Weight Loss In Obese Patients Research Articles

Semaglutide for weight loss in obese patients as an adjunctive treatment for hidradenitis suppurativa: its impact on disease control and quality of life.

Hidradenitis suppurativa (HS) has a significant impact on quality of life and mortality. We report the use of semaglutide and its impact on disease control and quality of life in 30 obese patients in a HS specialty clinic. This retrospective data suggests that the addition of semaglutide to standard HS therapies results in improvement in quality of life and less flares of HS. The retrospective nature of the study is a limitation. Placebo-controlled randomised clinical trials should be done in hidradenitis suppurativa to assess the efficacy of semaglutide in this debilitating condition.

THE EFFICACY OF VERY LOW CALORIE KETOGENIC DIET (VLCKD) ON CARDIO–METABOLIC PROFILE IN PATIENTS WITH OBESITY

Abstract Background Obesity is associated with alterations in cardiac structure and haemodynamics leading to cardiovascular mortality and morbidity. Very low calorie ketogenic diet (VLCKD) has been proposed as an effective intervention to achieve a significant weight loss in obese patients in a short time period. Furthermore, hyperketonemia induced by VLCKD is associated with beneficial cardiovascular effects. In addition, ketogenic diet is able to prevent mitochondrial fission, improve mitochondrial function, suppress oxidative stress and attenuate cardiac myocytes apoptosis in the heart of mice. Aim To evaluate the role of VLCKD on cardio–metabolic risk factors, cardiac dysfunction and myocardial remodelling in obese patients. Materials and Methods Ten obese patients treated with VLCKD were enrolled. All patients were characterized from an anthropometric, cardio–metabolic and echocardiographic point of view at baseline and 8 weeks after VLCKD treatment. In addition, each patient underwent measurement of global myocardial work efficiency (GWE), a novel indicator that accounts for deformation and afterload, which may provide additional value for assessment of myocardial function. The insulin resistance (IR) was evaluated by HOMA–IR. Results As expected, all the patients showed a significant reduction in body weight and an overall improvement of body composition parameters after VLCKD. Weight (kg) (from 105.1 ± 18.2 to 83.7 ± 16.7, P <0.05), BMI (kg/m2) (from 40.1 ± 4.7 to 31.8 ± 4.8, P= 0.002) and waist circumference (cm) (from 115 ± 13.6 to 101.8 ± 12.4, p < 0.05) were significantly lower after VLCKD treatment. VLCKD treatment improved also significantly fasting glucose levels (P <0.05), fasting insulin levels (P =0.004), HOMA–IR values (P <0.001), lipid profile and systolic and diastolic blood pressure levels. In addition, the echocardiogram evaluation showed an improved in end–diastolic left ventricular volume, end–systolic left ventricular volume, left ventricular mass and left ventricular mass index. Interestingly, a significantly changes in GWE was observed (P<0.05). Conclusion Although preliminary, our data suggest that VLCKD treatment is able to reduce cardio–metabolic risk factors and to improve cardiac dysfunction and myocardial function.

SIMULATED WEIGHT REDUCTION WITH AN ANTI-GRAVITY TREADMILL: A PILOT STUDY TO ASSESS PAIN REDUCTION IN FOOT AND ANKLE ARTHRITIS

IntroductionOsteoarthritis in the foot and ankle affects approximately 30,000 patients annually in the UK. Evidence has shown that excess weight exacerbates foot pain, with significant increases in joint forces. However, despite the current trend for Clinical Commissioning Groups to ration surgery for obese patients, studies have not yet determined the effect of weight loss in obese patients with foot and ankle arthritis.AimPilot study to investigate the effect of simulated weight loss on pain scores in obese patients with symptomatic foot and ankle arthritis.MethodsFollowing ethical approval, a prospective study of 17 obese patients (mean BMI 39.2, range 31.2 – 50.3) with foot and ankle arthritis was undertaken (BOFAS funded). Under physiotherapist supervision, patients walked for one minute on an anti-gravity treadmill, which allowed simulated weight reduction. Following baseline assessment, reduced BMI was simulated, starting at 20, rising in increments of 5, until each patient's usual BMI was reached. Pain was assessed using a Visual Analogue Scale (VAS). Repeated measures ANOVA was used to assess for significant changes in pain, comparing baseline with each simulated BMI category (significance set at p< 0.05).ResultsSimulated weight loss caused a significant reduction in pain (p=0.005, power 0.91). Mean VAS pain scores improved by 24% (p=0.003) and 17% (p=0.040) for BMI categories 20 and 25, compared with baseline. Pain scores were not significantly different comparing BMI categories of 25 and 20.ConclusionSimulated weight loss to normal BMI significantly decreased pain in obese patients with foot and ankle arthritis. The use of the anti-gravity treadmill to demonstrate the feeling of normal BMI has also provided motivation to several patients to lose weight. The current study could be used to power future studies to investigate the effects of weight loss in foot and ankle patients.

Abstract LB376: Tirzepatide inhibits tumor growth in mice with diet-induced obesity

Abstract Tirzepatide, a drug used in management of type II diabetes, is an activator of both glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) receptors. Tirzepatide treatment leads to weight loss in murine models of obesity, and clinical trials have shown the drug can achieve ∼ 20% weight loss in obese patients. Obesity has been shown to increase risk and/or to worsen prognosis of certain common cancers, including colon cancer, but the effect of tirzepatide on neoplasia has not been examined in detail. We studied the effects of this drug on mouse weight and energy balance and on the murine MC38 colon cancer model, which was previously shown to exhibit accelerated growth in hosts with diet-induced obesity. Tirzepatide led to substantial reductions in food intake, to reduced adipose tissue mass, and to significant decreases in circulating levels of insulin and leptin. Tirzepatide did not cause tumor regression, but reduced tumor growth rates by ∼ 50%. Tirzepatide had no effect on MC38 cancer cell proliferation in vitro, and the effect of tirzepatide on tumor growth in vivo could be phenocopied in placebo treated mice simply by restricting food intake to the amount consumed mice receiving the drug. This provides evidence that the drug acts indirectly to inhibit tumor growth. Our findings raise the possibility that use of tirzepatide or similar agents may benefit patients with obesity-related cancers. Citation Format: Michael N. Pollak, Jibin Zeng, Linxuan Huang, Ye Wang, Janane Rahbani, Lawrence Kazak. Tirzepatide inhibits tumor growth in mice with diet-induced obesity [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr LB376.

Effect and safety of electroacupuncture on weight loss in obese patients with pre-diabetes: study protocol of a randomised controlled trial

IntroductionObesity has been identified as a significant risk factor for several chronic conditions, including diabetes, tumours and cardiovascular disease, and has been associated with increased mortality rates. Despite the well-established...

Brain access of incretins and incretin receptor agonists to their central targets relevant for appetite suppression and weight loss.

New incretin-based pharmacotherapies provide efficient and safe therapeutic options to curb appetite and produce weight loss in patients with obesity. Delivered systemically, these molecules produce pleiotropic metabolic benefits, but the target sites mediating their weight-suppressive action are located within the brain. Recent research has increased our understanding of the neural circuits and behavioral mechanisms involved in the anorectic and metabolic consequences of glucagon-like peptide 1 (GLP-1)-based weight loss strategies, yet little is known about how these drugs access their functional targets in the brain to produce sustained weight loss. The majority of brain cells expressing incretin receptors are located behind the blood-brain barrier, shielded from the circulation and fluctuations in the availability of peripheral signals, which is a major challenge for the development of CNS-targeted therapeutic peptides. GLP-1 receptor (GLP-1R) agonists with increased half-life and enhanced therapeutic benefit do not cross the blood-brain barrier, yet they manage to access discrete brain sites relevant to the regulation of energy homeostasis. In this review, we give a brief overview of the different routes for peptide hormones to access the brain. We then examine the evidence informing the routes employed by incretins and incretin receptor agonists to access brain targets relevant for their appetite and weight-suppressive actions. We highlight existing controversies and suggest future directions to further establish the functionally relevant access routes for GLP-1-based weight loss compounds, which might guide the development and selection of the future generation of incretin receptor polypharmacologies.

Feasibility study of Glucagon-like peptide-1 analogues for the optimization of Outcomes in obese patients undergoing AbLation for Atrial Fibrillation (GOAL-AF) protocol

BackgroundCatheter ablation for atrial fibrillation is recommended for symptomatic patients after failed medical therapy. Ablation has a higher failure rate in obese patients, and both the prevalence of atrial fibrillation and obesity are increasingly globally. The outcome of ablation can be improved if obese patients can achieve goal-oriented weight reduction prior to ablation. Conventional weight loss strategies, however, can be difficult to access and can delay ablation, thereby risking a lower chance of maintaining sinus rhythm. Effective weight-loss medications, such as the glucagon-like peptide inhibitor-1 drugs, offer the potential for incremental impact on weight loss over a shorter period of time as a bridging therapy. The aim of this study is to assess the feasibility of using liraglutide, a glucagon-like peptide inhibitor-1, in producing weight loss in obese patients before catheter ablation.MethodsThe study is an open-label, uncontrolled, prospective single-centre feasibility study of daily liraglutide injections in the treatment of obese patients for at least 13 weeks before and 52 weeks after AF ablation. Adult patients with symptomatic AF whose body mass index ≥ 30 will be recruited from those planning to undergo ablation. Feasibility will be determined based on the recruitment rate, adherence to the medication, and the amount of weight loss achieved over the study period. Exploratory outcomes include changes in atrial structure, function, and fibrosis with weight loss evaluated by cardiac magnetic resonance imaging, electroanatomic mapping, and patient-reported outcome measure.DiscussionThis study will allow us to determine whether the use of liraglutide in obese patients with atrial fibrillation undergoing ablation is feasible with adequate recruitment. The additional information on adherence and average weight loss over the study period will inform the design of a future definitive randomized controlled trial.Trial registrationClinicalTrials.gov (NCT05221229). Registered on 2 February 2022.Trial fundingMetchley Park Medical Society and University of Birmingham Starter Fellowship, British Heart Foundation Accelerator Grant, Abbott Investigator-Initiated Study Grant.

Obezitede Medikal Tedavi

The main aim of obesity management is to improve health. Weight loss of 5-10% or more provides improvement in obesity and obesityrelated
 comorbid diseases (Type 2 diabetes mellitus, hypertension, dyslipidemia, fatty liver disease, etc.) as well as an increase in quality
 of life. As with all chronic diseases, obesity management requires a multidisciplinary approach. Individual treatment should be targeted.
 Obesity treatment consists of lifestyle changes, medical treatment, and bariatric surgery. Until today, many drugs have worked with
 the aspect of appetite reduction and energy expenditure through the nervous system. However, many drugs have been withdrawn
 due to safety concerns. In recent years, drugs with gut-based incretin mechanisms of action have attracted considerable interest.
 The first approved glucagon-like peptide-1 receptor agonist (GLP-1) analog liraglutide is promising. As a new treatment, the GLP-1
 analog semaglutide 2.4 mg weekly is approved for the treatment of obesity. Another new treatment, tirzepatide, the first dual GLP-1/
 glucagon-like peptide-1 receptor agonist (GIP) analog, has achieved up to 20% weight loss in obese patients and has also shown positive
 cardiovascular outcomes. Although promising, there is no comparative study of new effective obesity drugs with bariatric surgery,
 which is currently known as the most effective method, with weight loss up to 25%. Today, as the pathophysiogenesis of obesity is better
 understood, newer, safer molecules will continue to emerge. In this review, current information about the current and future medical
 treatments for obesity will be discussed.

Nutrition Counseling, Lipid Profile Improvement and Weight Loss in Obese Patients with Dyslipidemia

Obesity with dyslipidemia is a serious problem because it risks various degenerative and metabolic diseases. The prevalence of obesity in Indonesia continues to increase every year, currently in the adult population reaching 21.8%. To prevent the onset of degenerative diseases and metabolic disorders, it is important to control obesity with dyslipidemia through weight loss and lipid profile improvement. This study aims to determine the effect of nutritional counseling in losing weight and improving lipid profiles in obese patients with dyslipidemia. This is a pseudo-experimental study with One group Pre and Post Test Design. The initial stage was the identification of obesity and lipid profile. In 100 respondents identified as obese, total cholesterol, LDL and triglycerides were examined. 40 obese respondents with dyslipidemia were determined as samples. The second stage was nutrition counseling intervention. The third stage of evaluation is the re-measurement of body weight and lipid profile. The research result is only 30 respondents participated in the evaluation. Average initial body weight was 75.11 kg and final body weight was 73.14 kg. Average weight loss was 1.97 kg. Average initial cholesterol 233.20 mg/dL and final cholesterol 224.70 mg/dL. Average cholesterol reduction of 8.5 mg/dL. Average initial LDL 152.37 mg/dL and final LDL 139.47 mg/dL. Average decrease in LDL 12.9 mg/dL Average initial triglycerides 161.23 mg/dL and final triglycerides 143.97 mg/dL. The average decrease in triglycerides is 17.26 mg/dL. The statistical test results showed a p-value = 0.000. There is an effect of nutritional counseling on weight loss and improvement of lipid profiles of obese patients with dyslipidemia.

Mirabegron, a Selective β3-Adrenergic Receptor Agonist, as a Potential Anti-Obesity Drug.

Obesity is becoming a global health epidemic. Brown and "beige" adipose tissue may produce heat, leading to energy expenditure enhancement and weight loss. Mirabegron, a selective β3-adrenergic receptor agonist, has been found to be effective as a brown adipose tissue activator, a "beige" cells stimulator and a metabolic homeostasis controller in animal and human studies. Although in animal studies, administration of mirabegron led to obesity improvement, significant weight loss in obese patients after mirabegron treatment has not been demonstrated so far, which may be associated with the too-short duration of the trials and the small number of participants in the studies. In humans, the most effective treatment for adipose tissue stimulation was high doses of mirabegron; however, cardiovascular side effects may limit the use of such doses, so the long-term safety must be evaluated. In cases of tachycardia or blood pressure elevation, the co-administration of a β1-adrenergic receptor blocker may be useful. It should be checked whether smaller doses of mirabegron, taken for a longer time, will be sufficient to stimulate brown and "beige" adipose tissue, leading to weight loss. The introduction of mirabegron into obesity treatment in the future will require long-term trials with larger numbers of subjects, to assess mirabegron efficacy, tolerability, and safety.

Diabetic Markers, Five Years after Bariatric Surgery.

Background: Bariatric surgery delivers substantial weight loss for obese patients with comorbidities like diabetes mellitus. We aimed to investigate the impacts of bariatric surgery on diabetic markers after 5 years of follow-up. Methods: This is a retrospective study on patients with diabetes and a history of bariatric surgery between 2016-2017. The diabetic markers before and 5 years following surgery, including a lipid profile, glucose level, and the required antidiabetic medications, were evaluated. Results: 34 consecutive patients were included, 30 (88.2%) women, with a mean age of 52.71±8.53 years. The majority (65%) of surgeries were Roux-en-Y gastric bypass (RYGB), and the remaining were one anastomosis gastric bypass (OAGB) and sleeve gastrectomy (SG). The serum levels of diabetic markers reduced during follow-up (P=0.001), except for high-density lipoprotein levels and serum total cholesterol, which increased (P=0.011, P=0.838). Low-density lipoprotein levels reduced, but it was insignificant (P=0.194). Surgery types had affected the changes of diabetic markers (P>0.05). Demand for oral medication was reduced significantly, but insulin injection reduction was not significant (P=0.006 and P=0.099, respectively). Conclusion: Our study showed favorable bariatric surgery results on patients with diabetes in long-term follow-up. However, dyslipidemia is still a concern.

Cardiovascular Effects of Weight Loss in Obese Patients with Diabetes: Is Bariatric Surgery the Additional Arrow in the Quiver?

Obesity is an increasingly widespread disease worldwide because of lifestyle changes. It is associated with an increased risk of cardiovascular disease, primarily type 2 diabetes mellitus, with an increase in major cardiovascular adverse events. Bariatric surgery has been shown to be able to reduce the incidence of obesity-related cardiovascular disease and thus overall mortality. This result has been shown to be the result of hormonal and metabolic effects induced by post-surgical anatomical changes, with important effects on multiple hormonal and molecular axes that make this treatment more effective than conservative therapy in determining a marked improvement in the patient's cardiovascular risk profile. This review, therefore, aimed to examine the surgical techniques currently available and how these might be responsible not only for weight loss but also for metabolic improvement and cardiovascular benefits in patients undergoing such procedures.

Novel Dual Incretin Receptor Agonists in the Spectrum of Metabolic Diseases with a Focus on Tirzepatide: Real Game-Changers or Great Expectations? A Narrative Review.

The prevalence of metabolic diseases including type 2 diabetes (T2D), obesity and non-alcoholic fatty liver disease (NAFLD) increases globally. This highlights an unmet need for identifying optimal therapies for the management of these conditions. Tirzepatide is a novel dual incretin receptor agonist (twincretin) that activates both glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptors. The aim of this narrative review was to examine the impact of novel twincretins, focusing on tirzepatide, on the management of a wide spectrum of metabolic diseases. Data from preclinical and clinical trials have shown that twincretins significantly reduce blood glucose levels in T2D, and tirzepatide is the first agent of this class that has been approved for the management of T2D. Additionally, the beneficial impact of tirzepatide on weight reduction has been corroborated in several studies, showing that this agent can achieve substantial and sustained weight loss in obese patients with or without T2D. Data also suggest that tirzepatide could be a promising drug for hepatic steatosis reduction in individuals with NAFLD. The remarkable effects of tirzepatide on glycaemic control, weight loss and liver-related outcomes have posed new research questions that are likely to lead to further advancements in the treatment of T2D, obesity and related metabolic disorders.

Combined GIP receptor and GLP1 receptor agonism attenuates NAFLD in male APOE∗3-Leiden.CETP mice.

Combined glucose-dependent insulinotropic polypeptide receptor (GIPR) and glucagon-like peptide-1 receptor (GLP1R) agonism is superior to single GLP1R agonism with respect to glycemic control and weight loss in obese patients with or without type 2 diabetes. As insulin resistance and obesity are strong risk factors for nonalcoholic fatty liver disease (NAFLD), in the current study we investigated the effects of combined GIPR/GLP1R agonism on NAFLD development. Male APOE∗3-Leiden.CETP mice, a humanized model for diabetic dyslipidemia and NAFLD when fed a high-fat high-cholesterol diet, received subcutaneous injections with either vehicle, a GIPR agonist, a GLP1R agonist, or both agonists combined every other day. GIPR and GLP1R agonism reduced body weight and additively lowered fasting plasma levels of glucose, triglycerides and total cholesterol. Strikingly, we report an additive reduction in hepatic steatosis as evidenced by lower hepatic lipid content and NAFLD scores. Underlying the lipid-lowering effects were a reduced food intake and intestinal lipid absorption and an increased uptake of glucose and triglyceride-derived fatty acids by energy-combusting brown adipose tissue. Combined GIPR/GLP1R agonism also attenuated hepatic inflammation as evidenced by a decreased number of monocyte-derived Kupffer cells and a reduced expression of inflammatory markers. Together, the reduced hepatic steatosis and inflammation coincided with lowered markers of liver injury. We interpretate that GIPR and GLP1R agonism additively attenuate hepatic steatosis, lower hepatic inflammation, ameliorate liver injury, together preventing NAFLD development in humanized APOE∗3-Leiden.CETP mice. We anticipate that combined GIPR/GLP1R agonism is a promising strategy to attenuate NAFLD progression in humans. This work was supported by a grant from the Netherlands CardioVascular Research Initiative: the Dutch Heart Foundation, Dutch Federation of University Medical Centers, the Netherlands Organization for Health Research and Development, and the Royal Netherlands Academy of Sciences [CVON-GENIUS-II] to P.C.N.R., a Lilly Research Award Program [LRAP] Award to P.C.N.R. and S.K., a Dutch Heart Foundation [2017T016] grant to S.K., and an NWO-VENI grant [09150161910073] to M.R.B.; J.F.D.B. is supported by the Nutrition and Health initiative of the University of Groningen; Z.Y. is supported by a full-time PhD scholarship from the China Scholarship Council (201806850094 to Z.Y.).

P31-018-23 Using Gut Transit Times To Increase Weight Loss in Obese Patients at Increased Risk for Colorectal Cancer

P31-018-23 Using Gut Transit Times To Increase Weight Loss in Obese Patients at Increased Risk for Colorectal Cancer

1665-P: Whole-Brain Activation Signatures of Weight-Lowering Drugs

Background: The development of effective anti-obesity therapeutics relies heavily on the ability to target CNS signaling mechanisms critically involved in the homeostatic control of body weight. To get insight into neurocircuits recruited by anti-obesity drug treatment, the present study aimed to determine whole-brain activation signatures of six different weight-lowering drug classes with documented efficacy in humans. Methods: Chow-fed mice received a single dose of lorcaserin (7 mg/kg, i.p.), rimonabant (10 mg/kg, i.p.), bromocriptine (D2 receptor agonist, 10 mg/kg, i.p.), sibutramine (10 mg/kg, p.o.), semaglutide (0.04 mg/kg, s.c.) or setmelanotide (4 mg/kg, s.c.). Brains were sampled two hours post-dosing, immunolabelled using c-Fos expression as a proxy for neuronal stimulation. Cleared whole-brains were imaged using light sheet fluorescence microscopy-deep learning pipeline enabling fully automated 3D mapping and quantitation of brain activation patterns at single-cell resolution. Results: The whole-brain analysis comprised 308 atlas-defined mouse brain areas. To enable fast and efficient data mining, an open-access web-based 3D imaging data viewer (NeuroPedia.dk) was developed. All weight-lowering drugs demonstrated brain-wide responses with notable similarities in c-Fos expression signatures. Overlapping c-Fos responses were detected in discrete homeostatic and non-homeostatic feeding centres located in the dorsal vagal complex and hypothalamus with concurrent activation of several limbic structures as well as the dopaminergic system. Conclusion: We pinpoint several overlapping brain activation signatures of various weight-lowering drugs. This shared feature suggests that weight-lowering drugs stimulate distinct homeostatic and non-homeostatic feeding centres. Future centrally acting anti-obesity compounds may be specifically designed to target key components of this neurocircuitry framework to provide more effective and sustained weight loss in obese patients. Disclosure L.S.Dalboege: Employee; Gubra aps. J.Hecksher-sørensen: Employee; Gubra ApS. M.Tozzi: None. C.G.Salinas: Employee; Gubra. T.Porsgaard: Employee; Gubra. D.D.Thorbek: Employee; Gubra APS. J.L.Skytte: Employee; Gubra ApS. U.Roostalu: Employee; Gubra. H.H.Hansen: None. J.Perens: Employee; Gubra ApS.

Correlations between modest weight loss and leptin to adiponectin ratio, insulin and leptin resensitization in a small cohort of Norwegian individuals with obesity

BackgroundWeight loss is important to reduce the risk of metabolic complications in obese individuals, in whom dysregulated adipokines play a central role. This study aims to investigate whether dysregulated adipokines and postprandial triglycerides (TG) improve with a modest weight loss. MethodsIndividuals with obesity (BMI ≥ 30 kg/m2) were recruited among patients at the University Hospital of North Norway and the Stamina Health weight loss rehabilitation program. We measured resting energy expenditure (REE), and calculated the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), leptin to adiponectin (L:A) ratio, indirect leptin sensitivity (REE:leptin ratio), postprandial TG clearance at 6 h, and TG response before and after weight loss. The goal of the weight loss intervention was a loss of ≥5 % of initial total body weight. Results28 participants completed the study, of which 13 lost ≥ 5 % body weight and 18 lost <5 % body weight. HOMA-IR (−23.1 %), REE:leptin ratio (+80.1 %) and L:A ratio (−45.7 %) significantly improved with weight loss, whereas there was no improvement of postprandial TG response or clearance. No significant changes were observed in the non-weight loss group. ConclusionThe data are consistent with the general concept that modest weight loss in obese patients may restore metabolic regulation by improving L:A ratio and insulin and leptin sensitivity.

P55: Phentermine-Topiramate for Weight Loss in Obese Patients with Left Ventricular Assist Devices

Study: Obesity in VAD patients has been associated with an increase in infection rates, device malfunction, cardiac arrhythmias and hospitalizaitons. Obesity can also restrict access to heart transplantation. Unfortunately, significant weight loss is difficult to achieve through lifestyle modification, especially in patients with advanced heart failure. Pharmacologic therapy for weight loss can be very effective but has not been studied in patients with LVADs. Exploring this option may limit the necessity of bariatric surgery for this patient group. Methods: We reviewed data from patients on LVAD support with baseline BMI > 40 kg/m2 who were treated with generic phentermine and topiramate for at least 90 days. Statistical analysis was performed using paired Student’s t-tests. Results: From February 2022 to September 2022, 9 LVAD patients with baseline BMI > 40 kg/m2 were prescribed phentermine and topiramate for at least 90 days. The mean weight loss was 4.02±2.7 kg (p=0.002) at 30 days. The mean weight loss was 4.17±4.9 kg (p=0.04) at 90 days. At 30 days, 8 patients lost weight (mean loss in successful group was 4.55kg) while 1 patient did not have any weight loss (Figure 1). At 90 days, 7 patients lost weight (mean loss in successful group was 5.8kg) (Figure 1). Successful weight loss with these medications was associated with patients adhering to a healthy diet and exercise regimen. Three patients had cessation of treatment during therapy: one patient had VT requiring ICD shock; one patient had recurrence of their known paroxysmal atrial fibrillation; and one patient had arrhythmias in the setting of pump dysfunction unrelated to phentermine/topiramate. Importantly, all three patients had previous history of arrhythmias and it is unknown if these agents directly contributed to their recurrence. There were no additional adverse events documented. One patient has reached a BMI of 37, making them eligible for heart transplant evaluation at our center. Conclusions: Treatment of severely obese LVAD patients with a combination of generic medications that work by appetite suppression was generally well tolerated and effective in the majority of subjects. Further study is needed to confirm efficacy and safety and to determine if there are patient characteristics that help to determine responsiveness. Follow up is ongoing and will present additional 60- and 90-day data.

Correlation between Preoperative Dietary Dehavior and Weight Loss after Laparoscopic Sleeve Gastrectomy

Purpose: The study aimed to investigate the relationship between preoperative dietary habits and weight loss in individuals with simple obesity who have undergone laparoscopic sleeve gastrectomy. Methods: From January 2020 to August 2021, the clinical data of 75 patients with simple obesity who underwent laparoscopic sleeve gastrectomy at the Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University were retrospectively analyzed, including gender, age, height, weight, calculated percentage of total weight loss (TWL), percentage of excess weight loss (%EWL), and the three-factor diet questionnaire, and correlation tests were performed. Results: At 1 month, 3 months, and 1 year postoperatively, postoperative follow-up weight and BMI were considerably reduced (P 0.001), while %TWL and %EWL levels were significantly higher (P 0.001). Emotional eating (EE) and unrestrained eating habits (UE) reduced considerably 1 month postoperatively (P 0.001). There was no significant link between preoperative CR and %TWL and %EWL at 1 month, 3 months, or 1 year postoperatively, while preoperative EE and UE were marginally positively connected with %TWL and %EWL at 1 month (r &gt; 0.3, P＜0.05). Conclusions: Following LSG, dietary habits improved dramatically, and preoperative EE and UE were shown to be weakly closely connected with early weight loss in obese patients after LSG.

Can prebiotics improve weight loss in obese patients?

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