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Abnormal eating attitudes in London schoolgirls--a prospective epidemiological study: outcome at twelve month follow-up.

The occurrence and course of eating disorder in a large representative population of 15-year-old London schoolgirls has been assessed using a two-stage survey methodology. Attempts to control weight were common and often transient. Dieting was in the great majority of girls found to be a benign practice without progression to more extreme concerns about food and weight. However, a small proportion of dieters did become cases and formed the majority of new cases found at follow-up. The relative risk of dieters becoming cases was eight times that of non-dieters. Many factors conventionally associated with eating disorder were associated more with attempting weight control than caseness. These included pre-morbid personality, pre-morbid obesity and family weight pathology. Other factors, including social class, career choice and psychosexual development, had no association either with attempting weight control or caseness.

Adolescent↗

Sex difference in lifestyle factors predictive of diabetes in Mexican-Americans.

OBJECTIVE: Little is known about the role of lifestyle factors in non-insulin-dependent diabetes mellitus (NIDDM) incidence among Mexican-Americans. Therefore, we examined whether baseline lifestyle factors predictive of 8-year NIDDM incidence differ in Mexican-American men and women. RESEARCH DESIGN AND METHODS: We studied 353 Mexican-American men and 491 Mexican-American women free of diabetes at baseline who participated in the San Antonio Heart Study follow-up. Lifestyle factors examined were body mass index (BMI), energy intake (total calories/kg), grams of alcohol consumed per week, efforts to control weight by dieting and exercise, leisure physical activity, sugar avoidance, saturated fat/cholesterol avoidance, and 24-h dietary recall assessment of total calories and percentage of calories from total carbohydrate, sucrose, and starch and from total, saturated, monounsaturated, and polyunsaturated fat. Incidence of NIDDM was regressed on lifestyle factors separately for men and women using a backward elimination procedure. RESULTS: Lifestyle factors significantly associated with NIDDM incidence differed for the two sexes. In men, leisure physical activity, was inversely associated and alcohol consumption, weight control by dieting, and BMI were positively associated with NIDDM. In women, BMI was positively associated with NIDDM and was the strongest lifestyle predictor. Sugar avoidance and leisure physical activity were also associated with increased NIDDM risk, while weight control by dieting was associated with decreased NIDDM risk. Saturated fat/cholesterol avoidance, grams of alcohol consumed per week, and energy intake were also negatively and indirectly associated with NIDDM in women by means of their direct effects on BMI. CONCLUSIONS: It may be important to tailor interventions designed to prevent NIDDM in Mexican-Americans to address sex differences in lifestyle precursors of this disease

Adult↗

[Control of weight gain between dialyses in patients undergoing periodic hemodialysis. Psychological aspects].

Some patients undergoing periodic hemodialysis have complained that between one treatment session and the next they suffer form thirst and have serious problems in maintaining their interdialytic weight gain within the limits indicated by the medical team. Weight gain may usually be explained by psychological factors: they may be more or less acute depending on the situation in which the patient finds himself. On the basis of the present study, the Authors affirm that the lack of interdialytic weight control may be easily improved by providing the patient with psychological support capable of optimising his general level of adaptation, and that this can lead to excellent results with regard to specific problems which otherwise detract from the wellbeing of the patient and hamper the work of the medical team.

Adult↗

Reoperation for failed gastric bypass procedures for obesity.

Reoperation is worthwhile when there is an obvious defect in the gastric reduction operation that has failed to control weight. Reoperation occasionally is necessary to correct a complication of gastric bypass. Vertical banded gastroplasty is the operation of choice for reoperations, as it provides weight control while eliminating the problems of bypass. Conversion of a horizontal to a vertical pouch is safe but requires careful attention to the technique to avoid injury to the other organs in the area and preservation of blood supply to the stomach. The gastrogastrostomy across the old horizontal staple line in the vertical pouch can be constructed in a way that will minimize the risk of obstruction. Vertical banded gastroplasty is now the only operation in use at UIHC for the treatment of obesity and is used not only as the primary operation but in all reoperations. Bypass of the stomach and duodenum is not necessary for weight control and adds some risk of malabsorption and duodenal and stomal ulcer plus a lifetime of inaccessibility of the excluded areas for diagnostic and therapeutic measures.

Animals↗

Relationships between weight change and changes in blood pressure and serum lipids in men and women.

An examination was made of the relationships between weight change and changes in blood pressure and serum lipids over a five-year period in apparently healthy men and women not engaging in a systematic regime of diet and/or weight control. Weight change was positively correlated with systolic and diastolic blood pressure, cholesterol, and triglycerides, though the correlation coefficients were small (0.11 to 0.28) and not statistically significant for systolic blood pressure and cholesterol for men, and triglycerides for women. After controlling for the effects of differences in age, weight, physical work capacity and initial values in risk factors, and for changes in physical work capacity, weight change in women was found to account independently for a proportion of the variance of changes in systolic blood pressure (3 per cent), diastolic blood pressure (6 per cent), and cholesterol (2 per cent); in men weight change was independently related only to change in diastolic blood pressure (4 per cent). Subjects with elevated blood pressure (diastolic greater than or equal to 95 mmHg) were apparently more sensitive to weight change than those with 'normal' blood pressure. It was concluded that in free-living populations the relationships between weight change and changes in blood pressure and lipids are not strong, and that the general value of weight control in this context may have been exaggerated.

Adult↗

Weight and perceptions of body image in women and men in a Sydney sample.

Using a modification of the distorting camera technique, 50 obese women (body mass index (BMI; kg/m2 35.1 +/- 1.1), 40 obese men (BMI 38.2 +/- 1.5) and their respective normal weight controls estimated their body size. The obese women, control women and obese men overestimated their body size, whilst control weight men were accurate. The control men were satisfied with their body size, control women less so and the obese were unsatisfied. Whilst the control women considered themselves overweight (BMI 26.7 +/- 0.8 compared to actual BMI 23.1 +/- 0.5, P less than 0.001) their preferred and actual body sizes were identical. There were no differences between obese subjects and controls in the sizes they considered healthy and attractive. The accepted normal size range for a woman was lower than that accepted for men. Older men (both obese and normal weight) accepted larger sizes for women than younger men. These results show that the obese overestimated their body size and supports the notion that there is social pressure on women to strive towards a slimmer ideal, whilst overweight men are more accepted.

Adult↗

The epidemic of dieting women: the need for a sociological approach to food and nutrition.

The social construction of overweight has meant that dieting is an experience of being a woman in Western society. Health promotion fails to counteract the cult of slimness and reinforces medicalized notions of the "problem" of overweight, legitimizing unnecessary dieting practices. The limitations of the health promotion approach are examined through medicalization and healthism critiques. The negative consequences for women of dieting to control weight are highlighted in this article through the concepts of gendered food and gendered bodies. The issue of gender and dieting is used here to illustrate the need for interdisciplinary and qualitative approaches to the study of food and nutrition practices, before intervening to change those practices. An examination of the social implications of health promotion in the area of weight control exposes the need for a moratorium on such strategies until a database of qualitative research is established through sociological studies on food and nutrition.

Body Weight↗

[Omega-3-fatty acids, Mediterranean cooking, low-fat diet. What really prevents myocardial infarct?].

The strength of evidence in support of dietary measures in the secondary prevention of coronary artery disease is variable (Table 1). The most impressive data available concern the impact of omega-3 fatty acids found in sea-fish at an intake of about 1.0 g/day, but the data underscoring the value of a Mediterranean diet are also convincing. No comparable data are available for low-fat and fat-modified diets. For diabetics, an HbA1c of < 7% should be achieved. There is indirect evidence that a body mass index of between 18.5 and 23.9 kg is optimal, and can be achieved by physical exercise and weight control. Weight reduction also lowers blood pressure, a goal that can equally be reached by a low-salt diet rich in fruit and vegetables, and the practice of endurance sports. The results of ongoing studies on the use of vitamin supplements are as yet unavailable.

Animals↗

Health-risk behaviors among our nation's youth: United States, 1992.

This report presents national estimates of the prevalence of selected health risk behaviors among youth ages 12-21 years, by sex, Hispanic origin, and race for youth of non-Hispanic origin. Topics include: cigarette and other tobacco use, alcohol and other drug use, sexual experience, HIV/AIDS education, runaway and homeless experiences, violence, unintentional injury control, weight control, and participation in physical activities. Data are from the 1992 National Health Interview Survey's Youth Risk Behavior Survey.

Adolescent↗

Fasting ghrelin levels are not elevated in children with hypothalamic obesity.

Morbid obesity is a common problem after damage to the hypothalamus. Hypothalamic dysfunction is also thought to underlie the obesity that is typical of Prader-Willi syndrome. Elevated fasting levels of the appetite-stimulating hormone ghrelin have been reported in Prader-Willi syndrome. The aim of this study was to determine whether fasting ghrelin levels are increased in children with hypothalamic obesity. Fasting total ghrelin levels were compared in three groups: normal-weight controls (n = 16), obese controls (n = 16), and patients with hypothalamic obesity (n = 16). Obese children had lower fasting total ghrelin levels than normal controls, but there was no difference between the fasting total ghrelin level in obese controls and children with hypothalamic obesity (P = 0.88). These data suggest that it is unlikely that an elevation in fasting total ghrelin is responsible for the obesity that occurs after hypothalamic damage. Therapeutic interventions aimed at reducing fasting total ghrelin may prove ineffective in controlling weight gain in this group.

Adolescent↗

Once-weekly hemodialysis helps continuous ambulatory peritoneal dialysis patients who have insufficient solute removal.

The most common cause of drop-out from continuous ambulatory peritoneal dialysis (CAPD) therapy is an insufficient dose of dialysis. Several reports and the Dialysis Outcomes Quality Initiative (DOQI) guidelines recommend maintaining a weekly creatinine clearance (CCr) of at least 60 L/1.73 m2. Previously, at our center, we found that many patients switched from CAPD to hemodialysis (HD) owing to insufficient solute clearance (less than 50 L/1.73 m2). We attempted to determine whether once-weekly HD would improve solute clearance. We treated 7 cases (6 men, 1 woman; average age: 54.3 +/- 4.5 years; mean duration of CAPD: 4.3 +/- 1.1 years) with once-weekly HD therapy (3.5 hours; 200 mL/hour). The average CCr was 45 +/- 2 L/1.73 m2. No ultrafiltration failure was found. Addition of once-weekly HD therapy improved CCr to 66 +/- 7 L/1.73 m2. That improvement was attributable to not only to the addition of HD therapy but also to an increase in peritoneal CCr for 3 consecutive days after completion of once-weekly HD therapy. Creatinine clearance and ultrafiltration were both significantly increased. Other clinical parameters such as blood pressure control, weight control, and dose of erythropoietin were significantly improved after introduction of once-weekly HD therapy. Moreover, uremic symptoms such as pruritus and depression were markedly improved. In conclusion, once-weekly HD therapy in conjunction with regular CAPD therapy improves solute clearance and symptoms related to uremia in CAPD patients with an insufficient dialysis dose.

Aged↗

De novo glutamine synthesis induced by corticosteroids in vivo in rats is secondary to weight loss.

INTRODUCTION: Corticosteroid treatment affects muscle protein and glutamine metabolism. In the present study we aimed to clarify to what extent anorexia, weight loss and corticosteroids determine protein and glutamine metabolism in muscle. METHODS: The study was performed in Wistar rats (300-350 g, n = 40) given triamcinolone (0.25 mg/kg/day i.m.) treatment (CS group) for 14 days, sham treated free fed (FF group), sham treated pair fed (PF group) and sham treated pair weight (PW group). In vivo protein and glutamine turnover were measured using L-[2,6-3H]phenylalanine and L-[3,4-3H]glurtamine as tracer in a three compartment model across the hindquarter. RESULTS: Corticosteroid treatment decreased total body weight to a greater extent than can be explained by decreased food intake only, justifying the need for pair weight controls. Muscle weight loss was relatively greater in the corticosteroid treated rats than in the pair weight controls indicating specific corticosteroid induced changes in muscle protein metabolism. Pair weight rats increased muscle net protein breakdown rates from -5 +/- 3 nmol x 100 g body weight(-1) x min(-1) to -15 +/- 3 nmol x 100 g body weight(-1) x min(-1) (P < 0.05 vs FF). In the corticosteroid treated rats net protein breakdown rates increased to -22 +/- 4 nmol x 100 g body weight(-1) x min(-1) (P < 0.01 CS vs FF/PF) Net protein breakdown in corticosteroid treated rats was accompanied by increased glutamine efflux from the hindquarter (P < 0.05, CS vs FF/PF/PW). The latter could predominantly be explained by de novo synthesis. Furthermore, corticosteroid treatment induced a loss of plasma to free muscle glutamine gradient indicating down regulation of glutamine membrane transport rates into muscle. This effect was, however, similar in the pair weight control group and can thus be fully accounted for by the muscle weight loss. CONCLUSION: Two weeks treatment with triamcinolone increases net in vivo protein breakdown of muscle directly and indirectly due to secondary weight loss and decreased food intake. The amino acid residues are used for glutamine de novo synthesis which is exported from muscle to visceral organs by down regulation of glutamine transport systems. These changes were in majority related to muscle weight loss.

Adrenal Cortex Hormones↗

Body image measurement in overweight females.

This article details two studies of the reliability and validity of three instruments to measure body image and suggestions for their use in interventions for weight control programs. Weight control programs often fail because there is no attempt to modify clients' negative body images; hence clients may regain weight to match incorrect images. Short, easily administered instruments, such as the Nash Body Image Scale, the Body Image Photo Technique, and the Body Shape Questionnaire used in these studies, are needed to evaluate clients' progress in weight control programs. Subjects were 120 women who were either satisfied or dissatisfied with their body image and weight. All subjects completed body image measures at the outset of the study and 43 subjects completed measures again to determine trait stability of body image at 1 year. Cronbach's alpha estimates provided evidence of reliability, with internal consistency coefficients ranging from .83 to .96. Validity of the measures was supported by significant correlations with scores on the Physical subscale of the Tennessee Self-Concept Scale (r = .60 to .63) as well as by significant differences on the three measures between normal-weight and overweight groups (Nash: F = 28.03, p = .001; Photo: F = 11.58, p = .001). Body image was found to be stable over the 1-year period on the Nash Body Image Scale and the Body Image Photo Technique. These instruments can provide valuable information and potential intervention content for practitioners and researchers alike. The three body image instruments discussed were found to have sufficient reliability and validity to warrant their use in practice and research.

Adolescent↗

[Effects of a comprehensive intervention program on simple obesity of children in kindergarten].

OBJECTIVE: The purpose of the study was to explore a comprehensive management program for the obese children in kindergarten. The program should be scientific, rational, suitable for kindergarten, and easy to apply. Child care workers, parents, and child health care doctors participated in the program to help obese children establish a scientific life style through their daily life, to control their weight and to maintain their physical and mental health. METHODS: The theories of behavior science, nutriology and kinematics were applied to make the weight control of obese children in kindergarten quantified and relatively standardized. Children were divided into three groups, intervened obese children, non-intervened obese children and normal children. Data such as weight, height, and body mass index (BMI) were observed to assess the effect of weight control and define whether it affects the linear gain of children's height. RESULTS: The recovery rate of intervened obese group, non-intervened group was 62.5% and 5.3%, respectively. The general effective rate was 91.7% and 15.8%, respectively. The weight gain of intervened group was 4.15 kg lower than that of non-intervened group. The BMI of intervened group significantly decreased by 2.9 as compared to the non-intervened group. The height gain of intervened group was similar to that of normal group. Parents and health care workers' realization of children obesity and their corresponding actions, the behaviors of obese children at home and in kindergarten were changed toward the direction beneficial to weight control. CONCLUSION: The implementation of the comprehensive intervention program for obesity in children, which involved obese children, child care worker, parents, and child care doctors alleviated the obesity level of those obese children without affecting their normal height gain. The program was safe and effective. Through the comprehensive intervention, the obese children could establish good habits during the sensitive period.

Body Height↗

Cognitive-behavioral therapy to reduce weight concerns improves smoking cessation outcome in weight-concerned women.

Women smokers concerned about weight gain (N = 219) were randomly assigned to 1 of 3 adjunct treatments accompanying group smoking cessation counseling: (a) behavioral weight control to prevent weight gain (weight control); (b) cognitive-behavioral therapy (CBT) to directly reduce weight concern, in which dieting was discouraged; and (c) standard counseling alone (standard), in which weight gain was not explicitly addressed. Ten sessions were conducted over 7 weeks, and no medication was provided. Continuous abstinence was significantly higher at posttreatment and at 6 and 12 months of follow-up for CBT (56%, 28%, and 21%, respectively), but not for weight control (44%, 18%, and 13%, respectively), relative to standard (31%, 12%, and 9%, respectively). However, weight control, and to a lesser extent CBT, was associated with attenuation of negative mood after quitting. Prequit body mass index, but not change in weight or in weight concerns postquit, predicted cessation outcome at 1 year. In sum, CBT to reduce weight concerns, but not behavioral weight control counseling to prevent weight gain, improves smoking cessation outcome in weight-concerned women.

Adolescent↗

Effect of diet and controlled exercise on weight loss in obese children.

The effects of adding exercise to diet for weight control in obese children were evaluated by randomizing obese girls to one of two groups: diet and diet plus exercise. During the first 6 weeks of the treatment, children exercised in a supervised three times a week exercise program, in which they walked or ran 3 miles. Significant decreases from baseline weight and in percent overweight were observed for both groups during the year of treatment. Significant decreases in percent overweight were observed at 0 to 2 months and then at 2 to 6 months for the children who were exercising, whereas percent overweight in children in the diet-alone group decreased only from 0 to 2 months. In addition, a significant improvement in fitness was observed only for children in the diet plus exercise group.

Behavior Therapy↗

Chronic dieting and the belief that smoking controls body weight in a biracial, population-based adolescent sample.

OBJECTIVE: To evaluate the prevalence of weight concerns and smoking for body weight reasons as a function of race and gender. DESIGN: A questionnaire measuring a number of factors thought to be predictive of smoking was administered. SETTING: The Memphis (Tennessee) school system. PARTICIPANTS: Participants were 6961 seventh-grade students (mean age 13 years). This population consisted of 80.8% black children, 16.5% white children, and 2.7% of other ethnic origins. MAIN OUTCOME MEASURES: Weight concerns were assessed using items from a restraint scale. Students were questioned regarding their smoking status, beliefs that smoking controls body weight, and their own weight-control smoking behaviour. RESULTS: Dietary restraint interacted with race in that, whereas white girls scored the highest on dietary restraint, black boys scored higher on dietary restraint than white boys. Almost 40% of subjects at this school level believed that smoking controls their body weight. Of the regular smokers, 12% indicated they have smoked to control their weight, with white girls endorsing this belief significantly more than other respondents. CONCLUSIONS: The propensity to smoke for weight control reasons, previously described by other researchers among white females of college and high-school age, was also found among this sample of students of junior high school age.

Adolescent↗

Dieting and slimming practices of South Australian women.

A random population survey of 406 Adelaide women who were aged 18 to 86 years, which was conducted in July, 1986, showed that in the previous year 68% of the women had exercised, 38% of the women had dieted, 15% of the women had fasted, 10% of the women had taken slimming tablets, 6% of the women had used diuretic agents and 3% of the women had used laxative agents in order to reduce or to control their weight. At the time of the survey 43% of women (60% of overweight women and 34% of non-overweight women) were attempting to lose weight. The most common reasons for wishing to lose weight were: to feel better (75% of women); to look better (65% of women); and health or medical reasons (33% of women). In addition, a majority of the women were dissatisfied with the shape of their stomach, hips, midriff, waist, thighs and buttocks. The family doctor, books and magazines acted as the major sources of information on dieting and weight control. However, most of the women felt that their doctors did not provide them with enough advice on this topic, and the women were almost unanimous in their criticism of the preoccupation of magazines with slimness. The results suggest that health professionals need to provide women with more advice on safe weight-control strategies and sensible body-weight goals.

Adolescent↗