Obesity Pillars最新文献_第2页

Adolescent obesity: Biochemical and dietary disparities in U.S. youth 青少年肥胖：美国青少年的生化和饮食差异

Obesity Pillars

Pub Date : 2025-12-03 DOI: 10.1016/j.obpill.2025.100239

John T. Stutts , Yong S. Choe , Ashley Lynn Bronston

Background

Adolescence is a critical period of growth with elevated nutritional demands, yet many U.S. adolescents fail to meet recommended dietary intakes. This study analyzed data from three NHANES cycles (2013–2018) to assess obesity trends among adolescents aged 12–18, compare dietary intake by BMI, and evaluate nutritional biomarkers.

Methods

This retrospective observational study analyzed data from three NHANES cycles to estimate obesity prevalence among U.S. adolescents aged 12–18 years. Dietary intake and blood concentrations of micro- and macronutrients were compared between adolescents with and without obesity. Obesity was defined as BMI ≥95th percentile per CDC growth charts. Nutrient intake was assessed against Estimated Average Requirement (EAR) and Adequate Intake (AI) benchmarks, and biomarker levels were evaluated using established clinical thresholds. All statistical analyses were conducted using SAS version 9.4 and SAS Enterprise Guide version 8.3.

Results

Obesity prevalence increased slightly from 20.3% to 21.3% across cycles. Among all dietary intake variables analyzed, only one demonstrated a statistically significant difference between those with obesity and those without. The adolescents with obesity were significantly more likely to have protein intakes below the EAR (50.3% vs. 22.9%, P < 0.001). Over half of all adolescents failed to meet recommended intake levels for several nutrients, regardless of their BMI categories. The blood biomarker analysis revealed significantly lower levels of vitamin D, vitamin C, serum iron, albumin, and MCV in those with obesity, alongside higher levels of total protein, globulin, and hs-CRP (P ≤ 0.05). The prevalence of low vitamin D, low hemoglobin, low MCV, and iron deficiency anemia was also significantly higher in the group with obesity.

Conclusions

This study reveals that despite similar caloric intakes, adolescents with obesity exhibited higher rates of nutrient deficiencies and markers of inflammation. This work underscores the importance of recognizing nutrition gaps in adolescent care.

背景：青春期是成长的关键时期，营养需求增加，但许多美国青少年未能达到推荐的膳食摄入量。本研究分析了三个NHANES周期（2013-2018）的数据，以评估12-18岁青少年的肥胖趋势，通过BMI比较饮食摄入量，并评估营养生物标志物。方法：本回顾性观察性研究分析了三个NHANES周期的数据，以估计美国12-18岁青少年的肥胖患病率。比较了肥胖和非肥胖青少年的饮食摄入和血液中微量和大量营养素的浓度。根据CDC生长图表，BMI≥95百分位定义为肥胖。根据估计平均需要量（EAR）和充足摄入量（AI）基准评估营养摄入量，并使用既定的临床阈值评估生物标志物水平。所有统计分析均采用SAS版本9.4和SAS Enterprise Guide版本8.3进行。结果各周期肥胖患病率从20.3%小幅上升至21.3%。在分析的所有饮食摄入变量中，只有一个变量在肥胖人群和非肥胖人群之间显示出统计学上的显著差异。肥胖青少年的蛋白质摄入量明显低于EAR（50.3%比22.9%,P < 0.001）。超过一半的青少年没有达到几种营养素的推荐摄入量，无论他们的BMI类别如何。血液生物标志物分析显示，肥胖患者的维生素D、维生素C、血清铁、白蛋白和MCV水平明显较低，而总蛋白、球蛋白和hs-CRP水平较高（P≤0.05）。低维生素D、低血红蛋白、低MCV和缺铁性贫血的患病率在肥胖组也明显更高。该研究表明，尽管热量摄入相似，肥胖青少年表现出更高的营养缺乏率和炎症标志物。这项工作强调了认识到青少年护理中的营养差距的重要性。

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引用次数: 0

Erratum regarding clinical trial numbers in previously published articles 先前发表的文章中关于临床试验编号的勘误表

Obesity Pillars

Pub Date : 2025-12-01 DOI: 10.1016/j.obpill.2025.100217

引用次数: 0

Weight reduction and treatment adherence with tirzepatide using the Individualized Virtual Integrative Medicine (IVIM) protocol 使用个体化虚拟综合医学（IVIM）方案减轻体重和坚持使用替西帕肽治疗

Obesity Pillars

Pub Date : 2025-11-29 DOI: 10.1016/j.obpill.2025.100236

Jessica Duncan, Patrick Lee Stevens, Emily Bigby, Courtney Floyd, Josh Malina, Jennifer Nickens, Amber Lambert, Taylor Kantor

Introduction

Obesity and its downstream effects continue to drive rising rates of chronic disease. Tirzepatide, a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist, has shown significant potential in supporting weight loss and improving metabolic health. This study examines the use of tirzepatide alongside the Individualized Virtual Integrative Medicine (IVIM) protocol. This is a telehealth-based approach to improving outcomes through consistent access to care and support throughout the weight reduction journey.

Methods

This is a retrospective analysis of 1166 patients who completed at least 52-weeks of the IVIM clinical protocol while on GLP-1 therapy with tirzepatide overseen by a team of board-certified obesity medicine physicians and nurse practitioners. Only patients with a body mass index (BMI) of 30 or greater were included. Due to the branded tirzepatide shortage, patients were provided with the ability to utilize compounded tirzepatide medications, if medically appropriate.

Results

Mean change at 12-weeks for patients both on compounded tirzepatide and branded tirzepatide was −20.12 lbs (−8.80 %), 24-weeks: −35.67 lbs (−15.72 %), 36-weeks: −47.33 lbs (−20.34 %), 52-weeks: −52.28 lbs (−22.74 %). At 72 weeks of therapy, patients had lost an average of −62.79 lbs (−26.54 %). The percentage of patients who lost at least 5 % of their body weight at 52 weeks was: 99.36 %, 10 % or more: 97.12 %, 15 % or more: 84.66 %, 20 % or more: 64.22 %, and 25 % or more: 41.21 %.

Discussion

Patients completing 52-weeks of tirzepatide therapy on the IVIM protocol experienced significant weight loss with a high level of treatment adherence and program utilization. The findings suggest that individualized dose titration and frequent access to support may improve outcomes of patients initiated on weight reduction therapy with GLP-1 medications. These findings support the IVIM protocol as a safe, effective and individualized model for delivering obesity treatment through a curated, patient-centered, virtual approach.

肥胖症及其下游影响继续推动慢性病发病率上升。tizepatide是一种双重葡萄糖依赖性胰岛素性多肽（GIP）和胰高血糖素样肽-1 （GLP-1）受体激动剂，在支持减肥和改善代谢健康方面显示出显著的潜力。本研究考察了替西帕肽与个体化虚拟综合医学（IVIM）方案的使用。这是一种基于远程保健的方法，通过在整个减肥过程中始终如一地获得护理和支持来改善结果。方法回顾性分析1166例患者，这些患者在接受GLP-1和替西帕肽治疗的同时完成了至少52周的IVIM临床方案，并由委员会认证的肥胖医学医生和执业护士团队监督。仅包括身体质量指数（BMI）为30或更高的患者。由于品牌替西肽短缺，如果医学上合适，患者可以使用复方替西肽药物。结果复方替西帕肽和品牌替西帕肽患者12周时的平均变化为- 20.12磅（- 8.80%），24周：- 35.67磅（- 15.72%），36周：- 47.33磅（- 20.34%），52周：- 52.28磅（- 22.74%）。在治疗72周时，患者平均减轻62.79磅（- 26.54%）。52周时体重减轻至少5%的患者比例为：99.36%，10%及以上：97.12%，15%及以上：84.66%，20%及以上：64.22%，25%及以上：41.21%。在IVIM方案下完成52周替西肽治疗的患者体重显著减轻，治疗依从性和方案使用率高。研究结果表明，个体化剂量滴定和频繁获得支持可以改善开始使用GLP-1药物减肥治疗的患者的预后。这些发现支持IVIM方案作为一种安全、有效和个性化的模式，通过精心策划的、以患者为中心的虚拟方法提供肥胖治疗。

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引用次数: 0

Logistics, effectiveness, safety, and accessibility: Factors determining obesity medication patient preferences from a photovoice analysis 物流，有效性，安全性和可及性：从光声分析中决定肥胖药物患者偏好的因素

Obesity Pillars

Pub Date : 2025-11-27 DOI: 10.1016/j.obpill.2025.100238

Alvin Mondoh , Francisca Contreras , Hilary Craig , Michael Crotty , Carel W. le Roux

Background

Obesity is a chronic, relapsing, and multifactorial disease that necessitates sustained, patient-centred management. Although pharmacotherapy is now an integral component of obesity care, there is limited evidence regarding the factors influencing patients’ choices among specific medications. As part of the Innovative Medicines Initiative 2 (IMI2) programme. Stratification of Obesity Phenotypes to Optimize Future Obesity Therapy (SOPHIA) and the second phase of a three-part qualitative doctoral programme, the present study is built upon previous interview findings that examined how patients conceptualize and interpret the factors shaping their pharmacotherapy preferences.

Methods

A qualitative Photovoice methodology was employed with treatment naive adults attending a specialist weight management clinic. Participants captured photographs reflecting factors shaping their medication choices and they also engaged in facilitated reflective interviews. Data was analysed using the MAXQDA 2024 software and the Braun and Clarke's framework for reflexive thematic analysis.

Results

The photovoice analysis revealed 4 themes around patient preferences for obesity medications including a) Logistics around Lifestyle, b) Effectiveness, c) Safety, risk and tolerability and d) Accessibility.

Conclusion

Patient preferences for obesity pharmacotherapy arise from the interaction of efficacy expectations with logistical challenged, while concerns regarding safety and accessibility also contribute to decision making. Clinicians should include explanations how the medications can fit into the lifestyle of patients, while also addressing structural barriers that may affect access to treatment, but ultimately allowing patients to understand the balance between efficacy and safety will allow optimal shared decision-making to support sustainable pharmacotherapy pathways.

背景：肥胖是一种慢性、复发性和多因素疾病，需要持续的、以患者为中心的管理。虽然药物治疗现在是肥胖治疗的一个组成部分，但关于影响患者选择特定药物的因素的证据有限。作为创新药物倡议2 （IMI2）规划的一部分。肥胖表型分层以优化未来肥胖治疗（SOPHIA）和一个由三部分组成的定性博士课程的第二阶段，本研究建立在之前的访谈结果的基础上，调查了患者如何概念化和解释影响其药物治疗偏好的因素。方法采用定性光声法对在某体重管理专科诊所就诊的初诊成人进行治疗。参与者拍摄的照片反映了影响他们药物选择的因素，他们还参与了便利的反思性访谈。数据分析使用MAXQDA 2024软件和Braun和Clarke的反思性主题分析框架。结果光声分析揭示了患者对减肥药偏好的4个主题，包括a)围绕生活方式的物流，b)有效性，c)安全性，风险和耐受性以及d)可及性。结论患者对肥胖药物治疗的偏好源于对疗效的期望与后勤挑战的相互作用，而对安全性和可及性的关注也有助于决策。临床医生应该解释药物如何适应患者的生活方式，同时也要解决可能影响治疗的结构性障碍，但最终让患者了解疗效和安全性之间的平衡，从而实现最佳的共同决策，以支持可持续的药物治疗途径。

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引用次数: 0

Taking back control: The experience of adults using semaglutide and tirzepatide for obesity treatment - A qualitative study 拿回控制权：成人使用西马鲁肽和替西帕肽治疗肥胖的经验-一项定性研究

Obesity Pillars

Pub Date : 2025-11-25 DOI: 10.1016/j.obpill.2025.100237

Lauren Lynn Trocchio , Fredrick Peters

Background

Adequately treating obesity remains a fundamental goal for improving quality of life and long-term health outcomes. Semaglutide and tirzepatide have shown clinically meaningful weight loss in clinical trials, yet despite this weight loss efficacy, little is understood about how patients with obesity using semaglutide or tirzepatide experience making dietary behavior change. Furthermore, little is known about their perceptions of obesity treatment and healthcare provider interactions since taking the medications.

Methods

This was a basic qualitative study wherein adults with obesity taking semaglutide or tirzepatide participated in in-depth interviews and open-ended questionnaires. Participation criteria included a Body Mass Index (BMI) ≥ 30.0 kg/m², taking semaglutide (between 1.0 and 2.4 mg) or tirzepatide (between 5.0 and 15.0 mg) for 6–18 months, and a weight loss of 7 %–20 %. Individual demographic data were reported, and interview transcripts and questionnaires were thematically analyzed.

Results

The final sample included 8 participants (100 % female, mean age 42). Three themes addressed the experience of dietary behavior change: (a) feeling more capable, (b) more measured and deliberate with dietary choices, and (c) experiencing a reduced mental burden. Four themes addressed the experience of obesity treatment: (a) frustration with historical guidance and treatment, (b) hopeful about treatment for the first time, (c) compassion for self and others, and (d) unanticipated outcomes. Finally, two themes addressed the experience of healthcare provider interactions: (a) physicians as gatekeepers to the medications, and (b) physicians were not the initial introduction to the medications.

Conclusion

The findings suggest the medications provide a sense of hope for effective treatment, facilitate dietary behavior change, and evoke quality of life benefits beyond weight loss. The patient-provider relationship and obesity knowledge of the physician are integral in discussing and acquiring the medications, yet patients initially learn about the medications outside the healthcare system.

充分治疗肥胖仍然是改善生活质量和长期健康结果的基本目标。在临床试验中，塞马鲁肽和替西帕肽显示出具有临床意义的减肥效果，然而，尽管有这种减肥效果，但对于使用塞马鲁肽或替西帕肽的肥胖患者如何改变饮食行为知之甚少。此外，自服用药物以来，他们对肥胖治疗和医疗保健提供者互动的看法知之甚少。方法采用基础定性研究方法，对服用西马鲁肽或替西帕肽的成人肥胖患者进行深度访谈和开放式问卷调查。参与标准包括身体质量指数(BMI)≥30.0 kg/m2，服用西马鲁肽（1.0 - 2.4 mg）或替西帕肽（5.0 - 15.0 mg） 6-18个月，体重减轻7% - 20%。报告了个人人口统计数据，并对访谈记录和问卷进行了主题分析。结果最终样本包括8名参与者（100%为女性，平均年龄42岁）。三个主题涉及饮食行为改变的体验：(a)感觉更有能力，(b)在饮食选择上更有节制和深思熟虑，(c)精神负担减轻。四个主题讨论了肥胖治疗的经验：(a)对历史指导和治疗的沮丧，(b)对第一次治疗的希望，(c)对自己和他人的同情，以及(d)意想不到的结果。最后，两个主题涉及医疗保健提供者互动的经验：(a)医生作为药物的看门人，以及(b)医生不是药物的最初介绍。结论该研究结果表明，药物治疗提供了有效治疗的希望，促进了饮食行为的改变，并唤起了减肥以外的生活质量益处。在讨论和获得药物时，医患关系和医生的肥胖知识是不可或缺的，然而患者最初是在医疗保健系统之外了解药物的。

{"title":"Taking back control: The experience of adults using semaglutide and tirzepatide for obesity treatment - A qualitative study","authors":"Lauren Lynn Trocchio , Fredrick Peters","doi":"10.1016/j.obpill.2025.100237","DOIUrl":"10.1016/j.obpill.2025.100237","url":null,"abstract":"<div><h3>Background</h3><div>Adequately treating obesity remains a fundamental goal for improving quality of life and long-term health outcomes. Semaglutide and tirzepatide have shown clinically meaningful weight loss in clinical trials, yet despite this weight loss efficacy, little is understood about how patients with obesity using semaglutide or tirzepatide experience making dietary behavior change. Furthermore, little is known about their perceptions of obesity treatment and healthcare provider interactions since taking the medications.</div></div><div><h3>Methods</h3><div>This was a basic qualitative study wherein adults with obesity taking semaglutide or tirzepatide participated in in-depth interviews and open-ended questionnaires. Participation criteria included a Body Mass Index (BMI) ≥ 30.0 kg/m<sup>2</sup>, taking semaglutide (between 1.0 and 2.4 mg) or tirzepatide (between 5.0 and 15.0 mg) for 6–18 months, and a weight loss of 7 %–20 %. Individual demographic data were reported, and interview transcripts and questionnaires were thematically analyzed.</div></div><div><h3>Results</h3><div>The final sample included 8 participants (100 % female, mean age 42). Three themes addressed the experience of dietary behavior change: (a) feeling more capable, (b) more measured and deliberate with dietary choices, and (c) experiencing a reduced mental burden. Four themes addressed the experience of obesity treatment: (a) frustration with historical guidance and treatment, (b) hopeful about treatment for the first time, (c) compassion for self and others, and (d) unanticipated outcomes. Finally, two themes addressed the experience of healthcare provider interactions: (a) physicians as gatekeepers to the medications, and (b) physicians were not the initial introduction to the medications.</div></div><div><h3>Conclusion</h3><div>The findings suggest the medications provide a sense of hope for effective treatment, facilitate dietary behavior change, and evoke quality of life benefits beyond weight loss. The patient-provider relationship and obesity knowledge of the physician are integral in discussing and acquiring the medications, yet patients initially learn about the medications outside the healthcare system.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"17 ","pages":"Article 100237"},"PeriodicalIF":0.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Microdosing of obesity medications: A Perspective Statement from the Access and Policy Working Group 微剂量的肥胖药物：从获取和政策工作组的观点声明

Obesity Pillars

Pub Date : 2025-11-21 DOI: 10.1016/j.obpill.2025.100234

Christopher Weber , Bharti Shetye , Courtney Younglove , Catherine Varney , Leslie Golden , Harold Edward Bays

引用次数: 0

Obesity pillars roundtable: Better together - combined obesity medicine and metabolic surgery care for the treatment of obesity 肥胖支柱圆桌会议：更好地结合-肥胖药物和代谢手术护理治疗肥胖

Obesity Pillars

Pub Date : 2025-11-21 DOI: 10.1016/j.obpill.2025.100232

Kirsten Frederiksen , Reed A. Berger-Fleishman , Ahmed Jad , Samer G. Mattar , Bharti Shetye

Background

Obesity is a chronic, multifactorial, complex, and relapsing disease typically requiring treatment from various medical providers throughout the continuum of care. A natural overlap in medical and procedural obesity treatment therefore often exists during the course of treatment. Given this, the optimal treatment of the medically complex patient population may best be delivered either within multi-disciplinary teams, or through more effective collaboration with diverse specialists sharing the common interest of managing patients with obesity. The aim of this roundtable is to more deeply engage on issues surrounding the multi-disciplinary approach for the treatment of obesity, along with highlighting areas of opportunity for improving collaborative care.

Methods

This roundtable review includes perspectives from two obesity medicine specialists and two metabolic bariatric surgeons, all with extensive experience in combining medical and surgical care.

Results

While the panelists generally agreed upon core principles of combined obesity medicine and metabolic surgical care for the treatment of obesity, each had their own priorities and approach regarding the best ways to overlap care. Variances in perceptions included importance of procedural care versus use of pharmacotherapy. However, the panelists endorsed more collaborative work as vital for improving outcomes. Further identification of existing barriers and the creation of pathways for action will bring this work forward.

Conclusions

Providing guidance on one universal approach to the care of patients with obesity is challenging due to the heterogeneity of patient populations and variance in practice patterns across the spectrum of care. The panel suggested adopting a continuum-of-care mindset, meaning that all available options should be considered for patients, either in sequence, or as adjuvant therapies, or as rescue options for patients who gain tolerance to a particular therapeutic modality. This approach is in keeping with the reality that obesity is a chronic, relapsing multifactorial disease.

背景：肥胖是一种慢性的、多因素的、复杂的、反复发作的疾病，通常需要不同的医疗提供者在连续的护理过程中进行治疗。因此，在治疗过程中，医学和程序性肥胖治疗经常存在自然重叠。鉴于此，对医学上复杂的患者群体的最佳治疗可能最好是在多学科团队中进行，或者通过与不同专家更有效的合作，分享管理肥胖患者的共同兴趣。本次圆桌会议的目的是更深入地探讨围绕多学科方法治疗肥胖的问题，同时强调改善协作护理的机会领域。方法本次圆桌会议综述包括两位肥胖医学专家和两位代谢减肥外科医生的观点，他们都具有丰富的内外科结合护理经验。结果虽然小组成员普遍同意联合肥胖药物和代谢手术治疗肥胖的核心原则，但对于重叠治疗的最佳方式，每个人都有自己的优先事项和方法。认知上的差异包括程序性护理与药物治疗的重要性。然而，小组成员赞同更多的协作工作对于改善结果至关重要。进一步查明现有障碍和创造行动途径将推动这项工作向前发展。结论：由于患者群体的异质性和护理范围内实践模式的差异，为肥胖患者提供一种通用方法的指导是具有挑战性的。专家组建议采用连续治疗的思维方式，这意味着所有可用的选择都应该考虑到患者，无论是按顺序，还是作为辅助治疗，或者作为对特定治疗方式产生耐受性的患者的拯救选择。这种方法符合肥胖是一种慢性、反复发作的多因素疾病的现实。

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引用次数: 0

Clinical review of how glucagon-like peptide-1 agonist obesity medications decrease sexual desire, and a biopsychosocial model for why we don’t ‘see’ it 胰高血糖素样肽-1激动剂减肥药物如何降低性欲的临床回顾，以及为什么我们没有“看到”它的生物心理社会模型

Obesity Pillars

Pub Date : 2025-11-20 DOI: 10.1016/j.obpill.2025.100233

Sonya T. Gelfand , Meghan C. Tveit , James A. Simon

Background

While prevailing assumptions suggest that improved body image and erectile function, even in people with diabetes, associated with glucagon-like peptide-1 (GLP-1) agonist medications would correlate with heightened sexual function, there is limited literature on the effects of GLP-1 agonists on hedonistic pleasures such as sexual activity. In this paper, we aim to elucidate the potential implications of GLP-1 agonists on sexual desire by proposing a serotonergic mechanism by which GLP-1 agonists theoretically decrease sexual desire, and a biopsychosocial perspective on why this effect may be camouflaged by competing influences.

Methods

This was a narrative review analysis with target literature search. A PubMed search was conducted to identify systematic reviews or meta-analyses investigating the effects of GLP-1 agonists on physiological and lifestyle factors. We used the same methodology to investigate the connection between GLP-1 agonism and the brain’s reward pathways to elucidate whether a connection exists between GLP-1 agonism and sexual desire.

Results

We established a theoretical model for how GLP-1 agonist modulation via increased serotonergic activity at the 5-HT2C receptor may result in diminished sexual desire. We then applied a biopsychosocial framework to highlight why this effect may be overlooked by GLP-1-treated patients and clinicians. Although the serotonergic pathway may create a physiological decrease in sexual desire for patients taking GLP-1 agonists, we postulate that this diminishing influence of GLP-1 agonism is both compounded by factors such as undesirable side effects and increased SHBG and offset by the enhancing influences on sexual desire such as increased total testosterone, and improved vascular reactivity and mood.

Conclusion

Failing to systematically measure and report on sexual desire as a potential adverse outcome of GLP-1 agonist use overlooks an essential aspect of patient well-being. Future research should prioritize longitudinal studies to assess changes in sexual desire among individuals prescribed GLP-1 agonists.

虽然普遍的假设认为，改善身体形象和勃起功能，甚至在糖尿病患者中，与胰高血糖素样肽-1 （GLP-1）激动剂药物可能与提高性功能有关，但关于GLP-1激动剂对性活动等享乐主义快感的影响的文献有限。在本文中，我们旨在阐明GLP-1激动剂对性欲的潜在影响，提出GLP-1激动剂理论上降低性欲的5 -羟色胺能机制，并从生物心理社会角度解释为什么这种作用可能被竞争影响掩盖。方法采用目标文献检索的叙事回顾分析法。PubMed检索进行了系统评价或荟萃分析，调查GLP-1激动剂对生理和生活方式因素的影响。我们使用相同的方法来研究GLP-1激动作用与大脑奖赏通路之间的联系，以阐明GLP-1激动作用与性欲之间是否存在联系。结果我们建立了GLP-1激动剂如何通过增加5-HT2C受体的血清素能活性来调节可能导致性欲减退的理论模型。然后，我们应用生物心理社会框架来强调为什么glp -1治疗的患者和临床医生可能会忽视这种影响。尽管5 -羟色胺能途径可能会使服用GLP-1激动剂的患者产生生理上的性欲下降，但我们假设GLP-1激动剂的这种减弱影响既会因不良副作用和SHBG增加等因素而加剧，也会因总睾酮增加、血管反应性和情绪改善等对性欲的增强影响而抵消。未能系统地测量和报告作为GLP-1激动剂使用的潜在不良后果的性欲，忽视了患者健康的一个重要方面。未来的研究应优先考虑纵向研究，以评估服用GLP-1激动剂的个体的性欲变化。

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引用次数: 0

Perceptions, attitudes, and practices influencing management of obesity in Ireland–The Awareness, Care and Treatment in Obesity maNagement, (ACTION) Ireland study 影响爱尔兰肥胖管理的观念、态度和实践——肥胖管理的意识、护理和治疗，（ACTION）爱尔兰研究

Obesity Pillars

Pub Date : 2025-11-17 DOI: 10.1016/j.obpill.2025.100231

Fiona Curran , Leona Ryan , Susan Birney , Karen Gaynor , Maura Murphy , Jean O’ Connell , Gráinne O'Donoghue

Background

Data is lacking comparing perceptions of people living with obesity (PWO) and health care professionals (HCPs) towards obesity management in Ireland, where 30 % of the population live with obesity. The ACTION-Ireland study aimed to explore perceptions, attitudes, practices, and barriers to effective obesity management in Ireland, using data from PWO and HCPs comparable to international data sets.

Methods

This was a cross-sectional online survey conducted among adults living with BMI ≥30 kg/m² and HCPs managing PWO.

Results

A total of 504 PWO and 159 HCPs completed the survey (August–December 2024). Most PWO (75 %) and almost all HCPs (98 %) believe obesity is a chronic disease. While 86 % of HCPs believe they have responsibility to support PWO, 82 % of PWO believe they are completely responsible for weight management.

PWO waited on average eight years (SD 9.7) from first weight concern to first weight discussion with their HCP. HCPs most initiated obesity conversations when the patient had (70 %) or were at risk of (63 %) obesity complications. Lifestyle interventions were most frequently discussed and recommended by HCPs (physical activity 72 %, diet 67 %), while fewer recommended prescription medication (34 %), referral to obesity specialists (23 %) or for bariatric surgery (24 %). Although 88 % of PWO had attempted weight loss, only 10 % used prescription medication, 4 % visited an obesity specialist, and 2–4 % had bariatric surgery.

Many HCPs expressed concern about obesity medication; side effects (60 %), long term safety (48 %), lack of knowledge (46 %), cost (79 %), and preference for lifestyle changes (35 %). Importantly, 81 % of HCPs believe society and the healthcare system are not meeting PWO needs.

Conclusions

Despite strong consensus that obesity is a disease, disparities remain regarding treatment of and responsibility for obesity management. This dataset highlights opportunities to improve education, management and system level support while identifying inequities and barriers in obesity care.

背景在爱尔兰，30%的人口患有肥胖症，缺乏比较肥胖症患者（pvo）和医疗保健专业人员（HCPs）对肥胖管理的看法的数据。爱尔兰行动研究旨在探索爱尔兰有效肥胖管理的认知、态度、做法和障碍，使用来自ppo和hcp的数据与国际数据集相比较。方法对BMI≥30 kg/m2、HCPs有ppo的成年人进行横断面在线调查。结果2024年8 - 12月，共有504名wpo和159名HCPs完成调查。大多数pvo（75%）和几乎所有hcp（98%）认为肥胖是一种慢性疾病。虽然86%的健康护理人员认为他们有责任支持体重管理，但82%的体重管理人员认为他们完全有责任管理体重。从第一次关注体重到第一次与HCP讨论体重，ppo平均等待了8年（SD 9.7）。当患者有肥胖并发症（70%）或有肥胖并发症风险（63%）时，HCPs大多会发起肥胖对话。HCPs最常讨论和推荐的是生活方式干预（体育活动占72%，饮食占67%），而较少推荐的是处方药（34%），转介给肥胖专家（23%）或减肥手术（24%）。虽然88%的pvo尝试过减肥，但只有10%的人使用处方药，4%的人看了肥胖专家，2 - 4%的人做了减肥手术。许多医护人员对肥胖药物表示担忧；副作用（60%）、长期安全性（48%）、缺乏相关知识（46%）、成本（79%）和偏好改变生活方式（35%）。重要的是，81%的HCPs认为社会和医疗保健系统不能满足ppo的需求。结论：尽管人们普遍认为肥胖是一种疾病，但在肥胖的治疗和管理责任方面仍然存在差异。该数据集强调了改善教育、管理和系统层面支持的机会，同时确定了肥胖护理方面的不公平和障碍。

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引用次数: 0

Association of Ethiopian Orthodox Tewahedo Christian fasting on appetite hormones and insulin sensitivity in type-II diabetes and healthy subjects in Ethiopia 埃塞俄比亚东正教Tewahedo基督教禁食对埃塞俄比亚ii型糖尿病和健康受试者的食欲激素和胰岛素敏感性的影响

Obesity Pillars

Pub Date : 2025-11-15 DOI: 10.1016/j.obpill.2025.100226

Alemayehu Michael , Kaleab Baye

Background

Energy restriction, time-restricted feeding, and vegetarian diet intake each have been linked independently to positive health effects. However, little is known about the religious fasts practiced by Ethiopian Orthodox Tewahedo Christians (EOTC) fasting, which combine energy restriction, time-restricted feeding, and vegetarian diet consumption.

Method

This longitudinal study compared the effects of EOTC fasting on appetite hormones, insulin sensitivity, and β-cell function. The fasting cohort comprised both individuals with diabetes and healthy individuals, and was compared against a non-fasting cohort that also included both individuals with diabetes and healthy individuals. We employed pretested structured questionnaire to collect information on fasting patterns, physical activity, and sociodemographic traits. Body weight was measured using an adult digital electronic scale (ASTO), and hormone activity was determined using enzyme-linked immunosorbent assay (ELISA) analyzer.

Results

EOTC fast significantly lower serum level of appetite hormones like glucagon (p < 0.0001, p = 0.001), leptin (p = 0.002, p = 0.046) in both type-II diabetes and healthy subjects respectively compared to non-fasting. Insulin increased significantly (p = 0.002) in people with diabetes while decreased (p = 0.003) in healthy subjects. The concentration of ghrelin (p = 0.030) increased significantly in type-II diabetes but insignificantly (p = 0.135) in healthy subjects when compared to non-fasting. Both fasting people with diabetes and healthy subjects showed significant (p = 0.03, 0.010) improvements in insulin sensitivity and β-cell function respectively.

Conclusion

Concurrent vegetarian diet and energy restriction practiced among EOTC fasting may improve body weight managements. EOTC fasting improves activities of appetite hormones, increase insulin sensitivity and β-cell function (HOMA-IR) in both people with diabetes and healthy subjects. EOTC fasting practice represents a promising, culturally-accepted, non-pharmacological strategy for diabetes prevention and management.

能量限制、限时喂养和素食摄入都与积极的健康影响有独立的联系。然而，人们对埃塞俄比亚东正教特瓦赫多基督徒（EOTC）的宗教禁食知之甚少，这种禁食结合了能量限制、限时进食和素食。方法本研究比较了EOTC禁食对食欲激素、胰岛素敏感性和β细胞功能的影响。禁食队列包括糖尿病患者和健康个体，并与非禁食队列进行比较，非禁食队列也包括糖尿病患者和健康个体。我们采用预先测试的结构化问卷来收集有关禁食模式、身体活动和社会人口特征的信息。采用成人数字电子秤（ASTO）测量体重，采用酶联免疫吸附试验（ELISA）分析仪测定激素活性。结果与非禁食组相比，otc快速组显著降低了2型糖尿病和健康组血清胰高血糖素（p < 0.0001, p = 0.001）和瘦素（p = 0.002, p = 0.046）的食欲激素水平。糖尿病患者胰岛素显著升高（p = 0.002），而健康受试者胰岛素显著降低（p = 0.003）。ii型糖尿病患者的胃饥饿素浓度显著升高（p = 0.030），而健康受试者的胃饥饿素浓度与非禁食受试者相比无显著升高（p = 0.135）。空腹糖尿病患者和健康受试者在胰岛素敏感性和β细胞功能方面分别有显著改善（p = 0.03, 0.010）。结论在EOTC禁食中同时实行素食和能量限制可以改善体重管理。EOTC禁食改善了糖尿病患者和健康受试者的食欲激素活动，增加了胰岛素敏感性和β细胞功能（HOMA-IR）。EOTC禁食实践代表了一种有前途的，文化上接受的，糖尿病预防和管理的非药物策略。

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