Relationship Between Clinician Language and the Success of Behavioral Weight Loss Interventions : A Mixed-Methods Cohort Study

Patient-Clinician Communication About Weight Loss

This JAMA Insights explores effective communication strategies for clinicians who do not specialize in treating obesity in how to introduce conversations about weight loss with their patients and offer them support and treatment.

Impact of Annual Health Checkups on Five-Year Weight Gain in Japan: Considering Behavioral Change Stages in the Transtheoretical Model

Background Obesity is a critical public health issue because this common disease leads to increased mortality. Therefore, controlling weight is essential. We aimed to evaluate whether undergoing health checkup examinations at least annually leads to better weight management. Methodology This longitudinal study utilized the health checkup examination data collected between April 2014 and March 2019 at the Seirei Health Care Division in Japan. Participants whose weight was measured in 2014 and 2019 were included. All analyses were performed according to sex and the three categories of health checkup examination frequency (twice, three to four times, and five to six times over five years). One-way analysis of variance (ANOVA) and trend analysis were conducted on the average weight differences between 2014 and 2019. Covariance analysis was performed using age, body mass index, and the categories of the behavioral change stages in the transtheoretical model in 2014 as covariates in the one-way ANOVA. Subgroup analyses were conducted for two age groups: ≥ 65 and < 65 years. Results A total of 84,078 males and 51,418 females were included. The mean age (standard deviation) in 2014 was 44.2 (13.1) and 46.7 (13.2), respectively. The more frequently weight was measured, the less weight was gained after five years in both sexes; the average weight gain was 1.32, 1.17, and 0.95 kg in males and 1.26, 0.96, and 0.78 kg in females in the twice, three to four times, and five to six times frequency groups, respectively. The P-values for the one-way ANOVA, trend analysis, and covariance analysis were all < 0.05. This trend was true for those aged <65 years, whereas in those aged ≥65 years, weight loss was noticeable. Conclusions An association between weight gain after five years and the frequency of health checkup examinations was revealed among individuals aged <65 years. Weight gain may be controlled with annual health checkup examinations.

Preventing diabetes: What overweight and obese adults with prediabetes in the United States report about their providers' communication and attempted weight loss

Objective

To investigate what overweight or obese adults with prediabetes in the United States report being told by providers about 1) having prediabetes, 2) diabetes risk, and 3) losing weight and the associations of these communications with attempted weight loss.

Methods

Data from 2015 to 2018 National Health and Nutrition Examination Surveys (NHANES) for adults with a body mass index in the overweight or obesity ranges and HbA1c in the prediabetes range were examined (n = 2085). Patient reported data on what providers told them about having prediabetes, being at risk for diabetes, and losing weight were compared with attempted weight loss.

Results

Most participants (66.4%) reported never being told they had prediabetes nor being at risk for diabetes, 13.0% reported being told they had prediabetes, 10.6% at risk for diabetes, and 8.0% both messages. 18.3% of participants reported being told to lose weight. Participants who reported being told they had prediabetes and at increased diabetes risk were more likely to report attempted weight loss (adjusted odds ratio (AOR) 1.8, 95% confidence interval (CI) 1.1-3.2). Reporting that they were told to lose weight was not significantly associated with an increase in reported weight loss attempts.

Conclusions

In this cohort of individuals with overweight/obesity and prediabetic HbA1c values, low rates communications with providers about prediabetes and diabetes risk were reported. When both were discussed, patients reported greater attempted weight loss. These findings draw attention to the potential impact that provider communications about prediabetes and diabetes risk may have on lifestyle behavior change.

Obesity

Obesity is a common condition and a major cause of morbidity and mortality. Fortunately, weight loss treatment can reduce obesity-related complications. This review summarizes the evidence-based strategies physicians can employ to identify, prevent, and treat obesity, including best practices to diagnose and counsel patients, to assess and address the burden of weight-related disease including weight stigma, to address secondary causes of weight gain, and to help patients set individualized and realistic weight loss goals and an effective treatment plan. Effective treatments include lifestyle modification and adjunctive therapies such as antiobesity medications and metabolic and bariatric surgery.

CVOT Summit Report 2023: new cardiovascular, kidney, and metabolic outcomes

The 9th Cardiovascular Outcome Trial (CVOT) Summit: Congress on Cardiovascular, Kidney, and Metabolic Outcomes was held virtually on November 30-December 1, 2023. This reference congress served as a platform for in-depth discussions and exchange on recently completed outcomes trials including dapagliflozin (DAPA-MI), semaglutide (SELECT and STEP-HFpEF) and bempedoic acid (CLEAR Outcomes), and the advances they represent in reducing the risk of major adverse cardiovascular events (MACE), improving metabolic outcomes, and treating obesity-related heart failure with preserved ejection fraction (HFpEF). A broad audience of endocrinologists, diabetologists, cardiologists, nephrologists and primary care physicians participated in online discussions on guideline updates for the management of cardiovascular disease (CVD) in diabetes, heart failure (HF) and chronic kidney disease (CKD); advances in the management of type 1 diabetes (T1D) and its comorbidities; advances in the management of CKD with SGLT2 inhibitors and non-steroidal mineralocorticoid receptor antagonists (nsMRAs); and advances in the treatment of obesity with GLP-1 and dual GIP/GLP-1 receptor agonists. The association of diabetes and obesity with nonalcoholic steatohepatitis (NASH; metabolic dysfunction-associated steatohepatitis, MASH) and cancer and possible treatments for these complications were also explored. It is generally assumed that treatment of chronic diseases is equally effective for all patients. However, as discussed at the Summit, this assumption may not be true. Therefore, it is important to enroll patients from diverse racial and ethnic groups in clinical trials and to analyze patient-reported outcomes to assess treatment efficacy, and to develop innovative approaches to tailor medications to those who benefit most with minimal side effects. Other keys to a successful management of diabetes and comorbidities, including dementia, entail the use of continuous glucose monitoring (CGM) technology and the implementation of appropriate patient-physician communication strategies. The 10th Cardiovascular Outcome Trial Summit will be held virtually on December 5-6, 2024 ( http://www.cvot.org ).