•BMI positively correlates with the presence of weight stigma.•The presence of weight stigma does not exert a significant influence on weight loss.•Inflammatory markers are greater with the presence ...of weight stigma among subjects living with obesity.
Weight stigma (WS) and prejudice are one of the most prevalent ways of discrimination among adults, comparable with rates of racial discrimination. Exposure to WS among patients with obesity (PWO) may make the adoption of healthy dietary patterns and regular physical activity even more challenging and, therefore, the achievement of weight loss. Additionally, WS could also induce physiological responses such as increased levels of inflammatory markers, due to stress exposure.
Subjects attending two obesity clinics were evaluated at baseline and after a minimum follow-up of six months. The weight Bias Internalization Scale (WBIS) and the Stigmatizing Situations Inventory (SSI) were administered to evaluate WS. Also, anthropometric and inflammatory markers, including cortisol, ferritin and C-reactive protein (CRP), were recorded at baseline.
79 PWO (87.3%♀, 45.5 ± 1.3 years, 35.9 ± 6.3 kg/m2) were included. At baseline, 72.2% started liraglutide as anti-obesity drug. Baseline body mass index (BMI) correlated positively with both WBIS (r = 0.23; p = 0.03) and SSI (r = 0.25; p = 0.02) scores. Mean percentual weight loss after a mean follow-up of six months was -7.28%. However, there was a negative, but not statistically significant, correlation between weight loss and both WBIS (r=-0.14; p = 0.2) and SSI (r=-0.19; p = 0.08). Regarding inflammatory markers, plasma cortisol levels at baseline correlated positively with WBIS (p = 0.005) and SSI (p = 0.02). CRP at baseline also presented a positive correlation with SSI (p = 0.03). No significant correlations were found for stigma tests and ferritin levels.
As weight increases among PWO, so does stigma. Despite we did not find a significant negative association between the presence of WS and weight loss outcomes, there was an increase in inflammatory markers among PWO who experienced higher levels of WS.
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Aims
Food addiction (FA) is conceptualized as a behavioral pattern that is similar in some ways to addictions to alcohol and other substances. This disorder has not been well studied among patients ...with type 2 diabetes (T2DM). We aimed to analyze if there is any relationship between FA and clinical or psychological variables among patients with T2DM.
Methods
Three hundred patients with T2DM were analyzed cross-sectionally. Participants were evaluated for the presence of FA by completing the Yale Food Addiction Scale 2.0 questionnaire.
Results
29.3% of patients screened positive for FA. Patients with FA had a greater BMI (33.41 ± 7.5 vs. 31.6 ± 5.9 kg/m
2
;
p
= 0.04). HbA1c was higher among individuals with FA (7.9 ± 4.4 vs. 7.6 ± 1.4%,
p
= 0.008). The proportion of subjects with diabetic retinopathy, neuropathy and nephropathy was greater among patients with criteria for FA compared with patients without this condition (25% vs. 13.2%, 29.5% vs. 21.8% and 32% vs. 22.3%;
p
= 0.03,
p
= 0.05 and
p
= 0.05, respectively). The percentage of patients with FA with significant depressive symptoms was also greater (36.4% vs. 18.5%;
p
= 0.002).
Conclusions
The presence of FA among T2DM patients implied a worse glycaemic control. Microvascular complications and depressive symptoms were higher among these patients.
Food addiction (FA) is highly prevalent among people with obesity (PwO) and may constitute a key factor in weight loss failure or weight regain. GLP-1 analogues have been shown to act on the ...mesolimbic system, which is related to hedonic overeating and substance abuse. We aimed to study the effects of low doses of semaglutide on FA symptomatology and to evaluate whether the presence of FA have a negative impact on weight loss despite treatment with semaglutide.
One hundred and thirteen PwO (45.5 ± 10.2 years) were evaluated anthropometrically baseline and after four months of treatment with semaglutide. PwO were evaluated for the presence of FA by completing The Spanish version of the Yale Food Addiction Scale 2.0 questionnaire (YFAS 2.0).
Baseline BMI and fat mass (%) were greater among PwO with FA (35.8 ± 4.5 vs 33 ± 3.9 kg/m
and 44.2 ± 6.5 vs 40.1 ± 7.9%;
= .01). After four months of treatment with semaglutide, the prevalence of FA diminished from 57.5% to 4.2% (
< .001). The percentage of weight loss (6.9 ± 12.7 vs 5.3 ± 4.6%;
= .4) and the proportion of fat mass loss (2 ± 9 vs 1.6 ± 3.1%;
= .7) were comparable between PwO with and without FA. No differences regarding side effects and treatment discontinuations were seen between the two groups.
Semaglutide is an effective tool for the amelioration of FA symptomatology among PwO. Despite PwO with FA had greater basal BMI and fat mass, semaglutide showed similar results compared to PwO without FA in terms of weight and fat mass loss at short term.
There is limited information available describing the clinical and epidemiological features of Spanish patients requiring hospitalization for coronavirus disease 2019 (COVID-19). In this ...observational study, we aimed to describe the clinical characteristics and epidemiological features of severe (non-ICU) and critically patients (ICU) with COVID-19 at triage, prior to hospitalization. Forty-eight patients (27 non-ICU and 21 ICU) with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection were analyzed (mean age, 66 years, range, 33–88 years; 67% males). There were no differences in age or sex among groups. Initial symptoms included fever (100%), coughing (85%), dyspnea (76%), diarrhea (42%) and asthenia (21%). ICU patients had a higher prevalence of dyspnea compared to non-ICU patients (95% vs. 61%, p = 0.022). ICU-patients had lymphopenia as well as hypoalbuminemia. Lactate dehydrogenase (LDH), C-reactive protein (CRP), and procalcitonin were significantly higher in ICU patients compared to non-ICU (p < 0.001). Lower albumin levels were associated with poor prognosis measured as longer hospital length (r = −0.472, p < 0.001) and mortality (r = −0.424, p = 0.003). As of 28 April 2020, 10 patients (8 ICU and 2 non-ICU) have died (21% mortality), and while 100% of the non-ICU patients have been discharged, 33% of the ICU patients still remained hospitalized (5 in ICU and 2 had been transferred to ward). Critically ill patients with COVID-19 present lymphopenia, hypoalbuminemia and high levels of inflammation.
Abstract Background and objectives Type 2 diabetes (T2DM) almost doubles the risk of comorbid depression, with lifetime prevalence up to 29%. Recognition and treatment of depression in T2DM are ...important because of its association with hyperglycemia, diabetic complications and poor quality of life (QoL). However, although currently available medical therapy for depression is effective in reducing depressive symptoms, it does not consistently improve HbA1c levels. The aim of this study was to determine the effects of antidepressant therapy on depressive symptoms, health-related QoL and metabolic control in T2DM. Methods 48 T2DM (47.8% males, age 59.8 ± 11.1, T2DM duration 9.5 ± 6.5 years) who had a major depressive disorder diagnosed with a Beck Depression Inventory (BDI) test score greater than 16 and confirmed with a structured interview, were prescribed citalopram 20 mg once daily. 10 out of 48 refused the prescription and were used as controls. BDI score, BMI, HbA1c and the Spanish version of the SF-36 Health Survey were recorded baseline and after 6 months of treatment. Sociodemographic characteristics, complications related to T2DM and comorbidities were also recorded. Results No differences in baseline characteristics were observed between the two groups. When compared with the untreated group ( n = 10), patients treated with citalopram ( n = 38) showed significant improvements in BDI score and in almost all areas of quality of life, except in general health and bodily pain. No differences in HbA1c, waist circumference or BMI were found. Conclusions Treating depressive symptoms with medical therapy in T2DM is associated with improvements in QoL and depression, but with no improvement in metabolic control or weight.
type-2 diabetes (T2DM) seems to worsen the prognosis of patients admitted for COVID-19, although most studies included Asiatic patients. We aimed to assess whether this condition applies for ...Mediterranean patients.
a total of 90 patients admitted for COVID-19 with T2DM were retrospectively compared with 50 patients without T2DM.
subjects with T2DM were older than their counterparts (73.3 ± 12.4 vs 53 ± 15.7 years; p < 0.0001). Either absolute lymphocyte count (1.1 ± 0.6 vs 1.3 ± 0.7 x 109/L; p = 0.005) or hemoglobin (11.9 ± 1.6 vs 13.1 ± 2.1 g/dL; p < 0.0001) were lower among subjects with T2DM. CRP and procalcitonin were higher among subjects with T2DM (91.9 ± 71.2 vs 70.1 ± 63.3 mg/L; p = 0.002 and 0.8 ± 0.3 vs 0.4 ± 0.1 ng/mL; p < 0.0001, respectively). Albumin was lower among patients with T2DM (3.4 ± 0.5 vs 3.8 ± 0.5 g/L: p < 0.001). Length of stay was longer among subjects with T2DM (11.7 ± 7.7 vs 9.7 ± 8.6 days; p = 0.01). However, both groups were comparable regarding both the proportion of subjects who were admitted to the ICU (16.5 % vs 8 %; p = 0.1) and mortality (11 % vs 4 %; p = 0.2).
in a Mediterranean sample, despite of age, comorbidities, nutritional status, and inflammatory markers, subjects with T2DM with a proper glycemic control admitted for COVID-19 had similar prognostic outcomes than patients without this metabolic condition.
Aims
Data regarding the prevalence of eating disorders (ED) and their influence on clinical outcomes among patients with type 2 diabetes (T2DM) are scarce. Our aim is to investigate the frequency of ...positive screening for ED, specifically binge eating disorder (BED), in a T2DM sample and analyze whether there are any differences among T2DM subjects with a positive screening for ED or BED.
Methods
Three hundred and twenty subjects with T2DM were recruited randomly. All participants were evaluated for the presence of ED by completing the “Eating Attitudes Test-26” (EAT-26). In addition, the “Questionnaire of Eating and Weight Patterns–Revised” (QEWP-R) for the screening of BED was also implemented. Sociodemographic, clinical and biochemical parameters were also recorded.
Results
According to EAT-26, 14 % of subjects screened positive for ED. Regarding QEWP-R, 16 % had a positive screening for ED, with BED having a frequency of 12.2 %, being the most prevalent one. There was a positive correlation between the scores obtained with the EAT-26 and the Beck Depression Inventory (
p
= 0.0014). Patients with BED were younger (57.5 ± 11.1 vs 63.3 ± 10.3 years;
p
= 0.004), with a lesser T2DM duration (8.5 ± 6.1 vs 12.1 ± 9.6 years;
p
= 0.002). Weight and BMI among subjects with BED were greater (89.1 ± 1.3 vs 82.4 ± 16.7 kg;
p
= 0.04 and 39.4 ± 10.3 vs 30.7 ± 5.5 kg/m
2
;
p
= 0.01). The frequency of subjects with one admission related to T2DM or any other condition during the last year was higher (10 vs 3 %;
p
= 0.04 and 33 vs 21 %;
p
= 0.01).
Conclusions
ED among T2DM are frequent. Due to their deleterious effect on different metabolic and psychological outcomes, they should be diagnosed promptly, especially BED.
After bariatric surgery, de novo eating patterns can develop, such as grazing. Although grazing has been associated with poorer weight loss, it has received minimal attention. We aimed to assess the ...influence of grazing in clinical, biochemical and psychological outcomes in a bariatric surgery sample.
Sixty patients (78.3%♀, age 46.35±9.89, months since BS 46.28±18.1) who underwent BS were evaluated cross-sectionally. Clinical, biochemical and psychological parameters were recorded. A pattern of grazing was assessed in this group of patients through interview.
41.7% met criteria for grazing. Mean time since BS was greater in the group with grazing (57.64±23.7months vs 38.8±26.44months; p=0.008). Although there were no differences in initial and current BMI, the percentage of patients with weight regain was greater among patients with grazing (72% vs 11.7%; p<0.0001) and the percentage of excess weight loss was lower (28.15±6.96% vs 33.35±11.9%; p=0.05). There were more difficulties in following the standardized visits according to our hospital's protocol (17.6% vs 56%; p=0.009). No significant differences were found when assessing presurgical psychiatric comorbidity among patients with a grazing pattern and individuals without this condition (68% vs 55.9%; p=0.423). When assessing quality of life only mental health was lower among patients with grazing (49.6±22.7 vs 64.2±23.3; p=0.02).
Development of grazing is frequent after BS, especially when weight loss has reached a plateau. Due to its potential association with weight regain, systematic screening of grazing after BS is warranted.
•After bariatric surgery, de novo eating patterns can develop, such as grazing•One aim of the study is to analyze the frequency of grazing among patients who undergo bariatric surgery.•We also wanted to assess the influence of such eating pattern in different outcomes.•Abnormal eating patterns should be monitored after surgery to prevent weight regain or unsuccessful results.
We wanted to assess the prevalence of individuals with food addiction (FA) among bariatric surgery (BS) patients at long term and to determine if there was any relationship between FA and both ...clinical and psychological outcomes at the time of the evaluation.
Participants were evaluated for the presence of FA with the Yale Food Addiction Scale 2.0.
Of 134 subjects, 32 (23.9%) included met criteria for FA. The frequency of patients with depression at the time of the evaluation was greater among subjects with FA (34.4% vs. 11.8%;
= 0.006). The score obtained with the Beck Depression Inventory at the time of the evaluation was greater among subjects with FA (14.8 ± 11.5 vs. 6 ± 6.5;
< 0.0001). The frequency of subjects with FA who had criteria for binge eating disorder at the time of the evaluation was significantly greater (56.3% vs. 20.5%;
< 0.001). Patients with FA scored higher in the Lattinen index for chronic pain at the time of the evaluation (8.7 ± 5.9 vs. 5.8 ± 5.4;
= 0.014). However, clinical outcomes were similar between the two groups.
Routine screening for FA at long term postoperatively should be recommended to improve psychological outcomes of BS.
Several factors that worsen the prognosis of the new coronavirus SARS-CoV-2 have been identified, such as obesity or diabetes. However, despite that nutrition may change in a lockdown situation, ...little is known about the influence of malnutrition among subjects hospitalized due to COVID-19. Our study aimed to assess whether the presence of malnutrition among patients admitted due to COVID-19 had any impact on clinical outcomes compared with patients with the same condition but well nourished.
75 patients admitted to hospital due to COVID-19 were analyzed cross-sectionally. Subjective Global Assessment (SGA) was completed by phone interview. Clinical parameters included were extracted from the electronic medical record.
According to the SGA, 27 admitted due to a COVID-19 infection had malnutrition. Patients not well nourished were older than patients with a SGA grade A (65 ± 14.1 vs 49 ± 15.1 years; p < 0.0001). Length of hospital stay among poorly nourished patients was significantly higher (18.4 ± 15.6 vs 8.5 ± 7.7 days; p = 0.001). Mortality rates and admission to ICU were greater among subjects with any degree of malnutrition compared with well-nourished patients (7.4% vs 0%; p = 0.05 and 44.4% vs 6.3%; p < 0.0001). CRP (120.9 ± 106.2 vs 60.8 ± 62.9 mg/l; p = 0.03), D-dimer (1516.9 ± 1466.9 vs 461.1 ± 353.7 ng/mL; p < 0.0001) and ferritin (847.8 ± 741.1 vs 617.8 ± 598.7mcg/l; p = 0.03) were higher in the group with malnutrition. Haemoglobin (11.6 ± 2.1 vs 13.6 ± 1.5 g/dl; p < 0.0001) and albumin 3.2 ± 0.7 vs 4.1 ± 0.5 g/dl; p < 0.0001) were lower in patients with any degree of malnutrition.
The presence of a poor nutritional status is related to a longer stay in hospital, a greater admission in the ICU and a higher mortality.
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