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JAMA Surgery Oct 2023
Topics: Humans; Obesity, Morbid; Obesity; Upper Extremity
PubMed: 37494032
DOI: 10.1001/jamasurg.2023.2931 -
Digestive Diseases and Sciences Apr 2007Intraabdominal hypertension and the abdominal compartment syndrome are known to deleteriously affect a wide array of organ systems. We retrospectively reviewed 62 women...
Intraabdominal hypertension and the abdominal compartment syndrome are known to deleteriously affect a wide array of organ systems. We retrospectively reviewed 62 women who underwent either laparoscopic gastric bypass surgery or adjustable gastric banding. Their age, body mass index (BMI), and race were known. Their opening abdominal pressure was recorded by connecting a Verress needle to a pressure monitor. Linear regression was used to assess the contribution of age, race, and BMI to the observed variation in opening abdominal pressure. Neither variation in age or race explained the variation in opening pressure (P > .05). By contrast, variation in BMI explained 8% of the observed variation in opening pressure (P < .05). For every 1 kg/mm(2) increase in BMI, there was on average a 0.07 mm Hg increase in opening pressure. Increases in BMI are associated with increases in intraabdominal pressure.
Topics: Abdomen; Adult; Body Mass Index; Compartment Syndromes; Female; Gastric Bypass; Gastroplasty; Humans; Laparoscopy; Middle Aged; Obesity, Morbid; Pressure
PubMed: 17342401
DOI: 10.1007/s10620-006-9203-4 -
Pediatric Obesity Oct 2014Studies have reported that children who are obese are becoming more severely obese.
BACKGROUND
Studies have reported that children who are obese are becoming more severely obese.
OBJECTIVE
We aimed to classify obese children based on age- and gender-specific centile curves passing through body mass index (BMI) 30, 35 and 40 at age 18 as 'class I', 'class II' or severe, and 'class III' or morbid obesity.
METHODS
In addition to the International Obesity Task Force BMI cut-offs corresponding to BMI 30 and 35, we calculated the BMI cut-offs corresponding to BMI 40 using the LMS method proposed by Cole and Lobstein. We classified 217 obese children according to these criteria.
RESULTS
Fifty-six (25.8%) children had class III obesity, 73 (33.6%) class II obesity and 88 (40.6%) class I obesity. Class III obese children had a higher waist circumference, systolic blood pressure and fasting insulinaemia compared with less obese children.
CONCLUSION
It is clinically important to classify obese children in different classes of obesity severity.
Topics: Adolescent; Blood Pressure; Body Composition; Body Mass Index; Child; Child, Preschool; Disease Progression; Female; Humans; Male; Obesity, Morbid; Prevalence; Reference Values; Risk Factors; Severity of Illness Index; Waist Circumference
PubMed: 24578314
DOI: 10.1111/j.2047-6310.2014.00217.x -
Endocrinologia Y Nutricion : Organo de... Dec 2014
Topics: Anxiety; Bariatric Surgery; Fatigue; Feeding Behavior; Female; Fibromyalgia; Humans; Obesity, Morbid; Pain; Socioeconomic Factors
PubMed: 25151428
DOI: 10.1016/j.endonu.2014.07.002 -
Endocrinologia Y Nutricion : Organo de... Mar 2013Criteria for the diagnosis of the metabolic syndrome are currently being reconsidered, as their usefulness is not the same for all phenotypes in relation to the risk of...
BACKGROUND
Criteria for the diagnosis of the metabolic syndrome are currently being reconsidered, as their usefulness is not the same for all phenotypes in relation to the risk of cardiovascular disease.
AIM
We analyzed the changes in metabolic parameters after a fat overload in different groups of patients.
MATERIALS AND METHODS
The study included 20 healthy persons, 30 metabolic syndrome patients without morbid obesity, 80 metabolic syndrome patients with morbid obesity and 16 patients with morbid obesity without the metabolic syndrome. All the participants received a fat overload of 60g. Measurements were made before the overload and 3h afterwards of triglycerides, free fatty acids, insulin and uric acid.
RESULTS
Metabolic syndrome patients with morbid obesity had a lower waist-to-hip ratio, and lower plasma free fatty acid and triglycerides levels at baseline and after the overload than patients without morbid obesity. Plasma uric acid levels rose after the fat overload in the metabolic syndrome patients who had morbid obesity but not in the patients without morbid obesity. A positive relation was found between plasma triglycerides and free fatty acid levels in all the patients but not in the controls after the fat overload. A positive relation was also found between uric acid and insulin levels in the metabolic syndrome patients with morbid obesity.
CONCLUSIONS
Metabolic syndrome patients with and without morbid obesity presented different metabolic characteristics. This suggests that there are 2 different clinical phenotypes, both grouped under the metabolic syndrome umbrella.
Topics: Adult; Female; Humans; Male; Metabolic Syndrome; Obesity, Morbid
PubMed: 23266153
DOI: 10.1016/j.endonu.2012.09.007 -
The American Journal of Clinical... Feb 1992Exercise induces negative energy balance either directly or by enhancing meal thermogenesis, increasing resting metabolic rate, and/or decreasing food intake. A... (Review)
Review
Exercise induces negative energy balance either directly or by enhancing meal thermogenesis, increasing resting metabolic rate, and/or decreasing food intake. A quantitative evaluation of these effects in programs of weight control led to the following conclusions: 1) energy cost of exercise per se is minimal, 2) effects on thermic of food are negligible, and 3) exercise training may be advantageous in conjunction with low-calorie diet programs because it helps to maintain resting metabolic rate and fat-free mass. However, exercise may not prevent, and may even accentuate, the fall in metabolic rate in programs of severe calorie restriction, thus hampering weight reduction. Overall, exercise should not be envisioned as a sole agent to induce negative energy balance, but it is an essential element in comprehensive programs for morbidly obese patients due to its effects on lipids, carbohydrate metabolism, and cardiovascular system.
Topics: Energy Metabolism; Exercise; Humans; Obesity, Morbid
PubMed: 1733122
DOI: 10.1093/ajcn/55.2.533s -
Current Psychiatry Reports Aug 2019Individuals with morbid obesity benefit from bariatric surgery with respect to weight loss and decreases in obesity-related somatic disorders. This paper focuses on... (Review)
Review
PURPOSE OF REVIEW
Individuals with morbid obesity benefit from bariatric surgery with respect to weight loss and decreases in obesity-related somatic disorders. This paper focuses on psychosocial outcomes and provides a narrative review of recent meta-analyses and controlled studies concerning postoperative depression and suicide.
RECENT FINDINGS
Considerable evidence shows short- and medium-term improvement in depressive symptoms after surgery. However, a subgroup of patients exhibits erosion of these improvements or new onset of depression in the long run. Some studies have found an increased risk for suicide among postoperative patients. Prospective longitudinal examinations of factors contributing to the increased risk for postoperative depression and suicide and the interaction between these factors are warranted. The inclusion of mental health professionals in bariatric teams would help to monitor patients for negative psychosocial outcomes and to identify those patients who are vulnerable to depression, suicide, and any other forms of deliberated self-harm following surgery.
Topics: Bariatric Surgery; Depression; Humans; Obesity, Morbid; Prospective Studies; Suicide
PubMed: 31410656
DOI: 10.1007/s11920-019-1069-1 -
Surgery For Obesity and Related... Apr 2022
Topics: Bariatric Surgery; Humans; Obesity, Morbid
PubMed: 35227637
DOI: 10.1016/j.soard.2022.01.006 -
Southern Medical Journal Aug 1999
Topics: Humans; Obesity, Morbid
PubMed: 10456731
DOI: 10.1097/00007611-199908000-00035 -
Professional Case Management 2010The proportion of Americans with clinically severe obesity has vast implications for the nation's healthcare system since this population have twice as many chronic... (Review)
Review
PURPOSE/OBJECTIVES
The proportion of Americans with clinically severe obesity has vast implications for the nation's healthcare system since this population have twice as many chronic medical conditions as people with normal weight. Through the use of review of literature, this article (a) describes the types of weight loss programs; (b) reviews the results from studies on effectiveness of bariatric surgery; and (c) identifies recommendations for obesity and bariatric surgery case management programs.
PRIMARY PRACTICE SETTINGS
Disease management companies appear to be concentrating on general weight loss strategies associated with wellness and other condition-specific disease management products, whereas larger national healthcare companies with at-risk and insurance products offer specific bariatric surgery management products. Case management programs within healthcare systems, health management organizations, and insurance companies are frequently faced with the management of individuals with morbid obesity and, increasingly, those who are requesting or have undergone bariatric surgery.
FINDINGS/CONCLUSIONS
Research shows that morbid obesity is a disease that remains generally unresponsive to diet and drug therapy but appears to respond well to bariatric surgery. Research findings suggest that surgical treatment is more effective than pharmacological treatment of weight loss and the control of some comorbidities associated with obesity. The number of Americans having weight loss surgery increased by 804% between 1998 and 2004, which appears to be a driver for the recent development of obesity disease management and bariatric surgery case management programs.
IMPLICATIONS FOR CASE MANAGEMENT PRACTICE
Although the immaturity and lack of studies citing outcomes of obesity disease and case management programs limit the identification of best practices based on outcomes, emerging practices can be identified and recommendations for case management can be formulated. In addition to primary prevention and treatment programs for obesity, this article describes program activities in detail for the following key areas: (1) identification and engagement; (2) coaching, education, and support; (3) collaboration among treating providers; (4) preparation, management, and follow-up when bariatric surgery is indicated; (5) aggressive follow-up until personal goals are achieved; and (6) outcome measurement.
Topics: Bariatric Surgery; Case Management; Disease Management; Humans; Obesity, Morbid; Program Evaluation; Weight Loss
PubMed: 20029316
DOI: 10.1097/NCM.0b013e3181b5ebeb