Short-term effects of semaglutide among patients with obesity with and without food addiction: an observational study.

INTRODUCTION: 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. METHODS: 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). RESULTS: Baseline BMI and fat mass (%) were greater among PwO with FA (35.8 ± 4.5 vs 33 ± 3.9 kg/m2and 44.2 ± 6.5 vs 40.1 ± 7.9%; p = .01). After four months of treatment with semaglutide, the prevalence of FA diminished from 57.5% to 4.2% (p < .001). The percentage of weight loss (6.9 ± 12.7 vs 5.3 ± 4.6%; p = .4) and the proportion of fat mass loss (2 ± 9 vs 1.6 ± 3.1%; p = .7) were comparable between PwO with and without FA. No differences regarding side effects and treatment discontinuations were seen between the two groups. CONCLUSION: 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.

Long-term chronic joint pain after sleeve gastrectomy and its influence on clinical and psychological outcomes.

INTRODUCTION: Bariatric surgery (BS) is effective in improving chronic joint pain (CJP). However, the long-term effects on this comorbidity are poorly understood. OBJECTIVES: To determine the prevalence of CJP in a sample of patients who had undergone BS with a minimum follow-up of 18 months. To determine whether or not there was any relationship between CJP and clinical or psychological outcomes after BS. MATERIAL AND METHODS: Cross-sectional study. The Lattinen index (LI) was used to evaluate CJP, using the cut-off point of 10 to define significant CJP (SCJP). RESULTS: Of the 110 subjects assessed, 31.2% (35/110) had SCJP. The patients with SCJP were older (57.4±13 vs 47.8±11.6 years; p<0.0001) and more time had elapsed since their BS (105.6±54.3 vs 78.5±39 months; p=0.023). The last BMI was higher in subjects with SCJP (35±5 vs 33.3±6.9kg/m2; p=0.05) and the percentage of patients who took significant regular exercise was lower (2.9% vs 68%; p<0.0001). Trauma problems after BS were more common in subjects with SCJP (61.8% vs 22.7%; p<0.0001). More patients with SCJP met depression criteria (47.1% vs 5.3%; p<0.0001) and/or were treated with antidepressants (38.2% vs 17.3%; p=0.003). Patients with SCJP reported fewer hours of sleep (6±1.4 vs 6.8±1.2h; p=0.003). CONCLUSIONS: SCJP is highly prevalent in patients who have had BS once they reach the weight plateau phase. There is an association between having SCJP and worse psychological and functional status, with potential detrimental metabolic effects.

The effects of chronic back pain on self-management, clinical and psychological outcomes among patients with type 2 diabetes.

BACKGROUND: Chronic back pain (CBP) in patients with type 2 diabetes (T2DM) is twice as high among age-and-gender-matched controls. The presence of both conditions impacts negatively on both quality of life and physical function, which might negatively affect mood. METHODS: We aimed to determine the prevalence of CBP among patients with T2DM by using the Lattinen Index (LI) and to assess whether the presence of CBP had any influence on clinical or psychological outcomes. RESULTS: 13.5% out of 299 patients had significant CBP. The percentage of patients with less than 150 minutes per 1 week of exercise was higher in the group of patients with significant CBP (70% vs 51.4%; p= 0.04). The proportion of patients who met criteria for food addiction was greater among subjects with CBP (47.5% vs 26.6%; p=0.009). The percentage of patients with criteria for depression was higher among the CBP group (82.5% vs 29.7%; p<0.0001), as well as the prescription of antidepressants (45% vs 17.4%; p<0.0001). However, no significant differences were seen regarding glycemic control or the frequency of complications related to T2DM. CONCLUSIONS: CBP is prevalent among subjects with T2DM and it constitutes an important limiting factor of both self-care behaviors and psychological well-being.

Long-Term Prevalence of Food Addiction Among Bariatric Surgery Patients: Influence on Metabolic and Psychological Outcomes.

Background: 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. Methods: Participants were evaluated for the presence of FA with the Yale Food Addiction Scale 2.0. Results: 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%; P = 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; P < 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%; P < 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; P = 0.014). However, clinical outcomes were similar between the two groups. Conclusions: Routine screening for FA at long term postoperatively should be recommended to improve psychological outcomes of BS.