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Obesity Medication

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101. Open letter from academics, practitioners, students and members of the public to the British Medical Association, the British Medical Journal publishing group, and the British Association of Sports and Exercise Medicine regarding editorial governance of t

Open letter from academics, practitioners, students and members of the public to the British Medical Association, the British Medical Journal publishing group, and the British Association of Sports and Exercise Medicine regarding editorial governance of t Open letter from academics, practitioners, students and members of the public to the British Medical Association, the British Medical Journal publishing group, and the British Association of Sports and Exercise Medicine regarding editorial (...) : 769-774. Malhotra A, Noakes T, Phinney S. It is time to bust the myth of physical inactivity and obesity: you cannot outrun a bad diet. Br J Sports Med 2015; 49: 967-968. Original Letter Dear Ms Phipps, Dr Nagpaul, Dr Godlee, and Mr Holloway, As academics (scientists, lecturers, researchers), practitioners and students in the fields of sport and exercise science and medicine, evidence-based medicine/health care, nutrition and dietetics, public health, general practice/family medicine, as well

2018 British Journal of Sports Medicine Blog

102. Comparative efficacy of five long-term weight loss drugs: quantitative information for medication guidelines. (Abstract)

Comparative efficacy of five long-term weight loss drugs: quantitative information for medication guidelines. Quantitative information is scarce in current obesity medication guidelines, and they do not clearly reflect the differences in the efficacy characteristics among various drugs. This study quantitatively assessed the efficacy characteristics of five FDA-approved long-term weight loss drugs. Potentially eligible studies were obtained from public databases. Using the differences (...) , 34.9 and 24.3% respectively. In addition, a significant dose-effect correlation was observed for orlistat and PT. This study provides valid quantitative information for medication guidelines.© 2017 World Obesity Federation.

2017 Obesity Reviews

103. Gender-related issues in the pharmacology of new anti-obesity drugs. (Abstract)

Gender-related issues in the pharmacology of new anti-obesity drugs. Four new medicines-liraglutide, lorcaserin, bupropion/naltrexone, and phentermine/topiramate-have been recently added to the pharmacological arsenal for obesity treatment and could represent important tools to manage this epidemic disease. To achieve satisfactory anti-obesity goals, the use of these new medicines should be optimized and tailored to specific patient subpopulations also by applying dose adjustments if needed (...) . In the present review, we posit that gender could be among the factors influencing the activity of the new obesity drugs both because of pharmacokinetic and pharmacodynamic factors. Although evidence from premarketing clinical studies suggested that no dose adjustment by gender is necessary for any of these new medicines, these studies were not specifically designed to identify gender-related differences. This observation, together with the strong theoretical background supporting the hypothesis of a gender

2018 Obesity Reviews

104. The polyherbal drug GGEx18 from Laminaria japonica, Rheum palmatum, and Ephedra sinica inhibits hepatic steatosis and fibroinflammtion in high-fat diet-induced obese mice. (Abstract)

The polyherbal drug GGEx18 from Laminaria japonica, Rheum palmatum, and Ephedra sinica inhibits hepatic steatosis and fibroinflammtion in high-fat diet-induced obese mice. The herbal composition Gyeongshingangjeehwan 18 (GGEx18), composed of Rheum palmatum L. (Polygonaceae), Laminaria japonica Aresch (Laminariaceae), and Ephedra sinica Stapf (Ephedraceae), is used as an antiobesity drug in Korean clinics. The constituents of GGEx18 have traditionally been reported to inhibit obesity and related (...) -smooth muscle actin-positive cells, and collagen levels induced by an HFD. Consistent with the histological data, the hepatic expression of lipogenesis-, inflammation-, and fibrosis-related genes was lower, while hepatic fatty acid β-oxidation-related gene expression was higher, in mice receiving GGEx18 compared to mice fed only the HFD.These results indicate that GGEx18 attenuates visceral obesity and NAFLD, in part by altering the expression of genes involved in hepatic steatosis

2018 Journal of Ethnopharmacology

105. Perioperative considerations for airway management and drug dosing in obese children. (Abstract)

Perioperative considerations for airway management and drug dosing in obese children. Childhood obesity, a phenomenon that is increasing globally, holds substantial relevance for pediatric anesthesia. In particular, understanding the nuances of airway management and drug dosing in obese children can be daunting.Respiratory adverse events and challenges in managing the airway may be anticipated. In addition, drug-dosing strategies for the obese child are complex and poorly understood although (...) recent advances have clarified the optimal dosing for anesthetics in these children.Theoretical knowledge, practical skills, meticulous risk stratification and optimal drug regimens are crucial to ensure the safe conduct of anesthesia for obese children.

2018 Current Opinion in Anaesthesiology

106. Obese Children Require Lower Doses of Pantoprazole Than Nonobese Peers to Achieve Equal Systemic Drug Exposures. Full Text available with Trip Pro

Obese Children Require Lower Doses of Pantoprazole Than Nonobese Peers to Achieve Equal Systemic Drug Exposures. To assess appropriate pantoprazole dosing for obese children, we conducted a prospective pharmacokinetics (PK) investigation of pantoprazole in obese children, a patient population that is traditionally excluded from clinical trials.A total of 41 obese children (6-17 years of age), genotyped for CYP2C19 variants *2, *3, *4, and *17, received a single oral dose of pantoprazole, ~1.2 (...)  mg/kg lean body weight (LBW), with LBW calculated via a validated formula. Ten post-dose pantoprazole plasma concentrations were measured, and PK variables generated via noncompartmental methods (WinNonlin). Linear and nonlinear regression analyses and analyses of variance were used to explore obesity, age, and CYP2C19 genotype contribution to pantoprazole PK. PK variables of interest were compared with historic nonobese peers treated with pantoprazole.Independent of genotype, when normalized

2018 Journal of Pediatrics

107. Drugs Involved in Dyslipidemia and Obesity Treatment: Focus on Adipose Tissue Full Text available with Trip Pro

Drugs Involved in Dyslipidemia and Obesity Treatment: Focus on Adipose Tissue Metabolic syndrome can be defined as a state of disturbed metabolic homeostasis characterized by visceral obesity, atherogenic dyslipidemia, arterial hypertension, and insulin resistance. The growing prevalence of metabolic syndrome will certainly contribute to the burden of cardiovascular disease. Obesity and dyslipidemia are main features of metabolic syndrome, and both can present with adipose tissue dysfunction (...) , involved in the pathogenic mechanisms underlying this syndrome. We revised the effects, and underlying mechanisms, of the current approved drugs for dyslipidemia and obesity (fibrates, statins, niacin, resins, ezetimibe, and orlistat; sibutramine; and diethylpropion, phentermine/topiramate, bupropion and naltrexone, and liraglutide) on adipose tissue. Specifically, we explored how these drugs can modulate the complex pathways involved in metabolism, inflammation, atherogenesis, insulin sensitivity

2018 International journal of endocrinology

108. A Medically Supervised Pregnancy Exercise Intervention in Obese Women: A Randomized Controlled Trial. (Abstract)

A Medically Supervised Pregnancy Exercise Intervention in Obese Women: A Randomized Controlled Trial. 29470327 2018 02 22 1873-233X 131 3 2018 Mar Obstetrics and gynecology Obstet Gynecol A Medically Supervised Pregnancy Exercise Intervention in Obese Women: A Randomized Controlled Trial. 599 10.1097/AOG.0000000000002505 Cambos Sophie S Endocrinology-Nutrition Department, CHU Bordeaux, Hospital Haut-Leveque, Pessac, France. Rigalleau Vincent V Blanco Laurence L eng Journal Article United States

2018 Obstetrics and Gynecology Controlled trial quality: predicted high

109. Evaluation of Treatment-Dose Enoxaparin in Acutely Ill Morbidly Obese Patients at an Academic Medical Center: A Randomized Clinical Trial. (Abstract)

Evaluation of Treatment-Dose Enoxaparin in Acutely Ill Morbidly Obese Patients at an Academic Medical Center: A Randomized Clinical Trial. Enoxaparin dosing recommendations for morbidly obese patients are lacking. Retrospective and observational studies reported goal anti-Xa levels with a median dose of 0.8 mg/kg using total body weight. Further studies are needed to determine if a more conservative dosing strategy is warranted.To determine if reduced dose enoxaparin was more effective than (...) standard dose at achieving goal anti-Xa levels in morbidly obese patients.A prospective, randomized, controlled study was conducted in patients with a body mass index (BMI) ≥40 kg/m2. Patients were randomized to standard (1 mg/kg) or reduced dose (0.8 mg/kg) enoxaparin every 12 hours. The primary outcome was the proportion of patients with an initial anti-Xa at goal (0.5-1.1 IU/mL).A total of 62 patients were enrolled and randomized to 1 mg/kg (n = 32) or 0.8 mg/kg (n = 30), and 54 patients completed

2018 The Annals of pharmacotherapy Controlled trial quality: uncertain

110. Effects of medical trainees' weight-loss history on perceptions of patients with obesity. (Abstract)

Effects of medical trainees' weight-loss history on perceptions of patients with obesity. Medical professionals often express weight-biased attitudes. Prior research suggests that people who overcome a challenge are critical of individuals who struggle to overcome the same challenge. Thus, medical trainees who have successfully achieved and maintained weight loss may express greater weight bias and more critical attitudes toward patients with obesity who fail to overcome these challenges.This (...) study was designed to determine the effects of medical trainees' weight-loss history on weight-biased attitudes and responses to patients with varying weight-loss outcomes.An online survey was completed by 219 medical students and internal medicine residents. Participants' weight-biased attitudes were assessed before they were randomly assigned to read one of three patient vignettes in which the patient lost no weight, lost/regained weight, or lost/maintained weight. Independent measures included

2018 Medical education Controlled trial quality: uncertain

111. Obesity: Are shared medical appointments part of the answer? Full Text available with Trip Pro

Obesity: Are shared medical appointments part of the answer? Shared medical appointments, in which a multidisciplinary team of healthcare providers meets with multiple patients in a group setting, may be an option for treating patients with obesity. To be effective, shared medical appointments need to address patients' nutrition, physical activity, appetite suppression, stress management, and sleep.Copyright © 2018 Cleveland Clinic.

2018 Cleveland Clinic Journal of Medicine

112. Long-term mortality in obese subjects undergoing malabsorptive surgery (biliopancreatic diversion and biliointestinal bypass) versus medical treatment. (Abstract)

Long-term mortality in obese subjects undergoing malabsorptive surgery (biliopancreatic diversion and biliointestinal bypass) versus medical treatment. Aim of this study was to analyze long-term mortality in obese patients receiving malabsorptive bariatric surgery (BS)[biliopancreatic diversion (BPD) and biliointestinal bypass (BIBP)] in comparison to medical treatment of obesity.Medical records of 1877 obese patients [body mass index (BMI) > 35 kg/m2, aged 18-65 years, undergoing BS (n = 472 (...) -surgical medical weight-loss treatment patients. Malabsorptive bariatric surgery significantly reduces long-term mortality in severely obese patients.

2018 International Journal of Obesity

113. Ileal interposition coupled with duodenal diverted sleeve gastrectomy versus standard medical treatment in type 2 diabetes mellitus obese patients: long-term results of a case-control study. (Abstract)

Ileal interposition coupled with duodenal diverted sleeve gastrectomy versus standard medical treatment in type 2 diabetes mellitus obese patients: long-term results of a case-control study. Randomized controlled trials have demonstrated that bariatric surgery is effective in obtaining remission of type 2 diabetes mellitus (T2DM) in obese patients, yet no data exist in the literature from prospective studies with ileal interposition with duodenal diversion sleeve gastrectomy (II-DD-SG). The aim (...) of this case-control study is to investigate if II-DD-SG is superior to medical treatment in T2DM obese patients.Thirty obese patients (BMI > 30) affected by T2DM were recruited for surgery (II-DD-SG) between 2008 and 2011 and were matched with an equal control group which received standard medical treatment. Anthropometric measures, glucose metabolism, cardiovascular risk factors were determined baseline and during follow-up. The primary end point was T2DM remission; reduction of body weight, BMI

2018 Surgical endoscopy

114. Laparoscopic Conversion of a Vertical Banded Gastroplasty to a Sleeve Gastrectomy in a Morbidly Obese Patient with a Complicated Medical History. Full Text available with Trip Pro

Laparoscopic Conversion of a Vertical Banded Gastroplasty to a Sleeve Gastrectomy in a Morbidly Obese Patient with a Complicated Medical History. We present our technique for performing a laparoscopic conversion of vertical banded gastroplasty (VBG) to sleeve gastrectomy (SG) in a morbidly obese patient.A 58-year-old female with history of hypertension, diabetes, and morbid obesity (BMI 41). She had initially undergone an open VBG (BMI 58) and cholecystectomy (2002) and subsequently underwent

2018 Obesity Surgery

115. Beyond lifestyle interventions: exploring the potential of anti‐obesity medications in the UK Full Text available with Trip Pro

Beyond lifestyle interventions: exploring the potential of anti‐obesity medications in the UK In the UK, over one-quarter of the adult population have obesity (body mass index ≥30 kg m-2 ). This has major implications for patients' health and the National Health Service. Despite published studies showing that significant weight loss can be achieved and maintained in primary care, and guidance from the National Institute for Health and Care Excellence, weight management services (...) are inconsistently implemented. This may be due primarily to workload and financial constraints. There is also a lack of belief that specialist weight management services and anti-obesity medications (AOMs) are a viable alternative to bariatric surgery for long-term maintenance of weight loss. This article discusses the challenges facing obesity management and explores the reasons for the lack of investment in AOMs in the UK to date. The aim of this article is to identify whether the newer AOMs

2018 Clinical Obesity

116. The Association between Antihypertensive Medication Use and Blood Pressure Is Influenced by Obesity Full Text available with Trip Pro

The Association between Antihypertensive Medication Use and Blood Pressure Is Influenced by Obesity One in three US adults is living with obesity or hypertension, and more than 75% of hypertensive individuals are using antihypertensive medications. Therefore, it is important to examine blood pressure (BP) differences in populations that are using these medications with differing obesity status.We examined whether BP attained when using various antihypertensive medications varies amongst (...) medications (NoBPMed) (P < 0.05), whereby in women, the differences in systolic BP between angiotensin-converting-enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) users and NoBPMed were greater in those with obesity (ACE inhibitors: -14 ± 1 mmHg; ARB: -16 ± 1 mmHg) compared to normal weight individuals (ACE inhibitors: -9 ± 1 mmHg; ARB: -11 ± 1 mmHg) (P < 0.05). Diastolic BP differences between women ARB users and NoBPMed were also greatest in obesity (-5 ± 1 mmHg) (P < 0.05) whilst there were

2018 Journal of obesity

117. Early Childhood Obesity Risk Factors: Socioeconomic Adversity, Family Dysfunction, Offspring Distress, and Junk Food Self-Medication Full Text available with Trip Pro

Early Childhood Obesity Risk Factors: Socioeconomic Adversity, Family Dysfunction, Offspring Distress, and Junk Food Self-Medication To explore the sequence and interaction of infancy and early childhood risk factors, particularly relating to disturbances in the social environment, and how the consequences of such exposures can promote weight gain and obesity.This review will argue that socioeconomic adversity is a key upstream catalyst that sets the stage for critical midstream risk factors (...) such as family strain and dysfunction, offspring insecurity, stress, emotional turmoil, low self-esteem, and poor mental health. These midstream risk factors, particularly stress and emotional turmoil, create a more or less perfect foil for calorie-dense junk food self-medication and subtle addiction, to alleviate uncomfortable psychological and emotional states. Disturbances in the social environment during infancy and early childhood appear to play a critical role in weight gain and obesity, through

2018 Current obesity reports

118. Medical Versus Surgical ICU Obese Patient Outcome: A Propensity-Matched Analysis to Resolve Clinical Trial Controversies. Full Text available with Trip Pro

Medical Versus Surgical ICU Obese Patient Outcome: A Propensity-Matched Analysis to Resolve Clinical Trial Controversies. To determine the short- and long-term mortality of obese ICU patients following medical as opposed to surgical admission and the relation between obesity and mortality.Retrospective analysis of prospectively collected data, using a propensity score-matched analysis of patients with medical or surgical admission.One French mixed medical-surgical ICU.Critically ill obese (...) patients (body mass index ≥ 30 kg/m) and nonobese patients admitted during a 14-year period.None.Seven-hundred ninety-one obese patients and 4,644 nonobese patients were included, 338 (43%) and 2,367 (51%) medical and 453 (57%) and 2,277 (49%) surgical obese and nonobese patients, respectively. Mortality was significantly higher in medical than in surgical obese patients in ICU (25% vs 12%; p < 0.001) and up to 365 days (36% vs 18%; p < 0.001) post ICU admission. One-to-one propensity score matching

2018 Critical Care Medicine

119. 7. Obesity Management for the Treatment of Type 2 Diabetes: <i>Standards of Medical Care in Diabetes-2018</i>. Full Text available with Trip Pro

7. Obesity Management for the Treatment of Type 2 Diabetes: Standards of Medical Care in Diabetes-2018. The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible

2018 Diabetes Care

120. Who pays for the medical costs of obesity? New evidence from the employer mandate. (Abstract)

Who pays for the medical costs of obesity? New evidence from the employer mandate. Theory suggests that the medical costs of obesity should be passed on to obese workers, in the form of lower wages, whenever health coverage is a part of employee compensation. In contrast to existing work on this topic, this paper illustrates that the medical expenditures caused by obesity among working adults are relatively small and that wage offsets should therefore be difficult to detect. The paper supports (...) this claim by exploiting the variation provided by the Affordable Care Act's employer mandate. Findings suggest that obese workers tend to bear the approximate cost of their medical expenditures via lower wages. However, the observed effects are often insignificantly different from zero.© 2018 John Wiley & Sons, Ltd.

2018 Health economics

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