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La Revue Du Praticien Nov 2019Genetics and epigenetics of obesity: the keys to understand. Obesity is a multifactorial disease due to central dysregulation of energy homeostasis. The contribution of...
Genetics and epigenetics of obesity: the keys to understand. Obesity is a multifactorial disease due to central dysregulation of energy homeostasis. The contribution of genetics is constant but varies according to the situations from the rare forms of non-syndromic and syndromic monogenic obesities (about 5% of cases) and the socalled polygenic obesity (or common obesity) which is the most frequent situation (95% of cases). Environmental factors (early pre- and post-natal, societal or psychological determinants) always interact closely with the genetic factors of predisposition. The better understanding of these different actors should lead in the future to a real personalized medicine (targeted drug treatments according to the identified genetic anomaly and / or multidisciplinary management or even bariatric surgery according to clinical situations).
Topics: Epigenesis, Genetic; Genetic Predisposition to Disease; Humans; Obesity
PubMed: 32237628
DOI: No ID Found -
The Journal of the American Osteopathic... Apr 1999The epidemic of obesity in the United States has major consequences for society. Healthcare providers need to have an appreciation for obesity's complexity and related... (Review)
Review
The epidemic of obesity in the United States has major consequences for society. Healthcare providers need to have an appreciation for obesity's complexity and related multiple comorbid medical problems. This article reviews the epidemiology, definitions, and assessment of obesity with emphasis on its clinical consequences. In addition, current techniques in evaluating and treating the obese patient are also described.
Topics: Comorbidity; Female; Humans; Male; Obesity; Pregnancy; Pregnancy Complications; United States
PubMed: 10334083
DOI: 10.7556/jaoa.1999.99.4.s7 -
Journal of Public Health Management and... 2021There is wide variation in the number and types of obesity policies enacted across states, and prior studies suggest that partisan factors may not fully explain this...
OBJECTIVE
There is wide variation in the number and types of obesity policies enacted across states, and prior studies suggest that partisan factors may not fully explain this variation. In this exploratory analysis, we examined the association of a broad array of state-level factors with the number and types of obesity policies across states.
DESIGN
We analyzed 32 predictor variables across 7 categories of state-level characteristics. We abstracted data from 1652 state obesity policies introduced during 2009-2014. We used multilevel regression models and principal component analysis to examine the association between state-level characteristics and policy outcomes.
MAIN OUTCOME MEASURES
Our outcome measures included whether bills involved topics that were public health-oriented or business interest-oriented, whether bills were enacted into law, and the number of introduced bills and enacted laws per state.
RESULTS
Numerous state-level characteristics were associated with obesity-related bill introduction and law enactment, and different state characteristics were associated with public health-oriented versus business interest-oriented policies. For example, state-level demographics, economic factors, policy environment, public programs, and the prevalence of obesity's downstream consequences were associated with the number of public health laws whereas obesity prevalence and policy environment were associated with the number of business interest laws.
CONCLUSIONS
Our results support the hypothesis that a variety of factors contribute to a complex state obesity policymaking environment, highlighting the need for future research to disentangle these key predictors.
Topics: Humans; Obesity; Policy Making; Prevalence; Public Health; United States
PubMed: 31415263
DOI: 10.1097/PHH.0000000000001039 -
European Journal of Clinical Nutrition May 1998Swedish Obese Subjects (SOS) is a multidisciplinary project involving aspects of obesity ranging from description of the severely obese state to effects of surgical... (Review)
Review
OBJECTIVES
Swedish Obese Subjects (SOS) is a multidisciplinary project involving aspects of obesity ranging from description of the severely obese state to effects of surgical intervention on long-term mortality and morbidity. Dietary studies, which represent an integral part of SOS research activities, are the focus of this review.
SUBJECTS AND METHODS
Due to the large number of obese subjects included in the SOS data bases ( > 5000), an early priority of the project was to develop a dietary assessment method which: (i) described usual intake patterns; (ii) could be self-administered by subjects and rapidly processed; and (iii) was equally valid in obese and non-obese individuals.
RESULTS
The SOS method has met these requirements and is now being completed by all subjects at baseline and during the intervention, and by a non-obese reference population. A number of dietary features distinguishing obese subjects have emerged, including: elevated intakes of energy and energy-percent fat; low consumption of alcohol, fruits and vegetables; high dietary disinhibition; frequent consumption of light meals and snacks; and night eating. In the surgical intervention group, a relatively high consumption of sweet foods was associated with better weight loss and maintenance.
CONCLUSIONS
The SOS method appears to be less susceptible to obesity-related under-reporting than traditional dietary methods, and if the distribution of foods and nutrients can be assumed to be as unbiased as the energy intakes, this method should make it possible to capture associations between diet and obesity-related diseases in the future.
Topics: Energy Intake; Humans; Nutrition Assessment; Nutritional Physiological Phenomena; Obesity; Registries; Sweden; Weight Loss
PubMed: 9630380
DOI: 10.1038/sj.ejcn.1600567 -
Explore (New York, N.Y.) 2012Obesity is a growing epidemic. Chronic stress produces endocrine and immune factors that are contributors to obesity's etiology. These biochemicals also can affect... (Review)
Review
Obesity is a growing epidemic. Chronic stress produces endocrine and immune factors that are contributors to obesity's etiology. These biochemicals also can affect appetite and eating behaviors that can lead to binge-eating disorder. The inadequacies of standard care and the problem of patient noncompliance have inspired a search for alternative treatments. Proposals in the literature have called for combination therapies involving behavioral or new biological therapies. This manuscript suggests that mind-body interventions would be ideal for such combinations. Two mind-body modalities, energy psychology and mindfulness meditation, are reviewed for their potential in treating weight loss, stress, and behavior modification related to binge-eating disorder. Whereas mindfulness meditation and practices show more compelling evidence, energy psychology, in the infancy stages of elucidation, exhibits initially promising outcomes but requires further evidence-based trials.
Topics: Behavior Therapy; Binge-Eating Disorder; Humans; Meditation; Mind-Body Therapies; Obesity; Stress, Psychological; Weight Loss
PubMed: 22938745
DOI: 10.1016/j.explore.2012.06.003 -
Cancer Epidemiology, Biomarkers &... Nov 2019The association of obesity at diagnosis with prostate cancer progression is uncertain. This study aimed to examine the relationship between body mass index (BMI;...
BACKGROUND
The association of obesity at diagnosis with prostate cancer progression is uncertain. This study aimed to examine the relationship between body mass index (BMI; 18.5-<25, 25-<30, 30-<35, ≥35 kg/m) and prognostic risk at diagnosis, compare the concordance between prognostic risk assessed at diagnostic biopsy versus pathologic risk assessed at surgery across BMI categories, and investigate the association between obesity and prostate cancer recurrence and all-cause death.
METHODS
We examined men enrolled in CaPSURE who underwent radical prostatectomy between 1995 and 2017. Multiple imputation methods were used to handle missing data and reported along with complete case findings.
RESULTS
Participants ( = 5,200) were followed for a median of 4.5 years; 685 experienced recurrence. Obesity was associated with higher prognostic risk at time of diagnosis (OR = 1.5; OR = 1.7) and upward reclassification of disease between biopsy and surgery, driven by change in tumor stage (OR = 1.3; OR = 1.6). We observed an association between BMI and recurrence with adjustment for disease severity using diagnostic factors (HR = 1.7); this association disappeared when adjusting for disease severity factors obtained at surgery.
CONCLUSIONS
Our findings suggest that residual confounding may partially explain the conflicting evidence regarding obesity's influence on prostate cancer progression. Assessing T-stage via digital rectal exam may be complicated in larger men, potentially affecting clinical treatment decisions. A strong association with all-cause mortality demonstrates healthier BMI at diagnosis may still improve overall survival.
IMPACT
Patients with greater BMI are prone to more advanced disease at diagnosis and may be more likely to have their tumor stage underestimated at diagnosis.
Topics: Disease Progression; Female; Humans; Male; Middle Aged; Obesity; Prostatectomy; Prostatic Neoplasms; Recurrence; Risk Factors
PubMed: 31462398
DOI: 10.1158/1055-9965.EPI-19-0488 -
American Journal of Surgery Mar 2014Obesity's effect on the outcomes of trauma patients remains inconclusive.
BACKGROUND
Obesity's effect on the outcomes of trauma patients remains inconclusive.
METHODS
A retrospective review of all falls, motor vehicle collisions (MVCs), and penetrating trauma patients admitted from January 2008 to December 2012 was performed. The outcomes evaluated included mortality, length of stay at hospital, and discharge disposition. Patients were grouped according to the body mass index (BMI) and stratified by injury severity scores.
RESULTS
Two thousand one hundred ninety six patients were analyzed; 132 penetrating, 913 falls, and 1,151 MVCs. Penetrating traumas had no significant difference in outcomes. In falls, obese patients had a lower mortality (P = .035). In MVCs, obese patients had longer hospitalizations (P = .02), and mild and moderate MVC injuries were less likely to be discharged home (P = .032 and .003). Obese patients sustained fewer head injuries in falls and MVCs (P = .005 and .043, respectively).
CONCLUSIONS
In falls, a higher BMI may benefit patients. However, an increasing BMI is associated with a longer length of stay at hospital, and decreased likelihood of discharge to home.
Topics: Accidental Falls; Accidents, Traffic; Body Mass Index; Comorbidity; Humans; Illinois; Injury Severity Score; Length of Stay; Obesity; Outcome Assessment, Health Care; Patient Discharge; Registries; Retrospective Studies; Wounds and Injuries; Wounds, Penetrating
PubMed: 24581763
DOI: 10.1016/j.amjsurg.2013.10.013 -
Annales D'endocrinologie Nov 2003In the singular, obesity is a symptom reflecting an excess of energy stores as fat mass, the only trait obese people are sharing. Long time ago we proposed to use the... (Review)
Review
In the singular, obesity is a symptom reflecting an excess of energy stores as fat mass, the only trait obese people are sharing. Long time ago we proposed to use the plural to account for the large diversity characterizing obese subjects that conceptual evolutions have put to the fore during the past three decades. Weight gain and obesity are resulting from a positive energy balance produced by the conjunction of a number of etiopathogenetic factors associated in various proportions according to patients and evolutive status. Decreasing physical activity, increasing sedentarity, quantitative and qualitative energy consumption unadapted to energy expenditure and to lipid oxidation capabilities, reinforced by psychological needs, are catching out the control of food intake, particularly since it is more efficient to defend against famine than to protect against plethora. These environmental factors, responsible for obesity pandemia, lead to obesity subjects predisposed by their genetic background, in itself extremely variable. The clinical heterogeneity of obesity is patent and a careful phenotypic analysis is a prerequisite to design the management strategy. Obesity is a chronic situation that needs a long-term treatment. The goals of treatment cannot be longer reduced to weight loss only, which in addition should be realistic, i.e. moderate. Management strategies must be conceived on a long-term basis, focused on prevention of weight regain, multifaceted and individually tailored. A number of tools are available and the state of the art is to use them appropriately to avoid being counter productive. Obesity may be viewed as an adaptive symptom in subjects poorly prepared to cope with recent environmental changes, but it is also a disease due to its prevalence, the number of weight dependent comorbidities and its socio economic costs. A specific medical approach of obesity has still to be developed.
Topics: Behavior Therapy; Diet; Digestive System Surgical Procedures; Environment; Exercise; Genetic Predisposition to Disease; Health Care Costs; Humans; Obesity
PubMed: 14707898
DOI: No ID Found -
Revista Medica de Chile Jul 2009The risk of complications of obesity is proportional to body mass index and is higher in severe or morbid obesities and when abdominal or visceral fat is predominant. In... (Review)
Review
The risk of complications of obesity is proportional to body mass index and is higher in severe or morbid obesities and when abdominal or visceral fat is predominant. In Chile the prevalence of obesity is increasing. According to the World Health Organization, obese subjects must reduce at least a 5% of their weight to reduce the risk of complications. Although this amount of reduction is seldom achieved with non pharmacological treatments, better results are obtained with multidisciplinary/ approaches that include a medical, psychosocial and laboratory assessment, to determine obesity level and different factors involved and the associated complications. In a second stage, goals of treatment are set and a personalized treatment is designed including dietary changes and physical activity. The aim is to obtain perdurable lifestyles modifications.
Topics: Body Mass Index; Cognitive Behavioral Therapy; Humans; Life Style; Obesity
PubMed: 19802427
DOI: No ID Found -
European Journal of Pediatrics Sep 2000In this article, information on the definition of obesity in childhood and adolescence, its differential diagnosis and its adverse health effects is provided. This... (Review)
Review
UNLABELLED
In this article, information on the definition of obesity in childhood and adolescence, its differential diagnosis and its adverse health effects is provided. This information can be considered as a basis for the evaluation of an obese patient. Review of the international and European literature shows that the co-morbidities of childhood obesity cover a large medical area ranging from secondary hormonal disturbances to orthopaedic problems. Most of them have so far been underestimated. However, the most severe problem of an obese child is his or her psychosocial discrimination. Longitudinal data demonstrate a positive relationship between childhood obesity and increased morbidity and mortality in adulthood.
CONCLUSION
Data from the literature are in some respect sparce since they do not allow to calculate the exact prevalence of adverse effects nor to assess the outcome of an obese child when it is successfully reducing the relative amount of body fat.
Topics: Adolescent; Child; Comorbidity; Energy Intake; Energy Metabolism; Europe; Humans; Obesity; Risk Factors; Social Isolation
PubMed: 11011952
DOI: 10.1007/pl00014368