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Background: Physical inactivity is recognized as a global health challenge. Attachment theory may provide insight into individual physical activity (PA) patterns, informing the development of PA interventions to promote the maintenance of behavior change. This study investigated the associations between attachment orientation and why and how individuals engage in PA. Given the association between attachment and sensory processing, this study also investigated the link between sensory processing and PA participation. Methods: Participants (N = 141) completed an online questionnaire that included the Modified Experiences of Close Relationships Scale and the Highly Sensitive Person Scale. The relationship between attachment orientation and sensory processing patterns, and preference for PA participation were analyzed using 2-sided independent t tests. Results: Attachment avoidance, attachment anxiety, and sensory sensitivity were significantly related to participants' preference for PA participation in theoretically consistent ways. Avoidantly attached individuals were less likely to participate in PA as a form of social interaction (mean = 8.57, SD = 2.87, P =.005, d = 0.48). Anxiously attached individuals were more likely to participate in PA to support weight management (mean = 37.02, SD = 11.54, P =.01, d = −0.46) or if recommended by a health professional (mean = 43.55, SD = 12.45, P =.039, d = −0.88). Sensory sensitive individuals were more likely to participate in PA alone (mean = 124.11, SD = 19.23, P =.005, d = −0.510), and more likely to prefer light-intensity forms of PA (mean = 133.29, SD = 12.67, F3,123 = 5.49, P =.001). Conclusions: Findings highlight the potential value of considering an individual's attachment orientation and sensory processing patterns in the development of PA interventions. This may help to address the challenges of PA participation, by individually tailoring interventions to participants. [ABSTRACT FROM AUTHOR]

Mixed martial arts' popularity has increased in recent years, alongside descriptive research and evidence-based performance recommendations. Guidelines for (both chronic and acute) weight making exist; however, how these translate in real-life scenarios and detailed investigations on practices in larger groups deserve attention. The present study examined the body mass (BM) and composition of 33 professional mixed martial arts athletes preparing for 80 fights. Athletes were supported by on-site dietitians, who encouraged evidence-based practices. Fasted BM was measured throughout the last ∼10 days before all bouts (acute weight management phase). A subset of athletes had body composition assessed before and after the chronic weight loss phase for 40 fights. Most athletes engaged in chronic BM loss, and all engaged in acute weight loss. Many lost fat-free mass (FFM) during the chronic phase, with rates of BM loss <0.5% best preserving FFM. Regardless of losses, the present athletes possessed greater FFM than other combat sport athletes and engaged in greater acute weight loss. Dehydration in the 24–48 hr before the weigh-in was not reflective of weight regain after the weigh-in, rather BM 7–10 days before the weigh-in was most reflective. These findings suggest that many mixed martial arts athletes could increase FFM at the time of competition by maintaining leaner physiques outside of competition and/or allowing increased time to reduce BM chronically. Acutely, athletes can utilize evidence-based protocols, eliminating carbohydrates, fiber, sodium, and finally fluid in a staged approach, before the weigh-in, reducing the amount of sweating required, thus theoretically better protecting health and preserving performance. [ABSTRACT FROM AUTHOR]

This paper proposes the use of machine learning models to predict one's risk of having hypertension in the future using their routine health checkup data of their current and past visits to a health checkup center. The large-scale and high-dimensional dataset used in this study comes from MJ Health Research Foundation in Taiwan. The training data for models is separated into 5 folds and used to train 5 models in a 5-fold cross validation manner. While predicting the results for the test set, the voted result of 5 models is used as the final prediction. Experimental results show that our models achieve 69.59% of precision, 77.90% of recall, and 73.51% of F1-score, which outperforms a baseline using only the blood pressure of visitors' last visits. Experiments also show that a visitor who performs a health checkup more often can be predicted better, and models trained with selected important factors achieve better results than those trained with Framingham risk score. We also demonstrate the possibility of using our models to suggest visitors for weight control by adding virtual visits that assume their body weight can be reduced in the near future to model input. Experimental results show that around 5.48% of the people who are with high Body Mass Index of the true positive cases are rejudged as negative, and a rising trend appears when adding more virtual visits, which may be used to suggest visitors that controlling their body weight for a longer time lead to lower probability of having hypertension in the future. [ABSTRACT FROM AUTHOR]

Summary The use of recommender systems in mobile health apps for weight control has grown, but user app uptake and engagement remain limited. The objective of our scoping review was to explore the influence of recommender systems on mHealth app user engagement, identify the theoretical frameworks that have been applied on digital health interventions designed for weight management, and examine the key aspects that support tailoring user engagement through recommender systems. Based on existing literature, we identified 13 articles on recommender systems for weight management. Themes emerged, including theoretical underpinnings, authors' domain knowledge, user motivation, and design. Most studies used constructs from the social cognitive theory. We found inconsistencies between authors' domain knowledge and the intervention's content, with few professionals from the health and psychology fields. Only 46% of articles measured user engagement, whereas gamification and tailored messages were common app features. Despite some positive weight change results, more attention is needed toward implementing behavior theory and other strategies to promote app user engagement. Future studies should more accurately measure user motivation and identify the best features and behavioral constructs to increase app user interaction. Larger studies with a more diverse population are needed to generalize findings and evaluate weight loss maintenance and physical activity habits among users of recommender system. [ABSTRACT FROM AUTHOR]

Obesity is a global health concern, steadily rising and posing risks to various health conditions. Despite available antiobesity drugs, their withdrawal due to severe side effects highlights the need for safer alternatives. Natural products, particularly mixed herbal formulations, present a promising avenue in obesity research. This study aimed to investigate the potential antiobesity effects of the NL herbal formula, a traditional remedy in Nakhon Si Thammarat, Thailand, composed of nine herbs. The specific focus was on the inhibitory effects on α‐glucosidase and pancreatic lipase enzyme activities, adipogenesis inhibition and lipolysis promotion. NL extract was phytochemically analyzed and assessed for its inhibitory effects on α‐glucosidase and pancreatic lipase. Its impact on lipid accumulation and glycerol release was also evaluated. Phytochemical analysis using liquid chromatography–tandem mass spectrometry (LC/MS‐MS) identified piperine as the major compound in the NL extract. NL extract exhibited significant inhibition of α‐glucosidase, moderate pancreatic lipase inhibition, and dose‐dependent reduction in fat accumulation and triglyceride content. Glycerol release increased compared to the control, indicating potential benefits in weight management. This research underscores the potential of the NL formula in combating obesity through its effects on adipogenesis, lipolysis, and enzyme activities. Further investigations into the molecular mechanisms are warranted to fully elucidate its therapeutic potential. [ABSTRACT FROM AUTHOR]

Aims Materials and Methods Results Conclusions The study aims to examine the outcome of replacement of prandial insulin with once‐weekly subcutaneous semaglutide in people with type 2 diabetes reasonably controlled on multiple daily insulin injections (MDI).This single‐centre, randomised, open‐label trial enrolled a statistically predetermined sample of 60 adults with HbA1c ≤7.5% (58 mmol/mol) receiving MDI, with a total daily dose (TDD) ≤120 units/day. Participants were assigned 2:1 to subcutaneous semaglutide 1.0 mg plus insulin degludec, or to continue MDI. The primary outcome was percentage of subjects maintaining HbA1c ≤7.5% (58 mmol/mol) at Week 26.At Week 26, 90% of semaglutide and 75% of MDI subjects maintained HbA1c ≤7.5% (≤58 mmol/mol) (p = 0.18). Mean changes (95% CI) in HbA1c, weight and percentage body weight for semaglutide versus MDI, respectively, were −0.5% (−0.7, −0.3) versus 0.0% (−0.3, 0.3; p = 0.009); −8.9 kg (−9.9, −7.8) versus 1.5 kg (−0.1, 3.1; p < 0.001); and −8.6% (−9.6, −7.6) versus 1.4% (0.0, 2.8; p < 0.001). Insulin TDD decreased 56.0% (−62.3, −49.7) with semaglutide and increased 6.7% (−2.5, 16.0) with MDI (p < 0.001). Among semaglutide subjects, 58% reduced insulin TDD > 50%, 97.5% stopped prandial insulin and 45% lost >10% body weight. Participant treatment satisfaction scores trended higher with semaglutide. Hypoglycaemia frequency was similar between groups.In people with type 2 diabetes well controlled (HbA1c ≤7.5% [≤58 mmol/mol]) on MDI ≤120 units/day, replacing multiple daily injections of prandial insulin with once‐weekly subcutaneous semaglutide can maintain and even improve HbA1c, lower body weight and lessen the burden of management. [ABSTRACT FROM AUTHOR]

Quinoa is a particularly nutrient-rich grain crop, which is abundant in micronutrients, fibre, and essential amino acids, making it an excellent staple food source. The current review provides an outline of the antioxidant and anti-inflammatory properties of quinoa and a critical evaluation of health benefits following its consumption focusing on diabetes and diabetes risk factors, non-alcoholic fatty liver disease, hypertension, cancer risk, body weight regulation and obesity, and cardiovascular disease risk factors. Quinoa has been demonstrated to have as hypoglycaemic effect and inducing favourable changes in cholesterol, HDL and LDL levels, inflammatory markers as well as body weight in humans. [ABSTRACT FROM AUTHOR]

Childhood-onset craniopharyngiomas, though rare, are intracranial malformations that can cause obesity by disrupting the hypothalamus, a condition that often persists even after tumor resection. This severe obesity increases the risk of diabetes and fatty liver disease in childhood. Concurrently, panhypopituitarism, including growth hormone (GH) deficiency, may develop. Notably, some individuals with GH deficiency may exhibit a normal growth rate, making GH therapy unnecessary for growth purposes. However, in these cases, GH therapy may still be beneficial in preventing the progression of nonalcoholic fatty liver disease or nonalcoholic steatohepatitis. Although weight management is traditionally considered the gold standard for preventing liver cirrhosis, its effectiveness can be limited by hypothalamic dysfunction and the difficulty of achieving successful weight control. Our case study highlights a patient with normal growth despite GH deficiency, who did not receive GH replacement therapy and continued to struggle with hypothalamic obesity. Despite effective body weight control, the patient developed hepatopulmonary syndrome, indicating that relying solely on weight management may not be sufficient to prevent liver complications. This case underscores the importance of addressing GH deficiency even when growth is normal. Our findings suggest that GH replacement therapy could be beneficial for preventing liver cirrhosis in such cases. [ABSTRACT FROM AUTHOR]

Summary Guidelines specify that clinicians should support patients living with obesity by referring to weight management programmes (WMPs), but clinicians do so infrequently. To provide additional support to patients living with obesity and weight‐related conditions, the UK government instated the National Enhanced Service (NES) for weight management in England, including a reimbursement to general practices for referring eligible patients to WMPs. To assess the impact of the NES on conversations regarding weight and relevant behavioural risk factors in primary care consultations we recruited 11 medical practices in England where the NES was operating and six comparator practices from Scotland and Wales where the NES was not implemented. Clinicians audio‐recorded annual review appointments of patients living with obesity and hypertension and/or diabetes. The content of these consultations was synthesised using quantitative content analysis. Consultations with 92 patients were analysed: 58 in England and 34 in Scotland and Wales. No difference was found between the NES sites (England) and non‐NES sites (Scotland and Wales) in the proportion of referrals made to WMPs. Clinicians in England weighed patients and took other body measurements more often, mentioned body mass index more often, and had more detailed discussions about patients' diets, but there was no evidence that they differed in their discussion of WMPs or other modifiable risk factors. We found no strong evidence that the NES affected how clinicians addressed weight management or related behavioural risk factors within annual review consultations for patients living with obesity and hypertension and/or diabetes. [ABSTRACT FROM AUTHOR]

Background: White tea, derived from the Camellia sinensis plant like other teas, uses tender buds and young leaves and undergoes minimal processing. This results in higher levels of antioxidants and bioactive substances, which may enhance thermogenesis more effectively than other teas. This first human study aimed to investigate the acute effects of white tea consumption on resting energy expenditure (REE) and some vital signs, including blood pressure (BP), heart rate (HR), and body temperature (BT). Methods: Thirty-two healthy female volunteers with normal initial BP and whose caffeine intakes were < 300 mg/d were enrolled in the study. The caffeine and total phenolic content of white tea samples were determined by the high-performance liquid chromatography method and the Folin-Ciocalteu colorimetric method, respectively. After baseline measurements, participants consumed white tea containing 6 mg of caffeine per kilogram of lean body mass, and the white tea was prepared with bottled drinking water at 80 °C and brewed for 3 min. REE, BP, and BT were assessed at various intervals (baseline, 30 min, 120 min, and 180 min) post-consumption of the white tea. Results: The results revealed a significant increase in REE by 8.7% at 180 min after the consumption. In particular, there was a substantial difference in both values between the intervals of 30 min to 180 min and baseline to 180 min for REE (p < 0.05). Maximal oxygen consumption and BT also increased significantly over time (p < 0.05) and the observed increment in BT suggests a thermogenic effect associated with white tea consumption. However, systolic BP, diastolic BP, and heart rate showed no significant difference. Conclusions: These findings suggest white tea consumption may acutely enhance REE and maximal oxygen consumption, so the results are promising for body weight management. This study is the first human study in the literature about the effects of white tea on energy expenditure and vital signs. [ABSTRACT FROM AUTHOR]

Lower limb oedema is a common condition in clinical practice, frequently affecting the distal lower limbs. Whereas benign causes such as prolonged sitting or standing are typical, oedema can also indicate serious systemic diseases such as cardiac failure, liver disease, or renal impairment. Identifying the cause is crucial to prevent irreversible skin and tissue changes. This clinical review aims to increase the knowledge of advanced clinical practitioners (ACPs) and generalist practitioners, including practice and community nurses, by providing an overview of how to approach patients with lower limb oedema, encompassing history-taking, examinations, investigations, and management plans. The main focus is on lymphoedema, which can be primary or secondary. Primary lymphoedema results from genetic abnormalities, while secondary lymphoedema arises from acquired defects due to factors such as obesity, infections, neoplasms, and trauma. Effective management includes addressing the underlying cause, ensuring proper skin care, recommending appropriate exercises, and the use of compression garments. Referral to a lymphoedema specialist is recommended for patient education on managing and treating the condition when required. Additionally, the article discusses the importance of regular skin inspections, minor injury management, environmental considerations, and the critical role of compression garments in lymphoedema management. This comprehensive approach aims to enhance patient outcomes and provide a thorough strategy for ACPs and generalist practitioners. [ABSTRACT FROM AUTHOR]

The use of glucagon-like peptide-1 receptor agonists (GLP-1RA) has experienced rapid growth amidst the obesity epidemic in the United States. While originally developed for glucose control in Type 2 Diabetes Mellitus, the scope of these agents now extends to encompass weight loss and cardiovascular risk reduction. GLP-1RAs have the potential to induce significant weight loss, in combination with lifestyle modifications, among adults who are overweight or obese. Furthermore, these agents demonstrate efficacy in ameliorating hyperglycemia, enhancing insulin sensitivity, regulating blood pressure, improving cardiometabolic parameters, mitigating kidney dysfunction, and potentially reducing the risk of several obesity-related cancers. Drug-related toxicity is primarily gastrointestinal and active management can prevent drug discontinuation. Obesity is associated both with an increased incidence of malignancy but also with decreased survival. More research is needed to evaluate the potential use of GLP-1RA to modify the endocrine function of adipocytes, regulate the chronic inflammatory state associated with obesity, and prospective applications in oncology. These agents can impact patients with gynecologic malignancies both through their direct mechanism of action as well as potential drug toxicity. • The use of GLP-1 receptor agonists (RA) for weight management is expanding rapidly. • GLP-1RAs have diverse and far-reaching impacts and therapeutic indications are expanding rapidly. • Understanding GLP-1RAs and their potential to impact our patients is important for the Gynecologic Oncologist. [ABSTRACT FROM AUTHOR]

Aims Materials and Methods Results Conclusions Both pioglitazone and glucagon‐like peptide 1 receptor agonists (GLP1RA) alone improve metabolic dysfunction‐associated steatohepatitis (MASH) in randomized clinical trials, whereas preclinical studies suggested MASH benefits with sodium glucose co‐transporter 2 inhibitors (SGLT2i). In the real world, patients with type 2 diabetes often require multiple agents for glycaemic control. Here, we investigated the benefits of combining these agents on risks of MASH.Longitudinal changes in FibroScan‐aspartate aminotransferase (FAST) score were measured in 888 patients with type 2 diabetes. Use of pioglitazone, GLP1RA and/or SGLT2i was defined as continuous prescriptions of ≥180 days prior to their last reassessment FibroScan. Multivariable logistic regression analysis was conducted to evaluate the associations between use of these agents and FAST score changes.Over a median follow‐up of 3.9 years, the increasing number of these agents used was significantly associated with more reductions in FAST score (p for trend <0.01). Dual combination was independently associated with a higher likelihood of achieving low FAST score at reassessment than single use of any of these agents (odds ratio [OR] 2.84, p = 0.01). Among the different drug combinations, using SGLT2i and pioglitazone (median dose 15 mg daily) together, as compared to not using any of these three agents, was associated with a higher likelihood of both low FAST score at reassessment (OR 6.51, p = 0.008) and FAST score regression (OR 12.52, p = 0.009), after adjusting for changes in glycaemic control and body weight during the study.Combining SGLT2i and pioglitazone is a potentially useful strategy to ameliorate ‘at‐risk’ MASH in patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Previous studies indicated that metabolic heterogeneity of obesity would affect the risk of cardiovascular disease (CVD). However, the alterations in CVD risk associated with transitions between various metabolic health statuses influenced by obesity status remain unclear.We utilized data from the China Health and Retirement Longitudinal Study (CHARLS), a longitudinal cohort study involving Chinese residents aged 45 years and older. Baseline data were collected in 2011–2012, with follow‐up surveys conducted up to 2020. Participants in the study were categorized into four body mass index–metabolic phenotypes: metabolically healthy normal weight (MHNW), metabolically healthy overweight/obesity (MHOO), metabolically unhealthy normal weight (MUNW) and metabolically unhealthy overweight/obesity (MUOO). Transitions in these phenotypes over 4 years were analysed. Cox regression models were used to assess the associations of these phenotypes and their transitions with CVD incidence.Among 7721 participants, 1353 (17.5%) developed CVD during the follow‐up period. Both overweight/obese and metabolically unhealthy statuses were associated with increased CVD risk. The highest risk was observed in the MUOO group (hazard ratio [HR]: 1.74, 95% confidence interval [CI]: 1.50–2.09, p < 0.0001), followed by the MUNW (HR 1.35, 95% CI: 1.13–1.66, p < 0.001) and MHOO (HR: 1.29, 95% CI: 1.08–1.56, p = 0.002) groups compared to the MHNW group. The deteriorations of obesity and metabolic health status elevated the incidence of CVD, whereas improvements in these statuses reduced the risk of CVD. Additionally, alterations in metabolic health status conferred greater benefits in overweight/obese individuals compared to those with normal weight.The study highlights the importance of maintaining and promoting metabolic health, particularly in overweight/obese individuals, to reduce CVD risk. Metabolic health status plays a more crucial role than obesity status in predicting CVD incidence. [ABSTRACT FROM AUTHOR]

Objective: In cross‐sectional and retrospective research, parental binge eating is associated with their children's eating psychopathology. The current study extended the evidence by cross‐sectionally and longitudinally examining the relation between parental binge eating and binge eating and weight‐control behaviors in the next generation of their adolescent children and young adult children in a population‐based sample. Methods: Adolescents (Time 1: M = 14.5, SD = 2.0 years) (n = 2367), followed into adulthood (Time 2: M = 22.1, SD = 2.0 years), and their parents (n = 3664) were enrolled in EAT 2010–2018 and Project F‐EAT 2010. The current study examined parental binge eating, and child binge eating and weight‐control behaviors. Adjusted models covaried for child gender, age, and race/ethnicity. Results: Approximately 7% of adolescents at Time 1 had at least one parent who reported binge eating with no differences by child's age, gender, or race/ethnicity. Having at least one parent experiencing binge eating at Time 1 (vs. not) was associated cross‐sectionally with adolescent children's use of extreme weight‐control behaviors (9.6% vs. 4.8%; Risk Difference [RD] = 4.9%) and associated longitudinally with binge eating during young adulthood (21.1% vs. 11.6%; RD = 9.5%). Other associations did not reach statistical significance. Conclusions: Children of parents with binge eating appear to have elevated risk of extreme weight‐control behaviors during adolescence and binge eating in young adulthood. Clinicians should assess whether eating psychopathology extends to other family members, and offer additional support to parents with binge eating. Further research is needed to identify risk factors in the children of parents with binge eating and to assess strategies for prevention. [ABSTRACT FROM AUTHOR]

Obesity is a complex health issue with growing prevalence worldwide. It is also becoming more prevalent in the population of older adults (i.e., 65 years of age and older), affecting frequency and severity as well as other comorbidities, quality of life and consequently, life expectancy. In this article we review currently available data on pharmacotherapy of obesity in the population of older adults and its role in obesity management. Even though there is growing evidence, in particular in the general population, of favourable efficacy and safety profiles of glucagon-like peptide-1 (GLP-1) receptor agonists liraglutide and semaglutide, and recently dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) agonist tirzepatide, concise guidelines for older adults are not available to this day. We further discuss specific approaches to frequently represented phenotype of obesity in older adults, in particular sarcopenic obesity and rationale when to treat and how. In older adults with obesity there is a need for more drug trials focusing not only on weight loss, but also on geriatric endpoints including muscle mass preservation, bone quality and favourable fat distribution changes to get enough data for evidence-based recommendation on obesity treatment in this growing sub-population. [ABSTRACT FROM AUTHOR]

BACKGROUND: Veterans Affairs and the Department of Defense (DOD) acknowledge that nutrition may be a modifier of mild traumatic brain injury (TBI) sequelae. Military clinicians are considering nutritional supplements and dietary interventions when managing patients with mild TBI. Therefore, clinicians should be familiar with the current evidence for nutritional interventions in mild TBI and special considerations related to the military lifestyle. OBJECTIVE: This narrative review aims to summarize the existing evidence surrounding the role of special diets and select nutrients in mild TBI outcomes, gut microbiota changes, and special considerations for Service members and Veterans recovering from mild TBI. METHODS: We conducted a literature review in PubMed and Google Scholar limited to nutritional interventions and nine topics with primary focus on mild TBI, although we included some articles related to moderate-to-severe TBI where relevant: 1) ketogenic diet, 2) Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, 3) omega-3 fatty acids, 4) creatine, 5) vitamin D, 6) weight management, 7) gut microbiota, 8) caffeine, and 9) alcohol. We summarized key findings and safety factors where appropriate for each intervention. We also identified nutritional supplement safety and operational rations considerations and areas in need of further research. RESULTS: Preclinical studies and early human trials suggest that the specific nutrients and diets discussed in the current article may offer neuroprotection or benefit during mild TBI rehabilitation. Omega-3 fatty acids, creatine, and vitamin D are generally safe when taken within recommended guidelines. CONCLUSION: More evidence is needed to support nutritional recommendations for enhancing neuroprotection and mitigating mild TBI symptoms in humans. The DOD's Warfighter Nutrition Guide recommends a whole food diet rich in antioxidants, phytonutrients, omega-3 fatty acids, micronutrients, probiotics, and fiber to optimize long-term health and performance. [ABSTRACT FROM AUTHOR]

This paper focuses on the phenomenon of self-initiated self-repair in weight loss discussions within clinical settings. It shows that one of the primary functions of self-repair is to manage epistemics in talk. The study explores repair operations and techniques, shedding light on the linguistic resources employed by doctors and patients to modify knowledge claims in relation to their interactional objectives, the speaker's epistemic status, and the epistemic stance expressed by the interlocutor. Throughout the paper, we demonstrate how self-initiated self-repairs contribute to achieving epistemic balance and congruence in talk between healthcare providers and seekers, supporting the smooth delivery of unsolicited weight loss advice. Data are in British English. • Both doctors and patients engage in self-repair to adjust their knowledge claims regarding weight management. • Doctors and patients show distinct repair styles aligned with their institutional roles. • In contrast to doctors, patients tend to perform more exposed repairs, openly rejecting their own projected turns. • Self-repairs sustain epistemic balance and congruence in talk on weight loss. [ABSTRACT FROM AUTHOR]

Summary A scoping review was conducted to identify barriers and enablers to effective weight management in healthcare settings for people living with overweight and obesity in English‐speaking high‐income countries. Peer‐reviewed and gray literature were systematically searched in June 2024. Data were analyzed using inductive thematic analysis. Of the 15,684 unique articles identified and screened for relevance, 216 studies were included. Healthcare‐related barriers and enablers to weight management were organized under three themes: a) healthcare provider‐related factors, b) provision of care, and c) policy/funding. Prominent barriers included healthcare provider knowledge deficits and low prioritization of obesity management, mainly in the primary care setting. Weight management beyond the primary care setting was found to be especially challenging, with poor referral pathways, service fragmentation, lack of multidisciplinary practice, and restricted eligibility criteria, hindering the accessibility of services. Developing consistent policies and guidelines, improving the education of healthcare providers, and increasing funding to provide low‐cost comprehensive care, were identified as enablers to access and uptake of weight management services. Considerable overlap in the identified barriers existed across healthcare providers and settings. A whole health system approach to minimize barriers and strengthen enablers to weight management services is needed, to address rising obesity rates. [ABSTRACT FROM AUTHOR]

Objective: Excessive weight gain, obesity, or insufficient weight gain during pregnancy can adversely affect both the mother and her offspring. This study aims to investigate the relationship between pregnant women's self‐perception and beliefs and their body weight management during pregnancy. Methods: A cross‐sectional survey involving 350 pregnant women in Changsha City was conducted from July to September 2023. Instruments included a sociodemographic data sheet, protective motivation questionnaire for pregnancy body quality management, and scales measuring body image, anxiety, self‐efficacy, and social support. Univariate analysis and multiple linear regression were employed to identify factors influencing protective motivation for body quality management during pregnancy. Results: The average score of the protective motivation questionnaire was 124 (SD = 13.07), suggesting a need for enhanced weight management. Key factors influencing protective motivation included household income, cooperation with healthcare workers, sources of pregnancy information, midnight snacking habits, prepregnancy exercise, body image, and self‐efficacy (P < 0.05). Conclusion: The study highlights significant factors influencing pregnant women's motivation for body quality management. These include economic status, healthcare collaboration, information accessibility, lifestyle habits, and psychological factors. The findings underscore the need for healthcare professionals to integrate these factors into pregnancy care programs to improve body quality management. Synopsis: Protective motivation for gestational weight management is medium to high, mainly influenced by household income, cooperation with healthcare professionals, knowledge sources, body image, and self‐efficacy. [ABSTRACT FROM AUTHOR]

Aims: To estimate healthcare resource utilization (HCRU) and healthcare costs by body mass index (BMI) in a UK cohort and to explore how this varied by defined BMI strata. Materials and Methods: This retrospective open cohort study used Discover, a linked primary and secondary electronic health records database covering 2.7 million individuals. Adults were stratified by BMI as: overweight (25–<30 kg/m2); obesity class I (30–<35 kg/m2); obesity class II (35–<40 kg/m2); or obesity class III (≥40 kg/m2). Cost data, comprising primary care, secondary care (inpatient admissions, outpatient appointments and emergency room visits) and prescriptions, were reported for 2015–2019. Results: Overall, 1 008 101 individuals were overweight, 278 782 had obesity class I; 80 621 had obesity class II, and 42 642 had obesity class III. Healthcare costs and HCRU events per person per year increased over time (2015: £851–£1321 and 10.6–13.4 events; 2019: £1143–£1871 and 11.4–14.9 events), and were higher for each successive BMI group. Groups with chronic kidney disease or cardiovascular disease incurred particularly high costs. In 270 493 individuals with obesity in 2019, more than 72% of total healthcare costs were incurred by the highest cost quintile, which had a higher mean age and more obesity‐related complications (ORCs) than lower cost quintiles. Conclusions: The economic impact of obesity could be alleviated by weight management support based on unmet need, to limit the effects of BMI progression and ORC development. [ABSTRACT FROM AUTHOR]

A preface to the November 2024 issue of the journal "Diabetes Spectrum" is presented.

Obesity is a chronic disease that may require multiple interventions and escalation of therapy throughout the years. Until recently, no universal definition existed for recurrent weight gain and insufficient weight loss. Standardization of reporting is key so outcomes can be compared and data can be pooled. The recent IFSO consensus provided standard terminology and definitions that will likely resolve this in the future, and publishers will need to enforce for authors to use these definitions. This current IFSO position statement provides guidance for the management of recurrent weight gain after bariatric surgery. [ABSTRACT FROM AUTHOR]

Awareness of issues and health concerns can prompt individuals to change their lifestyle behaviors. In fact, awareness is typically one of the first steps towards behavior change. However, awareness alone does not necessarily initiate or sustain behavioral changes. Specifically, many individuals experience significant barriers that prevent behavior change. Providers can address such barriers through ecological models of behavior change. Including concepts from an ecological model in health care settings can support positive lifestyle behavior change post-diagnosis. Moving beyond awareness alone and addressing barriers to change is an important goal that ultimately increases the probability of change for patients. [ABSTRACT FROM AUTHOR]

Objective: There is evidence showing the effect of hypocaloric diet and increasing physical activity on weight loss. However, the effect of these factors on body composition and functional capacity remains unclear. Also, it is not clear which type of exercise (aerobic, resistance) has effective health benefits for men who are overweight. The aim of this study is to investigate whether a 12-week combined exercise or walking intervention combined with a hypocaloric diet provides improvements in body composition and functional capacity of men who are overweight compared to those who do not exercise. Methods: 60 healthy adult men who are overweight were randomized and divided into 3 groups: 1: Hypocaloric Diet + Combined Exercise; 2: Hypocaloric Diet + Walking; 3: Hypocaloric Diet. The exercise groups were trained for 12 wk, 3 days a week and 60 min (60 min\3 days\12 wk). Body composition was determined with Bioelectrical Impedance Analysis (BIA) device, strength parameters with MicroFet 2, functional capacity with 6-min walking test. Results: Improvement was observed in all groups at the end of 12 wk. The greatest improvement was in the combined exercise group. While the values of the combined exercise group increased in Skeletal Muscle Mass, there was a decline in the walking and non-exercising group. Basal Metabolism was maintained in combined exercise, but a decrease occurred in the non-exercising group. Muscle force increased in combined exercise; however, it was maintained in the legs in the walking group. Cardiorespiratory fitness was at best level in walking group, but there was no difference between combined exercise. Conclusions: As a result, a hypocaloric diet without an exercise prescription is sufficient to lose weight in the short term (12 wk) at a certain level. But exercise is more important for body composition, weight management and functional capacity. Long-term and in-depth studies should be conducted to interpret the results better. [ABSTRACT FROM AUTHOR]

The global prevalence of obesity has almost tripled since 1975 and has become a major public health concern in the United Arab Emirates (UAE). Although physicians are considered as essential role players in the prevention and management of obesity, their perspectives towards obesity management still remain unknown in the UAE. Accordingly, this study aimed to assess physicians' attitudes and practices towards obesity management and prevention in the UAE using a qualitative research design. Face-to-face interviews, with a convenience sample of 15 health care practitioners from primary care clinics in Al-Ain City, Abu Dhabi, were employed during January–March 2019. Inductive thematic analysis was performed to identify main emerging themes and subthemes. Three major themes, namely beliefs and knowledge about obesity and its management, attitudes toward weight control, and current practices in relation to obesity management in primary care clinics, emerged. The results revealed that weight management is considered essential for all those with high body mass index but is suboptimal in primary care settings. Cultural misconceptions among patients regarding weight and lack of appropriate follow-up constitute major barriers to its management. As obesity is burdensome, its management is crucial and can be enhanced by multidisciplinary approach and unification of guidelines. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Nut consumption in Australia is low, perhaps due to concerns with weight gain. However, nut consumption is not associated with increased weight, in part because of their lower metabolisable energy. Current energy labelling for nuts use Atwater factors, which over‐represent the available energy from nuts. Therefore, this research aimed to examine stakeholders' knowledge, practices and perceptions of displaying true metabolisable energy on nutrition labels and its perceived impact on nut consumption.An anonymous and voluntary survey was conducted online. Eligible respondents lived in Australia, were aged 18 years or older and had either no formal nutrition education (consumer group) or had formal training and were working as a stakeholder (stakeholder group; working in nutrition/dietetics, public health, food industry, food regulation or nut growing). Convenience sampling and snowballing were used to recruit respondents primarily via online advertisement.Three hundred and forty‐eight respondents (63.2% female; 71.0% aged 18–39 years; 69.0% Bachelor's degree or higher) were included in the analyses. A larger proportion of stakeholders agreed that nut consumption assists with weight management (67.9%) compared with consumers (47.6%). Theoretical food packaging showing both Atwater and metabolisable energy in the nutrition information panel was favoured among consumers and stakeholders, though 62.3% of consumers reported that a lower metabolisable energy of nuts would not impact their consumption.This study indicates a need to further investigate the impact of metabolisable energy labelling on nut intake. Further education about the relationship between nuts and body weight is required for consumers and stakeholders. [ABSTRACT FROM AUTHOR]

The article discusses the use of financial incentives to promote healthy lifestyles, particularly focusing on obesity. Studies have shown that financial incentives can motivate weight loss and healthier choices, but long-term sustainability and outcomes remain uncertain. The effectiveness of financial incentives in managing obesity is promising, but questions about fairness, sustainability, and long-term impact need further exploration. The article highlights the need for a holistic approach that combines financial incentives with education and support to address the complex issue of obesity. [Extracted from the article]

Summary A cross‐sectional, online survey was conducted in the United Kingdom, France, Germany, and the United States (14 November–22 December 2022) to investigate preferences for anti‐obesity medication (AOM) among people with obesity (PwO) and healthcare providers (HCPs). Eligibility: Adult PwO who self‐defined their body type as overweight/obese, were trying to lose weight and had BMI ≥30.0 or 27.0–29.9 kg/m2 with ≥1 obesity‐related complication; HCPs had to see ≥30 PwO in a typical month and be a decision‐maker regarding their weight loss. The survey included 2500 PwO and 500 HCPs. Exercise (96%) and diet (90%) were the most common weight management methods; AOM use was low (8%). Key barriers to use of prescribed AOMs among PwO were not wanting to take AOM (34%), side effects concerns (33%), and not trusting AOM (26%). Most HCPs (79%) had prescribed/recommended AOMs. Efficacy was the most common reason for preferring one of the shown product profiles among PwO (60%) and HCPs (86%); improving cardiovascular risk was also important to 95% of HCPs when deciding which AOM to prescribe. AOM preference is largely driven by efficacy. Increasing knowledge could help to address barriers to AOM use and improve outcomes for PwO. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Design Patients Measurements Results Conclusion Basal metabolic rate (BMR) is an important factor in weight management and is influenced by fat‐free mass (FFM), fat mass (FM) and age. Current knowledge of the influence of hormonal levels on BMR is based on studies with small populations, studies that investigate exogenous administration and studies frequently lacking correction for body composition.Cross‐sectional study.All men (n = 457) who were referred to our centre for a metabolic work‐up were eligible for inclusion. Median age was 47 (18–78) years and the vast majority had obesity (BMI ≥ 30 kg/m², 90.9%).All men had a measurement of BMR, body composition and measurement of testosterone, sex hormone binding globulin (SHBG), dehydroepiandrosterone sulphate (DHEAS), insulin‐like growth factor 1 (IGF‐1), thyroid‐stimulating hormone (TSH) and free thyroxine (fT4). Men with low, normal and/or high levels of each of these hormones were compared. The association between hormone levels and BMR was assessed through linear regression models. All analyses were controlled for FFM, FM and age.In men with obesity, testosterone (total or free) was not associated with BMR. Linear regression analysis showed that DHEAS was positively associated with BMR in a sample of men with obesity and normal endogenous DHEAS levels, with the following equation: BMR (adjusted R² = 0.72): (BMR [kcal/d] = 513.402 + 18.940 × FFM [kg] + 9.507 × FM [kg] − 3.362 × age [years] + 0.307 × DHEAS [µg/dL]) (p < 0.01). TSH, fT4 and IGF‐1 were not associated with BMR.In men with obesity, endogenous DHEAS is positively associated with BMR. Testosterone, TSH, fT4 and IGF‐1 were not associated with BMR in men with obesity. Since we examined the specific population of men with obesity and only examined endogenous hormone levels, no extrapolation of results to other populations or the overall population can be made. [ABSTRACT FROM AUTHOR]

Background: Overweight and obesity are global health concerns, especially significant for older adults at higher risk for chronic diseases. The transition to retirement, altering daily routines, highlights the need for adequate weight management support. Since obesity is a challenging topic in healthcare and socioeconomic inequalities exist in access and utilization, we examined how retired individuals with obesity and low or high education describe their experiences of unmet needs, mismatches, and successes within the healthcare service system for weight management. Methods: This qualitative interview study is part of the Helsinki Health Study. The participants (N = 20, with a body mass index of at least 30 kg/m2) were selected from a cohort of retired former employees of the City of Helsinki. Half of the interviewees had low education, and the other half had high education. Women and men were equally represented. The interviews were conducted in 2023 and the data were analyzed using inductive thematic analysis. Results: Three main themes were formed: Deficiencies in engaged care, Services are mismatched with needs, and Facilitating conditions for individual successes. The first main theme had two sub-themes: Condescending attitude and Ignoring weight during the appointment. The second main theme had one sub-theme: Inadequate personnel resources. The third main theme had one sub-theme: Individual opportunities to acquire information and treatment. Educational differences were most clearly reflected in the sub-themes. Participants with low education more often described experiencing a condescending attitude towards them when seeking care and had had difficulties in obtaining time for appointments due to inadequate resources. Participants with high education described broader experiences related to individual opportunities to acquire information and treatment within the healthcare service system than participants with low education. Conclusions: The participants in this study highlighted the importance of respectful engagement with the subject of their weight and felt that these kinds of interaction skills should still be developed in healthcare personnel. The participants articulated a need for approaches that are tailored to their unique circumstances. According to the participants, long-term group intervention, provided with peer support and supported by a multidisciplinary team, could sustain their weight management. [ABSTRACT FROM AUTHOR]

Background: Childhood and adolescent obesity are persistent public health issues in the United States. Childhood obesity Electronic Health Record (EHR) tools strengthen provider-patient relationships and improve outcomes, but there are currently limited EHR tools that are linked to adolescent mHealth apps. This study is part of a larger study entitled, CommitFit, which features both an adolescent-targeted mobile health application (mHealth app) and an ambulatory EHR tool. The CommitFit mHealth app was designed to be paired with the CommitFit EHR tool for integration into clinical spaces for shared decision-making with patients and clinicians. Objectives: The objective of this sub-study was to identify the functional and design needs and preferences of healthcare clinicians and professionals for the development of the CommitFit EHR tool, specifically as it relates to childhood and adolescent obesity management. Methods: We utilized a user-centered design process with a mixed-method approach. Focus groups were used to assess current in-clinic practices, deficits, and general beliefs and preferences regarding the management of childhood and adolescent obesity. A pre- and post-focus group survey helped assess the perception of the design and functionality of the CommitFit EHR tool and other obesity clinic needs. Iterative design development of the CommitFit EHR tool occurred throughout the process. Results: A total of 12 healthcare providers participated throughout the three focus group sessions. Two themes emerged regarding EHR design: (1) Functional Needs, including Enhancing Clinical Practices and Workflow, and (2) Visualization, including Colors and Graphs. Responses from the surveys (n = 52) further reflect the need for Functionality and User-Interface Design by clinicians. Clinicians want the CommitFit EHR tool to enhance in-clinic adolescent lifestyle counseling, be easy to use, and presentable to adolescent patients and their caregivers. Additionally, we found that clinicians preferred colors and graphs that improved readability and usability. During each step of feedback from focus group sessions and the survey, the design of the CommitFit EHR tool was updated and co-developed by clinicians in an iterative user-centered design process. Conclusion: More research is needed to explore clinician actual user analytics for the CommitFit EHR tool to evaluate real-time workflow, design, and function needs. The effectiveness of the CommitFit mHealth and EHR tool as a weight management intervention needs to be evaluated in the future. [ABSTRACT FROM AUTHOR]

One of the biggest threats to global health that affects both individual health and global health is obesity. People have used traditional exercise programmes to deal with body fat for a long time but often have problems and limits. In the field of exercise science, blood flow restriction (BFR) training has gained popularity in the past few years. It could be a new way to deal with obesity. This review aims to examine previous research on the effectiveness of BFR training in treating obesity and provide an overview of the available data. Using particular search phrases associated with obesity, blood flow restriction training, and exercise interventions, several databases, including PubMed, ScienceDirect, and MEDLINE, were examined. Understanding these processes could lead to the creation of more effective treatments for people who are overweight. In the end, this review gives a full look at the current data about the role of BFR training in managing obesity. While initial findings are promising, more investigation is needed to prove the effectiveness, safety, and long-term effects of BFR training as a treatment to control obesity. The information learned from this review could help shape future research and help healthcare professionals plan exercise programmes for people who are overweight. [ABSTRACT FROM AUTHOR]

Obesity is implicated in the development of multiple sclerosis (MS), but its effect on disability is less well‐established. This study examined the effects of various obesity measures on MS severity in 12,584 MS cases, using Mendelian randomization to mitigate confounding. Results showed a significant association between higher genetically‐determined body mass index (N = 806,834) and increased MS severity (P = 0.02). This finding was supported by additional measures of general obesity but not adiposity distribution. The convergence of this genetic evidence with prior observational studies strengthens the association between obesity and adverse long‐term disability in MS, suggesting weight management as a potential therapeutic strategy. ANN NEUROL 2024 [ABSTRACT FROM AUTHOR]

Background: Hyperuricaemia is common among obese children and adolescents, and is closely related to insulin resistance. The aim of this study was to explore the relationships between youth insulin resistance and hyperuricaemia, as well as their relationships with lifestyle factors in youths, to provide early guidance on the risk factors for hyperuricaemia in adolescents. Methods: This study included 233 adolescents aged 10 to 20 years. Insulin resistance was evaluated via the homeostasis model assessment-insulin resistance (HOMA-IR) method. Binary logistic regression analysis was used to assess the associations of HOMA-IR with hyperuricaemia status and serum uric acid (UA) levels. The participants were subsequently divided into two groups, the noninsulin resistant group (HOMA-IR ≤ 3.2) and the insulin resistant group (HOMA-IR > 3.2), to further explore the factors that may affect the serum UA level. Finally, the predictive ability of different indicators of hyperuricaemia was evaluated via the ROC curve. Results: Binary logistic regression analysis revealed a significant increase in the risk of developing hyperuricaemia for individuals with elevated HOMA-IR (p < 0.001) and insulin resistance (p < 0.01). Spearman's correlation analysis revealed a significant positive linear correlation between HOMA-IR and serum UA levels (r = 0.4652, p < 0.001). Among insulin-resistant adolescents, UA levels were positively correlated with weight ratings, frequency of staying up late, and sugary beverages intake. Notably, individuals who engaged in 1–3 h of weekly exercise had the lowest UA levels. The area under the ROC curve for HOMA-IR was 0.847 (cut-off value = 2.165, p < 0.001), and the optimal prediction model included HOMA-IR, BMI z-score, and other lifestyle factors (AUC: 0.870, p < 0.001)). Conclusion: HOMA-IR was identified as an independent risk factor for the development of hyperuricaemia and could be used as a sensitive indicator for the prediction its development in adolescents. In insulin-resistant adolescents with hyperuricaemia, maintaining normal weight, engaging in physical exercise for 1–3 h per week, avoiding staying up late and limiting sugary beverages intake are recommended to reduce the prevalence of hyperuricaemia among adolescents. [ABSTRACT FROM AUTHOR]

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

Background: Obesity is a growing epidemic with non-surgical/non-pharmacological interventions having only nominal and transient effects on excess weight. Those persistent shortcomings are associated with minimal understandings of impacts of treatment-associated changes in psychological variables and their relationships. Women of lower incomes have high rates of obesity and might have increased difficulties accessing evidence-based programs. Methods: Women with obesity of lower- to lower-middle incomes participated in 6-month community-based treatments in the United States emphasizing either self-regulatory skills development (behavioral methods group: n = 63) or typical education in exercise and healthy dietary practices (education group: n = 48). Results: There were significant 6-month improvements in self-regulation, self-efficacy, mood, physical activity/exercise, dietary behaviors, and weight in both groups. All improvements were significantly greater in the behavioral group. Based on the incorporation of multiple behavioral theories, separate multiple regression models were fit for prediction of the weight-loss behavior changes. Stepwise entry of changes in self-regulation, self-efficacy, and mood each significantly contributed to the explained variance in physical activity/exercise change. Change in self-efficacy was most relevant in the prediction of change in dietary behaviors. Change in physical activity/exercise was significantly related to change in dietary behaviors; however, a regression analysis indicated that only physical activity/exercise change was a significant independent contributor to the overall accounted-for variance in lost weight. Conclusion: By incorporating key tenets of social cognitive theory, self-efficacy theory, self-regulation theory, coaction theory, and the mood-behavior model in an additive manner, suggestions and emphases for addressing psychological variables for improved weight-loss behaviors within scalable obesity treatments were advanced. [ABSTRACT FROM AUTHOR]

Background: There is growing evidence that the social blockade brought about by the COVID-19 pandemic has dramatically affected college students' physical activity; however, their weight management behaviors and mental health have not been fully explored, especially among healthcare students. This study aimed to assess physical activity, weight management behaviors, and mental health among healthcare students during the campus lockdown and to analyze the factors influencing physical activity. Methods: A cross-sectional survey of 1,216 healthcare students from March 24, 2022, to April 11, 2022. To collect information about students' physical activity, weight management behaviors, and mental health, they were asked to complete the Physical Activity Questionnaire-Short Form (IPAQ-SF), 11 issues related to weight management behavior, and the World Health Organization 5-Item Well-Being Index (WHO-5) questionnaire. Binary logistic regression was performed to determine the factors influencing physical activity. Results: Almost half of the participants had low levels of physical activity (45%), the mean score for weight management behavior was 39.55±6.26, and 54.6% had low levels of well-being. Healthcare students without exercise habits during the non-epidemic period reported lower levels of physical activity (OR = 1.81; 95%CI = 1.41–2.34, P<0.001). Participants with poor weight management behavior were more likely than other participants to report lower levels of physical activity (OR = 0.92; 95%CI = 0.90–0.94, P < 0.001). Likewise, the odds of being physically inactive were higher among the happier participants (OR = 0.98; 95%CI = 0.96–0.99, P = 0.031). Conclusions: During the COVID-19 lockdown, most healthcare students in Gansu province lack physical exercise and have a low health level. Significant correlation factors for low physical activity levels were grade level, non-lockout exercise habits, weight management level, and well-being. These findings demonstrate the importance of developing targeted policies and programs encouraging physical activity among medical students. [ABSTRACT FROM AUTHOR]

Introduction: Obesity is a complicated chronic disease associated with a series of other conditions. A weight loss of 5–10% has been shown to reduce obesity-related complications and improve quality of life. The efficacy and safety of liraglutide for reducing body weight have been demonstrated in clinical trials. This study evaluated the weight loss efficacy and adverse effects of liraglutide in those with obesity in the Turkish population. Methods: This is a retrospective cohort study; the patients that were included had a body mass index (BMI) of 27 or greater with additional comorbidities or a BMI of 30 or greater, and the patients were prescribed liraglutide for obesity treatment from the tertiary private clinic between January 2022 and January 2024. Their metabolic and anthropometric parameters were recorded at the initial appointment, and their body weight and adverse effects were followed up on during therapy. Results: For the 568 patients, of whom 487 (85.6%) were female, the mean values for age, weight, and BMI were 42.37 ± 10.50, 98.09 ± 17.48 kg, and 35.77 ± 5.45 kg/m2, respectively. Reductions in body weight at the 4th, 8th, 12th, and 24th weeks were 6.45 ± 2.32 kg, 10.66 ± 3.41 kg, 15.38 ± 8.30 kg, and 19 ± 9.06 kg, respectively; reductions in BMI at the 4th, 8th, 12th, and 24th weeks were 2.36 ± 1.00, 3.88 ± 1.25, 5.36 ± 1.76, and 7.09 ± 2.93, respectively; and the percentages of overall body weight loss at the 4th, 8th, 12th, and 24th weeks were 6.62 ± 2.1%, 10.75 ± 2.71%, 14.97 ± 6.8%, and 18.55 ± 4.63%, respectively (all p values < 0.0001). The percentage of patients who lost more than 5% and more than 10% of their initial weight was 100% at the 24th week. The most common side effect was nausea; no pancreatitis was observed. Conclusions: The results of our study indicate that liraglutide is an efficacious and safe treatment option for obesity in the Turkish population, in accordance with the findings from previous research. [ABSTRACT FROM AUTHOR]

The aim was to examine the acute effects of sprint exercise (SIT) on global gene expression in subcutaneous adipose tissue (AT) in healthy subjects, to enhance understanding of how SIT influences body weight regulation. The hypothesis was that SIT upregulates genes involved in mitochondrial function and fat metabolism. A total of 15 subjects performed three 30‐s all‐out sprints (SIT). Samples were collected from AT, skeletal muscle (SM) and blood (brachial artery and a subcutaneous AT vein) up to 15 min after the last sprint. Results showed that markers of oxidative stress, such as the purines hypoxanthine, xanthine and uric acid, increased markedly by SIT in both the artery and the AT vein. Purines also increased in AT and SM tissue. Differential gene expression analysis indicated a decrease in signaling for mitochondrial‐related pathways, including oxidative phosphorylation, electron transport, ATP synthesis, and heat production by uncoupling proteins, as well as mitochondrial fatty acid beta oxidation. This downregulation of genes related to oxidative metabolism suggests an early‐stage inhibition of the mitochondria, potentially as a protective mechanism against SIT‐induced oxidative stress. [ABSTRACT FROM AUTHOR]

Background Weight gain and associated metabolic complications are increasingly prevalent among people with human immunodeficiency virus (PWH). Glucagon-like peptide 1 receptor agonists (GLP-1RAs) are incretin-based therapies for diabetes and weight management that have been shown to result in substantial weight loss; however, studies of their effects in PWH are limited. Methods A retrospective single-center cohort study was conducted among PWH who were taking GLP-1RAs at the University of California, San Diego Owen Clinic between 1 February 2021 and 1 February 2023. Baseline clinical data were collected and changes in weight, body mass index (BMI), and hemoglobin A1C (A1C) before starting GLP-1RAs compared to the most recent clinic visit were calculated (with a minimum of 3 months follow-up time required). Logistic regression was performed to identify variables associated with >5% of total body weight loss. Results A total of 225 patients received on average 13 months of GLP-1RA therapy, with 85 (37.8%) achieving the maximum GLP-1RA dose. GLP-1RA therapy resulted, on average, in a weight loss of 5.4 kg, decrease in BMI by 1.8 kg/m2, and decrease in A1C by 0.6%. In the multivariable analysis, higher baseline BMI (odds ratio [OR], 1.10 [95% confidence interval {CI}, 1.03–1.16]), treatment duration of GLP-1RA therapy >6 months (OR, 3.12 [95% CI, 1.49–6.49]), and use of tirzepatide (OR, 5.46 [95% CI, 1.44–20.76]) were significantly more likely to be associated with >5% weight loss. Conclusions Use of GLP-1RAs led to declines in weight, BMI, and A1C among PWH and offers an additional strategy to address weight gain and diabetes. [ABSTRACT FROM AUTHOR]

Background: Obesity among healthcare students (HCs)is a growing concern that needs to be addressed. The purpose of this study was to evaluate the knowledge, awareness, perceptions, practice, and preparedness of obesity, and associated factors among undergraduate HCs. Methods: A cross-sectional study was conducted from December 2023 to March 2024 using an online prevalidated questionnaire, to assess clinical aspects of obesity.Simple random sampling was applied for data collection from nursing, emergency medical services (EMS), and pharmacy students at Saudi University, Riyadh Saudi Arabia. All data were analyzed using statistical package for social science (SPSS). Results: A total of 456 HCs participated in this study. Among those 68% believed eating high carbohydrates, fats, and sugars leads to obesity. At the same time, 52.2% and 57.2% were aware that smoking and stress can contribute to obesity. On the other hand, 41.9% live a healthy lifestyle and 38.65% engage in physical activity to control their obesity. The demographic variables such as age (p = 0.0001), gender (p = 0.0001), professional classification (p = 0.0001), presence of chronic diseases (p = 0.0001), history of weight loss treatment (p = 0.0001) and body mass index (BMI) (p = 0.0001) were significantly associated with knowledge of obesity(p = 0.001). Similarly, students' age (p = 0.001), presence of chronic diseases (p = 0.004) history of weight loss treatment (p = 0.0001), BMI (p = 0.001), and active status (p = 0.0001) were significantly associated with the perception of the obesity. Conclusion: Undergraduate HCs possess a good understanding of the clinical prospects of obesity. They know its causes, risks, and treatment options. Additionally, they are well-prepared to support individuals in managing their weight through lifestyle modifications and psychological counseling. [ABSTRACT FROM AUTHOR]

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

Despite the implementation of preventive measures to counteract the obesity epidemics, the prevalence of childhood obesity is still alarming all over the world. Childhood obesity is the most common risk factor for both cardiovascular and metabolic diseases. In fact, an earlier onset of obesity can cause a greater risk of adiposity tracking across the lifespan and consequently a longer exposure to cardiometabolic risk factors. Accumulating evidence provided by prospective and intervention studies demonstrated the link between pediatric obesity and selected subclinical signs of cardiovascular damage (atherosclerosis and left ventricular hypertrophy), or fatal and not fatal cardiovascular events as early as 40 years of age. The numerous guidelines and scientific documents published in the last years demonstrate the relevance of assessing cardiometabolic risk factors in children and adolescents with OB. This Position paper, released by experts of the "Childhood Obesity study group" within the Italian Society for Pediatric Endocrinology and Diabetology, aims to review the assessment of cardiometabolic risk factors and comorbidities in children and adolescents with OW/OB on the light of the most recent scientific evidence. The main recommendations are: (a) early detection of comorbidities, including hypertension, dyslipidemia, prediabetes/type 2 diabetes, metabolic dysfunction-associated steatotic liver disease, polycystic ovary syndrome, inactivity, obstructive sleep apnea and decline in kidney function; (b) weight loss treatment, which is associated with a reduction of all cardiometabolic risk factors; (c) specific treatment of comorbidities, through lifestyle modifications or pharmacological treatment added to lifestyle for suitable individuals; d). monitoring comorbidities for mitigating future morbidity and mortality. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular diseases (CVDs) and associated risk factors are a growing concern in Cameroon. Physiotherapists (PTs) can play a crucial role in prevention and management. However, the extent of Cameroonian PT involvement in health promotion (HP) activities remains unclear. This study assessed Cameroonian physiotherapists' current HP practices for people at risk of or with CVDs (pwCVDs). Methods: A cross-sectional survey was administered online to PTs practising in Cameroon. Results: Out of 181 PT responses, 95% reported providing a variety of HP activities, including weight management (74%), dietary advice (73%), physical activity (69%), smoking cessation (69%), stress management (61%), and sleep promotion (48%). While PTs were confident in lifestyle assessments, they felt less confident about sleep interventions. Strong beliefs, confidence, team support, and time allocation enhanced HP practice. However, preference for passive modalities, patient adherence issues, organisational challenges, role ambiguity among healthcare providers, inadequate training opportunities, and the absence of established guidelines for CVD prevention negatively affect HP practice. Conclusions: These findings highlight the challenges and opportunities for enhancing HP delivery within the physiotherapy profession in Cameroon. The findings are useful for future strategies by clinical practitioners and policy makers to address barriers and leverage facilitators effectively for scaling up HP initiatives in Cameroon. [ABSTRACT FROM AUTHOR]

Background: Weight stigma is the social devaluation and denigration of individuals because of their excess body weight, resulting in poorer physical and mental health and healthcare avoidance. Attribution Theory and Goffman's theory of spoiled identity provided a general overarching framework for understanding weight stigma experiences. Objective: Our purpose was to explore weight stigma experiences from a broad range of perspectives emphasizing identities typically excluded in the weight stigma literature. Design: We conducted a qualitative descriptive study with data drawn from 73 substantive narrative comments from participants who responded to a larger survey. Results: Analysis developed five themes: Working on weight, Not being overweight, Lack of help and empathy, Exposure and embarrassment and Positive experiences. Individuals who would be clinically assessed as overweight, especially men, often did not identify with having a weight problem and found the framing of personal responsibility for weight empowering. Participants with larger body sizes more often attributed embarrassment and shame about weight to treatment in the clinical setting. Older participants were more likely to have positive experiences. Conclusions: The findings suggest ongoing tension between the framing of weight as a personal responsibility as opposed to a multifactorial condition with many uncontrollable aspects. Gender, age and body size shaped respondent perspectives, with some young male respondents finding empowerment through perceived personal control of weight. The healthcare system perpetuates weight stigma through lack of adequate equipment and excessively weight‐centric medical counselling. Recommending a healthy lifestyle to patients without support or personalized medical assessment may perpetuate weight stigma and associated detrimental health outcomes. Patient or Public Contribution: Patients with obesity and overweight were integral to this study, providing comments for our qualitative analyses. [ABSTRACT FROM AUTHOR]

Purpose: Exercise benefits the body and mind, but its weight loss effect is less than generally expected. Although this phenomenon is likely due to an exercise intensity–dependent decrease in non-exercise physical activity (NEPA), resulting in a decrease in non-exercise activity thermogenesis, the underlying mechanisms and effects of exercise intensity remain unknown. Here we show that acute vigorous exercise decreases subsequent NEPA and body temperature (BT) in association with body weight gain. Methods: Adult male C57BL/6J mice were categorized into three groups: sedentary, moderate exercise, and vigorous exercise, with exercise groups undergoing a 30-min treadmill session. Using an intraperitoneally implanted activity monitor, NEPA and BT were monitored for 2 d before and 3 d after exercise. The daily synchrony between NEPA and BT was evaluated using a cross-correlation function. Plasma corticosterone was also detected 6 and 24 h after exercise. Results: Notably, only the vigorous exercise group exhibited a decline in both NEPA and BT, resulting in body weight gain the following day, despite no observed changes in food intake. Furthermore, vigorous exercise induces a distinct delay in the daily dynamics of NEPA compared with BT. A positive correlation was observed between plasma corticosterone levels and changes in NEPA levels before and after exercise across all exercise groups. Conclusions: Our findings provide evidence for vigorous exercise–specific reduction in subsequent NEPA, BT, and their synchrony linked to weight gain, likely due to the disturbed circadian rhythm of corticosterone. This is an initial investigation redefining the significance of exercise intensity in beneficial effects beyond the energy expenditure of the exercise itself [ABSTRACT FROM AUTHOR]

In parallel to the legalization of cannabis for both medicinal and recreational purposes, cannabinoid use has steadily increased over the last decade in the United States. Cannabinoids, such as tetrahydrocannabinol and anandamide, bind to the central cannabinoid‐1 (CB1) receptor to impact several physiological processes relevant for body weight regulation, including appetite and energy expenditure. The hypothalamus integrates peripheral signals related to energy balance, houses several nuclei that orchestrate eating, and expresses the CB1 receptor. Herein we review literature to date concerning cannabinergic action in the hypothalamus with a specific focus on eating behaviors. We highlight hypothalamic areas wherein researchers have focused their attention, including the lateral, arcuate, paraventricular, and ventromedial hypothalamic nuclei, and interactions with the hormone leptin. This review serves as a comprehensive analysis of what is known about cannabinoid signaling in the hypothalamus, highlights gaps in the literature, and suggests future directions. [ABSTRACT FROM AUTHOR]

Background • Previous studies link overweight/obesity to reduced fertility, highlighting weight intervention as vital for better pregnancy outcomes. However, clarity on the role and efficacy of weight loss in enhancing pregnancy is inconsistent. Objective • This study aimed to assess the impact of individualized weight intervention on pregnancy among Chinese overweight/obese infertile women and explore body composition indexes influencing pregnancy outcomes. Methods • This retrospective study involved 363 overweight/obese infertile women admitted to the First Affiliated Hospital of Guangxi Medical University, Guangxi, China, from June 2017 to November 2020. Among them, 249 received personalized weight intervention (intervention group), while 114 did not (control group). Pregnancy outcomes were compared between the two groups, and changes in body composition before and after intervention were measured. Multivariate logistic regression was employed to analyze factors influencing pregnancy outcomes. Results • The intervention group exhibited significantly higher clinical pregnancy rates, natural pregnancy rates, assisted reproductive pregnancy rates, and induced ovulation (IO) pregnancy rates compared to the control group (all P < .05). Following weight intervention, there were significant decreases in body weight, body mass index (BMI), visceral fat area, and body fat (all P < .01). Logistic regression analysis identified polycystic ovary syndrome as the reason for infertility (OR=3.446, P = .016), ∆body weight %≥10% (OR=2.931, P = .014), and ∆visceral fat area% (OR=1.025, P = .047) as positive factors for a successful pregnancy. Conversely, age≥35 years old (OR=0.337, P = .001), BMI≥25 kg/m² after intervention (OR=0.279, P < .001), and visceral fat area≥100 cm² after intervention (OR=0.287, P = .007) were identified as negative factors. Conclusions • Individualized weight management enhances pregnancy outcomes in overweight/obese infertile women. Achieving a reduction in body weight by 10% or more, combined with effective control of visceral fat, proves important in improving pregnancy outcomes. Excess visceral fat emerges as an adverse factor impacting successful pregnancy. [ABSTRACT FROM AUTHOR]