Management Of Obesity Research Articles

International consensus position statement on the role of obesity management medications in the context of metabolic bariatric surgery: expert guideline by the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO).

International consensus position statement on the role of obesity management medications in the context of metabolic bariatric surgery: expert guideline by the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO).

Dose-dependent effects of anthocyanin-rich extracts on obesity-induced inflammation and gut microbiota modulation.

Obesity and its associated inflammatory state pose a significant health burden. Anthocyanins, bioactive compounds found in fruits and vegetables, have garnered interest in their potential to attenuate these conditions. Understanding the dose-dependent response of anthocyanins is essential for optimizing their therapeutic potential in preventing and managing obesity. This comprehensive review explores the current knowledge on the dose-dependent effects of anthocyanins on obesity in both human and animal models, analyzing the structure and mechanism of absorption of these compounds. The article also highlights the diverse mechanisms underlying anthocyanin action, the symbiosis between anthocyanins and gut microbiota impacting metabolite production, influencing diverse health outcomes, modulating cytokines, and activating anti-inflammatory pathways. Additionally, their impact on energy metabolism and lipid regulation is discussed, highlighting potential contributions to weight management through AMPK and PPARγ pathways. Despite promising results, dose-dependent effects are fundamental considerations, with some studies indicating less favorable outcomes at higher doses. Future research should focus on optimizing dosages, accounting for individual responses, and translating findings into effective clinical applications for obesity management.

Healthcare utilization associated with obesity management in Ontario, Canada.

This study aimed to describe the characteristics, healthcare resources utilized and costs incurred by adults receiving publicly funded obesity care in Ontario, Canada. People living with obesity who first visited Wharton Medical Clinic, a weight and diabetes management clinic in Ontario, between 2015 and 2018 were identified. Pseudoanonymized data were linked to administrative databases to understand healthcare utilization and costs borne by the public payer over 3 years. 6208 participants had linked data, 63.9% and 27.3% of whom remained followed one and two years after their first clinic visit, respectively. The cohort was 71.84% female with a mean (SD) age of 50.86 (13.28) years and BMI of 40.21 (7.06) kg/m2. Approximately 25% of participants were prescribed pharmacotherapy (liraglutide, orlistat, naltrexone/bupropion), 4% received psychological therapy and 2% had weight-loss surgery. Common obesity-related complications were hypertension (42.62%), musculoskeletal pain (35.20%) and dyslipidaemia (33.65%). Participants had 22.16 physician visits per person-year in year one, mostly to general practitioners and endocrinologists, which decreased to 17.38 visits per person-year by year three. Mean total costs (excluding privately covered prescriptions) per person-year decreased from $5227.25 (Canadian dollars) (SE: $0.97) to $4982.88 (SE: $2.16) over the same period. Participants were mostly female and presented with obesity-related complications. Although healthcare utilization and costs incurred by the cohort were high, both showed a decreasing trend over the follow-up period.

Lifestyle Modification for Obesity Management—A Cornerstone and Not a Roadblock

Lifestyle Modification for Obesity Management—A Cornerstone and Not a Roadblock

Introduction to the differences in key points of obesity management between domestic and international guidelines

Introduction to the differences in key points of obesity management between domestic and international guidelines

Phytol and bilimbi phytocompounds induce thermogenic adipocyte differentiation: An in vitro study on potential anti-obesity effects

BackgroundObesity is a major health concern associated to diabetes, cardiovascular disease, and cancer. Brown adipocytes, which specialise in thermogenesis, offer a potential therapeutic target for obesity prevention and related conditions. This study builds on previous findings of the browning activity of Averrhoa bilimbi hexane fractions and aims to elucidate the underlying mechanisms in vitro. Squalene and phytol, key phytocompounds from bilimbi leaf extract and fractions, were assessed for their ability to induce thermogenic adipocyte using 3T3-L1 preadipocytes and C2C12 myoblasts in vitro models. The result shows that bilimbi fractions F7, F8, and F9, along with squalene and phytol, effectively induced thermogenic adipocyte differentiation. This was evidenced by the upregulation of key markers, including Ucp1, Prdm16, and Pgc1α, and increased expression of the brown adipocyte-specific protein CIDEA in treated 3T3-L1 preadipocytes. Notably, all treatments promoted thermogenic adipocytes differentiation in C2C12 myoblasts via the upregulation of Pgc1α, Ucp1 genes, and UCP1 protein. These findings suggest that bilimbi fractions and its phytocompounds may hold potential as nutraceutical interventions for obesity management.

Experiment of laparoscopic sleeve gastrectomy in Al-Imamein Al-Kadhimein Medical City

Background: Obesity is a multifactorial metabolic disorder characterized by the accumulation of excess energy in adipose tissue. The risk of this disorder lies in genetic problems, intake problems, psychological disorders, lack of exercise, eating habits, and medical conditions. Weight loss attempts involving dietary changes, behavioral modifications, and exercise have been of limited benefit to most affected individuals. Weight loss operations have obviously evolved in recent years. The most commonly used and best-studied procedure is laparoscopic sleeve gastrectomy (LSG). Aim: The aim of this study was to assess certain points of LSG (benefits and complications for patients with morbid obesity) performed in Al-Imamein Al-Kadhimein Medical City. Patients and Methods: Data were collected in a prospective cohort study in Al-Imamein Al-Kadhimein Medical City between January 2021 and December 2022. LSG was performed for 40 patients for the treatment of obesity and included the following demographic data: body mass index (BMI, weight in kilograms divided by height in square meters (kg/m2)), hip circumference, waist circumference, total cholesterol, triglyceride, low-density lipoprotein, high-density lipoprotein, HbA1c%, and fasting blood sugar, presence of comorbidity (e.g. diabetes and hypertension), and complications following surgery. All patients were followed 3 months and 9 months postoperatively. Results: A total of 40 obese patients underwent bariatric surgery (laparoscopic sleeve gastrectomy), there were 65% female and 35% male, their mean age was 34.30 ± 5.31 years (range:23-45 years), the mean weight of patients was 146.70 ± 21.92 kg (115- 200 kg), the mean BMI was 51.45 ± 5.65 kg/m2 (37.5-63.8 kg/m2). Excess weight loss was 69% after 9 months. The improvement in comorbid diseases was significant. Conclusion: LSG is a useful procedure for the surgical management of morbid obesity. Most people who underwent these operations experienced a reduction in complications of obesity, such as hypertension and diabetes mellitus.

Central obesity may account for most of the colorectal cancer risk linked to obesity: evidence from the UK Biobank prospective cohort.

General obesity commonly represented by body mass index (BMI) is an established risk factor for colorectal cancer (CRC). However, it is unclear to what extent this association is accounted for by central obesity. We aimed to evaluate the associations between BMI, waist-to-hip ratio (WHR), and waist circumference (WC) with CRC risk and to investigate if and to what extent these associations are independent from each other. Data from more than 500,000 male and female participants aged 40-69, recruited in the UK Biobank study between 2006 and 2010, were analyzed. Multivariable Cox proportional hazards models were fitted and hazard ratios (HR) and their 95% confidence intervals (CI) were calculated. During a median follow-up of 12.5 years, of 460,784 participants, 5,977 developed CRC. Multivariable adjusted HRs (95% CIs) per standard deviation increase of BMI, WHR, and WC were 1.10 (1.07-1.13), 1.18 (1.14-1.22), and 1.14 (1.11-1.18), respectively. After mutual adjustment, the association with CRC was substantially attenuated for BMI (1.04 (1.01-1.07)), and remained substantially stronger for WHR (1.15 (1.11-1.20)). Furthermore, WHR showed strong, statistically significant associations with CRC risk within all BMI categories, whereas associations of BMI with CRC risk were weak and not statistically significant within WHR categories. BMI was also not associated with CRC risk in women and with rectal cancer after mutual adjustment. Conversely, WHR was strongly associated with CRC risk in both sexes and with both colon and rectal cancer risk before and after adjustment for BMI. BMI and WC could not be mutually adjusted for due to their high correlation. Central obesity is a much stronger predictor of CRC and may account for most of the CRC risk linked to obesity. Our findings also emphasize the need for incorporating measures such as WHR alongside BMI in clinical practice to improve obesity prevention and management.

A Scoping Review of Existing Policy Instruments to Tackle Overweight and Obesity in India: Recommendations for a Social and Behaviour Change Communication Strategy

Background The Indian government is committed to addressing various manifestations of malnutrition, including overweight and obesity, inorder to improve individual health and well-being. The scoping review aims to map existing national policy instruments (programmes, schemes, regulations and guidelines) addressing overweight and obesity in India and analysing them for Social and Behaviour Change Communication (SBCC) strategies. Methods Systematic identification and selection of policy instruments using ‘Arksey and O’Malley’ framework was conducted from central government ministry websites, between March and June 2023. These instruments focused on nutrition and/or physical activity, targeting specific demographic groups like pregnant women, lactating mothers, children (0-5 years and 5-9 years), or adolescents (10-19 years); excluding those focusing on specific diseases like micronutrient deficiencies, wasting, and stunting. Based on search strategy six policy instruments were included and analysed for SBCC strategies. Results While many policy instruments incorporated SBCC plans; the ‘National Programme for Prevention of Non-Communicable Diseases (NP-NCD)’ stands out as a significant policy initiative specifically targeting the prevention of overweight and obesity within the broader context of Non-Communicable Diseases. It adopts a comprehensive approach addressing key drivers contributing to overweight/obesity across multiple levels of behavioural influence i.e., individual, interpersonal, community and organisation for health promotion. However, there’s need to strengthen SBCC strategies related to prevention and management of obesity, especially screening and counselling, to cover all age groups with a particular focus on adolescents and youth. SBCC strategies can also be incorporated into India’s Integrated Nutrition Support Programme (POSHAN 2.0) and/or Reproductive, Maternal, New-born, Child, Adolescent Health and Nutrition (RMNCAH+N) under the National Health Mission. Conclusion This paper underscores the necessity for comprehensive strategies to address multifaceted origins of overweight and obesity. The NP-NCD stands out as a noteworthy initiative, and there is considerable potential for other programmes to emulate SBCC strategies to bolster their overall effectiveness. Note : *Policy instruments throughout the paper have been used to cover programmes, schemes, regulations and guidelines.

Modulation of Serum Metabolic Profiles by Bifidobacterium breve BBr60 in Obesity: A Randomized Controlled Trial.

Obesity, a prevalent metabolic disorder in youth, leads to complications and economic strain. Gut dysbiosis significantly contributes to obesity and metabolic issues. Bifidobacterium breve, a probiotic strain, may help regulate gut dysbiosis and benefit obese individuals. However, more research is needed on its effect on serum metabolism. A total of 75 overweight or obese young adults (aged 19-45) participated in the current study, and were randomly divided into probiotic and placebo groups using a random number table. Both groups received dietary guidance and underwent twelve weeks of intervention with either oral Bifidobacterium breve BBr60 (BBr60) or a placebo. After the intervention, collection and analysis of fasting serum samples were conducted using mass spectrometry coupled with liquid chromatography. Analyses of associations were conducted in order to determine the correlations between key serum metabolites and clinical obesity indicators, aiming to understand the influence of BBr60. Due to 10 participants dropping out for personal reasons, the study included 32 and 33 participants in the placebo and the BBr60 groups, respectively. The BBr60 intervention significantly regulated 134 serum metabolites and influenced crucial metabolic pathways in obesity management (p < 0.05), including ascorbate and aldarate metabolism for oxidative stress reduction, cholesterol metabolism for lipid regulation, parathyroid hormone synthesis, secretion and action for the endocrine system, oxidative phosphorylation for enhanced energy efficiency, and glycolysis/gluconeogenesis for glucose metabolism. Analysis showed a positive relationship between fasting blood glucose (FBG), aspartate aminotransferase (AST), total protein (TP), and the content of 5-Methyl DL-glutamate (p < 0.05). Similarly, body mass index (BMI), weight, and body fat percentage (BFP) were positively linked to serum metabolites (1-Hydroxycyclohexyl) acetic acid, and 5-Oxooctanoic acid (p < 0.05). Significant associations of AST levels with key serum metabolites in cholesterol metabolism pathways further suggest BBr60's potential to improve liver function and overall metabolic health in overweight or obese individuals. These findings support BBr60's effectiveness in modulating serum metabolic profiles and suggest it may improve liver function and BMI in overweight or obese individuals by regulating key serum metabolites.

Obesity management in primary care: Are we adequately preparing the next generation of Canadian family physicians?

BackgroundObesity is a chronic disease that affects a large proportion of the population. We examined the preparation of Canadian medical learners for obesity management through three cross-sectional studies exploring the: 1) knowledge of evidence-based obesity management among medical students; 2) perspectives of family medicine residents on the adequacy of obesity management training in their residency programs; and 3) intentions of family medicine residents regarding obesity management when they enter practice. MethodsAn online survey instrument was developed for each study. For Study 1, the survey was developed by HP, VE and JA; the questions mapped onto the ten domains outlined in the 2020 Canadian Clinical Practice Guidelines on the Management of Obesity in Adults. For Study 2, the survey was developed by HP and TMcC; the questions aligned with competencies in the management of other chronic diseases. For Study 3, the survey was developed by MR, HP and MV; the Capability, Opportunity, and Motivation (COM-B) model was used as a framework for the questions. All three surveys met the criterion for face validity and the survey for Study 3 met criteria for content and criterion validity. ResultsStudy 1 enrolled 26 first-year and 22 fourth-year students. Total correct scores were below 50 % for both groups, and patient-centeredness scores differed significantly between the groups. Study 2 enrolled 494 family medicine residents; less than 25 % thought there was sufficient time devoted to training in obesity management during residency and approximately 75 % experienced inconsistent messaging about obesity management from their preceptors. Study 3 enrolled 150 family medicine residents. Few participants believed that they had been well trained or had a clear plan for managing obesity, but most believed that obesity management will form part of their practice and that they will have the time and resources for obesity management. ConclusionCurrent medical education does not reflect the requisite knowledge for contemporary obesity management. Further, family medicine residents identified gaps in mentorship of contemporary principles of obesity management. These findings support the revision of the medical curriculum in Canada to better reflect the science of obesity and its management.

Effects of multidisciplinary therapy on energy balance, inflammation, and metabolic diseases in adolescents with obesity: A narrative review.

Obesity is a consequence of multiple factors, including genetics, lifestyle and nutritional choices, physical activity, sleep duration, screen time, and mood disorders. These behavioral elements can impair the regulation of energy balance and obesity management that link obesity to a constellation of chronic conditions that lead to a high prevalence of cardiometabolic risk factors, metabolic syndrome, and nonalcoholic fatty liver disease. Multidisciplinary therapy is defined as an approach delivered by a multidisciplinary-trained health team covering at least two components of behavior, physical activity/exercise, dietary habits, and/or psychological counseling associated with clinical interventions. This narrative review summarizes the effects of multidisciplinary therapy on neuroendocrine regulation of energy balance, inflammatory biomarkers, cardiometabolic risk factors, metabolic syndrome, nonalcoholic fatty liver diseases, behavior, and quality of life. We found that multidisciplinary therapy, including medical, nutritional, exercise, and behavioral counseling, and/or education, was useful for addressing outcomes such as visceral adiposity, neuroendocrine regulation of energy balance, inflammatory biomarkers, cardiometabolic risk factors, nonalcoholic fatty liver disease, and metabolic syndrome. The effects were mediated by improvements in neuroendocrine regulation of energy balance, downregulation of the pro-inflammatory states, and a reduction in comorbidities. Multidisciplinary therapy also improved mood disorders and quality of life.

A Mechanistic Rationale for Incretin-Based Therapeutics in the Management of Obesity.

Driven by increased caloric intake relative to expenditure, obesity is a major health concern placing economic and operational strain on healthcare and social care worldwide. Pharmacologically, one of the most effective avenues for the management of excess adiposity is the suppression of appetite. However, owing to the body's natural physiological defense to weight loss and tolerability issues that typically accompany anorectic agents, leveraging this approach to induce sustained weight loss is often easier said than done. As such, to address these challenges, researchers have coupled a thorough understanding of the gut-brain axis with advancements in peptide engineering to design therapeutics mimicking the actions of endocrine hormones to promote a negative energy balance. Indeed, multireceptor agonists targeting the GLP-1, GIP, and glucagon receptors produce meaningful weight loss in people with obesity. Herein, we provide a rationale for how activation of the GIP receptor in the brain and the glucagon receptor in the liver and adipose tissue functions to synergize with GLP-1 receptor agonism to curb the drive to feed and ignite the combustion of excess calories for providing next-generation weight loss.

Phentermine-induced pancreatitis: an unpopular side effect of the popular weight loss medication

Obesity is becoming more common worldwide, putting a strain on healthcare systems. The first option for achieving significant weight loss is a comprehensive lifestyle modification program that includes diet, exercise, and behavior therapy. The inherent difficulties associated with maintaining lifestyle changes contribute to unsatisfactory long-term outcomes and weight regain in obesity management. Pharmacological interventions, in addition to lifestyle changes, can help with weight loss. Many weight loss drugs have been approved but withdrawn due to ineffectiveness and safety concerns. We report a case of severe acute pancreatitis in a patient with long-term Phentermine usage for weight loss.

BS O02 - Impact of Bariatric surgery on Obesity Indices and Reproductive Hormones: A Prospective Study in Morbidly Obese Women

Abstract Background Obesity, defined by a BMI of 30 kg/m² or higher, is influenced by genetics, socio-economic, and cultural factors. Genetic predispositions affect metabolism and energy regulation, while environmental factors like sedentary lifestyles and poor food environments worsen obesity. Obesity disrupts hormonal balances, impacting sex hormone levels and menstrual cycles, leading to infertility in women. This hormonal imbalance affects oocyte quality and ovulation. Bariatric surgery offers significant weight loss and metabolic improvements, enhancing reproductive hormone profiles and insulin sensitivity. Our study explores how sleeve gastrectomy affects BMI and hormone levels, aiming to understand its impact on obesity management and reproductive health. Method This prospective observational study examines the effects of laparoscopic sleeve gastrectomy on reproductive hormones and ovarian function in 32 morbidly obese women, adhering to Helsinki Declaration ethics. Participants, aged 18-50 with no menopause or chronic illness, consented to the study. Exclusions included those with polycystic ovary syndrome, recent reproductive organ surgery, or recent infertility medications. The study assessed changes in BMI, antral follicles, anti-Müllerian hormone, and reproductive hormones before surgery and at 6 and 12 months post-surgery. Blood samples and transvaginal ultrasounds were conducted preoperatively and at 6 and 12 months postoperatively to monitor outcomes. Results The study involved participants with an average age of 33 and a mean BMI of 42.12. Significant changes were observed post-sleeve gastrectomy at 6 and 12 months (p &amp;lt; 0.001). At 6 months, BMI decreased by 9.24 units, AMH levels dropped from 3 to 2.5 ng/mL, and antral follicle counts in both ovaries declined. By 12 months, BMI decreased by 16.47 units, AMH levels fell to 2 ng/mL, and antral follicle counts further reduced. Hormonal changes included increases in FSH, LH, and estradiol, while SHBG levels rose, and free testosterone levels decreased significantly. Conclusion Individual hormone responses to weight loss and surgery necessitate personalized obesity treatments. Tailoring surgical approaches and care to hormonal profiles can optimize outcomes and reduce complications. Monitoring AMH levels post-surgery can offer insights into reproductive effects, aiding clinical management and counseling for women with obesity-related infertility. We highlight the significant impact of sleeve gastrectomy on physiological parameters in obese individuals, especially regarding reproductive health and metabolic regulation. The findings enhance understanding of the changes associated with bariatric surgery and its potential benefits for metabolic and reproductive health.

A Natural Serotonin Stimulant for Appetite Suppression and Targeted Eating as an Alternative to Conventional Obesity Treatments

Recent advances in obesity management reflect the integration of pharmacological, surgical, and behavioral interventions, yet sustainable long-term outcomes remain elusive due to high attrition rates, the complexity of protocol compliance – and for some, costs, risks, and serious side effects. This research combined a patented nutraceutical designed to naturally stimulate serotonin, a biologic hunger agonist, to thereby aid in appetite control and facilitate weight loss through ‘Targeted Eating,’ a single, unrestricted daily meal protocol. Initial results from this ‘real world’ user study indicate promising weight management outcomes and compliance with this eating strategy. By exploring the evolutionary biology of perceived hunger and the anatomy associated with episodic versus circadian consumption, the study thus proposes a paradigm shift in obesity treatment and suggests further approaches to provide innovative solutions to the global obesity crisis.

Assessing the efficacy of pearl millet and finger millet enriched breakfast cereals to combat obesity

This research explores the development and evaluation of breakfast cereals formulated from pearl millet (P-1) and finger millet (F-1) flours, with a focus on their nutritional composition and potential anti-obesity properties. The techno-functional properties were assessed, revealing that P-1 exhibited a bulk density of 0.40 ± 0.01 g/ml and a true density of 0.61 ± 0.03 g/ml, while F-1 showed a bulk density of 0.54 ± 0.03 g/ml and a true density of 0.65 ± 0.02 g/ml. The Carr index and Hausner ratio were significantly higher in P-1 (40.33 ± 0.41 and 1.68 ± 0.03, respectively) compared to F-1 (22.3 ± 0.3 and 1.31 ± 0.02, respectively). Both flours demonstrated comparable water absorption indices, but P-1 had superior foaming capacity and stability. Nutritional analysis indicated that P-1 contained 12.64% moisture, 6.02% fat, 10.29% protein, 63.94% carbohydrates, 2.38% ash, and 2.75% fibre, whereas F-1 had 8.92% moisture, 1.78% fat, 8.65% protein, 73.65% carbohydrates, 1.77% ash, and 4.04% fibre. Composite flours (PF-1, PF-2, PF-3) exhibited varying compositions: PF-1 had 9.86% moisture, 5.83% fat, 11.62% protein, 66.04% carbohydrates, 2.19% ash, and 3.03% fibre; PF-2 had 10.79% moisture, 3.87% fat, 10.01% protein, 68.97% carbohydrates, 2.05% ash, and 3.37% fibre; PF-3 had 9.87% moisture, 2.84% fat, 9.33% protein, 71.12% carbohydrates, 1.92% ash, and 3.74% Fiber. Antioxidant activity was higher in F-1 (80.63%) compared to P-1 (59.58%), with PF-1, PF-2, and PF-3 showing 64.84%, 70.14%, and 75.4%, respectively. Lipase and amylase inhibition capacities were 73.15% and 28.66% for P-1, 28.31% and 30.65% for F-1, and varied for composites: PF-1 (79.12% lipase, 46.41% amylase), PF-2 (50.75% lipase, 53.15% amylase), and PF-3 (39.51% lipase, 41.84% amylase). These findings underscore the distinct nutritional and functional properties of these flours, highlighting their potential in obesity management.

Novel BMI cutoff points for obesity diagnosis in older Hispanic adults

Current body mass index (BMI) cutoff points (≥ 30 kg/m2) underestimate obesity prevalence in older adults. The aim of the present study was to propose new BMI cutoff points for identifying obesity in older Hispanic adults. In this study, new internally derived (ID) BMI cutoff point for obesity in older Hispanic adults was developed by analyzing data from the National Health and Nutrition Survey of 2018–2019 from Mexico. To evaluate the performance/validation of this newly proposed cutoff point, data from the "Study of the 1000", conducted in Northern Mexico, was utilized. Sensitivity, and negative predictive value (NPV) were assessed using receiver operating characteristic analysis, with obesity defined by fat mass index (FMI; ≥ 9.0 kg/m2 for men and ≥ 12.0 kg/m2 for women) as the reference method. The newly proposed ID BMI cutoff point was ≥ 27.2 kg/m2 which demonstrated high sensitivity (≥ 99.4%) and NPV (≥ 99.5%) in the total sample. Furthermore, the prevalence of obesity estimated by the new BMI cutoff point was comparable to that estimated by the FMI. The newly proposed BMI cutoff point provides a more accurate identification of obesity in older Hispanic adults. These findings have implications for improving obesity diagnosis and management in this population.

Is Gastric Balloon Implantation Still an Effective Procedure for the Management of Obesity and Associated Conditions? Findings from a Multi-Center Study.

Both surgical and endoscopic procedures represent a mainstay of obesity treatment. Several procedures have been developed in recent years, although their impact on obesity is variable. This study examines and presents the results of a 6-month gastric balloon implantation (GBI). The data from the German Bariatric Surgery Registry (GBSR) for the period from 2005 to 2021 were subjected to a multi-center analysis. Six months following GBI, demographic data, the peri-interventional course, weight, BMI reduction, as well as the development of comorbidities (arterial hypertension (aHTN), diabetes mellitus (T2D), reflux (GERD), and sleep apnea syndrome (OSAS)), were evaluated in male and female patients. Of 3754 patients, 788 (45.3% male, 54.7% female) met the inclusion criteria for the study. Following 6 months of therapy, an average weight loss of 19.3 ± 15.2 kg was observed in male patients, while female patients exhibited an average weight loss of 16.3 ± 13.1 kg (p = 0.013). The EWL was found to be significantly higher in female patients than in male patients (24.8 vs. 18; p < 0.001). BMI reduction, %TWL, and mortality rate showed no significant disadvantage in either group (p > 5%). After 6 months of therapy, there was a significant advantage for women in the remission of aHTN. The remaining comorbidities did not differ significantly between the two groups (p > 5%). GBI is an efficacious procedure for the treatment of obese patients with mild obesity and comorbidities or as a bridging procedure prior to planned bariatric surgery.

Parents' experiences of their children's obesity management at the children's hospital on Reunion Island.

Parents' perspectives on their child's obesity (BMI >IOTF-30) management are essential to ensure positive outcomes. This study explored parents' experiences in managing their children's obesity and investigated the sociocultural and environmental factors influencing such management on Reunion Island, a French overseas department in the Indian Ocean. This qualitative study used a general inductive analysis approach. Semi-structured telephone interviews were conducted from France, between January and April 2019, with nine parents of children treated in the Childhood Obesity Unit of the Children's Hospital on Reunion Island. The interviews were analysed by using thematic analysis until data saturation. Four main themes emerged reflecting the stages of parents' experiences during treatment: a life history with feelings of justification and guilt, acceptance, involvement and activism. Cultural food traditions were a barrier to implementing healthier habits. Support and advice from the healthcare services alleviated feelings of isolation and motivated parents to be more proactive in their children's obesity management. Parents' involvement motivated their children and improved their relationships. Parent's involvement is essential in managing children's obesity. To maximise treatment outcomes, tailored interventions that address parents' unique family dynamics and sociocultural perspectives are key.