scholarly journals Efficacy of Cognitive Behavior Therapy and Pharmacotherapy on Adolescent Obesity

2017 ◽  
Vol 6 (1) ◽  
pp. 52-55
Author(s):  
Danielle Grassi ◽  
Cassidy Forsyth ◽  
Masaru Teramoto ◽  
Krista Rompolski
Keyword(s):  
Weight Loss ◽  
Behavioral Therapy ◽  
Treatment Options ◽  
Adolescent Obesity ◽  
Lifestyle Changes ◽  
Cognitive Behavior ◽  
Psychological Conditions ◽  
Mental And Physical Health ◽  
The U.S

Adolescent obesity is an urgent health issue in the U.S., and is a precursor to many physiological and psychological conditions. There are different treatment options for adolescent obesity, and it is important for the general public to understand the benefits and risks associated with the particular treatments. This paper focuses on two treatment options for adolescent obesity, cognitive behavioral therapy (CBT; type of psychological therapy) and Orlistat (medication for obesity), and discusses the effectiveness of each treatment for adolescent obesity. CBT focuses on the behaviors that are associated with the development and maintenance of obesity, while Orlistat targets the physiologic mechanisms of obesity. It appears that while both treatments may be effective for obesity, in general, CBT could help adolescents make lifestyle changes that are more beneficial in long-term mental and physical health. Additionally, when CBT is combined with Orlistat to initiate weight loss, which is then maintained by CBT alone, it could have the greater treatment effects.

scholarly journals Rewriting One Patient’s Story of Disrupted Sleep

2019 ◽  
pp. 161-172
Author(s):  
Samantha Domingo ◽  
Michelle L. Drerup
Keyword(s):  
Social Support ◽  
Treatment Adherence ◽  
Relaxation Training ◽  
Behavioral Therapy ◽  
Treatment Options ◽  
Cognitive Restructuring ◽  
Sleep Hygiene ◽  
Sleep Restriction ◽  
Insomnia Disorder

This chapter covers treatment options for individuals with chronic insomnia disorder. We describe the effectiveness of cognitive behavioral therapy for insomnia (CBT-i) and various modalities of delivery of the treatment. CBT-i is an alternative treatment for insomnia that has been demonstrated to be as successful as pharmacological therapies in the short term, and more effective in the long term. CBT-i comprises sleep restriction, stimulus control, relaxation training, sleep hygiene, and cognitive restructuring. The authors examine group CBT-i as a way to increase social support and enhance treatment adherence. Computerized CBT-i is a newer option to provide increased access to this treatment.

Clinical considerations for the management of pediatric patients with attention-deficit/hyperactivity disorder

2013 ◽  
Vol 2 (11) ◽  
pp. 362-369
Author(s):  
Dustin Linn ◽  
Andrea Murray ◽  
Thomas Smith ◽  
David Fuentes
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
English Language ◽  
Behavioral Therapy ◽  
Treatment Options ◽  
Time Frame ◽  
Chronic Health Condition ◽  
Hyperactivity Disorder ◽  
Long Term Treatment

Introduction: Attention-deficit/hyperactivity disorder (ADHD) is a chronic health condition presenting with symptoms of hyperactivity, impulsivity, and/or inattention in early childhood, adolescence and adulthood. Many patients will persist with associated symptoms throughout their life and may require long term treatment to maintain adequate control. Objective: The purpose of this article is to review the current literature in regards to diagnosis, treatment, and management of ADHD in the pediatric and adolescent population. Methods: A search was conducted using PubMed, Medline, Ovid, and CINHAL with a focus on studies and reviews in the English language from 2008 – 2013, featuring pediatric/adolescent patients across the ages of 4–17 years using the terms: “management”, “attention-deficit”, “hyperactivity”, and “treatment.” Literature referenced prior to the five-year time frame outlined herein provided foundational information on diagnostics and medications. Discussion: Stimulants, in conjunction with behavioral therapy, are standard first line treatments used in ADHD. While stimulant medications have been shown to be effective in treating symptoms associated with ADHD, there are a variety of concerns that may prevent their use. These concerns are related to adverse consequences, many of which are not supported by concrete evidence. Other pharmacotherapy options such as norepinephrine reuptake inhibitors and selective alpha-2 adrenergic agonists are typically reserved as second line options. The use of novel and emerging complementary therapies will also be explored. Conclusion: Patients diagnosed with ADHD must be thoroughly evaluated when making decisions regarding treatment. Many studies and reviews support the efficacy of pharmacotherapy in treatment of ADHD; however, there is insufficient evidence regarding long-term safety of the medications. Further research is warranted to evaluate current treatment options and associated risks and benefits to guide the clinician in optimal management of these patients.

scholarly journals A clinic biochemical study of status of fasting serum insulin and lipid profile in PSOS patients and to determine correlation between BMI and HOMA index in PSOS patients

2021 ◽  
Vol 8 (3) ◽  
pp. 305-309
Author(s):  
Sumitra Yadav ◽  
Manisha Gupta
Keyword(s):  
Insulin Resistance ◽  
Weight Loss ◽  
Metabolic Disorders ◽  
Biochemical Study ◽  
Serum Insulin ◽  
Treatment Options ◽  
Reproductive Organs ◽  
Lifestyle Changes ◽  
Fasting Serum ◽  
Lipid Status

The importance of insulin resistance, compensatory hyperinsulinemia, and its effects, many of which have adverse effects on both the metabolic and reproductive organs. Treatment options for insulin resistance/hyperinsulinemia include lifestyle changes, exercise, weight loss, and or the use of thiazolidinediones (TZDs) or metformin. Weight loss measures are essential to the treatment of this condition. Lifestyle, exercise, and dietary changes, weight loss has been shown to reduce hyperandrogenism, increase ovulation and pregnancy rates, and improve immune conflict. Numerous studies have suggested that metformin plays an important role in the treatment of PCOS including restoring ovulation, weight loss, reducing androgen cycle levels, reducing the risk of miscarriage, and reducing the risk of gestational diabetes (GDM).PCOS patients may develop severe dyslipidemia, such as increased LDL-C and TG levels and decreased HDL-C levels associated with hyperandrogenism, IR, and chronic inflammation. Therefore, statins are widely used in the treatment of PCOS patients to reduce inflammation, oxidative stress, hyperandrogenemia, and other metabolic disorders. Statins have been reported to block HMG-CoA inhibiting mevalonate synthesis, which is a necessary substrate for cholesterol production and can be used to synthesize other important lipid links, therefore, statins can improve lipid status and hyperandrogenism.

Treatments for Eating Disorders

2015 ◽  
Author(s):  
Kathleen M. Pike ◽  
Loren M. Gianini ◽  
Katharine L. Loeb ◽  
Daniel Le Grange
Keyword(s):  
Eating Disorders ◽  
Weight Loss ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Behavioral Therapy ◽  
Treatment Options ◽  
Evidence Based Treatments ◽  
Substantial Progress

Substantial progress in advancing evidence-based treatments for eating disorders has been made. Many well-designed studies provide cumulative support for cognitive-behavioral therapy (CBT) as the treatment of choice for bulimia nervosa. Interpersonal psychotherapy (IPT) and pharmacotherapy are considered appropriate alternative treatments for bulimia nervosa. While CBT, IPT and pharmacotherapy often produce significant reductions in binge eating and compensatory behaviors, these treatment options need to be improved to help more individuals achieve full and lasting recovery. In the treatment of binge eating disorder, CBT and IPT have been shown to be the most efficacious in reducing symptoms and improving psychological outcomes. Weight loss is often an additional goal of those entering treatment for binge eating disorder; however, existing treatments have generally been unsuccessful in producing significant maintainable weight loss. Initial studies suggest that CBT may be associated with improved outcome both in the acute and maintenance phases of treatment for anorexia nervosa.

Designing digital health technology to support patients before and after bariatric surgery: a qualitative study exploring patient desires, suggestions and reflections to support lifestyle behaviour change. (Preprint)

2021 ◽  
Author(s):  
Anna Robinson ◽  
Andy Husband ◽  
Robert Slight ◽  
Sarah Slight
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Behaviour Change ◽  
Digital Technologies ◽  
Lifestyle Changes ◽  
Lifestyle Behaviour ◽  
Surgical Success ◽  
Before And After ◽  
Surgical Pathway

BACKGROUND A patient’s capability, motivation, and opportunity to change their lifestyle are significant determinants of successful outcomes following bariatric surgery. Healthier lifestyle changes before and after surgery, including improved dietary intake and physical activity levels, have been shown to contribute to greater post-surgical weight loss and improved long-term health. Integrating patient-centered digital technologies within the bariatric surgical pathway could form part of an innovative strategy to promote and sustain healthier behaviours and provide holistic patient support, to improve surgical success. Research has focused on implementing digital technologies and measuring their effectiveness in various surgical cohorts, yet there is limited work concerning the desires, suggestions and reflections of patients undergoing bariatric surgery. This qualitative investigation explores patient perspectives on technology features that would support them to change their lifestyle behaviours during the pre- and post-operative periods, to potentially maintain long-term healthy lifestyles following surgery. OBJECTIVE To understand how digital technologies could be used to better support patients across the perioperative pathway to improve weight-loss outcomes and surgical success. Specifically, the objectives concerned: 1) what do patients want from digital technologies, 2) how do they want to use them, and 3) when would they be of most benefit during their surgical journey? METHODS Patients attending bariatric surgery clinics within one hospital in the North of England were invited to take part. Semi-structured interviews were conducted with purposively sampled pre- and post-operative bariatric surgical patients to discuss lifestyle behaviour change and the use of digital technologies to complement their care. Interviews were audio-recorded and transcribed verbatim. Reflexive thematic analysis enabled the development of themes from the data. Ethical approval was obtained from the NHS Health Research Authority. RESULTS Twenty patients were interviewed. Four overarching themes were developed from the data relating to perspectives of optimised technology functionality. These centered on providing tailored content and support; facilitating self-monitoring and goal-setting; delivering information in an accessible, trusted, and usable manner; and meeting patient information-seeking and engagement needs. Interventions that supported the delivery of personalized feedback and post-operative follow-up were perceived as beneficial. Individualized goal- and target-setting could further support a generation of digitally engaged patients with bariatric conditions. Working towards achievable targets was deemed an effective strategy to successfully motivate behaviour change. The creation of digital ‘package of care’ checklists between patients and clinicians was a novel finding from this research. CONCLUSIONS Perceptions of patients undergoing bariatric surgery validated the integration of digital technologies within the surgical pathway, offering enhanced connectedness and support. Recommendations are made that relate to the design, content and functionality of digital interventions to best address the needs of this patient cohort. These findings have the potential to influence future co-design and integration of person-centered, perioperative technologies within surgical pathways. CLINICALTRIAL N/A

scholarly journals The Pain System in Oesophageal Disorders: Mechanisms, Clinical Characteristics, and Treatment

2011 ◽  
Vol 2011 ◽  
pp. 1-14 ◽  
Author(s):  
Christian Lottrup ◽  
Søren Schou Olesen ◽  
Asbjørn Mohr Drewes
Keyword(s):  
Severe Disease ◽  
Treatment Options ◽  
Primary Treatment ◽  
Lifestyle Changes ◽  
Sensory Receptors ◽  
Pain Mechanisms ◽  
Afferent Nerves ◽  
The Central Nervous System ◽  
The Brain

Pain is common in gastroenterology. This review aims at giving an overview of pain mechanisms, clinical features, and treatment options in oesophageal disorders. The oesophagus has sensory receptors specific for different stimuli. Painful stimuli are encoded by nociceptors and communicated via afferent nerves to the central nervous system. The pain stimulus is further processed and modulated in specific pain centres in the brain, which may undergo plastic alterations. Hence, tissue inflammation and long-term exposure to pain can cause sensitisation and hypersensitivity. Oesophageal sensitivity can be evaluated ,for example, with the oesophageal multimodal probe. Treatment should target the cause of the patient's symptoms. In gastro-oesophageal reflux diseases, proton pump inhibitors are the primary treatment option, surgery being reserved for patients with severe disease resistant to drug therapy. Functional oesophageal disorders are treated with analgesics, antidepressants, and psychological therapy. Lifestyle changes are another option with less documentation.

Changes in body composition at menopause—age, lifestyle or hormone deficiency?

2002 ◽  
Vol 8 (4) ◽  
pp. 137-140 ◽  
Author(s):  
Morten B Sørensen
Keyword(s):  
Weight Loss ◽  
Body Composition ◽  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Hormone Replacement ◽  
Good Reason ◽  
Health Benefit ◽  
Lifestyle Changes ◽  
Hormone Deficiency

One of the major concerns of perimenopausal women is obesity—and for a good reason. Both general and abdominal obesity as well as loss of skeletal muscle (sarcopenia) are accelerated through the menopausal transition and lifestyle changes as well as sex hormone deficiency play important roles. Most well conducted clinical trials have demonstrated hormone replacement therapy induced reversal or at least impairment of menopausal changes in body composition and the common worry that it causes weight gain is unsubstantiated. Coaching of weight loss in obese individuals is often a frustrating task but is nevertheless of immense importance because of the health hazards of obesity. Through the climacteric period, short-term hormone replacement therapy, with or without androgens for preservation of muscle mass, might inhibit obesity and this is likely to boost motivation for introduction of more comprehensive and long-lasting initiatives linked to persistent weight loss and long-term health benefit.

scholarly journals Maintenance of Weight Loss in Adolescents: Current Status and Future Directions

2010 ◽  
Vol 2010 ◽  
pp. 1-12 ◽  
Author(s):  
Meghan L. Butryn ◽  
Thomas A. Wadden ◽  
Margaret R. Rukstalis ◽  
Chanelle Bishop-Gilyard ◽  
Melissa S. Xanthopoulos ◽  
...  
Keyword(s):  
Weight Loss ◽  
Lifestyle Modification ◽  
Adolescent Obesity ◽  
Current Status ◽  
Long Term Outcomes ◽  
Future Directions ◽  
Length Of Treatment ◽  
Treatment Of Obesity ◽  
Effectiveness Data

There is a dearth of research on the long-term efficacy and safety of treatments for adolescent obesity. This narrative review examined several approaches to treatment, focusing on long-term effectiveness data in adolescents, as well as relevant findings from studies of adults. The available research suggests that lifestyle modification has promise in obese adolescents, although it is not clear that any particular dietary or physical activity approach is more effective than another. Meal replacements are quite effective in adults and deserve further research in adolescents. Extending the length of treatment to teach weight loss maintenance skills is likely to improve long-term outcomes in adolescents, and delivering treatment via the Internet or telephone is a novel way of doing so. Treatment that combines lifestyle modification with the medication orlistat generally appears to be safe but only marginally superior to lifestyle modification alone. More research is needed on the management of adolescent obesity, which has been overlooked when compared with research on the treatment of obesity in children and adults.

scholarly journals The Long-Term Dietitian and Psychological Support of Obese Patients Who Have Reduced Their Weight Allows Them to Maintain the Effects

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2020
Author(s):  
Katarzyna Iłowiecka ◽  
Paweł Glibowski ◽  
Michał Skrzypek ◽  
Wojciech Styk
Keyword(s):  
Weight Loss ◽  
Behavioral Therapy ◽  
Weight Maintenance ◽  
Obesity Treatment ◽  
Psychological Support ◽  
Controlled Study ◽  
Nucleotide Polymorphisms ◽  
Weight Changes ◽  
Anthropometric Parameters

The role of post-therapeutic support after weight loss in obesity treatment is not fully understood. Therefore, weight maintenance after a successful weight loss intervention is not very common, especially in obese individuals. This randomized controlled study was conducted to explore the efficacy of following dietary and psychological support in a group of 36 obese individuals. Participants (22 women, 14 men aged 35.58 ± 9.85 years, BMI 35.04 ± 3.80 kg/m2) who completed a 12-month weight loss phase (balanced energy-restricted diet) were randomly allocated to receive 18-month support (SG) or no additional care (CG). The support phase included some elements of Ten Top Tips (TTT), cognitive behavioral therapy (CBT), motivational interviewing (MI) in combination with nutritional education and assessment of the level of physical activity. The primary outcome was the maintenance of anthropometric parameters at an 18-month follow-up. The secondary outcomes included evaluation of biochemical parameters and single nucleotide polymorphisms (SNPs) in genes connected with obesity. A comparison of SG vs. CG after a 30-month period of the study revealed significant differences in weight changes (−3.83 ± 6.09 vs. 2.48 ± 6.24 kg), Body Mass Index (−1.27 ± 2.02 vs. 0.72 ± 2.12 kg/m2), visceral adipose tissue (−0.58 ± 0.63 vs. 0.45 ± 0.74 L), and waist circumference (−4.83 ± 4.05 vs. 1.83 ± 5.97 cm). Analysis of SNPs (rs9939609 FTO, rs987237 TFAP2B, and rs894160 PLIN1) provided further insight into the potential modulating effect of certain genotypes on weight loss and maintenance and extended the knowledge of the potential benefits of personalized medicine. Post-therapeutical support in current clinical practice may increase the chances of long-term weight loss maintenance in obesity treatment even in patients with a genetic predisposition to excessive weight.

scholarly journals Emerging drugs for obesity therapy

2009 ◽  
Vol 53 (2) ◽  
pp. 271-280 ◽  
Author(s):  
Maria Teresa Zanella ◽  
Fernando Flexa Ribeiro Filho
Keyword(s):  
Risk Factors ◽  
Weight Loss ◽  
Receptor Antagonist ◽  
Therapeutic Potential ◽  
Lifestyle Changes ◽  
Cannabinoid 1 Receptor ◽  
Obesity Therapy ◽  
Limited Effectiveness ◽  
Long Term Treatment

Central obesity have an important impact on the development of risk factors for coronary heart disease, including dislipidemia, glucose intolerance, insulin resistance and hypertension. These factors contribute to building cardiovascular (CV) disease as a major cause of death. The approach to obesity therapy should be designed to reduce CV risk and mortality. Diet and lifestyle changes remain the cornerstones of therapy for obesity, but the resultant weight loss is often small and long-term success is uncommon and disappointing. Drug therapy is considered for individuals with a body mass index greater than 30 kg/m² or ranging from 25 to 30 kg/m² if they have comorbid conditions. Antiobesity agents can be helpful to some patients in achieving and maintaining meaningful weight loss, but yet our pharmaceutical tools are of limited effectiveness considering the magnitude of the problem. At the present, only two drugs, orlistat and sibutramine, are approved for long-term treatment of obesity and promote no more than 5 to 10% of weight loss. Rimonabant, a cannabinoid-1 receptor antagonist, was withdrawn from the market because of concerns about its safety, including risk of suicidal and seizures, although very effective in promoting clinically meaningful weight loss, reduction in waist circumference, and improvements in several metabolic risk factors, rimonabant, a cannabinoid-1 receptor antagonist was withdrawn from the market because it concerns about its safety, including risk of suicidal and seizures. Fortunately, recent fundamental insights into the neuroendocrine mechanisms regulating body weight provide an expanding list of molecular targets for novel, rationally designed antiobesity drugs. In this review, the therapeutic potential of some antiobesity molecules in the development will be analyzed based on an understanding of energy homeostasis.

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