Andrea Elliott, Judy Bauer, Cassie McDonald, Simone Gibson
{"title":"Exploring dietitians' experiences caring for patients living with obesity in acute care: a qualitative study.","authors":"Andrea Elliott, Judy Bauer, Cassie McDonald, Simone Gibson","doi":"10.1038/s41366-024-01697-y","DOIUrl":"https://doi.org/10.1038/s41366-024-01697-y","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a modifiable risk factor associated with hospital-associated complications. Recent studies show there is a high prevalence of patients with obesity presenting to hospital and evidence indicates that people living with obesity should receive diet advice from a dietitian; however, patients often do not receive this care in acute settings.</p><p><strong>Aim: </strong>The primary aim of this study was to explore the experiences of dietitians caring for patients living with obesity in acute hospital settings.</p><p><strong>Methods: </strong>A multi-site qualitative study was conducted from October 2021 to November 2023 in Melbourne, Australia. Constructivist grounded theory methodology informed sampling and data collection. Semi-structured interviews were undertaken with dietitians working in acute care. Data were analysed using open coding and constant comparison underpinned by Charmaz's framework.</p><p><strong>Results: </strong>Interviews were conducted with 25 dietitians working across four hospitals. The theory developed from the data describes an enculturated decision-making process whereby acute clinical dietitians are limiting acute nutrition care for people living with obesity in hospital. The theory includes five interdependent categories that influence clinical decision-making and practice: (1) culture of professional practice, (2) science and evidence, (3) acknowledgement of weight bias and stigma, (4) dietitian-led care and (5) hospital systems and environment.</p><p><strong>Conclusion: </strong>The findings from this study provide new insights as to why dietitians may not be providing acute nutrition care for people living with obesity. Strategic leadership from clinical leaders and education providers together with the lived experience perspectives of people with obesity is needed to shift the culture of dietetic professional practice to consider all nutrition care needs of patients living with obesity who are accessing acute hospitals for health care.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785611","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}
Jumana Antoun, Cassandra Kfoury, Yara Chamaa, Youmna Saade, Sami El Tannir
{"title":"Acceptance, knowledge, and attitude of family physicians towards obesity as a chronic disease: a multinational cross-sectional study.","authors":"Jumana Antoun, Cassandra Kfoury, Yara Chamaa, Youmna Saade, Sami El Tannir","doi":"10.1038/s41366-024-01693-2","DOIUrl":"https://doi.org/10.1038/s41366-024-01693-2","url":null,"abstract":"<p><strong>Background/objectives: </strong>Obesity was previously perceived to be a lifestyle issue; however, it was declared a chronic disease by the American Medical Association (AMA) in 2013. However, family physician's views and actions toward managing obesity remain ambiguous and occasionally conflicting.</p><p><strong>Subjects/methods: </strong>This cross-sectional study explores the acceptance and knowledge of 171 family medicine physicians regarding obesity as a chronic disease. Family physicians were recruited through different channels, including members of professional scientific societies of family medicine that belong to the World Organization of Family Doctors (WONCA) Eastern Mediterranean Regional Office EMRO, a publicly available list of United States (US) family physicians, and authors' personal Facebook and LinkedIn connections. Data was collected across various countries through an anonymous online survey.</p><p><strong>Results: </strong>While most participants acknowledged obesity as a chronic condition with multifactorial origins, there was a notable discrepancy in treatment practices compared to other chronic diseases. A dual perspective emerged, as family physicians often emphasized self-responsibility and behavioral change over medical interventions, potentially hindering effective management. Lower initiation rates for obesity management was exhibited compared to other chronic diseases.</p><p><strong>Conclusion: </strong>There is a gap between recognition and effective management of obesity as a chronic disease within family practice. The findings underscore the need for comprehensive obesity education in medical training to bridge knowledge gaps and reduce weight stigma, enabling physicians to provide optimal care for patients with obesity.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780253","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}
Stephan Wueest, Chiara Scaffidi, Pim P van Krieken, Nils K Konrad, Christian Koch, Ioannis G Lempesis, Jonas Fullin, Konstantinos N Manolopoulos, Steffen Böttcher, Gijs H Goossens, Matthias Blüher, Daniel Konrad
{"title":"Expression of p53 in human adipose tissue correlates positively with FAS and BMI.","authors":"Stephan Wueest, Chiara Scaffidi, Pim P van Krieken, Nils K Konrad, Christian Koch, Ioannis G Lempesis, Jonas Fullin, Konstantinos N Manolopoulos, Steffen Böttcher, Gijs H Goossens, Matthias Blüher, Daniel Konrad","doi":"10.1038/s41366-024-01691-4","DOIUrl":"https://doi.org/10.1038/s41366-024-01691-4","url":null,"abstract":"<p><p>Activation of Fas (CD95) in adipocytes inhibits browning and may contribute to body weight gain in mice. Moreover, Fas expression in white adipose tissue (WAT) correlates positively with body mass index (BMI) in humans. However, molecular pathways involved in the inhibitory effect of Fas on energy metabolism remain incompletely understood. Herein, we report that protein levels of the tumor suppressor p53 were reduced in primary white adipocytes of adipocyte-specific Fas-knockout mice. Moreover, Fas ligand (FasL) treatment increased p53 concentrations in cultured adipocytes and decreased mitochondrial oxygen consumption in control but not in p53-depleted cells, indicating that Fas activation reduces energy expenditure in a p53-dependent manner. In line, in differentiated human mesenchymal stem cells and WAT derived from different anatomical depots, FAS expression was positively associated with p53. Furthermore, p53 expression in human subcutaneous and visceral WAT correlated positively with BMI, whereas its expression in visceral WAT was inversely associated with insulin sensitivity (as assessed by hyperinsulinemic-euglycemic clamp). Taken together, our data suggest that Fas regulates p53 expression in adipocytes, and may thereby affect body weight gain and insulin sensitivity.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768719","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}
Hester Jaspers Faijer-Westerink, Emma N M M von Scheibler, Elisabeth F C van Rossum, Mieke M van Haelst, Claudia Vingerhoets, Thérèse A M J van Amelsvoort, Agnies M van Eeghen, Erik Boot
{"title":"Obesity and metabolic syndrome in adults with a 22q11.2 microdeletion.","authors":"Hester Jaspers Faijer-Westerink, Emma N M M von Scheibler, Elisabeth F C van Rossum, Mieke M van Haelst, Claudia Vingerhoets, Thérèse A M J van Amelsvoort, Agnies M van Eeghen, Erik Boot","doi":"10.1038/s41366-024-01685-2","DOIUrl":"https://doi.org/10.1038/s41366-024-01685-2","url":null,"abstract":"<p><strong>Objective: </strong>Copy number variations (CNVs) may contribute to medical conditions. However, research on the impact of individual CNVs on endocrine disease is limited. This study aimed to provide new data on obesity and metabolic syndrome (MetS) in adults with microdeletion 22q11.2, the pathogenic CNV associated with 22q11.2 deletion syndrome.</p><p><strong>Methods: </strong>We examined prevalence rates of obesity and MetS in 103 adults with a typical 22q11.2 deletion (45.2% male, at median age 30.0 (range 17-71) years) and compared these rates with population-based data. Generalized obesity was defined by a body mass index (BMI) ≥ 30 kg/m<sup>2</sup>, abdominal obesity by a waist circumference (WC) of ≥102 cm in males and ≥88 cm in females, and MetS by standard Joint Interim Statement criteria. General linear models were used to examine the independent associations of age, sex, congenital heart defect, smoking, and antipsychotic use with BMI, WC, and the presence of MetS.</p><p><strong>Results: </strong>Prevalence rates of generalized obesity (32.0%), abdominal obesity (51.5%), and MetS (33.0%) were significantly higher compared to a population-based cohort (15.7% (P < 0.0001), 36.1% (P = 0.002), and 15.2% (P < 0.0001), respectively). In antipsychotic naïve subjects, significant correlations were observed between age and BMI (r = 0.54, P < 0.001), and age and WC (r = 0.60, P < 0.001). These correlations were not present in individuals taking antipsychotic medication. The models predicting BMI (F(5, 97) = 3.083, R<sup>2</sup> = 0.137, P = 0.01) and WC (F(5, 92) = 5.985, R<sup>2</sup> = 0.245, P < 0.001) were significant. Only age was individually predictive of outcomes (P < 0.05 and P < 0.001). The model predicting MetS was also significant (P < 0.001), with higher age being the only factor associated with MetS (OR = 1.07, 95% CI = 1.03-1.12, P < 0.001).</p><p><strong>Conclusions: </strong>Generalized and abdominal obesity, as well as MetS, appear to be common in adults with 22q11.2 deletion syndrome, emphasizing the importance of careful monitoring from a young age. These findings contribute to the limited knowledge about the association between pathogenic CNVs, obesity, and MetS.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768695","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":"Elevated serum pepsinogen level predicts postoperative nausea and vomiting and pain in females with obesity following laparoscopic sleeve gastrectomy.","authors":"Min Hou, Lina Wu, Zhuoqi Wei, Shuwen Jiang, Huaxi Wang, Wenhui Chen, Ruixiang Hu, Bingsheng Guan, Lyujia Cheng, Jianxue Wang, Songhao Hu, Cunchuan Wang, Junchang Zhang, Zhiyong Dong, Jingge Yang, Qingran Lin, Wah Yang","doi":"10.1038/s41366-024-01688-z","DOIUrl":"https://doi.org/10.1038/s41366-024-01688-z","url":null,"abstract":"<p><strong>Background: </strong>Postoperative nausea and vomiting (PONV) is the most common side effect after laparoscopic sleeve gastrectomy (LSG), affecting patients' postoperative recovery and increasing the medical and economic burden. This study aimed to analyze the relationship between serum pepsinogen and PONV.</p><p><strong>Methods: </strong>Patients with obesity who underwent LSG in our center between January 2021 and December 2022 were divided into PONV and NoPONV groups and analyzed retrospectively. Binary logistic regression analysis was used to determine the independent risk factors for PONV.</p><p><strong>Results: </strong>219 female patients were enrolled, with an average BMI of 36.74 ± 8.34 kg/m<sup>2</sup> and aged 32.61 ± 6.18 years. PONV occurred in 157 patients (71.7%). The influencing factors of PONV with different severity were analyzed, and the results showed that the severity of postoperative pain (χ2 = 13.169, p-values = 0.004), PGI (χ2 = 14.625, p-values = 0.002), PGII (χ2 = 25.916, p-values = 0.000), and PGR (χ2 = 17.697, p-values = 0.001) had statistical significance. Binary logistic regression showed that PGI was a risk factor for PONV with a OR (ng/mL) value of 1.013 (95% CI: 1.001-1.024, p-values = 0.037), while PGR was a protective factor for PONV with an OR(ng/mL) value of 0.952 (95% CI: 0.925-0.979, p-values = 0.001).</p><p><strong>Conclusions: </strong>The incidence of PONV after LSG is high. Higher PGI may be a risk factor for promoting PONV after LSG. The higher the preoperative PGI, the later the onset of PONV; the longer the duration, the more serious the degree.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750779","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":"Reflections on \"Sex-differential testosterone response to long-term weight loss\": Illuminating findings and considered limitations.","authors":"Yi Wang","doi":"10.1038/s41366-024-01690-5","DOIUrl":"10.1038/s41366-024-01690-5","url":null,"abstract":"","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750821","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}
Malgorzata M Brzozowska, Dana Bliuc, Artur Mazur, Paul A Baldock, John A Eisman, Jerry R Greenfield, Jacqueline R Center
{"title":"Response to the Letter by Yi Wang: \"Reflections on 'sex-differential testosterone response to long-term weight loss': illuminating findings and considered limitations\".","authors":"Malgorzata M Brzozowska, Dana Bliuc, Artur Mazur, Paul A Baldock, John A Eisman, Jerry R Greenfield, Jacqueline R Center","doi":"10.1038/s41366-024-01692-3","DOIUrl":"https://doi.org/10.1038/s41366-024-01692-3","url":null,"abstract":"","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750824","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}
Mikołaj Kamiński, Agata Fogel, Adrianna Dylik, Matylda Kręgielska-Narożna, Paweł Bogdański
{"title":"Whose tweets about obesity and weight loss gain the most attention: celebrities, political, or medical authorities?","authors":"Mikołaj Kamiński, Agata Fogel, Adrianna Dylik, Matylda Kręgielska-Narożna, Paweł Bogdański","doi":"10.1038/s41366-024-01689-y","DOIUrl":"https://doi.org/10.1038/s41366-024-01689-y","url":null,"abstract":"<p><strong>Background: </strong>X (formerly Twitter) is a unique social medium where many famous people and health institutions post and interact with casual users. We aimed to explore reactions to tweets about obesity and weight loss from accounts representing celebrities, politicians, sportsmen, and health authorities.</p><p><strong>Methods: </strong>We collected tweets from n = 2444 X profiles representing seven categories: celebrities, politicians, sportsmen, medical specialists, medical journals, medical universities, and health institutions. We retrieved tweets from the accounts and selected tweets about, e.g., obesity, overweight, body mass index, and weight loss. We conducted sentiment analysis, descriptive statistics, and multivariable quantile regression modeling. In quantile regression models, each tau represents a decile from 0.1 to 0.9 of the dependent variable (number of likes or retweets). Therefore, a tau value of 0.5 represents the 5th decile, the 50th percentile, and the median of the dependent variable.</p><p><strong>Results: </strong>The final dataset consisted of n = 8989 tweets. Achieving a large number of likes (taus 0.7, 0.8, and 0.9) was positively associated with posts written by celebrities, politicians, medical journals, and universities, while it was negatively associated with tweets authored by health institutions or medical specialists. In the case of a significant number of retweets, a positive association was observed for all account types, except for health institutions, for which the relationship was negative. These relationships were independent of verification status, the number of followers, tweet length, and sentiment.</p><p><strong>Conclusions: </strong>Tweets concerning obesity and weight loss originating from accounts representing health institutions garnered fewer likes and retweets compared to other types of accounts, including non-medical ones. A limitation of the study is the relatively small number of tweets emanating from non-medical accounts. A X informational campaign about obesity should engage non-medical accounts with many followers to reach as many users as possible.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142728799","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":"Plasma concentration of gastrointestinal hormones and subjective appetite ratings after diet or bariatric surgery: 1-year results from the DISGAP study.","authors":"Marthe Isaksen Aukan, Jens Frederik Rehfeld, Jens Juul Holst, Catia Martins","doi":"10.1038/s41366-024-01658-5","DOIUrl":"https://doi.org/10.1038/s41366-024-01658-5","url":null,"abstract":"<p><strong>Objective: </strong>Long-term weight loss outcomes are contrasting between bariatric surgery and dietary restriction alone. This is the first study to investigate changes in gastrointestinal (GI) hormones involved in appetite regulation, and subjective appetite feelings, at 1-year follow-up, after initial weight loss induced by a very-low energy (VLED) alone (controls), or with bariatric surgery.</p><p><strong>Methods: </strong>Patients scheduled for Sleeve Gastrectomy (SG) (n = 19) or Roux-en-Y gastric Bypass (RYGB) (n = 19), and controls (n = 16) were recruited. All groups underwent 10 weeks of a VLED (initial phase), followed by a 9-month maintenance phase. Body weight/composition, plasma concentrations of ghrelin, glucagon-like peptide 1 (GLP-1), peptide YY (PYY), cholecystokinin (CCK), and appetite ratings were measured before and after a meal, at baseline, week 11(W11), and 1Y follow-up.</p><p><strong>Results: </strong>Participants who completed all three follow ups were included in the analysis. Initial changes in body weight/composition were comparable across groups. SG (n = 11) and RYGB (n = 12) continued to lose weight from W11 to 1Y, whereas controls (n = 12) had regained weight. Postprandial GLP-1 increased over time post bariatric surgery and remained unchanged and lower in controls. Postprandial PYY increased in all groups, but greatest post-RYGB. Basal ghrelin decreased over time post-SG, while a small or marked increase was seen after RYGB and diet, respectively, with the control group exhibiting the greatest basal and postprandial concentrations at 1Y. A reduction in basal and postprandial CCK was seen in controls at 1Y, while no changes were observed post-bariatric surgery. Overall, small changes in subjective appetite ratings were seen over time.</p><p><strong>Conclusion: </strong>Weight change at 1Y follow up after SG and RYGB is followed by a GI hormone profile favoring a lower drive to eat and increased satiety. The opposite is seen 1Y after WL induced by dietary restriction alone.</p><p><strong>Clinical trial registration: </strong>clinicaltrials.gov NCT04051190.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686821","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}