Obesity PillarsPub Date : 2025-06-10DOI: 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 , Suela Sulo , Andrew T. Chang , Jeeyun A. Kim , Kirk W. Kerr , Dominique R. Williams , Refaat Hegazi , Thadchaigeni Panchalingam , Scott Goates , 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}
Obesity PillarsPub Date : 2025-06-06DOI: 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 , Kathryn L. Fantasia , 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 >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}
{"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 , Moges Derbe , Daniel Yilma , Ayalew Astatkie , 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 < 0.001), and body fat percentage (Δ = −2.02 %, p < 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 < 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}
Obesity PillarsPub Date : 2025-05-26DOI: 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 , Kostas Tsintzas , Bo Ahrén , Robert J. Chilton , Ambra Giorgetti , Alric Mondragon , Rachel Ambiaux , Eugenia Migliavacca , David Philippe , Olivier Aprikian , 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}
{"title":"Comorbidities of childhood obesity at a tertiary hospital in Kwazulu-Natal, South Africa","authors":"Nasheeta Peer , Janice Sewlall , Yusentha Balakrishna , Shafeeka Tayob , Andre-Pascal Kengne , 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 <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 <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 <30 min/day on physical activity, 43.5 % spent >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}
{"title":"Antiemetic effect of acupressure wristbands for GLP-1 medication associated nausea","authors":"Florencia Ziemke , Soufiane Belarj , Jem Esguerra , Anita Reyes , 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}
Obesity PillarsPub Date : 2025-05-08DOI: 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 , J. Zitsman , J. Woo Baidal , S.E. Oberfield , 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}
Obesity PillarsPub Date : 2025-05-02DOI: 10.1016/j.obpill.2025.100177
I.M.A.A. van Roessel , M.J. de Koning , M.V. Birk , J. Blom , J. Dekker , E.J.M. Feskens , J.P. de Graaf , Y. Lu , D.A. Lucassen , E. Pondaag , W.J.E. Tissing , H.M. van Santen
{"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 , M.J. de Koning , M.V. Birk , J. Blom , J. Dekker , E.J.M. Feskens , J.P. de Graaf , Y. Lu , D.A. Lucassen , E. Pondaag , W.J.E. Tissing , 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}
Obesity PillarsPub Date : 2025-04-26DOI: 10.1016/j.obpill.2025.100176
Fábio de Freitas , Mariana R. Zago , Maria Ângela Antônio , Maria Ângela Bellomo Brandão , António Videira-Silva
{"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 , Mariana R. Zago , Maria Ângela Antônio , Maria Ângela Bellomo Brandão , 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 < 0.001) and CG (β = −0.29, p < 0.001). Flexibility (β = 3.5, p < 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}
Obesity PillarsPub Date : 2025-04-02DOI: 10.1016/j.obpill.2025.100174
Tim Bober , Flor Cameron , Lane Alexander , J.G. Luiggi-Hernandez , David Rometo , Linda-Marie Lavenburg , Haley Grant , Emily Klawson , Autumn R. Boyer , Kathleen M. McTigue , Julie Gouveia-Pisano , Avani Patel , Lisa Tarasenko , Jannette Escobar , Allison Brenner , Scott M. Vouri , Feng Dai , Megan E. Hamm
{"title":"Characterizing obesity: A qualitative study","authors":"Tim Bober , Flor Cameron , Lane Alexander , J.G. Luiggi-Hernandez , David Rometo , Linda-Marie Lavenburg , Haley Grant , Emily Klawson , Autumn R. Boyer , Kathleen M. McTigue , Julie Gouveia-Pisano , Avani Patel , Lisa Tarasenko , Jannette Escobar , Allison Brenner , Scott M. Vouri , Feng Dai , 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/m<sup>2</sup> 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}