Obesity Science & Practice最新文献

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.

Background: There are large individual differences in weight loss and maintenance. Metabolic testing can provide phenotypical information that can be used to personalize treatment so that people remain in negative energy balance during weight loss and remain in energy balance during maintenance. Behavioral testing can assess the reinforcing value and change in the temporal window related to the personalized diet and exercise program to motivate people to maintain engagement in healthier eating and activity programs.

Objective: Provide an expository overview of how metabolic testing can be used to personalize weight control. Ideas about incorporating behavioral economic concepts are also included.

Methods: A broad overview of how resting metabolic rate, thermic effect of food and respiratory quotient can be used to improve weight control. Also discussed are behavioral economic principles that can maximize adherence to diet and activity protocols.

Results: Research suggests that measuring metabolic rate can be used to set calorie goals for weight loss and maintenance, thermic effect of food to increase energy expenditure, and respiratory quotient to guide macronutrient composition of the diet and maximize fat loss. Developing programs that foster a strong motivation to eat healthier and be active can maximize treatment success.

Conclusion: Incorporating metabolic measures can personalize behavioral weight loss programs, and the use of behavioral economic principles can increase the probability of adherence and long-term success in weight control.

Objective: Men who work in trade and labor occupations experience high rates of obesity but are underrepresented in weight control programs. This pilot study evaluated the feasibility and acceptability of a program tailored to this working group compared with a standard (untailored) weight loss program.

Methods: Participants for this study were recruited via direct mail, a university medical center, and other efforts. They were randomly assigned to either a tailored program or a standard program. Both programs were delivered via 16 one-hour virtual group sessions over six months. Semi-structured interviews and self-reports were used to assess the acceptability of the interventions. Feasibility was assessed using recruitment metrics and proportion group sessions and completed study assessments.

Results: Participants (N = 28; median 44.0 years, 31.8 BMI) were recruited into the study over 7 months, and 71% and 79% were retained for assessments at 3 and 6 months. Participants attended a median of 9.5 (tailored) and 5 (standard) of the 16 group sessions. All participants who completed the 6-month assessment in both groups reported that they would recommend the programs to other men. Participants achieved a median weight loss of 2.3% at 6 months (tailored: -3.0%; standard: -1.9%).

Conclusions: This study suggests that tailoring strategies identified in the formative work were feasible and potentially capable of producing weight loss similar to a standard program. Future research should focus on increasing recruitment and engagement before proceeding to a fully powered efficacy trial.

Trial registration: NCT05386238.

Objective: A Western diet is associated with obesity, and the link between parental and offsprings' obesity is unclear. Among mice, this study examined how parents' Western diets affect their male offspring's obesity risk. This study further explored whether early exposure to obesogenic diets from either parent influences offsprings' long-term weight gain.

Methods: Three-week-old C57BL6/NTac mice were assigned to a Western diet (WD) or control diet (CD), given from six to 14 weeks old. Adults from these dietary groups were then mated to create four breeding combinations: CD/CD, CD/WD, WD/CD, and WD/WD. Weight gain trajectories were studied in parents (P) and offspring (F1), along with gene expression in four tissues of male offspring. Non-linear mixed effect modeling and q-mode PCA were used to assess the influence of sex, litter size, and parental diet on gene expression, before describing gene expression in more detail.

Results: Offsprings' weight gain was mainly influenced by sex and litter size, with no significant impact from parental diet. At the same time, gene expression differences among offspring, particularly between WD/WD and CD/CD offspring, were linked to genes associated with inflammation, stress response, and other obesity-relevant processes.

Conclusions: Obegenesic diet of two parents with obesity, rather than only one, likely alters the risks of metabolic disease in male mice even at normal weights.

Objective: Healthcare is one of the primary contexts in which people experience weight stigma (social devaluation due to body weight), especially in gynecological care, where people's bodies are exposed. Thus, people may feel especially vulnerable to negative evaluations from healthcare providers due to their weight, given the physical exposure which accompanies a breast exam, abdominal palpitations, and a pap-smear or cervical exam. The existing literature examining weight stigma in obstetrics and gynecology has focused almost exclusively on pregnant or postpartum women. The only research on weight stigma during routine gynecological care is based on qualitative studies with small samples.

Methods: Participants (N = 1087; cisgender women) were sampled on Qualtrics, and quotas were set to reflect the most recent US census. The women reported their experiences with gynecological care and then were asked to qualitatively describe what they most recently encountered.

Results: Overall, 14% of the women in this sample had experienced weight stigma in reproductive or gynecological care at least once, and about 5% of this sample reported that this occurred frequently. Participants with higher body weights (≥ 30 kg/m²) were more likely to report frequent weight stigma in gynecological care. A few participants reported more serious experiences, such as misdiagnosis, environmental or systemic weight stigma, and provider reluctance to perform a pelvic exam.

Conclusions: Women experience weight stigma in routine gynecological care, and future research should continue investigating the effects of these experiences.

Background: Few prior interventions for obesity have focused on reward-related eating. Researchers developed a mobile health mindfulness-based intervention, Eat Right Now (ERN), for improving reward related eating; ERN has not yet been feasibility tested as a weight loss intervention.

Objective: To obtain 6-month pilot and feasibility data in patients using the ERN intervention alone or with asynchronous coaching.

Methods: A 6-month, two-arm pilot and feasibility randomized trial was conducted involving 20 adults with a BMI ≥ 25 kg/m² recruited from Kaiser Permanente Washington. Participants were randomized to ERN alone or ERN plus individualized coaching. Weight loss was assessed via a Wi-Fi-enabled digital scale.

Results: Among the 20 randomized participants, 17 (85%) started the intervention and remained enrolled in six months. Among these, 82% (14/17) had weight data captured by a Wi-Fi scale and 70.5% (12/17) completed follow-up questionnaires at the 6-month time point. The coached ERN participants had 4.3% weight loss (95% confidence interval (CI): 2.3%, 6.3%) and uncoached participants had 3.6% weight loss (95% CI: 1.2%, 5.9%). Participants in both approaches reported reductions in reward-related eating.

Conclusions: This pilot randomized trial of ERN demonstrates the feasibility and acceptability of the intervention for the majority of both the coached and uncoached groups. Further efforts are needed to ensure high retention and data capture in future studies.

Background: Clinical decision support systems (CDSS) are electronic health record tools that support practitioners' decision-making at the point-of-care. CDSS may aid clinical care but are not often centered on patients or practitioners.

Aims: To develop and preliminarily test a CDSS designed to support evidence-based obesity treatment, promote a patient-centered experience, and integrate with clinical workflows.

Materials & methods: The CDSS allowed patients to complete a pre-visit questionnaire via the patient portal, which activated multiple elements for the primary care practitioner (PCP). A 3-month proof-of-concept study was conducted among 10 PCPs at 5 clinics to determine usefulness, usability, and acceptability through validated surveys (mean score ≥ 2.5 signified positive outcome; max 5). Using t-tests, pre-post differences in PCPs' frequency of self-reported clinical practices (1-never; 5-always) were examined.

Results: Most PCPs were physicians with mean experience of 10.8 years (SD 7.5). Overall, mean scores for usefulness, usability, and acceptability were 3.2 (SD 0.8), 3.5 (SD 0.9), and 3.6 (SD 0.9), respectively. PCPs reported significant increases in three key clinical practices-counseling on behavioral interventions (3.1 vs. 3.9 [p < 0.01]), referring to weight-loss programs (2.8 vs. 3.5 [p < 0.01]), and discussing anti-obesity medications (3.3 vs. 3.8 [p = 0.02]).

Conclusion: This weight management CDSS was useful and usable for PCPs and improved obesity-related practice habits. Future studies need to evaluate its impact on patient outcomes.

Objective: This study aimed to examine how anti-fat attitudes and attitudes toward obesity management influence orthopedic surgeons' treatment preferences for patients with obesity who are candidates for elective total knee arthroplasty (TKA).

Methods: A cross-sectional survey was conducted among 150 orthopedic surgeons using a web-based questionnaire. The survey included four sections: socio-demographic data, the Antifat Attitudes Questionnaire (AFA) assessing biases related to obesity (dislike, fear of fatness, and beliefs about willpower), an adapted questionnaire on attitudes toward obesity management, and a custom section on treatment preferences.

Results: The sample had a mean age of 43.4 years (SD = 9.7) and was predominantly male (70.7%). Participants exhibited moderate anti-fat attitudes alongside positive views on obesity management. Stronger anti-fat attitudes correlated with a preference for conservative treatments over surgery (r = 0.45 to r = 0.29, p < 0.001), whereas supportive attitudes toward obesity management were associated with less preference for conservative treatment (r = -0.53, p < 0.001). Male surgeons demonstrated higher anti-fat attitudes and a greater inclination for conservative treatment than female surgeons. Regression analysis identified attitudes toward obesity management as a significant predictor of treatment preferences (β = -0.54, p < 0.001).

Conclusion: Findings highlight the impact of weight stigma on clinical decision-making and emphasise the need for increased awareness and education to ensure equitable access to TKA for patients with obesity.

Background: Patients perceive high levels of weight prejudice, stigma, and discrimination within health systems, affecting their ability to manage their obesity and related chronic conditions. Scientific and patient obesity associations worldwide have prioritized the reduction of weight stigma to improve patient experiences in health systems and overall health outcomes. Since a significant proportion of the population is now living with multiple chronic diseases related to obesity, healthcare systems must shift toward multi-disease management frameworks incorporating person-centered and non-stigmatizing clinical conversations. Motivational Interviewing (MI) has the potential to transform clinical interactions by using non-stigmatizing language, communication, and practices. Studies using MI in obesity management have solely focused on weight loss outcomes, while other patient experience related outcomes would also be relevant to evaluate.

Methods: A narrative review was undertaken to critically analyze the potential impact of MI on obesity and chronic disease management practices and experiences.

Findings: An analysis and contextualization of the MI theoretical framework for obesity management, based on the philosophy of motivational spirit, was reviewed, assessing micro skills or strategies.

Conclusion: MI may assist healthcare professionals conduct non-stigmatizing clinical conversations in accordance with basic principles of collaborative therapeutic alliances. A proposal for research considerations that can help illuminate the potential for of MI in obesity management is also outlined.

Background: Obesity and dyslipidemia are interconnected complex conditions and their prevalence differs across different geographical regions. As a major risk factor for cardiovascular diseases, dyslipidemia is often misdiagnosed and inadequately treated, highlighting the need for region-specific public health policies. Therefore, the objective of this study was to examine the associations between BMI and dyslipidemia in the Prospective Epidemiological Research Studies in Iran (PERSIAN) Guilan Cohort study (PGCS) population.

Methods: This cross-sectional study analyzed the demographic and biochemical data from 10,519 participants of the PGCS population. Participants were divided into two groups with and without dyslipidemia and were compared based on BMI. Data analysis was performed in SPSS v16 with a significance level of < 0.05.

Results: The average age of the participants was 51.52 ± 8.90 years. The prevalence of dyslipidemia in all participants was equal to 75.83%. Among those with dyslipidemia, 41.18% and 35.39% had overweight and obesity, respectively. There was a positive association between BMI and the prevalence of dyslipidemia (unadjusted OR = 1.09, 95% confidence interval (CI): 1.08-1.10) (p < 0.01), indicating that for a one-unit increase in participants' BMI, the probability of having dyslipidemia increased by 9%, which remained statistically significant even after adjusting. Analysis of dyslipidemia components and BMI revealed a significant association between elevated TG and cholesterol, as well as low HDL levels and higher BMI (unadjusted OR = 1.04, 1.01, and 1.09, respectively) (p < 0.01). However, this was not statistically significant for high LDL levels (unadjusted OR = 1.01) (p = 0.05).

Conclusion: Given the high prevalence of dyslipidemia in our studied region and its strong association with obesity, prioritizing obesity management in public health decision-making is vital. Greater focus should be given on accessing and modifying the components of dyslipidemia, particularly LDL particles, as a potentially significant research target to prevent the mismanagement of dyslipidemia in individuals with obesity.