Management of overweight and obese adults.
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ABSTRACT:
SUBMITTER: Noel PH
PROVIDER: S-EPMC1124275 | biostudies-literature | 2002 Oct
REPOSITORIES: biostudies-literature
Publications
Management of overweight and obese adults.
Noël Polly Hitchcock PH Pugh Jacqueline A JA
BMJ (Clinical research ed.) 20021001 7367
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Project description:BackgroundAlthough there are many wearable devices available to help people lose weight and decrease the rising prevalence of obesity, the effectiveness of these devices in long-term weight management has not been established.ObjectiveThis study aimed to systematically review the literature on using wearable technology for long-term weight loss in overweight and obese adults.MethodsWe searched the following databases: Medical Literature Analysis and Retrieval System Online, EMBASE, Compendex, ScienceDirect, Cochrane Central, and Scopus. The inclusion criteria were studies that took measurements for a period of ≥1 year (long-term) and had adult participants with a BMI >24. A total of 2 reviewers screened titles and abstracts and assessed the selected full-text papers for eligibility. The risk of bias assessment was performed using the following tools appropriate for different study types: the Cochrane risk of bias tool, Risk Of Bias In Nonrandomized Studies-of Interventions, A MeaSurement Tool to Assess systematic Reviews, and 6 questions to trigger critical thinking. The results of the studies have been provided in a narrative summary.ResultsWe included five intervention studies: four randomized controlled trials and one nonrandomized study. In addition, we used insights from six systematic reviews, four commentary papers, and a dissertation. The interventions delivered by wearable devices did not show a benefit over comparator interventions, but overweight and obese participants still lost weight over time. The included intervention studies were likely to suffer from bias. Significant variances in objectives, methods, and results of included studies prevented meta-analysis.ConclusionsThis review showed some evidence that wearable devices can improve long-term physical activity and weight loss outcomes, but there was not enough evidence to show a benefit over the comparator methods. A major issue is the challenge of separating the effect of decreasing use of wearable devices over time from the effect of the wearable devices on the outcomes. Consistency in study methods is needed in future long-term studies on the use of wearable devices for weight loss.Trial registrationPROSPERO CRD42018096932; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=96932.
| S-EPMC7093773 | biostudies-literature
Project description: Not available
| S-EPMC8094215 | biostudies-literature
Project description:BackgroundGeneral practitioners (GPs) can play an important role in both the prevention and management of overweight and obesity. Current general practice guidelines in the Netherlands allow room for GPs to execute their own weight management policy.ObjectiveTo examine GPs' current weight management policy and the factors associated with this policy.Methods800 Dutch GPs were asked to complete a questionnaire in December 2012. The questionnaire items were based on the Dutch Obesity Standard for GPs. The data were analyzed by means of descriptive statistics and multiple linear regression analyses in 2013.ResultsIn total, 307 GPs (39.0%) responded. Most respondents (82.9%) considered weight management as part of their responsibility for providing care. GPs aged <48 years discussed weight less frequent. Next, weight is less frequently discussed with patients without weight-related comorbidities or with moderately overweight patients compared to obese patients. On average, 47.7% of the GPs reported to refer obese patients to a weight management professional, preferably a dietitian (98.3%). GPs with a BMI ? 25 kg/m(2) were less likely to refer obese patients. In addition, GPs who had frequent contact with a dietitian were more likely to refer obese patients.ConclusionsIn the context of General Practice and preventive medicine, GPs' discussion of weight and the variety of obesity-determinants with their moderately overweight patients deserves more attention, especially from younger GPs. Strengthening interdisciplinary collaboration between GPs and dietitians could increase the referral percentage for dietary treatment.
| S-EPMC4472618 | biostudies-literature
Project description:BackgroundMetabolic syndrome (MetS) is one of the main reasons for elevated cardiovascular morbidity and mortality worldwide. Obese and overweight individuals are at high risk of developing these chronic diseases. The aim of this study was to characterize and establish sex-adjusted prevalence of metabolic syndrome and its components.MethodsA cross-sectional study was conducted in 2015, 689 (329 men and 360 women) aged 18-65 years from three refugee camps in the West Bank. International Diabetes Federation and modified National Cholesterol Education Program-Third Adult Treatment Panel definitions were used to identify MetS.ResultsThe overall prevalence of obesity and overweight was high, 63.1%; Obesity (42 and 29.2% in women men; respectively and overweight 25.8 and 28.9% in women and men; respectively. The prevalence of MetS among obese and overweight was significantly higher (69.4%) according to IDF than NCEP definition (52%) (p?<?0.002) with no significant differences between men and women using both definitions; (IDF; 71.8% men vs. 67.6% women, and (NCEP/ATP III; 51.9% men vs. 52.2% women). The prevalence of MetS increased significantly with increasing obesity and age when NCEP criterion is applied but not IDF. The prevalence of individual MetS components was: high waist circumference 81.3% according to IDF and 56.5% according to NCEP, elevated FBS 65.3% according to IDF and 56% according to NCEP, elevated blood pressure 48%, decreased HDL 65.8%, and elevated triglycerides 31.7%. Based on gender differences, waist circumferences were significantly higher in women according to both criteria and only elevated FBS was higher in women according to IDF criteria. Physical activity was inversely associated with MetS prevalence according to NCEP but not IDF. No significant associations were found with gender, smoking, TV watching, and family history of hypertension or diabetes mellitus.ConclusionIn this study, irrespective of the definition used, metabolic syndrome is highly prevalent in obese and overweight Palestinian adults with no gender-based differences. The contribution of the metabolic components to the metabolic syndrome is different in men and women. With the increase of age and obesity, the clustering of metabolic syndrome components increased remarkably. More attention through health care providers should, therefore, be given to the adult population at risk to reduce adulthood obesity and subsequent cardiovascular diseases.
| S-EPMC5907715 | biostudies-literature
Project description:Obesity has been associated with negative effects on postural control, including falls. Previous studies revealed different outcomes regarding the effects of obesity on gait features, and the use of BMI may lead to bias in assessing the true effects of obesity on gait. To better understand the effects of obesity on gait, it is important to examine gait features and associated body composition measures. The purpose of this study was: (1) to assess gait features of normal weight, overweight and obese adults, and (2) to assess the relationship between body composition measures and gait features. Thirty participants were assigned to one of three groups based upon their BMI at the onset of the study: healthy weight (BMI: 18.5-24.9kg/m2), overweight (BMI: 25-29.9kg/m2), or obese (BMI: 30-40kg/m2). Participants performed straight-line over-ground walking through a 200m hallway at their natural preferred speed while wearing their own shoes. The angular displacements, range of motion (ROM), and approximate entropy of kinematic data of the bilateral hips, knees, and ankles in the sagittal plane were computed. Walking speed, step length, stride length, single leg support phase, double leg support phase, swing phase and bilateral stance phase times were extracted from the GaitRite data. Overall, body mass and BMI were associated with peak flexion and ROM in the knees as well as single support, double support, stance, and swing phases. Body fat percentage did not exhibit correlations with measured gait features. Gait variables were more highly correlated with BMI and body mass instead of percent body fat, suggesting that absolute mass is more influential on gait features rather than amount of fat tissue.
| S-EPMC6510244 | biostudies-literature
Project description:Approximately two out of three adult Americans are overweight or obese. Despite widespread recognition of this disorder, there has been little progress in the past 20 years in finding effective noninvasive treatments for weight loss. The consequences of obesity are increasingly well recognized and include increases in blood pressure, plasma lipids, the onset of type 2 diabetes, sleep apnea, asthma, osteoarthritis and a variety of cancers. Obesity can increase the rate of pregnancy complications and fetal malformations in normoglycemic women. Current medical approaches to obesity, including intensive lifestyle interventions and drug therapies, have been successful in achieving modest weight loss of 4-7%, less than the 1998 NIH Guidelines target of 10%. Surgical approaches, including laparoscopic adjustable gastric banding, vertical banded gastroplasty and Roux-en-Y gastric bypass, are much more successful, achieving weight loss of 15-50%. A treatment gap therefore exists in the management of obese and overweight patients, because many patients desire and would receive great health benefits by achieving weight loss of 7-15%. This review will discuss the dilemma of the treatment gap and explore possible ways by which it may be filled in the future by the use of innovative approaches.
| S-EPMC4089698 | biostudies-other
Project description:Islet autoantibodies are typically associated with type 1 diabetes, but have been found in patients diagnosed with type 2 diabetes in whom they are associated with lower adiposity. The significance of autoantibody positivity in overweight and obese patients is not well understood. The aim of this study was to determine the prevalence and clinical significance of islet autoantibodies in overweight/obese adults diagnosed with type 2 diabetes. This study includes 204 participants at one site of the multicenter Look AHEAD (Action for Health in Diabetes) trial (ClinicalTrials.gov identifier: NCT00017953) which randomized overweight/obese adults diagnosed with type 2 diabetes to an intensive lifestyle intervention or diabetes support and education. We measured antibodies to glutamic acid decarboxylase, insulinoma antigen-2, and zinc transporter 8. Participants with and without autoantibodies were compared with respect to baseline clinical features, and longitudinal changes in weight, hemoglobin A1c, and antihyperglycemic medications. We found that 13 participants (6.4%) were autoantibody positive, including six of 47 participants (12.8%) with BMI ≥40 kg/m2. At baseline, autoantibody positive participants had higher HDL cholesterol (1.27 vs. 1.09 mmol/L, p = .034) and lower fasting C-peptide (0.32 vs. 0.57 nmol/L, p = .049). Over four years, autoantibody positive participants lost 5.1 kg more weight than autoantibody negative participants (p = .056). Longitudinal changes in hemoglobin A1c did not differ by autoantibody status, though autoantibody positive participants were more likely to increase the number of antihyperglycemic medications or initiate insulin (p = .011). In conclusion, islet autoantibodies were present in 6.4% of overweight/obese adults with type 2 diabetes including those with severe obesity, and were associated with distinct clinical features. The effect of autoantibody positivity on weight loss interventions requires further study.
| S-EPMC6362362 | biostudies-literature
Project description:BackgroundTo compare moderate-to-vigorous intensity physical activity (MVPA) assessed via questionnaires to an objective measure of MVPA in overweight or obese young adults.MethodsMVPA was assessed in 448 [median BMI = 31.2 (Interquartile Range: 28.5-34.3) kg/m2] young adults [median age: 30.9 (Interquartile Range: 27.8-33.7) years]. Measures included the SenseWear Armband (MVPAOBJ), the Paffenbarger Questionnaire (MVPAPAFF), and the Global Physical Activity Questionnaire (GPAQ). The GPAQ was used to compute total MVPA (MVPAGPAQ-TOTAL) and MVPA from transportation and recreation (MVPAGPAQ-REC).ResultsThe association between MVPAOBJ and MVPAPAFF was rs = 0.40 (P < .0001). Associations between MVPAOBJ and MVPAGPAQ-TOTAL and MVPAGPAQ-REC were rs = 0.19 and rs = 0.32, respectively (P < .0001). MVPAGPAQ-TOTAL was significantly greater than MVPAOBJ (P < .0001). Median differences in MET-min/week between MVPAOBJ and MVPAPAFF or MVPAGPAQ-REC were not significantly different from zero. There was proportional bias between each self-reported measure of MVPA and MVPAOBJ. There were significant associations between all measures of MVPA and fitness. MVPAOBJ was significantly associated with BMI and percent body fat.ConclusionsObjective and self-reported measures of MVPA are weakly to moderately correlated, with substantial differences between measures. MVPAOBJ provided predictive validity with fitness, BMI, and percent body fat. Thus, an objective measure of MVPA may be preferred to self-report in young adults.
| S-EPMC4506910 | biostudies-literature
Project description:ObjectivesTo explore the effects of weight change on the risk of metabolic abnormalities in the Chinese population.MethodsA total of 1895 metabolically healthy adults aged 21-78 years completed anthropometric and biological measurements at baseline (2012) and at an eight year follow-up (2020). Based on absolute weight change and relative weight change, the participants were split into five classes. A Cox proportional hazards regression model was used to estimate the relative risk (RR) and 95% confidence intervals (95% CI) for the risk of metabolic abnormalities using stable weight as the reference group. Stratified analysis was used to explore this relationship in participants with different baseline body mass index (BMI) levels.ResultsDuring the follow-up period, 35.41% of the participants retained a stable weight, and 10.71% had metabolic abnormalities. After covariate adjustment, for every kilogram gained over eight years, the risk of developing metabolic abnormalities increased by 22% (RR: 1.094; 95% CI: 1.063-1.127). Compared with stable weight participants, weight gain of 2-4 Kg and weight gain ≥ 4 Kg exhibited significantly higher risks of metabolic abnormalities, with RR of 1.700 (95% CI 1.150-2.513) and 1.981 (95% CI 1.372-2.859), respectively. A weight gain of ≥ 4 Kg had an opposite effect on the overweight/obesity and non-overweight/obesity groups, with an increased risk of metabolic abnormalities only in the non-overweight/obesity group (RR, 2.291; 95% CI, 1.331-3.942). Moreover, weight loss ≥ 4 Kg significantly reduced the risk of metabolic abnormalities only among overweight/obese adults (RR 0.373; 95% CI 0.154-0.906). Similar results were observed in relative body weight change analyses.ConclusionsLong-term excessive body weight gain is positively associated with an increased risk of metabolic abnormalities among adults with non-overweight/obesity, whereas long-term body weight loss is a protective factor for metabolic health among adults with overweight/obesity.
| S-EPMC9808089 | biostudies-literature
Project description:Background. Abdominal obesity and its relative distribution are known to differ in association with metabolic characteristics and cardiorespiratory fitness. This study aimed to determine an association between fitness level and abdominal adiposity in overweight and obese adults. Methods. 228 overweight and obese individuals were classified as either cardiorespiratory unfit or fit based on their recovery heart rate. Visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), the visceral-to-subcutaneous adipose tissue ratio (VAT/SAT ratio), and cardiometabolic characteristics were analyzed to examine the relationship between recovery heart rate and abdominal adiposity components. Results. After adjustments for age and sex, significant relationships of recovery heart rate and VAT, SAT, and VAT/SAT ratio were found; however, SAT was not significantly associated after further adjustment for body mass index (BMI) (r = 0.045, P = 0.499), whereas VAT (r = 0.232, P < 0.001) and VAT/SAT ratio (r = 0.214, P = 0.001) remained associated. Through stepwise multiple regression analyses after adjustment for age, sex, BMI, lifestyle factors, mean blood pressure, fasting glucose, HOMA-IR, lipid profiles, and hsCRP, recovery heart rate was identified as an independent variable associated with VAT (β = 0.204, P < 0.001) and VAT/SAT ratio (β = 0.163, P = 0.008) but not with SAT (β = 0.097, P = 0.111). Conclusions. Cardiorespiratory fitness level is independently associated with VAT and the VAT/SAT ratio but not with SAT in overweight and obese adults.
| S-EPMC3958687 | biostudies-literature