Re: A call for literature : Some Abstracts

[Guest guest]

Hawkins,

I found a few abstrcts.

Hull

Acta Chir Belg 1999 May-Jun;99(3):135-9 Related Articles, Books,

LinkOut

Medical aspects of obesity.

Scheen AJ, Luyckx FH.

Department of Medicine, CHU Sart Tilman, Liege, Belgium.

Obesity poses a serious health hazard and its treatment is often

disappointing. Major advances have been made during recent years in

the understanding of body weight regulation, with the discovery of

leptin, a protein produced by adipocytes and acting on the central

nervous system to reduce food intake, and that of beta-3 adrenergic

receptors and uncoupling proteins which contribute to stimulate

energy expenditure. Numerous metabolic complications are associated

with abdominal obesity and most of them, such as diabetes mellitus,

dyslipidaemias and arterial hypertension, appear to be linked to

insulin resistance and may be part of the socalled metabolic syndrome

or syndrome X. While very-low-calorie diets are usually effective in

the short-term, they cannot, in the long-term and for most patients,

solve the problem of severe obesity. Pharmacological antiobesity

treatment may include drugs that reduce food intake, drugs that

increase energy expenditure and drugs that affect nutrient

partitioning or metabolism. All of these pharmacological approaches

have potential efficacy, but unfortunately serious limitations. This

is also the case of mechanical means, such as intragastric balloons.

Consequently, bariatric surgery may be considered as a valuable

alternative therapy in well-selected patients with morbid obesity

refractory to classical treatments. In conclusion, obesity is a

chronic disease and should be treated as such with reasonable

expectations.

Publication Types:

Review

Review, Tutorial

PMID: 10427350 [PubMed - indexed for MEDLINE]

Am J Clin Nutr 1992 Jul;56(1 Suppl):244S-246S Related Articles,

Books, LinkOut

Weight loss and 2-y follow-up for 80 morbidly obese patients treated

with intensive very-low-calorie diet and an education program.

JW, Brinkman VL, Hamilton CC.

Endocrine-Metabolic Section, VA Medical Center, Lexington, KY 40511.

Eighty morbidly obese individuals consecutively enrolled in a

comprehensive very-low-calorie diet (VLCD) program were evaluated.

Patients' mean initial body mass index was 45.5 kg/m2 and they lost

35.3 kg in 26 wk. Serum total cholesterol, low-density-lipoprotein

cholesterol, and triglycerides decreased by 15.0%, 17.0%, and 14%,

respectively. Systolic and diastolic blood pressure decreased by 8.7%

and 10.0%, respectively. The 46 individuals completing 2-y follow-up

were maintaining 48.0 +/- 7.6% (means +/- SE) of their weight loss.

Morbidly obese persons lost substantial amounts of weight using a

comprehensive VLCD program, reduced risk factors associated with

obesity, and had encouraging long-term results, with 48% of weight

loss maintained at 2 y of follow-up.

PMID: 1615891 [PubMed - indexed for MEDLINE]

1: Am J Clin Nutr 1992 Jul;56(1 Suppl):240S-243S Related Articles,

Books, LinkOut

The role of very-low-calorie diets in obesity.

Pi-Sunyer FX.

Department of Medicine, Columbia University, New York, NY.

The popularity of very-low-calorie diets (VLCDs) is enormous, but

questions persist about their safety and their long-term efficacy.

This article addresses the following questions: who should be placed

on a VLCD? when should a patient go on a VLCD? how much should an

individual lose? where should a VLCD program be carried out and by

whom? It stresses the importance of evaluating VLCD programs by their

long-term goals and long-term results. Also, a few of the unanswered

questions in VLCD treatment are addressed. Finally, worrisome

financial-ethical questions of the business of VLCDs is discussed.

Publication Types:

Review

Review, Tutorial

PMID: 1615890 [PubMed - indexed for MEDLINE]

Am J Clin Nutr 1992 Jul;56(1 Suppl):235S-239S Related Articles,

Books, LinkOut

Liver and gallbladder disease before and after very-low-calorie diets.

Andersen T.

Department of Medical Gastroenterology, Hvidovre Hospital, University

of Copenhagen, Hvidovre, Denmark.

Hepatobiliary characteristics of untreated obese patients and those

of patients reducing weight through very-low-calorie diets (VLCDs)

are reviewed. In untreated obesity, hepatobiliary abnormalities are

prevalent. Fatty change is common and may be related to insulin

resistance. Moreover, portal inflammation and fibrosis are prevalent

findings, also in the absence of alcohol abuse. The liver plays a key

role in the hyperinsulinism and hyperlipidemia, and hepatic drug

metabolism is influenced by enhanced glucuronidation and

sulphatation. Predisposition to gallstone formation can be ascribed

to increased biliary cholesterol secretion in concert with changed

nucleating factors and altered gallbladder motility. Weight loss by

VLCD reduces fatty change but may induce slight portal inflammation

and fibrosis. Insulin resistance and pharmacokinetic abnormalities

regress. During VLCD the risk of gallstone formation is markedly

increased. The deleterious effects described of a rapid weight loss

should draw some attention to the liver and biliary tract during VLCD

treatment.

Publication Types:

Review

Review, Tutorial

PMID: 1615889 [PubMed - indexed for MEDLINE]

Am J Gastroenterol 1992 Jan;87(1):6-15 Related Articles, Books,

LinkOut

Benefits and risks of an intensive very-low-calorie diet program for

severe obesity.

JW, Hamilton CC, Brinkman-Kaplan V.

Metabolic Research Group, University of Kentucky College of Medicine,

Lexington.

Comprehensive very-low-calorie diet (VLCD) programs are the preferred

treatment for selected obese individuals. They combine energy intakes

of 400-800 kcal/day with medical monitoring and intensive lifestyle

education. Typical VLCD patients have median body mass indexes of 36

kg/m2 and have median ages of 40 years. About 70% are female.

Commonly associated medical problems include hypertension in 50%,

hyperlipidemia in 41%, and diabetes mellitus or glucose intolerance

in 14%. Typical weight loss with VLCD is around 21 kg in 16 wk.

Reductions of 8-13% in blood pressure, 5-15% in serum total

cholesterol, 5-20% in low-density lipoprotein-cholesterol, 15-50% in

triglycerides, and decreases in blood glucose and glycohemoglobin in

diabetic individuals accompany weight loss. VLCD-associated side

effects can be managed medically without discontinuing treatment.

Lifestyle education promotes long-term weight maintenance of

approximately 56% 2 yr after VLCD treatment. Weight losses using

comprehensive VLCDs allow moderately to morbidly obese persons to

achieve greater benefits than other nonsurgical treatments and should

be considered before opting for surgical treatment.

Publication Types:

Review

Review, Academic

PMID: 1728126 [PubMed - indexed for MEDLINE]