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Collazo-Castiñeira P, Sánchez-Izquierdo M, Reiter LJ, Bauer S, Cruz-Jentoft AJ, Schoufour JD, Weijs PJM, Eglseer D. Analysis of behavioral change techniques used in exercise and nutritional interventions targeting adults around retirement age with sarcopenic obesity in a systematic review. Arch Gerontol Geriatr 2024; 123:105437. [PMID: 38653002 DOI: 10.1016/j.archger.2024.105437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/27/2024] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Sarcopenic obesity significantly burdens health and autonomy. Strategies to intervene in or prevent sarcopenic obesity generally focus on losing body fat and building or maintaining muscle mass and function. For a lifestyle intervention, it is important to consider psychological aspects such as behavioral change techniques (BCTs) to elicit a long-lasting behavioral change. PURPOSE The study was carried out to analyze BCTs used in exercise and nutritional interventions targeting community-dwelling adults around retirement age with sarcopenic obesity. METHODS We conducted an analysis of articles cited in an existing systematic review on the effectiveness of exercise and nutritional interventions on physiological outcomes in community-dwelling adults around retirement age with sarcopenic obesity. We identified BCTs used in these studies by applying a standardized taxonomy. RESULTS Only nine BCTs were identified. Most BCTs were not used intentionally (82 %), and those used derived from the implementation of lifestyle components, such as exercise classes ("instructions on how to perform a behavior," "demonstration of the behavior," "behavioral practice/rehearsal," and "body changes"). Only two studies used BCTs intentionally to reinforce adherence in their interventions. CONCLUSIONS Few studies integrated BCTs in lifestyle interventions for community-dwelling persons around retirement age with sarcopenic obesity. Future studies on interventions to counteract sarcopenic obesity should include well-established BCTs to foster adherence and, therefore, their effectiveness.
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Affiliation(s)
- Paula Collazo-Castiñeira
- Geriatric Unit, Hospital Universitario Ramón y Cajal (IRYCIS), Ctra. de Colmenar Viejo, km. 9,100, 28034 Madrid, Spain; Psychology Department, Universidad Pontificia Comillas, C. Universidad Comillas, 3-5 28049 Madrid, Spain
| | - Macarena Sánchez-Izquierdo
- Psychology Department, Universidad Pontificia Comillas, C. Universidad Comillas, 3-5 28049 Madrid, Spain
| | - Lea Joanne Reiter
- Medical University of Graz, Institute of Nursing Science, Neue Stiftingtalstraße 6 West, P/06, 8010, Graz, Austria
| | - Silvia Bauer
- Medical University of Graz, Institute of Nursing Science, Neue Stiftingtalstraße 6 West, P/06, 8010, Graz, Austria
| | - Alfonso J Cruz-Jentoft
- Geriatric Unit, Hospital Universitario Ramón y Cajal (IRYCIS), Ctra. de Colmenar Viejo, km. 9,100, 28034 Madrid, Spain
| | - Josje D Schoufour
- Faculty of Sports and Nutrition, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Dr. Meurerhuis, Dokter Meurerlaan 8, 1067 SM, Amsterdam, the Netherlands
| | - Peter J M Weijs
- Faculty of Sports and Nutrition, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Dr. Meurerhuis, Dokter Meurerlaan 8, 1067 SM, Amsterdam, the Netherlands; Department of Nutrition and Dietetics, Amsterdam University Medical Centers, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - Doris Eglseer
- Medical University of Graz, Institute of Nursing Science, Neue Stiftingtalstraße 6 West, P/06, 8010, Graz, Austria.
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Alharbi AS, Al-Hindi MY, Alqwaiee M, Al-Shamrani A, Alharbi S, Yousef A, Alshammary A, Miqdad A, Said Y, Alnemri A, Alahmadi T, Almudeer AH. Saudi Initiative of Bronchiolitis Diagnosis, Management, and Prevention 2024 updated consensus on the prevention of respiratory syncytial virus. Ann Thorac Med 2024; 19:190-200. [PMID: 39144535 PMCID: PMC11321529 DOI: 10.4103/atm.atm_69_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 04/07/2024] [Indexed: 08/16/2024] Open
Abstract
Respiratory syncytial virus (RSV) is the major cause of bronchiolitis among children under 5 years of age worldwide, accounting for a prevalence of 25%-88% in Saudi Arabia. Although no effective treatment for the virus exists, passive immunoprophylaxis reduced RSV hospitalizations in high-risk children. With recent advances in immunization, the Saudi Initiative of Bronchiolitis Diagnosis, Management, and Prevention panel screened recent relevant international guidelines, locally published data, and expert consensus to update guidelines for RSV prevention, taking into consideration the resources, timing, varying health profiles, and RSV burden in Saudi Arabia. The panel updated its recommendations to include immunization of infants, mothers, and older adults. Practical guidelines were prepared to facilitate the administration of the short-acting and newly developed long-acting RSV monoclonal antibodies (mAb) during the regular follow-ups of high-risk infants in specialized clinics. In addition, long-acting mAb was highlighted as all-infant protection in the routine immunization calendar.
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Affiliation(s)
- Adel S. Alharbi
- Department of Pediatrics, Prince Sultan Military City, Ministry of Defense, Riyadh, Saudi Arabia
| | - Mohammed Y Al-Hindi
- Department of Pediatric, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
- Research and Development, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Department of Pediatrics, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Mansour Alqwaiee
- Department of Pediatrics, Prince Sultan Military City, Ministry of Defense, Riyadh, Saudi Arabia
| | - Abdullah Al-Shamrani
- Department of Pediatrics, Prince Sultan Military City, Ministry of Defense, Riyadh, Saudi Arabia
| | - Saleh Alharbi
- Department of Pediatrics, Umm Al Qura University, Makkah, Saudi Arabia
| | - Abdullah Yousef
- Department of Pediatrics, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Aisha Alshammary
- Department of Pediatrics, Alyammamah Hospital, Ministry of Health, Riyadh, Saudi Arabia
| | - Abeer Miqdad
- Department of Pediatrics, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Yazan Said
- Department of Pediatrics, King Fahad Specialist Hospital, Ministry of Health, Dammam, Saudi Arabia
| | - Abdulrahman Alnemri
- Department of Pediatrics, College of Medicine, Pediatrics Department, King Saud University, Riyadh, Saudi Arabia
| | - Turki Alahmadi
- Department of Pediatrics, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ali Husein Almudeer
- Department of Pediatrics, College of Medicine, Pediatrics Department, King Saud University, Riyadh, Saudi Arabia
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3
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Gavras A, Batsis JA. Medical weight loss in older persons with obesity. Clin Obes 2024:e12684. [PMID: 38924367 DOI: 10.1111/cob.12684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/16/2024] [Accepted: 05/24/2024] [Indexed: 06/28/2024]
Abstract
The prevalence of individuals with obesity or overweight has steadily increased over the past decades both worldwide, and in the United States. This trend is also evident in the older adult population, which has experienced a continuous rise in the number of individuals with overweight or obesity. This is relevant due to the impact of obesity in older adults' quality of life, physical function, morbidity, and healthcare costs. This review aims to provide practical guidance and currently available approaches for healthcare professionals in managing this population. Both non-pharmacological methods such as intensive behavioural therapy, nutritional interventions, and physical activity, as well as anti-obesity medications, are discussed, with a focus on their potential positive and negative effects in older adults. Additionally, bariatric therapy is evaluated, including current procedures available and the associated results and risks in the older population.
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Affiliation(s)
- Alessandro Gavras
- Division of Geriatric Medicine, Department of Medicine, University of Verona, Verona, Italy
- Division of Geriatric Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - John A Batsis
- Division of Geriatric Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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4
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Watanabe N, Inoue K, Hara H, Midorikawa M, Ohta M, Ohkura N. Randomised, double-blind, parallel group comparison of Ashitaba ( Angelica Keiskei) chalcone effects on visceral fat areas and waist circumference of overweight persons. Int J Food Sci Nutr 2024; 75:426-435. [PMID: 38557440 DOI: 10.1080/09637486.2024.2334070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 03/18/2024] [Indexed: 04/04/2024]
Abstract
This randomised, placebo-controlled, double-blind, parallel-group study aimed to determine whether encapsulated Ashitaba chalcone (16 mg comprising 10.1 mg 4-hydroxyderricin and 5.9 mg xanthoangelol) could reduce obesity in 17 men and 25 women with a body mass index (BMI) of 25 to < 30. Participants ingested capsules containing either the chalcone or a placebo daily for 12 weeks. The primary endpoint was changes in visceral fat areas determined by computed tomography (CT) at baseline, and at 8 and 12 weeks later. The primary endpoint, abdominal visceral fat area, was significantly reduced in the chalcone, compared with a placebo group 12 weeks after screening (p < 0.05). The secondary endpoint, waist circumference, was significantly decreased in the chalcone, compared with the placebo group at weeks 8 and 12 (p < 0.05 at week 8; p < 0.01 at week 12). Therefore, Ashitaba chalcone has anti-obesity benefits for overweight men and women.
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Affiliation(s)
| | | | | | | | - Mitsuhiro Ohta
- Research Institute for Production Development, Kyoto, Japan
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5
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Di Fusco SA, Mocini E, Gori M, Iacoviello M, Bilato C, Corda M, De Luca L, Di Marco M, Geraci G, Iacovoni A, Milli M, Navazio A, Pascale V, Riccio C, Scicchitano P, Tizzani E, Gabrielli D, Grimaldi M, Colivicchi F, Oliva F. Italian Association of Hospital Cardiologists position paper-obesity in adults: a clinical primer. Eur Heart J Suppl 2024; 26:ii221-ii235. [PMID: 38784672 PMCID: PMC11110455 DOI: 10.1093/eurheartjsupp/suae031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Obesity is a chronic and relapsing disease characterized by the interaction between individual predispositions and an obesogenic environment. Recent advances in understanding the mechanisms of energetic homoeostasis paved the way to more effective therapeutic approaches compared with traditional treatments. Since obesity is a complex disease, it necessitates a multi-disciplinary approach whose implementation remains challenging. Nonetheless, emerging pharmacological interventions appear promising. Currently, therapeutic success is discreet in the short term but often fails to maintain long-term weight loss due to a high likelihood of weight regain. Cardiologists play a key role in managing patients with obesity, yet often lack familiarity with its comprehensive management. The aim of this document is to summarize knowledge to consolidate essential knowledge for clinicians to effectively treat patients living with obesity. The paper emphasizes the pivotal role of a strong patient-clinician relationship in navigating successful treatment. We analyse the criteria commonly used to diagnose obesity and point out the strengths and limitations of different criteria. Furthermore, we discuss the role of obesiologists and the contributions of cardiologists. In addition, we detail key components of effective therapeutic strategies, including educational aspects and pharmacological options.
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Affiliation(s)
- Stefania Angela Di Fusco
- U.O.C. Cardiologia Clinica e Riabilitativa, Dipartimento di Emergenza e Accettazione, Presidio Ospedaliero San Filippo Neri—ASL Roma 1, via Martinotti 20, 00135 Roma, Italy
| | - Edoardo Mocini
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Mauro Gori
- Dipartimento Cardiovascolare, SSD Chirurgia dei Trapianti e del Trattamento Chirurgico dello Scompenso, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Massimo Iacoviello
- S.C. Di Cardiologia Universitaria-Utic Policlinico Riuniti, Foggia, Italy
| | - Claudio Bilato
- U.O.C. Cardiologia, Dipartimento di Medicina Cardiovascolare, Ospedali dell’Ovest Vicentino, Azienda ULSS 8 Berica, Vicenza, Italy
| | - Marco Corda
- S.C. Cardiologia e UTIC, Dipartimento Cardiovascolare, Azienda Ospedaliera G. Brotzu, Cagliari, Italy
| | - Leonardo De Luca
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Giovanna Geraci
- U.O. Cardiologia, P.O. Sant’Antonio Abate, ASP Trapani, Erice, TP, Italy
| | - Attilio Iacovoni
- Dipartimento Cardiovascolare, SSD Chirurgia dei Trapianti e del Trattamento Chirurgico dello Scompenso, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Massimo Milli
- Cardiologia Firenze 1 (Ospedali S. Maria Nuova e Nuovo San Giovanni di Dio), Azienda USL Toscana Centro, Firenze, Italy
| | - Alessandro Navazio
- S.O.C. Cardiologia Ospedaliera, Presidio Ospedaliero Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia—IRCCS, Reggio Emilia, Italy
| | - Vittorio Pascale
- SOC di Cardiologia-UTIC-Emodinamica e Cardiologia Interventistica, Presidio Ospedaliero ‘Pugliese’, Azienda Ospedaliero-Universitaria ‘Renato Dulbecco’, Catanzaro, Italy
| | - Carmine Riccio
- Dipartimento Cardio-Vascolare, U.O.S.D. Follow-up del Paziente Post-Acuto, AORN Sant’Anna e San Sebastiano, Caserta, Italy
| | | | - Emanuele Tizzani
- Dipartimento di Cardiologia, Ospedale degli Infermi, Rivoli, TO, Italy
| | - Domenico Gabrielli
- Fondazione per il Tuo cuore—Heart Care Foundation, Firenze, Italy
- Dipartimento Cardio-Toraco-Vascolare, U.O.C. Cardiologia, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy
| | - Massimo Grimaldi
- U.O.C. Cardiologia-UTIC, Ospedale Miulli, Acquaviva delle Fonti, BA, Italy
| | - Furio Colivicchi
- U.O.C. Cardiologia Clinica e Riabilitativa, Dipartimento di Emergenza e Accettazione, Presidio Ospedaliero San Filippo Neri—ASL Roma 1, via Martinotti 20, 00135 Roma, Italy
| | - Fabrizio Oliva
- Cardiologia 1-Emodinamica, Dipartimento Cardiotoracovascolare ‘A. De Gasperis’, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
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6
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Yamakage H, Jo T, Tanaka M, Kato S, Hasegawa K, Masuda I, Matsuhisa M, Kotani K, Noda M, Satoh-Asahara N. Five percent weight loss is a significant 1-year predictor and an optimal 5-year cut-off for reducing the number of obesity-related cardiovascular disease risk components: the Japan Obesity and Metabolic Syndrome Study. Front Endocrinol (Lausanne) 2024; 15:1343153. [PMID: 38601201 PMCID: PMC11005029 DOI: 10.3389/fendo.2024.1343153] [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: 11/23/2023] [Accepted: 03/14/2024] [Indexed: 04/12/2024] Open
Abstract
Objective This study aimed to identify the amount of weight loss needed in patients with obesity to improve metabolic syndrome (MetS), a risk factor for cardiovascular disease (CVD), over a long period of time. Methods A total of 576 patients with obesity were enrolled in this study. Effects of continuous physician-supervised weight loss on the cumulative MetS components excluding abdominal circumference (defined as obesity-related CVD risk score) were investigated during a 5-year follow-up period. The extent of weight loss required to reduce the obesity-related CVD risk components was assessed using receiver operating characteristic (ROC) curve analyses. Results Of the 576 participants, 266 completed 5-year follow-up, with 39.1% and 24.1% of them achieving ≥5.0% and ≥7.5% weight loss at the 5-year follow-up, respectively. The area under the ROC curve for reducing the obesity-related CVD risk components was 0.719 [0.662-0.777] at 1 year and 0.694 [0.613-0.775] at 5 years. The optimal cut-off value for weight loss was 5.0% (0.66 sensitivity and 0.69 specificity) and the value with 0.80 specificity was 7.5% (0.45 sensitivity) at 5 years. Greater reductions in weight were associated with greater improvements in the obesity-related CVD risk score at all follow-up periods (P-trend <0.001). Obesity-related CVD risk score was significantly improved by 5.0-7.5% and ≥7.5% weight loss at 1 year (P = 0.029 and P < 0.001, respectively) and ≥7.5% weight loss at 5 years (P = 0.034). Conclusions A weight loss of ≥5.0% at 1 year and ≥7.5% at 5 years could reduce the number of obesity-related CVD risk components in patients with obesity.
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Affiliation(s)
- Hajime Yamakage
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, NHO Kyoto Medical Center, Kyoto, Japan
| | - Takaaki Jo
- Department of General Internal Medicine, Fushimi Momoyama General Hospital, Kyoto, Japan
| | - Masashi Tanaka
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, NHO Kyoto Medical Center, Kyoto, Japan
- Department of Rehabilitation, Health Science University, Minamitsuru-gun, Japan
| | - Sayaka Kato
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, NHO Kyoto Medical Center, Kyoto, Japan
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Koji Hasegawa
- Division of Translational Research, Clinical Research Institute, NHO Kyoto Medical Center, Kyoto, Japan
| | - Izuru Masuda
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, NHO Kyoto Medical Center, Kyoto, Japan
| | - Munehide Matsuhisa
- Diabetes Therapeutics and Research Center, Institute of Advanced Medical Sciences, Tokushima University, Tokushima, Japan
| | - Kazuhiko Kotani
- Division of Community and Family Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Mitsuhiko Noda
- Department of Diabetes, Metabolism and Endocrinology, Ichikawa Hospital, International University of Health and Welfare, Ichikawa, Japan
- Department of Endocrinology and Diabetes, Saitama Medical University, Moroyama, Japan
| | - Noriko Satoh-Asahara
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, NHO Kyoto Medical Center, Kyoto, Japan
- Department of Metabolic Syndrome and Nutritional Science, Research Institute of Environmental Medicine, Nagoya University, Nagoya, Japan
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7
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Cha JY, Kim SY, Lim YW, Choi KH, Shin IS. Comparative Effectiveness of Cognitive Behavioral Therapy and Behavioral Therapy in Obesity: A Systematic Review and Network Meta-Analysis. J Clin Psychol Med Settings 2024:10.1007/s10880-023-10000-6. [PMID: 38285378 DOI: 10.1007/s10880-023-10000-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 01/30/2024]
Abstract
We aimed to evaluate the effects of obesity treatment with behavioral therapy (BT) and cognitive behavioral therapy (CBT) interventions compared with multiple comparators and find effective techniques or combinations of techniques in BT and CBT interventions for weight loss. We systematically searched electronic databases and selected randomized controlled trials using CBT or BT intervention for obesity treatment in overweight adults or adults with obesity without psychological symptoms. Both pairwise meta-analysis and network meta-analysis were performed to comprehensively evaluate the comparative effects between interventions. We classified the techniques used in BT and CBT interventions and compared the treatment effects between techniques. Compared with no treatment as a common comparator, CBT was most effective for weight loss, followed by BT, usual care (UC), and minimal care (MC). CBT was a more effective intervention than BT, but the effect of CBT compared to BT was not remarkable in network estimates. The most used BT techniques were feedback and monitoring, and the most used CBT technique was cognitive restructuring. Our results indicated that CBT and BT are effective interventions for weight loss, and that successful weight loss requires more aggressive interventions such as BT or CBT than MC and UC.
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Affiliation(s)
- Jin-Young Cha
- Nubebe Obesity Research Institute, Seoul, South Korea
| | - Seo-Young Kim
- Nubebe Obesity Research Institute, Seoul, South Korea
- Nubebe Korean Medical Clinic (Incheon Center), Incheon, South Korea
| | - Young-Woo Lim
- Nubebe Obesity Research Institute, Seoul, South Korea
- Nubebe Korean Medical Clinic (Bundang Center), Seongnam, South Korea
| | - Ka-Hye Choi
- Nubebe Korean Medical Clinic (Hongdae Center), Seoul, South Korea
| | - In-Soo Shin
- Graduate School of Education, Dongguk University, 30, Pildong-ro 1 gil, Jung-gu, Seoul, 04620, South Korea.
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8
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Althumiri NA, BinDhim NF, Aldabaeab AE, AlMousa N, Aljabbary RA, Alumran A. Comparing Lifestyle and Behavior of Post-Bariatric Surgery and Participants with Obesity: A Community-Based Cross-Sectional Study. Diabetes Metab Syndr Obes 2024; 17:31-44. [PMID: 38192495 PMCID: PMC10771717 DOI: 10.2147/dmso.s440209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/28/2023] [Indexed: 01/10/2024] Open
Abstract
Background There is a paucity of research dedicated to exploring behavioral change in patients following bariatric surgery. However, there is a need for comparison analysis of individuals with obesity who have received surgical treatment and those who have not opted for any surgical procedures for weight loss. This study is designed to scrutinize the lifestyle choices, behavioral patterns, psychological elements, and eating habits of individuals who have undergone bariatric surgery, in contrast to those with obesity who have not undergone such a procedure. Methods This study is a secondary analysis from Sharik Diet and Health National Survey (SDHNS) dataset, which is a cross-sectional investigation covering the period from 2020 to 2022. The study focused on demographic factors like age, gender, educational attainment, and monthly earnings. Furthermore, other variables such as physical activity, leisure and workplace sitting habits, smoking patterns, strategies for managing weight, and eating and consumption behaviors were also examined. Results Out of the initial 15,980 participants reached, 4,069 satisfied the study's inclusion criteria. Bariatric surgery was reported by 806 participants (19.8%). Upon comparing three obesity status groups - The participants who underwent bariatric surgery with or without obesity, those with obesity who did not opt for any surgical weight loss measure, the analysis found that the three obesity status groups were significantly different in 21 variables from a total of 26. Moreover, a logistic regression analysis revealed that 11 variables influenced persistent obesity in the post-surgery phase, as opposed to those who successfully lost weight. These variables included advanced age, limited education, being female, lower income, waterpipe smoking habits, and the consumption of carbonated drinks. Conclusion This study showed that inability to lose weight after bariatric surgery are linked to poor lifestyle choices and behavior compared to those who were able to lose weight after the surgery.
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Affiliation(s)
- Nora A Althumiri
- Scientific Department, Informed Decision Making (IDM), Riyadh, Saudi Arabia
- Scientific Department, Sharik Association for Research and Studies, Riyadh, Saudi Arabia
| | - Nasser F BinDhim
- Scientific Department, Informed Decision Making (IDM), Riyadh, Saudi Arabia
- Scientific Department, Sharik Association for Research and Studies, Riyadh, Saudi Arabia
| | - Abdulaziz E Aldabaeab
- Obesity Department, King Fahad Hospital of the Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Norah AlMousa
- Scientific Department, Sharik Association for Research and Studies, Riyadh, Saudi Arabia
| | | | - Arwa Alumran
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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9
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Nyman SJ, Vogel ME, Heller GM, Hella JR, Illes RA, Kirkpatrick HA. Development and Evaluation of a Health Behavior Change Clinic in Primary Care: An Interdisciplinary Partnership. J Clin Psychol Med Settings 2023; 30:909-923. [PMID: 36869987 PMCID: PMC9985097 DOI: 10.1007/s10880-023-09945-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 03/05/2023]
Abstract
Providing effective healthy behavior change interventions within primary care presents numerous challenges. Obesity, tobacco use, and sedentary lifestyle negatively impact the health quality of numerous medical patients, particularly in underserved patient populations with limited resources. Primary Care Behavioral Health (PCBH) models, which incorporate a Behavioral Health Consultant (BHC), can offer point-of-contact psychological consultation, treatment, and also provide opportunities for interdisciplinary psychologist-physician clinical partnerships to pair a BHC's health behavior change expertise with the physician's medical care. Such models can also enhance medical training programs by providing resident physicians with live, case-based learning opportunities when partnered with a BHC to address patient health behaviors. We will describe the development, implementation, and preliminary outcomes of a PCBH psychologist-physician interdisciplinary health behavior change clinic within a Family Medicine residency program. Patient outcomes revealed significant reductions (p < .01) in weight, BMI, and tobacco use. Implications and future directions are discussed.
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Affiliation(s)
- Scott J. Nyman
- Department of Clinical Health Psychology, Ascension Genesys Hospital, Grand Blanc, MI USA
- Departments of Family Medicine and Psychiatry, Michigan State University College of Human Medicine, Lansing, MI USA
- Department of Psychology, Ascension Genesys Family Health Center, 1460 N. Center Rd, Burton, MI 48509 USA
| | - Mark E. Vogel
- Department of Clinical Health Psychology, Ascension Genesys Hospital, Grand Blanc, MI USA
- Departments of Family Medicine and Psychiatry, Michigan State University College of Human Medicine, Lansing, MI USA
| | - Grant M. Heller
- Spectrum Health Lakeland, Saint Joseph, MI USA
- Department of Psychiatry, Michigan State University College of Osteopathic Medicine, Lansing, MI USA
| | - Jennifer R. Hella
- Department of Research, Ascension Genesys Hospital, Grand Blanc, MI USA
| | - Rose A. Illes
- Florida State University Family Medicine Residency Program at Lee Health, Fort Myers, FL USA
| | - Heather A. Kirkpatrick
- Department of Clinical Health Psychology, Ascension Genesys Hospital, Grand Blanc, MI USA
- Departments of Family Medicine and Psychiatry, Michigan State University College of Human Medicine, Lansing, MI USA
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10
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Althumiri NA, Bindhim NF, Aldabaeab AE, AlMousa N, Aljabbary R, Alumran A. Comparative analysis of lifestyle behaviors and dietary intake among obese and non-obese individuals following bariatric surgery: a secondary data analysis from 2020 to 2022. Front Nutr 2023; 10:1273164. [PMID: 37964934 PMCID: PMC10642296 DOI: 10.3389/fnut.2023.1273164] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 10/11/2023] [Indexed: 11/16/2023] Open
Abstract
Objective The aim of this research is to perform a comparative examination of lifestyle habits and dietary consumption between obese and non-obese subjects who have undergone bariatric surgery. This is done with the intent of investigating the disparities in obesity outcomes attributable to these elements. Method This study involves a secondary analysis of cross-sectional data obtained from the Sharik Diet and Health National Survey (SDHNS). To ensure a representative distribution of participants, the SDHNS employs a proportional quota sampling strategy, with stratification based on age, sex, and geographic location within Saudi Arabia's 13 administrative regions, utilizing the ZDataCloud® system for this purpose. The data, collected between 2020 and 2022 from over 15,000 participants, were screened to identify the eligible records of individuals who underwent bariatric surgery. Results Within the entire sample, a mere 5.0% (806 individuals) had undertook bariatric surgery, with females comprising 54% of this specific subgroup. The average age within this group was 38.85 years (SD 13.02) and range (18-87). Post-operative results showed that 33% of these individuals remained classified as obese. Utilizing the backward likelihood ratio regression model, it was determined that factors including age, decreased consumption of fresh juices and chicken, as well as current tobacco use, were significantly associated with persistent obesity. Conclusion The findings of this study suggest an association between the non-obese group and healthier lifestyle choices, including the consumption of high-protein diets and fresh juices, alongside a decreased prevalence of smoking. These observations underscore the significance of maintaining a healthy lifestyle for positive weight loss outcomes following bariatric surgery.
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Affiliation(s)
- Nora A. Althumiri
- Informed Decision Making (IDM), Riyadh, Saudi Arabia
- Sharik Association for Research and Studies, Riyadh, Saudi Arabia
| | - Nasser F. Bindhim
- Informed Decision Making (IDM), Riyadh, Saudi Arabia
- Sharik Association for Research and Studies, Riyadh, Saudi Arabia
- College of Medicine, Alafia University, Riyadh, Saudi Arabia
| | | | - Norah AlMousa
- Sharik Association for Research and Studies, Riyadh, Saudi Arabia
| | | | - Arwa Alumran
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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11
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Kurnik Mesarič K, Pajek J, Logar Zakrajšek B, Bogataj Š, Kodrič J. Cognitive behavioral therapy for lifestyle changes in patients with obesity and type 2 diabetes: a systematic review and meta-analysis. Sci Rep 2023; 13:12793. [PMID: 37550475 PMCID: PMC10406954 DOI: 10.1038/s41598-023-40141-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 08/05/2023] [Indexed: 08/09/2023] Open
Abstract
The aim of this systematic review and meta-analysis was to examine the contribution of cognitive behavioral therapy (CBT) to the implementation of lifestyle changes, considering health-related and behavioral outcomes. A systematic literature review was performed using multiple databases (PsycInfo, PubMed and MEDLINE). The inclusion criteria comprised randomised controlled trials of CBT for lifestyle changes in patients with obesity and/or type 2 diabetes. The quality of study reporting was assessed with the revised Cochrane Collaboration's risk of bias tool. A meta-analysis was conducted on studies with appropriate outcomes. Nine randomised controlled trials, with a total sample size of 902 participants, met the inclusion criteria. The meta-analysis has shown a medium, significant effect size of CBT interventions for weight loss and weight maintenance, and a low, non-significant effect size of CBT interventions for reducing glycated hemoglobin (HbA1c) levels. A separate, combined, meta-analysis for all nine calculated effect sizes has yielded a medium and significant overall effect size for the model. Our review of the studies about the effectiveness of CBT in implementing lifestyle changes has, in comparison to usual control groups, proven the efficacy of CBT interventions in implementing lifestyle changes, especially for weight loss and weight maintenance.
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Affiliation(s)
- Katja Kurnik Mesarič
- Department of Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
- Department of Psychology, Faculty of Arts, University of Ljubljana, Ljubljana, Slovenia.
| | - Jernej Pajek
- Department of Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | | | - Špela Bogataj
- Department of Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Jana Kodrič
- Unit of Child Psychiatry, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
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12
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Abstract
Psychological presence in multidisciplinary obesity teams has been highlighted as an important component of such teams. Although mentioned in guidelines and recommendations, there is little information regarding the extent to which this is present currently in weight management services, and in what form. Here, we discuss important ways in which psychological aspects of obesity can impact a person living with obesity and how psychology can be incorporated to provide holistic support in weight management services. Recommendations are also made to create clearer guidelines to provide a more robust reference for the inclusion of psychology in multidisciplinary teams.
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Affiliation(s)
| | - Emma Patten
- East London NHS Foundation Trust, London, UK
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13
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Valdez-Aguilar M, Vazquez-Arevalo R, López-Aguilar X, Ruíz Martínez AO, Rosinska M, Mancilla-Díaz JM. Online multidisciplinary treatment of binge eating disorder in people with high weight: a case series study. J Eat Disord 2023; 11:86. [PMID: 37264431 DOI: 10.1186/s40337-023-00809-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 05/12/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Binge eating disorder (BED) is the most frequent eating behavior among the general population (Guerdjikova in Med Clin 103:669-680, 2019). Many studies on interventions and BED treatments have been carried out in the United States and Europe, few have been reported in Latin American populations. People with this disorder not only have physical consequences of it but also social and psychological ones, therefore a multidisciplinary treatment approach is a good option to treat this condition. OBJECTIVE To evaluate the feasibility of a multidisciplinary online intervention (i.e., psychological, nutritional, and physical activity) in patients with BED. METHOD The design was a case series study of two clinical treatment groups, with pre-test and post-test psychometric measures along with two follow-ups (at 2 and 6 months). Fifteen people diagnosed with BED (2 men and 13 women), with a mean age of 34.93 years (SD=11.91) and a mean initial BMI of 42, participated in this study. The treatment was carried out over the span of 28 sessions, each one being two hours per week consisting of 1 hour of group therapy and 1 hour of individual therapy. There were four evaluations: pre, post and two follow-ups. RESULTS Five patients did not complete the treatment (30%). The comparisons were made through the non-parametric Friedman test, finding a statistically significant decrease in binge eating symptoms (x2=15.57; p=.001), anxiety symptoms (x2=15.96; p=.001) and depression (x2=15.03; p=.002). There was an improvement in clarity (x2=11.60; p=.010) and emotional regulation (x2=7.75; p=.050), only in women. The patients reduced their body weight, and improved their eating and exercise habits by introducing fruits and vegetables and including 20-30 minutes of physical activity into their daily routine. Regarding the Objective Clinical Change Index, in terms of the objective clinical change, a positive change was observed in all the variables addressed. CONCLUSIONS The data presented allowed us to conclude that the online multidisciplinary intervention was effective in the treatment of BED. Trial registration Retrospectively registered.
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Affiliation(s)
- Mariana Valdez-Aguilar
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Estado de México, México.
| | - Rosalia Vazquez-Arevalo
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Estado de México, México
| | - Xóchitl López-Aguilar
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Estado de México, México
| | | | | | - Juan Manuel Mancilla-Díaz
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Estado de México, México
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14
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Crane NT, Butryn ML, Gorin AA, Lowe MR, LaFata EM. Overlapping and distinct relationships between hedonic hunger, uncontrolled eating, food craving, and the obesogenic home food environment during and after a 12-month behavioral weight loss program. Appetite 2023; 185:106543. [PMID: 36940743 PMCID: PMC10121957 DOI: 10.1016/j.appet.2023.106543] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 02/24/2023] [Accepted: 03/17/2023] [Indexed: 03/23/2023]
Abstract
Hedonic hunger, reward-driven eating outside of biological need, is a newer construct in eating behavior research. During behavioral weight loss (BWL), greater improvements in hedonic hunger are associated with higher weight loss, but it remains unclear if hedonic hunger predicts weight loss independent of more well-established, similar constructs (uncontrolled eating and food craving). Research also is needed to understand how hedonic hunger interacts with contextual factors (e.g., obesogenic food environment) during weight loss. Adults (N = 283) in a 12-month randomized controlled trial of BWL were weighed at 0, 12, and 24 months, and completed questionnaires assessing hedonic hunger, food craving, uncontrolled eating, and the home food environment. All variables improved at 12 and 24 months. Decreases in hedonic hunger at 12 months were associated with higher concurrent weight loss, but not when accounting for improvements in craving and uncontrolled eating. At 24 months, reduction in craving was a stronger predictor of weight loss than hedonic hunger, but improvement in hedonic hunger was a stronger predictor of weight loss than change in uncontrolled eating. Changes to the obesogenic home food environment failed to predict weight loss, regardless of levels of hedonic hunger. This study adds novel information on the individual and contextual factors associated with short- and long-term weight control, which can help refine conceptual models and treatment strategies.
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Affiliation(s)
- Nicole T Crane
- Center for Weight, Eating, and Lifestyle Science, Department of Psychological and Brain Sciences, Drexel University, 3141 Chestnut Street, Stratton Hall, Philadelphia, PA, 19104, United States.
| | - Meghan L Butryn
- Center for Weight, Eating, and Lifestyle Science, Department of Psychological and Brain Sciences, Drexel University, 3141 Chestnut Street, Stratton Hall, Philadelphia, PA, 19104, United States
| | - Amy A Gorin
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, J.Ryan Building, 2006 Hillside Road, Storrs, CT, 06269, United States
| | - Michael R Lowe
- Department of Psychological and Brain Sciences, Drexel University, 3141 Chestnut Street, Stratton Hall, Philadelphia, PA, 19104, United States
| | - Erica M LaFata
- Center for Weight, Eating, and Lifestyle Science, Department of Psychological and Brain Sciences, Drexel University, 3141 Chestnut Street, Stratton Hall, Philadelphia, PA, 19104, United States
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15
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Oikarinen N, Jokelainen T, Heikkilä L, Nurkkala M, Hukkanen J, Salonurmi T, Savolainen MJ, Teeriniemi AM. Low eating self-efficacy is associated with unfavorable eating behavior tendencies among individuals with overweight and obesity. Sci Rep 2023; 13:7730. [PMID: 37173366 PMCID: PMC10182077 DOI: 10.1038/s41598-023-34513-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
Success in long-term weight management depends partly on psychological and behavioral aspects. Understanding the links between psychological factors and eating behavior tendencies is needed to develop more effective weight management methods. This population-based cross-sectional study examined whether eating self-efficacy (ESE) is associated with cognitive restraint (CR), uncontrolled eating (UE), emotional eating (EE), and binge eating (BE). The hypothesis was that individuals with low ESE have more unfavorable eating behavior tendencies than individuals with high ESE. Participants were classified as low ESE and high ESE by the Weight-Related Self-Efficacy questionnaire (WEL) median cut-off point. Eating behavior tendencies were assessed with Three Factor Eating Questionnaire R-18 and Binge Eating Scale, and additionally, by the number of difficulties in weight management. The difficulties were low CR, high UE, high EE, and moderate or severe BE. Five hundred and thirty-two volunteers with overweight and obesity were included in the study. Participants with low ESE had lower CR (p < 0.03) and higher UE, EE, and BE (p < 0.001) than participants with high ESE. Thirty-nine percent of men with low ESE had at least two difficulties in successful weight control while this percentage was only 8% in men with high ESE. In women, the corresponding figures were 56% and 10%. The risk of low ESE was increased by high UE [OR 5.37 (95% CI 1.99-14.51)], high EE [OR 6.05 (95% CI 2.07-17.66)], or moderate or severe BE [OR 12.31 (95% CI 1.52-99.84)] in men, and by low CR [OR 5.19 (95% CI 2.22-12.18)], high UE [OR 7.20 (95% CI 2.41-19.22)], or high EE [OR 23.66 (95% CI 4.79-116.77)] in women. Low ESE was associated with unfavorable eating behavior tendencies and multiple concomitant difficulties in successful weight loss promotion. These eating behavior tendencies should be considered when counseling patients with overweight and obesity.
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Affiliation(s)
- Noora Oikarinen
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
| | | | - Laura Heikkilä
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Marjukka Nurkkala
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Janne Hukkanen
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Biocenter Oulu, Oulu, Finland
| | - Tuire Salonurmi
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Research Unit of Health Sciences and Technology (HST), Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Markku J Savolainen
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
- Department of Medicine, Oulu University Hospital, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Anna-Maria Teeriniemi
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland.
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16
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Olszanecka-Glinianowicz M, Mazur A, Chudek J, Kos-Kudła B, Markuszewski L, Dudek D, Major P, Małczak P, Tarnowski W, Jaworski P, Tomiak E. Obesity in Adults: Position Statement of Polish Association for the Study on Obesity, Polish Association of Endocrinology, Polish Association of Cardiodiabetology, Polish Psychiatric Association, Section of Metabolic and Bariatric Surgery of the Association of Polish Surgeons, and the College of Family Physicians in Poland. Nutrients 2023; 15:nu15071641. [PMID: 37049479 PMCID: PMC10097178 DOI: 10.3390/nu15071641] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 03/22/2023] [Accepted: 03/24/2023] [Indexed: 03/30/2023] Open
Abstract
Obesity in adults and its complications are among the most important problems of public health. The search was conducted by using PubMed/MEDLINE, Cochrane Library, Science Direct, MEDLINE, and EBSCO databases from January 2010 to December 2022 for English language meta-analyses, systematic reviews, randomized clinical trials, and observational studies from all over the world. Six main topics were defined in the joint consensus statement of the Polish Association for the Study on Obesity, the Polish Association of Endocrinology, the Polish Association of Cardio-diabetology, the Polish Psychiatric Association, the Section of Metabolic and Bariatric Surgery of the Society of Polish Surgeons, and the College of Family Physicians in Poland: (1) the definition, causes and diagnosis of obesity; (2) treatment of obesity; (3) treatment of main complications of obesity; (4) bariatric surgery and its limitations; (5) the role of primary care in diagnostics and treatment of obesity and barriers; and (6) recommendations for general practitioners, regional authorities and the Ministry of Health. This statement outlines the role of an individual and the adequate approach to the treatment of obesity: overcoming obstacles in the treatment of obesity by primary health care. The approach to the treatment of obesity in patients with its most common complications is also discussed. Attention was drawn to the importance of interdisciplinary cooperation and considering the needs of patients in increasing the long-term effectiveness of obesity management.
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Affiliation(s)
- Magdalena Olszanecka-Glinianowicz
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, 40-055 Katowice, Poland
- Correspondence:
| | - Artur Mazur
- Institute of Medical Sciences, Medical College of Rzeszow University, University of Rzeszów, 35-601 Rzeszow, Poland;
| | - Jerzy Chudek
- Department of Internal Diseases and Oncological Chemotherapy, Medical Faculty in Katowice, Medical University of Silesia, 40-027 Katowice, Poland
| | - Beata Kos-Kudła
- Department of Endocrinology and Neuroendocrine Tumors, Department of Pathophysiology and Endocrinology, Medical University of Silesia, 40-055 Katowice, Poland
| | - Leszek Markuszewski
- Faculty of Medical Sciences and Health Sciences, University of Humanities and Technology in Radom, 26-600 Radom, Poland
| | - Dominika Dudek
- Department of Psychiatry, Jagiellonian University Medical College, 31-008 Cracow, Poland
| | - Piotr Major
- 2nd Department of General Surgery, Jagiellonian University Medical College, 31-008 Cracow, Poland
| | - Piotr Małczak
- 2nd Department of General Surgery, Jagiellonian University Medical College, 31-008 Cracow, Poland
| | - Wiesław Tarnowski
- Department of General, Oncological and Bariatric Surgery, Centre of Postgraduate Medical Education, Orłowski Hospital, 00-416 Warsaw, Poland
| | - Paweł Jaworski
- Department of General, Oncological and Bariatric Surgery, Centre of Postgraduate Medical Education, Orłowski Hospital, 00-416 Warsaw, Poland
| | - Elżbieta Tomiak
- The College of Family Physicians in Poland, 00-209 Warsaw, Poland
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17
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Imhagen A, Karlsson J, Jansson S, Anderzén-Carlsson A. A lifelong struggle for a lighter tomorrow: A qualitative study on experiences of obesity in primary healthcare patients. J Clin Nurs 2023; 32:834-846. [PMID: 35655375 PMCID: PMC10084391 DOI: 10.1111/jocn.16379] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/25/2022] [Accepted: 05/17/2022] [Indexed: 11/30/2022]
Abstract
AIM To describe experiences of living with obesity before the start of a group-based lifestyle intervention. BACKGROUND Obesity is a chronic disease that affects a person's physical and psychological health. Increased knowledge of experiences of living with obesity is required. DESIGN A qualitative study with a descriptive design. METHODS Semi-structured individual interviews with 17 participants living with obesity (Body Mass Index 32-49) were conducted between October and November 2019. The interviews were analysed using qualitative content analysis. The COREQ checklist was followed. RESULTS The analysis resulted in one main theme: Struggling for a lighter tomorrow and three subthemes: Suffering, Resilience and Need for support in making changes. For the majority of the participants, living with obesity was a lifelong struggle involving suffering on different levels. Yet despite this, the participants had not given up and hoped for a better life. They showed a degree of resilience and motivation, and a perceived ability to achieve lifestyle changes. However, there was a pronounced need for support to help them achieve this. CONCLUSION Living with obesity is complex and carries a risk of medical complications as well as psychosocial suffering. Healthy lifestyle habits to achieve better health and to lose weight should be encouraged, taking patient resources into account. Patients also need help in handling weight stigmatisation, and both healthcare professionals and society must engage with this. RELEVANCE TO CLINICAL PRACTICE Obesity is a chronic disease, and patients need ongoing support. Therefore, care for patients with obesity in primary health care must be further developed. Patient resources and strengths have to be acknowledged and encouraged in the process of helping them adopt healthy lifestyle habits. The findings of this study can contribute to ending weight stigmatisation by increasing the knowledge of living with obesity.
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Affiliation(s)
- Annika Imhagen
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
| | - Jan Karlsson
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
| | - Stefan Jansson
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Agneta Anderzén-Carlsson
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
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18
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Salituro N, Landi G, Garelli S, Balsamo F, Rottoli M, Cattivelli R, Tossani E, Grandi S, Pagotto U, Bernante P, Agostini A. The impact of psychological distress on weight regain in post-bariatric patients during the COVID-19 pandemic: A latent profile analysis. J Psychosom Res 2023; 165:111144. [PMID: 36608506 PMCID: PMC9805045 DOI: 10.1016/j.jpsychores.2022.111144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 12/29/2022] [Accepted: 12/29/2022] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The COVID-19 pandemic has caused a global health crisis disrupting healthcare delivery for people with severe obesity who have undergone bariatric surgery. This study examined the role of psychological distress during the first Italian COVID-19 lockdown in predicting post-operative outcomes in post-bariatric patients reaching the end of the 12-18 months follow-up during the lockdown. By using a person-centered approach, groups of patients with different psychological distress profiles were identified. We hypothesized that compared to post-bariatric patients with low psychological distress, post-bariatric patients with high psychological distress will be more at risk of weight regain. METHODS A total of 67 patients (71.6% female, Mage = 45.9) participated in this observational retrospective cohort study. Patients' anthropometric data were gathered from medical records while the weight at the end of the lockdown through phone interviews. Psychological distress, operationalized with anxiety symptoms, depressive symptoms, and sleep disturbances, was assessed by an online self-report questionnaire. RESULTS Significant differences were highlighted in the high and low psychological distressed group in weight changes, F(1,58) = 5.2, p < 0.001, η2 = 0.3. Specifically, compared to post-bariatric patients in the low psychological distress group, those in the high psychological distressed group reported weight regained (95% CI = 1.0, 2.6). CONCLUSION Results highlight the need to target post-bariatric patients with high psychological distress who are at risk for weight regain during the COVID-19 pandemic. Interventions mitigating psychological distress and obesogenic behaviors during future pandemics or in post-COVID times are needed in vulnerable post-bariatric patients reporting high psychological distress.
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Affiliation(s)
- N. Salituro
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - G. Landi
- Department of Psychology “Renzo Canestrari”, University of Bologna, Italy,Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Cesena, Italy,Corresponding author at: Department of Psychology, University of Bologna, viale Berti Pichat 5, Bologna 40127, Italy
| | - S. Garelli
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - F. Balsamo
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), S. Orsola-Malpighi Hospital, Alma Mater University of Bologna, Bologna 40138, Italy
| | - M. Rottoli
- Surgery of the Alimentary Tract, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - R. Cattivelli
- Department of Psychology “Renzo Canestrari”, University of Bologna, Italy,Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Cesena, Italy
| | - E. Tossani
- Department of Psychology “Renzo Canestrari”, University of Bologna, Italy,Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Cesena, Italy
| | - S. Grandi
- Department of Psychology “Renzo Canestrari”, University of Bologna, Italy,Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Cesena, Italy
| | - U. Pagotto
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - P. Bernante
- Surgery of the Alimentary Tract, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - A. Agostini
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), S. Orsola-Malpighi Hospital, Alma Mater University of Bologna, Bologna 40138, Italy
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19
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Pitil PP, Ghazali SR. Acceptance and Commitment Therapy and Weight-Related Difficulties in Overweight and Obese Adults: A Systematic Review. Psychol Rep 2022:332941221149172. [PMID: 36571322 DOI: 10.1177/00332941221149172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Multiple studies have investigated the efficacy of acceptance and commitment therapy (ACT) in improving psychological flexibility among overweight and obese individuals. However, to date, no specific reviews have focused on ACT and weight-related difficulties in this population. This systematic review of the literature aims to identify and assemble all ACT interventions in randomized controlled trials (RCT) that address weight-related difficulties in the treatment of overweight and obese adults. The PRISMA 2020 framework was used for the systematic review, includes manual and computerized database searches. Five databases (Medline, PubMed, Scopus, PsycInfo, and Google) were utilized to gather all articles that: (a) published in English; (b) adopted the RCT design; (c) used ACT as an intervention; (d) included adult participants aged over 18 years with BMI of over 25 kg/m2, and (e) included weight-related difficulties and weight as outcome measures. The review identified seven studies comprising 698 overweight or obese participants of both genders. Improvements were reported in weight-related difficulties and percentage of weight loss in the ACT group and the non-ACT group. The present review supports ACT as an effective intervention that can help adults with weight-related difficulties and excess body weight. Further studies should be conducted in various overweight or obese populations with a more systematic RCT research design to establish the effectiveness of ACT in this area.
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Affiliation(s)
- Patricia Pawa Pitil
- Faculty of Medicine & Health Sciences, 54706Universiti Malaysia Sarawak, Kota Samarahan, Malaysia
- Faculty of Sports Science & Recreation, Universiti Teknologi MARA Sarawak Branch, Kota Samarahan, Malaysia
| | - Siti Raudzah Ghazali
- Faculty of Medicine & Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Malaysia
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Distinct factors associated with short-term and long-term weight loss induced by low-fat or low-carbohydrate diet intervention. Cell Rep Med 2022; 3:100870. [PMID: 36516846 PMCID: PMC9798029 DOI: 10.1016/j.xcrm.2022.100870] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 09/16/2022] [Accepted: 11/21/2022] [Indexed: 12/15/2022]
Abstract
To understand what determines the success of short- and long-term weight loss, we conduct a secondary analysis of dietary, metabolic, and molecular data collected from 609 participants before, during, and after a 1-year weight-loss intervention with either a healthy low-carbohydrate (HLC) or a healthy low-fat (HLF) diet. Through systematic analysis of multidomain datasets, we find that dietary adherence and diet quality, not just caloric restriction, are important for short-term weight loss in both diets. Interestingly, we observe minimal dietary differences between those who succeeded in long-term weight loss and those who did not. Instead, proteomic and gut microbiota signatures significantly differ between these two groups at baseline. Moreover, the baseline respiratory quotient may suggest a specific diet for better weight-loss outcomes. Overall, the identification of these dietary, molecular, and metabolic factors, common or unique to the HLC and HLF diets, provides a roadmap for developing individualized weight-loss strategies.
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Sex Differences in Emotions and Eating Behaviors among People Affected by Obesity. Brain Sci 2022; 12:brainsci12121663. [PMID: 36552124 PMCID: PMC9775181 DOI: 10.3390/brainsci12121663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/30/2022] [Accepted: 11/30/2022] [Indexed: 12/07/2022] Open
Abstract
Relatively little research has examined sex differences among people affected by obesity. The aim of this study is to assess the relationship between negative emotions and eating behaviors, taking into account the role of biological sex. The final sample consists of 200 candidates for bariatric surgery, 62 males (31%) and 138 females (69%), aged from 18 to 60 years (M = 40.71; SD = 11.30). Participants were screened with the Binge Scale Questionnaire (BSQ) and individually evaluated with the Eating Disorder Inventory (EDI) and the Profile of Mood States (POMS). Correlations were calculated by splitting the sample by sex. Analyses of the relationship between negative emotions and eating behavior showed a large number of correlations in the sample of women and few correlations in men. The differences between women and men with obesity suggest the need for a different theoretical construct that explains the differentiated mechanisms of functioning and lays the foundations for specific therapeutic paths.
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Changes in Nutritional State and Cardiovascular Parameters in Alimentary Obese Children after a Month-Long Stay in Children's Treatment Center. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9111610. [PMID: 36360338 PMCID: PMC9688163 DOI: 10.3390/children9111610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022]
Abstract
Childhood and adolescent obesity has become an important public health issue, as it leads to higher risk of cardio−metabolic, orthopedic, and psychological comorbidities. The aim of this study was to evaluate the changes in nutritional state and cardiovascular system parameters in obese children. Sixty respondents aged 9−17 years with alimentary obesity participated in this research. Anthropometric parameters (body weight (BWT), body mass index (BMI), percentage of body fat (%), waist and hip circumference (WC and HC), waist−hip ratio (WHR)) and cardiovascular parameters (systolic and diastolic blood pressure (SP and DP), cardio-ankle vascular index (CAVI), ankle-brachial index (ABI), pulse wave velocity and its variability (PWV and PWVV), and parameters of pulse wave analysis) were measured. Every respondent went through two sets of measurements, the first (I.) after their admission to the children’s hospital and the second (II.) at the end of their one-month-long therapeutic stay. Statistically significant differences between measurements I. and II. were observed in the following parameters: BWT (p < 0.01), BMI (p < 0.01), WC (p < 0.01), HC (p < 0.01), DP (p < 0.01), PWV (p < 0.05), and ABI (p < 0.01). The results of this study show that obesity has a mostly negative impact on the cardiovascular health of affected children, with likely negative results in their adulthood.
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Mazur A, Zachurzok A, Baran J, Dereń K, Łuszczki E, Weres A, Wyszyńska J, Dylczyk J, Szczudlik E, Drożdż D, Metelska P, Brzeziński M, Kozioł-Kozakowska A, Matusik P, Socha P, Olszanecka-Gilianowicz M, Jackowska T, Walczak M, Peregud-Pogorzelski J, Tomiak E, Wójcik M. Childhood Obesity: Position Statement of Polish Society of Pediatrics, Polish Society for Pediatric Obesity, Polish Society of Pediatric Endocrinology and Diabetes, the College of Family Physicians in Poland and Polish Association for Study on Obesity. Nutrients 2022; 14:nu14183806. [PMID: 36145182 PMCID: PMC9505061 DOI: 10.3390/nu14183806] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/05/2022] [Accepted: 09/09/2022] [Indexed: 11/16/2022] Open
Abstract
Childhood obesity is one of the most important problems of public health. Searching was conducted by using PubMed/MEDLINE, Cochrane Library, Science Direct, MEDLINE, and EBSCO databases, from January 2022 to June 2022, for English language meta-analyses, systematic reviews, randomized clinical trials, and observational studies from all over the world. Five main topics were defined in a consensus join statement of the Polish Society of Pediatrics, Polish Society for Pediatric Obesity, Polish Society of Pediatric Endocrinology and Diabetes and Polish Association for the Study on Obesity: (1) definition, causes, consequences of obesity; (2) treatment of obesity; (3) obesity prevention; (4) the role of primary care in the prevention of obesity; (5) Recommendations for general practitioners, parents, teachers, and regional authorities. The statement outlines the role of diet, physical activity in the prevention and treatment of overweight and obesity, and gives appropriate recommendations for interventions by schools, parents, and primary health care. A multisite approach to weight control in children is recommended, taking into account the age, the severity of obesity, and the presence of obesity-related diseases. Combined interventions consisting of dietary modification, physical activity, behavioral therapy, and education are effective in improving metabolic and anthropometric indices. More actions are needed to strengthen the role of primary care in the effective prevention and treatment of obesity because a comprehensive, multi-component intervention appears to yield the best results.
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Affiliation(s)
- Artur Mazur
- Institute of Medical Sciences, Medical College of Rzeszow University, University of Rzeszów, 35-310 Rzeszów, Poland
- Correspondence: (A.M.); (A.Z.); (M.W.)
| | - Agnieszka Zachurzok
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Zabrze, Poland
- Correspondence: (A.M.); (A.Z.); (M.W.)
| | - Joanna Baran
- Institute of Health Sciences, Medical College of Rzeszow University, University of Rzeszów, 35-310 Rzeszów, Poland
| | - Katarzyna Dereń
- Institute of Health Sciences, Medical College of Rzeszow University, University of Rzeszów, 35-310 Rzeszów, Poland
| | - Edyta Łuszczki
- Institute of Health Sciences, Medical College of Rzeszow University, University of Rzeszów, 35-310 Rzeszów, Poland
| | - Aneta Weres
- Institute of Health Sciences, Medical College of Rzeszow University, University of Rzeszów, 35-310 Rzeszów, Poland
| | - Justyna Wyszyńska
- Institute of Health Sciences, Medical College of Rzeszow University, University of Rzeszów, 35-310 Rzeszów, Poland
| | - Justyna Dylczyk
- Children’s University Hospital, Jagiellonian University Medical College, 31-008 Kraków, Poland
| | - Ewa Szczudlik
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Pediatric Institute, Jagiellonian University Medical College, 31-008 Kraków, Poland
| | - Dorota Drożdż
- Department of Pediatric Nephrology and Hypertension, Chair of Pediatrics, Pediatric Institute, Jagiellonian University Medical College, 31-008 Kraków, Poland
| | - Paulina Metelska
- Department of Public Health and Social Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Michał Brzeziński
- Chair and Department of Paediatrics, Gastroenterology, Allergology and Child Nutrition, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Agnieszka Kozioł-Kozakowska
- Department of Pediatrics, Gastroenterology and Nutrition, Jagiellonian University Medical College, 31-008 Kraków, Poland
| | - Paweł Matusik
- Department of Pediatrics, Pediatric Obesity and Metabolic Bone Diseases, Chair of Pediatrics and Pediatric Endocrinology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland
| | - Piotr Socha
- The Children’s Memorial Health Institute, 04-736 Warsaw, Poland
| | - Magdalena Olszanecka-Gilianowicz
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, 40-055 Katowice, Poland
| | - Teresa Jackowska
- Department of Pediatrics, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland
| | - Mieczysław Walczak
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Disorders and Cardiology of the Developmental Age, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Jarosław Peregud-Pogorzelski
- Department of Pediatrics, Pediatric Oncology and Immunology, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Elżbieta Tomiak
- The College of Family Physicians in Poland, 00-209 Warszawa, Poland
| | - Małgorzata Wójcik
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Pediatric Institute, Jagiellonian University Medical College, 31-008 Kraków, Poland
- Correspondence: (A.M.); (A.Z.); (M.W.)
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Personal motivation, self-regulation barriers and strategies for weight loss in people with overweight and obesity: a thematic framework analysis. Public Health Nutr 2022; 25:2426-2435. [PMID: 35190011 PMCID: PMC9991665 DOI: 10.1017/s136898002200043x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To explore motivations, self-regulation barriers and strategies in a multi-ethnic Southeast Asian population with overweight and obesity. DESIGN Qualitative design using semi-structured face-to-face and videoconferencing interviews. Data were analysed using thematic framework analysis and constant comparison method. SETTING Specialist weight management clinic. PARTICIPANTS Twenty-two participants were purposively sampled from 13 April to 30 April 2021. Median age and BMI of the participants were 37·5 (interquartile range (IQR) = 13·3) and 39·2 kg/m2 (IQR = 6·1), respectively. And 31·8 % were men, majority had a high intention to adopt healthy eating behaviours (median = 6·5; IQR = 4·8-6·3) and 59 % of the participants had a medium level of self-regulation. RESULTS Six themes and fifteen subthemes were derived. Participants were motivated to lose weight by the sense of responsibility as the family's pillar of support and to feel 'normal' again. We coupled self-regulation barriers with corresponding strategies to come up with four broad themes: habitual overconsumption - mindful self-discipline; proximity and convenience of food available - mental tenacity; momentary lack of motivation and sense of control - motivational boosters; and overeating triggers - removing triggers. We highlighted six unique overeating triggers namely: trigger activities (e.g. using social media); eating with family, friends and colleagues; provision of food by someone; emotions (e.g. feeling bored at home, sad and stressed); physiological condition (e.g. premenstrual syndrome); and the time of the day. CONCLUSIONS Future weight management interventions should consider encompassing participant-led weight loss planning, motivation boosters and self-regulation skills to cope with momentary overeating triggers.
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Omondi H, Freysteinson W. The mirror and obesity: A systematic review on the effects of mirror exposure on behaviour and obese individuals. J Clin Nurs 2022; 31:2367-2376. [PMID: 34741363 DOI: 10.1111/jocn.16107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/21/2021] [Accepted: 10/12/2021] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To review the literature regarding the effects of mirror exposure on behaviour and obese patients. The review explored how mirror exposure influences behaviour in obese patients in terms of activity level, psychology and eating habits. BACKGROUND Obesity is a major epidemic that affects people worldwide but is more predominant in the Western world. Many health issues are directly linked to obesity, and current therapies have failed to provide a sustainable resolution to this problem. Mirror exposure has been used in eating disorders such as anorexia nervosa, bulimia and binge eating; however, there exists a gap in the use of mirrors in obese patients. The literature review focuses on the effects of mirror exposure on behaviour and obese patients. METHOD A literature review of articles published between 2006 and 2020 related to mirror exposure in obese patients and the related effects. RESULTS Literature that explicitly discussed mirror exposure in obese patients was included; five research articles were reviewed. CONCLUSIONS Mirror exposure can influence behaviour modification in obese patients. Therefore, the use of mirrors should be considered as an adjunct therapy in this group of patients. RELEVANCE TO CLINICAL PRACTICE Mirror exposure can positively alter behaviour in obese patients and can be used as an intervention in clinical practice to assist in weight loss and improve health outcomes.
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Executive Function-Related Improvements on a Commercial CBT-Based Weight Management Intervention: Pilot Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148763. [PMID: 35886615 PMCID: PMC9320503 DOI: 10.3390/ijerph19148763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/06/2022] [Accepted: 07/14/2022] [Indexed: 11/17/2022]
Abstract
Executive functioning is a key component involved in many of the processes necessary for effective weight management behavior change (e.g., setting goals). Cognitive behavioral therapy (CBT) and third-wave CBT (e.g., mindfulness) are considered first-line treatments for obesity, but it is unknown to what extent they can improve or sustain executive functioning in a generalized weight management intervention. This pilot randomized controlled trial examined if a CBT-based generalized weight management intervention would affect executive functioning and executive function-related brain activity in individuals with obesity or overweight. Participants were randomized to an intervention condition (N = 24) that received the Noom Weight program or to a control group (N = 26) receiving weekly educational newsletters. EEG measurements were taken during Flanker, Stroop, and N-back tasks at baseline and months 1 through 4. After 4 months, the intervention condition evidenced greater accuracy over time on the Flanker and Stroop tasks and, to a lesser extent, neural markers of executive function compared to the control group. The intervention condition also lost more weight than controls (−7.1 pounds vs. +1.0 pounds). Given mixed evidence on whether weight management interventions, particularly CBT-based weight management interventions, are associated with changes in markers of executive function, this pilot study contributes preliminary evidence that a multicomponent CBT-based weight management intervention (i.e., that which provides both support for weight management and is based on CBT) can help individuals sustain executive function over 4 months compared to controls.
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Ho AS, Behr H, Mitchell ES, Yang Q, Lee J, May CN, Michaelides A. Goal language is associated with attrition and weight loss on a digital program: Observational study. PLOS DIGITAL HEALTH 2022; 1:e0000050. [PMID: 36812521 PMCID: PMC9931249 DOI: 10.1371/journal.pdig.0000050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 04/24/2022] [Indexed: 06/18/2023]
Abstract
Behavioral weight loss reduces risk of weight-related health complications. Outcomes of behavioral weight loss programs include attrition and weight loss. There is reason to believe that individuals' written language on a weight management program may be associated with outcomes. Exploring associations between written language and these outcomes could potentially inform future efforts towards real-time automated identification of moments or individuals at high risk of suboptimal outcomes. Thus, in the first study of its kind, we explored whether individuals' written language in actual use of a program (i.e., outside of a controlled trial) is associated with attrition and weight loss. We examined two types of language: goal setting (i.e., language used in setting a goal at the start of the program) and goal striving (i.e., language used in conversations with a coach about the process of striving for goals) and whether they are associated with attrition and weight loss on a mobile weight management program. We used the most established automated text analysis program, Linguistic Inquiry Word Count (LIWC), to retrospectively analyze transcripts extracted from the program database. The strongest effects emerged for goal striving language. In striving for goals, psychologically distanced language was associated with more weight loss and less attrition, while psychologically immediate language was associated with less weight loss and higher attrition. Our results highlight the potential importance of distanced and immediate language in understanding outcomes like attrition and weight loss. These results, generated from real-world language, attrition, and weight loss (i.e., from individuals' natural usage of the program), have important implications for how future work can better understand outcomes, especially in real-world settings.
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Affiliation(s)
- Annabell Suh Ho
- Academic Research, Noom, Inc., New York, New York, United States of America
| | - Heather Behr
- Academic Research, Noom, Inc., New York, New York, United States of America
- Department of Integrative Health, Saybrook University, Pasadena, California, United States of America
| | | | - Qiuchen Yang
- Academic Research, Noom, Inc., New York, New York, United States of America
| | - Jihye Lee
- Department of Communication, Stanford University, Stanford, California, United States of America
| | - Christine N. May
- Academic Research, Noom, Inc., New York, New York, United States of America
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Jiskoot G, de Loos AD, Timman R, Beerthuizen A, Laven J, Busschbach J. Changes in eating behavior through lifestyle treatment in women with polycystic ovary syndrome (PCOS): a randomized controlled trial. J Eat Disord 2022; 10:69. [PMID: 35581616 PMCID: PMC9116037 DOI: 10.1186/s40337-022-00593-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Eating behaviors like emotional eating, external eating and restrained eating play an important role in weight gain and weight loss in the general population. Improvements in eating behavior are important for long-term weight. This has not yet been studied in women with Polycystic Ovary Syndrome (PCOS). The aim of this study is to examine if a three-component lifestyle intervention (LI) is effective for improving disordered eating behavior in women with PCOS. METHODS Women diagnosed with PCOS (N = 183), with a body mass index (BMI) > 25 kg/m2 and trying to achieve a pregnancy were either assigned to 1 year of 20 group sessions of cognitive behavioral therapy (CBT) combined with nutritional advice and exercise with or without additional feedback through Short Message Service (SMS) or Care As Usual (CAU), which includes the advice to lose weight using publicly available services. RESULTS The Eating Disorder Examination Questionnaire (EDEQ) scores worsened in CAU (47.5%) and improved in the LI (4.2%) at 12 months. The difference between the LI and CAU was significant (P = 0.007) and resulted in a medium to large effect size (Cohen's d: - 0.72). No significant differences were observed in EDEQ scores between LI with SMS compared to LI without SMS (Cohen's d: 0.28; P = 0.399). Also, weight loss did not mediate the changes in eating behavior. An overall completion rate of 67/183 (36.6%) was observed. CONCLUSIONS A three-component CBT lifestyle program resulted in significant improvements in disordered eating behavior compared to CAU. Changes in disordered eating behavior are important for long-term weight loss and mental health. TRIAL REGISTRATION NTR, NTR2450. Registered 2 August 2010, https://www.trialregister.nl/trial/2344.
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Affiliation(s)
- Geranne Jiskoot
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. .,Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Alexandra Dietz de Loos
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Reinier Timman
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Annemerle Beerthuizen
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Joop Laven
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Jan Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
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Jiskoot G, van der Kooi AL, Busschbach J, Laven J, Beerthuizen A. Cognitive behavioural therapy for depression in women with Polycystic Ovary Syndrome (PCOS): systematic review and meta-analysis. Reprod Biomed Online 2022; 45:599-607. [DOI: 10.1016/j.rbmo.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/21/2022] [Accepted: 05/03/2022] [Indexed: 10/18/2022]
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Effect of Mobility Restrictions During the Coronavirus Disease Epidemic on Body Composition and Exercise Tolerance in Patients With Obesity: Single Institutional Retrospective Cohort Study. J Phys Act Health 2022; 19:351-357. [PMID: 35393373 DOI: 10.1123/jpah.2021-0649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 02/05/2022] [Accepted: 02/18/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND This study investigated the effects of mobility restrictions (MRs) during the COVID-19 epidemic on physical activity, body composition, and exercise tolerance in patients with obesity. METHODS We analyzed data of obesity patients participating in a 6-month weight loss program in February 2020, and after, when the epidemic was considered to have had some effect on outdoor activity in Osaka, Japan (MR group). MR group patients were compared to patients with obesity attending the program in 2018 and 2019 (non-MR group) who had a similar number of months as MR group. Changes in physical activity, body composition, and exercise tolerance (O2 consumption; VO2) owing to the weight loss program were analyzed between both groups using analysis of covariance and logistic regression analysis. RESULTS Decreases in body fat were significantly higher in MR group than in non-MR group. However, increases in physical activity, VO2 at anaerobic threshold, and peak VO2 were significantly lower in MR group; however, increases in peak VO2 owing to the weight loss program were less likely to be achieved in MR group (odds ratio, 0.21; 95% confidence interval, 0.06-0.81). CONCLUSION MR during the COVID-19 epidemic may have affected the exercise tolerance of patients with obesity.
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Lurati A. Depression and Obesity. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Guerrini Usubini A, Varallo G, Giusti EM, Cattivelli R, Granese V, Consoli S, Bastoni I, Volpi C, Castelnuovo G. The Mediating Role of Psychological Inflexibility in the Relationship Between Anxiety, Depression, and Emotional Eating in Adult Individuals With Obesity. Front Psychol 2022; 13:861341. [PMID: 35432111 PMCID: PMC9012297 DOI: 10.3389/fpsyg.2022.861341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/11/2022] [Indexed: 12/22/2022] Open
Abstract
The aim of this cross-sectional study is to investigate the role of psychological inflexibility in the relationship between anxiety and depression and emotional eating in a sample of 123 inpatient Italian adult individuals with obesity. Participants completed the Anxiety and Depression subscales of the Psychological General Well-Being Inventory, the Acceptance and Action Questionnaire, and the Emotional Eating subscale of the Dutch Eating Behavior Questionnaire to assess anxiety and depression, psychological inflexibility, and emotional eating, respectively. Results showed that the indirect effect of PGWBI-A on DEBQ-EE through AAQ-II was significant [b = -0.0155; SE = 0.076; 95% BC-CI (-0.0320 to -0.023)]. Similarly, the indirect effect of PGWBI-D on DEBQ-EE through AAQ-II was significant [b = -0.0383; SE = 0.0207; 95% BC-CI (-0.0810 to -0.0002)]. These findings may help to plan and develop specific psychological interventions aimed at addressing emotional eating through targeting psychological inflexibility to be included in obesity treatment programs.
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Affiliation(s)
- Anna Guerrini Usubini
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | | | | | | | - Valentina Granese
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Simone Consoli
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
| | - Ilaria Bastoni
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
| | - Clarissa Volpi
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
| | - Gianluca Castelnuovo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
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Plasonja N, Brytek-Matera A, Décamps G. Psychological Profiles of Treatment-Seeking Adults with Overweight and Obesity: A Cluster Analysis Approach. J Clin Med 2022; 11:jcm11071952. [PMID: 35407559 PMCID: PMC8999798 DOI: 10.3390/jcm11071952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/25/2022] [Accepted: 03/28/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Overweight and obesity are associated with depression and well-being. Some psychological characteristics play a role in explaining well-being and depression in obesity and in identifying specific patient profiles. However, subtyping individuals with overweight/obesity based on variables like self-esteem or stress has not often been done. Therefore, our objective was to explore the psychological profiles of treatment-seeking individuals overweight or with obesity and to compare their depression and well-being. METHODS Data regarding eating self-efficacy, well-being, depression, physical hunger, self-esteem, body satisfaction and perceived stress in individuals with overweight/obesity were collected from the ESTEAM cohort. Hierarchical cluster analysis and mean comparisons were performed on female (n = 1427) and male samples (n = 310). RESULTS Three psychological profiles were identified in both samples. The "High psychological concerns" profile and the "Low psychological concerns" profile were identical in both samples. The third profile, "Bodily concerns", differed by sex and was characterized by appearance dissatisfaction for women and by appearance and eating concerns for men. The "Low psychological concerns" profile presented the highest well-being and the lowest depression scores in both samples. DISCUSSION The findings support the hypothesis of the heterogeneity of individuals with overweight and obesity and suggest sex-related therapeutic approaches.
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Affiliation(s)
- Natalija Plasonja
- Department of Human Sciences, Faculty of Psychology, Université de Bordeaux, LabPsy, EA 4139, F-33000 Bordeaux, France;
- Correspondence:
| | | | - Greg Décamps
- Department of Human Sciences, Faculty of Psychology, Université de Bordeaux, LabPsy, EA 4139, F-33000 Bordeaux, France;
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Virtual Reality in the Treatment of Patients with Overweight and Obesity: A Systematic Review. SUSTAINABILITY 2022. [DOI: 10.3390/su14063324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Obesity is one of the world’s most serious health issues. Therefore, therapists have looked for methods to fight obesity. Currently, technology-based intervention options in medical settings are very common. One such technology is virtual reality (VR) which has been used in the treatment of obesity since the late 1990s. The main objective of this study is to review the literature on the use of VR in the treatment of obesity and overweight to better understand the role of VR-based interventions in this field. To this end, four databases (PubMed, Medline, Scopus, and Web of Science) were searched for related publications from 2000 to 2022 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). From the 645 articles identified, 24 were selected. The main strength of this study is that it is the first systematic review to focus completely on the use of VR in the treatment of obesity. It includes most research in which VR was utilized to carry out the intervention. Although several limitations were detected in the reviewed studies, the findings of this review suggest that employing VR for self-monitoring of diet, physical activity, and/or weight is effective in supporting weight loss as well as improving satisfaction of body image and promoting health self-efficacy in overweight or obese persons.
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Abstract
PURPOSE OF REVIEW The COVID-19 pandemic is associated with increased levels of stress, anxiety and depression in the population. These are associated with unhealthy eating patterns and sedentary behaviour. In turn, this may increase risk of obesity or aggravate it. This narrative review discusses the link between adverse mental health states and weight related behaviours. We present emerging evidence for this phenomenon during the COVID-19 pandemic in individuals with and without pre-existing obesity. RECENT FINDINGS A sizeable proportion of the population exhibits deterioration in mental health during the pandemic and those affected often report unhealthy weight-related behaviours such as "junk food" consumption and physical inactivity. Women, individuals with obesity, and those with pre-existing mental health conditions seem to be particularly at risk for overeating in response to stress (i.e. emotional eating). A number of psychological interventions including cognitive behavioural therapy and self-compassion may be effective in improving mental health and emotional eating patterns among the general population and particularly in individuals living with obesity. There is a need to complement efforts to improve mental health in the general population during the COVID-19 pandemic with targeted action to improve physical activity levels and healthy eating particularly among groups at-risk. This may be achieved by reducing disruptions to specialist and primary healthcare services and facilitating access to psychological interventions that address stress-related eating behaviours. Additional studies that examine such interventions, especially those that are delivered remotely, are urgently needed.
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Affiliation(s)
- Osnat C Melamed
- Centre for Addiction and Mental Health, 100 Stokes St, Toronto, Ontario, M6J 1H4, Canada.
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
| | - Peter Selby
- Centre for Addiction and Mental Health, 100 Stokes St, Toronto, Ontario, M6J 1H4, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Valerie H Taylor
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
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Chu H, Kang B, Youn BY, Kim KI, Park J, Leem J. Comprehensive traditional East Asian medicine treatment strategy for obesity considering the therapeutic effects and adverse events: A protocol for systematic review and network meta-analysis. Medicine (Baltimore) 2022; 101:e28673. [PMID: 35147089 PMCID: PMC8830816 DOI: 10.1097/md.0000000000028673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Obesity has become a serious global health problem due to its increasing prevalence. Because of several limitations or adverse events associated with conventional western medicine therapies, there has been an increase in demand for alternative therapies such as traditional East Asian medicine (TEAM). This study aims to provide comprehensive evidence-based information assessing the clinical efficacy and safety of TEAM treatment for obesity as the basis for reliable clinical strategies for patients with obesity. METHODS Electronic searches of the PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure, OASIS, and Korea Citation Index will be performed. Methodological quality will be assessed using the "risk of bias" tool. The primary outcome for efficacy will be weight loss. The secondary outcomes will be response rate, body mass index, waist circumference, and blood pressure. We will also evaluate the rates of adverse events and mortality for safety assessment. First, we will conduct a conventional pairwise meta-analysis. Next, we will conduct network meta-analysis using the frequentist approach. We shall verify the assumption of network meta-analysis and provide network geometry, P-score, net league table, and intervention-based forest plot. A subgroup analysis will be conducted to ascertain the factors that affect treatment, such as dosage, treatment duration, and severity of obesity. RESULTS The results of this study will provide high-quality systematic reviews that can assist decision making in obesity management. Our network meta-analysis results can provide direct and indirect comparison evidence on comparative efficacy and safety. CONCLUSION This study will provide fundamental data for prospective research on the application of TEAM in patients with obesity. PROTOCOL REGISTRY NUMBER OF ONLINE REGISTRY This study protocol was registered in open Science framework (OSF) (Registration DOI: 10.17605/OSF.IO/ETWDS). URL OF THE ONLINE REGISTRY https://osf.io/etwds.
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Affiliation(s)
- Hongmin Chu
- Daecheong Public Health Subcenter, 3, Daecheong-ro, Daecheong-myeon, Ongjin-gun, Incheon, Republic of Korea
| | - Byungsoo Kang
- College of Korean Medicine, Dongshin University, 67, Dongsindae-gil, Naju-si, Jeollanamdo, Republic of Korea
| | - Bo-Young Youn
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, 26, Kyungheedae-ro, Seoul, Republic of Korea
| | - Kwan-il Kim
- Division of Allergy, Immune Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, Republic of Korea
| | - Jinbong Park
- Department of Pharmacology, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, Republic of Korea
| | - Jungtae Leem
- Research Center of Traditional Korean Medicine, Wonkwang University, 460, Iksan-daero, Sin-dong, Iksan, Jeollabuk-do, Republic of Korea
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McCallum M, Ho AS, May CN, Behr H, Mitchell ES, Michealides A. Body Positivity and Self-Compassion on a Publicly Available Behavior Change Weight Management Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413358. [PMID: 34948964 PMCID: PMC8708647 DOI: 10.3390/ijerph182413358] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 11/16/2022]
Abstract
According to recent research, body positivity and self-compassion are key outcomes that are tied to better psychological and physical health. To date, it is unclear whether body positivity and self-compassion improve, stay constant, or deteriorate over the course of a weight management program, particularly one that addresses the psychological roots of behavior change. Additionally, beyond controlled settings, there are no studies on body positivity and self-compassion in individuals who choose to join a commercial weight management program. Therefore, this single-arm prospective study examined changes in body positivity and self-compassion from baseline to the 16 week milestone of Noom Weight, a commercial behavior change weight management program informed by acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), and cognitive behavioral therapy (CBT). We also examined how baseline and over-time changes in body positivity and self-compassion predicted engagement in program-measured relevant behaviors (e.g., exercises logged). Participants were a random subset of individuals who had recently self-enrolled in the program (n = 133). Body positivity and self-compassion were measured via survey at baseline and end of the core program (16 weeks). Self-reported weight and program-recorded engagement were extracted from the program database. Compared to baseline, body appreciation, body image flexibility, self-compassion, and body-focused rumination significantly improved at 16 weeks (all ps < 0.007). Participants lost a statistically significant amount of weight (3.9 kg; t(128)) = 10.64, p < 0.001) by 16 weeks, which was 4.4% body weight. Greater engagement, especially messaging a coach, reading articles, and logging meals, was associated with improvements over time in body appreciation (r = 0.17, p = 0.04), body image flexibility (r = −0.23, p = 0.007), and the brooding component of rumination (r = −0.23, p = 0.007). Greater engagement was also associated with baseline total self-compassion (r = 0.19, p = 0.03) and self-judgment (r = 0.24, p = 0.006). The results suggest that individuals experience improvements in body positivity and self-compassion while learning about ACT, DBT, and CBT through curriculum and coaching in this setting. The results also have important clinical implications, such as the possibility that psychologically-oriented (i.e., ACT, DBT, and CBT-based) weight management could be important to improve body positivity or that baseline self-compassion could be used to target individuals at risk for lower engagement. Future work should investigate these possibilities as well as delineate the causal relationships between body positivity, self-compassion, engagement, and weight loss.
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Affiliation(s)
- Meaghan McCallum
- Academic Research, Noom, 229 W 28th St., New York, NY 10001, USA; (M.M.); (A.S.H.); (C.N.M.); (H.B.); (A.M.)
| | - Annabell Suh Ho
- Academic Research, Noom, 229 W 28th St., New York, NY 10001, USA; (M.M.); (A.S.H.); (C.N.M.); (H.B.); (A.M.)
| | - Christine N. May
- Academic Research, Noom, 229 W 28th St., New York, NY 10001, USA; (M.M.); (A.S.H.); (C.N.M.); (H.B.); (A.M.)
| | - Heather Behr
- Academic Research, Noom, 229 W 28th St., New York, NY 10001, USA; (M.M.); (A.S.H.); (C.N.M.); (H.B.); (A.M.)
- Department of Integrative Health, Saybrook University, 55 W Eureka St., Pasadena, CA 91103, USA
| | - Ellen Siobhan Mitchell
- Academic Research, Noom, 229 W 28th St., New York, NY 10001, USA; (M.M.); (A.S.H.); (C.N.M.); (H.B.); (A.M.)
- Correspondence:
| | - Andreas Michealides
- Academic Research, Noom, 229 W 28th St., New York, NY 10001, USA; (M.M.); (A.S.H.); (C.N.M.); (H.B.); (A.M.)
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Iturbe I, Echeburúa E, Maiz E. The effectiveness of acceptance and commitment therapy upon weight management and psychological well-being of adults with overweight or obesity: A systematic review. Clin Psychol Psychother 2021; 29:837-856. [PMID: 34802174 DOI: 10.1002/cpp.2695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 09/29/2021] [Accepted: 11/14/2021] [Indexed: 01/22/2023]
Abstract
Several studies have examined acceptance and commitment therapy's (ACT) effectiveness for addressing physical and psychological distress people with obesity can face. Nevertheless, no review focusing specifically on ACT analysing randomized controlled trials (RCT) has been done up to date in this field. The present systematic review was developed following the PRISMA statement and aimed to examine ACT's effects on weight management and psychological well-being of adults with overweight or obesity. A conjunction of keywords related to ACT and excess weight was searched in four databases (Medline, PubMed, Psycinfo and Scopus) for articles meeting inclusion criteria. The literature search yielded 2,074 papers, and 16 were included in the review, finally. In 71.43% of the studies, ACT was effective to enhance psychological well-being; in 50% effectively targeted process variables and health behaviours related to weight management; in 31.82% of studies, physical variables were improved; and 21.38% of studies showed evidence in favour of ACT for eating behaviour modification. The present review supports ACT for promoting emotional aspects of individuals immersed in such weight-related battles and highlights the benefits of psychological well-being-oriented ACT in the context of obesity treatment. More studies targeting psychological well-being primarily and with longer follow-ups are required.
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Affiliation(s)
- Idoia Iturbe
- Department of Clinical and Health Psychology and Research Methodology, University of the Basque Country UPV/EHU, Donostia-San Sebastian, Spain
| | - Enrique Echeburúa
- Department of Clinical and Health Psychology and Research Methodology, University of the Basque Country UPV/EHU, Donostia-San Sebastian, Spain
| | - Edurne Maiz
- Department of Clinical and Health Psychology and Research Methodology, University of the Basque Country UPV/EHU, Donostia-San Sebastian, Spain
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Carey A, Yang Q, DeLuca L, Toro-Ramos T, Kim Y, Michaelides A. The Relationship Between Weight Loss Outcomes and Engagement in a Mobile Behavioral Change Intervention: Retrospective Analysis. JMIR Mhealth Uhealth 2021; 9:e30622. [PMID: 34747706 PMCID: PMC8663454 DOI: 10.2196/30622] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/02/2021] [Accepted: 09/19/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND There is large variance in weight loss outcomes of digital behavior change interventions (DBCIs). It has been suggested that different patterns of engagement in the program could be responsible for this variance in outcomes. Previous studies have found that the amount of engagement on DBCIs, such as the number of meals logged or articles read, is positively associated with weight loss. OBJECTIVE This retrospective study extends previous research by observing how important weight loss outcomes (high weight loss: 10% or greater body weight loss; moderate weight loss: between 5% to 10%; stable weight: 0 plus or minus 1%) are associated with engagement on a publicly available mobile DBCI (Noom) from 9 to 52 weeks. METHODS Engagement and weight data for eligible participants (N=11,252) were extracted from the Noom database. Engagement measures included the number of articles read, meals logged, steps recorded, messages to coach, exercise logged, weigh-ins, and days with 1 meal logged per week. Weight was self-reported on the program. Multiple linear regressions examined how weight loss outcome (moderate and high vs stable) was associated with each engagement measure across 3 study time periods: 9-16 weeks, 17-32 weeks, and 33-52 weeks. RESULTS At 9-16 weeks, among the 11,252 participants, 2594 (23.05%) had stable weight, 6440 (57.23%) had moderate weight loss, and 2218 (19.71%) had high weight loss. By 33-52 weeks, 525 (18.21%) had stable weight, 1214 (42.11%) had moderate weight loss, and 1144 (39.68%) had high weight loss. Regression results showed that moderate weight loss and high weight loss outcomes were associated with all engagement measures to a significantly greater degree than was stable weight (all P values <.001). These differences held across all time periods with the exception of exercise for the moderate weight loss category at 1 time period of 33-52 weeks. Exercise logging increased from 9 to 52 weeks regardless of the weight loss group. CONCLUSIONS Our results suggest that these clinically important weight loss outcomes are related to the number of articles read, meals logged, steps recorded, messages to coach, exercise logged, weigh-ins, and days with 1 meal logged per week both in the short-term and long-term (ie, 1 year) on Noom. This provides valuable data on engagement patterns over time on a self-directed mobile DBCI, can help inform how interventions tailor recommendations for engagement depending on how much weight individuals have lost, and raises important questions for future research on engagement in DBCIs.
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Affiliation(s)
- Alissa Carey
- Academic Research, Noom Inc, New York, NY, United States
| | - Qiuchen Yang
- Academic Research, Noom Inc, New York, NY, United States
| | - Laura DeLuca
- Academic Research, Noom Inc, New York, NY, United States
- Department of Clinical Psychology, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States
| | - Tatiana Toro-Ramos
- Academic Research, Noom Inc, New York, NY, United States
- Amgen, Thousand Oaks, CA, United States
| | - Youngin Kim
- Academic Research, Noom Inc, New York, NY, United States
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
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Affective disorders, weight change, and patient engagement in a rural behavioral weight loss trial. Prev Med 2021; 152:106698. [PMID: 34175347 DOI: 10.1016/j.ypmed.2021.106698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/21/2021] [Accepted: 06/21/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Adults in rural areas have a higher prevalence of obesity and some mental health conditions. The degree to which mental health influences weight loss among rural residents remains unclear. This study evaluated changes in body weight, physical activity, diet, and program engagement outcomes in a cohort of participants with vs. without an affective disorder in a behavioral weight loss trial. METHODS A sample of 1407 adults with obesity were recruited from rural U.S. primary care practices to participate in a weight loss trial. In this secondary analysis, participants were stratified by those with vs. without an affective disorder at baseline. Mixed models were used to estimate changes in outcomes over 24 months. RESULTS One-third of participants (n = 468) had an affective disorder. After covariate adjustment, both groups experienced significant weight loss over 24 months, but weight loss was significantly less among those with an affective disorder at all follow-up times (all p's < 0.001; 24-month weight loss -2.7 ± 0.4 vs. -4.8 ± 0.3 kg). Compared to those without an affective disorder, participants with an affective disorder also had significantly less improvement in physical activity and fruit/vegetable consumption, lower attendance at weight loss sessions, and less engagement in setting weight loss goals and strategies. CONCLUSION Participants with an affective disorder lost less body weight and less improvement in lifestyle measures over 24 months. These trends paralleled reduced engagement in critical intervention activities such as weight loss session attendance. Future interventions should consider additional methods to minimize disengagement in adults with underlying affective disorders.
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Claes L, Kiekens G, Boekaerts E, Depestele L, Dierckx E, Gijbels S, Schoevaerts K, Luyckx K. Are Sensitivity to Punishment, Sensitivity to Reward and Effortful Control Transdiagnostic Mechanisms Underlying the Eating Disorder/Obesity Spectrum? Nutrients 2021; 13:nu13103327. [PMID: 34684327 PMCID: PMC8541040 DOI: 10.3390/nu13103327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 09/20/2021] [Accepted: 09/20/2021] [Indexed: 11/16/2022] Open
Abstract
Although it has been postulated that eating disorders (EDs) and obesity form part of a broad spectrum of eating- and weight-related disorders, this has not yet been tested empirically. In the present study, we investigated interindividual differences in sensitivity to punishment, sensitivity to reward, and effortful control along the ED/obesity spectrum in women. We used data on 286 patients with eating disorders (44.6% AN-R, 24.12% AN-BP, and 31.82% BN), 126 healthy controls, and 640 Class II/III obese bariatric patients (32.81% Class II and 67.19% Class III) with and without binge eating. Participants completed the behavioral inhibition and behavioral activation scales, as well as the effortful control scale, to assess sensitivity to punishment and reward and effortful control. Results showed that patients with EDs scored significantly higher on punishment sensitivity (anxiety) compared to healthy controls and Class II/III obese patients; the different groups did not differ significantly on reward sensitivity. Patients with binge eating or compensatory behaviors scored significantly lower on effortful control than patients without binge eating. Differences in temperamental profiles along the ED/obesity spectrum appear continuous and gradual rather than categorical. This implies that it may be meaningful to include emotion regulation and impulse regulation training in the treatment of both EDs and obesity.
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Affiliation(s)
- Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, 3000 Leuven, Belgium; (G.K.); (K.L.)
- Faculty of Medicine and Health Sciences, University Antwerp, 2000 Antwerp, Belgium
- Correspondence: ; Tel.: +32-16-32-61-33
| | - Glenn Kiekens
- Faculty of Psychology and Educational Sciences, KU Leuven, 3000 Leuven, Belgium; (G.K.); (K.L.)
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, 3000 Leuven, Belgium
| | - Els Boekaerts
- Obesity Centre Hasselt, Jessa Hospital, 3500 Hasselt, Belgium; (E.B.); (S.G.)
| | - Lies Depestele
- Psychiatric Hospital Alexianen Zorggroep Tienen, 3300 Tienen, Belgium; (L.D.); (E.D.); (K.S.)
| | - Eva Dierckx
- Psychiatric Hospital Alexianen Zorggroep Tienen, 3300 Tienen, Belgium; (L.D.); (E.D.); (K.S.)
- Department of Clinical Psychology, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Sylvia Gijbels
- Obesity Centre Hasselt, Jessa Hospital, 3500 Hasselt, Belgium; (E.B.); (S.G.)
| | - Katrien Schoevaerts
- Psychiatric Hospital Alexianen Zorggroep Tienen, 3300 Tienen, Belgium; (L.D.); (E.D.); (K.S.)
| | - Koen Luyckx
- Faculty of Psychology and Educational Sciences, KU Leuven, 3000 Leuven, Belgium; (G.K.); (K.L.)
- UNIBS, University of the Free State, Bloemfontein 9300, South Africa
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van der Windt M, Schoenmakers S, Willemsen S, van Rossem L, Steegers-Theunissen R. Optimizing the Periconception Lifestyle of Women With Overweight Using a Blended Personalized Care Intervention Combining eHealth and Face-to-face Counseling (eFUSE): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e28600. [PMID: 34477561 PMCID: PMC8449297 DOI: 10.2196/28600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 01/23/2023] Open
Abstract
Background Maternal overweight has a substantial impact on reproductive, maternal, pregnancy, and neonatal outcomes with long-term and transgenerational health consequences. Interventions that aim to optimize periconception maternal lifestyle can improve maternal and fetal health during pregnancy and throughout the life course. However, it remains difficult to change and adopt adequate lifestyle behaviors. We hypothesize that additional psychological therapy targeting cognitive and affective factors substantially contribute to the effectiveness of these interventions. Objective The proposed study aims to examine the feasibility and effectiveness of a blended personalized periconception lifestyle care intervention with additional psychological therapy aimed at women with a BMI≥25 and who are contemplating pregnancy or are already pregnant (≤12 weeks) in reducing inadequate lifestyle behaviors and improving early and late pregnancy outcome. Methods The eHealth and Face-to-face Counseling (eFUSE) study follows a single-center two-arm randomized controlled trial design at the Erasmus MC, University Medical Center, with a multicenter regional referral. The female patients with overweight (BMI≥25), together with their male partner, will be stratified by pregnancy status (preconception vs pregnant) and randomized to receive either the blended personalized periconception lifestyle care intervention with additional psychological therapy (n=313) or usual care (n=313). The primary outcome is a change in the lifestyle risk score (between baseline and 24 weeks) between the randomization arms (difference in differences). Secondary outcomes include measurements defined as most relevant by the International Consortium for Health Outcomes Measurement, including behavioral determinants, patient satisfaction, provider feasibility, and maternal pregnancy and neonatal complications. Results The study will be open for recruitment from Fall 2021 onward. Data collection is expected to be completed by the beginning of 2023, and the results are expected to be published by Fall 2023. Conclusions This study will evaluate the feasibility and effectiveness of a blended periconception lifestyle intervention with additional psychological therapy, aimed at women with a BMI≥25. Positive results of this innovative care approach will be used for implementation in routine medical care of all women with overweight, with the ultimate aim to improve clinical outcomes of these high-risk pregnancies. Trial Registration Netherlands Trial Register NL9264; https://www.trialregister.nl/trial/9264 International Registered Report Identifier (IRRID) PRR1-10.2196/28600
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Affiliation(s)
- Melissa van der Windt
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Sam Schoenmakers
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Sten Willemsen
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Lenie van Rossem
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
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Syan SK, McIntyre-Wood C, Minuzzi L, Hall G, McCabe RE, MacKillop J. Dysregulated resting state functional connectivity and obesity: A systematic review. Neurosci Biobehav Rev 2021; 131:270-292. [PMID: 34425125 DOI: 10.1016/j.neubiorev.2021.08.019] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 07/13/2021] [Accepted: 08/17/2021] [Indexed: 12/16/2022]
Abstract
Obesity has been variously linked to differences in brain functional connectivity in regions associated with reward, emotional regulation and cognition, potentially revealing neural mechanisms contributing to its development and maintenance. This systematic review summarizes and critically appraises the existing literature on differences in resting state functional connectivity (Rs-FC) between overweight and individuals with obesity in relation healthy-BMI controls. Twenty-nine studies were identified and the results consistently support the hypothesis that obesity is associated with differences in Rs-FC. Specifically, obesity/overweight was consistently associated with (i) DMN hypoconnectivity and salience network hyperconnectivity; (ii) increased Rs-FC between the hypothalamus and reward, limbic and salience networks, and decreased Rs-FC between the hypothalamus and cognitive regions; (iii) increased power within regions associated with inhibition/emotional reasoning; (iv) decreased nodal efficiency, degree centrality, and global efficiency. Collectively, the results suggest obesity is associated with disrupted connectivity of brain networks responsible for cognition, reward, self-referential processing and emotional regulation.
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Affiliation(s)
- Sabrina K Syan
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, Canada; Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada.
| | - Carly McIntyre-Wood
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, Canada
| | - Luciano Minuzzi
- Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Geoffrey Hall
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
| | - Randi E McCabe
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - James MacKillop
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, Canada; Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
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Moustafa AF, Quigley KM, Wadden TA, Berkowitz RI, Chao AM. A systematic review of binge eating, loss of control eating, and weight loss in children and adolescents. Obesity (Silver Spring) 2021; 29:1259-1271. [PMID: 34227229 PMCID: PMC8319063 DOI: 10.1002/oby.23185] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/16/2021] [Accepted: 03/22/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This review synthesizes literature on changes in binge eating (BE) and loss of control eating (LOC) following weight loss and the association between BE/LOC and weight loss in children and adolescents. METHODS A systematic literature search was conducted in PubMed, Scopus, and PsycInfo. Eligible studies included all peer-reviewed journal articles of primary research that assessed BE/LOC and weight change following a weight-loss intervention in individuals under 18 years of age. RESULTS The 29 articles included studies on behavioral therapy, pharmacotherapy, and surgical interventions. Of the 14 studies that assessed the relationship between weight loss and BE/LOC at baseline, 4 showed that higher baseline BE/LOC was associated with less weight loss, whereas 10 showed no significant association. BE/LOC behaviors significantly decreased following weight-loss interventions in 20 of 21 studies. A greater decrease in BE/LOC was associated with improved weight loss in 4 of 9 studies that assessed this change. CONCLUSIONS Weight-loss interventions are associated with improved BE/LOC in youth with obesity. The persistence of BE/LOC symptoms may be associated with less weight loss. These results can aid in guiding future treatment for youth with BE/LOC seeking weight-loss treatment.
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Affiliation(s)
| | - Kerry M. Quigley
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, US
| | - Thomas A. Wadden
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, US
| | - Robert I. Berkowitz
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, US
- The Children’s Hospital of Philadelphia, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Philadelphia, PA, USA
| | - Ariana M. Chao
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, US
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences, Philadelphia, PA, USA
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45
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D'Alessio R, Watanabe M, Gallo IF, Manfrini S, Tuccinardi D, Bruni V. The gastro-jejunal anastomosis site influences dumping syndrome and weight regain in patients with obesity undergoing Laparoscopic Roux-en-Y Gastric Bypass. Eat Weight Disord 2021; 26:1871-1880. [PMID: 33044727 DOI: 10.1007/s40519-020-01030-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 09/22/2020] [Indexed: 12/12/2022] Open
Abstract
PURPOSE The Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) is an effective weight loss procedure. The gastro-jejunal (GJ) anastomosis required can be performed on the anterior or posterior gastric pouch wall. No studies have compared these variants in terms of efficacy and onset of dumping syndrome (DS) and weight regain (WR). We aimed at assessing the prevalence of DS in relation to the site of anastomosis together with identifying prognostic factors of DS and WR. METHODS Patients who had undergone LRYGB with anterior (AGJ) or posterior (PGJ) anastomosis in 2010-2019 were retrospectively analyzed. We collected demographic data, medical history and the prevalence of DS evaluated through the Sigstad Score, together with WR data. RESULTS 213 patients were enrolled, of which 51.6% had an AGJ and 48.4% had a PGJ. The mean follow-up time was 81 ± 18 and 27 ± 13 months in the AGJ and PGJ group, respectively (p < 0.0001). Excess weight loss was 77.59% and 94.13% in patients with AGJ and PGJ, respectively (p < 0.001). WR rate was 16% and 4% in the AGJ and PGJ population, respectively (p < 0.001). DS prevalence was 38% and 76% in the AGJ and the PGJ population, respectively (p < 0.0001). The site of anastomosis was identified as an independent predictor of DS (OR5.15; 95% CI 2.82-9.41; p < 0.0001) and WR (OR5.31; 95% CI 2.32-12.15; p < 0.0001). Obesity-related complications significantly improved after surgery independent of the anastomosis site. CONCLUSION LRYGB is effective in determining long-term weight loss and improvement of complications. AGJ is associated with lower prevalence of DS but more frequent WR. The anastomosis site is a factor to be considered when performing LRYGB. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
| | - Mikiko Watanabe
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | | | - Silvia Manfrini
- Unit of Endocrinology and Diabetes, Department of Medicine, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 21, 00128, Rome, Italy
| | - Dario Tuccinardi
- Unit of Endocrinology and Diabetes, Department of Medicine, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 21, 00128, Rome, Italy.
| | - Vincenzo Bruni
- Obesity Surgery Unit, Campus Bio-Medico University of Rome, Rome, Italy
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Song T, Yu P, Bliokas V, Probst Y, Peoples GE, Qian S, Houston L, Perez P, Amirghasemi M, Cui T, Hitige NPR, Smith NA. A Clinician-Led, Experience-Based Co-Design Approach for Developing mHealth Services to Support the Patient Self-management of Chronic Conditions: Development Study and Design Case. JMIR Mhealth Uhealth 2021; 9:e20650. [PMID: 34283030 PMCID: PMC8335618 DOI: 10.2196/20650] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 11/09/2020] [Accepted: 05/17/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Despite the increasing use of mobile health (mHealth) services, such as mHealth apps or SMS text messaging services, that support the patient self-management of chronic conditions, many existing mHealth services lack theoretical guidance. In addition, although often the target audience for requirement acquisition at the initial mHealth app design stage, it is a common challenge for them to fully conceptualize their needs for mHealth services that help self-manage chronic conditions. OBJECTIVE This study proposes a novel co-design approach with the initial requirements for mHealth services proposed by clinicians based on their experiences in guiding patients to self-manage chronic conditions. A design case is presented to illustrate our innovative approach to designing an mHealth app that supports the self-management of patients with obesity in their preparation for elective surgery. METHODS We adopted a clinician-led co-design approach. The co-design approach consisted of the following four cyclic phases: understanding user needs, identifying an applicable underlying theory, integrating the theory into the prototype design, and evaluating and refining the prototype mHealth services with patients. Expert panel discussions, a literature review, intervention mapping, and patient focus group discussions were conducted in these four phases. RESULTS In stage 1, the expert panel proposed the following three common user needs: motivational, educational, and supportive needs. In stage 2, the team selected the Social Cognitive Theory to guide the app design. In stage 3, the team designed and developed the key functions of the mHealth app, including automatic push notifications; web-based resources; goal setting and monitoring; and interactive health-related exchanges that encourage physical activity, healthy eating, psychological preparation, and a positive outlook for elective surgery. Push notifications were designed in response to a patient's risk level, as informed by the person's response to a baseline health survey. In stage 4, the prototype mHealth app was used to capture further requirements from patients in the two focus group discussions. Focus group participants affirmed the potential benefits of the app and suggested more requirements for the function, presentation, and personalization needs. The app was improved based on these suggestions. CONCLUSIONS This study reports an innovative co-design approach that was used to leverage the clinical experiences of clinicians to produce the initial prototype app and the approach taken to allow patients to effectively voice their needs and expectations for the mHealth app in a focus group discussion. This approach can be generalized to the design of any mHealth service that aims to support the patient self-management of chronic conditions.
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Affiliation(s)
- Ting Song
- Centre for Digital Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Ping Yu
- Centre for Digital Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
- Smart Infrastructure Facility, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
| | - Vida Bliokas
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
- School of Psychology, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Yasmine Probst
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Gregory E Peoples
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Siyu Qian
- Centre for Digital Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
- Illawarra Shoalhaven Local Health District, Wollongong, Australia
| | - Lauren Houston
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Pascal Perez
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
- Smart Infrastructure Facility, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
| | - Mehrdad Amirghasemi
- Smart Infrastructure Facility, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
| | - Tingru Cui
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, University of Melbourne, Melbourne, Australia
| | - Nadeesha Pathiraja Rathnayaka Hitige
- Centre for Digital Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
| | - Natalie Anne Smith
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
- Department of Anaesthesia, Wollongong Hospital, Wollongong, Australia
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Ciria LF, Watson P, Vadillo MA, Luque D. Is the habit system altered in individuals with obesity? A systematic review. Neurosci Biobehav Rev 2021; 128:621-632. [PMID: 34252472 DOI: 10.1016/j.neubiorev.2021.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/27/2021] [Accepted: 07/06/2021] [Indexed: 12/15/2022]
Abstract
Habit-like eating behavior is repeatedly pointed to as a key cognitive mechanism contributing to the emergence and maintenance of obesity. Here, we conducted a systematic review of the literature to assess the existent behavioral evidence for the Habit Hypothesis for Overeating (HHO) which states that obesity is the consequence of an imbalance between the habit and goal-directed reward learning systems, leading to overconsumption of food. We found a total of 19 studies implementing a variety of experimental protocols (i.e., free operant paradigm, slips-of-action test, two-step task, Pavlovian-to-Instrumental paradigm, probabilistic learning task) and manipulations. Taken together, the studies on clinical (binge eating disorder) and non-clinical individuals with overweight or obesity do not support the HHO conclusively. While the scientific literature on HHO is still in its infancy, the heterogeneity of the extant studies makes it difficult to evaluate the degree of convergence of these findings. Uncovering the role of reward learning systems in eating behaviors might have a transformative impact on public health.
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Affiliation(s)
- Luis F Ciria
- Departamento de Psicología Básica, Universidad Autónoma de Madrid, Spain; Departamento de Psicología Básica, Universidad de Málaga, Spain.
| | - Poppy Watson
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Miguel A Vadillo
- Departamento de Psicología Básica, Universidad Autónoma de Madrid, Spain
| | - David Luque
- Departamento de Psicología Básica, Universidad Autónoma de Madrid, Spain; Departamento de Psicología Básica, Universidad de Málaga, Spain.
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48
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Varela C, Oda-Montecinos C, Andrés A, Saldaña C. Effectiveness of web-based feedback interventions for people with overweight and obesity: systematic review and network meta-analysis of randomized controlled trials. J Eat Disord 2021; 9:75. [PMID: 34174949 PMCID: PMC8234624 DOI: 10.1186/s40337-021-00432-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 06/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Web-based delivered interventions have become an innovative option to treat health problems, like obesity. The aim of this systematic review and network meta-analysis was to analyze the effectiveness of web-based behavioral treatments for adults with overweight and obesity. Web-based interventions and comparison interventions (traditional weight control programs) were classified according to the following feedback characteristics: frequency, personalization, and provider (human versus machine). METHOD From the initial 1789 studies, 15 were included in this review. A network meta-analysis was conducted to analyze the efficacy of web-based programs with traditional interventions, considering direct and indirect comparisons. The main outcome was the weight loss mean difference (kg) between baseline and post-treatment. Heterogeneity and consistency assumptions were validated to conduct the network meta-analysis. RESULTS Network meta-analysis showed comparisons between different treatment options. The main results were that Intensive Contact Web-based programs were more effective than wait-list (Mean Difference - 1.86 kg; 95% Confidence Interval: - 3.61, - 0.12). Moreover, Intensive Contact Web-based programs were more effective than the other web-based options and self-help traditional interventions. However, the only significant comparison was Intensive Contact Web-based programs versus Guided Self-Help Web-based programs (Mean Difference - 4.31 kg; 95% Confidence Interval: - 5,22, - 3,41). Intensive Contact Web-based programs were the most effective treatment option according the obtained results, achieving the first place in the ranking provided by the network meta-analysis with 98.5% of probabilities. CONCLUSIONS Intensive Contact Web-based interventions have obtained the first position in the ranking, proving the relevance of frequent, personalized, and professional feedback and their association with a better prognosis for people with overweight and obesity. These results provide relevant information to design more effective treatments for people with overweight and obesity, in a new format especially appropriate for the current situation.
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Affiliation(s)
- Carmen Varela
- Department of Clinical Psychology and Psychobiology, Section of Personality, Assessment and Treatment, Faculty of Psychology, University of Barcelona, Passeig Vall d'Hebrón, 171, P.C. 08035, Barcelona, Cataluña, Spain
| | | | - Ana Andrés
- Faculty of Psychology, Education and Sport Sciences, Blanquerna, Ramon Llull University, Barcelona, Spain
| | - Carmina Saldaña
- Department of Clinical Psychology and Psychobiology, Section of Personality, Assessment and Treatment, Faculty of Psychology, University of Barcelona, Passeig Vall d'Hebrón, 171, P.C. 08035, Barcelona, Cataluña, Spain.
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain.
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49
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Iłowiecka K, Glibowski P, Skrzypek M, Styk W. The Long-Term Dietitian and Psychological Support of Obese Patients Who Have Reduced Their Weight Allows Them to Maintain the Effects. Nutrients 2021; 13:nu13062020. [PMID: 34208363 PMCID: PMC8231289 DOI: 10.3390/nu13062020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 12/25/2022] Open
Abstract
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.
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Affiliation(s)
- Katarzyna Iłowiecka
- Department of Biotechnology, Microbiology and Human Nutrition, University of Life Sciences in Lublin, 20-704 Lublin, Poland;
| | - Paweł Glibowski
- Department of Biotechnology, Microbiology and Human Nutrition, University of Life Sciences in Lublin, 20-704 Lublin, Poland;
- Correspondence: ; Tel.: +48-(81)-462-33-49
| | - Michał Skrzypek
- Department of Clinical Dietetics, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Wojciech Styk
- Institute of Psychology, The John Paul II Catholic University of Lublin, 20-950 Lublin, Poland;
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50
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Choi HJ. Letter: Psycho-Physiological Responses to a 4-Month High-Intensity Interval Training-Centered Multidisciplinary Weight-Loss Intervention in Adolescents with Obesity (J Obes Metab Syndr 2020;29:292-302). J Obes Metab Syndr 2021; 30:188-189. [PMID: 34024770 PMCID: PMC8277588 DOI: 10.7570/jomes21030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/18/2021] [Accepted: 04/18/2021] [Indexed: 11/08/2022] Open
Affiliation(s)
- Hyung Jin Choi
- Department of Biomedical Sciences, Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul, Korea
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