Clinical Obesity最新文献

{"title":"Effect of the National Enhanced Service for weight management on the content of annual review consultations for patients living with obesity and hypertension and/or diabetes.","authors":"Stella J P Haffner, Sarah Mounsey, Rachna Begh, Anisa Hajizadeh, Alice E Hobson, Paul Doody, Charlotte Albury, Suzanne Mara, Laura Heath, Kayley McPherson, Susan A Jebb, Paul Aveyard","doi":"10.1111/cob.12718","DOIUrl":"https://doi.org/10.1111/cob.12718","url":null,"abstract":"<p><p>Guidelines specify that clinicians should support patients living with obesity by referring to weight management programmes (WMPs), but clinicians do so infrequently. To provide additional support to patients living with obesity and weight-related conditions, the UK government instated the National Enhanced Service (NES) for weight management in England, including a reimbursement to general practices for referring eligible patients to WMPs. To assess the impact of the NES on conversations regarding weight and relevant behavioural risk factors in primary care consultations we recruited 11 medical practices in England where the NES was operating and six comparator practices from Scotland and Wales where the NES was not implemented. Clinicians audio-recorded annual review appointments of patients living with obesity and hypertension and/or diabetes. The content of these consultations was synthesised using quantitative content analysis. Consultations with 92 patients were analysed: 58 in England and 34 in Scotland and Wales. No difference was found between the NES sites (England) and non-NES sites (Scotland and Wales) in the proportion of referrals made to WMPs. Clinicians in England weighed patients and took other body measurements more often, mentioned body mass index more often, and had more detailed discussions about patients' diets, but there was no evidence that they differed in their discussion of WMPs or other modifiable risk factors. We found no strong evidence that the NES affected how clinicians addressed weight management or related behavioural risk factors within annual review consultations for patients living with obesity and hypertension and/or diabetes.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":" ","pages":"e12718"},"PeriodicalIF":2.2,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615039","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 cluster randomised controlled trial investigating the efficacy of family-centred obesity management program in primary care settings: A study protocol.","authors":"Basma Al Yazeedi, Badriya Al-Haddabi, Mostafa Waly, Samir Al-Adawi, Salima Al-Mammari, Ibtesam Al-Ghammari, Saleh Al-Shammakhi, Hanan Al-Azkawi, Atika Khalaf","doi":"10.1111/cob.12719","DOIUrl":"https://doi.org/10.1111/cob.12719","url":null,"abstract":"<p><p>The study aims to test the efficacy of a family-centred healthy lifestyle program in primary care health centres among children with overweight or obesity, evaluating the results at 3, 6, and 9 months post-intervention. A single-blind, randomised controlled cluster study where participants will be blinded to group assignment to reduce bias will be followed. The intervention comprises a 6-month program with intensive and maintenance behavioural therapies, including dietary modifications and guidelines for physical activity, administered by a multidisciplinary team. Participants will be assigned to an intervention group or a treatment-as-usual control group. Primary health centres in Seeb Wilayat, serving densely populated areas and willing to participate, will be included. Randomisation will be conducted at the cluster level to improve recruitment efficiency. A sample size calculation will ensure adequate power to detect significant differences. Ethical approval is granted and informed consent/assent will be obtained from all participants. The proposed study focusses on testing the efficacy of a family-centred healthy lifestyle program in primary care centres through a controlled, randomised study. Successful outcomes could lead to informed interventions, improvements in the health system, policy recommendations, positive community impacts, information on behavioural therapies, and improved long-term health outcomes for affected children and their families. This study will contribute to the literature by providing a culturally sensitive and evidence-based solution to a pressing public health issue, which can be adapted to similar contexts in Oman and beyond.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":" ","pages":"e12719"},"PeriodicalIF":2.2,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603557","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":"Effect of interdisciplinary obesity care on metabolic markers and body weight in people with type 2 diabetes in a rural setting: A randomised controlled trial.","authors":"Giuliana O Murfet, Iain K Robertson, Sharon P Luccisano, Michelle L Kilpatrick","doi":"10.1111/cob.12715","DOIUrl":"https://doi.org/10.1111/cob.12715","url":null,"abstract":"<p><p>Management of type 2 diabetes includes medications that can unintentionally increase obesity and insulin resistance. This unblinded, single-centre, randomised controlled trial focused on rural Australian adults with type 2 diabetes (aged 18-75 and body mass index [BMI] >30 kg/m²), measuring the effectiveness of a tailored interdisciplinary obesity care approach compared with usual diabetes care. Led by a nurse practitioner with allied health support (dietitian ± psychologist and physiotherapist), the bariatric treatment involved reducing weight-gaining medications, a 500-calories/day deficit, an unsupervised exercise program emphasising movement/strength and psychotherapy, 3-monthly to 24-months with support phone calls at weeks 2, 4, 8 and 10. Outcomes from the 224 (113 intervention/111 control) participants were differences in biomedical and physical markers within- and between-groups estimated using multivariate mixed-effects linear regression between recruitment and 6-monthly follow-ups. Greater change occurred in intervention compared with control groups at 12 and 24 months in mean: body weight (-5.9 kg [95% confidence interval, CI: -8.53, -3.23] and -9.0 kg [95% CI: -13.2, -4.77]); BMI (-2.03 kg/m² [95% CI: -2.92, -1.15] and -3.51 kg/m² [95% CI: -4.93, -2.08]); and glycated haemoglobin (-0.26% [95% CI: -0.69%, 0.18%] and -0.63% [95% CI: -1.17%, 0.08%]). The control group showed a significant increase in mean leptin level, resulting in a between-group difference (-27.1 [95% CI: -42.7, -11.5]). Lipids and blood pressure differences were inconclusive, while exploratory analysis showed greater decline in estimated glomerular filtration rate in the control group. The interdisciplinary obesity approach, compared with usual diabetes care, resulted in sustained weight loss and improved diabetes control over 2 years. Trial registration number: ACTRN12622000240741.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":" ","pages":"e12715"},"PeriodicalIF":2.2,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603559","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":"Improving obesity management: Insights from the ACTION Switzerland survey of people with obesity, physicians and dietitians.","authors":"Dominique Durrer, Patrick Pasi, Ralph Peterli, Doris Fischer-Taeschler, Gabriela Fontana, Gionata Cavadini, Philipp A Gerber","doi":"10.1111/cob.12716","DOIUrl":"https://doi.org/10.1111/cob.12716","url":null,"abstract":"<p><p>ACTION Switzerland (NCT05232786) examined obesity-related perceptions, attitudes, behaviours and potential barriers to treatment among people with obesity (PwO) and healthcare professionals (HCPs). In March/April 2022, adult PwO (body mass index ≥30 kg/m², per self-reported height/weight) and physicians/certified dietitians who manage PwO in Switzerland completed online surveys in a cross-sectional design. Overall, 1002 PwO, 125 physicians and 25 dietitians completed the survey. Most physicians (97%) and dietitians (100%), but only 57% of PwO, recognized obesity as a chronic disease. Only 42% of PwO considered themselves to have obesity/extreme obesity, while 61% who had discussed weight with an HCP reported receiving an obesity diagnosis. Many PwO (76%) believed weight loss was entirely their responsibility; physicians were less likely than dietitians to agree it was completely their patients' responsibility (28% vs. 68%). Physicians and dietitians report primarily initiating conversations about weight when patients have obesity-related comorbidities (85% and 64%); their top reasons for not discussing obesity were patients' perceived lack of motivation (76% and 60%) or interest (72% and 64%) in losing weight. In conclusion, some PwO are not aware that obesity is a chronic disease and incorrectly assume complete responsibility for weight loss. Improved communication between PwO and HCPs is required.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":" ","pages":"e12716"},"PeriodicalIF":2.2,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603575","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":"Using continuous glucose monitoring (CGM) to understand glucose control in women with obesity during pregnancy.","authors":"Sarah A Price, Alice Lewin, Alison Nankervis, Rahul Barmanray","doi":"10.1111/cob.12717","DOIUrl":"https://doi.org/10.1111/cob.12717","url":null,"abstract":"<p><p>In women with obesity but without diabetes, the factors driving poor pregnancy outcomes are inadequately understood. This study explores glucose as a potential mediator of adverse pregnancy outcomes in women with obesity. A two-arm observational study was conducted in a single maternity hospital in Melbourne, Australia. Thirty-eight women without diabetes, 20 of normal weight (BMI 20-24.9 kg/m²) and 18 with obesity (BMI ≥30 kg/m²), wore a continuous glucose monitor and had anthropometry and blood samples collected in early, mid and late pregnancy. Subjects who developed gestational diabetes were excluded prior to analysis. Groups were compared with respect to patient-day mean glucose, mean blood glucose, daytime and nighttime glucose AUC, post-prandial glucose AUC, HOMA-IR and QUICKI. Five subjects developed gestational diabetes and were excluded from the analysis. Compared to controls (n = 19), women with obesity (n = 14) had significantly higher PDMG (p < .001), daytime and nighttime glucose AUC (p < .01) and post-breakfast glucose AUC (p < .001 and p = .043) and post-dinner glucose AUC (p < .001) in early and mid-pregnancy. Mean plasma glucose and post-lunch glucose AUC were only higher in women with obesity in early pregnancy (p = .009 and p < .001, respectively). In mid and late pregnancy, HOMA-IR was significantly higher (p < .05) and QUICKI (p < .01) significantly lower in the women with obesity compared to controls. Most parameters that used to assess glycaemic control in pregnancy demonstrated significantly higher plasma glucose in women with obesity compared to controls. This supports the hypothesis that glucose is a mediator of adverse pregnancy outcomes in women with obesity.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":" ","pages":"e12717"},"PeriodicalIF":2.2,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603577","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":"Determinants of quality of life and emotional well-being in a bariatric surgery seeking cohort of 1501 multi-ethnic Asian patients.","authors":"Wei Yu Chua, Daryl Kai Ann Chia, Yiong Huak Chan, Eugene Kwong Fei Leong, Ashley Chen, Sharen Asif, Yu An Wong, Javis Fung, Rachel Patricia Johnson, Shefali Jay Poojari, Qamaruzaman Syed Gani, Wen Lin, Shu Ning Wai, Geetha Kayambu, Serene Peiying Lim, Wen Joo Neo, Candice Xin Yi Wee, Davide Lomanto, Guowei Kim, Jimmy Bok Yan So, Asim Shabbir","doi":"10.1111/cob.12707","DOIUrl":"https://doi.org/10.1111/cob.12707","url":null,"abstract":"<p><strong>Objective: </strong>The relationship between ethnicity, obesity and health-related quality of life outcomes in a multi-ethnic population remains poorly understood. We aim to investigate the relationship between ethnicity, body mass index (BMI), obesity-associated diseases, as well as determinants of quality of life (QoL) in Southeast Asian patients with obesity. We aim to develop and validate a simple objective score to identify patients with obesity at high risk for major depression.</p><p><strong>Methods: </strong>Associations between ethnicity, obesity-associated diseases, BMI and determinants of QoL (Patient Health Questionnaire-9 and 36-Item Short Form Survey) were analysed using multivariate logistic regression in a prospective cohort of 1501 patients with obesity. Multivariate regression and receiver operating characteristics curves were used to develop and validate a novel scoring system to identify patients at risk of major depression.</p><p><strong>Results: </strong>Patients of Chinese, Malay and Indian ethnicity had increased risk of hypertension (odds ratio [OR]: 1.51 [95% confidence interval [CI]: 1.19-1.92, p < .001]), BMI Class 4 (OR: 17.89 [95% CI: 9.53-33.60, p < .001]) and major depression (OR: 1.71 [95% CI: 1.23-2.39, p = .002]), respectively. Factors associated with major depression (gender, ethnicity, age, obstructive sleep apnoea, Physical Component Score and Mental Component Score scores) were used to create and validate a novel scoring system with an area under curve of 0.812 (95% CI: 0.787-0.837). A cutoff of 4 of 7 points was identified with a sensitivity of 70%, specificity of 81%, positive predictive of 53% and negative predictive value of 90%.</p><p><strong>Conclusion: </strong>The prevalence of metabolic complications from obesity significantly varies with ethnicity. We developed a novel and simple scoring tool combining objective demographic and patient-reported outcomes to screen and triage patients at risk of major depression.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":" ","pages":"e12707"},"PeriodicalIF":2.2,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544124","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":"Fructose restriction has beneficial effects on adipose tissue distribution but not on serum adipokine levels: Post-hoc analysis of a double-blind randomized controlled trial.","authors":"Michelle A J van Oeteren, Nynke Simons, Pomme I H G Simons, Marjo P H van de Waarenburg, M Eline Kooi, Edith J M Feskens, E M C Liesbeth van der Ploeg, Mathias D G Van den Eynde, Alfons J H M Houben, Casper G Schalkwijk, Martijn C G J Brouwers","doi":"10.1111/cob.12714","DOIUrl":"https://doi.org/10.1111/cob.12714","url":null,"abstract":"<p><p>We aimed to examine the effects of isocaloric fructose restriction on adipose tissue distribution and serum adipokines. Individuals with BMI >28 kg/m² (n = 44) followed a 6-week fructose-restricted diet and were randomly allocated to (double-blind) oral supplementation with fructose (control) or glucose (intervention) powder three times daily. Visceral (VAT) and subcutaneous (SAT) adipose tissue was quantified with MRI. Serum interleukin 6 and 8, tumour necrosis factor alpha and adiponectin levels were measured with sandwich immunoassay. BMI decreased in both groups, but the change did not differ between groups (-0.1 kg/m², 95%CI: -0.3; 0.5). SAT decreased statistically significantly in the control group (-23.2 cm³, 95%CI: -49.4; -4.1), but not in the intervention group. The change in SAT did not differ between groups (29.6 cm³, 95%CI: -1.2; 61.8). No significant differences in VAT were observed within or between study arms. The VAT/SAT ratio decreased statistically significantly in the intervention group (-0.02, 95%CI: -0.04; -0.003) and the change was significantly different between groups (-0.03, 95%CI: -0.54; -0.003). Serum adipokine levels were not affected by the intervention. This study shows that a fructose-restricted diet resulted in a favourable change in adipose tissue distribution, but did not affect serum adipokines. Further studies are warranted to clarify the underlying mechanisms how fructose affects adipose tissue distribution.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":" ","pages":"e12714"},"PeriodicalIF":2.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521196","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":"Anti-obesity treatment preferences of healthcare providers and people living with obesity: A survey-based study.","authors":"Carel W Le Roux, Anna Koroleva, Sara Larsen, Ellie Foot","doi":"10.1111/cob.12704","DOIUrl":"https://doi.org/10.1111/cob.12704","url":null,"abstract":"<p><p>A cross-sectional, online survey was conducted in the United Kingdom, France, Germany, and the United States (14 November-22 December 2022) to investigate preferences for anti-obesity medication (AOM) among people with obesity (PwO) and healthcare providers (HCPs). Eligibility: Adult PwO who self-defined their body type as overweight/obese, were trying to lose weight and had BMI ≥30.0 or 27.0-29.9 kg/m² with ≥1 obesity-related complication; HCPs had to see ≥30 PwO in a typical month and be a decision-maker regarding their weight loss. The survey included 2500 PwO and 500 HCPs. Exercise (96%) and diet (90%) were the most common weight management methods; AOM use was low (8%). Key barriers to use of prescribed AOMs among PwO were not wanting to take AOM (34%), side effects concerns (33%), and not trusting AOM (26%). Most HCPs (79%) had prescribed/recommended AOMs. Efficacy was the most common reason for preferring one of the shown product profiles among PwO (60%) and HCPs (86%); improving cardiovascular risk was also important to 95% of HCPs when deciding which AOM to prescribe. AOM preference is largely driven by efficacy. Increasing knowledge could help to address barriers to AOM use and improve outcomes for PwO.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":" ","pages":"e12704"},"PeriodicalIF":2.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521195","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":"Comments on: Comparison of fluid and body composition measures in women with lipoedema, lymphoedema, and control participants.","authors":"Henrique Jose Pereira de Godoy, Jose Maria Pereira de Godoy","doi":"10.1111/cob.12713","DOIUrl":"https://doi.org/10.1111/cob.12713","url":null,"abstract":"<p><p>Recently, we read with interest the article 'Comparison of fluid and body composition measures in women with lipoedema, lymphoedema, and control participants' by Stellmaker R, Thompson B, Mackie H, Koelmeyer L. Clin Obes. 2024:e12658, is very important study, but some considerations are necessary.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":" ","pages":"e12713"},"PeriodicalIF":2.2,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496323","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":"Gamma-glutamyl transferase: A potential biomarker for pancreas steatosis in patients with concurrent obesity, insulin resistance and metabolic dysfunction-associated steatotic liver disease.","authors":"Chileka Chiyanika, Elizabeth Shumbayawonda, Michele Pansini, Kin Hung Liu, Terry Cheuk-Fung Yip, Vincent Wai-Sun Wong, Winnie Chiu Wing Chu","doi":"10.1111/cob.12712","DOIUrl":"10.1111/cob.12712","url":null,"abstract":"<p><p>To evaluate the relationship between serum gamma-glutamyl transferase (GGT) levels and fatty pancreas in subjects with concurrent obesity, insulin resistance and metabolic dysfunction-associated steatotic liver disease (MASLD) without a history of pancreatitis. From March 2019 to September 2021, 31 adult subjects with concurrent obesity and MASLD were recruited as part of the study investigating the biological impact of bariatric surgery and lifestyle modification on obesity. Chemical shift encoded MRI of the abdomen, LiverMultiScan, anthropometric, clinical and blood biochemistry analyses were performed prior to any intervention at baseline. GGT (p <.001) was significantly different between those 'with fatty pancreas' and 'without fatty pancreas' groups. GGT (p <.001) was significantly different between those 'with both metabolic syndrome and fatty pancreas' and those 'with metabolic syndrome but without fatty pancreas.' GGT (p <.001) was also significantly different between those 'with both diabetes and fatty pancreas' and those 'with diabetes but without fatty pancreas'. Logistic regression analysis showed that abnormal GGT levels (p = .010) and Hypertension (p = .045) were significant independent predictors of fatty pancreas. GGT was associated with fatty pancreas by an odds ratio 7.333 (95% [CI]: 1.467-36.664), while the AUROC of GGT in determining fatty pancreas was 0.849. Elevation in serum GGT might be a potential marker to identify fatty pancreas.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":" ","pages":"e12712"},"PeriodicalIF":2.2,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459565","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}