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Mansoo Yu

Jan. 24, 2024 Contact: Brian Consiglio, 573-882-9144, consigliob@missouri.edu

Obesity is a problem in the United States. In fact, 42.5% of U.S. adults aged 20 and over have the disease. Not only is obesity the nations second leading cause of preventable death (behind only smoking cigarettes), it also leads to other serious health issues, including an increased risk of type 2 diabetes, high blood pressure, heart disease, stroke, cancer, sleep apnea and liver disease. The disease and its side effects impose a significant financial burden on Americas health care system.

As many make and often fail to keep New Years resolutions about exercise and weight loss goals, University of Missouri researcher Mansoo Yu has completed a long-term study that highlights which specific features of online weight loss interventions are most likely to lead to long-term weight loss and maintenance. Yu found that counseling with professional health coaches and social support from other users are the two most beneficial features of online weight-loss programs for middle-aged adults (ages 35-55) with obesity or overweight.

The findings can help the public choose from among the seemingly infinite number of online weight loss interventions available in todays digital age.

Not only are there physical health issues related to obesity, but individuals with obesity are also at higher risk for mental health issues such as depression, poor self-esteem and social isolation, said Mansoo Yu, a professor in the MU College of Health Sciences. My research is at the intersection of social work and public health, and my goal is to help people live happier, healthier lives.

In the study, Yu collaborated with Kyung Jung Han, a former MU doctoral student who is an associate professor at California State University, Bakersfield. The pair examined 20 years of existing published research on the topic of various online interventions geared toward helping those with obesity lose weight. They identified which online features were associated with the most significant long-term weight loss.

The three categories of online interventions we evaluated were those that only provided educational information and self-monitoring tools, those that had an online group chat function where participants could share their progress with their peers and befriend each other, and finally those that included a professional health coach who could answer any questions participants had, Yu said. The interventions with access to social support from other participants or professional health coaches were as effective as in-person weight loss interventions.

Yu added that for people who live in rural areas, where individuals experience obesity at higher rates, online interventions can provide more accessibility, flexibility and convenience as well as reduce transportation times and costs.

The key is picking the online intervention with the most effective features, such as access to social support from other participants and professional health coaches, Yu said. Our research, which took eight years to complete, combed through 20 years worth of published research in order to provide the broader community with the best evidence-based recommendations.

For those with New Years resolutions surrounding weight loss and more exercise, Yu recommends the following tips:

1. Sharing your resolution with friends, family members, significant others and colleagues to increase accountability and social support.

2. Scheduling some form of physical activity into your daily routine.

3. Checking in with others to see how their resolutions are going and offering words of encouragement.

4. Having friendly competition with peers to see who walked or ran more steps each day.

5. Asking professional heath coaches for evidence-based advice when it comes to exercise or diet-related questions.

Effectiveness of different online intervention modalities for middle-aged adults with overweight and obesity: A 20-year systematic review and meta-analysis was recently published in Journal of Prevention.

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The more the merrier: Research shows online interventions with social support help middle-aged adults with obesity ... - University of Missouri

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Losing weight is hard. Here are 5 things to keep in mind - KXLY Spokane

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Dr. Roach: Weight-loss drugs are only recommended for severe obesity - Detroit News

Found is a personalized health program focused on sustainable weight loss. Its an online medically supervised program for those with a BMI of 30 or a BMI of 27 with comorbidities such as diabetes or heart disease. Its available in 31 states.

It encompasses diet, exercise, and prescription medications when deemed necessary. It also takes into account other important factors that can impact weight loss and shouldnt be ignored, such as:

The program takes a multidisciplinary approach to wellness and includes board-certified physicians in weight management, nutrition, and health coaches as part of your care.

According to Caroline Thomason, RD, CDCES, a dietitian based in Washington, DC, Programs like these offer alluring aspects of working with a weight loss physician: a virtual program setting and access to medications that may be challenging to get otherwise.

Adrienne Youdim, MD, an obesity medicine and physician nutrition specialist, echoes this opinion and says, It is an evidence-based program that evaluates patients on an individual basis and prescribes FDA-approved weight loss drugs in a guideline-based manner.

Here are the key components that you get with your monthly membership.

Personalized nutritionYou receive personalized nutrition recommendations from a health coach. With the Found program, no food is off-limits, but they encourage portion control and staying in a calorie deficit.

MovementYou also receive personalized exercise guidance from an expert.

Prescription medicationFDA-approved medications are prescribed if you qualify. Two classes of drugs are offered: oral or injectable medications, or glucagon-like peptide-1 agonists (GLP-1s). GLP-1s are medications traditionally used to treat diabetes; these may be oral or injectable meds.

While all the medications are FDA-approved, not all of them are approved for weight loss specifically. This means some of them are prescribed off-label and may produce weight loss as a side effect.

For example, metformin is a diabetes medication that may be prescribed to a Found member. Its associated with weight loss in some research, but its not FDA-approved for this purpose specifically.

The full list of medications you could be prescribed includes:

The drugs used all have evidence for the treatment of obesity or excess weight resulting in medical comorbidity. I fully support the use of anti-obesity medications in the right individual to treat the chronic condition of obesity, says Dr. Youdim.

Medical guidance and consultationThe program provides initial and ongoing access to a medical provider who helps guide your treatment path and provides support.

Personal health coachingYou receive support from a personal health coach. It needs to be clarified if this coach is a registered dietitian or what their credentials are.

Access to an exclusive communityYou receive access to a private Facebook group where you can ask questions and share your experiences.

Link:
Review of Found Weight Loss: Pros, Cons, and How It Works - Everyday Health

Researchers in the School of Population Health atRCSI University of Medicine and Health Sciences have providednew evidence of the health benefits of weight loss efforts that lead to diabetes remission fortype 2diabetespatients.

For participants in the weight-loss trial who were able to achieve remission i.e. reduce the need for medications and reduce their HbA1c levels(a measure of blood sugar control), the research found there was a 40% lower rate of cardiovascular disease and 33% lower rate of chronic kidney diseasein this group.

While previoustrials have shown that substantial weight loss using diet and lifestyle can reverse type 2 diabetes, the new researchpublished in Diabetologiais among the first to show that reversal of diabetes, in turn, affects cardiovascular and kidney disease outcomes.The researchwas ledby Professor Edward Gregg, Head of the RCSI School of Population Health.

The studycalled Look AHEAD(Action for Health in Diabetes)monitoredover 5,000 patients duringa period of 12 years.The magnitudeof risk reduction was greatest for participants with evidence of at least fouryears of remission.

Using lessons learned from this study we can help inform diabetes treatment methods andimprovequality of life for people with type 2 diabetes.It has highlighted the significance of weight loss for achieving remission from type 2 diabetes and then long-term positivecardiovascularand kidney disease outcomes

Professor Edward Gregg, Head of the RCSI School of Population Health

Over the course of the study, the effect of intensive lifestyle intervention was compared with that of diabetes support and education on cardiovascular diseaseand other long-term health conditions.It wasnoted that although 18% of participants achieved remission at some point during follow-up, the percentage of participants withcurrentremission had decreased to 3% by the 8th year of the study, underlining the challenges of keeping weight off using lifestyle interventions.

RCSI researchers collaborated on the study with colleagues Wake Forest University, Brown Universityand other study sites in the United States.

Source:

Journal reference:

Gregg, E.W., et al. (2024) Impact of remission from type 2 diabetes on long-term health outcomes: findings from the Look AHEAD study. Diabetologia. doi.org/10.1007/s00125-023-06048-6.

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Study shows lasting benefits of weight loss and diabetes remission for the heart and kidneys - News-Medical.Net

Losing weight and keeping it off isn't easy, even for medical professionals. Betsy Grunch, MD, a board-certified neurosurgeon based near Atlanta, recently spoke to Business Insider about her long-term struggle with weight loss after not receiving a lot of nutritional education in her medical training. By educating herself, however, the doctor was eventually able to lose 80 pounds. She did this largely by changing what she ate, and honing in on a weight-loss diet that actually works.

RELATED: Lose 50 Pounds by Following 2 Simple Rules, Successful Dieter Says.

In addition to being a busy neurosurgeon, Grunch is also a mother of two, so it can be a challenge for her to find the time to prepare nutritious food, she told Business Insider. Before her weight loss, she would usually rely on the fast food she could grab at her hospital.

Grunch said she was consuming a lot of calories through her drinks as well, as she would regularly drink three or four sugar-filled sodas and sweet coffee drinks such as Frappuccinos every day.

"I didn't realize what the cumulative effects of all that was," she told the news outlet. "Just like every other American, really."

In an attempt to lose weight over the years, Grunch often found herself falling for fad diets. But it was only after she started eating a high-protein, lower-carb diet in 2018 that she was actually able to maintain her weight loss.

RELATED: Certain Foods Trigger Natural Ozempic-Like Weight Loss Effect, Doctor Says.

Grunch managed to lose 50 pounds with this weight-loss dietwhich she still follows todaycombined with intermittent fasting. That means she eats all of her food in a six- to eight-hour window, and fasts for the rest of the time. The only exception is a coffee with heavy cream and MCT oil she consumes in the morning, Business Insider reported.

For lunch, the doctor usually eat a large, high-protein meal based around chicken or fish around 12 p.m. or 1 p.m. She then has a lighter dinner, sometimes eating whatever her kids are having.

"Intermittent fasting works by prolonging the period when your body has burned through the calories consumed during your last meal and begins burning fat," according to Johns Hopkins. For what it's worth, research has shown somewhat mixed results as to whether limiting when you eat leads to significant weight loss.

RELATED:42-Year-Old Woman Lost 100 Pounds Through "Very Basic" Lifestyle Change. ae0fcc31ae342fd3a1346ebb1f342fcb

For her part, though, Grunch says her high-protein, lower-carb diet helps her to stay full, maintain muscle, recover from workouts, and feel healthier overall.

"I feel better when I don't eat processed foods and gluten," she shared.

Of course, it wasn't just her diet that helped her lose weight. Grunch told Business Insider that she also had to figure out her goals and try to maintain a positive relationship with her body throughout her journey.

"Weight loss has such a huge psychological component," the neurosurgeon said.

After her initial 50-pound weight loss, Grunch took Mounjaro to lose another 30 pounds. Similar to Ozempic, Mounjaro is a diabetes drug that is now often prescribed off-label for weight loss because it targets the hunger hormone GLP-1.

Best Life offers the most up-to-date information from top experts, new research, and health agencies, but our content is not meant to be a substitute for professional guidance. When it comes to the medication you're taking or any other health questions you have, always consult your healthcare provider directly.

Excerpt from:
43-Year-Old Doctor Who Lost 80 Pounds Shares Her Weight-Loss Diet - Best Life

Patients with type 2 diabetes who showed evidence of remission through lifestyle interventions had a significantly lower risk of chronic kidney and cardiovascular disease, according to research published in the journal Diabetologia.1

Remission from Type 2 diabetes is known to have many potential benefits for patients, including improved quality of life. While remission through weight loss has usually been associated with bariatric surgery, lifestyle interventions have also been shown to be effective.

Remission from diabetes after bariatric surgery has been shown to be followed by lower incidences of cardiovascular disease and chronic kidney disease, the authors wrote. However, bariatric surgery leads to substantially greater and longer-term normalization of glucose than remission achieved through lifestyle intervention. Despite the growing interest in diabetes remission as a goal through lifestyle intervention, the long-term impact of achieving this goal remains unclear.

Investigators from RCSI University of Medicine and Health Sciences in Dublin, Ireland conducted a study to examine the association of diabetes remission in the context of a 12-year intensive lifestyle intervention with subsequent incidence of chronic kidney disease and cardiovascular disease. Data was gathered from the Look AHEAD study (NCT00017953), a clinical trial assessing the long-term effects of a lifestyle intervention designed to achieve and maintain weight loss in patients with type 2 diabetes.

The Look AHEAD study included 5145 adults with overweight or obesity and type 2 diabetes. The intervention included attending weekly group and individual support sessions for 12 years. The sessions were used to offer participants advice on diet, physical activity, and social support. The aim of the interventions were to reduce total caloric intake, total fat and saturated fat intake, and increase levels of physical activity.

Investigators found that, compared to participants who did not achieve remission, those who showed evidence of any remission had a 33% lower rate of chronic kidney disease, and a 40% lower rate of the composite cardiovascular disease measure. Analyses were adjusted for HbA1C, blood pressure, lipid levels, cardiovascular disease history, and diabetes duration.

Participants who had a short duration of diabetes, low starting HbA1C, and a larger amount of weight loss were the most likely to experience remission. Additionally, patients with evidence of longer-term remission had the greatest risk reduction.

The authors noted that remission from type 2 diabetes may be associated with lower rates of chronic kidney disease and cardiovascular disease through several pathways, including sustained reduction in HbA1C, and physiological effects of extensive weight loss like reductions in blood pressure, insulin resistance, and inflammation.

Using lessons learned from this study we can help inform diabetes treatment methods and improve quality of life for people with type 2 diabetes, Edward Gregg, lead author on the study, said in a release.2 It has highlighted the significance of weight loss for achieving remission from type 2 diabetes and then long-term positive cardiovascular and kidney disease outcomes

Link:
T2D Remission Through Weight Loss Linked With Lower Rates of Chronic Kidney, Cardiovascular Disease - Drug Topics

Why Wall Street no longer fears sprawling impact from the weight loss drug craze  Yahoo Finance

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Why Wall Street no longer fears sprawling impact from the weight loss drug craze - Yahoo Finance

In a recent study published in Diabetologia, researchers examine the effect of diabetes remission on long-term health outcomes.

Study:Impact of remission from type 2 diabetes on long-term health outcomes: findings from the Look AHEAD study. Image Credit: Proxima Studio / Shutterstock.com

Remission from type 2 diabetes is considered attainable by many patients. Although diabetes remission is typically associated with bariatric surgery, lifestyle interventions have also been effective in achieving remission from prediabetes and diabetes.

Diabetes remission following bariatric surgery can lead to chronic kidney disease (CKD) and cardiovascular disease (CVD). Nevertheless, bariatric surgery results in longer and greater glucose normalization than remission through lifestyle interventions.

To date, no studies have assessed the impact of lifestyle-based remission from diabetes on long-term outcomes.

In the present study, researchers examined the impact of diabetes remission on the subsequent incidence of CVD and CKD. To this end, an observational post hoc analysis of the Look AHEAD study participants was performed.

Look AHEAD was a randomized controlled trial comparing the effects of an intensive lifestyle intervention (ILI) to diabetes support and education (DSE) on long-term outcomes. The trial randomized 5,145 obese or overweight adults 45-76 years of age with type 2 diabetes.

ILI encompassed weekly individual and group sessions in the first six months, followed by one individual session and two group sessions every month for the next six months. For years two through four, two contacts to the study participants were made every month.

These participants were asked to attend support sessions every month between years four and 12. Behavioral strategies were used to help meet weight, behavioral, physical activity, and dietary goals.

DSE recipients were offered three annual group sessions focused on social support, diet, and physical activity; however, they were not offered personalized behavioral support.

All study participants made a baseline clinic visit, followed by annual follow-up visits for four years and every two years thereafter. Study personnel examined health status, body weight, height, glycated hemoglobin (HbA 1c), and use of medications at each visit.

Diabetes remission was defined as the transition from meeting the criteria of diabetes to those of prediabetes without using glucose-lowering drugs. The primary outcomes were the incidences of CKD and CVD.

Overall, 4,448 participants from the Look AHEAD study were retained in this analysis after excluding those with insufficient follow-up data, bariatric surgery, and remission at baseline. About 12.7% of participants met the definition of remission for at least one follow-up visit. Remission prevalence was 11.2% in the first year for the ILI group and declined by 0.7 percentage points every year.

By contrast, remission prevalence was about 2% yearly in the DSE group. Remission status and duration were significantly associated with baseline disease duration, medication use, and fasting plasma glucose, HbA 1c, and systolic blood pressure levels. Individuals who attained remission were highly likely to have used medications at baseline.

Individuals with remission for two or more follow-up visits were less likely to have CVD. Furthermore, longer remission periods were associated with shorter diabetes durations.

Remission was associated with changes in risk factors and weight over four years. The average weight loss was four kilograms after one year and 2.2 kg after four years for individuals without remission. By contrast, average weight loss was 12.3 kg and 9.6 kg after one and four years, respectively, for subjects with remission for at least four visits.

Participants who achieved remission exhibited greater improvements in fitness and high-density lipoprotein (HDL)-cholesterol levels after one and four years than those without remission. However, individuals with remission had smaller reductions in low-density lipoprotein (LDL)-cholesterol. Participants with remission had a 40% and 33% reduced rate of CVD and CKD, respectively, as compared to those without remission.

In analyses with the DSE group as the reference, ILI subjects with remission had a 23% reduced rate of CVD and 40% lower rate of CKD. In analyses stratified by randomization, remission was associated with a 68% reduction in CVD but not CKD in the DSE group, whereas the LIL group was associated with a 34% decrease in CKD but not CVD.

About 11% of study participants achieved remission by the first year, which was reduced to 4% by the eighth year. Despite the short-lived remission period, remission was associated with 40% and 33% lower CVD and CKD rates than in participants without remission, respectively.

Individuals with a shorter diabetes period, greater weight loss, or low baseline HbA 1c were most likely to achieve remission. The magnitude of risk reduction was highest for those with longer-term remission.

Journal reference:

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The long-term outcomes of diabetes remission and its impact on health - News-Medical.Net

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