Pub Date : 2025-03-01Epub Date: 2024-12-05DOI: 10.1016/j.obpill.2024.100155
Jesse Richards , Madisen Fae Dorand , Maria Paszkowiak , Sana Ahmed , Courtney McCorkle , Pranay Kathuria
Background
Kinase D-interacting substrate of 220 kDa (“KIDINS220”) is an integral plasma membrane protein essential to signaling throughout the body; abnormalities are linked to a variety of disorders, including obesity, but have never been directly linked to chronic- or end-stage renal disease.
Methods
Retrospective chart review identified patients with severe obesity who presented for pre-kidney transplant weight management. 20 individuals met criteria for testing for genetic causes of obesity. A χ2 test of independence was utilized to compare genetic mutation rates in this cohort to all individuals tested nationally.
Results
This case series presents a cohort of patients with severe obesity and end-stage renal disease who were subsequently found to have a significantly higher rate of KIDINS220 mutations (20 %, χ2 = 27.8, p < 0.0001) compared to the national positivity rate of all individuals tested for genetic causes of obesity.
Conclusions
Mutations within KIDINS220 may play a modulatory role in the progression of chronic kidney disease in patients with obesity, as evidenced by this small retrospective study. The relationship between KIDINS200, kidney disease, and obesity is complex and requires further study, but may represent a potential therapeutic target in the future.
{"title":"Significantly higher rates of KIDINS220 polymorphisms in patients with obesity and end-stage renal disease","authors":"Jesse Richards , Madisen Fae Dorand , Maria Paszkowiak , Sana Ahmed , Courtney McCorkle , Pranay Kathuria","doi":"10.1016/j.obpill.2024.100155","DOIUrl":"10.1016/j.obpill.2024.100155","url":null,"abstract":"<div><h3>Background</h3><div>Kinase D-interacting substrate of 220 kDa (“KIDINS220”) is an integral plasma membrane protein essential to signaling throughout the body; abnormalities are linked to a variety of disorders, including obesity, but have never been directly linked to chronic- or end-stage renal disease.</div></div><div><h3>Methods</h3><div>Retrospective chart review identified patients with severe obesity who presented for pre-kidney transplant weight management. 20 individuals met criteria for testing for genetic causes of obesity. A χ<sup>2</sup> test of independence was utilized to compare genetic mutation rates in this cohort to all individuals tested nationally.</div></div><div><h3>Results</h3><div>This case series presents a cohort of patients with severe obesity and end-stage renal disease who were subsequently found to have a significantly higher rate of KIDINS220 mutations (20 %, χ<sup>2</sup> = 27.8, <em>p</em> < 0.0001) compared to the national positivity rate of all individuals tested for genetic causes of obesity.</div></div><div><h3>Conclusions</h3><div>Mutations within KIDINS220 may play a modulatory role in the progression of chronic kidney disease in patients with obesity, as evidenced by this small retrospective study. The relationship between KIDINS200, kidney disease, and obesity is complex and requires further study, but may represent a potential therapeutic target in the future.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100155"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974036","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}
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of chronic liver disease worldwide. Although the epidemiology of MASLD and its association with metabolically healthy obesity (MHO) is well-studied in the United States, data for Asian Americans with MHO is limited. We sought to evaluate the association of MASLD in young Asian American patients with MHO.
Methods
This was a retrospective, matched cohort, database review of Asian American Individuals. After excluding adult hospitalizations with metabolic risk factors (hypertension, diabetes, or hyperlipidemia), we identified all National Inpatient Sample (2019) admissions with obesity (MHO) and MASLD using relevant ICD-10-CM codes. We matched (1:1) propensity scores for age, sex, household income, hospital location, and teaching status to obtain cohorts with and without obesity (MHO+) vs. (MHO-). Categorical and continuous data were compared using the Chi-square and Mann-Whitney U tests. The primary endpoint was the prevalence and adjusted multivariable odds/predictors of MASLD in (MHO+) vs. (MHO-) cohort.
Results
In the adjusted multivariate regression for demographics, and comorbidities, the (MHO+) cohort was associated with higher odds of admissions with MASLD (OR 4.07, 95%CI 2.02–8.19, p < 0.001). In addition, among the (MHO+) cohort, higher rates of MASLD-related hospitalizations were observed in males (OR 8.40, p < 0.001), females (OR 2.69, p = 0.025), high-income quartiles (OR 10.51, p < 0.001), no prior bariatric surgery (OR 4.07, p < 0.001), non-tobacco users(OR 4.16, p < 0.001), and non-hypothyroid patients (OR 4.00, p < 0.001) compared to the (MHO-) cohort. There was no statistically significant difference in the groups with low-income quartiles, tobacco use disorder, and hypothyroidism.
Conclusion
This nationwide analysis demonstrates that (MHO+) is associated with a higher prevalence of MASLD. In the (MHO+) cohort, there was an association of MASLD with sex, high-income quartile, no prior bariatric surgery, non-tobacco use, and non-hypothyroidism. Further prospective multicenter studies are needed to evaluate the association of MASLD in (MHO+) patients with comorbid conditions.
背景：代谢功能障碍相关脂肪变性肝病（MASLD）是世界范围内慢性肝病的主要原因。尽管MASLD的流行病学及其与代谢健康型肥胖（MHO）的关系在美国得到了充分的研究，但关于MHO的亚裔美国人的数据有限。我们试图评估年轻亚裔美国人MHO患者与MASLD的关系。方法对亚裔美国人进行回顾性、匹配队列、数据库回顾。在排除了伴有代谢危险因素（高血压、糖尿病或高脂血症）的成人住院患者后，我们使用相关的ICD-10-CM代码确定了所有患有肥胖症（MHO）和MASLD的全国住院患者样本（2019）。我们将年龄、性别、家庭收入、医院位置和教学状况的倾向评分（1:1）进行匹配，以获得有肥胖和没有肥胖的队列（MHO+）和（MHO-）。分类数据和连续数据采用卡方检验和Mann-Whitney U检验进行比较。主要终点是（MHO+）与（MHO-）队列中MASLD的患病率和调整后的多变量赔率/预测因子。结果在人口统计学和合并症的调整多因素回归中，（MHO+）队列与MASLD入院几率较高相关(OR 4.07, 95%CI 2.02-8.19, p <；0.001)。此外，在（MHO+）队列中，男性与masld相关的住院率较高(OR 8.40, p <；0.001)，女性（OR 2.69, p = 0.025），高收入四分位数(OR 10.51, p <；0.001)，既往无减肥手术(OR 4.07, p <；0.001)，非烟草使用者(OR 4.16, p <；0.001)，非甲状腺功能减退患者(OR 4.00, p <；0.001)，与（MHO-）队列相比。在低收入四分位数组、烟草使用障碍组和甲状腺功能减退组中，没有统计学上的显著差异。结论全国范围内的分析表明（MHO+）与MASLD的高患病率相关。在（MHO+）队列中，MASLD与性别、高收入四分位数、既往无减肥手术、非吸烟和非甲状腺功能减退有关。需要进一步的前瞻性多中心研究来评估MASLD在（MHO+）合并合并症患者中的相关性。
{"title":"Prevalence and association of MASLD in metabolically healthy young Asian Americans with obesity: A nationwide inpatient perspective (2019)","authors":"Ahmad Alhomaid , Sukhjinder Chauhan , Yamini Katamreddy , Avideep Sidhu , Praveena Sunkara , Rupak Desai","doi":"10.1016/j.obpill.2025.100168","DOIUrl":"10.1016/j.obpill.2025.100168","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of chronic liver disease worldwide. Although the epidemiology of MASLD and its association with metabolically healthy obesity (MHO) is well-studied in the United States, data for Asian Americans with MHO is limited. We sought to evaluate the association of MASLD in young Asian American patients with MHO.</div></div><div><h3>Methods</h3><div>This was a retrospective, matched cohort, database review of Asian American Individuals. After excluding adult hospitalizations with metabolic risk factors (hypertension, diabetes, or hyperlipidemia), we identified all National Inpatient Sample (2019) admissions with obesity (MHO) and MASLD using relevant ICD-10-CM codes. We matched (1:1) propensity scores for age, sex, household income, hospital location, and teaching status to obtain cohorts with and without obesity (MHO+) vs. (MHO-). Categorical and continuous data were compared using the Chi-square and Mann-Whitney U tests. The primary endpoint was the prevalence and adjusted multivariable odds/predictors of MASLD in (MHO+) vs. (MHO-) cohort.</div></div><div><h3>Results</h3><div>In the adjusted multivariate regression for demographics, and comorbidities, the (MHO+) cohort was associated with higher odds of admissions with MASLD (OR 4.07, 95%CI 2.02–8.19, p < 0.001). In addition, among the (MHO+) cohort, higher rates of MASLD-related hospitalizations were observed in males (OR 8.40, p < 0.001), females (OR 2.69, p = 0.025), high-income quartiles (OR 10.51, p < 0.001), no prior bariatric surgery (OR 4.07, p < 0.001), non-tobacco users(OR 4.16, p < 0.001), and non-hypothyroid patients (OR 4.00, p < 0.001) compared to the (MHO-) cohort. There was no statistically significant difference in the groups with low-income quartiles, tobacco use disorder, and hypothyroidism.</div></div><div><h3>Conclusion</h3><div>This nationwide analysis demonstrates that (MHO+) is associated with a higher prevalence of MASLD. In the (MHO+) cohort, there was an association of MASLD with sex, high-income quartile, no prior bariatric surgery, non-tobacco use, and non-hypothyroidism. Further prospective multicenter studies are needed to evaluate the association of MASLD in (MHO+) patients with comorbid conditions.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100168"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512562","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 : 2025-03-01Epub Date: 2024-11-15DOI: 10.1016/j.obpill.2024.100150
Harold Bays (Editor– in -Chief)
{"title":"Editorial: Exploring the nuances of obesity in Asian populations","authors":"Harold Bays (Editor– in -Chief)","doi":"10.1016/j.obpill.2024.100150","DOIUrl":"10.1016/j.obpill.2024.100150","url":null,"abstract":"","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100150"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578230","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 : 2025-03-01Epub Date: 2025-01-31DOI: 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].
{"title":"Weight and cardiometabolic effects of a novel oral shape-shifting superabsorbent hydrogel capsule: Prespecified and exploratory analysis of the Epitomee capsule RESET study","authors":"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","doi":"10.1016/j.obpill.2025.100163","DOIUrl":"10.1016/j.obpill.2025.100163","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusion</h3><div>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 <span><span>[ClinicalTrials.gov</span><svg><path></path></svg></span> ID NCT04222322].</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100163"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143388251","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}
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 , Avilash Mondal , Boney Lapsiwala , Venkata Balaji Chenna , Pratik Rajpopat , Vaidehi Mendpara , Athri Kodali , Amritha R. Nair , Ayodya Perera , 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, >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":"2025-03-01","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}
Pub Date : 2024-12-01Epub Date: 2024-09-30DOI: 10.1016/j.obpill.2024.100138
Catherine Bacus , Terri-Lynne South , Sonia Raudszus , Odd Erik Johansen
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":"Catherine Bacus , Terri-Lynne South , Sonia Raudszus , Odd Erik Johansen","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":"12 ","pages":"Article 100138"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","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 : 2024-12-01Epub Date: 2024-09-10DOI: 10.1016/j.obpill.2024.100128
Mehak Gupta , Daniel Eckrich , H. Timothy Bunnell , Thao-Ly T. Phan , Rahmatollah Beheshti
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":"Mehak Gupta , Daniel Eckrich , H. Timothy Bunnell , Thao-Ly T. Phan , Rahmatollah Beheshti","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":"12 ","pages":"Article 100128"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","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 : 2024-12-01Epub Date: 2024-08-31DOI: 10.1016/j.obpill.2024.100127
Wissam Ghusn , Maria D. Hurtado
Background
This review investigates the side effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) like liraglutide, semaglutide, and tirzepatide, medications known for their efficacy in promoting weight loss among individuals with obesity. The rationale is rooted in understanding the balance between their therapeutic benefits and associated risks.
Methods
This was a comprehensive clinical review, including systematic reviews, meta-analyses, randomized controlled trials (RCTs), and cohort studies. Data were extracted from databases such as PubMed, Scopus, Embase, MEDLINE, and Google Scholar, focusing on the tolerability, severity, and risks of these medications.
Results
GLP-1RAs demonstrated significant weight loss outcomes. In clinical trials, liraglutide showed a placebo-corrected weight loss of around 5 %, semaglutide 12 %, and tirzepatide 18 %. Common side effects were predominantly gastrointestinal, including nausea, diarrhea, constipation, and vomiting. Rare serious adverse events included gallbladder disorders and acute pancreatitis. In, addition, multiple studies identify new risks associated with GLP-1RAs including increased aspiration risk during anesthesia due to delayed gastric emptying and challenges with bowel preparation for colonoscopies.
Conclusion
While GLP-1RAs are effective in managing obesity, their use is associated with gastrointestinal side effects and rare but serious adverse events. The findings underscore the importance of individualized dosing and thorough patient assessment. Continuous research and vigilant monitoring are essential to optimize their safe use. Further studies are needed to refine guidelines, particularly regarding new concerns such as delayed gastric emptying and its implications for anesthesia.
{"title":"Glucagon-like Receptor-1 agonists for obesity: Weight loss outcomes, tolerability, side effects, and risks","authors":"Wissam Ghusn , Maria D. Hurtado","doi":"10.1016/j.obpill.2024.100127","DOIUrl":"10.1016/j.obpill.2024.100127","url":null,"abstract":"<div><h3>Background</h3><p>This review investigates the side effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) like liraglutide, semaglutide, and tirzepatide, medications known for their efficacy in promoting weight loss among individuals with obesity. The rationale is rooted in understanding the balance between their therapeutic benefits and associated risks.</p></div><div><h3>Methods</h3><p>This was a comprehensive clinical review, including systematic reviews, meta-analyses, randomized controlled trials (RCTs), and cohort studies. Data were extracted from databases such as PubMed, Scopus, Embase, MEDLINE, and Google Scholar, focusing on the tolerability, severity, and risks of these medications.</p></div><div><h3>Results</h3><p>GLP-1RAs demonstrated significant weight loss outcomes. In clinical trials, liraglutide showed a placebo-corrected weight loss of around 5 %, semaglutide 12 %, and tirzepatide 18 %. Common side effects were predominantly gastrointestinal, including nausea, diarrhea, constipation, and vomiting. Rare serious adverse events included gallbladder disorders and acute pancreatitis. In, addition, multiple studies identify new risks associated with GLP-1RAs including increased aspiration risk during anesthesia due to delayed gastric emptying and challenges with bowel preparation for colonoscopies.</p></div><div><h3>Conclusion</h3><p>While GLP-1RAs are effective in managing obesity, their use is associated with gastrointestinal side effects and rare but serious adverse events. The findings underscore the importance of individualized dosing and thorough patient assessment. Continuous research and vigilant monitoring are essential to optimize their safe use. Further studies are needed to refine guidelines, particularly regarding new concerns such as delayed gastric emptying and its implications for anesthesia.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"Article 100127"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667368124000299/pdfft?md5=165894a56a8d179b8b2f34a9cd907832&pid=1-s2.0-S2667368124000299-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142136867","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 : 2024-12-01Epub Date: 2024-08-23DOI: 10.1016/j.obpill.2024.100129
Emma Farrell , Joseph Nadglowski , Eva Hollmann , Carel W. le Roux , Deirdre McGillicuddy
Background
The uptake of obesity treatments remains disproportionally low in people living with the disease, even with the advent and availability of GLP-1 agonists in recent years. Efforts to understand this discrepancy have centred on literature syntheses and Healthcare Professionals’ (HCPs) perspectives on the barriers to obesity treatment. This study focuses on patient perspectives on the risks of obesity treatment.
Method
This qualitative study consisted of online focus groups with 30 adults with obesity from Europe and North America. The focus group discussions were recorded, transcribed verbatim and analysed thematically.
Results
Patients identified three risks associated with obesity treatment: (a) the risk that they can’t access treatment; (b) the risk that they would fail to meet treatment expectations – their own, their HCPs and societal expectations, and (c) the risk that the treatment would be ‘successful’ but that they would lose their sense of self, their coping mechanisms and identity along with weight.
Conclusion
Understanding patient concerns about the risks of obesity treatment is essential to addressing obesity treatment inertia.
{"title":"“What would be left of me?” Patient perspectives on the risks of obesity treatment: An innovative health initiative stratification of obesity phenotypes to optimise future obesity therapy (IMI2 SOPHIA) qualitative study","authors":"Emma Farrell , Joseph Nadglowski , Eva Hollmann , Carel W. le Roux , Deirdre McGillicuddy","doi":"10.1016/j.obpill.2024.100129","DOIUrl":"10.1016/j.obpill.2024.100129","url":null,"abstract":"<div><h3>Background</h3><p>The uptake of obesity treatments remains disproportionally low in people living with the disease, even with the advent and availability of GLP-1 agonists in recent years. Efforts to understand this discrepancy have centred on literature syntheses and Healthcare Professionals’ (HCPs) perspectives on the barriers to obesity treatment. This study focuses on patient perspectives on the <em>risks</em> of obesity treatment.</p></div><div><h3>Method</h3><p>This qualitative study consisted of online focus groups with 30 adults with obesity from Europe and North America. The focus group discussions were recorded, transcribed verbatim and analysed thematically.</p></div><div><h3>Results</h3><p>Patients identified three risks associated with obesity treatment: (a) the risk that they can’t access treatment; (b) the risk that they would fail to meet treatment expectations – their own, their HCPs and societal expectations, and (c) the risk that the treatment would be ‘successful’ but that they would lose their sense of self, their coping mechanisms and identity along with weight.</p></div><div><h3>Conclusion</h3><p>Understanding patient concerns about the risks of obesity treatment is essential to addressing obesity treatment inertia.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"Article 100129"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667368124000317/pdfft?md5=d76a124c3aad24ed22a66ffca1e3865d&pid=1-s2.0-S2667368124000317-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142076815","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 : 2024-12-01Epub Date: 2024-10-19DOI: 10.1016/j.obpill.2024.100144
Catherine Bacus , Terri-Lynne South , Sonia Raudszus , Odd Erik Johansen
{"title":"Corrigendum to “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” [Obesity Pillars 12C (2024) 100138]","authors":"Catherine Bacus , Terri-Lynne South , Sonia Raudszus , Odd Erik Johansen","doi":"10.1016/j.obpill.2024.100144","DOIUrl":"10.1016/j.obpill.2024.100144","url":null,"abstract":"","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"Article 100144"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904699","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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