Metabolic and Bariatric Surgery in Adolescents

Chalklin, Christopher; Harper, Elizabeth G Ryan; Beamish, Andrew J.

doi:10.1007/s13679-021-00423-3

Cited by 28 publications

(18 citation statements)

References 61 publications

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“… 40 Obesity will progress from childhood to adulthood without effective intervention, followed by a series of expanding related physical and mental health problems. 41 We found that stress management behavior and life appreciation behavior scores of NWNO female students were significantly higher than those of the NWO, and these two indicators remarkably negatively correlated with BF%. Regression analysis revealed that the risk of NWO was lower in females with a higher score in stress management behavior, which was consistent with the previous researches that stress had been shown as a key risk factor affecting obesity, 42 and psychological stress in the family led to childhood obesity.…”

Section: Discussionmentioning

confidence: 60%

Characteristics of Body Composition and Lifestyle in Chinese University Students with Normal-Weight Obesity: A Cross-Sectional Study

Maitiniyazi¹,

Chen²,

Qiu³

et al. 2021

DMSO

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Normal weight obesity (NWO), defined as normal body mass index (BMI) and excessive body fat percentage (BF%), has been shown to be associated with a significantly higher risk of developing metabolic syndrome, cardiometabolic dysfunction and with higher mortality. However, there is limited literature regarding the potential associations between NWO and lifestyles. This study aimed to investigate the associations of lifestyles with NWO in Chinese university students. Participants and Methods: A total of 279 university students with normal BMI were recruited and divided into NWO and normal weight non-obesity (NWNO) groups by BF%. Body composition and anthropometrics were measured, and participants were asked to finish the Healthy Lifestyle Scale for University Students (HLSUS) questionnaire. Results: A total of 26 male (25.5%) and 71 female (40.1%) students were identified as NWO. Compared to NWNO students, body weight, BMI, body fat mass, visceral fat area, waist circumference and hip circumference of NWO students were all significantly higher both in male and female students (P < 0.05). The body fat mass, BF% and visceral fat area were significantly negatively correlated with the total HLSUS, physical exercise behavior, and dietary nutrition behavior scores in NWNO males, NWO and NWNO females (P < 0.05). The risk of NWO was lower in those students with higher scores in physical exercise behavior in both males (OR = 0.298, 95% CI = 0.121~0.733) and females (OR = 0.653, 95% CI = 0.505~0.843), while dietary nutrition behavior (OR = 0.759, 95% CI = 0.584~0.986) and stress management behavior (OR = 0.503, 95% CI = 0.335~0.755) decreased the risk of NWO only in females. Conclusion:The incidence of NWO was high among university students, especially in females, which might be related with unhealthy lifestyles. NWO university students should pay attention to lifestyle adjustments, especially physical exercise, dietary nutrition and stress management, for preventing the health risk in NWO.

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Section: Discussionmentioning

confidence: 60%

Characteristics of Body Composition and Lifestyle in Chinese University Students with Normal-Weight Obesity: A Cross-Sectional Study

Maitiniyazi¹,

Chen²,

Qiu³

et al. 2021

DMSO

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“…Many patients consider bariatric surgery to address their obesity [20][21][22][23]. Variation in the type of bariatric surgery that is used can depend on the surgeon and the site that the surgery is performed.…”

Section: Possible Solutions To the Problems Associated With Obesitymentioning

confidence: 99%

Obesity, the Obesity Epidemic, and Metabolic Dysfunction: The Conundrum Presented by the Disconnect between Evolution and Modern Societies

Hart¹

2021

JBiSE

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Currently, there is an obesity epidemic in the developed world, with both adults and children being affected. The consequences of this epidemic on health and health outcomes have impact at multiple levels, and it is increasing. The basis for this epidemic, which appears to have emerged with significance ~40 -50 years ago, is unknown but is believed by many to have much of its basis in poor diets and inactivity/sedentary behaviour. Analysis of the human genome has revealed >100 loci which exhibit risk for development of obesity. Why there are so many loci, and how they benefited humans evolutionarily are unknown. In spite of these limitations, there are urgent needs for effective short-term interventions to assist those with obesity, as well as longer-term needs to effectively prevent development of obesity. For the former, personalized exercise programs, use of prebiotics, optimal nutrition and surgical interventions can be effective for some individuals but more interventions that address cause are also needed. For longer term solutions more detailed genetic and epigenetic understanding of risk will be required. An attractive speculation is that the genomic risk factors for obesity (>100 identified) have been retained evolutionarily to address acute metabolic needs and current conditions have converted such risks to a chronic state, making reversal more difficult and with more consequences, including possible epigenetic modifications of risk genes. Other contributing factors to chronic obesity could also relate to chemical disruptors in the environment over the past 50+ years which may impact metabolic regulation via the established risk genomic risk factors or new variants. Therefore, to

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“…Several recognized post-operative complications may require further operative procedures, particularly symptomatic gallstone disease and small bowel obstruction. The rate of reoperation in the 5 years after RYGB appears to be slightly higher in adolescents than that in adults (20–25%) [ 67 ]. However, recent improvements in operative technique and post-operative management have led to substantial reductions in the major causes of reoperation after bariatric surgery [ 67 ].…”

Section: Introductionmentioning

confidence: 99%

“…The rate of reoperation in the 5 years after RYGB appears to be slightly higher in adolescents than that in adults (20–25%) [ 67 ]. However, recent improvements in operative technique and post-operative management have led to substantial reductions in the major causes of reoperation after bariatric surgery [ 67 ].…”

Section: Introductionmentioning

confidence: 99%

The adolescent with obesity: what perspectives for treatment?

Nicolucci

Maffeis

2022

Ital J Pediatr

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The dramatic increase in overweight and obesity among children and adolescents has become a major public health problem. Obesity in children and young adults is associated with an increased prevalence of cardiometabolic risk factors. Obesity during adolescence represents a strong predictor of obesity and higher mortality in adulthood. Due to the serious implications of obesity in adolescents, effective treatments are urgently needed. Lifestyle interventions represent the recommended therapy. Nevertheless, real world data show that the majority of adolescents do not achieve weight loss in the long term, and are reluctant to participate in lifestyle interventions. Pharmacological treatment is recommended if a formal lifestyle modification program fails to limit weight gain or to improve comorbidities. However, until 2020 the European Medicines Agency (EMA) had not approved any pharmacotherapeutic agents for obesity in pediatric patients. On April 2021, EMA has authorized the use of Liraglutide, a glucagon-like peptide (GLP)-1 analog, for the treatment of obesity in adolescents (12–17 years). The efficacy and safety of Liraglutide were demonstrated in a randomized, double-blind trial, enrolling 251 adolescents. After 56 weeks, a reduction in BMI of at least 5% was observed in 43.3% of participants in the liraglutide group vs. 18.7% in the placebo group, and a reduction in BMI of at least 10% was observed in 26.1 and 8.1%, respectively. Gastrointestinal events were the events most frequently reported with liraglutide. Bariatric surgery represents another effective treatment for adolescents with severe obesity, with sustained benefits on weight loss and cardiometabolic risk factors. However, long-term safety and effectiveness data in adolescents are still scarce. Risks of bariatric surgery include the need for additional abdominal surgical procedures and specific micronutrient deficiencies. Hopefully, new pharmacological treatments in addition to lifestyle interventions will offer more chances of success.

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Metabolic and Bariatric Surgery in Adolescents

Cited by 28 publications

References 61 publications

Characteristics of Body Composition and Lifestyle in Chinese University Students with Normal-Weight Obesity: A Cross-Sectional Study

Characteristics of Body Composition and Lifestyle in Chinese University Students with Normal-Weight Obesity: A Cross-Sectional Study

Obesity, the Obesity Epidemic, and Metabolic Dysfunction: The Conundrum Presented by the Disconnect between Evolution and Modern Societies

The adolescent with obesity: what perspectives for treatment?

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