scholarly journals Through Thick and Thin: Identifying Barriers to Bariatric Surgery, Weight Loss Maintenance, and Tailoring Obesity Treatment for the Future

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Donevan Westerveld ◽  
Dennis Yang
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Weight Control ◽  
Weight Loss Maintenance ◽  
The United States ◽  
Physician Perceptions ◽  
Perceptions And Attitudes ◽  
Treatment Of Obesity ◽  
Weight Loss Interventions

More than one-third of the adults in the United States are obese. This complex metabolic disorder is associated with multiple comorbidities and increased all-cause mortality. Bariatric surgery has been shown to be more effective than medical therapy and has been associated with weight loss maintenance and decreased mortality. In spite of these well-established benefits, less than 1% of candidates undergo surgery due to multiple factors, such as patient and physician perceptions and attitudes, patient-physician interaction, lack of resources, and cost burden. Furthermore, even in patients who do undergo bariatric surgery and/or alternate weight loss interventions, long-term weight control is associated with high-risk failure and weight regain. In this review, we highlight some of the current barriers to bariatric surgery and long-term weight loss maintenance and underscore the importance of an individualized multidisciplinary longitudinal strategy for the treatment of obesity.

scholarly journals A Conceptual Model of Long-Term Weight Loss Maintenance: The Importance of Cognitive, Empirical and Computational Approaches

2021 ◽  
Vol 18 (2) ◽  
pp. 635
Author(s):  
Darren Haywood ◽  
Blake J. Lawrence ◽  
Frank D. Baughman ◽  
Barbara A. Mullan
Keyword(s):  
Weight Loss ◽  
Weight Loss Maintenance ◽  
Computational Approaches ◽  
Healthy Habits ◽  
Health Related ◽  
The One ◽  
Major Factors ◽  
Positive Social Support ◽  
Weight Loss Interventions

Living with obesity is related to numerous negative health outcomes, including various cancers, type II diabetes, and cardiovascular disease. Although much is known about the factors associated with obesity, and a range of weight loss interventions have been established, changing health-related behaviours to positively affect obesity outcomes has proven difficult. In this paper, we first draw together major factors that have emerged within the literature on weight loss to describe a new conceptual framework of long-term weight loss maintenance. Key to this framework is the suggestion that increased positive social support influences a reduction in psychosocial stress, and that this has the effect of promoting better executive functioning which in turn facilitates the development of healthy habits and the breaking of unhealthy habits, leading to improved ongoing maintenance of weight loss. We then outline how the use of computational approaches are an essential next step, to more rigorously test conceptual frameworks, such as the one we propose, and the benefits that a mixture of conceptual, empirical and computational approaches offer to the field of health psychology.

scholarly journals Long-term weight loss maintenance in the United States

2010 ◽  
Vol 34 (11) ◽  
pp. 1644-1654 ◽  
Author(s):  
J L Kraschnewski ◽  
J Boan ◽  
J Esposito ◽  
N E Sherwood ◽  
E B Lehman ◽  
...  
Keyword(s):  
United States ◽  
Weight Loss ◽  
Weight Loss Maintenance ◽  
The United States

scholarly journals Bariatric surgery reverses metabolic risk in patients treated in outpatient level

2014 ◽  
Vol 27 (1) ◽  
pp. 38-42 ◽  
Author(s):  
Epifânio Feitosa da SILVA-NETO ◽  
Cecília Mª Passos VÁZQUEZ ◽  
Fabiana Melo SOARES ◽  
Danielle Góes da SILVA ◽  
Márcia Ferreira Cândido de SOUZA ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Life Expectancy ◽  
Conventional Treatment ◽  
Cardiometabolic Risk ◽  
Metabolic Risk ◽  
Outpatient Basis ◽  
Treatment Of Obesity

Background : The conventional treatment of obesity presents unsatisfactory results on weight loss and its long-term sustainability, therefore bariatric surgery has been suggested as an effective therapy, determining sustainable long-term weight loss, reversal of components of cardiometabolic risk and improved quality and life expectancy. Aim : To investigate the clinical component of the cardiometabolic risk in patients undergoing bariatric surgery assisted on outpatient basis. Methods : The sample consisted of 47 patients with ages between 18 and 60 years, 72% females. Diabetes mellitus, hypertension, and dyslipidemia were prospectively evaluated by using the Assessment of Obesity-Related Co-morbidities scale. Results : Occurred improvement in these co-morbidities within 12 months after surgery. Co-morbidities resolved were greater than those improved. Conclusion : The study revealed that the Assessment of Obesity-Related Co-morbidities is a system that can be effectively used to quantify the degree of reduction of the severity of the cardiometabolic risk in response to bariatric surgery.

scholarly journals The Influence of Body Contouring Surgery on Weight Control and Comorbidities in Patients After Bariatric Surgery

2019 ◽  
Vol 30 (3) ◽  
pp. 924-930 ◽  
Author(s):  
C. E. E. de Vries ◽  
M. C. Kalff ◽  
E. M. van Praag ◽  
J. M. G. Florisson ◽  
M. J. P. F. Ritt ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Weight Control ◽  
Body Contouring ◽  
Mixed Effect ◽  
Body Contouring Surgery ◽  
Number Of Patients ◽  
Post Bariatric Surgery ◽  
The Impact

Abstract Introduction A considerable number of patients experience some long-term weight regain after bariatric surgery. Body contouring surgery (BCS) is thought to strengthen post-bariatric surgery patients in their weight control and maintenance of achieved improvements in comorbidities. Objectives To examine the impact of BCS on long-term weight control and comorbidities after bariatric surgery. Methods We performed a retrospective study in a prospective database. All patients who underwent primary Roux-en-Y gastric bypass (RYGB) and presented for preoperative consultation of BCS in the same hospital were included in the study. Linear and logistic mixed-effect model analyses were used to evaluate the longitudinal relationships between patients who were accepted or rejected for BCS and their weight loss outcomes or changes in comorbidities. Results Of the 1150 patients who underwent primary RYGB between January 2010 and December 2014, 258 patients (22.4%) presented for preoperative consultation of BCS. Of these patients, 126 patients eventually underwent BCS (48.8%). Patients who were accepted for BCS demonstrated significant better ∆body mass index (BMI) on average over time (− 1.31 kg/m2/year, 95% confidence interval (CI) −2.52 − −0.10, p = 0.034) and percent total weight loss (%TWL) was significantly different at 36 months (5.79, 95%CI 1.22 – 10.37, p = 0.013) and 48 months (6.78, 95%CI 0.93 – 12.63, p = 0.023) after body contouring consultation. Patients who were accepted or rejected did not differ significantly in the maintenance of achieved improvements in comorbidities. Conclusion BCS could not be associated with the maintenance of achieved improvements in comorbidities after bariatric surgery, whereas it could be associated with improved weight loss maintenance at 36 and 48 months after body contouring consultation. This association should be further explored in a large longitudinal study.

scholarly journals Feasibility of a virtual reality-based approach to improve behavioral weight management outcomes

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Suzanne Phelan ◽  
Sapna Peruvemba ◽  
David Levinson ◽  
Noah Stulberg ◽  
Aidan Lacy ◽  
...  
Keyword(s):  
Weight Loss ◽  
Virtual Reality ◽  
Weight Control ◽  
Weight Loss Maintenance ◽  
Habit Strength ◽  
Control Group ◽  
Behavioral Weight Loss ◽  
Point Scale ◽  
Weight Control Behaviors

Abstract Background Behavioral weight loss interventions promote clinically significant weight loss over 12 months, but weight regain remains problematic and a substantial proportion of participants do not achieve long-term weight loss maintenance. Novel methods are needed that instill habit strength for sustaining weight control behaviors long term. Virtual reality (VR) has the potential to provide opportunities within behavioral treatment for patients to practice desired weight control behaviors in the frequency and magnitude necessary to build durable habits. A pilot randomized trial was done to test the feasibility integrating virtual reality (VR) into standard behavioral weight loss treatment. Methods Participants were 15 adults (43 years; 46.7% Hispanic), with overweight or obesity who were randomly assigned to a 4-week Standard Behavioral Weight Loss plus Non-Weight-Related VR app (i.e., Control Group) or Standard Behavioral Weight Loss plus Weight-Related VR app (i.e., Intervention Group). The Intervention’s VR tool was designed to enable practice of behavioral skills taught in weekly group meetings, including managing social and home environmental cues for eating and activity. Results Participants were recruited over 3 months, and retention at the final assessment visit was high (86.6%). The VR footage and resulting app were rated as highly realistic (6.7 on a 10-point scale), and the VR program overall was rated as highly satisfactory (3.6 on a 4-point scale). Adverse effects of eye strain and motion sickness were minimal (~ 2 on a 7-point scale). As expected, the intervention and control groups both lost weight and unadjusted means (SD) averaged 3.4% (2.7) and 2.3% (3.6), respectively, over the 4 weeks. Overall, participants reported preferring a VR approach above traditional weight loss programs (rating of 5 on a 7-point scale). Conclusions Future research is needed to develop and test the feasibility of using VR for other weight control skills with a larger sample size and longer evaluation period to determine if VR can improve standard behavioral weight loss outcomes by intensifying practice opportunities and building habit strength for weight loss maintenance. Trial registration NCT04534088; date of registration: 09/01/2020, retrospectively registered.

scholarly journals Persuasive System Design Principles and Behavior Change Techniques to Stimulate Motivation and Adherence in Electronic Health Interventions to Support Weight Loss Maintenance: Scoping Review (Preprint)

2019 ◽  
Author(s):  
Rikke Aune Asbjørnsen ◽  
Mirjam Lien Smedsrød ◽  
Lise Solberg Nes ◽  
Jobke Wentzel ◽  
Cecilie Varsi ◽  
...  
Keyword(s):  
Weight Loss ◽  
Behavior Change ◽  
Goal Setting ◽  
Weight Loss Maintenance ◽  
Behavior Change Techniques ◽  
Self Monitoring ◽  
Support Weight ◽  
And Behavior ◽  
Weight Loss Interventions

BACKGROUND Maintaining weight after weight loss is a major health challenge, and eHealth (electronic health) solutions may be a way to meet this challenge. Application of behavior change techniques (BCTs) and persuasive system design (PSD) principles in eHealth development may contribute to the design of technologies that positively influence behavior and motivation to support the sustainable health behavior change needed. OBJECTIVE This review aimed to identify BCTs and PSD principles applied in eHealth interventions to support weight loss and weight loss maintenance, as well as techniques and principles applied to stimulate motivation and adherence for long-term weight loss maintenance. METHODS A systematic literature search was conducted in PsycINFO, Ovid MEDLINE (including PubMed), EMBASE, Scopus, Web of Science, and AMED, from January 1, 2007 to June 30, 2018. Arksey and O’Malley’s scoping review methodology was applied. Publications on eHealth interventions were included if focusing on weight loss or weight loss maintenance, in combination with motivation or adherence and behavior change. RESULTS The search identified 317 publications, of which 45 met the inclusion criteria. Of the 45 publications, 11 (24%) focused on weight loss maintenance, and 34 (76%) focused on weight loss. Mobile phones were the most frequently used technology (28/45, 62%). Frequently used wearables were activity trackers (14/45, 31%), as well as other monitoring technologies such as wireless or digital scales (8/45, 18%). All included publications were anchored in behavior change theories. Feedback and monitoring and goals and planning were core behavior change technique clusters applied in the majority of included publications. Social support and associations through prompts and cues to support and maintain new habits were more frequently used in weight loss maintenance than weight loss interventions. In both types of interventions, frequently applied persuasive principles were self-monitoring, goal setting, and feedback. Tailoring, reminders, personalization, and rewards were additional principles frequently applied in weight loss maintenance interventions. Results did not reveal an ideal combination of techniques or principles to stimulate motivation, adherence, and weight loss maintenance. However, the most frequently mentioned individual techniques and principles applied to stimulate motivation were, personalization, simulation, praise, and feedback, whereas associations were frequently mentioned to stimulate adherence. eHealth interventions that found significant effects for weight loss maintenance all applied self-monitoring, feedback, goal setting, and shaping knowledge, combined with a human social support component to support healthy behaviors. CONCLUSIONS To our knowledge, this is the first review examining key BCTs and PSD principles applied in weight loss maintenance interventions compared with those of weight loss interventions. This review identified several techniques and principles applied to stimulate motivation and adherence. Future research should aim to examine which eHealth design combinations can be the most effective in support of long-term behavior change and weight loss maintenance.

scholarly journals Barriers to Adherence to a Weight Loss Diet Using the Nominal Group Technique

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1297-1297
Author(s):  
Angela De Leon ◽  
James Roemmich ◽  
Shanon Casperson
Keyword(s):  
Weight Loss ◽  
Nominal Group Technique ◽  
The United States ◽  
Nominal Group ◽  
Female Population ◽  
Weight Loss Diet ◽  
Weight Loss Interventions ◽  
Environmental Level ◽  
Group Technique

Abstract Objectives At any given time, a large percentage of the female population, especially those of childbearing age, is engaged in some form of weight loss behavior. Although numerous weight loss plans and diets have been shown to achieve weight loss in the short term, the long-term maintenance of weight loss is modest at best. The identification of factors associated with difficulty adhering to a weight loss diet and sustaining weight loss maintenance is paramount to improving the long-term success of weight loss interventions. Methods As part of a study investigating the effects of dietary protein distribution on weight loss in women (N = 33; age = 33 ± 8; BMI = 36 ± 4), we conducted a series of nominal group technique (NGT) sessions aimed at identifying perceived barriers to adherence to a weight-loss diet. NGT generates a large number of unique responses to a specific research question, in this case, factors that make it hard to stick to a weight-loss diet. Responses from all NGT sessions were then aggregated and grouped into major themes to create an overall thematic framework of highest ranking responses. Results The major themes to emerge were individual- and environmental-level barriers. Individual-level themes rated the most highly by the groups were knowledge, cravings, emotions, habits, impatience, and willpower—specifically, knowing when to stop eating, being able to control cravings and emotional eating, and sustaining dietary lifestyle changes. The highest ranking environmental-level themes included family/social, time constraints, eating out, food being present, and cost. Events that bring people together, especially those centered around food and drink, and busy schedules were particularly challenging for women's efforts to stay “on track” with their weight control goals. Conclusions Our findings provide a rich depiction of the barriers that women find most salient in adhering to a weight-loss diet. These results highlight the importance of understanding the intricate interplay between individual- and environmental-level factors that make achieving and maintaining a healthy body weight difficult. This information can be used to inform the planning and implementation of behavioral weight-loss interventions in women. Funding Sources The United States Department of Agriculture, Agricultural Research Service and the North Dakota Beef Commission.

scholarly journals Different Weight Loss Intervention Approaches Reveal a Lack of a Common Pattern of Gut Microbiota Changes

2021 ◽  
Vol 11 (2) ◽  
pp. 109
Author(s):  
Carolina Gutiérrez-Repiso ◽  
María Molina-Vega ◽  
M. Rosa Bernal-López ◽  
Lourdes Garrido-Sánchez ◽  
José M. García-Almeida ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gut Microbiota ◽  
Short Chain Fatty Acids ◽  
Specific Pattern ◽  
Weight Loss Intervention ◽  
Metagenome Analysis ◽  
The Family ◽  
Treatment Of Obesity ◽  
Weight Loss Interventions

Options for treatment of obesity include dietary approaches and bariatric surgery. Previous studies have shown that weight loss interventions have an impact on gut microbiota. However, a pattern of gut microbiota changes associated with weight loss independently of the type of intervention has not been described yet. This study includes 61 individuals who followed different weight loss strategies in three different trials: 21 followed a hypocaloric Mediterranean diet (MedDiet), 18 followed a very-low-calorie ketogenic diet (VLCKD) and 22 patients underwent sleeve gastrectomy bariatric surgery (BS). Gut microbiota profile was assessed by next-generation sequencing. A common taxon that had significantly changed within the three weight loss interventions could not be find. At the family level, Clostiridiaceae significantly increased its abundance with MedDiet and VLCKD, whilst Porphyromonadacean and Rikenellaceae significantly increased with VLCKD and BS. At genus level, in VLCKD and BS, Parabacteroides and Alistipes significantly increased their abundance whilst Lactobacillus decreased. At the species level, BS and VLCKD produced an increase in Parabacteroidesdistasonis and a decrease in Eubactieriumventriosum and Lactobacillusrogosae, whilst Orodibactersplanchnicus increased its abundance after the BS and MedDiet. Predicted metagenome analysis suggested that most of the changes after VLCKD were focused on pathways related to biosynthesis and degradation/utilization/assimilation, while BS seems to decrease most of the biosynthesis pathways. MedDiet was enriched in several pathways related to fermentation to short-chain fatty acids. Our results show that weight loss is not associated with a specific pattern of gut microbiota changes independently of the strategy used. Indeed, gut microbiota changes according to type of weight loss intervention.

scholarly journals Treatment of Obesity in Children and Adolescents

2012 ◽  
Vol 17 (1) ◽  
pp. 45-57 ◽  
Author(s):  
Kelly L Matson ◽  
Renee M Fallon
Keyword(s):  
Weight Loss ◽  
Children And Adolescents ◽  
Lifestyle Modification ◽  
Pediatric Population ◽  
The United States ◽  
Long Term Results ◽  
Treatment Of Obesity ◽  
Weight Loss Medications ◽  
Obesity In Children

The prevalence of childhood and adolescent obesity continues to rise in the United States (US). Immediate health consequences are being observed, and long-term risks are mounting within the pediatric population, secondary to obesity. The hallmark of prevention and treatment of obesity in children and adolescents includes lifestyle modification (i.e., dietary modification, increased physical activity, and behavioral modifications). However, when intensive lifestyle modification is insufficient to reach weight loss goals, adjunctive pharmacotherapy is recommended. Among the group of weight-loss medications, orlistat is the only US Food and Drug Administration (FDA)-approved prescription drug for the treatment of overweight and obese adolescents. Other medications, including metformin, need larger studies to establish their role in treatment. No single approach to management of pediatric obesity is the answer, given the complexity of the disorder and the many reasons for failure. Evidence of weight loss medications in addition to lifestyle modification supports short-term efficacy for treatment of obese children and adolescents, although long-term results remain unclear.

scholarly journals Factors Related to Weight Loss Maintenance in the Medium–Long Term after Bariatric Surgery: A Review

2021 ◽  
Vol 10 (8) ◽  
pp. 1739
Author(s):  
Isabel Cornejo-Pareja ◽  
María Molina-Vega ◽  
Ana María Gómez-Pérez ◽  
Miguel Damas-Fuentes ◽  
Francisco J. Tinahones
Keyword(s):  
Physical Activity ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Weight Maintenance ◽  
Weight Loss Maintenance ◽  
Appetite Control ◽  
Adherence To Diet ◽  
Physical Activity Adherence ◽  
The Impact

Despite bariatric surgery being the most effective treatment for obesity, some individuals do not respond adequately, especially in the long term. Identifying the predictors of correct weight maintenance in the medium (from 1 to 3 years after surgery) and long term (from 3 years and above) is of vital importance to reduce failure after bariatric surgery; therefore, we summarize the evidence about certain factors, among which we highlight surgical technique, psychological factors, physical activity, adherence to diet, gastrointestinal hormones or neurological factors related to appetite control. We conducted a search in PubMed focused on the last five years (2015–2021). Main findings are as follows: despite Roux-en-Y gastric bypass being more effective in the long term, sleeve gastrectomy shows a more beneficial effectiveness–complications balance; pre-surgical psychological and behavioral evaluation along with post-surgical treatment improve long-term surgical outcomes; physical activity programs after bariatric surgery, in addition to continuous and comprehensive care interventions regarding diet habits, improve weight loss maintenance, but it is necessary to improve adherence; the impact of bariatric surgery on the gut–brain axis seems to influence weight maintenance. In conclusion, although interesting findings exist, the evidence is contradictory in some places, and long-term clinical trials are necessary to draw more robust conclusions.

Sign in / Sign up

Export Citation Format

Share Document