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At least 307 records · Page 17Linked to original sources
PubMed1982

[Vascular diseases in lipedema of the legs. Special symptoms, common therapeutic results, viewpoint on vascular surgery].

Lipedema of the legs is a symmetrical thickening of upper and lower leg and topically accentuated fat pads. The back of the foot is usually free of swelling. Pathogenetically it is a disturbance of the distribution pattern of subcutaneous fat tissue. Epidemiologically, the subjects affected are women, starting from puberty. Weight reduction programs do not influence the real deformations. If this abnormal fat tissue is infiltrated by angiological diseases, these manifest themselves in modified form. In particular, all the symptoms are more painful. In arterial ischemic syndromes that taut skin is susceptible to necrosis at atypical locations. For reconstruction of trunk arteries it is advisable to bypass larger bulges for better wound nealing. Venous strips should be peeled out away from fat pads and venous-bridges very carefully to protect the tissue. Acute and chronic phlebothrombosis lead to unusual and asymmetrical forms of swelling. The venous ulcer lies directly beneath a fat-muff in the gaiter region. Since they are hard to compress, free skin transplants should be considered early in the course of development. Surgery of varicose veins calls for most careful technique to ensure wound healing. From the lymphological viewpoint there are clinically and lymphographically mixed forms of lymphedema with lipedema.

Adipose Tissue↗
PubMed1978

Protein diets for obesity: metabolic and clinical aspects.

The alleged benefits of protein diets remain unproven, since research data on the safety and long-term utility of protein products as the principal or only source of nutrients for weight reduction programs are as yet insufficient. First, it is uncertain whether the decreases in body protein turnover occurring with these diets are consistent with normal function over long periods, though net balance of protein is obtained. Second, the main advantage to the patient is the suppression of appetite by the ketoacidosis, but it is the ketoacidosis that causes many of the untoward effects. Third, the addition of carbohydrate to a protein diet does not mitigate the benefit of the protein and prevents most of the untoward effects. Fourth, there is clearly no advantage of "predigested" proteins (which are generally poorer in quality than normal high-protein foods) except for the psychologic factor of being given "medication" for the "disease" of obesity. Fifth, there is a distinct danger of deficiencies of micronutrients developing with prolonged consumption of unsupplemented diets. Sixth, the cardiac disorders associated with death in persons taking these diets have not been shown to be coincidental rather than a direct consequence of the diets.In the present state of understanding of protein diets, they should be supervised only by specially trained physicians in rigorous multidisciplinary programs, preferably those with ongoing research. Only individuals free from contraindications should be so treated. Until compelling data proving the safety and efficacy of these diets are forthcoming, the general public should be counselled against their use.

Acidosis↗
PubMed1995

Alberta hospital tries to boost revenue by attracting gastroplasty patients from US.

The fate of a surgical weight-reduction program at the 25-bed hospital in Cardston, Alta., is in limbo as Alberta's Conservative government decides whether it will allow the hospital to keep profits made by performing gastroplasty on American patients last year. Cardston Municipal Hospital, which has had more than 1200 Canadian banded-gastroplasty patients since 1979, began recruiting American patients from Montana and Idaho last year. However, rumours that the Klein government will reduce the regional health authority's operating budget by an amount equal to the hospital's profit have jeopardized the program's future. The hospital first marketed the program in the US to cushion short-falls in government funding.

Alberta↗
PubMed1993

Abdominal vibration alters sleep state in fetal sheep.

Many pregnant women are exposed to low frequency sounds and vibrations while at work or play. How the fetus is affected by these physical stimuli is not clearly documented. We recorded behavioral state and intrauterine sound pressure levels in eight fetal sheep previously instrumented with electrocortical, electroocular and neck electromyographic leads, and with a miniature hydrophone. Data were collected before, during and after 30 min of abdominal vibration using a belt vibrator commonly used by humans in weight reduction programs. A sudden shift in behavioral state occurred at the onset of vibration. There was a decrease in non-rapid eye movement sleep (P < 0.02) and an increase in time during which the sleep state could not be determined (P < 0.03). A 63% increase in number of epochs spent in this indeterminate period was evident during vibration. During the post-stimulus period, percentage of time spent in rapid eye movement sleep decreased as compared to the pre-stimulus period (P < 0.04), and non-rapid eye movement sleep increased as compared to the stimulus period (P < 0.01). Vibration-induced intrauterine sound pressures ranged from 131-142 dB at the fundamental frequency of 19 Hz and were 20-40 dB lower at the overtones which appeared in the spectrum between 35-200 Hz. Results indicated that environmental vibration can disrupt fetal behavioral state, induce abnormal state changes, and alter distribution of sleep states.

Acoustic Stimulation↗
PubMedDate not supplied

[Effects of fiber administration in the prevention of gallstones in obese patients on a reducing diet. A clinical trial].

Nearly 30% of the obese patients treated with hypoenergetic diets for weight reduction develop gallstone disease (GD). Until the present time, the use of ursodeoxycholic acid (UDA) is the only available therapeutic measure to avoid the development of GD. Dietary fiber induce a bile acid synthesis. A double-blind clinical trial was conducted to compare the effect of rational diet plus UDA vs a rational diet supplemented with Psyllium plantago (Pp) for the prevention of GD in obese subjects undergoing a weight-reduction diet. Patients with a body mass index (BMI = weight in Kg/square height in m) of 30 Kg/m2 or more and with normal gallbladder and biliary tree ultrasound (GBUS) were included. Weight-reduction diets were individually calculated for each patient according to their energy expenditure (EE). Patients were randomly and blindly assigned either to group I (diet + 750 mg UDA + fiber placebo) or group II (diet + 15 g Pp+ UDA placebo). An anthropometric evaluation was performed to each patient before and after the two-month treatment, as well as resting EE by indirect calorimetry, GBUS and endoscopy for the determination of cholesterol crystals in duodenal bile. Weight reduction was similar in both groups (group I = 6 +/- 2 Kg vs group II = 6 +/- 3 Kg). GD development was observed in one patient of group I (5.5%) and two patients of group II (p > 0.05). All patients with GD lost a minimum of 4 Kg during the study period. GD development did not correlate with the presence of crystals in the duodenal bile at the beginning of the study. Our results suggest a beneficial effect of a rational diet with fiber supplementation to prevent GD development in obese patients included in a weight reduction program.

Adult↗
PubMed1998

Acute interstitial nephritis following treatment with anorectic agents phentermine and phendimetrazine.

A 47-year-old mildly obese female began a weight reduction program that included anorectic therapy with phentermine and phendimetrazine. A normal urinalysis and serum creatinine were documented at the start of therapy. After three weeks of treatment, the patient felt ill and discontinued her treatment. Subsequently she was found to have leukocyturia, a rash on her face and chest, and a rise in her serum creatinine from 0.8 mg/dl to 2.1 mg/dl. A renal biopsy confirmed the diagnosis of acute interstitial nephritis. The patient was treated with corticosteroids and her renal function returned to normal. Despite the recent withdrawal of two anorectic agents due to data linking them to severe cardiac and pulmonary disease, the appetite suppressants phentermine and phendimetrazine remain in widespread usage for the treatment of obesity. This case represents the first report of acute interstitial nephritis associated with phentermine or phendimetrazine.

Acute Disease↗
PubMed2005

A short-term cognitive group treatment program gives substantial weight reduction up to 18 months from the end of treatment. A randomized controlled trial.

OBJECTIVE: To describe and evaluate long-term efficacy (18 months from the end of treatment) of a new cognitive short-term weight reducing treatment program for obese patients. SUBJECTS: One hundred and five obese [Body Mass Index (BMI) > or = 30] patients participated in the study. Of these, 62 took part in the treatment program and 43 served as controls. METHOD: From an obesity unit's waiting list, the patients were randomly assigned to either a treatment group or remained in the waiting list to serve as a control group. The treatment group participated in a 10-week (30 hours) cognitive group treatment program. All participants were weighed at the outset of the study, directly after treatment and at a 6-, 12- and 18-month post-treatment follow-up without any booster treatment after the 10-week program. RESULTS: Fifty-seven (92%) patients completed treatment. For the 34 (60%) patients who participated in the study 18 months after treatment was terminated, the mean weight loss at treatment's end was 8.5 kg (SD=16.1). Eighteen months later their mean weight loss was 10.4 kg (SD=10.8). The control patients (n=31.72%) that participated in the study during the same period increased in weight by 2.3 kg (SD=7.0). The weight difference between the treatment and control group at the 18-month follow-up was highly significant (p<0.001). CONCLUSION: The cognitive group treatment program was highly acceptable among the participants and was completed by nearly all the patients. The 10-week treatment program resulted in satisfactory weight loss. The weight difference between the treatment group and controls was nearly the same at 18 months after end of treatment as at six months. The study, therefore, does not provide support for the contention that a lengthy therapy for obesity is necessary if treatment results are lasting.

Cognitive Behavioral Therapy↗
PubMed1980

An evaluation of behavioral techniques reinforced with an anorectic drug in a double-blind weight loss study.

Sixty obese outpatients participated in a double-blind comparison of diethylpropion hydrochloride and placebo in conjunction with a behavior modification program for weight reduction. Assessments of efficacy and program acceptance included total weight loss, percent of initial (baseline) weight loss, percent excess weight lost, effectiveness of overall program, and helpfulness of medication. Diethylpropion was significantly better than placebo in all five assessments. An added behavioral technique, a substantial refundable deposit of money, reduced the attrition rate of all study entrants from 50% to 10%; thus patient compliance was greatly enhanced.

Adult↗
PubMed2003

Short-term changes of fatigability and muscle performance in severe obese patients after an integrated body mass reduction program.

The effects of a short-term (3-week) integrated body weight reduction (BWR) program on fatigue perception and on lower limb anaerobic power output were evaluated in 200 severely obese in-patients (40 males and 160 females, age: 18-83 yr, BMI: 35.0-65.3 kg/m2). Fatigue was assessed by a 7-point Likert-type scale questionnaire (Fatigue Severity Scale, FSS), while average lower limb power output (W) during a maximal effort was determined with a modification of the Margaria test for stair climbing. In both genders, total FSS score was influenced by both age and obesity level, resulting significantly (p < 0.001) lower in younger subjects (< 45 yr) than in older (> 45 yr) and in patients with lower BMI (< 40 kg/m2) than in those with a higher one (> 40 kg/m2). An opposite trend was observed in W. The 3-week BWR integrated program with moderate aerobic exercise and free standing and ground gymnastic routines induced a significant reduction in body weight (p < 0.001), in total FSS score (p < 0.001) and a significant increase in W, both in absolute terms (p < 0.05) and relative to body mass (p < 0.001). Total FSS score and absolute or relative power output were positively correlated both before and after the BWR program (p < 0.001, Wilcoxon rank test). It is concluded that: a) subjective fatigue perception, assessed by a FSS questionnaire, can be considered an indirect indicator of effective lower limb power output in severely obese patients and, b) in spite of a relatively small, although significant, decline of BMI, the full-time participation in a hospital-based, integrated BWR program with moderate exercise activity is associated with significant short-term improvements of both fatigue sensation and power output. Dia

Adolescent↗
PubMed1992

Compartmental change after weight reduction in childhood obesity.

Ten obese children aged 8-13 years participated in a 4-week program of weight reduction. Dietary restriction of 800 kcal/day and mild exercise were the two features of the program. With this regimen the investigators expected that their lean body mass would be preserved while body fat would decrease. After the 4-week program, we found that those who were mildly and moderately obese lost more than 5 per cent of their body fat but less than 1 per cent of lean body mass. Those children with morbid obesity lost more than 5 per cent of body fat and lean body mass. It is concluded that the regimen is suitable for mild and moderate obesity, but for morbid obesity, a new regimen with higher energy and higher protein in the diet may be more suitable than the current one.

Adolescent↗
PubMed2000

Obesity prevalence by age group and 5-year changes in adults residing in rural Wisconsin.

OBJECTIVE: To estimate the prevalence of overweight and obesity and weight changes over a 5-year period in a rural adult population by age group. SUBJECTS: Residents of Marinette County, Wis: 613 women and 352 men. METHODS: Age, body weight, and height data were collected during October and December 1997 in a volunteer convenience sample of white men and women (aged 20 to 74 years). Age groups in 10-year increments were defined by age in 1992. Weights obtained from medical and employment records from 1992 by medical personnel, as well as self-reported weights, were recorded for 1992 to assess weight changes from 1992 to 1997. RESULTS: In 1992 women and men had mean body weights of 72.1 and 88.4 kg, respectively. By 1997, the average weight for women in the same data set was 79.3 and that for men was 96.4 kg, a gain of 7.3 and 7.9 kg, respectively. For both women and men, those in the youngest age group (age 20 to 30 years) experienced the greatest 5-year increase in body weight: 11.0 and 12.1 kg, respectively; the next largest increase occurred in the second youngest group (age 30 to 40 years). The majority of the normal-weight subjects (58%, 229 of 393) moved into an overweight or obese category, the overweight and obese generally gained weight, and only 20 of 572 overweight or obese individuals moved from an unhealthful to a healthful body weight during the 5 years. APPLICATIONS/CONCLUSIONS: The data indicate a need for community-wide weight-gain prevention programs for young adult men and women in rural areas. Weight-reduction treatment programs should be geared toward older adults, as most have already attained an unhealthful weight, which is likely to increase.

Adult↗
PubMed1976

A weight control program for students using diet and behavior therapy.

A twelve-week weight-reducing program for students was conducted at the University of Kentucky. The program, which was developed and directed by graduate students in nutrition, utilized a combination of behavior therapy and diet therapy. Initiated in the spring of 1975, the program has been continued in the 1975-76 year. All students completing the program achieved weight reduction. Their weight losses averaged 2/3 lb. a week. The dropout rate for the program was 40 per cent. One-third of the participants completing the program reached their weight-reduction goals. These results suggest that further attempts should be made to improve weight-reducing suitable for college students.

Adult↗
PubMed1986

Energy balance and blood-pressure regulation. Update and future perspectives.

The relationship of blood pressure to body weight within populations is well documented: it is also generally accepted that the body mass index, as well as the change in body mass index over time, are predictive of risk for future hypertension. Short-term clinical trials suggest that satisfactory blood-pressure control can be more easily achieved in obese hypertensive subjects by a successful program of weight reduction. On the other hand, the pathophysiological aspects of the association between excessive weight and high blood pressure are still obscure; particularly the putative role of hyperinsulinemia, as well as exaggerated sympathetic activity, need to be confirmed. Recent evidence indicates that upper body fat predominance and low habitual physical exercise may be factors contributing to the increase in blood pressure, but the importance of still other factors, such as associated abnormalities of cell cation transport, has to be further elucidated. From the therapeutic point of view, there is a strong need for controlled trials to confirm feasibility and effectiveness of long-term programs of weight reduction as a means to control hypertension in the obese. Based on these considerations and the enormous potential for primary prevention, the problem of energy balance and blood-pressure regulation stands as a most important issue for future cardiovascular research.

Adult↗
PubMed1996

Effect of fluvoxamine on total serum cholesterol levels during weight reduction.

BACKGROUND: The effect of fluvoxamine versus placebo on serum cholesterol levels in obese women undergoing behavior therapy for weight reduction was evaluated. METHOD: Forty obese female outpatients undergoing 13 weeks of a behaviorally oriented treatment program for weight reduction were randomly assigned to double-blind treatment with fluvoxamine 100 mg/day (N = 18) or placebo (N = 22). Total serum cholesterol levels were measured before and after the 13-week study period. RESULTS: Patients of the two treatment groups did not differ in age, weight, body mass index, cholesterol levels before treatment, and the extent of weight reduction during treatment. Cholesterol levels were significantly lower after fluvoxamine treatment than before, whereas cholesterol levels remained unaltered after placebo administration. Patients with initially high total cholesterol levels (> or = 200 mg/dL) showed a significantly larger reduction than patients with desirable cholesterol levels. However, there was no interaction between treatment and initial cholesterol level. CONCLUSION: The results might suggest a cholesterol-lowering effect of fluvoxamine.

Adult↗
PubMed2003

Ghrelin secretion in severely obese subjects before and after a 3-week integrated body mass reduction program.

Ghrelin, the endogenous ligand of GH-secretagogue receptors, has been implicated in the regulation of feeding behavior and energy balance. Aim of the study was to investigate ghrelin levels in fasting conditions and after a standard meal test in obese subjects before and after a 3-week integrated body weight reduction (BWR) program (consisting of energy-restricted diet, exercise training, psychological counselling and nutritional education). Weight, height, fat mass, fat free mass (by impedentiometry), circulating ghrelin, insulin and leptin levels were evaluated in 10 obese subjects (3 male, 7 female; mean age: 35 +/- 9.3 yr; body mass index BMI: 45.2 +/- 10.6 kg/m2) before and after weight reduction. At baseline, obese subjects showed significantly lower ghrelin levels than controls, which were negatively correlated with BMI, weight, insulin and leptin levels. Fasting ghrelin levels were not modified by standard meal test in obese subjects (from 110.8 +/- 69.7 to 91.8 +/- 70.2 pmol/l p=ns), while a significant reduction was observed in controls (from 352.4 +/- 176.7 to 199.0 +/- 105.2 pmol/l; p<0.01). After a 3-week integrated BWR program obese subjects significantly reduced weight, BMI and leptin levels, while no significant changes were found both in fasting ghrelin and in ghrelin response after the meal. In conclusion, 5% weight loss obtained after a short-term period of integrated BWR program is not sufficient to normalize fasting ghrelin levels nor to restore the normal ghrelin suppression after a meal in severely obese subjects.

Adult↗