Weight Management In Obese Patients Research Articles

Glucagonlike Peptide-1 Receptor Agonists: The Good, the Bad, and the Ugly-Benefits for Glucose Control and Weight Loss with Side Effects of Delaying Gastric Emptying.

Glucagonlike peptide-1 (GLP-1) receptor agonists (RAs) are being increasingly used for glycemic control in patients with diabetes and for weight loss and weight management in obese subjects. There has been recent public awareness of the potential of GLP-1 RAs to delay gastric emptying and cause gastroparesis. By delaying gastric emptying, these agents can complicate the clinical evaluation of patients on these drugs by affecting diagnostic testing for gastroparesis. This article discusses GLP-1 RAs and their effects on gastric emptying, gastric food retention, and gastroparesis. This article highlights how physicians should be attuned to the gastric side effects of these popular therapeutic agents for blood glucose control in people with diabetes and for weight loss and weight management in obese patients.

Assessment of public awareness about Semaglutide (Ozempic) use, safety, and adverse drug reaction in Saudi Arabia

Background: Obesity is a growing epidemic in Saudi Arabia, and Semaglutide has emerged as a promising pharmacotherapeutic option for weight management in obese patients. This study aims to assess public knowledge about Ozempic (semaglutide) use, safety, and adverse drug reactions in Saudi Arabia. Methods: We conducted a cross-sectional survey to collect data among the adult population in Saudi Arabia. Statistical tests of significance, including the chi-squared test and Spearman\'s rho correlation test, were employed to examine differences between groups and assess correlations between variables. Results: Of the 739 participants, 50.7% were females, and most participants had a bachelor's degree level of education. Study respondents reported that they had heard of Ozempic, but only 244 (58%) knew its indication (Type 2 DM). The analysis showed that good knowledge was observed among the 31–40 and 18–30 age groups compared to other age groups (p = 0.020); no other sociodemographic variables showed a significant association with the knowledge level (p > 0.05).The questionnaire was distributed to a representative sample with a minimum of 385 participants among the Saudi population, with a 95% confidence level and a margin of error of 5%, through online platforms. Data were collected and analyzed using descriptive and inferential statistical methods. Conclusion: Semaglutide is a valuable medication for the treatment of type 2 diabetes and, under appropriate circumstances, for weight loss management. The study showed that the majority of the participants used it for weight loss management, and their awareness regarding its indications, contraindications, and adverse effects was not adequate.

Development and Usability of a Life-Logging Behavior Monitoring Application for Obese Patients

BackgroundObesity is a global epidemic. Behavior change monitoring using a smartphone application (app) can support weight management in obese patients. These apps must undergo usability testing, which is an important step in mobile healthcare app development. The current study aimed to develop a mobile app for behavioral monitoring and to test its usability including technical effectiveness, user efficiency, and user satisfaction for obese adults.MethodsDevelopment of the Dr. Youth app components included information on behavioral monitoring indicators and their obesity subtypes. The usability of the app was tested with 50 obese adults in a university hospital. Participants were asked to complete eight tasks for evaluating the technical effectiveness of the app. The time to complete each task was measured to test user efficiency. To explore user satisfaction, each participant completed the System Usability Scale (SUS). Descriptive statistics were used to examine the mean user efficiency and SUS scores.ResultsFifty adults (14 men and 36 women, aged 20–59 years) who are obese (body mass index ≥25 kg/m2) were recruited. The mean age of participants was 42.6 years (standard deviation [SD], 10.8 years); their mean body mass index was 29.6 kg/m2 (SD, 5.7 kg/m2). The tasks were completed with a 99% success rate. The overall mean SUS score was 76.65 (SD, 15.43).ConclusionThe Dr. Youth app shows acceptable technical effectiveness, user efficiency, and user satisfaction. Future study is warranted to establish the app’s clinical efficacy.

Psychometric properties of the Patient Assessment of Chronic Illness Care measure (PACIC-5A) among patients with obesity

BackgroundThe Patient Assessment of Chronic Illness Care (PACIC-5A) was developed to assess the satisfaction with patient-provider interaction based on the Chronic Care Model. The additional 5A approach (assess, advise, agree, assist, arrange) allows to score behavioral counseling. The aim of the study was to assess the psychometric properties of the German adaptation of the PACIC-5A questionnaire in a sample of general practitioners (GP) patients with obesity.MethodsAnalyses were based on data from the study “Five A’s counseling in weight management of obese patients in primary care: a cluster randomized controlled trial (INTERACT)”. Data were collected via standardized questionnaires containing the 26-item version of the PACIC-5A questionnaire. A total of 117 patients with obesity were included in the analyses. Statistical procedures comprised descriptive analyses, the calculation of Cronbach’s alpha, test-retest analyses and factor analyses in order to assess the psychometric properties including reliability and validity of the PACIC-5A.ResultsThe patient’s mean age was 43.4 years and the sample was mostly female (59%). Middle educational level was found for the majority (78%) and the mean Body Mass Index was 38.9 kg/m2. Descriptive analyses revealed a mean PACIC score of 2.33 and 5A sum score of 2.29. Notable floor effects were found. PACIC-5A showed high level of internal consistency (Cronbach’s alphas > 0.9) and exploratory factor analyses resulted in a unidimensional structure.ConclusionThe results of this study provide evidence regarding the psychometric properties of the German version of the PACIC-5A used in a sample of GP patients with obesity and make an important contribution to the reliable and valid assessment of the patient-GP interaction with regard to obesity counseling in primary care.

Erickson health coaching: An innovative approach for weight management in obese patients with obstructive sleep apnoea?

Obstructive sleep apnoea (OSA) is a highly prevalent medical condition and amajor cardiovascular risk factor. Obesity is present in ∼70% of patients with OSA, nevertheless, continuous positive airway pressure (CPAP) ventilation – the gold standard therapy for moderate and severe OSA – has no appreciable long-term beneficial effects on obesity, body composition, energy metabolism, physical activities or the incidence of major cardiovascular events. Therefore, effective weight loss strategies in conjunction with CPAP therapy in OSA are critically needed. Since lifestyle interventions may positively impact body weight, there is a strong rationale to testing the hypothesis that Erikson coaching intervention as a form of lifestyle intervention to obese patients with OSA may increase their adherence to healthy lifestyle behaviour and thus result in weight reduction, improved body composition (reduction in %body fat) and improvements in glucose and lipid metabolism. There are three lines of evidence to justify testing this hypothesis: First, health coaching significantly facilitates uptake of healthy behaviours across a broad variety of chronic conditions; second, several randomized clinical trials suggested positive impact of health coaching on weight management and on cardiometabolic risk factors in overweight/obese otherwise healthy persons; third, Erickson coaching approach empowers the three key elements of health coaching (patient-centeredness, patient-determined goals, use of a self-discovery process) further, namely by introducing two other specific core elements into the coaching process: a) solution-focus and outcome frame, b) orientation at the patient-formulated positive outcomes (i.e., positive values resulting from behavioural change). Importantly, results of our recent pilot observational cohort study suggested that Erickson coaching is a powerful tool to address behavioural modification in obesity. In conclusion, testing our hypothesis may have significant clinical implications: if clinical randomized trials indicate that Erickson health coaching is an efficient approach to behavioural change and weight management in OSA then combining Erickson coaching with CPAP therapy may result in reductions in cardiovascular morbidity and mortality in these high-risk patients.

Erickson solution-focused coaching for weight management in obese patients with obstructive sleep apnoea: ECOHEALTH pilot study.

Coaching as a lifestyle modification approach to weight management is insufficiently explored in obstructive sleep apnoea. We investigated anthropometry and body composition after 20 weeks of Erickson coaching in 26 obstructive sleep apnoea patients (19 males; 47.6 ± 2.4 years). Body weight, neck circumference, waist-to-hip ratio and %body fat significantly decreased after 20 weeks. The mean weight loss was 5.2 per cent ± 1.0 per cent; 20 (77%) participants achieved target reduction of >3 per cent. Coaching session attendance (p = 0.006) and reaching personal goal related to physical performance (p = 0.044) were independently associated with weight loss (multiple regression model R2 = 0.608, p < 0.001). Erickson solution-focused coaching supports adherence to healthy lifestyle and weight reduction in obstructive sleep apnoea.

Five A\u2019s counseling in weight management of obese patients in primary care: a cluster-randomized controlled trial (INTERACT)

BackgroundObesity is one of the most prevalent health problems in western societies. However, it seems not effectively managed in the healthcare system at present. Originating from smoking cessation a tool called the 5As for obesity management has been drafted and adapted by the Canadian Obesity Network (CON) to improve weight counseling and provider-patient-interaction. This paper describes the rationale and design of the INTERACT study. The objective of the INTERACT study is to evaluate the effectiveness and intervention costs of a 5As eLearning program for obesity management aimed specifically at general practitioners (GPs).MethodsThe INTERACT study is a cluster randomized controlled trial aimed at implementing and evaluating an online-tutorial for obesity management based on the 5As approach in cooperating primary health care practices. Effectiveness of the 5As intervention will be evaluated by assessing patients and doctors perspectives on obesity management in primary care before and after the training. GPs in the intervention group will get access to the 5As obesity management online-tutorial while GPs in the control group will be assigned to a waiting list. Outcome measures for patients and GPs will be compared between the intervention group (treatment as usual + training of the GP) and the control group (treatment as usual). Hierarchical regression models will be used to analyze effects over time pre- and post-intervention.DiscussionThe 5As present physicians with a simple mnemonic for patient counseling in the primary care context. While the use of the 5As in weight counseling seems to be associated with improved doctor-patient interaction and motivation to lose weight, intervention studies assessing the effectiveness of a short 5A eLearning tutorial for physicians on secondary outcomes, such as weight development, are lacking.Trial registrationThe study has been registered at the German Clinical Trials Register (DRKS00009241; date of registration: 03.02.2016).

Antiobesity Strategy Targets Energy Economy Safeguards

A fundamental barrier in obesity management is that caloric restriction triggers energy-conserving responses that evolved to prevent body weight loss. ATP-sensitive potassium (KATP) channels have been identified as safeguards controlling energy expenditure in skeletal muscles and thereby key factors determining body weight.1 In this issue of Molecular Therapy, Koganti and colleagues report the successful reduction of muscle energy efficiency through targeted intramuscular injections of cell-penetrating vivo-morpholinos to prevent translation of the channel pore-forming Kir6.2 subunit.2 In this elegant proof-of-concept study, the authors demonstrate localized reduction of KATP channel expression and function, leading in turn to an increase in activity-related energy consumption, without compromising exercise tolerance. This report opens a new avenue of investigation in targeted therapies aiming to control weight management.

Factors predictive of drop-out and weight loss success in weight management of obese patients.

The prevention and treatment of overweight and obese individuals on a population-wide basis is challenging because patients have difficulties with adhering to weight loss programmes. The present study aimed to evaluate patients' adherence to the weight reduction programme by identifying factors predictive of both drop-out rate and weight loss success. One-hundred and twenty-four obese patients participated in a 12-month weight reduction programme, involving group therapy during an intensive 5-day educational intervention, followed by five, 2-h follow-up visits. The primary outcome measures included drop-out rate and percentage weight loss. Sociodemographic and clinical characteristics, as well as type of diet, were explored as potential predictive factors. Type of diet was assigned based on randomisation. Regression analyses were conducted to identify predictive variables of drop-out and weight loss success. In total, 33.1% of all recruited participants were deemed successful because they reduced the initial weight by more than 5% after the 12-month intervention. The overall attrition rate was 32.3%. In a multiple regression model, initial weight loss and marital status were the strongest predictors of weight loss success after 1-year period (r(2) = 0.481, P < 0.001). In a separate analysis, subjects more likely to drop-out were those with a lower educational level [odds ratio (OR) = 3.26, 95% confidence interval (CI) = 1.22-8.70, P = 0.018] and a higher level of obesity (OR = 0.974, 95% CI = 0.95-0.99, P = 0.010). The present study demonstrates that initial weight loss at 1 month made the strongest unique contribution to the prediction of percentage weight loss after 12 months, whereas being married was a negative predictor. Those with a lower educational level and a higher level of obesity were more likely to drop-out.

Antiobesity Pharmacotherapy: New Drugs and Emerging Targets

Obesity is a growing pandemic, and related health and economic costs are staggering. Pharmacotherapy, partnered with lifestyle modifications, forms the core of current strategies to reduce the burden of this disease and its sequelae. However, therapies targeting weight loss have a significant history of safety risks, including cardiovascular and psychiatric events. Here, evolving strategies for developing antiobesity therapies, including targets, mechanisms, and developmental status, are highlighted. Progress in this field is underscored by Belviq (lorcaserin) and Qsymia (phentermine/topiramate), the first agents in more than 10 years to achieve regulatory approval for chronic weight management in obese patients. On the horizon, novel insights into metabolism and energy homeostasis reveal guanosine 3',5'-cyclic monophosphate (cGMP) signaling circuits as emerging targets for antiobesity pharmacotherapy. These innovations in molecular discovery may elegantly align with practical off-the-shelf approaches, leveraging existing approved drugs that modulate cGMP levels for the management of obesity.

Weight management of obese patients on the renal ward

The worldwide increase in obesity has occurred alongside rising rates of chronic kidney disease. Here Helen MacLaughlin and Sharlene Greenwood explain the link between obesity and renal disease and outline strategies for weight management of obese or overweight patients with chronic kidney disease.

Barriers to weight loss in obese patients with knee osteoarthritis

Obesity contributes to the development of knee osteoarthritis and complicates its surgical treatment. The aim of this study was to explore barriers to effective weight management in obese patients with knee osteoarthritis. A cross-sectional questionnaire study was performed in an elective out-patient setting and on an orthopaedic ward on patients with a body mass index (BMI) of 30 kg/m2 or over and knee osteoarthritis. Of 47 patients approached, 45 agreed to participate. Forty of 45 patients (89%) had tried to lose weight at some point, 35 of 40 (87.5%) by adjusting their diet. Forty of 45 (89%) patients considered lack of motivation to be the greatest barrier to weight loss and only 13 of 45 (28%) pain in the knee. Patients with a BMI of less than 40 kg/m2 expressed a preference for dietary advice to help with weight loss, compared with those with a BMI of over 40 kg/m2 who expressed a preference for an NHS or other support group. Obesity is a significant problem for many patients with knee osteoarthritis. Attendance at an orthopaedic clinic is an opportunity to address obesity, by providing information about diet and possibly support groups for morbidly obese patients. Patients may be motivated to lose weight to improve their symptoms.

Long-term effects of leucine supplementation on body composition

Leucine does not only serve as a substrate for protein synthesis but is also recognized as a potent signal nutrient that regulates protein metabolism. Accordingly, leucine supplementation has been suggested to develop muscle mass or prevent protein loss in several conditions characterized by muscle protein wasting. In the present review, we reported the recent results related to the effect of dietary leucine or leucine-rich amino acid mixture and proteins on whole body composition. Although recent studies corroborate that increasing plasma leucine concentration generally induces an increase in muscle protein synthesis, long-term dietary leucine supplementation has been poorly investigated. Chronic free leucine supplementation alone did not improve lean body or muscle mass during resistance training or in elderly, whereas it was able to limit the weight loss induced by malnutrition. Contradictory data were also reported concerning the effect of leucine supplementation for weight management in obese patients. Leucine-rich amino acid mixture or proteins appeared more efficient than leucine alone to improve muscle mass and performance, suggesting the efficacy of leucine depends nevertheless on the presence of other amino acids. Until now, there is no evidence that chronic leucine supplementation is efficient in promoting muscle mass or preventing protein loss during catabolic states. Further studies are required to determine the duration and nutritional conditions of long-term leucine supplementation and to establish whether such nutritional interventions can help to prevent or treat muscle loss in various pathological or physiological conditions.

Efficacy of sibutramine, orlistat and combination therapy on short-term weight management in obese patients

Objectives. – To compare changes in anthropometric measures [body mass index (BMI), body weight] of obese patients treated with diet and exercise alone or additionally sibutramine, orlistat or the combination of both drugs, respectively. To describe encountered adverse effects. Methods. – Short-term (12 weeks), randomized, open-labeled trial. A total of 86 patients (18.6% male, age 41.1 ± 8.7 years, BMI: 36.11 ± 4.34 kg/m 2) were randomized to (1) sibutramine group (10 mg/d, n = 22), or (2) orlistat group (3 × 120 mg/d, n = 25), or (3) combination group (10 mg sibutramine/d + 3 × 120 mg orlistat/d, n = 20), or (4) diet group ( n = 19). The primary outcome parameter was a decrease in BMI. Additionally patient-reported adverse effects were reported. Results. – The four interventional groups displayed decreases in BMI as follows: (1) –4.41 ± 1.26 kg/m 2; (2) –3.64 ± 0.97 kg/m 2; (3) –5.12 ± 1.44 kg/m 2 and (4) –2.52 ± 1.36 kg/m 2; with the diet group showing the significantly lowest decrease in BMI compared to the orlistat ( P = 0.004), sibutramine ( P < 0.001) or the combination groups ( P < 0.001), respectively. Decreases in BMI did not statistically differed between the sibutramine group and the combination therapy group ( P = 0.072). However, both treatment groups were significantly more efficient in decreasing BMI than the orlistat group ( P < 0.001). In addition to well-known side effects, such as gastrointestinal disturbances, headache and dry mouth, newly described adverse effects were self-reported hypermenorrhea (13.6%, n = 3) with sibutramine and forgetfulness with orlistat (24%, n = 6). Conclusion. – In our study pharmacotherapy showed significant better results in the short-term management of obesity than dietary regimens alone. Sibutramine and sibutramine in combination with orlistat seemed to be equally effective in terms of weight reduction compared to orlistat monotherapy. Attention should be paid to the possibility of adverse effects.