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Latest & greatest articles for obesity
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on obesity or other clinical topics then use Trip today.
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Long-term clinical effectiveness of continuous positive airway pressure therapy versus non-invasive ventilation therapy in patients with obesity hypoventilation syndrome: a multicentre, open-label, randomised controlled trial. Obesity hypoventilation syndrome is commonly treated with continuous positive airway pressure or non-invasive ventilation during sleep. Non-invasive ventilation is more complex and costly than continuous positive airway pressure but might be advantageous because (...) it provides ventilatory support. To date there have been no long-term trials comparing these treatment modalities. We therefore aimed to determine the long-term comparative effectiveness of both treatment modalities.We did a multicentre, open-label, randomised controlled trial at 16 clinical sites in Spain. We included patients aged 15-80 years with untreated obesity hypoventilation syndrome and an apnoea-hypopnoea index of 30 or more events per h. We randomly assigned patients, using simple randomisation
WITHDRAWN: Interventions for treating obesity in children. Child and adolescent obesity is increasingly prevalent, and can be associated with significant short- and long-term health consequences.To assess the efficacy of lifestyle, drug and surgical interventions for treating obesity in childhood.We searched CENTRAL on The Cochrane Library Issue 2 2008, MEDLINE, EMBASE, CINAHL, PsycINFO, ISI Web of Science, DARE and NHS EED. Searches were undertaken from 1985 to May 2008. References were (...) checked. No language restrictions were applied.We selected randomised controlled trials (RCTs) of lifestyle (i.e. dietary, physical activity and/or behavioural therapy), drug and surgical interventions for treating obesity in children (mean age under 18 years) with or without the support of family members, with a minimum of six months follow up (three months for actual drug therapy). Interventions that specifically dealt with the treatment of eating disorders or type 2 diabetes, or included
Efficacy and safety of one anastomosis gastric bypass versus Roux-en-Y gastric bypass for obesity (YOMEGA): a multicentre, randomised, open-label, non-inferiority trial. One anastomosis gastric bypass (OAGB) is increasingly used in the treatment of morbid obesity. However, the efficacy and safety outcomes of this procedure remain debated. We report the results of a randomised trial (YOMEGA) comparing the outcomes of OAGB versus standard Roux-en-Y gastric bypass (RYGB).This prospective (...) , multicentre, randomised non-inferiority trial, was held in nine obesity centres in France. Patients were eligible for inclusion if their body-mass index (BMI) was 40 kg/m2 or higher, or 35 kg/m2 or higher with the presence of at least one comorbidity (type 2 diabetes, high blood pressure, obstructive sleep apnoea, dyslipidaemia, or arthritis), and were aged 18-65 years. Key exclusion criteria were a history of oesophagitis, Barrett's oesophagus, severe gastro-oesophageal reflux disease resistant to proton
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.
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. Coexisting obesity and depression exacerbate morbidity and disability, but effective treatments remain elusive.To test the hypothesis that an integrated collaborative care intervention would significantly improve both obesity and depression at 12 months compared with usual care.The Research (...) 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
Obesity. The role of internists in evaluating obesity is to assess the burden of weight-related disease, mitigate secondary causes of weight gain (medications, sleep deprivation), and solicit patient motivation for weight loss. Internists should assess these factors and emphasize the importance of weight loss for the individual patient. All patients wishing to lose weight should be encouraged to monitor their diet and physical activity and should be referred to high-intensity behavioral (...) programs. Some patients with obesity may also benefit from pharmacotherapy or bariatric surgery.
Transition from metabolically benign to metabolically unhealthy obesity and 10-year cardiovascular disease incidence: the ATTICA cohort study Metabolically benign obesity remains a scientific field of considerable debate. The aim of the present work was to evaluate whether metabolically healthy obese (MHO) status is a transient condition which propagates 10-year cardiovascular disease (CVD) onset.A prospective longitudinal study was conducted during 2001-2012, the ATTICA study studying 1514 (...) (49.8%) men and 1528 (50.2%) women (aged >18 years old) free of CVD and residing in the greater Athens area, Greece. Follow-up assessment of first combined CVD event (2011-2012) was achieved in n = 2020 participants; of them, 317 (15.7%) incident cases were identified. Obesity was defined as body mass index ≥30 kg/m2 and healthy metabolic status as absence of all NCEP ATP III (2005) metabolic syndrome components (excluding waist circumference).The MHO prevalence was 4.8% (n = 146) with 28.2
Lorcaserin and Renal Outcomes in Obese and Overweight Patients in the CAMELLIA-TIMI 61 Trial Obesity is thought to increase renal hyperfiltration, thereby increasing albuminuria and the progression of renal disease. The effect of pharmacologically mediated weight loss on renal outcomes is not well-described. Lorcaserin, a selective serotonin 2C receptor agonist that promotes appetite suppression, led to sustained weight loss without any increased risk for major adverse cardiovascular (CV (...) ) events in the CAMELLIA-TIMI 61 trial (Cardiovascular and Metabolic Effects of Lorcaserin in Overweight and Obese Patients-Thrombolysis in Myocardial Infarction 61).CAMELLIA-TIMI 61 randomly assigned 12 000 overweight or obese patients with or at high risk for atherosclerotic CV disease to lorcaserin or placebo on a background of lifestyle modification. The primary renal outcome was a composite of new or worsening persistent micro- or macroalbuminuria, new or worsening chronic kidney disease, doubling
Probiotics for the Prevention of Gestational Diabetes Mellitus in Overweight and Obese Women: Findings From the SPRING Double-blind Randomized Controlled Trial Given the role of gut microbiota in regulating metabolism, probiotics administered during pregnancy might prevent gestational diabetes mellitus (GDM). This question has not previously been studied in high-risk overweight and obese pregnant women. We aimed to determine whether probiotics (Lactobacillus rhamnosus and Bifidobacterium (...) animalis subspecies lactis) administered from the second trimester in overweight and obese women prevent GDM as assessed by an oral glucose tolerance test (OGTT) at 28 weeks' gestation. Secondary outcomes included maternal and neonatal complications, maternal blood pressure and BMI, and infant body composition.This was a double-blind randomized controlled trial of probiotic versus placebo in overweight and obese pregnant women in Brisbane, Australia.The study was completed in 411 women. GDM occurred
Pegbelfermin (BMS-986036), PEGylated FGF21, in Patients with Obesity and Type 2 Diabetes: Results from a Randomized Phase 2 Study Obesity and type 2 diabetes mellitus (T2DM) are risk factors for nonalcoholic fatty liver disease, including nonalcoholic steatohepatitis. This study assessed pegbelfermin (BMS-986036), recombinant PEGylated human fibroblast growth factor 21 (FGF21), in patients with obesity and T2DM predisposed to fatty liver.In this randomized, double-blind, placebo-controlled (...) = 0.015) and triglycerides (P = 0.037). All pegbelfermin regimens significantly increased adiponectin levels; 20-mg daily and weekly regimens decreased serum PRO-C3. Most adverse events were mild; the most frequent adverse events were injection-site bruising and diarrhea.Twelve-week pegbelfermin treatment did not impact HbA1c concentrations, but QW and higher daily doses were associated with improved metabolic parameters and fibrosis biomarkers in patients with obesity and T2DM predisposed to fatty
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
Being overweight or obese is linked with heart disease even without other metabolic risk factors Being overweight or obese is linked with heart disease even without other metabolic risk factors Discover Portal Discover Portal Being overweight or obese is linked with heart disease even without other metabolic risk factors Published on 7 November 2017 doi: People with certain metabolic risk factors who are obese are two and a half times as likely to develop heart disease as healthy people (...) of normal weight. But those who are obese without these other risk factors still have a 28% increased risk of heart disease compared with healthy people of normal weight. This suggests excess weight should be seen as an independent risk factor, challenging the idea that people can be “fat but fit”. Metabolic risk factors for heart disease cluster together and in this large study the researchers defined “metabolically healthy” as not having; high blood pressure, raised blood sugar, high triglyceride
Takeaways linked to increased cardiovascular risk factors and obesity in children Takeaways linked to increased cardiovascular risk factors and obesity in children Discover Portal Discover Portal Takeaways linked to increased cardiovascular risk factors and obesity in children Published on 13 February 2018 doi: Children who eat takeaways once or more each week have more body fat and higher low-density lipoprotein (LDL) “bad” cholesterol levels than those who never or hardly ever eat them (...) . Their diets were also higher in fat and lower in protein and calcium. This cross-sectional study looked in depth at eating habits and risk markers for coronary heart disease, obesity and diabetes in 2,529 children in England. Though this type of study can only show an association between takeaways and risk markers, it is one of the first of its type, and the results do give cause for concern. Increasing numbers of people are eating takeaways in the UK. Local authorities and healthcare professionals
Resistance training may prevent obese older people becoming frail when losing weight Resistance training may prevent obese older people becoming frail when losing weight Discover Portal Discover Portal Resistance training may prevent obese older people becoming frail when losing weight Published on 29 August 2017 doi: Combining resistance training with aerobic exercise increased physical function in older, obese adults who were following a weight loss programme. Functional improvements (...) , such as the speed to stand from a chair or to climb stairs, were greater with combination training (21%) than with either type of exercise performed alone (14%). This randomised controlled trial assigned 160 obese adults in the USA (aged over 65, mostly educated white females) to the different types of exercise for six months. Those exercising lost about 9% body weight on their diets. Resistance training was most effective for preventing loss of muscle and bone mass. This highlights the importance of strength
Intensive lifestyle interventions can help obese young people lose weight Intensive lifestyle interventions can help obese young people lose weight Discover Portal Discover Portal Intensive lifestyle interventions can help obese young people lose weight Published on 19 September 2017 doi: Obese children and adolescents can lose up to seven pounds over six to 12 months when they engage in at least 52 hours of behaviour-based lifestyle interventions. Minimal benefit was seen with shorter contact (...) time, with less than 25 hours ineffective. The control group gained weight. Rising obesity in the young is a global concern, which may lead to high rates of obesity-related diseases in adulthood. This review identified trials covering various weight management strategies. Lifestyle-based-interventions with sufficient contact time – as recommended by UK guidelines – showed clear benefits with no evidence of harms. Investing in effective strategies to manage child obesity will ultimately save
A school-based obesity prevention programme was ineffective A school-based obesity prevention programme was ineffective Discover Portal Discover Portal A school-based obesity prevention programme was ineffective Published on 10 April 2018 doi: A school-based healthy lifestyle programme delivered to 6-7-year-old children and their parents made no difference to children’s weight, diet or activity levels. Around 1 in 4 remained overweight or obese. The NIHR-funded year-long programme was delivered (...) in 54 primary schools in one region of England. Teachers were trained to provide an additional 30 minutes of physical activity a day and deliver cookery workshops with parents each term. It also included activities with a local football club, Aston Villa. Children in schools that took part were no less likely to be overweight or obese after 15 or 30 months, and their diet and exercise levels did not improve. Less than one in six schools managed to deliver the activity sessions as planned
Weight loss surgery is value for money in selected people with severe obesity Weight loss surgery is value for money in selected people with severe obesity Discover Portal Discover Portal Weight loss surgery is value for money in selected people with severe obesity Published on 23 August 2016 doi: Surgery is a cost-effective method of weight loss for severely and morbidly obese people. This study of general practice data compared health costs and outcomes for people with severe or morbid (...) obesity who underwent surgery and those who did not. Surgery was associated with a reduced chance of developing diabetes and an increased chance of remission in people with diabetes. It was more cost-effective – using NHS thresholds – for morbidly obese people who had diabetes, than for those without diabetes. Weight loss surgery either reduces the amount of food people can consume or the amount of energy they can absorb from food. A quarter of UK adults are obese, with 3.6% of women and 1.8% of men
A total diet replacement programme helped obese people lose weight and keep weight off Total diet replacement for weight loss in obesity Discover Portal Discover Portal A total diet replacement programme helped obese people lose weight and keep weight off Published on 18 December 2018 doi: A programme of weekly behavioural support with total diet replacement led to over 7kg greater weight loss than usual care in primary care. This weight loss was maintained for a year after starting the 8-12 (...) . After eight weeks of this low calorie diet, conventional meals were gradually reintroduced. This trial provides evidence that the rapid weight loss from these replacement diets can be maintained for a reasonable time and so could be considered as a treatment option for anyone who is obese and needs support to lose weight. Share your views on the research. Why was this study needed? In 2016, 26% of adults in England were obese. Obesity can lead to several medical conditions, including heart disease
Obesity in children Obesity in children - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Obesity in children Last reviewed: February 2019 Last updated: January 2019 Summary Behavioural and environmental factors are primarily responsible for the dramatic increase in obesity in the past two decades, although genes play an important role in regulation of body weight. Calculating body mass index (BMI) is the most widely (...) accepted method of screening for obesity in children. Abnormal BMI cut-offs in children are determined by age- and sex-specific percentiles. The dramatic increase in childhood obesity has led to a marked increase in the diagnosis of impaired glucose tolerance and type 2 diabetes mellitus in children. Preventing excessive weight gain in children is of paramount importance in confronting the obesity epidemic, as obesity is difficult to treat at all ages, and obese children tend to become obese adults
Does Prior Bariatric Surgery Improve Outcomes Following Total Joint Arthroplasty in the Morbidly Obese? A Meta-Analysis There remains a controversy regarding the risks in subsequent total joint arthroplasty (TJA) with and without previous bariatric surgery (BS). We performed a meta-analysis based on the current evidence-based study to determine the influences of prior BS on the short-term and long-term outcomes following TJA.From the inception to July 2018, the EMBASE, PubMed, Web of Science (...) morbid obesity group before TJA. Our meta-analysis revealed that BS prior to TJA was associated with reduced short-term medical complications, length of stay, and operative time. However, BS did not reduce the short-term risks for superficial wound infection or venous thromboembolism, and the long-term risks for dislocation, periprosthetic infection, periprosthetic fracture, and revision. Subgroup analysis identified a significant reduction in the risk of short-term periprosthetic infection in the BS