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

50 patients were operated on; 42 women and 8 men at the age of 17 to 57. The weight of the patients was 100 to 184 kg. and the overweight amounted in most cases to 70 to 188%. Long lasting conservative treatment proved to be inefficient. The endocrynological basis of the obesity was excluded. 6 patients were operated upon according to the Salmon-method and 44 according to the Payne-De Wind-method. 3 patients died. 47 patients recovered without complications. For two years after the operation the loss of weight was 28 to 50% compared with the initial weight. Diarrhoe stopped six months after the operation. During this time a decrease in the concentration of potassium and calcium in the blood serum was observed. Judging from the positive changes the decrease of the cholesterol concentration in the blood was observed as well as the general improvement of the patients health. All patients are in good health and have taken up their jobs again.
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PMID:[Surgical treatment of obesity by jejuno-ileal bypass (author's transl)]. 86 29

Thirty-two patients, 28 women and 4 men aged from 17 to 57 years were treated surgically for obesity. Their body weight ranged from 90 to 184 kg, with an excess weight from 42% to 180%. In 6 cases the Salmon operation and in 26 the Payne-de Wind operation were performed. Two patients died. In the remaining cases the postoperative course was uneventful and relatively mild. The longest follow-up period was 22 months. Weight loss rate was highest in the first period after the operation and the monthly rate of the weight loss in the first year after the operation was 3.5 to 6 kg. Diarrhea disappeared usually after 4 months. In some patients a transient fall in serum potassium and calcium level was observed. Other favorable results included a significant fall in the serum levels of cholesterol and beta-lipoproteins and improved value of BSP retention test. The condition of the patients is good and they have returned to work.
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PMID:Surgical treatment of obesity. 99 59

Short- and long-term weight reduction programmes both resulted in a significant decrease in the waist/hip ratio (WHR) among obese premenopausal women. In matched groups of women with gynoid and android obesity, the latter demonstrated a greater decrease in WHR after 1 year's weight reduction and, at the same level of body weight loss, a consistently lower decrease in the lean body mass. Gluteal fat cells were found to empty at a slower rate than those in the abdominal region, particularly in gynoid obesity. After 1 year's weight reduction, the decrease in WHR correlated significantly with decreases in body weight, blood pressure and metabolic variables. Six months' physical training with and without reduction of body weight resulted in a significant decrease in WHR, while one-leg exercise caused a local decrease in the circumference of the trained leg. Reduction of flatulence in obese men was also found to be associated with decreased WHR.
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PMID:Can body fat patterning be changed? 316 69

Acarbose is an alpha-glucosidase inhibitor which reversibly and competitively inhibits the digestion of oligo- and disaccharides at the brush border of the small intestine. This study evaluates the preventive and therapeutic properties of acarbose in the treatment of obesity. Dose-response experiments were performed during repeated sucrose loads in man in order to investigate the effects of acarbose on plasma insulin and blood glucose levels. After titration of efficient doses, a long-term tolerance test of acarbose was undertaken in a small pilot study. Finally, the relapse preventing effect of acarbose was tested during double-blind cross-over conditions in 24 weight reduced obese women. In growing Sprague-Dawley rats, the effects of acarbose on body weight, lipid depots and adipose tissue cellularity were tested during pair-feeding and ad libitum conditions. Such effects were also studied in adult ad libitum-fed rats. Blood glucose, plasma insulin, body fat, depot lipids as well as fat cell weight and number were determined with established techniques. During a sucrose load, acarbose reduced insulin in a dose-dependent fashion. Glucose was also reduced, but not dose-dependently and only to a moderate extent. During a 200 g sucrose load, 400 mg of acarbose did not necessarily result in a maximal reduction of the insulin response while the glucose response was maximally inhibited after 100 mg. Acarbose reduced the relapse rate after weight reduction. No serious side effects were observed. Flatulence and meteorism occurred frequently. In growing rats, acarbose retarded the development of body weight and of lipid depots not only during pair-feeding conditions but also in ad libitum-fed animals eating considerably more than their controls. The spontaneous food consumption was increased by acarbose also in adult rats but in these animals neither body weight nor lipid depots were significantly reduced by acarbose. It is concluded that acarbose induces a carbohydrate malabsorption. Insulin levels are reduced not only via a decreased glycemic stimulus but also by interference with other insulin releasing mechanism(s). Acarbose is the first drug ever tested with long-term relapse reducing effects after weight reduction. Animal experiments suggest that acarbose may be of value in the prevention of obesity, particularly since the drug retards lipid accumulation also during ad libitum-feeding.
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PMID:alpha-Glucosidase inhibition in obesity. 391 27

In a multicenter study by 243 practicing physicians in Austria 819 severely obese subjects of both sexes without overt disease were encouraged to keep a calorie-restricted diet to reduce weight. After a run-in period of more than two weeks of dieting patients started taking 15 mg dexfenfluramine (Isomeride) twice daily for three month. While their weight was fairly stable during the run-in period progressive weight loss occurred during taking dexfenfluramine due to obvious changes in eating habits and appetite allowing to keep the reducing diet more strictly. Females lost 7.7 +/- 3.9 kg while obese men lost 9.32 +/- 4.6 kg. Laboratory tests obtained before starting dexfenfluramine and after 3 months at termination of medication showed blood glucose, cholesterol, LDL and triglycerides to decrease while HDL-cholesterol increased moderately. Dexfenfluramine was well tolerated by the majority of patients. Side effects such as fatigue, sedation, flatulence or diarrhea occurred in only 7.9% of the probands initially and dropped to 2.1% during the third month of the medication. It is concluded that Dexfenfluramine modifies eating habits and appetite thus making weight reducing diets easier acceptable and resulting in weight loss. It is suggested that Dexfenfluramine has a role in treatment regimes for morbid and refractory obesity.
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PMID:[Effect of dexfenfluramine on eating behavior and body weight of obese patients: results of a field study of Isomeride in Austrian general practice]. 865 Oct 45

Dieting or a change in eating habits is the most widely used approach aimed at reducing body weight. However, it is also well known that many obese people cannot reduce body weight substantially, no matter how hard they try, and that they soon regain whatever they do lose. The conventional approach to the treatment of obesity is to control it by prohibition or suppression of overeating, and by orders to change eating habits. This paper presented and examined a new psychosomatic approach for obesity (NPAO). Taking the story of "The North Wind and the Sun" from Aesop's Fables as a metaphor, this hypothesis is based on the reduction of overstressors through a "Sun"-type approach as opposed to a "North Wind"-type approach. This "Sun"-type approach, which incorporates 2 principles and 3 basic rules, is useful in decreasing stressors such as prohibition, suppression and orders, and increasing pleasantness, which competes with unpleasant stress. The treatment based on this hypothesis was applied to 77 subjects: 62 men (age 46.2 +/- 8.0 years) and 15 women (age 50.6 +/- 4.5 years). All subjects were given medical checks just before and 6 months after the psychosomatic approach for obesity. For a proportion of cases, maximal oxygen uptake (VO2max) was measured before and after. In the practiced group (48 cases) except for three persons who had stopped the program within 3 months after the start, body weight and body mass index fell significantly by 5.2 kg (p < 0.001) and 2.0 kg/m2 (p < 0.001) respectively, after 6 months. There were significant reductions in total cholesterol and triglyceride (p < 0.01, p < 0.01 respectively). VO2max, however, increased significantly (p < 0.05). The subjects' impressions of this therapy, collected after 6 months were as follows: "It was comfortable" 67.7%, "It was hard going" 8.8%, "My body has become lighter" 79.4%, "I have become more energetic" 70.5%, and "I have become happier" 64.7%. During the period of the therapy, there was no report of any appearance of new physical or mental abnormalities such as fatigue or uncomfortableness. On the other hand, there were no significant changes in any parameters except for an increase of blood sugar in the non-practiced group (26 cases). These results strongly indicate that the NPAO is easy in practice, has a high success rate, shows no rebounding, reduces body weight safely, and results in an increase of vigor.
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PMID:Proposal of a new hypothesis for the psychosomatic treatment of obesity and its application. 1053 2

BACKGROUND: Super-obesity (BMI > 50) is life-threatening. The jejunoileal bypass had Potential long-term problems, and weight loss with gastroplasty May be inadequate. METHODS: From 1988 to 1995, 19 Patients with morbid obesity had jejunolleal bypass with anastomosis of the fundus of the gallbladder to the proximal end of the bypassed jejunum. Of these patients, 11 were superobese, with ages 19-49 years, weight 125-172 kg, mean excess weight 97 kg (73-119) and BMI 56 (50-67). RESULTS: Mean weight loss at 3 years was 60 kg. There was no mortality and no major complications. Patients had 5-6 stools per day and some flatulence. There have been no hepatic, renal, calcium or electrolyte problems. Diseases secondary to obesity resolved. CONCLUSION: Billo-intestinal bypass has been effective and safe thus far.
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PMID:Does Bilio-intestinal Bypass Still have a Role in the Treatment of Super-obesity? 1072 56

Orlistat (Xenical, Hoffmann-La Roche) is a powerful inhibitor of gastrointestinal lipase and as such, reduces fat absorption. Unlike other weight-reducing drugs it is minimally absorbed and has no effects in the CNS. Orlistat is indicated for patients with a body mass index (BMI) of at least 30 kg/m2 or 28 kg/m2 in the presence of obesity-associated complications, such as hypertension, diabetes mellitus, hyperlipidaemia and obstructive sleep apnoea. In clinical trials, orlistat (120 mg t.i.d.) in combination with life-style modification and a hypocaloric diet (30% of energy from fat) induced significantly more weight loss and improved health complications of obesity (diabetes, hypertension, hyperlipidaemia) compared to patients treated with diet alone. Side effects related to fat malabsorption, occurred in more than 20% of subjects during the first year of treatment and included oily faecal spotting, abdominal pain, flatus with discharge and fatty/oily stool. Side effects from orlistat diminished in the second year of treatment. Plasma concentrations of fat soluble vitamins decreased in orlistat-treated patients but did not usually fall below the normal range. No studies have evaluated the efficacy of orlistat or side effect profile beyond two years.
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PMID:Orlistat in the treatment of obesity. 2694 9

Orlistat, a potent gastrointestinal lipase inhibitor, is a member of a new class of drugs designed for the long-term treatment of obesity. When given with a fat-containing meal, orlistat reduces dietary fat absorption by approximately 30%, which equates to a decrease in caloric absorption of approximately 200 kilocalories per day. A 2-year European study found a mean decrease in body weight of 10.2% (10.3 kg) in the orlistat group compared to 6.1% (6.1 kg) in the placebo group at 1 year. Additionally, 9.3% of the orlistat group versus 2.1% of the placebo group lost >20% of their initial weight. Serum lipids and diabetes control are also improved by orlistat. Related to orlistat's mechanism of action, side effects include oily spotting, flatulence and frequent loose stools, but not frank diarrhea or intestinal malabsorption. Vitamin D and beta-carotene levels decreased, but remained within the normal range. In summary, orlistat is the first example of a new class of antiobesity drugs that enhances weight loss and weight maintenance by interfering with dietary fat absorption. Orlistat has tolerable gastrointestinal side effects and no major drug toxicity. Orlistat is a viable adjunct to lifestyle interventions used in the long-term management of obesity.
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PMID:Orlistat for the long-term treatment of obesity. 1297 16

Glucomannan is a dietary fiber employed quite frequently in the western countries since two decades now, as its ingestion plays an important role in human health. However, eastern people have used this fiber for more than a thousand years. This dietary fiber is the main polysaccharide obtain from the tubers of the Amorphophallus konjac plant, a member of the family Araceae found in east Asia. The chemical structure of glucomannan consists, mainly, in mannose and glucose in the ratio 8:5 linked by beta (1-->4) glycosidic bonds. This soluble fiber has a extraordinarily high waterholding capacity, forming highly viscous solutions when dissolved in water. It has the highest molecular weight and viscosity of any known dietary fiber. It has been demonstrated that this product is highly effective in the treatment of obesity due to the satiety sensation that it produces; as a remedy for constipation, because it increases the faeces volume; as hypocholesterolemic agent, interfering in the transport of cholesterol and of bile acids and as hypoglycemic and hypoinsulinemic agent, probably, by delaying gastric emptying and slowering glucose delivery to the intestinal mucosa. To the beneficial properties of this fiber, several disadvantages can be added as the production of flatulence, abdominal pain, esophageal obstruction, lower gastrointestinal obstruction or even the possible modification of the bioavailability of other drugs. This paper reviews the main characteristics of glucomannan, as well as its properties, physiologic effects and therapeutic uses.
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PMID:[Glucomannan: properties and therapeutic applications]. 1498 41


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