To retrospectively review the efficacy of short term supervised medical weight loss for women with obesity, body mass index (BMI ≥40 kg/m 2 ) in gynaecologic oncology, and the associated perioperative and pathologic outcomes. A retrospective study of a dedicated preoperative weight loss clinic for gynaecologic oncology patients from March to December 2019. Statistical analysis was performed with McNemar's test for correlated proportions, Pearson's correlation tests for continuous variables, and paired t-tests to compare means. Generalized estimating equations (GEE) were used to determine the factors associated with weight loss over time. A P-value of <.05 was used for statistical significance. Review of cases up-graded after surgery was performed by a gynaecologic pathologist. There were a total of 49 women included in the study. The most common referral reason was endometrioid carcinoma or hyperplasia of the endometrium (77.6%). Mean initial weight was 130.2 kg, and corresponding mean BMI 48.1 kg/m 2 . Patients attended on average nine preoperative weight loss visits. A significant difference between initial weight and weight at surgery was demonstrated, from 129.6 to 118.0 kg (8.4% weight loss) (P < .0001). This difference persisted to their post-surgical visit, with an additional mean loss of 1.89 kg (9.4% weight loss) (P = .044). The majority (92.1%) of patients with endometrial pathology had surgical management, and of these 85.7% were minimally invasive. Preoperative weight loss is a feasible option in gynaecologic oncology patients. Greater understanding of clinical significance, follow-up, and ideal target population for this intervention is needed.
ObjectiveTo review for Canadian physicians the latest pharmacological options for obesity management. Quality of EvidenceA literature search was conducted in PubMed with no time restriction. Canadian and international guidelines referenced. National and international statistics databases quoted for epidemiological data. Levels of evidence range from I to III. Main MessageAs a chronic progressive disease affecting over 7.2 million Canadians, obesity requires early identification and treatment by primary care practitioners. Three anti-obesity medications are approved for use in Canada under the tradenames Xenical®, Saxenda®, and Contrave® which help bridge the gap between non-pharmacological and surgical options for the treatment of obesity. Family physicians are front-line members of the obesity management team and should remain updated on the pharmacological options for weight management. ConclusionAnti-obesity medications lead to greater average weight loss when combined with behavior modifications and provide individuals with excess weight a sustainable option for obesity management. RESUMEObjectifExaminer, à l’intention des médecins canadiens, les dernières options pharmacologiques pour la gestion de l’obésité. Qualité des preuvesUne recherche documentaire a été effectuée dans PubMed sans restriction de temps. Les lignes directrices canadiennes et internationales sont référencées. Bases de données statistiques nationales et internationales citées pour les données épidémiologiques. Les niveaux de preuve vont de I à III. Message principal En tant que maladie chronique progressive touchant plus de 7,2 millions de Canadiens, l’obésité nécessite un dépistage et un traitement précoces par les praticiens de soins primaires. Trois médicaments contre l’obésité sont approuvés au Canada sous les noms commerciaux Xenical®, Saxenda® et Contrave®, qui aident à combler le fossé entre les options non pharmacologiques et chirurgicales pour le traitement de l’obésité. Les médecins de famille sont des membres de première ligne de l’équipe de gestion de l’obésité et doivent se tenir au courant des options pharmacologiques pour la gestion du poids. ConclusionLes médicaments contre l’obésité entraînent une perte de poids moyenne plus importante lorsqu’ils sont associés à des modifications du comportement et offrent aux personnes en surpoids une option durable pour la gestion de l’obésité.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.