Weight loss goals among African-American women with type 2 diabetes

In the review of the suggestion that overly ambitious weight loss expectations may negatively affect weight losses achieved but it is unknown whether they affect weight loss among African-American women, researchers found that women indicated weight loss goals of 14.1 ± 6.6 kg (14% of initial weight). They also reported relatively high expected satisfaction with a reasonable weight loss (7-10%). On average, participants lost 3.0 ± 3.9 kg (3% of initial weight) and attended 73 ± 21% of group sessions. Neither weight loss goals nor expected satisfaction with a reasonable weight loss was correlated with either actual weight loss outcome or attendance. Having higher personal weight loss goals was associated with lower expectations of satisfaction with a reasonable weight loss. This suggests that African-American women with type 2 diabetes enter treatment hoping to lose far more weight than they are likely to achieve. It is important to understand the psychosocial sequelae of failing to reach these goals on subsequent weight maintenance and future weight loss attempts within this population.(1)

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(1) "Weight loss goals among African-American women with type 2 diabetes in a behavioral weight control program" by White DB, Bursac Z, Dilillo V, West DS.

Models for dietary and weight change in African-American women

In the study to explore the cultural factors that potentially influence the effectiveness of weight-control programs for African-American women and attempts to challenge the perception that such programs operate in a culture-free context, researchers showed that Evidence from clinical trials also suggests that African-American women have difficulty in losing weight. Cultural variables are thought to limit the intensity of weight-loss motivations among African-American women, but it is also possible that unrecognized cultural variables within behavioral weight-control programs limit their applicability to persons who do not fit a typical middle-class white American prototype. Many perspectives that differ between African-American and American cultures are directly relevant to the tasks and expectations involved in conventional behavioral therapy. Thus, efforts to make programs culturally appropriate for African-American women may need to go beyond superficial adaptations (eg, logistical accommodations) toward a behavioral analysis of weight control as it is likely to be approached by African-American women within their cultural context.(1)

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(1) "Models for dietary and weight change in African-American women: identifying cultural components" by Kumanyika SK, Morssink C, Agurs T.

Additional protein intake limits weight regain after weight loss

In the study to to investigate whether the addition of protein to the diet might limit weight regain after a weight loss of 5-10 % in overweight subjects, During WM, the protein group showed a higher protein intake (18 % v. 15 %; P<0.05), a lower weight regain (0.8 v. 3.0 kg; P<0.05), a decreased waist circumference (-1.2 (SD 0.7) v. 0.5 (SD 0.5 ) cm; P<0.05) and a smaller increase in respiratory quotient (0.03 (SD 0.01) v. 0.07 0.01; (SD/)P <0.05) compared with the control group. Weight regain in the protein group consisted of only fat-free mass, whereas the control group gained fat mass as well. Satiety in the fasted state before breakfast increased significantly more in the protein group than in the control group. After 6 months follow-up, body weight showed a significant group x time interaction. A protein intake of 18 % compared with 15 % resulted in improved WM in overweight subjects after a weight loss of 7.5 %. This improved WM implied several factors, i.e. improved body composition, fat distribution, substrate oxidation and satiety.(1)

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(1) "Additional protein intake limits weight regain after weight loss in humans" by Lejeune MP, Kovacs EM, Westerterp-Plantenga MS.

Body weight loss and weight maintenance in relation to habitual caffeine intake and green tea supplementation

In the Investigation of the effect of a green tea-caffeine mixture on weight maintenance after body weight loss in moderately obese subjects in relation to habitual caffeine intake, Subjects lost 5.9 +/-1.8 (SD) kg (7.0 +/- 2.1%) of body weight (p < 0.001). At baseline, satiety was positively, and in women, leptin was inversely, related to subjects' habitual caffeine consumption (p < 0.01). High caffeine consumers reduced weight, fat mass, and waist circumference more than low caffeine consumers; resting energy expenditure was reduced less and respiratory quotient was reduced more during weight loss (p < 0.01). In the low caffeine consumers, during WM, green tea still reduced body weight, waist, respiratory quotient and body fat, whereas resting energy expenditure was increased compared with a restoration of these variables with placebo (p < 0.01). In the high caffeine consumers, no effects of the green tea-caffeine mixture were observed during WM.(1)

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(1) "Body weight loss and weight maintenance in relation to habitual caffeine intake and green tea supplementation" by Westerterp-Plantenga MS, Lejeune MP, Kovacs EM.

The effects of green tea on weight loss and weight maintenance: a meta-analysis

In the study to To elucidate by meta-analysis whether green tea indeed has a function in body weight regulation, Catechins significantly decreased body weight and significantly maintained body weight after a period of WL (microcirc=-1.31 kg; P<0.001). Inhibition of this effect by high habitual caffeine intake (>300 mg per day) failed to reach significance (microcirc=-0.27 kg for high and microcirc=-1.60 kg for low habitual caffeine intake; P=0.09). Also, the seemingly smaller effect of catechins in Caucasian (microcirc=-0.82 kg) subjects compared with Asians (microcirc=-1.51 kg; P=0.37) did not reach significance. Interaction of ethnicity and caffeine intake was a significant moderator (P=0.04).(1)

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(1) "The effects of green tea on weight loss and weight maintenance: a meta-analysis" by

Hursel R, Viechtbauer W, Westerterp-Plantenga MS.

The risk of postpartum hemorrhage in women using high dose of low-molecular-weight heparins during pregnancy

In the evaluation to study the low-molecular-weight heparins (LMWH) are the most commonly used anticoagulant during pregnancy for prevention or treatment of VTE. However, the size of the associated risk of postpartum haemorrhage (PPH) is unknown conducted by University Medical Centre Groningen, Risk of PPH after vaginal delivery was 30% and 18% for LMWH-users and non-users, respectively (OR 1.9, 95%CI 1.1-3.5). Risk of severe PPH after vaginal delivery was not different (5.6 vs 5.0%; OR 1.1; 0.4-3.6). Risk of PPH after CS was 12% in LMWH-users and 4% in non-users (OR 2.9; 0.5-19.4). Both events of LMWH-users occurred after emergency CS. The risk of PPH associated with delivery within 24 hours after last dose of LMWH was 1.2 fold higher (95%CI 0.4-3.6) compared to a larger interval.(1)


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(1) 'The risk of postpartum hemorrhage in women using high dose of low-molecular-weight heparins during pregnancy" By Knol HM, Schultinge L, Veeger NJ, Kluin-Nelemans HC, Erwich JJ, Meijer K.

Glycosylated Hemoglobin and Intentional Weight Loss

In the sudy to assess the relationship between magnitude of weight loss and improvement in percentage A1C (A1C%) among overweight and obese patients with type 2 diabetes mellitus (DM) undergoing weight reduction, found that in seventy-two patients formed the study cohort. Mean baseline body mass index was 35.1 kg/m(2), mean age was 52.6 years, and 59% were males. Mean starting A1C% was 8.6. Patients achieved significant mean weight loss (10.7 kg) at study exit. Weight loss of 6.5 kg (4.5% of baseline body weight), 12.2 kg (8.7%), and 15.9 kg (10.3%) was required to reduce A1C% by 0.5, 1, and 1.5, respectively, and it took a mean of 5.6, 8.7, and 10.1 months, respectively, to achieve this. After adjustment for antidiabetic medication intake, for every 10% weight loss, the predicted reduction in A1C% was 0.81.(1)

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(1)" Association Between Glycosylated Hemoglobin and Intentional Weight Loss in Overweight and Obese Patients With Type 2 Diabetes Mellitus: A Retrospective Cohort Study".

Palamaner Subash Shantha G, Kumar AA, Kahan S, Cheskin LJ.

Intentional weight loss and dose reductions of anti-diabetic medications--

In the investigation to study the mean starting BMI was 35 kg/m(2), mean age 53.4 years, and 58% were male. All 50 used at least one anti-diabetic medication (30 metformin, 39 sulfonylureas, 31 insulin, 21 sitagliptin) to manage blood sugar. Mean duration of follow-up was 30.2 months. Mean weight loss was 10.8 ± 4.1 kgs (11.1% of initial body weight ± 4.7%). 22/50 patients (44%) discontinued anti-diabetes medications (14 sulfonylureas [36%], 7 insulin [23%], 4 sitagliptin [19%]), found that the mean percentage weight loss achieved at the point of successful discontinuation of medication was 11.2% ± 3.5% (14% for sulphonylureas, 11% for insulin, and 7.1% for sitagliptin). Mean percentage weight loss of 5.6% ± 2.8% (5.1% for sulphonylureas, 4.3% for insulin, and 7.1% for sitagliptin) was required for initial dose reduction. For every 5% weight loss, predicted dose reductions were sulphonylureas, 39%; insulin, 42%; and any anti-diabetic medications, 49%. by  Johns Hopkins Bloomberg School of Public Health

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(1) "Intentional weight loss and dose reductions of anti-diabetic medications--a retrospective cohort study" by Kumar AA, Palamaner Subash Shantha G, Kahan S, Samson RJ, Boddu ND, Cheskin LJ.

Gestational weight loss has adverse effects on placental development.

In the study to To clarify whether mothers with gestational weight loss (GWL) were likely to have adverse effects on the placenta. Study design: Subjects who delivered viable singleton infants after 24 weeks of gestation were enrolled. A retrospective analysis to evaluate cases of GWL in association with the findings of the placenta and amniotic membrane after delivery was conducted, conducted by Showa University School of Medicine, found that GWL is associated with SGA, small placenta, short umbilical cord length, preterm delivery and pPROM.(1)

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(1) "Gestational weight loss has adverse effects on placental development" by Hasegawa J, Nakamura M, Hamada S, Okuyama A, Matsuoka R, Ichizuka K, Sekizawa A, Okai T.

Changes in Dermal Histomorphology Following Surgical Weight Loss Versus Diet-Induced Weight Loss in the Morbidly Obese Patient.

In the investigation of Between July 2008 and December 2010, 30 consecutive patients with significant weight loss (17 surgical, 13 nonsurgical) underwent a panniculectomy (n = 15), abdominoplasty (n = 13), and lower body lift (n = 2), with an average age of 48.3 ± 11.10 years and a body mass index of 39.23 ± 13.65 kg/m conducted by Duke University Medical Center, found that Blinded histologic evaluation revealed a trend toward normal elastic fiber appearance (P = 0.255), increased wound complications (P = 0.546), and mild inflammation (P = 0.462) in the surgical group. Analysis of dermal histomorphology correlating with wound complications was not statistically significant at follow-up (4.76 ± 5.55 months). Interestingly, there was a persistent inflammatory component in both groups when compared with age-matched controls

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(1) "Changes in Dermal Histomorphology Following Surgical Weight Loss Versus Diet-Induced Weight Loss in the Morbidly Obese Patient". by Fearmonti RM, Blanton M, Bond JE, Pestana IA, Selim MA, Erdmann D.

Eat, Play, Love: Adolescent and Parent Perceptions of the Components of a Multidisciplinary Weight Management Program.

In the interviews performed (spring 2010) with past participants of the Michigan Pediatric Outpatient Weight Evaluation and Reduction program. Transcripts were reviewed and themes identified, found that parents (38) and adolescents (25) were interviewed separately; similar themes emerged. Theme 1: Support/encouragement-Participants emphasized the importance of a supportive environment with a positive, compassionate approach from providers. Theme 2: Exercise-Fun, achievable activities were a valued means of making exercise enjoyable and building self-efficacy. Theme 3: Nutrition-Hands on demonstrations and tangible suggestions were preferred over activities such as self-monitoring. Theme 4: Behavioral factors-Participants valued the opportunity to hear their peers' experiences. However, individual/family sessions addressing their personal concerns were also viewed as important. Conclusion. Beyond program content, participants valued a supportive environment emphasizing health over habitus(1)

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(1) " Eat, Play, Love: Adolescent and Parent Perceptions of the Components of a Multidisciplinary Weight Management Program" by Woolford SJ, Sallinen BJ, Schaffer S, Clark SJ.

The obesity paradox in chronic disease: facts and numbers

In the investigation of Whether this is justified depends upon the state of health and should be judged individually. For patients with established chronic disease, there is sufficient evidence to support the benefits of large body size, i.e., the obesity paradox, found that the uniform finding is shared over a variety of cardiovascular, pulmonary, and renal diseases and is counterintuitive to the current concepts on ideal body weight. The scientific community has to increase the awareness about differences for optimal body size in health and disease. Simultaneously, clinicians have to be aware about body weight dynamics implications and should interpret the changes in the context of an underlying disease in order to implement the best available management.(1)

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(1) "The obesity paradox in chronic disease: facts and numbers" by Lainscak M, von Haehling S, Doehner W, Anker SD.

No longer just a pretty face: fashion magazines' depictions of ideal female beauty from 1959 to 1999.

In the examination of The print media's depiction of the ideal of feminine beauty as presented to American women was examined for the years 1959-1999, found that Both the increasingly thin images and the striking increase in full-body portrayals suggest an increase in the value placed by American society on a thin ideal for women, a change that is concurrent with the increase in disturbed eating patterns among American women(1)

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(1) "No longer just a pretty face: fashion magazines' depictions of ideal female beauty from 1959 to 1999" by Sypeck MF, Gray JJ, Ahrens AH.

Body weight and beauty: the changing face of the ideal female body weight.

By observing the art of different eras, as well as the more recent existence of the media, found that it is obvious that there have been dramatic changes in what is considered a beautiful body. The ideal of female beauty has shifted from a symbol of fertility to one of mathematically calculated proportions. It has taken the form of an image responding to men's sexual desires. Nowadays there seems to be a tendency towards the destruction of the feminine, as androgynous fashion and appearance dominate our culture. The metamorphosis of the ideal woman follows the shifting role of women in society from mother and mistress to a career-orientated individual. Her depiction by artists across the centuries reveals this change in role and appearance that should be interpreted within the social and historical context of each era with its own theories of what constituted the ideal female body weight.(1)

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(1) "Body weight and beauty: the changing face of the ideal female body weight" by

Bonafini BA, Pozzilli P.

Should dosing of rocuronium in obese patients be based on ideal or corrected body weight?

In the evaluation of Fifty-one obese patients, with a median (range) body mass index of 44 (34-72) kg/m2, scheduled for laparoscopic gastric banding or gastric bypass under propofol-remifentanil anesthesia were randomized into three groups. The patients received rocuronium (0.6 mg/kg) based on IBW (IBW group, n = 17), IBW plus 20% of excess weight (corrected body weight [CBW]20% group, n = 17), or IBW plus 40% of excess weight (CBW40% group, n = 17). Propofol was administered as a bolus of 200 mg and an infusion at 5 mg x kg(-1) x h(-1) and remifentanil was administered at 1.0 microg x kg(-1) x min(-1), both according to CBW40%, found that The median (range) duration of action was 32 (18-49), 38 (25-66), and 42 (24-66) min in the IBW, CBW20%, and CBW40% groups, respectively (P = 0.001 for comparison of the IBW and CBW40% group). There were no significant differences in onset time (85 vs 84 vs 80 s) or in intubation conditions 90 s after administration of rocuronium(1)

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(1) "Should dosing of rocuronium in obese patients be based on ideal or corrected body weight?" by Meyhoff CS, Lund J, Jenstrup MT, Claudius C, Sørensen AM, Viby-Mogensen J, Rasmussen LS.

Spanish Ketogenic Mediterranean Diet on nonalcoholic

Non-alcoholic fatty liver disease (NAFLD) is a fatty liver, as a result of fat deposit into the liver, not caused by excessive alcohol use.

In the investigation of the effect of Spanish Ketogenic Mediterranean Diet on nonalcoholic of 14 obese men meeting the inclusion criteria and whose body mass index (BMI) and age were 36.58±0.54 kg/m² and 41.18±2.28 years, respectively, found that After the diet all the subjects were free of MS according to the IDF definition, and 100% of them had normal triacylglycerols and HDLc levels, in spite of the fact that 100% of them still had a BMI of >30 kg/m². We conclude that the SKMD could be an effective and safe way to treat patients suffering from MS and the associated NAFLD(1)
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(1) "The effect of the Spanish Ketogenic Mediterranean Diet on nonalcoholic fatty liver disease: a pilot study" by.Pérez-Guisado J, Muñoz-Serrano A.

Spanish Ketogenic Mediterranean Diet

In the study 31 obese subjects (22 male and 19 female) with the inclusion criteria whose body mass index and age was 36.46 +/- 2.22 and 38.48 +/- 2.27, respectively. This Ketogenic diet was called "Spanish Ketogenic Mediterranean Diet" (SKMD) due to the incorporation of virgin olive oil as the principal source of fat (> or =30 ml/day), moderate red wine intake (200-400 ml/day), green vegetables and salads as the main source of carbohydrates and fish as the main source of proteins, conducted by University of Córdoba(1), found that The Spanish Ketogenic Mediterranean Diet(SKMD) is safe, an effective way of losing weight, promoting non-atherogenic lipid profiles, lowering blood pressure and improving fasting blood glucose levels. Future research should include a larger sample size, a longer term use and a comparison with other ketogenic diets.

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(1) "Spanish Ketogenic Mediterranean Diet: a healthy cardiovascular diet for weight loss by Pérez-Guisado J, Muñoz-Serrano A, Alonso-Moraga A.

Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss?

Atkins diet or Atkins Nutritional Approach is a low-carbohydrate diet created by Robert Atkins. The diet books have sold more than 45 million copies over 40 years.
In the evaluation of diet claims to be effective at producing weight loss despite ad-libitum consumption of fatty meat, butter, and other high-fat dairy products, restricting only the intake of carbohydrates to under 30 g a day and a systematic review of low-carbohydrate diets found that the weight loss achieved is associated with the duration of the diet and restriction of energy intake, but not with restriction of carbohydrates, found that ad-libitum intake of high-fat foods produces weight loss might be due to severe restriction of carbohydrate depleting glycogen stores, leading to excretion of bound water, the ketogenic nature of the diet being appetite suppressing, the high protein-content being highly satiating and reducing spontaneous food intake, or limited food choices leading to decreased energy intake. Long-term studies are needed to measure changes in nutritional status and body composition during the low-carbohydrate diet, and to assess fasting and postprandial cardiovascular risk factors and adverse effects(1)

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(1) "Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss?" by Astrup A, Meinert Larsen T, Harper A.

Low-carbohydrate nutrition and metabolism.

As the persistence of an epidemic of obesity and type 2 diabetes suggests that new nutritional strategies are needed if the epidemic is to be overcome, some researchers suggested under conditions of carbohydrate restriction, fuel sources shift from glucose and fatty acids to fatty acids and ketones, and that ad libitum-fed carbohydrate-restricted diets lead to appetite reduction, weight loss, and improvement in surrogate markers of cardiovascular disease.

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(1) "Low-carbohydrate nutrition and metabolism" by Westman EC, Feinman RD, Mavropoulos JC, Vernon MC, Volek JS, Wortman JA, Yancy WS, Phinney SD.

The ketogenic diet: an underappreciated therapeutic option

The ketogenic diet is defined as a a special diet with high-fat, low-carbohydrate diet thathas been use as treatment to control seizures in some people with epilepsy.
In the review of Obesity as a epidemic proportions in Western countries and its strong risk factor for cardiovascular disease, found that most studies show that ketogenic diet or VLCKD (very low carbohydrate ketogenic diet) has a solid physiological and biochemical basis which is able to induce effective weight loss and improvement of several parameters of cardiovascular risk(1)

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(1)" [The ketogenic diet: an underappreciated therapeutic option?]." [Article in Italian]by Paoli A, Canato M, Toniolo L, Bargossi AM, Neri M, Mediati M, Alesso D, Sanna G, Grimaldi KA, Fazzari AL, Bianco A

Identifying predictive variables for long-term weight change after participation in a weight loss program

In the investigation of whether there was an association between weight change and 31 independent variables among obese persons 2 years after a weight loss program, conducted by Marshall University School of Medicine,(1) found that Of the 31 independent variables, 16 were significantly predictive of weight change. The adjusted R2 for the entire group of 16 variables was .379. Thus, 37.9% of the variance was explained by the joint efforts of the 16 variables. Eight variables with an adjusted R2 of .371 (accounting for 37.1% of the variance) were most important: feeling in control of eating habits, percentage over ideal body weight at enrollment, percentage of weight lost during the 8-week treatment, frequency of weight measurement, increase in physical activity, frequency of eating in response to emotions, number of pounds gained before subject resumed diet, and occupation

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(1) "Identifying predictive variables for long-term weight change after participation in a weight loss program" by Lavery MA, Loewy JW.

Long-term follow-up of weight status of subjects in a behavioral weight control program

In the study of examined the long-term effectiveness of behavioral weight control programs, conducted by Marshall University School of Medicine(1), researchers found that A 2-year follow-up study was designed to assess the effectiveness of a behavioral weight control program on 123 obese male and 386 obese female subjects. Following an 8-week treatment period, mean weight was 176.4 +/- 41.3 lb (no. = 509), yielding a mean weight loss of 9.2 +/- 6.4 lb. Weight change after the 8-week treatment period ranged from a loss of 37 lb to a gain of 5 lb. The 2-year follow-up study showed that mean weight of the 498 subjects was 179.8 +/- 42.9 lb, yielding a mean weight loss of 5.8 +/- 15.5 lb. Weight change ranged from a loss of 71 lb to a gain of 47 lb. After 2 years, 325 subjects (65.3%) were still below their baseline weights, 182 subjects (36.6% of the entire study group) had maintained or enhanced the weight loss achieved during treatment, and 80 subjects (16.1%) weighed at least 10% less than their baseline weight.

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(1) "Long-term follow-up of weight status of subjects in a behavioral weight control program" by

Lavery MA, Loewy JW, Kapadia AS, Nichaman MZ, Foreyt JP, Gee M.

Weight changes in a couples program

In the investigation the difference in weight changes of subjects who rated their marriages as more adjusted vs subjects who rated their marriages as less adjusted, conducted by Purdue University, West Lafayette (1),researchers found that Significantly more subjects in the unhappy group also reached ideal weight than subjects in the happy group (50% vs 7.7%). Subjects' initial MAS scores were significantly and negatively correlated with weight changes at post-treatment and follow-up; partners' MAS scores at the end of treatment were also significantly and negatively correlated to subjects' weight losses at post-treatment. None of the couples was initially maritally distressed but one couple met this criterion (MAS less than or equal to 85) by the end of treatment and follow-up

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(1) "Weight changes in a couples program: negative association of marital adjustment" by

Black DR.

Partner weight status and subject weight loss

In the examination of the difference in body changes of subjects with overweight partners and those with normal weight partners, conducted by Purdue University, West Lafayette(1), researchers found that both overweight and normal weight partners lost weight incidental to treatment but as expected, body changes of overweight partners significantly decreased over time whereas body changes of normal weight partners did not. Overweight partners and subjects lost statistical equivalent amounts of weight but there was a significant correlation at posttreatment between body changes of subjects in the overweight partner group and their partners. It was concluded that if body changes of both subjects and their overweight partners are considered, couples programs might be a cost-effective and important public health approach because two individuals lose weight as inexpensively as one and more people are treated.

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(1) "Partner weight status and subject weight loss: implications for cost-effective programs and public health" by Black DR, Threlfall WE.

Are standard behavioral weight loss programs effective for young adults

In the comparison of the enrollment, attendance, retention and weight losses of young adults in behavioral weight loss (BWL) programs with older participants in the same trials, conducted by Weight Control and Diabetes Research Center, Brown Medical School and The Miriam Hospital(1), found that Young adults represented 7% of the sample, attended significantly fewer sessions than did adults (52 vs 74%, respectively; P<0.001) and were less likely to be retained for the 6-month assessment (67 vs 95%, respectively; P<0.05). Controlling for demographic variables, study and baseline weight, the mean weight losses achieved were significantly less for young adults compared with adults (-4.3 kg (6.3) vs -7.7 kg (7.0), respectively; P<0.05); fewer young adults achieved > or =5% weight loss at 6 months compared with older participants (8/21 (38%) vs 171/277 (62%); P<0.05). After controlling for session attendance, differences in the mean weight loss were not significant (P=0.81). Controlling for baseline values, study and demographics, changes in total physical activity over the initial 6 months of treatment were less for young adults compared with adults, but these differences only approached statistical significance (P=0.07).

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(1) "Are standard behavioral weight loss programs effective for young adults?" by Gokee-LaRose J, Gorin AA, Raynor HA, Laska MN, Jeffery RW, Levy RL, Wing RR., posted in Pubmed