Kevin Foley

Smell identification deficits exist in children with early-onset psychotic disorder, just as they do in adults, and can be a marker for underlying neurodevelopmental pathophysiology that leads to vulnerability for schizophrenia and other psychotic disorders, said Dr. Cheryl Corcoran and her colleagues at the New York State Psychiatric Institute in New York City.

In addition, children with both intact smell identification and psychotic disorders can have a more affective illness with fewer negative symptoms and less neuropsychological impairment, the investigators said (Schizophr. Res. 2005;80:283–93).

In a study of 26 children aged 11–17 years, microsmia (significant smell deficit) was present in 8 of the 13 children with schizophrenia or schizoaffective disorder, 4 of 5 depressed children, and none of the 3 patients with bipolar disorder or 5 with psychosis not otherwise specified. Of those with microsmia, two-thirds had schizophrenia or schizoaffective disorder, and one-third had major depression with psychotic features, Dr. Corcoran and her associates reported.

Smell identification deficits exist in children with early-onset psychotic disorder, just as they do in adults, and can be a marker for underlying neurodevelopmental pathophysiology that leads to vulnerability for schizophrenia and other psychotic disorders, said Dr. Cheryl Corcoran and her colleagues at the New York State Psychiatric Institute in New York City.

In addition, children with both intact smell identification and psychotic disorders can have a more affective illness with fewer negative symptoms and less neuropsychological impairment, the investigators said (Schizophr. Res. 2005;80:283–93).

In a study of 26 children aged 11–17 years, microsmia (significant smell deficit) was present in 8 of the 13 children with schizophrenia or schizoaffective disorder, 4 of 5 depressed children, and none of the 3 patients with bipolar disorder or 5 with psychosis not otherwise specified. Of those with microsmia, two-thirds had schizophrenia or schizoaffective disorder, and one-third had major depression with psychotic features, Dr. Corcoran and her associates reported.

Smell identification deficits exist in children with early-onset psychotic disorder, just as they do in adults, and can be a marker for underlying neurodevelopmental pathophysiology that leads to vulnerability for schizophrenia and other psychotic disorders, said Dr. Cheryl Corcoran and her colleagues at the New York State Psychiatric Institute in New York City.

In addition, children with both intact smell identification and psychotic disorders can have a more affective illness with fewer negative symptoms and less neuropsychological impairment, the investigators said (Schizophr. Res. 2005;80:283–93).

In a study of 26 children aged 11–17 years, microsmia (significant smell deficit) was present in 8 of the 13 children with schizophrenia or schizoaffective disorder, 4 of 5 depressed children, and none of the 3 patients with bipolar disorder or 5 with psychosis not otherwise specified. Of those with microsmia, two-thirds had schizophrenia or schizoaffective disorder, and one-third had major depression with psychotic features, Dr. Corcoran and her associates reported.

Group lifestyle modification should be prescribed along with weight-loss medication to obese patients trying to lose weight, said Thomas A. Wadden, Ph.D., of the University of Pennsylvania in Philadelphia, and his colleagues.

In a 1-year trial, 55 patients were randomized to sibutramine (Meridia) alone. Another 55 were treated with lifestyle modification alone, attending sessions weekly until week 18, then twice a month thereafter, as well as completing daily food logs. Also, 60 patients received both treatments, and 54 received sibutramine and eight brief therapy sessions with a primary care provider who examined their daily food logs (N. Engl. J. Med. 2005;353:2111–20).

At 1 year, subjects who received combined therapy lost a mean of 12.1 kg, significantly more than the other groups.

The sibutramine plus brief therapy group lost 7.5 kg, the lifestyle modification group lost 6.7 kg, and those taking only sibutramine lost 5.0 kg, the investigators said.

Group lifestyle modification should be prescribed along with weight-loss medication to obese patients trying to lose weight, said Thomas A. Wadden, Ph.D., of the University of Pennsylvania in Philadelphia, and his colleagues.

In a 1-year trial, 55 patients were randomized to sibutramine (Meridia) alone. Another 55 were treated with lifestyle modification alone, attending sessions weekly until week 18, then twice a month thereafter, as well as completing daily food logs. Also, 60 patients received both treatments, and 54 received sibutramine and eight brief therapy sessions with a primary care provider who examined their daily food logs (N. Engl. J. Med. 2005;353:2111–20).

At 1 year, subjects who received combined therapy lost a mean of 12.1 kg, significantly more than the other groups.

The sibutramine plus brief therapy group lost 7.5 kg, the lifestyle modification group lost 6.7 kg, and those taking only sibutramine lost 5.0 kg, the investigators said.

Group lifestyle modification should be prescribed along with weight-loss medication to obese patients trying to lose weight, said Thomas A. Wadden, Ph.D., of the University of Pennsylvania in Philadelphia, and his colleagues.

In a 1-year trial, 55 patients were randomized to sibutramine (Meridia) alone. Another 55 were treated with lifestyle modification alone, attending sessions weekly until week 18, then twice a month thereafter, as well as completing daily food logs. Also, 60 patients received both treatments, and 54 received sibutramine and eight brief therapy sessions with a primary care provider who examined their daily food logs (N. Engl. J. Med. 2005;353:2111–20).

At 1 year, subjects who received combined therapy lost a mean of 12.1 kg, significantly more than the other groups.

The sibutramine plus brief therapy group lost 7.5 kg, the lifestyle modification group lost 6.7 kg, and those taking only sibutramine lost 5.0 kg, the investigators said.

Behavioral weight loss treatment benefited overweight and obese women with fibromyalgia syndrome, reported Jennifer R. Shapiro, Ph.D., and her colleagues at the University of Albany, State University of New York.

In a 20-week pilot study, 31 overweight or obese Caucasian women with fibromyalgia syndrome lost an average of 9.2 lbs, or more than 4% of their initial body weight. Most who lost weight shed at least 5% of their initial body weight (J. Psychosomatic Res. 2005;59:275–82).

The intervention entailed small group meetings every week for 1.5 hours, along with use of guidelines for diet and exercise.

Weight loss treatment at week 20 was significantly associated with improvements in depression, anxiety, pain, body concerns, support, and quality of life, the investigators said. “The amount of weight loss, as opposed to both absolute weight and treatment participation in general, is a better predictor of pain improvement,” the researchers said.

Behavioral weight loss treatment benefited overweight and obese women with fibromyalgia syndrome, reported Jennifer R. Shapiro, Ph.D., and her colleagues at the University of Albany, State University of New York.

In a 20-week pilot study, 31 overweight or obese Caucasian women with fibromyalgia syndrome lost an average of 9.2 lbs, or more than 4% of their initial body weight. Most who lost weight shed at least 5% of their initial body weight (J. Psychosomatic Res. 2005;59:275–82).

The intervention entailed small group meetings every week for 1.5 hours, along with use of guidelines for diet and exercise.

Weight loss treatment at week 20 was significantly associated with improvements in depression, anxiety, pain, body concerns, support, and quality of life, the investigators said. “The amount of weight loss, as opposed to both absolute weight and treatment participation in general, is a better predictor of pain improvement,” the researchers said.

Behavioral weight loss treatment benefited overweight and obese women with fibromyalgia syndrome, reported Jennifer R. Shapiro, Ph.D., and her colleagues at the University of Albany, State University of New York.

In a 20-week pilot study, 31 overweight or obese Caucasian women with fibromyalgia syndrome lost an average of 9.2 lbs, or more than 4% of their initial body weight. Most who lost weight shed at least 5% of their initial body weight (J. Psychosomatic Res. 2005;59:275–82).

The intervention entailed small group meetings every week for 1.5 hours, along with use of guidelines for diet and exercise.

Weight loss treatment at week 20 was significantly associated with improvements in depression, anxiety, pain, body concerns, support, and quality of life, the investigators said. “The amount of weight loss, as opposed to both absolute weight and treatment participation in general, is a better predictor of pain improvement,” the researchers said.

BMI Risk: 19th vs. 20th Century

Experts should periodically revise the risk limits for body mass index among ethnically similar populations, as well as among different populations and ethnicities, to keep abreast of changing height, weight, and nutritional intake, reported R. Max Henderson of the University of Chicago.

Among 9,509 white Civil War veterans of the Union Army, the healthiest range of body mass index (BMI) was approximately 2 kg/m

Union Army veterans with BMIs in the range of 20–26 kg/m

Anger, Eating Disorders, and College

Anger management may help in treating eating disorders in obese, college-age students of both sexes, reported Jeanne L. Edman, Ph.D., of Cosumnes River College, Sacramento, Calif.

Compared with the 88 male subjects, the 102 female subjects reported higher levels of eating disorders, body dissatisfaction, and self-dissatisfaction and more frequent dieting, while males reported higher activity levels (Eat Behav. 2005; 6:308–17).

Multiple regression analyses were used to determine which variables best predicted subjects' drive for thinness and interoceptive awareness. Anger discomfort and dieting significantly predicted drive for thinness in males, accounting for 46% of the variance.

Among females, anger discomfort and self-dissatisfaction were significant predictors of the drive for thinness, accounting for 47% of the variance. The only predictor of interoceptive awareness in both males and females was anger discomfort, accounting for 28% and 36% of the variance, respectively.

Weight Loss in Fibromyalgia

Behavioral weight loss treatment benefited overweight and obese women with fibromyalgia syndrome, reported Jennifer R. Shapiro, Ph.D., and her colleagues at the University of Albany, State University of New York.

In a 20-week pilot study, 31 overweight or obese Caucasian women with fibromyalgia syndrome lost an average of 9.2 lbs, or more than 4% of their initial body weight. Most who lost weight shed at least 5% of their initial body weight (J. Psychosomatic Res. 2005;59:275–82).

The intervention entailed small group meetings every week for 1.5 hours, along with use of guidelines for diet and exercise.

Weight loss treatment at week 20 was significantly associated with improvements in depression, anxiety, pain, body concerns, support, and quality of life, the investigators said. “The amount of weight loss, as opposed to both absolute weight and treatment participation in general, is a better predictor of pain improvement,” the researchers said.

Pregnancy After Bariatric Surgery

Women who have undergone laparoscopic adjustable gastric banding have similar pregnancy outcomes as women in their general community, and they have better outcomes than severely obese women, reported John B. Dixon, MBBS, Ph.D., of the Monash Medical School, Melbourne, Australia.

Dr. Dixon and his associates prospectively examined 79 consecutive pregnancies in women who had had laparoscopic adjustable gastric banding (LAGB) and compared the data with these patients' previous pre-LAGB pregnancies (n = 40); pregnancies in 79 matched, severely obese subjects; and community outcomes in Victoria (n = 61,000).

In LAGB subjects, the mean maternal weight gain was 9.6 kg, versus 14.4 kg for the 40 pre-LAGB pregnancies and 15.5 kg for the matched obese controls. Birth weights were similar after LAGB (3,397 g) and before LAGB (3,350 g), and both were within the normal range of community birth weights (Obstet. Gynecol. 2005; 106:965–72).

The rate of pregnancy-induced hypertension was similar after LAGB and in the community (10% and 10%–13%, respectively), but was much higher in pre-LAGB pregnancies (45%) and in matched, obese controls (38%).

Rates of gestational diabetes were nearly the same in women who underwent LAGD (6.3%) and in the community (5.5%), but were 19% in the obese controls and 15% in pre-LAGB pregnancies. Neonatal outcomes were also similar for LAGB subjects and the overall community.

BMI Risk: 19th vs. 20th Century

Experts should periodically revise the risk limits for body mass index among ethnically similar populations, as well as among different populations and ethnicities, to keep abreast of changing height, weight, and nutritional intake, reported R. Max Henderson of the University of Chicago.

Among 9,509 white Civil War veterans of the Union Army, the healthiest range of body mass index (BMI) was approximately 2 kg/m

Union Army veterans with BMIs in the range of 20–26 kg/m

Anger, Eating Disorders, and College

Anger management may help in treating eating disorders in obese, college-age students of both sexes, reported Jeanne L. Edman, Ph.D., of Cosumnes River College, Sacramento, Calif.

Compared with the 88 male subjects, the 102 female subjects reported higher levels of eating disorders, body dissatisfaction, and self-dissatisfaction and more frequent dieting, while males reported higher activity levels (Eat Behav. 2005; 6:308–17).

Multiple regression analyses were used to determine which variables best predicted subjects' drive for thinness and interoceptive awareness. Anger discomfort and dieting significantly predicted drive for thinness in males, accounting for 46% of the variance.

Among females, anger discomfort and self-dissatisfaction were significant predictors of the drive for thinness, accounting for 47% of the variance. The only predictor of interoceptive awareness in both males and females was anger discomfort, accounting for 28% and 36% of the variance, respectively.

Weight Loss in Fibromyalgia

Behavioral weight loss treatment benefited overweight and obese women with fibromyalgia syndrome, reported Jennifer R. Shapiro, Ph.D., and her colleagues at the University of Albany, State University of New York.

In a 20-week pilot study, 31 overweight or obese Caucasian women with fibromyalgia syndrome lost an average of 9.2 lbs, or more than 4% of their initial body weight. Most who lost weight shed at least 5% of their initial body weight (J. Psychosomatic Res. 2005;59:275–82).

The intervention entailed small group meetings every week for 1.5 hours, along with use of guidelines for diet and exercise.

Weight loss treatment at week 20 was significantly associated with improvements in depression, anxiety, pain, body concerns, support, and quality of life, the investigators said. “The amount of weight loss, as opposed to both absolute weight and treatment participation in general, is a better predictor of pain improvement,” the researchers said.

Pregnancy After Bariatric Surgery

Women who have undergone laparoscopic adjustable gastric banding have similar pregnancy outcomes as women in their general community, and they have better outcomes than severely obese women, reported John B. Dixon, MBBS, Ph.D., of the Monash Medical School, Melbourne, Australia.

Dr. Dixon and his associates prospectively examined 79 consecutive pregnancies in women who had had laparoscopic adjustable gastric banding (LAGB) and compared the data with these patients' previous pre-LAGB pregnancies (n = 40); pregnancies in 79 matched, severely obese subjects; and community outcomes in Victoria (n = 61,000).

In LAGB subjects, the mean maternal weight gain was 9.6 kg, versus 14.4 kg for the 40 pre-LAGB pregnancies and 15.5 kg for the matched obese controls. Birth weights were similar after LAGB (3,397 g) and before LAGB (3,350 g), and both were within the normal range of community birth weights (Obstet. Gynecol. 2005; 106:965–72).

The rate of pregnancy-induced hypertension was similar after LAGB and in the community (10% and 10%–13%, respectively), but was much higher in pre-LAGB pregnancies (45%) and in matched, obese controls (38%).

Rates of gestational diabetes were nearly the same in women who underwent LAGD (6.3%) and in the community (5.5%), but were 19% in the obese controls and 15% in pre-LAGB pregnancies. Neonatal outcomes were also similar for LAGB subjects and the overall community.

BMI Risk: 19th vs. 20th Century

Experts should periodically revise the risk limits for body mass index among ethnically similar populations, as well as among different populations and ethnicities, to keep abreast of changing height, weight, and nutritional intake, reported R. Max Henderson of the University of Chicago.

Among 9,509 white Civil War veterans of the Union Army, the healthiest range of body mass index (BMI) was approximately 2 kg/m

Union Army veterans with BMIs in the range of 20–26 kg/m

Anger, Eating Disorders, and College

Anger management may help in treating eating disorders in obese, college-age students of both sexes, reported Jeanne L. Edman, Ph.D., of Cosumnes River College, Sacramento, Calif.

Compared with the 88 male subjects, the 102 female subjects reported higher levels of eating disorders, body dissatisfaction, and self-dissatisfaction and more frequent dieting, while males reported higher activity levels (Eat Behav. 2005; 6:308–17).

Multiple regression analyses were used to determine which variables best predicted subjects' drive for thinness and interoceptive awareness. Anger discomfort and dieting significantly predicted drive for thinness in males, accounting for 46% of the variance.

Among females, anger discomfort and self-dissatisfaction were significant predictors of the drive for thinness, accounting for 47% of the variance. The only predictor of interoceptive awareness in both males and females was anger discomfort, accounting for 28% and 36% of the variance, respectively.

Weight Loss in Fibromyalgia

Behavioral weight loss treatment benefited overweight and obese women with fibromyalgia syndrome, reported Jennifer R. Shapiro, Ph.D., and her colleagues at the University of Albany, State University of New York.

In a 20-week pilot study, 31 overweight or obese Caucasian women with fibromyalgia syndrome lost an average of 9.2 lbs, or more than 4% of their initial body weight. Most who lost weight shed at least 5% of their initial body weight (J. Psychosomatic Res. 2005;59:275–82).

The intervention entailed small group meetings every week for 1.5 hours, along with use of guidelines for diet and exercise.

Weight loss treatment at week 20 was significantly associated with improvements in depression, anxiety, pain, body concerns, support, and quality of life, the investigators said. “The amount of weight loss, as opposed to both absolute weight and treatment participation in general, is a better predictor of pain improvement,” the researchers said.

Pregnancy After Bariatric Surgery

Women who have undergone laparoscopic adjustable gastric banding have similar pregnancy outcomes as women in their general community, and they have better outcomes than severely obese women, reported John B. Dixon, MBBS, Ph.D., of the Monash Medical School, Melbourne, Australia.

Dr. Dixon and his associates prospectively examined 79 consecutive pregnancies in women who had had laparoscopic adjustable gastric banding (LAGB) and compared the data with these patients' previous pre-LAGB pregnancies (n = 40); pregnancies in 79 matched, severely obese subjects; and community outcomes in Victoria (n = 61,000).

In LAGB subjects, the mean maternal weight gain was 9.6 kg, versus 14.4 kg for the 40 pre-LAGB pregnancies and 15.5 kg for the matched obese controls. Birth weights were similar after LAGB (3,397 g) and before LAGB (3,350 g), and both were within the normal range of community birth weights (Obstet. Gynecol. 2005; 106:965–72).

The rate of pregnancy-induced hypertension was similar after LAGB and in the community (10% and 10%–13%, respectively), but was much higher in pre-LAGB pregnancies (45%) and in matched, obese controls (38%).

Rates of gestational diabetes were nearly the same in women who underwent LAGD (6.3%) and in the community (5.5%), but were 19% in the obese controls and 15% in pre-LAGB pregnancies. Neonatal outcomes were also similar for LAGB subjects and the overall community.

Watching television may be a bigger culprit in the risk of youth in the industrialized world being overweight than candy and chocolate, according to Ian Janssen, Ph.D., of Queen's University, Kingston, Ont.

In a self-reported cross-sectional survey of 137,593 youths aged 10–16 years in 34 industrialized countries, a higher intake of sweets was associated with lower odds of being overweight in 91% of the countries, the investigators said. And there was no consistent link between overweight and fruit, vegetable, and soft drink intake (Obes. Rev. 2005;6:123–32).

However, greater television viewing time was linked to greater odds of being overweight in 65% of the countries.

But time spent on a computer did not correlate with being overweight, Dr. Janssen and his associates said.

The investigators noted that greater physical activity was associated with lower odds of being overweight in 88% of the countries.

The results imply that “physical inactivity and television viewing are important determinants of overweight in youth throughout the industrialized world,” they said.

The highest prevalence of overweight youths was found in Malta (25.4%), the United States (25.1%), and Wales (21.2%).

The lowest prevalence of overweight youths was found in Lithuania (5.1%), Russia (5.9%), and Latvia (5.9%).

The highest prevalence of obese youths was found in Malta (7.9%), the United States (6.8%), and England (5.1%), while the lowest prevalence of obese youths was found in Lithuania (0.4%), Russia (0.6%), and Latvia (0.5%).

The study results are based on the 2001–2002 Health Behaviour in School-Aged Children Study.

Watching television may be a bigger culprit in the risk of youth in the industrialized world being overweight than candy and chocolate, according to Ian Janssen, Ph.D., of Queen's University, Kingston, Ont.

In a self-reported cross-sectional survey of 137,593 youths aged 10–16 years in 34 industrialized countries, a higher intake of sweets was associated with lower odds of being overweight in 91% of the countries, the investigators said. And there was no consistent link between overweight and fruit, vegetable, and soft drink intake (Obes. Rev. 2005;6:123–32).

However, greater television viewing time was linked to greater odds of being overweight in 65% of the countries.

But time spent on a computer did not correlate with being overweight, Dr. Janssen and his associates said.

The investigators noted that greater physical activity was associated with lower odds of being overweight in 88% of the countries.

The results imply that “physical inactivity and television viewing are important determinants of overweight in youth throughout the industrialized world,” they said.

The highest prevalence of overweight youths was found in Malta (25.4%), the United States (25.1%), and Wales (21.2%).

The lowest prevalence of overweight youths was found in Lithuania (5.1%), Russia (5.9%), and Latvia (5.9%).

The highest prevalence of obese youths was found in Malta (7.9%), the United States (6.8%), and England (5.1%), while the lowest prevalence of obese youths was found in Lithuania (0.4%), Russia (0.6%), and Latvia (0.5%).

The study results are based on the 2001–2002 Health Behaviour in School-Aged Children Study.

Watching television may be a bigger culprit in the risk of youth in the industrialized world being overweight than candy and chocolate, according to Ian Janssen, Ph.D., of Queen's University, Kingston, Ont.

In a self-reported cross-sectional survey of 137,593 youths aged 10–16 years in 34 industrialized countries, a higher intake of sweets was associated with lower odds of being overweight in 91% of the countries, the investigators said. And there was no consistent link between overweight and fruit, vegetable, and soft drink intake (Obes. Rev. 2005;6:123–32).

However, greater television viewing time was linked to greater odds of being overweight in 65% of the countries.

But time spent on a computer did not correlate with being overweight, Dr. Janssen and his associates said.

The investigators noted that greater physical activity was associated with lower odds of being overweight in 88% of the countries.

The results imply that “physical inactivity and television viewing are important determinants of overweight in youth throughout the industrialized world,” they said.

The highest prevalence of overweight youths was found in Malta (25.4%), the United States (25.1%), and Wales (21.2%).

The lowest prevalence of overweight youths was found in Lithuania (5.1%), Russia (5.9%), and Latvia (5.9%).

The highest prevalence of obese youths was found in Malta (7.9%), the United States (6.8%), and England (5.1%), while the lowest prevalence of obese youths was found in Lithuania (0.4%), Russia (0.6%), and Latvia (0.5%).

The study results are based on the 2001–2002 Health Behaviour in School-Aged Children Study.

Teen Girls' Activity Levels Drop

A steep decrease in activity levels among teen girls as they age has led to increases in body mass index and adiposity, particularly in black girls, reported Sue Y.S. Kimm, M.D., of the University of New Mexico in Albuquerque.

Dr. Kimm and her associates assessed body mass index (BMI) and the sum of skinfold thickness anually in 1,152 black and 1,135 white girls from age 9 or 10 years to 18 or 19 years.

They also measured habitual activity at year 1, year 3, year 5, and annually from year 7 to year 10 (Lancet 2005;366:301–7).

A decline in activity of 10 metabolic equivalent times per week (brisk walking 2.5 hours per week) was tied to increases in BMI (0.14 kg/m

By the end of the study, the difference in BMI between the most active and least active girls was 2.98 kg/m

Binge Eating Disorder

Guided self-help cognitive-behavioral therapy was associated with a significantly higher remission rate for binge eating disorder than was guided self-help behavioral weight loss treatment, but weight loss was minimal among both groups, reported Carlos M. Grilo, Ph.D., and Robin M. Masheb, Ph.D., of Yale University, New Haven.

Of 90 overweight adults who had binge eating disorder, 37 were randomized to cognitive-behavioral therapy (CBT), 38 to behavioral weight loss treatment (BWL), and 15 to a control group. The completion rate for the 12-week study was 87% for the CBT and control groups, significantly higher than the BWL group's 67% rate (Behav. Res. Ther. 2005;43:1509–25).

In an intent-to-treat analysis, the CBT remission rate (46%) was also significantly higher than that of the BWL and control groups (18% and 13%, respectively), the investigators said. Patients in the CBT group used a self-help manual to learn about binge eating disorder and to follow six steps for assessing and changing their eating behaviors.

Managing Gastrogastric Fistulas

Gastrogastric fistulas are a rare but serious complication of Roux-en-Y gastric bypass, often marked by unresponsive marginal ulcers, failure of weight loss, nausea, and/or vomiting, reported Lester Carrodeguas, M.D., and his associates at the Bariatric Institute and Division of Minimally Invasive Surgery, Cleveland Clinic Florida, Weston, Fla.

In a consecutive series of 1,292 patients who underwent divided laparoscopic Roux-en-Y gastric bypass, 15 (1.2%) presented with gastrogastric fistula. The mean time to diagnosis was 80 days, and 5 of the 15 patients with gastrogastric fistula (33%) required revisional laproscopic surgery (Surg. Obes. Relat. Dis. 2005;1:467–74).

Of the 15 patients, 12 (80%) presented with new-onset, nonspecific complaints, such as nausea, vomiting, and epigastric pain, Dr. Carrodeguas said. Nearly 30% were dissatisfied with their weight loss. Implementing routine screening may allow for early detection and intervention, which can reduce hospital stays, the authors said.

“In our series, the vast majority of the patients who developed gastrogastric fistulas were diagnosed with either a Gastrografin study or an [intraoperative esophagogastroduodenoscopy], dramatically reducing the need for the more costly CT as a diagnostic method,” the investigators said.

Antipsychotic-Related Weight Gain

A behavioral weight control program was associated with modest improvements in obese patients taking antipsychotic medications, but longer and more robust interventions are necessary, reported Melissa A. Kalarchian, Ph.D., of the University of Pittsburgh Medical Center, and her associates.

Over 12 weeks, 35 obese outpatients taking antipsychotics for schizophrenia or related psychoses underwent 16 behavioral sessions reinforcing diet restrictions and promoting exercise. Among the 29 who completed the study, the mean weight loss was just over 5 pounds, the mean Eating Behavior Inventory score improved by 13%, and health-related quality of life improved significantly (J. Clin. Psychiatry 2005;66:1058–63).

At a 3-month follow-up, weight continued to drop to a mean of just over 7 pounds in the 27 subjects who completed the posttreatment session. This amounted to a 3.2% loss of initial body weight, Dr. Kalarchian said. “Behavioral weight control is a feasible and promising approach to the treatment of obesity in this population,” the investigators said.

Teen Girls' Activity Levels Drop

A steep decrease in activity levels among teen girls as they age has led to increases in body mass index and adiposity, particularly in black girls, reported Sue Y.S. Kimm, M.D., of the University of New Mexico in Albuquerque.

Dr. Kimm and her associates assessed body mass index (BMI) and the sum of skinfold thickness anually in 1,152 black and 1,135 white girls from age 9 or 10 years to 18 or 19 years.

They also measured habitual activity at year 1, year 3, year 5, and annually from year 7 to year 10 (Lancet 2005;366:301–7).

A decline in activity of 10 metabolic equivalent times per week (brisk walking 2.5 hours per week) was tied to increases in BMI (0.14 kg/m

By the end of the study, the difference in BMI between the most active and least active girls was 2.98 kg/m

Binge Eating Disorder

Guided self-help cognitive-behavioral therapy was associated with a significantly higher remission rate for binge eating disorder than was guided self-help behavioral weight loss treatment, but weight loss was minimal among both groups, reported Carlos M. Grilo, Ph.D., and Robin M. Masheb, Ph.D., of Yale University, New Haven.

Of 90 overweight adults who had binge eating disorder, 37 were randomized to cognitive-behavioral therapy (CBT), 38 to behavioral weight loss treatment (BWL), and 15 to a control group. The completion rate for the 12-week study was 87% for the CBT and control groups, significantly higher than the BWL group's 67% rate (Behav. Res. Ther. 2005;43:1509–25).

In an intent-to-treat analysis, the CBT remission rate (46%) was also significantly higher than that of the BWL and control groups (18% and 13%, respectively), the investigators said. Patients in the CBT group used a self-help manual to learn about binge eating disorder and to follow six steps for assessing and changing their eating behaviors.

Managing Gastrogastric Fistulas

Gastrogastric fistulas are a rare but serious complication of Roux-en-Y gastric bypass, often marked by unresponsive marginal ulcers, failure of weight loss, nausea, and/or vomiting, reported Lester Carrodeguas, M.D., and his associates at the Bariatric Institute and Division of Minimally Invasive Surgery, Cleveland Clinic Florida, Weston, Fla.

In a consecutive series of 1,292 patients who underwent divided laparoscopic Roux-en-Y gastric bypass, 15 (1.2%) presented with gastrogastric fistula. The mean time to diagnosis was 80 days, and 5 of the 15 patients with gastrogastric fistula (33%) required revisional laproscopic surgery (Surg. Obes. Relat. Dis. 2005;1:467–74).

Of the 15 patients, 12 (80%) presented with new-onset, nonspecific complaints, such as nausea, vomiting, and epigastric pain, Dr. Carrodeguas said. Nearly 30% were dissatisfied with their weight loss. Implementing routine screening may allow for early detection and intervention, which can reduce hospital stays, the authors said.

“In our series, the vast majority of the patients who developed gastrogastric fistulas were diagnosed with either a Gastrografin study or an [intraoperative esophagogastroduodenoscopy], dramatically reducing the need for the more costly CT as a diagnostic method,” the investigators said.

Antipsychotic-Related Weight Gain

A behavioral weight control program was associated with modest improvements in obese patients taking antipsychotic medications, but longer and more robust interventions are necessary, reported Melissa A. Kalarchian, Ph.D., of the University of Pittsburgh Medical Center, and her associates.

Over 12 weeks, 35 obese outpatients taking antipsychotics for schizophrenia or related psychoses underwent 16 behavioral sessions reinforcing diet restrictions and promoting exercise. Among the 29 who completed the study, the mean weight loss was just over 5 pounds, the mean Eating Behavior Inventory score improved by 13%, and health-related quality of life improved significantly (J. Clin. Psychiatry 2005;66:1058–63).

At a 3-month follow-up, weight continued to drop to a mean of just over 7 pounds in the 27 subjects who completed the posttreatment session. This amounted to a 3.2% loss of initial body weight, Dr. Kalarchian said. “Behavioral weight control is a feasible and promising approach to the treatment of obesity in this population,” the investigators said.

Teen Girls' Activity Levels Drop

A steep decrease in activity levels among teen girls as they age has led to increases in body mass index and adiposity, particularly in black girls, reported Sue Y.S. Kimm, M.D., of the University of New Mexico in Albuquerque.

Dr. Kimm and her associates assessed body mass index (BMI) and the sum of skinfold thickness anually in 1,152 black and 1,135 white girls from age 9 or 10 years to 18 or 19 years.

They also measured habitual activity at year 1, year 3, year 5, and annually from year 7 to year 10 (Lancet 2005;366:301–7).

A decline in activity of 10 metabolic equivalent times per week (brisk walking 2.5 hours per week) was tied to increases in BMI (0.14 kg/m

By the end of the study, the difference in BMI between the most active and least active girls was 2.98 kg/m

Binge Eating Disorder

Guided self-help cognitive-behavioral therapy was associated with a significantly higher remission rate for binge eating disorder than was guided self-help behavioral weight loss treatment, but weight loss was minimal among both groups, reported Carlos M. Grilo, Ph.D., and Robin M. Masheb, Ph.D., of Yale University, New Haven.

Of 90 overweight adults who had binge eating disorder, 37 were randomized to cognitive-behavioral therapy (CBT), 38 to behavioral weight loss treatment (BWL), and 15 to a control group. The completion rate for the 12-week study was 87% for the CBT and control groups, significantly higher than the BWL group's 67% rate (Behav. Res. Ther. 2005;43:1509–25).

In an intent-to-treat analysis, the CBT remission rate (46%) was also significantly higher than that of the BWL and control groups (18% and 13%, respectively), the investigators said. Patients in the CBT group used a self-help manual to learn about binge eating disorder and to follow six steps for assessing and changing their eating behaviors.

Managing Gastrogastric Fistulas

Gastrogastric fistulas are a rare but serious complication of Roux-en-Y gastric bypass, often marked by unresponsive marginal ulcers, failure of weight loss, nausea, and/or vomiting, reported Lester Carrodeguas, M.D., and his associates at the Bariatric Institute and Division of Minimally Invasive Surgery, Cleveland Clinic Florida, Weston, Fla.

In a consecutive series of 1,292 patients who underwent divided laparoscopic Roux-en-Y gastric bypass, 15 (1.2%) presented with gastrogastric fistula. The mean time to diagnosis was 80 days, and 5 of the 15 patients with gastrogastric fistula (33%) required revisional laproscopic surgery (Surg. Obes. Relat. Dis. 2005;1:467–74).

Of the 15 patients, 12 (80%) presented with new-onset, nonspecific complaints, such as nausea, vomiting, and epigastric pain, Dr. Carrodeguas said. Nearly 30% were dissatisfied with their weight loss. Implementing routine screening may allow for early detection and intervention, which can reduce hospital stays, the authors said.

“In our series, the vast majority of the patients who developed gastrogastric fistulas were diagnosed with either a Gastrografin study or an [intraoperative esophagogastroduodenoscopy], dramatically reducing the need for the more costly CT as a diagnostic method,” the investigators said.

Antipsychotic-Related Weight Gain

A behavioral weight control program was associated with modest improvements in obese patients taking antipsychotic medications, but longer and more robust interventions are necessary, reported Melissa A. Kalarchian, Ph.D., of the University of Pittsburgh Medical Center, and her associates.

Over 12 weeks, 35 obese outpatients taking antipsychotics for schizophrenia or related psychoses underwent 16 behavioral sessions reinforcing diet restrictions and promoting exercise. Among the 29 who completed the study, the mean weight loss was just over 5 pounds, the mean Eating Behavior Inventory score improved by 13%, and health-related quality of life improved significantly (J. Clin. Psychiatry 2005;66:1058–63).

At a 3-month follow-up, weight continued to drop to a mean of just over 7 pounds in the 27 subjects who completed the posttreatment session. This amounted to a 3.2% loss of initial body weight, Dr. Kalarchian said. “Behavioral weight control is a feasible and promising approach to the treatment of obesity in this population,” the investigators said.

Rosiglitazone and Obesity

Rosiglitazone may be an effective adjunct to insulin therapy in patients with type 1 diabetes and a body mass index (BMI) greater than or equal to 30 kg/m

In an 8-month, randomized, double-blind study, 50 adults with a baseline BMI of 27 or higher were assigned to receive either insulin and rosiglitazone or insulin and placebo. HbA_1C levels declined significantly in treated subjects (−1.0%) and placebo subjects (−0.7%), but the placebo group required an 11% higher insulin dose (Diabetes Care 2005;28:1562–7).

Subjects with a baseline BMI of 30 or higher who were treated with rosiglitazone had significantly greater improvements in HbA_1C (−1.4%) and total cholesterol (−18 mg/dL) levels, compared with rosiglitazone-treated subjects whose BMI was less than 30.

These outcomes were not observed among placebo subjects. In fact, placebo subjects with a BMI of 30 or higher had the greatest increase in insulin dose of all placebo subjects (12.3 units/day), while patients with a BMI over 30 taking rosiglitazone lowered their daily insulin requirements (−5.7 units/day).

Obesity, Smoking, and Aging

Obesity and cigarette smoking are associated with accelerated aging in white women, reported A.M. Valdes, Ph.D., of the Twin Research and Genetic Epidemiology Unit, St. Thomas' Hospital, London.

Both smoking and obesity result in oxidative stress, which increases white blood cell telomere erosion; telomeres protect chromosomes from degradation by capping the ends of the chromosomes. This suggests that obese subjects and smokers will have shortened telomeres, a marker for aging (Lancet 2005;366:662–4).

In a study of 1,122 white female twins aged 18–72 years, telomere length in white blood cells decreased steadily with age at a mean rate of 27 base pair (bp) per year. The telomere length of obese women was 240 bp shorter, compared with lean women. There was also a dose-dependent relationship between smoking and telomere length: Each pack-year smoked was equivalent to an age-adjusted average of 5 bp of telomere length lost per year, an 18% decrease, Dr. Valdes and colleagues wrote. Lean women had significantly longer telomeres than women with BMIs in the middle of the range, who in turn had longer telomeres than obese women.

The data showed that the difference in telomere length between lean and obese women corresponded to 8.8 years of aging, and current or previous smoking accounted for 4.6 years of aging.

Nutritional Adjunct Tied to Savings

Supplementation with chromium picolinate plus biotin may substantially reduce the cost of treating type 2 diabetes, reported Joseph P. Fuhr Jr., Ph.D., of Widener University, Chester, Penn., and Thomas Jefferson University, Philadelphia, and his associates, based on an economic analysis.

Studies have shown that daily use of the supplement, at an average annual cost of less than $120, improved glycemic control in patients with poorly controlled type 2 diabetes over and above the improvement achieved by oral hypoglycemic agents, the authors noted. In patients with a baseline HbA_1c level of at least 10%, the average HbA_1c level decreased by 1.78% in users of chromium picolinate plus biotin, compared with 0.78% in placebo users (Dis. Manag. 2005;8:265–75).

The average 3-year cost savings of decreasing HbA_1c levels from 10.62% to 9.18% was estimated to be $1,636 for patients with poorly controlled type 2 diabetes and $5,435 for patients who also have heart disease and hypertension; the combination of chromium picolinate and biotin has been shown to affect both lipid and glucose levels. This could result in an average 3-year savings of between $3.9 and $52.9 billion in treating the 16.3 million patients who currently have type 2 diabetes, the authors estimated.

Body Mass and Stature

The acute response of the spine to loading may be a risk factor for low back pain in obese subjects, reported André Luiz Felix Rodacki of Paraná Federal University, Curitiba, Brazil, and his associates.

Ten obese men with a BMI greater than 30 kg/m

The obese subjects' stature loss was an average of 8.49 mm loaded and 7.02 mm unloaded, compared with the nonobese subjects, who had an average loss of 6.52 mm loaded and 3.55 mm unloaded. The obese group did not regain stature during the standing recovery period, while the nonobese group recovered stature (Clin. Biomech. 2005;20:799–805).

A longer recovery period may be necessary for obese subjects to reestablish their intervertebral disc height after loading, which “may help to explain the high incidence of back disorders in obese individuals,” the authors wrote.

Rosiglitazone and Obesity

Rosiglitazone may be an effective adjunct to insulin therapy in patients with type 1 diabetes and a body mass index (BMI) greater than or equal to 30 kg/m

In an 8-month, randomized, double-blind study, 50 adults with a baseline BMI of 27 or higher were assigned to receive either insulin and rosiglitazone or insulin and placebo. HbA_1C levels declined significantly in treated subjects (−1.0%) and placebo subjects (−0.7%), but the placebo group required an 11% higher insulin dose (Diabetes Care 2005;28:1562–7).

Subjects with a baseline BMI of 30 or higher who were treated with rosiglitazone had significantly greater improvements in HbA_1C (−1.4%) and total cholesterol (−18 mg/dL) levels, compared with rosiglitazone-treated subjects whose BMI was less than 30.

These outcomes were not observed among placebo subjects. In fact, placebo subjects with a BMI of 30 or higher had the greatest increase in insulin dose of all placebo subjects (12.3 units/day), while patients with a BMI over 30 taking rosiglitazone lowered their daily insulin requirements (−5.7 units/day).

Obesity, Smoking, and Aging

Obesity and cigarette smoking are associated with accelerated aging in white women, reported A.M. Valdes, Ph.D., of the Twin Research and Genetic Epidemiology Unit, St. Thomas' Hospital, London.

Both smoking and obesity result in oxidative stress, which increases white blood cell telomere erosion; telomeres protect chromosomes from degradation by capping the ends of the chromosomes. This suggests that obese subjects and smokers will have shortened telomeres, a marker for aging (Lancet 2005;366:662–4).

In a study of 1,122 white female twins aged 18–72 years, telomere length in white blood cells decreased steadily with age at a mean rate of 27 base pair (bp) per year. The telomere length of obese women was 240 bp shorter, compared with lean women. There was also a dose-dependent relationship between smoking and telomere length: Each pack-year smoked was equivalent to an age-adjusted average of 5 bp of telomere length lost per year, an 18% decrease, Dr. Valdes and colleagues wrote. Lean women had significantly longer telomeres than women with BMIs in the middle of the range, who in turn had longer telomeres than obese women.

The data showed that the difference in telomere length between lean and obese women corresponded to 8.8 years of aging, and current or previous smoking accounted for 4.6 years of aging.

Nutritional Adjunct Tied to Savings

Supplementation with chromium picolinate plus biotin may substantially reduce the cost of treating type 2 diabetes, reported Joseph P. Fuhr Jr., Ph.D., of Widener University, Chester, Penn., and Thomas Jefferson University, Philadelphia, and his associates, based on an economic analysis.

Studies have shown that daily use of the supplement, at an average annual cost of less than $120, improved glycemic control in patients with poorly controlled type 2 diabetes over and above the improvement achieved by oral hypoglycemic agents, the authors noted. In patients with a baseline HbA_1c level of at least 10%, the average HbA_1c level decreased by 1.78% in users of chromium picolinate plus biotin, compared with 0.78% in placebo users (Dis. Manag. 2005;8:265–75).

The average 3-year cost savings of decreasing HbA_1c levels from 10.62% to 9.18% was estimated to be $1,636 for patients with poorly controlled type 2 diabetes and $5,435 for patients who also have heart disease and hypertension; the combination of chromium picolinate and biotin has been shown to affect both lipid and glucose levels. This could result in an average 3-year savings of between $3.9 and $52.9 billion in treating the 16.3 million patients who currently have type 2 diabetes, the authors estimated.

Body Mass and Stature

The acute response of the spine to loading may be a risk factor for low back pain in obese subjects, reported André Luiz Felix Rodacki of Paraná Federal University, Curitiba, Brazil, and his associates.

Ten obese men with a BMI greater than 30 kg/m

The obese subjects' stature loss was an average of 8.49 mm loaded and 7.02 mm unloaded, compared with the nonobese subjects, who had an average loss of 6.52 mm loaded and 3.55 mm unloaded. The obese group did not regain stature during the standing recovery period, while the nonobese group recovered stature (Clin. Biomech. 2005;20:799–805).

A longer recovery period may be necessary for obese subjects to reestablish their intervertebral disc height after loading, which “may help to explain the high incidence of back disorders in obese individuals,” the authors wrote.

Rosiglitazone and Obesity

Rosiglitazone may be an effective adjunct to insulin therapy in patients with type 1 diabetes and a body mass index (BMI) greater than or equal to 30 kg/m

In an 8-month, randomized, double-blind study, 50 adults with a baseline BMI of 27 or higher were assigned to receive either insulin and rosiglitazone or insulin and placebo. HbA_1C levels declined significantly in treated subjects (−1.0%) and placebo subjects (−0.7%), but the placebo group required an 11% higher insulin dose (Diabetes Care 2005;28:1562–7).

Subjects with a baseline BMI of 30 or higher who were treated with rosiglitazone had significantly greater improvements in HbA_1C (−1.4%) and total cholesterol (−18 mg/dL) levels, compared with rosiglitazone-treated subjects whose BMI was less than 30.

These outcomes were not observed among placebo subjects. In fact, placebo subjects with a BMI of 30 or higher had the greatest increase in insulin dose of all placebo subjects (12.3 units/day), while patients with a BMI over 30 taking rosiglitazone lowered their daily insulin requirements (−5.7 units/day).

Obesity, Smoking, and Aging

Obesity and cigarette smoking are associated with accelerated aging in white women, reported A.M. Valdes, Ph.D., of the Twin Research and Genetic Epidemiology Unit, St. Thomas' Hospital, London.

Both smoking and obesity result in oxidative stress, which increases white blood cell telomere erosion; telomeres protect chromosomes from degradation by capping the ends of the chromosomes. This suggests that obese subjects and smokers will have shortened telomeres, a marker for aging (Lancet 2005;366:662–4).

In a study of 1,122 white female twins aged 18–72 years, telomere length in white blood cells decreased steadily with age at a mean rate of 27 base pair (bp) per year. The telomere length of obese women was 240 bp shorter, compared with lean women. There was also a dose-dependent relationship between smoking and telomere length: Each pack-year smoked was equivalent to an age-adjusted average of 5 bp of telomere length lost per year, an 18% decrease, Dr. Valdes and colleagues wrote. Lean women had significantly longer telomeres than women with BMIs in the middle of the range, who in turn had longer telomeres than obese women.

The data showed that the difference in telomere length between lean and obese women corresponded to 8.8 years of aging, and current or previous smoking accounted for 4.6 years of aging.

Nutritional Adjunct Tied to Savings

Supplementation with chromium picolinate plus biotin may substantially reduce the cost of treating type 2 diabetes, reported Joseph P. Fuhr Jr., Ph.D., of Widener University, Chester, Penn., and Thomas Jefferson University, Philadelphia, and his associates, based on an economic analysis.

Studies have shown that daily use of the supplement, at an average annual cost of less than $120, improved glycemic control in patients with poorly controlled type 2 diabetes over and above the improvement achieved by oral hypoglycemic agents, the authors noted. In patients with a baseline HbA_1c level of at least 10%, the average HbA_1c level decreased by 1.78% in users of chromium picolinate plus biotin, compared with 0.78% in placebo users (Dis. Manag. 2005;8:265–75).

The average 3-year cost savings of decreasing HbA_1c levels from 10.62% to 9.18% was estimated to be $1,636 for patients with poorly controlled type 2 diabetes and $5,435 for patients who also have heart disease and hypertension; the combination of chromium picolinate and biotin has been shown to affect both lipid and glucose levels. This could result in an average 3-year savings of between $3.9 and $52.9 billion in treating the 16.3 million patients who currently have type 2 diabetes, the authors estimated.

Body Mass and Stature

The acute response of the spine to loading may be a risk factor for low back pain in obese subjects, reported André Luiz Felix Rodacki of Paraná Federal University, Curitiba, Brazil, and his associates.

Ten obese men with a BMI greater than 30 kg/m

The obese subjects' stature loss was an average of 8.49 mm loaded and 7.02 mm unloaded, compared with the nonobese subjects, who had an average loss of 6.52 mm loaded and 3.55 mm unloaded. The obese group did not regain stature during the standing recovery period, while the nonobese group recovered stature (Clin. Biomech. 2005;20:799–805).

A longer recovery period may be necessary for obese subjects to reestablish their intervertebral disc height after loading, which “may help to explain the high incidence of back disorders in obese individuals,” the authors wrote.

People who are obese or overweight at middle age are at significantly greater risk for dementia in later life than normal-weight people, reported Rachel A. Whitmer, Ph.D., of the division of research, Kaiser Permanente, Oakland, Calif.

The investigators prospectively followed 10,276 people enrolled in the Kaiser Permanente medical program of northern California who were 40–45 years old between 1964 and 1973. At midlife, 10% were obese (BMI of 30 kg/m

From January 1994 to April 2003, people who were obese at midlife had a 74% greater risk of dementia, compared with people who had been of normal weight, while overweight people had a 35% greater risk.

In women, the corresponding increases were 107% for obesity and 55% for overweight; no significant differences were found in men.

People in the highest quintile of subscapular skinfold at midlife had a 72% increased risk of dementia, while people in the highest quintile of tricep skinfold had a 59% increased risk of dementia, compared with people in the lowest fifth of the two measures, Dr. Whitmer reported in the April 29 online edition of the British Medical Journal.

People who are obese or overweight at middle age are at significantly greater risk for dementia in later life than normal-weight people, reported Rachel A. Whitmer, Ph.D., of the division of research, Kaiser Permanente, Oakland, Calif.

The investigators prospectively followed 10,276 people enrolled in the Kaiser Permanente medical program of northern California who were 40–45 years old between 1964 and 1973. At midlife, 10% were obese (BMI of 30 kg/m

From January 1994 to April 2003, people who were obese at midlife had a 74% greater risk of dementia, compared with people who had been of normal weight, while overweight people had a 35% greater risk.

In women, the corresponding increases were 107% for obesity and 55% for overweight; no significant differences were found in men.

People in the highest quintile of subscapular skinfold at midlife had a 72% increased risk of dementia, while people in the highest quintile of tricep skinfold had a 59% increased risk of dementia, compared with people in the lowest fifth of the two measures, Dr. Whitmer reported in the April 29 online edition of the British Medical Journal.

People who are obese or overweight at middle age are at significantly greater risk for dementia in later life than normal-weight people, reported Rachel A. Whitmer, Ph.D., of the division of research, Kaiser Permanente, Oakland, Calif.

The investigators prospectively followed 10,276 people enrolled in the Kaiser Permanente medical program of northern California who were 40–45 years old between 1964 and 1973. At midlife, 10% were obese (BMI of 30 kg/m

From January 1994 to April 2003, people who were obese at midlife had a 74% greater risk of dementia, compared with people who had been of normal weight, while overweight people had a 35% greater risk.

In women, the corresponding increases were 107% for obesity and 55% for overweight; no significant differences were found in men.

People in the highest quintile of subscapular skinfold at midlife had a 72% increased risk of dementia, while people in the highest quintile of tricep skinfold had a 59% increased risk of dementia, compared with people in the lowest fifth of the two measures, Dr. Whitmer reported in the April 29 online edition of the British Medical Journal.

Walking at the moderate pace of 4 km/h appears as beneficial to fat oxidation as more strenuous exercise in prepubertal boys, according to Claudio Maffeis, M.D., of the Department of Pediatrics at University Hospital, Verona, Italy.

Twenty-four boys, aged 9–11 years, with an average body mass index of 25.5 were given a treadmill test, their respiratory exchange measured by indirect calorimetry while they walked at 4, 5, and 6 km/h. The investigators also measured the boys' maximal oxygen uptake. All the boys reported a sedentary lifestyle, spending 2 hours per week in recreational organized physical activity after school.

Energy expenditure and carbohydrate oxidation increased progressively as the treadmill speed was increased. However, the fat oxidation rate did not change significantly when walking speed increased (J. Clin. Endocrinol. Metab. 2005;90:231–6).

After adjusting for fat-free mass, a partial regression analysis demonstrated that energy expenditure during walking correlated with adiposity in boys, the researchers said. In another partial regression analysis, they found a significant association between adiposity and the fat-to-carbohydrate oxidation rate during walking at all three speeds.

“Therefore, at similar exercise intensities, the greater the adiposity of the body, the higher the energy expenditure and the proportion of carbohydrate in the fuel mix that oxidized during walking,” the researchers said.

Low-intensity exercise may be more acceptable to overweight children and may not lead to the higher carbohydrate oxidation tied to later sedentary behavior and increased appetite, they added.

Walking at the moderate pace of 4 km/h appears as beneficial to fat oxidation as more strenuous exercise in prepubertal boys, according to Claudio Maffeis, M.D., of the Department of Pediatrics at University Hospital, Verona, Italy.

Twenty-four boys, aged 9–11 years, with an average body mass index of 25.5 were given a treadmill test, their respiratory exchange measured by indirect calorimetry while they walked at 4, 5, and 6 km/h. The investigators also measured the boys' maximal oxygen uptake. All the boys reported a sedentary lifestyle, spending 2 hours per week in recreational organized physical activity after school.

Energy expenditure and carbohydrate oxidation increased progressively as the treadmill speed was increased. However, the fat oxidation rate did not change significantly when walking speed increased (J. Clin. Endocrinol. Metab. 2005;90:231–6).

After adjusting for fat-free mass, a partial regression analysis demonstrated that energy expenditure during walking correlated with adiposity in boys, the researchers said. In another partial regression analysis, they found a significant association between adiposity and the fat-to-carbohydrate oxidation rate during walking at all three speeds.

“Therefore, at similar exercise intensities, the greater the adiposity of the body, the higher the energy expenditure and the proportion of carbohydrate in the fuel mix that oxidized during walking,” the researchers said.

Low-intensity exercise may be more acceptable to overweight children and may not lead to the higher carbohydrate oxidation tied to later sedentary behavior and increased appetite, they added.

Walking at the moderate pace of 4 km/h appears as beneficial to fat oxidation as more strenuous exercise in prepubertal boys, according to Claudio Maffeis, M.D., of the Department of Pediatrics at University Hospital, Verona, Italy.

Twenty-four boys, aged 9–11 years, with an average body mass index of 25.5 were given a treadmill test, their respiratory exchange measured by indirect calorimetry while they walked at 4, 5, and 6 km/h. The investigators also measured the boys' maximal oxygen uptake. All the boys reported a sedentary lifestyle, spending 2 hours per week in recreational organized physical activity after school.

Energy expenditure and carbohydrate oxidation increased progressively as the treadmill speed was increased. However, the fat oxidation rate did not change significantly when walking speed increased (J. Clin. Endocrinol. Metab. 2005;90:231–6).

After adjusting for fat-free mass, a partial regression analysis demonstrated that energy expenditure during walking correlated with adiposity in boys, the researchers said. In another partial regression analysis, they found a significant association between adiposity and the fat-to-carbohydrate oxidation rate during walking at all three speeds.

“Therefore, at similar exercise intensities, the greater the adiposity of the body, the higher the energy expenditure and the proportion of carbohydrate in the fuel mix that oxidized during walking,” the researchers said.

Low-intensity exercise may be more acceptable to overweight children and may not lead to the higher carbohydrate oxidation tied to later sedentary behavior and increased appetite, they added.

Obesity, Inactivity Tied to Diabetes

Target both fitness and fatness to help control diabetes and diabetes-related comorbidities in the general population, advised Patrick W. Sullivan, Ph.D., of the University of Colorado, Denver, and his associates.

The Medical Expenditure Panel Survey, a nationally representative survey of the U.S. population, was used to gather data on 68,500 adults from 2000 to 2002. After the investigators controlled for various factors, the data showed that being overweight or inactive was significantly and independently linked to an increased risk of diabetes and related comorbidities such as hypertension, hyperlipidemia, and heart disease (Diabetes Care 2005;28:1599–1603).

Inactive, normal-weight subjects had a lower risk (odds ratio 1.52) of diabetes, compared with obese, active subjects (odds ratio 3.62).

More Desk Time, Bigger Waistline

The more time men spend sitting at work, the greater their risk of being overweight or obese, reported W. Kerry Mummery, Ph.D., of Central Queensland University, Rockhampton, Australia, and associates.

In a cross-sectional study of 875 men and 704 women who worked full time, average time spent sitting at work was more than 3 hours per day, and 25% reported sitting more than 6 hours per day. There was a significant gender difference, with men sitting an average of 209 minutes and women sitting an average of 189 minutes (Am. J. Prev. Med. 2005;29:91–7).

Using a univariate analysis, the investigators found that having a body mass index (BMI) of 25 kg/m

Plasma Peptides Influence Satiety

Apelin, orexin-A, and leptin levels in the plasma appear to work together to influence satiety, reported M.V. Heinonen and colleagues at the University of Kuopio (Finland).

The investigators measured basal plasma values in 32 morbidly obese subjects and 12 healthy controls; a subgroup of 8 obese patients also had their basal peptide plasma values measured the day before gastric banding surgery and 1 year later.

Apelin, orexin-A, and leptin levels were found to be significantly higher in obese subjects than in controls (736 pg/mL vs. 174 pg/mL, 75.3 pg/mL vs. 0.8 pg/mL, and 79 pg/mL vs. 5.8 pg/mL, respectively). Plasma apelin and leptin concentrations were significantly correlated with body mass index, whereas orexin-A was only weakly correlated with BMI. “The increased plasma concentrations of these peptides in obese patients suggest an influence on satiety,” the investigators explained (Regul. Pept. 2005;130:7–13).

One year after surgery, the eight gastric-banding patients had achieved significant weight loss: Average BMI had dropped from 48 to 39. Orexin-A levels remained the same from before the operation to a year later, but plasma leptin levels were significantly lower, falling from 45.1 ng/mL to 27.3 ng/mL.

Setting Up Obesity Programs

To launch effective obesity treatment programs in primary health care centers, health professionals need education, support from colleagues, and backing from management, reported Ingela Melin of the Karolinska Institute, Stockholm, and her associates.

In a study of 135 health providers followed for 2.5 years, 87 (64%) started an obesity treatment program after receiving training and mentoring in person and by telephone (Patient Educ. Couns. 2005;58:127–36).

Most (69%) of the providers were nurses. Previous theoretical education in obesity was significantly associated with starting the program, as was practical experience in treating obesity. Receiving in-person and telephone supervision were also significant positive influences on starting the program.

But there were obstacles to starting an obesity program, including priority given to ongoing medical care, lack of time to start a new program, negative provider views of obese people, staff turnover, and a lack of support from management, physicians, and colleagues. The most significant factors in getting a program started were having a colleague to work with (30 of 33 who had a colleague started one, while 45 of 102 who had no colleague didn't) and management backing (73 of 87 who had backing started a program; 34 of 48 with no backing didn't start a program).

Obesity, Inactivity Tied to Diabetes

Target both fitness and fatness to help control diabetes and diabetes-related comorbidities in the general population, advised Patrick W. Sullivan, Ph.D., of the University of Colorado, Denver, and his associates.

The Medical Expenditure Panel Survey, a nationally representative survey of the U.S. population, was used to gather data on 68,500 adults from 2000 to 2002. After the investigators controlled for various factors, the data showed that being overweight or inactive was significantly and independently linked to an increased risk of diabetes and related comorbidities such as hypertension, hyperlipidemia, and heart disease (Diabetes Care 2005;28:1599–1603).

Inactive, normal-weight subjects had a lower risk (odds ratio 1.52) of diabetes, compared with obese, active subjects (odds ratio 3.62).

More Desk Time, Bigger Waistline

The more time men spend sitting at work, the greater their risk of being overweight or obese, reported W. Kerry Mummery, Ph.D., of Central Queensland University, Rockhampton, Australia, and associates.

In a cross-sectional study of 875 men and 704 women who worked full time, average time spent sitting at work was more than 3 hours per day, and 25% reported sitting more than 6 hours per day. There was a significant gender difference, with men sitting an average of 209 minutes and women sitting an average of 189 minutes (Am. J. Prev. Med. 2005;29:91–7).

Using a univariate analysis, the investigators found that having a body mass index (BMI) of 25 kg/m

Plasma Peptides Influence Satiety

Apelin, orexin-A, and leptin levels in the plasma appear to work together to influence satiety, reported M.V. Heinonen and colleagues at the University of Kuopio (Finland).

The investigators measured basal plasma values in 32 morbidly obese subjects and 12 healthy controls; a subgroup of 8 obese patients also had their basal peptide plasma values measured the day before gastric banding surgery and 1 year later.

Apelin, orexin-A, and leptin levels were found to be significantly higher in obese subjects than in controls (736 pg/mL vs. 174 pg/mL, 75.3 pg/mL vs. 0.8 pg/mL, and 79 pg/mL vs. 5.8 pg/mL, respectively). Plasma apelin and leptin concentrations were significantly correlated with body mass index, whereas orexin-A was only weakly correlated with BMI. “The increased plasma concentrations of these peptides in obese patients suggest an influence on satiety,” the investigators explained (Regul. Pept. 2005;130:7–13).

One year after surgery, the eight gastric-banding patients had achieved significant weight loss: Average BMI had dropped from 48 to 39. Orexin-A levels remained the same from before the operation to a year later, but plasma leptin levels were significantly lower, falling from 45.1 ng/mL to 27.3 ng/mL.

Setting Up Obesity Programs

To launch effective obesity treatment programs in primary health care centers, health professionals need education, support from colleagues, and backing from management, reported Ingela Melin of the Karolinska Institute, Stockholm, and her associates.

In a study of 135 health providers followed for 2.5 years, 87 (64%) started an obesity treatment program after receiving training and mentoring in person and by telephone (Patient Educ. Couns. 2005;58:127–36).

Most (69%) of the providers were nurses. Previous theoretical education in obesity was significantly associated with starting the program, as was practical experience in treating obesity. Receiving in-person and telephone supervision were also significant positive influences on starting the program.

But there were obstacles to starting an obesity program, including priority given to ongoing medical care, lack of time to start a new program, negative provider views of obese people, staff turnover, and a lack of support from management, physicians, and colleagues. The most significant factors in getting a program started were having a colleague to work with (30 of 33 who had a colleague started one, while 45 of 102 who had no colleague didn't) and management backing (73 of 87 who had backing started a program; 34 of 48 with no backing didn't start a program).

Obesity, Inactivity Tied to Diabetes

Target both fitness and fatness to help control diabetes and diabetes-related comorbidities in the general population, advised Patrick W. Sullivan, Ph.D., of the University of Colorado, Denver, and his associates.

The Medical Expenditure Panel Survey, a nationally representative survey of the U.S. population, was used to gather data on 68,500 adults from 2000 to 2002. After the investigators controlled for various factors, the data showed that being overweight or inactive was significantly and independently linked to an increased risk of diabetes and related comorbidities such as hypertension, hyperlipidemia, and heart disease (Diabetes Care 2005;28:1599–1603).

Inactive, normal-weight subjects had a lower risk (odds ratio 1.52) of diabetes, compared with obese, active subjects (odds ratio 3.62).

More Desk Time, Bigger Waistline

The more time men spend sitting at work, the greater their risk of being overweight or obese, reported W. Kerry Mummery, Ph.D., of Central Queensland University, Rockhampton, Australia, and associates.

In a cross-sectional study of 875 men and 704 women who worked full time, average time spent sitting at work was more than 3 hours per day, and 25% reported sitting more than 6 hours per day. There was a significant gender difference, with men sitting an average of 209 minutes and women sitting an average of 189 minutes (Am. J. Prev. Med. 2005;29:91–7).

Using a univariate analysis, the investigators found that having a body mass index (BMI) of 25 kg/m

Plasma Peptides Influence Satiety

Apelin, orexin-A, and leptin levels in the plasma appear to work together to influence satiety, reported M.V. Heinonen and colleagues at the University of Kuopio (Finland).

The investigators measured basal plasma values in 32 morbidly obese subjects and 12 healthy controls; a subgroup of 8 obese patients also had their basal peptide plasma values measured the day before gastric banding surgery and 1 year later.

Apelin, orexin-A, and leptin levels were found to be significantly higher in obese subjects than in controls (736 pg/mL vs. 174 pg/mL, 75.3 pg/mL vs. 0.8 pg/mL, and 79 pg/mL vs. 5.8 pg/mL, respectively). Plasma apelin and leptin concentrations were significantly correlated with body mass index, whereas orexin-A was only weakly correlated with BMI. “The increased plasma concentrations of these peptides in obese patients suggest an influence on satiety,” the investigators explained (Regul. Pept. 2005;130:7–13).

One year after surgery, the eight gastric-banding patients had achieved significant weight loss: Average BMI had dropped from 48 to 39. Orexin-A levels remained the same from before the operation to a year later, but plasma leptin levels were significantly lower, falling from 45.1 ng/mL to 27.3 ng/mL.

Setting Up Obesity Programs

To launch effective obesity treatment programs in primary health care centers, health professionals need education, support from colleagues, and backing from management, reported Ingela Melin of the Karolinska Institute, Stockholm, and her associates.

In a study of 135 health providers followed for 2.5 years, 87 (64%) started an obesity treatment program after receiving training and mentoring in person and by telephone (Patient Educ. Couns. 2005;58:127–36).

Most (69%) of the providers were nurses. Previous theoretical education in obesity was significantly associated with starting the program, as was practical experience in treating obesity. Receiving in-person and telephone supervision were also significant positive influences on starting the program.

But there were obstacles to starting an obesity program, including priority given to ongoing medical care, lack of time to start a new program, negative provider views of obese people, staff turnover, and a lack of support from management, physicians, and colleagues. The most significant factors in getting a program started were having a colleague to work with (30 of 33 who had a colleague started one, while 45 of 102 who had no colleague didn't) and management backing (73 of 87 who had backing started a program; 34 of 48 with no backing didn't start a program).