Gradual Weight Loss Research Articles

The Association Between Rate of Initial Weight Loss and Long-Term Success in Obesity Treatment: Does Slow and Steady Win the Race?

Controversy exists regarding the optimal rate of weight loss for long-term weight management success. This study examined whether gradual initial weight loss was associated with greater long-term weight reduction than rapid initial loss. Groups were drawn from participants in the TOURS trial, which included a sample of middle-aged (mean = 59.3 years) obese women (mean BMI = 36.8) who received a 6-month lifestyle intervention followed by a 1-year extended care program. Participants were encouraged to reduce caloric intake to achieve weight losses of 0.45 kg/week. Groups were categorized as "FAST" (> or =0.68 kg/week, n = 69), "MODERATE" (> or =0.23 and <0.68 kg/week, n = 104), and "SLOW" (<0.23 kg/week, n = 89) based on rate of weight loss during first month of treatment. The FAST, MODERATE, and SLOW groups differed significantly in mean weight changes at 6 months (-13.5, -8.9, and -5.1 kg, respectively, ps < 0.001), and the FAST and SLOW groups differed significantly at 18 months (-10.9, -7.1, and -3.7 kg, respectively, ps < 0.001). No significant group differences were found in weight regain between 6 and 18 months (2.6, 1.8, and 1.3 kg, respectively, ps < 0.9). The FAST and MODERATE groups were 5.1 and 2.7 times more likely to achieve 10% weight losses at 18 months than the SLOW group. Collectively, findings indicate both short- and long-term advantages to fast initial weight loss. Fast weight losers obtained greater weight reduction and long-term maintenance, and were not more susceptible to weight regain than gradual weight losers.

Long-term Effect Of Two Different Weight Loss Interventions On Changes In Body Composition And Performance.

During weight reduction, athletes are recommended a gradual weight loss of 0.5-1 kg·week-1 through moderate energy restriction. However, the effect of weight loss rate on long-term changes in body composition and performance has not been investigated in elite athletes.PURPOSE: To compare the lo

Thermodynamic investigations of nitroxoline sublimation by simultaneous DSC-FTIR method and isothermal TG analysis

To investigate the physicochemical characteristics, thermodynamics, possible sublimation process and kinetics of nitroxoline, differential scanning calorimetry (DSC), isothermal thermogravimetry (TG), and Fourier transform infrared (FTIR) microspectroscopy equipped with a micro hot-stage of DSC microscopy assembly (simultaneous DSC-FTIR method) were used. The DSC result indicates that nitroxoline exhibited a sharp endothermic peak at 182°C with enthalpy of 103.1 J/g due to the melting point of nitroxoline. A sublimation behavior of nitroxoline was found from 129°C by gradual weight loss in TG curve. However, the nonisothermal DSC-FTIR method reveals that the temperature at 95°C was the onset temperature of nitroxoline sublimation. A significant difference between DSC-FTIR method and TG analysis suggests that the simultaneous DSC-FTIR method was more sensitive than that of the TG analysis to detect the beginning temperature of nitroxoline sublimation. The sublimation kinetics of nitroxoline determined by isothermal TG analysis evidenced that the zero-order kinetics was followed over the sublimation time. The sublimation enthalpy correction was also carried out by a group additivity approach for the estimation of heat capacity. The enthalpy of nitroxoline sublimation estimated was 86.14 KJ/mol at 298.15 K. © 2009 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 99:255–261, 2010

Combination drug treatment in patients with non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) includes simple steatosis, a benign condition, and non-alcoholic steatohepatitis, a condition that beyond TG accumulation also includes necroinflammation and fibrosis. An association between NAFLD and cardiovascular disease (CVD) has been recently suggested. NAFLD patients usually have an increased CVD risk profile. NAFLD is also associated with metabolic syndrome (MetS) and is considered as the hepatic component of MetS by some authors. Currently, the only established treatment of NAFLD is gradual weight loss. However, multifactorial treatment of NAFLD risk factors may be needed to reduce the increased CVD risk of NALFD patients. Drug combinations that include antiobesity drugs (such as orlistat and sibutramine) and target CVD risk factors may be a good approach to NAFLD patients. Our group has investigated the orlistat-fenofibrate combination treatment in obese patients with MetS and the orlistat-ezetimibe and sibutramine-antihypertensive combination treatment in obese patients with hyperlipidaemia with promising results in CVD risk factor reduction and improvement of liver function tests. Small studies give promising results but double-blind, randomized trials examining the effects of such multifactorial treatment in hard CVD endpoints in NAFLD patients are missing.

The impact of female obesity on the outcome of fertility treatment

The rising prevalence of obesity has had a profound impact on female reproductive health. Increased body mass index (BMI) is associated with ovulatory subfertility and anovulatory infertility. Overweight and obese women have poorer outcomes following fertility treatment. They respond poorly to clomiphene induction of ovulation and require higher doses of gonadotrophins for ovulation induction and superovulation. Ovarian stimulation for assisted reproduction produces fewer follicles resulting in the harvest of fewer oocytes. Fertilization rates are poorer and the embryo quality is impaired in younger women who are obese. Pregnancy rate in some studies is lower and there is an increased risk of early pregnancy loss. Weight loss regularizes menstrual cycles and increases the chance of spontaneous ovulation and conception in anovulatory overweight and obese women. Gradual sustained weight loss is beneficial whereas crash dieting is detrimental.

Preparation and thermal stability of porous alumina membranes with nano-pore arrays

Porous alumina membranes (PAMs) were fabricated using a two-step oxidization method in oxalic acid. Polycrystalline PAMs have been prepared after annealing at different temperatures. The high-temperature properties of the PAMs were investigated using scanning electron microscopy, thermal analysis, X-ray diffraction and infrared spectrometer. At 870°C the amorphous alumina crystallizes to γ-Al2O3. Finally at 1228°C the alumina converts into the thermodynamically preferred phase, α-Al2O3. Differential thermal analysis showed that there was a gradual weight loss at about 900°C due to decomposed of oxalate. A mass of carboxylate ions and carboxylic groups were found in the infrared spectrum of PAMs, and reduced with the increasing of annealing temperature. Characteristic analysis with scanning electron microscopy shows that the pore structure of the PAMs was very stable and there was no detectable structural modification below 900°C, and microstructures of the pores changed slightly during the transformation from α-Al2O3 to γ-Al2O3 while increasing the annealing temperature.

Comparison of Combined Bupropion and Naltrexone Therapy for Obesity with Monotherapy and Placebo

The efficacy of current centrally acting obesity pharmacotherapies is limited by compensatory mechanisms that mitigate weight loss. Our objective was to determine whether opioid receptor antagonism (naltrexone) plus pro-opiomelanocortin activation (bupropion) causes greater weight loss than placebo or monotherapy. A randomized, placebo- and monotherapy-controlled, double-blind, dose-finding trial was conducted from August 2005 to December 2006 in seven U.S. outpatient clinics. A total of 419 patients with uncomplicated obesity participated. Interventions included 24 wk of sustained-release bupropion (400 mg/d), immediate-release naltrexone (48 mg/d), placebo, and three combination therapy [naltrexone/bupropion (NB)] groups consisting of immediate-release naltrexone, 16, 32, or 48 mg/d, plus sustained-release bupropion (400 mg/d) with a 24-wk extension. A minimal diet and exercise component was also included. Percent weight change from baseline at wk 24 in the intent-to-treat population for NB48 vs. placebo and monotherapy was assessed. Other measurements included body mass index, waist circumference, fasting lipids, glycemic variables, safety, and tolerability. At wk 24, placebo-subtracted weight loss was -4.62% [95% confidence interval (CI) -6.24 to -2.99; P < 0.001] for NB16, -4.65% (95% CI -6.20 to -3.09; P < 0.001) for NB32, and -3.53% (95% CI -5.15 to -1.90; P < 0.001) for NB48. Weight loss was statistically significant vs. monotherapy for all three NB combinations with the exception of NB48 vs. bupropion. Weight loss with NB continued after wk 24. The most common treatment-emergent adverse event was mild transient nausea. NB caused gradual sustained weight loss over 48 wk; NB32 and NB16 demonstrated greater weight loss in the intent-to-treat population due to lower attrition rates. Further study is needed to demonstrate long-term efficacy and safety of NB.

Análise do impacto da cirurgia bariátrica em uma população do centro do estado do Rio Grande do Sul utilizando o método BAROS

Due to metabolic alterations caused by overweight, the bariatric surgery has been a largely used procedure in order to propitiate long term weight loss and maintenance in a population with morbid obesity. To analyze the impact of bariatric surgery in a population from the center area of Rio Grande do Sul State, Brazil, using the BAROS method. It was carried out a retrospective study with 32 patients from both sexes, aging between 19 and 44 years old who were patients from a private clinic at the city of Santa Maria, RS. The patients' weight variation and the body mass index were analyzed, as well as their intestinal habit, use of tobacco and practice of physical activity to compare the results in pre and postoperative periods. The patients were divided into groups: group A (preoperative), group B (up to 6 months of postoperative period), group C (7 to 8 months of postoperative period), and group D (19 to 30 months of postoperative period). To evaluate the efficacy of the bariatric surgery BAROS method was applied. Statistical analysis was performed using analysis of variance (ANOVA), followed by post-hoc by Duncan's. It were considered as statistically significant the data with P<0.05. The results were expressed as mean +/- SEM RESULTS: The patients presented a significant weight-loss, in preoperative the average was 118.8 kg (+/- 2.89) and, in postoperative period, group B showed 89 kg (+/- 5.69), group C 76.8 kg (+/- 4.85) and, group D 76 kg (+/- 4.46), demonstrating a gradual weight loss. Likewise, the body mass index presented a significant reduction in groups B, C e D in relation to group A. The patients showed an intestinal habit improvement of 15.6% in postoperative period in relation to the preoperative period. As for the use of tobacco it was observed a decrease of 33.3% in postoperative period. The practice of a physical activity increased in 34.4% among the patients after surgery. According to the BAROS method appliance the patients showed excellent, very good and good classifications and, none of them was classified as insufficient. The results obtained according to the BAROS method and the patients' evaluated characteristics made it possible to observe that the bariatric surgery presented satisfactory results in this population.

Is It Possible To Maintain Lean Body Mass And Performance During Energy-restriction In Elite Athletes?

Many athletes in sports that emphasize low weight and leanness attempt to reduce their weight in order to enhance competitive performance. The strategy recommended is a gradual weight-loss due to moderate energy restriction promoting a weekly weight-loss of 0.5-1 kg. However, a decrease in body mass due to energy restriction can lead to loss of lean body mass (LBM) and thereby impair performance. PURPOSE: To compare the loss of fat mass, LBM and performance in two different weight-loss interventions promoting loss of 0.7% versus 1.4% of body weight per week in elite athletes. METHODS: 30 male and female elite athletes where randomized into two groups, "slow reduction" (SR, n=14, 23.5±3.3 y, 72.2±12.2 kg) and "fast reduction" (FR, n=16, 22.3±4.9 y, 72.2±11.2kg). All athletes followed a 6-12 week energy restriction period depending on the intervention and desired weight loss. Diets were recorded by 4-day weighed food records and each athlete followed an individualized diet plan promoting weekly body weight-loss of 0.7% or 1.4%. All athletes continued training their sport as usual (14.6±3.5h per week), and in addition all included four resistance-training sessions per week to emphasize muscle hypertrophy. Measurements done pre and post intervention were: body weight (BW), dual energy x-ray absorptiometry (DEXA), 1 RM tests (squat and bench press) and vertical jumping test. RESULTS: There were no significant differences between groups in any of the measurements pre intervention. BW was reduced with 5.6±3.0% in SR-group (p<0.001) and 5.3±2.1% in FR-group (p<0.001). There was a significant decrease in fat-mass in both groups by 31.2±10.9% in SR-group (p<0.001) and 23.4±13.5% in FR-group (p<0.001). Total LBM was increased by 2.0±1.3% in the SR-group (p<0.001) and 1.1±3.0% in the FR group (NS, p=0.4). The performance was improved in the SR and FS group by 8.0±8.4% (p<0.01) and 4.3±9.1% (NS, p=0.1) in vertical jump, 13.1±10.9% (p=0.001) and 9.7±7.4% (p<0.001) in 1RM squat and 15.1±6.7% (p<0.001) and 7.8±12.1% (p=0.05) in bench press, respectively. CONCLUSION: Despite a weight-loss of ∼5% of body mass it is possible to increase LBM and performance during a gradual weight-loss in normal-weight athletes. The magnitude of weekly weight-loss seems to be one of the factors that influence loss of fat mass versus LBM and performance.

BH-204: Predicting weight loss before surgery - motivating the bariatric patient

3D scanning equipment and techniques provide the ability to capture an accurate pre-operative whole-body image of the bariatric surgery candidate. This 3D image can be manipulated using algorithmic digital techniques to develop a set of progressive images depicting gradual weight loss based on expected percentage of body volume reduction at particular points in time.

Combination of gradual and rapid weight loss: Effects on physical performance and psychological state of elite judo athletes

The aim of the present study was to examine the effects of a combination of gradual and rapid body mass loss on the physical performance and psychological state of elite judo athletes. Participants were divided into two groups: the experimental (diet) group needed to reduce body mass by 2–6%, whereas the control group did not need to lose body mass. Body mass, percentage of body fat, vertical jump, repetitions of judo movements, rowing with additional loads, and the Profile of Mood States were assessed at 4 weeks before a championship and again one day before the same championship. Compared with 4 weeks before the championship, the experimental group showed a significant decrease in body mass (−4 ± 1.1%, P < 0.05), estimated body fat (−10 ± 4.0%, P < 0.05), and judo movement repetitions over 30 s (−4.5 ± 2.7, P < 0.05), and an increase in scores for confusion (−14.6 ± 7.9, P < 0.05) and tension (−10.1 ± 12.5, P < 0.05), but a decrease in vigour (11.3 ± 8.5, P < 0.05), one day before the championship. There was no difference in squat jump or countermovement jump performance or in judo movement repetitions over 5 s. Our results show that for the experimental group some aspects of performance were impaired one day before a competition, but performance of judo movements over 5 s was not affected.

Structural, Electrochemical, and Thermal Aspects of Li [ ( Ni0.5Mn0.5 ) 1 − xCox ] O2 ( 0 ≤ x ≤ 0.2 ) for High-Voltage Application of Lithium-Ion Secondary Batteries

We investigated structural, electrochemical, and thermal properties of layered oxides synthesized via coprecipitation. The prepared materials had a well-ordered O3 type layer structure. The occupation of divalent Ni in the Li layer decreased monotonously with increasing Co amount in . Because of the improved structural integrity and electrical conductivity, the Co substitution for Ni and Mn gave rise to the increment on the initial discharge capacity. However, the replacement brought about severe capacity fading during extensive cycling in a Li-ion cell. To elucidate the possible reasons for the capacity fading, electrochemically and chemically delithiated powders were examined through the storage at for in the electrolyte. With increasing Co content, the amount of dissolved Ni, Co, and Mn greatly increased. Furthermore, the original O3 layer structure was completely transformed to O1 phase for the , being accompanied by a severe particle degradation. However, maintained its original structure with uniform surface morphology, which would be mainly attributed to the presence of divalent Ni in the Li layer. A high-temperature X-ray diffraction study with a combination of thermal gravimetric analysis also confirmed that the O3 phase was stable to without significant weight loss in that region for the . Whereas the having O1 layer structure showed a gradual weight loss at the temperature, which would result from the oxygen loss from the oxide. The has a large amount of in the Li layer, which provided significant structural, electrochemical, and thermal stabilities at a highly delithiated state, compared to the .

Implications of the biology of weight regulation and obesity on the treatment of obesity

The purposes of this article are to provide a brief review of the complex biology of weight regulation and obesity, to explain some of the effects of diet and exercise on the biology of weight regulation and obesity, and to propose a coherent way to assess and treat people related to weight and obesity. Scientific publications, clinical guidelines, and government sources. Obesity is a complex problem requiring an understanding of how interventions interact with the biology of weight regulation in people who are obese. Promoting health in obese people requires a focus on improving insulin sensitivity. Helping individuals maintain normal weight throughout life is important in order to keep the long- and short-term weight signals in balance and reflective of true energy requirements. Exercise is associated with loss of total and abdominal adipose tissue and improved insulin sensitivity. Diets inducing gradual weight loss are less likely to stimulate appetite. Diets should include antioxidants to neutralize the increase in free radical production associated with obesity and exercise. Other interventions in the treatment of obesity may include treating sleep deficits and the dysregulated endocannabinoid system.

Nonalcoholic fatty liver disease: from clinical recognition to treatment

Nonalcoholic fatty liver disease (NAFLD) is probably the most common spectrum of metabolic liver disease in the world, encompassing simple steatosis to steatohepatitis, advanced fibrosis, cirrhosis and hepatocellular carcinoma. NAFLD affects a significant part of the general population worldwide. The existing correlation between obesity and NAFLD in combination with the increase in the frequency of obesity in the developed world implies that the incidence and severity of NAFLD will increase in the near future. Newer data support the idea that NAFLD constitutes the more important cause of cryptogenic cirrhosis of the liver and a ground for the development of hepatocellular carcinoma. Liver biopsy remains the most specific and sensitive method to differentiate NAFLD, providing important information on the long-term prognosis of the patients. The ‘two hit’ hypothesis constitutes the currently prevailing theory for the development of NAFLD and nonalcoholic steatohepatitis. The first ‘hit’ is purported to be the increase of free fatty acids in hepatocytes, which results in a decrease of β-oxidation. The second step includes all mechanisms contributing to the development of necroinflammation and fibrosis. Currently, an effective treatment for patients with NAFLD does not exist. Improvement in liver histology remains the primary goal of any therapeutic approach in patients with NAFLD. Viewing NAFLD in the frame of the metabolic syndrome opens the possibility that both the onset of the disease and disease progression could be prevented by changes in lifestyle. Physical exercise and a low calorie diet in combination with the gradual loss of body weight represent the cornerstone for the management of NAFLD patients.

Assessment of biological changes of continuous whole body exposure to static magnetic field and extremely low frequency electromagnetic fields in mice

The question whether static magnetic fields (SMFs) and extremely low frequency electromagnetic fields (ELF-EMF) cause biological effects is of special interest. We investigated the effects of continuous whole body exposure to both fields for 30 days on some liver and blood parameters in mice. Two exposure systems were designed; the first produced a gradient SMF while the second generated uniform 50 Hz ELF-EMF. The results showed a gradual body weight loss when mice were exposed to either field. This is coupled with a significant decrease ( P<0.05) in the levels of glucose, total protein and the activity of alkaline phosphatase in serum. A significant increase in lactate dehydrogenase activity was demonstrated in serum and liver paralleled with a significant elevation in hepatic γ-glutamyl transferase activity. The glutathione- S-transferase activity and lipid peroxidation level in the liver were significantly increased while a significant decrease in hepatic gluthathione content was recorded. A significant decrease in the counts of monocytes, platelets, peripheral lymphocytes as well as splenic total, T and B lymphocytes levels was observed for SMF and ELF-EMF exposed groups. The granulocytes percentage was significantly increased. The results indicate that there is a relation between the exposure to SMF or ELF-EMF and the oxidative stress through distressing redox balance leading to physiological disturbances.

Current Treatment Strategies for Non-Alcoholic Fatty Liver Disease (NAFLD)

Nonalcoholic fatty liver disease (NAFLD) is recognized as the most common cause of chronic liver disease worldwide. NAFLD is a clinicopathologic syndrome ranging from simple steatosis, which is relatively benign, to the more severe form known as nonalcoholic steatohepatitis (NASH), which may progress to cirrhosis, liver failure, and hepatocellular carcinoma. NAFLD is associated with significant liver related morbidity and mortality, and its underlying pathophysiology is thought to result from a multiple hit process. The initial insult is the accumulation of hepatic fat secondary to insulin resistance. In the setting of hepatic steatosis, the second hit can be caused by reactive oxygen species, inflammatory cytokines, and adipokines. Several therapeutic modalities that target these mechanisms are under investigation, but no proven treatment has yet emerged. Insulin sensitizers such as thiazolidinediones and metformin show promise, and several studies have explored the role of lipid lowering agents, antioxidants, and cytoprotective agents. Novel agents such as anti-obesity drugs, selective cannabinoid-1 receptor blockers, and dual PPAR alpha and gamma agonists are also under investigation. Unfortunately, data on the long-term safety and efficacy of these agents and their impact on liver related histologic outcomes are currently lacking. NAFLD treatment currently focuses on reducing metabolic risk factors, with the mainstay of therapy focusing on life-style modifications such as gradual weight loss through diet and regular exercise.

Clinically obese children identified facilitators and barriers to initiating and maintaining the behaviours required for weight loss

DESIGNQualitative study.SETTINGLeeds, UK.PARTICIPANTS20 clinically obese children (8–14 y, 14 boys), who were attending aNational Health Service funded weight loss programme for .3months, were selected on the basis of availability.METHODSAll children...

Weight loss during chronic, cervical vagus nerve stimulation in depressed patients with obesity: an observation

Fourteen patients were treated over 2 years with cervical vagus nerve stimulation (VNS) for adjunctive therapy of severe, treatment-resistant depression. Here, we report the serendipitous observation that this treatment was associated with highly significant, gradual weight loss despite the patients' report of not dieting or exercising. The weight loss was proportional to the initial BMI, that is, the more severe the obesity, the greater the weight loss. Weight loss did not correlate with changes in mood symptoms. The vagus nerve carries visceral information to and from the brain; modulation of its activity may alter eating behavior. Chronic cervical VNS may merit controlled study for the treatment of severe obesity.

Combined occurrence of hyperthyroid Graves' and Hashimoto's thyroiditis

A 40 years old, married Govt. servant from Sadar upazila, Mymensingh was admitted in Mymensingh Medical College Hospital on 9(th) February, 2005 with the complaints of excessive sweating for 1 year, gradual loss of weight for 6 months, swelling in front of the neck for 1(1/2) months, and hoarseness of voice for 1 month. He was nervous, irritable, emotionally labile. Thyroid gland was symmetrically enlarged, firm in consistency with scalloped surface. Palms were warm and sweaty with fine tremor in outstretched hands. Lid lag, lid retraction and proptosis were the occular manifestations. All the reflexes were exaggerated. Radioactive iodine uptake showed enlarged gland with homogenously increased radiotracer concentration, ultrasonogram findings were enlarged gland with hypoechoic parenchyma with fibrous septa, T(3), T(4), TSH values were 6.56 nmol/L, 241.09 nmol/L and 0.14 mIU/L respectively. Thyroid microsomal antibody level was 32.87%. Thyroid FNAC findings were sheets of regular follicular cells, some large cells with granular basophilic cytoplasm, macrophages, a few inflammatory cells and giant cells. All the above findings were in favour of a diagnosis of hyperthyroid Graves' with Hashimoto's thyroiditis.

Benchmarking hospital outcomes for laparoscopic adjustable gastric banding

Since the Food and Drug Administration (FDA) approval of laparoscopic adjustable gastric bands (LAGB) in June 2001, the number LAGB procedures performed in the United States has increased exponentially. This study aimed to benchmark the authors' initial hospital experience to FDA research trials and evidence-based literature. Over a 2-year period, 87 consecutive patients with a mean age of 43 years (range, 21-64 years) and a body mass index of 45.6 kg/m2 (range, 35-69 kg/m2) underwent an LAGB procedure at the authors' institution. The authors conducted a retrospective review of the outcomes including conversion, reoperation, mortality, perforation, erosion, prolapse, port dysfunction, excess weight loss, and changes in comorbidities, then compared the data with published benchmarks. Gender, age, and body mass index were comparable with those of other series. Perioperative adverse events included acute stoma obstruction (n = 1) and respiratory complications (n = 2). Delayed complications included gastric prolapse (n = 4) and port reservoir malposition (n = 4). Five bands were explanted. The mean follow-up period was 14 months (n = 79). The mean percentage of excess weight loss was 30% (range, 4.7-69%) at 6 months, 41% (range, 9.6-82%) at 12 months, and 47% (range, 14-92%) at 24 months. Comorbidities resolved included diabetes (74%), hypertension (57%), gastroesophageal reflux disease (55%) and dyslipidemia (38%). The short-term outcomes for LAGB were comparable with published benchmarks. With adequate weight loss, most patients achieve significant improvement in obesity-related illnesses. With new bariatric accreditation standards and mandates required for financial reimbursement, hospitals will need to demonstrate that their clinical outcomes are consistent with best practices. The authors' early experience shows that LAGB achieves significant weight loss with low mortality and morbidity rates. Despite a more gradual weight loss, most patients achieve excellent weight loss with corresponding improvement of comorbidities within the first 2 years postoperatively.