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About the journal - Obesity is the peer-reviewed, scientific journal of The Obesity Society.
Editors' Choice 1 - Intensive Behavioral Therapy: Protocol Now Available Online, Thomas A. Wadden, wadden@pennmedicine.upenn.edu, Adam G. Tsai, and Jena Shaw Tronieri
(http://onlinelibrary.wiley.com/doi/10.1002/oby.22594)
See accompanying Commentary by Scott Kahan and Steven B. Heymsfield (http://onlinelibrary.wiley.com/doi/10.1002/oby.22643)
Editors' Choice 2 -Lipedema: An Under-Recognized and Poorly Understood Disease, Giacomo Buso, Michele Depairon, Didier Tomson, Wassim Raffoul, Roberto Vettor, and Lucia Mazzolai, lucia.mazzolai@chuv.ch
(http://onlinelibrary.wiley.com/doi/10.1002/oby.22597)
Editors' Choice 3 - Obesity Found to Increase Risk of Unemployment, Illness Absence, Maja Bramming, Maja B. Jørgensen, Anne I. Christensen, Cathrine J. Lau, Kia K. Egan, and Janne S. Tolstrup, jest@sdu.dk
(http://onlinelibrary.wiley.com/doi/10.1002/oby.22578)
Editors' Choice 4 - Self-Reported Height and Weight Consistently Taller and Lighter, Katherine M. Flegal, kmflegal@stanford.edu; katherine.flegal@gmail.com, Cynthia L. Ogden, Cheryl Fryar, Joseph Afful, Richard Klein, and David T. Huang
(http://onlinelibrary.wiley.com/doi/10.1002/oby.22591)
Scroll down to find abstracts for each of the above papers. To request the full text of any of these studies and agree to the embargo policy, or to arrange an interview with a study's author or an obesity expert, please contact communications@obesity.org.
Editors' Choice Abstracts
Editors' Choice 1 - A Protocol to Deliver Intensive Behavioral Therapy (IBT) for Obesity in Primary Care Settings: The MODEL-IBT Program
Objective The Centers for Medicare and Medicaid Services (CMS) initiated coverage of intensive behavioral therapy (IBT) for obesity in 2011, providing beneficiaries 14 to 15 brief, individual counseling visits in 6 months. CMS offered general recommendations for delivering IBT but did not provide an evidence-based treatment protocol, which was the objective of the present research.
Methods: This review describes the evidence that CMS considered in developing its IBT benefit. It also examines weight losses produced by the intensive lifestyle intervention in the Diabetes Prevention Program (DPP), as well an adapted version of the DPP delivered (for the first 6 months) on the visit schedule recommended by CMS. This new protocol, which was evaluated in a recent randomized trial, provided 14 visits in the first 24 weeks, with 7 additional monthly visits through week 52.
Results: As reported previously, the 50 participants with obesity assigned to the new IBT protocol lost a mean of 5.4% of their initial weight at week 24; 46% of participants lost ? 5% of their baseline weight. At 1 year, the mean loss was 6.1%, and 44% of participants lost ? 5%.
Conclusions: With these generally favorable results, the IBT protocol is being posted online for practitioners and researchers to use.
Editors' Choice 2 - Lipedema: A Call to Action!
Lipedema is a chronic progressive disease characterized by abnormal fat distribution resulting in disproportionate, painful limbs. It almost exclusively affects women, leading to considerable disability, daily functioning impairment, and psychosocial distress. Literature shows both scarce and conflicting data regarding its prevalence. Lipedema has been considered a rare entity by several authors, though it may be a far more frequent condition than thought. Despite the clinical impact on women's health, lipedema is in fact mostly unknown, underdiagnosed, and too often misdiagnosed with other similarly presenting diseases. Polygenic susceptibility combined with hormonal, microvascular, and lymphatic disorders may be partly responsible for its development. Furthermore, consistent information on lipedema pathophysiology is still lacking, and an etiological treatment is not yet available. Weight loss measures exhibit minimal effect on the abnormal body fat distribution, resulting in eating disorders, increased obesity risk, depression, and other psychological complaints. Surgical techniques, such as liposuction and excisional lipectomy, represent therapeutic options in selected cases. This review aims to outline current evidence regarding lipedema epidemiology, pathophysiology, clinical presentation, differential diagnosis, and management. Increased awareness and a better understanding of its clinical presentation and pathophysiology are warranted to enable clinicians to diagnose and treat affected patients at an earlier stage.
Editors' Choice 3 - BMI and Labor Market Participation: A Cohort Study of Transitions Between Work, Unemployment, and Sickness Absence
Objective This study aimed to test the hypotheses that individuals with obesity are at higher risk of unemployment and sickness absence and have a lower chance of getting employed compared with individuals with normal weight.
Methods: Data on weight and height were collected at baseline from 87,796 participants in the Danish National Health Survey 2010. Participants were then followed in national registers for 5 years. Outcome measures were transitions from employment to unemployment and sickness absence and the transitions from unemployment or sickness absence to employment. Data were analyzed by Cox proportional hazards models adjusted for potential confounders.
Results: Hazard ratios for unemployment were 1.18 (95% CI: 1.10-1.26) for individuals with obesity and 1.27 (95% CI: 1.14-1.41) for individuals with severe obesity compared with individuals with normal weight. Participants with obesity also had a higher risk of sickness absence. Additionally, participants with obesity who were unemployed at baseline had a lower chance of becoming employed compared with participants with normal weight.
Conclusions: Obesity was associated with a higher risk of unemployment and sickness absence compared with individuals with normal weight. Additionally, obesity was associated with a lower chance of employment.
Editors' Choice 4 - Comparisons of Self-Reported and Measured Height and Weight, BMI, and Obesity Prevalence from National Surveys: 1999-2016
Objective The aim of this study was to compare national estimates of self-reported and measured height and weight, BMI, and obesity prevalence among adults from US surveys.
Methods: Self-reported height and weight data came from the National Health and Nutrition Examination Survey (NHANES), the National Health Interview Survey, and the Behavioral Risk Factor Surveillance System for the years 1999 to 2016. Measured height and weight data were available from NHANES. BMI was calculated from height and weight; obesity was defined as BMI ? 30.
Results: In all three surveys, mean self-reported height was higher than mean measured height in NHANES for both men and women. Mean BMI from self-reported data was lower than mean BMI from measured data across all surveys. For women, mean self-reported weight, BMI, and obesity prevalence in the National Health Interview Survey and Behavioral Risk Factor Surveillance System were lower than self-report in NHANES. The distribution of BMI was narrower for self-reported than for measured data, leading to lower estimates of obesity prevalence.
Conclusions: Self-reported height, weight, BMI, and obesity prevalence were not identical across the three surveys, particularly for women. Patterns of misreporting of height and weight and their effects on BMI and obesity prevalence are complex.
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