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Medical Indications for Weight Reduction

  • Charles P. Lucas
Part of the Sports Medicine and Health Science book series (SMHS)

Abstract

Men and women who are above average weight have an increased likelihood of dying at a younger age than people of average weight. Table 1, taken from the 1979 Build and Blood Pressure Study of the Society of Actuaries [1], describes this relationship, constructed from data on nearly 100,000 insured deaths. Men in the bracket 15% below to 5% above average weight have a relative risk less than the population average of 100. Between 15–25% above average weight, the risk for men is 117, rising to 186 when weight is 55–65% above average. For women who weigh 15% below to 5% above average, the risk is also less than 100, while in the group 45–55% above average weight, the risk increases to 130. These data thus indicate that men are more adversely affected by obesity than women.

Keywords

Insulin Resistance Weight Reduction Insulin Binding Medical Indication Fasting Hyperglycemia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Build and Blood Pressure Study, 1979. Chicago, Society of Actuaries and Association of Life Insurance Medical Directors of America, pp. 1–255, 1980.Google Scholar
  2. 2.
    Sorlie, P., Gordon, T., and Kannel, W. B. Body Build and Mortality, The Framingham Study. JAMA. 243:1828, 1980.PubMedCrossRefGoogle Scholar
  3. 3.
    Build and Blood Pressure Study, 1959. Chicago, Society of Actuaries and Association of Life Insurance Medical Directors of America, pp. 1–268, 1959.Google Scholar
  4. 4.
    Kleinbaum, D. G., Kupper, L. L., Cassel, J. C., et al. Multi-variate analysis of risk of coronary artery disease in Evans County, Georgia. Arch. Intern. Med. 128:943, 1971.PubMedCrossRefGoogle Scholar
  5. 5.
    Paul, O., Lepper, M. H., Phelaw, W. H., et al. A longitudinal study of coronary heart disease. Circulation 28:10, 1963.CrossRefGoogle Scholar
  6. 6.
    Kagan, A., Gordon, T., Rhoades, G. G., et al. Some factors related to coronary heart disease incidence in Honolulu Japanese men: The Honolulu Heart Study. Int. J. Epidemiol. 4:271, 1975.CrossRefGoogle Scholar
  7. 7.
    Garrison, R. J., Wilson, P. W., Castelli, W. P., et al. Obesity and lipoprotein cholesterol in the Framingham offspring study. Metabolism 29:1055, 1980.CrossRefGoogle Scholar
  8. 8.
    Kannell, E. B., Castelli, W. P., and Gordon, T. Cholesterol in the prediction of arteriosclerotic disease. Ann. Intern. Med. 90:85, 1979.Google Scholar
  9. 9.
    DeFronzo, R., Ferrannini, E., and Koivisto, V. New concepts in the pathogenesia and treatment of diabetes mellitus. Proceedings of a Symposium: The role of insulin resistance in the pathogenesis and treatment of noninsulin dependent diabetes mellitus. Am. J. Med. 74:52, 1983.CrossRefGoogle Scholar
  10. 10.
    Kosaka, K., Hagura, E., and Kuzuya, T. Insulin response in equivocal and definite diabetes, with special reference to subjects who had mild glucose intolerance but later developed definite diabetes. Diabetes 26:944, 1977.PubMedGoogle Scholar
  11. 11.
    Himsworth, H. P, and Kerr, R. B. Insulin-sensitive and insulin-insensitive types of diabetes mellitus. Gin. Sci. 4:120, 1942.Google Scholar
  12. 12.
    Alford, R. P., Martin, F. L., and Pearson, M. J. The significance of interpretation of mildly abnormal oral glucose tolerance. Diabetologia 7:173, 1971.PubMedCrossRefGoogle Scholar
  13. 13.
    Butterfield, W. J. H., and Whichelow, M. J. Peripheral glucose metabolism in control subjects and diabetic patients during glucose, glucose-insulin and insulin sensitivity tests. Diabetologia 1:43, 1965.CrossRefGoogle Scholar
  14. 14.
    Jackson, R. A., Perry, G. Rogers, J., Advani, U., and Pikington, T. R. Relationship between the basal glucose concentration, glucose tolerance and forearm glucose uptake in maturity-onset diabetes. Diabetes 22:751, 1973.PubMedGoogle Scholar
  15. 15.
    Jackson, R. A., Peters, N., Advani, U., et al. Forearm glucose uptake during oral glucose tolerance test in normal subjects. Diabetes 22:442, 1973.PubMedGoogle Scholar
  16. 16.
    Zierler, K. L., and Pabinowitz, D. Roles of insulin and growth hormone, based on studies of forearm metabolism in man. Medicine 42:385, 1963.PubMedCrossRefGoogle Scholar
  17. 17.
    Reaven, G. M., Bernstein, R., Davis, B., and Olefsky, J. M. Nonketotic diabetes mellitus; insulin deficiency or insulin resistance? Am. J. Med. 60:80,1976.PubMedCrossRefGoogle Scholar
  18. 18.
    Permutt, A., Chirgwin, J., Giddings, S., Kakita, K., and Rotwein, P. Insulin biosynthesis and diabetes mellitus. Clin. Biochem. 14:230, 1981.PubMedCrossRefGoogle Scholar
  19. 19.
    DeFronzo, R. A., Soman, V., Sherwin, R. S., Hendler, R., and Felig, P. Insulin binding to monocytes and insulin action in human obesity, starvation, and refeeding. J. Clin. Invest. 62:204, 1978.CrossRefGoogle Scholar
  20. 20.
    Kolterman, O. G., Insel, J., Saekow, M., and Olefsky, J. M Mechanism of insulin resistance in human obesity. J. Clin. Invest. 65:1272, 1980.PubMedCrossRefGoogle Scholar
  21. 21.
    Holloszy, J. O., and Narahara, H. T. Enhanced permeability to sugar associated with muscle contraction, studies on the role of Ca++. J. Gen. Physiol. 50:551, 1967.PubMedCrossRefGoogle Scholar
  22. 22.
    Richter, E., Garetto, L. P., Goodman M. N., and Ruderman B. Muscle glucose metabolism following exercise in the rat: increased snesitivity to insulin. J. Clin. Invest. 69:785, 1982.PubMedCrossRefGoogle Scholar
  23. 23.
    Zierler, K. L., and Rabinowitz, D. Roles of insulin and growth hormone, based on studies of forearm metabolism in man. Medicine 42: 285, 1963.CrossRefGoogle Scholar
  24. 24.
    DeFronzo, R. A., Simonson, D., and Ferrannini, E. Hepatic and peripheral insulin resistance: a common feature in non-insulin dependent and insulin dependent diabetes. Diabetologia 23:313, 1982.Google Scholar
  25. 25.
    Olefsky, J. M., and Reaven, G. M. Insulin binding in diabetes. Relationship with plasma insulin levels and insulin sensitivity. Diabetes 26:680, 1977.PubMedGoogle Scholar
  26. 26.
    Kolterman, O. G., Gray, R. S., Griffin, J., et al. Receptor and postreceptor defects contribute to the insulin resistance in non-insulin dependent diabetes mellitus. J. Clin. Invest. 68:957, 1981.PubMedCrossRefGoogle Scholar
  27. 27.
    Scarlett, J. A., Gray, R. S., Griffin, J., Olefsky, J. M., and Kilterman, O. G. Insulin treatment reverses insulin resistance of type II diabetes mellitus. Diabetes Care 5:353, 1982.PubMedGoogle Scholar
  28. 28.
    Savage, P. J., Bennion, L. J., Flock, E. V., et al. Diet induced improvement of abnormalities in insulin and glucagon secretion and in insulin receptor binding in diabetes mellitus. J. Clin. Endocrinal. and Metab. 48:999, 1979.CrossRefGoogle Scholar
  29. 29.
    Genuth, S. M., Vertes, V., and Hazelton, I. Supplemental fasting in the treatment of obesity. In G. Bray (ed.), Recent Advances in Obesity Research. II. John Libbey and Co. Ltd., London, pp. 370–378, 1978.Google Scholar
  30. 30.
    Brunzell, J. D., Lerner, R. L., Porte, D. Jr., and Bierman, E. L. Effect of a fat free, high carbohydrate diet on diabetic subjects with fasting hyperglycemia. Diabetes 23:138, 1974.PubMedGoogle Scholar
  31. 31.
    Wall, J. R., Payke, D. A., and Oakly, W. F. Effect of carbohydrate restriction in obese diabetics: relationship of control to weight loss. Br. Med. J. 1:577, 1973.PubMedCrossRefGoogle Scholar
  32. 32.
    Crapo, P. F., Kolterman, O. G., and Olefsky, J. M. Effects of oral fructose in normal, diabetic and impaired glucose tolerance subjects. Diabetes Care 3:575, 1980.PubMedCrossRefGoogle Scholar
  33. 33.
    Crapo, P. A., Reaven, G., and Olefsky, J. M. Plasma glucose and insulin responses to orally administered simple and complex carbohydrates. Diabetes 25:741, 1976.PubMedCrossRefGoogle Scholar
  34. 34.
    Akgum, S., and Ertel, N. H. A comparison of carbohydrate metabolism after sucrose, sorbitol and fructose meals in normal and diabetic subjects. Diabetes Care 3: 582, 1980.CrossRefGoogle Scholar
  35. 35.
    Jenkins, D. J. A., Leeds, A. R., Gassull, M. A., Cochet, B., and Alberti, K. G. M. M. Decrease in postprandial insulin and glucose concentrations by sugar and pectin. Ann. Intern. Med. 86: 20, 1977.PubMedGoogle Scholar
  36. 36.
    Kiehm, T. G., Anderson, J. W., and Ward, K. Beneficial effects of high carbohydrate, high fiber diet on hyperglycemic diabetic men. Am. J. Clin. Nutr. 29: 895, 1976.PubMedGoogle Scholar
  37. 37.
    Savage, P. J., Bennion, L. J., Flock, E. V., et al. Diet-induced improvement of abnormalities in insulin and glucagon secretion and in insulin receptor binding in diabetes mellitus. J. Clin. Endocrinol. Metab. 48: 999, 1979.PubMedCrossRefGoogle Scholar
  38. 38.
    Naugulesparan, M., Savage, P. J., Bennion, L. J., Unger, R. H., and Bennett, P. H. Diminished effect of caloric restriction on control of hyperglycemia with increasing duration of type II mellitus. J. Clin. Endocrinol. Metab. 53:560, 1981.CrossRefGoogle Scholar
  39. 39.
    Hadden, D. R., Montgomery, D. A., Skelly, R. J., et al. Maturity onset diabetes mellitus. Br. Med. J. 3:276, 1975.PubMedCrossRefGoogle Scholar
  40. 40.
    Stanik, S., and Marcus, R. Insulin secretion improves following dietary control of plasma glucose in severely hyperglycemic obese patients. Metabolism 29:346, 1980.PubMedCrossRefGoogle Scholar
  41. 41.
    Bec-Neilson, H., Pedersen, O., and Sorensen, N. S. Effects of dietary changes on cellular insulin binding and in vivo insulin sensitivity. Metabolism 29:482, 1980.CrossRefGoogle Scholar
  42. 42.
    Newburgh, L. H. Control of hyperglycemia of obese diabetics by weight reduction. Ann. Intern. Med. 17:935, 1942.Google Scholar
  43. 43.
    Rudnick, P. A., and Taylor, K. W. Effect of prolonged carbohydrate restriction on serum insulin levels in mild diabetics. Br. Med. J. 1: 222, 1965.Google Scholar
  44. 44.
    Doar, J. W., Thompson, M. E., Wilde, C. E., and Sewell, C. E. Influence of treatment with diet alone on oral glucose tolerance test and plasma sugar and insulin levels in patients with maturity-onset diabetes mellitus. Lancet 1:1263, 1975.PubMedCrossRefGoogle Scholar
  45. 45.
    Felber, J. P., Meyer, H. U., Curchod, B., Maeder, E., Pahud, P., and Jequier, E. Effect of a 3-day fast on glucose storage and oxidation in obese hyperinsulinemic diabetics. Metabolism 30:184, 1981.PubMedCrossRefGoogle Scholar
  46. 46.
    Savage, P. J., Bennion, L., and Bennett, P. H. Normalization of insulin and glucagon secretion in Keton’s-resistant diabetes mellitus with prolonged diet therapy. J. C. E. and M. 49:831, 1979.Google Scholar
  47. 47.
    Vranic, M., and Berger, M. Exercise and diabetes mellitus. Diabetes 28(supplement):147, 1979.Google Scholar
  48. 48.
    Pruett, E. D. R. Plasma insulin concentrations during prolonged work at near maximal oxygen uptake. J. Appl. Physiol. 29:155, 1970.PubMedGoogle Scholar
  49. 49.
    Felig, P., Wahren, J., Hendler, R., et al. Plasma glucagon levels in exercising man. N. Engl. J. Med. 287:184, 1972.PubMedCrossRefGoogle Scholar
  50. 50.
    Galbo, H., Holst, J., and Christensen, N. J. Glucagon and plasma catecholamine responses to graded and prolonged exercise in man. J. Appl. Physiol. 38:70, 1975.PubMedGoogle Scholar
  51. 51.
    Christensen, N. J., Galbo, H., Hansen, J. F., Hess, B., Richter, E. A., and Trap-Jensen, J. Catecholamines and exercise. Diabetes 28 (supple-ment):58, 1979.Google Scholar
  52. 52.
    Holloszy, J. O., and Narahara, H. T. Enhanced permeability to sugar associated with muscle contraction. Studies on the role of Ca++. J. Gen. Physiol 50:551,1967.PubMedCrossRefGoogle Scholar
  53. 53.
    Richter, E. A., Garetto, L. P., Goodman, M. N., and Ruderman, B. Muscle glucose metabolism following exercise in the rat: increased sensitivity to insulin. J. Clin. Invest. 69:785, 1982.PubMedCrossRefGoogle Scholar
  54. 54.
    Wahren, J., Felig, P., and Hagenfeldt, L. Physical and fuel homeostasis in diabetes mellitus. Diabetologia 14:213, 1978.PubMedCrossRefGoogle Scholar
  55. 55.
    Vranic, M., and Wrenshall, G. A. Exercise, insulin and glucose turnover in dogs. Endocrinology 85:165, 1969.PubMedCrossRefGoogle Scholar
  56. 56.
    DeFronzo, R. A., Ferrannini, E., Sato, Y., Felig, P., and Wahren, J. Synergistic interaction between exercise and insulin on peripheral glucose metabolism. J. Clin. Invest. 68:1468, 1981.CrossRefGoogle Scholar
  57. 57.
    Lohmann, D., Liebold, F., Heilmann, W., Senger, H., and Pohl, A. Diminished insulin response in highly trained athletes. Metabolism 27:521, 1978.PubMedCrossRefGoogle Scholar
  58. 58.
    LeBlanc, J., Nadeau, A., and Boulay, M. Rousseau-Migneron, W. Effects of physical training and adiposity on glucose metabolism and 124I-insulin binding. J. Appl. Physiol. 46:235, 1979.PubMedGoogle Scholar
  59. 59.
    Bjorntorp, P., DeJounge, K., Sjostrom, L., and Sullivan, L. The effect of physical training on insulin production in obesity. Metabolism 19: 631, 1970.PubMedCrossRefGoogle Scholar
  60. 60.
    Bjorntorp, P., Holm, G., Jacobsson, B., et al. Physical training in h-man hyperplastic obesity. IV. Effects on the hormonal status. Metabolism 6:319, 1977.CrossRefGoogle Scholar
  61. 61.
    Soman, V. R., Koivisto, V. A., Delbert, D., Felig, P., and DeFonzo, R. A. Increased insulin sensitivity and insulin binding to monocytes after physical training. N. Engl. J. Med. 301:1200, 1979.PubMedCrossRefGoogle Scholar
  62. 62.
    Olefsky, J. M., and Reaven, G. M. Effects of sulfonylurea therapy on insulin binding to mononuclear leukocytes of diabetic patients. Am. J. Med. 60:89,1976.PubMedCrossRefGoogle Scholar
  63. 63.
    Friedman, C. I., Falko, J. M., Patel, S., Kim, M. H., and Newman, H. A. I. Serum lipoprotein responses during active and stable weight reduction in reproductive obese females. Clin. Res. 28:152, 1980.Google Scholar
  64. 64.
    Schrott, H. G., Mason, E. E., and Printen, K. J. High density lipoprotein cholesterol changes in massive weight loss. Clin. Res. 27: 227A, 1979.Google Scholar
  65. 65.
    Thompson, P. D., Jeffery, R. W., Wing, R. R., and Wood, P. D. Unexpected decrease in plasma high density lipoprotein cholesterol with weight loss. American Journal of Clinical Nutrition 32:2016, 1979.PubMedGoogle Scholar
  66. 66.
    Brownell, K. D., and Stunkard, A. J. Differential changes in plasma high-density lipoprotein-cholesterol levels in obese men and women during weight reduction. Arch. Intern. Med. 141:1142, 1981.PubMedCrossRefGoogle Scholar
  67. 67.
    Streja, D. A., Boydo, E., and Rabkin, S. W. Changes in plasma high-density lipoprotein cholesterol concentration after weight reduction in grossly obese subjects. British Medical Journal 281:770, 1980.PubMedCrossRefGoogle Scholar
  68. 68.
    Lopes-Virella, M. E. L., Stone, P. G., and Colwell, J. A. Serum high density lipoprotein in diabetic patients. Diabetologia 13:285, 1977.PubMedCrossRefGoogle Scholar
  69. 69.
    Hartung, G. H., Foreyt, J. P., Mitchell, R. E., Mitchell, J. G., Reeves, R. S., and Gotto, A. M. Effect of alcohol intake on high-density lipoprotein cholesterol levels in runners and inactive men. J.A.M.A. 249: 747, 1983.PubMedCrossRefGoogle Scholar
  70. 70.
    Hunt, J. C., Cooper, T., Frohlich, E. D., Gifford, R. W., Kaplan, N. M., Laragh, J. H., Maxwell, M. H., and Strong, C. G. Dialogues in Hypertension. Health Learning Systems, Inc., Bloomfield, N.J. p. 1, 1980.Google Scholar
  71. 71.
    Altschul, A. M., and Grommet, J. K. Food choices for lowering sodium intake. Hypertension 4(supplement III): 111–116, 1982.Google Scholar
  72. 72.
    MacGregor, G. A., Best, F. E., Cam, J. M., Markandu, N. D., Elder, D. M., Sagnella, G. A., and Squires, M. Double-blind randomised crossover trial of moderate sodium restriction in essential hypertension. Lancet 8:268, 1982.Google Scholar
  73. 73.
    Dahl, L. K., Heine, M., and Thompson, K. Genetic influence of the kidneys in blood pressure, evidence from chronic reual homograples in rats with opposite predispositions to hypertension. Arch. Res. 40: 94, 1974.Google Scholar
  74. 74.
    Dietz, R., Schomig, A., Wolfgang, R., Strasser, R., Borwin Luth, J., Ganten, U., and Wolfgang, K. Contribution of the sympathetic nervous system to the hypertensive effect of a high sodium diet in stroke-prone spontaneously hypertensive rats. Hypertension 4:773, 1982.PubMedCrossRefGoogle Scholar
  75. 75.
    Langford, H. Drug and dietary intervention in hypertension. Hypertension 4 (supplement III): 166, 1982.Google Scholar
  76. 76.
    Reisin, E., Abel, R., and Modan, M. Effect of weight loss without salt restriction on the reduction of blood pressure in overweight hypertensive subjects. New Engl J. Med. 298:1, 1978.PubMedCrossRefGoogle Scholar
  77. 77.
    Sowers, J. R., Nyby, M., Stern, N., Beck, F., Baron, S., Catania, R., and Vlachis, N. Blood pressure and hormone changes associated with weight reduction in the obese. Hypertension 4:686, 1982.PubMedCrossRefGoogle Scholar
  78. 78.
    Sowers, J. R., Whitfield, L. A., Catania, R. A., Tuck, M. L., Dornfeld, L., Stern, N., and Maxwell, M. Role of the sympathetic nervous system in blood pressure maintenance in obesity. Journal of Clinical Endocrinology and Metabolism 54:1181, 1982.PubMedCrossRefGoogle Scholar
  79. 79.
    Danforth, E. Jr., Horton, F. S., O’Connell, N., Sims, E. A. H., Gurger, A. G., Ingbar, S. H., Braverman, L., and Vageuakis, A. G. Dietary-induced alteration in thyroid hormone metabolism during over nutrition. J. Clin. Invest. 64:1336, 1979.PubMedCrossRefGoogle Scholar
  80. 80.
    Besareb, A., Silva, P., Laudsberg, L., and Epstein, F. H. Effect of catecholamines on tubular function in the isolated perfused rat kidney. Am. J. Physiol. 233:F29, 1977.Google Scholar
  81. 81.
    Young, J. B., Rowe, J. W., Palotta, J. A., Sparrow, D., and Laudsberg, L. Enhanced plasma norepinephrine response to upright posture and oral glucose administration in elderly human subjects. Metabolism 29: 532, 1980.PubMedCrossRefGoogle Scholar
  82. 82.
    Rowe, J. W., Young, J. B., Minaker, K. L., Stevens, A. L., Pallottia, J., and Landsberg, L. Effect of insulin and glucose infusions on sympathetic nervous system activity in normal man. Diabetes 30:219, 1981.PubMedGoogle Scholar
  83. 83.
    Andre, R., and Crabge, J. Stimulation by insulin of active sodium transport by toad skin; influence of celdesterene and vasopressin. Arch. Int. Physiol Biochem. 74:538, 1966.Google Scholar
  84. 84.
    DeFronzo, R. A., Cooke, C. R., Andres, R., Faloona, G., and Davis, P. J. The effect of insulin on reval handling of sodium, potassium calcium and phosphate in man. J. Clin. Invest. 55:845, 1975.CrossRefGoogle Scholar
  85. 85.
    Cahill, C. F. Starvation in man. New Engl. J. Med. 282:660, 1970.CrossRefGoogle Scholar
  86. 86.
    Tuck, M. L., Sowers, J., Dornfeld, L., Kledzik, G., and Maxwell, M. The effect of weight reduction on blood pressure, plasma renin activity, and plasma aldosterone levels in obese patients. New Engl. J. Med. 304:930, 1981.PubMedCrossRefGoogle Scholar
  87. 87.
    DeFronzo, R. A., Goldberg, M., and Agus, Z. The effects of glucose and insulin reval electrolyte transport. J. Clin. Invest. 58:85, 1976.Google Scholar
  88. 88.
    Bjorntorp, P., DeJounga, K., Sjostrom, L., and Sullivan, L. The effect of physical training on insulin prodirection in obesity. Metabolism 19: 631, 1970.PubMedCrossRefGoogle Scholar
  89. 89.
    Euler, U. S., and Hellner, S. Excretion of rioradrenaline and adrenaline in muscular work. Acta Physiol Scand. 26:183, 1952.CrossRefGoogle Scholar
  90. 90.
    Krotkiewski, M., Mandroukas, M., Sjostrom, L. M., Sullivan, H., and Bjorntorp, P. Effects of long-term physical training on body fat, metabolism and blood pressure in obesity. Metabolism 28:649, 1979.CrossRefGoogle Scholar
  91. 91.
    Hovel, M. F. The experimental evidence for weight-loss treatment of essential hypertension: a critical review. Am. J. Publ. Health 72:359, 1982.CrossRefGoogle Scholar
  92. 92.
    Puska, P., Nissinen, A., Vartiainen, E., Dougherty, R., Mutanen, M., Iacono, J., Korhonen, H., Pietinen, P., Leino, U., Moisio, S., and Huttunen, J. Controlled randomised trial of the effect of dietary fat on blood pressure. Lancet 8314:5, 1983.Google Scholar

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© Spectrum Publications, Inc. 1984

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  • Charles P. Lucas

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