scholarly journals Obesity – A global Burden, Crucial Problem for the Society

2018 ◽  
Vol 29 (2) ◽  
pp. 75-83
Author(s):  
Quazi Tarikul Islam ◽  
Ishrat Binte Reza
Keyword(s):  
Physical Activity ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Lifestyle Intervention ◽  
Global Public Health ◽  
Health Crisis ◽  
The Us ◽  
And Behavior ◽  
The Impact ◽  
Care Costs

Objectives: To aware doctors, patients, food producers and consumers.Data source: Online search via Google, 70 articles were down loaded, 52 valid papers were selected. Only 12 full text articles were eligible for review. Obesity rates have increased sharply over the past 30 years, creating a global public health crisis. The impact of obesity on morbidity, mortality, and health care costs is profound. Obesity and weight related complications exert a huge burden on patient suffering and social costs. In recent years, exciting advances have occurred in all 3 modalities used to treat obesity: lifestyle intervention, pharmacotherapy, and weight-loss procedures including bariatric surgery. Obese individuals lose approximately 6 to 8 kg (approximately 6% to 8% of initial weight) with 6 months of participation in a high-intensity lifestyle intervention ($ 14 treatment visits) consisting of diet, physical activity, and behavior therapy. Such losses reduce progression to type 2 diabetes in at-risk people and decrease blood pressure and triglyceride levels. All diets, regardless of macronutrient composition, can produce clinically meaningful weight loss (.5%) if they induce a deficit of 500 kcal/d. Physical activity of 150 to 180 min/week yields modest short-term weight loss compared with diet but contributes to improvements in obesity-related conditions. Gradual weight regain is common after lifestyle intervention but can be prevented by continued participation in monthly weight loss maintenance sessions, as well as by high levels of physical activity (ie, 200 to 300min/wk). Patients unable to reduce satisfactorily with lifestyle intervention may be candidates for pharmacotherapy, recommended as an adjunct. Five medications have been approved by the US Food and Drug Administration for chronic weight management, and each has its own risk/benefit profile. The addition of these medications to lifestyle intervention increases mean weight loss by 2.5 to 8.9 kg compared with placebo. Patients with severe obesity who are unable to reduce successfully with lifestyle intervention and pharmacotherapy are eligible for bariatric surgery, including Roux-en-Y gastric bypass, sleeve gastrectomy, or adjustable gastric banding.Bangladesh J Medicine Jul 2018; 29(2) : 75-83

Management of Obesity

2016 ◽  
Vol 34 (35) ◽  
pp. 4295-4305 ◽  
Author(s):  
Naji Alamuddin ◽  
Zayna Bakizada ◽  
Thomas A. Wadden
Keyword(s):  
Physical Activity ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Lifestyle Intervention ◽  
Weight Regain ◽  
Initial Weight ◽  
The Us ◽  
And Behavior

This review examines weight loss and accompanying improvements in obesity-related comorbidities produced by intensive lifestyle intervention, pharmacotherapy, and bariatric surgery. Obese individuals lose approximately 6 to 8 kg (approximately 6% to 8% of initial weight) with 6 months of participation in a high-intensity lifestyle intervention (≥ 14 treatment visits) consisting of diet, physical activity, and behavior therapy. Such losses reduce progression to type 2 diabetes in at-risk people and decrease blood pressure and triglyceride levels. All diets, regardless of macronutrient composition, can produce clinically meaningful weight loss (> 5%) if they induce a deficit ≥ 500 kcal/d. Physical activity of 150 to 180 min/wk yields modest short-term weight loss compared with diet but contributes to improvements in obesity-related conditions. Gradual weight regain is common after lifestyle intervention but can be prevented by continued participation in monthly weight loss maintenance sessions, as well as by high levels of physical activity (ie, 200 to 300 min/wk). Patients unable to reduce satisfactorily with lifestyle intervention may be candidates for pharmacotherapy, recommended as an adjunct. Five medications have been approved by the US Food and Drug Administration for chronic weight management, and each has its own risk/benefit profile. The addition of these medications to lifestyle intervention increases mean weight loss by 2.5 to 8.9 kg compared with placebo. Patients with severe obesity who are unable to reduce successfully with lifestyle intervention and pharmacotherapy are eligible for bariatric surgery, including Roux-en-Y gastric bypass, sleeve gastrectomy, or adjustable gastric banding. The first two procedures yield long-term (≥ 3 years) reductions of ≥ 20% of initial weight that are associated with decreases in morbidity and potentially mortality. Greater resources and dissemination efforts are needed to increase the availability of these three approaches for the millions of Americans who would benefit from them.

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.

The Impact of Physical Activity on Mitigation of Health Care Costs Related to Diabetes Mellitus: Findings from Developed and Developing Settings

2016 ◽  
Vol 12 (4) ◽  
pp. 307-311 ◽  
Author(s):  
Bruna Camilo Turi ◽  
Henrique Luiz Monteiro ◽  
Rômulo Araújo Fernandes ◽  
Jamile Sanches Codogno
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Health Care ◽  
Health Care Costs ◽  
The Impact ◽  
Care Costs ◽  
Developing Settings

scholarly journals Bariatric Surgery vs Lifestyle Intervention for Diabetes Treatment: 5-Year Outcomes From a Randomized Trial

2020 ◽  
Vol 105 (3) ◽  
pp. 866-876 ◽  
Author(s):  
Anita P Courcoulas ◽  
James W Gallagher ◽  
Rebecca H Neiberg ◽  
Emily B Eagleton ◽  
James P DeLany ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Lifestyle Intervention ◽  
Controlled Trial ◽  
The United States ◽  
Diabetes Remission ◽  
University Of Pittsburgh ◽  
Lifestyle Treatment ◽  
Surgical Treatments ◽  
The University

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.

scholarly journals Decrease of dipeptidyl peptidase 4 activity is associated with weight loss after bariatric surgery

2021 ◽  
Author(s):  
Carsten T. Herz ◽  
Johanna M. Brix ◽  
Bernhard Ludvik ◽  
Guntram Schernthaner ◽  
Gerit-Holger Schernthaner
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Hepatic Injury ◽  
Dipeptidyl Peptidase ◽  
Diabetic Patients ◽  
Metabolic Dysfunction ◽  
Dipeptidyl Peptidase 4 ◽  
Cholesterol Levels ◽  
Glucagon Like Peptide 1 ◽  
The Impact

Abstract Purpose Dipeptidyl peptidase 4 (DPP4) is expressed and secreted by adipocytes. DPP4 induces insulin resistance independently of its effect on glucagon-like peptide 1, thus it is conceivable that DPP4 directly contributes to metabolic dysfunction in patients with morbid obesity. The aim of this study was to investigate the impact of weight loss induced by bariatric surgery on DPP4 activity, and whether these changes are associated with improvements in markers of metabolic dysfunction and fatty liver disease. Materials and Methods We included 68 non-diabetic patients who underwent bariatric surgery. Serum DPP4 activity was measured using a fluorogenic substrate before and after surgery. Results Results: After a median follow-up period of 12 (IQR 11-17) months, median serum DPP4 activity decreased from 230 (IQR: 194-273) to 193 (164-252) pmol/min (p=0.012). The decrease in DPP4 activity was significantly correlated with decreases in BMI, improved cholesterol levels, reduced hepatic injury markers as well as improved post-prandial insulin sensitivity. After multivariable adjustment, ΔDPP4 activity remained significantly associated with Δcholesterol (beta=0.341, p=0.025), ΔLDL cholesterol (beta=0.350, p=0.019), Δgamma-glutamyltransferase (beta=0.323, p=0.040) and ΔMatsuda index (beta=-0.386, p=0.045). Conclusion We demonstrated that weight loss induced by bariatric surgery results in decreased circulating DPP4 activity beyond the initial phase of weight loss. The associations between decreased DPP4 activity and improved cholesterol levels as well as hepatic injury markers point towards pleiotropic effects of DPP4 beyond glucose metabolism which warrant further investigation.

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

Circulation ◽  
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.

scholarly journals COVID-19 as an “Infodemic” in Public Health: Critical Role of the Social Media

2021 ◽  
Vol 9 ◽  
Author(s):  
Debanjan Banerjee ◽  
K. S. Meena
Keyword(s):  
Public Health ◽  
Social Media ◽  
Critical Role ◽  
Global Public Health ◽  
Sources Of Information ◽  
Multiple Sources ◽  
Health Crisis ◽  
Digital Platforms ◽  
The Impact

The Coronavirus disease 2019 (COVID-19) pandemic has emerged as a significant and global public health crisis. Besides the rising number of cases and fatalities, the outbreak has also affected economies, employment and policies alike. As billions are being isolated at their homes to contain the infection, the uncertainty gives rise to mass hysteria and panic. Amidst this, there has been a hidden epidemic of “information” that makes COVID-19 stand out as a “digital infodemic” from the earlier outbreaks. Repeated and detailed content about the virus, geographical statistics, and multiple sources of information can all lead to chronic stress and confusion at times of crisis. Added to this is the plethora of misinformation, rumor and conspiracy theories circulating every day. With increased digitalization, media penetration has increased with a more significant number of people aiding in the “information pollution.” In this article, we glance at the unique evolution of COVID-19 as an “infodemic” in the hands of social media and the impact it had on its spread and public reaction. We then look at the ways forward in which the role of social media (as well as other digital platforms) can be integrated into social and public health, for a better symbiosis, “digital balance” and pandemic preparedness for the ongoing crisis and the future.

Translating promoting factors and behavior change principles into the blended and technology supported intervention “Foxfit” to stimulate physical activity in children with asthma: Design study (Preprint)

2021 ◽  
Author(s):  
Annette Brons ◽  
Katja Braam ◽  
Aline Broekema ◽  
Annieck Timmerman ◽  
Karel Millenaar ◽  
...  
Keyword(s):  
Physical Activity ◽  
Behavior Change ◽  
Developmental Process ◽  
Intervention Mapping ◽  
Healthcare Providers ◽  
Children With Asthma ◽  
Change Principles ◽  
And Behavior ◽  
The Impact ◽  
Functional Components

BACKGROUND Children with asthma can decrease the impact of their disease by improving their physical activity (PA). However, healthcare providers lack in interventions for children with asthma that effectively increase their PA levels and achieve behavior change regarding PA. A technology supported approach can positively influence PA and physical functioning in children. OBJECTIVE The aim of this study was to develop a technology supported intervention that facilitates healthcare providers in promoting PA for children with asthma and to systematically describe this developmental process. METHODS Intervention mapping (IM) was applied to develop a blended and technology supported intervention in co-creation with children with asthma, their parents, and healthcare providers. According to the IM framework, the following steps were performed: 1) conduct a needs assessment; 2) define the intervention outcome, performance objectives, and change objectives; 3) select theory based intervention methods and strategies; 4) create components of the intervention and conduct pilot tests; 5) create an implementation plan; and 6) create an evaluation plan. RESULTS We developed the blended intervention “Foxfit” that consists of an app with a physical activity monitor (PAM) for children with asthma, and a web-based dashboard for their healthcare provider. The intervention focusses on PA in everyday life to improve social participation. Foxfit contains components based on behavior change principles and gamification: goal setting, rewards, action planning, (self-)monitoring, shaping knowledge, a gamified story, personal coaching and feedback, and a tailored approach. CONCLUSIONS The IM framework was very useful to systematically develop a technology supported intervention and to describe the translational process from scientific evidence, the needs and wishes of future users, and behavior change principles into this intervention. This has led to the technology supported intervention Foxfit that facilitates healthcare providers in promoting PA in children with asthma. The structured description of the development process and functional components shows the way behavior change techniques are incorporated in the intervention. CLINICALTRIAL Dutch Trial Register: NTR6658

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