BackgroundThe cause of the obesity epidemic is multifactorial, but may, in part, be related to medication-induced weight gain. While clinicians may strive to do their best to select pharmacotherapy(ies) that has the least negative impact on weight, the literature regarding the weight effects of medication is often limited and devoid of alternative therapies.ResultsAntipsychotics, antidepressants, antihyperglycemics, antihypertensives and corticosteroids all contain medications that were associated with significant weight gain. However, there are several medication alternatives within the majority of these classes associated with weight neutral or even weight loss effects. Further, while not all of the classes of medication examined in this review have weight-favorable alternatives, there exist many other tools to mitigate weight gain associated with medication use, such as changes in dosing, medication delivery or the use of adjunctive therapies.ConclusionMedication-induced weight gain can be frustrating for both the patient and the clinician. As the use of pharmaceuticals continues to increase, it is pertinent for clinicians to consider the weight effects of medications prior to prescribing or in the course of treatment. In the case where it is not feasible to make changes to medication, adjunctive therapies should be considered.

The aim of this article was to examine the associations between having had a sinus infection (SI) and BMI and physical activity (PA), diet quality, stress and/or sleep. A total of 2915 adults from the National Health and Nutrition Examination Survey 2005-2006 were examined. Logistic regression analysis was used to examine the association between having had an SI with BMI and PA, diet quality, stress or sleep. As these factors are known to influence one another, a fully adjusted model with PA, diet quality, stress and sleep was also constructed to examine their independent associations with having had an SI. Overall, 15.5 ± 1.2% of the population report having had an SI in the past year. In all models, individuals with obesity were approximately twice as likely to have had an SI compared to those of normal weight (P < 0.05). While PA and diet quality were not significantly associated with having had an SI (P > 0.05), individuals with stress and sleep troubles were also twice as likely to have had an SI (P < 0.05) independent of BMI. In the fully adjusted model, only the associations for BMI and sleep troubles remained significant (P < 0.05). Results from this study suggest that obesity and sleep troubles, but not PA, quality of diet and stress, are associated with having had an SI. As interactions exist between obesity, immune system factors and exposure to infectious disease(s), more research is necessary to understand the directionality of these relationships.

Body weight is positively associated with RMR. However, there exists a paucity of research on the associations between baseline and changes in resting metabolic rate (ΔRMR) with chronic conditions and weight loss (WL), with findings being inconsistent. Sex stratified analysis was undertaken. Despite having a significant WL of 6.2 ± 8.5 kg (P<0.05), there were no significant ΔRMR (16 ±325 kcal/day, P > 0.05). Men and women with high blood pressure had higher baseline RMR, and only women with high LDL had lower baseline RMR than those without the respective chronic condition (P<0.05). Regardless of sex, WL was not significantly associated with baseline RMR or ΔRMR (P>0.05). This study suggests that participants with a low baseline RMR do not appear to be at a disadvantage for WL. Further, WL can occur without reductions in RMR in individuals with high levels of obesity and obesity-related comorbidities.iii

We aimed to predict % maximal oxygen consumption at absolute accelerometer thresholds and to estimate and compare durations of objective physical activity (PA) among body mass index (BMI) categories using thresholds that account for cardiorespiratory fitness. Eight hundred twenty-eight adults (53.5% male; age, 33.9 ± 0.3 years) from the National Health and Nutrition Examination Survey 2003–2004 were analyzed. Metabolic equivalent values at absolute thresholds were converted to percentage of maximal oxygen consumption, and accelerometer counts corresponding to 40% or 60% maximal oxygen consumption were determined using 4 energy expenditure prediction equations. Absolute thresholds underestimated PA intensity for all adults; however, because of lower fitness, individuals with overweight and obesity work at significantly higher percentage of maximal oxygen consumption at the absolute thresholds and require significantly lower accelerometer counts to reach relative moderate and vigorous PA intensities compared with those with normal weight (P < 0.05). However, moderate-to-vigorous physical activity (MVPA) durations were shorter when using relative thresholds compared with absolute thresholds (in all BMI groups, P < 0.05), and they were shorter among individuals with obesity compared with those with normal weight when using relative thresholds (P < 0.05). Regardless of the thresholds used, a greater proportion of individuals with normal weight met the PA guideline of 150 min·week–1 of MVPA compared with individuals with obesity (absolute: 21.3% vs 6.7%; Yngve: 4.0% vs 0.2%; Swartz: 10.7% vs 3.9%; Hendelman: 4.7% vs 0.2%; Freedson: 6.4% vs 0.5%; P < 0.05). Current absolute thresholds of accelerometry-derived PA may overestimate MVPA for all BMI categories when compared with relative thresholds that account for cardiorespiratory fitness. Given the large variability in our results, more work is needed to better understand how to use accelerometers for evaluating PA at the population level.

Objective: To explore whether accelerometer thresholds that are adjusted to account for differences in body mass influence discrepancies between self-report and accelerometer measured physical activity (PA) volume for individuals with overweight and obesity.Methods: 6164 adults from 2003-2006 NHANES surveys were analyzed. Established accelerometer thresholds were adjusted to account for differences in body mass to produce a similar energy expenditure (EE) rate as individuals with normal weight. Moderate, vigorous, and moderate-to-vigorous (MV) intensity PA durations were measured using established and adjusted accelerometer thresholds and compared to self-report.Results: Durations of self-report were longer than accelerometer measured MVPA using established thresholds (normal weight: 57.8±2.4 vs 9.0±0.5 min/day, overweight: 56.1±2.7 vs 7.4±0.5 min/day, and obesity: 46.5±2.2 vs 3.7±0.3 min/day). Durations of subjective and objective PA were negatively associated with body mass index (BMI) (P<0.05). Using adjusted thresholds increased MVPA durations, and reduced discrepancies between accelerometer and self-report measures for overweight and obese groups by 6.0±0.3 min/day and 17.7±0.8 min/day, respectively (P<0.05). Conclusion:Using accelerometer thresholds that represent equal EE rates across BMI categories reduced the discrepancies between durations of subjective and objective PA for overweight and obese groups. However, accelerometer measured PA generally remained shorter than durations of self-report within all BMI categories. Further research may be necessary to improve analytical approaches when using objective measures of PA for individuals with overweight or obesity.