Obesity Science & Practice最新文献

Background: Mechanisms by which glucagon-like peptide receptor agonists (GLPRAs) improve cardiovascular outcomes remain incompletely understood. Whether taking GLPRAs are associated with differential dietary patterns remains unknown.

Methods: Data from the National Health and Nutrition Examination Survey (2009-2020) were used to match GLPRA users to non-users with exact matching. Dietary patterns were identified using principal component analysis.

Results: The four dietary patterns were "Standard American", "Legume-Heavy", "Animal Protein and Vegetable", and "Whole Food Carbohydrate". In a multinomial logit model among matched cases (n = 127) and comparisons (n = 1264), taking a GLPRA (vs. not) was associated with lower alignment with the Legume-Heavy pattern (0.15 vs. 0.24, p = 0.01), but no difference for Standard American (0.29 vs. 0.29, p = 0.97), Animal Protein and Vegetable (0.30 vs. 0.22, p = 0.07), or Whole Food Carbohydrate patterns (0.26 vs. 0.25, p = 0.87). There was no difference in dietary quality based on taking or not taking GLPRAs (mean Healthy Eating Index 53.7 (12.1) versus 52.6 (12.3), p = 0.09).

Conclusion: GLPRAs were associated with lower likelihood of legume-focused dietary pattern and no difference in dietary healthfulness. Without simultaneous improvement in dietary healthfulness, there is a risk of a missed opportunity to promote healthy dietary habits among those taking GLPRAs.

Introduction: Abdominal obesity significantly increases the risk of various health conditions, making accurate assessment crucial for diagnosis and treatment. This study compares the effectiveness of anthropometric methods and conventional bioelectrical impedance analysis in evaluating abdominal obesity.

Materials and methods: Twenty adults (10 males, 10 females; age 45 ± 11.4 years; height 170 ± 8.63 cm; body weight 91.3 ± 19.2 kg; BMI 31.7 ± 5.31 kg/m²) participated in a single-visit pilot study at the Bern Movement Lab at Bern University of Applied Sciences. Anthropometric measurements; including body weight, height, waist and hip circumferences; anthropometric indices; including BMI, waist-to-hip ratio, waist-to-height ratio and conventional bioelectrical impedance analysis were collected. Spearman's Rank Correlation was used for statistical analysis due to non-normal data distribution.

Results: Waist circumference, waist-to-hip ratio, and waist-to-height ratio consistently classified all participants as having abdominal obesity. In contrast, bioelectrical impedance analysis identified fewer cases, with only 40% of men and 10% of women classified as having abdominal obesity. Strong correlations were observed between waist circumference, waist-to-height ratio, and visceral fat, whereas waist-to-hip ratio showed weaker correlations.

Conclusions: Simple anthropometric methods such as waist circumference, waist-to-hip ratio, and waist-to-height ratio are useful for evaluating abdominal obesity, with waist-to-height ratio often considered a more reliable predictor of central obesity. However, bioelectrical impedance analysis shows inconsistencies, and the waist-to-height ratio should be considered as a standard metric in future guidelines. Large-scale multiethnic studies are recommended to validate these findings.

Objective: Although aging is associated with reduced hunger and energy intake (EI), obesity is increasing in older adults. This study aimed to identify appetite regulation differences between older adults with obesity and older adults with normal weight (NW).

Methods: This cross-sectional study recruited older adults with obesity (BMI 30-40 kg/m²) and NW (BMI < 25 kg/m²) aged 65-85 years. Fasting appetite-related behavioral questionnaires were collected. Ghrelin, polypeptide YY [PYY], glucagon-like peptide-1 [GLP-1], glucose, insulin, and triglycerides were measured fasting and every 30 min for 3 h following a test breakfast, and the incremental area under the curve (iAUC) was calculated.

Results: 13 older adults with obesity (aged 70.8 ± 4.0 years, 54% female, BMI 33.1 ± 3.6 kg/m²) and 14 with NW (aged 70.8 ± 5.3 years, 71% female, BMI 22.5 ± 2.1 kg/m²) were analyzed. Compared to older adults with NW, older adults with obesity had higher disinhibition and perceived hunger (p < 0.001 and p < 0.05, respectively), lower confidence in preventing overeating (p < 0.05), higher fasting GLP-1 and insulin (both p < 0.05), and higher PYY and insulin iAUCs (p < 0.01 and p < 0.05, respectively).

Conclusion: Despite similar meal-related appetite and EI, older adults with obesity had higher fasting disinhibition, perceived hunger, GLP-1 and insulin, higher PYY and insulin iAUCs, and lower confidence in preventing overeating than those with NW. These differences between older adults with obesity and NW have implications for tailored obesity treatments in older adults.

Weight-based victimization represents a critical challenge for youth, particularly those with obesity, and has been linked to a range of negative psychological, academic, and behavioral outcomes. While research has extensively examined in-person victimization, the rise of digital platforms has given way to weight-based cybervictimization, which remains understudied. This paper highlights the urgent need for research, prevention, and intervention strategies focused on weight-based cybervictimization, emphasizing its harmful effects and its overlap with traditional forms of victimization. It identifies gaps in the existing literature, particularly regarding the inconsistent use of assessment tools and terminology in research on weight-based victimization, and proposes the necessity for culturally relevant and validated measurement tools that accurately capture youth experiences. Finally, it aims to inform best practices for healthcare providers, educators, and parents by promoting strategies that effectively address and mitigate the impact of weight-based victimization among youth.

Background: Greater adherence to daily self-weighing has been associated with improved outcomes within behavioral weight-loss programs. Identifying factors that can predict adherence to self-weighing may support the development of novel tailored interventions.

Methods: The current study examined whether baseline body mass index (BMI) and body image satisfaction (assessed via the Body Image States Scale [BISS]) predicted adherence to self-weighing during a 16-week behavioral weight-loss program in 449 adults with obesity (mean ± SD age = 49.47 ± 11.37 years; BMI = 35.73 ± 4.03 kg/m²; 83.52% female, 74.16% White). Participants were provided with e-scales and encouraged to self-weigh daily during the program. Linear regressions were used to examine associations between BMI and BISS scores (and their interaction) and the proportion of program days that participants self-weighed.

Results: At baseline, average (mean ± SD) BISS scores were 3.57 ± 1.28; higher BMI was associated with lower BISS scores, r = -0.11. Participants self-weighed an average of 80.92 ± 23.35% of days during the intervention; greater self-weighing was associated with greater weight loss, r = -0.56. Neither BMI nor BISS at baseline predicted self-weighing adherence; moreover, there was not an interaction between BMI and BISS scores in relation to self-weighing adherence.

Conclusions: Although results demonstrating negative associations between BMI and body image satisfaction and between self-weighing adherence and weight loss were consistent with prior literature, the lack of an association between BMI, BISS, and self-weighing was not consistent with hypotheses or the prior cross-sectional literature. Given the role self-weighing plays in behavioral weight-loss programs, future research should aim to identify other predictors of self-weighing adherence.

Background: The experience of obesity stigma is associated with negative clinical outcomes that include increased mental health problems and additional weight gain. Researchers have treated the public view that obesity is caused by poor willpower as both an element of obesity stigma and as a cause of obesity stigma. Here we test the hypothesis that awareness of new and effective glucagon-like peptide receptor agonist anti-obesity medications (AOMs) will encourage the view that obesity is a biologically-determined medical condition rather than a personal willpower failure and thereby lessen obesity stigma.

Materials and methods: Two questionnaire studies, in which participants were randomly assigned to either read about the success of AOMs or to read various alternative material (N = 640 in total), investigated the effect that AOM awareness has on views of obesity.

Results: Contrary to the study hypotheses, reading about AOMs did not increase the degree to which participants viewed obesity as a medical condition, nor did it reduce the role willpower failure was believed to play in obesity. Across conditions, participants reporting more personal success in weight loss without medication indicated greater belief that obesity was amenable to self-control, expressed greater obesity stigma, and held less positive attitudes toward the use of AOMs to manage weight.

Conclusion: Taken together, these two studies provide no evidence that the success of AOMs will, in the short-term, lead to changes in how people view the etiology of obesity or to a reduction in obesity stigma. Correlational data suggest the possibility that blame and stigma associated with obesity may be robustly informed by participants' understanding of their own experiences managing weight.

Background: Individuals with obesity often experience weight bias in healthcare, which may negatively impact health outcomes. Weight bias (WB) can be reduced by provider participation in weight bias interventions. This mixed-methods study investigated the sustainability of reduced WB in those who received a weight bias intervention.

Method: Registered nurses (RNs) who completed a weight bias intervention during their nursing education and those who did not were recruited to complete an online survey. WB scores and approaches towards caring for patients with obesity were compared.

Results: Eighty-four RNs (50 intervention; 34 control) participated. Reduced WB was sustained over 4 and 6 years compared to pre-intervention scores (p < 0.001). No significant WB differences were found between the groups (p = 0.501). Thematic analysis identified three overarching themes: physical care differences, recognition of obesity's causality and controllability, and equal treatment of all patients.

Conclusions: Weight bias intervention effects were sustained, but non-intervention nurses had comparable WB scores, indicating multifaceted influences on WB in clinical practice. In order for nurses to provide unbiased care for individuals with obesity, it is important to develop and implement both high-impact educational interventions that support reduced weight bias and organizational and structural supports in the practice environment.

Introduction: Predicting pregnancy is a challenge in preconception weight loss intervention trials. The current study examined whether self-reported pregnancy likelihood and timing were predictive of conception.

Methods: Adults (n = 184; 58% Hispanic; age = 33.4 ± 5.1; BMI = 33.6 ± 6.6) with overweight or obesity, prior gestational diabetes mellitus, and plans to become pregnant participated in a pre-conception behavioral weight loss intervention or control. At baseline, participants reported their estimated likelihood of pregnancy from 1 to 10 (categorized as low [1-3], medium [4-7], and high [8-10] likelihood); they also reported expected timeframe for pregnancy.

Results: Over the 4-year trial, 62 (30%) participants became pregnant. Participants who reported a high likelihood of pregnancy were more likely to conceive than those with a lower rating (45.7% vs. 21.1%). The sensitivity and specificity of a high likelihood rating predicting conception were 69%, 95% CI (56.2%, 80.1%), and 58%, 95% CI (48.9%, 67.0%), respectively. Among those who conceived, mean expected time to pregnancy was 21.6 ± 13.2 months while actual mean time was 11.3 ± 9.1 months. Baseline age, ethnicity, parity, BMI, income, and other demographics did not predict conception.

Conclusions: Pregnancy likelihood estimates best predicted conception, but sensitivity and specificity were low. Future work may consider additional ways to screen for likelihood of conception in preconception trials.

Despite the well-documented effectiveness of metabolic and bariatric surgery (MBS) in treating severe obesity, significant gaps persist in understanding adolescents' lived experiences and perspectives. Addressing these gaps is essential for enhancing patient-centered care and supporting long-term outcomes.

Objective: To explore the long-term patient experiences of adolescents undergoing MBS.

Methods: A qualitative content analysis utilizing individual semi-structured interviews with 18 patients conducted a decade after MBS.

Results: The analysis identified three key categories: Enhanced daily life with the help of MBS, Support and routines, and Reflections on the decision to undergo MBS as an adolescent. Weight loss following MBS was described as pivotal in improving daily life due to enhanced physical, mental and social health. Participants emphasized the need for enhanced access to primary and specialist healthcare with appropriate knowledge of follow-up care. They also underscored the importance of identifying and treating concomitant neuropsychiatric and mental disorders prior to MBS. Additionally, informants highlighted the importance of psychosocial support to maintain the positive changes established post-surgery.

Conclusions: A high level of satisfaction was expressed among those who had undergone MBS as an adolescent. The treatment was considered to help improve daily life and overall well-being and the majority would recommend MBS to others in comparable situations. However, participants highlighted the need for ongoing multidisciplinary support and acknowledged the challenges associated with life after MBS. Notably, a significant proportion of individuals did not attend regular medical follow-ups, emphasizing the importance of structured strategies to ensure adherence to postoperative care.

Background: Residential programs have been utilized for the treatment of adolescents with severe obesity, yet few have been evaluated.

Objective: The objectives were to (1) evaluate the effect of a long-term residential treatment program focused on treating adolescent girls with obesity and (2) explore girls' perceptions of weight management during and after participating in the program.

Methods: A mixed-methods approach was used to examine changes in weight outcomes over time among adolescent girls who completed the program (N = 12), and conduct qualitative interviews to explore perceptions of weight management after completion (N = 5).

Results: Girls in the program showed a reduction in mean BMI of 16.1 ± 4.2 kg/m² (-36.3% ± 5.9%) over a mean of 57 weeks. At follow-up, three participants regained weight while two maintained their completion weight. The program shifted girls' health goals from weight loss to improved overall health. Experiences of social connection and disconnection were identified as components that impacted weight management trajectories over time.

Conclusion: This program demonstrated clinically meaningful improvements in BMI. The structured nature and the emphasis on therapeutic methods were key components of the program. Social support was identified by participants as being integral to successful weight maintenance over time.