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Mixed martial arts' popularity has increased in recent years, alongside descriptive research and evidence-based performance recommendations. Guidelines for (both chronic and acute) weight making exist; however, how these translate in real-life scenarios and detailed investigations on practices in larger groups deserve attention. The present study examined the body mass (BM) and composition of 33 professional mixed martial arts athletes preparing for 80 fights. Athletes were supported by on-site dietitians, who encouraged evidence-based practices. Fasted BM was measured throughout the last ∼10 days before all bouts (acute weight management phase). A subset of athletes had body composition assessed before and after the chronic weight loss phase for 40 fights. Most athletes engaged in chronic BM loss, and all engaged in acute weight loss. Many lost fat-free mass (FFM) during the chronic phase, with rates of BM loss <0.5% best preserving FFM. Regardless of losses, the present athletes possessed greater FFM than other combat sport athletes and engaged in greater acute weight loss. Dehydration in the 24–48 hr before the weigh-in was not reflective of weight regain after the weigh-in, rather BM 7–10 days before the weigh-in was most reflective. These findings suggest that many mixed martial arts athletes could increase FFM at the time of competition by maintaining leaner physiques outside of competition and/or allowing increased time to reduce BM chronically. Acutely, athletes can utilize evidence-based protocols, eliminating carbohydrates, fiber, sodium, and finally fluid in a staged approach, before the weigh-in, reducing the amount of sweating required, thus theoretically better protecting health and preserving performance. [ABSTRACT FROM AUTHOR]

Background: Women with higher body mass index report low rates of and face unique barriers to exercise. Increasing exercise participation can improve mental and physical health independent of weight loss; however, most exercise programs targeting this population focus predominately on losing weight. This paper aims to describe the development of Fit&Fab, a community-based exercise intervention focused on increasing exercise participation and enjoyment for women with obesity. Methods: In partnership with the YMCA, we recruited women ages 35–64 years (body mass index ≥ 30) to participate in 4 focus groups to understand exercise preferences. Formative work was used to identify theory constructs and associated intervention components. Women from the focus groups were recruited for a community advisory board that finalized the intervention design, recruitment, and evaluation plan. Results: Focus groups participants (N = 29) preferred to exercise without men and wanted a cohort-style class that included women of similar exercise levels and body types, incorporated social support, fun activities, and broke exercise into smaller bouts. They wanted a supportive instructor who was fit but understood weight-related challenges. The community advisory board and research team used focus group findings to inform design of the final intervention including group exercise classes, psychosocial support sessions, personalized training, exercise tracking, outcome monitoring, and rewards. Conclusions: Our findings emphasize the need to focus on exercise enjoyment and benefits other than losing weight to improve exercise participation among women with higher body mass index. In addition to having outcomes other than weight loss, exercise interventions with this population should also consider group composition, instructor, and class format. [ABSTRACT FROM AUTHOR]

Summary People with excess weight and obesity compose 64.5% of the Ecuadorian population. The Allurion Intragastric Balloon (IGB) is a noninvasive weight loss alternative for patients ineligible for other bariatric procedures. The impact of the procedure on weight loss and body composition, along with insertion complications and secondary effects were investigated. This is a single‐centre retrospective study of patients who underwent Allurion IGB insertion from July 2020 to March 2021. This study followed 167 patients for 12 months after EIGB insertion. Our sample had a mean initial weight of 83.6 ± 13.8 kg and initial body mass index of 31.3 ± 3.6 kg/m2. Percentage total weight loss was 4.65% ± 0.56%, 8.5% ± 4%, 12.29% ± 4.65%, 15.68% ± 5.22%, 17.14% ± 6.05%, and 14.68% ± 18.02% for months 1, 2, 3, 4, 6 and 12, respectively. In the fourth month, 92 patients (56.4%) had lost ≥50% excess body weight; at month 6, 104 patients (67.5%) achieved this goal. Regarding body composition, body fat percentage started at 38.99% ± 7.92%, and at month 6 was 35.67% ± 6.84%, this was the only significance in the statistical analysis.This study aligns with the literature's safety and efficacy results for the Allurion IGB while illustrating the need for further research regarding weight behaviour after its expulsion. [ABSTRACT FROM AUTHOR]

AbstractDespite their widespread use, research is needed to evaluate the weight loss and related health/wellness outcomes of herbal plants. Preliminary research found that the fruit of Dichrostachys glomerata is safe and has potential weight loss effects. This study aimed to examine the effect of a standardized powder of D. glomerata fruit pods (DYG-400®) on weight, food cravings, mood, and health-related quality of life of overweight and mildly obese adults. In this CONSORT-compliant double-blind placebo-controlled trial, 56 adults (Mean [M] age = 44.50, M [body mass index] BMI = 31.66) were randomized to either the D. glomerata Group (DG; 300 mg/d) or Placebo Group (PG; rice protein, 300 mg/d) for 60 days. Participants weight was assessed along with self-report assessments of the Food Cravings Questionnaire, CDC Health-related Quality of Life, Perceived Stress Scale, Trait Anxiety Inventory, and Profile of Mood States at Baseline, Day 30, and Day 60. The data were collected from March 2023 to June 2023 and stored electronically, and analyzed using general linear models with repeated measures. DG lost more weight at Day 60 compared to PG, p = .05 (4.11 vs. 2.19 lbs). DG had reduced food cravings from Baseline to Day 30 and Day 60 compared to PG, p < .001. Perceived stress, p < .001, and mood, p = .017, improved from Baseline to Day 60 for DG compared to PG. Anxiety decreased from Baseline to Day 60 for DG and from Baseline to Day 30 for PG, p < .001. Health-related Quality of Life improved for DG compared to PG, p < .001. D. glomerata (DYG-400®) may be an effective herbal intervention to promote weight loss and health. Extended clinical trials across diverse populations and settings are needed.Clinical trial registry number and website: ISRCTN10099861, https://doi.org/10.1186/ISRCTN10099861. [ABSTRACT FROM AUTHOR]

Summary Resting energy expenditure (REE) and metabolic fuel utilization (carbohydrate or fat) proxied by respiratory quotient (RQ) from indirect calorimetry enables more precise measurement of energy needs and fat oxidation capacity. The study compared the effectiveness of providing energy expenditure information during diet and exercise weight intervention versus standard of care (SOC) on weight loss outcomes. Fifty‐two participants with obesity were recruited from a specialist weight loss service, randomized 1:1 to intervention (INT) or SOC only. Participants in INT received four‐weekly dietetic counselling, using biofeedback from energy expenditure data to recommend caloric restriction and physical activity goals, in addition to SOC. The primary outcome was the mean difference in weight loss between both groups after 24 weeks. Secondary outcomes include participant acceptability and tolerability using indirect calorimetry. Participants in the INT group demonstrated additional weight loss (−2.3 kg [95% CI: −3.1, −1.5]; p <.001), reduced waist circumference (−3.9 cm [95% CI: −5.48, −2.26]; p <.001), and decreased body fat percentage (−1.5% [95% CI:−2.31, −0.72], p <.001), compared to SOC, after adjusting for baseline body mass index, age, and sex. Forty‐two percent (10/24) of participants in INT group achieved the minimum clinically significant threshold of 5% weight loss from baseline, compared to 8% (2/26) in the SOC group (p = .007). Participant acceptability and tolerability of indirect calorimetry were high, with mean scores of 4.5 ± 0.6 and 4.2 ± 0.7 (5‐point Likert scale). The study establishes the safety and practical integration of biofeedback using indirect calorimetry promoting improved self‐regulation and enhancing weight loss. [ABSTRACT FROM AUTHOR]

No therapy has been shown to reduce the risk of major adverse cardiovascular events (MACE) and death in patients with obstructive sleep apnea (OSA). The authors sought to investigate the long-term relationship between metabolic surgery and incident MACE in patients with OSA and obesity. Adult patients with a body mass index 35 to 70 kg/m2 and moderate-to-severe OSA at a U.S. health system (2004-2018) were identified. Baseline characteristics of patients who underwent metabolic surgery were balanced with a nonsurgical control group using overlap-weighting methods. Multivariable Cox regression analysis estimated time-to-incident MACE. Follow-up ended in September 2022. A total of 13,657 patients (7,496 [54.9%] men; mean age 52.0 ± 12.4 years; median body mass index 41.0 kg/m2 [Q1-Q3: 37.6-46.2 kg/m2]), including 970 patients in the metabolic surgery group and 12,687 patients in the nonsurgical group, with a median follow-up of 5.3 years (Q1-Q3: 3.1-8.4 years) were analyzed. The mean between-group difference in body weight at 10 years was 26.6 kg (95% CI: 25.6-27.6 kg) or 19.3% (95% CI: 18.6%-19.9%). The 10-year cumulative incidence of MACE was 27.0% (95% CI: 21.6%-32.0%) in the metabolic surgery group and 35.6% (95% CI: 33.8%-37.4%) in the nonsurgical group (adjusted HR: 0.58 [95% CI: 0.48-0.71]; P < 0.001). The 10-year cumulative incidence of all-cause mortality was 9.1% (95% CI: 5.7%-12.4%) in the metabolic surgery group and 12.5% (95% CI: 11.2%-13.8%) in the nonsurgical group (adjusted HR: 0.63 [95% CI: 0.45-0.89]; P = 0.009). Among patients with moderate-to-severe OSA and obesity, metabolic surgery, compared with nonsurgical management, was associated with a significantly lower risk of incident MACE and death. [ABSTRACT FROM AUTHOR]

Overweight and obesity are among the most serious public health problems, making new methods for their prevention, as well as treatment, constantly being sought. This study was designed as a 6 month intervention study. The main objective was to evaluate the effect of an energy deficit (10%, 20%, and 25%—groups D10, D20, and D25, respectively) on the rate of weight loss and waist and hip circumferences. The protocol was completed by 180 participants. Men as well as women comprised 90 patients each. The mean body mass index (BMI) was 30.5 ± 5.0 kg/m2 (min 21.3–max 49.2). Among the patients, there were 86 with a BMI indicating overweight. Fifty‐four patients had class 1 obesity, while the remaining 30 patients had class 2 or greater obesity. After 6 months of intervention, the D10 group noted a 7.6% (median) reduction in weight, the D20 group a 9.9% (median) reduction in weight, and the D25 group a 10.3% (median) reduction in weight. After the intervention, 51.7% of patients chose to continue further weight reduction already outside the research protocol. Key factors influencing the willingness to stay on the diet longer than 6 months were higher baseline body weight and/or higher BMI and a rate of weight loss of at least 1.5% of body weight per month. In summary, it appears that a larger energy deficit (on the order of 20%–25%) is most appropriate in terms of weight loss lasting 6 months and motivation for continued therapy. [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusions Tirzepatide is a first‐in‐class combination glucose‐dependent insulinotropic polypeptide (GIP) receptor agonist and glucagon‐like peptide 1 receptor agonist (GLP1‐RA) approved for treatment of adults with type 2 diabetes mellitus (T2DM) and chronic weight management. The aim of this analysis was to assess the real‐world efficacy of tirzepatide in patients with T2DM.This retrospective observational study evaluated patients with T2DM from a large urban academic medical centre who received at least 3 months of continuous tirzepatide treatment. The primary outcome was change in A1C from following tirzepatide treatment. Secondary outcomes included change in body weight and body mass index (BMI) after tirzepatide was initiated.A total of 1896 patient charts were reviewed, and 612 patients were evaluated for the primary outcome. Over a median time period of 10.4 months, treatment with tirzepatide resulted in a mean A1C reduction of 1.02 ± 1.48% (p < 0.001). A total of 570 patients were evaluated for the secondary outcomes. Tirzepatide was associated with a mean reduction in body weight of 7.3 ± 9.3 kg (p < 0.001) and a mean reduction in BMI of 2.5 kg/m2. Greater A1C lowering and weight loss was observed in patients without prior GLP1‐RA treatment compared to those switched to tirzepatide from GLP1‐RA.In a real‐world population of US patients with T2DM, tirzepatide was associated with clinically and statistically significant reductions in A1C and body weight. Greater reductions in both A1C and body weight were observed among patients who were GLP1‐RA naïve compared to patients switched from GLP1‐RA to tirzepatide. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Method Results Discussion Post‐operative development of restrictive eating disorders can occur in patients after bariatric surgery. In children and adolescents with anorexia nervosa (AN) or atypical AN, premorbid body mass index (BMI) has recently been shown to predict total weight loss. We hypothesized that pre‐operative BMI similarly predicts weight loss and the development of a restrictive eating disorder in adult bariatric patients.A PubMed search identified case studies/series of 29 adult females who developed AN or atypical AN/eating disorder not otherwise specified following bariatric surgery. Non‐parametric Spearman's correlation (rs) between pre‐operative BMI and total weight loss was calculated; a scatterplot was used to illustrate the relationship between pre‐operative/premorbid BMI and weight loss in kg for 29 bariatric patients and 460 children and adolescents with AN or atypical AN as published previously.The correlation between pre‐operative BMI and weight loss among bariatric patients was rs = 0.65 (p = 0.0001). Scatterplot data of this relationship fit the previously identified pattern in children and adolescents with AN or atypical AN.The prediction of weight loss by pre‐operative/premorbid BMI appears applicable across the weight spectrum, from underweight to severe obesity, thus strengthening our hypothesis of underlying regulatory mechanisms for the development of AN and atypical AN. Such data may guide the determination of critical weight loss thresholds that trigger eating disorder development in predisposed individuals. [ABSTRACT FROM AUTHOR]

Given the heightened risk of postoperative complications associated with obesity, delaying total hip arthroplasty (THA) in patients who have a body mass index (BMI) > 40 to maximize preoperative weight loss has been advocated by professional societies and orthopaedic surgeons. While the benefits of this strategy are not well-understood, previous studies have suggested that a 5% reduction in weight or BMI may be associated with reduced complications after THA. We identified 613 patients who underwent primary THA in a single institution during a 7-year period and who had a BMI >40 recorded from 9 to 12 months prior to surgery. Subjects were stratified into 3 cohorts based on whether their baseline BMI decreased by >5% (147 patients, 24%), was unchanged (± 5%) (336 patients, 55%), or increased by >5% (130 patients, 21%) on the day of surgery. The frequency of 90-days Hip Society and Centers for Medicare & Medicaid Services complications was compared between these cohorts. There were significant baseline differences between the cohorts with respect to baseline American Society of Anesthesiologists class (P <.001) and hemoglobin A1C (P =.011), which were accounted for in a multivariate regression analysis. In univariate analysis, there was a lower incidence of readmission (P =.025) and total complications (P =.005) in the increased BMI cohort. The overall complication rate was 18.4% in the decreased BMI cohort, 17.6% in the unchanged cohort, and 6.2% in the increased cohort. However, multivariable regression analysis controlling for potential confounders did not find that preoperative change in BMI was associated with differences in 90-days complications between cohorts (P >.05). Patients who have a BMI >40 and achieved a clinically significant (>5%) BMI reduction prior to THA did not have a lower risk of 90-days complications or readmissions. Thus, delaying THA in these patients to encourage weight loss may result in restricting access to a beneficial surgery without an appreciable safety benefit. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Dulaglutide is a relatively unpopular GLP‐1 receptor agonist used for weight loss. This case demonstrates that dulaglutide may be beneficial for weight loss in morbidly obese patients with multiple comorbidities after thoroughly evaluating its efficacy, benefits, and long‐term adverse effects through clinical trials. We present a case of a 27‐year‐old ex‐sumo wrestler with bipolar II disorder, morbid obesity, hypertension, Type 2 Diabetes Mellitus (DM), and a Body Mass Index (BMI) of 49.66 kg/m2. He was non‐compliant with lifestyle modifications and resistant to conventional treatments, including metformin, and was also using multiple antipsychotic drugs. After introducing dulaglutide, he achieved a 40 kg (−21%) weight loss and a BMI reduction of 10.3 kg/m2 over 6 months, with no side effects and improved glycemic control, demonstrating dulaglutide's efficacy for weight loss in such challenging presentations. [ABSTRACT FROM AUTHOR]

Understanding the co-occurrence of food insecurity and eating disorders is a pressing concern. Several factors have been hypothesized to increase risk for eating disorders in women with food insecurity including dietary restriction, body weight, and weight-related bias, but few studies have tested these factors simultaneously to determine which are associated most strongly with eating disorder status. We tested cross-sectional associations of dietary restriction, current body mass index (BMI), weight suppression (i.e. the difference between current weight and highest weight), and weight bias with eating disorder diagnosis in a sample of 99 self-identified women with current food insecurity (54% White; mean [SD] age = 40.26 [14.33] years). Participants completed two virtual study visits consisting of electronic questionnaires and interviews. A binary logistic regression model was conducted to test relations between the hypothesized correlates and eating disorder diagnostic status in the past 12 months, controlling for age, food insecurity severity, and body dissatisfaction. Higher levels of weight suppression and weight bias, but not current BMI, were significantly associated with the presence of an eating disorder. Contrary to our hypothesis, greater dietary restriction was associated with lower likelihood of eating disorder diagnosis. Results suggest high levels of weight bias and weight suppression characterize women with food insecurity who meet criteria for an eating disorder. Women who experience food insecurity and have lost a relatively great deal of weight and/or hold biases about high weight should be screened for eating pathology in clinical settings. [ABSTRACT FROM AUTHOR]

To investigate the release of lipolytic hormones during various high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT), and their effects on fat loss. 39 young women categorized as obese (with a body fat percentage (BFP) ≥30%) were randomly allocated to one of the following groups: all-out sprint interval training (SIT, n =10); supramaximal HIIT (HIIT120, 120% VO2peak, n = 10); HIIT (HIIT90, 90% VO2peak, n = 10), or MICT, (60% VO2peak, n = 9) for a twelve-week observation period consisting of 3 to 4 exercise sessions per week. Serum epinephrine (EPI) and growth hormone (GH) were measured during the 1st, 20th, and 44th training sessions. Body weight (BW), body mass index (BMI), whole-body fat mass (FM) and BFP were assessed pre- and post-intervention. Following the 1st and 20th sessions, significant increases in EPI (p < 0.05) were observed post-exercise in HIIT120 and HIIT90, but not in SIT and MICT. In the 44th session, the increased EPI was found in SIT, HIIT120, and HIIT90, but not in MICT (p < 0.05). For the GH, a significant increase was observed post-exercise in all groups in the three sessions. The increased EPI and GH returned to baselines 3 hours post-exercise. After the 12-week intervention, significant reductions in FM and BFP were found in all groups, while reductions in BW and BMI were only found in the SIT and HIIT groups. Greater reductions in FM and BFP, in comparison to MICT, were observed in the SIT and HIIT groups (p < 0.05). 12-week SIT, HIIT120, and HIIT90, in comparison to MICT, were more efficacious in fat reduction in obese women, partly benefiting from the greater release of lipolytic hormones during training sessions. [ABSTRACT FROM AUTHOR]

Background: Obesity is characterized by increased oxidative stress, which, in a vicious circle, promotes chronic low-grade inflammation. Melatonin, a well-documented antioxidant, might be useful as a supplement to enhance the cardiometabolic benefits of any body weight reduction program (BWRP). Objectives/Methods: The present study aimed to evaluate the post-exercise oxidative stress and inflammation in a group of subjects with obesity treated with melatonin (2 mg/die) or placebo, undergoing a 2-week BWRP, with the administration of a single bout of acute exercise at the start and the end of the protocol (G1–G15). Results: Eighteen adults with obesity were enrolled and distributed to the two arms of the study: the melatonin group (F/M: 7/2; age: 27.8 ± 5.6 years; body mass index [BMI]: 43.0 ± 4.9 kg/m2) and the placebo group (F/M: 6/3; age: 28.8 ± 5.0 years; BMI: 42.8 ± 4.0 kg/m2). BWRP induced a decrease in BMI and waist circumference (WC) in both groups; plasma glucose, blood glycated hemoglobin (HbA1c), and neutrophil to lymphocyte ratio (NLR) were reduced only in the placebo group. Importantly, plasma biological antioxidant potential (BAP) increased throughout BWRP. Paradoxically, melatonin enhanced post-exercise production of plasma derivatives of reactive oxygen metabolites (d-ROMs) and erythrocytic glutathionyl-Hb (HbSSG) (at G1 and G15). Finally, differently from the placebo group, melatonin-treated subjects did not exhibit the BWRP-induced decrease in plasma levels of interleukin-6 (IL-6), before and after exercise, at the end of two weeks (G15). Conclusions: Melatonin is presumably an antioxidant with "conditional" prooxidant actions. The use of melatonin as a supplement in subjects with obesity might be deleterious due to the abolishment of BWRP-induced cardiometabolic benefits. [ABSTRACT FROM AUTHOR]

Background: The prevalence of obesity is already a worldwide health concern. The development of straightforward guidelines regarding the whole available armamentarium (i.e., medical, endoscopic, and surgical interventions in conjunction with a guidance program) is paramount to offering the best multimodal approach to patients with obesity. Methods: The International Federation for Surgery of Obesity and Metabolic Disorders-European Chapter (IFSO-EC) identified a panel of experts to develop the present guidelines. The panel formulated a series of clinical questions (based on the patient, intervention, comparison, and outcome conceptual framework), which have been voted on and approved. A GRADE methodology will be applied to assess the quality of evidence and formulate recommendations employed to minimize selection and information biases. This approach aims to enhance the reliability and validity of recommendations, promoting greater adherence to the best available evidence. Results: These guidelines are intended for adult patients with a body mass index (BMI) ≥ 30 kg/m2 who are candidates for metabolic bariatric surgery (MBS). The expert panel responsible for developing these guidelines comprised 25 panelists (92% were bariatric surgeons) and 3 evidence reviewers, with an average age of 50.1 ± 10.2 years. The panel focused on 3 key questions regarding the combined use of structured lifestyle interventions, approved obesity management medications, and endoscopic weight loss procedures with MBS. Conclusions: The complexity of obesity as a chronic disease requires a comprehensive knowledge of all the available and feasible therapeutic options. The IFSO-EC society felt the urgent need to develop methodologically valid guidelines to give a full picture and awareness of the possible surgical and non-surgical therapeutic strategies employed with a multimodal approach. [ABSTRACT FROM AUTHOR]

Summary: Obesity is a major health burden worldwide. Although bariatric surgery (BS) is recognized as an effective strategy for weight loss and comorbidities improvement, its impact on muscle strength and quality is still unclear. We aimed to examine postoperative changes in muscle strength and quality and their relationship with body mass index (BMI) changes among adults undergoing BS. To this end, we systematically searched the WoS, PubMed, EBSCO, and Scopus databases. The meta‐analyses, which included 24 articles (666 participants), showed that BS reduces absolute lower‐limb isometric strength (ES = −0.599; 95% CI = ‐0.972, −0.226; p = 0.002). Subjects who experienced a more significant reduction in BMI after BS also suffered a higher loss of absolute muscle strength. Similarly, absolute handgrip strength showed a significant decrease (ES = −0.376; 95% CI = −0.630, −0.121; p = 0.004). We found insufficient studies investigating medium‐ and long‐term changes in muscle strength and/or quality after BS. This study provides moderate‐quality evidence that BS‐induced weight loss can reduce the strength of appendicular muscles in the short term, which should be addressed in management these subjects. More high‐quality studies are needed to evaluate the impact of BS on muscle strength and the different domains of muscle quality in the medium and long term (registered on PROSPERO CRD42022332581). [ABSTRACT FROM AUTHOR]

Aim: To perform a meta‐analysis to investigate the effects of intermittent fasting (IF), as compared with either a control diet (CON) and/or calorie restriction (CR), on body composition and cardiometabolic health in individuals with prediabetes and type 2 diabetes (T2D). Methods: PubMed, Web of Science, and Scopus were searched from their inception to March 2024 to identify original randomized trials with parallel or crossover designs that studied the effects of IF on body composition and cardiometabolic health. Weighted mean differences (WMDs) or standardized mean differences with 95% confidence intervals (CIs) were calculated using random‐effects models. Results: Overall, 14 studies involving 1101 adults with prediabetes or T2D were included in the meta‐analysis. IF decreased body weight (WMD −4.56 kg [95% CI −6.23 to −2.83]; p = 0.001), body mass index (BMI; WMD −1.99 kg.m2 [95% CI −2.74 to −1.23]; p = 0.001), glycated haemoglobin (HbA1c; WMD −0.81% [95% CI −1.24 to −0.38]; p = 0.001), fasting glucose (WMD −0.36 mmol/L [95% CI −0.63 to −0.09]; p = 0.008), total cholesterol (WMD −0.31 mmol/L [95% CI −0.60 to −0.02]; p = 0.03) and triglycerides (WMD −0.14 mmol/L [95% CI −0.27 to −0.01]; p = 0.02), but did not significantly decrease fat mass, insulin, low‐densitiy lipoprotein, high‐density lipoprotein, or blood pressure as compared with CON. Furthermore, IF decreased body weight (WMD −1.14 kg [95% CI −1.69 to −0.60]; p = 0.001) and BMI (WMD −0.43 kg.m2 [95% CI −0.58 to −0.27]; p = 0.001), but did not significantly affect fat mass, lean body mass, visceral fat, insulin, HbA1c, lipid profiles or blood pressure. Conclusion: Intermittent fasting is effective for weight loss and specific cardiometabolic health markers in individuals with prediabetes or T2D. Additionally, IF is associated with a reduction in body weight and BMI compared to CR, without effects on glycaemic markers, lipid profiles or blood pressure. [ABSTRACT FROM AUTHOR]

Aim: To investigate the relationship between thyroid function and weight regain in patients with obesity after metabolic surgery. Methods: This retrospective study enrolled 162 patients who underwent metabolic surgery. Correlations between decreases in thyroid hormone levels and changes in weight, waist circumference (WC) and the Chinese visceral adiposity index (CVAI) were assessed. Binary logistic regression and receiver operating characteristic (ROC) curves were used to identify predictors and clinically useful cut‐off values, respectively. Results: The levels of thyroid‐stimulating hormone (TSH) and free triiodothyronine (FT3) decreased markedly at 1 year after surgery, as did weight, body mass index (BMI), triglycerides, total cholesterol, high‐density lipoprotein cholesterol, low‐density lipoprotein cholesterol, WC and CVAI. Decreases in TSH and FT3 after metabolic surgery were associated with changes in weight, BMI and CVAI. Binary logistic regression and ROC curve analyses confirmed that decreases in TSH can predict good weight loss after metabolic surgery to some extent. Finally, binary logistic regression and ROC curve analyses confirmed that changes in TSH can predict weight regain after metabolic surgery. Conclusions: Changes in TSH and FT3 after metabolic surgery were correlated with changes in weight and CVAI. Changes in thyroid hormones can predict weight regain in patients with obesity who underwent metabolic surgery. [ABSTRACT FROM AUTHOR]

Objective: While sleeve gastrectomy (SG) results in sustained weight loss for the majority of patients, some will experience inadequate weight loss or weight regain requiring revision. The objective of this study was to evaluate differences in weight loss over time between patients undergoing Roux-en-Y gastric bypass (RYGB) or single anastomosis duodenoileostomy (SADI) after SG. Methods: We queried a single institution's bariatrics registry to identify patients who underwent RYGB or SADI after previous SG over a three-year period. Demographics, operative characteristics, and post-operative complications were evaluated. Interval total body weight loss (TBWL) and excess body weight loss (EBWL) were calculated from available follow-ups within 2 years. Results: We identified 124 patients who underwent conversion to RYGB (n = 61) or SADI (n = 63) following previous SG. There were no differences in sex, age, or medical comorbidities between groups. The median initial BMI was higher in the SADI group (44.9 vs. 41.9 for RYGB, p = 0.03) with greater excess body weight (56.7 vs. 64.3 kg, p = 0.04). The SADI group had a shorter median operative duration (157 vs. 182 min for RYGB, p < 0.01) and lower readmission rates (0 vs. 14.75%, p < 0.01). There was no difference in post-operative complications or need for rehydration therapy between the groups. Among 122 patients (98.4%) that had follow-up weights available, there were no differences in TBWL between groups. RYGB patients had a higher EBWL at 2, 3, and 6 months (p < 0.05 for all comparisons), but there were no differences between RYGB and SADI at 1 or 2 years. Conclusions: Both RYGB and SADI conversions proved effective for further weight loss following failed SG at our academic center. While neither demonstrated clear superiority in long-term (> 1 year) weight loss, RYGB's restrictive gastric pouch may explain its early weight loss advantage. [ABSTRACT FROM AUTHOR]

Background: The increasing prevalence of overweight and obesity worldwide represents a (chronic) complex public health problem. This is also seen among women of childbearing age despite increased efforts to promote physical activity (PA) interventions. Excessive gestational weight gain (GWG) is associated with negative health outcomes for both mothers and offspring. Objectives: To summarize current systematic reviews (SRs) on PA interventions during pregnancy and postpartum to prevent excessive GWG and identify the most effective approaches. Search Strategy: A literature search was conducted on major electronic databases (MEDLINE/Pubmed, Cochrane, Web of Science, Epistemonikos) from inception to March 2023. Selection Criteria: This study included SRs and meta‐analyses of studies involving women aged 18 years or older from diverse ethnic backgrounds, who were either in the preconception period, pregnant, or within 1 year postpartum and who had no contraindications for exercise. Women with chronic diseases, such as pre‐existing diabetes (type 1 or type 2) were excluded. Data Collection and Analysis: Two reviewers extracted data from selected studies assessing the impact of PA in preconception, pregnancy, and postpartum. Methodologic quality was assessed with the AMSTAR‐2 tool. A narrative summary of results addresses relationships between PA and weight before, during, and after pregnancy, informing future research priorities for preventing excessive weight gain. This study is registered on PROSPERO (CRD420233946666). Main Results: Out of 892 identified articles, 25 studies were included after removing duplicates, unrelated titles, and screening titles and abstracts for eligibility. The results demonstrate that PA can help prevent excessive GWG and postpartum weight retention. Structured and supervised moderate‐intensity exercise, at least twice a week, and each session lasting a minimum of 35 min seems to provide the greatest benefits. Conclusions: Women who comply with the PA program and recommendations are more likely to achieve adequate GWG and return to their pre‐pregnancy body mass index after delivery. Further research is warranted to explore how preconception PA influences pregnancy and postpartum outcomes given the absence of identified preconception‐focused interventions. Synopsis: There is evidence that interventions of physical activity during pregnancy and postpartum to control/reduce weight gain in women. There are no systematic reviews before pregnancy. [ABSTRACT FROM AUTHOR]

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]

Background and Aims: Exercise is recommended for the management of metabolic dysfunction‐associated steatotic liver disease (MASLD), yet effects on liver histology remain unknown, especially without significant weight loss. We aimed to examine changes in surrogate measures of liver histological response with exercise training. Methods: We conducted a post hoc pooled analysis of three randomised controlled trials (duration: 12–20 weeks) comparing aerobic exercise interventions with controls. The primary outcome measure was a ≥30% relative reduction in (MRI‐measured) liver fat, as a surrogate measure of liver histological response (the threshold necessary for fibrosis improvement). Secondary outcome measures were changes in other biomarkers of liver fibrosis, anthropometry, body composition and aerobic fitness. Results: Eighty‐eight adults (exercise: 54, control: 34; male: 67%) were included with mean (SD) age 51 (11) years and body mass index 33.3 (5.2) kg/m2. Following the intervention, exercise had ~5‐fold (OR [95%CI]: 4.86 [1.72, 13.8], p =.002) greater odds of ≥30% relative reduction in MRI‐measured liver fat compared with control. This paralleled the improvements in anthropometry (waist and hip circumference reduction), body composition (body fat, visceral and subcutaneous adipose tissue) and aerobic fitness (V̇O2peak, ventilatory threshold and exercise capacity). Importantly, these effects were independent of clinically significant body weight loss (<3% body weight). Conclusion: Exercise training led to clinically meaningful improvements in surrogate serum‐ and imaging‐based measures of liver histological change, without clinically meaningful body weight reduction. These data reinforce the weight‐neutral benefit of exercise training and suggest that aerobic training may improve liver fibrosis in patients with MASLD. [ABSTRACT FROM AUTHOR]

This study investigates gender-specific differences in obesity and the treatment by metabolic bariatric surgery (MBS). The database includes 2393 patients (1725 women, 668 men) from for a high-volume center for bariatric surgery. Demographic, perioperative and follow-up data were retrospectively analyzed. Men had a significantly higher body mass index (BMI) and more frequent obesity-associated diseases. Despite the higher prevalence of obesity in men, women accounted for 80% of the surgical patients. On average men had longer operation times but with the same complication rates. Postoperatively, both sexes experienced a significant reduction in excess body weight, which was slightly more pronounced in women. The study particularly emphasizes the need to better motivate men to undergo obesity treatment in order to reduce the health consequences of morbid obesity in this population group. [ABSTRACT FROM AUTHOR]

The pathophysiology of immune thrombocytopenia (ITP) involves immune-mediated platelet destruction. The presence of adipose tissue in obese individuals creates an inflammatory environment that could potentially impact the clinical course and outcomes of ITP. However the relationship between obesity and ITP outcomes has not been well described. We evaluated ITP outcomes in 275 patients diagnosed with primary ITP from 2012 to 2022. Patients were categorized into four groups based on their body mass index (BMI) at diagnosis. Female gender was associated with a lower platelet count at the time of diagnosis at any BMI. Patients with high BMI had lower platelet counts at diagnosis and at platelet nadir (p < 0.001), an increased likelihood of requiring therapy (p < 0.001) and requiring multiple lines of therapy (p = 0.032). Non-obese patients who required corticosteroid treatment experienced a longer remission duration compared to obese patients (p = 0.009) and were less likely to be steroid-dependent (p = 0.048). Our findings suggest that obesity may be a significant risk factor for developing ITP and for ITP prognosis. Future studies are needed to evaluate the role of weight loss intervention in improving ITP outcomes. [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]

Background Exercise Referral Schemes (ERS) are designed so health professionals can refer certain patients to a supervised programme of physical activity. However, evaluations have questioned the effectiveness of these schemes/programmes. The aim of this study was to systematically review the provision of ERS in England and analyse related promotional material. Methods Content analysis methods were used to analyse scheme websites and promotional material. A coding scheme was used to analyse the data, which included information on the programme's aims, inclusion criteria, type of activities, accessibility and cost. Results The study identified 625 sites offering ERS across 168 geographic areas. Findings highlighted a lack of clarity in what constitutes a scheme. Over a third of schemes did not explicitly state their aims, but of those that did, the focus was mainly on notions of physical and mental health benefits. Conclusions This study is the first to review the scope and offer of ERS in the UK by examining promotional material and highlights issues around the stated aims of ERS. More clarity on aims is needed in the material that promotes the schemes and most likely within the schemes themselves. Such improvements could make a difference when considering engagement with delivery stakeholders and potential participants. [ABSTRACT FROM AUTHOR]

Introduction: Patients with body mass index (BMI) ≥ 50 kg/m2, classified with obesity class IV/V, require complex treatments. Intragastric balloon (IGB) is a possible treatment before metabolic bariatric surgery (MBS) that may reduce peri-operative complications. This study evaluates IGB outcomes and complications before MBS in patients with Obesity IV/V, and subsequent MBS results, regarding weight loss and comorbidity resolution. Methods: Retrospective cohort study of all patients with BMI above 50 kg/m2 submitted to IGB before MBS between 2009 and 2023 in a high-volume center. Variables analyzed included weight loss after IGB and MBS, IGB complications, and comorbidity resolution. Suboptimal clinical responses were defined as %TWL < 5% for IGB, %TWL < 20% for MBS, and %TWL < 25% or BMI ≥ 35 kg/m2 for IGB + MBS. Results: Seventy-four patients (mean BMI 58.8 ± 8 kg/m2) were included. After IGB, the mean %TWL was 14.2 ± 8.5%, with a 21.6% complication rate, predominantly nausea and vomiting, and one death. Suboptimal clinical response of IGB affected 13.5% of patients, and 5.4% required early removal. Two years after MBS, the mean %TWL was 38.2 ± 11.6%, mainly due to MBS, yet approximately one-third of %TWL was attributed to IGB. No correlation was found between IGB and MBS outcomes. At 2-year follow-up, 45.1% patients had %TWL ≥ 25 and BMI < 35 kg/m2. Conclusion: The IGB is a treatment option before MBS in patients with Obesity Class IV/V, with acceptable weight loss outcomes but not infrequent complications. A multidisciplinary approach is mandatory, and all treatments must be considered in this difficult subset of patients. [ABSTRACT FROM AUTHOR]

Introduction: The swallowable intragastric balloon (IGB) has recently emerged as a popular alternative for weight loss in Malaysia. It can reduce total body weight loss (TBWL) by 6–15%. We aim to observe positive weight loss up to a year after the swallowable IGB is implanted. Methods: A total of 486 consecutive patients with overweight or obesity who underwent swallowable IGB insertion were included in this prospective data collection. Results: Out of 486 patients, 404 patients (83%) had complete data at the end of 4 and 12 months. Patients included in the study had a starting mean body mass index of 35.3 ± 7.2 kg/m2 which decreased to 31.5 ± 5.7 kg/m2 (p < 0.0001) at the end of 4 months and further reduced to 30.3 ± 5.4 kg/m2 (p < 0.0001) at the end of 12 months. At 4 months, the overall average weight loss was 9.8 kg, meanwhile, at 12 months, the average weight loss increased to 12.9 kg. At 4 months, the average TBWL was 10.5%, while at the end of 1 year, the combined %TBWL increased to 13.7%. Conclusion: Most weight loss is typically observed within the first 4 months following the procedure. However, it is important to note that patients can continue to experience ongoing weight loss for up to 1 year. The swallowable IGB is a safe and effective option for patients seeking weight loss solutions. It offers numerous advantages, especially its non-invasive procedureless nature, which makes it more appealing to individuals considering this treatment. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic sleeve gastrectomy (LSG) has emerged as the predominant metabolic bariatric surgery. With a growing number of studies evaluating the feasibility of robotic sleeve gastrectomy (RSG), it becomes imperative to ascertain whether the outcomes of both techniques are comparable. This study endeavors to synthesize existing evidence and juxtapose the surgical outcomes of LSG and RSG. Methods: We collected articles comparing LSG and RSG published between 2011 and 2024. The compiled data included author names, study duration, sample size, average age, gender distribution, geographical location, preoperative body mass index (BMI), bougie diameter, duration of hospitalization, surgical duration, readmission rates, conversion rates, costs, postoperative percentage of excess weight loss (%EWL), postoperative BMI, mortality rates, and complications. Results: We incorporated 21 articles. Both the RSG and LSG cohorts exhibited comparable rates of readmission, conversion, mortality, and incidence of complications (p > 0.05). Moreover, the efficacy of weight loss was similar between RSG and LSG. Nonetheless, RSG was linked to longer operative duration (WMD, -27.50 minutes; 95% confidence interval [CI], -28.82 to -26.18; p < 0.0001), prolonged hospitalization (WMD, -0.15 days; 95% CI, −0.25 to -0.04; p = 0.006), and elevated expenses (WMD, -5830.9 dollars; 95% CI, -8075.98 to -3585.81; p < 0.0001). Conclusions: While both RSG and LSG demonstrated positive postoperative clinical outcomes, RSG patients experienced extended hospital stays, longer operative times, and increased hospitalization costs compared to LSG patients. Using the robotic platform for sleeve gastrectomy (SG) in patients with obesity did not appear to offer any clear benefits. [ABSTRACT FROM AUTHOR]

Aim Materials and Methods Results Conclusions Normoglycaemia was achieved in a significant proportion of Japanese participants with type 2 diabetes in two phase 3 studies of tirzepatide. This post hoc exploratory analysis aimed to identify predictive factors associated with normoglycaemia achievement.SURPASS J‐mono and SURPASS J‐combo study data were pooled for this analysis. Characteristics of participants in whom normoglycaemia [glycated haemoglobin (HbA1c) <5.7%] was achieved were summarized. Logistic regression analyses were performed with HbA1c <5.7% achievement as the target variable.Of 912 participants, normoglycaemia was achieved in 553 (60.6%) following 52 weeks of tirzepatide treatment. Overall, the mean (SD) age was 56.7 (10.6) years and mean diabetes duration was 7.7 (6.0) years, and 76% of participants were men. Mean (SD) change from baseline in HbA1c and bodyweight was −2.87% (0.95) versus −2.47% (1.1) and −10.30 (5.8) kg versus −3.75 (4.3) kg for participants in whom normoglycaemia was and was not reached, respectively. Multivariate regression analyses showed that lower baseline body mass index, shorter disease duration and lower baseline HbA1c were significantly associated with higher rates of normoglycaemia achievement (p = 0.009, p = 0.008, p < 0.001, respectively) as was a tirzepatide dose of 10 or 15 mg compared with 5 mg (p < 0.001). The highest percentage of participants in whom normoglycaemia (94%) was achieved were those with lower baseline HbA1c (<8%) and the greatest weight reduction (≥15%).Baseline HbA1c and body mass index, disease duration and the tirzepatide treatment group were shown to be predictive factors for achieving normoglycaemia. A lower baseline HbA1c was most strongly associated with normoglycaemia achievement. [ABSTRACT FROM AUTHOR]

Summary This study aimed to evaluate the efficacy and safety of duodenal–jejunal bypass liner (DJBL) for obesity and type 2 diabetes mellitus. A comprehensive search of electronic databases was conducted up to September 15, 2022. Thirty studies involving 1751 patients were included. At 12 months post‐implantation, the reduction in body mass index (BMI) was 4.8 kg/m2 (95% CI 4.1, 5.5), with an excess weight loss of 41.3% (95% CI 33.4%,49.2%) and a total weight loss of 13.1% (95% CI 10.1%, 16.0%). Significant decrease was observed in HbA1c and fasting glucose, with a standardized mean difference of − 0.72 (95% CI − 0.95, − 0.48) and − 0.62 (95% CI − 0.82, − 0.42), respectively. However, these improvements in weight loss and glycemic control were only partially sustained after explantation. In situ, DJBL significantly improves blood pressure and lipid levels. The pooled early removal rate was 19%, and the incidence of severe adverse events was 17%, including device migration (6%), gastrointestinal hemorrhage (4%), device obstruction (4%), and hepatic abscess (2%). DJBL offers significant improvement in weight loss and glycemic control, as well as cardiovascular parameters while in situ. Further studies are warranted to better understand the long‐term efficacy and safety of DJBL. The benefits of DJBL need to be carefully weighed against the risks in clinical decision‐making. [ABSTRACT FROM AUTHOR]

This study aimed to identify differences among body mass index (BMI) categories of older family caregivers (=60 years) and their care recipients (=65 years). Secondly, this study aimed to examine group differences and factors associated with weight change during a nutrition and oral health intervention. This secondary analysis of a randomized controlled trial (ClinicalTrial.gov (NCT04003493)) involved individually tailored nutritional guidance from a clinical nutritionist and oral health guidance from a dental hygienist. Baseline BMI differences were analyzed, followed by further analyses of group differences and associated factors of weight change over a 6-month period using generalized estimating equations. Among the participants (113 family caregivers and 107 care recipients), 36.3% and 35.1% were overweight (BMI >29 kg/m²), while 18.6% and 21.6% were underweight (BMI <24 kg/m²) at baseline, respectively. For family caregivers differences in BMI categories included age, mid-arm and calf circumferences, and plasma prealbumin concentration. For care recipients differences were observed in medication use, mid-arm and calf circumferences, Mini Nutritional Assessment scores, physical function, and number of teeth. During the 6-month intervention, there were no differences in weight change between intervention and control groups for both caregivers and care recipients. Factors significantly associated (p < 0.05) with weight loss included female sex for both caregivers and care recipients, and frailty for caregivers. Family caregivers' characteristics were not significantly associated with weight change in their care recipients. In conclusion, being overweight is a prevalent among older family caregivers and care recipients. Factors such as age, medication use, physical function, number of teeth, and Mini Nutritional Assessment scores varied across BMI categories. Female sex was associated with weight loss in both older family caregivers and care recipients, and frailty was associated with weight loss in caregivers. However, the characteristics of family caregivers did not explain the weight loss of their care recipients. [ABSTRACT FROM AUTHOR]

Background: Epidemiological evidence on weight change and atrial fibrillation (AF) remains limited and inconsistent. Previous studies on body mass index (BMI) in youth and AF rarely considered subsequent BMI. This study aimed to assess the associations of AF with weight change and BMI in youth, as well as modified effect by genetic susceptibility of AF. Methods: The study included 21,761 individuals (mean age 57.8 years) from the Malmö Diet and Cancer cohort. Weight information was obtained at three time points, including recalled weight at age 20 years, measured weight at baseline (middle adulthood), and reported weight at 5-year follow-up examination (late middle adulthood). A weighted genetic risk score of AF was created using 134 variants. Results: During a median follow-up of 23.2 years, a total of 4038 participants developed AF. The association between weight change from early to middle adulthood and AF risk was modified by sex (Pinteraction = 0.004); weight loss was associated with a lower AF risk in females, but not in males. Conversely, weight gain was positively associated with AF risk in a linear manner in females, whereas increased AF risk appeared only when weight gain exceeded a threshold in males. Participants with weight gain of > 5 kg from middle to late middle adulthood had a 19% higher risk of AF relative to those with stable weight, whereas weight loss showed a null association. Compared to individuals with a lower BMI at age 20 years, those with a BMI above 25 kg/m2 had an increased risk of AF (HR = 1.14; 95% CI: 1.02–1.28), after controlling for baseline BMI; this association was more pronounced in males or those with a lower genetic risk of AF. Conclusions: Weight gain in middle adulthood was associated with higher AF risk. Weight loss from early to middle adulthood, but not from middle to late middle adulthood, was associated with a lower risk of AF only in females. Higher BMI in youth was associated with an increased risk of AF, particularly among males or those with a lower genetic risk of AF. [ABSTRACT FROM AUTHOR]

Aims Materials and Methods Results Conclusions To investigate the efficacy of the integrated data platform of cloud hospital combined with dietary management for adults with type 2 diabetes.We conducted a randomized controlled clinical trial. One hundred eighty patients with type 2 diabetes were randomly allocated into a control group (Group A) and an experimental group (Group B). Routine standard diabetes care was applied to the patients in Group A. The integrated data platform with dietary management was applied to Group B. Individualized diabetes education videos were sent to the patients through the platform. The primary endpoint was the change in HbA1c and change in body weight from baseline to Week 12 during the follow‐up.At Week 12, HbA1c was 7.4 ± 0.7%, 6.9 ± 0.9% in Groups A and B, P < 0.01. The rate of fasting blood glucose <7 mmol/L, and glycosylated hemoglobin <7% was higher in Group B than in Group A. At Week 12, there was a significant weight loss and body mass index decrease in the overweight or obese patients of the experimental group. Those overweight or obese patients in the experimental group utilizing the appetite suppressant semaglutide achieved the most significant weight loss, with a 13.4% reduction after 12 weeks.The integrated data platform combined with personalized diabetes education video delivery was verified to be a more effective management mode for diabetes. For overweight or obese adults with diabetes, the use of semaglutide in conjunction with dietary management and the integrated data platform led to greater weight loss. [ABSTRACT FROM AUTHOR]

Background: Obesity causes many physical and mental illnesses. This study compares mindfulness-based eating awareness training (MB-EAT) versus MB-EAT plus implementation intention model for effectiveness on body mass index (BMI), weight self-efficacy, and physical activity in obese women with BMIs ≤ 25 (n = 52). Methods: In this randomized clinical trial, the participants were selected by the simple random sampling method and randomly divided into three groups. A 12-session MB-EAT of 150 min per session was performed for experimental group I. The experimental group II received MB-EAT alone for physical activity planning and MB-EAT plus implementation intention; also, both groups were compared to the control group. Data were measured by the scales, a questionnaire, and a checklist, and the P-values are based on the results of the generalized estimating equation (GEE) test. P < 0.001 were considered the significance level. Results: The MB-EAT and MB-EAT + implementation intention effectiveness on the two experimental groups' BMI, weight self-efficacy, and physical activity was significantly different from the control group. In the integrated group versus the MB-EAT group, BMI, physical activity, and physical discomfort, were more effective than the weight self-efficacy subscales. Both intervention groups were effective on BMI, weight self-efficacy, and physical activity, but the integrated group's effectiveness was more. Conclusions: The MB-EAT effectiveness trial is theory-based, reducing weight and the psychological and behavioral consequences of overweight and obese adults. The MB-EAT + the Implementation intention model is to plan regular and daily exercise according to each individual's specific circumstances. Trial registration: The trial registration number: (IRCT20200919048767N1). [ABSTRACT FROM AUTHOR]

Background: Fatigue with obesity negatively affects the motivation to lose weight and causes failure of treatment. So, obesity and fatigue are two related entities that worsen each other in a vicious circle. This study aimed to examine the changes in fatigue levels in obese patients undergoing laparoscopic sleeve gastrectomy (LSG). Methods: Preoperative and postoperative BMI, fat percentage, and obesity degree were determined based on Tanita test results, and the rates of change were calculated. The Fatigue Assessment Scale (FAS) was used to assess the impact of obesity on mental and physical fatigue. Results: Six months after LSG, there was a 29.7% decrease in Body Mass Index (BMI) across all patients (45.0 to 31.4, p < 0.001). Significant reductions in the percentage of body fat, obesity grade, and HgA1C were observed in both women and men and overall (p < 0.001 for all comparisons). Scores on the Fatigue Assessment Scale (FAS) for total, mental, and physical scales decreased significantly for women, men, and all participants (p < 0.001 for all comparisons). There was a weak but significant positive correlation between the percentage change in FAS total and FAS physical scale scores and the change in BMI% (p = 0.015 and 0.004; r = 0.089, 0.106, respectively). Change in obesity grade and FAS physical subscale scores negatively correlated (p = 0.029, r = 0.080). Conclusions: LSG not only leads to significant weight reduction but also improves fatigue levels in patients with obesity. [ABSTRACT FROM AUTHOR]

The relationship of weight change has extended to accelerated ageing, yet little is known about the association between weight change and anti-aging protein α-Klotho. This study included 10,972 subjects from the National Health and Nutrition Examination Survey 2007–2016. Participants were measured body weight and height at baseline and recalled weight at young adulthood and middle adulthood. α-Klotho concentrations were quantified. Generalized linear regression models were used to assess the association between weight change and α-Klotho. Across adulthood, maximal overweight, non-obese to obese, and stable obesity were consistently associated with lower serum Klotho levels. Compared with participants who remained at normal weight, from middle to late adulthood, participants experiencing maximal overweight, moving from the non-obese to obese, and maintaining obesity had 27.97 (95% CI: − 46.57 to − 9.36), 39.16 (95% CI: − 61.15 to − 17.18), and 34.55 (95% CI: − 55.73 to − 13.37) pg/ml lower α-Klotho, respectively; similarly, from young to late adulthood, those had 29.21 (95% CI: − 47.00 to − 11.42) , 34.14 (95% CI: − 52.88 to − 15.40), and 36.61 (95% CI: − 65.01 to − 8.21) lower, respectively. Interestingly, from middle to late adulthood, the absolute weight change values of 590 participants who changed from obese to non-obese were negatively associated with serum α-Klotho. Each 1 kg of weight loss during the process of changing from obese to non-obese brought about a relative increase in α-Klotho levels of 3.03 pg/ml. The findings suggest the potential role of weight management across adulthood for aging. [ABSTRACT FROM AUTHOR]

Summary Introduction Methods Results Conclusion Weight regain and insufficient weight loss are major challenges after metabolic bariatric surgery (MBS), affecting patients' comorbidities and quality of life. The current systematic review and meta‐analysis aim to assess the efficacy and safety of GLP‐1 receptor agonists (GLP‐1 RA) in patients with weight regain or insufficient weight loss after MBS.A systematic search was conducted across PubMed, Embase, Scopus, and Web of Science databases to find the relevant studies.A total of 19 articles were included. The highest doses of liraglutide and semaglutide were 3 mg per day and 1 mg once weekly, respectively, in the included studies. The mean differences in weight and body mass index after treatment were −7.02 kg or 3.07 kg/m2, −8.65 or −5.22 kg/m2, and −6.99 kg or −3.09 kg/m2 for treatment durations of ≤ 6 months, 6–12 months, and >12 months with liraglutide, respectively. Additionally, weekly semaglutide showed significantly greater weight loss compared to daily liraglutide, with a mean difference of 4.15 kg. Common complications included nausea (19.1%), constipation (8.6%), abdominal pain (3.7%), and vomiting (2.4%).Using GLP‐1 RA is a safe and effective treatment for weight regain and insufficient weight loss after MBS. [ABSTRACT FROM AUTHOR]

Frailty, known as a syndrome affecting the elderly, have a direct impact on both social well-being and body's ability to function properly. Specific to geriatric healthcare, the early detection of frailty helps the specialists to mitigate risks of severe health outcomes. This article presents the development process of a system used to determine frailty-specific parameters, focusing on easy-to-use, non-intrusive nature and reliance on objectively measured parameters. The multitude of methodologies and metrics involved in frailty assessment emphasize the multidimensional aspects of this process and the lack of a common and widely accepted methodology as being the gold standard. After the research phase, the frailty-specific parameters considered are physical activity, energy expenditure, unintentional weight loss, and exhaustion, along with additional parameters like daily sedentary time, steps history, heart rate, and body mass index. The system architecture, artificial intelligence models, feature selection, and final prototype results are presented. The last section addresses the challenges, limitations, and future work related to the Frailty Insights Detection System (FIDS). [ABSTRACT FROM AUTHOR]

Background: Recent evidence shows the role of sirtuin 1(SIRT1), a family of evolutionarily conserved proteins, as a potential therapeutic target in the prevention and treatment of obesity and metabolic diseases. Some evidence shows the moderating effects of weight loss interventions on this factor. However, the findings are contradictory. In order to obtain a better viewpoint from them, this study aimed to comprehensively investigate the effects of weight loss interventions on SIRT 1 modulation. Methods: For this study, we searched four electronic databases using predefined keywords from inception until March 2024. We includedrandomized controlled trials that evaluated the effect of weight reduction strategies on SIRT1 levels. The random-effects model analysis was used to obtain the pooled weighted mean difference (WMD) and 95% confidence intervals (95% CI). The meta-analysis was conducted using RevMan version 5.3 software and Stata version 12.0. Results: Twelve studies with 627 volunteers were included. The pooled findings showed that weight loss interventions have no significant effect on the modulation of SIRT1 compared to the control group (pooled WMD of 0.58 ng/mL; 95% confidence interval [CI] -0.17 to 1.33; p = 0.130). However, subgroup analysis showed that weight loss interventions significantly modulate SIRT1 at metabolic disease (WMD: 1.2 ng/mL, 95% CI: 0.11 to 2.62, I2 = 82.9%). In addition, subgroup findings indicated health status and body mass index (BMI) as sources of high and potential heterogeneity. Conclusions: Based on the findings, weight loss therapies in individuals having a metabolic disorder appear to generate a considerable increase in SIRT1 levels. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions In March 2021, the Japanese Ministry of Health, Labour and Welfare revised the optimal gestational weight gain standards. In this study, we examined whether this revision affected gestational weight gain and low birth weight rates.We analyzed the records of singleton pregnant women who underwent checkups from their 1st trimester and delivered at our institute after 37 weeks between 2020 and 2021 (before the revision) and between 2022 and 2023 (after the revision). Pregnancy outcomes were assessed in the following four groups stratified by pre‐pregnancy body mass index (BMI): underweight (BMI: <18.5 kg/m2), normal‐weight (BMI: 18.5–24.9 kg/m2), overweight (BMI: 25–29.9 kg/m2), and obese (BMI: ≥30 kg/m2). Leaflets on the optimal gestational weight gain standards for each group were distributed to all pregnant women at the first prenatal checkup.In each group, gestational weight gain did not change before and after the revision, with the corresponding values of 10.8 kg and 11.1 kg in the underweight (p = 0.94), 10.7 kg and 10.4 kg in the normal weight (p = 0.14), 9.7 kg and 9.2 kg in the overweight (p = 0.32), and 7.4 kg and 6.7 kg in the obese (p = 0.44) groups. Furthermore, the prevalence of low birth weight did not decrease in all groups.No significant differences in gestational weight gain or low birth weight were observed after the revision of the 2021 gestational weight gain recommendations. Merely distributing leaflets to pregnant women may not be sufficient to improve gestational weight gain or reduce low birth weight rates. [ABSTRACT FROM AUTHOR]

Accurate weight predictions are essential for weight management program patients. The freely available National Institutes of Health Body Weight Planner (NIH-BWP) returns expected weights over time but overestimates weight when patients consume a low-calorie diet. This study sought to increase the accuracy of NIH-BWP predicted weights for people on low-calorie diets. People enrolled in a weight management program were included if they received meal replacements with defined caloric content for the 3 months of the weight loss phase of the program. The Ottawa Weight Loss Prediction Model (OWL-PM) modelled the relative difference between observed and NIH-BWP predicted weights using longitudinal analysis methods based on patient factors. OWL-PM was externally validated. 1761 people were included (mean age 46 years, 73.3% women) with a mean (SD) baseline weight in pounds and body mass index of 271.9 (55.6) and 43.9 (7.4), respectively. At the end of the program's weight loss phase, people lost a median (IQR) of 17.1% (14.8–19.5) of their baseline weight. Observed weight relative to NIH-BWP predicted weights had a median value of − 4.9% but ranged from − 32.1% to + 28.5%. After adjustment, weight overestimation by NIH-BWP was most pronounced in male patients, people without diabetes and with increased observation time. OWL-PM returned expected weights at 3 months that were significantly more accurate than those from NIH-BWP alone (mean difference observed vs. expected [95% CI] 6.7lbs [6.4–7.0] vs. 12.6lbs [12.1–13.0]). In the external validation cohort (n = 106), OWL-PM was significantly more accurate than NIH-BWP (mean squared error 24.3 vs. 40.0, p = 0.0018). OWL-PM incorporated patient-level covariates to significantly increase weight prediction accuracy of NIH-BWP in patients consuming a low-calorie diet. [ABSTRACT FROM AUTHOR]

Background Very low calorie diets (VLCDs) are an obesity treatment option in the general population, but their efficacy and safety in patients on haemodialysis (HD) is unknown. Methods Prospective single arm study of VLCD in haemodialysis patients. All participants received 2.5–3.3 MJ/day for 12 weeks. Weekly assessment of VLCD, pre- and post-dialysis weight, inter-dialytic weight gain, and blood electrolytes occurred for the first 4 weeks, then fortnightly for another 8 weeks. Linear mixed models compared the change in weight over time as well as biochemical outcomes including potassium. Results Twenty-two participants [nine home HD (HHD) and 13 satellite HD (SHD)] enrolled with 19 completing the 12-week intervention. Mean post-dialysis weight declined from 121.1 kg at baseline to 109.9 at week 12 resulting in average decline of 0.88 kg per week (95% C.I. 0.71, 1.05, P  < .001) with 12-week mean percentage weight loss9.3% (SD 3.5). Mean post-dialysis body mass index declined from 40.9 kg/m2 at baseline to 37.1 kg/m2 at week 12 (95% C.I. 0.25, 0.35, P  < .001). Serum potassium rose from week 1 to 3, stabilized during weeks 4 to 6, and fell from week 8, returning near baseline by week 12. Six of the nine (66.6%) HHD participants and seven of the 13 (70%) SHD participants had at least one episode of hyperkalaemia (K  > 6 mmol/l). There were no clinical changes in serum sodium, corrected calcium, or phosphate levels during the study. Conclusion VLCD with dietitian supervision was effective in producing significant weight reduction, with an acceptable safety profile in patients treated with haemodialysis. [ABSTRACT FROM AUTHOR]

Background: Obesity has been shown to have many deleterious physical and psychological consequences. Objective: This study examined the effectiveness of adding the Life Enhancement and Advancement Program (LEAP) to a weight management program. Design: To evaluate the different components of a weight loss program, this study included four groups: (1) dieting, exercise, and LEAP; (2) dieting, exercise, and sham training; (3) dieting and exercise; and (4) exercise only. An assessment was administered at baseline, post-intervention, and a three-month follow-up. Participants: Forty female participants with a body mass index (BMI) ≥ 25 were recruited from a local sports center. They provided informed consent and were randomly assigned to one of the four groups. Measures: Participants' heights were recorded at baseline, and their weight, waist circumference (WC), and BMI were measured at each of the three assessments. Participants completed the Personal Concerns Inventory (PCI) to assess their adaptive motivation at all three assessments. Results: A MANCOVA indicated that participants who received LEAP along with dieting and exercise had a greater reduction in BMI and WC and improved more in adaptive motivation than the other groups. Conclusions: The results suggest that adding LEAP to a weight management program enhanced participants' ability to achieve and maintain weight loss. LEAP enabled participants to pursue and achieve their important goals successfully. [ABSTRACT FROM AUTHOR]

Aim: Tirzepatide is a glucose‐dependent insulinotropic polypeptide and glucagon‐like peptide‐1 (GLP‐1) dual receptor agonist (RA) that reduces glycated haemoglobin (HbA1c) and weight in patients with type 2 diabetes. We assessed the effectiveness of tirzepatide in real‐world use in an Arab population. Methods: Review of clinical data from a specialist outpatient diabetes centre; study time points and outcome measures were pre‐specified. Results: Tirzepatide was initiated in 8945 patients between 24 October 2022 and 31 December 2023. Of these, 3686 individuals reached 40 weeks of follow‐up. At initiation, the mean ± SD age was 54.1 ± 11.5 years, body mass index 34.6 ± 6.0 kg/m2 and HbA1c 7.3 ± 1.5% (56 ± 17 mmol/mol); 2296 (62%) were switched to tirzepatide from another GLP‐RA and 317 (8.6%) reported previous bariatric surgery. The maximum dose dispensed was ≥12.5 mg/week in 1087, 7.5‐10.0 mg/week in 1688 and 2.5‐5.0 mg/week in 911. The mean 40‐week reduction in HbA1c was 0.6 ± 1.2% (8 ± 13 mmol/mol) and the reduction in weight was 4.5 ± 6.9 kg (4.8 ± 7.3%). GLP‐RA‐naïve patients experienced a significantly greater reduction in HbA1c [1.0 ± 1.3% (11 ± 14 mmol/mol) versus 0.5 ± 1.2% (6 ± 13 mmol/mol), p <.0001] and weight (7.2 ± 8.6 vs. 4.2 ± 6.6 kg, p <.0001) compared with previously exposed individuals. Post‐metabolic bariatric surgery patients lost significantly more weight (7.8 ± 9.4 vs. 4.5 ± 7.0 kg, p <.0001). Improvements in blood pressure, lipid profile, and liver transaminases were noted at 40 weeks. Tirzepatide was well tolerated, with 288 (7.8%) of patients discontinuing treatment because of adverse effects, predominantly gastrointestinal. Conclusion: In real‐world use, tirzepatide significantly reduced HbA1c levels and weight and was well tolerated. Previous GLP‐RA use was associated with significantly lesser HbA1c and weight reduction, and previous metabolic bariatric surgery was associated with greater weight loss. [ABSTRACT FROM AUTHOR]

Summary: Background: The identification of predictive parameters of the success of multidisciplinary weight loss interventions (MWLI) appears essential to optimize obesity management. The association between baseline cardiorespiratory fitness (CRF) and changes in anthropometric parameters and body composition during MWLI remains underexplored in adolescents with obesity. Objectives: To assess whether baseline CRF was associated with the effectiveness of a 16‐week MWLI measured through improved body mass, body mass index (BMI) and body composition (percentage of total fat mass (FM) as the main criterion). Methods: Cardiorespiratory fitness and body composition were respectively measured by peak oxygen consumption (VO2peak) during maximal exercise tests and dual‐photon x‐ray absorptiometry (DXA), before (T0) and after (T1) a 16‐week MWLI in 165 adolescents (aged 13.3 ± 1.38 years, 61.2% female, BMI 35.11 ± 5.16 kg/m2). Results: Reductions in BMI and total FM percentage between T0 and T1 were greater in subjects with a baseline VO2peak ≥ 3rd quartile compared to the first quartile (p < 0.001) and the interquartile range (p < 0.05 and p < 0.001, respectively). Baseline VO2peak and VO2 at the first ventilator threshold were positively correlated with the reductions in body mass, BMI and total and visceral FM percentages and with the increase in lean mass (LM) percentage between T0 and T1 after adjustment for age and gender (p < 0.001). Conclusion: Initial CRF is associated with the success of MWLI in adolescents with obesity. Improving their aerobic fitness before starting a MWLI might be a promising strategy to optimize its benefits. [ABSTRACT FROM AUTHOR]

Summary: Background: Anti‐obesity medications (AOMs) are promising lifestyle modification (LSM) adjuncts for obesity treatment, and phentermine is commonly prescribed in paediatric weight management clinics. Determining 'real‐world' AOM effectiveness and characteristics predicting response is important. Objectives: We sought to describe phentermine plus LSM effectiveness and identify baseline characteristics predicting response. Methods: This was a retrospective cohort study among youth seen in a US academic‐based weight management clinic from 2012 to 2020. Baseline characteristics (e.g., body mass index (BMI), liver transaminases, eating‐related behaviours) and outcomes (%BMI of 95th percentile (%BMIp95), BMI, %BMI change, weight) were determined through electronic health records and intake surveys. Results: Among 91 youth prescribed phentermine plus LSM over 8 years (mean %BMIp95 150%), %BMIp95 was statistically significantly reduced at 1.5, 3, 6 and 12 months (peak reduction 10.9 percentage points at 6 months; p < 0.001). Considering multiple comparisons, the presence of baseline elevated alanine aminotransferase was associated with statistically significant smaller 1.5‐month %BMIp95 reductions (p = 0.001) and higher food responsiveness with smaller 3‐ (p = 0.001) and 6‐month (p < 0.001) reductions. Conclusions: Phentermine plus LSM reduced %BMIp95 among youth in a weight management clinic, and baseline characteristics may help determine those more or less likely to respond. Prospective studies are needed to further characterize effectiveness and confirm response predictors. [ABSTRACT FROM AUTHOR]

Combat sports athletes often undergo rapid body mass loss (BML), which presents health risks. Hydration testing has been proposed as a possible solution to reduce or eliminate rapid BML. However, combat sports athletes may exhibit distinct physiological characteristics due to repeated exposure to BML. Thus, traditional and emerging hydration biomarkers should be investigated to determine their potential suitability for field use in this cohort. This study examined whether BML can explain changes in serum and urine osmolality (SosmΔ, UosmΔ), tear osmolarity (TosmΔ), hematocrit (HctΔ), and urine‐specific gravity (USGΔ) after mild–moderate passive dehydration. Biomarker reliability was also assessed across two trials. Fifteen male and female combat sports athletes (age: 26.3 ± 5.3 years, body mass: 67.7 ± 9.9 kg) underwent a sauna protocol twice (5–28 days apart) aiming for 4% BML. The average BML in Trials 1 and 2 was 3.0 ± 0.7%. Regression analysis revealed that BML explained HctΔ (R2 = 0.22, p = 0.009) but not SosmΔ (R2 = 0.11, p = 0.079) or other biomarkers. Intraclass correlation coefficients (ICCs) were significant for all biomarkers except TosmΔ (ICC = 0.06, p = 0.37) and post‐Tosm (ICC = 0.04, p = 0.42); post‐Hct performed best (ICC = 0.82, p < 0.001). Contingency tables with post‐Sosm (295 mOsm/kg) and post‐USG (1.020) cutoffs revealed an 80% true negative rate (TNR) and a 62% true positive rate (TPR). Increasing the Sosm cutoff to 301 mOsm/kg decreased the TNR to 52% but increased the TPR to 83%. Although blood parameters were most sensitive to BML, they could only explain 11%–22% of biomarker variation. The typical USG cutoff misclassified 42% of athletes postdehydration, and reliability was generally poor‐moderate. Alternative strategies should be pursued to manage rapid BML in combat sports. [ABSTRACT FROM AUTHOR]

Background: Bariatric surgery has been proven to be the most effective therapy for obesity and Roux-en-Y gastric bypass (RYGB) is one of the most commonly performed procedure. However, weight regain and dumping syndrome occur over time. The transoral outlet reduction (TORe) procedure using an endoscopic suturing device may be an option to treat these conditions. We aimed to analyze outcome parameters and long-term results for this endoscopic technique. Methods: A retrospective data analysis of patients who underwent TORe using an endoscopic suturing system at our institution from January 2015 to December 2020 was performed. A total of 71 subjects were included. Forty-five patients received the intervention for weight regain, 9 for dumping syndrome and 17 for both. The primary endpoint was weight stabilization or weight loss for subjects with weight regain, and resolution of symptoms for those with dumping syndrome. Secondary endpoints were intraoperative complications, procedure time, length of hospital stay and diameter of gastrojejunal anastomosis 1 year post-intervention. Results: The median size of the gastrojejunal anastomosis was estimated at 30 mm before intervention, and after performing a median of 3 endoscopic sutures, the median estimated gastrojejunal anastomosis width was reduced to 9.5 mm. Eight perioperative complications occurred. Overall mean follow-up was 26.5 months. All interventions achieved weight stabilization or weight loss or resolution of dumping symptoms within the first 3 months, 98.2% at 12 months, 91.4% at 24 months and 75.0% at 48 months. In 22/26 subjects a persisting improvement of dumping syndrome was achieved. Conclusions: TORe is a safe and effective procedure in the treatment of patients with dumping syndrome after laparoscopic RYGB, the effect on weight stabilization is less significant. A prospective randomized trial should be conducted to compare the effects of TORe with other surgical methods like banding the gastrojejunal anastomosis. [ABSTRACT FROM AUTHOR]

Objectives: Obesogenic medications are a putative contributor to the obesity epidemic. While 20% of adults take ≥1 obesogenic medication, the proportion in the end‐stage kidney disease (ESKD) population—a group enriched for cardiometabolic complications—is unknown. Obesogenic medications may contribute to obesity and hamper weight loss efforts to achieve transplant listing. Methods: Using 2017–2020 USRDS and Medicare claims, patients were identified as taking obesogenic medications if prescribed anticonvulsants, antidepressants, antidiabetics, anti‐inflammatories, antipsychotics, and/or antihypertensives known to cause weight gain for ≥30 days in their first hemodialysis year. Ordinal logistic and Cox regression with inverse probability of treatment weighting were used to quantify obesogenic medications' association with body mass index (BMI) and listing, respectively. Results: Among 271 401 hemodialysis initiates, 63.5% took ≥1 obesogenic medication. For those in underweight, normal weight, overweight, and class I, II, and III categories, 54.3%, 58.4%, 63.1%, 66.5%, 68.6%, and 68.8% took ≥1, respectively. Number of obesogenic medications was associated with increased BMI; use of one was associated with 13% increased odds of higher BMI (aOR [adjusted odds ratio] 1.14; 95%CI: 1.13–1.16; p < 0.001), use of three was associated with a 55% increase (aOR 1.55; 95%CI: 1.53–1.57; p < 0.001). Any use was associated with 6% lower odds of transplant listing (aHR [adjusted hazard ratio] 0.94; 95%CI: 0.92–0.96; p < 0.001). Within each BMI category, obesogenic medication use was associated with lower listing likelihood. Conclusions: Obesogenic medication use is common in ESKD patients—particularly those with obesity—and is associated with lower listing likelihood. Whenever possible, non‐obesogenic alternatives should be chosen for ESKD patients attempting weight loss to achieve transplant listing. [ABSTRACT FROM AUTHOR]