Editorial: With Obesity Becoming the New Normal, What Should We Do?

Nutritional status and body image perception in a group of moroccan adolescents

BACKGROUND: Adolescent obesity has become a pressing public health issue in Morocco. Along with the increased prevalence of obesity, body weight misperceptions have also increased among adolescents, which may reduce the effectiveness of intervention programs. The main study objective was to establish the relationship between body image perception, anthropometric status and their associated factors among a sample of Moroccan adolescents. METHODS: A cross-sectional school-based survey was conducted during 2018, involving 250 adolescents from Morocco. Data on sociodemographic information, anthropometric characteristics, and weight perception were collected and reported as the means and proportions. Statistical analysis was carried out using Statistical Package for Social Sciences version 19.0 software. RESULTS: The prevalence of overweight and obesity in our study reached 12.8% and 4.8%, respectively. Misperception of body weight compared to body mass index (BMI) was found in 50.4% of young adolescents (χ2 = 54.05; p <  0.001), and dissatisfaction computed by the Feel minus Ideal Discrepancy (FID) index reached 46% with no difference between the sexes (χ2 = 2.55; p >  0.05). The Feel weight status minus Actual weight status Inconsistency (FAI) index was used to determine whether the subjects’ perception of their weight was realistic. The results showed that both sexes tended to underestimate their weight. Only 68.2% of overweight/obese participants reported trying to lose weight (χ2 = 39.74; p <  0.001), while this number increased to 94.7% when the intention to lose weight was related to perceived body image (χ2 = 86.09; p <  0.001). CONCLUSIONS: The results of this study reveal that a mismatch exists between the perception of body weight and actual BMI in adolescents, with a tendency toward underestimation, affirming the early effect of social norms and the vulnerability to sociocultural influences of individuals in this age category. Future interventions and educational programs are thus required to prevent overweight and obesity and to address the mismatch between adolescents’ weight status and their perceived weight.

Potential Bias and Misconceptions in Liver Transplantation for Alcohol- and Obesity-Related Liver Disease

INTRODUCTION

Bias and misconceptions surrounding alcohol-related liver disease (ALD) and obesity-related liver disease (OLD) may lead to transplant listing inequities. The aim of this study was to evaluate patients, medical students, residents, fellows, and attending physicians for bias and misconceptions regarding liver transplantation (LT) for patients with ALD and OLD.

METHODS

Participants took a survey asking them whether patients with ALD who continue/discontinue drinking alcohol or patients with OLD who do/do not commit to a weight loss program deserve equal LT rights. A Likert scale was used for their responses. Participants also estimated 5-year survival and advanced fibrosis recurrence after LT. The primary outcome of the study was bias measured by expected agreement or disagreement to questions using a Likert scale, significant underestimation of a 5-year survival rate after LT, and significant overestimation of 5-year advanced fibrosis recurrence after LT.

RESULTS

A total of 381 participants were included in the analysis: 153 residents/fellows, 31 attending physicians, 98 medical students, and 99 patients. A higher percentage from all 4 participating groups either were neutral or disagreed with equal LT rights for patients with ALD who discontinue drinking compared with patients with OLD who commit to weight loss program. The attending physician group was the only group with a majority estimating >60% 5-year survival after LT in patients with ALD and OLD (P < 0.05). All 4 groups had a majority estimate >20% 5-year advanced fibrosis recurrence in patients with ALD and OLD (P > 0.05).

DISCUSSION

There seems to be current bias and misconceptions regarding LT for patients with ALD and OLD.

Cognitive Behavioral Approach to Treat Obesity: A Randomized Clinical Trial

Our aim was to analyze and compare the effects of three different long-term treatments on anthropometric profiles, eating behaviors, anxiety and depression levels, and quality of life of groups of adults with obesity. Methods: The 43 participants in the study were randomly assigned to one of three groups: the education and health group (EH, n = 12), which received lectures on health topics; the physical exercise group (PE, n = 13), which underwent physical training; and the interdisciplinary therapy plus cognitive behavioral therapy (IT + CBT) (n = 18) group, which received physical training, nutritional advice, and physical and psychological therapy. Results: Total quality of life increased significantly in the EH group (△ = 2.00); in the PE group, body weight significantly decreased (△ = -1.42) and the physical domain of quality of life improved (△ = 1.05). However, the most significant changes were seen in the IT + CBT group, in which the anthropometric profile improved; there were an increase in quality of life in all domains (physical, psychological, social, and environmental), an improvement in eating behaviors [Dutch Eating Behavior Questionnaire (DEBQ), total △ = -8.39], and a reduction in depression [Beck Depression Inventory (BDI), △ = -10.13). Conclusion: The IT + CBT program was more effective than the PE and EH programs. Clinical Trial Registration Number: NCT02573688.