Pub Date : 2025-09-09DOI: 10.1016/j.obpill.2025.100207
Mohey Elbanna , Amany Falah , Ahmed Magdy Hafez
Background
Bariatric surgery is the most effective treatment for obesity in Adolescents. However, disordered eating is frequent in this population. Several studies found that disordered eating affects weight loss after bariatric surgery. The aim of this study was to find out the impact of disordered eating on weight loss in Egyptian adolescents two years after sleeve gastrectomy.
Methods
This is a retrospective cohort study conducted at Ain Shams University Hospitals from March 2020 to March 2024. It included 47 adolescents with obesity who underwent laparoscopic sleeve gastrectomy (LSG) two years before. Their age was 16.2 ± 0.67 years (range 14.5 – 17.8 years old). Their body mass indices were above 99th percentile for age and sex with or without comorbidities. They had a mean BMI of 39.9 kg/m² (range: 36.9 – 54.3 kg/m²). Patients with psychiatric illnesses and eating disorders were excluded. Patients were recruited after completion of two years of follow up for weight loss. Weight loss was evaluated by total weight loss % (TWL%). Disordered eating was detected by the Arabic version of EDE-Q v.6.0, and a global score of > 2.5 was considered positive. TWL% was correlated with EDE-Q score.
Results
After two years, the mean TWL% was 27.5% ± 7.7%. Nineteen patients (40.4%) had EDE-Q score more than 2.5. The EDE-Q positive patients had a mean %TWL of 25.7% ± 4.8%, while EDE-Q negative patients had a mean %TWL of 30.5% ± 6.2%. The difference is statistically significant.
Conclusion
We conclude that the outcome of sleeve gastrectomy in adolescents is affected by their eating behavior as soon as the restrictive effect of the operations subsides.
{"title":"The impact of disordered eating and eating behavior on weight loss after sleeve gastrectomy in Egyptian adolescents","authors":"Mohey Elbanna , Amany Falah , Ahmed Magdy Hafez","doi":"10.1016/j.obpill.2025.100207","DOIUrl":"10.1016/j.obpill.2025.100207","url":null,"abstract":"<div><h3>Background</h3><div>Bariatric surgery is the most effective treatment for obesity in Adolescents. However, disordered eating is frequent in this population. Several studies found that disordered eating affects weight loss after bariatric surgery. The aim of this study was to find out the impact of disordered eating on weight loss in Egyptian adolescents two years after sleeve gastrectomy.</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study conducted at Ain Shams University Hospitals from March 2020 to March 2024. It included 47 adolescents with obesity who underwent laparoscopic sleeve gastrectomy (LSG) two years before. Their age was 16.2 ± 0.67 years (range 14.5 – 17.8 years old). Their body mass indices were above 99th percentile for age and sex with or without comorbidities. They had a mean BMI of 39.9 kg/m² (range: 36.9 – 54.3 kg/m²). Patients with psychiatric illnesses and eating disorders were excluded. Patients were recruited after completion of two years of follow up for weight loss. Weight loss was evaluated by total weight loss % (TWL%). Disordered eating was detected by the Arabic version of EDE-Q v.6.0, and a global score of > 2.5 was considered positive. TWL% was correlated with EDE-Q score.</div></div><div><h3>Results</h3><div>After two years, the mean TWL% was 27.5% ± 7.7%. Nineteen patients (40.4%) had EDE-Q score more than 2.5. The EDE-Q positive patients had a mean %TWL of 25.7% ± 4.8%, while EDE-Q negative patients had a mean %TWL of 30.5% ± 6.2%. The difference is statistically significant.</div></div><div><h3>Conclusion</h3><div>We conclude that the outcome of sleeve gastrectomy in adolescents is affected by their eating behavior as soon as the restrictive effect of the operations subsides.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100207"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105018","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}
Pub Date : 2025-09-08DOI: 10.1016/j.obpill.2025.100209
Brittany V.B. Johnson, Mary Milstead, Rachel Kreider, Rachel Jones
Background
Recent advancements with Glucagon-like Peptide-1 Receptor Agonists (GLP-1RA) result in approximately 15 % or more weight reduction. Scientific research addressing specific nutritional concerns with GLP-1RA are still emerging. While some guidelines currently exist for nutritional considerations, they are largely focused on side effect management and providing basic dietary guidance during GLP-1RA.
Methods
This narrative review aims to provide practical evidence-based considerations for dietary supplementation to help optimize health outcomes while using GLP-1RA. We reviewed available literature of dietary supplementation interventions among individuals with obesity, weight loss clinical trials, and adiposity-related complications to help guide clinicians on potentially advantageous supplementation.
Results
Robust data from meta-analyses provides justification for a variety of dietary supplements that can support the unintended consequences of GLP-1RA treatments. Multivitamins are recommended to address micronutrient insufficiencies as determined by individual deficiencies and suboptimal intake. Protein supplements can help individuals meet daily protein intake recommendations of 1.2–2.0 g/kg/d. When combined with resistance training, whey protein can help preserve lean body mass during weight loss, with additional strength benefits from creatine monohydrate and β-Hydroxy β-Methylbutyrate supplementation. Antioxidants and anti-inflammatory nutrients can mitigate oxidative stress and inflammation. Fiber and probiotics can improve bowel regularity and mitigate side effects.
Conclusion
Healthcare providers play an active role in supporting their patients with comprehensive obesity treatment. Guidance should focus on improving their long-term health and potentially mitigating unintended consequences. Optimizing nutrient intakes with therapeutic doses of dietary supplements may enhance outcomes when used alongside GLP-1RA, such as increasing nutrient status, retaining lean mass, reducing oxidative stress and inflammation, and improving gastrointestinal health.
{"title":"Dietary supplement considerations during glucagon-like Peptide-1 receptor agonist treatment: A narrative review","authors":"Brittany V.B. Johnson, Mary Milstead, Rachel Kreider, Rachel Jones","doi":"10.1016/j.obpill.2025.100209","DOIUrl":"10.1016/j.obpill.2025.100209","url":null,"abstract":"<div><h3>Background</h3><div>Recent advancements with Glucagon-like Peptide-1 Receptor Agonists (GLP-1RA) result in approximately 15 % or more weight reduction. Scientific research addressing specific nutritional concerns with GLP-1RA are still emerging. While some guidelines currently exist for nutritional considerations, they are largely focused on side effect management and providing basic dietary guidance during GLP-1RA.</div></div><div><h3>Methods</h3><div>This narrative review aims to provide practical evidence-based considerations for dietary supplementation to help optimize health outcomes while using GLP-1RA. We reviewed available literature of dietary supplementation interventions among individuals with obesity, weight loss clinical trials, and adiposity-related complications to help guide clinicians on potentially advantageous supplementation.</div></div><div><h3>Results</h3><div>Robust data from meta-analyses provides justification for a variety of dietary supplements that can support the unintended consequences of GLP-1RA treatments. Multivitamins are recommended to address micronutrient insufficiencies as determined by individual deficiencies and suboptimal intake. Protein supplements can help individuals meet daily protein intake recommendations of 1.2–2.0 g/kg/d. When combined with resistance training, whey protein can help preserve lean body mass during weight loss, with additional strength benefits from creatine monohydrate and β-Hydroxy β-Methylbutyrate supplementation. Antioxidants and anti-inflammatory nutrients can mitigate oxidative stress and inflammation. Fiber and probiotics can improve bowel regularity and mitigate side effects.</div></div><div><h3>Conclusion</h3><div>Healthcare providers play an active role in supporting their patients with comprehensive obesity treatment. Guidance should focus on improving their long-term health and potentially mitigating unintended consequences. Optimizing nutrient intakes with therapeutic doses of dietary supplements may enhance outcomes when used alongside GLP-1RA, such as increasing nutrient status, retaining lean mass, reducing oxidative stress and inflammation, and improving gastrointestinal health.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100209"},"PeriodicalIF":0.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048594","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}
Pub Date : 2025-09-02DOI: 10.1016/j.obpill.2025.100208
Ola Faleh, Zaynab Alourfi
Introduction
Calcium is one of the most important elements in the human body playing a crucial role in various physiological functions. Its serum levels might be influenced by multiple factors. Obesity is a prevalent disease worldwide, and many studies have explored the relationship between obesity and serum calcium levels. This study aimed to investigate the association between Body Mass Index (BMI) and serum calcium.
Material and method
This cross-sectional study conducted at the National University Hospital between 2023 and 2024 involved 206 participants. Serum calcium levels were measured. A fasting morning blood sample was collected from each subject, and all tests were performed at The National University Hospital.
Result
The analysis showed no significant association between BMI and serum calcium levels, nor between age and serum calcium. However, after adjusting for age, the relationship between BMI and serum calcium strengthened and reached statistical significance, revealing an inverse correlation. This suggests that age acted as a partial confounding variable in the initial assessment.
Conclusion
While the initial findings of this cross-sectional study initially revealed no significant relationship between body mass index (BMI) and serum calcium, after adjusting for age, an inverse relationship was found between BMI and serum calcium, with higher BMI associated with lower serum calcium levels.
{"title":"The relationship between obesity and serum calcium level in a sample of Syrian people a cross sectional study","authors":"Ola Faleh, Zaynab Alourfi","doi":"10.1016/j.obpill.2025.100208","DOIUrl":"10.1016/j.obpill.2025.100208","url":null,"abstract":"<div><h3>Introduction</h3><div>Calcium is one of the most important elements in the human body playing a crucial role in various physiological functions. Its serum levels might be influenced by multiple factors. Obesity is a prevalent disease worldwide, and many studies have explored the relationship between obesity and serum calcium levels. This study aimed to investigate the association between Body Mass Index (BMI) and serum calcium.</div></div><div><h3>Material and method</h3><div>This cross-sectional study conducted at the National University Hospital between 2023 and 2024 involved 206 participants. Serum calcium levels were measured. A fasting morning blood sample was collected from each subject, and all tests were performed at The National University Hospital.</div></div><div><h3>Result</h3><div>The analysis showed no significant association between BMI and serum calcium levels, nor between age and serum calcium. However, after adjusting for age, the relationship between BMI and serum calcium strengthened and reached statistical significance, revealing an inverse correlation. This suggests that age acted as a partial confounding variable in the initial assessment.</div></div><div><h3>Conclusion</h3><div>While the initial findings of this cross-sectional study initially revealed no significant relationship between body mass index (BMI) and serum calcium, after adjusting for age, an inverse relationship was found between BMI and serum calcium, with higher BMI associated with lower serum calcium levels.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100208"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988583","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}
Pub Date : 2025-08-29DOI: 10.1016/j.obpill.2025.100206
Nora Struckmeyer , Torben Biester , Chantal Weiner , Evelin Sadeghian , Cathrin Guntermann , Laura Galuschka , Kisa von Stuelpnagel , Jantje Weiskorn , Kerstin Kapitzke , Karin Lange , Thomas Danne , Rebecca Toenne , Felix Reschke
Background
Childhood obesity is a growing global health crisis, driven by poor diet, reduced physical activity, and psychosocial distress. The COVID-19 pandemic amplified these factors, contributing to rising BMI and impaired health-related quality of life (HrQoL). Telehealth offers a promising, scalable modality to deliver multimodal obesity care. This study evaluated the long-term effectiveness of a structured pediatric telehealth intervention compared to historical in-person treatment.
Methods
This retrospective cohort study analyzed data from 237 children and adolescents with obesity treated at a single academic center. Between 2020 and 2022, 117 participants received a 12-month structured lifestyle intervention via telehealth. A historical cohort (n = 120; 2017–2019) received the same intervention in person. Clinical outcomes were assessed at baseline and after 12 months; the telehealth group was additionally followed up at 24 and 36 months. Primary outcome was change in BMI standard deviation score (BMI SDS). Secondary outcomes included physical fitness (6-min walk test), insulin resistance (HOMA index), lipid profile, dietary behavior (K-FFL), eating regulation (K-FEV), and HrQoL (KINDL-R).
Results
Both groups achieved significant reductions in BMI SDS after 12 months, with sustained improvements in the telehealth group through 36 months (Δ = −0.18; p < 0.05). Physical performance and HOMA index improved in both cohorts. Telehealth participants showed greater improvements in healthy dietary behavior, cognitive appetite regulation, and Health-related quality of life HrQoL, especially in emotional and family domains. No adverse events occurred; adherence exceeded 85 %.
Conclusion
A structured telehealth lifestyle intervention is safe, effective, and sustainable for pediatric obesity management. These findings support telehealth as a clinically viable and sustainable model for pediatric obesity care, recognizing that both weight reduction and weight stabilization may contribute to improved long-term outcomes.
{"title":"Evaluating the long-term effectiveness of a structured telehealth obesity program in children and adolescents: A retrospective matched-control study","authors":"Nora Struckmeyer , Torben Biester , Chantal Weiner , Evelin Sadeghian , Cathrin Guntermann , Laura Galuschka , Kisa von Stuelpnagel , Jantje Weiskorn , Kerstin Kapitzke , Karin Lange , Thomas Danne , Rebecca Toenne , Felix Reschke","doi":"10.1016/j.obpill.2025.100206","DOIUrl":"10.1016/j.obpill.2025.100206","url":null,"abstract":"<div><h3>Background</h3><div>Childhood obesity is a growing global health crisis, driven by poor diet, reduced physical activity, and psychosocial distress. The COVID-19 pandemic amplified these factors, contributing to rising BMI and impaired health-related quality of life (HrQoL). Telehealth offers a promising, scalable modality to deliver multimodal obesity care. This study evaluated the long-term effectiveness of a structured pediatric telehealth intervention compared to historical in-person treatment.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analyzed data from 237 children and adolescents with obesity treated at a single academic center. Between 2020 and 2022, 117 participants received a 12-month structured lifestyle intervention via telehealth. A historical cohort (n = 120; 2017–2019) received the same intervention in person. Clinical outcomes were assessed at baseline and after 12 months; the telehealth group was additionally followed up at 24 and 36 months. Primary outcome was change in BMI standard deviation score (BMI SDS). Secondary outcomes included physical fitness (6-min walk test), insulin resistance (HOMA index), lipid profile, dietary behavior (K-FFL), eating regulation (K-FEV), and HrQoL (KINDL-R).</div></div><div><h3>Results</h3><div>Both groups achieved significant reductions in BMI SDS after 12 months, with sustained improvements in the telehealth group through 36 months (Δ = −0.18; p < 0.05). Physical performance and HOMA index improved in both cohorts. Telehealth participants showed greater improvements in healthy dietary behavior, cognitive appetite regulation, and Health-related quality of life HrQoL, especially in emotional and family domains. No adverse events occurred; adherence exceeded 85 %.</div></div><div><h3>Conclusion</h3><div>A structured telehealth lifestyle intervention is safe, effective, and sustainable for pediatric obesity management. These findings support telehealth as a clinically viable and sustainable model for pediatric obesity care, recognizing that both weight reduction and weight stabilization may contribute to improved long-term outcomes.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100206"},"PeriodicalIF":0.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988586","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}
Pub Date : 2025-08-28DOI: 10.1016/j.obpill.2025.100205
Angela Fitch , Linda Gigliotti , Harold Edward Bays
Background
Obesity is a heterogeneous systemic chronic disease associated with excess adiposity and a complex etiology and is increasing in prevalence worldwide. Initially used to treat type 2 diabetes mellitus, glucagon-like peptide-1 (GLP-1) based therapies are now widely prescribed for individuals with overweight and obesity as an adjunct to a reduced-calorie diet and increased physical activity. However, despite their impressive weight reduction capabilities, many patients on GLP-1 based therapies do not receive appropriate nutrition advice and struggle to maintain their weight reduction.
Methods
This narrative review explores and summarizes existing literature on the challenges associated with nutrition intake in people with obesity taking GLP-1 based therapies and practical applications of nutrition and lifestyle interventions for the management of these individuals to ensure their best long-term health outcomes.
Results
Delivering optimal nutrition management to people with obesity treated with GLP-1 based therapies presents healthcare providers with many challenges including addressing the impact of obesity and weight reduction on body composition (particularly muscle mass loss and risk of sarcopenic obesity), and poor nutrition. Physicians should work with dietitians and other healthcare providers to deliver comprehensive lifestyle counselling that is patient-centered, aligning with the needs and preferences of the individual. This should include advice on: timely and appropriate nutrition that centers on adequate macronutrient, micronutrient and fluid intake, particularly increased protein intake alongside resistance training for the preservation of muscle mass; mental health; sleep hygiene, physical activity; and medication adherence and persistence. Evidence-based nutrition guidelines can also provide an important framework for healthcare professionals, helping to ensure nutrition advice is consistent and based on rigorous scientific research.
Conclusions
Our findings underscore the importance of ensuring that patients treated with GLP-1 based therapies are closely monitored and provided with comprehensive nutrition and lifestyle support to ensure they achieve the best long-term health outcomes.
{"title":"Application of nutrition interventions with GLP-1 based therapies: A narrative review of the challenges and solutions","authors":"Angela Fitch , Linda Gigliotti , Harold Edward Bays","doi":"10.1016/j.obpill.2025.100205","DOIUrl":"10.1016/j.obpill.2025.100205","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is a heterogeneous systemic chronic disease associated with excess adiposity and a complex etiology and is increasing in prevalence worldwide. Initially used to treat type 2 diabetes mellitus, glucagon-like peptide-1 (GLP-1) based therapies are now widely prescribed for individuals with overweight and obesity as an adjunct to a reduced-calorie diet and increased physical activity. However, despite their impressive weight reduction capabilities, many patients on GLP-1 based therapies do not receive appropriate nutrition advice and struggle to maintain their weight reduction.</div></div><div><h3>Methods</h3><div>This narrative review explores and summarizes existing literature on the challenges associated with nutrition intake in people with obesity taking GLP-1 based therapies and practical applications of nutrition and lifestyle interventions for the management of these individuals to ensure their best long-term health outcomes.</div></div><div><h3>Results</h3><div>Delivering optimal nutrition management to people with obesity treated with GLP-1 based therapies presents healthcare providers with many challenges including addressing the impact of obesity and weight reduction on body composition (particularly muscle mass loss and risk of sarcopenic obesity), and poor nutrition. Physicians should work with dietitians and other healthcare providers to deliver comprehensive lifestyle counselling that is patient-centered, aligning with the needs and preferences of the individual. This should include advice on: timely and appropriate nutrition that centers on adequate macronutrient, micronutrient and fluid intake, particularly increased protein intake alongside resistance training for the preservation of muscle mass; mental health; sleep hygiene, physical activity; and medication adherence and persistence. Evidence-based nutrition guidelines can also provide an important framework for healthcare professionals, helping to ensure nutrition advice is consistent and based on rigorous scientific research.</div></div><div><h3>Conclusions</h3><div>Our findings underscore the importance of ensuring that patients treated with GLP-1 based therapies are closely monitored and provided with comprehensive nutrition and lifestyle support to ensure they achieve the best long-term health outcomes.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100205"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105016","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}
Pub Date : 2025-08-27DOI: 10.1016/j.obpill.2025.100204
Zoobia W. Chaudhry , Marci Laudenslager , Kimberly A. Gudzune , Selvi Rajagopal
Background
Obesity is a prevalent and complex chronic disease yet physicians’ training in obesity care is often inadequate. Fellowship training in obesity medicine is now available at multiple academic medical centers; however, there has been limited description and evaluation of these programs to date. Therefore, this article describes our curriculum development process and fellowship program implementation experience at a U.S. academic medical center.
Methods
This was a structured, multi-phase curriculum development study guided by established obesity medicine competencies and certification standards. We used a six-step approach to curriculum development to guide our design with content informed by the Obesity Medicine Education Collaborative competencies, American Board of Obesity Medicine (ABOM) content outline, and Accreditation Council for Graduate Medical Education - International Obesity Medicine Fellowship program requirements. We utilized several tools of instruction as well as modes of assessing learners. Feedback from fellows and faculty was used to iteratively refine the program over the initial 3 years.
Results
We identified 19 content domains key for obesity medicine. Within each domain, we created instructional components including didactic e-lectures, directed readings, reflective assignments, role play activities, and clinical experiences. We developed evaluation tools to determine trainee progress including knowledge check assessments, mini-clinical evaluation exercises (mini-CEXs), and structured feedback. Early outcomes indicate that trainees achieve competence in obesity care, engage in meaningful scholarly activity, and benefit from professional development opportunities. All graduating fellows have successfully achieved ABOM certification. Feedback has informed fellowship refinements, particularly improvements in rotation timing and duration as well as additional subspecialty elective options.
Conclusion
This obesity medicine fellowship curriculum provides a structured, multidisciplinary program and graduates have achieved competency in obesity care. Obesity medicine fellowship training holds promise in advancing the field through innovative education and leadership development.
{"title":"Developing and implementing an obesity medicine fellowship program: Experience at a U.S. academic medical center","authors":"Zoobia W. Chaudhry , Marci Laudenslager , Kimberly A. Gudzune , Selvi Rajagopal","doi":"10.1016/j.obpill.2025.100204","DOIUrl":"10.1016/j.obpill.2025.100204","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is a prevalent and complex chronic disease yet physicians’ training in obesity care is often inadequate. Fellowship training in obesity medicine is now available at multiple academic medical centers; however, there has been limited description and evaluation of these programs to date. Therefore, this article describes our curriculum development process and fellowship program implementation experience at a U.S. academic medical center.</div></div><div><h3>Methods</h3><div>This was a structured, multi-phase curriculum development study guided by established obesity medicine competencies and certification standards. We used a six-step approach to curriculum development to guide our design with content informed by the Obesity Medicine Education Collaborative competencies, American Board of Obesity Medicine (ABOM) content outline, and Accreditation Council for Graduate Medical Education - International Obesity Medicine Fellowship program requirements. We utilized several tools of instruction as well as modes of assessing learners. Feedback from fellows and faculty was used to iteratively refine the program over the initial 3 years.</div></div><div><h3>Results</h3><div>We identified 19 content domains key for obesity medicine. Within each domain, we created instructional components including didactic e-lectures, directed readings, reflective assignments, role play activities, and clinical experiences. We developed evaluation tools to determine trainee progress including knowledge check assessments, mini-clinical evaluation exercises (mini-CEXs), and structured feedback. Early outcomes indicate that trainees achieve competence in obesity care, engage in meaningful scholarly activity, and benefit from professional development opportunities. All graduating fellows have successfully achieved ABOM certification. Feedback has informed fellowship refinements, particularly improvements in rotation timing and duration as well as additional subspecialty elective options.</div></div><div><h3>Conclusion</h3><div>This obesity medicine fellowship curriculum provides a structured, multidisciplinary program and graduates have achieved competency in obesity care. Obesity medicine fellowship training holds promise in advancing the field through innovative education and leadership development.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100204"},"PeriodicalIF":0.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925170","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}
Pub Date : 2025-08-19DOI: 10.1016/j.obpill.2025.100202
Francisca Contreras, Tak Ying Louise Ko, Carel W. le Roux, Werd Al-Najim
Introduction
Obesity is a disease that represents a major global health problem, affecting over a quarter of European adults and straining healthcare systems. Despite its multifactorial causes, many healthcare professionals lack adequate training and confidence in delivering effective, person-centered obesity care. Weight stigma and misconceptions further impair outcomes. Thus, improved education and interprofessional training are essential to support healthcare professionals in delivering optimal obesity care. The aim of this study is to explore the current state of obesity management training among healthcare professionals working in obesity management services by identifying perceived training gaps, confidence levels and impact on clinical practice.
Methodology
This study employed a mixed-methods design by combining a cross-sectional survey of 100 healthcare professionals with semi-structured interviews of 20 professionals who work in obesity management. Survey data were analyzed descriptively, and interview transcripts underwent thematic analysis using Braun and Clarke's framework.
Results
Of the 100 healthcare professionals surveyed, 88 % reported actively working in obesity management and completed the full survey. Undergraduate training in obesity care was limited, with only 44 % receiving any, and only 12 % rated it as good or excellent. Postgraduate training was pursued by 51 %, with only 6 % completing formal advanced education. Participant perceptions of obesity training were organized in 5 domains: a) Current state of obesity management training, b) Confidence level, c) Gaps in training, d) Impact on clinical practice and d) Recommendation for obesity training curriculum.
Conclusion
Healthcare professionals report significant gaps in obesity management training that impact their confidence and clinical practice. The key recommendations made by participants in this study reflect both the perceived deficits and a clear demand for more structured and comprehensive training in obesity management. Integrating structured, evidence-based obesity education into healthcare training programs is essential to reduce stigma, build competence, and improve obesity care.
{"title":"Healthcare professionals’ perspectives on the current state of obesity management training: A mix methods study","authors":"Francisca Contreras, Tak Ying Louise Ko, Carel W. le Roux, Werd Al-Najim","doi":"10.1016/j.obpill.2025.100202","DOIUrl":"10.1016/j.obpill.2025.100202","url":null,"abstract":"<div><h3>Introduction</h3><div>Obesity is a disease that represents a major global health problem, affecting over a quarter of European adults and straining healthcare systems. Despite its multifactorial causes, many healthcare professionals lack adequate training and confidence in delivering effective, person-centered obesity care. Weight stigma and misconceptions further impair outcomes. Thus, improved education and interprofessional training are essential to support healthcare professionals in delivering optimal obesity care. The aim of this study is to explore the current state of obesity management training among healthcare professionals working in obesity management services by identifying perceived training gaps, confidence levels and impact on clinical practice.</div></div><div><h3>Methodology</h3><div>This study employed a mixed-methods design by combining a cross-sectional survey of 100 healthcare professionals with semi-structured interviews of 20 professionals who work in obesity management. Survey data were analyzed descriptively, and interview transcripts underwent thematic analysis using Braun and Clarke's framework.</div></div><div><h3>Results</h3><div>Of the 100 healthcare professionals surveyed, 88 % reported actively working in obesity management and completed the full survey. Undergraduate training in obesity care was limited, with only 44 % receiving any, and only 12 % rated it as good or excellent. Postgraduate training was pursued by 51 %, with only 6 % completing formal advanced education. Participant perceptions of obesity training were organized in 5 domains: a) Current state of obesity management training, b) Confidence level, c) Gaps in training, d) Impact on clinical practice and d) Recommendation for obesity training curriculum.</div></div><div><h3>Conclusion</h3><div>Healthcare professionals report significant gaps in obesity management training that impact their confidence and clinical practice. The key recommendations made by participants in this study reflect both the perceived deficits and a clear demand for more structured and comprehensive training in obesity management. Integrating structured, evidence-based obesity education into healthcare training programs is essential to reduce stigma, build competence, and improve obesity care.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100202"},"PeriodicalIF":0.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144902894","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}
Pub Date : 2025-08-16DOI: 10.1016/j.obpill.2025.100201
Prateek Srivastav , K. Vaishali , H. Vinod Bhat , Suzanne Broadbent
Background
Health-related quality of life (HRQOL) is a critical yet often overlooked component of adolescent obesity management. While physical activity (PA) and body mass index (BMI) are established markers of health, their combined influence on HRQOL in Indian adolescents remains underexplored.
Objective
To examine how PA and BMI influence overall and domain-specific HRQOL in overweight and adolescents with obesity following a structured lifestyle program.
Methods
In this randomized controlled study, 604 adolescents (aged 11–16 years) with BMI above the 85th percentile were recruited from schools in Udupi, India. Individuals were randomized into three groups: multifactorial strategy (MFI: exercise, lifestyle education, behavioral counseling), exercise-only (EX), and Control group (CON). PA was measured using the Physical Activity Questionnaire for Adolescents (PAQ-A), and HRQOL was measured via the Pediatric Quality of Life Inventory (PedsQL 4.0). Linear mixed-effects models evaluated associations between PA, BMI, and HRQOL over a 12-month period, which included a 12-week intervention followed by 9 months of follow-up.
Results
PA was linked with better HRQOL in the MFI (β = 9.30, p < 0.001) and EX (β = 4.47, p < 0.001) groups. Interestingly, higher BMI correlated with better HRQOL scores in both program arms. The CON group showed no meaningful association between PA and HRQOL. The domain-level analysis found that PA and BMI were positively linked to physical, emotional, social, and school functioning in both program groups, with more pronounced effects in the MFI group. The CON group showed improvement only in emotional functioning related to BMI.
Conclusion
Structured PA programs, especially those combining education and behavioral support, notably enhance the quality of life among overweight Indian adolescents. These findings reinforce the importance of focusing not solely on weight loss, but on holistic, behavior-driven health outcomes in adolescent obesity care.
Clinical trial registration
CTRI/2019/04/018,834.
背景：与健康相关的生活质量（HRQOL）是青少年肥胖管理中一个关键但经常被忽视的组成部分。虽然身体活动（PA）和身体质量指数（BMI）是公认的健康指标，但它们对印度青少年HRQOL的综合影响仍未得到充分探讨。目的探讨PA和BMI如何影响超重和青少年肥胖患者遵循结构化生活方式计划的整体和特定领域的HRQOL。方法在这项随机对照研究中，从印度Udupi的学校招募了体重指数高于85百分位的604名青少年（11-16岁）。个体被随机分为三组：多因素策略组（MFI：运动，生活方式教育，行为咨询），只运动组（EX）和对照组（CON）。使用青少年体育活动问卷（PAQ-A）测量PA，通过儿科生活质量量表（PedsQL 4.0）测量HRQOL。线性混合效应模型评估了12个月期间PA、BMI和HRQOL之间的关系，其中包括12周的干预和9个月的随访。结果在MFI组（β = 9.30, p < 0.001）和EX组（β = 4.47, p < 0.001）中，spa与较好的HRQOL相关。有趣的是，在两个项目组中，较高的BMI与较好的HRQOL评分相关。CON组PA与HRQOL之间无显著相关性。领域水平分析发现，在两个项目组中，PA和BMI与身体、情感、社会和学校功能呈正相关，在MFI组中效果更明显。CON组仅在与BMI相关的情绪功能上有所改善。结论结构化的PA项目，特别是那些将教育和行为支持相结合的项目，显著提高了印度超重青少年的生活质量。这些发现强调了在青少年肥胖护理中，不仅要关注减肥，还要关注整体的、行为驱动的健康结果的重要性。临床试验注册ctri /2019/04/018,834。
{"title":"Impact of physical activity and BMI on health-related quality of life in overweight Indian adolescents: A randomized controlled study","authors":"Prateek Srivastav , K. Vaishali , H. Vinod Bhat , Suzanne Broadbent","doi":"10.1016/j.obpill.2025.100201","DOIUrl":"10.1016/j.obpill.2025.100201","url":null,"abstract":"<div><h3>Background</h3><div>Health-related quality of life (HRQOL) is a critical yet often overlooked component of adolescent obesity management. While physical activity (PA) and body mass index (BMI) are established markers of health, their combined influence on HRQOL in Indian adolescents remains underexplored.</div></div><div><h3>Objective</h3><div>To examine how PA and BMI influence overall and domain-specific HRQOL in overweight and adolescents with obesity following a structured lifestyle program.</div></div><div><h3>Methods</h3><div>In this randomized controlled study, 604 adolescents (aged 11–16 years) with BMI above the 85th percentile were recruited from schools in Udupi, India. Individuals were randomized into three groups: multifactorial strategy (MFI: exercise, lifestyle education, behavioral counseling), exercise-only (EX), and Control group (CON). PA was measured using the Physical Activity Questionnaire for Adolescents (PAQ-A), and HRQOL was measured via the Pediatric Quality of Life Inventory (PedsQL 4.0). Linear mixed-effects models evaluated associations between PA, BMI, and HRQOL over a 12-month period, which included a 12-week intervention followed by 9 months of follow-up.</div></div><div><h3>Results</h3><div>PA was linked with better HRQOL in the MFI (β = 9.30, p < 0.001) and EX (β = 4.47, p < 0.001) groups. Interestingly, higher BMI correlated with better HRQOL scores in both program arms. The CON group showed no meaningful association between PA and HRQOL. The domain-level analysis found that PA and BMI were positively linked to physical, emotional, social, and school functioning in both program groups, with more pronounced effects in the MFI group. The CON group showed improvement only in emotional functioning related to BMI.</div></div><div><h3>Conclusion</h3><div>Structured PA programs, especially those combining education and behavioral support, notably enhance the quality of life among overweight Indian adolescents. These findings reinforce the importance of focusing not solely on weight loss, but on holistic, behavior-driven health outcomes in adolescent obesity care.</div></div><div><h3>Clinical trial registration</h3><div>CTRI/2019/04/018,834.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100201"},"PeriodicalIF":0.0,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889615","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}
Pub Date : 2025-08-08DOI: 10.1016/j.obpill.2025.100200
Leslie Golden, Harold Edward Bays
{"title":"Obesity Medicine Association statement regarding online pharmacologic management of obesity","authors":"Leslie Golden, Harold Edward Bays","doi":"10.1016/j.obpill.2025.100200","DOIUrl":"10.1016/j.obpill.2025.100200","url":null,"abstract":"","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100200"},"PeriodicalIF":0.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048593","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}
Pub Date : 2025-07-26DOI: 10.1016/j.obpill.2025.100199
Kevin L. Roddy, Matthew R. Greenwald, Nicholas Hollman, Madisen F. Dorand, Jesse R. Richards
Background
Organ transplant is a rapidly growing area of medicine, with over 42,800 organ transplants occurring in 2022.[1] Obesity complicates the transplant surgery process; historically, the only available treatment for patients with both severe obesity and end-organ damage requiring transplant was bariatric surgery. Glucagon-like peptide-1 (GLP-1) and dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) agonists (such as semaglutide and tirzepatide, respectively) may offer a non-surgical alternative to weight management prior to transplant surgery.
Methods
This descriptive case series utilized retrospective chart review to compare peri-transplant weight loss in individuals treated with bariatric surgery alone, GLP-1 or GLP-1/GIP medication without surgical intervention, and GLP-1 or GLP-1/GIP medication with surgical intervention. Nineteen (N = 19) patients pursuing kidney transplant met inclusion criteria. Primary outcomes of interest in each group were median weight loss, total weight loss percent, and portion of individuals who met the BMI cut-off for transplantation following the intervention.
Results
Individuals treated with tirzepatide (n = 9) demonstrated 8 % less weight loss than the surgical-intervention group, and 77.8 % (n = 7) met BMI cutoff for transplant after treatment. Among patients treated with semaglutide (n = 4), 50 % (n = 2) met BMI cutoff for transplant. In the bariatric-surgery only group, 66.7 % (n = 2) met the BMI cutoff for transplant. Among those who received both bariatric surgery and GLP-1 medication (n = 3), all met the BMI cutoff for transplant.
Conclusions
This descriptive case series demonstrates that the current generation of weight loss medications produce a degree of weight loss comparable to bariatric surgery; this is particularly relevant to individuals with obesity who are pursuing organ transplant. Conclusions are limited due to the small, retrospective, and observational nature of this study; however, the results support the hypothesis that medications could revolutionize the organ transplant process by providing a reasonable non-surgical weight loss option for individuals with obesity. Further study with a larger, prospective randomized trial is needed to fully evaluate the viability of utilizing anti-obesity medications for this unique clinical indication.
{"title":"Obesity treatment as a bridge to solid organ transplantation: A comparison of bariatric surgery to medical therapy","authors":"Kevin L. Roddy, Matthew R. Greenwald, Nicholas Hollman, Madisen F. Dorand, Jesse R. Richards","doi":"10.1016/j.obpill.2025.100199","DOIUrl":"10.1016/j.obpill.2025.100199","url":null,"abstract":"<div><h3>Background</h3><div>Organ transplant is a rapidly growing area of medicine, with over 42,800 organ transplants occurring in 2022.[1] Obesity complicates the transplant surgery process; historically, the only available treatment for patients with both severe obesity and end-organ damage requiring transplant was bariatric surgery. Glucagon-like peptide-1 (GLP-1) and dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) agonists (such as semaglutide and tirzepatide, respectively) may offer a non-surgical alternative to weight management prior to transplant surgery.</div></div><div><h3>Methods</h3><div>This descriptive case series utilized retrospective chart review to compare peri-transplant weight loss in individuals treated with bariatric surgery alone, GLP-1 or GLP-1/GIP medication without surgical intervention, and GLP-1 or GLP-1/GIP medication with surgical intervention. Nineteen (N = 19) patients pursuing kidney transplant met inclusion criteria. Primary outcomes of interest in each group were median weight loss, total weight loss percent, and portion of individuals who met the BMI cut-off for transplantation following the intervention.</div></div><div><h3>Results</h3><div>Individuals treated with tirzepatide (n = 9) demonstrated 8 % less weight loss than the surgical-intervention group, and 77.8 % (n = 7) met BMI cutoff for transplant after treatment. Among patients treated with semaglutide (n = 4), 50 % (n = 2) met BMI cutoff for transplant. In the bariatric-surgery only group, 66.7 % (n = 2) met the BMI cutoff for transplant. Among those who received both bariatric surgery and GLP-1 medication (n = 3), all met the BMI cutoff for transplant.</div></div><div><h3>Conclusions</h3><div>This descriptive case series demonstrates that the current generation of weight loss medications produce a degree of weight loss comparable to bariatric surgery; this is particularly relevant to individuals with obesity who are pursuing organ transplant. Conclusions are limited due to the small, retrospective, and observational nature of this study; however, the results support the hypothesis that medications could revolutionize the organ transplant process by providing a reasonable non-surgical weight loss option for individuals with obesity. Further study with a larger, prospective randomized trial is needed to fully evaluate the viability of utilizing anti-obesity medications for this unique clinical indication.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100199"},"PeriodicalIF":0.0,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144902395","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}
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