Latest news with #AnnalsOfInternalMedicine
Yahoo
16-07-2025
- Health
- Yahoo
GLP-1 drugs increase risk of acid reflux, GERD, study finds
July 14 (UPI) -- Folks using GLP-1 weight loss drugs like Ozempic are more likely to suffer from severe acid reflux, a new study says. People with type 2 diabetes were more likely to suffer from gastroesophageal reflux disease (GERD) if they were prescribed a GLP-1 drug compared to those taking sodium-glucose cotransporter-2 (SGLT-2) inhibitors, researchers reported Tuesday in the Annals of Internal Medicine. "We estimated that most GLP-1 [drugs] increased risk for GERD," concluded the research team led by Laurent Azoulay, an associate professor with the Jewish General Hospital's Center for Clinical Epidemiology in Montreal, Canada. The risk for serious GERD-related complications was higher among smokers, people with obesity and folks with existing stomach problems, researchers said. "Although our findings need to be corroborated in other studies, clinicians and patients should be aware of a possible adverse effect of GLP-1 [drugs] on GERD," researchers noted. For the study, researchers tracked more than 24,700 type 2 diabetics newly prescribed GLP-1 drugs, comparing their health to that of more than 89,000 who were prescribed SGLT-2 inhibitors. Glucagon-like peptide-1 (GLP-1) drugs mimic the GLP-1 hormone, which helps control insulin and blood sugar levels, decreases appetite and slows digestion of food. Because the drugs slow the rate at which food passes through the stomach, researchers thought they might increase the risk of acid reflux. GERD occurs when acid reflux happens repeatedly over time, the Mayo Clinic says. If it continues, GERD can cause scarring and narrowing of the esophagus and increase a person's risk of esophageal cancer. Results show that people taking GLP-1 drugs were 27% more likely to develop GERD and 55% more likely to have GERD complications, when compared to people taking SGLT-2 inhibitors. More than 90% of GERD complications involved Barrett esophagus, in which acid damage changes the tissue lining of the esophagus and increases cancer risk, researchers noted. "We also found that the risk for GERD was higher with long-acting GLP-1 (drug) use," researchers wrote. However, they noted that these findings need to be verified by studies involving other groups, including those taking GLP-1 drugs for obesity. "There is limited evidence on the risk for GERD among patients with obesity who do not have type 2 diabetes," researchers wrote. "Use of GLP-1 [drugs] is rapidly expanding in this population, highlighting an important area for future research." More information The Mayo Clinic has more on GERD. Copyright © 2025 HealthDay. All rights reserved.
Daily Mail
15-07-2025
- Health
- Daily Mail
Millions more Americans now deemed obese under shocking new weight measure
Millions more Americans could be classified as obese under a shocking new measurement from Europe. Researchers in Israel analyzed data on 44,000 adults in the US, including nearly 15,000 marked as overweight using existing methods. But under the new framework, they found some 18.8 percent of overweight adults, or one in five, were re-classified as obese. Overall, this translated into America having an obesity rate of 54.2 percent, or a new record. The US already has the highest obesity rate out of any large country. In the new method from Europe, researchers still consider anyone with a Body Mass Index (BMI) over 30 kg/m2 as obese. But they also re-classify anyone who is overweight (a BMI or 25 to 29.9 kg/m2) and has an obesity-related condition, like diabetes or high blood pressure, into the category. Researchers said the new definition reveals the overall toll of obesity in the nation, and the surging number of people already suffering from obesity-related conditions like stroke, heart disease and early death. It also revealed how millions who consider themselves 'just a little overweight' could now be suffering from a weight-related complication. About 42.4 percent of adults in the US are obese, while 30.7 percent, or one in three, are considered overweight. For the study, published in the Annals of Internal Medicine, researchers analyzed data from NHANES, an annual survey tracking participants, including their BMI and underlying conditions. Participants had all submitted data between 1999 and 2018, and were aged 43.4 years old on average. About half were women. The study found that using BMI alone, about 35.4 percent of participants were considered obese, while 33.3 percent were considered overweight and 31.3 percent were considered to be a healthy weight. But after using the new method, developed by The European Association for the Study of Obesity (EASO), a total of 54.2 percent were defined as obese. Of the individuals moved from the overweight to the obese category, they were more likely to be older, with an average age of 51.3 years compared to 36.5 years among those in the overweight category. They were also more likely to be male, and to have at least one underlying condition, with 57.5 percent having one underlying condition like diabetes compared to 34.3 percent in the overweight group. Among the conditions, high blood pressure (79 percent of the group) was most common, followed by arthritis (33.2 percent) and diabetes (15.6 percent). EASO published its new framework in July last year, and some countries, including Ireland and the Netherlands, have already adopted parts of it. The framework recommends surgeons calculate a patient's BMI and then assess underlying health conditions, such as type 2 diabetes or high blood pressure. Under the guidelines, anyone whose BMI is above 30 kg/m2 is automatically classified as obese. But those who are overweight, with a BMI of 25 to 29.9 kg/m2, and have at least one obesity-related health condition are also considered obese. The framework has not been adopted by other major organizations like the World Health Organization, which still recommends using BMI. It can help someone to be defined as obese because it may lead to them being targeted for early interventions to prevent complications like heart disease or stroke. It could also make it easier for them to access medications like Ozempic and help the patient recognize that they may need care. For the study, researchers also analyzed participants for their mortality risk, or risk of death. They found those who were redefined as obese had a similar mortality risk to those who were overweight, but a 50 percent higher risk than those of the healthy weight. In the study, the researchers wrote that the EASO framework may provide a 'more sensitive tool for diagnosing obesity disease earlier'. It added that some people may have experienced unintentional weight loss due to underlying conditions, which may previously have led them to be included in the overweight category.
Washington Post
14-07-2025
- Health
- Washington Post
New framework would classify many more U.S. adults as ‘obese'
Nearly a fifth of U.S. adults previously deemed 'overweight' would be categorized as 'obese' under a 2024 obesity classification framework, according to a new study published in Annals of Internal Medicine. Using the recent obesity framework, 18.8 percent of the adults who had previously been categorized as 'overweight' now fit under the 'obese' category, researchers said.
Medscape
30-06-2025
- Health
- Medscape
Sharp Obesity Increase Since Pandemic in Black Youth
A report comparing childhood obesity prevalence before the COVID pandemic and since the height of the pandemic shows a dramatic rise in the numbers for Black children and Black adolescents with obesity. Findings were published in the Annals of Internal Medicine. Researchers, led by Michael Liu, MD, MPhil, with the Center for Outcomes Research at Beth Israel Deaconess Medical Center in Boston, found that overall, the prevalence of obesity didn't change significantly. Prevalence was 20.3% from January 2011 to March 2020, when COVID shutdowns began, and rose to 22.0% from August 2021 to August 2023. But after accounting for secular trends, 'no overall increase in obesity prevalence was seen during the pandemic relative to the pre-pandemic period (adjusted difference, 0.52 percentage points; 95% CI, 2.3-3.3 percentage points). Pandemic-related increases in obesity prevalence were observed only in Black children and adolescents, the authors wrote, for whom rates were 22.4% in the decade before the pandemic and 35% in the 2 years after the height of COVID. Racial Disparities Clear Now, 'In the US, more than in 1 in 3 Black youth, more than 1 in 4 Hispanic youth, nearly 1 in 5 White youth, and 1 in 10 Asian youth currently meet the criteria for obesity,' the authors reported. Prevalence of severe obesity overall and across all subgroups remained stable between 2011 and August 2023. Researchers used serial cross-sectional data from the 2011 to August 2023 survey cycles of the National Health and Nutrition Examination Survey and included 17,507 children aged 2-11 years and adolescents aged 12-19 years. Height and weight from in-person examinations were used to calculate BMI. Obesity in this study was defined as a BMI at or above the age- and sex-specific 95th percentile according to the CDC growth charts. Severe obesity was defined as a BMI of 120% or more of the 95th percentile. Addressing Underlying Factors The next step is to address the factors that have led to the disparities documented in this report through public health and policy interventions, Therese F. Anderson, MD, assistant professor of family medicine at Mayo College of Medicine in Jacksonville, Florida, told Medscape Medical News . She pointed out the authors discuss multiple factors that have contributed to an increase in obesity during the COVID-19 pandemic and thereafter, including disruption in daily routines with school closures and reduced access to structured exercise and activity, leading to increased screen time and sedentary behaviors. Mealtimes were disrupted, and there was more reliance on ultraprocessed foods. 'Studies thus far have shown that Black and minority youth were disproportionately impacted due to higher rates of food insecurity, lower neighborhood resources — such as access to parks and safe spaces for exercise — as well as increased economic stress during the pandemic,' she noted. Anderson said these new numbers add support for policies and funding in areas such as improvement of access to healthy foods, expansion of food assistance programs, incentives to build grocery stores in food deserts, and promotion of safe spaces for activity. Medicaid Coverage for GLP-1s 'Additionally, expanding state Medicaid programs to fund weight management programs as well as medications like GLP-1s [glucagon-like peptide-1s], which are FDA approved for age 12 and up, are potential avenues for improvement. Currently, there are only 13 states with coverage for GLP-1s under Medicaid,' Anderson said. Pediatricians have an important role in addressing childhood obesity, she said. First, she said, is promoting family-based approaches to lifestyle modifications, such as healthy meals and family exercise. 'Secondly, we need to continue to advocate for policy changes as they impact the health of Black and minority youth. For example, the American Academy of Pediatrics is urging lawmakers to reject funding cuts to Medicaid and the Children's Health Insurance Program (CHIP),' she said. 'Lastly, we need to familiarize ourselves with new interventions as they are emerging, such as telehealth and medications like GLP-1s.' Financial disclosures for authors are available with the full article. Anderson reported having no relevant financial relationships.
Medscape
25-06-2025
- Health
- Medscape
‘Twincretin' Weight Loss Scales Up Cardiometabolic Gains
Patients who lose weight taking the drug tirzepatide experience robust improvements in cardiometabolic health, gains that appear to increase with the extent of pounds lost, researchers have found. The findings from a post hoc analysis of the SURMOUNT-1 trial confirm the close association between weight loss and improvements in cardiovascular risk factors and point to potential trajectories patients may experience when taking the medication, experts said. Tirzepatide, a dual glucose-dependent insulinotropic polypeptide and GLP-1 receptor agonist — commonly known as a 'twincretin' agent — had already shown efficacy in reducing body weight in individuals without diabetes. The current analysis stratifies these effects by the amount of weight loss and how that translates to improvements in blood pressure, glycemic control, lipid profiles, and insulin resistance. The study appeared on June 24 in Annals of Internal Medicine . The analysis included 1605 participants from the SURMOUNT-1 trial who were randomly assigned to one of the three doses of tirzepatide — 5, 10, or 15 mg weekly — for 72 weeks. All participants had a baseline BMI of 30 or higher, or 27 or greater with weight-related comorbidities, and all were engaged in a concurrent lifestyle intervention. Individuals with type 2 diabetes were excluded to isolate weight-related effects on cardiometabolic outcomes. Weight loss was categorized into eight brackets, from less than 5% to 35% or more of their baseline body weight. 'One of the more notable and somewhat unexpected findings was the clear linearity in outcomes — specifically, the incremental benefits observed in each cardiometabolic risk factor with every additional 5% of weight reduction,' said Bruno Linetzky, MD, PhD, a co-author of the paper and an executive director of research and development at Eli Lilly and Company, Indianapolis. 'It highlighted how even continued improvements in weight loss can contribute meaningfully across multiple endpoints. While this trend aligns with prior hypotheses, seeing it so consistently reflected in the data was both affirming and informative.' Scaling Down and Scaling Up The analysis revealed a largely linear relationship between percentage weight loss and improvements in key risk markers. Blood pressure: Participants who lost at least 35% of their baseline body weight experienced reductions of 14.2 mm Hg in systolic and 9.2 mm Hg in diastolic blood pressure. These declines were dose-dependent and more pronounced in systolic values, the researchers reported. Participants who lost at least 35% of their baseline body weight experienced reductions of 14.2 mm Hg in systolic and 9.2 mm Hg in diastolic blood pressure. These declines were dose-dependent and more pronounced in systolic values, the researchers reported. Waist circumference: Waist circumference dropped an average of 32.4 cm in the group who lost the most weight, suggesting significant reductions in visceral fat. Waist circumference dropped an average of 32.4 cm in the group who lost the most weight, suggesting significant reductions in visceral fat. Insulin resistance: Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) decreased by nearly 60% in those with the most weight loss, with noticeable improvements starting at modest reductions. Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) decreased by nearly 60% in those with the most weight loss, with noticeable improvements starting at modest reductions. Glycemic markers: Hemoglobin A1c decreased across all categories of weight loss and among people who did not lose weight. The average reduction in the group that lost the most weight was 0.65 percentage points. Hemoglobin A1c decreased across all categories of weight loss and among people who did not lose weight. The average reduction in the group that lost the most weight was 0.65 percentage points. Lipid profile: Significant improvements in triglycerides, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were generally observed with weight losses exceeding 10%. HDL increased by nearly 18%, while LDL dropped by more than 15% in the highest weight loss group. Even modest weight loss, between 5% and 10% of body weight, was associated with meaningful improvements in key health markers among participants treated with tirzepatide. For glycemic control, individuals in this weight loss range experienced an average reduction in hemoglobin A1c of 0.33 percentage points, a clinically relevant improvement that helps lower the risk of progressing to type 2 diabetes. Insulin resistance, as measured by HOMA-IR, improved by 23.2%, indicating better insulin sensitivity even with relatively small reductions in weight. Blood pressure also responded favorably within this modest weight loss category. Systolic blood pressure dropped by 3.4 mm Hg, and diastolic pressure decreased by 2.7 mm Hg. These reductions, while moderate, are statistically significant and align with guideline-recommended targets for reducing cardiovascular risk in individuals with overweight or obesity. 'The analysis suggests physicians could consider targeting 5% weight loss to improve blood pressure and waist circumference. For meaningful changes in lipids, particularly LDL and HDL cholesterol, reductions of more than 10% may be needed,' Linetzky said. Implications and Limitations The researchers said their analysis was limited by its post hoc nature and exclusion of placebo participants due to small sample sizes across weight categories. And while surrogate endpoints showed improvement, cardiovascular outcomes were not evaluated, although these are the focus of ongoing trials, they noted. The new findings strengthen the case for setting individualized weight loss targets in obesity treatment. 'Understanding whether there are specific thresholds of weight reduction associated with minimum or maximum cardiometabolic benefits may assist clinicians in tailoring weight reduction goals to individual patients seeking to reduce their cardiometabolic risk,' the researchers wrote. Clinicians may consider aiming for at least 10% weight loss to initiate meaningful changes in lipid parameters, while more substantial reductions may be necessary for optimal cardiometabolic benefit. 'There certainly has been a paucity of data on the effect that greater than 20% of the body weight from baseline has on the cardiometabolic parameters,' said Tina K. Thethi, MD, MPH, an endocrinologist at AdventHealth in Orlando, Florida. 'The threshold weight loss percentages were a gauge to understand what to expect in a patient that may follow a similar trajectory of weight loss as the participants in SURMOUNT-1, whose data were analyzed.' 'This data does equip a physician with an understanding of what can be expected when a patient is on the trajectory to losing more than 20% of their body weight with the use of tirzepatide,' she said. 'And this knowledge can also help guide the conversation with patients, which is an important piece, as these improvements can result in a decrease in background medications as well.' 'For the improvement in hemoglobin A1c with less than 5% weight reduction, the mechanism may be attributed to the direct glucose-lowering effect of tirzepatide and improvement in insulin resistance with weight reduction,' Linetzky and his colleague wrote. The study was funded by Eli Lilly and Company. Linetzky is employed by Eli Lilly.
