Obesities

Endoscopic sleeve gastroplasty (ESG) does not produce homogeneous results, with some patients showing little weight loss after the procedure. The aim of the present study was to evaluate the ability of pre-procedural psychometric questionnaires to predict insufficient weight loss after ESG in patients with obesity. Patient candidates for ESG were requested to complete the following psychometric questionnaires: Short Form-36 (SF-36), Symptom Checklist-90 Revised (SCL-90-R), Binge Eating Scale (BES), Yale Food Addiction Questionnaire (Y-FAS), Eating Attitude Test-26 (EAT-26), and Barratt Impulsiveness Scale-11 (BIS-11). The results of the psychometric scores were then compared with the ESG outcome, which was considered a therapeutic failure if the %EWL was less than 30% at 12 months after the follow-up. Thirty-five patients (8 males and 27 females, mean age 49 years, range 21–75 years) were included in this study. At the one-year follow-up, the mean %EWL was 40 ± 43%. Male sex and higher preoperative BMI were identified as risk factors for poor weight loss. A logistic regression analysis adjusted for sex and preoperative BMI showed that low scores on the SF-36 (Subscale Mental Health), high scores on the SCL_90-R, and an elevated BES score were predictors of therapeutic failure. The results of the present study seem to confirm the usefulness of the SF-36, SCL-90R, and BES questionnaires in the selection of patients eligible for ESG.

The American Academy of Pediatrics recently revised its guidelines on pediatric obesity treatment to recommend that primary care providers offer anti-obesity medications to patients based on age and body mass index. Anti-obesity medications like glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are efficacious in lowering body mass index (BMI) and improving metabolic health, including in children. However, although the landscape for medication production and insurance coverage is rapidly evolving, these medications can be difficult to access due to cost, lack of insurance coverage, and supply chain issues. Compounded versions of GLP-1 RAs offer the benefits of providing lower cost and higher availability alternatives to FDA-approved versions. But they include risks associated with less regulated medications. This paper identifies the risks and benefits of compounded GLP-1 RA use in the pediatric population, particularly considering structural inequities in obesity burden and treatment, and offers recommendations for pediatricians to ethically and equitable address compounded GLP-1 RA use with their patients and their families.

Nutritional deficiencies and metabolic alterations are common complications following bariatric surgery, requiring often lifelong monitoring and supplementation. The aim of this retrospective study is to investigate whether a structured follow-up can mitigate micronutrient deficiencies and metabolic changes. This study was conducted at Cannizaro Hospital (Catania, Italy), a national referral center accredited by SICOB (Italian Society for Bariatric and Metabolic Surgery). The cohort included patients who underwent bariatric surgery who completed one year follow-up between October 2022 and May 2024. Medical records such as anthropometric, clinical and laboratory data were collected for each patient at five different timepoints: baseline, 1-, 3-, 6- and 12-months post-surgery. Serum levels of iron, hemoglobin, vitamin D, folate, vitamin B12 and uric acid were analyzed to assess nutritional and metabolic status over time. One-year follow-up adherence of the patient cohort was equal to 97.5%. A significant increase in serum iron, vitamin D and folate levels was observed one year after surgery. Hemoglobin and vitamin B12 levels remained stable over time. Uric acid showed a significant rise at 1 month after surgery, followed by a progressive reduction by 12 months. This study highlights the importance of a structured follow-up program after bariatric surgery, contributing to the prevention of common postoperative complications.