title: Functional status and emotional well-being, dietary intake, and physical activity of severely obese subjects.
abstract: OBJECTIVE
  Analyze functional status and emotional well-being, energy and nutrient intake, and physical activity in sibling pairs raised together in the same family.
  
  
  METHODS
  One sibling classified as severely obese (body mass index > or = 35) and the other sibling as normal weight (body mass index < or = 27).
  
  
  METHODS
  From January 1994 through December 1996 at the Cardiovascular Genetics Research Clinic of the University of Utah School of Medicine, 145 sibling pairs (n = 290) were selected from a population-based, family history database or a hospital-based, very-low-energy weight-loss program.
  
  
  METHODS
  Repeated-measures analysis of variance tested for differences between severely obese and normal-weight siblings.
  
  
  RESULTS
  All functional status and emotional well-being scores (poorer perceived health) were significantly lower in severely obese siblings compared with normal-weight siblings. The severely obese siblings had a higher percentage dietary fat intake (3% higher) and total energy intake (more than 350 kcal higher), and lower weight-adjusted total energy intake (almost 10 kcal/kg lower) and activity energy expenditure (3.5 kcal/kg lower), compared with normal-weight siblings. Thus, environmental influences such as energy and nutrient intake and physical activity are highly related to severe obesity.
  
  
  CONCLUSIONS
  Previously shared environment of severely obese and normal-weight siblings raises questions about whether strong environmental influences or genetic predisposition account for the differences in sibling weight. When counseling individuals or families with a history of severe obesity, dietetics practitioners should be familiar with the potential for strong genetic factors and related environmental influences. In addition, dietitians should be prepared to offer a flexible approach to physical exercise as well as provide additional behavioral support.
authors.affiliation: Department of Medicine, University of Utah School of Medicine, Salt Lake City 84108, USA.
authors.forename: M M
authors.initials: MM
authors.lastname: Richards
authors.forename: T D
authors.initials: TD
authors.lastname: Adams
authors.forename: S C
authors.initials: SC
authors.lastname: Hunt
mesh_terms: D000328:Adult; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D016022:Case-Control Studies; D015331:Cohort Studies; D004435:Eating / Q000502:physiology*; D004522:Educational Status; D002149:Energy Intake / Q000502:physiology*; D015444:Exercise / Q000502:physiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D017533:Marital Status; D009767:Obesity, Morbid / Q000503:physiopathology* / Q000523:psychology; D012923:Social Class; D011795:Surveys and Questionnaires