“You Are Always at War With Yourself” The Perceptions and Beliefs of People With Obesity Regarding Obesity as a Disease

2021 ◽  
pp. 104973232110407
Author(s):  
Andrew Grannell ◽  
Carel W. le Roux ◽  
Deirdre McGillicuddy
Keyword(s):  
Weight Loss ◽  
Emotional Eating ◽  
Severe Obesity ◽  
Personal Responsibility ◽  
Tertiary Care ◽  
Biological Factors ◽  
Structured Interviews ◽  
Key Stakeholders ◽  
Lack Of Control ◽  
Reduced State

Obesity as a disease remains poorly understood by key stakeholders. Here, in people living with severe obesity, perceptions and beliefs relating to obesity as a disease and obesity causality were examined. Semi-structured interviews were conducted in a tertiary care obesity clinic. 23 people with obesity (10 males, 13 females) volunteered. An overall agreement that obesity is a disease was present. Perceptions related to why obesity is and is not a disease were diverse: Lack of control and addiction, biological determinism, and personal responsibility. For weight loss maintenance, the perceptions and beliefs were heterogeneous with biological factors not considered a determinant of success. Instead, exercise, support, and willpower were described as associated with success. Barriers related to remaining in a weight-reduced state included the following: Emotional eating, sustainability of diet, occupational impact, and defeatism due to misaligned expectation and outcome. In conclusion, people living with obesity tend to agree obesity is a disease yet an incomplete understanding of the disease is present.

scholarly journals Barriers and facilitators in implementing a pilot, pragmatic, telemedicine-delivered healthy lifestyle program for obesity management in a rural, academic obesity clinic

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
John A. Batsis ◽  
Auden C. McClure ◽  
Aaron B. Weintraub ◽  
Diane Sette ◽  
Sivan Rotenberg ◽  
...  
Keyword(s):  
Weight Loss ◽  
Healthy Lifestyle ◽  
Video Conferencing ◽  
Tertiary Care ◽  
Physical Space ◽  
Individual Characteristics ◽  
Barriers And Facilitators ◽  
Structured Interviews ◽  
Intervention Delivery ◽  
Link Type

Abstract Purpose Few evidence-based strategies are specifically tailored for disparity populations such as rural adults. Two-way video-conferencing using telemedicine can potentially surmount geographic barriers that impede participation in high-intensity treatment programs offering frequent visits to clinic facilities. We aimed to understand barriers and facilitators of implementing a telemedicine-delivered tertiary-care, rural academic weight-loss program for the management of obesity. Methods A single-arm study of a 16-week, weight-loss pilot evaluated barriers and facilitators to program participation and exploratory measures of program adoption and staff confidence in implementation and intervention delivery. A program was delivered using video-conferencing within an existing clinical infrastructure. Elements of Consolidated Framework for Implementation Research (CFIR) provided a basis for assessing intervention characteristics, inner and outer settings, and individual characteristics using surveys and semi-structured interviews. We evaluated elements of the RE-AIM model (reach, adoption) to assess staff barriers to success for future scalability. Findings There were 27 patients and 8 staff completing measures. Using CFIR, the intervention was valuable from a patient participant standpoint; staff equally had positive feelings about using telemedicine as useful for patient care. The RE-AIM framework demonstrated limited reach but willingness to adopt was above average. A significant barrier limiting sustainability was physical space for intervention delivery and privacy and dedicated resources for staff. Scheduling stressors were also a challenge in its implementation. Conclusions The need to engage staff, enhance organizational culture, and increase reach are major factors for rural health obesity clinics to enhance sustainability of using telemedicine for the management of obesity. Trial registration Clinicaltrials.gov NCT03309787. Registered on 16 October 2017.

scholarly journals “I’m Still on Track”: A Qualitative Exploration of Participant Experiences of a Weight Loss Maintenance Program

Healthcare ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 21
Author(s):  
Bronwyn McGill ◽  
Blythe J. O’Hara ◽  
Philayrath Phongsavan ◽  
Adrian Bauman ◽  
Luke Lawler ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Management ◽  
Personal Responsibility ◽  
Self Regulation ◽  
Real Life ◽  
Weight Loss Maintenance ◽  
External Support ◽  
Structured Interviews ◽  
Positive Health ◽  
Maintenance Program

Qualitative evidence of participants’ experiences of real-life weight loss maintenance programs is important for ongoing participant engagement and can inform program improvements. The purpose of this study was to understand how participants account for their engagement with a weight loss maintenance program and the role of the program in their weight management. A qualitative study using semi-structured interviews with 17 participants of a weight loss maintenance program was conducted; common themes were identified using a thematic inductive approach. Many participant narratives incorporated recurrent descriptions of their program experiences as a weight management journey. Our analysis generated four themes: returning to real life as a threat, the personal responsibility imperative, the program supporting agency and the program supporting self-regulation. The program, which provides external support and strategies, overlapped with the context of returning to real life and the personal responsibility imperative. Participant accounts of their journey at this intersection include the program supporting both agency and self-regulation which influences ongoing weight management. The interplay between themes identified and the maintenance program services allows compatibility between participants’ sense of personal responsibility and the program components to help participants to ‘stay on track’ or ‘get back on track’. In providing sufficient structure, opportunities to revisit successful strategies, and accountability, participants are empowered to overcome real-life threats and make positive health choices.

scholarly journals Using a Revised Protein-Sparing Modified Fast (rPSMF) for Children and Adolescents with Severe Obesity: A Pilot Study

2019 ◽  
Vol 16 (17) ◽  
pp. 3061 ◽  
Author(s):  
Ihuoma Eneli ◽  
Jinyu Xu ◽  
Alexis Tindall ◽  
Rosanna Watowicz ◽  
Jennifer Worthington ◽  
...  
Keyword(s):  
Weight Loss ◽  
Children And Adolescents ◽  
Weight Change ◽  
Severe Obesity ◽  
Treatment Options ◽  
Tertiary Care ◽  
High Protein Diet ◽  
Management Program ◽  
Protein Sparing ◽  
The Mean

Treatment options are limited for children and adolescents with severe obesity. One alternative treatment is the protein-sparing modified fast (PSMF), a low-carbohydrate, high-protein diet that can result in substantial weight loss. The aim of the study is to evaluate the adherence and efficacy of a revised PSMF (rPSMF) for severe obesity in a pediatric tertiary care weight-management program. The rPSMF with 1200–1800 calories, 40–60 g of carbohydrate/day and 1.2–1.5 g protein/kg of ideal bodyweight was implemented over 12 months. Twenty-one participants enrolled in the study. Mean age 16.2 ± 1.4 years, females (76.2%) and mean weight at baseline was 119 ± 19.9 kg. Regardless of adherence to the rPSMF, the mean weight change at 1 month was −3.7 ± 3.5 kg, (range −13.5 kg to 0.9 kg); at 3 months was −5.5 ± 5.1 kg, (range −19.3 kg to 1.8 kg) and at 6 months was −4.7 ± 6.6 kg, (range −18.3 kg to 8.6 kg). At 12 months, the mean weight change was −1.3 ± 10.6 kg (range −17.7 kg to 14.8 kg). Parent and child-reported physical and psychosocial quality of life (HRQOL) improved. Despite limited adherence, the rPSMF diet resulted in clinically significant weight loss and improved HRQOL for children and adolescents with severe obesity.

828-P: The Impact of Diabetes and Depression Status on Weight Loss Outcomes in Mexican Patients with Severe Obesity

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 828-P
Author(s):  
MARCELA RODRIGUEZ FLORES ◽  
SYLVANA STEPHANO Z. ◽  
MARÍA RABASA ◽  
JUANA MONTOYA ◽  
CLAUDIA VELEZ ◽  
...  
Keyword(s):  
Weight Loss ◽  
Severe Obesity ◽  
Depression Status ◽  
Weight Loss Outcomes ◽  
The Impact ◽  
Mexican Patients

scholarly journals Conservation Debates: People’s Perceptions and Values towards a Privately Protected Area in Southern Ecuador

Land ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 233
Author(s):  
Verónica Iñiguez-Gallardo ◽  
Fabián Reyes-Bueno ◽  
Olga Peñaranda
Keyword(s):  
Protected Areas ◽  
Land Tenure ◽  
Protected Area ◽  
Planning Process ◽  
Social Needs ◽  
Structured Interviews ◽  
Key Stakeholders ◽  
Southern Ecuador ◽  
Negative Perceptions ◽  
Land Tenure System

The perceptions and values that local communities have towards protected areas are of great value for the improvement of these territories’ management. Such perceptions and values are often absent in the conservation planning process, particularly in those privately protected areas that are established in areas where the land tenure system is based not only on ownership but also on customary uses. Drawing on qualitative and quantitative data obtained through semi-structured interviews with key stakeholders and members of communities surrounding a privately protected area in southern Ecuador, we identify that the level of collaboration with the managers, the distance to the protected area, the percentage of untitled land, and the dependence on the resources (customary uses) are among the variables affecting these perceptions and values. Positive perceptions towards protected areas and naturalistic values are developed among those who collaborate with the protected area managers, whereas negative perceptions, and a mix of naturalistic and biospheric values are developed among those who have a sense of a lack of attention to social needs although supporting nature conservation at the same time. The evidence presented shows the importance of matching local peoples’ expectations with conservation goals during the establishment of a protected area.

scholarly journals Increasing Facemask Compliance among Healthcare Personnel during the COVID-19 Pandemic

2021 ◽  
pp. 1-22
Author(s):  
Rupak Datta ◽  
Keith Glenn ◽  
Anthony Pellegrino ◽  
Jessica Tuan ◽  
Brian Linde ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Baseline Period ◽  
Healthcare Personnel ◽  
Structured Interviews ◽  
Time Series Regression ◽  
Multimodal Intervention ◽  
Direct Observations ◽  
Chi Squared ◽  
Ancillary Staff

Abstract Objective: Prior studies of universal masking have not measured facemask compliance. We performed a quality improvement study to monitor and improve facemask compliance among healthcare personnel (HCP) during the coronavirus disease 2019 (COVID-19) pandemic. Design: Mixed-methods study Setting: Tertiary care center in West Haven, Connecticut Patients: HCP including physicians, nurses, and ancillary staff Methods: Facemask compliance was measured through direct observations during a 4-week baseline period after universal masking was mandated. Frontline and management HCP completed semi-structured interviews from which a multimodal intervention was developed. Direct observations were repeated during a 14-week period following implementation of the multimodal intervention. Differences between units were evaluated with chi-squared testing using the Bonferroni correction. Facemask compliance between baseline and intervention periods was compared using time series regression. Results: Among 1,561 observations during the baseline period, median weekly facemask compliance was 82.2% (range, 80.8%-84.4%). Semi-structured interviews were performed with 16 HCP. Qualitative analysis informed the development of a multimodal intervention consisting of audit and passive feedback, active discussion, and increased communication from leadership. Among 2,651 observations during the intervention period, median weekly facemask compliance was 92.6% (range, 84.6%-97.9%). There was no difference in weekly facemask compliance between COVID-19 and non-COVID-19 units. The multimodal intervention was associated with an increase in facemask compliance (β=0.023, p=0.002) Conclusions: Facemask compliance remained suboptimal among HCP despite a facility-wide mandate for universal masking. A multimodal intervention consisting of audit and passive feedback, active discussion, and increased communication from leadership was effective in increasing facemask compliance among HCP.

scholarly journals Central Noradrenergic Neurotransmission and Weight Loss 6 Months After Gastric Bypass Surgery in Patients with Severe Obesity

2021 ◽  
Author(s):  
J. Marvin Soeder ◽  
Julia Luthardt ◽  
Michael Rullmann ◽  
Georg A. Becker ◽  
Mohammed K. Hankir ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Severe Obesity ◽  
Occipital Cortex ◽  
Brain Regions ◽  
General Tendency ◽  
Strong Positive Correlation ◽  
Reference Tissue ◽  
Efficient Treatment ◽  
Post Surgery

Abstract Purpose Roux-en-Y gastric bypass (RYGB) surgery is currently the most efficient treatment to achieve long-term weight loss in individuals with severe obesity. This is largely attributed to marked reductions in food intake mediated in part by changes in gut-brain communication. Here, we investigated for the first time whether weight loss after RYGB is associated with alterations in central noradrenaline (NA) neurotransmission. Materials and Methods We longitudinally studied 10 individuals with severe obesity (8 females; age 43.9 ± 13.1 years; body mass index (BMI) 46.5 ± 4.8 kg/m2) using (S,S)-[11C]O-methylreboxetine and positron emission tomography to estimate NA transporter (NAT) availability before and 6 months after surgery. NAT distribution volume ratios (DVR) were calculated by volume-of-interest analysis and the two-parameter multilinear reference tissue model (reference region: occipital cortex). Results The participants responded to RYGB surgery with a reduction in BMI of 12.0 ± 3.5 kg/m2 (p < 0.001) from baseline. This was paralleled by a significant reduction in DVR in the dorsolateral prefrontal cortex (pre-surgery 1.12 ± 0.04 vs. post-surgery 1.07 ± 0.04; p = 0.019) and a general tendency towards reduced DVR throughout the brain. Furthermore, we found a strong positive correlation between pre-surgery DVR in hypothalamus and the change in BMI (r = 0.78; p = 0.01). Conclusion Reductions in BMI after RYGB surgery are associated with NAT availability in brain regions responsible for decision-making and homeostasis. However, these results need further validation in larger cohorts, to assess whether brain NAT availability could prognosticate the outcome of RYGB on BMI. Graphical abstract

scholarly journals ADIPOQ gene is linked to emotional eating behaviour in young Nigerian adults independent of psychological traits

2020 ◽  
Vol 44 (1) ◽  
Author(s):  
Awoyemi Abayomi Awofala ◽  
Olusegun Emmanuel Ogundele ◽  
Khalid Olajide Adekoya
Keyword(s):  
Emotional Eating ◽  
Genetic Variant ◽  
Eating Behaviour ◽  
Biological Factors ◽  
Psychological Traits ◽  
Adipoq Gene ◽  
Cognitive Restraint ◽  
Beta Coefficient ◽  
And Gender ◽  
Uncontrolled Eating

Abstract Background A disturbance in eating behaviour (EB) is the hallmark of patients with eating disorders, and depicts a complex interaction of environmental, psychological and biological factors. In the present study, we propose a model of association of genetic susceptibility—represented by adiponectin (ADIPOQ) gene—with eating behavioural and psychological traits. Results Evaluation of the distribution of a polymorphism of the ADIPOQ (rs1501299 G > T) with respect to three EB factors involving cognitive restraint, uncontrolled eating and emotional eating revealed that T-allele in rs1501299 was associated with a decreased susceptibility to emotional EB in codominant (e.g., GG vs. TT) (beta-coefficient [β] = 2.39, 95% Confidence interval [CI] = − 4.02, − 0.76; p value [p] = 0.02), recessive (GG + GT vs. TT) (β = − 2.77, 95% CI = − 3.65, − 0.69; p = 0.005) and additive (GG = 0, GT = 1, TT = 2) (β = − 1.02, 95% CI = − 1.80, − 0.24; p = 0.01) models of inheritance. The presence of the T-allele was not significantly associated with psychological factors involving depression, anxiety and stress. Finally, none of the psychological traits significantly predicted any of the EB factors after controlling for age, body weight and gender. Conclusions Our data suggest that genetic variant in ADIPOQ locus may influence human emotional eating behaviour.

scholarly journals Assessment of Protein Intake in the First Three Months after Sleeve Gastrectomy in Patients with Severe Obesity

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 771
Author(s):  
Lucrezia Bertoni ◽  
Romina Valentini ◽  
Alessandra Zattarin ◽  
Anna Belligoli ◽  
Silvia Bettini ◽  
...  
Keyword(s):  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Protein Intake ◽  
Severe Obesity ◽  
Protein Supplementation ◽  
Fat Free Mass ◽  
The Third ◽  
Total Protein Intake ◽  
Dietary Record ◽  
Protein Rich

An adequate protein intake prevents the loss of fat-free mass during weight loss. Laparoscopic sleeve gastrectomy (SG) jeopardizes protein intake due to post-operative dietary restriction and intolerance to protein-rich foods. The purpose of this study is to evaluate protein intake in the first three months after SG. We evaluated, 1 month and 3 months after surgery, 47 consecutive patients treated with SG. Protein intake, both from foods and from protein supplementation, was assessed through a weekly dietary record. Patients consumed 30.0 ± 10.2 g of protein/day on average from foods in the first month, with a significant increase to 34.9 ± 4.8 g of protein/day in the third month (p = 0.003). The use of protein supplementation significantly increased total protein intake to 42.3 ± 15.9 g protein/day (p < 0.001) in the first month and to 39.6 ± 14.2 g of protein/day (p = 0.002) in the third one. Compliance with supplement consumption was 63.8% in the first month and only 21.3% in the third month. In conclusion, both one and three months after SG, protein intake from foods was not sufficient. The use of modular supplements seems to have a significant impact on protein intake, but nevertheless it remains lower than recommended.

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