WeightControl.com

Weight loss, weight control and obesity research interviews from

WeightControl.com

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Substance Use Following Bariatric Weight Loss Surgery Author Interview: Alexis Conason, Psy.D.Licensed Clinical Psychologist

• WeightControl.com: What are the main findings of the study?

• Our study investigated substance use following bariatric weight loss surgery.• The main findings of our study are that participants reported an increase in composite substance use (a

measure of combined cigarette, alcohol, and recreational drug use) 2 years following weight loss surgery. Specifically, participants who underwent Roux-en-Y Gastric Bypass Surgery experienced significant increases in alcohol use 2 years after surgery.

• This study only assessed substance use, not substance abuse or substance dependence.

• WeightControl.com: Were any of the findings unexpected?

• It was interesting to find that the increase in alcohol use occurred primarily in participants who underwent the Roux-en-Y gastric bypass procedure and did not occur as strongly in participants who underwent the adjustable gastric banding procedure.

• We know from other research studies that gastric bypass surgery changes the way that the body digests alcohol.

• Patients become intoxicated more quickly with less alcohol following gastric bypass surgery. It is possible that the gastric bypass changes the reward mechanisms of alcohol following weight loss surgery.

• Read the rest of the Interview on WeightControl.com

Zonisamide for Weight Reduction in Obese AdultsA 1-Year Randomized Controlled Trial

WeightControl.com Author Interview: Kishore Gadde, MD

• WeightControl.com : What are the main findings of the study?• Zonisamide 400 mg/d plus lifestyle intervention achieved 7.3 kg weight loss after 1

year.

• WeightControl.com : Were any of the findings unexpected?• Our placebo group (lifestyle intervention plus placebo) lost 4 kg on the average.

Our lifestyle intervention consisting of half hour every month was not very intense.

• WeightControl.com : What should clinicians and patients take away from this study?

• Mild mood changes and mild memory problems occurred at a higher frequency with zonisamide than with placebo although only 4 of 75 patients dropped out due to an adverse event. The drug’s benefit-to-risk ratio needs be thoughtfully assessed when using to treat obesity.

• Read the rest of the Interview on WeightControl.com

Effects of Aerobic and/or Resistance Training on Body Mass and Fat Mass in Overweight or Obese Adults.

WeightControl.com Author Interview: Leslie Willis, MSClinical Research Coordinator Duke Medical Center – Cardiology

• WeightControl.com : What are the main findings of the study?• Our study results suggest that for fat mass reduction, aerobic training is significantly more effective than resistance training.• The aerobic training group lost on average 3.65lbs of fat in 8 months of exercise training. In contrast, the substantial

resistance training group, which completed a routine similar to the upper threshold recommended by the American College of Sports Medicine, lost an average of 0.57lbs of fat and this was not statistically different from their pre-exercise value.

• The results for the total fat mass variable are further substantiated in a previous publication from this study that showed aerobic training was more effective at reducing visceral and total abdominal fat as measured by computed tomography(Slentz et al., AJP vol301 (5)).

• Furthermore, a combined aerobic and resistance training program in this study that required double the time commitment of the aerobic-only group, did not produce statistically different results for fat mass reduction than the aerobic-only group, this suggesting that aerobic exercise could be the most time-effective method for losing fat mass.

• WeightControl.com : Were any of the findings unexpected?• The answer to this question depends on whom you ask.• Often, the lay person is told that resistance training will cause weight loss and fat loss.• The primary mechanism given for this is that resistance training increases the resting metabolic rate (RMR). While we did

not measure RMR, we would suggest that the important myth that this study debunks is that resistance training causes fat loss. We simply did not see this.

• It is possible that the more prudent way to report this for the lay public is that resistance training can improve fat percentage. However, fat percentage is simply a ratio of fat mass to lean mass and resistance training in this study improved fat percentage based solely on improvements to lean mass.

• Read the rest of the Interview on WeightControl.com

Effects of lifestyle intervention in obese pregnant women on gestational weight gain and mental health: a randomized controlled trial

WeightControl.com: Author Interview: Roland Devlieger, MD, PhD

• WeightControl.com : What are the main findings of the study?That feelings of anxiety and depression are relatively common in obese pregnant

women, and can be improved by the intensity and quality of the follow-up during pregnancy.• That an intensive specialized follow-up of obese women, including motivational

behavior coaching, will result in an improvement of their psychological well-being and that this is reflected in an important (3-4 kg) decrease in the amount of weight that they will take up during pregnancy.

• WeightControl.com: Were any of the findings unexpected?• Yes, it was known that life-style factors like diet and physical activity can be

improved during pregnancy in obese pregnant women, but psychological factors were often neglected in these intervention studies. This is the first study showing that a targeted lifestyle program for this specific group of women, based on the principles of motivational interviewing, will result in a better outcome of these pregnancies.

• Read the rest of the Interview on WeightControl.com

Overweight in singletons compared to children with siblings:the IDEFICS study WeightControl.com Author Interview: Monica Hunsberger

• WeightControl.com What are the main findings of the study? • The main finding is that children living in households without siblings

are more likely to be overweight and this could not be explained by the factors we examined, such as rewarding with food, play time outdoors, and screen time.

• WeightControl.com Were any of the findings unexpected? • We expected only children would be more overweight but it was

unexpected that the factors we thought might explain this finding were not significant despite there being differences in regards to the factors noted. For example, parents of only children reported rewarding with food more often and also reported less time spent playing outdoors.

• Read the rest of the Interview on WeightControl.com

Ghrelin Regulates the Hypothalamic-Pituitary-Adrenal Axis and Restricts Anxiety After Acute Stress

WeightControl.com Author Interview: Zane B. Andrews

• WeightControl.com: What are the main findings of the study?

• Ghrelin is a hormone that stimulates food intake. Our studies in mice show that exposure to a single acute stress increases ghrelin in order to prevent excessive anxiety.

• WeightControl.com: Were any of the findings unexpected?

• Mice need to be stressed in order for ghrelin to reduce anxiety.

• WeightControl.com: What should clinicians and patients take away from this study?

• Stress induces ghrelin (the hormone that increases food intake) to help alleviate anxiety – the elevated food intake from ghrelin may help control anxiety. This study builds on from studies by Jeff Zigman at UTSW

• Ghrelin promotes the drive for food intake and maintains blood glucose during negative energy balance as well as subserving the rewarding nature of food.

• Read the rest of the Interview on WeightControl.com

Dysfunctional Adiposity and the Risk of Prediabetes and Type 2 Diabetes in Obese Adults

Author Interview: Dr. Ian Neeland, Cardiology fellow

• WeightControl.com What are the main findings of the study?• 1. One of the greatest risk factors for developing diabetes if you are obese is

having excess visceral fat (fat stored around the body’s internal abdominal organs). On the other hand, fat stored in the thigh and buttock area may potentially be protective against diabetes.

• 2. Individuals who developed pre-diabetes and diabetes had evidence of early cardiovascular disease years before the onset of type 2 diabetes.

• WeightControl.com: Were any of the findings unexpected?• 1. At the outset of the study, we hypothesized that markers of general obesity

(e.g. body mass index, total body fat, and abdominal subcutaneous fat (fat stored in the abdomen but underneath the skin) would not be associated with the development of diabetes in obese persons, even though they are risk factors for diabetes in non-obese persons.

• This turned out to be true in our study population.• Read the rest of the Interview on WeightControl.com

Day-to-day physical functioning and disability in obese 10- to 13-year-oldsWeightControl.com Authors’ Interview:

Dr. Alison Coates Ph.D. and Dr Margarita Tsiros Ph.D

• WeightControl.com: What are the main findings of the study? • This study found that children who are obese have reduced physical functioning.• In particular, children with obesity found it more difficult to carry out everyday

tasks like climbing stairs, getting up from a chair and walking.• They also rated their own physical well-being much lower than their healthy-

weight peers and spent less time participating in community activities, including recreation and sports.

• WeightControl.com: Were any of the findings unexpected? • With the exception of community participation, we did not find any other

meaningful differences in how obese children spent their time in key areas of their lives (self-care, domestic and mobility activities) and they did not report experiencing greater physical difficulty with these activities. We think these unexpected findings could be explained in a number of ways…

• Read the rest of the Interview on WeightControl.com

Timed high-fat diet resets circadian metabolism and prevents obesityWeightControl.com Author Interview; Professor Oren Froy

• WeightControl.com: What are the main findings of the study?• We tested whether long-term (18 weeks) clock resetting by time-restricted

feeding can attenuate the disruptive effects of diet-induced obesity. Analyses included liver clock gene expression, locomotor activity, blood glucose, metabolic markers, lipids and hormones around the circadian cycle for a more accurate assessment.

• Timed HF diet led to decreased body weight, cholesterol and inflammation levels and improved insulin sensitivity compared with mice fed free HF diet. Timed HF-fed mice exhibited a better satiated and less stressed phenotype of low ghrelin and corticosterone compared with mice fed timed low-fat diet.

• WeightControl.com: Were any of the findings unexpected?• Yes, we found that same caloric intake leads to lower body weight when it’s

timed to a 4 hour window.• Read the rest of the Interview on WeightControl.com

ALDH1A Isozymes are Markers of Human Melanoma Stem Cells and Potential Therapeutic Targets.

Author Interview: Mayumi Fujita, MD, PhD

• DermatologistsBlog.com: What are the main findings of the study?• There are three major findings in this study:• 1) Aldehyde dehydrogenase (ALDH) – positive human melanoma cells are demonstrated to be cancer

stem cells (CSCs), responsible for tumor initiation, propagation, resistance to treatment and tumor recurrence after treatment.

• 2) ALDH1A isozymes (enzymes) contribute to the ALDH activity in human melanoma.• 3) ALDH isozymes are not only markers of CSCs but also therapeutic targets for human melanoma

.• DermatologistsBlog.com Were any of the findings unexpected?

• The existence of CSCs in human melanoma had been questioned because it was reported that most melanoma cells were tumorigenic.In this paper, we have confirmed that human melanoma tumors contain cells that fulfill the criteria for CSCs.

• DermatologistsBlog.com What should clinicians and patients take away from this study?• This study indicates that we have to control CSCs in addition to non-CSCs to treat human melanoma.• Read the rest of the Interview on WeightControl.com

Morbidity patterns among the underweight, overweight and obese between 2 and 18 years: population-based cross-sectional analysesAuthor Interview: Dr Susan Clifford BSc(Hons) PhD

• WeightControl.com: What are the main findings of the study?• From previous studies, we have a fragmented picture of how health comorbidities are associated with

body mass index (BMI) in children of different ages. Our study looked at the physical health, mental health and health care needs of 11,000 underweight, normal weight, overweight and obese Australian children aged 2-18 years old.

• Our study confirms that overweight and obese older children and adolescents report poorer global health, more primary health-care needs and higher prevalence of wheeze and asthma than children of normal weight. A new finding of this study was that while obese children experience lower health-related quality of life than their normal weight peers, this association is weak or absent in very young children, emerges convincingly only in the school years, and then steadily strengthens with age

• Among pre-school aged children, those who are underweight have poorer health than those who are normal weight, overweight and obese.

• WeightControl.com: Were any of the findings unexpected?• The health of underweight children and adolescents who do not have disordered eating is under-

studied. We looked at this and were surprised to find that underweight school-aged children and adolescents were physically among the healthiest in their age groups.

• Nonetheless, normal weight children experienced the best overall psychosocial and mental health outcomes.

• Read the rest of the Interview on WeightControl.com

Self-Monitoring and Eating-Related Behaviors Are Associated with 12-Month Weight Loss in Postmenopausal Overweight-to-Obese WomenAuthor Interview: Angela Kong, PhD, MPH, RD

• WeightControl.com : What are the main findings of the study?• In our study, more frequent food journal use predicted greater weight loss

at 12 months, whereas skipping meals and eating out for lunch at least weekly were associated with less weight loss.

• WeightControl.com : Were any of the findings unexpected?• While we expected more frequent food journal use to be associated with

greater weight loss, we were somewhat surprised to see how big a difference it made.

• WeightControl.com : What should clinicians and patients take away from this study?

• Basic strategies such as maintaining food journals, eating out less, and eating at regular intervals are simple tools patients can use to lose weight more successfully.

• Read the rest of the Interview on WeightControl.com

Time-of-day and nutrient composition of eating occasions: prospective association with the metabolic syndrome in the 1946 British birth cohortAuthor Interview Suzana Al Moosawi

• WeightControl.com: What are the main findings of the study?• We have long known that metabolic processes in living organisms follow circadian rhythms

– in other words, their level of function varies with time of day. Circadian rhythms are regulated by internal biological clocks that dictate periods of rest and activity in all living organisms from plants to humans. Eating behaviour like other physiological process follows a circadian rhythm.

• However, it is only until recently that we began to realise that the time of eating could impact human health. In the current study we observed that increasing carbohydrate intake at breakfast at the expense of fat could protect against long-term development of the metabolic syndrome and its individual components, such as abdominal obesity, and therefore may be protective against the development of diabetes

• WeightControl.com: Were any of the findings unexpected?• The results were in line with some earlier studies on shift workers that have shown that

shift workers are at a higher risk of developing metabolic disorders, like diabetes. Nonetheless, our findings are exciting as they are unveiling novel aspects of diet and eating behaviour that have been largely unexplored to date.

• Read the rest of the Interview on WeightControl.com

Race, Place, and Obesity: The Complex Relationships Among Community Racial/Ethnic Composition, Individual Race/Ethnicity, and Obesity in the United States

WeightControl.com Author Interview: James B. Kirby, PhD

• WeightControl.com? What are the main findings of the study?• The racial and ethnic composition of a community is associated with the

obesity rates of individuals living within the community. Specifically, we find that living in communities with a high Hispanic concentration is associated with an elevated risk of obesity for both Hispanics and Whites. Additionally, the study found that living in communities with a high concentration of Asians is associated with a lower risk of obesity of Whites, though there is no association found among fellow Asians. Until further study, we do not have an explanation for these findings.

• WeightControl.com? Were any of the findings unexpected? • What we don’t find is as important as what we do find. Though Blacks have

the highest rate of obesity, living in a community with a high concentration of Blacks is not associated with the risk of obesity, even for Blacks themselves.

• Read the rest of the Interview on WeightControl.com

Mu-Opioid Receptors and Dietary Protein Stimulate a Gut-Brain Neural Circuitry Limiting Food IntakeAuthor Interview: Dr. Gilles Mithieux

• WeightControl.com: What are the main findings of the study? • When protein are digested, peptides produced may inhibit mu-opioide

receptors present in the nervous system of the portal vein walls. This sends a ascending message to the brain, which responds by sending a descending message to the gut, which induces glucose production by the gut.

• Glucose is then detected by a specific glucose sensor (present in other nerve types), which in turn transmits a second ascending message to the brain (this second signal curbs hunger).WeightControl.com: Were any of the findings unexpected?

• The role of MOR in the portal vein was unexpected, to initiate this gut-brain circuitry curbing hunger as a final point. Mor were known to influence food intake in the brain only.

• Read the rest of the Interview on WeightControl.com

Weight Loss Can Lead to Resolution of Gastroesophageal Reflux Disease Symptoms: A Prospective Intervention Trial

Author Interview: Dr. Prateek Sharma, MD

• WeightControl.com: What are the main findings of the study?• In obese and overweight subjects, undergoing weight loss

through a structured program, reduction of weight leads to a significant improvement in their acid reflux symptoms.

• WeightControl.com: Were any of the findings unexpected?• More than 40% of obese/overweight subjects complained of

acid reflux and heartburn symptoms – this was not a complaint that they were discussing with their doctors but on being queried, they responded in the affirmative and these symptoms were impacting their quality of life.

• Read the rest of the Interview on WeightControl.com

Prevention of Weight Gain Following a Worksite Nutrition and Exercise Program: A Randomized Controlled TrialAuthor Interview: Anne Needham Thorndike MD

• WeightControl.com: What are the main findings of the study?• We found that an intensive 10-week worksite exercise and nutrition

program resulted in moderate weight loss and changes in exercise and nutrition habits at one year follow-up, but employees who were randomly assigned to an Internet-based maintenance program immediately following the 10-week program did not have better outcomes than employees who were not assigned to the maintenance program.

• WeightControl.com: Were any of the findings unexpected?• The findings were not what we expected. We thought the maintenance

program, which could be used at either work or home, would result in better weight loss outcomes than usual care.

• Read the rest of the Interview on WeightControl.com

Low carbohydrate-high protein diet and incidence of cardiovascular diseases in Swedish women: prospective cohort study

Pagona Lagiou, MD, PhD

• WeightControl.com: What are the main findings of the study?• Women who regularly eat a low carbohydrate-high protein diet are in

the long term at greater risk of cardiovascular disease (such as heart disease and stroke) than those who do not.

• WeightControl.com: Were any of the findings unexpected?• Not really. Some, but not all, earlier and generally smaller studies had

pointed to the same direction.• Moreover, low carbohydrate-high protein diets may in many

instances imply reductions in the consumption of fruits, whole grain cereals, vegetables and pulses, and increases in red and processed meat intake – all these have been reported to increase cardiovascular disease risk.

• Read the rest of the Interview on WeightControl.com

Eating disorder symptoms and weight and shape concerns in a large web-based convenience sample of women ages 50 and above: Results of the gender and body image (GABI) study

Author Interview: Cynthia Bulik, PhD

• WeightControl.com: What should clinicians and patients take away from this study?• The most important take home message for clinicians is to keep eating disorders on

your radar screen regardless of the age of the patient—this means anorexia nervosa, bulimia nervosa, binge eating disorder, as well as symptoms of these disorders if a person does not meet full diagnostic criteria. Eating disorders are stigmatized at any age, but many adult women are especially hesitant to bring up their eating disorder with their health care providers for fear of being told that they should have grown out of it, or that it is a young person’s disorder. Clinicians need to be sensitive to this and to consider the possibility of eating disorders regardless of the age of the patient.

• Feedback from this study has been overwhelming from women over 50 with eating disorder symptoms who feared they were alone. These results have busted the stereotype that these are problems that afflict only the young. When seeking treatment, women should ask what special provisions programs have to address the unique features of eating disorders in midlife and beyond (e.g., impact on marriage or partnership, impact on children, impact on work, physical effects).

• Read the rest of the Interview on WeightControl.com

Eating disorder symptoms and weight and shape concerns in a large web-based convenience sample of women ages 50 and above: Results of the gender and body image (GABI) study

Author Interview: Cynthia Bulik, PhD

• WeightControl.com: What should clinicians and patients take away from this study?• The most important take home message for clinicians is to keep eating disorders on

your radar screen regardless of the age of the patient—this means anorexia nervosa, bulimia nervosa, binge eating disorder, as well as symptoms of these disorders if a person does not meet full diagnostic criteria. Eating disorders are stigmatized at any age, but many adult women are especially hesitant to bring up their eating disorder with their health care providers for fear of being told that they should have grown out of it, or that it is a young person’s disorder. Clinicians need to be sensitive to this and to consider the possibility of eating disorders regardless of the age of the patient.

• Feedback from this study has been overwhelming from women over 50 with eating disorder symptoms who feared they were alone. These results have busted the stereotype that these are problems that afflict only the young. When seeking treatment, women should ask what special provisions programs have to address the unique features of eating disorders in midlife and beyond (e.g., impact on marriage or partnership, impact on children, impact on work, physical effects).

• Read the rest of the Interview on WeightControl.com