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Aims: The SURMOUNT‐1 trial investigated effects of tirzepatide, a glucose‐dependent insulinotropic polypeptide and glucagon‐like peptide‐1 receptor agonist, on body weight in participants with obesity or overweight. This analysis evaluated changes in patient‐reported outcomes (PROs) assessing physical function, psychosocial well‐being, and overall health aspects of participants' health‐related quality of life (HRQoL) in SURMOUNT‐1. Methods: PRO instruments included the Impact of Weight on Quality of Life‐Lite Clinical Trials version (IWQOL‐Lite‐CT), Short Form Survey‐36 version 2 (SF‐36v2) and EQ‐5D‐5L. Scores were analysed by treatment group and by categorical degree of weight reduction group: >0 to <5%, ≥5 to <10%, ≥10 to <20% and ≥20%. Relevant PROs were evaluated for participants with or without physical or psychosocial limitations at baseline, as measured by Patient Global Impression of Status for physical activity (PGIS) and Patient Health Questionnaire‐2 (PHQ‐2), respectively. Results: All tirzepatide groups demonstrated significant improvements in PRO scores versus placebo. There was a consistent trend of incremental PRO improvement with greater degrees of weight reduction, starting from ≥5% weight reduction. Participants achieving ≥20% weight reduction demonstrated the greatest changes from baseline to week 72 (SF‐36v2 Physical Component Summary, 4.60; SF‐36v2 Mental Component Summary, 0.80; IWQOL‐Lite CT Total score, 24.7). Those with baseline physical and psychosocial limitations experienced greater improvements than those without. Conclusions: Tirzepatide treatment was associated with improved HRQoL compared to placebo in people with overweight or obesity. Higher percentages of weight reduction were associated with greater improvements. Clinical trial registration number for SURMOUNT‐1: NCT04184622. [ABSTRACT FROM AUTHOR]

Recent studies have explored the influence of obesity and critical illness on ciprofloxacin pharmacokinetics. However, variation across the subpopulation of individuals with obesity admitted to the intensive care unit (ICU) with varying renal function remains unexamined. This study aims to characterize ciprofloxacin pharmacokinetics in ICU patients with obesity and provide dose recommendations for this special population. Individual patient data of 34 ICU patients with obesity (BMI >30 kg/m2) from four studies evaluating ciprofloxacin pharmacokinetics in ICU patients were pooled and combined with data from a study involving 10 individuals with obesity undergoing bariatric surgery. All samples were collected after intravenous administration. Non‐linear mixed effects modeling and simulation were used to develop a population pharmacokinetic model and describe ciprofloxacin exposure in plasma. Model‐based dose evaluations were performed using a pharmacokinetic/pharmacodynamic target of AUC/MIC >125. The data from patients with BMI ranging from 30.2 to 58.1 were best described by a two‐compartment model with first‐order elimination and a proportional error model. The inclusion of Chronic Kidney Disease Epidemiology Collaboration (CKD‐EPI) as a covariate on clearance reduced inter‐individual variability from 57.3% to 38.5% (P <.001). Neither body weight nor ICU admission significantly influenced clearance or volume of distribution. Renal function is a viable predictor for ciprofloxacin clearance in ICU patients with obesity, while critical illness and body weight do not significantly alter clearance. As such, body weight and critical illness do not need to be accounted for when dosing ciprofloxacin in ICU patients with obesity. Individuals with CKD‐EPI >60 mL/min/1.73 m2 may require higher dosages for the treatment of pathogens with minimal inhibitory concentration ≥0.25 mg/L. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine whether semaglutide slows progression of glycemia in people with cardiovascular disease and overweight or obesity but without diabetes. RESEARCH DESIGN AND METHODS: In a multicenter, double-blind trial, participants aged ≥45 years, with BMI ≥27 kg/m2, and with preexisting cardiovascular disease but without diabetes (HbA1c <6.5%) were randomized to receive subcutaneous semaglutide (2.4 mg weekly) or placebo. Major glycemic outcomes were HbA1c and proportions achieving biochemical normoglycemia (HbA1c <5.7%) and progressing to biochemical diabetes (HbA1c ≥6.5%). RESULTS: Of 17,604 participants, 8,803 were assigned to semaglutide and 8,801 to placebo. Mean ± SD intervention exposure was 152 ± 56 weeks and follow-up 176 ± 40 weeks. In both treatment arms mean nadir HbA1c for participants was at 20 weeks. Thereafter, HbA1c increased similarly in both arms, with a mean difference of −0.32 percentage points (95% CI −0.33 to −0.30; −3.49 mmol/mol [−3.66 to −3.32]) and with the difference favoring semaglutide throughout the study (P < 0.0001). Body weight plateaued at 65 weeks and was 8.9% lower with semaglutide. At week 156, a greater proportion treated with semaglutide were normoglycemic (69.5% vs. 35.8%; P < 0.0001) and a smaller proportion had biochemical diabetes by week 156 (1.5% vs. 6.9%; P < 0.0001). The number needed to treat was 18.5 to prevent a case of diabetes. Both regression and progression were dependent on glycemia at baseline, with the magnitude of weight reduction important in mediating 24.5% of progression and 27.1% of regression. CONCLUSIONS: In people with preexisting cardiovascular disease and overweight or obesity but without diabetes, long-term semaglutide increases regression to biochemical normoglycemia and reduces progression to biochemical diabetes but does not slow glycemic progression over time. 6357437865112 dc240491video1 Video 1. This image is from a video available online at https://bcove.video/3WedKuq. American Diabetes Association 84th Scientific Sessions: SELECT Trial—New Looks at Glycemia, Inflammation, and Heart Failure. [ABSTRACT FROM AUTHOR]

The words used to refer to weight and individuals with large bodies can be used to reinforce weight stigma. Given that most previous research has examined preferred terminology within homogenous groups, this research sought to examine terminology preferences across populations. This paper reports on data gathered with the general public, family physicians, and obesity researchers/practitioners. Participants were asked about the words they commonly: (1) used to refer to people with large bodies (general public); (2) heard in their professional contexts (physicians and obesity specialists); and (3) perceived to be the most socially or professionally acceptable (all samples). Similarities and differences were evident between samples, especially related to weight-related clinical terms, the word fat, and behavioral stereotypes. The results provide some clarity into the differences between populations and highlight the need to incorporate use of strategies that may move beyond person-first language to humanize research and clinical practice with people with large bodies. [ABSTRACT FROM AUTHOR]

Introduction Obesity is a significant health concern for veterans and individuals with spinal cord injury, yet screening for overweight/obesity can be challenging. This study examines how healthcare providers screen for overweight/obesity and the challenges encountered in identifying overweight/obesity in veterans and persons with spinal cord injury. Materials and Methods Healthcare providers who provide care for persons with spinal cord injury completed a semi-structured interview. The interview explored their perspectives on measuring overweight/obesity in persons with spinal cord injury and the challenges they faced. Thematic analysis was used to identify themes that emerged from the interviews. Results Twenty-five providers (88% female with an average experience of 9.6 ± 7.3 years in providing care for spinal cord injury patients) participated in the interviews. The themes described the health indicators and equipment used to assess overweight/obesity, provider concerns regarding measurement, and criteria for classifying overweight/obesity. Body weight and body mass index were the most commonly used indicators. However, concerns were raised regarding accuracy of these measures for spinal cord injury patients, as well as issues related to the accessibility, calibration, and usability of the equipment. Many providers reported using standard body mass index ranges and categories instead of those specific to spinal cord injury. Conclusion This study identified the most commonly used indicators of weight or body composition in veterans and persons with spinal cord injury and highlighted providers' concerns with these measures. Future research is needed to identify the most feasible, accurate, and appropriate health indicators that could be used in a clinical setting to identify overweight and obesity in this population. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the efficacy of Lactobacillus delbrueckii ssp. bulgaricus (L. bulgaricus) in improving body weight, obesity-related outcomes, and lipid profiles of overweight people. Thirty-six overweight participants were randomly assigned to either a probiotic or a placebo group. A placebo powder or L. bulgaricus powder (containing 1 × 108 colony-forming unit (CFU) of the probiotic) was administered daily for 12 weeks. Body composition was determined, and blood tests were performed before and after the intervention. L. bulgaricus supplementation under the present condition did not affect the body weight, fat percentage, or body mass index (BMI) of the participants, while it resulted in a notable decrease in blood triglyceride (TG) levels, which corresponded to a lowering of the TG proportion in the composition of large VLDL (L–XXL sized fractions) and HDL (M and L fractions) in the probiotic-treated group. These results suggest that L. bulgaricus supplementation under the current conditions may not be helpful for losing weight, but it has the potential to decrease blood TG levels by modulating TG accumulation in or transport by VLDL/HDL in obese patients. L. bulgaricus supplements may have health-promoting properties in preventing TG-related diseases in overweight people. [ABSTRACT FROM AUTHOR]

Copyright of Heart & Vascular Diseases / Choroby Serca & Naczyn is the property of VM Medica-VM Group (Via Medica) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and objective: Psychological health is as important as physical health. Obesity is a multifactorial disease that affects both these aspects of health. Despite serious effects of psychological factors on obesity, relationship between obesity and psychological aspects is less obvious. The current study aimed to investigate association of overweight and obesity with metaphors, quality of life, and hedonic hunger as some psychosocial factors related to body weight. Subjects and method: This cross-sectional study was conducted on 40 overweight and obese staff of Shahid Beheshti university of Medical Sciences (SBMU) aged 35-60 years. Data on anthropometric measurements, self/life metaphors, impact of weight on quality of life, hedonic hunger score, dietary intake and physical activity were collected. Results and conclusion: In the current research, 55% of participants were women. Self-metaphor and physical part of Impact of Weight on Quality of Life (IWQOL) questionnaire in obese participants were significantly higher than those with overweight (P<0.05). There is no difference between hedonic score of obese and overweight persons. The mean ±SD of total score of IWQOL and its subscales including physical, self-esteem, sexual and social, in the fourth quartile of hedonic score was higher than the first one, significantly (p<0.05). There are important insights on the specific psychological aspects of obesity. It seems necessary to reinforce attention to phenotype of obesity, beyond energy intake and consumption to meet psychological and physical health. [ABSTRACT FROM AUTHOR]

Overweight and obesity is a multifactorial, multisystem disease declared a global epidemic by the World Health Organization (WHO) as early as in 1997. At least 30% of the working-age population in Russia is overweight. Only the use of physical activity as an integral (basic) part of obesity treatment and maintenance of the body weight achieved in the course of treatment can achieve durable and long-lasting treatment results as well as significant changes in the body structure (fat/non-fat body weight ratio). Terrainkur (therapeutic walking) is a method of spa treatment that combines climatotherapy and physical therapy. One of the problems in physical activity in obese people is the difficulty they experience in exercising due to the impaired walking pattern caused by imbalances in the muscle chains, including pelvic region, cervical region, which reduces endurance and commitment to physical activity. The study found that the exposure group (Terrainkur) showed lower values of "total fat", "metabolic age", "basic caloric value" compared to initial results and the control group; the exposure group (Terrainkur) showed a decrease in the deviation of the centre of body axis projection from the proper axis, the percentage of non-compliance with the proper fluctuations of the foot underextension. These changes contributed to the elimination of terrainkur restrictions and, as a result, improved the patient compliance during the terrainkur exercises. [ABSTRACT FROM AUTHOR]

Novo Nordisk's amycretin, a GLP-1 and amylin receptor agonist, showed promising results in a phase 1b/2a clinical trial for individuals with overweight or obesity. The trial demonstrated significant weight loss of up to 22% in participants receiving amycretin compared to those on a placebo. The safety profile of amycretin was similar to other incretin-based therapies, with gastrointestinal events being the most commonly reported adverse effects. Novo Nordisk plans to continue developing amycretin for the treatment of overweight and obesity based on these positive trial results. [Extracted from the article]

A comparative analysis of specific immunobiochemical parameters, including natural antibodies (NAb) to endogenous regulators of the cardiovascular system, adrenal and gastrointestinal hormones, was performed in students aged 18-22 years with normal and increased body weight (the body mass index from 18.5 to 24.9 kg/m2 and from 25 to 29.9 kg/m2, respectively). The serum content of NAb and hormones was determined by ELISA. The level of the studied indicators depended on the body mass index value. In overweight subjects, the main immune indicators of the biogenic amine system, renin-angiotensin system, and kinin system exceeded the normal. The cortisol level was higher than in subjects with normal body weight. Aldosterone secretion was less dependent on the ACTH content and was lower than in students with normal body weight. The content of cholecystokinin and gastrin corresponded to the values for overweight. These trends in hormone contents are a predisposing factor for further weight gain. Practical significance of the combined assessment of disturbances in the immunological and biochemical homeostasis has been established. Analysis of the adrenal and gastrointestinal hormones can predict the risk of weight gain, but at the same time, changes in the level of immunological indicators in subjects with increased body weight characterizes the possibility of developing cardiovascular pathologies. [ABSTRACT FROM AUTHOR]

Introduction: Behavioral strategies have been adding to the effectiveness of obesity treatment. And the assessment of the decisional balance (DB) for weight reduction, that is, the balance between expected losses and gains around the behavioral changes, is strategic for managing obesity. The DB assessment may contribute to the agreement on strategies to face the challenges of the treatment. But, there is a need to use a valid instrument to assess the DB. Objective: evaluate the quality of instruments assessing DB for weight reduction to qualify obesity management in the Sistema Único de Saúde - SUS (Unified Health System). Methods: A systematic review of studies about instrument development and/or validation was carried out on seven databases using the Cosmin methodology. Terms related to psychometrics, obesity, and DB were combined with Boolean operators to guide the search. Two researchers performed independently and in duplicate: data extraction, quality assessment, and evidence synthesis, and divergences were resolved by consensus. This review was registered in the international database Prospero (CRD42020197797). Results: Five studies were identified. Three of them reported translations and cross-cultural validity of the same instrument. All analyses presented DB in two dimensions (pros and cons), but used doubtful or inadequate methods. Most of the evidence was very low rate. Conclusions: The results did not support the instrument's use, translations, or cross-cultural adaptation. It is necessary to develop a new tool. By providing a valid instrument for use in SUS, this study could contribute to qualifying the care of people with obesity and stopping the growth of obesity in the country. [ABSTRACT FROM AUTHOR]

Background: Branched chain amino acids (BCAAs) have been revealed to be closely related to insulin resistance and obesity. This study aimed to investigate if BCAA levels at baseline are related to an improvement in insulin resistance after implementing a weight loss program intervention. Methods: Stored blood samples from participants in previous trials were used for BCAA evaluation. Linear regression was used to analyze the relationship between baseline amino acid levels and changes in the insulin resistance index (HOMA-IR) and blood glucose. Results: A total of 48 participants were enrolled. After the intervention, the body weight (78.29± 12.68 vs 72.06 ± 13.30 kg, p=0.020), fasting glucose (4.76 ± 0.43 vs 4.48 ± 0.39 mmol/L, p=0.001), fasting insulin (18.41± 13.58 vs 12.87± 10.88, p=0.028), and HOMA-IR (4.01± 3.39 vs 2.62± 2.18, p=0.018) were improved significantly. BCAA levels were related to the improvement in HOMA-IR (β=− 0.006, p=0.039), and valine was found to be the most closely related to the improvement in HOMA-IR (β=− 0.013, p=0.017). Conclusion: The baseline BCAA is related to the improvement in insulin resistance among participants after a weight loss intervention. [ABSTRACT FROM AUTHOR]

Background: Obesity is a chronic disease with high prevalence in all age groups. Many overweight and obese people seem to be unaware of excess body weight. Aim: Analysis of people affected by the misperception of excess body weight and their eating behaviors simultaneously with selected health parameters. Methods: The study was conducted in 2017–2019 among 658 participants aged 20–79 from the population study—Bialystok PLUS (Poland). Results were based on clinical examinations and questionnaires. Results: Unawareness of overweight and obesity is common among adults (21.7%). Participants unaware of their overweight and obesity presented much higher risk factors. A high cardiovascular risk profile was observed more often among people not aware of overweight and obesity than among normal weight people (23.0% vs. 10.0%) as well as more common asymptomatic carotid artery atherosclerosis (49.7% vs. 31.3%). The subjective perception of overweight and obesity based on BMI (body mass index) was equal to 26.4 kg/m2 in women and 27.9 kg/m2 in men. The assessment of their diet was less favorable than that of people with normal weight. Conclusions: Unawareness of one's excessive weight and its health consequences may lead to hesitancy to apply a healthy lifestyle and hence increase the cardiovascular risk in a substantial part of society. Therefore, it should be considered a part of the cardiovascular disease risk spectrum. Measurement of BMI and discussion about its health implications should be a routine procedure during healthcare contacts. [ABSTRACT FROM AUTHOR]

Current behavioral interventions for weight loss in overweight and obesity present problems in maintaining long-term weight loss results. Acceptance and commitment therapy (ACT) could be a suitable approach to promote long-term weight loss. The aim of this pilot study is to evaluate the efficacy of an ACT-based intervention on body weight change at the end of the intervention and after a 9- month follow-up, in addition to analyzing the effects of the intervention on several variables of interest. Nine women (Mage= 44.11 years; SD= 5.82) attended a group intervention of 10 weekly sessions, addressing contents of eating habits, physical activity, and ACT. At the end of the intervention, the average weight loss was 2.8%, and after a 9-month follow-up, it was 3.9%. Based on the results, it can be concluded that the study provides evidence in favor of the suitability of ACT to help promote weight loss. [ABSTRACT FROM AUTHOR]

The increasing prevalence of obesity is a worldwide health concern. Although obesity primarily affects the development of cardiometabolic disorders, it has also been closely linked to chronic kidney disease (CKD). However, potential causal relationships between obesity and CKD remain unclear, as obesity and CKD share a number of common risk factors. Accordingly, the risk of incident CKD in obese people without metabolic abnormalities, also called "metabolically healthy obesity" (MHO), has been a matter of interest. Recent investigations found that MHO was related to increased risk of incident CKD; however, the conclusions were based primarily on the static state. According to previous publications, approximately one-half of people initially identified as MHO became metabolically unhealthy, while one-tenth reduced their body weight to normal range while remaining metabolically healthy. It is essential to consider these transitions in obese-metabolic health status when analyzing obesity-related outcomes. This review discusses research on obesity and metabolic health in patients with CKD. Furthermore, we summarize recent reports on the implications of obesity and metabolic health in CKD and discuss the possible mechanisms of their relationship with CKD. [ABSTRACT FROM AUTHOR]

A study presented at the 60th Annual Meeting of the European Association for the Study of Diabetes 2024 revealed that a novel oral antiobesity drug called amycretin can reduce body weight by up to 13%. The drug, which is a protein-based unimolecular amylin and glucagon-like peptide-1 (GLP-1) receptor agonist coagonist, was tested in a single-center, placebo-controlled, double-blinded study. Participants who received amycretin experienced significant reductions in body weight compared to those in the placebo group, with no significant safety issues observed. The findings suggest that amycretin has promising potential as a patient-centered weight-management option. [Extracted from the article]

For several decades, a steady increase in the percentage of overweight and obese people has been observed all over the world. There are many studies available in the literature emphasizing the relationship of overweight and obesity with the occurrence of other diseases. The aim of this study is to characterize the prevalence of obesity and severe obesity, as well as their changes over time, among professionally active adults who underwent occupational medicine examinations in Poland in 2016–2020, for the POL-O-CARIA 2016–2020 study. In total, the results of 1,450,455 initial, control and periodic visits as part of the occupational medicine certificate were analyzed. Statistical calculations were performed with the use of IBM SPSS Statistics 25. In both groups (men/women), a significant decrease was observed every year for people who had normal body weight. In addition, the tendency to increase in people with I and III degrees of obesity was more strongly observed in the male group. A significant relationship was also observed between BMI categories and the occurrence of all analyzed comorbidities: hypertension, type 2 diabetes, lipid disorders and coronary artery disease (chi2 (70) = 12,228.11; p < 0.001). Detailed results showed that in the group of patients diagnosed with hypertension or lipid disorders, significant differences were observed between all groups; it turned out that as the BMI level increased (I, I, III), there was an increase in the percentage of occurrence of hypertension (38.1%, 41% and 45.3%, respectively) and type 2 diabetes (3.2%, 4.6% and 5.8%, respectively) (p < 0.001). Our analysis indicates that the prevalence of adult obesity and severe obesity will continue to increase nationwide, with an accompanying large increase in comorbidities. [ABSTRACT FROM AUTHOR]

Weight stigma, a negative attitude toward the overweight, can lead to discriminatory practices, as well as increase overweight individuals' vulnerability to depression, anxiety, and low self‐esteem. We propose that a nostalgia induction can attenuate weight stigma. Participants identified an overweight individual, before writing about an interpersonal encounter with that individual, characterized by either central (e.g., "keepsakes" and "childhood") or peripheral (e.g., "wishing" and "daydreaming") features of the construct "nostalgia." Participants who recalled a central (vs. peripheral) nostalgic encounter reported more positive feelings and beliefs toward overweight individuals in general. Moreover, nostalgia influenced behavior: Nostalgic (vs. control) participants reduced their social distance when anticipating an interaction with an overweight individual. The effect of nostalgia on all three outcomes (i.e., positive feelings, beliefs, and behavior) was mediated by greater social connectedness, which in turn was associated with higher inclusion of the outgroup in the self and increased outgroup trust. [ABSTRACT FROM AUTHOR]

Introduction: The increasing prevalence of excess body weight among young adults is worrying as they may receive negative attitudes from society. Purpose: To examine whether attitudes toward obese persons differ among gender, body mass index (BMI) and levels of physical activity (PA) among healthcare students. Methods: This cross-sectional study recruited 185 participants (78 men, 107 women, mean age=23.45±4.02 years, BMI=25.84±5.59 kg/m2). BMI and levels of PA were measured using a body composition monitor and the International Physical Activity Questionnaire-Short Form (IPAQ-SF), respectively. A self-administered questionnaire assessed attitudes toward obese persons using "The Attitudes Toward Obese Persons (ATOP)". Results: Analysis showed that females scored a higher ATOP score (65.56±13.11) than males (64.37±10.50) (p>0.05). In terms of BMI, the obese individuals had the highest ATOP score (65.84±14.10), followed by those with a healthy weight (64.96±12.03) and the overweight (64.42±9.96) (p>0.05). There were also no significant differences in ATOP score among individuals with different levels of PA (p>0.05), but those with low PA had the highest ATOP score (65.29±13.80) followed by high PA (65.25±11.34) and moderate PA (64.76±12.21). Conclusion: Differences in gender, BMI and levels of PA might have less impact on the attitudes toward obese persons. Negative attitudes toward obesity may not be acceptable in the community. On the other hand, showing a positive or neutral attitude may discourage people with obesity to adopt a healthy lifestyle or seek intervention for weight management. [ABSTRACT FROM AUTHOR]

Background: Overweight and obesity are important public health priorities. Mindful eating can contribute in preventing automatic eating behavior and emotional dysregulation, both being primary causes of overeating and negative body image. This research outlines an eight-week mindful eating intervention (i.e., project EATT) focusing on people with overweight or obesity in assisting positive behavioral, psychological and physiological change. Methods: Fifty-seven people residing in Athens were recruited to participate in this research, where participants were allocated to either an experimental or a waitlist condition. Changes in body weight, and eating attitude, mindfulness, self-compassion, anxiety questionnaires were administered at baseline and post-intervention, and at a 14-month follow-up. Results: Results indicated that mindfulness and self-compassion increased significantly, while anxiety symptoms decreased. Significance was also observed in reduction of overeating symptoms and oral control. While a negative relationship was observed between anxiety and mindfulness, and anxiety and self-compassion, self-compassion was negatively associated with overeating episodes. Conclusions: The intervention improved participants' relationship with food and enabled changes towards successful weight regulation. [ABSTRACT FROM AUTHOR]

Copyright of Revista Latinoamericana de Hipertension is the property of Revista Latinoamericana de Hipertension and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Key Points: Question: Among adults with overweight or obesity without diabetes, what is the effect of once-weekly subcutaneous semaglutide, 2.4 mg, vs once-daily subcutaneous liraglutide, 3.0 mg, on weight loss when each is added to counseling for diet and physical activity? Findings: In this randomized clinical trial that included 338 participants, mean body weight change from baseline to 68 weeks was –15.8% with semaglutide vs –6.4% with liraglutide, a statistically significant difference. Meaning: Among adults with overweight or obesity without diabetes, once-weekly subcutaneous semaglutide, compared with once-daily subcutaneous liraglutide, added to counseling for diet and physical activity resulted in significantly greater weight loss at 68 weeks. Importance: Phase 3 trials have not compared semaglutide and liraglutide, glucagon-like peptide-1 analogues available for weight management. Objective: To compare the efficacy and adverse event profiles of once-weekly subcutaneous semaglutide, 2.4 mg, vs once-daily subcutaneous liraglutide, 3.0 mg (both with diet and physical activity), in people with overweight or obesity. Design, Setting, and Participants: Randomized, open-label, 68-week, phase 3b trial conducted at 19 US sites from September 2019 (enrollment: September 11-November 26) to May 2021 (end of follow-up: May 11) in adults with body mass index of 30 or greater or 27 or greater with 1 or more weight-related comorbidities, without diabetes (N = 338). Interventions: Participants were randomized (3:1:3:1) to receive once-weekly subcutaneous semaglutide, 2.4 mg (16-week escalation; n = 126), or matching placebo, or once-daily subcutaneous liraglutide, 3.0 mg (4-week escalation; n = 127), or matching placebo, plus diet and physical activity. Participants unable to tolerate 2.4 mg of semaglutide could receive 1.7 mg; participants unable to tolerate 3.0 mg of liraglutide discontinued treatment and could restart the 4-week titration. Placebo groups were pooled (n = 85). Main Outcomes and Measures: The primary end point was percentage change in body weight, and confirmatory secondary end points were achievement of 10% or more, 15% or more, and 20% or more weight loss, assessed for semaglutide vs liraglutide at week 68. Semaglutide vs liraglutide comparisons were open-label, with active treatment groups double-blinded against matched placebo groups. Comparisons of active treatments vs pooled placebo were supportive secondary end points. Results: Of 338 randomized participants (mean [SD] age, 49 [13] years; 265 women [78.4%]; mean [SD] body weight, 104.5 [23.8] kg; mean [SD] body mass index, 37.5 [6.8]), 319 (94.4%) completed the trial, and 271 (80.2%) completed treatment. The mean weight change from baseline was –15.8% with semaglutide vs –6.4% with liraglutide (difference, –9.4 percentage points [95% CI, –12.0 to –6.8]; P <.001); weight change with pooled placebo was –1.9%. Participants had significantly greater odds of achieving 10% or more, 15% or more, and 20% or more weight loss with semaglutide vs liraglutide (70.9% of participants vs 25.6% [odds ratio, 6.3 {95% CI, 3.5 to 11.2}], 55.6% vs 12.0% [odds ratio, 7.9 {95% CI, 4.1 to 15.4}], and 38.5% vs 6.0% [odds ratio, 8.2 {95% CI, 3.5 to 19.1}], respectively; all P <.001). Proportions of participants discontinuing treatment for any reason were 13.5% with semaglutide and 27.6% with liraglutide. Gastrointestinal adverse events were reported by 84.1% with semaglutide and 82.7% with liraglutide. Conclusions and Relevance: Among adults with overweight or obesity without diabetes, once-weekly subcutaneous semaglutide compared with once-daily subcutaneous liraglutide, added to counseling for diet and physical activity, resulted in significantly greater weight loss at 68 weeks. Trial Registration: ClinicalTrials.gov Identifier: NCT04074161 This clinical trial compares the efficacy and adverse event profiles of once-weekly subcutaneous semaglutide, 2.4 mg, vs once-daily subcutaneous liraglutide, 3.0 mg (both with diet and physical activity), in people with overweight or obesity. [ABSTRACT FROM AUTHOR]

Summary: Previous studies have explored people's perceptions of weight‐related terminology; however, to date, limited data has explored the emotional response to weight‐related terms used by healthcare professionals (HCPs). This study explored the preferences and emotional responses of terms used by HCPs to describe body weight and of parents to describe their children's weight. A total of 2911 adults completed an online cross‐sectional survey, with 1693 living with overweight or obesity (mean age 49.2 years [SD 12.5], female (96%), median body mass index (BMI) 31.4 kg/m2 [28.1, 36.5]). The survey explored preferences of 22 weight‐related terms using a 5‐point Likert scale and their emotional response to these terms (using 7‐core emotions). Parents also indicated preferences and emotional responses to terms used to describe their children's weight. Respondents completed the modified weight bias internalization scale to examine how this may impacted preferences. 'Weight', "unhealthy weight" and "overweight" were the three preferred terms, while "super obese", "chubby", and "extra‐large" were least preferred in people living with overweight and obesity. Parents preferred 'weight', "unhealthy weight" and "body mass index", and least preferred "fat", "extra‐large" and "extremely obese" when describing their children's weight. All terms elicited a negative emotional response. The most commonly emotion was sadness for terms to describe adult's bodyweight, and anger for terms used to describe children's weight. All BMI categories reported disgust with terms incorporating "obese". Our results offer novel insight into the preferred terminology and emotional responses to terminology used by HCPs for both adults and parents to describe their children's weight. [ABSTRACT FROM AUTHOR]

Background: This review aimed to estimate the time-trend prevalence of excess weight, overweight and obesity in the Brazilian adult population, from the 1970s–2020, through systematic review and meta-analysis (Protocol: CRD42018091002). Methods: A search for articles was conducted in the databases MEDLINE, EMBASE, Scopus, and LILACS up to June 2021. Studies that assessed excess weight, overweight and obesity in the adult population were eligible. Two authors selected studies, collected data and assessed the methodological quality of the studies. The primary outcomes were the prevalence of excess weight, overweight, and obesity by sex and period of years. Pooled prevalence and 95% confidence intervals (CIs) were calculated in the meta-analysis of the random effects model. Heterogeneity (I2) was investigated by meta-regression and publication bias was investigated by Egger's test. Results: A total of 7,938 references were identified in the search strategies, of which eighty-nine studies and nine national surveys, conducted from 1974–2020, were included in the meta-analysis. The pooled prevalence of excess weight in Brazilian adults increased from 33.5% (95% CI: 25.0; 42.6%) in 1974–1990 to 52.5% (95% CI: 47.6; 57.3%) in 2011–2020. The pooled prevalence of overweight in Brazilian adults was 24.6% (95% CI: 18.8; 31.0%) from 1974–1990 and 40.5% (95% CI: 37.0; 43.9%) from 2011–2020. The pooled prevalence of obesity in Brazilian adults increased by 15.0% from 1974–1990 to 2011–2020. The increases were observed for both men and women in almost all periods. The prevalence of excess weight and obesity remained higher among women in all periods. Conclusions: A continuous increase in the prevalence of excess weight, overweight and obesity were observed over the years. The prevalence of excess weight affected half of Brazilian adults in the period from 2011–2020 and both sexes. [ABSTRACT FROM AUTHOR]

Purpose: This cross-sectional study was conducted to determine the risk factors which affect obesity in preadolescents. Materials and Methods: The sample of the study consisted of 500 preadolescents (girls: n=271, boys: n=229) attended in 18 secondary schools in the Cappadocia region of Turkey, and their parents. Data were collected using a questionnaire, the body weight, height, and waist circumference of the preadolescents were measured; the body mass index (BMI) and the waist-toheight ratio were calculated. Results: Of preadolescents; 14.4% were obese, 11.4% were overweight, 35.2% had abdominal obesity, and 27% had likehood of being at high metabolic and cardiovascular risk based on their waist/height ratio. According to the results of binary multiple logistic regression analysis (the backward stepwise procedure), the presence of an obese person in the family (boys), mother's educational level (girls), leisure time activities (girls), and an increase in eating according to mood (girls) were revealed as significant predictors of being overweight/obese, adjusted for age. Satisfied with current body weight and mother’s BMI were the strongest variable to be associated with overweight/obese for both genders. Conclusion: For early diagnosis and prevention of obesity in childhood, it is recommended to perform height-weight monitoring of students regularly, monitor risky children more frequently, provide training and consultancy for students and parents regarding balanced diets and physical activity, and provide the school-family cooperation. [ABSTRACT FROM AUTHOR]

Introduction: Background: predicting weight loss outcomes from information collected from subjects before they start a weight management program is an objective strongly pursued by scientists who study energy balance. Objective: to develop and validate two prognostic models for the estimation of final body weight after a six-month intervention period. Material and methods: the present work was developed following the TRIPOD standard to report prognostic multivariable prediction models. A multivariable linear regression analysis was applied to 70 % of participants to identify the most relevant variables and develop the best prognostic model for body weight estimation. Then, 30 % of the remaining sample was used to validate the model. The study involved a 6-month intervention based on 25-30 % caloric restriction and exercise. A total of 239 volunteers who had participated in the PRONAF study, aged 18 to 50 years, with overweight or obesity (body mass index: 25-34.9 kg/m2), were enrolled. Body composition was estimated by dual-energy X-ray absorptiometry (DXA) and by hand-to-foot bioelectrical impedance (BIA) analysis. Results: prognostic models were developed and validated with a high correlation (0.954 and 0.951 for DXA and BIA, respectively), with the paired t-tests showing no significant differences between estimated and measured body weights. The mean difference, standard error, and 95 % confidence interval of the DXA model were 0.067 ± 0.547 (-1.036-1.170), and those of the BIA model were -0.105 ± 0.511 (-1.134-0.924). Conclusions: the models developed in this work make it possible to calculate the final BW of any participant engaged in an intervention like the one employed in this study based only on baseline body composition variables. [ABSTRACT FROM AUTHOR]

Aim: To systematically review the effects of pharmacological and lifestyle interventions on body weight as a secondary outcome in people with type 1 diabetes. Methods: The Ovid Medline, Embase and Cochrane Library databases were searched for relevant pharmacological (glucagon‐like peptide‐1 [GLP‐1] receptor agonist, sodium‐glucose co‐transporter‐2 [SGLT‐2] inhibitor, dipeptidyl peptidase‐4 [DPP‐4] inhibitor and metformin) and lifestyle intervention studies (diet and exercise) for adults with type 1 diabetes reporting body weight change and HbA1c published from January 2000 to May 2020. Meta‐analyses were performed for 16 randomized controlled trials (RCTs). Results: Thirty‐three RCTs (n = 9344 participants), 26 pharmacological (on average 43.9 years, 83.1 kg, HbA1c 8.1%; 55.8% male) and seven lifestyle‐based interventions (on average 37.0 years, 85.0 kg, HbA1c 8.1%; 84.6% male), were analysed. The GLP‐1 receptor agonist liraglutide 0.6 mg (mean difference [MD]: –2.22 kg [95% CI: –2.55 to –1.90]), 1.2 mg (MD: –3.74 kg [95% CI: –4.16 to –3.33]) and 1.8 mg (MD: –4.85 kg [95% CI: –5.29 to –4.41]), and the SGLT‐2 inhibitors empagliflozin 2.5 mg (MD: –1.47 kg [95% CI: –2.23 to –0.71]), 10 mg (MD: –2.77 kg [95% CI: –3.24 to –2.31]) and 25 mg (MD: –3.06 kg [95% CI: –3.57 to –2.55]) and sotagliflozin 200 mg (MD: –2.40 kg [95% CI: –2.87 to –1.94]) and 400 mg (MD: –3.23 [95% CI: –3.73 to –2.72]) were associated with significant reductions in body weight. No significant effect on body weight was found for DPP‐4 inhibitors, other GLP‐1‐receptor agonists, metformin, or for lifestyle interventions (i.e. exercise and diet). Conclusions: In people with type 1 diabetes, several adjuvant pharmacological interventions showed weight reduction as a secondary outcome. Future studies in overweight people with type 1 diabetes are needed to establish whether the lifestyle and pharmacological interventions reviewed here have potential as components of complex interventions aimed at body weight reduction as a primary outcome. [ABSTRACT FROM AUTHOR]

Background: The prevalence of overweight and obesity continues to rise and is associated with increased morbidity and mortality. Weight bias is common among physicians and medical students and limits the therapeutic alliance between providers and patients with overweight and obesity. Objective: The authors sought to explore the relationship between the gross anatomy course and medical student attitudes towards weight and obesity. Design: The authors employed a mixed-methods approach consisting of semi-structured interviews and anonymous web-based surveys of first-year medical students taking gross anatomy at one USA medical school. They analyzed transcripts of interviews and free-text survey responses using a grounded theory approach and performed tests of association to investigate the relationship between demographic information, responses to multiple-choice survey questions and weight bias. Results: A total of 319 (52%) first-year medical students (2015–2018) completed the survey and 33 participated in interviews. Of survey respondents, 71 (22%) responded that the course had changed how they felt about people with overweight/obesity. These respondents were also more likely to affirm that the course had affected their views toward their own bodies (p < 0.001). Qualitative data analysis identified three overarching themes within students' descriptions of the effects of the gross anatomy lab on attitudes toward bodies perceived to have excess weight: these bodies were described as 1) difficult, 2) unhealthy, and 3) evoking disgust. Students extrapolated from their experiences with cadavers to imagined interactions with future patients, relying heavily on the narrative of the difficult patient. Conclusions: At one USA medical school, students perceived their experiences in gross anatomy as shaping their attitudes toward individuals with overweight or obesity. Efforts to reduce medical student weight bias ought to target this previously unexplored potential site of weight bias. [ABSTRACT FROM AUTHOR]

The objective of the present study is to determine the anti-obesity effects of Akkermansia munciniphila on some biometric measurements. 40 patients were divided into two groups, each with 20 patients; G1 group consumed the probiotic of A. munciphila and G2 consumed placebo capsules. The results showed significant effects on the body weight (p≤ 0.001), which was reduced by a range of 2.29 to -0.7, whereas non-significant differences were observed in the Waist circumferance . The study also showed significant differences (p≤0.001) between the two groups in the levels of cholesterol (287 vs. 285 mg/dl), whereas the level of Triglyceride significantly decreased in the treated patients (p≤0.001). No significant differences were observed in the concentration of fat. There were also significant differences in the levels of fetuin-A (p≤0.020) and serotonin ( p≤ 0.039 ). The consumption of the probiotic of A. muciniphila was proved to be beneficial for human health, while further studies are needed to explore more effects. [ABSTRACT FROM AUTHOR]

Summary: Despite the increasing worldwide prevalence of obesity and iron deficiency (ID), there are still no guidelines on how to treat and manage obesity‐related ID. The aim of this systematic review and meta‐analysis was to investigate whether weight loss can re‐establish iron homoeostasis among subjects with unhealthy weight (overweight [OW] or obesity). PubMed, Medline, Embase, Web of Science, and the Cochrane Library were systemically searched for studies that compared the iron status before and after a weight‐loss intervention. A random‐effects model was used to calculate the pooled and subgroup weighted mean differences (WMDs) of iron biomarkers. In total, 879 subjects were pooled across 14 studies. Improved haemoglobin was found in longitudinal studies (WMD = 2.50 g/dl, 95% confidence interval [CI]: 0.88, 4.12 g/dl, I2 = 14%) but not in randomized controlled trials or after being stratified by dietary programmes. Significantly increased transferrin saturation was observed in pooled (WMD = 1.68%, 95% CI: 0.97%, 2.39%, I2 = 44%) and subgroup analyses. A meta‐regression showed that changes in the iron status were positively correlated with changes in the body mass index (BMI) and the intervention duration but negatively correlated with the baseline body weight/BMI, age, gender and a standard hypocaloric diet. Our data suggested that in spite of energy restrictions, weight loss may help re‐establish iron homoeostasis in people who are OW or obese. [ABSTRACT FROM AUTHOR]

Background: In observational studies of the general population, higher body mass index (BMI) has been associated with increased incidence of and mortality from bloodstream infection (BSI) and sepsis. On the other hand, higher BMI has been observed to be apparently protective among patients with infection and sepsis. We aimed to evaluate the causal association of BMI with risk of and mortality from BSI.Methods and Findings: We used a population-based cohort in Norway followed from 1995 to 2017 (the Trøndelag Health Study [HUNT]), and carried out linear and nonlinear Mendelian randomization analyses. Among 55,908 participants, the mean age at enrollment was 48.3 years, 26,324 (47.1%) were men, and mean BMI was 26.3 kg/m2. During a median 21 years of follow-up, 2,547 (4.6%) participants experienced a BSI, and 451 (0.8%) died from BSI. Compared with a genetically predicted BMI of 25 kg/m2, a genetically predicted BMI of 30 kg/m2 was associated with a hazard ratio for BSI incidence of 1.78 (95% CI: 1.40 to 2.27; p < 0.001) and for BSI mortality of 2.56 (95% CI: 1.31 to 4.99; p = 0.006) in the general population, and a hazard ratio for BSI mortality of 2.34 (95% CI: 1.11 to 4.94; p = 0.025) in an inverse-probability-weighted analysis of patients with BSI. Limitations of this study include a risk of pleiotropic effects that may affect causal inference, and that only participants of European ancestry were considered.Conclusions: Supportive of a causal relationship, genetically predicted BMI was positively associated with BSI incidence and mortality in this cohort. Our findings contradict the "obesity paradox," where previous traditional epidemiological studies have found increased BMI to be apparently protective in terms of mortality for patients with BSI or sepsis. [ABSTRACT FROM AUTHOR]

Background: The longer upper airway is more collapsible during sleep. This study aims to reveal relationships among upper airway length, weight, and obstructive sleep apnea (OSA), particularly to answer why the upper airway of OSA patients is longer than that of healthy people and why some obese people suffer from OSA while others do not.Methods: We perform head and neck MRI on male patients and controls, and measure > 20 morphological parameters, including several never before investigated, to quantify the effect of weight change on upper airway length.Results: The upper airway length is longer in patients and correlates strongly to body weight. Weight increase leads to significant fat infiltration in the tongue, causing the hyoid to move downward and lengthen the airway in patients. The apnea-hypopnea index (AHI) strongly correlates to airway length and tongue size. Surprisingly, a distance parameter h and angle β near the occipital bone both show significant differences between healthy males and patients due to their different head backward tilt angle, and strongly correlates with AHI. The contributions of downward hyoid movement and head tilt on airway lengthening are 67.4-80.5% and19.5-32.6%, respectively, in patients. The parapharyngeal fat pad also correlates strongly with AHI.Conclusions: The findings in this study reveal that the amount of body weight and distribution of deposited fat both affect airway length, and therefore OSA. Fat distribution plays a larger impact than the amount of weight, and is a better predictor of who among obese people are more prone to OSA. [ABSTRACT FROM AUTHOR]

Summary: COVID‐19 crisis has lasted since the late 2019 to the present day. The severity of the disease is positively correlated with several factors, such as age and coexisting diseases. Furthermore, obesity is increasingly considered as a yet another risk factor, particularly, because it has been observed that people suffering from excessive body weight may experience a more severe course of COVID‐19 infection. On the basis of current research, in our nonsystematic review, we have investigated the extent to which obesity can affect the SARS‐CoV‐2 course and identify the potential mechanisms of the disease. We have also described the role of proper nutrition, physical activity and other aspects relevant to the management of obesity. [ABSTRACT FROM AUTHOR]

Purpose: Discrimination and stigmatization of patients with obesity are a commonly occurring social problem. The purpose of our research was to analyze the scale of the experience including medical staff's improper behaviours towards patients with obesity in Poland. Patients and Methods: In a completed national study, we studied the statements of 621 adult patients who suffer from obesity. An original closed question survey was used as a tool to collect the data. Patients were informed about the possibility to participate in the study through social media, medical institutions and patient foundations. Results: As many as 82.6% have experienced improper behaviours. Usually, it came from doctors (90%), nurses and midwives (51%), people who operated medical equipment (24%), nutritionists (14%) and paramedics (9%). Exactly 81% of the respondents pointed to unpleasant and judgmental comments as the most frequent form of improper behaviour which they have encountered mainly during diagnostic tests, palpation or procedures. Conclusion: There is an urgent need for developing national strategies connected with care for individuals with higher body weight. Introducing dedicated solutions in this field may contribute to increasing the quality of health care and reducing stigmatizing behaviours. [ABSTRACT FROM AUTHOR]

Introduction: the use of a restrictive diet for treating obesity has been proven inefficient in the long-term. Besides, body dissatisfaction could be the reason for starting a restrictive diet. In this sense, intuitive eating emerges as an alternative for reconnecting individuals with their bodies and the signals it sends. Objective: to evaluate an individuals' tendency to follow physiological signs of hunger and satiety and correlate them with body dissatisfaction in overweight people. Materials and methods: this is a transversal and quantitative study with users of a specialized obesity treatment service in the city of Fortaleza. Sociodemographic data was collected and the Intuitive Eating Scale - 2 (IES-2) and Stunkard Silhouettes Scale were applied; weight and height were also collected. Results: A negative correlation was observed between "Reliance on Hunger and Satiety Cues", weight (ρ=-0,298; p=0,030) and current silhouette (ρ=-0,341; p=0,012) and also between "Body-Food Choice Congruence" and current silhouette (ρ=-0,297; p=0,031). Discussion: the literature analysis and the presented data have shown that there are interactions between hunger and satiety cues, body-food choice congruence, and anthropometric variables and body perception. Conclusion: reliance on hunger and satiety cues is linked with body image and weight, and body-food choice congruence are also linked with body image. [ABSTRACT FROM AUTHOR]

Aims: LIK066 (licogliflozin) is a dual sodium glucose co‐transporter 1/2 inhibitor with potential benefits in weight loss. This study evaluated the efficacy, tolerability and safety of licogliflozin in Japanese adults with obesity. Materials and methods: This study was a randomized, double‐blind, placebo‐controlled, dose‐finding study to evaluate the effect of licogliflozin (2.5, 10, 25 and 50 mg once daily) in 126 Japanese patients with obesity. The primary objective was to examine the dose–response relationship of licogliflozin treatment in body weight reduction relative to placebo at 12 weeks. The secondary objectives included assessment of responder rates, change in parameters related to complications, visceral and subcutaneous fat area, and safety during 12 weeks of treatment. Results: The placebo‐subtracted least square mean percentage change in body weight from baseline at week 12 was −1.99 (95% confidence interval −2.92, −0.21), −3.00 (−4.15, −1.70), −3.54 (−4.54, −2.26) and − 3.91% (−5.01, −2.77) in licogliflozin 2.5, 10, 25 and 50 mg once‐daily dose groups, respectively. The proportion of responders with ≥3% reduction in body weight in the licogliflozin 2.5, 10, 25 and 50 mg once‐daily dose groups were 15.8%, 55.6%, 50.0% and 56.7%, respectively, versus placebo [7.1%; P ≤0.002 for all except the 2.5 mg once‐daily group (P = 0.39)]. Dose‐dependent reductions were observed significantly in haemoglobin A1c, uric acid, fasting plasma glucose and potentially in the waist circumference, diastolic blood pressure and visceral fat area. Conclusion: Dual inhibition of SGLT1/2 with licogliflozin treatment induced a dose‐dependent reduction in body weight in Japanese patients with obesity. Treatment with licogliflozin was safe and well tolerated in this study. The study is registered with ClinicalTrials.gov (NCT03320941). [ABSTRACT FROM AUTHOR]

Aims: To investigate the impact on weight loss of the treatment changes in overweight or obese people that may be needed in case of gastrointestinal (GI) tolerability issues during escalation of the glucagon‐like peptide‐1 analogue liraglutide. Materials and methods: The individual longitudinal body weight data from the main trial periods of three phase II/III trials in overweight or obese patients (56‐week treatment with once‐daily liraglutide 1.2, 1.8, 2.4 or 3.0 mg or placebo, n = 4952) were analysed using a non‐linear mixed‐effect modelling approach. Individual pharmacokinetic profiles were derived based on published pharmacokinetic models. Baseline body weight, baseline glycated haemoglobin (HbA1c), age, gender, diabetes status (no diabetes, prediabetes or type 2 diabetes), race and trial region were investigated as covariates. As a form of external validation, the model was used to predict the weight regain after treatment cessation at week 56 (data not included in model development). Results: A pharmacokinetic/pharmacodynamic model provided an adequate description of the weight loss trajectories for all studied doses. Gender and diabetes status were identified as the most influential covariates, and an underlying seasonal weight fluctuation was identified. Slower than that recommended, one‐week dose‐escalation algorithms led up to 2 weeks slower initial weight loss but similar long‐term weight loss trajectories. Conclusions: The relationship between liraglutide systemic exposure and weight loss was successfully established in overweight or obese people. The model could predict the time course of weight regain after treatment cessation and suggests that GI tolerability can be mitigated by slower escalation with only minor impact on the weight loss trajectory. [ABSTRACT FROM AUTHOR]

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Obesity predicts adverse microvasculature from childhood, potentially via inflammatory pathways. We investigated whether inflammation mediates associations between obesity and microvascular parameters. In 1054 children (mean age 11 years) and 1147 adults (44 years) from a cross-sectional study, we measured BMI (z-scores for children) and WHtR, Glycoprotein acetyls (GlycA), an inflammatory marker, and retinal arteriolar and venular calibre. Causal mediation analysis methods decomposed a "total effect" into "direct" and "indirect" components via a mediator, considering continuous and categorical measures and adjusting for potential confounders. Compared to normal-weight BMI children, those with overweight or obesity had narrower arteriolar calibre (total effects −0.21 to −0.12 standard deviation (SD)): direct (not mediated via GlycA) effects were similar. Children with overweight or obesity had 0.25 to 0.35 SD wider venular calibre, of which 19 to 25% was mediated via GlycA. In adults, those with obesity had 0.07 SD greater venular calibre, which was completely mediated by GlycA (indirect effect: 0.07 SD, 95% CI −0.01 to 0.16). Similar findings were obtained with other obesity measures. Inflammation mediated associations between obesity and retinal venules, but not arterioles from mid-childhood, with higher mediation effects observed in adults. Interventions targeting inflammatory pathways may help mitigate adverse impacts of obesity on the microvasculature. [ABSTRACT FROM AUTHOR]

Background: Endoscopic sleeve gastroplasty (ESG) is a minimally invasive, effective, and safe technique for weight loss intervention. Since a relatively small number of cases were present in previous studies, this study aimed to elucidate the efficacy and safety of ESG.Methods: Relevant publications were identified through searching PubMed, EMBASE, Cochrane, and Web of Science before March 1, 2019. The percentage of total body weight loss (%TBWL), percentage of excess weight loss (%EWL), and the adverse event rate in each follow-up session were extracted, pooled, and analyzed. Forest plots were graphed based on random effects models.Results: A total of 1542 patients from nine studies were eligible for analysis. The pooled results of %TBWL at 1, 3, 6, and 12 months were 8.78% (p = 0.000), 11.85% (p = 0.000), 14.47% (p = 0.024), and 16.09% (p = 0.063), respectively. The pooled results of %EWL at 1, 3, 6, and 12 months were 31.16% (p = 0.000), 43.61% (p = 0.000), 53.14% (p = 0.000), and 59.08% (p = 0.015), respectively. Finally, the pooled rate of mild adverse events was 72% (p < 0.01), and the pooled estimate of severe adverse events was only 1% (p = 0.08).Conclusion: Although the conventional surgical sleeve gastrectomy is the gold standard for bariatric surgery, ESG could be a promising minimally invasive alternative for treating obesity with satisfactory efficacy and low risk. [ABSTRACT FROM AUTHOR]

A study presented at the American College of Cardiology's Annual Scientific Session found that semaglutide, a medication used to treat type 2 diabetes, can improve functional status and body weight in patients with heart failure with preserved ejection fraction (HFpEF), obesity, and type 2 diabetes. The study involved 616 adults who were randomly assigned to receive semaglutide or a placebo for 52 weeks. The results showed that semaglutide led to significant improvements in the Kansas City Cardiomyopathy Questionnaire clinical summary score, body weight, 6-minute walk distance, and C-reactive protein levels compared to the placebo. The findings suggest that targeting obesity could be an effective treatment strategy for patients with obesity-related HFpEF, with or without diabetes. [Extracted from the article]