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

Percutaneous endoscopic gastrostomy (PEG) has become a commonly performed procedure to provide nutritional support to chronically ill patients. Following a PEG-related death, we retrospectively reviewed our complication rate with that of the published values. In the past 48 months at Madigan Army Medical Center and Eisenhower Army Medical Center, 147 PEGs have been performed. We have had 20 minor complications and 5 major complications, with 2 reported deaths directly related to the procedure. Minor complications included 14 cases of localized cellulitis and 5 cases of prolonged ileus. The major complications included two cases of necrotizing fasciitis (both fatal), two cases of tube extubation within 24 hours, both resulting in surgical gastrostomy, and one bowel obstruction requiring laparotomy. Both patients who developed necrotizing fasciitis had several predisposing factors including diabetes, malnutrition, obesity, and long-term hospitalization. In conclusion, we believe PEG is an extremely valuable procedure which should be utilized with caution in the immunocompromised or morbidly obese patient.
Mil Med 1992 Jul
PMID:Complications of percutaneous endoscopic gastrostomy. 152 71

The U.S.A. has the distinction of being the "fattest" nation in the world, with an estimated 34 million obese citizens. Of grave concern is the reported finding that obesity contributes to 20% of the annual mortality rate, primarily for such conditions as diabetes mellitus, digestive diseases, coronary heart disease, and cerebrovascular disease. In 1982, the Navy initiated the "Health and Physical Readiness Program" in order to establish body fat percentages and physical conditioning standards and to provide Navy personnel with weight reduction and other health promotion programs. Participation in such programs is expected to help overweight personnel solve their weight problems and reduce the risks of obesity-related conditions. The purpose of this study was (1) to identify the health conditions recorded in a sample of U.S. Navy enlisted men who had been diagnosed as obese during one or more of their admissions to a Naval hospital from 1974 through 1984, (2) to determine whether these disorders correspond with those reported in the scientific literature, and (3) to examine the obesity-related costs in terms of numbers of days hospitalized and career outcome. The patient population consisted of 518 U.S. Navy enlisted men who were given a primary diagnosis of obesity and 1,092 who received a secondary or additional diagnosis of obesity on at least one of their inpatient medical records between 1974 and 1984. A 10% sample of Navy male patients, all of whom had not been diagnosed as obese, was selected as a comparison group (n = 30,829). All diagnoses (ICD-9) for each hospitalization were included in the data compilations; however, each unique diagnosis was only counted once.(ABSTRACT TRUNCATED AT 250 WORDS)
Mil Med 1991 Feb
PMID:Profiling overweight patients in the U.S. Navy: health conditions and costs. 178 60

The Canadian Forces (CF), concerned with the possible adverse effects of obesity on military performance and image, recently adopted the body mass index (BMI) to monitor excess weight among its personnel. Subsequently, the records of 17,098 CF men (32.0 +/- 8 years) and 2,087 CF women (26.2 +/- 5 years) were examined. Approximately 50% of the men and 25% of the women had a BMI greater than 25 kg/m2, while 26% of the men and 12% of the women had a BMI greater than 27 kg/m2. Except for grip strength, both men and women in higher BMI zones typically demonstrated significantly lower fitness and performance scores than those in lower BMI zones. For men and women, increasing BMI was associated with progressive and significant increases in body weight, chest girth, waist girth, gluteal girth, thigh girth, waist-to-hip ratio, and waist-to-height ratio, and decreases in difference between chest-minus-waist girths. Waist girth increased proportionately more than other circumferences with increasing BMI, thus indicating a greater relative deposition of body fat in the abdominal region. In view of the relationship between high BMI and compromised fitness, appearance, and health observed in this population, the CF would benefit from continued educational and clinical efforts to reduce the prevalence of obesity. The BMI would serve as a useful epidemiologic standard to help monitor progress in these areas.
Mil Med 1990 Mar
PMID:Fitness, performance and anthropometric characteristics of 19,185 Canadian Forces personnel classified according to body mass index. 210 66

The purpose of this study was to analyze the assumptions underlying the Army's Weight Control Program (AWCP) and to determine whether overweight and normal-weight soldiers differed with respect to health risk, health status, self-motivation, psychological symptomatic distress, and physical fitness. The sample consisted of 154 active-duty male and female enlisted Army soldiers assigned to the Maryland and District of Washington area: 77 overweight soldiers and 77 normal-weight soldiers were randomly selected from a gender-stratified, unit-specific list. To test the hypothesis that the two groups would differ, data were analyzed using multivariate analysis of variance (MANOVA). The hypothesis was supported. The overweight and normal-weight soldiers differed, with the former having greater health risk, lower health status, and lower physical fitness; but the two groups did not differ in self-motivation or psychological symptomatic distress. These results support the concept that obesity is associated with increased morbidity. Further studies are necessary to examine the mechanisms by which endogenous physiological factors contribute to the expression of obesity.
Mil Med 1990 Sep
PMID:A comparison of the health risk, health status, self-motivation, psychological symptomatic distress, and physical fitness of overweight and normal-weight soldiers. 212 Jun 30

This study evaluated the overall effectiveness of the Navy's three-tiered obesity treatment program and compared effectiveness across the three treatment levels. Height, weight, and body circumference measurements were obtained from 369 program participants at baseline and follow-up (6 weeks, 6 months, 12 months). Results demonstrated a significant and sustained reduction in percent body fat in all three program tiers, but the absolute losses at the end of 12 months were small: -3.7% fat for men, -4.5% fat for women. The level III tier, which employs a multidimensional approach to treatment, was the most effective program, even after differences in enrollees' initial percent body fat were taken into account. Changes in the approach to treatment and development of a supportive, long-term, behaviorally based aftercare program are recommended.
Mil Med 1995 Jul
PMID:Evaluation of the Navy's obesity treatment program. 765 36

The Navy's diverse, three-tiered obesity treatment program is described. Level I (command-directed) programs rely primarily on group exercise to treat obesity; most level II (outpatient counseling) and level III (6-week inpatient) programs are modeled on Overeaters Anonymous and devote substantial amounts of time to group discussion, behavior modification, and nutrition education. Lack of funding or staffing has prevented many level II facilities from conducting a weight-management program, however. Further research might explore the potential for level II to provide a cost-effective middle ground for obesity treatment.
Mil Med 1993 Sep
PMID:Survey of the Navy's three-tiered obesity treatment program. 823 1

A weight-loss treatment program for active duty military personnel is discussed and evaluated. The Fat Loss and Exercise Program at U.S. Army Hospital, Bremerhaven, Germany, consisted of a 3-week inpatient treatment program and 6 months of weekly outpatient follow-up. The program combined a multidisciplinary team approach to the treatment of obesity--psychology, internal medicine, nursing, nutrition care, and physical therapy. Patients showed a significant weight and body fat loss [F(2,90) = 52.91 and 65.85, p < 0.001, respectively] from the initiation of treatment (mean = 205.9 pounds, 28.91%) to the end of the inpatient program (mean = 192.8 pounds, 25.97%) with maintenance over 6 months (mean = 190.4 pounds, 25.03%). Changes in cholesterol levels by treatment phase are also discussed. Results demonstrate positive increases in high-density lipoprotein at each phase. These results support a comprehensive, multidisciplinary inpatient treatment of obesity within the military.
Mil Med 1996 Feb
PMID:A comprehensive weight-loss program for soldiers. 885 19

The prevalence and pattern of osteoarthritis of the knee and its association with obesity among security forces personnel was investigated. A single survey with a control group was done at the Mobile Hospital, Ministry of Interior, Makkah Al Mukarramah. One hundred twenty-five patients presenting to the orthopedic clinic with painful knees of at least 12 months duration gave detailed histories and were treated with bi-planar conventional radiography; they were matched with a similar number from the clinics of internal medicine without painful knees. One hundred three patients (82.4%) with 126 painful knees had various degrees of osteoarthritis. The mean age was 41 and 41.76 years for the patient and control group, respectively. The medial tibio-femoral and patello-femoral compartment were involved in 116 cases (92%). Fifty-nine knees (46.8%) had mild, 46 (36.5%) had moderate, and 21 (16.6%) had severe osteoarthritis changes. There were statistically significant differences between the two groups for weight and Quetelet index of body mass (p < 0.047 and < 0.0001). In the study group, the mean Quetelet body index was 31.6638 kg/m2, and in the control group it was 28.5633 kg/m2. The prevalence of osteoarthritis among the security forces personnel was 1.19%. The medial and patello-femoral compartment was affected in the majority of cases, and obesity was confirmed as one of the important causes of osteoarthritis in the Saudi Arabian population.
Mil Med 1996 Feb
PMID:Osteoarthritis of the knee among Saudi Arabian security forces personnel. 885 24

Obesity is often associated with poor heat tolerance. This case-control study was to determine the effect of obesity measured by the Body Mass Index (BMI) on the occurrence of heat disorders. The subjects, 218 soldiers with heat disorders and 537 controls, were matched for age and sex. Obesity was defined as a BMI of greater than 27. The odds ratio for obese soldiers was 3.53; however, their rectal temperatures were not significantly higher at presentation for heat disorder. The Physical Employment Standard (PES) classifies soldiers into A, B, C, and E depending on medical history at the time of enlistment. Soldiers with PES status of A and B were at a marginally higher risk of heat disorders. Correcting for the effect of the PES status, the odds ratio for obese soldiers was 4.29. Therefore, obese soldiers training in a hot and humid environment are at an increased risk of heat disorders.
Mil Med 1996 Dec
PMID:Obesity and the occurrence of heat disorders. 899 Aug 32

Guidelines for preventing heat injury (HI) among military personnel are not directly applicable to civilian personnel. Military guidelines call for relatively large volumes of prophylactic water consumption and physical activity limitations depending on the wet bulb globe temperature. However, in civilian populations, there is an increased prevalence of HI risk factors: older age, medication use, especially anticholinergic and psychotropic medications, obesity, previous HI, and skin disorders. Although dehydration is a major contributor to HI in military situations, it is unlikely in classical heat stroke among civilians. Civilian guidelines are based on the heat index. Activity levels must be restricted more for civilians, and prophylactic water consumption (beyond replacing loss from sweat) is not necessary. This review discusses the pathophysiology of heat injury, contrasts the military and civilian approach to prevention of HI, and describes appropriate field intervention for HI.
Mil Med 1997 Jan
PMID:Preventing heat injury: military versus civilian perspective. 900 5


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