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Biomedical subjects

A J Stunkard

Publications and source records attributed to A J Stunkard.

At least 145 records · Page 8Linked to original sources
PubMed1980

Caloric intake and expenditure of obese boys.

Caloric intake and expenditure of children in four families were assessed by nonparticipant observations of family dinners and school lunches. In each family there were one obese boy and one nonobese brother whose ages were within two years of each other. For family dinners the nonobese brother served as a control; for school lunches, a nonobese peer served as a control. The obese boys consumed more calories (766 +/- 290) than did their nonobese brothers at dinner (504 +/- 183) and far more (907 +/- 217) than their nonobese peers at lunch (500 +/- 386). The obese boys also ate faster (65.7 +/- 37.0 kcal/minute) than their brothers at dinner (31.7 +/- 13.8 kcal/minute) and far faster (103.5 +/- 40.9 kcal/minute) than their nonobese peers at lunch (46.2 +/- 22.5 kcal/minute). Time-sampled activity assessments showed the obese boys far less active than their controls inside the home, slightly less active outside the home, and equally active at school. When these activity values were converted into energy expenditure by measurement of oxygen consumption, obese boys expended more calories in moving than did their controls; as a result, there was no difference in energy expenditure between obese and nonobese boys at home and greater energy expenditure outside the home and at school. Increased intake, thus, and not decreased caloric output maintained the obesity of these four boys. In this respect, obesity in childhood may differ from obesity in adult life.

Adolescent↗
PubMed1980

Evaluation and modification of exercise patterns in the natural environment.

Using a new experimental paradigm to evaluate physical activity in the natural environment, the authors made of 45,694 observations of persons using stairs or an adjacent escalator at a shopping mall, train station, and bus terminal. In study 1, stair use more than doubled for both obese and nonobese persons during two-week periods when a colorful sign encouraging use of the stairs was positioned at the stairs/escalator choice point. In study 2, stair use remained elevated for 15 consecutive days while the sign was present, decreased during a 1-month follow-up period, and returned to baseline by 3 months. These results not only demonstrate the usefulness of this paradigm, but also suggest the strength of simple, inexpensive public health interventions to increase physical activity.

Adult↗
PubMed1980

Psychiatric diagnosis of morbidly obese gastric bypass patients.

Eighty morbidly obese patients who had had gastric bypass operations were interviewed for psychiatric diagnoses using DSM-III criteria. The lifetime prevalence of Axis I clinical psychiatric diagnoses was 47.5%, with depressive disorders occurring in 28.7% of the total sample. No other diagnosis exceeded a 2.5% prevalence. The authors believe there is no evidence of an increased prevalence of major psychiatric disorder in obese persons when strictly defined diagnostic criteria are used.

Adolescent↗
PubMed1980

Determination of high density lipoprotein-cholesterol in stored human plasma.

This study was performed to determine the effect of frozen and unfrozen storage on plasma high density lipoprotein (HDL) cholesterol analysis. HDL-cholesterol was determined, following removal of the other lipoproteins by precipitation with heparin and MnCl(2), in fresh plasma samples and in aliquots of the samples that had been stored 1) unfrozen (4 degrees C), up to 14 days, 2) frozen (-20 degrees C), up to 14 days, and 3) frozen (-20 degrees C), 5-6 years. There were progressive changes in measured HDL-cholesterol values under all conditions of storage. The changes were significantly and most highly correlated with HDL-cholesterol level and they reached about 4 mg/dl for each 10 mg/dl initial HDL-cholesterol concentration. Samples with low HDL-cholesterol concentrations tended to increase with storage, and those with high HDL-cholesterol levels tended to decrease. Since the changes were in opposite directions, the group means tended to be preserved. The mean differences between fresh and stored samples were (stored-fresh): 1-14 days, 4 degrees C, -0.10 to +4.60 mg/dl; 1 hour-14 days, -20 degrees C, +0.80 to +1.92 mg/dl; 5-6 years -20 degrees C, -1.92 mg/dl. Values changed most rapidly during storage at 4 degrees C and were accompanied by changes in the precipitability of the lipoproteins; low density lipoproteins became progressively difficult to precipitate completely, and HDL became progressively easier to precipitate. The measured HDL-cholesterol level depends on which process predominates and can lead to grossly inaccurate measurements, particularly at the extremes of HDL-cholesterol concentration.-Bachorik, P. S., R. Walker, K. D. Brownell, A. J. Stunkard, and P. O. Kwiterovich. Determination of high density lipoprotein-cholesterol in stored human plasma.

Blood Specimen Collection↗
PubMed1979

Obesity and food choices in public places.

More than 5,000 food choices were observed at nine eating sites--four where meals were served and five where snacks were served. Caloric content of food choice was strongly affected by eating site and there was great variability in the amount chosen at each site. Men chose somewhat more food than women. Body weight had no overall effect on food choice, although obese people chose somewhat more food than nonobese people at one site--that serving food with the highest caloric content. These findings are consistent with the six earlier studies of food choice, which concluded that the major influence on how much people choose to eat is where they eat, and that there is great variability in the amount they choose at any one site. The presence of obesity is not a major determinant of food choice in public places.

Adult↗
PubMed1979

Behavior modification in the treatment of obesity. The problem of maintaining weight loss.

The introduction of behavior modification in the treatment of obesity a decade ago resulted in a substantial increase in weight loss of persons treated for mild to moderate obesity. It has been hoped that this increased effectiveness of treatment would extend also to maintenance of weight loss, and the first controlled clinical trial suggested that it did. This article reports the results of (1) a five-year follow-up of this first trial and (2) all follow-up studies of behavior modification for obesity yet conducted, six published and four previously unpublished. A new method of data analysis shows that weight losses are only modestly maintained, although the question of how their maintenance compares with that of other treatments cannot be answered because comparable data on other treatments are not available. In contrast to the vast amount of work on the initiation and generalization of behavior change, study of its maintenance has been a neglected area of behavior modification. We suggest that this area constitutes a new frontier for research in behavior modification.

Behavior Therapy↗
PubMed1979

Effects of jejunoileal bypass on meal patterns in genetically obese and lean rats.

Jejunoileal bypass surgery, designed to reproduce the human operation (long bypass) was contrasted with a short bypass of only a few centimeters of ileum in both genetically obese rats and their lean littermates. In comparison with the short-bypassed rats, long-bypassed rats of both genotypes lost weight and reduced food intake. When adjustments were made for group differences before surgery, no significant differences were detected in the effectiveness of the operation on the two genotypes. The reduction in food intake was accomplished by a decrease in meal size and an increase in intermeal interval. Food intake gradually returned in the long-bypassed rats toward its level in the short-bypassed rats. This increase was accomplished by an increase in meal size alone. Intermeal intervals remained prolonged. In the long-bypassed rats, compared with the short, meal duration was initially elevated and gradually increased more than did meal size, indicating a great slowing of eating rate. Water intake was unaffected, but water-to-food ratio was elevated initially and gradually declined in the long-bypassed rats. Learned food aversion, dehydration, and gastrointestinal and metabolic alterations due to malabsorption are mentioned as possible contributors to the reduction in food intake, but none of these alone can account for all the changes in meal pattern by which intake reduction is accomplished.

Animals↗
PubMed1979

A method of quantifying cultural ideals of beauty and the obese.

A series of photographs of persons which had been varied by anamorphic lens to produce images both thinner and thicker than the originals were assessed by three experts in terms of percentage deviation from ideal body weight. Together with the photographs, five questions about preferences for body size were put to 341 persons who were also asked to assign each photograph to one of six basic categories of body weight in Puerto Rican culture.

Beauty↗
PubMed1978

Behavioral treatment of obesity in children.

The development of behavioral techniques for the control of obesity in children is reviewed. Techniques developed for the treatment of obese adults have recently been modified for use with children, and to date, six studies exist that have evaluated their use. The results are encouraging and it appears that behavior therapy offers new promise in the treatment of this difficult problem. The review ends with a survey of behavioral techniques and suggestions for further reading.

Adolescent↗
PubMed1978

Obesity and psychoanalysis.

Seventy-two psychoanalysts collected information on 84 obese patients and on a control sample of 63 of their patients of normal weight. Despite the fact that obesity was the chief complaint of only 6% of the obese patients, weight losses at 42 months of psychoanalytic treatment compared favorably with those after traditional medical efforts: 47% of the obese psychoanalytic patients lost more than 9 kg, and 19% lost more than 18 kg. There was also a striking decrease in the percentage of obese patients suffering from body image disparagement--from 44% to 12%, an unexpectedly good result for this chronic and intractable disorder.

Adolescent↗
PubMed1978

Behavioral treatment of obesity: the current status.

The introduction of a behavioral approach to the treatment of obesity ten years ago stimulated a large amount of research and clinical application, and has had an influence upon psychological treatment far beyond the field of obesity. This research has demonstrated that behavior therapy represents a significant improvement over traditional methods of treatment of mild and moderate obesity. Furthermore, ten years of investigation have introduced into psychological treatment research designs and a methodological sophistication without precedent in this field. Although behavior therapy has advanced the treatment of obesity, its results are still of limited clinical significance. Weight losses have been modest and the variability in results large and unexplained even long-term maintenance of weight loss, which, it was originally hoped, would be a particular benefit of the behavioral approach, has not yet been established. On possibility of increasing the effectiveness of behavioral treatments is to combine them with other measures--dietary and pharmacological. Three recent efforts at combining treatments show promise.

Behavior Therapy↗
PubMed1977

Phenytoin treatment of the binge-eating syndrome.

Nineteen subjects completed a 12-week double-blind crossover study comparing phenytoin with placebo in the treatment of severe binge eating. In the placebophenytoin sequence the number of binges decreased during phenytoin treatment from both placebo and pretreatment levels. However, in the phenytoin-placebo sequence, not only did phenytoin reduce the number of binges from pretreatment levels, but there was no reversal of this effect during the placebo period. This sequential effect was unexpected and is still unexplained. The mechanism of phenytoin action and the significance of EEG abnormalities found in 7 of the subjects remain uncertain.

Adolescent↗