Effects of Lifestyle Activity vs Structured Aerobic Exercise in Obese Women&lt;SUBTITLE&gt;A Randomized Trial&lt;/SUBTITLE&gt;

Andersen, Ross E.; Wadden, Thomas A.; Bartlett, Susan J.; Zemel, Babette S.; Verde, T. J.; Franckowiak, Shawn C.

doi:10.1001/jama.281.4.335

Cited by 578 publications

(336 citation statements)

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“…23,24 However, exercise training appears to be an important component for weight loss and, therefore, should be encouraged in obese patients with coronary heart disease because it produces favourable effects on lipid profile, glucose levels and blood pressure, as well as associated cardiovascular risk. 25,26 Another limitation is that angiographically visible collaterals represent only a fraction of the total collateral vessels as collaterals are angiographically demonstrable only when they reach 100 mm. However, this limitation influences the collateral score of both groups to the same extent and does not change the interpretation of the results.…”

Section: Discussionmentioning

confidence: 99%

Obesity is associated with impaired coronary collateral vessel development

et al. 2003

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BACKGROUND: Chronic myocardial ischaemia due to coronary artery stenosis or occlusion has been shown to increase the growth of coronary collateral circulation. Collateralization leads to increased oxygen delivery to the area at risk and hence may reduce ischaemia, prevent infarction and preserve contractile function. However, there is considerable variation among patient subsets in terms of the presence or degree of collateralization. We aimed to evaluate the relationship between obesity and coronary collateral development in patients with ischaemic heart disease. METHODS AND RESULTS:In all, 215 patients (mean age, 57.878.9 y) with body mass index (BMI)Z30 kg/m 2 were enrolled into our study. A total of 90 age-and sex-matched patients (mean age, 58.7710 y) with BMIo25 kg/m 2 and significant coronary artery disease were selected as a control group. The mean age and distribution of risk factors for coronary heart disease were not significantly different between two groups other than poorer HDL cholesterol and triglyceride profile in obese patients. The mean BMI was significantly higher in the patient group (33.372.4 vs 22.871.7, Po0.001). The mean number of diseased vessels and maximum lesion severity were not significantly different between the two groups. The mean Rentrop collateral score of the patient group was significantly worse than the control group (1.0870.68 vs 2.1070.72, Po0.001). CONCLUSIONS: Our findings suggest that collateral vessel development is poorer in obese patients (defined as BMIZ30 kg/m 2 ) with ischemic heart disease compared to normal range BMI, and the risk of having poor collateral vessel development is significantly increased. However, this might be reflecting the cluster of risk factors, associated with metabolic syndrome, in which insulin resistance plays a major role.

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Section: Discussionmentioning

confidence: 99%

Obesity is associated with impaired coronary collateral vessel development

et al. 2003

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“…Post hoc analyses of several studies revealed the benefits of this higher goal (Andersen et al, 1999;Jakicic et al, 1999;Jeffery, Wing, Thorson, & Burton, 1998). Similarly, participants in the National Weight Control Registry, who had lost at least 14 kg and kept it off for 1 year, reported that they expended approximately 2,800 kcal/week (Klem, Wing, McGuire, Seagle, & Hill, 1997).…”

Section: Group Behavioral Treatmentmentioning

confidence: 99%

Obesity: Responding to the global epidemic.

Wadden¹,

Brownell²,

Foster³

2002

Journal of Consulting and Clinical Psychology

438

328

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Obesity has reached epidemic proportions in the United States and other developed nations. In the United States, 27% of adults are obese and an additional 34% are overweight. Research in the past decade has shown that genetic influences clearly predispose some individuals to obesity. The marked increase in prevalence, however, appears to be attributable to a toxic environment that implicitly discourages physical activity while explicitly encouraging the consumption of supersized portions of high-fat, high-sugar foods. Management of the obesity epidemic will require a two-pronged approach. First, better treatments, including behavioral, pharmacologic, and surgical interventions, are needed for individuals who are already obese. The second and potentially more promising approach is to prevent the development of obesity by tackling the toxic environment. This will require bold public policy initiatives such as regulating food advertising directed at children. The authors call not for the adoption of a specific policy initiative, but instead propose that policy research, based on viewing obesity as a public health problem, become a central focus of research.Research on obesity has increased exponentially during the past decade and has yielded remarkable discoveries in the regulation of body weight. This same period, however, has witnessed an unparalleled increase in the prevalence of obesity, making it one of our nation's most pressing health problems. This article reviews the epidemiology and complications of obesity and the factors that have contributed to its sharp increase. Consistent with previous reviews, we examine advances in treatment including behavioral, pharmacologic, and surgical interventions (Brownell, 1982;Brownell & Wadden, 1992). Advances in treatment, however, must be complemented in the next decade by innovative public policy designed to prevent the development of obesity. Epidemiology and Complications of ObesityObesity refers to an excess of body fat, which normally accounts for about 25% of weight in women and 18% in men (Bray, 1998). Body fat can be measured by a number of methods but is now usually estimated by the body mass index (BMI), which is calculated as weight in kilograms divided by height in meters squared (i.e., kg/m 2 ; Bray, 1998). (Figure 1 provides for this calculation using pounds and inches.) The BMI is highly correlated with measures of body fat and has replaced the more traditional measure of percentage over ideal weight (VanItallie & Lew, 1992).The World Health Organization (WHO; 1998) has defined obesity as a BMI Ն 30 kg/m 2 , as has the National Institutes of Health/National Heart, Lung, and Blood Institute (NIH/NHLBI; 1998). By this criterion, in 1994 (the last period for which most complete analyses are available), 25% of U. S. women and 20% of men were obese (Flegal, Carroll, Kuczmarski, & Johnson, 1998). An additional 25% and 39%, respectively, were considered overweight, defined as a BMI of 25.0 to 29.9 kg/m 2 . Thus, 55% of adult Americans were either overweight or...

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“…The LEARN Program for Weight Management, 10 th Edition (Brownell, 2004) is popular with both clinicians and participants and is often employed in university-based clinics (Andersen et al, 1999;Foster et al, 2003;Womble et al, 2004). LEARN stands for lifestyle, exercise, attitudes, relationships, and nutrition.…”

Section: Treatment Protocols Learnmentioning

confidence: 99%

The use of motivational interviewing techniques to enhance the efficacy of guided self-help behavioral weight loss treatment

et al. 2009

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This study assessed whether motivational interviewing (MI), applied as part of a standard guided self-help (GSH) behavioral weight loss treatment, reduced attrition rate and improved participant weight loss and other eating-related and general psychological measures. The study also included assessments based on two theories of motivated behavior, to assess whether these measures predicted treatment outcome and whether MI increased participant motivation. Thirty-nine overweight patients (7 males, 32 females) were randomized to receive either 6 sessions of traditional GSH and 2 traditional motivation-focused sessions (GSH); or 6 GSH sessions and 2 sessions utilizing an MI

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Effects of Lifestyle Activity vs Structured Aerobic Exercise in Obese Women<SUBTITLE>A Randomized Trial</SUBTITLE>

Abstract: A program of diet plus lifestyle activity may offer similar health benefits and be a suitable alternative to diet plus structured aerobic activity for obese women.

Cited by 578 publications

References 14 publications

Obesity is associated with impaired coronary collateral vessel development

Obesity is associated with impaired coronary collateral vessel development

Obesity: Responding to the global epidemic.

The use of motivational interviewing techniques to enhance the efficacy of guided self-help behavioral weight loss treatment

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