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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Concern with weight control should begin sufficiently early in life to reduce the risk of developing obesity. The complex etiology of obesity is, in part, responsible for the difficulty physicians encounter in treating this condition. Prevention is the "treatment" of choice. Early identification of individuals genetically at risk can be helpful in targeting those most likely to gain excess weight. Numerous dietary regimens have been devised in an attempt to achieve progressive weight loss in obese individuals. Since the ultimate goal of a weight-reduction program is to lose weight and maintain the loss, a nutritionally balanced, low-energy diet that is applicable to the patient's life-style is most appropriate. Increasing energy expenditure through physical activity, in addition to decreasing energy intake, generally improves results in the management of obesity. Major changes in eating and exercise behaviors are necessary to ensure long-term weight control. Diet, exercise, and behavior modification are interdependent and mutually supportive. A comprehensive weight-reduction program that incorporates all three components is more likely to lead to long-term weight control.
JAMA 1988 Nov 04
PMID:Treatment of obesity in adults. Council on Scientific Affairs. 292 61

Isolated systolic hypertension (ISH), defined as systolic blood pressure of 160 mm Hg or greater when the diastolic pressure is less than 95 mm Hg, is a common form of hypertension among the elderly. We collected incidence and prevalence data on ISH and evaluated several potential factors for its occurrence in the Framingham Heart Study during 16 biennial examinations. The factors evaluated were age, sex, all components of the blood pressure (systolic and diastolic blood pressure, pulse pressure, and mean arterial pressure), Metropolitan relative weight, serum cholesterol level, serum uric acid level, cigarette smoking, ventricular heart rate, glucose intolerance, and hematocrit. The population at risk (1687 men and 1992 women) were those members of the Framingham cohort with a systolic blood pressure less than 160 mm Hg in the first four biennial examinations. Results showed ISH in 14.4% of the men and 22.8% of the women. Cumulative incidence rates were 418 per 1000 in men and 533 per 1000 in women. Significant risk factors for ISH were age, sex, all components of the blood pressure, and increased relative weight in women. We conclude that ISH is a highly prevalent disorder. Its major determinants are age, sex, increasing levels of blood pressure, and obesity in women.
JAMA 1988 Dec 16
PMID:Determinants of isolated systolic hypertension. 321 Feb 85

The report on aversion therapy by the American Medical Association's (AMA) Council on Scientific Affairs was submitted to the AMA House of Delegates in June 1987 as an informational report and is not intended to serve as a standard of care. It reflects the views of the scientific literature as of February 1987. Aversive techniques designed to reduce dangerous or unwanted behaviors are applied most commonly to obesity, smoking, alcoholism and drug abuse, sexual behavior, and self-injurious and aggressive behavior in the mentally retarded. Specific techniques that have obtained the most positive results in some of these areas are described. The report notes, however, that carefully designed and controlled studies are needed before definitive conclusions can be drawn.
JAMA 1987 Nov 13
PMID:Aversion therapy. Council on Scientific Affairs. 331 61

Mediterranean populations have low incidence rates of cardiovascular disease and hypertension that may be due, in part, to dietary factors, particularly a relatively high intake of monounsaturated fat as olive oil. In this study, nutritional components (as grams per 4200 kJ) (1 kcal = 4.2 kJ) from three-day food records were examined in association with resting blood pressure in a cross-sectional survey of 76 sedentary middle-aged American men, aged 30 to 55 years, with resting blood pressures below 160/100 mm Hg. Systolic and diastolic blood pressures correlated significantly and inversely with monounsaturated fat consumption. Polyunsaturated fat consumption also correlated inversely with diastolic blood pressure; however, this relationship became nonsignificant when adjusted for an index of regional adiposity that characterizes the male-type obesity pattern. Detailed analyses of specific fatty acids showed that the correlations with monounsaturates were specific to oleic acid, and the correlation with polyunsaturates was specific to linoleic acid. Multiple regression analysis suggested that 18.2% of the variance in systolic blood pressure and 23.2% of the variance in diastolic blood pressure were related to monounsaturated and polyunsaturated fat consumption and regional adiposity. Thus, increased consumption of monounsaturated fat is related inversely to resting blood pressure, although causality remains to be determined.
JAMA 1987 Jun 19
PMID:Associations of dietary fat, regional adiposity, and blood pressure in men. 358 49

Recent studies suggest that obesity may protect hypertensives against cardiovascular disease (CVD). This concept was investigated by the Honolulu Heart Program, a prospective epidemiologic study of CVD in a cohort of Japanese-American men aged 45 to 65 years who have been followed up for 12 years. The combined effect of body mass index (BMI), as a measure of obesity, and blood pressure on coronary heart disease and CVD incidence was examined in 7554 men who were free of CVD and cancer at baseline. Rates of coronary heart disease and CVD were higher in the most obese than in the nonobese men for both normotensives and hypertensives. Blood pressure-BMI interaction was not significant for any CVD end point. Hypertension was associated with higher rates of coronary heart disease and CVD at all levels of BMI. This study supports the conclusion that hypertension is associated with an increased risk of CVD in both obese and nonobese men and that the relationship of blood pressure to CVD incidence does not vary with level of BMI. The inclusion of prevalent cases of CVD and the collapsing of continuous data into two categories may explain the results of earlier studies.
JAMA 1986 Dec 05
PMID:Does obesity protect hypertensives against cardiovascular diseases? 377 13

Conflicting results have been reported concerning the association between body weight and longevity. The shape of the curve relating weight to all-cause mortality has been variously described as linear, J-shaped, and even U-shaped. To assess the validity of the evidence for optimal weight recommendations, we examined the 25 major prospective studies on the subject. Each study had at least one of three major biases: failure to control for cigarette smoking, inappropriate control of biologic effects of obesity, such as hypertension and hyperglycemia, and failure to control for weight loss due to subclinical disease. The presence of these biases leads to a systematic underestimate of the impact of obesity on premature mortality. Although these biases preclude a valid assessment of optimal weight from existing data, available evidence suggests that minimum mortality occurs at relative weights at least 10% below the US average.
JAMA 1987 Jan 16
PMID:Body weight and longevity. A reassessment. 379 18

To assess relationships between increases in triceps skin-fold thickness (TRSF) and changes in levels of serum lipids and lipoproteins in early life, a biracial sample of 1,598 five to 12 year olds were reexamined five years after an initial examination. Significant positive correlations, controlled for age, were observed between changes in TRSF and changes in levels of serum total cholesterol, serum triglycerides, and low- and very low-density lipoprotein cholesterol. Inverse associations between changes in TRSF and high-density lipoprotein cholesterol were weaker, but also statistically significant. Although females showed the largest increases in TRSF, most associations were stronger in males. Increases in estimated percentage body fat and ponderal index (kilograms per cubic meter) were highly associated with changes in TRSF, but showed slightly different associations with the serum lipids and lipoproteins. Results show that increases in obesity in youth are accompanied by an increasingly atherogenic lipoprotein profile.
JAMA 1985 Jul 26
PMID:Relationship of changes in obesity to serum lipid and lipoprotein changes in childhood and adolescence. 385 72

Data from the first Health and Nutrition Examination Survey were analyzed with multivariate statistical techniques to determine whether there was evidence for a contributory role of alcohol in hypertension and to provide a suitable perspective on the importance of nutrient variables compared with other established risk factors for hypertension. The results of these analyses reaffirm the importance of alcohol and sodium intakes on blood pressures among US adults. Potassium (inversely) and phosphorus (directly) were also identified as important nutrient predictors of higher systolic blood pressure. Calcium intake was significantly related to systolic blood pressure only among nonwhite men and was not a significant predictor of systolic pressure overall. In addition, the results of the study reemphasized the paramount importance of age, race, and obesity in determining hypertension. Current nutrient intakes, by comparison, are relatively less important.
JAMA 1985 Mar 15
PMID:Alcohol, nutrient intake, and hypertension in US adults. 397 35

In a randomized five-year multifactorial primary prevention trial of vascular diseases, hyperlipidemias, hypertension, smoking, obesity, and abnormal glucose tolerance of the high-risk test group (n = 612 men) were treated with dietetic-hygienic measures and hypolipidemic (mainly probucol and clofibrate) and antihypertensive (mainly diuretics and beta-blockers) agents. A matched high-risk control group (n = 610) and a low-risk control group (n = 593) were not treated. The program markedly improved the risk factor status, yet the five-year coronary incidence tended to be higher in the intervention group than in the control group (3.1% vs 1.5%), while the stroke incidence was significantly reduced (1.3% vs 0%). The coronary events tended to be accumulated in subgroups treated with beta-blocking agents or clofibrate, but there were few in those receiving probucol or diuretics. Thus, the intervention program significantly reduced development of stroke, but the occurrence of cardiac events was not prevented. Possible adverse drug effects offsetting the probable benefit of improved risk profile are not excluded.
JAMA 1985 Oct 18
PMID:Multifactorial primary prevention of cardiovascular diseases in middle-aged men. Risk factor changes, incidence, and mortality. 404 37

Progressive left hemiparesis followed by face and trunk cutaneous vasodilation and hyperphagia developed in a 28-year-old man. He began eating five to six meals a day and gained 16 kg in 60 days. Computed tomography disclosed a neoplastic lesion involving the midline via the hypothalamus and reaching the contralateral lenticular nucleus. Findings from endocrine studies, including thyroid-stimulating hormone, growth hormone, prolactin, and cortisol serum levels, were normal. Hyperphagia and consequent obesity were associated with bilateral destruction of the ventromedial hypothalamic area; cutaneous vasodilation was related to involvement of the preoptic area.
JAMA 1981 Jul 10
PMID:Hyperphagia and obesity. Relationship to medial hypothalamic lesions. 626 71


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