Clinical Obesity最新文献

{"title":"Tier 2 adult weight management services in the UK: A case study evaluation of local authority provision of targeted services for higher-risk groups in England","authors":"Lorraine McSweeney,&nbsp;Charlotte Rothwell,&nbsp;Ashley Adamson,&nbsp;Simon Barrett,&nbsp;Claire Mathews,&nbsp;Scott Lloyd,&nbsp;Mackenzie Fong","doi":"10.1111/cob.12723","DOIUrl":"10.1111/cob.12723","url":null,"abstract":"<p>In 2021, the UK Government announced additional funding in England for Adult Weight Management Services (AWMS); it was specified that the extra funding must be used to commission or extend existing tier 2 services. The Office for Health Improvement and Disparities encouraged commissioners to prioritise services for higher-risk groups such as those with learning disabilities, severe mental illness, people from minority ethnic groups, those living in deprived areas and men. To better understand the findings from previous survey work and to explore the implementation of targeted services in greater depth, we undertook a multiple case study comprising eight tier 2 adult weight management service providers and 35 individual stakeholder interviewees. Using the Consolidated Framework for Implementation Research as an interview guide and in data analysis, we determined key enablers and barriers to successful service provision and programme implementation. Good practice for successful AWMS provision for higher-risk groups includes, having an existing programme in place that can be adapted, ensuring adequate time for programme development/implementation, having good existing networks/partnerships, collaborative working and putting the target group at the heart of any intervention. The findings from this work provide practical recommendations for policy and practice when targeting tier 2 services for higher-risk groups.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"15 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cob.12723","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucocorticoids and HPA axis regulation in the stress–obesity connection: A comprehensive overview of biological, physiological and behavioural dimensions","authors":"Robin Lengton,&nbsp;Myrte Schoenmakers,&nbsp;Brenda W. J. H. Penninx,&nbsp;Mariëtte R. Boon,&nbsp;Elisabeth F. C. van Rossum","doi":"10.1111/cob.12725","DOIUrl":"10.1111/cob.12725","url":null,"abstract":"<p>Chronic stress, characterized by increased long-term exposure to the glucocorticoid hormone cortisol, is increasingly linked to obesity development. Still, various knowledge gaps persist, including on underlying pathophysiological mechanisms. The aim of the current review is to provide the latest insights on the connection between stress and obesity. We discuss three biological stress systems—the autonomic nervous system, the hypothalamus–pituitary–adrenal (HPA) axis and the immune system—and their link with obesity, with a particular focus on the HPA axis. The role of cortisol and its regulatory variations (including glucocorticoid rhythmicity and altered sensitivity) in adipose tissue biology and obesity development is discussed. Moreover, we highlight the physiological, affective, cognitive and behavioural dimensions of the stress response offering a deeper understanding of how stress contributes to obesity development and vice versa. Finally, stress as a treatment target for obesity is discussed. We conclude that the link between stress and obesity is complex and multifaceted, influenced by physiological, affective, cognitive and behavioural stress response mechanisms, which especially when chronically present, play a key role in the development of obesity and associated cardiometabolic diseases. This necessitates integrated approaches tailored to individual needs, including lifestyle modifications, behavioural interventions, psychosocial support and possible additional pharmacological interventions.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"15 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cob.12725","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The real-world relationship between naltrexone/bupropion treatment and weight loss in Canada: A retrospective chart review","authors":"Sean Wharton,&nbsp;Elham Kamran,&nbsp;Lehana Thabane,&nbsp;Peter Yin,&nbsp;Rebecca Christensen","doi":"10.1111/cob.12724","DOIUrl":"10.1111/cob.12724","url":null,"abstract":"<p>This study examined the change in weight at 6 months of naltrexone/bupropion (NB), a combination pharmacological therapy for weight management, in real-world practice in Canada. The study was conducted through an observational, retrospective, single-arm chart review of adult patients who attended the Wharton Medical Clinic in Ontario, Canada, between 2018 and 2021. The patients had a body mass index ≥30 or ≥27 kg/m² with at least one weight-related comorbidity. They were prescribed NB, titrated from 1 (8 mg/90 mg) to 4 tablets daily, along with lifestyle modification. Approximately 52% of 468 participants completed 6 months of treatment and 48.7% titrated to the maximum dose of 4 tablets daily. Participants were mainly female, with mean age of 49.5 years and BMI 38.4 kg/m². After 6 months, participants lost a mean of 4.23 kg (95% confidence interval [CI] −4.99, −3.47) or 4.05% (CI −4.77, −3.34) of body weight, with 42.5% losing at least 5% of their body weight and 15.5% losing at least 10%. The most frequent adverse events were nausea (5.7%), constipation (5.7%), and headache (2.5%). Participants also experienced decreased appetite (14.7%), decreased cravings (13.9%), decreased hunger (9.4%) and felt full sooner (2.5%), which are changes likely to result in sustained healthy food choices and improved quality of life. The 6-month NB treatment adjunct to lifestyle modification in a real-world population resulted in clinically significant weight loss.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"15 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cob.12724","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare utilization associated with obesity management in Ontario, Canada","authors":"Sean Wharton,&nbsp;Adel Belloum,&nbsp;Maria Luckevich,&nbsp;Elham Kamran,&nbsp;Artis Luguzis,&nbsp;Maria Eberg,&nbsp;Atif Kukaswadia,&nbsp;Calum S. Neish,&nbsp;Silvia Capucci,&nbsp;Anette Varbo,&nbsp;Camilla S. Morgen","doi":"10.1111/cob.12720","DOIUrl":"10.1111/cob.12720","url":null,"abstract":"<div>\u0000 \u0000 <p>This study aimed to describe the characteristics, healthcare resources utilized and costs incurred by adults receiving publicly funded obesity care in Ontario, Canada. People living with obesity who first visited Wharton Medical Clinic, a weight and diabetes management clinic in Ontario, between 2015 and 2018 were identified. Pseudoanonymized data were linked to administrative databases to understand healthcare utilization and costs borne by the public payer over 3 years. 6208 participants had linked data, 63.9% and 27.3% of whom remained followed one and two years after their first clinic visit, respectively. The cohort was 71.84% female with a mean (SD) age of 50.86 (13.28) years and BMI of 40.21 (7.06) kg/m². Approximately 25% of participants were prescribed pharmacotherapy (liraglutide, orlistat, naltrexone/bupropion), 4% received psychological therapy and 2% had weight-loss surgery. Common obesity-related complications were hypertension (42.62%), musculoskeletal pain (35.20%) and dyslipidaemia (33.65%). Participants had 22.16 physician visits per person-year in year one, mostly to general practitioners and endocrinologists, which decreased to 17.38 visits per person-year by year three. Mean total costs (excluding privately covered prescriptions) per person-year decreased from $5227.25 (Canadian dollars) (SE: $0.97) to $4982.88 (SE: $2.16) over the same period. Participants were mostly female and presented with obesity-related complications. Although healthcare utilization and costs incurred by the cohort were high, both showed a decreasing trend over the follow-up period.</p>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"15 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708867","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 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,&nbsp;Sarah Mounsey,&nbsp;Rachna Begh,&nbsp;Anisa Hajizadeh,&nbsp;Alice E. Hobson,&nbsp;Paul Doody,&nbsp;Charlotte Albury,&nbsp;Suzanne Mara,&nbsp;Laura Heath,&nbsp;Kayley McPherson,&nbsp;Susan A. Jebb,&nbsp;Paul Aveyard","doi":"10.1111/cob.12718","DOIUrl":"10.1111/cob.12718","url":null,"abstract":"<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":"15 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cob.12718","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"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,&nbsp;Badriya Al-Haddabi,&nbsp;Mostafa Waly,&nbsp;Samir Al-Adawi,&nbsp;Salima Al-Mammari,&nbsp;Ibtesam Al-Ghammari,&nbsp;Saleh Al-Shammakhi,&nbsp;Hanan Al-Azkawi,&nbsp;Atika Khalaf","doi":"10.1111/cob.12719","DOIUrl":"10.1111/cob.12719","url":null,"abstract":"<div>\u0000 \u0000 <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>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"15 2","pages":""},"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,&nbsp;Iain K. Robertson,&nbsp;Sharon P. Luccisano,&nbsp;Michelle L. Kilpatrick","doi":"10.1111/cob.12715","DOIUrl":"10.1111/cob.12715","url":null,"abstract":"<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] &gt;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. <i>Trial registration number</i>: ACTRN12622000240741.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"15 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cob.12715","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving obesity management: Insights from the ACTION Switzerland survey of people with obesity, physicians and dietitians","authors":"Dominique Durrer,&nbsp;Patrick Pasi,&nbsp;Ralph Peterli,&nbsp;Doris Fischer-Taeschler,&nbsp;Gabriela Fontana,&nbsp;Gionata Cavadini,&nbsp;Philipp A. Gerber","doi":"10.1111/cob.12716","DOIUrl":"10.1111/cob.12716","url":null,"abstract":"<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":"15 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cob.12716","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using continuous glucose monitoring (CGM) to understand glucose control in women with obesity during pregnancy","authors":"Sarah A. Price,&nbsp;Alice Lewin,&nbsp;Alison Nankervis,&nbsp;Rahul Barmanray","doi":"10.1111/cob.12717","DOIUrl":"10.1111/cob.12717","url":null,"abstract":"<div>\u0000 \u0000 <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 (<i>n</i> = 19), women with obesity (<i>n</i> = 14) had significantly higher PDMG (<i>p</i> &lt; .001), daytime and nighttime glucose AUC (<i>p</i> &lt; .01) and post-breakfast glucose AUC (<i>p</i> &lt; .001 and <i>p</i> = .043) and post-dinner glucose AUC (<i>p</i> &lt; .001) in early and mid-pregnancy. Mean plasma glucose and post-lunch glucose AUC were only higher in women with obesity in early pregnancy (<i>p</i> = .009 and <i>p</i> &lt; .001, respectively). In mid and late pregnancy, HOMA-IR was significantly higher (<i>p</i> &lt; .05) and QUICKI (<i>p</i> &lt; .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>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"15 2","pages":""},"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,&nbsp;Daryl Kai Ann Chia,&nbsp;Yiong Huak Chan,&nbsp;Eugene Kwong Fei Leong,&nbsp;Ashley Chen,&nbsp;Sharen Asif,&nbsp;Yu An Wong,&nbsp;Javis Fung,&nbsp;Rachel Patricia Johnson,&nbsp;Shefali Jay Poojari,&nbsp;Qamaruzaman Syed Gani,&nbsp;Wen Lin,&nbsp;Shu Ning Wai,&nbsp;Geetha Kayambu,&nbsp;Serene Peiying Lim,&nbsp;Wen Joo Neo,&nbsp;Candice Xin Yi Wee,&nbsp;Davide Lomanto,&nbsp;Guowei Kim,&nbsp;Jimmy Bok Yan So,&nbsp;Asim Shabbir","doi":"10.1111/cob.12707","DOIUrl":"10.1111/cob.12707","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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, <i>p</i> &lt; .001]), BMI Class 4 (OR: 17.89 [95% CI: 9.53–33.60, <i>p</i> &lt; .001]) and major depression (OR: 1.71 [95% CI: 1.23–2.39, <i>p</i> = .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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"15 1","pages":""},"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}