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Purpose: The Sustainable Culturally Adapted Nutrition Program (SCAN) is a novel adaptation to the National Diabetes Prevention Program (NDPP) that aims to improve attendance and effectiveness. This paper presents its feasibility and impact through the initial 6-month outcomes. Design: A pragmatic quasi-experimental pilot study with intervention (DPP plus SCAN) and control (DPP only) groups. Samples and Inclusion Criteria: Sustainable Culturally Adapted Nutrition Program participants were recruited from federally qualified health center (FQHC) clinic patients enrolled in a NDPP in Houston, Texas. Participants needed to be (1) ≥18 years old, (2) body mass index >25, (3) no prior diagnosis of diabetes, and (4) not pregnant. Intervention: Sustainable Culturally Adapted Nutrition Program cooking classes were designed to teach skills to prepare fresh produce, and utilized Motivational Interviewing (MI) techniques to encourage participants to adapt these skills for foods that were culturally important to them. Outcome Measures: (1) National Diabetes Prevention Program attendance, (2) BMI and (3) percent weight loss. Analysis: We used linear mixed models to test the association between weights and NDPP attendance. Results: 22 intervention and 15 control participants completed the program to the 6-month point. Intervention participants had increased DPP attendance over controls (7.14 vs 6.87 session). Intervention participants also demonstrated on average, 1.5% weight loss for each additional SCAN class attended (P =.144). Conclusions: The SCAN adaptation shows promising results for effectively increasing both NDPP attendance and weight loss. [ABSTRACT FROM AUTHOR]

Hormonal disorders like PCOS (Polycystic Ovary Syndrome), autoimmune thyroid disease (AITD) including Hashimoto's thyroiditis, male hypogonadism are commonly encountered in clinical practice in the US and worldwide, with rising frequency. These typically affect patients during young or middle age, compared with other common chronic illnesses like type 2 diabetes, hypertension, atherosclerotic cardiovascular disease, where onset may usually be in middle or older age. Multiple studies point to the role of disordered lifestyle health behaviors as contributory to these endocrinopathies, and conversely therapeutic lifestyle changes leading to improvement in signs, symptoms, biochemical markers, and sequelae of these conditions. This article presents 3 different real life case studies of the conditions enlisted above and documents the positive impact of lifestyle improvements on their disease condition. Therapeutic lifestyle behaviors are an extremely useful and important component of management of these familiar endocrinologic disorders, and clinicians need to routinely counsel their patients about healthy lifestyle interventions when treating these common syndromes. [ABSTRACT FROM AUTHOR]

Purpose: Weight concern is a barrier to smoking cessation. We examined the impact of weight concern on post-cessation weight gain, abstinence and program engagement. Design: Randomized-controlled trial. Setting: Telephone-based and group-based intervention sessions. Subjects: 305 participants were randomized and analyzed. Intervention: Participants were randomized to receive a self-guided intervention, a weight loss intervention, or a weight stability intervention prior to all receiving the same smoking cessation intervention. Measures: Level of weight concern on three measures, point-prevalence abstinence, weight change, and session attendance at 12 months. Analysis: Continuous and discrete outcomes were compared between weight-concerned and non-weight-concerned participants using two-sample t-tests and chi-square tests respectively. Results: There were no significant differences in weight change (range: +1.77, −1.91 kg) when comparing weight-concerned and non-weight-concerned participants. Point-prevalence abstinence ranged from 36% to 64%, with no differences by condition based on level of weight concern. There were no significant differences in session attendance by weight concern (Weight sessions: 50–70%, Smoking cessation sessions: 41–56%, Booster sessions: 28–45%). Weight concern, on all measures, significantly decreased between screening and 2 months (after the weight management intervention), for most of the comparisons made overall and by condition. Conclusion: It may not be necessary to screen for weight concerns in smoking cessation and/or post-cessation weight management programs, as the trial interventions were beneficial regardless of weight concern. [ABSTRACT FROM AUTHOR]

Body mass index (BMI) is routinely used to ascertain health status, including activities of daily living (ADLs); however, the associations of ADLs with height and weight in older adults have not been elucidated. Therefore, we cross-sectionally investigated the correlations between ADLs and height, weight, and BMI in 155 participants aged 82 to 103 years and characterized the naïve Bayesian prediction for ADLs. Activities of daily living showed a significant negative correlation with height and weight and a positive correlation with age. In males, a shorter height was associated with an increased risk of falling and disability in phone calling independently, and losing weight was associated with an increased risk of disability in going out. Combining age, weight, and height improved the area under the receiver operating characteristic curve in the prediction of disability in going out and phone calling independently in males. Therefore, height and weight, not BMI, are potential predictors of ADL decline. [ABSTRACT FROM AUTHOR]

Background: Crohn's patients' nutritional status can be suboptimal given disease pathophysiology; the effect of a malnourished state prior to elective surgery on post-operative outcomes remains to be more clearly elucidated. This study aims to characterize the effect of malnutrition on post-operative outcomes and readmission patterns for Crohn's patients undergoing elective ileocecectomy using a nationally representative cohort. Methods: The colectomy-targeted National Surgical Quality Improvement Program Database (2016-2020) was used to identify patients with Crohn's disease without systemic complications who underwent elective ileocecectomy; emergency surgeries were excluded. Malnourished status was defined as pre-operative hypoalbuminemia <3.5 g/dL, weight loss >10% in 6 months, or body mass index <18.5 kg/m2 prior to surgery. Results: Of 1464 patients (56% female) who met inclusion criteria, 1137 (78%) were well-nourished and 327 (22%) were malnourished. Post-operatively, malnourished patients had more organ space surgical site infections (SSI) (9% vs 4% nourished groups, P <.001) and more bleeding events requiring transfusion (9% vs 3% nourished, P <.001). 30-day unplanned readmission was higher in the malnourished group (14% vs 9% nourished, P =.032). Index admission length of stay was significantly longer in the malnourished group (4 days [3-7 days] vs the nourished cohort: 4 days [3-5 days], P <.001). Discussion: Poor nutritional status is associated with organ space infections and bleeding as well as longer hospitalizations and more readmissions in Crohn's patients undergoing elective ileocecectomy. A detailed nutritional risk profile and nutritional optimization is important prior to elective surgery. [ABSTRACT FROM AUTHOR]

ABO blood system is not only important for determining the lifestyle diseases, blood transfusion and exchange but it has also been found to be highly relevant to genetic marker of obesity. Recent studies are trying to explore the relation between blood grouping and obesity, and blood group diets and management of obesity. But still there are limited studies related to reduction of weight from blood group diets. The aim of this study is to examine the association of blood groups and weight reduction through a Moderate-Fat, Balanced Nutrient Reduction Diets among overweight and obese adults. A longitudinal study was conducted over 175 overweight and obese adults (>18 years and <60 years of age) of urban Bihar. A planned diet regime was followed by participants for a period of six months, and their anthropometric measurements were used for statistical analysis. There were substantial decreases in weight, BMI and waist circumference across different blood groups resulted through moderate-fat balanced nutrient reduction diet plan in both genders. For all blood groups, BMI reduction was at least 3.78 kg/m2 through the program, and the program was most effective for blood group O positive participants. [ABSTRACT FROM AUTHOR]

Background: In recent years, various novel surgical and non-surgical therapeutic options have been developed for treating obesity. Due to its disputed success, intragastric botulinum toxin A (BTX-A) injection is still being debated. Objectives: We aim to contribute to this controversial issue in the literature by sharing our center's findings regarding intragastric BTX-A injections in the treatment of obesity. Design: Patients with a body mass index (BMI) of greater than 25 kg/m2 and at least one obesity-related complication, or a BMI of greater than 30 kg/m2 without complications, were eligible for the study if they were between the ages of 18 and 65. Methods: Following the same procedure, two endoscopists administered BTX-A to all patients. All patients were evaluated for obesity by measuring their lipid profile, hormone profile, and insulin resistance level before treatment. Results: In our study on 82 patients, we saw a significant mean weight loss (−9.2 kg, p < 0.001) in the second month, and there was no additional mean weight loss in the sixth month of follow-up. In addition, this result seems to be independent of the patient's insulin resistance. We did not see any serious side effects in any of the patients. Conclusion: Although the use of intragastric injection of BTX-A in the treatment of obesity is a controversial issue, we showed in our study that it causes significant weight loss. Further studies are needed on this subject, as it can be a safe method when the ideal dose and application site are combined with appropriate patient selection. [ABSTRACT FROM AUTHOR]

Objectives: Identifying whether obesity is a risk factor for dementia is complicated by the possibility of weight change as dementia evolves. This article investigates an extended time path of body mass index (BMI) before and after incident dementia in a nationally representative sample. Methods: Using the Health and Retirement Study (2000–2016), we examine (1) the longitudinal relationship between BMI and incident dementia and (2) heterogeneity in the BMI trajectory by initial BMI level. Results: Weight loss begins at least one decade before incident dementia, then accelerates in the years immediately preceding dementia onset and continues after incident dementia. Those with higher levels of BMI at baseline experienced a much greater decline relative to those with a normal weight. Discussion: Our results help explain the contradicting findings in the literature regarding the relationship between obesity and dementia and highlight the need for using extended longitudinal data to understand dementia risk. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to assess the effects of an acupuncture–diet program for treatment of overweight and obesity. Methods: The program consisted of weekly acupuncture sessions combined with a very low-carbohydrate diet in patients with a body mass index (BMI) of 25 kg/m2 or above. Data were collected retrospectively between 2002 and 2021 in seven clinics in Switzerland through automated data extraction of existing medical records. The treatments described are standard care at the facilities where they took place. Results: A total of 11,233 patients were included. In those with a BMI of 25 kg/m2 or above, a positive effect on body weight was noted with a peak average body weight loss of approximately 17.5 kg reached after 7 months. Long-term stabilization was at about 15.5 kg after 18 months. Significant male–female differences (p < 0.01) were observed with women losing less weight. Differences were also noted between overweight, obese and extremely obese patients suggesting a BMI-dependent effect. Maximum weight loss of patients with BMI of 35 kg/m2 or above was 29.8 ± 12 kg, while it was 18.8 ± 8 kg for obese patients (BMI = 30–34.9 kg/m2) and 12 ± 7 kg for overweight patients (BMI = 25–29.9 kg/m2), reflecting a significant overall difference between groups (p < 0.01). Compliance to the protocol by patients and physicians seemed to be another differentiating factor; more adherent patients appeared to lose more weight and preserve body weight loss better over time. Conclusion: Although this study lacked a control group and was retrospective and observational in nature, a program of acupuncture combined with a very low-carbohydrate diet appeared to be effective at inducing weight loss among obese patients. The observed weight reduction in this retrospective chart review represents a good starting point for further investigation of this approach via a comparative evaluation. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness of the 8-week, community health worker (CHW)–led La Vida Buena childhood obesity program among Latino children 5 to 8 years old in a rural county along the U.S.-Mexico border. Methods: This quasi-experimental study used a community-based participatory research approach to compare the effectiveness of the La Vida Buena (The Good Life) curriculum as compared with a single educational session. We took anthropomorphic measures and administered parent-reported nutrition and physical activity surveys at baseline, 3 months, and 6 months. The study took place between 2017 and 2020 in Santa Cruz County, Arizona. Results: Change in body mass index (BMI) z-score was negligible for both groups. The parent-reported behavior indicated a shift toward healthier family behaviors and environment in the intervention group. Implications for Practice: This study adds to the growing literature of CHW-led childhood obesity interventions. The engagement of the CHWs in all aspects of the intervention helped to facilitate important behavior changes. Future interventions should emphasize health and wellness rather than BMI z-score and include community, socioeconomic, and systems-level interventions to promote healthy environments. [ABSTRACT FROM AUTHOR]

Depression is common in patients with chronic heart failure (CHF), and is associated with an increased risk of adverse health outcomes. There is a paucity of data on this subject from the developing countries. The aim was to examine the prevalence and related factors of depressive symptoms among Chinese inpatients with CHF. A cross-sectional study was conducted. PHQ-9 questionnaire was used to assess depressive symptoms. The overall prevalence of depressive symptoms was 7.5%. Low BMI (OR = 4.837, CI = 1.278–18.301, p = 0.02), disease duration 3–5 years (OR = 5.033, CI = 1.248–20.292, p = 0.023) and 5–10 years (OR = 5.848, CI = 1.440–23.744, p = 0.013) were risk factors for depressive symptoms, while being married (OR = 0.304, CI = 0.123–0.753, p = 0.010) was protective factor. We should pay more attention to patients without a spouse, with low BMI and whose disease duration is between 3 and 10 years in Chinese inpatients with CHF. [ABSTRACT FROM AUTHOR]

Introduction: Orthognathic surgery is routinely practiced, yet little comparative data exists to evaluate post-orthognathic surgery diet protocols. Objective: To evaluate which postoperative diet protocols are recommended and to quantify post-orthognathic surgery weight changes in our institutional cohort. Methods: An internet search was carried out on Google for "orthognathic surgery diet" and the postoperative diet recommendations from centers worldwide were quantified. Additionally, a retrospective analysis of patients that underwent orthognathic surgery at our institution was performed, and their preoperative and postoperative weights were recorded. Results: The internet search yielded 58 centers that met our inclusion criteria. Most centers were in the United States (n = 37, 63.8%) and were oral and maxillofacial surgeon (OMFS)-led centers (n = 39, 67.2%). Postoperative diets were categorized into 7 distinct protocols, ranging from most to least restrictive—the most popular was liquid diet for 2 to 4 weeks followed by soft diet for 2 to 6 weeks. There were no significant patterns observed across different geographical regions or specialties. In our institution, 135 patients were identified. Overall, there was an average maximum weight loss of 4.1 kg by week 4, followed by a gradual increase in weight. Linear regression analysis showed that patients with greater preoperative body mass index (BMI) lost more weight postoperatively than patients with lower BMI (R2 = 0.25, P <.001). Conclusion: There is a significant variability in recommended postoperative diets following orthognathic surgery. Following a moderately restrictive diet at our institution, patients returned to their preoperative weight after approximately 4 months. [ABSTRACT FROM AUTHOR]

Background: Since bariatric surgery results in massive weight loss, it may be associated with a disproportionate decrease in lean body mass. Objective: To evaluate body composition in post-bariatric surgery patients who had a successful weight loss at 12 months (>50% excess weight loss) with comparisons to healthy controls who were matched for age, sex and BMI. Methods: This is an observational analytic study using data from post-bariatric surgery patients who had laparoscopic Roux-en-Y gastric bypass (RYGB) or laparoscopic sleeve gastrectomy (SG) at King Chulalongkorn Memorial Hospital. Patients who had percentage excessive weight loss (%EWL) >50% and achieved a BMI of <30 kg/m2 within 12 months after the surgery were included. Non-operative healthy controls matched for sex, age, and BMI (1:1) were recruited. The 12-month post-bariatric surgery BMI was used to match the BMI of the control subjects. A single bioelectrical impedance analysis (BIA) (Inbody 770) machine was used for the entire study. Results: Sixty participants were included in this study. There are 30 post-bariatric surgery patients (female n = 19, male n = 11) and 30 non-operative controls (female n = 19, male n = 11). The 12-month post-bariatric surgery patients had lower percentage of body fat (PBF) (30.6% vs 35.9%, P -value.001) and trunk fat mass (10.3 vs 12.4 kg, P -value.04) than non-operative controls. The 12-month post-bariatric surgery patients also were found to have more soft lean mass (SLM) (47.7 vs 39.9 kg, P -value.001), fat free mass (FFM) (51.1 vs 42.3 kg, P -value.001), skeletal muscle mass (SMM) (27.5 vs 23 kg, P -value.003), and trunk lean mass (21.2 vs 19 kg, P -value.02). Conclusion: Despite the significant reductions in all body composition variables in post-bariatric surgery patients at 12-month follow-up, both fat free mass and skeletal muscle mass were found to be higher in the surgical patients compared to the control group. Clinical trials: Thai Clinical Trials Registry, https://thaiclinicaltrials.org/ ID:TCTR20200223003 [ABSTRACT FROM AUTHOR]

Backgro und: Accurate prediction of risk for chronic diseases like type 2 diabetes (T2D) is challenging due to the complex underlying etiology. Integration of more complex data types from sensors and leveraging technologies for collection of -omics datasets may provide greater insights into the specific risk profile for complex diseases. Methods: We performed a literature review to identify feature selection methods and machine learning models for prediction of weight loss in a previously completed clinical trial (NCT02278939) of a behavioral intervention for weight loss in Filipinos at risk for T2D. Features included demographic and clinical characteristics, dietary factors, physical activity, and transcriptomics. Results: We identified four feature selection methods: Correlation-based Feature Subset Selection (CfsSubsetEval) with BestFirst, Kolmogorov–Smirnov (KS) test with correlation featureselection (CFS), DESeq2, and max-relevance-min-relevance (MRMR) with linear forward search and mutual information (MI) and four machine learning algorithms: support vector machine, decision tree, random forest, and extra trees that are applicable to prediction of weight loss using the specified feature types. Conclusion: More accurate prediction of risk for T2D and other complex conditions may be possible by leveraging complex data types from sensors and -omics datasets. Emerging methods for feature selection and machine learning algorithms make this type of modeling feasible. [ABSTRACT FROM AUTHOR]

Background: Currently, there is no nationally accepted protocol for addressing weight regain or inadequate weight loss after MBS. Objectives: To devise, implement, and evaluate a protocol targeting weight regain or inadequate weight loss in MBS patients at our institution. Setting: Vanderbilt University Medical Center, Nashville, TN, United States Methods: Patients at least 6 months following primary sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) who achieved or were trending toward <50% excess body weight loss or who regained ≥10% of their lowest postoperative weight, were identified and referred for medical weight loss (MWL) intervention. Exclusion criteria were body mass index (BMI) ≤ 27 kg/m2, treatment with adjustable gastric banding, and conversion from SG to RYGB. Results: 2274 patients who were >6 months out from surgery were evaluated over 12 months. 93 patients (86% female) met criteria for inclusion. 69 (74%) patients agreed to intervention and were followed for an average of 165 days (SD 106.89 days), demonstrating a mean weight change of −5.11 kg (SD 6.86 kg), and BMI change of −1.81 kg/m2 (SD 2.37 kg/m2). Patients who spent <90 days in a MWL program demonstrated less average weight loss (1.75 kg vs 6.48 kg) (P =.0042), and less change in BMI (−.63 kg/m2 vs −2.29 kg/m2) (P =.0037) when compared to patients who spent >90 days in the MWL intervention. Conclusions: This study identifies criteria for intervention in patients suffering weight regain or inadequate weight loss after MBS and demonstrates that standardized identification and referral for treatment results in modest weight loss. [ABSTRACT FROM AUTHOR]

The publication of the American Academy of Pediatrics report on a "Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity" has been met with considerable debate about the merits of taking a more aggressive treatment approach. Supporters of the new guidance argue that the time has come to treat childhood obesity with more intensive behavior therapy along with, as needed, weight loss medications and bariatric surgery. Detractors of the report believe that medicalizing this condition will lead to greater stigma and increase health disparities. Critics of the new guidance favor a "healthy at every size" approach. This editorial examines the reasoning behind these arguments. Given obesity is a complex issue that demands both clinical and societal solutions, this commentary advocates for multi-disciplinary cooperation and understanding in order to achieve an effective balance between prevention and treatment. [ABSTRACT FROM AUTHOR]

This study investigated romantic partners' undermining of weight management (i.e. hindrance of weight loss efforts) and how perceived motivations behind undermining were associated with weight loss progress. Data from 241 overweight individuals currently cohabiting with a romantic partner and trying to lose weight revealed two overarching undermining factors (i.e. verbal criticism/complaint, behavioral interference) and six perceived motivations (e.g. partner believed weight loss was unnecessary, partner relational fears, weight loss was an imposition on partner). Path modeling showed both undermining behaviors were negatively associated with weight management. Yet, only certain motivations (e.g. imposition on partner, weight loss was unnecessary) were linked to weight management, either directly or indirectly, through undermining. Specifically, whereas criticism/complaint mediated the associations between these motivations and weight management, interference only mediated the association between imposition and weight management. Findings are discussed in terms of the theoretical and practical value of distinguishing undermining behaviors and their underlying motivations. [ABSTRACT FROM AUTHOR]

Body perception is an individual's ability to recognize their body in attitudinal and/or dimensional aspects. We investigated women's body perceptions before and after bariatric surgery. Participants were 31 women (M age = 36.23, SD = 7.95 years old) with an average pre-operative body mass index of 44.58 (SD = 4.65) kg/m2. We collected anthropometric and body perception measures (attitudinal body image [ABI] and dimensional body image [DBI]) before bariatric surgery and 30, 60, 90, and 120 days after it. There was an average decrease of 21.09% in participants' body weight over the 120 days. Regarding ABI, 51.61% of participants had high body dissatisfaction before surgery, and this proportion of dissatisfied participants decreased to 3.23% 120 days after surgery. We observed no statistically significant differences in DBI perceptions. Fast weight loss caused by bariatric surgery appeared to generate a perception of ghost fat. Somatosensory interventions and/or a longer follow-up are needed to alter this persistent distortion of body dimensions. [ABSTRACT FROM AUTHOR]

A large portion of the U.S. population desires to lose weight, but only a small portion maintains a desirable body weight. We examined weight loss success and the psychological benefits of exercise among men and women who were obese and initially sedentary (N = 33). These participants completed anthropometric assessments and psychological inventories before and after graded exercise tests (GXTs) at the beginning and end of their enrollment in a 6-month behavioral weight loss program (BWLP). Participants significantly decreased their body weight, body mass index (BMI), and % body fat; they also increased their aerobic capacity and exercise time. They reported long-term increases in their stage of change, self-efficacy, exercise enjoyment and processes of change. They also reported immediate changes toward more positive affect, as measured with pre-to post-GXTs on both the Profile of Mood States (POMS) and State Anxiety Subscale (A-State) at the beginning and again at end of the BWLP. Mood benefits were reported on the POMS subscales of Tension, Depression, Anger, Vigor, and Confusion. At the end of the BWLP, Fatigue and Confusion continued to improve after a 20-min post-GXT recovery period. Finally, reductions in Depression and Fatigue after the first GXT were correlated with program success, as indicated by decreases in BMI, percent body fat, and body weight. Initial scores on trait enjoyment were associated with decreased BMI and body weight. Psychological benefits of exercise may help individuals who are obese and sedentary change their behavior and exercise perceptions from something they "should do" to something they "want to do." Feeling good during weight loss efforts is an important pathway to change and should be an explicit component goal of BWLPs. [ABSTRACT FROM AUTHOR]

The role that the superwoman schema (SWS) plays in U.S. Black women's perceptions of barriers (biological, psychological, and sociological) to healthy weight management is unknown. This exploratory study examined whether 122 women classified as normal weight, overweight or obese differed in their perceptions of types of barriers and if the SWS predicted perceived barriers to weight management. Women classified as obese reported more barriers than those classified as normal weight. The SWS uniquely positively predicted perceived psychological and sociological barriers. Our findings suggest that the SWS may play a vital role in the self-management of weight in U.S. Black women. [ABSTRACT FROM AUTHOR]

In this study, we assessed the influences of change in moderate-to-vigorous physical activity (MVPA)/sedentary time (ST) of caregivers participating in a commercial weight-loss program on their children's change in MVPA/ST. Data from 29 caregivers and their children were collected over 8 weeks. We used multivariable linear regression to assess associations of changes in caregiver's percent of time spent in MVPA/ST and changes in their child's percent of time spent in MVPA/ST. For caregivers that decreased body mass index (BMI) over 8 weeks, changes in caregivers' MVPA was strongly associated with the change in children's MVPA (β = 2.61 [95% CI: 0.45, 4.77]) compared to caregivers who maintained/increased BMI (β = 0.24 [–2.16, 2.64]). Changes in caregivers' ST was strongly associated with changes in children's ST (β = 2.42 [1.02, 3.81]) compared to caregivers who maintained/increased BMI (β = 0.35 [–0.45, 1.14]). Findings reinforce encouraging caregivers to enroll in weight-loss programs for the benefit of their children as well as for themselves. [ABSTRACT FROM AUTHOR]

Men who work in blue-collar occupations (skilled and unskilled trades) experience high rates of obesity and comorbid conditions. This group is underrepresented in behavioral interventions for weight management, which may stem from a mismatch between the features of available programs and these men's preferences. This qualitative study explored the views of these men, their experiences with weight loss, their preferences for weight loss programs, and messaging related to these programs. We conducted remote interviews with 20 men (age: 43 ± 13 years, M ± SD) currently working in blue-collar occupations (50% construction, 25% transportation, and 25% manufacturing) who had body mass indices (BMIs) in the overweight/obese categories (BMI: 33 ± 6 kg/m2). Deductive codes and summary themes were developed and discussed by the first two authors. A selection of transcripts was reviewed following theme development to confirm accuracy of the themes. Most participants (n = 16, 80%) reported a prior weight loss attempt. The most common approaches to weight loss reported were increased exercise and following their own approach to changing diet (e.g., "eating less junk food"). For program and message preferences, two major themes emerged: participants wanted accurate and trustworthy information and wanted programs that fit their lifestyle. Results suggest that weight loss programs targeting men working in blue-collar occupations should emphasize the accuracy of information related to the program and the ease of incorporating it into participants' lifestyles. There is an urgent need to incorporate these preferences into effective programs. [ABSTRACT FROM AUTHOR]

Background: Plausible phenotype mechanisms following bariatric surgery include changes in neural and gastrointestinal physiology. This pilot study aims to investigate individual and combined neurologic, gut microbiome, and plasma hormone changes pre- versus post-vertical sleeve gastrectomy (VSG), Roux-en-Y gastric bypass (RYGB), and medical weight loss (MWL). We hypothesized post-weight loss phenotype would be associated with changes in central reward system brain connectivity, differences in postprandial gut hormone responses, and increased gut microbiome diversity. Methods: Subjects included participants undergoing VSG, n = 7; RYGB, n = 9; and MWL, n = 6. Ghrelin, glucagon-like peptide-1, peptide-YY, gut microbiome, and resting state functional magnetic resonance imaging (rsfMRI; using fractional amplitude of low-frequency fluctuations [fALFF]) were measured pre- and post-intervention in fasting and fed states. We explored phenotype characterization using clustering on gut hormone, microbiome, and rsfMRI datasets and a combined analysis. Results: We observed more widespread fALFF differences post-bariatric surgery versus post-MWL. Decreased post-prandial fALFF was seen in food reward regions post-RYGB. The highest number of microbial taxa that increased post-intervention occurred in the RYGB group, followed by VSG and MWL. The combined hormone, microbiome, and MRI dataset most accurately clustered samples into pre- versus post-VSG phenotypes followed by RYGB subjects. Conclusion: The data suggest surgical weight loss (VSG and RYGB) has a bigger impact on brain and gut function versus MWL and leads to lesser post-prandial activation of food-related neural circuits. VSG subjects had the greatest phenotype differences in interactions of microbiome, rsfMRI, and gut hormone features, followed by RYGB and MWL. These results will inform future prospective research studying gut-brain changes post-bariatric surgery. [ABSTRACT FROM AUTHOR]

Background: Weight loss is an important side effect of long-term anticancer treatment for nasopharyngeal carcinoma patients. The decline in body function will cause many adverse effects, such as local recurrence and distant metastasis, and reduce the patient's quality of life. Therefore, this study developed a predictive model for the probability of critical weight loss to provide timely appropriate nutritional interventions and prevent serious side effects. Methods: A 20-week prospective follow-up study of 137 nasopharyngeal carcinoma patients in West China Hospital of Sichuan University undergoing radiotherapy and chemotherapy from February 2018 to March 2020 was conducted to collect relevant clinical data. The clinical usefulness and calibration of the prediction model were assessed using the C-index, calibration plot, receiver operating curve, and decision curve analysis. Internal validation was assessed using bootstrapping validation. Results: The nomogram consisted of sex, smoking status, physical status, chemotherapy regimen, and body mass index. Good calibration was observed for the cohort, with an area under the curve of 0.924. Five independent prognostic factors were included in the nomogram, which showed a high C-index value of 0.815 in the interval validation. Decision curve analysis showed that the nomogram was clinically useful when the intervention was decided at the critical weight loss possibility threshold in the 0% to 97% range. Conclusions: We constructed and validated a nomogram for predicting the incidence of critical weight loss in nasopharyngeal cancer patients undergoing chemotherapy and radiotherapy. [ABSTRACT FROM AUTHOR]

Introduction: Linaclotide is approved for adults with moderate-to-severe irritable bowel syndrome (IBS) with constipation (IBS-C). Linaclotide is not indicated for weight loss or for patients with inflammatory bowel disease (IBD); it is contraindicated in patients with mechanical bowel obstruction (MBO). Some patients with obesity or eating disorders (ED) may use linaclotide off-label for weight loss or as a laxative. Objectives: To describe the use of linaclotide in clinical practice, including patients with potential for off-label use or misuse. Methods: Post-authorization safety study conducted in three databases from the linaclotide launch date to 2017: the Clinical Practice Research Datalink in the United Kingdom (UK), the Information System for Research in Primary Care database in Spain and the linked Patient, Prescription and Causes of Death Registries in Sweden. Cohorts of patients were identified as having IBS using diagnostic and treatment codes; IBS subtypes were identified using symptoms and treatment codes; patients with obesity, ED, MBO, and IBD were identified using diagnostic codes or body mass index. Results: There were 1319, 1981, and 5081 linaclotide users from the United Kingdom, Spain, and Sweden with a median age of 45, 57, and 51 years, respectively; most were females. In the United Kingdom, Spain, and Sweden, respectively: 59.0%, 60.3%, and 31.3% of linaclotide users had an IBS diagnosis recorded, and among those, 68.8%, 61.3%, and 92.7% were classified as IBS-C. The proportions of linaclotide users considered at risk for potential off-label use for weight loss or as a laxative were 17.1%, 29.7%, and 1.7%, and the proportions of users considered at risk of misuse due to a history of MBO or IBD were 3.5%, 4.6%, and 5.7% in the United Kingdom, Spain, and Sweden, respectively. Conclusions: Potential linaclotide off-label use and misuse appears limited, as evidenced by the small sizes of the patient subgroups at risk for off-label use and misuse. [ABSTRACT FROM AUTHOR]

Background: Endoscopic sleeve gastroplasty (ESG) is an incisionless procedure that reduces the size of the gastric cavity. In prior studies, it has been proven to be a safe and effective treatment for obesity. In this study, we performed a collaborative study to evaluate the effectiveness of ESG among new endobariatric programs. Methods: This was an international, multicenter study reviewing the outcomes of ESG in centers starting ESG programs. Total body weight loss, change of body mass index (BMI), excess body weight loss (EBWL), technical success, duration of hospitalization, and immediate and delayed adverse events and complications at 24 h, 1 week, and 1, 3, and 6 months post-procedure were evaluated. Results: A total of 91 patients (35 males) from six centers were included. The patients' mean BMI before the procedure was 38.7 kg/m2. BMI reduction at 3 months was 7.3 (p < 0.000), at 6 months 9.3 (p < 0.000), and at 12 months 8.6 (p < 0.000) from baseline. EBWL was 17.3% at 1 month (p < 0.000), 29.2% at 3 months (p < 0.000), and 35.6% at 6 months (p < 0.000). The mean procedure duration was 85.1 min. The mean length of hospital stay post-procedure was 27 h. Conclusion: ESG provides EBWL percentage sustained up to 12 months. These results are equivalent among the new ESG centers compared to previous studies by expert centers. Lay title: Endoscopic sleeve gastroplasty in new bariatric endoscopy programs: Plain Language Summary: This article is the result of a collaborative international study on new endoscopic programs offering endoscopic sleeve gastroplasty. The minimally invasiveness and increasing accessibility of this technique makes it very attractive for patients with obesity while being poor candidate for surgery or refusing surgery. This study will also provide valuable information regarding this rising technique of endobariatric treatment. [ABSTRACT FROM AUTHOR]

Background: Sleeve gastrectomy (SG) is the most frequently performed bariatric procedure in the world. Our purpose was to evaluate the percentage of excess weight loss (%EWL), resolution of obesity-related comorbidities after SG, and identify predictive factors of weight loss failure.Methods: A prospective cohort study of adults who underwent SG during 2014 in 7 Belgian-French centers. Their demographic, preoperative, and postoperative data were prospectively collected and analyzed statistically.Results: Overall, 529 patients underwent SG, with a mean preoperative weight and body mass index (BMI) of 118.9 ± 19.9 kg and 42.9 ± 5.5 kg/m2, respectively. Body mass index significantly decreased to 32.2 kg/m2 at 5 years (P < .001). The mean %EWL was 63.6% at 5 years. A significant reduction in dyslipidemia (28.0%-18.2%), obstructive sleep apnea (OSAS) (34.6%-25.1%), and arterial hypertension (HTN) (30.4%-21.5%) was observed after 5 years, but not for diabetes and gastroesophageal reflux disease (GERD). At multivariate analysis, age >50 years old, BMI >50 kg/m2, and previous laparoscopic adjustable gastric banding (LAGB) remained independent predictors of weight loss failure.Conclusions: Five years after SG, weight loss was satisfactory; the reduction of comorbidities was significant for dyslipidemia, OSAS, and HTN, but not diabetes and GERD. Age >50 years old, BMI >50 kg/m2, and previous LAGB were independent predictors of weight loss failure. [ABSTRACT FROM AUTHOR]

This study examined the mediating role of sociocultural pressures (i.e., parental, peer, significant others, and media) and the internalization of appearance ideals (i.e., thin, muscular, attractive) on the relationship of Body Mass Index (BMI) and exercise frequency to exercise motives (i.e., weight management, appearance, positive health). A total of 262 young women, age 18 to 29, participated in the study. Average BMI in this sample was 22.09 (SD = 2.69) and ranged from 18.03 to 31.51, with 15.3% of the sample having a BMI of 25 and above, which qualifies as overweight. Participants completed Sociocultural Attitudes Towards Appearance Questionnaire-4-Revised and Exercise Motivations Inventory-2 (EMI-2) along with some demographic information and questions regarding their exercise habits. The results indicated that women with higher BMI are more motivated to exercise to lose weight, and women who exercise more frequently are motivated by the aspect of positive health. Also, women with higher BMI perceive more sociocultural pressures to obtain a culturally acceptable body. The sociocultural pressures and appearance internalization mediated the relationship between BMI and the frequency of exercise with motives for exercise. The implications and future directions of research are discussed. [ABSTRACT FROM AUTHOR]

Background. It is hypothesized that normal weight individuals develop diabetes through different pathophysiological mechanisms and that methods of prevention may differ in the absence of overweight/obesity. In this study, we compared the effect of lifestyle health coaching (LHC) on fasting plasma glucose (FPG) in normal weight, overweight, and obese US adults with prediabetes. Methods. Subjects were 1358 individuals who completed baseline and follow-up evaluations as part of an LHC program (follow-up = ~6 months). Participants were stratified, based on baseline body mass index (BMI), into normal weight (n = 129), overweight (n = 345), and obese (n = 884) cohorts. LHC included counseling, predominantly via telehealth, on exercise and nutrition. Results. BMI decreased (P <.001) in the overweight and obese participants but was unchanged in the normal weight participants. FPG decreased (P <.001) in all 3 cohorts, and the magnitude of decrease did not differ significantly among cohorts. FPG decreased to <5.6 mmol/L in 58.1%, 49.3%, and 41.4% of the normal weight, overweight, and obese participants, respectively. Conclusions. To our knowledge, this study is the first outside of Asia to show that LHC is as effective in managing FPG in normal weight adults with prediabetes versus those who are overweight/obese. [ABSTRACT FROM AUTHOR]

The 15-day Jumpstart was developed as an evidence-based, affordable, standardized, replicable, and scalable program, designed to demonstrate quickly to patients that changing what they eat can improve their health. The program was designed using the principles of the self-determination theory of motivation and personality. Patients were instructed to eat an Esselstyn-compliant, whole-food plant-based diet consisting of vegetables, fruits, whole grains, and legumes. Of the 389 participants in the program from September 2018 to February 2020, average weight loss was 5.8 pounds (7.3 for those whose body mass index was >30), average systolic blood pressure drop was 6.8 points (16.8 points for those with systolic blood pressure >140), average drop in cholesterol was 26 points (44 points for those with a cholesterol >200), average drop in low-density lipoprotein was 19 points (33 points for those with a low-density lipoprotein >100), and average drop in fasting blood sugar was 5.1 points (28.4 points for those starting in the diabetic range); P value was <.005 for fasting blood sugar and <.001 for all other comparisons. A 15-day program that helps patients adopt an Esselstyn-style whole-food plant-based diet, through education, individualized medical feedback, social support, and facilitated small group work, rapidly improves health. [ABSTRACT FROM AUTHOR]

Failure of weight-loss programs is high. We evaluated a whole-food plant-based (WFPB) lifestyle program. We investigated the obesity indices of 151 healthy adults who were on our ongoing, community-based program for the short (0.5 to ≤2 years), medium (2 to ≤5 years), or long term (5 to 10 years). Body composition indices were measured by medically approved bioimpedance. Body composition changes were favorable for all 3 groups and both genders. There were no differences in body composition between the males for all 3 groups, while there were lower body mass (BM), body mass index (BMI), and muscle mass in females on long-term versus short-term programs. All participants experienced a decrease in BMI (−2.5 kg/m2), BM (−7.1 kg), and body fat percentage (−6.4%; P <.001 for all). The reductions for those with a baseline BMI of obese, overweight, and normal were −5.6, −2.4, and −0.9 kg/m2 for BMI, −16.1, −7.1, and −2.5 kg for total BM, and −9.5%, −6.6%, and −4.8% for body fat percentage (baseline vs current; P <.001 for all). A total of 86% of parents of underage children introduced the WFPB lifestyle to children. Our WFPB lifestyle program provides a long-term reversal of obesity. [ABSTRACT FROM AUTHOR]

Introduction: Australia has one of the highest rates of obesity in the developed world. In response to increasing rates of overweight and obesity in rural Australia, one regional primary health network commissioned the development of a multi-faceted weight and lifestyle management program, addressing nutrition, physical activity, and psychological approaches to behavioral change. This study evaluated the success of the program that was implemented in multiple general practices within regional New South Wales. Methods: De-identified data were received from 16 general practices that participated in the Murrumbidgee Lifestyle and Weight Management Program (MLWMP). Patient weight outcome and functional status measures were determined using descriptive statistics (SPSS). Results: Mean body mass index (BMI) of the 1217 participants was 37.4 kg/m2 and 75% of participants were female. Almost 40% of participants who had a BMI ≥ 40 kg/m2 had been diagnosed with a mental health condition. Upon completion of the program at 6 months, participants had lost an average of 3.2 kg. Over 31% of participants had lost at least 5% of their initial weight and 40% had reduced their waist circumference by at least 5 cm. Overall health and functional status measures were significantly higher upon program completion. There were significant improvements in quality of life measures regardless of level of weight loss during the program. Conclusions: The MLWMP, implemented in general practices within rural and regional Australia, had positive effects on both practices and participants demonstrating the value of intervention programs in primary care. Participants achieved a modest reduction in BMI, waist circumference, and weight. Further work is needed to determine the longer-term success of the program. [ABSTRACT FROM AUTHOR]

We aimed to assess the association between bariatric surgery and incident Dupuytren's disease (DD) using propensity score-matched cohort studies among Swedish nationwide healthcare registries. Patients aged 30–79 years who underwent bariatric surgery 2006–2019 were matched on their propensity scores, up to two obese bariatric surgery-free (unexposed) patients. We applied Cox proportional hazard regression to calculate hazard ratios (HR) with 95% confidence intervals (CI) for the risk of DD overall, in subgroups of age, sex, bariatric surgery type and duration of follow-up. Among 34,959 bariatric surgery patients and 54,769 propensity score-matched obese patients, the risk of DD was increased in bariatric surgery patients compared with obese unexposed patients (HR 1.30, 95% CI 1.02–1.65), among women (HR 1.36; 1.00–1.84); those undergoing gastric bypass (HR 1.33; 1.04–1.71) and those with >5 years follow-up (HR 1.63; 1.14–2.34). Our results suggest that substantial weight loss is associated with an increased risk of DD in an obese population. Level of evidence: III [ABSTRACT FROM AUTHOR]

Objective: This study determined the incidence rates for obesity among adult patients ages 20 and older empaneled in primary care practice in Midwest United States to potentially identify an optimum timeframe for initiating intervention. Background: Primary care practice patients are likely to reflect underlying community trends in overweight and obesity; however, data on overweight and obesity in primary care patients is limited. While childhood incidence rates of obesity have been well reported, there is still a paucity of data on the incidence of obesity among adult population; literature has mainly focused on its prevalence. Methods: Medical record review of identified cohort with BMI data was conducted. Population was stratified by age and sex and overweight category was subdivided into tertiles. Results: Majority of 40 390 individuals who comprised the final population and had follow-up data, consisted of adults ages 40 to 69 years (47.5%), female (59.8%) of non-Hispanic ethnicity (95.9%) with 21 379 (52.8%) falling in weight category of overweight. Incidence of obesity was 7% at 1 year and 16% at 3 years follow-up. Highest percentages of individuals who became obese at 1 and 3 years were in age category of 40 to 69 years among men and 20 to 39 years among women. In Cox regression analysis, there was statistically significant association to developing obesity among all tertile groups in the overweight category. Age and particularly gender appeared to be modifying factors to likelihood of developing obesity. Conclusion: Study results suggest that while obesity incidence is higher among certain age groups in both genders, middle-aged women, and men in all tertiles of overweight category are at highest risk and may be the optimum population to target for weight loss interventions. Findings support the initiation of population-based interventions before onset of obesity. [ABSTRACT FROM AUTHOR]

Obesity as a disease remains poorly understood by key stakeholders. Here, in people living with severe obesity, perceptions and beliefs relating to obesity as a disease and obesity causality were examined. Semi-structured interviews were conducted in a tertiary care obesity clinic. 23 people with obesity (10 males, 13 females) volunteered. An overall agreement that obesity is a disease was present. Perceptions related to why obesity is and is not a disease were diverse: Lack of control and addiction, biological determinism, and personal responsibility. For weight loss maintenance, the perceptions and beliefs were heterogeneous with biological factors not considered a determinant of success. Instead, exercise, support, and willpower were described as associated with success. Barriers related to remaining in a weight-reduced state included the following: Emotional eating, sustainability of diet, occupational impact, and defeatism due to misaligned expectation and outcome. In conclusion, people living with obesity tend to agree obesity is a disease yet an incomplete understanding of the disease is present. [ABSTRACT FROM AUTHOR]

Individuals can be sensitized to the reinforcing effects of exercise, although it is unknown if this process increases habitual exercise behavior. Sedentary men and women (body mass index: 25–35 kg/m2, N = 52) participated in a 12-week aerobic exercise intervention. Exercise reinforcement was determined by how much work was performed for exercise relative to a sedentary alternative in a progressive ratio schedule task. Habitual physical activity was assessed via accelerometry. Post-intervention increases in exercise reinforcement predicted increases in physical activity bouts among those who expended over 2000 kcal per week in exercise and who compensated for less than 50 percent of their exercise energy expenditure. [ABSTRACT FROM AUTHOR]

Background: The efficacy and tolerability of modern cytotoxic chemotherapy regimens used in malnourished metastatic colorectal cancer (mCRC) patients is uncertain. The aim of this study was to investigate the effect of malnutrition on efficacy and tolerability of cytotoxic chemotherapy and overall survival in mCRC patients. Methods: In this multicenter study, demographic, oncologic and nutritional data were collected prospectively from mCRC patients. Nutritional status of the patients were evaluated on the basis of NRI (Nutritional Risk Assessment), BMI (Body Mass Index) and WL (Weight Loss) before the first chemotherapy, after the first and second chemotherapy during 2 cycles of chemotherapy every 15 days. To determine the inter-treatment weight loss toxicity assessment was included to theese parameters after each chemotherapy. NRI calculation was performed as [1.51xserum albumin level (g/L)+41.7xcurrent weight/basic weight]. NRIs were examined in 3 categories as 'no malnutrition' (NRI >97.5), 'moderate malnutrition' (97.5 ≥NRI ≥83.5) or 'severe malnutrition' (NRI <83.5). Response to treatment and drug-induced toxicities were assessed based on Criteria in Solid Tumors (RECIST) 1.1 and National Cancer Institute CTCAE version 4.0 respectively. Results: One-hundred and thirty-seven mCRC patients were prospectively included. Median age was 48 (range 18-83). Primary location was colon in 66% of patients and 84% of their primary source was left colon. Malnutrition was detected in 39% of the cases. Response rate to treatment was twenty four percent. While there was no significant relationship between chemotherapy response and moderate/severe malnutrition (p = 0.24), moderate/severe malnutrition was associated with multipl site of metastases, WHO PS (World Health Organization Performance Status) of 1, over the median value of CEA/CA 19-9 (carcinoembryonic antigen/carbohydate antigen 19-9) levels (p = 0.003, p = 0.03, p < 0.001, and p = 0.02; respectively). Hypoalbuminemia and moderate/severe malnutrition were associated with all types of toxicity (p < 0.001 and p < 0.001). Moderate/severe malnutrition was associated with thrombocytopenia, and diarrhea following chemotherapy predominately, (p = 0.02 and p = 0.04; respectively). In moderate/severe malnutrition group median overall survival was prominently shorter than those with no malnutrition [6.6 moths (95%CI, 5.6-7.6) vs 11.9 moths (95% CI, 11.1-12.7) respectively, p < 0.001]. Conclusions: Our study showed that moderate/severe malnutrition in mCRC patients was associated with decreased overall survival and increased chemotherapy toxicity. [ABSTRACT FROM AUTHOR]

Childhood obesity is a major public health concern. We wanted to evaluate the effectiveness of a multidisciplinary program based on healthy eating, exercise, cognitive-behavioral therapy, and health education to achieve weight loss and improve metabolic parameters in overweight and obese children. A randomized, controlled clinical trial with long-term follow-up (24 months) was conducted at a community care center in overweight and obese individuals aged 6–12 years. A sample of 108 children was divided into an experimental and a control group receiving a standard care program. The experimental groups received a 12-month interdisciplinary program; the results were evaluated at 4 months, the end of the intervention, and at follow-up 12 months later. Anthropometric and biological marker measurements related to metabolic alterations, dyslipidemia (based on total cholesterol), hyperglycemia, fasting glycaemia, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol in blood were recorded. The intervention had a significant effect (p < 0.001) in terms of decreased body mass index, skinfolds, and waist and arm circumferences. These changes were accompanied by biochemical changes underlying an improvement in metabolic parameters, such as a significant reduction in total cholesterol, low-density lipoprotein-cholesterol, triglycerides, and hyperglycemia and a significant increase in high-density lipoprotein-cholesterol. These effects were still significant for markers of excess weight or obesity in the experimental group 12 months after the end of the intervention, suggesting that an enduring change in healthy lifestyles had been maintained period. This interdisciplinary, nurse-led program helped to reduce childhood and adolescent excess weight and obesity and had long-lasting effects. [ABSTRACT FROM AUTHOR]

Aims: This study evaluated the effect of behaviour change interventions at Norwegian Healthy Life Centres on change in body mass index (BMI) and body attitude, and explored the predictors for change after 6 months. Methods: We randomised 118 participants to either an intervention or a control group. Eligible participants: ⩾18 years and able to take part in group-based interventions. Body attitude, weight, and height were assessed at inclusion and after 6 months. We analysed the data using simple and multiple regression. Results: Eighty-six participants completed 6-month follow-up. The study found no intervention effect on BMI or body attitude across the two groups. However, an interaction effect indicated that the leaner participants in the intervention group reduced their weight significantly (b 0.94, p < 0.001). BMI reduction was predicted by self-efficacy for physical activity and autonomous motivation for change. Weight loss was associated with impaired body attitude, body shape concern, impaired weight-related self-esteem, weight cycling, and controlled motivation for change. Improvement in body attitude was positively impacted by self-rated health, the experience of childhood respect, life satisfaction, and self-efficacy for physical activity. Impaired body attitude was predicted by body shape concern, impaired weight-related self-esteem, and controlled motivation. Conclusions: The interventions did not affect body mass on average, but promoted weight loss among the leaner participants. Because weight reduction was associated body shape concern and impaired body attitude, the study supports the claim that interventions should be weight neutral and aim to improve body image and psychological well-being rather than weight reduction. [ABSTRACT FROM AUTHOR]

Obesity is prevalent among African Americans, and church-based weight management programs may help address this public health issue. To develop more effective interventions, a survey was administered to members of a large, African American faith-based organization that assessed weight management intervention targets and preferences. Respondents (N = 1,439) represented the Midwestern and Southern United States. Mean body mass index was 30.8 ± 9.2 kg/m2, and 82.5% of respondents were overweight/obese. The majority (65.0%) wanted a weight management intervention conducted with the church and preferred an in-person (69.0%), group-based (68.0%) program that meets weekly for one hour or less (72%) and addresses identified barriers including access to healthy foods, childcare, and physical activity support. Church support was linked to better dietary quality and higher physical activity among parishioners (p 's ≤ 0.02), suggesting church support may be important for healthy eating and exercise. This study provides a clear path forward for developing and delivering weight loss interventions within African American churches. [ABSTRACT FROM AUTHOR]

Purpose: Examining the effect of a workplace weight-loss program on weight loss, and physical, behavioral and mental well-being among overweight/obese healthcare workers. Design: Quasi experimental design Setting: Single healthcare setting Participants: Forty-one (48.0 ± 11.2 years) day-time shift healthcare employees with body mass index [BMI] >29 kg/m2. Intervention: Sixteen-week program with weekly group meetings/activities and individual appointments with nutrition/health experts. Measures: Objective (weight, BMI, blood pressure) and self-reported measures were collected at baseline, conclusion of the intervention and 3 to 6 months post-intervention. Analysis: Repeated measure analysis accounting for confounders. Results: Participants had an average of 13 pounds (5.6%) weight loss (224.2 ± 6.4 vs. 211.6 ± 6.4 lbs.; P < 0.0001) upon program completion with significant decreases in BMI (37.7 ± 1.0 vs. 35.1 ± 1.0 kg/m2; P < 0.0001). Extreme obesity (BMI≥40 kg/m2) rate was reduced from 36.6% to 17.1% (P < 0.0001). There were decreases in diastolic blood pressure (76.0 ± 1.4 vs. 68.7 ± 1.5 mmHg; P = 0.001) and self-reported blood glucose (119.9 ± 4.4 vs. 105.5 ± 4.6 mg/dL; P = 0.03). Participants had improvements in weekly physical activity (25% change; P = 0.01), nutrition behavior (33% change, P < 0.0001), sleep quality (23% change, P = 0.005), and depression (72% change, P < 0.0001). Twenty-seven participants had post-intervention follow-up data. On average participants regained 8 pounds, which was less than the initial weight loss (16 lbs., N = 27). Conclusion: The results suggest the program may benefit healthcare employees. Further emphasis should be placed on post-intervention weight management to prevent weight regain. [ABSTRACT FROM AUTHOR]

The aim of this research is to study young adults who try to lose weight using only healthful weight-control behaviors. Secondary analyses of the US National Longitudinal Study of Adolescent to Adult Health (Add-Health, N = 3,882) were performed. Females who used only healthful weight-control behaviors had lower self-esteem than females who did not try to lose weight, and less depressive symptoms than females who used unhealthful weight-control behaviors. Data suggested that females who used only healthful weight-control behaviors were at higher risk for gains in body mass index than females who did not try to lose weight. This study adds to the extant literature about weight-control behaviors by highlighting that people who try to lose weight using only healthful weight-control behaviors merit special attention from both scientific and practical points of view. [ABSTRACT FROM AUTHOR]

Background: Total joint arthroplasty (TJA) postsurgical complications are increased in patients with a body mass index (BMI) greater than 30 kg/m2. Reducing BMI prior to surgery can be complicated and it is important to find effective methods to achieve weight loss goals prior to surgery. Pharmacy services have proven to be effective models for weight loss in prior studies and may be an avenue for achieving BMI reduction prior to TJA surgeries. Objective: The purpose of this study was to examine the benefit of pharmacist-driven interventions in an ambulatory care setting to achieve weight loss goals prior to TJA orthopedic surgeries. Methods: A retrospective chart review was conducted on patients referred from an orthopedic surgeon's office to a clinical pharmacist service providing chronic disease state management. Patients were referred based on need to decrease BMI prior to TJA orthopedic surgeries. Visits included evaluations of medications, education on weight loss management techniques, including therapeutic lifestyle changes, and recommendations for weight loss medications. Results: There was a statistically significant difference in post-BMI when compared with pre-BMI (P =.007). Of 16 subjects who had complete pre- and post-BMI measurements, 4 (25%) subjects met their BMI goal. There was a statistically significant relationship between the number of appointments and difference in BMI (ρ = −0.71, P =.002). Conclusion: Pharmacists may be utilized in a collaborative health care model in the ambulatory care setting to assist patients with lifestyle or medication management to achieve weight loss prior to orthopedic surgeries. [ABSTRACT FROM AUTHOR]

Suboptimal weight losses are partially attributable to lapses from a prescribed diet. We developed an app (OnTrack) that uses ecological momentary assessment to measure dietary lapses and relevant lapse triggers and provides personalized intervention using machine learning. Initially, tension between user burden and complete data was resolved by presenting a subset of lapse trigger questions per ecological momentary assessment survey. However, this produced substantial missing data, which could reduce algorithm performance. We examined the effect of more questions per ecological momentary assessment survey on algorithm performance, app utilization, and behavioral outcomes. Participants with overweight/obesity (n = 121) used a 10-week mobile weight loss program and were randomized to OnTrack-short (i.e. 8 questions/survey) or OnTrack-long (i.e. 17 questions/survey). Additional questions reduced ecological momentary assessment adherence; however, increased data completeness improved algorithm performance. There were no differences in perceived effectiveness, app utilization, or behavioral outcomes. Minimal differences in utilization and perceived effectiveness likely contributed to similar behavioral outcomes across various conditions. [ABSTRACT FROM AUTHOR]

Objective: To synthesize the evidence from systematic reviews of clinical trials investigating the effectiveness of pharmacological therapies approved by the Australian Therapeutic Goods Administration and the US Food and Drug Administration for the management of obesity in adults. Data Sources: A 3-step literature search of the MEDLINE, EMBASE, CINAHL, and PubMed databases was conducted between March and May 2019. The key terms used were obesity, pharmacological therapy, antiobesity agent, antiobesity medication, weight loss, and systematic review. Study Selection and Data Extraction: Systematic reviews that evaluated the effectiveness of pharmacological therapies for the management of obesity in patients with a body mass index of or greater than 25 kg/m2. Data Synthesis: Nine systematic reviews involving three pharmacotherapies, liraglutide, orlistat, and naltrexone-bupropion were identified. The results indicate that the pharmacotherapies reduced weight when compared with placebo. Orlistat was effective in significantly reducing fasting blood glucose, HbA1c, total cholesterol, triglycerides, and systolic and diastolic blood pressure. All reviews discussed the presence or risk of gastrointestinal adverse effects including diarrhea, vomiting, and nausea related to orlistat and liraglutide. Relevance to Patient Care and Clinical Practice: This umbrella review compares the efficacy and safety of antiobesity medications for reducing weight and a discussion on their weight loss and metabolic control to guide clinicians when prescribing medications for obesity. Conclusions: All pharmacological therapies included in this review are superior to placebo in reducing weight. Clinicians should consider patient comorbidities and risk of adverse events when recommending medications for weight loss. [ABSTRACT FROM AUTHOR]

Background: Obesity is an independent risk factor for many diseases. Many studies have investigated the benefits of losing weight as well as the best methods for weight loss. This research evaluated the impact of various weight loss programs on health enhancement among overweight women aged 40–60 years. Methods: This was a retrospective observational study that analyzed data from 145 overweight women in weight loss programs. Each woman joined one of four programs: 8 weeks of exercise plus diet (exe + nutr), 8 weeks of diet only (nutrition), 8 weeks of exercise only, or a control group. Women completed a psychological questionnaire and also underwent anthropometric tests, blood pressure checks, a predicted maximal oxygen consumption (VO2 max) test on an ergometer bicycle, a one-leg balance test, straight leg test, and a sit and reach test, both before and after the program. Participants also provided a blood sample. Results: All of the measured variables improved in the exe + nutr and nutrition programs when compared with the control group; the exe + nutr group improved the most: body mass index, −1.3 kg/m2; body fat, −2.9%; lean body mass, +1.1; VO2 max, +4.8; body image, +1.02; and p < 0.01. Conclusion: The hypothesis-generating findings showed that weight loss programs improved anthropometric, biochemical, physiological, physical, and psychological variables in women aged 40–60 years. The program that included diet restriction with exercise, guidance, and regular counseling showed the best results. [ABSTRACT FROM AUTHOR]

Purpose. To use the Awareness, Motivation, Skills, and Opportunity (AMSO) framework as a foundation for service delivery in a primary care network (PCN). Method. The AMSO framework (awareness, motivation, skills, opportunity) was integrated into PCN program design: Health Basics (8 weeks with monthly follow-up) focused on healthy living and Happiness Basics (6 weeks) used positive psychology. Evaluation included quality of life (QofL) and participant experience; weight, body mass index, and waist circumference were included for Health Basics. Data were analyzed using descriptive statistics, paired t tests, and thematic analysis. Setting. PCN in western Canada with midsized urban center and surrounding areas. Participants. Health Basics—adults with or at risk for chronic disease (n = 103). Happiness Basics—adults with depression, languishing, or flourishing (n = 124). Results. Changes were evident in weight loss, body mass index, waist circumference, and QofL (p <.05) for Health Basics participants. The participants also reported being more active, eating healthier, having a more positive mind-set, and having confidence in making lifestyle changes. Happiness Basics participants' QofL improved in all domains (p <.05) except the physical summary score (p =.079). Happiness participants described positive experiences and learned new skills. Conclusion. The AMSO framework was successfully implemented in our PCN. Recommendations are included to improve program effectiveness and use. [ABSTRACT FROM AUTHOR]

Background and Objectives: Obesity is a global pandemic with psychological, physical and metabolic consequences including in people with mental health conditions. Anti-obesity medications (AOMs) are available to treat obesity and can produce clinically meaningful weight loss but do not address associated psychological issues. We evaluated the usefulness and acceptability of an adjunct online cognitive behavioural therapy (CBT) programme for improving psychological outcomes.Method: We conducted a real-world 26-week observational study of 120 adults attending an obesity clinic who undertook a comprehensive weight management programme that included standard diet and exercise interventions, an AOM and an online 10-module CBT intervention. Baseline and 26-week psychological, metabolic and physical measures were compared.Results: At 26 weeks, depression, anxiety, stress and emotional eating levels for the sample decreased significantly compared to baseline (all p < .01). Satisfaction and acceptability were highly rated. The mean weight loss was 8.13 ± 3.83%. Mean waist circumference reduction was 7.62 ± 3.4 cm.Discussion: Online CBT has the potential to be a useful adjunct to AOMs and lifestyle interventions for providing psychological support as shown by improvement in mental health, emotional eating and acceptability scales. This warrants further investigation through a randomised controlled trail. [ABSTRACT FROM AUTHOR]

Researchers have shown that fruit and vegetable consumption (FVC) promotes weight loss and prevents weight gain, thereby reducing risks for chronic health conditions. We conducted a meta-analysis to examine the overall effects of FVC interventions on weight loss for those with body-mass index (BMI) >25; we follow-up with moderator analyses to determine if effects varied based on participants, interventions, methods, or source characteristics. Extensive literature searches were conducted, resulting in 16 studies and providing 17 comparisons, across 3,719 participants. The overall summary effect was large (−2.81kg; p<.001). Several moderators were significant for increased weight loss: low socio-economic status (−4.99kg; p<.001), higher baseline BMI (slope=−0.29; p=.047), longer interventions (slope=0.012; p<.001), and recruitment setting [health care/programs (−3.7kg; p<.001); work/academic settings (−5.2kg: p<.001)]. Future researchers should investigate varying intervention lengths and examine specific needs of subgroups—higher versus lower socio-economic status, and overweight versus obese. [ABSTRACT FROM AUTHOR]

Purpose: To explore perceived motivators and barriers to weight loss after childbirth and ideas for postpartum weight loss interventions among participants of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).Approach: Four (2 with English-speaking and 2 with Spanish-speaking participants) focus groups were conducted.Setting: A WIC clinic in Southern California.Participants: Of 22 participants, the majority were Hispanic/Latina. The mean age of the mothers' infants was 6.18 months.Measures: A structured focus group guide was used.Analysis: Audio-recordings were transcribed verbatim. The Spanish transcriptions were reviewed for discrepancies by a bilingual coinvestigator and translated into English for analysis. Transcriptions of the focus group audio-recordings were organized in ATLAS.ti version 8.0. and analyzed using content analysis.Results: Participants had a mean age of 30.5 and a mean prepregnancy body mass index of 32.4. Motivators for weight loss after childbirth included modeling healthy behavior for children and a fear of developing chronic illness. Barriers to weight loss included lack of knowledge, self-efficacy, time, child care and support, postpartum depression, the 40-day rule, and having a c-section. Intervention ideas included providing accountability and peer support for weight loss, providing nutrition/exercise weight loss strategies, and integrating mobile phone technologies into weight loss programs.Conclusions: Weight loss strategies for postpartum WIC participants should provide knowledge, support, accountability, and preferably integrate technology. [ABSTRACT FROM AUTHOR]