Obesity Pillars最新文献

{"title":"Obesity medicine provider-directed health coaching in a commercial weight loss program: Proof of concept","authors":"Michelle Alencar ,&nbsp;Angela Fitch ,&nbsp;Rachel M. Sauls ,&nbsp;Kelly Johnson ,&nbsp;Mayur Patel","doi":"10.1016/j.obpill.2024.100146","DOIUrl":"10.1016/j.obpill.2024.100146","url":null,"abstract":"<div><h3>Background</h3><div>Obesity remains a leading serious chronic disease and cause of death in the U.S. Despite previous research in diets (i.e., caloric restriction), physical activity levels, and biochemical markers, no studies to date have investigated the combination of an obesity medicine physician with a health coach alongside a commercial program for reducing body weight. As a result, this pilot study aims to assess the relationship between a commercial diet program and health and wellness coaching (HWC) for weight reduction outcomes when delivered in conjunction with an obesity medicine physician chronic disease care model, as a proof-of-concept study.</div></div><div><h3>Methods</h3><div>This 24-week proof-of-concept study was pragmatic, being an unblinded, unrandomized, uncontrolled, longitudinal, observational study. Its purpose was to assess participant weight reduction from a commercial weight reduction program using a pre-packaged portion-controlled reduced-calorie diet while meeting with a health coach and obesity medicine physician for counseling and support. Participants in the sample underwent a commercial weight reduction program through dietary control while meeting with an HWC. A repeated measures ANOVA was conducted to determine the weight reduction trends across a 24-week program.</div></div><div><h3>Results</h3><div>This study included n = 53 participants; a majority were white females (n = 45; 85 %), with an average (SD) age of 50.3 (12.2) years. There was a significant improvement in weight reduction (21.8 ± 9.4 lbs. WL) seen throughout the 24-week program (F (7, 364) = 33.129, p &lt; 0.001), with a large effect (η² = 0.922).</div></div><div><h3>Conclusion</h3><div>This proof-of-concept project found that Obesity Medicine Physician-directed, portion-controlled meals and HWC can improve weight reduction across a 24-week program using portioned-controlled meals. Confirmation of these findings and their clinical significance requires a follow-up randomized, controlled clinical trial using validated assessment tools.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"Article 100146"},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142553081","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":"“Metabolic surgery in Asian patients with type 2 diabetes mellitus and body mass index less than 30kg/m2: A systematic review”","authors":"Angel Alois Osorio Manyari ,&nbsp;Azucena Lirio Armas Alvarez ,&nbsp;Joel Davis Osorio Manyari ,&nbsp;Francisco Gonzalez Caballero ,&nbsp;Sjaak Pouwels","doi":"10.1016/j.obpill.2024.100145","DOIUrl":"10.1016/j.obpill.2024.100145","url":null,"abstract":"<div><h3>Background</h3><div>The effect of metabolic surgery on long-term diabetes remission in Asian patients with a body mass index (BMI) &lt; 30 kg/m² has not been widely reported.</div></div><div><h3>Methods</h3><div>We conducted a systematic review of the PubMed and Cochrane Library databases from inception to June 2024. All clinical trials and observational studies involving the effect of metabolic surgery in Asian patients with type 2 diabetes mellitus and BMI &lt;30 kg/m² were considered. The quality of the studies was assessed using the Newcastle-Ottawa scale.</div></div><div><h3>Results</h3><div>Of the 1175 studies screened, 21 studies (11 prospective and 10 retrospective), including 1005 patients, were selected. Only one study had a control group. The longest follow-up was 60 months. The results showed significant improvement in glycated hemoglobin (HbA1c), fasting blood glucose (FBG), 2-h plasma glucose (2hPG), homeostasis model assessment for insulin resistance index (HOMA-IR), fasting C-peptide, triglycerides, total cholesterol, and a reduction in the use of oral hypoglycemic agents/insulin at 12, 24, 36, and 60 months after metabolic surgery. The most common surgical complications observed were anemia (2.1 %–33 %), marginal ulcer (4.2 %–17.3 %), gastrointestinal bleeding (1.9 %–12 %), anastomotic leak (2.1 %–3.5 %), anastomotic stenosis (2.1 %–3.5 %), reoperation (1.18 %), and a mortality rate of zero.</div></div><div><h3>Conclusions</h3><div>Long-term diabetes remission, along with improvements in HbA1c, 2hPG, FBG, and HOMA-IR, with an acceptable rate of complications, was observed in Asian patients with BMI &lt;30 kg/m² after metabolic surgery. Future research with controlled studies should focus on preoperative patient selection criteria beyond just the BMI cutoff.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"Article 100145"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528275","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":"Efficacy of in-person versus digital enhanced lifestyle interventions in adults with overweight and obesity","authors":"Diego Anazco ,&nbsp;Maria A. Espinosa ,&nbsp;Lizeth Cifuentes ,&nbsp;Blake Kassmeyer ,&nbsp;Tara M. Schmidt ,&nbsp;Sima Fansa ,&nbsp;Alejandro Campos ,&nbsp;Elif Tama ,&nbsp;William S. Harmsen ,&nbsp;Maria D. Hurtado ,&nbsp;Donald D. Hensrud ,&nbsp;Andres Acosta","doi":"10.1016/j.obpill.2024.100133","DOIUrl":"10.1016/j.obpill.2024.100133","url":null,"abstract":"<div><h3>Background</h3><div>Lifestyle interventions (LIs) are the cornerstone for obesity management. The Mayo Clinic Diet (MCD) offers two approaches for LIs: the In-Person LI (IPLI) and the Digital Enhanced LI (DELI). The IPLI includes a 2-day in-person program with monthly follow-ups, whereas the DELI provides on-demand digital tools. The comparative efficacy of these approaches is currently unknown.</div></div><div><h3>Methods</h3><div>This retrospective study included two cohorts of adults with a body mass index (BMI) of ≥25 kg/m² and weight metrics at least 3 months after starting either the IPLI or DELI program. The primary endpoint was the total body weight loss percentage (TBWL%) at 6 months.</div></div><div><h3>Results</h3><div>The study included 133 participants in the IPLI cohort (mean age 46.3 years, 65.4 % female, BMI 36.4) and 9603 in the DELI cohort (mean age 60.1 years, 85.0 % female, BMI 33.1). The DELI group achieved superior TBWL% at 1, 3, and 6 months compared to the IPLI group (3.4 % vs. 1.5 %, 4.7 % vs. 2.4 %, 5.3 % vs. 2.9 %, respectively; p &lt; 0.001). After adjusting for age, gender, and starting weight, the DELI group maintained a higher TBWL% (difference 2.0 %; 95 % CI [1.0, 3.0], p &lt; 0.001) and a greater proportion of participants achieved &gt;5 % TBWL at 6 months (OR 1.66; 95 % CI [1.08, 2.55], p &lt; 0.023).</div></div><div><h3>Conclusion</h3><div>The DELI approach resulted in superior weight loss outcomes compared to the IPLI. Further research is needed to explore how digital tools can improve weight loss effectiveness.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"Article 100133"},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442055","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":"Optimizing nutrition, diet, and lifestyle communication in GLP-1 medication therapy for weight management: A qualitative research study with registered dietitians","authors":"David Despain,&nbsp;Brenda L. Hoffman","doi":"10.1016/j.obpill.2024.100143","DOIUrl":"10.1016/j.obpill.2024.100143","url":null,"abstract":"<div><h3>Background</h3><div>This qualitative study used semi-structured interviews to examine registered dietitians’ perspectives on diet, nutrition, and lifestyle communication for patients on GLP-1 medications for obesity management.</div></div><div><h3>Methods</h3><div>Through in-depth interviews with registered dietitians, this research identifies elements that could improve both the efficacy of GLP-1 medication therapies and patient adherence.</div></div><div><h3>Results</h3><div>indicate that a comprehensive approach, integrating patient communication with proactive management of side effects and ongoing lifestyle counseling, is essential for optimizing treatment outcomes.</div></div><div><h3>Conclusion</h3><div>Key findings include the importance of using visual and metaphorical aids to improve understanding, the necessity for structured lifestyle programs, and the pivotal role of personalized diet plans. These insights offer valuable directions for enhancing patient care and formulating clinical practices around the use of GLP-1 receptor agonist medications.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"Article 100143"},"PeriodicalIF":0.0,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528221","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":"Effect of resveratrol supplementation on metabolic risk markers and anthropometric parameters in individuals with obesity or overweight: A systematic review and meta-analysis of randomized controlled trials","authors":"Hafiz Shahbaz Zahoor ,&nbsp;Adina Arshad ,&nbsp;Muhammad Abdullah Masood ,&nbsp;Muhammad Abdul Muqtadir Qureshi ,&nbsp;Javed Iqbal","doi":"10.1016/j.obpill.2024.100141","DOIUrl":"10.1016/j.obpill.2024.100141","url":null,"abstract":"<div><h3>Background</h3><div>Obesity, a progressively widespread disease with a multifaceted etiology, affects nearly 800 million people worldwide. Recent trials suggest that resveratrol, a polyphenolic compound, can be effective for metabolic risk markers and anthropometric parameters in Individuals with Obesity or Overweight. However, a comprehensive analysis is necessary to consolidate these results.</div></div><div><h3>Objectives</h3><div>To evaluate the impact of 4-week resveratrol supplementation on metabolic risk markers and anthropometric parameters in individuals with obesity or overweight.</div></div><div><h3>Methods</h3><div>A comprehensive search was executed across PubMed, Cochrane Library, Scopus, Google Scholar, and <span><span>clinicaltrials.gov</span><svg><path></path></svg></span>, yielding 43 studies after the omission of 20 duplicates. RevMan 5.4 software was used to statistically analyze randomized controlled studies to gauge the impact of resveratrol on the said outcomes in Individuals with Obesity or Overweight. Quality of bias and potential publication bias were measured using the Cochrane Risk of Bias tool and CMA4 software, respectively. Certainty of the evidence was appraised using GRADEpro software. Data was quantified as the standardized mean difference (SMD) and 95 % confidence intervals (CI).</div></div><div><h3>Results</h3><div>The meta-analysis included 5 trials with 419 participants, evaluating the effect of intervention. Resveratrol showed no significant impact on triglycerides (SMD = 0.11, 95%CI [-0.14, 0.35], P = 0.39, I² = 0 %), total cholesterol (SMD = 0.04, 95%CI [-0.26, 0.33], P = 0.82, I² = 0 %), or HbA1c (SMD = 0.00, 95%CI [-0.99, 1.00], P = 0.99, I² = 80 %). Similarly, no significant effect was observed for insulin levels (SMD = −0.00, 95%CI [-0.25, 0.24], P = 0.97, I² = 0 %), AST (SMD = 0.15, 95%CI [-0.35, 0.65], P = 0.55, I² = 0 %), or ALT (SMD = −0.03, 95%CI [-0.46, 0.39], P = 0.98, I² = 0 %). Additionally, resveratrol had no significant effect on BMI (MD = 0.21, 95%CI [-0.970, 1.39], P = 0.70, I² = 0 %).</div></div><div><h3>Conclusions</h3><div>Our results tagged with p-value&gt;0.05 are an evidence-based indication that resveratrol supplementation does not lead to significant improvements in metabolic or anthropometric parameters. This suggests that resveratrol may not be an effective standalone intervention for managing obesity-related outcomes. Therefore, future research should be redirected to evaluating its potential effects on other health metrics to elucidate its efficacy and therapeutic potential better.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"Article 100141"},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432495","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":"Diagnosis and management of metabolic dysfunction- associated steatotic liver disease in South Asians- A clinical review","authors":"Prajith Raj Ramesh ,&nbsp;Priya Krishnan ,&nbsp;Samyuktha Prabu ,&nbsp;Varshini Srinivasan ,&nbsp;Varalakshmi Niranjan","doi":"10.1016/j.obpill.2024.100142","DOIUrl":"10.1016/j.obpill.2024.100142","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed as nonalcoholic fatty liver disease (NAFLD) is a hepatic manifestation of obesity and metabolic syndrome. It is mainly caused by insulin resistance. With the increased risk of visceral obesity in South Asians, the prevalence of MASLD is on the rise. The morbidity associated with MASLD and its complications, including hepatocellular carcinoma is projected to increase in this South Asian population.</div></div><div><h3>Methods</h3><div>In this narrative review we explore the diagnosis and management of MASLD in the South Asian population. We summarize the findings from the recent literature on the diagnostic methods and management options for MASLD in this population.</div></div><div><h3>Results</h3><div>Through our search we found no specific guidelines for the diagnosis and management of MASLD in the South Asian population. The existing general guidelines may not be applied to South Asian populations due to the differences in phenotype, genotype, social and cultural aspects. South Asian countries also have limited resources with the non-availability of newer pharmacotherapeutic agents.</div></div><div><h3>Conclusion</h3><div>The goal of this review is to guide obesity physicians and primary care providers to have a stepwise approach to treat patients at risk for MASLD with a main focus on interdisciplinary management most applicable to South Asian patients. More research is needed to formulate guidelines and algorithm that are specific for the South Asian population.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"Article 100142"},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442056","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":"Relationship of visceral adiposity index (VAI) and visceral body fat among metabolically obese normal weight individuals from Pakistan","authors":"Faisal Ishfaq ,&nbsp;Somia Iqtadar ,&nbsp;Sidrah Lodhi ,&nbsp;Sibgha Kanwal ,&nbsp;Hira Amir ,&nbsp;Arslan Ishfaq ,&nbsp;Asma Ishfaq","doi":"10.1016/j.obpill.2024.100140","DOIUrl":"10.1016/j.obpill.2024.100140","url":null,"abstract":"<div><h3>Background</h3><div>An increasing number of people throughout the world are suffering with visceral obesity. Accumulation of visceral fat is a pathogenic manifestation of global fat dysfunction, that leads to inflammation, atherosclerosis, abnormal lipid levels, and high blood pressure.</div></div><div><h3>Methods</h3><div>This association study was conducted at Department of Medicine, Mayo Hospital Lahore, Pakistan. 30 participants who meet the selection criteria were recruited after taking written consent. Then patients were evaluated for their height, weight and waist circumference body mass index. Visceral fat was calculated by using machine for bio-impendence analysis. Visceral adiposity index was calculated. 5 cc venous blood sample was' collected under aseptic measures and all samples were sent to the hospital's laboratory for assessment of lipid profile and blood sugar levels.</div></div><div><h3>Results</h3><div>We have studied 30 patients (43.8 % female and 56.3 % male), mean age of study population calculated was 40.6 ± 11.80 years. The mean Visceral Body Fat was found to be 13.53 ± 1.41, High-Density Lipoprotein cholesterol mean calculated was 36.91 ± 9.18 mg/dL, and mean Visceral Adiposity Index calculated was 16.75 ​± ​7.55. Pearson Correlation was used, to find correlation between Visceral Adiposity Index and Visceral Body fat. The value turned out to be 00.899∗∗ shows positive correlation, p-value was 0. 001 significant.</div></div><div><h3>Conclusion</h3><div>In this study we found positive correlation of visceral adiposity index and visceral body fat by use of Bio impedance analysis machine among metabolically obese normal weight individuals. Visceral adiposity index requires many blood tests while Bio impedance analysis machine can be used in simple outdoor settings hence, we can isolate high risk patient in outdoor settings without any invasive procedures or laboratory investigations.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"Article 100140"},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528276","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":"Case report of a female western Indian vegetarian with obesity","authors":"Varalakshmi Niranjan MD, MBA, Dip ABOM ,&nbsp;Jennifer Ozimek MD, FACP","doi":"10.1016/j.obpill.2024.100137","DOIUrl":"10.1016/j.obpill.2024.100137","url":null,"abstract":"<div><h3>Background</h3><div>South Asians are defined as those indigenous to the Indian subcontinent - India, Pakistan, Sri Lanka, Nepal, Maldives, Bhutan, and Bangladesh. This ethnic group is a unique population with increased prevalence of metabolic syndrome even at a lower body mass index (BMI). Should they also have increased BMI, the risk for development of diabetes mellitus and cardiovascular complications are further magnified. Strong cultural perceptions about ideal body weight, lack of awareness about the race and ethnicity-specific risks, and knowledge gaps regarding different dietary patterns among the healthcare providers confound further the metabolic issues pertinent to South Asians living in North America.</div></div><div><h3>Methods</h3><div>In this case study of a South Asian patient, we present asynchronous co-management of obesity by an obesity specialist and the primary care provider in a university-based clinic.</div></div><div><h3>Results</h3><div>Intense lifestyle interventions including a custom-tailored Indian vegetarian meal plan and weekly injectable Semaglutide was offered to the patient as treatment plan. The patient lost 59 pounds, and BMI changed from 34.1 kg/m² to 23.5 kg/m^2.</div></div><div><h3>Conclusion</h3><div>Intensive lifestyle interventions with custom-tailored dietary changes, regular physical activity and behavior modifications combined with appropriate pharmacotherapy can be very successful in the management of obesity among South Asians living in North America.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"Article 100137"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446012","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":"Retrospective review of seven patients with obesity simultaneously treated with a combination of a glucagon-like peptide-1 receptor agonist and a meal replacement product","authors":"Catherine Bacus ,&nbsp;Terri-Lynne South ,&nbsp;Sonia Raudszus ,&nbsp;Odd Erik Johansen","doi":"10.1016/j.obpill.2024.100138","DOIUrl":"10.1016/j.obpill.2024.100138","url":null,"abstract":"<div><h3>Background</h3><div>The use of meal replacement products (MRPs) to obtain a caloric deficit while maintaining micro- and macronutrient requirements, has a long tradition in obesity medicine. Limitations include low compliance, variability in efficacy, adverse events (related to acute changes in nutrient intake), and risk of weight regain when discontinued, and their popularity has declined after the emergence of potent GLP-1 receptor analogues (GLP1-RAs). However, GLP-1RAs have limitations, including dose-dependent risk for adverse events (AEs), high cost, as well as weight regain when discontinued. Although concomitant use of MRPs and GLP-1RAs could address some of the limitations, there is a scarcity of data reported on this. Herein we report real world clinical experience of such combined use.</div></div><div><h3>Methods</h3><div>This retrospective case evaluation involved people with obesity that concomitantly used MRPs (Optifast) and a GLP-1RA and were followed at one of three weight management centers in Australia or South Africa. Parameters collected were gender, age, co-morbidities, height, weight, frequency/amount of MRPs used, dose/type of GLP-1RA used, duration of combined use, and occurrence of AEs. Written informed consent for use of data was obtained from each individual, and the data were managed in an anonymized form and summarized descriptively.</div></div><div><h3>Result</h3><div>A total of seven (5 females) individuals (mean [min, max] age 49 [30,66] years, BMI 44.8 [30.7, 57.9] kg/m²) initiated either semaglutide (n=4) or liraglutide (n=3) concomitantly with daily MRPs (starting number of servings/day 2.7 [1,6]) for a duration of 12 [4, 25] months. Change in weight/BMI/% TBW was -32.0 (-9.6, -77.8) kg/-10.3 (-3.4, -24.5) kg/m²/-24.2 %. Five individuals experienced ≥1 GLP-1RA related AE (nausea, reflux, burping, diarrhea, constipation). One individual discontinued GLP-1RA, whereas two persons discontinued the use of MRPs.</div></div><div><h3>Conclusions</h3><div>MRPs can be initiated concomitantly with a GLP-1 RA for weight management. This might enhance weight-loss effectiveness, with potential additional benefits that should be elucidated in further and larger studies.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"Article 100138"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422210","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 in patients with craniopharyngioma in the South Asian region – A distinct phenotype","authors":"Sreevatsa Tatachar ,&nbsp;Remya Rajan ,&nbsp;Asha Hesaraghatta Shyamsunder ,&nbsp;Nitin Kapoor","doi":"10.1016/j.obpill.2024.100139","DOIUrl":"10.1016/j.obpill.2024.100139","url":null,"abstract":"<div><h3>Background</h3><div>Craniopharyngiomas are rare benign tumors located in the sellar and suprasellar region, with an incidence of 0.5–2 cases per million as reported in Western studies. Post-treatment, including surgery and/or radiotherapy, many patients develop significant obesity, primarily due to hypothalamic damage and associated complications such as hypopituitarism. In the South Asian population, genetic predisposition to obesity at lower BMIs, coupled with a carbohydrate-rich diet, may exacerbate obesity in craniopharyngioma patients, presenting a unique challenge.</div></div><div><h3>Methods</h3><div>This submission is a commentary based on a comprehensive literature review. The authors conducted the review using PubMed to focus on English-language articles covering hypothalamic obesity, craniopharyngioma and obesity in the South Asian population from 1939 to the present.</div></div><div><h3>Results</h3><div>The literature review revealed that 50–60 % of patients treated for craniopharyngioma develop obesity, predominantly linked to hypothalamic damage, although these data are mainly derived from Western studies. Hypopituitarism was frequently observed, further contributing to the obesity. Despite a caloric intake appropriate for the age and gender, these patients exhibited reduced physical activity as measured by wrist accelerometers. Patients with hypothalamic obesity due to craniopharyngioma are at risk for metabolic syndrome and cardiovascular morbidity. Additionally, visual impairment was common, leading to a decreased quality of life. The South Asian population, genetically predisposed to visceral obesity and a carbohydrate-rich diet, may display a distinct phenotype. Although multiple treatment modalities have been tried, there is no definite treatment modality available to counteract this condition at present.</div></div><div><h3>Conclusion</h3><div>South Asian phenotype of craniopharyngioma-related obesity is characterized by significant metabolic and hormonal dysregulation, influenced by both dietary and genetic factors. Nevertheless, there may be a lot to be still understood about this devastating, rapid, relentless hypothalamic obesity syndrome. Also, a higher morbidity rate within this population, underscores the need for further research to develop targeted interventions.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"Article 100139"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422211","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}