Current Obesity Reports最新文献

Purpose of review: Eating behaviour-focused interventions are essential for improving health and weight-related outcomes in patients undergoing metabolic bariatric surgery (MBS). This work aims to examine the content of eating behaviour-focused weight management interventions adjunct to MBS in terms of the type and quantity of behaviour change techniques (BCTs). A literature search retrieved randomised controlled and parallel group trials up to March 2024.

Recent findings: A total of 25 trials were included in the final analysis. Trained coders used Michie's BCT taxonomy v1.0 to code intervention components from each trial and applied descriptive methods to report the types and frequency of BCTs. Calculated effect sizes were used to compare the impact of the experimental and comparator arms. Common BCTs applied in eating behaviour-focused interventions were '4.1 Instruction on how to perform a behaviour' (68%), '2.3 Self-monitoring of behaviour' (56%), '1.1 Goal setting (behaviour)' (52%), '1.2 Problem solving' (44%), '3.1 Social support (unspecified)' (40%), and '1.4 Action planning' (40%). However, the BCTs associated with the largest intervention effect sizes (2.1. Monitoring of behaviour by others without feedback and 4.2. Information about antecedents) were not among the most frequently employed techniques. Only one study described the intervention explicitly using BCT taxonomy groupings. In more than half of the studies (52%), authors did not use BCTs to describe interventions. This work highlights the importance of using standard frameworks for reporting the components of behavioural interventions to enhance scientific replication, evidence synthesis, and the ability to test interventions' effectiveness in the future.

Purpose of review: This review examines the long-term efficacy and safety of various nutritional and pharmacological strategies for managing obesity. The focus is on the Mediterranean diet (MedDiet), very low-energy ketogenic therapy (VLEKT), and pharmacological interventions such as naltrexone/bupropion and liraglutide. Given the chronic nature of obesity, understanding the sustainability and impact of these treatments over time is critical.

Recent findings: The MedDiet has shown significant benefits for cardiovascular health and moderate long-term weight loss, though it does not always outperform other diets in terms of weight reduction. VLEKT is highly effective for rapid weight loss, but concerns remain about its long-term sustainability. Pharmacological treatments, including naltrexone/bupropion and liraglutide, have shown promise in promoting significant weight loss and improving metabolic markers. However, issues related to long-term adherence and potential side effects need further exploration. Both nutritional and pharmacological strategies offer valuable tools in obesity management. While treatments like VLEKT and pharmacological options provide significant short-term benefits, the MedDiet remains a sustainable long-term approach. The long-term efficacy and safety of naltrexone/bupropion and liraglutide require more investigation to address challenges in weight maintenance and side effects. Further studies are needed to establish the optimal duration and combination of these therapies for sustained obesity management.

Purpose of review: To summarize the recent literature regarding the interaction between the public health concerns of obesity and depression and provide preliminary recommendations for assessment and management of patients with co-occurring obesity and depression. RECENT FINDINGS : Recent studies have reinforced that while there is a bi-directional link between obesity and depression, there is stronger evidence that obesity contributes to the development of depression. Recent research has also elucidated potential mediating factors in the association between depression and obesity (e.g., demographical, biological, and psychological) as well as a moderating effect of treatment of depression on outcomes for treatment of obesity. There is evidence to suggest that in co-occurring depression and obesity, it is beneficial to treat depression first. Cognitive behavioral therapies have demonstrated effectiveness in treating co-occurring depression and obesity and there is preliminary evidence suggesting that increasing emotion regulation and reducing weight bias internalization may be important treatment targets.

Purpose of review: To highlight recent research on antidepressant use and weight change and explore best clinical practices for reducing weight gain and obesity risk in individuals with depression.

Recent findings: Research on antidepressant use and weight gain suggests that genetic and biological factors including metabolizer phenotypes and inflammation can help to predict an individual's threshold for weight change among specific agents. For individuals with increased susceptibility to metabolic complications, medications including bupropion, fluoxetine, and newer agents (e.g., gepirone) have shown to be efficacious in improving depressive symptoms while concurrently reducing metabolic risks. Additional areas of focus following antidepressant related weight gain include switching to a weight neutral drug alternative, integrated behavioral interventions, and/or pharmacotherapy including GLP-1 receptor agonists (e.g., metformin, liraglutide). Individuals experiencing depression are at heightened risk of metabolic disorders and weight gain, which may be further exacerbated by antidepressant treatment. The increased support of weight neutral antidepressant agents in addition to innovative lifestyle interventions, breakthroughs in drug mechanisms, anti-obesity medications and overall familiarity with the side effects of each antidepressant class will help clinicians make appropriate decisions when treating patients with depression.

Purpose of review: To critically summarize evidence on the potential role of osteokines in the pathogenesis and progression of nonalcoholic fatty liver disease (NAFLD).

Recent findings: There are emerging data supporting that certain osteokines, which are specific bone-derived proteins, may beneficially or adversely affect hepatic metabolism, and their alterations in the setting of osteoporosis or other bone metabolic diseases may possibly contribute to the development and progression of NAFLD. There is evidence showing a potential bidirectional association between NAFLD and bone metabolism, which may imply the existence of a liver-bone axis. In this regard, osteocalcin, osteoprotegerin, bone morphogenic protein 4 (BMP4) and BMP6 appear to have a positive impact on the liver, thus possibly alleviating NAFLD, whereas osteopontin, receptor activator of nuclear factor kappa Β ligand (RANKL), sclerostin, periostin, BMP8B, and fibroblast growth factor 23 (FGF23) appear to have a negative impact on the liver, thus possibly exacerbating NAFLD. The potential implication of osteokines in NAFLD warrants further animal and clinical research in the field that may possibly result in novel therapeutic targets for NAFLD in the future.

Purpose of review: This consensus statement from the Italian Society of Motor and Sports Sciences (Società Italiana di Scienze Motorie e Sportive, SISMeS) and the Italian Society of Phlebology (Società Italiana di Flebologia, SIF) provides the official view on the role of exercise as a non-pharmacological approach in lipedema. In detail, this consensus statement SISMeS - SIF aims to provide a comprehensive overview of lipedema, focusing, in particular, on the role played by physical exercise (PE) in the management of its clinical features.

Recent findings: Lipedema is a chronic disease characterized by abnormal fat accumulation. It is often misdiagnosed as obesity, despite presenting distinct pathological mechanisms. Indeed, recent evidence has reported differences in adipose tissue histology, metabolomic profiles, and gene polymorphisms associated with this condition, adding new pieces to the complex puzzle of lipedema pathophysiology. Although by definition lipedema is a condition resistant to diet and PE, the latter emerges for its key role in the management of lipedema, contributing to multiple benefits, including improvements in mitochondrial function, lymphatic drainage, and reduction of inflammation. Various types of exercise, such as aquatic exercises and strength training, have been shown to alleviate symptoms and improve the quality of life of patients with lipedema. However, standardized guidelines for PE prescription and long-term management of patients with lipedema are lacking, highlighting the need for recommendations and further research in this area in order to optimise therapeutic strategies.

Purpose of review: As obesity and chronic kidney disease (CKD) remain a public health issue, we aim to elaborate on their complex relationship regarding pathogenetic mechanisms and therapeutic potential as well. The purpose of this review is to enhance our understanding of the interplay between obesity and CKD in order to timely diagnose and treat obesity-related CKD.

Recent findings: Obesity and CKD pose significant intertwined challenges to global health, affecting a substantial portion of the population worldwide. Obesity is recognized as an independent risk factor, intricately contributing to CKD pathogenesis through mechanisms such as lipotoxicity, chronic inflammation, and insulin resistance. Recent evidence highlights additional factors including hemodynamic changes and intestinal dysbiosis that exacerbate kidney dysfunction in obese individuals, leading to histologic alterations known as obesity-related glomerulopathy (ORG). This narrative review synthesizes current knowledge on the prevalence, pathophysiology, clinical manifestations, and diagnostic strategies of obesity-related kidney disease. Furthermore, it explores mechanistic insights to delineate current therapeutic approaches, future directions for managing this condition and controversies. By elucidating the multifaceted interactions between obesity and kidney health, this review aims to inform clinical practice and stimulate further research to address this global health epidemic effectively.

Purpose: To develop Mexico's first methodologically rigorous clinical practice guideline for the management of adult overweight and obesity. The target audiences are interdisciplinary healthcare professionals across healthcare systems who are the first point of contact for patients with obesity in Mexico, patients, and health system decision makers.

Recent findings: A review of recent international obesity clinical practice guidelines and an expert consensus process identified: i) common recommendations appropriate for implementation in Mexico and ii) knowledge gaps requiring the formulation of new recommendations. In all, 20 new recommendations and 20 good practice statements were developed using the GRADE Evidence-to-Decision Framework and expert consensus. Overweight and obesity negatively impact the health and well-being of individuals and populations in Mexico. This guideline aims to establish a new evidence-based, patient-centered, non-stigmatizing, and practical treatment and management framework, based on the fundamental principles of chronic disease prevention and management.

Purpose of review: While some parenting interventions designed for early-life obesity prevention have demonstrated short-term success, there is limited evidence of longer-term impacts and feasibility with underrepresented populations. The goal of this review was to examine existing general parenting programs for parents of children 0-5 years that were not designed to target obesity but investigated long-term effects on parenting and/or were conducted with underrepresented populations to offer recommendations for the modification or development of parenting-focused obesity prevention programs.

Recent findings: Most studies with sustained impacts on parenting in underrepresented populations were brief, group-based programs for parents of children 2-5 years. Many effective interventions included guided practice of skills and cultural adaptations. Unique intervention approaches included remote or school-based delivery models and motivational interviewing. Brief, group-based programs for parents of young children may be a promising approach to achieving longer-term impacts of parenting interventions on obesity risk among underrepresented populations.

Purpose of review: The approval of resmetirom brings great hope to patients with metabolic dysfunction-associated steatohepatitis (MASH). The purpose of this review is to explore its impact on the global health environment. The implementation of multidisciplinary management MASH is proposed.

Recent findings: Resmetirom has benefits in the treatment of MASH, and its safety and effectiveness have been studied. The adverse events (AEs) need to be noticed. To improve patient outcomes, a multimodal approach with medication such as resmetirom, combined with metabolic and bariatric surgery (MBS) and lifestyle interventions can be conducted. MASH, a liver disease linked with obesity, is a challenging global healthcare burden compounded by the absence of any approved pharmacotherapy. The recent conditional approval by the Food and Drug Administration (FDA) in the United States of resmetirom, an oral, liver-directed, thyroid hormone receptor beta-selective agonist, marks a significant milestone, offering a treatment option for adults with non-cirrhotic MASH and who have moderate to advanced liver fibrosis. This narrative review discusses the efficacy and safety of resmetirom and its role in the therapeutic landscape of MASH treatment. Despite the promising hepatoprotective effect of resmetirom on histological liver endpoints, its use need further research, particularly regarding ethnic differences, effectiveness and cost-effectiveness, production scalability, social acceptance and accessibility. In addition, integrating resmetirom with other multidisciplinary therapeutic approaches, including lifestyle changes and MBS, might further improve clinical liver-related and cardiometabolic outcomes of individuals with MASH. This review highlights the importance of a comprehensive treatment strategy, supporting continued innovation and collaborative research to refine treatment guidelines and consensus for managing MASH, thereby improving clinical patient outcomes in the growing global epidemic of MASH. Studies done to date have been relatively short and ongoing, the course of the disease is highly variable, the conditions of various patients vary, and given this complex clinical phenotype, it may take many years of clinical trials to show long-term benefits.