Clinical implications of obesity with specific focus on cardiovascular disease: A statement for professionals from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism

Circulation

Volumn 110, Issue 18, 2004, Pages 2952-2967

  Klein, Samuel ^a   Burke, Lora E ^a   Bray, George A ^a   Blair, Steven ^a   Allison, David B ^a   Pi Sunyer, Xavier ^a   Hong, Yuling ^a   Eckel, Robert H ^a  

^a NONE

Author keywords

AHA Scientific Statements; Cardiovascular diseases; Diet; Exercise; Obesity

Indexed keywords

AMFEPRAMONE; BENZPHETAMINE; CHITOSAN; CHROMIUM PICOLINATE; CITRUS FRUIT EXTRACT; HERBACEOUS AGENT; HYDROXYCITRIC ACID; PHENDIMETRAZINE; PHENTERMINE; PHENYLEPHRINE; PLACEBO; SIBUTRAMINE; TETRAHYDROLIPSTATIN;

AUTONOMIC DYSFUNCTION; BARIATRIC SURGERY; BODY MASS; CARDIOVASCULAR DISEASE; CLINICAL TRIAL; CONSTIPATION; DIET THERAPY; DYSLIPIDEMIA; ELECTROCARDIOGRAM; EPHEDRA SINICA; EXERCISE; GARCINIA CAMBOGIA; GASTROINTESTINAL SYMPTOM; HEALTH BEHAVIOR; HEART FUNCTION; HUMAN; HYPERTENSION; INFLAMMATION; INSOMNIA; INSULIN RESISTANCE; ISCHEMIC HEART DISEASE; LIME (FRUIT); LUNG DISEASE; MEDICAL SOCIETY; METABOLIC SYNDROME X; NON INSULIN DEPENDENT DIABETES MELLITUS; NUTRITION; OBESITY; PHYSICAL ACTIVITY; PHYSICAL EXAMINATION; PRACTICE GUIDELINE; PRIORITY JOURNAL; REVIEW; RISK FACTOR; UNITED STATES; WEIGHT REDUCTION; XEROSTOMIA;

ANTI-OBESITY AGENTS; AUTONOMIC NERVOUS SYSTEM DISEASES; BARIATRICS; BODY COMPOSITION; CARDIOVASCULAR DISEASES; COMBINED MODALITY THERAPY; DIABETES MELLITUS, TYPE 2; DIET, REDUCING; FEEDING BEHAVIOR; GASTRIC BYPASS; HUMANS; HYPERLIPIDEMIAS; INFLAMMATION; INSULIN RESISTANCE; METABOLIC SYNDROME X; MOTOR ACTIVITY; OBESITY; PHYTOTHERAPY; RISK FACTORS; SLEEP APNEA, OBSTRUCTIVE; WEIGHT LOSS;

EID: 8144231115     PISSN: 00097322     EISSN: None     Source Type: Journal    
DOI: 10.1161/01.CIR.0000145546.97738.1E     Document Type: Review

References (213)

1. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults - The Evidence Report. National Institutes of Health. Obes Res. 1998;6:51S-209S.
2. Sjostrom CD, Lissner L, Wedel H, Sjostrom L. Reduction in incidence of diabetes, hypertension and lipid disturbances after intentional weight loss induced by bariatric surgery: the SOS Intervention Study. Obes Res. 1999;7:477-484.
3. Alpert MA, Terry BE, Kelly DL. Effect of weight loss on cardiac chamber size, wall thickness and left ventricular function in morbid obesity. Am J Cardiol. 1985;55:783-786.
4. Salans LB, Cushman SW, Weismann RE. Studies of human adipose tissue. Adipose cell size and number in nonobese and obese patients. J Clin Invest. 1973;52:929-941.
5. Pouliot MC, Despres JP, Lemieux S, Moorjani S, Bouchard C, Tremblay A, Nadeau A, Lupien PJ. Waist circumference and abdominal sagittal diameter: best simple anthropometric indices of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol. 1994;73:460-468.
6. Krssak M, Falk Petersen K, Dresner A, DiPietro L, Vogel SM, Rothman DL, Roden M, Shulman GI. Intramyocellular lipid concentrations are correlated with insulin sensitivity in humans: a 1H NMR spectroscopy study. Diabetologia. 1999;42:113-116.
7. Seppala-Lindroos A, Vehkavaara S, Hakkinen AM, Goto T, Westerbacka J, Sovijarvi A, Halavaara J, Yki-Jarvinen H. Fat accumulation in the liver is associated with defects in insulin suppression of glucose production and serum free fatty acids independent of obesity in normal men. J Clin Endocrinol Metab. 2002;87:3023-3028.
8. Alpert MA. Obesity cardiomyopathy: pathophysiology and evolution of the clinical syndrome. Am J Med Sci. 2001;321:225-236.
9. Peterson LR, Waggoner AD, Schechtman KB, Meyer T, Gropler RJ, Barzilai B, Davila-Roman VG. Alterations in left ventricular structure and function in young healthy obese women: assessment by echocardiography and tissue Doppler imaging. J Am Coll Cardiol. 2004;43:1399-1404.
10. Bailor DL, Poehlman ET. Exercise-training enhances fat-free mass preservation during diet-induced weight loss: a meta-analytical finding. Int J Obes Relat Metab Disord. 1994;18:35-40.
11. Garrow JS, Summerbell CD. Meta-analysis: effect of exercise, with or without dieting, on the body composition of overweight subjects. Eur J Clin Nutr. 1995;49:1-10.
12. Knittle JL, Ginsberg-Fellner F. Effect of weight reduction on in vitro adipose tissue lipolysis and cellularity in obese adolescents and adults. Diabetes. 1972;21:754-761.
13. Naslund I, Hallgren P, Sjostrom L. Fat cell weight and number before and after gastric surgery for morbid obesity in women. Int J Obes. 1988;12:191-197.
14. Ross R, Rissanen J, Pedwell H, Clifford J, Shragge P. Influence of diet and exercise on skeletal muscle and visceral adipose tissue in men. J Appl Physiol 1996;81:2445-2455.
15. Goodpaster BH, Theriault R, Watkins SC, et al. Intramuscular lipid content is increased in obesity and decreased by weight loss. Metabolism. 2000;49:467-472.
16. Tiikkainen M, Bergholm R, Vehkavaara S, Rissanen A, Hakkinen AM, Tamminen M, Teramo K, Yki-Jarvinen H. Effects of identical weight loss on body composition and features of insulin resistance in obese women with high and low liver fat content. Diabetes. 2003;52:701-707.
17. Goldstein DJ. Beneficial health effects of modest weight loss. Int J Obes Relat Metab Disord. 1992;16:397-415.
18. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106:3143-3421.
19. Isomaa B, Almgren P, Tuomi T, Forsen B, Lahti K, Nissen M, Taskinen MR, Groop L. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care. 2001;24:683-689.
20. Alexander CM, Landsman PB, Teutsch SM, Haffner SM; Third National Health and Nutrition Examination Survey (NHANES III); National Cholesterol Education Program (NCEP). NCEP-defined metabolic syndrome, diabetes, and prevalence of coronary heart disease among NHANES III participants age 50 years and older. Diabetes. 2003;52:1210-1214.
21. Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, Salonen JT. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA. 2002;288:2709-2716.
22. Kelley DE, Wing R, Buonocore C, Sturis J, Polonsky K, Fitzsimmons M. Relative effects of calorie restriction and weight loss in noninsulin-dependent diabetes mellitus. J Clin Endocrinol Metab. 1993;77:1287-1293.
23. Wing RR, Koeske R, Epstein LH, Nowalk MP, Gooding W, Becker D. Long-term effects of modest weight loss in type II diabetic patients. Arch Intern Med. 1987;147:1749-1753.
24. Pories WJ, Swanson MS, MacDonald KG, Long SB, Morris PG, Brown BM, Barakat HA, deRamon RA, Israel G, Dolezal JM, et al. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg. 1995;222:339-350.
25. Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, et al. Finnish Diabetes Prevention Study Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344:1343-1350.
26. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393-403.
27. Sjostrom CD, Peltonen M, Wedel H, Sjostrom L. Differentiated long-term effects of intentional weight loss on diabetes and hypertension. Hypertension. 2000;36:20-25.
28. Torgerson JS, Hauptman J, Boldrin MN, Sjostrom L. XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care. 2004;27:155-161.
29. Dattilo AM, Kris-Etherton PM. Effects of weight reduction on blood lipids and lipoproteins: a meta-analysis. Am J Clin Nutr. 1992;56:320-328.
30. Eckel RH, Yost TJ. HDL subfractions and adipose tissue metabolism in the reduced-obese state. Am J Physiol. 1989;256:E740-E746.
31. Wadden TA, Anderson DA, Foster GD. Two-year changes in lipids and lipoproteins associated with the maintenance of a 5% to 10% reduction in initial weight: some findings and some questions. Obes Res. 1999;7:170-178.
32. Rossner S, Bjorvell H. Early and late effects of weight loss on lipoprotein metabolism in severe obesity. Atherosclerosis. 1987;64:125-130.
33. Effects of weight loss and sodium reduction intervention on blood pressure and hypertension incidence in overweight people with high-normal blood pressure. The Trials of Hypertension Prevention, phase II. The Trials of Hypertension Prevention Collaborative Research Group. Arch Intern Med. 1997;157:657-667.
34. Stevens VJ, Obarzanek E, Cook NR, Lee IM, Appel LJ, Smith West D, Milas NC, Mattfeldt-Beman M, Beiden L, Bragg C, et al. Long-term weight loss and changes in blood pressure: results of the Trials of Hypertension Prevention, phase II. Ann Intern Med. 2001;134:1-11.
35. Foley EF, Benotti PN, Borlase BC, Hollingshead J, Blackburn GL. Impact of gastric restrictive surgery on hypertension in the morbidly obese. Am J Surg. 1992;163:294-297.
36. Carson JL, Ruddy ME, Duff AE, Holmes NJ, Cody RP, Brolin RE. The effect of gastric bypass surgery on hypertension in morbidly obese patients. Arch Intern Med. 1994;154:193-200.
37. Sjostrom CD, Peltonen M, Sjostrom L. Blood pressure and pulse pressure during long-term weight loss in the obese: the Swedish Obese Subjects (SOS) Intervention Study. Obes Res. 2001;9:188-195.
38. Huang Z, Willett WC, Manson JE, Rosner B, Stampfer MJ, Speizer FE, Colditz GA. Body weight, weight change, and risk for hypertension in women. Ann Intern Med. 1998;128:81-88.
39. Orea-Tejeda A, Valencia-Flores M, Castillo-Martinez L, Rebollar-Gonzalez V, Gonzalez-Barranco J, Castano A, Asensio E, Dorantes-Garcia J, Sepulveda-Mendez J, Oseguera-Moguel J, et al. Abnormal SPECT myocardial perfusion imaging during periods of obstructive sleep apnea in morbid obese patients without known heart disease. Rev Invest Clin. 2003;55:18-25.
40. Blankfield RP, Hudgel DW, Tapolyai AA, Zyzanski SJ. Bilateral leg edema, obesity, pulmonary hypertension, and obstructive sleep apnea. Arch Intern Med. 2000;160:2357-2362.
41. Valencia-Flores M, Orea A, Castano VA, Resendiz M, Rosales M, Rebollar V, Santiago V, Gallegos J, Campos RM, Gonzalez J, et al. Prevalence of sleep apnea and electrocardiographic disturbances in morbidly obese patients. Obes Res. 2000;8:262-269.
42. Marrone O, Bonsignore MR. Pulmonary haemodynamics in obstructive sleep apnoea. Sleep Med Rev. 2002;6:175-193.
43. Liuzzo G, Biasucci LM, Gallimore JR, Grillo RL, Rebuzzi AG, Pepys MB, Maseri A. The prognostic value of C-reactive protein and serum amyloid a protein in severe unstable angina. N Engl J Med. 1994;331:417-424.
44. Thompson G, Kienast J, Pyke SD, Haverkate F, van de Loo JC. Hemostatic factors and the risk of myocardial infarction or sudden death in patients with angina pectoris. European Concerted Action on Thrombosis and Disabilities Angina Pectoris Study Group. N Engl J Med. 1995;332:635-641.
45. Danesh J, Collins R, Appleby P, Peto R. Association of fibrinogen, C-reactive protein, albumin, or leukocyte count with coronary heart disease: meta-analyses of prospective studies. JAMA. 1998;279:1477-1482.
46. Mohamed-Ali V, Goodrick S, Rawesh A, Katz DR, Miles JM, Yudkin JS, Klein S, Coppack SW. Subcutaneous adipose tissue releases interleukin-6, but not tumor necrosis factor-alpha, in vivo. J Clin Endocrinol Metab. 1997;82:4196-4200.
47. Bastard JP, Jardel C, Bruckert E, Blondy P, Capeau J, Laville M, Vidal H, Hainque B. Elevated levels of interleukin 6 are reduced in serum and subcutaneous adipose tissue of obese women after weight loss. J Clin Endocrinol Metab. 2000;85:3338-3342.
48. Ziccardi P, Nappo F, Giugliano G, Esposito K, Marfella R, Cioffi M, D'Andrea F, Molinari AM, Giugliano D. Reduction of inflammatory cytokine concentrations and improvement of endothelial functions in obese women after weight loss over one year. Circulation. 2002;105:804-809.
49. Esposito K, Pontillo A, Ciotola M, Di Palo C, Grella E, Nicoletti G, Giugliano D. Weight loss reduces interleukin-18 levels in obese women. J Clin Endocrinol Metab. 2002;87:3864-3866.
50. Kern PA, Saghizadeh M, Ong JM, Bosch RJ, Deem R, Simsolo RB. The expression of tumor necrosis factor in human adipose tissue. Regulation by obesity, weight loss, and relationship to lipoprotein lipase. J Clin Invest. 1995;95:2111-2119.
51. Heinrich PC, Castell JV, Andus T. Interleukin-6 and the acute phase response. Biochem J. 1990;265:621-636.
52. McLaughlin T, Abbasi F, Lamendola C, Liang L, Reaven G, Schaaf P, Reaven P. Differentiation between obesity and insulin resistance in the association with C-reactive protein. Circulation. 2002;106:2908-2912.
53. Hak AE, Stehouwer CD, Bots ML, Polderman KH, Schalkwijk CG, Westendorp IC, Hofman A, Witteman JC. Associations of C-reactive protein with measures of obesity, insulin resistance and subclinical atherosclerosis in healthy, middle-aged women. Arterioscler Thromb Vasc Biol. 1999;19:1986-1991.
54. Yudkin JS, Stehouwer CD, Emeis JJ, Coppack SW. C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue? Arterioscler Thromb Vasc Biol. 1999;19:972-978.
55. Lemieux I, Pascot A, Prud'homme D, Almeras N, Bogaty P, Nadeau A, Bergeron J, Despres JP. Elevated C-reactive protein: another component of the atherothrombotic profile of abdominal obesity. Arterioscler Thromb Vasc Biol. 2001;21:961-967.
56. Festa A, D'Agostino R Jr, Howard G, Mykkanen L, Tracy P, Haffner SM. Chronic subclinical inflammation as part of the insulin resistance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS). Circulation. 2000;102:42-47.
57. Kuller LH, Tracy RP, Shaten J, Meilahn EN. Relation of C-reactive protein and coronary heart disease in the MRFIT nested case-control study. Multiple Risk Factor Intervention Trial. Am J Epidemiol. 1996;144:537-547.
58. Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med. 1997;336:973-979.
59. Harris TB, Ferrucci L, Tracy RP, Corti MC, Wacholder S, Ettinger WH Jr, Heimovitz H, Cohen HJ, Wallace R. Associations of elevated interleukin-6 and C-reactive protein levels with mortality in the elderly. Am J Med. 1999;106:506-512.
60. Ridker PM. High-sensitivity C-reactive protein: potential adjunct for global risk assessment in the primary prevention of cardiovascular disease. Circulation. 2001;103:1813-1818.
61. Ridker PM, Hennekens CH, Buring JE, Rifai N. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med. 2000;342:836-843.
62. Heilbronn LK, Noakes M. Clifton PM. Energy restriction and weight loss on very low-fat diets reduce C-reactive protein concentrations in obese, healthy women. Arterioscler Thromb Vasc Biol. 2001;21:968-970.
63. Tchernof A, Nolan A, Sites CK, Ades PA, Poehlman ET. Weight loss reduces C-reactive protein levels in obese postmenopausal women. Circulation. 2002;105:564-569.
64. Hanusch-Enserer U, Cauza E, Spak M, Dunky A, Rosen HR, Wolf H, Prager R, Eibl MM. Acute-phase response and immunological markers in morbid obese patients and patients following adjustable gastric banding. Int J Obes Relat Metab Disord. 2003;27:355-361.
65. Kopp HP, Kopp CW, Festa A, Krzyzanowska K, Kriwanek S, Minar E, Roka R, Schernthaner G. Impact of weight loss on inflammatory proteins and their association with the insulin resistance syndrome in morbidly obese patients. Arterioscler Thromb Vasc Biol. 2003;23:1042-1047.
66. Laimer M, Ebenbichler CF, Kaser S, Sandhofer A, Weiss H, Nehoda H, Aigner F, Patsch JR. Markers of chronic inflammation and obesity: a prospective study on the reversibility of this association in middle-aged women undergoing weight loss by surgical intervention. Int J Obes Relat Metab Disord. 2002;26:659-662.
67. Marfella R, Esposito K, Siniscalchi M, Cacciapuoti F, Giugliano F, Labriola D, Ciotola M, Di Palo C, Misso L, Giugliano D. Effect of weight loss on cardiac synchronization and proinflammatory cytokines in premenopausal obese women. Diabetes Care. 2004;27:47-52.
68. Monzillo LU, Hamdy O, Horton ES, Ledbury S, Mullooly C, Jarema C, Porter S, Ovalle K, Moussa A, Mantzoros CS. Effect of lifestyle modification on adipokine levels in obese subjects with insulin resistance. Obes Res. 2003;11:1048-1054.
69. Bastard JP, Jardel C, Bruckert E, Vidal H, Hainque B. Variations in plasma soluble tumour necrosis factor receptors after diet-induced weight loss in obesity. Diabetes Obes Metab. 2000;2:323-325.
70. Hirsch J, Leibel RL, Mackintosh R, Aguirre A. Heart rate variability as a measure of autonomic function during weight change in humans. Am J Physiol. 1991;261:R1418-R1423.
71. Kannel WB, Kannel C, Paffenbarger RS Jr, Cupples LA. Heart rate and cardiovascular mortality: the Framingham Study. Am Heart J. 1987;113:1489-1494.
72. Seccareccia F, Pannozzo F, Dima F, Minoprio A, Menditto A, Lo Noce C, Giampaoli S; Malattie Cardiovascolari Aterosclerotiche Istituto Superiore di Sanita Project. Heart rate as a predictor of mortality: the MATISS project. Am J Public Health. 2001;91:1258-1263.
73. Karason K, Molgaard H, Wikstrand J, Sjostrom L. Heart rate variability in obesity and the effect of weight loss. Am J Cardiol. 1999;83:1242-1247.
74. Arone LJ, Mackintosh R, Rosenbaum M, Leibel RL, Hirsch J. Autonomic nervous system activity in weight gain and weight loss. Am J Physiol. 1995;269:R222-R225.
75. Poirier P, Hernandez TL, Weil KM, Shepard TJ, Eckel RH. Impact of diet-induced weight loss on the cardiac autonomic nervous system in severe obesity. Obes Res. 2003;11:1040-1046.
76. Laaksonen DE, Laitinen T, Schonberg J, Rissanen A, Niskanen LK. Weight loss and weight maintenance, ambulatory blood pressure and cardiac autonomic tone in obese persons with the metabolic syndrome. J Hypertens. 2003;21:371-378.
77. Rissanen P, Franssila-Kallunki A, Rissanen A. Cardiac parasympathetic activity is increased by weight loss in healthy obese women. Obes Res. 2001;9:637-643.
78. Alexander JK. Obesity and coronary heart disease. Am J Med Sci. 2001;321:215-224.
79. Yang D, Fontaine KR, Wang C, Allison DB. Weight loss causes increased mortality: cons. Obes Rev. 2003;4:9-16.
80. Fontaine KR, Allison DB. Does intentional weight loss affect mortality rate? Eat Behav. 2001;2:87-95.
81. Miller WC, Koceja DM, Hamilton EJ. A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention. Int J Obes Relat Metab Disord. 1997;21:941-947.
82. Torgerson JS, Sjostrom L. The Swedish Obese Subjects (SOS) study - rationale and results. Int J Obes Relat Metab Disord. 2001;25:S2-S4.
83. Allison DB, Fontaine KR, Manson JE, Stevens J, VanItallie TB. Annual deaths attributable to obesity in the United States. JAMA. 1999;282:1530-1538.
84. Lee IM, Blair SN, Allison DB, Folsom AR, Harris TB, Manson JE, Wing RR. Epidemiologic data on the relationships of caloric intake, energy balance, and weight gain over the life span with longevity and morbidity. J Gerontol A Biol Sci Med Sci. 2001;56:7-19.
85. Troiano RP, Frongillo EA Jr, Sobal J, Levitsky DA. The relationship between body weight and mortality: a quantitative analysis of combined information from existing studies. Int J Obes Relat Metab Disord. 1996;20:63-75.
86. Albert CM, Chae CU, Grodstein F, Rose LM, Rexrode KM, Ruskin JN, Stampfer MJ, Manson JE. Prospective study of sudden cardiac death among women in the United States. Circulation. 2003;107:2096-2101.
87. Stevens J, Cai J, Evenson KR, Thomas R. Fitness and fatness as predictors of mortality from all causes and from cardiovascular disease in men and women in the lipid research clinics study. Am J Epidemiol. 2002;156:832-841.
88. Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW Jr. Body-mass index and mortality in a prospective cohort of US adults. N Engl J Med. 1999;341:1097-1105.
89. Selmer R, Tverdal A. Body mass index and cardiovascular mortality at different levels of blood pressure: a prospective study of Norwegian men and women. J Epidemiol Community Health. 1995;49:265-270.
90. Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH. Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935. N Engl J Med. 1992;327:1350-1355.
91. Pamuk ER, Williamson DF, Madans J, Serdula MK, Kleinman JC, Byers T. Weight loss and mortality in a national cohort of adults, 1971-1987. Am J Epidemiol. 1992;136:686-697.
92. Pascual M, Pascual DA, Soria F, Vicente T, Hernandez AM, Tebar FJ, Valdes M. Effects of isolated obesity on systolic and diastolic left ventricular function. Heart. 2003;89:1152-1156.
93. Alpert MA, Lambert CR, Panayiotou H, Terry BE, Cohen MV, Massey CV, Hashimi MW, Mukerji V. Relation of duration of morbid obesity to left ventricular mass, systolic function, and diastolic filling, and effect of weight loss. Am J Cardiol. 1995;76:1194-1197.
94. Kasper EK, Hruban RH, Baughman KL. Cardiomyopathy of obesity: a clinicopathologic evaluation of 43 obese patients with heart failure. Am J Cardiol. 1992;70:921-924.
95. Ku CS, Lin SL, Wang DJ, Chang SK, Lee WJ. Left ventricular filling in young normotensive obese adults. Am J Cardiol. 1994;73:613-615.
96. Messerli FH. Cardiopathy of obesity - a not-so-Victorian disease. N Engl J Med. 1986;314:378-380.
97. Deleted in proof.
98. Contaldo F, Pasanisi F, Finelli C, de Simone G. Obesity, heart failure and sudden death. Nutr Metab Cardiovasc Dis. 2002;12:190-197.
99. Alpert MA, Hashimi MW. Obesity and the heart. Am J Med Sci. 1993;306:117-123.
100. Jornet A, Batalla J, Uson M, Mallol A, Reig J, Petit M. Lipomatous hypertrophy of the interatrial septum: Diagnosis by transesophageal echocardiography. Echocardiography. 1992;9:501-503.
101. Alaud-din A, Meterissian S, Lisbona R, MacLean LD, Forse RA. Assessment of cardiac function in patients who were morbidly obese. Surgery. 1990;108:809-820.
102. Karason K, Wallentin I, Larsson B, Sjostrom L. Effects of obesity and weight loss on cardiac function and valvular performance. Obes Res. 1998;6:422-429.
103. MacMahon SW, Wilcken DE, Macdonald GJ. The effect of weight reduction on left ventricular mass. A randomized, controlled trial in young, overweight hypertensive patients. N Engl J Med. 1986;314:334-339.
104. Himeno E, Nishino K, Nakashima Y, Kuroiwa A, Ikeda M. Weight reduction regresses left ventricular mass regardless of blood pressure level in obese subjects. Am Heart J. 1996;131:313-319.
105. Wirth A, Kroger H. Improvement of left ventricular morphology and function in obese subjects following a diet and exercise program. Int J Obes Relat Metab Disord. 1995;19:61-66.
106. Hinderliter A, Sherwood A, Gullette EC, Babyak M, Waugh R, Georgiades A, Blumenthal JA. Reduction of left ventricular hypertrophy after exercise and weight loss in overweight patients with mild hypertension. Arch Intern Med. 2002;162:1333-1339.
107. Reid CM, Dart AM, Dewar EM, Jennings GL. Interactions between the effects of exercise and weight loss on risk factors, cardiovascular haemodynamics and left ventricular structure in overweight subjects. J Hypertens. 1994;12:291-301.
108. Archibald EH, Stallings VA, Pencharz PB, Duncan WJ, Williams C. Changes in intraventricular septal thickness, left ventrical wall thickness and left ventricular volume in obese adolescents on a high protein weight reducing diet. Int J Obes. 1989;13:265-269.
109. Mitchell BM, Gutin B, Kapuku G, Barbeau P, Humphries MC, Owens S, Vemulapalli S, Allison J. Left ventricular structure and function in obese adolescents: relations to cardiovascular fitness, percent body fat, and visceral adiposity, and effects of physical training. Pediatrics. 2002;109:E73-3.
110. Klein S, Fontana L, Young VL, Coggan AR, Kilo C, Patterson BW, Mohammed BS. Absence of an effect of liposuction on insulin action and risk factors for coronary heart disease. N Engl J Med. 2004;350:2549-2557.
111. Ryttig KR, Flaten H, Rossner S. Long-term effects of a very low calorie diet (Nutrilett) in obesity treatment. A prospective, randomized, comparison between VLCD and a hypocaloric diet+behavior modification and their combination. Int J Obes Relat Metab Disord. 1997;21:574-579.
112. Wadden TA, Stunkard AJ. Controlled trial of very-low-calorie diet, behavior therapy, and their combination in the treatment of obesity. J Consult Clin Psychol. 1986;54:482-488.
113. Wadden TA, Foster GD, Letizia KA. One-year behavioral treatment of obesity: comparison of moderate and severe caloric restriction and the effects of weight maintenance therapy. J Consult Clin Psychol. 1994;62:165-171.
114. Klein S, Wadden T, Sugerman HJ. AGA technical review on obesity. Gastroenterology. 2002;123:882-932.
115. Astrup A, Grunwald GK, Melanson EL, Saris WH, Hill JO. The role of low-fat diets in body weight control: a meta-analysis of ad libitum dietary intervention studies. Int J Obes Relat Metab Disord. 2000;24:1545-1552.
116. Klem ML, Wing RR, McGuire MT, Seagle HM, Hill JO. A descriptive study of individuals successful at long-term maintenance of substantial weight loss. Am J Clin Nutr. 1997;66:239-246.
117. Pirozzo S, Summerbell C, Cameron C, Glasziou P. Advice on low-fat diets for obesity. Cochrane Database Syst Rev. 2002;2:CD003640.
118. Skov AR, Toubro S, Ronn B, Holm L, Astrup A. Randomized trial on protein vs carbohydrate in ad libitum fat reduced diet for the treatment of obesity. Int J Obes Relat Metab Disord. 1999;23:528-536.
119. Brehm BJ, Seeley RJ, Daniels SR, D'Alessio DA. A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. J Clin Endocrinol Metab. 2003;88:1617-1623.
120. Samaha FF, Iqbal N, Seshadri P, Chicano KL, Daily DA, McGrory J, Williams T, Williams M, Gracely EJ, Stern L. A low-carbohydrate as compared with a low-fat diet in severe obesity. N Engl J Med. 2003;348:2074-2081.
121. Foster GD, Wyatt H, Hill JO, McGuckin BG, Brill C, Mohammed BS, Szapary PO, Rader DJ, Edman JS, Klein S. A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med. 2003;348:2082-2090.
122. Stern L, Iqbal N, Seshadri P, Chicano KL, Daily DA, McGrory J, Williams M, Gracely EJ, Samaha FF. The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow up of a randomized trial. Ann Intern Med. 2004;140:778-785.
123. Yancy WS Jr, Olsen MK, Guyton JR, Bakst RP, Westman EC. A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial. Ann Intern Med. 2004;140:769-777.
124. Sondike SB, Copperman N, Jacobson MS. Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factor in overweight adolescents. J Pediatr. 2003;142:253-258.
125. Bonow RO, Eckel RH. Diet, obesity, and cardiovascular risk. N Engl J Med. 2003;348:2057-2058.
126. Jenkins DJ, Wolever TM, Taylor RH, Barker H, Fielden H, Baldwin JM, Bowling AC, Newman HC, Jenkins AL, Goff DV. Glycemic index of foods: a physiological basis for carbohydrate exchange. Am J Clin Nutr. 1981;34:362-366.
127. Wolever TM, Nuttall FQ, Lee R, Wong GS, Josse RG, Csima A, Jenkins DJ. Prediction of the relative blood glucose response of mixed meals using the white bread glycemic index. Diabetes Care. 1985;8:418-428.
128. Ebbeling CB, Leidig MM, Sinclair KB, Hangen JP, Ludwig DS. A reduced-glycemic load diet in the treatment of adolescent obesity. Arch Pediatr Adolesc Med. 2003;157:773-779.
129. Rolls BJ, Bell EA. Dietary approaches to the treatment of obesity. Med Clin North Am. 2000;84:401-418.
130. Saris WH, Astrup A, Prentice AM, Zunft HJ, Formiguera X, Verboeket-van de Venne WP, Raben A, Poppitt SD, Seppelt B, Johnston S, et al. Randomized controlled trial of changes in dietary carbohydrate/fat ratio and simple vs complex carbohydrates on body weight and blood lipids: the CARMEN study. The Carbohydrate Ratio Management in European National diets. Int J Obes Relat Metab Disord. 2000;24:1310-1318.
131. Rolls BJ, Morris EL, Roe LS. Portion size of food affects energy intake in normal-weight and overweight men and women. Am J Clin Nutr. 2002;76:1207-1213.
132. Jeffery RW, Wing RR, Thorson C, Burton LR, Raether C, Harvey J, Mullen M. Strengthening behavioral interventions for weight loss: a randomized trial of food provision and monetary incentives. J Consult Clin Psychol. 1993;61:1038-1045.
133. Ditschuneit HH, Flechtner-Mors M, Johnson TD, Adler G. Metabolic and weight-loss effects of long-term dietary intervention in obese subjects. Am J Clin Nutr. 1999;69:198-204.
134. Flechtner-Mors M, Ditschuneit HH, Johnson TD, Suchard MA, Adler G. Metabolic and weight loss effects of long-term dietary intervention in obese patients: four-year results. Obes Res. 2000;8:399-402.
135. Krauss RM, Eckel RH, Howard B, Appel LJ, Daniels SR, Deckelbaum RJ, Erdman JW Jr, Kris-Etherton P, Goldberg IJ, Kotchen TA, et al. AHA Dietary Guidelines: revision 2000: A statement for healthcare professionals from the Nutrition Committee of the American Heart Association. Circulation. 2000;102:2284-2299.
136. Physical activity and cardiovascular health. NIH Consensus Development Panel on Physical Activity and Cardiovascular Health. JAMA. 1996;276:241-246.
137. Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C, Buchner D, Ettinger W, Heath GW, King AC, et al. Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995;273:402-407.
138. Physical Activity and Health: A Report of the Surgeon General. Atlanta, Ga: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion, 1996. S/N 017-023-00196-5.
139. Blair SN, Brodney S. Effects of physical inactivity and obesity on morbidity and mortality: current evidence and research issues. Med Sci Sports Exerc. 1999;31:S646-S662.
140. Church TS, Cheng YJ, Earnest CP, Barlow CE, Gibbons LW, Priest EL, Blair SN. Exercise capacity and body composition as predictors of mortality among men with diabetes. Diabetes Care. 2004;27:83-88.
141. Lee CD, Jackson AS, Blair SN. US weight guidelines: is it also important to consider cardiorespiratory fitness? Int J Obes Relat Metab Disord. 1998;22:S2-S7.
142. Lee CD, Blair SN, Jackson AS. Cardiorespiratory fitness, body composition, and all-cause and cardiovascular disease mortality in men. Am J Clin Nutr. 1999;69:373-380.
143. Wei M, Kampert JB, Barlow CE, Nichaman MZ, Gibbons LW, Paffenbarger RS Jr, Blair SN. Relationship between low cardiorespiratory fitness and mortality in normal-weight, overweight, and obese men. JAMA. 1999;282:1547-1553.
144. Wing RR. Physical activity in the treatment of the adulthood overweight and obesity: current evidence and research issues. Med Sci Sports Exerc. 1999;31:S547-S552.
145. Saris WH, Blair SN, van Baak MA, Eaton SB, Davies PS, Di Pietro L, Fogelholm M, Rissanen A, Schoeller D, Swinburn B, et al. How much physical activity is enough to prevent unhealthy weight gain? Outcome of the IASO 1st Stock Conference and consensus statement. Obes Rev. 2003;4:101-114.
146. Jakicic JM, Clark K, Coleman E, Donnelly JE, Foreyt J, Melanson E, Volek J, Volpe SL: American College of Sports Medicine. American College of Sports Medicine position stand. Appropriate intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc. 2001;33:2145-2156.
147. Jeffery RW, Wing RR, Sherwood NE, Tate DF. Physical activity and weight loss: dose prescribing higher physical activity goals improve outcome? Am J Clin Nutr. 2003:78:684-689.
148. Dunn AL, Marcus BH, Kampert JB Garcia ME, Kohl HW III, Blair SN. Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness: a randomized trial. JAMA. 1999;281:327-334.
149. Castro CM, King AC, Brassington GS. Telephone versus mail intervention for maintenance of physical activity in older adults. Health Psychol. 2001;20:438-444.
150. Jakicic JM, Wing RR, Butler BA, Robertson RJ. Prescribing exercise in multiple short bouts versus one continuous bout: effects on adherence, cardiorespiratory fitness, and weight loss in overweight women. Int J Obes Relat Metab Disord. 1995;19:893-901.
151. Jakicic JM, Winters C, Lang W, Wing RR. Effects of intermittent exercise and use of home exercise equipment on adherence, weight loss, and fitness in overweight women: a randomized trial. JAMA. 1999;282:1554-1560.
152. Perri MG, Martin AD, Leermakers EA, Sears SF, Notelovitz M. Effects of group- versus home-based exercise in the treatment of obesity. J Consult Clin Psychol. 1997;65:278-285.
153. Andersen RE, Wadden TA, Bartlett SJ, Zemel BS, Verde TJ, Franckowiak SC. Effects of lifestyle activity vs structured aerobic exercise in obese women: a randomized trial. JAMA. 1999;281:335-340.
154. King AC, Taylor CB, Haskell WL, Debusk RF. Strategies for increasing early adherence to and long-term maintenance of home-based exercise training in healthy middle-aged men and women. Am J Cardiol. 1988;61:628-632.
155. Foreyt JP, Poston WS II. The role of the behavioral counselor in obesity treatment. J Am Diet Assoc. 1998;98:S27-S30.
156. Wing RR. Behavioral approaches to the treatment of obesity. In: Bray GA, Bouchard C, James WPT, eds. Handbook of Obesity. New York, NY: Marcel Dekker, 1998:855-877.
157. Wadden TA, Sarwer DB, Berkowitz RI. Behavioural treatment of the overweight patient. Baillieres Best Pract Res Clin Endocrinol Metab. 1999;13:93-107.
158. Perri MG, Nezu AM, Patti ET, McCann KL. Effect of length of treatment on
159. Perri MG, Shapiro RM, Ludwig WW, Twentyman CT, McAdoo WG. Maintenance strategies for the treatment of obesity: an evaluation of relapse prevention training and posttreatment contact by mail and telephone. J Consult Clin Psychol. 1984;52:404-413.
160. Tate DF, Wing RR, Winett RA. Using Internet technology to deliver a behavioral weight loss program. JAMA. 2001;285:1172-1177.
161. Tate DF, Jackvony EH, Wing RR. Effects of Internet behavioral counseling on weight loss in adults at risk for type 2 diabetes: a randomized trial. JAMA. 2003;289:1833-1836.
162. Heshka S, Anderson JW, Atkinson RL, Greenway FL, Hill JO, Phinney SD, Kolotkin RL, Miller-Kovach K, Pi-Sunyer FX. Weight loss with self-help compared with a structured commercial program: a randomized trial. JAMA. 2003;289:1792-1798.
163. Wadden TA, Berkowitz RI, Sarwer DB, Prus-Wisniewski R, Steinberg C. Benefits of lifestyle modification in the pharmacologic treatment of obesity: a randomized trial. Arch Intern Med. 2001;161:218-227.
164. Haynes RB. Improving patient adherence: state of the art, with a special focus on medication taking for cardiovascular disorders. In: Burke LE, Ockene IS, eds. Compliance in Healthcare and Research. Armonk, NY: Futura Publishing; 2001:3-21.
165. Simkin-Silverman L, Wing RR. Management of obesity in primary care. Obes Res. 1997;5:603-612.
166. Stephenson BJ, Rowe BH, Haynes RB, Macharia WM, Leon G. The rational clinical examination. Is this patient taking the treatment as prescribed? JAMA. 1993;269:2779-2781.
167. Smith IG, Goulder MA; On behalf of the Members of the Sibutramine Clinical Study 1047 Team. Randomized placebo-controlled trial of long-term treatment with sibutramine in mild to moderate obesity. J Fam Pract. 2001;50:505-512.
168. Wirth A, Krause J. Long-term weight loss with sibutramine: a randomized controlled trial. JAMA. 2001;286:1331-1339.
169. Deleted in proof.
170. James WP, Astrup A, Finer N, Hilsted J, Kopelman P, Rossner S, Saris WH, Van Gaal LF. Effect of sibutramine on weight maintenance after weight loss: a randomised trial. STORM Study Group. Sibutramine Trial of Obesity Reduction and Maintenance. Lancet. 2000;356:2119-2125.
171. McMahon FG, Fujioka K, Singh BN, Mendel CM, Rowe E, Rolston K, Johnson F, Mooradian AD. Efficacy and safety of sibutramine in obese white and African American patients with hypertension: a 1-year, double-blind, placebo-controlled, multicenter trial. Arch Intern Med. 2000;160:2185-2191.
172. Fujioka K, Seaton TB, Rowe E, Jelinek CA, Raskin P, Lebovitz HE, Weinstein SP; Sibutramine/Diabetes Clinical Study Group. Weight loss with sibutramine improves glycaemic control and other metabolic parameters in obese patients with type 2 diabetes mellitus. Diabetes Obes Metab. 2000;2:175-187.
173. Apfelbaum M, Vague P, Ziegler O, Hanotin C, Thomas F, Leutenegger E. Long-term maintenance of weight loss after a very-low-calorie diet: a randomized blinded trial of the efficacy and tolerability of sibutramine. Am J Med. 1999;106:179-184.
174. Hadvary P, Lengsfeld H, Wolfer H. Inhibition of pancreatic lipase in vitro by the covalent inhibitor tetrahydrolipstatin. Biochem J. 1988;256:357-361.
175. Zhi J, Melia AT, Guerciolini R, Chung J, Kinberg J, Hauptman JB, Patel IH. Retrospective population-based analysis of the dose-response (fecal fat excretion) relationship of orlistat in normal and obese volunteers. Clin Pharmacol Ther. 1994;56:82-85.
176. Zhi J, Melia AT, Funk C, Viger-Chougnet A, Hopfgartner G, Lausecker B, Wang K, Fulton JS, Gabriel L, Mulligan TE. Metabolic profiles of minimally absorbed orlistat in obese/overweight volunteers. J Clin Pharmacol. 1996;36:1006-1011.
177. Rossner S, Sjostrom L, Noack R, Meinders AE, Noseda G. Weight loss, weight maintenance, and improved cardiovascular risk factors after 2 years treatment with orlistat for obesity. European Orlistat Obesity Study Group. Obes Res. 2000;8:49-61.
178. Sjostrom L, Rissanen A, Andersen T, Boldrin M, Golay A, Koppeschaar HP, Krempf M. Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients. European Multicentre Orlistat Study Group. Lancet. 1998;352:167-172.
179. Davidson MH, Hauptman J, DiGirolamo M, Foreyt JP, Halsted CH, Heber D, Heimburger DC, Lucas CP, Robbins DC, Chung J, et al. Weight control and risk factor reduction in obese subjects treated for 2 years with orlistat: a randomized controlled trial. JAMA. 1999;281:235-242.
180. Finer N, James WP, Kopelman PG, Lean ME, Williams G. One-year treatment of obesity: a randomized, double-blind, placebo-controlled, multicentre study of orlistat, a gastrointestinal lipase inhibitor. Int J Obes Relat Metab Disord. 2000;24:306-313.
181. Hauptman J, Lucas C, Boldrin MN, Collins H, Segal KR. Orlistat in the long-term treatment of obesity in primary care settings. Arch Fam Med. 2000;9:160-167.
182. Hill JO, Hauptman J, Anderson JW, Fujioka K, O'Neil PM, Smith DK, Zavoral JH, Aronne LJ. Orlistat, a lipase inhibitor, for weight maintenance after conventional dieting: a 1-y study. Am J Clin Nutr. 1999;69:1108-1116.
183. Hollander PA, Elbein SC, Hirsch IB, Kelley D, McGill J, Taylor T, Weiss SR, Crockett SE, Kaplan RA, Comstock J, et al. Role of orlistat in the treatment of obese patients with type 2 diabetes. A 1-year randomized double-blind study. Diabetes Care. 1998;21:1288-1294.
184. Miles JM, Leiter L, Hollander P, Wadden T, Anderson JW, Doyle M, Foreyt J, Aronne L, Klein S. Effect of orlistat in overweight and obese patients with type 2 diabetes treated with metformin. Diabetes Care. 2002;25:1123-1128.
185. Kelley DE, Bray GA, Pi-Sunyer X, Klein S, Hill J, Miles J, Hollander P. Clinical efficacy of orlistat therapy in overweight and obese patients with insulin-treated type 2 diabetes: a 1-year, randomized controlled trial. Diabetes Care. 2002;25:1033-1041.
186. Schnetzler B, Kondo-Oestreicher M, Vala D, Khatchatourian G, Faidutti B. Orlistat decreases the plasma level of cyclosporine and may be responsible for the development of acute rejection episodes. Transplantation. 2000;70:1540-1541.
187. Colman E, Fossler M. Reduction in blood cyclosporine concentrations by orlistat. N Engl J Med. 2000;342:1141-1142.
188. Le Beller C, Bezie Y, Chabatte C, Guillemain R, Amrein C, Billaud EM. Co-administration of orlistat and cyclosporine in a heart transplant recipient. Transplantation. 2000;70:1541-1542.
189. Guerciolini R. Mode of action of orlistat. Int J Obes Relat Metab Disord. 1997;21:812-523.
190. Mittendorfer B, Ostlund RE Jr, Patterson BW, Klein S. Orlistat inhibits dietary cholesterol absorption. Obes Res. 2001;9:599-604.
191. Hellerstein MK. Carbohydrate-induced hypertriglyceridemia: modifying factors and implications for cardiovascular risk. Curr Opin Lipidol. 2002;13:33-40.
192. Stafford RS, Radley DC. National trends in antiobesity medication use. Arch Intern Med. 2003;163:1046-1050.
193. Munro JF, MacCuish AC, Wilson EM, Duncan LJP. Comparison of continuous and intermittent anorectic therapy in obesity. BMJ. 1968;1:352-354.
194. Pittler MH, Ernst E. Dietary supplements for body-weight reduction: a systematic review. Am J Clin Nutr. 2004;79:529-536.
195. Allison DB, Fontaine KR, Heshka S, Mentore JL, Heymsfield SB. Alternative treatments for weight loss: a critical review. Crit Rev Food Sci Nutr. 2001;41:1-28, 39-40.
196. Shekelle PG, Hardy ML, Morton SC, Maglione M, Mojica WA, Suttorp MJ, Rhodes SL, Jungvig L, Gagne J. Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis. JAMA. 2003;289:1537-1545.
197. Boozer CN, Nasser JA, Heymsfield SB, Wang V, Chen G, Solomon JL. An herbal supplement containing Ma Huang-Guarana for weight loss: a randomized, double-blind trial. Int J Obes Relat Metab Disord. 2001;25:316-324.
198. Boozer CN, Daly PA, Homel P, Solomon JL, Blanchard D, Nasser JA, Strauss R, Meredith T. Herbal ephedra/caffeine for weight loss: a 6-month randomized safety and efficacy trial. Int J Obes Relat Metab Disord. 2002;26:593-604.
199. NIH Conference. Gastrointestinal surgery for severe obesity: Consensus Development Conference Panel. Ann Intern Med. 1991;115:956-961.
200. MacLean LD, Rhode BM, Sampalis J, Forse RA. Results of the surgical treatment of obesity. Am J Surg. 1993;165:155-162.
201. Sugerman HJ, Starkey JV, Birkenhauer R. A randomized prospective trial of gastric bypass versus vertical banded gastroplasty for morbid obesity and their effects on sweets versus non-sweets eaters. Ann Surg. 1987;205:613-624.
202. Hall JC, Watts JM, O'Brien PE, Dunstan RE, Walsh JF, Slavotinek AH, Elmslie RG. Gastric surgery for morbid obesity. The Adelaide Study. Ann Surg. 1990;211:419-427.
203. Howard L, Malone M, Michalek A, Carter J, Alger S, Van Woert J. Gastric bypass and vertical banded gastroplasty - a prospective randomized comparison and 5-year follow-up. Obes Surg. 1995;5:55-60.
204. Balsiger BM, Kennedy FP, Abu-Lebdeh HS, Collazo-Clavell M, Jensen MD, O'Brien T, Hensrud DD, Dinneen SF, Thompson GB, Que FG, et al. Prospective evaluation of Roux-en-Y gastric bypass as primary operation for medically complicated obesity. Mayo Clin Proc. 2000;75:673-680.
205. Podnos YD, Jimenez JC, Wilson SE, Stevens CM, Nguyen NT. Complications after laparoscopic gastric bypass: a review of 3464 cases. Arch Surg. 2003;138:957-961.
206. Flum DR, Dellinger EP. Impact of gastric bypass operation on survival: a population-based analysis. J Am Coll Surg. 2004;199:543-551.
207. Nguyen NT, Goldman C, Rosenquist CJ, Arango A, Cole CJ, Lee SJ, Wolfe BM. Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and costs. Ann Surg. 2001;234:279-291.
208. Gallagher D, Heymsfield SB, Heo M, Jebb SA, Murgatroyd PR, Sakamoto Y. Health percentage body fat ranges: an approach for developing guidelines based on body mass index. Am J Clin Nutr. 2000;72:694-701.
209. Risk assessment tool for estimating 10-year risk of developing hard CHD (myocardial infarction and coronary death). National Heart, Lung, and Blood Institute web site. Available at: http://hin.nhlbi.nih.gov/atpiii/calculator. asp?usertype=prof. Accessed September 17, 2004.
210. O'Rourke RA, Brundage BH, Froelicher VF, Greenland P, Grundy SM, Hachamovitch R, Pohost GM, Shaw LJ, Weintraub WS, Winters WL Jr, et al. American College of Cardiology/American Heart Association Expert Consensus document on electron-beam computed tomography for the diagnosis and prognosis of coronary artery disease. Circulation. 2000;102:126-140.
211. Gibbons RJ, Balady GJ, Bricker JT, Chaitman BR, Fletcher GF, Froelicher VF, Mark DB, McCallister BD, Mooss AN, O'Reilly MG, et al. ACC/AHA 2002 guideline update for exercise testing: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). Circulation. 2002;106:1883-1892.
212. National Institutes of Health, National Heart, Lung and Blood Institute, and North American Association for the Study of Obesity. The Practical Guide: Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Rockville, Md: National Institutes of Health; 2000. NIH publication 00-4084.
213. Strecher VJ, Seijts GH, Kok GJ, Latham GP, Glasgow R, DeVellis B, Meertens RM, Bulger DW. Goal setting as a strategy for health behavior change. Health Educ Q. 1995;22:190-200.