Obesity Pillars最新文献

{"title":"Patient perceptions about obesity management in the context of concomitant care for other chronic diseases","authors":"Ian Patton ,&nbsp;Ximena Ramos Salas ,&nbsp;Brad Hussey ,&nbsp;Megha Poddar ,&nbsp;Sanjeev Sockalingam ,&nbsp;Laurie Twells ,&nbsp;Hassan Mir ,&nbsp;Mary Forhan ,&nbsp;Pam Hung ,&nbsp;Al Martin ,&nbsp;Lisa Schaffer ,&nbsp;Candace Vilhan","doi":"10.1016/j.obpill.2023.100089","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100089","url":null,"abstract":"<div><h3>Background</h3><p>Approximately 15% of Canadian adults live with two or more chronic diseases, many of which are obesity related. The degree to which Canadian obesity treatment guidelines are integrated into chronic disease management is unknown.</p></div><div><h3>Methods</h3><p>We conducted a 12-min online survey among a non-probability sample of 2506 adult Canadians who met at least one of the following criteria: 1) BMI ≥30 kg/m²; 2) medical diagnosis of obesity; 3) undergone medically supervised treatment for obesity; or 4) a belief that excess/abnormal adipose tissue impairs their health. Participants must have been diagnosed with at least one of 12 prevalent obesity-related chronic diseases. Data analysis consisted of descriptive statistics.</p></div><div><h3>Results</h3><p>One in four (26.4%) reported a diagnosis of obesity, but only 9.2% said they had received medically supervised obesity treatment. The majority (55%) agreed obesity makes managing their other chronic diseases challenging; 39% agreed their chronic disease(s) have progressed or gotten worse because of their obesity. While over half (54%) reported being aware that obesity is classified as a chronic disease, 78% responded obesity was their responsibility to manage on their own. Only 33% of respondents responded they have had success with obesity treatment.</p></div><div><h3>Interpretation</h3><p>While awareness of obesity as a chronic disease is increasing, obesity care within the context of a wider chronic disease management model is suboptimal. More work remains to be done to make Canadian obesity guidelines standard for obesity care.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"8 ","pages":"Article 100089"},"PeriodicalIF":0.0,"publicationDate":"2023-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49700861","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":"Helping providers address psychological aspects of obesity in routine care: Development of the obesity adjustment dialogue tool (OADT)","authors":"Michael Vallis","doi":"10.1016/j.obpill.2023.100088","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100088","url":null,"abstract":"<div><h3>Background</h3><p>This study developed and validated a dialogue tool (Obesity Adjustment Dialogue Tool) to efficiently assess QoL and drive to eat for use in routine clinical care.</p></div><div><h3>Methods</h3><p>A 13-question interview was created, assessing the impact of living with obesity on quality of life and drive to eat. In a counter-balanced order, PwO were interviewed and completed the Obesity Adjustment Survey (OAS), the Impact of Obesity on Quality of Life-Lite scale (IWQoL), the Three Factor Eating Questionnaire (TREQ), and the Control of Eating Questionnaire (COEQ). Questionnaire results were used to validate the interview using correlational and concordance measures.</p></div><div><h3>Results</h3><p>101 PwO consented and 98 completed all measures (mean BMI = 37.8; 30.7% Class III obesity). Correlations between the QoL dialogue tool and validated instruments (OAS, IWQOL) were moderate to high. Correlations between cravings questions and validated measures (TFEQ, COEQ) were high except for attempts to control eating. Correspondence based on categorizing both the dialogue tool and scales into high/low impact was high except for attempts to control eating (which was dropped from the final tool).</p></div><div><h3>Conclusion</h3><p>The Obesity Adjustment Dialogue Tool is a brief clinician-led structured interview which closely matches information derived from validated scales. This tool offers an efficient approach to incorporating QoL factors into obesity management.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"8 ","pages":"Article 100088"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49700860","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 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}