Weight Management Research Articles

Application of Fourier Transform Infrared (FTIR) spectroscopy for the analysis of legume seeds

Legume seeds are highly valued for their rich nutritional profile and many culinary applications, making them essential to human diets in many civilizations worldwide. Legume seeds have lower protein content comparable to that found in animal sources. Legumes have many health benefits, such as improved blood sugar control, weight management, cardiovascular health, and a reduced risk of developing chronic diseases, including diabetes, cancer, and heart conditions. The functional groups in legume seeds such as black chickpea, cowpea, white chickpea, small red bean, and red lentil were analyzed using FTIR spectroscopy combined with principal compound analysis. The findings indicated that five samples had O-H stretching, C-H stretching, and N-H stretching bonds in the wave number range of 2924 cm- 1, which implies the presence of alcohol, carboxylic acid, amine salt, and alkane. The nitro compound having N-O stretching was observed in all samples except white chickpea. All the samples have C-F stretching bonds, representing the presence of fluoro compound in the wave range of 1002- 1115 cm-1, except for red beans. It is worth noting that the properties of red lentils differ significantly from those of black chickpeas and cowpeas, and the properties of cowpeas differ from those of small red beans.

Is Fasting Superior to Continuous Caloric Restriction for Weight Loss and Metabolic Outcomes in Obese Adults? A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

fasting-based strategies (FBS) and continuous caloric restriction (CCR) are popular methods for weight loss and improving metabolic health. FBS alternates between eating and fasting periods, while CCR reduces daily calorie intake consistently. Both aim to create a calorie deficit, but it is still uncertain as to which is more effective for short- and long-term weight and metabolic outcomes. this systematic review and meta-analysis aimed to compare the effectiveness of FBS and CCR on these parameters in obese adults. after screening 342 articles, 10 randomized controlled trials (RCTs) with 623 participants were included. both interventions led to weight loss, with a reduction of 5.5 to 6.5 kg observed at the six-month mark. However, the results showed that FBS led to slightly greater short-term reductions in body weight (-0.94 kg, p = 0.004) and fat mass (-1.08 kg, p = 0.0001) compared to CCR, although these differences are not clinically significant. Both interventions had similar effects on lean mass, waist and hip circumference, blood pressure, lipid profiles, and glucose metabolism. However, FBS improved insulin sensitivity, with significant reductions in fasting insulin (-7.46 pmol/L, p = 0.02) and HOMA-IR (-0.14, p = 0.02). despite these short-term benefits, FBS did not show superior long-term outcomes compared to CCR. Both strategies are effective for weight management, but more research is needed to explore the long-term clinical relevance of FBS in obese populations.

Health optimisation for patients with obesity before elective orthopaedic surgery: a qualitative study of professionals’ views on restrictive approaches and future practice

BackgroundPreoperative health optimisation for elective surgery entails supporting patients to improve their health in preparation for their treatment and recovery. While there is consensus that this process should address obesity, approaches vary across England. Despite guidance from the National Institute for Health and Care Excellence to the contrary, restrictive approaches with body mass index thresholds for referral to arthroplasty are in use. This qualitative study aimed to investigate the views of professionals on the current use and future implications of these policies.MethodsSemi-structured interviews were conducted with 20 professionals including clinicians, commissioners, policymakers, and health service managers, with experience of developing and/or implementing health optimisation policies for elective arthroplasty. Participants were sampled from areas in England with and without restrictive policies. We undertook thematic analysis of the interview data.ResultsParticipants described pre-surgical health optimisation as an important trigger for health improvement but identified current resourcing and inadequacies in provision of weight management support as significant barriers to success. Participants expressed concerns about the appropriateness and fairness of including obesity as a determinant to restrict access to surgery. They described short-term financial pressures underlying the use of restrictive body mass index thresholds and a lack of an evidence base, such that policies amounted to rationing and risked exacerbations of health inequalities. The study identified four priorities for improvements to future health optimisation practices: developing and implementing national guidance with flexibility for local variation, initiating patient engagement in primary care with onward integration across all services, improving resourcing to support effective equitable impact, and addressing wider determinants of obesity through societal change.ConclusionsOverall, participants had limited expectations of the impact of health optimisation policies on obesity without additional support, investment, and national guideline implementation. They raised strong concerns over current restrictive approaches. We conclude that addressing concerns around weight management support service availability and impacts on health inequalities is essential for shaping effective health optimisation policies. Future policy direction should support health optimisation to be offered early (ideally in primary care). Health optimisation interventions should be non-restrictive, inclusive, and well-monitored, particularly around equality impact.

Recipient selection for lung transplantation: perspective in decision-making.

To determine the conditions that prevented transplant in patients referred to our center due to end-stage lung disease. Descriptive study. Department of lung transplant clinic, Koşuyolu High Specialization Education and Research Hospital, Istanbul, Turkey, from December 2017 to January 2022. Patients with end-stage lung disease referred to our clinic were retrospectively evaluated with regard to reasons for exclusion, diagnosis, and demographic data. The Karnofsky Performance Status scoring scale was used to measure the functional status of the patients. A total of 311 patients were evaluated during the study period. The mean age was 44.2 (range 4-73) years. There were 207 (66.6%) male patients. The most common indications were idiopathic interstitial pneumonia in 104 (33.4%) patients, chronic obstructive pulmonary disease in 53 (17%) patients, bronchiectasis in 49 (15.7%) patients, and cystic fibrosis in 28 (9%) patients. Of the patients, 106 (34%) were not appropriate candidates for a lung transplant. The most common reasons for refusal were preventable situations such as activity limitation and poor performance in 53 (50%) patients, weight in 49 (46.2%) patients, and smoking in 10 (9.4%) patients. Impaired performance status was the most common cause of lung transplant exclusion. Weight and smoking were preventable causes of exclusion. Implementing pulmonary rehabilitation in very few patients was the most important handicap. It is believed that providing optimal treatment with a multidisciplinary approach and timely referral to transplant centers will significantly reduce the reasons for exclusion. Key message What is already known on this topic? Referring lung transplant candidates to clinics at the earliest stage is essential for assessing their condition and exploring treatment options. What this study adds? Factors like smoking, obesity, and muscle loss can hinder the transplantation process; thus, timely interventions are crucial. The primary reason for excluding candidates from lung transplantation is the decline in performance status. How this study might affect research, practice or policy? Programs focused on smoking cessation, weight management, and muscle strengthening can play a vital role in enhancing patients' health before transplantation. It is imperative to expand and enhance the accessibility of pulmonary rehabilitation programs.

Middle-aged Central American men’s perceptions of a healthy body weight, excess body weight and its relationship to chronic disease: Qualitative findings

Objective: To explore Central American men’s perceptions of healthy body weight, factors that influence weight gain and increase awareness of being overweight/obese, consequences of excess weight gain and gender similarities and differences in body weight. Design: In-depth, qualitative interviews were conducted with low-income, overweight or obese Central American men residing in the USA ( n = 25). Setting: Semi-structured, individual interviews (via Zoom or phone call) were conducted in Washington, DC in 2020–2021. Methods: Participants discussed their thoughts on the meaning of healthy weight; the role that weight management plays in the likelihood of getting diseases such as diabetes, cancer or hypertension; and whether having a healthy weight is different for men and women. Audio-recorded interviews were transcribed and analysed to identify themes using NVivo v12. Results: Participants were first-generation immigrants (mean age 50.9 ± 6.4) and had resided in the USA for 23.7 ± 10.2 years. They defined healthy weight as having the energy to carry on daily activities, not carrying extra body fat, being in good physical health, and having a balance between height and weight. Participants discussed having an unbalanced diet, not engaging in physical activity and getting older influenced weight gain. Factors that raised awareness of their weight gain included doctors’ advice and cognisance of their current body weight. Participants in the study discussed the connection between weight status and some chronic diseases (i.e. cardiovascular diseases, diabetes and SARS-CoV-2 virus infection); cancer was the least discussed. Participants discussed that both men and women should have a healthy weight and contributing factors to why men weigh more than women. Conclusion: Health promotion interventions for Central American immigrant men should consider framing weight management as a means to continue fulfilling important social and cultural roles and responsibilities. Future research should examine Central American men’s perceptions of weight management as part of cancer prevention.

How do employees feel their health is valued? a descriptive case study

PurposeA descriptive case study approach was adopted to examine employees' perceptions of the prevalence and usefulness of wellness programs. Relying on Centers for Disease Control and Prevention Health ScoreCard (CDC HSC), this study aims to assess the prevalence of worksite wellness programs, policies and benefits in general and incorporated employee perspectives to contextualize the CDC HSC wellness assessments.Design/methodology/approachThe authors first compared the CDC HSC assessments to evaluate the effectiveness of wellness programs in 20 select organizations. Follow-up employee interviews (n = 25) were conducted to contextualize the CDC HSC assessments.FindingsA variety of wellness programs are likely to increase employee engagement and participation when organizations adopt a bundling approach to combine wellness policies, incentives and an array of wellness programming opportunities that encourage and incentivize employees’ health promotion behaviors.Research limitations/implicationsFuture researchers might examine health metrics, in terms of dollars, doctor visits or biometrics before and after the implementation of a wellness program or paid wellness coordinator. Because this study interviewed employees and not members of executive leadership or finance and accounting, financial metrics were not available or the focus of this study. The inclusion of leaders and directors of wellness initiatives would offer additional ways for examining the impact of wellness initiatives on employee behaviors on organizational outcomes.Practical implicationsNutrition, weight management and chronic disease management were identified as major challenges impacting the health of employees. Even when organizations reported robust scores in their CDC HSC assessments, employers identified these three areas as critical for sustaining the health and well-being of their employees. Finally, the issue of employee safety was a top priority for all organizations regardless of how they scored on their CDC HSC assessments.Social implicationsThe authors suggest that when high-impact wellness practices are linked to organizational supports in the workplace, these efforts are likely to have more positive effects on both employee outcomes and organizational outcomes. A regular routine of checking on wellness issues can help keep potential problems from going unnoticed. An example of this is a reminder to stretch at a morning meeting or during work hours as a reminder to stay focused on health and well-being.Originality/valueThe authors aggregated the organizational assessments for different wellness interventions and compared the scores (falling above or below) with standardized CDC wellness scores. The incorporation of the CDC scorecard ensured a standardized and evidence-based evaluation of workplace wellness programs. This additional step informed the interview guide and follow-up with employees who offered recommendations for how organizations could enhance their wellness programs and policies.

Rapid Weight Changes and Competitive Outcomes in Muay Thai and Mixed Martial Arts: A 14-Month Study of 24 Combat Sports Events.

This study investigates the rapid weight loss (RWL) and rapid weight gain (RWG) of contest winners and losers from Muay Thai (MT) and mixed martial arts (MMA) events. The relationship between rapid weight change variables of males and females, and competitive success is also examined. Data from a weight management questionnaire was collected one day post-competition from 185 participants across 24 fight events, resulting in 263 responses (MMA: n = 78, MT: n = 185). Official and secondary weigh-in data were provided by the Combat Sports Commission. The results show that in MT, contest winners compared to losers had significantly greater RWL-7 days (5.9 ± 2.6% vs. 4.6 ± 2.7%, p = 0.01), RWG (6.2 ± 2.9% vs. 4.7 ± 2.8%, p = 0.003), and RWG/RWL ratio (108% [86-132%] vs. 86% [60-119%], p = 0.038), while no significant differences were observed for MMA. Mixed logistic regression models that controlled for age showed that a 1% increase in female RWL-24 h ([OR = 1.57, R2 = 0.105, p = 0.001]) was associated with a 1.6 times higher likelihood of winning compared to female athletes without this increase. We emphasise that associations do not imply causation, and it is possible that other factors which align with rapid weight change practices may impact the observed relationship. Nonetheless, MT contest winners show greater RWL, RWG, and RWG/RWL ratio than losers, and female rapid weight changes appear to be associated with competitive success in this cohort.

Burden landscape of hepatobiliary and pancreatic cancers in Chinese young adults: 30 years' overview and forecasted trends.

Hepatobiliary and pancreatic (HBP) cancers impose a considerable burden on young populations (aged 15 to 49 years), resulting in a substantial number of new cases and fatalities each year. In young populations, the HBP cancers shows extensive variance worldwide and the updated data in China is lacking. To investigate the current status, trends, projections, and underlying risk factors of HBP cancers among young populations in China. The Global Burden of Disease Study 2019 provided data on the annual incidence, mortality, disability-adjusted life years (DALYs), age-standardized incidence rate (ASIR), mortality rate (ASMR), and DALYs rate (ASDR) of HBP cancers in young Chinese adults between 1990 and 2019. Temporal trends were assessed using estimated annual percentage change and hierarchical clustering. Sex-specific mortality and DALYs caused by various risks were analyzed across China and other regions, with future trends until 2035 projected using the Bayesian age-period-cohort model. From 1990 to 2019, incident cases, deaths, DALYs, ASIR, ASMR, and ASDR for liver cancer (LC) in young Chinese individuals decreased, classified into 'significant decrease' group. Conversely, cases of gallbladder and biliary tract cancer and pancreatic cancer rose, categorized as either 'significant increase' or 'minor increase' groups. The contribution of risk factors to mortality and DALYs for HBP tumors increased to varying degrees. Healthy lifestyle behaviors, such as tobacco control, weight management, alcohol moderation, and drug avoidance, could lower HBP cancers incidence. Moreover, except for LC in females, which is likely to initially decline slightly and then rise, the forecasting model predicted that the ASIR and ASMR for all HPB cancers subtypes by gender will increase among young adults. HBP cancers burden among young adults in China is expected to increase until 2035, necessitating lifestyle interventions and targeted treatment strategies to mitigate the public health impact of these cancers.

Factors influencing health literacy in overweight management among late adolescents in Thailand: A cross-sectional study.

Health literacy is crucial in managing health outcomes, including overweight, which is a significant issue among late adolescents. Despite the importance of health literacy in weight management, research focusing on this population remains limited. This study aimed to investigate the factors influencing health literacy in overweight management among late adolescents in Thailand. A cross-sectional study was conducted with late adolescents from five higher education institutions in Ubon Ratchathani Province, Thailand. A total of 403 participants were selected through multistage random sampling. Self-report questionnaires, validated for reliability and accuracy, were used to collect data from March to May 2023. Multiple regression analysis was employed, with a significance level set at 0.05. The sample consisted predominantly of females (91.10%) with an average age of 20-21 years (54.30%). The prevalence of overweight/obesity among participants was 25.06%. Four factors were significantly associated with health literacy in overweight management: access to health and weight control resources (r = 0.368, p <0.001), access to online social learning resources (r = 0.321, p <0.001), access to books, journals, and websites (r = 0.340, p <0.001), and management of weight control behaviors (r = 0.145, p <0.001). These factors together accounted for 20% of the variance in health literacy (R2 = 0.200). The study identified key factors that enhance health literacy in overweight management among late adolescents in Thailand. It is recommended that nurses and other healthcare professionals develop targeted interventions focusing on these factors to effectively manage overweight in this population.

Comprehensive Review on BMI, TDEE, BMR, and Calories for Weight Management: Insights into Energy Expenditure and Nutrient Balance for Long-Term Well-Being

Body Mass Index (BMI) is a basic tool for assessing body mass based on height and weight, classifying individuals in BMI categories as underweight, normal, overweight, or obese. However, it has limitations as it overlooks muscle mass and fat distribution. Total Daily Energy Expenditure (TDEE) plays a crucial role in measuring the current maintenance calories, surplus calories for weight gain, and deficit calories for weight loss associated with Bansal Metabolic Rate (BMR) and Physical Activity Level (PAL). TDEE is related to 3 phases incline, stable, and decline according to age groups. Keeping these parameters, the current review focused on BMI, TDEE, BMR and calories. Calories are essential for understanding the energy the body stores and uses, making them a key factor for weight management. Macronutrients such as carbohydrates, proteins, and fats provide different amounts of energy, which can impact insulin levels and trigger cravings. Tools like BMI and BMR are useful, but focusing solely on counting calories is not enough for effective weight management. A sustainable approach includes understanding how the body processes different foods, choosing nutrient-rich options, regulating blood sugar, and staying physically active are discussed. This work reveals the long-term well-being for weight management via focused on BMI, TDEE, BMR and calories.

Influence of slow and rapid weight loss periods on physiological performance, mood state and sleep quality in male freestyle wrestlers: a study from Sichuan Province, China.

This study aims to investigate the changes in physiological performance, mental state and sleep quality during the weight reduction phase prior to competition in male freestyle wrestlers. This study included 16 male freestyle wrestlers from Sichuan Province, China. Participants were evaluated at three time points: the first day of slow weight reduction (T1, March 26), the first day of rapid weight reduction (T2, April 26) and the day before the competition (T3, May 3), and measurements were taken for physiological performance, mood state and sleep quality. The most relevant findings indicated the following: Morning heart rate, creatine kinase and fatigue scores increased by 12.6, 64.6, and 19.0%, respectively, from T1 to T2 (p < 0.05), and decreased by 14.1, 36.6, and 16.8%, respectively, from T2 to T3 (p < 0.05). Hemoglobin and testosterone levels decreased by 3.0 and 16.8%, respectively, from T1 to T3 (p < 0.05), and by 2.9 and 18.2%, respectively, from T2 to T3 (p < 0.05); The secondary findings revealed the following: The total mood disturbance scores decreased by 3.8% from T2 to T3 (p = 0.072), positive mood scores decreased by 9.0% from T1 to T2 (p = 0.090), the Pittsburgh Sleep Quality Index total scores increased by 14.4% from T1 to T2 (p = 0.323) and total work output and average power output decreased by 7.3 and 7.8%, respectively, from T1 to T3 (p = 0.067, p = 0.052); Regression analyses predicted negative mood (Y 1 = 62.306-0.018 × maximum power output) and sleep quality (Y 2 = 2.527 + 0.278 × Immunoglobulin G) during the weight reduction period. The combined slow and rapid weight reduction approach effectively minimized body fat in athletes with limited effect on their physiological performance and sleep quality. However, the effects were adverse on certain health variables and anaerobic power in Chinese male freestyle wrestlers. The identified correlations between negative mood and maximum power, and between sleep quality and immunoglobulin G, shed new light on factors influencing athletes' well-being during weight reduction, and underscored the need for careful monitoring of physiological variables in future weight management strategies.

Association Between Body Mass Index Changes and All-Cause Mortality in Parkinson's Disease.

Whether body weight changes are associated with Parkinson's disease (PD) mortality remains uncertain. To investigate the association between changes in body mass index (BMI) and all-cause mortality in patients with PD. This nationwide cohort study enrolled 20,703 individuals with new-onset PD (ICD-10 code: G20 and a rare intractable disease registration code: V124) who underwent health screening program by the Korean National Health Insurance Service within two years from pre- and post-PD diagnosis. We identified nine BMI change groups based on three BMI status: underweight (BMI < 18.5 kg/m2), normal or overweight (18.5 kg/m2≤BMI < 25 kg/m2), and obese (BMI≥25 kg/m2). Of 20,703 individuals, 3,789 (18.0%) died during the follow-up period. Excessive weight loss to underweight in the obese group (hazard ratio [HR] = 3.36, 95% CI:1.60-7.08), weight loss in the normal to overweight group (HR = 2.04, 95% CI:1.75-2.39), sustained underweight status (HR = 2.05, 95% CI:1.67-2.52), and weight gain from underweight to normal or overweight (HR = 1.52, 95% CI:1.15-2.02) were associated with increased mortality. Sustained obese status (HR = 0.80, 95% CI:0.74-0.87) and weight gain in the normal to overweight group (HR = 0.82, 95% CI:0.71-0.95) were associated with reduced mortality. We found that BMI change at diagnosis was associated with mortality in patients with PD. Specifically, being underweight either before or after diagnosis as well as experiencing weight loss, were associated with increased mortality. These findings provide valuable insights for weight management planning in PD, highlighting the importance of individualized approach that consider pre-diagnosis BMI.

Weight-control compensatory behaviors patterns and correlates: a scoping review.

Weight-control compensatory behaviors appear to be a commonly utilized strategy for health management. Individuals engaging in such behaviors believe that the negative consequences from unhealthy behaviors will be neutralized by the positive consequences of healthy behaviors. Existing research has not reached a consensus on whether such behaviors are beneficial to health. This review aims to (1) summarize the patterns of weight-control compensatory health behaviors in different populations, (2) highlight correlates, predictors, and consequences of compensatory health behaviors, and (3) identify gaps for future research. This review identified existing literature using online databases, CINAHL and PubMed. Primary research articles published after 2000 with non-clinical participants of 12 years or older who engaged in compensatory behaviors for weight control purposes were selected. Descriptive statistics were extracted from 35 studies. Different patterns for weight-control compensatory behaviors emerged between the female and male sexes. Meanwhile, no clear association of such behaviors was found across weight status. Studies reviewed also highlighted three main areas of compensatory behaviors for weight management, namely dietary behaviors, physical activity, and alcohol consumption. Weight-control compensatory behaviors had significant negative correlations with mental health indicators, such as psychosocial functioning, emotional differentiation ability, and body esteem. Weight-control compensatory behaviors may be a widely used weight management strategy and can be presented in diverse ways. Although believed to be promoting health, such behaviors appear to be associated with poor psychological well-being. This emerging topic warrants more in-depth investigation to establish the direction of causation. Future research may investigate the relationship between weight-control compensatory behaviors and various aspects of health over longer time periods, examine the engagement of multiple weight-control compensatory behaviors, and focus on high-risk populations.

Novel Therapeutic Approach for Obesity: Seaweeds as an Alternative Medicine with the Latest Conventional Therapy.

The prevalence of overweight and obesity is increasing worldwide. Common comorbidities related to obesity, significantly polygenic disorders, cardiovascular disease, and heart conditions affect social and monetary systems. Over the past decade, research in drug discovery and development has opened new paths for alternative and conventional medicine. With a deeper comprehension of its underlying mechanisms, obesity is now recognized more as a chronic condition rather than merely a result of lifestyle choices. Nonetheless, addressing it solely through lifestyle changes is challenging due to the intricate nature of energy regulation dysfunction. The Federal Drug Administration (FDA) has approved six medications for the management of overweight and obesity. Seaweed are plants and algae that grow in oceans, rivers, and lakes. Studies have shown that seaweed has therapeutic potential in the management of body weight and obesity. Seaweed compounds such as carotenoids, xanthophyll, astaxanthin, fucoidans, and fucoxanthin have been demonstrated as potential bioactive components in the treatment of obesity. The abundance of natural seaweed bioactive compounds has been explored for their therapeutic potential for treating obesity worldwide. Keeping this view, this review covered the latest developments in the discovery of varied anti-obese seaweed and its bioactive components for the management of obesity.

Potential of GLP-1 Analogs in Managing Hyperphagia and Obesity in Prader-Willi Syndrome: A Review of Efficacy and Safety

Introduction: Prader-Willi Syndrome (PWS) is a genetic disorder marked by hyperphagia, obesity, developmental delays, and behavioral challenges. Traditional treatments like dietary control and growth hormone therapy often fail to effectively manage these symptoms. Recently, glucagon-like peptide-1 (GLP-1) analogs have shown potential in treating PWS. This review assesses the efficacy, safety and mechanisms of GLP-1 analogs in PWS treatment. They improve glycemic control, cardiovascular health, and appetite regulation, contributing to better weight management and overall health in PWS patients. These analogs enhance insulin secretion, inhibit glucagon release, and slow gastric emptying, helping to reduce postprandial glucose spikes and caloric intake. Results: Several small-scale studies and case reports have shown mixed results regarding the effectiveness of GLP-1 analogs in reducing BMI and hyperphagia in PWS patients. Although the studies demonstrated varied outcomes in terms of BMI reduction, all of them reported improvement in satiety or appetite levels.Conclusions: Overall, GLP-1 analogs hold promise for addressing hyperphagia, obesity, and glycemic control in PWS patients, improving their overall health and quality of life. Continued research and long-term studies are essential to establish these benefits and optimize treatment strategies.

Pediatric Obesity Pharmacotherapy: State of the Science, Research Gaps, and Opportunities.

Pediatric obesity is a major public health problem, affecting nearly 20% of children and adolescents living in the United States. In 2023, the American Academy of Pediatrics released its first clinical practice guideline for the evaluation and management of child and adolescent obesity and recommended integrating health behavior and lifestyle interventions with pharmacological treatment when medically indicated. However, there is a limited evidence base to guide antiobesity medication treatment decisions in clinical practice and limited data on long-term safety during this critical period of growth and development in youth. Thus, in November of 2023, the National Institute of Diabetes and Digestive and Kidney Diseases sponsored a workshop to identify knowledge gaps and opportunities for research on the use of pharmacotherapy for obesity in children and adolescents. Leading scientific and clinical experts in obesity pathophysiology and treatment, pharmacotherapy, clinical trial design, and health equity and disparities, among others, identified gaps in clinical trial design, guidance for clinical use of medications in children and adolescents, additional treatment outcomes beyond body fat or weight, and improvement in care delivery. Adolescent patients and caregivers with lived experience of obesity and weight management were also invited to participate in a panel discussion, providing personal perspectives on living with obesity, clinical care considerations, and research needs. This article summarizes the workshop proceedings on the state of the science and identifies gaps and opportunities for future research to inform optimal and equitable medical management of children and adolescents with obesity.

Addressing rural health disparities by optimizing “high-touch” intervention components in digital obesity treatment: The iREACH Rural study

BackgroundRural residents are more impacted by obesity and related comorbidities than their urban counterparts. Digital weight management interventions may produce meaningful weight loss among rural residents. ObjectivesThe iREACH Rural Study aims to identify “high-touch” component(s) that contribute to meaningful weight loss (≥1.5 kg) at 6-months, over and above what the 24-week core online program produces. Three treatment components are assessed: group video sessions (yes/no); self-monitoring feedback (counselor-crafted/pre-scripted, modular); and individual coaching calls (yes/no). DesignThe iREACH Rural Study is a factorial experiment (n = 616). MethodsParticipants receive up to 3 “high-touch” components (weekly synchronous facilitated group video sessions, weekly counselor-crafted self-monitoring feedback, and individual coaching calls) to determine which contribute meaningfully to 6-month weight loss. Participants complete assessments at baseline, 2 months, 6 months, and 12 months. Weight loss at 6 months (primary outcome) and 12 months (secondary outcome) is measured by Bluetooth-enabled scales. The study seeks to identify the weight loss approach for underserved rural residents which optimizes weight change outcomes and also examines costs associated with delivering different treatment constellations. SummaryThe iREACH Rural Study is the first of its kind to isolate digital weight loss intervention components to determine which meaningfully contribute to long-term weight loss among rural residing individuals. The results may be used to refine digital weight loss programs by enhancing their effectiveness to allow broad dissemination.

Development and feasibility testing of a time-restricted eating intervention for women living with overweight/obesity and HIV in a resource-limited setting of South Africa

BackgroundHuman Immunodeficiency Virus (HIV) and type 2 diabetes (T2D) are amongst the leading causes of death in South Africa. The preferred first-line anti-retroviral treatment contains dolutegravir (DTG), shown to increase body weight, may compound the already high rates of obesity and associated risk for T2D. South Africa has widespread food insecurity, making traditional dietary strategies difficult to implement. Time-restricted eating (TRE) may be an appropriate intervention in resource-limited communities.MethodsThis article outlines the development and feasibility testing of a TRE intervention to inform the design of a TRE randomised controlled trial in women (20–45 years old) living with overweight/obesity and HIV, receiving DTG-based treatment from a resource-limited community in Cape Town, South Africa. Factors influencing TRE adoption were identified using the Capability, Opportunity, Motivation – Behaviour model and the Theoretical Domains Framework, combining in-depth interviews (IDIs) and focus group discussions. Participants from the IDIs went on to participate in a single arm 4-week TRE pilot trial where feasibility was explored in terms of reach, acceptability, applicability, and implementation integrity. An iterative, thematic analysis approach was employed to analyse the qualitative data.ResultsParticipants included 33 isiXhosa-speaking women (mean age 37.1 years, mean BMI 35.9 kg/m2). Thematic analysis identified psychological capability (knowledge of fasting), social influences (cultural preferences, family support), and reflective motivation (awareness of weight, health impact, motivation for TRE) as key factors influencing adoption of TRE for weight management. In a 4-week TRE pilot trial (n = 12), retention was 100%. Positive outcomes perceived included improved energy, appetite control and weight loss. TRE was perceived as acceptable, easy, and enjoyable. Family support facilitated adherence, while habitual and social eating and drinking practices were barriers. Compliance was high, aided by self-selected eating times, reminders, and weekly calls. Recommendations included the incorporation of dietary education sessions and text messages to provide additional support and reminders.ConclusionsThis study indicates that TRE is a feasible weight management strategy in women living with overweight/obesity and HIV, receiving DTG-based treatment in a resource-limited community. These findings will ensure that the forthcoming TRE randomised controlled trial is adapted and optimised to the local South African context.

Perceptions of Cultural Adaptations and Other Characteristics of Weight Management Interventions among Hispanic/Latinx Immigrants.

Hispanic/Latinx immigrants have high obesity rates, yet they participate less in weight management interventions. This cross-sectional online study recruited Hispanic/ Latinx immigrants living in the United States (US). In a within-subject experimental crossover component, participants were presented with brief information about a hypothetical weight management intervention that was culturally adapted for Hispanics/ Latinx, or a standard intervention (not adapted) and asked about their willingness to enroll. Participants also reported their preferences for weight management intervention features. Participants (n = 54) were majority female (51.9%), aged 51 years or older (56.0%), American citizens (87.0%), and immigrated to US ≥10 years ago (81.7%), with a mean BMI 29.6 + 3.7 kg/m2. There was no difference in willingness to enroll in a culturally adapted (46.3%) compared to standard intervention (48.1%), though more participants preferred a culturally adapted intervention (68.5%). Preference for a culturally adapted intervention was greater among females (p = 0.008) and those with lower acculturation (p = 0.052). Use of non-evidence-based complementary and alternative medicine strategies was common and associated with greater willingness to enroll in a behavioral program (p = 0.007). Preferences for intervention features varied. These findings may inform efforts to increase the reach of weight management interventions for Hispanic/Latinx immigrants.

Risk factors and prediction model for low-birth-weight infants born to women with gestational diabetes mellitus.

To explore the risk factors for low-birth-weight infants born to pregnant women with GDM to develop a prediction model and to construct a prediction nomogram for the risk of low birth weight infants born to pregnant women with GDM. The clinical data of singleton infants diagnosed with gestational diabetes mellitus in Southeast China in 2019 were retrospectively reviewed. Gestational conditions and neonatal weight were assessed. A total of 386 diabetic mothers and infants were enrolled, including 193 in the low birth weight group and 193 in the normal birth weight group. The statistically significant factors were age over 36 years (OR = 1.916, 95% CI 1.048-3.505), junior high school education (OR = 4.454, 95% CI 1.882-10.543), history of fetal distress (OR = 0.120, 95% CI 0.016-0.925), gestational hypertension (OR = 3.681, 95% CI 1.357-9.986), preeclampsia (OR = 24.652, 95% CI 5.956-102.036), threatened preterm birth (OR = 18.393, 95% CI 8.457-39.999), triglycerides (OR = 0.642, 95% CI 0.485-0.850), and inadequate gestational weight gain (OR = 1.997, 95% CI 1.162-3.432). The area under the receiver operating characteristic curve (AUC) was 0.834 (95% CI: 0.794-0.874, p < 0.001), and the sensitivity and specificity were 82.38 and 87.56%, respectively. The goodness-of-fit test likelihood ratio 2 was 2.089 (p = 0.978). The comprehensive nomogram model showed that the discrimination and mean absolute error were 0.834 and 0.015, respectively. The calibration curves showed acceptable agreement between the predictions of the column line plots and the observations. The DCA curves showed good positive net yields in the prediction model. This study established a prediction model and risk score for low birth weight in pregnant women with GDM. It helps pregnancy clinics to identify the risk of low birth weight in newborns promptly, in addition to glycemic control and weight management for pregnant women with GDM, and should improve the appropriate treatment plan for pregnant women with higher risk, to provide personalized and precise treatment for pregnant women with GDM and improve infant outcomes.