scholarly journals From Morbid Obesity to a Healthy Weight Using Cognitive-Behavioral Methods: A Woman’s Three-Year Process With One and One-Half Years of Weight Maintenance

2012 ◽  
pp. 54-59
Author(s):  
James Annesi
2018 ◽  
Vol 48 (4) ◽  
pp. 422-427 ◽  
Author(s):  
Laura Keaver ◽  
Benshuai Xu ◽  
Abbygail Jaccard ◽  
Laura Webber

Background: Morbid obesity (body mass index ⩾40 kg/m2) carries a higher risk of non-communicable disease and is associated with more complex health issues and challenges than obesity body mass index ≥30kg/m2 and <40kg/m2, resulting in much higher financial implications for health systems. Although obesity trends have previously been projected to 2035, these projections do not separate morbid obesity from obesity. This study therefore complements these projections and looks at the prevalence and development of morbid obesity in the UK. Methods: Individual level body mass index data for people aged >15 years in England, Wales (2004–2014) and Scotland (2008–2014) were collated from national surveys and stratified by sex and five-year age groups (e.g. 15–19 years), then aggregated to calculate the annual distribution of healthy weight, overweight, obesity and morbid obesity for each age and sex group. A categorical multi-variate non-linear regression model was fitted to these distributions to project trends to 2035. Results: The prevalence of morbid obesity was predicted to increase to 5, 8 and 11% in Scotland, England and Wales, respectively, by 2035. Welsh women aged 55–64 years had the highest projected prevalence of 20%. In total, almost five million people are forecast to be classified as morbidly obese across the three countries in 2035. Conclusions: The prevalence of morbid obesity is predicted to increase by 2035 across the three UK countries, with Wales projected to have the highest rates. This is likely to have serious health and financial implications for society and the UK health system.


Nutrients ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 683 ◽  
Author(s):  
Mackenzie Fong ◽  
Ang Li ◽  
Andrew Hill ◽  
Michelle Cunich ◽  
Michael Skilton ◽  
...  

Background: Many dietary recommendations for weight control rely on the assumption that greater core food intake will displace intake of energy-dense discretionary foods and beverages. However, there is little evidence to support these assumptions. This study examined the naturalistic relationship between daily core and discretionary energy intake, and with discretionary food and discretionary beverage intake, separately. The impact of weight status on these associations was also examined. Method: One hundred participants completed a four-day (non-consecutive) estimated food diary. Discretionary foods and beverages were identified by reference to the Australian Dietary Guidelines. Non-discretionary items were considered core items. Simultaneous-equation random effects models using disaggregated dietary data controlling for sociodemographic variables were used to determine the association between various dietary components. Result: Core energy intake correlated negatively with discretionary energy intake (cross-equation correlation, ρ = −0.49 (95% CI: −0.57, −0.39)). Its correlation with discretionary foods (−0.47 (−0.56, −0.37)) was stronger than that with discretionary beverages (−0.19 (−0.30, −0.07)) The correlation between core energy intake and discretionary energy intake was significantly stronger in participants who did not have obesity (−0.67 (−0.71, −0.50)) than those with obesity (−0.32 (−0.46, −0.17)) (p = 0.0002). Conclusions: Core and discretionary energy intake share an inverse and potentially bidirectional, relationship that appears to be stronger with discretionary foods than discretionary beverages. These relationships were significantly weaker in participants with obesity which may indicate less precise dietary compensation in these individuals. While strategies that promote greater intake of core foods may assist with weight maintenance in individuals of healthy weight, its impact in individuals with obesity may be limited. These strategies should be accompanied by direct messages to reduce commensurately the intake of discretionary items, with special attention paid to discretionary beverage consumption.


2020 ◽  
Vol 150 (12) ◽  
pp. 3180-3189
Author(s):  
Hong Chang Tan ◽  
Jean W Hsu ◽  
Jean-Paul Kovalik ◽  
Alvin Eng ◽  
Weng Hoong Chan ◽  
...  

ABSTRACT Background Plasma concentrations of branched-chain amino acids (BCAAs) are elevated in obese individuals with insulin resistance (IR) and decrease after bariatric surgery. However, the metabolic mechanisms are unclear. Objectives Our objectives are to compare leucine kinetics between morbidly obese and healthy-weight individuals cross-sectionally, and to prospectively evaluate changes in the morbidly obese after sleeve gastrectomy. We hypothesized that leucine oxidation is slower in obese individuals and increases after surgery. Methods Ten morbidly obese [BMI (in kg/m2) ≥32.5, age 21–50 y] and 10 healthy-weight participants (BMI &lt;25), matched for age (median ∼30 y) but not gender, were infused with [U-13C6] leucine and [2H5] glycerol to quantify leucine and glycerol kinetics. Morbidly obese participants were studied again 6 mo postsurgery. Primary outcomes were kinetic parameters related to BCAA metabolism. Data were analyzed by nonparametric methods and presented as median (IQR). Results Participants with obesity had IR with an HOMA-IR (4.89; 4.36–8.76) greater than that of healthy-weight participants (1.32; 0.99–1.49; P &lt; 0.001) and had significantly faster leucine flux [218; 196–259 compared with 145; 138–149 μmol · kg fat-free mass (FFM)−1 · h−1], oxidation (24.0; 17.9–29.8 compared with 16.1; 14.3–18.5 μmol · kg FFM−1 · h−1), and nonoxidative disposal (204; 190–247 compared with 138; 129–140 μmol · kg FFM−1 · h−1) (P &lt; 0.017 for all). After surgery, the morbidly obese had a marked improvement in IR (3.54; 3.06–6.08; P = 0.008) and significant reductions in BCAA concentrations (113; 95–157 μmol/L) and leucine oxidation (9.37; 6.85–15.2 μmol · kg FFM−1 · h−1) (P = 0.017 for both). Further, leucine flux in this group correlated significantly with IR (r = 0.78, P &lt; 0.001). Conclusions BCAA oxidation is not impaired but elevated in individuals with morbid obesity. Plasma BCAA concentrations are lowered after surgery owing to slower breakdown of body proteins as insulin's ability to suppress proteolysis is restored. These findings suggest that IR is the underlying cause and not the consequence of elevated BCAAs in obesity.


1992 ◽  
Vol 6 (2) ◽  
pp. 137-143 ◽  
Author(s):  
James E. Elliott

The author discusses a technique for eliciting and challenging dysfunctional beliefs, based on the idea that such beliefs seem to have their source in an inferred internal agency known as the inner critic. Various conceptions of the inner critic are listed. An adaptation of the empty chair technique is described, which the clinician can use to elicit the inner critic’s voice as a phenomenological reality that issues dysfunctional messages, which, when accepted by the person, become dysfunctional beliefs. Once the messages are verbally expressed, they can be disputed and countered using cognitive-behavioral methods.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Linna Wu ◽  
Hongyan Liu ◽  
Zhuang Cui ◽  
Fang Hou ◽  
Xiaowen Gong ◽  
...  

Abstract Purpose To evaluate the effect of fluctuations in waist circumference (WC), weight, and body mass index (BMI) on the incidence of diabetes in older adults. Patients and methods A prospective cohort of 61,587 older adults (age, 60–96 years) who did not have diabetes at study initiation was examined. Data on weight, BMI, and WC were collected, and participants were followed up until 31 December 2018. The main end point was new-onset diabetes. A Cox regression model was used to estimate the risk of diabetes (hazard ratios [HRs] and confidence intervals [CI]) in these participants. Results During a mean follow-up of 3.6 years, being overweight (HR [95% CI] 1.87 [1.62–2.17]), obesity (1.41 [1.26–1.59]), abdominal obesity (1.42 [1.28–1.58]), and obesity plus abdominal obesity at baseline (1.93 [1.66–2.25]) increased the risk of diabetes onset. Compared with older adults who “maintained normal WC”, those who “remained abdominally obese” (HR = 1.66), “became abdominally obese” (HR = 1.58), or “achieved normal WC” (HR = 1.36) were at a higher risk of diabetes onset, as well as those with an increase in WC > 3 cm or > 5% compared with the baseline level. Weight gain or loss > 6 kg or weight gain > 5%, increase or decrease in BMI > 2 kg/m2, or an increase in BMI > 10% were associated with a higher diabetes risk. The diabetes risk was reduced by 19% in overweight older adults who exercised daily. Conclusion For older adults, WC, BMI, and healthy weight maintenance reduce the diabetes risk. The findings may provide evidence for developing guidelines of proper weight and WC control for older adults.


2021 ◽  
Author(s):  
Linna Wu ◽  
Hongyan Liu ◽  
Zhuang Cui ◽  
Fang Hou ◽  
Xiaowen Gong ◽  
...  

Abstract Purpose:To evaluate the effect of fluctuations in waist circumference (WC), weight, body mass index (BMI) on diabetes incidence in older adults.Patients and methods:We examined a prospective cohort of 61,587 older adults (age, 60-96 years) who did not have diabetes at study initiation. Data on weight, BMI, and WC were collected and participants were followed-up until 31 December 2019 . The main endpoint was new-onset diabetes. A Cox regression model was used to estimate the risk of diabetes (hazard ratios [HRs] and confidence intervals [CI]) in these participants.Results:During a mean followed-up of 3.6 years, individuals being overweight (HR [95% CI] 1.87 [1.62-2.17]), obesity (1.41 [1.26-1.59]), abdominal obesity (1.42 [1.28-1.58]), and obesity plus abdominal obesity at baseline (1.93 [1.66-2.25]) had higher risk of diabetes onset. Compared with older adults who “remained normal WC”, who “remained abdominally obese” (HR=1.66), “became abdominally obese”(HR=1.58) and “achieved normal WC” (HR=1.36) were also significantly associated with diabetes onset,as well as increase in WC >3 cm or >5% compared with baseline level . Weight gain or loss >6 kg or weight gain >5%; increase or decrease in BMI >2 kg/m2 or an increase in BMI >10% were associated with a higher diabetes risk. Diabetes risk reduced by 19% in overweight older adults who exercised daily.Conclusion:For old adults, waist circumference, BMI and healthy weight maintenance reduce diabetes risk. The findings may provide evidence for developing guidelines of proper weight and waist circumference control for older adults.


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