Real world efficacy of naltrexone/bupropion for weight management in obesity and after bariatric surgery.

Background: Insufficient weight loss or weight regain after metabolic and bariatric surgery (MBS) is frequent, and evidence to support the use of pharmacotherapy for weight management is limited.

Methods: In this single-centre retrospective cohort study, the effectiveness of naltrexone/bupropion (NB) for weight control in surgery-naive and post-MBS patients was evaluated. Data was collected between 2016 and 2022 on all patients started on NB after multidisciplinary consult.

"Just put in a little more effort": the help-seeking experience of patients living with obesity.

Background: Early detection of the disease obesity and support for patients living with obesity could improve the success of obesity treatment and management. The factors influencing the delay in obesity treatment, defined as the period between obesity onset and treatment start, are largely unknown. The aim of our study is to explore the help-seeking behavior of PwO towards obesity treatment.

Pharmacotherapy for obesity: are we ready to select, tailor and combine pharmacotherapy to achieve more ambitious goals?

Recent advancements in obesity pharmacotherapy have seen the approval of novel agents, like glucagon-like peptide-1 receptor agonist and dual agonists, offering unprecedented efficacy for obesity management. However, treatment outcomes remain highly variable, necessitating a more personalized approach to pharmacotherapy tailored to individual profiles. This review evaluates the current landscape of obesity pharmacotherapy, while exploring factors influencing variability in treatment response including early response predictors, genetic markers, and physiological traits.

Evaluating the potential of metabolic drugs in obstructive sleep apnea and obesity: a narrative review.

Study Objectives: To assess the effectiveness of sodium-glucose cotransporter-2 (SGLT2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and dual gastric inhibitory polypeptide/GLP-1 receptor agonists in the treatment of obstructive sleep apnea.

Methods: A comprehensive literature search was performed across multiple medical databases, including Embase, Medline, and Cochrane to look for English articles on interventions with SGLT2 inhibitors, GLP-1, and dual gastric inhibitory polypeptide/GLP-1 receptor agonists in people living with sleep apnea and overweight or obesity.

Results: Emerging evidence indicates that SGLT2 inhibitors, GLP-1, and dual gastric inhibitory polypeptide/GLP-1 receptor agonists are beneficial for treating obesity in combination with sleep apnea.

Current Clinical Practice Guidelines for Nutritional Screening Before and After Sleeve Gastrectomy and Roux-En-Y Gastric Bypass: A Scoping Review.

Introduction: Long-term data indicate that patients who underwent metabolic bariatric surgery have a higher risk of developing nutritional complications. Therefore, it is of utmost importance to monitor their nutritional status.

Methods: A scoping literature search was conducted in MEDLINE, EMBASE, CINAHL, and TRIP database to identify clinical practice guidelines for nutritional screening before and after metabolic bariatric surgery from learned societies.

Tracking the journey: Gastrointestinal transit and intraluminal pH dynamics in aging populations using wireless motility capsule.

Introduction: Gastrointestinal (GI) changes may alter drug absorption, potentially impacting both efficacy and safety of oral pharmacotherapy. However, the GI physiology is rarely studied in the aging population. This study aimed to explore GI transit time and pH in geriatric inpatients and older adults, and compare these findings with those from young volunteers.

Prevalence of obesity in people with and without type 1 diabetes across Belgium, Kuwait, and Mexico: an IMI2 SOPHIA study.

Background: Individuals with type 1 diabetes (T1D) are traditionally perceived as lean, but recent evidence suggests an increasing trend of obesity. To provide global estimates, this study explored the prevalence of obesity among adults with and without T1D across three distinct global regions.

Methods: An observational, cross-sectional study was performed utilizing data from T1D registries and national health surveys to assess the prevalence of obesity (BMI ≥ 30 kg/m) and the prevalence of overweight and obesity (BMI ≥ 25 kg/m) across Belgium, Kuwait, and Mexico.

Health-related quality of life of people with type 1 diabetes: An IMI2 SOPHIA post hoc analysis of FUTURE and ADJUNCT-ONE.

Aim: To characterize and stratify health-related quality of life in individuals with type 1 diabetes (T1D) using body mass index (BMI) and clustering analysis.

Material And Methods: Baseline data on individuals with T1D were pooled from two studies. A post hoc analysis of health-related quality of life, measured using the 36-item Short-Form questionnaire, was performed, referenced to the 2010 US general population.

The effect of physical activity on glycaemic control in people with type 1 diabetes mellitus: A systematic literature review and meta-analysis.

Aims: Type 1 diabetes mellitus (T1DM) is characterised by insulin deficiency. Due to perceived physical activity (PA)-related hypoglycaemia, a minority of people with T1DM exercise regularly. However, the relationship between T1DM and PA remains poorly understood.

Healthcare professionals perceptions of obesity management: An IMI2 SOPHIA qualitative study.

Understanding healthcare professionals' perceptions and approaches to obesity management is limited, as are the barriers impeding effective care. A questionnaire was developed to explore the perception, and barriers to obesity management. To ensure content validity, an expert and stakeholder panel evaluated the relevance and comprehension of each item.

Comparative impact of Roux-en-Y gastric bypass, sleeve gastrectomy or diet alone on beta-cell function in insulin-treated type 2 diabetes patients.

Although bariatric surgery is an effective treatment for type 2 diabetes by inducing weight loss and augmenting gut hormone secretion, the immediate effect on beta-cell function itself remains to be elucidated in type 2 diabetes. Therefore, a prospective, randomized trial was performed in 30 patients with insulin-treated type 2 diabetes and a body mass index ≥ 35 kg/m. Patients were randomly assigned (1:1:1) to Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) in combination with protein-sparing modified fast (PSMF), or to PSMF alone.

Understanding the gastrointestinal tract in obesity: From gut motility patterns to enzyme secretion.

The pathophysiology of obesity has been the product of extensive research, revealing multiple interconnected mechanisms contributing to body weight regulation. The regulation of energy balance involves an intricate network, including the gut-neuroendocrine interplay. As a consequence, research on the gut-brain-microbiota axis in obesity has grown extensively.

Effect of sleeve gastrectomy and Roux-en-Y gastric bypass on gastrointestinal physiology.

Background: Knowledge regarding the gastrointestinal physiology after sleeve gastrectomy and Roux-en-Y gastric bypass is urgently needed to understand, prevent and treat the nutritional and pharmacological complications of bariatric surgery.

Aim: To investigate the effect of sleeve gastrectomy and Roux-en-Y gastric bypass on gastrointestinal motility (e.g.

Development and complications of nutritional deficiencies after bariatric surgery.

The clinical effectiveness of bariatric surgery has encouraged the use of bariatric procedures for the treatment of morbid obesity and its comorbidities, with sleeve gastrectomy and Roux-en-Y gastric bypass being the most common procedures. Notwithstanding its success, bariatric procedures are recognised to predispose the development of nutritional deficiencies. A framework is proposed that provides clarity regarding the immediate role of diet, the gastrointestinal tract and the medical state of the patient in the development of nutritional deficiencies after bariatric surgery, while highlighting different enabling resources that may contribute.

A Mixed-Method Approach to Develop and Validate an Integrated Food Literacy Tool for Personalized Food Literacy Guidance.

Background: Food literacy refers to all practicalities associated with healthy eating. Current food literacy tools are limited in practical use in clinical practice. Therefore, an integrated food literacy tool (IFLT) to assess food literacy and to personalize food literacy guidance was developed and validated.

Late complications of biliopancreatic diversion in an older patient: a case report.

Background: In the mid-seventies, biliopancreatic diversion became popular as weight-loss surgery procedure. This bariatric procedure combines distal gastric resection and intestinal malabsorption, leading to greater weight loss and improvement of co-morbidities than other bariatric procedures. Nowadays, biliopancreatic diversion has become obsolete due to the high risk of nutritional complications.

Impact of gastrointestinal tract variability on oral drug absorption and pharmacokinetics: An UNGAP review.

The absorption of oral drugs is frequently plagued by significant variability with potentially serious therapeutic consequences. The source of variability can be traced back to interindividual variability in physiology, differences in special populations (age- and disease-dependent), drug and formulation properties, or food-drug interactions. Clinical evidence for the impact of some of these factors on drug pharmacokinetic variability is mounting: e.

Adaptations in gastrointestinal physiology after sleeve gastrectomy and Roux-en-Y gastric bypass.

Linked to the growing obesity epidemic, demand for bariatric and metabolic surgery has increased, the most common procedures being sleeve gastrectomy and Roux-en-Y gastric bypass. Originally, bariatric procedures were described as purely restrictive, malabsorptive, or combined restrictive-malabsorptive procedures limiting food intake, nutrient absorption, or both. Nowadays, anatomical alterations are known to affect gastrointestinal physiology, which in turn affects the digestion and absorption of nutrients and drugs.

Reversal of Roux-en-Y Gastric Bypass Fails to Facilitate the Management of Recalcitrant Hypocalcaemia Caused by Primary Hypoparathyroidism.

Roux-en-Y gastric bypass (RYGB) is thought to reduce calcium absorption from the gut. Here, we report the case of a patient with a RYGB, who developed primary hypoparathyroidism after a total thyroidectomy, leading to recalcitrant hypocalcaemia. Despite aggressive oral calcium and calcitriol supplementation, she remained hypocalcaemic and required intravenous (IV) calcium supplementation to control her symptoms, and to keep calcium serum levels within an acceptable range.

Predicting iron absorption from an effervescent iron supplement in obese patients before and after Roux-en-Y gastric bypass: a preliminary study.

Background & Aims: Oral iron absorption is hampered in obese and bariatric patients, especially after Roux-en-Y gastric bypass (RYGB). As a result, iron deficiency, which is common in both patient groups, can be difficult to treat by oral supplements, often necessitating a switch to parenteral administration. The aim of this study was to find possible predictors of the extent of absorption of an effervescent iron gluconate oral supplement, which enables to pre-emptively identify those patients in which oral supplementation is likely to fail.

Iron deficiency after bariatric surgery: what is the real problem?

The growing prevalence of obesity explains the rising interest in bariatric surgery. Compared with non-surgical treatment options, bariatric surgery results in greater and sustained improvements in weight loss, obesity associated complications, all-cause mortality and quality of life. These encouraging metabolic and weight effects come with a downside, namely the risk of nutritional deficiencies.