Obesity Genes and Weight Loss During Lifestyle Intervention in Children With Obesity

Abstract Context Questions remain about bariatric surgery for type 2 diabetes mellitus (T2DM) treatment. Objective Compare the remission of T2DM following surgical or nonsurgical treatments. Design, setting, and participants Randomized controlled trial at the University of Pittsburgh, in the United States. Five-year follow-up from February 2015 until June 2016. Interventions 61 participants with obesity and T2DM who were initially randomized to either bariatric surgical treatments (Roux-en-Y gastric bypass [RYGB] or laparoscopic adjustable gastric banding [LAGB]) or an intensive lifestyle weight loss intervention (LWLI) program for 1 year. Lower level lifestyle weight loss interventions (LLLIs) were then delivered for 4 years. Main Outcomes and Measures Diabetes remission assessed at 5 years. Results The mean age of the patients was 47 ± 6.6 years, 82% were women, and 21% African American. Mean hemoglobin A1c level 7.8% ± 1.9%, body mass index (BMI) 35.7 ± 3.1 kg/m2, and 26 participants (43%) had BMI < 35 kg/m2. Partial or complete T2DM remission was achieved by 30% (n = 6) of RYGB, 19% (n = 4) of LAGB, and no LWLI participants (P = .0208). At 5 years those in the RYGB group had the largest percentage of individuals (56%) not requiring any medications for T2DM compared with those in the LAGB (45%) and LWLI (0%) groups (P = .0065). Mean reductions in percent body weight at 5 years was the greatest after RYGB 25.2% ± 2.1%, followed by LAGB 12.7% ± 2.0% and lifestyle treatment 5.1% ± 2.5% (all pairwise P < .01). Conclusions Surgical treatments are more effective than lifestyle intervention alone for T2DM treatment.

Download Full-text

Return on Investment: Medical Savings of an Employer‐Sponsored Digital Intensive Lifestyle Intervention, Weight Loss

Obesity ◽

10.1002/oby.23117 ◽

2021 ◽

Vol 29 (4) ◽

pp. 654-661

Author(s):

Cecelia M. Horstman ◽

Donna H. Ryan ◽

Louis J. Aronne ◽

Caroline M. Apovian ◽

John P. Foreyt ◽

...

Keyword(s):

Weight Loss ◽

Lifestyle Intervention ◽

Return On Investment ◽

Intensive Lifestyle Intervention

Download Full-text

Abstract P073: Insufficient and Poor Sleep are Associated with Barriers to Healthy Eating and Lower Physical Activity: Baseline Characteristics of the EMPOWER Study

Circulation ◽

10.1161/circ.131.suppl_1.p073 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Christopher E Kline ◽

Patrick J Strollo ◽

Eileen R Chasens ◽

Bonny Rockette-Wagner ◽

Andrea Kriska ◽

...

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Sleep Quality ◽

Lifestyle Intervention ◽

Body Fat ◽

Healthy Eating ◽

Perceived Barriers ◽

Poor Sleep ◽

Body Habitus ◽

Overweight Adults

Background: Sleep is emerging as an important factor that impacts dietary habits, physical activity, and metabolism. However, minimal attention is typically given to sleep in traditional lifestyle interventions. The purpose of these analyses was to examine baseline associations between sleep and physical activity and perceived barriers to healthy eating, which are two common lifestyle intervention targets, in a sample of apparently healthy adults enrolled in a behavioral weight loss intervention study. Methods: 150 overweight adults (51.1±10.2 y; 91% female; 79% Caucasian) participated in a 12-month lifestyle intervention that featured adaptive ecological momentary assessment. Sleep, physical activity, barriers to healthy eating and body habitus/composition were assessed prior to the intervention. Objective sleep was estimated with 7 days of wrist-worn actigraphy (Philips Actiwatch 2); sleep onset latency (SOL; the amount of time it takes to fall asleep after going to bed), sleep efficiency (SE; the percentage of time in bed that is spent asleep), and total sleep time (TST; total time spent asleep) served as the primary actigraphic sleep variables. Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). Physical activity was assessed with 7 days of waist-worn accelerometry (ActiGraph GT3x). Perceived barriers to healthy eating were assessed with the Barriers to Healthy Eating questionnaire. Body mass index (BMI) served as the measure of body habitus, and body fat was assessed with bioelectrical impedance. Results: Mean BMI and body fat for the sample were 34.0±4.6 kg/m2 and 43.7±5.5%, respectively. Mean TST was 6.6±0.8 h/night; approximately 23% of the sample averaged less than 6 hours of sleep. Mean SOL and SE for the sample were 15.3±16.2 min and 85.7±6.1%, respectively. Based on the PSQI, 52.0% of the sample had poor sleep quality. Following adjustment for age, sex, and race, longer SOL was associated with fewer steps/day (β=-.19, p=.02) and less time spent in moderate to vigorous physical activity (MVPA; β=-.16, p=.03), and lower SE was related to less MVPA (β=.15, p=.04). Shorter TST was associated with greater barriers to healthy eating (β=-.16, p=.05). Longer SOL was associated with higher BMI (β=.16, p=.05) and body fat % (β=.15, p=.03), and lower SE was related to higher body fat % (β=-.13, p=.06). Conclusions: Short sleep duration and sleep disturbance were highly prevalent in this sample of overweight adults. Significant associations were observed between sleep and measures of body habitus/composition and eating and physical activity habits. Efforts to improve sleep during a behavioral intervention for weight loss may reduce barriers to healthy eating and improve physical activity habits as well as weight loss outcomes.

Download Full-text

Abstract MP006: A Feasible and Effective Mobile Health Weight Loss Lifestyle Intervention for Filipinos With Type 2 Diabetes

Circulation ◽

10.1161/circ.135.suppl_1.mp006 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Melinda S Bender ◽

Bruce Cooper ◽

Shoshana Arai

Keyword(s):

Weight Loss ◽

Waist Circumference ◽

Lifestyle Intervention ◽

Plasma Glucose ◽

Fasting Plasma Glucose ◽

Retention Rate ◽

Intervention Group ◽

Step Counts ◽

Fasting Plasma ◽

Cardiometabolic Risks

Introduction: Filipino Americans have the highest prevalence of obesity and type 2 diabetes (T2D) compared to Asian American subgroups placing them at high risk for cardiometabolic disease. Effective interventions are needed to reduce these health disparities. Mobile health (mHealth) weight loss lifestyle interventions have been effective in reducing cardiometabolic risks, but are untested among Filipinos, particularly with T2D. As prolific users of digital technology, Filipinos are ideal candidates for mHealth lifestyle interventions. Therefore, we conducted the PilAm Go4Health intervention study - a culturally adapted weight loss lifestyle intervention using mobile technology to reduce cardiometabolic risks among Filipinos with T2D. Objective: To demonstrate intervention feasibility and potential efficacy. Hypothesis: 1) participant retention rate will be greater than 80%; 2) Compared to the control, intervention group will have significantly greater reduction in: % weight loss, waist circumference, fasting plasma glucose, and HbA1; and greater increase in step-counts. Methods: Two-arm (intervention +active control groups) RCT compared a 3-month intervention (Fitbit accelerometer +mHealth app/diary +Facebook group) and control (Fitbit accelerometer). N=45 overweight Filipino adults with T2D were recruited from Northern California communities. Between group differences from baseline to 3-months were analyzed using: 1) multilevel regression for within-person change in weight and step-counts using a nonparametric bias-corrected bootstrapped 95% CI for the multilevel models, and 2) T-tests, ANOVA for waist circumference, fasting plasma glucose, and HbA1c (significance =p<0.05, 2-sided). Cohen’s d was used for effect size analyses. Results: Randomized N=45 Filipinos (intervention =22 and control =23). Mean age was 58±10 years, 62% women, and retention rate=100%. There was significantly greater reduction in the intervention group compared to the control for: % weight (2.3% greater decrease, d=0.46); waist circumference (-2.68cm; d= 0.88); and fasting plasma glucose (-18.52mg/dl; d= -0.86). HbA1c group difference was not significant (-0.34%; p< 0.19). Step-counts significantly increased in the intervention group compared to control (3432 steps at endpoint; d=1.44). Conclusion: PilAm Go4Health intervention demonstrated excellent feasibility in recruitment and retention, and potential efficacy for reducing cardiometabolic risks in Filipinos with T2D. Results warrant further testing of this lifestyle intervention that may support translation to other at-risk diverse populations living with T2D.

Download Full-text

Normalization of haemostatic alterations in overweight children with weight loss due to lifestyle intervention

Atherosclerosis ◽

10.1016/j.atherosclerosis.2011.01.042 ◽

2011 ◽

Vol 216 (1) ◽

pp. 170-173 ◽

Cited By ~ 7

Author(s):

P. Fritsch ◽

M. Kleber ◽

A. Schlagenhauf ◽

B. Laschnik ◽

M. Fritsch ◽

...

Keyword(s):

Weight Loss ◽

Lifestyle Intervention ◽

Overweight Children

Download Full-text

Utilization of Topiramate as an Adjunct to Lifestyle Intervention for Weight Loss in Pediatric Nonalcoholic Fatty Liver Disease

JPGN Reports ◽

10.1097/pg9.0000000000000126 ◽

2021 ◽

Vol 2 (4) ◽

pp. e126

Author(s):

Taisa Kohut ◽

Suraj Serai ◽

Jennifer Panganiban

Keyword(s):

Weight Loss ◽

Liver Disease ◽

Fatty Liver ◽

Nonalcoholic Fatty Liver Disease ◽

Lifestyle Intervention ◽

Fatty Liver Disease ◽

Nonalcoholic Fatty Liver

Download Full-text

O-159 Prediction of weight loss and drop-out in a lifestyle intervention in women with pcos: A randomized controlled trial

Human Reproduction ◽

10.1093/humrep/deab127.027 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

G Jiskoot ◽

A Dietz de Loos ◽

R Timman ◽

A Beerthuizen ◽

J Busschbach ◽

...

Keyword(s):

Weight Loss ◽

Body Image ◽

Lifestyle Intervention ◽

Drop Out ◽

Short Message ◽

Obese Women ◽

Lifestyle Program ◽

Message Service ◽

Lifestyle Treatment

Abstract Study question Which patient related determinants contribute to a ≥ 5% weight loss and drop-out? Summary answer Participating in the lifestyle treatment and a worse body image at baseline were significantly associated with ≥5% weight loss. What is known already In general, three-component interventions including diet, exercise, and cognitive behavioral therapy have shown to be effective at the long-term to achieve weight loss. In a lifestyle program for infertile women, higher external eating behavior scores and not receiving previous support by a dietician were associated with weight loss. In a short term lifestyle program for women with PCOS, weight loss was associated with better quality of life scores and attendance of study appointments. Little has been published about the potential role of PCOS characteristics, psychological and behavioral variables on the ability to achieve weight loss in this group of women. Study design, size, duration The present study is a longitudinal RCT to study the effectiveness of a three component 1-year cognitive-behavioural lifestyle intervention on weight loss in overweight/obese women with PCOS. A total of 183 participants were randomly assigned to three groups: 1) CBT provided by the multidisciplinary team or; 2) CBT provided by the multidisciplinary team and Short Message Service (SMS) or; 3) usual care: women are encouraged to lose weight through publicly available services (control group). Participants/materials, setting, methods Women with menstrual cycle disorders are systematically screened using a standardised protocol. Data of 183 women diagnosed with PCOS according to the Rotterdam criteria, a Body Mass Index above 25 kg/m² were included. All variables were measured at start and at three, six, nine and twelve months. Main results and the role of chance The multivariable mixed-effect logistic regression model showed that participation in the lifestyle treatment (HR 2.3, P = 0.012) and a worse body image (FNAE) (HR 0.95, P = 0.023) at baseline were significantly associated with ≥5% weight loss. Drop-out was predicted by participation in the lifestyle treatment (OR 0.2 P = 0.003), additional short message service (OR 3.7, P = 0.008), smoking (OR 0.3, P = 0.22), drinking alcohol (OR 2.4, P = 0.04), higher levels of androstenedione (OR 1.2, P = 0.047). Also, women who achieved spontaneous pregnancies were more likely to drop-out (OR 0.09, P = 0.002). Limitations, reasons for caution A limitation of our study is the high discontinuation rate we observed especially after 3 months of the intervention. Therefore a statistical method was chosen that included all available data even if participants dropped out during the study period. Wider implications of the findings A three-component lifestyle intervention program for obese women with PCOS is effective for weight loss. The group of women with a more negative body image should receive additional treatment before entering such a lifestyle intervention to achieve better results. Trial registration number Registered at the Netherlands National Trial Register with number NTR2450 on August 2nd, 2010.

Download Full-text

Rationale and description of a lifestyle intervention programme to achieve moderate weight loss in women with non-metastatic breast cancer: the lifestyle intervention part of the SUCCESS C Study

BMJ Nutrition, Prevention & Health ◽

10.1136/bmjnph-2020-000119 ◽

2020 ◽

pp. bmjnph-2020-000119

Author(s):

Dagmar Hauner ◽

Brigitte Rack ◽

Thomas Friedl ◽

Philip Hepp ◽

Wolfgang Janni ◽

...

Keyword(s):

Breast Cancer ◽

Weight Loss ◽

Lifestyle Intervention ◽

Disease Free Survival ◽

Metastatic Breast ◽

Phase Iii ◽

Intervention Programme ◽

Long Term Outcome ◽

Free Survival ◽

Disease Free

ObjectiveThere is growing evidence from observational studies that lifestyle factors such as obesity, an unhealthy diet and lack of physical activity are associated with poor long-term outcome in women with breast cancer. The primary objective of the lifestyle modification part of the Simultaneous Study of Docetaxel Based Anthracycline Free Adjuvant Treatment Evaluation, as well as Life Style Intervention Strategies (SUCCESS C) Trial is to investigate the effect of an individualised lifestyle intervention programme aiming at moderate weight loss on disease-free survival in women with HER2/neu-negative breast cancer. Secondary objectives include the effect of the intervention on body weight, cardiovascular risk and quality of life.MethodsThe SUCCESS C Trial is an open-label, multicentre, randomised controlled phase III study using a 2×2 factorial design in women with newly diagnosed HER2/neu-negative intermediate-risk to high-risk breast cancer. The first randomisation served to compare disease-free survival in patients treated with two different chemotherapy regimens (3642 participants). The second randomisation served to compare disease-free survival in patients with a body mass index of 24–40 kg/m² (2292 participants) receiving either a telephone-based individualised lifestyle intervention programme for moderate weight loss or general recommendations for a healthy lifestyle for 2 years. Outcome analyses will be conducted after 5 years of follow-up.PerspectiveThis study will provide information on the efficacy and safety of a comprehensive lifestyle intervention programme on disease-free survival in a large cohort of women with breast cancer. EU Clinical Trials Identifier: 2008-005453-38.

Download Full-text