Obesity embargo alert for December 2019 issue
Editors’ Choice 1 – Anti-obesity Drug Prescriptions: Updated Analysis of Patterns, David R. Saxon, [email protected], Sean J. Iwamoto, Christie J. Mettenbrink, Emily McCormick, David Arterburn, Matthew F. Daley, Caryn E. Oshiro, Corinna Koebnick, Michael Horberg, Deborah R. Young, and Daniel H. Bessesen
Also see accompanying Commentary by William H. Dietz (http://onlinelibrary.
Editors’ Choice 2 – IBT Plus Liraglutide Improves Eating Disorder Psychopathology, Ariana M. Chao, [email protected], Thomas A. Wadden, Olivia A. Walsh, Kathryn A. Gruber, Naji Alamuddin, Robert I. Berkowitz, and Jena S. Tronieri
Editors’ Choice 3 – Novel Adipokine May Regulate Tissue Remodeling in Weight Loss, Robert M. Jackson, Beth A. Griesel, Kevin R. Short, David Sparling, Willard M. Freeman, and Ann Louise Olson, [email protected]
Editors’ Choice 4 – School Programs Promoting Intake of Water: Cheap and Effective?, Erica L. Kenney, [email protected], Angie L. Cradock, Michael W. Long, Jessica L. Barrett, Catherine M. Giles, Zachary J. Ward, and Steven L. Gortmaker
ADDITIONAL EMBARGOED RESEARCH
Population?Based Study of Traffic?Related Air Pollution and Obesity in Mexican Americans, Xueying Zhang, Hua Zhao, Wong-Ho Chow, Moira Bixby , Casey Durand , Christine Markham , Kai Zhang, [email protected]
Scroll down to find abstracts for each of the above papers. To request the full text of any of these studies and agree to the embargo policy, or to arrange an interview with a study’s author or an obesity expert, please contact [email protected]
Editors’ Choice Abstracts
Editors’ Choice 1 – Anti-obesity Medication Use in 2.2 Million Adults Across Eight Large Health Care Organizations: 2009-2015
Objective: The aim of this study was to examine the prescribing patterns and use of anti-obesity medications in a large cohort of patients using data from electronic health records.
Methods: Pharmacy- and patient-level electronic health record data were obtained on 2,248,407 adults eligible for weight-loss medications from eight geographically dispersed health care organizations.
Results: A total of 29,964 patients (1.3% of total cohort) filled at least one weight-loss medication prescription. This cohort was 82.3% female, with median age 44.9 years and median BMI 37.2 kg/m2. Phentermine accounted for 76.6% of all prescriptions, with 51.7% of prescriptions being filled for ? 120 days and 33.8% filled for ? 360 days. There was an increase of 32.9% in medication days for all medications in 2015 compared with 2009. Higher prescription rates were observed in women, black patients, and patients in higher BMI classes. Of 3,919 providers who wrote at least one filled prescription, 23.8% (n = 863) were “frequent prescribers” who wrote 89.6% of all filled prescriptions.
Conclusions: Weight-loss medications are rarely prescribed to eligible patients. Phentermine accounted for > 75% of all medication days, with a majority of patients filling it for more than 4 months. Less than one-quarter of prescribing providers accounted for approximately 90% of all prescriptions.
Editors’ Choice 2 – Effects of Liraglutide and Behavioral Weight Loss on Food Cravings, Eating Behaviors, and Eating Disorder Psychopathology
Objective: This exploratory analysis examined the effects of intensive behavioral therapy (IBT) for obesity (“IBT-alone”), IBT plus liraglutide 3.0 mg/d (“IBT-liraglutide”), and IBT plus liraglutide 3.0 mg/d plus 12 weeks of a portion-controlled diet that provided 1,000 to 1,200 kcal/d (“Multicomponent”) on changes in food cravings, eating behaviors, and eating disorder psychopathology at 24 and 52 weeks post randomization.
Methods: Adults with obesity (mean age = 47.6 ± 11.8 years and BMI = 38.4 ± 4.9 kg/m2; 79.3% female; 54.0% non-Hispanic white; 44.7% black) were randomized to IBT-alone (n = 50), IBT-liraglutide (n = 50), or Multicomponent (n = 50).
Results: At weeks 24 and 52, liraglutide-treated groups reported significantly larger declines in weight concern relative to the IBT-alone group. At week 24, compared with IBT-alone, liraglutide-treated groups reported significantly greater reductions in dietary disinhibition, global eating disorder psychopathology, and shape concern. The Multicomponent group had significantly greater reductions in binge eating at week 24 relative to the IBT-alone group. However, differences among groups were no longer significant at week 52. Groups did not differ in total food cravings at week 24 or 52.
Conclusions: The combination of liraglutide and IBT was associated with greater short-term improvements in dietary disinhibition, global eating disorder psychopathology, and shape concern than IBT alone.
Editors’ Choice 3 – Weight Loss Results in Increased Expression of Anti-Inflammatory Protein CRISPLD2 in Mouse Adipose Tissue
Objective: Obesity is a major risk factor for cardiovascular disease, metabolic syndrome, and type 2 diabetes mellitus, whereas weight loss is associated with improved health outcomes. It is therefore important to learn how adipose contraction during weight loss contributes to improved health. It was hypothesized that adipose tissue undergoing weight loss would have a unique transcriptomic profile, expressing specific genes that might improve health.
Methods: This study conducted an RNA-sequencing analysis of the epididymal adipose tissue of mice fed either a high-fat diet (HFD) or a regular rodent chow diet (RD) ad libitum for 10 weeks versus a cohort of mice fed HFD for the first 5 weeks before being swapped to an RD for the remainder of the study (swapped diet [SWAP]).
Results: The swapped diet resulted in weight loss, with a parallel improvement in insulin sensitivity. RNA sequencing revealed several transcriptomic signatures distinct to adipose tissue in SWAP mice, distinguished from both RD and HFD adipose tissue. The analysis found a unique upregulated mRNA that encodes a secreted lipopolysaccharide-binding glycoprotein (CRISPLD2) in adipose tissue. Whereas cellular CRISPLD2 protein levels were unchanged, plasma CRIPSLD2 levels increased in SWAP mice following weight loss and could correlate with insulin sensitivity.
Conclusions: Taken together, these data demonstrate that CRISPLD2 is a circulating adipokine that may regulate adipocyte remodeling during weight loss.
Editors’ Choice 4 – Cost-Effectiveness of Water Promotion Strategies in Schools for Preventing Childhood Obesity and Increasing Water Intake
Objective: This study aimed to estimate the cost-effectiveness and impact on childhood obesity of installation of chilled water dispensers (“water jets”) on school lunch lines and to compare water jets’ cost, reach, and impact on water consumption with three additional strategies.
Methods: The Childhood Obesity Intervention Cost Effectiveness Study (CHOICES) microsimulation model estimated the cost-effectiveness of water jets on US childhood obesity cases prevented in 2025. Also estimated were the cost, number of children reached, and impact on water consumption of the installation
of water jets and three other strategies.
Results: Installing water jets on school lunch lines was projected to reach 29.6 million children (95% uncertainty interval [UI]: 29.4 million-29.8 million), cost $4.25 (95% UI: $2.74-$5.69) per child, prevent 179,550 cases of childhood obesity in 2025 (95% UI: 101,970-257,870), and save $0.31 in health care costs per dollar invested (95% UI: $0.15-$0.55). In the secondary analysis, installing cup dispensers next to existing water fountains was the least costly but also had the lowest population reach.
Conclusions: Installing water jet dispensers on school lunch lines could also save almost half of the dollars needed for implementation via a reduction in obesity-related health care costs. School-based interventions to promote drinking water may be relatively inexpensive strategies for improving child health.
ADDITIONAL EMBARGOED RESEARCH
Population-Based Study of Traffic-Related Air Pollution and Obesity in Mexican Americans
Objective: The purpose of this study was to assess the cross?sectional association between residential exposure to traffic?related air pollution and obesity in Mexican American adults.
Methods: A total of 7,826 self?reported Mexican Americans aged 20 to 60 years old were selected from the baseline survey of the MD Anderson Mano?a?Mano Cohort. Concentrations of traffic?related particulate matter with a diameter of?
2.5 μm were modeled at geocoded residential addresses using dispersion models. The residential proximity to the nearest major road was calculated using a Geographic Information System. Linear and logistic regression models were used to estimate the adjusted associations between exposure and obesity, defined as a BMI of over 30.
Results: More than half (53.6%) of the study participants had a BMI over 30, with a higher prevalence in women (55.0%) than in men (48.8%). Overall higher traffic?related air pollution exposures were associated with lower BMI in men but higher BMI in women. By stratifying for those who lived in a 0? to 1,500?m road buffer, the one?interquartile?range (685.1 m) increase of distance to a major road had a significant association with a 0.58 kg/m2 lower BMI (95% CI: ?0.92 to ?0.24) in women.
Conclusions: Exposure to intensive traffic is associated with increased risk of obesity in Mexican American women.
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ALL ARTICLES EMBARGOED TO 3:00 a.m. (EST) Nov. 20, 2019
All print, broadcast and online journalists who receive the Obesity embargo alert agree to abide by the embargo and may not publish, post, broadcast or distribute embargoed press releases or details of the embargoed studies before the embargo date and time.
When writing about these studies, journalists are asked to attribute the source as the journal Obesity and to include the online link to the Obesity articles as provided below. Links become active when articles post at 3:00 a.m. (EST) on Nov. 20, 2019.
About the journal – Obesity is the peer-reviewed, scientific journal of The Obesity Society.