Efficacy of a Very-Low-Calorie Weight Loss Diet Plus Exercise Compared With Exercise Alone on Hip Osteoarthritis Pain : A Randomized Controlled Trial.

Background: Exercise is recommended to manage hip osteoarthritis, but weight loss recommendations are conflicting.

Objective: To evaluate the efficacy of a weight loss diet added to exercise on change in hip pain.

Design: 2-group superiority randomized trial.

Advancing Person-Centered Care in the New Era of Obesity Treatment.

The obesity treatment landscape has changed markedly in the past few years following the Food and Drug Administration's approval of several highly effective obesity medications. This Perspective piece advocates for a strong focus on advancing person-centered, evidence-based obesity care at this exciting time-a time when perhaps more patients than ever before are expressing interest in obesity treatment-in order to capitalize on these innovations and ensure high-quality, compassionate, impactful patient care. Recognizing the pivotal role that clinicians play in partnering with patients to develop treatment plans, we highlight four key principles that can support clinicians' efforts in advancing these goals: (1) bias-free care, (2) education, (3) autonomy, and (4) access to care.

Development of an item bank and outcome importance survey for the Australian and New Zealand Bariatric Surgery Registry.

Purpose: The Australian and New Zealand Bariatric Surgery Registry is developing a bariatric-specific patient-reported outcome measure (PROM) to capture patient outcomes. This study aimed to establish an item bank and questionnaire to assess which outcomes are considered the most important by pre- & post-surgical patients and healthcare practitioners.

Methods: Initial qualitative studies were undertaken to provide an in-depth understanding of patients' lived experiences, and a targeted literature search was conducted to identify appropriate PROMs.

Exploring population and sex-specific disease trajectories for multimorbidities among individuals with overweight or obesity: A retrospective cohort study in UK biobank.

Background: Overweight and obesity are major risk factors for non-communicable diseases (NCDs). This study aimed to explore the pattern of multimorbidity development and disease trajectories in individuals with overweight and obesity.

Methods: We followed a cohort of 392 541 individuals retrospectively from the UK Biobank.

Habenula contributions to negative self-cognitions.

Self-related cognitions are integral to personal identity and psychological wellbeing. Persistent engagement with negative self-cognitions can precipitate mental ill health; whereas the ability to restructure them is protective. Here, we leverage ultra-high field 7T fMRI and dynamic causal modelling to characterise a negative self-cognition network centred on the habenula - a small midbrain region linked to the encoding of punishment and negative outcomes.

Current Understanding of the Pathophysiology of Idiopathic Intracranial Hypertension.

Purpose Of Review: Development of safe targeted therapies for idiopathic intracranial hypertension requires a thorough understanding of recent evidence discovering the pathophysiology of the condition. The aim is to provide a review of studies that inform on the underpinning mechanisms that have been associated with idiopathic intracranial hypertension.

Recent Findings: People living with active idiopathic intracranial hypertension and obesity have been found to have with insulin resistance, hyperleptinaemia, and adverse cardiovascular outcomes.

Association between glucagon-like peptide-1 receptor agonist use and peri-operative pulmonary aspiration: a systematic review and meta-analysis.

Introduction: Glucagon-like peptide-1 receptor agonists are known to delay gastric emptying; however, the association between glucagon-like peptide-1 receptor agonist use and peri-operative pulmonary aspiration risk is not known. This systematic review and meta-analysis aimed to summarise the evidence on whether glucagon-like peptide-1 receptor agonist exposure is associated with pulmonary aspiration or increased residual gastric content in fasted patients undergoing procedures requiring anaesthesia or sedation.

Methods: We searched six databases for studies assessing peri-operative pulmonary aspiration or residual gastric contents in fasted patients or volunteers who were using any form of glucagon-like peptide-1 receptor agonist.

Depressive symptoms at short-, medium-, and long-term follow-up after bariatric surgical procedures: A systematic review and meta-analysis.

Importance: Patients experience both positive and negative changes in mood following bariatric surgery and mental health outcomes have been reported to differ between procedure types. Understanding changes in symptoms over time and between surgical procedures is vital to providing meaningful, long-term, patient-centered care.

Objective: To examine the nature and time course of changes in depressive symptoms after different bariatric procedures.

Exploring the utility of N-acetylcysteine for loss of control eating: protocol of an open-label single-arm pilot study.

Background: A sense of loss of control over eating, such that eating occurs despite the intent not to, is common in people with obesity and eating disorders such as binge eating disorder and bulimia nervosa. Currently, options for management of loss of control eating are limited. We recently determined that the pro-drug N-acetylcysteine (NAC) reduces compulsive-like eating in a rat model of diet-induced obesity.

The experiences of physical therapists delivering a very low energy diet and exercise intervention for weight loss in people with knee osteoarthritis: A qualitative study.

Background: Exercise and weight loss are core treatments for knee osteoarthritis (OA). While physical therapists are considered well placed to engage in weight management alongside exercise (not replacing dietician care), evidence surrounding physical therapist-delivered weight loss interventions is sparse.

Objective: To understand the experiences and perceptions of physical therapists delivering a very low energy diet (VLED) and exercise intervention to people with knee OA and overweight or obesity in a randomized controlled trial (RCT).

Medical management of obesity: unlocking the potential.

After a long and challenging history, there have finally been major breakthroughs in the development of effective obesity medications. Agents that act at receptors of one or more gut hormones are achieving unprecedented weight reductions and improvements in cardiovascular risk factors, comparable to some bariatric surgical procedures. Importantly, there is evidence of beneficial effects on a growing range of conditions, including type 2 diabetes, fatty liver, chronic kidney disease, obstructive sleep apnea and cardiovascular disease.

Definition and diagnostic criteria of clinical obesity.

Current BMI-based measures of obesity can both underestimate and overestimate adiposity and provide inadequate information about health at the individual level, which undermines medically-sound approaches to health care and policy. This Commission sought to define clinical obesity as a condition of illness that, akin to the notion of chronic disease in other medical specialties, directly results from the effect of excess adiposity on the function of organs and tissues. The specific aim of the Commission was to establish objective criteria for disease diagnosis, aiding clinical decision making and prioritisation of therapeutic interventions and public health strategies.

Cardiovascular effects of tirzepatide.

Tirzepatide is a first-in-class dual agonist at receptors for glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) for the treatment of T2D and obesity, with unprecedented efficacy for glycaemic control, reductions in body weight and improvements in blood pressure and lipid profile compared with placebo and GLP-1 receptor agonists. To date, clinical trials of tirzepatide have fulfilled the requirement by regulatory authorities of demonstrated cardiovascular safety in high-risk patients. Whether cardiovascular benefits will be found with dual GLP-1/GIP receptor agonists remains uncertain, and the contribution of GIP receptor activation to cardiovascular risk has not been established.

Comparison of the Nutritional Adequacy of Current Food-Based Very Low Energy Diets: A Review and Nutritional Analysis.

Very low energy diets (VLEDs) contain <800 kcal/day and typically comprise formulated meal replacement products with adequate protein and micronutrients. Food-based VLEDs are an alternative approach, but it is uncertain whether they can provide adequate nutrition within an 800 kcal/day restriction. This analysis aimed to assess the nutritional adequacy of food-based VLEDs compared with formula VLEDs.

Obesity in adults.

Obesity has increased in prevalence worldwide and WHO has declared it a global epidemic. Population-level preventive interventions have been insufficient to slow down this trajectory. Obesity is a complex, heterogeneous, chronic, and progressive disease, which substantially affects health, quality of life, and mortality.

The cost-effectiveness of semaglutide in reducing cardiovascular risk among people with overweight and obesity and existing cardiovascular disease, but without diabetes.

Background And Aims: The Semaglutide Effects on Cardiovascular Outcomes in People with Overweight or Obesity (SELECT) trial demonstrated significant reductions in cardiovascular outcomes in people with cardiovascular disease (CVD) and overweight or obesity (but without diabetes). However, the cost of the medication has raised concerns about its financial viability and accessibility within healthcare systems. This study explored whether use of semaglutide for the secondary prevention of CVD in overweight or obesity is cost-effective from the Australian healthcare perspective.

Patient and healthcare practitioner evaluation of patient-reported outcomes in bariatric surgery - a modified Delphi study.

Background: Patient-reported outcomes are an important emerging metric increasingly utilised in clinical, research and registry settings. These outcomes, while vital, are underutilised and require refinement for the specific patient population of those undergoing bariatric surgery. This study aimed to investigate and compare how pre-surgical patients, post-surgical patients, and healthcare practitioners evaluate patient-reported outcomes of bariatric surgery to identify outcomes that are considered most important.

Exploring Experiences of People With Knee Osteoarthritis Who Received a Physiotherapist-Delivered Dietary Weight Loss and Exercise Intervention: A Mixed Methods Study.

Objective: Explore the experiences of people with knee osteoarthritis (OA) who received a very low energy diet (VLED) and exercise program from a physiotherapist.

Methods: Mixed methods study involving questionnaires (n = 42) and semistructured interviews (n = 22) with randomized control trial participants with knee OA who had received a 6-month physiotherapist-delivered VLED weight loss and exercise intervention. Questionnaires measured participant satisfaction and perceptions about physiotherapist's skills/knowledge in delivery of the dietary intervention (measured on 5-7 point Likert scales).

Alternative models to support weight loss in chronic musculoskeletal conditions: effectiveness of a physiotherapist-delivered intensive diet programme for knee osteoarthritis, the POWER randomised controlled trial.

Objectives: To determine if physiotherapists can deliver a clinically effective very low energy diet (VLED) supplementary to exercise in people with knee osteoarthritis (OA) and overweight or obesity.

Methods: 88 participants with knee OA and body mass index (BMI) >27 kg/m were randomised to either intervention (n=42: VLED including two daily meal replacement products supplementary to control) or control (n=46: exercise). Both interventions were delivered by unblinded physiotherapists via six videoconference sessions over 6 months.

Effectiveness of a telehealth-delivered clinician-supported exercise and weight loss program for hip osteoarthritis - protocol for the Better Hip randomised controlled trial.

Background: Hip osteoarthritis (OA) is a leading cause of chronic pain and disability worldwide. Self-management is vital with education, exercise and weight loss core recommended treatments. However, evidence-practice gaps exist, and service models that increase patient accessibility to clinicians who can support lifestyle management are needed.

The effect of bariatric surgery on the expression of gastrointestinal taste receptors: A systematic review.

Gastrointestinal nutrient sensing via taste receptors may contribute to weight loss, metabolic improvements, and a reduced preference for sweet and fatty foods following bariatric surgery. This review aimed to investigate the effect of bariatric surgery on the expression of oral and post-oral gastrointestinal taste receptors and associations between taste receptor alterations and clinical outcomes of bariatric surgery. A systematic review was conducted to capture data from both human and animal studies on changes in the expression of taste receptors in oral or post-oral gastrointestinal tissue following any type of bariatric surgery.