IF 6.9 2区医学 Q1 Nursing

Obesity

Pub Date : 2024-04-25 DOI: 10.1002/oby.24014

Marina Panova-Noeva, Thomas Koeck, Corinna Schoelch, Andreas Schulz, Jürgen H. Prochaska, Matthias Michal, Konstantin Strauch, Alexander K. Schuster, Karl J. Lackner, Thomas Münzel, Anita M. Hennige, Philipp S. Wild

Objective

The objective of this study was to investigate whether an obesity-related inflammatory protein signature (OIPS) is associated with adverse cardiovascular events.

Methods

The Olink Target 96 Inflammation panel was performed in 6662 participants from the population-based Gutenberg Health Study (GHS). The OIPS was selected by a logistic regression model, and its association with cardiovascular outcomes was evaluated by Cox regression analysis. The GHS-derived OIPS was externally validated in the MyoVasc study.

Results

The identified OIPS entailed 21 proteins involved in chemokine activity, tumor necrosis factor (TNF) receptor binding, and growth factor receptor binding. The signature revealed a novel positive association of axis inhibition protein 1 with obesity. The OIPS was associated with increased risk of all-cause and cardiac deaths, major adverse cardiovascular events, and incident coronary artery disease, independent of clinical covariates and established risk instruments. A BMI-stratified analysis confirmed the association of OIPS with increased death in those with obesity and overweight and with increased risk for coronary artery disease in those with obesity. The association of OIPS with increased risk of all-cause and cardiac deaths was validated in the MyoVasc cohort.

Conclusions

The OIPS showed a significant association with adverse clinical outcomes, particularly in those with overweight and obesity, and represents a promising tool for identifying patients at higher risk for worse cardiovascular outcomes.

目的本研究旨在探讨肥胖相关炎症蛋白特征（OIPS）是否与不良心血管事件有关。方法对基于人群的古腾堡健康研究（GHS）的6662名参与者进行了Olink Target 96炎症面板分析。通过逻辑回归模型选择 OIPS，并通过 Cox 回归分析评估其与心血管预后的关系。结果发现，OIPS包含21种参与趋化因子活性、肿瘤坏死因子（TNF）受体结合和生长因子受体结合的蛋白质。该特征揭示了轴抑制蛋白 1 与肥胖的新的正相关性。OIPS与全因死亡和心源性死亡、主要不良心血管事件和冠状动脉疾病风险的增加有关，不受临床协变量和既定风险工具的影响。体重指数分层分析证实，OIPS 与肥胖和超重者死亡风险增加以及肥胖者冠状动脉疾病风险增加有关。结论：OIPS 与不良临床预后有显著关联，尤其是在超重和肥胖患者中，是识别心血管预后较差的高风险患者的有效工具。

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引用次数: 0

Correction to “NADPH oxidase 4 in mouse β cells participates in inflammation on chronic nutrient overload” 对 "小鼠 β 细胞中的 NADPH 氧化酶 4 参与慢性营养过剩引起的炎症 "的更正。

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity

Pub Date : 2024-04-25 DOI: 10.1002/oby.24045

Holendová, B, Benáková, Š, Křivonosková, M, et al. NADPH oxidase 4 in mouse β cells participates in inflammation on chronic nutrient overload. Obesity (Silver Spring). 2024; 32(2): 339–351. doi:10.1002/oby.23956

On page 339, the funding information was incomplete. The complete funding information is as follows:

Grant Agency of the Czech Republic, Grant/Award Numbers: 21-01205S, 22-11439S; Charles University Grant Agency, Grant/Award Number: 110120; National Institute for Research of Metabolic and Cardiovascular Diseases (Programme EXCELES, ID Project No. LX22NPO5104)—Funded by the European Union Next Generation EU.

The online version of the article has been corrected accordingly.

We apologize for this error.

Holendová, B, Benáková, Š, Křivonosková, M, et al. 小鼠 β 细胞中的 NADPH 氧化酶 4 参与了慢性营养过剩引起的炎症。肥胖症（银泉）。 2024; 32(2): DOI:10.1002/BY.23956，第 339 页，经费信息不完整。完整的资助信息如下：捷克共和国拨款机构，拨款/奖励编号：21-01205S, 22-11439S; Charles University Grant Agency, Grant/Award Number: 110120; National Institute for Research of Metabolic and Cardiovascular Diseases (Programme EXCELES, ID Project No. LX22NPO5104)-Funded by the European Union Next Generation EU.The online version of the article has been corrected accordingly.We apologize for this error.

引用次数: 0

Body weight variability and the risk of liver-related outcomes in type 2 diabetes and steatotic liver disease: a cohort study 体重变化与 2 型糖尿病和脂肪性肝病的肝脏相关风险：一项队列研究。

IF 6.9 2区医学 Q1 Nursing

Obesity

Pub Date : 2024-04-25 DOI: 10.1002/oby.24035

Nathalie C. Leite, Claudia R. L. Cardoso, Cristiane A. Villela-Nogueira, Gil F. Salles

Objective

The objective of this study was to evaluate the effects of body weight variability (BWV) on the occurrence of adverse liver outcomes in individuals with type 2 diabetes (T2D) and metabolic dysfunction-associated steatotic liver disease (MASLD).

Methods

A total of 549 patients with T2D and MASLD had BWV parameters assessed during the first 2 years of follow-up. The associations between increasing BWV and liver outcomes (clinical cirrhosis or a liver stiffness measurement on transient elastography > 15 kPa, performed after a median of 7 years of cohort entry) were examined by multivariable logistic regressions. Interaction/subgroup analyses were performed according to participants' physical activity during the initial 2-year period.

Results

Individuals were followed up for an additional median 9.7 years, over which 34 liver outcomes occurred (14 with clinical cirrhosis and 20 with liver stiffness measurement > 15 kPa). A 1-SD increase in weight SD and average real variability was associated with 52% higher (95% CI: 4%–128%) odds of having an adverse liver outcome. Otherwise, in interaction/subgroup analyses, an increased BWV was associated with a higher likelihood of outcomes only in sedentary individuals.

Conclusions

Increased BWV was associated with adverse liver outcomes in individuals with T2D and MASLD; however, in those who were physically active, it was not hazardous.

目的本研究旨在评估体重变异性（BWV）对 2 型糖尿病（T2D）和代谢功能障碍相关性脂肪性肝病（MASLD）患者不良肝脏预后发生的影响。方法共有 549 名 T2D 和 MASLD 患者在随访的头两年中接受了体重变异性参数评估。通过多变量逻辑回归分析了BWV增加与肝脏预后（临床肝硬化或瞬态弹性成像肝脏僵硬度测量值大于15 kPa，中位数为入组7年后）之间的关系。根据参与者在最初 2 年期间的体育锻炼情况进行了交互/亚组分析。结果参与者又接受了中位数为 9.7 年的随访，在此期间出现了 34 种肝脏病变（14 例临床肝硬化，20 例肝脏硬度测量值 > 15 kPa）。体重SD和平均实际变异性每增加1个SD，肝脏不良结果的发生几率就会增加52%（95% CI：4%-128%）。结论在患有 T2D 和 MASLD 的人群中，体重变异性增加与肝脏不良结果有关；但在那些身体活跃的人群中，体重变异性增加并不危险。

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引用次数: 0

Response to Fitch and Huett-Garcia 对 Fitch 和 Huett-Garcia 的回应。

IF 6.9 2区医学 Q1 Nursing

Obesity

Pub Date : 2024-04-24 DOI: 10.1002/oby.24039

Hamlet Gasoyan, Elizabeth R. Pfoh, Rebecca Schulte, Phuc Le, Michael B. Rothberg

引用次数: 0

Response to “Early- and later-stage persistence with antiobesity medications: a retrospective cohort study” 对 "抗肥胖药物的早期和晚期持续作用：一项回顾性队列研究 "的回应

IF 6.9 2区医学 Q1 Nursing

Obesity

Pub Date : 2024-04-24 DOI: 10.1002/oby.24038

Angela Fitch, Amber Huett-Garcia

TO THE EDITOR: We have read and appreciate the hypothesis and the data collected and analyzed to report on patient persistence with antiobesity medications (AOMs) using electronic health records [(1)]. Although we agree that this study explores an interesting topic, we are concerned that the study methodology may have inadvertently introduced bias, thereby impacting the conclusions.

We have concerns with the classification of patients by the last AOM prescribed and the categorization of patients switched from brand-name AOMs to non-Food and Drug Administration (FDA)-approved generic combinations. We recognize that classification of patients to the last AOM prescribed among patients who switched AOMs during the first year of the study period may be appropriate when looking strictly at overall persistence, irrespective of AOMs (primary aim); however, this artificially inflates the observed persistence with novel AOMs (e.g., semaglutide). Furthermore, the classification of patients to FDA-approved, branded, fixed-dose combination AOMs (e.g., phentermine-topiramate, naltrexone-bupropion) who were switched to generic combinations during the study period is concerning because the safety and efficacy of the combined generic components have not been demonstrated and cannot be compared to or combined with that of the FDA-approved treatment.

Another concern is that the entirety of the patient journey (patients often undergo ≥1 obesity treatment) was not considered. The unbalanced exclusion of patients (e.g., patients undergoing bariatric surgery, patients with diabetes on injectable forms of semaglutide and liraglutide) is of concern because clinical evidence has reliably demonstrated that AOM effectiveness for weight loss among patients with diabetes is generally less than that for patients without diabetes [(2, 3)]. This study reports that patients with diabetes were less persistent with AOM therapy; however, excluding patients with diabetes using semaglutide and liraglutide but not excluding patients using the other AOMs may have falsely inflated the persistence and weight loss achieved from semaglutide and liraglutide. Additionally, many issues of persistence are not reflective of treatment response or patient participation but, instead, are affected by coverage and availability [(4)].

Finally, the study failed to account for the vastly different drug titration schedules of the AOMs (e.g., 2 weeks for phentermine-topiramate, 4 weeks for naltrexone-bupropion, 16 weeks for semaglutide) [(5-7)]. These differences in titration schedule are important to consider because the variations observed in persistence may be due, in part, to the time to reach the respective maintenance dose of each AOM.

We acknowledge that all studies have limitations that cannot be overcome; however, careful consideration must be taken when contextualizing those implications. Manuscripts such as th

致编辑：我们阅读并欣赏了该研究的假设以及收集和分析的数据，这些数据旨在报告患者利用电子健康记录持续服用抗肥胖药物（AOMs）的情况[(1)]。虽然我们同意这项研究探讨了一个有趣的话题，但我们担心研究方法可能无意中引入了偏见，从而影响了研究结论。我们对按照最后一次处方的 AOM 对患者进行分类以及将从品牌 AOM 转为非食品药品管理局 (FDA) 批准的非专利复方药物的患者进行分类表示担忧。我们认识到，如果不考虑AOMs（主要目的），而严格着眼于总体持续性，那么将研究期间第一年内更换AOMs的患者按最后一次处方的AOMs分类可能是合适的；但是，这种做法会人为夸大所观察到的新型AOMs（如semaglutide）的持续性。此外，在研究期间转用非专利复方制剂（如芬特明-托吡酯、纳曲酮-安非他酮）的美国食品及药物管理局批准的品牌固定剂量复方制剂患者的分类也令人担忧，因为非专利复方制剂的安全性和有效性尚未得到证实，无法与美国食品及药物管理局批准的治疗方法进行比较或结合使用。由于临床证据可靠地表明，AOM 对糖尿病患者的减肥效果通常低于对非糖尿病患者的减肥效果，因此不平衡地排除患者（如接受减肥手术的患者、使用注射形式的塞马鲁肽和利拉鲁肽的糖尿病患者）令人担忧[(2, 3)]。本研究报告称，糖尿病患者接受AOM治疗的持续性较差；然而，排除使用塞马鲁肽和利拉鲁肽的糖尿病患者，而不排除使用其他AOM的患者，可能会虚假夸大塞马鲁肽和利拉鲁肽的持续性和体重减轻效果。此外，许多持续性问题并不反映治疗反应或患者参与情况，而是受到覆盖范围和可用性的影响[(4)]。最后，该研究没有考虑到AOMs药物滴定时间的巨大差异（例如，芬特明-托吡酯为2周，纳曲酮-安非他酮为4周，而塞马鲁肽为16周）[(5-7)]。我们承认，所有研究都存在无法克服的局限性；但是，在考虑这些影响时必须慎重。像加索扬及其同事的研究报告这样的手稿为支付方和提供方提供了决策依据，因此可能会进一步限制患者治疗肥胖症的选择。因此，以客观为基础、以科学为导向的方法对于设计未来的研究至关重要，这样才能准确地告知患者、护理人员和付款人有关肥胖症治疗的选择。这项工作由 Currax Pharmaceuticals, LLC 赞助。Angela Fitch 曾在诺和诺德、Gelesis、Vivus、Jenny Craig、FoundHealth、Ms.Amber Huett-Garcia 声明没有利益冲突。

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引用次数: 0

Overweight/obesity, gestational weight gain, postpartum weight retention, and maternal/neonatal complications in the military 军队中的超重/肥胖、妊娠体重增加、产后体重潴留以及产妇/新生儿并发症

IF 6.9 2区医学 Q1 Nursing

Obesity

Pub Date : 2024-04-23 DOI: 10.1002/oby.24016

Rebecca A. Krukowski, Erin Solomon, Juan Lang, Emily Stone, Wen You, Rosemary Estevez Burns, Carol Copeland, Zoran Bursac, Marion E. Hare, Teresa M. Waters

Objective

The objective of this study was to examine the prevalence of overweight/obesity and excessive gestational weight gain (GWG) among military beneficiaries and to assess associations of these risk factors with maternal/neonatal complications and substantial postpartum weight retention (PPWR).

Methods

We obtained data for 48,391 TRICARE beneficiaries who gave birth in 2018 or 2019 in the United States. We used logistic regression and ANOVA to examine relationships among overweight/obesity, GWG, maternal/neonatal complications, and substantial PPWR.

Results

Most TRICARE beneficiaries (75%) had excessive GWG, and 42% had substantial PPWR. Dependents were less likely than active-duty women to have excessive GWG (odds ratio [OR] = 0.73, 95% CI: 0.60–0.88). Women with excessive GWG were three times more likely to have substantial PPWR (OR = 3.57, 95% CI: 3.14–4.06). Those with excessive GWG were more likely to have maternal/neonatal complications (e.g., pregnancy-induced hypertension, cesarean delivery).

Conclusions

Excessive GWG is frequent among TRICARE beneficiaries, particularly active-duty personnel, and is strongly associated with costly maternal/neonatal complications. Substantial PPWR is also common in this population, with excessive GWG as a key risk factor.

目的本研究旨在检测军人受益者中超重/肥胖和妊娠体重增加过多（GWG）的发生率，并评估这些风险因素与孕产妇/新生儿并发症和产后体重严重滞留（PPWR）之间的关联。方法我们获得了 2018 年或 2019 年在美国分娩的 48,391 名 TRICARE 受益人的数据。我们使用逻辑回归和方差分析来研究超重/肥胖、GWG、产妇/新生儿并发症和大量 PPWR 之间的关系。结果大多数 TRICARE 受益人（75%）的 GWG 超标，42% 的人有严重的 PPWR。与现役女性相比，家属患 GWG 超标的几率较低（几率比 [OR] = 0.73，95% CI：0.60-0.88）。GWG 过高的女性患 PPWR 的几率是普通女性的三倍（OR = 3.57，95% CI：3.14-4.06）。GWG过高的妇女更有可能出现孕产妇/新生儿并发症（如妊娠高血压、剖宫产）。结论 GWG 过高在 TRICARE 受益人（尤其是现役军人）中很常见，并且与代价高昂的孕产妇/新生儿并发症密切相关。在这一人群中，PPWR 也很常见，而 GWG 过高是一个关键的风险因素。

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引用次数: 0

Impaired metabolic flexibility to fasting is associated with increased ad libitum energy intake in healthy adults 空腹代谢灵活性受损与健康成年人随意摄入能量增加有关

IF 6.9 2区医学 Q1 Nursing

Obesity

Pub Date : 2024-04-23 DOI: 10.1002/oby.24011

Yigit Unlu, Paolo Piaggi, Emma J. Stinson, Tomás Cabeza De Baca, Theresa L. Rodzevik, Mary Walter, Jonathan Krakoff, Douglas C. Chang

Objective

We investigated how changes in 24-h respiratory exchange ratio (RER) and substrate oxidation during fasting versus an energy balance condition influence subsequent ad libitum food intake.

Methods

Forty-four healthy, weight-stable volunteers (30 male and 14 female; mean [SD], age 39.3 [11.0] years; BMI 31.7 [8.3] kg/m²) underwent 24-h energy expenditure measurements in a respiratory chamber during energy balance (50% carbohydrate, 30% fat, and 20% protein) and 24-h fasting. Immediately after each chamber stay, participants were allowed 24-h ad libitum food intake from computerized vending machines.

Results

Twenty-four-hour RER decreased by 9.4% (95% CI: −10.4% to −8.5%; p < 0.0001) during fasting compared to energy balance, reflecting a decrease in carbohydrate oxidation (mean [SD], −2.6 [0.8] MJ/day; p < 0.0001) and an increase in lipid oxidation (2.3 [0.9] MJ/day; p < 0.0001). Changes in 24-h RER and carbohydrate oxidation in response to fasting were correlated with the subsequent energy intake such that smaller decreases in fasting 24-h RER and carbohydrate oxidation, but not lipid oxidation, were associated with greater energy intake after fasting (r = 0.31, p = 0.04; r = 0.40, p = 0.007; and r = −0.27, p = 0.07, respectively).

Conclusions

Impaired metabolic flexibility to fasting, reflected by an inability to transition away from carbohydrate oxidation, is linked with increased energy intake.

目的我们研究了空腹与能量平衡条件下 24 小时呼吸交换比（RER）和底物氧化的变化如何影响随后的自由食物摄入量。方法 44 名体重稳定的健康志愿者（男性 30 人，女性 14 人；平均 [SD] 年龄 39.3 [11.0] 岁；体重指数 31.7 [8.3] kg/m2）在能量平衡（50% 碳水化合物、30% 脂肪和 20% 蛋白质）和 24 小时禁食状态下，在呼吸室内进行 24 小时能量消耗测量。每次在呼吸室停留后，参与者可立即从电脑自动售货机中自由摄入 24 小时的食物。结果与能量平衡相比，禁食期间 24 小时 RER 减少了 9.4% (95% CI: -10.4% to -8.5%; p <0.0001)，反映了碳水化合物氧化的减少（平均值 [SD], -2.6 [0.8] MJ/天；p <0.0001）和脂质氧化的增加（2.3 [0.9] MJ/天；p <0.0001）。空腹时 24 h RER 和碳水化合物氧化反应的变化与随后的能量摄入相关，因此空腹 24 h RER 和碳水化合物氧化反应的较小降幅与空腹后能量摄入的增加相关，但与脂质氧化反应无关（分别为 r = 0.31，p = 0.04；r = 0.40，p = 0.007；和 r = -0.27，p = 0.07）。结论禁食后新陈代谢的灵活性受损（反映为无法从碳水化合物氧化过渡）与能量摄入增加有关。

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引用次数: 0

Hedonic hunger, eating behavior, and food reward and preferences 1 year after initial weight loss by diet or bariatric surgery 通过节食或减肥手术初步减轻体重 1 年后的饥饿感、进食行为、食物奖励和偏好。

IF 6.9 2区医学 Q1 Nursing

Obesity

Pub Date : 2024-04-23 DOI: 10.1002/oby.24021

Marthe Isaksen Aukan, Graham Finlayson, Catia Martins

Objective

The objective of this study was to investigate changes in hedonic hunger, eating behavior, and food reward and preferences at 1-year (1Y) follow-up after an initial weight loss (WL) induced by a 10-week, very low-energy diet alone (controls) or in combination with bariatric surgery.

Methods

Patients scheduled for sleeve gastrectomy or Roux-en-Y gastric bypass and controls were recruited. Body weight/composition, hedonic hunger (Power of Food Scale), eating behavior traits (Dutch Eating Behavior Questionnaire and Three-Factor Eating Questionnaire), and food reward and preferences (computerized behavioral task) were measured at baseline, 11 weeks, and 1Y follow-up.

Results

Changes in anthropometric variables were comparable across groups in the initial phase (week 11), and hedonic hunger decreased overall. The bariatric-surgery groups continued to lose body weight and fat mass, whereas weight regain was seen in controls at 1Y follow-up. Decreases in emotional eating, hunger, disinhibition, and food reward and increases in dietary restraint were seen at 1Y follow-up in the bariatric-surgery groups only.

Conclusions

Continued WL with bariatric surgery is paralleled by favorable changes in eating behavior and food reward and preferences. By contrast, controls experienced weight regain at 1Y follow-up and no changes in eating behavior. These striking differences are likely to be important in the long-term WL management of individuals with severe obesity.

目的：本研究旨在调查单独（对照组）或结合减肥手术进行为期 10 周的极低能量饮食诱导初始体重减轻（WL）后，随访 1 年（1Y）时享乐性饥饿感、进食行为以及食物奖赏和偏好的变化。在基线、11 周和随访 1 年时测量体重/体型、享乐性饥饿感（食物力量量表）、进食行为特征（荷兰进食行为问卷和三因素进食问卷）以及食物奖励和偏好（计算机化行为任务）。结果在初始阶段（第 11 周），各组人体测量变量的变化相当，享乐性饥饿感总体下降。减肥手术组的体重和脂肪量持续下降，而对照组在随访 1 年后体重有所恢复。结论减肥手术组在持续减重的同时，饮食行为、食物奖励和偏好也发生了有利的变化。相比之下，对照组在随访 1 年后体重反弹，但进食行为没有变化。这些显著差异可能对重度肥胖症患者的长期减肥管理非常重要。

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引用次数: 0

Physiology of the weight-loss plateau in response to diet restriction, GLP-1 receptor agonism, and bariatric surgery 限制饮食、GLP-1 受体激动剂和减肥手术导致的减肥高原生理现象

IF 6.9 2区医学 Q1 Nursing

Obesity

Pub Date : 2024-04-22 DOI: 10.1002/oby.24027

Kevin D. Hall

Objective

The objective of this study was to investigate why different weight-loss interventions result in varying durations of weight loss prior to approaching plateaus.

Methods

A validated mathematical model of energy metabolism and body composition dynamics was used to simulate mean weight- and fat-loss trajectories in response to diet restriction, semaglutide 2.4 mg, tirzepatide 10 mg, and Roux-en-Y gastric bypass (RYGB) surgery interventions. Each intervention was simulated by adjusting two model parameters affecting energy intake to fit the mean weight-loss data. One parameter represented the persistent shift of the system from baseline equilibrium, and the other parameter represented the strength of the feedback control circuit relating weight loss to increased appetite.

Results

RYGB surgery resulted in a persistent intervention magnitude more than threefold greater than diet restriction and about double that of tirzepatide and semaglutide. All interventions except diet restriction substantially weakened the appetite feedback control circuit, resulting in an extended period of weight loss prior to the plateau.

Conclusions

These preliminary mathematical modeling results suggest that both glucagon-like peptide 1 (GLP-1) receptor agonism and RYGB surgery interventions act to weaken the appetite feedback control circuit that regulates body weight and induce greater persistent effects to shift the body weight equilibrium compared with diet restriction.

方法采用经过验证的能量代谢和身体成分动态数学模型，模拟限制饮食、塞马鲁肽 2.4 毫克、替唑帕肽 10 毫克和鲁-恩-Y 胃旁路手术（RYGB）干预的平均体重和脂肪下降轨迹。通过调整影响能量摄入的两个模型参数来模拟每种干预措施，以符合平均体重减轻数据。结果RYGB手术导致的持续干预幅度是限制饮食的三倍多，是替齐帕肽和塞马鲁肽的两倍左右。结论这些初步的数学建模结果表明，胰高血糖素样肽 1（GLP-1）受体激动剂和 RYGB 手术干预措施都会削弱调节体重的食欲反馈控制回路，与限制饮食相比，它们会产生更大的持续影响，从而改变体重平衡。

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引用次数: 0

Early outcomes of referrals to the English National Health Service Digital Weight Management Programme 英国国民健康服务数字体重管理计划转诊的早期结果

IF 6.9 2区医学 Q1 Nursing

Obesity

Pub Date : 2024-04-21 DOI: 10.1002/oby.24024

Katharine Taylor, Tejal Indulkar, Bethany Thompson, Christine Pinkard, Emma Barron, Tom Frost, Priyantha Jayawardane, Neil Davies, Chirag Bakhai, Nita Gandhi Forouhi, Paul Aveyard, Susan Jebb, Jonathan Valabhji

Objective

The study objective was to assess participant weight change for the English National Health Service (NHS) Digital Weight Management Programme, the first such digital intervention to achieve population coverage.

Methods

A service evaluation was used to assess intervention effectiveness for adults with obesity and a diagnosis of hypertension and/or diabetes, between April 2021 and March 2022, using prospectively collected, national service–level data in England.

Results

Of the 63,937 referrals made from general practices, within the time period, 31,861 (50%) chose to take up the 12-week Programme. There were 31,718 participants who had time to finish the Programme; of those, 14,268 completed the Programme (defined as attending ≥60%), a 45% completion rate. The mean weight change for those who had time to finish the Programme was −2.2 kg (95% CI: −2.25 to −2.16), for those who completed it was −3.9 kg (95% CI: −3.99 to −3.84), and for those who had time to finish the Programme but did not complete it was −0.74 kg (95% CI: −0.79 to −0.70).

Conclusions

The NHS Digital Weight Management Programme is effective at achieving clinically meaningful weight loss. The outcomes compare favorably to web-based weight management interventions tested in randomized trials and those delivered as face-to-face interventions, and results suggest that the approach may, with increased participation, bring population-level benefits.

研究目的是评估英国国民健康服务系统（NHS）数字体重管理计划参与者的体重变化情况，该计划是首个实现人口覆盖的此类数字干预措施。研究方法在2021年4月至2022年3月期间，利用前瞻性收集的英格兰国家服务水平数据，对肥胖并诊断出高血压和/或糖尿病的成年人进行服务评估，以评估干预效果。有时间完成计划的参与者有 31718 人；其中 14268 人完成了计划（定义为参加率≥60%），完成率为 45%。有时间完成计划者的平均体重变化为-2.2千克（95% CI：-2.25至-2.16），完成计划者的平均体重变化为-3.9千克（95% CI：-3.99至-3.84），有时间完成计划但未完成者的平均体重变化为-0.74千克（95% CI：-0.79至-0.70）。其结果与随机试验中测试的基于网络的体重管理干预措施以及面对面的干预措施相比毫不逊色。

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