Obesity Facts最新文献

{"title":"Development of a Clinical Pathway for Bariatric Surgery as an Integral Part of a Comprehensive Treatment for Adolescents with Severe Obesity in the Netherlands.","authors":"Kelly G H van de Pas, Anita C E Vreugdenhil, Loes Janssen, Wouter K G Leclercq, Meeike Kusters, Malika Chegary, Ines von Rosenstiel, Eric J Hazebroek, Edgar G A H van Mil, Renske Wassenberg, Linda M W Hover, Wim G van Gemert, François M H van Dielen","doi":"10.1159/000539256","DOIUrl":"10.1159/000539256","url":null,"abstract":"<p><strong>Introduction: </strong>In the Netherlands, bariatric surgery in adolescents is currently only allowed in the context of scientific research. Besides this, there was no clinical pathway for bariatric surgery in adolescents. In this paper, the development of a comprehensive clinical pathway for bariatric surgery in adolescents with severe obesity in the Netherlands is described.</p><p><strong>Methods: </strong>The clinical pathway for bariatric surgery in adolescents consists of an eligibility assessment as well as comprehensive peri- and postoperative care. Regarding the eligibility assessment, the adolescents need to be identified by their attending pediatricians and afterwards be evaluated by specialized pediatric obesity units. If the provided treatment is considered to be insufficiently effective, the adolescent will anonymously be evaluated by a national board. This is an additional diligence procedure specifically established for bariatric surgery in adolescents. The national board consists of independent experts regarding adolescent bariatric surgery and evaluates whether the adolescents meet the criteria defined by the national professional associations. The final step is an assessment by a multidisciplinary team for adolescent bariatric surgery. The various disciplines (pediatrician, bariatric surgeon, psychologist, dietician) evaluate whether an adolescent is eligible for bariatric surgery. In this decision-making process, it is crucial to assess whether the adolescent is expected to adhere to postoperative behavioral changes and follow-up. When an adolescent is deemed eligible for bariatric surgery, he or she will receive preoperative counseling by a bariatric surgeon to decide on the type of bariatric procedure (Roux-en-Y gastric bypass or sleeve gastrectomy). Postoperative care consists of intensive guidance by the multidisciplinary team for adolescent bariatric surgery. In this guidance, several regular appointments are included and additional care will be provided based on the needs of the adolescent and his or her family. Furthermore, the multidisciplinary lifestyle intervention, in which the adolescents participated before bariatric surgery, continues in coordination with the multidisciplinary team for adolescent bariatric surgery, and this ensures long-term counseling and follow-up.</p><p><strong>Conclusion: </strong>The implementation of bariatric surgery as an integral part of a comprehensive treatment for adolescents with severe obesity requires the development of a clinical pathway with a variety of disciplines.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"535-544"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11458160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Linking Factors Associated with Constipation in Obesity.","authors":"Brendan Jen-Wei Tan, Ling-Ling Chan, Eng-King Tan, Zhi-Dong Zhou","doi":"10.1159/000538431","DOIUrl":"10.1159/000538431","url":null,"abstract":"","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"372-373"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Correlates of Night Eating Syndrome, Insomnia, and Psychological Distress in Primary Care Patients with Obesity: A Cross-Sectional Study.","authors":"Hazem A Sayed Ahmed, Sohila G Abo El-Ela, Anwar I Joudeh, Sally M Moawd, Samer El Hayek, Jaffer Shah, Nahed Amen Eldahshan","doi":"10.1159/000538341","DOIUrl":"10.1159/000538341","url":null,"abstract":"<p><strong>Introduction: </strong>Management of obesity is challenging for both patients and healthcare workers. Considering the low success rate of current interventions, this study aimed to explore the prevalence and associated factors of night eating syndrome (NES), insomnia, and psychological distress among individuals with obesity in order to plan comprehensive obesity management interventions.</p><p><strong>Methods: </strong>A cross-sectional study on a convenient sample from five primary healthcare centers in Port Said, Egypt, was conducted from November 2020 to March 2021. Sociodemographic and clinical characteristics were collected in addition to the assessment of NES, insomnia, and psychological distress using the Arabic versions of the Night Eating Diagnostic Questionnaire (NEQ), the Insomnia Severity Index (ISI), and the Patient Health Questionnaire-4 (PHQ-4) scales, respectively. Associations of NES, insomnia, and psychological distress were assessed by multiple regression analysis. We performed Bonferroni adjustments for multiple comparisons.</p><p><strong>Results: </strong>We included 425 participants with obesity with a mean age of 45.52 ± 6.96 years. In all, 54.4% were females and the mean body mass index (BMI) was 35.20 ± 4.41 kg/m2. The prevalence rates of NES, insomnia, and psychological distress were 21.6% (95% CI: 17.7-25.6%), 15.3% (95% CI: 11.9-18.7%), and 18.8% (95% CI: 15.1-22.6%), respectively. NES was significantly associated with younger age (OR 0.974, p = 0.016), physical inactivity (OR 0.485, p = 0.010), insomnia (OR 2.227, p = 0.014), and psychological distress (OR 2.503, p = 0.002). Insomnia showed strong associations with NES (OR 2.255, p = 0.015) and psychological distress (OR 5.990, p &lt; 0.001). Associated factors of psychological distress symptoms included insomnia (OR 6.098, p &lt; 0.001) and NES (OR 2.463, p = 0.003).</p><p><strong>Conclusion: </strong>The prevalence rates of NES, insomnia, and psychological distress were high among primary care patients with obesity, and these conditions were interrelated. Optimal obesity management necessitates individualized and targeted multidisciplinary care plans that take into consideration individual patients' mental, behavioral, and dietary habits needs.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"274-285"},"PeriodicalIF":3.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological Benefits of a Preoperative Educational Bridging Program for Bariatric Surgery: Does Face-to-Face versus Videoconference-Based Delivery Make a Difference?","authors":"Teresa Lau, Sandra Schild, Bea Klos, Jessica Schraml, Rami Archid, Andreas Stengel, Andreas Nieß, Gunnar Erz, Stephan Zipfel, Isabelle Mack","doi":"10.1159/000539797","DOIUrl":"10.1159/000539797","url":null,"abstract":"<p><strong>Introduction: </strong>Short educational programs prior to metabolic and bariatric surgery (MBS) provide information to prepare patients adequately for surgery and subsequent changes. Our knowledge of the beneficial effects of these programs on stabilizing and improving mental health of patients with obesity awaiting surgery is incomplete. The objective of this study was to assess the effects of a group-based educational program before MBS on three key factors: (i) patients' mental health, (ii) the program's perceived helpfulness from the patients' perspective, and (iii) the effectiveness of delivering the program online via videoconferencing.</p><p><strong>Methods: </strong>Validated questionnaires for anxiety, depression, stress, and quality of life before and after the program were assessed. Additionally, participants' perspectives of benefits were assessed. Two subgroups, one participating in face-to-face classes, the other participating online via videoconferencing, were compared.</p><p><strong>Results: </strong>Three hundred five patients with obesity waiting for MBS participated in the program. The dropout rate was 3%. On mean average, symptoms of anxiety (-1.1 units [SD 4.6], p < 0.001), depression (-0.9 units [SD 4.6], p < 0.001), and stress (-4.6 units [SD 15.6], p < 0.001) improved, while physical quality of life (+1.7 units [SD 9.7], p = 0.016) and body weight (-0.3 kg [SD 8.7], p = 0.57) remained stable. Patients perceived the program as very beneficial. The results were similar between delivery methods (face-to-face vs. videoconferencing).</p><p><strong>Conclusion: </strong>The educational program proved to be effective in bridging the gap in preoperative preparation while also stabilizing participants' mental health. In addition, participants perceived the program as supportive. Online participation via video conferencing can be offered as an equivalent option to face-to-face classes.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"553-569"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Body Size in Relation to 10-Year Weight Change in the Swedish Obese Subjects Intervention Study.","authors":"Verena Parzer, Magdalena Taube, Bernhard Ludvik, Markku Peltonen, Per-Arne Svensson, Johanna Maria Brix, Kajsa Sjöholm","doi":"10.1159/000535489","DOIUrl":"10.1159/000535489","url":null,"abstract":"<p><strong>Introduction: </strong>Body size underestimation in patients with obesity may be associated with long-term weight increase. In the current report, we analyse changes in body size perception in patients with obesity undergoing either bariatric surgery or usual obesity care, and in subgroups of patients who gain weight or maintain their body weight over 10 years.</p><p><strong>Materials and methods: </strong>A total of 2,504 patients with obesity from the prospective, controlled Swedish Obese Subjects (SOS) intervention study were included in this report, 1,370 patients underwent bariatric surgery and 1,134 patients were usual care controls. Weight was measured and body size was self-estimated using the Stunkard's figure rating scale at baseline and after 0.5, 1, 2, 3, 4, 6, 8 and 10 years of follow-up. A body perception index (BPI) was calculated as estimated/measured BMI. Weight (re)gain was defined as ≥10% increase between 1 and 10 years of follow-up.</p><p><strong>Results: </strong>Body size was underestimated by 12% in the surgery and 14% in the control group (i.e., &gt;5 BMI units) at baseline and underestimation largely persisted over 10 years in both intervention groups. When stratified by long-term weight development, weight regainers from the surgery group underestimated their body size to a larger degree compared to weight maintainers (12 vs. 9%, p &lt; 0.001) after 10 years. Likewise weight gainers in the control group also underestimated their body size to a larger degree (17% vs. 13%, p &lt; 0.001). In both groups, the change in BPI was significantly different between weight regainers and maintainers during follow-up (time-BPI interactions both p &lt; 0.001).</p><p><strong>Conclusion: </strong>Patients with obesity underestimate their body size and this underestimation remains long-term even after major weight loss induced by bariatric surgery. In patients with obesity who maintain their weight, regardless of treatment, underestimation of body size persists but body size perception is slightly more accurate compared to patients who gain or regain weight long-term.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"81-89"},"PeriodicalIF":3.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138461300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucometabolic Alterations In Pregnant Women With Overweight or Obesity But Without Gestational Diabetes Mellitus – An Observational Study","authors":"Tina Linder, Daniel Eppel, G. Kotzaeridi, Guelen Yerlikaya-Schatten, I. Rosicky, M. Morettini, Andrea Tura, Christian S. Göbl","doi":"10.1159/000535490","DOIUrl":"https://doi.org/10.1159/000535490","url":null,"abstract":"Introduction: Maternal overweight is a risk factor for Gestational Diabetes Mellitus (GDM). However, emerging evidence suggests that an increased maternal body mass index (BMI) promotes the development of perinatal complications even in women who do not develop GDM. This study aims to assess physiological glucometabolic changes associated with increased BMI.\u0000Methods: 21 women with overweight and 21 normal weight controls received a metabolic assessment at 13 weeks of gestation, including a 60 min frequently sampled intravenous glucose tolerance test. A further investigation was performed between 24 and 28 weeks in women who remained normal glucose tolerant.\u0000Results: At baseline, mothers with overweight showed impaired insulin action, whereby the calculated insulin sensitivity index (CSI) was lower as compared to normal weight controls (3.5 vs. 6.7 10-4 min-1 [microU/ml]-1, p=0.025). After excluding women who developed GDM, mothers with overweight showed higher average glucose during the oral glucose tolerance test (OGTT) at third trimester. Moreover, early pregnancy insulin resistance and secretion were associated with increased placental weight in normal glucose tolerant women.\u0000Conclusion: Mothers with overweight or obesity show an unfavourable metabolic environment already at the early stage of pregnancy, possibly associated with perinatal complications in women who remain normal glucose tolerant.","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":"34 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138593642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Intragastric Balloon Therapy Compared to a Multidisciplinary Weight Loss Program (OPTIFAST) in a Real-World Population: A Propensity Score Matching Analysis.","authors":"Miriam Oster,&nbsp;Nathalena Hein,&nbsp;Aysegül Aksan,&nbsp;Heiner Krammer,&nbsp;Sophia Theodoridou,&nbsp;Jürgen Stein","doi":"10.1159/000524895","DOIUrl":"https://doi.org/10.1159/000524895","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity is a major global health problem associated with comorbidities such as diabetes, cardiovascular disease, and cancer. Bariatric surgery is recognized to be the most effective weight loss intervention, but it is highly invasive and costly and can have serious side effects. Intragastric balloon (IGB) placement by endoscopy and hypocaloric diets are among a number of techniques that have been used in patients unsuitable for, or unwilling to undergo, obesity surgery. In this study, we compared the efficacy, safety, and cost-effectiveness of the hypocaloric OPTIFAST program (OPT) with endoscopic IGB placement for weight loss.</p><p><strong>Methods: </strong>In this retrospective observational cohort propensity score-weighted comparison (performed May 2014 to December 2020), participants with a BMI of 30-55 kg/m2, aged 18-70 years, were randomized to OPT or IGB for 26 weeks, followed by a weight maintenance phase. Patients were matched according to age, gender, and BMI. The study outcomes were percentage excess body weight lost, total body weight lost (TBWL), and percentage TBWL (%TBWL).</p><p><strong>Results: </strong>A total of 148 participants (75% of those randomized; 74 OPT, 74 IGB) made up the ITT population. Mean age was 44.1 ± 10.4 years, and the patients were predominantly female (77%). Baseline BMI was 44.1 ± 10.4 kg/m2. At 26 weeks, %TBWL in the OPT group was 19.6 ± 6.8% versus 11.9 ± 6.7% for IGB (p < 0.001). At 52 weeks, %TBWL for OPT was 18.2 ± 9.0% versus 12.0 ± 6.6% for IGB (p < 0.001). The OPT cohort also experienced significantly fewer adverse events compared with the IGB group.</p><p><strong>Conclusion: </strong>IGB placement and OPT induce clinically meaningful weight loss. However, OPT appears to induce clinically superior weight loss and has economic advantages through lower rates of complications and adverse events.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":"16 1","pages":"89-98"},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1f/30/ofa-0016-0089.PMC9889727.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9402362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency and Functional Consequences of Low Appendicular Lean Mass and Sarcopenic Obesity in Patients with Asthma Referred for Pulmonary Rehabilitation.","authors":"Roy Meys,&nbsp;Felipe V C Machado,&nbsp;Martijn A Spruit,&nbsp;Anouk A F Stoffels,&nbsp;Hieronymus W H van Hees,&nbsp;Bram van den Borst,&nbsp;Peter H Klijn,&nbsp;Chris Burtin,&nbsp;Fabio Pitta,&nbsp;Frits M E Franssen","doi":"10.1159/000531196","DOIUrl":"10.1159/000531196","url":null,"abstract":"<p><strong>Introduction: </strong>One of the most prominent extrapulmonary manifestations in patients with chronic respiratory disease is changes in body weight and composition. However, the frequency and functional consequences of low appendicular lean mass (ALM) or sarcopenic obesity (SO) in patients with asthma are largely unknown. Therefore, the aim of the current study was to assess the frequency and functional consequences of low appendicular lean mass index (ALMI) and SO in patients with asthma.</p><p><strong>Methods: </strong>A retrospectively analyzed cross-sectional study was conducted in 687 patients with asthma (60% female, 58 ± 13 years, FEV1 76 ± 25% pred) referred for comprehensive pulmonary rehabilitation (PR). Body composition, pulmonary function, exercise capacity, quadriceps muscle function, and quality of life were assessed. Patients were classified as presenting low ALMI according to the 10th percentiles of age-sex-body mass index (BMI)-specific reference values and as having SO according to the diagnostic procedure proposed by the 2022 ESPEN/EASO consensus. In addition, clinical outcomes between patients with normal and low ALMI or with and without SO were compared.</p><p><strong>Results: </strong>The frequency of patients classified as low ALMI was 19%, whereas 45% of the patients were obese. Among the obese patients, 29% had SO. In patients with normal weight, those with low ALMI were younger and had worse pulmonary function, exercise capacity and quadriceps muscle function than those with normal ALMI (all p &lt; 0.05). Overweight patients with low ALMI presented poorer pulmonary function and quadriceps muscle function (both strength and total work capacity). In obese class I patients, those with low ALMI showed lower quadriceps strength and maximal oxygen uptake acquired during cardiopulmonary exercise testing. Both male and female patients with SO showed lower quadriceps muscle function and reduced maximal exercise capacity compared to non-SO asthma patients.</p><p><strong>Conclusion: </strong>Approximately one in five asthma patients presented low ALM when age-sex-BMI-specific ALMI cutoffs were applied. Obesity is common among patients with asthma referred for PR. Among the obese patients, a significant proportion presented SO. Low ALM and SO were associated with worse functional outcomes.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"435-446"},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/76/df/ofa-2023-0016-0005-531196.PMC10601668.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9527236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Related Predictors for Seeking and Receiving Obesity Surgery.","authors":"Sonja Elisabeth Sauerbrey,&nbsp;Ricarda Schmidt,&nbsp;Haiko Schlögl,&nbsp;Matthias Blüher,&nbsp;Arne Dietrich,&nbsp;Anja Hilbert","doi":"10.1159/000531353","DOIUrl":"10.1159/000531353","url":null,"abstract":"<p><strong>Introduction: </strong>The decision for obesity surgery (OS) is complex and strongly driven by patients' preference. This study aimed to examine patients' preference for OS before and after behavioral weight loss treatment (BWLT), associated patient characteristics, its role in predicting the receipt of OS after BWLT, and potential mediators.</p><p><strong>Methods: </strong>Data of N = 431 adults with obesity starting a 1-year routine care obesity BWLT were analyzed. Patients were interviewed before (pre-BWLT) and after BWLT (post-BWLT) regarding their preference for OS, and anthropometric, medical, and psychological data were collected.</p><p><strong>Results: </strong>Only a minority of patients (11.6%) had an explicit preference for OS pre-BWLT. Post-BWLT, the number of patients preferring OS significantly increased (27.4%). Patients with a constant or emerging preference for OS showed less favorable anthropometric, psychological, and medical characteristics than patients without or with a vanishing preference for OS. Patients' pre-BWLT preference for OS significantly predicted receiving OS post-BWLT. This association was mediated by higher body mass index pre- and post-BWLT, but not by less percentage total body weight loss (%TBWL) through BWLT.</p><p><strong>Conclusion: </strong>Although the preference for OS pre-BWLT predicted the receipt of OS post-BWLT, it was not associated with %TBWL during BWLT. Further prospective studies with multiple assessment time points during BWLT may help understand when and why patients' attitude toward OS changes, and identify possible mediators on the association between the preference and receipt of OS.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"447-456"},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7b/c5/ofa-2023-0016-0005-531353.PMC10601674.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9573739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Physiology of Neurogenic Obesity: Lessons from Spinal Cord Injury Research.","authors":"David W McMillan,&nbsp;Gregory E Bigford,&nbsp;Gary J Farkas","doi":"10.1159/000530888","DOIUrl":"10.1159/000530888","url":null,"abstract":"<p><strong>Background: </strong>A spinal cord injury (SCI) from trauma or disease impairs sensorimotor pathways in somatic and autonomic divisions of the nervous system, affecting multiple body systems. Improved medical practices have increased survivability and life expectancy after SCI, allowing for the development of extensive metabolic comorbidities and profound changes in body composition that culminate in prevalent obesity.</p><p><strong>Summary: </strong>Obesity is the most common cardiometabolic component risk in people living with SCI, with a diagnostic body mass index cutoff of 22 kg/m2 to account for a phenotype of high adiposity and low lean mass. The metameric organization of specific divisions of the nervous system results in level-dependent pathology, with resulting sympathetic decentralization altering physiological functions such as lipolysis, hepatic lipoprotein metabolism, dietary fat absorption, and neuroendocrine signaling. In this manner, SCI provides a unique opportunity to study in vivo the \"neurogenic\" components of certain pathologies that otherwise are not readily observable in other populations. We discuss the unique physiology of neurogenic obesity after SCI, including the altered functions mentioned above as well as structural changes such as reduced skeletal muscle and bone mass and increased lipid deposition in the adipose tissue, skeletal muscle, bone marrow, and liver.</p><p><strong>Key message: </strong>The study of neurogenic obesity after SCI gives us a unique neurological perspective on the physiology of obesity. The lessons learned from this field can guide future research and advancements to inform the study of obesity in persons with and without SCI.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":"16 4","pages":"313-325"},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3f/3e/ofa-2023-0016-0004-530888.PMC10427964.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10584534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}