Developing a Personalized Integrative Obesity-Coaching Program: A Systems Health Perspective

Current obesity management strategies are failing to achieve sustainable and favorable long-term results. We propose a more personalized, dynamic, and systemic perspective on the interactions of key determinants and coaching advice on obesity. The aim of this study was to use a systems view on overweight, complexity science, and a transdisciplinary process to develop a five-year personalized integrative obesity-coaching and research program. Managers, medical specialists, clinical psychologists, dieticians, physical- and psychomotor therapists, and lifestyle coaches aligned their perspectives and objectives with experts in systems thinking and systems biology. A systems health model of obesity was used to identify the causal relations of variables with the most influence on obesity. The model helped to align and design a personalized integrative obesity-coaching program and to identify the key variables to monitor the progress and to adjust the personalized program, depending on the goals and needs of the participant. It was decided to use subtyping of participants by a systems biologist, based on traditional Chinese medicine symptoms, as a novel method to personalize the intervention. The collaborative transdisciplinary approach based upon a systems view on obesity was successful in developing a personalized and adaptive five-year obesity-coaching and research program.

Management of GERD in Patients With Obesity

Gastroesophageal reflux disease (GERD) affects an estimated 20% of the population in the Unites States. Lifestyle modifications and proton pump inhibitor therapy are effective for majority of patients, however, some patients cannot tolerate this treatment or find it ineffective requiring endoscopic or surgical management. Obese patients with GERD who pursue surgical management are at increased risk of developing recurrence of symptoms after laparoscopic anti-reflux surgery. Roux en Y gastric bypass remains the surgical procedure of choice for obese patients with GERD. Endoluminal weight loss interventions seek to offer minimally invasive options for obesity management, however, their efficacy for GERD management in patients with obesity remains to be determined.

Neuromusculoskeletal Health in Pediatric Obesity: Incorporating Evidence into Clinical Examination

Purpose of Review The study aims to highlight the clinical importance of assessing and managing neuromusculoskeletal health in pediatric obesity and to support translation of evidence into practice. Recent Findings A growing evidence base suggests that children with obesity experience neuromusculoskeletal impairments and physical complications including increased pain, reduced muscle strength, impaired balance and motor skill, gait deviations, postural malalignment, greater fatigue, and potentially reduced flexibility and sub-optimal bone health. Such evidence supports the need to screen, assess, and optimize neuromusculoskeletal health as part of pediatric obesity management. Summary The likelihood of children with obesity experiencing neuromusculoskeletal impairments is high and can impact the way a child moves, and their interest or capacity to engage in physical activity and exercise. Barriers to movement should be minimized to promote optimal development of the neuromusculoskeletal system and to support engagement in sufficient physical activity for weight management. Healthcare professionals should screen for neuromusculoskeletal impairments as well as personalize interventions and modify standardized exercise interventions to optimize obesity treatment. Further research should explore whether neuromusculoskeletal impairments influence the success of obesity treatment or whether they improve following obesity treatment.

Ageing and Obesity Shared Patterns: From Molecular Pathogenesis to Epigenetics

In modern societies, ageing and obesity represent medical challenges for healthcare professionals and caregivers. Obesity and ageing share common features including the related cellular and molecular pathways as well as the impacts they have as risk factors for a variety of diseases and health problems. Both of these health problems also share exercise and a healthy lifestyle as the best therapeutic options. Importantly, ageing and obesity also have common epigenetic changes (histone modification, DNA methylation, noncoding RNAs, and chromatin remodeling) that are also impacted by exercise. This suggests that epigenetic pathways are among the mechanisms via which exercise induces its benefits, including ageing and obesity improvements. Exploring these interrelations and based on the fact that both ageing and obesity represent risk factors for each other, would lead to optimizing the available therapeutic approaches towards improved obesity management and healthy ageing.

What Are the Challenges of School Nurses in South Korea in Managing Obese Children From Low-Income Households?

Given that the obesity rate among school-age children is increasing, school nurses can play a vital role in managing obesity and encouraging healthy living in school settings. Obese children from low-income backgrounds are more vulnerable than other students and require more careful attention and intervention. This qualitative study aimed to explore and understand the barriers recognized by school nurses in managing obesity in low-income household children. A focus group interview was conducted with 17 school nurses working at an elementary school. Children, home, school, political and structural, and social areas were revealed as intricate factors in obesity management. This study can help understand school nurses’ obstacles in managing obese children from low-income families and can help them prepare practical measures to overcome these obstacles.

Prevalence of Overweight and Obesity in Type 2 Diabetic Patients Visiting PHC in the Dubai Health Authority

<b><i>Background:</i></b> Diabetes is a highly prevalent global and local major health problem according to the International Diabetes Federation (IDF) and will double by 2045. A strong relationship between obesity and type 2 diabetes has been found. Both are leading causes of cardiovascular disease and death; thus, understanding the prevalence of obesity in type 2 diabetes is crucial for planning obesity management and preventing complications. <b><i>Objectives:</i></b> This study aimed to determine the prevalence of obesity and overweight among people with type 2 diabetes attending primary healthcare centers (PHC) in the Dubai Health Authority (DHA). <b><i>Methods:</i></b> The study sample consisted of type 2 diabetes mellitus patients who attended family medicine clinics in primary healthcare centers in DHA. All cases with type 2 diabetes attending family clinics for their periodic health checkup screening were included in the study. Patients &#x3c;18 years old, pregnant, and/or those with cancer and/or chronic kidney disease were excluded. <b><i>Results:</i></b> Our study sample had 9,198 type 2 diabetes mellitus cases with 51.6% males, 69.7% United Arab Emirates nationals, 7.9% who exercised regularly, and 1.8% who followed a healthy diet. Obesity and overweight cases were 49.5% and 35.5%, respectively. <b><i>Conclusion:</i></b> Without an aggressive obesity management approach, control of diabetes is difficult. The prevalence of obesity and overweight among people with type 2 diabetes is high. Obesity and overweight cases were 49.5% and 35.5%, respectively, among diabetic patients attending PHC. Over 50% (55%) of UAE nationals were obese, while 31.8% were overweight, suggesting that active interventions to control weight gain would be appropriate.