Changes in fitness and excess body weight and its association with the Triglyceride/HDL- C ratio in individuals with severe obesity undergoing structured lifestyle modification

Background Structured lifestyle modification is the foundation of treatment for patients with severe obesity. Metabolic improvements in health (such as decreased insulin resistance) are sought through a combination of increased fitness and decreased excess body weight. It is not clear how fitness or excess body weight, as well as the change in these variables influence the response to lifestyle modification. This thesis sought to investigate the association between baseline and changes in fitness, excess body weight and the Tri/HDL-C ratio (a surrogate marker of insulin resistance) in patients with severe obesity undergoing an 8-week structured lifestyle modification programme. Methods A prospective cohort study data set containing 1122 patients (751, (66.9%)) female, mean age 47.3 ± 11.9 years, mean body mass index (BMI 46.7 ±7.8 kg/m2 ) who were referred from a hospital-based obesity clinic to an 8-week structured lifestyle modification programme was used for this thesis. I compared excess body weight %, cardiovascular fitness and Tri/HDL ratio before after the intervention as well as assessing changes in these variables in response to the intervention. Results Of 1122 patients who initiated the intervention, 377 (33%) had both pre and post data points for each of the variables of interest. There was no significant relationship between pre and post measurements or the change in fitness, % excess body weight and the Tri/HDL-C ratio. There was a significantly negative relationship between baseline Tri/HDL-C ratio and the change in this ratio in response to the intervention (r=-0.59 p= Conclusions In adults with sever and complicated obesity, an 8-week structured lifestyle modification programme can result in a small but significant decrease in excess body weight, increase in cardiovascular fitness as well as improvements to participants lipid profile. However, there was no change in the Tri/HDL-C ratio or any relationship between Tri/HDL-C ratio, excess body weight or fitness observed in this study. Additionally, no relationship was found between Tri/HDL-C ratio and age, suggesting that this surrogate marker of insulin sensitivity may not be applicable in this population.

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University of Galway

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Attribution-NoDerivatives 4.0 International

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University of Galway Theses (Research Masters Theses)