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PubMed1995

Swedish Obese Subjects (SOS)--an intervention study of obesity. Measuring psychosocial factors and health by means of short-form questionnaires. Results from a method study.

Lengthy questionnaires should be shortened to enable better compliance in large-scale trials also ensuring adequate measurement precision. As the number of questions sufficient to create reliable scales may vary considerably depending on the complexity of concepts and purposes, consecutive participants of a large study, the Swedish Obese Subjects (SOS), received a second mailing of original long-form questionnaires after 1 week to be compared with the SOS short-form measures. Internal consistency, unidimensionality, robustness and reproducibility were tested for scales reflecting social support and life events, personality traits, health perception and psychosocial functioning. Very brief generic scales could perform satisfactorily for study-specific purposes in diseased populations. The short-form social support scales yielded satisfactory psychometric properties and the short life events module was best divided into two multi-item variables. High and consistent metric values were found for the personality, general health and psychosocial functioning scales. Our method study thus guided in striking a balance between scaling properties/reliability levels and length of questionnaires/subject burden. We recommend a method study like ours in every instance where patient-based data recordings are among the primary measures of outcome.

Attitude to Health↗
PubMed2005

Comparison of energy balance in two inbred strains of rats: Fischer F344 prone to obesity and Lou rats resistant to obesity.

This study aimed to compare energy balance, metabolic profiles and body composition between two inbred strains of rats (F344 and Lou) submitted to a self-selecting macronutrient. During the 3 weeks of experiment, the two strains did not differ significantly for their total energy intake; males: F344 = 5875.4 +/- 171.4 kJ, Lou = 5619.2 +/- 349.4 kJ; and females: F344 = 4058.8 +/- 118.7 kJ, Lou = 3864.4+/-166.4 kJ. However, F344 rats showed a higher weight gain, and percentage of total fat tissue, together with a lower percentage of carcass weight than Lou rats regardless of sex. The percentages of each macronutrient revealed a lower preference of protein for F344 males and the opposite in females for CHO. The thermogenic activity measured in interscapular brown adipose tissue was lower in Fischer than in Lou while the reverse was observed for leptinemia and insulinemia. These results indicate that the mechanism responsible for the regulation of body composition observed in Lou rats takes place very early in life and attest the interest in this strain for studying the features of resistance to obesity.

Adipose Tissue↗
PubMed2001

Sex differences in obese children and siblings in family-based obesity treatment.

OBJECTIVE: The primary goal was to evaluate sex differences in child weight control programs that targeted increasing physical activity (increase) or the combination of reducing sedentary behavior and increasing physical activity (combined). A second goal was to evaluate the benefits of family-based interventions on nontargeted siblings. RESEARCH METHODS AND PROCEDURES: Sixty-seven families with obese children and 89 siblings were randomized to interventions that targeted increasing physical activity (increase) or the combination of reducing sedentary behavior and increasing physical activity (combined). Targeted participants and nontargeted siblings were followed for 1 year. RESULTS: At 12 months, boys showed significantly better percentages of overweight changes (-15.8%) for the combined treatment than girls (-1.0%), with no significant differences for the increase intervention for boys (-9.3%) or girls (-7.6%). Boys adhered to treatment better than girls (p < 0.01). Adherence and predilection for physical activity were significant predictors of targeted child weight loss at 1 year in multiple regression analysis. Predictors of sibling weight loss included age, number of siblings, targeted child percentage of overweight change, and the interaction of group assignment by same sex of treated sibling. DISCUSSION: Gender may influence response to programs that attempt to decrease sedentary behavior, and generalization of treatment effects to siblings may depend on the intervention and characteristics of the siblings.

Adolescent↗
PubMed2002

Understanding the physiology of obesity: review of recent developments in obesity research.

Knowledge of the genetic and regulatory factors that influence energy homeostasis is advancing rapidly. There is increased understanding of the molecular signals that reach the brain with information regarding the current state of energy balance, how those signals are detected by the brain, and key neuronal systems important in translating the information into efferent responses. The identification of molecules that control food intake has generated new targets for drug development in the treatment of obesity. In view of the complexities of the energy control system, therapeutic strategies that target only one site are likely to be less effective than those targeting two or more sites.

Adipose Tissue↗
PubMed2004

Weight loss without losing muscle mass in pre-obese and obese subjects induced by a high-soy-protein diet.

OBJECTIVE: To determine change of weight, body composition, metabolic and hormonal parameters induced by different intervention protocols. DESIGN: Randomized, controlled study including participants exhibiting a BMI between 27.5 and 35. Three different interventions containing lifestyle education (LE-G), or a substitutional diet containing a high-soy-protein low-fat diet with (SD/PA-G) or without (SD-G) a guided physical activity program. SUBJECTS: A total of 90 subjects (mean weight 89.9 kg; mean BMI 31.5), randomly assigned to one of three treatment groups. MEASUREMENTS: Change in body weight, fat mass and lean body mass measured with the Bod Pod device at baseline, 6 weeks and 6 months; change in metabolic and hormonal parameters. RESULTS: In all, 83 subjects completed the 6-months study. BMI dropped highly significantly in all groups (LE-G: -2.2+/-1.43 kg/m(2); SD-G: -3.1+/-1.29 kg/m(2); SD/PA-G: -3.0+/-1.29 kg/m(2)). Subjects in the SD-G and in the SD/PA-G lost more weight during the 6-months study (-8.9+/-3.9; -8.9+/-3.9 kg) than did those in the LE-G (-6.2+/-4.2 kg), and had a greater decrease in fat mass (-8.8+/-4.27; -9.4+/-4.54 kg) than those in the LE-G (-6.6+/-4.59 kg). In contrast, no significant intraindividual or between-group changes in the fat-free mass were seen. In all groups, metabolic parameters showed an improvement in glycemic control and lipid profile. CONCLUSIONS: Our data suggest that a high-soy-protein and low-fat diet can improve the body composition in overweight and obese people, losing fat but preserving muscle mass.

Body Composition↗
PubMed1999

The hypogonadal-obesity cycle: role of aromatase in modulating the testosterone-estradiol shunt--a major factor in the genesis of morbid obesity.

Massive obesity in males is associated with decreased total and free testosterone levels as well as elevated estradiol levels. The decrease in testosterone occurs without the compensatory increases in gonadotropin and a progressive hypogonadotropic hypogonadal cycle develops. During the hypogonadal state, there is a preferential deposition of abdominal adipose tissue. With the increasing fatty-tissue accumulation, there is an increase of aromatase activity that is associated with a greater conversion of testosterone to estradiol (testosterone-estradiol shunt). This results in further depression of testosterone concentrations and leads to the increased preferential deposition of abdominal fat that, in turn, leads to a progressive hypogonadal state. Testalactone, an aromatase inhibitor, interrupts this cycle and repairs the depressed testosterone concentrations and decreases estradiol levels. This increases the testosterone levels and reverses the preferential deposition of abdominal fat, while increasing muscle protein and fat-free mass.

Aromatase↗
PubMed1976

An analysis of the relationships among obesity, plasma insulin and hepatic lipogenic enzymes in "viable yellow obese" mice (Avy/a).

The development of obesity, hyperinsulinemia and six hepatic lipogenic enzymes in Avy/a mice were compared to that in a/a mice. Correlation between body weight, liver weight, plasma insulin concentration and activities of hepatic enzymes was analyzed. In the Avy/a mice, body weight, liver weight and plasma insulin level increased steadily as the mice aged. In the a/a mice, the change of these three parameters was much slower. Plasma insulin concentration in a/a mice did not increase until eight months of age. Compared with a/a mice, Avy/a mice had higher 6-phosphogluconate dehydrogenase and fatty acid synthetase activities at two months of age; lower citrate cleavage enzyme, glucose-6-phosphate dehydrogenase and 6-phosphogluconate dehydrogenase activities at three months of age; lower citrate cleavage enzyme and glucose-6-phosphate dehydrogenase and higher acetyl CoA carboxylase activities at five months of age; and higher malic enzyme, citrate cleavage enzyme and 6-phosphogluconate dehydrogenase activities at eight months of age. There were significant correlations between plasma insulin level and body weight and between plasma insulin level and the activities of malic enzyme and citrate cleavage enzyme in Avy/a mice. The correlation between body weight and malic enzyme and citrate cleavage enzyme activities disappeared after the analysis was adjusted for plasma insulin level.

ATP Citrate (pro-S)-Lyase↗
PubMed1998

Anti-obesity drugs: what does sibutramine offer? An analysis of its potential contribution to obesity treatment.

Sibutramine is a serotonin and noradrenaline re-uptake inhibitor (SNRI) which induces weight loss via a dual mode of action: enhancing both satiety and energy expenditure. Sibutramine exerts its in vivo effects predominantly via its secondary and primary amine metabolites. Following oral ingestion, sibutramine is well absorbed and undergoes extensive first pass metabolism. Sibutramine produces statistically and clinically significant, dose-related weight loss over the range 5-30 mg once daily; active weight loss occurs for 6 months. Long-term studies of up to 1 year have found that weight loss is maintained with continued sibutramine therapy. Sibutramine-induced weight loss is associated with beneficial changes in obesity-related risk factors, such as serum lipids, uric acid levels, and glycaemic control (in patients with type 2 diabetes). Subcutaneous/visceral fat ratio was found to increase significantly under sibutramine treatment, indicating that relatively more visceral fat than subcutaneous fat is lost. Sibutramine is well tolerated; side-effects are generally mild, non-treatment limiting, and consistent with the known mechanism of action of the drug. Overall, studies have found sibutramine to be an effective weight loss agent with a good safety profile.

Adipose Tissue↗
PubMed1977

Studies of operated and nonoperated obese patients. An interim report on the Scandinavian Obesity Project.

For 2 years, 12 Danish hospitals have conducted a randomized clinical trial to evaluate the hazards and benefits of jejunoileal bypass operations for severe obesity. At present (January, 1976), there are 92 operated and 46 unoperated patients. There has been no mortality in the operated group. One control patient has died. Weight loss is significantly better in the operated group, but not always satisfactory. The well-known postoperative complications have not been deterring in frequency or seriousness. On the whole, but not invariably, the operation has been followed by an improvement in psychosocial status.

Body Weight↗
PubMed2003

A war on obesity, not the obese.

In their efforts to lose weight, obese individuals may be fighting a powerful set of evolutionary forces honed in an environment drastically different from that of today.

Adipose Tissue↗
PubMed1987

Sucrose-induced obesity: effect of diet on obesity and brown adipose tissue.

Adult male Sprague-Dawley rats were divided into three groups and fed diets containing either 10, 20, or 40% protein for 56 days. Half of the rats in each dietary condition were given a 32% sucrose solution plus the standard diet and water. Sucrose intake varied directly as a function of dietary protein levels. Rats fed either the 10 or 20% protein diet and sucrose had higher caloric intakes, gained more weight, were more efficient at using calories for weight gain, and had more adipose tissue than rats given the same diet without sucrose. Rats fed the 40% protein diet and sucrose did not exhibit overeating, excess weight gain, or increased feed efficiency relative to animals fed the 40% diet alone. Animals given sucrose had more interscapular brown adipose tissue (IBAT) and a greater metabolic potential for thermogenesis in IBAT as determined by GDP binding in mitochondria than rats not fed sucrose. These results demonstrate that dietary protein is important in the development of sucrose-induced obesity and that increases in IBAT mass and activity can occur concomitant with increased feed efficiency.

Adipose Tissue, Brown↗
PubMed1989

Initiation and perpetuation of obesity and obesity resistance in rats.

A search was made for predisposing factors and sequelae of diet-induced obesity (DIO) or resistance to DIO (DR). During 3 mo on a high-energy (CM) diet, two-thirds of the male Sprague-Dawley rats ate 16% more calories over the first 30 days and developed DIO. The remaining one-third were DR, gaining the same amount of weight as chow-fed controls. Basal and norepinephrine (NE)-stimulated in vivo O2 consumption, performed before rats were placed on the CM diet, was the same in those rats that later became DR or DIO after 3 mo on the CM diet. DR rats were 4% lighter, whereas DIO rats were equal to chow-fed rats before their exposure to the CM diet. When CM-fed rats were switched to chow, DIO rats took 14 wk to reduce their body and retroperitoneal fat pad weights to those of chow-fed controls, whereas DR rats gained only 40% of the body weight, and fat pads were 34% lighter than controls. After 14 wk, DIO rats were neither hyperinsulinemic nor insulin resistant, whereas DR rats had 64% reduced areas under their insulin curves after intravenous glucose (1 g/kg) compared with controls. Unlike younger rats, animals here had inconsistent plasma NE responses to intravenous glucose. Therefore the CM diet produces DR and DIO states that tend to become self-perpetuating once established.

Animals↗
PubMedDate not supplied

Body composition and energy expenditure in obese patients prior to and following biliopancreatic diversion for obesity.

Body composition and resting energy expenditure (REE) were assessed in 69 obese patients prior to and 1 year following biliopancreatic diversion (BPD). Fat-free mass (FFM) and body fat sizes were very similar to those of nonoperated subjects closely matched for body weight and FFM size. In the BPD subjects, the REE data were high, thus excluding a dilatation of non-energy-consuming extracellular spaces and suggesting an increase in the ratio between the organs and the less metabolically active muscle mass within the FFM.

Adult↗
PubMed2001

Accumulation of triglyceride-rich lipoprotein in subjects with abdominal obesity: the biguanides and the prevention of the risk of obesity (BIGPRO) 1 study.

The present study represents a new insight into the Biguanides and the Prevention of the Risk of Obesity (BIGPRO) 1 study population at inclusion. This population, selected basically on the basis of a high waist-to-hip ratio (>/=0.95 for men and >/=0.80 for women), is supposed to represent a group of patients with insulin resistance. The present study was undergone to establish whether apolipoprotein C-III (apoC-III) and apolipoprotein E (apoE) associated with apo B (apoC-III LpB and apoE LpB, respectively), considered to be markers of remnant accumulation, play a role in the hypertriglyceridemia associated with insulin resistance and whether they are related to other biological abnormalities frequently observed in this syndrome. In this population, the concentration of the markers of remnant accumulation increases with triglyceride levels. Therefore, correlation studies were realized to assess the relative effect of insulin and the markers of remnant accumulation on triglyceride plasma level. As a first attempt, a simple correlation analysis revealed that insulin is positively related to the markers of remnant accumulation only in hypertriglyceridemic patients (triglycerides >/=1.7 mmol/L). To assess the independent contribution of these markers, insulin, and other parameters related to the plasma triglyceride concentration, a stepwise multiple regression analysis was run. Results revealed that insulin and the markers of remnant accumulation (specifically, apoE LpB) are independent contributors to the plasma triglyceride concentration. Markers of the endothelial damage, plasminogen activator inhibitor-1, tissue plasminogen activator, and von Willebrand factor, which are often increased in the case of insulin resistance, were tested for their correlation with the markers of remnant accumulation. Plasminogen activator inhibitor-1 is positively correlated with these markers only in hypertriglyceridemic male subjects. It is concluded that increased insulin levels found in insulin resistance syndrome are associated with an increased production of triglyceride-rich lipoproteins enriched in apoC-III and apoE. The accumulation of these remnants and/or their abnormal composition in apoC-III and apoE could be an explanation for the development of hypertriglyceridemia in this syndrome.

Abdomen↗
PubMedDate not supplied

Arginine stimulates thymic immune function and ameliorates the obesity and the hyperglycemia of genetically obese mice.

The effect of 6-day dietary arginine supplementation on the weight gain, blood glucose, thymus weight, thymic lymphocyte content, and in vitro thymic lymphocyte immune reactivity was studied in obese (C57BL/6J-OB/)B) and heterozygous lean mice. Control mice were fed a commercial laboratory chow (1.8% arginine content) and drank tap water, while supplemented mice were given 0.5% arginine in the chow and 0.5% arginine solution for drinking. All mice ate and drank ad libitum. Supplemental arginine significantly decreased the weight gain (1.2 g vs. 2.2 g, p less than 0.01) and blood glucose levels (303 mg% vs 236 mg%, p less than 0.02) of the OB/OB mice; no such effects were noted in the lean heterozygotes, all of which had normal blood glucose levels. OB/OB mice had thymus glands which weighed less and contained significantly fewer lymphocytes than their lean littermates. In vitro mitogen-stimulated thymic lymphocyte protein synthetic rates were equal in chow-fed lean and OB/OB mice. In both groups, supplemental arginine significantly increased thymus weight, the number of thymic lymphocytes per gland, and thymic lymphocyte immunoreactivity in vitro. The hormonal secretagogue activity of arginine on the pituitary may explain its beneficial effects on the rate of weight gain, hyperglycemia, and depressed thymic immune function of OB/OB mice.

Animals↗
PubMed1999

Long-term follow-up after gastric surgery for morbid obesity: preoperative weight loss improves the long-term control of morbid obesity after vertical banded gastroplasty.

BACKGROUND: Gastric restrictive surgery in a large non-university teaching hospital has been combined with preoperative weight loss by diet. The aims of preoperative dieting were to test patient motivation, to reduce perioperative morbidity, to accustom patients to the restriction of food intake after surgery, and to increase total weight loss. This study was performed to investigate the long-term results of this approach. METHODS: 200 morbidly obese persons were operated on between 1978 and 1986 after they had lost more than 50% of their excess weight by diet. 100 Roux-en-Y gastric bypasses (RYGB) and, after 1983, 100 vertical banded gastroplasties (VBG) were performed. Data from medical records and data concerning present weight, complaints, food intolerance, nutritional deficiencies, and medical follow-up visits were obtained by questionnaire. RESULTS: The lowest body weight was obtained 1 year after operation with an average excess weight loss (EWL) of 78% after RYGB and 75% after VBG. Body weight gradually increased, and 7 years after surgery the average EWL was 67% after RYGB and 63% after VBG. Ten patients had died (three postoperatively after RYGB). Preoperative dieting did not decrease perioperative morbidity and mortality in comparison with other reports. CONCLUSIONS: After combined preoperative dieting and VBG, weight loss is greater than after surgery alone. No additional weight loss after preoperative dieting was observed in RYGB patients. Most patients who underwent bariatric surgery still experience nutritional, physical, and cosmetic problems 7 years after surgery.

Adolescent↗
PubMed1998

Effect of weight change and metformin on fibrinolysis and the von Willebrand factor in obese nondiabetic subjects: the BIGPRO1 Study. Biguanides and the Prevention of the Risk of Obesity.

OBJECTIVE: Insulin resistance is associated with hypofibrinolysis. Metformin has been shown to improve insulin sensitivity and fibrinolysis. Its action on fibrinolysis and the von Willebrand factor was evaluated in the Biguanides and the Prevention of the Risk of Obesity (BIGPRO)1 trial in nondiabetic men (n = 151) and women (n = 306) aged between 34 and 65 years with a central fat distribution and a mean BMI of 32.5 kg/m2. RESEARCH DESIGN AND METHODS: The subjects were randomly allocated to a 1-year treatment with metformin (850 mg b.i.d.) or placebo, in addition to diet and exercise recommendations. RESULTS: Plasminogen activator inhibitor 1 (PAI-1) activity and antigen decreased significantly but similarly by 30 and 40%, respectively, in both the placebo and the metformin groups. This decrease occurred mainly in subjects who lost weight. Metformin did not have any significant additional effect on PAI-1. In contrast to the results for PAI-1, there was a significantly greater decrease in tissue-type plasminogen activator (tPA) antigen in the metformin than in the placebo group (mean+/-SD: -1.1+/-3.1 vs. 0.2+/-3.2 ng/ml, P < 0.02). The von Willebrand factor (vWF) also decreased significantly more in the metformin group (-0.17+/-0.42 vs. -0.05+/-0.38 U/I, P < 0.02). CONCLUSIONS: Weight loss was the main factor associated with the decrease in PAI-1, in accordance with the recent demonstration of production of PAI-1 by adipocytes. Metformin had a significant effect on two factors, tPA antigen and vWF, mainly secreted by the endothelial cells, which suggests an effect of the drug on the production or the metabolism of these two hemostatic proteins.

Adult↗