Prevalence of Pre‐obesity and Obesity in Urban Adult Mexicans in Comparison with Other Large Surveys

Objective: 1. To estimate the prevalence of pre‐obesity and obesity in a 1992 to 1993 national survey of the Mexican urban adult population. 2. To compare our findings with other national surveys and with data for Mexican Americans. Research Methods and Procedures: The national representative sample of the Mexican urban adult population included 8462 women and 5929 men aged 20 to 69 years from 417 towns of >2500 people. Body mass index (BMI), calculated from measured weight and height, was classified using the World Health Organization categories of underweight (BMI < 18.5 kg/m²), normal weight (BMI 18.5 to 24.9 kg/m²), pre‐obesity (PreOB = BMI 25 to 29.9 kg/m²) and obesity (OB = BMI 30+ kg/m²). Estimates for Mexican Americans were calculated from U.S. survey data. Results: Overall, 38% of the Mexican urban adult population were classified as pre‐obese and 21% as obese. Men had a higher prevalence of pre‐obesity than women did at all ages, but women had higher values of obesity. Both pre‐obesity and obesity increased with age up to the age range brackets of 40 to 49 or 50 to 59 years for both men and women. Both pre‐obesity and obesity prevalence estimates were remarkably similar to data for Mexican Americans from 1982 through 1984. Comparison with other large surveys showed that countries differed more in the prevalence of obesity than of pre‐obesity, leading to differences in the PreOB/OB ratio, and that countries also differed in the gender ratio (female/male) for both pre‐obesity and obesity. Discussion: Pre‐obesity and obesity were high in our population and increased with age. Our approach of characterizing large surveys by PreOB/OB and gender ratios appeared promising.     

Does Ethnicity Influence Body-Size Preference? A Comparison of Body Image and Body Size

Objective: Obesity is most common in the United States among women of ethnic minority groups (black and Hispanic). Researchers have hypothesized that these subcultures are more accepting of overweight figures. The purpose of this study was to examine body image and body size assessments in a large community sample of men and women. Research Methods and Procedures: Participants were 801 women and 428 men: 23% Asian, 45% Hispanic, 17% black, and 15% white. The figure rating scale was used to rate: body dissatisfaction, attractive male and female shapes, acceptable female size, and perceptions of underweight to obese female figures. Results: Controlling for age, education, and body weight, no ethnic differences were found for men. Asian women reported less body dissatisfaction than the other groups. Women were more dissatisfied with their size than men and chose thinner female figures as attractive and acceptable. Discussion: Ethnicity, independent of age, education, and body weight, does not influence preference for female and male shapes or tolerance for obesity.     

Characteristics of Patients Undergoing Bariatric Surgery in Canada

Objective: The increasing prevalence of obesity has led to an increased use of bariatric surgery in the treatment of severely obese individuals. The characteristics of patients undergoing bariatric procedures outside of clinical studies and on a national level have not previously been reported. Research Methods and Procedures: Acute‐care hospital discharge data from the Canadian Institute for Health Information were analyzed to determine the demographic and clinical features and in‐hospital mortality rates of individuals undergoing bariatric surgery in Canada. Data from individuals undergoing surgery in fiscal year 2002/2003 were compared with data from 1993/1994. Results: Over 1100 bariatric surgeries were performed in Canada in 2002/2003, with the vast majority being performed in middle‐aged women. Ten percent of patients had hypertension or diabetes, and only 1% or fewer had dyslipidemia or cardiovascular or cerebrovascular disease. Compared with 1993/1994, patients undergoing surgery in 2002/2003 were older, more likely to have diabetes or hypertension, and had shorter hospital stays. In‐hospital mortality rates were <1% in both years. Discussion: In the last decade, there has been a small increase in the average age and the number of patients with concomitant cardiovascular risk factors who are undergoing bariatric procedures in Canada. However, the vast majority of surgeries are being performed in middle‐aged women with little cardiovascular comorbidity, and this is likely contributing to very low in‐hospital death rates. Such individuals likely represent a highly selected sample of severely obese patients within Canada.     

Weight Loss and Gender: An Examination of Physician Attitudes

Objective: The purpose of this study was to investigate physician attitudes toward the treatment of overweight and obese individuals and to evaluate potential gender differences in treatment recommendations. Research Methods and Procedures: A survey describing several hypothetical patients was sent to 700 randomly selected physicians; 209 (29.9%) returned the survey. Two versions of the questionnaire (one for men and one for women) described three hypothetical patients at three levels of body mass index (BMI) (32, 28, and 25 kg/m²). One‐half of the physicians received a version of the questionnaire describing the patients as women, and one‐half received a version describing the patients as men. Respondents answered questions about attitudes toward treatment and specific interventions and referrals they would view as appropriate. Results: Physicians were more likely to encourage women with a BMI of 25 kg/m² to lose weight than men with the same BMI, and indicated that they would suggest more treatment referrals for women than men. Men with a BMI of 32 kg/m² were more likely to be encouraged to lose weight than women with the identical BMI. Physicians were more likely to encourage weight loss and see treatment referrals as appropriate for patients with higher BMIs. Discussion: This study indicates that physicians treat male and female patients differently, with physicians more likely to encourage weight loss and provide referrals for women with a BMI of 25 kg/m² than for men with an identical BMI and less likely to encourage weight loss for women than men with a BMI of 32 kg/m².     

Binge Eating and Eating‐Related Cognitions and Behavior in Ethnically Diverse Obese Women

Objective: To examine binge eating and eating‐related cognitions and behavior in a sample of ethnically diverse women who are severely obese and seeking bariatric surgery. Research Methods and Procedures: Female bariatric surgery candidates (62 African Americans, 18 Latinas, 130 whites) completed questionnaires on binge eating and eating‐related cognitions and behavior and completed a structured clinical interview to confirm binge‐eating disorder diagnosis. Results: Ethnic minorities and whites did not differ in rates of binge‐eating disorder (26.3%), binges per week (M = 0.95), or dietary restraint. Ethnic minorities reported less disinhibition, and there was a trend to report less hunger awareness than whites. After controlling for BMI and education, ethnicity accounted for significant variance in disinhibition (4%; p < 0.01). Ethnic minorities were younger, became overweight at a later age, and were overweight for fewer years than whites. Discussion: Results suggest that ethnicity exerts an important influence on disinhibition and that ethnic differences are not caused by BMI or education. Findings point to the need to continue to investigate the role of ethnicity, binge eating, and disinhibition in severely obese women, so that culturally appropriate services can be provided.     

Do Energy Density and Dietary Fiber Influence Subsequent 5‐Year Weight Changes in Adult Men and Women?

Objective: We examined whether associations between dietary components and, in particular, energy density (ED) predicted subsequent 5‐year weight changes. Research Methods and Procedures: The present longitudinal population study was part of the Danish World Health Organization Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) and the 1936 cohort dietary studies. Effects of components were studied in relation to subsequent 5‐year weight changes in 862 men and 900 women, 30 to 60 years old. Linear multiple regression analyses were conducted. Results: Mean 5‐year changes in body weight (BW) were 1.2 ± 3.9 and 1.3 ± 4.6 kg for men and women, respectively. In general, neither ED nor any of the dietary components was associated with subsequent change in BW. In women, ED was positively associated with weight gain among the obese (BMI > 30 kg/m²) and inversely associated with weight gain in normal‐weight women (BMI < 25 kg/m²) (p = 0.01). However, in men there was a non‐ significant inverse trend between ED and weight gain in the obese and no significant interaction. Discussion: To our knowledge, this is the first prospective study to examine the associations between ED and subsequent changes in BW, and despite a general belief that ED is a major determinant of obesity, the present study did not generally lend support for an association. However, among certain subgroups, an energy‐dense diet may be a risk factor for weight development.     

BMI and Health‐Related Quality of Life in Adults 65 Years and Older

Objective: To examine relationships of BMI with health‐related quality of life in adults 65 years and older. Research Methods and Procedures: In 1996, a health survey was mailed to all surviving participants ≥ 65 years old from the Chicago Heart Association Detection Project in Industry Study (1967 to 1973). The response rate was 60%, and the sample included 3981 male and 3099 female respondents. BMI (kilograms per meter squared) was classified into four groups: underweight (<18.5), normal weight (18.5 to 24.9), overweight (25.0 to 29.9), and obese (≥30.0). Main outcome measures were Health Status Questionnaire‐12 scores (ranging from 0 to 100) assessing eight domains: health perception, physical functioning, role limitations‐physical, bodily pain, energy/fatigue, social functioning, role limitations‐mental, and mental health. The higher the score, the better the outcome. Results: With adjustment for age, race, education, smoking, and alcohol intake, obesity was associated with lower health perception and poorer physical and social functioning (women only) but not impaired mental health. Overweight was associated with impaired physical well‐being among women only. Both underweight men and women reported impairment in physical, social, and mental well‐being. For example, multivariable‐adjusted health perception domain scores for women were 50.8 (underweight), 62.7 (normal weight), 60.5 (overweight), and 52.1 (obese), respectively. Associations weakened but remained significant with further adjustment for comorbidities. Discussion: Compared with normal‐weight people, both underweight and obese older adults reported impaired quality of life, particularly worse physical functioning and physical well‐being. These results reinforce the importance of normal body weight in older age.     

Secular trends of obesity and cardiovascular risk factors in a Mediterranean population

Objective: To evaluate time trends of obesity, abdominal obesity, and cardiovascular risk factors (CRFs) according to BMI and waist circumference (WC) categories in a Mediterranean population. Research Methods and Procedures: Subjects were Spanish men (n = 2383) and women (n = 2525) 25 to 74 years old, examined in 1994 to 1995 and 1999 to 2000 in two independent population‐based cross‐sectional surveys in the northeast of Spain. Lifestyle measures, CRFs, and anthropometric variables were analyzed. Results: Over the 5 years of the study, mean age‐standardized BMI increased by 1.0 units in men and by 0.8 units in women. At the same time the prevalence of obesity increased from 15.4% to 21.9% in men and from 15.4% to 21.4% in women. An upward trend was observed for WC and abdominal obesity (WC > 102 cm in men and WC > 88 cm in women) only in men. The proportion of men and women with hypercholesterolemia, diabetes, and low high‐density lipoprotein‐cholesterol plasma concentration remained stable within BMI and WC categories. The proportion of hypertension and smoking in obese men significantly increased from 1995 to 2000. Discussion: The 5‐year increase in BMI and WC is of considerable magnitude in the present population, although several CRFs remained stable within BMI and WC categories.     

What Is the Accurate Prevalence of Obesity in Sweden in the 21st Century? Methodological Experiences From the Skaraborg Project

Objective: To examine the impact of non‐response to self‐reported body weight and height in health questionnaires for the estimation of obesity prevalence. Methods and Procedures: A cross‐sectional population‐based health survey in the community of Vara with 16,009 residents (in year 2002) in South‐western Sweden. Participants randomly selected in strata by sex and age among residents being 30–74 years old were consecutively invited to the local health care center for a health examination, including two visits. Self‐reported information on body weight and height were obtained by health questionnaires at the first visit, and measured information on both variables at the second visit. For this study 1,809 subjects (904 men and 905 women) completed both visits (participation rate 81%), and a nurse measured body weight and height of all at visit two. Participants not self‐reporting body weight and/or height at the first visit were defined as non‐responders. Results: Both male and female non‐responders were significantly older than responders. Female non‐responders had significantly higher BMI (29.8 ± 5.8 kg/m²) than female responders (26.6 ± 5.3 kg/m²), (P < 0.001). No similar findings were seen in men. Non‐responders were more likely to be obese than responders both in men (odds ratio (OR) 2.06, 95% confidence interval (CI) 1.03–4.11) and in women (OR 2.24, 95% CI 1.25–4.02). Discussion: Non‐responders to self‐reported body weight and height in health questionnaires contribute to the underestimation of obesity. Measured body weight and height are to prefer when describing the accurate prevalence of obesity in populations.     

Gastric Bypass as Treatment for Obesity: Trends,Characteristics, and Complications

Objective: This paper describes national trends in gastric bypass procedures from 1998 through 2003 and explores the demographic and health profile of those who receive this procedure. Short‐term outcomes such as length of stay and in‐hospital complication rates are also examined. Research Methods and Procedures: Data on obese hospital inpatients who had gastric bypass were obtained from the 1998 to 2003 National Hospital Discharge Survey. Gastric bypass was reported for an estimated 288,000 discharges during the 6‐year study period. Trends within the 6‐year period were tested using weighted regression. Characteristics of gastric bypass patients were compared with those of other inpatients using a χ² test of independence and the two‐sided t test. Results: The estimated number of hospital discharges with gastric bypass increased significantly, from 14,000 in 1998 to 108,000 in 2003. During this period, the average length of stay declined by 56% from 7.2 to 3.2 days. Gastric bypass patients were primarily women (84%), 25 to 54 years of age (82%), and privately insured (76%). A 1 in 10 complication rate was found for discharges with gastric bypass. Discussion: Gastric bypass procedures in the United States have increased rapidly since 1998, whereas the average hospital stay has decreased. The decreasing length of stay needs to be evaluated in conjunction with potential complication rates and the permanent change in anatomy and lifestyle that must accompany this procedure. Monitoring trends in use of this procedure is important, especially if reimbursement policies change and the epidemic of obesity continues.     

The Role of Adolescent Behaviors in the Female–Male Disparity in Obesity Incidence in US Black and White Young Adults

In the United States, black women are at much greater risk for obesity than black men. We explored whether adolescent behaviors (family dinners, hours of television, playing sports with mother, playing sports with father, bouts of physical activity) were associated with gender disparity in 6‐year obesity incidence in young adulthood. We used data from the nationally representative National Longitudinal Study of Adolescent Health to examine adolescent behaviors in nonimmigrant black (n = 1,503) and white (n = 4,452) youths in 1994–95 (aged 11–19 years) and 1995–96 (aged 12–20). We assessed gender disparity in obesity incidence (female incidence minus male incidence) during young adulthood (2001–02; aged 18–26). Standardized gender disparities were calculated using race‐ and gender‐stratified, covariate‐adjusted logistic regression models in which males and females were set to the same distributions of adolescent behaviors. In adolescence, black females reported less leisure‐time physical activity and lower likelihood of playing sports with either parent compared with black males. Setting adolescent behaviors equal for black males and females did not reduce the estimated gender disparity in obesity incidence (nonstandardized: 9.8 percentage points (95% confidence interval (CI): 4.5, 15.1); fully standardized: 10.2 percentage points (5.2, 15.2)). There was little gender disparity in whites before or after adjustments. To our knowledge, this is the first study to examine to what extent behavioral differences during adolescence might account for gender disparity in obesity incidence in black young adults. Male‐female differences in these adolescent behaviors did not appear to underlie the gender gap in young adult obesity.     

Accuracy of self-reported weight among bariatric surgery candidates: the influence of race and weight cycling

Objective: Research on the accuracy of self‐reported weight has indicated that the degree of misreporting (underestimating) weight is associated with increasing weight but is variable across patient groups. We examined the degree of discrepancy between actual and self‐reported BMI in severely obese bariatric surgery candidates, and whether the degree of accuracy varied by race and by eating‐related and psychological factors. Research Methods and Procedures: Participants were 179 obese female gastric bypass surgery candidates (31 black, 22 Hispanic, 126 white) who were asked to self‐report height and weight as part of a larger assessment battery. Actual height and weight were then measured and a discrepancy score was generated (actual BMI ? reported BMI). Results: In this group of severely obese patients, degree of misreporting was unrelated to BMI. The race groups did not differ in actual or self‐reported BMI but differed significantly in the degree of misestimation between self‐reported and actual BMI. Post hoc tests indicated that black women underestimated their BMI significantly more than white women; Hispanic women did not differ from the other race groups. No eating‐related or psychological variables assessed predicted percentage discrepancy; however, the accuracy in self‐reported weight was related to history of weight cycling. Discussion: Overall, obese bariatric surgery candidates were accurate in self‐report of weight, although the degree of accuracy differed by race and weight cycling history.     

Endothelial activation markers and their key regulators after restrictive bariatric surgery

Objective: Increased plasma levels of endothelial activation markers in obese subjects reflect the positive association between cardiovascular diseases and obesity. The pro‐inflammatory state associated with obesity is thought to play a major role in endothelial cell activation in severely obese individuals. Previous studies demonstrated that long‐term weight loss after bariatric surgery is accompanied by a decreased proinflammatory state. However, little is known about the long‐term effects of bariatric surgery on endothelial cell activation. Research Methods and Procedures: Plasma levels of soluble intercellular adhesion molecule‐1 (sICAM‐1), soluble endothelial selectin (sE‐selectin), and soluble vascular cell adhesion molecule‐1 (sVCAM‐1), all markers of endothelial cell activation, and of their regulators adiponectin and resistin were measured at different time‐points postoperatively in 26 consecutive patients who underwent restrictive surgery, with a follow‐up of 2 years. Results: During the first 6 months after bariatric surgery, sE‐selectin levels decreased. Despite substantial weight loss, sICAM‐1 and sVCAM‐1 plasma levels did not decrease significantly. After 24 months, sICAM‐1 levels were significantly decreased, whereas sE‐selectin levels were further decreased. However, sVCAM‐1 levels remained elevated. Adiponectin levels did not change significantly during the first 6 months after bariatric surgery, whereas resistin levels increased. After 24 months, adiponectin levels were similar to normal‐weight controls, but resistin levels remained high. Discussion: Reductions in plasma levels of different markers of endothelial activation after bariatric surgery show different temporal patterns, suggesting that distinct mechanisms are involved in their regulation. Although not all endothelial activation markers normalize after bariatric surgery, our findings suggest that bariatric surgery can reduce endothelial activation in the long term.     

Effort‐Related Calf Pain in the Obese and Long‐Term Changes after Surgical Obesity Treatment**

Objective: To compare the prevalence of effort‐related calf pain in an obese and a general population and to analyze the incidence of and recovery from such pain after surgical and conventional obesity treatment. Research Methods and Procedures: A random sample of 1135 subjects from a general population was compared with 6328 obese subjects in the Swedish Obese Subjects study. Obese subjects were followed longitudinally, and information about calf pain was obtained from surgically and conventionally treated patients for up to 6 years. Results: In both sexes, self‐reported calf pain was more common in the obese than in the general population [odds ratios (ORs) 5.0 and 4.0 in men and women, respectively, p < 0.001]. Obese patients undergoing surgery had a lower 6‐year incidence of calf pain compared with the conventionally treated control group (ORs 0.39 and 0.61, p < 0.05). Among subjects reporting symptoms at baseline, the 6‐year recovery rate was higher in the surgical group compared with the control group (ORs 15.3 and 5.9, p < 0.001). Discussion: Obese subjects have markedly more problems with effort‐related calf pain than the general population. Surgical obesity treatment reduces the long‐term risk of developing claudication symptoms and increases the likelihood of recovering from such symptoms.     

Work stress, obesity and the risk of type 2 diabetes: gender-specific bidirectional effect in the Whitehall II study

Psychosocial work stress has been linked to higher risk of type 2 diabetes (T2DM), with the effect being consistently higher among women than men. Also, work stress has been linked to prospective weight gain among obese men but weight loss among lean men. Here, we aimed to examine the interaction between work stress and obesity in relation to T2DM risk in a gender‐specific manner. We studied 5,568 white middle‐aged men and women in the Whitehall II study, who were free from diabetes at analysis baseline (1993). After 1993, diabetes was ascertained at six consecutive phases by an oral glucose tolerance test supplemented by self‐reports. Cox regression analysis was used to assess the association between job strain (high job demands/low job control) and 18‐year incident T2DM stratifying by BMI (BMI <30 kg/m² vs. BMI ≥30 kg/m²). Overall, work stress was associated with incident T2DM among women (hazard ratio (HR) 1.41: 95% confidence intervals: 1.02; 1.95) but not among men (HR 0.87: 95% confidence interval 0.69; 1.11) (P_INTERACTION = 0.017). Among men, work stress was associated with a lower risk of T2DM in nonobese (HR 0.70: 0.53; 0.93) but not in obese individuals (P_INTERACTION = 0.17). Among women, work stress was associated with higher risk of T2DM in the obese (HR 2.01: 1.06; 3.92) but not in the nonobese (P_INTERACTION = 0.005). Gender and body weight status play a critical role in determining the direction of the association between psychosocial stress and T2DM. The potential effect‐modifying role of gender and obesity should not be ignored by future studies looking at stress‐disease associations.     

Awakening cortisol response in lean, obese, and reduced obese individuals: effect of gender and fat distribution

Objective: Our goal was to assess the awakening cortisol response (ACR) in obese and reduced obese men and women. Research Methods and Procedures: Fifty‐one men (16 lean, 19 abdominally obese, and 16 reduced obese) and 31 women (12 lean, 10 subcutaneously obese, and 9 reduced obese) were selected to participate to this study. Strict ranges of BMI and waist circumference were used to select the participants. Medical examination, psychological assessment, anthropometric measurements, and blood sampling were undergone at the laboratory. Cortisol response to awakening was determined with saliva cortisol sampling being taken immediately at the time of awakening and 30 minutes thereafter over 3 days within a period of 2 months. Results: Men with visceral obesity exhibited an enhanced ACR, whereas this response tends to return to normal in a reduced obese state. In women, peripheral fat accumulation does not modify ACR, but weight loss increased the response. Discussion: These results highlight gender effects on ACR of obese and reduced obese subjects, which could be accounted for by the different fat distribution profiles that characterize men and women. They also provide further support for the usefulness of ACR in assessing the hypothalamic‐pituitary‐adrenal axis activity status.     

Sex,Race/Ethnicity,Socioeconomic Status,and BMI in Relation to Self‐Perception of Overweight

Objective: To compare the self‐perception of overweight in the study population according to sex, race/ethnicity, and socioeconomic status and to compare the self‐perception of overweight among individuals classified as normal weight, overweight, and obese. Research Methods and Procedures: Data from 5440 adults who participated in the 1994 to 1996 Continuing Survey of Food Intakes by Individuals and the Diet and Health Knowledge Survey conducted by the U.S. Department of Agriculture were analyzed. Data for analysis included self‐perceived weight status, self‐reported weight and height, and demographic and socioeconomic data. Underweight individuals, defined as those with a body mass index <18.5 kg/m², were excluded from the analysis. Results: Self‐perception of overweight was more common in women compared with men and in whites compared with blacks or Hispanics. Both the correct and incorrect perception of overweight was more common in normal weight and overweight white women compared with black women. More overweight and obese white men correctly perceived their overweight status compared with black men. Multiple logistic regression showed that the odds ratio of perceived overweight was significantly higher in women, whites, and individuals with higher body mass index, higher income, and higher education. Discussion: Self‐perceived overweight varied by sex, race/ethnicity, and socioeconomic status. Erroneous perception of body weight may have important health and behavioral implications. In particular, a considerable proportion of overweight men may be at risk of obesity if they continue to perceive themselves as having normal weight.     

Evaluation of risk profiles by subcutaneous adipose tissue topography in obese juveniles

Objective: To compare subcutaneous adipose tissue topography (SAT‐top) in obese juveniles with age‐matched normal‐weight controls. Research Methods and Procedures: The optical device LIPOMETER (European Patent EP 0516251) enables the non‐invasive, rapid, safe, and precise measurement of the thickness of subcutaneous adipose tissue. Fifteen defined body sites (1 = neck to 15 = calf) characterize the individual SAT‐top like an individual fingerprint. SAT‐top of 1351 juveniles (obese: 42 boys, 59 girls, normal weight: 680 boys, 570 girls) from 7 to 19 years of age were measured. For visual comparison, the 15‐dimensional SAT‐top information was condensed by factor analysis into a two‐dimensional factor plot. Results: Both female and male obese juveniles had markedly increased adipose tissue layers at 7 = upper abdomen, 8 = lower abdomen, 5 = front chest, and 6 = lateral chest. The pubertal changes of body shape and fat distribution of the normal‐weight boys and girls (boys show thinner adipose tissue layers on their legs, whereas girls had thicker adipose tissue layers at the extremities) were not seen in the obese group. Independently of age and sex, all of the obese juveniles showed a similar, more android body fat distribution with increased trunk fat. Discussion: SAT‐top of the obese juveniles is similar to that of patients with type 2 diabetes, polycystic ovary syndrome, and coronary heart disease. Patients with these metabolic disorders and obese juveniles are located in the factor plot in the same area. This body shape may indicate a risk profile for developing polycystic ovary syndrome (women), type 2 diabetes, and early atherosclerosis (both sexes).     

Sympathovagal Balance,Nighttime Blood Pressure,and QT Intervals in Normotensive Obese Women

Objective : We describe associations among the heart‐rate‐corrected QT (QTc) interval, QTc dispersion (QTc‐d), circadian BP variation, and autonomic function in obese normotensive women and the effect of sustained weight loss. Research Methods and Procedures : In 71 obese (BMI = 37.14 ± 2.6 kg/m²) women, 25 to 44 years of age, circadian BP variations (24‐hour ambulatory BP monitoring), autonomic function (power spectral analysis of RR interval oscillations), and cardiac repolarization times (QTc‐d and QTc interval) were recorded at baseline and after 1 year of a multidisciplinary program of weight reduction. Results : Compared with nonobese age‐matched women (n = 28, BMI = 23 ± 2.0 kg/m²), obese women had higher values of QTc‐d (p < 0.05) and QTc (p < 0.05), an altered sympathovagal balance (ratio of low‐frequency/high‐frequency power, p < 0.01), and a blunted nocturnal drop in BP (p < 0.01). In obese women, QTc‐d and the QTc interval correlated with diastolic nighttime BP (p < 0.01) and sympathovagal balance (p < 0.01). Waist‐to‐hip ratio, free fatty acids, and plasma insulin levels correlated with QT intervals and reduced nocturnal drops in both systolic and diastolic BP and sympathovagal balance (p < 0.01). After 1 year, obese women lost at least 10% of their original weight, which was associated with decrements of QTc‐d (p < 0.02), the QTc interval (p < 0.05), nighttime BP (p < 0.01), and sympathovagal balance (p < 0.02). Discussion : Sustained weight loss is a safe method to ameliorate diastolic nighttime BP drop and sympathetic overactivity, which may reduce the cardiovascular risk in obese women.