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

p-[(R)-3-[bis-[(R)-beta-hydroxyphenethyl]amino]butyl]benzamide (Ro 16-8714/000) is one of the most effective compounds, of a new series of calorigenic bis-phenethanolamine derivatives, which combine anti-obesity and antidiabetic qualities. Ro 16-8714 exhibited potent stimulation of oxygen consumption in normal rats and obese mice and rats. Calorigenesis appeared to be directly mediated by beta-adrenoceptors. Ro 16-8714 stimulated brown adipose tissue (BAT) thermogenesis in vitro and increased BAT calorigenic capacity in obese rodents during prolonged treatment. Furthermore, the compound induced fat mobilization and oxidation in normal and obese rats. Subchronic treatment of obese mice revealed potent antidiabetic effects which were mainly due to stimulation of carbohydrate oxidation. Prolonged treatment of obese mice and rats resulted in inhibition of body weight gain and depression of body fat content while body protein was maintained. The compound may, therefore, offer a new approach to the treatment of morbid obesity and maturity-onset diabetes.
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PMID:Phenethanolamine derivatives with calorigenic and antidiabetic qualities. 653 94

We describe a new technique for the surgical treatment of exogenous morbid obesity. The stomach is partitioned from the angle of His toward the lesser curvature, and a Roux-en-Y proximal jejunal limb drains the proximal gastric pouch, which is 25 to 35 ml in capacity. By use of the enteroanastomosis (EEA) or the intraluminal (ILS) stapling instrument for the gastrojejunostomy from the lesser curvature of the stomach, the functional reliability, vascular integrity, and ease of construction of the stoma have been improved. We performed the gastric bypass operation on 300 consecutive patients, 268 women and 32 men, over a two-year period beginning in June 1979. The patients' average admission weight was 126 kg. Diseases associated with obesity were observed in 57% of the patients, and concomitant operations were performed in 29%. The average weight loss at 6, 12, 18, and 24 months was 37.0, 48.5, 51.5, and 52.0 kg, respectively. Early and late complications occurred in 37 patients (12%), requiring 40 reoperations. Two deaths (0.6%) occurred within the 30 months' of observation.
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PMID:Gastric bypass: Roux-en-Y gastrojejunostomy from the lesser curvature. 662 29

We studied a woman who underwent a jejunoileal bypass for the treatment of morbid obesity and in whom severe jaundice and hepatic failure developed six months later; these developments prompted restoration of the normal continuity of the small bowel. Four serial wedge biopsy specimens of the liver were taken during a three-year follow-up. The first biopsy was performed before the bypass surgery, the second six months after the operation, the third three months after restoration of normal continuity of the bowel, and the fourth three years later. The biopsy specimens clearly showed the morphologic changes of the liver in obesity, the effect of small intestinal bypass and its reversal on hepatic structure, and the natural evolution of liver disease in morbid obesity.
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PMID:Evolution of liver disease in morbid obesity after small-intestinal bypass and its restoration. A case report. 668 40

This review has considered the current status of the treatment of obesity from the point of view of a new theory and a new classification. The theory states that obesity is the result of regulated, homeostatic processes that maintain body fat at an elevated level. The classification divides obesity into three categories--mild, moderate, and severe. Severe obesity, more than 100% overweight, which afflicts 0.5% of the female obese population is most effectively treated by surgical measures, particularly ones that reduce the size of the stomach and of its opening into the lower gastrointestinal tract. Such surgery may produce very large weight losses with relatively few untoward consequences, suggesting that it acts by lowering a body weight set point. Moderate obesity, 41 to 100% overweight, afflicts 9% of the female obese population. It is currently treated under medical auspices either by diets that may achieve satisfactory weight loss but poor maintenance of this loss, or by behavior modification that achieves good maintenance, but only modest weight loss. Medication is of limited value because of its continued efficacy, rather than because, as was thought, tolerance develops to its effects. It appears to lower a body weight set point and cessation of medication is followed by a rapid rebound in body weight. For this reason, medication should probably be used either for an indefinite period of time or not at all. Mild obesity, 20 to 40% overweight, afflicts 90% of the female obese population and today is largely managed by large organizations, both commercial and nonprofit. The basis of treatment is behavior modification in groups, a liberal, balanced diet, and exercise. Despite very high drop-out rates from these organizations, their low costs result in favorable cost/effective ratios, and they are continuing to increase the number of obese people that they treat.
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PMID:The current status of treatment for obesity in adults. 669 12

A report is presented on gastric bypass (n = 27) and gastroplasty (n = 2) in patients with morbid obesity. One patient died postoperatively (mortality 3.4%). Mean weight prior to operation was 129 kg (96 to 205 kg), i.e. 117% (63 to 253%) in excess of the ideal weight. During a follow-up period of 6 to 46 months, the mean loss of weight amounted to 38 kg (3 to 77 kg). 86% of the patients judged their condition as being very good to good. Diseases related to obesity were reduced to a remarkable degree: hypertension from 43 to 5%, hypertriglyceridaemia from 50 to 5% and diabetes mellitus from 52 to 13%. Two patients had to be reoperated on due to a peptic jejunal ulcer, five because of an incisional hernia. No patient suffered from diarrhoea, calculi of the biliary or urinary tract or electrolyte disorders. On the basis of these results gastric bypass would appear to be indicated for the treatment of obesity not amenable to conventional therapy.
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PMID:[Indications and results of gastric bypass in the treatment of extreme obesity]. 674 Nov 46

Three patients with the obesity hypoventilation syndrome and one patient with the sleep apnea syndrome underwent gastroplasty for weight reduction. A tracheostomy was also performed in the patient with sleep apnea. The PaO2 rose from an average of 51 +/- 9 to 71 +/- 5 torr and the PaCO2 fell from an average of 51 +/- 21 to 41 +/- 6 torr within two to ten months following bariatric surgery. The improved arterial blood gases were associated with an increased forced vital capacity in each patient. The change in maximum voluntary ventilation was variable. Sleep capneography demonstrated cure of the patient with sleep apnea permitting removal of the tracheostomy. All four patients have returned to productive lives in society. Given proper pre- and postoperative care, patients with respiratory insufficiency tolerate the operation well. Respiratory insufficiency associated with morbid obesity should be considered an indication for the gastroplasty procedure, rather than a contraindication as previously suggested.
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PMID:Gastroplasty for respiratory insufficiency of obesity. 678 2

One hundred twenty-two morbidly obese patients were selected for gastric partitioning from a multidisciplinary obesity clinic over a 4 year period. Initial early success was not a guarantee against cessation of weight loss or the regaining of lost weight. By emphasizing criteria for success and failure, both from our series and the literature, we showed an alarming increase in the failure rates for this procedure which is predicated on the fact that those lost to follow-up were probably failure patients. Numerous articles in the literature contain inadequate data because they refer to pounds rather than percentage of weight loss, they fail to consider revisions as failures, they do not provide 24 month follow-up data, and they do not take into account the possibility that those lost to follow-up are failure patients. The operation carries mortality and serious morbidity rates of 0 to 3 percent and 4 to 10 percent, respectively, with an average 28 percent weight loss at 24 months and a minimal failure rate of 50 percent. The alarming increase in the number of these procedures being carried out across the continent makes it mandatory for surgeons to accurately collect and register their data until the long-term effects and results are known. Gastric partitioning, although probably not experimental, is still developmental. The widespread use and possibly abuse of these operations may result in discreditation of the surgical approach to morbid obesity which would be unfortunate since it is the only practical method at this time for dealing with the problem.
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PMID:Failure rate with gastric partitioning for morbid obesity. 684 81

A 79-year-old woman presented with an unusual form of obesity limited to the lower half of the body from the waistline down but sparing the lower legs and feet. The patient was massive (360 lbs) and symmetrical. The superior half of the body was normal with no morbid obesity or lipoatrophy. These findings do not correspond to any classic form of lipodystrophy. The fat distribution is reminiscent of a pair of knickers and qualifies for the name "pantaloon obesity."
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PMID:A case of pantaloon obesity. 686 15

Morbid obesity (100 pounds over ideal body weight) carries with it numerous medical complications and increased mortality which can be improved by weight loss. Medical treatment of obesity is usually not successful, and jejunoileal bypass surgery often produces considerable chronic morbidity which seriously compromises its benefits. Gastric bypass is equally effective and avoids the most severe long-term complications of jejunoileal bypass, but has a higher operative morbidity. Gastric plication will perhaps offer the least operative and chronic morbidity, though few long-term statistics are as yet available.
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PMID:Surgery for morbid obesity: indications, complications, alternatives. 700 94

A report of reduced serum levels of progestins, following oral administration after jejunoileal bypass, promoted the present investigation of the absorption of D-norgestrel and estradiol following different types of intestinal bypass surgery for morbid obesity. A group of non-operated obese patients served as control. Apart from significantly higher gonadotrophin levels, which could be attributed to periovulatory sampling in the non-operated group, there was no significant differences in basal levels of estradiol, estrone, conjugated estrone, androstendione, testosterone, and progesterone. The operation did not influence the pattern of the menstrual cycle. Following a single oral dose of 4 mg micronized estradiol and 125 microgram D-norgestrel, serum levels of estradiol and estrone were equal in the three groups. serum D-norgestrel was equal in the two operated groups, but was significantly higher in the bypass group with 1:3 jejunoileal ratio, compared with the non-operated group. Further, a significant negative correlation between peak levels and weight was found. It is suggested that one year following bypass surgery, obesity - but not intestinal bypass - might be associated with reduced serum levels of exogenous sex steroids following oral administration.
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PMID:Sex hormone levels and intestinal absorption of estradiol and D-norgestrel in women following bypass surgery for morbid obesity. 706 18


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