Multidisciplinary Team–Based Obesity Treatment in Patients With Diabetes: Current Practices and the State of the Science

Foster, Daniel; Sanchez-Collins, Shakira

doi:10.2337/ds17-0045

Cited by 32 publications

(27 citation statements)

References 84 publications

(75 reference statements)

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“…A meta‐analysis of 29 weight loss interventions in the United States, with at least a 2‐year follow‐up period, found that over a quarter of lost weight had been regained at 1 year and 80% of lost weight was regained by 5 years 11,12 . At the individual level, a multidisciplinary team approach with input from medical, dietetic, exercise, and behavioural experts is recommended for chronic disease management, weight loss, and long‐term weight maintenance 7,8,12–17 . The multidisciplinary approach allows each team member to deliver regular and ongoing care and support within their specific expertise.…”

Section: Introductionmentioning

confidence: 99%

Association of clinically significant weight loss with number of patient visits and months of attendance at an Australian multidisciplinary weight management clinic

et al. 2022

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Summary Despite the obesity epidemic, there are relatively few multidisciplinary obesity services in Australia, and only limited data on the effectiveness of these services. The aim of this study was to evaluate the effectiveness of a university hospital‐based weight management clinic—the ‘Healthy Weight Clinic’ in supporting patients to achieve clinically significant weight loss (≥5% reduction in body weight), weight maintenance, and changes in body composition. A retrospective review was conducted to determine weight and associated health outcomes in patients who attended an initial consultation in the first 2 years of the clinic—between March 2017 and March 2019. Follow up was at least 1 year for all patients. Patients who underwent bariatric surgery were excluded. Of 213 total patients, 172 patients attended more than one follow‐up consultation for lifestyle modification. Mean weight change and percentage total weight change at last follow‐up was −6.2 kg (SD 7.4) and − 6.0% (SD 6.9), respectively. For every additional clinic follow‐up, there was 21.4% increased odds of achieving clinically significant weight loss, and for every additional month of follow‐up, there was 10.1% increased odds of achieving clinically significant weight loss. Twenty percent of patients (34/172) maintained ≥5% of initial body weight loss for at least 1 year. Body composition measurements were also favourable, with significant changes in percentage skeletal muscle mass of +0.8% (SD 1.5) and in percentage fat mass by −1.4% (SD 3.2). Regular support in a structured holistic multidisciplinary obesity service enables patients to achieve clinically meaningful weight loss and improved skeletal muscle mass to body fat ratio, and maintain this loss for at least 1 year. Improved weight loss was associated with more patient visits and longer duration of attendance at the clinic.

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Section: Introductionmentioning

confidence: 99%

Association of clinically significant weight loss with number of patient visits and months of attendance at an Australian multidisciplinary weight management clinic

et al. 2022

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“…57 Low fat diets, where fat intake is reduced by 10% and protein intake is increased to 25%, have been shown to satiate patients using fewer overall calories. 58,59 Despite these findings, no specific plan has shown to be more effective so long as an energy intake deficit occurs. 54 With regards to food content (eg, low vs high fat), weight loss trumps any negative effects of individual dietary components.…”

Section: Dietary Interventionsmentioning

confidence: 99%

Obesity: Scope, Lifestyle Interventions, and Medical Management

McCafferty

Hill

Gunn

2020

Techniques in Vascular and Interventional Radiology

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“…Of note, exercise without dietary restrictions is able to achieve only 3–5% weight loss in patients with obesity [ 16 ]. A wide variety of dietary intervention patterns, such as Mediterranean diet, low carbohydrate diet, low-fat diet and ketogenic diet (KD), which significantly differ in the proportions of macronutrients, have been extensively evaluated in clinical trials and displayed great efficacy in reducing body weight and in improving metabolic abnormalities in obese patients [ 17 – 19 ]. On the other hand, bariatric surgery is a highly effective strategy for weight loss and comorbidities improvement in morbidly obese patients when life style intervention fails.…”

Section: The Challenges Of Obesity Treatmentmentioning

confidence: 99%

Tissue and circulating microRNAs as biomarkers of response to obesity treatment strategies

Catanzaro

Filardi

Sabato

et al. 2020

J Endocrinol Invest

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Background Obesity, characterized by an increased amount of adipose tissue, is a metabolic chronic alteration which has reached pandemic proportion. Lifestyle changes are the first line therapy for obesity and a large variety of dietary approaches have demonstrated efficacy in promoting weight loss and improving obesity-related metabolic alterations. Besides diet and physical activity, bariatric surgery might be an effective therapeutic strategy for morbid obese patients. Response to weight-loss interventions is characterised by high inter-individual variability, which might involve epigenetic factors. microRNAs have critical roles in metabolic processes and their dysregulated expression has been reported in obesity. Aim The aim of this review is to provide a comprehensive overview of current studies evaluating changes in microRNA expression in obese patients undergoing lifestyle interventions or bariatric surgery. Results A considerable number of studies have reported a differential expression of circulating microRNAs before and after various dietary and bariatric surgery approaches, identifying several candidate biomarkers of response to weight loss. Significant changes in microRNA expression have been observed at a tissue level as well, with entirely different patterns between visceral and subcutaneous adipose tissue. Interestingly, relevant differences in microRNA expression have emerged between responders and non-responders to dietary or surgical interventions. A wide variety of dysregulated microRNA target pathways have also been identified, helping to understand the pathophysiological mechanisms underlying obesity and obesity-related metabolic diseases. Conclusions Although further research is needed to draw firm conclusions, there is increasing evidence about microRNAs as potential biomarkers for weight loss and response to intervention strategies in obesity.

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Multidisciplinary Team–Based Obesity Treatment in Patients With Diabetes: Current Practices and the State of the Science

Cited by 32 publications

References 84 publications

Association of clinically significant weight loss with number of patient visits and months of attendance at an Australian multidisciplinary weight management clinic

Association of clinically significant weight loss with number of patient visits and months of attendance at an Australian multidisciplinary weight management clinic

Obesity: Scope, Lifestyle Interventions, and Medical Management

Tissue and circulating microRNAs as biomarkers of response to obesity treatment strategies

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