Greater Reduction In BMI Research Articles

Nutritional Gender-Specific Differences in Head and Neck Cancer Patients Treated with (Chemo)Radiotherapy: Results from a Prospective Trial.

Background/Objectives: This analysis aims to evaluate gender-specific differences in nutritional status, body weight changes, and their impact on overall survival (OS) in head and neck cancer (HNC) patients undergoing (chemo)radiotherapy (CRT). Methods: Between 2018 and 2020, 61 HNC (17 female and 44 male) patients were prospectively recruited to receive curative (chemo)radiotherapy. Nutritional assessments included dietary questionnaire screenings and records, anthropometric methods (body mass index, BMI, body composition via bioelectrical impedance analysis (BIA)), and the determination of biomarkers like albumin and CRP. Assessments were conducted before, during, and after (chemo)radiotherapy. Results: Gender differences were observed at baseline in Karnofsky performance status (p = 0.01), daily calorie intake (p = 0.04), phase angle (PA) (p = 0.003), and fat-free mass index (FFMI) (p < 0.001). During CRT, males showed a larger increase in calorie deficit (p < 0.001) and greater reductions in BMI, FFMI, and PA compared to females. Malnutrition risk (MUST score) increased significantly in males (p = 0.008) but not in females. Albumin and total protein declined in both genders, with a more pronounced drop in albumin for females. Survival analysis revealed that, for males, several factors, including baseline calorie deficit, BMI, PA, and FFMI, were linked to survival. For females, only albumin at therapy end was significantly associated with survival (p < 0.001). In multivariable analysis, baseline PA remained a significant predictor of survival for males (p = 0.026). Conclusions: Our findings suggest distinct gender differences in the nutritional and biochemical responses of HNC patients undergoing CRT, indicating the importance of tailored, gender-specific nutritional support during treatment.

Liraglutide for Children 6 to

No medications are currently approved for the treatment of nonmonogenic, nonsyndromic obesity in children younger than 12 years of age. Although the use of liraglutide has been shown to induce weight loss in adults and adolescents with obesity, its safety and efficacy have not been established in children. In this phase 3a trial, which consisted of a 56-week treatment period and a 26-week follow-up period,we randomly assigned children (6 to <12 years of age) with obesity, in a 2:1 ratio, to receive either once-daily subcutaneous liraglutide at a dose of 3.0 mg (or the maximum tolerated dose) or placebo, plus lifestyle interventions. The primary end point was the percentage change in the body-mass index (BMI; the weight in kilograms divided by the square of the height in meters). The confirmatory secondary end points were the percentage change in body weight and a reduction in BMI of at least 5%. A total of 82 participants underwent randomization; 56 were assigned to the liraglutide group and 26 to the placebo group. At week 56, the mean percentage change from baseline in BMI was -5.8% with liraglutide and 1.6% with placebo, representing an estimated difference of -7.4 percentage points (95% confidence interval [CI], -11.6 to -3.2; P<0.001). The mean percentage change in body weight was 1.6% with liraglutide and 10.0% with placebo, representing an estimated difference of -8.4 percentage points (95% CI, -13.4 to -3.3; P = 0.001), and a reduction in BMI of at least 5% occurred in 46% of participants in the liraglutide group and in 9% of participants in the placebo group (adjusted odds ratio, 6.3 [95% CI, 1.4 to 28.8]; P = 0.02). Adverse events occurred in 89% and 88% of participants in the liraglutide and placebo groups, respectively. Gastrointestinal adverse events were more common in the liraglutide group (80% vs. 54%); serious adverse events were reported in 12% and 8% of participants in the liraglutide and placebo groups, respectively. Among children (6 to <12 years of age) with obesity, treatment with liraglutide for 56 weeks plus lifestyle interventions resulted in a greater reduction in BMI than placebo plus lifestyle interventions. (Funded by Novo Nordisk; SCALE Kids ClinicalTrials.gov number, NCT04775082.).

SP9.13 - Influence of Gastrojejunostomy Diameter on Weight Reduction Following Roux-En-Y Gastric Bypass Surgery

Abstract Introduction The debate on whether the diameter of the gastrojejunostomy in Roux-En-Y Gastric Bypass (RYGB) affects long-term weight loss was addressed in this study by comparing outcomes between two different anastomosis diameters. Methods This retrospective study analysed primary RYGB performed from January 2017 to July 2021, comparing 30mm and 45mm gastrojejunostomy diameters. Weight loss was assessed at 12, 24, and 60 months post-operatively. Results Of the 1,081 patients who had RYGB, 79.6% were female, with a median age of 48 (IQR 40-55). The median starting BMI was 44.6 Kg/m2 (IQR: 40.4-50.1). The 30mm group comprised 36.6% (396/1,081) of the participants. There were no notable differences in baseline demographics such as gender, age, ASA classification, and medical history between the groups. At the 12-month follow-up, the average BMI reduction was 12.8 Kg/m2 (IQR: 9.3-17.9), with no significant differences between the 30mm (median: 13.0 Kg/, IQR: 9.4-23.5) and 45mm groups (median: 12.6 Kg/m2, IQR: 9.1-16.9, p=0.053). At 24 months, the BMI reduction was more substantial in the 30mm group (median: -16.2 Kg/m2, IQR: 11.6-40.5) than in the 45mm group (median: -15.3 Kg/m2, IQR: 10.0-35.6, p=0.006). A greater divergence was observed at 60 months, with the 30mm group showing more weight loss (median: -17.2, IQR: 11.3-31.1) compared to the 45mm group (median: -15.8, IQR: 11.9-28.3, p=0.003). Conclusion A smaller gastrojejunostomy diameter of 30mm is linked with greater BMI reduction up to five years post-RYGB. Further study is necessary to evaluate the anastomosis size's impact on long-term weight maintenance and regain.

Different intensities of aerobic training for patients with type 2 diabetes mellitus and knee osteoarthritis: a randomized controlled trial.

The purpose of this study was to compare different intensities of aerobic exercise for patients with knee osteoarthritis (KOA) and type 2 diabetes mellitus (T2DM) in terms of glycemic control, pain relief, and functional outcomes. A prospective randomized open-label parallel multicenter clinical trial conducted at two hospitals in Shanghai and Sichuan that included 228 patients with type 2 diabetes mellitus (T2DM) and knee osteoarthritis (KOA). Enrollment occurred between January 2021 and February 2023, and follow-up was completed in September 2023. Participants were randomized to threshold training/high-intensive stationary cycling training (n=76), intensive endurance/moderate-intensive stationary cycling training (n=77), and regular rehabilitation programs (n=75). The primary outcome at the 6-month follow-up was the HbA1c level. Key secondary outcomes included the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscale of pain and quality of life. Of 228 patients, 212 (93%) completed the trial. The mean adjusted (sex, baseline BMI, and baseline outcome measures) HbA1c level at the 6-month follow-up decreased significantly in the high-intensive training group compared with other groups (high-intensity group vs. control group; difference, 0.51%, 95% confidence interval, 0.05% to 1.15%). Mean KOOS subscales of pain and quality of life were statistically significantly different between the control group and moderate-intensity or high-intensity groups, but no statistical differences were noted between the different intensities of aerobic exercise. Patients in all groups achieved a greater reduction in BMI but no significant differences were observed between groups. In KOA and T2DM patients, high-intensity stationary cycling can significantly improve glycemic control compared with moderate-intensity and regular rehabilitation programs. However, high-intensity stationary cycling does not exert a superior effect on pain relief and functional improvement for KOA compared with moderate-intensity and regular rehabilitation programs.

Laser Acupuncture versus Liraglutide in Treatment of Obesity: A Multi-Institutional Retrospective Cohort Study.

Obesity is a global concern, driving the search for alternative treatments beyond lifestyle changes and medications. Laser acupuncture (LA) shows promise in obesity management, yet few studies compare it with FDA-approved medications. This study aimed to assess and compare LA's impact with liraglutide on weight reduction in obese individuals. Data from the Chang Gung Research Database (CGRD) (2013-2018) were analyzed. Primary outcomes included changes in body weight and BMI within 180 days, with secondary outcomes measuring the proportion achieving 5%, 10%, and 15% weight loss. Adverse events were also assessed. Of 745 subjects (173 LA users, 572 liraglutide users), LA users lost more weight by day 180 (5.82 ± 4.39 vs. 2.38 ± 5.75 kg; p < 0.001) and had a greater BMI reduction (-2.27 ± 1.73 vs. -0.93 ± 2.25 kg/m2; p < 0.001). More LA users achieved 5% and 10% weight loss compared to liraglutide users (64.2% vs. 22.7%, 26.6% vs. 4.2%; all p < 0.001). After balancing baseline differences, LA's benefits remained significant. No adverse events were reported with LA. LA may offer superior weight reduction compared to liraglutide. Future studies should explore LA alone or in combination with liraglutide for obesity management.

Financial Incentives and Treatment Outcomes in Adolescents With Severe Obesity

Adolescent severe obesity is usually not effectively treated with traditional lifestyle modification therapy. Meal replacement therapy (MRT) shows short-term efficacy for body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) reduction in adolescents, and financial incentives (FIs) may be an appropriate adjunct intervention to enhance long-term efficacy. To evaluate the effect of MRT plus FIs vs MRT alone on BMI, body fat, and cardiometabolic risk factors in adolescents with severe obesity. This was a randomized clinical trial of MRT plus FIs vs MRT alone at a large academic health center in the Midwest conducted from 2018 to 2022. Participants were adolescents (ages 13-17 y) with severe obesity (≥120% of the 95th BMI percentile based on sex and age or ≥35 BMI, whichever was lower) who were unaware of the FI component of the trial until they were randomized to MRT plus FIs or until the end of the trial. Study staff members collecting clinical measures were blinded to treatment condition. Data were analyzed from March 2022 to February 2024. MRT included provision of preportioned, calorie-controlled meals (~1200 kcals/d). In the MRT plus FI group, incentives were provided based on reduction in body weight from baseline. The primary end point was mean BMI percentage change from randomization to 52 weeks. Secondary end points included total body fat and cardiometabolic risk factors: blood pressure, triglyceride to high-density lipoprotein ratio, heart rate variability, and arterial stiffness. Cost-effectiveness was additionally evaluated. Safety was assessed through monthly adverse event monitoring and frequent assessment of unhealthy weight-control behaviors. Among 126 adolescents with severe obesity (73 female [57.9%]; mean [SD] age, 15.3 [1.2] years), 63 participants received MRT plus FIs and 63 participants received only MRT. At 52 weeks, the mean BMI reduction was greater by -5.9 percentage points (95% CI, -9.9 to -1.9 percentage points; P = .004) in the MRT plus FI compared with the MRT group. The MRT plus FI group had a greater reduction in mean total body fat mass by -4.8 kg (95% CI, -9.1 to -0.6 kg; P = .03) and was cost-effective (incremental cost-effectiveness ratio, $39 178 per quality-adjusted life year) compared with MRT alone. There were no significant differences in cardiometabolic risk factors or unhealthy weight-control behaviors between groups. In this study, adding FIs to MRT resulted in greater reductions in BMI and total body fat in adolescents with severe obesity without increased unhealthy weight-control behaviors. FIs were cost-effective and possibly promoted adherence to health behaviors. ClinicalTrials.gov Identifier: NCT03137433.

Effects of Lacticaseibacillus rhamnosus HA-114 probiotic supplementation on circulating IGFBP-2 levels during a calorie-restricted diet in overweight humans

Background and aimGut microbiota influences energy homeostasis in part through circulating hormones. Insulin-like growth factor-binding protein (IGFBP)-2 is a biomarker whose increase in systemic circulation is associated with positive effects on body weight and metabolism. In a recent clinical trial, probiotic Lacticaseibacillus rhamnosus HA-114 supplementation showed positive effects on eating behaviors and insulin resistance in overweight participants undergoing a weight-loss intervention. In this context, this ancillary study aimed at assessing the impact of L. rhamnosus HA-114 supplementation on plasma IGFBP-2 levels in these individuals, and whether this modulation correlated with changes in fat mass, energy metabolism, and eating behaviors. MethodsFasting plasma IGFBP-2 concentrations were quantified in 100 overweight or obese men and women enrolled in a 12-week diet-based weight reduction program (−500 kcal/day), in combination with probiotic L. rhamnosus HA-114 or placebo supplementation. Baseline and changes in circulating IGFBP-2 concentrations were correlated with anthropometric parameter, glucose and lipid metabolism, cardiorespiratory function and eating behaviors. ResultsOn average, the intervention reduced BMI by 4.6 % and increased IGFBP-2 by 13 %, regardless of supplementation group. Individuals who presented an increase in IGFBP-2 levels had significantly greater reductions in BMI. Changes in IGFBP-2 levels were correlated with loss in fat mass (r = 0.2, p < 0.001) in the probiotic-supplemented group, but not with other metabolic parameters or eating behaviors. Baseline IGFBP-2 levels were not associated with weight loss or improvements in cardiometabolic parameters. ConclusionProbiotic supplementation with L. rhamnosus HA-114 did not modulate plasma IGFBP-2 levels. Changes in IGFBP-2 levels were correlated with greater reductions in BMI, but not with other metabolic parameters or eating behaviors, indicating that the benefits of HA-114 on eating behaviors are likely independent of IGFBP-2. Additional changes in microbiota might be required to modulate IGFBP-2 and observe its associations with eating behaviors and cardiometabolic improvements.

Impact of the motivational interviewing for childhood obesity treatment: The Obemat2.0 randomized clinical trial.

The aim was assessing a short training for healthcare providers on patient-focused counselling to treat childhood obesity in primary care, along with dietitian-led workshops and educational materials. Randomized clustered trial conducted with paediatrician-nurse pairs (Basic Care Units [BCU]) in primary care centres from Tarragona (Spain). BCUs were randomized to intervention (MI) (motivational interview, dietitian-led education, and educational materials) or control group (SC, standard care). Participants were 8-14-year-old children with obesity, undergoing 1-11 monthly treatment visits during 1 year at primary care centres. The primary outcome was BMI z-score reduction. The study included 44 clusters (23 MI). Out of 303 allocated children, 201 (n = 106 MI) completed baseline, final visits, and at least one treatment visit and were included in the analysis. BMI z-score reduction was -0.27 (±0.31) in SC, versus -0.36 (±0.35) in MI (p = 0.036). Mixed models with centres as random effects showed greater reductions in BMI in MI than SC; differences were B = -0.11 (95% CI: -0.20, -0.01, p = 0.025) for BMI z-score, and B = -2.06 (95% CI: -3.89, -0.23, p = 0.028) for BMI %. No severe adverse events related to the study were notified. Training primary care professionals on motivational interviewing supported by dietitians and educational materials, enhanced the efficacy of childhood obesity therapy.

Exposure to 4,4'-DDE in visceral adipose tissue and weight loss in adolescents from the Teen-LABS cohort.

Dichlorodiphenyldichloroethylene (DDE), an obesogen accumulating in adipose tissue, is released into circulation with weight loss, although its impact is underexplored among adolescents. We tested the association using an integrative translational approach of epidemiological analysis among adolescents with obesity and in vitro measures exploring the impact of DDE on adipogenesis via preadipocytes. We included 63 participants from the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) cohort. We assessed 4,4'-DDE in visceral adipose tissue at surgery and BMI and waist circumference at surgery and 0.5, 1, 3, and 5 years after. We conducted longitudinal analysis to estimate the interaction on weight loss between DDE and time since surgery. In vitro analysis quantified adipogenic differentiation in commercial human preadipocytes exposed to 4,4'-DDE via fluorescent staining and imaging. A dose-response relationship was observed, with the low-exposure group having a greater reduction in BMI during the first year compared to higher-exposure groups and showing smaller regains compared to higher-exposure groups after the first year. In vitro analysis of preadipocytes treated with 4,4'-DDE during adipogenic differentiation for 12 days showed a concentration-dependent increase in lipid accumulation. DDE could contribute to weight trajectory among adolescents undergoing bariatric surgery, potentially mediated via promoted adipogenesis in preadipocytes.

Durability of Effectiveness Between Users of Once-Weekly Semaglutide and Dipeptidyl Peptidase4 Inhibitors (DPP-4i) in US Adults with Type2 Diabetes.

Long-term effectiveness and durability of glucose-lowering medications are important considerations in managing type2 diabetes (T2D). This study aimed to compare durability of treatment efficacy of once-weekly (OW) semaglutide for T2D with that of the dipeptidyl peptidase4 inhibitor (DPP-4i) class. This observational cohort study used 2017-2022 data from the Optum® Clinformatics® Data Mart to compare long-term clinical outcomes associated with semaglutide or DPP-4i in US adults with T2D. The primary outcomes were HbA1c at 2-year follow-up, change in HbA1c from baseline, and the odds of achieving HbA1c targets. BMI at 2-year follow-up, change in BMI from baseline, odds of reducing BMI category, and the need for treatment augmentation were exploratory outcomes. Bivariate and multivariate analyses were conducted using inverse probability of treatment weighting (IPTW) weighted descriptive statistics. Weighted HbA1c and BMI cohorts included 865 and 642 semaglutide users and 779 and 537 DPP-4i users, respectively. In the weighted HbA1c cohort, semaglutide and DPP-4i users had an average age of 60years and similar baseline characteristics including HbA1c level and comorbidity status. Two-year follow-up HbA1c with semaglutide was 0.56% lower than with DPP-4i; reduction in HbA1c from baseline was 0.61% greater. Odds of achieving HbA1c level < 7% were 2.16 times greater after covariate adjustment (all, p < 0.001). Semaglutide was associated with 1.03kg/m2 greater reduction in BMI and 2.27 times greater odds of reducing BMI category vs DPP-4i (p < 0.001). Semaglutide users were less likely to add new glucose-lowering treatment (hazard ratio [HR] 0.57; p < 0.001) or initiate insulin (HR 0.49; p < 0.001) vs DPP-4i users. Compared with DPP-4i, semaglutide was associated with lower follow-up HbA1c and BMI, greater reduction in HbA1c and BMI from baseline, and reduced likelihood of requiring treatment augmentation or insulin initiation to manage T2D in US adults, suggesting better durability of semaglutide vs DPP-4i. INFOGRAPHIC.

1073 Roux-en-Y Gastric Bypass or Sleeve Gastrectomy Versus Medical Therapy in the Management of Obesity in Patients with Type 2 Diabetes Mellitus: Systematic Review and Meta-Analysis

Abstract Aim Bariatric Surgery has proven to be effective in achieving diabetic control in morbidly obese patients. Advances in Roux-En-Y Gastric Bypass (RYGB) and Sleeve gastrectomy procedures have influenced this majorly. This review aims to analyse the clinical outcomes by comparing the two procedures and medical therapy, in morbidly obese patients with Type 2 Diabetes Mellitus (T2DM). Method A systematic literature review was conducted in accordance to the PRISMA guidelines to identify relevant articles that compared RYGB, sleeve gastrectomy and medical therapy for obesity in diabetic patients. Primary outcomes included BMI and HbA1c. Results Seven studies were identified enrolling 900 patients. Participants were predominantly female (61.31%) with a mean follow up of 2.71 years. A greater reduction in BMI and HbA1c was noted with both procedures compared to medical therapy. Sleeve gastrectomy was better in reducing BMI than RYGB (SMD = 19.23 [15.61 – 22.84], p&amp;lt;0.01). HbA1c (SMD = -2.37 [-2.72 – -2.02], p&amp;lt;0.01) and Triglycerides (SMD = -0.87 [-1.65 – -0.08], p = 0.03) were statistically significantly in favour of RYGB. No differences were noted between the two procedures in other outcomes including fasting glucose, weight and Blood pressure. Both procedures compared to medical therapy were considered to be superior statistically across all outcomes measured. Conclusions Overall, the study shows the superiority of Bariatric surgery to medical therapy in managing T2DM in obese patients. No significant differences were noted between the types of bariatric surgery, however, there exists a need to perform studies with longer follow up and compare the feasibility of these procedures.

Comparison of the Effect of a Low-Carbohydrate Diet with a Low-Fat Diet on Anthropometric Indices and Body Fat Percentage: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background: Although many studies have been conducted to compare the effect of adherence to a low-carbohydrate diet (LCD) with a low-fat diet (LFD) on anthropometric indices and body fat percentage, there is still no definite conclusion in this regard. Therefore, the present study aims to summarize results of studies comparing a LFD and a LCD on weight loss.&#x0D; Methods: A systematic search of databases including PubMed, Scopus, and Cochran Library was performed up to November 2020. All randomized controlled trials (RCTs) comparing the effect of adherence to a LCD with a LFD on anthropometric indices and body fat percentage were included. Search results were limited to English-language publications. Sixty-three RCTs, including 7660 participants, were selected for the present study.&#x0D; Results: Pooled analysis indicated that adherence to LCD was significantly associated with a greater reduction in BMI (SMD = - 0.07, 95% CI: -0.14,-0.001; P = 0.04), weight (kg) (SMD = - 0.22, 95% CI: - 0.31, - 0.12; P ≤ 0.001), and percentage of body fat mass (SMD = - 0.28, 95% CI: -0.48, - 0.08; P = 0.006) compared to LFD. However, no significant difference in changes of kilogram of body fat mass and waist circumference was observed between the two diet programs.&#x0D; Conclusion: Overall, adhering to LCD was more effective than LFD in losing weight and body fat percentage.

1246-P: Magnitude of Intentional Weight Reduction and Associated Clinical Outcomes

Purpose: To describe the association of BMI reduction with clinical outcomes (medication utilization, HbA1c, and blood pressure) in adults undergoing medical intervention for weight reduction. Methods: Optum’s Market Clarity database (Study Period: 2007-2020) was used to identify adults with overweight/obesity with a medical intervention for weight reduction (surgery, procedure, anti-obesity medication, or lifestyle) whose weight after a 3-year period was less than or equal to their pre-intervention weight (date of weight: index). Patients were grouped by percent BMI change (Figure 1). Outcomes included change in 6-month pre-index versus 6-month follow-up (starting after the 3-year period) for HbA1c and blood pressure in patients with measures in both periods, and change in condition-specific pharmacy utilization for patients with the condition during pre-index. Results: There were n=127,267 patients meeting study criteria. Mean Rx utilization during follow-up decreased (relative to pre-index) as BMI reduction increased, (p&amp;lt;0.001; Figure 1a-1c) with groups achieving ≥15% BMI reduction having lower mean utilization in follow-up versus pre-index. Greater BMI reduction was also associated with improvements in HbA1c and blood pressure (p&amp;lt;0.001; Figure 1d-1f). Conclusions: Higher BMI reduction groups had greater mean improvements in clinical measures while mean medication utilization decreased. Disclosure H.Kan: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. J.P.Dunn: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. L.Bengtson: Other Relationship; Eli Lilly and Company. N.Ahmad: Employee; Eli Lilly and Company. J.P.Bae: None. N.Gronroos: Other Relationship; Eli Lilly and Company. C.Landis: Other Relationship; Eli Lilly and Company. C.Chinthammit: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. A.H.Owora: None. N.A.Gletsu miller: Research Support; Lilly.

Blood Group and Response to Bariatric Surgery in Morbidly Obese Patients: A Retrospective Study in Saudi Arabia.

To explore the relationship between the blood group of patients and their response to bariatric surgery and to identify predictors of better outcomes. This was a retrospective cross-sectional analysis of patients who underwent laparoscopic sleeve gastrectomy for morbid obesity between 2014 and 2020 at King Saud University Medical City in Riyadh, Saudi Arabia. This study included 1434 individuals. The mean change in BMI (pre- versus post-BMI) differed statistically significantly between blood groups (p ≤ 0.01). The greatest drop in body weight was seen in individuals with the AB-negative blood type (56.0 (21.4) kg), which corresponds to the greatest percentage of reduction from baseline (47.7% (14.8)). The mean BMI of the patients decreased by 34.7% (9.2) from a mean pre-operation BMI of 45.5 (8.4) kg/m2 to 29.7 (6.1) kg/m2 (p ≤ 0.001). After laparoscopic sleeve gastrectomy, male patients and those with the B-negative blood type are more likely to see a greater BMI reduction (pre-operation compared to post-operation) (p ≤ 0.05). For morbidly obese patients, laparoscopic sleeve gastrectomy demonstrated promising weight loss outcomes. Blood groups may be able to predict the success rate of bariatric surgery in morbidly obese patients.

Once-Weekly Semaglutide in Adolescents with Obesity

BackgroundA once-weekly, 2.4-mg dose of subcutaneous semaglutide, a glucagon-like peptide-1 receptor agonist, is used to treat obesity in adults, but assessment of the drug in adolescents has been lacking.MethodsIn this double-blind, parallel-group, randomized, placebo-controlled trial, we enrolled adolescents (12 to <18 years of age) with obesity (a body-mass index [BMI] in the 95th percentile or higher) or with overweight (a BMI in the 85th percentile or higher) and at least one weight-related coexisting condition. Participants were randomly assigned in a 2:1 ratio to receive once-weekly subcutaneous semaglutide (at a dose of 2.4 mg) or placebo for 68 weeks, plus lifestyle intervention. The primary end point was the percentage change in BMI from baseline to week 68; the secondary confirmatory end point was weight loss of at least 5% at week 68.ResultsA total of 201 participants underwent randomization, and 180 (90%) completed treatment. All but one of the participants had obesity. The mean change in BMI from baseline to week 68 was −16.1% with semaglutide and 0.6% with placebo (estimated difference, −16.7 percentage points; 95% confidence interval [CI], −20.3 to −13.2; P<0.001). At week 68, a total of 95 of 131 participants (73%) in the semaglutide group had weight loss of 5% or more, as compared with 11 of 62 participants (18%) in the placebo group (estimated odds ratio, 14.0; 95% CI, 6.3 to 31.0; P<0.001). Reductions in body weight and improvement with respect to cardiometabolic risk factors (waist circumference and levels of glycated hemoglobin, lipids [except high-density lipoprotein cholesterol], and alanine aminotransferase) were greater with semaglutide than with placebo. The incidence of gastrointestinal adverse events was greater with semaglutide than with placebo (62% vs. 42%). Five participants (4%) in the semaglutide group and no participants in the placebo group had cholelithiasis. Serious adverse events were reported in 15 of 133 participants (11%) in the semaglutide group and in 6 of 67 participants (9%) in the placebo group.ConclusionsAmong adolescents with obesity, once-weekly treatment with a 2.4-mg dose of semaglutide plus lifestyle intervention resulted in a greater reduction in BMI than lifestyle intervention alone. (Funded by Novo Nordisk; STEP TEENS ClinicalTrials.gov number, NCT04102189.)

Use of Information and Communication Technologies among Adults in Weight Control: Systematic Review and Meta-Analysis.

Information and communication technologies are part of our day-to-day life in the execution of all activities, including health care. However, it is not known how much the use of technologies can contribute to the adoption of healthy lifestyle habits. Thus, the objective of this study was to analyze whether the use of information and communication technologies contributes to weight control among adults when compared to the traditional approach method. The search was performed in November 2021 in eight electronic databases in addition to gray literature bases. The quality of the studies was assessed using the Cochrane risk of bias tool. The standardized mean difference was used for the meta-analytic measurement using the random effects model using the Dersimonian-Laid method in the Stata statistical package version 17. The body mass index of the intervention group decreased by an average of 0.56 (95% CI: -0.83; -0.30) when compared to the control group. When comparing the before and after groups, the intervention group also had a greater reduction in BMI (summarized mean: -0.83; 95% CI: -1.40; -0.26). Information and communication technologies contribute to the reduction of the body mass index in the adult population when compared to the traditional model of monitoring. Prospero registration: number 42020186340.

Volunteers: An Effective Medium for Delivering Therapeutic Lifestyle Interventions.

Lifestyle modification programs have been shown to effectively treat chronic disease. The Coronary Health Improvement Program has been delivered by both paid professional and unpaid volunteer facilitators. This study compared participant outcomes of each mode in the United States. Pre-/post-analysis of CHIP interventions delivered between 1999 and 2012. Professional-delivered programs in Rockford Illinois 1999-2004 and volunteer-delivered programs across North America 2005-2012. Adults ≥21 years (professional programs N = 3158 34.3% men, mean age = 54.0 ± 11.4 years; volunteer programs N = 7115 33.4% men, mean age = 57.4 ± 13.0 years). Body mass index, blood pressure (systolic and diastolic), blood lipid profile (total cholesterol, high-density lipoprotein, triglycerides, low-density lipoprotein), and fasting plasma glucose. Analysis of Covariance, with adjustment for age, gender, BMI change and baseline biometric and effect sizes. The professional-delivered programs achieved significantly greater reductions in BMI (.4%, P < .001) and HDL (1.9%, P < .001) and the volunteer-delivered programs achieved greater reductions in SBP (1.4%, P < .001), DBP (1.1%, P < .001), TC (1.4%, P = .004), LDL (2.3%, P < .001), TG (4.0%, P = .006), and FPG (2.7%, P < .001). However, the effect size differences between the groups were minimal (Cohen's d .1-.2). Lifestyle modification programs have been shown to effectively treat chronic disease. The Complete Health Improvement Program (CHIP) lifestyle intervention has been delivered by both paid professional and unpaid volunteer facilitators. This study compared selected chronic disease biometric outcomes of participants in each mode in the United States. It found volunteer-delivered programs do not appear to be any less effective than programs delivered by paid professionals, which is noteworthy as volunteers may provide important social capital in the combat of chronic disease.

Longitudinal association between adiposity measures and regression of prediabetes/diabetes

Background and aimsThe recent COVID-19 pandemic has further increased the importance of reducing obesity and prediabetes/diabetes. We aimed to evaluate the association between adiposity and regression of prediabetes/diabetes. Methods and resultsThe San Juan Overweight Adults Longitudinal Study (SOALS) included 1351 individuals with overweight/obesity, aged 40–65, free of major cardiovascular diseases and physician diagnosed diabetes. From the 1012 participants with baseline prediabetes/diabetes, 598 who completed the follow-up were included. Over the follow-up, 25% regressed from prediabetes to normoglycemia or from diabetes to prediabetes or normoglycemia. Poisson regression with robust standard error was used to estimate the relative risk (RR) adjusting for major confounders. Higher neck circumference (NC) was associated with regression of prediabetes/diabetes (RR = 0.45 comparing extreme tertiles; 95% CI:0.30–0.66); RR was 0.49 (95% CI:0.34–0.73) for waist circumference (WC) and 0.64 (95% CI:0.44–0.92) for BMI. Significant associations were found using median cut-offs or continuous measures for weight and BMI. Greater reduction in BMI (comparing extreme tertiles) was significantly associated with regression of prediabetes/diabetes (RR = 1.44; 95% CI:1.02–2.02). Continuous measures of change in adiposity (except for NC) were also associated with regression of prediabetes/diabetes for BMI and weight. Participants who reduced BMI (>5%) increased prediabetes/diabetes regression (RR = 1.61; 95% CI:1.15–2.25) compared to those who did not; similarly for weight (RR = 1.55; 95% CI: 1.10–2.19). Additional analysis for body fat percentage showing slightly weaker results than BMI/weight further supported our findings. ConclusionLower baseline adiposity and higher reduction in adiposity were associated with regression of prediabetes/diabetes among individuals with overweight/obesity.

1226-P: Three Year Outcomes after Metabolic Surgery or Medical/Lifestyle Intervention: The ARMMS-T2D Trial

There is limited Level-1 evidence from well-powered randomized controlled trials (RCTs) examining improved glycemic control after metabolic surgery in patients with type 2 diabetes (T2D) and obesity. ARMMS-T2D is a multi-center consortium conducting a follow-up study of 4 merged RCTs in 256 patients with baseline Class 1-3 obesity and T2D, randomly assigned to metabolic surgery (MS; Roux-en-Y gastric bypass, sleeve gastrectomy, or gastric banding) or intensive Medical/Lifestyle Intervention (MLI). Three years after randomization, T2D remission rates were higher after MS than MLI (37.5%, 60/160 vs. 2.6%, 2/76, respectively, P&amp;lt;0.001). Adjusting for treatment allocation, baseline HbA1c, and T2D duration, the probability of remission with MS was 41.6% (95% CI, 29.6-58.3%) compared to 1% (95% CI, 0.2-4.0%) with MLI (P&amp;lt;0.001). MS patients experienced greater reductions than MLI in HbA1c (-1.9±2.0 vs. -0.1±2.0%, P&amp;lt;0.001) and fasting plasma glucose ( -52 [-105, 5] vs. -12 [-48, 26] mg/dL, P&amp;lt;0.001). Compared to MLI, MS patients had greater reductions in BMI (-22.0±9.4 vs. -4.8±7.9 kg/m2, P&amp;lt;0.001) and waist circumference (-17.5 ±10.2 vs. -2.1±9.6 cm, P&amp;lt;0.001), greater increases in HDL-C (35.5± 27.6 vs. 9.1±24.1, P&amp;lt;0.001), greater reductions in triglycerides (-33[-52, -2] vs. -10 [-36, 14] P&amp;lt;0.001), and similar changes in LDL-C (9.5±41.5 vs. 4.2±31.6 mg/dL). MS and MLI rendered similar reductions in albumin/creatinine ratio (-2 [-13, 1] vs. 0 [-4, 4]) and eGFR (-3.1±16.7 vs. -4.6±19.5 mL/min/1.73 m2). Also, MS patients required fewer medications for diabetes, hypertension, and dyslipidemia compared to MLI (P&amp;lt;0.001). In summary, this 3-year follow-up of the largest cohort of patients randomized to metabolic surgery vs. non-surgical treatment demonstrates that surgery is more effective than intensive medical/lifestyle therapy in achieving extended diabetes remission, BMI reduction, and improved metabolic disease biomarkers while reducing medication requirements. Disclosure J. P. Kirwan: None. J. M. Jakicic: Advisory Panel; Self; Naturally Slim, Spark360, Weight Watchers International, Inc. M. Patti: Consultant; Self; Cello Health, Fractyl Laboratories, Inc., MBX, Poxel SA, WGBH, Other Relationship; Self; Xeris Pharmaceuticals, Inc., Research Support; Self; Dexcom, Inc. K. Wolski: None. P. Schauer: Advisory Panel; Self; GI Dynamics, Keyron, Mediflix, Persona, Consultant; Self; Ethicon, Inc., Medtronic, Research Support; Self; Ethicon, Inc., Medtronic, Pacira. A. Courcoulas: None. D. E. Cummings: Advisory Panel; Self; DyaMx, GI Dynamics. A. Goldfine: Employee; Self; Novartis AG. S. Kashyap: Advisory Panel; Self; Fractyl Laboratories, Inc., GI Dynamics. D. C. Simonson: Stock/Shareholder; Spouse/Partner; Phase V Technologies, Inc. D. Arterburn: None. W. F. Gourash: None. A. H. Vernon: None. Funding National Institutes of Health (DK114156); Ethicon Endo-Surgery; Covidien

Weight Management Outcomes of Youth with Autism Spectrum Disorder Seeking Treatment from a Multidisciplinary Team.

Youth with Autism Spectrum Disorder (ASD) are at an increased risk for developing obesity when compared to their typically developing peers. Given higher prevalence of obesity in youth with ASD, understanding factors relating to success in obesity treatment provides insight into implementing efficacious treatments for youth. The current study examines age, sleep, and metabolic factors potentially affecting success in 74 youth (Mage = 11.66) attending a multidisciplinary weight management treatment program over a year. Multilevel modeling indicated that higher baseline BMI class category, medications at baseline, and absence of sleep difficulties predicted greater reduction in BMI after a year of treatment.