Obesity Pillars最新文献

{"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}

{"title":"Physical and psychosocial determinants of quality of life in children with obesity","authors":"Beau L. Mansker ,&nbsp;Katherine Schwartzkopf ,&nbsp;Jose A. Velez II ,&nbsp;Anthony J. Perkins ,&nbsp;Sara K. Naramore","doi":"10.1016/j.obpill.2023.100081","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100081","url":null,"abstract":"<div><h3>Background</h3><p>Obesity has a negative impact on the physical and psychosocial quality of life of children. As rates of obesity continue to increase, it is important to recognize the widespread effects obesity has on children and their families.</p></div><div><h3>Methods</h3><p>This clinical investigation evaluated the self-reported quality of life of children with obesity in a weight management program and compared this to a parent/guardian’s perspective of the child’s quality of life using the Pediatric Quality of Life survey 4.0. The quality of life of children with obesity was compared to children with other chronic diseases and healthy children.</p></div><div><h3>Results</h3><p>An association was discovered between the guardians’ responses to the Pediatric Quality of Life survey and the child’s age. Guardians with children younger than 11 years reported higher quality of life scores than guardians of children 11 years and older. Race, comorbidities of obesity, insurance type, household structure, and parental education attainment were not significantly associated with a child’s quality of life. Children with obesity had a lower quality of life compared to children who were organ transplant recipients and children with organic gastrointestinal disease.</p></div><div><h3>Conclusions</h3><p>These results emphasize the need to evaluate and treat the physical and psychosocial components of wellbeing in children with obesity at an early age.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"7 ","pages":"Article 100081"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49700769","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 management for cardiovascular disease prevention","authors":"Rama Hritani ,&nbsp;Mahmoud Al Rifai ,&nbsp;Anurag Mehta ,&nbsp;Charles German","doi":"10.1016/j.obpill.2023.100069","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100069","url":null,"abstract":"<div><h3>Background</h3><p>Obesity is a complex disease that leads to higher morbidity and mortality and its rate in the United States is rapidly rising. Targeting obesity management is one of the cornerstones of preventive medicine. Early intervention can significantly reduce the risk of developing cardiovascular disease. While it is well known that lifestyle interventions such as healthful nutrition and routine physical activity are the first and most important step in management, some do not achieve the desired results and require further therapies.</p></div><div><h3>Methods</h3><p>A literature review was conducted, that included clinical documents, public scientific citations and peer review articles to evaluate anti-obesity medications, endoscopic procedures and bariatric surgeries in the management of obesity. We also included effects of these interventions on weight loss, cardiovascular disease risk reduction and side effects.</p></div><div><h3>Results</h3><p>This clinical review summarizes recent evidence for the different approaches in obesity management including medications, common endoscopic procedures and bariatric surgeries. For more detailed review on the different management options discussed, we recommend reviewing Obesity Medicine Association Clinical Practice Statement [1].</p></div><div><h3>Conclusion</h3><p>Management of obesity reduces cardiovascular risk, improves metabolic parameters and other important health outcomes. Different management approaches are available, hence, a high level of awareness of the growing epidemic of obesity is needed to ensure timely referrals to obesity medicine specialists.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"7 ","pages":"Article 100069"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49699879","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 review of the evidence on cardiovascular outcomes from obesity treatment","authors":"Roshaida Abdul Wahab ,&nbsp;Carel W. le Roux","doi":"10.1016/j.obpill.2023.100071","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100071","url":null,"abstract":"<div><h3>Background</h3><p>Obesity is a chronic disease with a myriad of complications including cardiovascular disease. There is a growing interest to examine if obesity treatment is associated with cardiovascular outcomes.</p></div><div><h3>Methods</h3><p>In this narrative review, we focused on randomized controlled trials (RCT) with cardiovascular outcomes (CVO) from lifestyle intervention, bariatric surgery, glucagon-like peptide-1 analogues (GLP-1a) and other pharmacotherapy. Additionally, we provide a comprehensive look into the RCT of sodium glucose cotransporter 2 inhibitors (SGLT2i) and CVO in obesity, while also summarizing several ongoing randomized cardiovascular outcome controlled trials for the pharmacological treatment of obesity.</p></div><div><h3>Results</h3><p>To date, the results from the randomized controlled trials supported the association between obesity treatment and cardiovascular outcomes. Studies have large sample sizes, conducted over long duration, with the majority demonstrating superiority in primary cardiovascular outcome end points compared to placebo.</p></div><div><h3>Conclusion</h3><p>Future data from several ongoing anti-obesity medications cardiovascular outcome trials such as SELECT, SURPASS, SUMMIT and SURMOUNT-MMO hold promises. Further studies are warranted to investigate the long term cardiovascular outcomes following lifestyle intervention and bariatric surgery.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"7 ","pages":"Article 100071"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49699924","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 scoping review of obesity education interventions for current and prospective medical professionals in Canada","authors":"Taniya S. Nagpal ,&nbsp;Nicole Pearce ,&nbsp;Sanjeev Sockalingam ,&nbsp;Raed Hawa ,&nbsp;Khushmol K. Dhaliwal ,&nbsp;Dayna Lee-Baggley ,&nbsp;Mohamed El-Hussein ,&nbsp;Sarah Nutter ,&nbsp;Helena Piccinini-Vallis ,&nbsp;Michael Vallis ,&nbsp;Liz Dennett ,&nbsp;Mary Forhan ,&nbsp;Stasia Hadjiyanakkis ,&nbsp;Robert F. Kushner ,&nbsp;Michelle McMillan ,&nbsp;Sean Wharton ,&nbsp;David Wiljer ,&nbsp;Joseph Roshan Abraham","doi":"10.1016/j.obpill.2023.100085","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100085","url":null,"abstract":"<div><h3>Background</h3><p>Obesity is a prevalent chronic disease in Canada. Individuals living with obesity frequently interact with medical professionals who must be prepared to provide evidence-based and person-centred care options. The purpose of this scoping review was to summarize existing educational interventions on obesity in Canada for current and prospective medical professionals and to identify key future directions for practice and research.</p></div><div><h3>Methods</h3><p>A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. The search strategy was conducted using Medline (via PubMed), Embase, Eric, CBCA, Proquest Education, and Proquest Theses. The inclusion criteria included delivery of an educational intervention on obesity for current medical professionals, medical undergraduate trainees, or residents administered in Canada. Data were extracted from the included studies to thematically summarize the intervention content, and main outcomes assessed. Future directions for research and practice were identified.</p></div><div><h3>Results</h3><p>Eight studies met the inclusion criteria. The interventions ranged in terms of the mode of delivery, including interactive in-person workshops and seminars, online learning modules, webinars, and videos. The main outcomes assessed were attitudes towards patients living with obesity, self-efficacy for having sensitive obesity-related discussions, skills to assess obesity and provision of management options. All studies reported improvements in the outcomes. Future directions identified were the need to develop standardized obesity competencies for inclusion across medical education programs, further research on effective pedagogical approaches to integrating content into existing curricula and the need for broader awareness and assessment of the quality of obesity education resources.</p></div><div><h3>Conclusion</h3><p>Although there have been few obesity-specific educational interventions for current and prospective medical professionals in Canada, existing evidence shows positive learning outcomes. These findings advocate for continued investment in the development of obesity medical training and educational interventions.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"8 ","pages":"Article 100085"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49700864","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":"Implementing evidence-based obesity management guidelines requires development of medical competencies: A commentary outlining future directions in obesity education in Canada","authors":"Taniya S. Nagpal ,&nbsp;Nicole Pearce ,&nbsp;Khushmol Dhaliwal ,&nbsp;Joseph Roshan Abraham","doi":"10.1016/j.obpill.2023.100086","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100086","url":null,"abstract":"<div><h3>Background</h3><p>This commentary provides an overview of forthcoming activities by Obesity Canada (OC) to inform obesity competencies in medical education. Competencies in medical education refer to abilities of medical professionals to appropriately provide patients the care they need. A recognized Canadian framework for informing medical competencies is CanMEDs. Additionally, the Obesity Medicine Education Collaborative (OMEC) provides 32 obesity specific medical competencies to be integrated across medical education curriculum. OC released the first globally recognized Adult Obesity Clinical Practice Guideline (CPGs) in 2020 inclusive of 80 recommendations. Referring to the CanMEDs and OMEC competencies, OC is developing medical education competencies for caring for patients who have obesity in line with the recent CPGs that can be applied to health professions education programs around the world.</p></div><div><h3>Methods</h3><p>Activities being completed by OC’s Education Action Team include a scoping review to summarize Canadian obesity medical education interventions or programs. Next, with expert consensus a competency set is being developed by utilizing the CanMEDs Framework, OMEC and the CPGs. Following this, OC will initially survey undergraduate medical programs across the country and determine to what degree they are meeting the competencies in content delivery. These findings will lead to a national report card outlining the current state of obesity medical education in Canada within undergraduate medical education.</p></div><div><h3>Results</h3><p>To date, OC has completed the scoping review and the competency set. The Education Action Team is in the process of developing the survey tools to assess the current delivery of obesity medical education in Canada.</p></div><div><h3>Conclusion</h3><p>The evidenced-based report card will support advocacy to refine and enhance future educational initiatives with the overall goal of improving patient care for individuals living with obesity. The process being applied in Canada may also be applicable and modified for other regions to assess and better obesity medical education.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"8 ","pages":"Article 100086"},"PeriodicalIF":0.0,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49757505","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":"Parental and familial factors related to participation in a home-based physical activity intervention in children with obesity or Prader-Willi syndrome","authors":"Kryston E. Honea,&nbsp;Kathleen S. Wilson,&nbsp;Koren L. Fisher,&nbsp;Daniela A. Rubin","doi":"10.1016/j.obpill.2023.100084","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100084","url":null,"abstract":"<div><h3>Background</h3><p>Increasing physical activity (PA) participation is vital to promote the development of health behaviors in childhood. This study examined which parental and familial factors predicted completion of and compliance with a home-based family PA program in a cohort of families with a child with Prader-Willi syndrome (PWS; a rare disorder with obesity and developmental disability) or with obesity but with neurotypical development.</p></div><div><h3>Methods</h3><p>Participants (<em>n</em> = 105) were parents of children with PWS (<em>n</em> = 41) and parents of children with obesity but without PWS (<em>n</em> = 64). Parents completed a series of questionnaires documenting their demographic characteristics, self-efficacy, social support, and family environment (active-recreational orientation and cohesion). Relationships between these factors and intervention completion and compliance were evaluated using bivariate correlations and logistic regression (compliance) and multiple regression (completion) analyses with groups together and then separately if the child group was a significant predictor.</p></div><div><h3>Results</h3><p>None of the variables of interest (marital status, employment, employed hours per week, self-efficacy, social support, and family environment) were significant predictors of intervention completion. Intervention compliance was negatively associated with parents working part-time and working full-time and positively associated with family cohesion (Model R² = 0.107, <em>F</em>(3,100) = 4.011, <em>p</em> = .010). Child group was not a factor.</p></div><div><h3>Conclusions</h3><p>Compliance with a 24-week family home-based PA intervention was related to fewer employment hours of the primary caregiver and family environment factors. Future interventions should consider how to reduce the intervention's burden in working parents along with strategies to foster family cohesion.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"8 ","pages":"Article 100084"},"PeriodicalIF":0.0,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49700889","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 hypertension: Obesity medicine association (OMA) clinical practice statement (CPS) 2023","authors":"Tiffany Lowe Clayton,&nbsp;Angela Fitch,&nbsp;Harold Edward Bays","doi":"10.1016/j.obpill.2023.100083","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100083","url":null,"abstract":"<div><h3>Background</h3><p>This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) provides an overview of the mechanisms and treatment of obesity and hypertension.</p></div><div><h3>Methods</h3><p>The scientific support for this CPS is based upon published citations, clinical perspectives of OMA authors, and peer review by the Obesity Medicine Association leadership.</p></div><div><h3>Results</h3><p>Mechanisms contributing to obesity-related hypertension include unhealthful nutrition, physical inactivity, insulin resistance, increased sympathetic nervous system activity, renal dysfunction, vascular dysfunction, heart dysfunction, increased pancreatic insulin secretion, sleep apnea, and psychosocial stress. Adiposopathic factors that may contribute to hypertension include increased release of free fatty acids, increased leptin, decreased adiponectin, increased renin-angiotensin-aldosterone system activation, increased 11 beta-hydroxysteroid dehydrogenase type 1, reduced nitric oxide activity, and increased inflammation.</p></div><div><h3>Conclusions</h3><p>Increase in body fat is the most common cause of hypertension. Among patients with obesity and hypertension, weight reduction via healthful nutrition, physical activity, behavior modification, bariatric surgery, and anti-obesity medications mostly decrease blood pressure, with the greatest degree of weight reduction generally correlated with the greatest degree of blood pressure reduction.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"8 ","pages":"Article 100083"},"PeriodicalIF":0.0,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49700888","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":"Universal Prior Authorization Template for glucagon like peptide-1 based anti-obesity medications: An Obesity Medicine Association proposal","authors":"Harold Edward Bays ,&nbsp;Carolynn Francavilla Brown ,&nbsp;Angela Fitch","doi":"10.1016/j.obpill.2023.100079","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100079","url":null,"abstract":"","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"8 ","pages":"Article 100079"},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49700934","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}