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Journal of Evidence-informed Social Work 2016Adult obesity in the United States has risen to epidemic proportions, and mental health professionals must be called to action. The objectives of this article were to... (Review)
Review
Adult obesity in the United States has risen to epidemic proportions, and mental health professionals must be called to action. The objectives of this article were to (a) synthesize outcomes of behavioral health interventions for adult obesity in recent meta-analyses and systematic reviews (MAs/SRs) as well as randomized controlled trials (RCTs) and further, (b) evaluate the role of mental health professionals in these behavioral health interventions. Articles were included if published in English between January 1, 2004, and May 1, 2014, in peer-reviewed journals examining behavioral health interventions for adults with obesity. Data were subsequently extracted and independently checked by two authors. Included MAs/SRs utilized motivational interviewing, financial incentives, multicomponent behavioral weight management programs, as well as dietary and lifestyle interventions. Behavioral health interventions in randomized controlled trials (RCTs) were discussed across 3 major intervention types (educational, modified caloric intake, cognitive-based). Regarding the 1st study objective, multiple positive primary (e.g., weight loss) and secondary outcomes (e.g., quality of life) were found in both MAs/SRs and RCTs. However, the majority of included studies made no mention of interventionist professional background and little inference could be made regarding the effects of professional background on behavioral health intervention outcomes for adults facing obesity; an important limitation and direction for future research. Future studies should assess the effects of interventionist profession in addition to primary and secondary outcomes for adults facing obesity. Implications for mental health professionals' educational curricula, assessment, and treatment strategies are discussed.
Topics: Behavior Therapy; Humans; Meta-Analysis as Topic; Obesity; Randomized Controlled Trials as Topic; Review Literature as Topic; United States
PubMed: 26087070
DOI: 10.1080/23761407.2015.1031418 -
The Bone & Joint Journal Jan 2017The purpose of our study is to summarise the current scientific findings regarding the impact of obesity on total hip arthroplasty (THA); specifically the influence of... (Review)
Review
AIMS
The purpose of our study is to summarise the current scientific findings regarding the impact of obesity on total hip arthroplasty (THA); specifically the influence of obesity on the timing of THA, incidence of complications, and effect on clinical and functional outcomes.
MATERIALS AND METHODS
We performed a systematic review that was compliant with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify prospective studies from the PubMed/Medline, Embase, and Cochrane Library databases that evaluated primary THA in obese (body mass index (BMI) ≥ 30 kg/m) patients.
RESULTS
There were 17 articles included in the review, which encompassed 13 722 THA patients. Analysis of the included studies showed that, when compared with non-obese patients, obesity was associated with younger age at time of primary THA, and an increased incidence of complications (up to four-fold). Results were mixed on the influence of obesity on the outcomes of primary THA, with three studies showing a detrimental effect on outcomes of a BMI ≥ 30 kg/m, while eight studies showed no effect.
CONCLUSION
Obesity is associated with significantly younger age at time of primary THA and obese patients are likely to experience a higher rate of peri-operative complications. More investigation is needed into the effect of obesity on clinical outcomes, as the current literature is mixed. Cite this article: Bone Joint J 2017;99-B(1 Supple A):31-6.
Topics: Age Factors; Arthroplasty, Replacement, Hip; Hip Dislocation; Humans; Obesity; Postoperative Complications; Risk Factors; Treatment Outcome
PubMed: 28042116
DOI: 10.1302/0301-620X.99B1.BJJ-2016-0346.R1 -
Clinical Gastroenterology and... Mar 2016Obesity is associated with an increased risk for pancreatic cancer, but it is unclear whether it affects mortality. We performed a systematic review and meta-analysis to... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND & AIMS
Obesity is associated with an increased risk for pancreatic cancer, but it is unclear whether it affects mortality. We performed a systematic review and meta-analysis to assess the association between premorbid obesity and mortality from pancreatic cancer.
METHODS
We performed a systematic search through January 2015 and identified studies of the association between premorbid obesity (at least 1 year prior to pancreatic cancer diagnosis) and pancreatic cancer-related mortality. We estimated summary adjusted hazard ratio (aHR) with 95% confidence interval (CI), comparing data from obese (body mass index [BMI] ≥30 kg/m(2)) and overweight subjects (BMI, 25.0-29.9 kg/m(2)) with those from individuals with a normal BMI (controls) by using random-effects model.
RESULTS
We identified 13 studies (including 3 studies that pooled multiple cohorts); 5 studies included only patients with pancreatic cancer, whereas 8 studies evaluated pancreatic cancer-related mortality in cancer-free individuals at inception. In the meta-analysis, we observed increase in pancreatic cancer-related mortality among overweight (aHR, 1.06; 95% CI, 1.02-1.11; I(2) = 0) and obese individuals (aHR, 1.31; 95% CI, 1.20-1.42; I(2) = 43%), compared with controls; the association remained when we analyzed data from only subjects with pancreatic cancer. Each 1 kg/m(2) increase in BMI was associated with 10% increase in mortality (aHR, 1.10; 95% CI, 1.05-1.15) with minimal heterogeneity (I(2) = 0). In the subgroup analysis, obesity was associated with increased mortality in Western populations (11 studies; aHR, 1.32; 95% CI, 1.22-1.42) but not in Asia-Pacific populations (2 studies; aHR, 0.98; 95% CI, 0.76-1.27).
CONCLUSIONS
In a systematic review and meta-analysis, we associated increasing level of obesity with increased mortality in patients with pancreatic cancer in Western but not Asia-Pacific populations. Strategies to reduce obesity-induced metabolic abnormalities might be developed to treat patients with pancreatic cancer.
Topics: Body Mass Index; Global Health; Humans; Obesity; Pancreatic Neoplasms
PubMed: 26460214
DOI: 10.1016/j.cgh.2015.09.036 -
Antimicrobial Resistance and Infection... Nov 2022The role of obesity in catheter-related bloodstream infection has been reported in several studies, but it is still controversial. We conducted this meta-analysis to... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The role of obesity in catheter-related bloodstream infection has been reported in several studies, but it is still controversial. We conducted this meta-analysis to summarize existing evidence to assess the relationship between obesity and the risk of catheter-related bloodstream infection.
METHODS
We searched MEDLINE, EMBASE, PubMed and Web of Science for the related studies published before January 2022. Meta-analysis was performed by use of a random-effects model.
RESULTS
A total of 5 articles were included in this meta-analysis. Patients with body mass index ≥ 25 kg/m had an increased risk of catheter-related bloodstream infection (OR 1.75, 95% CI 1.38-2.22) in overall analysis. Further analysis indicated that patients with overweight, obesity and severely obesity were all significantly associated with a higher risk of for catheter-related bloodstream infection (OR 1.51 [1.10-2.08], OR 1.43 [1.12-1.82] and OR 2.74 [1.85-4.05], respectively).
CONCLUSION
This meta-analysis provided evidence that obesity was significantly associated with a higher risk of catheter-related bloodstream infection. Close attention should be paid to the complications and prognosis of obese patients with vascular catheterization in clinical work.
Topics: Humans; Catheter-Related Infections; Sepsis; Obesity; Catheters
PubMed: 36371230
DOI: 10.1186/s13756-022-01166-z -
Obesity Research & Clinical Practice 2015The increasing prevalence of both obesity and dementia is a significant public health concern, especially as recent research demonstrates a significant relationship... (Review)
Review
The increasing prevalence of both obesity and dementia is a significant public health concern, especially as recent research demonstrates a significant relationship between these conditions. However, while there is evidence of an obesity-dementia relationship, the effect of obesity on cognitive function in adults, independent of obesity related comorbidities, remains ambiguous. Furthermore, research is yet to systematically compare evidence for domain specific cognitive deficits in obese adults. A systematic literature review was conducted to assess evidence for domain specific cognitive deficits in obese (BMI>30 kg/m(2)) adults (18-65 years of age) and whether these studies have been able to determine an independent relationship between obesity and cognition over and above relevant comorbidities. Seventeen articles were identified. The literature revealed impairments in obese adults across almost all cognitive domains investigated (e.g. complex attention, verbal and visual memory, decision making). However, numerous methodological limitations were identified which need to be considered in interpretations and conclusions regarding an independent effect. While cognitive impairments in obese adults are evident, as a result of these methodological limitations there is currently insufficient evidence to indicate a reliable and valid independent association between obesity and cognitive impairment in mid-life adults. Further research addressing key methodological limitations (e.g. application of relevant exclusions and control variables, use of appropriate comparison groups and measures) is recommended in order to improve understanding of the relationship between mid-life obesity and cognition. Such research will inform the development of appropriate approaches to identification, prevention and treatment of cognitive decline in obese adults.
Topics: Body Mass Index; Cognition; Cognition Disorders; Humans; Obesity
PubMed: 25890426
DOI: 10.1016/j.orcp.2014.05.001 -
PloS One 2022Smoking and obesity are leading causes of morbidity and mortality worldwide. E-cigarette which was first introduced in 2000s is perceived as an effective alternative to... (Review)
Review
Smoking and obesity are leading causes of morbidity and mortality worldwide. E-cigarette which was first introduced in 2000s is perceived as an effective alternative to conventional tobacco smoking. Limited knowledge is available regarding the risks and benefits of e-cigarettes. This study systematically reviews the current literature on the effects of e-cigarettes on body weight changes and adipocytes. The search was performed using OVID Medline and Scopus databases and studies meeting the inclusion criteria were independently assessed. This review included all English language, empirical quantitative and qualitative papers that investigated the effects of e-cigarettes on bodyweight or lipid accumulation or adipocytes. Literature searches identified 4965 references. After removing duplicates and screening for eligibility, thirteen references which involve human, in vivo and in vitro studies were reviewed and appraised. High prevalence of e-cigarette was reported in majority of the cross sectional studies conducted among respondent who are obese or overweight. More conclusive findings were identified in in vivo studies with e-cigarette causing weight decrease. However, these observations were not supported by in vitro data. Hence, the effect of e-cigarette on body weight changes warrants further investigations. Well-designed population and molecular studies are needed to further elucidate the role of e-cigarettes in obesity.
Topics: Adipocytes; Body Weight; Cross-Sectional Studies; Electronic Nicotine Delivery Systems; Humans; Obesity; Weight Gain
PubMed: 35788209
DOI: 10.1371/journal.pone.0270818 -
Psychological Trauma : Theory,... Jul 2018Studies have demonstrated a relationship between adverse childhood experiences (ACEs) and adult obesity. Group interventions addressing the psychosocial sequelae of ACES... (Review)
Review
OBJECTIVE
Studies have demonstrated a relationship between adverse childhood experiences (ACEs) and adult obesity. Group interventions addressing the psychosocial sequelae of ACES using a trauma-informed approach for adults are well described in the literature. There is also a significant body of literature on the efficacy and proposed structure of interventions addressing weight reduction in adults. However, it is unknown how often interventions addressing attainment of a healthy weight incorporate a specific focus on adult women with a history of ACEs, including childhood abuse and trauma.
METHOD
A systematic review of the literature was conducted using standard approaches. Two additional reviews used broadened inclusion criteria to identify and include group-level interventions that addressed intended outcomes other than obesity. Studies that examined the link between ACEs and obesity as a primary outcome and that provided a description of any potential mediating variables were also identified. The current literature search was conducted as the first step in a multifaceted approach to the development of a set of proposed research protocol designs for an Office on Women's Health-sponsored trauma-informed healthy weight pilot intervention for obese women with a history of ACEs.
RESULTS
No articles describing interventions for the treatment of obesity or overweight women with a history of ACEs were identified. Eleven articles describing ACE-related interventions and 15 studies identifying mediators were reviewed.
CONCLUSIONS
Intervention studies for women with ACEs, other than psychotherapy, are limited. Significant mediators to be considered include anxiety symptoms and internalizing behaviors. Specific recommendations for interventions are provided. (PsycINFO Database Record
Topics: Adult Survivors of Child Adverse Events; Female; Humans; Obesity
PubMed: 28758770
DOI: 10.1037/tra0000313 -
International Journal of Obesity (2005) Nov 2015The association between eating rate and obesity has recently been reported. However, the findings remain inconclusive. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The association between eating rate and obesity has recently been reported. However, the findings remain inconclusive.
OBJECTIVES
We undertook a systematic review with a meta-analysis of published epidemiological studies to provide a reliable close estimate of the association between eating rate and obesity.
METHODS
A comprehensive search of MEDLINE, EMBASE and CINAHL was conducted to identify studies that reported quantitative estimates for indices of obesity based on the category of eating rate. Interventional studies or studies conducted using children as subjects were excluded. Two independent researchers extracted the data. A summary estimate was calculated using a random-effects model, and subgroup analyses were conducted to identify sources of heterogeneity.
RESULTS
Data from 23 published studies were eligible for inclusion. The mean difference in body mass indices (BMIs) between individuals who ate quickly and those who ate slowly was 1.78 kg m(-2) (95% confidence interval (CI), 1.53-2.04 kg m(-2)). The pooled odds ratio of eating quickly on the presence of obesity was 2.15 (95% CI, 1.84-2.51). There was evidence of significant quantitative heterogeneity in the magnitudes of the association across studies (I2=78.4%, P-value for heterogeneity <0.001 for BMI, I2=71.9%, P-value for heterogeneity <0.001 for obesity), which may be partially explained by differences in the type of study population (a weaker association was observed for BMI in diabetic patients).
CONCLUSIONS
Eating quickly is positively associated with excess body weight. Further studies are warranted to determine whether interventions to slow the speed of eating are effective for weight control.
Topics: Body Mass Index; Energy Metabolism; Feeding Behavior; Humans; Obesity; Risk Factors
PubMed: 26100137
DOI: 10.1038/ijo.2015.96 -
International Journal of Cardiology Aug 2016Post-operative atrial fibrillation (POAF) is one of the most common complications following cardiac surgery. However, it is unclear whether there is a relationship... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Post-operative atrial fibrillation (POAF) is one of the most common complications following cardiac surgery. However, it is unclear whether there is a relationship between obesity and POAF. We thus assessed all available evidence investigating the association between obesity and POAF, also considering any link between POAF and other post-operative conditions such as mortality, stroke, myocardial infarctions and respiratory complications.
METHODS
Five electronic databases were searched and relevant studies were identified. Data was extracted and meta-analyzed from the identified studies.
RESULTS
We found that obese patients had significantly higher odds of POAF when compared with non-obese patients (P=0.006). There was also significant heterogeneity among the identified studies. POAF when compared with no-POAF was associated with an increased risk of stroke (P<0.0001), 30-day mortality (P=0.005) and respiratory complications (P<0.00001). However, we found no significant link between POAF and myocardial infarctions (P=0.79).
CONCLUSIONS
Our findings suggest that obesity is associated with a moderately higher risk of POAF. While POAF is also associated with an increased incidence of stroke, 30-day mortality and respiratory complications, further studies must be conducted before conclusions can be made about the long-term outcomes.
Topics: Atrial Fibrillation; Cardiac Surgical Procedures; Cardiovascular Diseases; Databases, Bibliographic; Female; Humans; Male; Obesity; Postoperative Period; Risk Factors
PubMed: 27179208
DOI: 10.1016/j.ijcard.2016.05.002 -
JAMA Pediatrics Jul 2015Obesity affects nearly one-sixth of US children and results in alterations to body composition and physiology that can affect drug disposition, possibly leading to... (Review)
Review
IMPORTANCE
Obesity affects nearly one-sixth of US children and results in alterations to body composition and physiology that can affect drug disposition, possibly leading to therapeutic failure or toxic side effects. The depth of available literature regarding obesity's effect on drug safety, pharmacokinetics, and dosing in obese children is unknown.
OBJECTIVE
To perform a systematic literature review describing the current evidence of the effect of obesity on drug disposition in children.
EVIDENCE REVIEW
We searched the MEDLINE, Cochrane, and EMBASE databases (January 1, 1970-December 31, 2012) and included studies if they contained data on drug clearance, volume of distribution, or drug concentration in obese children (aged ≤18 years). We compared exposure and weight-normalized volume of distribution and clearance between obese and nonobese children. We explored the association between drug physicochemical properties and clearance and volume of distribution.
FINDINGS
Twenty studies met the inclusion criteria and contained pharmacokinetic data for 21 drugs. The median number of obese children studied per drug was 10 (range, 1-112) and ages ranged from newborn to 29 years (1 study described pharmacokinetics in children and adults together). Dosing schema varied and were either a fixed dose (6 [29%]) or based on body weight (10 [48%]) and body surface area (4 [19%]). Clinically significant pharmacokinetic alterations were observed in obese children for 65% (11 of 17) of the studied drugs. Pharmacokinetic alterations resulted in substantial differences in exposure between obese and nonobese children for 38% (5 of 13) of the drugs. We found no association between drug lipophilicity or Biopharmaceutical Drug Disposition Classification System class and changes in volume of distribution or clearance due to obesity.
CONCLUSIONS AND RELEVANCE
Consensus is lacking on the most appropriate weight-based dosing strategy for obese children. Prospective pharmacokinetic trials in obese children are needed to ensure therapeutic efficacy and enhance drug safety.
Topics: Body Composition; Body Weight; Child; Child, Preschool; Drug Dosage Calculations; Humans; Metabolic Clearance Rate; Obesity; Pharmacokinetics
PubMed: 25961828
DOI: 10.1001/jamapediatrics.2015.132