WeightControl.com - Obesity and Weight Control Research Interviews

WeightControl.com

Weight loss, weight control and
obesity research interviews from
WeightControl.com

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Read more interviews on Hemodialysis.com

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 Adults
A 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.

Effects of Aerobic and/or Resistance Training on Body Mass and Fat Mass in
Overweight or Obese Adults.
WeightControl.com Author Interview: Leslie Willis, MS
Clinical Research Coordinator Duke Medical Center – Cardiology

• 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.
• 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.

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

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.
• 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.

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.

Ghrelin Regulates the Hypothalamic-Pituitary-Adrenal Axis an
d Restricts Anxiety After Acute Stress
WeightControl.com Author Interview: Zane B. Andrews


• 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.


• 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.


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.
• 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.

Day-to-day physical functioning and disability in obese 10- to 13-year-olds
WeightControl.com Authors’ Interview:
Dr. Alison Coates Ph.D. and Dr Margarita Tsiros Ph.D

• 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.
• 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…

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

• 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.
• Yes, we found that same caloric intake leads to lower body weight when
it’s timed to a 4 hour window.

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.

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

• 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.
• 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.

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

• 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.
• 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.

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

• 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
• 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.

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.

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

• 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.

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.
• 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.

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

• 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.
• 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.


Low carbohydrate-high protein diet and incidence of cardiovascular diseases in Swedish women:
prospective cohort study
Pagona Lagiou, MD, PhD

• 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.
• 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.

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).

WeightControl.com - Obesity and Weight Control Research Interviews

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