Obesity Pillars最新文献_第6页

Improving obesity treatment through online motivational support in primary care 在初级保健中通过在线激励支持改善肥胖治疗

Obesity Pillars

Pub Date : 2025-12-01 Epub Date: 2025-07-01 DOI: 10.1016/j.obpill.2025.100191

Jessica Stockham , Shannon Harris , William Berard

Background

Obesity is a complex, chronic disease requiring time-intensive, multifaceted management strategies that are often difficult to implement in primary care. This quality improvement project aimed to evaluate whether the integration of an online motivational support group via Facebook, in addition to routine monthly office visits, could enhance obesity treatment outcomes and patient motivation in a primary care setting. As a nurse practitioner driven project, nurse practitioners have the training to make significant improvements in the area of obesity treatment. Nurse practitioners are key in providing patients with education and tools to help patients lose weight and maintain successful weight loss (Fruh, 2017) [1].

Methods

This was a quality improvement project using a pre-post design conducted at a private outpatient internal medicine clinic. Adult patients (n = 68) with a BMI ≥30 or ≥25 with comorbidities were enrolled. Participants joined a Facebook-based support group and received standardized education and monthly in-person follow-up for 12 weeks. Outcomes measured before and after the intervention included weight, BMI, waist circumference, and responses to the Weight Efficacy Lifestyle Questionnaire-Short Form (WEL-SF). Paired t-tests were used for statistical analysis.

Results

Statistically significant improvements were observed in weight (−9.46 lbs, p < 0.0001), BMI (−1.91, p < 0.0001), and waist circumference (−1.87 inches, p < 0.0001). WEL-SF scores improved significantly in 7 of 8 domains, with an average increase of 11.8 %, indicating enhanced self-efficacy and motivation for healthy eating behaviors.

Conclusion

The integration of an online motivational support platform with monthly in-office visits significantly improved physiologic outcomes and patient self-efficacy in managing obesity. These findings support the feasibility and potential benefit of low-cost digital support tools in augmenting outpatient obesity care, particularly in settings with limited resources. Further research should explore the impact of engagement level and long-term outcomes.

背景：肥胖是一种复杂的慢性疾病，需要耗时、多方面的管理策略，往往难以在初级保健中实施。本质量改进项目旨在评估通过Facebook整合在线激励支持小组，除了常规的每月办公室访问外，是否可以提高初级保健环境中的肥胖治疗结果和患者动机。作为一个由执业护士驱动的项目，执业护士接受了培训，在肥胖治疗领域取得了重大进展。执业护士是为患者提供教育和工具以帮助患者减肥并保持成功减肥的关键（Fruh, 2017）。方法采用岗前设计，在某私立内科门诊进行质量改进项目。纳入BMI≥30或≥25并伴有合并症的成年患者（n = 68）。参与者加入了一个基于facebook的支持小组，并接受了标准化的教育和为期12周的每月面对面随访。干预前后测量的结果包括体重、BMI、腰围和对体重功效生活方式问卷（well - sf）的回答。采用配对t检验进行统计分析。结果：在体重方面有统计学上的显著改善(- 9.46磅，p <；0.0001), BMI (- 1.91, p <；0.0001)，腰围(- 1.87英寸，p <；0.0001)。well - sf得分在8个领域中的7个领域显著提高，平均提高11.8%，表明自我效能感和健康饮食行为动机增强。结论将在线激励支持平台与每月就诊相结合，可显著改善肥胖患者的生理结局和自我效能感。这些发现支持了低成本数字支持工具在增加门诊肥胖护理方面的可行性和潜在效益，特别是在资源有限的情况下。进一步的研究应探讨参与水平和长期结果的影响。

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引用次数: 0

Diet quality and nutrient distribution while using glucagon-like-peptide-1 receptor agonist: A secondary cross-sectional analysis 使用胰高血糖素样肽-1受体激动剂时的饮食质量和营养分布：二次横断面分析

Obesity Pillars

Pub Date : 2025-12-01 Epub Date: 2025-07-08 DOI: 10.1016/j.obpill.2025.100195

Brittany V.B. Johnson, Mary Milstead, Lauren Green, Rachel Kreider, Rachel Jones

Background

With the rise of glucagon-like-peptide-1 receptor agonist medications (GLP-1RA) for obesity treatment, understanding diet quality can be a valuable tool for providing evidence-based nutrition guidance. However, there is limited data on dietary intake during GLP-1RA treatment. Thus, we analyzed diet quality and nutrient timing while using GLP-1RA.

Methods

This was a secondary analysis from a previous cross-sectional online survey questionnaire study involving adults currently using GLP-1RA for weight reduction (N = 69, 49.6 ± 12.3 years old, 35.9 ± 9.1 kg/m2). Three-day food records were analyzed using the Healthy Eating Index (HEI), a validated score that indicates overall diet quality. The 13 HEI components were scored from average 3-day food records and calculated using 95 % confidence intervals (CI). A Bonferroni correction applied significance accepted at p = 0.0038. Additionally, 95 % CI were calculated for calories, macronutrients, and fiber intake reported for breakfast, lunch, dinner, and snacks.

Results

A 95 % CI revealed a total HEI score of 54 ± 12 (51.4, 57.3), significantly below the HEI goal (p < 0.0038). All components, except added sugars, were significantly under the max score. There was no significant difference for HEI scores based on duration of GLP-1RA use. The largest number of calories were consumed at dinner, averaging 649 compared to 538, 392, and 391 calories at lunch, breakfast, and snacks, respectively. Further, 40 % of the total daily protein intake occurred at dinnertime.

Conclusion

Within the sample of patients using GLP-1RAs, dietary quality was suboptimal for fruits, vegetables, whole grains, seafood and plant proteins, dairy and fatty acids. Future research is needed to determine if HEI scores change before, during, and after GLP-1RA treatments and nutrient timing.

随着胰高血糖素样肽-1受体激动剂（GLP-1RA）药物用于肥胖治疗的兴起，了解饮食质量可能是提供循证营养指导的宝贵工具。然而，关于GLP-1RA治疗期间饮食摄入的数据有限。因此，我们在使用GLP-1RA时分析了饮食质量和营养时机。方法：这是先前一项横断面在线调查问卷研究的二次分析，该研究涉及目前使用GLP-1RA减肥的成年人（N = 69, 49.6±12.3岁，35.9±9.1 kg/m2）。三天的饮食记录分析使用健康饮食指数（HEI），一个有效的分数，表明整体饮食质量。13种HEI成分根据平均3天的食物记录进行评分，并使用95%置信区间（CI）计算。Bonferroni校正应用显著性接受p = 0.0038。此外，计算了早餐、午餐、晚餐和零食的卡路里、常量营养素和纤维摄入量的95%置信区间。结果95% CI显示HEI总分为54±12(51.4,57.3)，明显低于HEI目标(p <；0.0038)。除添加糖外，其余组分均显著低于最高分数。基于GLP-1RA使用时间的HEI评分无显著差异。晚餐消耗的卡路里最多，平均为649卡路里，而午餐、早餐和零食分别为538、392和391卡路里。此外，每日总蛋白质摄入量的40%发生在晚餐时间。结论在使用GLP-1RAs的患者样本中，水果、蔬菜、全谷物、海鲜和植物蛋白、乳制品和脂肪酸的膳食质量较差。未来的研究需要确定HEI评分是否在GLP-1RA治疗和营养时机之前，期间和之后发生变化。

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引用次数: 0

Physical activity as a moderator of the association between central obesity and Type 2 diabetes in Asian American older adults 体育活动对亚裔美国老年人中心性肥胖和2型糖尿病之间关系的调节作用

Obesity Pillars

Pub Date : 2025-12-01 Epub Date: 2025-10-30 DOI: 10.1016/j.obpill.2025.100224

Kevin H. Kim , Mojgan Sami , Kathleen S. Wilson , Koren L. Fisher

Background

Asian American older adults (65+) face elevated risks for central obesity and Type 2 diabetes mellitus (T2DM). This study tested whether moderate to vigorous physical activity (MVPA) moderates the association between central obesity and T2DM, hypothesizing that the odds of T2DM linked to central obesity would be lower at higher levels of MVPA.

Methods

Generalized logistic regression models were used to test whether MVPA moderated the association between central obesity and T2DM, adjusting for demographic, cultural, and health-related covariates. Moderation was evaluated by comparing odds ratios from models using uncentered versus centered interaction terms.

Results

MVPA significantly moderated the association between central obesity and T2DM risk in older Asian Americans. Among individuals with central obesity, achieving the recommended threshold of 150 min of MVPA per week was associated with 43 % lower odds of T2DM (p < 0.001), based on comparisons of regression models incorporating uncentered versus centered interaction terms.

Conclusion

Increasing time spent in MVPA was associated with a lower likelihood of T2DM among Asian American older adults with central obesity. Further research examining these associations within specific Asian American subgroups will be critical for the development of culturally relevant recommendations and tailored lifestyle interventions with the potential to address diabetes-related health disparities in this population.

亚裔美国老年人（65岁以上）面临中枢性肥胖和2型糖尿病（T2DM）的高风险。本研究测试了中度至剧烈体育活动（MVPA）是否能调节中心性肥胖和T2DM之间的关联，并假设MVPA水平越高，T2DM与中心性肥胖相关的几率越低。方法采用广义逻辑回归模型，在调整人口统计学、文化和健康相关协变量后，检验MVPA是否调节了中心性肥胖和2型糖尿病之间的关联。通过比较使用非中心和中心相互作用项的模型的比值比来评估适度性。结果smvpa显著降低了老年亚裔美国人中心性肥胖与2型糖尿病风险之间的关系。在中心性肥胖患者中，达到每周150分钟MVPA的推荐阈值与T2DM的发生率降低43%相关（p < 0.001），这是基于纳入非中心与中心相互作用项的回归模型的比较。结论：在中心性肥胖的亚裔美国老年人中，MVPA时间的增加与T2DM的可能性降低有关。在特定的亚裔美国人亚群体中进一步研究这些关联，对于制定与文化相关的建议和量身定制的生活方式干预措施至关重要，有可能解决该人群中与糖尿病相关的健康差异。

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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 Epub Date: 2025-10-08 DOI: 10.1016/j.obpill.2025.100217

引用次数: 0

Exploring the role of digital health technologies in assessing functional mobility and physical activity: Insights from qualitative interviews in adults with obesity or overweight 探索数字健康技术在评估功能流动性和身体活动中的作用：来自肥胖或超重成人定性访谈的见解

Obesity Pillars

Pub Date : 2025-12-01 Epub Date: 2025-10-01 DOI: 10.1016/j.obpill.2025.100214

Jeremiah J. Trudeau , Brian Winger , Theresa Hunter Gibble , Lisa M. Neff , Chris Marshall , Chloe Carmichael , Daniel M. Ford , Elizabeth Collins

Background

Digital health technologies (DHTs) offer passive, objective, and continuous monitoring of difficult-to-report mobility-related behaviors like physical activity (PA) and functional mobility (FM), which are important concepts of interest in obesity-related clinical studies. This study was conducted to identify which aspects of FM/PA are meaningful to people living with obesity or overweight and establish how those concepts can be measured by passive monitoring using DHTs.

Methods

Qualitative concept elicitation interviews were conducted among 4 groups of adults (≥18 years) with obesity (body mass index [BMI] ≥30 kg/m²) and no obesity-related complications, overweight (BMI ≥27 kg/m²) with type 2 diabetes, overweight with obstructive sleep apnea, and overweight with lower-limb osteoarthritis. Two rounds of interviews were conducted to first identify the most important concepts of interest relating to FM/PA and then determine what level of change in FM and PA would be considered meaningful and important in the context of obesity treatment.

Results

A total of 48 participants were recruited for Round 1 (n = 24) and Round 2 (n = 24). The most frequently reported concepts of interest identified for FM and PA were walking on a flat surface, moderate-to-vigorous physical activity (MVPA), climbing stairs, walking uphill, and standing. All four most frequently reported concepts of FM/PA in Round 1 (MVPA, going up stairs, walking, and standing) were also considered relevant and bothersome in Round 2. The majority of the participants confirmed that measuring step count and changes in minutes of MVPA would be meaningful for them with respect to treatment for obesity.

Conclusion

People with obesity or overweight reported the ability to perform MVPA, going up stairs, walking, and standing as meaningful FM/PA outcomes. DHTs have the potential to provide relevant information about the functional status of people with obesity and could be more frequently implemented in obesity treatment studies and clinical practice.

数字健康技术（dht）提供被动、客观和持续的监测难以报告的活动相关行为，如身体活动（PA）和功能活动（FM），这是肥胖相关临床研究的重要概念。本研究旨在确定FM/PA的哪些方面对肥胖或超重人群有意义，并确定如何通过使用dht进行被动监测来测量这些概念。方法采用定性概念启发访谈法，对4组肥胖（体重指数[BMI]≥30 kg/m2）且无肥胖相关并发症、超重（BMI≥27 kg/m2）合并2型糖尿病、超重合并阻塞性睡眠呼吸暂停、超重合并下肢骨关节炎的成年人（≥18岁）进行问卷调查。进行了两轮访谈，首先确定与FM/PA相关的最重要的概念，然后确定FM和PA的变化水平在肥胖治疗的背景下被认为是有意义和重要的。结果第1轮（n = 24）和第2轮（n = 24）共招募48名受试者。FM和PA最常被报道的兴趣概念是在平面上行走、中等到剧烈的身体活动（MVPA）、爬楼梯、爬山和站立。在第1轮中，FM/PA的所有四个最常被报道的概念（MVPA、上楼、行走和站立）在第2轮中也被认为是相关的和麻烦的。大多数参与者确认，测量步数和MVPA的分钟变化对他们来说对于治疗肥胖是有意义的。结论肥胖或超重的人报告MVPA、上楼、行走和站立的能力是有意义的FM/PA结果。dht有可能提供有关肥胖患者功能状态的相关信息，并且可以更频繁地在肥胖治疗研究和临床实践中实施。

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引用次数: 0

Using the stages of change model to develop an understanding of caregiver intent for family behavior change following pediatric testing for genetic obesity: A qualitative analysis 利用变化阶段模型来理解儿童遗传性肥胖测试后家庭行为改变的照顾者意图：一项定性分析

Obesity Pillars

Pub Date : 2025-12-01 Epub Date: 2025-11-08 DOI: 10.1016/j.obpill.2025.100227

Eileen Chaves , Emily Kunkler

Introduction

Obesity rates continue to rise in children and adolescents worldwide. The heritability of obesity is estimated to be 40–80 %. Genetic testing for monogenic causes of obesity in the clinical setting is increasing; however, how results of these tests affect family behaviors is unclear. The objective of this study was to understand caregiver intent to change family behaviors following genetic testing for obesity.

Methods

The sample from this qualitative analysis derives from a larger study identifying mutations on the melanocortin 4 receptor (MC4R) pathway. Inclusion criteria included participation in the main study, aged 2–17 years, and a history of severe obesity and hyperphagia. Caregiver-child dyads were recruited to ensure equal representation of genetic results across racial/ethnic subgroups (Non-Hispanic White, Black, Hispanic). A third of participants in the main study enrolled in the sub-study. Structured caregiver interviews were analyzed using grounded theory.

Results

Twenty caregivers were female, 55 % White, 45 % Black, and 5 % Hispanic. Mean caregiver age was 42.3 ± 6.5 years and BMI 40.5 ± 7.9 kg/m². Majority of children were male (55 %), mean age was 10.0 ± 4.7 years and BMI 40.8 ± 9.9 kg/m². Interview themes related to all stages except for maintenance stage in the Stages of Change Model (SoC). After receiving their child's genetic test results, regardless of outcome, the majority of caregivers in the study reported either remaining in the contemplation, preparation, or action stage or were motivated to move forward to a more action-oriented stage.

Conclusions

Genetic testing for pediatric obesity, regardless of test outcome, motivates caregivers to move forward within the SoC Model or to remain in their current stage. These findings suggest that engaging caregivers to have their child with obesity tested for a genetic cause of obesity does not cause families to stop engaging in behavior change, unless the family was not ready to engage in behavior change prior to genetic testing.

世界范围内儿童和青少年肥胖率持续上升。肥胖的遗传率估计为40 - 80%。在临床环境中，对肥胖单基因原因的基因检测正在增加；然而，这些测试的结果如何影响家庭行为尚不清楚。本研究的目的是了解照顾者在进行肥胖基因检测后改变家庭行为的意图。方法定性分析的样本来源于一项更大的研究，该研究鉴定了黑素皮质素4受体（MC4R）途径的突变。纳入标准包括参与主要研究，年龄2-17岁，有严重肥胖和贪食史。为了确保不同种族/民族（非西班牙裔白人、黑人、西班牙裔）的遗传结果具有平等代表性，研究人员招募了照顾者-儿童二人组。主研究中三分之一的参与者参加了子研究。结构化的照顾者访谈使用扎根理论进行分析。结果20名护理人员为女性，白人占55%，黑人占45%，西班牙裔占5%。平均照顾者年龄为42.3±6.5岁，BMI为40.5±7.9 kg/m2。多数患儿为男性（55%），平均年龄10.0±4.7岁，BMI 40.8±9.9 kg/m2。访谈主题涉及变革阶段模型（SoC）中除维护阶段外的所有阶段。在收到孩子的基因测试结果后，无论结果如何，研究中的大多数看护人都报告说，他们要么仍处于沉思、准备或行动阶段，要么有动力向更以行动为导向的阶段迈进。结论：无论测试结果如何，儿童肥胖的基因检测都能激励护理人员在SoC模型中向前发展或保持在当前阶段。这些发现表明，让照顾者让他们的肥胖孩子接受肥胖基因检测并不会导致家庭停止行为改变，除非这个家庭在基因检测之前还没有准备好进行行为改变。

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引用次数: 0

Optimizing GLP-1 therapies for obesity and diabetes management 优化GLP-1治疗肥胖和糖尿病的方法

Obesity Pillars

Pub Date : 2025-12-01 Epub Date: 2025-10-24 DOI: 10.1016/j.obpill.2025.100222

Jarvis C. Noronha , Luc F. Van Gaal , Ian J. Neeland , Angela Fitch , Andreas FH. Pfeiffer , Laura Chiavaroli , Cyril WC. Kendall , John L. Sievenpiper

Background

Glucagon-like peptide-1 (GLP-1) therapies are highly effective for weight loss and metabolic improvement in obesity and type 2 diabetes management. However, their use poses clinical challenges, including loss of lean muscle mass and gastrointestinal side effects, both of which may affect adherence and long-term outcomes.

Methods

This commentary synthesizes current evidence and expert perspectives, drawing on presentations from the 42nd International Symposium on Diabetes and Nutrition by the Diabetes and Nutrition Study Group, to develop practical recommendations for integrating nutrition and physical activity with GLP-1 therapies for obesity and diabetes management.

Results

We summarize consensus recommendations from a global working group, organized into seven thematic modules, to guide alignment of GLP-1 therapies with dietary and lifestyle interventions across the key stages of the weight management journey. Evidence from several clinical trials demonstrate that the combination of GLP-1 therapies with structured dietary and exercise interventions results in additive weight loss effects compared with either strategy alone. Strategies to preserve lean mass with GLP-1 therapies include achieving protein intakes >1.2 g/kg/day, evenly distributed across meals, combined with aerobic activity and structured resistance training. Specific recommendations are provided to minimize nausea, vomiting, diarrhea, and constipation associated with GLP-1 therapies, as well as to prevent and manage complications such as, cholelithiasis and gastroesophageal reflux disease. Future research priorities include examining the impact of GLP-1 therapies on dietary habits and physical activity levels, improving muscle health assessment, and testing pharmacologic adjuncts to limit lean mass loss.

Conclusion

Maximizing the benefits of GLP-1 therapies require a multidisciplinary approach that integrates evidence-based nutrition, physical activity, and proactive management of gastrointestinal side effects. Such an approach can enhance adherence, preserve functional capacity, and sustain the long-term benefits of these therapies.

胰高血糖素样肽-1 （GLP-1）治疗对于肥胖和2型糖尿病患者的减肥和代谢改善非常有效。然而，它们的使用带来了临床挑战，包括瘦肌肉量的减少和胃肠道副作用，这两者都可能影响依从性和长期疗效。方法：本文综合了目前的证据和专家的观点，借鉴了糖尿病和营养研究小组在第42届糖尿病和营养国际研讨会上的演讲，提出了将营养和体育活动与GLP-1治疗结合起来治疗肥胖和糖尿病的实用建议。我们总结了全球工作组的共识建议，分为七个主题模块，以指导在体重管理过程的关键阶段将GLP-1治疗与饮食和生活方式干预相结合。来自几个临床试验的证据表明，与单独使用任何一种策略相比，GLP-1治疗与有组织的饮食和运动干预相结合会产生附加的减肥效果。通过GLP-1疗法保持瘦体重的策略包括实现蛋白质摄入量1.2 g/kg/天，均匀分布在每餐中，结合有氧运动和结构化阻力训练。提供了具体的建议，以尽量减少与GLP-1治疗相关的恶心、呕吐、腹泻和便秘，以及预防和管理并发症，如胆石症和胃食管反流病。未来的研究重点包括检查GLP-1疗法对饮食习惯和身体活动水平的影响，改善肌肉健康评估，以及测试药物辅助物以限制瘦体重损失。结论：要使GLP-1治疗的益处最大化，需要多学科的方法，将循证营养、身体活动和胃肠道副作用的积极管理结合起来。这种方法可以增强依从性，保持功能能力，并维持这些疗法的长期益处。

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引用次数: 0

Letters to the editor regarding the “Nutritional priorities to support GLP-1 therapy for obesity: A joint advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and the Obesity Society” 关于“支持GLP-1治疗肥胖的营养优先：美国生活方式医学院、美国营养学会、肥胖医学协会和肥胖学会的联合咨询”给编辑的信

Obesity Pillars

Pub Date : 2025-12-01 Epub Date: 2025-09-16 DOI: 10.1016/j.obpill.2025.100210

引用次数: 0

Knowledge, attitudes, and practices in obesity among trained and in-training primary care providers in an urban safety-net hospital system 城市安全网医院系统中训练有素和在职初级保健提供者关于肥胖的知识、态度和做法

Obesity Pillars

Pub Date : 2025-09-01 Epub Date: 2025-06-06 DOI: 10.1016/j.obpill.2025.100185

Alejandro Campos , Kathryn L. Fantasia , Ivania Rizo

Background

Obesity is a highly prevalent, chronic, and treatable disease that disproportionately impacts some minoritized populations who seek care in safety-net settings. Given that primary care providers (PCPs) often serve as the initial point of contact for patients, we aimed to assess their knowledge, attitudes, and practices related to management of obesity.

Methods

This was a cross-sectional study conducted to assess knowledge, attitudes, and practices on obesity management through an anonymous, electronic survey among trained (MD/DO and NP) and in-training (residents) primary care providers (PCPs) in the Departments of Internal Medicine and Family Medicine within an urban safety-net healthcare system.

Results

Among 350 sampled, 96 PCPs completed the survey (27 % response rate). Participants were predominantly (60.4 %) Internal Medicine trainees. The majority of PCPs accurately identified common weight-related comorbidities and improvement of these with >10 % weight loss. Only 25 % of PCPs correctly identified both body mass index (BMI) criteria for anti-obesity medication (AOM) prescription and only 9.1 % identified both BMI criteria for bariatric surgery. Nearly two-thirds (64 %) of PCPs reported prescribing AOMs, with greater comfort in using glucagon like peptide-1 receptor agonist (GLP-1 RA) injectable agents (semaglutide and liraglutide) than with older oral AOMs (phentermine, phentermine-topiramate, and naltrexone-bupropion). Knowledge about side effects and insurance coverage were reported as influencing AOM prescription. Time constraints and lack of training and/or knowledge were identified as barriers in obesity management by more than 50 % of PCPs.

Conclusions

Our study highlights gaps in obesity-related knowledge and practice among PCPs, emphasizing the need for enhanced training, clinical support, and policy reforms to improve obesity management and patient outcomes.

背景：肥胖是一种非常普遍的、慢性的、可治疗的疾病，对一些在安全网环境中寻求治疗的少数群体产生了不成比例的影响。鉴于初级保健提供者（pcp）经常作为患者的初始接触点，我们旨在评估他们的知识、态度和与肥胖管理相关的实践。方法本研究是一项横断面研究，旨在通过匿名电子调查，对城市安全网医疗保健系统内内科和家庭医学部培训过的（MD/DO和NP）和正在培训的（住院医师）初级保健提供者（pcp）进行评估肥胖管理的知识、态度和实践。结果在350份抽样调查中，96名执业医师完成问卷调查，回复率为27%。参与者主要是内科实习生（60.4%）。大多数pcp准确地确定了常见的体重相关合并症，并通过体重减轻10%来改善这些合并症。只有25%的pcp正确识别抗肥胖药物（AOM）处方的体重指数（BMI）标准，只有9.1%的pcp正确识别减肥手术的BMI标准。近三分之二（64%）的pcp报告使用AOMs，使用胰高血糖素样肽-1受体激动剂（GLP-1 RA）注射剂（semaglutide和liraglutide）比使用较老的口服AOMs（芬特明、芬特明-托吡酯和纳曲酮-安非他酮）更舒适。对副作用的了解和保险范围是影响AOM处方的因素。超过50%的pcp认为时间限制和缺乏培训和/或知识是肥胖管理的障碍。结论本研究突出了pcp在肥胖相关知识和实践方面的差距，强调需要加强培训、临床支持和政策改革，以改善肥胖管理和患者预后。

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引用次数: 0

Examining effects of sleeve gastrectomy in an urban youth population 探讨袖式胃切除术在城市青年人群中的效果

Obesity Pillars

Pub Date : 2025-09-01 Epub Date: 2025-05-08 DOI: 10.1016/j.obpill.2025.100179

L.B. Ditchek , J. Zitsman , J. Woo Baidal , S.E. Oberfield , I. Fennoy

Background

Extensive evidence demonstrates the positive health effects of metabolic and bariatric surgery (MBS) in adolescents, including a reduction in body mass index (BMI) and improvements in cardiometabolic health. However, studies often lack generalizability due to their inclusion of predominately non-Hispanic White and privately insured patients.

Methods

This retrospective study aims to provide insight into MBS outcomes for an urban youth population.

Results

All groups showed a statistically significant improvement in BMI, HgbA1c, HDL, and triglyceride levels, postoperatively. Postoperative BMI did not differ between Non-Hispanic and Hispanic participants (P = 0.45) or between publicly and privately insured patients (P = 0.52). There was a statistically significantly lower postoperative HgbA1c in non-Hispanic participants compared to Hispanic participants (P = 0.01) and a statistically significantly lower postoperative Systolic blood pressure (SBP) in privately insured patients compared to publicly insured patient (P = 0.02). No other significant differences were detected between privately/publicly insured and Hispanic/non-Hispanic outcomes at 12 months postoperatively.

Conclusion

In our urban youth patient population, MBS resulted in significant improvement in BMI across all groups. Notably, there were no statistically significant differences in preoperative characteristics (BMI, HgbA1, LDL, HDL, triglycerides, total cholesterol, SBP or DBP). However, postoperative differences in HgbA1c and SBP were detected between groups. The reasons behind these differences remain unclear, emphasizing the need for further research with greater population variability. This study underscores the importance of increasing generalizability in studies of MBS to fully understand outcomes in underrepresented groups.

背景大量证据表明，代谢和减肥手术（MBS）对青少年的健康有积极影响，包括身体质量指数（BMI）的降低和心脏代谢健康的改善。然而，研究往往缺乏普遍性，因为他们主要包括非西班牙裔白人和私人保险患者。方法本回顾性研究旨在深入了解MBS对城市青年人口的影响。结果两组患者术后BMI、hba1c、HDL、甘油三酯水平均有显著改善。术后BMI在非西班牙裔和西班牙裔参与者之间没有差异（P = 0.45），在公共和私人保险患者之间也没有差异（P = 0.52）。与西班牙裔患者相比，非西班牙裔患者术后hba1c显著降低（P = 0.01），私人参保患者术后收缩压显著低于公共参保患者（P = 0.02）。术后12个月，私人/公共保险和西班牙裔/非西班牙裔结果之间没有发现其他显著差异。结论：在我们的城市青年患者人群中，MBS导致所有组的BMI显著改善。值得注意的是，两组术前特征（BMI、HgbA1、LDL、HDL、甘油三酯、总胆固醇、收缩压、舒张压）差异无统计学意义。但术后各组间hba1c和收缩压存在差异。这些差异背后的原因尚不清楚，强调需要进一步研究更大的人口变异性。这项研究强调了在MBS研究中增加普遍性的重要性，以充分了解代表性不足群体的结果。

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引用次数: 0