Modern approaches to the diagnosis, treatment and prevention of obesity

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Abstract

Approximately 2 billion people worldwide are overweight, including about 20% of adults and a quarter of a billion children. In Russia and Europe, about 60% of the population is diagnosed with obesity. According to global data, obesity is the fifth leading risk factor for premature death. The World Health Organization predicts that the number of people with morbid obesity will nearly double in the near future. Obesity increases the risk of cardiovascular, endocrine, and digestive diseases, obstructive sleep apnea, osteoarthritis, etc. Socio-demographic, behavioral and genetic factors are common causes of obesity. The diagnosis of obesity is made through the integrated use of parameters such as body mass index, waist circumference, fasting triglyceride levels, and others. Radiographic and ultrasound methods are being actively implemented. Today in Russia the choice of drugs for the treatment of obesity is very limited. Orlistat, sibutramine, liraglutide are approved for this indication. In addition, gastric electrostimulation and various surgical methods of treatment are effectively used. A targeted and comprehensive approach to improving the healthcare system for people with overweight and obesity should be a key factor in achieving the national goal of improving people’s health and well-being. Escalation of prevention efforts at all levels will help significantly reduce the spread of this disease and prevent its development around the world.

About the authors

Tatiana N. Petrova

N.N. Burdenko Voronezh State Medical University

Email: tnpetrova@vrngmu.ru
ORCID iD: 0000-0002-5701-9779
SPIN-code: 9440-7638

MD, Dr. Sci. (Medicine)

Russian Federation, Voronezh

Natalia S. Kovalenko

N.N. Burdenko Voronezh State Medical University

Email: sugery@mail.ru
ORCID iD: 0009-0009-8688-5594
SPIN-code: 4748-7639

MD

Russian Federation, Voronezh

Alexander A. Andreev

N.N. Burdenko Voronezh State Medical University

Email: sugery@mail.ru
ORCID iD: 0000-0001-8215-7519
SPIN-code: 1394-5147

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Voronezh

Maksim V. Eliseev

N.N. Burdenko Voronezh State Medical University

Email: sugery@mail.ru
ORCID iD: 0009-0005-5460-6002
SPIN-code: 6402-9256

MD

Russian Federation, Voronezh

Anastasia Y. Laptiyova

N.N. Burdenko Voronezh State Medical University

Author for correspondence.
Email: laptievaa@mail.ru
ORCID iD: 0000-0002-3307-1425
SPIN-code: 7626-9016

MD, Cand. Sci. (Medicine)

Russian Federation, Voronezh

Anton P. Ostroushko

N.N. Burdenko Voronezh State Medical University

Email: anton@vrngmu.com
ORCID iD: 0000-0003-3656-5954
SPIN-code: 9811-2385

MD, Cand. Sci. (Medicine), Associate Professor

Russian Federation, Voronezh

References

  1. Dzhioeva ON, Angarsky RK, Shvartz EN, et al. Visceral obesity: key risk factors and diagnostic aspects (review). Saratov Journal of Medical Scientific Research. 2022;18(2):234–239. EDN: OARXQB
  2. Lyasnikova MB, Belyakova NA, Tsvetkova IG, et al. Risk of developing severe alimentary-constitutional obesity and metabolic disorders: interventional comparative study. Kuban Scientific Medical Bulletin. 2023;30(1):49–57. EDN: NSELMH doi: 10.25207/1608-6228-2023-30-1-49-57
  3. Vasyukova OV, Okorokov PL, Kasyanova YuV, Bezlepkina OB. Energy exchange: how we can personalize obesity therapy. Problems of Endocrinology. 2021;67(5):4–10. EDN: PBCCRU doi: 10.14341/probl12830
  4. Kim OT, Drapkina OM. Obesity epidemic through the prism of evolutionary processes. Cardiovascular Therapy and Prevention. 2022;21(1):72–79. EDN: MUTNZI doi: 10.15829/1728-8800-2022-3109
  5. Seidell JC. Obesity: a growing problem. Acta Paediatr Suppl. 1999;88(428):46–50. doi: 10.1111/j.1651-2227.1999.tb14350.x
  6. Kumanyika S, Dietz WH. Solving population-wide obesity — progress and future prospects. N Engl J Med. 2020;383(23): 2197–2200. doi: 10.1056/NEJMp2029646
  7. Chubarov TV, Bessonova AV, Zhdanova OA, et al. Risk factors for obesity development in different periods of childhood. Obesity and Metabolism. 2021;18(2):163–168. EDN: HEPAWF doi: 10.14341/omet12756
  8. Peterkova VA, Bezlepkina OB, Bolotova NV, et al. Clinical guidelines "Obesity in children". Problems of Endocrinology. 2021;67(5):67–83. EDN: IXIZSV doi: 10.14341/probl12802
  9. Chubarov TV, Zhdanova OA, Sharshova OG, et al. Artificial intelligence predicting the risk of obesity in children. Aspirantskiy Vestnik Povolzhiya. 2022;22(1):64–70. EDN: AUKYRS doi: 10.55531/2072-2354.2022.22.1.64-70
  10. Berry EM. The obesity pandemic — whose responsibility? No blame, no shame, not more of the same. Front Nutr. 2020;7:2. doi: 10.3389/fnut.2020.00002
  11. Zabolotskikh IB, Anisimov MA, Gorobets ES, et al. Perioperative management of patients with concomitant morbid obesity. Guidelines of the all-Russian public organization "Federation of Anesthesiologists and Reanimatologists". Annals of Critical Care. 2021;(1):7–18. EDN: YHJNQH doi: 10.21320/1818-474X-2021-1-7-18
  12. Antonopoulos AS, Tousoulis D. The molecular mechanisms of obesity paradox. Cardiovasc Res. 2017;113(9):1074–1086. doi: 10.1093/cvr/cvx106
  13. German AI, Sedykh DYu, Hryachkova ON, Kashtalap VV. Abdominal obesity and ten-year prognosis of patients with myocardial infarction. Complex Issues of Cardiovascular Diseases. 2021;10(1):26–39. EDN: QETIIU doi: 10.17802/2306-1278-2021-10-1-26-39
  14. Panova EI, Pimankina MS. Coronavirus infection an obese patient (literature review). The Russian Archives of Internal Medicine. 2021;11(3):209–216. EDN: ICNGAH doi: 10.20514/2226-6704-2021-11-3-209-216
  15. Chen ZA, Roy K, Gotway Crawford CA. Obesity prevention: the impact of local health departments. Health Serv Res. 2013;48(2 Pt 1):603–627. doi: 10.1111/j.1475-6773.2012.01447.x
  16. Lerman OV, Lukina YuV, Kutishenko NP, et al. The problem of obesity "through the eyes" of patients (results of the survey of patients of the outpatient registry). Rational Pharmacotherapy in Cardiology. 2022;18(5):578–584. EDN: NDFFKI doi: 10.20996/1819-6446-2022-10-05
  17. Egorova VV, Brumberg AA. A dependence of the obesity prevalence on the consumption structure for the main food groups in the population of the Russian Federation and the city of Moscow. City-Healthcare. 2021;2(4):6–15. EDN: TOLZGU
  18. Chumakova GA, Veselovskaya NG, Kozarenko AA, Vorobyeva YuV. Heart morphology, structure, and function in obesity. Russian Journal of Cardiology. 2012;17(4):93–99. EDN: PBUQHP
  19. Nimptsch K, Konigorski S, Pischon T. Diagnosis of obesity and use of obesity biomarkers in science and clinical medicine. Metabolism. 2019;92:61–70. doi: 10.1016/j.metabol.2018.12.006
  20. Druzhilov MA, Kuznetsova TYu. Epicardial adiposity as a predictor of covid-19 severity in overweight and obese patients. Russian Journal of Cardiology. 2022;27(3):39–44. EDN: PLXCBG doi: 10.15829/1560-4071-2022-4850
  21. Syurin SA, Gorbanev SA. Prevalence and correlates of obesity in industrial workers in Arctic Russia. Ecologiya cheloveka (Human Ecology). 2021;28(5):28–35. EDN: UCSYJM doi: 10.33396/1728-0869-2021-5-28-35
  22. Salekhova MP, Gulov MK, Abdulloev SM, Korabelnikov AI. Pathogenetic significance of psychological stress in the development of alimentary obesity. Vestnik NovSU. Issue: Medical Sciences. 2021;(1):58–61. EDN: CWMVPU doi: 10.34680/2076-8052.2021.1(122).58-61
  23. Ismael U, Khafagy W, El Bassioune W, et al. Explicating the negative impact of obesity on the quality of life in older women with stress urinary incontinence. Gynecology, Obstetrics and Perinatology. 2022;21(4):60–68.
  24. Khamoshina MB, Artemenko YuS, Bayramova AA, et al. Polycystic ovary syndrome and obesity: a modern paradigm. RUDN Journal of Medicine. 2022;26(4):382–395. EDN: HVMYRO doi: 10.22363/2313-0245-2022-26-4-382-395
  25. Mamatov A, Polupanov A, Kakeev B, et al. Physical inactivity and low educational level as factors associated with the development of obesity. The Scientific Heritage. 2021;(68-2):39–46. EDN: BXUCQK doi: 10.24412/9215-0365-2021-68-2-39-46
  26. Berkovskaya MA, Gurova OY, Khaykina IA, Fadeev VV. Time-restricted eating as a novel strategy for treatment of obesity and it’s comorbid conditions. Problems of Endocrinology. 2022;68(4):78–91. EDN: FOUMEQ doi: 10.14341/probl13078
  27. Tkachenko V, Bagro T. Quality of life, mental health and sleep disorders in obese people of working age. West Kazakhstan Medical Journal. 2021;(3):145–151. EDN: UVMJKY doi: 10.24412/2707-6180-2021-63-145-151
  28. Medanić D, Pucarin-Cvetković J. Obesity — a public health problem and challenge. Acta Med Croatica. 2012;66(5):347–355. (In Croatian).
  29. Tikhonov SV, Bakulina NV, Simanenkov VI. Overweight and obese patients on gastroenterological visit. Medical Alphabet. 2022;(12):7–11. EDN: KNJQVO doi: 10.33667/2078-5631-2022-12-7-11
  30. Fursov AB, Ospanov OB, Fursov RA. Obesity and covid-19 — signs of convergence of two pandemics. Guidelines to fight obesity based on the principles of "ROOTS". Obesity and Metabolism. 2021;18(4):456–464. EDN: MRQNEE doi: 10.14341/omet12745
  31. Larsson SC, Spyrou N, Mantzoros CS. Body fatness associations with cancer: evidence from recent epidemiological studies and future directions. Metabolism. 2022;137:155326. doi: 10.1016/j.metabol.2022.155326
  32. Tikhonov SV, Simanenkov VI, Bakulina NV, et al. Multitarget therapy in patients with GERD and obesity. Medical Alphabet. 2021;(6):8–13. EDN: NTYKCH doi: 10.33667/2078-5631-2021-6-8-13
  33. Akkaliev MN, AukenovNYe, Massabayeva MR, et al. The relationship between types of obesity and testosterone levels in men with age-related hypogonadism from kazakh population. Science & Healthcare. 2021;23(5):125–131.
  34. Purdy JC, Shatzel JJ. The hematologic consequences of obesity. Eur J Haematol. 2021;106(3):306–319. doi: 10.1111/ejh.13560
  35. Kim C, Youm S. Development of an obesity information diagnosis model reflecting body type information using 3D body information values. Sensors (Basel). 2022;22(20):7808. doi: 10.3390/s22207808
  36. O'Neill D. Measuring obesity in the absence of a gold standard. Econ Hum Biol. 2015;17:116–128. doi: 10.1016/j.ehb.2015.02.002
  37. Gradidge PJ, Norris SA, Crowther NJ. The effect of obesity on the waist circumference cut-point used for the diagnosis of the metabolic syndrome in African women: results from the SWEET study. Int J Environ Res Public Health. 2022;19(16):10250. doi: 10.3390/ijerph191610250
  38. Dedov II, Shestakova MV, Melnichenko GA, et al. Interdisciplinary clinical practice guidelines "Management of obesity and its comorbidities". Obesity and Metabolism. 2021;18(1):5–99. EDN: AHSBSE doi: 10.14341/omet12714
  39. Bardia A, Holtan SG, Slezak JM, Thompson WG. Diagnosis of obesity by primary care physicians and impact on obesity management. Mayo Clin Proc. 2007;82(8):927–932. doi: 10.4065/82.8.927
  40. Pearce C, Rychetnik L, Wutzke S, Wilson A. Obesity prevention and the role of hospital and community-based health services: a scoping review. BMC Health Serv Res. 2019;19(1):453. doi: 10.1186/s12913-019-4262-3
  41. Palacios C, Magnus M, Arrieta A, et al. Obesity in Latin America, a scoping review of public health prevention strategies and an overview of their impact on obesity prevention. Public Health Nutr. 2021;24(15):5142–5155. doi: 10.1017/S1368980021001403
  42. Shabutdinova OR, Dautov AR, Samkov AA, et al. Semaglutide — effectiveness in weight loss and side effects when used according to studies by SUSTAIN, PIONEER, STEP. Problems of Endocrinology. 2023;69(3):68–82. EDN: MQQLQH doi: 10.14341/probl13197
  43. Druzhilov MA, Kuznetsova TYu, Chumakova GA. promising areas of pharmacotherapy for obesity. Russian Journal of Cardiology. 2021;26(3):95–101. EDN: ZPTZXN doi: 10.15829/1560-4071-2021-4279
  44. Rippe JM, Hess S. The role of physical activity in the prevention and management of obesity. J Am Diet Assoc. 1998;98(10 Suppl. 2):S31–S38. doi: 10.1016/s0002-8223(98)00708-1
  45. Beauchamp A, Backholer K, Magliano D, Peeters A. The effect of obesity prevention interventions according to socioeconomic position: a systematic review. Obes Rev. 2014;15(7):541–554. doi: 10.1111/obr.12161
  46. Dyer RG. Traditional treatment of obesity: does it work? Baillieres Clin Endocrinol Metab. 1994;8(3):661–688. doi: 10.1016/s0950-351x(05)80290-3
  47. Mironov VI, Khodasevich LS. The use of physical therapeutic factors to prevent obesity and correct overweight. Resort Medicine. 2022;(3):82–94. EDN: VVRYEP doi: 10.51871/2304-0343_2022_3_82
  48. Fried M, Yumuk V, Oppert JM, et al. Interdisciplinary European guidelines on metabolic and bariatric surgery. Obes Surg. 2014;24(1):42–55. doi: 10.1007/s11695-013-1079-8
  49. Dedov II, Mel'nichenko GA, Shestakova MV, et al. Russian national clinical recommendations for morbid obesity treatment in adults. 3rd revision (morbid obesity treatment in adults). Obesity and Metabolism. 2018;15(1):53–70. EDN: OUJNNF doi: 10.14341/omet2018153-70
  50. Matveev GA, Golikova TI, Vasileva AA, et al. Comparison of the effects of liraglutide and sibutramine in obese patients. Obesity and Metabolism. 2021;18(2):218–228. EDN: VILJZF doi: 10.14341/omet12498
  51. Srivastava G, Apovian C. Future pharmacotherapy for obesity: new anti-obesity drugs on the horizon. Curr Obes Rep. 2018;7(2):147–161. doi: 10.1007/s13679-018-0300-4
  52. Stumbo P, Hemingway D, Haynes WG. Dietary and medical therapy of obesity. Surg Clin North Am. 2005;85(4):703-vi. doi: 10.1016/j.suc.2005.04.002
  53. Garvey WT. Phentermine and topiramate extended-release: a new treatment for obesity and its role in a complications-centric approach to obesity medical management. Expert Opin Drug Saf. 2013;12(5):741–756. doi: 10.1517/14740338.2013.806481
  54. Boulghassoul-Pietrzykowska N, Franceschelli J, Still C. New medications for obesity management: changing the landscape of obesity treatment. Curr Opin Endocrinol Diabetes Obes. 2013;20(5):407–411. doi: 10.1097/01.med.0000433059.78485.fa
  55. Lebovitz HE. Interventional treatment of obesity and diabetes: An interim report on gastric electrical stimulation. Rev Endocr Metab Disord. 2016;17(1):73–80. doi: 10.1007/s11154-016-9350-7
  56. Kissane NA, Pratt JS. Medical and surgical treatment of obesity. Best Pract Res Clin Anaesthesiol. 2011;25(1):11–25. doi: 10.1016/j.bpa.2011.01.001
  57. English WJ, DeMaria EJ, Brethauer SA, et al. American Society for Metabolic and Bariatric Surgery estimation of metabolic and bariatric procedures performed in the United States in 2016. Surg Obes Relat Dis. 2018;14(3):259–263. doi: 10.1016/j.soard.2017.12.013
  58. Scopinaro N, Gianetta E, Adami GF, et al. Biliopancreatic diversion for obesity at eighteen years. Surgery. 1996;119(3):261–268. doi: 10.1016/s0039-6060(96)80111-5
  59. Scopinaro N. The IFSO and obesity surgery throughout the world. International Federation for the Surgery of Obesity. Obes Surg. 1998;8(1):3–8. doi: 10.1381/096089298765554971
  60. Kolle K, Bo O, Stadaas J. Gastric banding. In: OMGI 7th Congress. Stockholm, 1982. P. 37.
  61. Vreeswijk SJ, van Rutte PW, Nienhuijs SW, et al. The safety and efficiency of a fast-track protocol for sleeve gastrectomy: a team approach. Minerva Anestesiol. 2018;84(8):898–906. doi: 10.23736/S0375-9393.17.12298-4
  62. Bollag RJ, Zhong Q, Ding KH, et al. Glucose-dependent insulinotropic peptide is an integrative hormone with osteotropic effects. Mol Cell Endocrinol. 2001;177(1-2):35–41. doi: 10.1016/s0303-7207(01)00405-1
  63. Yashkov YI. Effectiveness of surgical methods of obesity treatment in type II diabetes mellitus. Surgery. 2000;(12):49–54. (In Russ.)
  64. Reid TJ, Korner J. Medical and surgical treatment of obesity. Med Clin North Am. 2022;106(5):837–852. doi: 10.1016/j.mcna.2022.03.002
  65. Volkova AR, Fishman MB, Semikova GV. Thyroid-stimulating hormone, leptin and insulin resistance in patients with obesity after bariatric surgery. Obesity and Metabolism. 2020;17(2):187–192. EDN: BGTTTE doi: 10.14341/omet11887
  66. Askarpour M, Alizadeh S, Hadi A, et al. Effect of bariatric surgery on the circulating level of adiponectin, chemerin, plasminogen activator inhibitor-1, leptin, resistin, and visfatin: a systematic review and meta-analysis. Horm Metab Res. 2020;52(4):207–215. doi: 10.1055/a-1129-6785
  67. Mazurina NV, Sviridonova MA. Endocrine and metabolic aspects of the management of patients undergoing bariatric surgery. Review of clinical recommendations. Obesity and Metabolism. 2012;9(1):51–57. EDN: PDQNST
  68. Yashkov YuI, Lutsevich OE, Nikol'skiy AV, Bekuzarov DK. Comparative evaluation of different operative methods for treating obesity. Obesity and Metabolism. 2008;5(1):31–38. EDN: SZWDGP doi: 10.14341/OMET2008131-38

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