Clinical Obesity最新文献_第8页

Alcohol Use After Bariatric Surgery: A Comprehensive Review of Current Knowledge and Research Gaps 减肥手术后的酒精使用：对当前知识和研究差距的全面回顾

IF 2.1

Clinical Obesity Pub Date : 2025-10-28 DOI: 10.1111/cob.70048

Esin Er, Cécile Flahault, Anne-Marie Etienne

{"title":"Alcohol Use After Bariatric Surgery: A Comprehensive Review of Current Knowledge and Research Gaps","authors":"Esin Er, Cécile Flahault, Anne-Marie Etienne","doi":"10.1111/cob.70048","DOIUrl":"10.1111/cob.70048","url":null,"abstract":"<div>\u0000 \u0000 <p>In recent years, there has been increased research on alcohol consumption following bariatric surgery. This review aimed to synthesise existing quantitative research on this topic and identify knowledge gaps in the literature. A comprehensive search was performed across Medline, PsychInfo and Scopus. Studies involving human participants who underwent bariatric surgery and reporting postoperative alcohol consumption were considered. A total of 88 studies were included. Overall, most longitudinal studies found an increased prevalence of problematic alcohol consumption (PAC) post-surgery. Risk factors for postoperative PAC remain poorly understood. Explanatory hypotheses include addiction transfer theory, changes in alcohol pharmacokinetics, and increased rewarding effects of alcohol postoperatively. While the addiction transfer theory lacks empirical support, further research is needed to understand how alterations in alcohol metabolism may lead to problematic consumption in some cases. We found only one study on alcohol's rewarding effects post-surgery. Regarding the consequences of PAC, body weight seems unaffected while alcohol-related hospitalizations, liver disease and mortality post-surgery are all increased. Few studies referred to interventions aiming to prevent or treat PAC postoperatively. In conclusion, while the increase in PAC prevalence after bariatric surgery is well documented, substantial knowledge gaps remain regarding its risk factors, underlying mechanisms, potential consequences and the development of prevention and treatment strategies.</p>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"16 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145387487","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}

引用次数: 0

Removing Barriers to Bariatric Surgery: The Role of Intellectual and Developmental Disabilities on Outcomes in Adolescents and Young Adults 消除减肥手术的障碍：智力和发育障碍在青少年和年轻人预后中的作用。

IF 2.1

Clinical Obesity Pub Date : 2025-10-13 DOI: 10.1111/cob.70047

Fiona Beltran, Alyssa Stetson, Christa Bizimana, Michael Kochis, Cornelia Griggs

{"title":"Removing Barriers to Bariatric Surgery: The Role of Intellectual and Developmental Disabilities on Outcomes in Adolescents and Young Adults","authors":"Fiona Beltran, Alyssa Stetson, Christa Bizimana, Michael Kochis, Cornelia Griggs","doi":"10.1111/cob.70047","DOIUrl":"10.1111/cob.70047","url":null,"abstract":"<div>\u0000 \u0000 <p>Metabolic and bariatric surgery (MBS) is an effective means of achieving weight loss for adolescents and young adults (AYA) with obesity. Intellectual and developmental disabilities (IDD) are not absolute contraindications for MBS treatment in AYA with obesity. We sought to determine whether a diagnosis of IDD is associated with weight loss after MBS. We conducted a retrospective chart review of patients ≤ 21 years who underwent MBS at a single institution, comparing outcomes among those with IDD and those without. A total of 103 patients were included. Nine were diagnosed with IDD preoperatively: two had Autism, two had Down Syndrome and five had unspecified IDD. Preoperative BMI was comparable in patients with IDD and those without. Postoperative weight loss was equivalent between AYA with and without IDD at 12 (24.7% vs. 28.9%), 24 (30.9% vs. 25.1%) and 36 months (25.3% vs. 20.8%). At 12 months, four non-IDD patients were deficient in B1, B12 or iron, while no patients with IDD were deficient in any micronutrients. AYA patients with IDD may derive equal weight loss benefit from MBS with comparable micronutrient status. Barriers to MBS in AYA with IDD need to be addressed to expand obesity treatment.</p>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"16 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285793","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}

引用次数: 0

Early Weight Loss and Other Factors Associated With Clinically Significant Weight Loss in Two Commercial Weight Loss Programmes 在两个商业减肥计划中早期体重减轻和其他与临床显著体重减轻相关的因素。

IF 2.1

Clinical Obesity Pub Date : 2025-10-11 DOI: 10.1111/cob.70046

Christopher D. Coleman, Jessica R. Kiel, Orsolya M. Palacios, Marjorie Bell, Meredith L. Wilcox, Kevin C. Maki, Jessica L. Unick, Satya S. Jonnalagadda

{"title":"Early Weight Loss and Other Factors Associated With Clinically Significant Weight Loss in Two Commercial Weight Loss Programmes","authors":"Christopher D. Coleman, Jessica R. Kiel, Orsolya M. Palacios, Marjorie Bell, Meredith L. Wilcox, Kevin C. Maki, Jessica L. Unick, Satya S. Jonnalagadda","doi":"10.1111/cob.70046","DOIUrl":"10.1111/cob.70046","url":null,"abstract":"<p>This secondary analysis assessed potential factors associated with achieving ≥ 5% or ≥ 10% weight loss among adults in a clinical trial evaluating two commercial weight loss programmes. Participants [<i>n</i> = 124, 45.7 (13.1) years, 20.2% male, BMI 34.4 (3.4) kg/m<sup>2</sup>] were randomised to the Medifast or OPTAVIA weight loss programme, both of which included meal replacements and behavioural support. Multivariable logistic regression analyses were used to assess early weight loss thresholds (percent weight loss at 2 and 4 weeks) and potential demographic, anthropometric, behavioural, and lifestyle factors associated with ≥ 5% or ≥ 10% weight loss at 16 weeks. Age, education, ≥ 1% weight loss by Week 2, ≥ 2% weight loss by Week 4, number of support contacts and programme adherence through Week 4 were significantly (<i>p</i> < 0.05) associated with achieving ≥ 5% weight loss. Participants losing ≥ 2% by Week 4 had 24.6 (95% CI: 2.49, 243) times greater odds of losing ≥ 5% by Week 16. For ≥ 10% weight loss at 16 weeks, positive factors associated included age, assignment to the OPTAVIA programme, ≥ 3% weight loss by Week 4 and programme adherence through Week 4 (<i>p</i> < 0.05). Participants losing ≥ 3% by Week 4 had 19.4 (95% CI: 2.02, 186) times greater odds of losing ≥ 10%. While several variables were significantly associated with achieving clinically significant weight loss, 4-week weight loss was strongest. These results may be useful for early identification of individuals at risk for failing to achieve clinically significant weight loss who may benefit from intensification of counselling to assist in attaining weight loss goals.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"16 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12705255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274144","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}

引用次数: 0

Variation in the Commissioning of Semaglutide for the Treatment of Obesity and Overweight Across England: Results of Three Freedom of Information-Based Mapping Exercises Across the 42 Integrated Care Boards of England 西马鲁肽在整个英格兰治疗肥胖和超重的调试差异：英格兰42个综合护理委员会的三个基于信息的自由测绘练习的结果。

IF 2.1

Clinical Obesity Pub Date : 2025-09-11 DOI: 10.1111/cob.70044

Anne de Bray, Hanna Schnitzer, Elisabeth Mahase, Puspha Singh, Rob Andrews, Barbara M. McGowan, Sarah Le Brocq, John P. H. Wilding, Stuart W. Flint, Jonathan M. Hazlehurst

{"title":"Variation in the Commissioning of Semaglutide for the Treatment of Obesity and Overweight Across England: Results of Three Freedom of Information-Based Mapping Exercises Across the 42 Integrated Care Boards of England","authors":"Anne de Bray, Hanna Schnitzer, Elisabeth Mahase, Puspha Singh, Rob Andrews, Barbara M. McGowan, Sarah Le Brocq, John P. H. Wilding, Stuart W. Flint, Jonathan M. Hazlehurst","doi":"10.1111/cob.70044","DOIUrl":"10.1111/cob.70044","url":null,"abstract":"<p>Obesity medications are recommended in England with legislation necessitating their availability. However, given the number of people who meet clinically approved eligibility criteria, funding these medications and associated support services may limit efficacy at a population health level. This study aimed to assess the commissioning and availability of services and obesity medications across England. Three sets of freedom of information requests were sent to the 42 ICBs in England by Sky News Ltd, The BMJ and the study investigators of this work with questions focused on commissioning of services and medication eligibility and prescription across England. The three data sets were combined to provide a narrative description to inform further development in obesity care. The availability of services across England was partial, and when services did exist, medication access was limited by funding and more restrictive eligibility criteria beyond those approved by the National Institute of Health and Care Excellence. Subsequently, very few patients receive NHS prescriptions even in areas where funding medications are reportedly available. The capacity of services to offer comprehensive care for patients to receive obesity medications is insufficient to meet current demand. Despite legislation for the delivery of obesity medications, these treatment options are not widely available on the NHS. There is insufficient service capacity to provide comprehensive care for eligible patients seeking obesity medications as a treatment option.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"16 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12705252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032817","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}

引用次数: 0

Beyond BMI: Practical Guide for Clinicians to Integrate the Lancet Commission's Obesity Framework and King's Obesity Staging System 超越BMI：临床医生整合柳叶刀委员会肥胖框架和国王肥胖分期系统的实用指南。

IF 2.1

Clinical Obesity Pub Date : 2025-09-09 DOI: 10.1111/cob.70045

Tak Ying Louise Ko, Alexander D. Miras, Dimitri J. Pournaras, Carel W. Le Roux

引用次数: 0

Measuring and Managing Obesity in Pregnancy Using the Edmonton Obesity Staging System: A Scoping Review 使用埃德蒙顿肥胖分期系统测量和管理妊娠期肥胖：范围综述。

IF 2.1

Clinical Obesity Pub Date : 2025-08-28 DOI: 10.1111/cob.70043

Taniya S. Nagpal, Jordyn M. Cox, Ximena Ramos Salas, Kristi B. Adamo

{"title":"Measuring and Managing Obesity in Pregnancy Using the Edmonton Obesity Staging System: A Scoping Review","authors":"Taniya S. Nagpal, Jordyn M. Cox, Ximena Ramos Salas, Kristi B. Adamo","doi":"10.1111/cob.70043","DOIUrl":"10.1111/cob.70043","url":null,"abstract":"<p>Emerging evidence and clinical practice guidelines have highlighted that obesity, defined as a chronic disease characterised by excess or dysfunctional adipose tissue, may not be accurately measured or understood by solely relying on body mass index (BMI) which is a measure of size not functionality. An alternative to BMI, as proposed in the Canadian Adult Obesity Management Guideline, is the use of the Edmonton Obesity Staging System (EOSS). While the EOSS has been evaluated in both adult and paediatric populations, pregnant individuals remain an underrepresented clinical group in its application. Prenatal care relies on BMI for measurement of maternal obesity; however, the EOSS may be an adjunct or alternative method to consider. This scoping review aimed to summarise previous research on EOSS in pregnancy and to advise future directions. Only three cohort studies were identified, emphasising a critical gap in obesity research. Both BMI and higher EOSS stages (i.e., 3 and 4) were associated with prenatal complications (e.g., preeclampsia, venous thromboembolism, wound complications). Given that EOSS has been used in other populations and is noted to be an effective patient-centred tool to diagnose and manage obesity, future work may explore its use in pregnancy both in comparison to and in conjunction with BMI.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"16 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12705254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945120","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}

引用次数: 0

Severe Alcohol-Related Liver Disease Following Bariatric Surgery 减肥手术后的严重酒精相关性肝病

IF 2.1

Clinical Obesity Pub Date : 2025-08-20 DOI: 10.1111/cob.70041

Ahmed Ibrahim, Don C. Rockey

{"title":"Severe Alcohol-Related Liver Disease Following Bariatric Surgery","authors":"Ahmed Ibrahim, Don C. Rockey","doi":"10.1111/cob.70041","DOIUrl":"10.1111/cob.70041","url":null,"abstract":"<div>\u0000 \u0000 <p>Given the potential for more rapid ethanol absorption in patients who have undergone bariatric surgery, we hypothesized that bariatric surgery is associated with risk for more severe alcohol-related liver disease. Therefore, patients ≥ 18 years with alcohol use disorder (AUD) after bariatric surgery were examined using TriNetX (2010–2024). Propensity score matching (PSM) was used to compare patients with AUD following surgery to those with AUD without surgery. Primary outcomes included the likelihood of developing alcohol-associated hepatitis, cirrhosis, or any clinical decompensation event. All-cause mortality was a secondary outcome. Of 2 241 137 patients with AUD, 15 808 patients had AUD following bariatric surgery. Before PSM, patients undergoing surgery were generally older, predominantly female, with a higher body mass index (BMI) than those with AUD without surgery. After PSM, each cohort had 15 808 patients (mean [SD] age, 51 [13] years; 70% women). Patients with AUD following bariatric surgery had increased odds of acute alcohol-associated hepatitis (OR = 1.67, 95% CI: 1.51–1.85; <i>p</i> < 0.001), alcohol-associated cirrhosis (OR = 1.49, 95% CI: 1.37–1.52; <i>p</i> < 0.001), liver-related decompensation events (OR = 1.51, 95% CI: 1.39–1.64; <i>p</i> < 0.001) and all-cause mortality (OR = 1.13, 95% CI: 1.07–1.20; <i>p</i> < 0.001) than those with AUD without surgery. The data suggest an increased risk of severe alcohol-related liver disease in patients with AUD subsequent to bariatric surgery.</p>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"15 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945129","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}

引用次数: 0

A Review of the Management of Obesity in Primary Care 肥胖症在初级保健中的管理综述。

IF 2.1

Clinical Obesity Pub Date : 2025-08-20 DOI: 10.1111/cob.70040

H. M. Parretti, S. E. Erskine, K. D. Coulman, R. Mears, K. Clare, K. Williamson, R. Watkins, C. A. Hughes

{"title":"A Review of the Management of Obesity in Primary Care","authors":"H. M. Parretti, S. E. Erskine, K. D. Coulman, R. Mears, K. Clare, K. Williamson, R. Watkins, C. A. Hughes","doi":"10.1111/cob.70040","DOIUrl":"10.1111/cob.70040","url":null,"abstract":"<p>This review highlights the important role primary care plays in obesity management, using England as an example. It includes a comprehensive summary of current management and referral options for primary care clinicians, a discussion of the most up-to-date clinical guidelines for the use of GLP-1 receptor agonists in England, and the evolving ways in which obesity is identified and defined. Reflections from people living with obesity are considered. Despite the potential of primary care to engage with patients regarding obesity prevention and treatment, several factors have limited this, including low prioritisation by clinicians, workload pressures, regional variations in services, insufficient specialist training and ongoing weight stigma. The introduction of new pharmacotherapies, such as GLP-1 receptor agonists, offers both an opportunity and a challenge for primary care providers. These treatments could help patients access more effective obesity management strategies via primary care. However, there is concern about non-specialist clinicians keeping up to date with evolving strategies and understanding how new medications fit into broader care. The current complex referral pathways hinder timely access to appropriate treatment. The need for more straightforward pathways, improved clinician education and a reduction in the stigma associated with obesity is critical for better outcomes. In summary, while primary care could play a pivotal role in addressing obesity, several issues need to be resolved for this potential to be fully realised. Addressing these challenges, via enhancing clinician training, improving referral pathways and ensuring access to new treatments, will be crucial for advancing the care of people living with obesity.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"16 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12705257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882286","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}

引用次数: 0

Effect of Tirzepatide on the Risk of Developing Type 2 Diabetes Mellitus Among the People Living With Obesity or Overweight: A Systematic Review 替西肽对肥胖或超重人群发生2型糖尿病风险的影响：一项系统综述

IF 2.1

Clinical Obesity Pub Date : 2025-08-20 DOI: 10.1111/cob.70042

Geeta Pardeshi, Uddhav T. Kumbhar, Mogan Kaviprawin, Aninda Debnath, Ashok Kumar Dubey, Kalyani Deshmukh, Chanchal Goyal, Aravind P. Gandhi

{"title":"Effect of Tirzepatide on the Risk of Developing Type 2 Diabetes Mellitus Among the People Living With Obesity or Overweight: A Systematic Review","authors":"Geeta Pardeshi, Uddhav T. Kumbhar, Mogan Kaviprawin, Aninda Debnath, Ashok Kumar Dubey, Kalyani Deshmukh, Chanchal Goyal, Aravind P. Gandhi","doi":"10.1111/cob.70042","DOIUrl":"10.1111/cob.70042","url":null,"abstract":"<div>\u0000 \u0000 <p>Tirzepatide provides superior efficacy in weight reduction and metabolic control compared to existing therapies. The present systematic review assessed the effect of Tirzepatide on the risk of developing type 2 diabetes mellitus (T2DM) among people living with obesity or overweight. Six major databases [MEDLINE (PubMed), ClinicalTrials.gov, EMBASE, Scopus, Web of Science and Cochrane Library] were searched for potential studies published till 10 July 2025. Two-stage dual screening with third-person adjudication was adopted for screening of studies. PROSPERO ID: CRD42024614466. RoB 2.0 and the Newcastle-Ottawa Scale were used to assess the quality of randomised controlled trials (RCTs) and cohort studies, respectively. Database search yielded 2601 studies, among which three studies were eligible (one RCT and two cohort studies) for systematic review. The hazard ratio (HR) for the new-onset diabetes at 12 months following the Tirzepatide intake was significantly lower than that of the Semaglutide group of patients (HR = 0.73, <i>p</i> < 0.001 [95% CI: 0.58–0.92]). The risk of the new-onset diabetes for 176 weeks (HR = 0.07, <i>p</i> < 0.001 [95% CI: < 0.01–0.1]) and 193 weeks (HR = 0.12, <i>p</i> < 0.001 [95% CI: 0.1–0.2]) following the Tirzepatide intake was significantly lower than that of the placebo group of patients. Tirzepatide might have significant efficacy in the prevention of T2DM in patients with obesity or overweight.</p>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"16 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945153","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}

引用次数: 0

Commissioning of Tier 3 Obesity Services by Integrated Care Boards in England: An Analysis of Responses to Freedom of Information Requests 英国综合护理委员会对三级肥胖服务的委托：对信息自由要求的回应分析。

IF 2.1

Clinical Obesity Pub Date : 2025-08-14 DOI: 10.1111/cob.70038

Nicholas Finer, Nikolaos Fragkas, Alexander Dimitri Miras, Sarah Le Brocq, Dimitri J. Pournaras, John Wass, Cecilia Pyper

{"title":"Commissioning of Tier 3 Obesity Services by Integrated Care Boards in England: An Analysis of Responses to Freedom of Information Requests","authors":"Nicholas Finer, Nikolaos Fragkas, Alexander Dimitri Miras, Sarah Le Brocq, Dimitri J. Pournaras, John Wass, Cecilia Pyper","doi":"10.1111/cob.70038","DOIUrl":"10.1111/cob.70038","url":null,"abstract":"<div>\u0000 \u0000 <p>This research surveyed Tier 3 (specialist, multidisciplinary) adult weight management services in England commissioned for the National Health Service (NHS) by Integrated Care Boards (ICBs) across England in financial year 2022–2023. A survey of public health services commissioned by ICBs gathered via freedom of information requests. All 42 ICBs in England surveyed between September and December 2023. Outcome measures were: whether or not there was Tier 3 provision, the type of Tier 3 services provided, the estimated number of patients referred and treated, and the relation of referral rates to measures of deprivation. We had a 100% response rate; five reported no Tier 3 provision. Using regional data and estimates of eligibility for referral to Tier 3 management, only 0%–1.1% of those eligible were referred. Referral rates exclusively to Tier 3 services showed no correlation with the Index of Multiple Deprivation IMD (<i>R</i>\u0000 <sup>2</sup> = 0.27; <i>p</i> = 0.21). Four services commissioned appeared not to meet the definition of a Tier 3 service. Provision of Tier 3 services in England is inadequate and variable and currently fails to meet the needs of the population. Many areas with high levels of deprivation provide the most limited access. Even where commissioned, some services do not meet commissioning guidelines. Action is required to implement Health Service Policy and to ensure obesity services conform with clinical need and national guidelines.</p>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"15 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854760","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}

引用次数: 0