Obesity Science & Practice最新文献

{"title":"Weight Stigma and Orthopedic Surgeons' Treatment Preferences for Patients With Obesity Who Are Candidates for Elective Total Knee Arthroplasty.","authors":"Yaniv Yonai, Rawan Masarwa, Merav Ben Natan, Yaron Berkovich","doi":"10.1002/osp4.70059","DOIUrl":"10.1002/osp4.70059","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine how anti-fat attitudes and attitudes toward obesity management influence orthopedic surgeons' treatment preferences for patients with obesity who are candidates for elective total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 150 orthopedic surgeons using a web-based questionnaire. The survey included four sections: socio-demographic data, the Antifat Attitudes Questionnaire (AFA) assessing biases related to obesity (dislike, fear of fatness, and beliefs about willpower), an adapted questionnaire on attitudes toward obesity management, and a custom section on treatment preferences.</p><p><strong>Results: </strong>The sample had a mean age of 43.4 years (SD = 9.7) and was predominantly male (70.7%). Participants exhibited moderate anti-fat attitudes alongside positive views on obesity management. Stronger anti-fat attitudes correlated with a preference for conservative treatments over surgery (<i>r</i> = 0.45 to <i>r</i> = 0.29, <i>p</i> < 0.001), whereas supportive attitudes toward obesity management were associated with less preference for conservative treatment (<i>r</i> = -0.53, <i>p</i> < 0.001). Male surgeons demonstrated higher anti-fat attitudes and a greater inclination for conservative treatment than female surgeons. Regression analysis identified attitudes toward obesity management as a significant predictor of treatment preferences (<i>β</i> = -0.54, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Findings highlight the impact of weight stigma on clinical decision-making and emphasise the need for increased awareness and education to ensure equitable access to TKA for patients with obesity.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"11 1","pages":"e70059"},"PeriodicalIF":1.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143409337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motivational Interviewing (MI) in Obesity Care: Cultivating Person-Centered and Supportive Clinical Conversations to Reduce Stigma: A Narrative Review.","authors":"Violeta Moizé, Yitka Graham, Ximena Ramos Salas, Mercè Balcells","doi":"10.1002/osp4.70057","DOIUrl":"10.1002/osp4.70057","url":null,"abstract":"<p><strong>Background: </strong>Patients perceive high levels of weight prejudice, stigma, and discrimination within health systems, affecting their ability to manage their obesity and related chronic conditions. Scientific and patient obesity associations worldwide have prioritized the reduction of weight stigma to improve patient experiences in health systems and overall health outcomes. Since a significant proportion of the population is now living with multiple chronic diseases related to obesity, healthcare systems must shift toward multi-disease management frameworks incorporating person-centered and non-stigmatizing clinical conversations. Motivational Interviewing (MI) has the potential to transform clinical interactions by using non-stigmatizing language, communication, and practices. Studies using MI in obesity management have solely focused on weight loss outcomes, while other patient experience related outcomes would also be relevant to evaluate.</p><p><strong>Methods: </strong>A narrative review was undertaken to critically analyze the potential impact of MI on obesity and chronic disease management practices and experiences.</p><p><strong>Findings: </strong>An analysis and contextualization of the MI theoretical framework for obesity management, based on the philosophy of motivational spirit, was reviewed, assessing micro skills or strategies.</p><p><strong>Conclusion: </strong>MI may assist healthcare professionals conduct non-stigmatizing clinical conversations in accordance with basic principles of collaborative therapeutic alliances. A proposal for research considerations that can help illuminate the potential for of MI in obesity management is also outlined.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"11 1","pages":"e70057"},"PeriodicalIF":1.9,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Body Mass Index (BMI) and Dyslipidemia: Results From the PERSIAN Guilan Cohort Study (PGCS).","authors":"Jahangir Shahraz, Farahnaz Joukar, Fateme Sheida, Sara Yeganeh, Saman Maroufizadeh, Massood Baghaee, Mohammadreza Naghipour, Fariborz Mansour-Ghanaei","doi":"10.1002/osp4.70055","DOIUrl":"10.1002/osp4.70055","url":null,"abstract":"<p><strong>Background: </strong>Obesity and dyslipidemia are interconnected complex conditions and their prevalence differs across different geographical regions. As a major risk factor for cardiovascular diseases, dyslipidemia is often misdiagnosed and inadequately treated, highlighting the need for region-specific public health policies. Therefore, the objective of this study was to examine the associations between BMI and dyslipidemia in the Prospective Epidemiological Research Studies in Iran (PERSIAN) Guilan Cohort study (PGCS) population.</p><p><strong>Methods: </strong>This cross-sectional study analyzed the demographic and biochemical data from 10,519 participants of the PGCS population. Participants were divided into two groups with and without dyslipidemia and were compared based on BMI. Data analysis was performed in SPSS v16 with a significance level of < 0.05.</p><p><strong>Results: </strong>The average age of the participants was 51.52 ± 8.90 years. The prevalence of dyslipidemia in all participants was equal to 75.83%. Among those with dyslipidemia, 41.18% and 35.39% had overweight and obesity, respectively. There was a positive association between BMI and the prevalence of dyslipidemia (unadjusted OR = 1.09, 95% confidence interval (CI): 1.08-1.10) (<i>p</i> < 0.01), indicating that for a one-unit increase in participants' BMI, the probability of having dyslipidemia increased by 9%, which remained statistically significant even after adjusting. Analysis of dyslipidemia components and BMI revealed a significant association between elevated TG and cholesterol, as well as low HDL levels and higher BMI (unadjusted OR = 1.04, 1.01, and 1.09, respectively) (<i>p</i> < 0.01). However, this was not statistically significant for high LDL levels (unadjusted OR = 1.01) (<i>p</i> = 0.05).</p><p><strong>Conclusion: </strong>Given the high prevalence of dyslipidemia in our studied region and its strong association with obesity, prioritizing obesity management in public health decision-making is vital. Greater focus should be given on accessing and modifying the components of dyslipidemia, particularly LDL particles, as a potentially significant research target to prevent the mismanagement of dyslipidemia in individuals with obesity.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"11 1","pages":"e70055"},"PeriodicalIF":1.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11802237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Testing a Personalized Behavioral Weight Loss Approach Using Multifactor Prescriptions and Self-Experimentation: 12-Week mHealth Pilot Randomized Controlled Trial Results.","authors":"Caitlin E Martinez, Karen E Hatley, Kristen Polzien, Molly Diamond, Deborah F Tate","doi":"10.1002/osp4.70051","DOIUrl":"10.1002/osp4.70051","url":null,"abstract":"<p><strong>Background: </strong>Behavioral weight loss (WL) interventions typically follow standard diet and activity prescriptions for intervention duration to produce an energy deficit. Though average weight losses in these programs are clinically meaningful, there is heterogeneity in weight outcomes. Personalized diet and activity prescriptions may help increase the potency of WL programs by reducing this heterogeneity.</p><p><strong>Methods: </strong>This 12-week pilot study randomized participants (<i>n</i> = 35; BMI 34.6 ± 4.9 kg/m², 34% with HbA1c 5.7%-6.4%) in a 3:1 ratio to a Personalized Behavioral Weight Loss (PBWL) or standard BWL and compared the feasibility and efficacy of these approaches. Both groups received a study mobile app, smart scale, activity tracker, and weekly telephone coaching sessions; PBWL participants received a continuous glucose monitoring device. PBWL participants had goals for 1) macronutrient composition (low fat or carbohydrate), 2) meal frequency (3 meals or meals and snacks), and 3) activity focus (daily or weekly goal); they experimented with different 3-part prescriptions, in random order and combination, for the first 4 weeks then picked their 3 goals to follow for weeks 5-12.</p><p><strong>Results: </strong>Study retention (100%) and satisfaction were high. Mean 3-month weight loss (kg) was greater in PBWL (-7.08 (0.74)) than BWL (-3.79 (0.84), <i>P</i> = 0.03); 74% of PBWL and 63% of BWL participants were \"optimizers\" who achieved a 5% weight loss at 3 months. PBWL optimizers lost more weight (-8.66 (0.66)) than BWL optimizers (-4.76 (0.43), <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Experimentally-derived personalized prescriptions supported greater 12-week weight loss than standard recommendations. <b>Trial Registration:</b> ClinicalTrials.gov NCT04639076.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"11 1","pages":"e70051"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11794237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association of Physical Activity With Overweight/Obesity and Type 2 Diabetes in Nepalese Adults: Evidence From a Nationwide Non-Communicable Disease Risk Factor Survey.","authors":"Ritesh Chimoriya, Kritika Rana, Jonas Adhikari, Sarah J Aitken, Prakash Poudel, Aayush Baral, Lal Rawal, Milan K Piya","doi":"10.1002/osp4.70046","DOIUrl":"10.1002/osp4.70046","url":null,"abstract":"<p><strong>Background: </strong>The rising prevalence of obesity and type 2 diabetes (T2DM) is a significant public health concern, particularly in low- and middle-income countries. This study aimed to explore the association between physical activity levels, overweight/obesity, and T2DM in a nationwide survey of Nepalese adults.</p><p><strong>Methods: </strong>This was a secondary analysis of the 2019 non-communicable diseases (NCD) risk factors STEPS survey conducted in Nepal. Demographic and anthropometric data, body mass index (BMI) and T2DM status were collected along with assessment of physical activity using Global Physical Activity Questionnaire (GPAQ). A two-stage data analysis was conducted, first using descriptive statistics to summarize participant characteristics and differences across BMI and T2DM status, and then applying multivariate analyses to assess associations between physical activity levels, BMI and T2DM.</p><p><strong>Results: </strong>Of the 5284 participants included, 28.0% had overweight/obesity, 5.8% had obesity, and 6.5% had T2DM. The mean age of the participants was 40.1 years (95% CI: 39.8-40.6), and 63.9% were female. The overall physical activity energy expenditure was higher in the lean group (BMI < 25 kg/m²) compared to the those with overweight/obesity, and among participants without T2DM compared to those with T2DM. Sedentary behavior was more common among individuals with overweight/obesity and T2DM. A higher proportion of participants with low physical activity was observed in the overweight/obesity group compared to the lean group (8.9% vs. 6.3%) and the T2DM group compared to the non-T2DM group (11.7% vs. 6.7%). Low physical activity was associated with overweight/obesity (OR:1.4; 95% CI:1.1-1.8), obesity (OR:2.1; 95% CI:1.5-2.3), T2DM (OR:1.6; 95% CI:1.1-2.3) and T2DM in the presence of obesity (OR:3.6; 95% CI:1.7-7.8).</p><p><strong>Conclusion: </strong>This study highlights the low rates of physical activity and higher rates of sedentary behavior among adults with overweight/obesity and T2DM in Nepal. Public health interventions promoting physical activity and reducing sedentary behavior may help reduce the burden of these NCDs.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"11 1","pages":"e70046"},"PeriodicalIF":1.9,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization of Low-Dose Phentermine for Weight Loss Prior to Metabolic and Bariatric Surgery: A Prospective, Randomized, and Placebo-Controlled Trial.","authors":"Luis Garcia, Homero Rivas, John Morton","doi":"10.1002/osp4.70043","DOIUrl":"10.1002/osp4.70043","url":null,"abstract":"<p><strong>Introduction: </strong>Studies examining preoperative weight loss using pharmacotherapy in metabolic and bariatric patients are limited. The objective was to investigate if patients taking a low-dose formulation of phentermine had improved weight loss.</p><p><strong>Methods: </strong>This study was a randomized, placebo-controlled trial including patients undergoing laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy. Anthropometric and serological data were collected during the initial consult visit and again during two follow-up visits. Lomaira is a low-dose formulation of phentermine. Patients took 8-mg tablets three times a day for 14 weeks. The primary outcome of this study was weight loss, which was measured as percentage total weight loss (%TWL) and change in body mass index (BMI).</p><p><strong>Results: </strong>Among 53 participants randomized, 45 (85%) completed the trial. Participants were predominantly female (91%); the mean age was 41 years (SD = 11); and the mean initial BMI was 48.4 kg/m² (SD = 8.2 kg/m²). Average weight loss was 6.2 kg (SD = 6) in the treatment group versus 1.1 kg (SD = 4.54) in the placebo group (<i>p</i> = 0.001). Average % TWL was greater in treatment Group 4.7 ± 4.3 versus placebo Group 1.1 ± 3.6, <i>p</i> = 0.001. Multivariate regression analysis demonstrated that preoperative medication use was significantly associated with greater %TWL (<i>p</i> = 0.004). There was no difference in OR time or post-operative complications between the groups.</p><p><strong>Conclusions: </strong>Low-dose phentermine is efficacious and safe for preoperative weight loss in patients undergoing metabolic and bariatric surgery.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"11 1","pages":"e70043"},"PeriodicalIF":1.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Weight Loss Outcomes in a Virtual Weight Care Clinic Prescribing a Broad Range of Medications Alongside Behavior Change.","authors":"Jennifer M Clark, Brooke J Smith, Jessie L Juusola, Rekha B Kumar","doi":"10.1002/osp4.70036","DOIUrl":"10.1002/osp4.70036","url":null,"abstract":"<p><strong>Background: </strong>Virtually-delivered obesity care has the potential to increase access to weight loss interventions at scale. While there is ample literature assessing various weight loss interventions, studies specifically demonstrating outcomes of commercial programs offering antiobesity medications in virtual care settings are lacking.</p><p><strong>Methods: </strong>This retrospective cohort study assessed the weight loss outcomes of 66,094 participants in a virtual weight care program that prescribes antiobesity medications alongside a digital behavior change program. Outcomes included the primary endpoint of percent weight loss at 12 months, as well as absolute change in body weight, change in body mass index (BMI), categorical weight loss at three, six, and 12 months, and stratifications by program engagement and medication type (first vs. second generation antiobesity medications).</p><p><strong>Results: </strong>At program enrollment, members were on average 42.6 years old and 91.5% female, with a BMI of 36.0 kg/m². At 12 months, the mean percent weight loss was 8.0%, with weight loss increasing over time from 2.9 kg (SD = 3.7, Cohen's <i>d</i> = 0.8) at 3 months, to 5.8 kg (SD = 6.1, Cohen's <i>d</i> = 0.9) at 6 months, to 8.0 kg (SD = 8.7, Cohen's <i>d</i> = 0.9) at 12 months (<i>p</i> < 0.001 for all time points). At 12 months, 64.2% had achieved ≥ 5% weight loss. Weight loss outcomes increased with program engagement. At 12 months, those engaging at least once weekly lost 10.0% of body weight, while those logging weight at least weekly lost 12.0%.</p><p><strong>Conclusion: </strong>This study provides real-world evidence that users of a virtual commercial weight care clinic who were prescribed antiobesity medications achieved clinically significant weight loss at six and 12 months. These findings support the value of virtual platforms in efficiently scaling access to high-quality weight care.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"11 1","pages":"e70036"},"PeriodicalIF":1.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Longitudinal Changes in Body Mass Index and Longitudinal Changes in Hours of Screen Time, and Hours of Physical Activity in German Children.","authors":"Sophie Hoehne, Olga Pollatos, Petra Warschburger, Daniel Zimprich","doi":"10.1002/osp4.70031","DOIUrl":"10.1002/osp4.70031","url":null,"abstract":"<p><strong>Introduction: </strong>The association of screen time and physical activity with body weight in children has been investigated in cross-sectional and prospective studies, as well as randomized controlled trials. The present study extends previous research by examining how longitudinal within-person changes in screen time and physical activity relate to changes in Body Mass Index (BMI) in children, and how changes in screen time and physical activity relate to each other.</p><p><strong>Methods: </strong>The data for the present study came from the PIER Youth Study. Data were collected from 971 children and their parents at two time points approximately 1 year apart. A multilevel modeling approach with measurement occasions nested within children was used to model changes in BMI across age.</p><p><strong>Results: </strong>Within a child, a change in daily hours of TV viewing was associated with a corresponding change in BMI, whereas a change in daily hours of physical activity was associated with an opposite change in BMI. Within-person correlations between changes in screen time and physical activity were small but positive.</p><p><strong>Conclusion: </strong>The present findings have important implications for interventions to reduce and prevent childhood overweight and obesity. Specifically, interventions should focus on both reducing daily TV viewing and promoting physical activity.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"10 6","pages":"e70031"},"PeriodicalIF":1.9,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic and Bariatric Surgery Patients' Preoperative Dieting Attempts and Associations With Postoperative Outcomes.","authors":"LeeAnn C Swager, Keeley J Pratt, Haley M Kiser, Ashleigh A Pona","doi":"10.1002/osp4.70030","DOIUrl":"10.1002/osp4.70030","url":null,"abstract":"<p><strong>Purpose: </strong>Pre-operative eating disorders are well documented within the metabolic and bariatric surgery (MBS) population, yet subthreshold dieting attempts are less understood. The objectives of this study were to define and categorize patients' preoperative dieting attempts, and to determine how attempts are associated with postoperative outcomes, eating disorders, and demographics.</p><p><strong>Materials and methods: </strong>Three hundred twenty-one patients (81.0% female; 68.3% White) who had MBS (57.3% Roux-en-Y) between 2019 and 2020 were included. Preoperative dieting attempt responses were categorized as provider-managed, non-medically managed, and self-directed attempts; subtypes of dieting methods (e.g., low calorie) were described. Descriptive analyses were conducted for attempt categories and subtypes, and between attempts and readmissions, complications, eating disorders, and demographics. ANOVAs determined associations between attempts and %TWL at 6 and 12 months.</p><p><strong>Results: </strong>Patients reported an average of five to six preoperative dieting attempts; self-directed attempts were the most common (91.9%), and exercise was the most common subcategory (70.7%). Patients with  ≥ 1 provider-managed attempt were less likely to experience a complication (<i>p</i> < 0.001) and more likely to experience readmission (<i>p</i> = 0.018). Patients with 1 self-directed attempt were less likely to experience a complication (<i>p</i> = 0.045) and readmission (<i>p</i> < 0.001). Patients who experienced  ≥ 2 low fat diet attempts were more likely to have complications (<i>p</i> < 0.001) and readmissions (<i>p</i> = 0.008); patients with  ≥ 2 VLCD attempts were more likely to have a complication (<i>p</i> < 0.001). Patients who experienced  ≥ 2 non-medically managed attempts had higher preoperative BMIs (<i>p</i> = 0.03).</p><p><strong>Discussion: </strong>Given that patients engaged in frequent dieting attempts that fall outside formal assessments, future work should seek to expand pre-operative assessments.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"10 6","pages":"e70030"},"PeriodicalIF":1.9,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatic Safety of Tirzepatide and Its Effects on Islet Cell Function: A Systematic Review and Meta-Analysis.","authors":"A B M Kamrul-Hasan, Sunetra Mondal, Deep Dutta, Lakshmi Nagendra, Mohammed Ruhul Kabir, Joseph M Pappachan","doi":"10.1002/osp4.70032","DOIUrl":"10.1002/osp4.70032","url":null,"abstract":"<p><strong>Background: </strong>Endogenous glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) regulate islet cell function. GLP-1 receptor agonists (GLP-1RAs) have been associated with an elevated risk of acute pancreatitis. Data on the pancreatic safety of tirzepatide (a dual GLP-1 and GIP agonist) and its effects on islet cell function in randomized controlled trials (RCTs) are scarce. Moreover, no meta-analysis has comprehensively examined such effects of tirzepatide.</p><p><strong>Methods: </strong>Electronic databases were searched for RCTs with tirzepatide as the intervention and a placebo or active comparator as the control. The primary outcome was adjudication-confirmed pancreatitis; secondary outcomes were the percent changes from baseline in serum pancreatic amylase, lipase, insulin, C-peptide, glucagon, and homeostasis model assessment of insulin resistance (HOMA2-IR).</p><p><strong>Results: </strong>Seventeen RCTs with 18 published reports involving 14,645 subjects were analyzed. Over a follow-up duration of 12-72 weeks, tirzepatide had identical risks of pancreatitis to placebo (tirzepatide 5 mg: RR 2.04, 95% CI [0.27-15.69], <i>p</i> = 0.49; 10 mg: RR 0.63, 95% CI [0.08-5.12], <i>p</i> = 0.67; and 15 mg: RR 1.26, 95% CI [0.36-4.98], <i>p</i> = 0.72). Tirzepatide was also associated with comparable risks of pancreatitis to insulin and GLP-1RAs. However, tirzepatide (at all doses) caused greater increases in pancreatic amylase and lipase than placebo and insulin. Individuals on tirzepatide 15 mg and GLP-1RAs had similar risks of having increased lipase levels. The percent reductions in fasting insulin were greater with tirzepatide 10 and 15 mg than with placebo. All doses of tirzepatide caused greater percent reductions in fasting insulin, C-peptide, and glucagon than GLP-1RAs. Compared to placebo and GLP-1RAs, the percent reductions in HOMA2-IR were greater with all doses of tirzepatide.</p><p><strong>Conclusion: </strong>The meta-analysis provides evidence of the safety of tirzepatide regarding pancreatitis and establishes its positive effect on islet cell functions and insulin resistance.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"10 6","pages":"e70032"},"PeriodicalIF":1.9,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}