Healthcare utilization associated with obesity management in Ontario, Canada.

This study aimed to describe the characteristics, healthcare resources utilized and costs incurred by adults receiving publicly funded obesity care in Ontario, Canada. People living with obesity who first visited Wharton Medical Clinic, a weight and diabetes management clinic in Ontario, between 2015 and 2018 were identified. Pseudoanonymized data were linked to administrative databases to understand healthcare utilization and costs borne by the public payer over 3 years.

Association between weight-loss history and weight loss achieved in clinical obesity management: Retrospective chart review.

Objective: Weight history and its association with the weight loss achieved in a publicly funded clinical obesity management program were examined in 9348 patients.

Methods: Weight history (frequency and magnitude of weight losses) was collected through questionnaires at enrollment, and weight change was assessed with retrospective electronic medical chart review.

Results: The majority of patients reported developing overweight prior to the age of 40 years and having lost at least 4.

Predictors of Weight Loss and Weight Gain in Weight Management Patients during the COVID-19 Pandemic.

Objective: To examine the associations between patient struggles, health, and weight management changes during the COVID-19 pandemic.

Methods: 585 patients attending a publicly funded clinical weight management program responded to an electronic survey.

Results: Over half of the patients reported worsened overall health, mental health, physical activity, or diet during the pandemic.

The association of sex and calendar month with changes in weight: A retrospective cohort study of a community-based weight management clinic.

Objective: To assess changes in weight by calendar month and sex in patients enrolled in a weight loss intervention.

Methods: Adults participating in a lifestyle weight loss intervention at the Wharton Medical Clinic from January 1st, 2007 to July 4th, 2019 were examined (N = 19,153). A linear generalized estimating equation was used to examine the association between weight change (baseline, month 1, month 2) and calendar month with adjustment for age, sex and baseline body mass index.

Extended-release naltrexone/bupropion is safe and effective among subjects with type 2 diabetes already taking incretin agents: a post-hoc analysis of the LIGHT trial.

Background: Extended-release naltrexone/bupropion (NB) is indicated for chronic weight management. Incretin agents are recommended for patients with type 2 diabetes. This analysis looked at the add-on of NB to incretins to see if weight loss could occur in patients already stabilized on incretin agents.

An analysis of weight loss efforts and expectations in a Canadian Cohort: A retrospective medical chart review.

The weight loss history and weight loss goals were examined in 4108 patients referred to a publicly funded evidence-based clinical weight management program using a retrospective chart review. The majority of patients were white females, aged of 50.1 ± 13.

Estimating and reporting treatment effects in clinical trials for weight management: using estimands to interpret effects of intercurrent events and missing data.

In the approval process for new weight management therapies, regulators typically require estimates of effect size. Usually, as with other drug evaluations, the placebo-adjusted treatment effect (i.e.

The effectiveness and safety of pharmaceuticals to manage excess weight post-bariatric surgery: a systematic literature review.

To systematically review the literature on weight management pharmaceutical use in patients who have had bariatric surgery. Google Scholar, Pubmed, Cochrane, Embase, Web of Science, and Clinical Trials were searched from inception to December 31st, 2018 inclusive. Thirteen studies met inclusion and reported decreases in weight with the use of weight management medications in post-bariatric surgical patients.

Effect of a functional fibre supplement on glycemic control when added to a year-long medically supervised weight management program in adults with type 2 diabetes.

Purpose: Soluble fibre beneficially affects metabolism but whether it can augment the reductions in glycemia induced through intensive weight management has not been extensively studied. Our objective was to examine the adjunct effect of the soluble viscous fibre PGX on glycemic control in adults with type 2 diabetes (T2D) enrolled in a year-long medically supervised weight management program.

Methods: In a placebo-controlled, double-blind study, 290 adults with overweight/obesity and T2D were randomized to receive PGX (15-20 g/day) or isocaloric placebo (rice flour, 6.

Liraglutide 3.0 mg for the management of insufficient weight loss or excessive weight regain post-bariatric surgery.

To assess the effectiveness of liraglutide 3.0 mg in post-bariatric surgery patients, and to determine whether this would differ based on the type of bariatric surgery. One hundred seventeen post-bariatric surgery patients from the Wharton Medical Clinic were analysed.

The safety and effectiveness of commonly-marketed natural supplements for weight loss in populations with obesity: A critical review of the literature from 2006 to 2016.

To evaluate the evidence published from 2006 to 2016 on the effectiveness and safety of commonly used natural supplements for weight loss in individuals with obesity. Amazon and Google were searched for names of mono-agent natural supplements marketed for weight loss and a list of the 10 supplements was created. Google Scholar, Pubmed, Science Direct, and the Cochrane Library were searched for articles that met inclusion.

Absolute Weight Loss, and Not Weight Loss Rate, Is Associated with Better Improvements in Metabolic Health.

Objective: To determine if the rate of weight loss (WL) is associated with metabolic changes independent of the absolute WL.

Methods: WL and health changes were assessed in 11,281 patients attending a publicly funded clinical weight management program over a treatment period of 12.7 months.

The Association between Antihypertensive Medication Use and Blood Pressure Is Influenced by Obesity.

Introduction: One in three US adults is living with obesity or hypertension, and more than 75% of hypertensive individuals are using antihypertensive medications. Therefore, it is important to examine blood pressure (BP) differences in populations that are using these medications with differing obesity status.

Aim: We examined whether BP attained when using various antihypertensive medications varies amongst different body mass index (BMI) categories and whether antihypertensive medication use is associated with differences in other metabolic risk factors, independent of BMI.

Medications that cause weight gain and alternatives in Canada: a narrative review.

Background: The 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.

Results: Antipsychotics, antidepressants, antihyperglycemics, antihypertensives and corticosteroids all contain medications that were associated with significant weight gain.

Waist circumference at five common measurement sites in normal weight and overweight adults: which site is most optimal?

The aim of this study was to determine (i) if adults would measure their own waist circumference (WC), (ii) which WC site(s) are the most intuitive and easy to measure and (iii) if measurement accuracy and association between WC and blood pressure differs across five measurement sites. Participants (n = 198) measured their WC first with no instruction and then using visual instructions for the iliac crest, last rib, midpoint, minimal waist and umbilicus. Without instruction, men most commonly measured their WC at the umbilicus and iliac crest, while women measured their WC at the umbilicus and minimal WC.

Weight loss medications in Canada - a new frontier or a repeat of past mistakes?

Current methods for the treatment of excess weight can involve healthy behavior changes, pharmacotherapy, and surgical interventions. Many individuals are able to lose some degree of weight through behavioral changes; however, they are often unable to maintain their weight loss long-term. This is in part due to physiological processes that cannot be addressed through behavioral changes alone.

Receptivity to Bariatric Surgery in Qualified Patients.

Objectives. Bariatric surgery has been shown to be an effective intervention for weight loss and diabetes management. Despite this, many patients qualified for bariatric surgery are not interested in undergoing the procedure.

Differences in weight change trajectory patterns in a publicly funded adult weight management centre.

Objective: To describe differences in weight loss (WL) trajectory patterns at a publicly funded clinical weight management centre.

Methods: Groups with differences in the attainment of a 5% total body WL and percentage WL patterns over time were identified in 7,121 patients who attended a physician lead multi-disciplinary clinical lifestyle weight management that predominantly focused on education and diet counselling. Resultant health differences were examined.

Current Perspectives on Long-term Obesity Pharmacotherapy.

Approximately 1 in 4 adult Canadians are obese and, thus, are at an elevated risk for developing type 2 diabetes, cardiovascular disease and other conditions. Current treatment guidelines recommend that obese individuals lose 5% to 10% of their starting weights to minimize the risk factors for cardiovascular disease and reduce the risk for developing type 2 diabetes or hypertension. All obesity-management strategies involve lifestyle management, but few patients will lose a significant amount of weight and manage to keep it off over the long term using just this strategy.

Edmonton Obesity Staging System Prevalence and Association with Weight Loss in a Publicly Funded Referral-Based Obesity Clinic.

Objectives: To determine the distribution of EOSS stages and differences in weight loss achieved according to EOSS stage, in patients attending a referral-based publically funded multisite weight management clinic.

Subjects/methods: 5,787 obese patients were categorized using EOSS staging using metabolic risk factors, medication use, and severity of doctor diagnosis of obesity-related physiological, functional, and psychological comorbidities from electronic patient files.

Results: The prevalence of EOSS stages 0 (no risk factors or comorbidities), 1 (mild conditions), 2 (moderate conditions), and 3 (severe conditions) was 1.

Next generation of weight management medications: implications for diabetes and CVD risk.

Since the 1980s, the prevalence of obesity has almost doubled worldwide. Treatments for obesity include lifestyle modification, medications and surgery. Newer anti-obesity medications have been shown to be effective at inducing initial weight management in addition to successful long-term weight maintenance.