Gastroenterology Clinics of North America This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Contributors
ALAN L. BUCHMAN, MD, MSPH, FACP, FACN, FACG, AGAF (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 16, 2023 Category: Gastroenterology Source Type: research

Contents
Alan L. Buchman (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 16, 2023 Category: Gastroenterology Source Type: research

Forthcoming Issues
Management of Obesity, Part 2: Treatment Strategies (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 16, 2023 Category: Gastroenterology Source Type: research

Fat Forward —What We’ve Learned About Obesity, Where We Are, and Where We Need to Go
Fat has become a “big” public health issue. It’s treated like a four-letter word, even though it is only three. As parodized by Weird Al Yankovic in his song, “Fat,” numerous health consequences of what we now understand is a serious chronic disease, obesity, have been exposed as we understand more and mor e about the impact of fat mass. Obesity has become a global epidemic. We are now growing to understand the genetic and environmental contributions to obesity and its resultant effect on multiple organs. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 16, 2023 Category: Gastroenterology Authors: Alan L. Buchman Tags: Foreword Source Type: research

Developmental Contributions to Obesity
Obesity is prevalent and continuing to rise across all age groups, even children. As obesity is challenging to manage and treat, prevention is critical. Here, we highlight nutritional influences during periods of early developmental plasticity, namely the prenatal period and infancy, that have been shown to contribute to the development of obesity into childhood and beyond. We review recent research that examines maternal nutritional factors including dietary patterns and quality, as well as the infant diet, such as complementary foods and beverages, that influence long-term obesity risk. We end with recommendations for cl...
Source: Gastroenterology Clinics of North America - April 7, 2023 Category: Gastroenterology Authors: Allison J. Wu, Emily Oken Source Type: research

Weight Stigma and Barriers to Effective Obesity Care
This article summarizes the ways in which weight stigma creates barriers to effective care, including poor patient-provider communication, reduced quality of care, and healthcare avoidance. Priorities for stigma reduction in healthcare are discussed, with a clear need for multifaceted approaches and inclusion of people with obesity whose perspectives can inform strategies to effectively remove bias-related barriers to patient care. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - April 7, 2023 Category: Gastroenterology Authors: Rebecca M. Puhl Source Type: research

Disparities in Access and Quality of Obesity Care
Obesity is a chronic disease and a significant public health threat predicated on complex genetic, psychological, and environmental factors. Individuals with higher body mass index are more likely to avoid health care due to weight stigma. Disparities in obesity care disproportionately impact racial and ethnic minorities. In addition to this unequal disease burden, access to obesity treatment varies significantly. Even if treatment options are theoretically productive, they may be more difficult for low-income families, and racial and ethnic minorities to implement in practice secondary to socioeconomic factors. Lastly, th...
Source: Gastroenterology Clinics of North America - April 7, 2023 Category: Gastroenterology Authors: Tiffani Bell Washington, Veronica R. Johnson, Karla Kendrick, Awab Ali Ibrahim, Lucy Tu, Kristen Sun, Fatima Cody Stanford Source Type: research

What is Obesity?
Advances in the understanding of weight regulation provide the framework for the recognition of obesity as a chronic disease. Lifestyle approaches are foundational in the prevention of obesity and should be continued while weight management interventions, including antiobesity medications and metabolic-bariatric procedures, are offered to eligible patients. Clinical challenges remain, however, including overcoming obesity stigma and bias within the medical community toward medical and surgical approaches, ensuring insurance coverage for obesity management (including medications and surgery), and promoting policies that rev...
Source: Gastroenterology Clinics of North America - April 7, 2023 Category: Gastroenterology Authors: Jonathan Q. Purnell Source Type: research

Global Impact of Obesity
The prevalence of preobesity and obesity is rising globally, multiple epidemiologic studies have identified preobesity and obesity as predisposing factors to a number of noncommunicable diseases including type 2 diabetes (T2DM), cardiovascular disease (CVD), and cancer. In this review, we discuss the epidemiology of obesity in both children and adults in different regions of the world. We also explore the impact of obesity as a disease not only on physical and mental health but also its economic impact. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - April 7, 2023 Category: Gastroenterology Authors: Nasreen Alfaris, Ali Mohammed Alqahtani, Naji Alamuddin, Georgia Rigas Source Type: research

The Physiological Regulation of Body Fat Mass
Disturbances inbody weight and adiposity in both humans and animals are met by compensatory adjustments in energy intake and energy expenditure, suggesting that body weight or fat is regulated. From a clinical viewpoint, this is likely to contribute to the difficulty that many people with obesity have in maintaining weight loss. Finding ways to modify these physiologic responses is likely to improve the long-term success of obesity treatments. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - April 7, 2023 Category: Gastroenterology Authors: Priya Sumithran Source Type: research

Genetic Contributors to Obesity
Genetic forms of obesity contribute to ∼7% of severe obesity in children and adolescents. The exact global prevalence of monogenic and syndromic forms of obesity is not well established, most likely due to missed or delayed diagnosis. The challenge in determining the prevalence can be attributed to the lack of consensus on identifying and evaluating symptoms of genetic defects in a timely manner and hence a vastly undertested patient population. Further large-scale and long-term studies are needed to advance the understanding of this unique phenotype of obesity and effective treatment options." (Source: Gastroenterology ...
Source: Gastroenterology Clinics of North America - April 7, 2023 Category: Gastroenterology Authors: Ramya Sivasubramanian, Sonali Malhotra Source Type: research

The Effect of Obesity on Gastrointestinal Disease
Obesity exerts both direct and indirect effects on gastrointestinal function. From physical effects of central adiposity on intragastric pressure resulting in higher incidence of reflux to dyslipidemia and effects on gallstone disease, the gastrointestinal manifestations of obesity are wide-ranging. Of particular emphasis is the identification and management of non-alcoholic fatty liver disease including non-invasive assessment and lifestyle and pharmacologic interventions for patients with non-alcoholic steatohepatitis. Additional focus is on the impact of obesity and western diet on intestinal disorders and colorectal ca...
Source: Gastroenterology Clinics of North America - April 7, 2023 Category: Gastroenterology Authors: Jessica E.S. Shay, Amandeep Singh Source Type: research

Obesity, Chronic Stress, and Stress Reduction
The obesity epidemic is caused by the misalignment between human biology and the modern food environment, which has led to unhealthy eating patterns and behaviors and an increase in metabolic diseases. This has been caused by the shift from a "leptogenic" to an "obesogenic" food environment, characterized by the availability of unhealthy food and the ability to eat at any time of day due to advances in technology. Binge Eating Disorder (BED) is the most commonly diagnosed eating disorder, characterized by recurrent episodes of binge eating and a sense of loss of control over eating, and is treated with cognitive-behavioral...
Source: Gastroenterology Clinics of North America - April 7, 2023 Category: Gastroenterology Authors: Donald Goens, Nicole E. Virzi, Sarah E. Jung, Thomas R. Rutledge, Amir Zarrinpar Source Type: research

Dietary Supplements for Weight Loss
The Federal Drug Administration has approved, following rigorous testing, 6 pharmacologic agents and one drug in device form for the management of overweight and obesity. Myriad products that purport to act on physiological mechanisms leading to weight loss also pervade the market with minimal regulatory oversight. Systematic reviews and meta-analyses of these products and their ingredients fail to establish any as meaningfully effective at the clinical level. Moreover, safety concerns prevail with adulteration, hypersensitivity reactions, and recognized adverse reactions. Lifestyle, pharmacologic, and bariatric surgical t...
Source: Gastroenterology Clinics of North America - April 7, 2023 Category: Gastroenterology Authors: Steven B. Heymsfield Source Type: research

Obesity Management in Children and Adolescents
Obesity in the pediatric population is increasing in the United States and globally. Childhood obesity is associated with cardiometabolic and psychosocial comorbidities and decreased overall life span. The cause of pediatric obesity is multifactorial and includes genetic predisposition, lifestyle, behavioral patterns, and consequences of social determinants of health. Routine screening of BMI and comorbid conditions is essential to identifying patients who require treatment. The AAP recommends immediate Intensive Health Behavior and Lifestyle Treatment for children with obesity, encompassing lifestyle changes, behavioral c...
Source: Gastroenterology Clinics of North America - April 7, 2023 Category: Gastroenterology Authors: Gunther Wong, Gitanjali Srivastava Source Type: research