Percentage Of Initial Weight Research Articles

525-P: The Influence of Age of on the Weight Loss Outcome of Women in the National Diabetes Prevention Program

In the National Diabetes Prevention Program (DPP) developed by the CDC, participants receive health-coach facilitated education on lifestyle modification to develop better eating and exercise habits with the goal of losing 5-7% weight over the course of a year. Incorrect assumptions about weight loss can lead to reduced participation and low outcomes in DPP. This study aims to determine the truth of common assumptions about weight loss and the impact that such assumptions have on the effectiveness of DPP. A common assumption observed is that women of menopausal age (45-60) find it more difficult to lose weight and we hypothesized that women at the menopausal age will achieve the weight loss goal at a slower rate compared to younger women of pre-menopausal age (18-44) . Weight loss is defined as the difference between initial and final weight as a percentage of initial weight; a positive value indicates weight loss. Effectiveness is defined as the percentage of participants who achieve a specific weight loss threshold. The data used was the number of days until each participant achieved the weight loss goal of 5%. This was divided into two groups: 641 women aged 45-60) , and 278 women aged 18-44. A Students t-test was then performed on the data sets to measure the effect of assumptions about menopause and weight loss. Contrary to the hypothesis, we found that menopausal women to be just as likely to achieve the 5% weight loss goal as pre-menopausal women in the same amount of time. This indicates that the assumption is untrue, however it is a useful assumption in the sense that it can encourage menopausal women to lose weight. Disclosure M.Ottur: None. G.Cooke: None. S.Rajan: None.

Two-year follow-up cohort study focused on gender-specific associations between socioeconomic status and body weight changes in overweight and obese middle-aged and older adults

ObjectiveAs overall spread of obesity in populations is generally acknowledged to result from unhealthy lifestyles rather than individual genetic makeup, this study aimed to gain specific insights into its determinants...

Use of phentermine-topiramate extended release in combination with sleeve gastrectomy in patients with BMI 50 kg/m2 or more

BackgroundSuper obesity (body mass index [BMI] ≥50 kg/m2) treatment can be complicated and high risk. ObjectivesWe studied whether the pre and postoperative use of phentermine and topiramate (phen/top) combined with laparoscopic sleeve gastrectomy (LSG) in super obesity increases the odds of achieving a BMI <40 at 2 years postoperatively. SettingAcademic medical center in Winston Salem, North Carolina. MethodsWe recruited patients between 2014 and 2016 who had a BMI ≥50 and planned to undergo LSG (n = 25) to participate in an open-label trial. Participants took phen/top (7.5/46–15/92 mg/d) for at least 3 months preoperatively and 2 years postoperatively. We compared weight loss, BMI changes, and odds for achieving BMI <40 for phen/top + LSG to historical controls. Controls had an initial BMI ≥50 and underwent LSG, without phen/top, at our center during the same timeframe (n = 40). ResultsOf the 25 participants recruited, 13 completed LSG. Phen/top participants had a baseline BMI of 61.2 ± 7.1 kg/m2 compared with 57.0 ± 5.6 kg/m2 for control participants. Percent initial weight loss was –39.3% (phen/top + LSG) versus –31.4% (control) at 12 months, P = .018; by 24 months, phen/top + LSG had an 11.2% greater initial weight loss, P = .007. At 24 months, the mean BMI was 33.8 kg/m2 for phen/top versus 42 kg/m2 for controls. The odds ratio for achieving a BMI <40 at 2 years with phen/top + LSG versus LSG alone was 4.1 (95% confidence interval, 0.8–21). ConclusionsCompared with LSG alone, phen/top combined with LSG may help patients with a BMI >50 achieve greater weight loss and reach a BMI <40. Long-term, controlled trials are needed to follow up these results.

Activating the Growth of High Surface Area Alumina Using a Liquid Galinstan Alloy

The growth of high surface area alumina has been investigated with the use of a liquid Galinstan alloy [66.5% (wt %) Ga, 20.5% In and 13.0% Sn] as an activator for aluminum. In this process, the aluminum is slowly dissolved into the gallium–indium–tin alloy, which is then selectively oxidized at ambient temperature and pressure under a humid stream of flowing CO2 or N2 to yield amorphous alumina. This preparative route represents a simple and low toxicity approach to obtain amorphous high surface area alumina with very low water content. The as-synthesized high surface area alumina aerogel was a blue-colored solid owing to the Rayleigh scattering by its dendritic fibrous nanostructure consisting of mainly alumina with small amounts of water. Upon annealing at 850 °C, the amorphous product transformed into γ-Al2O3, as well as θ-Al2O3 upon annealing at 1050 °C. Elemental analysis by energy-dispersive spectroscopy provides further evidence that the high surface area alumina is composed of only aluminum and oxygen. The surface area of the amorphous alumina varied from ∼79 to ∼140 m2/g, depending on the initial weight percentage of aluminum used in the alloy. A correlation between the initial concentration of aluminum in the alloy and the surface area of the alumina product was found to peak at ∼30% Al. These results suggest a novel route to the formation of amorphous alumina aerogel-type materials.

Product yield distribution and Essential Oil Composition of Eucalyptus Terminalis Sawdust Pyrolysis

In this study, pyrolysis of sawdust sample (Western blood-wood- Eucalyptus terminalis) was investigated. Experiments were performed at six temperature levels ranging from 300 °C to 800 °C under N2 atmosphere. The weights of char, tar and gas yields produced in each experiment were measured and recorded in percentage of initial weight of the pyrolyzed sample. Results of the study showed that product yield of Eucalyptus terminalis char, tar and gas of 41.28% at 300 °C, 45.10% at 300 °C and 57.20% at 800 °C, respectively were produced. Proximate analysis shows that volatile matter, fixed carbon, ash content and moisture content of sawdust sample were 75.53%, 15.35%, 1.56% and 7.56%, respectively. Result of the elemental analysis shows that the carbon, hydrogen, nitrogen, oxygen and sulphur contents of the sawdust sample were 54.19%, 7.05%, 0.97%, 37.15%, and 0.64%, respectively. The higher heating value and pH of the sawdust sample are 23.40 kJ/g and 2.30% respectively. This indicate that char and tar yields decrease with increased pyrolysis temperature while gas yield increases as pyrolysis temperature increases for the sawdust sample. The value of the correlation coefficient obtained indicate a fairly high degree of accuracy of the regression models to predict experimental result when used within the temperature range considered in this study. Result of analytical Py-GC/MS shows that the proportion of phenolic compounds identified was more than 50% with trans-2-octadecadecen-1-ol, cis-10-pentadecen-1-ol, 9-octadecenal and methyl-1-cyclohexenyl ketone dominating. This study establishes the fact that pyro-oil can not only be used as a fuel but can also be purified and serves as raw materials for chemical and processing industries.

Compositional and experimental investigation of the effect of reactor temperature on softwood and hardwood pyrolysis

PurposeThis study aims to investigate the effect of reactor temperature on softwood and hardwood pyrolysis. Experiments are performed at six temperature levels ranging from 300 to 800°C under N2 atmosphere. The weights of char, tar and gas yields produced were measured and recorded in percentage of initial weight of the pyrolyzed samples. Results of the study showed that hardwood produces maximum char, tar and gas yields of 41.02 per cent at 300°C,44.10 per cent at 300°C and 56.86 per cent at 800°C, respectively, whereas softwood produces maximum yields of 30.10 per cent at 300°C, 28.25 per cent at 300°C and 68.73 per cent at 800°C, respectively. Proximate analysis shows that volatile matter, fixed carbon, ash content and moisture content of hardwood are 74.83, 14.28, 2.81 and 8.08 per cent, respectively, and that of softwood are 79.76, 12.65, 0.98 and 6.61 per cent, respectively. Result of the elemental analysis results shows that the carbon, hydrogen, nitrogen, oxygen and sulphur contents for hardwood are 52.20, 6.45, 0.68, 39.64 and 1.03 per cent, respectively, and that of softwood are 45.95, 4.57, 0.56, 48.13 and 0.79 per cent, respectively. The higher heating value of hardwood and softwood are 21.76 and 16.50 kJ/g respectively. This study shows that char and tar yields decrease with increase pyrolysis temperature, whereas gas yield increases as pyrolysis temperature increases for the wood samples considered. At all temperatures considered in this study, gas yields are higher than tar and char yields for softwood, whereas for hardwood, tar yield decreases with increase in temperature with accompanying increase in gas yield.Design/methodology/approachExperiments are performed at six temperature levels ranging from 300 to 800°C under N2 atmosphere.FindingsAt all temperatures considered in this study, gas yields are higher than tar and char yields for softwood, whereas for hardwood, tar yield decreases with increase in temperature with accompanying increase in gas yield.Originality/valueResults of the study showed that hardwood produces maximum char, tar and gas yields of 41.02 per cent at 300°C,44.10 per cent at 300°C and 56.86 per cent at 800°C, respectively, whereas softwood produces maximum yields of 30.10 per cent at 300°C, 28.25 per cent at 300°C and 68.73 per cent at 800°C, respectively.

Chlorhexidine and silver sulfadiazine coating on central venous catheters is not sufficient for protection against catheter-related infection: Simulation-based laboratory research with clinical validation.

ObjectiveThe efficacy of chlorhexidine- and silver sulfadiazine-coated central venous catheters (CSS-CVC) against catheter-related infection remains controversial. We hypothesized that the loss of silver nanoparticles may reduce the antibacterial efficacy of CSS-CVCs and that this loss could be due to the frictional force between the surface of the CVC and the bloodstream. The objective of this study was to investigate whether the antimicrobial effect of CSS-CVCs decreases with increasing exposure time in a bloodstream model and quantitatively assay the antimicrobial effect of CSS-CVCs compared with polyurethane and antiseptic-impregnated CVCs.MethodsEach CVC was subjected to 120 hours of saline flow and analyzed at intervals over 24 hours. The analyses included energy-dispersive X-ray spectroscopy, scanning electron microscopy, and optical density after a Staphylococcus aureus incubation test.ResultsThe weight percentage of silver in the CSS-CVCs significantly decreased to 56.18% (44.10% ± 3.32%) with 48-hour catheterization and to 18.88% (14.82% ± 1.33%) with 120-hour catheterization compared with the initial weight percentage (78.50% ± 6.32%). In the S. aureus incubation test, the antibacterial function of CSS-CVCs was lost after 48 hours [3 (N/D) of OD]. Similar results were observed in a pilot clinical study using 18 CSS-CVCs.ConclusionsWe found that the efficacy of CSS-CVCs decreased over time and that the antibacterial function was lost after 48 hours of simulated wear-out. Therefore, antibiotic-impregnated CVCs may be a better option when longer (>48 hours) indwelling is needed.

Abstract MP003: Development and Validation of a Prediction Model of Weight Loss Maintenance or Regain at 4 Years in the Look AHEAD Trial

Introduction: The development of type 2 diabetes is strongly associated with excess weight gain and can often be partially ameliorated or reversed by weight loss. While many lifestyle interventions have resulted in successful weight loss, strategies to maintain the weight loss have been considerably less successful. Prior studies have identified multiple predictors of weight regain, but none have synthesized them into one analytic stream. Methods: We developed a prediction model of 4-year weight regain after a one-year lifestyle-induced weight loss intervention followed by a 3 year maintenance intervention in 1791 overweight or obese adults with type 2 diabetes from the Action for Health in Diabetes (Look AHEAD) trial who lost ≥3% of initial weight by the end of year 1. Weight regain was defined as regaining &lt;50% of the weight lost during the intervention by year 4. Using machine learning we integrated factors from several domains, including demographics, psychosocial metrics, health status and behaviors (e.g. physical activity, self-monitoring, medication use and intervention adherence). We used classification trees and stochastic gradient boosting with 10-fold cross validation to develop and internally validate the prediction model. Results: At the end of four years, 928 individuals maintained ≥50% of their initial weight lost (maintainers), whereas 863 did not met that criterion (regainers). We identified an interaction between age and several variables in the model, as well as percent initial weight loss. Several factors were significant predictors of weight regain based on variable importance plots, regardless of age or initial weight loss, such as insurance status, physical function score, baseline BMI, meal replacement use and minutes of exercise recorded during year 1. We also identified several factors that were significant predictors depending on age group (45-55y/ 56-65y/66-76y) and initial weight loss (lost 3-9% vs. ≥10% of initial weight). When the variables identified from machine learning were added to a logistic regression model stratified by age and initial weight loss groups, the models showed good prediction (3-9% initial weight loss, ages 45-55y (n=293): ROC AUC=0.78; ≥10% initial weight loss, ages 45-55y (n=242): ROC AUC=0.78; (3-9% initial weight loss, ages 56-65y (n=484): ROC AUC=0.70; ≥10% initial weight loss, ages 56-65y (n=455): ROC AUC = 0.74; 3-9% initial weight loss, ages 66-76y (n=150): ROC AUC=0.84; ≥10% initial weight loss, ages 66-76y (n=167): ROC AUC=0.86). Conclusion: The combination of machine learning methodology and logistic regression generates a prediction model that can consider numerous factors simultaneously, can be used to predict weight regain in other populations and can assist in the development of better strategies to prevent post-loss regain.

Up to 7 Years of Sustained Weight Loss for Weight-Loss Program Completers.

Two issues remain elusive in weight management programs: significant, long-term weight-loss maintenance and widely accessible programs that produce significant weight loss for reasonable costs. The purpose of this study is to determine the long-term weight loss of participants who consecutively renew their annual membership in Take Off Pounds Sensibly (TOPS), a national, nonprofit, low-cost, peer-led weight-loss program. This completers' analysis was a retrospective cohort study of overweight and obese men and women who joined TOPS in 2005-2011 and consecutively renewed their annual membership at least once. Data were analyzed from June to October 2013. TOPS participants' weights are sent to the national database when they join and at the time of their annual renewal; thus, follow-up weight is only available for those who renew their membership. Among 207,469 individuals who joined during the study period, 74,629 (35.9%) had at least one consecutive annual renewal and were included in the study. Cumulative mean (95% CI) weight change as a percentage of initial weight ranged from -6.0% (-6.0%, -5.9%) for 74,629 participants who renewed at 1 year to -8.3% (-8.7%, -7.8%) for 2,289 participants with 7 years of consecutive annual renewal. In the subset of individuals who choose to renew their program membership, TOPS can effectively promote maintenance of clinically significant weight loss for an extended period of time. RCTs are needed to further evaluate this low-cost, widely available program, which could be a viable option to treat overweight and obesity.

Ecotoxicological assessment of a dredged sediment using bioassays with three species of soil invertebrates.

The ecotoxicity of a dredged sediment from the Guanabara Bay (Rio de Janeiro, RJ, Brazil) was evaluated using reproduction tests with Eisenia andrei, Folsomia candida and Enchytraeus crypticus, and avoidance and feeding inhibition tests with Folsomia candida. The sediment was mixed with artificial soil to obtain the following doses: 1.25, 2.5, 5.0, 10.0, 20.0 and 40.0%. Lead, nickel, chromium, copper and zinc concentrations were determined in the test mixtures. In reproduction tests, E. andrei was the most sensitive species (EC50=2.94%), followed by F. candida (EC50=7.72%) and E. crypticus (EC50=10.10%). The percentage of initial weight of earthworms was significantly higher in all test concentrations compared to the control except at the highest one where earthworms biomass significantly decreased. No feeding inhibition of F. candida was observed for any test mixture and the number of organisms with a dark gut (the fed collembolans) generally increased with the increasing dose of sediment. Significant avoidance responses of F. candida were observed towards all test mixtures, however, the avoidance behaviour was the less sensitive endpoint after feeding inhibition. The results showed that chemical analysis is not sufficient to foresee toxic effects in terrestrial systems resulting from sediment disposal in soil if not complemented with an ecotoxicological evaluation.

Gender and racial/ethnic background predict weight loss after Roux-en-Y gastric bypass independent of health and lifestyle behaviors.

Our study investigated how demographic, health, and behavioral factors interacted to affect weight outcomes in bariatric patients. Roux-en-Y gastric bypass (RYGB) patients who were non-Hispanic black, Hispanic, or non-Hispanic white race/ethnicity, had no revisions to their RYGB during 2004-2009, and had at least 1 year of follow-up data for body weight after surgery (n = 860) were surveyed by phone about their health and behaviors. The main outcomes of interest were percent excess weight loss and percent of initial weight lost. Participants were 47 ± 11 years old, 54 % non-Hispanic white, 25 % Hispanic, and 21 % non-Hispanic black, 82 % female, 60 % married, 82 % had some college education, and 47 % had an annual income between $35,000 and $80,000. At the time of surgery, patients had lost 50 ± 29 % of their excess weight and had achieved 24 ± 15 % initial weight lost after an average of 54 months of follow-up. After accounting for weight at the time of surgery, demographics, and self-reported health and behavior, non-Hispanic black men had significantly greater weight loss compared to non-Hispanic white men (p < .05). There were no differences between racial/ethnic groups of women in weight outcomes. Percent excess weight loss was related to greater diet soda intake, and percent initial weight lost was related to greater water intake. Independent of health status and lifestyle behaviors, age, and weight at the time of surgery, race/ethnicity, gender, and diet soda and water intake were the strongest predictors of weight outcomes after RYGB surgery.

Housing Mice At Sub-Thermoneutral Temperatures Influences Severity Of Gvhd In Mouse Models

While a very high proportion of humans develop serious and fatal GVHD following bone marrow transplantation (BMT), mice typically do not develop lethal graft versus host disease (GVHD) when receiving bone marrow alone, even when the donor and recipient mice are MHC mismatched. Thus, the major pre-clinical model in which novel treatments for GVHD are being tested has a fundamental resistance to GVHD. Researchers therefore add donor-derived T cells from spleen or lymph node in order to generate a similar incidence and severity of GVHD as seen in humans, thus using a model system that has fundamental differences from the clinical situation.Recent work from our lab has revealed that the standard cool (sub-thermoneutral) temperature in which all laboratory mice must be housed (creating a chronic condition of metabolic cold stress) results in impaired CD8+ immune function, while bolstering the action of immunosuppressive cells. Current work suggests that the excessive stimulation of cold-stress induced sympathetic nerve activity, and subsequent production of norepinephrine is the cause of this immunosuppressive environment. Because GVHD depends upon the activation and function of donor CD8+ T cells in the host environment, we hypothesized that mouse models do not develop expected amounts of GVHD following a bone marrow only transplant because the host environment, which is metabolically cold-stressed, blocks the function of effector T cells.To test our hypothesis we first housed BALB/c mice at standard (22°C) and thermoneutral temperatures (30°C) for two weeks. To generate a MHC disparate model, we lethally irradiated the mice and transplanted C57BL/6 bone marrow without additional splenocytes. We used both weight loss and survival following BMT as a readout for GVHD severity. As expected, under standard conditions of housing at 22° mice were able to recover from the transplant and return to their initial weight within the same 17 day post-transplant timeframe (percent initial weight at 22°: 101% ± 1%; N=10). In support of our hypothesis we saw weight loss in the mice maintained at 30° as early as 17 days post-transplant (percent initial weight at 30°: 93% ± 2%; N=10). Interestingly, weight loss continued in the mice maintained at thermoneutrality (percent initial weight loss 48 days post-transplant at 30°: 0.84 ± 0.03, N=10). Beginning 49 days post-transplant some mice at thermoneutrality began to succumb to GVHD. Thus, housing mice at thermoneutrality decreased survival suggesting a greater incidence/more severe GVHD (Figure 1; p=0.01, N=10). As our previous data in solid tumor models suggests that numbers of immunosuppressive myeloid derived suppressor cells (MDSCs) are increased when mice are metabolically stressed at 22°, we next examined differences in this cell population in the spleens of transplanted mice. We found an obvious trend towards decreased splenic MDSCs in mice housed at 30° compared to 22°. [Display omitted] To retest this hypothesis in a clinically relevant minor antigen mismatch model we housed male C57BL/6 mice at ST or TT for two weeks. We then lethally irradiated the mice and transplanted female 129/SvJ bone marrow. Again, we found a greater weight loss (p=0.02; N=10) in the mice receiving bone marrow only maintained at 30° compared to 22° as early as 28 days post-transplant (percent initial weight at 22°: 103% ± 2%, N=10; percent initial weight at 30°: 96% ± 2%, N=10). We also found increased numbers of MDSCs in the spleens of mice housed at 22° compared to 30° (p=0.09, N=10).The increasing number of patients receiving BMT for various malignancies clearly highlights the critical importance of improving mouse models for understanding GVHD as this problem remains a major barrier to achieving greater survival for patients. These data demonstrate the existence of a fundamental relationship between cool standard housing temperature used in all research institutes and a resistance to GVHD, which is likely linked to a reduced immune response and/or increased immunosuppression. Achieving a better understanding of this potential confounding environmental factor could help to improve the use of mouse models for identifying the best therapies to attenuate or eliminate GVHD in humans, while at the same time, promoting effective immune reconstitution and graft versus tumor effect. Disclosures:No relevant conflicts of interest to declare.

Circadian rhythmicity as a predictor of weight-loss effectiveness

Some of the major challenges associated with successful dietary weight management include the identification of individuals not responsive to specific interventions. The aim was to investigate the potential relationship between weight loss and circadian rhythmicity, using wrist temperature and actimetry measurements, in women undergoing a weight-loss program, in order to assess whether circadian rhythmicity could be a marker of weight-loss effectiveness. Participants were 85 overweight and obese women (body mass index, BMI: 30.24±4.95 kg m(-2)) subjected to a weight-reduction program. Efficacy of the treatment was defined as total weight loss, percentage of initial weight and weekly weight loss rates. Circadian rhythmicity in wrist temperature motor activity and position were analyzed using different sensors. Lower weight loss was related with a more flattened pattern measured as amplitude from cosinor (r=0.235, P=0.032), a higher fragmentation of rhythms determined by higher intradaily variability (IV) (r=-0.339, P=0.002), and an impaired wrist temperature circadian rhythm determined by the means of Circadian Function Index (r=0.228, P=0.038). Further analyses showed that low responders displayed lower amplitude (0.71±0.36 versus 1.24±0.62, P=0.036) and higher fragmentation of the circadian rhythm (0.24±0.11 versus 0.15±0.07, P=0.043) than high responders. Whereas we did not find significant differences in total activity rates between high responders and low responders, we found significant differences for the mean values of body position for high responders (39.12±3.79°) as compared with low responder women (35.31±2.53°, P=0.01). Circadian rhythms at the beginning of the treatment are good predictors of future weight loss. Further treatment should consider chronobiological aspects to diagnose obesity and effectiveness of treatments.

Promoting healthy weight with “stability skills first”: A randomized trial.

Although behavioral weight-loss interventions produce short-term weight loss, long-term maintenance remains elusive. This randomized trial examined whether learning a novel set of "stability skills" before losing weight improved long-term weight management. Stability skills were designed to optimize individuals' current satisfaction with lifestyle and self-regulatory habits while requiring the minimum effort and attention necessary. Overweight/obese women (N = 267) were randomly assigned to one of two 6-month interventions and assessed at baseline and at 6, 12, and 18 months. Maintenance First women participated first in an 8-week stability skills maintenance module and then in a standard 20-week behavioral weight-loss program. Weight Loss First women participated first in a standard 20-week behavioral weight-loss program and then in a standard 8-week problem-solving skills maintenance module. There was no intervention staff contact during the 12-month follow-up period (6-18 months). As designed, Maintenance First participants lost the same percentage of initial weight during the 6-month intervention period as Weight Loss First participants (M = -8.6%, SD = 5.7, vs. M = -9.1%, SD = 6.9; t = -0.6, p = .52). However, Maintenance First participants regained significantly less weight during the 12-month follow-up period (6-18 months) than Weight Loss First participants (M = 3.2 lb, SD = 10.4, vs. M = 7.3 lb, SD = 9.9 [M = 1.4 kg, SD = 4.7, vs. M = 3.3 kg, SD = 4.5]; t = 3.3, p = .001, d = 0.4). Learning stability skills before losing weight was successful in helping women to maintain weight loss without intervention staff contact during follow-up. These results can inform the study design of future innovative interventions.

Synthesis, Electrical Conductivity, and Dielectric Behavior of Polyaniline/V2O5Composites

Conducting polymer composites of polyaniline/vanadium pentaoxide PANI/V2O5(with different initial weight percentage of V2O5) has been synthesized byin situpolymerization method. DC conductivity of compressed pellets has been analyzed in the temperature range 300–550 K and was found to increase with V2O5doping. This increase in conductivity is mainly due to band conduction. It has also been observed that the dielectric constant and dielectric loss increase with the level of doping of V2O5but remain independent of the frequency (50 KHz–1 MHz). X-ray diffraction pattern shows some order of crystallinity of composites due to interaction of polyaniline with V2O5. UV-visible spectroscopy shows an increase in the optical band gap with doping.

Mo1183 Screening Pre-Bariatric Surgery Patients for Esophageal Disease With Esophageal Capsule Endoscopy Compared to Esophagogastroduodenoscopy

INTRODUCTION: Endoscopic methods, especially the intragastric balloon (IGB), have been shown to be effective for the treatment of excess weight. OBJECTIVE: To assess the efficacy and complications of excess weight treatment with an IGB in patients seen at the Endogastro Med Service clinic. METHODS: A total of 418 patients were analyzed. An Allergan IGB (BIB®) with a volume of 600 to 700 ml was used. The patients had a minimum initial body mass index (BMI) of 27 kg/m2 and were followed up by a multidisciplinary team consisting of a nutritionist, a doctor and a psychologist. For statistical analysis, the patients were divided into groups according to sex and degree of excess weight (overweight and grade I, II and III obesity). Data were analyzed using descriptive statistical methods, the Student t-test, Spearman correlation, and analysis of variance followed by the Tukey post-test. The level of significance was set at p<0.05. RESULTS: 40 patients were excluded from the analysis: 24 (5.74%) due to early IGB removal, 4 (0.95%) due to absence of weight loss, 2 (0.48%) due to weight gain, and 10 (2.39%) due to incomplete data. The incidence of fungus was 0.95% (n=4) and the incidence of leakage was 0.48% (n=2). Of the 378 remaining patients, 295 were women and 83 were men. Mean age was 37.02 years. The patients showed a significant weight loss, with a significantly lower final BMI (mean: 29.57±5.06 kg/m2; range: 19.81-48.18) than the initial BMI (mean: 36.70±5.53 kg/m2; range: 27.04-60.4) (p<0.0001). Mean BMI reduction was 7.13±2.76 kg/m2 (range: 1.59-16.09). Mean percent weight loss was 19.38±6.75% and mean percent excess weight loss was 70.73±38.78% (range: 11,16336,14). There was no difference between BMI ranges regarding percent initial weight loss (p=0.5026) and there was no difference between men and women regarding BMI reduction (p=0.0944) or percent initial weight loss (p=0.7902). There was a positive correlation between the numbers of visits to a nutritionist and a greater loss of initial weight (p=0.0001). CONCLUSION: Endoscopic treatment of excess weight with an IGB has been established as an excellent therapeutic option for patients of both genders with overweight or different degrees of obesity.

A Simpler Method for Predicting Weight Loss in the First Year after Roux-en-Y Gastric Bypass

Factors postulated to predict weight loss after gastric bypass surgery, include race, age, gender, technique, height, and initial weight. This paper contained 1551 gastric bypass patients (85.9% female). Operations were performed by one surgeon (MLO) at community hospitals in Southern California from 1989 to 2008 with 314 being laparoscopic and 1237 open. We created the following equation: In[percent weight] = At2 − Bt, where t was the time after operation (days) and A and B are constants. Analysis was completed on R-software. The model fits with R2 value 0.93 and gives patients a realistic mean target weight with a confidence interval of 95% for the first year. Conclusion. We created a curve predicting weight loss after surgery as a percentage of initial weight. Initial weight was the single most important predictor of weight loss after surgery. Other recorded variables accounted for less than 1% of variability. Unknown factors account for the remaining 6-7%.

Motivation for Participating in a Weight Loss Program and Financial Incentives: An Analysis from a Randomized Trial

This analysis investigated if changes in autonomous or controlled motivation for participation in a weight loss program differed between individuals offered a financial incentive for weight loss compared to individuals not offered an incentive. Additionally, the same relationships were tested among those who lost weight and either received or did not receive an incentive. This analysis used data from a year-long randomized worksite weight loss program that randomly assigned employees in each worksite to either a low-intensity weight loss program or the same program plus small financial incentives for weight loss ($5.00 per percentage of initial weight lost). There were no differences in changes between groups on motivation during the study, however, increases in autonomous motivation were consistently associated with greater weight losses. This suggests that the small incentives used in this program did not lead to increases in controlled motivation nor did they undermine autonomous motivation. Future studies are needed to evaluate the magnitude and timing of incentives to more fully understand the relationship between incentives and motivation.

The Fat:Carbohydrate Energy Ratio of the Weaning Diet Programs Later Susceptibility to Obesity in Male Sprague Dawley Rats 3

Dietary fat intake, which is high during suckling, is markedly reduced when food and drinks are introduced into the diet. We investigated whether alterations in the fat:carbohydrate (CHO) content of the weaning diet influenced the later development of adiposity and insulin sensitivity. Three groups of male rats (24/group) were fed from age 16–37 d (phase I) with weaning diets varying in their fat:CHO energy (E) ratios, 10:70 low-fat, high-CHO (LFHC); 30:50 medium-fat, medium-CHO (MFMC), and 60:30 high-fat, high-CHO (HFLC), on an isocaloric basis. Then, all groups consumed ad libitum first a low-fat diet (13% fat E) for 30 wk (phase II) and subsequently a high-fat diet (45% fat E) for another 18 wk (phase III). At the end of phase I, the group fed the HFLC diet demonstrated higher plasma glucose and insulin responses to an oral glucose tolerance test (P < 0.05), but this effect was transient and did not persist into adulthood (phases II and III). By contrast, when challenged with a high-fat diet later in life (age 35.3–53.3 wk), the LFHC group had greater gains in weight (as percent initial weight) and body fat (as absolute and percent body weight) than the other 2 groups that had been weaned with diets higher in fat (P < 0.04 for all). These results provide evidence that metabolic programming by altering the dietary fat:CHO ratio can occur during the weaning period and emphasizes the importance of the fat:CHO ratio of the complementary diet and its relation to the susceptibility to develop adiposity later in life.

Percentage of excess BMI lost correlates better with improvement of metabolic syndrome after Roux-en- Y gastric bypass in morbidly obese subjects: anthropometric indexes and gastric bypass

Background The metabolic syndrome (MS) is a complex disorder characterized by a number of cardiovascular risk factors usually associated with central fat deposition and insulin resistance. Many different medical treatments are available for MS, including bariatric surgery, which improves all risk factors. The present study aimed to evaluate, at the Clinic of Gastroenterology and Obesity Surgery (Brazil), the accuracy of different anthropometric indexes and their correlation with improvement of the MS factors in the postoperative (6-month) period. Methods This was a retrospective study of 140 patients who had undergone gastric bypass. Most of the patients were women (79.3%). The mean body mass index was 44.17 kg/m 2. We evaluated the weight of the subjects, the presence of diabetes mellitus and hypertension as co-morbidities, and the biochemical parameters. The anthropometric indexes tested included the percentage of excess weight loss, amount lost in kilograms, difference in the body mass index, percentage of initial weight lost, percentage of excess body mass index lost (%EBL), and percentage of initial fat mass lost. Results The %EBL had a Spearman's correlation coefficient of 0.55 ( P <.0001) for the difference between the MS factors before and after Roux-en- Y gastric bypass. The receiver operating characteristic curve for the %EBL resulted in an area under the curve of 0.846 ( P = 0.0001) and a sensitivity and specificity of 100% and 61.29%, respectively, for a cutoff value of 64.55%. Conclusion The %EBL was the best method to report weight loss and the improvement in MS in morbidly obese subjects after Roux-en- Y gastric bypass.