Obesities, Volume 4, Issue 2 (June 2024) – 12 articles

A healthy body mass contributes to a positive quality of life, and for overweight/obese individuals, weight loss of even modest proportions improves health-related outcomes. A novel approach to promoting body mass regulation is to pair exercise with high altitude, thereby upregulating metabolic processes and increasing caloric expenditure. As an added measure of body mass regulation, data suggest that high altitude stimulates the production of the appetite-suppressing hormone leptin. Issues arise, however, given that high altitude compromises aerobic exercise capacity. Whereas exercising at high altitude may compromise exercise intensity and duration, recovering at high altitude retains the integrity of exercise while still potentially conferring the benefits of the low oxygen environment on energy expenditure and energy intake. The purpose of this study was to perform a proof-of-concept pilot test on whether post-exercise exposure to a simulated high altitude influenced acute energy balance. Twelve healthy men and women ran for 30 min at a moderate intensity on two separate occasions. Following exercise, participants recovered for 30 min while breathing either sea level air or low oxygen air simulating high altitude (equivalent to 4500 m elevation). Blood samples and hunger ratings were collected pre-exercise and post-recovery. Heart rate was recorded throughout exercise and recovery and used to calculate caloric expenditure. Post-exercise energy expenditure was significantly higher (p = 0.03) following high altitude recovery (139 ± 15 kcal) compared to sea-level recovery (98 ± 11 kcal). Participants reported a lower desire to eat when they recovered in the high altitude environment (p = 0.01), though post-recovery leptin concentrations were similar between the two conditions. Post-exercise exposure to a simulated high altitude environment represents a promising method for increasing daily caloric expenditure and lowering appetite. Given the pilot nature of this study, future research is needed to address the question of high altitude recovery on a larger sample over a longer time period and with robust measures of caloric expenditure. Full article

Background: Little is known about the role of rehabilitation medicine in obesity. Objective: to examine the benefits of a multidisciplinary rehabilitation program on the quality of life in patients with severe obesity. Methodology: We included 124 patients with obesity (mean age: 57 years; BMI ≥30), in an 8-week in-hospital multidisciplinary supervised program combining physiotherapy, nutrition and psychological support. Clinical, bio-psychological and functional parameters, as well as an obesity-specific quality-of-life score, were acquired at 0 and 8 weeks. Results: The quality-of-life score improved significantly at 8 weeks, from 60.8 to 68.8 (p < 0.0001), and was positively correlated with cardio-respiratory function (r = 0.47; p < 0.0001). Conclusions: Our results highlight the important role of multidisciplinary rehabilitation medicine and its integrated approach to improve the quality of life of people with obesity. Full article

The efficacy of two different online treatment programs for people with binge eating disorder (BED) was compared. One hundred and nineteen adults with BED were randomized to treatments based on the Healthy Approach to Weight Management and Food in Eating Disorders (HAPIFED) or cognitive behavioural therapy (CBT). The treatments were delivered via videoconferencing in 10 groups with approximately 12 participants in each group. Each group included 13 treatment sessions and two follow-up sessions. Participants’ self-reported eating disorder behaviours/psychopathology, general mental health, and weight were assessed at pre-treatment, the end of treatment, a 3-month follow-up, and a 6-month follow-up. The participants in both treatments similarly reduced objective and subjective binge eating episodes from pre-treatment to the end of treatment. There were no significant differences in weight loss for the participants in either treatment. The participants in both treatments had reduced levels of loss of control over eating, eating disorder psychopathology, depression, psychological stress, and difficulties in emotion regulation from pre-treatment to the end of treatment. Treatments based on the HAPIFED or CBT delivered via videoconferencing can reduce binge eating and improve mental health in people with BED. Full article

Obesity interventions typically involve some form of dietary restraint (i.e., intentional limiting of food intake), yet the restraint model of binge eating proposes that engaging in dietary restraint is a causal factor for binge eating symptoms. Evidence for this model has been mixed and differs by measures, study design, and sample. Further, there also may be moderators of the association between dietary restraint and binge eating. The purpose of this systematic review was to compile the current evidence on moderators of the association between dietary restraint and binge eating. A literature search was conducted across electronic databases, resulting in the inclusion of 16 papers (with 15 different samples). The reviewed studies were primarily heterosexual White college student females and were primarily cross-sectional studies with self-report measures. There were no consistent moderators across the studies. However, there was some evidence for interactions between affective constructs and dietary restraint in relation to binge eating, as well as three-way interactions between affect, cognitive constructs, and dietary restraint. Although there were few studies, there was little current evidence for social, biological, and demographic factors as moderators. Overall, our systematic review shows a need for further research to clarify and validate the moderators, and to understand the complex interactions as well as the potential causal relationships between restraint and binge eating behaviors. Full article

Obesity is a chronic metabolic disease that can promote serious comorbidities as maternal complications. Thus, the objective of this study was to analyze the prevalence of overweight and obesity, and the incidence of maternal complications in pregnant women of Sinop, Mato Grosso, Brazil. It was a retrospective cohort study with clinical and epidemiological data collected from the medical records of pregnant women diagnosed in 2020. Pregnant women were subdivided into three groups: eutrophic, overweight, and obese. Data from 700 pregnant women were evaluated, 251 in the eutrophic group, in the 220 overweight group and 229 in the obese group. The percentage of pregnant women with diabetes mellitus and arterial hypertension was significantly higher in the overweight and obesity groups when compared with the eutrophic group. The incidence of gestational diabetes mellitus was significantly higher in the overweight and obese groups when compared with the eutrophic group (p < 0.0001). The incidence of gestational arterial hypertension was also significantly higher in the overweight (6.8%) and obese (12.7%) groups when compared with the eutrophic group (1.2%) (p < 0.0001). The incidence of pre-eclampsia was also higher and statistically different in the overweight and obese groups. In conclusion, it was observed that most of the pregnant women presented with overweight/obesity and that this excess body weight contributed significantly to the incidence of several maternal complications. Full article

(1) Introduction: Coenzyme Q10 (CoQ10) is a component present in the transport chain of mitochondrial electrons with antioxidant property. Currently, there are limited studies which indicate the effects of its supplementation on Metabolic Syndrome (MetS) and Non-Alcoholic Fatty Liver Disease (NAFLD). (2) Objective: This work was conducted to determine the effects of CoQ10 supplementation in women with MetS and NAFLD. (3) Methodology: This double-blind randomized clinical-controlled trial was performed among 22 women with MetS and NAFLD. Patients were randomized into two groups: group A (n = 11), which received 200 mg/day of CoQ10; and group B (n = 11), which received a placebo medication for 12 weeks. The hepatic steatosis present in NAFLD, the volume of abdominal fat, and visceral fat volume were evaluated by Magnetic Resonance Imaging (MRI). Anthropometric, blood pressure, and marker serums that compound the MetS were also analyzed. (4) Results: A decrease in visceral fat volume (p = 0.02), abdominal circumference (p = 0.03/CI = 0.19–3.80), and increase in HDL-cholesterol (p = 0.01/CI = −9.80: −1.44) was observed in the CoQ10-supplemented group. We did not find significant changes in any of the other variables evaluated. (5) Conclusions: Supplementation with CoQ10 for 12 weeks, even if discreetly, brought some benefits for the supplemented group whereas no changes were observed in the control group. Full article

Background: Obesity is a critical public health concern with its prevalence growing at an alarming rate worldwide. The Western diet that typically includes high-fat or high-fructose components is one of the leading contributing factors of obesity. Recent findings demonstrate the essential role of BAT in regulating whole-body metabolism. However, the explicit mechanism through which BAT maintains homeostasis is still unknown. Methods: Six-week-old C57BL/6 male mice were fed either a low-fat diet (LFD) or a high-fat high-fructose diet (HFHFD) for 4, 12, and 20 weeks. Results: We observed a significant increase in BAT weight under HFHFD along with BAT whitening in a time-dependent manner. This was also accompanied by a significant decrease in UCP1 and PGC1α protein, as well as a significant increase in the Bax/Bcl-2 ratio as early as 12 weeks, indicating increased apoptosis under HFHFD. Interestingly, miRNA-103 expression that holds a seed sequence within the miRNA biogenesis machinery, Dicer, was significantly upregulated after 12 and 20 weeks of HFHFD. Dicer and another biogenesis regulator, TRBP2, exhibited significant upregulation at 4 weeks of HFHFD. Conversely, those gene expressions were significantly downregulated at 12 and 20 weeks of HFHFD, followed by a significant decrease in the protein level at 12 weeks. To confirm the mechanistic connection, miRNA-103 knockdown in vitro significantly upregulated Dicer and the TRBP2 gene. However, only Dicer exhibited a significant increase at the translational level. Conclusion: Overall, we conclude that HFHFD may elicit BAT dysfunction by inhibiting Dicer via miRNA-103. Full article

Obesity, a multifactorial disorder, has been associated with alterations in metal metabolismand epigenetic modifications. This pilot case–control study aimed to investigate serum cobalt concentrations and associated DNA methylation patterns in women with obesity. Serum cobalt levels were measured using inductively coupled plasma mass spectrometry (ICP-MS), revealing significantly higher cobalt concentrations in participants with normal weight than in participants with obesity. Additionally, DNA methylation analysis identified differentially methylated positions (DMPs) associated with cobalt exposure, and DMPs between groups highlighted hypomethylation in the top DMPs in individuals with obesity. Functional enrichment analysis of these DMPs unveiled potential pathways implicated in apoptosis, cancer, and metabolic signaling, warranting further investigation into the mechanistic links. This study provides preliminary insights into the interplay between cobalt exposure, DNA methylation, and potential implications for obesity management. Full article

Beyond the challenges presented by obesity itself, a considerable portion of the population encounters prejudice and discriminatory behavior based on their weight and size. This phenomenon, termed weight stigma and weight bias, appears to be perpetuated not only by the broader society but also by healthcare providers, leading to distrust and alienation among individuals with obesity, thereby exacerbating a global issue. Recognizing weight stigma as a violation of human rights and its association with declining health outcomes, there is a pressing need to explore evidence-based strategies for mitigating it within healthcare. This is especially crucial at the early stages of professional development. Methodology: A randomized controlled trial employing a 60 min lecture experimental design was conducted to evaluate changes in conceptions, beliefs, and prejudices toward obesity among healthcare undergraduates (n = 242). Results: Semantic network analysis revealed participants’ conceptualization of obesity as a condition closely linked to diet and sedentary habits. Moreover, three out of four healthcare students considered obesity a disease for which the individual is responsible. While individuals with obesity were described as weak, lazy, and having a high affinity for food, these prejudices decreased following the educational intervention. Conclusion: Following an educational intervention based on the multifactorial nature of obesity and weight stigma, it was possible to modify prejudices and conceptions about obesity among future healthcare professionals. Full article

Background: Individuals with food addiction (FA) compose a distinct subset of people with obesity who are less responsive to weight loss interventions. An emerging field of study explores the role of telomere length in disease processes. Some evidence suggests that obesity is associated with telomere shortening; however, we are not aware of studies examining telomere length in obesity subtypes. Therefore, we explored whether FA and levels of obesity were associated with telomere shortening. Methods: We enrolled 120 adults (aged 19–70) with overweight/obesity (BMI ≥ 25); half were positive for severe food addiction (FA+), and half were negative for food addiction (FA−) (Yale Food Addiction Scale 2.0). Participants completed a demographic form and provided a saliva sample (Oragene saliva DNA collection kit). Telomere length was analyzed using the monoplex quantitative polymerase chain reaction (qPCR). Data were analyzed using descriptive statistics, t-tests, and ANOVAs (α = 0.05). Results: Participants with overweight (mean = 1.40 t/s, SD = 0.40) had longer telomeres (p = 0.013) than those with morbid obesity (mean = 1.15 t/s, SD = 1.29). Telomere length did not differ (p = 0.306) between persons who were FA− (mean = 1.26 t/s, SD = 0.26) and those who were FA+ (mean = 1.32 t/s, SD = 0.34). The youngest participants (mean = 1.39 t/s, SD = 0.33) had longer telomeres (p = 0.006) than the oldest participants (mean = 1.18 t/s, SD = 0.19). Conclusion: Those who were morbidly obese had the shortest telomere lengths. Interestingly, however, there were not significant telomere length differences in the food addicted vs. nonfood-addicted subtypes. Full article

Obesity is a complex disease with a multifactorial etiology and could be associated with psychiatric disorders, such as Binge Eating Disorder (BED), characterized by recurrent episodes of binge eating in the absence of compensatory behaviors. The present study aimed to analyze anthropometric and body composition changes over five years after bariatric surgery in patients diagnosed or not diagnosed with BED, depression, and anxiety in the preoperative period. One hundred and eighteen patients undergoing bariatric surgery were evaluated and divided into two groups according to the presence or absence of BED. The patients were submitted to anthropometric and body composition evaluation. We also analyzed BED diagnosis, depression, and anxiety according to the DSM-5 and validated questionnaires. The Kolmogorov–Smirnov, t-test, Fisher’s, and chi-square tests were used for statistical analysis. Over five years after bariatric surgery, only the BED group exhibited an increased weight and BMI (p < 0.05). In the preoperative period, patients with BED had severe depression (13,11%, p = 0.0079) and a higher frequency of moderate (22.95%, p < 0.01) or severe (14.75%, p < 0.01) anxiety. In conclusion, patients with BED had more intense symptoms of depression and anxiety in the preoperative period, and this disorder may persist in the postoperative period of bariatric surgery, contributing to weight gain and increased BMI. Full article

Background: Previous studies have suggested that changes in the composition of intestinal microbiota may be influenced by dietary quality. Objective: This study aimed to assess the impact of a hypocaloric diet on the relationship between microbiota and clinical/dietary variables. Methods: This was a longitudinal study. Ten women with obesity (Obese Group, ObG) participated in an 8-week home-based hypocaloric diet intervention. Anthropometric, dietary intake, biochemical, and gut microbiota assessments were conducted before and after the intervention. Microbiota relative abundance was determined using real-time PCR in triplicate. Results: In the ObG, the hypocaloric diet intervention led to significant weight loss (before: 119.5 ± 10.3 kg; after: 114.9 ± 10.2 kg; p = 0.003). Following the intervention, positive correlations were observed between nutrient intake and phyla composition: Actinobacteria phylum with fibers (r = 0.787; p = 0.012), Firmicutes phylum with proteins (r = 0.736; p = 0.024), and Proteobacteria phylum with lipids (r = 0.669; p = 0.049). Conclusions: The hypocaloric diet intervention improved health parameters associated with obesity and its comorbidities, demonstrating associations between nutrient intake and specific phyla. Full article