Obesity Pillars最新文献_第6页

The complexity of obesity-related health problems after bariatric surgery: The patient perspective 减肥手术后肥胖相关健康问题的复杂性:患者视角

Obesity Pillars

Pub Date : 2023-09-01 DOI: 10.1016/j.obpill.2023.100082

G. Konings , M. Drukker , R. Severeijns , R. Ponds

Background

Bariatric surgery aims to improve quality of life by means of weight loss. Obesity-related physical and psychological health problems should improve, but long-term data are scarce.

Objectives

To evaluate preoperative physical and mental health problems perceived by the patient and the association with weight loss and quality of life, 5 years after bariatric surgery.

Methods

101 persons (response rate 67%) who had had bariatric surgery an average of 4.6 years before this study completed a written survey on obesity-related physical and psychological health problems and three psychological questionnaires collecting information on eating behavior and quality of life. Over half of the participants (55%) had had a laparoscopic adjustable gastric banding.

Results

Preoperatively reported health problems improved but were not necessarily associated with weight loss. Minimal improvement in tiredness, shame and weight instability were associated with significantly less weight loss. Preoperative type 2 diabetes mellitus (T2D) improved but participants had significantly less weight loss and more dissatisfaction regarding the bariatric trajectory than participants without T2D. Eating concerns, emotional eating and external eating improved but not restrained eating. Compared to the Dutch population reference, most quality of life scores of the participants were lower.

Conclusion

In this analysis, participants did report satisfaction although from a patients’ perspective, improvements of weight and health did not necessarily lead to satisfaction regarding the bariatric trajectory. Participants with postoperative reported fatigue and shame as well as participants with preoperative T2D showed significant less weight loss. More long-term research is necessary to close the current knowledge gap.

背景减肥手术旨在通过减肥来提高生活质量。与肥胖相关的身体和心理健康问题应该得到改善，但长期数据很少。目的评估患者在减肥手术后5年的术前身心健康问题及其与体重减轻和生活质量的关系。方法对101名平均4.6年前接受过减肥手术的患者（有效率67%）进行了与肥胖相关的身体和心理健康问题的书面调查，并收集了3份关于饮食行为和生活质量的心理问卷。超过一半的参与者（55%）进行了腹腔镜可调节胃束带术。结果术前报告的健康问题有所改善，但不一定与体重减轻有关。疲劳、羞耻感和体重不稳定的轻微改善与明显减少的体重减轻有关。术前2型糖尿病（T2D）有所改善，但与没有T2D的参与者相比，参与者的体重减轻明显较少，对减肥轨迹的不满程度更高。饮食问题、情绪化饮食和外部饮食改善了，但没有抑制饮食。与荷兰人口参考相比，参与者的大多数生活质量分数都较低。结论在这项分析中，参与者确实报告了满意度，尽管从患者的角度来看，体重和健康的改善并不一定会导致对减肥轨迹的满意度。术后报告疲劳和羞耻的参与者以及术前T2D的参与者的体重减轻明显减少。为了缩小目前的知识差距，需要进行更长期的研究。

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引用次数: 0

How to get back on track? Experiences of patients and healthcare professionals regarding weight recurrence and needs for an intervention after bariatric-metabolic surgery 如何回到正轨?患者和医疗保健专业人员关于体重复发和减肥代谢手术后干预需求的经验

Obesity Pillars

Pub Date : 2023-09-01 DOI: 10.1016/j.obpill.2023.100074

Vera Voorwinde , Sahar Moukadem , Maartje M. van Stralen , Ignace M.C. Janssen , Valerie M. Monpellier , Ingrid H.M. Steenhuis

Background

Multidisciplinary lifestyle interventions are recommended as a first step in treating weight recurrence after bariatric-metabolic surgery (BMS). However, little is known about the experience of patients and healthcare professionals (HCP) with these interventions and how they should be tailored to the patients’ needs. The aim of this study was to gain more insight into the experiences and needs of patients and HCP regarding weight recurrence after BMS and an intervention to get Back on Track. In addition, attitudes towards integrating e-Health into the care program were explored.

Methods

A qualitative process evaluation of an intervention for weight recurrence, the Back on Track (BoT), was conducted by means of in-depth interviews and focus groups with 19 stakeholders, including patients and HCP involved in BoT. Interviews were transcribed verbatim. Data were analyzed through thematic analysis.

Results

Patients and HCP reported a wide array of causes of weight recurrence. Patients found it difficult to decide when weight recurrence is problematic and when they should ask for help. Patients reported feeling like the exception and ashamed, therefore experiencing a high threshold to seek help. E-Health was seen as a promising way to improve tailoring, screening, autonomy for the patient, and accessible contact.

Conclusion

Patients should be adequately counselled on weight recurrence after BMS and the importance of intervening early. It is important to lower the threshold for seeking help. For example by offering more long-term standard care or by adding e-Health to the intervention.

背景建议将多学科的生活方式干预作为治疗减肥代谢手术（BMS）后体重复发的第一步。然而，人们对患者和医疗保健专业人员（HCP）在这些干预措施方面的经验以及如何根据患者的需求进行调整知之甚少。本研究的目的是深入了解患者和HCP在BMS后体重复发方面的经验和需求，以及重返正轨的干预措施。此外，还探讨了将电子健康纳入护理计划的态度。方法通过对19名利益相关者（包括参与BoT的患者和HCP）进行深入访谈和焦点小组，对体重复发干预措施“回到正轨”（BoT）进行定性过程评估。访谈逐字记录。数据通过专题分析进行分析。结果患者和HCP报告了各种各样的体重复发原因。患者发现很难决定何时体重复发有问题，以及何时应该寻求帮助。患者报告称，他们感觉自己是个例外，感到羞愧，因此寻求帮助的门槛很高。电子健康被视为一种很有前途的方法，可以改善患者的定制、筛查、自主性和可接触性。结论应充分告知患者BMS后的体重复发以及早期干预的重要性。降低寻求帮助的门槛很重要。例如，通过提供更长期的标准护理或在干预中加入电子健康。

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引用次数: 0

Comparing the use of food and physical activity parenting practices: Parents of children with overweight and obesity versus parents of children with a healthy weight 比较使用食物和体育活动的父母做法:超重和肥胖儿童的父母与健康体重儿童的父母

Obesity Pillars

Pub Date : 2023-09-01 DOI: 10.1016/j.obpill.2023.100078

Lisanne Arayess , Sanne M. Gerards , Junilla K. Larsen , Ester F.C. van der Borgh-Sleddens , Anita C.E. Vreugdenhil

Background

Paediatric overweight and obesity are caused by a complex imbalance between energy intake and expenditure. Parents may influence this imbalance through energy balance-related parenting practices. This study aims to compare the use of energy balance-related parenting practices between parents of children with overweight and obesity and children with a healthy weight.

Methods

This study compares energy balance-related parenting practices among a group of parents with children with overweight and obesity at the start of a lifestyle intervention (N = 107) and children with a healthy weight (N = 137). Specifically, it compares the feeding practices ‘overt control’ (open control over eating), ‘encouragement’, ‘instrumental feeding’, ‘emotional feeding’, and ‘covert control’ (hidden control over eating), as well as the physical activity parenting practice ‘promoting physical activity’. Multiple regression analyses are used to calculate associations between child weight groups and parenting practices when corrected for children's characteristics.

Results

Parents of children with overweight and obesity reported significantly different scores on control over eating practices than parents of children with a healthy weight, namely a significantly higher score on covert control (B = 0.397, S.E. 0.123, p = 0.001) and a significantly lower score for overt control (B = −0.136, S.E. 0.068, p = 0.046).

Conclusion

Covert control is reported more, while overt control is reported less in parents of children with overweight and obesity compared to parents of children with a healthy weight, even after correction for the child's, family, and maternal characteristics. Future longitudinal research and intervention trials are recommended to determine whether and how the use of control over eating practices changes.

背景儿童超重和肥胖是由能量摄入和消耗之间的复杂失衡引起的。父母可能会通过与能量平衡相关的育儿实践来影响这种不平衡。本研究旨在比较超重和肥胖儿童的父母与健康体重儿童在能量平衡相关育儿实践方面的使用情况。方法本研究比较了一组在生活方式干预开始时超重和肥胖儿童（N=107）和健康体重儿童（N=137）的父母与能量平衡相关的育儿实践。具体而言，它比较了“显性控制”（对饮食的公开控制）、“鼓励”、“工具性喂养”、“情感性喂养”和“隐性控制”（饮食的隐性控制）的喂养实践，以及“促进体育活动”的体育活动育儿实践。多元回归分析用于计算校正儿童特征后儿童体重组与育儿实践之间的关联。结果超重和肥胖儿童的父母在饮食控制方面的得分与健康体重儿童的父母显著不同，即隐性控制得分显著较高（B=0.397，S.E.0.123，p=0.001），显性控制得分显著较低（B=−0.136，S.E.0.068，p=0.046），即使在对孩子、家庭和母亲的特征进行校正之后。建议未来进行纵向研究和干预试验，以确定对饮食习惯的控制是否以及如何改变。

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引用次数: 0

Comprehensive care for patients with obesity: An Obesity Medicine Association Position Statement 肥胖症患者的综合护理:肥胖症医学协会立场声明

Obesity Pillars

Pub Date : 2023-09-01 DOI: 10.1016/j.obpill.2023.100070

Angela Fitch , Lydia Alexander , Carolynn Francavilla Brown , Harold Edward Bays

引用次数: 4

Diagnostic challenge: A pediatric patient with severe obesity and complications of imminent death 诊断挑战:一名患有严重肥胖和即将死亡并发症的儿科患者

Obesity Pillars

Pub Date : 2023-09-01 DOI: 10.1016/j.obpill.2023.100077

Gitanjali Srivastava

Background

A 15-year-old patient suffering from severe obesity (400 pounds, BMI 71.6 kg/m²) with a clinical phenotype suggestive of syndromic obesity was hospitalized for severe heart failure and cardiogenic shock. The hospital admission prompted a palliative care and heart transplant consultation given end-stage-disease and poor prognosis. It further necessitated a pediatric inpatient obesity consult, which was complicated by several significant hurdles including lack of insurance coverage, FDA approvals, availability of medications, and inadequate knowledge among the medical community.

Methods

Innovative treatment, proactive, persistent advocacy, anti-obesity medication combination strategies modeled after diabetes and hypertension treatment algorithms, and latest evidence in obesity management were utilized to effectively and expeditiously overcome major challenges to care and the medical emergency.

Results

The patient was stabilized and ultimately discharged home, after −25.2% weight loss over 4 months (weight down to 299 pounds, BMI 49.9 kg/m²) through collaborative medical obesity intervention.

Conclusion

The typical delay in care sought by patients suffering from obesity, often due to stigma and lack of disease awareness, results in missed opportunities to prevent serious obesity-related complications. Skilled specialist expertise, fund of obesity-specific knowledge, and constant advocacy can be crucial in surmounting regulatory barriers to obesity care and in generating successful weight loss outcomes.

背景一名患有严重肥胖（400磅，BMI 71.6 kg/m2）的15岁患者因严重心力衰竭和心源性休克住院，其临床表型提示为综合征性肥胖。考虑到末期疾病和预后不佳，入院后进行了姑息治疗和心脏移植咨询。这进一步需要进行儿科住院肥胖咨询，这因几个重大障碍而变得复杂，包括缺乏保险、美国食品药品监督管理局批准、药物可用性以及医学界知识不足。方法利用创新治疗、积极、持续的宣传、模仿糖尿病和高血压治疗算法的抗肥胖药物组合策略，以及肥胖管理的最新证据，有效、迅速地克服护理和医疗紧急情况方面的重大挑战。结果患者在4个月内体重减轻了25.2%（体重降至299磅，BMI为49.9 kg/m2），通过协作性肥胖医疗干预，病情稳定，最终出院回家。结论肥胖患者寻求护理的典型延迟，通常是由于耻辱感和缺乏疾病意识，导致错过了预防严重肥胖相关并发症的机会。熟练的专业知识、专门针对肥胖的知识基金和持续的宣传对于克服肥胖护理的监管障碍和成功减肥至关重要。

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引用次数: 0

Successful treatment of binge eating disorder with the GLP-1 agonist semaglutide: A retrospective cohort study GLP-1激动剂西马鲁肽成功治疗暴食症:一项回顾性队列研究

Obesity Pillars

Pub Date : 2023-09-01 DOI: 10.1016/j.obpill.2023.100080

Jesse Richards , Neha Bang , Erin L. Ratliff , Maria A. Paszkowiak , Zhamak Khorgami , Sahib S. Khalsa , W. Kyle Simmons

Objective

Binge eating disorder (BED) is the most common eating disorder, and yet only one pharmacotherapy (lisdexamfetamine), which has known abuse-potential, is FDA-approved. Topiramate is also commonly prescribed off-label for binge eating but has many contraindications. In contrast, the glucagon-like peptide-1 (GLP1) analog semaglutide has profound effects on central satiety signaling leading to reduced food intake, and has been approved for the treatment of obesity based on its efficacy and safety profile. Semaglutide would thus seem to be a potential candidate for the treatment of BED.

Methods

This open-label study examined the effects of semaglutide on Binge Eating Scale (BES) scores in individuals with BED. Patients were divided into three groups: those prescribed semaglutide, those prescribed either lisdexamphetamine or topiramate, and those prescribed a combination of semaglutide with lisdexamphetamine or topiramate.

Results

Patients receiving semaglutide only exhibited greater reductions in BES scores compared to the other groups. Combined pharmacotherapy with both semaglutide and the other anti-obesity medications did not result in greater reductions in BES scores compared to the semaglutide-only group. Findings were similar in patients with moderate/severe BED, as well as the full sample.

Conclusion

The therapeutic effects of semaglutide in binge eating disorder warrant further investigation.

Binge饮食障碍（BED）是最常见的饮食障碍，但只有一种已知有滥用潜力的药物疗法（利沙非他明）获得了美国食品药品监督管理局的批准。托吡酯通常也被标示外用于暴饮，但有许多禁忌症。相比之下，胰高血糖素样肽-1（GLP1）类似物semaglutide对中枢饱腹感信号具有深远影响，导致食物摄入减少，并已根据其疗效和安全性被批准用于治疗肥胖。因此，Semagudie似乎是治疗BED的潜在候选药物。方法本项开放标签研究考察了赛马鲁肽对BED患者Binge Eating Scale（BES）评分的影响。患者被分为三组：服用塞米鲁肽的患者、服用利右苯丙胺或托吡酯的患者，以及服用塞米鲁肽与利右苯安非他明或托吡酸联合用药的患者。结果与其他组相比，接受赛马鲁肽治疗的患者BES评分下降幅度更大。与仅使用赛马鲁肽的组相比，同时使用赛马鲁肽和其他抗肥胖药物的联合药物治疗并没有导致BES评分的更大降低。中度/重度BED患者和全样本的结果相似。结论赛马鲁肽治疗暴饮性饮食障碍的疗效值得进一步研究。

{"title":"Successful treatment of binge eating disorder with the GLP-1 agonist semaglutide: A retrospective cohort study","authors":"Jesse Richards , Neha Bang , Erin L. Ratliff , Maria A. Paszkowiak , Zhamak Khorgami , Sahib S. Khalsa , W. Kyle Simmons","doi":"10.1016/j.obpill.2023.100080","DOIUrl":"https://doi.org/10.1016/j.obpill.2023.100080","url":null,"abstract":"<div><h3>Objective</h3><p>Binge eating disorder (BED) is the most common eating disorder, and yet only one pharmacotherapy (lisdexamfetamine), which has known abuse-potential, is FDA-approved. Topiramate is also commonly prescribed off-label for binge eating but has many contraindications. In contrast, the glucagon-like peptide-1 (GLP1) analog semaglutide has profound effects on central satiety signaling leading to reduced food intake, and has been approved for the treatment of obesity based on its efficacy and safety profile. Semaglutide would thus seem to be a potential candidate for the treatment of BED.</p></div><div><h3>Methods</h3><p>This open-label study examined the effects of semaglutide on Binge Eating Scale (BES) scores in individuals with BED. Patients were divided into three groups: those prescribed semaglutide, those prescribed either lisdexamphetamine or topiramate, and those prescribed a combination of semaglutide with lisdexamphetamine or topiramate.</p></div><div><h3>Results</h3><p>Patients receiving semaglutide only exhibited greater reductions in BES scores compared to the other groups. Combined pharmacotherapy with both semaglutide and the other anti-obesity medications did not result in greater reductions in BES scores compared to the semaglutide-only group. Findings were similar in patients with moderate/severe BED, as well as the full sample.</p></div><div><h3>Conclusion</h3><p>The therapeutic effects of semaglutide in binge eating disorder warrant further investigation.</p></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49700031","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: 1

Whole-body bone mineral density and markers of bone homeostasis in adults with normal-weight obesity 正常体重肥胖成人的全身骨密度和骨稳态指标

Obesity Pillars

Pub Date : 2023-09-01 DOI: 10.1016/j.obpill.2023.100073

Bryant H. Keirns , Christina M. Sciarrillo , Austin R. Medlin , Samantha M. Hart , Elyse M. Cronic , Sam R. Emerson

Background

Normal-weight obesity (NWO) describes individuals with a normal body mass index (BMI), but high body fat percent. NWO are at-risk for cardiometabolic diseases, but little is known about their bone health.

Methods

Adults (N = 24) were classified as NWO (n = 12; 5M/7F) or low body fat percent controls (Con; n = 12; 6M/6F). Body composition and whole-body bone mineral density (BMD) were assessed using DXA. A serum bioplex assay was performed to examine markers related to bone formation and resorption.

Results

In addition to higher body fat percent and visceral fat, NWO had lower whole-body BMD relative to Con (p's < 0.05). Circulating leptin was higher in NWO than Con (p < 0.05). Two biomarkers generally associated with lower bone mass – sclerostin and parathyroid hormone – were higher in NWO compared to Con (p's < 0.05).

Conclusion

In this preliminary study, adults with NWO displayed lower whole-body BMD alongside evidence of bone resorption. Impaired bone health may be another subclinical risk factor present in NWO.

背景正常体重肥胖（NWO）是指体重指数（BMI）正常，但体脂百分比较高的个体。NWO有患心脏代谢疾病的风险，但对其骨骼健康知之甚少。方法将成年人（N=24）分为NWO（N=12；5M/7F）或低体脂百分比对照组（Con；N=12；6M/6F）。使用DXA评估身体成分和全身骨密度（BMD）。进行血清生物复合物测定以检查与骨形成和骨吸收相关的标志物。结果除了较高的体脂百分比和内脏脂肪外，与Con相比，NWO的全身BMD较低（p’s<；0.05）。NWO的循环瘦素高于Con（p＜0.05）。通常与较低骨量相关的两种生物标志物——硬化素和甲状旁腺激素——在NWO中高于Con。结论在本初步研究中，患有NWO的成年人显示出较低的全身BMD以及骨吸收的证据。骨健康受损可能是NWO中存在的另一个亚临床风险因素。

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引用次数: 1

Why does type 2 diabetes mellitus impair weight reduction in patients with obesity? A review 为什么2型糖尿病会损害肥胖患者的体重减轻?回顾

Obesity Pillars

Pub Date : 2023-09-01 DOI: 10.1016/j.obpill.2023.100076

Harold Edward Bays

Background

A common adiposopathic complication of obesity is type 2 diabetes mellitus. Healthful weight reduction in patients with obesity can improve glucose metabolism and potentially promote remission of type 2 diabetes mellitus. However, weight-reduction in patients with increased adiposity is impaired among patients with type 2 diabetes mellitus compared to patients without diabetes mellitus.

Methods

Data for this review were derived from PubMed and applicable websites.

Results

Among patients with increased body fat, the mechanisms underlying impaired weight reduction for those with type 2 diabetes mellitus are multifactorial, and include energy conservation (i.e., improved glucose control and reduced glucosuria), hyperinsulinemia (commonly found in many patients with type 2 diabetes mellitus), potential use of obesogenic anti-diabetes medications, and contributions from multiple body systems. Other factors include increased age, sex, genetic/epigenetic predisposition, and obesogenic environments.

Conclusions

Even though type 2 diabetes mellitus impairs weight reduction among patients with increased adiposity, clinically meaningful weight reduction improves glucose metabolism and can sometimes promote diabetes remission. An illustrative approach to mitigate impaired weight reduction due to type 2 diabetes mellitus is choosing anti-diabetes medications that increase insulin sensitivity and promote weight loss and deprioritize use of anti-diabetes medications that increase insulin exposure and promote weight gain.

肥胖的常见脂肪病并发症是2型糖尿病。肥胖患者健康减肥可以改善葡萄糖代谢，并有可能促进2型糖尿病的缓解。然而，与没有糖尿病的患者相比，2型糖尿病患者中肥胖增加的患者的体重减轻受到损害。方法本综述的数据来源于PubMed和相关网站。结果在体脂增加的患者中，2型糖尿病患者体重减轻受损的机制是多因素的，包括节能（即改善血糖控制和减少血糖）、高胰岛素血症（常见于许多2型糖尿病病人）、潜在的肥胖抗糖尿病药物的使用，以及来自多个身体系统的贡献。其他因素包括年龄、性别、遗传/表观遗传易感性和肥胖环境的增加。结论尽管2型糖尿病阻碍了肥胖增加患者的减肥，但有临床意义的减肥可以改善糖代谢，有时还可以促进糖尿病的缓解。减轻2型糖尿病导致的体重减轻障碍的一种说明性方法是选择增加胰岛素敏感性和促进体重减轻的抗糖尿病药物，并优先使用增加胰岛素暴露和促进体重增加的抗糖尿病药。

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引用次数: 1

Weight management treatment modalities in patients with overweight or obesity: A retrospective cohort study of administrative claims data 超重或肥胖患者的体重管理治疗方式:行政索赔数据的回顾性队列研究

Obesity Pillars

Pub Date : 2023-09-01 DOI: 10.1016/j.obpill.2023.100072

Hong Kan , Jason P. Swindle , Jay Bae , Julia P. Dunn , Erin K. Buysman , Noelle N. Gronroos , Lindsay Bengtson , Chanadda Chinthammit , Janet Ford , Nadia Ahmad

Background

The purpose of this study was to describe demographic and clinical characteristics among patients who have medical encounters for weight management treatments and to investigate the association of those characteristics with treatment modality.

Methods

This was a retrospective database study using medical claims, pharmacy claims, and enrollment information from commercial and Medicare Advantage with Part D members in the Optum Research Database from 01/01/2011−2/29/2020. Adult patients with a claim for a weight management treatment from 01/01/2012−2/28/2019 were categorized into cohorts according to the highest intensity intervention received. To examine the association between patient characteristics and treatment modality received, a multinomial logit model was performed.

Results

Cohorts by increasing intensity included lifestyle intervention (LSI, n = 67,679), weight reduction pharmacotherapy (WRRx) with an anti-obesity medication (AOM, n = 6,905), weight reduction procedure (WRP, n = 1,172), and weight reduction surgery (WRS, n = 18,036). Approximately 32.1% and 16.6% of patients who received WRS or WRP had an LSI during the 12-month baseline, and only 0.6% and 0.4% had treatment with long-term AOMs. In a multinomial logit model, patients with type 2 diabetes (not including WRRx cohort), respiratory disorders, cardiovascular risk factors, pain disorders, and mental health conditions had increased odds of treatment with higher intensity intervention versus LSI. Patients who were male, received an intervention more recently (2016-2019), or had a Charlson comorbidity score of 1 (compared to 0) had decreased odds of treatment with higher intensity interventions.

Conclusion

In this study, age, sex, body mass index, obesity-related complications, and Charlson comorbidity score appeared to influence the type of weight management treatment modality received. This study improves understanding of weight management treatment utilization and identifies gaps and opportunities to improve obesity care with the appropriate use of different treatment modalities.

背景本研究的目的是描述有体重管理治疗经历的患者的人口统计学和临床特征，并调查这些特征与治疗方式的关系。方法这是一项回顾性数据库研究，使用了2011年1月1日至2020年2月29日Optum研究数据库中商业和医疗保险优势D部分成员的医疗索赔、药房索赔和注册信息。根据接受的最高强度干预，将2012年1月1日至2019年2月28日期间要求接受体重管理治疗的成年患者分为队列。为了检验患者特征和接受的治疗方式之间的相关性，进行了多项logit模型。结果按强度递增的队列包括生活方式干预（LSI，n=67679）、抗肥胖药物减肥药物治疗（WRRx）（AOM，n=6905）、减肥程序（WRP，n=1172）和减肥手术（WRS，n=18036）。在12个月的基线期内，接受WRS或WRP治疗的患者中，约有32.1%和16.6%患有LSI，只有0.6%和0.4%接受了长期AOM治疗。在多项logit模型中，与LSI相比，患有2型糖尿病（不包括WRRx队列）、呼吸系统疾病、心血管危险因素、疼痛障碍和心理健康状况的患者接受更高强度干预的几率增加。男性患者、最近接受干预的患者（2016-2019年）或Charlson共病评分为1（与0相比）的患者接受更高强度干预的几率降低。结论在本研究中，年龄、性别、体重指数、肥胖相关并发症和Charlson共病评分似乎会影响所接受的体重管理治疗方式的类型。这项研究提高了对体重管理治疗利用率的理解，并确定了通过适当使用不同治疗模式来改善肥胖护理的差距和机会。

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引用次数: 0

Physical and psychosocial determinants of quality of life in children with obesity 肥胖儿童生活质量的生理和心理决定因素

Obesity Pillars

Pub Date : 2023-09-01 DOI: 10.1016/j.obpill.2023.100081

Beau L. Mansker , Katherine Schwartzkopf , Jose A. Velez II , Anthony J. Perkins , Sara K. Naramore

Background

Obesity has a negative impact on the physical and psychosocial quality of life of children. As rates of obesity continue to increase, it is important to recognize the widespread effects obesity has on children and their families.

Methods

This clinical investigation evaluated the self-reported quality of life of children with obesity in a weight management program and compared this to a parent/guardian’s perspective of the child’s quality of life using the Pediatric Quality of Life survey 4.0. The quality of life of children with obesity was compared to children with other chronic diseases and healthy children.

Results

An association was discovered between the guardians’ responses to the Pediatric Quality of Life survey and the child’s age. Guardians with children younger than 11 years reported higher quality of life scores than guardians of children 11 years and older. Race, comorbidities of obesity, insurance type, household structure, and parental education attainment were not significantly associated with a child’s quality of life. Children with obesity had a lower quality of life compared to children who were organ transplant recipients and children with organic gastrointestinal disease.

Conclusions

These results emphasize the need to evaluate and treat the physical and psychosocial components of wellbeing in children with obesity at an early age.

背景肥胖对儿童的身体和心理生活质量有负面影响。随着肥胖率的持续上升，重要的是要认识到肥胖对儿童及其家庭的广泛影响。方法本临床调查评估了体重管理项目中肥胖儿童自我报告的生活质量，并使用儿科生活质量调查4.0将其与父母/监护人对儿童生活质量的看法进行了比较。将肥胖儿童的生活质量与患有其他慢性病的儿童和健康儿童进行比较。结果发现监护人对儿童生活质量调查的反应与孩子的年龄有关。有11岁以下儿童的监护人的生活质量得分高于11岁及以上儿童的监护人。种族、肥胖合并症、保险类型、家庭结构和父母教育程度与儿童的生活质量没有显著相关性。与接受器官移植的儿童和患有器质性胃肠道疾病的儿童相比，肥胖儿童的生活质量较低。结论这些结果强调了评估和治疗早期肥胖儿童健康的身体和心理社会组成部分的必要性。

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引用次数: 0