Desired Weight Loss Research Articles

Therapeutic ketogenic diet as treatment for anorexia nervosa.

Anorexia nervosa (AN) is a severe psychiatric disorder. However, we lack neurobiological models and interventions to explain and treat the core characteristics of food restriction, feeling fat, and body size overestimation. Research has made progress in understanding brain function involved in the pathophysiology of AN, but translating those results into biological therapies has been challenging. Studies have suggested that metabolic factors could contribute to developing and maintaining AN pathophysiology. Here, we describe a neurobiological model for why using a therapeutic ketogenic diet could address key alterations in brain function in AN and prevent the desire for weight loss and associated eating disorder-specific symptoms. This translational model is based on animal studies and human data and integrates behavioral traits, brain neural energy metabolism, and neurotransmitter function. Pilot data indicate that the intervention can dramatically reduce eating and body-related fears, although larger studies across illness stages still need to be conducted.

Lifestyle Medicine in Focus: A Cross-Sectional Study Comparing Domestic and International Students.

This study investigated lifestyle factors among Hungarian and international students, utilizing lifestyle medicine principles to enhance overall well-being. Conducted at the University of Debrecen through a cross-sectional survey, we examined selected lifestyle factors, more specifically sleep patterns, weight management, nutrition, physical activity, mental well-being, and alcohol use. Hungarian (N = 122) and international (N = 139) students were compared, revealing significant differences. Hungarian students slept less (p = 0.041), desired weight loss (p = 0.040), ate more fruits and vegetables (p = 0.014), exercised longer (p = 0.002), and reported higher purpose and social support (p = 0.009), with higher alcohol use (p < 0.001). These findings highlight distinct experiences and challenges faced by these student groups including variations in sleep, weight management, diet, exercise, and social support. Targeted interventions and tailored support are essential to address their specific needs. To promote the well-being of both Hungarian and international students, educational programs addressing various facets of a healthy lifestyle are crucial. This study offers valuable insights into lifestyle factors and health outcomes among Hungarian and international students and underscores the importance of addressing the unique needs of each group through tailored interventions.

Eating Disorder Symptoms, Attention Deficit/Hyperactivity Disorder Symptoms, and Executive Functioning Deficits in Iranian College Students: A Network Analysis

Introduction: Attention deficit/hyperactivity disorder (ADHD) symptoms and executive functioning deficits are prevalent among college and eating disorder (ED) populations. Although a few studies have examined which specific ADHD and executive functioning deficits are most strongly connected to specific ED symptoms, no studies have investigated them all in one study, or in non-Western societies such as Iran. This study used network analysis to identify central and bridge symptoms across ED symptoms, ADHD symptoms, and executive functioning in Iran. Methods: Participants were Iranian college students (n = 1,013; 82.7% women) who completed the Farsi-Eating Disorder Examination-Questionnaire (F-EDE-Q), the Adult ADHD Self-Report Scale (ASRS), and Web-Based Executive Function Questionnaire (Webexec). We computed three networks and identified central and bridge symptoms. Results: For ADHD symptoms, the most central nodes were difficulty with organization and remembering obligations; for executive functioning, problems with attention and concentration were most central. The most central bridge symptoms were desire for weight loss, binge eating, and problems with concentration. Discussion: Desire for weight loss, binge eating, and problems with concentration may explain the association between ED symptoms, ADHD symptoms, and executive functioning. Future research should explore ways to disrupt the relationship between these symptoms in therapeutic settings.

Exploring Factors Associated with Gender Differences in Perceived Stress among Adults with Higher Body Weight in the United States—A Cross-Sectional Analysis

This study aimed to explore factors associated with perceived stress in adults with higher body sizes. An analysis of data from participants who self-reported higher body weight was conducted (n = 1716). The mean (standard deviation) age was 55.92 (15.94) years and 71.3% and 28.7% identified themselves as women and men, respectively. Gender differences in perceived stress, desire for weight loss, trust in physicians, body affirmation, and perceived weight discrimination were examined. Perceived stress and perceived weight discrimination were significantly higher in women than in men, while trust in physicians and body affirmation was higher in men than women. Trust in physicians and body affirmation were both negatively associated with perceived stress. Perceived weight discrimination and desire for weight loss were both positively associated with perceived stress. Trust in physicians, body affirmation, and perceived weight discrimination were examined as mediators of the observed gender differences between men and women. Trust in physicians, body affirmation, and perceived weight discrimination were significant mediators of the relationship between gender and perceived stress. These results suggest that a possible point of intervention for addressing gender differences in rates of perceived stress among higher body weight adults may be to increase trust in physicians, encourage body affirmation, and reduce weight discrimination.

Relationship of masked obesity to self-reported lifestyle habits, ideal body image, and anthropometric measures in Japanese university students: A cross-sectional study.

Masked obesity (MO) is defined as a normal body mass index (BMI) with a high body fat percentage (%BF), and is associated with the onset of lifestyle-related diseases. However, little is known about the current status of MO. Therefore, we investigated the relationship of MO to physical characteristics and lifestyle habits among Japanese university students. Between 2011 and 2019, we conducted a survey of 10,168 males and 4,954 females with BMI within the normal range (18.5 ≤ BMI < 25 kg/m2). MO was defined as %BF ≥ 20% in males and %BF ≥ 30% in females. Students completed a questionnaire containing items about lifestyle habits. Systolic and diastolic blood pressures were measured, and hypertension was defined as systolic above 140 mmHg and/or diastolic blood pressure above 90 mmHg. A multivariate logistic regression analysis was performed to evaluate the relationships as follows: the relationship of masked obesity to self-reported lifestyle habits, ideal body image, and anthropometric measures; the relationship between hypertension and body indices. The proportion of students with MO in 2019 was 13.4% in males and 25.8% in females, and the proportion of females increased over time. MO was associated with desire for weight loss (odds ratio, 95% confidence interval: 1.76, 1.53-2.02), intake of five macronutrients (0.79, 0.67-0.93), rice and wheat intakes (1.22, 1.01-1.47), sleep duration of < 7hr (0.85, 0.74-0.98), and exercise habit (0.71, 0.63-0.81) in males; and with balanced diet intake (0.79, 0.64-0.99) and exercise habit (0.65, 0.51-0.82) in females. There was a significant association of MO with hypertension in males (1.29, 1.09-1.53). The percentage of female students with MO increased during the study period, and in males, MO may be a risk factor for hypertension. These results suggest that intervention for MO is needed in Japanese university students.

The relationship between weight history and psychological health-Differences related to gender and weight loss patterns.

The prevalence and burden of obesity continues to grow worldwide. Psychological comorbidities may not only influence quality of life, but may also hinder successful weight loss. The causality between excess weight and mental health issues is still not fully understood. The aim of the study was to investigate whetherweight history parameters, (ie.age of onset) are related to psychological comorbidities. The data were derived from a representative telephone survey in Germany, collecting information on weight loss patterns and mental health outcomes among individuals with BMI>30kg/m2. Overall, 787 participants were examined in terms of depressive symptoms (Patient Health Questionnaire, PHQ-9) and anxiety (Generalized Anxiety Disorder Questionnaire, GAD7). In addition, participants were asked about different aspects of their weight history (ie. weight loss patterns and trajectories) over the lifespan. The relationship between weight history and mental health was analyzed using multivariate statistics. According to regression analyses, having had more weight loss attempts, a greater weight loss being desired and being a "weight maintainer" was associated with more symptoms of depression (p < 0.001), whereas a greater desired weight loss and being categorized as a "weight maintainer" was associated with more anxiety (p < 0.001). Moroever, the prevalence of depressive symptoms was significantly higher in male individuals who desire to lose more weight or had more weight loss attempts in the past. Gender-specific differences were observed in terms of weight history parameters, as well as mental health outcomes. Especially for men, weight loss patterns seem to be related to depressive symptoms. Concerning the overall results, it becomes clear that screening for weight history at the beginning of a multidisciplinary weight loss program in the context of gender-specific psychological comorbidities is important. The question remains why some aspects of weight history seem to be more important than others.

Gamification and neurotraining to engage men in behavioral weight loss: Protocol for a factorial randomized controlled trial

Over 70% of men are overweight, and most desire weight loss; however, men are profoundly underrepresented in weight loss programs. Gamification represents a novel approach to engaging men and may enhance efficacy through two means: (1) game-based elements (e.g., streaks, badges, team-based competition) to motivate weight control behaviors and (2) arcade-style “neurotraining” to enhance neurocognitive capacities to resist the temptation of unhealthy foods and more automatically select healthy foods. This study will use a 2 × 2 factorial design to examine the independent and combinatory efficacy of gamification and inhibitory control training (ICT). Men with overweight/obesity (N = 228) will receive a 12-month mobile weight loss program that incorporates behavioral weight loss strategies (e.g., self-monitoring, goal setting, stimulus control). Men will be randomly assigned to a non-gamified or gamified version, and an active or sham ICT. A game design company will create the program, with input from a male advisory panel. Aims of the project are to test whether a gamified (versus non-gamified) weight loss program and/or ICT (versus sham) promotes greater improvements in weight, diet, and physical activity; whether these treatment factors have combinatory or synergistic effects; to test whether postulated mechanisms of action (increased engagement, for gamification, and inhibitory control, for ICT) mediate treatment effects; and whether baseline gameplay frequency and implicit preferences for ICT-targeted foods moderate effects. It is hoped this study will contribute to improved mHealth programs for men and enhance our understanding of the impact of gamified elements and neurocognitive training on weight control.

Desired weight loss and its association with health, health behaviors and perceptions in an adult population with weight excess: One-year follow-up.

BackgroundMetabolic syndrome (MetS) worsens quality of life and increases mortality. Dissatisfaction with weight in patients with MetS may modify the effect of lifestyle interventions to achieve changes in health-related behaviors.ObjectiveTo assess 1-year changes in cardiovascular risk scores, self-perceived general health and health-related behaviors according to observed changes in desired weight loss during the first year of intervention in a large cardiovascular prevention trial.DesignProspective analysis of the PREDIMED-PLUS trial, including 5,499 adults (55–75 years old) with overweight or obesity at baseline.MethodsThe desired weight loss was the difference between ideal and measured weight. Tertiles of change in desired weight loss (1 year vs. baseline) were defined by the following cut-off points: ≥0.0 kg (T1, n = 1,638); 0.0 to −4.0 kg (T2, n = 1,903); ≤−4.0 kg (T3, n = 1,958). A food frequency questionnaire assessed diet and the Minnesota-REGICOR questionnaire assessed physical activity. The Framingham equation assessed cardiovascular risks. The changes in the severity of MetS were also assessed. The Beck Depression Inventory assessed depressive symptoms and the SF-36 assessed health-related quality of life. Data were analyzed using general linear models.ResultsBMI decreased at T2 and T3 (T1: 0.3, T2: −0.7, T3: −1.9). The most significant improvement in diet quality was observed at T3. Cardiovascular risk decreased at T2 and T3. Mean reductions in MetS severity score were: −0.02 at T1, −0.39 at T2 and −0.78 at T3. The perception of physical health increases in successive tertiles.ConclusionsIn older adults with MetS, more ambitious desired weight loss goals were associated with improvements in diet, cardiovascular health and perceived physical health during the first year of a healthy lifestyle intervention programme. Weight dissatisfaction needs to be considered by health professionals.Clinical trial registrationhttp://www.isrctn.com/ISRCTN89898870, identifier 89898870.

Conversion to Roux-en-Y gastric bypass versus one-anastomosis gastric bypass after a failed primary gastric band: a matched nationwide study.

Primary laparoscopic adjustable gastric band (LAGB) has high rates of patients not achieving the desired weight loss, and it remains unclear which bariatric conversion procedure gives better results. To compare weight loss among patients undergoing conversion one-anastomosis gastric bypass (cOAGB) and conversion Roux-en-Y gastric bypass (cRYGB) after a failed LAGB. Nationwide population-based study including all 18 hospitals providing metabolic and bariatric surgery. Patients with a failed primary LAGB who underwent a cRYGB or cOAGB between January 1, 2015, and December 31, 2019, were selected from the Dutch Audit for Treatment of Obesity. The primary outcome was not achieving ≥20% total weight loss (TWL) at 1-year and up to 5-year follow-up. Secondary outcomes included postoperative complications, defined as Clavien-Dindo ≥III within 30 days, and co-morbidity remission. A propensity score matched logistic and Poisson regression model was used to estimate the difference in patients not achieving ≥20% TWL between cRYGB and cOAGB. A total of 615 (78.7%) patients underwent cRYGB, and 166 (21.3%) patients underwent cOAGB, with 163 patients successfully matched. Both groups had similar rates of patients not achieving ≥20% TWL at 1 year (odds ratio [OR] = .64, 95% confidence interval [CI]: .38-1.05). However, a sensitivity analysis showed that patients undergoing cOAGB had lower rates of patients not achieving ≥20% TWL up to 5-year follow-up (rate ratio = .69, 95% CI: .51-.95, P < .05). Patients undergoing cOAGB were less likely to achieve hypertension remission (OR = .22, 95% CI: .07-.66). There were no significant differences between groups in postoperative complications (OR = .39, 95% CI: .07-2.06, P > .05). This matched nationwide study suggests that the cOAGB has similar short-term weight loss outcomes but potentially better long-term weight loss results than cRYGB. Therefore, cOAGB could provide a reliable alternative but needs to be substantiated in future long-term studies.

One size does not fit all; practical, personal tailoring of the diet to NAFLD patients.

Different dietary regimens for weight loss have developed over the years. Since the most evidenced treatment for non-alcoholic fatty liver disease (NAFLD) is weight reduction, it is not surprising that more diets targeting obesity are also utilized for NAFLD treatment. However, beyond the desired weight loss effects, one should not ignore the dietary composition of each diet, which may not necessarily be healthy or safe over the long term for hepatic and extrahepatic outcomes, especially cardiometabolic outcomes. Some of these diets are rich in saturated fat and red meat, are very strict, and require close medical supervision. Some may also be very difficult to adhere to for long periods, thus reducing the patient's motivation. The evidence for a direct benefit to NAFLD by restrictive diets such as very-low-carb, ketogenic, very-low-calorie diets, and intermittent fasting is scarce, and the long-term safety has not been tested. Nowadays, the approach is that the diet should be tailored to the patient's cultural and personal preferences. There is strong evidence for the independent protective association of NAFLD with a diet based on healthy eating patterns of minimally-processed foods, low in sugar and saturated fat, high in polyphenols, and healthy types of fats. This leads to the conclusion that a Mediterranean diet should serve as a basis that can be restructured into other kinds of diets. This review will elaborate on the different diets and their role in NAFLD. It will provide a practical guide to tailor the diet to the patients without compromising its composition and safety.

Body composition, mitochondrial oxygen metabolism and metabolome of patients with obesity before and after bariatric surgery (COMMITMENT): protocol for a monocentric prospective cohort study

IntroductionObesity, defined as a body mass index ≥30 kg/m2, is one of the most prevalent health conditions worldwide. It is part of the metabolic syndrome, which encompasses arterial hypertension, dyslipoproteinaemia and diabetes. Obesity is viewed as a systemic disease with pathophysiological mechanisms on the molecular level. Dysfunction of the mitochondrion and systemic low-grade inflammation are among the proposed causes for the metabolic changes. In severe cases of obesity, laparoscopic sleeve gastrectomy, a bariatric operation, can achieve the desired weight loss and has been associated with clinical outcome improvement. Hitherto, the influence of patients’ body composition on mitochondrial function and concomitant metabolic changes has not been fully understood. This study aims to quantify the patient’s body composition before and after laparoscopic sleeve gastrectomy and to correlate these findings with changes in mitochondrial oxygen metabolism, metabolome and immune status.Methods and analysisIn this prospective monocentric cohort study, patients undergoing laparoscopic sleeve gastrectomy (n=30) at Jena University Hospital (Germany) will be assessed before surgery and at four time points during a 1-year follow-up. Body composition will be measured by bioimpedance analysis. Non-invasive assessment of mitochondrial oxygen metabolism using protoporphyrin IX-triplet state lifetime technique (PPIX-TSLT) and blood sampling for, among other, metabolomic and immunological analysis, will be performed. The primary outcome is the difference in relative fat mass between the preoperative time point and 6 months postoperatively. Further outcomes comprise longitudinal changes of PPIX-TSLT and metabolic and immunological variables. Outcomes will be assessed using paired t-tests, Wilcoxon signed-rank tests and regression analyses.Ethics and disseminationThe study was approved by the Ethics Committee of Friedrich Schiller University Jena (2018-1192-BO). Written informed consent will be obtained from all patients prior to enrolment in the study. The results will be published in peer-reviewed journals and presented at appropriate conferences.Trial registration numberDRKS00015891.

The role of physical exercise and diet in the treatment of non-alcoholic fatty liver disease.

Non-alcoholic fatty liver disease (NAFLD) is characterized by an accumulation of hepatic fat, diagnosed histologically or radiologically (ultrasound), in the absence of a secondary cause of steatosis, especially alcohol consumption. Its prevalence is estimated to be approximately 25%. This high prevalence is correlated with the risk factors attributed to the metabolic syndrome. Non-alcoholic steatohepatitis (NASH) is a progressive form of NAFL and it can lead to end-stage liver disease in some patients. Once diagnosed, lifestyle changes must be initiated to lower hepatic fat accumulations in the liver. Physical exercise and diet play the most important role in achieving the desired weight loss goal.

Evaluation of the metabolic status and sarcopenia in the long-term period after Roux-en-Y gastric bypass and mini-gastric bypass surgery

INTRODUCTION. Bariatric operations lead to changes in body composition. The desired fat loss may be accompanied by decrease of muscle mass, thus raising the risk of sarcopenia.The OBJECTIVE was to evaluate the long-term results of surgical treatment of morbid obesity and concomitant comorbid conditions, as well as a decrease of muscle mass in the pre - and long-term postoperative period.METHODS AND MATERIALS. This prospective randomized controlled blind trial included the results of treatment of 241 patients. Patients were divided into 2 groups depending on the type of surgical treatment. The first group consisted of 116 people who underwent RYGB; the second group included 125 patients who underwent OAGB/MGB. 83 patients from the first group and 95 patients from the control group at the preoperative stage and 24 months after the operation randomly underwent bioelectrical impedance with the determination of skeletal muscle mass (SMM) and skeletal muscle mass index (SMMI)=SMM/Height2. The calculated SMMI index for men normally corresponds to &gt;10.76 kg/m2; moderate sarcopenia SMMI=8.51–10.75 kg/m2; the SMMI index of ≤8.5 kg/m2 corresponds to severe sarcopenia. For women, this index is normally ≥6.76 kg/m2; moderate – 5.76–6.75 kg/m2; severe sarcopenia ≤5.75 kg/m2. Bioelectrical impedance were performed on a «AVS-01 Medass» bioelectrical impedance body composition analyzer (Russia). RESULTS. The difference in changes in the results of anthropometric indicators, as well as laboratory indicators of diabetes compensation within 24 months in both groups was statistically insignificant (p&gt;0.05). According to bioelectrical impedance data, the incidence of sarcopenia in patient groups was as follows: the initially normal ratio of muscle mass to the square of growth in meters, i.e. normal SMMI in 71 (85.5 %) patients in the group with RYGB, and in 78 (85.7 %) patients in the group with OAGB/MGB. Moderate sarcopenia was detected in 12 (14.5 %) patients with RYGB and 13 (14.3 %) patients with OAGB/MGB. 24 months after the operation, SMMI was distributed as follows – Norm in 59 (71.1 %) patients of the study group and 47 (51.6 %) patients in the control group. Moderate sarcopenia was found in 16 (19.3 %) patients in the group of patients with RYGB, and in 29 (31.9 %) cases in the group of patients with OAGB/MGB. Severe sarcopenia was observed in 8 (9.6 %) patients of the first group and 15 (16.5 %) patients of the second group (p=0.0001).CONCLUSIONS. Bariatric bypass surgery results in significant changes in body composition 24 months after surgery. Bioelectrical impedance allows to effectively detect these changes. The desired weight loss is associated with a significant decrease in skeletal muscle mass, mineral mass. Thus, patients after bypass surgery are at risk of sarcopenia. Sarcopenia is more pronounced in patients after OAGB/MGB than after RYGB.

LigaSure Impact\u2122 reduces complications after abdominoplasty in weight loss patients

PurposeBariatric surgery is on the rise worldwide. With the desired weight loss after bariatric surgery, patients frequently develop massive skin flaps resulting in the need of abdominoplasty. In these patients, this surgical technique is frequently associated with perioperative complications. Strategies to minimize complications are sought after. The objective of our study was to compare two different dissection techniques and their impact on postoperative outcome.MethodsWe included 66 patients in our study who underwent abdominoplasty after massive weight loss following bariatric surgery. In group 1, abdominoplasty was performed using the conventional technique of diathermia (n = 20). In group 2, abdominoplasty was performed using LigaSure Impact™ (n = 46). The duration of the surgical procedure and perioperative complications were recorded as primary endpoints. Secondary endpoints were length of hospital stay and assessment of additional risk factors.ResultsBaseline characteristics were comparable between groups. The duration of surgery was significantly shorter in group 2. Postoperative complications were significantly less frequent in group 2 (p = 0.0035). Additional risk factors, e.g., smoking and diabetes mellitus, were not associated with increased rates of perioperative complications.ConclusionsThe choice of technical device for dissection in abdominoplasty alone will not guarantee minimized complication rates. Yet, the utilization of LigaSure Impact™ in refined surgical techniques may facilitate reduced rates of complications, especially wound infections, and a shortened duration of surgery.

P–787 Impact of delaying ART to promote weight loss: a large multicentre study accounting for the combined effect of female/male age and body mass index (BMI)

Abstract Study question Is postponing the start of ART (to promote a reduction in female BMI) beneficial for cumulative live birth rates (CLBR) when accounting for the female/male ageing this delay will cause? Summary answer Postponing ART treatment in one year to promote female weight loss could be detrimental in women of advanced maternal age (AMA, &amp;gt;35 years-old). What is known already Overweight/obese couples are frequently encouraged to lose weight prior to infertility treatment to enhance ART outcomes. However, a meaningful weight loss is often difficult to achieve for these couples, frequently taking at least one year to accomplish. Given that both female and male ageing are also important for ART success, we were interested in understanding the combined impact on CLBR of BMI reduction and ageing following a one-year delay. Study design, size, duration A retrospective study including patients performing their first ART cycle using autologous gametes between 2013–2018 in one of 39 participating ART centres. Only GnRH antagonist cycles were included (n = 14260). CLBR was the primary outcome. Secondary outcomes included time-to-pregnancy, birthweight and gestational age. Participants/materials, setting, methods Patients were subdivided according to female BMI (Kg/m2) in either underweight (&amp;lt;18.5), normal-weight (18.5–24.9), overweight (BMI 25.0–29.9 kg/m2) and obese (≥30 kg/m2). Meaningful and extreme weight loss were defined as a reduction from obesity to either overweight or normal-weight, respectively. We performed multivariable regression analysis to account for potential confounding. Main results and the role of chance Overweight (36.8%) and obese (33.0%) women had significantly lower CLBR when compared to the underweight (42.6%) and normal-weight (41.4%). When assessing the confounder-adjusted net-effect of male/female age and BMI, the predicted benefit of promoting a meaningful BMI reduction was lower than the estimated hindrance due to male/female ageing as soon as women reached AMA (n = 8365, 58.6%). This absence of benefit was especially important in women &amp;gt;38 years-old, in which even extreme weight-loss did not compensate for the age-related reduction in CLBR caused by the one-year delay. Moreover, male weight-loss failed to provide any additional benefit when accounted for in the regression models. Finally, obesity was also associated with a modest but statistically significant one-month delay in time-to-pregnancy and a 96.1 g (95% confidence interval: 39.9–152.4) increase in birth weight. The diagram of predicted outcomes presented in this study may serve as a useful tool to counsel patients before treatment, namely when recommending treatment postponement to promote short-term (i.e. 3–6 months) or long-term (i.e. 1 year) weight loss. Limitations, reasons for caution Caution is recommended when extrapolating these results into everyday practice owing to the retrospective nature of the study and the fact that only GnRH antagonist cycles were included. Wider implications of the findings: Patients are frequently confronted with the dilemma to either postpone treatment (and promote weight loss) or start treatment immediately (to avoid further ageing). Our results seem to show that women in AMA may have hindered CLBR if recommended to delay treatment even if the desired weight loss is ultimately achieved. Trial registration number Not applicable

What do gynecologic cancer survivors desire in a survivorship program?

Objectives: This study aims to assess the concerns and quality of life (QOL) of women treated for gynecologic cancers who were invited to participate in a survivorship program. The primary objective is to identify components of a survivorship program that would be most useful for survivors of gynecologic malignancies. Methods: This is a quality improvement initiative. Women diagnosed and treated for a gynecologic malignancy at our cancer center in 2018 were asked to participate in a survivorship survey by mail between 1/2019 and 3/2019. Additionally, women attending an inperson survivorship visit between 12/2019 and 10/2020 were asked to participate at their first visit. All data was self-reported including cross-sectional data on demographics, treatment and current symptoms. Patients’ concerns and desires for assistance were assessed using a 5-point Likert scale with 0=not helpful/no concern to 4=extremely helpful/very concerning. QOL was assessed with the Functional Assessment of Cancer Therapy (FACT-G). Descriptive statistics were performed. Results: A total of 92 women completed the survey, representing a 57% response rate. A total of 41 (45.5%) patients had uterine cancer, 40 (44.4%) had ovarian/fallopian tube/primary peritoneal cancer, and 10 (11.1%) had a lower genital tract cancer (cervical, vulvar, vaginal). A total of 83 (95.4%) of patients received initial surgery and 61 (67.8%) received adjuvant chemotherapy and/or radiation therapy with a mean time from treatment completion to survey administration of 6.0 + 7.6 months. The mean age was 61 years old + 11 years. Women with lower genital tract cancers were significantly younger than the women with uterine and ovarian cancer, respectively (50y + 10y vs. 64y + 10y vs. 61y + 12y, p 60 years old. The top 5 most-desired survivorship components included: instruction in nutrition (35%), assistance with weight loss (30%), stress reduction (27%), fatigue reduction (27%), and improved long-term side effects (24%). A total of 15% of respondents desired components focused on anxiety treatment, and less than 10% desired help with sleep, relationships, sex life, and finances. Uterine cancer survivors were more likely to desire weight loss assistance versus non-uterine survivors (37% vs 24%, p=0.05). Patients with lower genital tract cancers desired assistance with relationships more frequently when compared to uterine and ovarian groups, respectively (11% vs 5% vs 3%, p Download : Download high-res image (130KB) Download : Download full-size image Conclusions: Survivors of gynecologic cancer desire nutrition, weight loss, and stress reduction as part of their survivorship programs. Further research should be done to assess patient preferences for survivorship program content and consider age and disease type preferences to optimize personalized participation.

Traditional weight loss and dukan diets as to nutritional and laboratory results

Traditional weight loss and dukan diets as to nutritional and laboratory results

Understanding outcomes in family-based treatment for adolescent anorexia nervosa: a network approach.

Family-based treatment (FBT) is the first-line treatment for adolescent anorexia nervosa (AN). Yet, remission is not achieved for about half of adolescents with AN receiving FBT. Understanding patient- and parent-level factors that predict FBT response may inform treatment development and improve outcomes. Network analysis was used to identify the most central symptoms of AN in adolescents who completed the Eating Disorder Examination (EDE) prior to FBT (N = 409). Bridge pathways between adolescent AN and parental self-efficacy in facilitating their child's recovery from AN were identified in a subset of participants (n = 184). Central and bridge symptoms were tested as predictors of early response (⩾2.4 kg weight gain by the fourth session of FBT) and end-of-treatment weight restoration [⩾95% expected body weight (EBW)] and full remission (⩾95% EBW and EDE score within 1 standard deviation of norms). The most central symptoms of adolescent AN included desiring weight loss, dietary restraint, and feeling fat. These symptoms predicted early response, but not end-of-treatment outcomes. Bridge symptoms were parental beliefs about their responsibility to renourish their child, adolescent discomfort eating in front of others, and adolescent dietary restraint. Bridge symptoms predicted end-of-treatment weight restoration, but not early response nor full remission. Findings highlight the prognostic utility of core symptoms of adolescent AN. Parent beliefs about their responsibility to renourish their child may maintain associations between parental self-efficacy and AN psychopathology. These findings could inform strategies to adapt FBT and improve outcomes.

6 voces en 10 minutos: Estrategias para prevenir reganancia de peso

6 voces en 10 minutos: Estrategias para el descenso de peso en personas con diabetes mellitus tipo 2 Estrategias para prevenir reganancia de pesoEl éxito a largo plazo de los procedimientos bariátricos depende tanto de factores técnicos como de factores clínicos, motivacionales y comportamentales.Si bien la cirugía bariátrica-metabólica es una herramienta eficaz en el arsenal terapéutico de la obesidad, la diabetes y de otras enfermedades crónicas, el 20-30% de los pacientes muestran resultados subóptimos, que incluyen no alcanzar la pérdida de peso deseada o recuperar peso. El mayor desafío es adoptar los cambios requeridos en el estilo de vida. El mantenimiento exitoso del peso se asocia con un ritmo regular de comidas, incluyendo el desayuno, un estilo de vida físicamente activo y mayor autocontrol de los comportamientos.

Annals for Educators - 18 August 2020.

Annals for Educators - 18 August 2020.