Weight loss behavior in obese patients before seeking professional treatment in Taiwan

Healthcare Service Providers' Perspectives on Sociocultural Aspects Affecting Weight Management Activities Amongst People with Obesity in Taiwan-A Qualitative Study

The prevalence of obesity and morbid obesity in Taiwan has risen sharply in recent decades, as in other parts of the world, necessitating urgent action to prevent and curb its detrimental effects. Asian populations are susceptible to the repercussions of obesity at a lower body weight. A higher BMI is associated with more frequent outpatient visits, in-hospital admissions, higher medical costs, and a lower quality of life. However, effective weight management approaches are unlikely to be maintained in the long term without assimilation into daily lifestyle practices. This qualitative study, based on semi-structured interviews with 14 doctors, dieticians, and nurses who work to control the weight of people with obesity, explored and identified multilevel barriers in the context of daily life to improve the efficacy and execution of weight management strategies. They considered diets, physical activity, and sleep as key weight management activities. The cultural and psychosocial aspects of daily life were observed to have an impact upon weight management, particularly family conflicts due to cultural dynamics and socially and culturally reinforced food practices. To improve population weight, less-recognised aspects need to be addressed alongside the inclusion of mental health specialists in weight management protocols and policy interventions to minimise obesogenic practices and create environments conducive to weight management.

The prevalence of weight-control behaviors and associated factors among adolescent girls in Tehran

Objectives Weight control behavior is a strategy for weight loss or weight gains that range from healthy to unhealthy. This study is aimed to determine the prevalence of weight control behaviors and their related factors in adolescent girls in Tehran. Methods Adolescent girls in the last grade of high school (n=491) that were selected by a multi-stage sampling method completed a cross-sectional survey (2018) in Tehran city in Iran. Data were collected using questionnaires (standard and researcher-made) by the self-report method and analyzed using descriptive and inferential statistics, including Chi-square, independent t-test, and logistic regression. Results 17.5% of adolescents had healthy, 60.6% had unhealthy, 15.8% had extreme unhealthy weight control behaviors, and 6.1% had no weight control behaviors. 74.8% of adolescents were in the normal body mass index (BMI) percentile. Unhealthy weight control behaviors were observed more than healthy behaviors at all BMI levels. Weight control behaviors had significant relationships with weight control intention (p=0.005), family (p=0.016) and peers (p=0.011) encouragement to weight control, engagement of relatives in weight control behaviors (p=0.016), anxiety (p<0.001), and age (p=0.030). BMI has a positive correlation with body weight satisfaction (p<0.001) and body weight perception (p<0.001). The results of logistic regression showed that increasing anxiety score can increase the possibility of engaging in unhealthy weight control behaviors (odd ratio=1.086, p=0.006). Conclusions Considering that a significant percentage of adolescents have unhealthy and extreme unhealthy weight control behaviors, and some of these behaviors leave irreversible effects on the health of this age group, design, and implementation of educational programs to prevent such behaviors seem imperative.

Pharmacotherapy of Obesity: Limits and Perspectives

Obesity is a severe worldwide epidemic. Obesity comorbidities, such as type 2 diabetes mellitus, hypertension, and atherosclerosis, are costly for patients and governments. The treatment of obesity involves several facets, including lifestyle changes, bariatric surgery, and pharmacotherapy. As changes in lifestyle require considerable patient commitment that is sometimes unachievable, and surgery is expensive and invasive, pharmacotherapy is the primary option for most patients. This review describes the pharmacotherapy currently available in the USA, Europe, and Brazil, focusing on its limitations. We then analyze the results from clinical trials of new drug candidates. Most drugs cause weight loss of < 4 kg compared with controls, and severe adverse effects have caused a number of drugs to be withdrawn from the market in several countries. Drugs under development have not shown more significant weight loss or reduced adverse effects. We conclude that a significant portion of obese patients have few treatment options because of the adverse effects and minimal weight loss associated with current pharmacotherapy. However, drugs currently under development appear unable to change this scenario in the near future. Thus, it is essential that new compounds are developed and new molecular targets studied so obesity can be efficiently treated in all patients in the future.