obesity.

Severe obesity is associated with a number of co-morbidities. Medical weight reduction programs have not been proven to have long-term efficacy for these severely obese patients. Surgically induced weight loss has been found to completely reverse or markedly ameliorate obesity-related problems. Gastric bypass has been found to provide significantly more weight loss than a purely restrictive procedure such as a vertical banded gastroplasty or adjustable silicone gastric banding. Gastric bypass may be associated with micronutrient deficiencies such as iron, vitamin B(12), and calcium. These patients require life-long supplementation. Laparoscopic gastric bypass has been shown to be feasible and safe and equivalent to the weight loss seen following open gastric bypass. The mortality in most series of gastric bypass surgery, whether open or laparoscopic, is <1%. Problems of stomal stenosis and marginal ulcer can almost always be treated medically with endoscopic dilatation or acid suppression therapy, respectively.

Clinical Trials as Topic↗

PubMed1994

Report on the NIH Workshop on Pharmacologic Treatment of Obesity.

A National Institutes of Health workshop on pharmacologic treatment of obesity concluded that pharmacologic agents may be effective in reducing body weight over an extended period of time. Drugs should be used as only one component of a comprehensive weight-reduction program, and additional research is needed on the long-term efficacy and safety of drugs for obesity, and especially for combinations of drugs. Improvement in comorbidities and risk factors of obesity should be used along with weight reduction as an outcome measure in clinical trials. Industry, professional societies, and governmental agencies should work together to explore the potential for drugs for obesity and to reassess the regulatory and administrative controls on the use of currently available drugs for obesity and on the approval process for future drugs.

Animals↗