Average Weight Loss Research Articles

Long-Term Efficacy of primary care combining a mobile healthcare application with human coaching

Abstract Background Chronic diseases have become a global burden, and digital self-healthcare using mobile devices has gained importance in managing these conditions. However, barriers to implementing mobile self-management healthcare applications in current primary care system, and previous research has focused on short-term effects. This study aims to evaluate the long-lasting effect of combining human coaching with mobile self-management healthcare applications for chronic disease patients in primary healthcare services. Methods The study recruited 178 patients with chronic diseases from participating primary care clinics. The intervention group (N = 128) received a 12-week mobile self-management healthcare application service combined with traditional primary care, while the control group (N = 50) received only traditional healthcare. The Noom application was used, with two weekly human coaching sessions by a nutritionist. A telephone survey on weight changes was conducted one year after the intervention. Results The intervention group showed a greater weight loss compared to the control group during the intervention period (Intervention: -1.29 ± 2.94 vs Control: -0.38 ± 1.72, P-value 0.002). Although there was no statistically significant difference in additional weight change between the two groups during the follow-up period, the difference in weight loss during the intervention period was maintained (Intervention: -2.16 ± 5.54 vs Control: -1.06 ± 3.24, P-value: 0.008). Additionally, among the intervention group continuously for 1 year using the health management application, the average weight loss was higher than the other groups. Conclusions Combining a mobile self-management healthcare application with human coaching has long-lasting effects and can be effective in primary healthcare services. This suggests that such an approach has the potential to be a treatment option in current primary healthcare systems, but further large-scale long-term studies are needed. Key messages • This study suggests that using mobile self-management healthcare apps with human coaching can be an effective long-term treatment option for chronic disease patients in primary healthcare services. • The combination of the two methods may provide better outcomes than traditional healthcare services alone.

Characterization and product analysis of Chlorella vulgaris microalgae and oil seed biomass waste by microwave co-pyrolysis

Microwave co-pyrolysis of Chlorella vulgaris (CV) and tea oil seed residue (TR) with different mixing ratios was carried out on a microwave oven. The co-pyrolysis characteristics, product distribution and bio-oil components of CV and TR were analyzed by thermogravimetric analysis and gas chromatography mass spectrometry (GC-MS). The results showed the highest average weight loss of 0.01721 wt%/s and the total weight loss of 74.27 wt% obtained at the mixing ratio of CV/TR = 1:1 (C1T1). Also, the C1T1 group obtained the highest yield of bio-oil (21.13 wt%), and it showed the most potent synergistic effect among the co-pyrolysis groups. Compared with the pure TR (PTR) group, the hydrocarbons in bio-oil of the C1T1 group increased by 6.53 %, and acids decreased by 12.61 %. Besides, compared with the pure CV (PCV) group, N-containing compounds and N,O-containing compounds in the C1T1 group were reduced by 9.29 % and 18.15 %, respectively. On the other hand, compared to CV/rice straw (RS) = 1:1 (C1R1) group, C1T1 group had a higher content of hydrocarbons and a lower content of N-containing compounds and N,O-containing compounds. Thus, co-pyrolysis of CV and TR was beneficial in promoting the production of hydrocarbons and reducing nitrogenous and oxygenated compounds.

Increasing Exclusive Nursery Care of Late Preterm and Low Birth Weight Infants.

Late preterm (LPT) and low birth weight (LBW) infants are populations at increased risk for NICU admission, partly due to feeding-related conditions. This study was aimed to increase the percentage of LPT and LBW infants receiving exclusive nursery care using quality improvement methodologies. A multidisciplinary team implemented interventions at a single academic center. Included infants were 35 to 36 weeks gestational age and term infants with birth weights <2500 g admitted from the delivery room to the nursery. Drivers of change included feeding protocol, knowledge, and care standardization. We used statistical process control charts to track data over time. The primary outcome was the percentage of infants receiving exclusive nursery care. Secondary outcomes included rates of hypoglycemia, phototherapy, and average weight loss. Balancing measures were exclusive breast milk feeding rates and length of stay. Included infants totaled 1336. The percentage of LPT and LBW infants receiving exclusive nursery care increased from 83.9% to 88.8% with special cause variation starting 1 month into the postintervention period. Reduction in neonatal hypoglycemia, 51.7% to 45.1%, coincided. Among infants receiving exclusive nursery care, phototherapy, weight loss, exclusive breast milk feeding, and length of stay had no special cause variation. Interventions involving a nursery feeding protocol, knowledge, and standardization of care for LPT and LBW infants were associated with increased exclusive nursery care (4.9%) and reduced rates of neonatal hypoglycemia (6.6%) without adverse effects. This quality initiative allowed for the preservation of the mother-infant dyad using high-value care.

A Novel Prescription Digital Therapeutic Option for the Treatment of Metabolic Dysfunction-Associated Steatotic Liver Disease

Metabolic dysfunction-associated steatotic liver disease and metabolic dysfunction-associated steatohepatitis are pressing public health problems occurring alongside the rising prevalence of obesity and diabetes. This feasibility study explored the use of a novel prescription digital therapeutic (PDT) in this patient population. A prospective, open-label study was conducted at two hepatology clinics. Eligible patients had a baseline FibroScan controlled attenuation parameter >274 dB/m. Participants were given access to a PDT containing a novel form of cognitive behavioral therapy designed to treat cardiometabolic disease. Laboratory assessments, FibroScan, and magnetic resonance imaging proton density fat fraction (MRI-PDFF) imaging were conducted preintervention and postintervention. Twenty-two participants were enrolled. Mean baseline fat fraction on MRI-PDFF was 18.7%. After the 90-day intervention, the mean relative reduction in MRI-PDFF was-16.2% (P= .011) in those with baseline PDFF ≥10%. Mean alanine transaminase decreased by-17.1 IU/L (P= .002). Participants achieved an average total body weight loss of-2.9% (P= .008) and controlled attenuation parameter score was reduced by-18.8 dB/m (P= .021). No serious or device-related adverse events were reported. An average improvement in health-related quality of life of+2.2 Healthy Days per month (P= .500) and high treatment satisfaction (mean Net Promoter Score of+75) were reported. After 90 days of digitally delivered cognitive behavioral therapy, improvements were observed in multiple endpoints without any adverse device effects. The safety, efficacy, and usability data observed strengthen the hypothesis that PDTs provide a scalable tool to address unmet behavioral treatment needs in metabolic dysfunction-associated steatotic liver disease and metabolic dysfunction-associated steatohepatitis (ClinicalTrials.gov number, NCT05357248).

Evaluation of weight loss counsel for Osteoarthritis patients: A cross-sectional analysis of NHANES 2011–2018

Though health care providers (HCPs) know the importance of weight loss counsel for Osteoarthritis (OA), little is known about how frequently it is practiced and even less of its effectiveness. Thus, we analyzed the prevalence and effectiveness of weight counsel receipt in overweight/obese OA patients. Using 2011-2018 National Health and Nutrition Examination Survey data, we cross-sectionally analyzed overweight/obese patients in the United States to determine the prevalence of receipt of HCP weight counsel in those with OA and among other variables. We used multivariate logistic regression models to calculate odds ratios of being counseled and of achieving ten percent weight loss in groups with and without counsel. Mean weight losses were also compared among groups. 39,156 patients were identified, of whom 1948 met inclusion criteria. Overall, 51.89% of overweight/obese OA patients received weight counseling. The odds of receiving counsel varied with several demographic variables. The odds of achieving 10% weight loss in those counseled was 1.84 times (95% confidence interval: 1.028, 3.299) that of those not counseled (p=0.04). In contrast, patients counseled lost a mean of 0.49 pounds while those not counseled gained a mean of 0.03 pounds, a difference which was not statistically significant (p=0.59). Prevalence of weight counsel receipt for OA has not changed significantly between 2011 and 2018. Though counsel for weight more frequently leads to adequate weight loss in those with OA, the average weight loss is minimal regardless of counsel. Thus, refinement of this intervention may be needed to bolster weight loss.

An investigation on the tribological behaviour of AlCrCuNiFe high entropy alloy optimized TIG weld cladding in room temperature conditions

In the current study, the tribological behaviour of the AlCrCuNiFe high entropy alloy TIG weld cladding deposited on 1045 steel substrate has been investigated. Taguchi’s L9-GRA (grey relational analysis) approach was used to design experiments and optimize the welding parameters. The microstructural investigation revealed that the samples as-deposited at run no. 7 and optimized settings exhibited uniform and dense claddings. The microhardness and abrasive wear tests were conducted at room temperature. The optimized cladding exhibited average weight loss and microhardness of 27.12 mg and 738.25 HV0.3, whereas the substrate showed average weight loss and microhardness of 147.26 mg and 320 HV0.3, respectively. The worn surfaces of claddings showed wear debris, deeper grooves, micro-cutting, and micro ploughing resulting from the abrasion.

Personality Profiles Associated with Long-Term Success in Bariatric Surgery: 24-Month Follow-Up.

(1) Background: Bariatric surgery (BS) is highly effective for treating severe obesity in the long term. However, studies investigating predictors and personality profiles linked to BS success yield inconsistent results due to varying methodologies and limited research. This paper aims to identify personality profiles associated with BS success. (2) Method: The study involved 67 patients undergoing bariatric surgery, evaluated through clinical and personality measures. Weight loss was monitored at 6, 12, and 24 months post-surgery. Hierarchical case cluster analysis and iterative k-means cluster analysis identified distinct groups based on excess body mass index loss (%EBL) at these intervals. ANOVA was employed to compare personality profiles between groups. (3) Results: Average weight loss after 24 months was 67.2%. Two success profiles emerged: 46.5% showed very good success, achieving 90% EBL in 24 months, while 55% in the second cluster had less than 40% EBL throughout follow-up. The successful profile correlated with greater self-efficacy and improved emotional adjustment. (4) Conclusions: Successful BS outcomes were linked to personality traits promoting sustained weight loss post-surgery.

Assessment of the chipping process of beech (Fagus sylvatica L.) wood: knives wear, chemical and microscopic analysis of wood

ABSTRACT The objective of this work was to investigate the rate of knife wear during the beech wood chipping process and to evaluate the changes in the chemical and microscopic structure of wood. A knife coated with AlCrN was selected for the study. This coating creates an abrasion resistant layer on the knife and has a higher resistance to abrasive wear and, therefore, a longer life. After chipping, the degree of knife wear was assessed using a gravimetric method and 3D scanning analysis. Microstructural and surface characterisation revealed that cracking and abrasive wear were the main causes of tool blunting. The maximum removal of material on the cutting edge was 240 µm, the average weight loss of 0.58 g. In relation to wear, wood fragments remained on the cutting knife. Infrared spectroscopy of wood fragments showed changes in the chemical composition due to the high temperatures in the blade of the knife, and elemental analysis, the higher content of Al, Cr, and N elements in the wood fragments, probably due to the presence of particles from the coating of the knives. Microscopic analysis of the chips revealed the presence of metal particles from the knives on the structural wood elements.

Long-term outcomes following laparoscopic Roux-en-Y gastric bypass: weight loss and resolution of comorbidities at 15years and beyond.

Laparoscopic Roux-en-Y gastric bypass (LRYGB) is the gold-standard bariatric procedure with proven efficacy in morbidly obese populations. While the short-term benefits of LRYGB have been well-documented, durable weight loss and long-term resolution of obesity-related comorbidities have been less clearly described. This single-center study prospectively reports weight loss and comorbidity resolution in patients undergoing LRYGB between August 2001 and September 2007 with at least 15-year follow-up. Data were collected at the time of surgery; 1, 3, 6, and 12months postoperatively; and then annually thereafter. A total of 486 patients were included in this analysis. Patients were predominantly female (88.7%), and the median age was 36.0 [IQR 29.0-45.0] years. Patients were ethnically diverse, including Black/African American (43.6%), White/Caucasian (35.0%), Hispanic (18.3%), and other backgrounds (3.1%). Mean preoperative weight and body mass index were 133.0 ± 21.9kg and 48.4 ± 6.5kg/m2, and the median number of comorbidities was 6.0 [IQR 4.0-7.0]. Follow-up rates at 1, 5, 10, and 15years were 75.3%, 37.2%, 35.2%, and 18.9%, respectively. On average, maximum percentage total weight loss (%TWL) occurred 2years postoperatively (-36.2 ± 9.5%), and ≥ 25% TWL was consistently achieved at 1, 5, 10, and 15-year time intervals (-28.0 ± 13.0% at 15years). Patients with comorbidities experienced improvement or resolution of their conditions within 1year, including type 2 diabetes mellitus (83/84, 98.8%), obstructive sleep apnea (112/116, 96.6%), hypertension (142/150, 94.7%), and gastroesophageal reflux disease (217/223, 97.3%). Rates of improved/resolved comorbidities remained consistently high through at least 10years after surgery. LRYGB provides durable weight loss for at least 15years after surgery, with stable average relative weight loss of approximately 25% from baseline. This outcome corresponds with sustainable resolution of obesity-related comorbidities for at least 10years after the initial operation.

Transoral gastric outlet reduction for post-prandial hypoglycemia after Roux-en-Y gastric bypass.

Post-prandial hypoglycemia is an uncommon but disabling late complication of Roux-en-Y gastric bypass (RYGB). Most patients can be treated with dietary interventions and medications; however, some patients develop refractory hypoglycemia that may lead to multiple daily episodes and seizures. While RYGB reversal surgery is an effective treatment, complication rates are high, and patients inevitably experience weight regain. Transoral gastric outlet reduction (TORe) is a minimally invasive treatment that is effective for early and late dumping syndrome. However, prior studies have not distinguished the effectiveness of TORe specifically for patients with post-prandial hypoglycemia. This study aims to describe a single institution's experience of TORe for treating post-prandial hypoglycemia. This is a case series of patients with prior RYGB complicated by post-prandial hypoglycemia who underwent TORe from February 2020 to September 2021. Pre-procedural characteristics and post-procedural outcomes were obtained. Outcomes assessed included post-prandial hypoglycemia episodes, dumping syndrome symptoms, and weight change. A total of 11 patients underwent TORe from 2020 to 2021 for post-prandial hypoglycemia. Three (27%) patients had a history of seizures due to hypoglycemia. All had been advised on dietary changes, and ten patients (91%) were on medications for dumping. All patients reported a reduction in post-prandial hypoglycemic events as well as the majority of dumping syndrome symptoms during an average follow-up time of 409 ± 125days. Ten patients (91%) had experienced weight regain from their post-RYGB nadir weight. For these patients, the average total body weight loss 12months post-TORe was 12.4 ± 12%. There were no complications requiring hospitalization. One patient experienced post-TORe nausea and vomiting requiring dilation of the gastrojejunal anastomosis with resolution in symptoms. TORe is a safe and effective treatment for post-prandial hypoglycemia and weight regain after RYGB in patients with symptoms refractory to medications and dietary changes.

Effect of cocoa pulp as a coating for fresh eggs in terms of physical and chemical qualities during storage period

Eggs as a source of animal protein have a high nutritional content and since they are categorized as a fresh food, eggs are easily got damaged. Preservation technology is needed to maintain the quality of fresh eggs during storage in order to ensure safe consumption. This study aimed at determining the effect of cocoa pulp as a coating for fresh eggs in terms of physical and chemical qualities during storage. The study used a completely randomized design experiment with 5 treatments and 4 replications. The treatments were without cocoa pulp coating (P0), cocoa pulp coating with a concentration of 97.5% (P1); 95% (P2); 92.5% (P3); and 90% (P4). The variables observed were weight loss, specific gravity, pH, water, ash and fat content. The data obtained were analyzed using analysis of variance continued with the Honest Significant Difference Test. The results showed that different concentrations of cocoa pulp did not give a significant difference (P>0.05) on specific gravity, ash and fat content; gave a significant difference (P<0.05) on pH and gave a very significant difference (P<0.01) on weight loss and moisture content. The average weight loss (g) in treatments P0, P1, P2, P3, and P4 were 9.187; 1.828; 0.346; 0.4255 and 0.234 respectively. Egg content specific gravity 1.024; 1.038; 1.049; 1.045 and 1.061. pH 8.282; 7.547; 7.692; 7.742 and 7.457. Moisture content (%) 70.791; 72.341; 74.309; 76.020 and 76.245. Ash content (%) 0.841; 0.754; 0.836; 0.844 and 0.833. Fat content (%) 9.551; 8.196; 8.658; 8.540 and 7.988.

Microwave catalytic co-pyrolysis of sugarcane bagasse and Chlorella vulgaris over metal modified bio-chars: Characteristics and bio-oil analysis

Bio-char (BC) is a cheap, environmentally friendly and easy-to-produce material, which is widely used as pyrolysis catalyst. In this study, the modified catalysts (Fe/BC, Co/BC and Mg/BC) were prepared using BC produced by the co-pyrolysis of sugarcane bagasse and Chlorella vulgaris. The characterization of the modified catalysts showed that they had a higher surface area (SBET) and pore volume compared with BC. Besides, the influence of modified catalysts on co-pyrolysis was analyzed at different additions. Except for 10% Mg/BC, the catalysts effectively increased the average weight loss rate (Rv) and decreased the reaction time (ts) of co-pyrolysis at all additions, and 40% Fe/BC addition had the highest Rv and lowest ts. The catalyst addition increased the bio-oil yield of the co-pyrolysis, and the maximum bio-oil yield (25.94%) was obtained under 40% Mg/BC addition. Moreover, the catalysts not only facilitated the formation of hydrocarbons, but also suppressed the generation of amines/nitriles and acids/esters. After adding 40% Fe/BC, the hydrocarbons content reached the highest (26.01%), while the amines/nitriles content (3.23%) and acids/esters content (4.66%) reached the lowest. The results provided theoretical support for improving microwave pyrolysis characteristics and bio-oil quality using modified BC catalysts.

Effects of Road Transportation on Some Physiological Stress Measures in Anpera and Boerka Goats

Transporting livestock is a common practice in agriculture, but it can be a stressful situation for the animals. This stress can lead to physiological responses like live weight loss, changes in blood cortisol levels, and immune suppression. Goats are particularly sensitive to transportation stress and stress-induced diseases. In this study, we investigated the effects of road transport on the physiological condition of 33 goats (13 Anpera goats and 20 Boerka goats) transported for 72 hours over approximately ±2.000 km. Live weight loss was determined by comparing the body weights of the goats before and after transportation. We measured psychological responses (heart rate, respiratory rate, rectal temperature), blood parameters (Blood urea nitrogen/BUN, creatinine, glucose), cortisol, and hematological parameters. The results showed that transportation caused an average weight loss of 4.05 kg/head (14.22%). Heart rate decreased by 14.71 x/minute after transport, while respiratory rate and rectal temperature increased by 8.44 x/minute and 0.41 units, respectively. BUN levels increased by approximately 10.92 mg/dL (35%) and glucose levels increased by approximately 30.07 mg/dL (48%). Hematological parameters also showed significant changes, with transportation causing alterations in WBC, RBC, hemoglobin, hematocrit, MCV, and MCH levels. The study also showed an interaction between the sex and breed of goats on BUN, glucose, MCV, MCH. The comparison between Anpera goats and Boerka showed that transportation had significant influence on heart rate, rectal temperature, cortisol, RBC, haemoglobin, RDW. In conclusion, transportation for 72 hours caused stress on goats, leading to weight loss, changes in psychological behavior, and blood parameters, and the breed and sex of the goats played a crucial role in the observed changes.

Evaluation of Single Anastomosis Gastric Bypass

Abstract Objective The study was performed to evaluate the technique of laproscopic single anastomosis gastric bypass for treatment of morbidly obese patient. Study design The patients were enrolled in a Prospective observational study, from May 2013 till May 2015, including 100 patients set for laparoscopic Single anastomosis gastric bypass. Surgical procedures and follow up were performed at Ain Shams University hospitals. Patient and methods The study includes one hundred patients; 33 males and 67 females with a mean age of 33±10 years (range, 20–59), who fulfilled the criteria for bariatric surgery with BMI &amp;gt;35 with associated co-morbidities, all patients underwent laparoscopic single anastomosis gastric bypass. Results The average operative time was 90 minutes, and the median length of hospital stay was 2 day. No mortality reported within 30 days postoperatively. early postoperative complication within 30 day, no cases of leak reported, endo luminal hemorrhage (2%)treated conservatively. long-term complications were bile reflux(1%), with failed medical treatment which Laparoscopically converted to RYGBP. iron deficiency anemia (1%.). Average weight loss at 1 year was 46 kg (70.08% of excess body weight). (88.8%) of the obesity-associated co morbidities are resolved within 1 year. Conclusion Laparoscopic single anastomosis gastric bypass offers major benefits with great satisfactory results over most alternative procedures, is a successful procedure for weight loss and maintaining the weight reduction in morbid obesity, it has highly safe with good technical feasibility, short hospital stay, a low rate of major postoperative complications and growing learning curve

In Vivo Visualization and Quantification of Rat Laryngeal Blood Supply After Hydration Challenge.

Systemic dehydration decreases total body blood volume; however, hemodynamic alterations at the level of local organs, such as the larynx, remain unclear. Here we sought to quantify superior thyroid artery (STA) blood flow after dehydration and rehydration using in vivo magnetic resonance angiography (MRA) and ultrasound imaging in a rat model. Male Sprague-Dawley rats (N = 17) were included in this prospective, repeated measures design. Rats first underwent MRA to determine baseline STA cross-sectional area, followed by high-frequency in vivo ultrasound imaging to measure STA blood velocity at baseline. Next, rats were systemically dehydrated (water withholding), followed by rehydration (water ad-lib). Ultrasound imaging was repeated immediately after dehydration and following rehydration. The STA blood velocity and STA cross-sectional area were used to compute STA blood flow. Three rats served as temporal controls for ultrasound imaging. To determine if the challenges to hydration status affected the STA cross-sectional area, four rats underwent only MRA at baseline, dehydration, and rehydration. Systemic dehydration resulted in 10.5% average body weight loss. Rehydration resulted in average body weight gain of 10.9%. Statistically significant reductions were observed in STA mean blood flow rate after dehydration. Rehydration reversed these changes to pre-dehydration levels. No significant differences were observed in STA cross-sectional area with dehydration or rehydration. Systemic dehydration decreased blood flow in the superior thyroid artery. Rehydration restored blood flow in the STA. Change in hydration status did not alter the STA cross-sectional area. These preliminary findings demonstrate the feasibility of using ultrasound and MRA to quantify hemodynamic changes and visualize laryngeal blood vessels. NA Laryngoscope, 134:779-785, 2024.

Modeling of the Fresh Fruit Bunches Collection and Transportation System with Agent-Based Simulation in Optimizing the Mode of Transportation on Oil Palm Industry

Uncertainty number of harvests per day causes the allocation of transportation modes are less optimal in collecting fruit from plantations to palm oil mills causing a shortage of trucks in some afdeling and some are unemployed in some afdeling causing large transportation costs. The use of Agent-Based Simulations can help to identify the factors that cause the number of trucks that are not optimal by looking at the behavior and interaction between the agent actors involved in the tbs collection and transportation process. The results showed the utilization rate of transportation modes increased from 27% to 40% by reducing the number of truck units rented from 177 trucks to 118 trucks and reducing transportation collection costs by 0.225% of the total cost value. With the reduced journey time, the quality of the oil palm is better with the reduction of free fatty acids (FFA) and the average weight loss of fruit.

Glucagon-Like Peptide 1 Analogues as Adjunctive Therapy for Patients With Type 1 Diabetes: An Updated Systematic Review and Meta-analysis.

Concomitant obesity is common among patients with type 1 diabetes mellitus (T1DM), yet adjunctive therapy options are scarce. We assess the efficacy and adverse outcomes of glucagon-like peptide 1 (GLP-1) analogues when used as adjunctive therapy for T1DM. PubMed, EMBASE, Cochrane Central, and Scopus databases were searched for randomized controlled trials up to December 2022. Efficacy outcomes were A1c level, body weight, and total daily insulin (TDI) after ≥12 weeks of GLP-1 therapy. We also assessed 12 different adverse outcomes. Subgroup analysis was done for newly diagnosed or C-peptide positive (C-pos) patients. We report the certainty of evidence based on the GRADE assessment tool. A total of 24 studies using 4 different GLP-1 analogues with a total of 3377 patients were included. Liraglutide had the most substantial evidence with effect sizes on A1c (-0.09%/mg), weight (-2.2 kg/mg), and TDI (-4.32 IU/mg). Liraglutide dose was the greatest predictor of greater average weight loss and TDI decrease but was associated with higher odds of nausea (OR 6.5; 95% CI, 5.0-8.4) and ketosis (OR 1.8; 95% CI, 1.1-2.8). Odds of severe (OR 0.67; 95% CI, 0.43-1.04) or symptomatic hypoglycemia (OR 0.89; 95% CI, 0.53-1.51) were not significantly elevated. Among C-pos patients, greater A1c decrease (-0.51% vs -0.28%) but similar weight loss and TDI were seen. Effect sizes for exenatide were similar, but studies had higher risk of bias and safety data were sparse. Our meta-analysis supports therapeutic benefits of liraglutide for patients with T1DM mainly for weight loss and insulin dose reduction. Newly diagnosed or C-pos patients do not appear to experience greater weight loss benefits.

Weight loss and side-effects of liraglutide and lixisenatide in obesity and type 2 diabetes mellitus

AimsGlucagon-like peptide-1 receptor agonist (GLP-1 RA) is used to treat obesity or type 2 diabetes mellitus (DM). We compared weight loss and side-effects between patients with and without DM using GLP-1 RA. MethodsThis was a retrospective cohort study based on electronic medical records. Patients were categorized into three groups: liraglutide without DM (LiRa_NL), liraglutide with DM (LiRa_DM), and lixisenatide with DM (LiXi_DM). Six-month outcomes were evaluated for weight loss, side-effect types, and onset discontinuation of GLP-1 RA. ResultsWe enrolled 356 (190 LiRa_NL, 95 LiRa_DM, and 71 LiXi_DM) patients (women, 72.5 %; mean age, 43.7 ± 12.7 years; mean body mass index, 30.7 ± 5.2 kg/m2). The mean glycated hemoglobin (HbA1c) participants were 7.7 ± 2.1 %. Average weight loss was 2.9 ± 0.3 kg. The change in HbA1c was lower in the LiXi_DM group than in the LiRa_DM group (− 1.1 ± 0.2 % vs. − 0.4 ± 0.1 %, P < 0.05). The LiRa_DM group showed a more effective weight loss (− 3.0 ± 0.4 kg) than the LiXi_DM group (− 0.9 ± 0.4 kg) (P < 0.05). Approximately 30 % of the patients reported experiencing side-effects, with gastrointestinal side-effects being the most frequent (20.5 %). The median side-effect onset was 1.9 ± 0.1 months from first treatment. The rate of GLP-1 RA discontinuation was 72.8 %. Discontinuation rates due to side-effects were 75.7 %, 68.9 %, and 64.4 % in the LiRa_NL, LiRa_DM, and LiXi_DM groups, respectively. ConclusionsThe LiRa_NL group showed the most weight loss, although the discontinuation rate was high. Most side-effects occurred at 1–2 months. When prescribing GLP-1 RA, education concerning side-effects and discontinuation is needed to enhance treatment adherence.

Concept of an Intervention for Sustainable Weight Loss in Postmenopausal Women with Overweight-Secondary Analysis of a Randomized Dietary Intervention Study.

The approach of an individual diet has great potential for sustainable weight reduction. Social support, participation and empowerment are also key factors for high motivation and compliance. So, the impact of an individual diet in combination with group sessions on weight loss in postmenopausal women with overweight was investigated. In this reanalysis of a controlled intervention study, postmenopausal women (n = 54; BMI 30.9 ± 3.4 kg/m2; 59 ± 7 years) were recruited receiving an energy restricted diet for 12 weeks, followed by a six-month follow-up phase. The women received 51 individual meal plans based on their habits and were trained in four group sessions. Forty-six women completed the intervention phase, and 29 completed the follow-up. Average weight loss was -5.8 ± 3.0 kg (p < 0.001) after 12 weeks and was still significant at follow-up (-4.9 ± 5.4 kg, p < 0.001). Also, decreases in fat-free mass (-1.1 ± 1.2 kg, p < 0.001) and resting energy expenditure (-1096 ± 439 kJ/24 h, p < 0.001) were observed. The individual nutrition approach with a focus on nutritype in combination with group sessions was effective for long-lasting weight loss in postmenopausal women. An important factor is close individual and group support.

Telehealth vs In-Person Shared Medical Appointments for an Intensive Therapeutic Lifestyle Change Program for Patients With Type 2 Diabetes and Prediabetes

In response to Covid-19, the Lifestyle Medicine Clinic at Midland Health elected to utilize telehealth to engage remotely with patients to deliver a 12-week intensive therapeutic lifestyle change (ITLC) program for patients with type 2 diabetes and prediabetes. This program utilized a shared medical appointment (SMA) group visit model. Beginning in May/2020, the program was offered again in-person; however, the telehealth option remained. This study is a retrospective chart review, aimed at comparing pre- and post-program changes in body weight, HbA1c, fasting lipid profile, systolic pressure, and diastolic blood pressure between in-person vs telehealth SMA formats. This study found no statistical difference in ITLC program health outcomes between telehealth vs in-person shared medical groups. At the end of ITLC Programs between both groups, an average weight loss of 9.66 pounds and 1% reduction was noted in ptHbA1C. Total cholesterol reduced by 7.1 mg/dL, and LDL by 15.19 mg/dL. The blood pressure readings showed a reduction in systolic blood pressure of 13.4 mmHg and diastolic blood pressure of 4.14 mmHg. Our results indicated that this novel telehealth delivery model could be equally successful in delivering an intensive therapeutic lifestyle program (ITLC) using an SMA approach to prevent, treat and often put chronic diseases in remission.