Day 1 :
- Current Research on Obesity
Biography:
Abstract:
Introduction: Obesity is a major health problem with serious sequences. There is little evidence on the development and growth of obesity among Lebanese women. This paper will describe 25 years’ changes in BMI and weight among Lebanese postmenopausal women.
Subjects and methods: Data was collected from 12492 ambulatory Lebanese postmenopausal women attended outpatient clinic in one hospital between July 1997 and December 2021 and were subjected to osteodensitometry study. Gender, birthdate, height, weight and BMI were recorded in all patients. Patients on kidney dialysis and on chemotherapy, radiotherapy treatment were excluded.
Result: The mean age of the 12492 women was 60.63 (SD 11.744) and the mean BMI was 30.09 (SD 5.780) and the average (weight) was 72.24 (SD 14.165) It was particularly notable that both BMI and weight were levelling off over 25 year of the survey.
Conclusion: This epidemiological survey provides a national data addressing prevalence of obesity over 25 years in Lebanese women. The prevalence of overweight was present over the years of this survey and our review indicates a clear tendency towards stabilization of the overweight epidemic among post-menopausal Lebanese women.
This raises a question if BMI is still a useful indicator of overall obesity or it’s a poor tool for defining the health of an individual. Or that it indicates a clear tendency towards stabilization of the obesity epidemic among postmenopausal women which could be the result of mass media work focused on promoting better food habits or it’s a consequence of the lower socioeconomic status of subjects studied. Further studies are needed to examine socioeconomic factor influencing BMI and if TBF and % BF would be a more accurate measure of obesity which directly calculates a person’s relative body composition without regard to height and weight.
Biography:
Abstract:
Objective
The study aimed to investigate the association between sleeping behavior (specifically sleep duration), body mass index (BMI), eating habits, and psychological mood depression among adolescents in the Emirate of Abu Dhabi- UAE.
Methods and materials
A subsample of three hundred and ninety-five participants (209 females and 186 males) from middle and high schools (aged 12–18 years) in the emirate of Abu Dhabi completed the surveys in the presence of their parents and two research assistants. Measures of daytime sleepiness and other sleep parameters (sleep duration on weekdays and weekends), eating habits, and mood depression questionnaires were reported.
Results
Differences in BMI between males and females were statistically significant (26.12 ± 4.5 vs. 24.4 ± 4.3; p < 0.01). There was a negative linear association (p < 0.01) between the students’ BMI and the weekday/ weekend sleep duration. The average weekday and weekend sleep duration ranged from 5.7 hours (weekdays) to 9.3 hours(weekend). The study showed that an increase in BMI was correlated to mood depression (r = 0.396, p<0.01). In terms of eating habits, there was a significant association between eating unhealthy food and sleep duration; 72.6% of students who slept less than 6 hours reported unhealthy eating habits (p <0.05).
Conclusion
The study showed a clear association between short sleep duration and obesity among adolescents in the UAE. This relationship between sleep duration and obesity is less studied and less understandable. Future research about exploring how sleeping behaviors can affect obesity during adolescence can support understanding this association and create an effective intervention
- Obesity Medications
Session Introduction
Resham Uttamchandani
American Board of Obesity Medicine, United States
Title: Obesity Medications: The new wonder drugs
Biography:
Abstract:
According to the Framingham Heart Study, adults who were obese at 40 years of age lost 6 to 7 years of expected life! Weight loss, as low as 5% of body weight, can lead to improvement in metabolic diseases such as diabetes, hypertension and hyperlipidemia. Evidence has demonstrated that Diabetes medications such as GLP-1 agonists, such as semaglutide, are gaining a lot of recognition for their weight loss effects, equivalent to weight loss rates seen with bariatric surgery!. Studies found people using semaglutide and making lifestyle changes lost about 33.7 pounds (15.3 kilograms) versus 5.7 pounds (2.6 kilograms) in those who didn't use the drug. Clinicians need to be cautious when prescribing these medications. Some contraindications include personal or family medical history of medullary thyroid cancer or recurrent pancreatitis. If the patient is on another anti-diabetes medication that can cause hypoglycemia, such as insulin or a sulfonylurea, they will need to be carefully monitored. There are newer weight loss medications as well - tirzepatide (dual GIP and GLP-1 agonist). Common side-effects of this medication include gastrointestinal-related side effects such as nausea, vomiting, and generalized abdominal discomfort as well as pancreatitis. Overweight or obese participants without type 2 diabetes who took the drug, called tirzepatide (sold as the diabetes drug Mounjaro), lost an average of nearly 21% of their body weight at the highest dose studied. It can take more than a year for the drug to reach full effectiveness, although some patients hit their plateau earlier than that. The goal for physicians is to see a benchmark of 5% total body weight loss in the first three months, which is a good predictor of whether the medication will continue to work. It is also important to remember that medications don’t replace physical activity or healthy eating habits as a way to lose weight. Studies show that weight management medications work best when combined with a lifestyle program - such as cessation of tobacco use/ alcohol intake, dietary changes and physical activity.
Biography:
Basma Mandour, a clinical dietitian, holds a master's degree in specialized nutrition from Cairo University, holds a diploma in clinical nutrition from the Center for Science and Research, one year of experience from the Fit Book Center for Obesity and Underweight, one year of experience in the v-clinic for obesity and thinness, Worked online with all conditions, including thyroid dysfunction and fibromyalgia. I worked with the Elderly, children and newborns, whether obese or underweight, and they achieved impressive results and reached their goal.
Abstract:
Antiobesity pharmacotherapy is one strategy to offset the adaptive changes in appetite and energy expenditure that occur with weight loss and to improve adherence to lifestyle interventions. According to the 2013 American College of Cardiology/Amer-ican Heart Association/The Obesity Society's guideline for the management of overweight and obesity in adults and the Endocrine Society's clinical practice guidelines on the pharmacologic management of obesity, pharmacotherapy for obesity can be considered if patients have a body mass index (BMI) of 30 kg/m? or greater or a BMI of 27 kg/m~ or greater with weight-related comorbidities, such as hypertension, dyslipidemia, type 2 diabetes, and obstructive sleep apnea.
As obesity is a chronic disease, most antiobesity medications are approved is Phentermine was approved by the FDA in 1959 and has been the most commonly prescribed medication for obesity in the United States.
ORLISTAT
Before 2012, the only antiobesity medicine approved for long-term use was orlistat, which was approved by the FDA in 1999.
PHENTERMINE/TOPIRAMATE EXTENDED RELEASE
In 2012, the FDA approved phentermine/topiramate ER for chronic weight management as an adjunct to a reduced-calorie diet and increased physical activity.
LORCASERIN
Lorcaserin, a selective serotonin (5-hydroxytryptamine [5HT)-2C receptor agonist, was approved by the FDA in 2012 as a long-term treatment of obesity.
NALTREXONE SUSTAINED RELEASE/BUPROPION
Naltrexone/bupropion was approved for the treatment of obesity in 2014. Bupropion is a dopamine and norepinephrine reuptake inhibitor that was FDA approved as an antidepressant in 1989..
LIRAGLUTIDE 3.0 MG
Liraglutide 3.0 mg was the second agent approved by the FDA in 2014 for chronic weight management.
PRACTICAL TIPS FOR TREATMENT
important for primary care providers to be familiar with the pharmacotherapy available to patients who are unable to lose weight and sustain weight loss with lifestyle interventions alone.
There are 2 important questions to ask when prescribing an antiobesity medication to patients. The first question is whether there are undesirable side effects, contrain-dications, or drug-drug interactions. For example, avoid orlistat if patients have a condition predisposing to malabsorption and avoid phentermine and phentermine/ topiramate ER if patients have unstable coronary disease.
The second question is whether any of the medications could improve another symptom or condition.
Pharmacotherapy should not be prescribed in the absence of behavioral counseling focusing on diet, physical activity, and lifestyle modifications, which are the cornerstones of weight management.
Biography:
Prof. Dr. Anil Batta is presently professor & Head with senior consultant in Govt. Medical College, Amritsar. He did his M.B.B.S. and M.D. in Medical Biochemistry from Govt. Medical College, Patiala in 1984 and 1991, respectively. His research interest is mainly in clinical application especially cancer and drug de-addiction. He has supervised more than 25 M.D., M.Sc. and Doctorate researches and published more than 130 international research papers. He is the chief editor of America’s Journal of Biochemistry. He is also working as advisor to the editorial board of International Journal of Biological and Medical Research. He has been deputed member Editorial Board of numerous International & National Medical Journals of Biochemistry. He has also been attached as technical advisor to various national and international conferences in Biochemistry. He has been attached as hi-tech endocrinal, genetics and automated labs of Baba Farid Univ. of Health Sciences, Faridkot. He has chaired various sessions in the Biochemistry meets. He has been designated as member Editorial Board of various in US and other European Countries. He is also involved in various research projects at Govt. Medical, Amritsar. He has done superspecialisation in Drug-de-addiction from PGIMER, Chandigarh.
Abstract:
Obesity is one of the most common medical problems in the United States and a risk factor for illnesses such as hypertension, diabetes, degenerative arthritis and myocardial infarction. It is a cause of significant morbidity and mortality and generates great social and financial costs. Obesity is defined as a body mass index greater than 30. Many patients accomplish weight loss with diet, exercise and lifestyle modification. Others require more aggressive therapy. Weight loss medications may be appropriate for use in selected patients who meet the definition of obesity or who are overweight with comorbid conditions. Medications are formulated to reduce energy intake, increase energy output or decrease the absorption of nutrients. Drugs cannot replace diet, exercise and lifestyle modification, which remain the cornerstones of obesity treatment. Two new agents, sibutramine and orlistat, exhibit novel mechanisms of action and avoid some of the side effects that occurred with earlier drugs. Sibutramine acts to block uptake of serotonin, norepinephrine and dopamine, while orlistat decreases fat absorption in the intestines.