Barriers and enablers to effective weight management for people living with overweight and obesity: A rapid scoping review.

A scoping review was conducted to identify barriers and enablers to effective weight management in healthcare settings for people living with overweight and obesity in English-speaking high-income countries. Peer-reviewed and gray literature were systematically searched in June 2024. Data were analyzed using inductive thematic analysis. Of the 15,684 unique articles identified and screened for relevance, 216 studies were included. Healthcare-related barriers and enablers to weight management were organized under three themes: a) healthcare provider-related factors, b) provision of care, and c) policy/funding. Prominent barriers included healthcare provider knowledge deficits and low prioritization of obesity management, mainly in the primary care setting. Weight management beyond the primary care setting was found to be especially challenging, with poor referral pathways, service fragmentation, lack of multidisciplinary practice, and restricted eligibility criteria, hindering the accessibility of services. Developing consistent policies and guidelines, improving the education of healthcare providers, and increasing funding to provide low-cost comprehensive care, were identified as enablers to access and uptake of weight management services. Considerable overlap in the identified barriers existed across healthcare providers and settings. A whole health system approach to minimize barriers and strengthen enablers to weight management services is needed, to address rising obesity rates.

Role of Dual GIP and GLP-1 Receptor Agonist, Tirzepatide in the Management of Weight Loss; A Systematic Review.

AIM: The eventuality of tirzepatide, a binary GIP and GLP- 1 receptor agonist, as a treatment for rotundity and metabolic diseases is addressed in this comprehensive review. BACKGROUND: A definition of tirzepatide is that it is an implicit intervention for rotundity, given its effectualness per the cure-dependent effect. Beyond the beneficial effects on body weight loss, tirzepatide also brings about an improvement in lipid biographies and insulin perceptivity, in harmony with binary receptor activation. METHODOLOGY: Assaying data from seven phases 3 trials, it's constantly shown that tirizepatide reduces body weight in a significant and clinically meaningful way for a variety of party biographies and lengths of time. RESULTS: The drug's effect was supported by its favorable safety profile, which shows low prevalence rates of common adverse goods. Its efficacy in the management of type 2 diabetes is supported by relative evaluations, underscoring the inevitability of its breakthrough as a therapeutic volition. Treatment individualization is key, as evidenced by the tailor-made response proposed by group analysis based on birth BMI. The efficacy, safety, and demand for personalized treatment plans of tirzepatide are each supported in recommendations for clinical practice. CONCLUSION: Tirzepatide's eventuality as a long-term strategy for habitual rotundity is corroborated by long-term follow-up studies that show sustained weight loss. Indeed with these encouraging results, further study and clinical experience are demanded to completely comprehend the safety, optimal integration, and long-term effectiveness of tirzepatide in a multiplicity of patient populations.

Psychological Scars Shouldn't be Ignored: Addressing Factors Linked to Depression among Individuals with Laparoscopic Sleeve Gastrectomy.

Introduction: Although bariatric surgeries have been linked to improved mental health, yet, some individuals develop depression. Objectives: The present study aimed to assess the levels of depression and examine factors linked to depression among individuals with laparoscopic sleeve gastrectomy (LSG) in Saudi Arabia. Methods: A cross-sectional design using a digital online survey was used to collect data. Depression was assessed using the Patient Health Questionnaire among individuals with LSG. Results: A total of 344 eligible participants were included in the study. A significant percentage of the participants, almost one-third, were suffering from depression 27% (n = 94). Moderate to severe depression levels among participants were significantly associated with postoperative complications [odds ratio, OR: 2.92 (95% CI: 1.42-6.01, p = .003)] and having preoperative psychological disorders before LSG [OR: 3.68 (95% CI: 1.88-7.26, p < .001)]. In contrast, lower levels of depression were significantly associated with believing LSG has achieved its goals [OR: 0.46 (95% CI: 0.22-0.97, p = .014)] and recommending LSG to family or friends [OR: 0.15 (95% CI: 0.05-0.44, p = .001)]. Conclusion: There is an evident link between depression and experiencing postoperative complications and suffering from psychological disorders before LSG. The findings of the current study would pave the road for the development of psychological strategies designed to break the cyclic pattern of occurrence of depression as well as optimize the success and maintenance of this treatment modality and support recovery for individuals undergoing LSG.

Weight Loss and Number of Present Teeth in Community-Dwelling Japanese Older Adults: A Cross-Sectional Study in Niigata.

BACKGROUND AND OBJECTIVES: Weight loss is a critical health issue among the older population. This study aimed to explore the association between weight loss and oral health in older adults. METHODS: We used cross-sectional data from the Uonuma Chronic Kidney Disease Cohort Study. The binary logistic regression models were fitted to estimate the relationship between weight loss and independent variables including the number of teeth present. RESULTS: The participants included 1656 females and 1625 males. There were 1217 females (73.4%) and 1236 males (76.0%) with normal BMI (18.5 ≤ BMI < 25) in the previous year. Weight loss was determined over a 12-month period. Individuals with normal BMI in previous year, and those with weight loss (≥ 5%) or those whom maintained a stable weight were further analysed. The regression analysis (model 3, fully adjusted) showed that females with 0 and 1-10 teeth present had a higher likelihood of losing weight (OR = 4.07; 95% CI = 1.85-8.93, OR = 2.33; 95% CI = 1.24-4.39) compared with those with 20 or more teeth. Current smokers had a higher likelihood of losing weight (OR = 3.15; 95% CI = 1.01-9.76) than lifelong abstainers. Among males, both current and previous smokers showed a higher likelihood of losing weight (OR = 4.94; 95%CI = 1.76-13.8, OR = 3.35; 95% CI = 1.29-8.68) than those who never smoked. CONCLUSIONS: This study indicates that the number of teeth and smoking are both linked to weight loss in females. However, in males, the association between the number of teeth and weight loss may be compromised due to the high prevalence of smoking in this group.

Effect of 1-Week Weight Loss While Maintaining Total Body Water on Jump Performance.

Jumping performance is influenced by body composition and excess fat mass impairs performance. Maintaining optimal fat mass and fat-free mass (FFM) is crucial for enhancing jump height. However, there is limited evidence on short-term weight loss programs that reduce fat mass without water restriction and their effects on muscle function and jumping performance. This study aimed to clarify the effects of a 1-week weight loss program on jumping height and muscle function of volleyball players. The weight loss group engaged in two 40 min slow-paced jogging sessions in addition to their daily training routine. Energy intake was restricted without limitations on water intake. Total body water and body composition using the deuterium dilution method, muscle strength, and jump height before and after 1 week were evaluated for those in the weight loss and control groups. Body mass was significantly reduced in the weight loss group (-2.7 ± 1.3%, p < 0.05) with a significant reduction in fat mass (-17.7 ± 10.7%, p < 0.05). Meanwhile, there were no significant changes in total body water or FFM. Muscle strength and power tests indicated no significant differences between the groups; no notable differences were observed in handgrip strength or knee extension torque. The height of a single vertical and continuous jump remained consistent pre- and postintervention in the control group. In the weight loss group, although the height of a single vertical jump exhibited a slight decline postintervention, the height of a continuous jump displayed no significant changes. The short-term weight loss program significantly reduced fat mass without compromising muscle function, which is crucial for sports performance. These findings may benefit other athletes who require fat mass reduction while maintaining muscle function and help create new programs during specific training phases.

The impact of weight self-stigma on weight-loss treatment engagement and outcome.

Background: Individuals with overweight or obesity often endure significant weight-based prejudice and discrimination in various settings. Experiencing weight-related stigma is linked to many adverse psychosocial outcomes. Weight self-stigma is when an individual internalizes and identifies with negative attributes ascribed to people with larger bodies and has self-devaluing thoughts because of their weight and is associated with poorer health outcomes. Aims: This study explored how weight self-stigma may impact weight management efforts and outcomes for adults participating in an onlight weight-loss intervention. Materials and Methods: 508 adults (86.2% female, 84.6% White) with overweight or obesity participated in an asynchronous 12-week online weight-loss intervention with computer-generated feedback. Weight and weight self-stigma were measured at baseline and 3 months later. Results: Thirty-one point five percent of the sample reported high levels of stigma, which was associated with greater program dropout than those who did not report high stigma (32.5% vs. 21.6%). Program completers reporting high self-stigma showed better treatment engagement (77.0% vs. 69.7% lessons viewed) and weight loss (M = -6.31% vs. -5.08%); these differences were not observed when using intent-to-treat assumptions. When analyzed as a continuous variable, weight self-stigma showed no association with treatment engagement and outcome. Discussion: These findings highlight the complexity of understanding how self-stigma affects treatment engagement and outcome in behavioral weight loss and the need for more targeted research in this understudied area. Conclusion: Results suggest that weight self-stigma plays a role in weight management during an online weight-loss intervention, affecting engagement and outcomes.

The corrosion inhibition performance of a diissocyanate-imidazole based organic compound during acid cleaning of MSF desalination plant.

Inorganic scale formation is a common issue in multi-stage flash (MSF) desalination plants, significantly impacting operational efficiency. To address this, acid cleaning is frequently employed, but it can lead to severe corrosion of alloy components if not properly controlled with corrosion inhibitors. This study investigates the effectiveness of toluene-2,4-diisocyanate-4-(1H-imidazole-ly) aniline (TDIA) as a corrosion inhibitor for 304L stainless steel in a simulated acid cleaning solution (1M HCl and 3.5 % NaCl). A range of tests, including electrochemical analysis, weight loss measurements, and surface characterization techniques such as AFM, EDS, and SEM, were used to assess the inhibitor's performance at temperatures of 25, 45, 65, and 90 °C. At a concentration of 50 ppm, TDIA achieved inhibition efficiencies of around 90% at 25 °C and above 80% at 90 °C, demonstrating effective protection across all temperatures studied. The adsorption behavior of TDIA followed the Langmuir adsorption model, and it acted as a mixed-type inhibitor by forming a protective layer on the metal surface, which prevents corrosive agents from accessing the steel. The dual-environment testing method, simulating conditions in desalination plants, offers valuable insights into the inhibitor's practical performance, enhancing the applicability of these findings to real-world industrial scenarios.

Conversion of one-anastomosis gastric bypass to Roux-En-Y gastric bypass: mid-term results from the United Arab Emirates.

BACKGROUND: One-Anastomosis Gastric Bypass (OAGB) is becoming popular, but some patients may need to convert to Roux-en-Y Gastric Bypass (RYGB) due weight-related difficulties or postoperative complications. The data on conversions is currently limited to 30-day or short-term follow-up studies. As such, the objective of this study was to evaluate the indications and mid-term outcomes for OAGB conversions to RYGB at a tertiary referral center in the United Arab Emirates. METHODS: A retrospective analysis was conducted on patients who underwent conversion from OAGB to RYGB between February 2016 and May 2023. Demographic information, indications for conversion, intraoperative details, and mid-term outcomes were collected and analyzed. RESULTS: Sixty-four patients underwent conversion from previous OAGB to RYGB. The cohort was 73.4% female (n = 47) with a mean age of 40.8 years. Indications for conversion included acid reflux (n = 28, 43.7%), intractable nausea/vomiting (n = 20, 31.2%), protein-calorie malnutrition (n = 7, 10.9%), anastomotic ulcer (n = 6, 9.3%) and weight recidivism (n = 3, 4.7%). The mean operative time was 238 ± 78.3 min. During the procedure, three intraoperative complications occurred: two cases of bleeding and one case of bowel perforation; all successfully addressed during surgery. The median hospital stay was 3 ± 15.8 days. Three patients (4.6%) experienced major postoperative complications comprising 2 anastomotic leaks and 1 small bowel obstruction. The mean follow-up time was 26.2 ± 19.7 months, with 96.2% of patients reporting resolution of symptoms. There were no mortalities. CONCLUSIONS: Acid reflux is representing 43.7% of the indications for conversion from OAGB to RYGB. The symptom resolution rate holds significance, standing at a remarkable 96.8%. Despite surgical technique advancements, the complication rate after conversions remains significant at 4.6%, with no mortality reported. OAGB patients should be informed about these risks prior to undergoing conversions from OAGB to RYGB.

Impact of waitlist weight change on outcomes in heart transplant recipients: a UNOS database analysis.

BACKGROUND: While the effect of pre-transplant weight on patient outcomes following heart transplantation (HTx) has previously been studied, data regarding the impact of dynamic weight change prior to HTx are extremely limited. OBJECTIVES: We sought to elucidate the interaction between HTx listing weight and weight change while waitlisted, and explore how that interaction impacts post-HTx survival in a continuous manner. METHODS: Adult patients listed for HTx from 1987 to 2020 were identified from UNOS database. Three-dimensional restricted cubic spline analysis explored post-HTx survival relative to both changes in BMI/weight and BMI at time of HTx listing. Continuous predictor variables were analyzed with Cox proportional hazards method. RESULTS: 9,628 included patients underwent HTx. Median recipient age was 55 [IQR 46-62] years, and 21% were females. 53% of patients lost while 47% gained weight on the waitlist. Median BMI (27.6 kg/m2 [24.3-31.3] vs. 27.4 kg/m2 [24.2-30.9], paired p < 0.001) and weight (84.8 kg [73.0-98.0] kg vs. 84.4 kg [72.6-96.6], p < 0.001) were similar at listing and transplant. One-year survival was 89.3%. Weight loss over 3 BMI points or 10 kg was associated with higher hazard of death irrespective of listing BMI. In non-obese patients, some weight gain (1-4 BMI points or 5-15 kg) was associated with improved survival. In cachectic patients (BMI < 18.5), failure to gain weight was associated with worse survival. CONCLUSIONS: Impact of weight change varies depending on listing BMI. While a survival benefit is seen in non-obese patients who gain some weight, significant weight loss is associated with poorer survival.

Effects of visual feedback balance system combined with weight loss training system on balance and walking ability in the early rehabilitation stage of stroke: a randomized controlled exploratory study.

Background: Previous studies have suggested that the Pro-Kin visual feedback balance system can promote the recovery of balance function in stroke patients. Objectives: However, this system has not been used effectively in the early stages of stroke rehabilitation. This study aimed to investigate the effect of Pro-Kin system combined with weight loss system for the early recovery of balance and walking ability following a stroke. Methods: A total of 62 patients who underwent radiological diagnosis of stroke were randomly divided into two groups: a control group (n = 31) and a treatment group (n = 31). Both groups received conventional balance training. The treatment group also received training on the Pro-Kin system in conjunction with a weight loss system. Balance was measured using the Berg Balance Scale (BBS), Timed 'Up & Go' (TUG) test and Pro-Kin system. Walking ability was assessed using the Functional Ambulation Classification (FAC). The tests were performed before the start of treatment and on the 4th week following the training. There was no statistically significant difference between the groups before training. Results: After 4 weeks of training in both groups, there were significant improvements in balance and walking ability. BBS values and FAC were significantly higher (p < 0.01), TUG times, ellipse area and motion trajectory length were significantly reduced (p < 0.01, p < 0.05) after training. The treatment group outperformed the control group (p < 0.05). In addition, there was a positive correlation between balance function and walking ability (p < 0.01). Conclusion: The Pro-Kin system combined with weight loss system is a viable method that promotes early reconstruction of balance and walking ability following a stroke. Trial registration: Clinical trial number ChiCTR1900026370. https://www.chictr.org.cn/showprojEN.html?proj=43736.

Increased incidence of weight-loss-associated humane endpoints in rats administered buprenorphine slow-release LAB formulation following traumatic brain injury: a retrospective study.

Traumatic brain injury (TBI) remains a significant global public health epidemic with adverse health and cost implications. Due to its complex, heterogeneous nature and wide-ranging impacts, definitive TBI treatments remain elusive. As such, continued laboratory research using animal models is warranted. In accordance with guidelines set forth for the humane treatment of research animals, TBI animal models are often administered analgesics for pain management. The choice of drug, timing, dose, and formulation of analgesic can vary depending on the study's unique needs and can potentially and unintentionally influence experimental results. In TBI studies utilizing rats as animal models, buprenorphine is a common analgesic administered. In addition to pain management in such studies, investigators must also monitor the research animals post-operatively and make the decision for humane euthanasia before intended experimental survival timepoint if the animals are assessed to be excessively suffering. This study investigated the differences in adult, male Sprague Dawley rats used for various TBI studies that reached weight-loss-induced humane endpoints following a single administration of buprenorphine slow-release LAB (bup-SR-LAB) or buprenorphine slow-release HCl (bup-SR-HCl). Our findings indicate that TBI-induced rats receiving bup-SR-LAB in conjunction with a secondary surgical insult such as artificial intracranial pressure elevation and/or osmotic pump implantation reach a weight-loss-induced humane euthanasia endpoint more often compared to sham-injured rats. When stratifying into the same groups, we did not find this pattern to hold true for rats administered bup-SR-HCl. Overall, this study contributes to the limited body of literature addressing different analgesic formulations' effects on laboratory animals.

Efficacy of Different Doses and Forms of the GLP-1 Receptor Agonist Semaglutide in Weight Reduction Among Non-diabetic Obese or Overweight Populations.

Disorders linked to increased body weight are on the rise and obesity is a global epidemic associated with a rising risk for developing comorbidities, such as hypertension or type 2 diabetes. There is a significant need to develop a multimodal approach targeting obesity within clinical medicine. Pharmacological options to produce weight loss have been a popular research area and the novel glucagon-like Peptide-1 receptor agonists (GLP-1 RA) are highly effective glycemic control agents that have shown a substantial weight loss effect. This systematic review explores the efficacy of semaglutide, a GLP-1 RA agent, in a non-diabetic population, looking at endpoints of changes in weight and waist circumference and the percentage of patients achieving a clinically effective weight loss of at least 5%. This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A comprehensive search was undertaken to find applicable papers using three databases, including PubMed, PubMed Central, and Cochrane Library. The included articles were narrowed down from an initial pool of 423 papers using filters, automation tools, inclusion/exclusion criteria, and quality appraisal tools. In this systematic review, we have analyzed 10 high-quality studies published in the last five years, including nine randomized control trials (RCTs) and a retrospective cohort study. The aim was to combine the results of these studies, encompassing 6623 participants, to showcase the effectiveness of GLP-1 RAs in the non-diabetic obese or overweight population. The consolidated data from the literature in this systematic review endorses the use of semaglutide as a highly efficient weight-reducing agent, contributing positive insight to both clinicians and researchers in the field of obesity treatment.

Effect of pyloroplasty on clinical outcomes following esophagectomy.

INTRODUCTION: The role of concurrent pyloroplasty with esophagectomy is unclear. Available literature on the impact of pyloroplasty during esophagectomy on complications and weight loss is varied. Data on the need for further pyloric intervention are scarce. Our study compares the clinical outcomes after esophagectomy with or without pyloroplasty and investigates the role of post-operative pyloric dilatation. METHODS: Consecutive patients (n = 207) undergoing Ivor Lewis esophagectomy performed by two surgeons at our institution were included. Data on patient demographics, mortality rate, anastomotic leak, respiratory complications (Clavien-Dindo grade ≥ 3), anastomotic stricture rate, and percentage weight loss at 1 and 2 year post-operatively were evaluated. For weight analysis at 1 and 2 year post-operatively, patients were excluded if they had been diagnosed with recurrence or died prior to the 1 or 2 year timepoints. RESULTS: Ninety-two patients did not have a pyloroplasty, and 115 patients had a pyloroplasty. There were no complications resulting from pyloroplasty. There was no significant demographic difference between the groups except for age. Mortality rate, anastomotic leak, respiratory complications, anastomotic stricture rate, and percentage weight loss at 1 and 2 years were statistically similar between the two groups. However, 14.1% of patients without pyloroplasty required post-operative endoscopic pyloric balloon dilatation to treat respiratory complications or gastroparesis. Subgroup analysis of patients without pyloroplasty indicated that patients requiring dilatation had greater weight loss at 1 year (15.8% vs 9.4%, p = 0.02) and higher respiratory complications rate (27.3% vs 4.7%, p = 0.038). CONCLUSIONS: Overall results from our study that pyloroplasty during Ivor Lewis esophagectomy is safe and useful to prevent the need for post-operative pyloric dilatation.

GLP-1 receptor agonists are a transformative prehabilitation tool for weight loss in obese patients undergoing elective hernia repair.

BACKGROUND: Obesity is an independent risk factor for complications after abdominal hernia repair. Glucagon-like-peptide-1 (GLP-1) receptor agonists are gaining popularity as pharmacologic weight loss adjuncts and may help patients reach weight loss goals for surgery. We examine our early experience utilizing GLP-1 agonists versus lifestyle modifications alone to achieve weight loss in patients before elective hernia repair. METHODS: This single-center, retrospective review identified obese patients who underwent elective hernia repair from 2014 to 2023. Patients were asked to achieve a BMI ≤ 33 kg/m2 before surgery. Patients who lost weight with GLP-1 therapy in addition to lifestyle changes were compared to a control cohort that achieved similar preoperative weight loss without GLP-1 therapy. Primary outcome was mean time from GLP-1 agonist initiation and initial surgery clinic visit to surgery. Secondary outcomes were 30-day morbidity, mortality, and reoperation rates, and hernia recurrence. RESULTS: Forty-six patients with ventral/incisional, flank, umbilical, parastomal, inguinal, and hiatal hernias were identified (GLP-1 N = 24, control N = 22). 81.8% (N = 18) of controls had a ventral/incisional hernia, compared to 45.8% (N = 11) of GLP-1 patients (p = 0.03). Mean BMI at GLP-1 agonist initiation was similar to mean BMI at initial clinic visit for controls (38.1 ± 4.9 vs 38.2 ± 2.7 kg/m2, p = 0.66). Preoperative mean percentage total weight loss (14.9 ± 7.5 vs 12.4 ± 6.9 kg, p = 0.39) and mean BMI reduction (6.0 ± 3.8 vs 4.9 ± 2.3 kg/m2, p = 0.43) were similar between groups. The mean time from GLP-1 agonist initiation to surgery was significantly shorter than initial clinic visit to surgery for controls (6.3 ± 4.0 vs 14.7 ± 17.6 months, p = 0.03). There was no statistically significant difference in time from initial clinic visit to surgery between groups (7.6 ± 4.4 vs 14.7 ± 17.6 months, p = 0.06). There was no significant difference in 30-day morbidity between groups (8.3 vs 27.3%, p = 0.13). CONCLUSION: GLP-1 agonists accelerate preoperative weight loss for obese hernia patients without negatively impacting postoperative outcomes.

Evaluation of a Workplace Diabetes Prevention Program Delivered via Distance Learning: A Qualitative Study.

Little is known about how distance learning impacts delivery of the National Diabetes Prevention Program (DPP) despite a rapid shift to this platform during the coronavirus disease 2019 (COVID-19) public health emergency. We explored how a workplace DPP, delivered via distance learning, impacted knowledge, motivation, and behavioral skills of participants throughout the program. We conducted repeated qualitative interviews with distance learning participants at baseline, 6 months, and 12 months from September 2020 to July 2022. Three study team members coded interview data using individual responses as the unit of analysis. We used a thematic approach, using the information-motivation-behavioral skills framework, to analyze responses and generate understanding of the program's impact. The 27 individuals who participated in the interviews (89% women, mean age 56 years) reported the distance learning platform was effective in changing their behavior. The program's focus on food logging and setting limits on specific types of caloric intake was perceived as essential. Education on ideal levels of fat and sugar consumption, lessons on how to read food labels, and dissemination of recipes with healthy food substitutions allowed participants to initiate and sustain healthy decision-making. Strategies to increase physical activity, including breaking up exercise throughout the day, made reaching their goals more feasible. Participants reported food logging and weight reporting, as well as group support during sessions, either sustained or increased their motivation to adhere to the program over time. A workplace DPP delivered via distance learning successfully prompted improvements in the knowledge, motivation, and behavioral skills necessary to increase healthy eating and physical activity among participants.

Effect of telemedicine interventions on weight loss: A systematic review and meta-analysis.

BACKGROUND AND OBJECTIVE: Obesity and its associated health challenges represent a pressing global concern. Telemedicine interventions offer a promising solution for effective weight loss support. This study examines the impact of telemedicine interventions on weight loss support. METHODS: We conducted a search of PubMed, Scopus, and Web of Science, starting from their inception. Both researchers systematically selected articles and extracted data using a designated data collection form. To assess the risk of bias in the included studies, we employed the Mixed Methods Appraisal Tool. Publication bias was evaluated through funnel plots and Egger's and Begg's tests. Utilizing the gathered data, we computed the standardized mean differences (Hedges's g) between the treatment and control groups. We estimated heterogeneity variance using the Q test and I2 statistic. The analysis was carried out using Stata 17.0. RESULTS: Out of a total of 2626 retrieved articles, 30 studies were included in the analysis. Telemedicine interventions can cause weight loss in people (Hedges's g = 0.09, 95% CI: -0.13, 0.39; p-value < 0.001). The type of telemedicine intervention and target population were a significant moderator of the heterogeneity between studies (p < 0.05). CONCLUSION: This study highlights the potential of telemedicine interventions as valuable tools in weight loss programs. Embracing these technologies can enhance the effectiveness of weight management strategies for diverse populations.

The prognostic role of food addiction for weight loss treatment outcomes in individuals with overweight and obesity: A systematic review and meta-analysis.

Food addiction (FA) could be a potential prognostic factor of weight loss intervention outcomes. This systematic review with meta-analysis aimed to (1) estimate this prognostic effect of FA diagnosis and symptom count in individuals with overweight or obesity and (2) explore potential sources of heterogeneity based on properties of the weight loss intervention, study, and sample (e.g., age, gender, ethnicity). We searched PubMed, PsycINFO, and Web of Science for studies reporting on associations between pre-intervention FA (assessed with the Yale Food Addiction Scale) and weight outcomes after weight loss intervention in individuals with overweight or obesity without a medically diagnosed eating disorder. Twenty-five studies met inclusion criteria, including 4904 individuals (71% women, Mage = 41 years, BMI = 40.82 kg/m2), k = 18 correlations of weight loss with FA symptom count, and k = 21 mean differences between FA diagnosis groups. Pooled estimates of random-effects meta-analyses found limited support for a detrimental effect of FA symptom count and diagnosis on weight loss intervention outcomes. Negative associations with FA increased for behavioral weight loss interventions and among more ethnically diverse samples. More research on the interaction of FA with pre-existing mental health problems and environmental factors is needed.

Evaluation of an oral small-molecule glucagon-like peptide-1 receptor agonist, lotiglipron, for type 2 diabetes and obesity: A dose-ranging, phase 2, randomized, placebo-controlled study.

AIM: The aim was to investigate the effects of lotiglipron, a once-daily, oral small-molecule glucagon-like peptide-1 (GLP-1) receptor agonist, in participants with type 2 diabetes (T2D) or obesity. MATERIALS AND METHODS: A phase 2, randomized, double-blind, placebo-controlled, dose-ranging study investigated the efficacy and safety of lotiglipron. The study was terminated early for safety reasons after routine data and monitoring review. The planned analyses for the end points were modified prior to unblinding the study. RESULTS: In total, 901 participants were treated with at least one dose of the study drug (T2D cohort: n = 512, obesity cohort: n = 389). Although the majority of participants who were randomly assigned to higher doses did not reach their target maintenance dose, statistically significant changes in HbA1c and body weight were observed. In the T2D cohort, reductions in HbA1c were observed across all lotiglipron doses at week 16 (p < 0.0001), with least squares mean decreases up to -1.44% (90% confidence interval [CI]: -1.63, -1.26) (lotiglipron 80 mg), versus placebo, -0.07% (90% CI: -0.25, 0.11). In the obesity cohort, decreases in body weight were observed across all lotiglipron doses at week 20 (p < 0.01), up to -7.47% (90% CI: -8.50, -6.43) (lotiglipron 200 mg, five-step titration), versus placebo, -1.84% (90% CI: -2.85, -0.83). Across cohorts, the most frequently reported treatment-emergent adverse events were gastrointestinal related (most mild to moderate severity), with nausea being the most common (ranging from 4% [placebo] to 28.8% [80 mg] in the T2D cohort and 12.5% [placebo] to 60.6% [200 mg, four-step titration] in the obesity cohort). Transaminase elevations were observed in a subset of participants (6.6% and 6.0% of participants on lotiglipron in the T2D and obesity cohorts, respectively, compared with 1.6% on placebo in the obesity cohort). CONCLUSIONS: The efficacy (HbA1c and/or body weight) of a range of lotiglipron doses was demonstrated in T2D and obesity cohorts. The safety profile was largely consistent with what has been previously known about the mechanism of action. Our results are unique in reporting elevations in liver transaminases in a subset of participants treated with lotiglipron, with attempts to identify the at-risk population unsuccessful and therefore clinical development of lotiglipron terminated. CLINICALTRIALS: GOV: NCT05579977.

Semaglutide Versus Other Glucagon-Like Peptide-1 Agonists for Weight Loss in Type 2 Diabetes Patients: A Systematic Review and Meta-Analysis.

Obesity places patients at higher risk for numerous problems, including prediabetes, type 2 diabetes mellitus (T2DM), hypertension, metabolic syndrome, cardiovascular disease, and nonalcoholic fatty liver disease. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are antidiabetic drugs that have a recognized effect on weight loss. This systematic review analyzed semaglutide against alternative GLP-1 agonists in facilitating weight loss and evaluated their associated adverse events (AEs) in diabetic patients. A systematic search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed using PubMed, Embase, and Cochrane Library for studies comparing semaglutide and other GLP-1 RAs for weight loss. A narrative synthesis and meta-analysis using SPSS program version 29 were performed to analyze the differences in weight loss between cohorts. Nine studies with 5,445 patients whose mean age was 60.01 years (55.5-70) and mean follow-up of 32.5 weeks (4-58.7) were included. The meta-analysis showed that semaglutide had a greater mean weight loss compared to liraglutide (-6.08, 95% confidence interval (Cl) = -8.40, -3.75) and dulaglutide (-2.85, 95% CI = -5.59, 0.11). Tirzepatide had a greater mean weight loss compared to semaglutide (-3.78, 95% CI = -5.52, -2.04). Common AEs included minor and moderate gastrointestinal events. In conclusion, GLP-1 RAs have shown efficacy in reducing body weight in T2DM patients. Semaglutide, liraglutide, dulaglutide, tirzepatide, and exenatide demonstrated mean weight loss reductions of 4.81 kg, 2.81 kg, 4.03 kg, 9.7 kg, and 1.9 kg, respectively, with high rates of minimal to moderate-severity AEs. Semaglutide demonstrated increased numerical weight loss compared to its comparators (dulaglutide, liraglutide, and exenatide). However, tirzepatide, a dual-agonist, produced greater weight loss compared to semaglutide. The paucity of comparative head-to-head trials prevents a definitive conclusion of the superiority of one GLP-1 RA over another.