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Biomedical subjects

Stephan Rössner

Publications and source records attributed to Stephan Rössner.

At least 19 recordsLinked to original sources
PubMed2007

Effect of orlistat on weight regain and cardiovascular risk factors following a very-low-energy diet in abdominally obese patients: a 3-year randomized, placebo-controlled study.

OBJECTIVE: To investigate the efficacy of orlistat on the maintenance of weight loss over 3 years following a major weight loss induced by very-low-energy diet (VLED) in obese patients with metabolic risk factors such as dyslipidemia, impaired fasting glucose, and diet-treated type 2 diabetes. RESEARCH DESIGN AND METHODS: Initially, weight loss was induced by an 8-week VLED (600-800 kcal/day) in 383 patients with a mean BMI of 37.5 kg/m(2) (range 30.0-45.2). Those who lost > or = 5% of their body weight (309 of 383 patients) were then randomized to receive lifestyle counseling for 3 years together with either orlistat 120 mg t.i.d. or matching placebo capsules. Primary end points were the maintenance of > or = 5% weight loss after 3 years. Additionally, differences in the development of type 2 diabetes between orlistat and placebo were analyzed. RESULTS: The VLED induced a mean weight loss of 14.4 +/- 2.0 kg among the subsequently randomized patients. The mean weight gain after 3 years was lower with orlistat than with placebo (4.6 +/- 8.6 vs. 7.0 +/- 7.1 kg; P < 0.02). The number of participants who achieved > or =5% weight loss also favored orlistat (67 vs. 56%; P = 0.037). Waist circumference was significantly more reduced in the orlistat group (P < 0.05), but no other differences in the risk factors were observed between the two groups. The incidences of new cases of type 2 diabetes were significantly reduced in the orlistat group (8 cases out of 153 subjects) versus placebo (17 cases out of 156 subjects) (P = 0.041). CONCLUSIONS: The addition of orlistat to lifestyle intervention was associated with maintenance of an extra 2.4 kg weight loss after VLED for up to 3 years in obese subjects. The combination of orlistat and lifestyle intervention was associated with a reduced occurrence of type 2 diabetes.

Adult↗
PubMed2006

Association of weight gain in infancy and early childhood with metabolic risk in young adults.

CONTEXT: Early postnatal life has been suggested as an important window during which risks for long-term health may be influenced. OBJECTIVE: The aim of this study was to examine the independent associations between weight gain during infancy (0-6 months) and early childhood (3-6 yr) with components of the metabolic syndrome in young adults. DESIGN: This was a prospective cohort study (The Stockholm Weight Development Study). SETTING: The study was conducted in a general community. PARTICIPANTS: Subjects included 128 (54 males) singletons, followed from birth to 17 yr. MAIN OUTCOME MEASURE: None of these young adults met the full criteria for the metabolic syndrome. We therefore calculated a continuous clustered metabolic risk score by averaging the standardized values of the following components: waist circumference, blood pressure, fasting triglycerides, high-density lipoprotein cholesterol, glucose, and insulin level. RESULTS: Clustered metabolic risk at age 17 yr was predicted by weight gain during infancy (standardized beta = 0.16; P < 0.0001) but not during early childhood (standardized beta = 0.10; P = 0.23), adjusted for birth weight, gestational age, current height, maternal fat mass, and socioeconomic status at age 17 yr. Further adjustment for current fat mass and weight gain during childhood did not alter the significant association between infancy weight gain with the metabolic risk score (standardized beta = 0.20; P = 0.007). CONCLUSIONS: Rapid weight gain during infancy (0-6 months) but not during early childhood (3-6 yr) predicted clustered metabolic risk at age 17 yr. Early interventions to moderate rapid weight gain even at very young ages may help to reduce adult cardiovascular disease risks.

Adolescent↗
PubMed2006

[Alternative causes of obesity].

The prevailing understanding of the causes of obesity is based on the disturbance of the thermodynamic law of energy balance, primarily through increased intake or decreased expenditure of energy. Alternative causes of obesity, which still respect the law but also allow for primary fat accumulation, are: virus infection of fat cells, energy supply from bacterial fermentation of indigestible food components, psychosocial factors mediated by psychoneuroendocrine pathways, sleeplessness or poor quality of sleep and early life programming, in addition to the well-known and proven genetic programming.

Animals↗
PubMed2006

The significance of overweight and obesity for individual health behaviour: an economic analysis based on the Swedish surveys of living conditions 1980-81, 1988-89, and 1996-97.

AIMS: The aim of the study was to examine whether being overweight (25 or=30) affect subsequent individual health behaviour, applying the framework of the individual-as-producer-of-health model. METHODS: A set of panel data for 3,693 individuals interviewed repeatedly in 1980-81, 1988-89, and 1996-97 was created from the Swedish population-based biannual survey of living conditions. Self-assessed health was chosen as indicator of individual health capital and physical exercise as indicator of individual health investment. RESULTS: (a) Men and women who suffered from obesity invested significantly less in their health in terms of physical exercise and reported significantly lower self-assessed health than the general male and female population, respectively. (b) Men who suffered from overweight invested less in their health and reported significantly lower self-assessed health than the general population, whereas women who were overweight--but not obese--did not differ from the general population. (c) Men and women who went from being obese to being overweight reported self-assessed health levels that did not differ from the general male and female population, respectively, but exercised less than men and women in general. CONCLUSIONS: The results imply (a) that the individual weight history must be taken into account in studies of the effect of obesity and overweight on health and health-related behaviour and (b) that men and women differ concerning the impact of obesity and overweight on health and health investments.

Adolescent↗
PubMed2006

Upward weight percentile crossing in infancy and early childhood independently predicts fat mass in young adults: the Stockholm Weight Development Study (SWEDES).

BACKGROUND: Rapid early postnatal weight gain predicts increased subsequent obesity and related disease risks. However, the exact timing of adverse rapid postnatal weight gain is unclear. OBJECTIVE: The objective was to examine the associations between rapid weight gain in infancy and in early childhood in relation to body composition at age 17 y. DESIGN: This prospective cohort study was conducted in 248 (103 males) singletons and their mothers. Height and weight were measured at birth, 6 mo, and 3 and 6 y. The rates of weight gain during infancy (0-6 mo) and early childhood (3-6 y) were calculated as changes in sex- and age-adjusted weight SD scores during these time periods. At 17 y, body composition was measured by air-displacement plethysmography. RESULTS: Increasing weight gain during infancy and early childhood were both independently associated with larger body mass index, fat mass, relative fat mass, fat-free mass, and waist circumference at 17 y (P < 0.005 for all; adjusted for sex, birth weight, gestational age, current height, maternal socioeconomic status, and maternal fat mass). Rapid weight gain in infancy, but not in early childhood, also predicted taller height at 17 y (P < 0.001). CONCLUSIONS: Rapid weight gain in both infancy and early childhood is a risk factor for adult adiposity and obesity. Rapid weight gain in infancy also predicted taller adult height. We hypothesize that rapid weight gains in infancy and early childhood are different processes and may allow separate opportunities for early intervention against obesity risk later in life.

Adipose Tissue↗
PubMed2005

Locus of control and weight reduction.

The objective of this study was to determine if locus of control orientation is predictive for weight loss among participants in a behaviour modification weight reduction programme. The subjects completed a locus of control questionnaire consisting of 40 questions before starting the programme and again after 1 year. Forty-one participants started the programme, 28 remained after 1 year. Their weight loss was significant (P < 0.001) and associated with an internal locus of control orientation (P < 0.05). The findings suggest that different weight reduction activities could be offered depending on the person's locus of control orientation. Participants with an internal orientation could be offered a standard weight reduction programme. Others, with a more external locus of control orientation, could be offered an adapted programme, which also focused on and encouraged the participants' internal orientation.

Adult↗
PubMed2005

Education and supervision of health care professionals to initiate, implement and improve management of obesity.

The objective of this study was to explore whether there were differences in organisational setting and professional intervention between health professionals who, after 1 year of education, and ongoing supervision for all together 30 months, started obesity treatment and those who did not. Furthermore to analyse what factors facilitate the start of obesity treatment. One hundred and seventy-one health professionals from different parts of Sweden were included in the education. One hundred and thirty-five health professionals remained in the study for up to 2.5 years. Eighty-seven subjects started the obesity treatment program, whereas 48 subjects had no possibility to start treatment. Significantly more of those who started the behavioural treatment program had previous theoretical education and clinical experience of obesity. They also, to a greater degree, had a go-ahead from the management and support from physicians, colleagues and were more likely to be part of a team or had a colleague to work with. In addition, they could find the time to organise and plan the treatment. Supervision had a significant positive influence on starting up the treatment program. Education, working organization, a structural behavioural treatment program, seems to be significant factors in facilitating and increasing the likelihood for a start.

Attitude of Health Personnel↗
PubMed2005

Sibutramine treatment in obesity: initial eating behaviour in relation to weight loss results and changes in mood.

The aim of the study was to study the role of initial eating behaviour for subsequent weight loss in treatment with sibutramine (Reductil, Meridia) an anti-obesity drug enhancing satiety, and also to assess changes in mood during the treatment. The participants were 36 obese patients with a mean BMI of 39 kg m(-2). Eating behaviour was assessed with the three factor eating questionnaire (TFEQ), and depressive features with the comprehensive psychopathological rating scale (CPRS). Sibutramine (15 mg) was administered daily. The TFEQ restraint scale was negatively related to 6 months weight loss. In particular, strategic dieting behaviour and a more controlled attitude towards self-regulation were negatively related to weight loss. A positive non-placebo controlled change in mood was found already after 2 months treatment. The changes in mood were not related to the weight loss. Patients with more unrestrained eating seem to have reduced their amount of food intake more radically with enhanced satiety, manifested by greater weight loss. Physiologically enhanced satiety could have the greatest weight loss effect for patients whose eating is more governed by hunger drives and appetite rather that by conscious efforts and cognitive control.

Adult↗
PubMed2005

Associations between physical activity and fat mass in adolescents: the Stockholm Weight Development Study.

BACKGROUND: Obesity is multifactorial. However, the accumulation of fat mass (FM) is proposed to be due to a positive energy balance, which may be caused by reduced physical activity (PA). OBJECTIVE: The objectives of the study were to describe the independent associations between PA and FM in adolescents and to describe the intergenerational association of FM between mothers and their offspring. DESIGN: We conducted a cross-sectional study in 445 (190 M, 255 F) 17-y-old adolescents and their mothers. PA was assessed with a self-reported questionnaire and validated by comparison with accelerometric data in a subsample of the cohort. Body composition was measured by using air-displacement plethysmography. RESULTS: Males were significantly more active than were females (P<0.01). PA was significantly and inversely associated with FM (beta=-3.63, P=0.005) and percentage FM (beta=-3.117, P=0.017) in males but not in females (beta=-0.576, P=0.54; beta=-0.532, P=0.59, respectively) after adjustment for birth weight and maternal FM and education level. However, FM and percentage FM in females were significantly associated with maternal FM (beta=0.159, P<0.0001; beta=0.145, P=0.002, respectively) and education level (beta=-1.048, P<0.005; beta=-1.085, P=0.006, respectively). No such associations were observed in males. CONCLUSIONS: PA was independently associated with FM in males but not in females. The data also showed an intergenerational association of FM between mothers and their daughters but not between mothers and their sons.

Adipose Tissue↗