Reduction In Body Mass Index Research Articles

Effects of repetitive transcranial magnetic stimulation therapy on weight and lipid metabolism in patients with treatment‐resistant depression: A preliminary single‐center retrospective cohort study

AbstractAimThis study aimed to elucidate the effects of repetitive transcranial magnetic stimulation (rTMS) on weight, body mass index (BMI), and lipid metabolism in patients with treatment‐resistant depression (TRD).MethodsThis retrospective observational study included patients with TRD who received rTMS treatment at the Jikei University Hospital from September 2018 to August 2021. The patients were diagnosed based on the DSM‐5 and ICD‐10 criteria and treated using the NeuroStar TMS System. For 3–6 weeks, 10‐Hz rTMS was administered to the left dorsolateral prefrontal cortex at 120% motor threshold. The primary outcomes were changes in weight and BMI, whereas the secondary outcomes included changes in total, high‐density lipoprotein (HDL), and low‐density lipoprotein (LDL) cholesterol levels, thyroid function indicators, as well as HAMD‐17, HAMD‐24, and Montgomery–Åsberg Depression Rating Scale (MADRS) scores. Statistical analysis was conducted using paired t‐tests and repeated measures ANOVA.ResultsAmong the 34 patients (20 men and 14 women) included, no significant changes were observed in weight or BMI after rTMS treatment (average weight reduction: −0.50 kg, 95% CI: −0.14 to 0.56, p = 0.24; average BMI reduction: −0.21, 95% CI: −0.10 to 0.61, p = 0.15). However, significant reductions in total, HDL, and LDL cholesterol levels and FT4 were observed. Furthermore, the HAMD‐17, HAMD‐24, and MADRS scores significantly increased post‐treatment.ConclusionrTMS treatment did not affect weight or BMI in patients with TRD but is believed to improve lipid metabolism.

Effect of FTO Gene polymorphism on anthropometric, hemodynamic, and autonomic variables in adolescents

Objective: The study aimed to analyze the influence of physical activity levels and the rs9939609 polymorphism (FTO gene) on anthropometric, hemodynamic, and cardiac autonomic variables in public school students. Methods: A total of 288 students (aged 11 to 18, both sexes) from public schools in São Luís, Maranhão, were divided into four groups: sedentary AA+AT (AA+AT sed), active AA+AT (AA+AT activ), sedentary TT (TT sed), and active TT (TT activ). Evaluations included the International Physical Activity Questionnaire, weight, height, body mass index (BMI), buccal cells collection for DNA extraction, systolic (SBP) and diastolic (DBP) blood pressure measurements, and heart rate variability (HRV) analysis. A chi-square test for allelic associations was applied a 5% significance level. Results: No significant differences were observed in DBP or heart rate (HR). The active groups (AA+AT activ and TT activ) exhibited reductions in weight and METs/min/week compared to their respective sedentary groups (P<0.05). The TT activ group also demonstrated reductions in SBP and BMI compared to the TT sed group (P<0.05). The TT activ group had higher HRV in the RR time domain (ms) compared to the TT sed group (P<0.05), though no significant differences were found in other HRV variables. Conclusions: The FTO gene polymorphism influences cardiac autonomic modulation, while physical activity levels affect anthropometric variables.

Elucidating the role of weight loss and glycaemic control in patients with type 2 diabetes.

To investigate the independent contributions of glycated haemoglobin (HbA1c) reduction and weight loss to clinical outcomes in patients with type 2 diabetes (T2D) treated with antidiabetic drugs, including glucagon-like peptide-1 receptor agonists (GLP-1RAs). This observational, retrospective cohort study used deidentified electronic health record-derived data from patients evaluated at the Cleveland Clinic (1 January 2000-31 December 2020). Cohort A included 8876 patients with newly diagnosed T2D treated with any of six antidiabetic drug classes. Cohort B included 4161 patients with T2D initiating GLP-1RA treatment. The effects of body mass index (BMI) and HbA1c reduction, variability, and durability on clinical outcomes were investigated. In Cohort A, each 1% BMI reduction was associated with 3%, 1%, and 4% reduced risk of heart failure (p = 0.017), hypertension (p = 0.006), and insulin initiation (p = 0.001), respectively. Each 1% (~11 mmol/mol) HbA1creduction was associated with 4% and 29% reduced risk of hypertension (p = 0.041) and insulin initiation (p = 0.001), respectively. In Cohort B, each 1% BMI reduction was associated with 4% and 3% reduced risk of cardiovascular disease (p = 0.008) and insulin initiation (p = 0.002), respectively. Each 1% (~11 mmol/mol) HbA1c reduction was associated with 4% and 16% reduced risk of chronic kidney disease (p = 0.014) and insulin initiation (p = 1 × 10-4), respectively. Lower BMI variability and greater BMI durability were associated with decreased risk of clinical outcomes in both cohorts. Antidiabetic medication-associated, and specifically GLP-1RA-associated, weight loss and HbA1c reductions independently reduce real-world clinical outcome risk.

The role of metformin in modulating cardiometabolic risk in obese pediatric populations with metabolic syndrome: A systematic review

Introduction: Obesity significantly increases the risk of developing cardiometabolic complications, which are precursors to cardiovascular diseases (CVD). In children and adolescents, metabolic dysfunctions such as insulin resistance, dyslipidemia, and hypertension are key contributors to early-onset cardiovascular risk. Metformin, a well-established antidiabetic agent, has shown potential benefits in addressing these metabolic imbalances. However, the long-term impact of metformin on cardiovascular outcomes in obese pediatric patients remains unclear. Aim: This systematic review aims to evaluate the effect of metformin on cardiometabolic parameters in obese children and adolescents with metabolic syndrome, focusing on insulin sensitivity, body mass index (BMI), blood pressure, and lipid profiles. Methods: A systematic review was conducted by searching databases including PubMed, Cochrane Library, Embase, and Web of Science. The inclusion criteria targeted randomized controlled trials (RCTs), cohort studies, systematic reviews, and meta-analyses published between 2004 and 2024. Pediatric patients aged 6-18 years with obesity and metabolic syndrome were included. The primary outcomes assessed were BMI, insulin sensitivity, lipid profiles, blood pressure, and cardiovascular outcomes. Results: A total of 23 studies, including 10 RCTs and 1 meta-analysis, were reviewed, involving 777 patients. Metformin demonstrated consistent improvements in insulin sensitivity and BMI in obese children and adolescents. Several studies reported modest reductions in BMI, improved insulin resistance, and better lipid profiles. However, variability in results was observed regarding long-term cardiovascular outcomes. While metformin reduced systolic blood pressure and carotid intimal-medial thickness (CIMT), the long-term impact on preventing major cardiovascular events remained inconclusive. Discussion: Metformin’s benefits on cardiometabolic risk factors in obese children are primarily attributed to its effects on insulin sensitivity, lipid metabolism, and inflammatory pathways. Its ability to activate AMP-activated protein kinase (AMPK) leads to improved metabolic profiles and reduced inflammation and is crucial for mitigating obesity-related cardiovascular risks. Despite these positive effects, the evidence for long-term prevention of cardiovascular events is limited and requires further exploration. Conclusions: Metformin offers significant short-term benefits in improving BMI, insulin sensitivity, and cardiometabolic parameters in obese children and adolescents. However, its long-term efficacy in preventing cardiovascular events remains uncertain. Further studies are necessary to establish its role in long-term cardiovascular protection in pediatric populations

Outcomes of post-acute coronary syndrome patients enrolled in a phase 2 cardiac rehabilitation program

Abstract Introduction Cardiac rehabilitation (CR) is a class I recommendation in the management of patients with acute coronary syndrome (ACS), namely ST-elevation myocardial infarction (STEMI) and non-ST acute coronary syndrome (NST-ACS). Reported mortality and recurrent cardiovascular (CV) events are still unacceptably high in these patients. Purpose To assess CV outcomes of patients enrolled in a CR program and its association with ACS presentation. Methods Single-center, retrospective observational study that included all consecutive post-ACS patients enrolled in a phase 2 CR program in 2017, with a follow-up of 24 months. Group 1 were patients with STEMI; group 2 were patients with NST-ACS. Major adverse cardiovascular events (MACE) were defined as a composite of death, non-fatal ACS, non-fatal stroke, and unplanned revascularization. Results Of the 202 ACS patients who attended the CR program in 2017, 4 were excluded due to missing data. Of the 198 patients analyzed (age 60.3±10.7 years, 82% male), 101 patients had a STEMI and 97 NST-ACS. STEMI patients were significantly younger (57±9.5 vs. 63±10, p<0.001), with fewer CV risk factors (diabetes 16% vs. 32%, p=0.008; hypertension 51% vs. 72%, p=0.002; obesity 17% vs. 31%, p=0.020; dyslipidemia 54% vs. 77%, p<0.001), except for active smoking (53% vs. 29%, p=0.001), and were less likely to have previous history of coronary artery disease (9% vs. 31%, p<0.001). During the 3-month CR program, both groups achieved significant reduction in body mass index, LDL-Cholesterol, functional capacity, and smoking cessation rates. At 3-, 12-, and 24-months evaluation, both groups showed no differences in risk factor management, nor differences in lipid-lowering therapy, namely percentage of high-intensity statin and ezetimibe use. STEMI patients were treated more frequently with ticagrelor (86% vs. 67%, p=0.001) at baseline. MACE occurrence was significantly lower in STEMI patients (11% vs. 28%, p=0.003), driven mainly by recurrent ACS (4% vs. 15%, p=0.006). Conclusions In our study, NST-ACS patients had significantly higher CV disease burden and worse outcomes at 24-month follow-up. Despite the heightened CV risk in this group, secondary prevention treatment intensity was similar in both groups.

Impact of addressing modifiable risk factors on the 10-year risk of cardiovascular disease in individuals with familial hypercholesterolemia: a causal analysis utilising UK biobank

Abstract Background Familial hypercholesterolemia (FH) is a prevalent autosomal dominant disorder characterised by elevated low-density lipoprotein cholesterol (LDL-C) levels from birth. These elevated LDL-C levels significantly amplify the lifetime risk of cardiovascular disease (CVD). While the impact of early and effective initiation of lipid-lowering medication (LLM) on CVD risk is well documented in genetically confirmed FH, the additional impact of addressing modifiable lifestyle risk factors (MLRF) in that patient population remains largely unquantified. Methods This study quantified the potential effects of successfully managing 4 MLRF (smoking, obesity, alcohol consumption, and low physical activity) on the 10-year incidence of a first CVD diagnosis in adults with genetically confirmed FH treated with LLM within the UK Biobank. The synthesised causal estimates of these 4 MLF were obtained using two recent causal analysis frameworks, namely the doWhy causal calculus framework and the Causal Forest Double Machine Learning Method. Results In 660 FH individuals (mean age 56±8 years; 60.15% women), smoking cessation and reducing body mass index below 30 kg/m2 delivered the most substantial risk reductions (pooled estimates, adjusted for the 3 other MLRF: -6.5% and -3.2%, respectively; both p<0.001), followed by initiating moderate or high physical activity (-1.7%; p<0.001; Figure). Notably, cessation of alcohol consumption significantly increased CVD risk (+2.5%; p<0.001), aligning with existing literature. Conclusion In over 10 years, reductions in CVD risk ranging from 1.7% to 6.5% were achievable through smoking cessation, BMI reduction, and enhanced physical activity in FH individuals. Leveraging causal inference methodologies facilitates the discernment of which risk factors offer the most pronounced additional benefits beyond lipid-lowering interventions in this high-risk population.Forest Plot of Causal Effect Estimates

Effect of incremental exercise training interventions in a Cardiac Rehabilitation Program following myocardial infarction

Abstract Background Exercise-based cardiac rehabilitation is recommended after myocardial infarction (MI) to improve prognosis, quality of life and control of cardiovascular risk factors. However, the specific impact of different exercise training interventions remains incompletely understood. Purpose To study the health outcomes of three incremental exercise training interventions during a Cardiac Rehabilitation Program (CRP) following MI. Methods We implemented a post-MI Phase 2 CRP in 2022. After initial exercise testing, a 3-month, individualized aerobic and strength ambulatory training program was provided by Cardiologists and Physical Medicine and Rehabilitation physicians (Group 1, n=58). Additionally, a subset of patients received one session of supervised teaching of aerobic and strength training by physiotherapists (Group 2, n=19), and another subset received 8-20 sessions of in-hospital supervised training (Group 3, n=13). Exercise testing was repeated at the end of Phase 2 and peak oxygen consumption (peak VO2) was measured. We analysed quality of life (SF-36), depression (PHQ2), anxiety (GAD2), adherence to Mediterranean diet (PREDIMED) and pharmacological treatment (Morisky-Green), and weekly physical activity (IPAQ). Health outcomes were compared at the beginning and after Phase 2 CRP. Results The cohort comprised 90 patients who completed Phase 2 CRP (mean age 61.2±10.8 years, 84.4% male and 47.8% smokers). Reductions in systolic blood pressure (-10.3±13.8mmHg), LDL cholesterol (-60.7±35.4mg/dL), weight (-2.8±6.6kg, -3±7.8%) and body mass index (-1±2.2) were attained (p<0.05). Smoking abstinence was accomplished in 88.4% of smokers and most patients achieved an LDL<55mg/dL (81.1%). Improvements in quality of life (SF-36 +10.4±19.4 points, p<0.001) and anxiety and depression symptoms (PHQ2 -0.5±1.6 points and GAD2 -0.6±1.6 points, p<0.01) were noted. An increase in peak VO2 (+5.12±5.44ml/kg/min, +23.5±27.4% from baseline, p<0.001) and predicted functional capacity (+13.4±23.8%, p<0.001) was achieved. Patients increased their reported weekly physical activity by 2520.3±2935.4 METS/week (+132% from baseline, p<0.001) and most of them were adherent to Mediterranean diet (91.1%) and pharmacological treatment (95.6%). Patients achieved similar health outcomes regardless of their exercise training group, except for patients in Group 3, who experienced a more pronounced improvement in peak VO2 (+8.1±6.4ml/kg/min, +37.8±34.7% from baseline; p<0.05) and a trend towards higher increase in predicted functional capacity (+21.7±19.2%, p<0.25) and greater weight loss (-5.5±9.4kg, -5.9±9.6%; p<0.2). Conclusions Supervised in-hospital training during a Phase 2 CRP provides superior physical fitness improvements and more pronounced weight loss in MI patients. However, a Phase 2 CRP based on ambulatory training provides similar benefits regarding other health outcomes, such as control of cardiovascular risk factors and quality of life amelioration.Exercise training interventions in a CRP

Effects of glyphosate based herbicide exposure in early developmental stages of Physalaemus gracilis

The impact of environmental pollutants has been a focus of investigation in recent years. Studies assessing the effects of these pollutants are essential for understanding the challenges faced by non-target species. Among the many substances used for agricultural purposes, the herbicide glyphosate is one of the most widely marketed in recent years. This broad-spectrum herbicide is commonly used to protect a variety of crops. In this study, we evaluated the effects of chronic glyphosate exposure on a native amphibian species, Physalaemus gracilis. Amphibians, which develop in aquatic environments, are highly sensitive to pesticides. Because of this, we investigated morphological, physiological, behavioral, and biochemical parameters in the early stages of development. The animals were exposed to environmentally relevant concentrations of a glyphosate-based herbicide (0, 100, 350, and 700 µg L⁻¹) during their first seven days of life. As a result, we observed impairments in anti-predatory behavior, reduced body mass index, and scaled mass index, malformations of the mouth and intestine, increased acetylcholinesterase activity, cardiotoxicity, and oxidative stress. These findings underscore the importance of studying native non-target species and highlight the need to evaluate the effects of environmentally relevant concentrations, as well as to review legislation regarding permissible levels of glyphosate in surface water and public water supplies.

Assessing the Impact of Wheat Flour and Baker's Yeast Restricted Diet vs. Calorie Restriction in NAFLD Patients

IntroductionNon-alcoholic fatty liver disease (NAFLD) is a prevalent and nonalcoholic progressive liver disorder associated with metabolic disturbance. This study aimed to compare the efficacy of wheat flour or baker's yeast-restricted diet with traditional calorie restriction in NAFLD patients.Material and methodsAnalyzed data was obtained from 243 individuals with NAFLD who completed the study. Of these patients, 54 belonged to Group (1) (Standard Diet, SD); 104 belonged to Group (2) (Wheat Flour-Free Diet, WFFD); and 85 belonged to Group (3) (Yeast-Free Diet, YFD). The intervention period lasted 6 months, during which participants' dietary compliance was closely monitored.ResultsAt the end of the six-month trial, both the WFFD and HFD groups exhibited a noteworthy reduction in body mass index (BMI) and triglyceride (TG) levels when compared to a standard diet that only involved calorie restriction. Furthermore, a notable reduction in the severity of liver steatosis was seen in these groups (p<0.05). The SD group did not exhibit any significant changes in these metrics. The WFFD group experienced a notable reduction in HSI values (p<0.05). Cluster analysis revealed that the obese group had higher HSI, weight, and BMI values throughout the study period, indicating a more advanced stage of NAFLD.ConclusionsTo summarize, this study highlights the significance of food constituents and dietary strategies in the treatment of NAFLD. It suggests that limiting the intake of wheat flour and baker's yeast specifically could have positive effects on liver well-being.

Impact of bariatric surgery on infertility in obese women: A systematic review and meta-analysis

Background: The prevalence of obesity is increasing worldwide, with several consequences, including reduced fertility in both men and women. One of the ways to reduce weight is bariatric surgery. The aim of this systematic review and meta-analysis study was to evaluate the effectiveness of bariatric surgery on weight loss and subsequent improvement of fertility in obese infertile women. Methods: Several databases were searched using MESH terms to investigate the studies that evaluated the fertility rates after bariatric surgery in infertile obese women. Related data were obtained and analyzed using Stata software with P-value ≤ 0.05 was considered as significant. Results: Of the 283 articles related to the purpose of this study, 9 articles including 231 obese infertile women were included in the study. Body mass index (BMI) before surgery was 42.2 [95% confidence interval (CI)= 39.2-45.2] and BMI after surgery was 31.9 (95%CI= 28.9- 34.8) which shows the significance of weight loss after bariatric surgery. Conception rate after bariatric surgery weight loss was increased and was 67% (95% CI= 47%-87%, P-value<0.05). Conclusions: Bariatric surgery had a significant effect on the reduction of BMI and subsequent significant improvement of fertility in obese infertile women.

Effects of healthy low-carbohydrate diet and time-restricted eating on weight and gut microbiome in adults with overweight or obesity: Feeding RCT.

The effect of a healthy low-carbohydrate diet (HLCD) and time-restricted eating (TRE), alone or in combination, on body weight and gut microbiome beyond caloric restriction remains unclear. In this 12-week two-by-two factorial randomized trial with a 28-week follow-up among 96 participants with overweight or obesity, isocaloric-restricted feeding yields significant weight loss, ranging from 2.57 to 4.11kg across different groups. Beyond caloric restriction, HLCD and TRE lead to additional reduction in body mass index. HLCD results in additional fat mass loss while TRE yields more lean mass loss. Additionally, HLCD leads to decreased fecal branched-chain amino acids, and TRE tends to yield an increased abundance of probiotic species involved in synthesizing short-chain fatty acids. Moreover, the effect of HLCD on reducing fat mass is sustained during the post-intervention follow-up. Overall, HLCD and TRE are effective in weight management and yield profound gut microbiome and metabolome alteration beyond caloric restriction. This study was registered at ChiCTR.org.cn (ChiCTR2200056363).

Effect of exercise alone and in combination with time-restricted eating on cardiometabolic health in menopausal women

There is a need to investigate the effect of lifestyle modifications on cardiometabolic health-related issues that occur during menopause. The aim of this study was to compare the effect of resistance and endurance circuit training program alone (exercise group, n = 34) with the effect of time-restricted eating (16:8) combined with a training program (combination group, n = 28) on cardiometabolic health in 62 menopausal women (aged 51.3 ± 4.69 years). Testing was conducted before and after a 12-week period and included an assessment of body composition, glycemic control, lipid panel, blood pressure, and anthropometric measurements. Decreases in body mass index and systolic blood pressure were significantly greater in the combination group than in the exercise group (F(1,60) = 4.482, p = 0.038, η2 = 0.07; F(1,57) = 5.215, p = 0.026, η2 = 0.08, respectively, indicating moderate effects). There were significant decreases in fat mass (p = 0.001, r = 0.654), glucose level (p = 0.017, r = 0.459), insulin level (p = 0.013, r = 0.467), homeostatic model assessment for insulin resistance (p = 0.009, r = 0.499), waist circumference (p = 0.002, r = 0.596), and waist-to-height ratio (p = 0.003, r = 0.588) (indicating moderate effect) in the combination group, while there were no significant changes in the exercise group. There were no changes in lipid panel indicators in either group. This is the first study to investigate the effect of time-restricted eating combined with exercise in menopausal women. The results of the study provide evidence that the combination of time-restricted eating and exercise leads to a greater body mass index reduction than exercise alone in menopausal women.Trial registration: ClinicalTrials.gov, NCT06138015 registered 18 November 2023—Retrospectively registered, https://clinicaltrials.gov/study/NCT06138015.

Metabolite, Biochemical, and Dietary Intake Alterations Associated with Lifestyle Interventions in Obese and Overweight Malaysian Women.

Differences in metabolic regulation among obesity phenotypes, specifically metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO) women, may lead to varied responses to interventions, which could be elucidated through metabolomics. Therefore, this study aims to investigate the differences in metabolite profiles between MHO and MUO women and the changes following a lifestyle intervention. Serum samples from 36 MHO and 34 MUO women who participated in a lifestyle intervention for weight loss were analysed using untargeted proton nuclear magnetic resonance spectroscopy (1H NMR) at baseline and 6 months post-intervention. Anthropometric, clinical, and dietary intake parameters were assessed at both time points. Both groups showed differential metabolite profiles at baseline and after six months. Seven metabolites, including trimethylamine-N-oxide (TMAO), arginine, ribose, aspartate, carnitine, choline, and tyrosine, significantly changed between groups post-intervention, which all showed a decreasing pattern in MHO. Significant reductions in body weight and body mass index (BMI) in the MUO correlated with changes in the carnitine and tyrosine levels. In conclusion, metabolite profiles differed significantly between MHO and MUO women before and after a lifestyle intervention. The changes in carnitine and tyrosine levels in MUO were correlated with weight loss, suggesting potential targets for therapeutic intervention.

Real-World Clinical Effectiveness of Liraglutide for Weight Management in Türkiye: Insights from the LIRA-TR Study

Introduction: Obesity is a complicated chronic disease associated with a series of other conditions. A weight loss of 5–10% has been shown to reduce obesity-related complications and improve quality of life. The efficacy and safety of liraglutide for reducing body weight have been demonstrated in clinical trials. This study evaluated the weight loss efficacy and adverse effects of liraglutide in those with obesity in the Turkish population. Methods: This is a retrospective cohort study; the patients that were included had a body mass index (BMI) of 27 or greater with additional comorbidities or a BMI of 30 or greater, and the patients were prescribed liraglutide for obesity treatment from the tertiary private clinic between January 2022 and January 2024. Their metabolic and anthropometric parameters were recorded at the initial appointment, and their body weight and adverse effects were followed up on during therapy. Results: For the 568 patients, of whom 487 (85.6%) were female, the mean values for age, weight, and BMI were 42.37 ± 10.50, 98.09 ± 17.48 kg, and 35.77 ± 5.45 kg/m2, respectively. Reductions in body weight at the 4th, 8th, 12th, and 24th weeks were 6.45 ± 2.32 kg, 10.66 ± 3.41 kg, 15.38 ± 8.30 kg, and 19 ± 9.06 kg, respectively; reductions in BMI at the 4th, 8th, 12th, and 24th weeks were 2.36 ± 1.00, 3.88 ± 1.25, 5.36 ± 1.76, and 7.09 ± 2.93, respectively; and the percentages of overall body weight loss at the 4th, 8th, 12th, and 24th weeks were 6.62 ± 2.1%, 10.75 ± 2.71%, 14.97 ± 6.8%, and 18.55 ± 4.63%, respectively (all p values < 0.0001). The percentage of patients who lost more than 5% and more than 10% of their initial weight was 100% at the 24th week. The most common side effect was nausea; no pancreatitis was observed. Conclusions: The results of our study indicate that liraglutide is an efficacious and safe treatment option for obesity in the Turkish population, in accordance with the findings from previous research.

Effect of the consumption of probiotic foods in overweight/obese individuals: A systematic review and meta-analysis

This study aimed to assess whether the consumption of probiotic foods reduces anthropometric measurements in overweight and obese individuals through a systematic review and meta-analysis of randomized controlled trials. Of the 4370 identified studies, eight were eligible and included in the meta-analysis, which showed that there was a significant reduction in the variables body mass index, visceral fat area, subcutaneous fat area, body fat mass, fat percentage, waist circumference, hip circumference, and waist-to-hip ratio in the probiotic food consumption group compared to the control group. There was no significant reduction in body weight and lean mass. When evaluating meta-analyses of subgroups of microorganisms, positive outcomes in Lactobacillus gasseri (Lg2 and Lg3) are observed. Regarding the intervention period, the longer the duration of the intervention with probiotic foods, the better the outcome. In subgroup analyses, promising results were observed with the probiotic microorganism strain Lactobacillus gasseri SBT2055.

Retrospective Analysis Comparing the Efficacy of GLP-1 Receptor Agonists Dulaglutide and Semaglutide

Background: Glucagon-like peptide-1 receptor agonists have gained popularity in recent years because of their well-established benefits of increased glycemic control, weight loss, cardiovascular protection, and renal protection, with minimal adverse effects, and low risk for hypoglycemia in patients with type 2 diabetes. This study explored the effectiveness of the GLP-1 receptor agonist semaglutide and dulaglutide on body weight and hemoglobin A1c in patients with type 2 diabetes. Methods: In this retrospective cohort study, 244 patients diagnosed with type 2 diabetes and prescribed semaglutide or dulaglutide were identified through Lourdes Hospital electronic medical records. Over a 12-month period, in set intervals every 3 months, patients were assessed for changes in their hemoglobin A1c and body weight measured as a reduction in their body mass index (BMI). These primary outcomes were compared using linear mixed models from the lme4 package in R (v. 4.2.2). Results: Semaglutide and dulaglutide showed comparable effectiveness in reducing hemoglobin A1c compared with baseline. Both medications also led to a reduction in BMI. However, semaglutide showed statistically significant improvements in weight loss compared with dulaglutide at 3-6 months ( P = 0.01), 6-9 months ( P = 0.01), and 9-12 months ( P = 0.01). Conclusions: These findings suggest that in type 2 diabetes, semaglutide and dulaglutide show comparable effectiveness in reducing hemoglobin A1c. However, semaglutide was shown to be more effective in promoting weight loss. While these findings may be beneficial when treating patients with type 2 diabetes and obesity, treatment should be individualized to the patient, considering all factors before treatment choice.

The Metabolic Effects and Effectiveness of the Different Reconstruction Methods used in Gastric Cancer Surgery: A Systematic Review and Meta-Analysis.

Gastric Cancer (GC) is the fifth most common cancer worldwide. Early stages of GC began being detected, giving rise to a new concern, Quality of Life. This study aimed to systematically assess the effects of different GC reconstruction techniques on postoperative type 2 diabetes mellitus (T2DM), hypertension (HBP), and body mass index (BMI) reduction rate and to provide an overview of recent research on oncometabolic surgery (OS). We performed a systematic review and meta-analysis by searching three databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We performed a meta-analysis of risk ratios and mean differences to estimate the impact of duodenal bypass, Roux-en-Y reconstruction, and residual stomach on T2DM, HBP, and BMI reduction rate. Heterogeneity was assessed using the I2 statistics. At the end of the follow-up, the duodenal bypass group compared to Billroth I had a significantly higher postoperative remission of T2DM and HBP, with a relative risk (RR) of 1.43 (95% confidence interval (95% CI) [1.27; 1.62]) and 1.3 (95% CI [1.00; 1.69]), respectively. Compared with the Billroth II group, Roux-en-Y reconstruction had significantly greater T2DM remission after gastrectomy (RR = 1.19; 95% CI [1.08; 1.31]), while HBP showed no significant differences. Regarding the improvement of HBP, total gastrectomy was significantly superior to subtotal gastrectomy (95% CI [1.01; 2.64]). A trend towards Roux-en-Y Esophagojejunostomy as the best option for T2DM remission was observed (95% CI [0.98; 2.77]; p = 0.06). Gastrectomy with Roux-en-Y reconstruction appears to be the most effective treatment for T2DM remission. Further research is needed to assess the impact of OS on metabolic diseases.

Telerehabilitation Program Impact on Overactive Bladder Symptoms and Metabolic Health in Obese Women: a Randomized Controlled Trial

INTRODUCTION. Overactive bladder syndrome is caused by many factors including obesity, insulin resistance and poor dietary habits. Since it is a chronic disease and needs time to be treated, introducing telepilates in addition to Mediterranean diet would encourage better adherence and results to the treatment program. AIM. To assess the impact of a virtual group-based telerehabilitation program on overactive bladder symptoms and metabolic health in women with obesity. MATERIAL AND METHODS. Eighty obese women (BMI 30.0–34.9 kg/m2) between the ages of 35 and 45 were allocated into two equal groups, 40 for each: (A) supervised telepilates and (B) unsupervised telepilates. The supervised group participated in a 12-week Pilates workout program over videoconference platforms three times a week. Meanwhile, the unsupervised group only received four online meetings. The groups’ diet was the Mediterranean style. The Hemostatic Model of Insulin Resistance (HOMA-IR), body mass index (BMI), waist circumference (WC), Patient Perception of Urgency Scale (PPIUS), Overactive Bladder Questionnaire Short Form (OAB-q SF), and Telehealth Usability Scale (TUS) were measured. RESULTS AND DISCUSSION. The supervised telepilates group exhibited statistically significant amelioration of overactive bladder symptoms and a reduction in HOMA-IR (p 0.001), while the unsupervised telepilates group showed insignificant changes in these measures (p 0.05). Furthermore, the supervised telepilates group showed significantly greater reductions in BMI and WC (p 0.001) than the unsupervised telepilates group (p 0.05). Additionally, the supervised telegroup outperformed the unsupervised telegroup on all parameters of TUS (p 0.001) CONCLUSION. Women with obesity experienced decrease in overactive bladder symptoms and improved metabolic health after completing a 12-week telepilates training program.

12497 Stage 1 Results Of The Phase 2 Daybreak Trial Assessing Setmelanotide In Patients With Early-onset, Severe Obesity And Hyperphagia Who Carried A Confirmed Variant Related To The Melanocortin-4 Receptor Pathway

Abstract Disclosure: G. Ortiz: Speaker; Self; Rhythm Pharmaceuticals, Inc. S.B. Ten: Advisory Board Member; Self; Rhythm Pharmaceuticals, Inc. Speaker; Self; Rhythm Pharmaceuticals, Inc. W. Herring: Advisory Board Member; Self; Rhythm Pharmaceuticals, Inc, Novo Nordisk. O. Pinhas-Hamiel: None. E.A. Oral: Consulting Fee; Self; Rhythm Pharmaceuticals, Inc., Akcea Therapeutics, Ionis Pharmaceuticals Inc., Morphic Medical, Fractyl Laboratories, Regeneron Pharmaceuticals, Amryt Pharmaceuticals (now Chiesi), Third Rock Ventures, Rejuvenate Bio, NIDDK. Other; Self; Has patents for use of metreleptin in lipodystrophy and recombinant leptin or analogues in NASH. N. Rosano: Consulting Fee; Self; Novo Nordisk. Speaker; Self; Rhythm Pharmaceuticals, Inc. D. Koren: Employee; Self; Rhythm Pharmaceuticals, Inc.. Stock Owner; Self; Rhythm Pharmaceuticals, Inc. H. Lee: Employee; Self; Rhythm Pharmaceuticals, Inc.. Stock Owner; Self; Rhythm Pharmaceuticals, Inc. J. Garrison: Employee; Self; Rhythm Pharmaceuticals, Inc.. Stock Owner; Self; Rhythm Pharmaceuticals, Inc. O. Ohayon: Employee; Self; Rhythm Pharmaceuticals, Inc.. Stock Owner; Self; Rhythm Pharmaceuticals, Inc. P. Sleiman: Employee; Self; Rhythm Pharmaceuticals, Inc.. Stock Owner; Self; Rhythm Pharmaceuticals, Inc. M. Wabitsch: Consulting Fee; Self; Rhythm Pharmaceuticals, Inc.. Speaker; Self; Rhythm Pharmaceuticals, Inc.. Other; Self; Rhythm Pharmaceuticals, Inc. E. van den Akker: Speaker; Self; Federatie Medisch Specialisten, Stichting Kwaliteitsgelden Medisch Specialisten, Medialane TV, Pfizer, Inc.. Other; Self; Nederlandse Hartstichting/ZonMW, Stichting Erasmus Trustfonds, Rhythm Pharmaceuticals, Inc. J. Argente: Advisory Board Member; Self; Rhythm Pharmaceuticals, Inc. Speaker; Self; Rhythm Pharmaceuticals, Inc.. I. Farooqi: None. Background: DAYBREAK (NCT04963231) was designed to evaluate setmelanotide in individuals who carried a confirmed variant in ≥1 of 31 genes with strong or very strong relevance to the melanocortin-4 receptor (MC4R) pathway, which regulates energy balance and satiety. Methods: DAYBREAK is a 2-stage, double-blind, placebo-controlled trial conducted at 37 sites across 8 countries. Individuals aged 6 to 65 years with body mass index (BMI) ≥40 kg/m2 (aged ≥18 years) or ≥97th percentile (aged ≥6 to <18 years) and hyperphagia who carried variants classified as uncertain significance (VUS), likely pathogenic, or pathogenic according to the American College of Medical Genetics (ACMG) criteria in ≥1 of the 31 genes were eligible. Individuals with ≥5% BMI reduction from baseline (ie, responders) at the end of the 16-week, open-label run-in period (Stage 1) were eligible to enter a 24-week, double-blind, randomized, placebo-controlled period (Stage 2). The primary endpoint of Stage 1 was the proportion of responders per gene cohort at the end of the Stage. Results: A total of 164 individuals were enrolled; 100 patients who completed Stage 1 and 12 who discontinued treatment within a prespecified 2 weeks before the end of Stage 1 were included in the completers analysis. Participants were divided into 15 gene cohorts; of 7 cohorts with ≥5 patients, 6 (SEMA3[A-G], PLXNA[1-4], PHIP, TBX3, MAGEL2, and SIM1) showed potential setmelanotide efficacy (KSR2 did not). Response rates across cohorts (range, 25.0%-56.3%), intracohort response magnitudes (percent BMI change from baseline to Week 16; range, −6.4% to −4.0%), and intracohort variant types varied. While response rate was highest in the PHIP cohort (56.3% of the full cohort and 69.2% of completers), ≥1 patient per cohort achieved ≥10% BMI reduction. Because ∼80% of VUS are eventually reclassified to benign or likely benign, the inclusion of VUS may have contributed to response variability. An ad hoc analysis showed an increased response rate with updated versus starting ACMG variant classification. Overall, 49 responders across 6 gene cohorts were randomized into Stage 2. Setmelanotide was well tolerated with no new safety concerns. Conclusions: DAYBREAK Stage 1 identified 6 additional genes or gene families in the MC4R pathway that respond to setmelanotide. Response was associated with predicted variant pathogenicity, allowing for further refinement of patient selection. Stage 2 results will further elucidate Stage 1 findings. Presentation: 6/3/2024

8585 Using Stimulants to Treat Childhood Obesity

Abstract Disclosure: C. Elatrash: None. S.R. Sisley: None. Background: Hyperphagia, characterized by excessive hunger, can significantly contribute to weight gain in early-onset childhood obesity and lacks an FDA-approved therapy. Stimulants commonly used in the treatment of attention deficit and hyperactivity disorder (ADHD) have a significant side effect of suppressing appetite. However, there is no data on the effectiveness of stimulants to reduce measures of obesity in children with severe obesity and hyperphagia. Methods: We retrospectively analyzed electronic medical records of children < 17 years old with severe, early-onset obesity (defined as a Body Mass Index (BMI) ≥ 120% of the 95th percentile (BMI%95th) prior to age 5 years) who were seen in the Genetic Disorders of Obesity Program (GDOP) at Texas Children’s Hospital (TCH). We included children who had a history of abnormal food behavior consistent with a clinical diagnosis of hyperphagia by having 2 of 9 symptoms of hyperphagia (consuming large portions, consistently feeling hungry, not feeling full with one serving, temper tantrums over food, asking for food frequently, sneaking food, getting up at night to eat, hiding food, constant asking for snacks) and were prescribed lisdexamfetamine treatment for hyperphagia for 6 months. We extracted BMI %95th for up to 12 months prior to treatment and 6 months after treatment. Paired t-tests were utilized to compare data from pre- vs. post-treatment. Results: Our cohort included 22 patients and was 68.2% female, 50% non-Hispanic White, 36.4% Hispanic white, and 13.6% black, with a mean age of 7.73 years±3.82 (range 3-17 years). There was a significant decrease in BMI%95th after treatment with lisdexamfetamine (167.3±38.8 vs. 158.0±40.2; p<0.001). We also observed a significant change in the rate of weight gain after lisdexamfetamine treatment; prior to treatment, patients gained 0.6 BMI%95th points/month compared to a loss of 1.9 points/month after treatment (p=0.002). 16 (72.72%) patients reported tolerable side effects, the rate of side effects was (33)33.33%. 19(57.57%) lasted from 1 week to 1 month and 6(18.18%) lasted more than 1 month. Side effects included adverse behavioral (9)27.27%, sleep disturbance (5)15.15%, and headache (4)12.12%. Conclusion: Children with severe obesity and clinical hyperphagia showed reductions in BMI%95th after six months of lisdexamfetamine treatment. Future research is needed to confirm the clinical efficacy of lisdexamfetamine in this high-risk population. Keywords: Childhood obesity, Stimulants, Hyperphagia, Pharmacologic Treatment Presentation: 6/3/2024