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Background: Obesity is associated with adverse health effects and is common in the United States and West Virginia. We describe the development of a medical-surgical obesity center in an academic health system in West Virginia. Me...
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Background: Obesity is associated with adverse health effects and is common in the United States and West Virginia. We describe the development of a medical-surgical obesity center in an academic health system in West Virginia. Methods: With institutional leadership guidance, the Surgery and Medicine departments collaborated to form this program. Evidence-based interventions were implemented using standardized scalable workflows. Patient demographics, comorbidities, medications, and preliminary outcomes were analyzed. Outcomes: Between May 1, 2019, and August 31, 2020, 447 new obesity medicine patients were seen. Average body mass index was 43.5 ±10.5 kg/m~2 (range 23.5-101 kg/m~2). Average age was 48 ±13 years (range 19-81 years). Eighty-five percent were female. Ninety-four percent were Caucasian. Seventeen percent had prior bariatric surgery. Common comorbidities were hypertension (69%), depression (65%), gastroesophageal reflux disease (63%), obstructive sleep apnea (46%), and diabetes mellitus type 2 (36%). In a sample population of patients served by one insurance carrier (n = 76), participants experienced statistically significant weight loss in the program: 15 lbs (5.3%) of weight loss (p < 0.01 for pre- vs. post-intervention weight), and 42% lost at least 5% of weight. Conclusions: This successful implementation of a medical-surgical obesity center can become a model for other health systems looking to treat obesity and improve their patients' health.
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Paediatric referrals for obesity are increasing. The paediatric literature provides good guidance for the management of older children, but there is little relating to obese babies and toddlers. This article offers a guide for pae...
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Paediatric referrals for obesity are increasing. The paediatric literature provides good guidance for the management of older children, but there is little relating to obese babies and toddlers. This article offers a guide for paediatricians encountering obese infants and preschool children in the paediatric outpatient setting. The paediatricians' role includes addressing concerns about the aetiology; excluding a medical cause; looking for comorbidity; providing guidance around weight management and ensuring that it is safe; supporting colleagues providing lifestyle advice; and preventing obesity in children who are at high risk. A sensitive approach is crucial to helping parents and colleagues tackle the problem effectively.
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摘要 :
Paediatric referrals for obesity are increasing. The paediatric literature provides good guidance for the management of older children, but there is little relating to obese babies and toddlers. This article offers a guide for pae...
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Paediatric referrals for obesity are increasing. The paediatric literature provides good guidance for the management of older children, but there is little relating to obese babies and toddlers. This article offers a guide for paediatricians encountering obese infants and preschool children in the paediatric outpatient setting. The paediatricians' role includes addressing concerns about the aetiology; excluding a medical cause; looking for comorbidity; providing guidance around weight management and ensuring that it is safe; supporting colleagues providing lifestyle advice; and preventing obesity in children who are at high risk. A sensitive approach is crucial to helping parents and colleagues tackle the problem effectively.
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With the majority of patients seen by primary care practitioners suffering from overweight or obesity, an additional certification in obesity medicine provides the critical tools and skillset to expertly address the many chronic h...
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With the majority of patients seen by primary care practitioners suffering from overweight or obesity, an additional certification in obesity medicine provides the critical tools and skillset to expertly address the many chronic health conditions predicated by unhealthy adiposity and excess weight.
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Abstract Purpose of Review The worldwide prevalence of obesity is increasing. Obesity is strongly associated with many chronic health conditions that have been shown to improve with weight loss. However, counseling patients on wei...
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Abstract Purpose of Review The worldwide prevalence of obesity is increasing. Obesity is strongly associated with many chronic health conditions that have been shown to improve with weight loss. However, counseling patients on weight loss can be challenging. Identifying specific aspects of weight management may personalize the conversation about weight loss and better address the individual patient’s health goals and perceived barriers to change. Recent Findings Physical and behavioral phenotypes are being identified to better tailor treatment recommendations, given lack of efficacy of currently available interventions. Summary The current review provides a summary of the evidence behind the management of several recognized clinical phenotypes, to include body fat distribution (e.g., central obesity), muscle mass (e.g., sarcopenic obesity of the elderly), and problematic eating behaviors (e.g., cravings). Identifying specific aspects of weight management may personalize the conversation about weight loss and better address the individual patient’s health goals and perceived barriers to change.
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Background: Childhood obesity is a major health concern worldwide. This study examined prevalence trends in severe obesity and related comorbidities among patients referred to a tertiary pediatric obesity clinic in Israel. Methods...
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Background: Childhood obesity is a major health concern worldwide. This study examined prevalence trends in severe obesity and related comorbidities among patients referred to a tertiary pediatric obesity clinic in Israel. Methods: The medical files of patients aged 2-18 years with BMI >95th percentile at initial referral to our obesity clinic in 2008-2017 were reviewed for demographic, anthropometric, and cardiometabolic data. Findings were compared between patients with 2.3 > BMI-SDS >= 1.645 and BMI-SDS >= 2.33 (severe obesity), and yearly rates of severe obesity were calculated. Results: The cohort included 1,027 children (median age 10.8 years, 41.8% male) of whom 55% were severely obese. The rate of severe obesity among referrals increased from 54% in 2008 to 69% in 2017, but it seemed to plateau during the last 3 years. In between-group comparison, the severe obesity group had a significantly greater predominance of males (p = 0.002), younger age at obesity onset in males (p <0.001), higher rate of a family history of obesity (overall and in males; p = 0.002 and p = 0.01, respectively), and higher rates of obesity-related comorbidities (systolic hypertension, dyslipidemia, obstructive sleep apnea, and nonalcoholic fatty liver disease; p < 0.001). Conclusions: Our data show an increased prevalence of severe obesity over the last decade among Israeli children and adolescents referred to an obesity clinic. This finding may reflect the trend in the general pediatric population or a change in the policy of referral to obesity clinics of pediatricians. The high rate of obesity-related comorbidities emphasizes the importance of early intervention to prevent their devastating consequences, especially in patients with severe obesity.
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