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Rao V, Pena A, James A, Phadke A, Grover J, Blendis E, Choudhary N, Kampegowda P. The role of meditation and mindfulness in the management of polycystic ovary syndrome: a scoping review. Front Endocrinol (Lausanne) 2024; 15:1295705. [PMID: 38818503 PMCID: PMC11137171 DOI: 10.3389/fendo.2024.1295705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 05/02/2024] [Indexed: 06/01/2024] Open
Abstract
Polycystic Ovary Syndrome (PCOS) presents multifaceted challenges affecting women's reproductive, metabolic, and psychological systems, consequently impacting their psychological and emotional well-being. The utilization of meditation and mindfulness interventions (MMIs) is found to be increasing for the management of PCOS. This scoping review systematically explored the current literature to identify the type and application of MMIs for PCOS management. A systematic search of literature was conducted using CINAHL, PsycINFO, Scopus, MEDLINE, and PubMed databases for identifying studies conducted on the usage of MMIs in women diagnosed with PCOS, irrespective of age. The comprehensive search identified 14 trials (comprising 17 citations) meeting inclusion criteria, involving 723 participants across various age groups. Among these, nine were randomized controlled trials (RCTs), while the remaining comprised non-RCTs. Several types of MMIs, including Rajayoga of Brahmakumaris, Yoga Nidra, OM cyclic meditation, unspecified forms of meditation, mindfulness-based stress reduction programs, mindful yoga, and mindfulness-based activities, were used. Outcomes were predominantly assessed in psychological domains (n=11), followed by anthropometric (n=9), quality of life (n=7), and metabolic metrics (n=7). The review findings suggest the integration of meditation with conventional treatment modalities. Preliminary data indicate that MMIs have the potential to improve psychosocial well-being and quality of life among PCOS-affected women. However, adequately powered studies with extended follow-up periods are required to investigate the mechanisms and therapeutic efficacy of MMIs, particularly concerning reproductive outcomes and weight management. Furthermore, diligent monitoring and reporting of adverse events and adherence are essential for a comprehensive understanding of MMI utilization in PCOS management.
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Affiliation(s)
- Vibhuti Rao
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Alexia Pena
- Discipline of Paediatrics, The University of Adelaide and Robinson Research Institute, Adelaide, SA, Australia
| | - Annie James
- School of Social Sciences, Christ University, Bengaluru, India
| | - Aashish Phadke
- Division of Endocrine and Metabolic Disorders, Kasturba Health Society’s Medical Research Centre, Mumbai, India
| | - Jahnavi Grover
- Medical School, Western Sydney University, Penrith, NSW, Australia
| | - Ella Blendis
- Medical School, University of Birmingham, Birmingham, United Kingdom
| | | | - Punith Kampegowda
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
- Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
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Smith J, Ang XQ, Giles EL, Traviss-Turner G. Emotional Eating Interventions for Adults Living with Overweight or Obesity: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2722. [PMID: 36768088 PMCID: PMC9915727 DOI: 10.3390/ijerph20032722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Emotional eating (EE) may be defined as a tendency to eat in response to negative emotions and energy-dense and palatable foods, and is common amongst adults with overweight or obesity. There is limited evidence regarding the effectiveness of interventions that address EE. OBJECTIVES To synthesize evidence on the effectiveness of EE interventions for weight loss and EE in adults living with overweight or obesity. METHODS This is a systematic review and meta-analysis. Adhering to the PRISMA guidance, a comprehensive electronic search was completed up to February 2022. Random effects meta-analysis was carried out to determine the percentage change in weight and EE scores. RESULTS Thirty-four studies were included. The combined effect size for percentage weight change was -1.08% (95% CI: -1.66 to -0.49, I2 = 64.65%, n = 37), once adjusted for publication bias. Similarly, the combined effect size for percentage change in EE was -2.37%, (95% CI: -3.76 to -0.99, I2 = 87.77%, n = 46). Cognitive Behavioural Therapy showed the most promise for reducing weight and improving EE. CONCLUSIONS Interventions to address EE showed promise in reducing EE and promoted a small amount of weight loss in adults living with overweight or obesity.
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Affiliation(s)
- Jo Smith
- School of Health and Life Sciences, Teesside University, Middlesbrough TS1 3BX, UK
- Tees, Esk and Wear Valleys NHS Foundation Trust, Darlington DL2 2TS, UK
| | - Xiao Qi Ang
- School of Health and Life Sciences, Teesside University, Middlesbrough TS1 3BX, UK
| | - Emma L. Giles
- School of Health and Life Sciences, Teesside University, Middlesbrough TS1 3BX, UK
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Hanson P, Lange M, Oduro-Donkor D, Shuttlewood E, Weickert MO, Randeva HS, Menon V, Alexander RT, Basset P, Shankar R, Barber TM. The role of mindfulness training in sustaining weight reduction: retrospective cohort analysis. BJPsych Open 2022; 8:e198. [PMID: 36377522 PMCID: PMC9707508 DOI: 10.1192/bjo.2022.602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Psychological stress has an established bi-directional relationship with obesity. Mindfulness techniques reduce stress and improve eating behaviours, but their long-term impact remains untested. CALMPOD (Compassionate Approach to Living Mindfully for Prevention of Disease) is a psychoeducational mindfulness-based course evidenced to improve eating patterns across a 6-month period, possibly by reducing stress. However, no long-term evaluation of impact exists. AIMS This study retrospectively evaluates 2-year outcomes of CALMPOD on patient engagement, weight and metabolic markers. METHOD All adults with a body mass index >35 kg/m2 attending an UK obesity service during 2016-2020 were offered CALMPOD. Those who refused CALMPOD were offered standard lifestyle advice. Routine clinic data over 2 years, including age, gender, 6-monthly appointment attendance, weight, haemoglobin A1C and total cholesterol, were pooled and analysed to evaluate CALMPOD. RESULTS Of 289 patients, 163 participated in the CALMPOD course and 126 did not. No baseline demographic differences existed between the participating and non-participating groups. The CALMPOD group had improved attendance across all 6-monthly appointments compared with the non-CALMPOD group (P < 0.05). Mean body weight reduction at 2 years was 5.6 kg (s.d. 11.2, P < 0.001) for the CALMPOD group compared with 3.9 kg (s.d. 10.5, P < 0.001) for the non-CALMPOD group. No differences in haemoglobin A1C and fasting serum total cholesterol were identified between the groups. CONCLUSIONS The retrospective evaluation of CALMPOD suggests potential for mindfulness and compassion-based group educational techniques to improve longer-term patient and clinical outcomes. Prospective large-scale studies are needed to evaluate the impact of stress on obesity and the true impact of CALMPOD.
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Affiliation(s)
- Petra Hanson
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, UK; Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, UK; and NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, UK
| | - Maria Lange
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, UK; Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, UK; and NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, UK
| | - Dominic Oduro-Donkor
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, UK; Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, UK; and NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, UK
| | - Emma Shuttlewood
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, UK
| | - Martin O Weickert
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, UK; Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, UK; NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, UK; and Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Coventry University, UK
| | - Harpal S Randeva
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, UK; Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, UK; NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, UK; and Aston Medical Research Institute, Aston Medical School, Aston University, UK
| | - Vinod Menon
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, UK
| | - Regi T Alexander
- Adult Learning Disability Services, Hertfordshire Partnership University NHS Foundation Trust, Little Plumstead Hospital, Norwich, UK; and School of Life and Medical Sciences, University of Hertfordshire, UK
| | | | - Rohit Shankar
- Cornwall Institute of Intellectual Disability Research (CIDER), Peninsula Medical School, University of Plymouth, UK and Cornwall Partnership NHS Foundation Trust, UK
| | - Tom M Barber
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, UK; Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, UK; and NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, UK
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4
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Tatta J, Willgens AM, Palombaro KM. Mindfulness and Acceptance-Based Interventions in Physical Therapist Practice: The Time Is Now. Phys Ther 2022; 102:6481182. [PMID: 35079796 DOI: 10.1093/ptj/pzab293] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/03/2021] [Accepted: 11/04/2021] [Indexed: 12/20/2022]
Abstract
UNLABELLED One in 5 adults in the United States lives with a mental illness, and many more struggle with stress-related chronic illnesses. Physical therapists often see the physical effects that stress has on the body, but there is an underutilization of evidence-based stress management strategies with patients and clients. Mindfulness and acceptance-based interventions (MABIs) constitute a family of methods that emphasize present-moment awareness, nonjudgment, and values-based living. They operate by teaching patients to cope with stressful thoughts, emotions, and physical sensations. MABIs are associated with improved health outcomes in areas commonly seen in physical therapist practice, including health promotion, physical function, injury prevention, pain management, immune function, and noncommunicable diseases. The purpose of this Perspective article is to (1) describe MABIs; (2) discuss the relevance of MABIs to physical therapist practice; (3) discuss the positive impact of MABIs for pain, sports, immune function, physical and mental health promotion, and wellness; and (4) identify MABI outcome measures related to health behavior change. It is time. IMPACT Contemporary practice requires that physical therapists manage patient care by addressing both the mind and body. Given the existing research on MABIs, it is time to translate the evidence into minimum accreditable standards for health promotion and prevention of chronic, noncommunicable disease. This approach would have far-reaching benefits for individuals, family units, communities, and society as a whole. LAY SUMMARY Mindfulness instruction delivered by a physical therapist can help improve physical and mental well-being.
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Affiliation(s)
- Joe Tatta
- Integrative Pain Science Institute, New York, New York, USA
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Barber TM, Franks S. Obesity and polycystic ovary syndrome. Clin Endocrinol (Oxf) 2021; 95:531-541. [PMID: 33460482 DOI: 10.1111/cen.14421] [Citation(s) in RCA: 84] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/02/2020] [Accepted: 01/14/2021] [Indexed: 02/06/2023]
Abstract
The increased global prevalence of obesity over the last 40-years has driven a rise in prevalence of obesity-related co-morbidities, including polycystic ovary syndrome (PCOS). On a background of genetic susceptibility, PCOS often becomes clinically manifest following weight gain, commonly during adolescence. A common endocrinopathy affecting between 6%-10% of reproductive-age women, PCOS presents with the cardinal features of hyperandrogenism, reproductive and metabolic dysfunction. PCOS associates with insulin resistance, independently of (but amplified by) obesity. Insulin resistance in PCOS is characterized by abnormal post-receptor signalling within the phosphatidylinositol-kinase (PI3-K) pathway. Multiple factors (including most notably, weight gain) contribute towards the severity of insulin resistance in PCOS. Compensatory hyperinsulinaemia ensues, resulting in over-stimulation of the (intact) post-receptor mitogen-activated protein kinase (MAP-K) insulin pathway, with consequent implications for steroidogenesis and ovarian function. In this concise review, we explore the effects of weight gain and obesity on the pathogenesis of PCOS from the perspective of its three cardinal features of hyperandrogenism, reproductive and metabolic dysfunction, with a focus on the central mediating role of the insulin pathway. We also consider key lifestyle strategies for the effective management of obese and overweight women with PCOS.
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Affiliation(s)
- Thomas M Barber
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Stephen Franks
- Institute of Reproductive & Developmental Biology, Department of Metabolism, Digestion & Reproduction, Imperial College London, London, UK
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Pellegrini M, Carletto S, Scumaci E, Ponzo V, Ostacoli L, Bo S. The Use of Self-Help Strategies in Obesity Treatment. A Narrative Review Focused on Hypnosis and Mindfulness. Curr Obes Rep 2021; 10:351-364. [PMID: 34050891 PMCID: PMC8408071 DOI: 10.1007/s13679-021-00443-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/21/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The aim of this narrative review was to summarize the evidence evaluating the possibilities and limitations of self-hypnosis and mindfulness strategies in the treatment of obesity. RECENT FINDINGS Psychological factors, such as mood disorders and stress, can affect eating behaviors and deeply influence weight gain. Psychological approaches to weight management could increase the motivation and self-control of the patients with obesity, limiting their impulsiveness and inappropriate use of food. The cognitive-behavioral therapy (CBT) represents the cornerstone of obesity treatment, but complementary and self-directed psychological interventions, such as hypnosis and mindfulness, could represent additional strategies to increase the effectiveness of weight loss programs, by improving dysfunctional eating behaviors, self-motivation, and stimulus control. Both hypnosis and mindfulness provide a promising therapeutic option by improving weight loss, food awareness, self-acceptance of body image, and limiting food cravings and emotional eating. Greater effectiveness occurs when hypnosis and mindfulness are associated with other psychological therapies in addition to diet and physical activity. Additional research is needed to determine whether these strategies are effective in the long term and whether they can be routinely introduced into the clinical practice.
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Affiliation(s)
- Marianna Pellegrini
- Department of Medical Sciences, University of Torino, c.so AM Dogliotti 14, 10126, Torino, Italy
| | - Sara Carletto
- Department of Neuroscience "Rita Levi Montalcini", University of Torino, Torino, Italy
| | - Elena Scumaci
- Department of Medical Sciences, University of Torino, c.so AM Dogliotti 14, 10126, Torino, Italy
| | - Valentina Ponzo
- Department of Medical Sciences, University of Torino, c.so AM Dogliotti 14, 10126, Torino, Italy
| | - Luca Ostacoli
- Department of Clinical and Biological Sciences, University of Torino, Torino, Italy
| | - Simona Bo
- Department of Medical Sciences, University of Torino, c.so AM Dogliotti 14, 10126, Torino, Italy.
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Lawlor ER, Islam N, Bates S, Griffin SJ, Hill AJ, Hughes CA, Sharp SJ, Ahern AL. Third-wave cognitive behaviour therapies for weight management: A systematic review and network meta-analysis. Obes Rev 2020; 21:e13013. [PMID: 32181957 PMCID: PMC7379202 DOI: 10.1111/obr.13013] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/28/2020] [Accepted: 02/06/2020] [Indexed: 12/30/2022]
Abstract
This systematic review and network meta-analysis synthesized evidence on the effects of third-wave cognitive behaviour therapies (3wCBT) on body weight, and psychological and physical health outcomes in adults with overweight or obesity. Studies that included a 3wCBT for the purposes of weight management and measured weight or body mass index (BMI) pre-intervention and ≥ 3 months post-baseline were identified through database searches (MEDLINE, CINAHL, Embase, Cochrane database [CENTRAL], PsycINFO, AMED, ASSIA, and Web of Science). Thirty-seven studies were eligible; 21 were randomized controlled trials (RCT) and included in the network meta-analyses. Risk of bias was assessed using RoB2, and evidence quality was assessed using GRADE. Random-effects pairwise meta-analysis found moderate- to high-quality evidence suggesting that 3wCBT had greater weight loss than standard behavioural treatment (SBT) at post-intervention (standardized mean difference [SMD]: -0.09, 95% confidence interval [CI]: -0.22, 0.04; N = 19; I2 = 32%), 12 months (SMD: -0.17, 95% CI: -0.36, 0.02; N = 5; I2 = 33%), and 24 months (SMD: -0.21, 95% CI: -0.42, 0.00; N = 2; I2 = 0%). Network meta-analysis compared the relative effectiveness of different types of 3wCBT that were not tested in head-to-head trials up to 18 months. Acceptance and commitment therapy (ACT)-based interventions had the most consistent evidence of effectiveness. Only ACT had RCT evidence of effectiveness beyond 18 months. Meta-regression did not identify any specific intervention characteristics (dose, duration, delivery) that were associated with greater weight loss. Evidence supports the use of 3wCBT for weight management, specifically ACT. Larger trials with long-term follow-up are needed to identify who these interventions work for, their most effective components, and the most cost-effective method of delivery.
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Affiliation(s)
| | - Nazrul Islam
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | - Sarah Bates
- School of Health and Related Research, Faculty of Medicine, Dentistry and HealthUniversity of SheffieldSheffieldUK
| | - Simon J. Griffin
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
- Primary Care Unit, Institute of Public HealthUniversity of CambridgeCambridgeUK
| | - Andrew J. Hill
- Division of Psychological and Social Medicine, School of MedicineUniversity of LeedsLeedsUK
| | - Carly A. Hughes
- Fakenham Medical PracticeNorfolkUK
- Norwich Medical SchoolUniversity of East AngliaNorwichUK
| | | | - Amy L. Ahern
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
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Aditee D, Pankaj M, Neil B, Nayereh P, Dali F, N Srivatsa U. Meditation for Improved Clinical Outcomes in Patients with Implantable Defibrillators for Heart Failure- Pilot Study. J Atr Fibrillation 2020; 12:2314. [PMID: 33024493 DOI: 10.4022/jafib.2314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 12/23/2019] [Accepted: 02/25/2020] [Indexed: 12/28/2022]
Abstract
Background Sympathetic activation is associated with congestive heart failure (CHF) and leads to adverse clinical events.We hypothesized that meditation by reducing emotional reactivity would have beneficial effect in reducing arrhythmias compared to control patients. Methods Patients known to have CHF and implantable cardioverter defibrillators (ICD) were randomized to Vipassana meditation or usual care control group. Meditation group underwent meditation classes three times during the first week, thereafter every once two weeks. They were encouraged to practice meditation at least once everyday. The ICD was followed by clinic/ remote visits. Atrial (AA) and ventricular arrhythmias (VA) as well cardiac events were assessed in follow up. Chi square test was used to compare nominal variables and t test for continuous variables. Results Patients (n=25, 65% male, mean LVEF 25%, HTN 38%, Diabetes 12%, coronary artery disease 38%, NYHA class 2.2) were followed for 79 + 36 months. Comparing meditation vs control, survival was higher (88%vs 67%); there was less cumulative sustained AF episodes (mean 0.9, IQR 0-1 vs 2.5, IQR 2-4, p=0.045), sustained VT occurred (25% vs 55%, amiodarone use (none vs 44%), and VT ablation in 6.6% vs 33% in the meditation group. Conclusions In this first pilot study of meditation in CHF patients with ICD, during long term follow up, there is a trend for improved survival and reduced arrhythmias in patients randomized to meditation.
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Affiliation(s)
| | | | | | | | - Fan Dali
- Division of Cardiovascular Medicine
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9
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Hanson P, Weickert MO, Barber TM. Obesity: novel and unusual predisposing factors. Ther Adv Endocrinol Metab 2020; 11:2042018820922018. [PMID: 32489583 PMCID: PMC7238298 DOI: 10.1177/2042018820922018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 04/05/2020] [Indexed: 12/28/2022] Open
Abstract
To tackle the complexity of the global obesity epidemic, it is important to consider the many predisposing factors that underlie progressive and sustained weight gain. Some of the biological drivers for weight gain following initial weight loss include persistent changes in appetite hormones [including ghrelin and postprandial plasma peptide YY (PYY)], and 'persistent metabolic adaptation'. However, many factors within our busy, stressful modern-day environment seem to conspire towards promotion of weight gain. These include the effects of sleep deprivation on appetite regulation, and the effects of modern-day technology on 'attention competition'. These factors, combined with cultural and societal factors can result in a 'mindless' attitude regarding eating-related behaviour that is likely to predispose to weight gain. In addition to the external environment, our internal environment within the gut has also changed radically within the last few decades, resulting from changes in fibre intake, and increased ingestion of highly refined, sterilised and processed foods. Although contentious, these dietary changes have implications for our gut microbiota, and possible downstream effects on control of appetite and metabolism. In this brief review, we consider some of the novel predisposing factors for weight gain within our modern-day 21st century environments (both external and internal), and explore how legal terminology can help to conceptualise the numerous factors that contribute towards weight gain, and, ultimately the global obesity epidemic.
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Affiliation(s)
- Petra Hanson
- Clinical Sciences Research Laboratories, Warwick
Medical School, University Hospitals Coventry and Warwickshire, Clifford
Bridge Road, Coventry, CV2 2DX
- Warwickshire Institute for the Study of
Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and
Warwickshire, Clifford Bridge Road, Coventry, CV2 2DX
| | - Martin O. Weickert
- Clinical Sciences Research Laboratories, Warwick
Medical School, University Hospitals Coventry and Warwickshire, Clifford
Bridge Road, Coventry, CV2 2DX
- Warwickshire Institute for the Study of
Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and
Warwickshire, Clifford Bridge Road, Coventry, CV2 2DX
- Centre of Applied Biological & Exercise
Sciences (ABES), Faculty of Health & Life Sciences, Coventry University,
Coventry, UK
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Radin RM, Epel ES, Daubenmier J, Moran P, Schleicher S, Kristeller J, Hecht FM, Mason AE. Do stress eating or compulsive eating influence metabolic health in a mindfulness-based weight loss intervention? Health Psychol 2019; 39:147-158. [PMID: 31724424 DOI: 10.1037/hea0000807] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE We aimed to understand the associations of compulsive eating (CE) and stress eating (SE) with metabolic health among adults with obesity and whether mindfulness-based weight loss training may buffer these associations. METHOD We used data from a trial in which we randomized 194 participants with obesity to a diet-exercise weight loss intervention with either mindful eating training plus mindfulness-based eating awareness and stress management training (n = 100) or active control components (n = 94). We measured CE, SE, weight, and fasting blood glucose (FBG) at baseline, and 6, 12 months, and 18 months. We tested CE and SE as both moderators and mediators of intervention effects on changes in metabolic health. RESULTS Participants higher (+ 1 SD) in CE at baseline randomized to the mindfulness (vs. control) intervention had greater improvements in FBG at 18 months (p = .05). Twelve-month reductions in CE mediated the effect of the intervention on changes in FBG and weight at 12 and 18 months postbaseline (p ≤ .05). Furthermore, those higher (+ 1 SD) in SE at baseline were nearly 2 BMI points higher than those lower (-1 SD) in SE (p < .01). Decreases in SE (B = 3.42; p < .001; 95% CI [2.55, 4.30]) and CE (B = 0.45; p < .001; 95% CI [0.36, 0.54]) in all participants at 6 months were associated with greater weight loss at 18 months. CONCLUSIONS Those with greater compulsive eating may reduce risk for metabolic decline by participating in a mindfulness-based weight loss program. Future obesity interventions should consider tailoring treatment toward trait-level characteristics, such as compulsive eating. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Abstract
As the rate of obesity increases globally, so does the incidence of other non-communicable diseases such as diabetes, cardiovascular disease, cancer, osteoporosis, osteoarthritis, and dementia, which have been referred to as 'adiposity-based chronic disease'. With timely lifestyle modification such as behavioral changes, implementation of a healthy diet, and proper physical activity, many of these diseases can be prevented. Weight gain is one of the major health concerns of midlife. Midlife body changes are the result of aging, menopause, and other influences unique to menopausal women which interfere with adoption of a healthy lifestyle. Reduced metabolism levels lead to low energy levels, which discourage physical activity. In addition, with the onset of bone loss, menopausal women begin to lose muscle mass and gain more fat, resulting in osteopenic sarco-obesity. Adoption of a healthy lifestyle is a first-line option in the treatment for these midlife changes. Lifestyle medicine offers a broad set of network-based interventions, which need to be brought to the forefront in preventing and managing obesity at all stages. This review article focuses on evidence-based lifestyle changes and their benefits for reducing morbidity and mortality related to obesity and its complications prevalent at midlife and beyond.
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Affiliation(s)
- S Khandelwal
- Department of Obstetrics and Gynaecology, Fortis Escort Hospital, Jaipur, India
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12
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Barber TM, Hanson P, Weickert MO, Franks S. Obesity and Polycystic Ovary Syndrome: Implications for Pathogenesis and Novel Management Strategies. CLINICAL MEDICINE INSIGHTS. REPRODUCTIVE HEALTH 2019; 13:1179558119874042. [PMID: 31523137 PMCID: PMC6734597 DOI: 10.1177/1179558119874042] [Citation(s) in RCA: 131] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 08/05/2019] [Indexed: 01/06/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a common female condition typified by reproductive, hyperandrogenic, and metabolic features. Polycystic ovary syndrome is a genetic condition, exacerbated by obesity. There is a close link between obesity and PCOS based on epidemiological data, and more recently corroborated through genetic studies. There are many mechanisms mediating the effects of weight-gain and obesity on the development of PCOS. The metabolic effects of insulin resistance and steroidogenic and reproductive effects of hyperinsulinaemia are important mechanisms. Adipokine production by subcutaneous and visceral fat appears to play a part in metabolic function. However, given the complexity of PCOS pathogenesis, it is important also to consider possible effects of PCOS on further weight-gain, or at least on hampering attempts at weight-loss and maintenance through lifestyle changes. Possible mediators of these effects include changes in energy expenditure, mental ill health, or physical inactivity. In this brief review, we discuss the main mechanisms that underlie the association between obesity and PCOS, from divergent perspectives of weight-gain contributing to development of PCOS and vice versa. We also consider novel management options for women with obesity and PCOS.
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Affiliation(s)
- Thomas M Barber
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Coventry, UK.,Warwick Medical School, University of Warwick, Coventry, UK
| | - Petra Hanson
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Coventry, UK.,Warwick Medical School, University of Warwick, Coventry, UK
| | - Martin O Weickert
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Coventry, UK.,Warwick Medical School, University of Warwick, Coventry, UK.,Centre of Applied Biological and Exercise Sciences, Coventry University, Coventry, UK
| | - Stephen Franks
- Institute of Reproductive Medicine, Imperial College London, London, UK
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13
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Wheatley SD, Whitaker MJG. Why do people overeat? Hunger, psychological eating and type 2 diabetes. PRACTICAL DIABETES 2019. [DOI: 10.1002/pdi.2232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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14
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Black M. Mindful Eating for Weight Loss: Try Before You Buy. J Clin Endocrinol Metab 2019; 104:864-866. [PMID: 30590714 DOI: 10.1210/jc.2018-02551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 12/19/2018] [Indexed: 11/19/2022]
Affiliation(s)
- Marissa Black
- Veterans Affairs Puget Sound Geriatric, Research, and Education Clinical Center (GRECC), Seattle, Washington
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Seattle, Washington
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