Correlates of body image dissatisfaction among overweight women seeking weight loss

Predictors of body image dissatisfaction (BID) among obese people are poorly understood. In 79 obese women seeking weight reduction, associations with BID of self-esteem, youth teasing, adult teasing, and internalization of sociocultural appearance standards (ISAS) were studied. Analyses revealed that only self-esteem, adult teasing, and ISAS predicted BID. Results highlight the importance of adulthood self-esteem and interpersonal-cultural context--rather than childhood experiences--in predicting adulthood BID.     

Alexithymia and body weight in obese patients

The authors evaluated severely obese patients to determine whether being far different in body shape from the accepted standard may cause obese people to develop alexithymic personality traits. They evaluated the food- and weight-related attitudes in obesity surgery patients and in long-term follow-up of those who had previously had biliopancreatic diversion (BPD) for obesity. One quarter of the obese patients had alexithymic characteristics without any modification following stable weight loss, a rate of alexithymia similar to that observed in the nonclinical population. Furthermore, the frequency of alexithymia and the patients' scores on the Toronto Alexithymia Scale were similar in obese and post-BPD individuals. The authors concluded that being obese by itself does not influence the presence of alexithymic personality traits. However, they suggest that the improvement in food-related and weight-related attitudes following stable weight loss may be different in alexithymic and in nonalexithymic obese patients.     

Age-related changes in resting energy expenditure in normal weight,overweight and obese men and women

ObjectivesAging is associated with changes in resting energy expenditure (REE) and body composition. We investigated the association between age and changes in REE in men and women stratified by body mass index (BMI) categories (normal weight, overweight and obesity). We also examined whether the age-related decline in REE was explained by concomitant changes in body composition and lifestyle factors.Study designCross-sectional.Main outcome measures3442 adult participants (age range: 18–81 y; men/women: 977/2465) were included. The BMI range was 18.5–60.2 kg/m². REE was measured by indirect calorimetry in fasting conditions and body composition by bioelectrical impedance. Regression models were used to evaluate age-related changes in REE in subjects stratified by sex and BMI. Models were adjusted for body composition (fat mass, fat free mass), smoking, disease count and physical activity.ResultsIn unadjusted models, the rate of decline in REE was highest in obese men (slope = −8.7 ± 0.8 kcal/day/year) whereas the lowest rate of decline was observed in normal weight women (−2.9 ± 0.3 kcal/day/year). Gender differences were observed for the age of onset of REE adaptive changes (i.e., not accounted by age related changes in body composition and lifestyle factors). In women, adaptive changes appeared to occur in middle-age (∼47 y) across all BMI groups whereas changes seemed to be delayed in obese men (∼54 y) compared to overweight (∼43 y) and normal weight (∼39 y) men.ConclusionsSex and BMI influenced the rate and degree of the age-related decline in REE. Critical age windows have been identified for the onset of putative mechanisms of energy adaptation. These findings require confirmation in prospective studies.     

Effect of percutaneous androgen replacement therapy on body composition and body weight in postmenopausal women

Objectives: This study was carried out to assess the effect of topical androgen replacement therapy on body weight, body composition and fat distribution in postmenopausal women. Methods: 39 healthy postmenopausal women (51.4±2.24 years), with increasing body weight, were prospectively studied for 6 months. Body composition (fat mass, kg, %) was measured by means of dual-energy X-ray absorptiometry (DXA). Hormonal and lipid parameters were also measured. Subjects were divided into two groups. An androgen gel (group A) or placebo gel (group P) was topically administered to the abdominal and gluteo-femoral regions. DXA was performed before commencement of topical treatment and after 6 months. Results: A highly significant total body weight reduction was found in group A (68.0±13.1 to 65.4±11.8 kg). Abdominal fat (37.3±11.2 to 35.1±9.7%), gluteo-femoral fat (46.3±6.6 to 45.4±7.7%), total body fat (38.2±7.9 to 36.1±8.6%) and BMI (24.8±4.3 to 23.7±3.8) were also found to have decreased significantly in this group. No significant reduction in body weight (kg) and body fat (%) could be measured in the placebo group. No influence on lipid parameters was found although total testosterone increased significantly in group A (0.29±0.24 to 0.72±0.17 ng/ml). Conclusions: Topically applied androgen is capable of reducing abdominal fat accumulations as well as total body weight in postmenopausal women with unexplained weight gain. In contrast to systemic androgen application, topical administration has no effect on the lipid profile. Gluteal fat, however, is less effectively influenced by androgens.     

A comparison of MMPI-2 and MMPI T-scores for men and women

The original MMPI linear T-score norms are compared with the new linear and uniform T-score norms for the MMPI-2 across basic validity and clinical scales for both men and women. The comparison indicated more pronounced normative changes for certain scales and somewhat more pronounced changes for men than for women. Relationships between MMPI-2 and MMPI T-scores across scales are complex; a few MMPI-2 scales show enhancement, others show attenuation across the full range of the scale, and other scales show attenuation in the middle and lower ranges of the scale with enhancement in the upper ranges. Possible implications and effects of the new MMPI-2 T-score norms on original MMPI scale high-point elevation and high-point codes are discussed.     

Beneficial effect of hormone replacement therapy on weight loss in obese menopausal women

Objective: at the onset of menopause, weight-gain and the aggravation of certain cardiovascular risk factors are frequently observed. The aim of this study was to examine the metabolic effects of combined hormone replacement therapy (17β-oestradiol transdermic 50 μg for 21 days and oral medroxyprogesterone acetate 5 mg from day 10 to 21) using, in particular, indirect calorimetry. Methods: patients (21; 12 substituted and nine controls) were studied twice (3 months apart) during an oral glucose load (75 g). Results: total body weight was unaltered after 3 months in the control group, whereas a fat-loss of 2.1±0.2 kg and a decrease of the waist:hip ratio were observed in the substituted group. In the latter group, a significant increase in lipid oxidation was observed (0.58±0.06 mg/kg/min before and 0.75±0.04 mg/kg/min after substitution P<0.05), whilst total energy expenditure and thermogenesis were also increased. Glucose, lipid and protein oxidation remained stable during three months in the control group. The insulin response to an oral glucose load diminished by 30% with hormone replacemnet therapy (102.3±32.8 mμ/l versus 71.4±20.0 mμ/l). Total and LDL-cholesterol improved after hormone replacement therapy whereas plasma triglycerides were not altered. Conclusions: combined hormone replacement therapy not only prevented weight-gain, but favored weight-loss by significantly increasing lipid oxidation after 3 months of treatment. It also favourably influenced the insulin response, plasma lipids and energy expenditure.     

Heparin therapy adjusted for body weight

A linear relation between heparin concentrations and the dosage of heparin/kg body weight (r = 0.91, N = 47) was found after bolus injections of 2,500, 5,000, or 10,000 U heparin; the heparin concentrations agreed with plasma distribution. The maintenance therapy showed linearity between heparin concentrations and the dosage of heparin/kg body weight and 24 hours; however, the sensitivity for maintenance therapy differed between patients. The mean dosage required for maintaining heparin at 0.5 U/mL was 400 but ranged between 250 and 600 U heparin/kg body weight and 24 hours. A bolus dose of 75 U heparin/kg body weight, followed by a maintenance dose of 400 U heparin/kg body weight and 24 hours, showed therapeutic heparin response in 78% of patients, however, heparin monitoring two times daily is necessary for adjustment of dosage.     

Natural products and body weight control

The purpose of the review was to summarise the effect of some commonly available natural products used for body weight management. We collected data from PubMed and scientific journals. There are numerous publications on this topic, however we have summarized the most commonly available and potent natural products from recent 53 publications. The natural products analyzed in this paper include catechins, capsaicin, conjugated linoleic acid, fucoxanthin, soy isoflavone, glabridin, astaxanthin and cyaniding-3-glucoside. These natural products are effective and safe for body weight management. Further studies need to be conducted to investigate the mechanism of action, metabolism, long term safety and side effects of these natural products, as well as interactions between these natural products with dietary components.     

Childhood maltreatment and pre-pregnancy obesity: a comparison of obese,overweight, and normal weight pregnant women

Pre-pregnancy overweight and obesity is associated with poor health outcomes for the mother and the child. General population studies suggest that childhood maltreatment is associated with obesity in adulthood. The aim of our study was to examine the association between pre-pregnancy overweight and obesity and a history of childhood abuse or neglect including different stages of severity of abuse and neglect. Three hundred twenty-six normal weight, overweight, or obese pregnant women reported demographic data, height and weight, and general psychological distress at 18–22 weeks of gestation. Childhood maltreatment was assessed using the Childhood Trauma Questionnaire. Associations were examined using logistic regression analyses and a reference group of normal weight women. Fifty percent reported a history of abuse or neglect. After adjusting for age, education, income, marital status, and the number of previous children, pre-pregnancy overweight and obesity were strongly associated with severe physical abuse (overweight: OR?=?8.33, 95 % CI 1.48–47.03; obesity: OR?=?6.31, 95 % CI 1.06–37.60). Women with severe physical neglect (OR?=?4.25, 95 % CI 1.23–14.74) were at increased risk of pregnancy overweight. We found a dose-response relationship between physical abuse and pre-pregnancy overweight and obesity. Whereas other studies report an association between childhood maltreatment and pre-pregnancy obesity, this is the first study that found an association between childhood maltreatment and pre-pregnancy overweight. Considering the severe health risks of pre-pregnancy overweight and obesity and the long-term consequences of childhood maltreatment, affected women constitute a subgroup with special needs in prenatal care. Further research is needed to improve the understanding of the underlying mechanisms.     

Prospective evaluation of body weight and body fat distribution in early postmenopausal women with and without hormonal replacement therapy

AIMS: In order to assess the effects of menopause and hormonal replacement therapy (HRT) on body weight and body fat distribution (determined by dual energy X-ray), early postmenopausal women were given either oral calcium (500 mg/day, control group, n=13) or HRT, a combination of estradiol valerate (EV, 2 mg/day for 21 days) with cyproterone acetate (CPA, 1 mg/day in the last 10 days of the treatment cycle, n=18; Climen, Schering). RESULTS: There were no differences in basal body weight and body fat distribution in the two groups before the study. In control group, a significant (P<0.05) increase in body weight (from 63.5+/-2.0 to 68.7+/-2.0 kg after 36 months) paralleled a shift to a prevalent central, android fat distribution with a slight but significant (P<0.05) increase in total body fat mass (from 23.4+/-2.1 to 29.1+/-2.1 kg), an increase in trunk (from 10.1+/-0.4 to 12.7+/-0.4 kg, P<0.05), arms (from 2.4+/-0.2 to 2.9+/-0.2 kg, P<0.05) and legs (from 6.5+/-0.4 to 7.8+/-0.4 kg, P<0.05) fat. In the HRT group total body bone mineral showed a significant increase (from 1086+/-21 to 1128+/-19 mg/cm(2), P<0.05) increase after 36 months, with no significant increase in body weight (from 62.6+/-1.8 to 65.0+/-1.9 kg), and no modifications in trunk (from 10.0+/-0.2 to 10.1+/-0.2 kg) and arms (from 2.4+/-0.1 to 2.6+/-0.1 kg) fat, but a significant increase in legs fat (from 6.9+/-0.3 to 9.9+/-0.4 kg, P<0.05). CONCLUSION: Present results demonstrate that menopause is associated with an accelerated increase in body weight and body fat, with a prevalent central, android fat distribution, that can be counteracted at least in part by oral HRT.     

Relationship between weight loss and gallbladder motility in obese women

OBJECTIVE AND AIM: Most studies have detected impairment of gallbladder motility among obese compared with nonobese people. However, the relationship between gallbladder motility and weight loss is not well defined. The aim of this study was to evaluate the relationship between percent of weight loss and gallbladder motility during weight-reducing programs in obese women. PATIENTS AND METHODS: Thirty-four premenopausal obese women (body mass index >30 kg/m2) were included in the study. Following an overnight fast, fasting and postprandial 15-, 30-, 45-, 60-, 75-, 90-, 120- and 150th-minute gallbladder volumes and ejection fractions were evaluated with real-time ultrasonography as baseline and repeated after sixth months of weight-reducing programs. The lowest postprandial gallbladder volume was accepted as the residual volume. Gallstone formation was found in three (8.8%) patients during the study period, and these patients were dropped out. Thirty-one obese women were divided into three groups based on weight loss percent (group 1: 11 patients, weight loss <5%; group 2: 10 patients, weight loss 5-10%; group 3: 10 patients, weight loss >10%). RESULTS: Fasting gallbladder volume and all ejection fractions were not significantly different between baseline and after sixth months in all groups (p>0.05). Residual volume was decreased after sixth months in only group 3 (p=0.005). Difference of fasting and residual volumes, and ejection fractions at baseline and after sixth months was similar in all groups (p>0.05). There was a positive correlation between weight loss and the change of residual volume (r=0.395, p=0.028). CONCLUSION: Our findings suggest no relationship between degree of weight loss and ejection fraction. However, decreased residual volume and late-phase gallbladder volumes indicate gallbladder motility changing in patients who had >10% weight loss.     

Factors differentiating women and men who successfully maintain weight loss from women and men who do not

The current study explored the relative contribution of exercise, coping responses, cognitive attributions, and emotional experiences to successful weight-loss maintenance in men and women. The data were collected via a large community-based survey on dieting and weight loss commissioned by Consumer Union. Men and women who met our criteria for successful (n = 277 men, n = 329 women) and unsuccessful (n = 277 men, n = 329 women) weight-loss maintenance were included in the sample. Successful weight-loss maintainers (Maintainers) reported having lost at least 10% of their highest adult weight and having maintained that weight loss for at least the three years immediately prior to the survey. Unsuccessful weight-loss maintainers (Regainers) reported not ever having been able to maintain a significant weight loss and having lost and regained a minimum of 10 to 19 pounds at least once. In response to a dietary lapse, Maintainers, as compared with Regainers, reported being more likely to use direct coping and less likely to seek help. The results imply that the most useful variables for differentiating between successful and unsuccessful weight-loss maintainers may involve how they respond to a dietary lapse.     

Psychobiological impact of a progressive weight loss program in obese men

Psychobiological effects associated with a progressive body weight loss may help to improve the understanding of psychological barriers to weight loss. We hypothesized that a moderate body weight loss (about 10% of initial body weight) is accompanied with some negative psychological impact. Four questionnaires [SF-36 Health Survey, Three-Factor Eating Questionnaire (TFEQ), Beck Depression Inventory (BDI) and Pittsburgh Sleep Quality Index (PSQI)] were administered at each phase of a body weight loss program that consisted of a supervised diet and exercise clinical intervention to 11 obese men (mean BMI = 33.4 kg/m(2), mean age = 38 yr). The three phases investigated were: 1) at the beginning of the intervention (baseline); 2) after 5 +/- 1 kg body weight loss (Phase 1); and 3) after 10 +/- 1 kg body weight loss (Phase 2). Using the SF-36 Health Survey, physical and mental health were shown to be significantly improved at Phase 1 (p < 0.05). The TFEQ showed that cognitive dietary restraint increased (p < 0.001), and both disinhibition (p < 0.05) and susceptibility to hunger (p < 0.05) were significantly reduced at both Phase 1 and 2 compared to baseline. Depression as measured by the BDI significantly increased at Phase 2 (p < 0.05) compared to baseline and Phase 1. However, the mean BDI scores observed remained below the cut-off point for likely clinical significance. Finally, the PSQI showed that sleep quality was significantly improved at Phase 1 compared to baseline (p < 0.01). Altogether, these results suggest that a substantial improvement in the psychobiological profile occurs with a 5-kg weight loss (Phase 1) but that with additional weight loss (Phase 2) a small, but significant increase in depression occurred and seems to be associated with the increase in rigid restraint of eating. However, prospective studies with a larger sample are needed to confirm and deepen these results.     

Gastric balloon reduces food intake and body weight in obese rats

A less invasive method than gastric reduction surgery for treating obesity was tested by inserting balloons into the stomachs of obese rats. Male Sprague-Dawley rats were placed on a high fat diet. After 4 months, the rats weighed an average of 750 g or 23% more than rats on a chow diet. Balloons were then passed orally into the stomach, inflated with 10 ml of water, and detached from the inflating tube. Eight rats had inflated balloons; six rats had no balloons. The balloons, which could be palpated, remained inflated for 12 to 49 days with a mean of 25 days. During the period of inflation, rats with balloons consumed significantly less food (p less than 0.001) relative to rats without balloons. Gastric emptying rate was significantly slowed (p less than 0.0025) in rats with inflated balloons compared to rats with balloons that had deflated and rats with no balloons. Histology of the stomachs that held inflated balloons did not reveal pathology.     

Fluoxetine-maintained obese humans: effect on food intake and body weight

The effects of fluoxetine on food intake, body weight, and mood of obese individuals was examined in a 16-week inpatient/outpatient study. Six male and eight female obese volunteers began the study (four male and five females completed all phases of the study). They lived in a residential laboratory during three one-week inpatient periods separated by a 5-week and an 8-week outpatient period. Following an initial 4-day placebo baseline, participants were maintained on fluoxetine (60 mg/day) for the remainder of the study. Food intake parameters (total daily energy intake, macronutrient intake, mean number of eating bouts, interbout interval), body weight, subjective effects, and task performance were measured several times during the day during inpatient periods; food intake questionnaires were completed daily during the outpatient periods. Fluoxetine significantly reduced daily energy intake derived from fat, carbohydrate, and protein by decreasing the mean number of eating bouts per day throughout the study. No other food intake parameter was affected. Body weight was significantly reduced after 7 weeks, but not after 16 weeks of daily fluoxetine administration. These results indicate that fluoxetine reduced food intake for at least 16 weeks in nondepressed obese individuals without specifically affecting carbohydrate intake. Weight that was lost during the first few weeks of daily fluoxetine administration was subsequently regained even though food intake remained reduced. Therefore, fluoxetine maintenance does not appear promising as a sole long-term therapy for obesity.