Obesity and Control

Background: It has been evident that there is a sharp decline in participation in physical activity for adolescent girls. Using social cognitive theory as a theoretical framework, this study was designed to examine the relationships between several psychosocial constructs and physical activity levels in adolescent girls, as well as their differences across several ethnicities. 

Methods: Participants were 92 sixth through ninth grade girls recruited from four urban schools. All girls’ psychosocial correlates (self-efficacy, outcome expectancy, and social support) were measured and used to predict their physical activity levels as measured by W4L Neo II pedometers (mean steps per day and mean time spent in Moderate to Vigorous Physical Activity [MVPA]).  

Results: Girls’ self-efficacy emerged as the sole predictor of their mean steps (β = .36, p < .01) and mean time in MVPA (β = .38, p < .01). However, girls’ outcome expectancy and social support failed to predict physical activity levels. Additionally, White girls had more daily steps and daily physical activity time than the AfricanAmerican girls did.  

Conclusion: Adolescent girls’ self-efficacy appeared as the only predictor of their daily physical activity levels,  and therefore interventions to enhance their self-efficacy should be considered.  

In a sample of 8th and 11th grade children at one rural school located in Oregon, USA we demonstrate that measured anthropometric values are needed for accurate surveillance of body mass index (BMI). Gender and grade adjusted quantile regression analysis showed the median self-reported BMI (calculated from reported height and weight) was 1.39 ± 0.43 kg/m2 lower than that of measured anthropometric data, p<0.001, and the 75th percentile was 1.90 ± 0.77 kg/m2 lower in self-reported data, p<0.05). The bias in self-reported data increases as BMI increases, underestimating rural population obesity prevalence among youth. School nurses are poised to systematically and longitudinally assess students that may not have regular access to health care.  

Purpose: Laparoscopic sleeve gastrectomy has proven effectiveness regarding weight reduction, but metabolic consequences, especially in the long-term, have not yet been adequately clarified. The aim of the present study is to examine metabolic changes after laparoscopic sleeve gastrectomy in a two-year prospective survey. 

Methods: Eighty-one patients were examined before laparoscopic sleeve gastrectomy and 3, 6, 12, 18, and 24 months postoperatively. Different markers of metabolic diseases including blood lipids and liver enzymes, inflammation markers and markers of glucose metabolism were assessed.  

Results: Body weight was significantly reduced from 144.4 ± 23.0 kg before surgery to 101.3 ± 20.0 kg 24 months postoperatively. Excess weight loss  after 24 months was 58 ± 20 % in our study population. Besides body weight changes, significant improvements were found for triglycerides (p < 0.001), low density lipoprotein cholesterol (p < 0.01), and high density lipoprotein cholesterol  (p < 0.001). Moreover, C-reactive protein and leukocytes, as well as the liver enzymes improved in the 2-yearscourse (all p < 0.001). These changes resulted in a sharp reduction of the prevalence of the metabolic syndrome from 69 to 26 % (p < 0.001). Furthermore, the number of patients with hypertension and diabetes – assessed by fasting glucose and glycated hemoglobin –, were reduced to less than half. 

Conclusions: Laparoscopic sleeve gastrectomy improves lipid profile and liver enzyme status, and reduces signs of inflammation in obese patients within 2 years. These changes suggest a significant risk reduction of metabolic diseases in obese patients undergoing laparoscopic sleeve gastrectomy.