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Pursuing a self-regulatory goal, such as weight loss, motivates consumers to forego pleasure seeking, typically by selecting virtue over vice. We propose that in the absence of virtuous options, consumers with a self-regulatory goal will instead choose less variety in choice sets of exclusively vice options because the extra pleasure that variety affords seems incompatible with the goal. We find converging evidence for the decrease in variety seeking in vice categories across five studies (and three supplementary studies in the web appendix , N  = 6,066), using both scenario-based and actual consumption contexts. We also demonstrate the underlying process: consumers are motivated to curtail pleasure seeking when pursuing a weight-loss goal and that leads them to choose less variety in vice categories when there is no virtue alternative available. [ABSTRACT FROM AUTHOR]

This mixed methods study aimed to investigate weight cutting practices of female taekwon-do athletes internationally and explore their experiences of "making weight." A survey of weight loss practices and eating behaviors was completed by 103 taekwon-do athletes from 12 countries, which illustrated that 72.5% of athletes engage in both acute and chronic weight loss practices prior to competition and that there were higher levels of disordered eating within this athletic population than nonweight cutting athletes. Semistructured interviews were conducted with five international-level competitors; thematic analysis of the interviews identified that the women in general felt weight cutting was "horrible—but worth it" and the women believed that (a) weight cutting is unpleasant, difficult, and challenging; and (b) weight cutting provides a competitive advantage. The implications of this study are that weight cutting is widespread among high-level competitive female taekwon-do athletes and this is unlikely to change given the perceived advantages. Efforts are needed to make sure that the women are knowledgeable of the risks and are provided with safe and effective means of making weight. [ABSTRACT FROM AUTHOR]

PURPOSE: We investigated the effect of metformin and lifestyle intervention on metabolic, inflammatory, and steroid biomarkers of breast cancer (BC) recurrence risk in two intervention trials among BC survivors with overweight or obesity. METHODS: Baseline and follow-up serum samples collected during the two trials were analyzed and data pooled. The USA trial (Reach for Health) included postmenopausal BC survivors (n = 333) randomly assigned to 6-month metformin vs placebo and lifestyle intervention (LSI) vs control (2 × 2 factorial design). The Italian trial (MetBreCS) included BC survivors (n = 40) randomized to 12-month metformin vs placebo. Insulin resistance (HOMA-IR), adipokines, cytokines, and steroids were measured. RESULTS: Metformin compared to placebo showed a favorable decrease in leptin (- 8.8 vs - 3.5 ng/mL; p

Weight change trajectory from diet and lifestyle interventions typically involves rapid weight loss followed by a weight plateau after approximately 6 months. Changing from one weight-loss diet to another at the time of the plateau could instigate renewed weight loss. Therefore, our secondary analysis aimed to assess trajectory of weight loss in a 12-month, randomized, cross-over study. Forty-two adults were randomized to eat a healthy low-fat or healthy low-carbohydrate diet for 6 months then switched to the opposite diet for an additional 6 months. Regardless of diet assignment, participants experienced rapid initial weight loss, which slowed between 3 to 6 months. After switching diets at 6 months, weight modestly decreased until 9 months, but at a rate slower than the initial 3 months and slower than the rate from 3 to 6 months. This suggests that the weight loss plateau typically seen at 6 months is physiological and cannot be overcome by simply switching to a different weight-loss diet.

Circulating levels of the soluble ligand-binding ectodomain of the LDL receptor (sLDLR) that is proteolytically cleaved from the cell surface have been shown to correlate with plasma triglycerides, but the lipid and lipoprotein effects of longitudinal changes in sLDLR have not been examined. We sought to assess associations between changes in sLDLR and detailed lipoprotein measurements between baseline and 6 months in participants in the DIETFITS (Diet Intervention Examining The Factors Interacting with Treatment Success) weight loss trial who were randomly assigned to the low-fat (n = 225) or low-carbohydrate (n = 236) diet arms. sLDLR was assayed using a proteomic procedure, lipids and apoprotein (apo) B and apoAI were measured by standard assays, and lipoprotein particle subfractions were quantified by ion mobility methodology. Changes in sLDLR were significantly positively associated with changes in plasma cholesterol, triglycerides, apoB, large-sized and medium-sized VLDL, and small and very small LDL, and inversely with changes in large LDL and HDL. The lipoprotein subfraction associations with sLDLR were independent of age, sex, diet, and BMI, but all except for large LDL were reduced to insignificance when adjusted for triglyceride change. Principal component analysis identified three independent clusters of changes in lipoprotein subfractions that accounted for 78% of their total variance. Change in sLDLR was most strongly correlated with change in the principal component that was loaded positively with large VLDL and small and very small LDL and negatively with large LDL and HDL. In conclusion, sLDLR is a component of a cluster of lipids and lipoproteins that are characteristic of atherogenic dyslipidemia.

INTRODUCTION: The University of California (UC) implemented the Diabetes Prevention Program (DPP) to address diabetes and obesity risk. This project examined the reach and effectiveness of this university-based DPP delivery approach. METHODS: This project compared 12-month weight change among three groups of UC beneficiaries with overweight/obesity: (1) those who received invitation letters and enrolled in UC DPP, (2) those mailed invitation letters but did not enroll, and (3) those who were not mailed letters and did not enroll (controls). Using 2012-2022 EHR, administrative and DPP cohort data, an interrupted time series was conducted in 2022-2023 to compare group differences in rate of weight change. RESULTS: Among 6,231 beneficiaries (132 UC DPP aware enrollees, 1,750 DPP aware non-enrollees, 4,349 controls), UC DPP enrollees were older (mean age 49), mostly women (76%), and more diverse (33% Asian, 8% Black, 20% Hispanic, 4% Multi/Other). Over 12 months of follow-up, UC DPP enrollee postenrollment rate of weight loss was -0.68 lbs./month. UC DPP enrollees had significantly greater weight change from pre- to post-enrollment than DPP aware non-enrollees (adjusted Δ-1.02 vs. Δ-0.07 lbs./month, difference= -0.95, p

ObjectivesWe characterize functional outcomes in head and neck cancer of unknown primary (CUP) based on primary site identification.MethodsIn this retrospective study, CUP cases were categorized as known primaries (KP) if a tumor was localized after diagnostic workup or persisting unknown primaries (UP). Age, sex, HPV status, diagnostic methods, and treatments regimens were collected. Pretreatment and short-term posttreatment (3-6 months after completion of treatment) weights, PHQ-9, Eating Assessment Tool (EAT-10), and Voice Handicap Index (VHI-10) scores were compared between UP and KP.ResultsAmong 67 CUP patients, 35 (52.2%) had identified primaries (91.4% oropharyngeal and 8.6% nasopharyngeal). KP patients were younger (58 vs. 64, p = 0.04) and more likely to be HPV-positive (88.6% vs. 50%, p = 0.002). Overall detection rates were 16.7% for PET/CT, 34.7% for direct laryngoscopy, and 46.6% for transoral robotic oropharyngectomy. Diagnostic workup was not significantly different between groups. Patients with KP received smaller intermediate radiation dose volumes (436.5 vs. 278.9 cc, p = 0.03) and lower doses to the cricopharyngeal muscle (41.6 vs. 24.6 Gy, p = 0.03).Pretreatment weights, PHQ-9, EAT-10, and VHI-10 scores did not differ between groups. However, posttreatment, UP had greater relative weight loss (-14.1% vs. -7.6%, p = 0.032), higher EAT-10 scores (12.5 vs. 3, p = 0.004), and higher PHQ-9 scores (6 vs. 1.4, p = 0.017). Specifically, UP reported more stressful swallowing, difficulty swallowing solids and pills, and swallowing affecting public eating.ConclusionKP patients experienced less weight loss, depression, and reduced swallowing dysfunction, highlighting an early functional benefit of primary tumor identification likely driven by reduced radiation treatment volumes.Level of evidence4 Laryngoscope, 134:701-707, 2024.

BackgroundObesity influences the development of osteoarthritis via low-grade inflammation. Progression of local inflammation (= synovitis) increased with weight gain in overweight and obese women compared to stable weight. Synovitis could be associated with subcutaneous fat (SCF) around the knee. Purpose of the study was to investigate the effect of weight loss on synovitis progression and to assess whether SCF around the knee mediates the relationship between weight loss and synovitis progression.MethodsWe included 234 overweight and obese participants (body mass index [BMI] ≥ 25 kg/m2) from the Osteoarthritis Initiative (OAI) with > 10% weight loss (n = 117) or stable overweight (

BackgroundEating a high-quality diet or adhering to a given dietary strategy may influence weight loss. However, these 2 factors have not been examined concurrently for those following macronutrient-limiting diets.ObjectiveTo determine whether improvement in dietary quality, change in dietary macronutrient composition, or the combination of these factors is associated with differential weight loss when following a healthy low-carbohydrate (HLC) or healthy low-fat (HLF) diet.DesignGenerally healthy adults were randomly assigned to HLC or HLF diets for 12 mo (n = 609) as part of a randomized controlled weight loss study. Participants with complete 24-h dietary recall data at baseline and 12-mo were included in this secondary analysis (total N = 448; N = 224 HLC, N = 224 HLF). Participants were divided into 4 subgroups according to 12-mo change in HEI-2010 score [above median = high quality (HQ) and below median = low quality (LQ)] and 12-mo change in macronutrient intake [below median = high adherence (HA) and above median = low adherence (LA) for net carbohydrate (g) or fat (g) for HLC and HLF, respectively]. Baseline to 12-mo changes in mean BMI were compared for those in HQ/HA, HQ/LA, LQ/HA subgroups with the LQ/LA subgroup within HLC and HLF.ResultsFor HLC, changes (95 % confidence level [CI]) in mean BMI were -1.15 kg/m2 (-2.04, -0.26) for HQ/HA, -0.30 (-1.22, 0.61) for HQ/LA, and -0.80 (-1.74, 0.14) for LQ/HA compared with the LQ/LA subgroup. For HLF, changes (95% CI) in mean BMI were -1.11kg/m2 (-2.10, -0.11) for HQ/HA, -0.26 (-1.26, 0.75) for HQ/LA, and -0.66 (-1.74, 0.41) for LQ/HA compared with the LQ/LA subgroup.ConclusionWithin both HLC and HLF diet arms, 12-mo decrease in BMI was significantly greater in HQ/HA subgroups relative to LQ/LA subgroups. Neither HQ nor HA alone were significantly different than LQ/LA subgroups. Results of this analysis support the combination of dietary adherence and high-quality diets for weight loss.Clinical trial registryclinicaltrials.gov (Identifier: NCT01826591).

Purpose: To evaluate the effect of bulb thickness on the weight of obturator prostheses and masticatory performance in edentulous hemimaxillectomy patients.Materials and Methods: A randomized, single-blind, three-period crossover trial was conducted with 17 edentulous patients. All patients were provided with three definitive 3D-printed obturator prostheses each. Obturators were divided into three groups: (1) group 1 (G1; 1-mm bulb); (2) group 2 (G2; 2-mm bulb); and (3) group 3 (G3; 3-mm bulb). After fabrication, the weight of each obturator was measured using a digital analytical balance. The patients used each obturator for a period of 2 weeks without a passive period (ie, they did not stop using the obturator). After using each obturator, masticatory function was evaluated with an adapted Sato questionnaire and the sieve test. Data were analyzed using one-way ANOVA and Pearson correlation analysis (α = .05).Results: According to the results of the Sato questionnaire and sieve test, G1 demonstrated the highest masticatory function scores (70.88 ± 9.39; 1.06 ± 0.06), while G3 exhibited the lowest scores (48.23 ± 7.69; 0.92 ± 0.05) (P < .001). The weight of the obturators was significantly different between groups (G1 = 31.58 ± 1.09 g; G2 = 33.99 ± 1.21 g; G3 = 36.57 ± 1.13 g) (P < .001). The correlation between masticatory function and the weight of the obturator was significant (P < .05).Conclusion: This study revealed that using 1-mm obturator bulb thickness was an effective fabrication method for improving masticatory function and reducing the weight of obturator prostheses in edentulous hemimaxillectomy patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: Obesity is a major threat to public health and traditional bariatric surgery continues to have low utilization. Endoscopic treatments for obesity have emerged that offer less risk, but questions remain regarding efficacy, durability, and safety. We compared the efficacy of endoscopic bariatric procedures as compared to other existing treatments. METHODS: A literature search of Embase, Cochrane Central, and Pubmed was conducted from January 1, 2014 to December 7, 2021, including endoscopic bariatric therapies that were FDA or CE approved at the time of search to non-endoscopic treatments. Thirty-seven studies involving 15,639 patients were included. Primary outcomes included % total body weight loss (%TBWL), % excess body weight loss (%EBWL), and adverse events. Secondary outcomes included quality of life data and differences in hemoglobin A1C levels. Strength of clinical trial and observational data were graded according to the Cochrane methods. RESULTS: Intragastric balloons achieved greater %TBWL with a range of 7.6-14.1% compared to 3.3-6.7% with lifestyle modification at 6 months, and 7.5-14.0% compared to 3.1-7.9%, respectively, at 12 months. When endoscopic sleeve gastroplasty (ESG) was compared to laparoscopic sleeve gastrectomy (LSG), ESG had less %TBWL at 4.7-14.4% compared to 18.8-26.5% after LSG at 6 months, and 4.5-18.6% as compared to 28.4-29.3%, respectively, at 12 months. For the AspireAssist, there was greater %TBWL with aspiration therapy compared to lifestyle modification at 12 months, 12.1-18.3% TBWL versus 3.5-5.9% TBWL, respectively. All endoscopic interventions had higher adverse events rates compared to lifestyle modification. CONCLUSION: This review is the first to evaluate various endoscopic bariatric therapies using only RCTs and observational studies for evaluation of weight loss compared with conservative management, lifestyle modification, and bariatric surgery. Endoscopic therapies result in greater weight loss compared to lifestyle modification, but not as much as bariatric surgery. Endoscopic therapies may be beneficial as an alternative to bariatric surgery.

Obesity is a chronic disease affecting over 670 million adults globally, with multiple complications including obstructive sleep apnea (OSA). Substantial weight loss in patients with obesity-related OSA can reduce or even eliminate OSA as well as reduce sleepiness and improve cardio-metabolic health. Evidence suggests that these improvements exceed those that occur with device-based OSA therapies like continuous positive airway pressure which continue to be the first-line of therapy. Resistance to weight management as a first-line strategy to combat OSA could arise from the complexities in delivering and maintaining adequate weight management, particularly in sleep clinic settings. Recently, incretin-based pharmacotherapies including glucagon-like peptide 1 (GLP-1) receptor agonists alone or combined with glucose-dependent insulinotropic polypeptide (GIP) receptor agonists have been developed to target glycemic control in type 2 diabetes. These medications also slow gastric emptying and reduce energy intake. In randomized, placebo-controlled trials of these medications in diabetic and non-diabetic populations with obesity, participants on active medication lost up to 20% of their body weight, with corresponding improvements in blood pressure, lipid levels, physical functioning, and fat mass loss. Their adverse effects are predominantly gastrointestinal-related, mild, and transient. There are trials currently underway within individuals with obesity-related OSA, with a focus on reduction in weight, OSA severity, and cardio-metabolic outcomes. These medications have the potential to substantially disrupt the management of OSA. Pending coming data, we will need to consider pharmacological weight loss as a first-line therapy and how that influences training and management guidelines.

BACKGROUND: New recommendations for the assessment of malnutrition and sarcopenia include body composition, specifically reduced muscle mass. Three-dimensional optical imaging (3DO) is a validated, accessible, and affordable alternative to dual X-ray absorptiometry (DXA). OBJECTIVE: Identify strengths and weaknesses of 3DO for identification of malnutrition in participants with low body mass index (BMI) and eating disorders. DESIGN: Participants were enrolled in the cross-sectional Shape Up! Adults and Kids studies of body shape, metabolic risk, and functional assessment and had BMI of

BackgroundTraditionally, weight loss (WL) trials utilize dual energy X-ray absorptiometry (DXA) to measure lean mass. This method assumes lean mass, as the sum of all non-bone and non-fat tissue, is a reasonable proxy for muscle mass. In contrast, the D3 -creatine (D3 Cr) dilution method directly measures whole body skeletal muscle mass, although this method has yet to be applied in the context of a geriatric WL trial. The purpose of this project was to (1) describe estimates of change and variability in D3 Cr muscle mass in older adults participating in an intentional WL intervention and (2) relate its change to other measures of body composition as well as muscle function and strength.MethodsThe INVEST in Bone Health trial (NCT04076618), used as a scaffold for this ancillary pilot project, is a three-armed, 12-month randomized, controlled trial designed to determine the effects of resistance training or weighted vest use during intentional WL on a battery of musculoskeletal health outcomes among 150 older adults living with obesity. A convenience sample of 24 participants (n = 8/arm) are included in this analysis. At baseline and 6 months, participants were weighed, ingested a 30 mg D3 Cr tracer dose, provided a fasted urine sample 3-6 days post-dosage, underwent DXA (total body fat and lean masses, appendicular lean mass) and computed tomography (mid-thigh and trunk muscle/intermuscular fat areas) scans, and performed 400-m walk, stair climb, knee extensor strength, and grip strength tests.ResultsParticipants were older (68.0 ± 4.4 years), mostly White (75.0%), predominantly female (66.7%), and living with obesity (body mass index: 33.8 ± 2.7 kg/m2 ). Six month total body WL was -10.3 (95% confidence interval, CI: -12.7, -7.9) kg. All DXA and computed tomography-derived body composition measures were significantly decreased from baseline, yet D3 Cr muscle mass did not change [+0.5 (95% CI: -2.0, 3.0) kg]. Of muscle function and strength measures, only grip strength significantly changed [+2.5 (95% CI: 1.0, 4.0) kg] from baseline.ConclusionsAmong 24 older adults, significant WL with or without weighted vest use or resistance training over a 6-month period was associated with significant declines in all bioimaging metrics, while D3 Cr muscle mass and muscle function and strength were preserved. Treatment assignment for the trial remains blinded; therefore, full interpretation of these findings is limited. Future work in this area will assess change in D3 Cr muscle mass by parent trial treatment group assignment in all study participants.

BackgroundThis study investigates the cross-sectional and prospective associations between accelerometer-measured sedentary behavior and body composition from adolescence to early adulthood.MethodsData from the Santiago Longitudinal Study were analyzed (n = 212). Sedentary time was measured at age 16 years, and body composition (body mass index [BMI], waist circumference, waist-to-height ratio [WHtR], fat mass percentage, and lean mass percentage) was examined at both age 16 and 23 years. Adjusted linear regression models estimated associations between sedentary time, sedentary bout duration, and body composition, overall and by sex.ResultsIn all analyses, mean sedentary bout duration was not associated with body composition. In cross-sectional analyses, more sedentary time during adolescence was significantly associated with lower BMI, waist circumference, WHtR, fat mass percentage, and higher lean mass percentage (p

BACKGROUND: Socioeconomic status (SES) is multifactorial, and its effect on post-bariatric weight recurrence is unclear. Distressed Community Index (DCI) is a composite SES score measuring community economic well-being. This study aims to evaluate the effect of DCI on long-term post-bariatric weight outcomes. METHODS: Retrospective analysis of patients undergoing primary laparoscopic Roux-en-Y gastric bypass or sleeve gastrectomy between 2015 and 2020 was performed. All weights in the electronic medical record (EMR), including non-bariatric visits, were captured. Patients were stratified into low tier (LT) and high tier (HT) DCI groups. RESULTS: Of 583 patients, 431 (73.9%) were HT and 152 (26.1%) were LT. Average bariatric follow up was 1.78 ± 1.6 years and average postoperative weight in the EMR was 3.96 ± 2.26 years. Rates of bariatric follow up within the last year were similar (13.8% LT vs 16.2% HT, p = 0.47). LT had higher percent total body weight loss (%TWL; 26% LT vs 23% HT, p  15% increase from their 1-year weight (33.3% LT vs 21.0% HT, p = 0.06), on multivariate analysis this difference was significant (OR 2.0, LT 95%CI 1.41-2.84). There were no differences in the percentage of patients with > 15% decrease in %EWL from 1 to 3 + years postop between groups (OR 0.98, LT 95% CI 0.72-1.35). CONCLUSIONS: While low tier patients had similar weight loss at 1 year, they were twice as likely to have weight recurrence at ≥ 3 years. Further studies are needed to identify factors contributing to greater weight recurrence among this population.

Exercise training (EX) and weight loss (WL) improve lower extremity physical function (LEPF) in older overweight women; however, effects on rate of torque development (RTD) are unknown. This study aimed to determine the effects of WL + EX or WL alone on RTD, and relatedly LEPF, in overweight older women. Leg strength was assessed using isokinetic dynamometry, and RTD was calculated (RTD200 = RTD at 200 ms, RTDPeak = peak RTD, T2P = time to 1st peak). LEPF was determined via clinical functional tasks. Women (n = 44, 69.1 ± 3.6 years, 30.6 ± 4.3 kg/m2) completed a 6-month trial in EX + WL or WL groups with similar weight loss (−9.8 ± 4.2%, p >.95). EX + WL had greater improvements in (a) most LEPF tasks (p <.001) and (b) RTD200, compared with WL (36% vs. −16%, p =.031); no other RTD parameters differed. Changes in RTD parameters and LEPF were not related (all p >.05). RTD is responsive to EX but is not associated with LEPF in older women. [ABSTRACT FROM AUTHOR]

Adipocyte dysregulation is one mechanism linking overweight and breast cancer recurrence. Exercise and weight loss are associated with a decreased risk of breast cancer recurrence in breast cancer survivors with overweight or obesity, which may be mediated through reduced leptin levels, increased adiponectin levels, and an elevated adiponectin to leptin (A:L) ratio. The four-arm randomized controlled WISER Survivor trial examined the 12-month intervention effects of exercise, weight loss, and the combination of exercise and weight loss on adipokine levels among breast cancer survivors (n = 339) with overweight or obesity. Compared with Control, the Combination of Exercise and Weight Loss decreased leptin levels (-35.9%; 95% CI: -46.8%, -25.0%) and increased A:L ratio (11.6%; 95% CI: 5.6%, 17.6%) but did not change adiponectin levels (4.1%; 95% CI: -3.1%, 11.2%). Compared with Control, Weight Loss Alone decreased leptin levels (-35.6%; 95% CI: -46.6%, -24.5%) and increased A:L ratio (10.6%; 95% CI: 4.7%, 16.5%) but did not change adiponectin levels (0.9%; 95% CI: -6.0%, 7.9%). Compared with Control, Exercise Alone did not change leptin levels, adiponectin levels, or A:L ratio. In analyses that consolidated intervention groups, compared with Control, weight loss of ≥5% decreased leptin levels (p trend < 0.01) and increased A:L ratio (p trend < 0.01) but did not alter adiponectin levels (p trend = 0.53). Weight loss, with or without exercise, was associated with decreased leptin levels in breast cancer survivors with overweight or obesity. Improvements in the adipokine secretion profile (A:L ratio) were primarily driven by a weight loss-induced change in leptin levels.

BackgroundMultidisciplinary approaches to weight loss have been shown to improve outcomes in bariatric patients. Few studies have been performed assessing the utility and compliance of fitness tracking devices after bariatric surgery. We aim to determine whether use of an activity tracking device assists bariatric patients in improving postoperative weight loss behaviors.MethodsA fitness wearable was offered to patients undergoing bariatric surgery from 2019 to 2022. A telephone survey was conducted to elucidate the impact of the device on the patient's postoperative weight loss efforts 6 to 12 months after surgery. Weight loss outcomes of sleeve gastrectomy (SG) patients receiving the fitness wearable (FW) were compared to those of a group of SG patients who did not receive one (non-FW).ResultsThirty-seven patients were given a fitness wearable, 20 of whom responded to our telephone survey. Five patients reported not using the device and were excluded. 88.2% reported that using the device had a positive impact on their overall lifestyle. Patients felt that using the fitness wearable to keeping track of their progress helped them both to achieve short-term fitness goals and sustain them in the long run. From the patients that utilized the device, 44.4% of those that discontinued felt like it helped them build a routine that they maintained even after they were no longer using it. Demographic data between FW and non-FW groups (age, sex, CCI, initial BMI, and surgery BMI) did not differ significantly. The FW group trended towards greater %EWL at 1 year post-operation (65.2% versus 52.4%, p = 0.066) and had significantly greater %TWL at 1 year post-operation (30.3% versus 22.3%, p = 0.02).ConclusionThe use of an activity tracking device enhances a patient's post-bariatric surgery experience, serving to keep patients informed and motivated, and leading to improved activity that may translate to better weight loss outcomes.

ObjectiveMost guidelines recommending weight loss for hip osteoarthritis are based on research on knee osteoarthritis. Prior studies found no association between weight loss and hip osteoarthritis, but no previous studies have targeted older adults. Therefore, we aimed to determine whether there is any clear benefit of weight loss for radiographic hip osteoarthritis in older adults because weight loss is associated with health risks in older adults.MethodsWe used data from white female participants aged ≥65 years from the Study of Osteoporotic Fractures. Our exposure of interest was weight change from baseline to follow-up at 8 years. Our outcomes were the development of radiographic hip osteoarthritis (RHOA) and the progression of RHOA over 8 years. Generalized estimating equations (clustering of 2 hips per participant) were used to investigate the association between exposure and outcomes adjusted for major covariates.ResultsThere was a total of 11,018 hips from 5509 participants. There was no associated benefit of weight loss for either of our outcomes. The odds ratios (95% confidence intervals) for the development and progression of RHOA were 0.99 (0.92-1.07) and 0.97 (0.86-1.09) for each 5% weight loss, respectively. The results were consistent in sensitivity analyses where participants were limited to those who reported trying to lose weight and who also had a body mass index in the overweight or obese range.ConclusionOur findings suggest no associated benefit of weight loss in older female adults in the structure of the hip joint as assessed by radiography.

Summary This research explores the cryoprotective potential of gelatin hydrolysate by determining weight loss and physicochemical changes in the muscle protein of freeze–thawed shrimp. Shrimp treated with gelatin hydrolysate exhibited significantly higher and lower weight gain (9.20%) than those treated with distilled water (0.93%) and mixed phosphates (16.99%), respectively. Gelatin hydrolysate could lower the increasing rate of thawing and cooking loss and freezable water content in freeze–thawed shrimp (P < 0.05) and comparable to those of mixed phosphates treated shrimp (P > 0.05). As the shrimp were subjected to freeze–thawing, gelatin hydrolysate slowed the decline of protein solubility and Ca2+‐ATPase activity and mitigated the rise of surface hydrophobicity and disulfide bond content. It also delayed the shear force increase. These findings suggest that gelatin hydrolysate could be an effective alternative to traditional cryoprotectants, retarding weight loss and protein denaturation to preserve shrimp quality during freezing and frozen storage. [ABSTRACT FROM AUTHOR]

Key points High altitude residents have a lower incidence of type 2 diabetes mellitus (T2DM). Therefore, we examined the effect of repeated overnight normobaric hypoxic exposure on glycaemic control, appetite, gut microbiota and inflammation in adults with T2DM. Thirteen adults with T2DM [glycated haemoglobin (HbA1c): 61.1 ± 14.1 mmol mol−1; aged 64.2 ± 9.4 years; four female] completed a single‐blind, randomised, sham‐controlled, cross‐over study for 10 nights, sleeping when exposed to hypoxia (fractional inspired O2 [FIO2${{F}_{{\mathrm{I}}{{{\mathrm{O}}}_{\mathrm{2}}}}}$] = 0.155; ∼2500 m simulated altitude) or normoxic conditions (FIO2${{F}_{{\mathrm{I}}{{{\mathrm{O}}}_{\mathrm{2}}}}}$ = 0.209) in a randomised order. Outcome measures included: fasted plasma [glucose]; [hypoxia inducible factor‐1α]; [interleukin‐6]; [tumour necrosis factor‐α]; [interleukin‐10]; [heat shock protein 70]; [butyric acid]; peak plasma [glucose] and insulin sensitivity following a 2 h oral glucose tolerance test; body composition; appetite indices ([leptin], [acyl ghrelin], [peptide YY], [glucagon‐like peptide‐1]); and gut microbiota diversity and abundance [16S rRNA amplicon sequencing]. During intervention periods, accelerometers measured physical activity, sleep duration and efficiency, whereas continuous glucose monitors were used to assess estimated HbA1c and glucose management indicator and time in target range. Overnight hypoxia was not associated with changes in any outcome measure (P > 0.05 with small effect sizes) except fasting insulin sensitivity and gut microbiota alpha diversity, which exhibited trends (P = 0.10; P = 0.08 respectively) for a medium beneficial effect (d = 0.49; d = 0.59 respectively). Ten nights of overnight moderate hypoxic exposure did not significantly affect glycaemic control, gut microbiome, appetite, or inflammation in adults with T2DM. However, the intervention was well tolerated and a medium effect‐size for improved insulin sensitivity and reduced alpha diversity warrants further investigation. Living at altitude lowers the incidence of type 2 diabetes mellitus (T2DM). Animal studies suggest that exposure to hypoxia may lead to weight loss and suppressed appetite. In a single‐blind, randomised sham‐controlled, cross‐over trial, we assessed the effects of 10 nights of hypoxia (fractional inspired O2 ∼0.155) on glucose homeostasis, appetite, gut microbiota, inflammatory stress ([interleukin‐6]; [tumour necrosis factor‐α]; [interleukin‐10]) and hypoxic stress ([hypoxia inducible factor 1α]; heat shock protein 70]) in 13 adults with T2DM. Appetite and inflammatory markers were unchanged following hypoxic exposure, but an increased insulin sensitivity and reduced gut microbiota alpha diversity were associated with a medium effect‐size and statistical trends, which warrant further investigation using a definitive large randomised controlled trial. Hypoxic exposure may represent a viable therapeutic intervention in people with T2DM and particularly those unable or unwilling to exercise because barriers to uptake and adherence may be lower than for other lifestyle interventions (e.g. diet and exercise). [ABSTRACT FROM AUTHOR]

Scutellariabarbata D. Don (S. barbata), a medicinal herb commonly used in traditional Chinese and Korean medicine, consists of bioactive neoclerodanes and flavonoids. However, its anti-hyperglycemic activity has not been reported. In this work, we used bioassay-guided fractionation to find effective anti-hyperglycemic fractions of S. barbata. The chemical components of these fractions were also determined structurally; they are scutellarin (1), luteolin (2), naringenin (3), tricin (4), baicalein (5), baicalin (6), apigenin (7), and wogonin (8). The most potent fraction SB6 consisting of flavonoids 5, 6, 7, and 8 showed 89% inhibition of α-glucosidase in the in vitro experiment. In further in vivo experiments on streptozotocin (STZ)-induced diabetic mice, SB6 exhibited significant anti-hyperglycemic activity comparable to metformin after 28 days of treatment. This fraction, however, did not show efficiency in reducing the weight gain of the treated mice. [ABSTRACT FROM AUTHOR]

Beneficial weight-loss properties of glucagon-like peptide-1 receptor agonists (GLP-1RA) in obese people, with corresponding improvements in cardiometabolic risk factors, are well established. OKV-119 is an investigational drug delivery system that is being developed for the long-term delivery of the GLP-1RA exenatide to feline patients. The purpose of this study was to evaluate the drug release characteristics of subcutaneous OKV-119 implants configured to release exenatide for 84 days. Following a 7-day acclimation period, five purpose-bred cats were implanted with OKV-119 protypes and observed for a 112-day study period. Food intake, weekly plasma exenatide concentrations and body weight were measured. Exenatide plasma concentrations were detected at the first measured timepoint (Day 7) and maintained above baseline for over 84 Days. Over the first 28 days, reduced caloric intake and a reduction in body weight were observed in four of five cats. In these cats, a body weight reduction of at least 5% was maintained throughout the 112-day study period. This study demonstrates that a single OKV-119 implant can deliver the GLP-1RA exenatide for a months long duration. Results suggest that exposure to exenatide plasma concentrations ranging from 1.5 ng/ml to 4 ng/ml are sufficient for inducing weight loss in cats. [ABSTRACT FROM AUTHOR]

In vivo experiments are increasingly using clinical score sheets to ensure minimal distress to the animals. A score sheet is a document that includes a list of specific symptoms, behaviours and intervention guidelines, all balanced to for an objective clinical assessment of experimental animals. Artificial Intelligence (AI) technologies are increasingly being applied in the field of preclinical research, not only in analysis but also in documentation processes, reflecting a significant shift towards more technologically advanced research methodologies. The present study explores the application of Large Language Models (LLM) in generating score sheets for an animal welfare assessment in a preclinical research setting. Focusing on a mouse model of inflammatory bowel disease, the study evaluates the performance of three LLM – ChatGPT-4, ChatGPT-3.5, and Google Bard – in creating clinical score sheets based on specified criteria such as weight loss, stool consistency, and visible fecal blood. Key parameters evaluated include the consistency of structure, accuracy in representing severity levels, and appropriateness of intervention thresholds. The findings reveal a duality in LLM-generated score sheets: while some LLM consistently structure their outputs effectively, all models exhibit notable variations in assigning numerical values to symptoms and defining intervention thresholds accurately. This emphasizes the dual nature of AI performance in this field—its potential to create useful foundational drafts and the critical need for professional review to ensure precision and reliability. The results highlight the significance of balancing AI-generated tools with expert oversight in preclinical research. [ABSTRACT FROM AUTHOR]

Approximately 30–49% of heart failure (HF) patients are living with obesity. The recommended body mass index (BMI) for the general population is 18.5–24.9 kg/m2. The obesity paradox suggests that HF patients with obesity (HFpwO) have a better prognosis compared to normal BMI. Guideline recommendations on ideal BMI for HFpwO are limited. This systematic review aims to examine the evidence base for intentional weight loss in HFpwO on the following parameters: mortality, hospitalization, symptoms, quality of life (QOL), effects on left ventricular ejection fraction (LVEF) and adverse events. A total of 22 studies were identified: lifestyle intervention (n = 9), pharmacotherapy (n = 3), bariatric surgery (n = 10). Mortality and hospitalization, symptoms, QOL, and LVEF were reported in 8, 15 and 14 studies, respectively. All studies had moderate to high risk of bias except one randomized controlled trial (RCT) which evaluated semaglutide in HF with preserved ejection fraction (HFpEF) patients. Semaglutide resulted in weight loss with improvement in QOL. Lifestyle intervention led to weight loss, minimal adverse events, and improvement in symptoms in both HF with reduced ejection fraction (HFrEF) and HFpEF patients. In six observational studies, bariatric surgery in HFrEF patients achieved weight loss and improvement in LVEF safely in most patients but some patients developed worsening HF perioperatively. There is a need for high‐quality adequately powered RCTs on intentional weight loss in HFpwO with survival and hospitalization outcomes. All forms of weight loss intervention studied in this review were likely to result in significant weight loss, improved symptoms and QOL. Careful monitoring is required due to an increase in certain adverse events. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To systematically evaluate the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on body composition and glucose metabolism-related indexes in overweight or obese patients with type 2 diabetes and to compare the improvement effect of the two exercise modalities, thereby providing a reference basis for the development of exercise prescription for overweight or obese patients with type 2 diabetes. METHODS: The Cochrane Library, PubMed, EMbase, Web of Science, CNKI, CBM, WanFang, and ClinicalTrials.gov were searched for randomized controlled trials comparing the effects of HIIT and MICT interventions on body composition and glucose metabolism-related indicators in overweight or obese patients with type 2 diabetes. The search was conducted from database inception to June 2022. Meta-analysis of outcome indicators was performed using RevMan 5.4. RESULTS: (1) A total of 13 randomized controlled trials with 371 subjects were included, and the overall quality of the included studies was relatively high. (2) There was no significant difference in the improvement of body composition between HIIT and MICT [body mass: weighted mean difference (WMD)=2.44, 95% confidence interval (CI): -3.01-7.89, P > 0.05; body mass index: WMD=0.28, 95%CI: -1.21-1.77, P > 0.05; waist circumference: WMD=2.16, 95% CI: -2.04-6.35, P > 0.05; body fat percentage: WMD=0.47, 95%CI: -2.11-3.05, P > 0.05). (3) The results of subgroup analysis showed that there was a significant difference in body mass and body mass index between the “training cycle ≥ 12 weeks” subgroup and the “training frequency ≤ 3 times/week” subgroup (training cycle ≥ 12 weeks subgroup: WMD=4.25, 95% CI: 0.90-7.59, P=0.01; WMD=2.71, 95%CI: 1.92-3.51, P < 0.000 01; training frequency ≤ 3 times/week subgroup: WMD=5.14, 95%CI: 1.7-8.57, P=0.003; WMD=1.67, 95% CI: 0.66-2.67, P=0.001). (4) The results of sensitivity analysis showed that there was a significant difference in body fat percentage between the HIIT and MICT groups (WMD=2.17, 95% CI: 1.20-3.14, P < 0.000 1), while there was no significant difference in the improvement of glucose metabolism between the HIIT and MICT groups (fasting blood glucose: WMD=0.31, 95% CI: -0.17-0.79, P > 0.05; glycosylated hemoglobin: WMD=0.01, 95% CI: -0.19-0.20, P > 0.05; insulin resistance index: WMD=-0.14, 95%CI: -0.71-0.42, P > 0.05). (5) The results of subgroup analysis showed that fasting blood glucose was significantly different in the subgroup of “training frequency ≤ 3 times/week” (WMD=0.92, 95% CI: 0.25-1.60, P=0.007) and glycosylated hemoglobin was significantly different in the “training frequency > 3 times/week” subgroup (WMD=-0.2, 95% CI: -0.3 to -0.1, P < 0.000 1). CONCLUSION: Overall, there is no significant difference between HIIT and MICT in improving body composition such as body mass, body mass index, waist circumference, body fat percentage as well as improving glucose metabolic indexes such as fasting blood glucose, glycated hemoglobin and insulin resistance index in overweight or obese patients with type 2 diabetes. When the training period is ≥ 12 weeks and the training frequency is ≤ 3 times/week, MICT has a better effect on the improvement of body mass as well as body mass index. [ABSTRACT FROM AUTHOR]

COVID-19 comorbid with noncommunicable chronic diseases (NCDs) complicates the diagnosis, treatment, and prognosis, and increases the mortality rate. The aim is to evaluate the effects of a restricted diet on clinical/laboratory inflammation and metabolic profile, reactive oxygen species (ROS), and body composition in patients with COVID-19 comorbid with NCDs. We conducted a 6-week open, pilot prospective controlled clinical trial. The study included 70 adult patients with COVID-19 comorbid with type 2 diabetes (T2D), hypertension, or nonalcoholic steatohepatitis (NASH). Interventions: a restricted diet including calorie restriction, hot water drinking, walking, and sexual self-restraint. Primary endpoints: COVID-19 diagnosis by detecting SARS-CoV-2 genome by RT-PCR; weight loss in Main group; body temperature; C-reactive protein. Secondary endpoints: the number of white blood cells; erythrocyte sedimentation rate; adverse effects during treatment; fasting blood glucose, glycosylated hemoglobin A1c (HbA1c), systolic/diastolic blood pressure (BP); blood lipids; ALT/AST, chest CT-scan. In Main group, patients with overweight lost weight from baseline (− 12.4%; P < 0.0001); 2.9% in Main group and 7.2% in Controls were positive for COVID-19 (RR: 0.41, CI: 0.04–4.31; P = 0.22) on the 14th day of treatment. Body temperature and C-reactive protein decreased significantly in Main group compared to Controls on day 14th of treatment (P < 0.025). Systolic/diastolic BP normalized (P < 0.025), glucose/lipids metabolism (P < 0.025); ALT/AST normalized (P < 0.025), platelets increased from baseline (P < 0.025), chest CT (P < 0.025) in Main group at 14 day of treatment. The previous antidiabetic, antihypertensive, anti-inflammatory, hepatoprotective, and other symptomatic medications were adequately decreased to completely stop during the weight loss treatment. Thus, the fast weight loss treatment may be beneficial for the COVID-19 patients with comorbid T2D, hypertension, and NASH over traditional medical treatment because, it improved clinical and laboratory/instrumental data on inflammation; glucose/lipid metabolism, systolic/diastolic BPs, and NASH biochemical outcomes, reactive oxygen species; and allowed patients to stop taking medications. Trial Registration: ClinicalTrials.gov NCT05635539 (02/12/2022): https://clinicaltrials.gov/ct2/show/NCT05635539?term=NCT05635539&draw=2&rank=1. [ABSTRACT FROM AUTHOR]

The relationship between gut microbiota and obesity has recently been an important subject for research as the gut microbiota is thought to affect body homeostasis including body weight and composition, intervening with pro and prebiotics is an intelligent possible way for obesity management. To evaluate the effect of hypo caloric adequate fiber regimen with probiotic supplementation and physical exercise, whether it will have a good impact on health, body composition, and physique among obese Egyptian women or has no significant effect. The enrolled 58 women, in this longitudinal follow-up intervention study; followed a weight loss eating regimen (prebiotic), including a low-carbohydrate adequate-fiber adequate-protein dietary pattern with decreased energy intake. They additionally received daily probiotic supplements in the form of yogurt and were instructed to exercise regularly for 3 months. Anthropometric measurements, body composition, laboratory investigations, and microbiota analysis were obtained before and after the 3 months weight loss program. Statistically highly significant differences in the anthropometry, body composition parameters: and obesity-related biomarkers (Leptin, ALT, and AST) between the pre and post-follow-up measurements at the end of the study as they were all decreased. The prebiotic and probiotic supplementation induced statistically highly significant alterations in the composition of the gut microbiota with increased relative abundance of Lactobacillus, Bifidobacteria, and Bacteroidetes and decreased relative abundance of Firmicutes and Firmicutes/Bacteroidetes Ratio. Hypo caloric adequate fiber regimen diet with probiotics positively impacts body composition and is effective for weight loss normalizing serum Leptin and AST. [ABSTRACT FROM AUTHOR]

The effects of boiling water treatment on the physical properties of Quercus variabilis virgin cork (Qv VC) were examined and compared with those of Quercus suber reproduction cork (Qs RC). The water treatment was conducted at 100 °C for 1 h. Qv VC showed a significantly higher dimensional change in the three directions and lower weight loss than Qs RC by boiling water treatment. Untreated and boiled Qv VC showed higher density, air-dried moisture content, red/green (a*) and yellow/blue (b*) chromaticity, overall color change, shrinkage in all three directions, moisture adsorption on the entire surface, and swelling per 1% moisture content than untreated and boiled Qs RC. However, the lightness (L*) and water absorption on each surface were higher for Qs RC than for Qv VC. Moisture adsorption on each surface was comparable before and after heat treatment for both species. After boiling water treatment, the air-dried moisture content, dimensions, volume shrinkage, water absorption, and moisture adsorption on each surface and the entire surface increased, whereas L*, a*, b*, and swelling per 1% moisture content decreased. The results of the present study could be useful for further utilization of Qv cork growing in Korea. [ABSTRACT FROM AUTHOR]

Neuroimaging studies have revealed alterations in habenular (Hb) structure and functional connectivity (FC) in psychiatric conditions. The Hb plays a particularly critical role in regulating negative emotions, which trigger excessive food intake and obesity. However, obesity and weight loss intervention (i.e., laparoscopic sleeve gastrectomy [LSG])–associated changes in Hb structure and FC have not been studied. We used voxel-based morphometry analysis to measure changes in gray matter volume (GMV) in the Hb in 56 patients with obesity at pre-LSG and 12 months post-LSG and in 78 normal-weight (NW) control participants. Then, we conducted Hb seed-based resting-state FC (RSFC) to examine obesity-related and LSG-induced alterations in RSFC. Finally, we used mediation analysis to characterize the interrelationships among Hb GMV, RSFC, and behaviors. Compared with NW participants, Hb GMV was smaller in patients at pre-LSG and increased at 12 months post-LSG to levels equivalent to that of NW; in addition, increases in Hb GMV were correlated with reduced body mass index (BMI). Compared with NW participants, pre-LSG patients showed greater RSFCs of the Hb–insula, Hb–precentral gyrus, and Hb–rolandic operculum and weaker RSFCs of the Hb–thalamus, Hb–hypothalamus, and Hb–caudate; LSG normalized these RSFCs. Decreased RSFC of the Hb-insula was correlated with reduced BMI, Yale Food Addiction Scale rating, and emotional eating; reduced hunger levels were correlated with increased RSFCs of the Hb–thalamus and Hb–hypothalamus; and reduced BMI and Yale Food Addiction Scale ratings were correlated with increased RSFCs of the Hb–thalamus and Hb–hypothalamus, respectively. The bidirectional relationships between Hb GMV and RSFC of the Hb–insula contributed to reduced BMI. These findings indicate that LSG increased Hb GMV and that its related improvement in RSFC of the Hb–insula may mediate long-term benefits of LSG for eating behaviors and weight loss. [ABSTRACT FROM AUTHOR]

Obesity is considered the leading public health problem in the medical sector. The phenotype includes overweight conditions that lead to several other comorbidities that drastically decrease health. Glucagon-like receptor agonists (GLP-1RAs) initially designed for treating type 2 diabetes mellitus (T2DM) had demonstrated weight loss benefits in several clinical trials. In vivo studies showed that GLP-1RA encourages reduced food consumption and consequent weight reduction by stimulating brown fat and enhancing energy outlay through the action of the sympathetic nervous system (SNS) pathways. Additionally, GLP-1RAs were found to regulate food intake through stimulation of sensory neurons in the vagus, interaction with the hypothalamus and hindbrain, and through inflammation and intestinal microbiota. However, the main concern with the use of GLP-1RA treatment was weight gain after withdrawal or discontinuation. We could identify three different ways that could lead to weight gain. Potential factors might include temporary hormonal adjustment in response to weight reduction, the central nervous system's (CNS) incompetence in regulating weight augmentation owing to the lack of GLP-1RA, and β-cell malfunction due to sustained exposure to GLP-1RA. Here, we also review the data from clinical studies that reported withdrawal symptoms. Although the use of GLP-1RA could be beneficial in multiple ways, withdrawal after years has the symptoms reversed. Clinical studies should emphasize the downside of these views we highlighted, and mechanistic studies must be carried out for a better outcome with GLP-1RA from the laboratory to the bedside. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity is a growing concern worldwide. School-based interventions have been proposed as effective means to improve nutritional knowledge and prevent obesity. In 2023, Mexico approved a reform to the General Education Law to strengthen the ban of sales and advertising of nonessential energy-dense food and beverages (NEDFBs) in schools and surroundings. We aimed to predict the expected one-year change in total caloric intake and obesity prevalence by introducing the ban of NEDFBs sales in schools, among school-aged children and adolescents (6 to 17 years old) in Mexico. Methods and findings: We used age-specific equations to predict baseline fat-free mass (FFM) and fat mass (FM) and then estimated total energy intake (TEI) per day. The TEI after the intervention was estimated under 4 scenarios: (1) using national data to inform the intervention effect; (2) varying law compliance; (3) using meta-analytic data to inform the intervention effect size on calories; and (4) using national data to inform the intervention effect by sex and socioeconomic status (SES). We used Hall's microsimulation model to estimate the potential impact on body weight and obesity prevalence of children and adolescents 1 year after implementing the intervention in Mexican schools. We found that children could reduce their daily energy intake by 33 kcal/day/person (uncertainty interval, UI, [25, 42] kcal/day/person), reducing on average 0.8 kg/person (UI [0.6, 1.0] kg/person) and 1.5 percentage points (pp) in obesity (UI [1.1, 1.9] pp) 1 year after implementing the law. We showed that compliance will be key to the success of this intervention: considering a 50% compliance the intervention effect could reduce 0.4 kg/person (UI [0.3, 0.5] kg/person). Our sensitivity analysis showed that the ban could reduce body weight by 1.3 kg/person (UI [0.8, 1.8] kg/person) and up to 5.4 kg/person (UI [3.4, 7.5] kg/person) in the best-case scenario. Study limitations include assuming that obesity and the contribution of NEDFBs consumed at school remain constant over time, assuming full compliance, and not considering the potential effect of banning NEDFBs in stores near schools. Conclusions: Even in the most conservative scenario, banning sales of NEDFBs in schools is expected to significantly reduce obesity, but achieving high compliance will be key to its success. Why was this study done?: - School-based interventions have been recognized as effective means to improve nutritional knowledge and prevent obesity-related diseases. - In December 2023, the Chamber of Representatives of Mexico approved an amendment that strengthens and updates the General Education Law (Article 75) and nutritional guidelines to ban the sales and advertising of nonessential energy-dense food and beverages (NEDFBs) in schools. What did the researchers do and find?: - We used age-specific equations to predict baseline fat-free mass (FFM) and fat mass (FM) and total energy intake (TEI) per day. - We used microsimulation modeling to predict body weight and obesity prevalence of children and adolescents 1 year after implementing the intervention in Mexican schools. - Our modeling study suggests that an important impact on obesity prevalence can be expected if the law is implemented and enforced as intended. What do these findings mean?: - If successful, this law could serve as an example beyond Mexico on how to achieve changes in body weight through school food regulation. - An important limitation of our main scenario is that we assumed full compliance of schools with the law, yet lower compliance will reduce its impact. We also did not consider historical trends on obesity or NEDFBs consumed in schools during our 1 year simulation, and we considered only the ban impact inside schools, excluding effects near and outside schools. [ABSTRACT FROM AUTHOR]

Objectives: To assess the long-term effects on weight reduction and health of a group-based behavioral weight intervention over six months focusing eating for fulfillment as compared to a control regime with brief intervention. Method: Overweight or obese adults (n = 176, 80% female, mean BMI 33.8 ± 4.7 kg/m2, mean age 55.2 ±10.1 years) were randomized to a group treatment or control receiving a brief intervention. Ninety-three participants (53% of original sample) completed the 5-year follow-up. Anthropometrics, blood pressure and biochemical measurements, self-rated lifestyle habits, quality of life and medication were obtained at baseline, at the end of the 6-month intervention, and once a year for five years following randomization. Results: A per-protocol analysis, performed due to a high drop-out rate, found that weight reduction was small and similar in the two groups after five years. Reduction of waist/hip ratio, total-cholesterol and triglycerides were somewhat larger in the control group than in the treatment group. No changes regarding blood pressure, quality of life or medication use between the treatment and control groups were found. Conclusions: No effect on weight reduction of the group intervention was found as compared to brief intervention but both groups achieved small weight loss over time. Findings indicate that any intervention or merely regular follow-ups might be promotive for weight maintenance in middle age. [ABSTRACT FROM AUTHOR]

Introduction Material and Methods Results Conclusions The knowledge regarding eating behavior and disorders in women with polycystic ovary syndrome (PCOS) and severe obesity is limited. This study aimed to assess eating behavior and lifestyle factors in women with severe obesity (BMI ≥35 kg/m2), with and without PCOS, and the effect of weight loss on these behaviors.A prospective clinical trial with participants screened for PCOS using National Institutes of Health criteria. Participants completed the Food Frequency Questionnaire, International Physical Activity Questionnaire, Three‐Factor Eating Questionnaire, and Questionnaire of Eating and Weight Patterns‐revised, and were evaluated regarding binge eating disorder using DSM‐5 criteria before and after a 12‐month weight loss intervention. Clinicaltrials.gov: NCT01319162.246 women were included (PCOS n = 63, age 33.0 ± 8.4, BMI 39.9 ± 4.7; non‐PCOS n = 183, age 37.7 ± 8.7, BMI 39.6 ± 4.3). Women with PCOS showed elevated baseline scores in cognitive restraint eating (50.0 [33.3–63.2]) compared to women without PCOS (38.9 [27.8–55.6]; p = 0.012). No differences were observed between groups in emotional and uncontrolled eating. In both groups, cognitive restraint eating was negatively correlated with energy intake (PCOS: r = −0.315, p < 0.05; non‐PCOS: r = −0.214, p < 0.001), while uncontrolled eating displayed a positive correlation with energy intake (PCOS: r = 0.263, p = 0.05; non‐PCOS: r = 0.402, p < 0.001). A positive correlation was found between emotional eating and energy intake only in women without PCOS (r = 0.400, p < 0.001). Baseline self‐reported energy intake and physical activity did not differ between groups. At 12‐month follow‐up, women with PCOS reported reduced fat intake. Women without PCOS reported reduced energy intake, carbohydrates and sugar, increased protein, reduced scores for emotional and uncontrolled eating, and heightened scores for cognitive restraint eating. Comparing changes from baseline to follow‐up, differences were found between groups in cognitive restraint, intake of fat, carbohydrates, and sugar. The mean weight loss was 12–14 kg, with no between‐group difference (p = 0.616).Women with severe obesity and PCOS showed elevated cognitive restraint eating behaviors compared to women without PCOS. Although significant weight loss was seen in both groups, alterations in eating behavior more favorable for weight loss were only seen in women without PCOS. [ABSTRACT FROM AUTHOR]

Introduction: Chronic pain is a prevalent issue among older adults in the United States that impairs quality of life. Physical activity has emerged as a costeffective and non-pharmacological treatment for chronic pain, offering benefits such as improved physical functioning, weight loss, and enhanced mood. However, promoting physical activity in older individuals with chronic pain is challenging, given the cyclical relationship between pain and sedentary behavior. The Mobile Intervention to Reduce Pain and Improve Health (MORPH) trial was designed as an innovative, mobile health (mHealth) supported intervention to address this issue by targeting daylong movement, weight loss, and mindfulness to manage pain in older adults with chronic multisite pain. The objective of this paper is to provide the result of a qualitative analysis conducted on post-intervention interviews with MORPH participants. Methods: At the conclusion of the MORPH study, 14 participants were interviewed regarding their experience with the program. All interviews were conducted by phone before being transcribed and verified. A codebook of significant takeaways was created based on these accounts. Summaries were further synthesized into themes using the principles of thematic analysis. Results: Three key themes of the MORPH intervention emerged from the qualitative interviews: MORPH technology (smart scales, Fitbit, MORPH Companion App) facilitated program adherence and accountability; MORPH intervention components (food tracking and mindfulness activities) facilitated program adherence and awareness, respectively; and, group meetings provided motivational support and accountability. Mobile health technologies, including a dedicated MORPH app, facilitated self-monitoring strategies, helped to break the cycle of old habits, and provided participants with immediate feedback on successes; however, technical issues required timely support to maintain engagement. Food tracking contributed to adherence and accountability for weight loss. Mindfulness activities increased participants' awareness of anxiety provoking thoughts and pain triggers. Finally, social support via group meetings and connection, played a crucial role in behavior change, but participants noted consistency in the delivery medium was essential to fostering genuine connections. Conclusion: Overall, the study results highlight the key considerations related to program technology, intervention components, and the value of social support that can help to guide the development of future interventions similar to MORPH. [ABSTRACT FROM AUTHOR]

Purpose: ACTION Teens (NCT05013359) was conducted in 10 countries to identify perceptions, attitudes, behaviors, and barriers to effective obesity care among adolescents living with obesity (ALwO), caregivers of ALwO, and healthcare professionals (HCPs). Here, we report data from participants in Italy. Methods: The ACTION Teens cross-sectional online survey was completed by 649 ALwO (aged 12– < 18 years), 455 caregivers, and 252 HCPs in Italy in 2021. Results: Most ALwO thought their weight was above normal (69%), worried about weight affecting their future health (87%), and reported making a weight-loss attempt in the past year (60%); fewer caregivers responded similarly regarding their child (46%, 72%, and 33%, respectively). In addition, 49% of caregivers believed their child would lose excess weight with age. ALwO (38%) and caregivers (30%) most often selected wanting to be more fit/in better shape as a weight-loss motivator for ALwO; HCPs most often selected improved social life/popularity (73%). ALwO (25%) and caregivers (22%) most frequently selected lack of hunger control and not liking exercise, respectively, as weight-loss barriers, while HCPs most often agreed that unhealthy eating habits were a barrier (93%). ALwO most often obtained weight-management information from family/friends (25%) and search engines (24%); caregivers most often obtained information from doctors (29%). Conclusion: In Italy, the impact of obesity on ALwO was underestimated by caregivers, and ALwO and HCPs had different perceptions of key weight-loss motivators and barriers. Additionally, the internet was a key information source for ALwO, which suggests new education/communication strategies are needed. Level of evidence: IV; Evidence obtained from multiple time series with/without intervention, e.g. case studies. Trial Registration: ClinicalTrials.gov, NCT05013359. [ABSTRACT FROM AUTHOR]

Introduction: Suboptimal weight loss or weight regain may occur after Roux-en-Y gastric bypass (RYGB). For this reason, revisional surgery has gained increasing interest. We aimed to compare the percentage of total body weight loss (%TBWL) at one-year follow-up among three different techniques: Jejuno-jejunostomy distalization (JJD), Sleeve resection of the gastrojejunostomy and gastric pouch (SRGJP), and the combination of both (JJD + SRGJP). Methods: This retrospective cohort study included all patients who underwent revisional surgery after RYGB (2020–2021). The cohort was stratified by the type of revisional technique performed. Postoperative bariatric outcomes and nutritional deficiencies were compared among groups. Results: A total of 78 patients underwent revisional surgery after RYGB: JJD was performed in 8 (10.3%), SRGJP in 34 (43.6%), and JJD + SRGJP in 36 (46.1%) patients. The most common indication for surgery was weight regain, in 72 (92.3%) patients. The median lengths of the BP limbs before and after distalization, were 50 cm (IQR 40–75 cm) and 175 cm (IQR 150–200 cm), respectively. The median length of the new common limb (NCL) and total alimentary limb length (TALL) were 277 cm (IQR 250–313 cm) and 400 cm (IQR 375–475 cm), respectively. Median percentage of total body weight loss (%TBWL) at one year was 15% (IQR 15—19%) for JJD, 20% (IQR 13—26%) for SRGJP, and 21% (IQR 15- 28%) for JJD + SRGJP (p = 0.40). Conclusions: In this study, the combined procedure (JJD + SRGJP) exhibited higher %TBWL at one year, however no statistically significant difference was identified among the three techniques. [ABSTRACT FROM AUTHOR]

Background: Whether nutrition messages in popular health magazines differ by country or season has seldom been studied. We assessed the nutrition topics featured in the headlines of Men's Health® (MH) and Women's Health® (WH) magazines from different countries. Methods: We sampled MH and WH magazines from Portugal, South Africa, Spain, the UK and the USA. Nutrition-related headlines were categorized as weight loss, weight gain, micronutrients and other. Results: The most frequent topics were "Other" (44%) and "weight loss" (41%), while "micronutrients" represented 4%. Topics related to weight gain were more frequent in MH (19% vs. 2% in WH), while no difference was found for weight loss (44% vs. 37% in WH). On multivariable analysis, weight gain had a higher likelihood of being present in MH than in WH, Odds ratio and (95% confidence interval): 8.3 (2.2–90.9), p = 0.002, while no association was found for weight loss: OR 1.1 (0.6-2.0), p = 0.80. Weight loss was absent from the US WH and present in two thirds of the Portuguese WH; in MH, weight gain was evenly distributed between countries. Prevalence of the weight loss topic was lower in March (15% vs. 54% in January, p < 0.01 by logistic regression) and to a lesser degree in June (35%) and July (35%). No seasonality was found for the "weight gain" topic. Conclusion: In WH and MH magazines, nutrition topics vary according to gender, country, and season. Weight gain remains a male topic, while weight loss is equally prevalent in both women's and men's magazines. [ABSTRACT FROM AUTHOR]

Achieving diabetes remission (HbA1c<48mmol/mol without the use of anti-diabetic medication for 3 months) might not assure restoration of a normal glycemic profile [fasting blood sugar level <5.6 mmol/L and Post-Prandial (PP) blood glucose <7.8mmol/L]. The study investigates the factors associated with OGTT clearance in patients under type 2 diabetes remission. Four hundred participants who achieved remission during a one-year online structured lifestyle modification program, which included a plant-based diet, physical activity, psychological support, and medical management (between January 2021 and June 2022), and appeared for the OGTT were included in the study. OGTT clearance was defined by fasting blood glucose < 5.6 mmol/L and 2-hour post-prandial blood glucose <7.8 mmol/L post-consumption of 75g glucose solution. Of the 400 participants, 207 (52%) cleared OGTT and 175 (44%) had impaired glucose tolerance (IGT). A shorter diabetes duration (<5 years) was significantly associated with OGTT clearance (p<0.05). Pre-intervention use of glucose-lowering drugs showed no association with OGTT clearance (p<0.1). Post-intervention, the OGTT-cleared group showed significantly higher weight loss (p<0.05) and a decrease in HbA1c compared to the IGT group (p<0.05). Improvement in Insulin resistance and β-cell function was also higher in the OGTT-cleared group compared to the IGT group (p<0.05). In conclusion, clearing the OGTT is a possibility for those achieving remission through lifestyle interventions. Higher weight loss, a shorter duration of diabetes, and improvement in insulin resistance were significantly associated with OGTT clearance in participants in remission. Future randomized controlled trials with longer follow-ups may help substantiate our findings. [ABSTRACT FROM AUTHOR]