Search

The novel banded one-anastomosis gastric bypass (B-OAGB) procedure has not previously been reported in super-obese patients over the long term. In this pilot study, outcomes in patients with a mean baseline body mass index (BMI, kg/m2) of ≥ 50 who underwent B-OAGB were evaluated through 5-year follow-up. Total weight loss (TWL), excess weight loss (EWL), BMI evolution, and changes in type 2 diabetes biomarkers were analyzed prospectively in super-obese patients who underwent B-OAGB. Paired samples t tests were used to assess weight outcome change from baseline through 5-year follow-up and 95% CIs were calculated. The Bariatric Outcomes and Reporting System (BAROS) was used to assess surgical success at 3 time points. Between October 2013 and February 2014, a 12-patient pilot cohort (mean baseline BMI 57.5 ± 6.3) underwent B-OAGB. No perioperative complications were observed within 30 days. Five-year mean BMI was 31.2 ± 5.4, a BMI loss of 25.9 (TWL 45.3 ± 7.5%; EWL 72.2 ± 12.8%). Between 11 and 24 months following surgery, 3 patients required band removal; each had one complication (1 stasis esophagitis and recurrent vomiting; 1 hypoalbuminemia; 1 anemia). There was no mortality. Long-term B-OAGB BAROS subscale and composite scores were comparable to other major bariatric procedures. In a pilot study of super-obese patients who underwent B-OAGB, excellent durable BMI loss of 25.9 kg/m2 (EWL 72.2%) at 5 years was achieved with an acceptable level of reoperation. More B-OAGB long-term follow-up studies are necessary to provide definitive conclusions regarding this combination bariatric procedure.

Background Obesity numbers have doubled worldwide since 1980, leading to individual life-quality threatening issues and a socioeconomic challenge. A number of school programs have been initiated to prevent the epidemic-like spreading of obesity. Methods 109 adolescents (42 females and 67 males aged 15.0 ± 0.7 years) were included into this six-month interdisciplinary school-based study. The aim was to assess various implementation outcomes based on the effect of health education, including the promotion of healthy eating patterns and a limitation of sugar-containing beverage consumption via the feedback of analysed anthropometric data, biomedical parameters, physical fitness tests and an eating and physical activity behaviour questionnaire. Results Overall, the results demonstrated a positive effect on body fat content and physical activity. In addition, a trend towards a benefit on parameters of muscle and fat metabolism was detected. Conclusions An interdisciplinary life-style program integrated into the school curriculum is suited to have a positive impact on health outcomes. By enhancing the awareness for healthy nutrition and the importance of physical activity, self-empowerment was increased, resulting in an improvement of health-associated parameters.

The novel banded one-anastomosis gastric bypass (B-OAGB) procedure has not previously been reported in super-obese patients over the long term. In this pilot study, outcomes in patients with a mean baseline body mass index (BMI, kg/mTotal weight loss (TWL), excess weight loss (EWL), BMI evolution, and changes in type 2 diabetes biomarkers were analyzed prospectively in super-obese patients who underwent B-OAGB. Paired samples t tests were used to assess weight outcome change from baseline through 5-year follow-up and 95% CIs were calculated. The Bariatric Outcomes and Reporting System (BAROS) was used to assess surgical success at 3 time points.Between October 2013 and February 2014, a 12-patient pilot cohort (mean baseline BMI 57.5 ± 6.3) underwent B-OAGB. No perioperative complications were observed within 30 days. Five-year mean BMI was 31.2 ± 5.4, a BMI loss of 25.9 (TWL 45.3 ± 7.5%; EWL 72.2 ± 12.8%). Between 11 and 24 months following surgery, 3 patients required band removal; each had one complication (1 stasis esophagitis and recurrent vomiting; 1 hypoalbuminemia; 1 anemia). There was no mortality. Long-term B-OAGB BAROS subscale and composite scores were comparable to other major bariatric procedures.In a pilot study of super-obese patients who underwent B-OAGB, excellent durable BMI loss of 25.9 kg/m

ZusammenfassungDas Ziel des BARI-AD ist die strukturierte Erfassung der für eine Adipositas-chirurgische Operation und den postoperativen Erfolg Jugendlicher als relevant erachteten Voraussetzungen. Es dient als Grundlage für eine präoperative schriftliche Stellungnahme an die Chirurg/innen und Sozialversicherungen sowie vor- und nachsorgender interdisziplinärer Maßnahmen. BARI-AD erhebt strukturiert Vorstellungen, Wissen, Verständnis, Handlungsmöglichkeiten der PatientInnen bezüglich der intra- und interdisziplinären prä- und postoperativen Notwendigkeiten, Stärken und Beeinträchtigungen. Zur objektiven und systematischen Extraktion der Inhalte der Leitlinien nationaler und internationaler Fachgesellschaften wurden qualitative Inhaltsanalysen durchgeführt und die Inhalte in ein strukturiertes Interview gefasst. Procedere und Gesprächsführung basieren auf aktuellen psychologischen Erkenntnissen. Das strukturierte Interviewschema erhebt und dokumentiert die in Leitlinien geforderten Informationen zur psychischen und sozialen Situation der Patient/innen nach der Aufklärung durch das interdisziplinäre Team vor bariatrischen Eingriffen.

Stellt man sich ein Kontinuum der auseren Gestalt des Korpers von dicken zu dunnen Menschen vor, so ist diese eindimensionale Vorstellung nur rein metrisch zutreffend. Eher passt das Bild von Korpern, das von unterschiedlichen Betrachtern geschaffen wird, zu einer Landschaft bestehend aus verschiedenen Formationen, die komplexen Entstehungs- und Veranderungsmechanismen in der Postmoderne unterliegen und oft tief eingegrabene Leidenswege aufweisen. Zudem uberlagern sich die Bilder, da ein Teil der Menschen mit einem wesentlich uberhohten Fettanteil auch Vollbilder von Essstorungen aufweisen.

Objective Despite alarming prevalence rates, surprisingly little is known about neural mechanisms underlying eating behavior in juveniles with obesity. To simulate reactivity to modern food environments, event-related potentials (ERP) to appetizing food images (relative to control images) were recorded in adolescents with obesity and healthy adolescents. Methods Thirty-four adolescents with obesity (patients) and 24 matched healthy control adolescents watched and rated standardized food and object images during ERP recording. Personality (impulsivity) and eating styles (trait craving and dietary restraint) were assessed as potential moderators. Results Food relative to object images triggered larger early (P100) and late (P300) ERPs. More impulsive individuals had considerably larger food-specific P100 amplitudes in both groups. Controls with higher restraint scores showed reduced food-specific P300 amplitudes and subjective palatability ratings whereas patients with higher restraint scores showed increased P300 and palatability ratings. Conclusions This first ERP study in adolescents with obesity and controls revealed impulsivity as a general risk factor in the current obesogenic environment by increasing food-cue salience. Dietary restraint showed paradoxical effects in patients, making them more vulnerable to visual food-cues. Salutogenic therapeutic approaches that deemphasize strict dietary restraint and foster healthy food choice might reduce such paradoxical effects.

Background: The prevalence of early childhood overweight and obesity in Austria has reached average European levels of 20% in boys and 18% in girls. The rationale and study protocol of SALTO, Salzburg Together against Obesity will be presented, which is aimed to assist adults in increasing the rate of 4- to 6-year-old children with a healthy body weight. Methods: A controlled longitudinal sequential study design consisting of 14 intervention (IK) and 8 control (CK) kindergarten was used to investigate the effect of actions tailored for teachers and parents on BMI among 4- to 6-year-old children. The study launched in November 2014 was approved by the ethics committee of the University of Salzburg. Results: 681 children, 181 parents (119 mothers, 62 fathers) and 30 teachers were investigated until October 2016. Preliminary analyses revealed that more boys (19%) and fathers (60% IK, 43% CK) were overweight and obese than girls (16%) and mothers (19% IK, 20% CK). Conclusion: The challenges faced by the SALTO staff in the implementation of health-promoting actions in the kindergarten are manifold. The Community-Oriented Core Setting (COCS) intervention approach will show whether the actions will reduce the percentage of obesity and be sustainable in the long term.

Objective: This paper introduces health professionals to the different psychological models thought to influence eating behaviour in the absence of hunger in children who are obese and to propose a method of assessing these behaviours in practice. Methods: Clinical researchers from the European Childhood Obesity Group (ECOG) adopted an evidence-based approach to examine the literature concerning the assessment of eating behaviour in children who are obese. Studies published in English were filtered out of the medical and psychological literature from 1960 to the present, and the resulting bibliography was searched for relevant articles. Key themes from the current evidence were compiled and classified according to the underpinning psychological models. Based on the current evidence and the authors' combined clinical experience, a three-staged approach to assessment was agreed by consensus. Results: Valid and reliable tools for assessing and monitoring each of the three identified models (Dietary Restraint Theory, Emotional Eating and the Diathesis-Stress Model) are suggested for use in clinical practice, and the ECOG three-staged approach to assessing eating behaviours in the absence of hunger is described. Conclusions: This paper presents practical guidance on how to assess eating behaviour in the absence of hunger in children who are clinically obese and suggests a focus for future research.

Background: Interdisciplinary state-of-the-art interventions to treat obesity demand equally interdisciplinary outcome assessments. The Bariatric Evaluation Score for Children (BAREV-C) was developed to reliably and comprehensively assess the outcomes of non-surgical and surgical obesity treatment in children and adolescents. Methods: BAREV-C assesses medical, psychological, nutritional, and data of physical fitness data. The body mass index standard deviation score and waist measurement were selected to describe anthropometry. Serum triglycerides, high-density lipoprotein (HDL) cholesterol, blood pressure, and plasma glucose tolerance were selected as parameters of the metabolic syndrome. Relevant interdisciplinary variables were tested using the interdisciplinary Adiposity Evaluation kit, which assesses cognitive steering variables of eating and exercise behaviour as well as psychological comorbidities, exercise motivation, nutritional preferences, and quality of life associated with obesity. Physical fitness was assessed by means of the Physical fitness test battery. The values for the BAREV-C were determined in several steps and in all relevant disciplines pre and post intervention. Results: The BAREV-C facilitated the identification and quantification of significant changes of interdisciplinary variables associated with obesity for groups and individuals (tables of critical differences) as well. The degree of success or failure of an intervention can be quantified for each of the disciplines. Conclusions: The BAREV-C is the first comprehensive outcome instrument for pre-post-intervention evaluation of obese individual children as well as groups. It can be applied for intervention studies and can provide the clinician with a differentiated overview in daily practice.

Chirurgische Adipositastherapie erzielt die fur die Vermeidung, Besserung oder Heilung von lebensgefahrlichen Komorbiditaten notige dauerhafte Gewichtsabnahme. Uber Veranderungen der psychologischen Atiologie- und Risikofaktoren weis man aber bislang wenig. In der vorliegende Studie wurde die Veranderung von auch subjektiv stark belastenden Atiologiefaktoren von Adipositas an 60 PatientInnen vor (24 m/36 w, 18–71, Body-Mass-Index [BMI] M=44,95, SD=6,91) und nach (BMI M=33,92, SD=7,23) einer Bypass- bzw. Magenbandoperation mithilfe des neuen Testsystems AD-EVA uberpruft. Die Variablen „Sucht“ (t=11,15, p

Zusammenfassung: Fragestellung: Die deutschsprachige Version des Strenghts and Difficulties Questionnaire-Self-Report (SDQ-S) hinsichtlich ihrer Reliabilität und Dimensionalität für Österreich zu überprüfen. Methodik: Dieser Fragebogen wurde 2529 gesunden Kindern und Jugendlichen im Alter von 11-18 Jahren (im Mittel 12.71 ± 1.4) vorgelegt. Berechnet wurden 4 Problem-Skalenwerte, 1 Gesamtproblemskalenwert sowie 1 Skalenwert prosoziales Verhalten. Deskriptive Statistik, Cronbachs Alpha sowie eine Varimax rotierte Faktorenanalyse nach der Hauptkomponentenmethode wurden berechnet. Ergebnisse: Cronbachs Alpha ist für die Gesamtproblemskala, die Skala emotionale Probleme und die prosoziale Skala > 0.63. Die anderen Skalen liegen unter 0.4. Es ergaben sich 5 Faktoren, die eine Varianz von 41.8% erklären. Die Item-Subskalen-Korrelationen sind ausreichend, die Faktorenstruktur entspricht für 3 Subskalen (Peerprobleme, Hyperaktivität, Verhaltensauffälligkeit) nicht der originalen Faktorenzusammensetzung. Schlussfolgerung: Die Reliabilität der Gesamt- und der erwähnten Subskalen wäre für ein Screeningverfahren gerade noch ausreichend, für die restlichen Subskalen ist dies nicht der Fall. Die Faktorenstruktur war nicht komplett replizierbar. Zusammenfassung: Die SDQ-Selbst-Version in ihrer deutschsprachigen Version wird für die Individualdiagnostik zur Zeit bei gleichzeitiger Verwendung von mehreren Informationsquellen empfohlen.

Eating behavior and physical activity behavior are under the control of certain cognitive patterns. 6600 adults and 4400 children/adolescents (8-18 years) were tested with the Obesity Diagnostics and Evaluation System (AD-EVA). Potentially significant gender differences will be detailed for the entire juvenile cohort, the subgroup of obese children/adolescents as compared to the adult cohort in this article.Among all the subscales tested, obese girls primarily showed significantly higher values of (preclinical) eating disorders than boys. These data are relevant for both prevention and health promotion.No significant differences were found in regard to sports motivation. This warrants facilitation of physical activity for both genders. Further, a male predilection for "Snacks" and "High-fat food" that could be found in the total representative study group, could not be verified in the subgroup of obese girls and boys, thus suggesting a similarily unhealthy eating behavior in both genders of juvenility.

Despite alarming prevalence rates, surprisingly little is known about neural mechanisms underlying eating behavior in juveniles with obesity. To simulate reactivity to modern food environments, event-related potentials (ERP) to appetizing food images (relative to control images) were recorded in adolescents with obesity and healthy adolescents.Thirty-four adolescents with obesity (patients) and 24 matched healthy control adolescents watched and rated standardized food and object images during ERP recording. Personality (impulsivity) and eating styles (trait craving and dietary restraint) were assessed as potential moderators.Food relative to object images triggered larger early (P100) and late (P300) ERPs. More impulsive individuals had considerably larger food-specific P100 amplitudes in both groups. Controls with higher restraint scores showed reduced food-specific P300 amplitudes and subjective palatability ratings whereas patients with higher restraint scores showed increased P300 and palatability ratings.This first ERP study in adolescents with obesity and controls revealed impulsivity as a general risk factor in the current obesogenic environment by increasing food-cue salience. Dietary restraint showed paradoxical effects in patients, making them more vulnerable to visual food-cues. Salutogenic therapeutic approaches that deemphasize strict dietary restraint and foster healthy food choice might reduce such paradoxical effects.

Experience with gastro-restrictive obesity showed the necessity of detailed research in three main tasks: 1. characteristics of morbidly obese people 2. psychological effects of surgery 3. interaction of these characteristics and effects of surgery. We carried out 7 studies with a total of 650 participants. Clinical interviews and tests measuring personality, eating behaviour, self esteem, addiction factors and quality of life were performed. Morbidly obese differ significantly from normal weight people with the exception of most personality scales. Effects of surgery can be summarized that patients learn to avoid overeating but they do not learn to nourish on healthy solid nutrition and they do not learn to exercise more than before. By paradox learning process 30-50 % of gastric banding patients establish vomiting behaviour or eating pulp and sweets. These who show low self esteem, high addiction score and high disinhibition behaviour are more at risk. Different psychological, nutritional as well as physiotherapeutic interventions are needed to help these patients.

Meta-analyses show that weight loss through conservative therapy and prevention does not indicate any big changes (Ebbeling et al. 2002; Miller and Jacob 2001). What is it specifically that makes it so difficult for obese adolescents to lose weight and puts so much stress on their life?

Grundlagen: Die psychischen Ursachen und Folgen extremen ubergewichts sind sehr unterschiedlich, oft auch widerspruchlich. Ubereinstimmend wird in allen Untersuchungen das hohe Ausmas von Stigmatisierung erwahnt. Um die postoperative Befindlichkeit und die Compliance sowie die Notwendigkeit einer begleitenden Beratung/Therapie besser vorhersagen zu konnen, erstellten wir eine Typologie, deren erste Ergebnisse nun vorliegen.

To assess the validity and the reliability of the self-report version of the Strength and Difficulties Questionnaire in an Austrian sample.The questionnaire was given to 2529 healthy children and adolescents aged 11-18 years (mean age 12.71 +/- 1.4). Evaluation was performed according to given criteria, yielding a Total Problem Score, scores on four clinical subscales, and on one scale for pro-social behaviour. Descriptive statistics, Cronbach's alpha, and a varimax rotated factorial analysis were calculated.Cronbach's Alpha was0.63 for the Total Problem Scale, the Pro-Social Behaviour Scale and Emotional Problems Subscale. Factorial analysis revealed five independent factors explaining 41.8% of the variance. The analysis revealed good item-subscale correlations, but could not replicate the original factorial structure completely. Normative data for the SDQ-Self for Austria are provided.The German self-report version of the SDQ should, at the moment, only be used with extended analysis of multi-informant information.

Background: The Moorehead-Ardelt Quality of Life Questionnaire was originally developed as a disease-specific instrument to measure postoperative outcomes of self-perceived quality of life (QoL) in obese patients. 5 key areas were examined: self-esteem, physical well-being, social relationships, work, and sexuality. Each of these questions offered 5 possible answers, which were given + or - points according to a scoring key. The questionnaire was used independently or incorporated into the Bariatric Analysis and Reporting System (BAROS). The instrument is simple, unbiased, user-friendly and can be completed in

Eating behavior and physical activity behavior are under the control of certain cognitive patterns. 6600 adults and 4400 children/adolescents (8-18 years) were tested with the Obesity Diagnostics and Evaluation System (AD-EVA). Potentially significant gender differences will be detailed for the entire juvenile cohort, the subgroup of obese children/adolescents as compared to the adult cohort in this article.Among all the subscales tested, obese girls primarily showed significantly higher values of (preclinical) eating disorders than boys. These data are relevant for both prevention and health promotion.No significant differences were found in regard to sports motivation. This warrants facilitation of physical activity for both genders. Further, a male predilection for "Snacks" and "High-fat food" that could be found in the total representative study group, could not be verified in the subgroup of obese girls and boys, thus suggesting a similarily unhealthy eating behavior in both genders of juvenility.