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Guo W, Xie S, Wang D, Wu J. Mapping IWQOL-Lite onto EQ-5D-5L and SF-6Dv2 among overweight and obese population in China. Qual Life Res 2024; 33:817-829. [PMID: 38167749 DOI: 10.1007/s11136-023-03568-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE To develop the mapping functions from the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) scores onto the EQ-5D-5L and SF-6Dv2 utility values among the overweight and obese population in China. METHODS A representative sample of the overweight and obese population in China stratified by age, sex, body mass index (BMI), and area of residence was collected by online survey and the sample was randomly divided into development (80%) and validation (20%) datasets. The conceptual overlap between the IWQOL-Lite and the EQ-5D-5L or SF-6Dv2 was evaluated by Spearman's correlation coefficients. Five models, including OLS, Tobit, CLAD, GLM, and PTM were explored to derive mapping functions using the development dataset. The model performance was assessed using MAE, RMSE, and the percentage of AE > 0.05 and AE > 0.1 in the validation dataset. RESULTS A total of 1000 respondents (48% female; mean [SD] age: 51.7 [15.3]; mean [SD] BMI: 27.4 [2.8]) were included in this study. The mean IWQOL-Lite scores and the utility values of EQ-5D-5L and SF-6Dv2 were 78.5, 0.851, and 0.734, respectively. The best-performing models predicting EQ-5D-5L and SF-6Dv2 utilities both used IWQOL-Lite total score as a predictor in the CLAD model (MAE: 0.083 and 0.076 for the EQ-5D-5L and SF-6Dv2; RMSE: 0.125 and 0.103 for the EQ-5D-5L and SF-6Dv2; AE > 0.05: 20.5% and 27.5% for the EQ-5D-5L and SF-6Dv2; AE > 0.10: 9.5% and 15.0% for the EQ-5D-5L and SF-6Dv2). CONCLUSION CLAD models with the IWQOL-Lite total score can be used to predict both the EQ-5D-5L and SF-6Dv2 utility values among overweight and obese population in China.
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Affiliation(s)
- Weihua Guo
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
- Center for Social Science Survey and Data, Tianjin University, Tianjin, China
| | - Shitong Xie
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
- Center for Social Science Survey and Data, Tianjin University, Tianjin, China
| | - Dingyao Wang
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
- Center for Social Science Survey and Data, Tianjin University, Tianjin, China
| | - Jing Wu
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China.
- Center for Social Science Survey and Data, Tianjin University, Tianjin, China.
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Camacho-Cardenosa A, Clavero-Jimeno A, Martin-Olmedo JJ, Amaro-Gahete F, Cupeiro R, Cejudo MTG, García Pérez PV, Hernández-Martínez C, Sevilla-Lorente R, De-la-O A, López-Vázquez A, Molina-Fernandez M, Carneiro-Barrera A, Garcia F, Rodríguez-Nogales A, Gálvez Peralta JJ, Cabeza R, Martín-Rodríguez JL, Muñoz-Garach A, Muñoz-Torres M, Labayen I, Ruiz JR. Time-restricted eating and supervised exercise for improving hepatic steatosis and cardiometabolic health in adults with obesity: protocol for the TEMPUS randomised controlled trial. BMJ Open 2024; 14:e078472. [PMID: 38267239 PMCID: PMC10824004 DOI: 10.1136/bmjopen-2023-078472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/21/2023] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION Metabolic dysfunction-associated steatotic liver disease is a major public health problem considering its high prevalence and its strong association with extrahepatic diseases. Implementing strategies based on an intermittent fasting approach and supervised exercise may mitigate the risks. This study aims to investigate the effects of a 12-week time-restricted eating (TRE) intervention combined with a supervised exercise intervention, compared with TRE or supervised exercise alone and with a usual-care control group, on hepatic fat (primary outcome) and cardiometabolic health (secondary outcomes) in adults with obesity. METHODS AND ANALYSIS An anticipated 184 adults with obesity (50% women) will be recruited from Granada (south of Spain) for this parallel-group, randomised controlled trial (TEMPUS). Participants will be randomly designated to usual care, TRE alone, supervised exercise alone or TRE combined with supervised exercise, using a parallel design with a 1:1:1:1 allocation ratio. The TRE and TRE combined with supervised exercise groups will select an 8-hour eating window before the intervention and will maintain it over the intervention. The exercise alone and TRE combined with exercise groups will perform 24 sessions (2 sessions per week+walking intervention) of supervised exercise combining resistance and aerobic high-intensity interval training. All participants will receive nutritional counselling throughout the intervention. The primary outcome is change from baseline to 12 weeks in hepatic fat; secondary outcomes include measures of cardiometabolic health. ETHICS AND DISSEMINATION This study was approved by Granada Provincial Research Ethics Committee (CEI Granada-0365-N-23). All participants will be asked to provide written informed consent. The findings will be disseminated in scientific journals and at international scientific conferences. TRIAL REGISTRATION NUMBER NCT05897073.
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Affiliation(s)
- Alba Camacho-Cardenosa
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Antonio Clavero-Jimeno
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Juan J Martin-Olmedo
- Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology, Biomedical Research Centre, University of Granada, Granada, Spain
| | - Francisco Amaro-Gahete
- Instituto de Investigación Biosanitaria, Ibs, University of Granada, Granada, Spain
- Department of Physiology, Faculty of Medicine, University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Rocío Cupeiro
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Madrid, Spain
| | | | | | - Carlos Hernández-Martínez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Raquel Sevilla-Lorente
- Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology, Biomedical Research Centre, University of Granada, Granada, Spain
| | - Alejandro De-la-O
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Alejandro López-Vázquez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Marcos Molina-Fernandez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | | | - Federico Garcia
- Instituto de Investigación Biosanitaria, Ibs, University of Granada, Granada, Spain
- Servicio de Microbiología, Hospital Universitario San Cecilio, Granada, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERinfecc), Instituto de Salud Carlos III, Madrid, Spain
| | - Alba Rodríguez-Nogales
- Instituto de Investigación Biosanitaria, Ibs, University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Department of Pharmacology, School of Pharmacy, University of Granada, Granada, Spain
| | - Julio Juan Gálvez Peralta
- Instituto de Investigación Biosanitaria, Ibs, University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Department of Pharmacology, Center for Biomedical Research, Granada, Spain
| | - Rafael Cabeza
- Department of Electrical, Electronic and Communications Engineering, Public University of Navarre, Pamplona, Spain
| | | | - Araceli Muñoz-Garach
- Instituto de Investigación Biosanitaria, Ibs, University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Endocrinology and Nutrition Unit, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Manuel Muñoz-Torres
- Instituto de Investigación Biosanitaria, Ibs, University of Granada, Granada, Spain
- Endocrinology and Nutrition Unit, Hospital Universitario San Cecilio, Granada, Spain
- Department of Medicine, Faculty of Medicine, University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable (CIBERfes), Instituto de Salud Carlos III, Madrid, Spain
| | - Idoia Labayen
- Navarre Institute of Health Research, Pamplona, Spain
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain
| | - Jonatan R Ruiz
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs, University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
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De Luca M, Zese M, Silverii GA, Ragghianti B, Bandini G, Forestieri P, Zappa MA, Navarra G, Foschi D, Musella M, Sarro G, Pilone V, Facchiano E, Foletto M, Olmi S, Raffelli M, Bellini R, Gentileschi P, Cerbone MR, Grandone I, Berardi G, Di Lorenzo N, Lucchese M, Piazza L, Casella G, Manno E, Zaccaroni A, Balani A, Mannucci E, Monami M. Bariatric Surgery for Patients with Overweight/Obesity. A Comprehensive Grading Methodology and Network Metanalysis of Randomized Controlled Trials on Weight Loss Outcomes and Adverse Events. Obes Surg 2023; 33:4147-4158. [PMID: 37917391 DOI: 10.1007/s11695-023-06909-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/13/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023]
Abstract
This study aims to compare different types of metabolic bariatric surgery (MBS) with lifestyle intervention/medical therapy (LSI/MT) for the treatment of overweight/obesity. The present and network meta-analysis (NMA) includes randomized trials. MBS was associated with a reduction of BMI, body weight, and percent weight loss, when compared to LSI/MT, and also with a significant reduction of HbA1c and a higher remission of diabetes. Meta-regression analyses revealed that BMI, a higher proportion of women, and a longer duration of trial were associated with greater effects of MBS. The NMA showed that all surgical procedures included (except greater curvature plication) were associated with a reduction of BMI. MBS is an effective option for the treatment of obesity. The choice of BMI thresholds for eligibility for surgery of patients with different complications should be performed making an evaluation of risks and benefits in each BMI category.
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Affiliation(s)
- Maurizio De Luca
- Dipartimento di Chirurgia Generale e Metabolica, Azienda ULSS5 Polesana, Ospedale di Rovigo, 45010, Rovigo, Italia
| | - Monica Zese
- Dipartimento di Chirurgia Generale e Metabolica, Azienda ULSS5 Polesana, Ospedale di Rovigo, 45010, Rovigo, Italia.
| | | | - Benedetta Ragghianti
- Azienda Ospedaliero Universitaria Careggi e Università di Firenze, 50134, Firenze, Italia
| | - Giulia Bandini
- Azienda Ospedaliero Universitaria Careggi e Università di Firenze, 50134, Firenze, Italia
| | - Pietro Forestieri
- Dipartimento di Scienze Biochimiche Avanzate, Università Degli Studi Di Napoli "Federico II", 80138, Napoli, Italia
| | | | - Giuseppe Navarra
- Policlinico Universitario "G. Martino" Messina, 98124, Messina, Italia
| | | | - Mario Musella
- Dipartimento di Scienze Biochimiche Avanzate, Università Degli Studi Di Napoli "Federico II", 80138, Napoli, Italia
| | - Giuliano Sarro
- UOC Chirurgia Generale e Bariatrica, Istituto Clinico Alta Specialità' San Gaudenzio - Novara, Gruppo Policlinico di Monza, 28100, Novara, Italia
| | - Vincenzo Pilone
- Università degli Studi di Salerno A.O.U. San Giovanni di Dio e Ruggi D'Aragona Ospedale G. Fucito, 84131, Salerno, Italia
| | | | - Mirto Foletto
- Policlinico Universitario di Padova, 35128, Padova, Italia
| | - Stefano Olmi
- Policlinico San Marco, Bergamo, 24046, Bergamo, Italia
| | - Marco Raffelli
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, 00168, Italia
| | - Rosario Bellini
- Azienda Ospedaliero-Universitaria Pisana, 56126, Pisa, Italia
| | - Paolo Gentileschi
- Dipartimento di Chirurgia Bariatrica e Metabolica-Ospedale San Carlo di Nancy, Università di Roma Tor Vergata, Roma e Maria Cecilia Hospital, Cotignola, 00165, (Ravenna), Italia
| | | | - Ilenia Grandone
- SC Diabetologia Dietologia e Nutrizione Clinica, Azienda Ospedaliera Santa Maria di Terni, 05100, Terni, Italia
| | - Giovanna Berardi
- Dipartimento di Scienze Biochimiche Avanzate, Università Degli Studi Di Napoli "Federico II", 80138, Napoli, Italia
| | | | - Marcello Lucchese
- Ospedale Santa Maria Nuova-Chirurgia Generale e Bariatrica - Azienda Sanitaria Toscana Centro, 50122, Firenze, Italia
| | - Luigi Piazza
- UOC Chirurgia Generale e d'Urgenza, Arnas Garibaldi, 95123, Catania, Italia
| | - Giovanni Casella
- Dipartimento di Chirurgia, Università La Sapienza, AOU Policlinico Umberto I, 00161, Roma, Italia
| | - Emilio Manno
- AORN A. Cardarelli Napoli, UO Chirurgia Bariatrica e Metabolica, 80131, Napoli, Italia
| | - Alberto Zaccaroni
- Chirurgia Endocrina e Metabolica, Ospedale G.B.Morgagni, 47121, Forlì, Italia
| | - Alessandro Balani
- Dipartimento Chirurgico del Presidio Ospedaliero Gorizia-Monfalcone, ASS2 Isontina, 34170, Gorizia, Italia
| | - Edoardo Mannucci
- Azienda Ospedaliero Universitaria Careggi e Università di Firenze, 50134, Firenze, Italia
| | - Matteo Monami
- Azienda Ospedaliero Universitaria Careggi e Università di Firenze, 50134, Firenze, Italia
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Gelhorn HL, Maher S, Sapin H, Poon JL, Boye K. Estimating meaningful change for The Impact of Weight on Self-Perception (IW-SP) questionnaire among people with type 2 diabetes. Qual Life Res 2023; 32:3359-3371. [PMID: 37491582 PMCID: PMC10624730 DOI: 10.1007/s11136-023-03476-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 07/27/2023]
Abstract
PURPOSE The Impact of Weight on Self-perception Questionnaire (IW-SP) is a three-item patient-reported outcome measure (PROM) instrument assessing the impact of body weight on self-perception. To date no published threshold for meaningful change exists. The objective of this study was to estimate the minimal important change (MIC) for the IW-SP among people with type 2 diabetes. METHODS Responder analyses were conducted using anchor- and distribution-based approaches with existing clinical trial data (SURPASS-2). As SURPASS-2 did not include a priori anchors, a set of alternative exploratory anchors were identified based on the MICs and items from two conceptually related measures used in the trial as well as percent change in body weight. Exploratory anchors with change estimates that were sufficiently related to change in IW-SP (r ≥ 0.30) and were not redundant with other anchors were retained for the MIC analyses. The analyses were conducted in two stages (estimation = 2/3 of sample) to derive initial IW-SP MIC estimates, and a subsequent confirmation stage (remaining 1/3 of sample). RESULTS While the most conceptually related anchors and items performed best in responsiveness analyses, all anchors resulted in a similar estimate of minimal meaningful change for the IW-SP total score: a 1-point change in raw units (1-5-point scale), corresponding to a 25-point change for transformed scores (0-100 scale). Distribution-based analyses supported these MIC estimates. Results were similar across both stages for all analyses. CONCLUSION The MIC for the IW-SP for patients with T2D is a 25-point change on the transformed score.
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Affiliation(s)
- Heather L Gelhorn
- Evidera, Bethesda, MD, USA.
- Evidera, 7101 Wisconsin Blvd., Suite 1400, Bethesda, MD, 20814, USA.
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Malik Z, Sohn W, Nanayakkara S, Williams K. Poor dental service utilization in those with clinically severe obesity: A neglected issue with solutions needed. Clin Obes 2023; 13:e12608. [PMID: 37348852 DOI: 10.1111/cob.12608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/27/2023] [Accepted: 06/03/2023] [Indexed: 06/24/2023]
Abstract
Data linking body mass index (BMI) and dental service utilization with oral and general health, quality of life, wellbeing, and mental health are lacking. Adult patients with clinically severe obesity attending a hospital-based obesity service in Greater Western Sydney were invited to participate in a cross-sectional survey that collected data on dental utilization and visiting patterns, dental anxiety, and oral health-related quality of life (OHRQoL). General health data were obtained from participants' medical records. Of the 82 individuals who consented to participate, 81 (98.8%) completed the study questionnaire, and 74 (91.3%) answered additional screening questions related to their general wellbeing and mental health. Of the participants, 50 (61.7%) reported that their last dental visit was more than 1 year ago, 43 (53.1%) visited only as needed and 22 (27.2%) participants reported favourable dental visiting patterns. Twenty-four (29.6%) participants reported high levels of dental anxiety, and low levels of OHRQoL compared with national data. Screening questions suggested low general wellbeing and poor mental health in this patient cohort. Within this group, BMI was not significantly correlated with any of the variables of dental service utilization, dental anxiety, OHRQoL, wellbeing, or mental health (p > .05). There was a negative correlation between dental anxiety and dental utilization (p < .05). Patients with clinically severe obesity reported poor dental utilization, low OHRQoL, and high levels of dental anxiety. This study highlighted the frequency of medical complications, lack of wellbeing, and poor mental health, which were evident in this cohort and may complicate dental management.
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Affiliation(s)
- Zanab Malik
- Faculty of Medicine and Health, The University of Sydney School of Dentistry, Surry Hills, New South Wales, Australia
- School of Health Sciences (Oral Health), College of Health, Medicine and Wellbeing, The University of Newcastle, New South Wales, Australia
| | - Woosung Sohn
- Faculty of Medicine and Health, The University of Sydney School of Dentistry, Surry Hills, New South Wales, Australia
| | - Shanika Nanayakkara
- Faculty of Medicine and Health, The University of Sydney School of Dentistry, Surry Hills, New South Wales, Australia
| | - Kathryn Williams
- Nepean Blue Mountains Family Metabolic Health Service, Nepean Blue Mountains Local Health District, Kingswood, New South Wales, Australia
- Charles Perkins Centre-Nepean, The University of Sydney, Sydney, New South Wales, Australia
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Meepring S, Gray R, Li X, Chien WT, Li Y, Ho GWK, Kritkitrat P, Bressington D. Evaluating the efficacy of the Thai Health Improvement Profile intervention for preventing weight gain in people with early stage psychosis: A randomized controlled trial. Int J Nurs Stud 2023; 146:104570. [PMID: 37597457 DOI: 10.1016/j.ijnurstu.2023.104570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/21/2023]
Abstract
OBJECTIVES To investigate the efficacy of the Thai Health Improvement Profile intervention for preventing clinically significant weight gain in people with early stage psychosis. METHODS We undertook a randomised controlled trial from 10/2018 to 05/2021. Participants with early stage psychosis (<5 year duration) were recruited using convenience sampling from the caseloads of community psychiatric nurses in Thailand and randomly allocated to either the Thai Health Improvement Profile intervention or treatment as usual group following baseline assessment. Outcome assessors were blind to group allocation, whereas participants were not. Participants in the intervention group received three monthly (five in total) systematic health checks using the Thai Health Improvement Profile tool, which was used to develop a personal health plan in collaboration with a family member/carer. Nurses supported participants to implement the health plan using behaviour change techniques derived from motivational interviewing. The treatment as usual group consisted of medication and psychosocial support, and no additional intervention was provided. The primary outcome was weight gain (defined as a greater or equal to 7 % increase in weight against baseline) within 1 year. RESULTS Fifty-three participants were allocated to the intervention and an equal number to the treatment as usual group. Primary outcome data were available for 30 participants in each group at the 12 month follow-up. We undertook an intention to treat analysis with multiple imputation (to handle the missing data) for the primary outcome. The treatment as usual group was found to have higher odds than the Thai Health Improvement Profile intervention group of gaining ≥7 % of baseline body weight (OR = 6.52; 95 % CI: 1.88-22.65, p = 0.004). CONCLUSIONS The Thai Health Improvement Profile intervention was effective at preventing weight gain in people with early stage psychosis at one year, though attrition was relatively high. The results highlight the need for community mental health nurses to adopt a holistic approach, the potential benefits of conducting regular comprehensive health checks and the importance of involving family members when aiming to improve the physical health of people diagnosed with early stage psychosis. A large definitive multi-site randomised controlled trial of the Thai Health Improvement Profile with a longer follow-up is now justified. TRIAL REGISTRATION Prospectively registered with the Thai Clinical Trials Registry (reference: TCTR20180305002).
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Affiliation(s)
| | | | - Xia Li
- La Trobe University, Melbourne, Australia
| | - Wai Tong Chien
- Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Yan Li
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong
| | - Grace W K Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong
| | - Preeyakamon Kritkitrat
- Faculty of Nursing, Chiang Mai University, 110/406 Inthawaroros road, SriPhum District, Chiang Mai 50200, Thailand
| | - Daniel Bressington
- Faculty of Nursing, Chiang Mai University, 110/406 Inthawaroros road, SriPhum District, Chiang Mai 50200, Thailand; Faculty of Health, Charles Darwin University, Ellengowan Drive, Darwin 0810, Australia.
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Hocking S, Sumithran P. Individualised prescription of medications for treatment of obesity in adults. Rev Endocr Metab Disord 2023; 24:951-960. [PMID: 37202547 PMCID: PMC10492708 DOI: 10.1007/s11154-023-09808-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/24/2023] [Indexed: 05/20/2023]
Abstract
Obesity continues to increase in prevalence globally, driven by changes in environmental factors which have accelerated the development of obesity in individuals with an underlying predisposition to weight gain. The adverse health effects and increased risk for chronic disease associated with obesity are ameliorated by weight loss, with greater benefits from larger amounts of weight reduction. Obesity is a heterogeneous condition, with the drivers, phenotype and complications differing substantially between individuals. This raises the question of whether treatments for obesity, specifically pharmacotherapy, can be targeted based on individual characteristics. This review examines the rationale and the clinical data evaluating this strategy in adults. Individualised prescribing of obesity medication has been successful in rare cases of monogenic obesity where medications have been developed to target dysfunctions in leptin/melanocortin signalling pathways but has been unsuccessful in polygenic obesity due to a lack of understanding of how the gene variants associated with body mass index affect phenotype. At present, the only factor consistently associated with longer-term efficacy of obesity pharmacotherapy is early weight loss outcome, which cannot inform choice of therapy at the time of medication initiation. The concept of matching a therapy for obesity to the characteristics of the individual is appealing but as yet unproven in randomised clinical trials. With increasing technology allowing deeper phenotyping of individuals, increased sophistication in the analysis of big data and the emergence of new treatments, it is possible that precision medicine for obesity will eventuate. For now, a personalised approach that takes into account the person's context, preferences, comorbidities and contraindications is recommended.
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Affiliation(s)
- Samantha Hocking
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
- Department of Endocrinology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Priya Sumithran
- Department of Medicine, (St Vincent's Hospital), University of Melbourne, VIC, Fitzroy, Australia.
- Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia.
- Department of Surgery, Central Clinical School, Monash University, Level 6, 99 Commercial Rd, Melbourne, Victoria, 3004, Australia.
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Borg A, Lindblom J, Gomez A, Soltani A, Enman Y, Heintz E, Regardt M, Grannas D, Emamikia S, Parodis I. Obesity is associated with pain and impaired mobility despite therapy in systemic lupus erythematosus. Front Med (Lausanne) 2023; 10:1247354. [PMID: 37692782 PMCID: PMC10484101 DOI: 10.3389/fmed.2023.1247354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/15/2023] [Indexed: 09/12/2023] Open
Abstract
Objective To investigate whether abnormal BMI is associated with health-related quality of life (HRQoL) impairments, defined as patient-reported problems within the different dimensions of the three-level EQ-5D (EQ-5D-3L), before and after treatment for active systemic lupus erythematosus (SLE). Patients and methods We conducted a post-hoc analysis of data from two phase III clinical trials of belimumab in SLE, i.e., BLISS-52 (n = 865) and BLISS-76 (n = 819). Underweight was defined as BMI <18.5 kg/m2, normal weight as BMI ≥18.5 but <25 kg/m2, pre-obesity as BMI ≥25 but <30 kg/m2, and obesity as BMI ≥30 kg/m2. We investigated associations between BMI groups and problems (level 2 or 3) within each one of the five EQ-5D dimensions before treatment initiation and at week 52, using logistic regression analysis adjusting for age, ethnicity, disease activity, and glucocorticoid dose, and for the post-treatment analysis also for belimumab treatment and baseline EQ-5D-3L responses. Results Of 1,684 patients included, 73 (4%) were classified as underweight, 850 (50%) as normal weight, 438 (26%) as pre-obese, and 323 (19%) as obese. At baseline, obesity was associated with mild to severe problems in all EQ-5D dimensions (p < 0.05 for all), yielding the strongest association with problems in mobility (adjusted odds ratio, aOR: 2.1; 95% confidence interval, CI: 1.6-2.8; p < 0.001). Pre-obesity was also associated with problems in mobility (aOR: 1.4; 95% CI: 1.1-1.8; p = 0.005). Post-intervention, obesity was associated with problems in mobility and pain/discomfort, and pre-obesity with problems in mobility and self-care (p < 0.05 for all). Conclusion Our study adds to the evidence that high BMI negatively affects SLE patients' HRQoL, with obesity being associated with pain and impaired mobility despite therapy.
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Affiliation(s)
- Alexander Borg
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Julius Lindblom
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Alvaro Gomez
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Ameneh Soltani
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Yvonne Enman
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Emelie Heintz
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Malin Regardt
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - David Grannas
- Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sharzad Emamikia
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Ioannis Parodis
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Zhang Y, Tang N, Xia W, Sanjid Seraj S, Pereira M, Velu P, Zhou H, Yang H, Du G. The effect of green tea supplementation on the anthropometric outcomes in overweight and obese women: a time and dose-response meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr 2023:1-10. [PMID: 37300478 DOI: 10.1080/10408398.2023.2220796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Inconsistencies are evident within the literature regarding the role of Green Tea (GT) supplementation on women living with obesity. To address this, we conducted to determine the impact of GT supplementation on the weight, body mass index (BMI), and waist circumference (WC) in overweight and obese women using time and dose-response meta-analysis of randomized controlled trials (RCTs). This meta-analysis searched electronic Scopus, Web of Science, Embase, and PubMed/Medline databases from inception to December 1st, 2022. Data were reported as weighted mean difference (WMD) with 95% confidence interval (CI). A total of 2061 references were identified, and 15 articles with 16 RCT arms on body weight, 17 RCT arms on BMI, and 7 RCT arms on WC were included in the meta-analysis. GT supplementation significantly decreases body weight (WMD: -1.23 kg, 95% CI: -2.13 to -0.33, p = 0.007), BMI (WMD: -0.47 kg/m2, 95% CI: -0.87 to -0.07, p = 0.020) and WC (WMD: -3.46 cm, 95% CI: -6.75 to -0.16, p = 0.040). In subgroup analyses, GT consumption demonstrated lowered body weight with dosaes ≥1000 mg/day (WMD: -1.38 kg), in the RCTs, which lasted ≥8 wk (WMD: -1.24 kg). The non-linear dose-response assessment detected a negative correlation between the changes in body weight and BMI in green tea consumption of more than 1000 (mg/day). The GT supplementation reduced the weight, BMI, and WC in overweight and obese women. In clinical practice, healthcare professionals can recommend using GT with dosages ≥ 1000mg/day and duration ≥ 8 wk in obese women.
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Affiliation(s)
- Yiyi Zhang
- Department of Endocrinology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Nie Tang
- Department of Endocrinology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Wei Xia
- Department of Endocrinology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Shaikh Sanjid Seraj
- Department of Surgery, Royal Shrewsbury Hospital, Shrewsbury and Telford NHS Trust, Shrewsbury, West Midlands, United Kingdom
| | - Marcos Pereira
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | - Periyannan Velu
- Department of Biochemistry and Biotechnology, Faculty of Science, Annamalai University, Chidambaram, Tamil Nadu, India
| | - Hui Zhou
- Department of Endocrinology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Hanshu Yang
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Guanggang Du
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
- Department of Burns, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
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Aitzetmüller-Klietz MM, Raschke L, Hirsch T, Kückelhaus M, Wiebringhaus P, Aitzetmüller-Klietz ML, Harati K. Factors Influencing Quality of Life after Massive Weight Loss-What Makes the Difference? Healthcare (Basel) 2023; 11:healthcare11081147. [PMID: 37107981 PMCID: PMC10138039 DOI: 10.3390/healthcare11081147] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/08/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
Although weight reduction in obesity and morbid obesity has been shown to improve associated comorbidities, there is currently no information on what influences quality of life after a large reduction in body weight. The present study looks at differences in patients' quality of life classified by mode and amount of weight loss. MATERIAL AND METHODS A cross-sectional study was designed using a validated German version of the BODY-Q questionnaire. The internet-based questionnaire was distributed to patients via social media. RESULTS 460 patients (443 female, 17 male) were interviewed for this study via "Surveymonkey". The comparison of conservative and surgical weight loss showed no significant difference in the patients' quality of life (p > 0.05). A high BMI correlates negatively with body image (p = 0.023 *), as does the specific assessment of most body regions. For example, a negative correlation was found between a high BMI and satisfaction with skin appearance (p < 0.001 *) and satisfaction with the inner thigh (p = 0.011 *). CONCLUSION Increased weight loss is associated with a greater ability to maximise quality of life. The type of weight loss, whether conservative or surgical, can be neglected based on the present study. Bariatric surgery cannot be considered a universal solution to obesity. Body contouring interventions should also become a focus of therapy.
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Affiliation(s)
- Matthias Michael Aitzetmüller-Klietz
- Division for Plastic Surgery, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Waldeyerstrasse 1, 48149 Muenster, Germany
- Department for Plastic and Reconstructive Surgery, Institute for Muskuloskeletal Medicine, Westfaelian Wilhelms-University Muenster, 48149 Münster, Germany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand Surgery, Fachklinik Hornheide, Dorbaumstrasse 300, 48157 Muenster, Germany
| | - Laura Raschke
- Division for Plastic Surgery, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Waldeyerstrasse 1, 48149 Muenster, Germany
- Department for Plastic and Reconstructive Surgery, Institute for Muskuloskeletal Medicine, Westfaelian Wilhelms-University Muenster, 48149 Münster, Germany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand Surgery, Fachklinik Hornheide, Dorbaumstrasse 300, 48157 Muenster, Germany
| | - Tobias Hirsch
- Division for Plastic Surgery, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Waldeyerstrasse 1, 48149 Muenster, Germany
- Department for Plastic and Reconstructive Surgery, Institute for Muskuloskeletal Medicine, Westfaelian Wilhelms-University Muenster, 48149 Münster, Germany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand Surgery, Fachklinik Hornheide, Dorbaumstrasse 300, 48157 Muenster, Germany
| | - Maximilian Kückelhaus
- Division for Plastic Surgery, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Waldeyerstrasse 1, 48149 Muenster, Germany
- Department for Plastic and Reconstructive Surgery, Institute for Muskuloskeletal Medicine, Westfaelian Wilhelms-University Muenster, 48149 Münster, Germany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand Surgery, Fachklinik Hornheide, Dorbaumstrasse 300, 48157 Muenster, Germany
| | - Philipp Wiebringhaus
- Division for Plastic Surgery, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Waldeyerstrasse 1, 48149 Muenster, Germany
- Department for Plastic and Reconstructive Surgery, Institute for Muskuloskeletal Medicine, Westfaelian Wilhelms-University Muenster, 48149 Münster, Germany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand Surgery, Fachklinik Hornheide, Dorbaumstrasse 300, 48157 Muenster, Germany
| | - Marie-Luise Aitzetmüller-Klietz
- Division for Plastic Surgery, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Waldeyerstrasse 1, 48149 Muenster, Germany
- Department for Plastic and Reconstructive Surgery, Institute for Muskuloskeletal Medicine, Westfaelian Wilhelms-University Muenster, 48149 Münster, Germany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand Surgery, Fachklinik Hornheide, Dorbaumstrasse 300, 48157 Muenster, Germany
| | - Kamran Harati
- Division for Plastic Surgery, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Waldeyerstrasse 1, 48149 Muenster, Germany
- Department for Plastic and Reconstructive Surgery, Institute for Muskuloskeletal Medicine, Westfaelian Wilhelms-University Muenster, 48149 Münster, Germany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand Surgery, Fachklinik Hornheide, Dorbaumstrasse 300, 48157 Muenster, Germany
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Walmsley R, Sumithran P. Current and emerging medications for the management of obesity in adults. Med J Aust 2023; 218:276-283. [PMID: 36934408 PMCID: PMC10952877 DOI: 10.5694/mja2.51871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/31/2023] [Accepted: 02/06/2023] [Indexed: 03/20/2023]
Affiliation(s)
| | - Priya Sumithran
- University of MelbourneMelbourneVIC
- Austin HealthMelbourneVIC
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Sun S, Stenberg E, Cao Y, Lindholm L, Salén KG, Franklin KA, Luo N. Mapping the obesity problems scale to the SF-6D: results based on the Scandinavian Obesity Surgery Registry (SOReg). THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2023; 24:279-292. [PMID: 35596099 PMCID: PMC9985564 DOI: 10.1007/s10198-022-01473-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 04/21/2022] [Indexed: 05/22/2023]
Abstract
BACKGROUND Obesity Problem Scale (OP) is a widely applied instrument for obesity, however currently calculation of health utility based on OP is not feasible as it is not a preference-based measure. Using data from the Scandinavian Obesity Surgery Registry (SOReg), we sought to develop a mapping algorithm to estimate SF-6D utility from OP. Furthermore, to test whether the mapping algorithm is robust to the effect of surgery. METHOD The source data SOReg (n = 36 706) contains both OP and SF-36, collected at pre-surgery and at 1, 2 and 5 years post-surgery. The Ordinary Least Square (OLS), beta-regression and Tobit regression were used to predict the SF-6D utility for different time points respectively. Besides the main effect model, different combinations of patient characteristics (age, sex, Body Mass Index, obesity-related comorbidities) were tested. Both internal validation (split-sample validation) and validation with testing the mapping algorithm on a dataset from other time points were carried out. A multi-stage model selection process was used, accessing model consistency, parsimony, goodness-of-fit and predictive accuracy. Models with the best performance were selected as the final mapping algorithms. RESULTS The final mapping algorithms were based on OP summary score using OLS models, for pre- and post-surgery respectively. Mapping algorithms with different combinations of patients' characteristics were presented, to satisfy the user with a different need. CONCLUSION This study makes available algorithms enabling crosswalk from the Obesity Problem Scale to the SF-6D utility. Different mapping algorithms are recommended for the mapping of pre- and post-operative data.
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Affiliation(s)
- Sun Sun
- Department of Epidemiology and Global Health, Umeå University, 90185, Umeå, Sweden.
- Research Group Health Outcomes and Economic Evaluation, Department of Learning, Informatics, Management and Ethics, Karolinska Instiutet, Solna, Sweden.
| | - Erik Stenberg
- Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Yang Cao
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Lars Lindholm
- Department of Epidemiology and Global Health, Umeå University, 90185, Umeå, Sweden
| | - Klas-Göran Salén
- Department of Epidemiology and Global Health, Umeå University, 90185, Umeå, Sweden
| | - Karl A Franklin
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
| | - Nan Luo
- NUS Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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13
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Yu J, Huang HC, Cheng TCE, Wong MK, Teng CI. Effects of Playing Exergames on Quality of Life among Young Adults: A 12-Week Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1359. [PMID: 36674115 PMCID: PMC9858715 DOI: 10.3390/ijerph20021359] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/04/2023] [Accepted: 01/07/2023] [Indexed: 05/13/2023]
Abstract
Objective: The purpose of this paper is to investigate whether playing exergames can enhance quality of life among young adults and it examines the potential moderators. Methods: A 12-week randomized controlled trial was conducted. Quality of life was measured using the short-form 36-item version (SF-36) scale. All the participants were between 20 and 24 years old in Taiwan. Participants in the intervention group (n = 55) were asked to play exergames for 12 weeks, three times a week and 30 minutes at a time, while participants in the control group (n = 62) did not play exergames. The changes in the scores on quality of life between the beginning and the end of the 12-week trial were calculated. Independent t-tests were used to analyze the differences. Results: The intervention group participants experienced an enhanced quality of life in terms of physical functioning, role-physical (role limitations due to physical health), general health, and social functioning. Moreover, the intervention group participants who were not enthusiastic about exercisers experienced an enhanced quality of life in physical functioning, role-physical, and general health. The intervention group participants who attempted to control their weight experienced enhanced general health, vitality, and mental health. Conclusion: Playing exergaming could contribute to users' quality of life in terms of both physical and mental health.
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Affiliation(s)
- Jiajun Yu
- School of Management, Guangzhou Huashang College, Guangzhou 511300, China
- School of Innovation and Entrepreneurship, Guangzhou Huashang College, Guangzhou 511300, China
- Graduate Institute of Management, Chang Gung University, Taoyuan 333, Taiwan
| | - Han-Chung Huang
- Center for General Education, China University of Technology, Taipei 219, Taiwan
| | - T. C. E. Cheng
- Department of Logistics and Maritime Studies, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - May-Kuen Wong
- Taoyuan Branch, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Ching-I Teng
- Graduate Institute of Management, Chang Gung University, Taoyuan 333, Taiwan
- Department of Physical Medicine and Rehabilitation, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
- Department of Business and Management, Ming Chi University of Technology, New Taipei 243, Taiwan
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14
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King WC, Hinerman AS, White GE, Courcoulas AP, Belle SH. Associations Between Physical Activity and Changes in Depressive Symptoms and Health-related Quality of Life Across 7 Years After Roux-en-Y Gastric Bypass Surgery: A Multicenter Prospective Cohort Study. Ann Surg 2022; 276:e777-e783. [PMID: 33234795 PMCID: PMC10362941 DOI: 10.1097/sla.0000000000004652] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine associations of objectively-measured free-living physical activity (PA) with changes in depressive symptoms and mental and physical health-related quality of life (HRQoL) over 7 years after Roux-en-Y gastric bypass surgery (RYGB). BACKGROUND The contributions of PA to improvements in mental and physical health after RYGB, independent of weight loss, are unclear. METHODS Adults undergoing RYGB in a US multi-center cohort study wore an activity monitor and completed the Beck depression inventory (BDI) and 36-Item Short Form Health Survey (SF-36) annually ≤7 years (N = 646; 78% female, median age 47 years, median body mass index 46kg/m 2 ). Linear mixed models estimated associations of quartiles of steps, sedentary behavior (SB), and moderate-to-vigorous intensity physical activity (MVPA), respectively, with pre-to-post-surgery changes in the BDI and SF-36 mental component summary and physical component summary scores, respectively, over 1-7 years post-surgery, with adjustment for sex, age, race, pre-surgerybody mass index, the respective pre-surgery score, treatment for depression (time-varying) and pre-to-post-surgery weight change (time-varying). RESULTS There were dose-response associations between steps, SB (inverse) and MVPA quartiles, respectively, with improvements in each score. Across follow-up, mean improvements in the BDI, Mental Component Summary and physical component summary scores, were 1.9 [95% confidence interval (CI), 1.0-2.8], 3.1 (95% CI, 1.5-4.7), and 4.0 (95% CI, 2.7-5.4) points higher, respectively, in the highest versus lowest steps quartile. CONCLUSION Among adults who underwent RYGB, multiple objective PA measures were associated with decreases in depressive symptoms and improvements in mental and physical HRQoL throughout 7 years, independent of weight loss, indicating PA is a modifiable behavior to augment outcomes.
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Affiliation(s)
- Wendy C King
- Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Amanda S Hinerman
- Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Gretchen E White
- General and internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Anita P Courcoulas
- Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Steven H Belle
- Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
- Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
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Hafida S, Apovian C. Physiology of the Weight-Reduced State and Its Impact on Weight Regain. Endocrinol Metab Clin North Am 2022; 51:795-815. [PMID: 36244694 DOI: 10.1016/j.ecl.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Obesity is a chronic disease characterized by long duration, slow progression, and periods of remission and relapses. Despite the development of effective medical and surgical interventions and millions of people conducting tremendous personal efforts to manage their weight every year, recidivism remains a significant barrier to attaining long-term weight maintenance. This review aimed to explain the underlying physiology of the weight-reduced state including changes in energy balance, adipose tissue, genetic, environmental, and behavioral factors that may predispose individuals to weight regain following weight loss.
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Affiliation(s)
- Samar Hafida
- Division of Endocrinology, Diabetes, Nutrition and Weight Management, 72 East, Concord Street C3 (Room 321 A), Collamore Building, Boston, MA 02118, USA.
| | - Caroline Apovian
- Division of Endocrinology, Diabetes and Hypertension, Center for Weight Management and Wellness, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Suite RFB-2, Brigham and Women's at 221 Longwood, Boston, MA 02115, USA
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16
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Mental health and quality of life during weight loss in females with clinically severe obesity: a randomized clinical trial. J Behav Med 2022:10.1007/s10865-022-00377-4. [DOI: 10.1007/s10865-022-00377-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 10/25/2022] [Indexed: 11/23/2022]
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Keramat SA, Alam K, Keating B, Ahinkorah BO, Gyan Aboagye R, Seidu AA, Samad N, Saha M, Gow J, Biddle SJ, Comans T. Morbid obesity, multiple long-term conditions, and health-related quality of life among Australian adults: Estimates from three waves of a longitudinal household survey. Prev Med Rep 2022; 28:101823. [PMID: 35677316 PMCID: PMC9167973 DOI: 10.1016/j.pmedr.2022.101823] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 03/31/2022] [Accepted: 05/09/2022] [Indexed: 11/28/2022] Open
Abstract
Health-related quality of life is negatively impacted by morbid obesity and chronic conditions. Morbidly obese individuals scored lower on the PCS, MCS, and SF-6D utility indexes. Multiple long-term conditions also decreased PCS, MCS, and SF-6D utility scores. The interaction between morbid obesity and MLTCs has had an opposite effect on PCS and MCS.
This study aims to investigate the impact of morbid obesity and multiple long-term conditions (MLTCs) on health-related quality of life (HRQoL). Data for this study were sourced from three waves (waves 9, 13 and 17) of the Household, Income and Labour Dynamics in Australia (HILDA) survey. The paper analyses 37,887 person-year observations from 19,387 individuals during the period 2009–2017. The longitudinal random-effects Tobit model was fitted to examine the association between morbid obesity, MLTCs and HRQoL. This study found that morbid obesity and MLTCs were both negatively associated with HRQoL as measured through physical component summary (PCS), mental component summary (MCS), and the short-form six-dimension utility index (SF-6D) of the 36-item Short-Form Health Survey (SF-36). Morbidly obese scored lower points on the PCS (β = −5.05, 95% CI: −5.73, −4.37), MCS (β = −1.03, 95% CI: −1.84, −0.23), and in the SF-6D utility index (β = −0.045, 95% CI: −0.054, −0.036) compared to their healthy weight counterparts. Similar findings were observed for individuals with MLTCs, with lower scores for the PCS (β = −4.79, 95% CI: −5.20, −4.38), MCS (β = −4.95, 95% CI: −5.43, −4.48), and SF-6D utility (β = −0.071, 95% CI: −0.076, −0.066). Additionally, multiplicative interaction between morbid obesity and MLTCs was observed to modestly exacerbated the negative effect of morbid obesity on PCS scores (β = −1.69, 95% CI: −2.74, −0.64). The interaction effect, on the other hand, significantly lessen the unfavourable effect of morbid obesity on the MCS score (β = 1.34, 95% CI: 0.10, 2.58). The findings of this study will be useful for future cost-effectiveness analyses and measuring the burden of diseases since it provides information on the disutility associated with morbid obesity and MLTCs.
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Giusti L, Bianchini V, Aggio A, Mammarella S, Salza A, Necozione S, Alunno A, Ferri C, Casacchia M, Roncone R. Twelve-month outcomes in overweight/obese users with mental disorders following a multi-element treatment including diet, physical activity, and positive thinking: The real-world "An Apple a Day" controlled trial. Front Psychiatry 2022; 13:903759. [PMID: 36081460 PMCID: PMC9445251 DOI: 10.3389/fpsyt.2022.903759] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/27/2022] [Indexed: 11/15/2022] Open
Abstract
The present study aimed to evaluate the 12-month effectiveness of a real-world weight loss transdiagnostic intervention in overweight/obese participants affected by mental disorders under psychopharmacological treatment. We conducted a real-world, controlled, pragmatic outpatient trial. We allocated 58 overweight/obese adults under psychopharmacological treatment from a mental health outpatient unit and 48 overweight/obese adults from a cardiovascular prevention outpatient unit, and assigned them to an intervention or treatment usual as condition (TAU) enriched by life-style advice. Participants in both intervention groups took part in a diet programme (the modified OMNIHeart dietary protocol) and monitoring of regular aerobic activity. A brief group programme ("An Apple a Day" Metacognitive Training, Apple-MCT) was added in the intervention group of participants affected by mental disorders. The primary outcome was weight loss. Secondary outcomes included anthropometric, clinical, and metabolic variables. Psychopathology and health-related quality of life were also evaluated in the psychiatric sample. At 12 months, both intervention groups showed a more marked mean decrease in weight (6.7 kg, SD: 3.57) than the TAU group (0.32 kg, SD: 1.96), and a statistically significant improvement in metabolic variables compared with the control groups. Furthermore, the participants affected by mental disorders included in the intervention group reported improved health-related quality of life. Our findings suggest the need to implement integrated interventions based on a dietary protocol, physical activity, and modification of cognitive style in overweight/obese users with mental disorders.
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Affiliation(s)
- Laura Giusti
- Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Valeria Bianchini
- Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Annalisa Aggio
- Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Silvia Mammarella
- Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Anna Salza
- Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Stefano Necozione
- Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Alessia Alunno
- Division of Internal Medicine and Nephrology, School of Internal Medicine-San Salvatore Hospital, Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Claudio Ferri
- Division of Internal Medicine and Nephrology, School of Internal Medicine-San Salvatore Hospital, Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Massimo Casacchia
- Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Rita Roncone
- University Unit Rehabilitation Treatment, Early Interventions in Mental Health-San Salvatore Hospital, Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
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19
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AHMEDOV A, AHMEDOV Y. The Effect of High Body Mass Index on Self-Esteem and Sexual Functions in Obese Females Admitted to The Plastic Reconstructive and Aesthetic Surgery Department. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.748259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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20
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Borg A, Gomez A, Cederlund A, Cobar F, Qiu V, Lindblom J, Emamikia S, Enman Y, Pettersson S, Parodis I. Contribution of abnormal BMI to adverse health-related quality of life outcomes after a 52-week therapy in patients with SLE. Rheumatology (Oxford) 2021; 60:4205-4217. [PMID: 33404659 PMCID: PMC8410008 DOI: 10.1093/rheumatology/keaa909] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/30/2020] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES To investigate whether abnormal BMI is associated with adverse health-related quality of life (HRQoL) outcome, including severe fatigue, after 52 weeks of standard therapy plus belimumab or placebo in patients with SLE. METHODS We analysed data from the BLISS-52 (NCT00424476) and BLISS-76 (NCT00410384) trials (n = 1684). Adverse HRQoL was defined as SF-36 scores ≤ the fifth percentile in age- and sex-matched US population-based subjects, and FACIT-F scores <30. We compared BMI groups using the Pearson's χ2 test, and assessed independence with multivariable logistic regression analysis. RESULTS Overweight (BMI ≥25 kg/m2) and obese (BMI ≥30 kg/m2) patients showed increased likelihood to exhibit adverse SF-36 physical component summary (OR: 1.8; 95% CI: 1.4, 2.3; P <0.001 and OR: 2.4; 95% CI: 1.8, 3.2; P <0.001, respectively) and FACIT-F (OR: 1.3; 95% CI: 1.1, 1.6; P = 0.010 and OR: 1.5; 95% CI: 1.2, 2.0; P = 0.002, respectively) scores at week 52. Underweight was associated with adverse SF-36 mental component summary scores, also after adjustment for sex, ancestry, age, disease duration, disease activity, organ damage and prednisone dose during the study period (OR: 2.1; 95% CI: 1.2, 3.6; P = 0.007). Addition of belimumab to standard therapy independently protected against adverse SF-36 general health (OR: 0.8; 95% CI: 0.6, 1.0; P = 0.025) and FACIT-F < 30 (OR: 0.8; 95% CI: 0.6, 1.0; P = 0.018). CONCLUSION Overweight and obesity contributed to adverse physical and mental HRQoL outcomes after therapeutic intervention in SLE patients, and underweight contributed to adverse mental HRQoL outcome. A protective effect of belimumab against adverse general health and severe fatigue was implicated.
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Affiliation(s)
- Alexander Borg
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital
| | - Alvaro Gomez
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital
| | - Arvid Cederlund
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital
| | - Flordelyn Cobar
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital
| | - Victor Qiu
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital
| | - Julius Lindblom
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital
| | - Sharzad Emamikia
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital
| | - Yvonne Enman
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital
| | - Susanne Pettersson
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Ioannis Parodis
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital
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21
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Moran KM, González-Martínez LF, Delville Y. Lifelong enhancement of body mass from adolescent stress in male hamsters. Horm Behav 2021; 133:105004. [PMID: 34062278 DOI: 10.1016/j.yhbeh.2021.105004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 05/13/2021] [Accepted: 05/15/2021] [Indexed: 10/21/2022]
Abstract
In hamsters, exposure to stress in adulthood causes increased body weight. We addressed how social stress during puberty would impact food intake and body weight. Stressed hamsters started gaining significantly more weight than controls after only two days of stress exposure. Over a two-week period, stressed subjects gained 10% more weight and consumed more food than controls. At the end of the stress period, stressed hamsters collected nearly twice as many palatable sugar pellets from an arena than controls. Stressed subjects presented 15-20% more body fat in mesenteric, inguinal, and retroperitoneal fat pads. In order to assess the duration of these effects, we analyzed data from previous studies keeping hamsters for over two months past the stress period in puberty. Our analysis shows that stressed hamsters stopped gaining more weight after the stress period, but their body weights remained elevated for over two months, consistently weighing 10% more than their non-stressed counterparts. We also analyzed conditioning training data collected after the period of stress in late puberty and early adulthood (P56 to P70) that was part of the original studies. Training consisted of lever pressing for palatable food rewards. At these times, previously stressed hamsters retrieved similar numbers of food pellets from the conditioning chambers, suggesting no difference in appetite after the stress period. These data showing a long-lasting effect of stress on body weight may be relevant to studies on the ontogeny of lifelong obesity.
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Affiliation(s)
- Kevin M Moran
- Psychology Department, The University of Texas at Austin, Austin, TX 78712, USA.
| | | | - Yvon Delville
- Psychology Department, The University of Texas at Austin, Austin, TX 78712, USA
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22
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Dainelli L, Luo DR, Cohen SS, Marczewska A, Ard JD, Coburn SL, Lewis KH, Loper J, Matarese LE, Pories WJ, Rothberg AE. Health-Related Quality of Life in Weight Loss Interventions: Results from the OPTIWIN Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041785. [PMID: 33673158 PMCID: PMC7917903 DOI: 10.3390/ijerph18041785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 12/02/2022]
Abstract
Obesity is highly prevalent and associated with several adverse outcomes including health-related quality-of-life (HRQoL), work productivity, and activity impairment. The objective of this study is to examine group differences in HRQoL and labor-related health outcomes among participants in the OPTIWIN program, which compared the effectiveness of two intensive behavioral weight loss interventions. Participants (n = 273) were randomized to OPTIFAST®(OP) or food-based (FB) dietary interventions for 52 weeks. HRQoL and labor-related health outcomes were measured at baseline, week 26, and week 52, using two questionnaires. At baseline, there were no differences between groups on the Impact of Weight on Quality-of-Life Questionnaire (IWQOL-Lite). At week 26, the OP group had statistically significant differences towards better HRQoL for Physical Function, Self-Esteem, and the total score compared with the FB group. At week 52, the OP group showed better HRQoL in the total score (p = 0.0012) and in all but one domain. Moreover, the adjusted change-from-baseline normalized total score at week 52 was −5.9 points (p = 0.0001). Finally, the mean IWQOL-Lite normalized score showed that HRQoL improves by 0.4442 units (p < 0.0001) per kg lost, and that greater weight reduction was positively associated with better HRQoL. No statistically significant group differences were found with the Work Productivity and Activity Impairment (General Health) (WPAI-GH) Questionnaire. HRQoL improves with highly intensive, well-structured weight loss interventions. Greater weight loss lead to larger improvements. The lack of negative effect on productivity and activity suggests that these interventions may be compatible with an active work lifestyle.
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Affiliation(s)
- Livia Dainelli
- Nestlé Research, Nestlé, 1000 Lausanne, Switzerland; (L.D.); (D.R.L.)
| | - Dan Roberto Luo
- Nestlé Research, Nestlé, 1000 Lausanne, Switzerland; (L.D.); (D.R.L.)
| | | | | | - Jamy D. Ard
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA; (J.D.A.); (K.H.L.)
| | | | - Kristina H. Lewis
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA; (J.D.A.); (K.H.L.)
| | - Judy Loper
- The Central Ohio Nutrition Center, Inc., Gohanna, OH 43230, USA;
| | - Laura E. Matarese
- Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, NC 27101, USA; (L.E.M.); (W.J.P.)
| | - Walter J. Pories
- Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, NC 27101, USA; (L.E.M.); (W.J.P.)
| | - Amy E. Rothberg
- Department of Nutritional Sciences, School of Public Health and Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Harbour, MI 48109-2029, USA
- Correspondence:
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23
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Schroder JD, Falqueto H, Mânica A, Zanini D, de Oliveira T, de Sá CA, Cardoso AM, Manfredi LH. Effects of time-restricted feeding in weight loss, metabolic syndrome and cardiovascular risk in obese women. J Transl Med 2021; 19:3. [PMID: 33407612 PMCID: PMC7786967 DOI: 10.1186/s12967-020-02687-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 12/21/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The increasing prevalence of overweight and obesity among the worldwide population has been associated with a range of adverse health consequences such as Type 2 diabetes and cardiovascular diseases. The metabolic syndrome (MetS) is a cluster of cardiometabolic abnormalities that occur more commonly in overweight individuals. Time-restricted feeding (TRF) is a dietary approach used for weight loss and overall health. TRF may be an option for those subjects who struggle with extreme restriction diets with foods that generally do not belong to an individual's habits. OBJECTIVE The purpose of this study was to determine the effect of TRF on body composition and the association of weight loss with metabolic and cardiovascular risks in obese middle-aged women. METHODS A non-randomized controlled clinical trial was performed over 3 months in obese women (TRF group, n = 20, BMI 32.53 ± 1.13 vs. Control n = 12, BMI 34.55 ± 1.20). The TRF protocol adopted was 16 h without any energy intake followed by 8 h of normal food intake. MAIN OUTCOMES AND MEASURES Anthropometric measurements, body composition, blood biomarkers, cardiovascular risk in 30 years (CVDRisk30y), and quality of life were evaluated at baseline and after the 3 months. RESULTS TRF was effective in reducing weight (~ 4 kg), BMI, % of body fat (%BF), waist circumference from baseline without changes in blood biomarkers associated with MetS. TRF promoted a reduction in CVDRisk30y (12%) wich was moderately correlated with %BF (r = 0.62, n = 64, p < 0.001) and %MM (r = - 0.74, n = 64, p < 0.001). CONCLUSIONS TRF protocol reduces body weight without changes in biomarkers related to MetS. In addition, the anthropometric evaluation that predicts %BF and %MM could be used as an approach to follow individuals engaged in the TRF regimen since they correlate with cardiovascular risk.
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Affiliation(s)
- Jéssica D Schroder
- Medical School, Federal University of Fronteira Sul, UFFS, SC 484 - Km 02, Fronteira Sul, Chapecó, Santa Catarina, 89815-899, Brazil
| | - Hugo Falqueto
- Medical School, Federal University of Fronteira Sul, UFFS, SC 484 - Km 02, Fronteira Sul, Chapecó, Santa Catarina, 89815-899, Brazil.,Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, UFFS, SC 484 - Km 02, Fronteira Sul, Chapecó, Santa Catarina, Brazil
| | - Aline Mânica
- Health Science Department, Community University of the Region of Chapecó (UNOCHAPECÓ), Chapecó, SC, Brazil
| | - Daniela Zanini
- Medical School, Federal University of Fronteira Sul, UFFS, SC 484 - Km 02, Fronteira Sul, Chapecó, Santa Catarina, 89815-899, Brazil.,Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, UFFS, SC 484 - Km 02, Fronteira Sul, Chapecó, Santa Catarina, Brazil
| | - Tácio de Oliveira
- Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, UFFS, SC 484 - Km 02, Fronteira Sul, Chapecó, Santa Catarina, Brazil
| | - Clodoaldo A de Sá
- Health Science Department, Community University of the Region of Chapecó (UNOCHAPECÓ), Chapecó, SC, Brazil
| | - Andréia Machado Cardoso
- Medical School, Federal University of Fronteira Sul, UFFS, SC 484 - Km 02, Fronteira Sul, Chapecó, Santa Catarina, 89815-899, Brazil.,Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, UFFS, SC 484 - Km 02, Fronteira Sul, Chapecó, Santa Catarina, Brazil
| | - Leandro Henrique Manfredi
- Medical School, Federal University of Fronteira Sul, UFFS, SC 484 - Km 02, Fronteira Sul, Chapecó, Santa Catarina, 89815-899, Brazil. .,Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, UFFS, SC 484 - Km 02, Fronteira Sul, Chapecó, Santa Catarina, Brazil.
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24
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Bauer K, Schild S, Sauer H, Teufel M, Stengel A, Giel KE, Schellhorn P, Junne F, Nieß A, Zipfel S, Mack I. Attitude Matters! How Attitude towards Bariatric Surgery Influences the Effects of Behavioural Weight Loss Treatment. Obes Facts 2021; 14:531-542. [PMID: 34521092 PMCID: PMC8546453 DOI: 10.1159/000517850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 06/09/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Multidisciplinary obesity services at university hospitals usually treat patients with more complex and severe obesity. In addition, patients with Class 3 obesity, in particular, have different attitudes regarding the choices of therapy. METHODS This explorative study investigated the effect of patient attitudes towards bariatric surgery on body weight change (primary outcome) and psychological improvement (secondary outcomes: quality of life, depression, anxiety, and eating behaviour) in a 6-month moderate behavioural weight loss (BWL) programme in a university outpatient setting. RESULTS 297 patients with mostly Class 3 obesity participated in the programme. The patients did not yet have any indications for bariatric surgery. Of the participants, 37% had a positive attitude towards bariatric surgery (POS), whereas 38% had a negative attitude (NEG). The drop-out rate was 8%. NEG participants lost significantly more body weight than the POS participants (intention-to-treat population: 4.5 [SD: 6.3] kg versus 0.4 [SD: 5.8] kg; p < 0.001). In both subgroups, anxiety, depression, the mental score for quality of life, and eating behaviour improved. CONCLUSION A BWL treatment in a clinical setting identified 2 distinct groups with different attitudes towards bariatric surgery that were associated with different body weight change outcomes. These groups may require differently targeted programmes to achieve the best body weight loss results.
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Affiliation(s)
- Kerstin Bauer
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany,
| | - Sandra Schild
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Helene Sauer
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Martin Teufel
- LVR-Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, Essen, Germany
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- Department for Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charité Center for Internal Medicine and Dermatology, Berlin, Germany
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Philipp Schellhorn
- Department of Sports Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Magdeburg, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Andreas Nieß
- Department of Sports Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
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25
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Pearl RL, Wadden TA, Chao AM, Walsh O, Alamuddin N, Berkowitz RI, Tronieri JS. Weight Bias Internalization and Long-Term Weight Loss in Patients With Obesity. Ann Behav Med 2020; 53:782-787. [PMID: 30304382 DOI: 10.1093/abm/kay084] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The relationship between weight bias internalization (WBI) and long-term weight loss is largely unknown. PURPOSE To determine the effects of weight loss on WBI and assess whether WBI impairs long-term weight loss. METHODS One hundred thirty-three adults with obesity completed the Weight Bias Internalization Scale (WBIS) at baseline, after a 14-week lifestyle intervention in which they lost ≥5 per cent of initial weight, and at weeks 24 and 52 of a subsequent randomized controlled trial (RCT) for weight-loss maintenance (66 weeks total). Linear mixed models were used to examine the effects of weight loss on WBIS scores and the effects of baseline WBIS scores on weight change over time. Logistic regression was used to determine the effects of baseline WBIS scores on achieving ≥5 and ≥10 per cent weight loss. RESULTS Changes in weight did not predict changes in WBIS scores. Baseline WBIS scores predicted reduced odds of achieving ≥5 and ≥10 per cent weight loss at week 24 of the RCT (p values < .05). At week 52, the interaction between participant race and WBIS scores predicted weight loss (p = .046) such that nonblack (but not black) participants with higher baseline WBIS scores had lower odds of achieving ≥10 per cent weight loss (OR = 0.38, p = .01). Baseline WBIS scores did not significantly predict rate of weight change over time. CONCLUSIONS Among participants in a weight loss maintenance trial, WBI did not change in relation to changes in weight. More research is needed to clarify the effects of WBI on long-term weight loss and maintenance across race/ethnicity. CLINICAL TRIALS REGISTRATION ClinicalTrials.gov identifier NCT02388568.
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Affiliation(s)
- Rebecca L Pearl
- Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.,Department of Surgery, Edwin and Fannie Gray Hall Center for Human Appearance, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Thomas A Wadden
- Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Ariana M Chao
- Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.,Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, PA
| | - Olivia Walsh
- Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Naji Alamuddin
- Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.,Department of Medicine, Institute for Diabetes, Obesity, and Metabolism, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Robert I Berkowitz
- Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.,Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, PA
| | - Jena Shaw Tronieri
- Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
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26
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Cresci B, Cosentino C, Monami M, Mannucci E. Metabolic surgery for the treatment of type 2 diabetes: A network meta-analysis of randomized controlled trials. Diabetes Obes Metab 2020; 22:1378-1387. [PMID: 32243058 DOI: 10.1111/dom.14045] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/27/2020] [Accepted: 03/27/2020] [Indexed: 12/15/2022]
Abstract
AIM To compare different types of metabolic surgery (MS) with medical therapy (MT) for the treatment of type 2 diabetes (T2D). MATERIALS AND METHODS We conducted a network-meta-analysis (NMA) including randomized clinical trials comparing different MS techniques versus MT in people with T2D, with a duration of ≥24 weeks. Primary endpoints were glycated haemoglobin (HbA1c), fasting plasma glucose (FPG) and diabetes remission. Indirect comparisons of different types of surgery were performed by NMA. Mean and 95% confidence intervals for continuous variables, and Mantel-Haenzel odds ratios for categorial variables, were calculated using random effect models. Types of MS included: laparoscopic adjustable gastric banding (LAGB), Roux-en-Y gastric bypass, sleeve gastrectomy (SG), bilio-pancreatic diversion (BPD); greater curvature plication (GCP); one-anastomosis gastric bypass (OAGB); and duodenojejunal bypass. RESULTS The 24 retrieved trials included 1351 patients (1014 with MS and 337 with MT). The mean baseline BMI was 36.8 kg/m2 . MS was associated with significantly greater reductions in HbA1c and FPG and greater diabetes remission when compared to MT. In the NMA, a significant reduction in HbA1c was observed with OAGB and SG. All surgical procedures were associated with a significant increase in diabetes remission, except GCP and LAGB. All procedures were associated with a reduction of body mass index (BMI). CONCLUSIONS Metabolic surgery is an interesting option for the treatment of T2D, although further data are needed to demonstrate its long-term efficacy and safety. Present data are not sufficient to modify current recommendations, which consider MS a possible treatment for T2D in those with a BMI >35 kg/m2 .
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Affiliation(s)
| | | | | | - Edoardo Mannucci
- Diabetology, Careggi Hospital, Florence, Italy
- University of Florence, Florence, Italy
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27
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Tate DF, Quesnel DA, Lutes L, Hatley KE, Nezami BT, Wojtanowski AC, Pinto AM, Power J, Diamond M, Polzien K, Foster G. Examination of a partial dietary self-monitoring approach for behavioral weight management. Obes Sci Pract 2020; 6:353-364. [PMID: 32874670 PMCID: PMC7448156 DOI: 10.1002/osp4.416] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 02/18/2020] [Accepted: 02/21/2020] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Dietary self-monitoring in behavioral weight loss programmes traditionally involves keeping track of all foods and beverages to achieve a calorie deficit. While effective, adherence declines over time. WW™ (formerly Weight Watchers), a widely available commercial weight management programme, sought to pilot an approach that permitted participants to consume over 200 foods without monitoring them. METHODS The current study used a pre-post evaluation design with anthropometric, psychosocial and physical health assessments at baseline, 3 and 6 months. RESULTS Participants (N = 152) were, on average, 48.4 (±12.3) years old, with body mass index (BMI) of 32.8 (±4.8) m/kg2 and 94% female. Mean weight loss was 6.97 + 5.55 kg or 7.9 ± 6.1% of initial body weight (ps < .0001) at 6 months. One third (32.6%) of the sample lost 10% or more of initial body weight. Significant improvements in hunger, cravings, happiness, sleep, quality of life, aerobic stamina, flexibility and blood pressure were observed. Attendance at group meetings, as well as decreases in hunger, and fast food cravings from baseline to 3 months were associated with achieving 10% weight loss at 6 months (p < .01). CONCLUSIONS Using an approach that does not require self-monitoring of all foods and beverages produced significant weight losses and other physical and psychosocial improvements.
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Affiliation(s)
- Deborah F. Tate
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Department of Health BehaviorUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- WWNew YorkNYUSA
| | - Danika A. Quesnel
- Department of PsychologyUniversity of British Columbia, Okanagan CampusKelownaBritish ColumbiaCanada
| | - Lesley Lutes
- Department of PsychologyUniversity of British Columbia, Okanagan CampusKelownaBritish ColumbiaCanada
| | - Karen E. Hatley
- Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Brooke T. Nezami
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | | | | | - Julianne Power
- Department of Health BehaviorUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Molly Diamond
- Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Kristen Polzien
- Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Gary Foster
- WWNew YorkNYUSA
- Center for Weight and Eating Disorders, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
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Gryth K, Persson C, Näslund I, Sundbom M, Näslund E, Stenberg E. The Influence of Socioeconomic Factors on Quality-of-Life After Laparoscopic Gastric Bypass Surgery. Obes Surg 2020; 29:3569-3576. [PMID: 31190262 DOI: 10.1007/s11695-019-04028-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Patients with low socioeconomic status have been reported to experience poorer outcome after several types of surgery. The influence of socioeconomic factors on health-related quality-of-life (HRQoL) after bariatric surgery is unclear. MATERIALS AND METHODS Patients operated with a primary laparoscopic gastric bypass procedure in Sweden between 2007 and 2015 were identified in the Scandinavian Obesity Surgery Register. Patients with a completed assessment of health-related quality-of-life based on the Obesity-related Problem Scale (OP Scale) were included in the study. Socioeconomic status was based on data from Statistics Sweden. RESULTS A total of 13,723 patients (32% of the 43,096 operated during the same period), with complete OP scores at baseline and two years after surgery, were included in the study. Age, lower preoperative BMI, male gender, higher education, professional status and disposable income as well as not receiving social benefits (not including retirement pension), and not a first- or second-generation immigrant, were associated with a higher postoperative HRQoL. Patients aged 30-60 years, with lower BMI, higher socioeconomic status, women and those born in Sweden by Swedish parents experienced a higher degree of improvement in HRQoL. Postoperative weight-loss was associated with higher HRQoL (unadjusted B 16.3, 95%CI 14.72-17.93, p < 0.0001). CONCLUSION At 2 years, a strong association between weight loss and improvement in HRQoL was seen, though several factors influenced the degree of improvement. Age, sex, preoperative BMI and socioeconomic status all influence the postoperative HRQoL as well as the improvement in HRQoL after laparoscopic gastric bypass surgery.
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Affiliation(s)
- Karin Gryth
- Department of Surgery, Faculty of Medicine and Health, Örebro University Hospital, SE-701 85, Örebro, Sweden
| | - Carina Persson
- Department of Community Medicine and Public Health, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department for Sustainable Development, Region Örebro County, Örebro, Sweden
| | - Ingmar Näslund
- Department of Surgery, Faculty of Medicine and Health, Örebro University Hospital, SE-701 85, Örebro, Sweden
| | - Magnus Sundbom
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Erik Näslund
- Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Erik Stenberg
- Department of Surgery, Faculty of Medicine and Health, Örebro University Hospital, SE-701 85, Örebro, Sweden.
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A 5-Year Follow-up in Children and Adolescents Undergoing One-Anastomosis Gastric Bypass (OAGB) at a European IFSO Excellence Center (EAC-BS). Obes Surg 2020; 29:2739-2744. [PMID: 31049849 DOI: 10.1007/s11695-019-03908-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND The children and adolescent population with obesity has increased worldwide, both in developing areas and in developed countries. Consequently, the prevalence of morbid obesity among this population has also increased, leading to an exponential growth of bariatric approaches in this population. Many surgeons fear eventual nutritional sequelae after malabsorptive approaches and prefer restrictive or mixed procedures. METHODS A retrospective review of all the morbidly obese patients between 13 and 19 years, undergoing a one-anastomosis gastric bypass (OAGB) as bariatric procedure between 2004 and 2012, was performed. RESULTS A total of 39 patients were included, 8 males (20.5%) and 31 females (79.5%), with a mean age of 17.8 ± 2 years (range 13-19 years). Mean preoperative weight was 114.3 ± 20.4 kg and mean BMI 42.2 ± 5.9 kg/m2. Preoperative comorbidities include only type 2 diabetes mellitus (T2DM) in 7.9% of the patients, hypertension in 10.3%, and dyslipidemia in 23.1%. Five years after surgery, mean BMI was 25.9 ± 5.3 kg/m2 and total weight loss 32.1 ± 15.7%. Remission rate of T2DM, hypertension and dyslipidemia was 100%. All the patients received multivitamin and vitamin D supplementation. Anemia secondary to iron deficiency occurred in one female, requiring intravenous iron supplementation during 1 year and later on oral supplementation. CONCLUSIONS OAGB is a valid alternative for long-term weight loss and remission of comorbidities in childhood and adolescence. No cases of malnutrition or growth disorders were observed.
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Changes in weight and weight-related quality of life in a multicentre, randomized trial of aripiprazole versus standard of care. Eur Psychiatry 2020; 23:561-6. [PMID: 18374544 DOI: 10.1016/j.eurpsy.2008.01.1421] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2007] [Revised: 01/28/2008] [Accepted: 01/28/2008] [Indexed: 11/23/2022] Open
Abstract
AbstractBackgroundThis is a secondary analysis of clinical trial data collected in 12 European countries. We examined changes in weight and weight-related quality of life among community patients with schizophrenia treated with aripiprazole (ARI) versus standard of care (SOC), consisting of other marketed atypical antipsychotics (olanzapine, quetiapine, and risperidone).MethodFive-hundred and fifty-five patients whose clinical symptoms were not optimally controlled and/or experienced tolerability problems with current medication were randomized to ARI (10–30 mg/day) or SOC. Weight and weight-related quality of life (using the IWQOL-Lite) were assessed at baseline, and weeks 8, 18 and 26. Random regression analysis across all time points using all available data was used to compare groups on changes in weight and IWQOL-Lite. Meaningful change from baseline was also assessed.ResultsParticipants were 59.7% male, with a mean age of 38.5 years (SD 10.9) and mean baseline body mass index of 27.2 (SD 5.1). ARI participants lost an average of 1.7% of baseline weight in comparison to a gain of 2.1% by SOC participants (p < 0.0001) at 26 weeks. ARI participants experienced significantly greater increases in physical function, self-esteem, sexual life, and IWQOL-Lite total score. At 26 weeks, 20.7% of ARI participants experienced meaningful improvements in IWQOL-Lite score, versus 13.5% of SOC participants. A clinically meaningful change in weight was also associated with a meaningful change in quality of life (p < 0.001). A potential limitation of this study was its funding by a pharmaceutical company.ConclusionsCompared to standard of care, patients with schizophrenia treated with aripiprazole experienced decreased weight and improved weight-related quality of life over 26 weeks. These changes were both statistically and clinically significant.
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Reinelt T, Petermann F, Bauer F, Bauer CP. Emotion regulation strategies predict weight loss during an inpatient obesity treatment for adolescents. Obes Sci Pract 2020; 6:293-299. [PMID: 32523718 PMCID: PMC7278908 DOI: 10.1002/osp4.410] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 01/09/2020] [Accepted: 02/04/2020] [Indexed: 01/10/2023] Open
Abstract
Objective Weight loss during an inpatient obesity treatment is an important predictor of subsequent weight maintenance. However, psychological factors influencing weight loss are not well established. Psychological models suggest some importance of executive functioning and emotion regulation strategies. Therefore, this study investigated whether these factors predict weight loss during an inpatient obesity treatment and whether this effect holds after controlling for general personal and treatment characteristics. Method A total of 158 adolescents with diagnosed obesity underwent inpatient obesity treatment at a German rehabilitation clinic. Psychological factors (executive functioning and emotion regulation) were measured at admission and used to predict BMI reduction after treatment completion. Results More frequent use of reappraisal as an emotion regulation strategy, but not suppression or executive functioning, predicted weight loss at the end of the obesity treatment, even after controlling for age, gender, treatment duration, and BMI at admission. Conclusion Functional emotion regulation strategies, like reappraisal, might offer an additional target for obesity treatment programmes, complementary to the more traditional components of psychoeducation, physical activity, and caloric restriction.
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Affiliation(s)
- Tilman Reinelt
- Center for Clinical Psychology and Rehabilitation University of Bremen Bremen Germany
| | - Franz Petermann
- Center for Clinical Psychology and Rehabilitation University of Bremen Bremen Germany
| | - Florian Bauer
- Clinic for Paediatrics and Adolescent Medicine at the Klinikum Harlaching Klinikum München Munich Germany
| | - Carl-Peter Bauer
- Clinic for Pediatrics at the Klinikum Schwabing Technical University Munich Munich Germany.,Fachklinik Gaißach Germany
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Muralidharan A, Brown CH, Zhang Y, Niv N, Cohen AN, Kreyenbuhl J, Oberman RS, Goldberg RW, Young AS. Quality of life outcomes of web-based and in-person weight management for adults with serious mental illness. J Behav Med 2019; 43:865-872. [PMID: 31741204 DOI: 10.1007/s10865-019-00117-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 11/02/2019] [Indexed: 10/25/2022]
Abstract
Adults with serious mental illness have high rates of obesity, with associated negative impacts on health-related quality of life. The present study utilized data from a randomized controlled trial (N = 276) to examine the effectiveness of in-person and online-delivered weight management interventions, compared to usual care, for improving health-related quality of life in this population. Participants completed quality of life assessments at baseline, 3 months, and 6 months. Mixed effects models examined group by time interactions. Compared to usual care, in-person MOVE was associated with improvements in loneliness (t = - 2.76, p = .006) and mental health related quality of life (t = 1.99, p = 0.048) at 6 months, and webMOVE was associated with improvements in weight-related self-esteem at 6 months (t = 2.23, p = .026) and mental health-related quality of life at 3 months (t = 2.17, p = 0.031) and 6 months (t = 2.38, p = .018). Web-based and in-person weight management led to improvements in health-related quality of life for adults with serious mental illness.ClinicalTrials.gov Identifier: NCT00983476.
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Affiliation(s)
- Anjana Muralidharan
- Veterans Affairs (VA) Capitol Health Care Network (VISN 5), Mental Illness, Research, Education, and Clinical Center (MIRECC), Baltimore, MD, USA. .,Division of Psychiatric Services Research, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Clayton H Brown
- Veterans Affairs (VA) Capitol Health Care Network (VISN 5), Mental Illness, Research, Education, and Clinical Center (MIRECC), Baltimore, MD, USA.,Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Yilin Zhang
- Division of Psychiatric Services Research, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Noosha Niv
- Veterans Affairs Desert Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Long Beach, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Amy N Cohen
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA.,VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Julie Kreyenbuhl
- Veterans Affairs (VA) Capitol Health Care Network (VISN 5), Mental Illness, Research, Education, and Clinical Center (MIRECC), Baltimore, MD, USA.,Division of Psychiatric Services Research, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Richard W Goldberg
- Veterans Affairs (VA) Capitol Health Care Network (VISN 5), Mental Illness, Research, Education, and Clinical Center (MIRECC), Baltimore, MD, USA.,Division of Psychiatric Services Research, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Alexander S Young
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA.,VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
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Kolotkin RL, Williams VSL, Ervin CM, Williams N, Meincke HH, Qin S, von Huth Smith L, Fehnel SE. Validation of a new measure of quality of life in obesity trials: Impact of Weight on Quality of Life-Lite Clinical Trials Version. Clin Obes 2019; 9:e12310. [PMID: 30993900 PMCID: PMC6593657 DOI: 10.1111/cob.12310] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/25/2019] [Accepted: 03/22/2019] [Indexed: 12/17/2022]
Abstract
The Impact of Weight on Quality of Life-Lite (IWQOL-Lite) is widely used in evaluations of weight-loss interventions, including pharmaceutical trials. Because this measure was developed using input from individuals undergoing intensive residential treatment, the IWQOL-Lite may include concepts not relevant to clinical trial populations and may be missing concepts that are relevant to these populations. An alternative version, the IWQOL-Lite Clinical Trials Version (IWQOL-Lite-CT), was developed and validated according to the US Food and Drug Administration's (FDA's) guidance on patient-reported outcomes. Psychometric analyses were conducted to validate the IWQOL-Lite-CT using data from two randomized trials (NCT02453711 and NCT02906930) that included individuals with overweight/obesity, with and without type 2 diabetes. Additional measures included the SF-36, global items, weight and body mass index. The IWQOL-Lite-CT is a 20-item measure with two primary domains (Physical [seven items] and Psychosocial [13 items]). A five-item Physical Function composite and Total score were also supported. Cronbach's alpha and intraclass correlation coefficients exceeded 0.77 at each time point; patterns of construct validity correlations were consistent with hypotheses; and scores demonstrated treatment benefit. The IWQOL-Lite-CT is appropriate for assessing weight-related physical and psychosocial functioning in populations commonly targeted for obesity clinical trials. Qualification from the FDA is being sought for use of the IWQOL-Lite-CT in clinical trials to support product approval and labelling claims.
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Affiliation(s)
- Ronette L. Kolotkin
- Quality of Life Consulting, PLLCDurhamNorth Carolina
- Department of Family Medicine and Community HealthDuke University School of MedicineDurhamNorth Carolina
- Faculty of Health and Social Sciences, Western Norway University of Applied SciencesFørdeNorway
- Centre of Health ResearchFørde Hospital TrustFørdeNorway
- Morbid Obesity CentreVestfold Hospital TrustTønsbergNorway
| | - Valerie S. L. Williams
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsResearch Triangle ParkNorth Carolina
| | - Claire M. Ervin
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsResearch Triangle ParkNorth Carolina
| | - Nicole Williams
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsResearch Triangle ParkNorth Carolina
| | - Henrik H. Meincke
- Health Economics and Outcomes Research, Novo Nordisk A/SSøborgDenmark
| | - Shanshan Qin
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsResearch Triangle ParkNorth Carolina
| | | | - Sheri E. Fehnel
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsResearch Triangle ParkNorth Carolina
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Khammassi M, Miguet M, O'Malley G, Fillon A, Masurier J, Damaso AR, Pereira B, Lambert C, Duclos M, Courteix D, Boirie Y, Thivel D. Health-related quality of life and perceived health status of adolescents with obesity are improved by a 10-month multidisciplinary intervention. Physiol Behav 2019; 210:112549. [PMID: 31082444 DOI: 10.1016/j.physbeh.2019.05.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 04/09/2019] [Accepted: 05/09/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Although multidisciplinary weight management interventions have been shown effective in improving body composition and cardio-respiratory fitness, their effects on HRQOL and perceived health status remain uncertain in adolescents with obesity. OBJECTIVE To assess the impact of a 10-month multidisciplinary weight management intervention on HRQOL and health perception in adolescents with obesity, exploring whether these changes were associated with changes in body weight and body composition. METHODS Thirty-six adolescents with obesity (28 girls and 8 boys; mean age: 13 ± 1.32 years) enrolled in a multidisciplinary weight management intervention composed of nutritional counseling, physical activity and health-related therapeutic education. Validated self-report questionnaires were used to assess HRQOL (SF-36) and health perception (HP questionnaire) at baseline (T0) after5 months (T1) and after 10 month of intervention (T2). In addition, anthropometric parameters and body composition (DXA) were measured at T0, T1 and T2. RESULTS Items of the SF-36 significantly improved at T1 and T2, such as physical functioning (P < .01), general health (P < .01), physical (P < .001) and mental score (T1: P < .05, T2: P < .01). Dimensions of health perception improved significantly such as physical condition (P < .01 at T2), adiposity (P < .001 at T1 and T2), healthy balanced diet (P < .01 at T1 and P < .001 at T2), general health (P < .05), and perceived general health (T1: P < .01, T2: P < .001). Body weight, BMI, and fat mass (in Kg and in %) were significantly decreased (P < .001) at T1 and T2. No relationship was observed between variations of weight, BMI and Fat mass and variations of HRQOL and health perception. CONCLUSION A 10-month multidisciplinary weight-management intervention was associated with positive changes in HRQOL and perceived health status, which might not be explained by body weight and adiposity improvements.
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Affiliation(s)
- Marwa Khammassi
- Clermont Auvergne University, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand EA 3533, France; Research Unit, Sportive Performance and Physical Rehabilitation, High Institute of Sports and Physical Education of Kef, University of Jendouba, Kef, Tunisia; Faculty of Science of Bizerte, University of Carthage, 7021 Zarzouna, Bizerte, Tunisia.
| | - Maud Miguet
- Clermont Auvergne University, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand EA 3533, France
| | - Grace O'Malley
- Division of Population Health Sciences, Royal College of Surgeons of Ireland, Childhood Obesity Service, Temple Street Children's University Hospital, Dublin 1, Ireland
| | - Alicia Fillon
- Clermont Auvergne University, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand EA 3533, France; INRA, UMR 1019, Clermont-Ferrand, France
| | - Julie Masurier
- UGECAM Nutrition Obesity Ambulatory Hospital, Clermont-Ferrand, France
| | - Ana R Damaso
- Program of Nutrition, Paulista Medicine School, Universidade Federal de São Paulo (UNIFESP), Rua Botucatu, 862-Vila Clementino, São Paulo, SP 04020-050, Brazil
| | - Bruno Pereira
- Clermont-Ferrand University Hospital, Biostatistics unit (DRCI), Clermont-Ferrand, France
| | - Céline Lambert
- Clermont-Ferrand University Hospital, Biostatistics unit (DRCI), Clermont-Ferrand, France
| | - Martine Duclos
- INRA, UMR 1019, Clermont-Ferrand, France; Department of Sport Medicine and Functional Explorations, Clermont-Ferrand University Hospital, G. Montpied Hospital, Clermont-Ferrand, France; CRNH-Auvergne, Clermont-Ferrand, France; University Clermont 1, UFR Medicine, Clermont-Ferrand, France
| | - Daniel Courteix
- Clermont Auvergne University, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand EA 3533, France; CRNH-Auvergne, Clermont-Ferrand, France
| | - Yves Boirie
- INRA, UMR 1019, Clermont-Ferrand, France; CRNH-Auvergne, Clermont-Ferrand, France; University Clermont 1, UFR Medicine, Clermont-Ferrand, France; Department of Human Nutrition, Clermont-Ferrand University Hospital, G. Montpied Hospital, Clermont-Ferrand, France
| | - David Thivel
- Clermont Auvergne University, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand EA 3533, France; CRNH-Auvergne, Clermont-Ferrand, France
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Lillis J, Thomas JG, Olson K, Wing RR. Weight self-stigma and weight loss during behavioural weight loss intervention. Obes Sci Pract 2019; 5:21-27. [PMID: 30847224 PMCID: PMC6381303 DOI: 10.1002/osp4.314] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 11/21/2018] [Accepted: 11/24/2018] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE Despite the myriad negative effects of weight self-stigma, its role in weight loss intervention has not been thoroughly examined. The aim of this study was to examine the association between weight self-stigma and weight loss. METHODS This longitudinal study examined the association between weight loss and changes in self-stigma, assessed by the Weight Self-Stigma Questionnaire, which distinguished between self-devaluation and fear of enacted stigma. Participants were adults with overweight or obesity enrolled in a 24-month weight loss intervention trial (groups were collapsed for this post hoc analysis) who were assessed at baseline, 6, 12, 18 and 24 months. RESULTS Baseline levels of self-stigma were not associated with weight loss outcomes. However, mixed models analysis showed that reductions in one aspect of weight self-stigma, self-devaluation, was associated with greater weight loss (p = 0.01). Cross products mediation analysis showed that increases in use of weight control strategies mediated the association between reductions in self-devaluation and greater weight loss (F = 14.86, p < 0.001; CI 0.09-0.37). CONCLUSIONS Results suggest that there may be potential for incorporating intervention methods targeting the reduction of self-stigma in order to improve weight loss outcomes.
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Affiliation(s)
- J. Lillis
- Department of Psychiatry and Human BehaviorAlpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research CenterProvidenceRIUSA
| | - J. G. Thomas
- Department of Psychiatry and Human BehaviorAlpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research CenterProvidenceRIUSA
| | - K. Olson
- Department of Psychiatry and Human BehaviorAlpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research CenterProvidenceRIUSA
| | - R. R. Wing
- Department of Psychiatry and Human BehaviorAlpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research CenterProvidenceRIUSA
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Ahmed HO, Ezzat RF. Quality of life of obese patients after treatment with the insertion of intra-gastric balloon versus Atkins diet in Sulaimani Governorate, Kurdistan Region, Iraq. Ann Med Surg (Lond) 2019; 37:42-46. [PMID: 30622706 PMCID: PMC6304342 DOI: 10.1016/j.amsu.2018.11.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 11/18/2018] [Accepted: 11/19/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Health-related quality of life of obese patients, before and after weight loss by insertion of BioEnterics Intra-gastric Balloon is studied widely. But the quality of life not related to comorbidity of the obese patients like mood, satisfaction with relationships, achieved goals, self-concepts, and self-perceived ability to cope with one's daily life is not studied on a wide scale. AIM To evaluates the effect of the obesity on different aspects of life, and to evaluate the influence of weight loss after BIB insertion or Atkins diet on the quality of life regarding mood, satisfaction with relationships, achieved goals, self-concepts, and self-perceived ability to cope with one's daily life. PATIENTS MATERIALS AND METHODS A prospective randomized study, from a total of 180 patients, 80 patients were selected to enroll in the work, over a period of 4 years from 2008 to 2012 in Hatwan private hospital and the private clinic, the closing date was 1st January 2013.Approval for the current work was obtained from the Ethics Committee of University, College of Medicine. The work has been reported in line with the STROCSS criteria. The study was designed as a descriptive longitudinal study conducted on 40 patients who underwent intra-gastric balloon insertion compared to a matched group (for age, BMI) of 40 patients on Atkin's diet. RESULTS Two comparable groups of obese patients were studied, each group consists of 40 female patients, mean age in group A was 27 years (20-39 years) with mean body weight 90 kg (80-100) and mean body mass index 36 (31-39.9) who were treated with insertion of BIB. While mean age in group B was 29 years (20-39 years) with mean body weight 91 kg (80-102) and mean body mass index 36.5 (31-39.9). Statistically important changes occurred in the quality of life of the patients after either method of treatments to different degrees (p-value 0.005917). CONCLUSION The patients lost more weight after insertion of intra-gastric balloon up to 35 kg of body weight, while the patients on Atkins diet lost up to 20 kg body weight. This results in statistically significant improvement of most aspects of QOL. Especially in Feeling happier, more satisfaction with the new body image, Improvement of self-esteem, encouraged for more regular exercises, less nervous, embarrassed less by unimportant matters, have less negative thoughts, and the craving of foods decreased remarkably.
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Affiliation(s)
- Hiwa Omer Ahmed
- Professor in Metabolic and Bariatric Surgery, Senior Lecturer in College of Medicine, University of Sulaimani, Manager of Hospital for Endoscopic and Bariatric Surgery, Sulaimani City, Kurdistan, Iraq
| | - Rajan Fuad Ezzat
- General Surgeon, Suliamani Teaching Hospital, Sulaimani City, Kurdistan, Iraq
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Chu IJH, Lim AYT, Ng CLW. Effects of meaningful weight loss beyond symptomatic relief in adults with knee osteoarthritis and obesity: a systematic review and meta-analysis. Obes Rev 2018; 19:1597-1607. [PMID: 30051952 DOI: 10.1111/obr.12726] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 05/24/2018] [Accepted: 06/04/2018] [Indexed: 12/31/2022]
Abstract
Existing clinical guidelines recommend weight loss for adults with knee osteoarthritis and obesity, but the supporting evidence to date remains inadequate. There is also no pooled data on physical function and quality of life. This study aims to examine the efficacy of weight loss on pain, self-reported disability, physical function and quality of life in adults with knee osteoarthritis and obesity. A systematic database search (from 1990 to June 2017) was conducted, and seven studies were eligible for inclusion. The meta-analyses demonstrated that a 5% to 10% weight loss significantly improved pain (effect size 0.33, 95% confidence intervals 0.17 to 0.48), self-reported disability (effect size 0.42, 95% confidence intervals 0.25 to 0.59) and quality of life (physical) (effect size 0.39, 95% confidence intervals 0.24 to 0.54). The results were based on adults with mean body mass index 33.6 to 36.4 kg m-2 and mild to moderate knee osteoarthritis. Results for physical function were inconclusive due to the lack of eligible studies and incomprehensive outcome measures used.
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Affiliation(s)
- I J H Chu
- Department of Physiotherapy, Singapore General Hospital, Singapore
| | - A Y T Lim
- Department of Physiotherapy, Singapore General Hospital, Singapore
| | - C L W Ng
- Department of Physiotherapy, Singapore General Hospital, Singapore
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James BL, Loken E, Roe LS, Myrissa K, Lawton CL, Dye L, Rolls BJ. Validation of the Diet Satisfaction Questionnaire: a new measure of satisfaction with diets for weight management. Obes Sci Pract 2018; 4:506-514. [PMID: 30574344 PMCID: PMC6298208 DOI: 10.1002/osp4.299] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 08/06/2018] [Accepted: 08/26/2018] [Indexed: 01/22/2023] Open
Abstract
Objective The Diet Satisfaction Questionnaire was developed to fill the need for a validated measure to evaluate satisfaction with weight‐management diets. This paper further develops the questionnaire, examining the factor structure of the original questionnaire, cross‐validating a revised version in a second sample and relating diet satisfaction to weight loss during a 1‐year trial. Methods The 45‐item Diet Satisfaction Questionnaire (DSat‐45) uses seven scales to assess characteristics that influence diet satisfaction: Healthy Lifestyle, Convenience, Cost, Family Dynamics, Preoccupation with Food, Negative Aspects, and Planning and Preparation. It was administered five times during a 1‐year weight‐loss trial (n = 186 women) and once as an online survey in a separate sample (n = 510 adults). Confirmatory factor analysis was used to assess and refine the DSat‐45 structure, and reliability and validity data were examined in both samples for the revised questionnaire, the DSat‐28. Associations were examined between both DSat questionnaires and weight loss in the trial. Results Internal consistency (reliability) was moderate for the DSat‐45. Confirmatory factor analysis showed improved fit for a five‐factor structure, resulting in the DSat‐28 that retained four of the original scales and a shortened fifth scale. This revised questionnaire was reliable in both samples. Weight loss across the year‐long trial was positively related to satisfaction with Healthy Lifestyle, Preoccupation with Food, and Planning and Preparation in both versions of the questionnaire. Conclusions Measures of reliability and validity were improved in the more concise DSat‐28 compared to the DSat‐45. This shorter measure should be used in future work to evaluate satisfaction with weight‐management diets.
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Affiliation(s)
- B L James
- Department of Nutritional Sciences The Pennsylvania State University, University Park PA USA
| | - E Loken
- Department of Human Development and Family Studies The Pennsylvania State University, University Park PA USA
| | - L S Roe
- Department of Nutritional Sciences The Pennsylvania State University, University Park PA USA
| | - K Myrissa
- Human Appetite Research Unit (Nutrition and Behaviour Research Group), School of Psychology University of Leeds Leeds UK
| | - C L Lawton
- Human Appetite Research Unit (Nutrition and Behaviour Research Group), School of Psychology University of Leeds Leeds UK
| | - L Dye
- Human Appetite Research Unit (Nutrition and Behaviour Research Group), School of Psychology University of Leeds Leeds UK
| | - B J Rolls
- Department of Nutritional Sciences The Pennsylvania State University, University Park PA USA
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Factors driving continued use of online health promotion competitions. ONLINE INFORMATION REVIEW 2018. [DOI: 10.1108/oir-02-2017-0047] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Gamification elements have been increasingly used in online weight-loss communities to help users lose weight. The purpose of this paper is to systemically examine whether and how social interactions influence users’ continued participation in the context of online weight-loss competitions (OWCs).
Design/methodology/approach
This study empirically investigated sustained involvement in OWCs using a Cox proportional hazards model. Additionally, the research utilized a text-mining technique to identify various types of social support and explored their roles in sustaining participation behavior in OWCs.
Findings
Community response both within and outside OWCs positively influence users’ continued participation in OWCs. Moreover, whereas emotional support and companionship received within OWCs have a greater impact on users’ continued participation than informational support received within OWCs, informational support received outside OWCs has a greater impact on users’ continued participation than emotional support and companionship received outside OWCs.
Originality/value
This paper highlights users’ social needs in OWC engagement and provides empirical evidence on how different types and sources of social support influence continued participation behavior in OWCs. The research additionally provides management implications for online health community service providers.
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Pearl RL, Wadden TA, Tronieri JS, Berkowitz RI, Chao AM, Alamuddin N, Leonard SM, Carvajal R, Bakizada ZM, Pinkasavage E, Gruber KA, Walsh OA, Alfaris N. Short- and Long-Term Changes in Health-Related Quality of Life with Weight Loss: Results from a Randomized Controlled Trial. Obesity (Silver Spring) 2018; 26:985-991. [PMID: 29676530 PMCID: PMC5970047 DOI: 10.1002/oby.22187] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 03/12/2018] [Accepted: 03/13/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The objective of this study was to determine the effects of weight loss and weight loss maintenance (WLM) on weight-specific health-related quality of life in a 66-week trial. METHODS Adults with obesity (N = 137, 86.1% female, 68.6% black, mean age = 46.1 years) who had lost ≥ 5% of initial weight in a 14-week intensive lifestyle intervention/low-calorie diet (LCD) program were randomly assigned to lorcaserin or placebo for an additional 52-week WLM program. The Impact of Weight on Quality of Life-Lite (IWQOL-Lite) scale (including five subscales), Patient Health Questionnaire-9 (depression), and Perceived Stress Scale were administered at the start of the 14-week LCD program, randomization, and week 52 of the randomized controlled trial (i.e., 66 weeks total). RESULTS Significant improvements in all outcomes, except weight-related public distress, were found following the 14-week LCD program (P values < 0.05). Improvements were largely maintained during the 52-week randomized controlled trial, despite weight regain of 2.0 to 2.5 kg across treatment groups. Participants who lost ≥ 10% of initial weight achieved greater improvements in physical function, self-esteem, sexual life, and the IWQOL-Lite total score than those who lost < 5% and did not differ from those who lost 5% to 9.9%. CONCLUSIONS Improvements in weight-specific health-related quality of life were achieved with moderate weight loss and were sustained during WLM.
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Affiliation(s)
- Rebecca L. Pearl
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
- Edwin & Fannie Gray Hall Center for Human Appearance, Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Thomas A. Wadden
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Jena Shaw Tronieri
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Robert I. Berkowitz
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, PA
| | - Ariana M. Chao
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
- Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, PA
| | - Naji Alamuddin
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
- Institute for Diabetes, Obesity, and Metabolism, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Sharon M. Leonard
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Ray Carvajal
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Zayna M. Bakizada
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Emilie Pinkasavage
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Kathryn A. Gruber
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Olivia A. Walsh
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
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Chouillard E, Alsabah S, Chahine E, Saikaly E, Debs T, Kassir R. Changing the quality of life in old age bariatric patients. Cross-sectional study for 79 old age patients. Int J Surg 2018; 54:236-241. [DOI: 10.1016/j.ijsu.2018.04.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 04/05/2018] [Accepted: 04/28/2018] [Indexed: 01/17/2023]
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Dontje ML, Dall PM, Skelton DA, Gill JMR, Chastin SFM. Reliability, minimal detectable change and responsiveness to change: Indicators to select the best method to measure sedentary behaviour in older adults in different study designs. PLoS One 2018; 13:e0195424. [PMID: 29649234 PMCID: PMC5896945 DOI: 10.1371/journal.pone.0195424] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Accepted: 02/26/2018] [Indexed: 12/03/2022] Open
Abstract
Introduction Prolonged sedentary behaviour (SB) is associated with poor health. It is unclear which SB measure is most appropriate for interventions and population surveillance to measure and interpret change in behaviour in older adults. The aims of this study: to examine the relative and absolute reliability, Minimal Detectable Change (MDC) and responsiveness to change of subjective and objective methods of measuring SB in older adults and give recommendations of use for different study designs. Methods SB of 18 older adults (aged 71 (IQR 7) years) was assessed using a systematic set of six subjective tools, derived from the TAxonomy of Self report Sedentary behaviour Tools (TASST), and one objective tool (activPAL3c), over 14 days. Relative reliability (Intra Class Correlation coefficients-ICC), absolute reliability (SEM), MDC, and the relative responsiveness (Cohen’s d effect size (ES) and Guyatt’s Responsiveness coefficient (GR)) were calculated for each of the different tools and ranked for different study designs. Results ICC ranged from 0.414 to 0.946, SEM from 36.03 to 137.01 min, MDC from 1.66 to 8.42 hours, ES from 0.017 to 0.259 and GR from 0.024 to 0.485. Objective average day per week measurement ranked as most responsive in a clinical practice setting, whereas a one day measurement ranked highest in quasi-experimental, longitudinal and controlled trial study designs. TV viewing–Previous Week Recall (PWR) ranked as most responsive subjective measure in all study designs. Conclusions The reliability, Minimal Detectable Change and responsiveness to change of subjective and objective methods of measuring SB is context dependent. Although TV viewing-PWR is the more reliable and responsive subjective method in most situations, it may have limitations as a reliable measure of total SB. Results of this study can be used to guide choice of tools for detecting change in sedentary behaviour in older adults in the contexts of population surveillance, intervention evaluation and individual care.
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Affiliation(s)
- Manon L. Dontje
- School of Health and life Science, Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Philippa M. Dall
- School of Health and life Science, Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, United Kingdom
- * E-mail:
| | - Dawn A. Skelton
- School of Health and life Science, Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Jason M. R. Gill
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Sebastien F. M. Chastin
- School of Health and life Science, Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, United Kingdom
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
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Simonson DC, Halperin F, Foster K, Vernon A, Goldfine AB. Clinical and Patient-Centered Outcomes in Obese Patients With Type 2 Diabetes 3 Years After Randomization to Roux-en-Y Gastric Bypass Surgery Versus Intensive Lifestyle Management: The SLIMM-T2D Study. Diabetes Care 2018; 41:670-679. [PMID: 29432125 PMCID: PMC5860843 DOI: 10.2337/dc17-0487] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 11/18/2017] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To compare the effect of Roux-en-Y gastric bypass (RYGB) surgery versus intensive medical diabetes and weight management (IMWM) on clinical and patient-reported outcomes in obese patients with type 2 diabetes. RESEARCH DESIGN AND METHODS We prospectively randomized 38 obese patients with type 2 diabetes (15 male and 23 female, with mean ± SD weight 104 ± 16 kg, BMI 36.3 ± 3.4 kg/m2, age 52 ± 6 years, and HbA1c 8.5 ± 1.3% [69 ± 14 mmol/mol]) to laparoscopic RYGB (n = 19) or IMWM (n = 19). Changes in weight, HbA1c, cardiovascular risk factors (UKPDS risk engine), and self-reported health status (the 36-Item Short-Form [SF-36] survey, Impact of Weight on Quality of Life [IWQOL] instrument, and Problem Areas in Diabetes Survey [PAID]) were assessed. RESULTS After 3 years, the RYGB group had greater weight loss (mean -24.9 kg [95% CI -29.5, -20.4] vs. -5.2 [-10.3, -0.2]; P < 0.001) and lowering of HbA1c (-1.79% [-2.38, -1.20] vs. -0.39% [-1.06, 0.28] [-19.6 mmol/mol {95% CI -26.0, -13.1} vs. -4.3 {-11.6, 3.1}]; P < 0.001) compared with the IMWM group. Changes in cardiometabolic risk for coronary heart disease and stroke were all more favorable in RYGB versus IMWM (P < 0.05 to P < 0.01). IWQOL improved more after RYGB (P < 0.001), primarily due to subscales of physical function, self-esteem, and work performance. SF-36 and PAID scores improved in both groups, with no difference between treatments. A structural equation model demonstrated that improvement in overall quality of life was more strongly associated with weight loss than with improved HbA1c and was manifest by greater improvements in IWQOL than with either SF-36 or PAID. CONCLUSIONS Three years after randomization to RYGB versus IMWM, surgery produced greater weight loss, lower HbA1c, reduced cardiovascular risk, and improvements in obesity-related quality of life in obese patients with type 2 diabetes.
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Affiliation(s)
- Donald C Simonson
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Florencia Halperin
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Kathleen Foster
- Research Division, Joslin Diabetes Center, Harvard Medical School, Boston, MA
| | - Ashley Vernon
- Center for Metabolic and Bariatric Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Allison B Goldfine
- Research Division, Joslin Diabetes Center, Harvard Medical School, Boston, MA
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Halseth A, Shan K, Gilder K, Malone M, Acevedo L, Fujioka K. Quality of life, binge eating and sexual function in participants treated for obesity with sustained release naltrexone/bupropion. Obes Sci Pract 2018; 4:141-152. [PMID: 29670752 PMCID: PMC5893468 DOI: 10.1002/osp4.156] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 01/12/2018] [Accepted: 01/15/2018] [Indexed: 12/14/2022] Open
Abstract
Objective This multicenter, randomized, controlled, open‐label trial examined weight‐related quality of life, control over eating behaviour and sexual function after 26 weeks of treatment with either 32 mg naltrexone sustained release (SR)/360 mg bupropion SR plus a comprehensive lifestyle intervention program (NB + CLI, N = 153) or usual care (UC, N = 89), which included minimal lifestyle intervention. Methods Impact of Weight on Quality of Life‐Lite, Binge Eating Scale and Arizona Sexual Experiences Scale were assessed at baseline (BL) and weeks 16 and 26. Results NB + CLI and UC participants lost 9.46 and 0.94% respectively of initial body weight at week 26 (P < 0.0001). NB + CLI participants had greater improvements in Impact of Weight on Quality of Life‐Lite total score than UC participants (P < 0.0001). In participants with moderate/severe Binge Eating Scale scores at BL, 91% of NB + CLI and 18% of UC participants experienced categorical improvements. In participants with Arizona Sexual Experiences Scale‐defined sexual dysfunction at BL, 58% of NB + CLI and 19% of UC participants no longer met dysfunction criteria at week 26. The most frequent adverse events leading to discontinuation before week 26 in NB + CLI included nausea (10.5%); anxiety (3.3%); and headache, hypertension, insomnia and palpitations (1.3% each). Conclusion Compared with UC, participants treated with NB + CLI experienced greater improvements in weight‐related quality of life, control over eating behaviour, and sexual function.
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Affiliation(s)
- A Halseth
- Orexigen Therapeutics, Inc.La Jolla CA USA
| | - K Shan
- Orexigen Therapeutics, Inc.La Jolla CA USA
| | - K Gilder
- Orexigen Therapeutics, Inc.La Jolla CA USA
| | - M Malone
- Orexigen Therapeutics, Inc.La Jolla CA USA
| | - L Acevedo
- Orexigen Therapeutics, Inc.La Jolla CA USA
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Kolotkin RL, Gabriel Smolarz B, Meincke HH, Fujioka K. Improvements in health-related quality of life over 3 years with liraglutide 3.0 mg compared with placebo in participants with overweight or obesity. Clin Obes 2018; 8:1-10. [PMID: 29045079 PMCID: PMC5813214 DOI: 10.1111/cob.12226] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 08/21/2017] [Accepted: 09/10/2017] [Indexed: 01/30/2023]
Abstract
Previously in the SCALE Obesity and Prediabetes trial, at 1 year, participants with obesity (or overweight with comorbidities) and prediabetes receiving liraglutide 3.0 mg experienced greater improvements in health-related quality of life (HRQoL) than those receiving placebo. The current study extends these findings by examining 3-year changes in HRQoL. HRQoL was assessed using the obesity-specific Impact of Weight on Quality of Life-Lite (IWQOL-Lite) questionnaire, as well as the Short-Form 36 v2 (SF-36) health survey. At 3 years, mean change (±standard deviation) in IWQOL-Lite total score from baseline for liraglutide (n = 1472) was 11.0 ± 14.2, vs. 8.1 ± 14.7 for placebo (n = 738) (estimated treatment difference [ETD] 3.4 [95% confidence interval (CI): 2.0, 4.7], P < 0.0001). Mean change in SF-36 physical component summary (PCS) score from baseline for liraglutide was 3.1 ± 7.3, vs. 2.6 ± 7.6 for placebo (ETD 0.87 [95% CI: 0.17, 1.6], P = 0.0156). Mean change in SF-36 mental component summary score did not significantly differ between groups. Both IWQOL-Lite total score and PCS score demonstrated an association between greater HRQoL improvement with higher weight loss. Liraglutide 3.0 mg was also associated with improved health utility (Short-Form-6D and EuroQol-5D, mapped from IWQOL-Lite and/or SF-36) vs. placebo. Liraglutide 3.0 mg, plus diet and exercise, is associated with long-term improvements in HRQoL with obesity or overweight with comorbidity vs. placebo.
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Affiliation(s)
- R. L. Kolotkin
- Quality of Life ConsultingDurhamNCUSA
- Department of Community and Family MedicineDuke University Medical CenterDurhamNCUSA
- Department of Health StudiesWestern Norway University of Applied SciencesFørdeNorway
- Førde Hospital TrustFørdeNorway
- Morbid Obesity CentreVestfold Hospital TrustTønsbergNorway
| | | | | | - K. Fujioka
- Nutrition and Metabolic Research Center Scripps Clinic Department of EndocrineLa JollaCAUSA
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Strain GW. Comment on: changes in bowel habits and patient-scored symptoms after Roux-en-Y gastric bypass and biliopancreatic diversion with duodenal switch. Surg Obes Relat Dis 2017; 14:149-150. [PMID: 29273190 DOI: 10.1016/j.soard.2017.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 11/17/2017] [Indexed: 11/20/2022]
Affiliation(s)
- Gladys Witt Strain
- Weill/Cornell College of Medicine of Cornell University, New York, New York
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Abstract
INTRODUCTION Effect of bariatric surgery on health-related quality of life (HRQOL) varies greatly. This might be caused by the diversity in questionnaires used to assess HRQOL and the weight loss of the studied population. This study assesses the relationship between weight loss and HRQOL in primary Roux-en-Y gastric bypass (RYGB) patients by using an obesity-specific (impact of weight on quality of life-lite, IWQOL-lite) and a generic (RAND-36) questionnaire. METHODS HRQOL and weight parameters were assessed before and 15 and 24 months after RYGB surgery. HRQOL was assessed by using IWQOL-lite (an obesity-specific questionnaire consisting of one total score and five domains) and RAND-36 (a generic questionnaire consisting of two subtotal scores, the physical health summary (PHS) and mental health summary (MHS), and nine scales). RESULTS Two thousand one hundred thirty-seven patients were included. HRQOL improved significantly after RYGB. Preoperative BMI was negatively related to baseline PHS (p < 0.001) and IWQOL-lite total (p < 0.001). Percentage total weight loss (%TWL) was positively related to HRQOL score at both follow-up moments. Change in HRQOL from baseline to 24 months was related to %TWL at 24 months in both subtotals of RAND-36 and IWQOL-lite total score (p ≤ 0.001 in all). CONCLUSION HRQOL improves after RYGB. Higher %TWL is related to greater improvement in HRQOL and better HRQOL 15 and 24 months after RYGB. The variance in the effect of RYGB surgery on HRQOL can be explained by the questionnaire used and weight loss of the population.
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Kolotkin RL, Crosby RD, Wang Z. Health-related quality of life in randomized controlled trials of lorcaserin for obesity management: what mediates improvement? Clin Obes 2017; 7:347-353. [PMID: 28815987 DOI: 10.1111/cob.12207] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 06/26/2017] [Accepted: 07/07/2017] [Indexed: 11/30/2022]
Abstract
Lorcaserin, plus diet and exercise, has demonstrated significant weight loss and improved cardiometabolic parameters vs. placebo in patients with overweight/obesity in three randomized, placebo-controlled trials. We examined whether lorcaserin is also associated with greater improvements in health-related quality of life (HRQOL) and whether these improvements are wholly attributable to weight loss. Pooled data from Behavioral Modification and Lorcaserin for Overweight and Obesity Management (BLOOM), Behavioral Modification and Lorcaserin Second Study for Obesity Management (BLOSSOM) and BLOOM-Diabetes Mellitus (BLOOM-DM) trials were analysed (n = 5624). HRQOL was assessed at baseline and 52 weeks using the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) questionnaire. Multiple mediation analyses were conducted to evaluate the mechanisms underlying improved HRQOL. Greater HRQOL improvements were observed at 52 weeks in lorcaserin vs. placebo (P < 0.0001). A greater percentage of lorcaserin patients (54.1%) experienced meaningful improvements in IWQOL-Lite total score than placebo patients (48.2%) (P < 0.001). Body mass index (BMI) reduction was the primary driver of improved HRQOL (P < 0.0001), with depressive symptoms and total cholesterol also playing a role (P < 0.05). Improved HRQOL varied by gender, age, race and presence of diabetes and other comorbidities. Lorcaserin treatment significantly improves HRQOL compared with placebo. Although BMI reduction accounts for the majority of these improvements, improvement in depressive symptoms and total cholesterol are contributing factors.
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Affiliation(s)
- R L Kolotkin
- Department of Community and Family Medicine, Duke University School of Medicine, Durham, NC, USA
- Quality of Life Consulting, Durham, NC, USA
- Department of Health Studies, Western Norway University of Applied Sciences, Førde, Norway
- Centre of Health Research, Førde Hospital Trust, Førde, Norway
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway
| | - R D Crosby
- Biomedical Statistics, Neuropsychiatric Research Institute, Fargo, ND, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Z Wang
- Health Economics and Outcomes Research, Eisai Inc., Woodcliff Lake, NJ, USA
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Mason TB, Crosby RD, Kolotkin RL, Grilo CM, Mitchell JE, Wonderlich SA, Crow SJ, Peterson CB. Correlates of weight-related quality of life among individuals with binge eating disorder before and after cognitive behavioral therapy. Eat Behav 2017; 27:1-6. [PMID: 28843136 PMCID: PMC5700842 DOI: 10.1016/j.eatbeh.2017.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 08/16/2017] [Accepted: 08/17/2017] [Indexed: 01/12/2023]
Abstract
Individuals with obesity and binge eating disorder (BED) report poorer weight-related quality of life (WRQOL) compared to individuals with obesity alone. Cognitive behavioral therapy (CBT), the best available treatment for BED, does not consistently produce weight loss or improvements in weight QOL. The purpose of the current study was to examine baseline and longitudinal associations between eating-related and psychosocial variables and dimensions of weight QOL. We examined associations between predictor variables, including body mass index (BMI), eating disorder (ED) psychopathology, and psychosocial factors, in relation to three dimensions of WRQOL among 171 patients whom received CBT for BED. Participants completed interviews and self-report measures at baseline prior to CBT and at end of treatment. At baseline the following associations were significant: BMI, ED psychopathology, and self-esteem were associated with weight-related self-esteem; gender, BMI, and self-esteem were associated with weight-related public distress (i.e., stigma and worry in public because of one's weight); and age, BMI, and ED psychopathology were associated with weight-related physical function. At end of treatment, the following associations were significant: changes in ED psychopathology and coping predicted weight-related self-esteem; changes in coping and self-esteem predicted weight-related public distress; and changes in BMI and subjective binge eating predicted weight-related physical function. Overall, changes in a number of ED and associated symptoms were associated with improvements in WRQOL.
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Affiliation(s)
- Tyler B Mason
- Department of Preventative Medicine, University of Southern California, Los Angeles, CA, United States.
| | - Ross D Crosby
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND, United States; Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, United States
| | - Ronette L Kolotkin
- Quality of Life Consulting, Durham, NC, United States; Department of Community and Family Medicine, Duke University School of Medicine, Durham, NC, United States; Western Norway University of Applied Sciences, Førde, Norway; Centre of Health Research, Førde Hospital Trust, Førde, Norway; Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway
| | - Carlos M Grilo
- Yale University School of Medicine, New Haven, CT, United States
| | - James E Mitchell
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND, United States; Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, United States
| | - Stephen A Wonderlich
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND, United States; Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, United States
| | - Scott J Crow
- University of Minnesota Medical School, Minneapolis, MN, United States; The Emily Program, St. Paul, MN, United States
| | - Carol B Peterson
- University of Minnesota Medical School, Minneapolis, MN, United States; The Emily Program, St. Paul, MN, United States
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Abstract
Excessive fat deposition in obesity has a multifactorial aetiology, but is widely considered the result of disequilibrium between energy intake and expenditure. Despite specific public health policies and individual treatment efforts to combat the obesity epidemic, >2 billion people worldwide are overweight or obese. The central nervous system circuitry, fuel turnover and metabolism as well as adipose tissue homeostasis are important to comprehend excessive weight gain and associated comorbidities. Obesity has a profound impact on quality of life, even in seemingly healthy individuals. Diet, physical activity or exercise and lifestyle changes are the cornerstones of obesity treatment, but medical treatment and bariatric surgery are becoming important. Family history, food environment, cultural preferences, adverse reactions to food, perinatal nutrition, previous or current diseases and physical activity patterns are relevant aspects for the health care professional to consider when treating the individual with obesity. Clinicians and other health care professionals are often ill-equipped to address the important environmental and socioeconomic drivers of the current obesity epidemic. Finally, understanding the epigenetic and genetic factors as well as metabolic pathways that take advantage of 'omics' technologies could play a very relevant part in combating obesity within a precision approach.
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