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Prevalence of obesity according to body mass index, waist circumference, and waist-to-height ratio in Peru: A systematic review and meta-analysis
Pub Date : 2025-02-08 DOI: 10.1016/j.obpill.2025.100166
Luisa Erika Milagros Vásquez-Romero , Fiorella E. Zuzunaga-Montoya , Joan A. Loayza-Castro , Enrique Vigil-Ventura , Willy Ramos , Víctor Juan Vera-Ponce

Introduction

Obesity is a global public health epidemic with significant health implications. However, studies on the prevalence of obesity in Peru have yielded varied results, highlighting the need for updated data to inform effective public health policies.

Objective

The primary objective of this study is to determine the prevalence of obesity in Peru using three anthropometric measures: body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR).

Methods

Between March and April 2024, a systematic review of published studies reporting the prevalence of obesity in Peru was conducted. The databases Scopus, Web of Science, Embase, PubMed, LILACS, and Scielo were Searched.

Results

Overall, the prevalence of obesity was 23.23 %, 38.90 %, and 81.53 % according to BMI, WC, and WHtR, respectively. However, these figures show wide variability, ranging from 13.10 % to 37.4 % according to BMI and from 19.4 % to 51.6 % according to WC. The highest reported prevalence of obesity by WHtR was 85.4 %. Nonetheless, only a fraction of these studies were published in the last five years, and few specifically focused on obesity as the primary objective.

Conclusions

The prevalence of obesity in Peru varies significantly depending on the anthropometric measure used. To improve the collection and frequency of data on obesity in Peru, it is recommended that cut-off points be standardized to be suitable for the country and that annual national surveys specifically designed for this purpose be implemented.
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引用次数: 0
Leveraging diagnosis and biometric data from the All of Us Research Program to uncover disparities in obesity diagnosis
Pub Date : 2025-02-07 DOI: 10.1016/j.obpill.2025.100165
Alina Arseniev-Koehler , Ming Tai-Seale , Crystal W. Cené , Eduardo Grunvald , Amy Sitapati

Background

Despite extensive efforts to standardize definitions of obesity, clinical practices of diagnosing obesity vary widely. This study examined (1) discrepancies between biometric body mass index (BMI) measures of obesity and documented diagnoses of obesity in patient electronic health records (EHRs) and (2) how these discrepancies vary by patient gender and race and ethnicity from an intersectional lens.

Methods

Observational study of 383,380 participants in the National Institutes of Health All of Us Research Program dataset.

Results

Over half (60 %) of participants with a BMI indicating obesity had no clinical diagnosis of obesity in their EHRs. Adjusting for BMI, comorbidities, and other covariates, women's adjusted odds of diagnosis were far higher than men's (95 % confidence interval 1.66–1.75). However, the gender gap between women's and men's likelihood of diagnosis varied widely across racial groups. Overall, Non-Hispanic (NH) Black women and Hispanic women were the most likely to be diagnosed and NH-Asian men were the least likely to be diagnosed.

Conclusion

Men, and particularly NH-Asian men, may be at heightened risk of underdiagnosis of obesity. Women, and especially Hispanic and NH-Black women, may be at heightened risk of unanticipated harms of obesity diagnosis, including stigma and competing demand with other health concerns. Leveraging diagnosis and biometric data from this unique public domain dataset from the All of Us project, this study revealed pervasive disparities in diagnostic attribution by gender, race, and ethnicity.
{"title":"Leveraging diagnosis and biometric data from the All of Us Research Program to uncover disparities in obesity diagnosis","authors":"Alina Arseniev-Koehler ,&nbsp;Ming Tai-Seale ,&nbsp;Crystal W. Cené ,&nbsp;Eduardo Grunvald ,&nbsp;Amy Sitapati","doi":"10.1016/j.obpill.2025.100165","DOIUrl":"10.1016/j.obpill.2025.100165","url":null,"abstract":"<div><h3>Background</h3><div>Despite extensive efforts to standardize definitions of obesity, clinical practices of diagnosing obesity vary widely. This study examined (1) discrepancies between biometric body mass index (BMI) measures of obesity and documented diagnoses of obesity in patient electronic health records (EHRs) and (2) how these discrepancies vary by patient gender and race and ethnicity from an intersectional lens.</div></div><div><h3>Methods</h3><div>Observational study of 383,380 participants in the National Institutes of Health <em>All of Us</em> Research Program dataset.</div></div><div><h3>Results</h3><div>Over half (60 %) of participants with a BMI indicating obesity had no clinical diagnosis of obesity in their EHRs. Adjusting for BMI, comorbidities, and other covariates, women's adjusted odds of diagnosis were far higher than men's (95 % confidence interval 1.66–1.75). However, the gender gap between women's and men's likelihood of diagnosis varied widely across racial groups. Overall, Non-Hispanic (NH) Black women and Hispanic women were the most likely to be diagnosed and NH-Asian men were the least likely to be diagnosed.</div></div><div><h3>Conclusion</h3><div>Men, and particularly NH-Asian men, may be at heightened risk of underdiagnosis of obesity. Women, and especially Hispanic and NH-Black women, may be at heightened risk of unanticipated harms of obesity diagnosis, including stigma and competing demand with other health concerns. Leveraging diagnosis and biometric data from this unique public domain dataset from the All of Us project, this study revealed pervasive disparities in diagnostic attribution by gender, race, and ethnicity.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100165"},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419812","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}
引用次数: 0
Weight and cardiometabolic effects of a novel oral shape-shifting superabsorbent hydrogel capsule: Prespecified and exploratory analysis of the Epitomee capsule RESET study
Pub Date : 2025-01-31 DOI: 10.1016/j.obpill.2025.100163
H.E. Bays , J.D. Ard , P.M. O'Neil , T.A. Wadden , R.F. Kushner , J.M. Jakicic , H.R. Wyatt , F.L. Greenway , M. Kamar , E. Ganon-Elazar , L. Cohen Asaraf , D.H. Ryan

Background

Management of obesity potentially improves cardiometabolic risk factors in patients with metabolic syndrome (MetS). The Epitomee capsule is a non-pharmacological, biodegradable device treatment for weight reduction in patients with overweight and obesity.

Methods

This secondary analysis of the Randomized Evaluation of Safety and Efficacy of the Epitomee capsule Trial (RESET) (a randomized, 24-week, multicenter, placebo-controlled, double-blind trial that enrolled 279 adults aged ≥18 years with a BMI of 27–40 kg/m2) evaluated changes in cardiometabolic parameters in participants treated with Epitomee or placebo combined with lifestyle counseling among (a) the entire RESET study population, and (b) participants meeting diagnostic criteria for prediabetes. Predefined and exploratory endpoints included changes in waist circumference, glycemic parameters, blood pressure, and lipid blood levels; this analysis also assessed percent weight loss in participants with MetS.

Results

Waist circumference, systolic and diastolic blood pressure and some measures of glycemia and lipids, improved with both Epitomee and placebo with no significant differences. Participants with prediabetes treated with Epitomee showed significantly greater reductions in HOMA-IR (p < 0.007) and insulin levels (p < 0.003) than the placebo group. Participants with MetS at baseline experienced significantly greater percent change in initial weight when treated with the Epitomee capsule (n = 27) compared to placebo (n = 31), −8.3% vs −5.2 %, respectively (p < 0.0004). Similar percentages of participants with MetS in both groups achieved ≥5 % weight reduction (59.3 % and 54.8 %, in Epitomee and placebo groups respectively). Significantly more participants with MetS treated with Epitomee achieved ≥10 % weight reduction compared with those treated with placebo (40.7 % vs. 6.5 %, respectively, p < 0.002).

Conclusion

Treatment with either Epitomee and placebo combined with lifestyle improve cardiometabolic risk factors. Compared to placebo, Epitomee significantly reduced HOMA-IR and insulin levels in participants with prediabetes. Among participants with MetS, Epitomee significantly reduced body weight [ClinicalTrials.gov ID NCT04222322].
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引用次数: 0
Comparative efficacy and safety of GLP-1 receptor agonists for weight reduction: A model-based meta-analysis of placebo-controlled trials
Pub Date : 2025-01-30 DOI: 10.1016/j.obpill.2025.100162
Haoyang Guo , Juan Yang , Jihan Huang , Ling Xu , Yinghua Lv , Yexuan Wang , Jiyuan Ren , Yulin Feng , Qingshan Zheng , Lujin Li

Aim

Obesity is a global epidemic. The FDA has approved glucagon-like peptide-1 (GLP-1) receptor agonists such as Liraglutide, Semaglutide, and the GLP-1/gastric inhibitory polypeptide (GIP) dual agonist Tirzepatide for the treatment of obesity. Clinical trials of GLP-1/GIP/glucagon(GCG) triple agonists are ongoing. This study compared the efficacy and safety profiles of different GLP-1 receptor agonists (GLP-1RAs) for weight reduction and explored the related influencing factors, providing quantitative information for the development of GLP-1RAs and their clinical use.

Methods

This systematic review of public databases included placebo-controlled randomized clinical trials of GLP-1RAs. Time-course, dose-response, and covariate models were used to describe the efficacy characteristics and influencing factors of different GLP-1RAs. Subgroup analyses were performed to explore efficacy differences in receptor specificity. Meta-analyses compared the incidence of adverse event and dropout rates among different GLP-1RAs.

Results

Fifty-five studies involving 16,269 participants and 12 GLP-1RAs were included. Six drugs showed significant dose-response relationships. The maximum weight reduction effect ranged from 4.25 kg (Liraglutide) to 22.6 kg (Retatrutide). Reported onset times ranged from 6.4 weeks (Orforglipron) to 19.5 weeks (Tirzepatide). At 52 weeks, weight reduction effects were 7.03 kg, 11.07 kg, and 24.15 kg for mono-agonists, dual-agonists, and tri-agonists, respectively. There was a significant negative correlation in the exponential pattern between age and weight reduction effect, whereas baseline weight and BMI had no significant impact. Common adverse events of GLP-1RAs, reported in the literature include nausea, vomiting, diarrhea, and constipation, with a significantly higher incidence of nausea than that of placebo.

Conclusions

This study provides a quantitative evaluation of the efficacy and safety of GLP-1RAs and offers valuable insights into the assessment of new drugs for weight reduction.
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引用次数: 0
Electronic health records tools for treating obesity among adult patients in primary care: A scoping review
Pub Date : 2025-01-19 DOI: 10.1016/j.obpill.2025.100161
Jyotsna Ghosh , Kimberly A. Gudzune , Jessica L. Schwartz

Background

Electronic health record (EHR)-based tools, such as clinical decision support systems (CDSS), support practitioners to promote evidence-based care, which may include obesity treatment. Our objective was to identify obesity-focused CDSS for adult patients in primary care settings to describe their designs, associated primary care practitioner (PCP) training, and outcomes among PCPs and patients.

Methods

We conducted a scoping review to identify and map available evidence using a search strategy for citations in MEDLINE from February 2009 to June 2024. We extracted information from included studies that described EHR-based CDSS tools designed to support obesity care (e.g., clinical decision support, counseling) for adult patients in primary care settings. We mapped common tool features to support weight management and synthesized key lessons learned during implementation of these tools.

Results

Of the 445 citations identified in our search, we included 13 citations reporting on 8 studies. The most common features across EHR-based CDSS tools were 1) identifying overweight or obesity using BMI (88 %) and 2) suggesting treatment strategies (88 %), particularly lifestyle modifications. Most studies provided limited information on the training PCPs received. Few PCPs used the CDSS with eligible patients (<20 %), describing these tools as cumbersome and lacking clinical workflow integration. Novel approaches included using CDSS during weight management-dedicated visits or for referral to obesity medicine physicians, which both showed promising early results of patients achieving weight reduction.

Conclusion

There is a growing body of evidence for obesity-focused CDSS among adult patients in the primary care setting. Our review identified three key lessons that may inform future health system implementation: 1) EHR-based CDSS tools need to be easy to use and integrate with clinical workflows; 2) PCPs need training on these tools for obesity treatment; and 3) Primary care workflow or work-scope may need to be modified to address obesity.
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引用次数: 0
Clinical considerations in the management of obesity in children and adolescents
Pub Date : 2025-01-16 DOI: 10.1016/j.obpill.2025.100160
Whitney Herring , Carina Kugelmas , Evan P. Nadler , Marsha Novick , Melissa Santos , Rachana Shah , Gitanjali Srivastava , Stephanie Walsh

Background

Obesity is a complex, chronic disease affecting more than one-fifth of adolescent children aged 12–19 years in the United States. Recent guidelines have recommended optimization of diagnosis and treatment approaches to help improve the immediate and long-term health of people with obesity.

Methods

Here, we describe the insights and recommendations of 9 nationally recognized experts in pediatric obesity, summarized from a virtual advisory board discussion.

Results

Advisors described their background, experiences, and patient populations, conveyed the journey experienced by many pediatric patients with obesity, discussed the recent landscape for pharmacotherapy in adolescents, and provided their perspectives on updated American Academy of Pediatrics Clinical Practice Guidelines.

Conclusion

Overall, the advisors agreed that the key to addressing the growing prevalence of obesity in children and adolescents depends on increased education in the medical field and community-wide initiatives to promote early intervention. Collaboration among all parties (e.g., physicians, policymakers, insurance companies, academic institutions, and researchers) to address barriers to treatment and reduce the social stigma surrounding obesity is also essential.
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引用次数: 0
The relationship between timing of screening for gestational diabetes mellitus and maternal and fetal outcomes: A retrospective cohort study linking primary care electronic and hospital administrative data
Pub Date : 2025-01-11 DOI: 10.1016/j.obpill.2025.100159
Helena Piccinini-Vallis , Mathew Grandy , Lynn Bussey , Jillian Coolen , Sarah Sabri

Background

Gestational diabetes (GDM) is associated with adverse outcomes including a large-for-gestational age (LGA) baby, which in turn is associated with downstream childhood obesity. Appropriate timing of GDM screening is important for prompt initiation and optimization of medical management, potentially mitigating the risk of those outcomes. The present study explored the association between the timing of GDM screening and macrosomia, LGA, shoulder dystocia and caesarean section.

Methods

This retrospective cohort study linked primary care prenatal data and intrapartum data from a provincial hospital administrative database. Women with singleton pregnancies who received prenatal care between July 1, 2019 and December 31, 2022 and who also delivered within that timeframe were included in the study.

Results

198 participants were linked between the databases. Among participants for whom GDM risk could be calculated (n = 180), 30.6 % had late GDM screening. Unadjusted logistic regression models showed that late screening for GDM was associated with higher likelihood of LGA (OR = 2.89; 95 % CI = 1.19–7.04; p = 00.019). Adjusted models showed that the best predictor of macrosomia, LGA, and shoulder dystocia was excess gestational weight gain (GWG) (OR = 3.26, CI = 1.17–9.10, p = 0.024; OR 3.00, 95 % CI 0.91–9.93, p = 00.072; and OR = 3.52, CI = 0.83–14.84, p = 00.087 respectively); the best predictor of caesarean section was pre-pregnancy BMI (OR = 2.86; CI = 1.12 = 7.27; p = 0.028).

Conclusions

Almost one-third of participants had screening later than recommended, and late screening for GDM was associated with a higher likelihood of LGA. Linking longitudinal prenatal primary care data to hospital administrative data creates opportunities for future studies pertaining to prenatal care, potentially resulting in improvements in the care provided to vulnerable populations experiencing disproportionate rates of pre-pregnancy obesity and excess GWG.
{"title":"The relationship between timing of screening for gestational diabetes mellitus and maternal and fetal outcomes: A retrospective cohort study linking primary care electronic and hospital administrative data","authors":"Helena Piccinini-Vallis ,&nbsp;Mathew Grandy ,&nbsp;Lynn Bussey ,&nbsp;Jillian Coolen ,&nbsp;Sarah Sabri","doi":"10.1016/j.obpill.2025.100159","DOIUrl":"10.1016/j.obpill.2025.100159","url":null,"abstract":"<div><h3>Background</h3><div>Gestational diabetes (GDM) is associated with adverse outcomes including a large-for-gestational age (LGA) baby, which in turn is associated with downstream childhood obesity. Appropriate timing of GDM screening is important for prompt initiation and optimization of medical management, potentially mitigating the risk of those outcomes. The present study explored the association between the timing of GDM screening and macrosomia, LGA, shoulder dystocia and caesarean section.</div></div><div><h3>Methods</h3><div>This retrospective cohort study linked primary care prenatal data and intrapartum data from a provincial hospital administrative database. Women with singleton pregnancies who received prenatal care between July 1, 2019 and December 31, 2022 and who also delivered within that timeframe were included in the study.</div></div><div><h3>Results</h3><div>198 participants were linked between the databases. Among participants for whom GDM risk could be calculated (n = 180), 30.6 % had late GDM screening. Unadjusted logistic regression models showed that late screening for GDM was associated with higher likelihood of LGA (OR = 2.89; 95 % CI = 1.19–7.04; p = 00.019). Adjusted models showed that the best predictor of macrosomia, LGA, and shoulder dystocia was excess gestational weight gain (GWG) (OR = 3.26, CI = 1.17–9.10, p = 0.024; OR 3.00, 95 % CI 0.91–9.93, p = 00.072; and OR = 3.52, CI = 0.83–14.84, p = 00.087 respectively); the best predictor of caesarean section was pre-pregnancy BMI (OR = 2.86; CI = 1.12 = 7.27; p = 0.028).</div></div><div><h3>Conclusions</h3><div>Almost one-third of participants had screening later than recommended, and late screening for GDM was associated with a higher likelihood of LGA. Linking longitudinal prenatal primary care data to hospital administrative data creates opportunities for future studies pertaining to prenatal care, potentially resulting in improvements in the care provided to vulnerable populations experiencing disproportionate rates of pre-pregnancy obesity and excess GWG.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100159"},"PeriodicalIF":0.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081877","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}
引用次数: 0
Cardiovascular outcomes in metabolically healthy Asian-American population with obesity (18–44 years): Insights from the National Inpatient Sample
Pub Date : 2025-01-10 DOI: 10.1016/j.obpill.2025.100158
Rupak Desai , Avilash Mondal , Boney Lapsiwala , Venkata Balaji Chenna , Pratik Rajpopat , Vaidehi Mendpara , Athri Kodali , Amritha R. Nair , Ayodya Perera , Subramanian Gnanaguruparan

Objective

Obesity, often associated with cardiometabolic risk factors such as hypertension, diabetes, and hyperlipidemia, is a predictor of major adverse cardiac and cerebrovascular events (MACCE) in hospitalized patients. However, in-hospital outcomes among young, metabolically healthy (MHO) Asians with obesity have not been explored.

Methods

This was a retrospective cohort study that utilized 2019 National Inpatient Sample (NIS) database to identify hospitalizations of metabolically healthy young (18–44 years) Asian-Americans/Pacific Islanders (AA/API). Demographically matched cohorts of metabolically healthy Asians with obesity (MHO+) and Asians without obesity (MHO-) patients were compared for comorbidities and in-hospital outcomes using 1:1 propensity matching. Multivariable logistic regression analysis was conducted to identify predictors of MACCE in the MHO+ group.

Results

Among 327,065 young AA/API hospitalizations, 7.8 % (n=25,470) were obese. Of which, 14315 were metabolically healthy after excluding encounters with concomitant cardiometabolic risk factors. Matched cohorts (MHO+ and MHO-, N = 14,200, median age 32 years, >84 % female) showed that the MHO + group had higher rates of depression, anxiety, tobacco use disorder, chronic pulmonary disease, and hypothyroidism, while the MHO- group had higher cancer and cannabis use disorder rates. The odds of MACCE (aOR 0.98, 95%CI 0.70–1.37, p = 0.886), and the odds of all-cause mortality (aOR 1.26, 95CI% 0.4–3.99, p = 0.690) were not of statistical significance. Males (aOR 10.18, 95%Cl 3.39–30.53), drug users (aOR 2.87, 95%Cl 1.05–7.86), cancer patients (aOR 9.70, 95%Cl 2.14–44.01), and those with congenital circulatory anomalies (aOR 21.77, 95%Cl 4.07–116.60) had significantly higher odds of MACCE. Depression (aOR 3.09, 95%Cl 0.86–11.08), elective admission (aOR 3.71, 95%Cl 0.74–18.58), and tobacco use (aOR 0.81, 95%Cl 0.26–2.60) were not statistically significant predictors.

Conclusion

Asian Americans males, drug users and cancer patients face elevated cardiovascular risk despite having a lower BMI, while overall odds of in-hospital cardiovascular event rates were not statistically significant compared to metabolically healthy cohorts with obesity.
{"title":"Cardiovascular outcomes in metabolically healthy Asian-American population with obesity (18–44 years): Insights from the National Inpatient Sample","authors":"Rupak Desai ,&nbsp;Avilash Mondal ,&nbsp;Boney Lapsiwala ,&nbsp;Venkata Balaji Chenna ,&nbsp;Pratik Rajpopat ,&nbsp;Vaidehi Mendpara ,&nbsp;Athri Kodali ,&nbsp;Amritha R. Nair ,&nbsp;Ayodya Perera ,&nbsp;Subramanian Gnanaguruparan","doi":"10.1016/j.obpill.2025.100158","DOIUrl":"10.1016/j.obpill.2025.100158","url":null,"abstract":"<div><h3>Objective</h3><div>Obesity, often associated with cardiometabolic risk factors such as hypertension, diabetes, and hyperlipidemia, is a predictor of major adverse cardiac and cerebrovascular events (MACCE) in hospitalized patients. However, in-hospital outcomes among young, metabolically healthy (MHO) Asians with obesity have not been explored.</div></div><div><h3>Methods</h3><div>This was a retrospective cohort study that utilized 2019 National Inpatient Sample (NIS) database to identify hospitalizations of metabolically healthy young (18–44 years) Asian-Americans/Pacific Islanders (AA/API). Demographically matched cohorts of metabolically healthy Asians with obesity (MHO+) and Asians without obesity (MHO-) patients were compared for comorbidities and in-hospital outcomes using 1:1 propensity matching. Multivariable logistic regression analysis was conducted to identify predictors of MACCE in the MHO+ group.</div></div><div><h3>Results</h3><div>Among 327,065 young AA/API hospitalizations, 7.8 % (n=25,470) were obese. Of which, 14315 were metabolically healthy after excluding encounters with concomitant cardiometabolic risk factors. Matched cohorts (MHO+ and MHO-, N = 14,200, median age 32 years, &gt;84 % female) showed that the MHO + group had higher rates of depression, anxiety, tobacco use disorder, chronic pulmonary disease, and hypothyroidism, while the MHO- group had higher cancer and cannabis use disorder rates. The odds of MACCE (aOR 0.98, 95%CI 0.70–1.37, p = 0.886), and the odds of all-cause mortality (aOR 1.26, 95CI% 0.4–3.99, p = 0.690) were not of statistical significance. Males (aOR 10.18, 95%Cl 3.39–30.53), drug users (aOR 2.87, 95%Cl 1.05–7.86), cancer patients (aOR 9.70, 95%Cl 2.14–44.01), and those with congenital circulatory anomalies (aOR 21.77, 95%Cl 4.07–116.60) had significantly higher odds of MACCE. Depression (aOR 3.09, 95%Cl 0.86–11.08), elective admission (aOR 3.71, 95%Cl 0.74–18.58), and tobacco use (aOR 0.81, 95%Cl 0.26–2.60) were not statistically significant predictors.</div></div><div><h3>Conclusion</h3><div>Asian Americans males, drug users and cancer patients face elevated cardiovascular risk despite having a lower BMI, while overall odds of in-hospital cardiovascular event rates were not statistically significant compared to metabolically healthy cohorts with obesity.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100158"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153363","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}
引用次数: 0
Comparing clinical practice habits among obesity medicine physicians by patient, physician and clinic factors
Pub Date : 2025-01-07 DOI: 10.1016/j.obpill.2025.100157
Selvi Rajagopal , Edmond P. Wickham III , Tirissa J. Reid , Dana R. Brittan , Judith Korner , Kimberly A. Gudzune

Background

While clinical practice habits vary by patient, physician and clinic factors in primary care, limited research has examined whether differences exist in obesity medicine. Our objective was to compare practice habits by such factors among obesity medicine physicians certified by the American Board of Obesity Medicine (ABOM).

Methods

We conducted secondary analyses of cross-sectional data from the 2023 ABOM Practice Analysis Validation Survey. We included three obesity medicine practice habits – prescribing anti-obesity medications (AOMs), off-label prescribing of medications for weight reduction, and obesity medicine clinical practice hours (4–20 h/week versus >20 h/week). We included patient (patient population), physician (primary medical specialty, years of obesity medicine experience) and clinic factors (practice setting, geographic catchment, accepts insurance for obesity care). We conducted bivariate analyses using Χ2 tests.

Results

Among 565 ABOM-certified physicians, 71.5 % had primary medical specialties within primary care and 9.2 % predominantly treated children/adolescents with obesity. Overall, 97.5 % prescribed AOMs and 85.1 % prescribed off-label medications for weight reduction. Fewer physicians who predominantly treated children/adolescents prescribed AOMs compared to physicians with no or limited treatment of children (88.5 % versus 98.4 % and 98.5 %, respectively; p < 0.001). Overall, 41.4 % reported practicing obesity medicine >20 h/week, which was more likely to occur as years of obesity medicine experience increased (i.e., 21.9 ​% among physicians with 1–2 years of experience versus 58.5 ​% with 10+ years; p ​< ​0.001). No significant differences in practice habits occurred by primary medical specialty, practice setting, geographic catchment, or accepting insurance.

Conclusion

Our findings may suggest that ABOM-certified physicians have consistent obesity medication prescribing practices regardless of physician or clinic factors, which may be particularly important to patients seeking pharmacologic treatment. Most ABOM-certified physicians who predominantly treat children/adolescents prescribe obesity medications. These current rates are relatively higher than prior findings among pediatric ABOM-certified physicians, which might help support pharmacologic access for pediatric patients.
{"title":"Comparing clinical practice habits among obesity medicine physicians by patient, physician and clinic factors","authors":"Selvi Rajagopal ,&nbsp;Edmond P. Wickham III ,&nbsp;Tirissa J. Reid ,&nbsp;Dana R. Brittan ,&nbsp;Judith Korner ,&nbsp;Kimberly A. Gudzune","doi":"10.1016/j.obpill.2025.100157","DOIUrl":"10.1016/j.obpill.2025.100157","url":null,"abstract":"<div><h3>Background</h3><div>While clinical practice habits vary by patient, physician and clinic factors in primary care, limited research has examined whether differences exist in obesity medicine. Our objective was to compare practice habits by such factors among obesity medicine physicians certified by the American Board of Obesity Medicine (ABOM).</div></div><div><h3>Methods</h3><div>We conducted secondary analyses of cross-sectional data from the 2023 ABOM Practice Analysis Validation Survey. We included three obesity medicine practice habits – prescribing anti-obesity medications (AOMs), off-label prescribing of medications for weight reduction, and obesity medicine clinical practice hours (4–20 h/week versus &gt;20 h/week). We included patient (patient population), physician (primary medical specialty, years of obesity medicine experience) and clinic factors (practice setting, geographic catchment, accepts insurance for obesity care). We conducted bivariate analyses using Χ<sup>2</sup> tests.</div></div><div><h3>Results</h3><div>Among 565 ABOM-certified physicians, 71.5 % had primary medical specialties within primary care and 9.2 % predominantly treated children/adolescents with obesity. Overall, 97.5 % prescribed AOMs and 85.1 % prescribed off-label medications for weight reduction. Fewer physicians who predominantly treated children/adolescents prescribed AOMs compared to physicians with no or limited treatment of children (88.5 % versus 98.4 % and 98.5 %, respectively; p &lt; 0.001). Overall, 41.4 % reported practicing obesity medicine &gt;20 h/week, which was more likely to occur as years of obesity medicine experience increased (i.e., 21.9 ​% among physicians with 1–2 years of experience versus 58.5 ​% with 10+ years; p ​&lt; ​0.001). No significant differences in practice habits occurred by primary medical specialty, practice setting, geographic catchment, or accepting insurance.</div></div><div><h3>Conclusion</h3><div>Our findings may suggest that ABOM-certified physicians have consistent obesity medication prescribing practices regardless of physician or clinic factors, which may be particularly important to patients seeking pharmacologic treatment. Most ABOM-certified physicians who predominantly treat children/adolescents prescribe obesity medications. These current rates are relatively higher than prior findings among pediatric ABOM-certified physicians, which might help support pharmacologic access for pediatric patients.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100157"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152679","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}
引用次数: 0
Beyond BMI: Exploring obesity trends in the south Asian region 超越BMI:探索南亚地区的肥胖趋势。
Pub Date : 2024-12-11 DOI: 10.1016/j.obpill.2024.100156
Musarrat Riaz , Sidrah Lodhi

Background

Obesity is a global health challenge affecting individuals across all demographics. In South Asia, the traditional method of assessing obesity using Body Mass Index (BMI), may not account for factors such as fat distribution, muscle mass, or ethnic variations.

Objective

This narrative review explores the multifaceted nature of obesity in South Asia, focusing on the region's demographic profiles and the socio-cultural and economic determinants shaping obesity trends. Additionally, the review critiques the limitations of BMI as an accurate measure of obesity in this diverse population.

Methods

A comprehensive literature search was conducted to identify studies that address obesity trends in South Asia, with a focus on regional variations, influencing factors, and the limitations of BMI.

Results

The review identifies significant variations in obesity prevalence across South Asian countries, influenced by cultural norms, economic disparities, and urbanization. The limitations of BMI as a tool for assessing obesity are highlighted, particularly in its inability to capture fat distribution and muscle mass variations specific to South Asian populations.

Conclusions

Obesity in South Asia is shaped by complex demographic, cultural, and economic factors. While BMI is commonly used, it is insufficient for accurately assessing obesity in this population. More refined, context-specific measures are needed to better understand and address the growing obesity epidemic in South Asia.
背景:肥胖是影响所有人群的全球性健康挑战。在南亚,使用身体质量指数(BMI)评估肥胖的传统方法可能无法考虑脂肪分布、肌肉质量或种族差异等因素。目的:这篇叙述性综述探讨了南亚肥胖的多面性,重点关注该地区的人口概况以及形成肥胖趋势的社会文化和经济决定因素。此外,该综述还批评了BMI作为这种不同人群中肥胖的准确测量的局限性。方法:进行全面的文献检索,以确定解决南亚肥胖趋势的研究,重点关注区域差异、影响因素和BMI的局限性。结果:该综述确定了南亚国家肥胖患病率的显著差异,受文化规范、经济差异和城市化的影响。强调了BMI作为评估肥胖工具的局限性,特别是它无法捕捉南亚人群特有的脂肪分布和肌肉质量变化。结论:南亚的肥胖是由复杂的人口、文化和经济因素决定的。虽然BMI被广泛使用,但它不足以准确评估这一人群的肥胖程度。为了更好地了解和解决南亚日益严重的肥胖流行病,需要采取更精确的、针对具体情况的措施。
{"title":"Beyond BMI: Exploring obesity trends in the south Asian region","authors":"Musarrat Riaz ,&nbsp;Sidrah Lodhi","doi":"10.1016/j.obpill.2024.100156","DOIUrl":"10.1016/j.obpill.2024.100156","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is a global health challenge affecting individuals across all demographics. In South Asia, the traditional method of assessing obesity using Body Mass Index (BMI), may not account for factors such as fat distribution, muscle mass, or ethnic variations.</div></div><div><h3>Objective</h3><div>This narrative review explores the multifaceted nature of obesity in South Asia, focusing on the region's demographic profiles and the socio-cultural and economic determinants shaping obesity trends. Additionally, the review critiques the limitations of BMI as an accurate measure of obesity in this diverse population.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted to identify studies that address obesity trends in South Asia, with a focus on regional variations, influencing factors, and the limitations of BMI.</div></div><div><h3>Results</h3><div>The review identifies significant variations in obesity prevalence across South Asian countries, influenced by cultural norms, economic disparities, and urbanization. The limitations of BMI as a tool for assessing obesity are highlighted, particularly in its inability to capture fat distribution and muscle mass variations specific to South Asian populations.</div></div><div><h3>Conclusions</h3><div>Obesity in South Asia is shaped by complex demographic, cultural, and economic factors. While BMI is commonly used, it is insufficient for accurately assessing obesity in this population. More refined, context-specific measures are needed to better understand and address the growing obesity epidemic in South Asia.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100156"},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985960","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}
引用次数: 0
期刊
Obesity Pillars
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