Journal of Obesity最新文献

This study evaluated the safety and economic impact of discharging bariatric surgery patients on Postoperative day (POD) 1 compared to the institutional POD 2 discharge protocol. A retrospective review of 115 patients who underwent laparoscopic or robot-assisted sleeve gastrectomy and Roux-en-Y gastric bypass (RYGB) revealed no significant differences in complications or readmissions between the groups. Discharge on POD 1 demonstrated a cost difference of approximately $1571. Our findings support the safety, feasibility, and financial benefits of implementing POD 1 discharge as standard practice for bariatric patients in underserved urban populations.

[This corrects the article DOI: 10.1155/jobe/3897161.].

Objective: Body mass index (BMI) has been criticised for its inability to differentiate between fat and nonfat tissues and to reflect body fat distribution. Body Roundness Index (BRI) and A Body Shape Index (ABSI) are novel indices addressing these limitations, yet their mortality risk-stratification utility remains understudied in Asian populations.

Methods: In this retrospective cohort study using a nationally representative Japanese claims database (2014-2022), we analysed 778,812 individuals who underwent healthcare checkups. Anthropometric indices were categorised into five groups based on restricted cubic spline curve-derived cutoffs. Multivariate Cox proportional hazards models, adjusted for demographic factors, lifestyle variables and comorbidities, assessed associations between these categorical variables and all-cause mortality.

Results: Among participants (mean [standard deviation] age of 62.8 [9.6] years and 445,250 [57.2%] women), 14,690 deaths occurred during a median [interquartile range] follow-up of 4.53 [3.28-6.23] years. While BMI and BRI showed U-shaped relationships with all-cause mortality, ABSI demonstrated a J-shaped relationship. Significant differences in mortality risk compared with the reference category were observed in three categories for BMI, four categories for BRI and four categories for ABSI.

Conclusions: BRI and ABSI identified mortality risk differences across more categories than BMI, indicating that these indices may provide additional insights beyond BMI for mortality risk assessment.

Background: The World Health Organization estimates that more than 500 million people will be affected by diseases related to physical inactivity in the next decade. Individuals with overweight or obesity are particularly vulnerable, making exercise adherence a critical public health concern. This review aimed to evaluate the efficacy of interventions designed to improve adherence to exercise in this population.

Methods: A systematic search was conducted in MEDLINE, Embase, Virtual Health Library, Cochrane Library, and SPORTDiscus. Two independent researchers performed screening, data extraction, and synthesis of studies including adults aged 18-59 years with overweight or obesity. Eligible interventions lasted at least 12 weeks, included a control group, and reported adherence-related outcomes. Methodological quality was assessed using the Cochrane Risk of Bias tool. When possible, meta-analysis was performed.

Results: Seventeen studies met the inclusion criteria. Group-based programs and interventions supervised by trained professionals were consistently associated with higher adherence. Factors, such as body weight, exercise frequency, session duration, intensity, and type of intervention, showed no consistent influence. However, most studies presented a moderate to high risk of bias.

Conclusion: Group and supervised interventions appear effective in improving exercise adherence among adults with overweight or obesity, but further high-quality studies are needed.

Background: Butterfly pea flowers (Clitoria ternatea L.) and lemon fruits (Citrus limon) are rich in phytochemicals and have shown potential anti-obesity effects. However, the combination of these two medicinal plants as an herbal beverage has not been extensively studied.

Objective: This study aimed to evaluate the effects of an herbal beverage composed of butterfly pea flowers and lemon fruits (BPL) on body weight (BW), Lee index (LI), body fat content (BFC), lipid profile (total cholesterol, low-density lipoprotein-cholesterol [LDL-C], high-density lipoprotein-cholesterol [HDL-C], and triglycerides [TGs]), leptin levels, and DPP4 activity in obese male Wistar rats.

Methods: A pre- and post-test experimental design was conducted using 40 obese male Wistar rats, divided into five groups: NC (negative control, given 3 mL/day mineral water), positive control (PC, given 3 mL/day plant stanol ester), BPL1 received 3 mL/day BPL 75:25%, BPL2 received 3 mL/day BPL 80:20%, and BPL3 received 3 mL/day BPL 85:15%. All treatments were administered orally via gastric probe for 21 days. Data were analyzed using appropriate statistical tests to assess significant differences.

Results: The BPL3 group showed the greatest reduction in BW and LI. The BPL1 group had the greatest reduction in TG levels, followed by the BPL3 group. The greatest reduction in leptin levels was found in the BPL2 group, followed by the BPL3 group.

Conclusion: Oral administration of BPL herbal beverage with 85:15% formulation reduces BW and LI through the modulation of lipid metabolism and hormonal regulation.

Background/objectives: Obesity is among the most common global public health issues in the 21^st century and contributes significantly to cardiovascular morbidity and mortality burden. The success of well-targeted policies and intervention strategies aimed at addressing obesity depends heavily on understanding the effect of geographical location on obesity and other predictors. The study aim was to quantify county-level geographical differences in obesity across Florida counties while simultaneously identifying predictors of obesity prevalence.

Methods: This study used the 2019 data from the Florida state-based telephone surveillance systems, known as the Behavioral Risk Factor Surveillance System (BRFSS) which provides county-level data on measures of the prevalence of personal health behaviors that are risk factors for morbidity and mortality. The survey collected data on a total sample of 54,260 adults residing in 67 counties of Florida. This study applied Bayesian geospatial models and interactive web-based mapping approaches to analyze and map county-level geographical differences in the risk of obesity. The estimated coefficients were presented as log mean with their associated 95% credible intervals (Cr.Is).

Results: The study identified sedentary lifestyle (log mean = 0.023, 95% Cr.I: 0.006, 0.039) as the only risk factor independently associated with increased burden of obesity. The results showed substantial county-level geographical differences in the predicted obesity prevalence with an overall obesity prevalence of 68.6% with a range of 59.0%-75.7%. Residing in Holmes was associated with the highest burden of obesity. Furthermore, the prevalence was relatively high in Levy, Columbia, Lafayette, Hendry, Bradford, Calhoun, Dixie, Okeechobee, and Gadsden counties.

Conclusion: The substantial county-level geographical difference in obesity prevalence found is of great importance for sound public health policy and intervention strategies at the local level. The geospatial modeling supported by the web-based spatial mapping tool employed in this study can help guide the design of geographical prioritization of targeted public health policies and intervention strategies to combat adult obesity and its associated mortality.

Background: Globally, many patients with Type 1 diabetes (T1D) are now characterized by excess adipose tissue and features of insulin resistance. In Kuwait, rapid urbanization, shifts in dietary patterns, and decreased physical activity have contributed to rising obesity prevalence in the general population.

Objectives: We aimed to investigate the interplay between the diseases of obesity and T1D, examining patients' perspectives on why they gained body weight, psychological aspects, and management challenges.

Methods: A mixed-methods approach was employed, encompassing quantitative analysis of body mass index (BMI) and lifestyle factors among 51 participants with T1D and obesity or obesity-related complications and a thematic analysis of perceptions and experiences related to obesity and T1D using an online survey.

Results: Participants identified lifestyle factors as the primary contributors to obesity, emphasizing the need for holistic interventions. About 56.8% of the participants perceived T1D as a barrier to obesity treatment. The qualitative analysis revealed four themes: 1) negative perceptions about obesity, 2) poor interface with healthcare professionals (HCPs), 3) lack of suggestions for improving obesity management, and 4) poor self-image and awareness. This provided in-depth insights into participants' perceptions, worries, experiences, and suggestions for managing obesity in the context of T1D.

Conclusions: This study contributes a nuanced understanding of obesity in patients with T1D, shedding light on the complexities beyond glycemic control. The findings emphasize the need for patient-centered, multidisciplinary approaches that consider both medical and psychological aspects in the management of obesity within patients with T1D.

Background: Parents' support for the National Childhood Measurement Programme (NCMP, England) is typically mixed, with qualitative data from small samples of self-selecting parents highlighting different responses depending on whether their child is classified as a 'healthy' or alternative weight.

Objective: Using data from the Gemini cohort study, we explored parents' emotional and behavioural responses to feedback on their children's weight status.

Methods: We performed secondary data analysis on data collected when children were 12-13 years old (2019-2021). Their parents completed a questionnaire online, which included (optional) questions about the NCMP. Parents indicated the weight status assigned to their child by the NCMP and answered questions about the weight feedback, including an open-ended question about their emotional responses.

Results: There were 567 complete responses to the NCMP questions (55.8% of parents who completed the questionnaire). The majority of children were categorised as 'healthy weight' (n = 440, 77.6%). Among parents whose children were categorised as an alternative weight status (n = 101), 29.7%, 54.5% and 45.0% of those with children categorised as underweight, overweight or very overweight, respectively, reported that they took action following the NCMP feedback. Qualitative results highlighted emotional responses and inferences made about children's well-being based on the feedback received; parents usually reacted positively (happy, inferred their child was healthy) if their child was categorised as a healthy weight, and negatively (worried, inferred their child was not healthy) if their child was categorised as an alternative weight status. There was also some distrust of the feedback and the NCMP itself.

Conclusion: The negative reactions of many parents to NCMP feedback, and the programme itself, highlight the need to involve parents and caregivers in the delivery of the NCMP and framing of feedback. Parent and caregiver input is vital to understand how best to communicate information about children's weight to parents, signpost them to support and what support pathway should be implemented to increase parent uptake.

Objective: We aimed to compare the molecular mechanisms and metabolic outcomes of Roux-en-Y gastric bypass (RYGB) and single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) using a preclinical model.

Methods: Otsuka Long-Evans Tokushima Fatty rats with diet-induced obesity underwent RYGB, SADI-S, or sham surgery. Metabolic parameters, including glucose tolerance, body weight, and 18F-fluorodeoxyglucose biodistribution, were assessed at 1- and 2-month postsurgery. The expression of Glucose transporter 1 (GLUT1) and glucose metabolism-related genes in intestinal segments was analyzed.

Results: Although RYGB and SADI-S yielded comparable improvements in glucose tolerance and body weight at 1 month postsurgery, they exerted their effects through distinct mechanisms. RYGB enhanced GLUT1-mediated glucose excretion in the common limb, whereas SADI-S upregulated the expression of the glycolytic genes Hk2, Fbp2, Aldob, and Ldha in the colon. Two months postsurgery, the observed metabolic improvements diminished despite sustained weight loss, which coincided with decreased expression of GLUT1 and glycolytic genes.

Conclusions: RYGB and SADI-S achieve similar benefits through distinct glucose handling pathways; however, these effects decline over time. Our data do not support the superiority of SADI-S over RYGB, particularly given its higher complication rate, and instead highlight the need for strategies aimed at prolonging the therapeutic benefits of metabolic surgeries.

Background: Obesity has emerged as a pressing global health challenge, and therapies based on glucagon-like Peptide 1 receptor agonists (GLP-1RAs) have transformed its management. Currently, liraglutide, semaglutide, and tirzepatide are FDA-approved for obesity treatment, while other agents are used off-label. These drugs not only provide unprecedented efficacy and acceptable safety in weight reduction and glycemic control for patients with obesity and Type 2 diabetes but also hold promise in broader indications, including neurodegenerative disorders, fatty liver disease, dyslipidemia, atherosclerosis, and cardiovascular conditions.

Methods: This narrative review examined the therapeutic applications of GLP-1RAs for obesity, emphasizing their efficacy, safety profile, challenges with patient adherence, and limitations. The review also explored emerging innovations such as ultralong-acting formulations, combination therapies, and the integration of digital health and artificial intelligence in advancing antiobesity drug development.

Results: GLP-1RAs represent a paradigm shift in the treatment of obesity and metabolic diseases, with rapidly expanding indications and global uptake. Recent evidence highlights improvements in tolerability, global accessibility, and the potential of novel technologies to optimize patient outcomes. By 2025, GLP-1RAs are anticipated to receive FDA approval for new indications, such as chronic kidney disease, heart failure with preserved ejection fraction, and metabolic dysfunction-associated steatohepatitis. Novel agents including CagriSema and higher dose oral semaglutide are advancing through clinical trials, while pivotal trial results for orforglipron, mazdutide, retatrutide, and survodutide are anticipated to further expand the therapeutic landscape. At the same time, the arrival of generic liraglutide and evolving insurance coverage are reshaping access and affordability.

Conclusion: The convergence of pharmacological innovation, digital health strategies, and equitable care initiatives is expected to revolutionize obesity therapeutics in the coming decade. Priorities for future research include sustaining long-term weight loss, establishing disease-modifying potential in nonmetabolic disorders, and addressing health equity concerns to ensure broader global benefit.