Obesity and Atrial Fibrillation: Epidemiology, Pathogenesis and Effect of Weight Loss

The obesity epidemic continues its relentless advance and is paralleled by an increase in the incidence of AF. Several epidemiological studies have highlighted obesity as an independent risk factor for the development of AF. This relationship is likely multifactorial through a number of interacting mechanisms. Weight loss through lifestyle changes or surgery has been associated with reverse remodelling of the atrial substrate and subsequent reduction in AF, making it an essential pillar in the management of AF in obese patients. In this review, the epidemiological data that support the obesity–AF relationship, the current insights into the underlying pathophysiological mechanism, the impact of weight loss on reverse remodelling and AF reduction, and the strategies to achieve weight loss in patients with AF are discussed.

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Towards Precision Health in Weight Reduction: Thematic Content Analysis of an Open-Ended Survey on Reasons Why Morbidly Obese Patients Want to Lose Weight.

10.21203/rs.3.rs-42745/v1 ◽

2020 ◽

Author(s):

Mazapuspavina Md-Ya ◽

Ilham Ameera Ismail ◽

Khasnur Abd Malek ◽

Khalid Yusoff ◽

Awang Bulgiba

Keyword(s):

Morbid Obesity ◽

Weight Loss ◽

Content Analysis ◽

Weight Reduction ◽

Extensive Study ◽

Morbidly Obese ◽

Obese Patients ◽

Thematic Content Analysis ◽

Thematic Content ◽

The Impact

Abstract Background: Addressing individuals’ motivation to lose weight among patients with morbid obesity is an essential entity in weight reduction. Failures to shift motivation into weight loss actions are common. These could be contributed by the inadequacy to identify and subsequently address the key reasons, that are of particular concern to the patient' individual needs. We aimed to understand the motivations better and identify the reasons why morbidly obese patients attending hospital-based weight management programmes (WMP) wanted to lose weight. Methods: The study used a qualitative approach to analyze part of a quantitative questionnaire of a more extensive study to understand factors influencing weight loss among morbidly obese patients. We used thematic content analysis to analyze responses from a self-administered open-ended question "What is the main factor why you want to lose your weight?”. A total of 225 new patients attending obesity clinics in two tertiary hospitals responded to the questionnaire. Results: Patients’ mean BMI was 45.6±8.05 kg/m2. Four themes emerged for the reasons why morbidly obese patients wanted to lose weight. Health was the most commonly inferred theme (84%). Patients were concerned about the impact obesity had on their health. Overcoming obesity was seen as a reward not just for physical health, but also for their psychological wellbeing. Patients regard being functional to care for themselves, their family members, as well as their religious and career needs as the next most crucial theme (25.8%). Patients raised the theme appearance (12.9%), especially with regards to wanting to look and feel beautiful. The last theme was perceived stigmatization for being morbidly obese as they were mocked and laughed at for their appearance (3.1%).Conclusion: Patients with morbid obesity in this study had expressed their main personal motivational reasons to lose weight. Concerns about the impact of morbid obesity on health, physical, social and obligatory function, appearance and perceived stigma warrant detailed exploration by the managing health professionals. Identifying and addressing these unique personal motivations in a focused approach is vital at the beginning and throughout a weight reduction program in this unique group.

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Diet composition and the risk of type 2 diabetes: epidemiological and clinical evidence

British Journal Of Nutrition ◽

10.1079/bjn20041117 ◽

2004 ◽

Vol 92 (1) ◽

pp. 7-19 ◽

Cited By ~ 111

Author(s):

M. Parillo ◽

G. Riccardi

Keyword(s):

Type 2 Diabetes ◽

Weight Loss ◽

Diet Composition ◽

Intervention Studies ◽

Epidemiological Studies ◽

Lifestyle Changes ◽

Lifestyle Modifications ◽

Body Weight Reduction ◽

Increased Risk

In the last 10 years nutritional research on diabetes has improved dramatically in terms of both number of studies produced and quality of methodologies employed. Therefore, it is now possible to attempt to provide the evidence on which nutritional recommendations for the prevention of type 2 diabetes could be based. We therefore performed a literature search and, among the papers published in indexed journals, we selected relevant epidemiological (mostly prospective) and controlled intervention studies. Lifestyle factors that have, so far, been consistently associated with increased risk of type 2 diabetes are overweight and physical inactivity. However, recent evidence from epidemiological studies has shown that the risk of type 2 diabetes is also associated with diet composition, particularly with: (1) low fibre intake; (2) a high trans fatty acid intake and a low unsaturated:saturated fat intake ratio; (3) absence of or excess alcohol consumption. All these factors are extremely common in Western populations and therefore the potential impact of any intervention on them is large: indeed, >90% of the general population has one or more of these risk factors. The ability to correct these behaviours in the population is estimated to reduce the incidence of diabetes by as much as 87%. Recent intervention studies have shown that type 2 diabetes can be prevented by lifestyle changes aimed at body-weight reduction, increased physical activity and multiple changes in the composition of the diet. Within this context, the average amount of weight loss needed is not large, about 5% initial weight, which is much less than the weight loss traditionally considered to be clinically significant for prevention of type 2 diabetes. In conclusion, new emphasis on prevention by multiple lifestyle modifications, including moderate changes in the composition of the habitual diet, might limit the dramatic increase in incidence of type 2 diabetes envisaged worldwide.

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Epidural Lipomatosis and Associated Spinal Stenosis—The Impact of Weight Loss: A Case Report

American Journal of Lifestyle Medicine ◽

10.1177/1559827616686764 ◽

2017 ◽

Vol 11 (6) ◽

pp. 511-514 ◽

Cited By ~ 1

Author(s):

William J. Beckworth ◽

Erin J. McCarty ◽

Jose E. Garcia-Corrada ◽

John F. Holbrook

Keyword(s):

Weight Loss ◽

Case Report ◽

Ligamentum Flavum ◽

Radiographic Finding ◽

Lumbar Stenosis ◽

Obesity Epidemic ◽

Epidural Lipomatosis ◽

Dietary Weight Loss ◽

The Impact ◽

Radiographic Improvement

Lumbar stenosis is a common radiographic finding that sometimes can be symptomatic. It usually results from a degenerative process of hypertrophic facets, ligamentum flavum hypertrophy, and disc involvement. A prominence of fat in the epidural space, epidural lipomatosis, can also be a contributing factor. This case report presents a 55-year-old man with radiographic improvement of epidural lipomatosis and stenosis from dietary weight loss. Given the rising obesity epidemic, practitioners should be cognizant of epidural lipomatosis and consider weight loss as a possible treatment option.

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Nutritional Management in Bariatric Surgery Patients

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182212049 ◽

2021 ◽

Vol 18 (22) ◽

pp. 12049

Author(s):

Andrea Deledda ◽

Stefano Pintus ◽

Andrea Loviselli ◽

Michele Fosci ◽

Giovanni Fantola ◽

...

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Life Expectancy ◽

Diabetes Remission ◽

Lifestyle Changes ◽

Nutritional Deficiencies ◽

Obesity Epidemic ◽

Sustained Weight Loss ◽

Before And After ◽

Reduce Life Expectancy

The obesity epidemic, mainly due to lifestyle changes in recent decades, leads to serious comorbidities that reduce life expectancy. This situation is affecting the health policies of many nations around the world. Traditional measures such as diet, physical activity, and drugs are often not enough to achieve weight loss goals and to maintain the results over time. Bariatric surgery (BS) includes various techniques, which favor rapid and sustained weight loss. BS is a useful and, in most cases, the best treatment in severe and complicated obesity. In addition, it has a greater benefit/risk ratio than non-surgical traditional therapies. BS can allow the obese patient to lose weight quickly compared with traditional lifestyle changes, and with a greater probability of maintaining the results. Moreover, BS promotes improvements in metabolic parameters, even diabetes remission, and in the quality of life. These changes can lead to an increase of life expectancy by over 6 years on average. The nutrition of people before and after BS must be the subject of indications from a trained staff, and patients must be followed in the subsequent years to reduce the risk of malnutrition and the associated problems. In particular, it is still debated whether it is necessary to lose weight prior to surgery, a procedure that can facilitate the surgeon’s work reducing the surgical risk, but at the same time, lengthens preparation times increasing the risks associated with concomitant pathologies. Furthermore, preventing nutritional deficiencies prior to the intervention can improve the results and reduce short- and long-term mortality.

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The Impact of the Pre-operative Neutrophil-lymphocyte Ratio as the Predictive Marker of Post-operative Weight Loss and Improving Diabetes in Sleeve Gastrectomy.

10.21203/rs.3.rs-131065/v1 ◽

2020 ◽

Author(s):

Hideya Kashihara ◽

Mitsuo Shimada ◽

Kozo Yoshikawa ◽

Jun Higashijima ◽

Takuya Tokunaga ◽

...

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Hemoglobin A1c ◽

Excess Weight Loss ◽

Predictive Marker ◽

Obese Patients ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Remission Of Diabetes ◽

The Impact

Abstract Background: The aim of this study was to investigate the impact of the neutrophil-lymphocyte ratio (NLR) in sleeve gastrectomy (SG).Methods: 15 obese patients were enrolled in this study. They consisted of 5 males and 10 females: mean body weight (BW) 127.5kg; mean body mass index (BMI) 46.7kg/m2. 10 of these were diabetics who underwent a SG. The impact of the pre-operative NLR on the percentage of excess weight loss (%EWL) and remission of diabetes 1 year post-operative were examined.Results: The BMI, %EWL and %TWL at 1 year post-operative were 35.1 kg/m2, 46.3% and 26.2%, respectively. Improvements were also evident in the diabetes at 1 year post-operative: complete remission (CR) (No medication and hemoglobin A1c (HbA1c) HbA1c<6.0%) 40%, PR (HbA1c<6.5) 20%; and (decrease of anti diabetic drug and HbA1c<7.0%) 40%. Comparing pre-operative NLR in %EWL<50% and >50% in one (1) year post-operative, <50% was 2.64 and >50% was 2.03 (p<0.05). The NLR in CR and partial remission (PR) was significantly lower than that in improved (Improve) (2.22 vs 3.27, p<0.05).Conclusions: The pre-operative NLR may be a predictive marker of weight loss and improving diabetes after SG.

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The Impact of Selection Criteria of Obese Patients on Evaluation of Heart Rate Variability Following Bariatric Surgery Weight Loss

Obesity Surgery ◽

10.1007/s11695-008-9784-4 ◽

2008 ◽

Vol 19 (3) ◽

pp. 397-398 ◽

Cited By ~ 4

Author(s):

Vincenzo Russo ◽

Gerardo Nigro ◽

Annabella de Chiara ◽

Anna Rago ◽

Raffaele Calabrò

Keyword(s):

Bariatric Surgery ◽

Heart Rate ◽

Weight Loss ◽

Heart Rate Variability ◽

Selection Criteria ◽

Obese Patients ◽

The Impact

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Physicians' Beliefs about Discussing Obesity: Results from Focus Groups

American Journal of Health Promotion ◽

10.4278/0890-1171-21.6.498 ◽

2007 ◽

Vol 21 (6) ◽

pp. 498-500 ◽

Cited By ~ 58

Author(s):

Stewart C. Alexander ◽

Truls Østbye ◽

Kathryn I. Pollak ◽

Margaret Gradison ◽

Lori A. Bastian ◽

...

Keyword(s):

Weight Loss ◽

Focus Groups ◽

Family Physicians ◽

Outcome Expectancies ◽

Physician Training ◽

Obese Patients ◽

Obesity Epidemic ◽

Target Populations ◽

Effective Care ◽

Duke University

Purpose. Physicians are expected to discuss weight loss with overweight and obese patients. Physicians' beliefs, outcome expectancies, and strategies for addressing weight with patients have not been examined. Design. Two focus groups of family physicians and internists included questions about obesity and how physicians discuss weight loss with patients. Setting/Subjects. Family physicians (n = 11) and internists (n = 6) from Duke University Medical Center's Department of Community and Family Medicine and Department of Medicine. Analysis. Qualitative analysis approach using grounded theory methodology. Results. Physicians' responses centered on five key themes: (1) responsibility, (2) barriers, (3) target populations, (4) introducing topic, and (5) ways to talk about obesity. Conclusion. Physicians have many barriers related to discussing weight loss with patients. Given the obesity epidemic, the need to understand how to have these discussions, when to have these discussions, and with whom to have these discussions becomes paramount to providing effective care for patients with obesity. Limited physician training in weight-loss counseling explains why physicians find it challenging to discuss obesity with patients.

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Weight Loss in Patients Waiting for Total Hip Arthroplasty: Fiber-Enriched High Carbohydrate Diet Improves Hip Function and Decreases Pain before Surgery

Journal of Clinical Medicine ◽

10.3390/jcm10184203 ◽

2021 ◽

Vol 10 (18) ◽

pp. 4203

Author(s):

Francesca Cannata ◽

Alice Laudisio ◽

Fabrizio Russo ◽

Luca Ambrosio ◽

Gianluca Vadalà ◽

...

Keyword(s):

Weight Loss ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Control Group ◽

Obese Patients ◽

Anthropometric Measures ◽

Total Hip ◽

High Carbohydrate ◽

Hip Function ◽

The Impact

The impact of obesity on clinical outcomes following joint replacement procedures is resounding. Therefore, multiple strategies to achieve a substantial weight loss before surgery are needed in obese patients. The aim of the study was to test the effect of a fiber-enriched high carbohydrate (FEHC) diet on the reduction in body weight and pain in elderly obese patients undergoing total hip arthroplasty (THA). Sixty-one candidates for THA were included in our study. Prior to the procedure, the participants have been randomly assigned to a 3-month diet intervention (FEHC diet or free diet). Anthropometric measures and food questionnaires were collected at the enrollment and after 3 months. The Oxford Hip Score (OHS), the Hip disability and Osteoarthritis Outcome Score (HOOS) and the Western Ontario McMaster Universities OA Index (WOMAC) were administered at baseline and before surgery. A statistically significant variation of weight was found in the FEHC diet group (−3.7 kg, −4.4–−2.5) compared to the control group (−0.2 kg; −1.4–1.7; p < 0.0001), as well as significant improvements in the OHS (p < 0.0001), the HOOS (p < 0.0001) and the WOMAC (p < 0.0001) questionnaires. According to the results of the study, the FEHC diet in obese patients undergoing THA might help weight loss and improve related anthropometric parameters as well as hip function and pain.

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Tissue and circulating microRNAs as biomarkers of response to obesity treatment strategies

Journal of Endocrinological Investigation ◽

10.1007/s40618-020-01453-9 ◽

2020 ◽

Cited By ~ 1

Author(s):

G. Catanzaro ◽

T. Filardi ◽

C. Sabato ◽

A. Vacca ◽

S. Migliaccio ◽

...

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Adipose Tissue ◽

Metabolic Diseases ◽

Lifestyle Changes ◽

Microrna Expression ◽

Obese Patients ◽

Microrna Target ◽

Comprehensive Overview ◽

Circulating Micrornas

Abstract Background Obesity, characterized by an increased amount of adipose tissue, is a metabolic chronic alteration which has reached pandemic proportion. Lifestyle changes are the first line therapy for obesity and a large variety of dietary approaches have demonstrated efficacy in promoting weight loss and improving obesity-related metabolic alterations. Besides diet and physical activity, bariatric surgery might be an effective therapeutic strategy for morbid obese patients. Response to weight-loss interventions is characterised by high inter-individual variability, which might involve epigenetic factors. microRNAs have critical roles in metabolic processes and their dysregulated expression has been reported in obesity. Aim The aim of this review is to provide a comprehensive overview of current studies evaluating changes in microRNA expression in obese patients undergoing lifestyle interventions or bariatric surgery. Results A considerable number of studies have reported a differential expression of circulating microRNAs before and after various dietary and bariatric surgery approaches, identifying several candidate biomarkers of response to weight loss. Significant changes in microRNA expression have been observed at a tissue level as well, with entirely different patterns between visceral and subcutaneous adipose tissue. Interestingly, relevant differences in microRNA expression have emerged between responders and non-responders to dietary or surgical interventions. A wide variety of dysregulated microRNA target pathways have also been identified, helping to understand the pathophysiological mechanisms underlying obesity and obesity-related metabolic diseases. Conclusions Although further research is needed to draw firm conclusions, there is increasing evidence about microRNAs as potential biomarkers for weight loss and response to intervention strategies in obesity.

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