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Morgan-Bathke M, Raynor HA, Baxter SD, Halliday TM, Lynch A, Malik N, Garay JL, Rozga M. Medical Nutrition Therapy Interventions Provided by Dietitians for Adult Overweight and Obesity Management: An Academy of Nutrition and Dietetics Evidence-Based Practice Guideline. J Acad Nutr Diet 2023; 123:520-545.e10. [PMID: 36462613 DOI: 10.1016/j.jand.2022.11.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 11/27/2022] [Indexed: 12/03/2022]
Abstract
Overweight and obesity affect most adults living in the United States and are causally linked to several adverse health outcomes. Registered dietitian nutritionists or international equivalents (dietitians) collaborate with each client and other health care professionals to meet client-centered goals, informed by the best available evidence, and translated through a lens of clinical expertise and client circumstances and preferences. Since the last iteration of the Academy of Nutrition and Dietetics guideline on adult weight management in 2014, considerable research has been conducted and circumstances confronting dietitians have evolved. Thus, updated guidance is needed. The objective of this evidence-based practice guideline is to provide recommendations for dietitians who deliver medical nutrition therapy behavioral interventions for adults (18 years and older) with overweight and obesity to improve cardiometabolic outcomes, quality of life, and weight outcomes, when appropriate for and desired by the client. Recommendations in this guideline highlight the importance of considering complex contributors to overweight and obesity and individualizing interventions to client-centered goals based on specific needs and preferences and shared decision making. The described recommendations have the potential to increase access to care and decrease costs through utilization of telehealth and group counseling as effective delivery methods, and to address other barriers to overweight and obesity management interventions. It is essential for dietitians to collaborate with clients and interprofessional health care teams to provide high-quality medical nutrition therapy interventions using the nutrition care process to promote attainment of client-centered outcomes for adults with overweight or obesity.
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Affiliation(s)
- Maria Morgan-Bathke
- Department of Nutrition and Dietetics, Viterbo University, La Crosse, Wisconsin
| | - Hollie A Raynor
- College of Education, Health, and Human Sciences, University of Tennessee, Knoxville, Tennessee
| | | | - Tanya M Halliday
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah
| | - Amanda Lynch
- Department of Interdisciplinary Health Sciences, Oakland University, Rochester, MI
| | - Neal Malik
- Department of Health Science and Human Ecology, California State University, San Bernardino, San Bernardino, California
| | - Jessica L Garay
- Department of Nutrition and Food Studies, Syracuse University, Syracuse
| | - Mary Rozga
- Academy of Nutrition and Dietetics, Chicago, Illinois.
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Mestre-Bach G, Potenza MN. Potential Biological Markers and Treatment Implications for Binge Eating Disorder and Behavioral Addictions. Nutrients 2023; 15:827. [PMID: 36839185 PMCID: PMC9962023 DOI: 10.3390/nu15040827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/28/2023] [Accepted: 02/04/2023] [Indexed: 02/08/2023] Open
Abstract
The reward system is highly relevant to behavioral addictions such as gambling disorder (GD), internet gaming disorder (IGD), and food addiction/binge eating disorder (FA/BED). Among other brain regions, the ventral striatum (VS) has been implicated in reward processing. The main objective of the present state-of-the-art review was to explore in depth the specific role of the VS in GD, IGD and FA/BED, understanding it as a possible biomarker of these conditions. Studies analyzing brain changes following interventions for these disorders, and especially those that had explored possible treatment-related changes in VS, are discussed. More evidence is needed on how existing treatments (both pharmacological and psychobehavioral) for behavioral addictions affect the activation of the VS and related circuitry.
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Affiliation(s)
- Gemma Mestre-Bach
- Facultad de Ciencias de la Salud, Universidad Internacional de La Rioja, 26006 Logroño, Spain
| | - Marc N. Potenza
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT 06510, USA
- Connecticut Mental Health Center, New Haven, CT 06519, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT 06109, USA
- Wu Tsai Institute, Yale University, New Haven, CT 06510, USA
- Yale Child Study Center, School of Medicine, Yale University, New Haven, CT 06510, USA
- Department of Neuroscience, School of Medicine, Yale University, New Haven, CT 06510, USA
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Camacho-Barcia L, Munguía L, Gaspar-Pérez A, Jimenez-Murcia S, Fernández-Aranda F. Impact of Food Addiction in Therapy Response in Obesity and Eating Disorders. CURRENT ADDICTION REPORTS 2022. [DOI: 10.1007/s40429-022-00421-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Vidmar AP, Naguib M, Raymond JK, Salvy SJ, Hegedus E, Wee CP, Goran MI. Time-Limited Eating and Continuous Glucose Monitoring in Adolescents with Obesity: A Pilot Study. Nutrients 2021; 13:nu13113697. [PMID: 34835953 PMCID: PMC8624400 DOI: 10.3390/nu13113697] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/07/2021] [Accepted: 10/15/2021] [Indexed: 01/25/2023] Open
Abstract
Due to its simplicity, time-limited eating (TLE) may represent a more feasible approach for treating adolescents with obesity compared to other caloric restriction regimens. This pilot study examines the feasibility and safety of TLE combined with continuous glucose monitoring (CGM) in adolescents. Fifty adolescents with BMI ≥95th percentile were recruited to complete a 12-week study. All received standard nutritional counseling, wore a CGM daily, and were randomized to: (1) Prolonged eating window: 12 h eating/12 h fasting + blinded CGM; (2) TLE (8 h eating/16 h fasting, 5 days per week) + blinded CGM; (3) TLE + real-time CGM feedback. Recruitment, retention, and adherence were recorded as indicators of feasibility. Weight loss, dietary intake, physical activity, eating behaviors, and quality of life over the course of the intervention were explored as secondary outcomes. Forty-five participants completed the study (16.4 ± 1.3 years, 64% female, 49% Hispanic, 75% public insurance). There was high adherence to prescribed eating windows (TLE 5.2 d/wk [SD 1.1]; control 6.1 d/wk [SD 1.4]) and daily CGM wear (5.85 d/wk [SD 4.8]). Most of the adolescents (90%) assigned to TLE reported that limiting their eating window and wearing a CGM was feasible without negative impact on daily functioning or adverse events. There were no between-group difference in terms of weight loss, energy intake, quality of life, physical activity, or eating behaviors. TLE combined with CGM appears feasible and safe among adolescents with obesity. Further investigation in larger samples, with a longer intervention duration and follow-up assessments are needed.
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Affiliation(s)
- Alaina P. Vidmar
- Center for Endocrinology, Diabetes and Metabolism, Diabetes & Obesity Program, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (M.N.); (J.K.R.); (E.H.); (M.I.G.)
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA 90027, USA
- Correspondence: ; Tel.: +1-323-361-3385
| | - Monica Naguib
- Center for Endocrinology, Diabetes and Metabolism, Diabetes & Obesity Program, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (M.N.); (J.K.R.); (E.H.); (M.I.G.)
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA 90027, USA
| | - Jennifer K. Raymond
- Center for Endocrinology, Diabetes and Metabolism, Diabetes & Obesity Program, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (M.N.); (J.K.R.); (E.H.); (M.I.G.)
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA 90027, USA
| | - Sarah Jeanne Salvy
- Research Center for Health Equity, Cedars-Sinai Medical Center, Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA 90048, USA;
| | - Elizabeth Hegedus
- Center for Endocrinology, Diabetes and Metabolism, Diabetes & Obesity Program, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (M.N.); (J.K.R.); (E.H.); (M.I.G.)
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA 90027, USA
| | - Choo Phei Wee
- Department of Population and Public Health Sciences, Keck School of Medicine, Southern California Clinical and Translational Science Institute (SC-CTSI), Los Angeles, CA 90007, USA;
| | - Michael I. Goran
- Center for Endocrinology, Diabetes and Metabolism, Diabetes & Obesity Program, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (M.N.); (J.K.R.); (E.H.); (M.I.G.)
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA 90027, USA
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