scholarly journals Hypothalamic obesity: prevalence, associations and longitudinal trends in weight in a specialist adult neuroendocrine clinic

2013 ◽  
Vol 168 (4) ◽  
pp. 501-507 ◽  
Author(s):  
Caroline A Steele ◽  
Daniel J Cuthbertson ◽  
Ian A MacFarlane ◽  
Mohsen Javadpour ◽  
Kumar S V Das ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Gain ◽  
Clinic Visit ◽  
Morbidly Obese ◽  
Obesity Prevalence ◽  
Hypothalamic Obesity ◽  
Physical Activity Advice ◽  
The Impact ◽  
Hypothalamic Damage

ObjectiveObesity is highly prevalent among adults with acquired, structural hypothalamic damage. We aimed to determine hormonal and neuroanatomical variables associated with weight gain and obesity in patients following hypothalamic damage and to evaluate the impact of early instigation of weight loss measures to prevent or limit the severity of obesity in these patients.DesignRetrospective study of 110 adults with hypothalamic tumours attending a specialist neuroendocrine clinic. BMI was calculated at diagnosis and at last follow-up clinic visit. Endocrine data, procedures, treatments and weight loss measures were recorded and all available brain imaging reviewed.ResultsAt last follow-up, 82.7% of patients were overweight or heavier (BMI≥25 kg/m2), 57.2% were obese (BMI≥30 kg/m2) and 14.5% were morbidly obese (BMI≥40 kg/m2). Multivariate analysis revealed that use of desmopressin (odds ratio (OR)=3.5;P=0.026), GH (OR=2.7;P=0.031) and thyroxine (OR=3.0;P=0.03) was associated with development of new or worsened obesity. Neuroimaging features were not associated with weight gain. Despite proactive treatments offered in clinic in recent years (counselling, dietetic and physical activity advice, and anti-obesity medications), patients have continued to gain weight.ConclusionsDespite increased awareness, hypothalamic obesity is difficult to prevent and to treat. Improved understanding of the underlying pathophysiologies and multicentre collaboration to examine efficacy of novel obesity interventions are warranted.

The weight change impact on metabolic syndrome: a 17-year follow-up study

Open Medicine ◽  
2011 ◽  
Vol 6 (6) ◽  
pp. 788-794 ◽  
Author(s):  
Magdalena Kwaśniewska ◽  
Dorota Kaleta ◽  
Anna Jegier ◽  
Tomasz Kostka ◽  
Elżbieta Dziankowska-Zaborszczyk ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Weight Loss ◽  
Weight Gain ◽  
Weight Change ◽  
Metabolic Risk ◽  
Adjusted Relative Risk ◽  
Prospective Longitudinal ◽  
The Impact

AbstractIntroduction: Data on long-term patterns of weight change in relation to the development of metabolic syndrome (MetS) are scarce. The aim of the study was to evaluate the impact of weight change on the risk of MetS in men. Material and Methods: Prospective longitudinal observation (17.9 ± 8.1 years) of apparently healthy 324 men aged 18–64 years. Metabolic risk was assessed in weight gain (⩾ 2.5 kg), stable weight (> −2.5 kg and < 2.5 kg) and weight loss (⩽ −2.5 kg) groups. Adjusted relative risk (RR) of MetS was analyzed using multivariate logistic regression. Results: The prevalence of MetS over follow-up was 22.5%. There was a strong relationship between weight gain and worsening of MetS components among baseline overweight men. Long-term increase in weight was most strongly related with the risk of abdominal obesity (RR=7.26; 95% CI 2.98–18.98), regardless of baseline body mass index (BMI). Weight loss was protective against most metabolic disorders. Leisure-time physical activity (LTPA) with energy expenditure > 2000 metabolic equivalent/min/week was associated with a significantly lower risk of MetS. Conclusions: Reducing weight among overweight and maintaining stable weight among normal-weight men lower the risk of MetS. High LTPA level may additionally decrease the metabolic risk regardless of BMI.

scholarly journals The effects of age on weight loss after sleeve gastrectomy

2021 ◽  
Vol 8 ◽  
Author(s):  
Taha Anbara
Keyword(s):  
Diabetes Mellitus ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Statistical Significance ◽  
Age Groups ◽  
Primary Treatment ◽  
Morbidly Obese ◽  
Safe Procedure ◽  
The Impact

Introduction: Laparoscopic sleeve gastrectomy is a primary treatment of obesity among older adults and its satisfactory outcomes would be the main reason behind the popularity of this procedure. We aim to evaluate the impact of age on excess weight loss in adult morbidly obese subjects older than 60 years old following LSG.Methods: In this retrospective survey, 3,072 subjects were included in the study that underwent LSG in Erfan Hospital. Screening follow-up period was 12 months. The level of statistical significance was set at P < 0.05. We hired comorbid conditions to avoid bias results including hypertension, diabetes mellitus and dyslipidemia. Results: Of 3072 patients, 1879 cases were females (61.2%) and 1193 subjects were males (38.8 %). Mean %EBMIL of the group 12 months after surgery was 78.9 %. In younger than 60 years old group, mean %EBMIL 12 months postoperative 83 % and patients  over 60 years demonstrated mean %EBMIL 74.9 %. There was an obvious difference among age groups in presence of diabetes mellitus and hypertension in the older group which was more frequent. Conclusion: To sum up, laparoscopic sleeve gastrectomy is safe procedure for older groups. Albeit, %EBMIL was significantly lower in older group compared to younger subjects, but resolution in comorbidities was satisfactory.

scholarly journals Towards Precision Health in Weight Reduction: Thematic Content Analysis of an Open-Ended Survey on Reasons Why Morbidly Obese Patients Want to Lose Weight.

2020 ◽  
Author(s):  
Mazapuspavina Md-Ya ◽  
Ilham Ameera Ismail ◽  
Khasnur Abd Malek ◽  
Khalid Yusoff ◽  
Awang Bulgiba
Keyword(s):  
Morbid Obesity ◽  
Weight Loss ◽  
Content Analysis ◽  
Weight Reduction ◽  
Extensive Study ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Thematic Content Analysis ◽  
Thematic Content ◽  
The Impact

Abstract Background: Addressing individuals’ motivation to lose weight among patients with morbid obesity is an essential entity in weight reduction. Failures to shift motivation into weight loss actions are common. These could be contributed by the inadequacy to identify and subsequently address the key reasons, that are of particular concern to the patient' individual needs. We aimed to understand the motivations better and identify the reasons why morbidly obese patients attending hospital-based weight management programmes (WMP) wanted to lose weight. Methods: The study used a qualitative approach to analyze part of a quantitative questionnaire of a more extensive study to understand factors influencing weight loss among morbidly obese patients. We used thematic content analysis to analyze responses from a self-administered open-ended question "What is the main factor why you want to lose your weight?”. A total of 225 new patients attending obesity clinics in two tertiary hospitals responded to the questionnaire. Results: Patients’ mean BMI was 45.6±8.05 kg/m2. Four themes emerged for the reasons why morbidly obese patients wanted to lose weight. Health was the most commonly inferred theme (84%). Patients were concerned about the impact obesity had on their health. Overcoming obesity was seen as a reward not just for physical health, but also for their psychological wellbeing. Patients regard being functional to care for themselves, their family members, as well as their religious and career needs as the next most crucial theme (25.8%). Patients raised the theme appearance (12.9%), especially with regards to wanting to look and feel beautiful. The last theme was perceived stigmatization for being morbidly obese as they were mocked and laughed at for their appearance (3.1%).Conclusion: Patients with morbid obesity in this study had expressed their main personal motivational reasons to lose weight. Concerns about the impact of morbid obesity on health, physical, social and obligatory function, appearance and perceived stigma warrant detailed exploration by the managing health professionals. Identifying and addressing these unique personal motivations in a focused approach is vital at the beginning and throughout a weight reduction program in this unique group.

Abstract 24: Changes in Generalized and Central Adiposity are Dynamically Associated with Left Ventricular Remodeling

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Bryan R Wilner ◽  
Sonia Garg ◽  
Colby R Ayers ◽  
Satyam Sarma ◽  
Anand Rohatgi ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Gain ◽  
Waist Circumference ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Left Ventricular ◽  
Study Cohort ◽  
Central Adiposity ◽  
Lv Mass

Introduction: Obesity is linked to an adverse cardiac structural phenotype in cross-sectional studies. However, the effects of longitudinal changes in generalized and central adiposity on left ventricular (LV) remodeling are unknown. Methods: Participants without baseline cardiovascular disease or LV dysfunction in the Dallas Heart Study underwent assessment of body composition and cardiac structure by MRI at baseline and then 7 years later. Associations between change in weight and waist circumference with alterations in structure and function were assessed using multivariable linear regression. Results: The study cohort (n=1262) had a mean age of 44 years and was 43% (545 of 1262) male, 44% (556 of 1262) African-American, and 36% (460 of 1262) obese at baseline. At 7 years follow-up, 7% (85 of 1262) had >10% weight loss, 8% (108 of 1262) had 5-10% weight loss, 44% (551 of 1262) had <5% weight change, 20% (248 of 1262) had 5-10% weight gain, and 21% (270 of 1262) had >10% weight gain. Those who gained >10% weight were younger, had lower BMI and LV mass at baseline, and had greater increases in blood pressure, glucose, triglycerides, LDL cholesterol, and hs-CRP over follow-up. In multivariable models adjusted for age, sex, race, and baseline and interim development of comorbidities, 1-standard deviation increases in body weight and waist circumference over follow-up were significantly associated with higher LV mass, LV wall thickness, and concentricity; but minimally or not significantly associated with LV end-diastolic volume or ejection fraction (EF) (Table). Conclusion: Increases in generalized and central adiposity are characterized primarily by concentric remodeling, with a more modest impact on LV volume and EF. These results support the notion that the development of specific obesity patterns may impact cardiac remodeling with potential implications for the development of cardiac hypertrophy and heart failure.

scholarly journals The influence of patient’s age on metabolic and bariatric results of laparoscopic sleeve gastrectomy in 2-year observation

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Paulina Woźniewska ◽  
Inna Diemieszczyk ◽  
Dawid Groth ◽  
Łukasz Szczerbiński ◽  
Barbara Choromańska ◽  
...  
Keyword(s):  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Laboratory Data ◽  
Morbidly Obese ◽  
Significant Weight Loss ◽  
Preoperative Body Mass Index ◽  
Age Related ◽  
Excess Bmi Loss

Abstract Background The incidence of obesity has been constantly growing and bariatric procedures are considered to be the most effective treatment solution for morbidly obese patients. The results of laparoscopic sleeve gastrectomy (LSG) may differ depending on patient’s age, gender, preoperative body mass index (BMI) and physical activity. Methods The aim of this study was to evaluate age-related differences in the outcome of LSG in terms of weight loss parameters, lipid and carbohydrate profile. The retrospective analysis of 555 patients who had undergone LSG was performed to compare the metabolic outcomes of surgery in individuals < 45 and ≥ 45 years old. Evaluation of weight loss parameters along with selected laboratory data was performed to demonstrate the results of LSG in 2 years follow-up. Results Overall, 238 males and 317 females (43%/57%) with median age of 43 years and median preoperative BMI of 46.41 (42.06–51.02) kg/m2 were analyzed. Patients in both groups presented significant weight loss at 24 months after the surgery with comparable percentage of total weight loss (40.95% in < 45 years old group and 40.44% in ≥ 45 years old group). The percentage of excess weight loss (78.52% vs. 74.53%) and percentage of excess BMI loss (91.95% vs. 88.01%) were higher in patients < 45 years old. However, the differences were not statistically significant (p = 0.662, p = 0.788 respectively). Patients under 45 years old experienced faster decrease in fasting glucose level that was observed after only 3 months (109 mg/dl to 95 mg/dl in < 45 years old group vs. 103.5 mg/dl to 99.5 mg/dl in ≥ 45 years old group, p < 0.001). Both groups presented improvement of lipid parameters during the observation. However, patients < 45 years old achieved lower values of LDL at 3 and 12 months follow-up (115 mg/dl vs. 126 mg/dl, p = 0.010; 114.8 mg/dl vs. 122 mg/dl, p = 0.002). Younger group of patients also showed superior improvement of triglycerides level. Conclusions LSG results in significant weight loss in all patients regardless age. In turn, superior and faster improvement in lipid and carbohydrate profile is achieved in patients under 45 years old.

scholarly journals Body Weight Variation Patterns as Predictors of Cognitive Decline over a 5 Year Follow-Up among Community-Dwelling Elderly (MAPT Study)

Nutrients ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 1371
Author(s):  
Kelly Giudici ◽  
Sophie Guyonnet ◽  
Yves Rolland ◽  
Bruno Vellas ◽  
Philipe de Souto Barreto ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Weight Gain ◽  
Hippocampal Volume ◽  
Community Dwelling ◽  
First Year ◽  
Z Score ◽  
Weight Variation ◽  
Variation Patterns

This study aimed to analyze associations between weight variation patterns and changes in cognitive function and hippocampal volume among non-demented, community-dwelling elderly. Sample was formed of 1394 adults >70 years (63.9% female), all volunteers from the Multidomain Alzheimer Preventive Trial (MAPT). Weight loss was defined as ≥5% of body weight decrease in the first year of follow-up; weight gain as ≥5% of weight increase; and stability if <5% weight variation. Cognition was examined by a Z-score combining four tests. Measures were assessed at baseline, 6, 12, 24, 36, 48, and 60 months of follow-up. Hippocampal volume was evaluated with magnetic resonance imaging in 349 subjects in the first year and at 36 months. Mixed models were performed. From the 1394 participants, 5.5% (n = 76) presented weight loss, and 9.0% (n = 125) presented weight gain. Cognitive Z-score decreased among all groups after 5 years, but decline was more pronounced among those who presented weight loss (adjusted between-group mean difference vs. stable: −0.24, 95%CI: −0.41 to −0.07; p = 0.006). After 3 years, hippocampal atrophy was observed among all groups, but no between-group differences were found. In conclusion, weight loss ≥5% in the first year predicted higher cognitive decline over a 5 year follow-up among community-dwelling elderly, independently of body mass index.

scholarly journals Does Personalized Nutrition Increase Weight Loss Self-Efficacy?

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1310-1310
Author(s):  
Lu Hu ◽  
Chan Wang ◽  
Huilin Li ◽  
Margaret Curran ◽  
Collin J Popp ◽  
...  
Keyword(s):  
Weight Loss ◽  
Real Time ◽  
Self Efficacy ◽  
Learning Algorithm ◽  
Mobile App ◽  
Small Sample ◽  
Dietary Counseling ◽  
Macronutrient Distribution ◽  
The Impact

Abstract Objectives We examined whether a diet personalized to reduce postprandial glycemic response (PPGR) to foods increases weight loss self-efficacy. Methods The Personal Diet Study is an ongoing clinical trial that aims to compare two weight loss diets: a one-size-fits-all, calorie-restricted, low-fat diet (Standardized) versus a diet having the same calorie restriction but utilizing a machine learning algorithm to predict and reduce PPGR (Personalized). Both groups receive the same behavioral counseling to enhance weight loss self-efficacy. Both groups self-monitor dietary intake using a mobile app, with Standardized receiving real-time feedback on calories and macronutrient distribution, and Personalized receiving real time feedback on calories, macronutrient distribution, and predicted PPGR. We examined changes in self-efficacy between baseline and 3 mos, using the 20-item Weight Efficacy Lifestyle questionnaire (WEL). Linear mixed models were used to analyze differences, adjusting for age, gender, and race. Results The analyses included the first 75 participants to complete 3-mos assessments (41 Personalized and 34 Standardized). The majority of the participants were white (69.3%), female (61.3%), with a mean age of 61.7 years (SD = 9.9) and BMI of 33.4 kg/m2 (SD = 4.8). At baseline, WEL scores were similar between the 2 groups [Standardized WEL: 118.8 (SD = 27.6); Personalized WEL: 124.9 (SD = 29.5), P = 0.47]. At 3 mos, the WEL score was significantly improved in both groups [16.0 (SD = 4.1) in the Standardized group (P &lt; 0.001) and 7.4 (SD = 3.7) in the Personalized group (P = 0.048)], but the between group difference was not significant (P = 0.12). Conclusions Personalized feedback on predicted PPGRs does not appear to enhance weight loss self-efficacy at 3 mos. The lack of significance may be related to the short follow-up period in these preliminary analyses, the small sample accrued to date, or the fact that WEL is designed to assess confidence in various situations (e.g., depressed, anxious) that may not be impacted by personalization. These analyses will be replicated with a larger sample using data obtained through the 6-mos follow-up. New self-efficacy measures may be required to assess the impact of personalized dietary counseling. Funding Sources This research was supported by the American Heart Association.

Psychological Well-Being, Health Behaviors, and Weight Loss Among Participants in a Residential, Kripalu Yoga-Based Weight Loss Program

2012 ◽  
Vol 22 (1) ◽  
pp. 9-22 ◽  
Author(s):  
Tosca Braun ◽  
Crystal Park ◽  
Lisa Ann Conboy
Keyword(s):  
Weight Loss ◽  
Health Behaviors ◽  
Well Being ◽  
The United States ◽  
Overweight And Obesity ◽  
Weight Loss Program ◽  
Health Concern ◽  
Psychological Well Being ◽  
The Impact

The increasing prevalence of overweight and obesity in humans is a growing public health concern in the United States. Concomitants include poor health behaviors and reduced psychological well-being. Preliminary evidence suggests yoga and treatment paradigms incorporating mindfulness, self-compassion (SC), acceptance, non-dieting, and intuitive eating may improve these ancillary correlates, which may promote long-term weight loss. Methods: We explored the impact of a 5-day residential weight loss program, which was multifaceted and based on Kripalu yoga, on health behaviors, weight loss, and psychological well-being in overweight/obese individuals. Thirty-seven overweight/obese program participants (age 32-65, BMI&lt;25) completed validated mind-fulness, SC, lifestyle behavior, and mood questionnaires at baseline, post-program, and 3-month follow-up and reported their weight 1 year after program completion. Results: Significant improvements in nutrition behaviors, SC, mindfulness, stress management, and spiritual growth were observed immediately post-program (n = 31, 84% retention), with medium to large effect sizes. At 3-month follow-up (n = 18, 49% retention), most changes persisted. Physical activity and mood disturbance had improved significantly post-program but failed to reach significance at 3-month follow-up. Self-report weight loss at 1 year (n = 19, 51% retention) was significant. Conclusion: These findings suggest a Kripalu yoga-based, residential weight loss program may foster psychological well-being, improved nutrition behaviors, and weight loss. Given the exploratory nature of this investigation, more rigorous work in this area is warranted.

The influence of a cachexia clinic on palliative care integration in oncology.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 124-124
Author(s):  
Diane Portman ◽  
Sarah Thirlwell ◽  
Kristine A. Donovan
Keyword(s):  
Palliative Care ◽  
Weight Loss ◽  
Advanced Cancer ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Cancer Center ◽  
Edmonton Symptom Assessment Scale ◽  
Symptom Assessment Scale ◽  
The Impact

124 Background: Appetite and weight loss are common in patients with advanced cancer and specialized cachexia clinics have been established to address these symptoms. Given the association between anorexia/cachexia and other adverse symptoms, these patients may also benefit from specialty level palliative care (PC). However, referral to outpatient specialty level PC is often delayed or does not occur. We sought to examine the prevalence of other factors associated with appetite and weight loss in patients with advanced cancer and the impact of a specialized cachexia clinic on identification and treatment of other PC needs. Methods: The records of patients referred by their Oncologist to the cachexia clinic of a cancer center from August 2016 to June 2017 were reviewed retrospectively. Subjects who had been referred to PC by their Oncologist were excluded. Patients had been assessed for symptom burden using the Edmonton Symptom Assessment Scale (ESAS-r). Patients identified with PC needs had been referred to the PC clinic for follow-up within 30 days after cachexia clinic consultation. Results: Thirty subjects were evaluated in the cachexia clinic (average age 68 years; 63% female). The predominant diagnosis was lung cancer (70%). An average of 6 symptoms per patient were in the moderate to severe range on ESAS, excluding appetite. Depression, fatigue and pain were most common. The average cachexia clinic total ESAS score was 51.61. Only 17% of patients had completed advance directives. Ninety-three % of patients were referred to PC and 68% were seen. The average number of PC visits was 2.79. Within the PC clinic, advance directive completion increased to 37%, goals of care discussion occurred with 50% and 17% received hospice referrals. At the most recent follow-up in the PC clinic, the average total ESAS score had decreased by 11.44 (22%) and all ESAS item scores were improved on average. Conclusions: The cachexia clinic proved a useful means to identify other PC needs and achieve effective PC referrals. We suggest this is proof of concept that specialty clinics can be a meaningful way to achieve an earlier entry point to comprehensive PC in patients who were not previously referred by their Oncologists.

P85: The impact of long-term surgical follow-up on weight loss after laparoscopic Roux-Y gastric bypass

2008 ◽  
Vol 4 (3) ◽  
pp. 344 ◽  
Author(s):  
Alain Ramirez ◽  
Andrew J. Duffy ◽  
Kurt E. Roberts ◽  
Robert L. Bell
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
The Impact
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