Decoding Obesity Management Medications and the Journey to Informed Treatment Choices for Patients.

Incretin-based obesity management medications (OMMs) fill a treatment gap in a stepped-care model between lifestyle change alone and metabolic bariatric surgery, resulting in weight loss of 15% to 20% of body weight. Public interest in and demand for OMMs has recently increased dramatically. Unfortunately, cost and access to OMMs remain a significant barrier for many patients.

Role of Adverse Childhood Experiences in the Onset of Overweight/Obesity.

Purpose Of Review: The goal of this chapter was to summarize the literature on childhood adversity and obesity, discuss treatment implications with a case example, and provide recommendations for trauma-informed care for clinicians who work with individuals living with obesity.

Recent Findings: Adversity in childhood is related directly and indirectly to obesity development. Upstream contributors like adverse childhood experiences (ACEs) and other factors can lead to experiences of toxic stress and increased allostatic load, resulting in downstream effects of obesity and other chronic health conditions.

Loneliness, immunological recovery patterns, and health-related quality of life (HRQOL) outcomes in patients receiving hematopoietic stem cell transplantation.

Purpose: Loneliness may compromise health-related quality of life (HRQOL) outcomes and the immunological impacts of loneliness via neuroendocrinological mechanisms likely have consequences for patients who have undergone a hematopoietic stem cell transplantation (HSCT).

Research Approach And Measures: Loneliness (pre-transplant), immunological recovery (Day 30, Day 100, 1-year post-transplant), and HRQOL (Day 100, 1 year) were measured in a sample of 205 patients completing a HSCT (127 autologous, 78 allogenic).

Results: Greater levels of pre-transplant loneliness predicted poorer HRQOL at Day 100 and 1-year follow-up.

Food cravings after bariatric surgery: comparing laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass.

Background: Research suggests that food choices, preferences, and tastes change after bariatric surgery, but evidence regarding changes in food cravings is mixed.

Objectives: The primary aim of this cohort study was to compare food cravings during the first year following bariatric surgery in patients who had undergone sleeve gastrectomy (SG) versus Roux-en-Y gastric bypass (RYGB).

Setting: Integrated multispecialty health system, United States.

A prospective study of the relationship between illness perception, depression, anxiety, and quality of life in hematopoietic stem cell transplant patients.

Aim: The aim of study was to investigate whether depression and anxiety symptoms and illness perception prior to hematopoietic stem cell transplantation (HSCT) predict health related quality of life (HRQOL) at Day 100 and 1 year following HSCT.

Methods: A total of 205 patients who underwent HSCT (N = 127 autologous transplants, N = 78 allogeneic transplants) were included in this prospective study. Baseline assessment was assessed prior to transplantation and post HSCT data were collected at Day 100 and 1 year.

Endoscopic sleeve gastroplasty and postprocedural nutritional deficiencies: results from a single center exploratory study.

Nutritional deficiencies following endoscopic sleeve gastroplasty (ESG) are unknown. We retrospectively studied nutritional deficiencies in 20 patients who underwent ESG at our institution. No subjects had preprocedural anemia, whereas 22.

Addiction Transfer and Other Behavioral Changes Following Bariatric Surgery.

Despite its important treatment implications for obesity and related comorbidities, bariatric surgery requires several behavioral changes that warrant comprehensive evaluation and support before and after surgery. This article outlines emerging scientific and anecdotal evidence for addiction transfer after bariatric surgery. Other common behavioral changes that impact adherence, weight loss, and psychiatric risk after surgery are also reviewed.

Validation of the Yale Food Addiction Scale 2.0 in Patients Seeking Bariatric Surgery.

Background: The Yale Food Addiction Scale (YFAS) was developed in 2009 to assess food addiction (FA); a revised version was released in 2016 (YFAS 2.0). The objective of this study was to determine the statistical and clinical validity of the YFAS 2.

Rethinking Patient and Medical Professional Perspectives on Bariatric Surgery as a Medically Necessary Treatment.

The prevalence of class 3 obesity (body mass index ≥40 kg/m) is 7.7% of the United States adult population; thus, more than 25 million people may be medically appropriate for consideration of bariatric surgery as therapy for severe obesity. Although bariatric surgery is the most effective therapy for patients with severe obesity, the surgery is performed in less than 1% of patients annually for whom it may be appropriate.

Preoperative high respiratory quotient correlates with lower weight loss after bariatric surgery.

Background: The respiratory coefficient (RQ), as determined by indirect calorimetry (IC), classifies diet as being carbohydrate rich (RQ = 0.7-0.8), fat rich (RQ = 0.

Association of Adverse Childhood Experiences and Food Addiction to Bariatric Surgery Completion and Weight Loss Outcome.

Introduction/purpose: Adverse childhood experiences (ACEs) are known risk factors for obesity and poor outcomes following weight loss interventions. ACEs are also associated with addictive behaviors and, potentially, food addiction (FA). This study examined the relationship between ACEs and FA, and their association to undergoing bariatric surgery and post-surgical weight loss outcomes.

Guiding Patients Toward the Appropriate Surgical Treatment for Obesity: Should Presurgery Psychological Correlates Influence Choice Between Roux-en-Y Gastric Bypass and Vertical Sleeve Gastrectomy?

Background: Helping patients determine which type of bariatric surgery, Roux-en-Y gastric bypass (RYGB) or vertical sleeve gastrectomy (VSG), may be the best treatment can be challenging. This study investigated psychological correlates and their influence on weight loss for patients who underwent RYGB or VSG.

Methods: Four hundred twenty-two patients (RYGB = 305; VSG = 117) completed screening questionnaires presurgery and underwent surgery between August 2012 and April 2015.

The relationship among food addiction, negative mood, and eating-disordered behaviors in patients seeking to have bariatric surgery.

Background: Food addiction (FA) may be related to poor weight loss outcomes; however, the literature on food addiction in bariatric surgery-seeking populations is limited.

Objectives: The aim of the present study was to identify the prevalence of FA in a bariatric surgery-seeking population and its association with mood, problematic eating behaviors, and substance use. The relationship between prebariatric surgery food addiction screening and postsurgical outcomes was assessed.

Further statistical and clinical validity for the Weight Efficacy Lifestyle Questionnaire-Short Form.

Identifying barriers to long-term adherence to reduced energy intake and increased physical activity level is critically important for obese patients seeking weight loss treatment. Previous research has identified that one such barrier is low eating self-efficacy or poor confidence in one's ability to control eating behavior in the presence of challenging situations. Accordingly, a valid, brief measure of eating self-efficacy for longitudinal assessment of weight loss and regain is needed.

Should providers encourage realistic weight expectations and satisfaction with lost weight in commercial weight loss programs? a preliminary study.

Background: Attrition is a problem among patients who participate in commercial weight loss programs. One possible explanation is that if patients are unable to reach a weight that they expect to achieve, they may be more likely to drop out of treatment. This study investigated variables associated with attrition among 30 obese patients who completed a liquid meal replacement program (LMR) and enrolled in a 52-week Small Changes Maintenance intervention (SCM).

Hypometabolizers: characteristics of obese patients with abnormally low resting energy expenditure.

Weight gain or loss is determined by the difference between calorie intake and energy expenditure. The Mifflin metabolic equation most accurately predicts resting energy expenditure (REE) in morbidly obese patients. Hypometabolizers have a measured REE that is much less than predicted and pose the greatest challenge for weight loss induced by restriction of calorie intake.

Improving maintenance of lost weight following a commercial liquid meal replacement program: a preliminary study.

Clinic-based liquid meal replacement (800kcals/day) programs produce substantial weight loss. Nevertheless, long-term maintenance remains a challenge. A limitation of maintenance programs is that they continue to promote large behavior changes that are initially required to induce weight loss which may be unsustainable long-term.

Eating self-efficacy: development of a short-form WEL.

Self-efficacy for eating is an important predictor of the successful adoption and maintenance of weight management behaviors. The Weight Efficacy Lifestyle Questionnaire (WEL) is a commonly used measure of eating self-efficacy consisting of 20-items and five situational factors. The aim of this study was to develop a short-form WEL (WEL-SF) for use in clinical practice and research.

Surgeon's requirement for obesity reduction: its influence on weight loss.

The objective of this study was to examine whether preoperative recommendation for specific reductions in body mass index (BMI) influenced weight loss in obese surgical patients. We retrospectively reviewed the electronic medical records of 48 patients who enrolled between January 2007 to June 2010 in an 800-calorie per day liquid meal replacement (LMR) weight loss program. Of these, 9 patients (surgical group) enrolled as a result of general surgeon-directed weight loss to enable nonbariatric surgery and 39 enrolled seeking weight loss (medical group).

Quality of life of patients undergoing surgical treatment for newly-diagnosed, clinically localized renal cell carcinoma.

This investigation sought to evaluate the psychological needs of individuals (N = 28) undergoing nephrectomy for newly diagnosed, localized renal cell carcinoma (RCC) using a mixed qualitative-quantitative approach. The qualitative component consisted of individual semi-structured interviews ≥4 weeks postnephrectomy. The quantitative component involved standardized measures assessing anxiety, depressive symptoms, psychological distress, and general and disease specific quality of life (QOL) prior to nephrectomy and at 4, 12, and 24 weeks postnephrectomy.

A pilot investigation of a multidisciplinary quality of life intervention for men with biochemical recurrence of prostate cancer.

Objective: This pilot project evaluated the acceptability and estimated the effect size of a tailored multidisciplinary quality of life (MQOL) intervention for men who have biochemical recurrence of prostate cancer.

Methods: Participants included 57 men with localized prostate cancer with biochemical recurrence (Median=76 years; 89% White). Participants were randomized to wait list control which offered the intervention upon conclusion of the study (n=27) or to an eight-session group-based, MQOL (n=30) intervention.

Integrated smoking cessation and binge drinking intervention for young adults: a pilot investigation.

Background: Alcohol consumption is strongly associated with cigarette smoking in young adults.

Purpose: The aim of this study was to evaluate the acceptability and estimate the magnitude of the effect of a novel-integrated smoking cessation and binge-drinking intervention for young adults compared with standard treatment control.

Methods: Participants were 41 young adult smokers (≥ 10 cigarettes per day) who regularly (≥ 2 times per month) binge drank who were randomly assigned to standard treatment (n = 19) involving eight individual treatment visits plus 8 weeks of nicotine patch therapy or the identical smoking cessation treatment integrated with a binge-drinking intervention (integrated intervention; n = 22).

Effect of expressive writing as a treatment adjunct for reducing smoking cessation related weight gain in young adult smokers.

This investigation evaluated the effect of expressive writing on weight gain in young adults being treated for smoking cessation. This study was conducted between July 2001 and June 2005. Participants (N = 196) ages 18-24 years (M = 20.

Quality of life of men with biochemical recurrence of prostate cancer.

This investigation evaluated the psychological needs of men (n = 28) with biochemical recurrence of prostate cancer. A mixed qualitative-quantitative approach was employed. The qualitative component consisted of focus groups and the quantitative component included administration of standardized measures assessing quality of life (QOL), anxiety, and mood.