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Results for “Weight Reduction Programs”

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PubMed2005

Gastric emptying, CCK release, and satiety in weight-stable obese subjects.

Scintigraphic gastric emptying studies are far from conclusive in obesity. The aim was to investigate gastric emptying and CCK release in weight-stable obese subjects on their usual diet and to study the impact of factors known to determine gastric emptying. Patients entering a weight reduction program were asked to participate in a study examining gastric emptying by scintigraphy and CCK release in response to a meal with questionnaires on feelings of satiety. Forty-five patients (9 M, 36 F) with a mean (SD) BMI of 37.0 (4.0) kg/m2 entered the study. The mean T50 (emptying of 50%) of fluids was 20.7 (10.3) min, and that of solids 141.9 (168.3) min. The percentage emptying of solids was 34.5 (19.9)%/hr. CCK values peaked within 42 min and paralleled the subjective ratings of satiety but did not correlate with gastric emptying. Five of 45 subjects (11%) had very prolonged gastric emptying of solids; they showed higher caloric intakes and higher insulin levels. They did not differ in CCK values and ratings of satiety but scored higher in being active and awake. Without these five subjects the T50 of solids was 94.3 (36.1) min, and the percentage of emptying 37.9 (18.4)%/hr. Liquid emptying was faster and solid emptying similar compared with those of normal-weight individuals. Height, fat-free mass, and waist-hip circumference were positively related to solid emptying. In weight-stable obese subjects liquid emptying was faster and solid emptying similar to those in normal-weight subjects. Higher caloric intakes and insulin levels were present in subjects with prolonged solid emptying; they also appeared more vigilant. Body size and composition were the only determinants suggesting a faster solid emptying in taller and muscular subjects or in subjects with more intraabdominal fat.

Adult↗

PubMed2005

Psychobehavioral and nutritional predictors of weight loss in obese women treated with sibutramine.

OBJECTIVE: To reveal whether baseline body mass index (BMI), and psychobehavioral and nutritional markers were significant predictors of the change in BMI observed after 4 and 12 months in obese women enrolled in a weight reduction program, including low-energy diet, increased physical activity, cognitive behavior therapy and sibutramine. The impact of changes in psychobehavioral and nutritional markers observed after 4 and 12 months of treatment on BMI changes was also investigated. DESIGN: During a double-blind placebo-controlled 4-month period, subjects received either sibutramine (10 mg/day) or placebo. Then, an open phase with sibutramine administered to all patients continued until month 12. SUBJECTS: In total, 80 obese women (age: 43.9+/-10.6 y, BMI: 36.7+/-4.8 kg/m(2)). MEASUREMENTS: The dependent variable was change in BMI while baseline BMI, mode of treatment, the Beck depression score, the three items (dietary restraint, disinhibition and perceived hunger) of the Eating Inventory (EI), energy and macronutrient intakes were independent variables. At 1-week dietary records were analyzed using a computer software for assessing energy and macronutrient intake. RESULTS: Multiple regression analysis revealed that the BMI loss at month 4 was significantly influenced by mode of treatment and initial BMI, whereas a borderline negative relationship was observed with the baseline restraint score. Baseline BMI, depression score, restraint score and total energy intake predicted weight loss at month 12. These predictive variables accounted for 43.8% of the variance in BMI loss at 12 months. When relationships between the BMI loss and changes in all included psychobehavioral and nutritional parameters were considered after 12 months of treatment, a drop in the disinhibition score of the EI appeared the only significant factor affecting the BMI decrease. CONCLUSIONS: Our results suggest that psychobehavioral and nutritional characteristics can be used as predictors of weight loss in response to a comprehensive weight management program including pharmacological treatment with sibutramine.

Adolescent↗

PubMed1989

Adipogenic activity in sera from obese children before and after weight reduction.

The adipogenic and mitogenic potentials of sera obtained from obese children before and after weight reduction and from lean control subjects were studied in clonal 3T3 L1 fibroblasts. The sera from the lean (n = 14) and obese (n = 12) children under habitual diet contained similar adipogenic activity. However, when the obese children underwent a weight-reduction program for 3 wk (600 kcal/d), the potential of their sera to stimulate glycero-phosphate dehydrogenase, an index of adipogenic activity, was significantly reduced by 32% (p less than 0.01). Similarly, the mitogenic activity of these sera decreased significantly (202 +/- 15 vs 231 +/- 27 micrograms per dish, p less than 0.01). Testing pooled sera from the different groups in cultured rat adipocyte precursor cells gave similar results. This study suggests that human childhood-onset obesity is not accompanied by increased circulatory factors involved in the formation of new fat cells. The adipogenic and mitogenic activity of sera from obese children may be influenced by long-term dietary restriction.

Adipose Tissue↗

PubMed2001

Relationship between total and regional bone mineral density and menopausal state, body composition and life style factors in overweight Japanese women.

OBJECTIVE: To investigate whether menopausal state, body composition and lifestyle factors influence total and regional bone mineral density in overweight Japanese women. DESIGN: Cross-sectional study of women who were recruited to the weight reduction program held at community-based health promotion center in Tokyo area. SUBJECTS: A total of 178 women with a mean age of 48 y old (20-69 y) with a clear menstrual history and BMI over 24. MEASUREMENTS: Total, regional and lumbar spine bone mineral density (BMD) and body composition were measured using DXA (Lunar). Menstrual history was taken by a questionnaire and walking steps per day and energy intake were measured. Physical fitness was assessed by cardio-respiratory fitness and leg extension power. Subjects were divided into pre-menopausal and post-menopausal groups. RESULTS: Pre-menopausal group had significantly higher total body BMD as well as regional BMD than post-menopausal group. However, no differences in BMI, percentage fat and fat mass (FM) were seen between the two groups. The multiple regression analysis stepwise method revealed that total and regional BMD correlated with menopausal state and total FM independently. Total and regional BMD did not correlate with total non-fat soft tissue mass (NFSM), energy intake, walking steps or physical fitness levels. Trunk and lower extremities BMD correlated with corresponding regional FM and NFSM, and upper extremities BMD correlated with only corresponding body part NFSM after adjusting menopausal state. CONCLUSION: Total and regional BMD had strong negative correlation with menopausal state rather than total FM in overweight Japanese women. Weight-bearing site BMD correlated with corresponding body part FM and NFSM and non-weight bearing site BMD only correlated with corresponding body part NFSM after adjusting for menopausal state.

Absorptiometry, Photon↗

PubMed1995

Three-factor eating questionnaire and the use and liking of sweet and fat among dieters.

The aim of this study was to examine whether the cognitive restraint, disinhibition and hunger factors of the three-factor eating questionnaire (TFEQ) can differentiate between low and high use, desired use and liking of various sugar- and fat-containing foods. A questionnaire with items on 44 foods and the TFEQ was obtained from 253 women taking part in weight reduction program. Principal component analysis was used to divide the foods into ten groups by their reported usage. The cognitive restraint factor was related to the reported use of some food groups such as fruit-based sweet foods, butter, margarine and regular-fat cheese, but not to the desired use or liking. High disinhibition and hunger scores were related to frequency of reported and desired use and to liking of several food groups (e.g., sweets, pastries served with coffee, fruit-based sweet foods, butter and margarine). Those scoring highest on cognitive restraint and lowest on disinhibition and hunger reported using all food groups less frequently than those with the lowest scores on restraint and the highest scores on disinhibition and hunger, except low-fat cheese and yogurt. These groups also differed in the desired use and liking of most sweet foods.

Adolescent↗

PubMed1988

Mortality rate, causes and predictive factors of death in severely obese patients.

Several studies have investigated the relationship between obesity and mortality or cardiovascular disease (CVD) reporting conflicting results. The very few data collected on extremely obese patients have shown an increased mortality in these patients compared to the general population. Two hundred and sixtyfour (182 f, 82 m) severely obese patients (BMI greater than or equal to 35 w/h2) living in Southern Italy (hospitalized from 1972 to 1985 in our Metabolic Unit for a weight reduction program) were followed-up for a mean period of 7.1 years. Twentynine (20f, 9m) deaths were recorded during the follow-up. Higher mortality was found at all ages and in both sexes in these patients when compared to the general italian population. The excess mortality reached its peak in the age range 25-54 yrs (observed/expected mortality rate was 6.9 in females and 4.32 in males) diminishing by aging in both sexes (3.52 in females and 1.56 in males in age range 55-72 yrs). Death from CV disease was found more frequent than in the general italian population but it was unable to fully explain the excess mortality. Predictive factors of mortality were: in females age, BMI, and serum glucose and in males only age. In conclusion severely obese patients living in Southern Italy have a very high mortality rate. The excess mortality is not fully explained by cardiovascular disease.

Actuarial Analysis↗

PubMed2005

Orlistat for obesity: benefits beyond weight loss.

Orlistat lowers lipids and improves insulin sensitivity, but its effect on other metabolic syndrome related parameters is not known. To assess its influence on adiponectin, high sensitive C-reactive protein (hs-CRP) and other metabolic syndrome related parameters, this study enrolled 106 participants in a weight-reduction program and categorized them into a group of 51 who had been treated with orlistat 360 mg/day for one year and a group of 55 age and sex and body mass index (BMI) matched controls. The orlistat group had greater changes in BMI, % body fat (% BF), waist circumference, and insulin resistance, hs-CRP, leptin and adiponectin levels after one year on the program than the controls. After adjusting for % BF and waist circumference, change of serum leptin and adiponectin levels remained significantly different. It was found that orlistat could effectively manage obesity related co-morbidities, especially insulin resistance and atherosclerosis risk. It decreases leptin and increases adiponectin independent of % BF and waist circumference. Therefore, orlistat appears to have anti-diabetic and anti-atherogenic properties and may help prevent metabolic syndrome in the overweight people.

Adult↗

PubMed2003

Correlation between serum resistin level and adiposity in obese individuals.

OBJECTIVE: Resistin is associated with insulin resistance in mice and may play a similar role in humans. The aim of our study was to examine the relationship of serum resistin level to body composition, insulin resistance, and related obesity phenotypes in humans. RESEARCH METHODS AND PROCEDURES: Sixty-four young (age 32 +/- 10 years), obese (BMI 32.9 +/- 5.6), nondiabetic subjects taking no medication, and 15 lean (BMI 21.1 +/- 1.3) volunteers were studied cross-sectionally. Thirty-five of the subjects were also reevaluated after 1.5 years on a weight reduction program entailing dieting and exercise; changes of serum resistin were compared with changes of BMI, body composition, fat distribution, and several indices of insulin sensitivity derived from plasma glucose and serum insulin levels measured during 75-g oral glucose tolerance test. RESULTS: In a cross-sectional analysis, serum resistin was significantly higher in obese subjects than in lean volunteers (24.58 +/- 12.93 ng/mL; n = 64 vs. 12.83 +/- 8.30 ng/mL; n = 15; p < 0.01), and there was a correlation between resistin level and BMI, when the two groups were combined (rho = 0.35, p < 0.01). Although cross-sectional analysis in obese subjects revealed no correlation between serum resistin and parameters related to adiposity or insulin resistance, longitudinal analysis revealed change in serum resistin to be positively correlated with changes in BMI, body fat, fat mass, visceral fat area, and mean glucose and insulin (rho = 0.39, 0.40, 0.44, 0.50, 0.40, and 0.50; p = 0.02, 0.03, 0.02, <0.01, 0.02, and <0.01, respectively). DISCUSSION: Resistin appears to be related to human adiposity and to be a possible candidate factor in human insulin resistance.

Adipose Tissue↗

PubMed2002

Homocysteine and psychological traits: a study in obesity.

OBJECTIVE: Total serum homocysteine is a risk factor for cardiovascular disease in the general population. Further, homocysteine might be the link between psychological traits (namely anger and hostility) and cardiovascular disease, mediated by stressful events and sympathetic nervous tone. METHODS: We measured total plasma homocysteine levels and psychological traits in 205 obese individuals entering a weight-reduction program (162 females; age range, 17-64 years; body mass index, 37.7 +/- 6.2 kg/m(2), mean +/- standard deviation). Psychometric assessment was performed with three self-administered questionnaires (Symptom Checklist 90, composed of nine subscales including Hostility/Anger and Depression scales; Beck Depression Inventory; and Binge Eating Scale). RESULTS: Homocysteine levels were moderately increased in obese individuals when compared with the normal population and higher in males (median, 12.9 micromol/L; range, 6.9-26.3) than in females (9.8; 4.6-24.6; P < 0.0002), but not different in relation to the severity of obesity. Serum folate and vitamin B12 were normal. Psychometric testing showed pathologic data in up to 50% of patients and the Anger/Hostility scale was positive in 24%, mainly female, subjects. There were no differences in psychological traits in relation to the severity of obesity. Homocysteine did not correlate with Symptom Checklist 90 values or other values of psychometric testing. CONCLUSIONS: In obese persons, psychological traits are not major determinants of total homocysteine. A different response to stressful events, not simply mediated by sympathetic nervous tone, might be present in obesity.

Adolescent↗

PubMed1995

Low molecular weight proteinuria in Chinese herbs nephropathy.

Urinary excretion of five low molecular weight proteins (LMWP) [beta 2-microglobulin (beta 2m), cystatin C (cyst C), Clara cell protein (CC16), retinol-binding protein (RBP) and alpha 1-microglobulin (alpha 1m)], albumin and N-acetyl-beta-D-glucosaminidase (NAG) were quantified in 16 patients who followed a weight reduction program which included Chinese herbs, which have been incriminated in the genesis of Chinese herbs nephropathy (CHN). An additional group of four patients transplanted for CHN were investigated. Urinary data were obtained for comparison purpose in five groups of proteinuric patients: two groups with normal serum creatinine (SCr) and glomerular albuminura [12 patients with diabetes mellitus and microalbuminuria (DN), 10 patients with primary nephrotic syndrome (NS)]; two groups with normal SCr and toxic nephropathy [6 patients with analgesic (AN), 9 patients with cadmium nephropathy (CdN)]; and one group of seven patients with glomerular diseases and increased SCr (GN). Patients were classified according to serum level S beta 2m to take into account the possibility of overflow proteinuria at S beta 2m > or = 5 mg/liter. Three patients (CHN0) with a S beta 2m < 5 mg/liter, had a normal urinary protein pattern including NAG and a normal S beta 2m. Eight patients (CHN1) with a S beta 2m < 5 mg/liter had various abnormalities of their urinary protein pattern. In four of them (CHN1a) only beta 2m, RBP and CC16 were increased while total proteinuria and SCr were normal. In the other four (CHN1b and c) albumin, cyst C, alpha 1m and NAG were also elevated, while total proteinuria and SCr were moderately raised. Five patients (CHN2) with a S beta 2m > or = 5 mg/liter had a markedly increased excretion of all LMWP, albumin and NAG (CHN1 vs. CHN2, P < 0.05) as well as a further increase in total proteinuria and SCr. The urinary LMWP/albumin concentration ratio was strikingly higher in CHN patients than in patients with glomerular albuminuria (CHN1 vs. DN and NS, P < 0.01) or moderate renal failure with elevated S beta 2m level (CHN2 vs. GN, P < 0.01), confirming the existence of a tubular proteinuria independent of glomerular albuminuria or overflow proteinuria. A similar proteinuria pattern was present in the two toxic nephropathies (CdN and AN). This pattern was no longer recognizable after transplantation. In conclusion, CHN exhibits various profiles of tubular proteinuria which are the hallmarks of the disease. This pattern is still detectable in patients with renal failure and/or glomerular albuminuria. It is identical to that observed in cadmium and analgesic nephropathies. It does not recur after transplantation. Its most sensitive and reliable marker is a raised urinary level of CC16 or RBP.

Adult↗

PubMed2002

Global and dimensional self-esteem in preadolescent and early adolescent children who are overweight: age and gender differences.

OBJECTIVE: To examine age and gender differences in global and dimensional self-esteem in children who are overweight. METHOD: As part of a pretreatment assessment, the Perceived Competence Scale for Children was completed by 121 children (ages 8-14) who were overweight and enrolling in a weight reduction program. RESULTS: Gender differences in general self-esteem and age differences in physical self-esteem were found. Also, girls who were highly overweight reported lower physical self-esteem than girls who were moderately overweight. However, for boys, the opposite pattern emerged. For both boys and girls, cognitive and social self-esteem predicted general self-esteem and physical self-esteem did not. DISCUSSION: Children who are overweight may emphasize dimensions of their self-esteem in nongender stereotyped ways that are protective of their general self-esteem. Understanding developmental trends and gender differences in self-esteem can enhance our ability to assist youth who are overweight in maintaining favorable self-evaluations.

Adolescent↗

PubMed1990

Foods with different satiating effects in humans.

The aim of this study was to identify particular properties of foods that can affect satiety. Two levels (50 and 200 kcal) of three preloads (tomato soup, melon, cheese on crackers) were given just before two different second courses (macaroni and beef casserole, grilled cheese sandwiches), allowing us to examine the effects of caloric level, energy density, and sensory-specific satiety on food intake in normal weight, non-dieting males. Eating time and initial palatability ratings were held constant. Soup was found to reduce second course intake significantly more than the other preloads. This reduction could be partially accounted for by the low energy density of tomato soup; however, soup reduced intake more than the melon preload, which was matched for energy density. Sensory-specific satiety did not explain the satiating efficiency of the soup. Thus, during a meal, tomato soup is more satiating than the melon and cheese on crackers. Further studies are required to determine why these foods have different effects and to determine whether soup consumption can be beneficial in weight reduction programs.

Adult↗

PubMed1991

Dietary restraint and disinhibition: is restraint a homogeneous construct?

The homogeneity of the restraint construct is investigated in a study of 54,525 subjects participating in a weight reduction program. Using the German version of the TFEQ (Stunkard & Messick, 1985, Journal of Psychosomatic Research, 29, 71-83; Pudel & Westenhoefer 1989a, Fragebogen zum Essverhalten; Handanweisung), it is shown that different types of relations exist between the items measuring dietary restraint and the disinhibition scale. A discriminant analysis in a subgroup of moderately highly restrained eaters with either low or high disinhibition (n = 1759) reveals different sets of restraint behaviours and cognitions that differentiate between high and low disinhibition. These findings are replicated in an independent validation sample (n = 1693). Two restraint subscales are constructed, one associated with increasing disinhibition, the other with decreasing disinhibition. It is argued that different sets of restrained behaviours and cognitions should be differentiated when looking at the causal link between restraint and disturbances of eating behaviour.

Adult↗

PubMed1982

The role of anticipated deprivation in overeating.

With recent research supporting a cognitive explanation of overeating, two experiments were designed to test the theory that the anticipated deprivation associated with dieting may lead to overeating once restraint is broken. In each of 2 experiments, 50 female undergraduates were preloaded and randomly assigned to no deprivation and deprivation conditions. The latter group anticipated a 4-hour food deprivation between two experimental sessions, while the former did not. The amount of food consumed during a 15-minute free eating period served as the dependent measure. Restraint scale scores were used to divide subjects into low-restraint and high-restraint groups. In Experiment 1, deprivation subjects ate significantly more than no deprivation subjects, F(1, 56) = 5.02, p less than .05; in Experiment 2, high-restraint subjects ate significantly more than low-restraint subjects, F(1, 56 = 5.07, p less than .05. The possible role of contextual cues is explored, and implications for weight-reduction programs are outlined.

Cues↗

PubMed1997

Inhibition of lipid absorption as an approach to the treatment of obesity.

A reduction in fat intake may be achieved by making educated choices to reduce total calorie intake, to consume a lower quantity of total fats, or to modify the ratio of saturated-to-polyunsaturated lipids. Leptin agonists or NPY or CCK antagonists may prove to be useful to diminish appetite and thereby reduce the total intake of food. But eating has such cultural, social, and hedonistic attributes that such a single-pronged approach is unlikely to be successful. The use of fat substitutes may prove to be popular to provide a wide range of snack food options, but these are likely to be of minimal use in weight reduction programs because of their distribution of additives in only a limited number of foods. The inhibitors of lipid digestion will be modestly successful in the short term; their long-term success will be influenced by gastrointestinal adverse effects and the need to consume fat-soluble vitamin supplements to prevent the development of fat-soluble vitamin deficiencies. The inhibition of lipid absorption is an attractive targeted approach for the treatment of obesity, since this would reduce the uptake of visible as well as invisible fats, which would potentially offer convenient dosing, and could also be a means to inhibit secondarily the uptake of carbohydrate calories.

Animals↗

PubMed1998

Mirror, mirror on the wall, who's the thinnest one of all? Effects of self-awareness on consumption of full-fat, reduced-fat, and no-fat products.

Two studies tested whether self-focusing situations influence people to avoid fatty food. In Study 1, college students tasted full-, reduced-, and no-fat cream cheese spreads on bagelettes. A large mirror was present in the room for some students and was absent for the remaining students. In Study 2, shoppers at large supermarkets tasted full-, reduced-, and no-fat margarine spread on bread. A large mirror was present on the table top for some shoppers and was absent for the remaining shoppers. In both studies, individuals in the mirror group ate less of the full-fat product than did those in the no-mirror group. The presence of a mirror did not influence consumption of reduced- and no-fat products, perhaps because people thought these products were not unhealthy. These findings support self-awareness theory and suggest that individuals on weight reduction programs may benefit from making food choices in self-focusing situations.

Adolescent↗

PubMed1997

Determinants of resting energy expenditure in obese non-diabetic caucasian women.

OBJECTIVE: To investigate the determinants of resting energy expenditure (REE) in obese non-diabetic Caucasian women. DESIGN: A cross-sectional survey study before the beginning of a weight-reduction program. SUBJECTS: 141 obese, non-diabetic women of Caucasian origin (BMI 34.8 +/- 3.7 kg/m2, age 43.2 +/- 8.0 y, mean +/- s.d.). MEASUREMENTS: Resting energy expenditure (an indirect calorimetry), body composition (a bioelectrical impedance), fat distribution (anthropometry) and heart rate (ECG) were determined after 12 h overnight fast and apolipoprotein E phenotype was examined. RESULTS: In a linear multiple regression analysis fat-free mass, fat mass and age together with heart rate and waist-hip ratio emerged as significant determinants of REE. In the other regression model, also serum insulin emerged as a significant determinant of REE, in addition to fat-free mass, fat mass and age. There was no significant differences in REE among the different apolipoprotein E phenotype groups. CONCLUSION: Besides fat-free mass, also fat mass, age, heart rate, waist-hip-ratio, and serum insulin level make a significant contribution to REE in obese women.

Adipose Tissue↗

PubMed2004

Insulin resistance and ferritin as major determinants of nonalcoholic fatty liver disease in apparently healthy obese patients.

OBJECTIVES: The aims of this study were to test the possible association between nonalcoholic fatty liver disease (NAFLD) and iron and insulin resistance, and to determine the prevalence of NAFLD in apparently healthy obese subjects. DESIGN: Cross-sectional, clinical epidemiologic study. SUBJECTS: A total of 210 apparently healthy obese patients, aged from 18 to 65 y, with a body mass index (BMI) of 28 kg/m2 or more, were enrolled in a body weight reduction program in our hospital. MEASUREMENTS: All the subjects underwent screening and preprogram examinations, including anthropometric data measurements, biochemistry testing, and ultrasonography of the liver. NAFLD was defined as fatty liver diagnosed by ultrasonography plus persistent elevation of alanine aminotransferase (ALT) levels. RESULTS: Of the 210 patients, 80% (168/210) had fatty liver. Persistent ALT elevation in two separate tests was further detected in 25.6% (43/168) of patients. Multiple logistic regression analysis showed waist circumference and insulin resistance to be independently associated with fatty liver. Serum ferritin level and insulin resistance were two major risk factors predicting NAFLD. CONCLUSION: The prevalence of NAFLD was 20.5% (43/210) in obese patients. As both hyperinsulinemia induced by insulin resistance and iron overload represented by ferritin elevation might damage hepatocytes, we concluded that these two factors were significantly associated with NAFLD in obese patients.\

Adolescent↗