Recent trends in intensive treatments of obesity: Is academic research matching public interest?

Assessing the effectiveness of actionable nutrigenomics and lifestyle genomics interventions for weight management in clinical practice: A critical, scoping review with directions for future research

BACKGROUND

The use of nutrigenomics and lifestyle genomics in clinical practice has the potential to optimize weight-related outcomes for patients.

AIM

A scoping review was conducted to summarize and evaluate the current body of knowledge related to the effectiveness of providing DNA-based lifestyle advice on weight-related outcomes, with the aim of providing direction for future research.

METHOD

Primary studies were included if they were written in English, evaluated weight-related and/or body mass index and/or body composition outcomes, and provided participants with an actionable genetic-based lifestyle intervention; interventions that only provided information on genetic risk for diseases/conditions were excluded. Data was extracted from each article meeting inclusion criteria (N=3) and the studies were critically appraised for methodological limitations.

RESULTS

Research in this area is promising, but limited. Specific limitations relate to study designs, the nature of the recommendations provided to participants, small (underpowered) sample sizes, the use of self-reported weight/BMI data and lack of consideration of important confounding factors.

CONCLUSIONS

Therefore, the effectiveness of nutrigenomics and lifestyle genomics interventions for weight management in clinical practice cannot yet be conclusively determined. Recommendations for future research are detailed in the present manuscript.

Seasonal variation and trends in the Internet searches for losing weight: An infodemiological study

OBJECTIVES

This study sought to examine the variation trends and seasonality of losing weight by using the data from Google Trends tool.

METHODS

According to the search term of [lose weight+weight loss], Google Trends data were obtained. Search activity was conducted within the USA, the UK, Canada, Ireland, Australia, and New Zealand from January 01, 2004, to December 31, 2018, utilizing the health category.

RESULTS

Dynamic series analysis and the plot of seasonal decomposition of time series show that relative search volume of [lose weight+weight loss] increased from 2004 to 2018 at both national and hemispherical levels. Statistically significant seasonal variations in relative search volume for the term [lose weight+weight loss] were observed using cosinor analyses in the USA (p<0.001), the UK (p<0.001), Canada (p<0.001), Ireland (p<0.001), Australia (p<0.001), and New Zealand (p<0.001), peaking in the spring months and reaching the lowest level in the autumn months. The highest level in spring and the lowest level in autumn were reversed by 6 months in both hemisphere countries, consistent with a seasonal pattern.

CONCLUSION

Our results indicate that Internet search queries for losing weight increased within the timeframe of 2004 to 2018, likely reflecting the rising global public interest. In addition, the present research provided preliminary evidence that there is a seasonality of losing weight with a peak in the spring months.

Patient motivations and expectations prior to bariatric surgery: A qualitative systematic review

Bariatric surgery is the most effective treatment for weight loss in individuals with severe and complex obesity. While the extant literature has mostly explored clinical outcomes of surgery, recent research has also examined patients' experiences prior to treatment. This systematic review synthesized findings from qualitative studies investigating patients' motives and expectations prior to undergoing bariatric surgery for weight loss. Twenty-eight studies published in English involving 580 participants were identified for inclusion. Data extraction and thematic synthesis yielded four global themes: physiological, emotional, cognitive, and interpersonal/environmental. These represented seven subthemes describing patients' presurgery experiences: relationship with food, physical health, activities of living, personal identity, social relations, presurgery information, and beliefs about surgery. In addition to improving physical and medical comorbidities associated with obesity, participants believed that postsurgery weight loss would produce positive psychosocial impacts by strengthening their personal identities, their relationships, and improving their engagement in public and professional life. The complex and widespread nature of the changes patients expected would result from bariatric surgery highlights the importance of providing pretreatment education focused on psychosocial well-being, as well as concurrent psychological support alongside surgery, to best inform individual treatment selection and clinical practice.

Interpersonal difficulties in obesity: A systematic review and meta-analysis to inform a rejection sensitivity-based model

Obesity is associated with difficulties due to stigma and loneliness. These impact negatively on individuals' quality of life and behaviour change efforts. Increased sensitivity to others' negative feedback might play a role in the maintenance of these difficulties and could be addressed in psychological interventions. We conducted a systematic review of interpersonal difficulties in individuals with obesity, across the lifespan. We investigated early interpersonal adversity (i.e. frequency of teasing/bullying), perceived interpersonal stress and quality of social life, based on a rejection sensitivity model. The databases PubMed, Web of Knowledge and AGRIS, Embase, Medline and PsychINFO were searched for published peer-reviewed journal articles (1980-June 2018). Thirty-two studies met inclusion criteria. Results from the meta-analyses (n = 16 studies) indicated that overweight/obese individuals reported more frequent experiences of teasing/bullying, greater interpersonal stress and poorer quality of social life than healthy weight individuals. Findings in the systematic review aligned to this evidence. Psychological interventions targeting increased sensitivity to negative interpersonal feedback could improve interpersonal functioning and, in turn, eating behaviours in individuals with obesity.

Concurrent Placements of a Duodenal-Jejunal Bypass Liner and an Intragastric Balloon Among Severely Obese Patients: A Case Series

The duodenal-jejunal bypass liner and the intragastric balloon are endoscopically deployed devices used in the treatment of obesity and diabetes. These devices use differing mechanisms of action, and concurrent use may lead to improved efficacy. Three obese patients who suffered from weight loss plateau with the liner had the intragastric balloon inserted concurrently. All 3 patients reported subsequent significant weight loss. None of the patients reported any symptom that indicate the interference between the devices. This is the first case series in humans of successfully combining 2 independent endoscopic bariatric therapies to overcome weight loss plateau in the primary treatment of obesity.