Obesity Pillars最新文献

{"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}

{"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}

{"title":"The introduction of a new mobile lifestyle tool in the battle against hypothalamic obesity; the “HAPPYthalamus” application","authors":"I.M.A.A. van Roessel ,&nbsp;M.J. de Koning ,&nbsp;M.V. Birk ,&nbsp;J. Blom ,&nbsp;J. Dekker ,&nbsp;E.J.M. Feskens ,&nbsp;J.P. de Graaf ,&nbsp;Y. Lu ,&nbsp;D.A. Lucassen ,&nbsp;E. Pondaag ,&nbsp;W.J.E. Tissing ,&nbsp;H.M. van Santen","doi":"10.1016/j.obpill.2025.100177","DOIUrl":"10.1016/j.obpill.2025.100177","url":null,"abstract":"<div><h3>Background</h3><div>Children with hypothalamic dysfunction may experience hypothalamic weight gain, marked by severe hyperphagia, low energy expenditure, and reduced initiative. We developed the mobile app “HAPPYthalamus” to support these children by promoting exercise, providing distraction from hyperphagia, and rewarding healthy behavior. This study evaluated the app's usability and patient satisfaction.</div></div><div><h3>Methods</h3><div>This was a non-randomized, explorative intervention study. Children (8–18 years) with hypothalamic dysfunction and a suprasellar brain tumor were included. Patients were instructed to use the mobile application (app) for six months. We applied a mixed-methods design evaluating app use and satisfaction through questionnaires and semi-structured interviews.</div></div><div><h3>Results</h3><div>Of 22 patients, 15 scored positive on learning to use the app. Positive effects on eating distraction were reported by 9 patients. The app was not well adapted to different age groups; some found the challenges motivating while others were indifferent to winning challenges and forgot the app due to limited variety. Overall, 64% of the children indicated the app should be part of the standard of care.</div></div><div><h3>Conclusions</h3><div>A mobile app as a lifestyle buddy for children with hypothalamic dysfunction is useable but needs improvements. Adapting to age groups and incorporating behavioral change theories, gamification, and reward systems could enhance engagement and support a healthier lifestyle.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"15 ","pages":"Article 100177"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143917273","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}

{"title":"Integrating remote high-intensity interval training into multi-component obesity treatment for adolescents: Impacts on body composition, fitness, and lifestyle","authors":"Fábio de Freitas ,&nbsp;Mariana R. Zago ,&nbsp;Maria Ângela Antônio ,&nbsp;Maria Ângela Bellomo Brandão ,&nbsp;António Videira-Silva","doi":"10.1016/j.obpill.2025.100176","DOIUrl":"10.1016/j.obpill.2025.100176","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to analyze the effects of a three-month remote High-Intensity Interval Training (HIIT) program as an adjunct to a multi-component clinical obesity treatment on body composition, physical fitness, movement behaviors, and nutritional habits in adolescents with obesity.</div></div><div><h3>Methods</h3><div>This study was designed as a non-randomized controlled trial involving a total of 100 adolescents with obesity (BMI z-score ≥2), aged 12–17, divided into a control group (CG, receiving only standard care, i.e., medical and nutritional guidance, n = 50), and an experimental group (EG, exposed to a remote HIIT program four times/week (∼20 min/session) for 3 months, additionally to standard care, n = 50). Intervention effect was analyzed based on adherence (presence in ≥80 % of sessions). Anthropometrics, body composition, and physical fitness data were assessed at baseline and at the end of the intervention. Changes in body composition and physical fitness were the primary outcomes, while movement behaviors and nutritional habits were considered secondary outcomes.</div></div><div><h3>Results</h3><div>Six participants were excluded from the analysis due to missing post-intervention assessments. Among the 44 (88 %) adolescents who completed the 3-month assessments, 28 were included in the adherents’ group (AG) and 16 in non-adherents (non-AG). BMI z-score significantly decreased over time (β = −0.08, p = 0.001), with the AG showing a more significant reduction than non-AG (β = −0.3, p &lt; 0.001) and CG (β = −0.29, p &lt; 0.001). Flexibility (β = 3.5, p &lt; 0.001) and Core strength improved (β = 2.9, p = 0.002), with no differences between the AG and non-AG. Water consumption also increased (β = 0.2, p = 0.022), but only in the AG.</div></div><div><h3>Conclusion</h3><div>The remote HIIT program was effective in improving body composition and physical fitness in adolescents with obesity. These findings highlight the potential of remote exercise interventions as a feasible and beneficial strategy within multi-component obesity treatments.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"14 ","pages":"Article 100176"},"PeriodicalIF":0.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895660","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}

{"title":"Characterizing obesity: A qualitative study","authors":"Tim Bober ,&nbsp;Flor Cameron ,&nbsp;Lane Alexander ,&nbsp;J.G. Luiggi-Hernandez ,&nbsp;David Rometo ,&nbsp;Linda-Marie Lavenburg ,&nbsp;Haley Grant ,&nbsp;Emily Klawson ,&nbsp;Autumn R. Boyer ,&nbsp;Kathleen M. McTigue ,&nbsp;Julie Gouveia-Pisano ,&nbsp;Avani Patel ,&nbsp;Lisa Tarasenko ,&nbsp;Jannette Escobar ,&nbsp;Allison Brenner ,&nbsp;Scott M. Vouri ,&nbsp;Feng Dai ,&nbsp;Megan E. Hamm","doi":"10.1016/j.obpill.2025.100174","DOIUrl":"10.1016/j.obpill.2025.100174","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence of obesity among US adults has risen over the past several decades. In addition to bariatric surgery and behavioral weight management, several effective anti-obesity medications have emerged in the last ten years and become increasingly available. The goal of this qualitative study is to explore the perspectives of people with obesity (PwO), health professionals (HPs), and payors on obesity management and treatments.</div></div><div><h3>Methods</h3><div>This was a 3-group interview study using a qualitative description approach with a target sample size of 40 PwO, 30 HPs who provide care to PwO (10 primary care providers; 10 providers specializing in obesity medicine; and 10 nurse practitioners, physician assistants, or dieticians/nutritionists), and 10 payors. PwO were eligible if they had a Body Mass Index (BMI) ≥30 kg/m² using self-reported height and weight and the National Institutes of Health (NIH) BMI calculator and were recruited via an online research registry. Health professionals and payors were recruited via direct contact from the research team and sponsor's professional networks in the United States.</div></div><div><h3>Results</h3><div>A total of 38 PwO, 30 HPs, and 6 payors were interviewed, with PwO interviews occurring from October 2023 to March 2024 and HP/payor interviews occurring from November 2023 to May 2024. The majority of participants in each group accepted the idea of obesity as a chronic disease and that discussing obesity and weight management was important in medical contexts; however, they also acknowledged that stigma around obesity negatively impacted PwO health and health care. All participants described a treatment landscape beginning with lifestyle interventions followed by pharmaceutical or surgical treatment options.</div></div><div><h3>Conclusion</h3><div>This qualitative study of people with obesity, health professionals, and payors demonstrated current views of addressing and treating obesity in clinical settings. These findings could spur person-centered, less stigmatizing methods to craft plans for weight management.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"14 ","pages":"Article 100174"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronicity of obesity and the importance of early treatment to reduce cardiometabolic risk and improve body composition","authors":"Sandra Christensen ,&nbsp;Christina Nelson","doi":"10.1016/j.obpill.2025.100175","DOIUrl":"10.1016/j.obpill.2025.100175","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is a chronic disease that affects millions of adults and children globally. Obesity is particularly prevalent in the US and is associated with adiposity-related complications, such as cardiovascular disease, hypertension, type 2 diabetes, dyslipidemia, obstructive sleep apnea, cancer, and reduced quality of life. The Obesity Medicine Association's 4 pillars of obesity treatment are nutrition therapy, physical activity, behavioral counseling, and medical interventions, the latter of which includes pharmacotherapy, complication management, and bariatric procedures. Long-term obesity treatment using these treatment modalities guides chronic disease management to achieve sustained weight reduction, improved health outcomes, and improved quality of life.</div></div><div><h3>Methods</h3><div>In this narrative review, we focus on obesity as a chronic disease and the importance of chronic disease management. We also review body composition changes that occur with obesity and the goals of obesity treatment as they relate to body composition. Finally, obesity treatment modalities and recommendations are discussed.</div></div><div><h3>Results</h3><div>Individuals with pre-obesity, which is a state of early obesity, often progress to obesity. Further, individuals with obesity attempting weight reduction frequently reduce weight and experience subsequent weight recurrence, highlighting the chronic nature of obesity. Pathophysiologic factors such as the location and degree of adiposity, as well as the health of adipose tissue, impact the risk factors, outcomes, and treatment options for patients with obesity. Treatment modalities and appointment frequency can be personalized to individualize treatment and maximize adiposity reduction and preservation of lean body mass.</div></div><div><h3>Conclusions</h3><div>Early and lifelong treatment is critical for maintaining lean body mass as well as preventing weight recurrence and increased adiposity. Obesity treatment should reduce adiposity, preserve lean muscle, and maintain bone health. Weight-reduction maintenance that can be sustained long-term is also a critical component of chronic disease management.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"15 ","pages":"Article 100175"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941680","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}

{"title":"The association between hepatic steatosis, vitamin D status, and insulin resistance in adolescents with obesity","authors":"Emir Tas ,&nbsp;Amanda Flint ,&nbsp;Ingrid Libman ,&nbsp;Radhika Muzumdar ,&nbsp;Xiawei Ou ,&nbsp;David K. Williams ,&nbsp;Elisabet Børsheim ,&nbsp;Eva C. Diaz","doi":"10.1016/j.obpill.2025.100173","DOIUrl":"10.1016/j.obpill.2025.100173","url":null,"abstract":"<div><h3>Introduction</h3><div>Epidemiological studies suggest an inverse relationship between circulating 25-hydroxy-vitamin D [25(OH)D] levels and insulin resistance (IR), yet interventional studies have yielded inconsistent findings. This study examined the relationship between changes in vitamin D status and markers of IR in adolescents, with a focus on the modifying effect of liver fat.</div></div><div><h3>Methods</h3><div>A post-hoc analysis was performed using data from 44 adolescents participating in a 6-month observational study evaluating biomarkers of hepatosteatosis. Participants were categorized into two groups based on vitamin D status at the end of the observation period: those whose vitamin D levels increased or remained sufficient (VDI, n = 22) and those whose levels decreased or remained insufficient/deficient (VDD, n = 22). Liver fat percentage was measured using magnetic resonance imaging (MRI) fat-fraction, and IR was assessed using the updated Homeostatic Model Assessment for Insulin Resistance (HOMA2-IR) and the triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL).</div></div><div><h3>Results</h3><div>Across the cohort, liver fat was positively associated with HOMA2-IR (β = 0.08, p = 0.023). The association between changes in vitamin D status and HOMA2-IR trajectories was modified by liver fat but only in Hispanic adolescents (β = −0.18, p &lt; 0.001). Among Hispanic adolescents in the VDD group, HOMA-IR worsened, particularly at higher levels of liver fat. In non-Hispanic adolescents, HOMA-IR increased in the VDD group (β = 0.65, p = 0.033) compared to the VDI group, independent of baseline liver fat. Across the cohort, changes in vitamin D status interacted with liver fat to influence TG/HDL trajectories (β = 0.20, p = 0.034).</div></div><div><h3>Conclusions</h3><div>The metabolic response to changes in vitamin D status in adolescents with IR may vary based on racial and ethnic differences and liver fat status. These findings underscore the importance of considering liver fat and racial/ethnic background in vitamin D and metabolic health studies. Future research with more extensive and diverse cohorts spanning the fatty liver disease spectrum is needed to clarify these relationships.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"14 ","pages":"Article 100173"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity management in primary care: A joint clinical perspective and expert review from the Obesity Medicine Association (OMA) and the American College of Osteopathic Family Physicians (ACOFP) - 2025","authors":"Nicholas Pennings ,&nbsp;Catherine Varney ,&nbsp;Shaun Hines ,&nbsp;Bernadette Riley ,&nbsp;Patricia Happel ,&nbsp;Samir Patel ,&nbsp;Harold Edward Bays","doi":"10.1016/j.obpill.2025.100172","DOIUrl":"10.1016/j.obpill.2025.100172","url":null,"abstract":"<div><h3>Background</h3><div>This collaboration from the Obesity Medicine Association (OMA) and the American College of Osteopathic Family Physicians (ACOFP) examines obesity management from a primary care perspective.</div></div><div><h3>Methods</h3><div>This joint perspective is based upon scientific evidence, clinical experience of the authors, and peer review by the OMA and ACOFP leadership. The goal is to identify and answer sentinel questions about obesity management from a primary care perspective, utilizing evidence-based publications, and guided by expert clinical experience.</div></div><div><h3>Results</h3><div>Obesity is a disease that contributes to both biomechanical complications and the most common cardiometabolic abnormalities encountered in primary care. Barriers that impede optimal care of patients with obesity in primary care include failure to recognize obesity as a disease, lack of accurate diagnosis, insufficient access to obesity treatment resources, inadequate training, insufficient time, lack of adequate reimbursement and the adverse impact of bias, stigma, and discrimination.</div></div><div><h3>Conclusions</h3><div>Family physicians are often the first line of treatment in the healthcare setting. This affords early intervention opportunities to prevent and/or treat overweight and/or obesity. Patient care is enhanced when primary care clinicians recognize the risks and benefits of anti-obesity medications and bariatric procedures, as well as long-term follow-up. Practical tools regarding the 4 pillars of nutrition therapy, physical activity, behavior modification, and medical interventions (anti-obesity medications and bariatric surgery) may assist primary care clinicians improve the health and lives of patients living with obesity.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"14 ","pages":"Article 100172"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular safety of fixed-dose extended-release naltrexone/bupropion in clinical practice","authors":"Michael Kyle ,&nbsp;Dustin Burns ,&nbsp;Catherine Rogers Murray ,&nbsp;Heather Watson ,&nbsp;Jeff Swaney ,&nbsp;Samuel Spevack ,&nbsp;Megan Leonhard ,&nbsp;Michael Simon ,&nbsp;Emma Moynihan ,&nbsp;Kate L. Lapane ,&nbsp;Shirley V. Wang ,&nbsp;Craig L. Longo ,&nbsp;Mary E. Ritchey ,&nbsp;David D. Dore","doi":"10.1016/j.obpill.2025.100169","DOIUrl":"10.1016/j.obpill.2025.100169","url":null,"abstract":"<div><h3>Background</h3><div>The fixed-dose extended-release combination of naltrexone/bupropion (NB-ER) is indicated to treat overweight and obesity in adults as an adjunct to a reduced-calorie diet and increased physical activity. This study compared the rate of major adverse cardiovascular events (MACE) and its components (nonfatal acute myocardial infarction [AMI], nonfatal stroke, and cardiovascular death) between patients initiating NB-ER and those initiating lorcaserin (removed from US market in 2020; included as active comparator to minimize possible confounding by indication) in routine clinical practice.</div></div><div><h3>Methods</h3><div>This was a retrospective cohort study with a new-user, active-comparator design. Patients initiating NB-ER or lorcaserin were identified using Arcadia Data Research electronic health records, including insurance claims (June 2012–February 2020). Incidence rate ratios were estimated, and adjusted hazard ratios (aHRs) with 95 % confidence intervals (CIs) were estimated using a propensity score (PS)-weighted Cox proportional hazard model in an intention-to-treat analysis.</div></div><div><h3>Results</h3><div>Patients initiating NB-ER (n = 12 475) or lorcaserin (n = 12 171) were followed for a mean observation period of 4.7 years. After PS weighting, baseline comorbidities, concomitant medications, lifestyle factors, and clinical measures were balanced between cohorts. MACE incidence was 0.77/1000 person-years for NB-ER and 1.03/1000 person-years for lorcaserin. Compared to lorcaserin, patients initiating NB-ER had statistically similar rates of MACE (aHR, 0.76; 95 % CI, 0.48–1.22), nonfatal AMI (aHR, 0.74; 95 % CI, 0.45–1.23), and nonfatal stroke (aHR, 1.05; 95 % CI, 0.34–3.22). No deaths were observed within 30 days of an AMI or stroke.</div></div><div><h3>Conclusion</h3><div>Patients initiating NB-ER compared with lorcaserin were not at an increased risk of MACE or its components. Conclusions from this study must be interpreted in the context of certain assumptions related to PS methodology and use of lorcaserin as an active comparator. Causal interpretations for the cardiovascular safety of NB-ER should be evaluated further in a prospective, randomized, blinded, controlled clinical trial.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100169"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of weight reduction on the diabetes foot: A scoping review and clinical implications","authors":"Janine E. Roll Ahmed ,&nbsp;John Veto ,&nbsp;Derek Santos","doi":"10.1016/j.obpill.2024.100152","DOIUrl":"10.1016/j.obpill.2024.100152","url":null,"abstract":"<div><h3>Background</h3><div>This scoping review aims to explore the literature available on rapid weight reduction (either via diet/exercise or bariatric surgery) on the diabetes foot.</div></div><div><h3>Methods</h3><div>A search strategy was developed using Population, Intervention, Comparison, Outcome (PICO). A search using all identified keywords and index terms was performed on Cumulated Index in Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica Database (EMBASE), PubMed, International Clinical Trials Registry Platform (ICTRP) and Web of Science (WoS) databases as well as Proquest, and Cochrane systematic reviews. A search of grey literature was also performed on Google Scholar and Internet explorer. No restrictions were placed on the date of publication.</div></div><div><h3>Results</h3><div>There were few studies that explored the effects of weight reduction on the diabetes foot. Only 2 articles met the scoping review's inclusion criteria. These were a case study where the intervention was bariatric surgery and a case series study where the interventions were bariatric surgery or diet and exercise.</div></div><div><h3>Conclusion</h3><div>This scoping review has highlighted the lack of research in this area, raising opportunities for further research that focus on the effects of rapid weight reduction (either following bariatric surgery or weight reduction and diet) on the diabetes foot. Patients with diabetes mellitus should receive individualised pre and post weight reduction care to their feet, either by a podiatrist or multidisciplinary care team.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100152"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}