Pub Date : 2024-10-16DOI: 10.1016/j.obpill.2024.100133
Background
Lifestyle interventions (LIs) are the cornerstone for obesity management. The Mayo Clinic Diet (MCD) offers two approaches for LIs: the In-Person LI (IPLI) and the Digital Enhanced LI (DELI). The IPLI includes a 2-day in-person program with monthly follow-ups, whereas the DELI provides on-demand digital tools. The comparative efficacy of these approaches is currently unknown.
Methods
This retrospective study included two cohorts of adults with a body mass index (BMI) of ≥25 kg/m2 and weight metrics at least 3 months after starting either the IPLI or DELI program. The primary endpoint was the total body weight loss percentage (TBWL%) at 6 months.
Results
The study included 133 participants in the IPLI cohort (mean age 46.3 years, 65.4 % female, BMI 36.4) and 9603 in the DELI cohort (mean age 60.1 years, 85.0 % female, BMI 33.1). The DELI group achieved superior TBWL% at 1, 3, and 6 months compared to the IPLI group (3.4 % vs. 1.5 %, 4.7 % vs. 2.4 %, 5.3 % vs. 2.9 %, respectively; p < 0.001). After adjusting for age, gender, and starting weight, the DELI group maintained a higher TBWL% (difference 2.0 %; 95 % CI [1.0, 3.0], p < 0.001) and a greater proportion of participants achieved >5 % TBWL at 6 months (OR 1.66; 95 % CI [1.08, 2.55], p < 0.023).
Conclusion
The DELI approach resulted in superior weight loss outcomes compared to the IPLI. Further research is needed to explore how digital tools can improve weight loss effectiveness.
背景生活方式干预（LIs）是肥胖管理的基石。梅奥诊所饮食中心（Mayo Clinic Diet，MCD）为生活方式干预提供了两种方法：面对面生活方式干预（IPLI）和数字增强生活方式干预（DELI）。IPLI 包括为期 2 天的面授课程和每月一次的随访，而 DELI 则提供按需使用的数字工具。这项回顾性研究包括两组体重指数（BMI）≥25 kg/m2，且在开始 IPLI 或 DELI 计划至少 3 个月后有体重指标的成年人。研究结果IPLI队列中有133名参与者（平均年龄46.3岁，65.4%为女性，体重指数36.4），DELI队列中有9603名参与者（平均年龄60.1岁，85.0%为女性，体重指数33.1）。与 IPLI 组相比，DELI 组在 1 个月、3 个月和 6 个月时的 TBWL% 更高（分别为 3.4% vs. 1.5%、4.7% vs. 2.4%、5.3% vs. 2.9%；P <0.001）。在对年龄、性别和起始体重进行调整后，DELI 组保持了更高的 TBWL%（差异为 2.0 %；95 % CI [1.0，3.0]，p < 0.001），并且有更大比例的参与者在 6 个月时达到了 >5 % 的 TBWL（OR 1.66；95 % CI [1.08，2.55]，p < 0.023）。需要进一步研究探索数字工具如何提高减肥效果。
{"title":"Efficacy of in-person versus digital enhanced lifestyle interventions in adults with overweight and obesity","authors":"","doi":"10.1016/j.obpill.2024.100133","DOIUrl":"10.1016/j.obpill.2024.100133","url":null,"abstract":"<div><h3>Background</h3><div>Lifestyle interventions (LIs) are the cornerstone for obesity management. The Mayo Clinic Diet (MCD) offers two approaches for LIs: the In-Person LI (IPLI) and the Digital Enhanced LI (DELI). The IPLI includes a 2-day in-person program with monthly follow-ups, whereas the DELI provides on-demand digital tools. The comparative efficacy of these approaches is currently unknown.</div></div><div><h3>Methods</h3><div>This retrospective study included two cohorts of adults with a body mass index (BMI) of ≥25 kg/m<sup>2</sup> and weight metrics at least 3 months after starting either the IPLI or DELI program. The primary endpoint was the total body weight loss percentage (TBWL%) at 6 months.</div></div><div><h3>Results</h3><div>The study included 133 participants in the IPLI cohort (mean age 46.3 years, 65.4 % female, BMI 36.4) and 9603 in the DELI cohort (mean age 60.1 years, 85.0 % female, BMI 33.1). The DELI group achieved superior TBWL% at 1, 3, and 6 months compared to the IPLI group (3.4 % vs. 1.5 %, 4.7 % vs. 2.4 %, 5.3 % vs. 2.9 %, respectively; p < 0.001). After adjusting for age, gender, and starting weight, the DELI group maintained a higher TBWL% (difference 2.0 %; 95 % CI [1.0, 3.0], p < 0.001) and a greater proportion of participants achieved >5 % TBWL at 6 months (OR 1.66; 95 % CI [1.08, 2.55], p < 0.023).</div></div><div><h3>Conclusion</h3><div>The DELI approach resulted in superior weight loss outcomes compared to the IPLI. Further research is needed to explore how digital tools can improve weight loss effectiveness.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-10DOI: 10.1016/j.obpill.2024.100141
Background
Obesity, a progressively widespread disease with a multifaceted etiology, affects nearly 800 million people worldwide. Recent trials suggest that resveratrol, a polyphenolic compound, can be effective for metabolic risk markers and anthropometric parameters in Individuals with Obesity or Overweight. However, a comprehensive analysis is necessary to consolidate these results.
Objectives
To evaluate the impact of 4-week resveratrol supplementation on metabolic risk markers and anthropometric parameters in individuals with obesity or overweight.
Methods
A comprehensive search was executed across PubMed, Cochrane Library, Scopus, Google Scholar, and clinicaltrials.gov, yielding 43 studies after the omission of 20 duplicates. RevMan 5.4 software was used to statistically analyze randomized controlled studies to gauge the impact of resveratrol on the said outcomes in Individuals with Obesity or Overweight. Quality of bias and potential publication bias were measured using the Cochrane Risk of Bias tool and CMA4 software, respectively. Certainty of the evidence was appraised using GRADEpro software. Data was quantified as the standardized mean difference (SMD) and 95 % confidence intervals (CI).
Results
The meta-analysis included 5 trials with 419 participants, evaluating the effect of intervention. Resveratrol showed no significant impact on triglycerides (SMD = 0.11, 95%CI [-0.14, 0.35], P = 0.39, I2 = 0 %), total cholesterol (SMD = 0.04, 95%CI [-0.26, 0.33], P = 0.82, I2 = 0 %), or HbA1c (SMD = 0.00, 95%CI [-0.99, 1.00], P = 0.99, I2 = 80 %). Similarly, no significant effect was observed for insulin levels (SMD = −0.00, 95%CI [-0.25, 0.24], P = 0.97, I2 = 0 %), AST (SMD = 0.15, 95%CI [-0.35, 0.65], P = 0.55, I2 = 0 %), or ALT (SMD = −0.03, 95%CI [-0.46, 0.39], P = 0.98, I2 = 0 %). Additionally, resveratrol had no significant effect on BMI (MD = 0.21, 95%CI [-0.970, 1.39], P = 0.70, I2 = 0 %).
Conclusions
Our results tagged with p-value>0.05 are an evidence-based indication that resveratrol supplementation does not lead to significant improvements in metabolic or anthropometric parameters. This suggests that resveratrol may not be an effective standalone intervention for managing obesity-related outcomes. Therefore, future research should be redirected to evaluating its potential effects on other health metrics to elucidate its efficacy and therapeutic potential better.
{"title":"Effect of resveratrol supplementation on metabolic risk markers and anthropometric parameters in individuals with obesity or overweight: A systematic review and meta-analysis of randomized controlled trials","authors":"","doi":"10.1016/j.obpill.2024.100141","DOIUrl":"10.1016/j.obpill.2024.100141","url":null,"abstract":"<div><h3>Background</h3><div>Obesity, a progressively widespread disease with a multifaceted etiology, affects nearly 800 million people worldwide. Recent trials suggest that resveratrol, a polyphenolic compound, can be effective for metabolic risk markers and anthropometric parameters in Individuals with Obesity or Overweight. However, a comprehensive analysis is necessary to consolidate these results.</div></div><div><h3>Objectives</h3><div>To evaluate the impact of 4-week resveratrol supplementation on metabolic risk markers and anthropometric parameters in individuals with obesity or overweight.</div></div><div><h3>Methods</h3><div>A comprehensive search was executed across PubMed, Cochrane Library, Scopus, Google Scholar, and <span><span>clinicaltrials.gov</span><svg><path></path></svg></span>, yielding 43 studies after the omission of 20 duplicates. RevMan 5.4 software was used to statistically analyze randomized controlled studies to gauge the impact of resveratrol on the said outcomes in Individuals with Obesity or Overweight. Quality of bias and potential publication bias were measured using the Cochrane Risk of Bias tool and CMA4 software, respectively. Certainty of the evidence was appraised using GRADEpro software. Data was quantified as the standardized mean difference (SMD) and 95 % confidence intervals (CI).</div></div><div><h3>Results</h3><div>The meta-analysis included 5 trials with 419 participants, evaluating the effect of intervention. Resveratrol showed no significant impact on triglycerides (SMD = 0.11, 95%CI [-0.14, 0.35], P = 0.39, I<sup>2</sup> = 0 %), total cholesterol (SMD = 0.04, 95%CI [-0.26, 0.33], P = 0.82, I<sup>2</sup> = 0 %), or HbA1c (SMD = 0.00, 95%CI [-0.99, 1.00], P = 0.99, I<sup>2</sup> = 80 %). Similarly, no significant effect was observed for insulin levels (SMD = −0.00, 95%CI [-0.25, 0.24], P = 0.97, I<sup>2</sup> = 0 %), AST (SMD = 0.15, 95%CI [-0.35, 0.65], P = 0.55, I<sup>2</sup> = 0 %), or ALT (SMD = −0.03, 95%CI [-0.46, 0.39], P = 0.98, I<sup>2</sup> = 0 %). Additionally, resveratrol had no significant effect on BMI (MD = 0.21, 95%CI [-0.970, 1.39], P = 0.70, I<sup>2</sup> = 0 %).</div></div><div><h3>Conclusions</h3><div>Our results tagged with p-value>0.05 are an evidence-based indication that resveratrol supplementation does not lead to significant improvements in metabolic or anthropometric parameters. This suggests that resveratrol may not be an effective standalone intervention for managing obesity-related outcomes. Therefore, future research should be redirected to evaluating its potential effects on other health metrics to elucidate its efficacy and therapeutic potential better.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-10DOI: 10.1016/j.obpill.2024.100142
Background
Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed as nonalcoholic fatty liver disease (NAFLD) is a hepatic manifestation of obesity and metabolic syndrome. It is mainly caused by insulin resistance. With the increased risk of visceral obesity in South Asians, the prevalence of MASLD is on the rise. The morbidity associated with MASLD and its complications, including hepatocellular carcinoma is projected to increase in this South Asian population.
Methods
In this narrative review we explore the diagnosis and management of MASLD in the South Asian population. We summarize the findings from the recent literature on the diagnostic methods and management options for MASLD in this population.
Results
Through our search we found no specific guidelines for the diagnosis and management of MASLD in the South Asian population. The existing general guidelines may not be applied to South Asian populations due to the differences in phenotype, genotype, social and cultural aspects. South Asian countries also have limited resources with the non-availability of newer pharmacotherapeutic agents.
Conclusion
The goal of this review is to guide obesity physicians and primary care providers to have a stepwise approach to treat patients at risk for MASLD with a main focus on interdisciplinary management most applicable to South Asian patients. More research is needed to formulate guidelines and algorithm that are specific for the South Asian population.
{"title":"Diagnosis and management of metabolic dysfunction- associated steatotic liver disease in South Asians- A clinical review","authors":"","doi":"10.1016/j.obpill.2024.100142","DOIUrl":"10.1016/j.obpill.2024.100142","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed as nonalcoholic fatty liver disease (NAFLD) is a hepatic manifestation of obesity and metabolic syndrome. It is mainly caused by insulin resistance. With the increased risk of visceral obesity in South Asians, the prevalence of MASLD is on the rise. The morbidity associated with MASLD and its complications, including hepatocellular carcinoma is projected to increase in this South Asian population.</div></div><div><h3>Methods</h3><div>In this narrative review we explore the diagnosis and management of MASLD in the South Asian population. We summarize the findings from the recent literature on the diagnostic methods and management options for MASLD in this population.</div></div><div><h3>Results</h3><div>Through our search we found no specific guidelines for the diagnosis and management of MASLD in the South Asian population. The existing general guidelines may not be applied to South Asian populations due to the differences in phenotype, genotype, social and cultural aspects. South Asian countries also have limited resources with the non-availability of newer pharmacotherapeutic agents.</div></div><div><h3>Conclusion</h3><div>The goal of this review is to guide obesity physicians and primary care providers to have a stepwise approach to treat patients at risk for MASLD with a main focus on interdisciplinary management most applicable to South Asian patients. More research is needed to formulate guidelines and algorithm that are specific for the South Asian population.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.obpill.2024.100137
Background
South Asians are defined as those indigenous to the Indian subcontinent - India, Pakistan, Sri Lanka, Nepal, Maldives, Bhutan, and Bangladesh. This ethnic group is a unique population with increased prevalence of metabolic syndrome even at a lower body mass index (BMI). Should they also have increased BMI, the risk for development of diabetes mellitus and cardiovascular complications are further magnified. Strong cultural perceptions about ideal body weight, lack of awareness about the race and ethnicity-specific risks, and knowledge gaps regarding different dietary patterns among the healthcare providers confound further the metabolic issues pertinent to South Asians living in North America.
Methods
In this case study of a South Asian patient, we present asynchronous co-management of obesity by an obesity specialist and the primary care provider in a university-based clinic.
Results
Intense lifestyle interventions including a custom-tailored Indian vegetarian meal plan and weekly injectable Semaglutide was offered to the patient as treatment plan. The patient lost 59 pounds, and BMI changed from 34.1 kg/m2 to 23.5 kg/m2.
Conclusion
Intensive lifestyle interventions with custom-tailored dietary changes, regular physical activity and behavior modifications combined with appropriate pharmacotherapy can be very successful in the management of obesity among South Asians living in North America.
{"title":"Case report of a female western Indian vegetarian with obesity","authors":"","doi":"10.1016/j.obpill.2024.100137","DOIUrl":"10.1016/j.obpill.2024.100137","url":null,"abstract":"<div><h3>Background</h3><div>South Asians are defined as those indigenous to the Indian subcontinent - India, Pakistan, Sri Lanka, Nepal, Maldives, Bhutan, and Bangladesh. This ethnic group is a unique population with increased prevalence of metabolic syndrome even at a lower body mass index (BMI). Should they also have increased BMI, the risk for development of diabetes mellitus and cardiovascular complications are further magnified. Strong cultural perceptions about ideal body weight, lack of awareness about the race and ethnicity-specific risks, and knowledge gaps regarding different dietary patterns among the healthcare providers confound further the metabolic issues pertinent to South Asians living in North America.</div></div><div><h3>Methods</h3><div>In this case study of a South Asian patient, we present asynchronous co-management of obesity by an obesity specialist and the primary care provider in a university-based clinic.</div></div><div><h3>Results</h3><div>Intense lifestyle interventions including a custom-tailored Indian vegetarian meal plan and weekly injectable Semaglutide was offered to the patient as treatment plan. The patient lost 59 pounds, and BMI changed from 34.1 kg/m<sup>2</sup> to 23.5 kg/m<sup>2.</sup></div></div><div><h3>Conclusion</h3><div>Intensive lifestyle interventions with custom-tailored dietary changes, regular physical activity and behavior modifications combined with appropriate pharmacotherapy can be very successful in the management of obesity among South Asians living in North America.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-30DOI: 10.1016/j.obpill.2024.100138
Background
The use of meal replacement products (MRPs) to obtain a caloric deficit while maintaining micro- and macronutrient requirements, has a long tradition in obesity medicine. Limitations include low compliance, variability in efficacy, adverse events (related to acute changes in nutrient intake), and risk of weight regain when discontinued, and their popularity has declined after the emergence of potent GLP-1 receptor analogues (GLP1-RAs). However, GLP-1RAs have limitations, including dose-dependent risk for adverse events (AEs), high cost, as well as weight regain when discontinued. Although concomitant use of MRPs and GLP-1RAs could address some of the limitations, there is a scarcity of data reported on this. Herein we report real world clinical experience of such combined use.
Methods
This retrospective case evaluation involved people with obesity that concomitantly used MRPs (Optifast) and a GLP-1RA and were followed at one of three weight management centers in Australia or South Africa. Parameters collected were gender, age, co-morbidities, height, weight, frequency/amount of MRPs used, dose/type of GLP-1RA used, duration of combined use, and occurrence of AEs. Written informed consent for use of data was obtained from each individual, and the data were managed in an anonymized form and summarized descriptively.
Result
A total of seven (5 females) individuals (mean [min, max] age 49 [30,66] years, BMI 44.8 [30.7, 57.9] kg/m2) initiated either semaglutide (n=4) or liraglutide (n=3) concomitantly with daily MRPs (starting number of servings/day 2.7 [1,6]) for a duration of 12 [4, 25] months. Change in weight/BMI/% TBW was -32.0 (-9.6, -77.8) kg/-10.3 (-3.4, -24.5) kg/m2/-24.2 %. Five individuals experienced ≥1 GLP-1RA related AE (nausea, reflux, burping, diarrhea, constipation). One individual discontinued GLP-1RA, whereas two persons discontinued the use of MRPs.
Conclusions
MRPs can be initiated concomitantly with a GLP-1 RA for weight management. This might enhance weight-loss effectiveness, with potential additional benefits that should be elucidated in further and larger studies.
{"title":"Retrospective review of seven patients with obesity simultaneously treated with a combination of a glucagon-like peptide-1 receptor agonist and a meal replacement product","authors":"","doi":"10.1016/j.obpill.2024.100138","DOIUrl":"10.1016/j.obpill.2024.100138","url":null,"abstract":"<div><h3>Background</h3><div>The use of meal replacement products (MRPs) to obtain a caloric deficit while maintaining micro- and macronutrient requirements, has a long tradition in obesity medicine. Limitations include low compliance, variability in efficacy, adverse events (related to acute changes in nutrient intake), and risk of weight regain when discontinued, and their popularity has declined after the emergence of potent GLP-1 receptor analogues (GLP1-RAs). However, GLP-1RAs have limitations, including dose-dependent risk for adverse events (AEs), high cost, as well as weight regain when discontinued. Although concomitant use of MRPs and GLP-1RAs could address some of the limitations, there is a scarcity of data reported on this. Herein we report real world clinical experience of such combined use.</div></div><div><h3>Methods</h3><div>This retrospective case evaluation involved people with obesity that concomitantly used MRPs (Optifast) and a GLP-1RA and were followed at one of three weight management centers in Australia or South Africa. Parameters collected were gender, age, co-morbidities, height, weight, frequency/amount of MRPs used, dose/type of GLP-1RA used, duration of combined use, and occurrence of AEs. Written informed consent for use of data was obtained from each individual, and the data were managed in an anonymized form and summarized descriptively.</div></div><div><h3>Result</h3><div>A total of seven (5 females) individuals (mean [min, max] age 49 [30,66] years, BMI 44.8 [30.7, 57.9] kg/m<sup>2</sup>) initiated either semaglutide (n=4) or liraglutide (n=3) concomitantly with daily MRPs (starting number of servings/day 2.7 [1,6]) for a duration of 12 [4, 25] months. Change in weight/BMI/% TBW was -32.0 (-9.6, -77.8) kg/-10.3 (-3.4, -24.5) kg/m<sup>2</sup>/-24.2 %. Five individuals experienced ≥1 GLP-1RA related AE (nausea, reflux, burping, diarrhea, constipation). One individual discontinued GLP-1RA, whereas two persons discontinued the use of MRPs.</div></div><div><h3>Conclusions</h3><div>MRPs can be initiated concomitantly with a GLP-1 RA for weight management. This might enhance weight-loss effectiveness, with potential additional benefits that should be elucidated in further and larger studies.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-30DOI: 10.1016/j.obpill.2024.100139
Background
Craniopharyngiomas are rare benign tumors located in the sellar and suprasellar region, with an incidence of 0.5–2 cases per million as reported in Western studies. Post-treatment, including surgery and/or radiotherapy, many patients develop significant obesity, primarily due to hypothalamic damage and associated complications such as hypopituitarism. In the South Asian population, genetic predisposition to obesity at lower BMIs, coupled with a carbohydrate-rich diet, may exacerbate obesity in craniopharyngioma patients, presenting a unique challenge.
Methods
This submission is a commentary based on a comprehensive literature review. The authors conducted the review using PubMed to focus on English-language articles covering hypothalamic obesity, craniopharyngioma and obesity in the South Asian population from 1939 to the present.
Results
The literature review revealed that 50–60 % of patients treated for craniopharyngioma develop obesity, predominantly linked to hypothalamic damage, although these data are mainly derived from Western studies. Hypopituitarism was frequently observed, further contributing to the obesity. Despite a caloric intake appropriate for the age and gender, these patients exhibited reduced physical activity as measured by wrist accelerometers. Patients with hypothalamic obesity due to craniopharyngioma are at risk for metabolic syndrome and cardiovascular morbidity. Additionally, visual impairment was common, leading to a decreased quality of life. The South Asian population, genetically predisposed to visceral obesity and a carbohydrate-rich diet, may display a distinct phenotype. Although multiple treatment modalities have been tried, there is no definite treatment modality available to counteract this condition at present.
Conclusion
South Asian phenotype of craniopharyngioma-related obesity is characterized by significant metabolic and hormonal dysregulation, influenced by both dietary and genetic factors. Nevertheless, there may be a lot to be still understood about this devastating, rapid, relentless hypothalamic obesity syndrome. Also, a higher morbidity rate within this population, underscores the need for further research to develop targeted interventions.
{"title":"Obesity in patients with craniopharyngioma in the South Asian region – A distinct phenotype","authors":"","doi":"10.1016/j.obpill.2024.100139","DOIUrl":"10.1016/j.obpill.2024.100139","url":null,"abstract":"<div><h3>Background</h3><div>Craniopharyngiomas are rare benign tumors located in the sellar and suprasellar region, with an incidence of 0.5–2 cases per million as reported in Western studies. Post-treatment, including surgery and/or radiotherapy, many patients develop significant obesity, primarily due to hypothalamic damage and associated complications such as hypopituitarism. In the South Asian population, genetic predisposition to obesity at lower BMIs, coupled with a carbohydrate-rich diet, may exacerbate obesity in craniopharyngioma patients, presenting a unique challenge.</div></div><div><h3>Methods</h3><div>This submission is a commentary based on a comprehensive literature review. The authors conducted the review using PubMed to focus on English-language articles covering hypothalamic obesity, craniopharyngioma and obesity in the South Asian population from 1939 to the present.</div></div><div><h3>Results</h3><div>The literature review revealed that 50–60 % of patients treated for craniopharyngioma develop obesity, predominantly linked to hypothalamic damage, although these data are mainly derived from Western studies. Hypopituitarism was frequently observed, further contributing to the obesity. Despite a caloric intake appropriate for the age and gender, these patients exhibited reduced physical activity as measured by wrist accelerometers. Patients with hypothalamic obesity due to craniopharyngioma are at risk for metabolic syndrome and cardiovascular morbidity. Additionally, visual impairment was common, leading to a decreased quality of life. The South Asian population, genetically predisposed to visceral obesity and a carbohydrate-rich diet, may display a distinct phenotype. Although multiple treatment modalities have been tried, there is no definite treatment modality available to counteract this condition at present.</div></div><div><h3>Conclusion</h3><div>South Asian phenotype of craniopharyngioma-related obesity is characterized by significant metabolic and hormonal dysregulation, influenced by both dietary and genetic factors. Nevertheless, there may be a lot to be still understood about this devastating, rapid, relentless hypothalamic obesity syndrome. Also, a higher morbidity rate within this population, underscores the need for further research to develop targeted interventions.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-27DOI: 10.1016/j.obpill.2024.100134
Introduction
The effect of vitamin D status after bariatric surgery on postoperative skeletal muscle condition has not been adequately studied.
Methods
Clinical data from 83 patients (median age 44 years, BMI 40.4 kg/m2) who underwent sleeve gastrectomy (SG) were collected from medical records and analyzed retrospectively. Of the 83 patients, 37 who received continuous guidance on native vitamin D3 supplementation from before to 12 months after surgery were defined as the vitamin D supplementation (VDS) group, and 46 patients who did not receive such guidance as the control group. Native vitamin D3 supplement was provided by a dietitian at preoperative and postoperative visits. The supplementation dose was prescribed at 3000 IU/day after SG.
Results
In VDS group, blood 25-hydroxyvitamin D (25OHD) level increased significantly from 18.5 at baseline to 29.7 ng/mL at 3 months after surgery and plateaued, while 25OHD level remained low in the control group. In the analysis that included both groups, change in 25OHD level from baseline to 12 months after surgery correlated significantly with mean vitamin D intake (r = 0.596, p < 0.001) and 12-month post-SG/baseline ratio of percent lower limb skeletal muscle mass (r = 0.469, p < 0.05). Multiple regression analysis identified change in 25OHD level and mean exercise time as significant factors independently associated with 12-month post-SG/baseline ratio of percent lower limb skeletal muscle mass.
Conclusion
Vitamin D3 supplementation after SG is useful for improving vitamin D status that may be associated with prevention of postoperative lower limb skeletal muscle mass loss.
{"title":"Effects of native vitamin D supplementation on vitamin D status and body composition after sleeve gastrectomy: A retrospective study in Japanese patients","authors":"","doi":"10.1016/j.obpill.2024.100134","DOIUrl":"10.1016/j.obpill.2024.100134","url":null,"abstract":"<div><h3>Introduction</h3><div>The effect of vitamin D status after bariatric surgery on postoperative skeletal muscle condition has not been adequately studied.</div></div><div><h3>Methods</h3><div>Clinical data from 83 patients (median age 44 years, BMI 40.4 kg/m<sup>2</sup>) who underwent sleeve gastrectomy (SG) were collected from medical records and analyzed retrospectively. Of the 83 patients, 37 who received continuous guidance on native vitamin D3 supplementation from before to 12 months after surgery were defined as the vitamin D supplementation (VDS) group, and 46 patients who did not receive such guidance as the control group. Native vitamin D3 supplement was provided by a dietitian at preoperative and postoperative visits. The supplementation dose was prescribed at 3000 IU/day after SG.</div></div><div><h3>Results</h3><div>In VDS group, blood 25-hydroxyvitamin D (25OHD) level increased significantly from 18.5 at baseline to 29.7 ng/mL at 3 months after surgery and plateaued, while 25OHD level remained low in the control group. In the analysis that included both groups, change in 25OHD level from baseline to 12 months after surgery correlated significantly with mean vitamin D intake (r = 0.596, p < 0.001) and 12-month post-SG/baseline ratio of percent lower limb skeletal muscle mass (r = 0.469, p < 0.05). Multiple regression analysis identified change in 25OHD level and mean exercise time as significant factors independently associated with 12-month post-SG/baseline ratio of percent lower limb skeletal muscle mass.</div></div><div><h3>Conclusion</h3><div>Vitamin D3 supplementation after SG is useful for improving vitamin D status that may be associated with prevention of postoperative lower limb skeletal muscle mass loss.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-10DOI: 10.1016/j.obpill.2024.100128
Background
Early identification of children at high risk of obesity can provide clinicians with the information needed to provide targeted lifestyle counseling to high-risk children at a critical time to change the disease course.
Objectives
This study aimed to develop predictive models of childhood obesity, applying advanced machine learning methods to a large unaugmented electronic health record (EHR) dataset. This work improves on other studies that have (i) relied on data not routinely available in EHRs (like prenatal data), (ii) focused on single-age predictions, or (iii) not been rigorously validated.
Methods
A customized sequential deep-learning model to predict the development of obesity was built, using EHR data from 36,191 diverse children aged 0–10 years. The model was evaluated using extensive discrimination, calibration, and utility analysis; and was validated temporally, geographically, and across various subgroups.
Results
Our results are mostly better or comparable to similar studies. Specifically, the model achieved an AUROC above 0.8 in all cases (with most cases around 0.9) for predicting obesity within the next 3 years for children 2–7 years of age. Validation results show the model's robustness and top predictors match important risk factors of obesity.
Conclusions
Our model can predict the risk of obesity for young children at multiple time points using only routinely collected EHR data, greatly facilitating its integration into clinical care. Our model can be used as an objective screening tool to provide clinicians with insights into a patient's risk for developing obesity so that early lifestyle counseling can be provided to prevent future obesity in young children.
{"title":"Reliable prediction of childhood obesity using only routinely collected EHRs may be possible","authors":"","doi":"10.1016/j.obpill.2024.100128","DOIUrl":"10.1016/j.obpill.2024.100128","url":null,"abstract":"<div><h3>Background</h3><p>Early identification of children at high risk of obesity can provide clinicians with the information needed to provide targeted lifestyle counseling to high-risk children at a critical time to change the disease course.</p></div><div><h3>Objectives</h3><p>This study aimed to develop predictive models of childhood obesity, applying advanced machine learning methods to a large unaugmented electronic health record (EHR) dataset. This work improves on other studies that have (i) relied on data not routinely available in EHRs (like prenatal data), (ii) focused on single-age predictions, or (iii) not been rigorously validated.</p></div><div><h3>Methods</h3><p>A customized sequential deep-learning model to predict the development of obesity was built, using EHR data from 36,191 diverse children aged 0–10 years. The model was evaluated using extensive discrimination, calibration, and utility analysis; and was validated temporally, geographically, and across various subgroups.</p></div><div><h3>Results</h3><p>Our results are mostly better or comparable to similar studies. Specifically, the model achieved an AUROC above 0.8 in all cases (with most cases around 0.9) for predicting obesity within the next 3 years for children 2–7 years of age. Validation results show the model's robustness and top predictors match important risk factors of obesity.</p></div><div><h3>Conclusions</h3><p>Our model can predict the risk of obesity for young children at multiple time points using only routinely collected EHR data, greatly facilitating its integration into clinical care. Our model can be used as an objective screening tool to provide clinicians with insights into a patient's risk for developing obesity so that early lifestyle counseling can be provided to prevent future obesity in young children.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667368124000305/pdfft?md5=1368ef77392745b12ee332e54b45f231&pid=1-s2.0-S2667368124000305-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-04DOI: 10.1016/j.obpill.2024.100132
Background
The prevalence of obesity among the general US adults is 42 %. With increasing immigrant population in the US, the obesity burden among immigrants in the US has been reported to approach or exceed that of the general US population. To our knowledge, this is the first study to report obesity treatment among immigrants in the US. The study aims to evaluate the effectiveness of obesity treatment among immigrant women in primary care at a safety-net academic health center in the US.
Methods
This was a retrospectively, electronic medical record chart review of patients who had virtual weight management visits in a primary care setting. Self-reported anthropometric and demographic data were used. Primary outcomes were changes in weight and BMI from initial to follow-up visits as well as bodyweight percentage change from initial weight. Secondary outcomes were ≥5 % and ≥10 % weight reduction. Chi-square or Fisher's exact tests were used for independent categorical variables. Paired t-tests were performed to evaluate the changes in weight and BMI.
Results
The study found average weight reduction of 8.6 kg (100.2–91.6, p < 0.01) which corresponds to an average of 8.7 % weight reduction among immigrant women in the program. The overall average BMI decreased by 3.4 kg/m2 (38.1–34.1, p < 0.01). In the study, 85 % lost 5 % or more, and 42 % lost 10 % or more of their initial weight.
Conclusion
Immigrant women followed for weight management in primary care lost significant weight and BMI, and significant proportion of them achieved clinically meaningful weight reduction. Future large sample size and randomized controlled studies are needed to confirm the findings.
{"title":"Effective medical treatment of obesity among immigrant women in primary care","authors":"","doi":"10.1016/j.obpill.2024.100132","DOIUrl":"10.1016/j.obpill.2024.100132","url":null,"abstract":"<div><h3>Background</h3><p>The prevalence of obesity among the general US adults is 42 %. With increasing immigrant population in the US, the obesity burden among immigrants in the US has been reported to approach or exceed that of the general US population. To our knowledge, this is the first study to report obesity treatment among immigrants in the US. The study aims to evaluate the effectiveness of obesity treatment among immigrant women in primary care at a safety-net academic health center in the US.</p></div><div><h3>Methods</h3><p>This was a retrospectively, electronic medical record chart review of patients who had virtual weight management visits in a primary care setting. Self-reported anthropometric and demographic data were used. Primary outcomes were changes in weight and BMI from initial to follow-up visits as well as bodyweight percentage change from initial weight. Secondary outcomes were ≥5 % and ≥10 % weight reduction. Chi-square or Fisher's exact tests were used for independent categorical variables. Paired t-tests were performed to evaluate the changes in weight and BMI.</p></div><div><h3>Results</h3><p>The study found average weight reduction of 8.6 kg (100.2–91.6, <em>p</em> < 0.01) which corresponds to an average of 8.7 % weight reduction among immigrant women in the program. The overall average BMI decreased by 3.4 kg/m<sup>2</sup> (38.1–34.1, <em>p</em> < 0.01). In the study, 85 % lost 5 % or more, and 42 % lost 10 % or more of their initial weight.</p></div><div><h3>Conclusion</h3><p>Immigrant women followed for weight management in primary care lost significant weight and BMI, and significant proportion of them achieved clinically meaningful weight reduction. Future large sample size and randomized controlled studies are needed to confirm the findings.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667368124000342/pdfft?md5=e95481bc7042886e6dc9b24a19cb93e2&pid=1-s2.0-S2667368124000342-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142163196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.obpill.2024.100116
{"title":"Corrigendum to “Outcomes of concomitant antiobesity medication use with endoscopic sleeve gastroplasty in clinical US settings” [Obes. Pillars, Volume 11, September 2024, 100112]","authors":"","doi":"10.1016/j.obpill.2024.100116","DOIUrl":"10.1016/j.obpill.2024.100116","url":null,"abstract":"","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667368124000184/pdfft?md5=d0eca7d4da1bc455fa3602e0eec476bb&pid=1-s2.0-S2667368124000184-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142098365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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