Rapid Weight Loss Research Articles

The objective of this study was to analyze safe and effective weight loss strategies in Jiu-Jitsu athletes, considering their impact on performance and health. Rapid weight loss (RWL) is a common practice among Brazilian jiu-jitsu athletes seeking to compete in lower weight categories. It is usually achieved through caloric restriction, dehydration, and the use of thermal clothing, leading to a loss of 3% to 10% of body weight within a few days. However, these methods impair physical and mental performance, reducing strength, endurance, aerobic capacity, and focus, while causing fatigue, dizziness, and mood changes. In contrast, gradual and professionally supervised nutritional strategies have proven to be safer and more effective, helping to preserve lean mass and improve performance. It is concluded that although RWL may offer temporary competitive advantages, its negative health effects outweigh the benefits, highlighting the importance of proper nutritional planning and a multidisciplinary approach.

Ketogenic diet is less effective in ameliorating depression and anxiety in obesity than Mediterranean diet: A pilot study for exploring the GUT-brain axis.

Outcomes of concomitant laparoscopic sleeve gastrectomy and cholecystectomy.

PurposeThis study investigated the effects of moderate (≤5%) and high (>5%) weight loss (WL) on physiological recovery, cognitive performance, self-control, and technical-tactical performance in elite judo athletes during international competitions.MethodsTwenty elite athletes (age: 20.6 ± 2.2 years; body mass: 72.3 ± 14.4kg; height: 1.73 ± 0.09m) were assessed during a 10-day period leading up to competition. Body mass, heart rate variability (HRV) at rest, cognitive performance, and technical-tactical performance were examined. Athletes were categorized into moderate (MWLG, n = 9) and high (HWLG, n = 11) weight-loss groups. Statistical analyses included repeated measures ANOVA and correlation tests.ResultsBoth groups showed significant body mass reduction (MWLG: mean: 3.0 ± 2.0%; HWLG: mean: 6.8 ± 1.5%), with moderate to strong correlations between body mass reduction and increased response times on Flanker task (r = 0.52-0.61, p < 0.05). HRV indices remained stable, reflecting athletes' physiological resilience across the pre-competition period. Importantly, no significant differences were observed between groups in technical-tactical performance, self-control and inhibitory control.ConclusionWL was moderately associated with delayed response times on an inhibitory control task, indicating a change in cognitive strategy. These findings emphasize the need for integrated strategies combining weight management, recovery protocols, and cognitive training, as the observed associations between WL and cognitive response times may influence decision-making processes without directly impairing technical-tactical performance.

Abstract Disclosure: B.A. Vista: None. O.C. Dampil: None. R.L. Dela Cruz: None. Background: Superior mesenteric artery (SMA) syndrome is a rare condition caused by duodenal compression between the aorta and the superior mesenteric artery, often resulting from the loss of mesenteric fat. Common triggers include rapid weight loss, malignancy, malabsorption, and other chronic conditions. Symptoms typically include postprandial epigastric pain, nausea and vomiting. Diagnosis is primarily radiologic, with CT imaging showing a reduced aortomesenteric angle (&amp;lt;22–28°) and distance (&amp;lt;8 mm).This case presents a Filipino patient with Type 2 Diabetes Mellitus and mixed anxiety and depressive disorder, diagnosed with SMA syndrome presenting as recurrent episodes of epigastric pain, nausea, and vomiting, following a significant weight loss of 10 kg over six months. Clinical Case: A 30-year-old female, with Type 2 Diabetes Mellitus and recently diagnosed with mixed anxiety and depressive disorder, presented with 1 month history of recurrent episodes of epigastric pain, nausea, vomiting, and significant weight loss of 10 kg over 6 months (42 kg from 52 kg). The patient reported that she was under considerable stress, which led to a poor appetite and a reduction in her food intake to only one meal per day. Physical examination revealed a BMI of 17 (Height 157 cm, weight 42 kg). Initial laboratory findings showed leukocytosis (WBC 13,150 mm3; Reference range 4800-10800), hypokalemia (K 3.1 mmol/L), normal renal function (Creatinine 0.66 mg/dL egFR 121), and normal lipase 22 U/L (Reference range 12-53 U/L). 12L ECG showed sinus rhythm, with nonspecific ST-T wave changes. Urinalysis was unremarkable and pregnancy test was negative. A whole abdominal CT scan with oral contrast revealed a reduced aorto-mesenteric angle, measuring 20.4°, with apparent compression of the left renal vein and the third portion of the duodenum. The patient was diagnosed with SMA syndrome. She was initially placed on NPO, received intravenous fluids, and underwent electrolyte replacement therapy. As her symptoms improved, she was gradually advanced to a clear liquid diet, followed by the introduction of oral medications and further dietary progression. At her 6-month follow-up, she achieved weight gain (54 kg from 42 kg, BMI 21.9) with resolution of symptoms and normalization of the aortomesenteric angle (34.2°). Conclusion: This case highlights the importance of recognizing SMA syndrome as a possible serious complication of rapid weight loss, particularly in patients presenting with gastrointestinal symptoms such as abdominal pain, nausea, and vomiting. The risk may be heightened in individuals with psychological conditions like mixed anxiety and depressive disorder, where significant weight loss may occur. Non-surgical intervention can be effective through early detection and prompt management. Presentation: Sunday, July 13, 2025

Disclosure: E. Camajani: None. C. Camilla: None. M. Spizzichini: None. D. Masi: None. R. Rebecca: None. M. Spoltore: None. C. Lubrano: None. L. Gnessi: None. C.G. Moretti: None. M. Caprio: None. M. watanabe: None.Obesity is a complex condition influenced by a combination of genetic, environmental, and behavioral factors, and it significantly impacts overall health. The management of obesity requires an integrated approach, with dietary therapy as its cornerstone. Among nutritional strategies, the Very Low Energy Ketogenic Therapy (VLEKT) has gained attention for its ability to induce rapid weight loss while minimizing lean mass loss and enhancing satiety. However, for many patients, dietary interventions alone often fall short in achieving sustainable long-term results. In this context, GLP-1 receptor agonists have demonstrated efficacy in reducing and maintaining body weight through appetite modulation and improved glycemic control long term.This single-center, prospective observational study evaluated the efficacy and safety of VLEKT alone (VLEKT group) compared to its combination with liraglutide (VLEKT +Lira group) over a four-month observation period.All participants followed a VLEKT with meal replacements for at least 45 days. The nutritional intervention provided approximately 800 kcal/day, consisting of 4-5 meal replacements daily and one serving of low glycemic index vegetables at lunch and dinner. The macronutrient composition was as follows: carbohydrates <50 g daily, protein 1.2-1.5 g/kg of ideal body weight, and fat comprising the remainder of the calorie intake. Meal replacements were then gradually replaced by protein dishes primarily made of egg, lean meat, and fish. Fats were primarily derived from extra virgin olive oil, fish, and seeds. Calorie intake was gradually increased up to approximately 1200 kcal/daily.Participants in the VLEKT+Lira group were prescribed liraglutide in addition to the dietary intervention. The initial dose was 0.6 mg daily, which was gradually uptitrated based on individual patient tolerance. Dose adjustments were made under close medical supervision to ensure safety and optimize treatment efficacy.Both strategies resulted in significant reductions in body weight and improvements in metabolic parameters. However, the VLEKT +Lira group experienced greater weight loss (-20.4% vs -14.7%, p = 0.013) and a more pronounced reduction in insulin resistance (p<0.001). Ketone levels were higher in the combination group, suggesting improved adherence to the dietary regimen. Despite the metabolic benefits, the VLEKT +Lira group reported a higher incidence of adverse effects, including nausea (p<0.001), heartburn (0.004), reflux (p=0.009), and mental and physical fatigue (p=0.003 and p=0.02, respectively). Safety parameters, including liver enzymes and renal function, remained stable in both groups.These findings suggest that the combination of VLEKT and obesity medications represents an effective strategy for obesity management, although the increased incidence of adverse effects needs careful clinical monitoring.Presentation: Sunday, July 13, 2025

Abstract Background and Aims The current KDIGO recommendations for the treatment of CKD recommend that every nephrologist should have an option for measuring kidney function (mGFR) with an exogenous substance. Currently, only iohexol or radioactively labeled DTPA are available as exogenous substances for clearance measurements. The iohexol clearance measurement is available in a standardized form and we show the introduction into clinical routine. Method A total of 289 patients were evaluated in the nephrology outpatient clinic for a potential kidney function measurement between October 2023 and March 2024. First, a kidney function was carried out by determining creatinine and estimating the GFR using the CKDEpi formula (eGFR). If there were reasons for the implausibility of the creatinine measurement and the associated eGFR, e.g. malnutrition, tumor disease, heart failure, cirrhosis, catabolic diseases or sarcopenic patients, an mGFR was also carried out using iohexol clearance measurement at 3 points in time (after 3, 4 and 5 hours). The iohexol concentration was determined in the central laboratory using a standardized CE-certified laboratory kit (Nephrolyx GmbH, Berlin, Germany) and the kidney function was calculated using a one-compartment model at three measurement timepoints. Results 289 patients were evaluated. In 56 patients there were reasons why the creatinine value was estimated rather implausible. Typical reasons were rapid weight loss during tumor therapy (n = 12 patients), cardiorenal syndrome (n = 16 patients) and patients with longer intensive care stays (N=8 patients). In 45 patients, kidney function could be determined using iohexol clearance in a technically straightforward manner. The average deviation from eGFR was calculated as the difference expressed in %. In the patients with tumor therapy, the estimate showed an overestimation of kidney function of over 32% on average, with one exceptional case in a patient having an mGFR of 11 ml/min/1.73 m2 with an eGFR of 33 ml/min/1.73 m2 had. In patients with cardiorenal syndrome, kidney function was overestimated by an average of 27%. Renal function was overestimated by 38% in patients after prolonged intensive care stays. In individual cases, especially in tumor therapy, adjustments to the dose of tumor medication made sense or also when potentially administering antibiotics. Conclusion A kidney function measurement in everyday clinical practice in an outpatient clinic is possible and useful. Renal function measurement should be performed in patients with potential implausibility for creatinine-based renal function measurement. Here, overestimation of kidney function due to the estimation is often observed and this can also result in medication dosage adjustments.

Semaglutide (Ozempic, Rybelsus, Wegovy) is a GLP-1 receptor agonist used for the treatment of type 2 diabetes and, more recently, weight management. Due to its efficacy in weight loss, semaglutide has gained worldwide popularity, particularly the branded version Ozempic, resulting in off-label use by people seeking rapid weight loss. The resulting high demand has led to an increase in falsified products sold by unregulated online marketplaces. We present a case of a 31-year-old woman who was admitted to the emergency room in a hypoglycaemic coma after self-administrating semaglutide (Ozempic) obtained from a website. Toxicological analysis showed that the vial contained insulin instead of semaglutide, therefore leading to severe hypoglycaemia. This case highlights the growing concern regarding falsified medicines sold in the online drug market and the associated risk of severe adverse events. We reported the case to the Italian Medicines Agency (AIFA) and local authorities. We propose regulatory measures to mitigate similar incidents in the future.

This study investigated the weight loss (WL) practices, perceptions, and eating disorders (ED) symptoms of Chinese female adolescent combat sport (CS) athletes. An adapted Rapid WL Questionnaire (RWLQ) and Eating Disorder Examination-Questionnaire 8 (EDE-Q8) were completed during the off-season of female adolescent CS athletes to provide WL practices, perceptions, and global ED score. There were 130 and 78 respondents for the adapted RWLQ and EDE-Q8, respectively. Seventy-three percent of participants purposefully engaged in WL practices. The average habitual WL was 8.0% of body mass (BM), and the average highest WL was 9.1% of BM. Participants predominantly allocated 15 + days before the weigh-in for WL (65%). Coaches were most commonly reported as the primary guides for WL (64%). Athletes engage in WL mainly to compete against lighter opponents (65%). Most participants perceived that WL had no impact on health (51%), is beneficial to performance (52%), and does not lead to unfair competition (79%). Only six percent of participants were considered as having ED symptoms. No significant differences or association in global ED scores and ED symptoms were observed across any examined dependent variables. The prevalence and magnitude of WL are high amongst Chinese female adolescent CS athletes. Most athletes adopted long-term strategies to lose a substantial percentage of their BM. Athletes’ WL practices did not differ according to their perceptions regarding the impact of WL on performance, health, or fairness. Off-season prevalence of ED symptoms and global ED score showed no significant differences or associations with athletes’ habitual WL behaviors.

Recent studies advocate prediabetes remission as a goal in diabetes prevention, but the optimal dietary composition for prediabetes remission over the long term is unknown. We aimed to examine the long-term effects on prediabetes remission of a prudent diet with moderate protein and a moderate glycaemic index (GI) (akin to general dietary guidelines) vs a high-protein, low-GI diet. This study is a secondary analysis of PREVIEW, which is a 3 year, multicentre, parallel, randomised trial. Adults with overweight/obesity (BMI ≥ 25 and <30 kg/m2 or BMI ≥ 30 kg/m2, respectively) and prediabetes (fasting glucose 5.6-6.9 mmol/l and/or 2h glucose 7.8-11.0 mmol/l determined using an OGTT) were recruited. Eligible participants underwent an 8-week rapid weight loss programme comprising a low-energy diet, followed by a 3 year weight maintenance phase comprising lifestyle intervention. At baseline, participants were randomly assigned to a high-protein (25% of energy from protein), low-GI (GI<50) diet, or a prudent diet with moderate protein (15% of energy from protein) and moderate GI (GI>56). The primary outcome of the current analysis was the number of participants who achieved prediabetes remission (i.e. a return to normal fasting glucose and normal glucose tolerance) at 1 year or 3 years. Secondary outcomes were changes in body weight and composition over 3 years (continuous variables) and maintenance of a ≥8% weight loss target (binary variable). Modified intention-to-treat analyses were performed on all participants who received the dietary intervention (n=1856). Risk ratios and 95% CI for prediabetes remission and maintaining the weight loss target in each diet group were estimated using multilevel modified Poisson regression adjusted for age and sex. Linear mixed models were used to estimate the dietary effects on changes in body weight and composition. The moderate-protein, moderate-GI group (n=923) had a higher rate of remission than the high-protein, low-GI group (n=933) at both 1 year (rate of remission 26.3% vs 20.7%; RR 1.26; 95% CI 1.04, 1.53; p=0.025) and 3 years (20.6% vs 15.5%; RR 1.26; 95% CI 1.06, 1.50; p=0.015). However, body weight and composition changes were similar for participants on the moderate-protein, moderate-GI vs high-protein, low-GI diet at 1 year (54.0% vs 57.3% of participants met the weight loss maintenance target [≥8% of initial body weight]; p=0.215) and 3 years (31.4% vs 30.4%, respectively; p=0.793). The differences in remission rates of the two dietary patterns were independent of body weight and composition changes. Following rapid weight loss, a prudent diet with moderate protein and moderate GI was more effective for long-term prediabetes remission than a high-protein, low-GI diet, irrespective of weight change. ClinicalTrials.gov NCT01777893.

Overweight and obesity are among the leading causes of degenerative musculoskeletal disorders. As aconsequence, the proportion of obese patients undergoing knee or hip joint arthroplasty or spinal surgery has significantly increased. In these interventions obese patients are at ahigher risk for perioperative complications, including thromboembolic events, wound healing disorders, periprosthetic infections, implant failure and the need for revision surgery. Abody mass index (BMI) >40 kg/m2 is considered acontraindication for many elective orthopedic procedures. Bariatric surgery can lead to rapid and sustained weight loss; however, the metabolic changes induced by these procedures can affect the absorption and bioavailability of nutrients and medications. At the same time, the altered metabolic state following bariatric surgery is associated with an increased risk of perioperative complications during orthopedic interventions. Furthermore, the efficacy of medications, such as analgesics, antimicrobial agents and oral anticoagulants can be significantly altered by metabolic and bariatric procedures. This article provides an overview of the specific considerations for orthopedic procedures following metabolic and bariatric surgery.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), previously referred to as NAFLD, affects nearly one-third of the global adult population and is a leading cause of chronic liver disease, particularly among individuals with obesity and type 2 diabetes (T2DM). Bariatric surgery, including sleeve gastrectomy (SG), has demonstrated a favorable impact on liver fat reduction. However, the predictive value of early postoperative weight-loss trajectories for long-term hepatic improvement remains uncertain, especially in Asian populations, in which MASLD remains understudied despite its increasing prevalence. Methods: We retrospectively reviewed 198 adults who underwent SG at a tertiary Korean center between January 2019 and April 2024. After excluding 21 who had postoperative complications or missed early follow-up, 177 patients (mean age 37 ± 9 years; 41% male; mean body mass index (BMI) 40 kg/m2) were included in the final analysis. The two-week total weight-loss index (TWL_2W) was calculated, and its association with one-year hepatic steatosis resolution, defined as the normalization of the hepatic steatosis index (HSI < 30) at one year, was assessed using receiver operating characteristic (ROC) analysis to explore the trend toward predictive value. Optimal cut-offs were derived using the Youden Index. Multivariable logistic regression models were adjusted for age, sex, baseline hemoglobin A1c (HbA1c), and BMI. Subgroup analyses were performed according to baseline HSI (35–44, 45–54, ≥55) and type 2 diabetes mellitus (T2DM) status. Results: The mean TWL_2W was 7.9 ± 6.6%. A loss of 7.9% optimally predicted HSI values < 30 at one year (area under the curve [AUC] 0.602; unadjusted odds ratio [OR] 2.34; 95% confidence interval [CI] 1.16–4.73). Predictive accuracy improved in T2DM patients (AUC 0.737, 95% CI 0.54–0.95), in whom TWL_2W ≥ 9.1% conferred an adjusted OR 9.12 (95% CI 1.39–59.82), whereas no association was observed in non-diabetic subjects. Stratified analysis showed a pronounced effect in moderate baseline steatosis (HSI 45–54; OR 3.56), but absolute normalization was rare when the baseline HSI was ≥55. Early weight loss was not significantly linked to one-year HbA1c or triglyceride targets. Conclusions: An 8–9% reduction in body weight within two weeks of SG was independently associated with the resolution of hepatic steatosis at one year, particularly among patients with T2DM or moderate baseline hepatic steatosis. This simple metric may assist in early risk stratification and guide personalized postoperative care.

The impact of exercise on fat free mass reduction during very low energy diet-induced weight loss in adults with overweight or obesity: A systematic review and meta-analysis.

Women with a raised body mass index are likely to take longer to conceive and have poorer outcomes from fertility treatment. Furthermore, fertility clinics commonly require women to have body mass index < 30 kg/m2 prior to treatment. Consequently, many women face the challenge of needing to lose weight to improve their chances of conception or to become eligible for fertility treatment. For these women, there is an additional pressure to lose weight quickly due to the diminishment in reproductive potential with advancing age. Synthetic glucagon-like peptide-1 receptor agonists have been shown to cause rapid weight loss in individuals with obesity, as well as reversing some of the metabolic dysfunction associated with obesity and polycystic ovarian syndrome. The potential effect of preconception glucagon-like peptide-1 receptor agonist therapy to increase the chance of pregnancy in women with obesity is an emerging area of research. If this treatment proves to be safe and effective, it could provide significant benefits for many overweight women facing infertility. This article summarizes our understanding of the effect of obesity and polycystic ovarian syndrome on fertility and the success of assisted reproductive techniques. It also describes the traditional treatments for obesity, the pharmacology of glucagon-like peptide-1 receptor agonists, and the evidence for glucagon-like peptide-1 receptor agonists in improving fertility and pregnancy outcomes in overweight women, as well as the potential safety and ethical issue.

Obesity is a prevalent modifiable cause of male factor infertility. Preconception guidelines recommend men maintain a healthy weight; however, they provide limited guidance regarding methods or volume of weight loss for men with obesity. First-line interventions for weight loss involve lifestyle optimization (healthy diet and exercise), followed by pharmacotherapy or bariatric surgery in severe cases. Each modality has differing weight loss potential and complications for which the reproductive implications are currently unclear. To synthesize the available evidence regarding the reproductive effects of obesity interventions in men with obesity. Where possible, to evaluate whether the observed effects depend on the magnitude of weight loss. Searches for articles published in English was performed using PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials and Scopus from inception until December 2024, using prespecified keywords pertaining to four categories: male, overweight/obesity, weight loss (bariatric surgery, nutrition, diet, lifestyle, exercise, pharmacotherapy) and fertility (conception, assisted reproduction, sperm, semen). Studies of reproductive-aged men (18-50 years) who underwent an obesity intervention with established weight loss benefits and undertook repeated assessment of reproduction capacity (semen analysis, conception rates, assisted reproduction outcomes) before and after the intervention were included. Meta-analysis was performed when two or more studies of the same modality assessed an outcome measure in a manner suitable for meta-analysis. A meta-regression considering weight loss achieved was performed when five or more suitable studies were available. Narrative review of studies not suitable for meta-analysis occurred. 32 studies were included in the analysis, with one study assessing both lifestyle interventions and pharmacotherapy. Assessment of conception rates and assisted reproduction was limited across all modalities. In almost all cases, the effect of obesity interventions on semen quality was examined as a surrogate for reproductive capacity and the certainty of evidence was low. Bariatric surgery was assessed in 18 studies, including 12 quasi-experimental studies, one randomized controlled trial, one case series and four case reports. Fixed- and random-effects meta-analysis of randomized controlled trials identified no differences in sperm parameters between control and intervention arms across any intervention, although small sample size limits interpretability. Random-effects meta-analyses of pre-post outcomes identified no clinically significant semen parameters or DNA damage changes following bariatric surgery. Pharmacotherapy (metformin and liraglutide) was assessed in five studies, including four quasi-experimental studies and one case report. There were insufficient data to draw clear conclusions regarding the impact of these agents on fertility outcomes. Lifestyle interventions were assessed in 10 studies, including five quasi-experimental studies and five randomized controlled trials. Fixed-effect meta-analysis identified improvements in sperm normal morphology (Mean difference = 0.59%, 95% Confidence interval = [0.23, 0.94]), and progressive motility (10.56% [8.97, 12.15]) following a lifestyle intervention. Data regarding weight loss interventions and male fertility is limited primarily to observational studies examining semen quality. Improvements in semen quality following lifestyle interventions suggest a potential benefit of optimizing nutrition and physical activity, whereas a limited change with bariatric surgery indicates obesity-associated sperm dysfunction does not resolve in a dose-dependent manner with weight loss and/or negative effects of rapid weight loss exist. Substantial knowledge gaps were identified, including limited randomized trials, inadequate examination of conception outcomes and limited assessment of GLP-1 agonist effects. CRD 42022349665.

In Mixed Martial Arts (MMA), a combination of combat techniques and physical demands takes center stage. Before competition, many athletes engage in rapid weight loss (RWL) strategies to qualify for lower weight classes, aiming to gain a competitive edge by facing smaller or less physically dominant opponents. This practice is driven by the belief that regaining weight after the official weigh-in enhances strength, power, and resilience during the bout. For MMA athletes, adhering to an evidence-based Weight Management Protocol (WMP), targeting a 10% body weight reduction within 7 days prior to weigh-in, poses a significant challenge. This study evaluated the efficacy and safety of a structured nutritional strategy, including controlled dietary interventions and fluid manipulation, tailored for athletes seeking to lose 10% of body mass, along with evidence-based recommendations for post-weigh-in recovery. We followed 31 professional MMA athletes (28 males, aged 28 ± 4 years), all with established experience in RWL protocols. The study was divided into two phases: pre- and post-RWL assessments. Athletes achieved a mean weight reduction of 7.25 kg (10.6%) within the 7 days leading up to the weigh-in, conducted 8 days before competition. They demonstrated a mean weight regain of 7.5 kg (11.2%) within 30 h post-weigh-in, indicating effective rehydration and recovery. Starting 7 days before the weigh-in, athletes consumed 7 liters of fluids per day, with intake gradually decreasing. On the day before the weigh-in, they consumed only 0.5 liters. Following adherence to the protocol, 67.7% (21 athletes) secured victory in their bouts. This study presents a structured, athlete-centered nutritional approach for RWL, offering a potentially safer and more effective alternative to uncontrolled practices. Future research should explore the physiological, psychological, and performance-related implications of such methods through larger, randomized controlled trials.

Abstract Introduction Obesity is a major risk factor for obstructive sleep apnoea (OSA). Very low energy diets (VLEDs) are effective for reducing weight but are associated with greater fat free mass (FFM) reduction where exercise may be protective. We aimed to assess the feasibility and tolerability of VLED-induced rapid weight loss with or without functional exercise in men with OSA and obesity. Methods This open-label pilot randomised controlled trial recruited men aged 18-55 years with BMI ≥27kg/m2 and untreated moderate-to-severe OSA to VLED-only (VO) or VLED-plus-exercise (VEX) for 12 weeks. Both groups followed a VLED providing &amp;lt;800kcal/day. The VEX group also participated in supervised functional exercise training. Results Nineteen men completed the study, with one drop out from VEX. Significant AHI reductions were observed in both VO (n = 9, -20.9events/hr [95%CI -28.3 to -13.6]) and VEX (n = 10, -12.4 events/hr [-21.7 to -3.1]). The VO group lost -16.6kg [-21.8 to -11.3] and -10.1kg fat mass [-8.2 to -1.9]. The VEX group lost -12.7kg [-17.1 to -8.3] and -8.6kg fat mass [-11.6 to -5.7]. FFM reduction occurred VO -5kg [-8.2 to -1.9] and VEX -3kg [-5 to -1.1]. Reduction in total AUC for glucose (-13.1 [-25.7 to -0.4; p=.04]) and insulin (-363.9 [-700.7 to -27.1 p=.04]) were significantly different between groups, favouring VEX. Discussion VLED, with or without exercise, proved feasible, tolerable and demonstrated positive improvement in AHI and body composition. Exercise induced favourable improvements in insulin sensitivity and the smaller reduction in FFM in the VEX group suggests exercise preserved FFM during VLED.

Objective diagnosis of Patulous Eustachian Tube following bariatric surgery using dynamic tympanometry.

With the rise in metabolic and bariatric surgery (MBS), many patients likely have family members who also underwent MBS, yet how attachment to these relatives affects surgical outcomes remains unclear. Understanding this relationship is crucial, as attachment influences emotional regulation, self-efficacy, and behavior change-key factors in long-term weight management and surgical success. This study examined whether attachment styles influenced body mass index (BMI) changes from presurgery to 6 months postsurgery in 123 MBS patients. Patients with higher avoidant attachment to a family member who had MBS had higher BMI at intake (b = 3.16) but showed more rapid weight loss over 6 months (b = - 2.02). Anxious attachment was unrelated to intake BMI but predicted less favorable BMI trajectories over 6 months (b = 0.82). Findings underscore the importance of considering attachment dynamics in families where multiple members have undergone MBS.

The role of whey protein supplementation after one-anastomosis gastric bypass: Results of a double-blind randomized controlled trial.