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| Name | Class |
|---|---|
| Ontario Lung Association | OTHER |
| The Ottawa Hospital | OTHER |
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Dyspnea is a common complaint in obese patients. The mechanisms behind this dyspnea and the effects of weight loss on dyspnea are not completely understood. The objectives of this study were to examine the relationships between exercise parameters and dyspnea in obesity and assess the effects of weight loss.
The investigators compared pulmonary function, exercise performance and dyspnea in 34 patients with abdominal obesity and metabolic syndrome (MS) against 34 age and sex-matched controls. The study also assessed within-group changes in physiology and symptoms in a subset of patients following participation in a weight management program.
Because obesity is a heterogeneous condition, with variable genetic associations, co-morbidities and distributions of adipose tissue, the study focused on patients with abdominal obesity who met diagnostic criteria for metabolic syndrome.
The study has two parts: first, the investigators compared dyspnea, pulmonary function and exercise measurements between obese patients and control subjects with normal weight; then, the investigators assessed the effects of medical weight loss in the obese group on these parameters. Baseline dyspnea was assessed using the baseline dyspnea index.The effect of weight loss on dyspnea was assessed using the transitional dyspnea index. The main physiologic measurement of interest was the inspiratory capacity (L, measured at rest and during exercise).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Weight Management Program | Experimental | Obese subjects participate in a year long medically supervised weight management program. |
|
| Normal Weight Controls | No Intervention | Normal weight age and sex-matched controls. Unlike the obese subjects, the controls did not participate in the Weight Management Program. Pulmonary function, exercise performance and dyspnea results for normal weight controls were compared against the results for obese subjects. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Weight Management Program | Other | Obese subjects partake in a medically supervised weight management program. This lifestyle modification program involves weekly three hour sessions for six months and monthly sessions for six months. The first twelve weeks comprise an initial weight loss phase when patients are placed on a 900 Kcal/day meal replacement. This is followed by a four week transition to a 1200-1800 Kcal diet followed by a ten week maintenance phase of 10 weekly sessions.The majority of weight loss occurs during the first 26 weeks followed by a 26 week period of stabilization of weight loss. Hence subjects are evaluated after the first 26 weeks. |
| Measure | Description | Time Frame |
|---|---|---|
| Dyspnea (measured by Transitional Dyspnea Index) | Dyspnea was assessed using a questionnaire based on the Transitional Dyspnea Index | Within 6 months following completion of 6 months (weight loss period) in the weight management program |
| Resting Inspiratory Capacity (L) | Inspiratory capacity (difference between total lung capacity and functional residual capacity), measured at rest | Within 6 months following completion of 6 months (weight loss period) in the weight management program |
| Inspiratory Capacity during Exercise (L) | Inspiratory capacity measured at identical time points during incremental exercise tests, performed before and after weight loss | Within 6 months following completion of 6 month (weight loss period) in the weight management program |
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Inclusion Criteria:
Individuals accepted into the behavioural weight management program at the Ottawa Hospital Bariatric Centre
Age between 20 and 60 years
BMI greater than 30
Abdominal girth (for females) greater than 88 cm
Abdominal girth (for males) greater than 102 cm
Plus any two of the other criteria for Metabolic Syndrome:
i.e. Blood Pressure greater or equal to 130/85; Fasting Glucose greater or equal to 6.1 mmol/L
Controls-normal weight (NW) and sedentary
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Nha Voduc, MD | University of Ottawa | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Ottawa Hospital | Ottawa | Ontario | K1H 8L6 | Canada |
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| ID | Term |
|---|---|
| D009765 | Obesity |
| D024821 | Metabolic Syndrome |
| D004417 | Dyspnea |
| ID | Term |
|---|---|
| D050177 | Overweight |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
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|
| D001835 |
| Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D007333 | Insulin Resistance |
| D006946 | Hyperinsulinism |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
| D012818 | Signs and Symptoms, Respiratory |