Treatment of Obesity

Wolfe, Bruce M.; Kvach, Elizaveta; Eckel, Robert H.

doi:10.1161/circresaha.116.307591

Cited by 520 publications

(254 citation statements)

References 121 publications

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“…The medical-surgical world is increasingly oriented towards drug-or surgeon-centered treatments. Obesity is treated with anti-obesity medications or bariatric surgery, 143,144 insomnia with transcranial magnetic stimulation, 145 and treatmentresistant conditions with neurosurgical implants. 146 It seems that multiple benefits deriving from healthy diet, physical activity, and restful sleep have been progressively forgotten.…”

Section: Resultsmentioning

confidence: 99%

<p>Healthy Eating, Physical Activity, and Sleep Hygiene (HEPAS) as the Winning Triad for Sustaining Physical and Mental Health in Patients at Risk for or with Neuropsychiatric Disorders: Considerations for Clinical Practice</p>

Briguglio¹,

Vitale²,

Galentino³

et al. 2020

NDT

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Neuropsychiatric disorders stem from gene-environment interaction and their development can be, at least in some cases, prevented by the adoption of healthy and protective lifestyles. Once full blown, neuropsychiatric disorders are prevalent conditions that patients live with a great burden of disability. Indeed, the determinants that increase the affliction of neuropsychiatric disorders are various, with unhealthy lifestyles providing a significant contribution in the interplay between genetic, epigenetic, and environmental factors that ultimately represent the pathophysiological basis of these impairing conditions. On one hand, the adoption of Healthy Eating education, Physical Activity programs, and Sleep hygiene promotion (HEPAS) has the potential to become one of the most suitable interventions to reduce the risk to develop neuropsychiatric disorders, while, on the other hand, its integration with pharmacological and psychological therapies seems to be essential in the overall management of neuropsychiatric disorders in order to reduce the disability and improve the quality of life of affected patients. We present an overview of the current evidence in relation to HEPAS components in the prevention and management of neuropsychiatric disorders and provide suggestions for clinical practice.

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Section: Resultsmentioning

confidence: 99%

<p>Healthy Eating, Physical Activity, and Sleep Hygiene (HEPAS) as the Winning Triad for Sustaining Physical and Mental Health in Patients at Risk for or with Neuropsychiatric Disorders: Considerations for Clinical Practice</p>

Briguglio¹,

Vitale²,

Galentino³

et al. 2020

NDT

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“…Weight loss is a known method for improving diabetes and dyslipidemia [65], and new publications support this. Body weight loss of even 5–7% is sufficient to lower triglycerides, and further weight loss causes greater improvements [66–68].…”

Section: Impact Of Diabetes On Lipoprotein Metabolismmentioning

confidence: 99%

Unexplained reciprocal regulation of diabetes and lipoproteins

Higuchi

Izquierdo

Haeusler

2018

Current Opinion in Lipidology

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Purpose of review Type 2 diabetes is associated with a characteristic dyslipidemia that may exacerbate cardiovascular risk. The causes of, and the effects of new antihyperglycemia medications on, this dyslipidemia, are under investigation. In an unexpected reciprocal manner, lowering LDL-cholesterol with statins slightly increases the risk of diabetes. Here we review the latest findings. Recent findings The inverse relationship between LDL-cholesterol and diabetes has now been confirmed by multiple lines of evidence. This includes clinical trials, genetic instruments using aggregate single nucleotide polymorphisms, as well as at least eight individual genes – HMGCR, NPC1L1, HNF4A, GCKR, APOE, PCKS9, TM6SF2, and PNPLA3 – support this inverse association. Genetic and pharmacologic evidence suggest that HDLcholesterol may also be inversely associated with diabetes risk. Regarding the effects of diabetes on lipoproteins, new evidence suggests that insulin resistance but not diabetes per se may explain impaired secretion and clearance of VLDL-triglycerides. Weight loss, bariatric surgery, and incretin-based therapies all lower triglycerides, whereas SGLT2 inhibitors may slightly increase HDL-cholesterol and LDL-cholesterol. Summary Diabetes and lipoproteins are highly interregulated. Further research is expected to uncover new mechanisms governing the metabolism of glucose, fat, and cholesterol. This topic has important implications for treating type 2 diabetes and cardiovascular disease.

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“…(15) Bariatric surgery should be considered for patients with a BMI ≥ 40 kg/m 2 and no co-morbidities; or ≥ 35 kg/m 2 with one or more co-morbidities and for whom the procedure would not be associated with excessive risk [69] . …”

Section: Methodsmentioning

confidence: 99%

Clinical Practice Recommendations for the Management of Obesity in the United Arab Emirates

et al. 2018

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With rapid urbanisation and improved living conditions as a result of rising incomes in Gulf Cooperation Council (GCC) countries, obesity has become a major and growing health problem for the region. The United Arab Emirates (UAE) has a resident population of 9.3 million (in 2016), many of whom (85.5%) lived in urban areas and led sedentary lifestyles. Based on the World Health Organisation (WHO) estimates for 2010, 25% of Emirati men and 40% of the women were obese. Obesity rates in this country has doubled from 16 to 34% compared to the year 2000, and severe obesity (BMI > 40 kg/m²) has risen dramatically from 2 to 11%. While a number of international guidelines for the management of obesity are already available in public domain, local guidelines for the UAE and the region, which are structured and individualized for the management of obesity, are sorely needed to help the family physician to provide affordable treatment for the patient at the point-of-care and to reduce the burden on the local healthcare system. A multi-disciplinary panel of international and regional experts who treat patients with overweight and obesity was convened with the aim of developing consensus recommendations for the UAE. The objective is to have a simple and easy-to-refer set of recommendations for busy clinicians as there were already many comprehensive international guidelines available. The panel reviewed and streamlined these recommendations in its entirety for relevance, coherence and usability in the local context. These recommendations for overweight and obesity management were circulated and endorsed by the local practising family medicine community, namely, the Emirates Medical Association and Family Medicine Society. We believe these recommendations would also be of interest to clinicians in other GCC countries. A summary and algorithm of these recommendations are provided.

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Treatment of Obesity

Cited by 520 publications

References 121 publications

<p>Healthy Eating, Physical Activity, and Sleep Hygiene (HEPAS) as the Winning Triad for Sustaining Physical and Mental Health in Patients at Risk for or with Neuropsychiatric Disorders: Considerations for Clinical Practice</p>

<p>Healthy Eating, Physical Activity, and Sleep Hygiene (HEPAS) as the Winning Triad for Sustaining Physical and Mental Health in Patients at Risk for or with Neuropsychiatric Disorders: Considerations for Clinical Practice</p>

Unexplained reciprocal regulation of diabetes and lipoproteins

Clinical Practice Recommendations for the Management of Obesity in the United Arab Emirates

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