Clinical Obesity最新文献

{"title":"Quantifying assumptions underlying peak oxygen consumption equations across the body mass spectrum","authors":"Vincent Busque,&nbsp;Jeffrey W. Christle,&nbsp;Kegan J. Moneghetti,&nbsp;Nicholas Cauwenberghs,&nbsp;Tatiana Kouznetsova,&nbsp;Yair Blumberg,&nbsp;Matthew T. Wheeler,&nbsp;Euan Ashley,&nbsp;Francois Haddad,&nbsp;Jonathan Myers","doi":"10.1111/cob.12653","DOIUrl":"10.1111/cob.12653","url":null,"abstract":"<div>\u0000 \u0000 <p>The goal of this study is to quantify the assumptions associated with the Wasserman-Hansen (WH) and Fitness Registry and the Importance of Exercise: A National Database (FRIEND) predictive peak oxygen consumption (pVO₂) equations across body mass index (BMI). Assumptions in pVO₂ for both equations were first determined using a simulation and then evaluated using exercise data from the Stanford Exercise Testing registry. We calculated percent-predicted VO₂ (ppVO₂) values for both equations and compared them using the Bland–Altman method. Assumptions associated with pVO₂ across BMI categories were quantified by comparing the slopes of age-adjusted VO₂ ratios (pVO₂/pre-exercise VO₂) and ppVO₂ values for different BMI categories. The simulation revealed lower predicted fitness among adults with obesity using the FRIEND equation compared to the WH equations. In the clinical cohort, we evaluated 2471 patients (56.9% male, 22% with BMI &gt;30 kg/m², pVO₂ 26.8 mlO₂/kg/min). The Bland–Altman plot revealed an average relative difference of −1.7% (95% CI: −2.1 to −1.2%) between WH and FRIEND ppVO₂ values with greater differences among those with obesity. Analysis of the VO₂ ratio to ppVO₂ slopes across the BMI spectrum confirmed the assumption of lower fitness in those with obesity, and this trend was more pronounced using the FRIEND equation. Peak VO₂ estimations between the WH and FRIEND equations differed significantly among individuals with obesity. The FRIEND equation resulted in a greater attributable reduction in pVO₂ associated with obesity relative to the WH equations. The outlined relationships between BMI and predicted VO₂ may better inform the clinical interpretation of ppVO₂ values during cardiopulmonary exercise test evaluations.</p>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"14 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140109537","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":"Liraglutide 3.0 mg in the treatment of adults with obesity and prediabetes using real-world UK data: A clinical evaluation of a multi-ethnic population","authors":"Laurence J. Dobbie,&nbsp;Claudia Coelho,&nbsp;Farah Mgaieth,&nbsp;Keisha Chauhan,&nbsp;Scott Campbell,&nbsp;Sumaya Shuriye,&nbsp;Joanna Hollington,&nbsp;Sarah Appleton,&nbsp;Piya Sen Gupta,&nbsp;Alastair Duncan,&nbsp;Barbara McGowan","doi":"10.1111/cob.12649","DOIUrl":"10.1111/cob.12649","url":null,"abstract":"<p>UK guidelines recommend liraglutide 3.0 mg in adults treated within specialist weight management services with BMI ≥35 kg/m², prediabetes and high cardiovascular disease risk. We aimed to clinically evaluate liraglutide 3.0 mg in specialist weight management services. We evaluated liraglutide 3.0 mg in weight management services at Guys and St Thomas' NHS Foundation Trust. Objective body weight (BW) was measured at baseline and 4 months, allowing classification as ‘responders’ (≥5% BW reduction) and ‘non-responders’ (&lt;5% BW reduction). One hundred and twenty-one patients were evaluated. At 4 months, 76.0% attended follow-up (82.6% responders, 17.4% non-responders); BW (−8.6 kg, 95%CI:-9.8, −7.4 kg), BMI (−3.2 kg/m², 95%CI: −3.6, −2.8) and %-BW (−6.6%, IQR: −8.8%, −5.2%) significantly reduced. In responders, HbA1c reduced by −5.0 mmol/mol (IQR: −7.0. −4.0 mmol/mol). In responders BW continued to reduce up to 12 months (4 m: −10.2 kg, <i>p</i> &lt; .0001; 6 m: −15.6 kg, <i>p</i> &lt; .0001; 9 m: −16.5 kg, <i>p</i> &lt; .0001; 12 m: −16.7 kg, <i>p</i> &lt; .01). Those of Black African and Caribbean ethnicity experienced less BW loss than those of white ethnicity (4.12 kg, <i>p</i> = .017) and had a greater attrition rate. In adults with obesity and prediabetes who are treated within specialist weight management services, liraglutide 3.0 mg reduces BW and HbA1c. Those of Black African and Caribbean ethnicity experienced less BW reduction and greater attrition at 4 months. Further evaluation of the ethnic differences in response to obesity pharmacotherapy is required.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"14 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cob.12649","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140027532","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":"Is the NHS low-calorie diet programme delivered as planned? An observational study examining adherence of intervention delivery to service specification","authors":"Jordan Marwood,&nbsp;Karina Kinsella,&nbsp;Catherine Homer,&nbsp;Kevin J. Drew,&nbsp;Tamara Brown,&nbsp;Tamla S. Evans,&nbsp;Pooja Dhir,&nbsp;Charlotte Freeman,&nbsp;Susan Jones,&nbsp;Chirag Bakhai,&nbsp;Louisa J. Ells","doi":"10.1111/cob.12652","DOIUrl":"10.1111/cob.12652","url":null,"abstract":"<p>Obesity and Type 2 Diabetes Mellitus (T2DM) are chronic conditions with significant personal, societal, and economic impacts. Expanding on existing trial evidence, the NHS piloted a 52-week low-calorie diet programme for T2DM, delivered by private providers using total diet replacement products and behaviour change support. This study aimed to determine the extent to which providers and coaches adhered to the service specification outlined by NHS England. An observational qualitative study was conducted to examine the delivery of both one-to-one and group-based delivery of programme sessions. Observations of 122 sessions across eight programme delivery samples and two service providers were completed. Adherence to the service specification was stronger for those outcomes that were easily measurable, such as weight and blood glucose, while less tangible elements of the specification, such as empowering service users, and person-centred delivery were less consistently observed. One-to-one sessions were more successful in their person-centred delivery, and the skills of the coaches delivering the sessions had a strong impact on adherence to the specification. Overall, the results show that there was variability by provider and delivery mode in the extent to which sessions of the NHS Low-Calorie Diet Programme reflected the intended service specification. In subsequent programmes it is recommended that one-to-one sessions are used, with accompanying peer support, and that providers improve standardised training and quality assurance to ensure specification adherence.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"14 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cob.12652","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140012346","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 need for standardized perioperative care for patients undergoing bariatric and metabolic surgery in the United Kingdom","authors":"Shiela Lee,&nbsp;Michael Courtney","doi":"10.1111/cob.12650","DOIUrl":"10.1111/cob.12650","url":null,"abstract":"<div>\u0000 \u0000 <p>Enhanced recovery after surgery (ERAS) protocols are shown to improve patient outcomes and reduce length of hospital stay. However, there is currently limited consensus on the perioperative management of patients undergoing bariatric and metabolic surgery (BMS) in the United Kingdom. This study aims to survey the level of consistency in patient care undergoing BMS. Bariatric nurse specialists from 30 bariatric units completed an anonymised, online survey from 21 December 2022 to 21 February 2023. Most units (77%) have implemented a premade postoperative care bundle protocol including predetermined timing of oral intake (77%) and postoperative day 1 bloods (60%). 63% of units have also established pre-set analgesia and anti-emetic bundles. Date of discharge is variable, ranging from 1 day after surgery (50%) to a ‘two night stay’ protocol (33%) to within 4 days after surgery (17%). Most follow-up clinics are either led by dietitians (33%) or both bariatric nurse specialists and dietitians collaboratively (57%). Patients are usually established on solid food 6 weeks after surgery in 53% (16/30) units. Chemical venous thromboembolism (VTE) prophylaxis was either given on day of surgery postoperatively (60%), day before (20%) or after (17%) surgery. Our study shows significant variability of care throughout the surgical pathway, in the study population. The results suggest a need for consensus guidelines outlining the best-practice approach to managing patients undergoing BMS; due to the heterogeneity of the patient group, these guidelines should contain overarching generalisable recommendations that can then be tailored to individual patients.</p>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"14 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139995795","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":"Obstructive sleep apnoea in obesity: A review","authors":"Jian E. Tai,&nbsp;Craig L. Phillips,&nbsp;Brendon J. Yee,&nbsp;Ronald R. Grunstein","doi":"10.1111/cob.12651","DOIUrl":"10.1111/cob.12651","url":null,"abstract":"<p>Obstructive sleep apnea is a common comorbidity that occurs in individuals with obesity. It classically manifests with excessive daytime sleepiness, resulting in reduced quality of life, workplace productivity, and an increased risk of motor vehicle accidents. Weight gain plays an important role in its pathogenesis through worsening upper airway collapsibility, and current treatment options are targeted towards mechanically overcoming upper airway obstruction and weight loss. Continuous positive airway pressure therapy remains the most widely prescribed treatment for obstructive sleep apnea but poor tolerance is a common barrier to effective treatment. Sustainable weight loss is an important treatment option but can be difficult to achieve without bariatric surgery. The recent advances in incretin-based pharmacotherapies represent a promising avenue not only in achieving long-term weight loss but also in treating obstructive sleep apnoea and alleviating the burden of its symptoms and comorbidities.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"14 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cob.12651","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139989533","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":"Treatment of childhood obesity based on the reduction of ultra-processed foods plus energy restriction: A randomised controlled trial based on the Brazilian guidelines","authors":"Joana Maia Brandão,&nbsp;Rosely Sichieri,&nbsp;Vitor Barreto Paravidino,&nbsp;Simone Augusta Ribas,&nbsp;Diana Barbosa Cunha","doi":"10.1111/cob.12648","DOIUrl":"10.1111/cob.12648","url":null,"abstract":"<div>\u0000 \u0000 <p>Reducing ultra-processed foods (UPF) improves diet quality and may curb energy consumption. This study aimed to compare an intervention based on the reduction of UPF, according to the Dietary Guideline for the Brazilian Population (DGBP), with and without advice on energy intake. A parallel and randomised controlled trial was carried out with children with obesity from 7 to 12 years old. Both control (CG) and intervention groups (IG) participated monthly in 6 standardised educational activities based on the 10 steps of the DGBP. An individualised food plan was also provided to the IG. The rate of change for body mass index (BMI), waist circumference, body weight, and UPF consumption were investigated based on mixed-effect models. At the end of the study, the BMI declined in the IG (Δ = −0.27 kg/m²) compared to the CG (Δ = + 0.53 kg/m²) (<i>p</i> = .0002). Both groups showed a decline in grams of UPF until the fourth month and a gradual increase in the following months. Combining the qualitative approach of the DGBP with counselling on energy restriction through the diet plan proved to be effective in reducing childhood obesity. <b>Clinical Trial Registration</b>: This trial is registered at the Brazilian Registry of Clinical Trials (REBEC), under the RBR-3st5sn registry, available at http://www.ensaiosclinicos.gov.br/rg/RBR-3st5sn/. The datasets generated by the current study are not publicly available but are available from the corresponding author on reasonable request.</p>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"14 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139939799","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":"Correlation between neck circumference and hepatic steatosis determined by controlled attenuation parameter","authors":"Sakkarin Chirapongsathorn,&nbsp;Pakapop Jinatongthai,&nbsp;Sudatip Sirichana,&nbsp;Apussanee Boonyavarakul,&nbsp;Sombat Treeprasertsuk,&nbsp;Nakarin Sansanayudh","doi":"10.1111/cob.12647","DOIUrl":"10.1111/cob.12647","url":null,"abstract":"<div>\u0000 \u0000 <p>Neck circumference is an attractive method for determining metabolic profiles and has many advantages over waist circumference. However, the correlation between neck circumference and hepatic fibrosis has not been evaluated. The aim of this study was to evaluate the correlation between neck circumference and hepatic fibrosis and define the optimal cut-off point for neck circumference to determine hepatic fibrosis. A cross-sectional study (<i>n</i> = 333) was conducted among Thai healthcare workers at Phramongkutklao Hospital who received an annual health maintenance program. Neck circumference was measured at the lower margin of the laryngeal prominence. Fibroscan® with a controlled attenuation parameter was used to measure the degree of hepatic fibrosis and steatosis by an experienced, well-trained operator. In the cross-sectional analysis, it was found that the large circumference of the neck was associated with hepatic fibrosis (<i>r</i> = 0.19, <i>p</i> = .001) and hepatic steatosis (<i>r</i> = 0.58, <i>p</i> &lt; .001). Hepatic fibrosis (<i>r</i> = 0.15, <i>p</i> = .004) and steatosis (<i>r</i> = 0.53, <i>p</i> &lt; .001) were also associated with waist circumference. The neck circumferences of 40 and 34 cm were the best cut-offs for male and female participants, respectively.Neck circumference is closely related to hepatic fibrosis and steatosis, which should be promoted and has a better advantage than waist circumference in the screening of hepatic steatosis.</p>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"14 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139740580","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":"Impact of COVID-19 pandemic on sleep parameters and characteristics in individuals living with overweight and obesity","authors":"Stephen A. Glazer,&nbsp;Michael Vallis","doi":"10.1111/cob.12646","DOIUrl":"10.1111/cob.12646","url":null,"abstract":"<div>\u0000 \u0000 <p>Coronavirus disease 2019 (COVID-19) has been very challenging for those living with overweight and obesity. The magnitude of this impact on sleep requires further attention to optimise patient care and outcomes. This study assessed the impact of the COVID-19 lockdown on sleep duration and quality as well as identify predictors of poor sleep quality in individuals with reported diagnoses of obstructive sleep apnoea and those without sleep apnoea. An online survey (June–October 2020) was conducted with two samples; one representative of Canadians living with overweight and obesity (<i>n</i> = 1089) and a second of individuals recruited through obesity clinical services or patient organisations (<i>n</i> = 980). While overall sleep duration did not decline much, there were identifiable groups with reduced or increased sleep. Those with changed sleep habits, especially reduced sleep, had much poorer sleep quality, were younger, gained more weight and were more likely to be female. Poor sleep quality was associated with medical, social and eating concerns as well as mood disturbance. Those with sleep apnoea had poorer quality sleep although this was offset to some degree by use of CPAP. Sleep quality and quantity has been significantly impacted during the early part of the COVID-19 pandemic in those living with overweight and obesity. Predictors of poor sleep and the impact of sleep apnoea with and without CPAP therapy on sleep parameters has been evaluated. Identifying those at increased risk of sleep alterations and its impact requires further clinical consideration.</p>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"14 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139721900","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 double burden: Navigating type 1 diabetes and obesity","authors":"Nele Steenackers,&nbsp;Alix Nessa Feldman,&nbsp;Chantal Mathieu,&nbsp;Jonathan Rosen,&nbsp;Jeannette Soderberg,&nbsp;Ebaa Al-Ozairi,&nbsp;Carel W. le Roux,&nbsp;Bart Van der Schueren","doi":"10.1111/cob.12645","DOIUrl":"10.1111/cob.12645","url":null,"abstract":"","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"14 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139706231","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":"ACTION APAC: Understanding perceptions, attitudes and behaviours in obesity and its management across south and Southeast Asia","authors":"Kwang Wei Tham,&nbsp;Asma Ahmed,&nbsp;Apussanee Boonyavarakul,&nbsp;Mariana Mercado Garcia,&nbsp;Miroslava Guajardo,&nbsp;Zubaidah Nor Hanipah,&nbsp;Tran Quang Nam,&nbsp;Nemencio A. Nicodemus Jr.,&nbsp;Faruque Pathan,&nbsp;Jack Garcia Uranga Romano,&nbsp;Sidartawan Soegonda,&nbsp;Edgardo L. Tolentino Jr.,&nbsp;Ambika Gopalakrishnan (A. G). Unnikrishnan,&nbsp;Brian J. Oldfield","doi":"10.1111/cob.12644","DOIUrl":"10.1111/cob.12644","url":null,"abstract":"<p>To identify perceptions and attitudes among people with obesity (PwO) and healthcare professionals (HCPs) toward obesity and its management in nine Asia-Pacific (APAC) countries, a cross-sectional online survey was conducted among adult PwO with self-reported body mass index of ≥25 kg/m² (≥27 kg/m², Singapore), and HCPs involved in direct patient care. In total, 10 429 PwO and 1901 HCPs completed the survey. Most PwO (68%) and HCPs (84%) agreed that obesity is a disease; however, a significant proportion of PwO (63%) and HCPs (41%) believed weight loss was the complete responsibility of PwO and only 43% of PwO discussed weight with an HCP in the prior 5 years. Most respondents acknowledged that weight loss would be extremely beneficial to PwO's overall health (PwO 76%, HCPs 85%), although nearly half (45%) of PwO misperceived themselves as overweight or of normal weight. Obesity was perceived by PwO (58%) and HCPs (53%) to negatively impact PwO forming romantic relationships. HCPs cited PwOs' lack of interest (41%) and poor motivation (37%) to lose weight as top reasons for not discussing weight. Most PwO (65%) preferred lifestyle changes over medications to lose weight. PwO and HCPs agreed that lack of exercise and unhealthy eating habits were the major barriers to weight loss. Our data highlights a discordance between the understanding of obesity as a disease and the actual behaviour and preferred approaches to manage it among PwO and HCPs. The study addresses a need to align these gaps to deliver optimal care for PwO.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"14 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cob.12644","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139706230","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}