Contemporary medical, device, and surgical therapies for obesity in adults

The Lancet, Journal Year: 2023, Volume and Issue: 401(10382), P. 1116 - 1130

Published: Feb. 9, 2023

Language: Английский

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Weight Loss Outcomes Associated With Semaglutide Treatment for Patients With Overweight or Obesity

JAMA Network Open, Journal Year: 2022, Volume and Issue: 5(9), P. e2231982 - e2231982

Published: Sept. 19, 2022

Importance No retrospective cohort study has assessed the effectiveness of semaglutide at doses used in randomized clinical trials to treat obesity (ie, 1.7 and 2.4 mg). Objective To weight loss outcomes associated with treatment for patients overweight or obesity. Design, Setting, Participants This study, conducted a referral center management, retrospectively collected data on use adults between January 1, 2021, March 15, 2022, follow-up up 6 months. A total 408 body mass index (BMI) 27 more were prescribed weekly subcutaneous injections 3 months more. Patients history bariatric procedures, taking other antiobesity medications, an active malignant neoplasm excluded. Exposures Weekly 1.7-mg 2.4-mg Main Outcomes Measures The primary end point was percentage loss. Secondary points proportion achieving 5% more, 10% 15% 20% after without type 2 diabetes Results included 175 (132 women [75.4%]; mean [SD] age, 49.3 [12.5] years; BMI, 41.3 [9.1]) analysis 102 (SD) 6.7 (4.4) kg, equivalent 5.9% (3.7%) ( P < .001), 12.3 (6.6) 10.9% (5.8%) .001 from baseline). Of who followed months, 89 (87.3%) achieved 56 (54.9%) 24 (23.5%) 8 (7.8%) had lower compared those diabetes: 3.9% (3.1%) vs 6.3% = .001) 7.2% (6.3%) 11.8% (5.3%) .005). Conclusions Relevance results this suggest that similar seen trials. Studies longer periods are needed evaluate prolonged outcomes.

Language: Английский

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Beyond BMI

Nutrients, Journal Year: 2023, Volume and Issue: 15(10), P. 2254 - 2254

Published: May 10, 2023

This review examined the origins of concept BMI in work Quetelet 19th century and its subsequent adoption use tracking course pandemic obesity during 20th century. In this respect, it has provided a valuable international epidemiological tool that should be retained. However, as noted review, is deficient at least three ways. First, does not measure body fat distribution, which probably more important guide to risk excess adiposity than itself. Second, very good fat, thus application diagnosis or individual patient limited. Finally, provide any insights into heterogeneity genetic, metabolic, physiological psychological origins. Some these mechanisms are traced review.

Language: Английский

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Antibody blockade of activin type II receptors preserves skeletal muscle mass and enhances fat loss during GLP-1 receptor agonism

Molecular Metabolism, Journal Year: 2024, Volume and Issue: 80, P. 101880 - 101880

Published: Jan. 11, 2024

Glucagon-like peptide 1 (GLP-1) receptor agonists reduce food intake, producing remarkable weight loss in overweight and obese individuals. While much of this is fat mass, there also a lean similar to other approaches that induce calorie deficit. Targeting signaling pathways regulate skeletal muscle hypertrophy promising avenue preserve mass modulate body composition. Myostatin Activin A are TGFβ-like ligands signal via the activin type II receptors (ActRII) antagonize growth. Pre-clinical clinical studies demonstrate ActRII blockade induces reduces mass. In manuscript, we test hypothesis combined plus GLP-1 agonist will leading improvements skeletomuscular metabolic function enhanced loss. study, explore therapeutic potential bimagrumab, monoclonal antibody against ActRII, modify composition alone during induced by semaglutide diet-induced mice. Mechanistically, define specific role anabolic kinase Akt mediating hypertrophic effects inhibition vivo. Treatment mice with bimagrumab ∼10% increase while simultaneously decreasing Daily treatment potently decreased weight; included significant decrease both Combination led superior preserving despite reduced intake. drugs was associated improved outcomes, increased exercise performance. Deletion isoforms modestly reduced, but did not prevent, driven inhbition. Collectively, these data improves parameters deficit agonism existence Akt-independent supporting absence signaling.

Language: Английский

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The Obese Brain: Mechanisms of Systemic and Local Inflammation, and Interventions to Reverse the Cognitive Deficit

Frontiers in Integrative Neuroscience, Journal Year: 2022, Volume and Issue: 16

Published: March 29, 2022

Overweight and obesity are now considered a worldwide pandemic growing public health problem with severe economic social consequences. Adipose tissue is an organ neuroimmune-endocrine functions, which participates in homeostasis. So, adipocyte hypertrophy hyperplasia induce state of chronic inflammation that causes changes the brain neuroinflammation. Studies obese animal models patients have shown relationship between diet cognitive decline, especially working memory learning deficiencies. Here we analyze how obesity-related peripheral can affect central nervous system physiology, generating Given blood-brain barrier interface periphery system, its altered physiology may mediate consequences on various processes. Finally, several interventions, use natural compounds exercise to prevent adverse effects also discussed.

Language: Английский

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Research progress of gut microbiota and obesity caused by high-fat diet

Frontiers in Cellular and Infection Microbiology, Journal Year: 2023, Volume and Issue: 13

Published: March 13, 2023

Obesity, a chronic metabolic disorder caused by an energy imbalance, has been increasingly prevalent and poses global health concern. The multifactorial etiology of obesity includes genetics factors, high-fat diet, gut microbiota, other factors. Among these the implication microbiota in pathogenesis prominently acknowledged. This study endeavors to investigate potential contribution development diet induced obesity, as well current state probiotic intervention therapy research, order provide novel insights for prevention management obesity.

Language: Английский

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Different Dietary Approaches, Non-Alcoholic Fatty Liver Disease and Cardiovascular Disease: A Literature Review

Nutrients, Journal Year: 2023, Volume and Issue: 15(6), P. 1483 - 1483

Published: March 20, 2023

Non-alcoholic fatty liver disease (NAFLD) is the first cause of chronic and also associated with other harmful entities such as obesity, metabolic syndrome, dyslipidemia, diabetes. NAFLD a significant public health concern worldwide, impacting individuals all ages, its prevalence projected to increase in near future due connection obesity. Intrinsic (genetics) external (lifestyle) factors may modulate NAFLD, and, turn, partly explain observed relationship between cardiovascular (CVD). Although many drugs are been tested treat date, no drug has indication specifically this disorder. Thus, current management relies on lifestyle modifications weight loss, physical activity, intake healthy diet. In present narrative review, we will discuss effects certain dietary patterns incidence progression.

Language: Английский

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Obstructive sleep apnea and obesity: A review of epidemiology, pathophysiology and the effect of weight-loss treatments

Sleep Medicine Reviews, Journal Year: 2024, Volume and Issue: 78, P. 101996 - 101996

Published: Aug. 30, 2024

Despite the commonly-accepted paradigm that patients with obstructive sleep apnea (OSA) also invariably have obesity, OSA prevalence extends beyond obesity. This necessitates a reevaluation of screening strategies, biomarkers increased risk, and heightened awareness among healthcare providers about array treatments for diverse adult populations. While obesity contributes importantly to pathogenesis, there is substantial evidence non-anatomical factors play crucial role, especially in who do not In recent years, notwithstanding recognition contributors research has frequently focused on weight reduction address OSA. Insights from past experiences bariatric surgery serve as lens anticipate potential outcomes emerging anti-obesity pharmacotherapies. Pharmacological alternatives, particularly incretin agonists, exhibit promise improvement, but encounter obstacles such side effects high costs. With this comprehensive narrative review, we delve into complex epidemiological pathophysiological connections between Additionally, emphasize importance multifaceted approach treatment, recognizing while management crucial, need strategies go traditional weight-centric perspectives.

Language: Английский

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Weight Gain in Midlife Women

Current Obesity Reports, Journal Year: 2024, Volume and Issue: 13(2), P. 352 - 363

Published: Feb. 28, 2024

Language: Английский

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Real‐world evidence on the utilization, clinical and comparative effectiveness, and adverse effects of newer GLP‐1RA‐based weight‐loss therapies

Diabetes Obesity and Metabolism, Journal Year: 2025, Volume and Issue: unknown

Published: April 8, 2025

Abstract Glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) have emerged as key agents for weight management, based on their marked efficacy observed in randomized controlled trials. While still limited, real‐world studies GLP‐1RA use populations with obesity are increasingly available. This narrative review discusses contemporary evidence demonstrating the utilization, clinical and comparative effectiveness, adverse effects of currently approved GLP‐1RA‐based weight‐loss therapies, that is, liraglutide, semaglutide tirzepatide. The reduction practice overall tends to be lower than trials; however, outcomes approach those seen trials when focusing highly adherent patients. Real‐world demonstrate high discontinuation rates GLP‐1RAs (20%–50%) within first year, much doses evaluated Evidence from observational type 2 diabetes or suggests frequent gastrointestinal disturbances users, also trials, but no clear increase risks severe events like pancreatitis pancreatic cancer, thyroid disorders, depression self‐harm. Further is needed understand possible associations eye disease other rare outcomes. We provide 10 areas particular importance further research space, including improved understanding exact drivers early suboptimal dosing, stopping treatment, investigations cost‐effectiveness hard settings, not only cardio‐reno‐metabolic obesity‐induced diseases neuropsychiatric disease, musculoskeletal infections. Plain Language Summary Recent advancements medications sparked a lot interest. so‐called GLP‐1 agonist gained attention, because they shown very effective, leading significant loss patients participating GLP‐1RAs, semaglutide, tirzepatide, help manage by mimicking hormones control blood sugar appetite. However, how these perform real life can different settings which carefully selected treatment plans closely followed. literature looks at used effectiveness safety settings. In real‐life practice, often less effective trial conditions. usually don't follow medication strictly data shows many do stick participants might, loss. who achieve results similar A major issue stop using them year due side costs medications, especially if covered insurance. Common include nausea digestive problems, main reasons taking treatments. These manageable decrease over time, this reviews found strong cause users. Despite challenges, effectively consistently, show substantial benefits loss, most so newest likely prevent weight‐related health conditions cardiovascular beneficial scarce emphasizes need more why improve dosing. It calls long‐term therapies various outcomes, mental health, cardiometabolic diseases. Overall, while valuable tool requires careful consideration individual patient factors, such ability plans, effects, afford medications. will make treatments wider range people them.

Language: Английский

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