Obesity Science & Practice最新文献

{"title":"A Cross-Sectional Study Investigating the Relationship Between the <i>FTO</i> Gene Polymorphism in Relation to Obesity Traits and Vitamin D Status in Adolescence.","authors":"Ahmad Al-Serri, Rabeah A Al-Temaimi, Abdullah Al-Taiar, Lemia Shaban, Reem Al-Sabah, Abdur Rahman, Ali H Ziyab","doi":"10.1002/osp4.70112","DOIUrl":"10.1002/osp4.70112","url":null,"abstract":"<p><strong>Background and objective: </strong>Obesity affects 18%-25% of adolescents globally and represents a major public health challenge. Genetic factors contribute to obesity susceptibility, with the <i>FTO</i> gene variant rs9939609 consistently associated with obesity in adults; however, evidence in adolescents is limited. This study examined the association between <i>FTO</i> and obesity traits in adolescents and explored potential interactions with vitamin D status.</p><p><strong>Methods: </strong>In this cross-sectional study, 509 adolescents aged 10-15 years were genotyped for <i>FTO</i> rs9939609. Obesity traits, including BMI, BMI z-score, and waist circumference, were assessed. Associations with genotype were analyzed using an additive genetic model, and potential interactions with vitamin D status were evaluated.</p><p><strong>Results: </strong>The A allele was significantly associated with higher adiposity: BMI (<i>β</i> = 1.29 kg/m², <i>p</i> = 0.0008) and waist circumference (<i>β</i> = 3.24 cm, <i>p</i> = 0.001). Each additional risk allele increased the odds of having overweight or obesity by 53% (OR = 1.53, 95% CI: 1.19-1.98, <i>p</i> = 0.001). No significant interaction was observed between <i>FTO</i> and vitamin D status (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>This first report from the Arabian Gulf region confirms the association between <i>FTO</i> rs9939609 and adiposity in adolescents, underscoring the contribution of genetic factors to obesity risk in young populations.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 1","pages":"e70112"},"PeriodicalIF":2.5,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12779603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952540","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 of Fitness, Fatness Indices and Fit-Fat Index Variants With Cardiovascular and All-Cause Mortality in Men.","authors":"Nzechukwu M Isiozor, Setor K Kunutsor, Sudhir Kurl, Kai Savonen, Jussi Kauhanen, Jari A Laukkanen","doi":"10.1002/osp4.70108","DOIUrl":"10.1002/osp4.70108","url":null,"abstract":"<p><strong>Background: </strong>Fit-Fat Index (FFI), defined as the ratio of cardiorespiratory fitness (CRF) to waist-to-height ratio (WHtR), combines measures of fitness and fatness, and may offer a more accurate assessment of cardiometabolic risk than either component alone. The prospective associations of CRF, fatness indices, and mortality were examined.</p><p><strong>Methods: </strong>CRF and fatness indices (body mass index [BMI], waist-to-hip ratio [WHR], and WHtR) were assessed in 1089 men aged 42-61 years. FFI variants (FFI_BMI, FFI_WHR, and FFI_WHtR) were calculated by dividing CRF by each corresponding fatness measure. Hazard ratios (HRs) with 95% confidence intervals (CIs) and risk prediction metrics were estimated.</p><p><strong>Results: </strong>Over a median follow-up of 31.2 years, 288 CVD deaths and 695 all-cause deaths were recorded. After multivariable adjustment, the HR (95% CI) for CVD death per 1 SD increase was 0.81 (0.70-0.93) for CRF, 1.09 (0.96-1.23) for BMI, 1.13 (1.02-1.25) for WHR, 1.13 (0.99-1.30) for WHtR, 0.82 (0.71-0.95) for FFI_BMI, 0.78 (0.68-0.91) for FFI_WHR, and 0.80 (0.69-0.93) for FFI_WHtR. Findings were similar for all-cause mortality. Addition of CRF and FFI variants to a model containing established risk factors significantly improved CVD mortality risk prediction and reclassification (<i>p</i>-value for all < 0.05).</p><p><strong>Conclusions: </strong>Combining aerobic fitness and fatness into FFI measures may provide better risk stratification than either aerobic fitness or fatness alone.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 1","pages":"e70108"},"PeriodicalIF":2.5,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12774866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934459","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":"Changes to Weight Bias Internalization and Eating Behaviors in Adults Aged 50+ With Overweight or Obesity During a Structured 12-Week Behavioral Weight Management Intervention.","authors":"Erica Howes, Kristen R Howard, Eleni Laskaridou, Molly Parker, Austin D'Angelo, Jenna Warnock, Cameron Heidary, Sienna Lambert, Ved Thakur, Brenda M Davy","doi":"10.1002/osp4.70110","DOIUrl":"10.1002/osp4.70110","url":null,"abstract":"<p><strong>Background: </strong>Weight stigma is a prevalent issue among individuals with overweight and obesity pursuing weight loss; however, few studies have examined this issue in middle-aged and older adults. Treatment-seeking populations may also be at risk of disordered eating or excess concern about weight and shape; thus, it is important to evaluate how these parameters may change over the course of a weight loss intervention.</p><p><strong>Methods: </strong>Adults aged 50+ (<i>n</i> = 83; 60 F, 23 M) completed measures of experiences of weight stigma, weight bias internalization (WBIS-M), the Eating Disorder Examination Questionnaire (EDE-Q), and binge eating (BES) at baseline and after completion of a structured 12-week behavioral weight loss intervention.</p><p><strong>Results: </strong>Forty-five percent of participants reported previous experiences of weight stigma at baseline through either teasing, unfair treatment, or discrimination. At baseline, the mean WBIS-M score was 3.37 (SD 1.03). From baseline to post-intervention, there were decreases (all <i>p</i> < 0.05) in WBIS-M scores (adjusted mean difference -0.46), scores on the shape concern subscale of the EDE-Q (adjusted mean difference -0.75), and BES scores (adjusted mean difference -3.75). Scores on the restraint subscale of the EDE-Q increased by an adjusted mean of 1.77 units.</p><p><strong>Conclusions: </strong>These findings suggest that participating in a structured behavioral weight loss program may have beneficial effects on weight bias, body shape concern, and binge eating, consistent with previous findings in weight management interventions in younger populations. Future work is needed to determine if changes to weight bias internalization and eating behaviors persist during weight loss maintenance.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 1","pages":"e70110"},"PeriodicalIF":2.5,"publicationDate":"2026-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12765478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906352","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":"Framing Obesity: The Role of the Research System in Perpetuating or Challenging Weight Stigma.","authors":"James Kite, Timothy Broady, Xochitl de la Piedad Garcia, John Dixon, Monica Garner, Tim Gill, Briony Hill, Elizabeth Holmes-Truscott, Blake Lawrence, Zanab Malik, Kimberley Norman, Andrew Wilson","doi":"10.1002/osp4.70111","DOIUrl":"10.1002/osp4.70111","url":null,"abstract":"<p><p>This commentary highlights the critical role of research systems and framing in either perpetuating or challenging weight stigma. Despite growing recognition of weight stigma as a public health issue, research discourse can reinforce harmful narratives through weight-centric models, stigmatizing language, and narrow focus on weight. We call for inclusive, transdisciplinary, and co-designed research that centers lived experience and prioritizes health outcomes over weight loss. We advocate for systemic changes across research funding, ethics, publication, and dissemination practices to reduce stigma and promote equity.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 1","pages":"e70111"},"PeriodicalIF":2.5,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12750094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878776","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":"Relationships Between Metabolic and Bariatric Surgery and Adverse Kidney Outcomes: An Analysis of a Retrospective Cohort.","authors":"Kevin C Maki, Stephanie L Dickinson, Carol F Kirkpatrick, Yongming Qu, Vipin Arora, Xiwei Chen, Bailey Ortyl, Douglas P Landsittel, Sumayyah Ali, Allon N Friedman","doi":"10.1002/osp4.70109","DOIUrl":"10.1002/osp4.70109","url":null,"abstract":"<p><strong>Objective: </strong>Obesity is associated with an increased risk of chronic kidney disease. Metabolic and bariatric surgery (MBS) is currently the most effective intervention for sustained weight loss and may reduce the risk of obesity-associated kidney disease. This study examined the relationships between MBS and adverse kidney outcomes.</p><p><strong>Methods: </strong>This retrospective cohort analysis included 4322 patients with obesity, with or without type 2 diabetes mellitus (T2D), who underwent MBS, and 30,919 nonsurgical control patients from a large health system within the state of Indiana. A primary kidney composite [≥ 1 estimated glomerular filtration rate (eGFR) < 15 mL/min/1.73 m², ≥ 1 eGFR measurement with a ≥ 40% decrease from baseline, or kidney failure-related death], as well as secondary and tertiary composite and individual outcomes were assessed. Multivariable Cox regression models with and without inverse propensity of treatment weighting were employed to assess associations between MBS and incidence rate for each kidney outcome compared with nonsurgical controls.</p><p><strong>Results: </strong>The mean (standard deviation) follow-up duration was 6.1 (4.5) years. MBS was associated with a 53% (HR: 0.47; 95% CI: 0.42, 0.52; <i>p</i> < 0.001) and 48% (HR: 0.52; 95% CI: 0.46, 0.60; <i>p</i> < 0.001) lower incidence of the primary kidney composite outcome in patients with and without T2D, respectively, and 48%-56% lower risks for the secondary and tertiary outcomes, regardless of T2D status, compared to controls.</p><p><strong>Conclusions: </strong>MBS was associated with markedly lower risks for adverse kidney outcomes in patients with obesity. These results support the potential for MBS as a weight loss intervention to preserve kidney function in patients with obesity, both with and without T2D.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"11 6","pages":"e70109"},"PeriodicalIF":2.5,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12744858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145857598","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":"Exploring Methods of Adjusting VO₂max for Body Size to Estimate Aerobic Capacity in People Presenting for Metabolic and Bariatric Surgery.","authors":"Rebecca Dostan, Sara Slayman, Belinda Durey, Brett Tarca, Justin Bessell, Kade Davison","doi":"10.1002/osp4.70105","DOIUrl":"10.1002/osp4.70105","url":null,"abstract":"<p><strong>Background: </strong>In perioperative settings exercise testing can be used to assess a patient's physical fitness, with VO₂max used as a marker to indicate fitness and subsequent risk of adverse surgical outcomes. However, the commonly used reporting methods of VO₂max may be problematic in populations with excessive FM such as those awaiting MBS for obesity. Hence, alternative ways of expressing VO₂max will be explored.</p><p><strong>Methods: </strong>Historical data from individuals presenting for MBS were analyzed. Predicted VO₂max values were adjusted relative to the participants measured and \"normative\" body mass, where each prediction was assigned a classification score. Predicted VO₂max adjusted to the participants measured FFM was also considered. Data were compared to individuals that are lean and sedentary as well as those with obesity from a previous study.</p><p><strong>Results: </strong>Data from 20 participants awaiting MBS (43.15 ± 11.82 years, 68.50 ± 8.39 cm, 115.29 ± 16.82 kg and 59.93 ± 8.69 kg FFM) were examined. Predicted VO₂max relative: to total mass was 20.15 ± 5.00 mL/kg/min; normative body mass was 30.04 ± 6.58 mL/kg/min; and FFM was 38.55 ± 9.08 mL/kg FFM/min. Median fitness classifications increased from very poor to poor when predicted VO₂max was expressed relative to normative body mass.</p><p><strong>Conclusions: </strong>Reporting predicted VO₂max results relative to body mass may be underestimating fitness and overestimating surgical risk in people who are very obese.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"11 6","pages":"e70105"},"PeriodicalIF":2.5,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12723064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145828073","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":"Interaction of Obese Body Mass Index and Comorbidities on Inflammatory Profiles and Clinical Outcomes After Traumatic Brain Injury: A TRACK-TBI Study.","authors":"Shawn R Eagle, Mary U Simons, Jason Barber, Nancy Temkin, John K Yue, Ava Puccio, Michael A McCrea, Joseph Giacino, Geoffrey Manley, David O Okonkwo, Lindsay D Nelson","doi":"10.1002/osp4.70101","DOIUrl":"10.1002/osp4.70101","url":null,"abstract":"<p><strong>Objective: </strong>Obesity has been associated with worse clinical outcomes after mild traumatic brain injury (mTBI; Glasgow Coma Scale score between 13 and 15). Augmented inflammatory response to mTBI appears to be an important modifier of outcomes for the patients with obesity, but the contribution of comorbidity profile has yet to be analyzed. The objective of this study was to examine the association of: 1. comorbidity profile; and 2. the interaction of obesity with comorbidity profile on clinical outcomes and inflammatory blood biomarkers after mTBI.</p><p><strong>Methods: </strong>Participants were enrolled across emergency departments within 24 h of injury, with clinical outcomes and neurocognitive tests assessed at 2 weeks and 6 months post-injury (<i>n</i> = 1337). Latent class analysis (LCA) was used to identify comorbidity profiles and mixed-effect models for the association of obesity and comorbidity profile on inflammatory/clinical outcomes.</p><p><strong>Results: </strong>Using LCA, 3 classes of comorbidities were identified: \"cardiovascular\" (high rates of cardiovascular disease, hypertension, hyperlipidemia, diabetes; <i>n</i> = 287; 21%), \"internalizing\" (high rates of depression/anxiety, <i>n</i> = 121; 9%), and \"healthy\" (0%-8% rate of comorbidities; <i>n</i> = 929; 69%). \"Healthy\" had higher rates of functional recovery at 6 month (31%; <i>p</i> = 0.001) than \"cardiovascular\" and \"internalizing\" (15%-26%). Within \"healthy,\" obesity was associated with higher c-reactive protein levels on day 1 (ratio = 1.86; <i>p</i> < 0.001), 2 week (ratio = 2.05; <i>p</i> < 0.001) and 6 month (ratio = 2.34; <i>p</i> < 0.001) relative to normal BMI. Obesity was associated with higher IL-6 levels at 2 week (ratio = 1.36; <i>p</i> = 0.005) and 6 month (ratio = 1.47; <i>p</i> < 0.001) relative to normal BMI within \"healthy.\"</p><p><strong>Conclusions: </strong>Obesity and comorbidity profiles are associated with an inflammatory response with the potential to impact recovery; consideration of systemic health at the time of injury could improve recovery.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"11 6","pages":"e70101"},"PeriodicalIF":2.5,"publicationDate":"2025-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12719804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145820404","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":"Body Mass Index and Its Influence on Electrocardiographic Parameters in Healthy and Cardiovascular Patients.","authors":"Roholla Hemmati, Mohanna Parvenous, Dorsa Bahrami Zanjanbar, Seyed Hossein Kia, Abbas Soleimani, Sina Bakhshaei","doi":"10.1002/osp4.70107","DOIUrl":"10.1002/osp4.70107","url":null,"abstract":"<p><strong>Objective: </strong>Cardiovascular diseases (CVDs) are a significant cause of mortality worldwide. Smoking, unhealthy diets, physical inactivity, and psychological stress are the main lifestyle factors associated with CVDs. This study was designed to investigate the relationship between electrocardiographic (ECG) changes and various body mass index (BMI) categories, considering demographic characteristics of the participants, such as age, gender, height, and weight.</p><p><strong>Methods: </strong>This cross-sectional study was conducted on 964 patients attending Mostafa Khomeini Hospital, Ilam, Iran. Pearson correlation coefficients and regression models were employed using SPSS v. 24 to assess the relationship between BMI and ECG parameters recorded using a 12-lead ECG.</p><p><strong>Results: </strong>A 10-cm increase in height (165 ± 14) was associated with a 0.089 ms decrease in the PR interval, while a 5-kg weight gain resulted in a 0.20 ms increase in the PR interval (<i>p</i> = 0.49). The QRS interval increased by 2 and 0.03 ms, with a 10 cm height and 5 kg weight gain, respectively. The QT interval remained stable with changes in height but decreased by 1.34 ms with a 5-kg increase in weight.</p><p><strong>Conclusion: </strong>The findings of this study suggest that ECG parameters are influenced by BMI and may be related to cardiovascular risks. An increase in PR and QRS intervals, a decrease in QRS voltage, and alterations in the ST segment and QT interval underscore the importance of maintaining a healthy BMI to reduce the risk of CVD. This message encourages proactive lifestyle changes to improve heart health.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"11 6","pages":"e70107"},"PeriodicalIF":2.5,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12706520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774858","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 in Adults With Overweight or Obesity Using a Breath Biofeedback mHealth App: A One-Year Follow-Up of a Randomized Trial.","authors":"Kaja Falkenhain, Dylan A Lowe, Sean R Locke, Joel Singer, Ethan J Weiss, Jonathan P Little","doi":"10.1002/osp4.70106","DOIUrl":"10.1002/osp4.70106","url":null,"abstract":"<p><strong>Background: </strong>Long-term weight loss success with dietary interventions is notoriously limited. Mobile health (mHealth) interventions offering personalized dietary guidance combined with real-time biofeedback may enhance long-term adherence and provide a sustainable solution for weight management.</p><p><strong>Objectives: </strong>This study reports the prespecified secondary outcome of weight loss at 48 weeks from a parallel-arm randomized clinical trial (ClinicalTrials.gov: NCT04165707) that aimed to evaluate the long-term effectiveness and sustainability of a Mediterranean-style low-carbohydrate diet delivered via an mHealth application paired with breath biofeedback compared with a calorie-restricted low-fat diet application.</p><p><strong>Methods: </strong>Adults with overweight or obesity (<i>N</i> = 155; mean ± SD age, 41 ± 11 years; 71% female; BMI, 33.5 ± 4.7 kg/m²) were randomized to either an intervention promoting a Mediterranean-style low-carbohydrate diet combined with biofeedback from a handheld breath acetone device or an evidence-based comparator promoting a calorie-restricted, low-fat diet. Participants recorded their daily weights using Bluetooth scales. Weight loss over 48 weeks was analyzed using a linear mixed-effects model, incorporating all available daily weight measurements from participants who provided at least one follow-up measurement.</p><p><strong>Results: </strong>At 48 weeks, participants using the breath biofeedback mHealth app achieved clinically meaningful weight loss (-9.54 kg, 95% CI: -12.27 to -6.81 kg). In contrast, participants using the low-fat diet app did not achieve statistically significant weight loss (-2.68 kg, 95% CI: -5.49 to 0.14 kg), resulting in a statistically significant between-group difference (-6.9 kg, 95% CI: -10.8 to -2.9, <i>p</i> < 0.001). No adverse effects were reported in either group.</p><p><strong>Conclusions: </strong>This study demonstrates that a Mediterranean-style diet promoting carbohydrate restriction coupled with biofeedback support delivered via an mHealth app results in clinically meaningful sustained weight loss at 48 weeks. Given its practicality and demonstrated effectiveness, this approach presents a promising non-pharmacological alternative or complement for longer-term weight management.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"11 6","pages":"e70106"},"PeriodicalIF":2.5,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12680900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701430","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":"Enhancing Shared Decision-Making in Metabolic and Bariatric Surgery: A Multi-System Implementation and Evaluation.","authors":"David E Arterburn, Robert Wellman, Anita Courcoulas, Jane Anau, Clarissa Hsu, Ali Tavakkoli, Gary S Fischer, Bestoun Ahmed, Joanna Eavey, Casey Luce, Neely Williams, Diana Stilwell, Kathleen Paul, Christopher R Daigle, Glyn Elwyn, Kathleen M McTigue","doi":"10.1002/osp4.70091","DOIUrl":"10.1002/osp4.70091","url":null,"abstract":"<p><strong>Objective: </strong>To enhance shared decision-making (SDM) about metabolic and bariatric surgery (MBS) through the systematic implementation and evaluation of SDM tools across two large healthcare systems.</p><p><strong>Methods: </strong>The project involved developing and integrating SDM tools into clinical workflows at two health systems and training clinicians to use two decision aids with eligible patients. Data were collected using patient surveys, electronic health record (EHR) data, and qualitative interviews with clinicians. The primary outcome was change in patient-reported measures of SDM using the collaboRATE items.</p><p><strong>Results: </strong>Decision aids were delivered to 1675 patients. Implementation was associated with an increase in referrals to MBS and the number of patients undergoing surgery at KPWA but not at UPMC. Baseline levels of SDM quality were high. Post-implementation collaboRATE scores decreased significantly, indicating a perceived decline in SDM quality, but not in two other SDM measures. Qualitative feedback highlighted the challenges and successes of integrating SDM tools into clinical practice.</p><p><strong>Conclusions: </strong>Implementation of SDM tools had mixed results across the sites. Implementation was associated with an increase in referrals and surgery at KPWA but not at UPMC. The perceived quality of SDM conversations also declined. Future efforts should focus on incorporating all weight management options, including medications and lifestyle interventions.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"11 6","pages":"e70091"},"PeriodicalIF":2.5,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12680512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701485","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}