Rebecca L. Pearl, Laurie C. Groshon, Marian Hernandez, Caroline Bach, Erica M. LaFata, Hannah F. Fitterman-Harris, Dakota L. Leget, Miriam Sheynblyum, Thomas A. Wadden
This research aimed to systematically characterise experiences of weight stigma and their impacts among weight-loss treatment-seeking adults with high body weight and high levels of internalised weight stigma. Participants recruited for two clinical trials completed a semi-structured interview about weight stigma (Study 1 n = 84, Mage = 47.8 ± 11.2 years, 83.3% women, 67.9% Black; Study 2 n = 129, Mage = 50.0 ± 12.2 years, 88.4% women, 65.1% White). Study 1 focused on first and most recent experiences of weight-based teasing, bullying, discrimination and unfair treatment, and Study 2 focused on the worst examples of these experiences; participants in both studies also identified their overall worst experiences. Participants reported the age at which the experiences occurred and rated (1–5) how upsetting they were. Interview responses were coded for interpersonal sources of weight stigma and impacts of these experiences. Across studies, weight teasing was the most commonly reported experience of weight stigma and the most frequently identified worst experience. Family members were the most commonly identified interpersonal source of weight stigma. Weight stigma experiences were reported across the lifespan and were predominantly described as having negative emotional impacts. Findings provide insights into the types and characteristics of weight stigma experiences that may contribute to the internalisation of this stigma and other adverse consequences.
本研究旨在系统地描述体重耻辱感的经历及其对寻求减肥治疗的高体重和高内化体重耻辱感的成年人的影响。两项临床试验招募的参与者完成了关于体重耻辱感的半结构化访谈(研究1 n = 84，年龄= 47.8±11.2，女性83.3%，黑人67.9%；研究2 n = 129,法师= 50.0±12.2年,88.4%的女性,65.1%的白人)。研究1关注的是基于体重的戏弄、欺凌、歧视和不公平待遇的最初和最近的经历，研究2关注的是这些经历中最糟糕的例子；两项研究的参与者还列出了他们最糟糕的经历。参与者报告了经历发生的年龄，并对他们的沮丧程度打分（1-5分）。访谈回答被编码为体重耻辱的人际来源和这些经历的影响。在所有研究中，体重戏弄是最常见的体重耻辱经历，也是最常见的最糟糕的经历。家庭成员是体重耻辱感最常见的人际来源。体重耻辱经历在整个生命周期中都有报道，主要被描述为对情绪产生负面影响。研究结果提供了对体重病耻感经历的类型和特征的见解，这可能有助于这种病耻感的内化和其他不良后果。
{"title":"Characterising first, recent and worst experiences of weight stigma in a clinical sample of adults with high body weight and high internalised stigma","authors":"Rebecca L. Pearl, Laurie C. Groshon, Marian Hernandez, Caroline Bach, Erica M. LaFata, Hannah F. Fitterman-Harris, Dakota L. Leget, Miriam Sheynblyum, Thomas A. Wadden","doi":"10.1111/cob.70005","DOIUrl":"10.1111/cob.70005","url":null,"abstract":"<div>\u0000 \u0000 <p>This research aimed to systematically characterise experiences of weight stigma and their impacts among weight-loss treatment-seeking adults with high body weight and high levels of internalised weight stigma. Participants recruited for two clinical trials completed a semi-structured interview about weight stigma (Study 1 <i>n</i> = 84, <i>M</i><sub>age</sub> = 47.8 ± 11.2 years, 83.3% women, 67.9% Black; Study 2 <i>n</i> = 129, <i>M</i><sub>age</sub> = 50.0 ± 12.2 years, 88.4% women, 65.1% White). Study 1 focused on first and most recent experiences of weight-based teasing, bullying, discrimination and unfair treatment, and Study 2 focused on the worst examples of these experiences; participants in both studies also identified their overall worst experiences. Participants reported the age at which the experiences occurred and rated (1–5) how upsetting they were. Interview responses were coded for interpersonal sources of weight stigma and impacts of these experiences. Across studies, weight teasing was the most commonly reported experience of weight stigma and the most frequently identified worst experience. Family members were the most commonly identified interpersonal source of weight stigma. Weight stigma experiences were reported across the lifespan and were predominantly described as having negative emotional impacts. Findings provide insights into the types and characteristics of weight stigma experiences that may contribute to the internalisation of this stigma and other adverse consequences.</p>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"15 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540414","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}
A multidisciplinary health team for perioperative care of the bariatric patient, sustained in a viable framework, may provide a comprehensive bariatric surgery process analysis. This study aimed to analyse patients' and professionals' experiences with the perioperative care process and identify their perceptions of the bariatric surgery process to support the long-term management of obesity surgical treatment. This study also wants to develop a framework to sustain a long-term follow-up. This qualitative study was conducted in July 2022 at a bariatric surgery centre in southern Portugal, comprising four focus group sessions. Participants included seven health professionals in one focus group and 16 patients divided across three focus groups. Patients were selected based on specific criteria, including those awaiting bariatric surgery and those who had undergone surgery within the past 1 to 5 years. The patient focus group script consisted of 11 open-ended main questions with follow-up prompts to explore motivations, experiences with the presurgery and postsurgery processes and perceptions of lifestyle changes. Sessions lasted between 40 and 70 min. Participants reported the need for a reference professional in the hospital to contact, the importance of psychological support to help patients deal with the ‘ups and downs’ of postsurgery life and the financial support for physical activity programmes. This research helped identify a need for a framework for long-term follow-up and showed priorities to tailor health services for managing bariatric surgery patients. This team should be led by a dedicated case manager and include physical activity specialists.
{"title":"Patient and professional perceptions for long-term success: Developing a framework for bariatric surgery care in Portugal","authors":"Cláudia Mendes, Manuel Carvalho, João Gregório","doi":"10.1111/cob.70004","DOIUrl":"10.1111/cob.70004","url":null,"abstract":"<div>\u0000 \u0000 <p>A multidisciplinary health team for perioperative care of the bariatric patient, sustained in a viable framework, may provide a comprehensive bariatric surgery process analysis. This study aimed to analyse patients' and professionals' experiences with the perioperative care process and identify their perceptions of the bariatric surgery process to support the long-term management of obesity surgical treatment. This study also wants to develop a framework to sustain a long-term follow-up. This qualitative study was conducted in July 2022 at a bariatric surgery centre in southern Portugal, comprising four focus group sessions. Participants included seven health professionals in one focus group and 16 patients divided across three focus groups. Patients were selected based on specific criteria, including those awaiting bariatric surgery and those who had undergone surgery within the past 1 to 5 years. The patient focus group script consisted of 11 open-ended main questions with follow-up prompts to explore motivations, experiences with the presurgery and postsurgery processes and perceptions of lifestyle changes. Sessions lasted between 40 and 70 min. Participants reported the need for a reference professional in the hospital to contact, the importance of psychological support to help patients deal with the ‘ups and downs’ of postsurgery life and the financial support for physical activity programmes. This research helped identify a need for a framework for long-term follow-up and showed priorities to tailor health services for managing bariatric surgery patients. This team should be led by a dedicated case manager and include physical activity specialists.</p>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"15 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522744","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}
Stuart W. Flint, Ezra Goldberg, Mohammad Kaykanloo, Stuart Sherman, Duncan Radley, Sarah R. Kingsbury, Louisa Ells
This pilot study explored the use of a novel behavioural artificial intelligence (AI) tool to examine whether personality is associated with the lived experience of the NHS England launched a low calorie diet (LCD). A cross-sectional survey was disseminated to service users to gather data on emotional wellbeing, physical activity, pain, motivation to manage diabetes, motivation to lose weight, rating of total diet replacement (TDR) products and frequency of using fibre supplements. The scaled insights behavioural AI tool was used to infer personality traits from service users' language construction, and in doing so, examine associations with the outcomes indicated above. Findings show that service users can be profiled by personality, and this can provide a method of understanding programme outcomes. Three clusters of personality traits were identified. Despite this, there was no association between personality features and emotional wellbeing, physical activity, pain, motivation to manage diabetes, motivation to lose weight, rating of TDR products and frequency of using fibre supplements. As the self-selected sample size was limited, future research should examine the use of behavioural AI tools and personality using larger and longitudinal samples.
{"title":"Is personality associated with the lived experience of the NHS England low calorie diet programme: A pilot study","authors":"Stuart W. Flint, Ezra Goldberg, Mohammad Kaykanloo, Stuart Sherman, Duncan Radley, Sarah R. Kingsbury, Louisa Ells","doi":"10.1111/cob.70003","DOIUrl":"10.1111/cob.70003","url":null,"abstract":"<p>This pilot study explored the use of a novel behavioural artificial intelligence (AI) tool to examine whether personality is associated with the lived experience of the NHS England launched a low calorie diet (LCD). A cross-sectional survey was disseminated to service users to gather data on emotional wellbeing, physical activity, pain, motivation to manage diabetes, motivation to lose weight, rating of total diet replacement (TDR) products and frequency of using fibre supplements. The scaled insights behavioural AI tool was used to infer personality traits from service users' language construction, and in doing so, examine associations with the outcomes indicated above. Findings show that service users can be profiled by personality, and this can provide a method of understanding programme outcomes. Three clusters of personality traits were identified. Despite this, there was no association between personality features and emotional wellbeing, physical activity, pain, motivation to manage diabetes, motivation to lose weight, rating of TDR products and frequency of using fibre supplements. As the self-selected sample size was limited, future research should examine the use of behavioural AI tools and personality using larger and longitudinal samples.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"15 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cob.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499531","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}
Firas Bahdi, Sagar Shah, Fadi Dahoud, Maryam Farooq, Philip Kozan, Stephen Kim, Alireza Sedarat, Na Shen, Adarsh Thaker, Jennifer M. Kolb, Erik Dutson, V. Raman Muthusamy, Danny Issa
Background and Aims
Weight recidivism following sleeve gastrectomy (SG) is common. Adjuvant treatments include new glucagon-like peptide 1 and glucose-dependent insulinotropic peptide receptor agonists (GLP1/GIP-RA) or revisional endoscopic sleeve gastroplasty (R-ESG). We here compare the outcomes of these treatments.
Methods
A retrospective study of patients ≥18 years with prior SG treated with semaglutide, tirzepatide or R-ESG for weight recidivism between January 2019 and 2023 at large academic centre. Primary outcomes were total body weight loss (TBWL) and adverse events (AEs). Secondary outcomes were changes in metabolic parameters. Tertiary outcome was to compare GLP1/GIP-RA outcomes in SG patients to matched patients with intact stomach.
Results
Our study included 68 (prior SG + GLP1/GIP-RA) and 22 (prior SG + R-ESG). R-ESG offered higher TBWL% than GLP1/GIP-RA at 3 (11.2% vs. 4.3%, p < .001), 6 (13.5% vs. 6.8%, p < .001) and 12 months (13.4% vs. 9.2%, p = .07) with no significant difference in AEs or change in metabolic parameters. On subgroup analysis, tirzepatide achieved similar 12-months TBWL% as R-ESG (13.2% vs. 13.4%, p = .9) and significantly more than semaglutide (13.2% vs. 8.1%, p = .04). Compared to patients with intact stomach (n = 87), GLP1/GIP-RA achieved significantly lower TBWL% in patients with prior SG at 3 (4.3% vs. 5.7%, p = .02), 6 (6.8% vs. 9.2%, p = .02) and 12 months (9.2% vs. 12.7%, p = .03). Medication refills were difficult in 41.3% of patients.
Conclusions
In a single-centre real-world experience study, R-ESG and tirzepatide appear to offer more weight loss than semaglutide in SG patients with weight recidivism although GLP1/GIP-RA were underdosed. GLP1/GIP-RA achieved higher weight loss in patients with intact stomach than those with prior SG.
{"title":"Revisional endoscopic sleeve gastroplasty versus semaglutide and tirzepatide for weight recidivism after sleeve gastrectomy","authors":"Firas Bahdi, Sagar Shah, Fadi Dahoud, Maryam Farooq, Philip Kozan, Stephen Kim, Alireza Sedarat, Na Shen, Adarsh Thaker, Jennifer M. Kolb, Erik Dutson, V. Raman Muthusamy, Danny Issa","doi":"10.1111/cob.70001","DOIUrl":"10.1111/cob.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Weight recidivism following sleeve gastrectomy (SG) is common. Adjuvant treatments include new glucagon-like peptide 1 and glucose-dependent insulinotropic peptide receptor agonists (GLP1/GIP-RA) or revisional endoscopic sleeve gastroplasty (R-ESG). We here compare the outcomes of these treatments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective study of patients ≥18 years with prior SG treated with semaglutide, tirzepatide or R-ESG for weight recidivism between January 2019 and 2023 at large academic centre. Primary outcomes were total body weight loss (TBWL) and adverse events (AEs). Secondary outcomes were changes in metabolic parameters. Tertiary outcome was to compare GLP1/GIP-RA outcomes in SG patients to matched patients with intact stomach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our study included 68 (prior SG + GLP1/GIP-RA) and 22 (prior SG + R-ESG). R-ESG offered higher TBWL% than GLP1/GIP-RA at 3 (11.2% vs. 4.3%, <i>p</i> < .001), 6 (13.5% vs. 6.8%, <i>p</i> < .001) and 12 months (13.4% vs. 9.2%, <i>p</i> = .07) with no significant difference in AEs or change in metabolic parameters. On subgroup analysis, tirzepatide achieved similar 12-months TBWL% as R-ESG (13.2% vs. 13.4%, <i>p</i> = .9) and significantly more than semaglutide (13.2% vs. 8.1%, <i>p</i> = .04). Compared to patients with intact stomach (<i>n</i> = 87), GLP1/GIP-RA achieved significantly lower TBWL% in patients with prior SG at 3 (4.3% vs. 5.7%, <i>p</i> = .02), 6 (6.8% vs. 9.2%, <i>p</i> = .02) and 12 months (9.2% vs. 12.7%, <i>p</i> = .03). Medication refills were difficult in 41.3% of patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In a single-centre real-world experience study, R-ESG and tirzepatide appear to offer more weight loss than semaglutide in SG patients with weight recidivism although GLP1/GIP-RA were underdosed. GLP1/GIP-RA achieved higher weight loss in patients with intact stomach than those with prior SG.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"15 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254930","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}
While the association between ultra-processed food (UPF) consumption and chronic non-communicable diseases in adults is well-established, its relationship with serum markers of chronic diseases in children remains underexplored. This research investigates changes in serum markers in children with obesity during a trial aimed at reducing UPF consumption. The study is a prospective cohort, based on a parallel randomized controlled trial conducted between August 2018 and February 2020, with children aged 7–12 years. Over 6 months, children and their guardians attended monthly consultations and educational activities aimed at reducing UPF consumption. Body weight, height, and 24-h dietary recall were measured at all visits. Serum markers were collected at baseline and at the 2- and 5-month visit (during the intervention). Data from 95 children were analysed. Body mass index (BMI), UPF consumption in grams and energy, and percentage of UPF in grams showed a quadratic trend, initially decreasing, followed by an increase in the following months. Glucose, insulin, and HOMA-IR decreased throughout the study, but after adjustment for BMI, the associations no longer persisted, except for glucose levels, which decreased linearly by 2.25 mg/dL. Reducing UPF consumption may lower blood glucose levels in children with obesity, independent of BMI changes.
{"title":"Change in glucose, insulin and serum lipids due to ultra-processed food consumption in children with obesity","authors":"Caroline Cortes, Joana Maia Brandão, Diana Barbosa Cunha, Vitor Barreto Paravidino, Rosely Sichieri","doi":"10.1111/cob.70000","DOIUrl":"10.1111/cob.70000","url":null,"abstract":"<div>\u0000 \u0000 <p>While the association between ultra-processed food (UPF) consumption and chronic non-communicable diseases in adults is well-established, its relationship with serum markers of chronic diseases in children remains underexplored. This research investigates changes in serum markers in children with obesity during a trial aimed at reducing UPF consumption. The study is a prospective cohort, based on a parallel randomized controlled trial conducted between August 2018 and February 2020, with children aged 7–12 years. Over 6 months, children and their guardians attended monthly consultations and educational activities aimed at reducing UPF consumption. Body weight, height, and 24-h dietary recall were measured at all visits. Serum markers were collected at baseline and at the 2- and 5-month visit (during the intervention). Data from 95 children were analysed. Body mass index (BMI), UPF consumption in grams and energy, and percentage of UPF in grams showed a quadratic trend, initially decreasing, followed by an increase in the following months. Glucose, insulin, and HOMA-IR decreased throughout the study, but after adjustment for BMI, the associations no longer persisted, except for glucose levels, which decreased linearly by 2.25 mg/dL. Reducing UPF consumption may lower blood glucose levels in children with obesity, independent of BMI changes.</p>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"15 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064116","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}
Matthew Cali, Deepali K. Ernest, Luyu Xie, Jeffrey N. Schellinger, M. Sunil Mathew, Aparajita Chandrasekhar, Jane Guo, Gloria L. Vega, Sarah E. Messiah, Jaime P. Almandoz
Background
Recurrent weight gain (RWG) is a major post-operative challenge among metabolic and bariatric surgery (MBS) patients. Binge eating behaviours (BEB) and food addiction (FA) have been identified as significant predictors of post-MBS RWG. However, limited research has investigated their independent associations with post-MBS RWG.
Methods
This cross-sectional study collected data via a self-reported questionnaire of post-MBS patient demographics and eating behaviours from a single-site academic obesity medicine program. The Binge Eating Scale and Yale Food Addiction Scale 2.0 collected data on BEB and FA exposure variables, respectively. ANOVA/chi-square tests determined bivariate associations with BEB and FA, while multivariable logistic regression models examined independent adjusted associations of BEB and FA with RWG% cut-offs.
Results
Of the 294 MBS patients (90.48% female, and 51.71% non-Hispanic white), 42.3% had BEB, 12.55% had severe FA, 7.36% moderate FA, and 7.36% mild FA. After adjustment, BEB was significantly associated with all magnitudes of post-MBS RWG, with the highest odds observed at 50% RWG [OR = 3.07; 95% CI: 1.45, 6.49; p = 0.003]. FA was not significantly associated with post-MBS RWG.
Conclusion
Results showed that BEB, but not FA, was associated with post-MBS RWG. MBS patient support teams should consider screening for BEB at post-MBS visits.
{"title":"Binge eating behaviours are associated with recurrent weight gain after metabolic and bariatric surgery","authors":"Matthew Cali, Deepali K. Ernest, Luyu Xie, Jeffrey N. Schellinger, M. Sunil Mathew, Aparajita Chandrasekhar, Jane Guo, Gloria L. Vega, Sarah E. Messiah, Jaime P. Almandoz","doi":"10.1111/cob.12735","DOIUrl":"10.1111/cob.12735","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Recurrent weight gain (RWG) is a major post-operative challenge among metabolic and bariatric surgery (MBS) patients. Binge eating behaviours (BEB) and food addiction (FA) have been identified as significant predictors of post-MBS RWG. However, limited research has investigated their independent associations with post-MBS RWG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study collected data via a self-reported questionnaire of post-MBS patient demographics and eating behaviours from a single-site academic obesity medicine program. The Binge Eating Scale and Yale Food Addiction Scale 2.0 collected data on BEB and FA exposure variables, respectively. ANOVA/chi-square tests determined bivariate associations with BEB and FA, while multivariable logistic regression models examined independent adjusted associations of BEB and FA with RWG% cut-offs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 294 MBS patients (90.48% female, and 51.71% non-Hispanic white), 42.3% had BEB, 12.55% had severe FA, 7.36% moderate FA, and 7.36% mild FA. After adjustment, BEB was significantly associated with all magnitudes of post-MBS RWG, with the highest odds observed at 50% RWG [OR = 3.07; 95% CI: 1.45, 6.49; <i>p</i> = 0.003]. FA was not significantly associated with post-MBS RWG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Results showed that BEB, but not FA, was associated with post-MBS RWG. MBS patient support teams should consider screening for BEB at post-MBS visits.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"15 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cob.12735","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045720","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}
Pathologic values of body mass index (BMI), body weight, and waist circumference correlate with higher absolute and lower relative trunk strength. Whether waist-to-height ratio (WHtR) is appropriate for showing trunk strength differences in people with obesity and whether a continuous linear relationship exists between the increase in obesity and trunk strength is unknown. This retrospective cross-sectional study included 1174 subjects (1114 men and 60 women). Measured values included body weight, height, waist circumference, WHtR, BMI, and both absolute and body weight-adapted trunk flexor/extensor strength. Statistical analyses included t-tests, Welch tests, Pearson correlations, mixed-linear, and nonlinear regression analyses. Positive correlations with absolute trunk strength were found in subjects without obesity for all anthropometric parameters except WHtR. Weaker positive and partly negative correlation and linear regression coefficients were found in subjects with obesity. Nonlinear relationships were found between age, BMI, WHtR, and absolute respective body weight-adapted trunk strength. The relationship between obesity-defining measures/ indices and trunk strength is non-linear. Increasing BMI, waist circumference, or WHtR above cut-off values known from cardiovascular research is linked to a decrease or weaker increase in trunk strength. Body weight adaptation is recommended to avoid misinterpretation of apparently good absolute trunk strength values in people with obesity.
{"title":"Relevance of body weight adaptation and modern obesity-defining parameters in the analysis of isokinetic trunk strength in people with obesity – A retrospective analysis","authors":"Daniel Geissler, Andreas Lison, Christoph Schulze","doi":"10.1111/cob.12736","DOIUrl":"10.1111/cob.12736","url":null,"abstract":"<p>Pathologic values of body mass index (BMI), body weight, and waist circumference correlate with higher absolute and lower relative trunk strength. Whether waist-to-height ratio (WHtR) is appropriate for showing trunk strength differences in people with obesity and whether a continuous linear relationship exists between the increase in obesity and trunk strength is unknown. This retrospective cross-sectional study included 1174 subjects (1114 men and 60 women). Measured values included body weight, height, waist circumference, WHtR, BMI, and both absolute and body weight-adapted trunk flexor/extensor strength. Statistical analyses included <i>t</i>-tests, Welch tests, Pearson correlations, mixed-linear, and nonlinear regression analyses. Positive correlations with absolute trunk strength were found in subjects without obesity for all anthropometric parameters except WHtR. Weaker positive and partly negative correlation and linear regression coefficients were found in subjects with obesity. Nonlinear relationships were found between age, BMI, WHtR, and absolute respective body weight-adapted trunk strength. The relationship between obesity-defining measures/ indices and trunk strength is non-linear. Increasing BMI, waist circumference, or WHtR above cut-off values known from cardiovascular research is linked to a decrease or weaker increase in trunk strength. Body weight adaptation is recommended to avoid misinterpretation of apparently good absolute trunk strength values in people with obesity.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"15 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cob.12736","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032181","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}
Maiar Elhariry, Pranav Iyer, Nadya Isack, Bernado Sousa, Pushpa Singh, Sally Abbott, Tom Wiggins, Krishnarajah Nirantharakumar, Srikanth Bellary, Stuart W. Flint, Dimitri J. Pournaras, Jonathan M. Hazlehurst
Specialist weight management services including bariatric surgery are commissioned within regions of England called Integrated Care Systems (ICSs) with eligibility and treatment guidelines determined as part of the National Institute for Health and Care Excellence (NICE) guidance. Reported variation in commissioning and bariatric surgery eligibility criteria has not been previously mapped. Freedom of Information (FOI) requests provide a tool, supported by legislation, to ask questions of public authorities including ICSs such that they must respond accurately. FOIs were sent to all 42 ICSs in England asking 4 questions aiming to establish whether there is variation in the commissioning of specialist weight management services and the eligibility criteria for bariatric surgery across England. Responses were presented descriptively and mapped across England. Responses were received from 41 out of 42 ICSs, with 34 reporting that they provide commissioned medical weight management programmes and 38 funding bariatric surgery. Thirteen reported using criteria that were not compliant with NICE guidance. A large area of the country centred around the East of England does not have a bariatric unit reducing access to care. There is significant geographical variation in the availability of both bariatric and specialist medical weight management services across England, with large portions of the country without local access to a service or no service at all. Where services are available, there is significant inconsistency in eligibility for bariatric surgery despite nationally available guidance.
{"title":"Variation in the commissioning of specialist weight management services and bariatric surgery across England: Results of a freedom of information-based mapping exercise across the 42 integrated Care Systems of England","authors":"Maiar Elhariry, Pranav Iyer, Nadya Isack, Bernado Sousa, Pushpa Singh, Sally Abbott, Tom Wiggins, Krishnarajah Nirantharakumar, Srikanth Bellary, Stuart W. Flint, Dimitri J. Pournaras, Jonathan M. Hazlehurst","doi":"10.1111/cob.12731","DOIUrl":"10.1111/cob.12731","url":null,"abstract":"<p>Specialist weight management services including bariatric surgery are commissioned within regions of England called Integrated Care Systems (ICSs) with eligibility and treatment guidelines determined as part of the National Institute for Health and Care Excellence (NICE) guidance. Reported variation in commissioning and bariatric surgery eligibility criteria has not been previously mapped. Freedom of Information (FOI) requests provide a tool, supported by legislation, to ask questions of public authorities including ICSs such that they must respond accurately. FOIs were sent to all 42 ICSs in England asking 4 questions aiming to establish whether there is variation in the commissioning of specialist weight management services and the eligibility criteria for bariatric surgery across England. Responses were presented descriptively and mapped across England. Responses were received from 41 out of 42 ICSs, with 34 reporting that they provide commissioned medical weight management programmes and 38 funding bariatric surgery. Thirteen reported using criteria that were not compliant with NICE guidance. A large area of the country centred around the East of England does not have a bariatric unit reducing access to care. There is significant geographical variation in the availability of both bariatric and specialist medical weight management services across England, with large portions of the country without local access to a service or no service at all. Where services are available, there is significant inconsistency in eligibility for bariatric surgery despite nationally available guidance.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"15 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cob.12731","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001231","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}
Deborah B. Horn, Scott Kahan, Rachel L. Batterham, Dachuang Cao, Clare J. Lee, Madhumita Murphy, Sylvia Gonsahn-Bollie, Farai Chigutsa, Adam Stefanski, Julia P. Dunn
The rate of weight reduction during obesity treatment declines over time and eventually reaches a weight plateau. We investigated factors associated with time to weight plateau (TTWP) in tirzepatide-treated participants with obesity or overweight in a post-hoc analysis of SURMOUNT-1 and SURMOUNT-4 trials. Participants adherent to tirzepatide treatment and achieving ≥5% weight loss by primary endpoint (week 72 SURMOUNT-1; week 88 SURMOUNT-4) were included. Weight plateau was defined as a weight change <5% over a 12-week interval and all subsequent 12-week intervals. TTWP was time from randomization to the start of the first 12-week interval. Association between baseline characteristics and TTWP was assessed. Overall, 1438 participants in SURMOUNT-1 and 259 in SURMOUNT-4 were included. Across BMI categories (overweight, class I, II, and III), median TTWP in SURMOUNT-1 was 24.3, 26.0, 36.1, and 36.1 weeks, respectively (p <.05, class II and III vs. overweight). By week 72, 90.2%, 88.9%, 87.6%, and 87.8% of participants in SURMOUNT-1 had reached a weight plateau across respective BMI categories [Correction added on 22 January 2025, after first online publication: The “72%” has been changed to “72” in this version.]. Higher doses of tirzepatide (10/15 mg), younger age, and female sex were more likely to reach a weight plateau later. Results in SURMOUNT-4 were similar. In this post-hoc analysis, most participants reached a weight plateau by week 72. Higher doses of tirzepatide, younger age, and female sex were associated with a longer TTWP. Further research into modifiers of weight reduction phases with tirzepatide may inform treatment decisions for its use in chronic weight management. Clinical Trial Registration: ClinicalTrials.gov, identifiers NCT04184622 (SURMOUNT-1) and NCT04660643 (SURMOUNT-4), available at http://www.clinicaltrials.gov/
{"title":"Time to weight plateau with tirzepatide treatment in the SURMOUNT-1 and SURMOUNT-4 clinical trials","authors":"Deborah B. Horn, Scott Kahan, Rachel L. Batterham, Dachuang Cao, Clare J. Lee, Madhumita Murphy, Sylvia Gonsahn-Bollie, Farai Chigutsa, Adam Stefanski, Julia P. Dunn","doi":"10.1111/cob.12734","DOIUrl":"10.1111/cob.12734","url":null,"abstract":"<p>The rate of weight reduction during obesity treatment declines over time and eventually reaches a weight plateau. We investigated factors associated with time to weight plateau (TTWP) in tirzepatide-treated participants with obesity or overweight in a post-hoc analysis of SURMOUNT-1 and SURMOUNT-4 trials. Participants adherent to tirzepatide treatment and achieving ≥5% weight loss by primary endpoint (week 72 SURMOUNT-1; week 88 SURMOUNT-4) were included. Weight plateau was defined as a weight change <5% over a 12-week interval and all subsequent 12-week intervals. TTWP was time from randomization to the start of the first 12-week interval. Association between baseline characteristics and TTWP was assessed. Overall, 1438 participants in SURMOUNT-1 and 259 in SURMOUNT-4 were included. Across BMI categories (overweight, class I, II, and III), median TTWP in SURMOUNT-1 was 24.3, 26.0, 36.1, and 36.1 weeks, respectively (<i>p</i> <.05, class II and III vs. overweight). By week 72, 90.2%, 88.9%, 87.6%, and 87.8% of participants in SURMOUNT-1 had reached a weight plateau across respective BMI categories [Correction added on 22 January 2025, after first online publication: The “72%” has been changed to “72” in this version.]. Higher doses of tirzepatide (10/15 mg), younger age, and female sex were more likely to reach a weight plateau later. Results in SURMOUNT-4 were similar. In this post-hoc analysis, most participants reached a weight plateau by week 72. Higher doses of tirzepatide, younger age, and female sex were associated with a longer TTWP. Further research into modifiers of weight reduction phases with tirzepatide may inform treatment decisions for its use in chronic weight management. <i>Clinical Trial Registration</i>: ClinicalTrials.gov, identifiers NCT04184622 (SURMOUNT-1) and NCT04660643 (SURMOUNT-4), available at http://www.clinicaltrials.gov/</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"15 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cob.12734","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969896","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}
Jennifer A. Wilbrink, Mark van Avesaat, Simon W. Nienhuijs, Arnold Stronkhorst, Ad A. M. Masclee
Background
Bariatric surgery is very effective in long-term weight management. The present study was undertaken to investigate the short-term effects of sleeve gastrectomy (SG) and of Roux-en-Y gastric bypass (RYGB) on (a) gastrointestinal (GI) motility, that is gastric emptying and oro-cecal transit time and (b) secretion of regulatory gut peptides and (c) their interrelationship.
Methods
Prospective single-centre study in which we assessed gastric emptying, oro-cecal transit time and gut peptide release in 28 severely obese individuals before and 2, respectively, 12 months after bariatric surgery (either SG or RYGB). Plasma PYY, GLP-1, ghrelin, insulin and glucose levels were measured fasting and after intake of a solid standard 459 kcal meal at each occasion. Gastric emptying was measured by 13 C octanoic acid breath testing, and oro-cecal transit time was measured by lactulose H2 breath testing. Satiation was measured using VAS scores.
Results
After both RYGB and SG gastric emptying become significantly accelerated, and postprandial release of the distal gut peptides GLP-1 and PYY becomes significantly increased, pointing to ileal brake activation. Oro-cecal transit time becomes significantly accelerated after SG but not after RYGB. No significant correlations were observed between changes in distal gut peptide release, changes in GI motility and clinical parameters.
Conclusion
Both SG and RYGB resulted in significant weight loss and significantly affected GI motility and PYY and GLP-1 secretion. Subtle differences between both procedures were found in effect on oro-cecal transit time and patterns of peptide secretion.
{"title":"Changes in gastrointestinal motility and gut hormone secretion after Roux-en-Y gastric bypass and sleeve gastrectomy for individuals with severe obesity","authors":"Jennifer A. Wilbrink, Mark van Avesaat, Simon W. Nienhuijs, Arnold Stronkhorst, Ad A. M. Masclee","doi":"10.1111/cob.12721","DOIUrl":"10.1111/cob.12721","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Bariatric surgery is very effective in long-term weight management. The present study was undertaken to investigate the short-term effects of sleeve gastrectomy (SG) and of Roux-en-Y gastric bypass (RYGB) on (a) gastrointestinal (GI) motility, that is gastric emptying and oro-cecal transit time and (b) secretion of regulatory gut peptides and (c) their interrelationship.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Prospective single-centre study in which we assessed gastric emptying, oro-cecal transit time and gut peptide release in 28 severely obese individuals before and 2, respectively, 12 months after bariatric surgery (either SG or RYGB). Plasma PYY, GLP-1, ghrelin, insulin and glucose levels were measured fasting and after intake of a solid standard 459 kcal meal at each occasion. Gastric emptying was measured by 13 C octanoic acid breath testing, and oro-cecal transit time was measured by lactulose H<sub>2</sub> breath testing. Satiation was measured using VAS scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After both RYGB and SG gastric emptying become significantly accelerated, and postprandial release of the distal gut peptides GLP-1 and PYY becomes significantly increased, pointing to ileal brake activation. Oro-cecal transit time becomes significantly accelerated after SG but not after RYGB. No significant correlations were observed between changes in distal gut peptide release, changes in GI motility and clinical parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Both SG and RYGB resulted in significant weight loss and significantly affected GI motility and PYY and GLP-1 secretion. Subtle differences between both procedures were found in effect on oro-cecal transit time and patterns of peptide secretion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"15 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cob.12721","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892744","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}
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