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Long-term Weight Loss (long-term + weight_loss)
Selected AbstractsWhat interventions should we add to weight reducing diets in adults with obesity?JOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 4 2004A systematic review of randomized controlled trials of adding drug therapy, behaviour therapy or combinations of these interventions, exercise Abstract Background, Evidence is needed for the effectiveness of interventions given with reducing diets for obese adults: drug therapy, exercise, or behaviour therapy. Methods, We systematically reviewed randomized controlled trials in any language. We searched 13 databases and handsearched journals. Trials lasted 1 year or more. One investigator extracted data and a second checked data extraction. Trial quality was assessed. Results, Adding orlistat to diet was associated with weight change for up to 24 months (,3.26 kg, 95% CI, ,4.15 to ,2.37 kg), and statistically significant beneficial changes were found for total and LDL cholesterol, blood pressure and glycaemic control. Adding sibutramine to diet was associated with a 12 month weight change of ,4.18 kg (95% CI, ,5.14 to ,3.21 kg), and statistically significant beneficial effects on high density lipoprotein cholesterol (HDL) and triglycerides (TGs), but an increase in diastolic blood pressure. Adding exercise to diet, or to diet and behaviour therapy, was associated with improved weight loss for up to 36 months and improvements in HDL, TGs and blood pressure. Adding behaviour therapy to diet, or to diet and sibutramine together, was associated with improved weight loss for up to 18 months. Adding drugs, exercise or behaviour therapy to dietary advice was each associated with similar weight change. Conclusions, Adding orlistat, sibutramine, exercise, or behaviour modification to dietary advice can improve long-term weight loss. [source] Long-term effectiveness of diet-plus-exercise interventions vs. diet-only interventions for weight loss: a meta-analysisOBESITY REVIEWS, Issue 3 2009T. Wu Summary Diet and exercise are two of the commonest strategies to reduce weight. Whether a diet-plus-exercise intervention is more effective for weight loss than a diet-only intervention in the long-term has not been conclusively established. The objective of this study was to systemically review the effect of diet-plus-exercise interventions vs. diet-only interventions on both long-term and short-term weight loss. Studies were retrieved by searching MEDLINE and Cochrane Library (1966 , June 2008). Studies were included if they were randomized controlled trials comparing the effect of diet-plus-exercise interventions vs. diet-only interventions on weight loss for a minimum of 6 months among obese or overweight adults. Eighteen studies met our inclusion criteria. Data were independently extracted by two investigators using a standardized protocol. We found that the overall standardized mean differences between diet-plus-exercise interventions and diet-only interventions at the end of follow-up were ,0.25 (95% confidence interval [CI],0.36 to ,0.14), with a P -value for heterogeneity of 0.4. Because there were two outcome measurements, weight (kg) and body mass index (kg m,2), we also stratified the results by weight and body mass index outcome. The pooled weight loss was 1.14 kg (95% CI 0.21 to 2.07) or 0.50 kg m,2 (95% CI 0.21 to 0.79) greater for the diet-plus-exercise group than the diet-only group. We did not detect significant heterogeneity in either stratum. Even in studies lasting 2 years or longer, diet-plus-exercise interventions provided significantly greater weight loss than diet-only interventions. In summary, a combined diet-plus-exercise programme provided greater long-term weight loss than a diet-only programme. However, both diet-only and diet-plus-exercise programmes are associated with partial weight regain, and future studies should explore better strategies to limit weight regain and achieve greater long-term weight loss. [source] Hormonal control of diabetes type 2 after surgery: Clinical and experimental evaluationASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 1 2009EE Frezza Abstract Diabetes mellitus (DM) type 2 now afflicts over 170 million people worldwide, a number expected to surpass 220 million by 2010. DM and its associated complications is a significant burden to public health care funding. In 2007, $US174 billion was spent in the United States, according to the American Diabetic Society. The morbidly obese have high serum leptin and insulin levels and low ghrelin levels, which have been associated with altered satiety. Exercise, medical therapy and dieting usually do not result in long-term weight loss or euglycemia. Bariatric surgery yields euglycemia for many patients, but its mechanism has yet to be fully elucidated. Our preliminary studies showed resolution of DM after both gastric bypass (GBP) and sleeve gastrectomy (SG), more so than after gastric banding. GBP significantly reduces ghrelin levels in the morbidly obese, perhaps as a result of exhausting ghrelin production in the stomach. A reduction in serum ghrelin levels would be expected after SG, which extirpates the ghrelin-producing cells by removing the fundus. This question has not, to our knowledge, been fully explored with regard to the relationship between ghrelin and other hormones. [source] Changes in gut hormones after bariatric surgeryCLINICAL ENDOCRINOLOGY, Issue 2 2008R. P. Vincent Summary Bariatric surgery is one of the most effective treatments for achieving long-term weight loss in morbidly obese patients. Bariatric surgery causes weight loss through substantial decline of hunger and increased satiety. Recently our understanding of neuroendocrine regulation of food intake and weight gain, especially regarding the role of gut hormones, has significantly increased. The changes in these hormones following bariatric surgery can partly explain the mechanism behind weight loss achieved through these procedures. In this paper, we review the effect bariatric procedures have on different gut hormone levels and how they in turn can alter the complex neuroendocrine regulation of energy homeostasis. [source] | ||||||||||