Clinical Obesity最新文献

{"title":"An obesity medicine curriculum increases the obesity care self-efficacy of internal medicine residents in the primary care setting","authors":"Kacey Chae,&nbsp;Jashalynn German,&nbsp;Karla Kendrick,&nbsp;Sean Tackett,&nbsp;Paul O'Rourke,&nbsp;Kimberly A. Gudzune,&nbsp;Marci Laudenslager","doi":"10.1111/cob.12656","DOIUrl":"10.1111/cob.12656","url":null,"abstract":"<div>\u0000 \u0000 <p>Primary care physicians (PCPs) report insufficient knowledge and training gaps in obesity care. Internal Medicine (IM) residency offers an opportunity to address this educational gap for future PCPs. We designed an innovative, multicomponent curriculum on obesity medicine (OM) in the primary care setting for IM residents. We then conducted a prospective, 6-month, two-arm study within two residency programs in Maryland evaluating feasibility (use, appropriateness for IM training, and satisfaction) of the curriculum as well as changes in self-efficacy within seven obesity care domains, assessed on 4-point scales (1—not at all confident to 4—very confident). One residency program received the curriculum and the other served as the control group. We recruited 35 IM residents to participate (17 intervention, 18 control). Among intervention residents, 42% used all curricular components; appropriateness and satisfaction with the curriculum were high. Compared with controls, intervention residents had statistically significant increases in five obesity care self-efficacy domains: nutrition (intervention 0.8 vs. control 0.2, <i>p</i> = .02), behaviour change (1.2 vs. 0.4, <i>p</i> &lt; .01), weight-gain-promoting medications (0.8 vs. 0.1, <i>p</i> = .01), anti-obesity medications (1.2 vs. 0.5, <i>p</i> = .03), and bariatric surgical counselling (0.9 vs. 0.4, <i>p</i> = .03). There were no significant changes in physical activity or post-bariatric surgical care domains. Our OM curriculum is feasible with IM residents and increases residents' obesity care self-efficacy beyond what is achieved with usual IM training.</p>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"14 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140317925","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":"‘My goal was to become normal’—A qualitative investigation of coping with stigma, body image and self-esteem long-term after bariatric surgery","authors":"Linda Jiretorn,&nbsp;My Engström,&nbsp;Cecilia Laursen,&nbsp;Ximena Ramos Salas,&nbsp;Kajsa Järvholm","doi":"10.1111/cob.12657","DOIUrl":"10.1111/cob.12657","url":null,"abstract":"<p>Improved self-esteem and body image, as well as reduced experiences of weight stigma are important patient-reported obesity treatment outcomes. However, more knowledge is needed about how individuals who have undergone metabolic and bariatric surgery (MBS) perceive themselves and their bodies and use different coping strategies in relation to body image and self-esteem long-term after MBS. In this qualitative study body image, self-esteem, weight stigma and coping strategies were explored among 18 individuals who underwent MBS more than 10 years ago when interviewed. Using reflexive thematic analysis, two primary themes were identified: ‘Experiences of living with a stigmatised body’ and ‘Coping with weight stigma, body image and self-esteem’, and eight sub-themes. Findings capture frequent experiences of weight stigma before bariatric surgery, the need for coping with stigma and body dissatisfaction before and after MBS, and how different coping strategies are related to participants' perceptions of their bodies and self-concepts. More adaptive coping strategies, such as confrontation and cognitive restructuring may facilitate more positive body image outcomes, than more ruminative and avoidant strategies. Understanding adaptive coping strategies can be useful to develop interventions to reduce negative consequences of weight stigma on body image and self-esteem.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"14 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cob.12657","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140317927","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":"Comparison of fluid and body composition measures in women with lipoedema, lymphoedema, and control participants","authors":"Rhiannon Stellmaker,&nbsp;Belinda Thompson,&nbsp;Helen Mackie,&nbsp;Louise Koelmeyer","doi":"10.1111/cob.12658","DOIUrl":"10.1111/cob.12658","url":null,"abstract":"<p>Lipoedema is the disproportionate accumulation of adipose tissue in the lower body, often associated with hormonal changes in women. Lipoedema is commonly misdiagnosed as lymphoedema or obesity due to similarities in appearance. The aim of this study is to compare body composition and fluid measures of women with lipoedema, lymphoedema, and matched control participants, to determine differences that may help distinguish between each condition. One hundred and eleven participants aged over 18, who presented with the complaint of leg swelling and underwent indocyanine green lymphography were included in this study. Our analysis showed that the individuals with lymphoedema had a significantly higher overall total body water (<i>lymphoedema</i>: 9.6 ± 4.2 L, <i>lipoedem</i>a: 7.4 ± 2.3 L, <i>control</i>: 7.5 ± 1.8 L; <i>p</i> &lt; .001) and extracellular fluid (<i>lymphoedema</i>: 4.6 ± 1.6, <i>lipoedema</i>: 3.4 ± 1.0 L, <i>control</i>: 3.5 ± 0.7 L; <i>p</i> &lt; .001) in the legs when compared to individuals with lipoedema and matched control participants. Individuals with lipoedema had a significantly higher overall fat mass as a percentage of body weight when compared to individuals with lymphoedema (<i>lymphoedema</i>: 33.1% ± 9.5%, <i>lipoedema</i>: 39.4% ± 6.5%; <i>p</i> = .003). We are unable to distinguish between individuals with lipoedema and control participants, therefore further research needs to be conducted to help reduce misdiagnosis.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"14 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cob.12658","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140317926","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":"Supporting faculty development for obesity education: A National Survey of United States family medicine residency programme directors","authors":"Jonathan Gabison,&nbsp;Beatrice Palazzolo,&nbsp;Christina Saleh,&nbsp;Olivia Ritchie,&nbsp;Kayla Sheehan,&nbsp;Amal Othman,&nbsp;Diane M. Harper,&nbsp;Lauren Oshman","doi":"10.1111/cob.12654","DOIUrl":"10.1111/cob.12654","url":null,"abstract":"<p>Obesity is the most common chronic condition in the United States (US), yet primary care physicians face barriers in providing obesity treatment. This study examines the prevalence of American Board of Obesity Medicine (ABOM) certified obesity specialists on the faculty of US Family Medicine residency training programmes, the preparedness of graduating resident physicians to treat obesity, and residency training programme director preferences for supporting faculty development to improve residency education in obesity management. This cross-sectional on-line survey of programme directors addressed the number of ABOM-certified faculty, perceived graduate preparedness to treat obesity, and priorities to improve faculty expertise and obesity curriculum. Of 672 eligible programme directors, 298 (44%) responded to our survey. Most programmes (76%) had no ABOM-certified faculty. The proportion of programme directors assessing their graduates as prepared to care for patients with obesity has significantly decreased in the last 5 years (2018: 74%, 2022: 58%, <i>p</i> = .016). Residents in programmes with ABOM-certified faculty member were more likely to be assessed as very prepared to provide medical care (18% vs. 7.8% <i>p</i> = .047). A majority (54%) of programme directors identified limited faculty training and expertise as the biggest faculty and resident-level barrier to quality obesity care. This study demonstrates an important trend towards increasing ABOM-certification among Family Medicine residency programme faculty and an urgent need to prioritise faculty development to improve faculty expertise and resident training to address the obesity epidemic.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"14 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cob.12654","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140206432","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 multidisciplinary management of patients living with obesity: The evaluation of seated bioimpedance measures and relationship to functional performance following targeted intervention","authors":"Elizabeth Ryan,&nbsp;Helen MacLaughlin,&nbsp;Robin Hay,&nbsp;Andrea Cawte,&nbsp;Leonie Naumann,&nbsp;Gemma Woodruff,&nbsp;Michelle Cottrell,&nbsp;Peter Window","doi":"10.1111/cob.12655","DOIUrl":"10.1111/cob.12655","url":null,"abstract":"<div>\u0000 \u0000 <p>Management of obesity requires a multidisciplinary approach including physical activity interventions, which have significant impacts on overall health outcomes. Greater levels of lean muscle mass are significantly associated with improved health and reduced risk of comorbidities and should be preserved where possible when undertaking rapid weight loss. This article reports on the physical and functional outcomes achieved during a 12-week intensive multidisciplinary intervention targeting obesity and evaluates correlations between body composition and functional outcomes. We additionally aimed to investigate the test–retest reliability and levels of agreement in body composition measurements using bioimpedance spectroscopy between seated and standing positions. Of the 35 participants included in analysis, significant differences were observed between baseline and post-intervention measures. These included weight loss of 12.6 kg, waist circumference reduction of 10.5 cm, fat mass reduction by 2.9%, muscle mass increase by 1.6%, 54.5 m improvement in the 6-minute walk test and 3.8 rep improvement in the 30-second sit-to-stand test. No significant correlations were observed between physical and functional outcome measures. Excellent test re-test reliability was observed in bioimpedance spectroscopy seated measurements (ICC &gt;.9). Significant differences were observed between seated and standing bioimpedance spectroscopy measurements, however they are regarded as small differences in a clinical setting.</p>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"14 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140130932","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":"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}