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Attiah M.A.,Center for Functional and Restorative Neurosurgery | Halpern C.H.,Center for Functional and Restorative Neurosurgery | Balmuri U.,Center for Functional and Restorative Neurosurgery | Vinai P.,GNOSIS Research Group | And 5 more authors.
Annals of Surgery | Year: 2012

OBJECTIVE: The present meta-regression pools data from reports of long-term follow-up (>2 years) to assess durability of the efficacy associated with Roux-en-Y gastric bypass (RYGB) surgery. DATA SOURCES: Medline and PubMed searches for articles pertaining to long-term weight loss after RYGB surgery were performed. BACKGROUND; Various studies have consistently shown short-term (<2 years) efficacy of RYGB surgery for morbid obesity, corroborated by meta-analytic techniques. Relatively few studies have assessed efficacy over longer periods of time. This is the first meta-analysis to analyze long-term effects of RYGB surgery on weight loss. METHODS: Twenty-two reports with a total of 4206 patient cases were included. Sixteen of the 22 studies had multiple follow-up times, ranging from 2 to 12.3 years (mean: 3.6 years). An inverse variance weighted model and meta-regression were used to generate the pooled percent mean excess weight loss (EWL) and the durability of EWL over time, respectively. RESULTS: Meta-regression did not reveal any significant change in EWL over time. Pooled mean EWL was 66.5%, and there was no significant association between EWL and length of follow-up. CONCLUSIONS: Pooling data from multiple studies meta-analytically revealed that weight loss after RYGB is maintained over the long-term. Further investigation would be necessary to ascertain similar durability in comorbidity reduction after RYGB surgery. © 2012 Lippincott Williams & Wilkins, Inc.


Bellani M.,University of Verona | Baiano M.,Center for Weight and Eating Disorders | Paolo B.,University of Udine | Paolo B.,Scientific Institute E Medea
Epidemiologia e Psichiatria Sociale | Year: 2010

Here we briefly summarize the most consistent structural MRI studies on hippocampus in major depression and debate the effects of clinical variables on hippocampal morphology.


Bellani M.,University of Verona | Baiano M.,Center for Weight and Eating Disorders | Brambilla P.,University of Udine | Brambilla P.,Ircss E Medea Scientific Institute
Epidemiology and Psychiatric Sciences | Year: 2011

Here, we briefly summarize the most consistent structural magnetic resonance imaging (MRI) studies on amygdala in major depression and debate the effects of clinical variables on amygdalar morphology. © Cambridge University Press 2011.


Foster G.D.,Temple University | Wyatt H.R.,University of Colorado at Denver | Hill J.O.,University of Colorado at Denver | Makris A.P.,45 Morning Glory Way | And 11 more authors.
Annals of Internal Medicine | Year: 2010

Background: Previous studies comparing low-carbohydrate and low-fat diets have not included a comprehensive behavioral treatment, resulting in suboptimal weight loss. Objective: To evaluate the effects of 2-year treatment with a low-carbohydrate or low-fat diet, each of which was combined with a comprehensive lifestyle modification program. Design: Randomized parallel-group trial. (ClinicalTrials.gov registration number: NCT00143936) Setting: 3 academic medical centers. Patients: 307 participants with a mean age of 45.5 years (SD, 9.7 years) and mean body mass index of 36.1 kg/m2 (SD, 3.5 kg/m2). Intervention: A low-carbohydrate diet, which consisted of limited carbohydrate intake (20 g/d for 3 months) in the form of low-glycemic index vegetables with unrestricted consumption of fat and protein. After 3 months, participants in the low-carbohydrate diet group increased their carbohydrate intake (5 g/d per wk) until a stable and desired weight was achieved. A low-fat diet consisted of limited energy intake (1200 to 1800 kcal/d; ≤30% calories from fat). Both diets were combined with comprehensive behavioral treatment. Measurements: Weight at 2 years was the primary outcome. Secondary measures included weight at 3, 6, and 12 months and serum lipid concentrations, blood pressure, urinary ketones, symptoms, bone mineral density, and body composition throughout the study. Results: Weight loss was approximately 11 kg (11%) at 1 year and 7 kg (7%) at 2 years. There were no differences in weight, body composition, or bone mineral density between the groups at any time point. During the first 6 months, the low-carbohydrate diet group had greater reductions in diastolic blood pressure, triglyceride levels, and very-low-density lipoprotein cholesterol levels, lesser reductions in low-density lipoprotein cholesterol levels, and more adverse symptoms than did the low-fat diet group. The low-carbohydrate diet group had greater increases in high-density lipoprotein cholesterol levels at all time points, approximating a 23% increase at 2 years. Limitation: Intensive behavioral treatment was provided, patients with dyslipidemia and diabetes were excluded, and attrition at 2 years was high. Conclusion: Successful weight loss can be achieved with either a low-fat or low-carbohydrate diet when coupled with behavioral treatment. A low-carbohydrate diet is associated with favorable changes in cardiovascular disease risk factors at 2 years. Primary Funding Source: National Institutes of Health. © 2010 American College of Physicians.


Xanthopoulos M.S.,Childrens Hospital of Philadelphia | Xanthopoulos M.S.,Center for Weight and Eating Disorders | Moore R.H.,Center for Weight and Eating Disorders | Moore R.H.,University of Pennsylvania | And 5 more authors.
Journal of Pediatric Psychology | Year: 2013

Objective The relationship between weight change in caregivers and their adolescents was evaluated following a randomized trial of lifestyle modification for adolescents, which included either a conventional diet or meal replacements. Methods Adolescents (N = 113) had an M ± SD age of 15.0 ± 1.3 years (62% African American; 26% Caucasian, 12% other; 81% female) and body mass index of 37.1 ± 5.1 kg/m2. Results Mixed effects models yielded a significant association between percentage change in body mass index of caregivers and adolescents from baseline to months 4 and 12 (p =. 01). When caregivers lost above the median (-1.67%) at month 4, their adolescents achieved a significantly greater loss at month 12 (-9.1 ± 1.3%) compared with adolescents whose caregivers lost less than the median (-4.3 ± 1.3%) (p =. 003). Conclusion Engaging caregivers in their own weight loss efforts during adolescent weight loss treatment may improve adolescent weight loss. © 2013 The Author.

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