A systematic review on the effectiveness of diet and exercise in the management of obesity.

BACKGROUND AND AIMS: Obesity is a worldwide epidemic and has quickly become a clinical and public health challenge. The primary concern is the effect of obesity on quality of life. This review assesses the effectiveness of interventions such as exercise and diet in the management of obesity. METHODS: Studies selected reported on the obese adult population (18 years and older), who had a lifestyle modification using diet, exercise, or both. We screened a total of 324 articles, 25 were found to be duplicated, 261 were excluded after screening for eligibility, and 27 full-text articles due to study design, incomplete data. 11 full-text articles were reviewed and included in our study. RESULTS: Participants placed on a dairy-based diet achieved a more significant reduction in body weight (-1.16 kg [-1.66, -0.66 kg], p < 0.001) and body fat mass (-1.49 kg [-2.06, -0.92 kg], p < 0.001). The ADF participants achieved body weight change of mean -0.9% ± 0.6% in the low-weight-loss group, and -9.9% ± 1.1% in the high-weight-loss group, whereas the caloric restricted (CR) participants achieved -1.3% ± 0.7% in the low-weight-loss, and -9.2% ± 1.2% in the high-weight-loss groups. A combination of intensive physical activity of about 175 min per week and a portion-controlled diet led to a more significant weight loss of 5%. CONCLUSION: This systematic review identified that the most efficient regimen for obesity management in adults is the combination of strength plus endurance exercise for a minimum of 175 min per week and a customized hypocaloric diet based on patient-specific metabolic needs and overall health status.

Does Cocaine Use Increase Medication Noncompliance in Bipolar Disorders? A United States Nationwide Inpatient Cross-Sectional Study.

Introduction Medication noncompliance among bipolar disorder (BD) is often linked with comorbid substance use disorders. This study aims to investigate cocaine use (CU) association with medication noncompliance in hospitalized BD patients. Methods Using data on 266,303 BD hospitalizations between 2010-2014 from the US Nationwide Inpatient Sample database, we obtained medication noncompliance rates stratified by demographics and cocaine use. Logistic regression was used to evaluate factors associated with medication noncompliance. Results Overall mean age, the prevalence of CU, and medication noncompliance were 41.58 (+0.11) years, 8.34%, and 16.08%, respectively. More than half of BD patients with comorbid CU were between 40-64 years (54.4%), while more male patients with BD were in the CU group (53.9%). With univariable logistic regression, CU (odds ratio [OR]: 1.77, 95% CI: 1.66-1.88) increased the odds of medication noncompliance among BD patients, and after adjusting for other variables there was sustained increased odds (adjusted odds ratio [aOR]: 1.40, 95% CI: 1.32-1.50). Conclusion This study showed that CU is associated with medication noncompliance among hospitalized BD patients. This highlights the importance of addressing CU among BD patients. Given the possible association of CU with medication noncompliance among BD patients, collaborative work between general adult psychiatry and addiction services is imperative in improving the management outcome of BD patients with comorbid CU.