Weight loss
Effect of surgical weight loss on free radical and antioxidant balance: a preliminary report.

Kisakol G, Guney E, Bayraktar F, Yilmaz C, Kabalak T, Ozmen D.

Department of Internal Medicine, Section of Endocrinology, Meram Medical Faculty of Selcuk University, Meram/Konya, Turkey. gurcank hotmail.com

BACKGROUND: This study observes the effect of surgical weight loss on free radical and antioxidant vitamin balance. PATIENTS AND METHODS: 22 consecutive morbidly obese patients undergoing vertical banded gastroplasty (VBG) were chosen for the study. Postoperative studies were done at 12 and 24 weeks. Plasma antioxidant and vitamin determinations were performed by HPLC method. RESULTS: Subjects lost a significant amount of weight (P < 0.01). Compared to preoperative measurements, postoperative measurements of plasma beta-carotene were not statististically different both at 12 and 24 weeks (13.86 +/- 1.26 microg/dl, 12.35 +/- 1.2, P = 0.44; 14.33 +/- 2.03, P = 0.77; preoperatively, 12 and 24 weeks respectively). Alpha-tocopherol increased slightly at the 12th week; the difference was not significant (8.50 +/- 0.77; 9.56 +/- 0.82, P = 0.37; preoperatively and 12th week respectively). The levels of alpha-tocopherol rose at 24th week significantly (10.89 +/- 0.55, P = 0.028). The indicator of lipid peroxidation (malondialdehyde) decreased with weight loss (1.505 +/- 0.11 micromol/L preoperatively; 0.75 +/- 0.062 at 12th week, P = 0.01; 0.712 +/- 0.05 at 24th week, P < 0.01). CONCLUSION: Our data show that free radical generation falls markedly in association with weight loss after VBG. Surgical weight loss leads to significant decrease in oxidant production and also leads to increase in some antioxidant vitamins. The demonstration of decreased free radical generation and correction of balance between free radicals and antioxidant vitamins has important implications for oxidative mechanisms underlying obesity-associated disorders.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12568184&dopt=Abstract weight loss



Weight loss
Ultrasound parameters of calcaneal bone density in girls with anorexia nervosa.

Kutilek S, Bayer M.

Department of Pediatrics, 1st Medical Faculty, Charles University, Prague, Czech Republic. kutilek leciva.cz

Osteoporosis is common in patients with anorexia nervosa (AN), but ultrasound has so far been scarcely used to detect it We measured calcaneal broadband ultrasound attenuation (BUA) and velocity of sound (VOS) in 26 AN girls (mean age 15.1+/- 1.5 years) using a Cuba Clinical device (McCue Ultrasonics, UK). Basic anthropometric (body weight, height and body mass index--BMI) and clinical data (mean duration of AN, number of absent cycles, weight loss) were collected. All of the girls reported that they did at least one hour's vigorous exercise a day. BUA was significantly lower (p<0.004) and VOS significantly higher (p<0.0001) in comparison with reference data. Body weight and BMI at the time of the measurements were significantly lower than the reference data (p<0.0001). There were no correlations between body weight or height and BUA or VOS, but there was a slight correlation between BUA and BMI (r=0.4, p<0.05) and a slight inverse correlation between VOS, body weight and BMI (r=-0.48 and r=-0.43, p<0.01). VOS slightly correlated with weight loss (r=0.4, p<0.05), significantly with the weekly number of exercise hours (r=0.48, p<0.01). The duration of AN, the number of missed cycles and the percentage of weight loss did not correlate with BUA, and neither the duration of AN nor the number of missed cycles correlated with VOS. The low BUA value could be attributed to poor nutrition, and substantial physical activity may lead to the increase in VOS. In conclusion, girls with AN have low BUA and high VOS values, neither of which correlate with the duration of AN or the number of missed cycles.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11808818&dopt=Abstract weight loss



Weight loss
Australian Longitudinal Study of Ageing: prospective evaluation of anthropometric indices in terms of four year mortality in community-living older adults.

Crotty M, Miller M, Giles L, Daniels L, Bannerman E, Whitehead C, Cobiac L, Andrews G.

Rehabilitation & Ageing Studies Unit, Repatriation General Hospital, Daw Park SA, Australia. maria.crotty flinders.edu.au

The Australian Longitudinal Study of Ageing (ALSA) aims to identify factors that contribute to & predict the health & social well-being of older Australians. Analyses were performed to determine the predictive value of anthropometric measurements in older Australians for four-year mortality. Weight, height, skinfolds (triceps, abdominal, supra-spinale, sub-scapular, medial calf, and front thigh) & girth (arm, waist, hip, calf) measurements were performed on a randomly selected community-living sample of 772 men & 624 women aged>70 years. Waist: Hip, % weight loss, corrected-arm-muscle area (CAMA) & BMI were calculated. These measures were categorised into quartiles & also according to commonly adopted definitions of nutritional status. Cox regression analysis was undertaken to assess the predictive value of the independent anthropometric variables for four-year mortality, adjusting for potential confounders (age, gender, marital status, smoking, alcohol status, self-rated health, basic activities of daily living & co-morbidity). Risk of four-year mortality increased with weight loss >10% over two years (HR=2.53, CI=1.37-4.67) & CAMA <21.4cm2(M) & <21.6cm2(F) (HR=1.93, CI=1.03-3.60) independent of confounding variables. These results confirm that selected anthropometric indices (weight loss, CAMA) independently increase the risk of four-year mortality & highlights their potential use in the nutrition screening and assessment of community-living older adults.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11813076&dopt=Abstract weight loss



Weight loss
Health outcomes of severely obese type 2 diabetic subjects 1 year after laparoscopic adjustable gastric banding.

Dixon JB, O'Brien PE.

Department of Surgery, Monash University, Alfred Hospital, Melbourne 3181, Victoria, Australia. john.dixon med.monash.edu.au

OBJECTIVE: To prospectively examine the effect of weight loss 1 year after laparoscopic adjustable gastric band surgery on a broad range of health outcomes in 50 diabetic subjects. RESEARCH DESIGN AND METHODS: A total of 50 (17 men, 33 women) of 51 patients with type 2 diabetes, from a total of 500 consecutive patients, were studied preoperatively and again 1 year after surgery. RESULTS: Preoperative weight and BMI (means +/- SD) were 137 +/- 30 kg and 48.2 +/- 8 kg/m(2), respectively; at 1 year, weight and BMI were 110 +/- 24 kg and 38.7 +/- 6 kg/m(2), respectively. There was significant improvement in all measures of glucose metabolism. Remission of diabetes occurred in 32 patients (64%), and major improvement of glucose control occurred in 13 patients (26%); glucose metabolism was unchanged in 5 patients (10%). HbA(1c) was 7.8 +/- 3.2% preoperatively and 6.2 +/- 2.7% at 1 year (P < 0.001). Remission of diabetes was predicted by greater weight loss and a shorter history of diabetes (pseudo r(2) = 0.44, P < 0.001). Improvement in diabetes was related to increased insulin sensitivity and beta-cell function. Weight loss was associated with significant improvements in fasting triglyceride level, HDL cholesterol level, hypertension, sleep, depression, appearance evaluation, and health-related quality of life. Early complications occurred in 6% of patients (wound infections in 4%, respiratory support in 2%), and late complications occurred in 30% of patients (gastric prolapse in 20%, band erosion in 6%, and tubing leaks in 4%). All late complications were successfully revised surgically. CONCLUSIONS: Modern laparoscopic weight-loss surgery is effective in managing the broad range of health problems experienced by severely obese individuals with type 2 diabetes. Surgery should be considered as an early intervention.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11815510&dopt=Abstract weight loss



Weight loss
Leptin, insulin and TNF-alpha in weight loss.

Xenachis C, Samojlik E, Raghuwanshi MP, Kirschner MA.

Division of Endocrinology, Diabetes and Metabolism, UMDNJ, New Jersey Medical School, Newark 07103, USA.

Forty-eight morbidly obese patients were placed on a very low calorie (800 kcal) formula diet (OPTIFAST) for a 10-week period with the goal of achieving 10% weight loss within this time. Weekly serum leptin measurements were performed to determine whether changes in this adipose protein would serve as a useful marker of acute and chronic weight loss compliance. In the basal state, serum leptin averaged 56.9 +/- 5.8 ng/ml (SE) in the 24 successful (S) patients, and 67.7 +/- 6.7 ng/ml in the non-successful (N-S) group. During the first week of weight loss there was little change in leptin despite an average weight loss of 2.2%, but after 4 weeks serum leptin decreased by 36% in the S group, and 20% in the N-S group. After 10 weeks, the S group averaged 13.6% weight loss and the serum leptin decreased to 50% of starting levels. In the 24 N-S patients, the mean weight loss was 7.0%, and serum leptin decreased by 22%, remaining unchanged in the final 6 weeks despite a weight loss of 3.6% in this time. On a week-to-week basis serum leptin changed concordantly with weight loss only two-thirds of the time. In a subgroup of 14 patients (8 S+6 N-S), serial assessments of serum leptin, insulin and tumor necrosis factor-alpha (TNF-alpha) were performed. Serum insulin levels decreased with weight loss similar in magnitude to that noted for leptin; however, the insulin changes occurred more rapidly. Serum TNF-alpha also decreased with weight loss, but the weekly changes were more erratic, with a concordance rate of only 48%. In summary, serum leptin, insulin and TNF-alpha all decreased during a rapid weight loss program but at differing rates and variability, precluding their usefulness as markers of week-to-week weight loss compliance.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11817710&dopt=Abstract weight loss



Weight loss
[Determination of insulin, leptin and neuropeptide y by radioimmunoanalysis in patients with morbid obesity and anorexia nervosa after therapeutic intervention]

[Article in Spanish]

Escobar L, Freire JM, Espinosa R, Pajares M, Giron JA, Vazquez JM, Chover A, Carrasco M, Ortero J, Gavilan I, Segura E, Aguilar M.

Servicio de Endocrinologia y Nutricion. Hospital Universitario Puerta del Mar, Cadiz. Spain. lescobar nhcges.com

The present study was conducted in order to analyze the relationship existing between leptin, insulin and neuropeptide Y (NPY) levels in massive weight loss and weight recovery. Twenty-three patients with severe obesity, 23 patients with anorexia nervosa and 28 healthy control subjects were studied. Patients with severe obesity underwent a vertical banded gastroplasty followed by an 800 kcal/day diet during 16 weeks, with evaluation taking place before (Body mass index, BMI, 52,1 8 Kg/m2) and after the drastic weight loss (BMI 39,2 6,2 Kg/m2). Patients with anorexia nervosa were treated with nutritional therapy exclusively during 16 weeks, and they were evaluated in the low weight situation (BMI 15,3 1,7 Kg/m2) and after weight recovery (BMI 18,9 2,8 Kg/m2). Normal subjects had a normal BMI from 20 to 27 (average 21,8 2 Kg/m2). BMI, percentage of body fat, and serum levels of leptin, insulin, and NPY, were determined in each patient and normal subjects. In severe obese patients serum leptin and insulin decreased significantly after drastic weight reduction (leptin: from 48,8 19,2 to 24,3 9,8 ng/ml; insulin: from 26,2 10,8 to 18 6 U/ml). In patients with anorexia nervosa serum leptin mean levels were significantly higher after weight recovery (3,7 1,9 vs 9,2 5,1 ng/ml). In subjects with morbid obesity NPY levels decreased after weight loss below those of control group (43,5 16,1 vs 57,3 12,8 pmol/l). On the other hand, patients with anorexia nervosa had NPY levels superior to those of control group. In subjects with anorexia, NPY levels decreased after weight recovery (69,1 16,7 a 59,1 20,3 pmol/l). In the whole population, Leptin and NPY plasma levels were correlated with body fat percentage. Leptin was positively correlated with BMI and body fat percentage in obese and anorectic subjects after weight loss or recovery, respectively. NPY was inversely correlated with body fat percentage in controls and obese subjects before treatment. These data reveal that the concentration of serum leptin and NPY correlates significantly with the total adiposity in subjects with a wide weight range and caloric intake. Leptin plasma levels are proportional to fat stores in patients with severe obesity and anorexia nervosa after drastic weight loss or recovery, respectively. NPY serum levels are negatively correlated with de total body fat in normal weight subjects and obese patients in their initial weight.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11820995&dopt=Abstract weight loss



Weight loss
Sibutramine: new preparation. Slight weight loss; but also a slight rise in blood pressure ...

[No authors listed]

(1) The reference treatment for achieving weight loss by obese patients is a combination of dietary measures, exercise and behavioural interventions. There is currently no drug treatment with demonstrated efficacy on the morbidity or mortality associated with excess body weight. (2) Sibutramine, a serotonin- and noradrenaline-reuptake inhibitor structurally related to the amphetamines has been granted marketing authorisation in France for the treatment of obesity and excess body weight in patients with associated risk factors. (3) The clinical file on sibutramine contains no trial focusing on morbidity or mortality end points. (4) According to comparative clinical trials, weight loss during a 6-12 month course of sibutramine is, on average, between 3 and 9 kg greater than that on placebo. Patients regain weight after sibutramine cessation. (5) Sibutramine has little or no benefit on blood sugar or lipid parameters. (6) The main known adverse effect of sibutramine is increased blood pressure. Sibutramine also has amphetamine-like side effects. (7) In practice, sibutramine currently has no place in the management of obesity.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11824428&dopt=Abstract weight loss



Weight loss
Adenosine triphosphate infusion increases liver energy status in advanced lung cancer patients: an in vivo 31P magnetic resonance spectroscopy study.

Leij-Halfwerk S, Agteresch HJ, Sijens PE, Dagnelie PC.

Institute of Internal Medicine II, Erasmus University Medical Center Rotterdam, The Netherlands.

We recently observed inhibition of weight loss in patients with advanced nonsmall-cell lung cancer after intravenous infusion of ATP. Because liver ATP levels were found to be decreased in lung cancer patients with weight loss, the present 31P magnetic resonance spectroscopy (MRS) study was aimed at investigating whether ATP infusion restores liver energy status in these patients. Nine patients with advanced nonsmall-cell lung cancer (stage IIIB/IV) were studied 1 week before (baseline) and at 22 to 24 hours of continuous ATP infusion (37-75 microg/kg/min). Localized hepatic 31P MR spectra (repetition time 15 seconds), obtained in the overnight-fasted state, were analyzed for ATP and P(i) content. Ten healthy subjects (without ATP infusion) served as control. Liver ATP levels in lung cancer patients increased from 8.8 +/- 0.7% (relative to total MR-detectable phosphate; mean +/- SE) at baseline to 12.2 +/- 0.9% during ATP infusion (P <.05), i.e., a level similar to that in healthy subjects (11.9 +/- 0.9%). The increase in ATP level during ATP infusion was most prominent in patients with > or = 5% weight loss (baseline: 7.9 +/- 0.7%, during ATP infusion: 12.8 +/- 1.0%, P < 0.01). In conclusion, ATP infusion restores hepatic energy levels in patients with advanced lung cancer, especially in weight-losing patients. These changes may contribute to the previously reported beneficial effects of ATP infusion on the nutritional status of lung cancer patients.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11826418&dopt=Abstract weight loss



Weight loss
Multiple exposure to activity anorexia in rats: effects on eating, weight loss, and wheel running.

Hampstead BM, LaBounty LP, Hurd C.

Department of Psychology, Drexel University, 3141 Chestnut Street, 19104, Philadelphia, PA, USA

Animals were given five cycles of an activity anorexia (AA) procedure in order to determine the effect of additional experience on eating, running, and weight loss. Female Sprague-Dawley rats were given a 1h meal and allowed access to a running wheel for the remainder of each day. Upon reaching 75% of free-feeding body weight, each animal was denied wheel access and given ad libitum food until it regained the lost weight. Then, food was again restricted and wheel access provided. Sedentary control animals were placed on the restricted feeding schedule for the median number of days experimental animals required to reach weight loss criterion. Experimental animals showed adaptation by increasing food consumption and decreasing the rate of weight loss despite an increase in running across cycles. Additionally, the distribution of running shifted gradually so that during the later cycles, much of the running occurred in the hours just before feeding. The results support the hypothesis that running interferes with adaptation to the restricted feeding schedule and also that the marked increase in anticipatory behavior during the later cycles is primarily responsible for the maintenance of AA.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12642171&dopt=Abstract weight loss