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PubMed1996

Effectiveness of a behavioral weight control program for blacks and whites with NIDDM.

OBJECTIVE: To compare the weight losses of black and white patients with NIDDM treated in a year-long behavioral weight loss program. RESEARCH DESIGN AND METHODS: Subjects were randomly assigned to a behavioral program that either used a low-calorie diet throughout or included two 12-week periods of a very-low calorie diet (VLCD). Weight, dietary intake, and exercise were measured at 0, 6, and 12 months of treatment, and attendance and self-monitoring records were assessed weekly throughout the year. RESULTS: Blacks had smaller weight losses than whites regardless of treatment condition. Overall weight losses (baseline to 1 year) were 7.1 kg in blacks vs 13.9 kg in whites. The differences in overall outcome resulted primarily from greater weight regain in blacks during months 6-12 than in whites. There was a trend for blacks to have poorer attendance than whites during the latter half of the program and for blacks to report smaller changes in calorie intake from baseline to 6 months. CONCLUSIONS: The results confirm prior studies with nondiabetic patients showing smaller weight losses in blacks than in whites and suggest that these differences may result primarily from faster weight regain in blacks. Further research is needed to more carefully examine the variables that may explain this difference and to develop more effective programs for blacks with NIDDM.

Adult↗
PubMed1998

Mothers, daughters and dieting: investigating the transmission of weight control.

OBJECTIVES: Research by Pike & Rodin (1991) found higher levels of weight concern and dissatisfaction with family functioning in mothers of eating disordered adolescent girls. The present study sought to extend this research by examining the maternal influences on weight and dieting concerns at a younger age. DESIGN: A cross-sectional comparison of high and low dietary restraint girls and their mothers was used. METHODS: Two groups of 20 11-year-old girls and their mothers completed assessments of dietary restraint, body shape preference, self-perception, family functioning and body weight and height. RESULTS: Mothers of high restraint girls did not differ from comparison mothers in their current level of dieting, but did report more between-meal snacking and fasting. In addition, they rated their daughters' attractiveness significantly lower than the other mothers. Furthermore, families with a highly restrained daughter scored significantly lower on perceived family cohesion, organization and moral-religious emphasis. CONCLUSIONS: The parallel with the findings of Pike & Rodin supports the role that mothers may play in the transmission of cultural values regarding weight, shape and appearance. Importantly, it also places early dieting within a wider context of dissatisfaction with family functioning.

Adult↗
PubMed1995

Health and weight control management among wrestlers. A proposed program for high school athletes.

Weight loss is a part of any competitive sport which matches participants of equal weight or sports where participating at lower weights or with a thinner body habitus is considered an advantage. For some wrestlers, weight loss is excessive and often accomplished by methods that lead to loss of lean body mass and total body water. There is convincing evidence that this excessive weight loss is unhealthy for all individuals who follow these practices. Even greater harm is experienced by high school wrestlers who have not yet completed their growth and development. These health consequences include growth retardation, decreased academic performance, altered endocrine or hormonal function and damage to many vital organs. "cycling" of weight results in decrease in strength, power and endurance which would effect adversely a wrestler's likelihood of success. The VHSL has begun an educational program to inform coaches, wrestlers and parents about the hazards inherent in these weight loss practices. History suggests that education alone will not alter the present practices of weight loss. Therefore a weight management program similar to ones initiated in other states is being pursued by the VHSL. The pilot program this year is scheduled to be followed next year by a more wide-spread voluntary program across the Commonwealth.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗
PubMed2001

Disturbed attitudes to weight control in female kibbutz adolescents: a preliminary study with a view to prevention.

Eating disorders have physical, emotional, social, and cultural aspects, which are manifested in the individual's preoccupation with food, physical build, and weight, and are maladjusted means of dealing with mental and emotional problems. The practice of unhealthy means of weight regulation and eating disorders affects the individual, family, community, and society at large, and affects primarily adolescent girls and young women in Western society. Thus, there exists today an urgent need to develop a comprehensive community prevention program. This preliminary study is an attempt to determine the scope of the problem among adolescent girls (n = 38) and their significant others (n = 42), in a kibbutz in northern Israel. Self-evaluation questionnaires were used to examine attitudes and characteristics related to eating and body image, in addition to a questionnaire for evaluation of knowledgeability and attitudes among the adolescents' significant others. It was found that 85% of adolescent girls were dissatisfied with their figure, 63% were considering a diet, and 60% were afraid of losing control over their weight. Fifty-five percent of significant others did not think that eating disorders were more prevalent in families with fallacious attitudes about physical build and eating, and 50% thought that pubescent girls should be encouraged to diet. In addition, a group at risk for developing eating disorders (n = 12) was found. Significant differences in all the indicators were found between the latter group and the other girls. The findings reinforce those of research studies from other Western countries, and establish the need for a community prevention program at three levels of prevention, targeting the community in general and focusing on adolescents' significant others as agents of change.

Journal Article↗
PubMed1999

Weight control and risk factor reduction in obese subjects treated for 2 years with orlistat: a randomized controlled trial.

CONTEXT: Orlistat, a gastrointestinal lipase inhibitor that reduces dietary fat absorption by approximately 30%, may promote weight loss and reduce cardiovascular risk factors. OBJECTIVE: To test the hypothesis that orlistat combined with dietary intervention is more effective than placebo plus diet for weight loss and maintenance over 2 years. DESIGN: Randomized, double-blind, placebo-controlled study conducted from October 1992 to October 1995. SETTING AND PARTICIPANTS: Obese adults (body mass index [weight in kilograms divided by the square of height in meters], 30-43 kg/m2) evaluated at 18 US research centers. INTERVENTION: Subjects received placebo plus a controlled-energy diet during a 4-week lead-in. On study day 1, the diet was continued and subjects were randomized to receive placebo 3 times a day or orlistat, 120 mg 3 times a day, for 52 weeks. After 52 weeks, subjects began a weight-maintenance diet, and the placebo group (n = 133) continued to receive placebo and orlistat-treated subjects were rerandomized to receive placebo 3 times a day (n = 138), orlistat, 60 mg (n = 152) or 120 mg (n = 153) 3 times a day, for an additional 52 weeks. MAIN OUTCOME MEASURES: Body weight change and changes in blood pressure and serum lipid, glucose, and insulin levels. RESULTS: A total of 1187 subjects entered the protocol, and 892 were randomly assigned on day 1 to double-blind treatment. For intent-to-treat analysis, 223 placebo-treated subjects and 657 orlistat-treated subjects were evaluated. During the first year orlistat-treated subjects lost more weight (mean +/- SEM, 8.76+/-0.37 kg) than placebo-treated subjects (5.81+/-0.67 kg) (P<.001). Subjects treated with orlistat, 120 mg 3 times a day, during year 1 and year 2 regained less weight during year 2 (3.2+/-0.45 kg; 35.2% regain) than those who received orlistat, 60 mg (4.26+/-0.57 kg; 51.3% regain), or placebo (5.63+/-0.42 kg; 63.4% regain) in year 2 (P<.001). Treatment with orlistat, 120 mg 3 times a day, was associated with improvements in fasting low-density lipoprotein cholesterol and insulin levels. CONCLUSIONS: Two-year treatment with orlistat plus diet significantly promotes weight loss, lessens weight regain, and improves some obesity-related disease risk factors.

Adult↗
PubMed1995

Exercise-training, macronutrient balance and body weight control.

It is well established that exercise-training can induce body weight and fat losses provided that mean daily energy expenditure exceeds mean energy intake. Recent experimental data show that under free living conditions, the composition of macronutrient intake tends to differ from the composition of macronutrient utilization when the body is in energy imbalance, even over a short period of time. Since protein and carbohydrate balances are precisely regulated under unrestricted food intake conditions, a body energy deficit is necessarily equivalent to a lipid deficit. In the context of an aerobic training program, a body lipid deficit should be spontaneously reached by performing prolonged vigorous exercise on a regular basis and by preventing a diet with a high fat content. However, as body fat decreases with exercise there is an associated decrease in the lipid content of the fuel mix oxidized and this acts to progressively decrease the lipid deficit. Ultimately, a new lipid balance will be reached at a reduced level of body fatness when the proportion of lipid in the substrate mix will become similar to the proportion of lipid in the diet. Recent research observations show that such a program has the potential to induce a substantial fat loss, particularly in the abdominal area, and a significant improvement of the metabolic profile of obese individuals. These beneficial effects cannot be maintained on a long-term basis if the new exercise and food habits are not incorporated in the lifestyle of these individuals.

Adipose Tissue↗
PubMed2001

A nutrition and exercise intervention program for controlling weight in Samoan communities in New Zealand.

OBJECTIVE: To promote weight loss in Samoan church communities through an exercise program and nutrition education. METHODS: A quasi-experimental design was used to assess weight change, over 1 y, in cohorts of people aged 20-77 y from three non-randomised Samoan church communities (two intervention, n=365 and one control, n=106) in Auckland, New Zealand. The intervention churches received aerobics sessions and nutrition education about dietary fat. RESULTS: Baseline body mass index for the intervention and control churches was (mean+/-s.e.) 34.8+/-0.4 and 34.3+/-0.9 kg/m(2), respectively. The intervention churches lost an average of 0.4+/-0.3 kg compared to a 1.3+/-0.6 kg weight gain in the control church (P=0.039, adjusted for confounders). The number of people who were vigorously active increased by 10% in the intervention churches compared to a 5% decline in the control church (P=0.007). Nutrition education had little apparent impact on knowledge or behaviour. CONCLUSION: Samoan communities in New Zealand are very obese and have high rates of annual weight gain. A community-based intervention program arrested this weight gain in the short term.

Adult↗
PubMed1992

Weight control counselling in children: is it effective?

This study evaluates the results of weight control/obesity counselling in the outpatient nutrition clinic of a children's hospital. Using a retrospective design, 96 randomly selected patients referred to the clinic were followed for up to four years using their hospital charts or through information obtained from the referring physician on current weights and heights. At initial assessment, 87 of 96 (91%) children were classified as obese or severely obese at greater than 120% of their Ideal Body Weight (IBW); eight other children would be classified as overweight and one child was within normal weight for height. Forty-nine referrals (51%) did not return for a follow-up visit after the initial assessment; weights were available on 18 (37%). On follow-up of 65 patients; 8% of patients achieved an IBW; a further 34% lost weight; 46% gained weight; and 12% maintained their weight. There was no difference in weight gain or loss by amount of participation in the program or by age or gender. We conclude that the weight control/obesity counselling program in our hospital is ineffective. A multidisciplinary program, based on a nutrition education theory and which includes an evaluation framework and addresses reasons for attrition and family needs, should be developed.

Adolescent↗
PubMed2004

Quantification of intra-abdominal fat during controlled weight reduction: assessment using the water-suppressed breath-hold MRI technique.

A group of 14 healthy female subjects was studied using MRI during 2 months of life-style intervention. A series of 21 water-suppressed images was used to determine the intra-abdominal fat volume before and after the controlled loss of weight. The average weight decrease was 8.2 %, but the average relative loss of visceral fat was 20.3 %, whereas subcutaneous fat decreased by 13.4 %. A small but significant increase of insulin sensitivity (decrease in fasting insulin and blood glucose) was observed, but no changes in lipoprotein parameters were demonstrated. There was a significant negative correlation (r=-0.633, p=0.028) between the relative abdominal fat decrease and the initial amount of subcutaneous fat.

Abdomen↗