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Results for “Weight Reduction Programs”

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PubMed1982

Childhood versus adult onset obesity in a comprehensive, multidisciplinary weight reduction program.

The weight loss of 16 obese patients (greater than 130% ideal body weight) who participated for three months in a comprehensive, multidisciplinary weight reduction program was studied. Patients were divided into two groups based on the reported time of onset of their obesity. Childhood-onset obesity was defined in this study as marked weight gain by the age of 11. Adult-onset obesity was defined as weight gain occurring at 18 years of age or later. Each group of patients consisted of two males and six females. The childhood-onset obesity group lost significantly more weight than the adult-onset obesity group during this three-month period (19.45 +/- 3.6% versus 16.17 +/- 2.8%). This preliminary study suggests that patients with childhood-onset obesity tend to lose more weight in a comprehensive multidisciplinary weight reduction program than patients with adult onset obesity.

Adult↗

PubMed1995

Serum cholesterol and triglyceride levels in weight reduction program dropouts.

Dropouts of a weight reduction program are not evaluated for the lasting effects of weight reduction. This study was an attempt to learn about the benefits of weight reduction received and sustained by the dropouts of the program. Ninety-seven males and females dropping out of a dietary weight management program after 16-18 weeks of treatment, and after 9-9.4kg weight loss and wishing to rejoin the program for a second time after at least 9 months' absence from it, were considered for the study. Their body weight, serum cholesterol, serum triglyceride, and blood sugar levels at the beginning of the second attempt, were compared with the respective values at the beginning of the first attempt. All patients had regained the weight lost during their first attempt when they reported for a second attempt. However, serum cholesterol and triglyceride values were 15% and 26% less for females, and 17% and 24% less for males, compared to their respective values on the first attempt, in the subgroup of patients with normal blood sugar levels. In the subgroup with above normal blood sugar levels, however, serum cholesterol and triglyceride values showed an increase by 12% and 17% respectively, for females, and by 2% and 7% respectively, for males, compared to their baseline values on their first attempt. The mechanism responsible for this observation was not uncovered. However, the observation that even an incomplete attempt at weight reduction appears to contribute in maintaining lower levels of serum cholesterol and triglyceride of at least those with normal blood sugar levels, is useful in nutritional counseling for emphasizing the health benefits of the weight reduction.

Adult↗

PubMed1995

Changes in lean body mass in obese children during a weight reduction program: effect on short term and long term outcome.

OBJECTIVE: To study the changes in body composition during a weight reduction program in obese children and adolescents. DESIGN: A short-term longitudinal study. SUBJECTS: Forty-one obese children and adolescents (19 M, 22F, age 8.5-14.8 [median 11.8] years. MEASUREMENTS: Lean body mass (LBM) was estimated from Resistance Index (RI) obtained by Bioelectrical Impedance Analysis (BIA) before and after the 3 week program. RESULTS: Mean percentage weight for height at baseline was 151 (s.d. 20)% and significantly decreased at the end of the three weeks (139 (s.d. 18)%, P = 0.005). The mean percentage body fat also decreased (from 46.0 s.d. 5.8% to 41.5 s.d. 6.5%, P = 0.0015). All individuals lost body fat during the three weeks, whereas the change in LBM was heterogeneous. The individual change in body fat was inversely correlated with the change in LBM (r = -0.64, P = 0.0001). After 4 months, 18 out of the 41 children could be reevaluated for height and weight. The regain in body weight during these 4 months was inversely correlated with the change in LBM during the weight reduction program (r = -0.55, P = 0.018). CONCLUSIONS: Changes in LBM during a weight reduction program can predict the short term result those children who manage to increase LBM having the greatest reduction in body fat. Changes in LBM during weight reduction seem also to predict the longterm outcome, a reduction in LBM being associated with greater regain of weight. Weight reduction programs for obese children should focus not only on weight loss but also on maintenance or increase of lean body mass to improve longterm results.

Adolescent↗

PubMed2003

[Body weight fluctuation and life-style change after short-term weight reduction programs].

PURPOSE: The purpose of this study was to assess the adherence rate after short-term weight reduction programs and to clarify the related life-style factors in community-residing obese women. METHOD: The study subjects were 243 women who completed twelve-week weight reduction programs held at the health promotion center in Tokyo from 1992 to 1999. The program consisted of exercise training and individualized diet education once a week. They were instructed to increase their daily walking steps. A mail-survey using a present body weight, walking steps, and diet any habits questionnaire was conducted in November 1999. RESULTS: 128 women (54%) responded to the questionnaire. They were 51.6 +/- 9.6 years old and 4 years had passed on average after the program. Among these, 126 women provided their present body weight. Their mean BMI was 26.7 +/- 2.6 and 25.5 +/- 2.6 before and after the program respectively. Their present BMI was 25.8 +/- 2.9 which was significantly higher than the value immediately after the program (P < 0.01). 54 women (42.9%) increased their BMI by more than 1 kg/m2 after the program (rebound-group). 24 women (19.0%) decreased their BMI by more than 1 kg/m2 and 28 women (22.2%) maintained their ideal BMI defined as less than 24 kg/m2 after the program (adherent-group). In the other 20 women (15.9%), BMI did not change significantly after the program, but their present BMI was over 24 (27.4 +/- 2.8). The mean present daily walking-steps were significantly lower in the rebound than the adherent-group although the percentage with a exercise habit did not differ between the two groups. Diet any behavior was also more favorable in the adherent-group. CONCLUSION: After 4 years on average from the end of short-term body-weight reduction programs, 42.9% of the participants had regained their original weight. Maintaining increased physical activity and a favorable diet is important for persistent weight reduction in obese women.

Adult↗

PubMed1979

The development and evaluation of a behavioral weight-reduction program.

The development of a comprehensive weight-reduction program and its implementation in the clinic are described. The program consisted of explicit instructions on food monitoring, stimulus control, chaining, exercise, and self-reinforcement. The results of pilot research indicated that the program produced reliable weight loss and that its implementation in a group format was more positive. A formal experiment evaluated the effectiveness of program components in a 2 x 2 factorial design after ten weeks of treatment and at three-month and one-year follow-ups. There was significant weight loss with no main or interaction effects. At follow-up, those exposed to exercise and/or contingency management better maintained their weight loss or continued to lose. Data on the implementation of the program in a clinical setting are presented and these results compare favorably with reports from other clinics using behavior modification. It is suggested that our more positive results may be related to an emphasis on activity and life-style change in addition to changing eating behavior.

Adolescent↗

PubMed2002

Psychobehavioral response and weight loss prediction in a hospital-based weight reduction program.

BACKGROUND AND PURPOSE: Depression and binge eating are common adverse psychologic responses associated with weight loss in overweight and obese adults. This study aimed to assess the effects of different degrees of weight loss on psychologic functioning and the relationship between mood change and weight reduction, and to identify predictors of short-term weight loss among subjects in a hospital-based weight reduction program. METHODS: A total of 189 obese subjects who participated in a hospital-based weight-reduction program during a 12-week interval were enrolled in this study. They ranged in age from 18 to 67 years (mean, 40.5 +/- 12.3 yr) with female predominance (87.8%). Mean body weight was 79.3 +/- 13.9 kg and mean body mass index was 31.1 +/- 3.8 kg/m2 on entry into the program. Body weight was periodically measured and subjects were asked to complete two self-administered questionnaires including the Brief Symptom Rating Scale (BSRS) and the Bulimic Investigatory Test, Edinburgh (BITE), pre- and post-treatment. RESULTS: Using the last observation carried forward method of analysis, the average weight loss for all participants was 5.6 +/- 3.7 kg. For subjects who completed the 12-week program, weight loss was 6.6 +/- 3.6 kg. Subjects who completed the program (n = 115, 60.8%) had significantly reduced BITE as well as all BSRS subscale scores at the end of the program. There was no linear relationship between mood change and weight loss by correlation analysis, but subjects with higher degrees of weight loss had improvement in more dimensions of psychologic functioning. Initial mood and binge-eating status predicted neither compliance nor weight reduction. Two biologic factors (initial weight loss, initial body weight) and one behavioral factor (attendance rate) were identified as significant predictors of short-term weight loss for all subjects. CONCLUSIONS: There was no evidence that weight loss made mood or eating pathology worse among those who completed the weight loss program. Beneficial effects on general psychologic functioning and eating pathology were demonstrated for subjects with a minimal weight loss of 5% of initial weight and who completed the program. Psychologic assessments at the start of the program did not predict weight loss at the end of participation in this hospital-based weight loss program.

Adolescent↗

PubMed2004

A weight reduction program preserves fat-free mass but not metabolic rate in obese adolescents.

OBJECTIVE: To determine the effects of a multidisciplinary weight reduction program on body composition and energy expenditure (EE) in severely obese adolescents. RESEARCH METHODS AND PROCEDURES: Twenty-six severely obese adolescents, 12 to 16 years old [mean BMI: 33.9 kg/m(2); 41.5% fat mass (FM)] followed a 9-month weight reduction program including moderate energy restriction and progressive endurance and resistance training. Body composition was assessed by DXA, basal metabolic rate by indirect calorimetry, and EE by whole-body indirect calorimetry with the same activity program over 36-hour periods before starting and 9 months after the weight reduction period. RESULTS: Adolescents gained (least-square mean +/- SE) 2.9 +/- 0.2 cm in height, lost 16.9 +/- 1.3 kg body weight (BW), 15.2 +/- 0.9 kg FM, and 1.8 +/- 0.5 kg fat-free mass (FFM) (p < 0.001). Basal metabolic rate, sleeping, sedentary, and daily EE were 8% to 14% lower 9 months after starting (p < 0.001) and still 6% to 12% lower after adjustment for FFM (p < 0.05). Energy cost of walking decreased by 22% (p < 0.001). The reduction in heart rate during sleep and sedentary activities (-10 to -13 beats/min), and walking (-20 to -25 beats/min) (p < 0.001) resulted from both the decrease in BW and physical training. DISCUSSION: A weight reduction program combining moderate energy restriction and physical training in severely obese adolescents resulted in great BW and FM losses and improvement of cardiovascular fitness but did not prevent the decline in EE even after adjustment for FFM.

Adolescent↗

PubMed1997

Counseling clinic for pediatric weight reduction: program formulation and follow-up.

The feasibility and efficacy of an outpatient-based multicomponent weight reduction program was tested with 68 consecutively enrolled obese children and adolescents. The patients were invited to participate in an individualized six-session program that included parent involvement, diet education, exercise management and behavior modification by a culturally sensitive method. Fifty-six patients were followed up 1 year after treatment. Comparison at pretreatment, end-of-treatment and 1-year-after-treatment with respect to changes in degree of obesity, measured by weight-for-length index (WLI), showed statistically significant differences. Ninety-seven percent of participants were below their pretreatment WLI at the end-of-treatment examination, and 80% at 1-year-after-treatment follow-up. At 1-year-after-treatment, 59% showed a reduction in WLI of 0.1 or more, as compared with 38% of participants at end-of-treatment. Two parameters previously considered predictors of successful weight control, notably age of participants and percentage of weight lost during treatment, were significantly associated with a reduction in the degree of obesity after one year. Although the long-term efficacy cannot be determined, our results indicated that this comprehensive weight reduction program may have an encouraging effect on the weight status of obese Chinese children and adolescents.

Adolescent↗

PubMed1993

[Parent-directed weight reduction program for obese children: model formulation and follow-up].

To investigate the effect of a parent-directed weight reduction program on childhood obesity, a prospective 12-month follow-up study was performed at an outpatient clinic in a district general hospital. Sixty obese children, who, together with their parents received a free of charge weight reduction program, were compared with 52 obese controls who refused the program. The program included knowledge of childhood obesity and ways to decrease calories and increase physical activity; emphasized family participation and behavior modification; and stressed parent direction and self-responsibility. Complete outcome information relating to weight and height changes and a compliance questionnaire was available for 70.5% of these children after 1 year. Twenty three (48.9%) of the 47 children in the treatment group showed a decrease in the percentage they were overweight, compared to only six (18.8%) of the 32 control children. The mean changes in percentage overweight showed a decrease of 2.3% for the treatment children and an increase of 3.1% for the control children. Of the 23 children who were more successful during therapy, two had normal weight, 5 were overweight and 16 remained obese. Child height was not changed after weight reduction in those children in the treatment group who were more successful. The degree of compliance was significantly correlated to the change in percentage overweight. A decrease in percentage overweight was not significantly predicted by sex, age, or severity of obesity of the children, nor by whether the children were excessive eaters or partook in insufficient physical activity prior to the treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed2001

Changes in lipoprotein(a) levels and hormonal correlations during a weight reduction program.

BACKGROUND AND AIM: To examine the effects of a weight reduction program on serum lipoprotein(a) [Lp(a)] levels and investigate whether the hormonal modifications occurring during weight loss may explain the changes in Lp(a) levels. METHODS AND RESULTS: This longitudinal clinical intervention study of a low-calorie diet involved 62 healthy obese patients (21 men aged 32 +/- 9.6 years and 41 women aged 37 +/- 14.6 years). Their anthropometric parameters (weight, height, body mass index, waist-to-hip ratio), fasting serum lipid levels, hormones (total testosterone, estradiol, total triiodothyronine, insulin), sex hormone binding globulin (SHBG) and blood sugar levels were determined at baseline and after six weeks of dietary treatment. A 7.5% loss in initial body weight was achieved and there was a statistically significant decrease in serum total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides (p < 0.001). No changes in Lp(a) levels were observed in the study population as a whole, but there was a 17.6% (p < 0.05) reduction in the subjects with high pre-treatment Lp(a) values (> 20 mg/dL). The decrease in Lp(a) levels closely correlated with initial Lp(a) levels (r = 0.81 p < 0.001), but did not correlate with changes in anthropometric parameters or the hormonal modifications occurring during the weight loss. CONCLUSIONS: A low-calorie diet associated with weight loss in obese subjects may have beneficial effects on serum Lp(a) levels in patients with high pre-treatment Lp(a) concentrations. This effect seems to be independent of the hormonal changes observed during weight loss.

Adult↗

PubMed2004

A cognitive-behavioral weight reduction program in the treatment of obstructive sleep apnea syndrome with or without initial nasal CPAP: a randomized study.

BACKGROUND AND PURPOSE: To evaluate (a) whether an active weight reduction strategy based on the cognitive-behavioral approach and an initial very-low-calorie diet might lead to short- and long-term weight loss and alleviation of OSAS; and (b) whether the results of this intervention could be enhanced by combining it with nasal continuous positive airway pressure (CPAP) treatment during the first 6 months. PATIENTS AND METHODS: Thirty-one obese male symptomatic sleep apnea patients underwent a 2-year weight reduction program with total follow-up of 36 months from baseline. The mean age (+/-SD) was 49.1+/-7.9 years, body mass index 43.8+/-5.4, and oxygen desaturation index (ODI4) 51.3+/-31.1. The patients were randomized to CPAP (17 patients) and non-CPAP groups (14 patients). RESULTS: The mean weight loss was 19.1+/-10.2 kg (14% of the original weight) for the whole group at 6 months, 18.3+/-13.2 (13%) at 12 months and 12.6+/-14.7 kg (9%) at 24 months. Excellent or good treatment results, as defined in terms of an ODI4 (average number of oxygen desaturation events p/h>4% from baseline) reduction of at least 50% from the baseline, were seen in 61% of patients at 6 months and were still observable in 42% of patients at 24 months. The correlations between changes in weight and in ODI4 were 0.59 (P<0.01) at 6 months, 0.68 (P<0.01) and 0.75 (P<0.01) at 24 months. Adding CPAP treatment to the weight reduction therapy for the first 6 months did not result in greater weight loss or diminution of desaturation indices (without CPAP) at any time point. One year after the termination of the program the mean weight loss was 6.6+/-12.9 kg, and 42% of patients still showed at least 5% weight loss as compared with their original weight. CONCLUSION: Satisfactory weight loss associated with improvement of OSAS could be achieved by means of a cognitive-behavioral weight loss program. Adding CPAP in the initial phase of the weight reduction program did not result in significantly greater weight loss.

Adult↗

PubMedDate not supplied

Postmenopausal women lose less visceral adipose tissue during a weight reduction program.

OBJECTIVE: Visceral adipose tissue (VAT) is increased in the postmenopausal state, which may contribute to an increase in cardiovascular diseases. This study was undertaken to investigate whether there is a difference in the change of VAT during a weight reduction program between premenopausal and postmenopausal obese women. DESIGN: This study was a longitudinal clinical intervention of a weight reduction program, including lifestyle modification and adjuvant pharmacotherapy, for 12 weeks in 21 premenopausal and 19 postmenopausal obese women. Weight, height, body fat percentage, and waist and hip circumferences were measured. Visceral, subcutaneous, and total adipose tissue of the abdomen were determined by CT scan at the level of L4-L5 before and after weight reduction. RESULTS: The percent changes in VAT and the visceral-to-subcutaneous adipose tissue ratio, as well as waist circumference and waist-to-hip ratio, in the postmenopausal women were significantly less than those in the premenopausal women, whereas the percent changes in hip circumference, fat mass, total adipose tissue, and subcutaneous adipose tissue were similar in the two groups. The association between percent changes of VAT and the percent change of waist circumference is stronger in postmenopausal than in premenopausal women. CONCLUSIONS: The postmenopausal women lost less VAT compared with the premenopausal women during the weight reduction program. This may make it more difficult for postmenopausal women to overcome the increased risk of cardiovascular diseases compared with premenopausal women.

Abdomen↗

PubMed2000

Changes of bioelectrical impedance after a body weight reduction program in highly obese subjects.

We used bioelectrical impedance analysis (BIA) as an exploratory tool to monitor the changes in body composition induced by a short-term (3-wk) weight reduction (energy-restricted diet, moderate aerobic exercise conditioning and psychological counselling) in 175 highly obese subjects (body mass index, BMI=41.7+/-5.8 kg/m2). The decrease in weight and BMI after the weight reduction program was 3.4% (geometric mean, p<0.0001) and 3.7+/-1.3 kg/m2 (mean+/-SD, p<0.0001), respectively. Bioelectrical impedance (Z) increased of about the same value at each of the measured frequencies (from 6+/-10% at 5 kHz to 5+/-9% at 100 kHz, mean+/-SD, p<0.0001). A statistically significant increase in Z5:Z100 was also seen (p<0.0001), but its clinical significance is questionable owing to its low absolute value (<1%). Taken together, these data suggest that no clinically relevant change in body water distribution occurred in our subjects as a result of the weight reduction program. However, the changes in Z did not satisfactorily predict the changes in anthropometric dimensions despite the evidence of a substantial association between Z and anthropometry both before and after the weight reduction program. Thus, accurate predictions of body composition changes in obese subjects may require more than two BIA measurements so as to have a better description of the weight-losing process.

Adult↗

PubMed1995

Relationship among self-esteem, internal-external locus of control, and weight change after participation in a weight reduction program.

This report covers 15 to 47 months of follow-up study of 66 obese women who participated in a 10-week weight reduction program. Subjects were divided into three self-esteem groups and into two groups of "internal" and "external" subjects. The average weight regain during the follow-up period was 3.1 kg, although all subjects remained below their pretreatment weight. The higher the self-esteem score, the lower the average weight regain during follow-up (1.7 kg, 2.6 kg, and 3.5 kg, respectively). For internals the average weight regain was 1.8 kg and for externals 3.4 kg. Implications are discussed, and suggestions for improved weight reduction programs are presented.

Adult↗

PubMed2003

Changes of autonomic cardiac profile after a 3-week integrated body weight reduction program in severely obese patients.

The autonomic control of the heart is abnormal in obese subjects due to a prevalence of sympathetic over parasympathetic limb of the autonomic balance. We evaluated the effects of a short-term (3 weeks) integrated body weight reduction program (consisting of energy restricted diet and high-intensity exercise training) on heart rate variability (HRV) in severely obese, normotensive patients. The HRV was evaluated both in the time and frequency domain over a 18-hour Holter recording period obtained before and at the end of the third week. Three-week body weight reduction program reduced BMI (from 41.4 +/- 4.6 to 39.5 +/- 4.3 kg/m2, -4.6%, p<0.0001) and heart rate (from 77.8 +/- 8.6 to 73.6 +/- 8.7 b/min, p=0.0003). Significant changes in the autonomic profile were observed both in the time and frequency domain (SD of RR interval, SDRR: +16.1%; mean squared successive difference: (MSSD) +16.7%; percentage of RR intervals differing more than 50 msec from the preceding one, pNN50: +31.8%; low frequency oscillation, LF: +17.1%; high frequency oscillation, HF: +/- 18.2%). In conclusion, this study demonstrates that a short-term, integrated body weight reduction program is able to favorably modify the autonomic profile in a population of normotensive, severely obese subjects. The reduction of heart rate and the increase in parasympathetic activity may consistently contribute to a reduction of the risk of cardiovascular morbidity and of sudden cardiac death, still high in this patients' group.

Adult↗

PubMed1991

The effect of a weight reduction program on cardiovascular risk factors among overweight hypertensives in primary health care.

The aim of the study was to test the effect of a nonpharmacological weight reduction program on cardiovascular risk factors among overweight hypertensives in a primary health care setting. Forty-nine overweight hypertensive patients completed the 12-month program. The patients were randomly allocated into either intervention or control groups. The examinations included interviews by a nutritionist, pertinent laboratory tests, and a medical examination. The intervention involved an individually planned energy-restricted diet of 1000-1500 kcal per day, weekly discussions, and various leaflets on diet modification and on increase of physical activity. The mean body weight was reduced by 5 kg in the intervention group, but remained unchanged in the control group. The intervention group reduced their fat intake by 14 g/day while the control group increased it by 9 g/day on the average. In the intervention group, the total serum cholesterol decreased, HDL-cholesterol increased and triglycerides decreased significantly. The systolic blood pressure fell by 8 mm Hg and 15 mm Hg in the intervention and control groups, respectively. The diastolic blood pressure fell on average by 11 mm Hg in both groups. The results demonstrate the comprehensive weight reduction program to be effective in the control of cardiovascular risk factors.

Adult↗

PubMed1981

High attrition rates in commercial weight reduction programs.

The management of obesity is increasingly dominated by nonprofessional self-helping groups. Little information about the efficacy of these groups is available from independent sources. In a study of 108 women enrolled in a commercial weight reduction program, we found very high attrition rates; 50% of the members dropped out in six weeks and 70% in 12 weeks. Similar attrition rates have been reported in five other programs in three different countries. Very high attrition rates diminish the effectiveness of commercial weight reduction programs, and they suggest caution in the interpretation of data based on weight losses of persons who remain in these programs.

Adult↗

PubMed1997

[Health risks and economic costs associated with obesity requiring a comprehensive weight reduction program].

An increasing prevalence of obesity all over the world reflects a lack of effective measures in both prevention and treatment of obesity. Obesity as a disease has been underestimated by the lay-public as well as health care providers. However, obesity represents a substantial health problem associated with a decreased quality of life. Obesity is linked to numerous chronic diseases (cardiovascular diseases, diabetes, hyperlipidemia, gout, osteoarthritis, gall-stones, and bowel, breast and genitourinary cancers) that lead to premature disability and mortality. Health risks increase with a body mass index (BMI) over 25 in individuals 19-35 years of age and with a BMI over 27 in those 35 years of age and older. Health risks also increase with an excess accumulation of visceral fat manifested as an increase in waist circumference (> 100 cm) or in waist to hip ratio (> 0.85 for females and > 1.00 for males). According to studies carried out in different countries current economic costs of obesity represent 5-8% of all direct health costs. In contrast, effective treatment of obesity results in a substantial decrease in expenditures associated with pharmacotherapy of hypertension, diabetes, hyperlipidemia and osteoarthritis. Both scientists and clinicians involved in obesity research and treatment recommend to introduce the long-term weight management programs focussing more on the overall health of the participants than the weight loss per se. Therefore, it will be necessary to establish new realistic goals in the obesity management that reflect reasonable weights and recently experienced beneficial health effects of modest (5-10%) weight loss. Comprehensive obesity treatment consisting of low fat diet, exercise, behavioral modification, drug therapy and surgical procedures requires differentiated weight management programs modified according to the degree and type of obesity as well as to current health complications present. The Czech Society for the Study of Obesity defined a comprehensive weight reduction program carried out in weight reduction clubs, out-patient obesity clinics and in specialized departments attached to the university hospitals. In order to provide an integrated knowledge from many different disciplines connected with obesity three week postgraduate course has been organized for physicians involved in obesity management. Even the most spread weight reduction clubs in our country (STOB) are supervised by the trained counselors. The main goal of different weight management programs is to find out optimal approaches leading to long-term beneficial outcome and ameliorating the variety of disorders associated with obesity.

Health Care Costs↗