Obesity Facts最新文献

{"title":"Associations between Type of Bariatric Surgery and Obstructive Sleep Apnoea, Employment Outcomes, and Body Image Satisfaction: A Systematic Review and Meta-Analysis.","authors":"Beatrice Leyaro, Daniel Boakye, Lyz Howie, Abdulmajid Ali, Raymond Carragher","doi":"10.1159/000541782","DOIUrl":"10.1159/000541782","url":null,"abstract":"<p><strong>Introduction: </strong>Bariatric surgery has been shown to provide significant patient benefits in terms of weight loss and mitigation of obesity-linked comorbidities, as well as providing improvements in occupational productivity and patient quality of life. However, the choice of which bariatric surgery procedure provides the most patient benefit in each of these cases is still in question. In this review, we provide a systematic review, with the objective of evaluating associations between different bariatric surgery procedures and mitigation of obesity-linked comorbidities, improvement in occupational productivity, and patient quality of life, concentrating on three areas: obstructive sleep apnoea (OSA), employment prospects, and body image.</p><p><strong>Methods: </strong>The CINAHL, PubMed, Web of Science, and CENTRAL databases were searched for eligible studies. Summary risk ratio (RR) and 95% confidence intervals were estimated using random-effects models. Thirty-three studies were included in this review, including 29 cohort studies and 4 randomised clinical trials (RCTs).</p><p><strong>Results: </strong>Pooled analysis of the observational studies showed significantly lower OSA remission in sleeve gastrectomy (SG) compared to Roux-en-Y gastric bypass (RYGB) across both short-term (1-2 years) and longer term (3+ years) follow-up periods (RR = 0.91, 95% CI = 0.84-0.99, p = 0.02; and RR = 0.88, 95% CI = 0.65-0.99, p = 0.03, respectively). In contrast, a meta-analysis of the RCT studies found no difference in OSA remission between SG and RYGB (RR = 1.01, 95% CI = 0.81-1.25, p = 0.93). An analysis of four studies showed significantly higher OSA remission for SG versus adjustable gastric banding (RR = 1.83, 95% CI = 1.57-2.14, p < 0.001). No significant difference was observed regarding improvement in employment status between SG and RYGB (RR = 0.77, 95% CI = 0.32-1.87, p = 0.57). A narrative synthesis of studies on body image reported no significant differences between body image scores and surgery types.</p><p><strong>Conclusion: </strong>This review found significantly lower OSA remission in SG as compared to RYGB across different follow-up periods, while no significant statistical difference was observed in RCT studies. Further studies are recommended to assess the effectiveness of the various bariatric surgeries in relation to improving employment status and body image, where primary studies are lacking.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"1-15"},"PeriodicalIF":3.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372441","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":"Food and Health Literacy in Patients Awaiting Metabolic-Bariatric Surgery.","authors":"Anne Jacobs, Leontien M G Nijland, Ingrid H M Steenhuis, Ruben N van Veen, Ronald S L Liem, Hanno Pijl, Lies Ter Beek, Rob A E M Tollenaar, Valerie M Monpellier","doi":"10.1159/000541408","DOIUrl":"10.1159/000541408","url":null,"abstract":"<p><strong>Introduction: </strong>Specialized lifestyle programmes for patients undergoing metabolic-bariatric surgery (MBS) are provided to facilitate adjustment and adherence to a healthy lifestyle after surgery. However, pre-programme food and health literacy in MBS patients is often unknown. In the general population, approximately three-quarters of people exhibit sufficient health literacy. This study aimed to examine food and health literacy of patients awaiting MBS and to identify patient-specific factors associated with these literacies.</p><p><strong>Methods: </strong>Patients awaiting MBS completed questionnaires on food literacy (Self-Perceived Food Literacy scale) and health literacy (European Health Literacy Survey Questionnaire-16) at the start of a preoperative lifestyle programme. Linear and logistic regression analyses were used to identify associations between multiple variables and preoperative food and health literacy.</p><p><strong>Results: </strong>Among 216 patients, the preoperative mean food literacy score was 3.49 ± 0.44, on a five-point scale. Furthermore, 96.3% of patients showed sufficient health literacy, with scores of 13 or more out of 16. Patients with sufficient health literacy had higher food literacy scores (β 0.508; 95% CI: 0.208-0.809, p &lt; 0.001).</p><p><strong>Conclusion: </strong>This study among people living with obesity awaiting MBS suggests that food literacy is comparable, and health literacy is higher than in the general population. These findings emphasize the complexity of the aetiology of obesity due to factors that extend beyond food and health literacy.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"1-9"},"PeriodicalIF":3.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372442","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":"Validation of the 40-Item and 24-Item Short Version of the Person-Centred Obesity Care Instrument for Patients Living with Obesity.","authors":"Paige I Crompvoets, Anna Petra Nieboer, Elisabeth F C van Rossum, Jane M Cramm","doi":"10.1159/000541499","DOIUrl":"10.1159/000541499","url":null,"abstract":"<p><strong>Introduction: </strong>Person-centred care (PCC) may hold promise for improved healthcare experiences and outcomes among patients living with obesity. A validated instrument to assess the delivery of PCC to patients living with obesity is, however, currently lacking. This study aimed to validate such an instrument. In this article, we describe the development and psychometric testing of the 40-item and 24-item short version of the Person-Centred Obesity Care (PCOC) instrument.</p><p><strong>Methods: </strong>A total of 590 individuals living with obesity (BMI 33.4 ± 3.9) from a representative Dutch sample completed the 49-item PCOC instrument measuring the eight dimensions of PCC (patient preferences, physical comfort, coordination of care, emotional support, access to care, continuity and transition, information and education, and family and friends), and two measures of satisfaction with care. We performed confirmatory factor analyses to verify the factor structure of the instrument and examined its reliability and validity.</p><p><strong>Results: </strong>Fit indicators of the first model with all 49 items showed that the model left room for improvement (comparative fit index [CFI] &lt;0.90). A 40-item version was obtained with satisfactory-to-good fit (standardized root mean square residual [SRMR] = 0.05, root mean square error of approximation [RMSEA] = 0.06, CFI = 0.90). The instrument demonstrated good reliability, and the relationship between the PCOC and two indicators of satisfaction with care supported the validity of the scale. Shortening the instrument only further improved the fit indicators, resulting in the development of a 24-item short version (SRMR = 0.04, RMSEA = 0.05, CFI = 0.96), with similar results in terms of reliability and validity.</p><p><strong>Conclusion: </strong>The 40-item PCOC instrument and the 24-item short version showed to be reliable and valid instruments for the assessment of PCC among patients living with obesity. Based on the results, the 40 and 24-item PCOC are promising tools that can be used by clinicians and researchers to explore PCC delivery for patients living with obesity.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"1-11"},"PeriodicalIF":3.9,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351048","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":"Youths with extreme obesity: A high-risk group for pain and mental health impairments.","authors":"Hannah Schmidt,Ingo Menrath,Susanna Wiegand,Thomas Reinehr,Wieland Kiess,Johannes Hebebrand,Julia von Schnurbein,Reinhard W Holl,Rolf Holle,André Scherag,Martin Wabitsch,Stephanie Brandt-Heunemann","doi":"10.1159/000540888","DOIUrl":"https://doi.org/10.1159/000540888","url":null,"abstract":"BACKGROUNDYouths with extreme obesity (Body mass index (BMI)&gt;40) are at increased risk for physical and mental health impairments but this patient group has received little attention in research. This study aimed to analyze the pain experience and mental health impairments of youths with extreme obesity compared to those with mild and moderate obesity (BMI=30-39.9) by considering gender differences.METHODSCross-sectional data of 431 youths (M=16.6; SD=2.3; 53.1% female) were analyzed. Of these, 159 (36.8%) youths were characterized by extreme obesity. Self-reported sociodemographic data, pain-related variables, depression, and health-related quality of life (HRQoL) were assessed with standardized questionnaires. Data were analyzed with univariate tests and logistic regression models.RESULTSYouths with extreme obesity reported more pain in the last 4 weeks (p=.018), increased pain-related impairments in daily life (p=.009), more pain-related days of absence (p=.030), higher depression scores (p = .030), and reduced HRQoL (p=.005) compared to youths with mild and moderate obesity. In regression models, extreme obesity and pain in the last 4 weeks were associated when additionally including sex and age in the model (odds ratio 1.88; 95 % confidence interval 1.16 - 30.40, p=.010). In the subgroup of extreme obesity (n=159), women (n=83) reported more pain in the last 4 weeks (p=.001), higher depression scores (p&lt;.001), and lower HRQoL (p&lt;.001) compared to men (n=76).CONCLUSIONThese findings underpin the need for standardized assessments of pain and mental health, especially in the treatment of female youths with extreme obesity. Upcoming studies may analyze reciprocal interactions since both aspects are important barriers for lifestyle changes and weight loss.","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":"13 1","pages":"1-25"},"PeriodicalIF":3.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253668","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":"Bibliometric insights into research hotspots and trends in obesity and asthma from 2013 to 2023.","authors":"Peng Cao,Jiake Li,Guohui Wang,Xulong Sun,Zhi Luo,Shaihong Zhu,Liyong Zhu","doi":"10.1159/000541474","DOIUrl":"https://doi.org/10.1159/000541474","url":null,"abstract":"INTRODUCTIONObesity and asthma are closely linked, but the current state of research on this topic and future research directions have yet to be comprehensively explored. This study aims to provide an up-to-date overview of the research landscape in the field of obesity and asthma.METHODSA bibliometric analysis was conducted using the Web of Science Core Collection database to identify papers published on obesity and asthma between 2013 and 2023. VOSviewer software was utilized for statistical analysis and visualization of collaborative networks, research trends, literature sources, citation analysis, co-citation analysis, and keyword analysis.RESULTSA total of 3406 records from 1010 journals authored by 17347 researchers affiliated with 4573 institutes across 117 countries and regions were retrieved. The number of publications and citations increased annually. The United States and China contributed the majority of records. Major nodes in the collaboration network map included Harvard Medical School, Johns Hopkins University, University of Newcastle, Karolinska Institution, University of Toronto, and Seoul National University. Prolific authors included Anne E. Dixon, Erick Forno, Lisa G. Wood, Deepa Rastogi, and Fernando Holguin. Research trends and hotspots focused on metabolism studies, Mendelian randomization, gut microbiome, inflammation response, gene, biomarker research, and comorbidities were identified as potential future research frontiers.CONCLUSIONThis study provides a comprehensive overview of the current research status and trends in the field of obesity and asthma. Our findings highlight the importance of understanding collaboration patterns, research hotspots, and emerging frontiers to guide future research in this area.","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":"194 1","pages":"1-34"},"PeriodicalIF":3.6,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253666","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":"Long-term change in BMI for children with obesity treated in family-centered lifestyle interventions.","authors":"Rasmus Møller Jørgensen,Henrik Støvring,Jane Nautrup Østergaard,Susanne Hede,Katrine Svendsen,Esben Thyssen Vestergaard,Jens Meldgaard Bruun","doi":"10.1159/000540389","DOIUrl":"https://doi.org/10.1159/000540389","url":null,"abstract":"Introduction Several evaluations of lifestyle interventions for childhood obesity exist; however, follow-up beyond two years is necessary to validate the effect. The aim of the present study was to investigate long-term weight development following children participating in one of two pragmatic family-centered lifestyle interventions for children with obesity. Methods This real-life observational study included Danish children 4-17 years of age classified as having obesity. Data from 2010-2020, from two community-based family-centered lifestyle interventions (designated hereafter as the Aarhus- and the Randers-intervention) were merged with national registers and routine health check-ups, including height and weight. Adjusted mixed effect models were used to model changes in Body Mass Index (BMI) z-score. We performed exploratory analyses of the development in BMI z-score within stratified subgroups of children treated in the interventions before investigating potential effect modifications induced by sex, age, family structure, socioeconomic or immigration status. Results With a median follow-up of 2.8 years (interquartile range: 1.3;4.8), 703 children participated in an intervention (445 the Aarhus-intervention; 258 the Randers-intervention) and 2,337 children were not invited to participate (no-intervention). Children in both interventions experienced a comparable reduction in BMI z-scores during the first 6 months compared to the no-intervention group (Aarhus-intervention: -0.12 SD/year and Randers-intervention: -0.25 SD/year). Only children in the Randers-intervention reduced their BMI z-score throughout follow-up (Aarhus-intervention vs. no-intervention: 0.01 SD/year; CI:-0.01;0.04; Randers-intervention vs. no-intervention: -0.05 SD/year; CI:-0.08;-0.02). In a subgroup comparisons combining the two interventions, family income below the median (-0.05 SD/year, CI: -0.02;-0.09), immigrant background (0.04 SD/year, CI: 0.00; 0.07), or receiving intervention less than one year (0.04 SD/year, CI: 0.00;0.08) were associated with a yearly change in BMI z-score. In addition, effect modification analyses did not observe any interaction by sex, age, family structure, socioeconomic or immigration. Conclusions Although the more dynamic intervention with longer duration obtained and sustained a minor reduction in BMI z-score, the clinical impact may only be modest. However, this effect may at the best be only modest and still not effective enough to induce a long-term beneficial development in BMI in children with obesity.","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":"66 1","pages":"1-19"},"PeriodicalIF":3.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253667","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":"Semaglutide Treatment in a Patient with Extreme Obesity and Massive Lymphedema: A Case Report.","authors":"Joanne Thanh-Tâm Nguyen,Marie-Amélie Barbet-Massin,Emilie Pupier,Alice Larroumet,Laurène Bosc,Marie Michelet,Maud Monsaingeon-Henry,Blandine Gatta-Cherifi","doi":"10.1159/000540241","DOIUrl":"https://doi.org/10.1159/000540241","url":null,"abstract":"INTRODUCTIONExtreme obesity (BMI ≥ 50 kg/m2) is a complex pathology to treat. One of the complications of extreme obesity is massive localized lymphedema (MLL), due to compromised lymphatic drainage. There is a lack of literature guiding the medical management of these conditions.CASE PRESENTATIONWe present a 43-year-old male who was admitted to our specialized obesity center for weight management. His initial weight was 255 kg and BMI, 93.7 kg/m2. He suffered from massive multifocal lymphedema of his left leg. He was bedridden due to his condition and malnourished, as shown by multiple vitamin deficiencies. The patient received care from our multidisciplinary team including nurses, dieticians, physical therapists, and psychologists. Treatment with semaglutide was started in hospital and continued at home. The maximal dose used was 1 mg/week but decreased during follow-up to 0.25 mg/week to avoid malnutrition. Protein and nutritional supplements were added. At 28 weeks of therapy, the patient had lost 40 kg or 15.7% of his total body weight (TBW). His lymphedema decreased; he had lost at least 16 cm of his left thigh circumference. He was able to walk again and regain autonomy of his daily activities of living.CONCLUSIONSemaglutide can be effective in patients with extreme obesity, with the support of a multidisciplinary team in a specialized obesity center. It can also help decrease MLL. More data is needed to guide medical treatment of patients with extreme obesity and MLL.","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":"2 1","pages":"1-11"},"PeriodicalIF":3.6,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142192529","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":"Psychometric Properties of the WBIS/M in a Representative Prebariatric Sample: Evidence for an Improved 10-Item Version.","authors":"Simon Schraven, Claudia Hübner, Janina Eichler, Thomas Mansfeld, Johannes Sander, Florian Seyfried, Stefan Kaiser, Arne Dietrich, Ricarda Schmidt, Anja Hilbert","doi":"10.1159/000537689","DOIUrl":"10.1159/000537689","url":null,"abstract":"<p><strong>Introduction: </strong>The Weight Bias Internalization Scale and the Modified Weight Bias Internalization Scale are well-established self-report questionnaires for assessing weight bias internalization, which is widespread among bariatric patients. However, among this group, psychometric properties of the Weight Bias Internalization Scale have only been examined in small samples showing unsatisfactory model fit and have not been explored for the modified questionnaire.</p><p><strong>Methods: </strong>This study psychometrically evaluated and compared the Weight Bias Internalization Scale and Modified Weight Bias Internalization Scale in a large sample of prebariatric patients (N = 825, mean age = 46.75 years, SD = 11.55) regarding item characteristics, model fit to unidimensionality, reliability, construct validity, and measurement invariance.</p><p><strong>Results: </strong>Item 4 of both questionnaires showed low corrected item-total correlations (&lt;0.40) and was therefore removed from the scales. The new 10-item versions showed improved item characteristics, internal consistency, model fit to unidimensionality, and convergent and divergent validity when compared to the 11-item versions. The best psychometric properties were found for the 10-item version of the Modified Weight Bias Internalization Scale.</p><p><strong>Conclusion: </strong>The 10-item version of the Modified Weight Bias Internalization Scale surpasses the other versions studied in all psychometric properties. Therefore, it should be used in prebariatric patients to detect weight bias internalization and provide them with psychological interventions that could improve bariatric surgery outcomes.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"329-337"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730181","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":"Behind BMI: The Potential Indicative Role of Abdominal Ectopic Fat on Glucose Metabolism.","authors":"Xiaoyang Li, Hao Ren, Hui Xu, Xinjun Han, Jun Lu, Zhenghan Yang","doi":"10.1159/000536160","DOIUrl":"10.1159/000536160","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study was to compare the difference in abdominal fat distribution between different metabolic groups and find the ectopic fat with the most risk significance.</p><p><strong>Methods: </strong>A total of 98 subjects were enrolled; there were 53 cases in the normal glucose metabolism group and 45 cases in the abnormal glucose metabolism group. Chemical shift-encoded magnetic resonance imaging was applied for quantification of pancreatic fat fraction (PFF) and hepatic fat fraction (HFF), subcutaneous adipose tissue (SAT), and visceral adipose tissue (VAT). The correlation and the difference of fat distribution between different metabolism groups were analyzed. The receiver operating characteristic (ROC) curve was used to analyze the suggestive effect of different body fat fraction.</p><p><strong>Results: </strong>Correlation analysis showed that body mass index (BMI) had the strongest correlation with fasting insulin (r = 0.473, p &lt; 0.001), HOMA-IR (r = 0.363, p &lt; 0.001), and C-reactive protein (r = 0.245, p &lt; 0.05). Pancreatic fat has a good correlation with fasting blood glucose (r = 0.247, p &lt; 0.05) and HbA1c (r = 0.363, p &lt; 0.001). With the increase of BMI, PFF, VAT, and SAT showed a clear upward trend, but liver fat was distributed relatively more randomly. The pancreatic fat content in the abnormal glucose metabolism group is significantly higher than that in the normal group, and pancreatic fat is also a reliable indicator of abnormal glucose metabolism, especially in the normal and overweight groups (the area under the curve was 0.859 and 0.864, respectively).</p><p><strong>Conclusion: </strong>MR-based fat quantification techniques can provide additional information on fat distribution. There are differences in fat distribution among people with different metabolic status. People with more severe pancreatic fat deposition have a higher risk of glucose metabolism disorders.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"158-168"},"PeriodicalIF":3.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10987183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139512971","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":"Adipositas Care and Health Therapy (ACHT) after Bariatric-Metabolic Surgery: A Prospective, Non-Randomized Intervention Study.","authors":"Renée Stark, Anna Renz, Michael Hanselmann, Christina Haas, Anne Neumann, Oliver Martini, Florian Seyfried, Michael Laxy, Christine Stier, Bettina Zippel-Schultz, Martin Fassnacht, Ann-Cathrin Koschker","doi":"10.1159/000538264","DOIUrl":"10.1159/000538264","url":null,"abstract":"<p><strong>Introduction: </strong>Almost 25% of German adults have obesity and numbers are rising, making it an important health issue. Bariatric-metabolic surgery reduces body weight and complications for persons with obesity, but therapeutic success requires long-term postoperative care. Since no German standards for follow-up by family physicians exist, follow-up is provided by surgical obesity centers, but they are reaching their limits. The ACHT study, funded by the German Innovation Fund, is designed to establish and evaluate the follow-up program, with local physicians following patients supported remotely by obesity centers.</p><p><strong>Methods: </strong>ACHT is a multicenter, prospective, non-randomized control group study. The 18-month ACHT follow-up program is a digitally supported, structured, cross-sectoral, and close-to-home program to improve success after bariatric-metabolic surgery. Four groups are compared: intervention group 1 starts the program immediately (3 weeks) after Roux-en-Y gastric bypass or sleeve gastrectomy (months 1-18 postoperatively), intervention group 2 begins the program 18 months after surgery (months 19-36 postoperatively). Intervention groups are compared to respective control groups that had surgery 18 and 36 months previously. In total, 250 patients, enrolled in the intervention groups, are compared with 360 patients in the control groups, who only receive standard care.</p><p><strong>Results: </strong>The primary endpoint to compare intervention and control groups is the adapted King's score, a composite tool evaluating physical, psychological, socioeconomic, and functional health status. Secondary endpoints include changes in care structures and care processes for the intervention groups. Multivariate regression analyses adjusting for confounders (including the type of surgery) are used to compare intervention and control groups and evaluate determinants in longitudinal analyses. The effect of the intervention on healthcare costs will be evaluated based on health insurance billing data of patients who had bariatric-metabolic surgery in the 3 years prior to the start of the study and of patients who undergo bariatric-metabolic surgery during the study period.</p><p><strong>Conclusions: </strong>ACHT will be the one of the first evaluated structured, close-to-home follow-up programs for bariatric surgery in Germany. It will evaluate the effectiveness of the implemented program regarding improvements in health status, mental health, quality of life, and the feasibility of such a program outside of specialized obesity centers.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"311-324"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140306332","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}