Once-weekly semaglutide administered after laparoscopic sleeve gastrectomy: Effects on body weight, glycemic control, and measured nutritional metrics in Japanese patients having both obesity and type 2 diabetes
This study investigated the impact of once-weekly semaglutide treatment after laparoscopic sleeve gastrectomy (LSG) in 29 Japanese patients with type 2 diabetes (T2D). The participants were divided into a group receiving a low-energy, high-protein formula diet (FD) and a conventional diet (CD) group.
After 12 months of semaglutide treatment, additional weight reduction and improved glycemic control were observed, but there were adverse effects on measured nutritional metrics, including decreases in serum albumin, vitamin B12, and zinc. The FD group, however, exhibited a significant increase in skeletal muscle mass per 1% body weight compared to the CD group during semaglutide treatment. This suggested that a low-energy, high-protein formula diet may mitigate the nutritional effects of semaglutide in patients with T2D after LSG.
An OMA Clinical Practice Statement 2024
Special Considerations for the Adolescent with Obesity
The article provides an extensive overview of the clinical practice statements (CPS) by the Obesity Medicine Association (OMA) aimed at addressing the assessment and management of children and adolescents with overweight and obesity (OW/OB). It highlights the multifaceted approach required in treating obesity in the pediatric population, emphasizing nutrition, physical activity, behavior, and medication as the four pillars of comprehensive obesity care and underscores the importance of individualized treatment plans through shared decision-making between clinicians and patients. The CPS delves into the special considerations needed for managing obesity in adolescents, pointing out the physical and emotional challenges unique to this age group. It then emphasizes the urgent need for early intervention to combat the escalating rates of obesity among U.S. adolescents, highlighting the role of genetic, environmental, and behavioral factors in obesity and its related health issues like metabolic syndrome and type 2 diabetes. It advocates for personalized management strategies for adolescents with special healthcare needs and obesity, emphasizing the complexity of their care, the necessity of a multidisciplinary approach, and addressing weight bias in healthcare.
The CPS also discusses the management of polycystic ovarian syndrome (PCOS) in the context of its relationship with obesity, focusing on treatments that reduce insulin resistance and hyperandrogenism. Additionally, it explores the unique challenges faced by adolescent athletes with obesity, including an increased risk of physical injuries and weight-based victimization, and emphasizes the importance of fostering positive experiences in sports participation.
Overall, the CPS by the OMA provides a comprehensive framework for clinicians in the assessment and management of obesity in children and adolescents, stresses the need for an individualized, evidence-based, and empathetic approach to care.
Motivational interviewing for weight management among college students during COVID-19: An exploratory randomized controlled trial
During the COVID-19 pandemic, obesity rates among U.S. college students rose due to obesogenic behaviors like decreased physical activity and higher caloric intake. This article explores how motivational interviewing (MI), a person-centered approach, affects body composition and self-determination theory (SDT) constructs in overweight or obese college students. The study conducted a randomized controlled trial with 40 participants, comparing the effects of MI against an online education control group over six months. Results showed that the MI group experienced significant improvements in body composition, including increased lean mass and decreased fat mass, along with psychological benefits such as enhanced autonomy and motivation. Despite limitations like a small sample size and high dropout rates, the study highlights MI's potential to improve health outcomes and motivation among college students during challenging times.
Patient perceptions of three-dimensional (3D) surface imaging technology and traditional methods used to assess anthropometry
The study discusses the limitations of traditional obesity assessment methods, like Body Mass Index (BMI), which fail to accurately reflect individual body composition variations, and highlights the societal and personal challenges faced by individuals in managing their weight, including stigma and reluctance to engage with healthcare services. It introduces three-dimensional (3D) surface imaging as a non-invasive, precise alternative for assessing human body shape and composition, suggesting it could improve engagement with weight management services by providing a more detailed and less stigmatizing assessment.
Through a questionnaire and interviews with 49 participants, the research found a preference for this innovative technology due to its detailed data and potential to offer a nuanced understanding of body composition over time. Despite its benefits, challenges such as data interpretation complexity and concerns over negative body image impacts were noted, indicating a need for further research into its integration into health practices, emphasizing sensitive communication and support for users.
Effects of phentermine / topiramate extended-release, phentermine, and placebo on ambulatory blood pressure monitoring in adults with overweight or obesity: A randomized, multicenter, double-blind study
While anti-obesity medications such as orlistat and glucagon-like peptide (GLP) receptor agonists may reduce blood pressure, the prescribing information for sympathomimetic agents such as phentermine (PHEN) or Phentermine + Topiramate (PHENT/TPM) warn of potential adverse reactions in raising blood pressure. However, this recent study seems to state otherwise! The study focused on the blood pressure-lowering effects of a phentermine and topiramate combination (PHEN/TPM) in overweight and obese patients, comparing its efficacy to placebo and phentermine alone. PHEN/TPM showed significant reductions in systolic blood pressure (SBP) when measured using 24-hour ambulatory blood pressure monitoring (ABPM), a method superior to clinic measurements for predicting cardiovascular risk. The study was randomized and double-blind, including 565 adults with BMI ≥ 27 kg/m² and weight-related comorbidities, across an 8-week period with lifestyle counseling. Participants received placebo (184), phentermine 30 mg (191) or PHEN 15 mg / TPM 92 mg (190). Results indicated that PHEN/TPM effectively reduced mean 24-hour SBP compared to placebo and phentermine monotherapy, without negatively impacting diastolic blood pressure (DBP). PHEN/TPM also led to weight reduction comparable to phentermine monotherapy. Despite its short duration and exclusion of participants with uncontrolled hypertension, the study suggests that PHEN/TPM could be a beneficial treatment for reducing a key cardiovascular disease risk factor in obese and overweight patients.
Article reviewed by:
Obesity Medicine Association
The Obesity Medicine Association (OMA) is the largest organization of physicians, nurse practitioners, physician assistants, and other health care providers working every day to improve the lives of patients affected by obesity. OMA members are clinical experts in obesity medicine. They use a comprehensive, scientific, and individualized approach when treating obesity, which helps patients achieve their health and weight goals. OMA offers resources, education, and community to physicians and other healthcare providers in the field of obesity medicine.
Point of Contact: Teresa Fraker, FACHE, RN, CPHQ, TFraker@obesitymedicine.org