Gastroenterology
Volume 123, Issue 3 , Pages 882-932 , September 2002

AGA technical review on obesity

References 

  1. Allison DB, Fontaine KR, Manson JE, Stevens J, Van Itallie TB. Annual deaths attributable to obesity in the United States. JAMA. 1999;282:1530–1538
  2. Wolf AM, Colditz GA. Current estimates of the economic cost of obesity in the United States. Obes Res. 1998;6:97–106
  3. World Health Organization . Obesity: preventing and managing the global epidemic. Report of a WHO Consultation on Obesity. Geneva: World Health Organization; 1998;
  4. National Institutes of Health, National Heart, Lung, and Blood Institute . Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults—The Evidence Report. Obes Res. 1998;6(Suppl 2):51S–209S
  5. US Department of Health and Human Services . Nutrition and overweight. In: Healthy People 2010. Washington, DC: US Government Printing Office; 2000;
  6. US Department of Agriculture and US Department of Health and Human Services . Nutrition and your health: dietary guidelines for Americans. 5th ed. Washington, DC: US Government Printing Office; 2000; (Home and Garden Bulletin no. 232)
  7. 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
  8. Troiano RP, Frongillo EA, 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
  9. Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW. Body-mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med. 1999;341:1097–1105
  10. Manson JE, Willett WC, Stampfer MJ, et al.  Body weight and mortality among women. N Engl J Med. 1995;333:677–685
  11. Stevens J, Cai J, Pamuk ER, Williamson DF, Thun MJ, Wood JL. The effect of age on the association between body-mass index and mortality. N Engl J Med. 1998;338:1–7
  12. Kassirer JP, Angell M. Losing weight–an ill-fated New Year's resolution. N Engl J Med. 1998;338:52–54
  13. Vague J. The degree of masculine differentiation of obesities: a factor determining predisposition to diabetes, atherosclerosis, gout and uric calculus disease. Am J Clin Nutr. 1956;34:416–422
  14. Kissebah AH, Videlingum N, Murray R, et al.  Relation of body fat distribution to metabolic complications of obesity. J Clin Endocrinol Metab. 1982;54:254–260
  15. Pouliot MC, Despres JP, Lemieux S, et al.  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
  16. Willett WC, Manson JE, Stampfer MJ, et al.  Weight, weight change, and coronary heart disease in women: risk within the “normal” weight range. JAMA. 1995;273:461–465
  17. Rimm EB, Stampfer MJ, Giovannucci E, et al.  Body size and fat distribution as predictors of coronary heart disease among middle-aged and older US men. Am J Epidemiol. 1995;141:1117–1127
  18. Colditz GA, Willett WC, Rotnitzky A, Manson JE. Weight gain as a risk factor for clinical diabetes mellitus in women. Ann Intern Med. 1995;122:481–486
  19. Chan JM, Rimm EB, Colditz GA, Stampfer MJ, Willett WC. Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men. Diabetes Care. 1994;17:961–969
  20. Huang Z, Willett WC, Manson JE, et al.  Body weight, weight change, and risk for hypertension in women. Ann Intern Med. 1998;128:81–88
  21. Maclure KM, Hayes KC, Colditz GA, Stampfer MJ, Speizer FE, Willett WC. Weight, diet, and risk of symptomatic gallstones in middle-aged women. N Engl J Med. 1989;321:563–569
  22. Wei M, Gibbons L, Mitchell T, Kampert J, Lee C, Blair S. The association between cardiorespiratory fitness and impaired fasting glucose and type 2 diabetes mellitus in men. Ann Intern Med. 1999;89–96
  23. 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
  24. McKeigue P, Shah B, Marmont MG. Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet. 1991;337:382–386
  25. International Diabetes Institute, World Health Organization . The Asia-Pacific perspective: redefining obesity and its treatment. February 2000;1–55 http:/www.idi.org.au/obesity_report.htm (accessed December 23, 2001)
  26. Bouchard C. Inhibition of food intake by inhibitors of fatty acid synthase. N Engl J Med. 2000;343:1888–1889
  27. National Center for Health Statistics, Centers for Disease Control and Prevention, website www.cdc.gov/nchs/products/pubs/pubd/hestats/obese/obse99.htm (accessed December 14, 2001).
  28. Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL. Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int J Obes Relat Metab Disord. 1998;22:39–47
  29. Kopelman PG. Obesity as a medical problem. Nature. 2000;404:635–643
  30. Flegal KM, Troiano RP. Changes in the distribution of body mass index of adults and children in the US population. Int J Obes Relat Metab Disord. 2000;24:807–818
  31. Barlow SE, Dietz WH. Obesity evaluation and treatment: Expert Committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services. Pediatrics. 1998;102:E29
  32. Serdula MK, Ivery D, Coates R, Freedman D, Williamson D, Byers T. Do obese children become obese adults?. Prev Med. 1993;22:167–177
  33. Guo SS, Huang C, Maynard LM, et al.  Body mass index during childhood, adolescent and young adulthood in relation to adult overweight and adiposity: the Fels Longitudinal Study. Int J Obes Relat Metab Disord. 2000;24:1628–1635
  34. Rosenbaum M, Leibel RL, Hirsch J. Obesity. N Engl J Med. 1997;337:396–408
  35. Bouchard C, Perusse L. Genetics of obesity. Annu Rev Nutr. 1993;3:337–354
  36. Rankinen T, Perusse L, Weisnagel SJ, Snyder EE, Chagnon YC, Bouchard C. The human obesity gene map: the 2001 update. Obes Res. 2002;10:196–243
  37. Montague CT, Farooqi IS, Whitehead JP, et al.  Congenital leptin deficiency is associated with severe early-onset obesity in humans. Nature. 1997;387:903–908
  38. Strobel A, Issad T, Camoin L, Ozata M, Strosberg AD. A leptin missense mutation associated with hypogonadism and morbid obesity. Nat Genet. 1998;18:213–215
  39. Farooqi IS, Jebb SA, Langmack G, et al.  Effects of recombinant leptin therapy in a child with congenital leptin deficiency. N Engl J Med. 1999;341:879–884
  40. Clement K, Vaisse C, Lahlou N, et al.  A mutation in the human leptin receptor gene causes obesity and pituitary dysfunction. Nature. 1998;392:398–401
  41. Jackson RS, Creemers JW, Ohagi S, et al.  Obesity and impaired prohormone processing associated with mutation of the human prohormone convertase 1 gene. Nat Genet. 1997;16:218–220
  42. Krude H, Biebermann H, Luck W, Horn R, Brabant G, Gruters A. Severe early-onset obesity, adrenal insufficiency and red hair pigmentation caused by POMC mutations in humans. Nat Genet. 1998;19:155–157
  43. Farooqi IS, Yeo GS, Keogh JM, Aminian S, Jebb SA, Butler G. Dominant and recessive inheritance of morbid obesity associated with melanocortin-4 receptor deficiency. J Clin Invest. 2000;106:271–279
  44. Ristow M, Muller-Wieland D, Pfeiffer A, Krone W, Kahn CR. Obesity associated with a mutation in a genetic regulator of adipocyte differentiation. N Engl J Med. 1998;339:953–959
  45. Harnack LJ, Jeffery RW, Boutelle KN. Temporal trends in energy intake in the United States: an ecologic perspective. Am J Clin Nutr. 2000;71:1478–1484
  46. Rissanen AM, Heliövaara M, Knekt P, Reunanen A, Aromaa A. Determinants of weight gain and overweight in adult Finns. Eur J Clin Nutr. 1991;45:419–430
  47. Prentice AM, Jebb SA. Obesity in Britain: gluttony or sloth?. Br Med J. 1995;311:437–439
  48. Heini AF, Weinsier RL. Divergent trends in obesity and fat intake patterns: the American paradox. Am J Med. 1997;102:259–264
  49. Pratley RE. Gene-environment interactions in the pathogenesis of type 2 diabetes mellitus: lessons learned from the Pima Indians. Proc Nutr Soc. 1998;57:175–181
  50. O'Dea K, White N, Sinclair A. An investigation of nutrition-related risk factors in an isolated Aboriginal community in Northern Australia: advantages of a traditionally-orientated life style. Med J Aust. 1988;148:177–180
  51. O'Dea K. Marked improvement in carbohydrate and lipid metabolism in diabetic Australian Aborigines after temporary reversion to traditional lifestyle. Diabetes. 1983;33:596–603
  52. Barker DJP, Winter PD, Osmond C, Margetts B, Simmonds SJ. Weight in infancy and death from ischaemic heart disease. Lancet. 1989;II:577–580
  53. Barker DJP, Hales CN, Fall CHD, Osmond C, Phipps K, Clark PMS. Type 2 (non-insulin-dependent) diabetes mellitus, hypertension and hyperlipidaemia (syndrome X): relation to reduced fetal growth. Diabetologia. 1993;36:62–67
  54. Valdez R, Athens MA, Thompson GH, Bradshaw BS, Stern MP. Birthweight and adult health outcomes in a biethnic population in the USA. Diabetologia. 1997;37:624–631
  55. Phillips DIW, Barker DJP, Hales CN, Hirst S, Osmond C. Thinness at birth and insulin resistance in adult life. Diabetologia. 1994;37:150–154
  56. Barker DJP. The fetal origins of diseases of old age. Eur J Clin Nutr. 1992;46:S3–S9
  57. von Kries R, Koletzko B, Sauerwald T, von Mutius E. Does breast-feeding protect against childhood obesity?. Adv Exp Med Biol. 2000;478:29–39
  58. von Kries R, Koletzko B, Sauerwald T, et al.  Breast feeding and obesity: cross sectional study. Br Med J. 1999;319:147–150
  59. Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med. 1997;337:869–873
  60. Ravussin E, Burnand B, Schutz Y, Jequier E. Twenty-four-hour energy expenditure and resting metabolic rate in obese, moderately obese, and control subjects. Am J Clin Nutr. 1982;35:566–573
  61. Segal KR, Lacayanga I, Dunaiff A, Gutin B, Pi-Sunyer FX. Impact of body fat mass and percent fat on metabolic rate and thermogenesis in men. Am J Physiol. 1989;256:E573–E579
  62. de Jonge L, Bray GA. The thermic effect of food and obesity: a critical review. Obes Res. 1997;5:622–631
  63. Segal KR, Presta E, Gutin B. Thermic effect of food during graded exercise in normal weight and obese men. Am J Clin Nutr. 1984;40:95–100
  64. Delany JP, Harsha DW, Kime JC, Kumler J, Melancon L, Bray GA. Energy expenditure in lean and obese prepubertal children. Obes Res. 1995;3(Suppl 1):67–72
  65. Trueth MS, Figueroa-Colon R, Hunter GR, Weinsier RL, Butte NF, Goran MI. Energy expenditure and physical fitness in overweight vs non-overweight prepubertal girls. Int J Obes Relat Metab Disord. 1998;22:440–447
  66. Skov AR, Toubro S, Buemann B, Astrup A. Normal levels of energy expenditure in patients with reported “low metabolism.”. Clin Physiol. 1997;17:279–285
  67. Lichtman SW, Pisarka K, Berman ER, et al.  Discrepancy between self-reported and actual caloric intake and exercise in obese subjects. N Engl J Med. 1992;327:1893–1898
  68. Roberts SB, Savage J, Coward WA, Chew B, Lucas A. Energy expenditure and intake from infants born to lean and overweight mothers. N Engl J Med. 1988;318:461–466
  69. Davies PSW, Wells JC, Fieldhouse CA, Day JM, Lucas A. Parental body composition and infant energy expenditure. Am J Clin Nutr. 1995;61:1026–1029
  70. Stunkard AJ, Berkowitz RI, Stallings VA, Schoeller DA. Energy intake, not energy output, is a determinant of body size in infants. Am J Clin Nutr. 1999;69:524–530
  71. Ravussin E, Stephen Lillioja MB, Knowler WC, et al.  Reduced rate of energy expenditure as a risk factor for body-weight gain. N Engl J Med. 1988;318:467–472
  72. Seidell JC, Muller DC, Sorkin JD, Andres R. Fasting respiratory exchange ratio and resting metabolic rate as predictors of weight gain: the Baltimore Longitudinal Study on Aging. Int J Obes Relat Metab Disord. 1992;16:667–674
  73. Bouchard C, Tremblay A, Despres JP, et al.  The response to long-term overfeeding in identical twins. N Engl J Med. 1990;322:1477–1482
  74. Levine JA, Eberhardt NL, Jensen MD. Role of nonexercise activity thermogenesis in resistance to fat gain in humans. Science. 1999;282:212–214
  75. Leibel R. Is obesity due to a heritable difference in “set point” for adiposity?. West J Med. 1990;153:429–431
  76. Wadden TA, Foster GD, Letizia KA, Mullen JL. Long-term effects of dieting on resting metabolic rate in obese outpatients. JAMA. 1990;264:707–711
  77. Amatruda JM, Statt MC, Welle SL. Total resting energy expenditure in obese women reduced to ideal body weight. J Clin Invest. 1993;92:1236–1242
  78. Weinsier RL, Nagy TR, Hunter GR, Darnell BE, Hensrud DD, Weiss HL. Do adaptive changes in metabolic rate favor weight regain in weight-reduced individuals? An examination of the set-point theory. Am J Clin Nutr. 2000;72:1088–1094
  79. Astrup A, Gotzsche PC, van de Werken K, et al.  Meta-analysis of resting metabolic rate in formerly obese subjects. Am J Clin Nutr. 1999;69:1117–1122
  80. Hirsch J, Knittle JL. Cellularity of obese and non-obese human adipose tissue. Fed Proc. 1970;29:1516–1521
  81. Leiter LA, Marliss EB. Survival during fasting may depend on fat as well as protein stores. JAMA. 1982;248:2306–2307
  82. Stewart WK, Fleming LW. Features of a successful therapeutic fast of 382 days duration. Postgrad Med J. 1973;49:203–209
  83. Ballor 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
  84. 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
  85. Smith SR, Zachwieja JJ. Visceral adipose tissue: a critical review of intervention strategies. Int J Obes Relat Metab Disord. 1999;23:329–335
  86. 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
  87. 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
  88. Prins JB, O'Rahilly S. Regulation of adipose cell number in man. Clin Sci. 1997;92:3–11
  89. Prins JB, Walker NL, Winterford CM, Cameron DP. Apoptosis of human adipocyte in vitro. Biochem Biophys Res Commun. 1994;201:500–507
  90. Prins JB, Walker NL, Winterford CM, Cameron DP. Human adipocyte apoptosis occurs in malignancy. Biochem Biophys Res Commun. 1994;205:625–630
  91. Pi-Sunyer FX. Medical hazards of obesity. Ann Intern Med. 1993;119:655–660
  92. National Task Force on the Prevention and Treatment of Obesity . Overweight, obesity, and health risk. Arch Intern Med. 2000;160:898–904
  93. Romero Y, Cameron AJ, Locke GR, et al.  Familial aggregation of gastroesophageal reflux in patients with Barrett's esophagus and esophageal adenocarcinoma. Gastroenterology. 1997;113:1449–1456
  94. Locke GR, Talley NJ, Fett SL, Zinmeister AR, Melton LJ. Risk factors associated with symptoms of gastroesophageal reflux. Am J Med. 1999;106:642–649
  95. Ruth M, Mansson I, Sandberg N. The prevalance of symptoms suggestive of esophageal disorders. Scand J Gastroenterol. 1991;26:73–81
  96. Kay L, Jorgensen T. Epidemiology of upper dyspepsia in a random population. Scand J Gastroenterol. 1994;26:1–6
  97. Isolauri J, Laippala P. Prevalence of symptoms suggestive of gastroesophageal reflux disease in an adult population. Ann Med. 1995;27:67–70
  98. Lagergren J, Bergeström R, Nyrén O. No relation between body mass and gastro-oesophageal reflux symptoms in a Swedish population based study. Gut. 2000;47:26–29
  99. O'Brien TF, Stop EM. Lower esophageal sphincter pressure (LESP) and esophageal function in obese humans. J Clin Gastroenterol. 1980;2:145–148
  100. Beauchamp G. Gastroesophageal reflux and obesity. Surg Clin North Am. 1983;63:869–876
  101. Lundell L, Ruth M, Sandberg N, Bove-Nielsen M. Does massive obesity promote abnormal gastroesophageal reflux?. Dig Dis Sci. 1995;40:1632–1635
  102. Fisher BL, Pennathur A, Mutnick JLM, Little AG. Obesity correlates with gastroesophageal reflux. Dig Dis Sci. 1999;44:2290–2294
  103. Fraser-Moodie CA, Norton B, Gornall C, Magnago S, Weale AR, Holmes GKT. Weight loss has an independent beneficial effect on symptoms of gastro-oesophageal reflux in patients who are overweight. Scand J Gastroenterol. 1999;34:337–340
  104. Kjellin A, Ramel S, Rossner S, Thor K. Gastroesophageal reflux in obese patients is not reduced by weight reduction. Scand J Gastroenterol. 1996;31:1047–1051
  105. Mathus-Vliegen L, Tytgat G. Twenty-four hour pH measurements in morbid obesity: effects of massive overweight, weight loss and gastric distension. Eur J Gastroenterol Hepatol. 1996;8:635–640
  106. Jones KB, Allen TV, Manas KJ. Roux-en Y gastric bypass; an effective antireflux procedure. Obes Surg. 1991;1:295–298
  107. Jones KB. Roux-en Y gastric bypass: an effective antireflux procedure in the less than morbidly obese. Obes Surg. 1998;8:35–38
  108. Smith CS, Edwards CB, Goodman GN. Symptomatic and clinical improvement in morbidly obese patients with gastroesophageal reflux disease following Roux-en Y gastric bypass. Obes Surg. 1997;7:479–483
  109. Naslund E, Granstrom L, Melcher A, Stockeld D, Backman L. Gastro-oesophageal reflux before and after vertical banded gastroplasty in the treatment of obesity. Eur J Surg. 1996;162:302–306
  110. Lundell L, Ruth M, Olbe L. Vertical banded gastroplasty or gastric banding for morbid obesity: Effects on gastro-oesophageal reflux. Eur J Surg. 1997;163:525–531
  111. MacLean LD, Rhode BM, Nohr C, Katz S, McLean AP. Stomal ulcer after gastric bypass. J Am Coll Surg. 1997;185:1–7
  112. Sugerman HJ. Obesity. In:  Wilmore DW,  Cheung LY,  Harken AH,  Holcroft JW,  Meakins JL editor. Care of the surgical patient. 7:Scientific American Medicine; 1999;p. 4
  113. Stampfer MJ, Maclure KM, Colditz GA, Manson JE, Willett WC. Risk of symptomatic gallstones in women. Am J Clin Nutr. 1992;55:652–658
  114. Kono S, Kochi S, Ohyama S, Wakisaka A. Gallstones, serum lipids and glucose tolerance among male officials of SelfDefense Forces in Japan. Dig Dis Sci. 1988;33:839–844
  115. Weatherall R, Shaper AG. Overweight and obesity in middle-aged British men. Eur J Clin Nutr. 1988;42:221–231
  116. Hay DW, Carey MC. Pathophysiology and pathogenesis of cholesterol gallstone formation. Semin Liver Dis. 1990;10:159–170
  117. Broomfield PH, Chopra R, Sheinbaum RC, et al.  Effects of ursodeoxycholic acid and aspirin on the formation of lithogenic bile gallstones during loss of weight. N Engl J Med. 1988;319:1567–1572
  118. Liddle RA, Goldstein RB, Saxton J. Gallstone formation during weight-reduction dieting. Arch Intern Med. 1989;149:1750–1753
  119. Yang H, Petersen GM, Roth MP, Schoenfield LJ, Marks JW. Risk factors for gallstone formation during rapid loss of weight. Dig Dis Sci. 1992;37:912–918
  120. Shiffman ML, Kaplan GD, Brinkman-Kaplan V, Vickers FF. Prophylaxis against gallstone formation with ursodeoxycholic acid in patients participating in a very-low-calorie diet program. Ann Intern Med. 1995;122:899–905
  121. Wattchow DA, Hall JC, Whiting MJ, Bradley B, Iannos J, Watts JM. Prevalence and treatment of gallstones after gastric bypass surgery for morbid obesity. Br Med J (Clin Res Ed). 1983;286:763
  122. Worobetz LJ, Inglis FG, Shaffer EA. The effect ursodeoxycholic acid therapy on gallstone formation in the morbid obese during rapid weight loss. Am J Gastroenterol. 1993;88:1705–1710
  123. Sugerman HJ, Brewer WH, Shiffman ML, et al.  A multicenter, placebo-controlled, randomized, double-blind, prospective trial of prophylactic ursodiol for the prevention of gallstone formation following gastric-bypass-induced rapid weight loss. Am J Surg. 1995;169:91–97
  124. Shiffman ML, Sugerman HJ, Kellum JM, Brewer WH, Moore EW. Gallstone formation after rapid weight loss: a prospective study in patients undergoing gastric bypass surgery for treatment of morbid obesity. Am J Gastroenterol. 1991;86:1000–1005
  125. Weinsier RL, Wilson LJ, Lee J. Medically safe rate of weight loss for the treatment of obesity: a guideline based on risk of gallstone formation. Am J Med. 1995;98:115–117
  126. Stone BG, Ansel HJ, Peterson FJ, Gebhard RL. Gallbladder emptying stimuli in obese and normal weight subjects. Hepatology. 1990;12:795–798
  127. Festi D, Colecchia A, Orsini M, et al.  Gallbladder motility and gallstone formation in obese patients following very low calorie diets. Use it (fat) to lose it (well). Int J Obes Relat Metab Disord. 1998;22:592–600
  128. Hoy MK, Heshka S, Allison DB, et al.  Reduced risk of liver-function-test abnormalities and new gallstone formation with weight loss on 3350-kJ (800-kcal) formula diets. Am J Clin Nutr. 1994;60:249–254
  129. Spirt BA, Graves LW, Weinstock R, Bartlett SJ, Wadden TA. Gallstone formation in obese women treated by a low-calorie diet. Int J Obes Relat Metab Disord. 1995;19:593–595
  130. Heshka S, Spitz A, Nunez C, Fittante AM, Heymsfield SB, Pi-Sunyer FX. Obesity and risk of gallstone development on a 1200 kcal/d (5025 kJ/d) regular food diet. Int J Obes Relat Metab Disord. 1996;20:450–454
  131. Gebhard RL, Prigge WF, Ansel JH, Schlasner L, Ketover SR, Sande D, et al.  The role of gallbladder emptying in gallstone formation during diet-induced rapid weight loss. Hepatology. 1996;24:544–548
  132. Vezina WC, Grace DM, Hutton LC, et al.  Similarity in gallstone formation from 900 kcal/day diets containing 16 g vs 30 g of daily fat. Dig Dis Sci. 1998;43:554–561
  133. Shoheiber O, Biskupiak JE, Nash DB. Estimation of the cost savings resulting from the use of ursodiol for the prevention of gallstones in obese patients undergoing rapid weight reduction. Int J Obes Relat Metab Disord. 1997;21:1038–1045
  134. Funnell IC, Bornman PC, Weakley SP. Obesity: an important prognostic factor in acute pancreatitis. Br J Surg. 1993;80:484–486
  135. Suazo-Baráhona J, Carmona-Sánchez R, Robles-Díaz G, et al.  Obesity: a risk factor for severe acute biliary and alcoholic pancreatitis. Am J Gastroenterol. 1998;93:1324–1328
  136. Tsai C-J. Is obesity a significant prognostic factor in acute pancreatitis?. Dig Dis Sci. 1998;43:2251–2254
  137. Lankisch PG, Schirren CA. Increased body weight as a prognostic parameter for complications in the course of acute pancreatitis. Pancreas. 1990;5:626–629
  138. Martínez J, Sánchez-Payá J, Palazón JM, Aparicio JR, Picó A, Pétez-Mateo M. Obesity: a prognostic factor of severity in acute pancreatitis. Pancreas. 1999;19:15–20
  139. Porter KA, Banks PA. Obesity as a predictor of severity in acute pancreatitis. Int J Pancreatol. 1991;10:247–252
  140. Adler M, Schaffner F. Fatty liver hepatitis and cirrhosis in obese patients. Am J Med. 1979;67:811–816
  141. Matteoni C, Younossi ZM, McCullough A. Nonalcoholic fatty liver disease: a spectrum of clinical pathological severity. Gastroenterology. 1999;116:1413–1419
  142. Friis R, Vaziri ND, Akbarpour F, Afasiabi A. Effect of rapid weight loss with supplemented fasting on liver tests. J Clin Gastroenterol. 1987;9:204–207
  143. Kreitzman S, Pedersen M, Budell W, Nichols D, Krissman P, Clements M. Safety and effectiveness of weight reduction using a very-low calorie formulated food. Arch Intern Med. 1984;44:747–750
  144. Ratziu V, Giral P, Charlotte F, et al.  Liver fibrosis in overweight patients. Gastroenterology. 2000;118:1117–1123
  145. Kumar KS, Malet PF. Nonalcoholic steatohepatitis. Mayo Clin Proc. 2000;75:733–739
  146. Wanless IR, Lentz JS. Fatty liver hepatitis (steatohepatitis) and obesity: an autopsy study with analysis of risk factors. Hepatology. 1990;12:1106–1110
  147. Luyckx FH, Desaive C, Thiry A, et al.  Liver abnormalities in severely obese subjects: effect of a drastic weight loss after gastroplasty. Int J Obes Relat Metab Disord. 1998;22:222–226
  148. Bellentani S, Saccocio G, Masutti F, et al.  Prevalence of and risk factors for hepatic steatosis in Northern Italy. Ann Intern Med. 2000;132:112–117
  149. Diehl AM. Nonalcoholic steatohepatitis. Semin Liver Dis. 1999;19:221–229
  150. Fong DG, Nehra V, Lindor KD, Buchman AL. Metabolic and nutritional considerations in nonalcoholic fatty liver. Hepatology. 2000;32:3–10
  151. Sheth SG, Gordon FD, Chopra S. Nonalcoholic steatohepatitis. Ann Intern Med. 1997;126:137–145
  152. Naveau S, Giraud V, Borotto E, Aubert A, Capron F, Chaput JC. Excess weight risk factor for alcoholic liver disease. Hepatology. 1997;25:108–111
  153. Hourigan LF, MacDonald GE, Purdie D, et al.  Fibrosis in chronic hepatitis C correlates significantly with body mass index and steatosis. Hepatology. 1999;29:1215–1219
  154. Marchesini G, Brizi M, Morselli-Labate M, et al.  Association of nonalcoholic fatty liver disease with insulin resistance. Am J Med. 1999;107:450–455
  155. Ikai E, Ishizaki M, Suzuki Y, Ishida M, Noborizaka Y, Yamada Y. Association between hepatic steatosis, insulin resistance and hyperinsulinemia as related to hypertension in alcohol consumers and obese people. J Hum Hypertens. 1995;9:101–105
  156. Cigolini M, Targher G, Agostino G, Tonoli M, Muggeo M, De Sandre G. Liver steatosis and its relation to plasma haemostatic factors in apparently healthy men. Role of the metabolic syndrome. Thromb Haemost. 1996;76:69–73
  157. Day CO, James OFW. Steatohepatitis: a tale of two “hits”. Gastroenterology. 1998;114:842–845
  158. Tilg H, Diehl AM. Cytokines in alcoholic and nonalcoholic steatohepatitis. N Engl J Med. 2000;343:1467–1476
  159. Palmer M, Schaffner F. Effect of weight reduction on hepatic abnormalities in overweight patients. Gastroenterology. 1990;99:1408–1413
  160. Eriksson S, Eriksson KF, Bondesson L. Nonalcoholic steatohepatitis in obesity: a reversible condition. Acta Med Scand. 1986;220:83–88
  161. Ranlov I, Hardt F. Regression of liver steatosis following gastroplasty or gastric bypass for morbid obesity. Digestion. 1990;47:208–214
  162. Andersen T, Gluud C, Franzmann MB, Christoffersen P. Hepatic effects of dietary weight loss in morbidly obese subjects. J Hepatology. 1991;12:224–226
  163. Capron JP, Delamarre J, Dupas JL, Braillon A, Degott C, Quenum C. Fasting in obesity: another cause of liver injury with alcoholic hyaline?. Dig Dis Sci. 1982;27:265–268
  164. Landin K, Stigendal L, Eriksson E, et al.  Abdominal obesity is associated with an impaired fibrinolytic activity and elevated plasminogen activator inhibitor-1. Metabolism. 1990;39:1044–1048
  165. Lemieux I, Pascot A, Couillard C, et al.  Hypertriglyceridemic waist: a marker of the atherogenic metabolic triad (hyperinsulinemia; hyperapolipoprotein B; small, dense LDL) in men?. Circulation. 2000;102:179–184
  166. Ruderman N, Chisholm D, Pi-Sunyer X, Schneider S. The metabolically obese, normal-weight individual revisited. Diabetes. 1998;47:699–713
  167. Reaven GM. Role of insulin resistance in human disease. Diabetes. 1988;37:1595–1607
  168. Meigs JB, D'Agostino RB, Wilson WF, Cupples LA, Nathan DM, Singer DE. Risk variable clustering in the insulin resistance syndrome. Diabetes. 1997;46:1594–1600
  169. Abate N, Burns D, Peshock RM, Stray-Gundersen J, Grundy SM. Relationship of generalized and regional adiposity to insulin sensitivity in men. J Clin Invest. 1995;96:88–98
  170. Abate N, Garg A, Peshock RM, Stray-Gundersen J, Adams-Huet B, Grundy SM. Relationship of generalized and regional adiposity to insulin sensitivity in men with NIDDM. Diabetes. 1996;45:1684–1693
  171. Goodpaster BH, Thaete FL, Simoneau J, Kelley DE. Subcutaneous abdominal fat and thigh muscle composition predict insulin sensitivity independently of visceral fat. Diabetes. 1997;46:1579–1585
  172. Pouliot M, Despres J, Nadeau A, et al.  Visceral obesity in men: associations with glucose tolerance, plasma insulin and lipoprotein levels. Diabetes. 1992;41:826–834
  173. Bergstrom RW, Newall-Morris LL, Leonetti DL, Wahl PW, Fujimoto WY. Association of elevated fasting C-peptide level and increased intra-abdominal fat distribution with development of NIDDM in Japanese-American men. Diabetes. 1990;39:104–111
  174. Banerji MA, Chaiken RL, Gordon D, Kral JG, Lebovitz HE. Does intra-abdominal adipose tissue in black men determine whether NIDDM is insulin-resistant or insulin-sensitive?. Diabetes. 1995;44:141–145
  175. Frayn KN. Visceral fat and insulin resistance–causative or correlative?. Br J Nutr. 2000;83(Suppl 1):S71–S77
  176. Harris MI, Flegal KM, Cowie CC, et al.  Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U.S. adults. The Third National Health and Nutrition Examination Survey, 1988–1994. Diabetes Care. 1998;21:518–524
  177. Colditz GA, Willett WC, Stampfer MJ, et al.  Weight as a risk factor for clinical diabetes in women. Am J Epidemiol. 1990;132:501–513
  178. Ohlson LO, Larsson B, Svardsudd K, et al.  The influence of body fat distribution on the incidence of diabetes mellitus. Diabetes. 1985;34:1055–1058
  179. Lundgren H, Bengtsson C, Blohme G, Lapidus L, Sjöström L. Adiposity and adipose tissue distribution in relation to incidence of diabetes in women: results from a prospective population study in Gothenburg, Sweden. Int J Obes. 1989;13:413–423
  180. Kaye SA, Folsom AR, Sprafka JM, Prineas RJ, Wallace RB. Increased incidence of diabetes mellitus in relation to abdominal adiposity in older women. J Clin Epidemiol. 1991;44:329–334
  181. Reaven GM, Chen YDI, Jeppesen J, Maheux P, Krauss RM. Insulin resistance and hyperinsulinemia in individuals with small, dense, low density lipoprotein particles. J Clin Invest. 1993;92:141–146
  182. Albrink MJ, Krauss RM, Lindgren FT, von der Groeben J, Pam S, Wood PD. Intercorrelations among plasma high density lipoprotein, obesity and triglycerides in a normal population. Lipids. 1980;15:668–676
  183. Terry RB, Wood PD, Haskell WL, Stefanick ML, Krauss RM. Regional adiposity pattern in relation to lipids, lipoprotein cholesterol, and lipoprotein subfraction mass in men. J Clin Endocrinol Metab. 1989;68:191–199
  184. Brown CD, Higgins M, Donato KA, et al.  Body mass index and the prevalence of hypertension and dyslipidemia. Obes Res. 2000;8:605–619
  185. Assmann G, Schulte H. Relation of high-density lipoprotein cholesterol and triglycerides to incidence of atherosclerotic coronary artery disease (the PROCAM Experience). Am J Cardiol. 1992;70:733–737
  186. Lamarche B, Lemieux I, Despres JP. The small, dense LDL phenotype and the risk of coronary heart disease: epidemiology, patho-physiology and therapeutic aspects. Diabetes Metab. 1999;25:199–211
  187. Stamler J, Wentworth D, Neaton JD. Is relationship between serum cholesterol and risk of premature death from coronary disease continuous or graded? Findings in 356,222 primary screenees of the Multiple Risk Factor Intervention Trial (MRFIT). JAMA. 1986;256:2823–2828
  188. Rexrode KM, Carey VJ, Hennekens CH, et al.  Abdominal adiposity and coronary heart disease in women. JAMA. 1998;280:1843–1848
  189. Hubert HB, Feinleib M, McNamara PM, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation. 1983;67:968–977
  190. Eckel RH, Krauss RM. American Heart Association call to action: obesity as a major risk factor for coronary heart disease. Circulation. 1998;97:2099–2100
  191. Krause RM, Eckel RH, Howard B, et al.  AHA Dietary guidelines revision 2000: a statement for healthcare professionals from the nutrition committee of the American Heart Association. Circulation. 2000;102:2296–2311
  192. Walker SP, Rimm EB, Ascherio A, Kawachi I, Stampfer MJ, Willett WC. Body size and fat distribution as predictors of stroke among US men. Am J Epidemiol. 1996;144:1143–1150
  193. Rexrode KM, Hennekens CH, Willett WC, et al.  A prospective study of body mass index weight change, and risk of stroke in women. JAMA. 1997;277:1539–1545
  194. Persson AV, Davis RJ, Villavicencio JL. Deep venous thrombosis and pulmonary embolism. Surg Clin North Am. 1991;71:1195–1209
  195. Scott TE, LaMorte WW, Gorin DR, Menzoian JO. Risk factors for chronic venous insufficiency: a dual case-control study. J Vasc Surg. 1995;22:622–628
  196. Hansson PO, Eriksson H, Welin L, Svardsudd K, Wilhelmsen L. Smoking and abdominal obesity. Risk factors for venous thromboembolism among middle-aged men: “The study of men born in 1913.”. Arch Intern Med. 1999;159:1886–1890
  197. Sugerman HJ, Windsor ACJ, Bessos MK, Wolfe L. Abdominal pressure, sagittal abdominal diameter and obesity co-morbidity. J Int Med. 1997;241:71–79
  198. Visser M, Bouter LM, McQuillan GM, Wener MH, Harris TB. Elevated C-reactive protein levels in overweight and obese adults. JAMA. 1999;282:2131–2135
  199. White RH, Gettner S, Newman JM, Trauner KB, Romano PS. Predictors of rehospitalization for symptomatic venous thromboembolism after total hip arthroplasty. N Engl J Med. 2000;343:1758–1764
  200. Stamler R, Stamler J, Riedlinger WF, Algera G, Roberts R. Weight and blood pressure. Findings in hypertension screening of 1 million Americans. JAMA. 1978;240:1607–1609
  201. Kannel W, Brand N, Skinner J, Dawber TR, McNamara PM. The relation of adiposity to blood pressure and development of hypertension. The Framingham study. Ann Intern Med. 1967;67:48–59
  202. McMahon SW, Blacket RB, McDonald GJ, Hall W. Obesity, alcohol consumption and blood pressure in Australian men and women: National Heart Foundation of Australia Risk Factor Prevalence Study. J Hypertens. 1984;2:85–91
  203. Landsberg L. Obesity and hypertension: experimental data. J Hypertens. 1992;10(Suppl):S195–S201
  204. Shear CL, Freedman DS, Burke GL, Harsha DW, Berenson GS. Body fat patterning and blood pressure in children and young adults: the Bogalusa Heart Study. Hypertension. 1987;9:236–244
  205. Kalkoff R, Hartz A, Rupley D, Kissebah AH, Kelber S. Relationship of body fat distribution to blood pressure, carbohydrate tolerance, and plasma lipids in healthy obese women. J Lab Clin Med. 1983;102:621–627
  206. Strohl KP, Strobel RJ, Parisi RA. Obesity and pulmonary function. In:  Bray GA,  Bouchard C,  James WPT editor. Handbook of Obesity. New York, NY: Mercel Dekker; 1998;p. 725–739
  207. Vgontzas AN, Tan TL, Bixler EO, Martin LF, Shubert D, Kales A. Sleep apnea and sleep disruption in obese patients. Arch Intern Med. 1994;154:1705–1711
  208. Shinohara E, Kihara S, Yamashita S, et al.  Visceral fat accumulation as an important risk factor for obstructive sleep apnoea syndrome in obese subjects. J Intern Med. 1997;24:11–18
  209. Davies RJ, Stradling JR. The relationship between neck circumference, radiographic pharyngeal anatomy, and the obstructive sleep apnoea syndrome. Eur Respir J. 1990;3:509–514
  210. Katz I, Stradling J, Slutsky AS, Zamel N, Hoffstein V. Do patients with obstructive sleep apnea have thick necks?. Am Rev Respir Dis. 1990;141:1228–1231
  211. Hoffstein V, Mateika S. Differences in abnormal and neck circumferences in patients with and without obstructive sleep apnoea. Eur Respir J. 1992;5:377–381
  212. Carmelli D, Swan GE, Bliwise DL. Relationship of 30-year changes in obesity to sleep-disordered breathing in the western collaborative group study. Obes Res. 2000;8:632–637
  213. Sakakibara H, Tong M, Batsushita K, Hirata M, Konishi Y, Suetsugu S. Cephalometric abnormalities in non-obese and obese patients with obstructive sleep apnea. Eur Respir J. 1999;13:403–410
  214. Rimm AA, Werner LH, Yserloo BV, Bernstein RA. Relationship of obesity and disease in 73,532 weight-conscious women. Public Health Rep. 1975;90:44–54
  215. Roubenoff R, Klag MJ, Mead LA, Liang KY, Seidler AJ, Hochberg MC. Incidence and risk factors for gout in white men. JAMA. 1991;266:3004–3007
  216. Seidell JC, Bakx JC, De Boer E, Deurenberg P, Hautvast JG. Fat distribution of overweight persons in relation to morbidity and subjective health. Int J Obes. 1985;9:363–374
  217. Cigolini M, Targher G, Tonoli M, Manara F, Muggeo M, De Sandre G. Hyperuricaemia: relationships to body fat distribution and other components of the insulin resistance syndrome in 38-year-old healthy men and women. Int J Obes Relat Metab Disord. 1995;19:92–96
  218. Facchini F, Chen YD, Hollenbeck CB, Reaven GM. Relationship between resistance to insulin-mediated glucose uptake, urinary uric acid clearance, and plasma uric acid concentration. JAMA. 1991;66:3008–3011
  219. Hartz AJ, Fischer ME, Bril G, et al.  The association of obesity with joint pain and osteoarthritis in the HANES data. J Chronic Dis. 1986;39:311–319
  220. Felson DT, Anderson JJ, Naimark A, Walker AM, Meenan RF. Obesity and knee osteoarthritis. The Framingham study. Ann Intern Med. 1988;109:18–24
  221. Cicuttini FM, Baker JR, Spector TD. The association of obesity with osteoarthritis of the hand and knee in women: a twin study. J Rheumatol. 1996;23:1221–1226
  222. Hart DJ, Spector TD. The relationship of obesity, fat distribution and osteoarthritis in women in the general population: the Chingford Study. J Rheumatol. 1993;20:331–335
  223. Bagge E, Bjelle A, Eden S, Svanborg A. Factors associated with radiographic osteoarthritis: results from the population study of 70-year-old people in Goteborg. J Rheumatol. 1991;18:1218–1222
  224. Carman WJ, Sowers M, Hawthorne VM, Weissfeld LA. Obesity as a risk factor for osteoarthritis of the hand and wrist: a prospective study. Am J Epidemiol. 1994;139:119–129
  225. Michaud DS, Giovannucci E, Willett WC, Colditz GA, Stampfer MJ, Fuchs CS. Physical activity, obesity, height, and the risk of pancreatic cancer. JAMA. 2001;286:921–929
  226. Chow WH, Gridley G, Fraumeni JF, Jarvholm B. Obesity, hypertension, and the risk of kidney cancer in men. N Engl J Med. 2000;343:1305–1311
  227. Lew EA, Garfinkel L. Variations in mortality by weight among 750,000 men and women. J Chronic Dis. 1979;32:563–576
  228. Giovannucci E, Ascherio A, Rimm EB, Coltizt GA, Stampfer MJ, Willett WC. Physical activity, obesity, and risk for colon cancer and adenoma in men. Ann Intern Med. 1995;122:327–334
  229. Giovannucci E, Colditz GA, Stampfer MJ, Willett WC. Physical activity, obesity, and risk of colorectal adenoma in women. Cancer Causes Control. 1996;7:253–263
  230. Potter JD, Slattery ML, Bostick RM, Gapstur SM. Colon cancer: a review of the epidemiology. Epidemiol Rev. 1993;15:499–545
  231. Suadicani P, Hein H, Gyntelberg F. Height, weight, and risk of colorectal cancer: an 18-year follow-up in a cohort of 5249 men. Scand J Gastroenterol. 1993;28:285–288
  232. Caan BJ, Coates AO, Slattery ML, Potter JD, Quesenberry CP, Edwards SM. Body size and the risk of colon cancer in a large case-control study. Int J Obes Relat Metab Disord. 1998;22:178–184
  233. Huang Z, Hankinson SE, Colditz GA, et al.  Dual effects of weight and weight gain on breast cancer risk. JAMA. 1997;278:1407–1411
  234. Willett WC, Browne ML, Bain C, et al.  Relative weight and risk of breast cancer among premenopausal women. Am J Epidemiol. 1985;122:731–740
  235. Grodstein F, Goldman MB, Cramer DW. Body mass index and ovulatory infertility. Epidemiology. 1994;5:247–250
  236. Johnson SR, Kolberg BH, Varner MW, Railsback LD. Maternal obesity and pregnancy. Surg Gynecol Obstet. 1987;164:431–437
  237. Garbaciak JA, Richter M, Miller S, Barton JJ. Maternal weight and pregnancy complications. Am J Obstet Gynecol. 1985;152:238–245
  238. Prentice A, Goldberg G. Maternal obesity increases congenital malformations. Nutr Rev. 1996;54:146–152
  239. Dwyer PL, Lee ETC, Hay DM. Obesity and urinary incontinence in women. Br J Obstet Gynecol. 1988;95:91–96
  240. Mommsen S, Foldspang A. Body mass index and adult female urinary incontinence. World J Urol. 1994;12:319–322
  241. Brown JS, Seeley DG, Fong J, Black DM, Ensrud KE, Grady D. Urinary incontinence in older women: who is at risk?. Obstet Gynecol. 1996;87:715–721
  242. Bump RC, Sugerman HJ, Fantl JA, McClish DK. Obesity and lower urinary tract function in women: effect of surgically induced weight loss. Am J Obstet Gynecol. 1992;167:392–399
  243. Durcan FJ, Corbett JJ, Wall M. The incidence of pseudotumor cerebri. Population studies in Iowa and Louisiana. Arch Neurol. 1988;45:875–877
  244. Giuseffi V, Wall M, Siegel PZ, Rojas PB. Symptoms and disease associations in idiopathic intracranial hypertension (pseudotumor cerebri): a case-control study. Neurology. 1991;41:239–244
  245. Sugerman HJ, Felton WL, Sismanis A, Salvant JB, Kellum JM. Effects of surgically induced weight loss on pseudotumor cerebri in morbid obesity. Neurology. 1995;45:1655–1659
  246. Sugerman HJ, Felton WL, Sismanis A, Kellum JM, DeMaria EJ, Sugerman EL. Gastric surgery for pseudotumor cerebri associated with severe obesity. Ann Surg. 1999;229:634–642
  247. Johnson LN, Krohel GB, Madsen RW, March GA. The role of weight loss and acetazolamide in the treatment of idiopathic intracranial hypertension (pseudotumor cerebri). Ophthalmology. 1998;105:2313–2317
  248. Hankinson SE, Seddon JM, Colditz GA, et al.  A prospective study of aspirin use and cataract extraction in women. Arch Ophthalmol. 1993;111:503–508
  249. Glynn RJ, Christen WG, Manson JE, Bernheimer J, Hennekens CH. Body mass index. An independent predictor of cataract. Arch Ophthalmol. 1995;113:1131–1137
  250. Hiller R, Podgor MJ, Sperduto RD, et al.  A longitudinal study of body mass index and lens opacities. The Framingham studies. Ophthalmology. 1998;105:1244–1250
  251. Schaumberg DA, Glynn RJ, Christen WG, Hankinson SE, Hennekens CH. Relations of body fat distribution and height with cataract in men. Am J Clin Nutr. 2000;72:1495–1502
  252. Leske MC, Wu S, Hennis A, Connell AM, Hyman L, Schachat A. Diabetes, hypertension, and central obesity as cataract risk factors in a black population. The Barbados Eye Study. Ophthalmology. 1999;106:35–41
  253. Fitzgibbon ML, Stolley MR, Kirschenbaum DS. Obese people who seek treatment have different characteristics than those who do not seek treatment. Health Psychol. 1993;12:342–345
  254. Rodin J, Schank D, Striegel-Moore R. Psychological features of obesity. Med Clin North Am. 1989;73:47–66
  255. Carpenter KM, Hasin DS, Allison DB, Faith MS. Relationships between obesity and DSM-IV major depression disorder, suicide ideation and suicide attempts: results from a general population study. Am J Public Health. 2000;90:251–257
  256. Spitzer RL, Yanovski SZ, Wadden TA, et al.  Binge eating disorder: Its further validation in a multisite study. Int J Eat Disord. 1993;13:137–153
  257. Marcus MD, Wing RR, Hopkins J. Obese binge eaters: affect, cognitions, and response to behavioral weight control. J Consult Clin Psychol. 1988;56:433–439
  258. Telch CF, Agras WS, Rossiter EM. Binge eating increases with increasing adiposity. Int J Eat Disord. 1988;7:115–119
  259. Wilfley DE, Agras WS, Telch CF, et al.  Group cognitive-behavioral therapy and group interpersonal psychotherapy for the nonpurging bulimic individual: a controlled comparison. J Consult Clin Psychol. 1993;61:296–305
  260. Birketvedt GS, Florholmen J, Sundsfjord J, et al.  Behavioral and neuroendocrine characteristics of the night-eating syndrome. JAMA. 1999;282:657–663
  261. Fontaine KR, Cheskin LJ, Barofsky I. Health-related quality of life in obese persons seeking treatment. J Fam Pract. 1996;43:265–270
  262. Thompson D, Edelsberg J, Kinsey KL, Oster G. Estimated economic costs of obesity in U.S. business. Am J Health Promot. 1998;13:120–127
  263. Burton WN, Chen C-Y, Schultz AB, Edington DW. The economic costs associated with body mass index in a workplace. J Occup Environ Med. 1998;40:786–792
  264. Andres R, Muller DC, Sorkin JD. Long-term effects of change in body weight on all-cause mortality. A review. Ann Intern Med. 1993;119:737–743
  265. Williamson DF, Pamuk E, Thun M, Flanders D, Byers T, Heath C. Prospective study of intentional weight loss and mortality in never-smoking overweight U.S. white women aged 40-64 years. Am J Epidemiol. 1995;141:1128–1141
  266. Williamson DF, Pamuk E, Thun M, Flanders D, Byers T, Heath C. Prospective study of intentional weight loss and mortality in overweight weight white women aged 40-64 years. Am J Epidemiol. 1999;149:491–503
  267. Williamson DF, Thompson TJ, Thun M, Flanders D, Pamuk E, Byers T. Intentional weight loss and mortality among overweight individuals with diabetes. Diabetes Care. 2000;23:1499–1504
  268. Pi-Sunyer FX. A review of the long-term studies evaluating the efficacy of weight loss in ameliorating disorders associated with obesity. Clin Ther. 1996;18:1006–1035
  269. Goldstein DJ. Beneficial health effects of modest weight loss. Int J Obes Relat Metab Disord. 1992;16:379–415
  270. 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
  271. Moore LL, Visioni AJ, Wilson PW, D'Agostino RB, Finkle WD, Ellison RC. Can sustained weight loss in overweight individuals reduce the risk of diabetes mellitus?. Epidemiology. 2000;11:269–273
  272. Wilson PW, Kannel WB, Silbershatz H, D'Agostino RB. Clustering of metabolic factors and coronary heart disease. Arch Intern Med. 1999;159:1104–1109
  273. MacMahon SW, Wilcken D, MacDonald GJ. The effect of weight reduction on left ventricular mass. N Engl J Med. 1986;314:334–339
  274. Alaud-din A, Meterissan S, Lisbona R, MacLean LD, Forse RA. Assessment of cardiac function in patients who were morbidly obese. Surgery. 1990;108:809–820
  275. Alpert MA, Lambert C, Terry B, et al.  Effect of weight loss on left ventricular mass in nonhypertensive morbidly obese patients. Am J Cardiol. 1994;73:918–921
  276. 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
  277. Karason K, Lindroos AK, Stenlof K, Sjostrom L. Relief of cardiorespiratory symptoms and increased physical activity after surgically induced weight loss: results from the Swedish Obese Subjects study. Arch Intern Med. 2000;160:1797–1802
  278. Karason K, Wikstrand J, Sjostrom L, Wendelhag I. Weight loss and progression of early atherosclerosis in the carotid artery: a four-year controlled study of obese subjects. Int J Obes Relat Metab Disord. 1999;23:948–956
  279. 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
  280. Pories WJ, Swanson MS, MacDonald KG, 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
  281. Watts NB, Spanheimer RG, DiGirolamo M, et al.  Prediction of glucose response to weight loss in patients with non-insulin-dependent diabetes mellitus. Arch Intern Med. 1990;150:803–806
  282. Pan XR, Li GW, Hu YH, et al.  Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care. 1997;20:537–544
  283. 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
  284. Tuomilehto J, Lindstrom J, Eriksson JG, 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
  285. Knowler WC, Barrett-Connor E, Fowler SE, et al.  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
  286. Henry RR, Wiest-Kent TA, Scheaffer L, Kolterman OG, Olefsky JM. Metabolic consequences of very-low-calorie diet therapy in obese non-insulin-dependent diabetic and nondiabetic subjects. Diabetes. 1986;35:155–164
  287. Wing RR, Marcus MD, Epstein LH, Salata R. Type II diabetic subjects lose less weight than their overweight nondiabetic spouses. Diabetes Care. 1987;10:563–566
  288. Khan MA, St Peter JV, Breen GA, Hartley GG, Vessey JT. Diabetes disease stage predicts weight loss outcomes with long-term appetite suppressants. Obes Res. 2000;8:43–48
  289. Prospective Diabetes Study UKPDS Group UK. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352:837–853
  290. 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
  291. 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
  292. Rössner S, Sjöström L, Noack R, Meinders AE, Noseda G. Weight loss, weight maintenance, and improved cardiovascular risk factors after 2 years treatment with orlistat for obesity. Obes Res. 2000;8:49–61
  293. Stefanick ML, Mackey S, Sheehan M, Ellsworth N, Haskell WL, Wood PD. Effects of diet and exercise in men and postmenopausal women with low levels of HDL cholesterol and high levels of LDL cholesterol. N Engl J Med. 1998;339:12–20
  294. Wing RR, Jeffery RW. Effect of modest weight loss on changes in cardiovascular risk factors: are there differences between men and women or between weight loss and maintenance?. Int J Obes Relat Metab Disord. 1995;19:67–73
  295. Rossner S, Bjorvell H. Early and late effects of weight loss on lipoprotein metabolism in severe obesity. Atherosclerosis. 1987;64:125–130
  296. 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
  297. 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
  298. Stevens VJ, Obarzanek E, Cook NR, Lee I-M, Appel LJ, West DS, 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
  299. 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
  300. 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
  301. Sugerman HJ, Fairman RP, Sood RK, Engle K, Wolfe L, Kellum JM. Long-term effects of gastric surgery for treating respiratory insufficiency of obesity. Am J Clin Nutr. 1992;55:597S–601S
  302. Barvaux VA, Aubert G, Rodenstein DO. Weight loss as a treatment for obstructive sleep apnoea. Sleep Med Rev. 2000;4:435–452
  303. Charuzi I, Ovnat A, Peiser J, Saltz H, Weitzman S, Lavie P. The effect of surgical weight reduction on sleep quality in obesity-related sleep apnea syndrome. Surgery. 1985;97:535–538
  304. Smith PL, Gold AR, Meyers DA, Haponik EF, Bleecker ER. Weight loss in mildly to moderately obese patients with obstructive sleep apnea. Ann Intern Med. 1985;103:850–855
  305. Schwartz AR, Gold AR, Schubert N, et al.  Effect of weight loss on upper airway collapsibility in obstructive sleep apnea. Am Rev Respir Dis. 1991;144:494–498
  306. Sugerman HJ, Baron PL, Fairman RP, Evans CR, Vetrovek GW. Hemodynamic dysfunction in obesity hypoventilation syndrome and the effects of treatment with surgically induced weight loss. Ann Surg. 1988;207:604–613
  307. Williams RA, Foulsham BM. Weight reduction in osteoarthritis using phentermine. Practitioner. 1981;225:231–232
  308. McGoey BV, Deitel M, Saplys RJ, Kliman ME. Effect of weight loss on musculoskeletal pain in the morbidly obese. J Bone Joint Surg. 1990;72:322–323
  309. Fontaine KR, Barofsky I, Andersen RE, et al.  Impact of weight loss on health-related quality of life. Qual Life Res. 1999;8:275–277
  310. Karlsson J, Sjostrom L, Sullivan M. Swedish obese subjects (SOS)—an intervention study of obesity. Two-year follow-up of health-related quality of life (HRQL) and eating behavior after gastric surgery for severe obesity. Int J Obes Relat Metab Disord. 1998;22:113–126
  311. Narbro K, Agren G, Jonsson E, et al.  Sick leave and disability pension before and after treatment for obesity: a report from the Swedish Obese Subjects (SOS) study. Int J Obes Relat Metab Disord. 1999;23:619–624
  312. Serdula MK, Mokdad AH, Williamson DF, Galuska DA, Mendlein JM, Heath GW. Prevalence of attempting weight loss and strategies for controlling weight. JAMA. 1999;282:1353–1358
  313. Wadden TA, Stunkard AJ, Liebschutz J. Three-year follow-up of the treatment of obesity by very low calorie diet, behavior therapy and their combination. J Consult Clin Psychol. 1988;56:925–928
  314. Lissner L, Odell PM, D'Agostino RB, et al.  Variability of body weight and health outcomes in the Framingham population. N Engl J Med. 1991;324:1839–1844
  315. Atkinson RL, Dietz WH, Foreyt JP, et al.  Weight cycling. National Task Force on the Prevention and Treatment of Obesity. JAMA. 1994;272:1196–1202
  316. Harris JA, Benedict FG. Standard basal metabolism constants for physiologists and clinicians. In: The Carnegie Institute of Washington. A biometric study of basal metabolism in man. Publication 279. Philadelphia, Pennsylvania: Lippincott; 1919;
  317. World Health Organization . WHO/FAO/UNO report: energy and protein requirements. WHO Technical Report Series, No. 724. 1985;
  318. 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
  319. Wadden TA, Stunkard AJ. A controlled trial of very-low-calorie diet, behavior therapy, and their combination in the treatment of obesity. J Consult Clin Psychol. 1986;4:482–488
  320. Wing RR, Marcus MD, Salata R, Epstein LH, Miaskiewicz S, Blair EH. Effects of a very-low-calorie diet on long-term glycemic control in obese type 2 diabetic subjects. Arch Intern Med. 1991;151:1334–1340
  321. Miura J, Arai K, Ohno M, Ikeda Y. The long term effectiveness of combined therapy by behavior modification and very low calorie diet: 2 year follow-up. Int J Obes. 1989;13:73–77
  322. Torgerson JS, Lissner L, Lindross AK, Kruijer H, Sjostrom L. VLCD plus dietary and behavioral support versus support alone in the treatment of severe obesity: a randomised two-year clinical trial. Int J Obes Relat Metab Disord. 1997;21:987–994
  323. Foster GD, Wadden TA, Peterson FJ, Letizia KA, Bartlett SJ, Conill AM. A controlled comparison of three very-low-calorie diets: effects on weight, body composition, and symptoms. Am J Clin Nutr. 1992;55:811–817
  324. Kanders BS, Blackburn GL, Norton D. Weight loss outcome and health benefits associated with the Optifast program in the treatment of obesity. Int J Obes. 1989;13(Suppl):131–134
  325. Metz JA, Stern JS, Kris-Etherton P, et al.  A randomized trial of improved weight loss with a prepared meal plan in overweight and obese patients. Arch Intern Med. 2000;160:2150–2158
  326. Jeffery RW, Thorson C, Burton LR, Raether C, Harvey J, Mullen M. Strengthening behavioral interventions for weight loss: a randomized trial of food provisions and monetary incentives. J Consult Clin Psychol. 1993;61:1038–1045
  327. Wing RR, Jeffery RW, Burton LR, Thorson C, Nissinoff K, Baxter JE. Food provisions vs structured meal plans in the behavioral treatment of obesity. Int J Obes Relat Metab Disord. 1996;20:56–62
  328. Ditschuneit HH, Flechtner-Mors M, Adler G. Metabolic and weight loss effects of long-term dietary intervention in obese subjects. Am J Clin Nutr. 1999;69:198–204
  329. Flechtner-Mors M, Ditschuneit HH, Johnson TD, Suchard MA, Adler G. Metabolic and weight-loss effects of a long-term dietary intervention in obese patients: a four-year follow-up. Obes Res. 2000;8:399–402
  330. Rothacker DQ. Five-year self-management of weight using meal replacements: comparison with matched controls in rural Wisconsin. Nutrition. 2000;16:344–348
  331. Bray GA, Popkin BM. Dietary fat intake does affect obesity!. Am J Clin Nutr. 1998;68:1157–1173
  332. Yu-Poth S, Zhao G, Etherton T, Naglak M, Jonnalagadda S, Kris-Etherton PM. Effects of the National Cholesterol Education Program's Step I and Step II dietary intervention programs on cardiovascular disease risk factors: a meta-analysis. Am J Clin Nutr. 1999;69:632–646
  333. 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
  334. Schlundt DG, Hill JO, Pope-Cordle J, Arnold D, Virts KL, Katahn M. Randomized evaluation of a low fat “ad libitum” carbohydrate diet for weight reduction. Int J Obes Relat Metab Disord. 1993;17:623–629
  335. Jeffery RW, Hellerstedt WL, French S, Baxter JE. A randomized trial of fat restricted versus calorie restricted diets for the treatment of obesity. Int J Obes Relat Metab Disord. 1995;19:132–137
  336. Toubro S, Astrup A. Randomised comparison of diets for maintaining obese subjects' weight after major weight loss: ad lib, low fat, high carbohydrate diet vs fixed energy intake. Br Med J. 1997;314:29–34
  337. 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
  338. Rolls BJ, Bell EA. Dietary approaches to the treatment of obesity. Med Clin North Am. 2000;84:401–418
  339. Duncan KH, Bacon JA, Weinsier RL. The effects of high and low energy density diets on satiety, energy intake, and eating time of obese and nonobese subjects. Am J Clin Nutr. 1983;37:763–767
  340. Stubbs RJ, Harbron CG, Murgafroyd PR, et al.  Covert manipulation of dietary fat and energy density: effect on substrate flux and food intake in men eating ad libitum. Am J Clin Nutr. 1995;62:316–329
  341. Saltzman E, Dallal GE, Roberts SB. Effect of high-fat and low-fat diets on voluntary energy intake and substrate oxidation: studies in identical twins consuming diets matched for energy density, fiber and palatability. Am J Clin Nutr. 1997;66:1332–1339
  342. van Stratum P, Lussenburg RN, van Wezel LA, Vergroesen AJ, Cremer HD. The effect of dietary carbohydrate:fat ratio on energy intake by adult women. Am J Clin Nutr. 1978;31:206–212
  343. Stubbs RJ, Johnstone AM, O'Reilly LM, Barton K, Reid C. The effect of covertly manipulating the energy density of mixed diets on ad libitum food intake in “pseudo free-living” humans. Int J Obes Relat Metab Disord. 1998;22:980–987
  344. Bell EA, Castellanos VH, Pelkman CL, Thorwart ML, Rolls BJ. Energy density of foods affects energy intake in normal-weight women. Am J Clin Nutr. 1998;67:412–420
  345. Rolls BJ, Bell EA, Thorwart ML. Water incorporated into a food but not served with a food decreases energy intake in lean women. Am J Clin Nutr. 1999;70:455–488
  346. Council on Foods and Nutrition . A critique of low-carbohydrate ketogenic weight reduction regimens. JAMA. 1973;224:1415–1419
  347. Yang M-U, Van Itallie TB. Composition of weight lost during short-term weight reduction. J Clin Invest. 1976;58:722–730
  348. Rabast U, Kasper H, Schonborn J. Comparative studies in obese subjects fed carbohydrate-restricted and high carbohydrate 1,000-calorie formula diets. Nutr Metab. 1978;22:269–277
  349. Golay A, Allaz AF, Morel Y, de Tonnac N, Tankova S, Reaven G. Similar weight loss with low- or high-carbohydrate diets. Am J Clin Nutr. 1996;63:174–178
  350. Golay A, Eigenheer C, Morel Y, Kujawski P, Lehmann T, de Tonnac N. Weight-loss with low or high carbohydrate diet?. Int J Obes Relat Metab Disord. 1996;20:1067–1072
  351. Atkins RC. Dr. Atkins' New Diet Revolution. New York: Avon Books; 1992;
  352. Miller BV, Bertino JS, Green A, et al.  Effect of a low-carbohydrate, high-protein diet on dietary intake (abstr). Obes Res. 2000;8(Suppl 1):25S
  353. Westman EC, Yancy WS, Edman JS, Tomlin KF, Perkins CE. Effects of a very-low-carbohydrate diet program on body weight: a pilot study (abstr). Obes Res. 2000;8(Suppl 1):73S
  354. Foster G, Wyatt H, Hill J, et al.  Evaluation of the Atkins diet: a randomized control trial (abstr). Obes Res. 2001;9(Suppl 3):85S
  355. 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
  356. Warwick PM, Garrow JS. The effect of addition of exercise to a regime of dietary restriction on weight loss, nitrogen balance, resting metabolic rate and spontaneous physical activity in three obese women in a metabolic ward. Int J Obes. 1981;5:25–32
  357. Wadden TA, Vogt RA, Anderson RE, et al.  Exercise in the treatment of obesity: effects of four interventions on body composition, resting energy expenditure, appetite and mood. J Consult Clin Psychol. 1997;65:269–277
  358. Geliebter A, Maher MM, Gerace L, Gutin B, Heymsfield SB, Hashim SA. Effects of strength or aerobic training on body composition, resting metabolic rate, and peak oxygen consumption in obese dieting subjects. Am J Clin Nutr. 1997;66:557–563
  359. Ballor DL, Poehlman ET. A meta-analysis of the effects of exercise and/or dietary restriction on resting metabolic rate. Eur J Appl Physiol Occup Physiol. 1995;71:535–542
  360. Wing RR. Physical activity in the treatment of the adulthood overweight and obesity: current evidence and research issues. Med Sci Sports Exerc. 1999;31(Suppl 11):S547–S551
  361. Wood PD, Stefanick ML, Dreon DM, et al.  Changes in plasma lipids and lipoproteins in overweight men during weight loss through dieting as compared with exercise. N Engl J Med. 1988;319:1173–1179
  362. Perri MG, McAdoo WG, McAllister DA, Lauer JB, Yancey DZ. Enhancing the efficacy of behavior therapy for obesity: effects of aerobic exercise and a multicomponent maintenance program. J Consult Clin Psychol. 1986;54:670–675
  363. Colvin RH, Ohlson SB. A descriptive analysis of men and women who have lost significant weight and are highly successful at maintaining the weight loss. Addict Behav. 1983;8:281–295
  364. Marston AR, Criss J. Maintenance of successful weight loss: incidence and prediction. Int J Obes. 1984;8:435–439
  365. Kayman S, Bruvold W, Stern JS. Maintenance and relapse after weight loss in women: behavioral aspects. Am J Clin Nutr. 1990;52:800–807
  366. Jeffery RW, Bjornson-Benson WM, Rosenthal BS, Lindquist RA, Kurth CL, Johnson SL. Correlates of weight loss and its maintenance over two years of follow-up among middle-aged men. Prev Med. 1984;13:155–168
  367. Hartman WM, Straud M, Sweet DM, Saxton J. Long-term maintenance of weight loss following supplemented fasting. Int J Eat Disord. 1993;87–93
  368. Hill JO, Schlundt DG, Sbrocco T, et al.  Evaluation of an alternating-calorie diet with and without exercise in the treatment of obesity. Am J Clint Nut. 1989;50:248–254
  369. Sikand G, Kondo A, Foreyt JP, Jones PH, Gotto AM. Two-year follow-up of patients treated with a very-low-calorie diet and exercise training. J Am Diet Assoc. 1988;88:487–488
  370. Pavlou KN, Krey S, Steffee WP. Exercise as an adjunct to weight loss and maintenance in moderately obese subjects. Am J Clin Nutr. 1989;49:1115–1123
  371. Wing RR, Epstein LH, Paternostro-Bayles M, Kriska A, Nowalk MP, Gooding W. Exercise in a behavioral weight control programme for obese patients with type 2 (non-insulin-dependent) diabetes. Diabetologia. 1988;31:902–909
  372. Grilo CM, Brownell KD, Stunkard AJ. The metabolic and psychological importance of exercise in weight control. In:  Stunkard AJ,  Wadden TA editor. Obesity: theory and therapy. New York: Raven; 1993;p. 253–273
  373. Pate RR, Pratt M, Blair SN, et al.  A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995;273:402–407
  374. Schoeller DA, Shay K, Kushner RF. How much physical activity is needed to minimize weight gain in previously obese women?. Am J Clin Nutr. 1997;66:551–556
  375. Jakicic JM, Wing RR, Winters D. Effects of intermittent exercise and use of home exercise equipment on adherence, weight loss, and fitness in overweight women. JAMA. 1999;282:1554–1560
  376. Jeffery RW, Wing RR, Thorson C, Burton LR. Use of personal trainers and financial incentives to increase exercise in a behavioral weight loss program. J Consult Clin Psychol. 1998;66:777–783
  377. Bassett DRL, Ainsworth BE, Leggett SR, et al.  Accuracy of five electronic pedometers for measuring distance walked. Med Sci Sports Exer. 1996;28:1071–1077
  378. Jakicic JM, 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;19:382–387
  379. King AC, Haskell WL, Young DR, Oka RK, Stefanick ML. Long-term effects of varying intensities and formats of physical activity on participation rates, fitness, and lipoproteins in men and women aged 50-65 years. Circulation. 1995;91:2596–2604
  380. Perri MG, Martin AD, Leermakers EA, Sears SF. Effects of group- versus home-based exercise training in healthy older men and women. J Consult Clin Psychol. 1997;65:278–285
  381. Epstein LH, Wing RR, Koeske R, Valoski A. A comparison of lifestyle exercise, aerobic exercise, and calisthenics on weight loss in obese children. Behav Ther. 1985;16:345–356
  382. Epstein L, Wing R, Koeske R, Ossip DJ, Beck S. A comparison of lifestyle change and programmed aerobic exercise on weight and fitness changes in obese children. Behav Ther. 1982;13:651–665
  383. 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
  384. Holloszy JO, Schultz J, Kusnierkiewicz J, Hagberg JM, Ehsani AA. Effects of exercise on glucose tolerance and insulin resistance. Acta Med Scand. 1986;711:55–65
  385. Helmrich SP, Ragland DR, Leung RW, Paffenbarger RS. Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. N Engl J Med. 1991;325:147–152
  386. Rodin J, Plante T. The psychological effects of exercise. In:  Sanders R,  Wallace W,  Wallace AG editor. Biological effects of physical activity. Champaign: Human Kinetics; 1989;p. 127–137
  387. Brownell KD. The LEARN Program for weight control. Dallas, TX: American Health Publishing Company; 2000;
  388. Wadden TA. Characteristics of successful weight loss maintainers. In:  Allison DB,  Pi-Suyner FX editor. Obesity treatment: establishing goals, improving outcomes, and reviewing the research agenda. New York: Plenum; 1995;p. 103–111
  389. Bandini LG, Schoeller DA, Cyr HN, Dietz WH. Validity of reported energy intake in obese and nonobese adolescents. Am J Clin Nutr. 1990;52:421–425
  390. Wadden TA, Foster GD. Behavioral assessment and treatment of markedly obese patients. In:  Wadden TA,  Van Itallie TB editor. Treatment of the seriously obese patient. New York: Guilford Press; 1992;p. 290–330
  391. Wadden TA, Sarwer DB, Berkowitz RI. Behavioural treatment of the overweight patient. Bailliere's Clin Endocrin Metab. 1999;13:93–107
  392. Wing RR, Blair EH, Marcus MD, Epstein LH, Harvey J. Year-long weight loss treatment for obese patients with type 2 diabetes: does including an intermittent very-low-calorie diet improve outcome?. Am J Med. 1994;97:354–362
  393. Perri MG, McAllister DA, Gange JJ, Jordan RC, McAdoo WG, Nezu AM. Effects of four maintenance programs on the long-term management of obesity. J Consult Clin Psychol. 1988;56:529–534
  394. Perri MG, Shapiro RM, Ludwig WW, Twentyman CT, McAdoo WG. Maintenance strategies for the treatment of obesity: an evaluation of relapse prevention training and postreatment contact by telephone and mail. J Consult Clin Psychol. 1984;52:404–413
  395. Perri MG, Nezu AM, Viegener BJ. Improving the long-term management of obesity: theory research and clinical guidelines. New York: Wiley; 1992;
  396. Wing RR, Venditti EM, Jakicic JM, Polley BA, Lang W. Lifestyle intervention in overweight individuals with a family history of diabetes. Diabetes Care. 1998;21:350–359
  397. Tate D, Wing RR, Winett R. Using Internet technology to deliver a behavioral weight loss program. JAMA. 2001;285:1172–1177
  398. Bray GA, Blackburn GL, Ferguson JM, et al.  Sibutramine produces dose-related weight loss. Obes Res. 1999;7:189–198
  399. Sjostrom L, Rissanen A, Andersen T, et al.  Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients. Lancet. 1998;352:167–172
  400. Weintraub M, Sundaresan PR, Schuster B, Averbuch M, Stein EC, Byrne L. Long-term weight control study. V (weeks 190 to 210). Follow-up of participants after cessation of medication. Clin Pharmacol Ther. 1992;51:615–618
  401. Lean ME. Sibutramine—a review of clinical efficacy. Int J Obes Relat Metab Disord. 1997;21(Suppl 1):S30–S36
  402. Sandage BWJ, Loar SB, Cary M, Cooper GL. Predictors of therapeutic success with dexfenfluramine. Obes Res. 1995;3:355S
  403. James WPT, Astrup A, Finer N, et al.  Effect of sibutramine on weight maintenance after weight loss: a randomised trial. Lancet. 2000;356:2119–2125
  404. Craighead LW, Stunkard AJ, O'Brien RM. Behavior therapy and pharmacotherapy for obesity. Arch Gen Psychiatry. 1981;38:736–738
  405. Wadden TA, Berkowitz RI, Sarwer DB, Prus-Wisniewski R, Steinberg CM. Benefits of lifestyle modification in the pharmacologic treatment of obesity: a randomized trial. Arch Intern Med. 2001;161:218–227
  406. Food and Drug Administration . Draft Guidance Clinical Evaluation of Weight Control Drug. Rockville, MD: FDA; 1996;
  407. Bray GA, Greenway FL. Current and potential drugs for treatment of obesity. Endocrine Rev. 1999;20:805–875
  408. Bray GA. Evaluation of drugs for treating obesity. Obes Res. 1995;3(Suppl):425S–434S
  409. Khan MA, Herzog CA, St Peter JV, et al.  The prevalence of cardiac valvular insufficiency assessed by transthoracic echocardiography in obese patients treated with appetite-suppressant drugs. N Engl J Med. 1998;339:713–718
  410. Kernan WN, Viscoli CM, Brass LM, et al.  Phenylpropanolamine and the risk of hemorrhagic stroke. N Engl J Med. 2000;343:1826–1832
  411. Hansen DL, Toubro S, Stock MJ, Macdonald IA, Astrup A. Thermogenic effects of sibutramine in humans. Am J Clin Nutr. 1998;68:1180–1186
  412. Hadvary P, Lengsfield H, Wolfer H. Inhibition of pancreatic lipase in vitro by the covalent inhibitor tetrahydrolipstatin. Biochem J. 1998;256:357–361
  413. Zhi J, Melia AT, Guerciolini R, et al.  Retrospective population-based analysis of the dose-response (fecal fat excretion) relationship of orlistat in normal and obese volunteers. Clin Pharmacol Ther. 1994;56:82–86
  414. Drent ML, van der Veen EA. Lipase inhibition: a novel concept in the treatment of obesity. Int J Obes Relat Metab Disord. 1993;17:241–244
  415. Hildebrand P, Petrig C, Burckhardt B, et al.  Hydrolysis of dietary fat by pancreatic lipase stimulates cholecystokinin release. Gastroenterology. 1998;114:123–129
  416. Zhi J, Melia AT, Funk C, et al.  Metabolic profiles of minimally absorbed orlistat in obese/overweight volunteers. J Clin Pharmacol. 1996;36:1006–1011
  417. Munro JF, MacCuish AC, Wilson EM, Duncan LJP. Comparison of continuous and intermittent anorectic therapy in obesity. Br Med J. 1968;1:352–356
  418. National Institutes of Health, National Heart, Lung and Blood Institute and North American Association for the Study of Obesity . Practical Guide to the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. NIH publication number 00-4084. October 2000;
  419. Smith IG, Goulder MA. Randomized placebo-controlled trial of long-term treatment with sibutramine in mild to moderate obesity. J Fam Pract. 2001;50:505–512
  420. McMahon FG, Fujioka K, Singh BN, et al.  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
  421. Wirth A, Krause J. Long-term weight loss with sibutramine. A randomized controlled trial. JAMA. 2001;286:1331–1339
  422. 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
  423. Davidson MH, Hauptman J, DiGirolamo M, et al.  Weight control and risk factor reduction in obese subjects treated for 2 years with orlistat. JAMA. 1999;281:235–242
  424. 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
  425. 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
  426. Hollander PA, Elbein SC, Hirsch IB, et al.  Role of orlistat in the treatment of obese patients with type 2 diabetes. Diabetes Care. 1998;21:1288–1294
  427. Lindgarde F. The effect of orlistat on body weight and coronary heart disease risk profile in obese patients: the Swedish Multimorbidity Study. J Intern Med. 2000;248:245–254
  428. Hill JO, Hauptman J, Anderson JW, et al.  Orlistat, a lipase inhibitor, for weight maintenance after conventional dieting: a 1-year study. Am J Clin Nutr. 1999;69:1108–1116
  429. Mittendorfer B, Ostlund R, Patterson BW, Klein S. Orlistat inhibits dietary cholesterol absorption. Obes Res. 2001;9:599–604
  430. Franson K, Rossner S. Fat intake and food choices during weight reduction with diet, behavioural modification and a lipase inhibitor. J Intern Med. 2000;247:607–614
  431. Cavaliere H, Floriano I, Medeiros-Neto G. Gastrointestinal side-effects of orlistat by concomitant prescription of natural fibers (psyllium mucilloid). Int J Obes Relat Metab Disord. 2001;25:1095–1099
  432. Zhi J, Melia AT, Kross-Twardy SG, Arora S, Patel IH. The effect of orlistat, an inhibitor of dietary fat absorption, on the pharmacokinetics of β-carotene in healthy volunteers. J Clin Pharmacol. 1996;36:152–159
  433. Melia AT, Kross-Twardy SG, Zhi J. The effect of orlistat, an inhibitor of dietary fat absorption, on the absorption of vitamins A and E in healthy volunteers. J Clin Pharmacol. 1996;36:647–653
  434. Colman E, Fossler M. Reduction in blood cyclosporin concentrations by orlistat. N Engl J Med. 2000;342:1141–1142
  435. Schnetzler B, Kondo-Oestreicher M, Vala D. Orlistat decreases the plasma level of cyclosporine and may be responsible for the development of acute rejection episodes. Transplantation. 2000;70:1540–1541
  436. 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
  437. Guerciolini R. Mode of action of orlistat. Int J Obes Relat Metab Disord. 1997;21(Suppl 3):S12–S23
  438. Froehlich F, Hartmann D, Guezelhan C, Gonvers JJ, Jansen JBMJ, Fried M. Influence of orlistat on the regulation of gallbladder contraction in man. A randomized double-blind placebo-controlled crossover study. Dig Dis Sci. 1996;12:2404–2408
  439. Pace D, Guerciolini R, Wargivich M, Woods C, Anhem D. Lack of effect of lipase inhibition with orlistat on colon cell turnover in obese subjects. Int J Obes Relat Metab Disord. 1998;22:S64
  440. Conference NIH. Gastrointestinal surgery for severe obesity: Consensus Development Conference Panel. Ann Intern Med. 1991;115:956–961
  441. Brolin RE, Kenler HA, Gorman JH, Cody RP. Long-limb gastric bypass in the superobese. A prospective randomized study. Ann Surg. 1992;215:387–395
  442. Sanyal AJ, Sugerman HJ, Kellum JM, Engle KM, Wolfe L. Stomal complications of gastric bypass: incidence and outcome of therapy. Am J Gastroenterol. 1992;87:1165–1169
  443. Oczkowski WJ, Kertesz A. Wernicke's encephalopathy after gastroplasty for morbid obesity. Neurology. 1985;35:99–101
  444. Somer H, Bergstrom L, Mustajoki P, Rovamo L. Morbid obesity, gastric plication and a severe neurological deficit. Acta Med Scand. 1985;217:575–576
  445. Halverson JD. Vitamin and mineral deficiencies following obesity surgery. Gastroenterol Clin North Am. 1987;16:307–315
  446. Rhode BM, Arsenau P, Cooper BA, Katz M, Gilfix BM, MacLean LD. Vitamin B-12 deficiency after gastric surgery for obesity. Am J Clin Nutr. 1996;63:103–109
  447. Brolin RE, Gorman JH, Gorman RC, et al.  Prophylactic iron supplementation after Roux-en-Y gastric bypass: a prospective, double-blind, randomized study. Arch Surg. 1998;133:740–744
  448. Brolin RE, Leung M. Survey of vitamin and mineral supplementation after gastric bypass and biliopancreatic diversion for morbid obesity. Obes Surg. 1999;9:150–154
  449. Mason EE. Vertical banded gastroplasty for obesity. Arch Surg. 1982;117:701–706
  450. Eckhout GV, Willibanks OL, Moore JT. Vertical ring gastroplasty for morbid obesity. Five year experience with 1,463 patients. Am J Surg. 1986;152:713–716
  451. MacLean LD, Rhode BM, Sampalis J, Forse RA. Results of the surgical treatment of obesity. Am J Surg. 1993;165:155–162
  452. Sugerman HJ, Starkey JV, Birkenhauer RA. A randomized prospective trial of gastric bypass versus vertical banded gastroplasty and their effects on sweets versus non sweets eaters. Ann Surg. 1987;205:613–624
  453. Hall JC, Watts JM, O'Brien PE, et al.  Gastric surgery for morbid obesity. The Adelaide study. Ann Surg. 1990;211:419–427
  454. 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
  455. Yale CE. Gastric surgery for morbid obesity. Complications and long-term weight control. Arch Surg. 1989;124:941–946
  456. Brolin RL, Robertson LB, Kenler HA, Cody RP. Weight loss and dietary intake after vertical banded gastroplasty and Roux-en-Y gastric bypass. Ann Surg. 1994;220:782–790
  457. Capella JF, Capella RF. The weight reduction operation of choice: vertical banded gastroplasty or gastric bypass?. Am J Surg. 1996;171:74–79
  458. Buchwald H, Menchacha HJ, Menchacha YM, Michalek VN. Surgically induced weight loss: gastric bypass versus gastroplasty. Prob Gen Surg. 2000;17:23–28
  459. Balsiger BM, Kelly KA, Poggio JL, Mai J, Sarr MG. Long term prospective follow-up (> 10 years) after vertical banded gastroplasty (VBG). Gastroenterology. 2000;118:A1060
  460. Kenler HA, Brolin RE, Cody RP. Changes in eating behavior after horizontal gastroplasty and Roux-en-Y gastric bypass. Am J Clin Nutr. 1990;52:87–92
  461. Sugerman HJ, Londrey GL, Kellum JM, et al.  Weight loss with vertical banded gastroplasty and Roux-en-Y gastric bypass for morbid obesity with selective versus random assignment. Am J Surg. 1989;157:93–100
  462. Belachew M, Legrand M, Vincent V, Lismonde M, LeDocte N, Deschamps V. Laparoscopic adjustable gastric banding. World J Surg. 1998;22:955–963
  463. DeMaria EJ, Sugerman HJ, Kellum JM, et al.  High failure rate following laparoscopic adjustable silicone gastric banding for treatment of morbid obesity. Ann Surg. 2001;233:809–818
  464. Hauri P, Steffen R, Ricklin T, Riedtmann HJ, Sendi P, Horber FF. Treatment of morbid obesity with the Swedish adjustable gastric band (SAGB): complication rate during a 12-month follow-up period. Surgery. 2000;127:484–488
  465. Gustavsson S. Laparoscopic adjustable gastric banding –a caution. Surgery. 2000;127:489–490
  466. Payne JH, DeWind LT. Surgical treatment of obesity. Am J Surg. 1969;118:141–147
  467. Scott HW, Dean RH, Shull HJ, Gluck F. Results of jejunoileal bypass in two hundred patients with morbid obesity. Surg Gynecol Obstet. 1977;145:661–673
  468. Hocking MP, Duerson MC, O'Leary JP, Woodward ER. Jejunoileal bypass for morbid obesity. Late follow-up in 100 cases. N Engl J Med. 1983;308:995–999
  469. Drenick EJ, Bassett LW, Stanley TM. Rheumatoid arthritis associated with jejunoileal bypass. Arthritis Rheum. 1984;27:1300–1305
  470. Drenick EJ, Stanley TM, Wills CE. Renal damage after intestinal bypass. Int J Obes. 1981;5:501–508
  471. Drenick EJ, Fisler J, Johnson D. Hepatic steatosis after intestinal bypass—prevention and reversal with metronidazole, irrespective of protein-calorie malnutrition. Gastroenterology. 1982;82:535–548
  472. Drenick EJ, Ament ME, Finegold SM, Passaro E. Bypass enteropathy: an inflammatory process in the excluded segment with systemic complications. Am J Clin Nutr. 1977;30:76–89
  473. Halverson JD, Gentry K, Wise L, Ballinger WF. Reanastomosis after jejunoileal bypass. Surgery. 1978;84:241–249
  474. Scopinaro N, Adami GF, Marinari GM, Gianetta E, Traverso E, Friedman D, et al.  Biliopancreatic diversion. World J Surg. 1998;22:936–946
  475. Sugerman HJ, Kellum JM, DeMaria EJ. Conversion of proximal to distal gastric bypass for failed gastric bypass for superobesity. J Gastrointest Surg. 1997;1:517–525
  476. Clare MW. Reversals on 504 biliopancreatic surgeries over 12 years. Obes Surg. 1993;3:169–173
  477. Marcia P, Byron S, Hold F-S, Label S, Marcia S. Malabsorption procedure in surgical treatment of morbid obesity. Probl Gen Surg. 2000;14:29–39
  478. Marcia P, Hold FS, Samara S, et al.  Biliopancreatic diversion with duodenal switch. World J Surg. 1998;22:947–954
  479. Marcia P, Hold FS, Potion M, Label S, Byron S. Biliopancreatic diversion (duodenal switch procedure). Eur J Gastroenterol Hepatol. 1999;1:99–103
  480. Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Roux-en-Y 500 patients: technique and results, with 3-60 month follow-up. Obes Surg. 2000;10:233–239
  481. Schauer PR, Ikramuddin S, Ramanathan R, Gourash W, Panzak G. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg. 2000;232:515–529
  482. Nguyen NT, Goldman C, Rosenquist CJ, et al.  Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and costs. Ann Surg. 2001;234:279–291
  483. Balsiger BM, Kennedy FP, Abu-Lebdeh HS, Collazo-Clavell M, Jensen MD, O'Brien T. Prospective evaluation of roux-en-Y gastric bypass as primary operation for medically complicated obesity. Mayo Clin Proc. 2000;75:673–680
  484. Mason EE, Printen KJ, Barron P, Kealey GP, Blommers TJ. Risk reduction in gastric operations for obesity. Ann Surg. 1979;190:158–165
  485. Sugerman HJ, Kellum JM, Engle KM, et al.  Gastric bypass for treating severe obesity. Am J Clin Nutr. 1992;55:560S–566S
  486. Sugerman HJ, Sugerman EL, Wolfe L, Kellum JM, Schweitzer MA, DeMaria EJ. Risks and benefits of gastric bypass in morbidly obese patients with severe venous stasis disease. Ann Surg 200;234:41–46.
  487. Sugerman HJ, Kellum JM, Reines HD, DeMaria EJ, Newsome HH, Lowry JW. Greater risk of incisional hernia with morbidly obese than steroid dependent patients and low recurrence with prefascial polypropylene mesh. Am J Surg. 1996;17:80–84
  488. Buckwalter JA, Herbst CA, Khouri RK. Morbid obesity. Second gastric operations for poor weight loss. Am J Surg. 1985;5:208–211
  489. Schwartz RW, Strodel WE, Simpson WS, Griffen WO. Gastric bypass revision: lessons learned from 920 cases. Surgery. 1988;104:806–812
  490. Davies IJ. Hairballs or haircasts of stomach and gastrointestinal tract. Lancet. 1921;2:791–795
  491. Mathus-Vliegen EMH. Treating morbid and supermorbid obesity. Int J Gastroenterol. 2000;5:9–12
  492. Kim WY, Kirkpatric UJ, Moody AP, Wake PN. Large bowel impaction by the BioEnterics intragastric balloon (BIB) necessitating surgical intervention. Ann R Coll Surg Engl. 2000;82:202–204
  493. Mathus-Vliegen EMH, Tytgat GNJ, Veldhuyzen-Offermans EAML. Intragastric balloon in the treatment of super-morbid obesity. Gastroenterology. 1990;99:362–369
  494. Riguad D, Trostler N, Rozen R, Vallot T, Apfelbaum M. Gastric distention, hunger and energy intake after balloon implantation in severe obesity. Int J Obes Relat Metab Disord. 1995;19:489–495
  495. Geliebter A, Melton PM, McCray RS, et al.  Clinical trial of silicone-rubber gastric balloon to treat obesity. Int J Obes Relat Metab Disord. 1991;15:259–266
  496. Krakamp B. Welche berechtigung hat der magenvolumen reduzierungsballon zur gewichtsreduktion bei adipositas permagna?. Adipositas. 1997;13:17–22
  497. Krakamp B, Leidig P, Gehmlich D, Paul A. Der magenvolumen-reduzierungsballon zur gewichtsreduktion: welche berechtigung hat diese umschritte methode?. Zentralbl Chir. 1997;122:349–356
  498. Ramhamadany EM, Fowler J, Baird IM. Effect of the gastric balloon versus sham procedures on weight loss in obese subjects. Gut. 1989;30:1054–1057
  499. Foster GD, Wadden TA, Vogt RA, Brewer G. What is a reasonable weight loss? Patients' expectations and evaluations of obesity treatment outcomes. J Consult Clin Psychol. 1997;65:79–85
  500. Rabner JG, Greenstein RJ. Obesity surgery: expectations and reality. Int J Obes Relat Metab Disord. 1991;15:841–855
  501. Rand CSW, Macgregor AMC. Successful weight loss following obesity surgery and the perceived liability of morbid obesity. Int J Obes Relat Metab Disord. 1991;15:577–579
  502. Lee I-M, Paffenbarger RS. Do physical activity and physical fitness avert premature mortality?. Exer Sport Sci Rev. 1996;24:135–171
  503. Fletcher GF, Blair SN, Blumenthal J, et al.  Statement on exercise. Benefits and recommendations for physical activity programs for all Americans. A statement for health professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart Association. Circulation. 1992;86:340–344
  504. Kiernan M, Winkleby MA. Identifying patients for weight-loss treatment. An empirical evaluation of the NHLBI Obesity Education Initiative Expert Panel treatment recommendations. Arch Intern Med. 2000;160:2169–2176

☆ Address requests for reprints to: Chair, Clinical Practice Committee, AGA National Office, c/o Membership Department, 7910 Woodmont Avenue, 7th Floor, Bethesda, Maryland 20814. fax: (301) 654-5920.

☆☆ Supported by National Institutes of Health grants DK 37948, DK 56341, DK12614, and RR-00036.

★ This literature review and the recommendations therein were prepared for the American Gastroenterological Association Clinical Practice Committee. The paper was approved by the Committee on March 3, 2002, and by the AGA Governing Board on May 19, 2002.

★★ Dr. Klein has received honoraria for speaking engagements on obesity from Roche Laboratories and R. W. Johnson; is a member of the Obesity and Diabetes Educational Council, which is funded by an unrestricted educational grant provided by Roche Laboratories; and has received research support for clinical studies from Roche Laboratories, R.W. Johnson, DMV International, Regeneron Pharmaceuticals, Novartis Nutrition, and GlaxoSmithKline. These funds were used for participating in multicenter clinical research trials and for investigator-initiated research in obesity.

♢ Dr. Wadden serves on the speakers' bureau for Abbott Laboratories and Roche Laboratories, which manufacture the weight-loss medications sibutramine and orlistat, respectively. He has received research support from Schering-Plough, GlaxoSmithKline, and Abbott Laboratories.

PII: S0016-5085(02)00180-4

Gastroenterology
Volume 123, Issue 3 , Pages 882-932 , September 2002

Article Tools

* Image Usage & Resolution