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Background: Initial findings from the Dietary Approaches to Stop Hypertension (DASH)-Sodium Trial demonstrated that reduction of sodium intake in two different diets decreased blood pressure in participants with and without hypertension.Objective: To determine effects on blood pressure of reduced sodium intake and the DASH diet in additional subgroups.Design: Randomized feeding study.Setting: Four clinical centers and a coordinating center.Participants: 412 adults with untreated systolic blood pressure of 120 to 160 mm Hg and diastolic blood pressure of 80 to 95 mm Hg.Intervention: Participants followed the DASH diet or a control (typical U.S.) diet for three consecutive 30-day feeding periods, during which sodium intake (50, 100, and 150 mmol/d at 2100 kcal) varied according to a randomly assigned sequence. Body weight was maintained.Measurements: Systolic and diastolic blood pressure.Results: In all subgroups, the DASH diet and reduced sodium intake were each associated with significant decreases in blood pressure; these two factors combined produced the greatest reductions. Among nonhypertensive participants who received the control diet, lower (vs. higher) sodium intake decreased blood pressure by 7.0/3.8 mm Hg in those older than 45 years of age (P < 0.001) and by 3.7/1.5 mm Hg in those 45 years of age or younger (P < 0.05).Conclusion: The DASH diet plus reduced sodium intake is recommended to control blood pressure in diverse subgroups. [ABSTRACT FROM AUTHOR]

Most of the available appetite-suppressant drugs act on noradrenergic and possibly dopaminergic receptors to produce satiety. A smaller number increase excess neuronal serotonin levels by blocking serotonin reuptake or by increasing its release. All these drugs produce significantly greater weight loss than does placebo in most studies. Abuse is a problem with amphetamine, methamphetamine, and benzphetamine, whereas other drugs have minimal or no potential for abuse. Weight loss can be sustained for up to 36 months. Net weight loss, compared with placebo, ranges from 2 to 10 kg, and weight regain after terminating drug treatment proves that drugs do not work when not taken. The stigma of obesity, the public opprobrium toward obese persons, and regulatory rigidity have led to unjustified distrust in the potential of drug treatment for obesity. [ABSTRACT FROM AUTHOR]

Explores obesity as a serious health problem. Definition of obesity; Factors that can produce obesity; Relationship between increased insulin secretion, insulin antagonism and the enlarged adipocyte in obesity; Discussion on weight reduction methods; Potential dangers and daily management of the fasting patient; Thyroid medication for weight maintenance.

Editorial. Deals with the barriers to the treatment of obesity. Difficulties faced in enhancing the effectiveness of the use of appetite-suppressant drugs; Drugs considered as appetite-suppressants.

The major diseases associated with obesity are hypertension, atherosclerosis, and diabetes, as well as certain types of cancer. Less well-known complications include hepatic steatosis, gallbladder disease, pulmonary function impairment, endocrine abnormalities, obstetric complications, trauma to the weight-bearing joints, gout, cutaneous disease, proteinuria, increased hemoglobin concentration, and possibly immunologic impairment. A U- or J-shaped curve illustrates the relation between body mass index and the degree of these various complications. This relationship can be used to provide guidelines for assessing treatment of obesity.

Plasma concentrations of zinc and copper were measured in 15 obese patients before intestinal bypass surgery, in 27 patients after intestinal bypass surgery, and in 52 lean control subjects. Preoperatively, the obese patients had zinc concentrations that were significantly lower than in the lean control subjects (76 +/- 3 versus 89 +/- 2 microgram/dl) (+/- SEM) and copper levels that were significantly higher (147 +/- 10 versus 119 +/- 3 microgram/dl). After intestinal bypass, plasma zinc and copper concentrations were significantly lower (zinc, 62 +/- 2 microgram/dl; copper, 90 +/- 5 microgram/dl; P less than 0.001) than in prebypass patients. One patient developed leukopenia associated with a plasma copper concentration of 36 microgram/dl. Leukocyte count and plasma copper level rose with oral copper sulfate replacement therapy. Intestinal bypass surgery may produce clinically significant decreases in plasma concentrations of zinc and copper. Careful observation and replacement therapy are indicated in all patients who develop deficiences after intestinal bypass surgery.