PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Weight Reduction Programs”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 127 records · Page 7Linked to original sources

Culturally-sensitive weight loss program produces significant reduction in weight, blood pressure, and cholesterol in eight weeks.

Dietary and behavioral needs of special populations are rarely considered in traditional weight loss programs. This study assessed the impact of culturally-sensitive modifications to the Duke University Rice Diet weight loss program for African-American dieters. The study was a randomized modified cross-over study in which volunteers received either early or delayed weight loss intervention. Final outcomes were measured at 8 weeks. At the onset of the study, there were 56 African American participants, however, only 44 (79%) completed the study. The eight-week intervention was a modified 1000-calorie/day version of the Rice Diet. Modifications to the program included decreased cost, culturally-sensitive recipes, addressing attitudes about exercise, and including family members in weight loss efforts. Average weight loss for subjects completing the program was 14.8 pounds (SD = 6.8 pounds). BMI decreased from 37.8 kg/m2 to 35.3 kg/m2 (p < 0.01). Total cholesterol levels decreased from 199.2 mg/dL to 185.4 mg/dL (p < 0.01); systolic and diastolic blood pressure decreased by 4.3 mmHg (p < 0.01) and 2.4 mmHg (p < 0.05), respectively. The control group showed no significant change in any outcome measures. We found that diet programs can be successfully tailored to incorporate the needs of African-Americans. Most importantly, these dietary program changes can lead to significant improvement in clinical parameters. Additional studies are necessary to determine the permanence of these short-term changes.

Adult↗

Leptin levels in obese children: effects of gender, weight reduction and androgens.

Obesity in children is accompanied by increased circulating leptin concentrations. Girls have higher leptin concentrations than boys. The aim of our study was to compare serum leptin levels before and after a five-week weight reduction program and to study the relationship of leptin levels, serum total cholesterol, and androgens (testosterone, dehydroepiandrosterone, dehydroepiandrosterone sulphate) in 33 obese boys (age: 12.7+/-1.97 years, BMI: 30.46+/-4.54) and 66 obese girls (age: 12.7+/-2.51 years, BMI: 29.31+/-4.62). We found that serum leptin concentrations in obese children were significantly decreased after a weight reduction program (before 20.79+/-9.61 ng/ml, after 13.50+/-8.65 ng/ml in girls; before 12.25+/-10.09 ng/ml and after 5.18+/-3.56 ng/ml in boys, p<0.0001 in both genders). Leptin levels correlated positively with the body mass index before and after weight reduction. There was a positive association in obese boys and a negative one in obese girls between leptin levels and the WHR (waist to hip circumference ratio). Serum leptin also shows a strong relationship to fat distribution (p=0.02 in boys, p<0.0001 in girls). No significant correlation was found between leptin concentrations and total cholesterol or androgens. We confirmed that leptin is a sensitive parameter of body composition and weight reduction in obese children.

Adolescent↗

Two forms of disordered eating in obesity: binge eating and night eating.

OBJECTIVE: Binge eating disorder (BED) and the night eating syndrome (NES) have been linked to obesity. This review summarizes their characteristics, implications of their diagnoses and treatment outcomes. METHOD: Selective review of the literature on BED and NES. RESULTS: BED was proposed as a distinctive disorder on the basis of two large multisite studies in the early 1990s. It is associated with more severe and earlier onset of obesity, earlier onset of dieting and greater psychopathology. It shows large placebo responses and reduction of bingeing in patients on waiting-list controls. Traditional weight reduction programs reduce bingeing at least as well as psychological treatments designed for this purpose. NES is a stress-related eating, sleeping and mood disorder that is associated with disordered neuroendocrine function. It follows a characteristic circadian pattern and has responded to an agent that enhances serotonin function. CONCLUSIONS: BED responds well to weight reduction programs. It is proposed that this diagnosis be used as a marker for psychological problems that deserve treatment in their own right. NES is an eating, sleep, and mood disorder with distinctive behavioral and neuroendocrine characteristics. Studies of treatment for NES are in their infancy but selective serotonin reuptake inhibitors (SSRI) show promise.

Bulimia↗

Peptide YY is a regulator of energy homeostasis in obese children before and after weight loss.

CONTEXT: The gut hormone peptide YY(3-36) (PYY) reduces food intake via hypothalamic Y2 receptors in the brain. There is not much known about PYY in obese children. OBJECTIVE: The objective of this study was to investigate the role of PYY in the metabolic changes in obese children and its change during weight loss. SETTING: The study was performed at a university medical center. PARTICIPANTS: We studied 73 obese children and 45 age-matched normal-weight children. INTERVENTIONS: We determined fasting serum total PYY and leptin by RIA in obese and normal-weight children. Fasting PYY was also measured in 28 obese children before and after completion of a 1-yr outpatient weight reduction program. MAIN OUTCOME MEASURES: PYY, insulin, and body mass index were the main outcome measures. RESULTS: Obese children demonstrated significantly lower PYY levels than lean children (median, 67 vs. 124 pg/ml; P < 0.001). Fasting PYY correlated negatively to the degree of overweight. PYY levels did not differ significantly between boys and girls, nor between prepubertal and pubertal children. The group of patients participating in the outpatient weight reduction program was divided into four quartiles according to their changes in body mass index SD score over a 1-yr period. PYY increased significantly in patients with the most effective weight loss, but decreased in the subgroup of children with weight gain. CONCLUSIONS: PYY is negatively correlated to the degree of overweight, with reduced values in obese compared with normal-weight children. Decreased PYY levels could predispose subjects to develop obesity. Our results indicate that low pretreatment PYY levels that increase during weight loss may be a predictor of maintained weight loss.

Case-Control Studies↗

Eating pattern and self-esteem in overweight women.

Recent studies have shown that the relationship between poor self-esteem and disturbed eating patterns may be more fully understood when the self-esteem concept is divided into an affective domain ('self-liking') and a cognitive domain ('self-competence'). In the present study 38 overweight women between the ages of 21 and 68 participated in an 8-week weight reduction program whereby the Self-Liking and Competence Scale [SLCS] and the Eating Disorder Scale [EDS-5] were used in order to measure self-esteem and eating patterns, respectively. An improvement in the eating patterns corresponded to an improvement in self-liking, but not in self-competence. Statistically significant weight reduction did occur, but on the average, the subjects still remained overweight. As in other studies on normal weight individuals in analogous test situations completing the same instruments, the results point only to a specific relationship between disturbed eating patterns and self-liking. The results suggest that an increased benefit from a weight reduction program could be expected if strategies for improving eating patterns and self-liking are included. This hypothesis warrants further controlled treatment studies.

Adult↗

Lipoprotein metabolism in normolipidemic obese women during very low calorie diet: changes in high density lipoprotein.

We examined changes in high density lipoprotein (HDL) metabolism during a very low calorie diet weight reduction program in 6 massively obese normolipidemic women. The diet protocol consisted of a 1st low calorie diet (LCD; 1440, 1280, and 880 kcal daily for 1 week, each, in succession), a 1st very low calorie diet (VLCD; 420 kcal daily for 4 weeks, using Optifast 70), intermission (880 kcal daily for 1 week), the 2nd VLCD (4 weeks) and the 2nd LCD (880 and 1280-1440 kcal daily for 1 week, each). Mean body weight reduction was 18.9 kg. HDL-cholesterol, more specifically HDL2-cholesterol, reduced transiently during the 1st VLCD, intermission, and 2nd VLCD periods, and tended to increase in the 2nd LCD. Apolipoprotein (apo) A-I showed a similar change to HDL-cholesterol. However, apo A-II decreased persistently throughout the weight reduction program, and the apo A-I/apo A-II ratio increased significantly in the later part of the program. Serum triglyceride, apo B, and lipoprotein lipase (LPL) activity in post-heparin plasma did not change. These data suggest that the observed decrease in HDL-cholesterol was not due to a reduction in very low density lipoprotein-derived HDL production or to an LPL deficiency, but was consistent with reduction in chylomicron-derived HDL formation following dietary fat restriction.

Adult↗

Validation of the flexible and rigid control dimensions of dietary restraint.

OBJECTIVE: Two subscales for the Eating Inventory (Three-Factor Eating Questionnaire) are developed and validated: Rigid and Flexible control of eating behavior. METHOD: Study I is an analysis of questionnaire data and a 7-day food diary of 54,517 participants in a computer-assisted weight reduction program. Study II is a study of 85 subjects used to develop a final item pool. Study III is a questionnaire survey of a random sample (N = 1,838) from the West German population aged 14 years and above used to validate the developed subscales. RESULTS: Rigid control is associated with higher scores of Disinhibition, with higher body mass index (BMI), and more frequent and more severe binge eating episodes. Flexible control is associated with lower Disinhibition, lower BMI, less frequent and less severe binge eating episodes, lower self-reported energy intake, and a higher probability of successful weight reduction during the 1-year weight reduction program. DISCUSSION: Rigid and flexible control represent distinct aspects of restraint having different relations to disturbed eating patterns and successful weight control.

Adolescent↗

Medication cost savings associated with weight loss for obese non-insulin-dependent diabetic men and women.

BACKGROUND: The cost of diabetes mellitus can be defined in both medical and economic terms. Although there is an abundance of literature concerning the medical management of diabetes, few studies have assessed the financial impact of its treatment. This study examined the savings in prescription costs associated with a weight reduction program for obese men and women with non-insulin-dependent diabetes mellitus (NIDDM). RESEARCH DESIGN AND METHODS: Forty subjects ages 40-70 years who had body mass indexes of 30-40 kg/m2 and NIDDM of more than 1 year duration were assigned to one of two 800-kcal weight-loss programs for 12 weeks. A cost analysis was done on the 32 subjects who were taking anti-hypertensive and/or anti-diabetes medications. A list of medications and monthly amounts was obtained at the start, upon completion, and 1 year following completion of the diet. The average out-of-pocket cost for a month's supply of each prescription was calculated by polling 16 retail pharmacies in Lexington, Kentucky. RESULTS: Subjects lost an average of 15.3 kg (33.7 lb) over the 12 weeks. At 1-year follow-up, subjects maintained a mean 9.0-kg (19.8 lb) weight loss. The average monthly prediet out-of-pocket cost for anti-hypertensive and anti-diabetes medications and supplies was $63.30 per subject. Following completion of the diet, this cost per month decreased to $20.40 and at 1-year follow-up the average monthly cost per subject was $32.40. The estimated average savings in prescription costs per subject over the year was $442.80. CONCLUSIONS: Significant short- and long-term savings in prescription costs were obtained following a 12-week hypocaloric weight reduction program for obese individuals with NIDDM.

Adult↗

A study of electrical conductance of meridian in the obese during weight reduction.

This study was designed to investigate the electrical conductance of meridian in the obese during weight reduction. Ten obese including overweight (Body Mass Index, BMI > 26) and 30 healthy (non-overweight) people were recruited from Chung Yuan Christian University. The obese subjects were instructed to follow a weight reduction program that included diet control, exercise and oral intake of Prozac. A device, the design of which is based on the Ryodoraku theorem, was used to measure the electrical conductance of 12 meridians on both sides of the subjects. The results showed that: (1) the average coefficient of variation of the electrical conductances in 24 meridians of the obese group was statistically different from that of the healthy group (p < 0.05); (2) the average coefficient of variation of electrical conductance in the obese after weight reduction was significantly decreased than before the weight reduction program (p < 0.05); (3) the BMI and the electrical conductance of meridian was correlated in the obese (r = -0.77, p < 0.001) as well as in the healthy group (r = -0.92, p < 0.001). These findings suggest that electrical conductance of meridians can be a parameter to monitor weight, especially for obese people.

Adult↗

Leptin serum levels in normal weight and obese children and adolescents: relationship with age, sex, pubertal development, body mass index and insulin.

OBJECTIVE: Leptin, the product of the ob gene, is present in higher concentrations in blood of obese subjects than of lean subjects. There is scarce information on the role of leptin in the pathogenesis of human obesity and little is known about leptin serum levels in obese children. DESIGN, SUBJECTS AND MEASUREMENTS: To evaluate the influences of age, sex, pubertal development and weight excess on serum leptin levels, we have studied 390 obese subjects (OS) and 320 normal weight subjects (NWS) aged 5-16 y. Fasting insulin concentrations were assayed in NWS, and an oral glucose tolerance test was carried out in OS and total insulin area under the curve (TIA) was calculated. RESULTS: Log-transformed values of leptin serum concentrations appeared to be distributed according to an acceptable Gaussian pattern. As observed in adults, serum leptin concentrations in children and adolescents were also increased (4-5 times) in OS as compared to NWS. In both males and females, subdivided according to pubertal stages, serum leptin varied significantly in stage IV-V as compared to the lower stages, with a reduction in males and an increase in females. On comparing the two sexes, greater serum leptin concentrations were observed in females of both NWS and OS. A significant linear correlation was found in both groups, subdivided according to sex and pubertal stage, between log values of serum leptin and standard deviation scores (SDS) of body mass index (BMI), and log-transformed relative body weight (RBW). Using partial correlation analysis in subjects subdivided according to sex and pubertal stages, log values of serum leptin and fasting insulin values, adjusted by age and SDS of BMI, correlated significantly with a weaker correlation in males than in females. In OS, the leptin concentrations correlated better with TIA than with fasting insulin. A weight reduction program (WRP) was carried out in 141 OS and significant reductions of serum leptin and fasting insulin were observed, showing a reduction of RBW. There was a correlation between the reduction of RBW and of serum leptin, but not of fasting insulin. No variation was found in non-responsive OS. RBW reduction correlated with leptin, but not with insulin (fasting and TIA), evaluated before the therapeutic program started. CONCLUSION: As observed in adults, obese children and adolescents have higher serum leptin concentrations. However, several conditions should be taken into account when evaluating leptin concentrations in children. There are differences, independent of BMI, relative to pubertal stage and sex, females having greater leptin concentrations than males. There is evidence of a possible role for leptin in the effectiveness of a weight reduction program in OS.

Adolescent↗

Magnesium and obesity: effects of treatment on magnesium and other parameters.

Obesity, a well-known phenomenon in Western society, is frequently associated with cardiovascular and endocrine disease. Strokes, myocardial infarction, diabetes and hyperlipidemia are classical reasons for the high mortality and morbidity of overweight people. For this reason, intensive weight-reduction programs have been proposed: low-calorie diets, total starvation, drugs and even surgery. Total starvation and some low-calorie diets are, however, also associated with sudden death, most probably of cardiac origin. Experimental data from our laboratory show that total starvation is accompanied by a severe depletion of magnesium in myocardial tissue. Protein-sparing modified low-calorie diets, however, can protect against this mineral loss even if magnesium supplementation alone cannot obtain this goal. Applying these principles in overweight man show weight reduction without mineral loss or cardiac disturbance. Surgery with 'ileal bypass' procedures gives rise to severe hypomagnesemia and hypocalcemia with tetany and spasmophilia. New procedures, derived from experimental surgery, are 'gastric bypass' and 'gastroplasty'. These methods, only applied in very obese patients (body mass index greater than 40, normal 23-27) show no change in mineral concentrations of calcium and magnesium and no clinical symptoms suggestive for mineral loss. A good, controlled weight-reduction program under strict medical surveillance can, in this way, offer new perspectives in the treatment of one of our most frequent 'culture-induced' diseases.

Adult↗

Periodic health examination, 1994 update: 1. Obesity in childhood. Canadian Task Force on the Periodic Health Examination.

OBJECTIVE: To update the 1979 Canadian Task Force on the Periodic Health Examination recommendation on screening for childhood obesity by reviewing any new evidence concerning health risks in childhood and adulthood, and effective preventive or therapeutic interventions. OPTIONS: Detection: routine measurement of height and weight, use of skinfold thickness measurements, calculation of body mass index (BMI). INTERVENTION: diet, exercise, behaviour modification and comprehensive family-based weight-reduction programs. Components of these interventions could be offered routinely or reserved for children and families who perceive obesity to be a present or potential problem. OUTCOMES: The task force reviewed the probability of obese children become obese adults as a risk factor for adult heart disease and overall related illness and death in adult life as well as obesity as a risk factor for physical and psychologic illness in childhood. EVIDENCE: A MEDLINE search for relevant articles published between January 1981 and February 1991 was undertaken. VALUES: The task force's evidence-based rules for recommendations were used. BENEFITS, HARMS AND COSTS: If weight reduction in childhood were shown to prevent physical or psychologic illness in childhood, or illness and death in adult life, screening and treatment should be recommended. Screening for obesity may cause anxiety on the part of the child and family; malnutrition in children as a result of parents becoming overly anxious about the health risks of obesity has been reported. Most weight reduction programs have limited long-term effectiveness and can be costly. RECOMMENDATIONS: There is insufficient evidence of short-term or long-term benefits from screening for or treatment of childhood obesity to recommend such screening or recommend against it. There is fair evidence to recommend against very-low-kilojoule diets for preadolescents. There is insufficient evidence to recommend for or against exercise programs or intensive family-based programs for most obese children. VALIDATION: These recommendations are similar to those of the American Academy of Pediatrics and the US Preventive Services Task Force. SPONSOR: These guidelines were developed and endorsed by the Canadian task force, which is funded by Health Canada.

Adolescent↗

Weight control and exercise.

Obesity in the United States can truly be called a national epidemic. The associated health risks and diseases present a tremendous drain to the economy. The most effective program to lose and maintain a desirable body weight incorporates a combination of restriction in caloric intake with an increase in caloric expenditure through exercise. A gradual approach of losing 1 or 2 pounds per week has proved to be the most effective. Men should strive to maintain approximately 15% body fat and women 25% body fat. Weight-reduction programs that demonstrate phenomenal weight loss in a short period will not work over the long term and may represent a significant health risk. The ability to lose fat and maintain a desirable body weight is not easy but can be attained through a firm commitment to a healthy life style.

Adipose Tissue↗

Treatment of hypertension in obese patients: efficacy and feasibility of weight and salt reduction programs.

The effect of three different nutrition counselling programs on well established hypertension was studied in 64 obese patients regularly attending a hypertension clinic. The 12-month program of weekly-monthly group sessions focused on weight reduction (W group, n = 24), salt restriction (S group, n = 17) or both (WS group, n = 23). The mean (+/-SEM) weight decreased by 6.9 +/- 0.7 kg in the W group (p less than 0.001) and by 5.0 +/- 0.6 kg (p less than 0.001) in the WS group during the first three months of the study and levelled off thereafter. The weight changes in the S group were small during the trial. The mean 24-hour urinary sodium excretion in the WS and S groups was reduced by about 35 and 50 mmol, respectively, during the first months of the study, and fell thereafter somewhat in the S group but not in the WS group. Sodium excretion remained unchanged in the W group. Systolic and diastolic blood pressure (BP) fell significantly in the W and WS groups during the first months of the study. BP remained thereafter stable in most patients but declined further in one fifth of them. BP changed little during the trial in the S group. By 12 months, BP control was improved in 67, 61 and 12% of the patients in the W, WS and S groups, respectively. Improved BP control was strongly related to weight loss but not to reduced sodium excretion. Weight reduction programs with even modest success help most obese patients with established hypertension, whereas moderate salt intake restriction gives little added benefit.

Adult↗

Use of very low-calorie diet in preoperative weight loss: efficacy and safety.

We report the efficacy of a very low-calorie diet (VLCD)-based weight reduction program in patients with morbid obesity whose elective surgery had been postponed because of being overweight. The safety of weight loss on the immune system will also be evaluated. Thirty patients (mean age, 50 years; weight, 125 kg; BMI, 44 kg/m2) were treated. The program consisted of a 7-week to 24-week VLCD period, supported by individual sessions with a therapist, and of a refeeding period of 1 month before surgery. Two patients discontinued, and the mean weight loss of the remaining 28 patients was 19.6 kg (15% of initial weight). In 23 patients, weight loss was 10% or more of the initial weight. After weight loss, 15 patients underwent surgery, 4 patients did not need an operation, and the remaining 9 patients were not operated on for various reasons. The numbers of circulating leukocytes, neutrophils, basophils, monocytes, CD3+, CD4+, CD8+, and natural killer cells did not change significantly by the ninth week on VLCD or by the end of the program. However, there was a significant (p < 0.05) decrease in the immunoglobulinM serum concentration during the program. In conclusion, a VLCD program is suitable for preoperative weight reduction in morbid obesity and seems not to compromise the immune system.

Adolescent↗

[Experiences with a behavior-therapeutic group program for weight reduction].

26 obese persons were treated in 3 groups of similar size with a behavior modification programme. The group sessions were led by a physician and a socialpsychologist and lasted 10 weeks. The average loss of weight in the 3 groups at the end of the programme was between 3,8 and 5,5kg. The results form a basis for developing a new and more broadly aimed programme.

Behavior Therapy↗

The effect of target behavior monitoring on weight loss and completion rate in a behavior modification program for weight reduction.

Although behavior modification of obesity is usually described as a behavior change procedure, measurement is most often limited to the outcome variable of weight loss. The present investigation employed detailed behavior monitoring forms in half of 16 obesity groups (n = 173) matched across four different therapists. The percentage of compliance for nine specific treatment behaviors was charted from these monitoring forms. At the end of treatment, the eight groups that had the behavior monitoring treatment averaged over 6 pounds more weight lost than the matched control groups as well as showing significantly better attendance. The between group weight loss differences were still evident 3 months after treatment.

Behavior Therapy↗

Assessment and conservative management of the overfat adolescent.

With the increasing incidence of obesity among adolescents, physicians are often asked about weight reduction programs and "ideal" body weights for patients of varying biological maturities. Morbidly obese patients are easily diagnosed; however, little differentiation is made in assessing adolescents who are considered overweight vs. overfat as defined by current growth charts. This article provides an overview of methods and norms for assessing body weight and energy needs within the context of a clinic setting and discusses the advantages and disadvantages of conservative treatment approaches: diet, exercise, and behavior modification.

Adolescent↗