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Very low-calorie diet in candidates for bariatric surgery: change in body composition during rapid weight loss.
Serafim, MP, Santo, MA, Gadducci, AV, Scabim, VM, Cecconello, I, de Cleva, R
Clinics (Sao Paulo, Brazil). 2019;:e560
Abstract
OBJECTIVE To analyze the changes in the body composition of morbidly obese patients induced by a very low-calorie diet. METHODS We evaluated 120 patients selected from a university hospital. Body composition was assessed before and after the diet provided during hospitalization, and changes in weight, body mass index, and neck, waist and hip circumferences were analyzed. Bioimpedance was used to obtain body fat and fat-free mass values. The data were categorized by gender, age, body mass index and diabetes diagnosis. RESULTS The patients consumed the diet for 8 days. They presented a 5% weight loss (without significant difference among groups), which represented an 85% reduction in body fat. All changes in body circumference were statistically significant. There was greater weight loss and a greater reduction of body fat in men, but the elderly showed a significantly higher percentage of weight loss and greater reductions in body fat and fat-free mass. Greater reductions in body fat and fat-free mass were also observed in superobese patients. The changes in the diabetic participants did not differ significantly from those of the non-diabetic participants. CONCLUSIONS The use of a VLCD before bariatric surgery led to a loss of weight at the expense of body fat over a short period, with no significant differences in the alteration of body composition according to gender, age, body mass index and diabetes status.
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Association of a history of childhood-onset obesity and dieting with eating disorders.
Cena, H, Stanford, FC, Ochner, L, Fonte, ML, Biino, G, De Giuseppe, R, Taveras, E, Misra, M
Eating disorders. 2017;(3):216-229
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Abstract
This was a retrospective, observational chart review conducted on a convenience sample of 537 outpatients, aged 16-60 years, referred to an Italian Dietetic and Nutrition University Center. The study aimed to look at the association between a history of childhood obesity and dieting behaviors with development of eating disorders (EDs) at a later age. Subjects with a history of EDs (n = 118), assessed using both self-report and health records, were compared with those with no EDs (n = 419), who were attending the clinic mainly for primary prevention of metabolic and cardiovascular risk. Logistic regression analysis was performed to assess the association of childhood-onset obesity with development of an ED at a later age. Childhood-onset obesity, gender, maternal history of eating disorders, and dieting were associated with a positive history of EDs at a later age (p < .05). It is important to raise professional awareness of early symptoms of EDs in children with a history of obesity and treat them accordingly.
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Recent trends in weight loss attempts: repeated cross-sectional analyses from the health survey for England.
Piernas, C, Aveyard, P, Jebb, SA
International journal of obesity (2005). 2016;(11):1754-1759
Abstract
BACKGROUND Public policies and clinical guidelines encourage people to achieve and maintain a healthy weight and societal culture, especially among women who tend to idealise thinness. OBJECTIVES To examine trends over time in the prevalence of weight loss attempts in England (1997-2013) and to investigate if the characteristics associated with attempts to lose weight have changed. METHODS Observational study using nationally representative data on adults ⩾18 years who participated in the Health Survey for England (HSE) in 1997 (n=8066), 1998 (n=14 733), 2002 (n=8803), 2012 (n=7132) and 2013 (n=7591), with self-reported attempts to lose weight, cardiovascular disease (CVD) events or medications and measured height, weight and blood pressure. Multivariable logistic regression was used to assess the association between weight loss attempts and survey year, socio-demographic variables and health status. RESULTS The age-standardised prevalence of weight loss attempts in the English population increased from 39% in 1997 to 47% in 2013. In 2013, 10% of those with BMI <22; 30% with BMI ⩾22 to <25; 53% with BMI ⩾25 to <30; and 76% with BMI ⩾30 were trying to lose weight. The odds of trying to lose weight increased linearly with each year: odds ratio (OR) 1.021 (95% confidence interval (CI) 1.018-1.024) and 1.024 (95% CI 1.008-1.039) after adjustment for changes in BMI and population characteristics. The biggest predictors of weight loss attempts were being in the overweight/obese categories: 5.42 (95% CI 5.05-5.81) and 12.68 (95% CI 11.52-13.96), respectively; and among women: 3.01 (95% CI 2.85-3.18). Having a BMI >25 and a CVD-related condition was associated with only a small increase in the odds of trying to lose weight. There was no evidence that these predictors changed over time. CONCLUSIONS More people are making weight loss attempts each year across all BMI categories. Having a health condition that would improve with weight loss was only very modestly associated with an increase in reported weight loss attempts, which reinforces data that suggests people's prime motivation to lose weight is unrelated to health.
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Changes in liver volume and body composition during 4 weeks of low calorie diet before laparoscopic gastric bypass.
Edholm, D, Kullberg, J, Karlsson, FA, Haenni, A, Ahlström, H, Sundbom, M
Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. 2015;(3):602-6
Abstract
BACKGROUND Weight loss before laparoscopic Roux-en-Y gastric bypass (LRYGB) is desirable, because it can reduce liver volume and thereby facilitate the procedure. The optimal duration of a low-calorie diet (LCD) has not been established. The objective of this study was to assess changes in liver volume and body composition during 4 weeks of LCD. METHODS Ten women (aged 43±8.9 years, 114±12.1 kg, and body mass index 42±2.6 kg/m(2)) were examined on days 0, 3, 7, 14, and 28 after commencing the LCD. At each evaluation, body composition was assessed through bioelectric impedance analysis, and liver volume and intrahepatic fat content were assessed by magnetic resonance imaging. Serum and urine samples were obtained. Questionnaires regarding quality of life and LCD-related symptoms were administered. RESULTS In total, mean weight decreased by 7.4±1.2 kg (range 5.7-9.1 kg), and 71% of the weight loss consisted of fat mass according to bioelectric impedance analysis. From day 0 to day 3, the weight loss (2.0 kg) consisted mainly of water. Liver volume decreased by 18%±6.2%, from 2.1 to 1.7 liters (P<.01), during the first 2 weeks with no further change thereafter. A continuous 51%±16% decrease was seen in intrahepatic fat content. Systolic blood pressure, insulin, and lipids improved, while liver enzymes, glucose levels, and quality of life were unaffected. CONCLUSION A significant decrease in liver volume (18%) occurred during the first 2 weeks of LCD treatment, and intrahepatic fat gradually decreased throughout the study period. A preoperative 2-week LCD treatment seems sufficient in similar patients.
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Efficacy and safety of liraglutide therapy in 195 Indian patients with type 2 diabetes in real world setting.
Kesavadev, J, Shankar, A, Gopalakrishnan, G, Jothydev, S
Diabetes & metabolic syndrome. 2015;(1):30-3
Abstract
BACKGROUND GLP-1 analogues has established role in the management of type 2 diabetes mellitus (T2DM). Liraglutide, a human GLP-1 analogue is used as an adjunct to diet and exercise in adults with T2DM for improvement of glycemic control. OBJECTIVE To assess the efficacy and safety of liraglutide in Indian patients with T2DM in real-world setting. METHODS A prospective, open label, single arm, single centre, observational study of 24 weeks duration in a real-world setting. Subjects with T2DM with impaired glucose control despite of antidiabetic therapy and clinically suitable for liraglutide therapy were enrolled and managed. All subjects received liraglutide therapy in addition to their existing anti-diabetic therapy. Starting dose of liraglutide (Victoza) was 0.6 mg/day for 7 days followed by 1.2 mg/day for next 7 days and finally 1.8 mg/day for 22 weeks. Subjects were evaluated at baseline and at 24 weeks. Adverse events (AE) noted during course of therapy were recorded. Student t test (two tailed, dependent) was performed for assessment of statistical significance. RESULTS Total 195 subjects were studied over 24 weeks. Mean fasting plasma glucose (FPG) was decreased from 163.81 mg/dL to 111.6 (P<0.001); similarly HbA1c was reduced from 8.14% to 6.96% (P=0.006) at 24 weeks. At week 24, 49.23% and 41.03% subjects treated with liraglutide reached an HbA1c<7.0% and ≤6.5%, respectively. Mean weight was reduced from 86.41 kg to 82.37 kg (P<0.001). Additionally mean systolic and diastolic blood pressure was reduced from 129.31 and 76.18 mm of Hg to 119.59 (P=0.90) and 70.88 (P<0.001) mm of Hg, respectively. Serum cholesterol was reduced from 166.68 mg/dL to 124.86 mg/dL (P<0.001). Twenty-two (11.28%) subjects reported adverse events (AE), the most common AEs being vomiting, tiredness, loose motion and nausea. All AEs were mild to moderate in nature without any serious AE. CONCLUSION In 195 Indian patients with T2DM receiving anti-diabetic drugs, addition of liraglutide resulted in significant improvement in glycemic parameters and was well tolerated. Clinically significant reduction in weight, blood pressure and serum cholesterol were also noted.