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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
2019LancetControlled trial quality: predicted high
Is Doctor Referral to a Low-Energy Total Diet Replacement Program Cost-Effective for the Routine Treatment of Obesity? The study objective was to estimate the cost-effectiveness of a commercially provided low-energy total diet replacement (TDR) program compared with nurse-led behavioral support.A multistate life table model and the weight reduction observed in a randomized controlled trial were used to evaluate the quality-adjusted life-years and direct health care costs (in United Kingdom 2017 (...) prices) over a lifetime with TDR versus nurse-led support in adults who had obesity, assuming that (i) weight returns to baseline over 5 years and (ii) a 1-kg weight loss is maintained after 5 years following TDR.The per-person costs of the TDR and nurse-led programs were £796 and £34, respectively. The incremental cost-effectiveness ratio of TDR was £12,955 (95% CI: £8,082-£17,827) assuming that all weight lost is regained and £3,203 (£2,580-£3,825) assuming that a 1-kg weight loss is maintained
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
2019LancetControlled trial quality: predicted high
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.
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
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
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
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
. Centers for Disease Control and Prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version. Pediatrics. 2002 Jan;109(1):45-60. http://www.ncbi.nlm.nih.gov/pubmed/11773541?tool=bestpractice.com Worldwide, the definition of overweight and obesity changes; however, a BMI >85th percentile is defined as overweight or at risk for overweight in the US and UK, a BMI ≥95th percentile is variably defined as obesity or overweight, and a BMI >99th (...) percentile is defined as severe obesity. Barlow SE. Expert Committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007 Dec;120(suppl 4):S164-92. http://pediatrics.aappublications.org/content/120/Supplement_4/S164.full http://www.ncbi.nlm.nih.gov/pubmed/18055651?tool=bestpractice.com Canoy D, Bundred P. Obesity in children. BMJ Clin Evid. 2011 Apr 4;2011. pii: 0325. http://www.ncbi.nlm.nih.gov/pmc/articles
Endoscopic placement and removal of an intra-gastric balloon (IGB) for the management of overweight and obesity in a high-risk patient 1 Public Summary Document Application No. 1515 Endoscopic placement and removal of an intragastric balloon for the management of moderate obesity in patients with type 2 diabetes mellitus who have failed first-line treatments Applicant: Apollo Endosurgery Australia Date of MSAC consideration: MSAC 76 th Meeting, 1-2 August 2019 Context for decision: MSAC makes (...) its advice in accordance with its Terms of Reference, visit the MSAC website 1. Purpose of application An application requesting Medicare Benefits Schedule (MBS) listing of the endoscopic placement and removal of an intragastric balloon (IGB) for the treatment of patients aged = 18 years with moderate obesity (body mass index (BMI) of 30.0 to 34.9 kg/m 2 ), who have poorly controlled type 2 diabetes mellitus (T2DM) and who have failed first-line treatment options, was received from Apollo
and interventions are effective in preventing overweight and obesity in children? 2.1.2 Question 2 ? What universal, whole system or settings based interventions are effective in preventing overweight and obesity in adults aged 18 to 65 years? 2.2 Source identification, selection and data extraction A sensitive search was undertaken using database subject headings and wide ranging free text, keywords and synonyms. The search was limited to English language, systematic reviews and meta-analyses. 1 Baker P et al (...) undertaken by the co-reviewer. Intervention summaries were provided for specific systematic reviews, as requested by the Health Improvement team. These are available in appendix II. 3 Results Question 1: Figure 1: Flow of information through the review process for Question 1. Records excluded 48 Abstracts screened 106 Full-text articles excluded At full-text review: 28 Reasons: Overweight/obese pop n = 9 Interventions targeted or not universal/ whole systems/settings based = 8 No relevant outcomes
definition • Caveats • Data source, geography & period • Further information • ReferencesThe notes sections in this presentation include technical information relating to the corresponding slide to aid user understanding. The notes sections include the following headings: • Indicator definition • Caveats • Data source, geography & period • Further information • ReferencesIndicator definition: • Overweight or obese - The percentage of children aged 4 to 5 years who are in the 85 th centile and above (...) in children. 2011. Oxford: National Obesity Observatory. 2. Keys, A. et al Indices of relative weight and obesity. Journal of Chronic Diseases. 1972; 25:329-343.Indicator definition: • Overweight or obese - The percentage of children aged 4 to 5 years who are in the 85 th centile and above as according to the British 1990 growth reference scale (UK90) 1 • Deprivation is classified according to 2014 Welsh Index of Multiple Deprivation fifths, based on the child’s postcode of residence. • The Child
[Effects of interval exercise in the improvement of glycemic control of obese adults with insulin resistance]. Background: physical exercise presents evidence for the treatment of insulin resistance. However, it is necessary to deepen this knowledge. Objective: to compare the effectiveness of a high intensity interval training program (HIIT) with one of resistance training (RT) to improve biochemical parameters of insulin/basal glycemia and post-load. Material and methods: twenty-eight (36 ± 13
[Teacher-Based Health Promotion in Primary School Children in Baden-WÃ¼rttemberg: Effects on Endurance Performance and Incidence of Abdominal Obesity]. Health promotion has to start early. Many prevention programmes lack proof of effectiveness. A programme that promotes an active and healthy lifestyle for primary school children in Baden-Württemberg is "Join the Healthy Boat".The effect of this one-year school-based intervention on endurance performance and incidence of paediatric abdominal (...) obesity was investigated in a large cluster randomised study.Data of 1739 children (7.1±0.6 years) were available at baseline and follow-up. Background variables were assessed via parent questionnaires. Endurance performance (6-minute run) and anthropometric data were collected on-site. Children with waist-to-height-ratio (WHtR) ≥ 0.5 were classified as being abdominally obese. The difference in endurance capacity and the incidence of abdominal obesity between baseline and follow-up were calculated
to ask the patient which terms are preferred when discussing body weight (29). Although more sensitive language is recommended when speaking with the patient, medical terminology and diagnoses such as "overweight," "obese," and "morbidly obese" should still be used, as appropriate, in the medical record and for billing and coding purposes. Exhibit Empathy, Sensitivity, and Support Obstetrician–gynecologists should understand that patients with obesity may have had negative experiences with other (...) the prevalence of obesity when counseling patients concerning their weight. Many women, irrespective of demographic characteristics or income, are vulnerable to becoming overweight or obese because of limited resources for physical activity and healthy food choices, work commitments, and family demands (8). It also is important to keep in mind that many patients have already tried to lose weight, often repeatedly. Some patients may view even empathic, motivational weight-loss counseling as biased