Obesity Pillars最新文献

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Individualized virtual integrative medicine (IVIM): A clinical model for enhanced GLP-1 therapeutic outcomes 个性化虚拟结合医学(IVIM):提高GLP-1治疗效果的临床模型
Obesity Pillars Pub Date : 2025-06-30 DOI: 10.1016/j.obpill.2025.100188
Jessica Duncan, Patrick Lee Stevens, Emily Bigby, Courtney Floyd, Josh Malina, Jennifer Nickens, Amber Lambert, Taylor Kantor
{"title":"Individualized virtual integrative medicine (IVIM): A clinical model for enhanced GLP-1 therapeutic outcomes","authors":"Jessica Duncan,&nbsp;Patrick Lee Stevens,&nbsp;Emily Bigby,&nbsp;Courtney Floyd,&nbsp;Josh Malina,&nbsp;Jennifer Nickens,&nbsp;Amber Lambert,&nbsp;Taylor Kantor","doi":"10.1016/j.obpill.2025.100188","DOIUrl":"10.1016/j.obpill.2025.100188","url":null,"abstract":"<div><h3>Background</h3><div>Here we show results of 1,131 patients on therapy with semaglutide who underwent a comprehensive clinical protocol utilizing the Individualized Virtual Integrative Medicine (IVIM) approach, evaluating the protocol as a comprehensive clinical care model for patients utilizing GLP-1 medications.</div></div><div><h3>Methods</h3><div>This is a retrospective analysis of patients who completed at least 365 days of the protocol while on GLP-1 therapy with semaglutide. Patients with a body-mass index (BMI) of 30 or greater were included. Patients were prescribed personalized therapy with semaglutide based on their weight reduction goals, insurance coverage, accessibility during the GLP-1 shortages of branded semaglutide, and socioeconomic factors.</div></div><div><h3>Results</h3><div>The cohort size was 1,131 patients who were prescribed semaglutide while on the IVIM protocol. A Linear Mixed Effects Model was used to test the relationship between time spent on the IVIM protocol and weight reduction. This model estimated a weight reduction coefficient of -0.739 lbs/week, providing a large z-statistic of -74.02 and a p value &lt; 0.0001. Mean change in weight at 12-weeks for all patients was 14.9 lbs (6.5 %), 24-weeks: 28.6 lbs (12.6 %), 36-weeks: 36.8 lbs (16.4 %), 52-weeks: 45.95 lbs (19.5 %), and those who extended to 68-weeks lost: 46.9 lbs (21.8 %). The percentage of patients who lost at least 5 % of their body weight at 52 weeks was: 99.2 %, 10 % or more: 93.9 %, 15 % or more: 73.5 %, and 20 % or more: 47.8 %.</div></div><div><h3>Conclusion</h3><div>Patients with obesity completing 52 weeks of the IVIM clinical protocol on semaglutide lost 19.5 % of total body weight with 47.8 % of patients losing 20 % or more. The results of this study indicate the protocol is a novel method to enhance therapeutic medical weight reduction results via a structured, telehealth-based approach for obesity management.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"15 ","pages":"Article 100188"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144534459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How do patients choose between obesity medications: A thematic analysis 患者如何选择减肥药:专题分析
Obesity Pillars Pub Date : 2025-06-16 DOI: 10.1016/j.obpill.2025.100187
Alvin Mondoh , Hilary Craig , Michael Crotty , Francisca Contreras , Carel W. le Roux
{"title":"How do patients choose between obesity medications: A thematic analysis","authors":"Alvin Mondoh ,&nbsp;Hilary Craig ,&nbsp;Michael Crotty ,&nbsp;Francisca Contreras ,&nbsp;Carel W. le Roux","doi":"10.1016/j.obpill.2025.100187","DOIUrl":"10.1016/j.obpill.2025.100187","url":null,"abstract":"<div><h3>Introduction</h3><div>The rising prevalence of obesity is of particular concern due to its association with a range of serious complications, including type 2 diabetes mellitus, cardiovascular diseases, and certain types of cancer. Obesity medications can control the disease but it is unclear how patients choose which medication to use.</div></div><div><h3>Methods</h3><div>A qualitative thematic analysis was conducted to investigate how patients select between obesity medications. Fifteen treatment naive adults with a body mass index ≥27 kg/m<sup>2</sup> with at least one weight-related complications were recruited.</div></div><div><h3>Results</h3><div>The 5 major themes depicting how patients make selections included 1) Effectiveness of medication, 2) Information to make decisions, 3) Safety of medications, 4) Practicality and 5) Individual Strategies and Community Supports in Obesity Management. Safety concerns of side effects and long-term risks were perceived major barriers to initiating or adhering to pharmacotherapy.</div></div><div><h3>Conclusion</h3><div>In a situation where the medications are described as being free and readily available, patient preferences for obesity medications are shaped by treatment efficacy, safety, information provided by healthcare providers. To enhance adherence and improve patient outcomes, healthcare providers should focus on delivering clear, comprehensive information and fostering strong support systems for patients.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"15 ","pages":"Article 100187"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Nutritional deficiencies and muscle loss in adults with type 2 diabetes using GLP-1 receptor agonists: A retrospective observational study GLP-1受体激动剂对成人2型糖尿病患者营养缺乏和肌肉损失的影响:一项回顾性观察研究
Obesity Pillars Pub Date : 2025-06-10 DOI: 10.1016/j.obpill.2025.100186
W. Scott Butsch , Suela Sulo , Andrew T. Chang , Jeeyun A. Kim , Kirk W. Kerr , Dominique R. Williams , Refaat Hegazi , Thadchaigeni Panchalingam , Scott Goates , Steven B. Heymsfield
{"title":"Nutritional deficiencies and muscle loss in adults with type 2 diabetes using GLP-1 receptor agonists: A retrospective observational study","authors":"W. Scott Butsch ,&nbsp;Suela Sulo ,&nbsp;Andrew T. Chang ,&nbsp;Jeeyun A. Kim ,&nbsp;Kirk W. Kerr ,&nbsp;Dominique R. Williams ,&nbsp;Refaat Hegazi ,&nbsp;Thadchaigeni Panchalingam ,&nbsp;Scott Goates ,&nbsp;Steven B. Heymsfield","doi":"10.1016/j.obpill.2025.100186","DOIUrl":"10.1016/j.obpill.2025.100186","url":null,"abstract":"<div><h3>Background</h3><div>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) drug-induced weight loss is associated with fat mass reduction but can also lead to nutritional deficiencies and loss of muscle. We quantified nutritional deficiencies in adults who had undergone GLP-1RA treatment.</div></div><div><h3>Methods</h3><div>This was an observational, retrospective analysis of de-identified patient-level claims data from 461,382 adults newly prescribed GLP-1RAs between 7/2017 and 12/2021 with no prior diagnoses of nutritional deficiencies. While most patients had type 2 diabetes (T2DM), the population also included individuals with type 1 diabetes (T1DM), prediabetes, or no recorded diabetes diagnosis. A secondary propensity-matched analysis compared GLP-1RA users with non-users. The matched comparator cohort consisted of adults with type 2 diabetes treated with metformin but not prescribed GLP-1RAs, whereas GLP-1RA users were treated with both metformin and GLP-1RA. Nutritional deficiencies were assessed at 6 and 12 months after GLP-1RA initiation. Nutritional deficiency diagnoses or complications were compared between patients with or without a dietitian visit within a 6-months of treatment initiation.</div></div><div><h3>Results</h3><div>Patients were mainly female (56.3 %), mean age (±SD) 52.9 (±11.7) years, with obesity (44.9 %) or overweight (5.6 %); type 2 diabetes (80.5 %) and hypertension (66.3 %) were the most common comorbidities. Nutritional deficiencies were diagnosed in 12.7 % of the patients within 6 months after GLP-1RA initiation and in 22.4 % within 12 months. Vitamin D deficiency was most common, having an incidence of 7.5 % and 13.6 % within 6 and 12 months, respectively. Recorded nutrient deficiencies or deficiency-related complications were more likely among patients with a dietitian visit within the first 6 months of GLP-1RA initiation compared to patients without a dietitian visit.</div></div><div><h3>Conclusion</h3><div>Over 20 % had nutritional deficiencies diagnosed within one-year of starting GLP-1RA treatment. These findings highlight the importance of nutritional screening and diagnosis of deficiencies and inclusion of physician nutrition specialists, dietitians, and other nutrition care specialists in patient care.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"15 ","pages":"Article 100186"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144272469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Knowledge, attitudes, and practices in obesity among trained and in-training primary care providers in an urban safety-net hospital system 城市安全网医院系统中训练有素和在职初级保健提供者关于肥胖的知识、态度和做法
Obesity Pillars Pub Date : 2025-06-06 DOI: 10.1016/j.obpill.2025.100185
Alejandro Campos , Kathryn L. Fantasia , Ivania Rizo
{"title":"Knowledge, attitudes, and practices in obesity among trained and in-training primary care providers in an urban safety-net hospital system","authors":"Alejandro Campos ,&nbsp;Kathryn L. Fantasia ,&nbsp;Ivania Rizo","doi":"10.1016/j.obpill.2025.100185","DOIUrl":"10.1016/j.obpill.2025.100185","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is a highly prevalent, chronic, and treatable disease that disproportionately impacts some minoritized populations who seek care in safety-net settings. Given that primary care providers (PCPs) often serve as the initial point of contact for patients, we aimed to assess their knowledge, attitudes, and practices related to management of obesity.</div></div><div><h3>Methods</h3><div>This was a cross-sectional study conducted to assess knowledge, attitudes, and practices on obesity management through an anonymous, electronic survey among trained (MD/DO and NP) and in-training (residents) primary care providers (PCPs) in the Departments of Internal Medicine and Family Medicine within an urban safety-net healthcare system.</div></div><div><h3>Results</h3><div>Among 350 sampled, 96 PCPs completed the survey (27 % response rate). Participants were predominantly (60.4 %) Internal Medicine trainees. The majority of PCPs accurately identified common weight-related comorbidities and improvement of these with &gt;10 % weight loss. Only 25 % of PCPs correctly identified both body mass index (BMI) criteria for anti-obesity medication (AOM) prescription and only 9.1 % identified both BMI criteria for bariatric surgery. Nearly two-thirds (64 %) of PCPs reported prescribing AOMs, with greater comfort in using glucagon like peptide-1 receptor agonist (GLP-1 RA) injectable agents (semaglutide and liraglutide) than with older oral AOMs (phentermine, phentermine-topiramate, and naltrexone-bupropion). Knowledge about side effects and insurance coverage were reported as influencing AOM prescription. Time constraints and lack of training and/or knowledge were identified as barriers in obesity management by more than 50 % of PCPs.</div></div><div><h3>Conclusions</h3><div>Our study highlights gaps in obesity-related knowledge and practice among PCPs, emphasizing the need for enhanced training, clinical support, and policy reforms to improve obesity management and patient outcomes.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"15 ","pages":"Article 100185"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of lifestyle modification counselling on weight and body composition among adults with overweight or obesity on antiretroviral therapy: a randomized controlled trial 生活方式改变咨询对接受抗逆转录病毒治疗的超重或肥胖成人体重和身体成分的影响:一项随机对照试验
Obesity Pillars Pub Date : 2025-06-06 DOI: 10.1016/j.obpill.2025.100184
Agete Tadewos Hirigo , Moges Derbe , Daniel Yilma , Ayalew Astatkie , Zelalem Debebe
{"title":"Effects of lifestyle modification counselling on weight and body composition among adults with overweight or obesity on antiretroviral therapy: a randomized controlled trial","authors":"Agete Tadewos Hirigo ,&nbsp;Moges Derbe ,&nbsp;Daniel Yilma ,&nbsp;Ayalew Astatkie ,&nbsp;Zelalem Debebe","doi":"10.1016/j.obpill.2025.100184","DOIUrl":"10.1016/j.obpill.2025.100184","url":null,"abstract":"<div><h3>Background</h3><div>we aimed to evaluate the impact of lifestyle modification counselling on weight and body composition among adults with overweight or obesity receiving antiretroviral treatment (ART).</div></div><div><h3>Methods</h3><div>This randomized, open-label, controlled trial enrolled 126 adults aged 18–65 years, living with human immunodeficiency virus (HIV) and classified as overweight or obese. Of these, 116 participants (63 in the control group and 53 in the intervention group) completed the six-month follow-up. Weight and body composition outcomes were analyzed among those who completed the study, with comparisons made between baseline and post-intervention measurements. The effect of lifestyle modification counselling on weight and body composition was evaluated through linear mixed effects model and multiple linear regression analysis.</div></div><div><h3>Results</h3><div>Over the six-month trial, participants who received lifestyle modification counselling showed significantly greater reductions in body weight (Δ = −1.4 kg, p = 0.002), visceral fat (Δ = −0.53, p = 0.006), fat mass (Δ = −2.16 kg, p ​&lt; ​0.001), and body fat percentage (Δ ​= ​−2.02 ​%, p ​&lt; ​0.001) compared to the control group. The intervention group experienced greater increases in fat-free mass (Δ ​= ​+0.673 kg, p ​= ​0.068) and percentage skeletal muscle (Δ ​= ​+1.27 ​%, p ​&lt; ​0.001) compared to the control group. Additionally, lifestyle modification counselling significantly contributed to achieving at least a 3 ​% weight loss from baseline (β ​= ​0.158, p ​= ​0.048).</div></div><div><h3>Conclusion</h3><div>Lifestyle modification counselling resulted in promising and favorable changes in weight and body composition. Therefore, offering routine structured counselling interventions within ART clinics for individuals with overweight or obesity may help reduce obesity-related health risks and improve clinical outcomes (Thai Clinical Trials Registry TCTR20240905007).</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"15 ","pages":"Article 100184"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144290891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Nutritional priorities to support GLP-1 therapy for obesity: A joint advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and the Obesity Society 支持GLP-1治疗肥胖的营养优先:美国生活方式医学院、美国营养学会、肥胖医学协会和肥胖学会的联合咨询
Obesity Pillars Pub Date : 2025-06-03 DOI: 10.1016/j.obpill.2025.100181
Dariush Mozaffarian , Monica Agarwal , Monica Aggarwal , Lydia Alexander , Caroline M. Apovian , Shagun Bindlish , Jonathan Bonnet , W. Scott Butsch , Sandra Christensen , Eugenia Gianos , Mahima Gulati , Alka Gupta , Debbie Horn , Ryan M. Kane , Jasdeep Saluja , Deepa Sannidhi , Fatima Cody Stanford , Emily A. Callahan
{"title":"Nutritional priorities to support GLP-1 therapy for obesity: A joint advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and the Obesity Society","authors":"Dariush Mozaffarian ,&nbsp;Monica Agarwal ,&nbsp;Monica Aggarwal ,&nbsp;Lydia Alexander ,&nbsp;Caroline M. Apovian ,&nbsp;Shagun Bindlish ,&nbsp;Jonathan Bonnet ,&nbsp;W. Scott Butsch ,&nbsp;Sandra Christensen ,&nbsp;Eugenia Gianos ,&nbsp;Mahima Gulati ,&nbsp;Alka Gupta ,&nbsp;Debbie Horn ,&nbsp;Ryan M. Kane ,&nbsp;Jasdeep Saluja ,&nbsp;Deepa Sannidhi ,&nbsp;Fatima Cody Stanford ,&nbsp;Emily A. Callahan","doi":"10.1016/j.obpill.2025.100181","DOIUrl":"10.1016/j.obpill.2025.100181","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Glucagon-like peptide 1 receptor agonists and combination medications (GLP-1s) are shifting the treatment landscape for obesity. However, real-world challenges and limited clinician and public knowledge on nutritional and lifestyle interventions can limit GLP-1 efficacy, equitable results, and cost-effectiveness.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;We aimed to identify pragmatic priorities for nutrition and other lifestyle interventions relevant to GLP-1 treatment of obesity for the practicing clinician.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;An expert group comprising multiple clinical and research disciplines appraised the scientific literature, informed by expert knowledge and clinical experience, to identify and summarize relevant topics, priorities, and emerging directions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;GLP-1s reduce body weight by 5–18 % in trials, with modestly lower effects in real-world analyses, with multiple demonstrated clinical benefits. Challenges include side effects, especially gastrointestinal; nutritional deficiencies due to calorie reduction; muscle and bone loss; low long-term adherence with subsequent weight regain; and high costs with resulting low cost-effectiveness. Numerous practice guidelines recommend multicomponent, evidence-based nutritional and behavioral therapy for adults with obesity, but use of such therapies with GLP-1s is not widespread. Priorities to address this include: (a) patient-centered initiation of GLP-1s, including goals for weight reduction and health; (b) baseline screening, including usual dietary habits, emotional triggers, disordered eating, and relevant medical conditions; (c) comprehensive exam including muscle strength, function, and body composition assessment; (d) social determinants of health screening; (e) and lifestyle assessment including aerobic activity, strength training, sleep, mental stress, substance use, and social connections. During GLP-1 use, nutritional and medical management of gastrointestinal side effects is critical, as is navigating altered dietary preferences and intakes, preventing nutrient deficiencies, preserving muscle and bone mass through resistance training and appropriate diet; and complementary lifestyle interventions. Supportive strategies include group-based visits, registered dietitian nutritionist counseling, telehealth and digital platforms, and Food is Medicine interventions. Drug access, food and nutrition insecurity, and nutrition and culinary knowledge influence equitable obesity management with GLP-1s. Emerging areas for more study include dietary modulation of endogenous GLP-1, strategies to improve compliance, nutritional priorities for weight maintenance post-cessation, combination or staged intensive lifestyle management, and diagnostic criteria for clinical obesity.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Evidence-based nutritional and lifestyle strategies play a pivotal role to address key challenges around ","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"15 ","pages":"Article 100181"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Short-term pre-meal whey protein microgel supplementation reduces postprandial glycemia and appetite in adults with overweight: An open-label randomised controlled trial 短期餐前补充乳清蛋白微凝胶可降低超重成人餐后血糖和食欲:一项开放标签随机对照试验
Obesity Pillars Pub Date : 2025-05-26 DOI: 10.1016/j.obpill.2025.100183
Ian J. Neeland , Kostas Tsintzas , Bo Ahrén , Robert J. Chilton , Ambra Giorgetti , Alric Mondragon , Rachel Ambiaux , Eugenia Migliavacca , David Philippe , Olivier Aprikian , Odd Erik Johansen
{"title":"Short-term pre-meal whey protein microgel supplementation reduces postprandial glycemia and appetite in adults with overweight: An open-label randomised controlled trial","authors":"Ian J. Neeland ,&nbsp;Kostas Tsintzas ,&nbsp;Bo Ahrén ,&nbsp;Robert J. Chilton ,&nbsp;Ambra Giorgetti ,&nbsp;Alric Mondragon ,&nbsp;Rachel Ambiaux ,&nbsp;Eugenia Migliavacca ,&nbsp;David Philippe ,&nbsp;Olivier Aprikian ,&nbsp;Odd Erik Johansen","doi":"10.1016/j.obpill.2025.100183","DOIUrl":"10.1016/j.obpill.2025.100183","url":null,"abstract":"<div><h3>Background</h3><div>Premeal whey protein (WP) consumption may reduce postprandial glucose (PPG) levels and appetite. We assessed the effects of twice daily consumption of a low-dose non-gelling novel WP formulation (WP microgel [WPM]) on PPG, self-reported appetite, and ad-libitum food consumption.</div></div><div><h3>Methods</h3><div>This was a randomized, prospective, open-label, controlled, single-center crossover study, and adults with BMI 27–35 kg/m<sup>2</sup> were randomized to consume either 125 mL of 10 g WPM or control (water) 15 min before breakfast and lunch for four consecutive days. Three days were under free-living conditions, and the 4th day was at the clinic where breakfast (09:00 a.m.) was standardized (323 kcal, 7.0 g proteins), and lunch (12:00 p.m.) ad-libitum (pizza, 228.8 kcal/9.9 g proteins per 100 g). Following a 3-day wash-out, participants were switched to the opposite regimen. The primary confirmatory endpoint was breakfast 2 h-PPG (assessed using CGM) analyzed as iAUC<sub>-15-120min</sub> using a linear mixed effects model. Appetite was captured by frequent self-reporting (hunger, desire, amount, fullness, satisfaction) using a visual analogue scale (0–100 mm). Ad-libitum food consumption (lunch) was assessed by weighing the amount consumed.</div></div><div><h3>Result</h3><div>18 individuals (8 females, median age 57 years, BMI 29.8 kg/m<sup>2</sup>, HbA1c 5.5 %) were randomized and consumed products. The breakfast 2 h-PPG iAUC was 39.3 % lower with WPM compared with control (LSM iAUC Ratio WPM/control (95 % CI): 0.607 [0.4 43, 0.831], p = 0.0047), and during lunch numerically reduced (p = 0.0649). Appetite scores during breakfast and lunch supported a modest suppressing effect of the WPM. Food consumption during the ad-libitum lunch was significantly reduced by 9.4 % (WPM vs Control −66.8 kcal [-133.1, −0.6], p = 0.0482).</div></div><div><h3>Conclusions</h3><div>A 125 mL pre-meal dose of WPM consumed twice daily before breakfast and lunch for 4 days in adults with obesity significantly reduced breakfast PPG and had a moderate appetite-suppressing effect, which led to a significantly lower energy consumption during ad-libitum lunch (NCT06593769).</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"15 ","pages":"Article 100183"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comorbidities of childhood obesity at a tertiary hospital in Kwazulu-Natal, South Africa 南非夸祖鲁-纳塔尔省一家三级医院儿童肥胖的合并症
Obesity Pillars Pub Date : 2025-05-24 DOI: 10.1016/j.obpill.2025.100182
Nasheeta Peer , Janice Sewlall , Yusentha Balakrishna , Shafeeka Tayob , Andre-Pascal Kengne , Yasmeen Ganie
{"title":"Comorbidities of childhood obesity at a tertiary hospital in Kwazulu-Natal, South Africa","authors":"Nasheeta Peer ,&nbsp;Janice Sewlall ,&nbsp;Yusentha Balakrishna ,&nbsp;Shafeeka Tayob ,&nbsp;Andre-Pascal Kengne ,&nbsp;Yasmeen Ganie","doi":"10.1016/j.obpill.2025.100182","DOIUrl":"10.1016/j.obpill.2025.100182","url":null,"abstract":"<div><h3>Aim</h3><div>To describe the distribution of childhood obesity and their related comorbidities in &lt;12-year-old children assessed at a South African tertiary hospital from 2012 to 2022.</div></div><div><h3>Methods</h3><div>In this retrospective electronic chart review, data extracted comprised socio-demographic and lifestyle histories, physical examination and biochemical analyses. World Health Organisation child growth reference defined obesity as z-score ≥2 standard deviations (SD) for 5-19-year-olds, and z-score ≥3 SD for &lt;5-year-olds. Systolic blood pressure and/or diastolic blood pressure ≥95th percentile and 90–94th percentile for age, gender and height, defined hypertension and prehypertension, respectively. Type 2 diabetes and prediabetes diagnoses were based on oral glucose tolerance tests or random blood glucose levels. Dyslipidaemia was deemed present with any abnormality of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol or triglycerides.</div></div><div><h3>Results</h3><div>Among 430 participants, 52.1 % (n = 224) male, 27.9 % (n = 120) ≤5-years-old and 64.7 % black African, unhealthy lifestyle behaviours were prevalent: 42.3 % spent &lt;30 min/day on physical activity, 43.5 % spent &gt;2 h/day on screen time and 47.9 % consumed soft drinks daily. Family history of obesity (41.9 %), diabetes (40.5 %) and hypertension (40.0 %) was common. Among participants, hypertension (46.1 %) and prehypertension (12.8 %) were high. Type 2 diabetes was low at 1.6 % but prediabetes was 3.3 %. Any dyslipidaemia was prevalent at 30.2 %.</div></div><div><h3>Conclusions</h3><div>The high burden of cardiometabolic comorbidities in children with obesity warrants concerted interventions at young ages to prevent worsening of comorbidities and the reversal of prehypertension and prediabetes. Unhealthy dietary habits, low activity levels and sedentary behaviours in children need to be urgently targeted to reduce obesity and its comorbidities.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"15 ","pages":"Article 100182"},"PeriodicalIF":0.0,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144196053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Antiemetic effect of acupressure wristbands for GLP-1 medication associated nausea 指压腕带对GLP-1药物相关恶心的止吐作用
Obesity Pillars Pub Date : 2025-05-08 DOI: 10.1016/j.obpill.2025.100178
Florencia Ziemke , Soufiane Belarj , Jem Esguerra , Anita Reyes , Nawfal Istfan
{"title":"Antiemetic effect of acupressure wristbands for GLP-1 medication associated nausea","authors":"Florencia Ziemke ,&nbsp;Soufiane Belarj ,&nbsp;Jem Esguerra ,&nbsp;Anita Reyes ,&nbsp;Nawfal Istfan","doi":"10.1016/j.obpill.2025.100178","DOIUrl":"10.1016/j.obpill.2025.100178","url":null,"abstract":"<div><h3>Background</h3><div>Nausea is one of the most reported side effect of GLP-1 receptor agonists (GLP-1a). Current recommendations fall short in taming the symptoms, include antiemetic medication, behavior changes, GLP-1a dose adjustment, and often cause a disruption to treatment. Sea-Band® is a drug-free, class II FDA-cleared medical device for relief of nausea in motion sickness, morning sickness, chemotherapy and anesthesia induced nausea. The device is a set of soft, elastic, reusable acupressure wristbands (ACW) with a skin-facing plastic button worn below the wrist crease applying pressure at acupoint pericardium 6. We hypothesized that ACW was an effective tool for GLP-1a associated nausea.</div></div><div><h3>Methods</h3><div>This was a one-arm, open-label, non-randomized, prospective interventional study evaluating the antiemetic effect of ACW in non-pregnant adults on GLP-1as with nausea. GLP-1a were semaglutide or tirzepatide. Exclusion criteria were patients on GLP-1a without nausea, recent use of antiemetic medications, other nausea-related conditions, history of gastroparesis, and uncontrolled gastroesophageal reflux disease. Patients were shown how to properly place and use ACW at the onset of nausea and were followed weekly for 4 weeks. Follow-ups assessed frequency of nausea, ACW use frequency and duration, and change in nausea.</div></div><div><h3>Results</h3><div>359 episodes of nausea were recorded amongst 31 adult participants over 4 weeks. Adults, mean age 55, mean BMI 34, mean HbA1c 5.9 %, reported nausea over 80 % of the time on a weekly basis. ACW were used in all recorded episodes of nausea. Medication doses were kept stable throughout the duration of this study. Nausea relief was achieved within 5 min in one third of episodes, and in over 5 min but under 20 min in the remainder of the episodes. A logistic regression model was used to evaluate the likelihood of nausea relief. A consistent rate of nausea relief over 80 % was observed during the study period, adjusting for the correlation between reduced nausea episodes and reduced episodes.</div></div><div><h3>Conclusion</h3><div>Although not a controlled trial, this pilot, proof of concept, pragmatic study suggests that ACW may offer a safe, self-administered, reusable, and drug-free option for managing GLP-1a associated nausea.ACW’s nausea reducing effect was seen in over 80 % of episodes, and remained consistent throughout the study period. One third of participants experienced relief within 5 min of wearing ACW in the first three weeks. Given the relatively small sample size of the population, further large-scale investigations are justified. Nausea is common in day-to-day real-world use of GLP-1as, and our results suggest that using ACW may provide a first-line therapeutic intervention used ad libitum to tame a disruptive symptom, improve day-to-day well-being, and positively impact a person’s treatment journey on GLP-1a.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"15 ","pages":"Article 100178"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Examining effects of sleeve gastrectomy in an urban youth population 探讨袖式胃切除术在城市青年人群中的效果
Obesity Pillars Pub Date : 2025-05-08 DOI: 10.1016/j.obpill.2025.100179
L.B. Ditchek , J. Zitsman , J. Woo Baidal , S.E. Oberfield , I. Fennoy
{"title":"Examining effects of sleeve gastrectomy in an urban youth population","authors":"L.B. Ditchek ,&nbsp;J. Zitsman ,&nbsp;J. Woo Baidal ,&nbsp;S.E. Oberfield ,&nbsp;I. Fennoy","doi":"10.1016/j.obpill.2025.100179","DOIUrl":"10.1016/j.obpill.2025.100179","url":null,"abstract":"<div><h3>Background</h3><div>Extensive evidence demonstrates the positive health effects of metabolic and bariatric surgery (MBS) in adolescents, including a reduction in body mass index (BMI) and improvements in cardiometabolic health. However, studies often lack generalizability due to their inclusion of predominately non-Hispanic White and privately insured patients.</div></div><div><h3>Methods</h3><div>This retrospective study aims to provide insight into MBS outcomes for an urban youth population.</div></div><div><h3>Results</h3><div>All groups showed a statistically significant improvement in BMI, HgbA1c, HDL, and triglyceride levels, postoperatively. Postoperative BMI did not differ between Non-Hispanic and Hispanic participants (P = 0.45) or between publicly and privately insured patients (P = 0.52). There was a statistically significantly lower postoperative HgbA1c in non-Hispanic participants compared to Hispanic participants (P = 0.01) and a statistically significantly lower postoperative Systolic blood pressure (SBP) in privately insured patients compared to publicly insured patient (P = 0.02). No other significant differences were detected between privately/publicly insured and Hispanic/non-Hispanic outcomes at 12 months postoperatively.</div></div><div><h3>Conclusion</h3><div>In our urban youth patient population, MBS resulted in significant improvement in BMI across all groups. Notably, there were no statistically significant differences in preoperative characteristics (BMI, HgbA1, LDL, HDL, triglycerides, total cholesterol, SBP or DBP). However, postoperative differences in HgbA1c and SBP were detected between groups. The reasons behind these differences remain unclear, emphasizing the need for further research with greater population variability. This study underscores the importance of increasing generalizability in studies of MBS to fully understand outcomes in underrepresented groups.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"15 ","pages":"Article 100179"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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