Obesity Management in Adults

JAMA, Journal Year: 2023, Volume and Issue: 330(20), P. 2000 - 2000

Published: Nov. 28, 2023

Importance Obesity affects approximately 42% of US adults and is associated with increased rates type 2 diabetes, hypertension, cardiovascular disease, sleep disorders, osteoarthritis, premature death. Observations A body mass index (BMI) 25 or greater commonly used to define overweight, a BMI 30 obesity, lower thresholds for Asian populations (BMI ≥25-27.5), although use alone not recommended determine individual risk. Individuals obesity have higher incident disease. In men 39, event are 20.21 per 1000 person-years compared 13.72 in normal BMI. women 39.9, 9.97 6.37 Among people 5% 10% weight loss improves systolic blood pressure by about 3 mm Hg those may decrease hemoglobin 1c 0.6% 1% diabetes. Evidence-based treatment includes interventions addressing 5 major categories: behavioral interventions, nutrition, physical activity, pharmacotherapy, metabolic/bariatric procedures. Comprehensive care plans combine appropriate patients. Multicomponent ideally consisting at least 14 sessions 6 months promote lifestyle changes, including components such as self-monitoring, dietary activity counseling, problem solving, often produce loss, regain occurs 25% more participants 2-year follow-up. Effective nutritional approaches focus on reducing total caloric intake strategies based patient preferences. Physical without calorie reduction typically causes less (2-3 kg) but important weight-loss maintenance. Commonly prescribed medications antidepressants (eg, mirtazapine, amitriptyline) antihyperglycemics glyburide insulin cause gain, clinicians should review consider alternatives. Antiobesity nonpregnant patients overweight weight-related comorbidities conjunction modifications. Six currently approved the Food Drug Administration long-term use: glucagon-like peptide receptor 1 (GLP-1) agonists (semaglutide liraglutide only), tirzepatide (a glucose-dependent insulinotropic polypeptide/GLP-1 agonist), phentermine-topiramate, naltrexone-bupropion, orlistat. Of these, has greatest effect, mean 21% 72 weeks. Endoscopic procedures (ie, intragastric balloon endoscopic sleeve gastroplasty) can attain 13% months. Weight from metabolic bariatric surgeries laparoscopic gastrectomy Roux-en-Y gastric bypass) ranges 30% 12 Maintaining difficult, clinical guidelines support antiobesity when maintenance inadequate alone. Conclusion Relevance US. Behavioral GLP-1 8% surgery loss. Comprehensive, evidence-based combines

Language: Английский

---

Excess body weight: Novel insights into its roles in obesity comorbidities

Seminars in Cancer Biology, Journal Year: 2023, Volume and Issue: 92, P. 16 - 27

Published: March 24, 2023

Excess body weight is a global health problem due to sedentary lifestyle and unhealthy diet, affecting 2 billion population worldwide. Obesity major risk factor for metabolic diseases. Notably, the of obesity largely depends on distribution, which visceral adipose tissues but not subcutaneous fats are closely associated with comorbidities, including type diabetes, non-alcoholic fatty liver disease, cardiovascular disease certain types cancer. Latest multi-omics mechanistical studies reported crucial involvement genetic epigenetic alterations, adipokines dysregulation, immunity changes, imbalance white brown tissues, gut microbial dysbiosis in mediating pathogenic association between comorbidities. In this review, we explore epidemiology excess up-to-date mechanism how lead chronic complications. We also examine utilization fat measurement as an accurate clinical parameter assessment healthy individuals outcome prediction obese subjects. addition, current approaches prevention treatment its related comorbidities further discussed.

Language: Английский

---

The Role of Lifestyle Modification with Second-Generation Anti-obesity Medications: Comparisons, Questions, and Clinical Opportunities

Current Obesity Reports, Journal Year: 2023, Volume and Issue: 12(4), P. 453 - 473

Published: Dec. 2, 2023

Abstract Purpose of Review This review examines lifestyle modification for obesity management with the goal identifying treatment components that could support use a new generation anti-obesity medications (AOMs). Recent Findings Semaglutide reliably reduces baseline body weight by approximately 15% at 68 weeks, in contrast to 5–10% modification. Tirzepatide induces mean losses as great 20.9%. Both reduce energy intake markedly enhancing satiation and decreasing hunger, they appear lessen need traditional cognitive behavioral strategies (e.g., monitoring food intake) achieve calorie restriction. Little, however, is known about whether patients who lose these AOMs adopt healthy diet activity patterns needed optimize composition, cardiometabolic health, quality life. Summary When used AOMs, focus likely change from inducing loss (through restriction) facilitating patients’ adoption dietary will promote optimal changes composition overall health.

Language: Английский

---

Effect of High-Intensity Interval Training vs. Moderate-Intensity Continuous Training on Fat Loss and Cardiorespiratory Fitness in the Young and Middle-Aged a Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health, Journal Year: 2023, Volume and Issue: 20(6), P. 4741 - 4741

Published: March 8, 2023

Objectives: This systematic review is conducted to evaluate the effect of high-intensity interval training (HIIT) and moderate-intensity continuous (MICT) on body composition cardiorespiratory fitness (CRF) in young middle-aged. Methods: Seven databases were searched from their inception 22 October 2022 for studies (randomized controlled trials only) with HIIT MICT intervention. Meta-analysis was carried out within-group (pre-intervention vs. post-intervention) between-group (HIIT MICT) comparisons change mass (BM), index (BMI), waist circumference (WC), percent fat (PFM), (FM), fat-free (FFM), CRF. Results: A total 1738 retrieved database, 29 included meta-analysis. Within-group analyses indicated that both can bring significant improvement CRF, except FFM. Between-group found compared MICT, brings benefits WC, PFM, VO2peak. Conclusions: The loss CRF middle-aged similar or better than which might be influenced by age (18–45 years), complications (obesity), duration (>6 weeks), frequency, interval. Despite clinical significance being limited, appears more time-saving enjoyable MICT.

Language: Английский

---

Ketogenic nutritional therapy (KeNuT)—a multi-step dietary model with meal replacements for the management of obesity and its related metabolic disorders: a consensus statement from the working group of the Club of the Italian Society of Endocrinology (SIE)—diet therapies in endocrinology and metabolism

Journal of Endocrinological Investigation, Journal Year: 2024, Volume and Issue: 47(3), P. 487 - 500

Published: Jan. 18, 2024

Abstract Purpose The ketogenic nutritional therapy (KeNuT) is an effective dietary treatment for patients with obesity and obesity-related comorbidities, including type 2 diabetes, dyslipidaemia, hypertension, coronary artery disease, some of cancers. However, to date official document on the correct prescription diet, validated by authoritative societies in nutrition or endocrine sciences, missing. It important emphasize that requires proper medical supervision patient selection, due complex biochemical implications ketosis need a strict therapeutic compliance, experienced nutritionist personalization whole protocol. Methods This practical guide provides update main clinical indications contraindications meal replacements its mechanisms action. In addition, various phases protocol involving replacements, monitoring, management potential side effects, are also discussed. Conclusion will help healthcare provider acquire necessary skills provide comprehensive care overweight, diseases, using multistep treatment, recognized Club Italian Society Endocrinology (SIE)—Diet Therapies Metabolism.

Language: Английский

---

High-protein diet prevents fat mass increase after dieting by counteracting Lactobacillus-enhanced lipid absorption

Nature Metabolism, Journal Year: 2022, Volume and Issue: 4(12), P. 1713 - 1731

Published: Dec. 1, 2022

Language: Английский

---

Butyrate and obesity: Current research status and future prospect

Frontiers in Endocrinology, Journal Year: 2023, Volume and Issue: 14

Published: Feb. 24, 2023

Over the past few decades, increasing prevalence of obesity caused an enormous medical, social, and economic burden. As sixth most important risk factor contributing to overall burden disease worldwide, not only directly harms human body, but also leads many chronic diseases such as diabetes, cardiovascular (CVD), nonalcoholic fatty liver (NAFLD), mental illness. Weight loss is still one effective strategies against related disorders. Recently, link between intestinal microflora metabolic health has been constantly established. Butyrate, a four-carbon short-chain acid, major metabolite gut microbiota that beneficial effects on health. The anti-obesity activity butyrate demonstrated, its mechanisms action have fully described. This review summarizes current knowledge butyrate, including production, absorption, distribution, metabolism, effect involved in weight obesity-related diseases. aim was contribute advance our understanding role obesity. Further exploration pathway may help identify new anti-obesity.

Language: Английский

---

A Balanced Dietary Ratio of n-6:n-3 Polyunsaturated Fatty Acids Exerts an Effect on Total Fatty Acid Profile in RBCs and Inflammatory Markers in Subjects with Obesity

Healthcare, Journal Year: 2023, Volume and Issue: 11(16), P. 2333 - 2333

Published: Aug. 18, 2023

The n-3 polyunsaturated fatty acids (PUFAs) can reduce inflammatory markers and may therefore be useful in obesity management. aim of this study was to analyze the effect supplementation with PUFAs on total acid profile red blood cells (RBCs), as well biochemical markers, subjects obesity. consisted a randomized placebo-controlled, double-blind clinical trial involving 41 during 4-month follow-up. Individuals were randomly assigned two groups: PUFA (1.5 g fish oil) placebo sunflower oil). Anthropometric, biochemical, dietetic, cytokine profiles RBCs measured. Both groups increased their intake DHA incorporation RBCs. However, group showed reduction serum IL-8 MCP-1 at end study. A multiple linear regression model adjusted by body fat mass sex that an increase decreased levels both Our results highlight role dietary usefulness exerting beneficial anti-inflammatory effects.

Language: Английский

---

Dietary patterns and cardiometabolic health: Clinical evidence and mechanism

MedComm, Journal Year: 2023, Volume and Issue: 4(1)

Published: Feb. 1, 2023

Abstract For centuries, the search for nutritional interventions to underpin cardiovascular treatment and prevention guidelines has contributed rapid development of field dietary patterns cardiometabolic disease (CMD). Numerous studies have demonstrated that healthy with emphasis on food‐based recommendations are gold standard extending lifespan reducing risks CMD mortality. Healthy include various permutations energy restriction, macronutrients, food intake such as calorie intermittent fasting, Mediterranean diet, plant‐based diets, etc. Early implementation in patients is encouraged, but an understanding mechanisms by which these trigger benefits remains incomplete. Hence, this review examined several may improve health, including restrictive patterns, regional diets based controlled macronutrients groups, summarizing cutting‐edge evidence potential treatment. Particularly, considering individual differences responses composition changes organ tissue diversity, we highlighted critical role gut microbiota crosstalk between diet recommend a more precise dynamic strategy developing profiles.

Language: Английский

---

Pharmacological Support for the Treatment of Obesity—Present and Future

Healthcare, Journal Year: 2023, Volume and Issue: 11(3), P. 433 - 433

Published: Feb. 2, 2023

Obesity is a growing civilization problem, associated with number of negative health consequences affecting almost all tissues and organs. Currently, obesity treatment includes lifestyle modifications (including diet exercise), pharmacologic therapies, in some clinical situations, bariatric surgery. These treatments seem to be the most effective method supporting obesity. However, they are many limitations options, both for practitioners patients. Often comorbidities, cost, age patient, even geographic locations may influence choices. The pharmacotherapy fast-growing market. we have at our disposal drugs various mechanisms action (directly reducing absorption calories-orlistat, acting centrally-bupropion naltrexone, phentermine topiramate, or multidirectional-liraglutide, dulaglutide, semaglutide). whose weight-reducing effect used course other diseases (e.g., glucose-sodium cotransporter inhibitors, exenatide) also worth mentioning. focusing on novel therapeutic agents improved safety efficacy profiles. trends include an assessment usefulness properties previously diseases. presented paper overview studies related currently those undergoing trials, taking into account individual approach patient.

Language: Английский

---