Current Obesity ReportsPub Date : 2023-09-01Epub Date: 2023-07-20DOI: 10.1007/s13679-023-00507-2
Hui Liang, Cong Li
{"title":"Bariatric and Metabolic Surgery and Medical Insurance Payment in China.","authors":"Hui Liang, Cong Li","doi":"10.1007/s13679-023-00507-2","DOIUrl":"10.1007/s13679-023-00507-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>This paper briefly introduces the status quo of bariatric and metabolic surgery and medical insurance payment in China.</p><p><strong>Recent findings: </strong>Along with China's rapid economic growth, the prevalence of obesity and diabetes is increasing quickly. Because of their high body fat percentage and predominance of abdominal obesity, Chinese people experience metabolic disorders more frequently than Caucasians with the same BMI. Treatments are not medical because there is a lack of social understanding of obesity. Furthermore, obesity has not been accepted as a disease in China and so has not been included in the medical insurance payment system. Therefore, weight-loss medications are not covered by medical insurance. In China, bariatric and metabolic surgery have advanced for almost 20 years, and corresponding guidelines have been developed. However, there are regional and cognitive variations in whether medical insurance covers bariatric surgery or not. Recent research on the financial advantages of medical insurance coverage for weight-loss surgery showed that it conserves healthcare system resources. It will be important to raise public awareness regarding obesity in the future, present more evidence of the clinical efficacy of surgery, and work towards a higher percentage of medical insurance reimbursement for obesity treatment and bariatric surgery.</p>","PeriodicalId":10846,"journal":{"name":"Current Obesity Reports","volume":null,"pages":null},"PeriodicalIF":8.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10520390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Current Obesity ReportsPub Date : 2023-09-01Epub Date: 2023-05-27DOI: 10.1007/s13679-023-00510-7
Ioannis G Lempesis, Dimitrios Varrias, Marios Sagris, Robert R Attaran, Elissa S Altin, Christos Bakoyiannis, Leonidas Palaiodimos, Maria Dalamaga, Damianos G Kokkinidis
{"title":"Obesity and Peripheral Artery Disease: Current Evidence and Controversies.","authors":"Ioannis G Lempesis, Dimitrios Varrias, Marios Sagris, Robert R Attaran, Elissa S Altin, Christos Bakoyiannis, Leonidas Palaiodimos, Maria Dalamaga, Damianos G Kokkinidis","doi":"10.1007/s13679-023-00510-7","DOIUrl":"10.1007/s13679-023-00510-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>Obesity is a significant public health problem and a major risk factor for the development and progression of atherosclerosis and its cardiovascular manifestations. Lower extremity peripheral artery disease (PAD) affects 3%-10% of the Western population and, if left untreated, can lead to devastating outcomes with both an increased risk of morbidity and mortality. Interestingly, the association between obesity and PAD remains debatable. Whereas it is well known that PAD and obesity frequently overlap in the same patients, many studies have demonstrated a negative association between obesity and PAD and a protective effect of obesity on disease development and progression, a phenomenon described as the \"obesity paradox.\" Possible mechanisms for this paradox may include genetic background, as assessed by mendelian randomization studies, adipose tissue dysfunction, and body fat distribution rather than adiposity, while other factors, such as sex, ethnicity, sarcopenia in the elderly population, or aggressive treatment of co-existing metabolic conditions in individuals with obesity compared to those with normal weight, could have some impact as well.</p><p><strong>Recent rindings: </strong>Few reviews and meta-analyses examining systematically the relationship between obesity and PAD exist. The impact of PAD development due to the presence of obesity remains largely controversial. However, the most current evidence, backed by a recent meta-analysis, suggests a potential protective role of a higher body mass index on PAD-related complications and mortality. In this review, we discuss the association between obesity and PAD development, progression, and management, and the potential pathophysiologic mechanisms linking the two diseases.</p>","PeriodicalId":10846,"journal":{"name":"Current Obesity Reports","volume":null,"pages":null},"PeriodicalIF":8.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10220347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10537281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oliwia Lange, Monika Proczko-Stepaniak, Adriana Mika
{"title":"Short-Chain Fatty Acids-A Product of the Microbiome and Its Participation in Two-Way Communication on the Microbiome-Host Mammal Line.","authors":"Oliwia Lange, Monika Proczko-Stepaniak, Adriana Mika","doi":"10.1007/s13679-023-00503-6","DOIUrl":"https://doi.org/10.1007/s13679-023-00503-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>The review aims to describe short-chain fatty acids (SCFAs) as metabolites of bacteria, their complex influence on whole-body metabolism, and alterations in the SCFA profile in obesity and after bariatric surgery (BS).</p><p><strong>Recent findings: </strong>The fecal profile of SCFAs in obese patients differs from that of lean patients, as well as their gut microbiota composition. In obese patients, a lower diversity of bacteria is observed, as well as higher concentrations of SCFAs in stool samples. Obesity is now considered a global epidemic and bariatric surgery (BS) is an effective treatment for severe obesity. BS affects the structure and functioning of the digestive system, and also alters gut microbiota and the concentration of fecal SCFAs. Generally, after BS, SCFA levels are lower but levels of branched short-chain fatty acids (BSCFAs) are elevated, the effect of which is not fully understood. Moreover, changes in the profile of circulating SCFAs are little known and this is an area for further research. Obesity seems to be inherently associated with changes in the SCFA profile. It is necessary to better understand the impact of BS on microbiota and the metabolome in both feces and blood as only a small percentage of SCFAs are excreted. Further research may allow the development of a personalized therapeutic approach to the BS patient in terms of diet and prebiotic intervention.</p>","PeriodicalId":10846,"journal":{"name":"Current Obesity Reports","volume":null,"pages":null},"PeriodicalIF":8.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10250490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9605091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stamatia Simati, Alexander Kokkinos, Maria Dalamaga, Georgia Argyrakopoulou
{"title":"Obesity Paradox: Fact or Fiction?","authors":"Stamatia Simati, Alexander Kokkinos, Maria Dalamaga, Georgia Argyrakopoulou","doi":"10.1007/s13679-023-00497-1","DOIUrl":"https://doi.org/10.1007/s13679-023-00497-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>Obesity is related to several comorbidities such as type 2 diabetes mellitus, cardiovascular disease, heart failure, and various types of cancers. While the detrimental effect of obesity in both mortality and morbidity has been well established, the concept of the obesity paradox in specific chronic diseases remains a topic of continuous interest. In the present review, we examine the controversial issues around the obesity paradox in certain conditions such as cardiovascular disease, several types of cancer and chronic obstructive pulmonary disease, and the factors that may confound the relation between obesity and mortality.</p><p><strong>Recent findings: </strong>We refer to the obesity paradox when particular chronic diseases exhibit an interesting \"paradoxical\" protective association between the body mass index (BMI) and clinical outcomes. This association, however, may be driven by multiple factors among which the limitations of the BMI itself; the unintended weight loss precipitated by chronic illness; the various phenotypes of obesity, i.e., sarcopenic obesity or the athlete's obesity phenotype; and the cardiorespiratory fitness levels of the included patients. Recent evidence highlighted that previous cardioprotective medications, obesity duration, and smoking status seem to play a role in the obesity paradox. The obesity paradox has been described in a plethora of chronic diseases. It cannot be emphasized enough that the incomplete information received from a single BMI measurement may interfere with outcomes of studies arguing in favor of the obesity paradox. Thus, the development of carefully designed studies, unhampered by confounding factors, is of great importance.</p>","PeriodicalId":10846,"journal":{"name":"Current Obesity Reports","volume":null,"pages":null},"PeriodicalIF":8.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9595655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Osteoprotegerin/Receptor Activator of Nuclear Factor-Kappa B Ligand/Receptor Activator of Nuclear Factor-Kappa B Axis in Obesity, Type 2 Diabetes Mellitus, and Nonalcoholic Fatty Liver Disease.","authors":"Ilias D Vachliotis, Stergios A Polyzos","doi":"10.1007/s13679-023-00505-4","DOIUrl":"https://doi.org/10.1007/s13679-023-00505-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>To summarize evidence on the potential involvement of the osteoprotegerin (OPG)/receptor activator of nuclear factor-kappa B (NF-κΒ) ligand (RANKL)/receptor activator of NF-κΒ (RANK) axis in the pathogenesis of metabolic diseases.</p><p><strong>Recent findings: </strong>The OPG-RANKL-RANK axis, which has been originally involved in bone remodeling and osteoporosis, is now recognized as a potential contributor in the pathogenesis of obesity and its associated comorbidities, i.e., type 2 diabetes mellitus and nonalcoholic fatty liver disease. Besides bone, OPG and RANKL are also produced in adipose tissue and may be involved in the inflammatory process associated with obesity. Metabolically healthy obesity has been associated with lower circulating OPG concentrations, possibly representing a counteracting mechanism, while elevated serum OPG levels may reflect an increased risk of metabolic dysfunction or cardiovascular disease. OPG and RANKL have been also proposed as potential regulators of glucose metabolism and are potentially involved in the pathogenesis of type 2 diabetes mellitus. In clinical terms, type 2 diabetes mellitus has been consistently associated with increased serum OPG concentrations. With regard to nonalcoholic fatty liver disease, experimental data suggest a potential contribution of OPG and RANKL in hepatic steatosis, inflammation, and fibrosis; however, most clinical studies showed reduction in serum concentrations of OPG and RANKL. The emerging contribution of the OPG-RANKL-RANK axis to the pathogenesis of obesity and its associated comorbidities warrants further investigation by mechanistic studies and may have potential diagnostic and therapeutic implications.</p>","PeriodicalId":10846,"journal":{"name":"Current Obesity Reports","volume":null,"pages":null},"PeriodicalIF":8.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10250495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9598763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sabotage, Collusion, and Being a Feeder: Towards a New Model of Negative Social Support and Its Impact on Weight Management.","authors":"Jane Ogden, Sophia Quirke-McFarlane","doi":"10.1007/s13679-023-00504-5","DOIUrl":"https://doi.org/10.1007/s13679-023-00504-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Whilst research indicates the positive impact of social support across a number of health domains, including weight management, not all social support is beneficial.</p><p><strong>Recent findings: </strong>This paper reviews the evidence for both positive and negative social support in the context of behavioural interventions and surgery for obesity. It then presents a new model of negative social support focusing on sabotage ('active and intentional undermining of another person's weight goals'), feeding behaviour ('explicit over feeding of someone when they are not hungry or wishing not to eat'), and collusion ('passive and benign negative social support to avoid conflict') which can be conceptualised within the context of relationships as systems and the mechanisms of homeostasis. There is increasing evidence for the negative impact of social support. This new model could form the basis of further research and the development of interventions for family, friends, and partners to maximise weight loss outcomes.</p>","PeriodicalId":10846,"journal":{"name":"Current Obesity Reports","volume":null,"pages":null},"PeriodicalIF":8.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10250496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9599866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Fat Kidney.","authors":"Ludovica Verde, Stefania Lucà, Simona Cernea, Cem Sulu, Volkan Demirhan Yumuk, Trond Geir Jenssen, Silvia Savastano, Gerardo Sarno, Annamaria Colao, Luigi Barrea, Giovanna Muscogiuri","doi":"10.1007/s13679-023-00500-9","DOIUrl":"https://doi.org/10.1007/s13679-023-00500-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review is to summarize the current evidence on the role of obesity in the development and progression of chronic kidney disease and the current evidence on nutritional, pharmacological, and surgical strategies for the management of individuals with obesity and chronic kidney disease.</p><p><strong>Recent findings: </strong>Obesity can hurt the kidney via direct pathways, through the production of pro-inflammatory adipocytokines, and indirectly due to systemic complications of obesity, including type 2 diabetes mellitus and hypertension. In particular, obesity can damage the kidney through alterations in renal hemodynamics resulting in glomerular hyperfiltration, proteinuria and, finally, impairment in glomerular filtratation rate. Several strategies are available for weight loss and maintenance, such as the modification of lifestyle (diet and physical activity), anti-obesity drugs, and surgery therapy, but there are no clinical practice guidelines to manage subjects with obesity and chronic kidney disease. Obesity is an independent risk factor for the progression of chronic kidney disease. In subjects with obesity, weight loss can slow down the progression of renal failure with a significant reduction in proteinuria and improvement in glomerular filtratation rate. Specifically, in the management of subjects with obesity and chronic renal disease, it has been shown that bariatric surgery can prevent the decline in renal function, while further clinical studies are needed to evaluate the efficacy and safety on the kidney of weight reducing agents and the very low-calorie ketogenic diet.</p>","PeriodicalId":10846,"journal":{"name":"Current Obesity Reports","volume":null,"pages":null},"PeriodicalIF":8.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10250266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9604020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Valeria Guglielmi, Silvia Bettini, Paolo Sbraccia, Luca Busetto, Massimo Pellegrini, Volkan Yumuk, Anna Maria Colao, Marwan El Ghoch, Giovanna Muscogiuri
{"title":"Beyond Weight Loss: Added Benefits Could Guide the Choice of Anti-Obesity Medications.","authors":"Valeria Guglielmi, Silvia Bettini, Paolo Sbraccia, Luca Busetto, Massimo Pellegrini, Volkan Yumuk, Anna Maria Colao, Marwan El Ghoch, Giovanna Muscogiuri","doi":"10.1007/s13679-023-00502-7","DOIUrl":"https://doi.org/10.1007/s13679-023-00502-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>To highlight the added benefits of approved and upcoming, centrally-acting, anti-obesity drugs, focusing not only on the most common metabolic and cardiovascular effects but also on their less explored clinical benefits and drawbacks, in order to provide clinicians with a tool for more comprehensive, pharmacological management of obesity.</p><p><strong>Recent findings: </strong>Obesity is increasingly prevalent worldwide and has become a challenge for healthcare systems and societies. Reduced life expectancy and cardiometabolic complications are some of the consequences of this complex disease. Recent insights into the pathophysiology of obesity have led to the development of several promising pharmacologic targets, so that even more effective drugs are on the horizon. The perspective of having a wider range of treatments increases the chance to personalize therapy. This primarily has the potential to take advantage of the long-term use of anti-obesity medication for safe, effective and sustainable weight loss, and to concomitantly address obesity complications/comorbidities when already established. The evolving scenario of the availability of anti-obesity drugs and the increasing knowledge of their added effects on obesity complications will allow clinicians to move into a new era of precision medicine.</p>","PeriodicalId":10846,"journal":{"name":"Current Obesity Reports","volume":null,"pages":null},"PeriodicalIF":8.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10250472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9606528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Obesity in Sexual and Gender Minority Populations: Prevalence and Correlates.","authors":"Serena D Stevens","doi":"10.1007/s13679-023-00499-z","DOIUrl":"https://doi.org/10.1007/s13679-023-00499-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review is to explore the prevalence and correlates of obesity among members of sexual and gender minority (SGM) populations.</p><p><strong>Recent findings: </strong>Research overall finds higher rates of obesity among lesbian and bisexual women than heterosexual women, lower rates of obesity among gay and bisexual men than heterosexual men, and inconsistent findings on obesity among transgender individuals. Rates of mental health disorders and disordered eating are high among all SGM groups. Rates of comorbid medical conditions differ among groups. More research needs to be conducted within all SGM groups but particularly among transgender populations. All members of SGM encounter stigma, including when seeking healthcare, and this may lead to individuals avoiding healthcare. Therefore, it is important to educate providers about population-specific factors. This article serves as an overview of important considerations for providers treating individuals within SGM populations.</p>","PeriodicalId":10846,"journal":{"name":"Current Obesity Reports","volume":null,"pages":null},"PeriodicalIF":8.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9978566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Water Consumption: Effect on Energy Expenditure and Body Weight Management.","authors":"Merve Esra Çıtar Dazıroğlu, Nilüfer Acar Tek","doi":"10.1007/s13679-023-00501-8","DOIUrl":"https://doi.org/10.1007/s13679-023-00501-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>Water, which is of vital importance, has a critical role in maintaining the normal function of the body, and even mild dehydration can play a role in the development of various diseases. Therefore, it is of great importance to meet the recommended daily water consumption amounts. In addition to the numerous roles of water in metabolism, its effect on energy metabolism should not be overlooked. Water consumption can increase energy expenditure and be an additional tool for weight management. Therefore, the importance of water consumption, which is like a hidden component for treating of obesity, should be emphasized. This review was written to explain the possible mechanisms of water consumption in energy expenditure and body weight management.</p><p><strong>Recent findings: </strong>Because water consumption is associated with sympathetic activity, which increases metabolic rate (thermogenesis) and daily energy expenditure, the increase in sympathetic activity caused by water consumption is an important and unrecognized component of daily energy expenditure. In addition to the concept of water-based thermogenesis, water, which is a potential improvement factor in body composition, also plays an auxiliary role in body weight loss with both less energy intake and increased fat oxidation. From this perspective, water consumption may have critical importance in the fight against increasing obesity worldwide. Considering its effect on energy metabolism in various ways, it becomes necessary to focus more on the importance of water on human health. (Created by BioRender.com).</p>","PeriodicalId":10846,"journal":{"name":"Current Obesity Reports","volume":null,"pages":null},"PeriodicalIF":8.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9596711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}