Obesity Pillars最新文献

{"title":"How do patients choose between obesity medications: A thematic analysis","authors":"Alvin Mondoh ,&nbsp;Hilary Craig ,&nbsp;Michael Crotty ,&nbsp;Francisca Contreras ,&nbsp;Carel W. le Roux","doi":"10.1016/j.obpill.2025.100187","DOIUrl":"10.1016/j.obpill.2025.100187","url":null,"abstract":"<div><h3>Introduction</h3><div>The rising prevalence of obesity is of particular concern due to its association with a range of serious complications, including type 2 diabetes mellitus, cardiovascular diseases, and certain types of cancer. Obesity medications can control the disease but it is unclear how patients choose which medication to use.</div></div><div><h3>Methods</h3><div>A qualitative thematic analysis was conducted to investigate how patients select between obesity medications. Fifteen treatment naive adults with a body mass index ≥27 kg/m² with at least one weight-related complications were recruited.</div></div><div><h3>Results</h3><div>The 5 major themes depicting how patients make selections included 1) Effectiveness of medication, 2) Information to make decisions, 3) Safety of medications, 4) Practicality and 5) Individual Strategies and Community Supports in Obesity Management. Safety concerns of side effects and long-term risks were perceived major barriers to initiating or adhering to pharmacotherapy.</div></div><div><h3>Conclusion</h3><div>In a situation where the medications are described as being free and readily available, patient preferences for obesity medications are shaped by treatment efficacy, safety, information provided by healthcare providers. To enhance adherence and improve patient outcomes, healthcare providers should focus on delivering clear, comprehensive information and fostering strong support systems for patients.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"15 ","pages":"Article 100187"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471124","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}

{"title":"Impact of metabolically healthy obesity on post percutaneous coronary intervention outcomes in patients with acute myocardial infarction: A nationwide propensity matched analysis","authors":"Rupak Desai ,&nbsp;Adhvithi Pingili ,&nbsp;Arankesh Mahadevan ,&nbsp;Vishal Reddy Bejugam ,&nbsp;Hafeezuddin Ahmed ,&nbsp;Vamsikalyan Borra ,&nbsp;Adil Sarvar Mohammed ,&nbsp;Gayatri Bondi ,&nbsp;Shobana Krishnamurthy ,&nbsp;Nithya Borra ,&nbsp;Gurpreet Kaur ,&nbsp;Rajesh Sachdeva ,&nbsp;Timir Paul","doi":"10.1016/j.obpill.2025.100167","DOIUrl":"10.1016/j.obpill.2025.100167","url":null,"abstract":"<div><h3>Background</h3><div>Obesity paradox in post-percutaneous coronary intervention (PCI) outcomes among acute myocardial infarction (AMI) patients is a known controversy. However, these studies included patients who had diabetes, hypertension, or hyperlipidemia. We studied relationship between metabolically healthy obesity (MHO—without diabetes, hypertension, or hyperlipidemia) and in-hospital post-PCI outcomes among AMI patients.</div></div><div><h3>Methods</h3><div>We extracted data from National Inpatient Sample 2020 using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes for admissions of AMI patients who underwent PCI. We then identified patients with diabetes, hypertension, and hyperlipidemia using Elixhauser comorbidity index and Clinical Classifications Software and excluded them. Then, using Elixhauser comorbidity index, we identified patients with and without obesity, defined as <strong>BMI &gt; 30</strong> <strong>kg/m</strong>^{<strong>2</strong>} and propensity score matching was done for age and sex. Later, multivariable regression analysis was done for in-hospital post-PCI outcomes.</div></div><div><h3>Results</h3><div>Among 25605 metabolically healthy patients who had AMI and underwent PCI, 2825 had obesity, and 22780 didn't. After propensity score matching (PSM) for age and sex, both cohorts had 2795 patients each. There was no statistically significant difference in in-hospital all-cause mortality (adjusted odds ratio [OR] 1.14, 95 % confidence interval [CI] 0.63–2.10, p = 0.661), post-PCI stroke (aOR 1.17, 95 % CI 0.50–2.75, p = 0.714), acute kidney injury (aOR 1.20, 95 % CI 0.84–1.72, p = 0.322), post-PCI bleeding (aOR 1.04, 95 % CI 0.35 to 3.12, p = 0.940) and intra or post-PCI cardiac arrest (aOR 1.14, 95 % CI 0.30 to 4.42, p = 0.835) between both cohorts.</div></div><div><h3>Conclusions</h3><div>No statistically significant association was found between obesity and post-PCI outcomes in metabolically healthy patients with AMI. Larger studies are needed to explore the controversial “obesity paradox” in cardiovascular diseases.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"14 ","pages":"Article 100167"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing obesity: A qualitative study","authors":"Tim Bober ,&nbsp;Flor Cameron ,&nbsp;Lane Alexander ,&nbsp;J.G. Luiggi-Hernandez ,&nbsp;David Rometo ,&nbsp;Linda-Marie Lavenburg ,&nbsp;Haley Grant ,&nbsp;Emily Klawson ,&nbsp;Autumn R. Boyer ,&nbsp;Kathleen M. McTigue ,&nbsp;Julie Gouveia-Pisano ,&nbsp;Avani Patel ,&nbsp;Lisa Tarasenko ,&nbsp;Jannette Escobar ,&nbsp;Allison Brenner ,&nbsp;Scott M. Vouri ,&nbsp;Feng Dai ,&nbsp;Megan E. Hamm","doi":"10.1016/j.obpill.2025.100174","DOIUrl":"10.1016/j.obpill.2025.100174","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence of obesity among US adults has risen over the past several decades. In addition to bariatric surgery and behavioral weight management, several effective anti-obesity medications have emerged in the last ten years and become increasingly available. The goal of this qualitative study is to explore the perspectives of people with obesity (PwO), health professionals (HPs), and payors on obesity management and treatments.</div></div><div><h3>Methods</h3><div>This was a 3-group interview study using a qualitative description approach with a target sample size of 40 PwO, 30 HPs who provide care to PwO (10 primary care providers; 10 providers specializing in obesity medicine; and 10 nurse practitioners, physician assistants, or dieticians/nutritionists), and 10 payors. PwO were eligible if they had a Body Mass Index (BMI) ≥30 kg/m² using self-reported height and weight and the National Institutes of Health (NIH) BMI calculator and were recruited via an online research registry. Health professionals and payors were recruited via direct contact from the research team and sponsor's professional networks in the United States.</div></div><div><h3>Results</h3><div>A total of 38 PwO, 30 HPs, and 6 payors were interviewed, with PwO interviews occurring from October 2023 to March 2024 and HP/payor interviews occurring from November 2023 to May 2024. The majority of participants in each group accepted the idea of obesity as a chronic disease and that discussing obesity and weight management was important in medical contexts; however, they also acknowledged that stigma around obesity negatively impacted PwO health and health care. All participants described a treatment landscape beginning with lifestyle interventions followed by pharmaceutical or surgical treatment options.</div></div><div><h3>Conclusion</h3><div>This qualitative study of people with obesity, health professionals, and payors demonstrated current views of addressing and treating obesity in clinical settings. These findings could spur person-centered, less stigmatizing methods to craft plans for weight management.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"14 ","pages":"Article 100174"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic dysfunction-associated steatotic liver disease (MASLD) in children with obesity: An Obesity Medicine Association (OMA) and expert joint perspective 2025","authors":"Jennifer Panganiban ,&nbsp;Mohit Kehar ,&nbsp;Samar H. Ibrahim ,&nbsp;Phillipp Hartmann ,&nbsp;Shilpa Sood ,&nbsp;Sara Hassan ,&nbsp;Charina M Ramirez ,&nbsp;Rohit Kohli ,&nbsp;Marisa Censani ,&nbsp;Erin Mauney ,&nbsp;Suzanne Cuda ,&nbsp;Sara Karjoo","doi":"10.1016/j.obpill.2025.100164","DOIUrl":"10.1016/j.obpill.2025.100164","url":null,"abstract":"<div><h3>Introduction</h3><div>This Obesity Medicine Association (OMA) Expert Joint Perspective examines steatotic liver disease (SLD), which is composed of metabolic dysfunction-associated steatotic liver disease (MASLD), and metabolic dysfunction-associated steatohepatitis (MASH) in children with obesity. The prevalence of obesity is increasing, rates have tripled since 1963 from 5 % to now 19 % of US children affected in 2018. MASLD, is the most common liver disease seen in children, can be a precursor to the development of Type 2 Diabetes (T2DM) and is the primary reason for liver transplant listing in young adults. We must be vigilant in prevention and treatment of MASLD in childhood to prevent further progression.</div></div><div><h3>Methods</h3><div>This joint clinical perspective is based upon scientific evidence, peer and clinical expertise. The medical literature was reviewed via PubMed search and appropriate articles were included in this review. This work was formulated from the collaboration of eight hepatologists/gastroenterologists with MASLD expertise and two physicians from the OMA.</div></div><div><h3>Results</h3><div>The authors who are experts in the field, determined sentinel questions often asked by clinicians regarding MASLD in children with obesity. They created a consensus and clinical guideline for clinicians on the screening, diagnosis, and treatment of MASLD associated with obesity in children.</div></div><div><h3>Conclusions</h3><div>Obesity and the comorbidity of MASLD is increasing in children, and this is a medical problem that needs to be addressed urgently. It is well known that children with metabolic associated chronic disease often continue to have these chronic diseases as adults, which leads to reduced life expectancy, quality of life, and increasing healthcare needs and financial burden. The authors of this paper recommend healthy weight reduction not only through lifestyle modification but through obesity pharmacotherapy and bariatric surgery. Therefore, this guidance reviews available therapies to achieve healthy weight reduction and reverse MASLD to prevent progressive liver fibrosis, and metabolic disease.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"14 ","pages":"Article 100164"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating remote high-intensity interval training into multi-component obesity treatment for adolescents: Impacts on body composition, fitness, and lifestyle","authors":"Fábio de Freitas ,&nbsp;Mariana R. Zago ,&nbsp;Maria Ângela Antônio ,&nbsp;Maria Ângela Bellomo Brandão ,&nbsp;António Videira-Silva","doi":"10.1016/j.obpill.2025.100176","DOIUrl":"10.1016/j.obpill.2025.100176","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to analyze the effects of a three-month remote High-Intensity Interval Training (HIIT) program as an adjunct to a multi-component clinical obesity treatment on body composition, physical fitness, movement behaviors, and nutritional habits in adolescents with obesity.</div></div><div><h3>Methods</h3><div>This study was designed as a non-randomized controlled trial involving a total of 100 adolescents with obesity (BMI z-score ≥2), aged 12–17, divided into a control group (CG, receiving only standard care, i.e., medical and nutritional guidance, n = 50), and an experimental group (EG, exposed to a remote HIIT program four times/week (∼20 min/session) for 3 months, additionally to standard care, n = 50). Intervention effect was analyzed based on adherence (presence in ≥80 % of sessions). Anthropometrics, body composition, and physical fitness data were assessed at baseline and at the end of the intervention. Changes in body composition and physical fitness were the primary outcomes, while movement behaviors and nutritional habits were considered secondary outcomes.</div></div><div><h3>Results</h3><div>Six participants were excluded from the analysis due to missing post-intervention assessments. Among the 44 (88 %) adolescents who completed the 3-month assessments, 28 were included in the adherents’ group (AG) and 16 in non-adherents (non-AG). BMI z-score significantly decreased over time (β = −0.08, p = 0.001), with the AG showing a more significant reduction than non-AG (β = −0.3, p &lt; 0.001) and CG (β = −0.29, p &lt; 0.001). Flexibility (β = 3.5, p &lt; 0.001) and Core strength improved (β = 2.9, p = 0.002), with no differences between the AG and non-AG. Water consumption also increased (β = 0.2, p = 0.022), but only in the AG.</div></div><div><h3>Conclusion</h3><div>The remote HIIT program was effective in improving body composition and physical fitness in adolescents with obesity. These findings highlight the potential of remote exercise interventions as a feasible and beneficial strategy within multi-component obesity treatments.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"14 ","pages":"Article 100176"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895660","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}

{"title":"Management and impact of obesity in Canada: A real-world survey of people with obesity and their physicians","authors":"Jennifer Glass ,&nbsp;Sophie Carter ,&nbsp;Esther Artime ,&nbsp;Victoria Higgins ,&nbsp;Lewis Harrison ,&nbsp;Andrea Leith ,&nbsp;David CW. Lau ,&nbsp;Ian Patton ,&nbsp;Jennifer L. Kuk","doi":"10.1016/j.obpill.2025.100171","DOIUrl":"10.1016/j.obpill.2025.100171","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is a chronic relapsing disease associated with multiple complications. This study described real-world demographic/clinical characteristics, including obesity-related complications (ORCs), prescribing rationale, and patient-reported outcome measures (PROMs) for adults living with obesity in Canada accessing treatment.</div></div><div><h3>Methods</h3><div>This was a cross-sectional survey of physicians and consulting people with obesity (PwO) in Canada with retrospective data capture in a real-world setting. Canadian data were drawn between July and November 2022 from the multinational Adelphi Real World Obesity Disease Specific Programme™. Consulting PwO were required to be on a weight management program and/or have a current body mass index of ≥30 kg/m². Physicians completed questionnaires for the next 3–5 consecutive PwO seen in their routine clinical practice. A quota was applied for obesity management medication (OMM). PROMs including Work Productivity and Activity Impairment (WPAI) questionnaire were provided voluntarily by PwO. Analyses were descriptive.</div></div><div><h3>Results</h3><div>Overall, 50 physicians (35 general practitioners, 15 endocrinologists) and 199 PwO were analyzed. More than 85 % of PwO had ≥1 ORC. The most common ORCs were hypertension, dyslipidemia, depression, and type 2 diabetes, and one-quarter to one-half of ORCs were not optimally controlled. Approximately two-thirds of the cohort were employed full-time, almost half had private insurance, and almost 70 % were classified as high socio-economic status. Mean number of weight-reduction attempts over the past 3 years was 2.9. Pharmacological treatment for obesity was common among those with ORCs. A general trend towards greater work impairment among people with ORCs than for PwO without ORCs was observed.</div></div><div><h3>Conclusions</h3><div>Among PwO participating in our study, ORCs were common, often uncontrolled, and their presence impacted the likelihood of obesity treatment and possibly impaired work productivity. Medical treatment for obesity was often delayed until ORCs developed, suggesting that preventative healthcare measures are not the norm for PwO in Canada. A large proportion of PwO had high socioeconomic status, suggesting that PwO who access treatment may not be representative of the overall population of PwO in Canada.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"14 ","pages":"Article 100171"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appropriate use of the fixed-dose, extended-release combination of naltrexone and bupropion as treatment for obesity in primary care","authors":"Ethan Lazarus","doi":"10.1016/j.obpill.2025.100170","DOIUrl":"10.1016/j.obpill.2025.100170","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is considered a chronic disease and is influenced by biological, environmental, and behavioral factors that can contribute to its progression. Although lifestyle changes are integral to treating obesity and maintaining a healthful weight, weight reduction from behavioral intervention alone is often insufficient because neurophysiologic factors may work against such changes in lifestyle and behavior. Research suggests that the mechanisms underlying food cravings and obesity overlap with dopaminergic signaling in the brain and pathways involved in addiction. As a result, patients who are differentially impacted by food cravings may have better outcomes with treatments targeting neural systems implicated in both homeostatic and hedonic food consumption or addictive behaviors.</div></div><div><h3>Methods</h3><div>In this clinical review, we describe the safety and efficacy data for the fixed-dose, extended-release combination of naltrexone and bupropion (NB-ER) compared with its monotherapy constituents (naltrexone and bupropion), as well as discuss the appropriate use of NB-ER to treat patients with obesity.</div></div><div><h3>Results</h3><div>NB-ER is approved for the treatment of patients with obesity, with studies showing that patients can achieve significant weight reduction compared with placebo when treatment is combined with a reduced-calorie diet and increased physical activity. Across NB-ER phase 3 trials, responders to treatment had a mean body weight reduction of 11.7 % at 56 weeks. Of note, the unique combination of naltrexone, an opioid receptor antagonist, and bupropion, a norepinephrine-dopamine reuptake inhibitor associated with stimulating pro-opiomelanocortin cells (POMC), in NB-ER may work together to target POMC cells to prevent endogenous negative feedback, thereby decreasing appetite and improving weight-related outcomes.</div></div><div><h3>Conclusions</h3><div>Unlike monotherapy with its component drugs, NB-ER is optimized for the treatment of obesity. The appropriate use of NB-ER should consider the specific characteristics and adiposity-related complications of an individual.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"14 ","pages":"Article 100170"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between hepatic steatosis, vitamin D status, and insulin resistance in adolescents with obesity","authors":"Emir Tas ,&nbsp;Amanda Flint ,&nbsp;Ingrid Libman ,&nbsp;Radhika Muzumdar ,&nbsp;Xiawei Ou ,&nbsp;David K. Williams ,&nbsp;Elisabet Børsheim ,&nbsp;Eva C. Diaz","doi":"10.1016/j.obpill.2025.100173","DOIUrl":"10.1016/j.obpill.2025.100173","url":null,"abstract":"<div><h3>Introduction</h3><div>Epidemiological studies suggest an inverse relationship between circulating 25-hydroxy-vitamin D [25(OH)D] levels and insulin resistance (IR), yet interventional studies have yielded inconsistent findings. This study examined the relationship between changes in vitamin D status and markers of IR in adolescents, with a focus on the modifying effect of liver fat.</div></div><div><h3>Methods</h3><div>A post-hoc analysis was performed using data from 44 adolescents participating in a 6-month observational study evaluating biomarkers of hepatosteatosis. Participants were categorized into two groups based on vitamin D status at the end of the observation period: those whose vitamin D levels increased or remained sufficient (VDI, n = 22) and those whose levels decreased or remained insufficient/deficient (VDD, n = 22). Liver fat percentage was measured using magnetic resonance imaging (MRI) fat-fraction, and IR was assessed using the updated Homeostatic Model Assessment for Insulin Resistance (HOMA2-IR) and the triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL).</div></div><div><h3>Results</h3><div>Across the cohort, liver fat was positively associated with HOMA2-IR (β = 0.08, p = 0.023). The association between changes in vitamin D status and HOMA2-IR trajectories was modified by liver fat but only in Hispanic adolescents (β = −0.18, p &lt; 0.001). Among Hispanic adolescents in the VDD group, HOMA-IR worsened, particularly at higher levels of liver fat. In non-Hispanic adolescents, HOMA-IR increased in the VDD group (β = 0.65, p = 0.033) compared to the VDI group, independent of baseline liver fat. Across the cohort, changes in vitamin D status interacted with liver fat to influence TG/HDL trajectories (β = 0.20, p = 0.034).</div></div><div><h3>Conclusions</h3><div>The metabolic response to changes in vitamin D status in adolescents with IR may vary based on racial and ethnic differences and liver fat status. These findings underscore the importance of considering liver fat and racial/ethnic background in vitamin D and metabolic health studies. Future research with more extensive and diverse cohorts spanning the fatty liver disease spectrum is needed to clarify these relationships.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"14 ","pages":"Article 100173"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity management in primary care: A joint clinical perspective and expert review from the Obesity Medicine Association (OMA) and the American College of Osteopathic Family Physicians (ACOFP) - 2025","authors":"Nicholas Pennings ,&nbsp;Catherine Varney ,&nbsp;Shaun Hines ,&nbsp;Bernadette Riley ,&nbsp;Patricia Happel ,&nbsp;Samir Patel ,&nbsp;Harold Edward Bays","doi":"10.1016/j.obpill.2025.100172","DOIUrl":"10.1016/j.obpill.2025.100172","url":null,"abstract":"<div><h3>Background</h3><div>This collaboration from the Obesity Medicine Association (OMA) and the American College of Osteopathic Family Physicians (ACOFP) examines obesity management from a primary care perspective.</div></div><div><h3>Methods</h3><div>This joint perspective is based upon scientific evidence, clinical experience of the authors, and peer review by the OMA and ACOFP leadership. The goal is to identify and answer sentinel questions about obesity management from a primary care perspective, utilizing evidence-based publications, and guided by expert clinical experience.</div></div><div><h3>Results</h3><div>Obesity is a disease that contributes to both biomechanical complications and the most common cardiometabolic abnormalities encountered in primary care. Barriers that impede optimal care of patients with obesity in primary care include failure to recognize obesity as a disease, lack of accurate diagnosis, insufficient access to obesity treatment resources, inadequate training, insufficient time, lack of adequate reimbursement and the adverse impact of bias, stigma, and discrimination.</div></div><div><h3>Conclusions</h3><div>Family physicians are often the first line of treatment in the healthcare setting. This affords early intervention opportunities to prevent and/or treat overweight and/or obesity. Patient care is enhanced when primary care clinicians recognize the risks and benefits of anti-obesity medications and bariatric procedures, as well as long-term follow-up. Practical tools regarding the 4 pillars of nutrition therapy, physical activity, behavior modification, and medical interventions (anti-obesity medications and bariatric surgery) may assist primary care clinicians improve the health and lives of patients living with obesity.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"14 ","pages":"Article 100172"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging diagnosis and biometric data from the All of Us Research Program to uncover disparities in obesity diagnosis","authors":"Alina Arseniev-Koehler ,&nbsp;Ming Tai-Seale ,&nbsp;Crystal W. Cené ,&nbsp;Eduardo Grunvald ,&nbsp;Amy Sitapati","doi":"10.1016/j.obpill.2025.100165","DOIUrl":"10.1016/j.obpill.2025.100165","url":null,"abstract":"<div><h3>Background</h3><div>Despite extensive efforts to standardize definitions of obesity, clinical practices of diagnosing obesity vary widely. This study examined (1) discrepancies between biometric body mass index (BMI) measures of obesity and documented diagnoses of obesity in patient electronic health records (EHRs) and (2) how these discrepancies vary by patient gender and race and ethnicity from an intersectional lens.</div></div><div><h3>Methods</h3><div>Observational study of 383,380 participants in the National Institutes of Health <em>All of Us</em> Research Program dataset.</div></div><div><h3>Results</h3><div>Over half (60 %) of participants with a BMI indicating obesity had no clinical diagnosis of obesity in their EHRs. Adjusting for BMI, comorbidities, and other covariates, women's adjusted odds of diagnosis were far higher than men's (95 % confidence interval 1.66–1.75). However, the gender gap between women's and men's likelihood of diagnosis varied widely across racial groups. Overall, Non-Hispanic (NH) Black women and Hispanic women were the most likely to be diagnosed and NH-Asian men were the least likely to be diagnosed.</div></div><div><h3>Conclusion</h3><div>Men, and particularly NH-Asian men, may be at heightened risk of underdiagnosis of obesity. Women, and especially Hispanic and NH-Black women, may be at heightened risk of unanticipated harms of obesity diagnosis, including stigma and competing demand with other health concerns. Leveraging diagnosis and biometric data from this unique public domain dataset from the All of Us project, this study revealed pervasive disparities in diagnostic attribution by gender, race, and ethnicity.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100165"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}