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Obesity Medication

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41. Shape-Up and Eat Right Families Pilot Program: Feasibility of a Weight Management Shared Medical Appointment Model in African-Americans With Obesity at an Urban Academic Medical Center Full Text available with Trip Pro

Shape-Up and Eat Right Families Pilot Program: Feasibility of a Weight Management Shared Medical Appointment Model in African-Americans With Obesity at an Urban Academic Medical Center Disparities in obesity care exist among African-American children and adults. We sought to test the feasibility of a pilot program, a 1-year family-based intervention for African-American families with obesity [shape up and eat right (SUPER)], adopting the shared medical appointment model (SMA) at an urban safety

2018 Frontiers in pediatrics

42. Effect of Multinutrient Supplementation and Food-Related Behavioral Activation Therapy on Prevention of Major Depressive Disorder Among Overweight or Obese Adults With Subsyndromal Depressive Symptoms: The MooDFOOD Randomized Clinical Trial. Full Text available with Trip Pro

Effect of Multinutrient Supplementation and Food-Related Behavioral Activation Therapy on Prevention of Major Depressive Disorder Among Overweight or Obese Adults With Subsyndromal Depressive Symptoms: The MooDFOOD Randomized Clinical Trial. Effects of nutritional interventions on the prevention of major depressive disorder (MDD) in overweight adults are unknown.To examine the effect of 2 nutritional strategies (multinutrient supplementation, food-related behavioral activation therapy (...) in the supplementation-only group were hospitalized.Among overweight or obese adults with subsyndromal depressive symptoms, multinutrient supplementation compared with placebo and food-related behavioral activation therapy compared with no therapy did not reduce episodes of major depressive disorder during 1 year. These findings do not support the use of these interventions for prevention of major depressive disorder.ClinicalTrials.gov Identifier: NCT02529423.

2019 JAMA Controlled trial quality: predicted high

43. The impact of obesity and overweight on medical expenditures and disease incidence in Korea from 2002 to 2013. Full Text available with Trip Pro

The impact of obesity and overweight on medical expenditures and disease incidence in Korea from 2002 to 2013. Few studies have assessed the long-term medical costs and incidence of obesity and overweight in Asia. We evaluated the impact of body mass index (BMI) on medical expenditures and disease incidence and prevalence over more than 10 years in South Korea.Using 2002-2013 data from the Korean National Claims Database, we analysed two population sets (initial BMI in 2002-2003; consistent BMI (...) in 2002-2003 and 2012-2013). Obesity was defined by Asian BMI criteria. Incremental medical expenditures or Charlson Comorbidity Index (CCI) ratios for obese compared to normal weight individuals were calculated. Medical expenditure over 11 years was estimated by BMI using a generalised linear model. Individual obesity-related disease incidence was determined and adjusted hazard ratios were calculated.Data for 496,469 and 214,477 individuals were included in the entire and consistent BMI level

2018 PLoS ONE

44. Pharmaceutical interventions for weight-loss maintenance: no effect from cabergoline (Abstract)

Pharmaceutical interventions for weight-loss maintenance: no effect from cabergoline Weight regain is a major limitation to successful weight maintenance following weight loss. Observational studies suggest that stimulation of dopamine receptors in the central nervous system is associated with weight loss and inhibition of weight gain. Our objective was to test the hypothesis that dopamine agonist treatment would prevent weight regain following acute weight loss in individuals with obesity.We (...) conducted a 2-year double blind randomised controlled trial comparing the effect of a dopamine agonist, cabergoline, with placebo on weight regain in obese individuals who had lost at least 5% of their body weight using an 800 kcal/day commercial meal replacement programme. The primary outcome measure was the difference in mean weight between the treatment and control groups over the 2-year period following randomisation.At 24 months, there was no difference in body weight between cabergoline

2018 EvidenceUpdates

45. University of Hawai‘i John A. Burns School of Medicine Medical Students' Attitudes Towards Obese Patients Full Text available with Trip Pro

University of Hawai‘i John A. Burns School of Medicine Medical Students' Attitudes Towards Obese Patients Studies have shown that healthcare professionals often demonstrate obesity biases, which in turn reduce the quality of care obese patients receive. The purpose of the current study was to describe third and fourth year University of Hawai'i, John A. Burns School of Medicine medical students' attitudes towards obese patients. Data were collected using previously validated questions from (...) a pilot study assessing how healthcare providers react and recommend medical care to patients with varying characteristics. The responses of 114 medical students were analyzed. Overall, the majority of students' responses reflected the belief that obesity may be a behavioral issue. There were no statistically significant differences between the third and fourth year students' responses. Important areas of future research include assessing students' awareness of the social determinants of health

2017 Hawai'i Journal of Medicine & Public Health

46. Sharing the 'weight' of obesity management in primary care: integration of registered dietitian nutritionists to provide intensive behavioural therapy for obesity for Medicare patients. (Abstract)

Sharing the 'weight' of obesity management in primary care: integration of registered dietitian nutritionists to provide intensive behavioural therapy for obesity for Medicare patients. Clinical provision of intensive behavioral therapy for obesity (IBTO) has been a reimbursable treatment for obesity since 2012. However, gaps remain in the literature regarding its impact on patient outcomes.The primary objective of this study was to examine the integration of registered dietitian nutritionist (...) provided IBTO into a primary care setting and evaluate clinic outcomes for Medicare Part B beneficiaries. A secondary objective was to examine intensity of IBTO (quantity of IBTO visits) versus clinical outcomes and influence of socioeconomic factors.A case-control retrospective chart review was conducted at a rural, Academic Family Medicine Clinic in Eastern North Carolina for patients seen between 1 January 2016 and 1 January 2019. In order to be included in the treatment group, patients had

2020 Family Practice

47. Are the effects of drugs to prevent and to treat heart failure always concordant? The statin paradox and its implications for understanding the actions of antidiabetic medications. Full Text available with Trip Pro

Are the effects of drugs to prevent and to treat heart failure always concordant? The statin paradox and its implications for understanding the actions of antidiabetic medications. Most treatments for chronic heart failure are effective both in preventing its onset and reducing its progression. However, statins prevent the development of heart failure, but they do not decrease morbidity and mortality in those with established heart failure. This apparent discordance cannot be explained (...) by an effect to prevent interval myocardial infarctions. Instead, it seems that the disease that statins were preventing in trials of patients with a metabolic disorder was different from the disease that they were treating in trials of chronic heart failure. The most common phenotype of heart failure in patients with obesity and diabetes is heart failure with a preserved ejection fraction (HFpEF). In this disorder, the anti-inflammatory effects of statins might ameliorate myocardial fibrosis and cardiac

2018 European Journal of Heart Failure

48. Demand for health services and drug prescriptions among overweight or obese preschool children. (Abstract)

Demand for health services and drug prescriptions among overweight or obese preschool children. To evaluate the association between excess weight and the demand of health services in preschool children compared with healthy weight.The data come from the Longitudinal Study of Childhood Obesity cohort (1884 4-year-old children, residing in the Madrid region, Spain) who provided information through telephone questionnaire, physical examination and electronic medical records. We defined overweight (...) , general and abdominal obesity based on body mass index, waist circumference and waist-to-height ratio. Using mixed models of multivariable negative binomial regression we calculated the incidence rate ratio (IRR) regarding primary care (PC) doctor visits, drug prescriptions and hospital admissions by weight status at the end of the 2-year follow-up.Childhood general obesity was associated with a higher demand for PC services related to psychological problems (IRR=1.53; 95% CI 1.02 to 2.28

2019 Archives of Disease in Childhood

49. Asthma medication in children who are overweight/obese: justified treatment? Full Text available with Trip Pro

Asthma medication in children who are overweight/obese: justified treatment? The prevalence of asthma and obesity have increased over the last decades. A possible association between these two chronic illnesses has been suggested, since the prevalence of asthmatic symptoms rises with increasing Body Mass Index (BMI). However, asthma is only one of several possible causes of shortness of breath in obese children. The aim of this study is to evaluate the prevalence of overtreatment with asthma (...) medication in a cohort overweight/obese children with respiratory symptoms visiting a pediatric outpatient clinic.Children referred to a pediatric outpatient clinic aged ≥4- ≤ 18 years with overweight/obesity (defined as BMI-sds > 1.1) and asthmatic symptoms were included. The diagnosis asthma was evaluated and classified in no, unlikely, probable and confirmed asthma, based on clinical parameters and/or spirometry results. Overtreatment was defined as asthma medication prescribed in participants

2019 BMC Pediatrics

50. American Association of Clinical Endocrinologists and American College of Endocrinology Clinical Practice Guidelines for Comprehensive Medical Care of Patients with Obesity

School of Medicine, Internal Medicine, Endocrinology, Pediatrics, Pediatric Endocrinology, New Haven, Connecticut; 7 Walter Reed National Military Medical Center, Diabetes Obesity & Metabolic Institute, Bethesda, Maryland; 8 Assistant Clinical Professor, Mount Sinai School of Medicine, NY, ProHealth Care Associates, Division of Endocrinology, Lake Success, New York; 9 Center for Weight Management, Division of Endocrinology, Diabetes and Metabolism, Scripps Clinic, San Diego, California. Address (...) Summary 4-30 Evidence Base 30 Post-hoc Question: By inductive evaluation of all evidence-based recommendations, what are the core recommendations for medical care of patients with obesity? 30 Q1. Do the 3 phases of chronic disease prevention and treatment (i.e., primary, secondary, and tertiary) apply to the disease of obesity? 31 Q2. How should the degree of adiposity be measured in the clinical setting? 33 Q2.1. What is the best way to optimally screen or aggressively case-find for overweight

2016 American Association of Clinical Endocrinologists

51. Closed Incision Negative Pressure Therapy in Morbidly Obese Women Undergoing Cesarean Delivery: A Randomized Controlled Trial Full Text available with Trip Pro

Closed Incision Negative Pressure Therapy in Morbidly Obese Women Undergoing Cesarean Delivery: A Randomized Controlled Trial To evaluate the efficacy of incisional negative pressure wound therapy in the prevention of postoperative wound morbidity in women with class III obesity undergoing cesarean delivery.In an open label randomized controlled trial, women admitted for delivery with class III obesity (body mass index 40 or higher) measured within 2 weeks of admission for delivery were offered (...) participation in the study. They were consented either in the outpatient maternal-fetal medicine specialty clinic, during admission to labor and delivery and before a decision to perform cesarean delivery, or in the preoperative area of the hospital before scheduled cesarean delivery. Exclusion criteria included anticoagulation therapy, human immunodeficiency virus infection, and silver or acrylic allergy. Those who ultimately underwent cesarean delivery were randomized to standard surgical dressing

2019 EvidenceUpdates

52. Cost-effectiveness of incisional negative pressure wound therapy compared with standard care after caesarean section in obese women: a trial-based economic evaluation Full Text available with Trip Pro

Cost-effectiveness of incisional negative pressure wound therapy compared with standard care after caesarean section in obese women: a trial-based economic evaluation To evaluate the cost-effectiveness of incisional negative pressure wound therapy (iNPWT) in preventing surgical site infection in obese women after caesarean section.A cost-effectiveness analysis conducted alongside a clinical trial.Five obstetric departments in Denmark.Women with a pregestational body mass index (BMI) ≥30 kg/m2 (...) .We used data from a randomised controlled trial of 876 obese women who underwent elective or emergency caesarean section and were subsequently treated with iNPWT (n = 432) or a standard dressing (n = 444). Costs were estimated using data from four Danish National Databases and analysed from a healthcare perspective with a time horizon of 3 months after birth.Cost-effectiveness based on incremental cost per surgical site infection avoided and per quality-adjusted life-year (QALY) gained.The total

2019 EvidenceUpdates

53. Effect of Integrated Behavioral Weight Loss Treatment and Problem-Solving Therapy on Body Mass Index and Depressive Symptoms Among Patients With Obesity and Depression: The RAINBOW Randomized Clinical Trial. Full Text available with Trip Pro

control group (n = 205) received medical care from their personal physicians as usual, received information on routine services for obesity and depression at their clinic, and received wireless physical activity trackers. Intervention participants also received a 12-month intervention that integrated a Diabetes Prevention Program-based behavioral weight loss treatment with problem-solving therapy for depression and, if indicated, antidepressant medications.The co-primary outcome measures were BMI (...) in the intervention group and 20 in the usual care group).Among adults with obesity and depression, a collaborative care intervention integrating behavioral weight loss treatment, problem-solving therapy, and as-needed antidepressant medications significantly improved weight loss and depressive symptoms at 12 months compared with usual care; however, the effect sizes were modest and of uncertain clinical importance.ClinicalTrials.gov Identifier: NCT02246413.

2019 JAMA Controlled trial quality: predicted high

54. Underdocumentation of Obesity by Medical Residents Highlights Challenges to Effective Obesity Care. Full Text available with Trip Pro

Underdocumentation of Obesity by Medical Residents Highlights Challenges to Effective Obesity Care. The goal of this study was to determine attitudes and practices of physicians in training with respect to the evaluation and treatment of obesity.Resident-generated admission and discharge notes of all 1,765 general medicine hospital admissions during 4 nonconsecutive months were analyzed, and any references to weight, obesity, BMI, adiposity, and body fat were identified. The full general (...) resident cohort was then surveyed for perceptions and behaviors related to obesity.Obesity was considered a highly important medical issue by 98.5% of residents; 90% correctly identified a class II obesity Stunkard phenotype, and 80% accurately calculated a BMI given height and weight in metric units. Residents overestimated inpatient obesity prevalence (estimate = 75%; actual = 35%) and the rate of obesity recording in the hospital admission note (estimate = 94%; actual = 49.5%). A BMI or current

2018 Obesity

55. Obesity Management Task Force of the European Association for the Study of Obesity Released "Practical Recommendations for the Post-Bariatric Surgery Medical Management". (Abstract)

Obesity Management Task Force of the European Association for the Study of Obesity Released "Practical Recommendations for the Post-Bariatric Surgery Medical Management". Bariatric patients may face specific clinical problems after surgery, and multidisciplinary long-term follow-up is usually provided in specialized centers. However, physicians, obstetricians, dieticians, nurses, clinical pharmacists, midwives, and physical therapists not specifically trained in bariatric medicine may encounter (...) post-bariatric patients with specific problems in their professional activity. This creates a growing need for dissemination of first level knowledge in the management of bariatric patients. Therefore, the Obesity Management Task Force (OMTF) of the European Association for the Study of Obesity (EASO) decided to produce and disseminate a document containing practical recommendations for the management of post-bariatric patients. The list of practical recommendations included in the EASO/OMTF

2018 Obesity Surgery

56. Association of Body Mass Index With Risk Factor Optimization and Guideline-Directed Medical Therapy in US Veterans With Cardiovascular Disease. Full Text available with Trip Pro

Association of Body Mass Index With Risk Factor Optimization and Guideline-Directed Medical Therapy in US Veterans With Cardiovascular Disease. Obesity is a growing epidemic that has been linked to the development of cardiovascular disease (CVD). Guideline-directed medications for secondary prevention and risk factor control are recommended for patients with all forms of CVD. The association of body mass index (BMI) with use of medications for secondary prevention and risk factor control (...) -termed optimal medial therapy (OMT) was compared among groups. Multivariable logistic regression was performed with normal BMI as the referent category. Underweight patients comprised 12 623 (1.1%), normal BMI 230 471 (20.5%), overweight 413 590 (36.8%), obese 404 105 (36%), and extremely obese 61 778 (5.5%) of the cohort. Only 43.7% of the entire cohort received OMT, and this was the highest in the overweight group. Adjusted odds ratios for receiving OMT were 0.81 (95% CI, 0.77-0.85), 1.11 (95% CI

2019 Circulation. Cardiovascular quality and outcomes

57. Effects of Bariatric Surgery Versus Medical Therapy on the 24-Hour Ambulatory Blood Pressure and the Prevalence of Resistant Hypertension. Full Text available with Trip Pro

Effects of Bariatric Surgery Versus Medical Therapy on the 24-Hour Ambulatory Blood Pressure and the Prevalence of Resistant Hypertension. Bariatric surgery is an effective strategy for blood pressure (BP) reduction, but most of the evidence relies on office BP measurements. In this study, we evaluated the impact of bariatric surgery on 24-hour BP profile, BP variability, and resistant hypertension prevalence. This is a randomized trial including obese patients with grade 1 and 2 using at least (...) 2 antihypertensive drugs at maximal doses or >2 at moderate doses. Patients were allocated to either Roux-en-Y Gastric Bypass (RYGB) combined with medical therapy or medical therapy alone for 12 months. The primary outcome was the 24-hour BP profile and variability (average real variability of daytime and night time BP). We evaluated the nondipping status and prevalence of resistant hypertension as secondary end points. We included 100 patients (76% female, body mass index, 36.9±2.7 kg/m2

2019 Hypertension Controlled trial quality: uncertain

58. Obesity: European patients protected against lorcaserin, a psychotropic drug sold as an appetite suppressant

|   |   |   |   |   |   |   |  Spotlight Obesity: European patients protected against lorcaserin, a psychotropic drug sold as an appetite suppressant It is unjustifiable to expose patients to the dangers of lorcaserin, which has no tangible effect on the complications of obesity or even on weight. The European Medicines Agency was right to refuse it a marketing authorisation. Treatment of obesity or just excess weight depends first (...) Obesity: European patients protected against lorcaserin, a psychotropic drug sold as an appetite suppressant Prescrire IN ENGLISH - Spotlight ''Obesity: European patients protected against lorcaserin, a psychotropic drug sold as an appetite suppressant'', 1 May 2014 {1} {1} {1} | | > > > Obesity: European patients protected against lorcaserin, a psychotropic drug sold as an appetite suppressant Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |   

2014 Prescrire

59. Effect of one time high dose "stoss therapy" of vitamin D on glucose homeostasis in high risk obese adolescents. Full Text available with Trip Pro

Effect of one time high dose "stoss therapy" of vitamin D on glucose homeostasis in high risk obese adolescents. To study the effect of using a one time high dose "stoss therapy" of vitamin D2 (ergocalciferol: VD2) on indices of insulin sensitivity {whole body sensitivity index: WBISI} and secretion {insulinogenic index: IGI} measured during an oral glucose tolerance test (OGTT) in obese adolescents with VDD (25 OHD; serum metabolite of vit D: < 30 ng/dL).In a randomized placebo controlled (...) respectively.Adolescents were obese and insulin resistant (mean ± SD: mean age = 15.1 ± 1.9 years; BMI: 32.7 ± 9.8; homeostatic model of insulin resistance: HOMA-IR: 4.2 ± 2.8). Stoss therapy with VD2 increased 25OHD from baseline (16.7 ± 2.9 to 19.5 ± 4.5; p = 0.0029) when compared to the placebo. WBISI (2.8 ± 1.9) showed a trend towards improvement in Rx group (p = 0.0577) after adjustment for covariates. IGI (3 ± 2.2) showed an improvement in both Rx and placebo groups.Our study demonstrated that using a high dose

2018 Archives of endocrinology and metabolism Controlled trial quality: uncertain

60. Intrapartum care for women with existing medical conditions or obstetric complications and their babies

-for-gestational-age baby 46 1.17 Large-for-gestational-age baby 46 1.18 No antenatal care 47 1.19 Previous caesarean section 50 1.20 Labour after 42 weeks of pregnancy 52 T erms used in this guideline 52 Recommendations for research 54 1 Subarachnoid haemorrhage or arteriovenous malformation of the brain 54 2 Needle siting in pregnant women who are obese 54 Intrapartum care for women with existing medical conditions or obstetric complications and their babies (NG121) © NICE 2019. All rights reserved. Subject (...) to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Last updated April 2019 Page 3 of 963 Obesity as a risk factor for perinatal morbidity and mortality 54 4 Risk assessment for women in labour with signs of sepsis 54 5 Previous caesarean section 55 Rationale and impact 56 Information for women with existing medical conditions 56 Planning for intrapartum care with women with existing medical conditions – involving a multidisciplinary team 56 Risk assessment for women

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

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