Obesity Pillars最新文献

{"title":"Clinical review: Guide to pharmacological management in pediatric obesity medicine","authors":"Valerie O'Hara ,&nbsp;Suzanne Cuda ,&nbsp;Roohi Kharofa ,&nbsp;Marisa Censani ,&nbsp;Rushika Conroy ,&nbsp;Nancy T. Browne","doi":"10.1016/j.obpill.2023.100066","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100066","url":null,"abstract":"<div><h3>Introduction</h3><p>Newer pharmacotherapy agents (anti-obesity medication [AOM]) are revolutionizing the management of children and adolescents with obesity. Previously, treatment based on intensive behavioral therapy involved many patient and family contact hours and yielded improvements in obesity status of 1-3 percent of the 95th percentile of the body mass index (BMI). Newer AOMs are yielding more clinically significant improvement of 5-18 percent. This review provides guidance for practitioners in the care of children and adolescents with obesity who frequently have complex medical and behavioral health care needs. Specifically, we discuss the use of newer AOMs in these complex patients.</p></div><div><h3>Methods</h3><p>This review details an approach to the care of the child and adolescent with obesity using AOMs. A shared decision-making process is presented in which the provider and the patient and family collaborate on care. Management of medical and behavioral components of the disease of obesity in the child are discussed.</p></div><div><h3>Results</h3><p>Early aggressive treatment is recommended, starting with an assessment of associated medical and behavioral complications, weight promoting medications, use of AOMs and ongoing care. Intensive behavioral therapy is foundational to treatment, but not a specific treatment. Patients and families deserve education on expected outcomes with each therapeutic option.</p></div><div><h3>Conclusions</h3><p>The use of new AOMs in children and adolescents has changed expected clinical outcomes in the field of pediatric obesity management. Clinically significant improvement in obesity status occurs when AOMs are used early and aggressively. Ongoing, chronic care is the model for optimizing outcomes using a shared decision-making between provider and patient/family. Depending on the experience and comfort level of the primary care practitioner, referral to an obesity medicine specialist may be appropriate, particularly when obesity related co-morbidities are present and pharmacotherapy and metabolic and bariatric surgery are considerations.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"6 ","pages":"Article 100066"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49699923","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":"Review: Evaluating existing policies to address overweight and obesity in the Anglophone Caribbean: A narrative review of Barbados, Grenada, St. Lucia, and Trinidad & Tobago","authors":"Renee Thomas-Venugopal ,&nbsp;Shivaughn Hem-Lee-Forsyth ,&nbsp;Angela Gomez ,&nbsp;Nesta Edwards ,&nbsp;Daniella James","doi":"10.1016/j.obpill.2023.100060","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100060","url":null,"abstract":"<div><p>Overweight and obesity continues to be a burden to the health and well-being of Caribbean residents. The rise of childhood obesity and non-communicable diseases within the Caribbean is a major public health challenge for policymakers, educators and health professionals. These alarming rates of obesity also pose a threat to the sustainability of existing health systems particularly in small island developing states like the Caribbean. Therefore, it is crucial to evaluate existing policies and create policy solutions to address these problems and reduce the potential impact later on.</p><p>This systematic review explored existing policies among countries within the Anglophone Caribbean to identify trends within the region. The literature search focused on the following themes: (i) national policies (ii) school nutrition policies and programs (iii) physical activity among youth, and (iv) food import bill and food security. An analysis was conducted on literature from national, regional and international institutions including but not limited to the World Health Organization, Ministries of Health and the Healthy Caribbean Coalition.</p><p>Countries throughout the region has acknowledged the challenges with overweight and obesity in the region. Collectively decisions have been made to address food insecurity and promote healthy lifestyle behaviours through policy changes. There's still a need for Caribbean countries to work together to create effective policy solutions in collaboration with community service organizations and other stakeholders. As small island developing states grappling with the same issues, pooling resources to create effective regional policies can help to address this public health crisis.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"6 ","pages":"Article 100060"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49728194","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":"Letter to the Editor of Obesity Pillars from the American Board of Obesity Medicine","authors":"Dana Brittan,&nbsp;Kimberly A. Gudzune,&nbsp;Edmond P. Wickham 3rd,&nbsp;Judith Korner","doi":"10.1016/j.obpill.2023.100064","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100064","url":null,"abstract":"","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"6 ","pages":"Article 100064"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49699878","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":"Weight stigma and bias: A guide for pediatric clinicians","authors":"Amy Braddock ,&nbsp;Nancy T. Browne ,&nbsp;Marcella Houser ,&nbsp;Giselle Blair ,&nbsp;Dominique R. Williams","doi":"10.1016/j.obpill.2023.100058","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100058","url":null,"abstract":"<div><h3>Introduction</h3><p>Many children and adolescents with obesity experience weight stigma and bias, which can have detrimental mental health, medical, and social consequences. Weight stigma in the healthcare setting threatens the therapeutic relationship between health care providers and their pediatric patients and families.</p></div><div><h3>Methods</h3><p>Data supporting this guidance were derived from cited references.</p></div><div><h3>Results</h3><p>Based upon referenced citations, this review offers 7 best practices for pediatric providers to work to reduce weight stigma including: assess for personal weight bias, improve communication, provide a welcoming clinic environment, seek out additional training and informative experiences, evaluate the messaging and culture of the organization, screen for trauma and bullying, and enlist the help of board-certified obesity medicine specialists.</p></div><div><h3>Conclusions</h3><p>Providers have an important role in mitigating the harmful effects of weight stigma. It is our hope these recommendations, as well as the other resources provided, will help providers to begin to address their own individual weight biases, as well as the institutional weight biases where we care for patients.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"6 ","pages":"Article 100058"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49699987","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":"A qualitative exploration on the needs of health care providers working with adolescents who are undergoing bariatric surgery","authors":"Biagina-Carla Farnesi ,&nbsp;Kimiya Kaffash ,&nbsp;Tamara R. Cohen ,&nbsp;Angela S. Alberga","doi":"10.1016/j.obpill.2023.100067","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100067","url":null,"abstract":"<div><h3>Background</h3><p>With increasing prevalence of severe obesity in youth, more adolescents are becoming candidates for bariatric surgery. In Canada, bariatric surgery in adolescents is in its infancy, and long-term health outcomes are not well known. It is unknown what health care providers (HCPs) are using to prepare and guide their adolescent patients for bariatric surgery. The needs of HCPs should be explored with the aim to improve patient outcomes. Therefore, the purpose of this study was to investigate the resource needs of HCPs working with adolescents living with severe obesity who are undergoing bariatric surgery.</p></div><div><h3>Methods</h3><p>This qualitative study consisted of a focus group with seven HCPs from an adolescent bariatric program using a semi-structured interview guide. The focus group discussion was audio-recorded, and the recording was transcribed verbatim. A thematic analysis was conducted.</p></div><div><h3>Results</h3><p>Four data-generated themes emerged highlighting the perceived needs and challenges faced by HCPs. These included (1) gaps in patient education materials on the subject of the bariatric surgery process, obesity as a chronic disease and mental health, (2) the need for designing resources that are teen-friendly, adaptable, and accessible, (3) the need for resources to facilitate decision-making and patient evaluation delivering more streamlined care and; (4) challenges to addressing resource needs due to limited clinical time and budgets.</p></div><div><h3>Conclusion</h3><p>This needs assessment study highlights the need for appropriate resources for patient education, as well as pre and post-operative preparation. The hope is that HCPs can improve quality of care delivered and positively impact surgical outcomes in their patients.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"6 ","pages":"Article 100067"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49700768","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":"Letter to the Editor of Obesity Pillars from the Obesity Medicine Fellowship Council","authors":"Yoon Ji Ahn ,&nbsp;John Michael Taormina ,&nbsp;Beverly G. Tchang,&nbsp;Gitanjali Srivastava,&nbsp;Stacy L. Schmidt,&nbsp;Lee M. Kaplan","doi":"10.1016/j.obpill.2023.100068","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100068","url":null,"abstract":"","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"6 ","pages":"Article 100068"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49699880","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":"Obesity medicine as a subspecialty and United States certification – A review","authors":"Angela Fitch ,&nbsp;Deborah B. Horn ,&nbsp;Christopher D. Still ,&nbsp;Lydia C. Alexander ,&nbsp;Sandra Christensen ,&nbsp;Nicholas Pennings ,&nbsp;Harold Edward Bays","doi":"10.1016/j.obpill.2023.100062","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100062","url":null,"abstract":"<div><h3>Background</h3><p>Certification of obesity medicine for physicians in the United States occurs mainly via the American Board of Obesity Medicine (ABOM). Obesity medicine is not recognized as a subspecialty by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA). This review examines the value of specialization, status of current ABOM Diplomates, governing bodies involved in ABMS/AOA Board Certification, and the advantages and disadvantages of an ABMS/AOA recognized obesity medicine subspecialty.</p></div><div><h3>Methods</h3><p>Data for this review were derived from PubMed and appliable websites. Content was driven by the expertise, insights, and perspectives of the authors.</p></div><div><h3>Results</h3><p>The existing ABOM obesity medicine certification process has resulted in a dramatic increase in the number of Obesity Medicine Diplomates. If ABMS/AOA were to recognize obesity medicine as a subspecialty under an existing ABMS Member Board, then Obesity Medicine would achieve a status like other ABMS recognized subspecialities. However, the transition of ABOM Diplomates to ABMS recognized subspecialists may affect the kinds and the number of physicians having an acknowledged focus on obesity medicine care. Among transition issues to consider include: (1) How many ABMS Member Boards would oversee Obesity Medicine as a subspecialty and which physicians would be eligible? (2) Would current ABOM Diplomates be required to complete an Obesity Medicine Fellowship? If not, then what would be the process for a current ABOM Diplomate to transition to an ABMS-recognized Obesity Medicine subspecialist (i.e., “grandfathering criteria”)? and (3) According to the ABMS, do enough Obesity Medicine Fellowship programs exist to recognize Obesity Medicine as a subspecialty?</p></div><div><h3>Conclusions</h3><p>Decisions regarding a transition to an ABMS recognized Obesity Medicine Subspecialty versus retention of the current ABOM Diplomate Certification should consider which best facilitates medical access and care to patients with obesity, and which best helps obesity medicine clinicians be recognized for their expertise.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"6 ","pages":"Article 100062"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49756593","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":"Artificial intelligence and obesity management: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2023","authors":"Harold Edward Bays ,&nbsp;Angela Fitch ,&nbsp;Suzanne Cuda ,&nbsp;Sylvia Gonsahn-Bollie ,&nbsp;Elario Rickey ,&nbsp;Joan Hablutzel ,&nbsp;Rachel Coy ,&nbsp;Marisa Censani","doi":"10.1016/j.obpill.2023.100065","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100065","url":null,"abstract":"<div><h3>Background</h3><p>This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) provides clinicians an overview of Artificial Intelligence, focused on the management of patients with obesity.</p></div><div><h3>Methods</h3><p>The perspectives of the authors were augmented by scientific support from published citations and integrated with information derived from search engines (i.e., Chrome by Google, Inc) and chatbots (i.e., Chat Generative Pretrained Transformer or Chat GPT).</p></div><div><h3>Results</h3><p>Artificial Intelligence (AI) is the technologic acquisition of knowledge and skill by a nonhuman device, that after being initially programmed, has varying degrees of operations autonomous from direct human control, and that performs adaptive output tasks based upon data input learnings. AI has applications regarding medical research, medical practice, and applications relevant to the management of patients with obesity. Chatbots may be useful to obesity medicine clinicians as a source of clinical/scientific information, helpful in writings and publications, as well as beneficial in drafting office or institutional Policies and Procedures and Standard Operating Procedures. AI may facilitate interactive programming related to analyses of body composition imaging, behavior coaching, personal nutritional intervention &amp; physical activity recommendations, predictive modeling to identify patients at risk for obesity-related complications, and aid clinicians in precision medicine. AI can enhance educational programming, such as personalized learning, virtual reality, and intelligent tutoring systems. AI may help augment in-person office operations and telemedicine (e.g., scheduling and remote monitoring of patients). Finally, AI may help identify patterns in datasets related to a medical practice or institution that may be used to assess population health and value-based care delivery (i.e., analytics related to electronic health records).</p></div><div><h3>Conclusions</h3><p>AI is contributing to both an evolution and revolution in medical care, including the management of patients with obesity. Challenges of Artificial Intelligence include ethical and legal concerns (e.g., privacy and security), accuracy and reliability, and the potential perpetuation of pervasive systemic biases.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"6 ","pages":"Article 100065"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49699807","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":"A whole new world: Managing pediatric obesity","authors":"Suzanne E. Cuda","doi":"10.1016/j.obpill.2023.100063","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100063","url":null,"abstract":"","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"6 ","pages":"Article 100063"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49699989","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":"Compounded peptides: An Obesity Medicine Association Position Statement","authors":"Angela Fitch ,&nbsp;Anthony Auriemma ,&nbsp;Harold Edward Bays","doi":"10.1016/j.obpill.2023.100061","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100061","url":null,"abstract":"","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"6 ","pages":"Article 100061"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49699959","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}