Search

Summary ACTION Switzerland (NCT05232786) examined obesity‐related perceptions, attitudes, behaviours and potential barriers to treatment among people with obesity (PwO) and healthcare professionals (HCPs). In March/April 2022, adult PwO (body mass index ≥30 kg/m2, per self‐reported height/weight) and physicians/certified dietitians who manage PwO in Switzerland completed online surveys in a cross‐sectional design. Overall, 1002 PwO, 125 physicians and 25 dietitians completed the survey. Most physicians (97%) and dietitians (100%), but only 57% of PwO, recognized obesity as a chronic disease. Only 42% of PwO considered themselves to have obesity/extreme obesity, while 61% who had discussed weight with an HCP reported receiving an obesity diagnosis. Many PwO (76%) believed weight loss was entirely their responsibility; physicians were less likely than dietitians to agree it was completely their patients' responsibility (28% vs. 68%). Physicians and dietitians report primarily initiating conversations about weight when patients have obesity‐related comorbidities (85% and 64%); their top reasons for not discussing obesity were patients' perceived lack of motivation (76% and 60%) or interest (72% and 64%) in losing weight. In conclusion, some PwO are not aware that obesity is a chronic disease and incorrectly assume complete responsibility for weight loss. Improved communication between PwO and HCPs is required. [ABSTRACT FROM AUTHOR]

Objective: Social support is mostly seen as a positive resource for many health outcomes. However, some research indicates that weight loss may disrupt the equilibrium of relationships and highlights the potential for a more negative form of social support. This qualitative study aimed to explore bariatric surgery (BS) patients' perceptions of the way in which their current or previous partner supported them throughout their BS journey. Design: BS patients (N = 30) participated in semi‐structured interviews. Methods: The data were analysed using an inductive approach to reflexive thematic analysis. Results: Four themes were derived from the data. While two themes reflected social support as a form of caring (Mutual Investment and Positive Reinforcements), the other two themes indicated aspects of sabotage (Feeder Behaviours and Negative Reactions to Weight Loss Attempts and Successes). Transcending these themes was the notion of Bariatric Surgery as an Opportunity or Threat to the Relationship. Conclusions: Some patients perceived social support as a positive resource in BS success involving Mutual Investment from their partners and being offered Positive Reinforcements for changes in their weight status and wellbeing. Some, however, described more negative aspects of support which had undermined their BS goals, either unintentionally or intentionally, through acts of sabotage including Feeder Behaviours and Negative Reactions to Weight Loss Attempts and Successes. Future research should develop interventions to help prepare the partners of those undergoing BS for the changes to both their partner's weight status and the dynamics of their relationship. [ABSTRACT FROM AUTHOR]

Aim: We aimed to investigate the long‐term impact of glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) on thyroid function, cardiovascular health, renal outcomes and adverse events in individuals with obesity and without type 2 diabetes (T2D). Materials and Methods: In this observational cohort study, we used propensity score matching to construct comparable cohorts of individuals with obesity and without T2D who were new to GLP‐1 RA treatment and those who did not receive glucose‐lowering medications. In total, 3,729,925 individuals with obesity were selected from the TriNetX Global Network, with an index event between 1 January 2016 and 31 March 2024. The primary outcomes were safety, cardiovascular, thyroid and clinical biochemical profile outcomes occurring within 5 years following the index event. Results: After propensity score matching, the study included 12,123 individuals in each group. GLP‐1 RA treatment was associated with a significantly lower risk of all‐cause mortality (hazard ratio 0.23; 95% confidence interval 0.15–0.34) and several cardiovascular complications, including ischaemic heart disease, heart failure, arrhythmias, hypertension, stroke and atrial fibrillation (all p < 0.05). GLP‐1 RAs were also associated with a lower risk of acute kidney injury and allergic reactions. These protective effects were consistent across various subgroups and regions. Conclusions: In this large observational study, GLP‐1 RAs showed long‐term protective effects on cardiovascular health, renal outcomes and adverse events in individuals with obesity and without T2D. Our findings suggest that GLP‐1 RAs may offer a comprehensive approach to managing obesity and its related comorbidities, potentially improving overall health and survival in this population. [ABSTRACT FROM AUTHOR]

Purpose of Review: Gauge the effectiveness of self-monitoring of weight for weight loss. Recent Findings: Daily self-monitoring of weight results in increased weight loss, or improved weight maintenance as compared to infrequent or no self-monitoring of weight. Self-weighing is most effective when tied with other behavioral interventions including tracking caloric intake and physical activity tracking. Summary: Self-monitoring of weight is an effective behavioral weight loss intervention which allows patients to track their progress, but also allows them to connect daily life activities with their weight, fostering real-time feedback that allows them to make more informed and personalized decisions related to dietary choices, physical activity, and lifestyle medicine. [ABSTRACT FROM AUTHOR]

The global prevalence of obesity has almost tripled since 1975 and has become a major public health concern in the United Arab Emirates (UAE). Although physicians are considered as essential role players in the prevention and management of obesity, their perspectives towards obesity management still remain unknown in the UAE. Accordingly, this study aimed to assess physicians' attitudes and practices towards obesity management and prevention in the UAE using a qualitative research design. Face-to-face interviews, with a convenience sample of 15 health care practitioners from primary care clinics in Al-Ain City, Abu Dhabi, were employed during January–March 2019. Inductive thematic analysis was performed to identify main emerging themes and subthemes. Three major themes, namely beliefs and knowledge about obesity and its management, attitudes toward weight control, and current practices in relation to obesity management in primary care clinics, emerged. The results revealed that weight management is considered essential for all those with high body mass index but is suboptimal in primary care settings. Cultural misconceptions among patients regarding weight and lack of appropriate follow-up constitute major barriers to its management. As obesity is burdensome, its management is crucial and can be enhanced by multidisciplinary approach and unification of guidelines. [ABSTRACT FROM AUTHOR]

Summary A cross‐sectional, online survey was conducted in the United Kingdom, France, Germany, and the United States (14 November–22 December 2022) to investigate preferences for anti‐obesity medication (AOM) among people with obesity (PwO) and healthcare providers (HCPs). Eligibility: Adult PwO who self‐defined their body type as overweight/obese, were trying to lose weight and had BMI ≥30.0 or 27.0–29.9 kg/m2 with ≥1 obesity‐related complication; HCPs had to see ≥30 PwO in a typical month and be a decision‐maker regarding their weight loss. The survey included 2500 PwO and 500 HCPs. Exercise (96%) and diet (90%) were the most common weight management methods; AOM use was low (8%). Key barriers to use of prescribed AOMs among PwO were not wanting to take AOM (34%), side effects concerns (33%), and not trusting AOM (26%). Most HCPs (79%) had prescribed/recommended AOMs. Efficacy was the most common reason for preferring one of the shown product profiles among PwO (60%) and HCPs (86%); improving cardiovascular risk was also important to 95% of HCPs when deciding which AOM to prescribe. AOM preference is largely driven by efficacy. Increasing knowledge could help to address barriers to AOM use and improve outcomes for PwO. [ABSTRACT FROM AUTHOR]

Background: Obesity is a chronic disease characterized by excess body fat and is a risk factor for other chronic non-communicable diseases. Its multifactorial and complex nature makes its management a challenge for health services. This manuscript presents an investigation protocol that aims to analyze the effectiveness of collective nutritional interventions for obesity management applicable to primary health care. Methods: Randomized Controlled Community Trial (RCCT) in a representative sample of users of the Programa Academia de Saúde (PAS), in Belo Horizonte, Minas Gerais, Brazil, with obesity. The research consists of four phases: (1) Screening to identify the participants eligible for the nutritional interventions (individuals with obesity, readiness for change to lose body weight, and willingness and interest to participate in a group activity for six months or more); (2) Baseline to characterize the participants; (3) Implementation of collective nutritional interventions; (4) Reassessment of the participants. Participants in the control group (CG) will receive the usual health service care, and participants in the intervention group (IG) will participate in collective nutritional interventions based on Therapeutic Group 1 (TG1) or Therapeutic Group 2 (TG2) of the "Instructive of Collective Approach for the obesity management in SUS". Discussion: The strengths of the study include its robust RCCT design, which allows for longitudinal analyses and is suitable for investigating causal hypotheses and applying strategies to improve adherence to interventions. Furthermore, the study included a representative sample of a public health service and aims to evaluate therapeutic proposals from the Brazilian Ministry of Health, which can contribute to implementation and extension in the national territory. Trial registration: RBR-3vzsyqq and RBR-6pg682m. [ABSTRACT FROM AUTHOR]

Summary: The prevalence of individuals with obesity or overweight has steadily increased over the past decades both worldwide, and in the United States. This trend is also evident in the older adult population, which has experienced a continuous rise in the number of individuals with overweight or obesity. This is relevant due to the impact of obesity in older adults' quality of life, physical function, morbidity, and healthcare costs. This review aims to provide practical guidance and currently available approaches for healthcare professionals in managing this population. Both non‐pharmacological methods such as intensive behavioural therapy, nutritional interventions, and physical activity, as well as anti‐obesity medications, are discussed, with a focus on their potential positive and negative effects in older adults. Additionally, bariatric therapy is evaluated, including current procedures available and the associated results and risks in the older population. [ABSTRACT FROM AUTHOR]

Purpose: It is essential to investigate the users' needs in developing user-centered, family-based applications (apps) for managing childhood obesity. Methods: This study conducted focus group interviews with ten parents, ten children, and four app developers to investigate the need to develop a family-based mobile app for childhood obesity. The interview period was from July 17 to August 30, 2023. The data were analyzed using thematic analysis. Results: The results highlighted 31 key themes critical to family-based app development, including the need for comprehensive content promoting healthy lifestyle habits, tailored expert support, and motivational factors for app engagement, which were categorized as intrinsic, extrinsic, and social motivations and technological features. Participants also highlighted potential challenges, such as app usability issues and the need for a user-friendly interface. The pivotal role of parents in guiding and supporting their children's health behaviors was emphasized, particularly in creating a supportive environment that encourages sustained engagement with the app. Conclusion: These findings provide a comprehensive understanding of the needs and preferences of parents, children, and app developers in managing childhood obesity. Emphasis on integrating healthy lifestyle content, providing expert support, and incorporating motivational strategies is crucial for the app's success. Additionally, addressing potential difficulties and recognizing the pivotal role of parents are essential considerations. These insights will inform the design and development of a user-centered mobile app that supports families in managing childhood obesity. [ABSTRACT FROM AUTHOR]

Bioinformatics has emerged as a valuable tool for screening drugs and understanding their effects. This systematic review aimed to evaluate whether in silico studies using anti-obesity peptides targeting therapeutic pathways for obesity, when subsequently evaluated in vitro and in vivo, demonstrated effects consistent with those predicted in the computational analysis. The review was framed by the question: "What peptides or proteins have been used to treat obesity in in silico studies?" and structured according to the acronym PECo. The systematic review protocol was developed and registered in PROSPERO (CRD42022355540) in accordance with the PRISMA-P, and all stages of the review adhered to these guidelines. Studies were sourced from the following databases: PubMed, ScienceDirect, Scopus, Web of Science, Virtual Heath Library, and EMBASE. The search strategies resulted in 1015 articles, of which, based on the exclusion and inclusion criteria, 7 were included in this systematic review. The anti-obesity peptides identified originated from various sources including bovine alpha-lactalbumin from cocoa seed (Theobroma cacao L.), chia seed (Salvia hispanica L.), rice bran (Oryza sativa), sesame (Sesamum indicum L.), sea buckthorn seed flour (Hippophae rhamnoides), and adzuki beans (Vigna angularis). All articles underwent in vitro and in vivo reassessment and used molecular docking methodology in their in silico studies. Among the studies included in the review, 46.15% were classified as having an "uncertain risk of bias" in six of the thirteen criteria evaluated. The primary target investigated was pancreatic lipase (n = 5), with all peptides targeting this enzyme demonstrating inhibition, a finding supported both in vitro and in vivo. Additionally, other peptides were identified as PPARγ and PPARα agonists (n = 2). Notably, all peptides exhibited different mechanisms of action in lipid metabolism and adipogenesis. The findings of this systematic review underscore the effectiveness of computational simulation as a screening tool, providing crucial insights and guiding in vitro and in vivo investigations for the discovery of novel anti-obesity peptides. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore the impact of central obesity on spinal sagittal balance in adults aged 18 and older by examining correlations between waist circumference (WC) and abdominal circumference (AC) and spinopelvic alignment parameters. This prospective cohort study included 350 adults aged 18 and older. Participants underwent whole-body biplanar radiography using the EOS imaging system. Spinal and pelvic parameters were measured and correlated with body mass index, WC, and AC. Statistical analyses included one-way analysis of variance, Wilcoxon rank-sum tests for data with nonhomogeneous variances, and chi-squared tests for categorical data. Intra-rater and inter-rater reliability were assessed using intraclass correlation coefficients, with subsequent analyses to explore correlations between body measurements and spinal parameters. The study found significant correlations between increased WC and AC and changes in spinopelvic parameters. However, obesity did not uniformly influence all sagittal alignment parameters. Significant variations in spinal measurements indicate that central obesity plays a role in altering spinal stability and alignment. The findings highlight the impact of central obesity on spinal alignment and emphasize the importance of considering central obesity in clinical assessments of spinal pathologies. Further research is essential to better understand the relationship between obesity, spinal sagittal balance, and related health conditions. [ABSTRACT FROM AUTHOR]

Objective: Obesity is a public health problem with a rising prevalence. When lifestyle modifications, diet, and exercise fail, anti-obesity medications and surgeries are treatment options. However, they seem to be underutilized, due in part to patients' attitudes towards these modalities. This study aimed to investigate patients' attitudes toward these treatments. Materials and Methods: A descriptive survey was conducted in a face-to-face fashion. Weight perception, prior weight loss trials, exercise and dietary treatments, perceptions related to obesity and its treatment, and demographic factors, were assessed in relation to anti-obesity medications and surgical treatments. Perception was analyzed both verbally and visually. Misperception was defined as being thinner than reality misperceptions (TTRM), fatter than reality misperceptions (FTRM), or either of them (ETFTRM). Results: 198 participants completed the survey. 30.8% and 23.7% of the participants would consider anti-obesity medications and surgeries, respectively. Females were more likely to consider anti-obesity medications (43.9% vs. 21.6%, p = 0.001). Patients who had exercised to lose weight were more likely to consider anti-obesity surgery (28.9% vs. 16.7%, p = 0.04). Appropriate weight perception was 16.2%. Weight misperception was not associated with higher or lower rates of anti-obesity treatments. However, among the patients in the highest body mass index (BMI) group (BMI > 35), participants with pure-TTRM were more likely to consider anti-obesity medications (66.7% vs. 18.8%, p = 0.01). Conclusion: Medical and surgical obesity treatments are considered at a low rate among candidates or at-risk patients. Age, gender, exercise history, and pure-TTRM were associated with higher treatment considerations. [ABSTRACT FROM AUTHOR]

Obesity is a chronic, prevalent, and complex health condition that adversely impairs physical and mental health. The World Health Organization calls for integrating obesity care into existing chronic disease management programs within primary healthcare services. This scoping review aimed to examine registered nurses' roles in the primary healthcare management of individuals with obesity. A scoping review was conducted using the Johanna Briggs Institute methodology framework. Thematic analysis was used to identify and categorize nurses' roles in primary healthcare obesity management of adults. Of 1142 documents included in this review, 15 papers met the inclusion criteria. Thematic analysis yielded the following six themes representing nurses' major roles: patient-centred care, patient assessments, therapeutic interventions, care management, patient education, and professional development. This review identified that the literature on nurses' roles primarily described their focus on lifestyle interventions (mainly nutrition and physical activity), anthropometric measurements, health planning, goal setting, supportive care, monitoring progress, and arranging follow-up. The Discussion highlights the importance of determining RN knowledge gaps and biases. More research is required to determine the need for additional RN pre-and or post-education related to obesity as a complex chronic disease. [ABSTRACT FROM AUTHOR]

Young Sang Lyu,1 Hongyup Ahn,2 Sangmo Hong,3 Cheol-Young Park4 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Chosun University Hospital, Gwangju, Republic of Korea; 2Department of Statistics, Dongguk University, Seoul, Republic of Korea; 3Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea; 4Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaCorrespondence: Cheol-Young Park, Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro,Jongno-gu, Seoul, 03181, Republic of Korea, Email cydoctor@skku.eduPurpose: To investigate the safety and effectiveness of naltrexone-bupropion in Korean adults with obesity.Patients and methods: This was a prospective, observational multicenter study from April 29, 2016, to April 28, 2022. Individuals with obesity with a body mass index of ≥ 30 kg/m2 or ≥ 27 kg/m2 who had obesity-related comorbidities were included. The naltrexone-bupropion dose was gradually titrated weekly from 8/90 to 32/360 mg and maintained at the maximum tolerated dose. In total, 612 and 300 individuals were evaluated for safety and effectiveness, respectively.Results: In total, 41.34% individuals reported drug-related adverse reactions, such as nausea (19.12%), headache (7.68%), and dizziness (5.23%). Older age and comorbidities were significantly associated with adverse events. At 12 weeks after reaching the maintenance dose, naltrexone-bupropion 32/360 mg resulted in the greatest weight reduction (− 7.21%) compared with other doses, which persisted at week 24 (− 7.69%). The naltrexone-bupropion 16/180 mg resulted in significant weight reduction, achieving − 5.99% and − 9.18% reductions at weeks 12 and 24, similar to that with naltrexone-bupropion 32/360 mg. Young age and no comorbidities were significantly associated > 5% weight reduction.Conclusion: Naltrexone-bupropion demonstrated marked stability and weight loss effectiveness, particularly in young individuals with obesity without comorbidities. Therefore, individualized treatment is necessary when prescribing naltrexone-bupropion.Keywords: naltrexone-bupropion, obesity management, post-marketing survey, weight loss efficacy, adverse events

Background Adolescence is a high-risk period for obesity, and it is crucial and urgent to implement obesity control among adolescents. However, existing interventions commonly face challenges in sustainability and scalability. Asset assessment to identify and leverage existing community assets and strengths is essential to facilitate and maintain the implementation of these programs. Objective To assess assets for obesity control among middle school students, and to identify the advantages and deficiencies in the current policy, physical, social, and information environments, along with suggestions for improvements. Methods From 2023 to January 2024, purposive sampling method was adopted, face-to-face one-by-one interviews were conducted with 11 staff members involved in obesity control for middle school students from the Center for Disease Control and Prevention, Education Bureau, and three middle schools in a major city in East China. Additionally, eight parents and their children from each of the three schools were invited to participate in focus group discussions, with 6 groups and 8 participants per group. Thematic analysis was applied to analyze the interview data. Results This study found that the advantages in obesity control for middle school students primarily included policies and conditions ensured for obesity surveillance, nutritional school lunch and physical activity, along with media for health communication. The main deficiencies were the lack of specific policies for efficient obesity control, insufficient physical and social assets to support healthy eating and physical activity, and the quality and intensity of information assets supporting to facilitate changes in knowledge, attitude, and behaviors. In response to these challenges, participants suggested the implementation of both rigid regulations and flexible incentives, improvement of asset accessibility, encouragement of multi-stakeholder cooperation, and strengthening of health communication. Integrating existing assets and suggestions for improvement has formed an asset assessment checklist, corresponding to 10 assets from the policy environment, 8 from the physical environment, 20 from the social environment, and 12 from the information environment. Conclusion Several assets exist for obesity control among middle school students and identifies areas for improvement. Subsequent efforts in obesity control for middle school students should be made on promoting intervention strategies to better align with the context based on the asset assessment checklist to diagnose the current status of assets, thus enhancing the efficacy and sustainability of the program.

Purpose It is essential to investigate the users’ needs in developing user-centered, family-based applications (apps) for managing childhood obesity. Methods This study conducted focus group interviews with ten parents, ten children, and four app developers to investigate the need to develop a family-based mobile app for childhood obesity. The interview period was from July 17 to August 30, 2023. The data were analyzed using thematic analysis. Results The results highlighted 31 key themes critical to family-based app development, including the need for comprehensive content promoting healthy lifestyle habits, tailored expert support, and motivational factors for app engagement, which were categorized as intrinsic, extrinsic, and social motivations and technological features. Participants also highlighted potential challenges, such as app usability issues and the need for a user-friendly interface. The pivotal role of parents in guiding and supporting their children’s health behaviors was emphasized, particularly in creating a supportive environment that encourages sustained engagement with the app. Conclusion These findings provide a comprehensive understanding of the needs and preferences of parents, children, and app developers in managing childhood obesity. Emphasis on integrating healthy lifestyle content, providing expert support, and incorporating motivational strategies is crucial for the app’s success. Additionally, addressing potential difficulties and recognizing the pivotal role of parents are essential considerations. These insights will inform the design and development of a user-centered mobile app that supports families in managing childhood obesity.

Abstract Background Obesity is a chronic disease characterized by excess body fat and is a risk factor for other chronic non-communicable diseases. Its multifactorial and complex nature makes its management a challenge for health services. This manuscript presents an investigation protocol that aims to analyze the effectiveness of collective nutritional interventions for obesity management applicable to primary health care. Methods Randomized Controlled Community Trial (RCCT) in a representative sample of users of the Programa Academia de Saúde (PAS), in Belo Horizonte, Minas Gerais, Brazil, with obesity. The research consists of four phases: (1) Screening to identify the participants eligible for the nutritional interventions (individuals with obesity, readiness for change to lose body weight, and willingness and interest to participate in a group activity for six months or more); (2) Baseline to characterize the participants; (3) Implementation of collective nutritional interventions; (4) Reassessment of the participants. Participants in the control group (CG) will receive the usual health service care, and participants in the intervention group (IG) will participate in collective nutritional interventions based on Therapeutic Group 1 (TG1) or Therapeutic Group 2 (TG2) of the “Instructive of Collective Approach for the obesity management in SUS”. Discussion The strengths of the study include its robust RCCT design, which allows for longitudinal analyses and is suitable for investigating causal hypotheses and applying strategies to improve adherence to interventions. Furthermore, the study included a representative sample of a public health service and aims to evaluate therapeutic proposals from the Brazilian Ministry of Health, which can contribute to implementation and extension in the national territory. Trial registration RBR-3vzsyqq and RBR-6pg682m.

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: Adolescence is a high‐risk life stage for obesity. Digital strategies are needed to prevent and manage obesity among adolescents. We assessed if digital health interventions are contributing to disparities in obesity outcomes and assessed the adequacy of reporting of digital health equity criteria across four levels of influence within the digital environment. The systematic search was conducted on 10 major electronic databases and limited to randomized controlled trials (RCTs) or cluster‐RCTs for prevention or management of obesity among 10–19 year olds. Primary outcome was mean body mass index (BMI), or BMI z‐score change. The Adapted Digital Health Equity Assessment Framework was applied to all studies. Thirty‐three articles (27 unique studies with 8483 participants) were identified, with only eight studies targeting adolescents from disadvantaged populations. Post‐intervention, only three studies reported significantly lower BMI outcomes in the intervention compared to control. Of the 432 digital health equity criteria assessed across 27 studies, 82% of criteria were "not addressed." Studies are not addressing digital health equity criteria or inadequately reporting information to assess if digital health interventions are contributing to disparities in obesity outcomes. Enhanced reporting is needed to inform decision‐makers and support the development of equitable interventions to prevent and manage obesity among adolescents. [ABSTRACT FROM AUTHOR]

Abstract Background Obesity (body mass index ≥ 30 kg/m2) is a major risk factor for heart failure with preserved ejection fraction (HFpEF) and affects most patients with HFpEF. Patients living with obesity may experience delays in HFpEF diagnosis and management. We aimed to understand the clinical journey of patients with obesity and HFpEF and the role of primary care providers (PCPs) in diagnosing and managing patients with both conditions. Methods An anonymous, US population-based online survey was conducted in September 2020 among 114 patients with self-reported HFpEF and obesity and 200 healthcare providers, 61 of whom were PCPs who treat patients with HFpEF and obesity. Results Half of patients (51%) with HFpEF reported waiting an average of 11 months to discuss their symptoms with a PCP; 11% then received their diagnosis from a PCP. PCPs initiated treatment and oversaw the management of HFpEF only 35% of the time, and 44% of PCPs discussed obesity treatment medication options with their patients. Only 20% of PCPs indicated they had received formal obesity management training, and 79% of PCPs indicated they would be interested in obesity management training and support. Conclusion PCPs could play a valuable role in addressing obesity and referring patients with obesity and signs and symptoms of HFpEF to cardiologists. Increased awareness of HFpEF and its link to obesity may help PCPs more quickly identify and diagnose their patients with these conditions. Graphical Abstract

Abstract Obesity is a prevalent chronic disease that has significant negative impacts on humans and our companion animals, including dogs and cats. Obesity occurs with multiple comorbidities, such as diabetes, hypertension, heart disease and osteoarthritis in dogs and cats. A direct link between lipid metabolism dysregulation and obesity-associated diseases has been implicated. However, the understanding of such pathophysiology in companion animals is limited. This review aims to address the role of lipid metabolism in various metabolic disorders associated with obesity, emphasizing the involvement of the gut microbiota. Furthermore, we also discuss the management of obesity, including approaches like nutritional interventions, thus providing novel insights into obesity prevention and treatment for canines and felines.

Abstract This systematic review and meta-analysis (SRMA) evaluates the efficacy and safety of Positive Airway Pressure (PAP) therapy in perioperative care for obese surgical patients. We reviewed 24 studies, encompassing data up to March 23, 2023, analyzing the impacts of Continuous Positive Airway Pressure (CPAP) and Bilevel Positive Airway Pressure (BIPAP) on postoperative adverse outcomes, oxygenation, and pulmonary function. Our findings underscore the significant potential of PAP therapy in managing obese patients during the perioperative period, particularly those at substantial risk for postoperative respiratory complications. PAP therapy not only enhances oxygenation levels and lung function but also substantially reduces the incidence of atelectasis and shortens hospital stays, thereby affirming its vital role in improving perioperative outcomes for this patient population.

This systematic review and meta-analysis (SRMA) evaluates the efficacy and safety of Positive Airway Pressure (PAP) therapy in perioperative care for obese surgical patients. We reviewed 24 studies, encompassing data up to March 23, 2023, analyzing the impacts of Continuous Positive Airway Pressure (CPAP) and Bilevel Positive Airway Pressure (BIPAP) on postoperative adverse outcomes, oxygenation, and pulmonary function. Our findings underscore the significant potential of PAP therapy in managing obese patients during the perioperative period, particularly those at substantial risk for postoperative respiratory complications. PAP therapy not only enhances oxygenation levels and lung function but also substantially reduces the incidence of atelectasis and shortens hospital stays, thereby affirming its vital role in improving perioperative outcomes for this patient population. [ABSTRACT FROM AUTHOR]

Background: Obesity (body mass index ≥ 30 kg/m2) is a major risk factor for heart failure with preserved ejection fraction (HFpEF) and affects most patients with HFpEF. Patients living with obesity may experience delays in HFpEF diagnosis and management. We aimed to understand the clinical journey of patients with obesity and HFpEF and the role of primary care providers (PCPs) in diagnosing and managing patients with both conditions. Methods: An anonymous, US population-based online survey was conducted in September 2020 among 114 patients with self-reported HFpEF and obesity and 200 healthcare providers, 61 of whom were PCPs who treat patients with HFpEF and obesity. Results: Half of patients (51%) with HFpEF reported waiting an average of 11 months to discuss their symptoms with a PCP; 11% then received their diagnosis from a PCP. PCPs initiated treatment and oversaw the management of HFpEF only 35% of the time, and 44% of PCPs discussed obesity treatment medication options with their patients. Only 20% of PCPs indicated they had received formal obesity management training, and 79% of PCPs indicated they would be interested in obesity management training and support. Conclusion: PCPs could play a valuable role in addressing obesity and referring patients with obesity and signs and symptoms of HFpEF to cardiologists. Increased awareness of HFpEF and its link to obesity may help PCPs more quickly identify and diagnose their patients with these conditions. Plain Language Summary: Heart failure with preserved ejection fraction (HFpEF) is a common form of heart failure. Many patients who have HFpEF also have obesity or excess weight. We wanted to understand the medical experience of patients with HFpEF and obesity and the role that primary care providers (PCPs) play in managing patients with these diseases. We surveyed 114 patients with HFpEF and obesity and 200 healthcare providers who treat patients with HFpEF and obesity, 61 of whom were PCPs. One-quarter of patients had a major heart-related event that led to their HFpEF diagnosis. Half of the patients said they had an initial discussion about HFpEF symptoms with a PCP, but only one in ten were diagnosed by a PCP. Few PCPs said they received obesity management training, but most were interested in receiving more obesity management training and support. PCPs play an important role in organizing care for patients with HFpEF and obesity. However, there is room to improve HFpEF awareness and access to obesity management tools and strategies among PCPs. [ABSTRACT FROM AUTHOR]

Interventions aimed at weight control often have limited effectiveness in combating obesity. This review explores how obesity‐induced dysfunction in white (WAT) and brown adipose tissue (BAT), skeletal muscle, and the brain blunt weight loss, leading to retention of stored fat. In obesity, increased adrenergic stimulation and inflammation downregulate β‐adrenoreceptors and impair catecholaminergic signalling in adipocytes. This disrupts adrenergic‐mediated lipolysis, diminishing lipid oxidation in both white and brown adipocytes, lowering thermogenesis and blunting fat loss. Emerging evidence suggests that WAT fibrosis is associated with worse weight loss outcomes; indeed, limiting collagen and laminin‐α4 deposition mitigates WAT accumulation, enhances browning, and protects against high‐fat‐diet‐induced obesity. Obesity compromises mitochondrial oxidative capacity and lipid oxidation in skeletal muscle, impairing its ability to switch between glucose and lipid metabolism in response to varying nutrient levels and exercise. This dysfunctional phenotype in muscle is exacerbated in the presence of obesity‐associated sarcopenia. Additionally, obesity suppresses sarcolipin‐induced sarcoplasmic reticulum calcium ATPase (SERCA) activation, resulting in reduced oxidative capacity, diminished energy expenditure, and increased adiposity. In the hypothalamus, obesity and overnutrition impair insulin and leptin signalling. This blunts central satiety signals, favouring a shift in energy balance toward energy conservation and body fat retention. Moreover, both obese animals and humans demonstrate impaired dopaminergic signalling and diminished responses to nutrient intake in the striatum, which tend to persist after weight loss. This may result in enduring inclinations toward overeating and a sedentary lifestyle. Collectively, the tissue adaptations described pose significant challenges to effectively achieving and sustaining weight loss in obesity. [ABSTRACT FROM AUTHOR]

Background: Recent guidelines, supported by large, well-designed studies, suggest that bariatric surgery is a safe and effective treatment for adolescents living with severe obesity to improve health and psychosocial functioning. The aim of this study was to assess the opinions and referral practices of general practitioners (GPs) and paediatricians in Ireland. Methods: A cross-sectional survey was circulated online to practising paediatricians and GPs. The survey consisted of a short introduction about childhood obesity and 12 questions on adolescent bariatric surgery and obesity medications. Results: There were 45 unique responses to the survey from 22 GPs (48%), 8 paediatricians (17%), and 15 others. Most GPs (72%) would not consider referring an adolescent for bariatric surgery. Paediatricians were significantly more likely to refer (72% vs. 28%, p = 0.034). A minimum BMI of 40 kg/m2 was the most common response, which GPs (45%) and paediatricians (37.5%) suggested should be a pre-requisite for surgery. There was strong support for family psychological assessment and a reported deficit in the community support needed to manage obesity. GPs were more likely than paediatricians to respond that anti-obesity medications should be made available to adolescents, specifically liraglutide (45% vs. 25%), semaglutide (45% vs. 37.5%), and orlistat (22% vs. 0%). Discussion: There is a reluctance among GPs to refer adolescents with severe obesity for consideration of bariatric surgery. Concerns regarding the different obesity treatments held by medical professionals should be addressed through education and engagement and should be fundamental to the development of child and adolescent obesity services. [ABSTRACT FROM AUTHOR]

Background/Objectives: ACTION-FRANCE (Awareness, Care, and Treatment In Obesity maNagement in France) aims to identify the perceptions, attitudes, behaviors, and potential barriers to effective obesity management in France and guide collaborative actions. Methods: ACTION-FRANCE is a cross-sectional survey of people with obesity (PwO) and healthcare professionals (HCPs) in France. The PwO and HCP survey questionnaire periods ran from 27 September 2022 to 1 February 2023 and from 19 December 2022 to 31 March 2023, respectively. Results: The study, encompassing 1226 PwO and 166 HCPs, reveals a shared recognition of obesity as a chronic condition. However, despite being requested by most PwO, weight-related discussions are surprisingly infrequent, leading to delayed diagnosis and care. PwO and HCPs held different views as to why: HCPs often attributed it to PwO's lack of motivation or disinterest, whereas PwO avoided them because they felt weight management was their own responsibility and were uncomfortable discussing it. When weight was discussed, primarily with general practitioners (GPs), discussions mostly focused on physical activity and diet. However, results identified the strong psychosocial impact of obesity: 42% of respondents reported anxiety/depressive symptoms, and many more hesitated to engage in certain social activities because of their weight. Psychotherapy was only discussed by 55% of HCPs. Pharmaceutical options were also rarely discussed (19.5% of HCPs), though 56.1% of PwO reported they would want to. Conclusions: HCPs' and PwO's perceptions differed significantly and need to converge through enhanced communication. A holistic approach, integrating comprehensive training for GPs and recognizing psychological comorbidities, would help to bridge perceptual gaps effectively and foster more empathetic and effective patient care. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Clinical Healthcare is the property of Chinese Journal of Clinical Healthcare and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Obesity management can effectively reduce the risks and complications associated with obesity and improve the quality of life of patients. After assessing the advantages and limitations of various obesity management approaches, self-management has been strongly recommended due to the advantages of minimal side effects and lower costs compared to treatment via drugs and surgery. However, successfully implementing lifestyle intervention strategies requires scientific guidance and strong determination. With the development of electronic and information technology, lifestyle intervention has transformed considerably. A new concept, called Gamified Digital Therapeutics (GDTx), represents a gaming format with Digital Therapeutics (DTx). It can effectively enhance patient compliance and accessibility to chronic disease management. Here, we review recent studies on the application of GDTx for the self-management of obesity and discuss three aspects surrounding its completion rates, satisfaction levels, and effectiveness. In contrast to traditional approaches to obesity self-management, implementing GDTx effectively corrects unhealthy dietary and lifestyle habits, markedly enhancing the dissemination of nutritional and exercise-related health knowledge. Of particular significance is the evident improvement in the adherence of obese patients to weight loss programs. Despite numerous studies indicating that GDTx may offer an effective solution for obesity self-management, there are still several limitations in the medicalization of GDTx for self-management of obesity. This review aimed to provide a reference for subsequent studies and promote the widespread application of GDTx in obesity self-management to help reduce the obesity rate and alleviate the burden on obese patients.

Abstract The global obesity problem is becoming increasingly serious, with eight of the top ten causes of death in Taiwan in 2020 being related to obesity. Morbid obesity poses a significant threat to one’s health and well-being. In recent years, bariatric surgery has emerged as a more effective treatment option for patients with morbid obesity. However, the procedure is not without risks. This study aims to examine the factors that impact the postoperative efficacy evaluation of patients with morbid obesity. This study uses a retrospective cross-sectional design, with medical records being collected retrospectively. The data was collected from patients who underwent bariatric surgery between July 1, 2017 and June 30, 2020 at a hospital in southern Taiwan. A total of 663 patients were included in the study and were observed for 1 year after the surgery. The independent variables included demographic variables, perceived symptoms variables, perceived lifestyle variables, and surgery-related variables, while the dependent variables included weight loss outcomes and complications. The prognostic factors affecting the postoperative efficacy evaluation of patients with pathological obesity were determined using multiple regression analysis and binary regression analysis. The study found that 65.6% of the participants were female, with an average age of 36.8 years. The results of the multiple regression and binary logistic regression showed that gender, age, BMI, diabetes, and smoking habit were the predictors of postoperative weight loss. Hypertension, diabetes, liver disease, kidney disease, smoking habit, drinking habit, and operation time were the predictors of postoperative complications. The study found that the presence of the aforementioned 12 significant factors can affect the success of weight loss after surgery and the incidence of postoperative complications. This information can serve as a reference for clinical care institutions and patients to improve the postoperative efficacy evaluation.

Abstract Family-based obesity management interventions targeting child, adolescent and parental lifestyle behaviour modifications have shown promising results. Further intervening on the family system may lead to greater improvements in obesity management outcomes due to the broader focus on family patterns and dynamics that shape behaviours and health. This review aimed to summarize the scope of pediatric obesity management interventions informed by family systems theory (FST). Medline, Embase, CINAHL and PsycInfo were searched for articles where FST was used to inform pediatric obesity management interventions published from January 1980 to October 2023. After removal of duplicates, 6053 records were screened to determine eligibility. Data were extracted from 50 articles which met inclusion criteria; these described 27 unique FST-informed interventions. Most interventions targeted adolescents (44%), were delivered in outpatient hospital settings (37%), and were delivered in person (81%) using group session modalities (44%). Professionals most often involved were dieticians and nutritionists (48%). We identified 11 FST-related concepts that guided intervention components, including parenting skills, family communication, and social/family support. Among included studies, 33 reported intervention effects on at least one outcome, including body mass index (BMI) (n = 24), lifestyle behaviours (physical activity, diet, and sedentary behaviours) (n = 18), mental health (n = 12), FST-related outcomes (n = 10), and other outcomes (e.g., adiposity, cardiometabolic health) (n = 18). BMI generally improved following interventions, however studies relied on a variety of comparison groups to evaluate intervention effects. This scoping review synthesises the characteristics and breadth of existing FST-informed pediatric obesity management interventions and provides considerations for future practice and research.

Abstract Purpose The objective of the study was to assess whether the history of psychiatric treatment was associated with (1) body weight and BMI on admission for bariatric surgery, (2) weight loss > 5 kg prior to bariatric surgery, and (3) postoperative body weight reduction. Methods Data from medical records of all consecutive patients admitted for surgical treatment of obesity in the 2nd Department of General Surgery Jagiellonian University Medical College were obtained. There were 1452 records of patients who underwent bariatric surgery between 2009 and 2021 included in the study. Results History of psychiatric treatment was found in 177 (12%) of the sample and was inversely associated with body weight and BMI on admission for surgery in women. Men with history of psychiatric treatment were 54% less likely to lose > 5 kg before the surgery (OR = 0.46 95% CI = 0.24–0.88). Both in men and women %TWL did not differ significantly by history of psychiatric treatment (Me: 40.7 vs. 45.9; p = 0.130 and Me: 27.0 vs. 23.9; p = 0.383, respectively). After adjustment for covariates no association was found between history of psychiatric treatment and body weight reduction one year after surgery. Conclusion Although men with preoperative history of psychiatric treatment had lower odds of losing weight before the surgery, psychiatric treatment did not differentiate the effectiveness of bariatric treatment in 1 year of observation. Bariatric surgery appears to be an effective obesity care for people treated for mental disorders. Level of evidence: III Evidence obtained from cohort or case-control analytic studies.

Background: Given the evolving nature of obesity medicine, periodic evaluation of its clinical practice is needed to ensure that certification requirements address real-world experience. Practice analysis is a systematic approach to define a field's body of knowledge, and its results can inform the content outline and examination blueprint for a certification examination. This study describes the 2023 practice analysis conducted by the American Board of Obesity Medicine (ABOM). Methods: Initially, 14 obesity medicine physicians participated in a practice analysis panel, resulting in 3 duties and 30 tasks required for competent practice of obesity medicine physicians. Each task included steps, knowledge, skills, and abilities needed to perform the task. ABOM then recruited 645 certified obesity medicine physicians from its database to participate in a validation survey to rate the frequency [scale: never (0) to very frequently (5)] and importance [scale: not important (0) to very important (3)] of each task. Survey participants could also provide open-ended comments. Results: Among validation survey participants (n = 645), the most common primary medical specialties reported were internal medicine (46.0 %), family medicine (33.8 %), and pediatrics (11.2 %). Years practicing obesity medicine varied with 45.3 % reporting 1–4 years, 26.0 % 5–9 years, and 28.7 % ≥ 10 years in practice. Most tasks were performed frequently (mean score ≥4.0) and rated as important (mean score ≥2.0). All tasks were retained based on the frequency and importance ratings. Survey results informed the weighting in the examination blueprint. Conclusion: There was consensus among practicing ABOM-certified physicians who participated in the validation survey in the tasks required for competent obesity medicine practice. Our practice analysis approach was a structured process that engaged obesity medicine physicians and captured the breadth and depth of knowledge required for obesity medicine. The new content outline and examination blueprint developed will be implemented with the 2025 ABOM certification exam administration.

Background: During the COVID-19 pandemic, weight loss programs rapidly transitioned to a virtual model, replacing in-person clinic visits. We sought to compare the observed weight loss and adherence to treatment between patients referred for intensive behavioral therapy (IBT) who were treated via telemedicine and those treated in person. Methods: After IRB approval, we conducted a retrospective observational study of patients referred for clinical bariatric IBT between January 2019 and June 2021 who were followed in person or via telemedicine. The primary endpoint was the percentage of excess BMI loss (EBL%); secondary endpoints included treatment adherence, duration of follow-up, and number of completed visits. Results: During the study period, 139 patients were seen for at least one IBT session for weight management: 62 were followed up in person (IP) and 77 via telemedicine (TM). The mean age, baseline BMI, and follow-up duration between the groups were similar. In the IP and TM groups, the EBL% was −24.7 ± 24.7 and −22.7 ± 19.5 (P = 0.989) and loss to follow-up after the first visit was 27.4% and 19.5% (P = 0.269), respectively. Conclusion: For the management of obesity, weight loss programs delivered via telemedicine can achieve similar outcomes to those provided via classical in-person visits. This study suggests that the integration of telecare into clinical practice in bariatric medicine should be considered in the future. Emerging technologies may allow adequate patient follow-up in multiple scenarios, specifically non-critical chronic disorders, and bring unanticipated benefits for patients and healthcare providers.

The global obesity problem is becoming increasingly serious, with eight of the top ten causes of death in Taiwan in 2020 being related to obesity. Morbid obesity poses a significant threat to one’s health and well-being. In recent years, bariatric surgery has emerged as a more effective treatment option for patients with morbid obesity. However, the procedure is not without risks. This study aims to examine the factors that impact the postoperative efficacy evaluation of patients with morbid obesity. This study uses a retrospective cross-sectional design, with medical records being collected retrospectively. The data was collected from patients who underwent bariatric surgery between July 1, 2017 and June 30, 2020 at a hospital in southern Taiwan. A total of 663 patients were included in the study and were observed for 1 year after the surgery. The independent variables included demographic variables, perceived symptoms variables, perceived lifestyle variables, and surgery-related variables, while the dependent variables included weight loss outcomes and complications. The prognostic factors affecting the postoperative efficacy evaluation of patients with pathological obesity were determined using multiple regression analysis and binary regression analysis. The study found that 65.6% of the participants were female, with an average age of 36.8 years. The results of the multiple regression and binary logistic regression showed that gender, age, BMI, diabetes, and smoking habit were the predictors of postoperative weight loss. Hypertension, diabetes, liver disease, kidney disease, smoking habit, drinking habit, and operation time were the predictors of postoperative complications. The study found that the presence of the aforementioned 12 significant factors can affect the success of weight loss after surgery and the incidence of postoperative complications. This information can serve as a reference for clinical care institutions and patients to improve the postoperative efficacy evaluation. [ABSTRACT FROM AUTHOR]

Introduction: Obesity affects approximately 20% of U.S. youth. Anti-obesity medications (AOMs) are promising lifestyle modification adjuncts for obesity treatment, and topiramate is commonly prescribed in pediatric weight management clinics. It is important to determine "real-world" effectiveness of AOMs and, given shifts towards personalized approaches, characteristics potentially predicting better or worse response. We therefore sought to describe clinical effectiveness from topiramate plus lifestyle modification, and to determine if baseline phenotypic characteristics are associated with better or worse response. Methods: We performed a retrospective cohort study (2012-2020) among youth (<18 years old) followed in a U.S. academic-based weight management clinic. Baseline characteristics (i.e., body mass index (BMI), liver function tests, eatingrelated behaviors) and outcomes (%BMI of 95th percentile (%BMIp95), BMI, percent %BMI change, weight) were determined through review of electronic health records and clinic intake survey data. Results: Among 282 youth prescribed topiramate plus lifestyle modifications (mean baseline age 12.7 years, %BMIp95 144%), %BMIp95 and percent BMI change were statistically significantly reduced at each time point (1.5-, 3-, 6-, and 12-month %BMIp95 reductions: -2.2, -3.9, -6.6, and -9.3 percentage points, respectively; percent BMI reduction: -1.2%, -1.9%, -3.2%, and -3.4%, respectively; all p<0.01). Considering multiple comparisons, no baseline characteristics statistically significantly predicted response at any time point. Conclusions: We found that topiramate plus lifestyle modification reduced % BMIp95 and BMI among youth in a weight management clinical setting, and that no baseline characteristics evaluated were associated with response. These results should be considered preliminary given the observational nature of this study, and prospective studies are needed to further characterize clinical effectiveness and identify and confirm potential predictors of response. [ABSTRACT FROM AUTHOR]

Introduction: obesity is an important public health problem worldwide. It is believed that obese candidates for bariatric surgery present cardiac autonomic dysfunction and that weight reduction achieved through surgical treatment of obesity may promote improvement in autonomic nervous system activity, minimizing cardiovascular risks. Objective: thus, the objective of this study is to assess the impact of surgical bariatric weight reduction on HRV and on anthropometric measurements (BMI, WHtR, and WC) comparing obesity classes II and III. Method: the study included 25 obese individuals who underwent a preoperative assessment. Anthropometric measurements and heart rate varability (HRV) were collected preoperatively. The participants were then divided into two groups: obesity class II and obesity class III (class II: BMI from 35 to 39 k/m2, and class III: BMI from > 40 kg/m2). Thirty days after surgery, a postoperative assessment was performed and the data were compared. Results: our results confirm that both class II and III obesity groups presented altered HRV preoperatively and that the participants in the obesity II group showed a statistically significant increase in the HRV index when compared to the obesity III group, through the mean RR, PNN50, SNS, and stress index. Conclusion: the findings confirmed the important contribution that bariatric surgery makes to improving metabolic health and lowering important obesity indices. The varying alterations in heart rate variability indicate subtle advantages concerning autonomic function, especially for individuals classified as obese II. [ABSTRACT FROM AUTHOR]

Introduction: The differences in the prevalence of obesity between the various regions of Spain, partly attributed to socioeconomic differences, may influence the approach to this disease. The aim of this study was to compare differences in attitudes, perception, and barriers to the treatment of obesity between people with obesity (PwO) and health care professionals (HCPs), between the different regions of Spain. Methods: Sub-analysis of the ACTION-IO Spain study, which included 1,500 PwO and 306 HCP, was performed to identify differences in PwQ and HCPs belonging to regions with high prevalence of obesity (>16%, n = 9 regions, high prevalence of obesity [HPO] group) and low prevalence of obesity (<16%, n = 8 regions, low prevalence of obesity [LPO] group) (self-reported data), according to the 2017 National Health Survey of Spain. Statistics: comparison of proportions (χ2). Results: A total of 746 PwO belonged to HPO and 754 to LPO group. The PwO in HPO group were younger, had lower income, a lower level of higher education, higher unemployment rate, and fewer comorbidities. Obesity was considered a chronic disease to a higher extent in HPO compared to LPO group (62 vs. 56%), but this difference was not statistically significant. The PwO in HPO group discussed less with the HCPs about their excess weight (57 vs. 70%), did not feel motivated to lose weight in a higher percentage (26 vs. 18%), and felt less emotionally supported (16 vs. 24%). In HPO group, the preference for unhealthy food (51 vs. 36%), and the costs of healthy eating, anti-obesity drugs and bariatric surgery were perceived barriers to losing weight. A higher proportion of PwO in HPO group considered that exercise (58 vs. 40%) was more effective for achieving weight loss. In contrast, LPO group considered diet more effective (48 vs. 32%). HCPs in HPO group felt more motivated to treat obesity (83 vs. 68%) and a higher proportion (14 vs. 5%) identified the economic burden as one of the main reasons why PwO do not start conversations to lose weight. Conclusions: There is less concern and conversation about excess weight in PwO in regions with a higher prevalence of obesity, with socioeconomic limitations being one of the main perceived barriers to treatment. [ABSTRACT FROM AUTHOR]

Aims: To identify and better understand themes related to why people living with obesity (PwO) in Canada may not use professional support and to explore potential strategies to address the challenges. Methods: One‐on‐one interviews and online surveys, informed by the Theoretical Domains Framework, were conducted. A total of 20 PwO were interviewed and a separate group of 200 PwO were surveyed. Results from the interviews guided the development of the survey. Spearman's correlation analysis was performed to investigate the association between the theme domain scores of the PwO and their prior experience with obesity management strategies. Results: The 200 PwO surveyed provided representation across Canada and were diverse in age, background and gender. The most prominent domains associated with use of professional support by PwO were: Intention (rs = −0.25; p < 0.01); Social/Professional Role and Identity (rs = −0.15; p < 0.05); and Optimism (rs = −0.15; p < 0.05). For example, PwO without professional support less often reported being transparent in obesity discussions, perceived obesity to be part of their identity, and expected to manage the illness long term. Many PwO hesitated to use various adjunctive therapies due to concerns about affordability, long‐term effectiveness, and side effects. Conclusion: This study identified contextual, perception and resource considerations that contribute to healthcare decision‐making and the use by PwO of professional support to manage obesity, and highlighted key areas to target with interventions to facilitate obesity management. Strategies such as consistent access to healthcare support and educational resources, as well as improved financial support may help PwO to feel more comfortable with exploring new strategies and take control of their healthcare. [ABSTRACT FROM AUTHOR]

Summary: Obesity is a chronic and complex disease affecting millions of people worldwide. Currently, there is no standard definition of success for the management of obesity. We set out to complete a synthesis of clinical practice guidelines for obesity management for adult populations, aiming to provide both a quantitative descriptive and qualitative analysis of definitions of success in clinical practice guidelines. An electronic search retrieved 4477 references. Sixteen clinical practice guidelines were included after screening and full‐text review. We coded definitions of success 147 times across the included guidelines. No standard or explicit definition of success was identified in the guidelines but rather success was implicitly defined. We developed three themes describing how success was defined in the clinical practice guidelines: Knowledge‐based decision making; management of expectations; and the perception of control. The review reinforced that success is an inherently subjective and complex concept. Defining success is limited by existing studies that focus on weight loss and would benefit from additional research on different outcomes. Equally, the relationship between people living with obesity and their clinicians should be further explored to understand how defining success is controlled, discussed and framed in a clinical setting. [ABSTRACT FROM AUTHOR]

Family-based obesity management interventions targeting child, adolescent and parental lifestyle behaviour modifications have shown promising results. Further intervening on the family system may lead to greater improvements in obesity management outcomes due to the broader focus on family patterns and dynamics that shape behaviours and health. This review aimed to summarize the scope of pediatric obesity management interventions informed by family systems theory (FST). Medline, Embase, CINAHL and PsycInfo were searched for articles where FST was used to inform pediatric obesity management interventions published from January 1980 to October 2023. After removal of duplicates, 6053 records were screened to determine eligibility. Data were extracted from 50 articles which met inclusion criteria; these described 27 unique FST-informed interventions. Most interventions targeted adolescents (44%), were delivered in outpatient hospital settings (37%), and were delivered in person (81%) using group session modalities (44%). Professionals most often involved were dieticians and nutritionists (48%). We identified 11 FST-related concepts that guided intervention components, including parenting skills, family communication, and social/family support. Among included studies, 33 reported intervention effects on at least one outcome, including body mass index (BMI) (n = 24), lifestyle behaviours (physical activity, diet, and sedentary behaviours) (n = 18), mental health (n = 12), FST-related outcomes (n = 10), and other outcomes (e.g., adiposity, cardiometabolic health) (n = 18). BMI generally improved following interventions, however studies relied on a variety of comparison groups to evaluate intervention effects. This scoping review synthesises the characteristics and breadth of existing FST-informed pediatric obesity management interventions and provides considerations for future practice and research. [ABSTRACT FROM AUTHOR]

Purpose: The objective of the study was to assess whether the history of psychiatric treatment was associated with (1) body weight and BMI on admission for bariatric surgery, (2) weight loss > 5 kg prior to bariatric surgery, and (3) postoperative body weight reduction. Methods: Data from medical records of all consecutive patients admitted for surgical treatment of obesity in the 2nd Department of General Surgery Jagiellonian University Medical College were obtained. There were 1452 records of patients who underwent bariatric surgery between 2009 and 2021 included in the study. Results: History of psychiatric treatment was found in 177 (12%) of the sample and was inversely associated with body weight and BMI on admission for surgery in women. Men with history of psychiatric treatment were 54% less likely to lose > 5 kg before the surgery (OR = 0.46 95% CI = 0.24–0.88). Both in men and women %TWL did not differ significantly by history of psychiatric treatment (Me: 40.7 vs. 45.9; p = 0.130 and Me: 27.0 vs. 23.9; p = 0.383, respectively). After adjustment for covariates no association was found between history of psychiatric treatment and body weight reduction one year after surgery. Conclusion: Although men with preoperative history of psychiatric treatment had lower odds of losing weight before the surgery, psychiatric treatment did not differentiate the effectiveness of bariatric treatment in 1 year of observation. Bariatric surgery appears to be an effective obesity care for people treated for mental disorders. Level of evidence: III Evidence obtained from cohort or case-control analytic studies. [ABSTRACT FROM AUTHOR]

Aim: The effects of weight loss with a partial or total meal replacement programme (MRP) on atherosclerotic cardiovascular disease (ASCVD) risk factors are not fully understood, in particular in people at higher CV risk. In the 52‐week randomized controlled OPTIWIN study in men and women with obesity, meal replacement programme (total for first 26 weeks, partial for the ensuing 26 weeks) with OPTIFAST (OP) resulted in significantly greater weight loss compared with a low‐calorie food‐based (FB) dietary plan, both as part of a comprehensive lifestyle intervention [OP (n = 135)/FB (n = 138) week 26: −12.4%/−6.0%, p <.001; week 52: −10.5%/−5.5%, p <.001]. Here, we examined effects on ASCVD risk factors and 10‐year ASCVD risk. Materials and Methods: Participants with body mass index 30‐55 kg/m2 and age 18‐70 years, and not on anti‐obesity medications, were recruited. The effects on systolic and diastolic blood pressure (SBP, DBP), lipid parameters and 10‐year ASCVD risk were analysed as changes over time using linear mixed models. Subgroup analyses were conducted for changes in SBP, DBP and ASCVD risk by categories of age (<40, 40‐59, ≥60 years), baseline SBP (

Introduction: The management of obesity should be conducted primarily by modifying the lifestyle (diet and physical activity), however if successive failures occur in this first option, one can use slimming drugs as a complementary therapy to the previous one. of this study is to compare nutritional and drug treatment between obese patients using or not using antiobesity drugs. Materials and methods: This is a quantitative, exploratory, and descriptive field research carried out from April to May 2023. Obese patients were divided into two groups, namely: Group A: Dietary intervention and Group B: use of medication anti-obesity in terms of anthropometric and qualitative variables. Paired t tests and descriptive statistics were applied with a significance of p<0.05. Results and discussion: When comparing the anthropometric results between the groups, it was seen that B had more expressive results in all parameters, however some factors interfered in the accuracy of this result, including the period of data collection and the divergence in the time interval of the consultations between groups. Conclusion: Therefore, the effectiveness of the drugs and the diet was verified, since both groups lost weight, however, larger and longer trials are needed in order to have a more comprehensive representation of the results found. In addition, more robust research, in sample and time, can more accurately determine whether the benefits outweigh the risks in the long term and whether there is weight regain after weaning from medications. [ABSTRACT FROM AUTHOR]

Diet is a modifiable risk factor in the prevention and management of obesity, and various foods have the potential to aid in obesity management by modulating different pathways involved in the disease's pathology. We performed a systematic review of literature, using CINAHL, PubMed, and Google Scholar, focusing on the antiobesity potential of foods crops and functional food products, and their mechanisms of action and clinical evidence. Sixty‐four articles were identified, of which 41 investigated food crops, while 23 investigated functional products. Food crops, such as cereals, vegetables, fruits, mushrooms, seaweeds, legumes, herbs, spices, and cocoa seeds, have antiobesity effects through mechanisms such as altering the metabolism of glucolipids by inhibiting enzymes like α‐amylase and α‐glucosidase, stimulating the bioenergetics of thermogenic fat, modulating gut microbiota, and inhibiting lipogenesis and storage. In addition, developed functional teas, beverages, and yoghurt have antiobesity effects through similar or different mechanisms, such as enhancing energy expenditure and satiety, suppressing adipogenesis and lipolysis, improving glucose and lipid metabolism, and altering hormonal secretion. This review reemphasized the significance of food in the control of obesity, and highlights the distinct methods these explored foods exert their antiobesity effects. In conclusion, foods are safe and effective means of combating obesity without the side effects of conventional drugs, which can help inform dietary choices, assist professionals in providing more accurate advice, and also lead to better understanding of food and its effect on overall health of the public. This approach will eradicate global diseases, especially if more underutilized and indigenous food crops are extensively researched. [ABSTRACT FROM AUTHOR]

Obesity, a multifactorial, relapsing chronic disease, serves as a gateway to a spectrum of metabolic, cardiovascular, mechanical and mental health problems. Over the last few decades, the global prevalence of obesity has surged nearly threefold, mirroring the escalating rates of type 2 diabetes mellitus (T2DM). This parallel trajectory strongly suggests a cause-and-effect relationship between obesity and T2DM. Extensive research indicates that even modest weight gain elevates the risk of T2DM, favoring the notion of obesity being a root cause. This perspective finds robust support in numerous studies demonstrating the preventive effects of obesity management on the onset of T2DM. Beyond prevention, obesity management has been shown to enhance remission in individuals with T2DM and to decrease microvascular complications, cardiovascular risk factors, renal failure and heart failure. This evidence underpins the urgent need for global initiatives aimed at addressing obesity management as a key strategy in the prevention and management of T2DM and its complications. [ABSTRACT FROM AUTHOR]

Introduction: The present study aimed to investigate whether and how normobaric intermittent hypoxic training (IHT) or remote ischemic preconditioning (RIPC) plus normoxic training (RNT) has a synergistic protective effect on lipid metabolism and vascular function compared with normoxic training (NT) in overweight or obese adults. Methods: A total of 37 overweight or obese adults (36.03 ± 10.48 years) were randomly assigned to 3 groups: NT group (exercise intervention in normoxia), IHT group (exercise intervention in normobaric hypoxic chamber), and RNT group (exercise intervention in normoxia + RIPC twice daily). All participants carried out the same 1-h exercise intervention for a total of 4 weeks, 5 days per week. Physical fitness parameters were evaluated at pre- and postexercise intervention. Results: After training, all three groups had a significantly decreased body mass index (p < 0.05). The IHT group had reduced body fat percentage, visceral fat mass (p < 0.05), blood pressure (p < 0.01), left ankle-brachial index (ABI), maximal heart rate (HRmax) (p < 0.05), expression of peroxisome proliferator-activated receptor-γ (PPARγ) (p < 0.01) and increased expression of SIRT1 (p < 0.05), VEGF (p < 0.01). The RNT group had lowered waist-to-hip ratio, visceral fat mass, blood pressure (p < 0.05), and HRmax (p < 0.01). Conclusion: IHT could effectively reduce visceral fat mass and improve vascular elasticity in overweight or obese individuals than pure NT with the activation of SIRT1-related pathways. And RNT also produced similar benefits on body composition and vascular function, which were weaker than those of IHT but stronger than NT. Given the convenience and economy of RNT, both intermittent hypoxic and ischemic training have the potential to be successful health promotion strategies for the overweight/obese population. [ABSTRACT FROM AUTHOR]

Introduction: The present study aimed to investigate whether and how normobaric intermittent hypoxic training (IHT) or remote ischemic preconditioning (RIPC) plus normoxic training (RNT) has a synergistic protective effect on lipid metabolism and vascular function compared with normoxic training (NT) in overweight or obese adults. Methods: A total of 37 overweight or obese adults (36.03 ± 10.48 years) were randomly assigned to 3 groups: NT group (exercise intervention in normoxia), IHT group (exercise intervention in normobaric hypoxic chamber), and RNT group (exercise intervention in normoxia + RIPC twice daily). All participants carried out the same 1-h exercise intervention for a total of 4 weeks, 5 days per week. Physical fitness parameters were evaluated at pre- and postexercise intervention. Results: After training, all three groups had a significantly decreased body mass index (p < 0.05). The IHT group had reduced body fat percentage, visceral fat mass (p < 0.05), blood pressure (p < 0.01), left ankle-brachial index (ABI), maximal heart rate (HRmax) (p < 0.05), expression of peroxisome proliferator-activated receptor-γ (PPARγ) (p < 0.01) and increased expression of SIRT1 (p < 0.05), VEGF (p < 0.01). The RNT group had lowered waist-to-hip ratio, visceral fat mass, blood pressure (p < 0.05), and HRmax (p < 0.01). Conclusion: IHT could effectively reduce visceral fat mass and improve vascular elasticity in overweight or obese individuals than pure NT with the activation of SIRT1-related pathways. And RNT also produced similar benefits on body composition and vascular function, which were weaker than those of IHT but stronger than NT. Given the convenience and economy of RNT, both intermittent hypoxic and ischemic training have the potential to be successful health promotion strategies for the overweight/obese population.