Obesity is a chronic disease, like diabetes and hypertension. If treatment is discontinued, it will relapse, though gradually.
WeightControl.com Interview with: Louis J Aronne M.D. Sanford I. Weill Professor of Metabolic Research Department of Medicine Weill Cornell Medicine
WeightControl.com: What is the background for this study? What are the main findings?
Response: The SURMOUNT -4 trial demonstrates that patients who discontinued tirzepatide after losing 20.9% over 36 weeks regained about half the weight in one year to an average 9.5% weight loss following discontinuation while those who continued lost an additional 5%.
The metabolic parameters which had improved with weight loss returned towards their starting point, but did not completely regress.
These findings underscore that some individual’s brains can be fundamentally different in regions that increase the risk for obesity.
WeightControl.com Interview with:
Casey H. Halpern, MD Division Head, Functional and Stereotactic Neurosurgery Associate Professor of Neurosurgery University of Pennsylvania
WeightControl.com: What is the background for this study?
Response: The dorsolateral hippocampus (dlHPC) is located in the region of the brain that processes memory, and the lateral hypothalamus (LH) is in the region of the brain that is responsible for keeping the body in a stable state, called homeostasis. Previous research has found an association with loss of function in the human hippocampus in individuals with obesity and related disordered eating, like BED. However, outside of imaging techniques such as magnetic resonance imaging (MRI), the role of the hippocampus has been difficult to study in humans with obesity and related eating disorders.
Given the health benefits of clinically meaningful weight reduction at any level of excess weight, 5% or greater weight loss can be a reasonable target for obesity management efforts.
WeightControl.com Interview with:
Dr. Lyudmyla Kompaniyets, PhD Division of Nutrition, Physical Activity and Obesity National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention, Atlanta, Georgia
Dr.Kompaniyets
WeightControl.com: What is the background for this study?
Response: Overweight and obesity affect more than 70% of US adults and are risk factors for other chronic diseases, including type 2 diabetes, cardiovascular disease, and many cancers. This is one of the only papers to assess the probability of a 5% weight loss or reducing BMI to healthy weight among US adults with overweight and obesity.
This study focused on the probability of weight loss in a healthcare seeking population with overweight or obesity regardless of any individual’s intention to lose weight.
This trial found that among the participants taking Wegovy the incidence of MACE was 20% lower than those with usual care.
WeightControl.com Interview with: Shauna Levy MD, MS, FACS. FASMBS, DABOM Assistant Professor Department of Surgery Division of Bariatric and Minimally Invasive Surgery Director of Bariatric Surgery American Board of Obesity Medicine, Diplomate Instagram @tulane_bariatric_center Tulaneweightloss.com
WeightControl.com: What is the background for this study?
Response: The SELECT trial evaluated over 17,000 patients with a history of overweight or obesity and cardiovascular disease. They randomized patients to usual care versus Wegovy (semaglutide), which is an anti-obesity medication. It is important to note that none of the participants had diabetes.
They evaluated the incidence of Major Adverse Cardiaovascular Events (MACE) for up to 5 years for all participants.
We found that participants who engaged in time-restricted eating ate 425 fewer calories per day than the control group and lost about 10 more pounds than the control group after one year
WeightControl.com Interview with: Krista Varady, PhD Professor, Kinesiology and Nutrition University of Illinois, Chicago
WeightControl.com: What is the background for this study?
Response: Obesity is a major health issue. Many traditional weight loss diets involve counting calories, which can be cumbersome and difficult to do well. Time-restricted eating, without calorie counting, has become a popular weight loss strategy because it is simple to do. Whether it’s effective in producing weight loss, especially beyond the short term, is unclear.
If you are experiencing chronic stress be specifically vigilant on what you eat. K
WeightControl.com Interview with: Prof. Herbert Herzog Chair in Neuroendocrinology Lab Leader, Eating Disorders Lab Garvan Institute of Medical Research
WeightControl.com: What is the background for this study?
Response: We used a systematic, unbiased approach to identify the regions in the brain that specifically respond to either a Prof. Herbert Herzog (HFD) or a HFD combined with stress. This identified the ‘Lateral Habenular’ (LHb) as the most responsive nuclei to a HFD, while when combining HFD and Stress the neurons in this nuclei were silent.
This indicates that stress can override the HFD induced activation of neurons in the LHb. The LHb is know as the so called ‘anti-reward’ centre, that when activated dampens the reward feeling in this case the pleasure of eating caloric dense food, normally high in fat and sugar. Chronic stress reverts that and brings the pleasure back by blocking the LHb pathway. Not only leads this to an increase of food intake but at the same time specifically promotes the graving for sweet food.
A primary consideration that this analysis could not investigate is the issue of long-term weight loss.
WeightControl.com Interview with:
Ainhoa Gomez-Lumbreras, MD, PhD Post-Doctoral Fellow Department of Pharmacotherapy College of Pharmacy, University of Utah
Dan Malone, PhD Professor Department of Pharmacotherapy College of Pharmacy, University of Utah Salt Lake City, UT 84112
WeightControl.com: What is the background for this study?
Response: Obesity, defined as having a body mass index of 30 or more, is a multifactorial disease that has been associated with cardiovascular and respiratory diseases, diabetes, and others. By 2030 it is expected that half of the U.S. adult population will be obese. More pharmacologic products are being investigated for weight loss, including the new anti-diabetes medications liraglutide, semaglutide and tirzepatide.
These patterns such as the Mediterranean diet, DASH diet, vegetarian diet, or other versions of healthy diets can be adapted to meet individual health needs, food preferences, and cultural traditions.
WeightControl.com Interview with: Frank B. Hu, MD, PhD Professor and Chair Department of Nutrition Harvard T.H. Chan School of Public Health
Dr. Frank Hu
WeightControl.com: What is the background for this study? What are the main findings?
Response: The current Dietary Guidelines for Americans (DGAs) recommend multiple healthy eating patterns. However, few studies have evaluated whether greater adherence to the DGAs-recommended dietary patterns is associated with long-term risk of total and cause-specific mortality. The researchers used health data collected over 36 years from 75,230 women participating in the Nurses’ Health Study and 44,085 men in the Health Professionals Follow-up Study. All participants were free of cardiovascular disease or cancer at the beginning of the study and completed dietary questionnaires every four years.
Their information was scored based on each of the four dietary pattern indexes (Healthy Eating Index 2015, Alternate Mediterranean Diet, Healthful Plant-based Diet Index, and Alternate Healthy Eating Index). All share key components including whole grains, fruits, vegetables, nuts, and legumes, although other components differ across different eating patterns.
Older individuals with a weight loss of 5-10% had a higher risk of all-cause mortality: 33% for men and 26% for women.
WeightControl.com Interview with: Dr Monira Hussain MBBS, MPH, PhD Senior Research Fellow & ECF Clinical Research Australian Fellow Public Health and Preventive Medicine Monash University Melbourne Australia
WeightControl.com: What is the background for this study?
Response: The impact of weight changes on healthy older adults is not fully understood, and the association between weight loss and cause-specific mortality needs to be explored using more reliable methods.
Patients were able to stay away from food for a longer time. For some of the patients that was really changing their lives. They are back to normal and not obsessed with food all the time.
WeightControl.com Interview with: Dr. Christian Roth, MD Seattle Children’s Research Institute and Division of Endocrinology Department of Pediatrics University of Washington
Dr. Roth
WeightControl.com: What is the background for this study? Would you briefly explain what is meant by Hypothalamic Obesity?
Response: Hypothalamic obesity is a different entity of obesity that is rare and very difficult to treat. It is an acquired form of obesity due to injury to the hypothalamus because of a brain tumor and/or its treatment. This causes an abrupt change in body weight regulation because tissues that are important for energy homeostasis are partially or completely removed.
Typically, these patients can’t control their appetite and within a very short time after surgery they gain weight quickly. Their energy expenditure is also very low. So even if they cut down on calorie intake, they are typically not able to lose weight.
