Role In Treatment Of Obesity Research Articles

Effect of Lacticaseibacillus paracasei K56 with galactooligosaccharide synbiotics on obese individuals: an in vitro fermentation model.

The use of synbiotics is emerging as a promising intervention strategy for regulating the gut microbiota and for preventing or reducing obesity, in comparison with the use of probiotics or prebiotics alone. A previous in vivo study revealed that Lacticaseibacillus paracasei K56 (L. paracasei K56) could alleviate obesity induced in high-fat-diet mice; however, the effect of the synbiotic combination of L. paracasei K56 and prebiotics in obese individuals has not been explored fully. The effect of prebiotics on the proliferation of L. paracasei K56 was determined by spectrophotometry. The results showed that polydextrose (PG), xylooligosaccharide (XOS), and galactooligosaccharide (GOS) had a greater potential to be used as substrates for L. paracasei K56 than three other prebiotics (melitose, stachyose, and mannan-oligosaccharide). An in vitro fermentation model based on the feces of ten obese female volunteers was then established. The results revealed that K56_GOS showed a significant increase in GOS degradation rate and short-chain fatty acid (SCFA) content, and a decrease in gas levels, compared with PG, XOS, GOS, K56_PG, and K56_XOS. Changes in these microbial biomarkers, including a significant increase in Bacteroidota, Bifidobacterium, Lactobacillus, Faecalibacterium, and Blautia and a decrease in the Firmicutes/Bacteroidota ratio and Escherichia-Shigella in the K56_GOS group, were associated with increased SCFA content and decreased gas levels. This study demonstrates the effect of the synbiotic combination of L. paracasei K56 and GOS on obese individuals and indicates its potential therapeutic role in obesity treatment. © 2024 Society of Chemical Industry.

Enantioselective Total Syntheses of Cassane Furanoditerpenoids and Their Stimulation of Cellular Respiration in Brown Adipocytes.

We report the first and enantioselective total syntheses of (+)-1-deacetylcaesalmin C, (+)-δ-caesalpin, (+)-norcaesalpinin MC, and (+)-norcaesalpinin P. Salient features of the synthetic strategy are an exo-selective intramolecular Diels-Alder reaction of a furanoquinone monoketal and subsequent chemoselective reduction of the resulting pentacyclic furfuryl ketal, furnishing a keystone intermediate. The latter enables access to the collection of natural products through implementation of stereoselective oxidations. Having accessed the cassane furanoditerpenoids, we unveil previously unknown bioactivity: (+)-1-deacetylcaesalmin C stimulates respiration in brown adipocytes, which has been suggested to play a central role in treatment of obesity.

Thiolated Chitosan as an Intestinal Absorption Carrier with Hesperidin Encapsulation for Obesity Treatment.

Obesity is characterized as abnormal or excessive fat accumulation harmful to one’s health, linked to hormonal imbalances, cardiovascular illness, and coronary artery disease. Since the disease stems mainly from overconsumption, studies have aimed to control intestinal absorption as a route for treatment. In this study, chitosan-thioglycolic acid (CT) was developed as a physical barrier in the gastrointestinal tracts to inhibit nutrient uptake. CT exhibits a superior mucoadhesive property compared to chitosan both in vitro and in vivo for the ability to form disulfide bonds with the intestinal mucosa. For CT as a potential drug delivery platform, hesperidin, a herb for bodyweight control in traditional Chinese medication, is encapsulated in CT and can be released consistently from this absorption barrier. In animal studies, CT encapsulated with hesperidin (CTH) not only results in a weight-controlling effect but limits adipose accumulation by hindering absorption, suggesting a potential role in obesity treatment. Neither CT nor CTH exhibit cytotoxicity or produce adverse immunological reactions in vivo.

Creation of an Anti-Inflammatory, Leptin-Dependent Anti-Obesity Celastrol Mimic with Better Druggability.

Obesity is characterized by an excessive body mass, but is also closely associated with metabolic syndrome. And, so far, only limited pharmacological treatments are available for obesity management. Celastrol, a pentacyclic triterpenoid from a traditional Chinese medicine (Tripterygium wilfordii Hook.f.), has shown remarkable potency against obesity, inflammation and cancer, but its high toxicity, low natural abundance and tedious chemical synthesis hindered its translation into clinics. In the present work, a triterpenoid library was screened for compounds with both high natural abundance and structural similarity to celastrol; from this library, glycyrrhetinic acid (GA), a compound present in extremely high yields in Glycyrrhiza uralensis Fisch. ex DC., was selected as a possible scaffold for a celastrol mimic active against obesity. A simple chemical modification of GA resulted in GA-02, a derivative that suppressed 68% of food intake in diet-induced obesity mice and led to 26.4% weight loss in 2 weeks. GA-02 plays a role in obesity treatment by re-activating leptin signaling and reducing systemic and, more importantly, hypothalamic inflammation. GA-02 was readily bioavailable with unnoticeable in vitro and in vivo toxicities. The strategy of scaffold search and modification on the basis of bio-content and structural similarity has proved to be a green, economic, efficient and practical way of widening the medicinal applications of “imperfect” bioactive natural compounds.

Six intragastric balloons: Which to choose?

Endoscopically placed intragastric balloons (IGBs) have played a significant role in obesity treatment over the last 30 years, successfully bridging the gap between lifestyle modification/pharmacotherapy and bariatric surgery. Since they provide a continuous sensation of satiety that helps the ingestion of smaller portions of food, facilitating maintenance of a low-calorie diet, they have generally been considered an effective and reversible, less invasive, non-surgical procedure for weight loss. However, some studies indicate that balloons have limited sustainable effectiveness for the vast majority attempting such therapy, resulting in a return to the previous weight after balloon removal. In this review we try to summarize the pros and cons of various balloon types, to guide decision making for both the physician and the obese individual looking for effective treatment. We analyzed the six most commonly used IGBs, namely the liquid-filled balloons Orbera, Spatz3, ReShape Duo and Elipse, and the gas-filled Heliosphere and Obalon - also including comments on the adjustable Spatz3, and the swallowable Obalon and Elipse - to optimize the choice for maximum efficacy and safety.

Dietary fibers reduce obesity-related disorders: mechanisms of action.

Dietary fibers decrease risk of cardiovascular disease and obesity, but the most important mechanisms for fiber's protective properties are debated. The purpose of the review is to summarize the recent human studies that examine mechanisms how dietary fiber decreases risk of obesity-related disorders. Dietary fiber has effects throughout the digestive tract that decrease risk of obesity-related diseases. Soluble, viscous fibers slow absorption of and decrease serum cholesterol. Intake of dietary fiber enhances satiety and reduces food intake at future meals. The importance of gut fermentation and changes in the gut microbiota and metabolites are linked to decrease risk for obesity-related disorders. Dietary fibers alter the gut microbiota and produce metabolites such as short-chain fatty acids that may explain fiber's role in obesity prevention and treatment. Dietary fiber encompasses many plant compounds, so conclusions that dietary fiber reduces or treats obesity-related disorders must be considered by the fiber was fed in the study. Dietary fiber prevents and treats obesity-related disorders. Mechanisms for this protection include decreased absorption of macronutrients and enhanced satiety. Changes in the gut microbiota and short-chain fatty acids are emerging mechanisms to explain why high fiber diets protect against obesity and have a role in obesity treatment.

Management of inadequate weight loss or weight regain in post-bariatric surgical patients.

Nurse practitioners play a key role in the front-line treatment of obesity in primary care practice settings. National guidelines for the management of obesity are provided by a majority of national organizations, yet little guidance is provided for the management of post-bariatric surgical patients who experience inadequate weight loss or early weight regain. As the number of surgical procedures increases, guidelines and interventions for managing this complex outcome are needed.

Benefits and Risks of Laparoscopic Gastric Surgery for Management of Morbidly Obese Patients

Background: Conservative management for obesity had limited role in treatment of obesity. Otherwise, surgical treatment is effective, But associated with many comorbidities. Aim of the work: To evaluate laparoscopic sleeve gastrectomy, greater curvature plication and gastric bypass in morbidly obese patients.Patients and Methods: Thirty patients were included. They were divided into three groups: A for laparoscopic greater curvature plication, B for laparoscopic sleeve gastrectomy, and C for laparoscopic gastric bypass. All subjects underwent full history taking, clinical examination, laboratory investigations, abdominal ultrasonography, and upper gastrointestinal endoscopy. Follow up carried out at the first two weeks then at 1, 3, 6, 12 months for late postoperative complications, changes in comorbidities (hypertension, diabetes mellitus, arthritis) and percentage of excess weight loss. Results: Studied groups were comparable as regard to patient demographics, preoperative comorbidities, intraoperative bleeding or postoperative complications. Operative time was significantly decreased in group B. EBWL differ significantly between groups at all postoperative follow up visits. For example at the second postoperative week, there was significant increase of EBWL in groups B and C when compared to group A (5.75±3.96 and 8.4±5.54 vs 1.15±0.81 respectively). Failure was 40%, 10% and 0% in groups A, B and C respectively. Only one patients died after operation in the bypass group. Morbidities were improved after surgery. Conclusion: Laparoscopic greater curvature plication, is lower than laparoscopic sleeve gastrectomy and laparoscopic gastric bypass surgery as the procedure for weight loss, despite of its less cost. In addition, it had higher complications, reoperations and weight gains.

Role of adiponectin and its target receptors to control deposition of fat in obesity related disorders

BackgroundAdiponectin is a protein hormone secreted by adipocytes. AimThe aim of present review is to enlist them all, and mention their significance in obesity, which helps researchers in drug discovery and future medicine. Material and methodsThe last 20 years data has been searched and studied to mention their current role in obesity treatment and ailments of disease. Results and conclusionAdiponectin exert its action through receptors AdipoR1, AdipoR2, T-cadherin. In muscle AdipoR1 is exhibit, while in liver AdipoR2 is mainly exhibit. AMPK and PPARα pathway in liver and skeletal muscle are magnified by adiponectin. Adiponectin show many function like expand fatty acids oxidation, control glucose level and manage receptor activity. Circulating level of adiponectin is lower in case of obesity, insulin resistance and other metabolic disorder. In this review we will focus on role of adiponectin and its receptors in metabolic disorder obesity.

Akkermansia muciniphila-Derived Extracellular Vesicles as a Mucosal Delivery Vector for Amelioration of Obesity in Mice.

Recent evidence suggests that probiotics can restore the mucosal barrier integrity, ameliorate inflammation, and promote homeostasis required for metabolism in obesity by affecting the gut microbiota composition. In this study, we investigated the effect of Akkermansia muciniphila and its extracellular vesicles (EVs) on obesity-related genes in microarray datasets and evaluated the cell line and C57BL/6 mice by conducting RT-PCR and ELISA assays. A. muciniphila-derived EVs caused a more significant loss in body and fat weight of high-fat diet (HFD)-fed mice, compared with the bacterium itself. Moreover, treatment with A. muciniphila and EVs had significant effects on lipid metabolism and expression of inflammatory markers in adipose tissues. Both treatments improved the intestinal barrier integrity, inflammation, energy balance, and blood parameters (i.e., lipid profile and glucose level). Our findings showed that A. muciniphila-derived EVs contain various biomolecules, which can have a positive impact on obesity by affecting the involved genes. Also, our results showed that A. muciniphila and its EVs had a significant relationship with intestinal homeostasis, which highlights their positive role in obesity treatment. In conclusion, A. muciniphila-derived EVs can be used as new therapeutic strategies to ameliorate HFD-induced obesity by affecting various mechanisms.

Exercise training improves intramuscular triglyceride lipolysis sensitivity in high-fat diet induced obese mice

BackgroundThe purpose of this study was to determine whether regular exercise training enhances intramuscular triglyceride (IMTG) lipolysis sensitivity during consumption of a continued high-fat diet by exploring changes in biochemical factors activated by IMTG lipolysis.MethodsMale C57BL/6 mice aged 4 weeks were randomly divided into a high-fat diet group (HF) to induce obesity for 6 weeks and a control (CO) group. Thereafter, the HF group was divided into a high-fat diet group (HF) and high-fat diet + training group (HFT). The HFT group was trained on an animal treadmill 40 min/day, 5 days/week for 8 weeks. PKA, Plin5, p-Plin5, CGI-58, ATGL, and HSL were analyzed to investigate IMTG sensitivity by western blotting.ResultsPKA, CGI-58, and HSL protein levels in the HF group were significantly lower than those in the CO group (p < 0.05). However, PKA, CGI-58, and HSL protein levels in the HFT group were significantly higher than those in the HF group, and ATGL and p-Plin5 protein levels as well as the p-Plin5/Plin5 ratio in the HFT group were significantly higher than those in the HF group (p < 0.05). In addition, the HF group showed a significantly higher IMTG volume than the CO and HFT groups (p < 0.05).ConclusionsThese results suggest that in an obese mouse model, 8 weeks of treadmill exercise contributes to decreased IMTG volume by activating lipolysis factors, such as PKA, PLIN5, CGI-58, and lipases. Therefore, regular exercise training may play an important role in obesity treatment by increasing IMTG lipolysis sensitivity.

Identification and characterization of metformin on peptidomic profiling in human visceral adipocytes.

To gain insight into the effect of metformin on losing weight from peptidomic perspective and to screen potential active peptides for reducing fat lipid deposition. After determining the proper concentration of metformin on human primary visceral adipocytes, we constructed a comparative peptidomic profiling between control and metformin treatment group (n = 3) using a stable isobaric labeling strategy involving tandem mass tag reagents, followed by liquid chromatography tandem mass spectrometry. We identified and quantified 3065 non-redundant peptides, 304 of which were differentially expressed after metformin treatment, 206 peptides were up regulated and 98 peptides were down regulated significantly. Gene ontology (GO) enrichment and pathway analysis were performed to study differentially peptides though their precursor proteins. We concluded three peptides located within the functional domains of their precursor proteins could be candidate bioactive peptides for obesity. On one hand, these results confirmed the versatile effects of metformin on adipocyte and advance our current understanding of metformin, on the other hand, these identified peptides might play putative roles in treatment of obesity.

Glucagon Decreases IGF-1 Bioactivity in Humans, Independently of Insulin, by Modulating Its Binding Proteins.

Depending on its lipolytic activity, glucagon plays a promising role in obesity treatment. Glucagon-induced growth hormone (GH) release can promote its effect on lipid metabolism, although the underlying mechanisms have not been well-defined. The present study highlights the glucagon effect on the GH/insulinlike growth factor 1 (IGF-1)/IGF-binding protein (IGFBP) axis in vivo and in vitro, taking into consideration insulin as a confounding factor. In a double-blind, placebo-controlled study, we investigated changes in GH, IGFBP, and IGF-1 bioactivity after intramuscular glucagon administration in 13 lean controls, 11 obese participants, and 13 patients with type 1 diabetes mellitus (T1DM). The effect of glucagon on the transcription factor forkhead box protein O1 (FOXO1) translocation, the transcription of GH/IGF-1 system members, and phosphorylation of protein kinase B (Akt) was further investigated in vitro. Despite unchanged total IGF-1 and IGFBP-3 levels, glucagon decreased IGF-1 bioactivity in all study groups by increasing IGFBP-1 and IGFBP-2. The reduction in IGF-1 bioactivity occurred before the glucagon-induced surge in GH. In contrast to the transient increase in circulating insulin in obese and lean participants, no change was observed in those with T1DM. In vitro, glucagon dose dependently induced a substantial nuclear translocation of FOXO1 in human osteosarcoma cells and tended to increase IGFBP-1 and IGFBP-2 gene expression in mouse primary hepatocytes, despite absent Akt phosphorylation. Our data point to the glucagon-induced decrease in bioactive IGF-1 levels as a mechanism through which glucagon induces GH secretion. This insulin-independent reduction is related to increased IGFBP-1 and IGFBP-2 levels, which are most likely mediated via activation of the FOXO/mTOR (mechanistic target of rapamycin) pathway.

Atitudes e práticas dos médicos de família do ACeS de Matosinhos face à obesidade

Aims: To study attitudes to obesity and obese patients among General Practitioners in the Group of Health Centres of Matosinhos. Study design: Cross-sectional. Setting: Group of Health Centres of Matosinhos, Portugal. Population: Family medicine specialists and trainees in the Matosinhos Group of Health Centres. Methods: A convenience sample was used, composed of all physicians attending the weekly staff meeting in their respective clinics. A questionnaire was developed for this study composed of six dimensions including: ‘self-efficacy and technical competence’, ‘training needs’, ‘convictions’, ‘self-perceived responsibility’, ‘barriers’ and ‘limitations’. The validity and reliability of the dimensions were studied. The variables in these dimensions are presented as a mean (M) on a five point Likert scale. Non-parametric statistical analyses were used to measure the differences between the groups. Results: Among the 104 study participants, most (71%) did not have post-graduate training in nutrition. However, they recognize the need to increase their knowledge of nutrition, with an average score of 3.96 in the dimension of the training needs perceived. The physicians participating showed a high level of conviction (M=4.33) about the importance of their role in the treatment of obesity, firmly recognizing their responsibility (M=4.27) in the treatment of this condition, perceiving their self-efficacy and technical competence in the area (M=3.58). Concerning the barriers and limitations felt, the results suggest that these professionals recognize some limitations and barriers while treating obesity (M=3.29 and M=2.60, respectively). Conclusions: Family medicine specialists have positive attitudes towards managing obesity and obese patients. These professionals are convinced of the importance of their role in management and treatment of obesity. They feel responsible for the treatment of this condition and recognize their training needs in the area of nutrition.

Current status of intragastric balloon for obesity treatment.

Endoscopic bariatric therapy may be a useful alternative to pharmacological treatment for obesity, and it provides greater efficacy with lower risks than do conventional surgical procedures. Among the various endoscopic treatments for obesity, the intragastric balloon is associated with significant efficacy in body weight reduction and relief of comorbid disease symptoms. Anatomically, this treatment is based on gastric space-occupying effects that increase the feeling of satiety and may also affect gut neuroendocrine signaling. The simplicity of the intragastric balloon procedure may account for its widespread role in obesity treatment and its applicability to various degrees of obesity. However, advances in device properties and procedural techniques are still needed in order to improve its safety and cost-effectiveness. Furthermore, verification of the physiological outcomes of intragastric balloon treatment and the clinical predictive factors for treatment responses should be considered. In this article, we discuss the types, efficacy, safety, and future directions of intragastric balloon treatment.

A qualitative study of GPs' views towards obesity: are they fighting or giving up?

ObjectivesSeveral studies indicate that general practitioners (GPs) are not taking the issue of obesity as seriously as they should. Therefore, the aim of this study was to understand GPs' views about obesity and obese people and how these professionals perceive their role in the treatment of this disease. Study designQualitative study using semi-structured interviews. MethodsSixteen semi-structured interviews were conducted with Portuguese GPs. Data were analyzed according to thematic analysis procedures. ResultsGPs are negative about their own role in obesity treatment. Although they believe it is part of their job to advise obese patients on the health risks of obesity, the majority of doctors think they are not making any difference in getting their patients to make long term lifestyle changes. GPs hold negative attitudes towards these patients blaming them for being unmotivated and non-compliant and are also pessimistic about their ability to lose weight. Doctors are facing a dilemma in their practices: they want to play an active role but, due to a set of negative beliefs and perceived barriers, they are playing a relatively passive role, feeling defeated and unmotivated, which is reflected in a decrease of efforts and a willing to give up on most of the cases. ConclusionsThis issue should be taken in to account during physicians' education since doctors should be aware of how their own beliefs and attitudes influence their behaviour and practices, compromising, therefore, the adherence to and the success in obesity treatment. They seem to need more precise guidelines and better tools for screening and management of obesity, more referral options, and improved coordination with other specialities.

Effects of Acupuncture on Heart Rate Variability in Obese Premenopausal Korean Women

Objectives: Although the autonomic nervous system (ANS) is thought to play an important role in treatment of obesity, no study has been conducted to investigate acupuncture’s effects on this aspect of the ANS. This study aimed to describe the effects of acupuncture in the ANS by means of heart rate variability (HRV) analysis. Methods: A total of 46 obese women aged from 21 to 54 with body mass index ranging from 25.1 to 39.3 ㎏/㎡ were recruited and randomized into both the real acupuncture group (n=23) and sham acupuncture group (n=23). A total of 3 instances of HRV analysis were conducted before, during, and after treatment. Statistically significant differences between time and groups were analyzed using repeated measure analysis of variance. Results: All parameters of time domain analysis and frequency domain analysis except for the square root of the mean squared differences of successive normal sinus intervals (RMSSD) and very low frequency (VLF) showed significant differences between times. The mean of all R-R intervals (mean RR) showed significant level of interaction between time and group. Between groups, time domain analysis of standard deviation of the normal-to-normal intervals (SDNN), RMSSD and frequency domain analysis of total power (TP) and high frequency (HF) showed significant differences. Conclusions: The real acupuncture group showed deactivation of parasympathetic function and relative increase of sympathetic activity in obese subjects. Further studies are necessary to uncover the mechanisms of acupuncture in obesity treatment.

Impact of readiness to change behavior on the effects of a multidisciplinary intervention in obese Brazilian children and adolescents

The obesity epidemic is a global challenge that requires evidence-based intervention to slow the emergence of weight-related illness in children and adolescents. Thus, effective treatments are urgently needed. This study aimed to analyze whether there is relationship between the initial stage of readiness for behavior change (SRBC) and the results obtained through participation in a multidisciplinary program of obesity treatment (MPOT). The study included 113 overweight or obese children and adolescents who participated in an intervention for 16 weeks, in which the categorical variable was the SRBC. The dependent variables included: anthropometric measures of body composition, hemodynamic parameters (e.g., blood pressure values), and health-related physical fitness. Although stages 1 and 2 had greater improvements in flexibility than those in stage 5, and stage 1 had greater percentage changes in abdominal strength than those in stage 5, children and adolescents in the highest stage had greater percentage changes for anthropometric, hemodynamic and cardiorespiratory fitness, suggesting an impact of the stage of change on the effects of a MPOT. This study suggests that SRBC plays a role in obesity treatment in Brazilian children and adolescents and warrants consideration when enrolling patients to intervention.

Community Pharmacists role in obesity treatment in Kuwait: a cross-sectional study.

BackgroundObesity is a growing health concern in Kuwait. Obesity has been identified as a key risk factor for many chronic diseases including hypertension, dyslipidemia and type 2 diabetes mellitus. It has been shown that community pharmacists' involvement is associated with successful weight management in developed countries. This study was conducted to investigate the role of community pharmacists in obesity counseling, and to identify the barriers to counseling in Kuwait.MethodsA descriptive cross-sectional study involved 220 community pharmacies that were selected via stratified and systematic random sampling. A pretested self-administered questionnaire collected information on frequency and comfort level with obesity counseling, and the perceived effectiveness of four aspects of obesity management (diet and exercise, prescribed antiobesity medications, diet foods, and nonprescription products and dietary supplements). Information on perceived confidence in achieving positive outcomes as a result of counseling and barriers to counseling was also collected. Descriptive and Spearman’ r analysis were conducted using SPSS version 17. Responses with Likert scale rating 1(low score) to 5 (high score) and binary choices (yes/no) were presented as mean (SD) and (95% CI), respectively.ResultsThe response rate was 93.6%. The overall mean (SD) responses indicated that pharmacists counseled obese patients sometimes to most of the time, 3.67 (1.19) and were neutral to comfortable with counseling about aspects of obesity management, 3.77 (1.19). Respondents perceived obesity management aspects to be somewhat effective, 3.80 (1.05). Of the four aspects of obesity management, diet and exercise, and diet foods were the highest ranked in terms of frequency of counseling, comfort level and perceived effectiveness. Pharmacists were neutral to confident in achieving positive outcomes as a result of obesity counseling, 3.44 (1.09). Overall mean responses of counseling obese patients by pharmacists were positively correlated with their perceived comfort with counseling and perceived effectiveness of obesity management aspects. The most anticipated barriers to obesity counseling were lack of patient awareness about pharmacists' expertise in counseling 76.2% (95% CI: 69.7-81.7) and pharmacists’ opinions that obese patients lack willpower and are non-adherent to weight reduction interventions 71.8% (95% CI: 65.1-77.8).ConclusionsStrengths, weaknesses and barriers related to obesity counseling by pharmacists in Kuwait were identified, and suggestions were provided to strengthen that role.

The Road Ahead

The Road Ahead