Obesity Facts最新文献

Introduction: Numerous cohort studies have consistently shown a significant link between obesity and an increased risk of gallstones. However, body mass index (BMI) alone may not fully capture the complexity of obesity. This study aimed to analyze the associations between different obesity indexes and the incidence of gallstones, using a competing risk model.

Methods: A total of 459,523 UK Biobank participants without gallstones at baseline were analyzed. Cox proportional hazards models, competing risk models, and restricted cubic spline were performed to assess the longitudinal associations between 11 obesity indexes including a body shape index (ABSI), body adiposity index (BAI), body roundness index (BRI), conicity index (ConI), cardiometabolic index (CMI), hip circumference (HC), visceral adiposity index (VAI), lipid accumulation product (LAP), waist circumference (WC), waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR) apart from BMI and gallstone occurrence risk, respectively.

Results: Over a follow-up period of 12.54 years, a total of 14,951 participants developed gallstones. After adjusting for confounding factors, competing risk regression analyses revealed that BMI, BRI, BAI, confidence interval, CMI, HC, LAP, VAI, WC, and WHtR were all positively associated with an increased risk of gallstones. ABSI and WHR showed a "J-shaped" association with the incidence of gallstones, suggesting a nonlinear relationship. Sensitivity analyses confirmed the consistency of the results even after excluding participants who developed gallstones within 1 year of follow-up.

Conclusion: Different dimensions of obesity are all significantly associated with an increased risk of gallstones. These findings highlight the importance of managing obesity, including both overall body weight and abdominal fat, to prevent the occurrence of gallstones.

Introduction: This case report presents the first documented instance in Italy of successful sleeve gastrectomy performed under spinal anesthesia, marking a significant milestone in the field of bariatric surgery. Case Presentation: Highlighting the innovative approach to anesthesia in the context of obesity treatment, this study explains the procedure and postoperative outcomes of a 46-year-old female patient with a BMI of 38 kg/m2, who had a history of moderate Obstructive Sleep Apnea Syndrome. Despite the complications associated with obese patients undergoing bariatric surgery, the use of regional anesthesia (RA) facilitated a favorable outcome, minimizing perioperative risks and enhancing postoperative recovery. The patient experienced no pain or respiratory complications, demonstrating the safety and feasibility of RA for sleeve gastrectomy, and underscoring its potential as a viable alternative to general anesthesia in bariatric surgery. In addition, the use of the Ramsey scale (score: 2) provided valuable insights into the patient's sedation level, contributing to the overall assessment of the anesthetic approach. Conclusion: This case contributes to the growing evidence supporting the use of RA in laparoscopic surgeries, offering significant advantages in terms of patient safety, satisfaction, and recovery outcomes.

Introduction: The prevalence of obesity and overweight has risen to an epidemic level globally, posing significant challenges to healthcare systems. Studies revealed that individuals with obesity and overweight frequently face negative societal perceptions and are often blamed for their weight. Healthcare personnel are not exempt from biases associated with obesity, which can affect their interaction with patients. As frontline providers of care, healthcare professionals play a critical role in managing obesity and related health conditions. However, their attitudes toward individuals with obesity and overweight can influence the quality of care provided, patient satisfaction, and health outcomes. The current study assesses healthcare professionals' attitudes about parturients living with overweight and obesity in northern Jordan, as well as the sociodemographic factors associated with their attitudes.

Methods: Using a cross-sectional, descriptive design, this study recruited a convenience sample consisting of 62 obstetricians, 30 registered nurses, and 95 certified midwives from labor units. Participants completed a questionnaire concerning their sociodemographic characteristics, and Arabic versions of the Fat Phobia Scale (FPS) and Nurses' Attitudes toward Obesity and Obese Patients Scale (NATOOPS).

Results: The overall mean scores of the sample on both scales indicated negative attitudes. Most of the sample was female, married, and aged 29 years. Midwives held more positive attitudes than did obstetricians and nurses. Most participants perceived parturients living with overweight and obesity as overate people, shapeless, slow, and unattractive. Younger participants with long years of experience held less negative attitudes than the rest of the sample. The ANOVA test results showed significant differences in attitudes toward parturients living with overweight and obesity based on age and educational level. Participants with PHD in medicine and a BS in midwifery held positive attitudes. Post hoc Tukey HSD test indicated that the mean (FPS) of the PhD holders and the bachelor's midwifery holders was significantly lower than that of the diploma in midwifery holders (p = 0.012 and p < 0.001, respectively).

Conclusions: It is necessary to treat maternal obesity more adequately in both beginning education courses and continuing professional education seminars for working professionals.

Background: The prevalence of obesity is rising globally. Evidence-informed guidance on preventing obesity is needed, but most existing obesity guidelines are focussed on treatment.

Methods: We developed an evidence- and consensus-based guideline on the prevention of obesity among adults. Following international best practice recommendations for guideline development, we systematically searched for relevant systematic reviews and conducted a structured consensus process involving 34 experts including 5 patient representatives. The guideline's target group is the adult population of Germany, but most recommendations are likely to be applicable internationally.

Results: We developed 24 recommendations for the general public, health care professionals, and policy makers. The guideline recommends, among others, a healthy diet in line with existing food-based dietary guidelines, regular physical activity, as well as appropriate sleep and stress management. Smoking cessation is recommended even when associated with weight gain. Offering qualified advice and counselling on diet and physical activity to all individuals in primary care is suggested. Potential effects of medication on body weight should be considered in prescription decisions. Implementation of evidence-informed policies for promoting healthy food and physical activity environments is recommended.

Conclusions: Evidence-based approaches for preventing obesity on the individual and societal levels exist and should be implemented more widely.

Introduction: Little is known about how the COVID-19 situation affected weight development among Indonesian adolescents. This longitudinal study examined whether, and for whom, the COVID-19 situation affected weight outcomes over time among adolescents from private schools and higher socio-economic positions in Indonesia, where being overweight is a rather prevalent characteristic. This study specifically examined whether appetitive traits (i.e., emotional overeating, food responsiveness) as well as baseline zBMI, sex, and urban area could explain changes in zBMI.

Methods: At baseline, 411 adolescents from 5 private schools in Indonesia (53.3% males, Mage = 12.02 years, SD = 0.45) filled out questionnaires on appetitive traits and background characteristics. In addition, their height and weight were measured. Of these, 336 adolescents (81.8%) also participated at follow-up. At follow-up, height and weight were measured or reported. We used linear regression to analyze the association between predictors and interactions with zBMI.

Results: The results showed a significant decrease in zBMI over time, with a lower average zBMI during COVID-19 compared to before COVID-19. Female adolescents and adolescents with higher baseline zBMI values particularly tended to show this zBMI decreasing pattern. We did not find statistically significant main effects of baseline emotional overeating, food responsiveness, and urban area or any interactions.

Conclusions: Indonesian adolescents appeared to decrease in terms of zBMI during COVID-19, particularly females and adolescents with higher pre-COVID-19 zBMI. Our findings suggest that (culturally-specific) contextual changes (i.e., less exposure to the Indonesian food environment at schools and more exposure to the home environment) might have a beneficial impact in terms of preventing overweight among Indonesian adolescents, particularly among those being more vulnerable (i.e., having higher baseline zBMI).

Introduction: Obesity has been established as a significant risk factor for rapid kidney function decline (RKFD) and chronic kidney disease (CKD). However, the comparative prognostic value of various obesity-related indices in predicting RKFD and CKD remains inadequately elucidated. The objective of this study was to explore the correlations between ten obesity-related indices: body mass index (BMI), Chinese visceral adiposity index (CVAI), waist-to-height ratio, visceral adiposity index (VAI), body roundness index (BRI), a body shape index (ABSI), lipid accumulation product (LAP), waist triglyceride index (WTI), relative fat mass (RFM), and conicity index (C-index) and RKFD and CKD.

Methods: This retrospective longitudinal cohort study leveraged data sourced from the China Health and Retirement Longitudinal Study (CHARLS). Multivariate logistic regression models with covariate adjustment were employed to assess independent associations between obesity-related indices and clinical outcomes. Restricted cubic spline (RCS) regression analyses were performed to characterize potential nonlinear relationships. Predictive performance was quantified through receiver operating characteristic (ROC) curve analysis, with area under the curve (AUC) comparisons.

Results: A total of 1,620 participants were enrolled in this study. Among them, 109 participants developed RKFD, and 60 progressed to CKD. Adjusted logistic regression revealed significant positive associations between CVAI, VAI, LAP, WTI, and RKFD risk, while BRI and C-index demonstrated per standard deviation increases associated with CKD progression. RCS curve analysis demonstrated that CVAI and LAP exhibited a nonlinear relationship with the risk of RKFD, while VAI and WTI had a linear relationship. Moreover, the C-index had a nonlinear relationship with the risk of CKD, whereas BRI had a linear relationship. ROC analysis revealed WTI as the superior RKFD predictor and ABSI as the optimal CKD progression indicator among the evaluated obesity-related indices.

Conclusion: This study comprehensively investigated the associations between ten obesity-related indices and both RKFD and CKD. Our findings indicated that CVAI, VAI, LAP, and WTI were associated with RKFD, with WTI exhibiting the highest predictive value. Furthermore, BRI and C-index were associated with CKD, with ABSI demonstrating the highest predictive value for the progression to CKD.

Introduction: The prevalence of overweight and obesity has increased in the last decades, posing significant health and economic impacts globally. These conditions are related to several non-communicable diseases, including cardiovascular disease, type II diabetes, and cancer. This study estimated the disease burden and healthcare costs associated with overweight and obesity in the adult population in mainland Portugal, in 2018.

Method: Burden of disease was measured in disability-adjusted life years (DALYs) following Global Burden of Disease (GBD) methodology. DALYs were calculated as the sum of years of life lost (YLL) and years lived with disability (YLD). The analyses included morbidity, mortality, and related costs directly related to overweight and obesity, as well as the attributable morbidity, mortality, and related costs of 25 selected diseases related to obesity (DrO). A prevalence-based cost analysis was conducted a from the perspective of the public National Health Service, including costs related to inpatient, outpatient care, and pharmacological treatment.

Results: In 2018, total DALY amounted to 260,943, with 75% due to premature death (196,438 YLL) and 25% due to disability (64,505 YLD). The economic burden of overweight and obesity was estimated at approximately EUR 1,148 million. Of these, approximately EUR 13.3 million (1%) were costs related to the treatment of obesity, and the remaining were costs of DrO attributed to overweight and obesity. Outpatient care corresponded to 43% of total costs, pharmacological treatment 38%, and inpatient care 19%. Cardiovascular and cerebrovascular diseases were the largest contributor to total costs (38%), followed by type II diabetes (34%).

Conclusion: Overweight and obesity incur a large disease and economic burden to the public healthcare sector, representing approximately 0.6% of the country's gross domestic product and 5.8% of public health expenditures.

Background: Obesity, gestational diabetes mellitus (GDM), and bariatric metabolic surgery (BMS) are increasingly common conditions during pregnancy.

Summary: However, clinical knowledge regarding GDM that occurs after BMS remains full of uncertainties. Given its prevalence and potential consequences for the dyad pregnant and offspring, it is imperative to increase knowledge about GDM after BMS, define diagnostic criteria and consequently strategies capable of improving pregnancy outcomes.

Key messages: This paper aimed to review GDM screening methods after BMS and gives insights regarding new paths of research on this paramount obstetric condition.

Introduction: The purpose of the review was to examine the impact of maternal body mass index (BMI) on outcomes of cervical cerclage for cervical insufficiency.

Methods: This prospectively registered review (CRD42024512436) searched PubMed, Embase, Scopus, and Web of Science for comparative studies published before 6 March 2024. Maternal and neonatal outcomes of females undergoing cerclage were compared based on BMI.

Results: Seven studies were included. Pooled data showed that the risk of preterm birth (PTB) (<37 weeks) was significantly increased in the obese vs. non-obese group (odds ratio 1.32, 95% confidence interval [CI]: 1.15, 1.51; I2 = 36%). Gestation age at delivery in weeks was also found to be significantly lower in the obese group (MD: -2.47, 95% CI: -4.83, -0.12; I2 = 96%). There was no significant difference in the risk of preterm premature rupture of membranes and chorioamnionitis between the two groups. Still, the rate of cesarean sections was significantly higher in the obese group. Neonatal birth weight in grams was not found to be significantly different between obese and non-obese groups but the risk of neonatal intensive care unit (NICU) admission was significantly increased in the obese group.

Conclusion: Low-quality evidence indicates that obesity may lead to an increased risk of PTB in women undergoing cervical cerclage. The risk of cesarean section and NICU admission is also increased in obese females.