Iranian Obese Women Research Articles

Traces of social culture in the lived experiences of emotional eating among Iranian obese women

IntroductionEmotional eating is a situation with harmful consequences for the physical, mental and social health of humans. In this regard, the present study aimed to explain the role of social culture in the lived experiences of emotional eating in Iranian obese women.MethodsThis was a qualitative study conducted using the phenomenological approach. Purposive heterogeneous sampling method was used to select 17 women with body mass index of 30 and above who had emotional eating experience. Data were collected through semi-structured and face-to-face interviews. A guideline designed by the research team, whose content validity was confirmed by the expert panel, was used to conduct the interviews. Data were analyzed based on Diekelmann 7-step approach, and trustworthiness was evaluated by Lincoln and Guba criteria.ResultsThe main topic of the findings was social culture and emotional eating, which was explained by three themes: “influence of social culture”, “language culture of eating” and “the culture of eating together”. Influence of social culture had three sub-themes: “a legal and popular entertainment”, “hospitality culture: encouraging guests to overeat”, and “coping with the social stigma of thinness and obesity”. The language culture of eating had two sub-themes of “association of common infinitives” and “the symbol of swallowing anger “. Also, “culture of eating together” included 2 sub-topics with the titles “pleasant symbol of belonging and love” and “the symbol of family cohesion”.ConclusionThis study found that social culture through language, norms, and customs can initiate and/or reinforce emotional eating. The results of this study can be used in the design of interventions to improve emotional eating behavior in women by emphasizing the characteristics of Iranian social culture.

Changes of biochemical parameters in normal weight and overweight/obese women with polycystic ovary Syndrome

Objectives: Polycystic ovary syndrome (PCOS) is an endocrine disease in reproductiveage women, which interferes with fertility, menstruation, and body composition. Some biochemical parameters change in women with PCOS, a feature which can be a consequence of the disease itself or of the accompanying obesity. This study investigated the glucose and lipid profiles, sex hormones, and hsCRP in normal weight and overweight/ obese Iranian women with and without PCOS.
 Methods: 314 women with PCOS and 138 healthy and fertile women were recruited for the study. The patients and controls were divided according to body mass index (BMI) into two groups as follows: BMI<25 Kg/m2 and BMI≥ 25 Kg/m2 . Blood samples were collected from all participants to assess fasting blood glucose, fasting insulin, lipid profile, FSH, LH, free testosterone, and hs-CRP levels. The homeostasis model of insulin resistance (HOMA-IR) was calculated for assessing insulin sensitivity.
 Results: BMI, fasting insulin, HOMA-IR, triglyceride, FT, LH, and hs-CRP levels were significantly higher in the PCOS group, while lower levels of FSH were observed in comparison to non-PCOS women. Among overweight PCOS women, hs-CRP levels were significantly elevated compared to normal-weight PCOS women. However, there was no significant difference in circulating hs-CRP levels between normal-weight and overweight participants in the control group.
 Conclusion: The study results suggest that both insulin resistance and an increase in hs-CRP may be relevant to PCOS. Moreover, the findings indicated that chronic inflammation in PCOS is not solely dependent on the pathogenesis of the disease but may be exacerbated by increased body weight.

Iranian Obese Women’s Lived Experiences of Social and Linguistic Factors Shaping Emotional Eating Behavior: A Phenomenological Study

Background: Emotional eating is harmful to health and is highly prevalent in obese women. Hence, an awareness of factors underlying emotional eating is important for weight management and maintaining women’s health. Research evidence indicates that several factors contribute to emotional eating behavior. The present study aimed to explore obese young Iranian women’s lived experiences of social and linguistic factors shaping emotional eating behavior. Methods: This qualitative and hermeneutic phenomenological study was conducted on 17 young women living in Kermanshah or Karaj, Iran who experienced emotional eating and had a body mass index (BMI) of 30 and higher. The participants were selected using purposive sampling with maximum variation in terms of demographic characteristics. The data were collected through in-depth individual and face-to-face interviews and analyzed using Dickelman et al’s seven-step phenomenological approach. Results: The data analysis revealed that social and linguistic factors underlying emotional eating behavior can be explained by two themes including social influence and linguistic culture. Social influence further accounted for compensating for the stigma of thinness, relieving the stigma of obesity, group conformity, and following taboos to cope with sexual and emotional desires. In addition, linguistic culture was explained by two subthemes including associating grieving with eating and the metaphor of swallowing anger. Conclusion: Following the findings of the study, psychotherapy interventions can be planned to address emotional eating and weight management with a focus on the role of social influence and the effects of spoken language in the development of emotional eating behavior.

The association between dietary pattern and visceral adiposity index, triglyceride-glucose index, inflammation, and body composition among Iranian overweight and obese women

The aim of the present study was to investigate the association between dietary patterns, derived through latent class analysis (LCA), with visceral adiposity index (VAI), Triglyceride-Glucose Index (TyG), inflammation biomarkers, and body composition in overweight and obese Iranian women. For this cross-sectional study, dietary exposure was assessed using a validated 147-item semi-quantitative food frequency questionnaire (FFQ). Dietary patterns were derived through LCA. Binary logistic was performed to test the associations of dietary patterns with VAI, TyG, inflammation biomarkers, and body composition. Health centers in Tehran, Iran. 376 obese and overweight women, aged > 18 years. Two dietary patterns were identified using LCA modeling: healthy and unhealthy. Women in the unhealthy class were characterized by higher consumption of fast food, sweetened beverages, grains, unhealthy oils, butter and margarine, and snacks. Compared with the healthy class, the unhealthy class was associated with an increased risk of higher fasting blood sugar (FBS) (OR = 6.07; 95% CI: 1.33–27.74, P value = 0.02), c-reactive protein (CRP) (OR = 1.72; 95% CI: 1.05–2.80; P value = 0.02), and lower fat free mass index (FFMI) (OR = 0.56; 95% CI: 0.35–0.88, P value = 0.01), after adjusting for confounders. We found that adherence to an unhealthy dietary pattern was associated with decreased FFMI and increased FBS and CRP using LCA, but not with the rest of the variables. Further studies should be conducted to confirm the veracity of these findings.

Inflammatory markers may mediate the relationship between processed meat consumption and metabolic unhealthy obesity in women: a cross sectional study

Metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO) are known to be affected by diet and inflammatory factors (such as TGF-β1, IL-β1, MCP1). We sought to survey that consume of processed meat could effect on MHO and MUHO phenotypes, mediated through inflammatory markers, in overweight and obese Iranian women. The current cross-sectional study was done on 224 women 18–48 years, with a body mass index (BMI) ≥ 25 kg/m2. A 147- item food frequency questionnaire (FFQ) was used to evaluate dietary intake. In all participants, anthropometric indices and biochemical factors, as well as metabolic health phenotypes based on Karelis score, were evaluated. According to results, 22.6% of participants had MHO and 75.7% had MUHO phenotypes. There was an association between higher adherence to processed meats and increasing odds of MUHO phenotype in Iranian women (OR:2.54; 95% CI 0.009, 7.51; P = 0.05). Moreover, we found that the relation can be affected by agents such as TGF-β1, IL-β1, and MCP1; however, more research is needed to confirm these results and finding.

Inflammatory biomarkers in overweight and obese Iranian women are associated with polyphenol intake

BackgroundThe evidence shows that obesity is associated with chronic inflammation in obese subjects. Polyphenols are a complex group of plant secondary metabolites that may play a role in reducing the risk of obesity and obesity-related diseases. Given the scarcity of evidence on the association between inflammatory markers and dietary polyphenols intake in overweight/obese Iranian women, the current study aims to investigate this link.MethodThe present cross-sectional study was conducted on 391 overweight and obese Iranian women aged 18–48 years (body mass index (BMI) ≥ 25 kg/m2). A 147-item food frequency questionnaire (FFQ) was used to assess dietary intake, as well as anthropometric indices including weight, height, waist circumference (WC), and hip circumference (HC) and biochemistry parameters including triglyceride (TG), total cholesterol (Chole), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), serum glutamic pyruvic transaminase (SGPT), serum glutamic-oxaloacetic transaminase (SGOT), galactin-3 (Gal-3), monocyte chemoattractant protein-1 (MCP-1), transforming growth factor beta (TGF-β), interleukin-1 beta (IL_1β), plasminogen activator inhibitor-1 (PA-I), serum leptin concentrations, and C-reactive protein of high sensitivity (hs-CRP) in all participants. The inflammatory markers were assessed using the enzyme-linked immunosorbent assay (ELISA).ResultThe findings revealed a significant negative association between flavonoids intake and MCP-1 (P = 0.024), lignans intake and MCP-1 (P = 0.017), and Gal-3 (P = 0.032). These significant associations were observed between other polyphenols intake and IL_1β (P = 0.014). There was also a significant positive association between other polyphenol intake and TGF-β (P = 0.008) and between phenolic acid intake and TGF-β (P = 0.014).ConclusionOur findings suggest that a high polyphenol intake may help individuals to reduce systemic inflammation. Further large studies involving participants of different ages and genders are highly warranted.

The association between fatty acid quality indices and quality of life among overweight and obese women: A cross-sectional study.

Reduced quality of life (QOL) is a major public health challenge affecting the global population. Fatty acid quality indices (FAQIs) are novel determinants of QOL and may impact various aspects of QOL. Prior research has established a significant link between dietary habits and QOL. However, the association between FAQIs and specific dimensions of QOL has not been established. Therefore, we aimed to investigate the association between FAQIs and QOL in overweight and obese women. In total, 378 adult overweight or obese women participated in this cross-sectional study. Several anthropometric indices, systolic and diastolic blood pressure, and biochemical factors were measured using standard protocols. Dietary intake was assessed using a validated and reliable semi-quantitative food frequency questionnaire (the FFQ, 147 items). The cholesterol-saturated fat index (CSI) and the ratio of omega-6/omega-3 (N6/N3) essential fatty acids consumed were employed as FAQIs. The SF-36 questionnaire was administered to measure QOL. Linear logistic regression was used, in the form of raw and adjusted models, to evaluate the associations between FAQIs and QOL. The study sample consisted of 279 participants for whom ω-6/ω-3 ratio was measured and 378 participants for whom CSI was measured. The mean (±SD) age of participants was 36.65 ± 9.07 years. Linear logistic regression, with adjustment for potential confounders, such as age, energy intake, body mass index, employment, and thyroid status, indicated that ω-6/ω-3 intake ratio was negatively and marginally significantly associated with general health (β = -139.94, 95% CI: [-286.54, 6.66]; p = 0.061) and physical role limitations (β= -337.68, 95% CI: [-679.99, 1.61]; p = 0.051). A significant negative association was observed between ω-6/ω-3 intake ratio and social functioning (β = -247.54, 95% CI: [-458.14, -36.94]; p = 0.021), which indicates that obese and overweight women with a higher ω-6/ω-3 intake ratio obtained lower scores on social functioning. It was found that FAQI scores were negatively associated with certain QOL measures among overweight and obese Iranian women, suggesting that a higher consumption of fatty acids, especially trans and saturated fatty acids, may be associated with lower QOL.

Red, white, and processed meat consumption related to inflammatory and metabolic biomarkers among overweight and obese women.

Considering that a high meat intake is directly associated with obesity, it is critical to address the relationship between consuming different types of meat with inflammation and metabolism in overweight and obese cohorts. Thus, we evaluated the association between red, white, and processed meat consumption with inflammatory and metabolic biomarkers in overweight and obese women. The current cross-sectional study was conducted on 391 overweight and obese Iranian women. Dietary intake was obtained from a food frequency questionnaire (FFQ) with 147 items. The anthropometric measurements, serum lipid profile, and inflammatory markers were measured by standard protocols. All associations were assessed utilizing one-way analysis of variance (ANOVA), analysis of covariance (ANCOVA), and linear regression models. In the adjusted model, it was established that higher intake of processed meat had a significant positive association with leptin levels (β: 0.900, 95% CI: 0.031;1.233, p = 0.015). Moreover, after considering the confounders, a significant positive association between processed meat and macrophage inflammatory protein (MCP-1) levels was observed (β: 0.304, 95% CI:0.100;1.596, p = 0.025). Positive significant associations between high-sensitivity C-reactive protein (hs-CRP) (β:0.020, 95% CI:0.000;0.050, P = 0.014) and plasminogen activator inhibitor 1 (PAI-1) (β:0.263, 95% CI:0.112;0.345, p = 0.053) and MCP-1 (β:0.490, 95% CI: 0.175;1.464, p = 0.071) levels with red meat were also shown; while there was a significant negative association between red meat and the homeostasis model assessment of insulin resistance (HOMA-IR) (β: -0.016, 95% CI: -0.022, -0.001, p = 0.033). Furthermore, a significant negative association were established following confounding adjustment between Galectin-3 (Gal-3) (β: -0.110, 95% CI: -0.271;0.000, p = 0.044), MCP-1 (β: -1.933, 95% CI: -3.721;0.192, p = 0.022) and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (β: -0.011, 95% CI: -0.020,0.000, p = 0.070) levels with high adherence of white meat intake. In contrast, a significant marginally positive association between PAI-1 levels and high adherence to white meat intake (β: -0.340, 95% CI: -0.751;0.050, p = 0.070) has been shown. Higher red and processed meat consumption were positively associated with inflammatory and metabolic markers in overweight and obese women. In contrast, negative relationships between high adherence to white meat and various inflammatory and metabolic parameters were established. Further studies are needed to confirm the causality of these associations and potential mediating pathways.

The relationship of genetic risk score with cardiometabolic risk factors: a cross-sectional study

Background & aimsFor more than eight decades, cardiovascular disease (CVD) has remained the leading cause of death in the world. CVD risk factors are multifaceted, with genetics and lifestyle both playing a role. The aim of this study was to investigate the association between a genetic profile risk score for obesity GRS and cardio-metabolic risk factors in overweight and obese women.MethodsThe current cross-sectional study was conducted on 391 overweight and obese women. The genetic risk score was created by combining three single nucleotide polymorphisms [MC4R (rs17782313), CAV-1 (rs3807992), and Cry-1 (rs2287161)]. Anthropometric measurements, blood pressure, and some blood parameters were measured by standard protocols.ResultsA significant association between the GRS and some of cardiometabolic risk factors variables such as body mass index (β = 0. 49, 95%CI = 0.22 to 0.76, p < 0.001), waist circumference (β = 0. 86, 95%CI = 0.18 to 1.54, p = 0.01), body fat mass (β = 0. 82, 95%CI = 0.25 to 1.39, p = 0.005), %body fat (β = 0. 44, 95%CI = 0.06 to 0.82, p = 0.02), and hs-CRP (β = 0.46, 95% CI = 0.14 to 0.78, p = 0.005) was observed in crude model. After adjustment for confounding factors (age, BMI, and physical activity), a significant positive association was observed between BMI (p = 0.004), WC (p = 0.02), body fat mass (p = 0.01), %BF (p = 0.01), hs-CRP (p = 0.009), and GRS. In addition, we discovered a significant negative association between the GRS and BMC (= -0.02, 95%CI = -0.05 to -0.001, p = 0.04). But other variables did not show any significant association with GRS among obese and overweight women.ConclusionWe found a significant positive association between GRS, including MC4R (rs17782313), CAV-1 (rs3807992), and Cry-1 (rs2287161) and cardiometabolic risk factors among overweight and obese Iranian women.

The association of appetite and hormones (leptin, ghrelin, and Insulin) with resting metabolic rate in overweight/ obese women: a case\u2013control study

ObjectiveLow resting metabolic rate (RMR), as a risk factor for weight gain and obesity, can be influenced by many factors. Empirical research has confirmed the role of appetite and related hormones in obesity and energy intake. This study aimed to investigate the relationship between appetite and related hormones in overweight or obese Iranian women with normal and hypo RMR.MethodsThis case–control study was conducted on 42 Iranian adult women (21 cases, and 21 controls), aged 18–48 years. An impedance body analyzer was used to obtain the body composition and an indirect calorimeter was used to assess the RMR. The Flint questionnaire was used to assess appetite, dietary intake, and physical activity were assessed by FFQ and IPAQ questionnaires respectively, and ELISA kits were used to assess leptin, ghrelin, and insulin hormones.ResultsThe results of the study demonstrated a negative association between ghrelin hormone level (β = -0.34, 95%CI = -61.70,-3.86, P-value = 0.027) and RMR, and a positive association between insulin hormone level (β = 0.48, 95%CI = 9.38–34.35, P-value = 0.001) and RMR. Also, results of the appetite questionnaire showed that, in general, both appetite (β = 0.32, 95%CI = -0.10–2.99 P-value = 0.044) and hunger variable (β = 0.30, 95%CI = 0.04–5.87, P-value = 0.047) have a positive association with RMR. There was no significant association between leptin levels and RMR.ConclusionIt is evident that appetite and related hormones have a potential role in promoting a normal RMR.

Circulating Inflammatory Markers May Mediate the Relationship between Healthy Plant-Based Diet and Metabolic Phenotype Obesity in Women: A Cross-Sectional Study

Background It has been posited that both metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO) could be emergent from diet and inflammatory markers. Thus, we sought to investigate the influence of plant-based diet on MHO and MUHO phenotypes mediated by inflammatory markers in overweight and obese women. Methods This cross-sectional study was conducted on 289 women aged ≥18 years, with a body mass index (BMI) ≥25 kg/m2. Dietary intake was measured using 147 item food frequency questionnaire, as well as anthropometrics and biochemistry panel, in all participants. Metabolic health phenotypes were considered using Karelis score, while plant-based diet indices (PDI) were evaluated based on 18 food groups, where healthy and unhealthy PDI were identified. Results Accordingly, 26.9% of women had MHO and 73.1% had MUHO phenotypes. After adjusting for potential confounders, TGF-β1 had a significant inverse association with hPDI (β: −0.28; 95% CI: 452.99, −85.25; P: 0.004). Moreover, we found that women with higher hPDI had lower odds of MUHO (OR: 0.95; 95% CI: 0.39, 2.30; P: 0.03). Regarding the mediatory effect of the inflammatory markers, TGF-β1 (P: 0.73), IL-β1 (P: 0.14), and MCP1 (P: 0.51) played a role in decreasing the odds of MUHO among hPDI tertiles. Conclusion There was a significant inverse relationship between adherence to hPDI and MUHO phenotype in overweight and obese Iranian women. This association appeared to be mediated by TGF-β1, IL-β1, and MCP1.

The Effectiveness of Interventions to Decrease Body Image Dissatisfaction; A Systematic Review

The prevalence of body image dissatisfaction is considered high in both developed and developing countries. Studies on obese individuals have shown associations between the risks of obesity and its hazardous effects both on physical and mental health as well as on the body image. Development of body image dissatisfaction in Eastern communities has been increased in the past years. Despite many studies in Asian societies, In Iran, studies are scattered and limited. Preventing and alleviating body Image dissatisfaction among Iranian obese women is an important area for policy and practice, but the effectiveness of many interventions has been questioned because of the lack of evidence. A systematic review was conducted to determine the effectiveness of health promotion interventions that target body Image dissatisfaction in Iranian obese women. Quantitative outcome studies between March 2016 and February 2021 in English and Persian language were included. Articles were identified by searching electronic databases, journals and abstracts, and contacting key informants. Information was extracted and synthesized using a standard form. 9 studies were identified. their design, methods, quality and transferability varied considerably. Just 1 of the 10 effective interventions were group activities. The review suggests that all of interventions are effective, involving some form of mindfulness and emotion regulation training that targeted obese women.

Association between the food security status and dietary patterns with polycystic ovary syndrome (PCOS) in overweight and obese Iranian women: a case-control study

BackgroundPolycystic ovary syndrome (PCOS), as one of the significant endocrine disorders, is common among women worldwide. Food insecurity (FI) and unhealthy dietary patterns can negatively affect reproductive health. The effects of the lifestyle modifications, especially dietary components, on PCOS are contradictory. The aim was the assessment of association between PCOS with food security status and dietary patterns among overweight or obese women.MethodsThis case-control study was performed on 240 overweight and obese women with and without PCOS (ratio 1:1) referred to the infertility clinic of Arash Hospital, Tehran, Iran. The general and socioeconomic characteristics, anthropometrics (weight, height, body mass index (BMI), waist circumference, hip circumference), physical activity, food security status, and dietary intakes (or patterns) were assessed using valid questionnaires, scales, stadiometer, and tape meter. The significant p-value was < 0.05.ResultsThe prevalence of FI was 60% in women with PCOS and 30% in healthy women. PCOS risk was positively related to FI, quasi-western dietary patterns, low economic levels, waist circumference, and menstrual age and negatively with physical activity and healthy dietary patterns, even after controlling the potential confounders (P < 0.05). PCOS women had a higher intake of saturated fats, monounsaturated fats, oleic acid, fluorine, sucrose, and caffeine and a lower intake of vitamins A, B5, B6, B12, C, and D, potassium, proteins, carbohydrates, cholesterols, docosahexaenoic acid, potassium, carotenes, lutein, beta-cryptoxanthin, lycopene, calcium, iron, thiamine, riboflavin, niacin, tetra- and dihydrofolate, biotin, phosphorus, magnesium, zinc, copper, fiber (total, insoluble, and crude), glucose, galactose, fructose, and lactose compared to the healthy women (P < 0.05).ConclusionsFI, quasi-western dietary patterns, low economic levels, and waist circumference were significantly associated with the higher risk of PCOS. The lifestyle changes, especially dietary patterns, may be an essential strategy for reducing PCOS. Further studies are warranted to confirm these findings and to identify the underlying mechanisms.

Nutrient patterns and their relation to obesity and metabolic syndrome in Iranian overweight and obese adult women.

Nutrient patterns have been associated with an increased risk for chronic disease. Evidence to confirm a direct relationship between nutrient patterns and obesity and metabolic syndrome (MetS) throughout population-based differences including cultural contexts add complexity is not well established yet. The aim of this study is to investigate the association between nutrient patterns and MetS among overweight and obese Iranian women. Three hundred and sixty obese and overweight women (25 < BMI < 40) were included in this cross-sectional analysis. Dietary intake of 19 nutrients was evaluated by a semi-quantitative standard food frequency questionnaire (FFQ). MetS was determined by abdominal obesity > 88 (cm) in females, Triglycerides ≥ 150 (mg/dL), dyslipidemia (HDL < 50mg/dL), systolic blood pressure > 130/85 (millimeters), and glucose > 100 (mg/dL). Body composition was assessed by a multi-frequency bioelectrical impedance analyzer, InBody 770 scanner. Principle components analysis was applied and four nutrient patterns were identified as following: Pattern 1 (thiamin, iron, carbohydrate, zinc, niacin, protein, magnesium, phosphorus, riboflavin), represented the carbo-vitamin group. Lipid group was showed in pattern 2 (PUFAs, MUFA, vitamin E, trans fatty acids, and Pattern 3 (beta-carotene, vitamin K, vitamin A, vitamin C) represented the anti-oxidant group, finally Pattern 4 was the indicator of the milk group (vitamin D, calcium). A significant positive association was observed between the anti-oxidant group and obesity (OR 1.40; 95% CI 1.09-1.8; P = 0.01). No relationship between other nutrient pattern and MetS was observed. The nutrient patterns that are highly loading of beta-carotene, vitamin K, vitamin A, and vitamin C in nutrient patterns may be associated to higher risk of obesity in overweight and obese Iranian women. Level V, cross-sectional descriptive study.

Exploring the Experiences of Iranian Women Regarding Obesity Self-Management: A Qualitative Study.

BACKGROUND:Despite the high and growing prevalence of obesity in Iran and a variety of interventions by the healthcare providers control the problem, and it is still a prevalent health problem among Iranian women.AIM:The aim of this study is to explore the perspective of obese Iranian women in the process of self-management regarding the facilitating factor in self-management of obesity.METHODS:In a qualitative study, the participants were selected through purposeful sampling, and the data were collected using semi-structured interviews and focus group (n = 25) between July 2017 and September 2018. All the interviews were transcribed verbatim and the data were analysed using constant comparative method.RESULTS:Supporting the umbrella was the main category found in the present study. The participating obese individuals found “support” as the main factor with an outstanding effect on motivating, incentivising and keeping diet in long-term. This category contains subcategories: self-help; family, friends, and peers’ support; and medical team’s support.CONCLUSION:The findings suggested the critical role of support in obesity self-management process. This critical factor improves our perception of the multi-aspect and complicated nature of obesity self-management. Moreover, policymakers and providers of health services can utilise this finding in the design of care plans with higher chance of success.

Exploring Iranian obese women's perceptions of barriers to and facilitators of self-management of obesity: A qualitative study.

Background:Despite the clinical importance of self-management for obesity, poor compliance or noncompliance with the treatment regimen is a prevalent and persistent problem concerning people with obesity.Aims:The aim of this study was to explore Iranian obese women's perceptions regarding the barriers to and facilitators of self-management of obesity.Materials and Methods:In this qualitative study, the participants were selected through purposeful sampling and the data were collected using semistructured interviews and focus groups between July 2017 and September 2018. Nineteen participants between the age range of 28–50 years and mean age of 38.56 years were interviewed. A focus group with seven participants was conducted to reach data saturation. All the interviews and the focus group were transcribed verbatim and the data were analyzed using constant comparative method.Results:The perceived barriers to obese women's self-management for obesity were identified and classified into four main categories: (I) restrictions, (II) the pressures of being in the group, (III (temptation, (IV) resonators. In addition, seven main categories emerged as facilitators of obese women's self-management for obesity: (I) achieving self-awareness, (II) positive consequences for weight loss success, (III) positive outcomes of exercise and physical activity, (IV) peers experience, (V) correct and logical program, (VI) autonomy and empowerment, and (VII) having supporting umbrella.Conclusion:This qualitative research provided a range of facilitators and barriers to self-management of obesity perceived by an obese woman to improve our understanding of the complex nature of self-management of obesity. Healthcare providers may consider this issue while designing and implementing appropriate interventions to upgrades woman's ability for self-management of obesity.

Cognitive Behavior Therapy’s Effect in a Weight Loss Program Among Obese Iranian Women

Obesity is a global health concern with a higher prevalence among women than men. Cognitive behavioral therapy (CBT) for obesity is a form of behavior therapy in combating obesity, which has rarely been used in developing countries. In a single-blind clinical trial, we evaluated the effect of CBT on the adherence to low-calorie diets (LCDs) with increased physical activity and anthropometric indices in a 4-month follow-up study of obese Iranian women. In this single-blind clinical trial, 72 Iranian women with obesity were recruited and divided into 2 study groups. The intervention group in addition to an individual LCD and a speed walking program received CBT. Assessments were accomplished on 3 time points (baseline and after 2 and 4 months). Anthropometric measurements showed a significant decrease in the intervention group compared with the control group over time (P &lt; .001). Adherence to diet (80% vs 74%) and mean steps counted (24 590 vs 20 466) were significantly higher in the intervention group compared with the control group after 4 months of follow-up, respectively (P &lt; .05). Changes in motivations with CBT can improve adherence to exercise and a healthy LCD among obese women in developing countries.

Effects of orlistat on serum androgen levels among iranian obese women with polycystic ovarian syndrome.

IntroductionPolycystic ovary syndrome is one of the most common endocrinopathies in young women, and it affects 6% to 8% of women in reproductive age. Hyperandrogenism is the hallmark of polycystic ovary syndrome. The aim of the present study was to evaluate the effects of orlistat on weight loss and serum androgen levels among Iranian women with polycystic ovary syndrome.MethodsThe present study was carried out in the clinic of Infertility and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Thirty-two patients with polycystic ovary syndrome were randomly enrolled. We measured serum androgens (Testosterone, 17α-hydroxyprogesterone, dehydroepiandrosterone and sex hormone-binding globulin) before and after 12 weeks of treatment with orlistat. We used the Rotterdam Criteria for all patients and transvaginal sonography was performed.ResultsThe mean age of patients was 27.75±6.22 and the mean body mass index was 32.69±0.94 kg/m2. Comparing with baseline, treatment with orlistat resulted in a significant reduction in weight, BMI, and waist circumference (p=0.001). We also found a remarkable reduction in total testosterone levels (p>0.001). Treatment improved the sex hormone-binding globulin plasma levels, but the improvement was not statistically significant. There was no reduction in other androgen levels.ConclusionThis study showed a significant reduction of weight and total testosterone level - the most important androgen in polycystic ovary syndrome - after 12 weeks of treatment with orlistat. Therefore, it seems that a short course of orlistat can be useful in the management of patients with polycystic ovary syndrome.

Association between FTO gene polymorphisms and type 2 diabetes mellitus, serum levels of apelin and androgen hormones among Iranian obese women

Background and aimsRecent studies show that FTO single nucleotide polymorphisms (SNPs) are associated with obesity and type 2 diabetes mellitus (T2DM). On the other hand, many animal models and clinical studies have demonstrated that apelin, an adipocytokine, is related to the obesity and T2DM. Additionally, obese women are at risk of Hyperandrogenemia. So, the aim of this study was to investigate the relationship between FTO variants (rs763967273, rs759031579, rs141115189, rs9926289, rs76804286 and rs9939609) with T2DM, serum apelin and androgenic hormones in Iranian obese women. Subjects and methods197 obese women (123 women with T2DM and 74 women as healthy control) were participated in this study. Anthropometrical and biochemical characteristics were measured. Serum apelin and androgen hormones levels were determined in 66 subjects consisting of 33 cases and 33 controls. PCR were carried out and subsequently, the PCR production was genotyped by Sanger sequencing assay. ResultsOur observations showed that all SNPs are related to T2DM. The rs9926289 FTO variant had a strong association with serum apelin and dehydroepiandrosterone-sulfate levels (P=0.04 and P=0.03, respectively) among SNPs. In addition, apelin and androgenic hormones were correlated with T2DM. Two polymorphisms including rs9939609 and rs9926289 had a strong Linkage disequilibrium (r2=1). ConclusionFTO variants not only were associated with T2DM, but also some variants had a strong association with apelin and androgenic hormones profile.

Metabolically healthy/unhealthy components may modify bone mineral density in obese people.

This cross-sectional study aimed to compare total BMD and L-L4 BMD in MHO and MUHO base on Karelis criteria. We enrolled 272 Iranian obese women and men (BMI ≥30). According to Karelis criteria, the participants were grouped base to MHO and MUHO. The body composition and BMD were assessed for all cases. Serum HDL-C, LDL-C, total cholesterol, triglyceride (TG), fasting blood glucose, homeostatic model assessment-insulin resistance (HOMA-IR), and hypersensitive C-reactive protein (hs-CRP) levels were quantified by ELISA method. Our results demonstrate MUHO phenotype have high total BMD more than MHO (P=0.01, CI=0.12 to 0.21). Also, the results of logistic regression analysis showed MUHO have strongly associated with total BMD (β=-0.42, CI=-0.31 to -0.04, P=0.009), but did not affected L2-L4 BMD (β=-0.09, CI=-0.14 to 0.08, P=0.578); this represents that there was discordance in MUHO subjects. Our evidence implicated that HOMA-IR, high level serum TG, hs-CRP, and low level serum HDL had mediatory effect on relationship between obesity and high BMD at the hip region in MUHO subjects (P<0.05). Present evidence indicates that, could be a novel link between difference in MUH phenotype and MH phenotype with bone status. Also, component metabolic can effect on BMD in different sites.