Obesity Class Research Articles

Obesity and the Need for Bariatric Surgery in Nigeria: A Review.

Obesity was mainly regarded as a disease of developed countries, but currently there is a growing rise in the population of patients with obesity in developing countries of Africa. A body mass index of 30 kg/m2 or higher is regarded as obesity, and this may be associated with comorbidities such as metabolic and cardiovascular diseases, orthopaedic and psychiatric conditions, and cancer. There is conclusive scientific evidence that shows that obesity is caused by complex psychosocial, genetic and environmental factors. Diet and exercise are not effective as sole management of severe obesity. Bariatric surgery is the most cost-effective definitive treatment for all classes of obesity, and the associated weight reduction causes improvement or complete resolution of obesity-associated comorbidity, improves the quality of life and reduces all-cause mortality. It is estimated that about 15% of adults in Nigeria are obese, and in the year 2023, it was reported that only 214 bariatric procedures were done locally, with 134 (62.6%) being gastric balloon insertions, 75 (35.1%) primary weight loss surgeries and 5 revisional surgeries (2.3%). In this article, we discussed the existing weight loss options in Nigeria, the current state of bariatric surgery and the need to improve the practice of bariatric surgery for obese Nigerians and complications of obesity.

Prevalence of metabolic syndrome and its association with CT-based central adiposity measures: a cross-sectional study at a tertiary care hospital in Pakistan

ObjectivesTo assess the prevalence of metabolic syndrome (MS) and association of central obesity measures such as body mass index (BMI), visceral fat adiposity (VFA) and superficial fat adiposity (SFA) with...

Association of Body Mass Index with Pain Perception, Anxiety, Depression, and Disability in Fibromyalgia Patients

Background: A disorder of uncertain origin, Fibromyalgia (FM) is accompanied by pervasive pain, tiredness, disturbed sleep, and cognitive deficit. It has been related to depression, manic-depressive illness, and chronic fatigue. FM is negatively affected by obesity on both clinical and biological parameters. Methods: A total of n=150 FM patients (132 Female and 18 Male) were included in the study. Initially, informed consent and demographic data were gathered from the participants. Afterwards, each patient's Body Mass Index (BMI) was calculated and classified into average weight, overweight, and obese categories. The Numeric Pain Rating Scale (NPRS) was used to quantify the intensity of pain, the Hamilton Anxiety Scale (HAM-A) was used to determine the participants’ anxiety levels, the Hamilton Rating Scale for Depression (HAM-D) was used to examine their depression levels, and Health Assessment Questionnaire Disability Index (HAQ-DI) was used to measure their functional status. All these questionnaires were self-administered by the participants. Results: In the NPRS, HAM-A, HAM-D, and HAQ-DI categories, no significant differences were found (p>0.05). However, between the BMI level and anxiety, a weak positive correlation was detected (r=0.195, p=0.017). BMI levels were not statistically significantly correlated with pain, depression, or disability (r=0.011, p=0.0897; r=0.048, p=0.562; r=0.072, p=0.383). Conclusion: The results of the study revealed that there is no significant association of pain perception, anxiety, depression and disability with increasing BMI among FM patients except for a weak positive correlation with anxiety. Keywords: Body Mass Index, Fibromyalgia, Pain, Obesity.

Class 3 Obesity and Oral Health in Adults: A Scoping Review of the Challenges for Oral Healthcare Services.

Background: Obesity is one of the most neglected public health problems affecting both developed and developing countries. The most clinically severe obesity (Class 3 obesity) has both clinical and service delivery implications on dental services. However, associations between Class 3 obesity and oral health are minimally explored in the literature and thus poorly understood. Aims: This scoping review aimed to explore the existing evidence on Class 3 obesity and oral health. Methods: A literature search was performed via Medline, Scopus, Google scholar and Embase research databases. Results: A total of 375 papers were sourced from the database search. Twenty seven full-text papers were included in the final literature review. Results revealed findings from both quantitative and qualitative studies. Papers included results pertaining to associations with dental disease, oral health and associated behaviours, oral health-related quality of life and the barriers experienced by adults with Class 3 obesity in accessing dental services. Conclusions: While mixed findings were identified, this scoping review reports associations between Class 3 obesity and poor oral health across various domains including clinical parameters and oral health related quality of life. The literature has also highlighted important barriers to dental care in those with the most severe Class 3 obesity. Based upon our findings, we have summarised current oral health management implications and directions for future research.

Using Artificial Intelligence Techniques for the Analysis of Obesity Status According to the Individuals' Social and Physical Activities

Obesity is a serious and chronic disease with genetic and environmental interactions. It is defined as an excessive amount of fat tissue in the body that is harmful to health. The main risk factors for obesity include social, psychological, and eating habits. Obesity is a significant health problem for all age groups in the world. Currently, more than 2 billion people worldwide are obese or overweight. Research has shown that obesity can be prevented. In this study, artificial intelligence methods were used to identify individuals at risk of obesity. An online survey was conducted on 1610 individuals to create the obesity dataset. To analyze the survey data, four commonly used artificial intelligence methods in literature, namely Artificial Neural Network, K Nearest Neighbors, Random Forest and Support Vector Machine, were employed after pre-processing. As a result of this analysis, obesity classes were predicted correctly with success rates of 74.96%, 74.03%, 74.03% and 87.82%, respectively. Random Forest was the most successful artificial intelligence method for this dataset and accurately classified obesity with a success rate of 87.82%.

The Impact of Maternal BMI on Time of Transvaginal Cervical Imaging

Introduction: Ultrasound is an integral part of obstetrical care and obesity has been shown to decrease the accuracy of ultrasound examination in high-risk pregnancy (Tsai et al, 2015). Obesity decreases the fidelity of ultrasound, as decreased visualization is seen with increasing depth of abdominal adipose tissue (Paladini, 2009). While maternal obesity has been shown to detrimentally impact anatomical ultrasound, the effects of obesity on the performance of transvaginal ultrasound are unclear. Our aim was to evaluate if obesity has an effect on the time required to obtain transvaginal cervical length. Methods: Retrospective chart review between January 2016-January 2022 identified patients with cervical shortening (<2.5 cm) at the time of mid-trimester anatomical ultrasound scans. Scans were performed at the Maternal Fetal Medicine Department at Promedica Toledo Hospital between 16- and 24-weeks gestation. Patient BMI was recorded at the time of ultrasound and divided into obese (BMI ≥ 30 kg/m²) and non-obese (BMI ≤ 30 kg/m²) categories. Time to complete transvaginal ultrasound imaging was recorded in both patient populations and compared. Results: 216 patients met study criteria. Out of the 216, 89 (41%) were obese and 127 (59%) were non-obese. Average BMI of all participants was 29.2 ± 7.4 kg/m². Average time spent on ultrasound for patients with BMI <30 was 13:36 ± 01:28 and for BMI >30 15:34 ± 01:48 (p=0.46). There was no statistical difference between obese and non-obese patients and transvaginal scanning time > 10 minutes (OR 1.24, 95% CI 0.719-2.13, p=0.44) Discussion: Our results suggest that the time to obtain cervical length measurements via transvaginal ultrasounds is similar between obese and non-obese patients. Time necessary to perform endovaginal ultrasonography of the cervix does not appear to be affected by maternal BMI. Since length of time necessary to complete transvaginal cervical length measurement does not appear to be affected by maternal BMI, our results suggest that additional scheduling time does not need to be allocated for obese patients. Other investigators have shown that early incorporation of transvaginal assessment of fetal anatomy in obese women improved the rate of survey completion and demonstrated earlier completion of the fetal anatomic evaluation (Toscano et al, 2021). This study encourages the further use of transvaginal ultrasound in obese, obstetrical patients.

In-hospital outcomes in COVID-19 patients with non-alcoholic fatty liver disease by severity of obesity: Insights from national inpatient sample 2020.

Non-alcoholic fatty liver disease (NAFLD) increases the risk of cardiovascular diseases independently of other risk factors. However, data on its effect on cardiovascular outcomes in coronavirus disease 2019 (COVID-19) hospitalizations with varied obesity levels is scarce. Clinical management and patient care depend on understanding COVID-19 admission results in NAFLD patients with varying obesity levels. To study the in-hospital outcomes in COVID-19 patients with NAFLD by severity of obesity. COVID-19 hospitalizations with NAFLD were identified using International Classification of Disease -10 CM codes in the 2020 National Inpatient Sample database. Overweight and Obesity Classes I, II, and III (body mass index 30-40) were compared. Major adverse cardiac and cerebrovascular events (MACCE) (all-cause mortality, acute myocardial infarction, cardiac arrest, and stroke) were compared between groups. Multivariable regression analyses adjusted for sociodemographic, hospitalization features, and comorbidities. Our analysis comprised 13260 hospitalizations, 7.3% of which were overweight, 24.3% Class I, 24.1% Class II, and 44.3% Class III. Class III obesity includes younger patients, blacks, females, diabetics, and hypertensive patients. On multivariable logistic analysis, Class III obese patients had higher risks of MACCE, inpatient mortality, and respiratory failure than Class I obese patients. Class II obesity showed increased risks of MACCE, inpatient mortality, and respiratory failure than Class I, but not significantly. All obesity classes had non-significant risks of MACCE, inpatient mortality, and respiratory failure compared to the overweight group. Class III obese NAFLD COVID-19 patients had a greater risk of adverse outcomes than class I. Using the overweight group as the reference, unfavorable outcomes were not significantly different. Morbid obesity had a greater risk of MACCE regardless of the referent group (overweight or Class I obese) compared to overweight NAFLD patients admitted with COVID-19.

Transition of cooking fuels and obesity risk in Chinese adults

BackgroundSince 1990 s, China has witnessed a widespread transition to clean cooking fuels, presenting an opportunity to investigate whether household fuel transition could mitigate obesity risk and reconcile inconsistencies in the literature regarding the association between cooking fuels and obesity. MethodsThe China Health and Nutrition Survey (CHNS) is a prospective cohort study covering 12 provinces of China (1989–2015). Participants were classified into persistent cleaner fuel users, fuel transitioners, and persistent polluting fuel users according to self-reported primary cooking fuels. Obesity and central obesity were defined as BMI ≥ 28.0 kg/m2 and waist circumference ≥ 90 cm in men and ≥ 85 cm in women according to Chinese criteria. FindingsAmong 13,032 participants, 3657 (28.06 %) were persistent cleaner fuel users; 5264 (40.39 %) transitioned from using polluting fuels to cleaner fuels after the baseline survey; and 4111 (31.55 %) were persistent polluting fuel users. During the period of follow-up of 9.0 ± 6.8 years, 1248 (9.58 %) participants were classified into the obesity category, and 4703 (36.09 %) into the central obesity category. Persistent polluting fuel users had a significantly higher risk of developing obesity (hazard ratio [HR]: 1.45, 95 %CI: 1.22–1.72) and central obesity (HR: 1.32, 95 %CI: 1.21–1.44), compared to persistent cleaner fuel users. Persistent polluting fuel use was positively associated with developing obesity in women (HR: 1.64, 95 %CI: 1.30–2.06), but not in men. Subgroup analyses showed higher HR of persistent polluting fuel use among individuals aged 18–44 years (HR: 2.04, 95 %CI: 1.62–2.56). In contrast, the transitioners did not exhibit a significantly different risk of developing obesity (HR: 0.94, 95 %CI: 0.80–1.10) compared to persistent cleaner fuel users, which was consistent across different sex, age and urbanicity. Similar trends were observed for developing central obesity. InterpretationPersistent polluting fuel use increased obesity risk while the obesity risk of the transition to cleaner fuels was similar to persistent use of cleaner fuels. The finding underscores the significance of advocating for the adoption of cleaner fuels as a strategy to mitigate the disease burden associated with obesity.

Obesity, a Single Pathology Influencing Both Mother and Child-A Retrospective Analysis in Hospital Settings.

The aim of the present study was to investigate the correlation between obesity and its implications for childbirth. We conducted a retrospective study involving 1513 patients, grouped into normal-weight, overweight, and obese categories using corrected BMI values. We performed comparative analyses to explore the association between BMI and various outcomes: the method of delivery, the Apgar score at birth, the incidence of fetal distress, fetal birth weight, the presence of pregnancy-associated pathologies, and the occurrence of postpartum hemorrhage. Descriptive statistical analysis was utilized to characterize the demographic and clinical features of the patients and newborns. By examining variables such as the occurrence of fetal distress during labor, the Apgar score at delivery, and the mode of delivery, we identified an association between increasing BMI and complications during labor and delivery. The results indicate that a higher BMI is linked with increased complications and variations in the mode of delivery. Obesity is the most common health issue among women of reproductive age and requires long-term care. It can contribute to numerous pregnancy-associated pathologies and affect both mother and child during labor and delivery. Obesity is associated with lower Apgar scores, the increased incidence of fetal distress, and a higher rate of cesarean section deliveries. Although the absolute risk of serious complications for mother, fetus, and newborn is low among women with obesity, adopting healthy eating and exercise behaviors prior to pregnancy, ideally, or as early in pregnancy as possible, can help minimize excessive weight gain during pregnancy.

Differing intensities of a midwife-led antenatal healthy lifestyle service on maternal and neonatal outcomes: A retrospective cohort study

IntroductionMaternal obesity and excessive gestational weight gain are associated with adverse maternal and neonatal outcomes. There is uncertainty over the most effective antenatal healthy lifestyle service, with little research determining the impact of different lifestyle intervention intensities on pregnancy outcomes. MethodThis retrospective cohort study compared pregnancy and birth outcomes in women with a body mass index of 40 or above who were offered a low intensity midwife-led antenatal healthy lifestyle service (one visit) with women who were offered an enhanced service (three visits). The primary outcome was gestational weight gain. ResultsThere were no differences between the two healthy lifestyle service intensities (N = 682) in the primary outcome of mean gestational weight gain [adjusted mean difference (aMD) -1.1 kg (95 % CI -2.3 to 0.1)]. Women offered the enhanced service had lower odds of gaining weight in excess of Institute of Medicine recommendations [adjusted odds ratio (aOR) 0.63 (95 % CI 0.40–0.98)] with this reduction mainly evident in multiparous women. Multiparous women also gained less weight per week [aMD -0.06 kg/week (95 % CI -0.11 to -0.01)]. No overall beneficial effects were seen in maternal or neonatal outcomes measured such as birth weight [aMD 25 g (95 % CI -71 to 121)], vaginal birth [aOR 0.87 (95 % CI 0.64–1.19)] or gestational diabetes mellitus [aOR 1.42 (95 % CI 0.93–2.17)]. However, multiparous women receiving the enhanced service had reduced odds of small for gestational age [aOR 0.52 (95 % CI 0.31–0.87)]. This study was however underpowered to detect differences in some outcomes with low incidences. DiscussionUncertainty remains over the best management of women with severe obesity regarding effective interventions in terms of intensity. It is suggested that further research needs to consider the different classes of obesity separately and have a particular focus on the needs of nulliparous women given the lack of effectiveness of this service among these women.

Comparison of The Effectiveness of Aerobic Endurance Training and Resistance Exercise on Reducing Daily Blood Sugar in The Elderly at The Puter Community Health Center Bandung City

Diabetes Mellitus (DM) is a chronic condition that occurs when there is an increase in glucose levels in the blood because the body cannot produce insulin or use insulin effectively. Insulin is an important hormone produced in the body's pancreatic gland, which transports glucose from the bloodstream into the body's cells where the glucose is converted into energy. This study uses a comparative study with experimental method to find out the comparison results of the treatment given to samples from aerobic exercise intervention treatment with resistance exercise, The first group will do Aerobic Endurance Exercise by walking for 20 minutes. While the second group will do Resistance Exercise by doing strength training or resistance training for 20 minutes, rest time is 15 seconds and the movement is done as many as 2 sets and 10 repetitions. Subject characteristics based on average age (61.58 ± 6.50), body weight (71.86 ± 9.76), body height (157.27 ± 8.99), and BMI of elderly people suffering from diabetes mellitus falls into the obese category with a value of (27.71 ± 4.23). The value of aerobic before exercise is (26.41 ± 33.67) after exercise it decrease (11.74 ± 10.28), resistance exercise before exercise is (31.74 ± 54.10) after exercise it decrease (9.33 ± 23.46). In this study it can be concluded that aerobic endurance and resistance exercise can reduce the increase in blood sugar in the elderly, but when compared to the two exercises, resistance exercise suppresses the increase in blood sugar more, of course with the appropriate intensity.

Nutritional, anthropometric and behavioral aspects of nutrition students that consume alcoholic beverages

Upon entering university, students face changes in their lifestyle that can alter the type of food they eat and lead to addictions, such as alcohol consumption. The aim of this study was to assess the eating habits and behavioral profile associated with alcohol consumption among university students. Anamnesis, anthropometric indices and data from alcohol consumption (AUDIT) and food consumption frequency questionnaires were collected. A moderate rate of overweight people was observed (22%) and only the oils food group showed a difference between the underweight, eutrophic, overweight and obese categories. In addition, body mass index showed a significant positive linear correlation with waist circumference. With regard to alcohol intake, 46% of the total sample was in the high-risk zone. There is an abnormal distribution in the consumption of foods from all food groups and there are indications that students have been consuming all types of food without stipulating an adequate and balanced diet, in parallel with a relatively high consumption of alcohol.

Overnight Monitoring Criteria for Children with Obstructive Sleep-Disordered Breathing After Tonsillectomy: Revisited.

Previous studies indicate children who pass an Asleep Room Air Challenge (AsRAC) do not have significant postoperative adverse respiratory events after adenotonsillectomy (T&A). Subsequently, we revised our overnight monitoring (OM) criteria, allowing patients with an obstructive apnea/hypopnea index (OAHI) ≤20 or nonsevere obesity (Class I) to be considered for same-day surgery (SDS) if they passed an AsRAC. Our hypothesis is that our modified OM criteria would not increase the return visits or readmission rates for patients undergoing SDS within 48 h or 15 days of T&A. A retrospective review of all children aged ≥3 and <21 years who underwent T&A at a tertiary children's hospital and its satellite locations was performed from January 2017 to September 2022. Descriptive statistics and outcome measures were compared using a 3% margin noninferiority test before and after the new criteria implementation. Before intervention, 3,266 (58%) T&As were performed as SDS. Afterward, 74% of T&As were performed as SDS (p-value <0.05). There was no difference in the ED revisit rate for SDS within the 3% noninferiority margin. Following intervention, 29% more children with Class I obesity (62% vs. 33%) underwent SDS (p-value <0.001). Afterward, 19% more children with polysomnography underwent SDS (39% vs. 20%), p-value <0.001. After intervention, within 48 h of SDS, six (0.9%) children had revisits for bleeding and seven (1.2%) for vomiting. There were no perioperative respiratory events. Our revised monitoring criteria did not demonstrate an increase in ED visit or readmissions rates within 48 h or 15 days of T&A. Additionally, we found a 29% increase in Class I obese children undergoing SDS T&A. 3 Laryngoscope, 2024.

BODYFAT: a new calculator to determine the risk of being overweight validated in Spanish children between 11 and 17 years of age

The assessment of body fat of children in primary care requires consideration of the dynamic changes in height, weight, lean mass, and fat mass during childhood growth. To achieve this, we aim to develop a predictive equation based on anthropometric values, with optimal diagnostic utility. This is a cross-sectional observational study, involving schoolgoers aged 11–17 years in the Vigo metropolitan area. Out of 10,747 individuals, 577 were randomly recruited. Variables: age, sex, ethnicity/country of origin, weight, height, 8 skinfolds, 3 diameters, 7 perimeters, and 85% percentile of body fat mass as the gold standard. Generalized additive regression was selected by cross-validation and compared using receiver operating characteristic curves (ROC curves). Sensitivity, specificity, positive and negative predictive values, true positive and true negative values, false positive and false negative values, accuracy, and positive and negative likelihood ratios were calculated. Two models were identified. The optimal model includes sex, weight, height, leg perimeter, and arm perimeter, with sensitivity of 0.93 (0.83–1.00), specificity of 0.91 (0.83–0.96), accuracy of 0.91 (0.84–0.96), and area under the curve (AUC) of 0.957 (0.928–0.986). The second model includes sex, age, and body mass index, with sensitivity of 0.93 (0.81–1.00), specificity of 0.90 (0.80–0.97), accuracy of 0.90 (0.82–0.96), and an AUC of 0.944 (0.903–0.984).Conclusion: Two predictive models, with the 85th percentile of fat mass as the gold standard, built with basic anthropometric measures, show very high diagnostic utility parameters. Their calculation is facilitated by a complementary online calculator.What is Known:• In routine clinical practice, mainly in primary care, BMI is used to determine overweight and obesity. This index has its weaknesses in the assessment of children.What is New:• We provide a calculator whose validated algorithm, through the determination of fat mass by impedanciometry, makes it possible to determine the risk of overweight and obesity in the community setting, through anthropometric measurements, providing a new practical, accessible and reliable model that improves the classification of overweight and obesity in children with respect to that obtained by determining BMI.

Examining Age-Adjusted Associations between BMI and Comorbidities in Mongolia: Cross-Sectional Prevalence.

(1) Background: This study investigated the association between body mass index (BMI) categories and comorbidities in the context of a developing country, utilizing data from a nationwide health screening in Mongolia. (2) Methods: The study included 181,080 individuals (mean age 47.0 ± 15.3, 42.0% male) from the population-based general health screening. We counted the number of diseases from participants' medical records based on ICD-10 codes, excluding those categorized under Z00-Z99 and codes indicating acute disorders, as well as individuals classified as underweight. (3) Results: Among study participants, the prevalence of two or more comorbidities was 4.2%. The weight distribution comprised 40.4% normal weight; 37.1% overweight; and 16.9%, 4.4%, and 1.2% in the Class I, II, and III obesity categories, respectively. Comorbidities increased with BMI: normal weight (0.222); overweight (0.255); and Class I (0.290), Class II (0.302), and Class III obesity (0.303), suggesting a dose-dependent likelihood of having multiple diseases. Adjusted linear regression (beta coefficients, 95% CIs) showed increased comorbidity risks in overweight (0.017, 0.013-0.021) and obesity (0.034, 0.030-0.039). Interaction analysis with age revealed a significant effect (p < 0.001). While comorbidities tend to increase with higher BMI categories in all age-tertile groups, this association was notably stronger among younger individuals. (4) Conclusions: Obesity is associated with a twofold increase in the prevalence of multiple comorbidities compared to normal weight. Our findings also highlight the critical role of age in the development of multiple diseases, with BMI remaining a significant factor across various age groups, encompassing both younger and older adults.

Body Size Perceptions Associated with Body Mass Index and Weight Loss Intentions Among Two Immigrant Populations.

The rates of obesity among immigrant populations within the USA rise with increasing duration of residency. The aims of this study were to examine weight self-perception and body image discrepancy within a large community sample of Hispanic and Somali predominantly immigrant adults. Utilizing a community-based participatory research (CBPR) approach to collect survey data from a sample of adults who self-identified as Hispanic, Latino, or Somali in Southeast Minnesota. Correlations among actual body mass index (BMI), perceived weight category, and perceived body size were assessed with Spearman rank correlation coefficients. Associations of weight loss intentions with actual BMI, perceived weight category, perceived body size, and body image discrepancy were assessed using Kruskal-Wallis nonparametric tests. A total of 1256 adults completed the survey and biometric measurements (610 Hispanic, 646 Somali); 81% (457) and 50% (328) had a BMI in the overweight or obese category in the Hispanic and Somali cohorts, respectively. Among participants with a BMI of > 25, more participants reported a perceived body size that was overweight or obese than a perceived weight category that was in the overweight or obese category (79% vs. 48%, p = < 0.0001). Body image discrepancy, but not actual BMI, was associated with weight loss intentions for both groups. Perceived body size and perceived weight category were associated with weight loss intentions for Hispanic participants only. Perceived body size is a more accurate self-report proxy of BMI-defined weight status compared with the perceived weight category among Hispanic and Somali immigrant groups. Body image discrepancy may be more predictive of weight loss intentions than actual BMI.

The association between body mass index and physical function in adult burn survivors: A Burn Model System National Database study

IntroductionAn area of rehabilitation research in burns is the impact of co-morbidities on disease trajectory. Obesity is a comorbidity of increasing public health concern, but its role remains controversial regarding burn injury and physical recovery. Our aim was to evaluate the association between body mass index (BMI) categories as a measure of obesity at discharge and self-reported physical function (PF) during recovery of adult burn survivors. MethodsThis is a retrospective study on data collected by four major US burn centers, which contribute to the Burn Model System National Database. The data included BMI obtained at hospital discharge and self-reported PF-mobility, using the PROMIS measures assessed at 6, 12, and 24 months after burn. Subjects were classified into weight status categories based on BMI: underweight (BMI <18.5), normal weight (18.5 ≤ BMI <25), overweight (25 ≤ BMI <30), obesity class 1 (30 ≤ BMI <35), obesity class 2 (35 ≤ BMI <40), and obesity class 3 (BMI ≥40). Mixed-effects linear regression models were used to assess the association between BMI categories and PF scores over time, adjusted for patient and injury characteristics. ResultsA total of 496 adult burn patients aged 47 ± 16 years were included, with mean total body surface area (TBSA) burned of 18 ± 19 % and mean BMI at discharge of 28 ± 7 kg/m2. PROMIS PF scores significantly improved over time in the recovery phase after burn (time effect, p < 0.001). Compared to overweight burn patients, normal-underweights exhibited lower PF score by an average of 4.06 units (p = 0.001) but scores increased linearly by an estimated 0.17 units per month (p = 0.01) over the 24 months after discharge. Similarly, compared to overweight burn patients, class 1 obese reported lower PF score by a mean 2.67 units (p = 0.07) but PF increased linearly by 0.15 units per month (p = 0.07) over the 24 months after discharge. These findings were independent of the effects of age at discharge, sex, TBSA burned, and hand and leg burn. ConclusionBeing overweight was associated with improved and faster recovery of PF scores compared to normal, underweight, and obese burn patients during long-term recovery. Hence, our data suggests that long-term recovery and restoration of PF in adult burn survivors is not compromised by a small excess in body weight.

Balancing the Scales: Caution in Reduction Mammaplasty Recommendations for Obesity Class III Patients.

The prevalence of obesity has risen worldwide, posing a problem to surgeons as obesity is a well-known risk factor for surgical outcomes. While prior studies have suggested performing reduction mammaplasty (RM) in patients with obesity, the variance in outcomes and quality of life (QoL) for obesity classes are ill-defined. We investigated whether obesity classes should be considered for RM by examining the surgical outcomes and QoL across different weight classes, aiming to pinpoint when outcomes become less favorable. Patients undergoing RM by nine surgeons from 2016 to 2022 were included. Body mass index (BMI) cohorts were formed according to the Center for Disease Control and Prevention (CDC) guidelines: Healthy (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2), obesity class I (30-34.9 kg/m2), II (35-39.9 kg/m2), and III (>40 kg/m2). QoL was assessed by comparing preoperative and postoperative BREAST-Q scores within cohorts. A comparison analysis was performed between weight classes. A total of 461 RM patients were identified (healthy: 83, overweight: 178, I: 142, II: 39, III: 19). Percentage of Black patients, procedure length, weight of tissue removed, and inferior pedicle technique all significantly increased as BMI increased (P < 0.001). Higher BMI cohorts, especially class III, had significantly higher rates of surgical site infections (healthy: 0%, overweight: 1.1%, I: 1.4%, II: 0%, III: 15.8%, P < 0.01), fat necrosis (healthy: 1.2%, overweight: 5.1%, I: 7%, II: 0%, III: 22.2%, P = 0.01), dehiscence (healthy: 3.6%, overweight: 2.8%, I: 2.1%, II: 5.1%, III: 31.6%, P < 0.01), delayed healing (health: 4.8%, overweight: 11.2%, I: 16.9%, II: 28.2%, III: 42.1%, P < 0.01), minor T-point breakdown (healthy: 10.8%, overweight: 15.7%, I: 23.9%, II: 23.1%, III: 52.6%, P = 0.01), and surgical site occurrence requiring procedural intervention (healthy: 6.0%, overweight: 5.6%, I: 6.3%, II: 15.4%, III: 21.1%, P < 0.05). When compared to the other weight classes independently, class III was associated with unfavorable outcomes (P < 0.05). Significant improvement in average postoperative QoL scores in satisfaction with breast, psychosocial well-being, sexual well-being, and physical well-being were seen in all cohorts except class III (P < 0.05). Severe obesity class III patients undergoing RM have a higher yet still acceptable risk profile and should be counseled on the risks despite its improved quality of life.

The effect of body weight on the knee joint biomechanics based on subject-specific finite element-musculoskeletal approach

Knee osteoarthritis (OA) and obesity are major public health concerns that are closely intertwined. This intimate relationship was documented by considering obesity as the most significant preventable risk factor associated with knee OA. To date, however, the effects of obesity on the knee joint's passive-active structure and cartilage loading have been inconclusive. Hence, this study investigates the intricate relationship between obesity and knee OA, centering on the biomechanical changes in knee joint active and passive reactions during the stance phase of gait. Using a subject-specific musculoskeletal and finite element approach, muscle forces, ligament stresses, and articular cartilage contact stresses were analyzed among 60 individuals with different body mass indices (BMI) classified under healthy weight, overweight, and obese categories. Our predicted results showed that obesity significantly influenced knee joint mechanical reaction, increasing muscle activations, ligament loading, and articular cartilage contact stresses, particularly during key instances of the gait cycle—first and second peak loading instances. The study underscores the critical role of excessive body weight in exacerbating knee joint stress distribution and cartilage damage. Hence, the insights gained provide a valuable biomechanical perspective on the interaction between body weight and knee joint health, offering a clinical utility in assessing the risks associated with obesity and knee OA.

Mapping Knowledge Landscapes and Emerging Trends of Sarcopenic Obesity in Older Adults: A Bibliometric Analysis From 2004 to 2023.

Background The prevalence of obesity in combination with sarcopenia, the age-related loss of muscle mass and strength or physical function, is on the rise among adults aged 65 years and older. A significant portion of this demographic now falls under the classification of sarcopenic obesity, a high-risk geriatric syndrome predominantly seen in an aging population vulnerable to compounded complications from both sarcopenia and obesity. It is essential to promptly evaluate the impact of academic research in this field, taking into account factors such as geographical regions, authors, journals, and institutions. Furthermore, exploring current topics and identifying potential areas that could inspire future researchers to conduct additional studies is crucial for advancing overall health in this population. Methodology A search was conducted in the Web of Science Core Collection database to identify English language articles and reviews focusing on sarcopenic obesity in older adults, published between January 1, 2004, and December 31, 2023. Bibliometric analysis was performed using VOSviewer (v.1.6.18) and CiteSpace (v.6.1.R2). Results A total of 985 original English-language articles were collected, consisting of 783 articles and 202 reviews. The volume of research publications in this field has shown significant growth since 2012. The United States leads in contributions, with 239 articles (24.3% of the total) and the highest number of citations at 18,403, along with the highest total link strength. The University of Melbourne in Australia stands out with 25 published articles (2.5% of the total). University of Verona in Italy has the most citations at 9,405, and Monash University in Australia has the highest total link strength at 53. Among prolific authors, John A. Batsis from Duke University is the most productive with 24 articles (2.4% of the total). The journal "Nutrients" has the most articles on sarcopenic obesity in older adults, publishing 54 articles (5.5% of the total). Key topics in this area include sarcopenia, obesity, sarcopenic obesity, and elderly. Recent interventions focus on "nutrition" and "exercise" for sarcopenic obesity in older adults. Conclusions Research on sarcopenic obesity in older adults has seen significant growth on a global scale from 2004 to 2023, indicating a promising area for further study with potential benefits from current advancements. Although academic inquiries have shed light on various aspects of sarcopenic obesityin older adults, there remains a noticeable dearth of clinical research and evidence-based medicine on the effective management of this condition in elderly individuals. Future studies could focus on developing tailored interventions for older adults with sarcopenic obesity.