Abstract P373: Changes in Adipokines with Weight Loss and Regain in a 24-Month Behavioral Weight Loss Study: The SMART Trial

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Lora E Burke ◽  
Erica Ambeba ◽  
Lei Ye ◽  
Mindi Styn ◽  
Sushama Acharya ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Fat ◽  
Behavioral Treatment ◽  
Weight Regain ◽  
Percent Body Fat ◽  
Behavioral Weight Loss ◽  
Healthy Behaviors ◽  
Increased Risk ◽  
Tnf Α ◽  
Over Time

Background: Weight regain commonly occurs in many adults who intentionally lose weight. Failure to maintain weight loss can lead to an increased risk for chronic diseases, such as type 2 diabetes and atherosclerosis. A potential mechanism behind the increased risk includes the increased secretion of pro-inflammatory adipokines (TNF-α and IL-6) and the decreased secretion of anti-inflammatory adipokines (adiponectin and IL-10). Objectives: We conducted an ancillary study to a 24-month behavioral weight loss trial. The purpose of the study was to examine the association between weight loss and regain and changes in body fat from baseline to 24 months and changes in TNF-α, IL-6, IL-10, and adiponectin. Methods: The analysis included a subsample of participants (n=67) from the SMART Trial who lost and regained at least 10 lbs during the 24-month trial. All participants received standard behavioral treatment for weight loss in group sessions during the first 18 months beginning with weekly sessions, which decreased in frequency over time. Linear mixed modeling was used to examine the association of percent changes in weight and body fat with percent changes in adipokines. Results: The sample was 81% female and 87% White with a mean (±SD) age of 48.4±7.34 years. At entry into study the mean weight was 96.4±15.6 kg and mean BMI was 34.5±4.35 kg/m 2 . Percent body fat was on average 42.1±6.13%. Mean weight change from baseline to six months was -10.7±5.19% and from baseline to 24 months was -3.34±6.66% while mean change in percent body fat was -8.07±11.6% from baseline to six months and -3.03±9.57% from baseline to 24 months. Weight loss over time was significantly associated with an increase in adiponectin [b(se)=-1.7(0.34), p<.0001] and a decrease in IL-6 [b(se)=1.26(0.49), p=0.01]. A similar pattern of associations was observed for reduction in body fat over time with an increase for adiponectin [b(se)=-0.76(0.19), p<.0001] and a decrease for IL-6 [b(se)=0.68(0.25), p=.006]. There were no significant associations found for either weight loss or change in percent body fat with change in IL-10 [weight: b(se)=0.51(0.54), p=.35; body fat: b(se)=0.43(0.28), p=.12] and TNF-alpha [weight: b(se)=0.35(0.44), p=.43; body fat: b(se)=0.19(0.24), p=.43] over 24-months. Conclusion: Weight loss and reduction in body fat were significantly associated with improvements in two of the adipokines. However, by 24 months, when weight regain occurred, those changes were attenuated. Implementing strategies that support healthy behaviors and sustained weight loss can help prevent a state of chronic systemic inflammation and prevent adverse health outcomes.

scholarly journals Later Meal and Sleep Timing Predicts Higher Percent Body Fat

Nutrients ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 73
Author(s):  
Elizabeth A. Thomas ◽  
Adnin Zaman ◽  
Marc-Andre Cornier ◽  
Victoria A. Catenacci ◽  
Emma J. Tussey ◽  
...  
Keyword(s):  
Body Fat ◽  
Overweight And Obesity ◽  
Percent Body Fat ◽  
P Value ◽  
Activity Monitors ◽  
Food Records ◽  
Sleep Timing ◽  
Meal Timing ◽  
Increased Risk ◽  
Unit Increase

Accumulating evidence suggests that later timing of energy intake (EI) is associated with increased risk of obesity. In this study, 83 individuals with overweight and obesity underwent assessment of a 7-day period of data collection, including measures of body weight and body composition (DXA) and 24-h measures of EI (photographic food records), sleep (actigraphy), and physical activity (PA, activity monitors) for 7 days. Relationships between body mass index (BMI) and percent body fat (DXA) with meal timing, sleep, and PA were examined. For every 1 h later start of eating, there was a 1.25 (95% CI: 0.60, 1.91) unit increase in percent body fat (False Discovery Rate (FDR) adjusted p value = 0.010). For every 1 h later midpoint of the eating window, there was a 1.35 (95% CI: 0.51, 2.19) unit increase in percent body fat (FDR p value = 0.029). For every 1 h increase in the end of the sleep period, there was a 1.64 (95% CI: 0.56, 2.72) unit increase in percent body fat (FDR p value = 0.044). Later meal and sleep timing were also associated with lower PA levels. In summary, later timing of EI and sleep are associated with higher body fat and lower levels of PA in people with overweight and obesity.

Resistive training increases fat-free mass and maintains RMR despite weight loss in postmenopausal women

1995 ◽  
Vol 79 (3) ◽  
pp. 818-823 ◽  
Author(s):  
A. S. Ryan ◽  
R. E. Pratley ◽  
D. Elahi ◽  
A. P. Goldberg
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Postmenopausal Women ◽  
Body Fat ◽  
Fat Mass ◽  
Management Program ◽  
Fat Free Mass ◽  
Percent Body Fat ◽  
Plasma Norepinephrine ◽  
Resistive Training

Percent body fat increases with age and is often accompanied by a loss in muscle mass, strength, and energy expenditure. The effects of 16 wk of resistive training (RT) alone or with weight loss (RTWL) on strength (isokinetic dynamometer), body composition (dual-energy X-ray absorptiometry), resting metabolic rate (RMR) (indirect calorimetry), and sympathetic nervous system activity (catecholamines) were examined in 15 postmenopausal women (50–69 yr). RT resulted in significant improvements in upper and lower body strength in both groups (P < 0.01). The nonobese women in the RT group (n = 8) did not change their body weight or fat mass with training. In the obese RTWL group (n = 7), body weight, fat mass, and percent body fat were significantly decreased (P < 0.001). Fat-free mass and RMR significantly increased with training in both groups combined (P < 0.05). There were no significant changes in resting arterialized plasma norepinephrine or epinephrine levels in either group with training. RT increases strength with and without weight loss. Furthermore, RT and RTWL increase fat-free mass and RMR and decrease percent fat in postmenopausal women. Thus, RT may be a valuable component of an integrated weight management program in postmenopausal women.

Effective Weight Loss

2016 ◽  
Author(s):  
Evan M. Forman ◽  
Meghan L. Butryn
Keyword(s):  
Weight Loss ◽  
Dialectical Behavior Therapy ◽  
Relapse Prevention ◽  
Weight Control ◽  
Behavioral Treatment ◽  
Self Control ◽  
Cognitive Behavioral Treatment ◽  
Behavioral Weight Loss ◽  
Empirically Supported ◽  
Look Ahead

Millions of people attempt to lose weight every year, but most will not succeed. Simply learning about a new diet and exercise plan is not enough. This book presents 25 detailed sessions of an empirically supported, cognitive-behavioral treatment package called acceptance-based behavioral treatment (ABT) that has now been utilized successfully in five large National Institute of Health–sponsored clinical trials. The foundation of this approach is comprised of the nutritional, physical activity, and behavioral components of the most successful, gold-standard behavioral weight loss packages, such as Look Ahead and the Diabetes Prevention Project. These components are synthesized with acceptance, willingness, behavioral commitment, motivation, and relapse prevention strategies drawn from acceptance and commitment therapy, dialectical behavior therapy and relapse prevention therapy. ABT is premised on the idea that specialized self-control skills are necessary for weight control, given our innate desire to consume delicious foods and to conserve energy. These self-control skills revolve around a willingness to choose behaviors that may be perceived as uncomfortable for the sake of a more valuable objective. The treatment focuses on both weight loss and weight loss maintenance and aims to confer lifelong skills that facilitate long-term weight control. This companion Client Workbook contains summaries of session content, worksheets, handouts, and assignments.

The impact of genetic polymorphisms on weight regain after successful weight loss

2020 ◽  
Vol 124 (8) ◽  
pp. 809-823
Author(s):  
Chanisa Thonusin ◽  
Krekwit Shinlapawittayatorn ◽  
Siriporn C. Chattipakorn ◽  
Nipon Chattipakorn
Keyword(s):  
Weight Loss ◽  
Genetic Polymorphisms ◽  
Weight Regain ◽  
Risk Estimation ◽  
Weight Maintenance ◽  
Obesity Prevalence ◽  
Physiological Factors ◽  
Increased Risk ◽  
Successful Weight Loss ◽  
The Impact

AbstractObesity is associated with an increased risk of various diseases and mortality. Although nearly 50 % of adults have been reported trying to lose weight, the prevalence of obesity has increased. One factor that hinders weight loss-induced decrease in obesity prevalence is weight regain. Although behavioural, psychological and physiological factors associated with weight regain have been reviewed, the information regarding the relationship between weight regain and genetics has not been previously summarised. In this paper, we comprehensively review the association between genetic polymorphisms and weight regain in adults and children with obesity after weight loss. Based on this information, identification of genetic polymorphism in patients who undergo weight loss intervention might be used to estimate their risks of weight regain. Additionally, the genetic-based risk estimation may be used as a guide for physicians and dietitians to provide each of their patients with the most appropriate strategies for weight loss and weight maintenance.

Multivariate Model for Defining Changes in Maximal Physical Working Capacity of Men, Ages 25 to 70 Years

1992 ◽  
Vol 36 (2) ◽  
pp. 171-174 ◽  
Author(s):  
Andrew S. Jackson ◽  
Earl F. Beard ◽  
Larry T. Wier ◽  
J. E. Stuteville
Keyword(s):  
Physical Activity ◽  
Body Fat ◽  
Multivariate Model ◽  
Percent Body Fat ◽  
Physical Working Capacity ◽  
Working Capacity ◽  
Cross Sectional ◽  
Exercise Habits ◽  
The Cross ◽  
Over Time

The purpose of this study was to develop a multivariate model with cross-sectional data that defined the decline in VO2max over time, and cross-validate the model with longitudinal data. The cross-sectional sample consisted of 1,608 healthy men who ranged in age from 25 to 70 years. VO2max was directly measured during a maximum Bruce treadmill stress test. Regression analysis showed that the cross-sectional age and VO2max relationship was linear, r = 0.45 and the age decline in VO2max was 0.48 ml/kg/min/year. Multiple regression developed the multivariate model from age, percent body fat (%fat), self-report physical activity (SR-PA), and the interaction of SR-PA and %fat (R = 0.793). Accounting for the variance in percent body fat and exercise habits decreased the influence of age on the decline of VO2max to just −0.27 ml/kg/min/year. This showed that much of decline in maximal physical working capacity was due to physical activity level and percent body fat, not aging. The multivariate equation was applied to the data of the longitudinal sample of 156 men who had been tested twice (Mean AgeΔ = 3.1 ± 1.2 years). The correlation between the measured and estimated change in VO2max over time (ΔVO2max) was 0.75. The results of the study showed that changes in body composition and exercise habits had more of an influence on changes in maximal physical working capacity than aging. The developed model provides a useful way to quantify the changes in physical working capacity with aging.

scholarly journals Reductions in visceral fat during weight loss and walking are associated with improvements inV˙o 2 max

2001 ◽  
Vol 90 (1) ◽  
pp. 99-104 ◽  
Author(s):  
Nicole A. Lynch ◽  
Barbara J. Nicklas ◽  
Dora M. Berman ◽  
Karen E. Dennis ◽  
Andrew P. Goldberg
Keyword(s):  
Weight Loss ◽  
Adipose Tissue ◽  
Postmenopausal Women ◽  
Body Fat ◽  
Fat Mass ◽  
Visceral Fat ◽  
Subcutaneous Adipose Tissue ◽  
Increased Risk ◽  
Tissue Area ◽  
Subcutaneous Adipose

The accumulation of visceral fat is independently associated with an increased risk for cardiovascular disease. The aim of this study was to determine whether the loss of visceral adipose tissue area (VAT; computed tomography) is related to improvements in maximal O2 uptake (V˙o 2 max) during a weight loss (250–350 kcal/day deficit) and walking (3 days/wk, 30–40 min) intervention. Forty obese [body fat 47 ± 1 (SE) %], sedentary (V˙o 2 max 19 ± 1 ml · kg−1 · min−1) postmenopausal women (age 62 ± 1 yr) participated in the study. The intervention resulted in significant declines in body weight (−8%), total fat mass (dual-energy X-ray absorptiometry; −17%), VAT (−17%), and subcutaneous adipose tissue area (−17%) with no change in lean body mass (all P < 0.001). Women with an average 10% increase in V˙o 2 max reduced VAT by an average of 20%, whereas those who did not increaseV˙o 2 max decreased VAT by only 10%, despite comparable reductions in body fat, fat mass, and subcutaneous adipose tissue area. The decrease in VAT was independently related to the change in V˙o 2 max( r 2 = 0.22; P < 0.01) and fat mass ( r 2 = 0.08; P = 0.05). These data indicate that greater improvements inV˙o 2 max with weight loss and walking are associated with greater reductions in visceral adiposity in obese postmenopausal women.

scholarly journals African Americans in Standard Behavioral Treatment for Obesity, 2001-2015: What Have We Learned?

2017 ◽  
Vol 39 (8) ◽  
pp. 1045-1069 ◽  
Author(s):  
Rachel W. Goode ◽  
Mindi A. Styn ◽  
Dara D. Mendez ◽  
Tiffany L. Gary-Webb
Keyword(s):  
Weight Loss ◽  
African Americans ◽  
Behavioral Treatment ◽  
The United States ◽  
Behavioral Weight Loss ◽  
Obesity Epidemic ◽  
Large N ◽  
Improved Outcomes ◽  
Telephone Calls ◽  
Disproportionate Burden

African Americans (AAs) bear a disproportionate burden of the obesity epidemic, yet have historically been underrepresented in weight loss research. We conducted a narrative review of large ( N > 75) randomized prospective clinical trials of standard behavioral treatment for weight loss that reported results in the past 15 years (2001-2015) to (a) determine the rates of inclusion and reported results for AAs and (b) further identify strategies that may result in improved outcomes. Of the 23 trials reviewed, 69.6% of the studies met or exceeded population estimates for AAs in the United States. However, only 10 reported outcomes and/or considered race in the analytic approach. At 6 months, AA participants consistently lost less weight than White participants. The use of culturally tailored intervention materials and monthly personal telephone calls were reported as factors that may have enhanced treatment response. Future behavioral weight loss trials should also increase reporting of outcomes by race.

scholarly journals Efficacy of vitamin D alone or in combination with weight-reduction programs in weight loss among adults with above-normal BMI: a systematic review and meta-analysis

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J R B Guevara ◽  
A R Velilia ◽  
S A K Tiu ◽  
A C Ti ◽  
K A F Tinio ◽  
...  
Keyword(s):  
Vitamin D ◽  
Weight Loss ◽  
Waist Circumference ◽  
Body Fat ◽  
Meta Analysis ◽  
Vitamin D Supplementation ◽  
Percent Body Fat ◽  
Waist To Hip Ratio ◽  
Arm Circumference ◽  
Mid Upper Arm Circumference

Abstract Introduction The impact of Vitamin D supplementation on weight loss has been demonstrated in several randomized controlled trials (RCT), but there is still lack of consensus regarding its efficacy. This study aims to assess the efficacy and safety of Vitamin D in weight reduction in terms of changes in weight loss, BMI, neck circumference, mid-upper arm circumference, waist circumference, waist-thigh ratio, waist-to-hip ratio, and percent body fat, as well as reported adverse effects. Methodology MEDLINE (PubMed), Google Scholar, WHO database, Herdin, Cochrane Database and EMBASE were searched for literature published from 2005–2020. A systematic search was conducted for RCTs on the efficacy of Vitamin D (alone or in combination with Calcium, or with a weight-loss program, or with both) in weight loss among participants 18–75 years old with above-normal BMI, and with a study duration of 4–12 weeks. Sixteen RCTs were included in this systematic review and meta-analysis. Screening and selection were based on the eligibility criteria, while appraisal included checking for the risk of bias, assessing the validity of the results of the study, and its methodological quality. Outcomes of eligible studies were obtained directly from the studies, if available, or summarized and calculated from the available data. For continuous data, mean differences were compared. Results When compared with placebo, Vitamin D supplementation showed a significant reduction in weight loss (mean difference [MD] = −0.92; 95% confidence interval [95% CI], −1.52 to −0.31; P=0.003), BMI (MD = −0.52; 95% CI: −0.73 to −0.31; P=0.02), waist circumference (MD = −1.35; 95% CI: −2.21 to −0.33 P=0.0006) and percent body fat (MD = −0.82; 95% CI; −1.40 to −0.25; P=0.005) but no significant effect on reduction of waist-to-hip ratio (MD = −0.01, 95% CI; −0.01 to 0.00; P=0.17). None of the studies reported outcomes for neck circumference, mid-upper arm circumference, and waist-thigh ratio. Heterogeneity was addressed using random effects model in analysis. Out of the 16 studies included, only two reported adverse events, which include constipation after intake of Vitamin D and calcium supplements and other multiple non-serious adverse events. Conclusion and recommendations Vitamin D as an adjunct showed a significant effect on weight loss, BMI reduction, decrease in waist circumference and percent body fat among adults after a short-term intake of oral Vitamin D, thus Vitamin D supplementation may be recommended as an adjunct treatment for weight loss among adults, but the study results should be used with caution as significant heterogeneity was observed. Further conduction of local RCTs and meta-analysis is recommended for further elucidation of data in order to determine its efficacy among Filipinos. FUNDunding Acknowledgement Type of funding sources: None. Effect of Vit D on waist circumference

scholarly journals Once-Weekly Exenatide Enhances Weight Loss Maintenance in Adolescents with Severe Obesity: A Randomized, Placebo-Controlled Trial

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A63-A63
Author(s):  
Claudia K Fox ◽  
Kyle Rudser ◽  
Justin Clark ◽  
Justin R Ryder ◽  
Amy C Gross ◽  
...  
Keyword(s):  
Risk Factors ◽  
Weight Loss ◽  
Placebo Group ◽  
Body Fat ◽  
Treatment Effect ◽  
Weight Regain ◽  
Cardiometabolic Risk ◽  
Severe Obesity ◽  
Weight Loss Maintenance ◽  
Short Term

Abstract Background: In adolescents with severe obesity, long-term weight loss maintenance using lifestyle therapy alone is hampered by numerous biological adaptations favoring weight regain such as increased appetite and sense of food palatability and decreased satiety and resting energy expenditure. Anti-obesity pharmacotherapy may have a role in mitigating some of these physiological adaptations, thereby enhancing weight loss maintenance. We conducted a randomized, double-blind, placebo-controlled clinical trial to evaluate the effect of the glucagon-like peptide-1 receptor agonist (GLP-1RA) exenatide extended release (XR) on the maintenance of BMI reduction and improvements in cardiometabolic risk factors induced by short-term meal replacement therapy (MRT) among adolescents with severe obesity. Methods: One-hundred adolescents ages 12 to &lt;18 years with BMI ≥120% of the 95th percentile engaged in an MRT intervention consisting of pre-portioned meals averaging 1,400 kcals/day with a goal of reducing BMI by ≥5% within eight weeks. Participants achieving this goal were randomized 1:1 to either exenatide XR (2 mg/week subcutaneously) + lifestyle therapy or matching placebo + lifestyle therapy for a subsequent 52 weeks. The primary outcome was mean percent change in BMI from randomization (post-MRT) to 52 weeks. Secondary outcomes included changes in body fat (DXA) and cardiometabolic risk factors. Results: Sixty-six participants (mean age 16±1.5 years; 47% female; mean BMI 36.9±4.4 kg/m2) achieved ≥5% BMI reduction with MRT and were randomized; 56 (85%) completed the 52-week visit. From randomization (post-MRT) to 52-weeks, the exenatide and placebo group mean BMI increased 4.6% and 10.1%, respectively. The prespecified intention-to-treat, last observation carried forward primary analysis demonstrated a placebo-subtracted exenatide treatment effect of -4.1% (95% CI -8.6 to 0.5, p=0.078). The per-protocol analysis (excluding participants with major protocol deviations) demonstrated a placebo-subtracted exenatide treatment effect of -5.7% (95% CI -10.9 to -0.6, p=0.030). The placebo-subtracted exenatide treatment effect on total body fat was -3.0 kg (95% CI -6.7 to 0.7, p=0.108), systolic blood pressure -3.2 mmHg (95% CI -7.0 to 0.7, p=0.107), and triglycerides to HDL ratio -0.6 (95% CI -1.2 to 0.0, p=0.050). Exenatide was generally well-tolerated and the adverse event profile was similar to previous reports of GLP-1RAs. Conclusion: The steep trajectory of weight regain following short-term MRT, particularly in the placebo group, underscores the challenge many adolescents encounter in maintaining weight loss over time. GLP-1RA treatment with once-weekly exenatide appears to partly mitigate the propensity toward weight regain after initial dietary-induced weight loss among adolescents with severe obesity.

Effect of Dronabinol on Nutritional Status in HIV Infection

1993 ◽  
Vol 27 (7-8) ◽  
pp. 827-831 ◽  
Author(s):  
Melissa Struwe ◽  
Suzanne H. Kaempfer ◽  
Constance J. Geiger ◽  
Andrew T. Pavia ◽  
Terry F. Plasse ◽  
...  
Keyword(s):  
Weight Loss ◽  
Nutritional Status ◽  
Hiv Infection ◽  
Outcome Measures ◽  
Body Fat ◽  
Caloric Intake ◽  
Symptom Distress ◽  
Percent Body Fat ◽  
Short Term Treatment ◽  
Double Blind

OBJECTIVE: To examine the effect of dronabinol (delta-9-tetrahydrocannabinol) on appetite and nutritional status in patients with symptomatic HIV infection and weight loss. DESIGN: Double-blind, randomized, placebo-controlled, crossover trial with two five-week treatment periods separated by a two-week washout period. Patients received dronabinol 5 mg twice daily before meals or placebo. SETTING: A university-based HIV/AIDS clinic and a large infectious disease private practice largely devoted to care of patients with HIV. PARTICIPANTS: Twelve HIV-infected patients who had had at least a 2.25-kg weight loss participated in the study. Five patients completed the protocol, and seven withdrew (two because of drug intolerance, two because of disease progression, two because of noncompliance, and one because of experimental antiretroviral therapy). MAIN OUTCOME MEASURES: Main outcome measures included caloric intake, weight, percent body fat, serum prealbumin, and symptom distress. RESULTS: During dronabinol treatment, subjects experienced increased percent body fat (one percent, p=0.04); decreased symptom distress (p=0.04); and trends toward weight gain (0.5 kg, p=0.13), increased prealbumin (29.0 mg/L, p=0.11), and improved appetite score (p=0.14). CONCLUSIONS: In a selected group of HIV-infected patients with weight loss, short-term treatment with dronabinol may result in improvement in nutritional status and symptom distress.

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