Greater Weight Loss Research Articles

IFN-γ Limits Immunopathogenesis but Delays Fungal Clearance during Pneumocystis Pneumonia.

High levels of IFN-γ are produced in the lung during an adaptive immune response to Pneumocystis, but the effects of this prototypical Th1 cytokine on fungal clearance and immunopathogenesis have not been fully defined. Therefore, Pneumocystis-infected immunodeficient mice were immune reconstituted and administered control or anti-IFN-γ neutralizing Ab to determine how IFN-γ regulates the balance between host defense and immune-mediated lung injury. Mice treated with anti-IFN-γ demonstrated an initial worsening of Pneumocystis pneumonia-related immunopathogenesis, with greater weight loss, heightened lung inflammation, and more severe pulmonary function deficits than control mice. However, IFN-γ neutralization also enhanced macrophage phagocytosis of Pneumocystis and accelerated fungal clearance. When anti-IFN-γ-treated mice were also given IL-4 and IL-13 to promote a Th2-biased lung environment, the accelerated fungal clearance was preserved, but the severity of immunopathogenesis was reduced, and a more rapid recovery was observed. A direct suppressive effect of IFN-γ on macrophages was required but was not solely responsible for delayed fungal clearance, suggesting that IFN-γ acts through multiple mechanisms that likely include modulation of both macrophage and Th polarization. Enhanced Pneumocystis clearance in anti-IFN-γ-treated and IFN-γR-deficient mice was associated with significantly elevated IL-17+ CD4+ T cells and IL-17 protein in the lungs. Furthermore, neutralization of IL-17, but not IL-4, signaling blocked the accelerated fungal clearance observed in anti-IFN-γ-treated mice. Together, these data demonstrate that although IFN-γ delays fungal clearance by suppressing the lung Th17 response, it also serves an important regulatory role that limits immunopathogenesis and preserves pulmonary function.

Impact of social connectedness on weight loss outcomes in an online program.

Obesity is linked to many negative health consequences. While online behavioral weight loss programs (BWL) are an effective treatment for obesity, weight losses are modest. Social connectedness has been found to improve weight loss outcomes and previous findings suggests that it may be especially important for people of color. The present study investigated the impact of social connectedness (structural connectedness, or network size; relationship quality, and functional connectedness, or social support) on weight loss outcomes in an online BWL program and whether Black race or Hispanic ethnicity moderates the relationship between social connectedness and weight loss. Participants (N = 387) enrolled in a 16-week online BWL program and completed measures of social connectedness before treatment and had their weight measured. Individuals with less structural connectedness (smaller social networks) had greater weight losses. Further, higher levels of functional connectedness (affectionate support, positive support, and relationship quality) mediated the relationship between smaller network size and better weight loss outcomes. Black race / Hispanic ethnicity did not moderate the relationship between social connectedness and weight loss. These findings suggest that the quality of one's relationships, not the size of one's social network, is important for weight loss. Future studies may examine whether online BWL programs that build relationship quality and affectionate and positive support in participants' existing social networks improve overall weight loss outcomes.

Pathogenicity of a goose astrovirus 2 strain causing fatal gout in goslings

Gosling gout has posed a serious threat to the development of the China's goose industry since the outbreak in mainland China in 2016; goose astrovirus (GAstV) was identified as the culprit pathogen. Two genotypes of this virus have been identified: GAstV-1 and GAstV-2, of which GAstV-2 is the main epidemic strain. Our current understanding of the pathogenic mechanisms of GAstV-2 remains limited. To assess pathogenicity, 1-day-old goslings were inoculated with the GAstV-2 YC20 strain via the subcutaneous, intranasal, and oral infection routes. All the goslings showed typical gout symptoms, with those in the oral infection group exhibiting earlier and more severe clinical symptoms, the highest mortality rate, and greatest weight loss. The blood biochemical indicators, viral loads in cloacal swabs and all representative tissues, and serum antibody titers of all infection groups increased significantly, and no significant differences in these parameters were observed among the three infection groups. Histopathological studies showed that the livers, kidneys, and spleens were the main damaged organs, and the pathological changes in the oral group were more severe than those in the other groups. Further analysis revealed that hepatic sinuses narrowed or became occluded as early as 1 day post-inoculation; urate deposition occurred in the renal tubules at 2 days post-inoculation (dpi), followed by necrosis of renal tubular epithelial cells; and lymphocytic infiltration appeared in the splenic tissue at 5 dpi. These results further our understanding of the pathogenic mechanisms of GAstV-2 and provide a reference for future studies.

The effect of Dapagliflozin on renal functions in hospitalized patients with Acute Heart Failure.

To evaluate the influence of dapagliflozin on renal functions and diuretics use in patients with acute heart failure (AHF). This comparative analytical study was conducted at Armed Forces Institute of Cardiology, Rawalpindi from July 2022 to November 2022. Patients were distributed equally in two groups i.e. Dapagliflozin and Conventional Groups, where patients received dapagliflozin added to conventional therapy for AHF and, only conventional therapy for AHF respectively. Estimated glomerular filtration rate (eGFR), serum creatinine were measured and compared on admission, after 48 hours and on discharge. Weight loss during hospitalization, daily dose of furosemide and length of hospital stay was also recorded. Quantitative parameters were analyzed using t-test or Mann Whitney U test accordingly. There were no significant baseline differences in renal functions. A modest decline in eGFR was observed in both groups after 48 hours. However, the variation in values of eGFR remained similar among both groups after 48 hours (p-value 0.365) and on discharge (p-value 0.768). Whereas, patients subjected to dapagliflozin treatment exhibited a more profound diuretic response expressed as greater weight loss (p-value < 0.001), achieved at comparatively lower doses of loop diuretics. Moreover, they also had a shorter duration of hospital stay (six vs eight days, p-value <0.001). Institution of dapagliflozin did not cause any significant deterioration of renal functions, whereas; it was associated with improved diuretic response as depicted by more pronounced weight loss at comparatively lower doses of loop diuretics.

Improved Glycaemic and Weight Management Are Associated with Better Quality of Life in People with Type 2 Diabetes Treated with Tirzepatide.

Limited data are available on the relationship between quality of life (QoL) change and significant degrees of reduction in glycated haemoglobin (HbA1c) and/or weight loss in people with type 2 diabetes (T2D). We explored the associations between HbA1c targets and/or weight loss achieved and patient-reported outcomes (PROs) in adults with T2D treated with tirzepatide, a first-in-class once weekly glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, using pooled data from SURPASS-1 to -5 Phase 3 clinical trials. PROs were assessed using five instruments at baseline and endpoint (Week 40 in SURPASS-1, -2 and -5; Week 52 in SURPASS-3 and -4): Impact of Weight on Quality of Life-Lite Clinical Trials Version; Impact of Weight on Self-Perception (IW-SP) questionnaire; Ability to Perform Physical Activities of Daily Living (APPADL); Diabetes Treatment Satisfaction Questionnaire change; and EQ-5D-5L. All PROs were assessed in participants receiving pooled doses of tirzepatide (5, 10 or 15mg) and achieving HbA1c targets of < 5.7%, ≥ 5.7-≤ 6.5% and > 6.5% or achieving ≥ 0-< 5%, ≥ 5-< 10%, ≥ 10-< 15% and ≥ 15% weight loss from baseline at endpoint. The APPADL, IW-SP and EQ visual analogue scores were evaluated in participants achieving each combination of HbA1c target and weight loss. Achievement of lower HbA1c targets or higher body weight percentage losses were each associated with greater improvements in QoL than achievement of higher HbA1c targets or lower body weight percentage losses, respectively. Achievement of lower HbA1c targets in combination with greater weight loss was generally associated with the best QoL ratings. Our findings demonstrate that HbA1c targets and significant percentage body weight reduction thresholds need to be achieved for people with T2D to help substantially increase their overall health-related QoL. Tirzepatide treatment may allow a high proportion of people with T2D to achieve these targets, enabling improved QoL. SURPASS-1: NCT03954834; SURPASS-2: NCT03987919; SURPASS-3: NCT03882970; SURPASS-4: NCT03730662; SURPASS-5: NCT04039503.

Long-Term Weight Changes After Starting Anti-IL-5/5Ra Biologics in Severe Asthma: The Role of Oral Corticosteroids.

Many patients with severe asthma are overweight or obese, often attributed to unintentional weight gain as a side effect of oral corticosteroids (OCSs). Anti-IL-5/5Ra biologics significantly reduce OCS use, but their long-term effects on weight are unknown. To examine (1) weight change up to 2 years after anti-IL-5/5Ra initiation in subgroups on the basis of maintenance OCS use at start of treatment and (2) whether cumulative OCS exposure before or changes in OCS exposure during treatment are related to weight change. Real-world data on weight and cumulative OCS dose from adults included in the Dutch Registry of Adult Patients with Severe asthma for Optimal DIsease management before and at least 2 years after starting anti-IL-5/5Ra were analyzed using linear mixed models and linear regression analyses. For the included 389 patients (55% female; mean body mass index, 28 ± 5 kg/m2; 58% maintenance OCS), mean weight decreased-0.27 kg/y (95% CI,-0.51 to-0.03; P= .03), with more weight loss in patients with maintenance OCS use than in those without maintenance OCS use (-0.87 kg/y [95% CI,-1.21 to-0.52; P < .001] vs+0.54 kg/y [0.26 to 0.82; P < .001]). Greater weight loss at 2 years was associated with higher cumulative OCS dose in the 2 years before anti-IL-5/5Ra initiation (β=-0.24 kg/g; 95% CI,-0.38 to-0.10; P < .001) and, independently, greater reduction in cumulative OCS dose during follow-up (β= 0.27 kg/g; 95% CI, 0.11 to 0.43; P < .001). Anti-IL-5/5Ra therapy is associated with long-term weight reduction, especially in patients with higher OCS exposure before treatment and those able to reduce OCS use during treatment. However, the effect is small and does not apply to all patients, and so additional interventions seem necessary if weight change is desired.

Tubularization of the gastric pouch helps sustain weight loss after transoral outlet reduction for post-Roux-en-Y gastric bypass weight recurrence.

Background and study aims Traditional transoral outlet reduction (TORe) is a minimally invasive endoscopic approach focused on reducing the aperture of the gastrojejunal (GJ) anastomosis, while the tubular transoral outlet reduction (tTORe) consists of tabularization of the distal pouch utilizing an O-shape gastroplasty suturing pattern. The primary aim of this study was to compare short-term weight loss between TORe and tTORe. Patients and methods Retrospective analysis of a prospectively maintained database was conducted at a tertiary care bariatric center of excellence. The study included patients with history of Roux-en-Y gastric bypass (RYGB) who had an endoscopic revision by TORe or tTORe and had follow-up data in their electronic medical record. The primary outcome was percent total body weight loss (%TBWL). Results A total of 128 patients were included (tTORe=85, TORe=43). At 3 and 6 months, the tTORe and TORe cohorts presented similar %TBWL (3 months: 8.5±4.9 vs. 7.3±6.0, P = 0.27 and 6 months: 8.1±7.4 vs. 6.8±5.6, P = 0.44). At 9 months, there was a trend toward greater weight loss in the tTORe cohort (9.7±8.6% vs. 5.1±6.8%, P = 0.053). At 12 months, the %TBWL was significantly higher in the tubularization group compared to the standard group (8.2±10.8 vs. 2.3±7.3%, P = 0.01). Procedure time was significantly different between both groups (60.5 vs. 53.4 minutes, P = 0.03). The adverse events rate was similar between groups (8.2% vs. 7.0% for tTORe and TORe, respectively, P = 0.61). Conclusions The tTORe enhances efficacy and durability of the standard procedure without adding significant procedure-related risks.

Combining loop and thiazide diuretics for acute heart failure across the estimated glomerular filtration rate spectrum: A post-hoc analysis of the CLOROTIC trial.

In patients with acute heart failure (AHF), the addition of hydrochlorothiazide (HCTZ) to furosemide improved diuretic response in the CLOROTIC trial. This work aimed to evaluate if these effects differ across the estimated glomerular filtration rate (eGFR) spectrum. This post-hoc analysis of the CLOROTIC trial analysed 230 patients with AHF and explored the influence of eGFR on primary and secondary endpoints. The median eGFR was 43 ml/min/1.73 m2 (range 14-109) and 23% had eGFR ≥60 ml/min/1.73 m2 (group 1), 24% from 45 to 59 ml/min/1.73 m2 (group 2), and 53% <45 ml/min/1.73 m2 (group 3). Patients treated with HCTZ had greatest weight loss at 72 h in all three groups, but patients in group 1 had a significantly greater response (-2.1 kg [-3.0 to 0.5]), compared to patients in groups 2 (-1.3 kg [-2.3 to 0.2]) and 3 (-0.1 kg [-1.3 to 0.4]) (p-value for interaction = 0.246). At 96 h, the differences in weight were -1.8 kg (-3.0 to -0.3), -1.4 kg (-2.6 to 0.3), and -0.5 kg (-1.3 to -0.1) in groups 1, 2, and 3, respectively (p-value for interaction = 0.256). There were no significant differences observed with the addition of HCTZ in terms of diuretic response, mortality or rehospitalizations, or safety endpoints (impaired renal function, hyponatraemia, and hypokalaemia) among the three eGFR groups (all p-values for interaction were no significant). The addition of eGFR-adjusted doses of oral HCTZ to loop diuretics in patients with AHF improved diuretic response across the eGFR spectrum. ClinicalTrials.gov: NCT01647932; EudraCT number: 2013-001852-36.

Body composition and nutritional status changes in adolescents with anorexia nervosa

IntroductionNutritional status assessment in anorexia nervosa (AN) includes the evaluation and monitoring of body composition throughout the treatment period. The gold standard for the study of body composition is dual-energy X-ray absorptiometry (DEXA), although electrical bioimpedance (BIA) is a more accessible, cheaper and faster method that does not involve exposure to radiation. Material and methodsWe recruited 33 female adolescents with AN (age, 11.7–16.3 years) by consecutive sampling. We collected data on clinical, anthropometric and laboratory variables. Patients were assessed with BIA and DEXA at inclusion in the study and at the end of the study, with a mean duration of follow-up of 1 year, during the nutritional rehabilitation phase. ResultsThere was significant improvement in nutritional status, reflected by the body composition obtained by anthropometric measurements and BIA. The phase angle increased significantly during the follow-up. Greater weight loss was associated with the presence of secondary amenorrhoea and decreased bone mineral density in the spine. ConclusionsElectrical BIA is a useful tool for assessment and monitoring of nutritional status in paediatric patients with AN. Dual-energy X-ray absorptiometry continues to be essential to assess bone mineral density. The role of hormones such as leptin remains to be elucidated.

Probability of 5% or Greater Weight Loss or BMI Reduction to Healthy Weight Among Adults With Overweight or Obesity

Information on the probability of weight loss among US adults with overweight or obesity is limited. To assess the probability of 5% or greater weight loss, 10% or greater weight loss, body mass index (BMI) reduction to a lower BMI category, and BMI reduction to the healthy weight category among US adults with initial overweight or obesity overall and by sex and race. This cohort study obtained data from the IQVIA ambulatory electronic medical records database. The sample consists of US ambulatory patients 17 years or older with at least 3 years of BMI information from January 1, 2009, to February 28, 2022. Minimum age was set at 17 years to allow for the change in BMI or weight starting at 18 years. Maximum age was censored at 70 years. Initial BMI (calculated as weight in kilograms divided by height in meters squared) category was the independent variable of interest, and the categories were as follows: lower than 18.5 (underweight), 18.5 to 24.9 (healthy weight), 25.0 to 29.9 (overweight), 30.0 to 34.9 (class 1 obesity), 35.0 to 39.9 (class 2 obesity), and 40.0 to 44.9 and 45.0 or higher (class 3 or severe obesity). The 2 main outcomes were 5% or greater weight loss (ie, a ≥5% reduction in initial weight) and BMI reduction to the healthy weight category (ie, BMI of 18.5-24.9). The 18 461 623 individuals in the sample had a median (IQR) age of 54 (40-66) years and included 10 464 598 females (56.7%) as well as 7.7% Black and 72.3% White patients. Overall, 72.5% of patients had overweight or obesity at the initial visit. Among adults with overweight and obesity, the annual probability of 5% or greater weight loss was low (1 in 10) but increased with higher initial BMI (from 1 in 12 individuals with initial overweight to 1 in 6 individuals with initial BMI of 45 or higher). Annual probability of BMI reduction to the healthy weight category ranged from 1 in 19 individuals with initial overweight to 1 in 1667 individuals with initial BMI of 45 or higher. Both outcomes were generally more likely among females than males and were highest among White females. Over the 3 to 14 years of follow-up, 33.4% of persons with overweight and 41.8% of persons with obesity lost 5% or greater of their initial weight. At the same time, 23.2% of persons with overweight and 2.0% of persons with obesity reduced BMI to the healthy weight category. Results of this cohort study indicate that the annual probability of 5% or greater weight loss was low (1 in 10) despite the known benefits of clinically meaningful weight loss, but 5% or greater weight loss was more likely than BMI reduction to the healthy weight category, especially for patients with the highest initial BMIs. Clinicians and public health efforts can focus on messaging and referrals to interventions that are aimed at clinically meaningful weight loss (ie, ≥5%) for adults at any level of excess weight.

Association between the use of weight management strategies and weight change among Australian adults over 12 months: an observational study

BackgroundObesity is a growing, global public health issue. This study aimed to describe the weight management strategies used by a sample of Australian adults; examine the socio-demographic characteristics of using each strategy; and examine whether use of each strategy was associated with 12-month weight change.MethodsThis observational study involved a community-based sample of 375 healthy adults (mean age: 40.1 ± 5.8 years, 56.8% female). Participants wore a Fitbit activity monitor, weighed themselves daily, and completed eight online surveys on socio-demographic characteristics. Participants also recalled their use of weight management strategies over the past month, at 8 timepoints during the 12-month study period.ResultsMost participants (81%) reported using at least one weight management strategy, with exercise/physical activity being the most common strategy at each timepoint (40–54%). Those who accepted their current bodyweight were less likely to use at least one weight management strategy (Odds ratio = 0.38, 95% CI = 0.22–0.64, p < 0.01) and those who reported being physically active for weight maintenance had a greater reduction in bodyweight, than those who did not (between group difference: -1.2 kg, p < 0.01). The use of supplements and fasting were associated with poorer mental health and quality of life outcomes (p < 0.01).ConclusionsThe use of weight management strategies appears to be common. Being physically active was associated with greater weight loss. Individuals who accepted their current body weight were less likely to use weight management strategies. Fasting and the use of supplements were associated with poorer mental health. Promoting physical activity as a weight management strategy appears important, particularly considering its multiple health benefits.

Composición corporal y evolución nutricional en adolescentes con anorexia nerviosa

IntroductionNutritional status assessment in anorexia nervosa (AN) includes the evaluation and monitoring of body composition throughout the treatment period. The gold standard for the study of body composition is dual-energy X-ray absorptiometry (DEXA), although electrical bioimpedance (BIA) is a more accessible, cheaper and faster method that does not involve exposure to radiation. Material and methodsWe recruited 33 female adolescents with AN (age, 11.7-16.3 years) by consecutive sampling. We collected data on clinical, anthropometric and laboratory variables. Patients were assessed with BIA and DEXA at inclusion in the study and at the end of the study, with a mean duration of followup of 1 year, during the nutritional rehabilitation phase. ResultsThere was significant improvement in nutritional status, reflected by the body composition obtained by anthropometric measurements and BIA. The phase angle increased significantly during the followup. Greater weight loss was associated with the presence of secondary amenorrhoea and decreased bone mineral density in the spine. ConclusionsElectrical BIA is a useful tool for assessment and monitoring of nutritional status in paediatric patients with AN. Dual-energy X-ray absorptiometry continues to be essential to assess bone mineral density. The role of hormones such as leptin remains to be elucidated.

Opuntia ficus-indica L. Fruits Cold Storage Using Different Packaging Materials

The prickly pear is a non-climacteric fruit and highly perishable. Therefore, it is crucial to find methods to extend its shelf life. The objective of this study was to evaluate the storage behavior of prickly pears under modified atmosphere conditions (2 °C, 90% RH) using different packaging materials (a cardboard box commercially used by the company, a rigid PET (polyethylene terephthalate) box, and a biodegradable plastic flexible bag). The fruits were produced in the Alentejo region and belong to a regional variety usually referred to as the “orange” variety. According to this study, the “orange” variety fruits could be stored at the specified temperature for 30 days. Among the storage methods tested, the biodegradable plastic bag was the most effective in maintaining the fruit’s quality throughout the entire period. The biodegradable package exhibited a weight loss lower than 5% for 30 days of storage, while the cardboard box showed great weight loss (&gt;6%) and more fruit contamination by fungi. Fruit firmness also decreased during storage, going from 10.1 N to 4.35 N, with bigger losses happening in the PET box. Throughout the study, the fruit acidity remained stable with values of 0.03% and 0.02%.

Alteration of BDNF, SPARC, FGF-21, and GDF-15 circulating levels after 1 year of anti-obesity treatments and their association with 1-year weight loss

PurposeEmerging evidence revealed that brain-derived neurotrophic factor (BDNF), secreted protein acidic and rich in cysteine (SPARC), fibroblast growth factor 21(FGF-21) and growth differentiation factor 15 (GDF-15) are involved in energy metabolism and body weight regulation. Our study aimed at examining their association with BMI, their alterations after anti-obesity treatments, and their association with 1-year weight loss.MethodsA prospective observational study of 171 participants with overweight and obesity and 46 lean controls was established. All participants received lifestyle educational intervention (LEI) with or without anti-obesity treatments (LEI + bariatric/metabolic surgery, n = 41; LEI + topiramate, n = 46; LEI + liraglutide, n = 31; LEI + orlistat, n = 12; and LEI alone, n = 41). Anthropometric and metabolic parameters, insulin sensitivity, C-reactive protein (CRP), fasting plasma levels of BDNF, SPARC, GDF-15, and FGF-21 were measured at baseline and 1 year.ResultsMultiple linear regression showed that fasting levels of SPARC, FGF-21, and GDF-15 were significantly associated with baseline BMI after adjustment for age and sex. At 1 year, the average weight loss was 4.8% in the entire cohort with a significant improvement in glycemia, insulin sensitivity, and CRP. Multiple linear regression adjusted for age, sex, baseline BMI, type of treatment, and presence of T2DM revealed that the decrease in log10FGF-21 and log10GDF-15 at 1 year from baseline was significantly associated with a greater percentage of weight loss at 1 year.ConclusionsThis study highlights the association of SPARC, FGF-21, and GDF-15 levels with BMI. Decreased circulating levels of GDF-15 and FGF-21 were associated with greater weight loss at 1 year, regardless of the types of anti-obesity modalities.

Perceived importance of moderate-to-vigorous physical activity as a weight control strategy in behavioral weight loss.

Previous research has established the importance of moderate-to-vigorous physical activity (MVPA) for weight control. One area of unexplored investigation is the relationship between individuals' perceptions of the importance of MVPA for weight control and MVPA engagement. This study examined the associations between the perceived importance of MVPA and MVPA engagement, weight loss, barriers to PA, and exercise enjoyment in adults enrolled in a long-term behavioral weight loss (BWL) intervention. Adults (N=301) with overweight/obesity (BMI=27-45kg/m2) completed an 18-month BWL intervention, followed by a no-intervention 18-month follow-up. At baseline, 6months, 18months (i.e., post-treatment), and 36months (i.e., follow-up), participants ranked the importance of six strategies for weight control: keeping a food record, MVPA, light PA, self-weighing, small portions, and low-calorie diet. Observed MVPA (measured by accelerometer), percent weight loss, perceived barriers to PA, and exercise enjoyment were also measured at each assessment. Results showed that most participants perceived MVPA as a primary weight control strategy (first, second, or third most important) throughout the intervention, regardless of the weight control goal (weight loss vs. maintenance). Individuals who ranked MVPA as a primary strategy for weight control at concurrent time points, compared to those who did not, engaged in significantly more MVPA at post-treatment, had greater weight loss at follow-up, endorsed fewer barriers to PA at post-treatment and follow-up, and reported greater exercise enjoyment at baseline and post-treatment. Perceived importance of MVPA was related to subjective experiences of MVPA, MVPA adherence, and weight loss in a long-term BWL intervention.

The Association Between Goal Setting and Weight Loss: Prospective Analysis of a Community Weight Loss Program.

Goal setting aids health-related behavior changes; however, the influence of different types of goals on weight loss remains unclear. We aimed to investigate the association of 3 aspects of goal setting with weight and program dropout over a 24-week period. This study was a prospective longitudinal analysis of participants in a 12-week digital behavioral weight loss program. Weight and engagement data for eligible participants (N=36,794) were extracted from the database. Eligible participants were adults in the United Kingdom who had enrolled in the program, had a BMI ≥25 kg/m2, and a weight reading recorded at baseline. Three aspects of goal setting were self-reported at enrollment: weight loss motivation (appearance, health, fitness, or self-efficacy), overall goal preference (low, medium, or high), and percentage weight loss goal (<5%, 5%-10%, or >10%). Weight was measured at 4, 12, and 24 weeks. Mixed models for repeated measures were used to explore the association between goals and weight across the 24-week period. To measure sustained weight change, the primary outcome was weight at 24 weeks. We explored dropout rates over the 24-week period by goal and whether engagement mediated the association between goals and weight loss. Of the 36,794 participants (mean 46.7, SD 11.1 years; 33,902/36,794, 92.14% female) included in the cohort, 13.09% (n=4818) reported weight at 24 weeks. Most participants set goals of 5%-10% weight loss (23,629/36,794, 64.22%), but setting goals for >10% was associated with greater weight loss (mean difference 5.21 kg, 95% CI 5.01-5.41; P<.001). There was no difference between goals of 5%-10% and <5% (mean difference 0.59 kg, 95% CI 0.00-1.18; P=.05). Appearance was the most prevalent motivational factor (14,736/36,794, 40.05%), but health and fitness were associated with greater weight losses (mean difference health vs appearance 1.40 kg, 95% CI 1.15-1.65; P<.001 and mean difference fitness vs appearance 0.38 kg, 95% CI 0.05-0.70; P=.03). Goal preference had no association with weight. Engagement was an independent predictor of weight loss but not a mediator of the effect of goal setting. At 24 weeks, those who set goals of >10% were less likely to drop out compared with 5%-10% goals (odds ratio [OR] 0.40, 95% CI 0.38-0.42; P<.001); those who liked to set overall high goals were more likely to drop out compared with medium goals (OR 1.20, 95% CI 1.11-1.29; P<.001); and those motivated by fitness or health were less likely to drop out compared with appearance (OR 0.92, 95% CI 0.85-0.995; P=.04 and OR 0.84, 95% CI 0.78-0.89; P<.001, respectively). Setting higher weight loss goals and being motivated by health or fitness were associated with greater weight loss and lower likelihood of dropout. Randomized trials for setting these types of goals are required to confirm causality.

A REVIEW AND CURRENT SITUATION OF PCOS WITH INFERTILITY

Polycystic ovary syndrome (PCOS) is a condition in which the ovaries produce an abnormal amount of androgens. PCOS causes an imbalance of androgen hormones and causes many of the symptoms of the disorder. It affects about 8-10% of all women of reproductive age and 22% in India. If lifestyle changes are not successful in controlling the symptoms of PCOS, then women may be advised to consider weight loss surgery.In some cases, the weight loss surgery may be combined with hormonal therapy.This treatment aims to achieve even greater weight loss, which may lead to the reduction of excessive facial and body hair. Too much testosterone can also interfere with the development of the follicles (the sacs in the ovaries where eggs develop) and prevents normal ovulation (the release of a mature egg). Hypothyroidism (low thyroid function) is common in women with PCOS. Excess androgens can be induced by insulin resistance and hyperinsulinemia, as they cause a reduction in sex hormone binding globulin levels, which lead to a subsequent increase in free androgens and unfavourable metabolic profiles. The ovarian PCOS morphological traits of enlarged, multi-cystic ovaries and theca interstitial hyperplasia are reported in women who are subjected to high levels of androgens as a result of endogenous adrenal androgen hyper secretion in congenital adrenal hyperplasia treatment in female-to-male transsexuals. Even if an egg is released, the uterus lining or the endometrial may not be ready for pregnancy Symptoms of PCOS The following symptoms will help you understand PCOS occurrence: Irregularity in menstrual cycles or lack of cycles Excessive body or facial hair is seen in teens and females in their 20s The condition worsens over the years with an increase in hair growth It is due to the surplus testosterone and androstenedione that results in high male hormone production in females in their blood. Reproductive age, approx 10% of women are affected by this syndrome, with common symptoms including weight gain, irregular periods, acne, an increase in body hair, and infertility due to ovulation failure.

The Relationship between Metabolic Comorbidities and Post-Surgical Weight Loss Outcomes in Adolescents Undergoing Laparoscopic Sleeve Gastrectomy

Introduction: Little is known about the relationship between metabolic factors and weight loss success in adolescents undergoing bariatric surgery. Methods: The objective of this study was to assess if baseline metabolic characteristics associate with weight loss in adolescents undergoing laparoscopic sleeve gastrectomy. A retrospective study was conducted in a comprehensive adolescent bariatric surgery center of 151 subjects (34 male, 117 female). Anthropometric measurements and metabolic factors including blood pressure, fasting glucose, hemoglobin A1c (HbA1c), metabolic syndrome (MeS), liver function, triglycerides, and waist circumference were collected at one pre-surgical visit and at 6- and/or 12-month post-laparoscopic sleeve gastrectomy. Weight loss was compared between subjects with normal or abnormal baseline metabolic factors. Absolute BMI change was used to measure successful weight loss. Results: Higher baseline systolic blood pressure (SBP) was associated with greater weight loss as measured by body mass index (BMI) change and BMI standard deviation score (BMI-SDS) change at 6 and 12 months. Those patients in the 6-month follow-up group with an abnormal HbA1c at baseline had significantly more weight loss as measured by BMI-SDS. None of the other parameters, including fasting glucose, MeS, liver function, triglycerides, and waist circumference showed a predictive relationship. Conclusion: Elevated SBP and HbA1c in adolescents with morbid obesity may reflect a population more likely to achieve successful weight loss and, thus, may be a good target for bariatric surgery, specifically laparoscopic sleeve gastrectomy, as an intervention for severe obesity. An assessment of behavioral differences in patients with and without elevated BP and HbA1c might explain the mechanism for the improved weight loss.

Tirzepatide 10 and 15 mg compared with semaglutide 2.4 mg for the treatment of obesity: An indirect treatment comparison.

To compare the efficacy of tirzepatide 10 and 15 mg with semaglutide 2.4 mg using an indirect treatment comparison. Using SURMOUNT-1 and STEP 1 trial data, mean percentage change in body weight from baseline and odds ratio (OR) of achieving 5% or greater weight loss were compared between tirzepatide 10 and 15 mg at week 72 and semaglutide 2.4 mg at week 68 using matching-adjusted indirect comparison of the efficacy estimand. Sensitivity analyses were completed using different methods, including the Bucher method, also using different estimands and/or time points. Greater reductions in percentage change in body weight were observed with tirzepatide 10 and 15 mg versus semaglutide 2.4 mg (tirzepatide 10 mg mean difference: -4.67% [95% CI -5.91%, -3.43%]; tirzepatide 15 mg mean difference: -5.92% [95% CI -7.16%, -4.68%]; both P < .001). Similarly, more participants achieved 5% or greater weight loss with tirzepatide 10 mg (OR 2.61 [95% CI 1.48, 4.57]; P < .001) and 15 mg (OR 2.75 [95% CI 1.57, 4.81]; P < .001) compared with semaglutide 2.4 mg. All sensitivity analyses were consistent, except for an OR of achieving 5% or greater weight loss with tirzepatide 10 mg using the Bucher method to analyse the treatment regimen estimand (P = .074). Currently there are no direct comparisons of tirzepatide and semaglutide for weight management. Using the matching-adjusted indirect treatment comparison method to compare the efficacy of tirzepatide and semaglutide for chronic weight management, this analysis showed greater weight loss with tirzepatide 10 and 15 mg versus semaglutide 2.4 mg.

Replacing Animal Fat with Gels of Psyllium Fiber and Combined Linseed Oil–Psyllium Fiber in Salamis: Impacts on Technological, Nutritional, Oxidative, and Sensory Properties

This study produced two gels: one solely using psyllium fiber (GP) and another combining this fiber with linseed oil (GL+P). Both gels replaced 15% and 30% of the animal fat content of salamis. The objective was to evaluate the impact of this lipid reformulation on the technological, nutritional, oxidative, and sensory properties of the salamis. The lipid reformulation did not alter the evolution of pH and lactic acid bacteria during processing. The addition of GL+P did not interfere with the product’s drying process. However, replacing 30% of animal fat with the GP resulted in greater weight loss and a lower final Aw value. The lipid reformulation minimally affected the color of the salamis but significantly enhanced their nutritional profile. This improvement was marked by a decrease in fat content and an increase in protein. Specifically, in the samples with GL+P, there was a rise in linolenic acid content and a reduction in the n-6/n-3 PUFA ratio. Adding GP did not affect the salamis’ oxidative stability and sensory profile. However, substituting 30% of the animal fat with GL+P increased the TBARS values, and volatile compounds derived from lipid oxidation hampered the products’ sensory profiles. A reduction in these negative effects was observed when replacing 15% of the fat with GL+P, suggesting this to be the ideal dosage for balancing the nutritional benefits with maintaining the product’s oxidative stability.