Effective treatment of obesity in women of reproductive age

The study included 82 women aged from 18 to 49 years old (mean age 29,7±5,7 years). A clinical examination, the study of body composition by bioimpedance measuring, questioning were carried out. Statistical analysis was performed using the program Microsoft Exel, "Statistica 7,0". Analysis of the diet revealed the excess of the daily energy value of food intake over energy requirements of 650±250 kcal/day in the group of persons with obesity in comparison with healthy. Disorders of balanced daily diet were noted. To improve motivation and compliance in the "School of overweight correction" the patients with obesity and healthy were trained in groups and individually. After training, the authors observed favorable trends in nutrition of patients, reducing the fat consumption in 7,2±0,8 g/day and refined carbohydrates to 8,2±0,5 g/day. In the treatment the authors used the drug The Reduxine (sibutramine in combination with microcrystalline cellulose) at a dose of 10 mg. The Observation lasted 24 weeks. Caloric value of daily ration decreased by 20-28% from initial, average weight loss was 8,9±1,6 kg, waist circumference decrease was 11,4±1,8 cm. Patients with risk of diabetes took the Sibutramine + microcrystalline cellulose (the Reduxine) at a dose of 10 mg and the Metformin at a dose of 500 mg. There is increase dose weekly by 500 mg to dose of 1500 mg. Energy intake decreased by 28 ± 7% of the original (p <0,05) on combination therapy. As a result of the combined therapy the Reduxine at a dose of 10 mg and the Metformin at a dose of 1500 mg, the authors revealed a decrease in body weight - 9,7 ± 1,5 kg (p<0,05), waist circumference - 11,4±1,8 cm (p<0.05). The therapy by the Reduxine at a dose of 10 mg for 6 months and combined therapy with the Reduxine 10 mg and the Metformin 1500 mg led to the control of feeding behavior, improvement in metabolic parameters, target weight loss. This therapy is effective and safety.

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OUTCOMES OF FIT & STRONG! PLUS: A GROUP EXERCISE AND WEIGHT LOSS PROGRAM TO TREAT OSTEOARTHRITIS

Innovation in Aging ◽

10.1093/geroni/igz038.2274 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S611-S611

Author(s):

Andrew DeMott ◽

Susan Hughes

Keyword(s):

Weight Loss ◽

Waist Circumference ◽

Physical Function ◽

Exercise Program ◽

Evidence Based ◽

Target Weight ◽

Increased Risk ◽

Trial Outcomes ◽

Sample Age ◽

Evidence Based Programs

Abstract Overweight older adults with osteoarthritis (OA) face increased risk for disability; however, no evidence-based programs target weight and OA simultaneously. Fit & Strong! (F&S!) is an 8-week evidence-based exercise program for persons with OA that improves lower extremity (LE) strength and mobility out to 18 months. F&S! Plus, a weight loss version of F&S! was tested against standard F&S! in a comparative effectiveness trial. Two and six-month trial outcomes were previously presented, this session will present maintenance outcomes at 12 and 18 months. This trial randomized 413 participants, 210 to F&S! and 203 to F&S! Plus. The mean sample age was 67.9, 86% female, and 92% African American. At 12 months, significant and marginally significant between-group differences favoring F&S! Plus were seen in several outcomes, including weight (p=.049), BMI (p=.04), waist circumference (p=.004), LE physical function (p=.09), 6-minute distance walk (mobility) (p=.08), 30-second chair stands (LE strength) (p=.46), and anxiety & depression (p=.08). At 18 months, only LE strength remained significantly improved for the F&S! Plus group (p=.045), however several within-group improvements remained statistically significant for both groups out to 18 months, including weight, BMI, waist circumference, LE pain & physical function, 30-second chair stands (LE strength), anxiety & depression, and self-efficacy for weight-management. F&S! Plus showed significant improvements over standard F&S! for several outcomes at the conclusion of the intervention (2 months) and many were maintained out to 12 months, with LE strength continuing to 18 months. Both groups showed significant within-group improvements out to 18 months.

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Experience of using sibutramine in combination with microcrystalline cellulose in clinical practice

Medical Council ◽

10.21518/2079-701x-2019-21-214-218 ◽

2020 ◽

pp. 214-218

Author(s):

N. A. Petunina ◽

M. E. Telnova ◽

E. V. Goncharova ◽

L. V. Trukhina ◽

N. S. Martirosyan

Keyword(s):

Quality Of Life ◽

Cardiovascular Disease ◽

Weight Loss ◽

Body Weight ◽

Microcrystalline Cellulose ◽

Positive Impact ◽

Comprehensive Treatment ◽

The Metabolic Syndrome ◽

Treatment Of Obesity

For many years, interest in the issue of obesity has not faded, as obesity is now one of the most common pathologies in the world that directly affects quality of life and lifespan. Even a slight weight loss (5-10% of baseline values) in obese patients is known to improve metabolism and reduce the risk of a range of comorbidities. The article reflects the importance of comprehensive treatment of obesity, presents positive experience of using Reduxin (sibutramine in combination with microcrystalline cellulose) to reduce body weight and risk factors for cardiovascular disease in a specific clinical example in a patient with exogenous-constitutional obesity and eating disorders. The case of obesity in a young man of 24 years old is presented, when other components of the metabolic syndrome (except for arterial hypertension) were not formed. Thus, following the results of 24-week complex treatment, clinically significant reduction of body weight (by 21.7% of initial values) was observed in the patient. The data of psychological researches have shown that the patient has no increase of anxiety and depression level during treatment, but at the same time the indicators of quality of life according to the results of health questionnaire testing have improved. This clinical case corresponds to the results of the PrimaVera program and demonstrates that weight loss during sibutramine therapy in combination with microcrystalline cellulose has a positive impact on the overall health and emotional status of patients and leads to improved quality of life. Therefore, successful treatment of obesity and the maintenance of other outcomes are key to preventing cardiovascular disease.

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Influence of weight loss on the clinical manifestations of osteoarthritis of the knee-joints.

Obesity and metabolism ◽

10.14341/omet2014441-47 ◽

2014 ◽

Vol 11 (4) ◽

pp. 41-47 ◽

Cited By ~ 3

Author(s):

Inna Vladimirovna Solov'eva ◽

Ekaterina Aleksandrovna Strebkova ◽

Lyudmila Ivanovna Alekseeva ◽

Ashot Musaelovich Mkrtumyan

Keyword(s):

Quality Of Life ◽

Weight Loss ◽

Body Weight ◽

Waist Circumference ◽

Clinical Manifestations ◽

Knee Joints ◽

Osteoarthritis Of The Knee ◽

Obese Patients ◽

Treatment Of Obesity

Obesity consistently associated with the development of a number of chronic diseases, leading to a decrease in quality of life, disability and death. The article examines the connection between obesity and disease of the musculoskeletal system, describes the mechanisms by means of which obesity leads to the development of osteoarthritis. It is evident that reduction of body mass can slow the progression of osteoporosis. The own experience of non-pharmacological and pharmacological treatment of obesity with the use of orlistat in 50 obese patients with osteoarthritis of the knee II–III stage is presented. Treatment has resulted in a decrease in body weight, waist circumference, accompanied by a decrease in symptoms osteoarthritis among all the patients. Our results showed that the addition of orlistat to standard osteoarthritis scheme leads to significant reduction in weight and reduction of clinical manifestations of osteoarthritis. According to the above, the drugs that have impact on weight loss, should be included in the treatment regimen of patients with osteoarthritis and obesity.

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Study of the properties larch and larch wood construction materials

Известия СПбЛТА ◽

10.21266/2079-4304.2016.215.255-265 ◽

2016 ◽

Author(s):

М.А. Чубинский ◽

К.В. Чаузов

Keyword(s):

Weight Loss ◽

Urea Formaldehyde ◽

Construction Materials ◽

Siberian Larch ◽

Larix Sibirica ◽

Average Weight ◽

Biological Stability ◽

Laminated Beam ◽

Coniophora Puteana ◽

Larch Wood

Несмотря на огромные запасы, древесина лиственницы до сего времени в незначительных объемах используется в строительной индустрии, других отраслях экономики, что связано как с технологическими сложностями ее переработки, так и недостаточной изученностью ее свойств. Одним из уникальных свойств древесины лиственницы сибирской (Larix sibirica) является ее повышенная естественная биостойкость, наряду с максимально высокой среди отечественных хвойных пород прочностью. Стойкость древесины лиственницы (Larix sibirica) к воздействию дереворазрушающих грибов Coniofora puteana значительно превышает стойкость сосны. В среднем потеря массы ядровой древесины лиственницы сибирской под воздействием дереворазрушающего гриба Coniophora puteana составляет 14,84%, снижаясь с увеличением возраста дерева, а контрольные образцы из ядровой древесины сосны в возрасте 90 лет имели потерю массы 57,8%. Возраст дерева является одним из наиболее значимых факторов, влияющих на степень биостойкости древесины. По мере его увеличения значительно повышается устойчивость деструктивному воздействию дереворазрушающих грибов Coniophora puteana. Положение образцов также влияет на степень биостойкости древесины, однако эта зависимость слабо выражена по сравнению с влиянием возраста и плотности древесины. Исследования кинетики разложения древесины лиственницы сибирской и роли экстрактивных веществ в развитии дереворазрушающих грибов позволяют утверждать наличие связи биостойкости и содержания в древесине экстрактивных веществ. Для изготовления клееного бруса из древесины лиственницы предложена клеевая композиция, включающая карбамидомеламиноформальдегидный клей и карбамидоформальдегидную смолу, модифицированную шунгитами. Ее применение позволяет получать клеевые соединения, не уступающие по прочности при скалывании массивной древесине, как по сухому образцу, так и после его вымачивания. Таким образом, клееный брус из древесины лиственницы сибирской характеризуется высокими показателями биостойкости, прочности и водостойкости. Despite vast reserves, larch wood so far in small volumes used in the construction industry and other sectors of the economy, which is connected as the technological difficulties of its treatment, as well as insufficient knowledge of its properties. One of the unique properties of the wood of Siberian larch (Larix sibirica) is its increased natural biological stability (decay resistant), along with the highest among the domestic softwood strength. Resistance Larch (Larix sibirica) to the effects of wood-destroying fungi Coniofora puteana is much higher than pine. The average weight loss of Siberian larch heartwood exposed wood-destroying fungi Coniophora puteana is 14.84%, decreasing with increasing age of the tree, and control samples of heartwood pine at age 90 had a weight loss of 57.8%. Age of a tree is one of the most significant factors affecting the degree of biological stability of wood. With the increase it significantly increases the stability of the destructive effects of wood-destroying fungi and Coniophora puteana. The position of the sample in tree also affects the degree of biological stability of wood, but this dependence is poorly developed in comparison with the influence of age and wood density. Studies of the kinetics of decomposition of Siberian larch wood and the role of extractives in the development of wood-destroying fungi suggest a link, and the decay resistant of the content in the wood extractives. For the manufacture of larch glued laminated beam proposed adhesive composition comprising urea and melamine-formaldehyde glue and urea-formaldehyde resins, modified shungites. Its use allows to obtain the bonds are not inferior in strength at shearing solid wood as dry sample, and after soaking. Thus, glued laminated beam from Siberian larch wood is characterized by high decay resistant, strength and water resistance.

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Liraglutide for the Treatment of Obesity: Analyzing Published Reviews

Current Pharmaceutical Design ◽

10.2174/1381612825666190701155737 ◽

2019 ◽

Vol 25 (15) ◽

pp. 1783-1790 ◽

Cited By ~ 3

Author(s):

Rosario Pastor ◽

Josep A. Tur

Keyword(s):

Weight Loss ◽

Clinical Trials ◽

Systematic Reviews ◽

Randomized Clinical Trials ◽

Statistical Tests ◽

Overweight And Obesity ◽

Cochrane Library ◽

Medical Subject Headings ◽

Mesh Terms ◽

Treatment Of Obesity

Background: Several drugs have been currently approved for the treatment of obesity. The pharmacokinetic of liraglutide, as well as the treatment of type 2 diabetes mellitus, have been widely described. Objective: To analyze the published systematic reviews on the use of liraglutide for the treatment of obesity. Methods: Systematic reviews were found out through MEDLINE searches, through EBSCO host and the Cochrane Library based on the following terms: "liraglutide" as major term and using the following Medical Subject Headings (MesH) terms: "obesity", "overweight", "weight loss". A total of 3 systematic reviews were finally included to be analyzed. Results: From the three systematic reviews selected, only two included the randomized clinical trials, while the third study reviewed both randomized and non-randomized clinical trials. Only one review performed statistical tests of heterogeneity and a meta-analysis, combining the results of individual studies. Another review showed the results of individual studies with odds ratio and confidence interval, but a second one just showed the means and confidence intervals. In all studies, weight loss was registered in persons treated with liraglutide in a dose dependent form, reaching a plateau at 3.0 mg dose, which was reached just in men. Most usual adverse events were gastrointestinal. Conclusion: More powerful and prospective studies are needed to assess all aspects related to liraglutide in the overweight and obesity treatment.

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Incidence and Outcomes of Home Parenteral Nutrition in Patients With Crohn Disease in Olmsted County, Minnesota

Crohn's & Colitis 360 ◽

10.1093/crocol/otaa083 ◽

2020 ◽

Vol 2 (4) ◽

Author(s):

Zeinab Bakhshi ◽

Siddhant Yadav ◽

Bradley R Salonen ◽

Sara L Bonnes ◽

Jithinraj Edakkanambeth Varayil ◽

...

Keyword(s):

Weight Loss ◽

Parenteral Nutrition ◽

Short Bowel Syndrome ◽

Crohn Disease ◽

Severe Disease ◽

Bloodstream Infections ◽

Home Parenteral Nutrition ◽

Average Weight ◽

Olmsted County ◽

Short Bowel

Abstract Background We sought to estimate the incidence of home parenteral nutrition (HPN) use in a population-based cohort of patients with Crohn disease (CD), and to assess clinical outcomes and complications associated with HPN. Methods We used the Rochester Epidemiology Project (REP) to identify residents of Olmsted County, who were diagnosed with CD between 1970 and 2011, and required HPN. Results Fourteen out of 429 patients (3.3%) with CD received HPN (86% female). Eleven patients (79%) had moderate–severe CD and 12 patients (86%) had fistulizing disease. Thirteen patients (93%) underwent surgery, primarily due to obstruction. Among CD incidence cases, the cumulative incidence of HPN from the date of CD diagnosis was 0% at 1 year, 0.5% at 5 years, 0.8% at 10 years, and 2.4% at 20 years. Indications for HPN included short bowel syndrome in 64%, malnutrition in 29%, and bowel rest in 21%. The median duration of HPN was 2.5 years. There was an average weight gain of 1.2 kg at 6 months, an average weight loss of 1.4 kg at 1 year, and a further weight loss of 2.2 kg at 2 years from the start of HPN. Patients were hospitalized a mean of 5 times after the start of HPN, mainly due to catheter-related bloodstream infections and thrombosis. Conclusions Less than 4% of patients with CD need HPN. Most have moderate to severe disease with short bowel syndrome or malnutrition. Possible reasons for the patients’ weight loss could be noncompliance, and increased metabolic needs because of active disease.

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Reduction of Cardio-Metabolic Risk and Body Weight through a Multiphasic Very-Low Calorie Ketogenic Diet Program in Women with Overweight/Obesity: A Study in a Real-World Setting

Nutrients ◽

10.3390/nu13061804 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1804

Author(s):

Elena Tragni ◽

Luisella Vigna ◽

Massimiliano Ruscica ◽

Chiara Macchi ◽

Manuela Casula ◽

...

Keyword(s):

Weight Loss ◽

Body Weight ◽

Waist Circumference ◽

Real World ◽

Metabolic Complications ◽

Multi Centre Study ◽

Low Calorie ◽

Ketogenic Diets ◽

Real World Setting ◽

Overweight Or Obesity

Background: The prevention and treatment of obesity and its cardio-metabolic complications are relevant issues worldwide. Among lifestyle approaches, very low-calorie ketogenic diets (VLCKD) have been shown to lead to rapid initial weight loss, resulting in better long-term weight loss maintenance. As no information on VLCKD studies carried on in a real-world setting are available, we conducted this multi-centre study in a real-world setting, aiming at assessing the efficacy and the safety of a specific multiphasic VLCKD program in women with overweight or obesity. Methods: A multi-center, prospective, uncontrolled trial was conducted in 33 outpatient women (age range 27–60 y) with overweight or obesity (BMI: 30.9 ± 2.7 kg/m2; waist circumference: 96.0 ± 9.4 cm) who started a VLCKD dietary program (duration: 24 weeks), divided into four phases. The efficacy of VLCKD was assessed by evaluating anthropometric measures and cardiometabolic markers; liver and kidney function biomarkers were assessed as safety parameters. Results: The VLCKD program resulted in a significant decrease of body weight and BMI (−14.6%) and waist circumference (−12.4%). At the end of the protocol, 33.3% of the participants reached a normal weight and the subjects in the obesity range were reduced from 70% to 16.7%. HOMA-IR was markedly reduced from 3.17 ± 2.67 to 1.73 ± 1.23 already after phase 2 and was unchanged thereafter. Systolic blood pressure decreased after phase 1 (−3.5 mmHg) and remained unchanged until the end of the program. Total and LDL cholesterol and triglycerides were significantly reduced by VLCKD along with a significant HDL cholesterol increase. Liver, kidney and thyroid function markers did not change and remained within the reference range. Conclusions: The findings of a multi-center VLCKD program conducted in a real-world setting in a cohort of overweight/obese women indicate that it is safe and effective, as it results in a major improvement of cardiometabolic parameters, thus leading to benefits that span well beyond the mere body weight/adiposity reduction.

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The use of Facebook in a community pharmacist-led weight management programme – a London-based proof of concept study

International Journal of Pharmacy Practice ◽

10.1093/ijpp/riab016.021 ◽

2021 ◽

Vol 29 (Supplement_1) ◽

pp. i17-i18

Author(s):

P Crilly ◽

E Chibueze ◽

M Khan ◽

J Modha ◽

S Satwaha ◽

...

Keyword(s):

Weight Loss ◽

Waist Circumference ◽

Digital Technology ◽

Technology Use ◽

Management Programme ◽

Proof Of Concept ◽

Percentage Weight Loss ◽

Weight Management Programme ◽

Percentage Weight ◽

Adults And Children

Abstract Introduction In the United Kingdom (UK), 63% of adults are overweight,(1) costing the NHS £6.1 billion/year. With the public using digital technology over healthcare professionals (HCPs) for health advice, this warrants an investigation of technology use in community pharmacy, given its previous successful use.(2) Aim To determine the feasibility and perceptions of a community pharmacist (CP)-led weight management programme (WMP), enhanced by a Facebook support group (FSG). Methods A proof of concept study was conducted between January-March 2020. Recruitment was via a pharmacy, the university and a community Facebook group. Inclusion criteria: over 18 years; overweight; no medical conditions. Participants attended face-to-face meetings (ftf) with a CP and final year pharmacy student (PS) on two occasions (0 (baseline) and 4 weeks). At baseline, participants were given the NHS weight loss programme and set weight loss goals. During ftf, participants had height, weight, and waist circumference (WC) measurements by a CP/PS and discussed eating habits, exercise and alcohol. In between ftf, participants accessed the FSG (created (December 2019) and moderated by a CP). Here, they received posts about diet, exercise and motivation. Participants were to have their measurements taken ftf at 8-weeks, however, COVID-19 meant participants had to self-declare these via video call. Following the 8-week programme, participants completed a 4-section survey about their experience (signing up to the service; comparison to previous weight loss attempts; the FSG and overall perceptions). Question types included multiple choice, Likert scale and free text comments. Data were analysed in Excel (Microsoft Corporation 2016) with changes in height, weight, waist circumference, alcohol and exercise being calculated. Results Fifty-five participants were recruited. 18 were lost to follow-up, most (n=12/18) citing COVID-19. Of the 37 participants remaining (70.3% female, mean age=37 years), 22 were obese, the rest overweight. Mean weight loss, mean percentage weight loss and mean WC reduction at 4-weeks was 1.6 kg (SD+/- 1.7 kg), 1.8% (SD+/- 1.9%) and 2 cm (SD+/- 1.96 cm) respectively. At week 8 measurements were self-declared. Mean weight loss at 8-weeks from baseline was 2.7 kg (SD +/- 2.6 kg) and mean percentage weight loss was 3% (SD+/- 3%). Only five participants’ self-declared WC measurements at 8-weeks with mean reduction being 3.6 cm. Five participants moved to healthier BMI classifications by week 8. All participants accessed the FSG at least weekly with 13 accessing it daily. Diet posts were the most popular (n=20/37). Participants learned about portion control and increasing fruits/vegetables intake. All participants would recommend the programme to their friends/family. Conclusion An 8-week CPWMP, enhanced with FSG, supported participants to lose a mean of 3% body weight. Participants accessed the page regularly and were positive about its usefulness. One limitation was that the COVID-19 lockdown prevented the 8-week ftf, therefore, self-declared measurements were used. The pandemic has highlighted the importance of pharmacy embracing technology for service delivery, particularly when in-person contact is limited. The implication of this study is that it provides proof that the concept of digital service delivery could work in practice. References 1. GOV.UK. Tackling obesity: empowering adults and children to live healthier lives [Internet]. Department of Health and Social Care. 2020 [cited 2020 Aug 18]. Available from: https://www.gov.uk/government/publications/tackling-obesity-government-strategy/tackling-obesity-empowering-adults-and-children-to-live-healthier-lives 2. Crilly P, Kayyali R. A Systematic Review of Randomized Controlled Trials of Telehealth and Digital Technology Use by Community Pharmacists to Improve Public Health. Pharmacy 2020;8(3):137. Available from: https://www.mdpi.com/2226–4787/8/3/137

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Patterns of Weight Change in Aging and Dying

Innovation in Aging ◽

10.1093/geroni/igaa057.1587 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 491-491

Author(s):

Stephen Thielke

Keyword(s):

Older Adults ◽

Weight Loss ◽

Risk Factor ◽

Weight Change ◽

Population Level ◽

Chronological Age ◽

Average Weight ◽

Remaining Life ◽

Entire Cohort ◽

History Of

Abstract Little research has characterized the natural history of weight change in older adults. Different changes may occur during aging and dying. We analyzed 18 years of weight measures from a cohort of 736,361 Veterans, all of whom had died at age 70 or older. We produced summary measures that accounted for both chronological age and number of years before death. Several clear population-level trends appeared. (1) The average weight of the sample declined across all ages at a rate of about 0.18 BMI points per year. (2) Starting about seven years before death, the amount of loss began to accelerate, reaching a decline of 0.75 BMI points in the year before death. (3) Changes in weight relative to years of remaining life were independent of chronologic age. People who died at age 70 experienced, on average, the same type and duration of terminal decline as did those who died at age 95. (4) The dying process involved a cumulative loss of about 1.3 BMI points. (5) The distribution of weights during advancing age both declined and narrowed. (6) Disproportionate deaths occurred at the lower BMI ranges (below a BMI of 24), and especially below 18, regardless of age. (7) The finding in #5 is explained by the entire cohort losing weight, with death of the thinnest members. These findings argue for examining survival time in studies of weight change. They indicate that weight loss may be a natural part of dying, rather than a risk factor for it.

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Weight Cycling in Women: Adaptation or Risk?

Seminars in Reproductive Medicine ◽

10.1055/s-0040-1721418 ◽

2020 ◽

Author(s):

Katelyn J. Carey ◽

Wendy Vitek

Keyword(s):

Weight Loss ◽

Body Composition ◽

Weight Gain ◽

Pregnancy Complications ◽

Weight Regain ◽

Reproductive Age ◽

Cardiometabolic Health ◽

Surrogate Markers ◽

Weight Cycling ◽

Gut Peptides

AbstractObesity, dieting, and weight cycling are common among reproductive-age women. Weight cycling refers to intentional weight loss followed by unintentional weight regain. Weight loss is accompanied by changes in gut peptides, adipose hormones, and energy expenditure that promote weight regain to a tightly regulated set point. While weight loss can improve body composition and surrogate markers of cardiometabolic health, it is hypothesized that the weight regain can result in an overshoot effect, resulting in excess weight gain, altered body composition, and negative effects on surrogate markers of cardiometabolic health. Numerous observational studies have examined the association of weight cycling and health outcomes. There appears to be modest association between weight cycling with type 2 diabetes mellitus and dyslipidemia in women, but no association with hypertension, cardiovascular events, and overall cancer risk. Interestingly, mild weight cycling may be associated with a decreased risk of overall and cardiovascular mortality. Little is known about the effects of weight cycling in the preconception period. Although obesity and weight gain are associated with pregnancy complications, preconception weight loss does not appear to mitigate the risk of most pregnancy complications related to obesity. Research on preconception weight cycling may provide insight into this paradox.

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