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Normal metabolic profile in severely obese patients
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FATTY ACIDS, LIPIDS, OBESITY
075-P. NORMAL PATIENTS
METABOLIC
PROFILE IN SEVERELY OBESE
.I. Faintuch, C. Oliveira, A. Rascovski, M. Matsuda, C. Bresciani, A. Halpem, .I. Rodrigues Nutrition and Obesity Group, Hospital das Clinicas, S o Pa&, Brazil Rationale: Biochemical aberrations, especially of serum lipids, xe a serious concern in obese populations, but their actual frequency is debated. In a prospective atudy of candidates for bxiatric surgery, values for principal laboratory measurements wenz monitored.The aim was to assess derangements typical of that population. Method: Patients admitted for elective anti-obesity operation ( gastroplasty with Roux-en-Y bypass) were consecutively enrolled.Age of the population (n=32) was 42.4-/+9.1 yezus (90.6% females) with body mass index (BMI) of 53.7-/+6.7 kg/m2 (37,9- 71,l). Preoperative work-up included conventional hematologic and biochemical tests. Results: Mean total cholesterol and triglicerydes were respectively 198.6/+ 32.0 mg/lOO ml (normal 1200) and 139.5-/+54.4 mg/lOO ml (normal 5150). Neither mean uric acid (6.3-/+1.3 mg/lOO ml, normal ~7.0) nor blood glucose (102.6-/+18.9 mg/lOO ml, nolmal 5110) exceeded the normal range, and the same was true for other lipid fractions, insulin, hematologic counts and inflammatory makers. However, 5-25% of the findings exceeded the reference valuesIn addition, mean values were higher than those observed in non-obese controls. Conclusions: 1) Metabolic indices in mxkedly obese subjects were usually normal; 2) Only a minority exhibited obvious aberrations; 2) Derangements in the whole group could be more easily demonstrated when findings were companzd to eutrophic subjects;
we performed this study to search the effect of a fiber rich dietxy product on weight loss and some biochemical parameters used as a part of dietary treatment of obese adult women. Method: A total of 25 adult women (12 were in study group (SG) and 13 were in control group (CG)) were taken into this study in which patients were selected randomly for both groups. At the beginning ofthe study height, weight, waist and hip circumferences of all women were measured and blood samples were taken for fasting blood glucose (FBG), insulin, trigliserid (TG), total cholesterol (C), HDL-C, LDL-C, VLDL-C, serum calcium, phosphorus, iron, iron binding capacity, ferritin levels and blood c0unting.A low calorie weight loosing diet were planned to all women, but women in SG were also advised to use a specific dietxy product rich in fiber as a bread exchange in their daily diet. Patients were controlled once a month with respect to weight loss and dietary obedience. Biochemical pxameters were repeated at third month. Statistical analysis was performed at a computer program with Mann Whithney-U ve Willcoxon tests. Results: Although biochemical parameters taken at the beginning of the study didn’t show any significant differences between groups, FBG and insulin levels were lower in study group than in control group after 3 months of the study. There were also significant decrease for insulin, TG, total C and VLDL-C levels in SG after 3 months, but not in CG. No significant differences were found at mineral levels between groups. Women in both groups loosed weight, their waist and hip circumferences decreased significantly. Conclusions: We cocluded that this fiber rich, fat and salt free dietxy product can be used for the dietary treatment of not only obesity but also dislipidemia and insulin resistant states.
078-P. PSYCHOLOGICAL OBESE W O M E N 076-P. PSYCHOLOGICAL
FRAGILITY
OF OBESE W O M E N
M.M. Silva, A.R. Silva, V.F. Matsuoka, .I. Faintuch, B. Zilberstein, .I. Gama-Rodrigues Obesity Group, Hospital das Clinicas, S o Paula, Brazil Rationale: It is widely accepted that obesity entails mental suffering especially in women, but studies in this area are relatively scarce. In a prospective protocol, female candidates for bariatric surgery wele investigated by a structured questionnaire, aiming to identify their inner feelings. Method: General infolmations were collected, and the Trinca DrawingStory Procedure was applied by trained psychologists. Age of the group (n=31) was 42.2 -/+ 8.8 yezus and body mass index was 45.0 -I+ 7.5 kg/m2. Obesity started mostly after pregnancy (48.4%) but 45.2% indicated lifelong disease and the remainder related it to adolescence. All subjects displayed comorbidities. Results: The Trinca test was consistent with denial or escape from reality (25.8%), aggressiveness (25.8%), fantasy cores (22.6%), regression to childhood (12.9%), and compulsive behavior (12.9%). Patients (100.0%) demonstrated awanznessof their body and disease, but refused to cope with it or demonstrated ambivalence. Conclusions: 1) Denial, aggressiveness, regression and ambivalence were the dominant psychologic changes; 2) Col7-ectimaging of body aberrations did not prevent a contradictory approach to it; 3) Specialized attention should be given to emotional shortcomings in this population;
IMPORTANCE
M.M. Silva, A.L. Ferreira, J. Faintuch, M. Maio, C.C. Bresciani, J. Gama-Rodrigues, B. Zilberstein Obesity Group, Hospital das Clinicas, S o Paula, Brazil Rationale: Body image is highly relevant for women. In a prospective study aiming to quantify its practical impact, morbidly obese bxiatric candidates (n= 30) wele compared to pre-operative esthetic surgery patients (n= 30). Method: General infolmations were collected,and a Body Image questionnatie was applied by trained psychologists. Age of the two groups was respectively 45 -/+lO and 43 -/+ 11 years (NS), whereas body mass index was 42 -I+ 5 and 24 -I+ 3 kg/m2 (piO.05). Results: Both groups were afraid of increasing body weight (lOO%, NS), displayed awxeness of the entire body as well as abdominal anatomy (100% and 35% respectively, NS) and declared regularly exercising 2-3 times/week (60% X 53%, NS),. Obese subjects were more upset by seing their body at the mirror (97% X 53%, piO.05) and always felt guilty after eating a loge meal ( controls only occasionally reported the same, piO.05). Nevertheless, passive attitude and magical expectations could be elicited in both populations (NS). Conclusions: 1) Uneasy feelings about body image were more prevalent in obese subjects; 2) Both groups had a contradictory approach to their problem, with frequent confusion between ideal and real management of the situation;
079-P. SLEEP ABNORMALITIES 077-P. THE EFFECT OF A FIBER RICH DIETARY PRODUCT USED FOR THE DIETARY TREATMENT OF OBESE ADULT W O M E N ON BLOOD LIPIDS AND SOME MINERAL LEVELS A. Ozenoglu’, N. Caneroglu’, G. Can3, H. Hatemi4 ‘Consultation and Liasion Psychiatry, Istanbul University, Cerrahpasa Medical Faculty, ‘Internal Disease, Endocrinology and Metabolism, Istanbul University, Cerrahpasa Medical faculty, 3Public Health, 41nternal Disease, Endocrinology and Metabolism, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey Rationale: Obesity is still a major health problem of many countries. Obesity related diseases like diabetes, coronary zuter disease have also been increasing. Fiber rich foods are known to have positive effects on health. So
OF BODY IMAGE Iii
IN MORBID
OBESITY
M.M. Silva, V.F. Matsuoka, A.R. Silva, R. Reim o, J. Faintuch, B. Zilberstein, J. Gama-Rodrigues Obesity Group, Hospital das Clinicas, S o Paula, Brazil Rationale: Sleep abnormalities are not always investigated in the assessment of candidates for anti-obesity surgery, and their frequency is debated. In a prospective study, a structured interview was conducted, aiming to better define the problem. Method: A consecutive group of 95 patients (39.6-/+11.3 years, 80.0% females, body mass index/BMI 49.5-/+9.5 kg/m2) was included. A general questionnaire was employed along with the Epworth and Giglio protocols as well as the test of Colored Pyramids of Pfister. Results: Mean nightly sleep period was 7.1-/+1.7 horns (2-12 h). Five hours
FATTY ACIDS, LIPIDS, OBESITY
075-P. NORMAL PATIENTS
METABOLIC
PROFILE IN SEVERELY OBESE
.I. Faintuch, C. Oliveira, A. Rascovski, M. Matsuda, C. Bresciani, A. Halpem, .I. Rodrigues Nutrition and Obesity Group, Hospital das Clinicas, S o Pa&, Brazil Rationale: Biochemical aberrations, especially of serum lipids, xe a serious concern in obese populations, but their actual frequency is debated. In a prospective atudy of candidates for bxiatric surgery, values for principal laboratory measurements wenz monitored.The aim was to assess derangements typical of that population. Method: Patients admitted for elective anti-obesity operation ( gastroplasty with Roux-en-Y bypass) were consecutively enrolled.Age of the population (n=32) was 42.4-/+9.1 yezus (90.6% females) with body mass index (BMI) of 53.7-/+6.7 kg/m2 (37,9- 71,l). Preoperative work-up included conventional hematologic and biochemical tests. Results: Mean total cholesterol and triglicerydes were respectively 198.6/+ 32.0 mg/lOO ml (normal 1200) and 139.5-/+54.4 mg/lOO ml (normal 5150). Neither mean uric acid (6.3-/+1.3 mg/lOO ml, normal ~7.0) nor blood glucose (102.6-/+18.9 mg/lOO ml, nolmal 5110) exceeded the normal range, and the same was true for other lipid fractions, insulin, hematologic counts and inflammatory makers. However, 5-25% of the findings exceeded the reference valuesIn addition, mean values were higher than those observed in non-obese controls. Conclusions: 1) Metabolic indices in mxkedly obese subjects were usually normal; 2) Only a minority exhibited obvious aberrations; 2) Derangements in the whole group could be more easily demonstrated when findings were companzd to eutrophic subjects;
we performed this study to search the effect of a fiber rich dietxy product on weight loss and some biochemical parameters used as a part of dietary treatment of obese adult women. Method: A total of 25 adult women (12 were in study group (SG) and 13 were in control group (CG)) were taken into this study in which patients were selected randomly for both groups. At the beginning ofthe study height, weight, waist and hip circumferences of all women were measured and blood samples were taken for fasting blood glucose (FBG), insulin, trigliserid (TG), total cholesterol (C), HDL-C, LDL-C, VLDL-C, serum calcium, phosphorus, iron, iron binding capacity, ferritin levels and blood c0unting.A low calorie weight loosing diet were planned to all women, but women in SG were also advised to use a specific dietxy product rich in fiber as a bread exchange in their daily diet. Patients were controlled once a month with respect to weight loss and dietary obedience. Biochemical pxameters were repeated at third month. Statistical analysis was performed at a computer program with Mann Whithney-U ve Willcoxon tests. Results: Although biochemical parameters taken at the beginning of the study didn’t show any significant differences between groups, FBG and insulin levels were lower in study group than in control group after 3 months of the study. There were also significant decrease for insulin, TG, total C and VLDL-C levels in SG after 3 months, but not in CG. No significant differences were found at mineral levels between groups. Women in both groups loosed weight, their waist and hip circumferences decreased significantly. Conclusions: We cocluded that this fiber rich, fat and salt free dietxy product can be used for the dietary treatment of not only obesity but also dislipidemia and insulin resistant states.
078-P. PSYCHOLOGICAL OBESE W O M E N 076-P. PSYCHOLOGICAL
FRAGILITY
OF OBESE W O M E N
M.M. Silva, A.R. Silva, V.F. Matsuoka, .I. Faintuch, B. Zilberstein, .I. Gama-Rodrigues Obesity Group, Hospital das Clinicas, S o Paula, Brazil Rationale: It is widely accepted that obesity entails mental suffering especially in women, but studies in this area are relatively scarce. In a prospective protocol, female candidates for bariatric surgery wele investigated by a structured questionnaire, aiming to identify their inner feelings. Method: General infolmations were collected, and the Trinca DrawingStory Procedure was applied by trained psychologists. Age of the group (n=31) was 42.2 -/+ 8.8 yezus and body mass index was 45.0 -I+ 7.5 kg/m2. Obesity started mostly after pregnancy (48.4%) but 45.2% indicated lifelong disease and the remainder related it to adolescence. All subjects displayed comorbidities. Results: The Trinca test was consistent with denial or escape from reality (25.8%), aggressiveness (25.8%), fantasy cores (22.6%), regression to childhood (12.9%), and compulsive behavior (12.9%). Patients (100.0%) demonstrated awanznessof their body and disease, but refused to cope with it or demonstrated ambivalence. Conclusions: 1) Denial, aggressiveness, regression and ambivalence were the dominant psychologic changes; 2) Col7-ectimaging of body aberrations did not prevent a contradictory approach to it; 3) Specialized attention should be given to emotional shortcomings in this population;
IMPORTANCE
M.M. Silva, A.L. Ferreira, J. Faintuch, M. Maio, C.C. Bresciani, J. Gama-Rodrigues, B. Zilberstein Obesity Group, Hospital das Clinicas, S o Paula, Brazil Rationale: Body image is highly relevant for women. In a prospective study aiming to quantify its practical impact, morbidly obese bxiatric candidates (n= 30) wele compared to pre-operative esthetic surgery patients (n= 30). Method: General infolmations were collected,and a Body Image questionnatie was applied by trained psychologists. Age of the two groups was respectively 45 -/+lO and 43 -/+ 11 years (NS), whereas body mass index was 42 -I+ 5 and 24 -I+ 3 kg/m2 (piO.05). Results: Both groups were afraid of increasing body weight (lOO%, NS), displayed awxeness of the entire body as well as abdominal anatomy (100% and 35% respectively, NS) and declared regularly exercising 2-3 times/week (60% X 53%, NS),. Obese subjects were more upset by seing their body at the mirror (97% X 53%, piO.05) and always felt guilty after eating a loge meal ( controls only occasionally reported the same, piO.05). Nevertheless, passive attitude and magical expectations could be elicited in both populations (NS). Conclusions: 1) Uneasy feelings about body image were more prevalent in obese subjects; 2) Both groups had a contradictory approach to their problem, with frequent confusion between ideal and real management of the situation;
079-P. SLEEP ABNORMALITIES 077-P. THE EFFECT OF A FIBER RICH DIETARY PRODUCT USED FOR THE DIETARY TREATMENT OF OBESE ADULT W O M E N ON BLOOD LIPIDS AND SOME MINERAL LEVELS A. Ozenoglu’, N. Caneroglu’, G. Can3, H. Hatemi4 ‘Consultation and Liasion Psychiatry, Istanbul University, Cerrahpasa Medical Faculty, ‘Internal Disease, Endocrinology and Metabolism, Istanbul University, Cerrahpasa Medical faculty, 3Public Health, 41nternal Disease, Endocrinology and Metabolism, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey Rationale: Obesity is still a major health problem of many countries. Obesity related diseases like diabetes, coronary zuter disease have also been increasing. Fiber rich foods are known to have positive effects on health. So
OF BODY IMAGE Iii
IN MORBID
OBESITY
M.M. Silva, V.F. Matsuoka, A.R. Silva, R. Reim o, J. Faintuch, B. Zilberstein, J. Gama-Rodrigues Obesity Group, Hospital das Clinicas, S o Paula, Brazil Rationale: Sleep abnormalities are not always investigated in the assessment of candidates for anti-obesity surgery, and their frequency is debated. In a prospective study, a structured interview was conducted, aiming to better define the problem. Method: A consecutive group of 95 patients (39.6-/+11.3 years, 80.0% females, body mass index/BMI 49.5-/+9.5 kg/m2) was included. A general questionnaire was employed along with the Epworth and Giglio protocols as well as the test of Colored Pyramids of Pfister. Results: Mean nightly sleep period was 7.1-/+1.7 horns (2-12 h). Five hours