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

A postal questionnaire was used to assess general practitioners' knowledge, attitudes and current practice of treatment regarding obesity and weight problems. Overall, 299 responses (75%) were received from general practitioners randomly selected from family practitioner committee lists in Portsmouth and Norwich. Currently 27% of the doctors were overweight and a further 3% obese. Many doctors (69%) had tried to lose weight at some time and 40% had been overweight and a further 12% obese in the past. The most popular methods used to educate overweight and obese patients were one to one counselling and giving out diet sheets and leaflets on healthy eating. The treatment advice to patients from the majority of doctors was to eat less in general (78%) (specifically to eat fewer calories 75%); to exercise (77%); or to attend a slimmers group (54%). Doctors thought that they were less effective than the media or the family in persuading overweight patients to lose weight. Doctors said they were prepared to counsel on weight reduction but felt they had little success in achieving weight loss in patients. Experience was ranked as the most important contributor to knowledge about managing obesity, and medical school was rated as least important. Further study is needed to discover how different practices and attitudes affect patient management and which ones are associated with greatest success. Medical schools and postgraduate centres could play a more important role in educating doctors about nutrition.
Br J Gen Pract 1991 Apr
PMID:Management of weight problems and obesity: knowledge, attitudes and current practice of general practitioners. 177 90

Predictors of distal and proximal forearm bone density, measured by photon absorbtiometry, were investigated in 248 premenopausal women aged 39-56 years. Only one strong predictor of lower bone density was found--history of previous fracture at any site (P less than 0.001). Two other factors showed a weaker association with density, but only at the distal site--history of diuretic use showed a positive association (P less than 0.02) whereas alkaline phosphatase level was inversely correlated with density (P less than 0.01). Other factors were not significant predictors: these included age, calcium intake, level of exercise, anthropometric measures of obesity, serum calcium level, parity, lactation history, a menopausal symptom history, use of the contraceptive pill, smoking and alcohol intake. These results contrast with the far stronger predictors found for postmenopausal women and suggest that genetic endowment rather than lifestyle may be the major determinant of bone density before the menopause.
Br J Gen Pract 1991 May
PMID:Determinants of forearm bone density in premenopausal women: a study in one general practice. 187 69

The lessons learned from developing countries which are applicable equally to developed countries include the recognition that poverty and social justice are an integral part of a health strategy, that disease prevention involved active participation of the population, that better cost effective measures are desirable, and that individual and community involvement need to be encouraged. Prior to 1940, health care strategy involved the doctor as the locus of care for curing disease. Thereafter, through the agenda of the WHO, there was a shift towards emphasis on community health, environmental sanitation, health education, and prevention; the goal was health for all. The 1978 WHO meeting in Alma-Ata set goals for the year 2000 as 1) health care users being actively involved in caring for themselves, 2) the implementation of cost effective strategies, 3) expanding the health team to other disciplines, and 4) achieving equity in services provided and outcomes. Primary health care approaches have successfully reduced infant and child mortality through immunization, clean water and sanitation efforts, breast feeding, household involvement in treatment of diarrhea, and monitoring growth and nutrition. The lesson to be learned from developed countries is that prevention is more cost effective than illness management, particularly with the availability of new expensive technologies. Education and other primary prevention efforts can be successful in reducing smoking, auto fatalities, environmental contamination, and AIDS. Health in the US: 50-100 years ago was similar to that in developing countries today, and the shift from infectious disease to chronic disease was not smooth. Countries like Mexico are already straining under the difficulties of both disease patterns, while Brazil's public resources spent on illness treatment have jumped from 36% in 1965 to 85% in 1982, or 6% of the GNP. This could easily expand to the US figure of 12% due to similar problems with injuries, heart and cerebrovascular disease, cancer, dietary patterns of high salt and fat intake inadequate exercise and obesity, and environmental risks.
J Gen Intern Med
PMID:Prevention in developing countries. 223 Oct 55

Certain scrapie strains cause obesity in several strains of mice. The potential association between obesity and altered glucose tolerance was assessed by monitoring body weight and glucose tolerance throughout the incubation period in scrapie strain-mouse strain combinations that do and do not produce obesity. Virtually all obese mice showed reduced glucose tolerance as shown by significantly higher blood glucose levels 2 h after a glucose overload. Mice injected with a scrapie strain that did not cause obesity showed normal tolerance. The scrapie infectivity titre of the pancreas of obese mice clinically affected with scrapie was very low. Adrenalectomy prevented both the increase in weight and aberrant glucose tolerance but had no other effect on the course of the disease. Following increasing dilution of the inoculum, the increase in body weight and the development of aberrant glucose tolerance reached an end-point that was similar to that of scrapie infectivity. The system described provides an inducible model of obesity with altered glucose tolerance.
J Gen Virol 1989 Apr
PMID:Scrapie-induced alterations in glucose tolerance in mice. 249 60

Few data are available regarding the prevalence and causes of false-negative auscultation (mis-auscultation) of aortic (AR), mitral (MR), or tricuspid regurgitation (TR), and there are no such data that are relevant when the patient's pretest probability of having regurgitation is unknown. The authors therefore studied 294 patients examined by pulsed Doppler echocardiography. On 755 examinations (2.57 examinations per patient), Doppler velocity patterns typical of AR, MR, or TR were found in 63, 96, and 49 patients, respectively. For all three murmurs, mis-auscultation was the rule, rather than the exception, with sensitivities of auscultation ranging from 0 to 37%, depending (but weakly) on the site of the murmur and the years of training of the observer. Specificity of auscultation was high (85% to 100%). The factors associated with the mis-auscultation of AR were poor image quality in the echocardiograms, absence of cardiomegaly, and less experience of the examiner. The probability of missing MR increased in the presence of coronary artery disease (CAD) or if the examiner had less experience. The likelihood of missing TR by auscultation was increased by CAD, obesity, chronic obstructive pulmonary disease, or the absence of cardiomegaly. This study suggests that there is a high prevalence of "silent" murmurs, and that not hearing a regurgitant murmur does not suffice to rule out the presence of regurgitation.
J Gen Intern Med
PMID:Causes of false-negative auscultation of regurgitant lesions: a Doppler echocardiographic study of 294 patients. 297 89

To investigate the involvement of adrenergic mechanisms in the development of obesity, hyperglycaemia and hyperinsulinaemia in Aston ob/ob mice, the sympathomimetic agent ephedrine (12 mg/kg/day) and the predominantly beta 1-adrenergic antagonist atenolol (12 mg/kg/day) were administered alone and in combination to weanling ob/ob mice for 40 days. Excessive weight gain in ob/ob mice was reduced (15-20%) by ephedrine, exacerbated (8-10%) by atenolol, but not significantly altered by a combination of these agents. The effects of ephedrine and atenolol were lost rapidly (within 5 days) when these agents were withdrawn. Ephedrine slightly reduced the hyperphagia in ob/ob mice, and food intake was transiently increased above that of untreated ob/ob mice when this agent was withdrawn. The development of basal hyperglycaemia and hyperinsulinaemia was not significantly altered by any of the treatments studied. None of the treatments significantly altered body weight, food intake, plasma glucose or plasma insulin concentrations in lean (+/+) mice. The results indicate that a defective adrenergic mechanism involving beta 1-adrenergic receptors contributes to the development of obesity in ob/ob mice.
Gen Pharmacol 1986
PMID:Effects of ephedrine and atenolol on the development of obesity and diabetes in ob/ob mice. 351 92

The relationship between blood glucose and diabetic retinopathy remains controversial. To obtain a proper perspective on this issue, a critical appraisal of clinical evidence published between 1974 and 1984 was done using standard methodologic criteria. Thirteen cohort studies and four intervention trials were found which provided the following new information: systolic hypertension, alcohol ingestion, female sex, and obesity were implicated as potential adverse prognostic factors related to retinopathy development. Although initial diagnostic blood glucose concentration was associated with subsequent retinopathy development, the reviewed studies did not provide evidence that tight glucose control prevented or retarded its development and progression. Some funduscopic and angiographic lesions deteriorated with tight control.
J Gen Intern Med
PMID:Blood glucose and diabetic retinopathy: a critical appraisal of new evidence. 353 72

The interactions between cholecystokinin (CCK) and brain monoamines have been investigated. The data found in the literature are quite dissimilar. Several reasons for these disparities have been suggested. We have sought to test some of them, such as the strain of rat, the nutritional state (by the use of two models of obesity), the length of the peptide (CCK 8 and CCK 33), the route of administration (i.p. and i.c.v.) and the time of sacrifice. We indeed found all these experimental conditions to be the cause of differential effects on brain monoamines and metabolites. However, by repeating the same experiments several times, we did not always obtain the same variations, even under the same conditions. In addition to the different parameters tested, another source of variability exists, possibly due to the molecule itself or to seasonal variations.
Gen Pharmacol 1986
PMID:Variability of changes in obese rat brain monoamines in response to cholecystokinin. 381 33

A morbidity survey in the Falkland Islands, conducted in 1979, showed that Falkland Islands men had a lower prevalence of hypertension than their counterparts in the United Kingdon. Such a difference was not found in women.As a migrant population, Falkland Islanders are unusual in that they moved from a developed society to a more traditional setting. In men, but not in women, the change in environment led to a greater proportion of the population engaging in a high level of habitual physical activity and to a low prevalence of obesity.These findings (based on ICD codes rather than BP measurements) are consistent with the hypothesis that such a change in lifestyle may have resulted in the lower population prevalence of hypertension observed in the morbidity survey, and the implications could be important for public health.
J R Coll Gen Pract 1984 Feb
PMID:The low prevalence of hypertension in Falkland Islands men. 647 Oct 24

A multiple factor approach toward body weight regulation was proposed which uses elements of self-perception theory to integrate seemingly unrelated or conflicting findings on the etiology of human obesity. Four factors--cue responsiveness, incidence of eating related to emotional distress, dietary restraint, and activity level--were hypothesized to influence the likelihood of obesity, with eating style being the most important variable. The existence of subgroups--normal weight and overweight individuals differing with respect to eating style, emotional-distress-related eating, dieting, and activity level--were proposed. In experimental tests on 90 Ss, predictions about the relationship of independent variables to obesity and the existence of subgroups of obese and normal weight individuals received support.
J Gen Psychol 1984 Jan
PMID:A multiple factor study of body weight control. 669 28


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