Expert Panel on Weight Loss Surgery: Executive Report Update

Blackburn, George L.; Hutter, Matthew M.; Harvey, Alan M.; Apovian, Caroline M.; Boulton, Hannah; Cummings, Susan; Fallon, John; Greenberg, Isaac; Jiser, Michael E.; Jones, Daniel B.; Jones, Stephanie B.; Kaplan, Lee M.; Kelly, John J.; Kruger, Rayford S.; Lautz, David B.; Lenders, Carine; Lonigro, Robert J.; Luce, Helen; McNamara, Anne; Mulligan, Ann T.; Paasche‐Orlow, Michael K.; Perna, Frank M.; Pratt, Janey; Riley, Stancel M.; Robinson, Malcolm K.; Romanelli, John; Saltzman, Edward; Schumann, Roman; Shikora, Scott A.; Snow, Roger L.; Sogg, Stephanie; Sullivan, Mary Anna; Tarnoff, Michael; Thompson, Christopher C.; Wee, Christina C.; Ridley, Nancy; Auerbach, John; Hu, Frank B.; Kirle, Leslie; Buckley, Rita; Annas, Catherine L.

doi:10.1038/oby.2008.578

Cited by 90 publications

(49 citation statements)

References 68 publications

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“…Bariatric surgery † is recommended for severely obese individuals who have a BMI between 35 and 39 and more than one obesity-associated comorbidity, or a BMI >40 without medical comorbidity (Blackburn 2009). It should be noted that surgery reduces the transit time and surface area for absorption of drugs in the gastrointestinal tract, and these postoperative effects on the pharmacokinetics of psychotropic drugs have yet to be investigated in depth.…”

Section: Surgical Interventionmentioning

confidence: 99%

Metabolic syndrome in psychiatry: advances in understanding and management

Ho¹,

Zhang²,

Mak³

et al. 2014

Adv. psychiatr. treat

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SummaryMetabolic syndrome comprises a number of cardiovascular risk factors that increase morbidity and mortality. The increase in incidence of the syndrome among psychiatric patients has been unanimously demonstrated in recent studies and it has become one of the greatest challenges in psychiatric practice. Besides the use of psychotropic drugs, factors such as genetic polymorphisms, inflammation, endocrinopathies and unhealthy lifestyle contribute to the association between metabolic syndrome and a number of psychiatric disorders. In this article, we review the current diagnostic criteria for metabolic syndrome and propose clinically useful guidelines for psychiatrists to identify and monitor patients who may have the syndrome. We also outline the relationship between metabolic syndrome and individual psychiatric disorders, and discuss advances in pharmacological treatment for the syndrome, such as metformin.LEARNING OBJECTIVES•Be familiar with the definition of metabolic syndrome and its parameters of measurement.•Appreciate how individual psychiatric disorders contribute to metabolic syndrome and vice versa.•Develop a framework for the prevention, screening and management of metabolic syndrome in psychiatric patients.

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Section: Surgical Interventionmentioning

confidence: 99%

Metabolic syndrome in psychiatry: advances in understanding and management

Ho¹,

Zhang²,

Mak³

et al. 2014

Adv. psychiatr. treat

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“…Despite mediocre performance, these drugs are commonly associated with side effects such as tachycardia, hypertension, fecal incontinence, and/or cardiac valvopathy, thereby making anti-obesity drug development of paramount importance (6). The most effective weight reduction procedure is bariatric surgery, but it is restricted due to the risk of surgery and associated side effects (7). Readers are referred to two excellent reviews for more information on obesity research and drug development (6,8).…”

mentioning

confidence: 99%

Estrogen Receptor-β-selective Ligands Alleviate High-fat Diet- and Ovariectomy-induced Obesity in Mice

Yepuru

Eswaraka

Kearbey

et al. 2010

Journal of Biological Chemistry

114

112

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Obesity is an epidemic problem affecting millions of people in the Western hemisphere and costs the United States economy more than $200 billion annually. Currently, there are no effective treatments to combat obesity. Recent studies have implicated the constitutive activity of estrogen receptor (ER) ␤ as an important regulator of metabolic diseases. However, the potential of ER-␤-selective ligands to offset obesity is not clear. We evaluated the pharmacological effect of ER-␤-selective ligands (␤-LGNDs) in animal models of high-fat diet-and ovariectomyinduced obesity. Ligand binding, transactivation, and uterotrophic studies with ␤-LGNDs demonstrated selectivity for ER-␤ over ER-␣. Animals fed a high-fat diet showed a significant increase in body weight, and this weight gain was attenuated by ␤-LGNDs. High-fat diet-mediated increases in serum cholesterol, leptin, glucose, and fat accumulation in organs were also reduced by ␤-LGNDs. In addition, MRI scanning indicated that ␤-LGNDs altered body composition by reducing fat mass and increasing lean body mass. Organ weights and gene expression analyses demonstrated that adipose tissue is the center of action for ␤-LGNDs, and the reduction in body weight is likely due to increased energy expenditure. In vitro and in vivo mechanistic studies indicated that the anti-obesity effects of ␤-LGNDs were due to indirect peroxisome proliferator-activated receptor ␥ antagonistic actions requiring the ligand binding domain of ER-␤ and through abrogation of the ability of PGC-1 to coactivate peroxisome proliferator-activated receptor ␥. In conclusion, these studies indicate that ligand-activated ER-␤ is a potential therapeutic target to combat obesity and obesity-related metabolic diseases.Obesity is an epidemic disease affecting over 400 million people globally (1). Two-thirds of adults and children in the United States are either overweight or obese, making it a serious health risk and economic burden to society (2). Obesity is not a standalone disease, as its emergence leads to various complications, including type 2 diabetes mellitus (T2DM), 3 hypertension, atherosclerosis, and other cardiovascular diseases, osteoporosis, and clinical depression (3, 4). The United States Food and Drug Administration required an anti-obesity drug to reduce the body weight by 5% and/or better results than placebo in 12 months, indicating that even a marginal reduction in body weight will cause a significant improvement in the welfare of these patients (5). Despite the exponentially growing global obesity pharmaceutical market, only two Food and Drug Administration-approved drugs are available for this indication: 1) amphetamines and sibutramine that act on the hypothalamus to control appetite stimulation in the central nervous system, and 2) Orlistat, which is a lipase inhibitor that blocks gastrointestinal absorption of fat and decreases energy uptake (6). Despite mediocre performance, these drugs are commonly associated with side effects such as tachycardia, hypertension, fecal incontinence, ...

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“…WLS involves a uniquely vulnerable population in need of specialized resources and ongoing multidisciplinary care. Timely best practice updates are required to identify new risks, develop strategies to address them, and optimize treatment [10].…”

mentioning

confidence: 99%