Obesity Pillars最新文献

{"title":"Obesity and malnutrition in children and adults: A clinical review","authors":"Morgan Bradley ,&nbsp;Julian Melchor ,&nbsp;Rachel Carr ,&nbsp;Sara Karjoo","doi":"10.1016/j.obpill.2023.100087","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100087","url":null,"abstract":"<div><h3>Background</h3><p>In the U.S., children and adults are consuming more low-nutrient foods with added sugar and excess fats as compared to healthy, high-quality calories and micronutrients. This diet is increasing the prevalence of malnutrition and nutritional deficiencies, despite high calorie intake. This is a review of the common micronutrient deficiencies, the risk factors for malnutrition, dietary plans, and the health consequences in children and adults with obesity in the U.S.</p></div><div><h3>Methods</h3><p>This clinical review of literature was performed on the MEDLINE (PubMed) search engine. A total of 1391 articles were identified and after review, a total of 130 were found to be most pertinent.</p></div><div><h3>Discussion</h3><p>The most common micronutrient deficiencies found in patients with obesity were vitamin A, thiamine (B1), folate (B9), cobalamin (B12), vitamin D, iron, calcium, and magnesium, especially prior and after bariatric surgery. Diets that produced the most weight reduction also further puts these individuals at risk for worsening malnutrition. Malnutrition and micronutrient deficiencies can worsen health outcomes if not properly managed.</p></div><div><h3>Conclusion</h3><p>Adequate screening and awareness of malnutrition can improve the health outcomes in patients with obesity. Physiologic changes in response to increased adiposity and inadequate intake increase this population's risk of adverse health effects. Malnutrition affects the individual and contributes to worse public health outcomes. The recommendations for screening for malnutrition are not exclusive to individuals undergoing bariatric procedures and can improve the health outcomes of any patient with obesity. However, clearly, improved nutritional status can assist with metabolism and prevent adverse nutritional outcomes post-bariatric surgery. Clinicians should advise on proper nutrition and be aware of diets that worsen deficiencies.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"8 ","pages":"Article 100087"},"PeriodicalIF":0.0,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49700814","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 complexity of obesity-related health problems after bariatric surgery: The patient perspective","authors":"G. Konings ,&nbsp;M. Drukker ,&nbsp;R. Severeijns ,&nbsp;R. Ponds","doi":"10.1016/j.obpill.2023.100082","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100082","url":null,"abstract":"<div><h3>Background</h3><p>Bariatric surgery aims to improve quality of life by means of weight loss. Obesity-related physical and psychological health problems should improve, but long-term data are scarce.</p></div><div><h3>Objectives</h3><p>To evaluate preoperative physical and mental health problems perceived by the patient and the association with weight loss and quality of life, 5 years after bariatric surgery.</p></div><div><h3>Methods</h3><p>101 persons (response rate 67%) who had had bariatric surgery an average of 4.6 years before this study completed a written survey on obesity-related physical and psychological health problems and three psychological questionnaires collecting information on eating behavior and quality of life. Over half of the participants (55%) had had a laparoscopic adjustable gastric banding.</p></div><div><h3>Results</h3><p>Preoperatively reported health problems improved but were not necessarily associated with weight loss. Minimal improvement in tiredness, shame and weight instability were associated with significantly less weight loss. Preoperative type 2 diabetes mellitus (T2D) improved but participants had significantly less weight loss and more dissatisfaction regarding the bariatric trajectory than participants without T2D. Eating concerns, emotional eating and external eating improved but not restrained eating. Compared to the Dutch population reference, most quality of life scores of the participants were lower.</p></div><div><h3>Conclusion</h3><p>In this analysis, participants did report satisfaction although from a patients’ perspective, improvements of weight and health did not necessarily lead to satisfaction regarding the bariatric trajectory. Participants with postoperative reported fatigue and shame as well as participants with preoperative T2D showed significant less weight loss. More long-term research is necessary to close the current knowledge gap.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"7 ","pages":"Article 100082"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49700770","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":"How to get back on track? Experiences of patients and healthcare professionals regarding weight recurrence and needs for an intervention after bariatric-metabolic surgery","authors":"Vera Voorwinde ,&nbsp;Sahar Moukadem ,&nbsp;Maartje M. van Stralen ,&nbsp;Ignace M.C. Janssen ,&nbsp;Valerie M. Monpellier ,&nbsp;Ingrid H.M. Steenhuis","doi":"10.1016/j.obpill.2023.100074","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100074","url":null,"abstract":"<div><h3>Background</h3><p>Multidisciplinary lifestyle interventions are recommended as a first step in treating weight recurrence after bariatric-metabolic surgery (BMS). However, little is known about the experience of patients and healthcare professionals (HCP) with these interventions and how they should be tailored to the patients’ needs. The aim of this study was to gain more insight into the experiences and needs of patients and HCP regarding weight recurrence after BMS and an intervention to get Back on Track. In addition, attitudes towards integrating e-Health into the care program were explored.</p></div><div><h3>Methods</h3><p>A qualitative process evaluation of an intervention for weight recurrence, the Back on Track (BoT), was conducted by means of in-depth interviews and focus groups with 19 stakeholders, including patients and HCP involved in BoT. Interviews were transcribed verbatim. Data were analyzed through thematic analysis.</p></div><div><h3>Results</h3><p>Patients and HCP reported a wide array of causes of weight recurrence. Patients found it difficult to decide when weight recurrence is problematic and when they should ask for help. Patients reported feeling like the exception and ashamed, therefore experiencing a high threshold to seek help. E-Health was seen as a promising way to improve tailoring, screening, autonomy for the patient, and accessible contact.</p></div><div><h3>Conclusion</h3><p>Patients should be adequately counselled on weight recurrence after BMS and the importance of intervening early. It is important to lower the threshold for seeking help. For example by offering more long-term standard care or by adding e-Health to the intervention.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"7 ","pages":"Article 100074"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49728030","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":"Comparing the use of food and physical activity parenting practices: Parents of children with overweight and obesity versus parents of children with a healthy weight","authors":"Lisanne Arayess ,&nbsp;Sanne M. Gerards ,&nbsp;Junilla K. Larsen ,&nbsp;Ester F.C. van der Borgh-Sleddens ,&nbsp;Anita C.E. Vreugdenhil","doi":"10.1016/j.obpill.2023.100078","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100078","url":null,"abstract":"<div><h3>Background</h3><p>Paediatric overweight and obesity are caused by a complex imbalance between energy intake and expenditure. Parents may influence this imbalance through energy balance-related parenting practices. This study aims to compare the use of energy balance-related parenting practices between parents of children with overweight and obesity and children with a healthy weight.</p></div><div><h3>Methods</h3><p>This study compares energy balance-related parenting practices among a group of parents with children with overweight and obesity at the start of a lifestyle intervention (N = 107) and children with a healthy weight (N = 137). Specifically, it compares the feeding practices ‘overt control’ (open control over eating), ‘encouragement’, ‘instrumental feeding’, ‘emotional feeding’, and ‘covert control’ (hidden control over eating), as well as the physical activity parenting practice ‘promoting physical activity’. Multiple regression analyses are used to calculate associations between child weight groups and parenting practices when corrected for children's characteristics.</p></div><div><h3>Results</h3><p>Parents of children with overweight and obesity reported significantly different scores on control over eating practices than parents of children with a healthy weight, namely a significantly higher score on covert control (B = 0.397, S.E. 0.123, p = 0.001) and a significantly lower score for overt control (B = −0.136, S.E. 0.068, p = 0.046).</p></div><div><h3>Conclusion</h3><p>Covert control is reported more, while overt control is reported less in parents of children with overweight and obesity compared to parents of children with a healthy weight, even after correction for the child's, family, and maternal characteristics. Future longitudinal research and intervention trials are recommended to determine <em>whether</em> and <em>how</em> the use of control over eating practices changes.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"7 ","pages":"Article 100078"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49700767","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":"Comprehensive care for patients with obesity: An Obesity Medicine Association Position Statement","authors":"Angela Fitch ,&nbsp;Lydia Alexander ,&nbsp;Carolynn Francavilla Brown ,&nbsp;Harold Edward Bays","doi":"10.1016/j.obpill.2023.100070","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100070","url":null,"abstract":"","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"7 ","pages":"Article 100070"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49699920","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":"Diagnostic challenge: A pediatric patient with severe obesity and complications of imminent death","authors":"Gitanjali Srivastava","doi":"10.1016/j.obpill.2023.100077","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100077","url":null,"abstract":"<div><h3>Background</h3><p>A 15-year-old patient suffering from severe obesity (400 pounds, BMI 71.6 kg/m²) with a clinical phenotype suggestive of syndromic obesity was hospitalized for severe heart failure and cardiogenic shock. The hospital admission prompted a palliative care and heart transplant consultation given end-stage-disease and poor prognosis. It further necessitated a pediatric inpatient obesity consult, which was complicated by several significant hurdles including lack of insurance coverage, FDA approvals, availability of medications, and inadequate knowledge among the medical community.</p></div><div><h3>Methods</h3><p>Innovative treatment, proactive, persistent advocacy, anti-obesity medication combination strategies modeled after diabetes and hypertension treatment algorithms, and latest evidence in obesity management were utilized to effectively and expeditiously overcome major challenges to care and the medical emergency.</p></div><div><h3>Results</h3><p>The patient was stabilized and ultimately discharged home, after −25.2% weight loss over 4 months (weight down to 299 pounds, BMI 49.9 kg/m²) through collaborative medical obesity intervention.</p></div><div><h3>Conclusion</h3><p>The typical delay in care sought by patients suffering from obesity, often due to stigma and lack of disease awareness, results in missed opportunities to prevent serious obesity-related complications. Skilled specialist expertise, fund of obesity-specific knowledge, and constant advocacy can be crucial in surmounting regulatory barriers to obesity care and in generating successful weight loss outcomes.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"7 ","pages":"Article 100077"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49699922","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":"Successful treatment of binge eating disorder with the GLP-1 agonist semaglutide: A retrospective cohort study","authors":"Jesse Richards ,&nbsp;Neha Bang ,&nbsp;Erin L. Ratliff ,&nbsp;Maria A. Paszkowiak ,&nbsp;Zhamak Khorgami ,&nbsp;Sahib S. Khalsa ,&nbsp;W. Kyle Simmons","doi":"10.1016/j.obpill.2023.100080","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100080","url":null,"abstract":"<div><h3>Objective</h3><p>Binge eating disorder (BED) is the most common eating disorder, and yet only one pharmacotherapy (lisdexamfetamine), which has known abuse-potential, is FDA-approved. Topiramate is also commonly prescribed off-label for binge eating but has many contraindications. In contrast, the glucagon-like peptide-1 (GLP1) analog semaglutide has profound effects on central satiety signaling leading to reduced food intake, and has been approved for the treatment of obesity based on its efficacy and safety profile. Semaglutide would thus seem to be a potential candidate for the treatment of BED.</p></div><div><h3>Methods</h3><p>This open-label study examined the effects of semaglutide on Binge Eating Scale (BES) scores in individuals with BED. Patients were divided into three groups: those prescribed semaglutide, those prescribed either lisdexamphetamine or topiramate, and those prescribed a combination of semaglutide with lisdexamphetamine or topiramate.</p></div><div><h3>Results</h3><p>Patients receiving semaglutide only exhibited greater reductions in BES scores compared to the other groups. Combined pharmacotherapy with both semaglutide and the other anti-obesity medications did not result in greater reductions in BES scores compared to the semaglutide-only group. Findings were similar in patients with moderate/severe BED, as well as the full sample.</p></div><div><h3>Conclusion</h3><p>The therapeutic effects of semaglutide in binge eating disorder warrant further investigation.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"7 ","pages":"Article 100080"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49700031","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":"Whole-body bone mineral density and markers of bone homeostasis in adults with normal-weight obesity","authors":"Bryant H. Keirns ,&nbsp;Christina M. Sciarrillo ,&nbsp;Austin R. Medlin ,&nbsp;Samantha M. Hart ,&nbsp;Elyse M. Cronic ,&nbsp;Sam R. Emerson","doi":"10.1016/j.obpill.2023.100073","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100073","url":null,"abstract":"<div><h3>Background</h3><p>Normal-weight obesity (NWO) describes individuals with a normal body mass index (BMI), but high body fat percent. NWO are at-risk for cardiometabolic diseases, but little is known about their bone health.</p></div><div><h3>Methods</h3><p>Adults (N = 24) were classified as NWO (n = 12; 5M/7F) or low body fat percent controls (Con; n = 12; 6M/6F). Body composition and whole-body bone mineral density (BMD) were assessed using DXA. A serum bioplex assay was performed to examine markers related to bone formation and resorption.</p></div><div><h3>Results</h3><p>In addition to higher body fat percent and visceral fat, NWO had lower whole-body BMD relative to Con (<em>p</em>'s &lt; 0.05). Circulating leptin was higher in NWO than Con (<em>p</em> &lt; 0.05). Two biomarkers generally associated with lower bone mass – sclerostin and parathyroid hormone – were higher in NWO compared to Con (<em>p</em>'s &lt; 0.05).</p></div><div><h3>Conclusion</h3><p>In this preliminary study, adults with NWO displayed lower whole-body BMD alongside evidence of bone resorption. Impaired bone health may be another subclinical risk factor present in NWO.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"7 ","pages":"Article 100073"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49700032","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":"Why does type 2 diabetes mellitus impair weight reduction in patients with obesity? A review","authors":"Harold Edward Bays","doi":"10.1016/j.obpill.2023.100076","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100076","url":null,"abstract":"<div><h3>Background</h3><p>A common adiposopathic complication of obesity is type 2 diabetes mellitus. Healthful weight reduction in patients with obesity can improve glucose metabolism and potentially promote remission of type 2 diabetes mellitus. However, weight-reduction in patients with increased adiposity is impaired among patients with type 2 diabetes mellitus compared to patients without diabetes mellitus.</p></div><div><h3>Methods</h3><p>Data for this review were derived from PubMed and applicable websites.</p></div><div><h3>Results</h3><p>Among patients with increased body fat, the mechanisms underlying impaired weight reduction for those with type 2 diabetes mellitus are multifactorial, and include energy conservation (i.e., improved glucose control and reduced glucosuria), hyperinsulinemia (commonly found in many patients with type 2 diabetes mellitus), potential use of obesogenic anti-diabetes medications, and contributions from multiple body systems. Other factors include increased age, sex, genetic/epigenetic predisposition, and obesogenic environments.</p></div><div><h3>Conclusions</h3><p>Even though type 2 diabetes mellitus impairs weight reduction among patients with increased adiposity, clinically meaningful weight reduction improves glucose metabolism and can sometimes promote diabetes remission. An illustrative approach to mitigate impaired weight reduction due to type 2 diabetes mellitus is choosing anti-diabetes medications that increase insulin sensitivity and promote weight loss and deprioritize use of anti-diabetes medications that increase insulin exposure and promote weight gain.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"7 ","pages":"Article 100076"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49699840","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 management treatment modalities in patients with overweight or obesity: A retrospective cohort study of administrative claims data","authors":"Hong Kan ,&nbsp;Jason P. Swindle ,&nbsp;Jay Bae ,&nbsp;Julia P. Dunn ,&nbsp;Erin K. Buysman ,&nbsp;Noelle N. Gronroos ,&nbsp;Lindsay Bengtson ,&nbsp;Chanadda Chinthammit ,&nbsp;Janet Ford ,&nbsp;Nadia Ahmad","doi":"10.1016/j.obpill.2023.100072","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100072","url":null,"abstract":"<div><h3>Background</h3><p>The purpose of this study was to describe demographic and clinical characteristics among patients who have medical encounters for weight management treatments and to investigate the association of those characteristics with treatment modality.</p></div><div><h3>Methods</h3><p>This was a retrospective database study using medical claims, pharmacy claims, and enrollment information from commercial and Medicare Advantage with Part D members in the Optum Research Database from 01/01/2011−2/29/2020. Adult patients with a claim for a weight management treatment from 01/01/2012−2/28/2019 were categorized into cohorts according to the highest intensity intervention received. To examine the association between patient characteristics and treatment modality received, a multinomial logit model was performed.</p></div><div><h3>Results</h3><p>Cohorts by increasing intensity included lifestyle intervention (LSI, n = 67,679), weight reduction pharmacotherapy (WRRx) with an anti-obesity medication (AOM, n = 6,905), weight reduction procedure (WRP, n = 1,172), and weight reduction surgery (WRS, n = 18,036). Approximately 32.1% and 16.6% of patients who received WRS or WRP had an LSI during the 12-month baseline, and only 0.6% and 0.4% had treatment with long-term AOMs. In a multinomial logit model, patients with type 2 diabetes (not including WRRx cohort), respiratory disorders, cardiovascular risk factors, pain disorders, and mental health conditions had increased odds of treatment with higher intensity intervention versus LSI. Patients who were male, received an intervention more recently (2016-2019), or had a Charlson comorbidity score of 1 (compared to 0) had decreased odds of treatment with higher intensity interventions.</p></div><div><h3>Conclusion</h3><p>In this study, age, sex, body mass index, obesity-related complications, and Charlson comorbidity score appeared to influence the type of weight management treatment modality received. This study improves understanding of weight management treatment utilization and identifies gaps and opportunities to improve obesity care with the appropriate use of different treatment modalities.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"7 ","pages":"Article 100072"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49699805","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}