Significant Reduction In BMI Research Articles

Liraglutide for the treatment of obesity among patients with hidradenitis suppurativa

Background and aimsHidradenitis suppurativa (HS) is associated with obesity. Weight loss is frequently reflected in an amelioration in the severity of the lesions. Case reports have suggested that liraglutide might improve not only weight but also skin. We aimed to study the effects of liraglutide 3mg in patients with obesity and HS on metabolic and dermatological parameters. Methods14 patients started treatment with liraglutide for 3 months. Severity of the lesions was evaluated using the Hurley Staging System and quality of life with the DLQI (Dermatology Quality Index). ResultsThere was a significant reduction in BMI (39.3±6.2 vs 35.6±5.8; p=0.002), waist circumference (121.3±19.2 vs 110.6±18.1cm; p=0.01), CRP (4.5±2.2 vs 3±2.1mg/L; p=0.04), homocysteine (16.2±2.9 vs 13.3±3μmol/L; p=0.005) and plasma cortisol (15.9±4.8 vs 12.6±4.5μg/dL; p=0.007). Hurley (2.6±0.5 vs 1.1±0.3; p=0.002) and DLQI (12.3±2.8 vs 9.7±6.9; p=0.04) improved significantly. In multiple regression analysis, weight loss did not correlate with any inflammatory parameter or Hurley. ConclusionsLiraglutide 3mg is effective and safe among patients with HS and obesity. Long-term studies are mandatory to assess the effects of liraglutide on skin lesions and inflammatory markers among subjects with HS beyond weight loss.

Effect of Short Bouts of Vigorous Stair Climbing on Cardiorespiratory Fitness in Women with Overweight and Obesity: A Pilot Feasibility Study.

We examined the effect of 4 weeks of a brief vigorous stair climbing exercise on cardiorespiratory fitness (CRF) and body composition in women with overweight or obesity. Twenty-six participants (age, 25.4±4.9 years; body mass index [BMI], 25.3±1.8 kg/m2) were randomly assigned to either a stair climbing exercise group (n=13) or a non-exercising control group (n=13). The stair climbing exercise group performed 20 sessions (supervised, five sessions/week over 4 weeks) of brief intermittent stair climbing exercise consisting of a 3-minute warm-up followed by three bouts of 20 seconds of stair climbing (≥80% of age-predicted maximum heart rate) interspersed with 2-minute recovery periods (total exercise duration=10 minutes/session). Peak oxygen uptake (VO2peak) was measured using a graded maximal treadmill test with the use of a standard open-circuit spirometry technique. Body composition was assessed with bioelectrical impedance analysis. All participants, except one who dropped out due to coronavirus disease 2019 (COVID-19) infection, completed the study with 100% attendance rates. There were significant interaction effects (group×time) on body weight, BMI, waist circumference, and CRF such that the stair climbing exercise group had significant (P≤0.01) reductions in body weight (66.5±4.6 to 65.2±4.6 kg), BMI (24.8±1.2 to 24.4±1.1 kg/m2), and waist circumference (78.0±3.7 to 76.5±4.1 cm) and improvements in VO2peak (31.6±2.5 to 34.9±2.6 mL/kg/min) compared with controls. Short bouts of vigorous stair climbing is a feasible and time-efficient exercise strategy for improving CRF in previously sedentary, young women with overweight and obesity.

Comparison of Efficacy of Fermented Garlic and Orlistat (Lipase Inhibitor) in Obesity Management Using an Experimental Rodent Model.

Black garlic, also known as fermented garlic, is a useful food that may have therapeutic benefits. The aim of this study was to analyze the impact of fermented garlic and orlistat therapy on obese rats. A total of 40 male albino rats (245-250 g) were fed either an HFD (n = 32) or a normal diet (n = 8) for 6 weeks; therefore we randomly assigned the rats into: group I (normal diet), group II (HFD), groups III and IV (HFD with fermented garlic), and group V (orlistat for) 6 weeks. Two different dosages of fermented garlic (481.2 mg/kg and 963.3 mg/kg) were administered. Afterward, blood was collected, body weight was measured, and tissue was collected for further analysis. Both the orlistat and black garlic groups showed a significant reduction in BMI, lipid profiles, and insulin levels compared with the baseline. The orlistat group showed significant elevation (p < 0.005) in body weight, organ weight, lipids, and liver parameters, with histopathological findings. The administration of black garlic improved the inflammatory markers with all other parameters. The fermented garlic and orlistat reinstated all of the investigated parameters significantly (p < 0.05), especially body weight and lipid profiles, and induced histopathological changes compared to the drug orlistat. Additionally, it showed anti-obesity-related therapeutic impacts compared with the orlistat drug. Black garlic provides a reliable and effective treatment for obesity compared to orlistat.

Effects of Seven Weeks of Combined Physical Training on High-Density Lipoprotein Functionality in Overweight/Obese Subjects.

Our study aimed to investigate the effects of exercise on HDL composition and functional properties in overweight/obese subjects. Eighteen overweight/obese subjects (nine F and nine M, BMI = 30.3 ± 3 kg/m2) attended supervised training for 7 weeks. The protocol included combined resistance and conditioning training four to five times each week. The activity of the antioxidant enzyme paraoxonase-1 (PON1) associated with HDL was evaluated in all subjects before and after the training intervention. Moreover, myeloperoxidase (MPO) levels and oxidative stress markers (ox-LDLs and total antioxidant capacity) were studied in the serums of the subjects. At the end of the intervention, the activity of PON1 was increased (p < 0.0001), and MPO levels and the MPO/PON1 ratio were decreased (p < 0.0001). In addition, a significant improvement in muscle strength and maximal oxygen uptake (VO2max) (p < 0.0001) and a significant reduction in total and visceral adipose tissue mass (p < 0.001) and waist circumference (p < 0.008), without any significant decrease in body weight, were observed. A significant correlation was established between serum MPO/PON ratios, HDL redox activity and ox-LDLs. In conclusion, our results demonstrate that exercise training, without modifications of dietary habits, improved HDL functionality in overweight/obese adults, without any significant reduction in BMI or modifications of glucose and lipid biochemical parameters.

Weight Loss Promotion in Individuals with Obesity through Gut Microbiota Alterations with a Multiphase Modified Ketogenic Diet.

The occurrence of obesity and related metabolic disorders is rising, necessitating effective long-term weight management strategies. With growing interest in the potential role of gut microbes due to their association with responses to different weight loss diets, understanding the mechanisms underlying the interactions between diet, gut microbiota, and weight loss remains a challenge. This study aimed to investigate the potential impact of a multiphase dietary protocol, incorporating an improved ketogenic diet (MDP-i-KD), on weight loss and the gut microbiota. Using metagenomic sequencing, we comprehensively analyzed the taxonomic and functional composition of the gut microbiota in 13 participants before and after a 12-week MDP-i-KD intervention. The results revealed a significant reduction in BMI (9.2% weight loss) among obese participants following the MDP-i-KD intervention. Machine learning analysis identified seven key microbial species highly correlated with MDP-i-KD, with Parabacteroides distasonis exhibiting the highest response. Additionally, the co-occurrence network of the gut microbiota in post-weight-loss participants demonstrated a healthier state. Notably, metabolic pathways related to nucleotide biosynthesis, aromatic amino acid synthesis, and starch degradation were enriched in pre-intervention participants and positively correlated with BMI. Furthermore, species associated with obesity, such as Blautia obeum and Ruminococcus torques, played pivotal roles in regulating these metabolic activities. In conclusion, the MDP-i-KD intervention may assist in weight management by modulating the composition and metabolic functions of the gut microbiota. Parabacteroides distasonis, Blautia obeum, and Ruminococcus torques could be key targets for gut microbiota-based obesity interventions.

Real-World Retrospective Study into the Effects of Oral Semaglutide (As a Switchover or Add-On Therapy) in Type 2 Diabetes.

(1) Background: Oral semaglutide represents the first oral GLP-1 RA approved for the treatment of type 2 diabetes mellitus (T2DM). This real-world retrospective study aimed at evaluating its effectiveness and tolerability in the treatment of patients with T2DM when patients switched from a glucose-lowering agent to it and when it was added to the usual therapy. (2) Methods: Adult patients with T2DM taking oral semaglutide and followed in the ASUGI Diabetes Center were identified with the use of electronic medical records between October 2022 and May 2023. (3) Results: A total of 129 patients were recruited. The median follow-up was 6 months. Be it as a switchover or as an add-on therapy, oral semaglutide significantly reduced HbA1c and BMI. Switching from DPPIV inhibitors to oral semaglutide was associated with a significant reduction in HbA1c and BMI, switching from SGLT2 inhibitors was associated with a significant reduction in HbA1c, and switching from sulphonylureas was associated with a significant reduction in BMI. The median HbA1c change was associated with baseline HbA1c. SBP significantly decreased in the add-on group. Oral semaglutide was well tolerated. (4) Conclusions: This study shows that in the real-world setting, oral semaglutide is effective and safe as a switchover or as an add-on therapy for the treatment of T2DM.

Effect of the Hypoxic Chamber Training Series on Skin Characteristics of Overweight and Obese Women

Obesity is a disease of civilization. The COVID-19 pandemic has caused an increase in its incidence; therefore, there is an increasing emphasis on programs aimed at improving body composition, often through physical activity. Various modifications to training interventions are being introduced, including the modification of the thermo-climatic conditions of the training. However, to date, whether such a modification is safe for the skin has not been studied. The purpose of this study was to evaluate the effects of a series of workouts in a hypoxic chamber on skin characteristics such as elasticity, hydration, and transepidermal water loss (TEWL). Women who were overweight or obese were invited to participate in the project. The workouts took place in a hypoxic chamber where conditions were mimicked at 2500 m, three times a week for a period of four weeks, for 60 min each. Finally, the results from 11 women in the study group and 9 in the control group were included in the analysis. Body composition analysis was performed, and venous blood was drawn (morphology and lipidogram). No statistically significant changes in skin firmness or the amount of TEWL were observed in the subjects. An increase in skin hydration on the hand was observed only after the first workout (p = 0.046), while skin hydration on the mandible did not change. A significant reduction in body weight (p = 0.042), BMI (p = 0.045), and TBW (p = 0.017) was indicated in the study group. The control group showed an increase in BMI (p = 0.045) and VFA (p = 0.042). There was no correlation between measured skin characteristics and body composition indices or the results of blood indices. A correlation was observed between TEWL and lipidogram results. Training under hypoxic conditions does not affect skin features in overweight and obese women. Even a significant reduction in TBW did not result in a decrease in hydration. It was also shown that the proper barrier function of the skin is closely dependent on the serum lipid profile.

Weight Management Effectiveness and Predictors of Dropout in Breast Cancer Survivors: A Retrospective Study.

Reducing obesity and weight gain, which often occurs during breast cancer treatment, may represent an efficient secondary or tertiary prevention against cancer. This retrospective observational cohort study aimed to assess the impact of a Mediterranean diet on weight and anthropometric changes in women completing active breast cancer treatment. Additionally, we sought to identify factors associated with study dropout within one year. A total of 182 female patients (20 normal weight, 59 overweight, 103 obese) received personalized Mediterranean diet interventions and underwent monthly outpatient visits. Dropout rates were 42.3% at 6 months and 64.1% at 12 months. Among the obese subgroup, BMI (p < 0.001) and fat mass (p < 0.05) decreased after 6 months. At 12 months, the obese subgroup showed a borderline significant further reduction in BMI (p = 0.062). BMI or weight loss did not predict dropout at any time point. However, age (OR = 0.91) and diastolic blood pressure (OR = 1.07) were significant predictors of dropout at 12 months. Implementing a Mediterranean diet can lead to weight and anthropometric improvements in breast cancer survivors. Further research is necessary to explore the long-term effects of weight loss on these individuals, identify effective dietary approaches, and consider specific predictors of dropout.

Washed Microbiota Transplantation Improves Patients with Overweight by the Gut Microbiota and Sphingolipid Metabolism.

Overweight (OW) and obesity have become increasingly serious public health problems worldwide. The clinical impact of washed microbiota transplantation (WMT) from healthy donors in OW patients is unclear. This study aimed to investigate the effect of WMT in OW patients. The changes in body mass index (BMI = weight (kg)/height (m)2), blood glucose, blood lipids and other indicators before and after WMT were compared. At the same time, 16S rRNA gene amplicon sequencing was performed on fecal samples of OW patients before and after transplantation. Finally, serum samples were tested for sphingolipids targeted by lipid metabolomics. A total of 166 patients were included, including 52 in the OW group and 114 in the normal weight (NOW) group. For OW patients, WMT significantly improved the comprehensive efficacy of OW. In the short term (about 1 month) and medium term (about 2 months), a significant reduction in BMI was seen. At the same time, in the short term (about 1 month), liver fat attenuation (LFA), triglyceride (TG) and fasting blood glucose (FBG) were significantly reduced. In the long term (about 5 months), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), non-high-density lipoprotein (non-HDL-c), etc. were significantly reduced. WMT improved the gut microbiota of OW patients, and also had an improvement effect on OW patients by regulating sphingolipid metabolism. WMT had a significant improvement effect on OW patients. WMT could restore gut microbiota homeostasis and improve OW patients by regulating sphingolipid metabolism.

Long-Term Results of a Digital Hypertension Self-Management Program: Retrospective Cohort Study.

Digital health programs that incorporate frequent blood pressure (BP) self-monitoring and support for behavior change offer a scalable solution for hypertension management. We examined the impact of a digital hypertension self-management and lifestyle change support program on BP over 12 months. Data were analyzed from a retrospective observational cohort of commercially insured members (n=1117) that started the Omada for Hypertension program between January 1, 2019, and September 30, 2021. Paired t tests and linear regression were used to measure the changes in systolic blood pressure (SBP) over 12 months overall and by SBP control status at baseline (≥130 mm Hg vs <130 mm Hg). Members were on average 50.9 years old, 50.8% (n=567) of them were female, 60.5% (n=675) of them were White, and 70.5% (n=788) of them had uncontrolled SBP at baseline (≥130 mm Hg). At 12 months, all members (including members with controlled and uncontrolled BP at baseline) and those with uncontrolled SBP at baseline experienced significant mean reductions in SBP (mean -4.8 mm Hg, 95% CI -5.6 to -4.0; -8.1 mm Hg, 95% CI -9.0 to -7.1, respectively; both P<.001). Members with uncontrolled SBP at baseline also had significant reductions in diastolic blood pressure (-4.7 mm Hg; 95% CI -5.3 to -4.1), weight (-6.5 lbs, 95% CI -7.7 to -5.3; 2.7% weight loss), and BMI (-1.1 kg/m2; 95% CI -1.3 to -0.9; all P<.001). Those with controlled SBP at baseline maintained within BP goal range. Additionally, 48% (418/860) of members with uncontrolled BP at baseline experienced enough change in BP to improve their BP category. This study provides real-world evidence that a comprehensive digital health program involving hypertension education, at-home BP monitoring, and behavior change coaching support was effective for self-managing hypertension over 12 months.

Bridging public and private health services to best meet the cardiometabolic needs of people with severe mental illness: a retrospective cohort study.

Cardiovascular disease is the leading cause of premature mortality in people with severe mental illness (SMI). Despite this, there lacks consensus regarding the most appropriate platform to monitor and treat cardiometabolic risk factors in this cohort. The current study aims to evaluate the effectiveness of tailored cardiometabolic healthcare in a private, GP-led clinic for people with SMI. A total of 63 adults with SMI were referred to a private GP-led cardiometabolic clinic from a neighbouring inner-city mental health service, where they received individualised cardiometabolic healthcare free-of-charge between 2014 and 2020. Paired t test was used to measure change in cardiometabolic data over the course of treatment. Chi-squared and Fisher's Exact tests were used to examine differences in demographic data and client engagement. Over a mean period of 9months, there was a significant mean reduction of weight (2.1kg), BMI (0.72kg/m2) and waist circumference (6cm). Engagement over a longer period was associated with stable accommodation and improved cardiometabolic outcomes. Targeted referral for individualised cardiometabolic interventions can lead to clinically significant improvement in cardiometabolic outcomes, providing a cause for therapeutic optimism when approaching physical health in people with SMI.

Effects of liraglutide among patients living with psoriasis and obesity

Background and aimsThere is a bidirectional relationship between obesity and psoriasis. Liraglutide has been shown to improve the severity of psoriatic lesions in patients with type 2 diabetes. We aimed to study the effects of liraglutide 3mg in patients with obesity and psoriasis. MethodsTwenty patients started treatment with liraglutide 3mg for 3 months. Severity of the lesions was evaluated using the Psoriasis Area Severity Index (PASI) and the visual analogue scale of pain (VAS), and quality of life with the Dermatology Quality Index (DLQI). ResultsThere was a significant reduction in BMI (38.9±5.8 vs. 36.4±5.6; p<0.001), CRP (4.5±2.4 vs. 3±2mg/L; p<0.01), homocysteine (13.3±3.6 vs. 11.9±3μmol/L; p<0.01), ferritin (185.4±142.2 vs. 97.43±114.4ng/mL; p=0.04) and plasma cortisol (12±3.1 vs. 11.6±2.2μg/dL, p=0.04). PASI (10±8.4 vs. 5.1±6; p<0.0001), VAS (4.1±2 vs. 2.3±0.92; p=0.009) and DLQI (12.7±7 vs. 6.4±5.6, p<0.0001) improved significantly. In multiple regression analysis, weight loss did not correlate with any inflammatory parameter or PASI. ConclusionsLiraglutide 3mg for three months is effective and safe in reducing weight and improving psoriatic lesions among patients with psoriasis and obesity. Besides, there is an improvement in psoriatic lesions regardless of weight loss that deserves further studies.

Mid-Long-Term Effect of Metabolic Surgery on Type 2 Diabetes in Nonobese Patients: a Meta-analysis.

This study aimed to perform a meta-analysis regarding the mid-long-term effect (≥ 2-year follow-up) of metabolic surgery on T2DM in non-obese patients. PubMed, EMBASE and CENTRAL databases were searched for clinical studies from inception to March 2023. Stata 12.0 was used for data aggregation. Sensitivity, subgroup, and meta-regression analyses were performed when feasible. This meta-analysis included 18 articles involving 548 patients. A pooled rate of 47.5% of T2DM remission was found after metabolic surgery. To be more specific, 83.5% was obtained for hemoglobin A1c (HbA1c) < 7.0%, 45.1% for HbA1c < 6.5%, and 40.4% for HbA1c < 6.0%. Subgroup analysis showed that one-anastomosis gastric bypass (OAGB) had a higher remission rate (93.9%) than other surgeries. Studies conducted in America had a higher remission rate (61.4%) than in Asia (43.6%). Meta-regression analysis displayed that publication year, number of patients, study design, preoperative age, BMI, and quality assessment score were not significantly associated with T2DM remission rate. Additionally, metabolic surgery could result in significant reductions in BMI (-4.133kg/m2), weight (-9.874kg), HbA1c (-1.939%), fasting blood glucose, fasting C-peptide, and fasting insulin. However, metabolic surgery seemed to have poorer glycemic control in non-obese than obese T2DM patients. A moderate mid-long-term effect of T2DM remission was observed after metabolic surgery in non-obese patients. However, we still need more prospective multi-institutional studies using the same definitions for diabetes and the same surgical technique for the surgery. Without this, the exact role of bariatric surgery in non-obese patients is unanswered.

729-P: Metabolic Surgery for the Treatment of Type 2 Diabetes Mellitus in China—Five-Year Outcomes from a Prospective Multicenter Study

The prevalence of type 2 diabetes (T2D) among adults in China is 10.9%-13.2%. Multicenter, long-term, prospective studies evaluating bariatric/metabolic surgery in obese patients with T2D in China are limited. This prospective study evaluated the 5-year impact of laparoscopic Roux-en-Y gastric bypass (RYGB; n=76 subjects, mean [SD] age 36.4 [9.5], 52.6% women, mean [SD] BMI 34.6 [4.9] kg/m2, mean [SD] glycosylated hemoglobin A1c [HbA1c] 8.3% [1.7%], mean [SD] duration diabetes 3.7 [2.7]) and sleeve gastrectomy (SG; n=25 subjects, mean [SD] age 41.1 [10.8], 44.0% women, mean [SD] BMI 36.4 [6.0] kg/m2, mean [SD] HbA1c 7.5% [1.5%], mean [SD] duration diabetes 2.4 [2.4]) on T2D at six centers in China from August 2014-April 2021. According to the composite measure of glycemic control for metabolic surgeries as suggested by the American Society for Metabolic and Bariatric Surgery, among 62 subjects evaluable at five years (50 RYGB, 12 SG), complete remission occurred in 28.6% (27.5% RYGB, 33.3% SG), partial remission in 27.0% (29.4% RYGB, 16.7% SG), improvement in 30.2% (29.4% RYBG, 33.3% SG), no change in 9.5% (7.8% RYBG, 16.7% SG), and recurrence in 4.8% (5.9% RYGB). Significant 5-year reductions in HbA1c (RYGB -1.7±2.1%, SG -1.8±1.1%), body weight (RYGB -19.8±8.4 kg, SG -21.2±6.0 kg), and BMI (RYGB -7.1±3.1 kg/m2, SG -7.7±2.1 kg/m2) were observed (all p&amp;lt;0.001). Five-year improvements in triglycerides and high-density lipoprotein cholesterol were also observed. Procedure-related serious adverse events occurred in 8 RYGB subjects (7.9%). To our knowledge, this is the first prospective, multicenter, 5-year study of bariatric/metabolic surgery in subjects with T2D in China. These data demonstrate that RYGB and SG achieved clinically meaningful, sustained impacts on T2D remission in many subjects for up to five years. Bariatric/metabolic surgery has enormous potential to provide a safe and effective option for appropriately selected subjects with T2D in China. Disclosure Y.Bao: None. Y.Tu: None. S.Lin: None. H.Zhang: None. W.Yang: None. J.Yang: None. S.Chen: None. Q.Fan: None. Y.Ma: None. C.Ma: None. J.Waggoner: Employee; Ethicon, Inc., Janssen Research &amp; Development, LLC, Stock/Shareholder; Johnson &amp; Johnson. H.Liang: None. A.Tokarski: Employee; Ethicon, Inc. N.Edwards: Consultant; Boston Scientific Corporation, EMD Serono, Inc., Ethicon, Inc., Johnson &amp; Johnson, Becton, Dickinson and Company. T.Yang: None. R.Zhang: None. W.Jia: None. P.Zhang: None. C.Wang: None. T.Jiang: None. N.Zhang: None. J.Zhu: None. H.Yu: None. J.Han: None. Funding Ethicon, Inc.; Johnson &amp; Johnson

73-LB: Tirzepatide 5, 10, and 15 mg vs Injectable Semaglutide 0.5 mg for the Treatment of Type 2 Diabetes—An Indirect Treatment Comparison

Semaglutide (sema) 0.5 mg is part of type 2 diabetes (T2D) standard of care as initial maintenance dose. While there has been a study conducted on TZP and sema 1.0 mg, showing TZP superiority, currently there is no head-to-head study comparing TZP and sema 0.5 mg. Therefore, the objective of this analysis was to evaluate the efficacy and safety of TZP and sema 0.5 mg using adjusted indirect comparisons. Adjusted indirect comparisons were performed using the Bucher method to compare the relative efficacy and safety of TZP 5, 10, 15 mg and sema 0.5 mg via a common comparator (sema 1.0 mg) based on trial results from SURPASS-2 (TZP vs sema 1.0 mg) and SUSTAIN 7 (sema 0.5 and 1.0 mg vs dulaglutide 0.75 and 1.5 mg). All TZP doses showed statistically significant greater reductions in HbA1c, weight and BMI from baseline to week 40 compared to sema 0.5 mg (Figure). TZP demonstrated a comparative safety profile for adverse events (AEs) but patients had statistically significant greater odds of treatment discontinuations due to AEs for TZP 10 and 15 mg. All TZP doses demonstrated no statistically significant differences vs sema 0.5 mg in the odds or likelihood of gastrointestinal AEs. In these adjusted indirect comparisons the extent of differences between TZP and sema 0.5 mg regarding HbA1c and weight reductions provide insights on their comparative effectiveness in the absence of a head-to-head study. Disclosure K. M. Pantalone: Consultant; AstraZeneca, Bayer Inc., Corcept Therapeutics, Diasome, Eli Lilly and Company, Merck &amp; Co., Inc., Novo Nordisk, Sanofi, Research Support; Bayer Inc., Merck &amp; Co., Inc., Novo Nordisk, Twin Health, Speaker's Bureau; AstraZeneca, Corcept Therapeutics, Merck &amp; Co., Inc., Novo Nordisk. S. Tofe: Advisory Panel; Lilly, Novo Nordisk, Research Support; Lilly, Novo Nordisk, Speaker's Bureau; Lilly, Novo Nordisk. L. Fan: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. J. S. Paik: None. K. T. Ranta: Employee; Eli Lilly and Company. H. Sapin: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. B. Osumili: Employee; Eli Lilly and Company. Funding Eli Lilly and Company

The Effects of a Very-Low-Calorie Ketogenic Diet on the Intestinal Barrier Integrity and Function in Patients with Obesity: A Pilot Study.

The very-low-calorie ketogenic diet (VLCKD) is effective and safe for obese individuals, but limited information exists on its impact on the intestinal barrier. This study analyzed the effects of 8 weeks of VLCKD on 24 obese patients (11M/13F). Carbohydrate intake was fixed at 20-50 g/day, while protein and lipid intake varied from 1-1.4 g/kg of ideal body weight and 15-30 g per day, respectively. Daily calorie intake was below 800 kcal. The lactulose-mannitol absorption test assessed small intestinal permeability. Multiple markers, such as serum and fecal zonulin, fatty acid-binding protein, diamine oxidase concentrations, urinary dysbiosis markers (indican and skatole), and circulating lipopolysaccharide levels, were analyzed. Inflammation markers (serum interleukin 6, 8, 10, and tumor necrosis factor-α concentrations) were also evaluated. The results showed significant reductions in weight, BMI, and waist circumference post-diet. However, the lactulose-mannitol ratio increased by 76.5%, and a significant increase in dysbiosis markers at the end of the diet occurred. This trend was particularly evident in a subgroup of patients. Despite initial benefits, the VLCKD might negatively affect the intestinal barrier function in obese patients, potentially worsening their compromised intestinal balance.

Chronotype as a predictor of weight loss and body composition improvements in women with overweight or obesity undergoing a very low-calorie ketogenic diet (VLCKD)

Recent studies reported that chronotype play a role in the development of metabolic comorbidities and in determining dietary habits in obesity. However, little is known if chronotype could predict the efficacy of nutritional approaches for obesity. The aim of this study was to investigate whether chronotype categories can have a role in determining the efficacy of very low-calorie ketogenic diet (VLCKD) in terms of weight loss and changes of body composition in women with overweight or obesity. In this retrospective study we analyzed data from 248 women (BMI 36.03±5.20kg/m2, aged 38.76±14.05 years) clinically referred for weight loss and who completed a VLCKD program. In all women, we assessed anthropometric parameters (weight, height, and waist circumference), body composition and phase angle (through bioimpedance analysis, Akern BIA 101) at the baseline and after 31 days of active phase of VLCKD. Chronotype score was assessed using Morningness-Eveningness questionnaire (MEQ) at baseline. After 31 days of active phase of VLCKD all enrolled women experienced significant weight loss (p<0.001) and reduction of BMI (p<0.001), waist circumference (p<0.001), fat mass (kg and %) (p<0.001), and free fat mass (kg) (p<0.001). Women with evening chronotype experienced significantly less weight loss (p<0.001) and reduced fat mass (kg and %) (p<0.001), increased fat free mass (kg and %) (p<0.001) and phase angle (p<0.001) than women with morning chronotype. In addition, chronotype score correlated negatively with percentage changes in weight (p<0.001), BMI (p<0.001), waist circumference (p<0.001) and fat mass (p<0.001) and positively with fat free mass (p<0.001) and phase angle (p<0.001) from baseline to the 31st day of active phase of VLCKD. Using a linear regression model, chronotype score (p<0.001) was the main predictors of weight loss achieved with VLCKD. Evening chronotype is associated with a lower efficacy in terms of weight loss and improvements of body composition after VLCKD in obesity.

Efficacy and safety profile of Glucagon-Like Peptide-1 Receptor Agonist in obese Type-2 diabetes patients from a private institution in Karachi.

To assess the effectiveness of GLP-1RAs in managing obese T2DM patients. This prospective cohort analysis was conducted at Medicell Institute of Diabetes, Karachi, Pakistan; from July 2019 to July 2021. A total of 97 obese individuals >16 years of age with T2DM and IGT were initially enrolled, and 81 patients who showed up for the follow-up were prescribed one of the three GLP-1RAs available in Pakistan. Out of 81 patients who showed up for the follow-up visit, 43 had received Liraglutide, 25 were taking Dulaglutide, and 13 had been prescribed IDegLira supplemented with oral hypoglycemic medications ± insulin. The mean age of the enrolled patients was 49.21(12.44) years, and there was female predominance (55.6%). Overall, there was a significant weight and BMI reduction among the patients treated with either of the GLP-1RAs (P<.01). Furthermore, significant glycemic control was observed in all three groups after the treatment. The Dulaglutide group demonstrated a more significant reduction of HbA1c compared to Liraglutide group, which showed more pronounced weight and BMI reduction. Nevertheless, this class of medications was well-tolerated, with nausea being the most often reported side effect. GLP-1RAs showed favorable weight and HbA1c reduction among patients of all three treatment groups.

Bariatric surgery and obstructive sleep apnea: a systematic review and meta-analysis.

Several studies evaluated the effect of bariatric surgery on obstructive sleep apnea (OSA) but findings have been inconsistent. The aim of this study was to conduct an updated systematic review and meta-analysis to investigate the effect of bariatric surgery on OSA. The databases for PubMed, CENTRAL, and Scopuswere searched up to the 1st of December, 2021. Studies were included if they were cohort or case-control in design, included patients with diagnosisof OSA, the patients underwent any bariatric surgery, and the study performed postoperative polysomnography. The total number of the included patients was 2310 patientswith OSA from 32 studies. Our analysis showed that bariatric surgery was associated with significant reduction in BMI (WMD = - 11.9, 95%CI: - 13.4, - 10.4), apnea-hypopnea index (AHI) (WMD = - 19.3, 95%CI: - 23.9, - 14.6), and respiratory disturbance index (RDI) (WMD = - 33.9, 95%CI: - 42.1, - 25.7). The rate of OSA remission after the surgery was 65% (95%CI: 0.54, 0.76). Our results suggest that bariatric surgeries are effective in reducing obesity among patients withOSA in addition to OSA severity measures. However, the low rate of OSA remission suggests that the main etiology of OSA is not only obesity but also includes other important variables such as the anatomy of the jaw.

Intake of hot water after each meal as a weight reduction strategy – a prospective randomized controlled trial

Introduction and Aim: Intake of water before meal is associated with weight loss. There is a paucity of literature with comparative evaluation of taking warm water or regular water after meals on weight and BMI. Hence, we designed a randomized controlled trial with regular and warm water after meals to investigate the comparative efficacy of warm and regular water intake after meals on weight and BMI in overweight adults. Methodology: Fifty participants were randomized into two groups, with Group H instructed to drink 200-250 ml of warm water after each meal and Group C to drink the same amount of regular water. Results: The demographic data prior to the study in both the groups were similar. Compliance was high in both groups, and after three months, the warm water group experienced a significant reduction in weight and BMI compared to the regular water group (p=0.000). In Group H, weight and BMI came down from 76 to 73 and 29 to 27 respectively. Conclusion: The study concluded that warm water intake after meals may contribute to weight loss without major side effects. This is the first attempt to investigate the influence of warm water on weight reduction.