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  1. Article ; Online: Approach to Obesity Treatment in Primary Care: A Review.

    Yanovski, Susan Z / Yanovski, Jack A

    JAMA internal medicine

    2024  

    Abstract: Importance: More than 40% of US adults have obesity, which increases the risks for multiple chronic diseases and premature mortality. Historically, nonsurgical interventions often have not led to sufficient weight loss and maintenance to improve health, ...

    Abstract Importance: More than 40% of US adults have obesity, which increases the risks for multiple chronic diseases and premature mortality. Historically, nonsurgical interventions often have not led to sufficient weight loss and maintenance to improve health, but highly effective antiobesity medications (AOMs) have recently become available, and additional effective therapeutics are under development. Given that most medical care for adults with obesity is delivered in primary care settings, guidance for integrating weight-management approaches is needed.
    Observations: Lifestyle interventions can lead to a mean weight loss of 2% to 9% of initial weight at 1 year and increase the likelihood of weight loss of 5% or more, but weight regain over time is common even with continued treatment. Adjunctive treatments, including AOMs and surgical approaches, can lead to larger, more sustained weight loss and improvements in numerous obesity-associated medical conditions. Highly effective AOMs, including nutrient-stimulated hormone-based therapies, induce mean weight loss of 15% or more. Barriers to intervention, including access to care, have a disproportionate influence on populations most affected by obesity and its consequences.
    Conclusions and relevance: Primary care clinicians play a vital role in the assessment, management, and support of patients with obesity. With careful clinical assessment and shared decision-making, a flexible treatment plan can be developed that reflects evidence of treatment efficacy, patient preference, and feasibility of implementation. Adjunctive therapies to lifestyle interventions, including more effective pharmacotherapeutics for obesity, offer hope to patients and the potential for considerable improvements in health and quality of life.
    Language English
    Publishing date 2024-03-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2699338-7
    ISSN 2168-6114 ; 2168-6106
    ISSN (online) 2168-6114
    ISSN 2168-6106
    DOI 10.1001/jamainternmed.2023.8526
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: An evaluation of setmelanotide injection for chronic weight management in adult and pediatric patients with obesity due to Bardet-Biedl syndrome.

    Lazareva, Julia / Brady, Sheila M / Yanovski, Jack A

    Expert opinion on pharmacotherapy

    2023  Volume 24, Issue 6, Page(s) 667–674

    Abstract: Introduction: Bardet-Biedl Syndrome (BBS) is a rare, multisystemic ciliopathy with an incidence of obesity of 89%. Mutations in genes encoding BBS proteins are linked to reduced leptin sensitivity of hypothalamic POMC neurons and reduced activation of ... ...

    Abstract Introduction: Bardet-Biedl Syndrome (BBS) is a rare, multisystemic ciliopathy with an incidence of obesity of 89%. Mutations in genes encoding BBS proteins are linked to reduced leptin sensitivity of hypothalamic POMC neurons and reduced activation of the melanocortin-4 receptor (MC4R) pathway due to deficient α-MSH production by hypothalamic POMC neurons. The MC4R pathway is involved in controlling body weight and energy metabolism, and its disruption is linked to hyperphagia and obesity. Setmelanotide is an MC4R agonist that counteracts deficiencies in the MC4R pathway of individuals with BBS.
    Areas covered: Data from clinical trials were reviewed along with information available from setmelanotide's approval for treatment of obesity in people ages ≥6y with a clinical diagnosis of BBS.
    Expert opinion: Setmelanotide is available as a daily injectable that can be used for amelioration of obesity in people with Bardet-Biedl syndrome. Its cost is substantial, which may limit its use, but among those who respond, setmelanotide can reduce body mass dramatically and potentially improve comorbid conditions associated with obesity. Setmelanotide treatment has generally tolerable side effects, primarily injection site reactions and nausea/vomiting that generally improve with continued use; almost all people using setmelanotide experience marked skin darkening due to off-target activation of cutaneous MC1R.
    MeSH term(s) Humans ; Adult ; Child ; alpha-MSH/therapeutic use ; Bardet-Biedl Syndrome/drug therapy ; Bardet-Biedl Syndrome/complications ; Bardet-Biedl Syndrome/genetics ; Pro-Opiomelanocortin/metabolism ; Pro-Opiomelanocortin/therapeutic use ; Obesity/complications ; Obesity/drug therapy
    Chemical Substances setmelanotide ; alpha-MSH (581-05-5) ; Pro-Opiomelanocortin (66796-54-1)
    Language English
    Publishing date 2023-04-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 2001535-5
    ISSN 1744-7666 ; 1465-6566
    ISSN (online) 1744-7666
    ISSN 1465-6566
    DOI 10.1080/14656566.2023.2199152
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  3. Article ; Online: Progress in Pharmacotherapy for Obesity.

    Yanovski, Susan Z / Yanovski, Jack A

    JAMA

    2021  Volume 326, Issue 2, Page(s) 129–130

    MeSH term(s) Adult ; Anti-Obesity Agents/therapeutic use ; Clinical Trials, Phase III as Topic ; Gastric Inhibitory Polypeptide/therapeutic use ; Glucagon-Like Peptide-1 Receptor/agonists ; Glucagon-Like Peptides/therapeutic use ; Humans ; Obesity/drug therapy
    Chemical Substances Anti-Obesity Agents ; Glucagon-Like Peptide-1 Receptor ; semaglutide (53AXN4NNHX) ; Gastric Inhibitory Polypeptide (59392-49-3) ; Glucagon-Like Peptides (62340-29-8) ; tirzepatide (OYN3CCI6QE)
    Language English
    Publishing date 2021-06-23
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Intramural
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
    ISSN (online) 1538-3598
    ISSN 0254-9077 ; 0002-9955 ; 0098-7484
    DOI 10.1001/jama.2021.9486
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  4. Article ; Online: Obesity: Trends in underweight and obesity - scale of the problem.

    Yanovski, Jack A

    Nature reviews. Endocrinology

    2017  Volume 14, Issue 1, Page(s) 5–6

    MeSH term(s) Adolescent ; Adult ; Body Mass Index ; Child ; Humans ; Obesity ; Overweight ; Thinness
    Language English
    Publishing date 2017-11-24
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Intramural ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 2489381-X
    ISSN 1759-5037 ; 1759-5029
    ISSN (online) 1759-5037
    ISSN 1759-5029
    DOI 10.1038/nrendo.2017.157
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  5. Article ; Online: Pediatric obesity. An introduction.

    Yanovski, Jack A

    Appetite

    2015  Volume 93, Page(s) 3–12

    Abstract: The prevalence of child and adolescent obesity in the United States increased dramatically between 1970 and 2000, and there are few indications that the rates of childhood obesity are decreasing. Obesity is associated with myriad medical, psychological, ... ...

    Abstract The prevalence of child and adolescent obesity in the United States increased dramatically between 1970 and 2000, and there are few indications that the rates of childhood obesity are decreasing. Obesity is associated with myriad medical, psychological, and neurocognitive abnormalities that impact children's health and quality of life. Genotypic variation is important in determining the susceptibility of individual children to undue gains in adiposity; however, the rapid increase in pediatric obesity prevalence suggests that changes to children's environments and/or to their learned behaviors may dramatically affect body weight regulation. This paper presents an overview of the epidemiology, consequences, and etiopathogenesis of pediatric obesity, serving as a general introduction to the subsequent papers in this Special Issue that address aspects of childhood obesity and cognition in detail.
    MeSH term(s) Adolescent ; Body Weight ; Child ; Comorbidity ; Humans ; Pediatric Obesity/complications ; Pediatric Obesity/epidemiology ; Prevalence ; Risk Factors ; United States/epidemiology
    Language English
    Publishing date 2015-03-30
    Publishing country England
    Document type Introductory Journal Article ; Research Support, N.I.H., Intramural
    ZDB-ID 1461347-5
    ISSN 1095-8304 ; 0195-6663
    ISSN (online) 1095-8304
    ISSN 0195-6663
    DOI 10.1016/j.appet.2015.03.028
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  6. Article: Associations Between Phenotypes of Childhood and Adolescent Obesity and Incident Hypertension in Young Adulthood.

    Fleur, Ruth St / Tanofsky-Kraff, Marian / Yanovski, Jack / Horton, Nicholas / Reich, Laura / Chavarro, Jorge / Hirschhorn, Joel / Ziobrowski, Hannah / Field, Alison

    Research square

    2024  

    Abstract: Objectives: We investigated whether empirically derived childhood obesity phenotypes were differentially associated with risk of hypertension in young adulthood, and whether these associations differed by sex.: Methods: Data came from 11,404 ... ...

    Abstract Objectives: We investigated whether empirically derived childhood obesity phenotypes were differentially associated with risk of hypertension in young adulthood, and whether these associations differed by sex.
    Methods: Data came from 11,404 participants in the Growing Up Today Study, a prospective cohort study in the US established in 1996. We used a childhood obesity phenotype variable that was previously empirically derived using latent class analysis. The childhood obesity phenotypes included an early puberty phenotype (females only), a mothers with obesity phenotype, a high weight concerns phenotype, and a mixed phenotype. Participants without overweight or obesity in childhood or adolescence were the reference group. We then used logistic regression models with generalized estimating equations to examine associations of childhood obesity phenotypes with incident hypertension between ages 20-35 years. All analyses were stratified by sex.
    Results: Among females, participants in all of the empirically derived childhood obesity phenotypes were more likely than their peers without childhood overweight/obesity to develop hypertension in young adulthood (early puberty subtype odds ratio (OR) = 2.52; 95% confidence interval (CI) = 1.75, 3.62; mothers with obesity (MO) subtype OR = 2.98; 95% CI = 1.93, 4.59; high weight concerns (WC) subtype OR = 2.33; 95% CI = 1.65, 3.28; mixed subtype OR = 1.66; 95% CI = 1.25, 2.20). Among males, the childhood obesity phenotypes were associated with a higher risk of developing hypertension, although males in the MO (OR = 2.65; 95% CI = 1.82, 3.87) and WC phenotypes (OR = 3.52; 95% CI = 2.38, 5.20) had a greater risk of developing hypertension than the mixed subtype (OR = 1.51; 95% CI = 1.23, 1.86) (
    Conclusion: Risk for incident hypertension in young adulthood varied by childhood obesity phenotypes, as well as by biological sex. If replicated, these results may suggest that increased surveillance of specific childhood obesity phenotypes might help in targeting those at highest risk for hypertension.
    Language English
    Publishing date 2024-03-21
    Publishing country United States
    Document type Preprint
    DOI 10.21203/rs.3.rs-4113605/v1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Toward Precision Approaches for the Prevention and Treatment of Obesity.

    Yanovski, Susan Z / Yanovski, Jack A

    JAMA

    2018  Volume 319, Issue 3, Page(s) 223–224

    MeSH term(s) Humans ; Obesity/etiology ; Obesity/genetics ; Obesity/prevention & control ; Obesity/therapy ; Precision Medicine
    Language English
    Publishing date 2018-01-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
    ISSN (online) 1538-3598
    ISSN 0254-9077 ; 0002-9955 ; 0098-7484
    DOI 10.1001/jama.2017.20051
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  8. Article ; Online: Circadian variation of serum leptin and adipose tissue changes in children.

    Zenno, Anna / Brady, Sheila M / Faulkner, Loie M / Ballenger, Kaitlin L / Fatima, Syeda / Yanovski, Jack A

    Pediatric obesity

    2022  Volume 18, Issue 2, Page(s) e12984

    Abstract: Background: Higher morning serum leptin values are associated with larger adipose tissue gains in children; however, it is unclear if leptin circadian variation is itself associated with adipose tissue changes during growth.: Objective: We studied ... ...

    Abstract Background: Higher morning serum leptin values are associated with larger adipose tissue gains in children; however, it is unclear if leptin circadian variation is itself associated with adipose tissue changes during growth.
    Objective: We studied the association of circadian variation in leptin with change in total body fat mass (TBFM), total body percentage fat (%FM), and trunk fat mass (TrFM).
    Methods: Baseline serum samples for leptin were obtained every 3 h for 24 h from 130 children (baseline age 9.6 ± 2.5y; 51.1% male; BMI-Z 1.59) with mean follow-up of 11.1 ± 4.0y and underwent dual-energy x-ray absorptiometry. ANCOVA models examined change in TBFM, %FM, or TrFM as dependent variables and number of years of follow-up, sex, race, baseline age, pubertal status, initial visit body composition, and initial visit serum leptin circadian variables (maximal diurnal leptin [acrophase], diurnal amplitude, and percentage change of amplitude) as independent factors.
    Result: Although initial visit mesor (24 h average) leptin was positively associated with initial visit TBFM (r
    Conclusion: We found no evidence that circadian variation in serum leptin concentrations during childhood is associated with long-term changes in children's adiposity.
    MeSH term(s) Humans ; Male ; Child ; Female ; Leptin ; Adipose Tissue ; Body Composition ; Obesity ; Adiposity ; Body Mass Index
    Chemical Substances Leptin
    Language English
    Publishing date 2022-09-25
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Intramural
    ZDB-ID 2655527-X
    ISSN 2047-6310 ; 2047-6302
    ISSN (online) 2047-6310
    ISSN 2047-6302
    DOI 10.1111/ijpo.12984
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  9. Article ; Online: Body fat differences among US youth aged 8-19 by race and Hispanic origin, 2011-2018.

    Martin, Crescent B / Stierman, Bryan / Yanovski, Jack A / Hales, Craig M / Sarafrazi, Neda / Ogden, Cynthia L

    Pediatric obesity

    2022  Volume 17, Issue 7, Page(s) e12898

    Abstract: Background: The association between body mass index (BMI) and adiposity differs by race/ethnicity.: Objective: To examine differences in adiposity by race/Hispanic origin among US youth and explore how those differences relate to differences in BMI ... ...

    Abstract Background: The association between body mass index (BMI) and adiposity differs by race/ethnicity.
    Objective: To examine differences in adiposity by race/Hispanic origin among US youth and explore how those differences relate to differences in BMI using the most recent national data, including non-Hispanic Asian youth.
    Methods: Weight, height and DXA-derived fat mass index (FMI) and percentage body fat (%BF) from 6923 youth 8-19 years in the National Health and Nutrition Examination Survey (NHANES) 2011-2018 were examined. Age-adjusted mean BMI, FMI and %BF were reported. Sex-specific linear regression models predicting %BF and FMI were adjusted for age, BMI category and BMI category*race/Hispanic origin interaction.
    Results: %BF was highest among Hispanic males (28.2%) and females (35.7%). %BF was lower among non-Hispanic Black (23.9%) compared with non-Hispanic White (26.0%) and non-Hispanic Asian (26.6%) males. There was no difference between non-Hispanic Black females (32.7%) and non-Hispanic White (33.2%) or non-Hispanic Asian (32.7%) females. FMI was higher among Hispanic youth compared with non-Hispanic White youth. Among youth with underweight/healthy weight, predicted %BF and FMI were lower among non-Hispanic Black males (-2.8%; -0.5) and females (-2.0%; -0.3), compared with non-Hispanic White youth, and higher among Hispanic males (0.9%; 0.2) and females (2.0%; 0.5), while %BF but not FMI was higher among non-Hispanic Asian males (1.3%) and females (1.4%). Among females with obesity, non-Hispanic Asian females had lower %BF (-2.3%) and FMI (-1.7) than non-Hispanic White females.
    Conclusions: Differences in %BF and FMI by race/Hispanic origin were not consistent by BMI category among US youth in 2011-2018.
    MeSH term(s) Absorptiometry, Photon ; Adipose Tissue ; Adiposity ; Adolescent ; Body Composition ; Body Mass Index ; Female ; Humans ; Male ; Nutrition Surveys ; Obesity
    Language English
    Publishing date 2022-02-08
    Publishing country England
    Document type Journal Article
    ZDB-ID 2655527-X
    ISSN 2047-6310 ; 2047-6302
    ISSN (online) 2047-6310
    ISSN 2047-6302
    DOI 10.1111/ijpo.12898
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  10. Article ; Online: Phenotyping children and adolescents with obesity using behavioral, psychological, and familial data.

    St Fleur, Ruth G / Tanofsky-Kraff, Marian / Yanovski, Jack A / Horton, Nicholas J / Hirschhorn, Joel N / Field, Alison E

    Obesity (Silver Spring, Md.)

    2023  Volume 31, Issue 12, Page(s) 3016–3024

    Abstract: Objective: This prospective cohort study aimed to empirically derive phenotypes of children and adolescents with overweight and obesity.: Methods: Latent class analyses using Mplus were carried out in the Growing Up Today Study. Information on ... ...

    Abstract Objective: This prospective cohort study aimed to empirically derive phenotypes of children and adolescents with overweight and obesity.
    Methods: Latent class analyses using Mplus were carried out in the Growing Up Today Study. Information on participants' weight status, disordered eating behaviors, body image and weight concerns, depressive symptoms, and pubertal timing, as well as and maternal weight status, were included in the latent class analyses, which were stratified by sex. Mixed-effects regression was used to examine associations of the obesity phenotypes with adult weight gain, between age 20 and 35 years, independent of weight at beginning of follow-up and duration of follow-up.
    Results: Among the girls, four obesity phenotypes were identified: 1) "early puberty"; 2) "mothers with obesity"; 3) "high weight concerns"; and 4) "mixed." Only three phenotypes were identified among the boys: 1) "high weight concerns"; 2) "mothers with obesity"; and 3) "mixed." Participants who had overweight or obesity in childhood or adolescence gained more weight in young adulthood than their leaner peers, but the patterns of weight gain in young adulthood varied by phenotype of obesity in childhood and adolescence.
    Conclusions: These results support examining risk factors for and treatment outcomes by obesity phenotypes.
    MeSH term(s) Male ; Adult ; Female ; Adolescent ; Humans ; Child ; Young Adult ; Pediatric Obesity/epidemiology ; Pediatric Obesity/complications ; Overweight/complications ; Prospective Studies ; Risk Factors ; Weight Gain ; Body Mass Index
    Language English
    Publishing date 2023-11-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2230457-5
    ISSN 1930-739X ; 1071-7323 ; 1930-7381
    ISSN (online) 1930-739X
    ISSN 1071-7323 ; 1930-7381
    DOI 10.1002/oby.23893
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