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Goldstein M.,Macquarie University | Peters L.,Macquarie University | Baillie A.,Macquarie University | McVeagh P.,Eating Disorders Unit | And 2 more authors.
International Journal of Eating Disorders | Year: 2011

Objective: The risks of anorexia nervosa (AN) are well established. Despite its severity, little certainty exists for practitioners, with ethical and financial limitations yielding few controlled studies establishing effective treatments. Thus, other methods of establishing treatment effectiveness are necessary. This study presents preliminary results of an open clinical trial of a day program for adolescents with AN. Method: Participants were 26 anorectic females, 12-18 years, who completed the "Transition Program." Results: Significant change emerged on measures of weight gain, and behavioral and attitudinal measures of eating pathology. Large effect sizes were evident for weight gain at 6 month follow-up. Preliminary trends suggest that treatment gains on these and other measures of eating pathology were maintained at 6 month follow-up. Discussion: Preliminary results support day program treatment for adolescents with mild-moderately severe eating disorders. Present outcomes are discussed with respect to the dearth of efficacious treatment options for adolescents. © 2010 by Wiley Periodicals, Inc. Source


O'Malley E.,Weight Management Service | Ahern T.,Weight Management Service | Ahern T.,Park University | Dunlevy C.,Weight Management Service | And 4 more authors.
QJM | Year: 2015

Background: People with severe obesity (body mass index [BMI] > 40 kg/m2) have an 85% higher mortality than people with a healthy BMI. Poor physical function may contribute to this excess mortality. Lymphoedema-like swelling can affect the legs of severely obese people with normal lymphoscintigraphy. Aim: We sought to determine the relationship between the presence of lymphoedema-like swelling and physical function in the severely obese. Design and Methods: In people with severe obesity, we ascertained whether lower leg lymphoedemalike swelling was present and determined the circumference of the lower leg, time taken to ascend and descend a 17-cm step 50 times and time taken to walk 500 m. Results: The 330 participants, 33% of whom were male, were aged 43.4±12.7 years (mean±standard deviation) and had a BMI of 51.7±8.4 kg/m2. Lymphoedema-like swelling was present in approximately one-third (n = 108) in whom a prior history of cellulitis and venous thromboembolism was more common (relative risks 6.16 and 3.86, respectively) than in those without lymphoedemalike swelling. Participants with lymphoedema-like swelling, compared with non-affected counterparts, had a higher lower leg circumference (35.0±7.1 vs. 32.4±4.8 cm), a slower step speed (0.40±0.12 vs. 0.43±0.10 steps/s) and a slower walking speed (0.97±0.37 vs. 1.08±0.30 m/s, P<0.05 for all comparisons). Conclusions: In this cross-sectional study, 33% of our severely obese participants had lymphoedemalike swelling. Participants with lymphoedema-like swelling had worse physical function than those without. This association was independent of BMI. The presence of obesity-related chronic lymphoedema- like swelling should lead to interventions that improve physical function. © The Author 2014. Source


Ahern T.,Weight Management Service | Ahern T.,St Vincents University Hospital | Ahern T.,Park University | Khattak A.,Weight Management Service | And 13 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2014

Context: Mortality is 85% higher in severely obese subjects (body mass index [BMI] > 40 kg/m2) than in subjects with a healthy BMI; poor physical function may be contributory. Hypovitaminosis D is common in obese subjects and is associated with physical dysfunction in the elderly. Objective: We determined the relationship between vitamin D status and physical function in severely obese subjects. Design, Setting, and Patients: We conducted a clinic-based, cross-sectional study of severely obese subjects. Participants were stratified into three groups according to the Institute of Medicine (IOM) vitamin D status categorization. Main Outcome Measures: We compared levels of self-reported activity and times taken to walk 500 m and to ascend and descend a 17-cm step 50 times. Results: We recruited 252 subjects (age, 43.7 ± 11.2 y; BMI, 50.7 ± 9.7 kg/m2); 25-hydroxyvitamin D (25OHD) concentrations were less than 30 nmol/L in 109 participants. Participants with a 25OHD > 50 nmol/L, compared to those with a 25OHD < 30 nmol/L, had the highest activity levels (3.1 ± 3.4 h/wk versus 1.5 ± 2.5 h/wk; P = .015) and the shortest 500-m walk times (6.2 ± 1.1 min versus 7.4 ± 1.5 min; P = .003). Serum 25OHD concentrations had a weakly positive association with activity level (r = 0.19; P = .008) and a moderately negative association with 500-m walk time (r = -0.343; P < .001). Conclusions: Vitamin D status had a significant relationship with physical activity and physical function in this cohort of severely obese subjects. Low activity levels are likely to perpetuate the problem of hypovitaminosis D due to less time spent outdoors. Studies exploring the effects of vitamin D supplementation in this population are warranted. Copyright © 2014 by the Endocrine Society. Source

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